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040711 Fee schedule

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040711 Fee schedule Powered By Docstoc
					Procedure Code   Modifier
01996
01999
10021
10022
10040
10060
10061
10080
10081
10120
10121
10140
10160
10180
11000
11001
11004
11005
11006
11008
11010
11011
11012
11040
11041
11042
11043
11044
11055
11056
11057
11100
11101
11200
11201
11300
11301
11302
11303
11305
11306
11307
11308
11310
11311
11312
11313
11400
11401
11402
11403
11404
11406
11420
11421
11422
11423
11424
11426
11440
11441
11442
11443
11444
11446
11450
11451
11462
11463
11470
11471
11600
11601
11602
11603
11604
11606
11620
11621
11622
11623
11624
11626
11640
11641
11642
11643
11644
11646
11719
11720
11721
11730
11732
11740
11750
11752
11755
11758
11760
11762
11765
11770
11771
11772
11900
11901
11920
11921
11960
11970
11971
11975
11976
11977
11980
11981
11982
11983
12001
12002
12004
12005
12006
12007
12011
12013
12014
12015
12016
12017
12018
12020
12021
12031
12032
12034
12035
12036
12037
12041
12042
12044
12045
12046
12047
12051
12052
12053
12054
12055
12056
12057
13100
13101
13102
13120
13121
13122
13131
13132
13133
13150
13151
13152
13153
13160
14000
14001
14020
14021
14040
14041
14060
14061
14301
14302
14350
15002
15003
15004
15005
15040
15050
15100
15101
15110
15111
15115
15116
15120
15121
15130
15131
15135
15136
15150
15151
15152
15155
15156
15157
15170
15171
15175
15176
15200
15201
15220
15221
15240
15241
15260
15261
15300
15301
15320
15321
15330
15331
15335
15336
15340
15341
15360
15361
15365
15366
15400
15401
15420
15421
15430
15431
15570
15572
15574
15576
15600
15610
15620
15630
15650
15731
15732
15734
15736
15738
15740
15750
15756
15757
15758
15760
15770
15820
15821
15822
15823
15829
15830
15833
15836
15840
15841
15842
15845
15847
15850
15851
15852
15860
15877
15920
15922
15931
15933
15934
15935
15936
15937
15940
15941
15944
15945
15946
15950
15951
15952
15953
15956
15958
15999
16000
16020
16025
16030
16035
16036
17000
17003
17004
17106
17107
17108
17110
17111
17250
17260
17261
17262
17263
17264
17266
17270
17271
17272
17273
17274
17276
17280
17281
17282
17283
17284
17286
17311
17312
17313
17314
17315
17999
19000
19001
19020
19030
19100
19101
19102
19103
19105
19110
19112
19120
19125
19126
19260
19271
19272
19290
19291
19295
19296
19297
19298
19300
19301
19302
19303
19304
19305
19306
19307
19316
19318
19324
19325
19328
19330
19340
19342
19350
19357
19361
19364
19366
19367
19368
19369
19370
19371
19380
19499
20000
20005
20100
20101
20102
20103
20150
20200
20205
20206
20220
20225
20240
20245
20250
20251
20500
20501
20520
20525
20526
20550
20551
20552
20553
20555
20600
20605
20610
20612
20615
20650
20660
20661
20662
20663
20664
20665
20670
20680
20690
20692
20693
20694
20696
20697
20802
20805
20808
20816
20822
20824
20827
20838
20900
20902
20910
20912
20920
20922
20924
20926
20930
20931
20936
20937
20938
20950
20955
20956
20957
20962
20969
20970
20972
20973
20974
20975
20979
20982
20985
20999
21010
21011
21012
21013
21014
21015
21016
21025
21026
21029
21030
21031
21032
21034
21040
21044
21045
21046
21047
21048
21049
21050
21060
21070
21073
21076
21079
21080
21081
21082
21083
21084
21085
21086
21087
21088
21089
21100
21110
21116
21120
21121
21122
21123
21125
21127
21138
21141
21142
21143
21145
21146
21147
21150
21151
21154
21155
21159
21160
21172
21175
21179
21180
21181
21182
21183
21184
21188
21193
21194
21195
21196
21198
21199
21206
21208
21209
21210
21215
21230
21235
21240
21242
21243
21244
21245
21246
21247
21248
21249
21255
21256
21260
21261
21263
21267
21268
21270
21275
21280
21282
21295
21296
21299
21310
21315
21320
21325
21330
21335
21336
21337
21338
21339
21340
21343
21344
21345
21346
21347
21348
21355
21356
21360
21365
21366
21385
21386
21387
21390
21395
21400
21401
21406
21407
21408
21421
21422
21423
21431
21432
21433
21435
21436
21440
21445
21450
21451
21452
21453
21454
21461
21462
21465
21470
21480
21485
21490
21495
21497
21499
21501
21502
21510
21550
21552
21554
21555
21556
21557
21558
21600
21610
21615
21616
21620
21627
21630
21632
21685
21700
21705
21720
21725
21740
21742
21743
21750
21800
21805
21810
21820
21825
21899
21920
21925
21930
21931
21932
21933
21935
21936
22010
22015
22100
22101
22102
22103
22110
22112
22114
22116
22206
22207
22208
22210
22212
22214
22216
22220
22222
22224
22226
22305
22310
22315
22318
22319
22325
22326
22327
22328
22505
22520
22521
22522
22523
22524
22525
22532
22533
22534
22548
22554
22556
22558
22585
22590
22595
22600
22610
22612
22614
22630
22632
22800
22802
22804
22808
22810
22812
22818
22819
22830
22840
22841
22842
22843
22844
22845
22846
22847
22848
22849
22850
22851
22852
22855
22856
22861
22864
22899
22900
22901
22902
22903
22904
22905
22999
23000
23020
23030
23031
23035
23040
23044
23065
23066
23071
23073
23075
23076
23077
23078
23100
23101
23105
23106
23107
23120
23125
23130
23140
23145
23146
23150
23155
23156
23170
23172
23174
23180
23182
23184
23190
23195
23200
23210
23220
23330
23331
23332
23350
23395
23397
23400
23405
23406
23410
23412
23415
23420
23430
23440
23450
23455
23460
23462
23465
23466
23470
23472
23480
23485
23490
23491
23500
23505
23515
23520
23525
23530
23532
23540
23545
23550
23552
23570
23575
23585
23600
23605
23615
23616
23620
23625
23630
23650
23655
23660
23665
23670
23675
23680
23700
23800
23802
23900
23920
23921
23929
23930
23931
23935
24000
24006
24065
24066
24071
24073
24075
24076
24077
24079
24100
24101
24102
24105
24110
24115
24116
24120
24125
24126
24130
24134
24136
24138
24140
24145
24147
24149
24150
24152
24155
24160
24164
24200
24201
24220
24300
24301
24305
24310
24320
24330
24331
24332
24340
24341
24342
24343
24344
24345
24346
24357
24358
24359
24360
24361
24362
24363
24365
24366
24400
24410
24420
24430
24435
24470
24495
24498
24500
24505
24515
24516
24530
24535
24538
24545
24546
24560
24565
24566
24575
24576
24577
24579
24582
24586
24587
24600
24605
24615
24620
24635
24640
24650
24655
24665
24666
24670
24675
24685
24800
24802
24900
24920
24925
24930
24931
24935
24940
24999
25000
25001
25020
25023
25024
25025
25028
25031
25035
25040
25065
25066
25071
25073
25075
25076
25077
25078
25085
25100
25101
25105
25107
25109
25110
25111
25112
25115
25116
25118
25119
25120
25125
25126
25130
25135
25136
25145
25150
25151
25170
25210
25215
25230
25240
25246
25248
25250
25251
25259
25260
25263
25265
25270
25272
25274
25275
25280
25290
25295
25300
25301
25310
25312
25315
25316
25320
25332
25335
25337
25350
25355
25360
25365
25370
25375
25390
25391
25392
25393
25394
25400
25405
25415
25420
25425
25426
25430
25431
25440
25441
25442
25443
25444
25445
25446
25447
25449
25450
25455
25490
25491
25492
25500
25505
25515
25520
25525
25526
25530
25535
25545
25560
25565
25574
25575
25600
25605
25606
25607
25608
25609
25622
25624
25626
25628
25630
25635
25645
25650
25651
25652
25660
25670
25671
25675
25676
25680
25685
25690
25695
25800
25805
25810
25820
25825
25830
25900
25905
25907
25909
25920
25922
25924
25927
25929
25931
25999
26010
26011
26020
26025
26030
26034
26035
26037
26040
26045
26055
26060
26070
26075
26080
26100
26105
26110
26111
26113
26115
26116
26117
26118
26121
26123
26125
26130
26135
26140
26145
26160
26170
26180
26185
26200
26205
26210
26215
26230
26235
26236
26250
26260
26262
26320
26340
26350
26352
26356
26357
26358
26370
26372
26373
26390
26392
26410
26412
26415
26416
26418
26420
26426
26428
26432
26433
26434
26437
26440
26442
26445
26449
26450
26455
26460
26471
26474
26476
26477
26478
26479
26480
26483
26485
26489
26490
26492
26494
26496
26497
26498
26499
26500
26502
26508
26510
26516
26517
26518
26520
26525
26530
26531
26535
26536
26540
26541
26542
26545
26546
26548
26550
26551
26553
26554
26555
26556
26560
26561
26562
26565
26567
26568
26580
26587
26590
26591
26593
26596
26600
26605
26607
26608
26615
26641
26645
26650
26665
26670
26675
26676
26685
26686
26700
26705
26706
26715
26720
26725
26727
26735
26740
26742
26746
26750
26755
26756
26765
26770
26775
26776
26785
26806
26820
26841
26842
26843
26844
26850
26852
26860
26861
26862
26863
26910
26951
26952
26989
26990
26991
26992
27000
27001
27003
27005
27006
27025
27027
27030
27033
27035
27036
27040
27041
27043
27045
27047
27048
27049
27050
27052
27054
27057
27059
27060
27062
27065
27066
27067
27070
27071
27075
27076
27077
27078
27080
27086
27087
27090
27091
27093
27095
27096
27097
27098
27100
27105
27110
27111
27120
27122
27125
27130
27132
27134
27137
27138
27140
27146
27147
27151
27156
27158
27161
27165
27170
27175
27176
27177
27178
27179
27181
27185
27187
27193
27194
27200
27202
27215
27216
27217
27218
27220
27222
27226
27227
27228
27230
27232
27235
27236
27238
27240
27244
27245
27246
27248
27250
27252
27253
27254
27256
27257
27258
27259
27265
27266
27267
27268
27269
27275
27280
27282
27284
27286
27290
27295
27299
27301
27303
27305
27306
27307
27310
27323
27324
27325
27326
27327
27328
27329
27330
27331
27332
27333
27334
27335
27337
27339
27340
27345
27347
27350
27355
27356
27357
27358
27360
27364
27365
27370
27372
27380
27381
27385
27386
27390
27391
27392
27393
27394
27395
27396
27397
27400
27403
27405
27407
27409
27415
27416
27418
27420
27422
27424
27425
27427
27428
27429
27430
27435
27437
27438
27440
27441
27442
27443
27445
27446
27447
27448
27450
27454
27455
27457
27465
27466
27468
27470
27472
27475
27477
27479
27485
27486
27487
27488
27495
27496
27497
27498
27499
27500
27501
27502
27503
27506
27507
27508
27509
27510
27511
27513
27514
27516
27517
27519
27520
27524
27530
27532
27535
27536
27538
27540
27550
27552
27556
27557
27558
27560
27562
27566
27570
27580
27590
27591
27592
27594
27596
27598
27599
27600
27601
27602
27603
27604
27605
27606
27607
27610
27612
27613
27614
27615
27616
27618
27619
27620
27625
27626
27630
27632
27634
27635
27637
27638
27640
27641
27645
27646
27647
27648
27650
27652
27654
27656
27658
27659
27664
27665
27675
27676
27680
27681
27685
27686
27687
27690
27691
27692
27695
27696
27698
27700
27702
27703
27704
27705
27707
27709
27712
27715
27720
27722
27724
27725
27726
27727
27730
27732
27734
27740
27742
27745
27750
27752
27756
27758
27759
27760
27762
27766
27767
27768
27769
27780
27781
27784
27786
27788
27792
27808
27810
27814
27816
27818
27822
27823
27824
27825
27826
27827
27828
27829
27830
27831
27832
27840
27842
27846
27848
27860
27870
27871
27880
27881
27882
27884
27886
27888
27889
27892
27893
27894
27899
28001
28002
28003
28005
28008
28010
28011
28020
28022
28024
28035
28039
28041
28043
28045
28046
28047
28050
28052
28054
28055
28060
28062
28070
28072
28080
28086
28088
28090
28092
28100
28102
28103
28104
28106
28107
28108
28110
28111
28112
28113
28114
28116
28118
28119
28120
28122
28124
28126
28130
28140
28150
28153
28160
28171
28173
28175
28190
28192
28193
28200
28202
28208
28210
28220
28222
28225
28226
28230
28232
28234
28238
28240
28250
28260
28261
28262
28264
28270
28272
28280
28285
28286
28288
28289
28290
28292
28293
28294
28296
28297
28298
28299
28300
28302
28304
28305
28306
28307
28308
28309
28310
28312
28313
28315
28320
28322
28340
28341
28344
28345
28400
28405
28406
28415
28420
28430
28435
28436
28445
28446
28450
28455
28456
28465
28470
28475
28476
28485
28490
28495
28496
28505
28510
28515
28525
28530
28531
28540
28545
28546
28555
28570
28575
28576
28585
28600
28605
28606
28615
28630
28635
28636
28645
28660
28665
28666
28675
28705
28715
28725
28730
28735
28737
28740
28750
28755
28760
28800
28805
28810
28820
28825
28890
28899
29000
29010
29015
29020
29025
29035
29040
29044
29046
29049
29055
29058
29065
29075
29085
29086
29105
29125
29126
29130
29131
29200
29240
29260
29280
29305
29325
29345
29355
29358
29365
29405
29425
29435
29440
29445
29450
29505
29515
29520
29530
29540
29550
29580
29581
29590
29700
29705
29710
29715
29720
29730
29740
29750
29799
29800
29804
29805
29806
29807
29819
29820
29821
29822
29823
29824
29825
29826
29827
29828
29830
29834
29835
29836
29837
29838
29840
29843
29844
29845
29846
29847
29848
29850
29851
29855
29856
29860
29861
29862
29863
29866
29867
29868
29870
29871
29873
29874
29875
29876
29877
29879
29880
29881
29882
29883
29884
29885
29886
29887
29888
29889
29891
29892
29893
29894
29895
29897
29898
29899
29900
29901
29902
29904
29905
29906
29907
29999
30000
30020
30100
30110
30115
30117
30118
30120
30124
30125
30130
30140
30150
30160
30200
30210
30220
30300
30310
30320
30400
30410
30420
30430
30435
30450
30460
30462
30465
30520
30540
30545
30560
30580
30600
30620
30630
30801
30802
30901
30903
30905
30906
30915
30920
30930
30999
31000
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P2038
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Q2009
Q2017
Q3001
Q3014
Q3025
Q3026
Q3031
Q4001
Q4002
Q4003
Q4004
Q4005
Q4006
Q4007
Q4008
Q4009
Q4010
Q4011
Q4012
Q4013
Q4014
Q4015
Q4016
Q4017
Q4018
Q4019
Q4020
Q4021
Q4022
Q4023
Q4024
Q4025
Q4026
Q4027
Q4028
Q4029
Q4030
Q4031
Q4032
Q4033
Q4034
Q4035
Q4036
Q4037
Q4038
Q4039
Q4040
Q4041
Q4042
Q4043
Q4044
Q4045
Q4046
Q4047
Q4048
Q4049
Q4050
Q4051
Q4074
Q4081
Q4100
Q4101
Q4102
Q4103
Q4104
Q4105
Q4106
Q4107
Q4108
Q4109
Q4110
Q4111
Q4112
Q4113
Q4114
Q4115
Q4116
Q9951
Q9953
Q9954
Q9955
Q9956
Q9957
Q9958
Q9959
Q9960
Q9961
Q9962
Q9963
Q9964
Q9965
Q9966
Q9967
Q9968
R0070
R0075
S0180
S0181
S0215
S1040
S3620
S3854
S4993
S5000
S5001
S5115
S5120
S5121
S5125
S5130
S5135
S5140
S5145
S5160
S5161
S5165
S5170
S8100
S8101
S8265
S9123
S9125
S9127
S9470
T1001
T1002
T1003
T1004
T1005
T1013   CG
T1013
T1014
T1017
T1019
T1023
T1028
T2001
T2003
T2004
T2021
T2024
T2040
T4521
T4522
T4523
T4524
T4525
T4526
T4527
T4528
T4529
T4530
T4531
T4532
T4533
T4534
T4535
T4536
T4537
T4539
T4540
T4541
T4542
T4543
T5001
V2020
V2025
V2100
V2101
V2102
V2103
V2104
V2105
V2106
V2107
V2108
V2109
V2110
V2111
V2112
V2113
V2114
V2115
V2118
V2121
V2199
V2200
V2201
V2202
V2203
V2204
V2205
V2206
V2207
V2208
V2209
V2210
V2211
V2212
V2213
V2214
V2215
V2218
V2219
V2220
V2221
V2299
V2410
V2430
V2499
V2500
V2501
V2502
V2503
V2510
V2511
V2512
V2513
V2520
V2521
V2522
V2523
V2530
V2531
V2599
V2610
V2615
V2623
V2624
V2625
V2626
V2627
V2628
V2629
V2630
V2631
V2632
V2700
V2702
V2710
V2715
V2718
V2730
V2744
V2745
V2760
V2770
V2780
V2781
V2782
V2783
V2784
V2785
V2790
V2797
V2799
V5008
V5010
V5014
V5030
V5040
V5050
V5060
V5100
V5120
V5130
V5140
V5170
V5180
V5210
V5220
V5254
V5255
V5256
V5257
V5258
V5259
V5260
V5261
V5264
V5265
V5266
V5298
V5299
                           Reimbursement is in Effect as of 01/01/2011




Procedure Code Description
DAILY MGT OF EPIDURAL OR SUBARCHNOID DRUG ADM.
ANESTHESIA-UNLISTED ANESTHESIA
FINE NEEDLE APSIRATIONS; WITHOUT IMAGING GUIDANCE
FINE NEEDLE ASPIRATION WITH IMAGING GUIDANCE
OPENING OR REMOVAL OF MULTIPLE MILIA, COMEDONES, CYSTS, PUSTULES
INCISION AND DRAINAGE OF ABSCESS (SIMPLE OR SINGLE)
INCISION AND DRAINAGE OF ABSCESS (COMPLICATED OR MULTIPLE)
(OF PILONIDAL CYST) SIMPLE
(OF PILONIDAL CYST) COMPLICATED
(SUBCUTANEOUS TISSUES) SIMPLE
INCISION AND REMOVAL OF FOREIGN BODY, SUBCUTANEOUS TISSUES; COMPLICATED
OF HEMATOMA, SEROMA OR FLUID COLLECTION (SKIN)
OF ABSCESS, HEMATOMA, BULLA OR CYST (SKIN)
INCISION & DRAINAGE, COMPLEX, POSTOPERATIVE WOUND INFECTION
DEBRIDE INFECTED SKIN, UP-TO 10% OF BODY SURFACE
EA ADD 10% OF BODY SURFACE (LIST SEP IN ADD TO CODE FOR PRIMARY PROCEDURE)-ADDON
DEBRIDEMENT OF SKIN, SUBCUTANEOUS TISSUE, MUSCLE & FASCIA FOR NECROTIZING INFEC
DEBRIDEMENT OF SKIN, SUBCUTANEOUS TISSUE, MUSCLE & FASCIA FOR NECROTIZING INFEC
DEBRIDEMENT OF SKIN, SUBCU TISSUE, MUSCLE & FASCIA FOR NECROTIZING TISSUE INFEC
REMOVAL OF PROSTHETIC MAT OR MESH, ABDOMINAL WALL FOR NECROTIZING INFEC (ADD-ON)
FOREIGN MATERIAL ASSOC W/OPEN FRACTURE, AND/OR DISLOCATION; SKIN & SUB TISSUE
SKIN, SUBCUTANEOUS TISSUE, MUSCLE FASCIA, AND MUSCLE
SKIN, SUBCUTANEOUS TISSUE, MUSCLE FASCIA, MUSCLE AND BONE
DEBRIDEMENT OF SKIN, PARTIAL THICKNESS
DEBRIDEMENT SKIN, FULL THICKNESS
SKIN AND SUBCUTANEOUS TISSUE
SKIN, SUBCUTANEOUS TISSUE AND MUSCLE
SKIN, SUBCUTANEOUS TISSUE, MUSCLE AND BONE
PARING OR CUTTING OF BENIGN HYPERKERATOTIC LESION; SINGLE LESION
PARING OR CUTTING OF BENIGN HYPERKERATOTIC LESION; TWO TO FOUR LESIONS
PARING OR CUTTING OF BENIGN HYPERKERATOTIC LESION; MORE THAN FOUR LESIONS
SUBCUTANEOUS TISSUE OR MUSCOUS MEMBRANE; SINGLE LESION
EA SEPARATE/ADD LESION; LIST SEPARATELY IN ADDITN TO CD FOR PRIM PROC (ADD-ON)
MULTIPLE FIBROCUTANEOUS TAGS ANY AREA UP TO & INCLUDING 15 LESIONS
EA ADDITIONAL TEN LESIONS; LIST SEP IN ADD TO CODE FOR PRIMARY PROC (ADD-ON)
SINGLE LESION, TRUNK, ARMS OR LEGS; LESION DIAMETER 0.5 CM OR LESS
LESION DIAMETER 0.6 TO 1.0 CM
LESION DIAMTER 1.1 TO 2.0 CM
LESION DIAMTER OVER 2.0 CM
SINGLE LESION, SCALP, NECK, HANDS, FEET, GENITALIA (DIAMETER 0.5 CM OR LESS)
LESION DIAMTER 0.6 TO 1.0 CM
LESION DIAMETER 1.1 TO 2.0 CM
LESION DIAMETER OVER 2.0 CM
SINGLE LESION,FACE,EARS,EYELIDS,NOSE,LIPS,MUCOUS MEMBRANE; DIAMETER 0.5 CM LESS
SHAVING EPIDERMAL/DERMAL LESION DIAMETER 0.6 TO 1.0 CM
LESION DIAMETER 1.1 TO 2.0 CM
LESION DIAMETER OVER 2.0 CM
(EXCEPT SKIN TAG) TRUNK ARMS OR LEGS; LESION DIAMETER 0.5 CM OR LESS
(EXCEPT SKIN TAG) LESION DIAMETER 0.6 TO 1.0 CM
EXCISION, LESION, SKIN
(EXCEPT SKIN TAGS) LESION DIAMETER 2.1 TO 3.0 CM
(EXCEPT SKIN TAGS) LESION DIAMETER 3.1 TO 4.0 CM
(EXCEPT SKIN TAGS) LESION DIAMETER OVER 4.0 CM
(EXCEPT SKIN TAGS) SCALP,NECK,HANDS,FEET,GENITALIA; LESION DIAMETER 0.5 CM LESS
(EXCEPT SKIN TAGS) LESION DIAMETER 0.6 TO 1.0 CM
(EXCEPT SKIN TAGS) LESION DIAMETER 1.1 TO 2.0 CM
(EXCEPT SKIN TAGS) LESION DIAMETER 2.1 TO 3.0 CM
(EXCEPT SKIN TAGS) LESION DIAMETER 3.1 TO 4.0 CM
(EXCEPT SKIN TAGS) LESION DIAMETER OVER 4.0 CM
FACE, EARS, EYELIDS, NOSE, LIPS, MUCOUS MEMBRANE LESION DIAMETER 0.5 CM OR LESS
LESION DIAMETER 0.6 TO 1.0 CM
LESION DIAMETER 1.1 TO 2.0 CM
LESION DIAMETER 2.1 TO 3.0 CM
LESION DIAMETER 3.1 TO 4.0 CM
LESION DIAMETER OVER 4.0 CM
FOR HIDRADENITIS, AXILLARY; WITH SIMPLE OR INTERMEDIATE REPAIR
FOR HIDRADENITIS, AXILLARY WITH COMPLEX REPAIR
FOR HIDRADENITIS, INGUINAL; WITH SIMPLE OR INTERMEDIATE REPAIR
FOR HIDRADENITIS, INGUINAL; WITH COMPLEX REPAIR
FOR HIDRADENITIS, PERIANAL, PERNEAL, OR UMBILICAL; W/SIMPLE OR INTEMED. REPAIR
FOR HIDRADENITIS, PERIANAL, PERINEAL OR UMBILICAL; WITH COMPLEX REPAIR
TRUNK, ARMS OR LEGS; LESION DIAMETER 0.5 CM OR LESS
TRUNK ARMS OR LEGS; LESION DIAMETER 0.6 TO 1.0 CM
TRUNK ARMS OR LEGS; LESION DIAMETER 1.1 TO 2.0 CM
TRUNK ARMS OR LEGS; LESION DIAMETER 2.1 TO 3.0 CM
TRUNK ARMS OR LEGS; LESION DIAMETER 3.1 TO 4.0 CM
TRUNK, ARMS OR LEGS; LESION DIAMETER OVER 4.0 CM
SCALP, NECK, HANDS, FEET, GENITALIA; LESION DIAMETER 0.5 CM OR LESS
SCALP, NECK, HANDS, FEET, GENITALIA; LESION DIAMETER 0.6 TO 1.0 CM
SCALP, NECK, HANDS, FEET, GENITALIA; LESION DIAMETER 1.1 TO 2.0 CM
SCALP, NECK, HANDS, FEET, GENITALIA; LESION DIAMETER 2.1 TO 3.0 CM
SCALP, NECK, HANDS, FEET, GENITALIA; LESION DIAMETER 3.1 TO 4.0
SCALP, NECK, HANDS, FEET, GENITALIA; LESION DIAMETER OVER 4.0
FACE, EARS, EYELIDS, NOSE, LIPS; LESION DIAMETER 0.5 CM OR LESS
FACE, EARS, EYELIDS, NOSE, LIPS; LESION DIAMETER 0.6 TO 1.0 CM
FACE, EARS, EYELIDS, NOSE, LIPS; LESION DIAMETER 1.1 TO 2.0 CM
FACE, EARS, EYELIDS, NOSE, LIPS; LESION DIAMETER 2.1 TO 3.0 CM
FACE, EARS, EYELIDS, NOSE, LIPS; LESION DIAMETER 3.1 TO 4.0 CM
FACE, EARS, EYELIDS, NOSE, LIPS; LESION DIAMETER OVER 4.0 CM
TRIMMING NONDYSTROPHIC NAILS; ANY NUMBER
DEBRIDEMENT OF NAILS, BY ANY METHOD; ONE TO FIVE
DEBRIDEMENT OF NAIL(S) BY ANY METHOD; SIX OR MORE
AVULSION OF NAIL PLATE - PARTIAL OR COMPLETE, SIMPLE; SINGLE
EACH ADDITIONAL NAIL PLATE (LIST SEP. IN ADD TO CODE FOR PRIMARY PROC) (ADD-ON)
EVACUATION OF SUBUNGUAL HEMATOMA
PARTIAL OR COMPLETE(EG, INGROWN OR DEFORMED NAIL) FOR PERMANENT REMOVAL
WITH AMPUTATION OF TUFT OF DISTAL PHALANX
BIOPSY OF NAIL UNIT(PLATE, BED, MATRIX, HYPON, PROXIMAL AND LAT NAIL FOLD(SP)
FREE FASCIAL FLAP W/MICROVASCULAR ANASTOMOSIS
REPAIR OF NAIL BED
RECONSTRUCTION OF NAIL BED WITH GRAFT
WEDGE EXCISON OF SKIN OF NAIL FOLD (EG, FOR INGROWN TOENAIL)
EXCISION OF PILONIDAL CYST OR SINUS; SIMPLE
EXCISION OF PILONIDAL CYST OR SINUS; EXTENSIVE
EXCISION OF PILONIDAL CYST OR SINUS; COMPLICATED
INJECTION, INTRALESIONAL, UP TO AND INCLUDING SEVEN LESIONS
MORE THAN SEVEN LESIONS
TATTOOING, INTRADERMAL OPAQUE PIGMNTS/CORRECT COLOR DEFECT/SKIN, 6.0 SQ CM/LESS
6.1 TO 20.0 SQ CM
FOR OTHER THAN BREAST, INCLUDING SUBSEQUENT EXPANSION
WITH PERMANENT PROSTHESIS
WITHOUT INSERTION OF PROSTHESIS
INSERTION IMPLANTABLE CONTRACEPTIVE CAPSULES
REMOVAL IMPLANTABLE CONTRACEPTIVE CAPSULES
REMOVAL WITH REINSERTION IMPLANTABLE CONTRACEPTIVE CAPSULES
SUBCUTANEOUS HORMONE PELLET IMPLANATION
INSERTION, NON-BIODEGRADABLE DRUG DELIVERY IMPLANT
REMOVABLE, NON BIODEGRADABLE DRUG DELIVERY IMPLANT
REMOVAL W/REINSERTION, NON-BIODEGRADABLE DRUG DELIVERY IMPLANT
SCALP,NECK,AXILLAE,EXTERNAL GENITALIA,TRUNK AND/OR EXTREMITIES; 2.5 CM OR LESS
SCALP,NECK,AXILLAE,GENITALIA,TRUNK,HANDS,FEET; 2.6 CM TO 7.5
SCALP,NECK,AXILLAE,GENITALIA,TRUNK,HANDS,FEET; 7.6 CM TO 12.5 CM
SCALP,NECK,AXILLAE,GENITALIA,TRUNK,HANDS,FEET; 12.6 CM 20.0 CM
SCALP,NECK,AXILLAE,GENITALIA,TRUNK,HANDS,FEET; 20.1 CM TO 30.0 CM
SCALP,NECK,AXILLAE,GENITALIA,TRUNK,HANDS,FEET; OVER 30.0 CM
FACE,EARS,EYELIDS,NOSE,LIPS AND OR MUCOUS MEMBRANES; 2.5 CM OR LESS
FACE,EARS,EYELIDS,NOSE,LIPS AND OR MUCOUS MEMBRANES; 2.6 CM TO 5.0 CM
FACE,EARS,EYELIDS,NOSSE, LIPS AND OR MUCOUS MEMBRANES; 5.1 CM TO 7.5 CM
FACE,EARS,EYELIDS,NOSE,LIPS AND OR MUCOUS MEMBRANES; 7.6 CM TO 12.5 CM
FACE,EARS,EYELIDS,NOSE,LIPS AND OR MUCOUS MEMBRANES; 12.6 CM 20.0 CM
FACE,EARS,EYELIDS,NOSE,LIPS AND OR MUCOUS MEMBRANES; 20.1 CM TO 30.0 CM
FACE,EARS,EYELIDS,NOSE,LIPS AND OR MUCOUS MEMBRANES; OVER 30.0 CM
TREATMENT OF SUPERFICIAL WOUND DEHISCENCE; SIMPLE CLOSURE
TREATMENT OF SUPERFICIAL WOUND DEHISCENCE; WITH PACKING
WOUND CLOSURE - SCALP,AXILLAE,TRUNK,EXTREMI(EXCLUD HANDS & FEET); 2.5 CM OR LESS
SCALP,AXILLAE,TRUNK AND EXTREMITIES(EXCLUDING HANDS & FEET); 2.6 CM TO 7.5 CM
SCALP,AXILLAE,TRUNK,EXTREMITIES(EXCLUDING HANDS & FEET); 7.6 CM TO 12.5 CM
SCALP,AXILLAE,TRUNK,EXTREMITIES(EXCLUDING HANDS & FEET); 12.6 CM TO 20.0 CM
SCALP,AXILLAE,TRUNK,EXTREMITIES(EXCLUDING HANDS & FEET); 20.1 CM TO 30.0 CM
SCALP,AXILLAE,TRUNK,EXTREMITIES(EXCLUDING HANDS & FEET); OVER 30.0 CM
NECK, HANDS, FEET AND EXTERNAL GENITALIA; 2.5 CM OR LESS
NECK, HANDS, FEET AND EXTERNAL GENITALIA; 2.6 CM TO 7.5 CM
NECK, HANDS, FEET AND OR EXTERNAL GENITALIA; 7.6 CM TO 12.5 CM
NECK, HANDS, FEET AND EXTERNAL GENITALIA; 12.6 CM TO 20.0 CM
NECK, HANDS, FEET AND EXTERNAL GENITALIA; 20.1 CM TO 30.0 CM
NECK, HANDS, FEET AND EXTERNAL GENITALIA; OVER 30.0 CM
FACE, EARS, EYELIDS, NOSE, LIPS AND MUCOUS MEMBRANES; 2.5 CM OR LESS
FACE, EARS, EYELIDS, NOSE, LIPS AND MUCOUS MEMBRANES; 2.6 CM TO 5.0 CM
FACE, EARS, EYELIDS, NOSE, LIPS AND MUCOUS MEMBRANES; 5.1 CM TO 7.5 CM
FACE, EARS, EYELIDS, NOSE, LIPS AND MUCOUS MEMBRANES; 7.6 CM TO 12.5 CM
FACE, EARS, EYELIDS, NOSE, LIPS AND MUCOUS MEMBRANES; 12.6 CM TO 20.0 CM
FACE, EARS, EYELIDS, NOSE, LIPS AND MUCOUS MEMBRANES; 20.1 CM TO 30.0 CM
FACE, EARS, EYELIDS, NOSE, LIPS AND MUCOUS MEMBRANES; OVER 30.0 CM
TRUNK; 1.1 CM TO 2.5 CM
TRUNK; 2.6 CM TO 7.5 CM
REPAIR COMPLEX, TRUNK; EACH ADDITIONAL 5 CM OR LESS-ADD ON
SCALP, ARMS AND OR LEGS; 1.1 CM TO 2.5 CM
SCALP, ARMS AND OR LEGS; 2.6 CM TO 7.5 CM
REPAIR, COMPLEX; SCALP, ARMS AND/OR LEGS; 1.1 CM TO 2.5 CM-ADD ON
FOREHEAD,CHEEKS,CHIN,MOUTH,NECK,AXILLAE,GENITALIA,HANDS,FEET; 1.1 CM TO 2.5 CM
FOREHEAD,CHEEKS,CHIN,MOUTH,NECK,AXILLAE,GENITALIA,HANDS,FEET; 2.6 CM TO 7.5 CM
REPAIR,COMPLEX,FACE,NECK,AXILLAE,GENITALIA,HANDS AND/OR FEET;EA ADDTL 5 CM/LESS
EYELIDS, NOSE, EARS AND LIPS; 1.0 CM OR LESS
EYELIDS, NOSE, EARS AND LIPS; 1.1 CM TO 2.5 CM
EYELIDS, NOSE, EARS AND LIPS; 2.6 CM TO 7.5 CM
REPAIR, COMPLEX, EYELIDS, NOSE, EARS AND/OR LIPS; EACH ADDITIONAL 5 CM OR LESS
SECONDARY CLOSURE OF SURGICAL WOUND OR DEHISCENCE, EXTENSIVE OR COMPLICATED
TRUNK; DEFECT 10 SQ CM OR LESS
TRUNK; DEFECT 10.1 SQ CM TO 30.0 SQ CM
SCALP,ARMS AND/OR LEGS; DEFECT 10 SQ CM OR LESS
SCALP,ARMS AND OR LEGS; DEFECT 10.1 SQ CM TO 30.0 SQ CM
FOREHEAD,CHEEKS,CHIN,MOUTH,NECK,AXILLAE,GENITALIA,HANDS/FEET DEFECT 10 SQ CM
4 HEAD,CHEEKS,CHIN,MOUTH,NECK,AXIL.,GEN.,HANDS/FEET 10.1 SQ CM TO 30.0 SQ CM
EYELIDS,NOSE,EARS AND LIPS; DEFECT 10 SQ CM OR LESS
EYELIDS,NOSE,EARS AND LIPS; DEFECT 10.1 SQ CM TO 30.0 SQ CM
ADJACENT TISSUE TRANS OR REARRANG, ANY AREA; DEFECT 30.1 SP CM TO 60.0 SQ CM
EACH ADDITIONAL 30.0 SQ CM, OR PART THEREOF (SP)
INCLUDING PREPARATION OF RECIPIENT SITE
SURGICAL PREP/CREATION/RECIPIENT SITE BY EXCISION/OPEN WNDS 1ST 100 SQ CM (SP)
SURGICAL PREPARATION/CREATION OF RECIPIENT SITE/ EXCISION OF OPEN WOUNDS ADD ON
SURGICAL PREP/CREATION OF SITE/EXCISION OF OPEN WOUNDS, FACE, FEET, HANDS (SP)
SURGICAL PREPARATION OR CREATION/SITE BY EXCISION OF OPEN WOUNDS (ADD-ON)
HARVEST OF SKIN FOR TISSUE CULTURED SKIN AUTOGRAFT, 100SQ CM OR LESS
COVER SMALL ULCER,TIP OF DIGIT OR MINIMAL OPEN AREA; UP TO 2 CM DIAMETER
FIRST 100 SQ CM OR LESS OR 1% OF BODY AREA;INFANTS AND CHILDREN
SPLIT SKIN GRAFT-ADD ON
EPIDERMAL AUTOGRAFT TRUNK, ARMS, LEGS 1ST 100 SQ CM OR LESS OR 1% OF BODY AREA
EPIDERMAL AUTOGRAFT, TRUNK, ARMS, LEGS, EA ADD 100 SQ CM OR EA ADD 1% OF BODY
EPIDERMAL AUTOGRAFT, FACE/HEAD, NECK, HANDS, FEET, GENITALIA, 1ST 100 SQ CM<
EPIDERMAL AUTOGRFT, FACE/HEAD, NECK, HANDS, FEET, GENITALIA, EA ADD 100SQ CM
MOUTH,NECK,EARS,ORBITS,GENITALIA,HANDS,FEET;1ST 100 SQ CM OR LESS/INFANT,CHILD
MOUTH,NECK,EAR,ORBITS/GENITALIA,HANDS,FEET;EACH ADD.100 SQ CM-INFANT/CHILD-(A0)
DERMAL AUTOGRAFT, TRUNK, ARMS, LEGS, 1ST 100 SQ CM OR LESS OR 1% OF BODY AREA
DERMAL AUTOGRAFT, TRUNK, ARMS, LEGS, EA ADD 100SQ CM OR 1% OF BODY AREA
DERMAL AUTOGRAFT, FACE, HEAD, NECK, EARS, GENITAL, HAND, FEET, 1ST 100 SQ CM<
DERMAL AUTOGRAFT, FACE, HEAD, NECK, EARS, GENITAL, HAND, FEET, EA ADD 100 SQ CM
TISSUE CULTURED EPIDERMAL AUTOGRAFT, TRUNK, ARMS, LEGS 1ST 25SQ CM OR <
TISSUE CULTUR EPIDERMAL AUTOGRAFT TRUNK, ARMS, LEGS ADDITIONAL 1SQ CM TO 75SQ CM
TISSUE CULTUR EPIDERMAL AUTOGRAFT TRUNK, ARMS, LEGS EA ADD 100SQ CM/1% BODY
TISSUE CULT EPIDERMAL AUTOGRFT, FACE, HEAD GENITAL, HAND, FEET 1ST 25SQ CM/LESS
TISSUE CULT EPIDERMAL AUTOGRFT, HEAD, GENITAL, HAND, FEET 1ST 25 CM/LESS75 SQ CM
TISSUE CULTUR EPIDERMAL AUTOGRFT,HEAD,HANDS,FEET,GENITAL EA ADD 100SQ CM/1% BODY
ACELLULAR DERMAL REPLACEMENT, TRUNK, ARMS, LEGS; 1ST 100 SQ CM/LESS, OR 1% BODY
ACELLULAR DERMAL REPLACE,TRUNK,ARMS,LEGS EA ADD 100SQ CM OR 1% BODY AREA(SP)
ACELLULAR DERMAL REPLACEMENT,TRUNK,ARMS,LEGS 1ST 100SQ CM OR <OR 1% BODY AREA
ACELLULAR DERMAL REPLACEMENT,TRUNK,ARMS,LEGS 1ST 100SQ CM OR <OR 1% BODY AREA
FREE, INCLUDING DIRECT CLOSURE OF DONOR SITE, TRUNK; 20 SQ CM OR LESS
FREE, INCLUDING DIRECT CLOSURE OF DONOR SITE,TRUNK;EACH ADD.20 SQ CM-ADD ON
DIRECT CLOSURE OF DONOR SITE,SCALP,ARMS AND LEGS; 20 SQ CM OR LESS
CLOSURE OF DONOR SITE,SCALP,ARMS AND LEGS; EA ADDITIONAL 20 SQ CM-ADD ON
FORHEAD,CHEEKS,CHIN,MOUTH,NECK,AXIL.GENITALIA,HANDS/FEET;20 SQ CM OR LESS
FOREHEAD,CHEEKS,CHIN,MOUTH,NECK,AXIL.,GENITALIA,HANDS,FEET;EA ADD.20 SQ CM-ADDON
CLOSURE OF DONOR SITE,NOSE,EARS,EYELIDS/LIPS;20 SQ CM OR LESS
CLOSURE OF DONOR SITE,NOSE,EARS,EYELIDS/LIPS; EA ADD. 20 SQ CM-ADD ON
ALLOGRAFT SKIN/TEMPORARY WOUND CLOSURE TRUNK, ARMS, LEGS 1ST 100SQ CM OR <
ALLOGRAFT SKIN/TEMPORARY WOUND CLOSURE TRUNK, ARMS, LEGS EA ADD 100SQ CM OR 1%
ALLOGRAFT SKIN/TEMP WOUND CLOSURE HEAD, HANDS, FEET, GENITAL 1ST 100SQ CM OR <
ALLOGRAFT SKIN/TEMP WOUND CLOSURE HEAD, HANDS, FEET, GENITAL EACH ADD 100SQ CM
ACELLULAR DERMAL ALLOGRAFT, TRUNK, ARMS,LEGS 1ST 100 SQ CM OR LESS
ACELLULAR DERMAL ALLOGRAFT, TRUNK, ARMS,LEGS EA ADD 1ST 100 SQ CM OR 1% BODY
ACELLULAR DERMAL ALLOGRAFT, FACE, HEAD, GENITAL, HANDS, FEET 1ST 100 SQ CM OR <
ACELLULAR DERMAL ALLOGRAFT, FACE, HEAD, GENITAL, HANDS, FEET 1ST 100 SQ CM OR <
TISSUE CULTURED ALLOGENIC DERMAL SUBSTITUTE; EACH ADDITIONAL 25 SQ CM OR <
TISSUE CULTURED ALLOGENIC DERMAL SUBSTITUTE; EACH ADDITIONAL 25 SQ CM
TISSUE CULTURED ALLOGENIC DERMAL SUBSTITUTE, TRUNK, ARMS, LEGS 1ST 100SQ CM OR <
TISSUE CULTURED ALLOGENIC DERMAL SUBSTITUTE, EACH ADD 100 SQ CM OR 1% OF BODY
TISSUE CULT ALLOGENIC DERMAL SUBSTITUTE, HEAD, HANDS, FEET, GENITAL 1ST 100SQ CM
TISSUE CULT ALLOGEN DERMAL SUBSTITUT HEAD, HANDS, FEET, GENITAL EA ADD 100SQ CM
100 SQ CM OR LESS
EA ADD. 100 SQ CM (LIST SEP. IN ADD. TO CODE FOR PRIMARY PROCEDURE)
XENOGRAFT SKIN FOR TEMP WOUND CLOSURE, HEAD, HANDS, FEET, GENITAL 100 SQ CM OR <
XENOGRAFT SKIN FOR TEMP WOUND CLOSURE, HEAD/ HAND/ FEET/ GENITAL EA ADD/100SQ CM
ACELLULAR XENOGRAFT IMPLANT, FIRST 100 SQ CM OR LESS, OR 1% OF BODY AREA
ACELLULAR XENOGRAFT IMPLANT, EA ADDITIONAL 100 SQ CM OR EA ADD 1% OF BODY AREA
WITH OR WITHOUT TRANSFER; TRUNK
WITH WITHOUT TRANSFER; SCALP, ARMS, OR LEGS
FOREHEAD,CHEEKS,CHIN,MOUTH,NECK,AXILLAE,GENITALIA, HANDS OR FEET
W/WITHOUT TRANSFER; EYELIDS, NOSE, EARS, LIPS, OR INTRAORAL
(DIVISION AND INSET); AT TRUNK
AT SCALP, ARMS OR LEGS
FOREHEAD, CHEEKS, CHIN, NECK, AXILLAE, GENITALIA, HANDS OR FEET
AT EYELIDS, NOSE, EARS, OR LIPS
(EG, ABDOMEN TO WRIST, "WALKING" TUBE) ANY LOCATION
FOREHEAD FLAP WITH PRESERVATION OF VASCULAR PEDICLE
MYOCUTANEOUS OR FASCIOCUTANEOUS FLAP; HEAD AND NECK
MYOCUTANEOUS OR FASCIOCUTANEOUS FLAP; TRUNK
MYOCUTANEOUS OR FASCIOCUTANEOUS FLAP; UPPER EXTREMITY
MYOCUTANEOUS OR FASCIOCUTANEOUS FLAP; LOWER EXTREMITY
FLAP; ISLAND PEDICLE
FLAP; NEUROVASCULAR PEDICLE
WITH OR WITHOUT SKIN WITH MICROVASCULAR ANASTOMOSIS
WITH MICROVASCULAR ANASTOMOSIS S
WITH MICROVASCULAR ANASTOMOSIS
INCLUDING PRIMARY CLOSURE, DONOR AREA
DERMA-FAT-FASCIA
LOWER EYELID
LOWER EYELID; WITH EXTENSIVE HERNIATED FAT PAD
UPPER EYELID
BLEPHAROPLASTY UPPER EYELID; WITH EXCESSIVE SKIN WEIGHTING DOWN LID
SUPERFICIAL MUSCULOAPONEUROTIC SYSTEM (SMAS) FLAP
EXCISION, EXCESSIVE SKIN/SUBCUTANEOUS TISSUE ABDOMEN, UMBILICAL PANNICULECTOMY
EXCESSIVE SKIN AND SUBCUTANEOUS TISSUE; LEG
EXCESSIVE SKIN AND SUBCUTANEOUS TISSUE; ARM
FREE FASCIA GRAFT (INCLUDING OBATINING FASCIA)
FREE MUSCLE GRAFT (INCLUDING OBTAINING GRAFT)
FREE MUSCLE GRAFT BY MICROSURGICAL TECHNIQUE
REGIONAL MUSCLE TRANSFER
EXCISION, EXCESSIVE SKIN AND SUBCUTANEOUS TISSUE (ADD-ON)
REMOVAL OF SUTURES UNDER ANESTHESIA (OTHER THAN LOCAL), SAME SURGEON
UNDER ANESTHESIA (OTHER THAN LOCAL), OTHER SURGEON
UNDER ANESTHESIA (OTHER THAN LOCAL)
TO TEST BLOOD FLOW IN FLAP OR GRAFT
SUCTION ASSISTED LIPECTOMY; TRUNK
COCCYGEAL PRESSURE ULCER WITH COCCYGECTOMY; WITH PRIMARY SUTURE
COCCYGEAL PRESSURE ULCER WITH COCCYGECTOMY; WITH FLAP CLOSURE
WITH PRIMARY SUTURE
WITH PRIMARY SUTURE; WITH OSTECTOMY
WITH SKIN FLAP CLOSURE
WITH SKIN FLAP CLOSURE; WITH OSTECTOMY
IN PREPARATION FOR MUSCLE OR MYOCUTANEOUS FLAP OR SKIN GRAFT CLOSURE;
PREPARATION FOR MUSCLE OR MYOCUTANEOUS FLAP OR SKIN GRAFT CLOSURE; W/OSTECTOMY
WITH PRIMARY SUTURE;
WITH PRIMARY SUTURE; WITH OSTECTOMY (ISCHIECTOMY)
WITH SKIN FLAP CLOSURE;
WITH SKIN FLAP CLOSURE; WITH OSTECTOMY
W/OSTECTOMY IN PREPARATION FOR MUSCLE OR MYOCUTANEOUS FLAP OR SKIN GRAFT CLOSE
WITH PRIMARY SUTURE;
WITH PRIMARY SUTURE; WITH OSTECTOMY
WITH SKIN FLAP CLOSURE;
WITH SKIN FLAP CLOSURE; WITH OSTECTOMY
PREPARATION FOR MUSCLE OR MYOCUTANEOUS FLAP OR SKIN GRAFT CLOSURE;
PREPARATION FOR MUSCLE OR MYOCUTANEOUS FLAP OR SKIN GRAFT CLOSURE; W/OSTECTOMY
EXCISION PRESSURE ULCER
WHEN NO MORE THAN LOCAL TREATMENT IS REQUIRED
DRESSINGS AND OR DEBRIDEMENT WITHOUT ANESTHESIA, OFFICE OR HOSPITAL, SMALL
WITHOUT ANESTHESIA, MEDIUM (EG, WHOLE FACE OR WHOLE EXTREMITY)
WITHOUT ANESTHESIA, LARGE (EG, MORE THAN ONE EXTREMITY)
ESCHAROTOMY
ESCHAROTOMY; EACH ADDITIONAL INCISION (ADD-ON)
ALL BENIGN OR PREMALIGNANT LESIONS;INCLUDING LOCAL ANESTHESIA; FIRST LESION
ALL BENIGN OR PREMALIGNANT LESIONS;INCL LOCAL ANESTH;2ND-14 LESIONS, EACH ADD-ON
BENIGN OR PREMALIGNANT LESIONS;INCLUDING LOCAL ANESTH.;15 OR MORE LESIONS-(SP)
OF CUTANEOUS VASCULAR PROLIFERATIVE LESIONS; LESS THAN 10 SQ CM
DESTRUCTION OF CUTANEOUS VASCULAR PROLIF LESIONS; 10.0 - 50.0 SQ CM
OF CUTANEOUS VASCULAR PROLIFERATIVE LESIONS; OVER 50.0 SQ CM
DESTRUCTION OF FLAT WARTS, MOLLUSCUM CONTAGIOSUM, OR MILIA; UP TO 14 LESIONS
OF FLAT WARTS, MOLLUSCUM CONTAGIOSUM, OR MILIA; 15 OR MORE LESIONS
GRANULATION TISSUE (PROUD FLESH, SINUS OR FISTULA)
DESTRUCT MALIG LESION TRUNK-ARM-LEG 0.5 CM OR LESS
DESTRUCT MALIG LESION TRUNK-ARM-LEG 0.6 TO 1.0 CM
DESTRUCT MALIG LESION TRUNK-ARM-LEG 1.1 TO 2.0 CM
DESTRUCT MALIG LESION TRUNK-ARM-LEG 2.1 TO 3.0 CM
DESTRUCT MALIG LESION TRUNK-ARM-LEG 3.1 TO 4.0 CM
DESTRUCT MALIG LESION TRUNK-ARM-LEG OVER 4.0 CM
DESTRUCT MALIG LESION SCALP-NECK-HAND 0.5 CM LESS
DESTRUCT MALIG LESION SCALP-NECK-HAND 0.6-1.0 CM
DESTRUCT MALIG LESION SCALP-NECK-HAND 1.1-2.0 CM
DESTRUCT MALIG LESION SCALP-NECK-HAND 2.1-3.0 CM
DESTRUCT MALIG LESION SCALP-NECK-HAND 3.1-4.0 CM
DESTRUCT MALIG LESION SCALP-NECK-HAND 4.0 CM OVE
DESTRUCT MALIG LESION FACE-EARS-NOSE 0.5 OR LESS
DESTRUCT MALIG LESION FACE-EARS-NOSE 0.6-1.0 CM
DESTRUCT MALIG LESION FACE-EARS-NOSE 1.1-2.0 CM
DESTRUCT MALIG LESION FACE-EARS-NOSE 2.1-3.0 CM
DESTRUCT MALIG LESION FACE-EARS-NOSE 3.1-4.0 CM
DESTRUCT MALIG LESION FACE-EARS-NOSE OVER 4.0 CM
MOHS MICROGRAPHIC TECHNIQUE, INCL REMOVAL OF GROSS TUMOR, SURG EXCISION/TISSUE
MOHS MICROGRAPHIC TECHNIQUE, EA ADD STAGE AFTER 1ST , UP TO 5 TISSUE BLOCKS (SP)
MOHS MICROGRAPHIC TECHNIQUE/TRUNK, ARMS, LEGS; 1ST STAGE, UP TO 5 TISSUE BLOCKS
MOHS MICROGRAPHIC TECHNIQUE, EA ADD AFTER 1st STAGE, UP TO 5 TISSUE BLOCKS (SP)
MOHS MICROGRAPHIC TECHNIQUE, EA ADDITIONAL BLOCK AFTER 1st 5 TISSUE BLOCKS, (SP)
UNLISTED PROCEDURE, SKIN
ASPIRATION, CYST, BREAST
ASPIRATION, CYST, BREAST-ADD ON
MASTOTOMY
INJ PROCEDURE ONLY FOR MAMMARY DUCTOGRAM OR GALACT
BREAST BIOPSY
BREAST BIOPSY
BIOPSY OF BREAST; PERCUTANEOUS NEEDLE CORE, USING IMAGING GUIDANCE
BIOPSY OF BREAST;PERCUTANEOUS,AUTO VACUUM ASSISTED/ROTATING DEVICE,IMAGING
ABLATION, CRYOSURGICAL, OF FIBROADENOMA, INCL ULTRASOUND GUIDANCE, EA
NIPPLE EXPLORATION W/ OR W/O EXCISION
EXCISION OF LACTIFEROUS DUCT
EXCISION, CYST, BREAST
EXCISION BREAST LESION IDENTIFIED BY PRE-OP PLACEM
EA ADDITIONAL LESION SEPARATELY IDENTIFIED BY RADI-ADD ON
EXCISION, TUMOR, CHEST WALL
EXCISION CHEST WALL TUMOR W/PLASTIC RECONSTRUCTION
EXCISION CHEST WALL TUMOR W/MEDIASTINAL LYMPHADENE
PRE-OPERATIVE PLACEMENT NEEDLE LOCAL WIRE BREAST
PREOP PLACE NEEDLE WIRE BREAST EA ADD LESION-ADD ON
IMAGE GUIDED PLCMNT, METALLIC LOCALIZATION CLIP, DURING BREAST BIOPSY-ADD ON
AFTER LOADING CATHETER INTO BREAST; ON DATE OTHER THAN PARTIAL MASTECTOMY
PLACEMENT OF RADIOTHERAPY AFTER LOADING BALLOON CATH INTO THE BREAST (ADD-ON)
PLACEMENT OF RADIOTHERAPY AFTERLOADING BRACHYTHERAPY CATHETERS
MASTECTOMY FOR GYNECOMASTIA
MASTECTOMY, PARTIAL (EG, LUMPECTOMY, TYLECTOMY, QUADRANTECTOMY, SEGMENTECTOMY);
MASTECTOMY, PARTIAL ; W/ AXILLARY LYMPHADENECTOMY
MASTECTOMY, SIMPLE, COMPLETE
MASTECTOMY, SUBCUTANEOUS
MASTECTOMY, RADICAL, INCL PECTORAL MUSCLES, AXILLARY LYMPH NODES
MASTECTOMY, RADICAL, INCL PECTORAL MUSCLES, (URBAN TYPE OPERATION)
MASTECTOMY, MODIFIED RADICAL
MASTOPEXY
REDUCTION MAMMAPLASTY
MAMMAPLASTY,AUGMENTATION W/O PROSTHETIC IMPLANT
MAMMAPLASTY WITH PROSTHETIC IMPLANT
REMOVAL OF INTACT MAMMARYIMPLANT
REMOVAL, BREAST IMPLANT
IMMEDIATE INSERTION OF BREAST PROSTHESIS
DELAYED INSERTION OF BREAST PROSTHESIS
RECONSTRUCTION, NIPPLE
BREAST RECONSTRUCT W/TISSUE UXPANDER INCLUDE SUBSE
BREAST RECONSTRUST W/LATISSIMUS DORSI FLAP, W/WO M
BREAST RECONSTRUCTION WITH FREE FLAP
BREAST RECONSTRUCTION W/OTHER TECHNIQUE
BREAST RECONSTRUCTION W/TRAM SINGLE PEDICLE
BREAST RECONSTRUCTION W/MINCROVASCULAR ANASTOMOSIS
BREAST RECONSTRUCTION W/TRAM, DOUBLE PEDICLE
OPEN PERIPROSTHETIC CAPULOTOMY BREAST
PERIPROSTHETIC CAPSULECTOMY BREAST
REVISION OF RECONSTRUCTED BREAST
UNLISTED PROCEDURE, BREAST
INCISION, ABCESS, SOFT TISSUE
INCISION OF SOFT TISSUE ABSCESS, DEEP/COMPLICATED
EXPLORATION OF PENETRATING WOUND; NECK
EXPLORATION OF PENETRATING WOUND; CHEST
EXPLORATION OF PENETRATING WOUND; ABDOMEN/FLANK/BK
EXPLORATION OF PENETRATING WOUND; EXTREMITY
EXCISION EPIPHYSEAL BAR W/WO AUTOGENOUS SOFT TISSU
BIOPSY, MUSCLE
BIOPSY, MUSCLE
BIOPSY MUSCLE PERCUTANEOUS NEEDLE
BIOPSY, BONE
BIOPSY, BONE
BIOPSY, BONE
BIOPSY, BONE
BIOPSY VERTEBRAL BODY OPEN THORACIC
BIOPSY VERTEBRAL BODY OPEN LUMBAR OF CERVICAL
INJECTION, SINUS TRACT
INJECTION, SINUS TRACT
REMOVAL, FOREIGN BODY, MUSCLE
REMOVAL FB IN MUSCLE DEEP OR COMPLICATED
INJECTION, THERAPEUTIC (LOCAL) CARPAL TUNNEL
INJECTION, LIGAMENT
INJECTIONS; TENDON ORIGINAL/INSERTION
INJECTION; SINGLE/MULTIPLE TRIGGER POINTS, ONE OR TWO MUSCLE GROUPS
INJECTION; SINGLE/MULTIPLE TRIGGER POINTS 3 OR MORE MUSCLE GROUPS
PLACEMENT OF NEEDLES/CATHETERS INTO MUSCLE &/OR SOFT TISSUE
ARTHROCENTESIS
ARTHROCENTESIS
ARTHROCENTESIS
ASPIRATION AND/OR INJECTION OF GANGLION CYSTS; ANY LOCATION
ASPIRATIOFN AND INJECTION FOR BONE CYST
INSERTION, PIN, SKELETAL TRACT
APPLICATION OF CRANIAL TONGS, CALIPER, OR STEREOTACTIC FRAME, INC REMOVAL
APPLICATION OF HALO INC REMOVAL CRANIAL
APPLICATION OF HALO INC REMOVAL PELVDC
APPLICATION OF HALO INC REMOVAL FEMORAL
APPLICATION OF HALO, INCLUDING REMOVAL,CRANIAL,6 OR MORE PINS FOR THIN SKULL
REMOVAL, CALIPER
REMOVAL, PIN OR OTHER
REMOVAL, PIN OR OTHER
APP OF A UNIPLANE UNILATERAL, EXTERNAL FIXATION SYSTEM
APP OF MULTIPLANE (PINS OR WIRES MORE THAN 1 PLANE), UNILATERAL
ADJ/REVISION OF EXTERNAL FIXATION SYSTEM REQUIRING
REMOVAL,UNDER ANESTHESIA OF EXTERNAL FIXATION SYS
APPL OF MULTIPL PINS/WIRES >1PLN UNI EXTRNL FIXTN W/STEREOTACTIC COMP-ASSIST
EXCHANGE (IE, REMOVAL AND REPLACEMENT) OF STRUT, EACH
REPLANTATION, ARM, COMPLETE AMPUTATION
REPLANTATION, FOREARM; COMPLETE AMPUTATION
REPLANTATION HAND; COMPLETE AMPUTATION
REPLANTATION DIGIT COMPLETE
REPLANTATION,DIGIT,EXCLUDING THUMB;COMPLETE AMPUTA
REPLANTATION, THUMB; COMPLETE AMPUTATION
REPLANTATION, THUMB;DISTAL TIP TO MP JOINT;COMPLET
REPLANTATION, FOOT, COMPLETE AMPUTATION
BONE GRAFT, ANY DONOR AREA; MINOR OR SMALL
BONE GRAFT, ANY DONOR AREA; MAJOR OR LARGE
CARTILAGE GRAFT; COSTOCHONDRAL
CARTILAGE GRAFT, NASAL SEPTUM
FASCIA LATA GRAFT; BY STRIPPER
FASCIA LATA GRAFT; BY INCISION & AREA EXPOSURE, COMPLEX OR SHEET
TENDON GRAFT, FROM A DISTANCE
TISSUE GRAFTS, OTHER
ALLOGRAFT FOR SPINE SURGERY ONLY; MORSELIZED-(SP)
ALLOGRAFT FOR SPINE SURGERY ONLY; STRUCTURAL-(SP)
AUTOGRAFT FOR SPINE SURGERY ONLY; (INCL HARVEST) LOCAL FROM SAME INCISION-(SP)
AUTOGRAFT SPINE SURGERY ONLY; MORSELIZED-(SP)
AUTOGRAFT SPINE SURGERY; STRUCTURAL, BICORTAL/TRICORTICAL-(SP)
MONITOR INTERSTITIAL FLUID PRESSURE DETECT MCS
FIBULA GRAFT WITH MICROVASCULAR ANASTOMOSIS
BONE GRAFT W/MICROVASCULAR ANASTOMOSIS-ILIAC CREST
BONE GRAFT W/MICROVASCULAR ANASTOMOSIS-METATARSAL
BONE GRAFT W/MICROVASCULAR OR ANASTOMOSIS; OTHER B
FREE OSTEOCUTANEOUS FLAP W/MICROVASCULAR ANASTOMOS
FREE OSTEOCUTANEOUS FLAP W/MICROVASCU.-ILIAC CREST
FREE OSTEOCUTANEOUS FLAP W/MICROVASCULA-METATARSAL
FREE OSTEOCUTANEOUS FLAP, GREAT TOE W/WEB SPACE
ELECTRICAL STIMULATION TO AID BONE HEALING; NONINVASIVE-(SP)
ELECTRIC STIMULATION TO AID BONE HEALING; INVASIVE-(SP)
LOW INTENSITY ULTRASOUND TO AID BONE HEALING; NONINVASIVE
ABLATION, BONE TUMOR(S) (EG OSTEIOD OSTEOMA, METASTASIS) RADIOFREQUENCY, PERCUT.
COMPUTER-ASSISTED SURGICAL NAVIGATIONAL PROC FOR MUSCULOSKELETAL PROC (SP)
REPAIR, MUSCLE WOUND
ARTHROTOMY,TEMPOROMANDIBULAR JOINT;UNILATERAL
AMB SURG CTR -ARTHRO TEMPOROM JNT BILATERAL
2 CM OR GREATER
EXCISION, TUMOR SFT TISS OF FACE & SCALP SUBFASCIAL LESS THAN 2 CM
2 CM OR GREATER
RADICAL RESECTION TUMOR FACE OR SCALP
2 CM OR GREATER
EXCISION OF BONE, MANDIBLE
EXCISION OF FACIAL BONES
REMOVAL BY CONTOURING BENIGN TUMOR OF FACIAL BONE
EXCISION, TUMOR, FACIAL BONE
EXCISION TORUS MANDIBULARIS
EXCISION TORUS PALATINUS
EXCISION MALIGNANT TUMOR OF FACIAL BONE
EXCISION, TUMOR, MANDIBLE
EXCISION OF MALIGNANT TUMOR OF MANDIBLE
EXCISION OF MALIGNANT TUMOR
EXCISION OF BEGNIGN TUMOR OR CYST OF MANDIBLE REQUIRING INTRA-ORAL OSTEOTOMY
EXCISION OF BENIGN TUMOR/CYST OF MANDIBLE, EXTRA-ORAL OSTEOTOMY PART MANDIBULECT
EXCISION OF BENIGN TUMOR OR CYST OF MAXILLA REQUIRING INTRA-ORAL OSTEOTOMY
EXCISION BENIGH TUMOR/CYST REQUIRING EXTRA-ORAL OSTEOTOMY/PARTIAL MAXILLECTOMY
ARTHRECTOMY, TEMP-MANDBLR JNT
MENISCECTOMY
CORONOIDECTOMY
MANIPULATION OF TEMPOROMANDIBULAR JOINT(S)
IMPRESSION/CUSTOM PREP; SURGICAL OBTURATOR PROSTHE
IMPRESSION/CUSTOM PREP INTERIM OBTURATOR PROTHESIS
DEFINITIVE OBTURATOR PROTHESIS
MANDIBULAR RESECTION PROSTHESIS
PALATAL AUGMENTATION PROSTHESIS
PALATAL LIFT PROSTHESIS
SPEECH AID PROSTHESIS
IMPRESSION & CUSTOM PREPARATION ORAL SURGICAL SPLINT
AURICULAR PROSTHESIS
NASAL PROSTHESIS (DESIGNED PREPARED BY PHYSICIAN)
FACIAL PROSTHESIS (DESIGNED PREPARED BY PHYSICIAN)
UNLISTED MAXILLOFACIAL PROSTHETIC PROCEDURE
APPLICATION, HALO
APPL, INTERDENTAL FIX APPLNCE
INJECTION PROCEDURE FOR TEMPOROMANDIBULAR ARTHROTO
GENIOPLASTY; AUGMENTATION AUTO/ALLOGRAFT,PROST MTL
SLIDING OSTEOTOMY, SINGLE PIECE
SLIDING OSTEOTOMIES TWO OR MORE
GENIOPLASTY, AUGMENTATION SLIDING W BONE GRAFTS
AUGMENTATION MANDIBULAR BODY OR ANGLE, PROSTHETIC
AUGMENTATION,MANDIBULAR BODY OR ANGLE W BONE GRAFT
REDUCTION FOREHEAD CONTOURING & PROSTHETIC MATERL.
RECONSTRUCT MIDFACE,LEFORT 1;SINGLE W/O BONE GRAFT
RECONSTRUCT MIDFACE,LEFORT 1; TWO W/O BONE GRAFT
RECONSTRUCT MIDFACE LEFORT 1; THREE/MORE W/O GRAFT
RECONSTRUCT MIDFACE SINGLE PIECE ANY DIRECTION REQ
RECONSTRUCT MIDFACE 2 PIECES ANY DIRECTION REQUIRE
RECONSTRUCT MIDFACE 3 OR MORE PIECES ANY DIRECTION
RECONSTRUCT MIDFACE LEFORT II ANTERIOR INTRUSION
RECONSTRUCT MIDFACE LEFORT II, ANY DIRECTION
RECONSTRUCT MIDFACE LEFORT III ANY TYPE W/OLEFORTI
RECONSTRUCT MIDFACE, LEFORT III W/ LEFORT I ANY TY
RECONSTRUCT MIDFACE LEFORT III W/FOREHEAD ADVANCE.
RECONSTRUCT MIDFACE LEFORT III W/LEFORT I
RECONSTRUCT SUPERIOR-LATERAL ORBITAL RIM & FOREHEA
RECONSTRUCT,BIFRONTAL,SUP-LATERAL ORBITAL RIMS
RECONSTRUCT ENTIRE OR MAJORITY OF FOREHEAD
RECONSTRUCT FOREHEAD/SUPRAORBITAL RIMS W/AUTOGRAFT
REMOVAL CONTOURING BENIGN TUMOR OF CRANIAL BONES L
RECONSTRUCT ORBITAL WALLS RIMS FOREHEAD & NASOETHM
RECONST. ORBITAL WALLS RIMS FORE, BETWEEN 40&80CM2
RECONSTRUCT ORBIT WALL TOTAL AREA BONE GRAFT 80 CM
RECONST. MIDFACE OSTEOTOMIES AND BONE GRAFTS
RECONSTRUCTION OF MANDIBULAR RAMUS WO BONE GRAFT
RECONSTRUCTION AND BONE GRAFT
RECONSTRUCT OF MANDIBULARRAMUS WO INTERNAL FIXATIO
RECONSTRUCT MANDIBULAR RAMUS W/INTERNAL FIXATION
OSTEOTOMY, MANDIBLE, SEGMENTAL
OSTEOTOMY, MANDIBLE, SEGMENTAL; W/ GENIOGLOSSUS ADVANCEMENT
OSTEOPLASY, MAXILLA, SEGMENTAL
OSTEOPLASTY FACIAL BONES AUGMENTATION
OSTEOPLASTY, FACIAL BONES AUGMENTATION; REDUCTION
GRAFT, FACIAL BONE
BONE GRAFT, MANDIBLE
GRAFT, CARTILAGE
GRAFT, CARTILAGE
ARTHROPLASTY, TEMP-MANDBL JNT
TEMP MAND JOINT ARTHROPLASTY W/ALLOPLASTIC IMPLANT
ARTHROPLASTY TMJ W/PROSTHETIC JOINT REPLACEMENT
RECONSTRUCT MANDIBLE EXTRAORAL W/TRANSOSTEAL BONE
RECONSTRUCTION OF MANDIBLE OR MAXILLA
RECONSTRUCT MANDIBLE/MAXILLA SUBPERIOSTEAL IMPLANT
RECONSTRUCT MANDIBULAR CONDYLE W/BONE & CARTILAGE
RECONSTRUCT MAXILLA/MANDIBLE ENDOSTEAL IMPLANT PAR
RECONSTRUCT MANDIBLE/MAXILLA, ENDOSTEAL IMPLANT CO
RECONSTRUCT ZYGOMATIC ARCH & GLENOID FOSSA
RECONSTRUCT ORBIT W/OSTEOTOMIES (EXTRACRANIAL)
PERIORBITAL OSTEOTOMY FOR ORBITAL HYPERTELORISM
PERIORBITAL OSTEOTOMIES W/BONE GRAFTS COMBINED INT
PERIORBITAL OSTEOTOMIES W/FOREHEAD ADVANCEMENT
ORBITAL REPOSITION, PERIORBITAL OSTEOTOMIES UNILAT
ORBITAL REPOSITIONING, PERIORBITAL OSTEOTOMIES BIL
MALAR AUGMENTATION PROSTHETIC MATERIAL
SECONDARY REVISION FOR ORBITOCRANIOFACIAL RECONSTR
MEDIAL CANTHOPEXY
LATERAL CANTHOPEXY
REDUCTIN OF MASSETER MUSCLE AND BONE; EXTRAORAL APPROACH
REDUCTION OF MASSETER MUSCLE & BONE; INTRAORAL APPROACH
UNLISTED CRANIOFACIAL AND MAXILLOFACIAL PROCEDURE
TREAT CLOSED/OPEN NASAL FX WO/MANIPULATION
FRACTURE, NASAL
FRACTURE, NASAL
FRACTURE, NASAL
FRACTURE, NASAL
FRACTURE, NASAL
OPEN TX NASAL SEPTAL FX W/WO STABILIZATION
TREATMENT OF CLOSED NASAL SEPTAL FX
OPEN TREATMENT NASOETHMOID FRACTURE
TREATMENT OF NASOETHMOID FRACTURE W/INT FIXATION
TREAT CLOSED/OPEN NASOETHMOID COMPLEX FX, W/SPLINT
OPEN TREAT DEPRESSED FRONTAL SINUS FX
OPEN TREAT COMPLICATED FRONT SINUS FX VIA CORONAL
FRACTURE, NASO-MAXILLARY
FRACTURE, NASO-MAXILLARY
FRACTURE, NASO-MAXILLARY
OPEN TREATMENT NASOMAXILLARY W/BONE GRAFTING
FRACTURE, MALAR AREA
OPEN TREAT DEPRESSED ZYGOMATIC ARCH FX (GILLES APP
FRACTURE, MALAR AREA
FRACTURE, MALAR AREA
OPEN TREAT COMPLICATED FX MALLAR W/BONE GRAFT
ORBITAL FLOOR FRACTURE
OPEN TREAT ORBITAL FLOOR FX PERIORBITAL APPROACH
OPEN TREAT ORBITAL FLOOR FX COMBINED APPROACH
ORBITAL FLOOR FRACTURE
ORBITAL FLOOR FRACTURE
FRACTURE, ORBIT
FRACTURE, ORBIT
FRACTURE, ORBIT
FRACTURE, ORBIT
OPEN TREAT FX ORBIT W/BONE GRAFTING
FRACTURE, PALATAL RIDGE
OPEN TREAT PATATAL OR MAXILLARY FX
OPEN TREAT PALATAL MAXILLARY FX COMPLICATED
CRANIO-FACIAL SEPARATION
OPEN TREAT CRANIOFACIAL SEPARATION W/WIRING/INT FI
OPEN TREAT CRANIOFACIAL SEPARATION COMPLICATED MUL
COMPLICATED UTILIZING INTERNAL AND/OR EXTERNAL FIX
COMPLICATED MULTIPLE SURGICAL APPROACHES INTERNAL
MANIPULATIVE TREATMENT OF ALEOLAR RIDGE FRACTURE
OPEN TREAT MANDIBULAR-MAXILLARY ALVEOLAR RIDGE FX
CLOSED TREAT MANDIBULAR FX WO/MANIPULATION
CLOSED TREAT MANDIBULAR FX W/MANIPULATION
PERCUTANEOUS TREAT MANDIBULAR FX W0EXTERNAL FIXATI
TREATMENT OF OP MANDIBULAR FRACTURE
OPEN TRTMNT CLCS/OPN MANDIBULAR FRACT W/EXT FIXATN
FRACTURE, MANDIBULAR
FRACTURE, MANDIBULAR
OPEN TREAT MANDIBULAR CONDYLAR FX
OPEN TREAT COMPLICATED MANDIBULAR FX MULTI APPROAC
DISLOCATN, TEMPORO-MANDIBULAR
CLOSED TREAT TEMPOROMANDIBULAR DISLOC COMPLICATED
OPEN TREAT TEMPORMANDIBULAR DISLOCATION
OPEN TREAT HYOID FX
INTERDENATAL WIRING FOR CONDITION OTHER THAN FX
UNLISTED MUSCULOSKELETAL PROCEDURE, HEAD
INCISN & DRNGE, ABSCESS, NECK
INCISN & DRNGE, ABSCESS, NECK
INCISION DEEP W/OPENING OF BONE CORTEX THORAX
EXCISIONAL BIOPSY, SOFT TISSUES
3 CM OR GREATER
5 CM OR GREATER
EXCISION TUMOR SOFT TISSUE OF NECK OR THORAX
EXCISN, TUMR, SUBFASCIAL, NECK
RADICAL RESECTION OF TUMOR SOFT TISSUE NECK OR THO
5 CM OR GREATER
EXCISION, RIB
COSTOTRANSVERSECTOMY
BIOPSY, RIB
EXCISION FIRST AND/OR CERVICAL RIB W/SYMPATHECTOMY
OSTECTOMY OF STERNUM PARTIAL
EXCISION, STERNAL DEBRIDEMENT
RADICAL RESECTION OF STERNUM
EXCISION WITH MEDIASTINAL LYMPHADENECTOMY
HYOID MYOTOMY AND SUSPENSION
DIVISION, SCALENUS ANTICUS
DIVISION, SCALENUS ANTICUS
DIVISION, STERNOCLEIDOMASTOID
DIVISION, STERNOCLEIDOMASTOID
PECTUS EXCAVATUM OR CARINATUM
RECONSTRUCTIVE REPAIR OF PECTUS EXCAVATUM OR CARINATUM; MIN. INVASIVE APPROACH
RECONSTRUCTIVE REPAIR OF PECTUS EXCAVATUM/CARINATUM MINIMAL INVASIVE APPROACH
CLOSE STERNOTOMY SEPARATION W/WO DEBRIDEMENT
FRACTURE, RIB
RIB FX OPEN OR COMPLICATED
RIB FX OPEN/CLOSED REQUIRING EXTERNAL FIXATION
STERNUM FX CLOSED
STERNUM FX OPEX
UNLISTED PROC, NECK, THORAX
BIOPSY SOFT TISSUE BACK/FLANK SUPERFICIAL
BIOPSY SOFT TISSUE BACK/FLANK DEEP
EXCISION TUMOR SOFT TISSUE BACK OR FLANK
3 CM OR GREATER
EXCISION, TUMOR, SOFT TISSUE OF BACK OR FLANK, SUBFASCIAL; LESS THAN 5 CM
5 CM OR GREATER
RADICAL RESECTION OF TUMOR, SOFT TISSUE BACK/FIAN
5 CM OR GREATER
INCISION AND DRAINAGE, OPEN, OF DEEP ABSCESS POSTERIOR SPINE, CERVICAL, THORACIC
INCISION AND DRAINAGE, OPEN, OF DEEP ABSCESS POSTERIOR SPINE, CERVICAL, THORACIC
RESECTION, VERTEBRAL COMPONENT
RESECTION, VERTEBRAL COMPONENT
RESECTION, VERTEBRAL COMPONENT
PARTIAL EXCISION POST VERTEBRAL COMPONENT,SINGLE; EA ADDITION-ADD ON
EXCISION, PRTL, VERTEBRAL BODY
PARTIAL EXCISION VERTEBRAE THORACIC
PARTIAL EXCISION OF VERTEBRA LUMBAR
EXCISE VERTEBRAL BODY/BONY LESION,SINGLE; EA ADDIT-ADD ON
OSTEOTOMY OF SPINE, POSTERIOR OR POSTEROLATERAL APPROACH, THORACIC
OSTEOTOMY OF SPINE, POSTERIOR OR POSTEROLATERAL APPROACH; THORACIC
OSTEOTOMY OF SPINE, POSTERIOR/POSTEROLATERAL APPR, EA ADD VERTEBRAL SEGMENT (SP)
OSTEOTOMY SPINE POSTERIOR APPROACH CORR DEFORM CER
OSTEOTOMY OF SPINE; THORACIC
OSTEOTOMY OF SPINE; LUMBAR
OSTEOTOMY SPINE,ONE SEGMENT; EA ADDITIONAL SEGMENT-ADD ON
OSTEOTOMY OF SPINE; CERVICAL
OSTEOTOMY OF SPINE; THORCIC
OSTEOTOMY OF SPINE; LUMBAR
OSTEOTOMY SPINE/DISKECTOMY,SINGLE;EA ADD SEG-ADD ON
CLOSED TREAT VERTEBRAL PROCESS FX
CLOSED TREAT VERTEBRAL BODY FX WO/MANIPULATION
CLOSED TREATMENT OF VERTEBRAL FRACTURE
OPEN TREATMENT, ODONTOID FRACTURE; WITHOUT GRAFTING
OPEN TREATMENT, ODONTOID FRACTURE; WITH GRAFTING
FRACTURE, VERTEBRAL BODY
VERTEBRAL FRACTURE; CERVICAL EACH
FRACTURE AND/OR DISLOCATION THORACIC,EACH
TX/REDUCTION VERTEBRAL FRACTURE;EA ADDITIONAL SEGM-ADD ON
SPINAL MANIPULATION
PERCUTANEOUS VERTEBROPLASTY, ONE VERTEBRAL BODY UNILATERAL/BILATERAL;THORACIC
PERCUTANEOUS VERTEBROPLASTY, ONE VERTEBRAL BODY UNILATERAL/BILATERAL; LUMBAR
PERCUTANEOUS VERTEBROPLASTY, VERTEBRAL UNILATERAL/BILATERAL; EACH ADDITIONAL
PERCUTANEOUS VERTEBRAL AUGMENTATION, 1 VERTEBRAL BODY, THORACIC
PERCUTANEOUS VERTEBRAL AUGMENTATION, 1 VERTEBRAL BODY, UNIL/BILAT, LUMBAR
PERCUTANEOUS VERTEBRAL AUGMENTATION, EA ADD THORACIC/ LUMBAR ADD-ON
ARTHRODESIS, LATERAL EXTRACAVITARY TECHNIQUE, INCL MINIMAL DISKECTOMY
ARTHRODESIS, LATERAL EXTRACAVITARY TECHNIQUE, INCL MINIMAL DISKETOMY
ARTHRODESIS, LATERAL EXTRACAVITARY TECHNIQUE, INCL MINIMAL DISKECTOMY (ADD-ON)
ARTHRODESIS, CLIVUS-C1-C2
ARTHRODESIS
ARTHRODESIS, ANTERIOR INTERBODY TECHNIQUE
ARTHRODESIS ANTERIOR INTERBODY TECHNIQUE, LUMBAR
ARTHRODESIS ANTERIOR OR ANTEROLATERAL EA ADDITION-ADD ON
ARTHRODESIS, POSTERIOR TECHNIQUE, CRANIOCERVICAL
ARTHRODESIS POSTERIOR TECHNIQUE
ARTHRODESIS, CERVICAL
ARTHRODESIS LOCAL BONE ALLOGRAFT
ARTHRODESIS
ARTHRODESIS, SINGLE LEVEL; EA ADDITIONAL SEGMENT-ADD ON
ARTHRODESIS, POSTERIOR INTERBODY TECHNIQUE LUMBAR
ARTHRODESIS INTERBODY, SINGLE INTERSPACE;EA ADDITI-ADD ON
SCOLIOSIS CORRECTION
SCOLIOSIS CORRECTION
ARTHRODESIS,POST,SPINAL DEFORMITY W/W/O CAST; 13 +
ARTHRODESIS,ANT,SPINAL DEFORMITY W/W/O CAST;2 OR 3
ARTHRODESIS ANTERIOR-SPINAL DEFORMITY W/WO CAST W/
ARTHRODESIS POSTERIOR FOR SPINAL DEFORM 8 OR MORE
KYPHECTOMY, CIRCUMFERENTIAL EXPOSURE OF SPINE & RESECTION; SINGLE OR 2 SEGMENTS
KYPHECTOMY, CIRCUMFERENTIAL EXPOSURE OF SPINE & RESECTION; 3 OR MORE SEGMENTS
EXPLORATION OF SPINAL FUSION
POSTERIOR NON-SEGMENTAL INSTRUMENTATION-(SP)
INTERNAL SPINAL FIXATION BY WIRING OF SPINOUS PROCESSES-(SP)
POSTERIOR SEGMEMTAL INSTRUMENTATION; 3 TO 6 VERTEBRAL SEGMENTS-(SP)
POSTERIOR SEGMENTAL INSTRUMENTATION; 7-12 VERTEBRAL SEGMENTS-(SP)
POSTERIOR SEGMENTAL INSTRUMENTATION; 13 OR MORE VERTEBRAL SEGMENTS-(SP)
ANTERIOR INSTRUMENTATION; 2 TO 3 VERTEBRAL SEGMENTS-(SP)
ANTERIOR INSTRUMENTATION; 4-7 VERTEBRAL SEGMENTS-(SP)
ANTERIOR INSTRUMENTATION; 8 OR MORE VERTEBRAL SEGMENTS-(SP)
PELVIC FIXATION OTHER THAN SACRUM-(SP)
REINSERTION OF SPINAL FIXATION DEVICE
HARRINGTON ROD REMOVAL
APPLY PROSTHETIC DEVICE VERTEBRAL DEFECT OR INTERSPACE-(SP)
REMOVAL OF POSTERIOR SEGMENTAL INSTRUMENTATION
REMOVAL OF ANTERIOR INSTRUMENTATION
TOTL DISC ARTHROPLSTY ARTIF DISC INCL DISCECTOMY/ OSTEOPHYTECTOMY
REVI/ REPL. OF TOTL DISC ARTHROPLSTY ARTIF DISC ANTER APPRCH 1 INTRSPACE; CERV
REMVL TOTL DISC ARTHROPLASTY ARTIFICIAL DISC ANTER APPRCH, 1 INTRSPC;CERV
UNLISTED PROCEDURE, SPINE
EXCISION, TUMOR, ABDOMINL WALL
5 CM OR GREATER
EXCISION, TUMOR, SOFT TISSUE OF ABDOM WALL, SUBCUTANEOUS; LESS THAN 3 CM
3 CM OR GREATER
RADICAL RESECTION OF TUMOR SOFT TISSUE OF ABDOM WALL; LESS THAN 5 CM
5 CM OR GREATER
UNLISTED PROCEDURE, ABDOMEN
REMOVAL SUBDELTOID CALCAREOUS DEPOSTIS OPEN METHOD
CAPSULAR CONTRACTURE RELEASE
DRAINAGE, ABSCESS, SHOULDER
DRAINAGE, BURSA, INFECTED
INCISION, SHOULDER
ARTHROTOMY, GLENOHUMERAL
ARTHROTOMY, ACROMIOCAVICULAR
BIOPSY, SOFT TISSUE OF SHOULDER AREA; SUPERFICIAL
BIOPSY, SOFT TISSUE OF SHOULDER AREA,DEEP
3 CM OR GREATE
5 CM OR GREATER
EXCISION TUMOR SHOULDER AREA, SUBCUTANEOUS
EXCISION, TUMOR, SHOULDER
RADICAL RESECTION OF TUMOR, SHOULDER AREA
5 CM OR GREATER
ARTHROTOMY, GLENOHUMERAL
ARTHROTOMY FOR BX OR EXC TORN CART ACROCLAN/STERNC
SYNOVECTOMY, GLENOHUMERAL
ARTHROTOMY, ACROMIOCAVICULAR
ARTHROTOMY, GLENOHUMERAL JOINT
CLAVICULECTOMY
CLAVICULECTOMY
ACROMIOPLASTY-ACROMIONECTOMY,PARTIAL
EXCISION, CYST, CLAVICLE
EXCISION, CYST, CLAVICLE
EXCISION, CYST, CLAVICLE
EXCISION, CYST, HUMERAL HEAD
EXCISION, CYST, HUMERAL HEAD
EXCISION, CYST, HUMERAL HEAD
SEQUESTRECTOMY, CLAVICLE
SEQUESTRECTOMY, SCAPULA
SEQUESTRECTOMY, HUMERAL HEAD
EXCISION, PARTIAL, CLAVICLE
EXCISION, PARTIAL, SCAPULA
EXCISN, PTL, PROXIMAL HUMERUS
OSTECTOMY, SCAPULA
RESECTION, HUMERAL HEAD
RESECTION, CLAVICLE
RESECTION, SCAPULA
RESECTION, PROXIMAL HUMERUS
REMOVAL OF FEREIGN BODY; SUBCUTANEOUS
REMOVAL, FGN BODY, SHOULDER
REMOVAL, IMPLANT, SHOULDER JNT
ARTHROGRAPHY, SHLDR, INJ PROCD
TRANSFER, MUSCLE, SHOULDER
TRANSFER, MUSCLE, SHOULDER
SCAPULOPEXY
TENOMYOTOMY, SHOULDER
TENOMYOTOMY, SHOULDER
REPAIR, MUSCULOTENDINOUS CUFF
REPAIR, MUSCULOTENDINOUS CUFF
CORACOACROMIAL LIGAMNT RELEASE
REPAIR, SHOULDER CUFF AVULSION
TENODESIS, BICEPS
RESECTION, LONG TENDON, BICEPS
CAPSULORRHAPHY, SHOULDER JOINT
CAPSULORRHAPHY, SHOULDER JOINT
CAPSULORRHAPHY, SHOULDER JOINT
CAPSULORRHAPHY, SHOULDER JOINT
CAPSULORRHAPHY, SHOULDER JOINT
CAPSULORRHAPHY ANY TYPE MULTIDIRECTIONAL INSTABILI
ARTHROPLASTY, HUMERAL IMPLANT
ARTHROPLASTY W/GLENOID AND PROXIMAL HUMERAL REPLAC
OSTEOTOMY, CLAVICLE
OSTEOTOMY, CLAVICLE
PROPHYLACTIC TREATMENT; CLAVICLE
PROPHYLACTIC TREATMENT;PROXIMAL HUMERUS/HUMERAL HD
FRACTURE CLAVICLE
FRACTURE, CLAVICLE
FRACTURE, CLAVICLE
DISLOCATION, STERNOCLAVICULAR
DISLOCATION, STERNOCLAVICULAR
DISLOCATION, STERNOCLAVICULAR
DISLOCATION, STERNOCLAVICULAR
DISLOCATION, ACROMIOCLAVICULAR
TREATMENT CLOSED ACROMIOCLAVICULAR DISLOC. W/MANI.
DISLOCATION, ACROMIOCLAVICULAR
DISLOCATION, ACROMIOCLAVICULAR
CLOSED TX SCAPULAR FRACTURE;WITHOUT MANIPULATION
FRACTURE, SCAPULAR
FRACTURE, SCAPULAR
FRACTURE, HUMERAL NECK
FRACTURE, HUMERAL NECK
FRACTURE, HUMERAL NECK
OPEN TREAT W/PROXIMAL HUMERAL PROSTHETIC REPLACEME
FRACTURE, HUMERAL NECK
FRACTURE, HUMERAL NECK
FRACTURE, HUMERAL NECK
DISLOCATION, SHOULDER
DISLOCATION, SHOULDER
DISLOCATION, SHOULDER
DISLOCATION, SHOULDER
DISLOCATION, SHOULDER
DISLOCATION, SHOULDER
DISLOCATION, SHOULDER
MANIPULATION, SHOULDER
FUSION, SHOULDER JOINT
FUSION, SHOULDER JOINT
AMPUTATION, FOREQUARTER
DISARTICULATION, SHOULDER
DISARTICULATION, SHOULDER
UNLISTED PROCEDURE, SHOULDER
DRAINAGE, ABSCESS, HUMERUS
DRAINAGE ABSCESS ELBOW INFECTED BURSA
INCISION DEEP OPENING BONE CORTEX
ARTHROTOMY, ELBOW
ARTHROTOMY ELBOW W/CAPSULAR EXCISION FOR RELEASE
BIOPSY SOFT TISSUE UPPER ARM
BIOPSY,SOFT TISSUE UPPER ARM/ELBOW AREA; DEEP
3 CM OR GREATER
5 CM OR GREATER
EXCISION,TUMOR,UPPER ARM OR ELBOW AREA,SUBCUTANEOU
EXCISION, TUMOR, HUMERUS
RADICAL RESECTION OF TUMOR; UPPER ARM/ELBOW AREA
5 CM OR GREATER
ARTHROTOMY, ELBOW
ARTHROTOMY W/JOINT EXPLORE W/WO BX/REMOVE FOREIGN
ARTHROTOMY, ELBOW
EXCISION, BURSA, OLECRANON
EXCISION, CYST, HUMERUS
EXCISION, CYST, HUMERUS
EXCISION, CYST, HUMERUS
EXCISION, CYST, HUMERUS
EXCISION, CYST, HUMERUS
EXCISION, CYST, HUMERUS
EXCISION, RADIAL HEAD
SEQUESTRECTOMY, HUMERUS
SEQUESTRECTOMY, RADIAL HEAD
SEQUESTRECTOMY, OLECRANON PRCS
EXCISION, PARTIAL, HUMERUS
EXCISION, PARTIAL, RADIAL HEAD
EXCISION, PTL, OLECRANON PRCS
RADICAL RESECTION-CAPSULE, SOFT TISSUE-BONE-ELBOW
RESECTION, HUMERUS
RADICAL RESECTION FOR TUMOR RADIAL HEAD OR NECK
RESECTION, ELBOW JOINT
REMOVAL, IMPLANT, ELBOW JOINT
REMOVAL, IMPLANT, RADIAL JOINT
REMOVAL FOREIGN BODY,UPPER ARM/ELGOW,SUBCUTANEOUS
REMOVAL FB UPPER ARM/ELBOW DEEP
ARTHROGRAPHY, ELBOW, INJ PRCDR
MANIPULATION, ELBOW, UNDER ANESTHESIA
TRANSFER, TENDON, ARM
LENGTHENING, TENDON, UPPER ARM
TENOTOMY, UPPER ARM
TENOPLASTY, UPPER ARM
FLEXOR-PLASTY, ELBOW
FLEXOR-PLASTY, ELBOW
TENOLSIS, TRICEPS
TENODESIS, ELBOW
REPAIR TENDON/MUSCLE, UPPER ARM/ELBOW, EA.-EX.CUFF
REINSERTION, TENDON, UPPER ARM
REPAIR LATERAL COLLATERAL LIGAMENT, ELBOW, W/ LOCAL TISSUE
RECONSTRUCTION LATERAL COLLATERAL LIGAMENT, ELBOW W/ TENDON GRAFT
REPAIR MEDIAL COLLATERAL LIGAMENT, ELBOW, W/ LOCAL TISSUE
RECONSTRUCTION, MEDIAL COLLATERAL LIGAMENT, ELBOW, WITH TENDON GRAFTS
TENOTOMY, ELBOW, LATERAL OR MEDIAL
TENOTOMY, ELBOW, LATERAL/MEDIAL EG, EPICONDYLITIS, TENNIS ELBOW, GOLFER'S ELBOW
TENOTOMY, ELBOW, LATERAL OR MEDIAL, OPEN W/TENDON REPAIR/REATTACHMENT
ARTHROPLASTY, ELBOW
ARTHROPLASTY ELBOW W/DISTAL HUMERAL PROSTHETIC REP
ARTHROPLASTY ELBOW W/IMPLANT FASCIA LATA LIG RECON
ARTHROPLASTY ELBOW W/IMPLANT FASCIA LATA LIG RECON
ARTHROPLASTY, RADIAL HEAD
ARTHROPLASTY, RADIAL HEAD
OSTEOTOMY, HUMERUS
OSTEOTOMY, HUMERUS
OSTEOPLASTY, HUMERUS
REPAIR, MALUNION, HUMERUS
REPAIR, MALUNION, HUMERUS
HEMI-EPIPHYSEAL ARREST, HUMERS
DECOMPRESSION FASCIOTOMY FOREARM W/BRACH ARTERY EX
PROPHYLACTIC TREATMENT; HUMEROUS
FRACTURE, HUMERAL SHAFT
FRACTURE, HUMERAL SHAFT
FRACTURE, HUMERAL SHAFT
OPEN TREAT HUMERAL SHAFT FX W/INSERT INTRAMEDULLAR
FRACTURE, TRANSCONDYLAR
FRACTURE, TRANSCONDYLAR
FRACTURE, TRANSCONDYLAR
FRACTURE, TRANSCONDYLAR
CLOSED TREAT HUMERAL CONDYLAR FX WO/MANIPULATION
FRACTURE, EPICONDYLAR
FRACTURE, EPICONDYLAR
PERCUTANEOUS SKELETAL FIXATION OF HUMERAL EPICONDY
FRACTURE, EPICONDYLAR
FRACTURE, CONDYLAR
FRACTURE, CONDYLAR
FRACTURE, CONDYLAR
PERCUTANEOUS SKELETAL FIXATION HUMERAL CONDYLAR FX
OPEN TREAT C/O ELBOW FX W/ELBOW RESECTION
OPEN TREAT CLOSED/OPEN ELBOW FX W/IMPLANT
DISLOCATION, ELBOW
DISLOCATION, ELBOW
DISLOCATION, ELBOW
FRACTURE-DISLOCATION, ELBOW
FRACTURE-DISLOCATION, ELBOW
SUBLUXATION, RADIAL HEAD
FRACTURE, RADIAL HEAD
FRACTURE, RADIAL HEAD
FRACTURE, RADIAL HEAD
FRACTURE, RADIAL HEAD
FRACTURE, ULNAR
FRACTURE, ULNAR
FRACTURE, ULNAR
FUSION, ELBOW JOINT
FUSION, ELBOW JOINT
AMPUTATION, ARM
AMPUTATION, ARM
AMPUTATION, ARM
AMPUTATION, ARM
AMPUTATION, ARM
STUMP ELONGATION UPPER EXTREMITY
CINEPLASTY, ARM
UNLISTED PROCEDURE, HUMERUS OR ELBOW
TENOVAGINOTOMY, WRIST
INCLUSION FLEXOR TENDON SHEATH, WRIST
DECOMPRESSION FASCIOTOMY WRIST FLEXOR/EXTENSOR COM
DECOMP FASCIOTOMY W/DEBRIDEMENT NONVIABLE MUSCLE/N
DECOMPRESSION FASCIOTOMY FOREARM/WRIST W/O DEBRIDEMENT OF MUSCLE/NERVE
DECOMPRESSION FASCIOTOMY FOREARM/WRIST W/ DEBRIDEMENT OF MUSCLE/NERVE
INCISION DRAIN FOREARM/WRIST DEEP ABCESS OR HEMAT
INFECTED BURSA
INCISION DEEP W/OPENING BONE CORTEX FOREARM/WRIST
ARTHROTOMY, WRIST JOINT
EXCISION BIOPSY SOFT TISSUE FOREARM/WRIST
BIOPSY, SOFT TISSUES, DEEP
3 CM OR GREATER
3 CM OR GREATER
EXCISION, BENIGN TUMOR, SUBCUTANEOUS
EXCISION TUMOR FOREARM/WRIST DEEP SUBFASCIAL/INTRA
RADICAL RESECTION TUMOR, SOFT TISSUE FOREARM0WRIST
3 CM OR GREATER
CAPSULECTOMY, WRIST
ARTHROTOMY, WRIST JOINT
ARTHROTOMY WRIST JOINT,BIOPSY W/JOINT EXPLORATION
ARTHROTOMY, WRIST JOINT
ARTHROTOMY, DSTL RDO-ULNR JNT
EXCISION OF TENDON, FOREARM AND/OR WRIST, FLEXOR OR EXTENSOR, EACH
EXCSN, LSN, TENDN SHEATH, WRST
EXCISION, GANGLION, WRIST
EXCISION, GANGLION, WRIST
TENOSYNOVECTOMY, FOREARM
TENOSYNOVECTOMY, FOREARM
SYNOVECTOMY, EXTENSOR TENDON SHEATH, WRIST, SINGLE
SYNOVECTOMY,DSTL RDO-ULNR JNT
EXCISION, CYST, ULNA
EXCISION, CYST, ULNA
EXCISION, CYST, ULNA
EXCISION, CYST, CARPAL BONES
EXCISION, CYST, CARPAL BONES
EXCISION, CYST, CARPAL BONES
SEQUESTRECTOMY, FOREARM
EXCISION, PARTIAL, ULNA
EXCISION, PARTIAL, RADIUS
RESECTION, TUMOR, FOREARM
CARPECTOMY
CARPECTOMY
RADIAL STYLOIDECTOMY
EXCISION, DISTAL ULNA
ARTHROGRAPHY, WRIST, INJECTION
EXPLORATION REMOVAL DEEP FB FOREARM/WRIST
REMOVAL OF WRIST PROSTHESIS
REMOVAL OF WRIST PROSTHESIS; COMPLICATED
MANIPULATION, WRIST UNDER ANESTHESIA
REPAIR, MUSCLE, FOREARM
REPAIR, MUSCLE, FOREARM
REPAIR TENDON-MUSCLE FOREARM/WRIST SECOUNDARY W/FR
AMB SURG CTR-REPAIR,MUSCLE,FOREARM
REPAIR, MUSCLE, FOREARM
REPAIR, MUSCLE, FOREARM
REPAIR OF TENDON SHEATH, FOREARM/WRIST
LENGTHENING, TENDON, FOREARM
TENOTOMY, EACH, FOREARM
TENOLYSIS, EACH, FOREARM
TENODESIS, DGT FLEXRS, AT WRST
TENODESIS, DGT FLEXRS, AT WRST
TRANSPLANT, TENDON, WRIST
TRANSPLANT, TENDON, WRIST
FLEXOR ORIGIN SLIDE
REPAIR WITH TENDON TRANSFER
CAPSULORRHAPHY/RECONST CAPSULECTOMY WRIST
ARTHROPLASTY WRIST;PSEUDOARTHROSIS W/INTERNAL FIXA
CENTRALIZATION WRIST ON ULNA (EG RADIAL CLUB HAND)
RECONSTRUCT FOR STABILIZATION ULNA/RADIOULNAR JT
OSTEOTOMY, RADIUS
OSTEOTOMY, RADIUS
OSTEOTOMY, ULNA
OSTEOTOMY, RADIUS & ULNA
MULTIPLE OSTEOTOMIES W/REALIGNMENT ON INTRAMEDULLA
OSTEOTOMY, RADIUS AND/OR ULNA
OSTEOPLASTY, RADIUS/ULNA
OSTEOPLASTY, RADIUS/ULNA
OSTEOPLASTY, RADIUS/ULNA
OSTEOPLASTY, RADIUS/ULNA
OSTEOPLASTY CARPAL BONE SHORTENING
REPAIR, MALUNION, RADIUS/ULNA
REPAIR, MALUNION, RADIUS/ULNA
REPAIR, MALUNION, RADIUS/ULNA
REPAIR, MALUNION, RADIUS/ULNA
REPAIR, BONE DEFICIT, FOREARM
REPAIR, BONE DEFICIT, FOREARM
INSERTION OF VASCULAR PEDICLE INTO CARPAL BONE
REPAIR OF NONUNION OF CARPAL BONE, EACH BONE
REPAIR, NON-UNION, NAVICULAR
REPLACEMENT, IMPLANT, WRIST
REPLACEMENT, IMPLANT, WRIST
REPLACEMENT, IMPLANT, WRIST
REPLACEMENT, IMPLANT, WRIST
REPLACEMENT, IMPLANT, WRIST
TOTAL WRIST REPLACEMENT
INTERPOSITION ARTHROPLASTY,INTERCARPAL OR CARPOMEN
REVISION ARTHROPLASTY INC REMOV IMPLANT WRIST JOIN
EPIPHYSEAL ARREST, FOREARM
EPIPHYSEAL ARREST, FOREARM
PROPHYLACTIC TREATMENT; RADIUS
PROPHYLACTIC TREATMENT; ULNA
PROPHYLACTIC TREATMENT; RADIUS AND ULNA
TREAT CLOSED RADIAL SHAFT FX WO MANIPULATION
FRACTURE, RADIAL SHAFT
FRACTURE, RADIAL SHAFT
CLOSED TREAT RADIAL SHAFT FX W/DISLOCATION DISTAL
OPEN TREAT RADIAL SHAFT FX W/INTERNAL OR EXTERNAL
OPEN TREAT RADIAL SHAFT FX OPEN TREAT INTERNAL/EXT
FRACTURE, ULNAR SHAFT
FRACTURE, ULNAR SHAFT
FRACTURE, ULNAR SHAFT
FRACTURE, RADIAL & ULNAR SHAFT
TREAT CLOSED RADIAL/ULNAR SHAFT FX W/MANIPULATION
OPEN TREAT RADIAL/ULNAR SHAFT FX W/INTER-EXTER FIX
FRACTURE, RADIAL & ULNAR SHAFT
TREAT CLOSED DITAL RADIAL FX WO/MANIPULATION
COLLES FRACTURE W MANIPULATION
PERCUTANEOUS SKELETAL FIXATION OF DISTAL RADIAL FRACTURE OR EPIPHYSEAL SEP
OPEN TREATMENT/DISTAL RAD EXTRA-ARTICULAR FX/EPIPHYSEAL SEP W/INTERNAL FIXATION
OPEN TREATMENT DIST/RAD INTRA-ARTICULAR FX OR EPIPHYSEAL SEP
OPEN TREATMENT OF DISTAL RADIAL INTRA-ARTICULAR FRACTURE; 3 OR MORE FRAGMENTS
TRMT CLOSED CARPAL SCAPOID FRACTURE W/O MANIPULATI
TREAT CLOSED CARPAL SCOPHOID FX W/MANIPULATION
TREAT OPEN CARPAL SCAPHOID FX W/UMCOMP SOFT TISSUE
OPEN TREATMENT OF CARPAL SCAPHOID FRACTURE W/WO FI
TREAT CLOSED CARPAL BONE FX EXCLUDING CARPAL SCAPHOID WO MANIPULATION
TX CLOSED CARPAL BONE FRACTURE W/MANIPULATION, EA.
FRACTURE, CARPAL BONE
TREATMENT OF CLOSED ULNAR STYLOID FX
PERCUTANEOUS SKELETAL FIXATION OF ULNAR STYLOID FRACTURE
OPEN TREATMENT OF ULNAR STYLOID FRACTURE
TREAT RADIOCARPAL DISLOC 1-MORE BONES W/MAINPULATI
DISLOCATION, INTERCARPAL
PERCUTANEOUS SKELETAL FIXATION OF DISTAL RADIOULNAR
DISLOCATN, DISTAL RADIO-ULNAR
DISLOCATN, DISTAL RADIO-ULNAR
FRACTURE, TRANS-SCAPHO-PERILNR
FRACTURE, TRANS-SCAPHO-PERILNR
DISLOCATION, LUNATE
DISLOCATION, LUNATE
ARTHRODESIS, WRIST JOINT
ARTHRODESIS, WRIST JOINT WITH SLIDING GRAFT
ARTHRODESIS, WRIST JOINT
INTERCARPAL FUSION; WITHOUT GRAFT
INTERCARPAL FUSION & AUTOGENOUS BONE GRAFT
RESECTION ULNA W/W/O BONE GRAFT
AMPUTATION, FOREARM
AMPUTATION, FOREARM THRU ULNA; OPEN AND CIRCULAR
AMPUTATION, FOREARM
AMPUTATION, FOREARM
AMPUTATION, WRIST
AMPUTATION, WRIST
AMPUTATION, WRIST
AMPUTATION, TRANSMETACARPAL
AMPUTATION, TRANSMETACARPAL
AMPUTATION, TRANSMETACARPAL
UNLISTED PROCEDURE, FOREARM/WRIST
DRAINAGE, ABSCESS, FINGER TIP
DRAINAGE, ABSCESS, FINGER TIP
DRAINAGE, TENDON SHEATH, HAND
DRAINAGE, BURSA, PALMAR
DRAIN PALMAR BURSA MULTIPLE OR COMPLICATED
INCISION, HAND
DECOMPRESSION FINGER/HAND INJECTION INJURY
DECOMPRESS FASCIOTOMY HAND
FASCIOTOMY, PALMAR
FASCIOTOMY, PALMAR
TENDON SHEATH INCISION (EG, TRIGGER FINGER)
TENOTOMY, FINGER
ARTHROTOMY, HAND JOINTS
ARTHROTOMY, HAND JOINTS
ARTHROTOMY, HAND JOINTS
BIOPSY, SYNOVIAL, HAND JOINTS
BIOPSY, SYNOVIAL, HAND JOINTS
BIOPSY, SYNOVIAL, HAND JOINTS
1.5 CM OR GREATER
1.5 CM OR GREATER
EXCISION OF BENIGN TUMOR
EXCISION OF BENIGN TUMOR, DEEP, SUBFASCIAL, INTRMU
RADICAL RESECTION/TUMOR,SOFT TISSUE HAND OR FINGER
3 CM OR GREATER
FASCIECTOMY PALMAR WITH OR WITHOUT Z PLASTY
FACIECTOMY PARTIAL PALMAR EXCISION W/REALEASE SING
PARTIAL EXCISION RELEASE EACH ADD. DIGIT-ADD ON
SYNOVECTOMY, HAND JOINTS
SYNOVECTOMY, HAND JOINTS
SYNOVECTOMY, FINGER JOINTS
SYNOVECTOMY, TNDN SHEATH, HAND
EXCISN LSN,TNDN SHEATH HAND
EXCISION, TENDON, HAND
EXCISION, TENDON, HAND
SESAMOIDECTOMY, THUMB OR FINGER (SEPARATE PROCEDUR
EXCISION, CYST, METACARPAL
EXCISION, CYST, METACARPAL
EXCISION, CYST, PHALANX, FNGR
EXCISION, CYST, PHALANX, FNGR
EXCISION, PARTIAL, METACARPAL
EXCISION, PARTL, PHALANX, FNGR
EXCISION, PARTL, PHALANX, FNGR
OSTECTOMY, METACARPAL
OSTECTOMY, PHALANX, FINGER
RADICAL RESECTION FOR TUMOR DISTAL PHALANX OF FING
REMOVAL, IMPLANT, HAND
MANIPULATION, FINGER JOINT UNDER ANESTHESIA, EACH JOINT
REPAIR, TENDON, FINGER
REPAIR, TENDON, FINGER
FLEXOR TENDON REPAIR OR ADVANCEMENT, SINGLE PRIMA
FLEXOR TENDON REPAIR/ADVANCEMENT, SINGLE, SECOUND
FLEXOR TENDON REPAIR SECOUNDARY W/FREE GRAFT EA TE
PROFUNDUS TENDN REPR OR ADVANCEMNT W/INTACT SUBLIM
PROFUNDUS TENDON REPAIR SECOUNDARY W/FREE GRAFT
PROFUNDUS TENDON REPAIR/ADVANCEMENT W/SUBLIMIS SEC
EXCISION, FLEXOR TENDON, FINGR
GRAFT, TENDON, FINGER
REPAIR, TENDON, DORSUM
REPAIR, TENDON, DORSUM
EXTENSOR TENDON EXCISION IMPLANT PLASTIC TUBE/ROD
REMOVAL TUBE/ROD INSERT OF EXTENSOR TENDON GRAFT
REPAIR, TENDON, DORSUM
REPAIR, TENDON, DORSUM
REPAIR, CENTRAL SLIP
REPAIR, CENTRAL SLIP
MALLET FINGER OPERATION
EXSTENSOR TENDON REPAIR, DISTAL INSERTON (MALLET F
MALLET FINGER OPERATION
EXTENSOR TENDON REALIGNMENT, HAND
TENOLYSIS, PALM
TENOLYSIS, PALM
TENOLYSIS, FINGER
TENOLYSIS, FINGER
TENOTOMY, PALM
TENOTOMY, PALM
TENOTOMY, PALM
TENODESIS, FINGER JOINT
TENODESIS, FINGER JOINT
TENDON LENGTHENING EXTENSOR HAND/FINGER SINGLE EA
TENDON SHORTENING EXTENSOR HAND/FINGER SINGLE EA
TENDON LENGTHENING FLEXOR HAND/FINGER SINGLE EACH
TENDON SHORTENING FLEXOR HAND/FINGER SINGLE EACH
TRANSPLANT, TENDON, HAND
TRANSPLANT, TENDON, HAND
TRANSPLANT, TENDON, HAND
TRANSPLANT, TENDON, HAND
OPPONENS PLASTY, HAND
OPPONENS PLASTY, HAND
OPPONENS PLASTY, HAND
OPPONENS PLASTY; OTHER METHODS
TENDON TRANSFER RESTORE INTRINSIC FUNCTION 4&5 FIN
TENDON TRANSFER TO RESTORE INTRINSIC FUNCTION 4 FI
CORRECTION CLAW FINGER, OTHER METHODS
TENDON PULLEY RECNSTRCTN, HND
TENDON PULLEY RECNSTRCTN, HND
THENAR MUSCLE RELEASE
CROSS INTRINSIC TRANSFER
CAPSULODESIS M-P JOINT STABILIZATION SINGLE DIGIT
CAPSULODESIS, FINGER JOINT
CAPSULODESIS, FINGER JOINT
CAPSULECTOMY, FINGER JOINT
CAPSULECTOMY, FINGER JOINT
ARTHROPLASTY, FINGER JOINT
ARTHROPLASTY, FINGER JOINT
ARTHROPLASTY, FINGER JOINT
ARTHROPLASTY, FINGER JOINT
RECNSTRCTN, LIGAMENT, FGR JNT
RECNSTRCTN, LIGAMENT, FGR JNT
REPAIR OF CALLATELAL LIGAMENT METACARPO-PHALANGEAL
RECNSTRCTN, LIGAMENT, FGR JNT
REPAIR NON-UNION, METACARPAL/PHALANX (IN.BONE GRAF
REPAIR/RECONSTRUCT, FINGER,VOLAR PLATE,INTERPHALAN
POLLICIZATION, FINGER
TOE-TO-HAND TRANSFER; GREAT TOE WRAP-AROUND W/BONE
TOE-TO-HAND TRANSFER; OTHER THAN GREAT TOE, SINGLE
TOE-TO-HAND TRANSFER; OTHER THAN GREAT TOE, DOUBLE
POSITIONAL CHANGE, FINGER
FREE TOE JOINT TRANSFER W/MICROVASCULAR ANASTOMOSI
REPAIR, SYNDACTLY, FINGERS
REPAIR, SYNDACTLY, FINGERS
REPAIR SYNDACTYLY EA WEB SPACE COMPLEX
OSTEOTOMY, FINGER
OSTEOTOMY, FINGER
OSTEOPLASTY TO LENGTHEN METACARPAL OR PHALANX
REPAIR, CLEFT HAND
RECONSTRUCTION SUPERNUMERARY DIGIT
REPAIR, MACRODACTLY
REPAIR INTRINSIC MUSCLES OF HAND
RELEASE, INTRINSIC MUSCLES OF HAND
EXCISION CONSTRICTING RING OF FINGER;MULT ZPLASTIE
FRACTURE, METACARPAL
FRACTURE, METACARPAL
TREATMENT CLOSED METACARPAL FRACTURE & MANIP & FIX
PERCUTANEOUS SKELETAL FIXATION METACARPAL FX EA BO
FRACTURE, METACARPAL
TREATMENT OF CARPOMETACARPAL DISLOCATION W/MANIPUL
FCTRE/DISLOC, CARPOMETACARPAL
FCTRE/DISLOC, CARPOMETACARPAL
FCTRE/DISLOC, CARPOMETACARPAL
FCTRE/DISLOC, CARPOMETACARPAL
FCTRE/DISLOC, CARPOMETACARPAL
TREAT CLOSED CARPOMETACARPAL DISLOC W/PURCUTANEOUS
FCTRE/DISLOC, CARPOMETACARPAL
OPEN TREAT OF C/O CARPOMETACARPAL DISLOC COMPLEX M
DISLOC, METACARPO-PHALANGEAL
DISLOC, METACARPO-PHALANGEAL
TREAT CLOSED METACARPOPHALANGEAL DISLOC, W/PINNING
DISLOC, METACARPO-PHALANGEAL
FRACTURE, PHALANX, FINGER
FRACTURE, PHALANX, FINGER
TRTMT OF UNSTABLE PHALANGEAL SHAFT FRACTURE, EACH
FRACTURE, PHALANX, FINGER
TREAT OF CLOSED ARTICULAR FX INVOLVING METACARPOPH
TREATMENT CLOSED ARTICULAR FRACTURE
OPEN TX/ARTICULAR FX,METACARPAL-PHALANGEAL OR IP J
FRACTURE, PHALANX, FINGER
FRACTURE, PHALANX, FINGER
OPEN TREAT CLOSED/OPEN DISTAL PHALANGEAL FX EACH
FRACTURE, PHALANX, FINGER
DISLC, INTPHALANGEAL JNT, FGR
TREATMT CLOSED INTERPHALANGEAL JT DISLOC W/ANESTHE
WITH PERCUTANEOUS PINNING
DISLC, INTPHALANGEAL JNT, FGR
ARTHROSCOPY SHOULDER, SURGICAL; CAPSULORRHAPHY
FUSION IN OPPOSITION, THUMB
ARTHRODESIS, CARPOMTCRPL JNT
ARTHRODESIS, CARPOMTCRPL JNT
ARTHRODESIS, CARPOMTCRPL JNT
ARTHRODESIS, CARPOMTCRPL JNT
ARTHRODESIS, METCRPOPHALNGL JT
ARTHRODESIS, METCRPOPHALNGL JT
ARTHRODESIS, ITRPHLNGL JT, FGR
ARTHRODESIS INTERPHALANGEAL JNT W/WO INT FIX EA AD-ADD ON
ARTHRODESIS, ITRPHLNGL JT, FGR
ARTHRODESIS W/AUTOGRAFT, EACH ADDITIONAL JOINT-ADD ON
AMPUTATION, METACARPAL
AMPUTATION, FINGER/THUMB
AMPUTATION, FINGER/THUMB
DERMODESIS
DRAINAGE, ABSCESS, PELVIS
DRAINAGE, BURSA, HIP JOINT
INCISION, PELVIS
TENOTOMY,ADDUCTOR
TENOTOMY ABDUCTOR SUBCUTAN,OPEN
TENOTOMY, ADDUCTOR, SUBCUTANEOUS, OPEN
TENOTOMY, ILIOPSOAS
TENOTOMY, ABDUCTORS
OBER-YOUNG FASCIOTOMY-SPICA-PINS-WEDGINA
DECOMP FASCIOTOMY(IES), PELVIC (BUTTOCK) COMPARTMENT(S) (EG,GLUTEUS MIN/ MAX
ARTHROTOMY, HIP
ARTHROTOMY, HIP
DENERVATION, HIP JOINT
CAPSULECTOMY/OTOMY HIP, W/WO EXCISION OF BONE, W/R
BIOPSY, SOFT TISSUE OF PELVIS/HIP AREA;SUPERFICIAL
BIOPSY, SOFT TISSUES, DEEP
3 CM OR GREATER
5 CM OR GREATER
EXCISION OF TUMOR PELVIS, HIP AREA SUBQ
EXCISION, TUMOR, HIP
RADICAL RESECTION TUMOR,SOFT TISSUE PELVIS/HIP
BIOPSY, SACROILIAC JOINT
BIOPSY, HIP JOINT
BIOPSY, HIP JOINT
DECOMP FASCIOTOMY/PELVIC COMPRTMNT GLUTEUS MIN/MAX, ILIOPSOAS, UNILAT
5 CM OR GREATER
EXCISION, ISCHIAL BURSA
EXCISION, TROCHANTERIC BURSA
EXCISION, CYST, PELVIS
EXCISION, CYST, PELVIS
EXCISION OF BONE CYST/BENIGN TUMOR W/AUTOGRAFT
EXCISION, PARTIAL, ILIUM WING
EXCISION, PARTIAL, ILIUM WING
RESECTION, HIP
ILIUM,INCLUDE ACETABULUM,PUBIC RAMI,ISCHIUM,ACETA.
INNOMINATE BONE, TOTAL
RAD RESECT TUMOR/ISCHIAL TUBEROSITY-GREAT TROCHANT
COCCYGECTOMY-PRIMARY
REMOVAL FB PELVIS OR HIP SUBCUTANEOUS TISSUE
REMOVAL, FOREIGN BODY, HIP
REMOVAL, HIP IMPLANT
REMOVAL HIP PROSTHESIS COMPLICATED INC TOTAL HIP
INJ PROCEDURE HIP ARTHROGRAPHY WO/ANESTHESIA
ARTHROGRAPHY HIP INJ PROCEDURE W/ANESTHESIA
INJECTION FOR SACROILIAC JOINT ARTHROGRAPHY
HAMSTRING RECESSION
ADDUCTOR TRANSFER
TRANSFER, MUSCLE, OBLIQUE
TRANSFER, MUSCLE, PARASPINAL
TRANSFER, ILIOPSOAS
TRANSFER,ILIOPSOAS
ACETABULOPLASTY
ACETABULOPLASTY
ARTHROPLASTY, PROSTHESIS
TOTAL HIP REPLACEMENT
CONVERSION OF PREV HIP SURG TO TOTAL HIP REPLCMT
REVISION TOTAL HIP ARTHROPLASTY, BOTH COMPONENTS
REVISION TOTAL HIP ACETABULAR COMPONENT ONLY
REVISION TOTAL HIP ARTHROPLASTY,FEMORAL COMPONENT
OSTEOTOMY, GREATER TROCHANTER
OSTEOTOMY, ILIAC/ACETABULAR
OSTEOTOMY, ILIAC/ACETABULAR
OSTEOTOMY ILIAC ACETABULAR W/FEMORAL OSTEOTOMY
OSTEOTOMY ILIAC W/FEMORAL OSTEOTOMY W/OPEN RED HIP
OSTEOTOMY, PELVIS
OSTEOTOMY, FEMORAL NECK
OSTEOTOMY, INTERTROCHANTERIC
GRAFT, FEMORAL/TROCHANTERIC
SLIPPED EPIPHYSIS, FEMORAL
SLIPPED EPIPHYSIS, FEMORAL
REDUCTION, SLIPPED EPIPHYSIS
REDUCTION, SLIPPED EPIPHYSIS
HEYMAN PROCEDURE
SLIPPED EPIPHYSIS, FEMORAL
EPIPHYSEAL ARREST, TROCHANTER
PROPHYLACTIC TREATMENT, FEMORAL NECK/PROX. FEMUR
CLOSED TRTMENT OF PELVIC RING FRACTURE W/OUT MANIN
CLOSED TREAT PELVIC RING FX W/MANIP REQUIRING ANES
FRACTURE, COCCYX
OPEN TREATMENT OF CLOSED/OPEN COCCYGEAL FRACTURE
OPEN TREAT ILIAC SPINES TUBEROSITY AVULSION-WING
PERCUTANEOUS SKELETAL FIXATION/POSTERIOR PELVIC RI
OPEN TREAT ANTERIOR RING FX DISLOC W/INTERNAL FIXA
OPEN TREAT POSTERIOR RING FX W/INTERNAL FIXATION
FRACTURE, ACETABULUM
FRACTURE, ACETABULUM
OPEN TREAT ACETABULAR WALL FX W/INTERNAL FIXATION
OPEN TREATMENT ACETABULAR FX W/INTERNAL FIXATION
OPEN TREAT ACETABULAR FX 2 COLUMNS W/INTERNAL FIXA
FRACTURE, FEMUR
FRACTURE, FEMUR
FRACTURE, FEMUR
FRACTURE, FEMUR
FRACTURE, INTERTROCHANTERIC
FRACTURE, INTERTROCHANTERIC
FRACTURE, INTERTROCHANTERIC
OPEN TREAT FEMORAL FX W/INTRAMEDULLARY IMPLANT
FRACTURE, GREATER TROCHANTER
FRACTURE, GREATER TROCHANTER
DISLOCATION, HIP
DISLOCATION, HIP
DISLOCATION, HIP
DISLOCATION, HIP
DISLOCATION, HIP
DISLOCATION, HIP
DISLOCATION, HIP
OPEN TREAT CONGENITAL HIP W/FEMORAL SHAFT SHORTENI
TREATMENT ATRAUMATIC HIP DISLOCATION W/O ANETHESIA
TREATMENT OF ATRAUMATIC HIP DISLOCATION
CLOSED TREATMENT OF FEMORAL FRACTURE, PROXIMAL END, HEAD; W/O MANIPULATION
CLOSED TREATMENT OF FEMORAL FRACTURE, PROXIMAL END, HEAD; W/MANIPULATION
OPEN TREATMENT OF FEMORAL FRACTURE, PROXIMAL END, HEAD, INCL INTERNAL FIXATION
MANIPULATION, HIP JOINTS
ARTHRODESIS, SACRO-ILIAC JOINT
ARTHRODESIS, SYMPHYSIS PUBIS
ARTHRODESIS, HIP JOINT
ARTHRODESIS, HIP JOINT
INTERPELVIABDOMINAL AMPUTATION (HINDQUARTER)
DISARTICULATION, HIP
UNLISTED PROCEDURE, PELVIS OR HIP JOINT
INCISION/DRAINAGE DEEP ABSCESS KNEE/THIGH
INCISION DEEP W/OPENING BONE CORTEX FEMUR OR KNEE
FASCIOTOMY, ILIO-TIBIAL
TENOTOMY, DISTAL HAMSTRING
TENOTOMY, DISTAL HAMSTRING
ARTHROTOMY, KNEE
BIOPSY, SOFT TISSUE THIGH OR KNEE AREA; SUPERFICIAL
BIOPSY SOFT TISSUE DEEP THIGH OR KNEE
NEURECTOMY, HAMSTRING MUSCLE
NEURECTOMY, POPLITEAL (GASTROCNEMIUS)
EXCISION TUMOR THIGH OR KNEE SUBCUTANEOUS
EXCISION TUMOR THIGH OR KNEE DEEP SUBFASCIAL
RADICAL RESECTION OF TUMOR/SOFT TISSUE THIGH OR KN
ARTHROTOMY, KNEE
ARTHROTOMY, KNEE
ARTHROTOMY, KNEE
ARTHROTOMY, KNEE
ARTHROTOMY, KNEE
ARTHROTOMY, KNEE
3 CM OR GREATER
5 CM OR GREATER
EXCISION, BURSA, PREPATELLAR
EXCISION, CYST, POPLITEAL
EXCISION OF LESION OF MENISCUS OR CAPSULE, KNEE
PATELLECTOMY
EXCISION, CYST, FEMUR
EXCISION BONE CYST BENIGN TUMOR FEMUR W/ALLOGRAFT
EXCISION, CYST, FEMUR
EXCISION/CURETTAGE BONE CYST/BENIGN TUMOR OF FEMUR-ADD ON
EXCISION, PARTIAL, FEMUR
5 CM OR GREATER
RESECTION, FEMUR
ARTHROGRAPHY, KNEE, INJECTION
REMOVAL FB DEEP THIGH/KNEE
SUTURE, TENDON, INFRAPATELLAR
SUTURE INFRAPATELLAR TENDON SECOUNDARY INC TENDON
SUTURE, MUSCLE, QUADRICEPS
SUTURE, MUSCLE, QUADRICEPS
TENOTOMY, HAMSTRING
TENOTOMY, HAMSTRING
TENOTOMY, HAMSTRING,KNEE-HIP,MULTIPLE, BILATERAL
LENGTHENING, TENDON, HAMSTRING
LENGTHENING, TENDON, HAMSTRING
LENGTHENING OF HAMSTRING TENDON MULT. BILATERAL
TRANSPLANT, TENDON, HAMSTRING
TRANSPLANT, TENDON, HAMSTRING
TRANSFER, MUSCLE, HAMSTRING
ARTHROTOMY W/OPEN MENISCUS REPAIR
REPAIR, LIGAMENT, KNEE
REPAIR, LIGAMENT, KNEE
REPAIR, LIGAMENT, KNEE
OSTEOCHONDRAL ALLOGRAFT, KNEE, OPEN
OSTEOCHONDRAL AUTOGRAFT(S), KNEE, OPEN (INCL HARVESTING OF AUTOGRAFT[S])
ANTERIOR TIBIAL TUBERCLEPLASTY-CRONDROMALICIA PAT
RECONSTRUCTION, PATELLA
RECONSTRUCTION, PATELLA
RECONSTRUCTION, PATELLA
LATERAL RETINACULAR RELEASE (ANY METHOD)
LIGAMENT RECONSTRUCTION KNEE EXTRA ARTICULAR
RECONSTRUCTION KNEE INTRAARTICULAR (OPEN)
RECONSTRUCTION KNEE INTRA AND EXTRA ARTICULAR
QUADRICEPSPLASTY
CAPSULOTOMY, KNEE
ARTHROPLASTY PATELLA
ARTHROPLASTY PATELLA W/PROSTHESIS
ARTHROPLASTY, KNEE, TIBIAL PLATEAU
ARTHROPLASTY W/DEBRIDEMENT AND PARTIAL SYNOVECTOMY
ARTHROPLASTY, KNEE, FEMORAL CONDYLES OR TIBIAL PLA
ARTHROPLASTY W/DEBRIDEMENT & PARTIAL SYNOVECTOMY
ARTHROPLASTY KNEE CONSTRAINED PROSTHESIS
ARTHROPLASTY KNEE CONDYLE/PLATEAU MEDIAL/LATERAL C
TOTAL KNEE REPLACEMENT
OSTEOTOMY, FEMUR
OSTEOTOMY, FEMUR
OSTEOTOMY, FEMUR
OSTEOTOMY, PROXIMAL TIBIA
OSTEOTOMY, PROXIMAL TIBIA
OSTEOPLASTY, FEMORAL
OSTEOPLASTY, FEMORAL
OSTEOPLASTY, FEMORAL
REPAIR, MALUNION, FEMUR
REPAIR, MALUNION, FEMUR
EPIPHYSEAL ARREST, FEMUR
EPIPHYSEAL ARST, TIBIA & FIBLA
EPIPHYSEAL ARREST, KNEE
HEMI-EPIPHYSEAL ARREST, LEG
RIVISION TOTAL KNEE ARTHROPLASTY
REVISION TOTAL KNEE W/WO ALLOGRAFT ALL COMPONENTS
REMOVAL KNEE PROSTHESIS INCL TOTAL KNEE
PROPHYLACTIC TREATMENT W OR W/O METHYL METHACRYLAT
DECOMPRESSION FASCIOTOMY THIGH/KNEE ONE COMPARTMEN
DECOMPRESS FASCIOTOMY THIGH W/DEBRIDEMENT NONVIABL
DECOMPRESSION FASCIOTOMY HIGH MULIT COMPARTMENTS
DECOMPRESS FASCIOTOMY THIGH W/DEBRIDE NONVIABLE NE
FRACTURE, FEMUR
CLOSED TREAT SUPRACONDYLAR FEMORAL FX WO/MANIPULAT
FRACTURE, FEMUR
CLOSED TREAT SUPRACONDYLAR FEMORAL FX W/WO INTERCO
FRACTURE, FEMUR
OPEN TREAT FEMORAL SHAFT FX W/PLATE SCREWS W/WO CE
FRACTURE, FEMUR
PERCUTANEOUS SKELETAL FIXATION SUPRACONDYLAR FEMOR
FRACTURE, FEMUR
OPEN TREAT FEMORAL SUPRACONDYLAR/TRANSCONDYLAR FX
OPEN TREAT FEMORAL SUPRACONDYLAR FX W/INT FIXATION
FRACTURE, FEMUR
FRACTURE, FEMUR
FRACTURE, FEMUR
FRACTURE, FEMUR
FRACTURE, PATELLA
FRACTURE, PATELLA
CLOSED FRACTURE, TIBIA W/O MANIPULATION
FRACTURE, TIBIA
OPEN TREAT TIBIAL FX PROXIMAL UNICONDYLAR
FRACTURE, TIBIA
FRACTURE, TIBIA
FRACTURE, TIBIA
DISLOCATION, KNEE
DISLOCATION, KNEE
DISLOCATION, KNEE
OPEN TREAT KNEE DISLOC W/PRIMARY LIGAMENTOUS REPAI
O TREAT KNEE DISLOC W/PRIME LIGAMENT REPAIR W/AUGM
TREAT CLOSED PATELLAR DISLOCATION WO/ANESTHESIA
DISLOCATION, PATELLA
DISLOCATION, PATELLA
MANIPULATION, KNEE JOINT
FUSION, KNEE
AMPUTATION, THIGH
AMPUTATION THIGH IMM FITTING TECHNIQUE INC 1ST CAS
AMPUTATION, THIGH
AMPUTATION, THIGH
AMPUTATION, THIGH
DISARTICULATION, KNEE
UNLISTED PROCEDURE, FEMUR OR KNEE
DECOMPRESSION FASCIOTOMY LEG
DECOMPRESSION FASCIOTOMY,LEG; POSTERIOR COMP. ONLY
FASCIOTOMY, LEG
INCISION/DRAIN LEG/ANKLE DEEP ABSCESS OR HEMATOMA
INCISION/DRAIONAGE LEG/ANKLE DEEP INFECTED BURSA
TENOTOMY, ACHILLES TENDON
TENOTOMY, ACHILLES TENDON
INCISION DEEP W/OPENING BONE CORTEX LEG/ANKLE
ARTHROTOMY, ANKLE
ARTHROTOMY, ANKLE
BIOPSY,SOFT TISSUE OF LEG/ANKLE AREA, SUPERFICIAL
BX SOFT TISSUES, DEEP
RADICAL RECESTION OF TUMOR,SOFT TISSUE LEG/ANKLE
5 CM OR GREATER
EXCISION, BENIGN TUMOR, SUBCUTANEOUS
EXCISION, TUMOR, LEG OR ANKLE AREA; SUBCUTANEOUS
ARTHROTOMY, ANKLE
ARTHROTOMY, ANKLE
ARTHROTOMY, INCLUDING TENOSYNOVECTOMY
EXCISION, LESION, LEG
3 CM OR GREATER
5 CM OR GREATER
EXCISION, CYST, TIBIA/FIBULA
EXCISION, CYST, TIBIA/FIBULA
EXCISION/CURETTAGE BONE CYST/BENIGN TUMOR W/GRAFT
EXCISION, PARTIAL, TIBIA
EXCISION, PARTIAL, FIBULA
RESECTION, TIBIA
RESECTION, FIBULA
RESECTION, ASTRAGALUS
ARTHROGRAPHY, ANKLE, INJ PCDRE
REPAIR, ACHILLES TENDON
REPAIR RUPTURED ACHILLES TENDON; WITH GRAFT
REPAIR, ACHILLES TENDON
REPAIR, FASCIAL DEFECT, LEG
REPAIR, TENDON, LEG
REPAIR, TENDON, LEG
REPAIR OF EXTENSOR TENDON OF LEG PRIM W/O GRAFT EA
SECONDARY WITH OR W/O GRAFT, SINGLE TENDON, EACH
REPAIR DISLOCATING PERONAL TENDON W/OUT FIB OSTE
REPAIR, TENDON, LEG
TENOLYSIS, LEG
TENOLYSIS, LEG
LENGTHEN/SHORTEN TENDON, LEG OR ANKLE; SINGLE
LENGTHEN/SHORTEN TENDON, LEG
GASTROCNEMIUS RECESSION
TRANSFER, TENDON, LEG
TRANSFER, TENDON, LEG
TRANSFER, TENDON, LEG-ADD ON
REPAIR, LIGAMENT, ANKLE
REPAIR, LIGAMENT, ANKLE
REPAIR, LIGAMENT, ANKLE
ARTHROPLASTY, ANKLE
ARTHROPLASTY, ANKLE; WITH IMPLANT
ARTHROPLASTY, ANKLE-SECONDARY RECONSTRUCTION
REMOVAL OF ANKLE IMPLANT
OSTEOTOMY, TIBIA
OSTEOTOMY, FIBULA
OSTEOTOMY, TIBIA/FIBULA
OSTEOTOMY, TIBIA
OSTEOPLASTY, TIBIA/FIBULA
REPAIR, MALUNION, TIBIA
REPAIR, MALUNION, TIBIA
REPAIR, MALUNION, TIBIA
REPAIR, MALUNION, TIBIA
REPAIR OF FIBULA NONUNION AND/OR MALUNION WITH INTERNAL FIXATION
REPAIR, PSEUDARTHROSIS, TIBIA
EPIPHYSEAL ARREST, LOWER LEG
EPIPHYSEAL ARREST, LOWER LEG
EPIPHYSEAL ARREST, LOWER LEG
EPIPHYSEAL ARREST, LOWER LEG
EPIPHYSEAL ARREST, LOWER LEG
PROPHYLACTIC TREATMENT, TIBIA
FRACTURE, TIBIA
FRACTURE, TIBIA
FRACTURE, TIBIA
OPEN CLOSED TRIMENT TIBIAL SHAFT EX
OPEN TREAT TIBIAL SHAFT FX BY INTRAMEDULLARY
CLOSED FRACTURE MEDIAL MALLEOLUS FRACTURE, W/O MANIPULATION
FRACTURE, TIBIA
FRACTURE, TIBIA
CLOSED TREATMENT OF POSTERIOR MALLEOLUS FRACTURE; WITHOUT MANIPULATION
CLOSED TREATMENT OF POSTERIOR MALLEOLUS FRACTURE; W/MANIPULATION
OPEN TREATMENT OF POSTERIOR MALLEOLUS FRACTURE, INCL INTERNAL FIXATION
FRACTURE, FIBULA
FRACTURE, FIBULA; WITH MANIPULATION
FRACTURE, FIBULA
FRACTURE, FIBULA
FRACTURE, FIBULA
OPEN TREATMENT DISTAL FIBULAR FRACTURE W/WO FIX.
FRACTURE, TIBIA AND FIBULA
FRACTURE, TIBIA AND FIBULA
FRACTURE, TIBIA AND FIBULA
TREAT CLOSED TRIMALLEOLAR ANKLE WO/MANIPULATION
FRACTURE, TIBIA AND FIBULA
FRACTURE, TIBIA AND FIBULA
FRACTURE, TIBIA AND FIBULA
CLOSED TREAT WEIGHT BEARING ARTICULAR PORTION DIST
W/SKELETAL TRACTION OR REQUIRING MANIPULATION
OPEN TREAT FX WT BEARING ARTICULAR SURFACE PORTION
FRACTURE AND/OR DISLOCATION OF TIBIA ONLY
OF BOTH TIBIA AND FIBULA
OPEN TREAT DISTAL TIBIOFIBULAR JOINT
DISLOCATION, TIBIO-FIBULAR JNT
TREATMENT PROXIAML TIBIOFIBULAR JOINT DISLOC W/ANE
DISLOCATION, TIBIO-FIBULAR JNT
DISLOCATION, ANKLE
DISLOCATION, ANKLE
DISLOCATION, ANKLE
DISLOCATION, TIBIO-FIBULAR JNT
MANIPULATION, ANKLE
ARTHRODESIS, ANKLE
ARTHRODESIS TIBIOFIBULAR JOINT PROXIMAL OR DISTAL
AMPUTATION, LEG
AMPUTATE LEG W/FITTING INCL. APP. OF 1ST CAST
AMPUTATION LEG THRU TIBIA & FIBULA OPEN CIRCULAR
AMPUTATION, LEG
AMPUTATION, LEG
AMPUTATION, ANKLE
DISARTICULATION, ANKLE
DECOMPRESSION FASCIOTOMY LEG ANTERIOR LATERAL COMP
POSTERIOR COMPARTMENTS ONLY W/DEBRIDEMENT NONVIABL
ANTERIOR AND LATERAL COMPARTMENTS
UNLISTED PROCEDURE, LEG/ANKLE
DRAINAGE, BURSA, FOOT
DEEP DISSECTION BELOW FASCIA FOR DEEP INFECTION FO
DEEP DISSECTION BELOW FASCIA DEEP FOOT MULTIPLE AR
INCISION, DEEP, W/OPENING OF BONE CORTEX
FASCIOTOMY FOOT-TOE
TENOTOMY, TOE
TENOTOMY, TOE
ARTHROTOMY, TOE JOINTS
ARTHROTOMY, TOE JOINTS
ARTHROTOMY, TOE JOINTS
TARSAL TUNNEL RELEASE
1.5 CM OR GREATER
1.5 CM OR GREATER
EXCISION TUMOR FOOT SUBCUTANEOUS
EXCISION, TUMOR, FOOT
RADICAL RESECTION OF TUMOR, SOFT TISSUE OF FOOT
3 CM OR GREATER
ARTHROTOMY, FOOT JOINT
ARTHROTOMY, FOOT JOINT
ARTHROTOMY, FOOT JOINT
NEURECTOMY, INTRINSIC MUSCULATURE OF FOOT
FASCIECTOMY, PLANTAR
FASCIECTOMY EXCISION OF PLANTAR FASCIA RADICAL
SYNOVECTOMY, FOOT JOINTS
SYNOVECTOMY, FOOT JOINTS
EXCISION, MORTONS NEUROMA
SYNOVECTOMY, FOOT TENDONS
SYNOVECTOMY, FOOT TENDONS
EXCISION, LESION, FOOT
EXCISION LESION OF TENDON OR FIBROUS SHEATA TOES
EXCISION, TUMOR, FOOT BONES
EXCISION, TUMOR, FOOT BONES
EXCISION OF BONE CYST/BENIGN TUMOR W/ALLOGRAFT
EXCISION, TUMOR, FOOT BONES
EXCISION, TUMOR, FOOT BONES
EXCISION BONE CYST TARSAL/METATARSAL W/ALLOGRAFT
EXCISION, TUMOR, FOOT BONES
OSTECTOMY PARTIAL EXCISION FIFTH METATARSAL HEAD
OSTECTOMY, METATARSAL
OSTECTOMY, METATARSAL
OSTECTOMY COMPLETE 5TH METATARSAL HEAD
OSTECTOMY, METATARSAL
EXCISION, TARSAL COALITION
EXCISION, OS CALCIS
EXCISION, OS CALCIS
EXCISION, PARTIAL, FOOT BONES
EXCISION, PARTIAL, FOOT BONES
EXCISION, PARTL, PHALANX, TOE
CONDYLECTOMY, PHALANGEAL BASE, SINGLE TOE, EACH
ASTRAGALECTOMY
METATARSECTOMY, FOOT
PHALANGECTOMY, FOOT
RESECTION, HEAD OF PHALANX, TOE
HEMIPHALANGECTOMY, FOOT
RADICAL RESECTION FOR TUMOR TARSAL
RADICAL RESECTION FOR TUMOR METATARSAL
RADICAL RESECTION FOR TUMOR PHALANX OF TOE
REMOVE FOREIGN BODY; SUBCUTANEOUS
REMOVAL FB FOOT DEEP
REMOVAL FB FOOT COMPLICATED
REPAIR, TENDON, FOOT
REPAIR, TENDON, FOOT
REPAIR, TENDON, FOOT
REPAIR, TENDON, FOOT
TENOLYSIS, FOOT
TENOLYSIS, FOOT
TENOLYSIS, FOOT
TENOLYSIS, EXTENSOR, FOOT, MULTIPLE
TENOTOMY, FOOT
TENOTOMY, FOOT
TENOTOMY, FOOT
ADVANCEMENT, TENDON, FOOT
TENOTOMY, ABDUCTR HALLCS MSLE
DIVISION, PLANTAR FASCIA
CAPSULOTOMY, FOOT
CAPSULOTOMY, FOOT
CAPSULOTOMY, FOOT
CAPSULOTOMY, FOOT
CAPSULOTOMY, FOOT
CAPSULATOMY INTERPHALANGEAL JOINT, SINGLE, EACH
WEBBING OPERATION, TOES
ARTHRODESIS, INTRPHNGL JT, TOE
PLASTIC PROCEDURE, FIFTH TOE
EXOSTECTOMY, METATARSAL
HALLUX RIGIDUS CORRECT DEBRIDMENT CAPSULAR RELEASE; 1ST METATARSOPHALANGEAL JNT
HALLUX VALGUS CORRECTION
HALLUX VALGUS CORRECTION
HALLUX VALGUS CORRECTION
HALLUX VALGUS CORRECTION
HALLUX VALGUS CORRECTION
LAPIDUS PIPE PROCEDURE, BUNION CORRECTION
HALLUX VALGUS CORRECTION
OSTEOTOMY-HALLUS VALGUS
OSTEOTOMY, FOOT BONES
OSTEOTOMY, FOOT BONES
OSTEOTOMY, FOOT BONES
OSTEOTOMY, FOOT BONES
OSTEOTOMY, FOOT BONES
OSTEOTOMY FIRST METATARSAL W/AUTOGRAFT
OSTEOTOMY, FOOT BONES
OSTEOTOMY METATARSALS MULTIPLE
OSTEOTOMY, FOOT BONES
OSTEOTOMY, FOOT BONES
RECONSTRUCT ANGULAR DEFORMITY TOE (SOFT TISSUE)
SESAMOIDECTOMY, FIRST TOE
REPAIR, NON-UNION, FOOT BONES
REPAIR, NON-UNION, FOOT BONES
RECONSTRUCTION,TOE MACRODACTYLY;SOFT TISSUE RESECT
RECONSTRUCTION,TOE,MACRODACTYLY; W/BONE RESECTION
RECONSTRUCTION, TOE, MACRODACTYLY;SOFT TISSUE
RECONSTRUCTION, TOES; SYNDACTYLY
FRACTURE, OS CALCIS
FRACTURE, OS CALCIS
FRACTURE, OS CALCIS
FRACTURE, OS CALCIS
FRACTURE, OS CALCIS
FRACTURE, ASTRAGALUS
FRACTURE, ASTRAGALUS
TREAT CLOSED TALUS FX W/MANIP AND PERCUTANEOUS PIN
FRACTURE, ASTRAGALUS
OPEN OSTEOCHONDRAL AUTOGRAFT, TALUS (INCLUDES OBTAINING GRAFT[S])
FRACTURE, TARSAL BONES
FRACTURE, TARSAL BONES
TREAT CLOSED TARSAL BONE FX W/MANIP AND PERCUT PIN
FRACTURE, TARSAL BONES
FRACTURE, METATARSAL
FRACTURE, METATARSAL
TREATMENT OF CLOSED METATARSAL FRACTURE, EACH
FRACTURE, METATARSAL
FRACTURE, PHALANX, TOE
FRACTURE, PHALANX, TOE
CLOSED FX GT TOE W/MANIP AND PERCUTANEOUS PINNING
FRACTURE, PHALANX, TOE
FRACTURE, PHALANX, TOE
FRACTURE, PHALANX, TOE
FRACTURE, PHALANX, TOE
TREATMENT OF CLOSED SESAMOID FRACTURE
OPEN TREAT SESAMOID FX W/WO INTERNAL FIXATION
DISLOCATION, TARSAL BONE
DISLOCATION, TARSAL BONE
DISLOCATION, TARSAL BONE
DISLOCATION, TARSAL BONE
DISLOC, ASTRAGALO-TARSAL JOINT
DISLOC, ASTRAGALO-TARSAL JOINT
PERCUTANEOUS SKELETAL FIXATION TALOTARSAL JOINT DI
DISLOC, ASTRAGALO-TARSAL JOINT
DISLOC, TARSO-METATARSAL JOINT
DISLOC, TARSO-METATARSAL JOINT
DISLOC, TARSO-METATARSAL JOINT
DISLOC, TARSO-METATARSAL JOINT
DISLOC, METATARSO-PHLNGL JNT
DISLOC, METATARSO-PHLNGL JNT
PERCUTANEOUS SKELETAL FIXATION METATARSOPHALANGEAL
DISLOC, METATARSO-PHLNGL JNT
DISLOC, INTERPHLNGL JNT, TOE
CLOSED INTERPHALANGEAL JOINT DISLOCATION WITH ANES
PERCUTANEOUS SKELETAL FIXATION INTERPHALANGEAL JOI
DISLOC, INTERPHLNGL JNT, TOE
ARTHRODESIS, PANTALAR
TRIPLE ARTHRODESIS
ARTHRODESIS, SUBTALAR
ARTHRODESIS, MIDTARSAL
FLATFOOT CORRECTION
ARTHRODESIS, MIDTARSAL
ARTHRODESIS, MIDTARSAL OR TARSOMETATARSAL, SINGLE
ARTHRODESIS, GREAT TOE
ARTHRODESIS, GREAT TOE, INTERPHALAGEAL JOINT
ARTHRODESIS, INTERPHALANGEAL JOINT, W/TENDON TRANS
AMPUTATION, FOOT
AMPUTATION, FOOT
AMPUTATION, METATARSAL
AMPUTATION, TOE
AMPUTATION, TOE
EXTRACORPOREAL SHOCK WAVE, REQ ANESTHESIA, OTHER THAN LOCAL, PLANTAR FASCIA
UNLISTED PROCEDURE, FOOT OR TOES
APPLICATION OF HALO TYPE BODY CAST
RISSER JACKET
RISSER JACKET
TURNBUCKLE JACKET
TURNBUCKLE JACKET
BODY CAST
MINERVA CAST
BODY CAST
BODY CAST
PLASTER FIGURE OF 8
SHOULDER SPICA
VELPEAU CAST
LONG ARM CAST
SHORT ARM CAST
GAUNTLET CAST
FINGER, APPLICATION, CAST
SPLINTS,LONG ARM
SPLINTS, SHORT ARM
APPLICATION OF SHORT ARM SPLINT (FOREARM), DYNAMIC
APPLICATION OF FINGER SPLINT; STATIC
APPLICATION OF FINGER SPLINT; DYNAMIC
STRAPPING, THORAX
STRAPPING, SHOULDER (E.G. VELPEAU)
STRAPPING, ELBOW OR WRIST
STRAPPING, HAND OR FINGER
HIP SPICA
HIP SPICA
LONG LEG CAST
LONG LEG CAST
LONG LEG CAST BRACE
CYLINDER CAST
SHORT LEG CAST
SHORT LEG CAST
PTB CAST
CAST WALKER
APPLICATION OF RIGID TOTAL CONTACT LEG CAST
CLUB FOOT CAST
SPLINTS, LOWER EXTREMITY
SPLINTS, LOWER EXTREMITY
STRAPPING HIP
STRAPPING KNEE
STRAPPING ANKLE - ANY AGE
STRAPPING TOES
UNNA BOOT
APPLICATION OF MULTI-LAYER VENOUS WOUND COMPRESSION SYSTEM, BELOW KNEE
DENIS-BROWNE SPLINT STRAPPING
CAST REPAIR OR REMOVAL
REMOVAL OR BIVALVING FULL ARM OR FULL LEG CAST
CAST REPAIR OR REMOVAL
CAST REPAIR OR REMOVAL
CAST REPAIR OR REMOVAL
CAST REPAIR OR REMOVAL
CAST REPAIR OR REMOVAL
CAST REPAIR OR REMOVAL
BODY STRAPPING
ARTHROSCOPY,TMJ,DIAGNOSTIC W-W/O SYNOVIAL BIOPSY
ARTHROSCOPY, TMJ, SURGICAL
ARTHROSCOPY SHOULDER, DIAGNOSTIC, W/-W/O SYNOVIAL BIOPSY
ARTHROSCOPY SHOULDER/SURGICAL/CAPSULORRHAPHY
ARTHROSCOPY, SHOULDER, SURGICAL; REPAIR OF SLAP LESION
ARTHROSCOPY SHOULDER SURG W/REMOVAL LOOSE BODY
ARTHROSCOPY, SYNOVECTOMY, PARTIAL
SYNOVECTOMY COMPLETE
ARTHROSCOPY SHOULDER DEBRIDEMENT LIMITED
ARTHROSCOPY SHOULDER SURGICAL DEBRIDEMENT EXTENSIV
ARTHROSCOPY, SHOULDER SURGICAL; DISTAL CLAVICULECTOMY INC. DISTAL ARTICULAR
ARTHROSCOPY,SHOULDER W/LYSIS & RESECT W/W/O MANIPU
ARTHROSCOPY SHOULDER DECOMPRESSION
ARTHROSCOPY - SHOULDER, SURGICAL WITH ROTATOR CUFF REPAIR
ARTHROSCOPY, SHOULDER, SURGICAL; BICEPS TENODESIS
ARTHROSCOPY ELBOW DIAGNOSTIC
ARTHROSCOPY,ELBOW,SURGICAL;REMOVE FOREIGN BODY
ARTHROSCOPY ELBOW SURG SYNOVECTOMY PARTIAL
ARTHROSCOPY,ELBOW,SURGICAL;SYNOVECTOMY,COMPLETE
ARTHROSCOPY,ELBOW,SURGICAL;DEBRIDEMENT, LIMITED
DEBRIDEMENT EXTENSIVE
ARTHROSCOPY WRIST DIAGNOSTIC
ARTHROSCOPY WRIST SURG FOR INFECTION
ARTHROSCOPY, SNYOVECTOMY, PARTIAL
SYNOVECTOMY COMPLETE
ARTHROSCOPY, WRIST, EXCISION FIBROCARTILAGE/JOINT
ARTHROSCOPY,WRIST,SURGICAL;INTERNAL FIXATION FX
ARTHROSCOPY WRIST SURG/W/RELEASE TRANSVERSE CARPAL
ARTHROSCOPICALLY AIDED TREAT INTERCONDYLAR SPINES
ARTHROSCOPICALLY AID TREAT W/INTERNAL/EXTERNAL FIX
ARTHROSCOPICALLY AIDED TXOF TIBIAL FX,PROXIMAL;UNI
BICONDYLAR,W/WO INTERNAL OR EXTERNAL FIXATION
ARTHROSCOPY, HIP, DIAGNOSTIC W/W/O SYNOVIAL BIOPSY (SEPERATE PROCEDURE)
ARTHOSCOPY, HIP, SURGICAL WITH REMOVAL OF LOOSE BODY OR FOREIGN BODY
ARTHOSCOPY,HIP,SURGICAL; W/DEBRIDEMENT/SHAVING CARTILAGE,ABRASION ARTHROPLASTY
ARTHROSCOPY, HIP, SURGICAL; WITH SYNOVECTOMY
ARTHROSCOPY, KNEE, SURGICAL; OSTEOCHONDRAL AUTOGRAFT(S) (EG, MOSAICPLASTY)
ARTHROSCOPY, KNEE, SURGICAL; OSTEOCHONDRAL ALLOGRAFT (EG, MOSAICPLASTY)
ARTHROSCOPY, KNEE, SURGICAL; MENISCAL TRANSPLANTATION, MEDIAL OR LATERAL
ARTHROSCOPY KNEE DIAGNOSTIC W/WO SYNOVIAL BIOPSY
ARTHROSCOPY, KNEE SURGICAL FOR INFECTION, LAVAGE
ARTHROSCOPY - KNEE, SURGICAL WITH LATERAL RELEASE
ARTHROSCOPY KNEE FOR REMOVAL LOOSE & FOREIGN BODY
ARTHROSCOPY KNEE SYNOVECTOMY LTD PLICA/SHELF RESEC
ARTHROSCOPY KNEE SYNOVECTOMY MAJOR
ARTHROSCOPY KNEE DEBRIDEMENT/SHAVING ARTICULAR CAR
ARTHROSCOPY KNEE ABRASION ARTHROPLASTY MULT DRILL
ARTHROSCOPY KNEE SURGICAL WITH MENISCECTOMY MEDICA
ARTHROSCOPY KNEE W/MENISCECTOMY MEDIAL OR LATERAL
ARTHROSCOPY KNEE MENISCUS REPAIR MEDIAL OR LATERAL
ARTHROSCOPY WITH MENISCUS REPAIR
ARTHROSCOPY KNEE W/LYSIS OF ADHESIONS W/WO MANIPUL
DRILLING FOR OSTEOCONDRITIS DISSECANS
ARTHROSCOPY KNEE DRILLING FOR INTACT OSTEOCHRONDIT
ARTHROSCOPY KNEE DRILLING INTACT OSTEOCHONDRITIS
ARTHROSCOPICALLY AIDED ANTERIOR CRUCIATE LIGAMENT REPAIR OF KNEE
ARTHROSCOPICALLY AIDED POSTERIOR LIGAMENT REPAIR
ARTHROSCOPY,ANKLE,SURGICAL; EXCISION DEFECT OF TALUS AND/OR TIBIA,INC. DRILLING
ARTHROSCOPICALLY AIDED REPAIR OF LARGE LESION, TALAR DOME, OR TIBIAL FRACTURE
ENDOSCOPIC PLANTAR FASCIOTOMY
ARTHROSCOPY ANKLE TIBIOTALAR&FIBULOTALAR JOINTS
ARTHROSCOPY ANKLE SYNOVECTOMY PARTIAL
ARTHROSCOPY DEBRIDEMENT LIMITED
ARTHROSCOPY ANKLE TIB/FIB JOINT EXTENSIVE DEBRIDEM
ARTHROSCOPY - ANKLE, TIBIOTALAR JOINTS/ SURGICAL WIH ANKLE ARTHRODESIS
ARTHROSCOPY, METACARPOPHALANGEAL JOINT, DIAGNOSTIC INC. SYNOVIAL BIOPSY
ARTHROSCOPY, METACARPOPHALANGEAL JOINT SURGICAL W/ DEBRIDEMENT
ARTHROSCOPY, METACARPOPHALANGEAL W/REDUCTION ULNAR COLLATERAL LIGAMENT
ARTHROSCOPY, SUBTALAR JOINT, SURGICAL; W/REMOVAL OF LOOSE BODY/FOREIGN BODY
ARTHROSCOPY, SUBTALAR JOINT, SURGICAL; W/SYNOVECTOMY
ARTHROSCOPY, SUBTALAR JOINT, SURGICAL; WITH DEBRIDEMENT
ARTHROSCOPY, SUBTALAR JOINT, SURGICAL; W/SUBTALAR ARTHRODESIS
UNLISTED PROCEDURE, ARTHROSCOPY
DRAINAGE, ABSCESS, NOSE
DRAINAGE, ABSCESS, NASAL SEPTM
BIOPSY, INTRANASAL SOFT TISSUE
NASAL POLYP EXCISION
NASAL POLYP EXCISION
EXCISION/DESTRUCTION ANY METHOD INTERNAL APPROACH
EXCISION/DESTRUCTION ANY METHOD EXTERNAL APPROACH
EXCISION, SKIN NOSE
EXCISION, DERMOID CYST
EXCISION DERMOID CYST COMPLEX UNDER BONE/CARTILAGE
EXCISION, TURBINATE
RESECTION, TURBINATE
RHINECTOMY; PARTIAL
RHINECTOMY; TOTAL
INJECTION, TURBINATE
DISPLACEMENT THERAPY, NOSE
INSERT NASAL SEPTAL PROSTHESIS
REMOVAL FOREIGN BODY INTRANASL
REMOVAL FOREIGN BODY INTRANASL
REMOVAL FOREIGN BODY INTRANASL
RHINOPLASTY
RHINOPLASTY
RHINOPLASTY
RHINOPLASTY
RHINOPLASTY, SECONDARY INTERMEDIATE REVISION
RHINOPLASTY, MAJOR REVISION (NASAL TIP/OSTEOTOMY)
RHINOPLASTY FOR NASAL DEFORMITY SECONDARY TO CONGE
TIP, SEPTUM, OSTEOTOMIES
REPAIR OF NASAL VESTIBULAR STENOSIS
SEPTOPLASTY
REPAIR, CHOANAL ATRESIA
REPAIR, CHOANAL ATRESIA
LYSIS, SYNECHIA, INTRANASAL
REPAIR, FISTULA, OROMAXILLARY
REPAIR, FISTULA, ORONASAL
RECONSTRUCTION, INTERNAL NOSE
REPAIR NASAL SEPTAL PERFORATIONS
CAUTERIZATION MUCOSA OF TURBINATES ANY METHOD SUPE
CAUTERIZATION MUCOSA OF TURBINATES ANY METHOD INTR
SIMPLE CAUTERIZATION TO CONTROL NASAL HEMOR ANT UN
CONTROL NASAL HEMORRHAGE ANTERIOR, COMPLEX UNILAT
NASAL HEMORRHAGE CONTROL
NASAL HEMORHAGE CONTROL, SUBSEQUENT
LIGATION, ETHMOIDAL ARTERIES
LIGATION ARTERIES INTERNAL MAXILLARY ARTERY TRANSA
FRACTURE NASAL TRUBINATES THERAPEUTIC
UNLISTED PROCEDURE, NOSE
SINUS LAVAGE
SINUS LAVAGE
ANTROTOMY
ANTROTOMY
SINUSOTOMY RADICAL UNILAT W/REMOVAL ANTRACH POLYPS
PTERYGOMAXILLARY FOSSA SURGERY
SINUSOTOMY
SINUSOTOMY,SPHENOID,BIOPSY; W/MUCOSAL STRIP POLYPS
SINUSOTOMY
SINUSOTOMY
SINUSOTOMY
SINUSOTOMY
SINUSOTOMY
SINUSOTOMY
SINUSOTOMY;NONOBLITERATIVE,W/FLAPP,BROW INCISION
SINUSOTOMY;NONOBLITERATIVE,W/FLAP,CORONAL INCISION
SINUSOTOMY
ETHMOIDECTOMY
ETHMOIDECTOMY
ETHMOIDECTOMY
MAXILLECTOMY
MAXILLECTOMY
NASAL ENDOSCOPY, DIAGNOSTIC
NASAL/SINUS ENDOSCOPY,DIAGNOSTIC W/MAXILLARY SINUS
NASAL/SINUS ENDOSCOPY,DIAGNOSTIC W/SPHENOID SINUSO
NASAL/SINUS ENDOSCOPY W/BIOPSY,POLYPECTOMY OR DEBR
WITH CONTROL OF EPISTAXIS
WITH DACRYOCYSTORHINOSTOMY
WITH CONCHA BULLOSA RESECTION
NASAL ENDOSCOPY W/ETHMOIDECTOMY PARTIAL
NASAL ENDOSCOPY & ETHMOIDECTOMY
NASAL ENDOSCOPY WITH MAXILLARY ANTROSTOMY
MAXILLARY SINUS ENDOSCOPY DIAGNOSTIC OR BIOPSY
MAXILLARY SINUS ENDOSCOPY,SURGICAL;W/FOREIGN BODY
MAXILLARY ENDOSCOPY SURG W/REMOVAL OF MUCOUS MEMBR
SPHENOID ENDOSCOPY, DIAGNOSTIC, W/ W/O BIOPSY
SPHENOID ENDOSCOPY, SURGICAL
NASAL/SINUS ENDOSCOPY W/FRONTAL SINUS EXPLORATION
NASAL/SINUS ENDOSCOPY,SURGICAL WITH SPHENOIDOTOMY
WITH REMOVAL OF TISSUE FROM THE SPHENOID SINUS
NASAL/SINUS ENDOSCOPY,SURGICAL W/REPAIR OF CEREBRA
SPHENOID REGION
NASAL/SINUS ENDOSCOPY,SURGICAL,W/MEDIAL OR INFERIO
W/MEDIAL ORBITAL WALL & INFERIOR ORBITAL WALL DECO
WITH OPTIC NERVE DECOMPRESSION
UNLISTED SINUS PROCEDURE
LARYNGOTOMY
LARYNGOTOMY
LARYNGECTOMY
LARYNGECTOMY
LARYNGECTOMY
LARYNGECTOMY
HEMILARYNGECTOMY
HEMILARYNGECTOMY
HEMILARYNGECTOMY
HEMILARYNGECTOMY
PHARYNGOLARYNGECTOMY W/RADICAL NECK DISSECTION
PHARYNGOLARYNGECTOMY,W/RADICAL NECK DISSECTION/REC
ARYTENOIDECTOMY
EPIGLOTTIDECTOMY
INTUBATION, ENDOTRACHEAL, EMERGENCY PROCEDURE-(SP)
TRACHEOTOMI TUBE CHANGE
LARYNGOSCOPY
LARYNGOSCOPY
LARYNGOSCOPY, W/REMOVAL OF FOREIGN BODY
LARYNGOSCOPY, W/REMOVAL OF LESION
AMB SURG CTR -LARYNGOSCOPY INDIRECT SEP PROC DIAG
LARYNGOSCOPY
LARYNGOSCOPY
LARYNGOSCOPY
LARYNGOSCOPY-DIAGNOSTIC W/OPERATING MICROSCOPE
AMB SURG CTR -LARYNGOSCOPY
LARYNGOSCOPY, WITH DILATATION,INITIAL
LARYNGOSCOPY DIRECT, W/DILATION, SUBSEQUENT
LARYNGOSCOPY
LARYNGOSCOPY DIRECT;W/OPERATING MICROSCOPE
LARYNGOSCOPY
LARYNGOSCOPY DIRECT OPERATIVE W/BIOPSY&MICROSCOPE
LARYNGOSCOPY
LARYNGOSCOPY
LARYNGOSCOPY, DIRECT, OPERATIVE, WITH OPERATING MICROSCOPY OR TELESCOPE
LARYNGOSCOPY, DIRECT, OPERATIVE, W/ OPERATING MICRO/TELESCOPE; RECON W/ GRAFTS
LARYNGOSCOPY
LARYNGOSCOPY W/ARYTENOIDECTOMY W/MICROSCOPE
LARYNGOSCOPY
LARYNGOSCOPY W/INJECTION VOCAL CORDS & MICROSCOPE
LARYNGOSCOPY, FLEXIBLE FIBERSCOPIC, DIAGNOSTIC
LARYNGOSCOPY FLEXIBLE FIBERSCOPE DX WITH BIOPSY
LARYNGOSCOPY W/REMOVAL OF FOREIGN BODY
LARYNGOSCOPY, WITH REMOVALL OF LESION
LARNGOSCOY WITH STROBOSCOPY
LARYNGOPLASTY-2 STAGE, W/KEEL INSERTION & REMOVAL
LARYNGOPLASTY-FOR STENOSIS, W/GRAFT,MOLD,TRACHEOST
LARYNGOPLASTY; W/OPEN REDUCTION OF FRACTURE
LARYNGOPLASTY, CRICOID SPLIT
LARYNGOPLASTY, NOT OTHERWISE SPECIFIED
LARYNGEAL REINNERVATION NEUROMUSCULAR PEDICLE
SECTION RECURRENT LARYNGEAL NERVE, UNILATERAL
UNLISTED PROC, LARYNX
TRACHEOSTOMY
TRACHEOSTOMY
TRACHEOSTOMY, EMERGENCY PROCEDURE, TRANSTRACHEAL
TRACHEOSTOMY ER CRICOTHYROID MEMBRANE
TRACHEOSTOMY FENESTRATION PROCEDURE-SKIN FLAPS
CONSTR. OF T-E FISTULA&SUBSEQUENT PROSTHESIS
TRACHEAL PUNCTURE
TRACHEOSTROMA REV SIMPLE W/OUT FLAP ROTATION
TRACHEOSTOMA REVISION;COMPLEX, WITH FLAP ROTATION
TRACHEOBRONCHOSCOPY
ENDOBRONCHIAL UNTRASOUND (EBUS) DURING BRONCHO DIAG OR THERA INTERVEN (ADD-ON)
BRONCHOSCOPY,DIAGNOSTIC W/WO CELL WASHING OR BRUSH
BRONCHOSCOPY WITH BRUSHING OR PROTECTED BRUSHINGS
BRONCHOSCOPY WITH BRONCHIAL ALVEOLAR LAVAGE
BRONCHOSCOPY
WITH PLACEMENT OF FIDUCIAL MARKERS, SINGLE OR MULTIPLE
WITH COMPUTER-ASSISTED, IMAGE-GUIDED NAVIGATION (SP)
BRONCHOSCOPY WITH TRANSBRONCHIAL LUNG BX FIBEROPTI
BRONCHOSCOPY,DIAGNOSTIC W/TRANSBRONCHAIL BIOPSY
BRONCHOSCOPY W TRACHEAL/BRONCHIAL DILATION OR CLOSED REDUCTION OF FRACTURE
BRONCHOSCOPY W/PLACEMENT OF TRACHEAL STENTS INCLUDES TRACHEAL/BRONCHIAL DILATION
BRONCHOSCOPY, RIGID OR FLEXIBLE W/OR W/O FLUROSCOPIC GUIDANCE, (ADD-ON)
BRONCHOSCOPY, RIGID OR FLEX W/OR W/O FLUROS GUIDANCE; W/ NEEDLE ASPIR (ADD-ON)
BRONCHOSCOPY
BRONCHOSCOPY, RIGID OR FLEXIBLE, W/ PLACEMENT OF BRONCHIAL STENTS, INITIAL
BRONCHOSCOPY, RIGID OR FLEXIBLE, W/ PLACEMENT OF BRONCHIAL STENTS, EA ADDTL
BRONCHOSCOPY, RIGID OR FLEXIBLE, W/ PLACEMENT OF BRONCHIAL STENTS, W/ REVISION
BRONCHOSCOPY
W/DESTRUCTION TUMOR OR RELIEF STENOSIS ANY METHOD
BRONCHOSCOPY W/PLACEMENT OF CATHETERS FOR INTRACAVITARY RADIOELEMENT APPLICATION
BRONCHOSCOPY
BRONCHOSCOPY W/THERAPEUTIC ASPIRATION OF TREE, SUB
BRONCHOSCOPY WITH INJECTION OF CONTRAST MATERIL
BRONCHOGRAPHY INJECTION
BRONCHIAL BRUSH BIOPSY
ASPIRATION, NASOTRACHEOBRONCHIAL
ASPIRATION, TRACHEOBRONCHIAL
TRANSTRACHEAL INTRODUCTION NEEDLE WIRE DILATOR/STE
TRACHEOPLASTY
TRACHEOPHARYNGEAL FISTULIZATION, EACH STAGE
TRACHEOPLASTY
CARINAL RECONSTRUCTION
BRONCHOPLASTY
BRONCHOPLASTY EXCISION STENOSIS AND ANASTOMOSIS
TRACHEAL STENOSIS EXCISION
TRACHEAL STENOSIS EXCISION
EXCISION TRACHEAL TUMOR CANCER CERVICAL
EXCISION TRACHEAL TUMOR CANCER THORACIC
SUTURE TRACHEAL WOUND/INJURY; CERVICAL
SUTURE TRACHEAL WOUND/INJURY; INTRTHORACIC
SURG CLOSE TRACHEOSTOMY/FISTULA WO/PLASTIC REPAIR
TRACHEOSTOMY CLOSURE
REVISION, TRACHEOSTOMY SCAR
UNLISTED PROC TRACHEA/BRONCHI
THORACOSTOMY
THORACOSTOMY
THORACOTOMY
THORACOTOMY
THORACOTOMY
THORACOTOMY
THORACOTOMY; MAJOR WITH OPEN INTRAPLEURAL PNEUMONO
THORACOTOMY, MAJOR,WITH CYST REMOVAL W/WO PROCEDUR
THORACOTOMY
THORACOTOMY
THORACOTOMYW/REMOVAL INTRAPULMONARY FB
THORACOTOMYW/CARDIAC MASSAGE
PNEUMONOSTOMY
PNEUMONOSTOMY; W/PERCUTANEOUS DRAINAGE OF ABSCESS OR CYST
PLEURAL SCARIFICATION FOR REPEAT PNEUMOTHORAX
PULMONARY DECORTICATION
DECORTICATION PULMONARY, SEPARATE PROCEDURE/PARTIA
INSERTION OF INDWELLING TUNNELED PLEURAL CATHETER WITH CUFF
TUBE THORACOSTOMY, INCLUDES WATER SEAL WHEN PERFORMED (SEPARATE PROCEDURE)
PARIETAL PLEURECTOMY
DECORTICATION/PLEURECTOMY
BIOPSY, PLEURA, NEEDLE
BIOPSY PLEURA OPEN
BIOPSY, LUNG/PLEURA
PNEUMONOCENTESIS, PUNCTURE OF LUNG FOR ASPIRATION
THORACENTESIS, PUNCTURE OF PLEURAL CAVITY FOR ASPIRATION
THORACENTESIS WITH INSERTION OF TUBE, INCLUDES WATER SEAL
TOTAL PNEUMONECTOMY
W/RESECTION OF SEGMENT OF TRACHEA FOLLOWED BY BRON
PNEUMONECTOMY EXTRAPLEURAL WO/EMPYEMECTOMY
LOBECTOMY, LUNG
TWO LOBES
SINGLE SEGMENT
W/CIRCUMFERENTIAL RESECTION OF SEGMENT OF BRONCHUS
ALL REMAINING LUNG FOLLOWING PREVIOUS REMOVAL OF A
WEDGE RESECTION, SINGLE OR MULTIPLE OF LUNG
RESECTION/REPAIR PORTION OF BRONCHUS, ADD TO PRIMA-ADD ON
RESECTION/APICAL LUNG TUMOR INCL CHEST WALL W/O CHEST WALL RECONSTRUCTION
RESECTION/APICAL LUNG TUMOR INCL CHEST WALL WITH CHEST WALL RECONSTRUCTION
EXTRAPLEUAL ENUCLEATION
INSERTION OF INDWELLING TUNNELED PLEURAL CATHETER WITH CUFF
TUBE THORACOSTOMY, INCL WATER SEAL WHEN PERFORMED
REMOVAL OF INDWELLING TUNNELED PLEURAL CATHETER WITH CUFF
PLACEMENT OF INTERSTITIAL DEVICE(S) FOR RADIATION THERAPY GUIDANCE PERCUTANEOUS
CHEMICAL PLEURODESIS (EG, FOR RECURRENT OR PERSISTENT PNEUMOTHORAX)
INSTILLATION(S), VIA CHEST TUBE/CATHETER, AGENT FOR FIBRINOLYSIS; INITIAL DAY
INSTALLATION VIA CHEST TUBE, SUBSEQUENT DAY, ONLY ONCE
THORACOSCOPY,DIAGNOSTIC
LUNGS AND PLEURAL SPACE WITH BIOPSY
PERICARDIAL SAC, WITHOUT BIOPSY
PERICARDIAL SAC, WITH BIOPSY
MEDIASTINAL SPACE, WITH BIOPSY
MEDIASTINAL SPACE, WITHOUT BIOPSY
THOROSCOPY,SURGICAL;WITH PLEURODESIS,ANY METHOD
WITH PARTIAL PULMONARY DECORTCATION
WITH TOTAL PULMONARYT DECORTICATION
WITH REMOVAL OF INTRAPLEURAL FOREIGN BODY OR FIBRI
WITH CONTROL OF TRAUMATIC HEMORRHAGE
W/EXCISION-PLICATION OF BULLAE,INCLUDING ANY PLEUR
WITH PARIETAL PLEURECTOMY
W/WEDGE RESECTION OF LUNG,SINGLE OR MULTIPLE
W/REMOVAL OF CLOT OF FOREIGN BODY FROM PERICARDIAC
W/CREATION OF PERICARDIAL WINDOW
WITH TOTAL PERICARDECTOMY
WITH EXCISION OF PERICARDIAL CYST,TUMOR, OR MASS
WITH EXCISION OF MEDIASTINAL CYST,TUMOR, OR MASS
WITH LOBECTOMY, TOTAL OR SEGMENTAL
WITH THORACIC SYMPATHECTOMY
WITH ESOPHAGOMYOTOMY
REPAIR, HERNIA, LUNG
CLOSE CHEST WALL FOLLOWING OPEN FLAP DRAIN EMPYEMA
OPEN CLOSURE OF MAJOR BRONCHIAL FISTULA
MAJOR RECONSTRUCTION CHEST WALL (POSTTRAUMATIC)
DONOR PNEUMONECTOMY (INCLUDING COLD PRESERVATION) FROM CADAVER DONER
LUNG TRANSPLANT, SINGLE; WITHOUT CARDIOPULMONARY BYPASS
LUNG TRANSPLANT, SINGLE; WITH CARDIOPULMONARY BYPASS
LUNG TRANSPLANT, DOUBLE (BILATERAL SEQUENTIAL OR EN BLOC) W/O CARDIOPULM BYPASS
LUNG TRANSPLANT, DOUBLE (BILATERAL SEQUENTIAL OR EN BLOC) WITH CARDIOPULM BYPASS
BACKBENCH STANDARD PREP OF CADAVER DONOR LUNG ALLOGRAFT PRIOR TO TRANSPLANT
BACKBENCH STANDARD PREP OF CADAVER DONOR LUNG ALLOGRAFT; BILATERAL
RESECTION, RIBS, EXTRAPLEURAL
THORACOPLASTY SCHEDE TYPE OR EXTRAPLEURAL ALL STAG
THORACOPLASTY W/CLOSURE BRONCHOPLEURAL FISTULA
PNEUMONOLYSIS
PNEUMOTHORAX
TOTAL LUNG LAVAGE, UNILATERAL
ABLATION THERAPY FOR REDUCTION/ERADICATION OF 1/MORE PULMONARY TUMOR(S), UNILAT
UNLISTED PROCEDURE, LUNGS AND PLEURA
PERICARDIOCENTESIS
PERICARDIOCENTESIS
TUBE PERICARDIOSTOMY
PERICARDIOTOMY
PERICARDIAL WINDOW RESECTION
RESECTION, PERICARDIUM
PERICARDIECTOMY SUBTOTAL COMPLETE WITH BYPASS
EXCISION, CYST, PERICARDIAL
CARDIAC TUMOR RESECTION
CARDIAC TUMOR RESECTION
TRANSMYOCARDIAL LASER REVASCULARIZATION, BY THORACOTOMY
TRANSMYOCARDIAL REVASCULARIZATION AT TIME OF OPEN CARDIAC PROCEDURE (ADD-ON)
INSERTION OF EPICARDIAL ELECTRODE(S); OPEN INCISION
INSERTION OF EPICARDIAL ELECTRODE(S); ENDOSCOPIC APPROACH
INSERTION OF PERMANENT W/TRANSVENOUS ELECTRODES,AT
INSERTION OF PERMANENT PACEMAKER W/TRANS VEN ELECT
ARTIAL AND VENTRICULAR
INSERTION, PACEMAKER ELECTRODE
INSERTION OR REPLACEMENT TEMPORARY TRANSVENOUS DUA
INSERTION, PULSE GENERATOR
DUAL CHAMBER
UPGRADE IMPLANT PACEMAKER SYSTEM,CONVERSION OF SIN
REPOSITIONING OF PREVIOUSLY IMPLANTED TRANSVENOUS PACEMAKER/PACING CARDIOVERTER
INSERT REPLCMNT/REPOST.PERM.TRANSVENOUS ELECTRODES
DUAL CHAMBER
REPAIR, PACEMAKER ELECTRODES
DUAL CHAMBER
REVISION OR RELOCATION OF SKIN POCKET FOR PACEMAKE
REVISION OR RELOCATION OF SKIN POCKET FOR IMPLANTA
INSERTION OF PACING ELECTRODE, CARDIAC VENOUS SYSTEM FOR LEFT VENTRICULAR PACING
INSERTION OF PACING ELECTRODE, CARDIAC VENOUS SYSTEM, LEFT VENT PACING (ADD-ON)
REPOSITIONING OF PREVIOUSLY IMPLANTED CARDIAC VENOUS SYSTEM ELECTRODE
REMOVAL OF PERMANENT PACEMAKER;PULSE GENERATOR ONL
AND TRANSVENOUS ELECTRODES, SINGLE LEAD SYSTE
WITH TRANVENOUS ELECTRODES, DUAL LEAD SYSTEM
REMOVAL OF PERMANENT EPICARDIAL PACEMAKER & ELECTR
DUAL LEAD SYSTEM
REMOVAL OF PERM TRAN US PACEMAKER BY THO
INSERT/REPLACE IMPLANTABLE CARDIOVERTER DEFIBRILLA
REMOVE IMPLANT CARDIOVERTER DEFIBRILLATOR GEN ONLY
REMOVE IMPLANT CARDIO PULSE GEN &/OR LEAD SYSTEM B
REMOVAL OF PACING CARDIOVERTER-DEFIBRILLATOR BY OTHER THAN THORACOTOMY
W/INSERTION OF CARDIO-DEFIBRILLATOR PULSE GENERATO
OPERATIVE ABLATION OF SUPRAVENTRICULAR ARRHYTHMOGE
OP ABLATION OF SUPRAVENTRICULAR-W/CARDIO BYPASS
OPERATIVE TISSUE ABLATION AND RECONSTRUCTION OF ATRIA, LIMITED
OPERATIVE TISSUE ABLATION AND RECONSTRUCTION OF ATRIA, EXTENSIVE
OPERATIVE TISSUE ABLATION AND RECONSTRUCTION OF ATRIA, EXTENSIVE
OPERATIVE TISSUE ABLATION AND RECO OF ATRIA, PERF AT THE TIME OF OT CARDIAC PROC
OPERATIVE TISSUE ABLATION AND RECO OF ATRIA, PERF AT THE TIME OF OT CARDIAC PROC
OPERATIVE TISSUE ABLATION AND RECO OF ATRIA, PERF AT THE TIME OF OT CARDIAC PROC
OP ABLATION OF ARRHYTHMOGENIC W/CARDIOPULM BYPASS
ENDOSCOPY, SURG; OPERATIVE TISSUE ABLATION & RECONST/ATRIA, W/O CARDIO BYPASS
ENDOSCOPY, SURGICAL; OPERATIVE TISSUE ABLATION & RECONST OF ATRIA, EXTENSIVE
IMPLANTATION OF PATIENT-ACTIVATED CARDIAC EVENT RECORDER
REMOVAL OF IMPLANTABLE PATIENT-ACTIVATED CARDIAC EVENT RECORDER
CARDIAC WOUND REPAIR
CARDIAC WOUND REPAIR
CARDIOTOMY
CARDIOTOMY
REPAIR, AORTA
SUTURE REPAIR AORTA; WITH SHUNT BYPASS
REPAIR, AORTA
GRAFT INSERTION, CARDIAC
GRAFT INSERTION AORTA; W/SHUNT BYPASS
GRAFT INSERTION, CARDIAC
VALVULOPLASTY, AORTA
OPEN, WITH INFLOW OCCLUSTON
USING TRANSVENTRICULAR DILATION,W/CARDIOPULMO BYPA
CONSTRUCTION OF APICAL-AORTIC CONDUIT
REPLACEMENT, AORTIC VALVE
WITH HOMOGRAFT
AORTIC VALVE REPLACEMENT; WITH STENTLESS TISSUE VALVE
REPLACE AORTIC VALVE
REPLACE AORTIC VALVE W/TRANSVENTRICULAR ENLARGEMNT
BY TRANSLOCATION OF AUTOLOGOUS PULMONARY VALVE W/H
REPAIR OF LEFT VENTRICULAR OUTFLOW TRACT BY PATCH
RESECTION, SUBVALVULR STENOSIS
VENTRICULOMYOTOMY FOR INDIOPATHIC HYPERTOPHIC SUBA
AORTOPLASTY
VALVOTOMY; MITRAL VALVE; CLOSED HEART
VALVOTOMY; OPEN HEART W/BYPASS
VALVULOPLASTY, MITRAL VALVE
VULVULOPLASTY, MITRAL VALVE W/PROSTHETIC RING
VALVULOPLASTY; RADICAL RECONSTRUC, W/W/O RING
REPLACEMENT, MITRAL VALVE
VALVULOPLASTY, TRICUSPID VALVE
VALULOPLASTY TRICUSPID VALVE W/O RING INSERT
WITH RING INSERTION
REPLACEMENT, TRICUSPID VALVE
REPOSITIONING, TRICUSPID VALVE
VALVOTOMY PULMONARY VALVE CLOSED HEART; TRANSVENTR
VALVOTOMY,PULMONARY VALVE;VIA PULMONARY ARTERY
VALVOTOMY PULMONARY VALVE OPEN HEART W/INFLOW OCCL
VALVOTOMY-PULMONARY VALVE OPEN HEART; W/BYPASS
REPLACEMENT PULMONARY VALVE
INFUNDIBULAR STENOSIS RESECTN
AUGMENTATION, OUTFLOW TRACT
REPAIR OF NON-STRUCTURAL PROSTHETIC VALVE DYSFUNCTION W/CARDIOPULMONARY BYPASS
REP CORON A-V OR ARTERIO-CARDIAC CHAMBER FISTULA
REPAIR CORONARY ARTERIOVENOUS FISTULA WO/CARDIO-PU
REPAIR ANOMALOUS CORONARY ARTERY BY LIGATION
LIGATION, CORONARY ARTERY
LIGATION, CORONARY ARTERY
WITH CONSTRUCTION OF INTRO PULMONARY TUNNEL
BY TRANSLOCATION FROM PULMONARY ARTERY TO AORTA
REPAIR OF ANOMALOUS AORTIC ORIGIN ARTERY BY UNROOFING OR TRANSLOCATION
ENDOSCOPY SURGICAL W/ VIDEO ASSISTED HARVEST OF VEINS FOR CORON BYPASS (ADD-ON)
CORONARY ARTERY BYPASS, VEIN ONLY, SINGLE GRAFT
CORONARY ARTERY BYPASS
CORONARY ARTERY BYPASS
CORONARY ARTERY BYPASS, AUTOGENOUS GRAFT4 ARTERIES
CORONARY ARTERY BYPASS, FIVE CORONARY ARTERIES
CORONARY ARTERY BYPASS AUTOGENOUS GRAFT 6 OR MORE
CORONARY ARTERY BYPASS, USING VENOUS & ARTERIAL GRAFT; SINGLE VEIN-(SP)
CORONARY ARTERY BYPASS, USING VENOUS & ARTERIAL GRAFT(S)-2 VENOUS GRAFTS-(SP)
CORONARY ARTERY BYPASS, USING VENOUS & ARTERIAL GRAFT(S); 3 VENOUS GRAFTS-(SP)
CORONARY ARTERY BYPASS, USING VENOUS & ARTERIAL GRAFT(S); 4 VENOUS GRAFTS-(SP) S
CORONARY ARTERY BYPASS, USING VENOUS & ARTERIAL GRAFT(S); 5 VENOUS GRAFTS-(SP) S
CORONARY ARTERY BYPASS, USING VENOUS & ARTERIAL GRAFT(S); 6 OR MORE GRAFTS-(SP)
REOPERATION CORONARY ARTERY BYPASS PROCEDURE MORET-ADD ON
CORONARY ARTERY BYPASS USING ARTERIAL GRAFTS SINGL
CORONARY ARTERY BYPASS USING ARTERIAL GRAFTS 2 GRA
CORONARY ARTERY BYPASS 3 ARTERIAL GRAFTS
CORONARY ARTERY BYPASS 4 OR MORE ARTERIAL GRAFTS
RESECTION, MYOCARDIAL
VENTRICULAR SEPTAL DEFECT
SURGICAL VENTRICULAR RESTORATION PROC, INCL PROSTHETIC PATCH WHEN PERFORMED
CORONARY ENDARTERECTOMY, EACH VESSEL-ADD ON
CLOSURE OF ATRIOVENTRICULAR VALVE
CLOSURE OF SEMILUNAR VALVE BY SUTURE OR PATCH
ANASTOMOSIS OF PULMONARY ARTERY TO AORTA
REPAIR COMPLEX CARDIAC ANORMALY OTHER THAN PULMONA
REPAIR COMPLEX CARDIAC ANORMALY BY SURGICAL ENLARG
REPAIR DOUBLE OUTLET RT VENTRICLE W/INTRAVENTRICUL
WITH REPAIR OF RIGHT VENTRICULAR OUTFLOW TRACT OBS
REPAIR COMPLEX CARDIAC ANORMALY (TRICUSPID ATRESIA
REPAIR OF COMPLEX CARDIACANORMALY
REPAIR SINGLE VENTRICLE W/AORTIC OUTFLOW OBSTRUCTI
CLOSURE, ARTIAL DEFECT
CLOSURE, SINUS VENOSUS DEFECT
REPAIR OF ATRIAL AND VENTRICULAR SEPTAL DEFECTS
REPAIR ATRIOVENTRICULAR CANAL W/,W/O A-V VALVE REP
REPAIR INT/TRANSITIONAL ATRIOVENTRICULAR CANAL
ATRIO-VENTRICULAR CANAL
CLOSURE OF MULTIPLE VENTRICULAR SEPTAL DEFECTS;
CLOSURE OF MULTIPLE VENTRICULAR SEPTAL DEFECTS; WITH PULMONARY VALVOTOMY OR
CLOSURE OF MULTIPLE VENTRICULAR SEPTAL DEFECTS; W/REMOVAL/PULMONARY ARTERY BAND
VENTRICULAR SEPTAL DEFECT
VENTRICULAR SEPTAL DEFECT
VENTRICULAR SEPTAL DEFECT
PULMONARY ARTERY BANDING
TETRALOGY OF FALLOT
TETRALOGY OF FALLOT
COMPLETE REPAIR OF TETROLOGY OF FALLET W/PULMONARY
SINUS OF VALSALVA
REPAIR SINUS OF VALSALVA + VENTRICULAR SEPTAL
SINUS OF VALSALVA
CLOSURE AORTICO-LEFT VENTRICULAR TUNNEL
REPAIR OF ISOLATED PARTIAL ANOMALOUS PULMONARY VENOUS RETURN
REPAIR OF PULMONARY VENOUS STENOSIS
REPAIR, PULMONARY VEIN
REPAIR COR TRIATRIATUM ORSUPRAVALVULAR MITRAL RING
ATRIAL SEPTECTOMY
OPEN HEART WITH CARDIOPULMONARY BYPASS
OPEN HEART WITH INFLOW OCCLUSION
BLALOCK-TAUSSIG PROCEDURE
WATERSON PROCEDURE
POTTS-SMITH PROCEDURE
SHUNT WITH PROSTHETIC GRAFT
GLENN PROCEDURE
SUPERIOR VENA CAVR TO PULMONARY ARTERY FLOW TO BOT
ANASTOMOSIS CAVOPULMONARY 2ND SUPERIOR VENA CAVA (SP)
REPAIR OF TRANSPOSITION OF GREAT ARTERY W/ DEFECT
REPAIR OF GREAT ARTERY WITH SURGICAL ENLARGEMENT
REPAIR TRANS GREAT ART. MUST-SENNING TYPE W/BYPASS
REPAIR TRANSPOSITION OF GREAT NESSELS PULM, BAND
REPAIR TRANSPOS GREAT VESSELS WITH CLOSURE VSD
REPAIR TRANSPOSITION GREAT VESSELS SUBPULM. OBSTR.
REPAIR TRANS. GREAT ART. AO-PULM. EG-JATENE TYPE
REPAIR TRANS. GREAT ARTS. AO-PULM REM. PULM. BAND
REPAIR TRANSPOS GREAT ARTS AO-PULM CLOSURE VSD
REPAIR TRANSPOS GREAT ARS AO-PULM REP SUBPULM OBS
AORTIC ROOT TRANSLOC W/ VENTRICULAR SEPTAL DEFECT AND PULMONRY STENOSIS REPAIR
AORTIC ROOT TRANSLOCATION W/ REIMPLANTATION OF 1 OR BOTH CORONARY OSTIA.
REPAIR, TRUNCUS ARTERIOSUS
PULMONARY ARTERY REPLANT
AORTIC SUSPENSION FOR TRACHEAL DECOMPRESSION
DIVISION, ABERRANT VESSEL
DIVISION, ABERRANT VESSEL
OBLITERATION OF AORTOPULMONARY SEPTAL DEFECT; WO/C
OBLITERATION OF AORTOPULMONARY W/CARDIOPULMONARY B
DUCTUS ARTERIOSUS
DUCTUS ARTERIOSUS
DUCTUS ARTERIOSUS
EXCISION, COARCTATION
EXCISION, COARCTATION
REPAIR USE L SUBCLAVIAN ARTERY OR PROSTHETIC MATER
REPAIR HYPOPLASTIC INTERRUPTED AORTIC ARCH USE AUT
WITH CARDIOPULMONARY BYPASS
GRAFT, ASCENDING ARCH
WITH CORONARY RECONSTRUCTION
W/AORTIC ROOT REPLACEMENT USING COMPOSITE PROSTHES
ASCENDING AORTA GRAFT, WITH CARDIOPULMONARY BYPASS WITH VALVE SUSPENSION
GRAFT, TRANSVERSE ARCH
GRAFT, DESCNDNG THORACIC AORTA
REPAIR THORACOABDOMINAL.AORTIC ANEURYSM W/GRAFT W/
ENDOVASCULAR REPAIR OF DESCENDING THORACIC AORTA, INVOLVING ARTERY ORIGIN
ENDOVASCULAR REPAIR OF DESCENDING THORACIC AORTA, NOT INVOLVING ARTERY ORIGIN
PLACEMENT/PROXIMAL EXT PROSTHESIS/ENDOVASCULAR REPAIR/DESCENDING,INITIAL
PLACEMENT OF PROXIMAL PROSTHESIS FOR VASCULAR REPAIR THORACIC AORTA ADD-ON
PLACEMENT OF DISTAL EXTENSION PROSTHESIS DELAYED AFTER REPAIR/THORACIC AORTA
OPEN SUBCLAVICAL TO CAROTID ARTERY, BY NECK INCISION, UNILATERAL
BYPASS GRAFT W/OTHER THAN VEIN, PERFORMED IN CONJUNCTION W/ENDOVASCULAR REPAIR
PULMONARY EMBOLECTOMY
PULMONARY EMBOLECTOMY
PULMONARY ENDARTERECTOMY W/WO EMBOLECTOMY W/CARDIO
REPAIR OF PULMONARY ARTERY STENOSIS
REPAIR OF PULMONARY ATRESIA W/VENTRICULAR
TRANSECTION PULMONARY ARTERY W/CARDIOPULMONARY BYP
LIGATION/TAKEDOWN ARTERY SHUNT,ADD TO PRIMARY PROC
REPAIR OF PULMONARY ARTERY W/O CARDIOPULMONARY BYPASS
REPAIR OF PULMONARY ARTERY WITH CARDIOPULMONARY BYPASS
HEART-LUNG TRANSPLANT WITH RECIPIENT CARDIECTOMY PNEUMONECTOMY
DONOR CARDIECTOMY INCLUDING COLD PRESERVATIONS
BACKBENCH STANDARD PREP OF CADAVER DONOR HEART ALLOGRAFT PRIOR TO TRANSPLANT
HEART TRANSPLANT W/WO RECIPIENT CARDIECTOMY
PROLONGED EXTRACORPOREAL CIRCULATION FOR CARDFOPUC
EACH ADDITIONAL 24HOUR-ADD ON
INSERTION OF INTRA-AORTIC BALLOON ASSIST DEVICE, PERCUTANEOUS
REMOVAL OF INTRA-AORTIC ASSIST DEVICE, PERCUTANEOUS
INTRA-AORTIC BALLOON
REMOVAL OF INTRA-AORTIC BALLOON ASSIST DEVICE
INSERTION OF INTRA-AORTIC BALLOON ASSIST DEVICE TH
REMOVAL OF INTRA-AORTIC BALLOON ASSIST DEVICE FROM
IMPLANT VENTRICULAR ASSIST DEVICE;SINGLE VENTRICLE
BIVENTRICULAR SUPPORT
REMOVAL OF VENTRICULAR ASSIST DEVICE,SINGLE VENTRI
BIVENTRICULAR SUPPORT
INSERTION OF VENTRICULAR ASSIST DEVICE, IMPLANTABLE INTRACORPOREAL, SINGLE VENT
REMOVAL OF VENTRICULAR ASSIST DEVICE, IMPLANTABLE INTRACORPOREAL, SINGLE VENTRIC
REPLAC OF EXTRACORPOREAL VENTRICULAR DEVICE, SINGL OR BIVENTRICULAR, PUMP(S)
REPLACEMENT OF VENTRICULAR PUMP(S); IMPLANTABLE ,W/O CARDIOPULMONARY BYPASS
IMPLANTABLE INTRACORPOREAL, SINGLE VENTRICLE, WITH CARDIOPULMONARY BYPASS
UNLISTED CARDIAC PROCEDURE
CAROTID EMBOLECTOMY
SUBCLAVIAN EMBOLECTOMY
AXILLARY-BRACHIAL EMBOLECTOMY
EMBOLECTOMY/THROMBECTOMY RADIAL/ULNAR ARTERY ARM I
RENAL EMBOLECTOMY
FEMORAL-POPLITEAL EMBOLECTOMY
EMBOLECTOMY OR THROMBECTOMY POPLITEAL-TIBIO-PERONE
UPPER GI ENDOSCOPY WITH STENT PLACEMENT
THROMBECTOMY, ILIO-FEMORAL
VENA CAVA ILIAC FEMOROPOPLITEAL VIEN LEG INCISION
VENA CAVA ILIAC FEMOROPOPILITEAL VEIN BY ABDOMINAL
THROMBECTOMY,SUBCLAVIAN VEIN BY NECK INCISION
AXILALARY AND SUBCLAVIAN VEIN BY ARM INCISION
VALVULOPLASTY, FEMORAL VEIN
RECONSTRUCTION OF VENA CAVA
VENOUS VALVE TRANSPOSITION, ANY VEIN DONOR
CROSS-OVER VEIN GRAFT TO VENOUS SYSTEM
SAPHENOPOPLITEAL VEIN ANASTOMOSIS
ENDOVASCULAR REPAIR ANEURYSM/DISSECTION; AORTO-AORTIC TUBE PROSTHESIS
ENDOVASCULAR REPAIR ANEURYSM/DISSECTION; MODULAR BIFURCATED PROSTHESIS
ENDOVASCULAR REPAIR OF INFRARENAL ABDOMINAL AORTIC ANEURYSM; USING 2 DOCK LIMBS
ENDOVASCULAR PLACEMENT OF ILIAC UNIBODY BIFURCATED PROSTHESIS
ENDOVASCULAR REPAIR OF INFRARENAL ABDOMINAL SORTIC ANEURYSM OR DISSECTION
TRANSCATHETER PLACEMENT OF WIRELESS PHYSIOLOGIC SENSOR IN ANEURYSMAL SAC
ENDOVASCULAR PLACEMENT OF ILIAC ARTERY OCCLUSION DEVICE (ADD-ON)
OPEN FEMORAL ARTERY EXPOSURE BY GROIN INCISION, UNILATERAL
PLACEMENT FEMORAL-FEMORAL GRAFT DURING ENDOVASCULAR REPAIR (ADD-ON)
OPEN ILIAC ARTERY EXPOSURE BY ABDOMINAL/RETROPERITONEAL INCISION, UNILATERAL
PLACEMENT PROXIMAL/DISTAL EXTENSION PROSTHESIS; INITIAL VESSEL
PLACEMENT PROXIMAL/DISTAL EXTENSION PROSTHESIS; EACH ADDITIONAL VESSEL
OPEN REPAIR INFRARENAL ANEURYSM/DISSECTION & REPAIR ARTERIAL TRAUMA;TUBE PROSTH.
REPAIR INFRARENAL ANEURYSM/DISSECTION & ARTERIAL TRAUMA; AORTO-BI-ILIAC PROSTHES
REPAIR INFRARENAL ANEURYSM/DISSECTION & ARTERIAL TRAUMA;AORTO-BIFEMORAL PROSTHE.
OPEN ILIAC ARTERY EXPOSURE W/CREATION OF CONDUIT FOR DELIVERY OF INFRARENAL AORT
OPEN BRACHIAL ARTERY EXPOSURE TO ASSIST/ENDOVASCULAR PROSTHESIS BY ARM INCISION
ENDOVASCULAR GRAFT REPLACEMENT FOR REPAIR OF ILIAC ARTERY
CAROTID-EXCISION/GRAFT
REPAIR RUPTURED ANEURYSM CARTOID, SUBCLAVIAN ARTER
REPAIR ANEURYSM,FALSE ANEURYSM OR OCCCUSIVE DISEAS
BRACHIAL EXCISION/GRAFT
REPAIR RUPTURED ANEURYSM AXILLARY-BRACHIAL ARTERY
SUBCLAVIAN EXCISION/GRAFT
REPAIR RUPTURED ANEURYSM INNOMINATE SUBCLAVIAN ART
REPAIR ANEURYSM FALSE ANEURYSM,OCCLUSIVE DISEASE R
ABDOMINAL AORTIC ANEURYSM
DIRECT REPAIR OF ANEURYSM FOR RUPTURE ABDOM AORTA
ABDOMINAL AORTIC ANEURYSM
REPAIR RUPTURE ANEURYSM ABD AORTA INVOLV VISCERAL
REPAIR OF ANEURYSM,ABDOMINAL AORTA INVOLV ILIAC
FOR RUPTURED ANEURYSM, ABDOMINAL AORTA INV ILIAC V
REPAIR ANEURYSM FALSE ANEURYSM SPLENIC ARTERY
RUPTURE ANEURYSM SPLENIC ARTERY
REPAIR ANEURYSM FALSE ANEURYSM, HEPATIC, CELIAC, R
REPAIR FOR ANEURYSM OR OCCLUSIVE DISEASE, ILIAC
REPAIR ANEURYSM, FALSE ANEURYSM ILIAC ARTERY
DIRECT REPAIR RUPUTRED ANEURYSM ILIAC ARTERY
REPAIR ANEURYSM, FALSE ANEURYSM, FEMORAL ARTERY
DIRECT REPAIR OF RUPTURED ANEURYSM
REPAIR ANEURYSM, FALSE ANEURYSM POPLITEAL ARTERY
RUPTURED ANEURYSM POPLITEAL ARTERY
REPAIR CONGENITAL AV FISTULA HEAD-NECK
REPAIR CONGENITAL AV FISTULA THORAX-ABDOMEN
REPAIR AV FISTULA-EXTREMITIES
REPAIR ACQUIRED TRAMATIC FISTULA HEAD-NECK
REPAIR ACQUIRED ARTERIOVENOUS-FISTULA THORAX-ABDOM
REPAIR ARTERIOVENOUS FISTULA
REPAIR BLOOD VESSEL, DIRECT, NECK
REPAIR BLOOD VESSEL, DIRECT, UPPER EXTREMITY
REPAIR BLOOD VESSEL DIRECT, HAND FINGER
REPAIR BLOOD VESSEL INTRATHORACIC WITH BYBASS
REPAIR BLOOD VESSEL DIRECT,INTRA THORACIC WO/BYPAS
REPAIR BLOOD VESSEL DIRECT, INTRA-ABDOMINAL
REPAIR BLOOD VESSEL DIRECT, LOWER EXTREMITY
REPAIR BLOOD VESSEL W/VEIN GRAFT NECK
REPAIR BLOOD VESSEL W/VEIN GRAFT, UPPER EXTREMITY
REPAIR BLOOD VESSEL W/VEIN GRAFT INTERTHORACIC W/B
RAPAIR BLOOD VESSEL W/VEIN GRAFT, INTERTHORACIC WO
REPAIR BLOOD VESSEL W/VEIN GRAFT, INTRA ABDOMINAL
REPAIR BLOOD VESSEL W/VEIN GRAFTS LOWER EXTREMITY
REPAIR BLOOD VESSEL W/GRAFT OTHER THAN VEIN NECK
REPAIR BLOOD VESSEL W/GRAFT OTHER THAN VEIN UP EXT
REPAIR BLOOD VESSEL, INTRATHORACIC, WITH BYPASS
REPAIR BLOOD VESSEL W/GRAFT OTHER THAN VEIN, INTER
REPAIR BLOOD VESSEL WITH GRAFT INTRA-ABDOMINAL
REPAIR BLOOD VESSEL W/GRAFT OTHER THAN VEIN LOWER
THROMBOENDARTERECTOMY
THROMBOENDARTERECTOMY, INCLUDING PATCH GRAFT, IF PERFORMED; SUPERFICIAL FEMORAL
THROMBOENDARTERECTOMY, INCLUDING PATCH GRAFT, IF PERFORMED; POPLITEAL
THROMBOENDARTERECTOMY, INCL PATCH GRAFT, IF PERF; TIBIOPERONEAL TRUNK ARTERY
THROMBOENDARTERECTOMY, INCL PATCH GRAFT, IF PERF; INITIAL VESSEL
THROMBOENDARTERECTOMY, INCL PATCH GRAFT, EA ADDITIONAL (SP)
THROMBOENDARTERECTOMY
THROMBOENARTERECTOMY
THROMBOENDARTERECTOMY
THROMBOENDARTERECTOMY
THROMBOENDARTERECTOMY
THROMBOENDARTERECTOMY, ILIOFEMORAL
THROMBOENDARTERECTOMY
THROMBOENDARTERECTOMY COMBINED AIF
THROMBOENDARTERECTOMY
THROMBOENDARTERECTOMY, DEEP (PROFUNDA) FEMORAL
REOPERATION,CAROTID,THROMBOENDARTERECTOMY-ADD ON
ANGIOSCOPY DURING THERAPEUTIC INTERVENTION-ADD ON
TRANSLIMINAL ANGIOPLASTY OPEN RENAL OTHER VISCERAL
TRANSLUMINAL ANGIOPLASTY OPEN AORTIC
ANGIOPLASTY OPEN ILIAC
TRANSLUMINAL ANGIOPLASTY OPEN FEMORAL-POPLITEAL
ANGIOPLASTY OPEN BRACHIOCEPHALIC
TRANSLUMINAL ANGIOPLASTY OPEN/TIBIOPERONEAL TRUNK
TRANSLUMINAL ANGIOPLASTY OPEN VENOUS
ANGIOPLASTY PERCUTANEOUS TIBIOPERONEAL TRUNK
PERCUTANEOUS ANGIOPLASTY RENAL OR VISCERAL ARTERY
PERCUTANEOUS ANGIOPLASTY AORTIC
PERCUTANEOUS ANGIOPLASTY ILIAC
PERCUTANEOUS ANGIOPLASTY FEMORAL-POPLITEAL
PERCUTANEOUS ANGIOPLASTY BRACHIOCEPHALIC
PERCUTANEOUS ANGIOPLASTYVENOUS
TRANSLUMINAL PERIPHERAL ATHERECTOMY OPEN RENAL OTH
TRANSLUMINAL PERIPHERAL ATHERECTOMY OPEN AORTIC
TRANSLUMINAL PERIPHERAL ATHERECTOMY OPEN ILIAC
TRANSLUMINAL PERIPHERAL ATHERECTOMY FEMORAL-POPLIT
TRANSLUMINAL PERIPHERAL ATHERECTOMY BRACHIOCEPHALI
TRANSLUMINAL PERIPHERAL ATHERECTOMY TIBIOPERONEAL
TRANSLUMINAL PERIPHERAL ATHERECTOMY PERCUTAN RENAL
AORTIC
TRANSLUMINAL PERIPHERAL ATHERECTOMY ILIAC
TRANSLUMINAL PERIPHERAL ATHERECTOMY FEMORAL-POPLIT
TRANSLUMINAL PERIPHERAL ATHERECTOMY BRACHIOCOPHALI
TRANSLUMINAL PERIPHERAL ATHERECTOMY PERCUTAN TRUNK
HARVEST OF UPPER EXTREMITY VEIN; 1 SEG.FOR LOWER EXTREMITY BYPASS PROC.-ADDON
BYPASS GRAFT W/VEIN CAROTID
CAROTID-SUBCLAVIAN BYPASS
BYPASS GRAFT W/VEIN CAROTID-VERTEBRAL
BYPASS GRAFT W/VEIN CAROTID-CAROTID
SUBCLAVIAN-SUBCLAVIAN BYPASS
BYPASS GRAFT W/ VEIN; COMMON CAROTIS-IPSILAT INTERNAL CAROTID SUBCLAV-BRACH
BYPASS GRAFT W/VEIN SUBCLAVIAN-VERTEBRAL
SUBCLAVIAN-AXILLARY BYPASS
VEIN BYPASS AXILLARY-AXILLARY
AXILLARY-FEMORAL-FEMORAL BYPAS
BYPASS GRAFT, WITH VEIN; AXILLARY-BRACHIAL
BYPASS GRAFT, WITH VEIN; BRACHIAL-ULNAR OR -RADIAL
BYPASS GRAFT, WITH VEIN; BRACHIAL-BRACHIAL.
AORTO-SUBCLAVIAN BYPASS
AORTO-CELIAC BYPASS
VEIN BYPASS AXILLARY-FEMORAL-FEMORAL
HEPATORENAL
SPLENO-RENAL BYPASS
BYPASS GRAFT, WITH VEIN; AORTOILIAC
BYPASS GRAFT, WITH VEIN; AORTOBI-ILIAC
BYPASS GRAFT, WITH VEIN; AORTOFEMORAL
BYPASS GRAFT, WITH VEIN; AORTOBIFEMORAL
BYPASS GRAFT W/VEIN ARTOILIOFEMORAL, UNILATERAL
BYPASS GRAFT W/VIEW AORTOILIOFEMORAL, BILATERAL
AORTO-FEMORAL POPLITEAL BYPASS
FEMORAL-POPLITEAL BYPASS
FEMORAL-FEMORAL BYPASS
VEIN BYPASS AORTORENAL
VEIN BYPASS ILIOILIAC
BYPASS GRAFT, VEIN, ILIOFEMORAL
FEMORAL-TIBIAL BYPASS
TIBIAL-TIBIAL, PERONEAL-TIBIAL, OR TIBIAL/PERONEAL TRUNK-TIBIAL
BYPASS GRAFT-VEIN POPLITEAL-TIBAL/PERONEAL ARTERY
HARVEST OF FEMOROPOPLITEAL VEIN ONE SEGMENT FOR VASCULAR RECON PROC (ADD-ON)
IN SITU VEIN BYPASS, FEMORAL-POPLITEAL
IN-SITU VEIN BYPASS, FEMORAL ANTERIOR/POSTE TIBIAL
POPLITEAL TIBIAL PERCONEAL (IN-SITU)
HARVEST UPPER EXTREMITY ARTERY, ONE SEGMENT FOR CORONARY ARTERY BYPASS
BYPASS GRAFT, OTHER THAN VEIN
CAROTID-SUBCLAVIAN BYPASS
SUBCLAVIAN-SUBCLAVIAN BYPASS
SUBCLAVIAN-AXILLARY BYPASS
AXILLARY-FEMORAL BYPASS
AXILLARY-POPLITEAL OR TIBIAL
AORTO-SUBCLAVIAN BYPASS
AORTO-CELIAC BYPASS
ILIO-CELIAC
ILIO-MESENTERIC
ILIORENAL
BYPASS W/OTHER-THAN VEIN SPLENORENAL
BYPASS GRAFT OTHER-THAN VEIN-VERTEBRAL-CAROTID TRA
BYPASS GRAFT OTHER-THAN VEIN VERTEBAL-SUBCLAVIAN T
BYPASS GRAFT-OTHER THAN VEIN CAROTID-VERTEBRAL
BYPASS GRAFT OTHER THAN VEIN SUBCLAVIAN-VERTEBRAL
BYPASS GRAFT - AORTOFEMORAL
BYPASS GRAFT W/OTHER THAN VEIN; AORTOFEMORAL
BYPASS GRAFT-OTHER THAN VEIN AXILLARY-AXILLARY
BYPASS GRAFT-OTHER THAN VEIN AORTOFEMORAL-POPLITEA
BYPASS GRAFT OTHER THAN VEIN-AXILLARY-FEMORAL-FEMO
FEMORAL-POPLITEAL BYPASS
FEMORAL-FEMORAL BYPASS
BYPASS GRAFT OTHER THAN VEIN-ILIOILIAC
BYPASS GRAFT WITH OTHER THAN VEIN; ILIOFEMORAL
FEMORAL-TIBIAL BYPASS
BYPASS GRAFT OTHER THAN VEIN POPLITEAL-TIBIAL-PERO
BYPASS GRAFT COMPOSITE-ADD ON
BYPASS GRAFT AUTOGENOUS COMPOSITE; 2 SEG. OF VEINS FROM 2 LOC-ADD ON
BYPASS GRAFT AUTOGENOUS COMPOS;3 MORE SEG VEIN FROM 2 OR MORE LOC-ADD ON
BYPASS GRAFT PATENCY/VEIN PATCH, SYNTHETIC CONDUIT (ADD-ON)
BYPASS GRAFT PATENCY/AV FISTULA, LOWER EXTREMITY (ADD-ON)
TRANSPOSITION AND/OR REIMPLANTATION,VERTEBRAL CARO
VERTEBRAL TO SUBCLAVIAN ARTERY
SUBCLAVIAN TO CAROTID ARTERY
CAROTID TO SUBCLAVIAN ARTERY
REIMPLANTATION, VISCERAL ARTERY TO INFRARENAL AORTIC PROSTH, EA ARTERY
REOPERATION,FEMORAL-POPLITEAL MORE THAN 1 MO AFTER-ADD ON
EXPLORATION, CAROTID ARTERY
EXPLORATION, FEMORAL ARTERY
EXPLORATION, POPLITEAL ARTERY
EXPLORATION W/WO LYSIS OF ARTERY; OTHER VESSELS
EXPLORATION FOR POSTOP HEMORRAGE/THROMBOSIS, NECK
EXPLORATION FOR POSTOP HEMORRAGE/THROMBOSIS, CHEST
EXPLORATION FOR POSTOP HEMORRAGE/THROMBOSIS, ABDOM
EXPLORATION FOR POSTOP HEMORRAGE/THROMBOSIS, EXTRE
REPAIR OF GRAFT-ENTERIC FISTULA
THROMBECTOMY AND/OR REPAIR ARTERIAL/VENOUS GRAFT.
WITH REVISION OF ARTERIAL OR VENOUS GRAFT
REVISION OF LOWER EXTREMITY ARTERIAL BYPASS GRAFT; W/ VEIN PATCH ANGIOPLASTY
REVISION OF LOWER EXTREMITY ARTERIAL BYPASS GRAFT;W/SEGMENTAL VEIN INTERPOSITN
REVISION, FEMORAL ANASTOMOSIS OF SYNTHETIC ARTERIAL BYPASS GRAFT IN GROIN, OPEN
REVISION, FEMORAL ANASTOMOSIS OF SYNTHETIC ARTERIAL BYPASS GRAFT IN GROIN, OPEN
EXCISION OF INFECTED GRAFT, NECK
EXTREMITY
THORAX
ABDOMEN
VENOGRAPHY INJECTION PROCEDURE
INJECTION PROCEDURES PERCUTANEOUS TX OF EXTREMITY PSEUDOANEURYSM
INJ PROCEDURE CONTRAST VENOGRAPHY INC INTRO OF NEE
VENACAVA INJECTION PROCEDURE
SELECT CATHETER PLACE, VENOUS SYSTEM 1ST ORDER BRA
SELECT CATHETER PLACE, VENOUE SYSTEM 2ND ORDER SEL
INTRO CATHETER R-HEART/MAIN PULMONARY ARTERY
SELECT CATHETER PLACE L/R PULMONARY ARTERY
SELECT CATHETER PLACE, EA SEGMENTAL OR SUBSEGMENTA
ARTERIAL INJECTION PROCEDURE
ARTERIAL INJECTION PROCEDURE
EXTRMTY ARTERIOGRAPHY INJ PROC
INTRODUCTION OF NEEDLE AND/OR CATHETOR, ARTERIOVENOUS SHUNT CREATED FOR
ADDITIONAL ACCESS FOR THERAPEUTIC INTERVENTION (LIST SEPARATELY IN ADDITION)
TRANSLUMBAR AORTIC INJECTION
AORTOGRAPHY INJECTION PROCEDRE
SELECTIVE CATHETER PLACEMENT, ARTERIAL SYSTEM EA F
SELECT CATHETER PLACE, ARTERIAL 2ND ORDER THORACIC
SELECT CATHETER PLACE ARTERIAL 3RD ORDER THORACIC
SELECT CATHETER PLACE ARTERIAL ADDITIONAL 2ND/3RD THORA-ADD ON
SELECTIVE CATHETER PLACEMENT, ATERIAL SYSTEM; EACH
SELECT CATHETER PLACE, ARTERIAL 2ND ORDER ABDOMINA
SELECT CATHETER PLACE, ARTERIAL 3RD ORDER ABDOMINA
SELECT CATHETER PLACE ARTERIAL ADDIT 2ND/3RD ABDOM-ADD ON
INSERTION IMPLANTABLE INTRAVENOUS INFUSION PUMP
REVISION IMPLANTED INTRA-ARTERIAL INFUSTION PUMP
REMOVAL IMPLANTED INTRA-ARTERIAL INFUSION PUMP
UNLISTED VASCULAR INJECTION
VENIPUNCTURE
VENIPUNCTURE
VENIPUNCTURE UNDER 3 YRS OTHER VEIN
VENIPUNCTURE
ROUTINE VENIPUNCTURE FOR COLLECTION OF SPECIMEN(S)
COLLECTION OF CAPPILARY BLOOD SPECIMEN
VENIPUNCTURE
VENIPUNCTURE
TRANSFUSION BLOOD OR BLOOD COMPONENT
TRANSFUSION, BLOOD
EXCHANGE TRANSFUSION
EXCHANGE TRANSFUSION OTHER THAN NEWBORN
FETAL TRANSFUSION
SINGLE OR MULT INJECT OF SCLEROS SOL TELANGIECTASI
SINGLE OR MULT INJECT OF SCLEROS SOL TELANGIECTASI
SCLEROSING SOLUTION, SINGLE VEIN
MULTIPLE VEINS, SAME LEG
ENDOVENOUS ABLATION THERAPY OF INCOMPETENT VEIN, EXTREMITY, INCL IMAG GUIDANCE
ENDOVENOUS ABLATION THERAPY INCOMP VEIN, EXTREM, 2ND & SUBSEQUENT (ADD-ON)
ENDOVENOUS ABLATION THERAPY OF INCOMPETENT VEIN, EXTREMITY; 1ST VEIN
INCOMPENTENT VEIN, EXTREMITY, INCL OF ALL IMAGING GUIDANCE AND MONITORING, EACH
PERCUTANEOUS PORTAL VEIN CATHETERIZATION ANY METHO
ABDOMINAL VENOGRAPHY INJECTION
UMBILICAL VEIN CATHETERIZATION
THERAPEUTIC APHERESIS FOR WHITE BLOOD CELLS
THERAPEUTIC APHERESIS FOR RED BLOOD CELLS
THERAPEUTIC APHERESIS FOR PLATELETS
THERAPEUTIC APHERESIS FOR PLASMA PHRESIS
THERAPEUTIC APHERESIS WITH EXTRACORPREAL IMMUNOADSORPTION / PLASMA REINFUSION
THERAPEUTIC APHERESIS WITH EXTRACORPOREAL SELECTIVE ABSORPTION OR FILTRATION
PHOTOPHERESIS EXTRA CORPOREAL
INSERTION/NON TUNNELED CENTRALLY INSERTED CENTRAL VENOUS CATH; UNDER 5 YRS-(SP)
INSERTION OF NON TUNNELED CNTRLY INSRTD VENOUS CATH; 5 YRS OF AGE OR OLDER-(SP)
INSRTN OF TUNNELED CNTRLY INSRTD VENUS CATH; W/O SUBCU PORT OR PUMP; UNDER 5 YRS
INSRTN OF TUNLD CNTRLY INSRTD VEN CATH; W/O SUB PORT OR PUMP; 5 YRS OR OLDER
INSERTION OF TUNLD CNTRLY INSRTD VENUS CATH; W/ SUBCU PORT; UNDER 5 YRS
INSRTN OF TUNNELED CNTRLY INSRTD VENOUS CATH; W/ SUBCU PORT; 5 YRS OR OLDER
INSERTION OF TUNNELED CENTRALLY INSERTED CENTRAK ACCESS DEVISE W/ SUBCU PUMP
INSERTION OF TUNNELED CENTRALLY INSERTED CENTRAL ACCESS DEVICE
INSRTN OF TUNNLD CNTRLY INSRTD ACCESS DEVICE, REQ 2 CATH VIA 2 SEP SITES
INSERTION OF PICC W/O SUBCUTANEOUS PORT OR PUMP; UNDER 5 YRS-(SP)
INSERTION OF PICC W/O SUBCUTANEOUS PORT OF PUMP; 5 YRS OR OLDER- (SP)
INSERTION OF PICC WITH SUBCUTANEOUS PORT; UNDER 5 YRS OF AGE
INSERTION OF PICC WITH SUBCUTANEOUS PORT; 5 YEARS OF AGE OR OLDER
REPAIR OF TUNLD OR NON TUNLD CNTRL VENUS ACESS CATH W/O SUBCU PRT OR PUMP
REPAIR OF CNTRL VENUS CATH W/ SUBCU PORT OR PUMP CNTRL OR PERIPHRL INSRTN SITE
REPLACEMENT CATH ONLY, OF CNTRL VENUS DEVICE W SUBCU PORT, PUMP OR PERI SITE
REPLACEMENT COMPLETE/NON TUNLD CNTRLY INSRTD VENUS CATH W/O SUBCU PORT-(SP)
REPLACEMENT COMPLETE, OF TUNLD CNTRLY INSRT VEN CATH W/O SUBCU PORT OR PUMP
REPLACEMENT COMPLT, TUNNELED CNTRLY INSRTD VENUS ACCESS DEVICE W/O SUBCU PORT
REPLACEMNT COMPLT TUNNELED CNTRLY INSRTD CNTRL VNUS ACCESS DEVICE W/O SUBCU
REPLCMNT COMPLT, PICC W/O SUBCUTANEOUS PORT OR PUMP THRU SM VENUS ACCESS-(SP)
REPLACEMENT COMPLETE, PICC W/ SUBCUTANEOUS PORT THRU SAME VENOUS ACCESS
REMOVAL OF TUNNELED CNTRL VENOUS CATH W/O SUBCUTANEOUS PORT OR PUMP
REMOVAL OF TUNLD CNTRL VENOUS ACCESS DEVICE W/ SUBCU PORT OR PUMP OR PERI INSR
COLLECTION OF BLOOD SPECIMEN FROM A COMPLY IMPLANTABLE VENOUS ACC DEVICE- (SP)
COLLECTION OF BLOOD SPECIMEN USING ESTABL CENT/PERIPHERAL CATHETER, VENOUS-(SP)
DECLOTTING BY THROMBOLYTIC AGENT OF IMPL VASCULAR ACCESS DEVICE/CATHETER-(SP)
MECHANICAL REMOVAL OF PERICATHETER OBSTRUCTIVE MATERIAL
INSERTION OF NON TUNNELED CNTRLY INSERTED CNTRL VENOUS CATH; UNDER 5 YRS OF AGE
REPOSITIONING OF PREV PLACED CNTRL VENOUS CATH UNDER FLOROSCOPIC GUIDANCE
CONTRAST INJECTIONS FOR RADIOLOGICAL EVAL, INCL FLUOROSCOPY DOCO AND REPORT
ARTERIAL PUNCTURE
ARTERIAL CATHETERIZATION OR CANNULATION FOR SAMPLING, MONITOR OR TRANS.-(SP)
ARTERIAL CATHETERIZATION SEPARATE PROCEDURE (SP)
ARTERIAL CATHETERIZATION PROLONGED INFUSION THERAP
CATHETERIZATION, UMBILICAL ARTERY, NEWBORN, FOR DIAGNOSIS OR THERAPY
PLACEMENT OF NEEDLE FOR INTRASSEOUS INFUSION
INSERT CANNULA FOR HEMODIALYSIS, VEIN TO VEIN
ARTERIOVENOUS CANNULIZATION
ARTERIOVENOUS EXTERNAL REVISION OR CLOSURE
ARTERIOVENOUS ANASTOMOSIS, OPEN; BY UPPER ARM CEPHALIC VEIN TRANSPOSITION
ARTERIOVENOUS ANASTOMOSIS, OPEN; BY BASILIC VEIN TRANSPOSITION
ANASTOMOSIS, FOREARM VEIN TRANSPOSITION
ARTERIOVENOUS ANASTOMOSIS
INSERT CANNULA PROLONGED EXTRACORPOREAL CIRCULATIO
INSERTION OF ARTERIAL & VENOUS CANNULA(S) WITH REMOVAL AND REPAIR
ARTERIOVENOUS FISTULA
ARTERIOVENOUS FISTULA
THROMBECTOMY ARTERIOVERNOUS FISTULA WITHOUT REVISION
REVISION OF ART FISTULA WITH OR W/O AUTOG GRAFT
REVISION ARTERIOVENOUS FISTULA WITH THROMBECTOMY
THOMAS SHUNT
DISTAL REVASCULARIZATION & INTERVAL LIGATION , UPPER EXTREMITY HEMODIALYSIS ACC
CANNULA DECLOTTING WO/BALLOON CATHETER
CANNULA DECLOTTING W/BALLOON CATHETER
THROMBECTOMY, PERCUTANEOUS, ARTERIOVENOUS FISTULA, AUTO/NONAUTO GRAFT
PORTO-CAVAL ANASTOMOSIS
ANASTOMOSIS RENOPORTAL
CAVAL-MESENTERIC ANASTOMOSIS
SPLENO-RENAL ANASTOMOSIS
ANASTOMOSIS; SPLENORENAL,DISTAL(SELECTIVE DECOMP.)
INSERTION OF TRANSVENOUS INTRAHEPATIC
REVISION OF TRANSVENOUS INTRAHEPATIC PORTOSYSTEMIC SHUNT
PRIMARY PERCUTANEOUS TRANSLUMINAL MECHANICAL THROMBECTOMY, INITIAL VESSEL
PRIM PERCUTANEOUS TRANSLUMINAL MECHANICAL THROMBECTOMY,2ND/SUBSEQ, ADD-ON
SECONDARY PERCUTANEOUS TRANSLUMINAL THROMBECTOMY,ADD-ON
PERCUTANEOUS TRANSLUMINAL MECHANICALTHROMBECTOMY, INCL FLUOROSCOPIC GUIDANCE
PERCUTANEOUS TRANSLUMINAL MECHANICALTHROMBECTOMY, REPEAT TREATMENT/SAME DAY
THROMBOLYSIS; CEREBRAL, BY INTRAVENOUS INFUSION
TRANSCATHETER BIOPSY
TRANSCATHETER THERAPY, INFUSION FOR THROMBOLYSIS
TRANSCATHETER THERAPY INFUSION OTHER THAN THROMBOL
TRANSCATHETER RETRIEVAL INTRAVASULAR FOREIGN BOD
EMBOLIZATION, NONCENTRAL NERV SYS, NON HEAD OR NEC
TRANSCATHETER PLACEMENT INTRAVASCULAR STENTS EXCEPT CORONARY CAROTID VERTEBRAL
TRANSCATHETER PLACE INTRAVASCULAR STENT EA ADD VES-ADD ON
TRANSCATH PLACE INTRAVASCULAR STENT OPEN INIT VESS
TRANSCATA PLACE INTRAVASCULAR STENT OPEN EA ADD VE-ADD ON
EXCHANGE ARTERIAL CATHETER DURING THERAPY
UTERINE FIBROID EMBOLIZATION (TO TREAT UTERINE FIBROIDS, LEIOMYOMATA)
INTRAVASCULAR STENTS(S), CERVICAL CAROTID ARTERY, PERC; WITH DISTAL EMBOLIC
TRANSCATHETER PLACEMENT OF INTRAVASCULAR STENT(S), CERVIAL CAROTID ARTERY
INTRAVASCULAR ULTRASOUND DURING TX; INITIAL VESSEL-ADD ON
INTRAVASCULAR ULTRASOUND DURING TX-EA.ADD.VESSEL-ADD ON
VASCULAR ENDOSCOPY SURGICAL WITH LIGATION OF PERFORATOR VEINS SUBFASCIAL
UNLISTED VASCULAR ENDOSCOPY PROCEDURE
LIGATION OF INTERNAL JUGULAR VEIN
LIGATION, CAROTID
LIGATION, CAROTID
LIGATION INTERNAL CAROTID ARTERY W/GRADUAL OCCLUSI
LIGATION OR BANDING OF ANGIOACCESS ARTERIOVENOUS FISTULA
LIGATION OR BIOPSY TEMPORAL ARTERY
LIGATION MAJOR ARTERY; NECK
LIGATION MAJOR ARTERY; CHEST
LIGATION MAJOR ARTERY; ABDOMEN
LIGATION MAJOR ARTERY; EXTREMITY
INTERRUPTION PARTIAL/COMPLETE OF INFERIOR VENA CAVA BY SUTURE/LIGATION/PLACATION
INTERRUPTION PART/COMP OF FEMORAL VEIN BY LIGATURE
INTERRUPTION, PARTIAL OR COMPLETE OF ILIAC VEIN
LIGATION & DIVISION, VEINS
LIGATION, DIVISION, AND STRIPPING, SHORT SAPHENOUS VEIN
LIGATION, DIVIDE/STRIP SAPHENOUS VEINS. SAPHENOFEMORAL JUNCTION TO KNEE OR BELOW
REPAIR OF PULMONARY VENOUS STENOSIS
UNILATERAL LIGATION DIVISION & COMPLETE STRIPPING
STRIPPING, SUBFASCIAL, RADICAL
LIGATION OF PERFORATOR VEIN(S), SUBFASCIAL, OPEN INCL. ULTRSND GUIDANCE 1 LEG.
STAB PHLEBECTOMY OF VARICOSE VEINS, ONE EXTREMITY; 10-20 STAB INCISIONS
STAB PHLEBECTOMY OF VARICOSE VEINS, ONE EXTREMITY; MORE THAN 20 INCISIONS
LIGATION & DIVISION, VEINS
VARICOSE VEINS, LIGTN & EXCSN
PENILE VENOUS OCCLUSIVE PROCEEDURE
UNLISTED PROCEDURE, VASCULAR SURGERY
SPLENECTOMY
SPLENECTOMY, PARTIAL
TOTAL, EN BLOC FOR EXTENSIVE DISEASE-ADD ON
REPAIR OF RUPTURED SPLEEN W/WO PARTIAL SPLENECTOMY
LAPAROSCOPY, SURGICAL, SPLENECTOMY
UNLISTED LAPAROSCOPY PROCEDURE, SPLEEN
SPLENOPORTOGRAPHY, INJ PRO
MANAGEMENT OF RECIPIENT HEMATOPOIETIC PROGENITOR CELL DONOR SEARCH & CELL ACQUIS
BLOOD DERIVED HEMOTOPOIETIC PROGENITOR CELL HARVESTING FOR TRANSPLANTATION
BLOOD-DERIVED HEMATOPOIETIC PROGENITOR CELL HARVESTING FOR TRANSPLANT; AUTOLOGOU
BONE MARROW ASPIRATION
BONE MARROW BIOPSY NEEDLE OF TROCARE
BONE MARROW HARVESTING FOR TRANSPLANATATION
BONE MARROW TRANSPLANTATION; ALLOGENIC
BONE MARROW TRANSPLANTATION; AUTOLOGUS
BONE MARROW/STEM CELL TRANSPLANTATION; ALLOGENIC DONOR LYMPHOCYTE INFUSIONS
DRAINAGE, LYMPHADENITIS
DRAINAGE LYMPHADENITIS EXTENSIVE
LYMPHANGIOTOMY OR OTHER OPERATIONS ON LYMPHATIC
LIGATION, THORACIC DUCT
LIGATION, THORACIC DUCT
SUTURE/LIGATION THORACIC DUCT ABDOMINAL APPROACH
PERCUTANEOUS ANGIOPLASTY FEMORAL-POPLITEAL
BIOPSY, LYMPH NODE
BX OR EXC LYMPH NODE BY NEEDLE SUPERFICIAL
BIOPSY, LYMPH NODE
BIOPSY, LYMPH NODE
DEEP AXILLARY NODE
BIOPSY, LYMPH NODE
DISSECTION DEEP JUGULAR NODES
EXCISION, CYSTIC HYGROMA
EXCISION, CYSTIC HYGROMA
LIMITED LYMPHADENECTOMY FOR STAGING-PELVIC
LIMITED LYMPHADENECTOMY FOR STAGING RETROPERITONEA
LAPAROSCOPY RETROPERITONEAL LYMPH NODE BIOPSY; SINGLE OR MULTIPLE
LAPAROSCOPY PELVIC LYPMHADENECTOMY
LAPAROSCOPY PELVIC LYMPHADENECTOMY WITH BIOPSY
LAPAROSCOPY UNLISTED LYMPHATIC PROCEDURE
LYMPHADENECTOMY
LYMPHADENECTOMY
CERVIAL LYMPHADENECTOMY MODIFIED RADICAL NECK
AXILLARY LYMPHADENECTOMY, SUPERFICIAL
LYMPHADENECTOMY
THORACIC LYMPHADENECTOMY,REGIONAL,INCLUD MEDIASTIN-ADD ON
ABDOMINAL LYMPHADENECTOMY, REGIONAL-ADD ON
LYMPHADENECTOMY
LYMPHADENECTOMY
LYMPHADENECTOMY
LYMPHADENECTOMY
LYMPHANGIOGRAPHY, INJ PRO
INJECTION PROCEDURE FOR IDENTIFICATION OF SENTINEL NODE
CANNULATION, THORACIC DUCT
UNLISTED PROCEDURE, HEMIC OR LYMPHATIC SYSTEM
MEDTASTINOTOMY W/EXPLORATION DRAINAGE REMOVAL FB
MEDIASTINOTOMY
EXCISION, CYST, MEDIASTINAL
EXCISION, TUMOR, MEDIASTINAL
MEDIASTINOSCOPY
UNLISTED MEDIASTINUM PROC
REPAIR LACERATION OF DIAPHRAGM
REPAIR PARAESOPHAGEAL HIATUS HERNIA TRANSABDOMINAL
REPAIR NEONATAL DIAPHRAGMATIC HERNIA,INCL CHEST TU
REPAIR, ESOPHAGEAL HERNIA
REPAIR, ESOPHAGEAL HERNIA
COMBINED, THORACOABDOMINAC,/W DILATION STRICTURE
REPAIR DIAPHRAGMATIC HERNIA TRAMATIC ACUTE
REPAIR DIAPHRAGMATIC HERNIA CHRONIC
IMBRICATION DIAPHRAGM
RESECTION, DIAPHRAGM; WITH SIMPLE REPAIR
RESECTION, DIAPHRAGM; WITH COMPLEX REPAIR
UNLISTED DIAPHRAGM PROC
BIOPSY, LIP
VERMILIONECTOMY
RESECTION, LIP
EXCISION, LIP
LIP FULL-THICKNESS RECONSTRUCTION W/LOCAL FLAP
LIP-FULL THICKNESS RECONSTRUCT W/CROSS LIP FLAP
RESECTION, LIP
LIP REPAIR-FULL THICKNESS VERMILION ONLY
REPAIR LIP UP TO HALF VERTICAL HEIGHT
REPAIR LIP OVER 1/2 VERTICAL HEIGHT COMPLEX
PLASTIC REPAIR, LIP
PLASTIC REPAIR, LIP
PLASTIC REPAIR, LIP
PLASTIC REPAIR, LIP
PLASTIC REPAIR CLEFT LIP-W/CROSS LIP PEDICLE FLAP
UNLISTED PROCEDURE, LIP
DRAINAGE, CYST, MOUTH
DRAIN ABSCESS,CYST,HEMATOMA VESTIBULE MOUTH COMPLI
REMOVAL, FOREIGN BODY, MOUTH
REMOVAL EMBEDDED FB VESTIBULE OF MOUTH COMPLICATED
INCISION, LABIAL FRENUM
BIOPSY, VESTIBULE OF MOUTH
EXCISION, LESION, MOUTH
EXCISION, LESION, MOUTH
EXCISION LESION MUCOSA-SUBMUCOSA (MOUTH) W/COMPLEX
COMPLEX,WITH EXCISION OF UNDERLYING MUSCLE
EXCISION MUCOSA OF VESTIBULE OF MOUTH AS DONOR GRA
EXCISION OF FRENUM, LABIAL OR BUCCAL
DESTRUCTION, LESION, MOUTH
CLOSURE, LACERATION, MOUTH
CLOSURE LACERATION MOUTH OVER 2 1/2 CM COMPLEX
VESTIBULOPLASTY; ANTERIOR
VESTIBULOPLASTY, POSTERIOR, UNILATERAL
VESTIBULOPLASTY, POSTERIOR BILATERAL
VESTIBULOPLASTY, ENTIRE ARCH
VESTIBULOPLASTY, COMPLEX (INCL. RIDGE EXT.& MUSCLE
UNLISTED PROCEDURE, MOUTH
DRAINAGE, ABSCESS, TONGUE
DRAINAGE, ABSCESS, SUBLINGUAL
INTRAORAL INCISION SUBLINGUAL, DEEP, SUPRAMYLOHYOI
INTRAORAL I&D ABSCESS,CYST/HEMATOMA,SUBMENTAL SPAC
DRAIN ABCESS, CYST, HEMATOMA SUBMANDIBULAR SPACE
INTRAORAL INCISION DRAIN ABSCESS;MASTICATOR SPACE
INCISION, LINGUAL FRENUM
EX RAORAL INCISION & DRAINAGE OF ABCESS
EXTRORAL I&D ABSCESS,CYST/HEMATOMA, SUBMENTAL
EXTRAORAL INCISSION AND DRAIN ABSCESS,CYST,HEMATOM
EXTRAORAL I & D OF ABSCESS ETC MASTICATOR SPACE
PLACEMENT OF NEEDLES, CATHETERS, OR OTHER DEVICE(S) INTO THE HEAD AND/OR NECK
BIOPSY, TONGUE
BIOPSY, TONGUE
BIOPSY, FLOOR OF MOUTH
EXCISION, LESION, TONGUE
EXCISION, LESION, TONGUE
EXCISION LESION TONGUE W/CLOSURE POSTERIOR 1/3
EXCISION LESSION TONGUE W/LOCAL TONGUE FLAP
EXCISION OF LINGUAL FRENUM (FRENECTOMY)
EXCISION LESION FLOOR OF MOUTH
GLOSSECTOMY
HEMIGLOSSECTOMY
GLOSSECTOMY
GLOSSECTOMY
GLOSSECTOMY
COMPOSITE PROCEDURE W/RESECTFON FLOOR MOUTH-MANDIR
COMPOSITE PROCEDURE W/RESECTION W/SUPRAHYOID NECK
COMPOSITE PROCEDURE W/RESECTION-MANDIBULAR RESECTI
REPAIR, LACERATION, TONGUE
REPAIR, LACERATION, TONGUE
REPAIR LACERATION TONGUE OVER 2-6 CM COMPLEX
FIXATION, TONGUE
SUTURE, TONGUE TO LIP
TONGUE BASE SUSPENSION, PERMANENT SUTURE TECHNIQUE
FRENOPLASTY
UNLISTED PROCEDURE, TONGUE
DRNGE, CYST, DENTO ALVEOLAR ST
REMOVAL FB DENTO-ALVEOLAR SOFT-TISSUE
REMOVAL FB DENTO-ALVEOLAR BONE
GINGIVECTOMY
OPERCULECTOMY, EXCISION PERICORONAL TISSUE
EXCISION FIBROUS TUBEROSITIES, DENTOALVEOLAR STRUC
EXCISION OSSEOUS TUBEROSITIES, DENTOALVEOLAR STRUC
EXCSN, LESION, DENTO ALVEOLAR
EXCISION LSEION DENTO ALVEOLAR SIMPLE REPAIR
EXCISION LESION/TUMOR,DENTOALVEOLAR,W/COMPLEX REPA
EXC HYPERPLASTIC ALVEOLAR MUCOSA EA SEXTANT OR QUA
ALVEOLECTOMY W/CURETTAGE OF OSTEITUS-SEQUESTRECTMY
DSTRCTN, LESN, DENTO-ALVEOLAR
PERIODONTAL MUCOSAL GRAFTING
GINGIVOPLASTY - EACH QUADRANT (SPECIFY)
ALVEOLOPLASTY EACH QUADRANT (SPECIFY)
UNLISTED PROC, DENTOALVEOLAR
DRAINAGE, ABSCESS, PALATE
BIOPSY, PALATE/UVULA
EXCISION, LESION, PALATE
EXCISION, LESION, PALATE
EXCISION LESION OF PALATE, UVULA W/LOCAL FLAP CLOS
RESECTION, PALATE
EXCISION, UVULA
PALATOPHARYNGOPLASTY (LESION OF PALATE OR UVULA)
DESTRUCTION, LESION, PALATE
REPAIR, LACERATION, PALATE
REPAIR, LACERATION, PALATE
CLEFT PALATE REPAIR
CLEFT PALATE REPAIR
CLEFT PALATE REPAIR
CLEFT PALATE REPAIR
CLEFT PALATE REPAIR
CLEFT PALATE REPAIR
LENGTHENING OF PALATE & PHARYNGEAL FLAP
LENGTHENING OF PALATE WITH ISLAND FLAP
REPAIR, PALATE, ANTERIOR
REPAIR, FISTULA, NASOLABIAL
MAXILLARY IMPRESSION FOR PALATAL PROSTHESIS
INSERTION OF PIN-RETAINED PALATAL PROSTHESIS
UNLISTED PROC, PALATE
DRAINAGE, ABSCESS, PAROTID
DRAINAGE ABCESS PAROTID COMPLICATED
DRNG, ABSCESS, SUBMAXILLARY
DRNG, ABSCESS, SUBMAXILLARY
SIALOLITHOTOMY
SIALOLITHOTOMY
SIALOLITHOTOMY
BIOPSY, SALIVARY GLAND
BIOPSY, SALIVARY GLAND
EXCISION SUBLINGUAL SALIVARY GLAND
MARSUPIALIZATION SUBLINGIAL SALIVARY CYST
EXCISION, PAROTID GLAND
EXCISION, PAROTID GLAND
EXCISION, PAROTID GLAND
EXCISION, PAROTID GLAND
EXCISION, PAROTID GLAND
EXCISION, SUBMANDIBULAR GLAND
EXCISION, SUBLINGUAL GLAND
SIALODOCHOPLASTY
SIALODOCHOPLASTY SECOUNDARY OR COMPLICATED
PAROTID DUCT DIVERSION BILATERAL (WILKE TYPE)
PAROTID DUCT DIVERSION W/EXCISION ONE SUBMANDIBULA
PAROTID DUCT DIVERSION W/EXCISION BOTH SUBMANDIBUL
PAROTID DUCT DIVERSION W/LIGATION BOTH SUBMANDIBUL
SIALOGRAPHY, INJECTION PROCDRE
CLOSURE, FISTULA, SALIVARY
DILATION, SALIVARY DUCT
DILATION, SALIVARY DUCT
LIGATION, SALIVARY DUCT
UNLISTED PROC SALIVARY
INCISION & DRAINAGE ABSCESS; PERITONSILLAR
INCISION DRAIN ABSCESS, RETROPHARYNGEAL INTRAORAL
INCISION DRAIN ABSCESS, RETROPHARYNGEAL EXTERNAL A
BIOPSY, PHARYNX
BIOPSY, PHARYNX
BIOPSY, PHARYNX
BIOPSY; NASOPHARYNX SURVEEY UNKNOWN PRIMARY LESION
EXCISION OF LESION OF PHARNYX
REMOVAL OF FOREIGN BODY FROM PHARNYX.
EXCISION, BRACHIAL CLEFT CYST
EXCISION, BRACHIAL CLEFT CYST
TONSILLECTOMY AND ADENOIDECTOMY
TONSILLECTOMY & ADENOIDECTOMY
TONSILLECTOMY PRI OR SEC UNDER AGE 12
TONSILLECTOMY PRIMARY AND SECONDARY AGE 12 OR OVER
ADENOIDECTOMY, PRIMARY UNDER AGE 12
ADENOIDECTOMY, PRIMARY, AGE 12 OR OVER
ADENOIDECTOMY
ADENOIDECTOMY, SECONDARY, AGE 12 OR OVER
RADICAL RESECTION TONSIL,TONSILLAR PILLARS,WO/CLOS
RADICAL RESECTION TONSIL, CLOSURE W/LOCAL FLAP
RADICAL RESECTION TONSIL, CLOSURE W/OTHER FLAP
EXCISION, TONSIL TAGS
EXCISION, LINGUAL TONSIL
LIMITED PHARYNGECTOMY
RESECTION LATERAL PHARYNGEAL WALL DIRECT CLOSURE A
RESECTION PHARYNGEAL WALL REQUIRING CLOSEURE W/MYO
SUTURE, PHARYNX
PHARYNGOPLASTY
PHARYNGOESOPHAGEAL REPAIR
PHARYNGOSTOMY
CNTRL OROPHARYNGEAL HEMORRHAGE
CONTROL OROPHARYNGEAL HEMORRHAGE COMPLICATED
CONTROL OROPHARYNGEAL HEMORRHAGE W/SECOUND SURG IN
CTRL NASOPHARYNGEAL HEMORRHAGE
CTRL.NASOPHARYNGEAL HEMORRHAGE, COMPLICATED
CONTROL NASOPHARYNGEAL HEMORRHAGE W/SECOUND SURG I
UNLISTED PROC, T/A OR PHARYNX
ESOPHAGOTOMY
CRICOPHARYNGEAL MYOTOMY
ESOPHAGOTOMY
EXCISION, LESION, ESOPHAGUS
EXCISION, LESION, ESOPHAGUS
TOTAL ESOPHAGECTOMY W/W/O PYLOROPLASTY TRANSHIATAL
TOTAL ESOPHAGECTOMY W/INTTERPOSTION/RECONSTRUCT
TOTAL ESOPHAGECTOMY W/THORACOTOMY W/W/O PYLOROPLAS
ESOPHAGECTOMY W/THORACOTOMY W/INTERPOSITION/RECONS
PARTIAL ESOPHAGECTOMY,GRAFT/INTESTINAL RECONSTRUCT
PARTIAL ESOPHAGECTOMY W/W/O PYLOROPLASTY
PARTIAL ESOPHAGECTOMY W/INTERPOSITION/RECONSTRUCT
PARTIAL ESOPHAGECTOMY W/THORACOTOMY ONLY
PARTIAL ESOPHAGECTOMY W/ESOPHAGOGASTROSTOMY
PARTIAL ESOPHAGECTOMY W/INTERPOSITION/RECONSTRUCT
TOTAL OR PARTIAL ESOPHAGECTOMY W/O RECONTRUCTION
DIVERTICULECTOMY
DIVERTICULECTOMY
ESOPHAGOSCOPY
ESOPHAGOSCOPY, RIGID OR FLEXIBLE; W/DIRECTED SUBMUCOSAL INJECTION ANY SUBSTANCE
ESOPHAGOSCOPY
ESOPHAGOSCOPY, RIGID OR FIBEROPTIC WITH INJECTION
WITH BAND LIGATION OF ESOPHAGEAL VARICES
ESOPHAGOSCOPY
W/REMOVAL TUMORS,POLYPS,OR OTHER LESIONS BY HOT BI
ESOPHAGOSCOPY FOR REMOVAL OF POLYPOIA LESION
ESPOHAGOSCOPY FOR INSSERTION OF PLASTIC TUBE OR ST
ESOPHAGOSCOPY, RIGID OR FLEXIBLE; WITH BALLOON DILATION
ESOPHAGOSCOPY FOR INSERTION OF WIRE GUIDE DILATION
ESOPHAGOSCOPY FOR CONTROL OF HEMORRHAGE
FOR ABLATION OF TUMORS, POLYPS OR OTHER LESIONS
ESOPHAGOSCOPY WITH ENDOSCOPIC ULTRASOUND EXAM
ESOPHAGOSCOPY W/ TRANSENDOSCOPIC FINE NEEDLE ASPIRATION/BIOPSY
UPPER GI ENDOSCOPY SIMPLE PRIM EXAM
ESOPHAGOGASTRODUODENOSCOPY
UPPER GI ENDOSCOPY INC ESOPHAGUS, STOMACH, DUODENUM, JEJUNUM; W/ SUBMUCOSAL INJ.
WITH ENDOSCOPIC ULTRASOUND EXAMINATION LIMITED TO ESOPHAGUS
WITH TRANSENDOSCOPIC ULTRASOUND GUIDED ASPIRATION/BIOPSY
ESOPHAGOGASTROSCOPY
UPPER GI ENDOSCOPY FOR PSEUDOCYST DRAINAGE
UPPER GASTROINTESTINAL ENDOSCOPY INCLUDING ESOPHAG
UPPER GI ENDOSCOPY WITH ULTRASOUND FNA/BIOPSY
UPPER GASTROINTESTINAL ENDOSCOPY
UPPER GASTRO ENDOSCOPY W/BAND LIGATION OF ESOPHAGE
UPPER GI ENDOSCOPY FOR DIL GASTRIC OUTLET OBSTRUCT
UPPER GL ENDOSCOPY FOR PLACE OF G-TUBE
ESOPHAGOGASTRODUODENOSCOPY
W/INSERT OF GUIDE WIRE FOLLOWED BY DILATION OF ESO
GASTROINTESTINAL ENDOSCOPY W/BALLOON DILATION <30
W/REMOVAL OF TUMORS,POLYPS,OR OTHER LESIONS BY HOT
REMOVAL POLYPOID LESION
UPPER GASTROINTESTINAL ENDOSCOPY FOR HEMORHAGE CON
UPPER GI ENDOSCOPY WITH STENT PLACEMENT
INCLUDING ESOPHAGUS, STOMACH, AND EITHER THE DUODENUM AND/OR JEJUNUM
UPPER GASTRO ENDOSCOPY W/FULGURATION MUCOSAL LESIO
W/ ENDOSCOPIC ULTRASOUND EXAMINATION
ENDSCPIC RTRGRD CHOLANGIOPANCREATOGRAPHY, DIAGNSTC
WITH BIOPSY, SINGLE OR MULTIPLE
ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY
ERCP FOR PRESSURE MESURE OF SPHINCTER OF ODDI
UPPER GASTRO ENDOSCOPY INCL ESOPH W/REMOVAL STONE
ERCP FOR DESTRUCT LITHOTRIPSY OF STONE ANY METHOD
ERCP FOR INSERTION OF NASOBILIARY/NASOPANCREATIC D
ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRPHY
ERCP, FOR REMOVAL OR CHANGE OF TUBE
ERCP FOR BALLOON DILATION OF AMPULLA, BILARY/PANCR
ERCP FOR ABLATION OF TUMOR/MUCOSAL LESION (LASER H
ENDO ANNULTN OF PAPILLA W/DIRECT VISUL OF COMMONBILE DUCT & OR PANCRTIC DUCT
LAPAROSCOPY, SURGICAL, ESOPHAGOMYOTOMY (HELLER TYPE), WITH FUNDOPLASTY
LAPAROSCOPY ESOPHAGOGASTRIC FUNDOPLASTY
LAPAROSCOPY, SURGICAL, REPAIR OF PARAESOPHAGEAL HERNIA, INCLUDES FUNDOPLASTY
WITH IMPLANTATION OF MESH
LAPAROSCOPY UNLISTED ESOPHAGUS PROCEDURE
ESLPNAGOPLASTY, CERVICAL APPROACH; W/O REPAIR FIST
ESOPHAGOPLASTY
ESOPHAGOPLASTY
ESOPHAGOPLASTY
ESOPHAGOPLASTY FOR CONGENITAL DEFECT THORACIC APPROACH W/O FISTULA REPAIR
ESOPHAGOPLASTY FOR CONGENITAL DEFECT THORACIC APPROACH W/FISTULA REPAIR
ESOPHAGOGASTROSTOMY
FUNDOPLASTY, ESOPHAGOGASTRIC
ESOPHAGOGASTRIC FUNDOPLASTY W/FUNDIC PATCH
ESOPHAGOGASTRIC FUNDOPLASTY W/GASTROPLASTY
ESOPHAGOMYOTOMY W/OR W/O HIATAL HERNIA REPAIR ABOD
HELLER PROCEDURE
ESOPHAGOJEJUNOSTOMY
ESOPHAGEJEJUNOSTOMYTHORACIC APPROACH
ESOPHAGOSTOMY
ESOPHAGOSTOMY
ESOPHAGOSTOMY FISTULIZATION ESOPHAGUS EXT/CERVICAL
GASTROINTESTIONAL RECONSTRUCTION W/STOMACH
GASTROINTESTINAL RECONSTRUCT W/INTERPOSITION
LIGATION, ESOPHAGEAL VARICES
TRANSECTION OF ESOPHAGUS REPAIR VARIOUS
LIGATION/STAPLING GASTROESOPHAGEAL JUNCTION
SUTURE, ESOPHAGEAL WOUND
SUTURE, ESOPHAGEAL WOUND
ESOPHAGOSTOMY CLOSURE
CLOSE ESOPHAGOSTOMY OR FISTULA; THORACIC APPROACH
DILATION, ESOPHAGUS
DILATION OF ESOPHAGUS OVER GUIDE WIRE
DILATION ESOPHAGUS BY BALLOON OR DILATOR RETROGRAD
DILATION ESOPHAGUS W/BALLOON 30MM OR < FOR ACHALAS
ESOPHAGOGASTRIC TAMPONADE W/BALLOON
FREE JEJUNUM TRANSFER W/MICROVASCULAR ANASTOMOSIS
MULTIPLE ENDOSCOPIC PROCS
GASTROTOMY
GASTROTOMY,W/SUTURE REPAIR BLEEDING ULVER OR ESOPH
GASTROTOMY;W/REPAIR ESOPHAGOGASTRIC LACERATION
GASTROTOMY W/ESOPHAGEAL DILATION AND INSERT PLASTI
PYLOROMYOTOMY
GASTRIC BIOPSY
GASTRIC BIOPSY
EXCISION, ULCER, STOMACH
MALIGNANT TUMOR OF STOMACH
GASTRECTOMY
WITH ROUX-EN-Y RECONSTRUCTION
WITH FORMATION OF INTESTINAL POUCH
GASTRECTOMY,PARTIAL,DISTAL,WITH GASTRODUODENOSTOMY
WITH GASTROJEJUNOSTOMY
GASTRECTOMY WITH ROUX-EN-Y RECONTRUCTION
WITH FORMATION OF INTESTINAL POUCH
VAGOTOMY WITH PARTIAL DISTAL GASTRECTOMY-ADD ON
VAGOTOMY AND PYLOROPLASTY
EXCISION PARIETAL CELL
LAPARASCOPY, SURGICAL, GASTRIC RESTRICTIVE PROCEDURE: WITH GASTRIC BYPASS
LAPARASCOPY, WITH GASTRIC BYPASS AND SMALL INTESTINE RECONSTRUCTION TO LIMIT ABS
LAPAROSCOPY, SURGICAL; IMPLANT/REPLACEMENT/GASTRIC NEUROSTIMULATOR
REVISION OR REMOVAL OF GASTRIC NEUROSTIMULATOR ELECTRODES, ANTRUM
LAPAROSCOPY TRANSECTION OF VAGUS NERVES, TRUNCAL
LAPAROSCOPY TRANSECTION OF VAGUS NERVES, SELECTIVE
LAPAROSCOPY GASTROSTOMY
LAPAROSCOPY UNLISTED STOMACH PROCEDURE
NASO/ORO-GASTRIC TUBE PLACEMENT
CHANGE OF GASTROSTOMY TUBE; SIMPLE
REPOSITION GASTRIC FEEDING TUBE THRU DUODENUM OFEN
LAPAROSCOPY, SURGICAL, GASTRIC RESTRICTIVE PROCEDURE
LAPAROSCOPY, SURGICAL, GASTRIC RESTRICTIVE PROCEDURE, REVISION OF ADJUSTABLE
LAPAROSCOPY, SURGICAL, GASTRIC RESTRICTIVE PROCEDURE, REMOVAL OF ADJUSTABLE
LAPAROSCOPY, SURGICAL, GASTRIC RESTRICTIVE PROCEDURE, REMOVAL & REPLACE
LAPAROSCOPY, SURGICAL, GASTRIC RESTRICTIVE PROCEDURE, REMOVAL OF ADJUSTABLE
LONGITUDINAL GASTRECTOMY (IE, SLEEVE GASTRECTOMY)
PYLOROPLASTY
GASTRODUODENOSTOMY
GASTROJEJUNOSTOMY
GASTROJEJUNOSTOMY
GASTROSTOMY
GASTROSTOMY
GASTROSTOMY
GASTRORRHAPHY
GASTRIC RESTRICTIVE PROC,W/O GASTRIC BYPASS FOR MORBID OBESITY VERTICAL BANDING
GASTROPLASTY, OTHER THAN VERT-BANDED, W/O BYPASS
PARTIAL GASTRECTOMY, PYLORUS-PRESERVING DUODENOILEOSTOMY & ILEOILEOSTOMY
GASTRIC BYPASS, WITH ROUX-EN-Y GASTROENTEROSTOMY
GASTRIC PROCEDURE; W/BOWEL RECONSTRUCTION
REVISION OF GASTRIC PROCEDURE-MORBID OBESITY
REVISION OF GASTRODUODENAL ANSATOMOSIS W/RECONSTRU
RVSN GASTROENTERIC ANASTOMOSIS
REVISION OF GASTROJEJUNOSTOMY W/RECONSTRUCTION
REVISION OF GASTROJEJUNAL ANASTOMOSIS W/RECONSTRUC
GASTROSTOMY CLOSURE
CLOSURE, FISTULA, GASTROCOLIC
IMPLANTATION OR REPLACEMENT OF GASTRIC NEUROSTIMULATOR ELECTRODES, ANTRUM, OPEN
REVISION OR REMOVAL OF GASTRIC NEUROSTIMULATOR ELECTRODES, ANTRUM, OPEN
UNLISTED PROCEDURE, STOMACH
ENTEROLYSIS
DUODENOTOMY
NEEDLE CATH JEJUNOSTOMY FOR ENTERAL HYPERALIMENTAT-ADD ON
ENTEROTOMY SMALL INTESTINE FOR EXPLORATION
ENTEROTOMY; SMALL BOWEL OTHER THAN DUODENUM
ENTEROTOMY
REDUCTION, VOLVULUS
CORR OF MALROTATION BY LYSIS
BIOPSY, INTESTINES
EXCISION, LESION, BOWEL
EXCISION, LESION, BOWEL
ENTERECTOMY
ENTERECTOMY; EACH ADDITIONAL RESECTION/ANASTOMOSIS-ADD ON
ENTERECTOMY
ENTERECTOMY OF SMALL INTESTINE FOR CONGENITAL ATRESIA W/O TAPEERING
ENTERECTOMY OF SMALL INTESTINE FOR CONGENITAL ATRESIA W/TAPERING
ENTERECTOMY OF SMALL INTESTINE FOR CONGENITAL ATRESIA EACH ADDITIONSL RESECTION
ENTEROENTEROSTOMY
DONOR ENTERECTOMY INCLUDING COLD PRESERVATION OPEN FROM CADAVER DONOR
DONOR ENTERECTOMY PARTIAL, FROM LIVING DONOR
INTESTINAL ALLOTRANSPLANTATION; FROM CADAVER DONOR
INTESTINAL ALLOTRANSPLANATION; FROM LIVING DONOR
REMOVAL OF TRANSPLANTED INTESTINAL ALLOGRAFT, COMPLETE
MOBILIZATION SPLENIC FLEXURE W/PARTIAL COLECTOMY-ADD ON
COLECTOMY
COLECTOMY
HARTMANN PROCEDURE
COLECTOMY
COLECTOMY
COLECTOMY
COLECTOMY, PARTIAL, WITH ANASTOMOSIS
COLECTOMY;W/O PROCTECTOMY W/ILEOSTOMY OR ILEOPROCT
COLECTOMY TOTAL W/CONTINENT ILEOSTOMY
COLECTOMY
COLECTOMY,TOTAL,ABDOMINAL W/PROCTECTOMY& CONTINENT
COLECTOMY, TOTAL, ABD, W/PROCTECTOMY
COLECTOMY, TOTAL, ABDOMINAL, W/ PROCTECTOMY; W/ ILEOANAL
COLECTOMY WITH REMOVAL OF TER ILEUM & ILEOCOLOSTOM
LAPAROSCOPY, SURGICAL ENTEROLYSIS (SP)
LAPAROSCOPY, SURGICAL JEJUNOSTOMY, FOR DECOMPRESSION OR FEEDING
LAPAROSCOPY, SURGICAL ILEOSTOMY OR JEJUNOSTOMY,NON TUBE
LAPAROSCOPY, SURGICAL COLOSTOMY OR SKIN LEVEL CECOSTOMY
LAPAROSCOPY JEJUNOSTOMY, INTESTINAL RESECTION
LAPAROSCOPY EACH ADD SMALL INTESTINE RESECTION & ANASTOMOSIS (ADD-ON)
LAPAROSCOPY, COLECTOMY PARTIAL WITH ANASTOMOSIS
LAPAROSCOPY, COLECTOMY PARTIAL W/REMOVAL TERMINAL ILEUM W/ ILEOCOLOSTOMY
LAPAROSCOPY; COLECTOMY, PARTIAL, W/END COLOSTOMY & CLOSURE OF DISTAL SEGMENT
LAPAROSCOPY; COLECTOMY, PARTIAL, W/ANASTOMOSIS, W/COLOPROCTOSTOMY
LAPAROSCOPY; COLECTOMY, PARTIAL, W/ANASTOMOSIS, W/ COLOPROCTOSTOMY W/ COLOSTOMY
LAPAROSCOPY; COLECTOMY, TOTAL, ABDOMINAL,W/O PROCTECTOMY, W/ ILEOSTOMY/ILEOPROCT
LAPAROSCOPY; COLECTOMY, TOTAL W/PROCTECTOMY, W/ILEDANAL, ILEAL RESERVIOR, W/LOOP
LAPAROSCOPY; COLECTOMY, TOTAL, ABDOMINAL, W/PROCTECTOMY, W/ILEOSTOMY
LAPAROSCOPY, SURGICAL MOBILIZATION/SPLENIC FLEXURE ADD-ON
LAPAROSCOPY, SURG CLOSURE/ENTEROSTOMY, LG/SML INTESTINE W/RESECTION/ANASTOMOSIS
UNLISTED LAPAROSCOPY PROCEDURE, INTESTINE (EXCEPT RECTUM)
TUBE CECOSTOMY/ENTEROSTOMY
ILEOSTOMY
ILEOSTOMY
ILEOSTOMY
CONTINENT ILEOSTOMY
COLOSTOMY
COLOSTOMY W/MULTIPLE BIOPSIES
COLOSTOMY
COLOSTOMY
REV COLOSTOMY W/REPAIR PARACOLOSTOMY HERNIA
SM INTESTINAL ENDOSCOPY, BY SECOND PORTION OF DUOD
SM. INTESTINAL ENDOSCOPY W/OBIOPSY,SINGLE/MULTIPLE
S INTESTINAL ENDOSCOPY W/FB REMOVAL
W/REMOVAL OF TUMORS,POLYPS,OR OTHER LESIONS BY SNA
W/REMOVAL TUMORS,POLYPS,OR OTHER LESION,HOT BIOPSY
WITH CONTROL OF BLEEDING, ANYMETHOD
W/ABLATION OF TUMORS,POLYPS,OR OTHER LESIONS NOT A
SMALL INTESTINAL ENDOSCOPY WITH STENT PLACEMENT
W/PLACEMENT PERCUTANEOUS JEJUNOSTOMY TUBE
W/CONVERSION PERCUTANEOUS GASTROSTOMY TUBE TO PERC
SM INTESTINAL ENDOSCOPY, ENTEROSCOPY BEYOND SECOND
WITH BIOPSY, SINGLE OR MULTIPLE
WITH CONTROL OF BLEEDING, ANY METHOD
SMALL INTESTINAL ENDOSCOPY WITH STENT PLACEMENT
ILEOSCOPY,THRU STOMA;DIAGNOSTIC W/OR W/O COLLECTIO
FIBEROPTIC ILEOSCOPY W/BIOPSY-COLLECT BRUSHING/WAS
ILEOSCOPY W/STENT PLACEMENT
ENDOSCOPE EVALUATION OF SMALL INTESTINAL POUCH,DIA
WITH BIOPSY, SINGLE OR MULTIPLE
COLONOSCOPY THRU STOMA;DIAGNOSTICE,W/OR W/O COLLEC
WITH BIOPSY, SINGLE OR MULTIPLE
WITH REMOVAL OF FOREIGN BODY
WITH CONTROL OF BLEEDING ANY METHOD
W/REMOVAL OF FOREIGN BODY
W/ABLATION OF TUMORS,POLYPS,OR OTHER LESION NOT AM
COLONOSCOPY THROUGH STOMA; BY SNARE TECHNIQUE
COLONOSCOPY W/ STENT PLACEMENT
INTRODUCTION OF LONG GASTROINTESTINAL TUBE-(SP)
SUTURE SMALL INTESTINE FOR PERFORATED ULCER, DIVERTICULUM, WOUND, INJURY OR RUP
MULTIPLE PERFORATIONS
SUTURE LARGE INTESTINE FOR PERFORATED ULCER,DIVERT
ENTERORRHAPHY
INTESTINAL STRICTUROPLASTY W/OR W/O DILATION FOR I
CLOSURE, ENTEROSTOMY
CLOSURE, ENTEROSTOMY
CLOSURE ENTEROSTOMY; WITH RESECTION AND COLORECTAL ANATOMOSIS
CLOSURE, FISTULA, INTESTINAL
CLOSURE, FISTULA, ENTEROCOLIC
CLOSURE, FISTULA ENTEROVESICAL
CLOSURE ENTEROVESICAL FISTULA W/BOWEL AND BLADDER
SUTURE, PLICATION, INTESTINAL
EXCLUSION OF SMALL BOWEL FROM PELVIS BY MESH/OTHER PROSTHESIS,OR NATIVE TISSUE
INTRAOPERATIVE COLONIC LAVAGE (ADD-ON)
CADAVER OR LIVING DONOR INTESTINE ALLOGRAFT > TRANSPLANT INCLUDING MOBILIZATION
CADAVER OR LIVING DONOR INTESTINE ALLOGRAFT > TRANSPLANT VENOUS ANASTAMOSIS; EA
CADAVER OR LIVING DONOR INTESTINE ALLOGRAFT PRIOR TO TRANSPLANT; ARTERIAL ANAST
UNLISTED PROC, INTESTINE
DIVERTICULECTOMY
EXCISION, LESION, MESENTERY
SUTURE, MESENTERY
UNLISTED PROC, MESENTERY
DRAINAGE, ABSCESS, APPENDICIAL
INCISION AND DRAINAGE OF APPENDICEAL ABSCESS; PERCUTANEOUS
APPENDECTOMY
APPENDECTOMY WHEN DONE W.OTHER MAJOR PROCEDURE-ADD ON
APPENDECTOMY FOR RUPTURED APPENDIX W/ABSCESS
LAPAROSCOPY APPENDECTOMY
LAPAROSCOPY UNLISTED APPENDIX PROCEDURE
DRAINAGE, ABSCESS, PELVIC
INCISION & DRAINAGE OF SUBMUCOUS ABSCESS, RECTUM
DRAINAGE, ABSCESS, PELVIRECTAL
BIOPSY, ANO-RECTAL WALL
MYOMECTOMY, ANORECTAL
PROCTECTOMY
PROTECTOMY, PARTIAL RESECTION
PROCTECTOMY
PROCTECTOMY,PARTIAL W/MUCOSECTOMY W/W/O ILEOSTOMY
PROCTECTMY PARTIAL W ANASTOMOSIS ABDOMINAL & TRNSC
PROCTECTOMY PARTIAL TRANSACRAL APPROACH ONLY KRSKE
PROCTECTOMY,COLO-ANAL ANASTOMOSIS,W/COLONIC RESERVOIR,W/W/O DIVERTING OSTOMY
PROCTECTOMY
PROTECTOMY COMPLETE W SUBTOTAL OR TOTAL COLECTOMY
PROCTECTOMY PARTIAL W/O ANASTOMOSIS, PERINEAL
PELVIC EXENTERATION COLORECTAL MALIGNA WITH PROCTECTOMY
EXCISION, RECTAL PROCIDENTIA
EXCISION, RECTAL PROCIDENTIA
EXCISION OF ILEOANAL RESERVOIR W/ ILEOSTOMY
DIVISION, STRICTURE, RECTUM
EXCISION RECTAL TUMOR BY PROCTOTOMY TRANSANAL APPR
EXCISION OF RECTAL TUMOR, TRANSANAL APPROACH; NOT INCLUDING MUSCULARIS PROPRIA
INCLUDING MUSCULARIS (IE, FULL THICKNESS)
DESTRUCTION RECTAL TUMOR, TRANSANAL APPROACH
PROCTOSIGMOIDOSCOPY
PROCTOSIGMOIDOSCOPY WITH DILATION, ANY METHOD
PROSCTOSIGMOIDOSCOPY WITH BIOPSY
PROCTOSIGMOIDOSCOPY
W/REMOVAL OF SINGLE TUMOR,POLYP,BY HOT BIOPSY FORC
W/REMOVAL OF SINGLE TUMOR,POLYP,BY HOT BIOPSY FORC
PROCTOSIGMOIDOSCOPY-REMOVE MULTIPLE TUMORS,POLYPE
PROCTOSIGMOIDOSCOPY
PROCTOSIGMOIDOSCOPY W/ABLATION OF TUMOR
PORSTOSIGMOIDOSCOPY FOR DECOMPRESSION OF VOLVULUS
PROCTOSIGMOIDOSCOPY W/STENT PLACEMENT
SIGMIDOSCOPY, FLEXIBLE FIBEROPTIC, DIAGNOSITC
SIGMOIDOSCOPY, FLEX FIBEROPTIC DIAGNOSTIC W/BIOPSY
SIGMOIDOSCOPY, FLEXIBLE FIBEROPTIC W/REMOVAL OF FB
SIGMOIDOSCOPY, FLEX FIBEROPTIC, W/REMOVAL POLYPOID
WITH CONTROL OF BLEEDING, ANY METHOD
SIGMOIDOSCOPY, FLEXIBLE; W/DIRECTED SUBMUCOSAL INJ. ANY SUBSTANCE
WITH DECOMPRESSION OF VOLVULUS, ANY METHOD
W/REMOVAL OF TUMORS,POLYPS, OR OTHER LESION BY SNA
W/ABLATION OF TUMORS,POLYPS, OR OTHER LESIONS NOT
SIGMOIDOSCOPY, FLEXIBLE; W/DILATION BY BALLOON, 1 OR MORE STRICTURES
SIGMOIDOSCOPY W/ENDOSCOPIC ULTRASOUND
SIGMOIDOSCOPY CODE W/ULTRASOUND FNA/BIOPSY
SIGMOIDOSCOPY W/STENT PLACEMENT
COLONOSCOPY,RIGID OR FLEXIBLE,TRANSABDOMINAL VIA C
COLONOSCOPY
COLONOSCOPY
COLONOSCOPY
COLONOSCOPY DIAGNOSTIC W/REMOVAL OF FB
COLONOSCOPY
COLONOSCOPY, FLEXIBLE; PROXIMAL TO FLEXURE; W/DIRECTED SUBMUCOSAL INJ. ANY SUBST
COLONOSCOPY W/CONTROL OF HEMORRHAGE(EG ELECTROCOAGU
W/ABLATION OF TUMORS,POLYPS,OR OTHER LESIONS NOT A
COLONOSCOPY WITH REMOVAL OF TUMORS
COLONSCOPY W/REMVL OF TUMOR,POLYPIC BY SNARE TECHN
COLONOSCOPY, FLEXIBLE, PROXIMAL FLEXURE; W/DILATION BY BALLOON, 1 OR MORE STRICT
COLONOSCOPY W/STENT PLACEMNET
SPLENIC FLEXURE; WITH ENDOSCOPIC ULTRASOUND EXAMINATION
SPLENIC FLEXURE; TRANSENDOSCOPIC ULTRASOUND WITH NEEDLE ASPIRATIONS/BIOPSIES
LAPAROSCOPY, SURG PROTECTOMY COMBINED W/ABDOMINOPERINEALW/COLOSTOMY
LAPAROSCOPY, SURG PROTECTOMY COMBINED W/ABDOMINOPERINEAL PULL THRU PROC
LAPAROSCOPY, SURGICAL; PROCTOPEXY (FOR PROLAPSE)
LAPAROSCOPY, SURGICAL; PROCTOPEXY (FOR PROLAPSE) WITH SIGMOID RESECTION
UNLISTED LAPAROSCOPY PROCEDURE, RECTUM
PROCTOPLASTY
PROCTOPLASTY
SCLEROSING SOLUTION, RECTAL
PROCTOPEXY
PROCTOPEXY
PROCTOPEXY
REPAIR OF RECTOCELE (SEPARATE PROCEDURE)
EXPLORATION, REPAIR, DRAINAGE FOR RECTAL INJURY
EXPLORATION,REPAIR,DRAINAGE FOR INJURY W/COLOSTOMY
CLOSURE, FISTULA, RECTOVESICAL
CLOSURE, FISTULA, RECTOVESICAL
EXTRNAL DRAINAGE, PSEUDOCYST OF PANCREAS; PERCUTANEOUS
CLOSURE, FISTULA RECTOURETHRAL
CLOSURE, FISTULA RECTOURETHRAL
REDUCTION, PROCIDENTIA
DILATION OF ANAL SPHINCTER UNDER ANESTHESIA
DILATION OF RECTAL STRICTURE
REMOVAL OF FECAL IMPACTION OR FOREIGN BODY W/ANES
ANORECTAL EXAM, SURGICAL, REQUIRING ANESTHESIA(GEN SPINAL/EPIDURAL DIAGNOSTIC)
UNLISTED PROCEDURE, RECTUM
PLACEMENT OF SETON
REMOVAL, SETON
DRAINAGE, ABSCESS, PERIRECTAL
DRAINAGE, ABSCESS, TRANSANAL
DRAINAGE, ABSCESS, PERIANAL
DRAINAGE, ABSCESS, INTRAMURAL
INCISION, ANAL SEPTUM
SPHINCTEROTOMY
INCISION OF THROMBOSE HEMORRHOID, EXTERNAL
FISSURECTOMY, INCLUDING SPHINCTEROTOMY
EXCISION OF SINGLE EXTERNAL PAPILLA OR TAG, ANUS
HEMORRHOIDECTOMY, INTERNAL BY RUBBER BAND LIGATION(S)
EXCISION, MULTIPLE EXTERNAL PAPILLAE OR TAGS, ANUS
HEMORRHOIDECTOMY, EXTERNAL
HEMORRHOIDECTOMY, INTERNAL AND EXTERNAL
HEMORRHOIDECTOMY W/FISSURECTOMY
HEMORRHOIDECTOMY W/FISTULECTOMY, INCLUDING FISSURECTOMY
HEMORRHOIDECTOMY
HEMORRHOIDECTOMY INTERNAL/EXTERNAL W/FISSURECTOMY
HEMORRHOIDECTOMY COMPLEX W/FISTULECTOMY W/WO FISSU
FISTULECTOMY
HEMORRHOIDECTOMY, INTERSPHINCTERIC
HEMORRHOIDECTOMY, TRANS-SUPRA-EXTRA SPHINCTERIC
FISTULECTOMY
CLOSURE ANAL FISTULA W/ADVANCEMENT FLAP
EXCISION OF THROMBOSED HEMORRHOID, EXTERNAL
SCLEROSING HEMORRHOIDS
CHEMODENERVATION OF INTERNAL ANAL SPHINCTER
ANOSCOPY W-W/O COLLECTION OF SPECIMEN.
ANOSCOPY FOR DILATION DIRECT INSTRUMENTAL
ANOSCOPY FOR BIOPSY
ANOSCOPY FOR REMOVAL OF FB
ANOSCOPU FOR REMOVAL OF POLYP
W/REMOVAL OF SINGLE TUMOR,POLYP,OR OTHER LESION BY
ANOSCOPY FOR MULTI POLYP REMOVAL
ANOSCOPY W/COAGULATION FOR CONTROL HEMORRHAGE AND
W/ABLATION OF TUMORS,POLYPS,OR OTHER LESIONS NOT A
ANOPLASTY
ANOPLASTY INFANT
REPAIR OF ANAL FISTULA W/ FIBRIN GLUE
REPAIR OF ANORECTAL FISTULA W/PLUG (EG, PORCINE SMALL INTESTINE SUBMUCOSA [SIS])
REPAIR OF ILEOANAL POUCH FISTULA/SINUS POUCH ADVANCE, TRANSPERINEAL APPROACH
REPAIR/ILEOANAL POUCH FISTULA/SINUS POUCH COMBINE, TRANSPERINEAL /TRANSABDOMENAL
REPAIR CONGENTIAL ANO-VAGINAL FISTULA
W/TRANSPOSITION OF ANOPERINEAL OR ANOVESTIBULAR FI
REPAIR OF HIGH IMPERFORATE ANUS WITHOUT FISTULA
COMBINED TRANSABDOMINAL AND SACROPERINEAL APPROACH
ANORECTOPLASTY
COMBINED TRANSABODMINAL AND SACROPERINEAL APPROACH
REPAIR OF CLOACAL ANOMALY BY ANORECTOVAGINOPLASTY
REPAIR CLOACAL ANOMALY BY ANORECTOVAGINALOPLASTY &
W/VAGINAL LENGTHENING BY INTESTINAL GRAFT & PEDICL
SPHINCTEROPLASTY
SPHINCTEROPLASTY
GRAFT FOR RECTAL INCONTINENCE AND/OR PROLAPSE
REMOVAL THIERSCH WIRE OR SUTURE ANAL CANAL
SPHINCTEROPLASTY
LEVATOR MUSCLE IMBRICATION
IMPLANTATION ARTIFICIAL SPHINCTER
COMPLEX OR MULTIPLE
CONDYLOMATA DESTRUCTION
CONDYLOMATA DESTRUCTION
DESCTRUCTION OF LESION(S) ANUS SIMPLE CRYOSURGERY
DESTRUCTION OF LESIONS ANUS LASAR SURGERY SIMPLE
CONDYLOMATA DESTRUCTION
DESTRUCTION OF LESION, SURGICAL EXCISION
DESTRUCTION LESION,ANUS, EXTENSIVE, ANY METHOD
DESTRV OF INTNL HEMORRHOID BY THRMAL ENRGY INFRARED COAG, CAUTERY, RADIOFREQ
DESTRUCTION OF INTERNAL/EXTERNAL HEMORRHOIDS
CURETTAGE/CAUTERIZATION OF ANAL FISSURE; INITIAL
CURETTAGE/CAUTERIZATION ANAL FISSURE; SUBSEQUENT
HEMORRHOIDECTOMY, INTERNAL LIGATION OTHER THAN RUBBER BAND
HEMORRHOIDECTOMY, 2 OR MORE COLUMNS/GROUPS
HEMORRHOIDOPEXY (EG, FOR PROLAPSING INTERNAL HEMORRHOIDS) BY STAPLING
UNLISTED PROCEDURE ANUS
BIOPSY, LIVER
BIOPSY LIVER PERC NEEDLE DONE @ TIME OF MAJ PROCED (ADD-ON)
HEPATOTOMY FOR DRAINAGE ABSCESS ONE OR TWO STAGES
HEPATOTOMY; FOR PERCUTANEOUS DRAINAGE OF ABSCESS OR CYST, ONE OR TWO STAGES
LAPAROTOMY W/HEPATIC PARASITIC CYST OR ABSCESS(ES)
BIOPSY, LIVER
HEPATECTOMY
HEPATECTOMY TRISEGMENTECTOMY
HEPATECTOMY RESECTION OF LIVER TOTAL L LOBECTOMY
HEPATECTOMY RESECTION OF LIVER TOTAL R LOBECTOMY
DONOR HEPATECTOMY COLD PRESERVATION FROM CADAVER DONOR
LIVER ALLOTRANSPLANT; ORTHOTOPIC, PARTIAL OR WHOLE, FROM CADAVER OR DONOR
LIVER ALLOTRANSPLANTATION; HETEROTOPIC, ANY AGE
CADAVER DONOR WHOLE LIVER GRAFT > ALLOTRANSPLANT INCLUDING CHOLECYSTECTOMY, ETC.
CADAVER DONOR WHOLE LIVER GRAFT > ALLOTRANSPLANT INCLUDING CHOLECYSTECTOMY, ETC.
CADAVER DONOR WHOLE LIVER GRAFT > ALLOTRANSPLANT INCLUDING CHOLECYSTECTOMY, ETC.
CADAVER OR LIVING DONOR LIVER GRAFT > ALLOTRANSPLANT; VENOUS ANASTAMOSIS; EA
CADAVER OR LIVING DONOR LIVER GRAFT > ALLOTRANSPLANT;ARTERIAL ANASTAMOSIS; EA
MARSUPIALIZATION, CYST, LIVER
HEPATORRHAPHY
HEPATORRAPHY COMPLEX W/WO HEPATIC ARTERY LIGATION
MGMT LIVER HEMORRHAGE;EXPLORE HEPATIC WOUND, DEBRI
MGMT LIVER HEMORRHAGE;RE-EXPLORE HEPATIC WOUND
LAPAROSCOPY, SURGICAL ABLATION OF ONE OR MORE TUMORS RADIOFREQUENCY
LAPAROSCOPY, SURGICAL, ABLATION OF ONE OR MORE TUMORS, CRYOSURGICAL
UNLISTED LIVER LAPAROSCOPY
ABLATION OPEN ONE OR MORE LIVER TUMORS RADIOFREQUENCY
ABLATION OPEN ONE OR MORE LIVER TUMORS, CRYOSURGICAL
ABULATION, ONE OR MORE LIVER TUMORS, PERCUTANEOUS, RADIOFREQUENCY
UNLISTED PROC, LIVER
HEPATICOTOMY/HEPATICOSTOMY
CHOLEDOCHOTOMY/CHOLEDOCHOSTOMY
CHOLEDOCHOTOMY/CHOLEDOCHOSTOMY
SPHINCTEROTOMY
CHOLECYSTOTOMY/CHOLECYSTOSTOMY
PERCUTANEOUS CHOLECYSTOSTOMY
CHOLANGIOGRAPHY INJ PROC
CHOLANGIOGRAPHY INJ PROCEDURE THRU EXISTING CATH
INTRO OF PERCUTANEOUS TRANSHEPATIC CATHETER
INTRO TRANSHEPATIC STENT INTERNAL/EXTERNAL DRAINAG
CHANGE OF PERCUTANEOUS BILIARY DRAINAGE CATHETER
REVISION AND/OR REINSERTION OF TRANSHEPATIC T-TUBE
BILIARY ENDOSCOPY, INTRAOPERATIVE -CHOLEDOCHOSCOPY-ADD ON
BILIARY ENDOSCOPY PERCUTANEOUS VIA T-TUBE DIAGNOST
BILIARY ENDOSCOPY FOR BIOPSY AND/OR COLLECTION SPE
ENDOSCOPY W/REMOVAL OF STONES
BILIARY ENDOSCOPY FOR DILATION BILIARY DUCT STRICT
BILIARY ENDOSCOPY,DILATIOBILAIARY DUCT STRICTURE (
LAPAROSCOPY CHOLANGIOGRAPHY
LAPAROSCOPY CHOLANGIOGRAPHY WITH BIOPSY
LAPAROSCOPY CHOLECYSTECTOMY
LAPAROSCOPY CHOLECYSTECTOMY WITH CHOLANGIOGRAPHY
LAPAROSCOPY CHOLECYSTECTOMY WITH EXPLORATION
LAPAROSCOPY CHOLECYSTENTEROSTOMY
LAPAROSCOPY UNLISTED BILIARY TRACT PROCEDURE
CHOLECYSTECTOMY
CHOLECYSTECTOMY
CHOLECYSTECTOMY
CHOLECYSTECTOMY
CHOLECYSTECTOMY W/CHOLEDOCHOENTEROSTOMY
CHOLECYSTECTOMY
STONE EXTRACTION, BILIARY DUCT
EXPLORATION, BILE DUCT
PORTOENTEROSTOMY-ADD ON
EXCISION BILE DUCT TUMOR W/W/O REPAIR;EXTRAHEPATIC
EXCISION BILE DUCT TUMOR W/W/O REPAIR;INTRAHEPATIC
EXCISION OF CHOLEDOCHAL CYST
ANASTOMOSIS, GALL BLADDER
ANASTOMOSIS, GALL BLADDER
ROUX-EN-Y PROCEDURE
ROUX-EN-Y WITH GASTROENTEROSTOMY
ANASTOMOSIS, BILIARY DUCT
ANASTOMOSIS DIRECT OF INTRAHEPATIC DUCTS GASTROINT
ROUX-EN-Y PROCEDURE
ANASTOMOSIS, ROUX-EN-Y OF DUCTS AND TRACT
RECONSTRUCTION, BILIARY DUCTS
PLACEMENT OF CHOLEDOCHAL STENT
U-TUBE LEPATICOENTEROSTOMY
SUTURE EXTRAHEPATIC BILIARY DUCT FOR PRE INJURY
UNLISTED BILIARY TRACT PROC
DRAINAGE, PANCRRAS
WITH CHOLECYSTOSTOMY,GASTROSTOMY,AND JEJUNOSTOMY
REMOVAL, CALCULUS, PANCREAS
BIOPSY OF PANCREAS, OPEN, ANY MEHTOD
BIOPSY OF PANCREAS
RESECTION OR DEBRIDEMENT/PANCREAS & PERIPANCREATIC
EXCISION, LESION, PANCREAS
PANCREATECTOMY
PANCREATECTOMY
PANCREATECTOMY,DISTAL,NEAR-TOTAL W/PRESERVATION OR
EXCISION OF AMPULLA OF VATER
PANCREATECTOMY
WITHOUT PANCREATOJEJUNOSTOMY
PANCREATECTOMY,PROXIMAL NEAR TOTAL DUODENECTOMY,CH
WITHOUT PANCREATOJEJUNOSTOMY
PANCREATECTOMY TOTAL
PANCREATECTOMY
INJECTION PROCEDURE FOR INTRAOPERATIVE PANCREATOGR-ADD ON
REPAIR INITIAL INGUINAL HERNIA,UNDER AGE 6 MO
MARSUPIALIZATION CYST PANCREAS
EXTERNAL DRAINAGE, PSEUDOCYST OF PANCREAS
EXTERNAL DRAINAGE, PSEUDOCYST OF PANCREAS; PERCUTANEOUS
ANASTOMOSIS, PANCREATIC CYST
ROUX-EN-Y PROCEDURE
PANCREATORRHAPHY FOR TRAUMA
DUODENAL EXCLUSION W/GASTROJEJUNOSTOMY FOR PANCREA
PANCREATICOJEJUNOSTOMY, SIDE-TO-SIDE ANASTOMOSIS (PUESTOW-TYPE OPERATION)
UNLISTED PANCREAS PROCEDURE
LAPAROTOMY
REOPENING OF RECENT LAPAROTOMY INCISION FOR EXPLOR
RETROPERITONEAL EXPLORATION
DRAINAGE, PERITONITIS
DRAINAGE PERITONEAL ABSCESS; PERCUTANEOUS
DRAINAGE, ABSCESS, SUBPHRENIC
DRAINAGE OF SUBDIAPHRAGMATIC OR SUBPHRENIC ABSCESS; PERCUTANEOUS
DRNG, ABSCESS, RETROPERITONEAL
DRAINAGE OF RETROPERITONEAL ABSCESS; PERCUTANEOUS
DRAINAGE OF EXTRAPERITONEAL LYMPHOCELE TO PERITONAEAL CAVITY, OPEN
PERITONEOCENTESIS
PERITONEOCENTESIS
BIOPSY, ABDOMINAL/RETROPERITONEAL, PERCUTANEOUS NEEDLE
EXCISION OR DESTRUCTION, OPEN, INTRA-ABDOMINAL TUMORS, CYSTS OR ENDOMETRIOMAS
EXCISION OR DESTRUCTION, OPEN, INTRA-ABDOMINAL TUMORS, CYSTS OR ENDOMETRIOMAS
EXCISION OR DESTRUCTION, OPEN, INTRA-ABDOMINAL TUMORS, CYSTS OR ENDOMETRIOMAS
EXCISION OF PRESACRAL OR SACROCOCCYGEAL TUMOR
STAGING CELIOTOMY (LAPAROTOMY) FOR HODGKIN'S ECT.
UMBILECTOMY, OMPHALECTOMY, EXCISION OF UMBILICUS
EXCISION, GREATER OMENTUM
LAPAROSCOPY/PERITONEOSCOPY; DIAGNOSTIC PROCEDURE
LAPAROSCOPY/PERITONEOSCOPY WITH BIOPSY
LAPAROSCOPY/PERITONEOSCOPY WITH ASPIRATION
LAPAROSCOPY/PERITONEOSCOPY WITH DRAINAGE
LAPAROSCOPY, SURGICAL; W/ REVISION OF PREVIOUSLY PLACED CANNULA/CAT
LAPAROSCOPY, SURGICAL; W/ REVISION OF PREVIOUSLY PLACED CANNULA/CA
LAPAROSCOPY, SURGICAL; W/OMENTOPEXY (SP)
LAPAROSCOPY/PERITONEOSCOPY UNLISTED ABDOMEN
PNEUMOPERITONEUM
REMOVAL OF PERITONEAL FOREIGN BODY FROM PERITONEAL CAVITY
PLACEMENT OF INTERSTITIAL DEVICE FOR RADIATION THERAPY GUIDANCE, SINGLE/MULTIPLE
INSERTION INTRAPERITONEAL CANNULA/CATHETER, W/ RESERVOIR, PERMANENT
INTRAPERITONEAL CANNULA
INSERT INTRAPERITONEAL CANNULA FOR DRAINAGE PERMAN
REMOVE PERMANENT INTRAPERITONEAL CANNULA/CATHETER
EXCHANGE OF ABSCESS OR CYST DRAINAGE CATHETER UNDER RADIOLOGICAL GUIDANCE
CONTRAST INJECTION FOR ASSESMENT OF ABSCESS OR CYST VIA PLACED CATHETER
PERITONEAL VENOUS SHUNT
REVISION OF PERITONEAL VENOUS SHUNT
INJ PROCEDURE FOR EVALUATION PREVIOUSLY PLACE PERI
LIGATION OF PERITONEAL-VENOUS SHUNT
REMOVAL OF PERITONEAL-VENOUS SHUNT
PNEUMOGRAPHY INJECTION PROC
INSERT OF SUBCUTANEOUS EXT TO INTRAPERITONEAL CANNULA/CATHETER/REMOTE CHEST SITE
DELAYED CREATION OF EXIT SITE FROM EMBEDDED SUBCUTANEOUS SEGMENT
INSERTION OF GASTROSTOMY TUBE, PERCUTANEOUS, UNDER FLUOROSCOPIC GUIDANCE
INSERTION OF DUODENOSTOMY OR JEJUNOSTOMY TUBE, PERCUTANEOUS
INSERTION OF CECOSTOMY OR OTHER COLONIC TUBE, PERCUTANEOUS
CONVERSION OF GASTROSTOMY TUBE TO GASTRO-JEJUNOSTOMY TUBE, PERCUTANEOUS
REPLACEMENT OF GASTROSTOMY OR CECOSTOMY (OR OTHER COLONIC) TUBE, PERCUTANEOUS
REPLACEMENT OF DUODENOSTOMY OF JEJUNOSTOMY TUBE, PERCUTANEOUS
REPLACEMENT OF GASTRO-JEJUNOSTOMY TUBE, PERCUTANEOUS, UNDER FLUOROSCOPIC
MECHANICAL REMOVAL OF OBSTRUCTIVE MATERIAL FROM GASTROSTOMY, DUODENOSTOMY
CONTRAST INJECTION(S) FOR RADIOLOGICAL EVALUATION OF EXISTING GASTROSTOMY
INGUINAL HERNIA REPAIR ON PRETERM INFANT W/W/O HYDROCELECTOMY; REDUCIBLE
INGUINAL HERNIA REPAIR ON PRETERM INFANT W/W/O HYDROCELECTOMY; INCARCERATED
HERNIA REPAIR-INITIAL INGUINAL UNDER 6 MO
INCARCERATED OR STRANGULATED
REPAIR INITIAL INGUINAL HERNIA,AGE 6MO TO UNDER 5Y
HERNIA REPAIR DIGESTIVE SYSTEM
REPAIR INITIAL INGUINAL HERNIA,AGE 5YRS OR OVER
HERNIA REPAIR DIGESTIVE SYSTEM
INCARCERATED OR STRANGULATED
REPAIR RECURRENT INGUINAL HERNIA, ANY AGE
INCARCERATED OR STRANGULATED
REPAIR INGUINAL HERNIA
HERNIA REPAIR DIGESTIVE SYSTEM
REPAIR INITIAL FEMORAL HERNIA,ANY AGE
HERNIA REPAIR DIGESTIVE SYSTEM
HERNIA REPAIR DIGESTIVE SYSTEM
REPAIR RECURRENT FEMORAL HERNIA
INCARCERATED OR STRANGULATED
REPAIR INITIAL INC ISIONAL HERNIA
INCARCERATED OR STRANGULATED
REPAIR RECURRENT INCISIONAL HERNAI
INCARCERATED OR STRANGULATED
IPLANTATION OF MESH OR OTHER PROSTHESIS FOR INCIS-ADD ON
REPAIR EPIGASTRIC HERNIA
INCARCERATED OR STRANGULATED
REPAIR UMBILICAL HERNIA-UNDER AGE 5
INCARCERATED OR STRANGULATED
REPAIR UMBILICAL HERNIA, AGE 5 OR OVER
INCARCERATED OR STRANGULATED
HERNIA REPAIR DIGESTIVE SYSTEM
REPAIR OF SM OMPHALOCELE,WITH PRIMARY CLOSURE
REPAIR OF LG OMPHALOCELE OR GASTROSCHISIS
W/REMOVAL OF PROSTHESIS,FINAL REDUCTION & CLOSURE,
REPAIR, OMPHALOCELE
REPAIR OMPHALOLELE SECOUND STAGE
LAPAROSCOPY INGUINAL HERNIA REPAIR
LAPAROSCOPY INGUINAL HERNIA REPAIR
LAPARO SURG REP, VENTRAL, UMBIL SPIGELIAN OR EPIGSTR HERNIA W/MESH INSERT
INCARCERATED OR STRANGULATED
LAPAROSURGICAL, REPAIR, INCISIONAL HERNIA INCLUDS MESH INSERTION, REDUCIBLE
INCARCERATED OR STRANGULATED
LAPAROSURGICAL, REPAIR, RECURRENT INCISINL HERNIA W/MESH INSERT REDUCIBLE
INCARCERATED OR STRANGULATED
LAPAROSCOPY UNLISTED HERNIA PROCEDURE
SUTURE, ABDOMINAL WALL
OMENTAL FLAP, EXTRA-ABDOMINAL
OMENTAL FLAP (LIST SEPARATELY) (ADD-ON)
FREE OMENTAL FLAP W/MICROVASCULAR ANASTOMOSIS
UNLISTED PROC, ABDOMEN ETC.
RENAL EXPLORATION
DRAINAGE, ABSCESS, RENAL
DRAINAGE OF PERIRENAL OR RENAL ABSCESS; PERCUTANEOUS
NEPHROSTOMY
NEPHROTOMY
NEPHROLITHOTOMY
NEPHROLITHOTOMY
NEPHROLITHOTOMY
NEPHROLITHOTOMY
PERCUTANEOUS NEPHROSTOLITHOTOMY OR PYELOSTOLITHOTO
PERCUTANEOUS NEPHROSTOLITHOTOMY/PYELOSTOLITHOTOMY
TRANSECTION RENAL VESSELS
PYELOTOMY
PYELOSTOMY
PYELOLITHOTOMY
PYELOTOMY
AERSOL MASK, USED W/DME NEBULIZER
WATER,DISTILLED,USE W/LG VOL NEB 1000 ML
CHIN STRAP, USE W/CPAP
BIOPSY, RENAL
BIOPSY, RENAL
NEPHRECTOMY
NEPHRECTOMY
NEPHRECTOMY
NEPHRECTOMY
NEPHRECTOMY
NEPHRECTOMY
ABLATION, OPEN, ONE OR MORE RENAL MASS LESIONS, CYROSURGICAL INCL ULTRASOUND
EXCISION, CYST, KIDNEY
EXCISION, CYST, PERINEPHRIC
DONOR NEPHRECTOMY INCLUDING COLD PRESERVATION FROM CADAVER DONER UNILAT OR BI
OPEN FROM LIVING DONOR
LIVING DONOR RENAL ALLOGRAFT (OPEN OR LAPAROSCOPIC) > TRANSPLANT
LIVING DONOR RENAL ALLOGRAFT (OPEN OR LAPAROSCOPIC) > TRANSPLANT
CADAVER OR LIVING DONOR RENAL ALLOGRAFT > TRANSPLANT; VENOUS ANAST, EA
CADAVER OR LIVING DONOR RENAL ALLOGRAFT > TRANSPLANT; ARTERIAL ANAST, EA
BACKBENCH RECON OF CADAVER OR LIVING DONOR RENAL ALLOGRAFT PRIOR TO TRANSPLANT
RECIPIENT NEPHRECTOMY
RENAL HOMOTRANSPLANTATION WO/DONOR AND RECIPIENT N
RENAL HOMOTRANSPLANTATION W/RECIPIENT NEPHRECTOMY
REMOVAL OF TRANSPLANTED HOMOGRAFT (EG INFARTED/REJ
RENAL AUTOTRANSPLANTATION REIMPLANT OF KIDNEY
REMOVAL AND REPLACEMENT OF INTERNALLY DWELLING URETERAL STENT
REMOVAL OF INTERNALLY DWELLING URETERAL STENT
REMOVAL (VIA SNARE/CAPTURE) OF INTERNALLY DWELLING URETERAL
REMOVAL (VIA SNARE/CAPTURE) OF INTERNALLY DWELLING URETERAL STENT
REMOVAL & REPLACEMENT OF EXTERNALLY ACCESSIBLE TRANSNEPHRIC STENT
REMOVAL OF NEPHROSTOMY TUBE, REQUIRING FLOUROSCOPIC GUIDANCE
ASPIRATION, RENAL CYST
INTO RENAL PELVIS AND/OR URETER VIA EST. NEPHROSTOMY, PYELOSTOMY, EG. TUBE
CATHETER, RENAL PELVIS
INTRO URETERAL CATH OR STENT THRU RENAL PELVIS
PYELOGRAPHY INJECTION PROC
INTRO OF GUIDE INTO RENAL PELVIS AND/OR URETER W/D
MANOMETRIC STUDIES, KINDEY
CHANGE NEPHROSTOMY TUBE
PYELOPLASTY
PYELOPLASTY
NEPHROPEXY
NEPHRORRHAPHY
CLSR, FISTULA NEPHROCUTANEOUS
CLSR, FISTULA NEPHROVISCERAL
CLSR, FISTULA NEPHROVISCERAL
SYMPHYSIOTOMY
LAPAROSCOPY ABLATION OF RENAL CYSTS
LAPAROSCOPY, SURGICAL; ABLATION OF RENAL LESION
LAPAROSCOPY, SURGICAL; PARTIAL NEPHRECTOMY
LAPAROSCOPY PYELOPLASTY
LAPAROSCOPIC RADICAL NEPHRECTOMY
LAPAROSCOPY NEPHRECTOMY
DONOR NEPHRECTOMY INCLUDING COLD PRESERVATIONS FROM LIVING DONOR
LAPAROSCOPY, NEPHROURETEROECTOMY
LAPARSCOPY UNLISTED RENAL PROCEDURE
ENDOSCOPY, RENAL
ENDOSCOPY, RENAL
ENDOSCOPY, RENAL
ENDOSCOPY, RENAL
ENDOSCOPY, RENAL
RENAL ENDOSCOPY; WITH RESECTION OF TUMOR
ENDOSCOPY, RENAL
ENDOSCOPY, RENAL
ENDOSCOPY, RENAL
RENAL ENDOSCOPY WITH ENDOPYELOTOMY
ENDOSCOPY, RENAL
ENDOSCOPY, RENAL
LITHOTRIPSY,EXTRACORPOREAL SHOCK WAVE
ABLATION, ONE OR MORE RENAL TUMORS, PERCUTANEOUS, UNILATERAL, RADIOFREQUENCY
ABLATION, RENAL TUMOR(S), UNILATERAL, PERCUTANEOUS, CRYOTHERAPY
URETEROTOMY
URETEROTOMY FOR INSERTION OF INDWELLINS STENT
URETEROLITHOTOMY
URETEROLITHOTOMY
URETEROLITHOTOMY
URETERECTOMY
URETERECTOMY
URETEROGRAPHY INJECTION
MANOMETRIC STUDIES, URETER
URETEROSTOMY TUBE CHANGE
URETEROPYELOGRAPHY INJ PROC
URETEROPLASTY
URETEROLYSIS
URETEROLYSIS
URETEROLYSIS
REVISION URINARY-CUTANEOUS ANASTOMOSIS
REVISION URINARY-CUTANEOUS ANASTOMOSIS W/REPAIR FA
URETEROPYELOSTOMY
URETEROCALYCOSTOMY
URETEROURETEROSTOMY
TRANSURETEROURETEROSTOMY
URETERONEOCYSTOSTOMY
ANASTOMOSIS OF DUPLICATED URETER TO BLADDER
WITH EXTENSIVE URETERAL TAILORING
URETERONEOCYSTOSTOMY
URETEROENTEROSTOMY
URETEROSIGMOIDOSTOMY
URETEROCOLON CONDUIT, INCLUDING BOWEL ANASTOMOSIS
URETEROILEAL CONDUIT
CONTINENT DIV,INC BOWEL ANASTOMOSIS,SMALL/LG BOWEL
URINARY UNDIVERSION
REPLACEMENT, URETER
CUTANEOUS APPENDICO VESICOSTOMY
URETEROSTOMY
URETERORRHAPHY
CLSR, FISTULA URETEROCUTANOUS
CLSR, FISTULA URETEROVISCERAL
DELIGATION, URETER
LAPAROSCOPY, SURGICAL, URETEROLITHOTOMY
LAPAROSCOPIC URETERONECYSTOMOY W/CYSTOSCOPY & URETERAL STENT PLACEMENT
LAPAROSCOPIC URETERONEOCYSTOSTOMY W/O CYSTOSCOPY & URETERAL STENT PLACEMENT
UNLISTED LAPAROSCOPY PROCEDURE, URETER
URETERAL ENDOSCOPY
URETERAL ENDOSCOPY
URETERAL ENDOSCOPY
URETERAL ENDOSCOPY
URETERAL ENDOSCOPY
URETERAL ENDOSCOPY
URETERAL ENDOSCOPY
URETERAL ENDOSCOPY
URETERAL ENDOSCOPY
URETERAL ENDOSCOPY
URETERAL ENDOSCOPY
URETERAL ENDOSCOPY
URETERAL ENDOSCOPY
URETERAL ENDOSCOPY
URETERAL ENDOSCOPY
URETERAL ENDOSCOPY
CYSTOTOMY/CYSTOSTOMY
CYSTOTOMY/CYSTOSTOMY
CYSTOTOMY/CYSTOSTOMY
CYSTOTOMY/CYSTOSTOMY
CYSTOLITHOTOMY
TRANSVESICAL URETEROLITHOTOMY
CYSTOTOMY
DRAINAGE, ABSCESS, PERIVESICAL
ASPIRATION OF BLADDER; BY NEEDLE
ASPIRATION OF BLADDER; BY TROCAR OR INTRACATHETER
ASPIRATION OF BLADDER; WITH INSERTION OF SUPRAPUBIC CATHETER
EXCISION, CYST, URACHAL
CYSTOTOMY
CYSTOTOMY
CYSTOTOMY
CYSTOTOMY
CYSTECTOMY
CYSTECTOMY
URETERONEOCYSTOSTOMY
CYSTECTOMY
CYSTECTOMY
CYSTECTOMY
CYSTECTOMY
CYSTECTOMY
CYSTECTOMY
CYSTECTOMY;U SEG SM/LG BOWEL TO CONST NEOBLADDER
PELVIC EXENTERATION COMPLETE
CYSTOGRAPHY, INJECTION PROC
URETHROCYSTOGRAPHY, INJ PROC
URETHROCYSTOGRAPHY, INJ PROC
BLADDER IRRIGATION
INSERTION NON-INDWELLING BLADDER CATHETER
INSERTION OF TEMPORARY INDWELLING BLADDER CATHETER; SIMPLE (EG, FOLEY)
INSERTION TEMP. INDWELLING BLADDER CATHETER; COMPLICATED
CYSTOSTOMY TUBE CHANGE
CYSTOSTOMY TUBE CHANGE
ENDOSCOPIC INJECTION OF IMPLANT FOR INCONTINENCE
BLADDER INSTILLATION
CYSTOMETROGRAM
COMPLEX CYSTOMETROGRAM
WITH URETHRAL PRESSURE PROFILE STUDIES AND TECHNIQUE
WITH VOIDING PRESSURE STUDIES (IE, BLADDER VOIDING PRESSURE), ANY TECHNIQUE
WITH VOIDING PRESSURE STUDIES(IE, BLADDER,URETHRAL)ANY TECHNIQUE
UROFLOWMETRIC EVALUATION
COMPLEX UROFLOWMETRY
ELECTROMYOGRAPHY ANAL/URETHRAL SPHINCTER, ANY WAY
NEEDLE ELECTROMYOGRAPHY STD ANAL/URETHRL SPHINCTER
STIMULUS EVOKED RESPONSE
VOIDING PRESSURE STUDIES,INTRA-ABDOMINAL VOIDING
MEASUREMENT POST-VOIDING RESIDUAL URINE BY ULTRASOUND, NON-IMAGING
CYSTOPLASTY
CYSTOURETHROPLASTY
URETHROPEXY/VESICOURETHROPEXY
URETHROPEXY/VESICOURETHROPEXY
ABDOMINO-VAGINAL VESICAL NECK SUSPENSION W/WO ENDO
CYSTORRHAPHY
CYSTORRHAPHY
CLOSURE, CYSTOSTOMY
VESICOVAGINAL FISTULA CLOSURE
CLOSURE OF VESICOUTERINE FISTULA
CLOSURE VESICOUTERINE FISTULA W/HYSTERECTOMY
CLOSURE OF BLADDER EXTROPHY
ENTEROCYSTOPLASTY, INCLUDE BOWEL ANASTOMOSIS
CUTANEOUS VESICOSTOMY
LAPAROSCOPY URETHRAL SUSPENSION
LAPAROSCOPY SLING OPERATION
UNLISTED LAPAROSCOPY PROCEDURE, BLADDER
CYSTOSCOPY/URETHROSCOPY
CYSTOURETHROSCOPY W/ IRRIGATION AND EVACUATION OF CLOTS
CYSTOSCOPY/URETHROSCOPY
CYSTOURETHROSCOPY W/URETER CATH & BIOPSY URETER
CYSTOSCOPY/URETHROSCOPY
CYSTOSCOPY/URETHROSCOPY
CYSTOSCOPY/URETHROSCOPY
CYSTOSCOPY/URETHROSCOPY
CYSTOSCOPY/URETHROSCOPY
CYSTOSCOPY/URETHROSCOPY
CYSTOSCOPY/URETHROSCOPY
CYSTOSCOPY/URETHROSCOPY
CYSTOSCOPY/URETHROSCOPY
CYSTOSCOPY/URETHROSCOPY
CYSTOSCOPY/URETHROSCOPY
CYSTOSCOPY/URETHROSCOPY
CYSTOSCOPY/URETHROSCOPY
CYSTOSCOPY/URETHROSCOPY
CYSTOURETHROSCOPY WITH DIRECT VISION URETHROTOMY
CYSTOSCOPY/URETHROSCOPY
CYSTOSCOPY/URETHROSCOPY
CYSTOURETHROSCOPY, WITH INSERTION OF URETHRAL STENT
CYSTOSCOPY/URETHROSCOPY
CYSTOSCOPY/URETHROSCOPY
CYSTOSCOPY/URETHROSCOPY
CYSTOSCOPY/URETHROSCOPY
CYSTOURETHROSCOPY W/RESECTION-UNILATERAL/BILATERAL
CYSTOSCOPY/URETHROSCOPY
CYSTOSCOPY/URETHROSCOPY
CYSTOURETHROSCOPY W/REMOVAL FB COMPLICATED
LITHOLAPAXY-CRUSHING OR FRAGMENTATION OF CALCULUS
LITHOLAPAXY, COMPLICATED
CYSTOSCOPY/URETHROSCOPY
CYSTOURETHROSCOPYC/WFRAGMENTATION OF URETERAL CALC
CYSTOURETHROSCOPY; W/SUBURETERIC INJECTION
CYSTOSCOPY/URETHROSCOPY
CYSTOURETHROSCOPY, W/INSERT INDWELL URETERAL STENT
CYSTOURETHROSCOPY W/INSERT URETERAL GUIDE WIRE THR
CYSTOURETHROSCOPY W/ URETER STRICTURE
CYSTOURETHROSCOPY W/ UP STRICTURE TX
CYSTOURETHROSCOPY W/ RENAL STRICTURE TX
CYSTOURETHROSCOPY W/ URETEROSCOPY WITH URETER STRICTURE TX
CYSTOURETHROSCOPY / URETEROSCOPY W/ UP STRICTURE TX
CYSTOURETHROSCOPY URETEROSCOPY W/ RENAL STRICTURE TX
CYSTOURETHROSCOPY URETEROSCOPY / PYELOSCOPY DX
CYSTOURETHROSCOPY URETEROSCOPY / PYELOSCOPY W/ STONE TX
CYSTOURETHROSCOPY / URETEROSCOPY / PYELOSCOPY W/ LITHOTRIPSY
CYSTOURETHROSCOPY / URETEROSCOPY / PYELOSCOPY W/ BX
CYSTOURETHROSCOPY / URETEROSCOPY / PYELOSCOPY W/ TUMOR RESECTION
CYSTOURETHROSCOPY W/ CONGENITAL REPAIR
TRANSURETHRAL RESECTION OR INCISION OF EJACULATORY DUCTS
TRANSURETHRAL INCISION OF PROSTATE
RESECTION, VESICAL NECK
RESECTION, PROSTATE
FULGURATION, TRANSURETHRAL
RESECTION, PROSTATE
RESECTION, PROSTATE
NON-CONTACT LASER COAGULATION OF PROSTATE,COMPLETE
CONTACT LASER VAPORIZATION, COMPLETE
LASER ENUCLEATION OF THE PROSTATE WITH MORCELLATION
DRAINAGE, ABSCESS, PROSTATE
LITHOLAPAXY
LITHOLAPAXY
URETHROTOMY/URETHROSTOMY
URETHROTOMY/URETHROSTOMY
MEATOTOMY, CUTTING OF MEATUS; EXCEPT INFANT
MEATOTOMY, CUTTING OF MEATUS; INFANT
CYSTOSCOPY/URETHROSCOPY
DRAINAGE, CYST, SKENES GLAND
DRAINAGE URINARY EXTRAVASATION
DRAINAGE URINARY EXTRAVASATION
BIOPSY, URETHRA
URETHRECTOMY
URETHRECTOMY
EXCISION, CARCINOMA, URETHRA
EXCISION URETHRAL DIVERTICULUM
EXCISION URETHRAL DIVERTICULUM
MARSUP, URETHRAL DIVERTICULUM
EXCISION, BULBOURETHRAL GLAND
EXCISION, URETHRAL POLYP
FULGURATION, URETHRAL CARUNCLE
EXCISION, SKENES GLANDS
CYSTOSCOPY/URETHROSCOPY
URETHROPLASTY
URETHROPLASTY
URETHROPLASTY
URETHROPLASTY, TRANSPUBIC OR PERINEAL, ONE STAGE
URETHROPLASTY
URETHROPLASTY
URETHROPLASTY
URETHROPLASTY FOR INCONTINENCE
URINARY INCONTINENCE CORRECTN
REMOVAL OF PERINEAL PROSTHESIS INTR. FOR CONTINENC
INSERTION OF TANDEM CUFF (DUAL CUFF)
PLACEMENT OF INFLATABLE SPHINCTER INC PUMP/RESERV
REMOVAL INFLATABLE URETHRAL/BLADDER NECK SPHINCTER INC PUMP, RESERVOIR, CUFF
REMOVAL, REPAIR, REPLACE INFLATABLE SPHINCTER
REMOVAL/REPLACEMENT OF URETHRAL/BLADDER NECK SPHINCTER
SURG CORRECT HYDRAULIC ABNORM INFLATABLE SPHINCTER
URETHRAL MEATOPLASTY
CYSTOSCOPY/URETHROSCOPY
URETHROLYSIS, TRANSVAGINAL SECONDARY, OPEN INCLUDING CYSTOURETHROSCOPY
URETHRORRHAPHY SUTURE URETHRAL WOUND/INJURY FEMALE
URETHRORRHAPHY
URETHRORRHAPHY
URETHRORRHAPHY
URETHROSTOMY CLOSURE
DILATION, URETHRAL STRICTURE
DILATION, URETHRAL STRICTURE
DILATION, URETHRAL STRICTURE
DILATION, URETHRAL STRICTURE
DILATION, URETHRAL STRICTURE
DILATION, URETHRA, FEMALE
DILATION, URETHRA, FEMALE
DILATION, URETHRA, FEMALE
TRANSURETHRAL DESTRUCTION OF PROSTATE TISSUE; BY MICROWAVE THERMOTHERAPY
TRANSURETHRAL DESTRUCTION OF PROSTATE TISSUE; BY RADIOFREQUENCY THERMOTHERAPY
INSERTION OF A TEMPORARY PROSTATIC URETHRAL STENT, INCL URETHRAL MEASUREMENT
UNLISTED PROC, URINARY SYST
DORSAL SLIT
DORSAL SLIT
INCISION & DRAINAGE, PENIS
CONDYLOMATA DESTRUCTION
CONDYLOMATA DESTRUCTION
CRYOSURGERY
DESTRUCTION OF LESION(S), PENIS W/LASER SURGERY
CONDYLOMATA DESTRUCTION
CONDYLOMATA DESTRUCTION
BIOPSY, PENIS
BIOPSY, PENIS
EXCISION, PENILE PLAQUE
EXCISION PENILE PLAQUE W/GRAFT 5 CM IN LENGTH
BIOPSY PENIS W/GRAFT GREATER THAN 5 CM
REMOVAL, FOREIGN BODY, PENIS
AMPUTATION, PENIS
AMPUTATION, PENIS
AMPUTATION, PENIS
AMPUTATION, PENIS
CIRCUMCISION, USING CLAMP OR OTHER DEVICE; NEWBORN
CIRCUMCISION, SURGICAL EXCISION OTHER THAN CLAMP, DEVICE OR DORSAL SLIT; NEWBORN
CIRCUMCISION, SURG EXCISION OTHER THAN CLAMP, DEVICE/DORSAL SLIT; EXCEPT NEWBORN
LYSIS/EXCISION PENILE POST-CIRCUMCISION ADHESIONS
REPAIR INCOMPLETE CIRCUMCISION
FRENULOTOMY OF PENIS
INJECTION, PEYRONIES DISEASE
INJECTION, PEYRONIES DISEASE
IRRIGATION, CORPORA CAVERNOSA
STRAIGHTENING OF CHORDEE
PLASTIC OPERATION ON PENIS/CORRECTION OF CHORDEE
STRAIGHTENING OF CHORDEE
URETHROPLASTY FOR SECOND STAGE HYPOSPADICS REPAIR
URETHROPLASTY 2ND STAGE HYPOSPADIAS REPAIR;>3 CM
URETHROPLASTY 2ND STG HYPOSPADIAS REPAIR
URETHROPLASTY 3RD STAGE REPAIR RELEASE PENIS/SCROT
URETHROPLASTY
ONE STAGE DISTAL HYPOSPADIAS REPAIR W/WO CHORDEE
HYPOSPADIAS REPAIR WITH URETHROPLAST
URETHROPLASTY
ONE STAGE DISTAL HYPOSPADIAS REPAIR W/URETHROPLAST
ONE STAGE DISTAL HYPOSPADIAS REPAIR
URETHROPLASTY
ONE STAGE PROXIMAL PENILE/PENOSCROTAL HYPOSPADIAS
1-STG PERINEAL HYPOSPADIAS REQ. EXT. DISSECTION
REPAIR HYPOSPADIAS COMPLFISTULA,STRICTURE,DIVERTIC
REPAIR HYPOSPADIAS COMPLICATION;MOBILIZE SKIN FLAP
HYPO COMP REQUIRING MOBILIZATION OF SKIN FLAPS
REPAIR HYPOSPADIAS CRIPPLE REQUIRING EXT DISECTION
PLASTIC OPERATION ON PENIS TO CORRECT ANGULATION
EPISPADIAS
PLASTIC OPERATION PENIS FOR EPISPADIAS W/INCONTINE
PLASTIC REPAIR PENIS W/EXSTROPHY OF BLADDER
PRIAPISM OPERATION
PRIAPISM OPERATION
CORPORA CAVERNOSA-GLANS PENIS FISTULIZATION FOR PR
REPAIR, PENILE INJURY
FORESKIN MANIPULATION INC LYSIS OF ADHESIONS
BIOPSY, TESTIS
BIOPSY, TESTIS
EXCISION OF TESTIS LESION
ORCHIECTOMY
PARTIAL ORCHIECTOMY
ORCHIECTOMY
ORCHIECTOMY
EXPLORATION UNDESCENDED TESTIS
EXPLORATION UNDESCENDED TESTIS
REDUCTION, TORSION OF TESTIS
FIXATION, CONTRALATERAL TESTIS
ORCHIOPEXY
ORCHIPEXY, ABDOMINAL APPROACH, INTRA-AB-TESTIS
REPAIR, TESTICULAR INJURY
TRANSPLANTATION, TESTIS
LAPAROSCOPY ORCHIECTOMY
PAPAROSCOPY ORCHIOPEXY
LAPAROSCOPY UNLISTED TESTIS PROCEDURE
DRAINAGE, TESTIS/EPIDIDYMIS
BIOPSY, EPIDIDYMIS
EXCISION, LESION, EPIDIDYMIS
EXCISION SPERMATOCELE W/WO EPIDIDYMECTOMY
EPIDIDYMECTOMY UNILATERAL
EPIDIDYMECTOMY BILATERAL
EXPLORATION OF EPIDIDYMIS, WITH OR WITHOUT BIOPSY
ASPIR HYDROCELE TUNICA VAGINAL
HYDROCELECTOMY - UNILATERAL
HYDROCELECTOMY - BILATERAL
RPR HYDROCELE TUNICA VAGINALIS
DRAIN SCROTAL WALL ABSCESS
SCROTAL EXPLORATION
REMOVAL, FOREIGN BODY, SCROTUM
RESECTION, SCROTUM
SCROTOPLASTY, SIMPLE
SCROTOPLASTY; COMPLICATED
VASOTOMY
VASECTOMY
VASOGRAPHY INJECTION PROCEDURE
VASOVASOSTOMY
LIGATION, VAS DEFERENS
HYDROCELECTOMY, SPERMATIC CORD
EXCISION LESION SPERMATIC CORD
EXCISION, VARICOCELE
EXCISION, VARICOCELE
EXCISION, VARICOCELE
LAPARPSCOPY LIGATION OF SPERMATIC VEINS
LAPAROSCOPY UNLISTED SPERMATIC CORD PROCEDURE
VESICULECTOMY, ANY APPROACH; UNILATERAL
EXCISION, CYST, MULLERIAN DUCT
BIOPSY, PROSTATE
BIOPSY, PROSTATE
BIOPS PROSTATE NDLE, TRNSPRINL, STEROTAC TEMPLTE GUID SATUR SAMP INCL IMAG GUID
PROSTATOTOMY
PROSTATOTOMY
PROSTATECTOMY
PROSTATECTOMY
PROSTATECTOMY W/LYMPHNODE BIOPSY;LIMIT PEL LYMPHA.
PROSTATECTOMY W/BILATERAL PELVIC LYMPHADENECTOMY
PROSTATECTOMY
PROSTATECTOMY
PROSTATECTOMY
PROSTATECTOMY W/LYMPH NODE BIOPSY(S)
PROSTATECTOMY
EXPOSURE OF PROSTATE INSERTION OF RADIOACTIVE SUB.
EXPOSURE PROSTATE W/LYMPH NODE BIOPSY(S)
EXPOSURE PROSTATE W/BILAT PELVIC LYMPHADENECTOMY
LAPAROSCOPY, SURGICAL PROSTATECTOMY RETROPUBIC RADICAL, INC. NERVE SPARING
CRYOSURGICAL ABLATION OF PROSTATE
TRANSPERINEAL PLACEMENT OF NEEDLES OR CATHETERS INTO PROSTATE FOR INTERSTITIAL
PLACEMENT OF INTERSTITIAL DEVICE(S) FOR RADIATION THERAPY GUIDANCE
UNLISTED MALE GEN PROC
PLACEMENT OF NEEDLES OR CATHETERS INTO PELVIC ORGANS AND/ OR GENITALIA
INTERSEX SURGERY
INTERSEX SURGERY
INCISION AND DRAIN OF VULVA OR PERINEAL ABSCESS
DRAIN ABSCESS, BARTHOLINS GLND
MARSUP, CYST, BARTHOLINS GLAND
LYSIS OF LABIAL ADHESIONS
HYMENOTOMY, SIMPLE INCISION
DESTRUCTION OF LESIONS VULVA SIMPLE ANY METHOD
CONDYLOMATA DESTRUCTION
BIOPSY OF VULVA OR PERINEUM ONE LESION
BIOPSY OF VULVA OR PERINEUM EACH SEPARATE LESION-ADD ON
VULVECTOMY SIMPL; PARTIAL
VULVECTOMY SIMPLE; COMPLETE
VULVECTOMY RADICAL, PARTIAL
VULVECTOMY W/UNILATERAL INGUINOFEMORAL LYMPHADENECTOMY
WITH BILATERAL INGUINOFEMORAL LYMPHADENECTOMY
VULVECTOMY RADICAL, COMPLETE
VULVECTOMY W/UNILATERAL INGUINOFEMORAL LYMPHADENEC
VULVECTOMY W/BILATERAL INGUINOFEMORAL LYMPHADENECT
VULVECTOMY RADICAL COMPLETE W/LYMPHADECTOMY
HYMENECTOMY
EXCISION, CYST, BARTHOLINS GLD
REPAIR, VULVA
CLITOROPLASTY FOR ADRENOGENITAL SYNDROME
PERINEOPLASTY REPAIR OF PERINEUM NON-OBSTECTRICAL
COLPOSCOPY OF THE VULVA
COLPOSCOPY VULVA; W/BIOPSY
COLPOTOMY
COLPOTOMY W/DRAINAGE OF PELVIC ABSCESS
COLPOCENTESIS/CULDOCENTIS
INCISION & DRAINAGE OF VAGINAL HEMATOMA OB
INCISION & DRAINAGE OF VAGINAL HEMATOMA TRAUMA
DESTRUCTION VAG LESION SIMPLE
CHEMICAL CAUTERY OF VAGINA
DESTRUCTION EXTENSIVE ANY METHOD
BIOPSY, VAGINAL MUCOSA
BIOPSY, VAGINAL MUCOSA
VAGINECTOMY PARTIAL REMOVAL OF VAGINAL WALL
VAGINECTOMY PARTIAL REMOVAL OF VAGINAL WALL W/ REMOVAL OF PARAVAGINAL TISSUE
VAGINECTOMY PART REMOV VAGIN WALL REMOV PARAVAGIN TISS BILAT TOT PELVIC LYMPHADE
COLPECTOMY
VAGINECTOMY COMPLETE REMOVAL VAGINAL WALL WITH REMOVAL OF PARAVAGINAL TISSUE
VAGINECTOMY COMPLE REMOV VAGINAL WALL REMOV PARAVAG TISSUE BILAT TOT PELVIC LYMP
COLPOCLEISIS
EXCISION, VAGINAL SEPTUM
EXCISION, CYST, VAGINAL
IRRIGATION, VAGINA
INSERTION UTERINE TANDEMS AND/OR VAGINAL OVIODS FOR CLINICAL BRACHYTHERAPY
FITTING & INSERTION OF PESSARY/OTHER INTRVAGINAL D
DIAPHRAGM FITTING
INTRO ANY HEMOSTATIC AGENT/PACK SPONT/TRAU NON-OB
SUTURE, INJURY, VAGINA
COLPOPERINEORRHAPHY
PLASTIC RPR URETHRAL SPHINCTER
PLASTIC REPAIR, URETHROCELE
ANTERIOR COLPORRHAPHY
POSTERIOR COLPORRHAPHY
COLPORRHAPHY COMBINED
COLPORRHAPHY COMBINED
INSERTION PROSTHESIS FOR REPAIR PELVIC FLOOR DEF, EACH SITE (ANT/POST) VAGINAL
ENTEROCELE REPAIR
REPAIR, ENTEROCELE
COLPOPEXY
COLPOPXY VAGINAL EXTRA-PERITONEAL APPROACH SACROSPINOUS ILIOCOCCYGEUS
INTRA-PERITONEAL APPROACH (UTEROSACRAL, LEVATOR MYORRHAPHY)
PARAVAGINAL DEFECT REPAIR
PARAVAGINAL DEFECT REPAIR (INCLUDING REPAIR OF CYSTOCELE, IF PERFORMED
REMOVAL / REVISION OF SLING FOR STRESS INCONTINENCE
SLING OPERATION
PEREYRA PROCEDURE
REVISION (INCLUDING REMOVAL) OF PROSTHETIC VAGINAL GRAFT, VAGINAL APPROACH
REVISION (INCL REMOVAL) OF PROSTHETIC VAGINAL GRAFT; OPEN ABDOMINAL APPROACH
CLOSURE, FISTULA, RECTOVAGINAL
CLOSURE,FISTULA,RECTOVAGINAL; ABDOMINAL APPROACH
CLOSURE RECTOVAGINAL FISTULA; ABDOMINAL APPROACH
CLOSURE RECTOVAGINAL FISTULA;TRANSPERINEAL APPROACH W/RECONSTRUCTION W/W/O PLICA
CLOSURE FISTULA URETHROVAGINAL
CLOSURE URETHROVAGINAL FISTULA W/BULBO. TRANSPLANT
CLOSURE, FISTULA VESICOVAGINAL
CLOSURE, FISTULA VESICOVAGINAL
VAGINOPLASTY FOR INTERSEX STATE
DILATION, VAGINA
PELVIC EXAM ANESTHESIA
REMOVAL IMPACTED VAGINAL FB UNDER ANESTHESIA
COLPOSCOPY OF ENTIRE VAGINA W/ CERVIX
COLPOSCOPY OF ENTIRE VAGINA; WITH BIOPSY
PARAVAGINAL DEFECT REPAIR (INCLUDING REPAIR OF CYSTOCELE, IF PERFORMED),
LAPAROSCOPY, SURGICAL, COLPOPEXY (SUSPENSION OF VAGINAL APEX)
REVISON (INCL. REMOVAL) OF PROSTHETIC VAGINAL GRAFT, LAPAROSCOPIC APPROACH.
COLPOSCOPY OF THE CERVIX INCLUDING UPPER/ADJACENT VAGINA
COLPOSCOPY WITH BIOPSIES OR BIOPSY OF THE CERVIX
COLPOSCOPY CERVIX INC. UPPER VAGINA; W/BIOPSY OF CERVIX
COLPOSCOPY CERVIX INC. UPPER VAGINA; W/ENDOCERVICAL CURETTAGE
COLPOSCOPY W/LOOP ELECTROSURGICAL EXCISION OF CERV (SURGICAL TRAY=LEEP)
COLPOSCOPY CERVIX INC. UPPER VAGINA; W/LOOP ELECTRODE CONIZATION OF CERVIX
BIOPSY, CERVIX
ENDOCERVICAL CURRETTAGE (NOT DONE AS PART OF D&C)
CAUTERIZATION, CERVIX
CRYOCAUTERY, CERVIX
LASAR CAUTERY OF CERVIX
CONIZATION OF CERVIX W/WO FULGURATION W/WO D&C
CONIZATION OF CERVIX; LOOP ELECTRODE EXCISION
TRACHELECTOMY
RADICAL TRACHELECTOMY W/W/O REMOVAL OF TUBES, W/W/O REMOVAL OF OVARY
EXCISION, CERVICAL STUMP
EXCISION CERVICAL STUMP W/PELVIC FLOOR REPAIR
EXCISION, CERVICAL STUMP
EXCISION, CERVICAL STUMP
EXCISION, CERVICAL STUMP
DILATION AND CURETTAGE OF CERVICAL STUMP
INSERTION, HEMOSTATIC AGENT
CERCLAGE OF UTERINE CERVIX, NONOBSTETRICAL-TRACHEL
TRACHELORRHAPHY
DILATION, CERVICAL CANAL
ENDOMETRIAL BIOPSY SUCTION TYPE (INDEPENDENT PROC
ENDOMETRIAL SAMPLING PERFORMED IN CONJUNCTION W/COLPOSCOPY ADD-ON
DILATION AND CURETTAGE DIAGNOSTIC AND OR THERAPEUTIC/NON-OBSTETRICAL
MYOMECTOMY, UTERINE
MYOMECTOMY, UTERINE
MYOMECTOMY, EXCISION FIBROID TUMORS, >OR= TO 5 W/WEIGHT GREATER THAN 250 GRAMS
HYSTERECTOMY
TOTAL ABDOMINAL HYSTERECTOMY W/MARSHALL-M-KRANTZ
HYSTERECTOMY
HYSTERECTOMY
HYSTERECTOMY
PELVIC EXENTERATION FOR GYNECOLOGIC MALIGNANCY
HYSTERECTOMY
VAG HYSTERECTOMY W/REMOVAL TUBES AND/OR OVARYS
VAG HYST W/REMOV TUBES AND/OR OVARY W/REPAIR ENTER
HYSTERECTOMY
HYSTERECTOMY
HYSTERECTOMY
HYSTERECTOMY
HYSTERECTOMY
VAGINAL HYSTERECTOMY, FOR UTERUS > 250 GRAMS
VAGINAL HYSTERECTOMY, UTERUS >250 GRAMS; W/REMOVAL OF TUBES AND/OR OVARIES
VAGINAL HYSTERECTOMY, UTERUS >250 GRAMS; W/REMOVAL TUBES, OVARIES, REPAIR ENTERO
VAGINAL HYSTERECTOMY, UTERUS >250 GRAMS; W/COLPO-URETHROCYSTOPEXY
VAGINAL HYSTERECTOMY, UTERUS >250 GRAMS; W/REPAIR OF ENTEROCELE
IUD INSERTION
IUD REMOVAL
HYSTEROSALPINGOGRAPHY INJ PROC
INSERTION HEYMAN CAPSULES FOR CLINICAL BRACHYTHERAPY
ENDOMETRIAL ABLATION, THERMAL W/O HYSTEROSCOPIC GUIDANCE
ULTRASONIC GUIDANCE, INCLUDING ENDOMETRIAL CURRETTAGE, WHEN PERFORMED
UTERINE SUSPENSION
UTERINE SUSPENSION
INTERPOSITION OPERATION
HYSTEROSALPINGOSTOMY
HYSTERORRHAPHY
HYSTEROPLASTY
LAPAROSCOPY, SURGICAL, SUPRACERVICAL HYSTERECTOMY, FOR UTERUS 250 G OR LESS;
LAPAROSCOPY SURG SUPRACERVICAL HYST, UTERUS 250 G/LESS; W REMOV TUBE &/OR OVARY
LAPAROSCOPY, SURGICAL, SUPRACERVICAL HYSTERECTOMY, FOR UTERUS GREATER 250 G
LAPAROSCOPY SUPRACERVICAL HYSTERECTOMY UTERUS > 250 G; W/REM/TUBE(S)&/OR OVARY
LAPAROSCOPY, MYOMECTOMY, EXCISION; 1-4 INTRAMURAL MYOMAS <250 GRAMS
LAPAROSCOPY, MYOMECTOMY, EXCISION; GREATER THAN OR EQUAL TO 5 MYOMAS >250 GRAMS
LAPAROSCOPY, SURGICAL, WITH RADICAL HYSTERECTOMY
LAPAROSCOPY HYSTERECTOMY
LAPAROSCOPY W/VAGINAL HYSTERECTOMY UTERUS <250 GRAMS; W/REMOVAL TUBES & OVARIES
LAPAROSCOPY VAGINAL HYSTERECTOMY, UTERUS >250 GRAMS
LAPAROSCOPY W/VAGINAL HYSTERECTOMY, UTERUS >250 GRAMS; REMOVAL TUBES AND OVARIES
HYSTEROSCOPY DIAGNOSTIC
HYSTEROSCOPY, BIOPSY
HYSTEROSCOPY LYSIS OF ADHESIONS
HYSTEROCOSPY RESECT INTRAUTERINE SEPTUM
HYSTEROSCOPY LEIMYOMATA REMOVAL
HYSTEROSCOPY FOREIGN BODY REMOVAL
HYSTEROSCOPY ENDOMETRIAL ABLATION
WITH BILAT FALLOPIAN TUBE CANNULATION TO INDUCE OCCLUSION WITH IMPLANTS
LAPAROSCOPY, SURGICAL, WITH TOTAL HYSTERECTOMY, FOR UTERUS 250 G OR LESS;
LAPAROSCOPY, SURG, W/TOTAL HYSTERECTOMY, UTERUS 250 GM/LESS; W/REMOV/TUBE/OVARY
LAPAROSCOPY, SURGICAL, W/TOTAL HYSTERECTOMY, UTERUS GREATER THAN 250 GR
LAPAROSCOPY, SURG W/TOTAL HYSTERECTOMY, UTERUS > 250 GM W/REMOVE/TUBES/OVARY
LAPAROSCOPY UNLISTED UTERUS PROCEDURE
HYSTEROSCOPY UNLISTED UTERUS PROCEDURE
TRANSECTION, FALLOPIAN TUBE
TRANSECTION, FALLOPIAN TUBE
TUBAL LIGATION WITH C-SECTION OR OTHER ABDOM SURG-ADD ON
OCCLUSION OF FALLOPIAN TUBE(S) BY DEVICE
LAPAROSCOPY LYSIS OF ADHESIONS
LAPAROSCOPY OOPHORECTOMY/SALPINGECTOMY
LAPAROSCOPY FULGURATION/EXCISION OF LESIONS
LAPAROSCOPY FULGURATION OF OVIDUCTS
LAPAROSCOPY OCCLUSION OF OVIDUCTS
LAPAROSCOPY FIMBRIOPLASTY
LAPAROSCOPY SALPINGOSTOMY
LAPAROSCOPY UNLISTED OVIDUCT/OVARY PROCEDURE
SALPINGECTOMY
SALPINGO-OOPHORECTOMY
LYSIS OF ADHESIONS
SALPINGOSTOMY
DRAINAGE, CYST, OVARY
DRAIN OVARIAN CYST ABDOMINAL APPROACH
DRAINAGE, ABSCESS, OVARY
DRAINAGE OVARIAN ABSCESS, ABDOMINAL APPROACH
DRAINAGE OF PELVIC ABSCESS TRANSVAGINAL/TRANRECTAL APPROACH, PERCUTANEOUS
TRANSPOSITION, OVARY(S)
BIOPSY OF OVARY
RESECTION, OVARY
OVARIAN CYSTECTOMY, UNILATERAL OR BILATERAL
OOPHORECTOMY
OOPHORECTOMY PARTIAL OR TOTALW/PARA AORTIC & PELV
RESECTION OVARIAN MALIG W/BILATERAL SALPINGO/OOPHO
RESECTION OVARIAN MALIGNANCY
RESECTION OVARIAN MALIGNANCY W/RADICAL DISSECTION
HYSTERECTOMY REMOVAL OF TUBES AND OVARIES W/RADICAL DISSECTION FOR DEBULKING
HYSTERECTOMY/REMOVAL OF TUBES/OVARIES W/LYMPHADENECTOMY
BILATERAL SALPINGO-OOPHORECTOMY WITH TOTAL OMENTECTOMY
RESECTION OF RECURRENT OVARIAN, TUBAL, PRIMARY PERITONEAL, UTERINE MALIGNANCY
RESECTION OF RECURRENT OVARIAN, TUBAL, PRIMARY PERITONEAL, UTERINE MALIGNANCY
LAPAROTOMY OF OVARIAN MALIGNANCY,STAGING/RESTAGING
UNLISTED PROCEDURE, FEMALE GENITAL SYSTEM, NON OB
AMNIOCENTESIS, ANY METHOD
AMNIOCENTESIS; THERAPEUTIC AMNIOTIC FLUID REDUCTION
CORDOCENTESIS INTRAUTERINE
CHORIONIC VILLUS SAMPLING ANY METHOD
FETAL OXYTOCIN STRESS TEST
FETAL NON-STRESS TEST
FETAL BLOOD SAMPLING
FETAL MONITORING DURING LABOR; W/ WRITTEN REPORT, SUPERVISION & INTERP
FETAL MONITORING DURING LABOR W/ WRITTEN REPORT; INTERPRETATION ONLY
TRANSABDOMINAL AMNIOINFUSION, INCLUD ULTRASOUND GUIDANCE
FETAL UMBILICAN CORD OCCLUSION
FETAL FLUID DRAINAGE ( VESICOCENTESIS, THORACENTESIS, PARACENTESIS) W ULTRASOUND
FETAL SHUNT PLACEMENT, INCLUDING ULTRASOUND GUIDANCE
HYSTEROTOMY
SURGICAL TREATMENT ECTOPIC PREGNANCY: SALPINGECTOMY/SALPINGOSTOMY
TUBAL W/O SALPINGECTOMY &/OR OOPHORECTOMY
SALPINGECTOMY/SALPINGOSTOMY
SALPINGECTOMY/SALPINGOSTOMY
SURG TREAT ESTOPIC PREGNANCY INTERSTITIAL W/PART R
SURG FOR ECTOPIC PREGNANCY CERVICAL WITH EVAC
LAPAROSCOPIC TREATMENT ECTOPIC PREG W/O S-O
LAPAROSCOPIC TX ECTOPIC PREG. W/SALPING/OOPHORECTO
CURETTAGE POSTPARTUM
INSERTION HYGROSCOPIC CERVICAL DILATOR
EPISIOT OR VAG REPAIR BY OTHER THAN ATTENDING PHY
CERCLAGE CX VAGINAL
CERCLAGE CX ABDOMEN
HYSTERORRHAPHY OF RUPTURED UTERUS
VAGINAL DELIVERY W/7 OR MORE ANTEPARTUM & POSTPART
VAGINAL DELIVERY ONLY
VAGINAL DELIVERY; INCLUDING POSTPARTUM CARE
EXTERNAL CEPHALIC VERSIONW/WO TOCOLYSIS
DELIVERY PLACENTA FOLLOWING DELIVERY OF INFANT
ANTEPARTUM CARE ONLY; 4-6 VISITS
ANTEPARTUM CARE ONLY; 7 OR MORE VISITS
POST-PARTUM CARE
CESAREAN DELIVERY W/7 OR MORE ANTEPARTUM & POSTPAR
CESAREAN DELIVERY ONLY
CESAREAN DEL ONLY INCL. POST-PARTUM
SUBTOTAL OR TOTAL HYSTERECTOMY AFTER C-SECTION-ADD ON
ROUTINE OB CARE INCL ANTEPARTUM,VAG DELIVERY & POSTPARTUM; AFTER PREV CESAREAN
VAGINAL DELIVERY ONLY, AFTER PREVIOUS CESAREAN
VAGINAL DEL. ONLY AFTER CESAREAN, INC. POSTPARTUM
OB CARE INC. ANTEPARTUM,CESAREAN & POST AFTER ATTEMPTED VAGINAL DELIVERY
CESAREAN DELIVERY ONLY FOLLOWING ATTEMPTED VAGINAL AFTER PREVIOUS CESAREAN
CESAREAN AFTER ATT.VAGINAL AFTER CESAREAN; POSTPAR
TREATMENT OF SPONT ABORTION ANY TRIM COMP SURG
TREAT MISSED ABORTION COMPLETED SURGICALLY 1ST TRI
TREATMENT OF MISSED AB TREAT SURG 2ND TRIMESTER
ABORTION - SEPTIC
ABORTION INDUCED BY DILATION AND CURETTAGE (INCLU
LEGAL(THERAPEUTIC) ABORTION DILATION & EVACUATION
INDUCTION OF LABOR
ABORTION INDUCED COMPLETED BY DILATION AND CURET
ABORTION INDUCED BY HYSTEROTOMY
INDUCED ABORTION, DELIVERY OF FETUS & SECUDINES
INDUCED ABORTION, DELIVERY; W/D&C OR EVACUATION
INDUCED ABORTION, DELIVERY; WITH HYSTEROTOMY
MULTIFETAL PREGNANCY REDUCTION(S)
UTERINE EVAC + CURETTAGE FOR HYDAT MOLE
REMOVAL OF CERCLAGE SUTURE UNDER ANESTHESIA
UNLISTED FETAL INVASIVE PROCEDURE, INCLUDING ULTRASOUND GUIDANCE
LAPAROSCOPY UNLISTED OB CARE/DELIVERY PROCEDURE
UNLISTED MATERNITY PROCEDURE
DRAINAGE, CYST, THYROGLOSSAL
BIOPSY, THYROID
EXCISION, CYST, THYROID
PARTIAL THYROID LOBECTOMY, UNILATERAL
PARTIAL THYROID LOBECTOMY;W/CONTRALATERAL SUBTOTAL
TOTAL THYROID LOBECTOMY, UNILATERAL
THYROID LOBECTOMY
THYROIDECTOMY
THYROIDECTOMY
THYROIDECTOMY
THYROIDECTOMY
THYROIDECTOMY
THYROIDECTOMY, THYROID GLAND; CERVICAL APPROACH
EXCSN, CYST, THYROGLOSSAL DUCT
EXCISION THYROGLOSSAL DUCT CYST/SINUS RECURRENT
ASPIRATION AND/OR INJECTION, THYROID CYST
PARATHYROIDECTOMY
PARATHYROIDECTOMY-RE-EXPLORATION
PARATHYROIDECTOMY
PARATHYROID AUTOTRANSPLANTATION-ADD ON
THYMECTOMY
THYMECTOMY W/O RADICAL MEDIASTINAL DISSECTION
THYMECTOMY; W/RADICAL MEDIASTINAL DISSECTION
ADRENALECTOMY
ADRENALECTOMY
EXCISION, TUMOR, CAROTID BODY
EXCISION, TUMOR, CAROTID BODY
LAPARASCOPY ADRENALECTOMY
LAPAROSCOPY UNLISTED ENDOCRINE PROCEDURE
UNLISTED ENDOCRINE PROCEDURE
SUBDURAL TAP
SUBDURAL TAP
VENTRICULAR PUNCTURE
WITH INJECTION OF DRUG OR OTHER SUBSTANCE FOR DIAG
CISTERNAL PUNCTURES
INJECTION OF DRUG OR OTHER SUBSTANCE FOR DIAG.
PUNCTURE, SHUNT TUBING
TWIST DRILL HOLE FOR SUBDURAL/VENTRICULAR PUNCTURE
TWIST DRILL HOLE FOR IMPLANTING VENTRICULAR CATHETER OR PRESS. RECORD. DVC-(SP)
TWIST DRILL HOLE FOR PUNCTURE OF SUBDURAL HEMATOMA
BURR HOLES
BURR HOLES
BURR HOLES
BURR HOLES
BURR HOLES
BURR HOLES
BURR HOLES;FOR IMPLANTING VENT.CATH.RESERVOIR,EEG ELECT.OR PRESS.RECRD DVC
INSERTION OF SUB & RESERVOIR PUMP FOR VENT. CATH.
BURR HOLES
BURR HOLES
CRANIECTOMY
CRANIECTOMY
EVACUATION, HEMATOMA, CRANIAL
CRANIECTOMY OR CRANIOTOMY FOR EVACUATION HEMATOMA
CRANIECTOMY OR CRANIOTOMY EVACUATION OF HEMOTOMA
CRANIECTOMY OR CRANIOTOMY FOR EVACUATION HEMATOMA
ECTOMY/OTOMY FOR EVACUATION OF HEMATOMA INTERCEREB
INCISION SUBCUTANEOUS PLACEMENT CRANIAL BONE GRAFT- ADD ON CODE
DRAINAGE, ABSCESS INTRACRANIAL
DRAINAGE, ABSCESS INTRACRANIAL
CRANIECTOMY/CRANIOTOMY, TX INTRACRANIAL HYPERTENSION; W/O LOBECTOMY
CRANIECTOMY/CRANIOTOMY, TX INTRACRANIAL HYPERTENSION; W/LOBECTOMY
EXPLORATION, ORBIT
EXPLORATION, ORBIT
EXPLORATION, ORBIT
EXPLORATION, ORBIT
CRANIAL DECOMPRESSION
CRANIECTOMY SUBOCCIPITAL W/CERVICAL LAMINECTOMY FO
CRANIAL DECOMPRESSION
CRANIOTOMY SECTION OF TENTORIUM CEREBELLI SEPERATE
SENSORY ROOT SURGERY
CRANIECTOMY, SUBOCCIPITAL
SUBOCCIPITAL INCISION
SUBOCCIPITAL INCISION
CRANIECTOMY FOR MESENCEPHALIC TRACTOTOMY/PEDUNCULO
LOBOTOMY, CRANIAL
CRANIECTOMY
CRANIECTOMY W/EXCISION OF TUMOR FOR OSTEOMYELITIC
EXCISION, TUMOR, BRAIN
EXCISION, MENINGIOMA
CRANIECTOMY EXCISION OF BRAIN ABSCESS SUPRATENTORI
EXCISION, CYST, SUPRATENTORIAL
IMPLANT BRAIN INTRACAVITY CHEMOTHERAPY AGENT- ADD-ON CODE
EXCISION, TUMOR, BRAIN
EXCISION, MENINGIOMA
EXCISION CEREBELLOPONTINE ANGLE TUMOR
CRANIECTOMY EXCISION OF MIDLINE TUMOR BASE OF SKUL
EXCISION, ABSCESS, BRAIN
EXCISION, CYST, BRAIN
EXCISION, TUMOR, TRANSTEMPORAL
EXCISION, TUMOR, TRANSTEMPORAL
SUBDURAL IMPLANT STRIP ELECTRODES ONE OR MORE BURR
CRANIOTOMY W/ELEVATION OF BONE FLAP; ELECTRODE ARR
EXSN CEREBRAL CORTICAL SCAR
CRANIECTOMY FOR REMOVAL OF EPIDURAL/SUBDURAL ELECT
CRANIOTOMY; EXCISION-CEREBRAL EPILEPTOGENIC FOCUS
CRAINOTOMY W/ELEVATION OF BONE FLAP; FOR LOBECTOMY, TEMP LOBE, W/O ELECTROGRAPHY
TEMPORAL LOBECTOMY
LOBECTOMY, OTHER THAN TEMPORAL
CRAINIOTOMY W/ELEVATION OF BONE FLAP: FOR LOBECTOMY, OTHER THAN TEMPORAL LOBE
CRANIECTOMY FOR TRANSECTION OF CORPUS CALLOSUM
HEMISPHERECTOMY
CRANIECTOMY FOR PARTIAL OR SUBTOTAL HEMISPHERECTOM
COAGULATION, CHOROID PLEXUS
CRANIECTOMY FOR EXCISION OF CRANIOPHARYNGIOMA
HYPOPHYSECTOMY
HYPOPHYSECTOMY
CRANIECTOMY
CRANIECTOMY
CRANIOTOMY FOR CRANIOSYNOSTOSIS;FRONTAL OR PARIETA
CRANIOTOMY FOR CRANIO-SYNOSTOSIS,BIFRONTAL BONE FL
EXTENSIVE CRANIECTOMY NOT REQUIRING BONE GRAFTS
EXTENSIVE CRANIECTOMY RECOUNTOURING W/MULTI OSTEOM
EXCISION INTRA & EXTRACRANIEL BENIGN TUMOR CRANIAL
EXCISION INTRA & EXTRACRANIEL W/OPTIC NERVE COMPRE
CRANIOTOMY W/ELEVATION OF BONE FLAP, FOR SELECTIVE AMYGDALOHIPPOCAMPECTOMY
CRAINOTOMY W/ELEVATION OF BONE FLAP; FOR MULTIPLE SUBPIAL TRANSECTIONS W/ELEC
EXCISION, FOREIGN BODY, BRAIN
CRANIECTOMY W/TREATMENT OF PENETRATING WOUND BRAIN
TRANSORAL APPROACH TO SKULL BASE,BRAIN STEM OR UPP
TRANSORAL APP TO SKULL BASE FOR BIOPSY DECOMPRESSI
CRANIOFACIAL APPROACH TO ANTERIOR FOSSA
EXTRADURAL,INCLUDING LATERAL RHINOTOMY,ORBITAL EXC
EXTRADURAL CRANIOFACIAL APPROACH CRANIAL FOSSA
INTRADURAL CRANIOFACIAL APPROACH CRANIAL FOSSA
ORBITOCRANIAL APPROACH CRANIAL FOSSA W/O EXENTERAT
WITH ORBITAL EXENTERATION
BICORONAL-OSTEOTOMY APPROACH TO ANTERIOR CRANIAL
INFRATEMPORAL PRE-AURICULAR APPROACH CRANIAL FOSSA
INFRATEMPORAL POST-AURICULAR APPROACH CRANIAL FOSS
ORBITOCRANIAL ZYGOMATIC APPROACH CRANIAL FOSSA
TRANSTEMPORAL APPROACH CRANIAL FOSSA
TRANSCOCHLEAR APPROACH POSTERIOR CRANIAL FOSSA
TRANSCONDYLAR(FAR LATERAL) APPROACH TO POSTERIOR C
TRANSPETROSAL APPROACH TO POSTERIOR CRANIAL FOSSA
RESECTION NEOPLASTIC LESION CRANIAL FOSSA;EXTRADUR
RESECT NEOPLASTIC LESION CRANIAL FOSSA; INTRADURAL
RESECT NEOPLASTIC LESION INFRATEMPORAL FOSSA;EXTRA
RESECT NEOPLASTIC LESION INFRATEMPORAL FOSSA;INTRA
RESECT NEOPLASTIC LESION PARASELLAR AREA;EXTRADURA
RESECT NEOPLASTIC LESION PARASELLAR AREA;INTRADURA
TRANSECTION CAROTID ARTERY IN SINUS; W/O REPAIR-ADD ON
TRANSECTION CAROTID ARTERY IN SINUS; WITH REPAIR-ADD ON
TRANSECTION CAROTID ARTERY PETROUS CANAL;W/O REPAI-ADD ON
TRANSECTION CAROTID ARTERY PETROUS CANAL; W/REPAIR-ADD ON
OBLITERATION CAROTID ANEURYSM BY DISSECTION
RESECT NEOPLASTIC LESION CRANIAL FOSSA; EXTRADURAL
RESECT NEOPLASTIC LESION CRANIAL FOSSA; INTRADURAL
SECONDARY REPAIR FOR CSF LEAK BY FREE TISSUE GRAFT
SECONDARY REPAIR CSF LEAK BY LOCAL PEDICLE FLAP
ENDOVASCULAR TEMP. BALLOON ARTERIAL OCCLUSION, HEAD OR NECK AND SUPERVISION
TRANSCATHETER OCCLUSION/EMBOLIZATION ANY METHOD
TRANSCATHETER OCCLUSION NON-CENTRAL NERVOUS SYSTEM
BALLOON ANGIOPLASTY, INTRACRANIAL, PERCUTANEOUS
TRANSCATHETER PLACEMENT OF INTRAVASCULAR STENT, INTRACRANIAL, INCL BALLOON
BALLOON DILATION OF INTRACRANIAL VASOPASM, PERCUTANEOUS, INITIAL VESSEL
BALLOON DILATION/ INTRACRANIAL VASOPASM, PERCUTANEOUS, EA ADD VESSEL ADD-ON
BALLOON DILATION OF INTRACRANIAL VASOPLASM, PERCUTANEOUS, EA (ADD-ON)
INTERCRANIAL ARTERIOVENOUS MALFORMATION SIMPLE SUP
INTRACRANIAL ANTERIOVENOUS SUPRATENTORIAL COMPLEX
INTRACRANIAL ARTERIOVENOUS MALFORM SIMPLE INFRATEN
INTRACRANIAL ARTERIOVENOUS MALFORM COMPLEX INFRATE
INTRACRANIAL ARTERIOVENOUS MALFORM SIMPLE DURAL
INTRACRANIAL ARTERIOVENOUS MALFORM COMPLEX DURAL
SURGERY OF INTRACRANIAL ANEURYSM
SURGERY OF INTRACRANIAL ANEURYSM VERTEBROBASILAR CIRCULATION
INTRA-CRANIAL ANEURYSM SURGERY
INTRA-CRANIAL ANEURYSM SURGERY
SURGERY INTRA-CRANIAL ANEURYSM CERVICAL
ANEURYSM SURGERY
SURGERY ANEURYSM BY INTRACRANIAL ELECTROTHROMBOSIS
SURG ANEURYSM BY INTRA-ARTERIAL EMBOLIZATION INJEC
ANASTOMOSIS CRBRL/CORTICL ARTR
STEREOTAXIC LESION
STEREOTAXIC LESION
SURGERY OF ANEURYSM VASCULAR MALFORMATION OR CARTO
STEREOTACTIC BX, ASPIRATE OR EXCISE INCL BURR&CAT
STEREOTACTIC IMPLANT OF DEPTH ELECTRODES CEREBRUM
STEREOTACTIC LOCALIZATION ANY METHOD INC BURR HOLE
STEREOTAXIC LESION
CREATION LESION STEREOTACTIC METHOD-TRIGEMINAL MED
STEREOTACTIC COMPUTER ASSIST VOLUMETRIC INTRACRANI-ADD ON
STEROTACTIC RADIOSURG PART BEAM, GAMMA RAY/ LINEAR ACCEL 1 SIMPLE CRANIAL LESION
EACH ADDITIONAL CRANIAL LESION, SIMPLE LIST SEP IN ADD TO CODE FOR PRIMARY PROC
1 COMPLEX CRANIAL LESION
EA ADDL CRANIAL LESION, COMPLEX LIST SEP IN ADD TO CODE FOR PRIMARY PROCEDURE
APPL OF STEROTACTIC HEADFRAME FOR STEROTACTIC RADIOSURGRY IN ADD PRIM PROC
TWIST DRILL OR BURR HOLES FOR IMPLANT NEUROSTIMULA
ECTOMY/OTOMY IMPLANT NEUROSTIMULATOR ELECTRODES
TWIST DRILL OR BURR HOLES CRAINOTOMY
EACH ADDITIONAL ARRAY (ADD-ON)
TWIST DRILL OR BURR HOLES
EACH ADDITIONAL ARRAY
IMPLANT NEUROSTIMULATOR ELECTRODES CEREBELLAR CORT
IMPLANT NEUROSTIMULATOR ELECTRODES CEREBELLAR, SUB
REVISION/REMOVAL INTERCRANIEL NEUROSTIMULATOR ELEC
INSERTION OR REPLACEMENT OF CRANIAL NEUROSTIMULATOR PULSE GENERATOR OR RECEIVER
PLACEMENT OF CRANIAL NEUROST IMULATOR DEVICE
REVISION/REMOVAL CRANIAL NEUROSTIMULATOR PULSE GEN
REPAIR, SKULL FRACTURES
REPAIR, SKULL FRACTURES
REPAIR, SKULL FRACTURES
REPAIR, DURAL/CSF LEAK
REDUCTION CRANIOMEGALIC SKULL (EG TREATED HYDROCEP
REDUCTION CRANIOMGEALIC SKULL W/CRANIOPLASTY
REDUCTION CRANIOMEGALIC SKULL REQUIRING CRANIOTOMY
REPAIR, ENCEPHALOCELE
CRANIOTOMY W/REPAIR OF ENCEPHALOCELE SKULL BASE
CRANIOPLASTY
CRANIOPLASTY
REMOVAL BONE FLAP OR PROSTHETIC PLATE OF SKULL
REPLACE OF BONE FLAP OR PROSTHETIC PLATE OF SKULL
CRANIOPLASTY
CRANIOPLASTY WITH AUTOGRAFT UP TO 5CM DIAMETER
CRANIOPLASTY WITH AUTOGRAFT LARGER THAN 5CM DIAMET
INCISION/RETRIEVAL SUBCUTANEOUS CRANIAL BONE GRAFT FOR CRANIOPLASTY, ADD-ON CODE
NEUROENDOSCOPY, INTRACRANIAL PLACE VENTRICULAR CATHETER (ADD ON)
NEUROENDOSCOPY, INTRACRANIAL W/DISSECTION ADHESIONS, FENESTRATION OF SEPTUM/CYST
NEUROENDOSCOPY, INTRACRANIAL W/ FENESTRATION/EXCISION CYST, INC. CATH. FOR DRAIN
NEUROENDOSCOPY INTRACRANIAL W/ RETRIEVAL OF FOREIGN BODY
NEUROENDOSCOPY, INTRACRANIAL W/ EXCISION BRAIN TUMOR, INC. CATHETER FOR DRAINAGE
NEUROENDOSCOPY INTRACRANIAL W/EXCISION PITUITARY TUMOR, TRANSNASAL/TRANS-SPHENOL
VENTRICULOCISTERNOSTOMY
SUBDURAL SHUNT
SUBDURAL SHUNT
IRRIGATION, SUBDURAL CATHETER
VENTRICULOCISTERNOSTOMY
VENTRICULOCISTERNOSTOMY, 3RD VENT, STEREOTACTIC
VENTRICULAR SHUNT
VENTRICULAR SHUNT
IRRIGATION VENTRICULAR CATHETER
REVISION, OBSTRUCTED VALVE
REPROGRAMMING OF CSF SHUNT
SHUNT REMOVAL
SHUNT REMOVAL
LYSIS OF EPIDURAL ASHESIONS
LYSIS OF EPIDURAL ADHESIONS; 1 DAY
PERC ASPIRATION W/IN NUCLEUS PULPOSUS, INTERV DISC, OR PARAV TISSUE FOR DIAG
PERCUTANEOUS ASPIRATION, SPINAL CORD CYST OR SYRIN
BIOPSY OF SPINAL CORD, PERCUTANEOUS NEEDLE
SPINAL PUNCTURE, LUMBAR DIAGNOSTIC
SPINAL PUNCTURE THERAPEUTIC TO DRAIN SPINAL FLUID
INJECTION, BLOOD/CLOT PATCH
INJECTION NEUROLYTIC SUBSTANCE
NJ NEUROLYTIC SUBSTANCE EPIDURAL CERVICAL THRACI
INJECTION NEUROLYTIC SUBSTANCE
INJECTION PROC.FOR MYELOGRAPHY AND/OR COMPUTERIZED AXIAL TOMOGRAPHY, SPINAL
ASPIRATION, PERCUTANEOUS, ANY METHOD SING/MULTI
DISCOGRAPHY INJECTION PROC; EACH LEVEL, LUMBAR
DISCOGRAPHY INJECTION PROC; CERVICAL OR THORACIC
CHEMONEUCLEOLYSIS
ARTERIAL INJECTION PROCEDURES
EPIDURAL OR SUBARACHNOID INJECTION
EPIDURAL OR SUBARACHNOID INJECTION
EPIDURAL OR SUBARACHNOID INJECTION WITH INDWELLING CATHETER,CERVICAL/THORACIC
EPIDURAL OR SUBARACHNOID INJECTION WITH INDWELLING CATHETER, LUMBAR, SACRAL
IMPLANTATION CATHETER,RESERVOIR/PUMP;W/O LAMINECTO
IMPLANTATION CATHETER,RESERVOIR/PUMP; W/LAMINECTOM
REMOVAL IMPLANTED INTRATHECAL/EPIDURAL CATHETER
IMPLANT/REPLACE DEVICE FOR DRUG INFUSION;SUBCUTANE
IMPLANT/REPLACE DEVICE,DRUG INFUSION; PUMP
IMPLANT/REPLACE DEVICE,DRUG INFUSION,PROGRAM PUMP
REMOVAL SUBCUTANEOUS RESERVOIR OR PUMP IMPLANTED
ELECTRONIC ANALYSIS IMPLANTED PUMP;W/O REPROGRAM
ELECTRONIC ANALYSIS IMPLANTED PUMP; W/REPROGRAMMIN
LAMINECTOMY
LAMINECTOMY
LAMINECTOMY
LAMINECTOMY W/EXPLOR/DELOMPRESS SPINAL CORD SACRAL
LAMINECTOMY W/E PLOR AND/OR DECOMPRESSION OF SPINA
LAMINECTOMY
LAMINECTOMY
LAMINECTOMY
LAMINOTOMY
LAMINOTOMY
LAMINOTOMY-ADD ON
LAMINOTOMY
LAMINOTOMY
LAMINOTOMY; EACH ADDITIONAL CERVICAL INTERSPACE (ADD-ON)
LAMINOTOMY; EACH ADDITIONAL LUMBAR INTERSPACE
LAMINECTOMY,INCLUDING UNILATERAL OR BILATERAL COMP
LAMINECTOMY, THORACIC
LAMINECTOMY INCLUDING UNILATERAL OR BILATERAL COMP
LAMINECTOMY, EACH ADDITONAL SEGMENT-ADD ON
WITH DECOMPRESSION OF THE SPINAL CORD, TWO OR MORE VERTEBRAL SEGMENTS
DECOMPRESSION OF THE SPINAL CORD, 2 OR MORE VERTEBRAL SEGMENTS WITH
TRANSPEDICULAR APPROACH W/DECOMPRESSION SPINAL COR
DECOMPRESSION SPINAL CORD LUMBAR
DECOMPRESSION SPINAL CORD EA ADDIT SEG THORACIC/LU-ADD ON
LAMINOTOMY
LAMINOTOMY
COSTOVERTEBAL APP W/DECOMPRESS SPIN CORD EA ADD SE-ADD ON
DISCECTOMY
DISCECTOMY-ADD ON
DISKECTOMY; THORACIC, SINGLE INTERSPACE
VERTEBRAL CORPECTOMY, PARTIAL/COMPLETE; ANTERIOR
CERVICAL; EACH ADDITIONAL SEGMENT-ADD ON
VERTEBRAL CORPECTOMY
VERTEBRAL CORPECTOMY THORACIC GA ADD SEGMENT-ADD ON
VERTEBRAL CORPECTOMY,PARTIAL OR COMPLETE
VERTEBRAL CORPECTOMY, EACH ADDITIONAL SEGMENT-ADD ON
VERTEBRAL CORPECTOMY PARTIAL OR COMPLETE SINGLE SE
VERTEBRAL CORPECTOMY PARTIAL OR COMPLETE EACH ADDI-ADD ON
VERTEBRAL CORPECTOMY, PARTIAL OR COMPLETE, LATERAL EXTRACAVITARY APPROACH
LUMBAR, SINGLE SEGMENT
THORACIC OR LUMBAR, EACH ADDITIONAL SEGMENT
LAMINECTOMY FOR MYELOTOMY
LAMINECTOMY FOR DRAINAGE INTRAMEDULLARY CYST/SYRIN
LAMINECTOMY DRAINAGE OF CYST TO PERITONEAL SPACE
LAMINECTOMY
LAMINECTOMY
LAMINECTOMY WITH RHIZOTOMY
LAMINECTOMY W/RHIZOTOMY MORE THAN 2 SEGMENTS
LAMINECTOMY FOR SECTION OF SPINAL ACCESSORY NEVER
CORDOTOMY
LAMINECTOMY WITH CORDOTOMY
CORDOTOMY
CORDOTOMY
CORDOTOMY
LAMINECTOMY WITH CORDOTOMY, THORACIC
LAMINECTOMY FOR RELEASE OF TETHERED SPINAL CORD, LUMBAR
LAMINECTOMY CERVICAL
LAMINECTOMY THORACIC
THORACOLUMBAR LAMINECTOMY
LAMINECTOMY FOR EXCISION OF INTRASPINAL LESION
LAMINECTOMY FOR EXCISION INTRASPINAL LESION THORAC
LAMINECTOMY FOR INTRASPINAL LESION
LAMINECTOMY EXCISION INTRASPINAL LESION SACRAL
LAMINECTOMY EXCISION INTRASPINAL LESION CERVICAL
LAMINECTOMY FOR EXCISION INTRASPINAL LESION THORAC
LAMINECTOMY; LUMBAR
LAMINECTOMY; SACRAL
LAMINECTOMY-BIOPSY/EXCISION EXTRASPINAL LESION;
LAMINECTOMY
EXTRADURAL, LUMBAR
LAMINECTOMY, EXTRADURAL SACRAL
INTRADURAL, EXTRAMEDULLARY, CERVICAL
INTRADURAL, EXTRAMEDULLARY, THORACIC
LAMINECTOMY, INTRADURAL,EXTRAMEDULLARY,LUMBAR
LAMINECTOMY FOR BIOPSY/EXCISION INTRADURAL, SACRAL
LAMINECTOMY BIOPSY/INTRADURAL INTRAMEDULLARY CERVI
LAMINECTOMY FOR BIOPSY/EXCISION
LAMINECTOMY INTRADURAL INTRAMEDULLARY THORACOLUMBA
COMBINED EXTRADURAL/INTRADURAL LESION, ANY LEVEL
OSTEOPLASTIC RECON OF DORSAL SPINAL ELEMENTS, FOLLOWING PRIM PROC (ADD-ON)
VERTEBRAL CORPECTOMY SINGLE SEGMENT CERVICAL
VERTEBRAL CORPECTOMY EXTRADURAL TRANSTHORACIC
EXTRADURAL, THORACIC BY THORACOLUMBAR APPROACH
EXTRADURAL, LUMBAR/SACRAL TRANSPERITONEAL APPROACH
INTRADURAL, CERVICAL
INTRADURAL, THORACIC BY TRANSTHORACIC APPROACH
INTRADURAL, THORACIC BY THORACOLUMBAR APPROACH
VERTEBRAL CORPECTOMY INTRADURAL LUMBAR BY TRANSPER
VERTEBRAL CORPECTOMY EACH ADDITIONAL SEGMENT-ADD ON
STEREOTAXIC LESION SPINAL CORD
STEREOTAXIC LESION SPINAL CORD
STEREOTACTIC BIOPSY, ASPIRATION, SPINAL CORD
STEREOTACTIC RADIOSURG PART BEAM, GAMMA RAY, OR LINEAR ACCEL/1 SPINAL LESION
EACH ADD SPINAL LESION (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROC)
PERCUTANEOUS IMPLANT NEUROSTIMULATOR ELECTRODES
LAMINECTOMY IMPLANT NEUROSTIMULATOR ELECTEPIDURAL
REMOVAL OF SPINAL NEUROSTIMULATOR ELECTRODE PERCUTANEOUS ARRAY, INCL FLUORSCOPY
REMOVAL OF SPINAL NEUROSTIMULATOR ELECTRODE PLATE/PADDLE , INCL FLUOROSCOPY
REVISION INCL REPLACEMENT, WHEN PERFORMED, OF SPINAL NEUROSTIMULATOR ELECTRODE
REVISION INCL REPLACEMENT, WHEN PERFORMED, OF SPINAL NEUROSTIMULATOR ELECTRODE
INSERTION OR REPLACEMENT OF SPINAL NEUROSTIMULATOR PULSE GENERATOR OR RECEIVER
OF IMPLANTED SPINAL NEUROSTIMULATOR PULSE GENERATOR OR RECEIVER
REPAIR, MENINGOCELE
MENINGOCELE LARGER THAN 5CM
REPAIR, MYELOMENINGOCELE
REPAIR, MYELOMENINGOCELE
REPAIR OF DURAL/CSF LEAK NOT REQUIRING LAMINECTOMY
REPAIR OF DURAL/CSF LEAK
DURAL GRAFT
SHUNT, LUMBAR
CREATION OF SHUNT PERCUTANEOUS NOT REQUIRE LAMINEC
SHUNT, LUMBAR
SHUNT, LUMBAR
SOMATIC NERVE BLOCK
SOMATIC NERVE BLOCK
SOMATIC NERVE BLOCK
SOMATIC NERVE BLOCK
SOMATIC NERVE BLOCK
SOMATIC NERVE BLOCK
SOMATIC NERVES-CERVICAL PLEXUS
SOMATIC NERVE BLOCK
INJ. ANES. AGENT; BRACHIAL PLEXUS, CONTINUOUS INFUSION CATH. W/ DAILY MANAGEMENT
SOMATIC NERVE BLOCK
SUPRASCAPULAR NERVE
SOMATIC NERVE BLOCK
SOMATIC NERVE BLOCK
SOMATIC NERVE BLOCK
SOMATIC NERVE BLOCK
SOMATIC NERVE BLOCK
SOMATIC NERVE BLOCK
INJ. ANES. AGENT; SCIATIC NERVE, CONTINUOUS INFUSION CATH. W/DAILY MANAGEMENT
INJ. ANES. AGENT; FEMORAL NERVE SINGLE
INJ. ANES. AGENT; FEMORAL NERVE, CONTINUOUS CATH. INC. DAILY MANAGEMENT
LUMBAR PLEXUS, POSTERIOR APPROACH, CONTINUOUS INFUSION BY CATHETER
SOMATIC NERVE BLOCK
INJ ANESTH AGENT AND/OR STEROID PLANTAR COMMON DG NERVE EG MORTON'S NEURO
TRANSFORAMINAL CERVICAL OR THORACIC EPIDURAL INJECTION
TRANSFORAMINAL CERVICAL OR THORACIC EPIDURAL INJECTION-ADD ON
TRANSFORAMINAL LUMBAR OR SACRAL EPIDUARAL INJECTION
TRANSFORAMINAL LUMBAR OR SACRAL EPIDURAL INJECTION-ADD ON
INJECTION(S), DIAGNOSTIC OR THERAPEUTIC AGENT, PARAVERTEBRAL FACET JOINT, SINGLE
SECOND LEVEL (SP)
THIRD AND ANY ADDITIONAL LEVEL(S) (SP)
INJECTION(S) DIAGNOSTIC/THERAPEUTIC AGENT, PARAVERTEBRAL FACE, SINGLE LEVEL
SECOND LEVEL (SP)
THIRD AND ANY ADDITIONAL LEVEL(S) SP
SYMPATHETIC NERVE BLOCK
SYMPATHETIC NERVE BLOCK
SYMPATHETIC NERVE BLOCK
SUPERIOR HYPOGASTRIC PLEXUS
SYMPATHETIC NERVE BLOCK
INJECTION CELIAC PLEXUS W/WO RADIOLOGIC MONITORING
APPLICATION OF SURFACE (TRANSCUTANEOUS) NEURO STIM
PURCUTANEOUS IMPLANT OF NEUBO ELECTRODES, CRANIAL
PURCUTANEOUS IMPLANT OF NEURO ELECTRODES, PERIPHER
AUTONOMIC NERVE
PERCUTANEOUS IMPLANTAION NEUROSTIMULATOR ELECTRODES; SACRAL NERVE
NEUROMUSCULAR
INCISE FOR IMPLANT OF NEURO ELECTRODES, CRANIAL
IMPLANTATION NEUROSTIMULATOR ELECTRODES - PERIPHERAL NERVE
AUTONOMIC NERVE
NEUROMUSCULAR
INCISION NEUROSTIMULATOR ELECTRODE IMPLANTS; SACREAL NERVE
REVISE/REMOVE PERIPHERAL NEUROSTIMULATOR ELECTORDE
INSERTION OR REPLACEMENT OF PERIPHERAL NEUROSTIMULATOR PULSE GENERATOR OR RECEIV
REVISE/REMOVE PERIPHERAL NEUROSTIMULATOR RECEIVER
DESTRUCTION, SOMATIC NERVE
DESTRUCTION, SOMATIC NERVE
DESTRUCTION, SOMATIC NERVE
DESTRUCTION BY NEUROLYTIC AGENT; MUSCLES FACIAL NE
DESTRUCTION NEUROLYTIC AGENT CERVICAL SPINAL MUSCL
CHEMODENERVATION OF MUSCLES; EXTREMITY(S) AND/OR TRUNK MUSCLE(S)
DESTRUCTION, SOMATIC NERVE
DESTRUCTION-PARAVERTEBRALFACET JOINT NERVE LUMBAR
DESTRUCT NEUROLYTIC AGENT;JOINT NERVE,LUMBAR,EACH-ADD ON
PARAVERTEBRAL FACET JOINT NERVE DESTRUCTION
PARAVERTEBRAL FACET JOINT NERVE DESTRUCTION ADD-ON
DESTRUCTION BY NEUROLYTIC AGENT PUDENDAL NEVER
PLANTAR COMMON DIGITAL NERVE
DESTRUCTION, SOMATIC NERVE
CHEMODENERVATION OF ECCRINE GLANDS, BOTH AXILLE
CHEMODENERVATION OF ECCRINE GLANDS, OTHER AREA (SCALP, NECK FACE) PER DAY
DESTRUCTION, SYMPATHETIC NERVE
SUPERIOR HYPOGASTRIC PLEXUS
NEUROLYSIS
NEUROLYSIS
NEUROLYSIS
NEUROLYSIS
NEUROLYSIS
NEUROLYSIS
NEUROLYSIS AND/OR TRANSPOSITION CRANIAL NERVE SPEC
NEUROPLASTY &/OR TRANSPOSE: ULNAR NERVE T ELBOW
NEUROPLASTY &/OR TRANSPOSE: ULNAR NERVE AT WRIST
NEUROPLASTY &/OR TRANSPOSE: MEDIAN NERVE AT CARPAL
NERVE DECOMPRESSION
NERVE DECOMPRESSION
INTERNAL NEUROLYSIS; REQUIRE USE OPERATING MICROSC-ADD ON
TRANSECTION, NERVE
TRANSECTION, NERVE
TRANSECTION, NERVE
TRANSECTION, NERVE
TRANSECTION OR AVULSION LINGUAL NERVE
TRANSECTION, NERVE
TRANSECTION, NERVE
TRANSECTION, NERVE
TRANSECTION, NERVE
SELECTIVE VAGOTOMY
TRANSECTION, NERVE
TRANSECTION, NERVE
TRANSECTION, NERVE
TRANSECTION, NERVE
TRANSECTION/AVULSION OF OTHER CRANIAC NERVE EXTRAD
TRANSECTION OF OTHER SPINAL NERVE EXTRADURAL
EXCISION, NEUROMA
EXCISION, NEUROMA, DIGITAL NERVE,1 OR BOTH,SAME DI
EXCISION, NEUROMA-ADD ON
EXCISION, NEUROMA
EXCISION, NEUROMA-ADD ON
EXCISION, NEUROMA
EXCISION, NEUROMA
IMPLANTATION OF NERVE END INTO BONE OR MUSCLE-ADD ON
EXCISION, NEUROFIBROMA
EXCISION, NEUROFIBROMA
EXCISION, NEUROFIBROMA
BIOPSY, NERVE
EXCISION, NERVES, SYMPATHETIC
EXCISION, NERVES, SYMPATHETIC
EXCISION, NERVES, SYMPATHETIC
NEURECTOMY, HYPOGASTRIC
EXCISION, NERVES, SYMPATHETIC
SYMPATHECTOMY,DIGITAL ARTERIES,W/MAGNIFICATION, EA
SYMPATHECTOMY; RADIAL ARTERY
SYMPATHECTOMY; ULNAR ARTERY
SYMPATHECTOMY; SUPERFACIAL PALMAR ARCH
SUTURE DIGITAL NERVE HAND/FOOT 1 NERVE
SUTURE, NERVE-ADD ON
SUTURE, NERVE
SUTURE, NERVE
SUTURE, NERVE
SUTURE EACH ADDITIONAL NERVE HAND OR FOOT-ADD ON
SUTURE POST TIBIAL NERVE
SUTURE, NERVE
SUTURE MAJOR PERIPHERAL NERVE WO/TRANSPOSITION
SUTURE OF SCIATIC NERVE
SUTURE EACH ADDITIONAL MAJOR PERIPHERAL NERVE-ADD ON
SUTURE, NERVE
SUTURE LUMBAR PLEXUS
SUTURE FACIAL NERVE
SUTURE, NERVE
SUTURE, NERVE
SUTURE, NERVE
SUTURE, NERVE
SUTURE, NERVE-ADD ON
SUTURE NERVE REQUIRING EXTENSIVE MOBILIZATION OR-ADD ON
SUTURE NERVE; REQUIRING SHORTENING OF BONE EXTREM.-ADD ON
NERVE GRAFT HEAD OR NECK UP TO 4 CM
NERVE GRAFT HEAD OR NECK MORE THAN 4 CM
NERVE GRAFT
NERVE GRAFT
NERVE GRAFT
NERVE GRAFT
NERVE GRAFT
NERVE GRAFT
NERVE GRAFT ARM OR LEG UP TO 4 CM
NERVE GRAFT MORE THAN 4 CM
NERVE GRAFT EA ADDITIONAL NERVE-ADD ON
NERVE GRAFT; MULTIPLE STRANDS-ADD ON
NERVE PEDICLE TRANSFER
NERVE PEDICLE TRANSFER
NERVE REPAIR; W/ SYNTHETIC CONDUIT/VEIN ALLOGRAFT (EG, NERVE TUBE), EACH NERVE
NERVE REPAIR; WITH AUTOGENOUS VEIN GRAFT (INCL HARVEST OF VEIN GRAFT), EA NERVE
UNLISTED PROCEDURE, NERVOUS SYSTEM
EVISCERATION, OCULAR CONTENTS
EVISCERATION, OCULAR CONTENTS
ENUCLEATION, EYE
ENUCLEATION, EYE
ENUCLEATION, EYE
EXENTERATION, ORBIT
EXTENTERATION-ORBIT; W/THERAPEUTIC BONE REMOVAL
EXENTERATION, ORBIT
MODIFICATION OF OCULAR IMPLANT W/ PLACEMENT OR REPLACEMENT OF PEGS (SP)
INSERTION, OCULAR IMPLANT
INSERTION, OCULAR IMPLANT
INSERTION, OCULAR IMPLANT
REINSERTION, OCULAR IMPLANT
REINSERTION OF OCULAR IMPLANT; W/USE OF FOREIGN MATERIAL
REMOVAL, OCULAR IMPLANT
FOREIGN BODY, EYEBALL
FOREIGN BODY, EYEBALL
FOREIGN BODY, EYEBALL
FOREIGN BODY, EYEBALL
FOREIGN BODY, EYEBALL
FOREIGN BODY, EYEBALL
FOREIGN BODY, EYEBALL
REPAIR, LACERATION, EYEBALL
REPAIR LACERATION CONJUNCTIVA WO/HOSP
REPAIR LACERATION BY MOBILIZATION REARRANGEMENT WO
REPAIR LACERATION CORNEA W/WO REMOVAL FB
REPAIR LACERATION CORNEA PERFORATING, NOT UVEAL TI
REPAIR LACERATION CORNEA W/REPOSITION UVEAL TISSUE
APP OF TISSUE GLUE, WOUNDS OF CORNEA AND/OR SCLERA
REPAIR, WOUND, EXTRAOCULAR
EXCISION, LESION, CORNEA
BIOPSY, CORNEA
TRANSPOSITION, PTERYGIUM
EXICSION TRANSPOSITION OF PTERYGIUM W/GRAFT
CORNEAL SCRAPING
REMOVAL, CORNEAL EPITHELIUM
REMOVAL CORNEAL EPITHELIUM W/APP CHELATING AGENT
THERMOCAUTERIZATION, CORNEA
DESTRUCTION LESION CORNEA BY CRYOTHERAPY, PHOTOCOA
CRYOTHERAPY, CORNEA
MULTIPLE PUNCTURES OF ANTERIOR CORNEA/EROSION/TATT
KERATOPLASTY
KERATOPLASTY
KERATOPLASTY
KERATOPLASTY
KERATOPLASTY; PENETRATING (IN PSEUDOPHAKIA)
ENDOTHELIAL
KERATOMELEUSIS
KERATOPHAKIA
EPIKERATOPLASTY
KERATOPROSTHESIS
RADICAL KERATOTOMY
CORNEAL RELAXING INCISION
CORNEAL WEDGE RESECTION NO ASSIST
OCULAR SURFACE RECONSTRUCTION; AMNIOTIC MEMBRANE TRANSPLANTATION
LIMBAL STEM CELL ALLOGRAFT (EG, CADAVERIC OF LIVING DONOR)
LIMBAL CONJUNCTIVAL AUTOGRAFT (INCLUDES OBTAINING GRAFT)
PARACENTESIS EYE ANTE CHAMBER
PARACENTESIS EYE ANTE CHAMBER
PARACENTESIS EYE ANTE CHAMBER
PARACENTESIS EYE ANTE CHAMBER
GONIOTOMY
TRABECULOTOMY AB EXTERNO
TRABECULOPLASTY BY LASAR SURGERY, ONE OR MORE
SEVERING ADHESIONS ANTERIOR SEGMENT LASER TECHNIQU
LYSIS, ADHESIONS, EYE
LYSIS, ADHESIONS, EYE
LYSIS, ADHESIONS, EYE
LYSIS, ADHESIONS, EYE
REMOVAL EPITHELIAL DOWNGROWTH; ANTERIOR CHAMBER EY
REMOVAL IMPLANT MATERIAL, ANTERIOR SEGMENT EYE
REMOVAL, BLOOD CLOT, EYE
INJECTION, EYE, ANTE CHAMBER
INJECTION, EYE, ANTE CHAMBER
EXCISION, LESION, SCLERA
FISTULIZATION, SCLERA
THERMOCAUTERY, SCLERA
THERMOCAUTERY, SCLERA
IRIDENCLEISIS/IRIDOTASIS
TRABECULECTOMY AB EXTERNO
TRABECULECTOMY AB EXTERNO W/SCARRING FROM PREVIOUS
AQUEOUS SHUNT TO EXTRAOCULAR RESERVOIR
REVISION AQUEOUS SHUNT EXTRAOCULAR RESERVOIR
REPAIR, SCLERAL STAPHYLOMA
REPAIR, SCLERAL STAPHYLOMA
REVISION, OPERATIVE WOUND, EYE
IRIDOTOMY
TRANSFIXION IRIDOTOMY
IRIDECTOMY
IRIDECTOMY
IRIDECTOMY
IRIDECTOMY
IRIDECTOMY
REPAIR, IRIS/CILIARY BODY
SUTURE OF IRIS, CILIARY BODY W/RETRIEVAL OF SUTURE
CILIARY BODY DESTRUCTION; DIATHERMY
CYCLOPHOTOAGULATION TRANSCLERAL
CILIARY BODY DESTRUCTION; CYCLOPHOTOCOAGULATION, ENDOSCOPIC
CILIARY BODY DESTRUCION; CRYOTHERAPY
CILIARY BODY DESTRUCTION; CYCLODIALSIS
IRIDOTOMY
COREOPLASTY
DESTRUCTION, LESION, IRIS
DISCISSION, AFTERCATARACT
DISCISSION SECONDARY MEMBRANEOUS CATARACT; LASER
REPOSITION INTRAOCULAR LENS PROSTHESIS REQUIRE INC
REMOVAL SECONDARY MEMBRANOUS CATARACT
LENS MATERIAL REMOVAL
PHACOFRAGMENTATION, LENS
REMOVAL LENS MATERIAL, PARS PLANA APPROACH W/WO VI
EXTRACTION LENS (CATARACT) INTRACAPSULAR
EXTRACTION LENS (CATARACT) INTRACAPSULAR-DISLOCATD
EXTRACTION LENS (CATARACT) EXTRACAPSULAR
EXTRACTION, LENS
EXTRACAPSULAR CATARACT REMOVAL
INTRACAPSULAR CATARACT EXTRACTION WITH INSERTION
EXTRA CAPSULAR CATARACT REMOVAL W/INSERTION OF IOL
INSERTION LENS PROSTHESIS SECONDARY IMPLANT
EXCHANGE OF INTRAOCULAR LENS
OPHTHALMIC ENDOSCOPE, ADD-ON CODE
UNLISTED ANTERIOR SEG PROC
REMOVAL VITREOUS ANTERIOR APPROACH; PARTIAL
REMOVAL VITREOUS, SUBTOTAL REMOVAL W/MECHANICAL VI
ASPIRATION, VITREOUS
INJECTION, VITREOUS SUBSTITUTE
INPLANTATION OR REPLACEMENT OF INTRAVITREAL DRUG DELIVERY SYSTEM, INC.CONCOMITAN
INTRAVITREAL INJ OF A PHARMACOLOGIC AGENT SEPERATE
DISCISSION, VITREOUS STRANDS
SEVERING VITREOUS STRANDS ONE OR MORE STAGES LASER
VITRECTOMY, MECHANICAL, PARS PLANA APPROACH
VITRECTOMY W/FOCAL ENDOLASER PHOTOCOAGULATION
VITRECTOMY W/ANDOLASAR PANRETINAL PHOTOCOAGULATION
VITRECTOMY, MECHANICAL, PARS PLANA APPRCH; W/REMOV/PRERETINAL CELLULAR MEMBRANE
VITRECTOMY, MECHANICAL, PARS PLANA APPR; W/REMOV/INTERNAL LIMIT MEMBRANE/RETINA
VITRECTOMY, MECHANICAL, PARS PLANA APPROACH; W/REMOVAL OF SUBRETINAL MEMBRANE
REPAIR RETINAL DETACHMENT 1 OR MORE SESSIONS
REPAIR, RETINAL DETACHMENT
REPAIR, RETINAL DETACHMENT
REPAIR, RETINAL DETACHMENT
REPAIR RETINAL DETACHMENT BY PHOTO COAGULATION
REPAIR, RETINAL DETACHMENT
REPAIR, RETINAL DETACHMENT
REPAIR, RETINAL DETACHMENT
RETINAL DETACH BY INJ OF AIR OR OTHER GAS (PNEUMOR
REPAIR, RETINAL DETACHMENT
REPAIR OF COMPLEX RETINAL DETACHMENT
RELEASE OF ENCIRCLING MATERIAL (POSTERIOR SEGMENT)
REMOVAL IMPLANTED MATERIAL POSTERIOR SEG EXTRAOCUL
REMOVAL IMPLANTED MATERIAL POSTERIOR SEG INTRAOCUL
PROPHYLAXIS RETINAL DETACHMENT W/O DRAINAGE 1/MORE
PROPHYLAXIS RETINAL DETACHMENT
PROPHYLAXIS RETINAL DETACHMENT
PROPHYLAXIS RETINAL DETACHMENT
PROPHYLAXIS, PHOTOCOAGULATION(LASER OR XENON ARC)
PROPHYLAXIS RETINAL DETACHMENT
DESTRUCT LOCALIZED LESION RETINA ONE OR MORE SESSI
DESTRUCTION OF LOCALIZED LESION OF RETINA 1OR MORE
DESTRUCTION, LESION, RETINA
DESTRUCTION, LESION, RETINA
DESTRUCTION, LESION, RETINA
DESTRUCTION, LESION, RETINA
DESTRUCITON-RADIATION BY IMPLANTATION OF SOURCE
DESTRUCTION LOCALI LESION CHORDID ONE MORE SESSION PHOTO COAGULATION
OCULAR PHOTODYNAMIC THERAPY
DESTRUCTION, RETINOPATHIES
DESTRUCTION, RETINOPATHIES
DESTRUCTION, RETINOPATHIES
OCULAR PHOTODYNAMIC THERAPY; SECOND EYE, SINGLE SECTION (ADD-ON)
DESTRUCTION, RETINOPATHIES
DESTRUCTION EXTENSIVE RETINOPATHY
DESTRUCTION RETINOPATHY 1 OR MORE PHOTOCOAGULATIN
TREATMENT OF EXTENSIVE/PROGRESSIVE RETINOPATHY, 1/MORE SESSIONS; PRETERM INFANT
SCLERAL REINFORCEMENT
SCLERAL REINFORCEMENT
UNLISTED PROCEDURE POSTERIOR SEGMENT
STRABISMUS SURGERY
STRABISMUS SURGERY
ONE VERTICAL MUSCLE/EXCLUDING SUPERIOR OBLIQUE
OCULAR ADNEXA TWO OR MORE VERTICAL MUSCLES
STRABISMUS
TRANSPOSITION, EYE MUSCLES-ADD ON
STRABISMUS SURGERY-ADD ON
STRABISMUS SURGERY-ADD ON
STRABISMUS SURG BY POSTERIOR FIXATION SUTURE TECHN-ADD ON
OCULAR ADNEXA ADJ SUTURO TECHNIQUE-ADD ON
STRABISMUS SURG W/EXPLOR AND/OR DETACHED EXTRAOCUL-ADD ON
RELEASE EXTENSIVE SCAR TISSUE WO/DETACHING EXTRAOC
CHEMODENERVATION OF EXTRA OCULAR MUSCLE
BIOPSY OF EXTRAOCULAR MUSCLE
UNLISTED EYE MUSCLE PROC
ORBITOTOMY
ORBITOTOMY
ORBITOTOMY
ORBITOTOMY
ORBITOTOMY WO/BONE FLAP W/REMOVAL BONE FOR DECOMPR
BIOPSY, ORBIT
ORBITOTOMY
ORBITOTOMY
ORBITOTOMY
ORBITOTOMY W/REMOVAL OF BONE FOR DECOMPRESSION
ORBITOTOMY
INJECTION, ORBIT
INJECTION, ORBIT
ORBITOGRAPHY INJECTION PROC
INJECTION, TENONS CAPSULE
INSERTION, ORBITAL IMPLANT
REVISION, ORBITAL IMPLANT
OPTIC NERVE DECOMPRESSION
UNLISTED ORBIT PROC
BLEPHAROTOMY
SEVERING TARSORRHAPHY
CANTHOTOMY
EXCISION, CHALAZION
EXCISION, CHALAZION
EXCISION, CHALAZION
EXCISION, CHALAZION
BIOPSY, EYELID
TRICHIASIS CORRECTION
TRICHIASIS CORRECTION
TRICHIASIS CORRECTION
TRICHIASIS CORRECTION
EXCISION, LESION, LID MARGIN
DESTRUCTION LESION, LID MARGIN
TEMPORARY CLOSURE OF EYELIDS BY SUTURE
TARSORRHAPHY
TARSORRHAPHY
REPAIR OF BROW PTOSIS
REPAIR, BLEPHAROPTOSIS
REPAIR, BLEPHAROPTOSIS
REPAIR, BLEPHAROPTOSIS
REPAIR, BLEPHAROPTOSIS
REPAIR, BLEPHAROPTOSIS
REPAIR, BLEPHAROPTOSIS
REDUCTION OVERCORRECTED PTOSIS
CORRECTION, LID RETRACTION
CORRECTION OF LAGOPHTHALMOS, W/IMPLANTATION OF UPPER EYELID LID LOAD
ECTROPION REPAIR
ECTROPION REPAIR
ECTROPION REPAIR
ECTROPION REPAIR
ENTROPION REPAIR
THERMO COUTERIZATION
ENTROPION REPAIR
ENTROPION REPAIR
SUTURE, EYELID WOUND
SUTURE, EYELID WOUND
REMOVAL, FOREIGN BODY, EYELID
CANTHOPLASTY
EXCISION & REPAIR, EYELID
EXCISION & REPAIR, EYELID
RECONSTRUCTION, EYELID
RECONSTRUCTION, EYELID
RECONSTRUCTION, EYELID
RECONSTRUCTION, EYELID
UNLISTED EYELID PROCEDURE
DRAINAGE, CYST, CONJUNCTIVA
EXPRESSN FOLLICLES CONJUNCTIVA
BIOPSY, CONJUNCTIVA
EXCISION, LESION, CONJUNCTIVA
EXCISION, LESION, CONJUNCTIVA
EXCISION, LESION, CONJUNCTIVA
DESTRUCTION LESION CONJUNCTIVA
INJECTION, SUBCONJUNCTIVA
CONJUNCTIVOPLASTY
CONJUNCTIVOPLASTY
CONJUNCTIVOPLASTY
CONJUNCTIVOPLASTY
CONJUNCTIVOPLASTY
CONJUNCTIVOPLASTY
DIVISION SYMBLEPHARON W/WO INSERT OF CONFERMER OR
CONJUNCTIVAL FLAP
CONJUNCTIVAL FLAP
HARVESTING CONJUNCTIVAL ALLOGRAFT, LIVING DONOR
UNLISTED CONJUNCTIVA PROC
DRAINAGE, LACRIMAL GLAND
DACRYOCYSTOSTOMY
INCISION, LACRIMAL PUNCTUM
EXCISION, LACRIMAL GLAND
EXCISION, LACRIMAL GLAND
BIOPSY, LACRIMAL GLAND
EXCISION, LACRIMAL SAC
BIOPSY, LACRIMAL SAC
REMOVAL FB/DACRYOLITHA, LACRIMAL PASSAGES
EXCISION, TUMOR LACRIMAL GLAND
EXCISION, TUMOR LACRIMAL GLAND
PLASTIC REPAIR, CANALICULI
CORRECTION, EVERTED PUNCTUM
DACRYOCYSTORHINOSTOMY
CONJUNCTIVO-RHINOSTOMY
CONJUNCTIVO-RHINOSTOMY
CLOSURE, LACRIMAL PUNCTUM
CLOSURE LACRIMAL PUNCTUM BY PLUG EACH
CLOSURE, FISTULA, LACRIMAL SAC
DIALATION OF LACRIMAL PUNCTUM W/WO IRRIGATION
PROBING OF NASOLACRINAL DUCT, W/WO IRRIGATION
PROBING-NASOLACRIMAL DUCT REQUIRING GENERAL ANESTH
PROBING-NASOLACRIMAL DUCT W/INSERTION OF TUBE/STEN
PROBING OF NASOLACRIMAL DUCT, W/WO IRRIG; W/TRANSLUMINAL BALLOON CATH DILATION
PROBING, CANALICULI
DACRYOCYSTOGRAPHY, INJ PROC
UNLISTED LACRIMAL PROC
DRAINAGE, ABSCESS, EAR
DRAINAGE, ABSCESS, EAR
ABSCESS, AUDITORY CANAL
BIOPSY, EAR
BIOPSY, AUDITORY CANAL
EXCISION, EAR
EXCISION, EAR
EXOSTOSIS, AUDITORY CANAL
EXCISION LESION AUDITORY CANAL
EXCISION LESION AUDITORY CANAL
EXCISION LESION AUDITORY CANAL
FOREIGN BODY, AUDITORY CANAL
FOREIGN BODY, AUDITORY CANAL
REMOVAL, CERUMEN, IMPACTED, ONE OR BOTH EARS
DEBRIDEMENT, MASTOIDECTOMY CAVITY, SIMPLE, UNILATE
DEBRIDEMENT, MASTOIDECTOMY CAVITY, COMPLEX, UNILAT
OTOPLASTY
RECONSTRUCTION OF EXTERNAL AUDITORY CANAL MESTOPLA
RECONSTRUCTION, AUDITORY CANAL
UNLISTED EXT EAR PROC
EUSTACHIAN TUBE INFLATION
EUSTACHIAN TUBE INFLATION
EUSTACHIAN TUBE CATHETERIZATION TRANSYPMANIC
MYRINGOTOMY
MYRINGOTOMY INCLUDING ASPIRATION AND/OR EUSTACIAN
VENTILATING TUBE REMOVAL UNILATERAL
TYMPANOSTOMY
TYMPANOSTOMY GENERAL ANESTHESIA UNILATERAL
EXPLORATION, MIDDLE EAR
TYMPANALYSIS, TRANSCANAL
REVISION FENESTRATION OPERATION
TRANSMASTOID ANTROTOMY
MASTOIDECTOMY
MASTOIDECTOMY
MASTOIDECTOMY
PETROUS APICECTOMY
RESECTION, TEMPORAL BONE
EXCISION, AURAL POLYP
EXCISION, AURAL GLOMUS TUMOR
EXCISION, AURAL GLOMUS TUMOR
EXCISION, AURAL GLOMUS TUMOR
REVISION MASTOIDECTOMY
REVISION MASTOIDECTOMY
REVISION MASTOIDECTOMY
REVISION MASTOIDECTOMY, RESULT IN TYMPANOPLASTY
REVISION MASTOIDECTOMY
REPAIR OF EARDRUM
MYRINGOPLASTY
TYMPANOPLASTY
TYMPANOPLASTY
TYMPANOPLASTY W/OSSICULAR RECONST AND SYNTHETIC PR
TYMPANOPLASTY
TYMPANOPLASTY
TYMPANOPLASTY WITH OSSICULAR RECONSTRUCT & PROSTHE
TYMPANOPLASTY
TYMPANOPLASTY
TYMPANOPLASTY
TYMPANOPLASTY
TYMPANOPLASTY
TYMPANOPLASTY
STAPES MOBILIZATION
STAPEDECTOMY
STAPEDECTOMY/OTOMY W/FOOTPLATE DRILL OUT
REVISION OF STAPEDECTOMY OR STAPEDOTOMY
REPAIR, FISTULA, OVAL WINDOW
REPAIR, FISTULA, ROUND WINDOW
MASTOID OBLITERATION
TYMPANIC NEURECTOMY
CLOSURE, POST AURICULAR
IMPLANTATION/REPLACEMENT HEARING DEVICE TEMPORAL
REMOVAL/REPAIR ELECTROMAGNETIC BONE CONDUCTION HEA
OSSEOINTEGRATED INPLANT
OSSEOINTEGRATED IMPLANT W/ MASTOIDECTOMY
OSSEOINTEGRATED IMPLANT REPLACEMENT
OSSEOINTEGRATED IMPLANT REPLACEMENT W/ MASTOIDECTOMY
DECOMPRESSION, FACIAL NERVE
DECOMPRESS FACIAL NERVE INC MEDIAL TO GENICULATE G
SUTURE, FACIAL NERVE
SUTURE FACIAL NERVE INC MEDIAL TO GENICULATE GANGL
UNLISTED MID EAR PROC
LABYRINTHOTOMY
LABYRINTHOTOMY
ENDOLYMPHATIC SAC OPERATION
ENDOLYMPHATIC SAC OPERATION
FENESTRATION SEMICIRCULAR CNL
REV, FENESTRATION, INNER EAR
LABYRINTHECTOMY
LABYRINTHECTOMY
VESTIBULAR NERVE SECTION
COCHLEAR DEVICE IMPLANT; W/WO MASTOIDECTOMY
UNLISTED PROCEDURE, INNER EAR
TRANSECTION, VESTIBULAR NERVE
FACIAL NERVE DECOMPRESSION
DECOMPRESSION, AUDITORY CANAL
REMOVAL, TUMOR, TEMPORAL BONE
UNLISTED TEMPORAL BONE PROC
USE OF OPERATING MICROSCOPE-ADD ON
MYELOGRAPHY,POSTERIOR FOSSA, SUPER AND INTERP ONLY
CISTERNOGRAPHY POSITIVE CONTRAST W/INTERPRETATION
RADIOLOGICAL EYE EXAM-FOREIGN BODY; UNILATERAL-MOD 50 PAYS 100%
MANDIBLE X-RAYS
MANDIBLE X-RAYS
MASTOID X-RAY EXAM, LESS THAN 3 VIEWS/SIDE; UNILATERAL-MOD 50 PAYS 100%
MASTOID X-RAY EXAM COMPLETE, MIN 3 VIEWS/SIDE; UNILATERAL-MOD 50 PAYS 100%
AUDITORY MEATUSES X-RAY
FACIAL BONE X-RAY
FACIAL BONE X-RAY
NASAL BONE X-RAY
DACRYOCYSTOGRAPHY NASOLOCRIMAL DUST S&I
X-RAY EXAM, OPTIC FORAMINA; UNILATERAL-MOD 50 PAYS 100%
RADIOLOGIC EXAMINATION, ORBITS COMPLETE,MINIMUM 4V
PARANASAL SINUS X-RAY
PARANASAL SINUS X-RAY
SELLA TURCICA X-RAY
SKULL X-RAY
SKULL X-RAY
DENTAL X-RAYS
DENTAL X-RAYS
DENTAL X-RAYS
X-RAY, TMJ, OPEN AND CLOSED MOUTH; UNILATERAL
TEMPORAMANDIBULAR JOINTS X-RAY
TMJ ARTHROGRAPHY, S&I; UNILATERAL-MOD 50 PAYS 100%
MRI, TMJ; UNILATERAL-MOD 50 PAYS 100%
ORTHODONTIC X-RAY
PALATE X-RAY
NECK/SOFT TISSUE/ X-RAY
X-RAY LARYNX OR PHARYNX
COMPLEX DYNAMIC SPEECH EVALUATION
LARYNGOGRAPHY,CONTRAST, SUPERVISION & INTERP ONLY
SALIVARY GLAND X-RAY
SIALOGRAPHY, SUPERIVISION AND INTERPRETATION ONLY
COMPUTORIZED AXIAL TOMOGRAPHY HEAD WITHOUT CONTRAS
WITH CONTRAST MATERIAL(S)
WITHOUT IV CONTRAST FOLLOWED BY CONTRST
COMPUTERIZED AXIAL TOMOGRAPHY ORBIT SELLA OR POST
WIHT CONTRAST MATERIAL(S)
WITHOUT CONTRAST MATERIAL FOLLOWED BY CONTRAST MAT
COMPUTERIZED AXIAL TOMOGRAPHY MAXILLOFACIAL WO CON
WITH CONTRAST MATERIAL(S)
WITHOUT CONTRAST MATERIAL FOLLOWED BY CONTRAST MAT
COMPUTERIZED AXIAL TOMOGRAPHY SOFT TISSUE NECK WO
WITH CONTRAST MATERIAL(S)
WITHOUT CONTRAST MATERIAL FOLLOWED BY CONTRAST MAT
CT ANGIOGRAPHY HEAD
CT ANGIOGRAPHY NECK
MRI;ORBIT, FACE, AND NECK
MRI ORBIT FACE AND NECK WITH CONSTRAST MATERIAL(S)
MRI ORBIT FACE & NECK W/O CONTRAST MATERIAL(S) FOLLOWED BY CONTRAST MATERIAL(S)
MRA HEAD W/O CONTRAST MATERIAL(S) AND FURTHER SEQUENCES
MRA HEAD WITH CONTRAST MATERIAL(S)
MRA HEAD CODE W/O CONTRAST MATERIAL(S) FOLLOWED BY CONTRAST MATERIALS
MRA NECK W/O CONTRAST MATERIAL(S)
MRA NECK WITH CONTRAST MATERIAL(S)
MRA NECK W/O CONTRAST MATERIAL(S) FOLLOWED BY CONTRAST MATERIALS
MRI, BRAIN
MRI BRAIN WITH CONTRAST MATERIAL (S)
MRI BRAIN W/O CONTRAST FOLLOWED BY CONTRAST MATERI
MAGNETIC RESONANCE IMAGING, BRAIN, FUNCTIONAL MRI
MAGNETIC RESONANCE IMAGING, BRAIN, FUNCTION, REQ PHYS/PSYCH ADMIN NEURO TEST
MRA BRAIN INCLUDING BRAIN STEM & SKULL BASE
MRA W/CONTRAST MATERIAL(S)
MRA NECK W/O CONTRAST MATERIAL(S)
CHEST X-RAYS
X-RAY CHEST,STEREO, POSTEROANTERIOR
CHEST X-RAYS
CHEST X-RAYS
X-RAY CHEST OBLIQUE PROJECTIONS
RAD EXAM CHEST W/FLUOROSCOPY
CHEST X-RAYS
CHEST X-RAYS
X-RAY CHEST, SPECIAL STUDIES, EG LATERAL DECUBITUS
BRONCHOGRAPHY UNILATERAL S&I
BRONCHOGRAPHY BILATERAL, S & I
PACEMAKER INSERT/FLURO S&I
RIB X-RAYS
XRAY,RIBS,UNILATERAL,INCLUDES PA CHEST,MINIMUM 3V
RIB X-RAYS-BILATERAL
XRAY RIBS BILATERAL
STERNUM X-RAYS
STERNOCLAVICULAR JOINT X-RAYS
COMPUTERIZED AXIAL TOMOGRAPHY THORAX WITH CONTR
WITH CONTRAST MATERIAL(S)
WITHOUT CONTRAST MATERIAL FOLLOWED BY CONTRAST
CT ANGIOGRAPHY OF CHEST
MAGNETIC RESONANCE IMAGING, CHEST
MRI CHEST WITH CONTRAST MATERIALS
MRI CHEST W/O CONTRAST MATERIALS FOLLOWED BY CONTRAST MATERIALS
MAGNETIC RESONANCE ANGIOGRAPHY,CHEST W/WO CONTRAST MATERIALS
SPINE X-RAYS
SPINE X-RAYS
CERVICAL X-RAYS
CERVICAL X-RAYS
CERVICAL X-RAYS
RADIOLOGIC EXAM, SPINE, THORACOLUMBAR STANDING
THORACIC X-RAYS
X-RAY SPINE,THORACIC,AP AND LAT,INCLUDES SWIMMER'S
XRYA THORACIC COMPLETE INCLUDES OBLIQUES MIN 4V'S
THORACO-LUMBAR X-RAYS
SCOLIOSIS STUDY
LUMBAR X-RAYS
LUMBOSACRAL X-RAYS
LUMBOSACRAL X-RAYS
SPINE X-RAYS
COMPUTERIZED AXIAL TOMOGRAPHY CERVICAL SPINE WO C
WITH CONTRAST MATERIAL
COMPUTERIZED AXIAL TOMOGRAPHY,CERVICAL SPINE,WITHO
COMPUTERIZED AXIAL TOMOGRAPHY THORACIC SPINE WO C
COMPUTED TOMOGRAPHY, THORACIC SPINE; WITH CONTRAST MATERIAL
CAT, THORACIC SPINE W/O CONTRAST W/CONTRAST & SECS
COMPUTERIZED AXIAL TOMOGRAPHY LUMBAR SPINE WO CON
WITH CONTRAST MATERIAL
W/O CONTRAST MATERIAL
MRI SPINAL CANAL & CONTENTS,CERVICAL WITHOUT CONTR
WITH CONTRAST MATERIALS
MAGNETIC RESONANCE IMAGING,SPINAL CANAL & CONTENTS
WITH CONTRAST MATERIALS
MAGNETIC RESONANCE IMAGING,SPINAL CANAL & CONTENTS
WITH CONTRAST MATERIALS
MRI,SPINAL CANAL & CONTENTS W/O CONTRAST MATERIAL
THORACIC
LUMBAR
MAGNETIC RESONANCE ANGIOGRAPHY,SPINAL CANAL & CONTENTS W/W/O CONT
PELVIS X-RAYS
PELVIS X-RAYS
CT ANGIOGRAPHY OF PELVIS
COMPUTERIZED AXIAL TOMOGRAPHY PELVIS WO CONTRAST
WITH CONTRAST MATERIAL(S)
WITHOUT CONTRAST MATERIAL FOLLOWED BY CONTRAST MAT
MRI PELVIS W/O CONTRAST MATERIALS
MAGNETIC RESONANCE OF PELVIS
MRI PELVIS W/O CONTRAST MATERIALS FOLLOWED BY CONTRAST MATERIALS
MRI ANGIOGRAPHY, PELVIS W/OR W/O CONTRAST MATERIAL
XRAY SACROILIAC JOINTS LESS THAN THREE VIEWS
SACRO-ILIAC JOINT X-RAY
SACRUM AND COCCYX X-RAY
MYELOGRAPHY, CERVICAL, SUPERIVSION & INTERP ONLY
MYELOGRAPHYTHORACIC SUPERVISION AND INTER ONLY
MYELOGRAPHY,LUMBO SUPER AND INTERPRETATION ONLY
MYELOGRAPHY ENTIRE SPINAL CANAL:SUPER&INTERP ONLY
EPIDUROGRAPYHY RADIOLOGICAL SUPERVISION AND INTERPRETATION
DISKOGRAPHY CERVICAL,SUPERVISION AND INTERP ONLY
RADIOLOGICAL SUPERVISION/INTERPRETATION, PERCUTANEOUS VERTEBROPLASTY
RADIOLOGICAL SUPERVISION AND INTERPRETATION, UNDER CT GUIDANCE
DISKOGRAPHY,LUMBAR,SUPER AND INTERP ONLY
CLAVICLE X-RAYS-MOD 50 PAYS 100%
SCAPULA X-RAYS-MOD 50 PAYS 100%
RADIOLOGIC EXAM SHOULDER 1 VIEW; UNILATERAL-MOD 50 PAYS 100%
RADIOLOGIC EXAM SHOULDER MIN. 2 VIEWS; UNILATERAL-MOD 50 PAYS 100%
X-RAY SHOULDER ARTHROGRAPHY S&I: ONLY; UNILATERAL-MOD 50 PAYS 100%
ACROMIO-CLAVICULAR JOINT X-RAY-BILATERAL - 50 PAYS 100%
HUMERUS X-RAY-MOD 50 PAYS 100%
ELBOW X-RAYS-MOD 50 PAYS 100%
ELBOW X-RAYS-MOD 50 PAYS 100%
ELBOW ARTHROGRAPHY S&I-MOD 50 PAYS 100%
FOREARM X-RAY-MOD 50 PAYS 100%
RADIOLOGIC EXAMIN UPPER EXTREMITY INFANT A&P PLUS LATERAL VU-MOD 50 PAYS 100%
WRIST X-RAYS-MOD 50 PAYS 100%
WRIST X-RAYS-MOD 50 PAYS 100%
WRIST ARTHOGRAPHY S&I-MOD 50 PAYS 100%
HAND X-RAY-MOD 50 PAYS 100%
HAND X-RAY-MOD 50 PAYS 100%
FINGER X-RAYS-MOD 50 PAYS 100%
COMPUTERIZED AXIAL TOMOGRAPHY UPPER EXT WO CONTRAS-MOD 50 PAYS 100%
WITH CONTRAST MATERIAL(S)-MOD 50 PAYS 100%
WITHOUT CONTRAST MATERIAL FOLLOWED BY CONTRAST MAT-MOD 50 PAYS 100%
CT ANGIOGRAPHY OF UPPER EXTREMITY
MRI UPPER EXTREMITIES OTHER THAN JOINT W/O CONTRAST MATERIALS;MOD-50 PAYS 100%
MRI UPPER EXTREMITIES WITH CONTRAST MATERIALS; UNILATERAL- MOD 50 PAYS 100%
MRI, UPPER EXTREMITY, OTHER THAN JOINT-MOD 50 PAYS 100%
MRI, ANY JOINT UPPER EXTREMITY-MOD 50 PAYS 100%
MRI JOINT UPPER EXTREMITY WITH CONTRAST MATERIALS; UNILATERAL MOD-50 PAYS 100%
CONTRAST MATERIALS FOLLOWED BY CONTRAST MATERIALS;UNILATERAL MOD 50 PAYS 100%
MRI,ANGIOGRAPHY,UPPER EXTREMITY,W/OR W/O CONTRAST
RADIOLOGIC EXAMINATION, HIP, UNILATERAL; ONE VIEW
HIP X-RAYS (MIN OF 2 VIEWS)
HIP X-RAYS-BILATERAL
X-RAY EXAM, HIP ARTHROGRAPHY, S&I; UNILATERAL-MOD 50 PAYS 100%
X-RAY EXAM, HIP DURING OPERATIVE PROC; UNILATERAL-MOD 50 PAYS 100%
HIP X-RAYS
SACROILIAC JOINT ARTHROGRAPHY RADIOLOGIC EXAMINATION
X-RAY EXAM,FEMUR ANTEPOSTERIOR/LATERAL VIEWS; UNILATERAL-MOD 50 PAYS 100%
X-RAY EXAM KNEE ANTEPOSTERIOR/LATERAL VIEWS; UNILATERAL-MOD 50 PAYS 100%
XRAY KNEE ANTEPOS/LATERAL W/OBLIQ MIN 3 VIEW, UNILATERAL-MOD 50 PAYS 100%
X-RAY KNEE COMPLETE W/OBLIQUES/TUNNEL/PATEL; UNILATERAL-MOD 50 PAYS 100%
RADIOLOGIC EXAM KNEE, BOTH KNEES STANDING ANTEROPOSTERIOR-MOD 50 PAYS 100%
X-RAY EXAM KNEE ARTHROGRAPHY, S&I; UNILATERAL-MOD 50 PAYS 100%
X-RAY EXAM TIBIA & FIBULA ANTERO/LATERAL; UNILATERAL-MOD 50 PAYS 100%
X-RAY EXAM.TIBIA & FIBULA LOWER EXT.INFANT; UNILATERAL-MOD 50 PAYS 100%
X-RAY EXAM ANKLE ANTERO/LATERAL VIEWS; UNILATERAL-MOD 50 PAYS 100%
X-RAY EXAM ANKLE COMPLETE MIN 3 VIEWS; UNILATERAL-MOD 50 PAYS 100%
X-RAY EXAM ANKLE ARTHROGRAPHY, S&I; UNILATERAL-MOD 50 PAYS 100%
X-RAY FOOT ANTERO/LATERAL VIEWS; UNILATERAL-MOD 50 PAYS 100%
X-RAY FOOT COMPLETE MIN 3 VIEWS; UNILATERAL-MOD 50 PAYS 100%
OS CALCIS X-RAY-MOD 50 PAYS 100%
TOE X-RAYS-MOD 50 PAYS 100%
COMPUTERIZED AXIAL TOMOGRAPHY LOWER EXT WO CONTRAST
WITH CONTRAST MATERIAL(S)-BILATERAL
WITHOUT CONTRAST MATERIAL FOLLOWED BY CONTRAST MATERIAL-BILATERAL
CT ANGIOGRAPHY OF LOWER EXTREMITY
MRI LOWER EXTREMITY OTHER THAN JOINT W/O CONTRAST MATERIALS
MRI LOWER EXTREMITY WITH CONTRAST MATERIALS
MRI, LOWER EXTREMITY OTHER THAN JOINT-BILATERAL
MRI, ANY JOINT OF LOWER EXTREMITY-MOD 50 PAYS 100%
MRI JOINT LOWER EXTREMITY WITH CONTRAST MATERIALS; UNILATERAL MOD-50 PAYS 100%
CONTRAST MATERIALS FOLLOWED BY CONTRAST MATERIALS; UNILATERAL MOD 50 PAYS 100%
MRI ANGIOGRAPHY,LOWER EXTREMITY, W/OR/W/O CONTRAST
ABDOMEN X-RAYS
ABDOMEN X-RAYS
ABDOMEN X-RAYS
COMPLETE ACUTE ABDONEM SERIES INCLUDING SPINE CHES
COMPUTERIZED AXIAL TOMOGRAPHY ABDOMEN WO CONTRAST
COMPUTED TOMOGRAPHY, ABDOMEN, WITH CONTRAST MATERIAL(S)
COMPUTED TOMOGRAPHY, ABDOMEN W/OCONTRAST MATERIAL FOLLOWED BY CONTRAST MAT
CT ANGIOGRAPHY OF ABDOMEN
MRI, ABDOMEN
MRI ABDOMEN WITH CONTRAST MATERIALS
MRI ABDOMEN W/O CONTRAST MATERIALS FOLLOWED BY WITH CONTRAST MATERIALS
MAGNETIC RESONANCE ANGIOGRPHY,ABDOMEN,W/ OR W/O C
PERITONEOGRAM,RADIOLOGICAL SUPERVISION & INTERPRET
PHARYNX X-RAYS
ESOPHAGUS X-RAYS
PHARYNX/ESOPHAGS CINERADIOGRPY
REMOVAL FB ESOPH/W CATH S&I
RADIOLOGICALEXAM GASTROINTESTINAL TRACT UPPER
UPPER GI SERIES
UPPER GI SERIES
GASTROINTESTINAL TRACT UP
WITH KUB
RADIOLOGICAL EXAM GASTROINTESTINAL TRACT UP
SMALL BOWEL X-RAYS
VIA ENTEROCLYSIS TUBE
DUODENOGRAPHY
COMPUTED TOMOGRAPHIC (CT) COLONOGRAPHY, DIAGNOSTIC, INCLUDING IMAGE POSTPROC
WITH CONTRAST MATERIAL(S) INCLUDING NON-CONTRAST IMAGES; IF PERFORMED
BARIUM ENEMA X-RAYS
BARIUM ENEMA X-RAYS
BARIUM ENEMA,THERAPEUTIC,FOR REDUCTION INTUSSUSCEP
CHOLECYSTOGRAPHY
CHOLECYSTOGRAPHY
CHOLANGIOGRAPHY
ADDITIONAL SET DURING SURGERY (ADD-ON)
CHOLANGIOGRAPHY, POSTOPERATIVE
CHOLANGIOGRAPHY,PERCUTANEOUS,TRANSHEPATIC,S&I ONLY
POST-OP BILIARY DUCT STONE REMOVAL, RADIOLOGICAL S
ENDOSCOPIC CATH OF BILARYDUCTAL SYSTEM FLUOR-MONIT
ENDOSCOPIC CATHETERIZATION OF THE PANCREATIC DUCT
COMBINED ENDOSCOPIC CATH/BILIARY&PANCRETIC FLUORSC
MILLER-ABBOT TUBE
PERCUTANEOUS PLACEMENT OF ENTEROCLYSIS TUBE
X-RAY GUIDE 2 DILATION
PERCUTANEOUS TRANSHEPATIC DILATATION OF BILIARY DUCT
UROGRAPHY (PYELOGRAPHY) IV W/WO KUB
UROGRAPHY INFUSION DRIP TECHNIQUE
NEPHROTOMOGRAPHY
URETEROPYELOGRAPHY
UROGRAPHY, ANTEGRADE, SUPERVISION & INTERP
CYSTOGRAPHY,MIMIMUN 3VIEWS, S&I ONLY
EXAM MALE GENITAL TRACT
URETHROCYSTOGRAPHY,RETROGRADE, S&I ONLY
URELHROCYSTOGRAPHY, VOIDING, S & I
RETROPERITONEAL PNEUMOGRAPHY
X-RAY RENAL CYST, TRANSLUMBAR, CONTRAST, S & I
INTRO INTRACATH OR CATH INTO RENAL PELVIS
INTRO OF URETERAL CATH THROUGH RENAL PEL S&I ONLY
DILATION, NEPHROSTOMY, URETERS, URETHA, S & I
PELVIMETRY
HYSTEROSALPINGOGRAPHY,SUPER AND INTERP ONLY
TRANSCERVICAL CATHETERIZATION OF FALLOPIAN TUBE
PELVIC PNEUMOGRAPHY
PERINEOGRAM
CARDIAC MRI FOR MORPHOLOGY & FUNCTION W/O CONTRAST MATERIAL
CARDIAC MRI FOR MORPHOLOGY & FUNCTION W/O CONTRAST MATERIAL
CARDIAC MRI FOR MORPHOLOGY & FUNCTION WITHOUT CONTRAST MATERIAL
CARDIAC MRI FOR MORPHOLOGY & FUNCTION WO CONTRAST MAT, FOLLOWED BY CONTRAST MAT
CARDIAC MAGNETIC RESONANCE IMAGING FOR VELOCITY FLOW MAPPING SP
COMPUTED TOMOGRAPHY HEART W/O CONTRAST MATR W/QUANTITATIVE EVAL OF CORONARY CALC
COMPUTED TOMOGRAPHY HEART W/ CONTRAST MATERIAL, FOR EVAL OF CARDIAC
COMPUTED TOMOGRAPHY HEART WCONTRAST MATERIAL, FOR EVALOF CARDIAC MORPHOLO
COMPUTED TOMOGRAPHIC ANGIOGRAPHY HEART CORONARY ARTERIES AND BYPASS GRAFTS W/ CO
AORTOGRAPHY, THORACIC, WITHOUT SERIAL, INTERP
AORTOGRAPHY, THORACIC, SERIAL, S & I
AORTOGRAPHY, ABDOMINAL, SERIAL, S & I
AORTOGRAPHY ABDOM PLUS BILAT ILIOFEM CATH SERIAS&I
CT ANGIOGRAPHY OF ABDOMINAL AORTA
ANGIOGRAPHY CERVICOCEREBRAL CATH SUPER & INTERP
ANGIOGRAPHY,BRACHIAL,RETROGRADE,RADIOLOGICAL SUPER
ANGIO, EXT CAROTID, UNILAT, SELECTIVE, S & I
ANGIO, EXT CAROTID, BILAT, SELECTIVE, S & I
ANGIOGRAPHY, CAROTID, CEREBRAL, UNILATERAL, SUPER
ANGIOGRAPHY, CAROTID, CEREBRAL BILAT SUPER &INTERP
ANGIOGRAPHY CAROTID CERVICAL UNILAT SUPER & INTERP
ANGIOGRAPHY CAROTID CERVICAL BILAT SUPER & INTERP
AIGIO, VERTEBRAL, CERVICAL, &/OR INTRACRANIAL, S&I
ANGIOGRAPHY SPINAL SELECT SUPERVISION & INTERPRET
ANGIOGRAPHY, EXTREMITY, UNILATERAL, SUPER & INTERP
ANGIOGRAPHY EXTREMITY BILAT SUPERVISION & INTERPRE
ANGIO, RENAL, UNILAT, AORTA, FLUSH, S & I
ANGIO, RENAL, BILAT SELECT, AORTA FLUSH, S & I
ANGIO VESCERAL SELECT OR SUPER SELECT SPI
ANGIOGRAPHY,ADRENAL,UNILATERAL,SELECTIVE,RADIOLOGI
ANGIOGRAPHY, ADRENAL, BILAT, SELECT SUPER & INTERP
ANGIOGRAPHY, PELVIC, SELECT/SUPRASELECT S & I ONLY
ANGIOGRAPHY, PULMONARY, UNILAT SELECT S & I ONLY
ANGIOGRAPHY PULMONARY BILAT SELECT SUPER & INTERP
ANGIOGRAPHY PULMONARY NONSELECT CATH/VENINJECT S&I
ANGIOGRAPHY INTERNAL MAMMARY SUPER&INTERP ONLY
ANGIO SELECTIVE EA ADDITIONAL VESSEL, S&I (ADD-ON)
ANGIOGRAPHY, ARTERIOVENOUS SHUNT (EG. DIALYSIS PATNT FISTULA/GRAFT), COMPL EVAL
LYMPHANGIOGRAPHY EXTREMITY ONLY UNILATERAL
LYMPHANGIOGRAPHY,EXTREMITY ONLY,BILATERAL,S&I ONLY
LYMPHANGIOGRAPHY,PELVIC/ABDOMINAL,SUPERV & INTREP
LYMPHANGIOGRAPHY, PELVIC/ABDOMINAL, BILAT S & I
SHUNTOGRAM FOR INVESTIGATION OF PREV.PLACED NONVAS
SPLENOPORTOGRAPHY, RADIOLOGICAL SUPER. & INTERPRE.
VENOGRAPHY, EXTREMITY, UNILATERAL, SUPER/INTERP
VENOGRAPHY-BILATERAL
VENOGRAPHY - INTERPRETATION ONLY
VENOGRAPHY, CAVAL, SUPERIOR W/SERIALOGRAPHY
VENOGRAPHY RENAL,UNILAT,SELECTIVE;SUPRV & INTERP
VENOGRAPHY, RENAL,BILATERAL,SELECTIVE,RADIO. SUPER
VENOGRAPHY, ADRENAL, UNILATERAL, SELECTIVE
VENOGRAPHY, ADRENAL, BILATERAL, SELECTIVE
VENOGRAPHY,SINUS OR JUGULAR, CATHETER
VENOGRAPHY, SUPERIOR SAGITTAL SINUS
VEIN X-RAY SKULL
VEIN X-RAY EYE SOCKET
PERCUTANEOUS TRANSHEPATIC PORTOGRAPHY W/HEMO EVAL.
VEIN X-RAY LIVER
HEPATIC VENOGRAPHY WEDGED OR FREE W/HEMODYNAMIC EV
HEPATIC VENOGRAPHY WEDGED OR FREE W/O HEMODYNAMIC
VENOUS SAMPLING THROUGH A CATH W/O ANGIOGRAPHY
TRANSCATHETER THERAPY
TRANSCATHETER THERAPY INFUSION INC ANGIOGRAPHY
ANGIOGRAM FOLLOW UP FOR TRANSCATHETER THERAPY
EXCHANGE ARTERIAL CATHETER-SUPERVISION/INTERPRETAT
MECHANICAL REMOVAL OF MATERIAL CENTRAL VENOUS DEVICE VIA SEPARATE VENOUS ACCESS
MECHANICAL REMOVAL OF MATERIAL FROM CENTRAL VENOUS DEVICE THRU DEVICE LUMEN
PERUTANEOUS PLACEMENT IVC FILTER & INTERPRETATION
INTRAVASCULAR ULTRASOUND, RADIOLOGICAL SUPER/INTER
INTRAVASCULAR ULTRASOUND, RADIOLOGICAL SUPER/INTER (ADD-ON)
RADIOLOGICAL S & I ENDOVASCULAR AORTIC ANEURYSM REPAIR
RADIOLOGICAL S & I FOR ENDOVASCULAR EXTENSION PROSTHESIS PLACEMENT
ENDOVASCULAR REPAIR ILIAC ARTERY ANEURYSM, PSEUDOANEURYSM, MALFORM, OR TRAUMA
TRANSCATHETER INTRAVASCULAR OCCULSION-COMPLETE PRO
ENDOVASCULAR REPAIR OF DESCENDING THORACIC AORTA, LEVEL OF CELIAC ARTERY
PLACEMENT OF PROXIMAL EXTENSION PROSTHESIS FOR ENDOVASCULAR REPAIR
PLACEMENT OF DISTAL EXT PROSTHESIS AFTER ENDOVASCULAR REPAIR THORACIC AORTA
TRANSCATHETER INTRODUCTION OF INTRAVASCULAR STENTS
TRANSCATHETER RETRIEVAL PERCUTANEOUS INTRAVASCULAR
PERCUTANEOUS TRANSLUMINALANGIOPLASTY,PERIP,S&I ONL
PERCUTANEOUS TRANSLUMINALANGIOPLASTY (ADD-ON)
PERCUTANEOUS TRANSLUMINAL ANGIOPLASTY RENAL/VISCER
REPAIR ARTERY BLOCKAGE EACH
TRANSCATHETER BIOPSY SUPER VISION & INTERPRETATION
TRANSLUMINAL BALLOON ANGIOPLASTY VENOUS RADIOLOGIC
PERCUTNS TRANSHEPT BILRY DRAIN W/CONT;SUPV & INTER
PERCUTANEOUS PLACEMENT OF DRAINAGE CATHETER
CHG PERCUTANEOUS DRAIN CATH W/CONT;SUPER/INTER
RADIOLOGICAL GUIDANCE FOR DRAINAGE/SPECIMEN
TRANSLUMINAL ATHERECTOMY PERIPHERAL ARTERY RADIOLO
TRANSLUMINAL ARTHERECTOMY EACH ADD PERIPHERAL ARTE
RENAL RADIOLOGICAL SUPERVISION AND INTERPRETATION
VISION RADIOLOGIC SUPERVISION AND INTERPRETATION
TRANSLUMINAL ATHERECTOMY SUPERVISION AND INTERPERT (ADD-ON)
FLUOROSCOPY
FLUROSCOPY PHYSICIAN TIME MORE THAN 1 HOUR
RADIOLOGIC EXAMINATION FROM NOSE TO RECTUM FOR FB
FISTULA/SINUS TRACT STUDY, SUPERVISION & INTERPRET
RADIOLOGICAL EXAM, BREAST SURGICAL SPECIMEN
RADIOLOGIC EXAM,SINGLE BODY SECTION, WO UROGRAPHY
RADIOLOGIC EXAM COMPLEX MOTION BODY SECTION UNILAT
RAD EXAM/COMPLEX MOTION BODY SECTION OTHER THAN W/ UROGRAPHY-BILATERAL
CINERADIOGRAPHY
CINERADIOGRAPHY (ADD-ON)
RADIOLOGIC CONSULTATION, WRITTEN REPORT
MAMMOGRAPHY BY XERORADIOGRAPHY
SUBTRACTION STUDIES
3D RENDERING W/INTERPRETATION/REPORTING OF COMPUTED TOMOGRAPHY, MRI
3D RENDERING W/INTERPRETATION/REPORT/COMPUTED OTHER,INDEPENDENT WORKSTATION
COMPUTERIZED TOMOGRAPHY LIMITED FOLLOW-UP STUDY
MAGNETIC RESONANCE SPECTROSCOPY
UNLISTED FLUOROSCOPIC PROCEDURE (EG, DIAGNOSTIC, INTERVENTIONAL)
UNLISTED COMPUTED TOMOGRAPHY PROCEDURE (EG, DIAGNOSTIC, INTERVENTIONAL)
UNLISTED MAGNETIC RESONANCE PROCEDURE (EG, DIAGNOSTIC, INTERVENTIONAL)
UNLISTED RADIOLOGY PROCEDURE
ECHOGRAPHY
B-SCAN AND QUANTITATIVE A-SCAN PERFORMED DURING SAME ENCOUNTER MOD 50 PAYS 100%
QUANTITATIVE A-SCAN ONLY
QUANTITATIVE B-SCAN W/WO SUPERIMPOSED NON-QUANTATIVE A-SCAN
OPTHALMIC ULTRASOUND, IMMERSION B-SCAN; UNILATERAL-MOD 50 PAYS 100%
CORNEAL PACHYMETRY, UNILATERAL OR BILATERAL (DETERMINE OF CORNEAL THICKNESS)
OPHTHALMIC BIOMETRY BY ULTRASOUND ECHOGRAPHY A-SCAN-BILATERAL
WITH INTRAOCULAR LENS POWER CALCULATION-MOD 50 PAYS 100%
OPTHALMIC ULTRASOUND FOREIGN BODY LOCAL. UNILATERAL-MOD 50 PAYS 100%
ECHOGRAPHY SOFT TISSUES HEAD & NECK B-SCAN OR REAL
B SCAN
B SCAN-BILATERAL
ABDOMEN SURVEY-B SCAN
ABDOMEN SURVEY-B SCAN
KIDNEY SONOGRAM
ABDOMEN AND RETROPERITONEUM ULTRASOUND, LIMITED
ULTRASOUND, TRANSPLANTED KIDNEY
ECHOGRAPHY, SPINAL CANAL AND CONTENTS
ULTRASOUND, PREGNANT UTERUS 1ST TRIMESTER, SINGLE OR FIRST GESTATION
ULTRASOUND, PREGNANT UTERUS, EACH ADDITIONAL GESTATION (ADD-ON)
FETAL AGE DETERMINATION
ECHOGRAPH OB COMPLETE, MULTIPLE GESTATION AFTER 1ST TRIMESTER (ADD-ON)
ULTRASOUND, PREGNANT UTERUS, FETAL & MATERNAL EVAL; SINGLE OR FIRST GESTATION
ULTRASOUND PREGNANT UTERUS, FETAL & MATERNAL EVAL; EACH ADDITIONAL GESTATION
ULTRASOUND, PREGNANT UTERUS, SINGLE OR FIRST GESTATION
ULTRASOUND, PREGNANT UTERUS, EACH ADDITIONAL GESTATION
FETAL AGE MEASUREMENT
ULTRASOUND, PREGNANT UTERUS, REAL TIME W IMAGE DOCO, FOLLOW-UP
ULTRASOUND PREGNANT UTERUS, REAL TIME W/IMAGE DOCO., TRANSVAGINAL
FETAL BIOPHYSICAL PROFILE
FETAL BIOPHYSICAL PROFILE
DOPPLER VELOCIMETRY, FETAL; UMBILICAL ARTERY
DOPPLER VELOCIMETRY, FETAL; MIDDLE CEREBRAL ARTERY
ECHOCARDIOGRAPHY FETAL HEART IN UTERO
ECHOCARDIOGRAPHY FETAL HEART FOLLOW-UP OR REPEAT S
DOPPLER ECHOCARDIOGRAPHY FETAL PULSED WAVE AND/OR CONT WAVE W/SPECTRAL DISP
DOPPLER ECHOCARDIOGRAPHY FETAL REPEAT OR FOLLOW UP
ECHOGRAPHY, TRANSVAGINAL
HYSTEROSONOGRAPHY, WITH OR WITHOUT COLOR FLOW DOPPLER
ECHOGRAPHY PELVIC REAL TIME
ECHOGRAPHY PELVIC (NON-OBSTETRIC) LIMITED OR FOLLOW UP
ECHOGRAPHY SCROTUM AND CONTENTS
ECHOGRAPHY, PROSTATE, TRANSRECTAL
PROSTATE VOLUME STUDY
ECHOGRAPHY EXTREMITY B SCANS
ECHOGRAPHY OF INFANT HIPS, REAL TIME W/IMAGING DOCUMENTATION; DYNAMIC
ECHOGRAPHY F INFANT HIPS, REAL TIME W/INAGING DOCUMENTATION; LIMITED, STATIC
PERICARDIOCENTESIS SUPERVISION AND INTERPRETATION
ULTRASONIC GUIDANCE FOR ENDOMYOCARDIAL BIOPSY
ULTRASOUND REPAIR ARTERIAL PSEUDO-ANEURYSM/FISTULA
ULTRASOUND GUIDANCE FOR VASCULAR ACCESS REQ ULTRASOUND EVAL (ADD-ON)
ULTRASOUND GUIDANCE FOR, AND MONITORING OF, VISCERAL TISSUE ABLATION
ULTRASOUND INTRAUTERINE FETAL TRANSFUSION
ULTRASONIC GUIDANCE FOR NEEDLE BIOPSY/S&I ONLY
ULTRASONIC GUIDANCE CHORIONIC VILLUS - S&I
ULTRASONIC GUIDANCE FOR AMNIOCENTESIS /S&I ONLY
ULTRASONIC GUIDANCE/ASPIRATION OF OVA
MAPPING STUDIES, ULTRASOUND
ULTRASONIC GUIDANCE INTERSTITIAL RADIOELEMENT APP
ULTRASOUND STUDY FOLLOW-UP (SPECIFY)
GASTROINTESTINAL ENDOSCOPIC ULTRASOUND,RADIOLOGICA
ULTRASOUND BONE DENSITY MEASURE INTERPRET PERIIPHERAL SITE, ANY METHOD
ULTRASONIC GUIDANCE, INTRAOPERATIVE
UNLISTED ULTRASOUND PROC
FLUOROSCOPIC GUIDANCE FOR CENTRAL VENOUS ACCESS DEVICE PLACEMENT
FLUOROSCOPIC GUIDANCE FOR NEEDLE PLACEMENT
FLUOROSCOPIC GUIDANCE/LOCALIZATION OF NEEDLE/CATHETER TIP FOR SPINE/PARASPINOUS
COMPUTED TOMOGRAPHY GUIDANCE FOR STEREOTACTIC LOCALIZATION
COMPUTED TOMOGRAPHY GUIDANCE FOR NEEDLE PLACEMENT
COMPUTERIZED TOMOGRAPHY GUIDANCE FOR & MONITOR OF, PARENCHYMAL TISSUE ABLATION
COMPUTED TOMOGRAPHY GUIDANCE FOR PLACEMENT OF RADIATION THERAPY FIELDS
MAGNETIC RESONANCE GUIDANCE FOR NEEDLE PLACEMENT
MAGNETIC RESONANCE GUIDANCE FOR, AND MONITORING OF, PARENCHYMAL TISSUE ABLATION
STEREOTACTIC LOCALIZATION GUIDANCE FOR BREAST BIOPSY OR NEEDLE PLACEMENT
MAMMOGRAPHIC GUIDANCE FOR NEEDLE PLACEMENT, BREAST
COMPUTER-AIDED DETECTION, DIAGNOSTIC MAMMOGRAPHY
COMPUTER-AIDED DETECTION , SCREENING MAMMOGRAPHY
MAMMARY DUCTOGRAM OR GALACTOGRAM, SINGLE DUCT, RADIOLOGICAL SUPERVISION/ INTER
MAMMARY DUCTOGRAM OR GALACTOGRAM, MULTIPLE DUCTS, RADIOLOGICAL SUPERVISION/INTER
MAMMOGRAPHY; UNILATERAL
MAMMOGRAPHY; BILATERAL
SCREENING MAMMOGRAPHY, BILATERAL (2-VIEW FILM STUDY OF EACH BREAST)
MAGNETIC RESONANCE IMAGING, BREAST, W AND/OR W/O CONTRAST MATERIAL; UNILATERAL
MAGNETIC RESONANCE IMAGING, BREAST, W/O &/OR W/CONTRAST MATERIAL(S); BILATERAL
MANUAL APPLICATION/STRESS PERF BY PHYS FOR JOINT RADIOGRAPHY,
BONE AGE STUDIES
BONE LENGTH STUDIES (ORTHOROENTGENOGRAM, SCANOGRAM)
RADIOLOGIC EXAMINATION, OSSEOUS SURVEY; LIMITED (EG, FOR METASTASES)
RADIOLOGIC EXAM, OSSEOUS SURVEY; COMPLETE (AXIAL AND APPENDICULAR SKELETON)
RADIOLOGIC EXAMINATION, OSSEOUS SURVEY, INFANT
JOINT SURVEY, SINGLE VIEW, 2 OR MORE JOINTS (SPECIFY)
COMPUTED TOMOGRAPHY, BONE MINERAL DENSITY STUDY, 1/MORE SITES, AXIAL SKELETON
COMPUTED TOMOGRAPHY, BONE MINERAL DENSITY STUDY, APPENDICULAR SKELETON
DUAL-ENERGY X-RAY ABSORPTIOMETRY , 1 OR MORE SITES; AXIAL SKELETON
DUAL-ENERGY X-RAY ABSORPTIOMETRY (DXA), 1 OR MORE SITES; APPENDICULAR
DUAL-ENERGY X-RAY ABSORPTIOMETRY (DXA), 1 OR MORE SITES; VERTEBRAL
RADIOGRAPHIC ABSORPTIOMETRY , 1 OR MORE SITES
MAGNETIC RESONANCE (EG, PROTON) IMAGING, BONE MARROW BLOOD SUPPLY
THERAPEUTIC RADIOLOGY TREATMENT PLANNING, SIMPLE
THERAPEUTIC RADIOLOGY TREATMENT PLAN; INTERMEDIATE
THERAPEUTIC RADIOLOGY TREATMENT PLANNING; COMPLEX
THE RAPEUTIC RADIOLOGY FIELD SETTING; SIMPLE
THERAPTEUTIC RADIOLOGY FIELD SETTING; INTERMEDIATE
THERAPEUTIC RADIOLOGY FIELD SETTING; COMPLEX
BY THREE-DIMENSIONAL RECONSTRUCTION OF TUMOR VOLUM
UNLISTED PROCEDURE, THERAPEUTIC RADIOLOGY PLANNING
BASIC RADIATION DOSIMETRY CALC,CENT AXIS DEPTH DOS
INTENSITY MODULATED RADIOTHERAPY PLAN INC. HISTOGRAMS FOR PARTIAL TOLERANCE
ISODOSE DISTRIBUTIONS
TELETHERAPY INTERMEIDATE
ISODOSE DISTRIBUTIONS
SPECIAL TELETHERAPY PORT PLAN PARTICLES HEMI-BODY
ISODOSE DISTRIBUTIONS
ISODOSE DISTRIBUTIONS
COMPLEX MULTIPLANE ISODOSE PLAN VOLUME IMPLANT 10-
IN VIVO DOSIMETRY
BEAM SHAPING DEVICE DESIGN
TREATMENT DEVICES, DESIGN AND CONSTRUCTION
TREATMENT DEVICES COMPLEX
RADIOLOGICAL PHYSICS SPT SVC
MULTI-LEAF COLLIMATOR (MLC) DEVICE(S) FOR INTENSITY MODULATED RADIATION THERAPY
SPECIAL MEDICAL RADIATION PHYSICS CONSULTATION
RADIATION TREATMENT DELIVERY, STEREOTACTIC RADIOSURGERY
RADIATION TREATMENT DELIVERY, STEREOTACTIC RADIOSURGERY, LINEAR ACCELERATOR
STEREOTACTIC BODY RADIATION THERAPY, PER FRACTION TO 1 OR MORE LESIONS
UNLISTED ADJUNCT PHYSICS SV
RADIATION TREATMENT DELIVERY SUPERFICIAL
RADIATION TREATMENT DELIVERY SINGLE TREATMENT AREA
RADIATION TREAT SINGLE TREAT AREA 6-10 MEV
RADIATION TX DELIVERY,SINGLE TX AREA, 11/19 MEV
RADIATION TREATMENT SINGLE AREA 20 MEV OR GREATER
RADIATION TREATMENT TWO AREAS UP TO 5 MEV
RADIATION TX DELIVERY,2 SEPARATE TX AREAS,6/10 MEV
RADIATION TX DELIVERY,2 SEPARATE TX AREAS,11/19MEV
RADIATION TREATMENT TWO AREAS 20 MEV OR GREATER
RADIATION TREATMENT THREE AREAS UP TO 5 MEV
RADIATION TREATMENT DELIVERY; 6 - 10 MEV
RADIATION TX DELIVERY,3 0R MORE TX AREAS,11/19 MEV
RADIATION TREATMENT THREE AREAS 20 MEV OR GREATER
THERAPEUTIC RADIOLOGY PORT FILM
INTENSITY MODULATED TREATMENT DELIVERY, PER TX SESSION
STEREOSCOPIC X-RAY GUIDANCE/LOCALIZATION OF TARGET VOLUME/DELIVERY OF RADIATION
HIGH ENERGY NEUTRON RADIATION TREATMENT DELIVERY, SINGLE TREATMENT
HIGH ENERGY NEUTRON RADIATION TREATMENT DELIVERY, 1 OR MORE ISOCENTERS
RADIATION TREATMENT MANAGEMENT, FIVE TREATMENTS
RADIATION THERAPY MANAGEMENT W/ COMPLETE COURSE CONSISTING OF 1-2 FRACTIONS ONLY
STEREOTACTIC RADIATION TREATMENT MANAGEMENT OF CER
STEREOTACTIC BODY RADIATION THERAPY
SPECIAL TREATMET PROCEDURE
UNLISTED THERAPEUTIC RADIOLOGY
PROTON BEAM DELIVERY SINLGE TREATMENT AREA
PROTON TREATMENT DELIVERY SIMPLE
PROTON BEAM DELIVERY ONE OR TWO TREATMENT AREAS
PROTON TREATMENT DELIVERY COMPLEX
HYPERTHERMIA EXTERNALLY GENERATED
HYPERTHERMIA,EXTERNALLY GENERATED, DEEP
HYPERTHERMIA TREATMENT 5 OR FEWER APPLICATIONS
HYPERTHERMIA TREATMENTS 5 OR MORE APPLICATIONS
HYPERTHERMIA GENERATED BY INTRACAVITARY PROBES
INFUSION OR INSTILLATION OF RADIOELEMENT SOLUTION INCLUDES 3 MOS FOLLOW UP
INTRACAVITARY RADIOELEMENT APPLICATION; SIMPLE
INTRACAVITARY RADIOELEMENT APPLICATION, INTERMEDIA
BRACHYTHERAPY, INTRACAVITARY
BRACHYTHERAPY, INTERSTITIAL
INTERSTITIAL RADIOELEMENT APPLICATION INTERMEDIATG
BRACHYTHERAPY, INTERSTITIAL
REMOTE AFTERLOADING HIGH DOSE RATE RADIONUCLIDE BRACHYTHERAPY; 1 CHANNEL
2-12 CHANNELS
OVER 12 CHANNELS
BRACHYTHERAPY, SURFACE
SUPERIVISION, HANDLING, LOADING OF RADIOELEMENT
UNLISTED BRACHYTHERAPY
THYROID UPTAKE
THYROID UPTAKE
THYROID STIMULATION
THYROID IMAGING
THYROID IMAGING
THYROID IMAGING
THYROID IMAGING; WITH VASCULAR FLOW.
THYROID CARCINOMA METASTASES
THYROID CARCINOMA METASTASES
WHOLE BODY
THYROID CARCINOMA METATASES UPTAKE (ADD-ON)
PARATHYROID, IMAGING
ADRENAL, IMAGING
UNLISTED ENDOCRINE SYST TEST
BONE MARROW, IMAGING
BONE MARROW, IMAGING
BONE MARROW, IMAGING
BLOOD VOLUME
BLOOD VOLUME
RED CELL MASS DETERMINATION
RED CELL MASS DETERMINATION
NUCLEAR EXAM BLOOD VOLUME
RED CELL SURVIVAL STUDY
RED CELL SURVIVAL STUDY
RED CELL SEQUESTRATION
SPLEEN IMAGING
NUCLEAR EXAM OF PLATELETS
PLATELET SURVIVAL
LYMPH GLANDS IMAGING
UNLISTED NUCLEAR MED TEST
LIVER IMAGING
LIVER IMAGING
LIVER IMAGING (SPECT)
LIVER IMAGING WITH VASCULAR FLOW
LIVER & SPLEEN IMAGING
LIVER & SPLEEN IMAGING
LIVER FUNCTION STUDIES
HEPATOBILIARY DUCTAL SYSTEM IMAG INC GALL
SALIVARY GLAND IMAGING
SALIVARY GLAND IMAGING
SALIVARY GLAND FUNCTION STUDY
ESOPHAGEAL MOTILITY
GASTRIC MUCOSA IMAGING
GASTROESOPHAGEAL REFLUX STUDY
GASTRIC EMPYTING STUDY
UREA BREATH TEST C-14 ISOTOPIC ACUISITION FOR ANALYSIS
UREA BREATH TEST, C-14, ANALYSIS
VITAMIN B12 ABSORPTION
VITAMIN B12 ABSORPTION
VITAMIN B-12 ABSORPTION STUDIES
ACUTE GASTROINTESTINAL BLOOD LOSS IMAGING
GASTROINTESTINAL STD/NCLR MED
BOWEL IMAGING
TEST VENOUS DRAIN ABDOMEN
GASTROINTESTINAL STD/NCLR MED
BONE IMAGING
BONE IMAGING
BONE IMAGING
BONE IMAGING,BY THREE PHASE TECHNIQUE
TOMOGRAPHIC (SPECT)
BONE DENSITY STUDY(BONE MINERAL CONTENT),SINGLE PH
DUAL PHTON ABSORPTIOMETRY
UNLISTED M-S NUC MED TEST
DETERMINATION OF VENTRICULAR EJECTION FRACTION
CARDIAC SHUNT DETECTION
VASCULAR FLOW STUDY
MYOCARDIAL PERFUSION IMAG, TOMOGRAPHIC (SPECT) SINGLE STUDY, AT REST OR STRESS
MULTIPLE STUDIES, AT REST AND/OR STRESS AND/OR REDISTRIBUTION AND/OR RES
MYOCARDIAL PERFUSION IMAGING, PLANAR SINGLE STUDY, AT REST OR STRESS
MULTIPLE STUDIES, AT REST AND/OR STRESS AND/OR REDISTRIBUTION AND/OR RES
ACUTE VENOUS THROMBOSIS IMMAGING
VENOUS THROMBOSIS IMAGING UNILATERAL
BILATERAL
MYOCARDIAL IMAGING, PET, METABOLIC EVALUATION
MYOCARDIAL IMAGING INFARCT AVID PLANAR QUALITATIVE
NUCLEAR SCAN HEART MUSCLE W/INJECTION FRACTION
NUCLEAR SCAN HEART MUSCLE TOMOGRAPHIC SPECT
CARDIAC BLOOD POOL IMAGING,GRATED EQUILIBRIUM
RESTING $ STRESS W/ OR W/O ADD'L. QUANTIFICATION
CARDIAC BLOOD POOL IMAGING
CARDIAC BLOOD POOL MULTI RESTING/W/STRESS W/WO ADD
MYOCARDIAL IMAGING, PET, PERFUSION; SINGLE STUDY AT REST OR STRESS
MYOCARDIAL IMAGING, PET, PERFUSION; MULTIPLE STUDIES AT REST AND/OR STRESS
CARDIAC BLOOD POOL IMAG GATED EQUILIBRIUM SPECT AT TEST WALL MOTION PLUS EJECTIO
CARDIC BLOOD POOL IMAG GATED EQUILIBRIUM STUDY AT REST RT VENTRIC EJEC (ADD-ON)
UNLISTED C-V NUC MED TEST
PULMONARY PERFUSION IMAGING
PULMONARY PERGUSION IMAGING
REBREATHING AND WASHOUT
PULMONARY VENTILATION IMAGING
MULTIPLE PROJECTIONS
PULMONARY PERFUSION IMAGING PARTICULATE VENTILATION IMAGE AEROSOL
PULMONARY VENTILATION IMAGING
PULMONARY VENTILATION IMAGING
PULMONARY VENTILATION IMAGING
PULMONARY QUANTITATIVE DIFFERENTIAL FUNCTION STUDY
PULMONARY VENTILATION IMAGING
BRAIN IMAGING
BRAIN IMAGING
BRAIN IMAGING
BRAIN IMAGING
BRAIN IMAGING, COMPLETE STUDY; TOMAGRAPHIC (ECT)
BRAIN IMAGING, (PET), METABOLIC EVALUATION
BRAIN IMAGING, (PET), PERFUSION EVALUATION
BRAIN IMAGING
CEREBROSPINAL FLUID FLW IMGNG
CEREBROSPINAL FLUID FLW IMGNG
CEREBROSPINAL FLUID FLW IMGNG
CEREBROSPINAL FLUID FLOW,IMAGING; TOMOGRAPHIC
CEREBROSPINAL FLUID FLW IMGNG
DACTYOCYSTOGRAPHY
UNLISTED NERVOUS SYST TEST
KIDNEY IMAGING
KIDNEY IMAGING
KIDNEY IMAGING
KIDNEY IMAGING W/VALCULAR FLOW AND FUNCTION,SINGLE STUDY,W/PHARMACOLOGICAL INTER
KIDNEY IMAGING W/VALCULAR FLOW AND FUNCTION;MULTIPLE STUDIES,W/W/O PHARMOCOLOGIC
KIDNEY IMAGING
KIDNEY FUNCTION STUDY
URINARY BLADDER RESIDUAL STUDY
URETERAL REFLUX STUDY
TESTICULAR IMAGING WITH VASCULAR FLOW
UNLISTED G-U NUC MED TEST
TUMOR LOCALIZATION
TUMOR LOCALIZATION
TUMOR LOCALIZATION
TUMOR LOCALIZATION (SPECT)
WHOLE BODY, REQUIRING TWO OR MORE DAYS IMAGING
ABCESS LOCALIZATION LIMITED AREA
WHOLE BODY
RADIONUCLIDE LOCALIZATION OF ABSCESS, SPECT
INJ PROC F RADIOPHARMACEUTICAL LOC BY NON-IMAG PROBE STUDY IV EG
TUMOR IMAGING PET SCAN, LIMITED AREA
TUMOR IMAGING POSITRON EMISSION TOMOGRAPHY; SKULL BASE TO MID-THIGH
TUMOR IMAGING POSITRON EMISSION TOMOGRAPHY; WHOLE BODY
TUMOR IMAGING POSITROM EMISSION TOMOGRAPHY; LIMITED AREA (EG, CHEST, HEAD/NECK
TUMOR IMAGING POSITRON EMISSION TOMOGRAPHY; SKULL BASE TO MID-THIGH
TUMOR IMAGING (PET) W/CT, WHOLE BODY
GENERALIZATION OF AUTOMATED DATA
COMPLEX MANIPULATIONS AND INTERPRETATION EXC 30MIN
UNLISTED NUC MED TEST
RADIOPHARMACEUTICAL THERAPY, BY ORAL ADMINISTRATION
RADIOPHARMACEUTICAL THERAPY, BY INTRAVENOUS ADMINISTRATION
RADIOPHARMACEUTICAL THERAPY BY INTRA CAVITARY ADMINISTRATION
RADIOPHARMACEUTICAL THERAPY BY INTERSTITIAL RADIOACTIVE COLLOID ADMINISTRATION
RADIOPHARMACEUTICAL THERAPY, RADIOLABELED MONOCLONALANTIBODY BY IV INFUSION
RADIOPHARMACEUTICAL THERAPY BY INTRA-ARTICULAR ADMINISTRATION
RADIOPHARMACEUTICAL THERAPY, BY INTRA-ARTERIAL PARTICULATE ADMINISTRATION
RADIOPHARMACEUTICAL THERAPY UNLISTED PROCEDURE
BASIC METABOLIC PANEL (CALCIUM, IONIZED)
BASIC METABOLIC PANEL
GENERAL HEALTH SCREEN PANEL
ELECTROLYTE PANEL INC. 82374, 82435, 84132, AND 84295
COMPREHENSIVE METABOLIC PANEL
OBSTETRIC PROFILE
LIPID PROFILE
RENAL FUNCTIONAL PANEL
ACUTE HEPATITIS PANEL
HEPATIC FUNCTION PANEL
DRUG SCREEN; MULTI DRUG CLASSES
DRUG SCREEN SINGLE DRUG CLASS, EACH DRUG CLASS
DRUG, CONFIRMATION, EACH PROCEDURE
TISSUE PREPARATION FOR DRUG ANALYSIS
AMIKACIN
AMITRIPTYLINE
BENZODIAZEPINES
CARBAMAZEPINE
CARBAMAZEPINE ASSAY
CYCLOSPORINE
DESIPRAMINE
DIGOXIN
DIPROPYLACETIC ACID (VALPROIC ACID)
DOXEPIN
ETHOSUPIMIDE
GENTAMICIN
GOLD
HALOPERIDON ASSAY
IMIPRAMINE
LIDOCAINE
LITHIUM
NORTRIPTYLINE
PHENOBARBITAL
PHENYTOIN TOTAL
PHNEYTOIN; FREE
PRIMIDONE
PROCAINAMIDE
PROCAINAMIDE WITH METABOLITES
QUINIDINE
SIROLIMUS
DRUG SCREEN, SALICYLATE
DRUG SCREEN, TACROLIMUS
THEOPHYLLINE
TOBRAMYCIN
TOPIRAMATE
VANCOMYCIN
QUANITATION OF DRUG NOT ELSEWHERE SPECIFIED
ACTH STIMULATION PANEL; ADRENAL SUFFICIENCY
ACTH STIMULATION PANEL; 21 HYDROXYLASE DEFICIENCY
ACTH STIMULATION PANEL; 3 BETA-HYDROXYDEHYDROGENAS
ALDOSTERONE SUPPRESSION EVALUATION PANEL
CALCIUM-PENTAGASTRIN STIMULATION PANEL
CORTICOTROPIC RELEASING HORMONE (CRH) PANEL
CHORIONIC GONADOTROPHIN PANEL; TESTOSTERONE RESPON
CHORIONIC GONADOTROPHIN PANEL; ESTRADIOL RESPONSE
RENAL VEIN RENIN STIMULATION PANEL (EG, CAPTOPRIL)
PERIPHERAL VEIN RENIN STIMULATION PANEL (CAPTOPRIL
COMBINED RAPID ANTERIOR PITUITARY EVALUATION PANEL
DEXAMETHASONE SUPPRESSION PANEL, 48 HOURS
GLUCAGON TOLERANCE PANEL; FOR INSULINOMA
GLUCAGON TOLERANCE PANEL; FOR PHEOCHROMOCYTOMA
GONADOTROPIN RELASING HORMONE STIMULATION PANEL
GROWTH HORMONE STIMULATION PANEL
GROWTH HORMONE SUPPRESSION PANEL
INSULIN-INDUCED C-PEPTIDE SUPPRESSION PANEL
INSULIN TOLERANCE PANEL;FOR ACTH INSUFFICIENCY
INSULIN TOLERANCE PANEL;FOR GROWTH HORMONE DEFICIE
METYRAPONE PANEL
THYROTROPIN RELEASING HORMONE (TRH) PANEL
TRH STIMULATION PANEL; TWO HOUR
TRH STIMULATION PANEL; FOR HYPERPROLACTEMIA
CLINICAL PATHOLOGY CONSULTATION, LIMITED
CLINICAL PATHOLOGY CONSULTATION, COMPREHENSIVE
URINALYSIS
URINALYSIS, DIPSTICK/TABLET; AUTOMATED,W/MICROSCOP
URINALISIS, ROUTINE, WITHOUT MICROSCOPY
UA WO/MICROSCOPY AUTOMATED
URINALYSIS
URINALYSIS BACTERIURIA SCREEN NON-CULTURE TECH9
URINALYSIS
URINALYSIS; TWO OR THREE GLASS TEST
URINE PREGNANCY TEST BY VISUAL COLOR COMPARISON ME
VOLUME MEASUREMENT FOR TIMED COLLECTION, EACH
URINALYSIS
ACETALDEHYDE BLOOD
ACETAMINOPHEN TEST
ACETONE TESTING
ACETONE TESTING
ACETYLCHOLINESTERASE
ACYLCARNITINES QUALITATIVE; EACH SPECIMEN
ACYLCARNITINES QUANTITATIVE; EACH SPECIMEN
ACTH TESTING
ADENOSINE MONOPHOSPHATE TEST
SERUM ALBUMIN TEST
URINE QUNTITATIVE (SPECIFY METHOD)
ALBUMIN; URINE MICROALBUMIN, QUANTITATIVE
ALBUMIN;URINE MICROALBUMIN,SEMIQUANTITATIVE
ALBUMIN; ISCHEMIA MODIFIED
ALCOHOL TESTING
ALCOHOL TESTING
ALDOLASE TEST
ALDOSTERONE TESTING
QUANTITATIVE
ALPHA-1 ANTITRYPSIN; TOTAL
ALPHA-1-1ANTITRYPSIN; PHENOTYPE
ALPHA-FETOPROTEIN SERUM
ALPHA FETAPROTEIN; AMNIOTIC FLUID
ALPHA-FETOPROTEIN (AFP); AFP-L3 (INCLUDING RATIO)
ALUMINUM, BLOOD (SERUM)
AMINES, VAGINAL FLUID, QUALITATIVE
AMINO ACIDS SINGLE QUALITATIVE; EACH SPECIMEN
AMINO ACID TESTING
AMINO ACIDS,FRACTIONATION AND QUANTITATION, EACH
AMINOLEVULINIC ACID TEST
AMINO ACIDS 2 TO 5 AMINO ACIDS QUANTITATIVE; EACH SPECIMEN
AMINO ACIDS 6 OR MORE QUANTITATIVE; EACH SPECIMEN
AMMONIA TESTING
AMNIOTIC FLUID SCAN
AMPHETAMINE TEST
AMYLASE TESTING
ANDROSTANEDIOL GLUCURONIDE
ANDROSTENEDIONE RIA TEST
RIA
ANGIOTENSIN II RIA TEST
ANGIOTENSIN CONVERTING ENZYME
ARSENIC TESTING
ASCORBIC ACID TEST
ATOMIC ABSORPTION SPECTROSCOPY, EACH ANALYTE
BARBITURATE TESTING
BETA-2 MICROGLOBULIN
BILE ACIDS; TOTAL
BILE ACID TEST
BILIRUBIN TOTAL
BILIRUBIN DIRECT
BILIRUBIN, FECES, QUALITATIVE
BIOTINIDASE; EACH SPECIMEN
OCCULT BLOOD TEST
BLOOD OCCULT, BY PEROXIDASE ACTIVITY
BLOOD OCCULT, BY PEROXIDASE ACTIVITY, FECES, SINGLE SPECIMEN
FECAL HEMOGLOBIN IMMUNOASSAY TEST, 1-3 DETERMINATIONS
BRADYKININ TEST
CADMIUM TEST
CALCIFEDIOL (25-OH VITAMIN D-3) CHROMATOGRAPHIC
CALCITONIN TEST
CALCIUM TEST
CALCIUM TEST
AFTER CALCIUM INFUSION TEST
CALCIUM TEST
CALCULUS TESTING
CALCULUS TESTING
CALCULUS TESTING
CALCULUS TESTING
CARBOHYDRATE DEFICIENT TRANSFERRIN ASSAY
CARBON DIOXIDE TESTING
CARBON MONOXIDE TESTING
CARBON MONOXIDE TESTING
CARCINOEMBRYONIC ANTIGEN (CEA)
CARNITINE QUANTITATIVE; EACH SPECIMINE
CAROTENE TEST
CATECHOLAMINES TESTING
CATECHOLAMINES TESTING
CATECHOLAMINES TESTING
CATHEPSIN-D
CERULOPLASMIN TEST
CHEMILUMINESCENT ASSAY
CHLORAMPHENICOL TEST
CHLORIDE TESTING
URINE (SPECIFY CHEMICAL ELECTROMETRIC OR FANTUS)
SPINAL FLUID
CHLORINATED HYDROCARBON SCREEN
CHOLESTEROL TESTING
CHOLINESTERASE TESTING
CHOLINESTERASE TESTING
CHONDROITIN B SULFATE TEST
CHROMATOGRAPHY TESTS
CHROMATOGRAPHY TESTS
CHROMATOGRAPHY TESTS
CHROMATOGRAPHY TESTS
CHROMOTOGRAPHY, QUANTITATIVE; COLUMN, ANALYTE
CHROMATOGRAPHY QUANTITATIVE; COLUMN; MULTI ANALYTES; SINGLE STATIONARY & MOBILE
URINE
CITRIC ACID TEST
COCAINE QUANTITATIVE
COLLAGEN CROSS LINKS; ANY METHOD
COPPER TEST
CORTICOSTERONE TEST
CORTISOL;FREE
CORTISOL TESTING
CREATINE TEST
COLUMN CHROMATOGRAPHY/MASS SPECTROMETRY ANALYTE;NOT ELSEWHERE SPECIFIED;QUALITAT
COLUMN CHROMATOGRAPHY/MASS SPECTROMETRY ANALYTE NOT ELSEWHERE SPECIFIC;QUANTITAT
COLUMN CHROMATOGRAPHY/MASS SPECTRO ANALYTE STABLE ISOTOPE DILUTE SINGLE ANALYTE
COLUMN CHROMATOGRAPHY/MASS SPECTROMETRY STABLE ISOTOPE DILUTION MULTI ANALYTES
CPK TESTING
CPK TESTING
CREATINE KINASE (CK),(CPK), MB FRACTION ONLY
CREATINE KINASE (CK), (CPK); ISOFORMS
GREATININE TESTING
URINE
CREATININE CLEARANCE TEST
CRYOFIBRINOGEN TEST
CRYOGLOBULIN TEST
CYANIDE TEST
CYANOCOBALAMIN TESTING
UNSATURATED BINDING CAPACITY
CYSTATIN C
CYSTINE & HOMOCYSTINE TEST
DEHYDROEPIANDROSTERONE TEST
DEHYDROEPIANDROSTERONE-SULFATE (DHEA-S)
DESOXYCORTICOSTERONE, 11 TEST
DESOXYCORTISOL, 11 TEST
DIBUCCAINE NUMBER
DIHYDROCODINONE TEST
DIHYDROMORPHINONE TEST
DIHYDROTESTOSTERONE TEST
DIHYDROXYVITAMIN D, 1,25-
DIMETHADIONE
ELASTASE, PANCREATIC (EL-1), FECAL, QUALITATIVE OR SEMIQUANTITATIVE
ENZYME ACTIVE BL CELLS CULT OR TISSUE NOT ELSEWHERE SPEC NONRADIOACTIVE SUBTRATE
ENZYME ACTIVE BL CELLS CULTURE OR TISSU NOT ELSEWH SPEC RADIOACTIVE SUBTRATE EAC
ELECTROPHORETIC TESTING
EPIANDROSTERONE TEST
ERYTHROPOIETIN, BIOASSAY
ESTRADIOL TEST
ESTROGEN TESTING
ESTROGEN TESTING
ESTRIOL TESTING
ESTRONE TESTING
ETHCHLORVYNOL TEST
ETHYLENE GLYCOL
ETIOCHOLANOLONE RIA
FAT OR LIPIDS FECES SCREENING
FECES, FAT, TESTING
FECES, FAT, TESTING
FATTY ACID TESTING
VERY LONG CHAIN; FATTY ACIDS
FERRITIN SPECIFY METHOD
FETAL FIBRONECTIN CERVICOVAGINAL SECRETIONS SEMI-QUANTITATIVE
FLUORIDE TEST
FLURAZEPAM TEST
FOLIC ACID TESTING
FOLIC ACID; RBC
FRUCTOSE SEMEN
GALACTOKINASE RBC
GALACTOSE TESTING
GALACTOSE TESTING
GALACTOSE TESTING
GAMMA GLOBULIN TESTING
GAMMA GLOBULIN TESTING
GAMMAGLUBULIN; IMMUNOGLOBULIN SUBCLUSSES(IGG123OR4
BLOOD GAS TESTING
BLOOD GAS TESTING
GASES,BLOOD,ANYCOMB W/O2 SATURATION, EXCEPT PULSE
GASES, BLOOD, O2 SATURATION ONLY
HEMOGLOBIN-OXYGEN AFFINITY P02 FOR 50% SAT W/02
GASTRIC ACID TESTING
GASTRIC ACID TESTING
GASTRIN SERUM AFTER SECRETION STIMULATION EG FOR
GASTRIN TEST
GLUCAGON TEST
GLUCOSE BODY FLUID OTHER THAN BLOOD
GLOBULIM SERUM
GLUCOSE TESTING
GLUCOSE TESTING
GLUCOSE TESTING
GLUCOSE TESTING
GLUCOSE TESTING
TOLBUTAMIDE TOLERANCE TEST
GLUCSE-6-PHOSPHTE DEHYDROGENAS
GLUCSE-6-PHOSPHTE DEHYDROGENAS
GLUCOSE, BLOOD, BYGLUCOSE MONITORING DEVICE
GLUCOSIDASE BETA
GLUTAMATE DEHYDROGENASE TEST
GLUTAMINE TEST
GGT TEST
GLUTHATHIONE TEST
GLUTHATHIONE REDUCTASE RBC
GLUTETHIMIDE TEST
GLYCOPROTEIN TEST
GONADOTROPIN TESTING
GONADOTROPIN TESTING
GROWTH HORMONE TEST
GUANOSINE MONOPHOSPHATE TEST
HELICOBACTER PYLORI, BLOOD TEST ANALYSIS FOR UREASE ACTIVITY, NON RADIOACTIVE
HAPTOGLOBIN TESTING
HAPTOGLOBIN TESTING
HELIOCOBACTER PYLORI BREATH TEST ANALYSIS
HELICOBACTER PYLORI DRUG ADMINISTRATION
HEAVY METAL TESTING
HEAVY METAL TESTING
HELICOBACTER PYLORI, BREATH TEST
HEMOGLOBIN TESTING
HEMOGLOBIN FRACTIONATION AND QUANTITATION CHROMOTOGRAPHY
HEMOGLOBIN BY COPPER SULFATE METHOD
HEMOGLOBIN TESTING
HEMOGLOBIN TESTING
GLYCOSYLATED (AIC)
HEMOGLOBIN; GLYCOSYLATED BY DEVICE CLEARED BY FDA FOR HOME USE
METHEMOGLOBIN TESTING
METHEMOGLOBIN TESTING
HEMOGLOBIN TESTING
SULFHEMOGLOBIN TESTING
SULFHEMOGLOBIN TESTING
HEMOGLOBIN TESTING
HEMOGLOBIN TESTING
URINE
HEMOSIDERIN TEST
HEMOSIDERIN RIA
B-HEXOSAMINIDASE EACH ASSAY
HISTAMINE TEST
HOMOCYSTINE ASSAY
HOMOVANILLIC ACID TEST
HYDROXYCORTICOSTEROIDS 17-(17-OHCS) RIA
HIAA TEST
HYDROXYPROGESTERONE TESTING
HYDROXYPROGESTERONE TESTING
HYDROXYPROLINE TESTING
HYDROXYPROLINE TESTING
IMMUNOASSAY, FOR ANALYTE OTHER THAN ANTIBODY; MULTIPLE STEP METHOD
IMMUNOASSAY, FOR ANALYTE OTHER THAN ANTIBODY
IMMUNOASSAY, ANALYTE; BY RADIONUCLIDE TECHNIQUERIA
IMMUNOASSAY, ANALYTE; NOT OTHERWISE SPECIFIED
INSULIN, TOTAL
INSULIN; FREE
INTRINSIC FACTOR LEVEL
IRON TEST
IRON BINDING CAPACITY TEST
ISOCITRIC DEHYDROGENASE TEST
KETOGENIC STEROID TESTING
KETOSTEROID TESTING
KETOSTEROID TESTING
LACTATE TEST
LDH TEST
LDH TEST
ISOENZYMES CHEMICAL SEPARATION
LACTOBERRIN, FECAL, QUALITATIVE
LACTOFERRIN, FECAL, QUANTITATIVE
PLACENTAL LACTOGEN TEST
LACTOSE URINE QUALITATIVE
LACTOSE TEST
LEAD TESTING
L/S RATIO
L/S RATIO; FOAM STABILITY TEST
FETAL LUNG MATURITY ASSESSMENT FLUORESCENCE POLARIZATION
FETAL LUNG MATURITY ASSESSMENT LAMELLAR BODY DENSITY
LAP TEST
LIPASE TEST
LIPOPROTEIN (A)
LIPOPROTEIN-ASSOCIATED PHOSPHOLIPASE A2, (LP-PLA2)
LIPOPROTEIN, BLOOD, ELECTROPHORETIC SEPARATION AND QUANTITATION
LIPOPROTEIN, BLOOD, HIGH RESOLUTION FRACTIONAL AND QTY
LIPOPROTEIN, BLOOD, QTY/LIPTOPROTEIN PARTICLE #'S AND SUBCLASSES
LIPOPROTEIN HIGH DENSITY CHOLESTEROL HDL
LIPOPROTEN VERY LOW DNSITY (VLDL CHOLESTEROL)
LDL CHOLESTEROL
LUTEINIZING RELEASING FASTOR (LRH) RIA
MAGNESIUM TEST
MALATE DEHYDROGENASE TEST
MANGANESE TEST
MASS SPECTROMETRY & TANDEM MASS ANALYTE NOT ELSEWH SPECIFIED QUALITATIVE EA SPEC
MASS SPECTROMETRY & TANDEM MASS SPECTROMETRY ANALYTE NOT ELSEWH SPECIFIED QUANTI
MEPROBAMATE TEST
MERCURY TESTING
METANEPHRINES TEST
METHADONE TEST
METHEMALBUMIM TEST
METHSUXIMIDE SERUM
MUCOPOLYSACCHARIDES ACID BLOOD
MUCOPOLYSACCHARIDES TESTING
MUCIN-SYNOVIAL FLUID TEST
MYELIN BASIC PROTEIN CSF RIA
MYOGLOBIN ELECTROPHORESIS
MYELOPEROXIDASE (MPO)
NATRIURETIC PEPTIDE
NEPHELOMETRY,EACH ANALYTE NOT ELSEWHERE SPECIFIED
NICKEL TEST
NICOTINE TEST
NUCLEAR MOLECULAR DIAG. MOLECULAR ISOLATION/EXTRAC
MOLECULAR DIAGNOSTICS ISOLATION OR EXTRACTION OF HIGHLY PURIFIED NUCLEIC ACID
NUCLEAR MOLECULAR DIAGNOSTIC ENZYMATIC DIGESTION
MOLECULAR DIAGNOSTICS DOT/SLOT BLOT PRODUCTION
NUCLEAR MOLECULAR DIAGNOSTIC SEPARATION (EG DOT BL
NUCLEAR MOLECULAR DIAGNOSTICS;NUCLEIC ACID PROBE
MOLECULAR DIAGNOSTICS NUCLEIC ACID TRANSFER
NUCLEAR MOLECULAR DIAG NUCLEIC ACID PROBE W/AMPLIF
MOLECULAR DIAGNOSTICS, FIRST TWO NUCLEIC AND SEQUENCES
MOLECULAR DIAGNOSTICS AMPLIFICATION OF PATIENT NUCLEIC ACID MULTIPLEX EA MULTI R
MOLECUALR DX; REVERSE TRANSCRIPTION
MOLECULAR DIAGNOSTICS MUTATION SCANNING BY PHYSICAL PROPERTIES SINGLE SEGMENT EA
MOLECULAR DIAGNOSTICS MUTATION IDENTIFICATION BY SEQUENCING SINGLE SEGMENT EACH
MOLECULAR DIAGNOSTICS MUTATION ID BY ALLELE SPECIFIC TRANSCRIPTION SNGL SEG EACH
MOLECULAR DIAGNOSTICS MUTATION ID BY ALLELE SPECIFIC TRANSLATION SNGL SEG EACH
MOLECULAR DIAGNOSTICS, LYSIS OF CELLS
MOLECULAR DIAGNOSTICS, SEPERATION AND IDENTIFICATION
MOLECULAR DIAGNOSTICS, SEPERATION AND IDENTIFICATION/ HIGH RESOLUTION TECHNIQUE
NUCLEAR MOLECLULAR DIAGNOSTICS INTERPT AND REPORT
MOLECULAR DIAGNOSTICS; RNA STABILIZATION
MUTATION INDENTIFICATION BY ENZYMATIC LIGATION OR PRIMER EXTENSION
NUCLEOTIDASE 5 - TEST
OLIGOCLONAL IMMUNE GLOBULIN (IG) CSF ELECTROPHORES
ORGANIC ACIDS, QUANTITATIVE
ORGANIC ACIDS QUALITATIVE EACH SPECIMEN
ORGANIC ACID
OPIATES, (EG, MORPHINE, MEPERIDINE)
OSMOLALITY TEST
URINE
OSTEOCALCIN (BONE G1A PROTEIN)
OXALATE TEST
ONCOPROTEIN, HER-2/NEU
DES-GAMMA-CARBOXY-PROTHROMBIN (DCP)
PARATHORMONE RIA
GASTRIC PEPSIN TESTING
PH TESTING
EXHALED BREATH CONDENSATE
PHENCYCLIDINE TEST
CALPROTECTIN, FECAL
PHENOTHIAZINE TESTING
PKU TESTING
PHENYLKETONES BLOOD QUALITATIVE
PHOSPHATASE TESTING
PHOSPHATSE, ACID; FORENSIC EXAM
PHOSPHATASE, PROSTATIC FRACTION, R/A
PHOSPHATASE TESTING
PHOSPHATASE TESTING
PHOSPHATASE TESTING
PHOSPHATYOYLGLYCEROL
PHOSPHOGLUCONATE, 6-TEST
PHOSPHOHEXOSE ISOMERASE TEST
PHOSPHORUS TEST
URINE
PORPHOBILINOGEN TESTING
PORPHOBILINOGEN TESTING
PORPHYRIN TESTING
PORPHYRIN TESTING
PORPHYRIN TESTING
PORPHYRINS, FECES; QUALITATIVE
POTASSIUM TEST
URINE
PREALBUMIN
PREGNANEDIOL RIA
PREGNANETRIOL RIA
PREGNENOLONE
17-HYDROXYPREGNENOLONE
PROGESTERONE TEST
PROCALCITONIN (PCT)
PROLACTIN TEST
PROSTAGLANDIN ANY ONE RIA
PROSTATE SPECIFIC ANTIGEN
PROSTATE SPECIFIC ANTIGENS (PSA)
PROSTATE SPECIFIC ANTIGEN (PSA); FREE
PROTEIN, TOTAL, EXCEPT BY REFRACTOMETRY; SERUM
PROTEIN, TOTAL, EXCEPT BY REFRACTOMETRY; URINE
PROTEIN, TOTAL, EXCEPT BY REFRACTOMETRY; OTHER SOURCE
PROTEIN TESTING
PREGNANCY-ASSOCIATED PLASMA PROTEIN-A (PAPP-A)
PROTEIN ELECTROPHORETIC FRACTIONATION AND QUANTITATION SERUM
PROTEIN; ELECTROPHORETIC FRACTIONATION & QUANTITATION, OTHER FLUIDS W/ CONCENTRA
PROTEIN;WESTERN BLOT,INTERP & REPORT, FLUIDS
PROTEIN;WESTERN BLOT,INTERP & REPORT, FOR BAND ID
PROTOPORPHYRIN TEST
PROTOPORPHYRIN TEST
INSULIN TESTING
PYRIDOXINE TEST
PYRUVATE TEST
PYRUVIC-KINASE TEST
QUININE
RECEPTOR ASSAY ESTROGEN (ESTRADIOL)
PROGESTERONE
ENDOCRINE OTHER THAN ESTROGEN OR PROGESTERONE
RECEPTOR ASSAY; NONENDOCRINE
RENIN TEST
RIBOFLAVIN TEST
SELENIUM TEST
SEROTONIN TEST
SEX HORMONE BINDING GLOBNYLIN (SHBG)
SIALIC ACID BLOOD
SILICA TEST
SODIUM TEST
URINE
SODIUM; OTHER SOURCE
SOMATOMEDIN
SOMATOSTATIN
SPECTROPHOTOMETRY, ANALYTE NOT ELSEWHERE SPECIFIED
SPECIFIC GRAVITY TEST
CHROMATOGRAPHIC SUGARS
SUGARS SINGLE QUALITATIVE EACH SPECIMEN
SUGARS MULTIPLE QUALITATIVE EACH SPECIMEN
SUGARS SINGLE QUANTITATIVE EACH SPECIMEN
SUGARS MULTIPLE QUANTITATIVE EACH SPECIMEN
SULFATE, URINE
TESTOSTERONE; FREE
TESTOSTERONE TESTING
THIAMIN TEST
THIOCYANATE TEST
HUMAN LEUKOCYTE ANTIGEN (HLA) CROSSMATCH, NON-CYTOTOXIC FIRST SERUM SAM
THYROGLOBULIN
T4 TEST
THYROXINE (T4) NEONATAL
T4 TEST
TBG TEST
TSH TEST
THYROTROPIN RELEASING FACTOR
TOCOPHEROL ALPHA TEST
TRANSCORTIN (CORTISOL BINDING GLOBULIN)
SGOT TEST
SGPT TEST
TRANSFERRIN
TRIGLYCERIDE TESTING
THYROID HORMONE (T-3/T-4) OR THBR
TRIIODOTHYRONINE T3: TOTAL (TT-3)
TRIIODOTHYRONINE FREE (FT-3) RIA UNBOUND T-3 ONLY
TRIDOTHYRONINE (T-3); REVERSE
TROPONIN
TRYPSIN TESTS
TRYPSIN TESTS
QUANTITATIVE
TYROSINE TEST
TROPONIN, QUALITATIVE
UREA NITROGEN; QUANTITATIVE
BUN
UREA NITROGEN URINE
BUN
URIC ACID TESTING
URIC ACID, OTHER SOURCE
UROBILINOGEN FECES QUANTITATIVE
UROBILINOGEN URINE QUALITATIVE
UROBILINOGEN TESTING
UROBILINOGEN TESTING
VMA TEST
VASOACTIVE INTESTINAL PEPTIDE (VIP)
VASOPRESSIN TESTING
VITAMIN A TESTING
VITAMIN ASSAY
VITAMIN K TEST
VOLATILES TESTING
XYLOSE TOLERANCE TEST
ZINC TEST
ZINC SULPHATE TURBIDITY TEST
C-PEPTIDE, ANY METHOD
GONADOTRROPIN CHORIONIC QUANTITATIVE
QUALITATIVE
GONADOTROPIN, CHORIONIC (HCG); FREE BETA CHAIN
OVULATION TESTS BY COLOR COMPARISON FOR HORMONE
UNLISTED CHEMISTRY/TOXICOLOGY TEST
IVY TEST
BLOOD COUNT AUTOMATED DIFFERENTIAL WBC COUNT
BLOOD COUNT
BLOOD COUNT,MANUAL BLOOD SMEAR EXAM W/O PARAMETERS
BLOOD COUNT
BLOOD COUNT; SPUN MICROGEMATOCRIT
HEMATOCRIT TEST
HEMOGLOBIN TESTING
HEMOGRAM AND PLATELET COUNT AUTOMATED AND (CBC)
HEMOGRAM AUTOMATED WITH PLATELET COUNT
MANUAL CELL COUNT (ERYTHROCYTE LEUKOCYTE OR PLATELET)
RED BLOOD CELL COUNT
RETICULOCYTE COUNT
RETICULOCYTE COUNT FLOW CYTOMOETRY
BLOOD COUNT RETICULOCYTES AUTOMATED INCLUDING ONE OR MORE CELLULAR PARAMETERS
WHITE BLOOD CELL COUNT
PLATELET AUTOMATED
BLOOD SMEAR, PERIPHERAL BY PHYSICIAN/W WRITTEN REP
SMEAR, INTERP ONLY
CHROMOGENIC SUBSTRATE ASSAY
CLOT RETRACTION TESTING
CLOT LYSIS TIME WHOLE BLOOD DILUTION
BLOOD CLOTTING FACTORS II
ACG TEST
PROCONVERTIN TEST
AHG TEST
FACTOR VIII RELATED ANTIGEN, QUANITATIVE
CLOTTING;FACTOR VIII,VW FACTOR,RISTOCETIN,COFACTOR
CLOTTING; FACTOR VIII, VW FACTOR ANTIGEN
CLOTTING; FACTOR VIII, VON WILLEBRAND'S FACTOR
PTC TEST
STUART-PROWER TEST
PTA TEST
HAGEMANN TEST
PROTHROMBIN TESTING
PROTHROMBIN TESTING
CLOTTING PREKALLIKREIN ASSAY FLETCHER FACTOR ASS
CLOTTING;HIGH MOLECULAR WEIGHT KININDGEN ASSAY
CLOTTING INHIBITOR TESTING
ANTITHROMBIN III, ANTIGEN ASSAY
PROTEIN "C" ASSAY
CLOTTING INHIBITORS; PROTEIN C, ACTIVITY
CLOTTING INHIBITORS PROTERIN S TOTAL
CLOTTING INHIBITORS; PROTEIN S, FREE
ACTIVATED PROTEIN C ASSAY
ANTIPOTHROMBOPLASTIN
FACTOR INHIBITOR TEST
THROMBOMODULIN
COAGULATION TIME TESTING
ACT TEST
OTHER METHODS
EUGLOBULIN LYSIS TEST
FIBRIN DEGRADATN/SPLIT/PRODCTS
PARACOAGULATION
FIBRIN/DEGRADATION/PRODUCTS; QUANTITATIVE
FIBRIN DEGRADATION PRODUCTS,D-DIMER SEMIQUANTITATI
FIBRIN DEGRADATION PRODUCTS, D-DIMER; QUANTITATIVE
ULTRASENSITIVE QUALITATIVE OR SEMIQUANTITATIVE
FIBRINOGEN; ACTIVITY
FIBRINOGEN; ANTIGEN
FIBRINOLYSIN TESTING
COAGULATION & FIBRINOLYSIS, FUNCTIONAL ACTIVITY, NOS (EG, ADAMTS-13), EA ANALYTE
PLASMIN TEST
ANTI PLASMIN TEST
FIBRINOLYTIC FACTORS; PLASMINOGEN ACTIVATOR
PLASMINOGEN TEST
FIBRINOLYTIC FACOTRS;PLASINOGEN,ANTIGENIC ASSAY
HEINZ BODIES TESTING
HEINZ BODIES TESTING
FETAL HEMOGLOBIN TEST
FETAL HEMOGLOBIN TEST; ROSETTE
HEMOLYSIN, ACID
HEPARIN ASSAY
HEPARIN NEUTRALIZATION
HEPARIN-PROTAMINE TOLERANCE TEST
IRON STAIN
LEUCOCYTE ALKALINE PHOSPHATASE
MECHANICAL FRAGILITY, RBC
MURAMIDASE TEST
OSMOTIC FRAGILITY TESTING
OSMOTIC FRAGILITY TESTING
ACGREGATION (IN VITRO); ANY AGENT
PLATELET NEUTRALIZATION
PROTHROMBIN TIME
PROTHROMBIN TIME SUBSTITUTION PLASMA FRACTINS EA
RUSSELL VIPER VENOM TEST
RUSSELL VIPER VENOM TIME, DILUTED
REPTILASE TEST
SEDIMENTATION RATE
SEDIMENTATION RATE, ERTHROCYTHE; AUTOMATED
SICKLING OF RBC
THROMBIN TIME TESTING
THROMBIN TIME TESTING
THROMBOPLASTIN INHIBITION; TISSUE
THROMBOPLASTIN TIME TEST
THROMBOPLASTIN TIME, PARTIAL (PPT); SUBSTITUTION PLASMA FRACTIONS, EACH
BLOOD VISCOSITY TEST
UNLISTED HEMATOLOGY TEST
AGGLUTININ TESTING
ALLERGEN SPECIFIC IGG QUANTITIVE OR SEMI QUANTITIVE EACH ALLERGEN
ALLERGEN SPECIFIC IGE; QUANTIVE OR SEMIQUANT., EA.
ALLE%GEN SPECIFIC IGE QUALITATIVE MULTIALLERGEN
ANTIBODY TESTING
ANTIBODY TESTING
ANTIBODY IDENTIFICATION; PLATELET ASSOC IMMUNOASSA
ANTINUCLEAR ANTIBODEIS (ANA), RIA
ANTINUCLEAR ANTIBODIES (ANA); TITER
ANTI STREPTOLYSIN O TITRE TEST
ANTI STREPTOLYSIN O TITRE TEST
BLOOD BANK PHYSICIAN SERVICES DIFFICULT CROSSMATCH
BLOOD BANK PHYSICIAN SERVICES, INVESTIGATEONEACTIO
BLOOD BANK PHY SERV-AUTH FOR DEVIATION FROM STANDA
C-REACTIVE PROTEIN
C-REACTIVE PROTEIN; HIGH SENSITIVITY
BETA 2 GLYCOPROTEIN 1 ANTI-BODY EACH
CARDIOLIPIN (PHOSPHOLIPID) ANTIBODY, EACH LG CLASS
ANTI-PHOSPHATIDYLSERINE (PHOSPHOLIPID) ANTIBODY
CHEMOTAXIS ASSAY SPECIFY METHOD
COLD AGGLUTININ SCREEN
COLD AGGLUTININ; TITER
COMPLEMENT; ANTIGEN, EACH COMPONENT
COMPLEMENT; FUNCTIONAL ACTIVITY, EA COMPONENT
COMPLEMENT C2 ESTERASE TEST
COMPLEMENT FIXATION TESTS
COUNTER ELECTROPHORESIS
CYCLIC CITRULLINATED PEPTIDE ANTIBODY
DESOXYRIBONUCLEASE TEST
DNA TEST
DEOXYRIBONUCLEIC ACID ANTIBODY; DNA,SINGLE STRANDE
ENA TEST
FC RECEPTOR ASSAY SPECIFY METHOD
FLUORESCENT ANTIBODY TESTING
FLUORESCENT ANTIBODY TESTING
GROWTH HORMONE HUMAN (HGH) ANTIBODY RIA
HEMAGGLUTINATION INHIBITION TESTS (HAI) EACH
IMMUNOASSAY TUMOR ANTIGEN QUALITATIVE OR SEMI QUANTITIVE
IGM ANTIBODY
IMMUNOASSAY TUMOR ANTIGEN QUANTITIVE CA 15-3
IMMUNOASSAY TUMOR QUANTITIVE CA 19-9
IMMUNOASSAY TUMOR ANTIGEN QUANTITIVE CA 125
HUMAN EPIDIDYMIS PROTEIN 4 (HE4)
HETERAPHILE ANTIBODIES SCREENING
HETEROPHILE ANTIBODIES; TITER
HETEROPHILE ANTIBODIES TEST
IMMUNOASSAY FOR TUMOR ANTIGEN
IMMUNOASSAY FOR INFECTIOUS AGENT ANTIGEN/ANTIBODY
IMMUNOASSAY FOR CHEMICAL CONSTITUENT
IMMUNO-ELECTROPHORESIS
IMMUNO-ELECTROPHORESIS
IMMUNOELECTROPHORESIS; CROSSED (2 DIMENSION ASSAY)
IMMUNO-DIFFUSION TESTING
IMMUNO-DIFFUSION TESTING
IMMUNE COMPLEX ASSAY; C1Q BINDING CELL
IMMUNOFIXATION ELECTROPHORESIS
IMMUNOFIXATION ELECTROPHORESIS; OTHER FLUIDS W/ CONCENTRATION (EG, URINE, CSF)
INHIBIN A
INSULIN ANTIBODIES
INTRINSIC FACTOR ANTIBODIES RIA
ISLET CELL ANTIBODY
LEUKOCYTE HISTAMINE RELEASE LHR
LEUKOCYTE PHAGOCYTOSIS
CELLULAR FUNCTION ASSAY INVOLVING STIMULATION AND DETECTION OF BIOMARKER.
LYMPHOCYTE TRANSFORMATION
B CELLS, TOTAL COUNT
MONONUCLEAR CELL ANTIGEN, QUANTITATIVE NOS, EA ANTIGEN
NATURAL KILLER CELLS, TOTAL COUNT
T CELLS; TOTAL COUNT
T CELLS, ABSOLUTE CD4, CD8 INCLUDING RATIO
T CELLS; ABSOLUTE CD4 COUNT
STEM CELLS, TOTAL COUNT
MICROSOMAL ANTIBODY (THYROID) RIA
MIGRATION INHIBITION FACTOR TEST (MIF)
NEUTRALIZATION TEST, VIRAL
NITRO-BLUE TETRAZOLIUM TEST
PARTICLE AGGLUTINATION, ANTIBODY, EACH
PARTICLE AGGLUTINATION; TITER, EACH ANTIBODY
RHEUMATOID FACTOR LATEX FIXATION
RHEUMATOID FACTOR QUANTITATIVE
TUBERCULOSIS TEST
SKIN TEST; CANDIDA
SKIN TEST; UNLISTED ANTIGEN, EACH
COCCIDIOIDOMYCOSTS TEST
HISTOPLASMOSIS TEST
TUBERCULOSIS TESTING
STREPTOKINASE ANTIBODY TEST
SYPHILIS TESTS
SYPHILIS TESTS
ANTIBOYD; ACTINOMYCES
ADENOVIRUS
ANTIBODY; ASPIRGILLUS
ANTIBODY; BACTERIUM, NOT ELSEWHERE SPECIFIED
BARTONELLA ANTIBODY
ANTIBODY; BLASTOMYCES
ANTIBODY; BORDETELLA
BORRELIA BURGDORFERI CONFIRMATORY TEST
BORRELIA BURGDORFERI (LYME DISEASE)
ANTIBODY; BORRELIA (RELAPSING FEVER)
ANTIBODY; BRUCELLA
ANTIBODY; CAMPYLOBACTER
ANTIBODY; CANDIDA
CHLAMYDIA
CHLAMYDIA IGM
COCCIDIOIDES - ANTIBODY
ANTIBODY; COXIELLA BRUNET11 (Q FEVER)
ANTIBODY; CRYPTOCOCCUS
CYTOMEGALOVIRUS (CMV) - ANTIBODY
ANTIBODY CYTOMEGALOVIRUS CMV IGM
ANTIBODY, DIPTHERIA
ANTIBODY; ENCEPHALITIS, CALIFORNIA (LA CROSSE)
ANTIBODY; ENCEPHALITIS, EASTERN EQUINE
ANTIBODY; ENCEPHALITIS, ST. LOUIS
ANTIBODY; ENCEPHALITIS, WESTERN EQUINE
ANTIBODY; ENTEROVIRUS (EG,COXSACKIE,ECHO,POLIO)
EPSTEIN BARR VIRUS EARLY ANTIGEN(EA); ANTIBODY
EPSTEIN BARR(EB)VIRUS,NUCLEAR ANTGEN(EBNA);ANTIBOD
EPSTEIN BARR(EB)VIRUS,VIRAL CAPSID(VCA); ANTIDODY
ANTIBODY EHRLICHIA
ANTIBODY; FRANCISELLA TULARENSIS
ANTIBODY; FUNGUS, NOT ELSEWHERE SPECIFIED
GIARDIA LAMBLIA
ANTIBODY HELICOBACTER PYLORI
ANTIBODY; HELMINTH, NOTE ELSEWHERE SPECIFIED
ANTIBODY HEMOGLOBIN FECAL
ANTIBODY; HEMOPHILUS INFLUENZA
HTLV 1 ANTIBODY DETECTION IMMUNOASSAY
ANTIBOYD; HTLV-11
CONFIRMATORY TEST
ANTIBODY; HEPATITIS, DELTA AGENT
ANTIBODY; HERPES SIMPLEX, NON-SPECIFIC TYPE TEST
ANTIBODY; HERPES SIMPLEX, TYPE 1
ANTIBODY HERPES SIMPLEX TYPE 2
ANTIBODY; HISTOPLASMA
HIV-1
ANTIBODY; HIV-2
HIV-1 AND HIV-2 SINGLE ASSAY
HEPATITIS B CORE ANTIBODY; (HBCAB); 1GG AND 1GM
HEPATITIS B CORE ANTIBODY (HBCAB); 1GM ANTIBODY
HEPATITIS B SURFACE ANTIBODY (HBSAB)
HEPATITIS BE ANTIBODY (HBEAB)
HEPATITUS A ANTIBODY; IGG-IGM
HEPATITIS A ANTIBODY (HAAB); 1GM ANTIBODY
ANTIBODY; INFLUENZA VIRUS
ANTIBODY; LEGIONELLA
ANTIBODY; LEISHMANIA
ANTIBODY; LEPTOSPIRA
ANTIBODY; LISTERIA MONOCYTOGENES
ANTIBODY; LYMPHOCYTIC CHORIOMENGINGITIS
ANTIBODY; LYMPHOGRANULOMA VENEREUM
ANTIBODY; MUCORMYCOSIS
ANTIBODY; MUMPS
ANTIBODY; MYCOPLASMA
ANTIBODY; NEISSERIA MENINGITIDIS
ANTIBODY; NOCARDIA
ANTIBODY; PARVOVIRUS
ANTIBODY; PLASMODIUM (MALARIA)
ANTIBODY; PROTOZOA, NOT ELSEWHERE SPECIFIED
ANTIBODY; RESPIRATORY SYNCYTIAL VIRUS
ANTIBODY RICKETTSIA
ROTAVIRUS
RUBELLA
ANTIBODY; RUBEOLA
ANTIBODY; SALMONELLA
ANTIBODY; SHIGELLA
ANTIBODY; TETANUS
ANTIBODY; TOXOPLASMA
ANTIBODY; TOXOPLASMA, LGM
TREPONEMA PALLIDUM
ANTIBODY; TRICHINELLA
ANTIBODY; VARICELLA-ZOSTER
ANTIBODY; WEST NILE VIRUS, IGM
ANTIBODY; WEST NILE VIRUS
ANTIBODY; VIRUS, NOT ELSEWHERE SPECIFIED
ANTIBODY; YERSINIA
THYROGLOBULIN ANTIBODY RIA
HEPATITIS C ANTIOBODY
HEPATITIS C ANTIOBODY; CONFIRMATORY TEST
LYMPHOCYTOTOSICITY ASSAY VISUAL CROSSMATCH W/TITRA
LYMPHOCYTOTOXICITY ASSAY,VISUAL; W/O TITRATION
SERUM SCREENING FOR CYTOTOXIC PRA;STANDARD METHOD
SERUM SCREEN FO CYTOTOXIC PRA QUICK METHOD
TISSUE TYPING, HLA TYPING, A,B,C, SINGLE ANTIGEN
TISSUE TYPING FOR TRANSPLANT INCL DONOR CROSSMATCH
HLA TYPING, DR, SINGLE ANTIGEN
HLA TYPING, DR, MULTIPLE ANTIGENS
LYMPHOCYTE CULTURE, MIXED (MLC)
TISSUE TYPING/LYMPHOCYTE (PLC)
HUMAN LEUKOCYTE ANTIGEN (HLA) CROSSMATCH, NON-CYTOTOXIC FIRST SERUM SAM
EACH ADDITIONAL SERUM SAMPLE OR SAMPLE SOLUTION (SP)
UNLISTED IMMUNOLOGY PROCEDURE
ANTIBODY SCREEN RBC EACH SERUM TECHNIQUE
ANTIBODY ELUTION (RBC) EACH ELUTION
ANTIBODY ID, RBC ANTIBODIES, EA PANEL FOR EA SERUM
ANTIHUMAN GLOBULIN TEST (COOMB) DIRECT EA ANTISERU
INDIRECT; QUALITATIVE, EACH ANTISERUM
ANTIHUMAN G BULIN TEST INDIRECT TITER EA ANTISERU
AUT0LOGOUS BLOOD OR COMPONENT; COLLECTION, PROCESSING, STORAGE, PREDEPOSITED
AUTOLOGOUS BLOOD/COMPONENT; INTRA OR POSTOPERATIVE
BLOOD TYPING ABO
BLOOD TYPING RH (D)
ANTIGEN SCREENING FOR COMPATIBLE UNIT USING PATIEN
BLOOD TYPING;ANTIGEN USING PATIENT SERUM, PER UNIT
BLOOD TYPING;RBC ANTIGENS,OTHER THAN ABO/RH(D),EA
BLOOD TYPING, RH PHENOTYPING, COMPLETE
BLOOD TYPING; PATERNITY TEST,ABO,RH,MN
BLOOD TYPING;PATERNITY TEST, EA ADDITION ANTIGEN
COMPATIBILITY TEST EA UNIT;IMMEDIATE SPIN TECHNIQU
COMPATIBILITY TEST; EACH INCUBATION TECHNIQUE
COMPATABILITY TEST,(EACH) ANTIGLOBULIN TECHNIQUE
COMPATIBILITY TEST, EACH UNIT
FRESH FROZEN PLASMA, THAWING, EACH UNIT
FROZEN BLOOD, PREPARATION FOR FREEZING,EACH UNIT
FROZEN BLOOD,PREPARATION FOR FREEZING; W/THAWING
FROZEN BLOOD PREP FOR FREEZ, W/FREEZE & THAWING
HEMOLYSINS AND AGGLUTININS, AUTO, SCREEN, EACH
HEMOLYSINS AND AGGLUTININS, EACH; INCUBATED
IRRADIATION OF BLOOD PRODUCT EACH UNIT
LEUKOCYTE TRANSFUSION
VOLUME REDUCTION OF BLOOD OR BLOOD PRODUCT, EACH UNIT
POOLING OF PLATELETS OR OTHER BLOOD PRODUCTS
PRETREAT RBC'S FOR USE IN ANTIBODY DETECTION,IDENTI
INCUBATION WITH ENZYMES, EACH
BY DENSITY RADIENT SEPARATION
PRETREAT SERUM TO USE IN RBC ANTI IDENT,INCUBAT W/
BY DILUTION
INCUBATION WITH INHIBITORS, EACH
BY DIFFERNTIAL RED CELL ABSORPTION USING PATIENT R
SPLITTING OF BLOOD OR BLOOD PRODUCTS EA UNIT
UNLISTED TRANSFUSION MEDICINE PROCEDURE
ANIMAL INOCULATION
ANIMAL INOCULATION
CONCENTRATN FOR PARASITES ETC
CULTURE, BACTERIAL
CULTURE, BACTERIAL
CULTURE BACTERIAL STOOL AEROBIC ADDITIONAL PATHOGENS ISOLATION PRESUMPTIVE ID
CULTURE, BACTERIAL
CULTURE QUANTITIVE AEROBIC ANY SOURCE EXCEPT BLOOD URINE OR STOOL
CULTURE QUANTITIVE ANAEROBIC WITH ISOLATION ANY SOURCE EXCEPT URINE,BLOOD,STOOL
CULTURE, BACTERIAL
CULTURE, BACTERIAL
CULTURE AEROBIC ADDITIONAL METHODS FOR DEFINITIVE ID EACH ISOLATE
CULTURE, BACTERIAL
WITH COLONY ESTIMATION FROM DENSITY CHART
CULTURE, BACTERIAL
CULTURE, BACTERIAL
CULTURE, FUNGI
CULTURE, FUNGI
CULTURE-BLOOD
CULTURE, FUNGI
CULTURE MOLD
CULTURE, MYCOPLASMA
CULTURE, CHLAMYDIA
CULTURE, TUBERCLE BACILLI
CULTURE, TUBERCLE BACILLI
CULTURE, TYPING
CULTURE, TYPING
CULTURE, TYPING
CULTURE ID NUCLEIC ACID PROBE
INDENTIFITION BY NUCLEIC ACID PROBE DIRECT PROBE TECHNIQ, PER CULTURE OR ISOLATE
CULTURE ID PULSE FIELD GEL TYPING
IDENTIFICATION BY NUCLEIC ACID SEQUENCING METHOD, EACH ISOLATE
CULTURE, TYPING
DARK FIELD EXAMINATION ANY SOURCE INCLUDES COLLECT
DARK FIELD EXAMINATION
MACROSCOPIC EXAM ANTHROPOD
MACROSCOPIC EXAMINATION PARASITE
PINWORM EXAM
ENDOTOXIN TESTING
OVA AND PARASITES SMEARS
SENSITIVITY STUDIES
SENSITIVITY STUDIES
SUSCEPTIBILITY STUDIES ENZYME DETECTION PER ENZYME
SENSITIVITY STUDIES
MINIMUM BACTERICIDAL CONCENTRACTION (ADD-ON)
SENSITIVITY STUDIES
SENSITIVITY STUDIES
SERUM BACTERICIDAL TITER
STAINS/SMEARS
STAINS/SMEARS
STAINS/SMEARS
SMEAR, PRIMARY SOURCE WITH INTERPRETATION
WET MOUNT
TISSUE EXAMINATION FOR FUNGI (EG KOH SLIDE)
TOXIN OR ANTITOXIN ASSAY,TISSUE CULTURE(EG CLOSTRI
VIRUS, INOCULATION
VIRUS IDENTIFICATION
TISSUE CULTURE ADDITIONAL STUDIES(EG HEMADSORPTION
VIRUS ISOLATION SHELL VIAL W/IDENTIFICATION IMMUNOFLUORESCENCE STAIN EACH VIRUS
INCLUDING IDENTIFICATION BY NON-IMMUNOLOGIC METHOD
INFECTIOUS AGENT ANTIGEN DETECTION BY DIRECT FLUORESCENT ANTIBODY TECH; ADENOVIR
BORDETELLA PERTUSSIS/PARAPERTUSIS
INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOFLUORESCENT TECHNIQUE; GIARDIA
CHLAMYDIA TRACHOMATIS AG, DFA
CYTOMEGALOVIRUS DIRECT FLUORESCENT ANTIBODY (DFA)
CRYPTOSPORIDUM/GIARDIA AGDFA
INFECTIOUS AGENT ANTIGEN HERPES SIMPLEX VIRUS TYPE 2
HERPES SIMPLEX VIRUS AG, DFA
INFECTIOUS AGENT ANTIGEN BY IMMUNOFLUROESCENTE INFLUENZA B VIRUS
INFLUENZA A VIRUS AG, DFA
INFECTIOUS AGENT ANTIGEN DETECT BY IMMUNOFLUORESCENT LEGIONELLA MICDADEI
LEGIONELLA PNEUMOPHILA, AGDFA
INFECTIOUS AGENT ANTIGEN PARAINFLUENZA VIRUS EACH TYPE
RESPIRATORY SYNCYTIAL VIRUS
ANTIGEN DETECTION BY I.F. PHEUMOCYSTIS CARINII
ANTIGEN DETECTION BY I.F. RUBEOLA
TREPONEMA PALLIDUM AG, DFA
VARICELLA ZOSTER VIRUS, AGDFA
INFECTION AGENT ANTIGEN DETECTION BY FLOURESCENT ANTIBODY TECHNIQUE, NOS
ANTIGEN DETECTION BY I.F. POLYVALENT
INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOASSAY TECH. QUALITATIVE/SEMI. MULTIP
INFECTIOUS AGENT ANTIGEN DETECTION BY ENZYME IMMUNOASSAY TECHNIQUE
CHLAMYDIA TRACHOMATIC AG, EIA
CLOSTRIDIUM DIFFICILE TOXIN A
ANTIGEN DETECTION BY EIA CRYPTOCOCCUS NEOFORMANS
CRYPTOSPORIDUM/GIARDIA,AGEIA
INFECTIOUS AGENT ANTIGEN DETECTION BY ENZYME IMMUNOASSAY TECHNIQUE; GIARDIA
CYTOMEGALOVIRUS, AG, EIA
ESHERICHIA COLI 0157
ANTIGEN DETECTION BY EIA ENTAMOEBA HISTOLYTICA DISPAR GROUP
ANTIGEN DETECTION BY EIA ENTAMOEBA HISTOLYTICA GROUP
HELICOBACTER PYLORI, STOOL
ANTIGEN DETECTION BY EIA H PYLORI
HEPATITUS B SURFACE ANTIGEN HBSAG
ANTIGEN DETECTION BY EIA, HEPATITIS B SURFACE
HEPATITUS BE ANTIGEN (HBEAG)
HEPATITUS DELTA AGENT
HISTOPLASMA CAPSULATUM-AGEIA
HIV-1 AG, EIA
HIV-2, AG, EIA
INFLUENZA, A OR B, EACH
RESPIRATORY SYNCYTIAL VIRUS AG EIA
ROTAVIRUS AG, EIA
SHIGA-LIKE TOXIN
STREPTOCOCCUS, GROUP A AGEIA
INFECTIOUS AGENT ANTIGEN-ENZYME IMMUNOASSAY TECH.QUAL/SEMIQUAL.MULTIPLE STEP NOS
SINGLE STEP METHOD NOS
INFECTIOUS AGENT ANTIGEN; MULTIPLE STEP METHOD, EACH POLYVALENT ANTISERUM
INFECTIOUS AGENT DETECT. DNA/RNA;BARTONELLA HENSELAE/QUINTANA,DIRECT PROBE TECH.
BARTONELLA HENSELAE/QUINTANA AMPLIFIED PROBE TECHNIQUE
BARTONELLA HENSELAE/QUINTANA, QUANTIFICATION
BORRELIA BURGDORFERI, DIRECT PROBE TECHNIQUE
BORRELIA BURGDORFERI, AMPLIFIED PROBE TECHNIQUE
BORRELIA BURGDORFERI, QUANTIFICATION
CANDIDA SPECIES, DIRECT PROBE TECHNIQUE
CANDIDA SPECIES, AMPLIFIED PROBE TECHNIQUE
CANDIDA SPECIES, QUANTIFICATION
CHLAMYDIA PNEUMONIAE, DIRECT PROBE TECHNIQUE
CHLAMYDIA PNEUMONIAE, AMPLIFIED PROBE TECHNIQUE
CHLAMYDIA PNEUMONIAE, QUANTIFICATION
CHLAMYDIA TRACHOMATIS, DIRECT PROBE TECHNIQUE
CHLAMYDIA TRACHOMATIS, AMPLIFIED PROBE TECHNIQUE
CHLAMYDIA TRACHOMATIS, QUANTIFICATION
CLOSTRDIUM DIFFICILE, TOXIN GENE(S), AMPLIFEID PROBE TECHNIQUE
CYTOMEGALOVIRUS, DIRECT PROBE TECHNIQUE
CYTOMEGALOVIRUS, AMPLIFIED PROBE TECHNIQUE
CYTOMEGALOVIRUS, QUANTIFICATION
INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); ENTEROVIRUS
NFECTIOUS AGENT DETECTION BY NUCLEIC ACID; VANCOMYCIN RESISTANCE
GARDNERELLA VAGINALIS, DIRECT PROB TECHNIQUE
GARDERELLA VAGIALIS, AMPLIFIED PROBE TECHNIQUE
GARDNERELLA VAGINALIS, QUANTIFICATION
HEPATITUS B VIRUS, DIRECT PROBE TECHNIQUE
HEPATITUS B VIRUS, AMPLIFIED PROBE TECHNIQUE
HEPATITUS B VIRUS, QUANTIFICATION
HEPATITUS C, DIRECT PROBE TECHNIQUE
HEPATITIS C, AMPLIFIED PROBE TECHNIQUE
HEPATITUS C, QUANTIFICATION
HEPATITUS G, DIRECT PROBE TECHNIQUE
HEPATITUS G, AMPLIFIED PROBE TECHNIQUE
HEPATITUS G, QUANTIFICATION
HERPES SIMPLEX VIRUS, DIRECT PROBE TECHNIQUE
HERPES SIMPLEX VIRUS, AMPLIFIED PROBE TECHNIQUE
HERPES SIMPLEX VIRUS, QUANTIFICATION
HERPES VIRUS-6, DIRECT PROBE TECHNIQUE
HERPES VIRUS-6, AMPLIFIED PROBE TECHNIQUE
HERPES VIRUS-6,DNA, QUANT.
HIV-1, DNA, DIRECT PROBE TECHNIQUE
HIV-1,DNA AMPLIFIED PROBE TECHNIQUE
HIV-I, QUANTIFICATION
HIV-2, DNA, DIRECT PROBE TECH.
HIV-2,DNA,AMPLIFIED PROBE TECHNIQUE
HIV-2, DNA, QUANTIFICATION
LEGIONELLA PNEUMOPHILA, DIRECT PROBE TECHNIQUE
LEGIONELLA PNEUMOPHILA, AMPLIFIED PROBE TECHNIQUE
LEGIONELLA PNEUMOPHILA, QUANTIFICATION
MYCOBACTERIA SPECIES,DNA, DIRECT PROBE
MYCOBACTERIA SPECIES AMPLIFIED PROBE TECHNIQUE
MYCOBACTERIA SPECIES, DNA, QUANTIFICATION
MYCOBACTERIA TUBERCULOSIS, DIRECT PROBE
MYCOBACTERIA TUBERCULOSIS, AMPLIFIED PROBE TECHNIQUE
MYCOBACTERIA TUBERCULOSIS, QUANTIFICATION
MYCOBACTERIA AVIUM-INTRACELLULARE, DIRECT PROBE TECHNIQUE
MYCOBACTERIA AVIUM-INTRACELLULARE, AMPLIFIED PROBE TECHNIQUE
MYCOBACTERIA AVIUM-INTRACELLULARE, QUANTIFICATION
MYCOPLASMA PNEUMONIAE, DIRECT PROBE
MYCOPLASMA PNEUMONIAE, AMPLIFIED PROBE TECHNIQUE
MYCOPLASMA PNEUMONIAE, QUANTIFICATION
NIESSERIA GONORRHOEAE, DIRECT PROBE TECHNIQUE
NEISSERIA GONORRHOEAE, AMPLIFIED PROBE TECHNIQUE
NEISERIA GONORRHOEAE, QUANTIFICATION
PAPILLOMAVIRUS, HUMAN DIRECT PROBE TECHNIQUE
PAPILLOMAVIRUS, HUMAN, AMPLIFIED PROBE TECHNIQUE
PAPILLOMAVIRUS, HUMAN, QUANTIFICATION
INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA);
INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA)
STREPTOCOCCUS, GROUP A, DIRECT PROBE TECHNIQUE
STREPTOCCOCUS, GROUP A, AMPLIFIED PROBE TECHNIQUE
STREPTOCOCCUS, GROUP A, QUANTIFICATION
INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); GROUP B
INFECTIOUS AGENT DET BY NUCLEIC ACID. TRICH, VAGINALIS DIRECT PROBE TECH
INFECTIOUS AGENT DETECTION-NUCLEIC ACID, NOS, DIRECT PROBE TECHNIQUE
INFECTIOUS AGENT DETECTION-NUCLEIC ACID,NOS, AMPLIFIED PROBE TECHNIQUE
INFECTIOUS AGENT DETECTION-NUCLEIC ACID, NOS, QUANTIFICATION
INFECTIOUS AGENT DETECTION BY NUCLEIC ACID, MULTIPLE ORGANISMS, DIRECT PROBE(S)
INFECTIOUS AGENT DETECTION BY NUCLEIC ACID; AMPLIFIED PROBE(S) TECHNIQUE
STREP DETECTION IMMUNOASSAY DETECTION WITH OPTIC
CLOSTRIDIUM DIFFICILE TOXIN A IMMUNOASSAY DETECTION WITH OPTIC
INFLUENZA IMMUNOASSAY DETECTION WITH OPTIC
INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOASSAY W/ DIRECT OPTICAL OBSERVATION
INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOASSAY W/DIRECT OPTICAL OBSERV;
INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOASSAY W/DIRECT OPTICAL OBSER
INFECTIOUS AGENT DETECTION-IMMUNOASSAY W/DIRECT OPTICAL OBSER CHLAMYDIA TRACHOMA
NEISSERIA GONORRHOEAE W/OPTICAL OBSERVATIONS; INFECTIOUS AGENT DETECT.-IMMUNOASS
STREPTOCOCCUS A W/OPTICAL OBERSERVATION; INFECTIOUS AGENT DETECT.-IMMUNOASSAY
INFECT.AG.DETECT, NOS, W/OPTICAL OBSERVATION-BY IMMUNOASSAY
INFECTIOUS AGENT DRUG SUSCEPTIBILITY
INFECTIOUS AGENT GENOTYPE ANALYSIS BY NUCLEIC ACID, HIV 1 TRANSCRIPTASE/PROTEASE
HEPATITIS C VIRUS GENOTYPE ANALYSIS
PHENOTYPE BY DNA/RNA, HIV 1
PHENOTYPE BY DNA/RNA, HIV 1 (ADD-ON)
INFECTIOUS AGENT ENZYMATIC ACTIVITY OTH VIRUS (EG, SIALIDASE ACTIV/VAG FLUID)
UNLISTED MICROBIOLOGY TEST
CYTOPATHOLOGY
CYTOPATHOLOGY
CYTOPATHOLOGY
CYTOPATHOLOGY, CONCENTRATION TECHNIQUE SMEAR INTERP
CYTOPATHOLOGY, SELECTIVE CELLULAR ENHANCEMENT TECHNIQUE W/ INTERPRETATION
CYTOPATHOLOGY
BARR BODIES TEST
DRUMSTICKS TEST
CYTOPATHOLOGY, CERVICAL OR VAGINAL W/INTERPRETATION ONLY (ADD-ON)
CYTOPATHOLOGY, CERVICAL/VAGINAL. AUTOMATED THIN LAYER PREP. BY SUPERVISED TECH
CYTOPATHOLOGY CERVIC VAGINAL-MANUAL SCREEN & RESCREEN-PHYSICIAN SUPERVISION
CYTOPATHOLOGY SMEARS; CERVIC VAGINAL SCRN BY AUTOMATED SYSTEM; PHYS SUPERVISION
CYTOPATHOLOGY SMEARS CERVIC VAGINAL SCREEN AUTO SYS PHY SUPERVISION
PAPANICOLAOU SMEAR
CYTOPATHOLOGY SMEARS-UP TO 3, MANUAL TECH.SCREENING & AUTO RESCREENS-SUPERVISED
CYTOPATHOLOGY SLIDES W/MANUAL SCREENING/RESCREENING UNDER PHYSICIAN SUPERVISION
CYTOPATHOLOGY SLIDES; W/MANUAL SCREENING/COMPUTER ASSIST RESCREENING
SMEARS (ADD-ON)
SMEARS
CYTOPATHOGY, ANY OTHER SOURCE, PREP, SCREEN/INTERP
EXTENDED STUDY INVOLVING OVER 5 SLIDES AND/ORAMU
CYTOPATHOLOGY SLIDES; MANUAL SCREENING UNDER PHYSICIAN SUPERVISION
CYTOPATHOLOGY SLIDES; W/MANUAL SCREENING/RESCREENING UNDER PHYSICIAN SUPERVIS
CYTOPATHOLOGY SLIDES; W/MANUAL SCREENING/COMPUTER ASSISTED RESCREENING
CYTOPATHOLOGY SLIDES; W/MANUAL SCREENING/COMPUTER ASSISTED RESCREENING
EVALUATION NEEDLE ASPIRATE W/WO PREP OF SMEARS
INTERP & REPORT
CYTOPATHOLOGY, CERVICAL OR VAGINAL COLLECTED IN PRESERVATIVE FLUID AUTOMATED THI
WITH SCREENING BY AUTOMATED SYSTEM & MANUAL RESCREENING UNDER PHYSICIAN SUPERVIS
FLOW CYTOMETRY; CELL CYCLE OR DNA ANALYSIS
FLOW CYTOMETRY, CELL SURFACE, SYTOPLASMIC, OR NUCLEAR MARKER - FIRST
FLOW CYTOMETRY, CELL SURFACE, CYTOPLASMIC, OR NUCLEAR MARKER,TECH COMP,EA ADDTL
FLOW CYTOMETRY, INTERPRETATION; 2 TO 8 MARKERS
FLOW CYTOMETRY, INTERPRETATION; 9-15 MARKERS
FLOW CYTOMETRY, INTERPRETATION, 16 OR MORE MARKERS
UNLISTED CYTOPATHOLOGY TEST
TISSUE CULTURE FOR CHROMOSOME ANALYSIS
TISSUE CULTURE CHROMOSOME ANALYSIS SKIN/SOLID TISS
TISSUE CULTURE FOR CHROMOSOME ANALYSIS, AMNIOTIC
BONE MARROW (MYLOID) CELLS
TISSUE CULTURE FOR CHROMOSOME ANALYSIS; OTHER TISS
CRYOPRESERVATION FREEZING STORAGE CELLS EACH CELL LINE
THAWING AND EXPANSION OF FROZEN CELLS; EACH ALIQUOT
CHROMOSOME ANALYSIS FOR BREAKAGE SYNDROMES SCORE 2
CHROMOSONE ANALYSIS SCORE 100 CELLS COUNT 20 CELLS
CHROMOSOME ANALYSIS FOR BREAKAGE SYNDROME SCORE 100 CELLS CLASTOGEN STRESS
CHROMOSOME ANALYSIS
CHROMOSOME ANALYSIS
CHROMOSOME ANALYSIS;COUNT 45 CELLS FOR MOSAICISM
CHROMOSOME ANALYSIS ANALYZE 20-25 CELLS
CHROMOSOME ANALYSIS
CHROMOSOME ANALYSIS IN SITU FOR AMNIOTIC FLUID CEL
MOLECULAR CYTOGENETICS DNA PROBE; EACH
MOLECULAR CYTOGENETICS CHROMOSOMAL IN SITU HYBRIDIZATION ANALYZE 3-5 CELLS
MOLECULAR CYTOGENETICS CHROMOSOMAL IN SITU HYBRIDIZATION ANALYZE 10-30 CELLS
MOLECULAR CYTOGENETICS INTERPHASE IN SITU HYBRIDIZATION 25-99 CELLS
MOLECULAR CYTOGENETICS INTERPHASE IN SITU HYBRIDIZATION ANALYZE 100-300 CELLS
CHROMOSOME ANALYSIS
CHROMOSOME ANALYSIS ADD SPEC BANDING TECHNIQUE NOR
CHROMOSOME ANALYSIS
CHROMOSOME ANALYSIS ADDITIONAL HIGH RESOLUTION STU
CYTOGENETICS & MOLECULAR CYTOGENETICS INTERPRETATION & REPORT
UNLISTED CYTOGENIC TEST
GROSS EXAMINATION
GROSS/MICROSCOPIC EXAM
GROSS/MICROSCOPIC EXAM
GROSS/MICROSCOPIC EXAM
GROSS/MICROSCOPIC EXAM
GROSS/MICROSCOPIC EXAM
GROSS/MICROSCOPIC EXAM (ADD-ON)
STAINS, SPECIAL (ADD-ON)
STAINS, SPECIAL (ADD-ON)
HISTOCHEMICAL STAINING WITH FROZEN SECTION (ADD-ON)
DETERMINATIVE HISTOCHEMISTRY FOR CHEMICAL ELEMENTS
DETERMINATIVE HISTOCHEMISTRY TO IDENTIFY ENZYMES
CONSULTATION, PATHOLOGY
CONSULTATION, PATHOLOGY
CONSULTATION, PATHOLOGY
CONSULTATION, PATHOLOGY
PATH CONSULT DURING SURGERY; 1ST TISSUE BLOCK, W/ FROZEN SECTION, ONE SPECIMEN
PATH CONSULT DURING SURGERY; EA ADDITIONAL TISSUE BLOCK W/ FROZEN SECTION(S)
PATHOLOGY CONSULTATION DURING SURGERY, INITIAL SITE
PATHOLOGY CONSULTATION DURING SURGERY, EACH ADDITIONAL SITE
IMMUNOCYTHOCHEMISTRY, EACH ANTIBODY
IMMUNOFLUORESCENT STUDY, EACH ANTIBODY, DIRECT METHOD
IMMUNOGLUORESCENT STUDY, EACH ANTIBODY; INDIRECT METHOD
ELECTRON MICROSCOPY
ELECTRON MICROSCOPY
MORPHOMETRIC ANALYSIS SKELATAL MUSCLE
MORPHOMETRIC ANYALYSIS; NERVE
ANALYSIS TUMOR
MORPHOMETRIC ANALYSIS,TUMOR IMMUNOHISTOCHEMISTRY,QUANTITATIVE OR SEMI,EA ANTI
MORPHOMETRIC ANALYSIS USING COMPUTER-ASSISTED TECHNOLOGY
NERVE TEASING PREPARATIONS
IN SITU HYBRIDIZATION EG FISH EACH PROBE
MORPHOMETRIC ANALYSIS, IN SITU HYBRIDIZATION, EACH PROBE, USING COMP ASSIST TECH
MORPHOMETRIC ANALYSIS IN SITU HYBRIDIZATION, EACH PROBE; MANUAL
PROTEIN ANALYSIS BY WESTERN BLOT,INTERP & REPORT
PROTEIN ANALYSIS,INTERP & RPT;PROBE FOR BAND ID,EA
MICRODISSECTION (EG, MECHANICAL, LASER CAPTURE)
MICRODISSECTION (IE, SAMPLE PREP OF MICROSCOPICALLY IDENTIFIED TARGET); MANUAL
ARRAY-BASED EVALUATION OF MULTIPLE MOLECULAR PROBES, 11-50 PROBES
ARRAY-BASED EVALUATION OF MULTIPLE MOLECULAR PROBES, 51-250 PROBES
ARRAY-BASED EVALUATION OF MULTIPLE MOLECULAR PROBES, 251-500 PROBES
MACROSCOPIC EXAMINATION, DISSECTION, AND PREPARATION OF TISSUE FOR NON
IN CONJUNCTION W A TOUCH IMPRINT, INTRAOPERAT CONSULT OR FROZEN SECTION SP
UNLISTED SURGICAL PATH TEST
BILIRUBIN, TOTAL, TRANSCUTANEOUS
HEMOGLOBIN (HGB), QUANTITIVE, TRANSCUTANEOUS
HEMOGLOBIN, QUANTITATIVE, TRANSCUTANEOUS, PER DAY; CARBOXYHEMOGLOBIN
METHEMOGLOBIN
CAFFEINE HALOTHANE CONTRACTURE TEST
CELL COUNT, OTHER THAN BLOOD
CELL COUNT, OTHER THAN BLOOD
LEUKOCYTE COUNT, FECAL
CRYSTAL ID BY COMPENSATING POLARIZED LENS ANALYSIS
DUODENAL INTUBATION/ASPIRATION
DUODENAL INTUBATION/ASPIRATION
STAINS
GASTRIC INTUBATION/ASPIRATION
GASTRIC INTUBATION/ASPIRATION
GASTRIC INTUBATION/ASPIRATION
GASTRIC INTUBATION/ASPIRATION
GASTRIC INTUBATION, ASPIRATION, & FUNCTION COLLECT
GASTRIC INTUBATION/ASPIRATION
MEAT FIBERS TEST, FECES
EOSINOPHILS, NASAL SECRETIONS, SPUTUM, ETC
SPUTUM, OBTAINING SPECIMEN, AEROSOL INDUCED TECHNIQUE
STARCH GRANULES, FECES
SWEAT COLLECTION BY IONTOPHORESIS
WATER LOAD TEST
SEMEN ANALYSIS; PRESENSE AND/OR MOTILITY OF SPERM
UNLISTED REPRODUCTIVE MEDICINE LABORATORY PROCEDURE
IMMUNE GLOBULIN HUMAN FOR INTRAMUSCULAR USE
IMMUNE GLOBULIN IGIV HUMAN FOR INTRAVENOUS USE
IMMUNE GLOBULIN , HUMAN, FOR USE IN SUBCUTANEOUS INFUSIONS, 100 MG, EA
BOTULINUM ANTITOXIN EQUINE ANY ROUTE
BOTULISM IMMUNE GLOBULIN HUMAN FOR INTRAVENOUS USE
CYTOMEGALOVIRUS IMMUNE GLOBULIN, HUMAN FOR INTRAVENOUS USE
DIPHTHERIA ANTITOXIN, EQUINE, ANY ROUTE
HEPATITIS B IMMUNE GLOBULIN, HUMAN FOR INTRAMUSCULAR USE
RABIES IMMUNE GLOBULIN, HUMAN FOR INTRAMUSCULAR AND/OR SUBCUTANEOUS USE
RABIES IMMUNE GLOBULIN, HEAT-TREATED, HUMAN FOR INTRAMUSCULAR &/OR SUBCUTANEOUS
SYNAGIS 50 MG, RESPIRATORY SYNCTIAL VIRUS IMM.GLOB.NDC 60574411401
RHO IMMUNE GLOBULIN, HUMAN FULL DOSE FOR INTRAMUSCULAR USE
RHO IMMUNE GLOBULIN, HUMAN MINI DOSE FOR INTRAMUSCULAR USE
RHO IMMUNE GLOBULIN, HUMAN FOR INTRAVENOUS USE
TETANUS IMMUNE GLOBULIN, HUMAN FOR INTRAMUSCULAR USE
VACCINIA IMMUNE GLOBULIN, HUMAN FOR INTRAMUSCULAR USE
VARICELLA ZOSTER IMMUNE GLOBULIN, HUMAN FOR INTRAMUSCULAR USE
UNLISTED IMMUNE GLOBULIN
IMMUNIZATION ADMINISTRATION, UNDER 8 YRS OF AGE, INCL PHYS COUNS, 1ST INJECT/DAY
IMMUNIZATION ADMINISTRATION,UNDER 8 YRS OF AGE,INCL PHYS COUNS,EA ADD INJEC/DAY
IMMUNIZATION ADMINISTRATION UNDER AGE 8, INCL PHYS COUNSL, 1ST ADMIN, PER DAY
IMMUNIZATION ADMINISTRATION UNDER AGE 8 YEARS; INCL PHYS COUNS,EA ADDTL, PER DAY
IMMUNIZATION ADMINISTRATION, FIRST VACCINE. SINGLE OR COMBINATION VACCINE/TOXOID
IMMUNIZATION ADMINISTRATION; EACH ADDITIONAL VACCINE (SNGL OR COMBO VACC/TOXOID)
ONE VACCINE ADMINISTRATION; INTRANASAL OR ORAL
IMMUNIZATION ADMINISTRATION; EACH ADDITIONAL VACCINE, INTRANASAL OR ORAL
ADENOVIRUS VACCINE TYPE 4, LIVE FOR ORAL USE
ADENOVIRUS VACCINE TYPE 7, LIVE FOR ORAL USE
INTRACUTANEOUS TESTS W/ALLERGENIC EXTRACTS PER EAC
ANTHRAX VACCINE FOR SUBCUTANEOUS USE
BACILLUS CALMETTE-GUERIN VACCINE FOR TUBERCULOSIS, LIVE, PERCUTANEOUS USE
BACILLUS CALMETTE-GUERIN VACCINE FOR BLADDER CANCER, LIVE FOR INTRAVESICAL USE
HEPATITIS A VACCINE, ADULT DOSAGE FOR INTRAMUSCULAR USE
HEPATITIS A VACCINE, PEDIATRIC/ADOLESCENT DOSAGE 2 DOSE SCH, INTRAMUSCULAR USE
HEPATITIS A VACCINE, PEDIATRIC/ADOLESCENT DOSAGE 3 DOSE SCH, INTRAMUSCULAR USE
HEPATITIS A HEPATITIS B VACCINE, ADULT DOSAGE IM/USE < TWIN RX
HEMOPHILUS INFLUENZA B VACCINE HBOC CONJUGATE 4 DOSE SCH FOR INTRAMUSCULAR USE
HEMOPHILUS INFLUENZA B VACCINE PRP-D CONJUGATE BOOSTER ONLY
HEMOPHILUS INFLUENZA B VACCINE PRP-OMP CONJUGATE 3 DOSE SCH INTRAMUSCULAR
HEMOPHILUS INFLUENZA B VACCINE PRP-T CONJUGATE 4 DOSE SCH INTRAMUSCULAR
HUMAN PAPILLOMA VACCINE (HPV), TYPES 6, 11, 16, 18. 3 DOSE SCHEDULE FOR IM USE
INFLUENZA VIRUS VACCINE CHILDREN 6-35 MONTHS OF AGE FOR IM USE
INFLUENZA VIRUS VACCINE, SPLIT VIRUS PRESERVATIVE FREE FOR 3 YEARS & ABOVE
INFLUENZA VIRUS VACCINE SPLIT VIRUS 6-35 MONTH DOSAGE INTRAMUSCULAR OR JET INJEC
INFLUENZA VIRUS VACCINE SPLIT VIRUS 3 YRS & ABOVE DOSAGE INTRAMUSC OR JET INJECT
INFLUENZA VIRUS VACCINE, LIVE FOR INTRANASAL USE
LYME DISEASE VACCINE, ADULT DOSAGE INTRAMUSCULAR USE
PNEUMOCOCCAL CONJUGATE VACCINE, POLYVALENT. INTRAMUSCULAR; PREVNAR
RABIES VACCINE FOR INTRAMUSCULAR USE
RABIES VACCINE FOR INTRADERMAL USE
ROTAVIRUS VACCINE INACTIVATED PENTAVALENT 3 DOSE SCHEDULE LIVE FOR ORAL USE
ROTAVIRUS VACCINE, HUMAN, ATTENUATED, 2 DOSE SCHEDULE, LIVE FOR ORAL USE
TYPHOID VACCINE, LIVE, ORAL
TYPHOID VACCINE VI CAPSULAR POLYSACCHARIDE FOR INTRAMUSCULAR USE
TYPHOID VACCINE HEAT & PHENOL INACTIVATED H-P FOR SUBCUTANEOUS /INTRADERMAL/
TYPHOID VACCINE ACETON-KILLED & DRIED FOR SUBCUTANEOUS OR JET INJECTION USE
INACTIVE (DTAP-IPV), WHEN ADMINISTERED TO CHILDREN 4- 6 YEARS OF AGE, FOR IM USE
DIPHTHERIA, TETANUS TOXOIDS,VACCINE (DTaP-Hib-IPV), FOR IM USE
D.P. AND ACELLULAR PERTUSIS VACCINE, AGE 7 OR LESS
DPT OR DTP VACCINE
DT TOXOID INJ
TETANUS TOXOID
MUMPS VACCINE
MEASLES VACCINE
RUBELLA VACCINE
MMR VACCINE
MEASLES AND RUBELLA VACCINE
ORAL POLIO VACCINE
POLIOVIRUS VACCINE INACTIVATED (IPV) FOR SUBCUTANEOUS OR INTRAMUSCULAR USE
TETANUS & DIPTHERIA TOXOIDS ABSORBED PRESERVE FREE 7YRS/OLDER FOR IM USE
TETANUS AND DIPTHERIA TOXOIDS & ACELLULAR PERTUSSIS VACCINE 7 YRS/OLDER
IMMUNIZATION, ACTIVE; VARICELLA (CHICKEN POX)
YELLOW FEVER VACCINE
TETANUS AND DIPHTHERIA TOXOIDS ADULT USE TD
DIPHTHERIA TOXOID
D.T.P. AND HIB VACCINE
IMMUNIZATION, ACTIVE; DTAP AND HIB VACCINE
DIPTHERIA TETANUS, ACELLULAR PERTUSIS HEPATITUS B, POLIO HEPB-IPV INTRAMUSCULAR
CHOLERA VACCINE
PLAGUE VACCINE
PNEUMOCOCCAL POLYVALENT PNEUMOVAX PNU-IMMUNE
MENINGOCOCCAL POLYSACCHARDE VACCINE - ANY GROUP(S)
MENINGOCOCCAL CONJUGATE VACCINE, SEROGROUPS A, C, Y, AND W-135 (TETRAVALENT)
ENCEPHALITIS VACCINE
ZOSTER (SHINGLES) VACCINE LIVE FOR SUBCUTANEOUS INJECTION
JAPANESE ENCEPHALITIS VIRUS VACCINE, INACTIVATED, FOR INTRAMUSCULAR USE
HEPATITIS B VACCINE DIALYSIS OR IMMUNOSUPPRESSED PATIENT DSG-3 DOSE SCHEDULE
HEPATITIS B VACCINE ADOLESENT 2 DOSE SCHEDULE FOR INTRAMUSCULAR USE
IMMUNIZATION,ACTIVE, HEPATITUS B VAC-NEWBORN-11YRS
IMMUNIZATION,ACTIVE-HEPATITUS B VAC-20 YRS & ABOVE
IMMUNIZATION ACTIVE HEPATITUS B, ANY DIALYSIS,IMMU
IMMUNIZATION, ACTIVE, HEPATITIS B AND HEMOPHILUS INFLUENZA B (HB) VACCINE
UNLISTED IMMUNIZATION PROCEDURE
PSYCHIATRIC DIAGNOSTIC INTERVIEW EXAM
INTERACTIVE PSYCHIATRIC DIAGNOSTIC INTERVIEW EXAM
INDIVIDUAL PSYCHOTHERAPY, INSIGHT ORIENTED, 20-30 MINUTES
INDIVIDUAL PSYCHOTHERAPY INSIGHT ORIENTED, 20-30 MINUTES WITH E/M SERVICES
INDIVIDUAL PSYCHOTHERAPY INSIGHT ORIENTED, 45-50 MINUTES
INDIVIDUAL PSYCHOTHERAPY, INSIGHT ORIENTED, 45-50 MINUTES WITH E/M SERVICES
INDIVIDUAL PSYCHOTHERAPY, INSIGHT ORIENTED, 75-80 MINUTES FACE TO FACE WITH PT
INDIVIDUAL PSYCHOTHERAPY INSIGHT ORIENTED, 75-80 MINUTES WITH E/M SERVICES
INDIVIDUAL PSYCHOTHERAPY USING PLAY EQUIPMENT, 20-30 MINUTES FACE TO FACE
INDIVIDUAL PSYCHOTHERAPY, USING PLAY EQUIPMENT, 20-30 MINUTES, WITH E/M SERVICES
INDIVIDUAL PHYCHOTHERAPY, USING PLAY EQUIPMENT, 45-50 MINUTES FACE-TO-FACE W PT
INDIVIDUAL PSYCHOTHERAPY, USING PLAY EQUIPMENT, 45-50 MINUTES, WITH E/M SERVICES
INDIVIDUAL PSYCHOTHERAPY, USING PLAY EQUIPMENT, 75-80 MINUTES FACE-TO-FACE
INDIVIDUAL PSYCHOTHERAPY, USING PLAY EQUIPMENT, 75-80 MINUTES, WITH E/M SERVICES
INDIVIDUAL PSYCHOTHERAPY, INSIGHT ORIENTED, 20-30 MINUTES
INDIVIDUAL PSYCHOTHERAPY, INSIGHT ORIENTED, 20-30 MINUTES, WITH E/M SERVICES
INDIVIDUAL PSYCHOTHERAPY, INSIGHT ORIENTED, 45-50 MINUTES
INDIVIDUAL PSYCHOTHERAPY, INSIGHT ORIENTED, 45-50 MINUTES, WITH E/M SERVICES
INDIVIDUAL PSYCHOTHERAPY, INSIGHT ORIENTED, 75-80 MINUTES
INDIVIDUAL PSYCHOTHERAPY, INSIGHT ORIENTED, 75-80 MINUTES, WITH E/M SERVICES
INDIVIDUAL PSYCHOTHERAPY, USING PLAY EQUIPMENT, 20-30 MINUTES
INDIVIDUAL PSYCHOTHERAPY, USING PLAY EQUIPMENT, 20-30 MINUTES, WITH E/M SERVICES
INDIVIDUAL PSYCHOTHERAPY, USING PLAY EQUIPMENT, 45-50 MINUTES
INDIVIDUAL PSYCHOTHERAPY, USING PLAY EQUIPMENT, 45-50 MINUTES, WITH E/M SERVICES
INDIVIDUAL PSYCHOTHERAPY, USING PLAY EQUIPMENT, 75-80 MINUTES
INDIVIDUAL PSYCHOTHERAPY, USING PLAY EQUIPMENT, 75-80 MINUTES, WITH E/M SERVICES
MEDICAL PSYCHOANALYSIS
FAMILY PSYCHOTHERAPY - WITHOUT THE PATIENT PRESENT
FAMILY PSYCHOTHERAPY (CONJOINT PSYCHOTERAPY) W/PT PRESENT
MULTIPLE-FAMILY GROUP MEDICAL PSYCHOTHERAPY
GROUP MEDICAL PSYCHOTHERAPY (NOT MULTIPLE-FAMILY)
INTERACTIVE GP MEDICAL PSYCHOTHERAPY - ONE SESSION
PHARMACOLOGIC MANAGE INCL PRESC, USE, AND REVIEW OF MEDS WITH MINIMAL MED PSYCH
NARCOSYNTHESIS FOR PSYCHIATRIC DIAGNOSTIC AND THERAPEUTIC PURPOSES
ELECTROCONVULSIVE THERAPY
HYPNOTHERAPY - 25-30 MINUTES
PSYCHIATRIC EVAL OF HOSPITAL RECORDS AND OTHER FOR MEDICAL DIAGNOSTIC PURPOSES
INTERP OR EXPLAIN RESULTS OF TESTS TO RESP PERSONS
PREP OF REPORT OF PT'S PSYCH STATUS FOR INSURANCE
UNLISTED PSYCHIATRIC SERVICE
HEMODIALYSIS PROCEDURE
HEMODIALYSIS REPEAT EVALS
HEMODIALYSIS ACCESS FLOW
DIALYSIS PROCEDURE OTHER THAN HEMODIALYSIS
DIALYSIS OTHER THAN HEMODIALYSIS, REPEATED EVALS
ESRD RELATED SVS MNTHLY < 2 YEARS OF AGE W/MONITORING 4+FACE TO FACE
WITH 2-3 FACE-TO-FACE PHYSICIAN VISITS PER MONTH
WITH 1 FACE-TO-FACE PHYSICIAN VISIT PER MONTH
ESRD SVS MNTHLY 2-11 YRS W/MONITORING 4 OR MORE FACE-TO-FACE PHYS VISITS
WITH 2-3 FACE-TO-FACE PHYSICIAN VISITS PER MONTH
WITH 1 FACE-TO-FACE PHYSICIAN VISIT PER MONTH
ESRD SVS MNTHLY 12-19 YRS W/MONITORING 4 OR MORE FACE-TO-FACE PHYS VISITS
WITH 2-3 FACE-TO-FACE PHYSICIAN VISITS PER MONTH
WITH 1 FACE-TO-FACE PHYSICIAN VISIT PER MONTH
ESRD SVS MNTHLY 20 YRS W/MONITORING 4 OR MORE FACE-TO-FACE PHYS VISITS
WITH 2-3 FACE-TO-FACE PHYSICIAN VISITS PER MONTH
WITH 1 FACE-TO-FACE PHYSICIAN VISIT PER MONTH
ESRD RELATED SVS FOR HOME DIALYSIS PER FULL MONTH, FOR PTS <2 YRS OF AGE
ESRD RLTED SVS FOR HOME DIAL PER FULL MONTH, FOR PTS 2-11 YRS OF AGE
ESRD RELATED SVS FOR HOME DIALYSIS PER FULL MONTH, FOR PTS 12-19 YRS OF AGE
ESRD RELATED SVS FOR HOME DIALYSIS PER FULL MONTH, FOR PTS 20 YRS OF AGE
ESRD RELATED SVS FOR HOME DIAL LESS THAN FULL MONTH, FOR PTS <2 YRS OF AGE
FOR PATIENTS 2-11 YEARS OF AGE
FOR PATIENTS 12-19 YEARS OF AGE
FOR PATIENTS 20 YEARS OF AGE AND OLDER
DIALYSIS TRAINING,. PATIENT I.E. HELPER ANY MODE
DIALYSIS TRAINING PATIENT PER TRAINING SESSION
UNLISTED DIALYSIS PROCEDURE
ESOPHAGEAL INTUBATION
ESOPHAGEAL MOTILITY STUDY
ESOPHAGEAL MOTILITY STUDY
ESOPHAGEAL MOTILITY STUDY
ESOPHAGOGASTRIC MONOMETRIC STUDIES
DUODENAL MOTILITY STUDY
ESOPHAGUS ACID TEST
ESOPHAGUS,GASTROESOPHAGEAL REFLUX TEST,W/ NASAL CATH PLCMNT,RECORD,ANAL & INTER
ESOPHAGUS, GASTROESOPHAGEAL REFLUX TEST; W/ MUCOSAL ATTACHED TELEMETRY PH ELEC
ESOPHAGEAL FUNCTION TEST, GASTROESOPHAGEAL REFLUX TEST W/ NASAL CATHETER PLCMNT
ESOPHAGEAL FUNCTION TEST, GASTROESOPHAGEAL REFLUX TEST; > 1 HR UP TO 24
ESOPHAGEAL BALLOON DISTENSION PROVOCATION STUDY
GASTRIC ANALYSIS
GASTRIC ANALYSIS
BREATH HYDROGEN TEST FRUCTOSE INTOLERANCE BACTERIAL OVERGROWTH ORO-CECAL GASTROI
GASTRIC INTUBATION
GASTROINTERSINAL TRACT IMAGING, INTRALUMINAL
GASTROINTESTINAL TRACT IMAGING
RECTAL SENSATION, TONE,& COMPLIANCE TEST (IE RESPONSE TO GRADED BALLOON DIST)
ANORECTAL MANOMETRY
PULSED IRRIGATION OF FECAL IMPACTION
ELECTROGASTROGRAPHY; DIAGNOSTIC TRANSCUTANEOUS
ELECTROGASTROGRAPHY; DIAGNOSTIC TRANSCUTANEOUS WITH PROVALATIVE TESTING
UNLISTED DX GASTROENTEROLOGY PROCEDURE
OPTHALMOLOGICAL SERVICES:MEDICAL EXAM/EVAL W/DIAGNOSTIC/TREATMENT PRGM;NEW PATIE
OPTHALMOLOGICAL SERVICES;COMPREHENSIVE,NEW PATIENT,ONE OR MORE VISITS
OPTHALMOLOGICAL SERVICES:MED EXAM/EVAL,W/DIAGNOSTIC/TREATMENT PRGM;ESTBLSHD PAT
OPTHALMOLOGICAL SERVICES;COMPREHENSIVE,ESTABLISHED PAT, ONE OR MORE VISITS
DETERMINATION OF REFRACTIVE STATE
OPTHALMOLOGICAL EXAM/EVAL UNDER GEN ANESTH.W/ OR W/O GLOBE MANIPULATION;COMPLETE
OPTHALMOLOGICAL EXAM/EVAL UNDER GEN ANESTH.W/ OR W/O GLOBE MANIPULATION;LIMITED
GONIOSCOPY (SP)
COMPUTERIZED CORNEAL TOPOGRAPHY UNILATERAL OR BILATERAL
SENSORIMOTOR EXAM W/MULTIPLE MEASUREMENTS OF OCULAR DEVIATION (SP)
ORTHOPTIC/PLEOPTIC TRAINING W/CONTINUING MEDICAL DIRECTION AND EVAL
FITTING CONTACT LENS, TX OF DISEASE; INCLUDING SUPPLY OF LENSE-MOD 50=PAYS 100%
VISUAL FIELD EXAMINATION;UNILATERAL OR BILATERAL;W/INTERP.&REPORT;LIMITED
VISUAL FIELD EXAMINATION;UNILATERAL OR BILATERAL;W/INTERP.&REPORT;INTERMEDIATE
VISUAL FIELD EXAMINATION;UNILATERAL OR BILATERAL;W/INTERP.&REPORT;EXTENDED
SERIAL TONOMETRY W/INTERPRETATION/REPORT-SAME DAY (SP)
TONOGRAPHY W/INTERP.&REPORT;RECORDING INDENTATION TONOMETER OR PERILIMBAL METHOD
TONOGRAPHY W/WATER PROVOCATION
SCANNING COMPUTERIZED OPHTHALMIC DIAGNOSTIC IMAGING W/REPORT, UNILATERAL
OPTHALMIC BIOMETRY BY PARTIAL COHERANCE INTERFEROMETRY
GLAUCOMA, PROVOCATIVE TEST, W/O TONOGRAPHY
OPHTHALMOSCOPY, EXT.W/RETINAL DRAWING, W/INTERP & REPORT,INITL-MOD 50 PAYS 100%
OPTHALMOSCOPY, EXT.W/RETINAL DRAW, W/INTERP & REPORT,SUBSEQNT-MOD 50 PAYS 100%
FLOURECEIN ANGIOSCOPY W/INTER/REPORT
FLOURESCEIN ANGIOGRAPHY (MULTI/IMAG); W/INTERP & REPORT-MOD 50 PAYS 100%
INDOCYANINE-GREEN ANGIOGRAPHY W/INTER & REPORT
FUNDUS PHOTOGRAPHY WITH INTERPRETATION AND REPORT
OPTHALMODYNAMOMETRY
OCULOELECTROMYOGRAPHY;1 OR MORE EXTRAOCULAR MUSCLS;1 OR BOTH EYES;W/INTER & REPO
ELECTROOCULOGRAPHY WITH INTERPRETATION AND REPORT
ELECTRORETINOGRAPHY WITH INTERPRETATION AND REPORT
COLOR VISION EXAMINATION, EXTENDED, ANOMALOSCOPE OR EQUIVALENT
DARK ADAPTATION EXAMINATION WITH INTERPRETATION AND REPORT
EXTERNAL OCULAR PHOTOGRAPHY FOR DOCUMENTATION OF MEDICAL PROGRESS
SPECIAL ANTERIOR SEGMENT PHOTOGRAPHY;W/INTERP&REPORT;W/SPECULAR ENDOTHELIAL MICR
ANTERIOR SEGMENT PHOTOGRAPHY W/FLUORESCEIN ANGIOGRAPHY
CONTACT LENSES, PERSCRIPTION & FITTING;W/MEDC SUPERV;CORNEAL LENS;BOTH EYES;
CONTACT LENSES, RX AND FITTING;W/MED SUPERV;CORNEAL LENS FOR APHAKIA,ONE EYE
CONTACT LENS: RX & FITTING;W/MED SUPERV;CORNEAL LENS FOR APHAKIA,BOTH EYES
CONTACT LENSES, RX & FITTING;W/MED SUPERV;CORNEOSCLERAL LENS
CONTACT LENSES, FITTING BY TECH;CORNEAL LENS, BOTH EYES EXCEPT FOR APHAKIA
CONTACT LENSES, FITTING BY TECH;CORNEAL LENS FOR APHAKIA, ONE EYE
CONTACT LENS: FITTING BY TECH;CORNEAL LENS FOR APHAKIA, BOTH EYES
CONTACT LENSES, FITTING BY TECH; CORNEOSCLERAL LENS.
FITTING OF SPECTACLES;EXCEPT FOR APHAKIA,MONOFOCAL
FITTING OF SPECTACLES;EXCEPT FOR APHAKIA; BIFOCAL
SPECTACLES FITTING;EXCEPT FOR APHAKIA;MULITFOCAL OTHER THAN BIFOCAL
FITTING OF SPECTACLE PROSTHESIS FOR APHAKIA; MONOFOCAL
FITTING OF SPECTACLE PROSTHESIS FOR APHAKIA; MULTIFOCAL
FITTING OF SPECTACLE MOUNTED LOW VISION AID; SINGLE ELEMENT SYSTEM
FITTING OF SPECTACLE MOUNTED LOW VISION AID ;TELESCOPIC OR OTHER COMPOUND SYST.
PROSTHESIS SERVICE FOR APHAKIA, TEMP (DISPOSABLE OR LOAN, INCLD MATERIALS)
REPAIR/REFIT SPECTACLES;EXCEPT FOR APHAKIA;
SPECTACLE PROSHESIS FOR APHAKIA; REPAIR/REFIT
UNLISTED OPHTHALMOLOGICAL SERVICE OR PROCEDURE
OTOLARYNOLOGIC EXAM UNDER GENERAL ANESTHESIA
BINOCULAR MICROSCOPY
MEDICAL EVALUATION SPEECH LANGUAGE AND/OR HEAR PRO
LANGUAGE THERAPY
NASOPHARYNGOSCOPY
NASAL FUNCTION STUDIES
FACIAL NERVE FUNCTION STUDY
LARYNGEAL FUNCTION STUDIES
TX SWALLOWING DYSFUNCTION AND/OR ORAL FOR FEEDING
NYSTIGMUS TESTS
NYSTIGMUS TESTS
NYSTIGMUS TESTS
NYSTIGMUS TESTS
BASIC VESTIBULAR EVAL, INCLUDES NYSTAGMUS TESTS, STIMULATION TEST WITH RECORDING
SPONTANEOUS NYSTAGMUS TEST INCLUDING GAZE & FIXAT
POSITIONAL NUSTAGMUS TEST MINIMUM OF 4 POSITIONS
CALORIC VESTIBULAR TEST EACH IRRIGATION W/RECORDIN
OPTOKINETIC NYSTAGMUS TEST BIDIRECTIONAL W/RECORD
OSCILLATING TRACKING TEST WITH RECORD
SINUSOIDAL VERTICAL AXIS ROTATIONAL TESTING
USE OF VERTICAL ELECTRODES IN ANY OR ALL ABOVE TES (ADD-ON)
COMPUTERIZED DYNAMIC POSTUROGRAPHY
TYMPANOMETRY AND REFLEX THRESHOLD MEASUREMENTS
AUDIOMETRY, SCREENING TEST, PURE TONE, AIR ONLY
PURE TONE AUDIOMETRY (THRESHOLD), AIR ONLY
PURE TONE AUDIOMETRY (THRESHOLD), AIR AND BONE
SPEECH AUDIOMETRY, THRESHOLD ONLY
SPEECH AUDIOMETRY, THRESHOLD AND DISCRIMINATION
BASIC COMPREHENSIVE AUDIOMETRY
BEKESY AUDIOMETRY, DIAGNOSTIC
LOUDNESS BALANCE TEST, ALTERNATE BINAURAL OR MONAU
TONE DECAY TEST
SHORT INCREMENT SENSITIVITY INDEX (SISI)
STENGER TEST, PURE TONE
INPEDANCE TESTING
TYMPANOMETRY
ACOUSTIC REFLEX TESTING
ACOUSTIC REFLEX DECAY TEST
ACOUSTIC IMMITTANCE TESTING, INCLUDES TYMPANOMETRY (IMPEDANCE TESTING
FILTERED SPEECH TEST
STAGGERED SPONDIAC WORD TEST
SENSORINEURAL ACUITY LEVEL TEST
SYNTHETIC SENTENCE IDENTIFICATION TEST
STENGER TEST
VISUAL REINFORCEMENT AUDIOMETRY (VRA)
CONDITIONING PLAY AUDIOMETRY
SELECT PICTURE AUDIOMETRY
ELECTROCOCHLEOGRAPHY
BRAINSTEM EVOKED RESPONSE RECORDING
AUDITORY EVOKED POTENTIALS FOR EVOKED RESP. AUDIOMETRY TEST NERVOUS SYSTEM, LMTD
EVOKED OTOACOUSTIC EMISSIONS; LIMITED
EVOKED OTOACOUSTIC EMISSIONS;COMP/DIAG. EVALUATION
CENTRAL AUDITORY FUNCTION TESTS
HEARING AID EXAM AND SELECTION, MONAURAL
HEARING AID EXAMINATION AND SELECTION, BINAURAL
HEARING AID CHECK MONAURAL
HEARING AID CHECK BINAURAL
ELECTROACOUSTIC EVAL FOR HEARING AID, MONAURAL
ELECTRACOUSTIC EVALUATION FOR HEARING AID, BINAURA
EAR PROTECTOR ATTENUATION MEASUREMENTS
EVAL FOR USE PROSTHETIC/AUGMENTATIVE DEVICE,SPEECH
DIAGNOSTIC ANALYSIS OF COCHLEAR IMPLANT PATIENT UNDER 7 YEARS OF AGE WITH PROGRA
SUBSEQUENT REPROGRAMMING
DIAGNOSTIC ANALYSIS OF COCHLEAR IMPLANT AGE 7 YEARS OR OLDER WITH PROGRAMMING
SUBSEQUENT PROGRAMMING
EVALUATION FOR PRESCRIPTION FOR SPEECH-GENERATING AUGMENTATIVE & ALTERNATIVE COM
EACH ADDITIONAL 30 MINUTES (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROC
THERAPEUTIC SERVICES FOR THE USE OF SPEECH GENERATING DEVICE INCLUDING PROGRAM
EVALUATION OF ORAL AND PHARYNGEAL SWALLOWING FUNCTION
MOTION FLUOROSCOPIC EVALUATION OF SWALLOWING BY CINE OR VIDEO RECORDING
FLEXIBLE FIBEROPTIC ENDOSCOPIC EVALUATION OF SWALLOWING BY CINE OR VIDEO RECORDI
FLEXIBLE FIBEROPTIC ENDOSCOPIC EVAL. LARYNGEAL SENSORY TEST BY CINE OR VIDEO
FIBEROPTIC ENDOSCOPIC EVAL OF SWALLOWING/LARYNGEAL SENSORY TEST BY CINE OR VIDEO
EVALUATION OF CENTRAL AUDITORY FUNCTION, W/ REPORT; INITIAL 60 MINUTES
EVALUATION OF CENTRAL AUDITORY FUNCTION, W/ REPORT, EACH ADDITIONAL 15 MINUTES
ASSESSMENT OF TINNITUS (INCLUDES PITCH, LOUDNESS MATCHING, & MASKING)
EVALUATION OF AUDITORY REHABILITATION STATUS, FIRST HOUR
EVALUATION OF AUDITORY REHAB STATUS, EA ADD 15 MIN, ADD-ON
AUDITORY REHABILITATION, PRE-LINGUAL HEARING LOSS
AUDITORY REHABILITATION, POST-LINGUAL HEARING LOSS
DIAGNOSTIC ANALYSIS W/PROGRAMMING OF AUDITORY BRAINSTEM IMPLANT PER HR
CARDIOPULMONARY RESUSCITATION
TEMP. TRANSCUTANEOUS PACING
ARRHYTHMIA CONVERSN ELECTRICAL
INTERNAL CARDIOVERSION
CARDIO ASSIST METHOD OF CIRCULATORY ASSIST INTERNA
CARDIOASSIST EXTERNAL
PERCUTANEOUS TRANSLUMINAL CORONARY THROMBECTOMY (ADD-ON)
PLACEMENT OF RADIATION DELIVERY DEVICE FOR CORONARY BRACHYTHERAPY (ADD-ON)
THROMBOLYSIS CORONARY BY INTRACORONARY INFUSION IN
THROMBOLYSIS,BY INTRAVENOUS INFUSION
INTRAVASCULAR ULTRASOUND,IMAGING SUPERV-INTER/REPO (ADD-ON)
INTRAVASCULAR ULTRASOUND,IMAGING SUPERV-INTER/REPO (ADD-ON)
TRANSCATHETER PLACEMENT STENT; SINGLE VESSEL
TRANSCATHETER PLACEMENT-STENT; EA ADD. VESSEL (ADD-ON)
PERCUTANEOUS TRANSLUMINAL CORONARY BALLOON ANGIOPLASTY SINGLE VESSEL
PERCUTANEOUS TRANSLUMINAL CORONARY ANGIOPLASTY (ADD-ON)
PERCUTANEOUS BALLOON VALVULOPLASTY; AORTIC VALVE
PERCUATANEOUS BALLOON VALVULOPLASTY; MITRAL VALVE
PERCUTANEOUS BALLOON VALVULOPLASTY; PULMONARY VALV
ATRIAL SEPTECTOMY OR SEPTOSTOMY,TRANSVENOUS,BALLOO
BLADE METHOD
PERCUTANEOUS TRANSLUMINAL CORONARY ATHERECTOMY W/W
EACH ADDITIONAL VESSEL
PERCUTANEOUS TRANSLUMINAL PULONARY ARTERY BALLOON ANGIOPLASTY; SINGLE VESSEL
PERCUTANEOUS TRANSLUMINAL PULMONARY ARTERY BALLOON ANGIOPLASTY; EACH ADD. VESSEL
ELECTROCARDIOGRAPHY
PHONOCARDIOGRAM; TRACING W/O INTERPRET OR REPORT
ELECTROCARDIOGRAPHY INTERPRETATION AND REPORT ONLY
TELEPHONIC OR TELEMETRIC TRANSMISSION OF EKG STRIP
TELEPHONIC TRANSMISSION ECG; PHYS REVIEW W/INTERP
CARDIOVASCULAR STRESS TEST
PHYSICIAN SUPERVISION ONLY,WITHOUT INTERPRETATION
CARDIOVASCULAR STRESS TEST
CARDIOVASCULAR STRESS TEST
ERGONOVINE PROVOCATION TEST
MICROVOLT T-WAVE ALTERNANS FOR ASSESSMENT OF VENTRICULAR ARRHYTHMIAS
RHYTHM ECG, 1-3 LEADS, W/INTERPRETATION & REPORT
RHYTHM ECG
RHYTHM ECG
ECG MONITORING, 24 HR REPORT REVIEW INTERPRET
RECORDING
SCANNING ANALYSIS WITH REPORT
PHYSICIAN REVIEW AND INTERPRET
MOBILE CARDIO TELEMTRY W/ECG RECRDNG CONCURNT COMP REAL TIME DATA 24 HRS
TECH SUPRT FOR CONN & PT INST FOR USE, ATTEND SURV &PHYS TRNSMISN DAILY RPTS
ECG MONITORING, 24 HR W/O SCANNING
RECORDING
MICRO BASED ANALYSIS, REPORT
PHYSICIAN REVIEW & INTERPRET
ECG MONITOR 24HR COMPUTERIZED
MONITOR DATE ANALYSIS REPORT
PHYSICIAN REVIEW AND INTERPRETATION
PATIENT DEMAND SGL OR MULTI RECORDING PER 30 DAYS
PATIENT DEMAND RECORDING W/MEMORY LOOP; RECORDING
DEMAND RECORDING;MONITORING/ANALYSIS,PER 30 DAYS
PATIENT DEMAND RECORDING PHYSICIAN REVIEW & INTERP
SIGNAL-AVERAGED ELECTROCARDIOGRAPHY (SAEGC) W/WO E
PROGRM DEVICE EVAL W/ITERATIVE ADJ OF IMPLANT TO TEST SINGL LEAD PCEMKER SYST
DUAL LEAD PACEMAKER SYSTEM
MULTIPLE LEAD PACEMAKER SYSTEM
SINGLE LEAD IMPLANTABLE CARDIOVERTER-DEFIBRILLATOR SYSTEM
DUAL LEAD IMPLANTABLE CARDIOVERTER-DEFIBRILLATOR SYSTEM
MULTIPLE LEAD IMPLANTABLE CARDIOVERTER-DEFIBRILLATOR SYSTEM
IMPLANTABLE LOOP RECORDER SYSTEM
PERI-PROC DEVICE EVAL&PROG DEVICE SYS PARAMETERS BEF& AFTER A SURG/PROC
SINGLE, DUAL, OR MULTI LEAD IMPLANTABLE CARDIOVERTER-DEFIB SYSTEM
NTER DEVICE EVAL W/PHYS ANALYSIS, RVW &RPT, INCL CONNEC& DISCONNEC PER PT ENCNTR
1-2 OR MULTI LEAD IMPLNT CARDIOVRTR-DEFIB SYST INCL ANALY/HRT RHYTH DATA ELE
IMPLANT CARDIOVAS MONITOR SYS INCL ANALYSIS OF 1/MORE REC PHYS CARDIO DATA ELEM
IMPLANTABLE LOOP RECORDER SYSTEM, INCLU HEART RHYTHM DERIVED DATA ANALYSIS
WEARABLE DEFIBRILLATOR SYSTEM
TRS PACEMAKER EVAL 1-2 OR MULTI LEAD PACEMKR INCLD RECRD W&WITHOUT MAGNET
INTER DEVICE EVAL REMOTE ^ TO 90 DA 1-2 OR MULTI LEAD PACEMKR SYS W/INTERIM PHYS
1-2 OR MULT LEAD IMPLNTBLE CARDIOVERTER-DEFIB SYST W/INTERIM PHYS ANALYSIS
1-2 OR MULT LEAD IMPLNTBLE CARDIOVERTER-DEFIB SYST W/INTERIM PHYS ANALYSIS
INTER DEVICE EVAL REMOTE UP TO 30 DAYS IMPLANT CARDIOVAS MONITR SYST INCLUD
IMPLANT LOOP REC SYST, INC ANALYSIS OF REC HRT DATA, PHYS ANALY REVW & REP
IMPLNT CARDIOVAS MONTR SYSTM OR IMPLANT INC ANALYSIS OF 1 OR MORE REC PHYS
TRANSTHORACIC ECHOCARDIOGRAPHY-CONGENITAL ANOMALIE
TRANSTHORACIC ECG; FU OR LIMITED STUDY
ECHOCARDIOGRAPHY, TRANSTHORACIC, REAL-TIME WITH IMAGE DOCUMENTATION (2D)
ECHOCARDIOGRPHY, REAL TIME SCAN COMPLETE
ECHOCARDIOGRAPHY, REAL TIME SCAN LIMITED
ECHOCARDIOGRAPHY, REAL TIME W/IMAGE DOCUMENTATION
ECHOCARDIOGRAPHY PLACEMENT OF TRANSESOPHAGEAL PROB
ECHOCARDIOGRAPHY IMAGE ACQUISITION INTERP/REPORT O
TRANSESOPHAGEAL ECG; INCL PROBE-INTER & REPORT
TRANSESOPHAGEAL ECG; PLACEMENT OF PROBE ONLY- PC
TRANSESOPHAGEAL ECG; IMAGE ACQU-INTER & REPORT ONL
ECHOCARDITRANSESOPHAGEAL FOR MONITORING PROBE, REAL TIME IMAGE,INTERP.FOR CARDIA
DOPPLE ECHOCARDIOGRAPHY (ADD-ON)
FOLLOW UP OR LIMITED (ADD-ON)
DOPPLER COLOR FLOW VEL MAPPING (ADD-ON)
ECHOCARDIOGRAPHY, TRANSTHORACIC,W/MONITORING INTER
INCLUD PERFORM OF CONT ECG MONITORING, WITH PHYSICIAN SUPERVISION
USE OF ECG CONTRAST AGENT DURING STRESS ECHO LIST SEPART IN ADDN PRIME PROC
RIGHT HEART CATHETERIZATION
INSERTION & PLACEMENT OF FLOW DIRECTED CATHETER FOR MONITORING PURPOSES-(SP)
ENDOMYOCARDIAL BIOPSY
CATHETER PLACEMENT CORONARY ARTERY CONDUIT, AND/OR GRAFTS FOR ANGIOGRAPHY
LEFT HEART CATHETERIZATION
LEFT HEART CATHERTERIZATION; BY CUTDOWN
LEFT HEART CATHERTERIZATION BY LEFT VENTRICULAR PUNCTURE
COMBINED TRANSSEPTAL & RETROGRADE LEFT HEART CATHETERIZATION
COMBINED RT HEART CATHETERIZATION & RETROGRADE LEFT HEART CATHETERIZATION
COMBINED RT CATH & TRANSSEPTAL LT CATH THRU INTACT SEPTUM
COMBINED RT CATH W/ LT VENTRICULAR PUNCTURE
COMBINED RT & LT HEART CATH THRU EXISTING SEPTAL OPENING
RT HEART CATHETERIZATION, FOR CONGENITAL CARDIAC ANOMALIES
COMBINED RT HEART CATH & RETROGRADE LT HEAR CATH, FOR CONGEN.CARDIAC ANOM
COMBINED RT & TRANSSEPTAL LEFT HEART CATHETERIZATION THRU SEPTUM W/W/O CATH
RT & TRANSSEPTAL LEFT HART CATH. THRU EXISTING SEPTAL OPENING W/W/O CATHER
INJECTION PROCEDURE DURING CARDIAC CATH;FOR SELECT.OPACIF.OF ARTERIAL CON.-(SP)
INJEC PROC FOR SELEC OPACIF OF AORTOCORONARY VENOUS BYPASS GRAFTS,1 OR MOR-(SP)
INJECTION PROCEDURE DURING CARDIAC CATH; FOR PULMONARY ANGIOGRAPHY
INJEC PROC DURING CARDIAC CATH; FOR SELEC RT VENT OR RT ARTRIAL ANGIOG
INJEC PROC DURING CARDIAC CATH;FOR SELEC LT VENT OR LT ATRIAL ANGIOGRAPHY
INJECTION PROCEDURE DURING CARDIAC CATHETERIZATION; FOR AORTOGRAPHY-(SP)
INJECTION PROCEDURE DURING CARDIAC CATH; FOR SELECTIVE CORONARY ANGIO-(SP)
IMAGING SUPERVISION,INTERP & REPORT FOR INJEC PROC DURING CARDIAC CATH-(SP)
IMAGING SUPERVISIONY, INTERP & REPORT DURING INJEC PROC;PULMO ANGIO, AORTO-(SP)
INDICATOR DILUTION STUDIES
INDICATOR DILUTION STUDIES
INTRAVASC DOPPLER VELOCITY CORONARY FLOW RESER MEAS INITIAL VESSEL (ADD-ON)
INTRAVASCULAR DOPPLER VELOCITY CORONARY FLOW RESERVE MEASURE; EA ADDTL VESSEL
PERCUTANEOUS TRANSCATHETER CLOSURE OF CONGENITAL INTERARTERIAL COMMUNICATION
BUNDLE OF HIS RECORDING
INTRA-ATRIAL RECORDING
RIGHT VENTRICULAR RECORDING
INTRAVENTRICULAR AND/OR INTRA-ATRIAL MAPPING (ADD-ON)
INTRA-ATRIAL PACING
INTRAVENTRICULAR PACING
INTRACARDIAC ELECTROPHYSIOLOGIC 3-DIMENSIONAL MAPPING (ADD-ON)
ESOPHAGEAL RECORDING OF ATRIAL ELECTROGRAM
ESOPHAGEAL RECORDING OF ATRIAL ELECTROGRAM W/PACIN
INDUCTION OF ARRHYTHMIA BY ELECTRICAL PACING
COMPREHENSIVE ELECTROPHYSIOLOGIC EVALUATION
ELECTROPHYSIOLOGIC EVAL WITH INDUCTION OF ARRHYTHMIA
COMPREHENSIVE ELECTROPHYSIOLOGIC EVAL W/LT ATRIAL (ADD-ON)
W/LEFT VENTRICULAR RECORDING,WITH OR WITHOUT PACIN (ADD-ON)
PROGRAMMED STIMULATION AND PACING (ADD-ON)
ELECTRPHYSIOLOGIC FOLLOW-UP
INTRA-OPERATIVE CARDIAC PACING AND MAPPING
ELECTROPHYSIOLOGIC EVAL CARDIOVERTER-DEFIB LEAD
WITH TESTING CARDIOVERTER-DEFIB PULSE GENERATOR
ELECTROPHYSIOLOGIC EVALUATION OF CARDIOVERTER-DEFI
INTRACARDIAC CATH ABLATION
INTRACARDIAC CATHETER ABLATION OF ARRHYTHMOGENIC F
FOR TREATMENT OF VENTRICULAR TACHYCARDIA
AUTONOMIC NERVOUS SYSTEM EVAL W/TILT TABLE EVAL
INTRACARDIAC ECHOCARD THERAP/DIAGNOSTIC IMAGE SUPERVISION/INTERP (ADD-ON)
BIOIMPEDANCE, THORACIC, ELECTRICAL
PLETHYSMOGRAPHY
PLETHYSMOGRAPHY, TRACING ONLY
PLETHYSMOGRAPHY, INTERPRETATION AND REPORT ONLY
ELECTRONIC ANALYSIS OF ANTITACHYCARDIA PACEMAKER S
TEMPERATURE GRADIENT STUDIES
INITIAL SET UP & PROGRAMMING BY PHYS OF WEARABLE CARDIO-DEFIBRILLATOR
INTERROGATION OF VENTRICULAR ASSIST DEVICE PARAMETERS
THERMOGRAM CEPHALIC
PERIPHERAL
DETERMINATION OF VENOUS PRESSURE
AMBULATORY BLOOD PRESSURE MONITORING UTILIZING
AMBULATORY BP MONITORING; RECORDING ONLY
AMBULATORY BP MONITORING; ANALYSIS WITH REPOT
BLOOD PRESSURE MONITORING PHYSICIAN REVIEW/INT REP
PHYSICIAN SERVICES OUTPT CARDIAC REHAB PER SESSION
PHYSICIAN SERVICE OP CARDIAC REHAB W/CONTINUED ECG
UNLISTED CARDIOVASCULAR SERVICE OR PROCEDURE
NON-INVASIVE PSYC STUDIES OF EXTRACRANIAL ARTERIES
DUPLEX SCAN EXTRACRANIAL ARTERIES; COMPLETE BILATE
DUPLEX SCAN OF EXTRACRANIAL ARTERIES FOLLOW UP/LIM
TRANSCRANIAL DOPPLER STUDY INTRACRANIAL ARTER COMP
TRANSCRANIAL DOPPLER STUDY INTRACRAN ART FOLLOW-UP
TRANSCRANIAL DOPPLER STUDY OF INTRACRANIAL ARTERIES; VASOREACTIVITY STUDY
TRANSCRANIAL DOPPLER STUDY OF INTRACRANIAL ARTERIES; EMBOLI DETECT W/O INJECTION
TRANSCRANIAL DOPPLER STUDY OF THE INTRACRANIAL ARTERIES; COMPLETE; EMBOLI DETECT
NONINVASIVE PHYSIOLOGIC STUDIES,UPPER OR LOWER
NONINVASIVE PHYSIOLOGIC STUDIES, UPPER OR LOWER
NONINVASIVE PHYSILOGIC STUDIES,UPPER OR LOWER
DUPLEX SCAN LOWER EXTREMITY ARTERIES COMPLETE BILA
DUPLEX SCAN UPPER EXTREMITY ARTERIES; FOLLOW-UP
DUPLEX SCAN UPPER EXTREMITY ARTERIES; COMPLETE
DUPLEX SCAN UPPER EXTREMITY ARTERIES FOLLOW-UP
NON-INVASIVE PHYSC STUDIES EXTREMITY VEINS BILATER
DUPLEX SCAN EXTREMITY VEINS INC RESPONSES TO COMPR
DUPLEX SCAN - FOLLOW-UP - EXTREMITIES EXT VENOUS
DUPLEX SCAN ARTERIAL INFLOW/VENOUS OUTFLOW OF ABDO
DUPLEX SCAN ARTERIAL FLOW FOLLOW UP OR LIMITED STU
DUPLEX SCAN OF AORTA INFERIOR VENA CAVA ILIAC VASC
FOLLOW UP LIMITED
DUPLEX SCAN ARTERIAL INFLOW/OUTFLOW PENILE VESSELS
DUPLEX SCAN PENILE VESSLES FOLLOW-UP OR LIMITED ST
DUPLEX SCAN OF HEMODIALYSIS ACCESS
VENTILATION ASSIST AND MANAGEMENT, HOSPITAL INPATIENT/OBSERVATION, INIT DAY
VENTILATION ASSIST AND MANAGEMENT, HOSPITAL INPT/OBSERVATION, EA SUBSEQ DAY
VENTILATION ASSIST AND MANAGEMENT, NURSING FACILITY, PER DAY
SPIROMETRY
MEASUR OF SPIROMETRIC FORCED EXPIRATORY FLOWS IN KIDS THRU 2 YEARS OF AGE
MEASUR OF SPIROMETRIC FORCED EXPIRATORY FLOWS BEFORE AND AFTER BRONCHODILATOR
MEASUREMENT OF LUNG VOLUMES, FORCED VITAL CAPACITY, [FVC] IN AN INFANT THRU 2 YO
PATIENT INITIAT SPIROMETRIC RECORD 30 DY INCL REINFORCED PHY REV & INTERPRETA
PATIENT INITIATED SPIROMETRIC; PER 30 DAY; PHYSICIAN REVIEW & INTERP ONLY
PATIENT INITIAT SPIROMETRIC RECORD PER 30 DY PHY REVIEW & INTERPRETATION ONLY
BRONCHODILATION RESPONSIVENESS SPIROMETRY AS IN 94010 PRE/POST BRONCHODILATOR
BRONCHOSPASM PROVACATION EVALUATION MULTIPLE SPIROMETRIC DETERMINATIONS
VITAL CAPACITY
MAXIMUM BREATHING CAPACITY MAXIMAL VOLUNTARY VENT
FUNCTIONAL RESIDUAL CAPACITY
EXPIRED GAS ANALYSIS
THORACIC GAS VOLUME
VENTILATION DIST STUDIES
PULM MECHANICS STUDIES
VENTILATION DIST STUDIES
RESPIRATORY FLOW VOLUMN LOOP
BREATHING RESPONSE TO COZ
BREATHING RESPONSE TO HYPOXIA (HYPOXIA RESPONSE)
INTRAPULMONARY SURFACTANT ADMIN BY A PHYSICIAN THROUGH ENDOTRACHEAL TUBE
PULMONARY STRESS TESTING
PULMONARY STRESS TESTING COMPLEX
NONPRESSURED INHALATION TREATMENT FOR ACUTE AIRWAY
AEROSOL INHALATION OF PENTAMIDINE
CONTINUOUS INHALATION TRTMNT W/AEROSOL MEDICATION FOR ACUTE AIRWAY OBST; 1ST HR
CONTINUOUS INHALATION TRTMNT W/AEROSOL MEDICATION/ACUTE AIRWAY OBST; EA ADD HR
CONTINUOUS POSITIVE AIRWAY PRESSURE VENTILATION
CONTINUOUS NEGATIVE PRESSURE VENTILATION CNP
AEROSOL OR VAPOR INHALATIONS FOR SPUTUM MOBILIZATI
MANIPULATION CHEST WALL SUCH AS CUPPING PERCUSSION
MANIPULATION OF THE CHEST WALL, SUBSEQUENT
GAS ANALYSIS
EXPIRED GAS ANALYSIS
OXYGEN UPTAKE, REST INDIRECT
PULM DIFFUSION STUDIES
PULM DIFFUSION STUDIES
PULM MECHANICS STUDIES
NONINVASIVE EAR/PULSE OXIMETRY
NONINVASIVE EAR/PULSE OXIMETRY FOR 02 SATURATION
NONINVASIVE EAR OR PULSE OXIMETRY
GAS ANALYSIS
CIRCADIAN RESPIRATORY PATTERN RECORDING 12-24
UNLISTED PULMONARY SERVICE OR PROCEDURE
PERCUTANEOUS TESTS SCRATCH-PUNCTURE-PRICK PER EACH
PERCUTANEOUS TESTS SEQUENTIAL/INCREMENTAL W/DRUGS
NITRIC OXIDE EXPIRED GAS DETERMINATION
INTRACUTANEOUS TESTS SEQUENTIAL/INCREMENTAL PER EA
INTRACUTANEOUS TESTS W/ALLERGENIC EXTRACTS PER TES
SKIN END POINT TITRATION
INTRACUTANEOUS TESTS DELAYED REACTION PER EACH
PATCH OR APPLICATION TESTS, PER TEST
PHOTO PATCH TEST(S)(SPECIFY NUMBER OF TESTS)
PHOTO TEST
OPTHALMIC MUCOUS MEMBRANE TESTS
DIRECT NASAL MUCOUS MEMBRANE TEST
INHALATION BRONCHIAL CHALLENGE TESTING
INHALATION BRONCHIAL CHALLENGE TESTING W/ANTIGENS
INGESTION CHALLENGE TEST
PRO SERVICE ALLERGEN IMMUNO NOT INCL EXTRACT
ALLERGEN IMMUNOTHER NOT INCL EXTRACT, MULTI
IMMUNOTHERAPY IN PRESCRIBING PHYSICIAN'S OFFICE
ALLERGEN IMMUNOTHERAPY, MULTIPLE ANTIGENS
ALLERGEN IMMUNOTHERAPY, STINGING INSECT VENOM
ALLERGEN IMMUNOTHERAPY, TWO STINGING INSECT VENOM
IMMUNOTHERAPY-3 STINGING INSECT VENOMS
IMMUNOTHERAPY-4 STINGING INSECT VENOMS
IMMUNOTHERAPHY-5 STINGING INSECT VENOMS
PROFESSIONAL SVC FOR SUPERVISION & PROVISION ANTIG
STINGING INSECT ANTIGENS SINGLE DOSE VIALS
STINGING INSECT ANTIGENS TWO SINGLE DOSE VIALS
THREE SINGLE STINGING INSECT VENOMS MULT DOSE VIAL
ANTIGENS FOUR SINGLE STINGING INSECT VENOMS MULTI
STINGING INSECT ANTIGENS FIVE SINGLE DOSE VIALS
PROF SERVICE FOR SUPERVISION & PROVISION OF ANTIGE
:WHOLE BODY EXTRACT OF BITING INSECT/ARTHROPOD
DESENSITIZATION
UNLISTED ALLERGY/CLINICAL IMMUNOLOGIC SERVICE
GLUCOSE CONTINUOUS MONITORING; UP TO 72 HRS VIA SUBCUTANEOUS SENSOR
AMBULATORY CONTINUOUS GLUCOSE MONITORING OF INTERSTITIAL TISSUE. SQ UP TO 72 HRS
MULTIPLE SLEEP LATENCY TESTING
SLEEP STUDY, RECORD VENTILATION, RESPIRATORY EFFORT, ECG/HEART RATE, H2O SATURAT
SLEEP STUDY, 3 OR MORE PARAMETERS OTHER THAN STAGI
POLYSOMNOGRAPHY;SLEEP STAGING WITH 1 TO 3 PARAMETE
POLYSOMNOGRAPHY; SLEEP STAGING WITH 4 OR MORE
POLYSOMNOGRAPHY; 4 OR MORE & ARAMETERS, W/CPAP OR BILEVEL VENTILATION,INC. TECH
EEG EXTENDED MONITORING; UP TO ONE HOUR
EEG, EXTENDED MONITORING; GREATER THAN ONE HOUR
EEG AWAKE/DROWSY W/HYPERVENTILATION AND/OR PHOTIC
EEG-RECORDING AWAKE&ASLEEP W/HYPERVENT.-PHOTIC STI
ELECTROENCEPHALOGRAM (EEG); SLEEP ONLY
EEG CEREBRAL DEATH EVALUATION ONLY
ELECTROENCEPHALOGRAPHY
ELECTROCORTICOGRAM AT SURGERY (SEPARATE PROCEDURE)
INSERTION BY PHYSICIAN OF SPHENOIDAL ELECTRODES
MUSCLE TESTING
MUSCLE TESTING
MUSCLE TESTING
MUSCLE TESTING
RANGE OF MOTION MEASUREMENTS
RANGE OF MOTION MEASUREMENTS
TENSILON TEST
ELECTROMYOGRAPHY
ELECTROMYOGRAPHY
ELECTROMYOGRAPHY
ELECTROMYOGRAPHY
NEEDLE ELECTRROMYOGRAPHY, LARYNX
NEEDLE ELECTRROMYOGRAPHY, HEMIDIAPHRAGM
ELECTROMYOGRAPHY, CRANIAL NERVES, UNILATERAL
ELECTROMYOGRAPHY, BILATERAL
ELECTROMYOGRAPHY
NEEDLE ELECTROMYOGRAPHY; OTHER THAN PARASPINAL
ELECTROMYOGRAPHY, SINGLE FIBER, ANY TECHNIQUE
ELECTRICAL STIMULATION FOR GUIDANCE IN CONJUNCTION W/CHEMODENERVATION (SP)
NEEDLE ELECTROMYOGRAPHY FOR GUIDANCE IN CONJUNCTION W/CHEMODENERVATION (SP)
ISCHEMIC LIMB EXERCISE W/EMG
NERVE CONDUCTION, AMPLITUDE & LATENCY/VELOCITY STUDY, EA NRV, ANY/ALL STS-(SP)
NERVE CONDUCTION, EA NERVE, ANY SITE; MOTOR/W/F-WAVE STUDY-(SP)
NERVE CONDUCTION SENSORY, EACH NERVE.-(SP)
MOTOR AND/OR SENSORY NERVE CONDUCTION, USING ELECTRODE ARRAY(S), AMPLITUDE AND
INTRAOPERATIVE NERVE TESTING (ADD-ON)
SOMATOSENSORY TESTING, ONE OR MORE NERVES
SHORT-LATENCY SOMATOSENSORY STUDY;IN LOWER LIMBS
SHORT-LATENCY SOMATOSENSORY STUDY; TRUNK OR HEAD
CENTRAL MOTOR EVOKED POTENTIAL STUDY (TRANSCRANIAL MOTOR STIMU); UPPER LIMBS
CENTRAL MOTOR EVOKED POTENTIAL STUDY (TRANSCRANIAL MOTOR STIMU); LOWER LIMBS
VEP TESTING CENTRAL NERVOUS SYSTEM,CHECKER/FLASH
ORBICULARIS OCULI REFLEX
H-REFLEX STUDY; GASTROCNEMIUS/SOLEUS MUSCLE
H-REFLEX STUDY;MUSCLE OTHER THAN GASTROCNEMIUS/SOL
NEUROMUSC JUNCTION TEST
MONITOR FOR LOCALIZATION OF CEREBRAL SEIZURE 24HR
MONITORING LOCALIZ CEREBRAL SEIZURE,EEG W/VIDEO 24
MONITORING LOCALIZED CEREBRAL SEIZURE FOCUS COMPUT
PHARMACOLOGICAL ACTIVATION DURING PROLONGED MONITO
EEG DURING NONINTRACRANIAL SURGERY
MONITORING LOCAL CEREBRALSEIZURE FOCUS BY CABLE RA
DIGITAL ANALYSIS OF EEG
WADA ACTIVATION LIST FOR HEMISPHERIC FUNCTION
FUNCTIONAL CORTICAL MAPPING BY STIMULATION ELECTRO
ELECTRODE STIMULATION BRAIN EACH ADD HOUR
MAGNETOENCEPHALOGRAPHY; FOR SPONTANEOUS BRAIN MAGNETIC ACTIVITY
MAGNETOENCEPHALOGRAPHY; SINGLE EVOKED MAGNETIC FIELDS
MAGNETOENCEPHALOGRAPHY; EACH ADDITIONAL EVOKED MAGNETIC FIELDS (ADD-ON)
ELECTRONIC ANALYSIS OF IMPLANTED NEUROSTIMULATOR SIMPLE OR COMPLEX
ELECTRONIC ANALYSIS OF IMPLANTED NEUROSTIMULATOR SIMPLE
ELECTRONIC ANALY IMPLANTED NEUROSTIMULATOR COMPLEX SPINAL CORD 1ST HOUR
ELECTRONIC ANALY IMPLANTED NEUROSTIMULATOR COMPLEX SPINAL CORD; EA ADD 30 MIN
ELECTRONIC ANALYS IMPLANTED NEUROSTIMULATOR COMPLEX CRANIAL NERVE; FIRST HOUR
ELECTRONIC ANALYS IMPLANTED NEUROSTIMULATOR COMPLEX CRANIAL; EA ADDTL 30 MINUTES
ELECTRONIC ANALYSIS OF IMPLANTED NEUROSTIMULATOR PULSE GENERATOR SYSTEM; 1ST HR
ELECTRONIC ANALYSIS OF IMPLANTED NEUROSTIM PULSE GENERTR SYSTEM; EA ADDTL 30 MIN
ELECTRONIC ANALYSIS OF IMPLANTED NEUROSTIMULATOR PULSE GENERATOR , W/ PROGRAM
ELECTRONIC ANALYSIS OF IMPLANTED NEUROSTIMULATOR PULSE SYSTEM , W/O REPROGRAM
ELECTRONIC ANALYSIS OF IMPLANTED NEUROSTIMULATOR W/ REPROGRAMMING
REFILLING AND MAINTENANCE OF IMPLANTABLE PUMP OR RESERVOR FOR DRUG DELIVERY SPIN
REFILLING AND MAINTENANCE OF IMPLANTABLE PUMP/RESERVOIR FOR DRUG DELIVERY
CANALITH REPOSITION (EG, EPLEY MANEUVER, SEMONT MANEUVER) PER DAY
UNLISTED NEUROLOGICAL OR NEUROMUSCULAR DX PROCEDUR
MOTION ANALYSIS BY VIDEO-TAPING AND 3-D KINEMATICS
MOTION ANALYSIS; WITH DYNAMIC PLANTAR PRESSURE DURING WALKING
MOTION ANALYSIS; ELECTROMYOGRAPHY DURING WALKING/OTHER ACTIVITY, 1-12 MUSCLES
MOTION ANALYSIS; ELECTROMYOGRAPHY, WALKING/OTHER ACTIVITIES, 1 MUSCLE
MOTION ANALYSIS; PHYSICIAN REVIEW/INTERPRETATION WITH WRITTEN REPORT
PSYCHOLOGICAL TESTING, PER HOUR, FACE TO FACE
PSYCHOLOGICAL TESTING, PER HOUR, FACE TO FACE (EG, MMPI, WAIS)) TECHNICIAN
PSYCHOLOGICAL TESTING, ADMINISTERED BY A COMPUTER
ASSESS APHASIA,W/INTERPRETATION-REPORT, PER HOUR
DEVELOPMENTAL TESTING; LIMITED W/INTERPRETATION
DEVELOPMENTAL TESTING EXTENDED W/INTERPRETATION
NEUROBEHAVIORAL STATUS EXAM, PER HOUR
NEUROPSYCHOLOGICAL TESTING, PER HOUR, BY PSYCHOLOGIST
NEUROPSYCHOLOGICAL TESTING, PER HOUR BY TECHNICIAN
NEUROPSYCHOLOGICAL TESTING, ADMINISTERED BY COMPUTER
HEALTH/BEHAVIOR ASSESSMENT; EACH 15 MINUTE FACE-TO-FACE, INITIAL
HEALTH/BEHAVIOR ASSESSMENT; REASSESSMENT
HEALTH/BEHAVIOR INTERVENTION; EACH 15 MINUTES. FACE-TO-FACE; INDIVIDUAL
HEALTH/BEHAVIOR INTERVENTION; EA 15 MIN; GROUP
HEALTH/BEHAVIOR INTERVENTION; EA 15 MIN; FAMILY WITH PATIENT PRESENT
HEALTH/BEHAVIOR INTERVENTION; EA 15 MIN; FAMILY WITHOUT PATIENT PRESENT
INTRAVENOUS INFUSION, HYDRATION; INITIAL, 31 MINUTES TO 1 HOUR
EACH ADDITIONAL HOUR (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROC
IV FOR THERAPY, PROPHYLAXIS, OR DIAG (SPECIFY SUBST OR DRUG); INITI 1 HOUR
EACH ADDITIONAL HOUR (LIST SEPARATELY IN ADD TO CODE FOR PRIMARY PROC
ADDTNAL SEQUENTIAL INFUSION, UP TO 1 HR (LIST SEPAR. IN ADDTION TO PRIM PROC)
CONCURRENT INFUSION (LIST SEPARATELY IN ADD TO CODE FOR PRIMARY PROC)
SUBCU INFUS FOR THRPY OR PROPH SPEC SUB/DRUG INIT 1HR,INCL PUMP SET-UP EST SUB S
EACH ADDITIONAL HOUR (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROC)
ADDL PUMP SET-UP W/NEW SUBCUTANEOUS INFUSION SITE(S) LIST IN ADD PRIME PROC
THERAPEUTIC, PROPHYLACTIC, OR DIAGNOSTIC INJ(SPECIFY SUBS/DRUG) SUB OR IM
INTRA-ARTERIAL
INTRAVENOUS PUSH, SINGLE OR INITIAL SUBSTANCE/DRUG
EA ADD SEQ IV PUSH OF A NEW SUB/DRUG (LIST SEPARATELY IN ADD TO CODE PRIME PROC
UNLIS THERAPUTIC PROPHYLACTIC OR DIAG IV OR INTRA-ARTERIAL INJ OR INFUSION
CHEMOTHERAPY ADMINISTRATION, SQ OR IM, NON-HORMONAL ANTI NEOPLASTIC
CHEMOTHERAPY ADMINISTRATION, SQ OR IM, HORMONAL ANTI NEOPLASTIC
CHEMOTHERAPY ADMIN,INTRALESIONAL;UP TO & INCLUD 7L
MORE THAN 7 LESIONS
CHEMOTHERAPY ADMINISTRATION, IV, PUSH TECHNIQUE, SINGLE OR INITIAL
CHEMOTHERAPY ADMINISTRATION, IV, PUSH TECHNIQUE, EA ADD (SP)
CHEMOTHERAPY ADMINISTRATION, IV INFUSION, UP TO 1 HOUR,SINGLE OR INITIAL
CHEMOTHERAPY ADMINISTRATION, IV INFUSION, EACH ADDITIONAL HOUR (SP)
CHEMOTHERAPY ADMINISTRATION, PROLONGED, MORE THAN 8 HOURS
CHEMOTHERAPY ADMINISTRATION, EACH ADDITIONAL, UP TO 1 HOUR
CHEMOTHERAPY INTRA-ARTERIAL PUSH
CHEMOTHERAPY, INTRA-ARTERIAL, UP TO 1 HR INFUSION
CHEMOTHERAPY, INTRA-ARTERIAL; 1 TO 8 HR INFUSION (ADD-ON)
CHEMOTHERAPY; INTRA-ARTERIAL, INIATE PROLONGED INF
CHEMOTHERAPY PLEURAL CAVITY THORACENTESIS
CHEMOTHERAPY PERITONEAL CAVITY PARACENTESIS
CHEMOTHERAPY CNS LUMBAR PUNCTURE
REFILLING AND MAINTENANCE OF PORTABLE PUMP
REFILLING AND MAINTENANCE OF IMPLANTABLE PUMP OR RESEVOIR FOR DRUG DELIVERY
IRRIGATION OF IMPLANTED VENOUS ACCESS DEVICE FOR DRUG DELIVERY SYSTEMS
CHEMOTHERAPY INJECTION, SUBARACHNOID/INTRAVENTRICU
UNLISTED CHEMOTHERAPY PROCEDURE
PHOTODYNAMIC THERAPY OF SKIN; EACH EXPOSURE SESSION
PHOTODYNAMIC THERAPY FIRST 30 MINUTES (ADD-ON)
PHOTODYNAMIC THERAPY EACH ADDITIONAL 15 MINUTES
ACTINOTHERAPY
MICROSCOPIC EXAM OF HAIRS TO DETERMINE TELOGEN/ANAGEN COUNTS, OR ABNORMALITY.
PHOTOCHEMOTHERAPY, TAR AND ULTRAVIOLET B GOECKERMA
PHOTOCHEMOTHERAPY; PSORALENS AND ULTRAVIOLET A
PHOTOCHEMOTHERAPY BETWEEN 4&8 HRS CARE W/DIRCT SUP
LASER TREATMENT FOR INFLAMMATORY SKIN DISEASE TOTAL AREA LESS THAN 250 SQ CM
LASER TREATMENT INFLAMMATORY SKIN DISEASE 250 SQ CM TO 500 SQ CM
LASER TREATMENT FOR INFLAMMATORY SKIN DISEASE OVER 500 SQ CM
UNLISTED DERMATOLOGICAL SERVICE OR PROCEDURE
PHYSICAL THERAPY EVALUATION
PHYSICAL THERAPY RE-EVALUATION
OCCUPATIONAL THERAPY EVALUATION
OCCUPATIONAL THERAPY RE-EVALUATION
APPLICATION OF A MODALITY TO ONE OR MORE AREAS; TRACTION, MECHANICAL
APPLICATION OF A MODALITY TO ONE OR MORE AREAS; VASOPNEUMATIC DEVICES
APPLICATION OF A MODALITY TO ONE OR MORE AREAS; PARAFFIN BATH
APPLICATION OF A MODALITY TO ONE OR MORE AREAS; WHIRLPOOL
APPLICATION OF A MODALITY TO ONE OR MORE AREAS; DIATHERMY
APPLICATION OF A MODALITY TO ONE OR MORE AREAS; INFRARED
APPLICATION OF A MODALITY TO ONE OR MORE AREAS; ULTRAVIOLET
APPLICATION OF A MODALITY TO 1 OR MORE AREAS; ELEC STIMUL (MANUAL), EA 15 MIN
APPLICATION OF A MODALITY TO 1 OR MORE AREAS; IONTOPHORESIS, EACH 15 MIN
APPLICATION OF A MODALITY TO 1 OR MORE AREAS; CONTRAST BATHS, EA 15 MIN
APPLICATION OF A MODALITY TO 1 OR MORE AREAS; ULTRASOUND, EACH 15 MIN
APPLICATION OF A MODALITY TO 1 OR MORE AREAS; HUBBARD TANK, EACH 15 MIN
UNLISTED MODALITY (SPECIFY TYPE & TIME IF CONSTANT ATTENDANCE)
PHYSICAL MEDICINE TREATMENT THERAPEUTIC EXERCISES
PHYSICAL MEDICINE TREATMENT NEUROMUSCULAR REEDUCA-
THERAPEUTIC AQUATIC THERAPY W/EXER; 1 TO 1; 15 MIN
PHYSICAL MEDICINE TREATMENT GAIT TRAINING
PHYSICAL MEDICINE TREATMENT UNLISTED PROCEDURE
MANUAL THERAPY TECHNIQUES; ONE OR MORE REGIONS; EACH 15 MINUTES
THERAPEUTIC ACTIVITIES DIRECT ONE ON ONE PT CONTACT BY PROVIDER EACH 15 MIN
SELF CARE/HOME MGMT TRAINING,ONE-ON-ONE,EA 15 MIN
COMMUNITY/WORK REINTEGRATION,ONE-ON-ONE,EA 15 MIN
WHEELCHAIR MGMT/PROPULSION TRAINING, EACH 15 MIN
REMOVAL OF DEVITALIZED TISSUE FROM WOUND(S) SELECTIVE DEBRIDEMENT W/O ANESTH
REMOVAL OF DEVITALIZED TISSUE FROM WOUNDS, ELECTIVE DEBRID,W/O ANES;PER SESSION
NON SELECTIVE DEBRIDE, W/O ANESTHESIA WOUND ASSES. INST. FOR ONGOING CARE,PER 15
NEGATIVE PRESSURE WOUND THERAPY, INCL TOPICAL APP, ASSES & INSTRUCT, PER SESSION
NEGATIVE PRESSURE WOUND THERAPY; SURFACE AREA > THAN 50 SQ CENTIMETERS
PHYSICAL TEST/MEASURE,W/WRITTEN REPORT, EACH 15 MI
ORTHOTIC(S) MANAGEMENT AND TRAIN, UPPER, LOWER EXTREM AND/OR TRUNK 15 MIN EACH
PROSTHETIC TRAINING, UPPER AND/OR LOWER EXTREMITY(S) 15 MIN EACH
CHECKOUT FOR ORTHOTIC/PROSTHETIC USE, ESTAB PT 15 MIN EACH
UNLISTED PHYSICAL MEDICINE SERVICE OR PROCEDURE
REMOVAL OF DEVITALIZED TISSUE FROM WOUND(S), SELEC DEBRID W/O ANESTHESIA
OSTEOPATHIC MANIPULATIVE TREATMENT,1-2 BODY REGION
OSTEOPATHIC MANIPULATIVE TREATMENT-3 TO 4 REGIONS
OSTEOPATHIC MANIPULATIVE TREATMENT 5 TO 6 REGIONS
OSTEOPATHIC MANIPULATIVE TREATMENT 7 TO 8 REGIONS
OSTEOPATHIC MANIPULATIVE NINE TO TEN BODY REGIONS
CHIROPRACTIC MANIPULATIVE TX-SPINAL, 1-2 REGIONS
CHIROPRACTIC MANIUPULATIVE TX-SPINAL, 3-4 REGIONS
CHIROPRACTIC MANIPULATIVE TX-SPINAL, 5 REGIONS
HANDLING AND/OR CONVEYANCE OF SPECIMAN FOR TRANSFR
SERVICES PRIOR TO 10PM BUT AFTER OFFICE HOURS
OFFICE SERVICES PROVIDED ON AN EMERGENCY BASIS
SPECIAL REPORTS
COLLECTION AND INTERPRETATION OF PATIENT TRANSMITTED DATA; MINIMUM 30 MINUTES
MODERATE SEDATION SRVC (OTHER THAN 00100-01999) UNDER 5 YRS OLD, 1ST 30 MIN
MODERATE SEDATION SRVC (OTHER THAN 00100-01999) 5 YRS/ OLDER, 1ST 30 MIN
MODERATE SEDATION SRVC, EACH ADDITIONAL 15 MIN ADD-ON
MODERATE SEDATION SRVC, UNDER 5 YRS OLD, 1ST 30 MIN
MODERATE SEDATION SRVC, 5 YRS/ OLDER, 1ST 30 MIN
MODERATE SEDATION SRVC, EACH ADDITIONAL 15 MIN ADD-ON
ANOGENITAL EXAMINATION IN CHILD
OCCULAR FUNCTION SCREENING
VISION SCREENING, QUANTITATIVE, BILATERAL
IPECAC OR SIMILAR ADMINISTRATION FOR INDIVIDUALIZE
PHYSICIAN ATTENDANCE AND SUPERVISION OF HYPERBARIC
PUMP ASSEMBLY & OPERATION
3/4 HOUR ASSEMBLY & OPERATION OF PUMP W/OXYGENATOR
ASSEMBLY & OPERATION OF PUMP W/OXYGENATOR, 1/2 HR
PHLEBOTOMY
OV OR OP EVALUATION NEW PATIENT A PROBLEM 10 MIN
OV OR OP EVALUATION NEW PATIENT EXPANDED PROBLEM
OV OR OP EVALUATION NEW PATIENT DETAILED 30 MIN
OV OR OP EVALUATION NEW PATIENT COMPREHENSIVE 45MI
OV OR OP EVALUATION NEW PATIENT COMPREHENSIVE 60MI
OV OR OP EVALUATION ESTABLISHED MINIMAL PROBLEM 5
OV OR OP EVALUATION ESTABLISHED- A PROBLEM 10 MIN
OV OR OP EVALUATION ESTABLISHED/EXPANDED 15 MIN
OV OR OP EVALUATION ESTABLISHED/DETAILED 25 MIN
OV OR OP EVALUATION ESTABLISHED/COMPREHENSIVE 40MI
OBSERVATION CARE DISCHARGE DAY MANAGEMENT
INITIAL HOSP OBSERVATION PER DAY LOW COMPLEXITY
INITIAL HOSP OBSERVATION PER DAY MODERATE COMPLEXI
INITIAL HOSP OBSERVATION PER DAY HIGH COMPLEXITY
INITIAL HOSP CARE PER DAY LOW COMPLEXITY 30 MIN
INITIAL HOSP CARE PER DAY MODERATE COMPLEXITY 50MI
INITIAL HOSP CARE PER DAY HIGH COMPLEXITY 70 MIN
SUBSEQUENT HOSP DAY LOW COMPLEXITY 15 MIN
SUBSEQUENT HOSP DAY MODERATE COMPLEXITY 25 MIN
SUBSEQUENT HOSP DAY HIGH COMPLEXITY 35 MIN
OBSERVATION OR INPATIENT HOSPITAL CARE; DETAILED OR COMPREHENSIVE
OBSERVATION OR INPATIENT HOSPITAL CARE; COMPREHENSIVE, MODERATE COMPLEXITY
OBSERVATION OR INPATIENT HOSPITAL CARE; COMPREHENSIVE, HIGH COMPLEXITY
HOSPITAL DISCHARGE DAY MANAGEMENT
HOSP. DISCHARGE MGMT; MORE THAN 30 MINUTES
OFFICE CONSULT NEW/ESTABLISHED A PROBLEM 15 MIN
OFFICE CONSULT NEW/ESTABLISHED EXPANDED 30 MIN
OFFICE CONSULT NEW/ESTABLISHED-DETAILED 40 MIN
OFFICE CONSULT NEW/ESTABLISHED COMPREHENSIVE 60MIN
OFFICE CONSULT NEW/ESTABLISHED COMPREHENSIVE 80MIN
INITIAL IP CONSULT NEW/ESTABLISHED A PROBLEM 20MIN
INITIAL IP CONSULT NEW/ESTABLISHED EXPANDED 40 MIN
INITIAL IP CONSULT NEW/ESTABLISHED DETAILED 55 MIN
INITIAL IP CONSULT NEW/ESTABLISH COMPREHENS 80 MIN
INITIAL IP CONSULT NEW/ESTABLISH COMPREHENS 110MIN
ER VISIT NEW/EST PT/A PROBLEM (LIMITED OR MINOR)
ER VISIT NEW/EST PT/A PROBLEM (LOW TO MODERATE)
ER VISIT NEW/EST PT/EXPANDED (MODERATE)
ER VISIT NEW/EST PT/DETAILED (HIGH AND URGENT EVAL
ER VISIT NEW/EST PT COMPREHENSIVE (HIGH & IMMEDIAT
PHY DIRECT EMS/ER CARE ADVANCED LIFE SUPPORT
CRITICAL CARE, EVALUATION & MANAGEMENT, FIRST 30-74 MINUTES
CRITICAL CARE/PROLONGED PRESENCE EACH ADD 30 MIN
INITIAL NURSING FACILITY CARE, PER DAY
INITIAL NURSING FACILITY CARE, PER DAY
INITIAL NURSING FACILITY CARE, PER DAY
SUBSEQUENT NURSING FACILITY CARE, PER DAY
SUBSEQUENT NURSING FACILITY CARE, PER DAY
SUBSEQUENT NURSING FACILITY CARE, PER DAY
SUBSEQUENT NURSING FACILITY CARE, PER DAY
NURSING FACILITY DISCHARGE DAY MANAGEMENT; 30 MINUTES OR LESS
NURSING FACILITY DISCHARGE DAY MANAGEMENT; MORE THAN 30 MINUTES
E&M OF PT INVOLVING ANNUAL NURSING FACILITY ASSESSMENT
DOMICILIARY OR REST HOME VISIT FOR EVAL/MANAGEMENT OF NEW PATIENT
DOMICILIARY OR REST HOME VISIT FOR EVAL/MANAGEMENT OF NEW PATIENT
DOMICILIARY OR REST HOME VISIT FOR EVAL/MANAGEMENT OF NEW PATIENT
DOMICILIARY OR REST HOME VISIT FOR EVAL/MANAGEMENT OF NEW PATIENT
DOMICILIARY OR REST HOME VISIT FOR EVAL/MANAGEMENT OF NEW PATIENT
DOMICILIARY OR REST HOME VISIT FOR EVAL/MANAGEMENT OF EST PATIENT
DOMICILIARY OR REST HOME VISIT FOR EVAL/MANAGEMENT OF EST PATIENT
DOMICILIARY OR REST HOME VISIT FOR EVAL/MANAGEMENT OF EST PATIENT
DOMICILIARY OR REST HOME VISIT FOR EVAL/MANAGEMENT OF EST PATIENT
IND PHYSICIAN SUPERVISION OF PT (PT NOT PRESENT) IN HOME, DOMICILE OR REST HOME
HOME VISIT NEW PT/A PROBLEM (LOW SEVERITY)
HOME VISIT NEW PT/EXPANDED (MODERATE SEVERITY)
HOME VISIT NEW PT/DETAILED (HIGH SEVERITY)
HOME VISIT FOR E/M OF NEW PATIENT, COMPREHENSIVE
HOME VISIT FOR E/M OF NEW PATIENT; COMPREHENSIVE, HIGH COMPLEXITY
HOME VISIT FOR E/M OF ESTABLISHED PATIENT; PROBLEM FOCUSED
HOME VISIT FOR E/M OF ESTABLISHED PATIENTS; EXPANDED PROBLEM FOCUSED
HOME VISIT FOR E/M OF ESTABLISHED PATIENT; DETAILED EXAM
HOME VISIT FOR E/M OF ESTABLISHED PATIENT; COMPREHENSIVE
PROLONGED PHY SVCS BEYOND USUAL DUTY - 1ST HOUR (ADD-ON)
PROLONGED PHY SVCS - EACH ADDITIONAL 30 MINUTES.
PROLONGED PHYSICIAN SERVICEW - INPATIENT (ADD-ON)
EACH ADDITION 30 MINUTES
PHYSICIAN STANDBY SERVICE
PREVENTIVE VISIT- NEW PATIENT, INFANT
PREVENTIVE VISIT- NEW PATIENT AGES 1-4
PREVENTIVE VISIT- NEW PATIENT AGE 5-11
PREVENTIVE VISIT- NEW PATIENT AGE 12-17
PREVENTIVE VISIT- NEW PATIENT AGE 18-39
PREVENTIVE VISIT- NEW PATIENT AGE 40-64
PREVENTIVE VISIT- NEW PATIENT AGE 65 YEARS AND OLDER
PREVENTIVE VISIT- ESTABLISHED PATIENT INFANT
PREVENTIVE VISIT- ESTABLISHED PATIENT AGES 1-4
PREVENTIVE VISIT- ESTABLISHED PATIENT AGES 5-11
PREVENTIVE VISIT- ESTABLISHED PATIENT AGES 12-17
PREVENTIVE VISIT- ESTABLISHED PATIENT AGES 18-39
PREVENTIVE VISIT- ESTABLISHED PATIENT AGES 40-64
PREVENTIVE VISIT- ESTABLISHED PATIENT AGES 65 YEARS AND OLDER
COUNSELING HEALTHY INDIVIDUAL 15 MIN
COUNSELING HEALTHY INDIVIDUAL 30 MIN
COUNSELING HEALTHY INDIVIDUAL 45 MIN
COUNSELING HEALTHY INDIVIDUAL 60 MIN
ALCOHOL AND/OR SUBSTANCE ABUSE STRUCTURED SCREEN/BRIEF INTERVEN SERV15 -30 MIN
ALCOHOL &/OR SUBSTANCE ABUSE STRUCTURED SCREEN/BRIEF INTERVEN SER; < 30 MIN
UNLISTED PREVENTIVE MEDICINE SERVICE
BASIC LIFE AND/OR DISABILITY EXAMINATION
INITIAL HOSP OR BIRTHING CENTER CARE, PER DAY FOR E&M OF NORMAL NEWBORN INFANT
INITIAL CARE, PER DAY, FOR E & M OF NORMAL NB OTH THAN HOSP OR BIRTH CNTR
SUBSEQUENT HOSP CARE, PER DAY, FOR E&M NORMAL NEWBORN
INITIAL HOSP OR BIRTH CNTR PER DAY FOR E&M OF NORMAL NB ADMIT/DISCH SM DAY
ATTEND AT DELIVERY WHEN REQ BY DELIVERING PHYS & INITIAL STABILIZATION/NB
DELIV/BIRTH RM RESUS PROV/POS PRSSR VENT/CHEST COMPR IN PRES/ACUTE INADEQ VENT
CRIT CARE BY PHYS, DURING TRNSPRT OF CRIT ILL/INJRD PT 0-24 MO, 1ST 30-74 MIN
CRITICAL CARE EA ADD 30 MIN (SP)
INIT INPT NEONATE CRIT CARE, PER DAY, FOR E&M OF CRIT ILL NEONATE, 28 DAYS/LESS
SUB INPT NEONATE CRIT CARE, PER DAY, FOR E&M OF CRIT ILL NEONATE, 28 DAYS/LESS
INITL INPT PEDI CRIT CARE, FOR E&M OF CRIT ILL INFANT/CHILD 29 DAYS - 24 MO OLD
SUBS INPT PED CRIT CARE FOR E&M OF CRIT ILL INFANT/CHILD 29 DAYS - 24 MO OLD
INIT INPT PED CRIT CARE, PER DAY, FOR E&M CRIT ILL INFANT/CHILD, 2-5 YRS OLD
SUB INPT PED CRIT CARE, PER DAY, FOR E&M OF CRIT ILL INFANT/CHILD, 2 - 5 YRS OLD
INITIAL HOSPITAL CARE, PER DAY
SUBS INTENSV CARE, PER DAY, FOR E&M OF LOW BIRTH WGHT INFANT LESS THEN 1500 GRMS
SUBS INTNSVE CARE, PER DAY/E&M OF LOW BIRTH WGHT INFNT PRESNT WT 1500-2500 GMS
SUB INTENSIVE CARE, PER DAY, FOR THE E&M OF INFANT BODY WEIGHT OF 2501-5000 GRMS
UNLISTED EVALUATION AND MANAGEMENT SERVICE
HOME INFUSION/SPECIALTY DRUG ADMINISTRATION, PER VISIT (UP TO 2 HRS)
EACH ADDITIONAL HOUR (LIST SEPARATELY IN ADD TO CODE FOR PRIMARY PROC)
NON-EMERGENCY TRANSPORTATION; TAXI
BUS OR VAN TRAVEL 1 UNIT = 1 LOADED VEHICLE MILE
NON-EMERG TRANS WHEEL CHAIR VAN
NON-EMERGENCY TRANSPORTATION/AIR TRAVEL (PRIVATE OR COMM) INTRA OR INTER STATE
PARKING FEES AND TOLLS. 1 UNIT = 1 DAYS TOTAL FEES.
LODGING FOR CLIENT. ONE UNIT = 1 DAYS LODGING.
CLIENT DAILY MEALS OUT OF STATE.
LODGING FOR ATTENDANT. 1 UNIT = 1 DAYS LODGING.
ATTENDANT DAILY MEALS OUT OF STATE.
AMBUL SERV, NEONT TRANS, BASE RATE, EMERG TRAN ONE
BASIC LIFE SUPPORT MILEAGE (PER MILE)
ALS MILEAGE (PER MILE)
ALS DISPOSABLE SUPPLIES; DEFIBRILLATION - SET
ALS DISPOSABLE SUPPLIES; ESPOHAGEAL INTUBATION
ALS ROUTINE DISPOSABLE SUPPLIES
AMBULANCE WAITING TIME - ALS OR BLS, 1/2 HOUR INCREMENTS
ALS/BLS OXYGEN AND SUPPLIES, LIFE SUSTAINING
EXTRA AMBULANCE ATTENDANT, ALS OR BLS
GROUND MILEAGE, PER STATUTE MILE
AMBULANCE SERVICE ADVANCED LIFE SUPPORT NON EMERGENCY TRANSPORT LEVEL 1
ADVANCED LIFE SUPPORT EMERGENCY TRANSPORT LEVEL 1
AMBULANCE SERVICE BASIC LIFE SUPPORT NON EMERGENCY TRANSPORT
AMBULANCE SERVICE BASIC LIFE SUPPORT EMERGENCY TRANSPORT
AMBULANCE SERVICE CONVENTIONAL AIR SERVICE TRANSPORT ONE WAY FIXED WING
AMBULANCE SERVICE CONVENTIONAL AIR SERVICE TRANSPORT ONE WAY ROTARY WING
ADVANCED LIFE SUPPORT LEVEL 2
SPECIALTY CARE TRANSPORT
FIXED WING AIR MILEAGE, PER STATUTE MILE
ROTARY WING AIR MILEAGE, PER STATUTE MILE
AMBULANCE RESPONSE/TREATMENT, NO TRANSPORT
UNLISTED AMBULANCE SERVICE
SYRINGE W/NEEDLE STERILE 1CC
SYRINGE W/NEEDLE STERILE 2CC
SYRINGE W/NEEDLE, STERILE 3CC
SYRINGE W/NEEDLE
SUPPLIES FOR SELF-ADMINISTERED INJECTIONS
HUBER-TYPE NEEDLE, EACH
SYRINGE, STERILE 20CC OR GREATER
NEEDLES ONLY, STERILE, ANY SIZE
STERILE WATER/SALINE, 10ML
STERILE WATER/SALINE, 500 ML
STERILINE SALINE OR WATER, METERED DOSE DISPENSER, 10ML
REFILL KIT FOR IMPLANTABLE INFUSION KIT
SUPPLIES FOR MAINTENANCE DRUG INF.CATHETER; ONLY 1 PER WK
SUPPLIES EXT.DRUG INFUSION PUMP PER CASSETTE/BAG
INFUSION SUPPLIES NOT USED W EXTERNAL INFUSION PUMP, PER CASSETTE OR BAG
SYRINGE W/NEEDLE EXTERNAL INSULIN PUMP-STERILE-3CC
REPLACEMENT BATTERY, ALKALINE , FOR USE WITH MEDICALLY NEC HOME BLOOD GLUCOSE
REPLACEMENT BATTERY, ALKALINE, J CELL FOR USE WITH MEDICALLY NEC HOME GLUCOSE
REPLACEMENT BATTERY WITH LITHIUM, FOR HOME BLOOD GLUCOSE MONITOR
REPLACEMENT BATTERY /SILVER OXIDE, FOR HOME BLOOD GLUCOSE MONITOR
ALCOHOL OR PEROXIDE, PER PINT
ALCOHOL WIPES, PER BOX
BETADINE OR PHISOHEX SOLUTION PER PINT
BETADINE OR IODINE SWABS/WIPES, PER BOX
CHLORHEXIDINE CONTAINING ANTISEPTIC, 1ML
URINE TES OR REAGENT STRIPS OR TABLETS-100
BLOOD GLUCOSE TEST STRIPS/HOME MONITER 50 STRIPS
PLATFORMS FOR HOME GLUCOSE MONITOR; 50 PER BOX
NORMAL, LOW AND HIGH CALIBRATOR SOLUTION/ CHIPS
REPLACEMENT LENS SHIELD CARTRIDGE FOR USE WITH LASER SKIN PIERCING DEVICE, EACH
SPRING-POWERED DEVICE FOR LANCE
LANCETS, BOX 100 = 1 UNIT
CERVICAL CAP FOR CORTRACEPTIVE USE
TEMPORARY ABSORBABLE LACRIMALDUCT IMPLANT EACH
PERM. NON DISSOLUABLE LACRIMAL DUCT IMPLANT, EACH
PERMANENT IMPLANTABLE CONTRACEPTIVE INTRATUBAL OCCLUSION DEVICE/DELIVERY SYSTEM
DIAPHRAGM FOR CONTRACEPTIVE USE
ADHESIVE SKIN ATTACHMENT FOR EXTERNAL BREAST PROSTHESIS, EACH
TUBING FOR BREAST PUMP REPLACEMENT
CAP FOR BREAST PUMP BOTTLE REPLACEMENT
BREAST SHIELD AND SPLASH PROTECTOR FOR USE WITH BREAST PUMP REPLACEMENT
POLYCARBONATE BOTTLE FOR USE WITH BREAST PUMP REPLACEMENT
LOCKING RING FOR BREAST PUMP REPLACEMENT
SACRAL NERVE STIMULATION TEST, LEAD, EACH
IMPLANTABLE ACCESS CATHETER, EXT. ACCESS (VEN,ART,
IMPLANTABLE ACCESS TOTAL SYSTEM; CATHETER, PORT/RE
DISPOSABLE DRUG DELIVERY SYSTEM FLOW RATE 50 ML OR
DISPOSABLE DRUG DELIVERY SYSTEM 5 ML OR LESS PER H
INSERTION TRAY W/O DRAINAGE BAG
INSERTION TRAY WO/DRAINAGE BAG W/CATHETER FOLEY TY
INSERT TRAY, INDWEL CATH, W/O BAG, 2-WAY, SILICONE
INSERTION TRAY W/O BAG, W/CATH, 3-WAY IRRIGATION
INSERTION TRAY W//DRAINAGE W/CATCH,FOLEY TYPE,2 WA
INSERT TRAY SILICONE W/DRAINAGE BAG;INDWELLING CAT
INSERT TRAY,W/BAG & INDWEL CATH, 3-WAY,CONT IRRG
IRRIGATION TRAY FOR BLADDER
IRRIGATION SYRINGE,BULB OR PISTON
MALE EXTERNAL CATHETER SPECIALTY TYPE
FEMALE EXTERNAL URINARY COLLECTION DEVICE MEATAL C
FEMALE EXT URINARY COLLECTION DEVICE POUCH EACH
EXTENSION DRAINAGE TUBING ANY TYPE/LENGTH W/CONNECTOR/ADAPTOR FOR LEG BAG POUCH
LUBRICANT IND. STERILE PACKET FOR INSERTION OF URINARY CATHETER, EACH
URINARY ANCHORING DEVICE ADHESIVE SKIN ATTACHMENT, EACH
URINARY CATHETER ANCHORING DEVICE LEG STRAP, EACH
INCONTINENCE SUPPLY, MISCELLANEOUS
INCONTINENCE SUPPLY, URETHRAL INSERT, ANY TYPE, EA
FOLEY CATHETER
INDWELLING CATHETER SPECIALITY TYPE
INDWELLING CATHETER, FOLEY TYPE, TWO
INDWEL CATH,FOLEY,3-WAY,CONTINUOUS IRRGATION
MALE EXTERNAL CATHETER, W OR W/O ADHESIVE, DISPOSABLE, EACH
INTERMITTANT URINARY CATHETER STRAIGHT TIP WITH OR WITHOUT COATING, EACH
INTERMITTENT URINARY CATHETER, COUDE (CURVED) TIP, WITH OR WITHOUT COATING, EA.
INTERMITTENT URINARY CATHETER,W/INSERTION SUPPLIES
CATHETER INSERTION
CONTINUOS IRRIG TUBING SET FOR 3-WAY INDWELL CATH
INCONTINENCE CLAMP
URINARY DRAINING BAG
URINARY DRAINAGE BAG LEG OR ABDOMEN VINYL; WITH OR WITHOUT STRAPS
OSTOMY FACE PLATE - EACH
SKIN BARRIER, 4X4 OR EQUIVOLENT EACH
OSTOMY CLAMP, ANY TYPE, REPLACEMENT ONLY, EACH
OSTOMYSKIN BOND OR CEMET (PER OZ)
OSTOMY VENT, ANY TYPE, EACH
OSTOMY BELT
OSTOMY FILTER ANY TYPE, EACH
OSTOMY SKIN BARRIER, LIQUID. (SPRAY, BRUSH, ETC), PER OUNCE
OSTOMY SKIN BARRIER, PASTE, PER OUNCE
OSTOMY SKIN BARRIER, POWDER, PER OUNCE
OSTOMY SKIN BARRIER,SOLID 4X4 OR EQUIV.STANDARD WEAR, BUILT IN CONVEXITY, EACH
OSTOMY SKIN BARRIER, W/FLANGE STANDARD WEAR, BUILT-IN CONVEXITY, ANY SIZE, EACH
OSTOMY SKIN BARRIER, W/ FLANGE, EXTENDED WEAR, BUILT-IN CONVEXITY, ANY SIZE, EA
OSTOMY POUCH, DRAINABLE, WITH FACEPLATE ATTACHED, PLASTIC, EACH
OSTOMY POUCH, DRAINABLE, WITH FACEPLATE ATTACHED, RUBBER, EACH
OSTOMY POUCH, DRAINABLE, FOR USE ON FACEPLATE, PLASTIC, EACH
OSTOMY POUCH, DRAINABLE, FOR USE ON FACEPLATE, RUBBER, EACH
OSTOMY POUCH, URINARY, WITH FACEPLATE ATTACHED, PLASTIC, EACH
OSTOMY POUCH, URINARY, WITH FACEPLATE ATTACHED, RUBBER, EACH
OSTOMY POUCH, URINARY, FOR USE ON FACEPLATE, PLASTIC, EACH
OSTOMY POUCH, URINARY, FOR USE ON FACEPLATE, HEAVY PLASTIC, EACH
OSTOMY POUCH, URINARY, FOR USE ON FACEPLATE, RUBBER, EACH
OSTOMY FACEPLATE EQUIVALENT, SILICONE RING, EACH
OSTOMY SKIN BARRIER, SOLID 4X4/EQUIV. EXTENDED WEAR, W/O BUILT-IN CONVXITY, EACH
OSTOMY SKIN BARRIER, W/ FLANGE, EXTENDED WEAR, W/O BUILT-IN CONVXITY, ANY SZ, EA
OSTOMY POUCH CLOSED, STND WEAR BARRIER ATACHD, W/ BUILT-IN CONVEXITY (1), EACH
OSTOMY POUCH, DRAINABLE, W/STAND WEAR BARRIER ATACHD, W/O BUILT-IN CONVXTY, EA
OSTOMY POUCH, DRAINABLE,W/STAND WEAR BARRIER ATACHD, W/BUILT-IN CONVXITY, 1 PC
OSTOMY POUCH, DRAINABLE, W/EXTND WEAR BARRIER, W/ BUILT-IN CONVEXITY, 1 PC, EA
OSTOMY POUCH, URINARY, W/ EXTND WEAR BARRIER, W/O BUILT-IN CONVEXITY, 1 PC, EACH
OSTOMY POUCH, URINARY W/ STAND WEAR BARRIER, W/BUILT-IN CONVEXTIY, 1 PIECE, EACH
OSTOMY POUCH, URINARY, W/ EXTENDED WEAR BARRIER, W/ BUILT-IN CONVEXITY, 1 PC, EA
OSTOMY DEODORANT FOR USE IN OSTOMY POUCH, LIQUID, PER FLUID OUNCE
OSTOMY DEODORANT FOR USE IN OSTOMY POUCH, SOLID, PER TABLET
OSTOMY BELT WITH PERISTOMA/HERNIA SUPPORT
IRRIGATION SUPPLY
OSTOMY IRRIGATION SUPPLY; BAG, EACH
OSTOMY IRRIGATION SUPPLY; CONE, CATHETER AND BRUSH
OSTOMY LUBRICANT/KY JELLY (PER OZ)
OSTOMY RINGS
OSTOMY SKIN BARRIER NONPECTIN BASED PASTE PER OUNCE
OSTOMY SKIN BARRIER PECTIN-BASED PASTE PER OUNCE
OSTOMY SKIN BARRIER WITH FLANGE SOLID FLEXIBLE OR ACCORDION 4X4 OR SMALLER EACH
OSTOMY SKIN BARRIER WITH FLANGE SOLID FLEXIBLE OR ACCORDION WITH BUILT IN CONVEX
OSTOMY SKIN BARRIER W/FLANGE W/O BUILT IN CONVEXITY 4X4 OR SMALLER
OSTOMY SKIN BARRIER W/ FLANGE WITHOUT BUILT IN CONVEXITY LARGER THAN 4X4 INCHES
OSTOMY SKIN BARRIER, SOLID 4X4 OR EQUIVALENT, BUILT IN CONVEXITY
OSTOMY POUCH, DRAINABLE, HIGH OUTPUT, FOR USE ON A BARRIER
OSTOMY POUCH DRAINABLE HIGH OUTPUT FOR USE ON A BARRIER W/ FLANGE W/ FILTER EACH
OSTOMY SKIN BARRIER W/ FLANGE WITHOUT BUILTIN CONVEXITY 4X4 INCHES OR SMALLER EA
OSTOMY SKIN BARRIER WITH FLANGE (SOLID, FLEXIBLE OR ACCORDION) WITHOUT BUILT-IN
OSTOMY POUCH, CLOSED, W/BARRIER ATTACHED, W/FILTER (1 PIECE), EACH
OSTOMY POUCH, CLOSED, W/BARRIER ATTACHED, W/BUILTIN CONVEXITY, W/FILTER
OSTOMY POUCH, CLOSED, W/BARRIER ATTACHED, W/FILTER
OSTOMY POUCH, CLOSED; FOR USE ON BARRIER W/NONLOCKING FLANGE, W/FILTER
OSTOMY POUCH, CLOSED; FOR USE ON BARRIER W/NONLOCKING FLANGE (2 PIECE)
OSTOMY SUPPLIES MISC. URETEROSTOMY SUPPLIE NOS
OSTOMY ABSORBENT MATERIAL (SHEET/PAD/CRYSTAL PACKET) FOR USE IN OSTOMY POUCH
OSTOMY POUCH, CLOSED; FOR USE ON BARRIER W/LOCKING FLANGE, W/FILTER EACH
OSTOMY POUCH, DRAINABLE, W/BARRIER ATTACHED, W/FILTER 1 PIECE, EACH
OSTOMY POUCH, DRAINABLE, FOR USE ON BARRIER W/NONLOCKING FLANGE 2 PIECE, EACH
OSTOMY POUCH, DRAINABLE, FOR USE ON BARRIER W/LOCKING FLANGE 2 PC SYSTEM, EACH
OSTOMY POUCH, DRAINABLE, FOR USE ON BARRIER W/LOCKING FLANGE, W/FILTER 2PC, EACH
OSTOMY POUCH, URINARY W/EXTENDED WEAR BARRIER ATTACHED, W/FAUCET-TYPE TAP
OSTOMY POUCH, URINARY W/BARRIER ATTACHED, W/BUILT IN CONVEXITY, W/FAUCET TYPE
OSTOMY POUCH, URINARY W/EXTEND WEAR BARRIER ATTACHED, W/BUILT IN CONVEXITY
OSTOMY POUCH, URINARY W/BARRIER ATTACH. W/FAUCET TYPE TAP W/VALVE 1 PC EACH
OSTOMY POUCH, URINARY, FOR USE ON BARRIER W/NONLOCKING FLANGE, W/FAUCET TYPE TAP
OSTOMY POUCH, URINARY, FOR USE ON BARRIER W/LOCKING FLANGE 2 PCS, EACH
OSTOMY POUCH, URINARY; FOR USE ON BARRIER W/FAUCET TYPE TAPE W/VALVE 2PC, EACH
TAPE, NON-WATERPROOF, PER 18 SQUARE INCHES
TAPE, WATERPROOF, PER 18 SQUARE INCHES
TAPE ALL SIZES AND TYPES
SOLVENT REMOVER (PER OZ)
ADHESIVE REMOVER, WIPES, ANY TYPE, EACH
ENEMA BAG WITH TUBING, REUSEABLE
ELASTIC BANDAGE, PER ROLL (ACE)
SURGICAL DRESSING HOLDER, NON-REUSABLE, EACH
SURGICAL DRESSING HOLDER, REUSABLE, EACH
JOINT SUPPORT DEVICE/GARMENT ELASTIC OR EQUAL, EACH
NON-ELASTIC BINDER FOR EXTREMITY
GRAVLEE JET WASHER
VABRA ASPIRATOR
THRACHEOSTOMA FILTER, ANY SIZE/TYPE; EACH
MOISTURE EXCHANGER DISPOSABLE FOR USE WITH INVASIVE MECHANICAL VENT
SURGICAL STOCKINGS ABOVE KNEE LENGTH, EACH
SURGICAL STOCKINGS THIGH LENGTH, EACH
SURGICAL STOCKINGS, BELOW KNEE LENGTH, EACH
SURGICAL STOCKINGS FULL LENGTH, EACH
SURGICAL TRAYS
DISPOSABLE UNDERPADS, ALL SIZES
ELECTRODES
LEAD WIRES - E.G. APNEA MONITER
CONDUCTIVE PASTE OR GEL
COUPLING GEL OR PASTE, FOR USE WITH ULTRASOUND DEVICE, PER OZ
PESSARY RUBBER, ANY TYPE
PESSARY NON-RUBBER ANY TYPE
SLINGS
SPLINT
RIB BELT
SPEC CAST MAT,HEXCELITE & LIGHT CAST, PER ROLL
TENS SUPPLIES, 2 LEAD, PER MONTH
TUBING W/ INTEGRATED HEATING ELEMENT/ USE WITH POSITIVE AIRWAY PRESSURE DEVICE
TRACHEAL SUCTION CATHETER, CLOSED SYSTEM, EACH
OXYGEN PROBE FOR USE WITH OXIMETER DEVICE, REPLACEMENT
TRANSTRACHEAL OXYGEN CATHETER, EACH
BATTERY REPLACEMENT-VENTILATOR
BATTERY CABLES-VENTILATOR REPLACEMENT
BATTERY CHARGER FOR VENTILATOR
PEAK EXPIRATORY FLOW RATE METER, HAND HELD
NASAL CANNULA
TUBING, OCXYGEN, PER FOOT
MOUTH PIECE
BREATHING CIRCUITS
FACE TENT
VARIABLE CONCENTRATION MASK
TRACHEOSTOMY; INNER CANNULA (REPLACEMENT ONLY)
TRACHEAL SUCTION CATHETER ANY TYPE, EACH
TRACHEOSTOMY CARE OR CLEANING STARTER KIT
TRACHEOSTOMY CLEANING BRUSH; EACH
OROPHARANGEAL SUCTION CATHETER, EACH
TRACHEOSTOMY CARE KIT FOR ESTABLISHED TRACHEOSTOMY
REPLACE BATTERIES FOR TENOWNED BY PATIENT
REPLACEMENT BULB/LAMP FOR ULTRAVIOLET LIGHT THERAPY SYSTEM, EACH
REPLACEMENT BULB FOR THERAPEUTIC LIGHT BOX, TABLETOP MODEL
UNDERARM PAD, CRUTCH, REPLACEMENT LATCH
REPLACEMENT HANDGRIP,CANE CRUTCH OR WALKER
REPLACEMENT TIP, CANE, CRUTCH, WALKER, LATCH
REPLACEMENT BATTERY FOR PT OWNED EAR PULSE GENERATOR, EACH
REPLACE PAD FOR MN ALTERNATING PRESSURE PAD
PROVISION OF DIAGNOSTIC RADIONUCLIDE
DIAGNOSTIC IMAGING, SATUMOMAB PENETIDE, PER DOSE
SURGICAL SUPPLIES NEC
CALIBRATED MICROCAPILLARY TUBE, EACH
MICROCAPILLARY TUBE SEALANT
PERITONEAL DIALYSIS CATHETER ANCHORING DEVICE, BELT, EACH
SYRINGE WITH OR WITHOUT NEEDLE FOR DIALYSIS, EACH
SPHYGMOMANOMETER/BLOOD PRESS APP WITH CUFF AND STE
BLOOD PRESSURE CUFF ONLY FOR DIALYSIS
AUTOMATIC BLOOD PRESSURE MONITOR
DISPOSABLE CYCLER SET USED W/CYCLER DIALYSIS MACHINE, EACH
DRAINABLE EXTENSION LINE, STERILE, FOR DIALYSIS, EACH
EXTENSION LINE W/EASY LOCK CONNECTORS, USED W/DIALYSIS
CHEMICALS/ANTISEPTICS SOLUTION USED TO CLEAN/STERILIZE DIALYSIS EQUIP, PER 8OZ
ACITVATED CARBON FILTERS FOR HEMODIALYSIS
DIALYZER'S (ARTIFICIAL KIDNEY'S) ALL BRANDS, ALL SIZES
BICARBONATE CONCENTRATE SOLUTION FOR HEMODIALYSIS PER GALLON
BICARBONATE CONCENTRAT POWDER FOR HEMODIALYSIS PER PACKET
ACETATE CONCENTRATE SOLUTION FOR HEMODIALYSIS PER GALLON
ACID CONCENTRATE SOLUTION FOR HEMODIALYSIS PER PACKET
TREAT WATER (DEION, DISTILL, REVER OSMOS USES DIAL
Y SET TUBING FOR PERITONEAL DIALYSIS
DIALYSATE SOLUTION ANY CONCENTRATION OF DEXTROSE FOR PERITONEAL DIALYSIS
DIALYSATE SOLUTION AND CONCENTRATION OF DEXTROSE > 999 CC ; PERITOENAL DIALYSIS
DIALYSATE SOLUTION ANY CONCENTRATION DEXTROSE > 1999 CC; PERITONEAL DIALYSIS
DIALYSATE SOLUTION ANY CONCENTRATION DEXTROSE > 3999 CC; PERITONEAL DIALYSIS
DIALYSATE SOLUTION ANY CONCENTRATION DEXTROSE <3999 CC > 4999 CC; PERITONEAL
DIALYSATE SOLUTION ANY CONCENTRATION DEXTROSE < 4999 CC > 5999 CC; PERITONEAL
DIALYSAT SOLUTION ANY CONCENTRATON DEXTROSE < 5999 CC
DIALYSIS SOLUTION, NON-DEXTROSE CONTAINING 500ML
FISTULA CANNULA SET FOR DIALYSIS ONLY
TOPICAL ANESTHESIA FOR DIALYSIS PER GRAM
INJECTABLE ANESTHETIC FOR DIALYSIS PER S0 ML
SHUNT ACC FOR DIALY ONLY
BLOOD TUBING, ARTERIAL OR VENOUS, EACH
BLOOD TUBING ARTER AND VENOUS COMBINED
DIALYSATE STAND TEST SOLUTION, SUP
DIALYSATE CONCENTRATE ADDITIVES, EACH
DIALYSATE CONCENTRATE SOLUTION ADDITIVE FOR PERITONEAL DIALYSIS PER 10 ML
BLOOD TEST SUP (E.G. VACUTAINERS AND TUBES)
SERUM CLOTT TINE TUBE, PER BOX
DEXTROSTICK OR GLU COSI TEST STRIPS, PER BOX
HEMAOSTIX, PER BOTTLE
AMMONIA TEST PAPER, PER BOX
HEPARIN ANY TYPE FOR HEMODIALYSIS PER 1000 UNITS
PROTAMINE SULFATE FOR DIALYSIS PER 50 MG
DISPOSABLE CATHETER TIPS FOR PERITONEAL DIALYSIS, 1 UNIT = BOX OF 10
PLUMBING AND/OR ELECTRIC WORK FOR HOME DIALY EQUIP
CONTR, REPR AND MAINT, FOR HOME DIAL EQUIP NON COV
DRAIN BAG/BOTTLE FOR DIALYSIS
MISC DIALYSIS SUPPLIES, NOS
VENOUS PRESS CLAMPS, EACH
GLOVES, BOX OF 100
SURGICAL MASK FOR DIALYSIS PER 20
TOURNIQUET FOR DIALYSIS, EACH
GLOVES, STERILE, PER PAIR
POUCH,CLOSED; W/BARRIER ATTACHED (ONE PIECE)
POUCH, CLOSED W/O BARRIER ATTACHED
POUCH CLOSED, FOR FACEPLATE
POUCH CLOSED FOR USE ON BARRIER W/FLANGE 2PCE
STOMA CAP
POUCH DRAINABLE W/BARRIER ATTACHED (1 PIECE)
POUCH,DRAINAGE;WITHOUT BARRIER ATTACHED
POUCH DRAINABLE USE ON BARRIER W/FLANGE 2 PCE(EACH
POOUCH-URINARY BARRIER UNIT
POUCH,URINARY,WITHOUT BARRIER ATTACHED
POUCH URINARY FOR USE ON BARRIER W/FLANGE 2PCE
CONTINGENT DEVICE; PLUG CONTINENT STOMA
CONTINENT DEVICE; CATHETER FOR CONTINENT STOMA
CONTINENT DEVICE, STOMA ABSORPTIVE COVER FOR CONTINENT STOMA
OSTOMY ACCESSORY, CONVEX INSERT ADD-INCONTINANCE A
BEDSIDE DRAINAGE BOTTLE, RIGID OR EXPANDABLE
URINARY SUSPENSORY W/LEG BAG
URINARY LEG BAG LATEX
LEG STRAP, LATEX, PER SET
LEG STRAP FOAM OR FABRIC PER SET
SKIN BARRIER, WIPES OR SWABS, EACH
SKIN BARRIER, SOLID 6X6 OR EQUIVALENT, EACH
SKIN BARRIER; SOLID 8X8 OR EQUIVALENT EACH
SKIN BARRIER WITH FLANGE (EACH)
FOAM PAD OR ADHESIVE DISC
APPLIANCE CLEANER 16OZ FOR INCONTINENCE
OFF THE SHELF DEPTH INLAYSHOE MULT DENSITY INSERTS
DIABETICS ONLY, SUPPLY OF SHOE FROM MOLDED CAST
DIABETICS ONLY,OFF-SHELF DEPTH-INLAY, PER SHOE
DIABETICS ONLY,OFF-SHELF DEPTH-INLAY,WEDGE,PER SHO
DIABETICS ONLY,OFF-SHELF DEPTH-INLAY W/BAR,PER SHO
DIABETICS ONLY,OFF-SHELF DEPTH-INLAY OFF-SET HEEL
SHOE -DIABETICS ONLY-NOT OTHERWISE SPEC MODIFICATION
DIABETICS DLX FEATURE OFF-THE-SHELF DEPTH-INLAY SHOE/CUSTOM MOLDED, PER SHOE
DIABETICS ONLY DIRECT FORMED COMPRESSION MOLDED WITHOUT HEAT, MULTIPLE DENSITY
FOR DIABETICS ONLY, MULTIPLE DENSITY INSERT, DIRECT FORMED, MOLDED TO FOOT
MULTIPLE DENSITY INSERT, CUSTOM MOLDED DIABETICS ONLY
COLLEGEN-BASED WOUND FILLER; DRY FORM PER GRAM COLLEGEN
COLLAGEN BASED WOUND FILLER, GEL/PASTE, PER GRAM OF COLLAGEN
COLLAGEN DRESSING PAD SIZE 16 SQ INCH OR LESS; EACH
COLLAGEN DRESSING PAD MORE THAN 16 SQ INCH BUT LESS THAN OR EQUAL TO 48 SQ IN;EA
COLLAGEN DRESSING PAD SIZE MORE THAN 48 SQ INCH; EACH
COLLAGEN DRESSING WOUND FILLER; PER 6 INCH
SILICON GEL SHEET, EACH
WOUND POUCH, EACH
ALGINATE DRESSING, WOUND COVER PAD =<16 SQ.IN;
ALGINATE DRESSING, MORE THAN 16, LESS THAN 48 SQIN
ALGINATE DRESSING, MORE THAN 48 SQ IN;EA DRESSING
ALGINATE DRESSING, WOUND FILLER, PER 6 INCHES
COMPOSITE DRESSING, 16 SQ.IN.OR LESS.ADHESIVE BORD
COMPOSITE DRESSING,MORE THAN 16 LESS THAN 48 SQ.IN
COMPOSITE DRESSING,MORE THAN 48 SQ.IN. W/ADHESIVE
CONTACT LAYER, 16 SQ.IN. OR LESS, EACH DRESSING
CONTACT LAYER,MORE THAN 16 & LESS THAN 4,SQ.IN.,EA
CONTACT LAYER, MORE THAN 48 SQ.IN., EACH DRESSING
FOAM DRESSING,16 SQ.IN. OR LESS W/O ADHESIVE,EA
FOAM DRESSING,MORE THAN 16 LESS THAN 48SQ.IN., EA
FOAM DRESSING,MORE THAN 48 SQ.IN. W/O ADHESIVE, EA
FOAM DRESSING, 16 SQ.IN. OR LESS W/ADHESIVE, EACH
FOAM DRESSING,MORE THAN 16 LESS THAN 48SQ.IN.W/ADH
FOAM DRESSING,MORE THAN 48 SQ.IN. W/ADHESIVE, EACH
FOAM DRESSING, WOUND FILLER, PER GRAM
GAUZE,NON-IMPREGNATED 16 SQ.IN. OR LESS W/O ADHESI
GAUZE,NON-IMPREGNATED >16<48 SQ.IN. W/O ADHESIVE
GAUZE,NON-IMPREGNATED >48 SQ.IN. W/O ADHESIVE BORD
GAUZE,NON-IMPREGNATED 16 SQ.IN. OR LESS,W/ADHESIVE
GAUZE,NON-IMPREGNATED >16<48 SQ.IN. W/ADHESIVE; EA
GAUZE,NON-IMPREGNATED >48 SQ.IN. W/ADHESIVE BORDER
GAUZE,IMPRGENATED 16 SQ.IN. OR LESS W/O ADHESIVE
GAUZE,IMPREGNATED, >16<48 SQ.IN. W/O ADHESIVE BORD
GAUZE,IMPREGNATED >48 SQ.IN. W/O ADHESIVE BORDER
GAUZE,IMPREGNATED,SALINE 16 SQ.IN.OR LESS W/O ADHE
GAUZE,IMPREGNATED,SALINE>16<48 SQ.IN. W/O ADHESIVE
GAUZE,IMPREGNATED,SALINE>48 SQ.IN. W/O ADHESIVE,EA
GAUZE IMPREGNATED HYDROGEL FOR DIRECT WOUND CONTACT PAD SIZE 16 SQ IN OR LESS
GAUZE IMPREGNATED HYDROGEL FOR DIRECT WOUND CONTACT GREATER THAN 16 IN LESS 48
GAUZE IMPREGNATED HYDROGEL DIRECT WOUND CONTACT MORE THAN 48 IN
HYDROCOLLOID DRESSING,16 SQ.IN.OR LESS W/O ADHESIV
HYDROCOLLOID DRESSING >16<48 SQ.IN.W/O ADHESIVE EA
HYDROCOLLOID DRESSING,>16<48 SQ.IN. W/O ADHESIVE
HYDROCOLLOID DRESSING,16 SQ.IN.OR LESS W/ADHESIVE
HYDROCOLLOID DRESSING,>16<48 SQ.IN. W/ADHESIVE
HYDROCOLLOID DRESSING,>48 SQ.IN. W/ADHESIVE, EACH
HYDROCOLLOID DRESSING,WOUND FILLER,PASTE,PER FL.OZ
HYDROCOLLOID DRESSING, WOUND FILLER, DRY, PER GRAM
HYDROGEL DRESSING,16 SQ.IN.OR LESS W/O ADHESIVE EA
HYDROGEL DRESSING,>16<48 SQ.IN. W/O ADHESIVE, EACH
HYDROGEL DRESSING,>48 SQ.IN. W/O ADHESIVE, EACH
HYDROGEL DRESSING,16 SQ.IN. OR LESS W/ADHESIVE, EA
HYDROGEL DRESSING,>16<48 SQ.IN. W/ADHESIVE, EACH
HYDROGEL DRESSING,>48 SQ.IN. W/ADHESIVE, EACH
HYDROGEL DRESSING,WOUND FILLER,GEL,PER FLUID OUNCE
SKIN SEALANTS,PROTECTANTS,MOISTURIZERS,ANY TYPE/SI
ABSORPTIVE DRESSING,16 SQ.IN.OR LESS W/O ADHESIVE
ABSORPTIVE DRESSING,>16<48 SQ.IN. W/O ADHESIVE, EA
ABSORPTIVE DRESSING,>48 SQ.IN. W/O ADHESIVE, EACH
ABSORPTIVE DRESSING,16 SQ.IN.OR LESS W/ADHESIVE,EA
ABSORPTIVE DRESSING,>16<48 SQ.IN. W/ADHESIVE, EACH
ABSORPTIVE DRESSING, >48 SQ.IN. W/ADHESIVE, EACH
TRANSPARENT FILM, 16 SQ.IN. OR LESS, EACH DRESSING
TRANSPARENT FILM, >16<48 SQ.IN., EACH DRESSING
TRANSPARENT FILM,MORE THAN 48 SQ.IN., EACH DRESSIN
WOUND CLEANSERS, ANY TYPE, ANY SIZE
WOUND FILLER, GEL/PASTE, PER FLUID OUNCE
WOUND FILLER, UNCLASSIFIED, DRY FORM, PER GRAM
GAUZE, ELASTIC, ALL TYPES, PER LINEAR YARD
GAUZE, NON-ELASTIC, STERILE, PER LINEAR YARD
TAPE, ALL TYPES, ONE UNIT=18 SQUARE INCHES
GAUZE IMPREGNATED OTHER THAN WATER/SALINE/LIN. YD.
GAUZE,NON-IMPREG/STERILE PAD <16 SQ.IN.W/O ADHE;EA
GAUZE,NON-IMPREG/STERILE PAD 16-48SQ.IN. W/O ADHES
GAUZE NON-IMPREG/STERILE>48 SQ.IN.W/O ADHES. EACH
GAUZE,ELASTIC,STERILE, ALL TYPES, PER LINEAL YARD
GAUZE.NON-ELASTIC,STERILE ALL TYPES, PER LINEAL YD
PACKING STRIPS, NON-IMPREGNATED, UP TO 2 INCHS IN WIDTH, PER LINEAR YARD
EYE PAD, STERILE, EACH
EYE PAD, NON-STERILE, EACH
EYE PATCH, OCCLUSIVE, EACH
PADDING BANDAGE, NON-ELASTIC, NON-WOVEN-KNITTED, WIDTH >= 3 INCHS <= 5 INCHS
CONFORMING BANDAGE, NON-ELASTIC, KNITTED/WOVEN, NON-SERTILE WIDTH <3 INCHS/YD
CONFORMING BANDAGE, NON-ELASTIC, KNIT/WOVEN, NON-STER WDTH >=3 INCH< 5 INCH/YD
CONFORMING BANDAGE, NON-ELASTIC, KNIT/WOVEN, NON-STERILE WDTH >= 5 INCH/YD
CONFORMING BANDAGE, NON-ELASTIC, KNIT/WOVEN, WIDTH LESS 3 INCHS/YD
CONFORMING BANDAGE, NON-ELASTIC, KNIT/WOVEN, WIDTH >= 3 INCHES/YD
CONFORMING BANDAGE, NON-ELASTIC, KNIT/WOVEN, WIDTH >= 5 INCHES/YD
LIGHT COMPRESSION BANDAGE, ELASTIC, KNIT/WOVEN, WIDTH LESS 3 INCHES/YD
LIGHT COMPRESSION BANDAGE, ELASTIC, KNIT/WOVEN WIDTH >= 3 INCHES < 5 INCHES/YD
LIGHT COMPRESSION BANDAGE, ELASTIC, KNIT/WOVEN WIDTH >= 5 INCHES/YD
MODERATE COMP BANDAGE, ELASTIC, KNIT/WOVEN, LOAD RESISTANCE OF 1.25 TO 1.34 LB
HIGH COMP BANDAGE ELASTIC KNIT/WOVEN LOAD RESISTANCE >= TO 1.35 FOOT LBS
SELF-ADHERENT BANDAGE, ELASITC, NON/KNIT/NON-WOVEN, WIDTH < 3 INCHS/YD
SELF-ADHERENT BANDAGE, ELAST, NON/KNIT/NON-WOVEN, WIDTH >= 3 INCHS < 5 INCHS/YD
SELF-ADHERENT BANDAGE, ELAS, NON-KNIT/NON-WOVEN >= 5 INCH/YD
ZINC PASTE IMPREGNATED BANDAGE, NON-ELAS, KNIT/NON-WOVEN, WIDTH >= 3<5 INCH/YD
TUBULAR DRESSING W/WO ELASTIC, ANY WIDTH, PER LINEAR YARD
COMPRESSION BURN GARMENT BODYSUIT (HEAD TO FOOT) CUSTOM FABRICATED
COMPRESSION BODY GARMENT CAID STRAP CUSTOM FABRICATED
COMPRESSION BODY GARMENT FACIAL HOOD CUSTOM FABRICATED
COMPRESSION BODY GARMENT GLOVE TO WRIST CUSTOM FABRICATED
COMPRESSION BODY GARMENT GLOVE TO ELBOW CUSTOM FABRICATED
COMPRESSION BODY GARMENT GLOVE TO AXILLA CUSTOM FABRICATED
COMPRESSION BODY GARMENT FOOT TO KNEE LENGTH CUSTOM FABRICATED
COMPRESSION BODY GARMENT FOOT TO THIGH LENGTH CUSTOM FABRICATED
COMPRESSION BODY GARMENT UPPER TRUNK TO WAIST INCLUDING ARM OPENINGS (VEST)
COMPRESSION BODY GARMENT TRUNK INCLUDING ARMS DOWN TO LEG OPENINGS (LEOTARD)
COMPRESSION BODY GARMENT LOWER TRUNK INCLUDING LEG OPENINGS (PANTY) CUSTOM FABRI
COMPRESSION BODY GARMENT NOT OTHERWISE CLASSIFIED
COMPRESSION BURN MASK, FACE AND/PR NECK, PLASTIC OR EQUAL, CUSTOM FAB
GRADIENT COMPRESSION STOCKING, BELOW KNEE 18-30 MMHG, EACH
GRADIENT COMPRESSION STOCKING, BELOW KNEE 30-40 MMHG, EACH
GRADIENT COMPRESSION STOCKING, BELOW KNEE 40-50 MMHG, EACH
GRADIENT COMPRESSION STOCKING, THIGH LENGTH 18-30 MMHG, EACH
GRADIENT COMPRESSION STOCKING, THIGH LENGTH 30-40 MMHG, EACH
GRADIENT COMPRESSION STOCKING, THIGH LENGTH 40-50 MMHG, EACH
GRADIENT COMPRESSION STOCKING, FULL LENGTH 18-30 MMHG, EACH
GRADIENT COMPRESSION STOCKING, FULL LENGTH 30-40 MMHG, EACH
GRADIENT COMPRESSION STOCKING, FULL LENGTH 40-50 MMHG, EACH
GRADIENT COMPRESSION STOCKING, WAIST LENGTH 18-30 MMHG, EACH
GRADIENT COMPRESSION STOCKING, WAIST LENGTH 30-40 MMHG, EACH
GRADIENT COMPRESSION STOCKING, WAIST LENGTH 40-50 MMHG, EACH
GRADIENT COMPRESSION STOCKING, GARTER BELT
GRADIENT COMPRESSION WRAP, NON-ELASTIC, BK, 30-50 MM HG, EA
GRADIENT COMPRESSION STOCKING/SLEEVE, NOT OTHERWISE SPEC
DRESSING SET FOR NEGATIVE PRESSURE WOUND THERAPY ELECTRICAL PUMP, STAT OR PORT
CANISTER, DISPOSABLE, USED WITH SUCTION PUMP, EACH
CANISTER, NON-DISPOSABLE, USED WITH SUCTION PUMP, EACH
TUBING, USED WITH SUCTION PUMP, EACH
ADMINISTRATION SET, W/ SMALL VOLUME NON-FILTERED PNEUMATIC NEBULIZER, DISPOSABLE
SMALL VOLUME NONFILTERED PNEUMATIC NEBULIZER, DISPOSABLE
ADMINISTRATION SET, W/ SM VOLUME NON-FILTERED PNEUMATIC NEBULIZER, NON-DISPOSABL
ADMINISTRATION SET, WITH SMALL VOLUME FILTERED PNEUMATIC NEBULIZER
LARGE VOLUME NEBULIZER, DISPOSABLE, UNFILLED, USED WITH AEROSOL COMPRESSOR
LARGE VOLUME NEBULIZER, DISPOSABLE, PREFILLED, USED WITH AEROSOL COMPRESSOR
RESERVOIR BOTTLE, NON-DISPOSABLE, USED WITH LARGE VOLUME ULTRASONIC NEBULIZER
CORRUGATED TUBING, DISPOSABLE, USED WITH LARGE VOLUME NEBULIZER, 100 FEET
CORRUGATED TUBING, NON-DISPOSABLE, USED W/ LARGE VOLUME NEBULIZER, 10 FEET
WATER COLLECTION DEVICE, USED WITH LARGE VOLUME NEBULIZER
FILTER, DISPOSABLE, USED WITH AEROSOL COMPRESSOR
FILTER, NON-DISPOSABLE, USED W/AEROSOL COMPRESSOR OR ULTRASONIC GENERATOR
AEROSOL MASK, USED WITH DME NEBULIZER
DOME AND MOUTHPIECE, USED WITH SMALL VOLUME ULTRASONIC NEBULIZER
NEBULIZER, DURABLE, GLASS OR AUTOCLAVABLE PLASTIC BOTTLE TYPE NOT USED W/ OXYGEN
WATER DISTILLED USED WITH LARGE VOLUME NEBULIZER 1000 ML
HIGH FREQUENCY CHEST WALL OSCILLATION SYSTEM VEST REPLACEMENT FOR USE WITH PATI
HIGH FREQUENCY CHEST WALL OSCILLATION SYSTEM HOSE REPLACEMENT FOR USE WITH PATIE
COMBINATION ORAL/NASAL MASK, USED W/ CONTINUOUS POSITIVE AIRWAY PRESSURE DEVICE
ORAL CUSHION FOR COMBINATION ORAL/NASAL MASK, REPLACEMENT ONLY, EA
NASAL PILLOWS FOR COMBINATION ORAL/NASAL MASK, REPLACEMENT ONLY, PR
FULL FACE MASK USED WITH POSITIVE AIRWAY PRESSURE DEVICE; EACH
FACE MASK INTERFACE REPLACEMENT FOR FULL FACE MASK; EACH
REPLACEMENT CUSHION FOR NASAL APPLICATION DEVICE; EACH
REPLACEMENT PILLOWS FOR NASAL APPLICATION DEVICE; EACH
NASAL INTERFACE (MASK OR CANNULA TYPE)USED WITH POSITIVE AIRWAY PRESSURE DEVICE
HEADGEAR USED WITH POSITIVE AIRWAY PRESSURE DEVICE
CHINSTRAP USED WITH POSITIVE AIRWAY PRESSURE DEVICE
TUBING USED WITH POSITIVE AIRWAY PRESSURE DEVICE
FILTER;DISPOSABLE USED WITH POSITIVE AIRWAY PRESSURE DEVICE
FILTER;NON-DISPOSABLE USED WITH POSITIVE AIRWAY PRESSURE DEVICE
ONE WAY CHEST DRAIN VALVE
WATER SEAL DRAINAGE CONTAINER AND TUBING FOR USE WITH IMPLANTED CHEST TUBE
IMPLANTED PLEURAL CATHETER;EACH
VACUUM DRAINAGE BOTTLE AND TUBING FOR USE WITH IMPLANTED CATHETER
ORAL INTERFACE USED WITH POSITIVE AIRWAY PRESSURE DEVICE;EACH
EXHALATION PORT W OR W/O SWIVEL USED W ACCESSORIES FOR POSITIVE AIRWAY DEVICES
WATER CHAMBER FOR HUMIDIFIER, USED W/POSITIVE AIRWAY PRESSURE DEVICE, REPLACE
TRACHEOSTOMA VALVE INCLUDING DIAPHRAGM; EACH
REPLACEMENT DIAPHRAGM/FACEPLATE FOR TRACHEOSTOMA VALVE; EACH
FILTER HOLDER OR CAP REUSABLE FOR USE IN TRACH. HEAT AND MOISTURE EXCHANGE SYSTM
FILTER FOR USE IN A TRACHEOSTOMA HEAT AND MOISTURE EXCHANGE SYSTEM; EACH
HOUSING REUSABLE WITHOUT ADHESIVE FOR USE IN HEAT AND MOISTURE EXCHANGE SYSTEM
ADHESIVE DISC FOR USE IN A HEAT AND MOISTURE EXCHANGE SYSTEM, ANY TYPE, EACH
FILTER HOLDER & INTEGRATED FILTER WITHOUT ADHESIVE FOR USE WITH TRACH
HOUSING & INTEGRATED ADHESIVE FOR USE IN TRACH HEAT AND MOISTURE EXCHANGE
FILTER HOLDER & INTEGRATED FILTER HOUSING & ADHESIVE TRACH HEAT & MOISTURE
TRACHEOSTOMY/LARYNGECTOMY TUBE, NON-CUFFED; POLYVINYLCHLORIDE, (PVC) SILICON
TRACHEOSTOMY/LARYNGECTOMY TUBE NON-CUFF, POLYVINLCHLORIDE (PVC) SILICONE, EACH
TRACHEOSTOMY/LARYNGECTOMY TUBE, STAINLESS STEAL OR EQUAL (STERILIZABLE AND REUSE
TRACHEOSTOMY MASK, EACH
TRACHEOSTOMY TUBE COLLAR/HOLDER, EACH
TRACHEOSTOMY/LARYNECTOMY TUBE PLUG/STOP, EACH
HELMET, PROTECTIVE, SOFT, PREFABRICATED, INCLUDES ALL COMPONENTS AND ACCESSORIES
HELMET, PROTECTIVE, HARD, PREFABRICATED, INCLUDES ALL COMPONENTS AND ACCESSORIES
HELMET, PROTECTIVE, SOFT, CUSTOM FABRICATED, INCL ALL COMPONENTS/ACCESSORIES
HELMET, PROTECTIVE, HARD, CUSTOM FABRICATED, INCL/ COMPONENTS AND ACCESSORIES
SOFT INTERFACE FOR HELMET, REPLACEMENT ONLY
SUPPLY OF RADIOPHARM THEARP AGENT, IODINATED I-131 TOSITUMOMAB PER MILLICURIE
MULTIPLE VITAMINS, W/ OR W/O MINERALS & TRACE ELEMENTS, ORAL, PER DOSE, NOS
MULTIPLE VITAMINS WITH OR WITHOUT TRACE ELEMENTS, ORAL, PER DOSE
PEDICULOSIS TREATMENT, TOPICAL, FOR ADMINISTRATION BY PATIENT/CARETAKER
HOME GLUCOSE DISP MONITOR, INCLUDES TEST STRIPS
SPIROMETER, NON-ELECTRONIC, INCLUDES ALL ACCESSORIES
DIAGNOSTIC IMAGING, TECHNETIUM TC99M SESTAMIBI,PER
RADIOPHARM. DX IMAGING-AGENT TC99M TETROFOSMIN, PER UNIT DOSE
SUPPLY-TECHNETIUM TC 99M, MEDRONATE, UP TO 30 MCI
SUPPLY-TECHNETIUM TC-99M APCITIDE
DIAGNOSTIC IMAGING, THALLOUS CLORIDE TL201,PER MC1
INDIUM IN III CAPROMAB PENDETIDE RADIONUCLIDE
SUPPLY OF RADIOPHARMACEUTICAL DIAGNOSTIC IMAGING AGENT IOBENGUANE I-131 / 05 MCI
SUPPLY RADIOPHARMACEUTICAL DIAGNOSTIC IMAGAGING AGENT TECHNETIUM TC99 DISOFENIN
SUPPLY OF RADIOPHARMACEUTICAL DIAGN IMAG AGENT TECHNETIUM TC 99M PER MCI
SUPPLY OF RADIOPHARMACEUTICAL DIAGN IMAG AGENT I-123 SODIUM IODIDE PER MCI
SUPPLY OF RADIOPHARMACEUTIC AL DIAGN IMAGING AGENT I/123 SODIUM IODIDE PER MCI
SUPPLY OF RADIOPHARMACEUTICAL DIAGN IMAGING TECHNITIUM TC 99M, PER MCI
IODINATED I-131 SERUM ALBUMIN, 5 MICROCURIES
SUPPLY OF RADIOPHARMACEUTICAL DIAGNOSTIC IMAGING AGENT, AMMONIA N-13 PER DOSE
IODINE I-125, SODIUM IODIDE SOLUTION, THERAPEUTIC, PER MILLICURIE
SUPPLY OF RADIOPHARM DIAGNOSTIC AGENT, I-131 SODIUM IODIDE CAPSULE, PER MILLICUR
SUPPLY OF RADIOPHARMACEUTICAL DIAGNOSTIC AGENT, I-131 SOD IODIDE SOL, PER MILLI
SUPPLY OF RADIOPHARM THERAP AGENT, I-131 SOD IODIDE SOL, PER MILLIC UP TO 100
SUPPLY OF RADIOPHARM DIAGN AGENT, I-131 SODIUM IODIDE SOL, PER MILLIC UP TO 100
SUPPLY OF RADIOPHARM THEARP AGENT, IODINATED 1-125, SERUM ALBUMIN, 5 MICRO CUR
TECHNETIUM TC-99M DEPREOTIDE, DIAGNOSTIC, UP TO 35 MILLICURIES
TECHNETIUM TC-99M MEBROFENIN, DIAGNOSTIC, UP TO 15 MILLICURIES
TECHNETIUM TC-99M PYROPHOSPHATE, DIAGNOSTIC, UP TO 25 MILLICURIES
TECHNETIUM TC-99M PENTETATE, DIAGNOSTIC, UP TO 25 MILLICURIES
TECHNETIUM TC-99M MACROAGGREGATED ALBUMIN, DIAGNOSTIC, UP TO 10 MILLICURIES
TECHNETIUM TC-99M SULFUR COLLOID, DIAGNOSTIC, UP TO 20 MILLICURIES
INDIUM IN-111 IBRITUMOMAB, TIUXETAN, DIAGNOSTIC, UP TO 5 MILLICURIES
YTTRIUM Y-90 IBRITUMOMAB, TIUXETAN, THERAPEUTIC, UP TO 40 MILLICURIES
IODINE I-131 TOSITUMOMAB, DIAGNOSTIC, PER TREATMENT DOSE
IODINE I-131 TOSITUMOMAB, THERAPEUTIC, PER TREATMENT DOSE
COBALT CO-57/58 CYANOCOBALAMIN, DIAGNOSTIC, UP TO 1 MICROCURIE
INDIUM IN-111 OXYQUINOLINE, DIAGNOSTIC, PER 0.5 MILLICURE
INDIUM IN-111 PENTETATE DIAGNOSTIC, PER 0.5 MILLICURE
TECHNETIUM TC-99M SODIUM GLUCEPTATE, DIAGNOSTIC, UP TO 25 MILLICURIES
TECHNETIUM TC-99M SUCCIMER, DIAGNOSTIC, UP TO 10 MILLICURIES
FLOURODEOXYGLUCOSE F-18 FDG, DIAGNOSTIC PER STUDY DOSE, UP TO 45 MILLICURIES
CHROMIUM CR-51 SODIUM, DIAGNOSTIC, UP TO 250 MICROCURIES
IODINE I-125 SODIUM IOTHALAMATE, DIAGNOSTIC, UP TO 10 MICROCURIES
RUBIDIUM RB-82, DIAGNOSTIC, PER STUDY DOSE, UP TO 60 MILLICURIES
GALLIUM GA-67 CITRATE DIAGNOSTIC, PER MILLICURIE
TECHNETIUM TC-99M BICISATE, DIAGNOSTIC, PER STUDY DOSE, UP TO 25 MILLICURIES
XENON XE-133 GAS, DIAGNOSTIC, PER 10 MILLICURIES
COBALT CO-57 CYANOBOBALAMIN, ORAL, DIAGNOSTIC, UP TO 1 MICROCURIE
TECHNETIUM TC-99M LABELED RED BLODD CELLS, DIAGNOSTIC, UP TO 30 MILLICURIES
TECHNETIUM TC-99M OXIDRONATE, DIAGNOSTIC, UP TO 30 MILLICURIES
TECHNETIUM TC-99M MERTIATIDE, DIAGNOSTIC, UP TO 15 MILLICURIES
SODIUM PHOSPHATE P-32 THERAPEUTIC PER MILLICURIE
CHROMIC PHOSPHATE P-32 SUSPENSION, THERAPEUTIC, PER MILLICURIE
TECHNETIUM TC-99M FANOLESOMAB, DIAGNOSTIC, UP TO 25 MILLICURIES
TECHNETIUM TC-99M PENTETATE, DIAGNOSTIC, AEROSOL, UP TO 25 MILLICURIES
TECHNETIUM TC-99M ARCITUMOMAB, DIAGNOSTIC, PER STUDY DOSE, UP TO 45 MILLICURIES
TECHNETIUM TC -99M EXAMETAZIME LABELED AUTOLOGUS WHITE BLOOD CELLS
INDIUM IN -111 LABELED AUTOLOGUS WHITE BLOOD CELLS, DIAGNOSTIC PER STUDY DOSE
INDIUM IN -111 LABELED AUTOLOGUS PLATELETS, DIAGNOSTIC PER STUDY DOSE
INDIUM IN -111 PENTETREOTIDE, DIAGNOSTIC PER STUDY DOSE, UP TO 6 MILLICURIES
GADOTERIDOL, (PROHANCE MULTIPACK PER ML
INJECTION, GADOBENATE DIMEGLUMINE (MULTIHANCE) PER ML
INJECTION, GADOBENATE DIMEGLUMINE (MULTIHANCE MULTIPACK) PER ML
INJECTION, GADOLINUM -BASED MAGNETIC RESONANCE CONTRAST AGENT
NAFL F-18, DIAGNOSTIC, PER STUDY DOSE, UP TO 30 MILLICURIES
INJECTION, GADOXETATE DISODIUM, 1 ML
IODINE I-123 IOBENGUANE, DIAGNOSTIC, PER STUDY DOSE, UP TO 15 MILLICURIES
INJECTION, GADOFOSVESET TRISODIUM, 1 ML
RADIOPHARM.THERAPEUTIC, STRONTIUM-89 CHLORIDE, PER MCL
SAMARIUM SM-153 LEXIDRONAM, THERAPEUTIC, PER TX DOSE, UP TO 150
NON-RADIOACTIVE CONTRAST IMAGING MATERIAL, NOC
SUPPLY OF RADIOPHARM THERAPEUTIC IMAGNG AGNT, NOT OTHERWISE CLASSIFIED
SUPPLY INJECTABLE CONTRAST MATERIAL FOR USE IN ECHOCARDIOGRAPHY, PER STUDY
MISC DME SUPPLY ACCESSORY AND OR SERVICE COMPONENT OF ANOTHER HCPC CODE
FLOURODEOXYGL UCOSE F-18 FDG, DIAGNOSTIC, PER STUDY DOSE, UP TO 45 MILLICURIES
CHROMIUM CR-51 SODIUM, DIAGNOSTIC, UP TO 250 MICROCURRIES
IODINE I-125 SODIUM IOTHALAMATE, DIAGNOSTIC, UP TO 10 MICROCURRIES
RUBIDIUM RB-82, DIAGNOSTIC, PER STUDY DOSE, UP TO 60 MILLICURRIES
MISC DME SUPPLY OR ACCESSORY, NOT OTHERWISE SPECIFIED
ENTERAL FEEDING SUPPLY KIT-SYRINGE PER DAY
ENTERAL FEEDING SUPPLY KIT,PUMP FED, PER DAY
ENTERAL FEEDING SUPPLY KIT GRAVITY FED-PER DAY
NASOGASTRIC TUBING WITH STYLET
NASOGASTRIC TUBING WITHOUT STYLET
STOMACH TUBE - LEVINE TYPE
GASTROSTOMY/JEJUNOSTOMY TUBE, STANDARD, ANY MATERIAL, ANY TYPE, EA
GASTROSTOMY/JEJUNOSTOMY TUBE, LOW-PROFILE, ANY MATERIAL, ANY TYPE, EACH
FOOD THICKENER ADMINISTERED ORALLY PER OUNCE
ENTERAL FORMULA, FOR PEDIATRICS, TO REPLACE FLUIDS & ELECTROLYTES, 500 ML=1 UNIT
ADDITIVE FOR ENTERAL FORMULA
ENTERAL FORMULA, BLENDERIZED NATURAL FOODS W/ INTACT NUTRIENTS, 100 CAL=1 UNIT
ENTERAL FORMULA,CATEGORY I,SEMI-SYNTH.100 CAL=1 UNIT
ENTERAL FORMULA CATEGORY II:100 CAL=1 UNIT INTACT PROTEIN CALORICALLY DENSE
ENTRAL FORM.CAT 3-100 CAL=1 UNIT, HYDROLIZED PROTEIN/AMINO ACIDS
ENT.FORM.CAT.4:100 CAL=1 UNIT, DEFINED FORMULA FOR SPECIAL METABOLIC NEED
ENT.FORMULA CAT.5:100 CAL=-1 UNIT, MODULAR COMPONENTS
ENT FORM, NUTRITIONALLY COMPLETE, FOR SPECIAL METABOLIC NEEDS, 100 CAL=1 UNIT
ENTERAL FORMULA, FOR PEDIATRICS, NUTRITIONALLY COMPLETE, 100 CALL=1 UNIT
ENTERAL FORMULA, FOR PEDIATRICS, NUTRITIONALLY COMPLETE SOY BASED,100 CAL=1 UNIT
ENTERAL FORMULA, FOR PEDIATRICS, NUTRITIONALLY COMPLETE, CAL DENSE
ENTERAL FORMULA, FOR PEDIATRIC, HYDROLYZED/AMINO ACIDS
ENTERAL FORMULA, FOR PEDIATRIC, HYDROLYZED/AMINO ACIDS, 100 CAL=1 UN
TPN HOMEMIX DEXTROSE 50% OR LESS-500 ML=1 UNIT
PARENTERAL NUTR.SOL.AMINO ACID,3.5% HOMEMIX 500ML
PARENTERAL NUTR SOLU, AMINO ACID 5.5 TH 7% HOMEMIX
PARENTERAL NUTR SOL AMINOACID GREAT 7% HOMEMIX 500
TPN HOMEMIX AMINOACID 8.5% OR MORE 500ML = 1 UNIT
TPN HOMEMIX,CARBOHYDRATE(DEXTROSE)MORE THAN 50%
PARENTERAL NATURAL SOLUTION, PER 10 GRAMS LIPIDS
TPN 10-51 GMS PROTEIN-PREMIX
TPN PREMIX 52-73 GMS PROTEIN
TPN 74-100 GMS PROTEIN PREMIX
TPN OVER 100 GMS PROTEIN-PRE MIX
PARENTERAL NUTRITION ADDITIVE(HEPARIN,VIT,ELCTRLYT
PARENTERAL NUT SUP KIT FOR 1-DAY-PREMIX
PARENTAL NUTR SUPPLY KIT HOME MIX PER DAY
PARENTERAL NUTRITION ADMIN KIT PER DAY
TPN PREMIX W/PREP ANY STRENGTH PER GM RENAL
TPN PREMIX W/PREP ANY STRENGTH PER GM HEPATIC
TPN PREMIX W/PREP ANY STRENGTH PER GM STRESS
ENTERAL NUTRITION INFUSION PUMP W/O ALARM-PURCHASE
ENTERAL NUTRITION INFUSION PUMP W/ALARM-PURCHASE
PARENTERAL NUTRITION INFUSION PUMP, PORTABLE-PURCH
STATIONARY PARENTERAL PUMP
NOC FOR ENTERAL SUPPLIES
NOC FOR PARENTERAL SUPPLIES
HYPERBARIC OXYGEN UNDER PRESSURE, FULL BODY CHAMBER, PER 30 MIN INTERVAL
ADHESIVE BARRIER
OCCULAR IMPLANT, AQUEOUS DRAINAGE ASSIST DEVICE
RETINAL TAMPONADE DEVICE, SILICONE OIL
INTEGRATED KERATOPROSTHESIS
LEAD, LEFT VENTRICULAR CORONARY VENOUS SYSTEM
PROBE, PERCUTANEOUS LUMBAR DISCECTOMY
BRACHYTHERAPY SOURCE, YTTRIUM-90
PROBE, CRYOABLATION
MAGNETIC RESONANCE ANGIOGRAPHY W CONTRAST, ABDOMEN
MAGNETIC RESONANCE ANGIOGRAPHY W/O CONTRAST, ABDOMEN
MAGNETIC RESONANCE ANGIOGRAPHY W/O CONTRAST FOLLOWED BY CONTRAST, ABDOMEN
MAGNETIC RESONANCE ANGIOGRAPHY W CONTRAST, BREAST, UNILATERAL
MAGNETIC RESONANCE IMAGING W/O CONTRAST, BREAST, UNILATERAL
MAGNETIC RESONANCE IMAGING W/O CONTRAST BREAST, UNILATERAL
MAGNETIC RESONANCE IMAGING W CONTRAST, BREAST BILATERAL
MAGNETIC RESONANCE IMAGING WITHOUT CONTRAST, BREAST BILATERAL
MAGNETIC RESONANCE IMAGING W/O CONTRAST BREAST, BILATERAL
MAGNETIC RESONANCE ANGIOGRAPHY W CONTRAST, CHEST (EXCLUDING MYOCARDIUM)
MAGNETIC RESONANCE ANGIOGRAPHY W/O CONTRAST, CHEST (EXCLUDING MYOCARDIUM)
MAGNETIC RESONANCE ANGIOGRAPHY W/O CONTRAST FOLLOWED BY CONTRAST - CHEST
MAGNETIC RESONANCE ANGIOGRAPHY W CONTRAST LOWER EXTREMITY
MAGNETIC RESONANCE ANGIOGRAPHY W/O CONTRAST LOWER EXTREMITY
MAGNETIC RESONANCE ANGIOGRAPHY W/O CONTRAST FOLLOWED W CONTRAST L EXTREMITY
MAGNETIC RESONANCE ANGIOGRAPHY WITH CONTRAST, PELVIS
MAGNETIC RESONANCE ANGIOGRAPHY WITHOUT CONTRAST, PELVIS
MAGNETIC RESONANCE ANGIOGRAPHY W/O CONTRAST,FOLLOWED BY CONTRAST, PELVIS
TTE W/WO CNTRST W/ BYRECRD, IF, W/ SPCTRL DPLR ECHOCARD, & W/ COLR FLOW DPLR
TTE W OR W/O CONTR, CONT ECG
INJECTION, CLEVIDIPIEN BUTYRATE, 1 MG
TENDON, POROUS MATRIX OF CROSS LINKED COLLAGEN AND GLYCOSAMINOGLYCAN
DERMAL SUBS NATIVE NON DENATURED COLLAGEN PER 0.5 SQ CENTIMETERS
POROUS PURIFIED COLLAGEN MATRIX BONE VOID FILLER PER 0.5CC
CANE, ALL MATERIAL, FIXED OR ADJUST W/TIP
CANE, QUAD OR THREE PRONG
CRUTCHES,FOREARM,INCLUDES ADJUST/FIXED,PAIR
CRUTCH FOREARM ADJUST OR FIX W/TIP & HANDGRIP
CRUTCHES, UNDERARM, WOOD, ADJUSTABLE OR FIXED
CRUTCH,UNDER ARM WOOD,ADJUST OR FIXED EA W/PAD TIP
CRUTCH ALUM. ADJ. OR FIX, PAIR W/PAD TIP
CRUTCH W/ UNDERARM PAD ALUMINUM, ADJUST OR FIXED EACH
CRUTCH SUBSTITUTE, LOWER LEG PLATFORM, W OR W/O WHEELS, EACH
WALKER, RIGID, (PICKUP), ADJUSTABLE OR FIXED
WALKER FOLDING ADJUSTABLE OR FIXED HEIGHT
WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OF FIXED HEIGHT, ANY TYPE
RIGID WALKER, WHEELED W/O SEAT
FOLDING WALKER WHEELED WITHOUT SEAT
ENCLOSED, FRAMED FOLDING WALKER, WHEELED, WITH POSTERIOR SEAT
HEAVY DUTY, MULTIPLE BREAK SYS, VARIABLE WH RES WA
WALKER HEAVY DUTY WITHOUT WHEELS RIGID OR FOLDING ANY TYPE; EACH
WALKER HEAVY DUTY WHEELED RIGID OR FOLDING ANY TYPE; EACH
PLATFORM ATTACHMENT, FOREARM CRUTCH, EACH
PLATFORM ATTACHMENT, WALKER, EACH
WHEEL ATTACH, RIGID PICK-UP WALKER ATTACH
SEAT ATTACH, WALKER
CRUTCH ATTACH, WALKER, EACH
LEG EXTENSIONS FOR A WALKER (SET)
BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH
SITZ TYPE BATH,PORTABLE, FITS OVER COMMODE SEAT
SITZ BATH PORTABLE, FITS OVER COMMODE SEAT W/FAUCE
COMMODE CHAIR STATIONARY WITH FIXED ARMS
COMMODE CHAIR STATIONARY DETACH ARMS-PURCHASE PRIC
PAIL OR PAN FOR USE W/COMMODE CHAIR
COMODE CHAIR EXTRA WIDE. OR HEAVY DUTY STATIONARY OR MOBILE WITH OR W/O ARMS
COMMODE CHAIR WITH INTEGRATED SEAT LIFT MECHANISIM, ELECTRIC, ANY TYPE
COMMODE CHAIR WITH INTEGRATED SEAT LIFT MECHANISIM, NON-ELECTRIC, ANY TYPE
SEAT LIFT MECHANISM PLACED OVER OR ON TOP OF TOILET, ANY TYPE
FOOT REST, FOR USE WITH COMMODE CHAIR, EACH
PRESSURE PAD, ALTERN WITH PUMP, HEAVY DUTY
PUMP FOR ALTERN PRESSURE PAD
DRY PRESSURE MATTRESS EG EGGCRATE
GEL (LIKE) PRESSURE PAD FOR MATTRESS, STD. MATTRESS LENGTH & WIDTH
AIR PRESSURE MATTRESS
WATER PRESSURE MATTRESS-PURCHASE PRICE
SYNTHETIC SHEEPSKIN PAD
LAMBSWOOL SHEEPSKIN PAD, ANDY SIZE
POSITIONING CUSHION/PILLOW/WEDGE, ANY SHAPE OR SIZE
HEEL OR ELBOW PROTECTOR
POWERED AIR FLOTATION BED-LOW AIR LOSS THERAPY
AIR FLUIDIZED BED
GEL PRESSURE MATTRESS
AIR PRESSURE PAD FOR MATTRESS STANDARD MATTRESS LENGTH/WIDTH-PURCHASE PRICE
WATER PRESSURE PAD FOR MATTRESS STANDARD MATTRESS LENGTH/WIDTH-PURCHASE PRICE
DRY PRESSURE PAD FOR MATTRESS-STANDARD LENGTH AND WIDTH-PURCHASE PRICE
HEAT LAMP,WITHOUT STAND (TAB MOD) INC BULB OR INFR
PHOTOTHERAPY (BILIRUBIN) LIGHT W/PHOTOMETER-(DAILY)
HEAT LAMP, WITH STAND INC BULB OR INFRARED ELEMENT
ELECTRIC HEAT PAD, STANDARD
ELECTRIC HEAT PAD, MOIST
WATER CIRCULATING HEAT PAD W/PUMP
HOT WATER BOTTLE
HYDROCOLLATOR W/ PADS
ICE CAP OR COLLAR
NON-ELECTRIC HEAT PAD, MOIST
HYDROCOLLATOR UNIT, PORTABLE
BATH/SHOWER CHAIR, WITH OR W/O WHEELS, ANY SIZE
BATHTUB RAIL-WALL, EACH
BATH TUB RAIL, FLOOR BASE
TOILET RAIL, EACH
RAISED TOILET SEAT
TUB STOOL OR BENCH
TRANSFER TUB RAIL ATTACHMENT
TRANSFER BENCH FOR TUB OR TIOLET WITH OR W/O COMMODE OPENING
TRANSFER BENCH, HEAVY DUTY, FOR TUB OR TOILET WITH OR W/O COMMODE OPENING
PAD FOR WATER CIRCULATING HEAT UNIT
HP BED W/SIDE RAILS FIXED HGHT W/MATTRESS
HOSPITAL BED, WITH SIDE RAILS, FIXED HEIGHT NO MAT
HOSP BED, WITH SIDE RAILS VARI HEIGHT, HI-LO WI MA
HOSP BED VARIABLE HEIGHT HI/LOW SIDE RAIL WO/MATTR
HOSPITAL BED, W/SIDE RAILS,SEMI-ELECTRIC,W/MATRESS
HOSP BED SEMIELECTRIC W/SIDE RAIL WO/MATRESS
HP BED TOTAL ELECTRIC W/SIDERAILS
HOSP BED SIDE RAILS TOT ELEC HEAD, FT, HEIGHT ADJU
MATTRESS, INNERSPRING
MATTRESS, FOAM RUBBER
BED BOARD
BED PAN STANDARD
BED PAN, FRACTURE, METAL OR PLASTIC
POWERED PRESSURE-REDUCING AIR MATTRESS
BED CRADLE ANY TYPE
HOSP BED,FIXED HEIGHT,W/O SIDE RAILS, WITH MATTRES
HOSP BED, FIXED HGHT, W/OSIDE RAILS,W/O MATTRESS
HOSPITAL BED W/O SIDE RAILS W/MATTRESS
HOSP BED,VAR HGHT HI-LO, W/O SIDERAILS,W/O MATTRES
HOSPITAL BED W/O RAILS
SEMI-ELECTRIC HOSPITAL BED W/O RAILS & MATTRESS-PP
HOSP BED, TOTAL ELECTRIC U/O SIDERAILS, W/ MATTRES
HOSP BED,TOTAL ELECT: NO SIDERAILS, NO MATTRESS
PEDIATRIC CRIB, HOSPITAL GRADE, FULLY ENCLOSED
HOSPITAL BED, HEAVY DUTY, EXTRA WIDE WITH WEIGHT CAPACITY > 350 LBS < 600 LBS
HOSPITAL BED, HEAVY DUTY, EXTRA WIDE, WEIGHT CAPACITY <600 LBS W/ANY TYPE RAILS
HOSPITAL BED, HEAVY DUTY, EXTRA WIDE WEIGHT CAPACITY >350< 600 W/ANY TYPE RAILS
HOSPITAL BED, HVY DUTY, EXTRA WIDE CAPACITY >600 W/ANY SIDE RAILS W MATTRESS
BED SIDE RAILS, HALF LENGTH
BED SIDE RAILS, FULL LENGTH
SAFETY ENCLOSURE FRAME CANOPY FOR USE WITH HOSPITAL BED, ANY TYPE
URINAL MALE ANY MATERIAL
URINAL FEMALE ANY MATERIAL
NONPOWERED ADVANCED PRESSURE REDUCING MATTRESS OVERLAY, STD. L&W-PURCHASE PRICE
POWERED AIR OVERLAY FOR MATTRESS, STD. LENGTH & WIDTH- PURCHASE PRICE
NONPOWER ADVANCED PRESSURE REDUCING MATTRESS- PURCHASE PRICE
STATIONARY COMPRESSED 02 SYSTEM PURCHASE PRICE INC COMPLETE PKG 1 UNIT=50 CU FT
02 PORTABLE GASEOUS SYSTEM PURCHASE INCL COMPLETE PKG-RENTAL ONLY 6-1-97
PORTABLE LIQUID OXYGEN SYSTEM, RENTAL; HOME LIQUEFIER USED TO FILL PORTABLE
O2 PORTABLE LIQUID SYSTEM PURCHASE PRICE INCL COMPLETE PKG RENTAL ONLY 6-1-97
O2 SYSTEM, LIQUID, PORTABLE, PURCHASE ONLY
STATIONARY LIQUID 02 SYSTEM PURCHASE PRICE INC COMPLETE PKG 1 UNIT=10 LBS
STATIONARY 02 CONTENTS GASEOUS 1 UNIT=1 MONTH'S SUPPLY.
STATIONARY 02 CONTENTS LIQUID 1 UNIT= 1 MONTH'S SUPPLY
PORTABLE OXYGEN CONTENTS, GASEOUS, 1 UNIT=1 MONTH'S SUPPLY
PORTABLE 02 CONTENTS LIQUID PER UNIT 1-UNIT= 1 MONTH'S SUPPLY
OXIMETER DEVICE FOR MEASURING BLOOD OXYGEN LEVELS NON-INVASIVELY
VOLUME CONTROL VENTILATOR W/O PRESSURE SUPPORT MODE, MAY INCL PRES CNTRL MD
OXYGEN TENT, EXCLUDING CROUP OR PEDIATRIC TENTS
CHEST SHELL (CUIRASS)
CHEST WRAP
NEG PRESSURE VENTILATOR;PORTABLE, RENTAL/MONTH
VOLUME VENT, STATIONARY/ PORTABLE W/BACKUP RATE USED W/NON-INVASIVE INTERFACE
ROCKING BED W/WO SIDE RAILS
PRESSURE SUPPORT VENTILATOR W VOLUME CONTROL MODE, MAY INC PRESSURE MODE
PRESSURE SUPPORT VENTILATOR W VOLUME CONTROL MODE, W NON INVASIVE INTERFACE
RESPIRATORY ASSIST DEVICE, BI-LEVEL PRESSURE CAPABILITY W/O BACKUP RATE FEATURE
RESPIRATORY ASSIST DEVICE, BI-LEVEL PRESSURE CAPABILITY W/BACKUP RATE FEATURE
RESPIRATORY ASSIST DEVICE, BI-LEVEL PRESSURE CAPABILITY W/BACKUP RATE FEATURE
PERCUSSOR, ELECTRIC OR PNEUMATIC,HOME MODEL
COUGH STIMULATING DEVICE ALTERNATING POSITION AND NEGATIVE AIRWAY PRESSURE
HIGH FREQUENCY CHEST WALL OSCILLATION AIR-PULSE GENERATOR SYSTEM, EACH
OSCILLATORY POSITIVE EXPIRATORY PRESSURE DEVICE, NON-ELECTRIC, ANY TYPE, EACH
ORAL DEVICE APPLIANCE TO REDUCE UPPER AIRWAY COLLAPSIBILITY, PRE-FAB
ORAL DEVICE APPLIANCE TO REDUCE UPPER AIRWAY COLLAPSIBILITY, CUSTOM-FAB
IPPB MACHINE, ALL TYPES W/NEBULIZER-MONTHLY RENTAL
HUMIDIFIER EXTENSIVE SUPP HUMID FOR IPPB TX OR 02
HUMIDIFER DURABLE GLASS/PLASTIC BOTTLE; USE W/REG
HUMIDIFIER FOR SUPPLEMENTAL DURING IPPB TX OR 02 D
HUMIDIFIER, NON-HEATED USED W/POSITIVE AIR-WAY PRESSURE DEVICE
HUMIDIFIER, HEATED, USED W/POSITIVE AIR-WAY PRESSURE DEVICE
COMPRESSOR-AIR FOR DME NOT SELF CONTAINED, PUR.PRI
NEBULIZER WITH COMPRESSOR EG DEVILBISS, PULMO-AID
AEROSOL COMPRESSOR BATTERY POWERED FOR USE WITH SMALL VOLUME NEBULIZER
AEROSOL COMPRESSOR ADJUSTABLE PRESSURE LIGHT DUTY FOR INTERMITTENT USE
ULTRASONIC GENERATOR WITH SMALL VOLUME ULTRASONIC NEBULIZER
NEBULIZER, SELF-CONTAINED ULTRASONIC; PURCHASE PRI
NEBULIZER DURABLE BOTTLE TYPE
NEBULIZER, W/COMPRESSOR AND HEATER; PURCHASE PRICE
SUCTION PUMP HOME MODEL PORTABLE
NASAL CONTINUOUS AIRWAY PRESSURE (CPAP) DEVICE
BREAST PUMP ALL TYPES
BREAST PUMP; ELECTRIC, ANY TYPE
VAPORIZER, ROOM TYPE
POSTURAL DRAINAGE BOARD MONITORING EQUIPMENT
HOME BLOOD GLUCOSE MONITOR
PACEMAKER MON,SELF CONT CHEC BATT DEPLET/PACEMAK
PACEMAKER MONITOR
IMPLANTABLE CARDIAC EVENT RECORDER WITH MEMORY, ACTIVATOR, AND PROGRAMMER
EXTERNAL DEFIBRILLATOR WITH INTEGRATION ELECTROCARDIOGRAM ANALYSIS
APNEA MONITOR, WITH RECORDING FEATURE
SLING OR SEAT CANVAS OR NYLON
PATIENT LIFT, KARATOP, BATHROOM OR TOILET
SEAT LIFT MECHANISM INCORP INTO LIFT CHAIR MECHANT
SEPERATE SEAT LIFT MECHANISM W/PATIENT OWNED ELECT
SEPERATE SEAT LIFT MECHANISM W/PATIENT OWNED NON-E
HYDRAULIC PT LIFT W/SEAT OR SLING
PT LIFT ELECTRIC W/SEAT OR SLING
MULTIPOSITIONAL PATIENT SUPPORT SYSTEM, LIFT, PATIENT ACCESSIBLE CONTROLS
COMBINATION SIT TO STAND SYSTEM, ANY SIZE, W/SEAT LIFT FEATURE, W OR W/O WHEELS
STANDING FRAME SYSTEM, ANY SIZE, W OR W/O WHEELS
PATIENT LIFT, MOVEABLE FROM ROOM TO ROOM W DISASSEMBLY AND REASSEMBLY
PATIENT LIFT, FIXED SYSTEM, INCLUDES ALL COMPONENTS/ACCESSORIES
STANDING FRAME SYSTEM, MULTI POSITION
STANDING FRAME SYSTEM, MOBILE ANY SIZE INCL PEDIATRIC
PNEUMATIC COMPRESSOR HOME MODEL (LYMPHODEMA PUMP)
PNEUMATIC COMPRESSOR SEGMENTAL HOME MODEL (LUMPHAT
PNEU COMP SEG HOME MOD(LYMP PUMP)W/ CAL GRAD PRESS
PNEUMATIC APPL FOR USE WITH PNEUMATIC COMPRES HALE
PNEUMATIC APPL USE WITH PNEUMATIC COMP, FULL LEG
PNEUMATIC APPL USE WITH PNEUMATIC COMP, FULL ARM
PNEUMATIC APPLFOR USE WITH PNEUMATIC COMPR HALF L
PNEUM APPL FOR USE W/ SEGM PNEUM COMPRESSOR, LEG
PNEUM APPL FOR USE W/ SEGM PNEUM COMPRESSOR, ARM
SEGMENTAL PNEUMATIC APPLIANCE FOR USE WITH PNEUMATIC COMPRESSOR, HALF LEG
SEGMENTAL GRADIENT PRESSURE PNEUMATIC APPLIANCE, FULL LEG
SEGMENTAL GRADIENT PRESSURE PNEUMATIC APPLIANCE, FULL ARM
SEGMENTAL GRADIENT PRESSURE PNEUMATIC APPLIANCE, HALF LEG
INTERMITTENT LIMB COMPRESSION DEVICE (INCL ACCESSORIES), NOT OTHERWISE SPECIFIED
UV LIGHT THERAPY PANEL, INC. BULBS, TIMER, EYE PROTECT; TX AREA 2 SQ. FT OR LESS
UV LIGHT THERAPY PANEL, INC. BULBS, TIMER, EYE PROTECT; 4 FOOT PANEL
UV LIGHT THERAPY PANEL, INC. BULBS, TIMER, EYE PROTECTION, 6 FOOT PANEL
UV MULTIDIRECTIONAL LIGHT THERAPY SYSTEM IN 6 FOOT CABINET, INC. BULBS, TIMER, E
SAFETY EQUIP, DEVICE OR ACCESSORY, ANY TYPE
TRANSFER BOARD OR DEVICE, ANY TYPE, EACH
RESTRAINT, ANY TYPE
TENS TWO LEAD LOCALIZED STIMULATION
TENS FOUR LEAD LG AREA/MLTPL NERVE STIMULATION
FORM FITTING CONDUCTIVE GARMET FOR DELIV OF TENS/N
INCONTINENCT TX SYSTEM, PELVIC FLOOR STIMULATOR, MONITOR, SENSOR AND/OR TRAINER
NEUROMUSCULAR STIMULATOR FOR SCOLIOSIS
NEUROMUSCUL STIMUL, ELECTRON SHOCK UN NON-CLIN MOD
ELECTROMYOGRAPHY (EMG) FEEDBACK DEVICE
OSTEOGENESIS STIMULATOR (NON-INVASIVE)
OSTEOGENIC STIMULATOR, ELECTRICAL, NONINVASIVE, SPINAL APPLICATIONS
OSTEOGENESIS STIMULATOR (SURGICALLY IMPLANT)
OSTEOGENESIS STIMULATOR,LOW INTENSITY,ULTRASOUND
TRANSCUTANEOUS ELECTRICAL JOINT STIMULATION INCL ALL ACCESSORIES
FUNCTIONAL NEUROMUSCULAR STIMULATOR
FDA APPROVED NEUROSTIMULATOR W/ REPLACEABLE BATTERIES NAUSEA/VOMITING
ELECTRICAL STIMULATION OR ELECTROMAGNETIC WOUND TREATMENT DEVICE, NOC
FUNCT ELECT STIM, TRNSCUT STIM NRV &/OR MSCL GRPS, ANY TYPE, CMPLT SYST, NOS
IV POLE
AMBULATORY INFUSION PUMP; MECHANICAL REUSABLE FOR INFUSION; 8 HR OR GREATER
AMBULATORY INFUSION PUMP, MECHANICAL, REUSABLE FOR INFUSION LESS THAN 8 HOURS
EXTERNAL AMB INFUSION PUMP W/ADMIN EQUIP
PARENTERAL INFUSION PUMP, IMPLANTABLE
INFUSION PUMP, IMPLANTABLE, PROGRAMMABLE
EXTERNAL AMBULATORY INFUSION PUMP, INSULIN (PP)
IMPLANTABLE PROGRAMMABLE INFUSION PUMP REPLACEMENT
PARENTERAL INFUSION PUMP,STATIONARY-SINGLE/MULTICH
AMBULATORY TRACTION DEVICE; ALL TYPES; EACH
TRACTION FRAME ATTACH TO HEADBOARD SIMPLE CERVICAL
TRACTION EQUIPMENT, CERVICAL FREE STANDING STAND/FRAME, PNEUMATIC APPLYING TRACT
TRACTION STAND,FREE STANDING,CERVICAL TRACTION
CERVICAL TRACTION EQUIPMENT NOT REQUIRING ADDITIONAL STAND OR FRAME
CERVICAL TRACTION DEVICE, CERVICAL COLLAR W/INFLATABLE AIR BLADDER
OVERDOOR CERVICAL TRACTION PER EXTREMITY
TRAC FRAME,ATT TO FOOTBOARD SIMP EXTREM TRAC BUCK
TRAC STAND-FREE STAND-SIMPLE EXTREM TRAC EG BUCKS
TRAC FRAME ATTACH TO FOOTBOARD,SIMP PELVIC TRACT
TRAC STA FREE STAND SIMPL PELVIC TRAC TRAP EQUIP
TRAPEZE BARS ATT TO BED W/GRAB BAR
TRAPEZE BAR, FOR PATIENT WEIGHT CAPACITY GREATER THAN 250 LBS, ATTACHED TO BED
TRAPEZE BAR, FOR PATIENT WEIGHT CAPACITY GREATER THAN 250 LBS, FREESTANDING
FRAC FRAME, ATT TO BED INC WEIGHTS
FRAC FRAME, FREE STAND, INC WEIGHTS
PASSIVE MOTION EXERCISE DEVICE (PURCHASE PRICE)
TRAPEZE BAR FREE STANDING W/GRAB BAR
GRAVITY ASSISTED TRACT DEVICE, ANY TYPE
CERVICAL HEAD HARNESS/HALTER
PELVIC BELT/HARNESS/BOOT(PROSTHETIC TRACTION DEV)
EXTREMITY BELT/HARNESS
FRAC FRAMDUAL WI CROSS BAR ATT TO BED BALKEN 4 PO
FRAC FRAME ATT FOR COMPLEX PELVIC TRAC
FRAC FRAME ATT FOR COMPLEX CERVICAL TRAC
TRAY WHEELCHAIR
HEEL LOOP/HOLDER, ANY TYPE, W OR W/O ANKLE STRAP, WHEELCHAIR ACCES, EACH
TOE LOOP HOLDER ANY TYPE, WHEELCHAIR, EACH
WHEELCHAIR ACCESS, HEADREST CUSHIONED, ANY TYPE
WHEELCHAIR ACCESS, LATERAL TRUNK OR HIP SUPPORT, ANY TYPE
WHEELCHAIR ACCESS MEDIAL THIGH SUPPORT, ANY TYPE, EACH
WHEELCHR ATT TO CONV ANY WHEELCHR TO ONE ARM DRIVE
AMPUTEE ADAP DEV TO COMPEN TRAN OF WEIG LOST LIMIB
WHEELCHAIR ACCESSORY, SHOULDER HARNESS/STRAPS OR CHECT STRAPS, INCL ANY HARDWARE
BRAKE EXTENSION FOR WHEELCHAIR
HOOK ON HEAD REST EXTENSION
MANUAL WHEELCHAIR HAND RIMS WITH PROJECTIONS, ANY TYPE, REPLACEMENT EACH
COMMODE SEAT, WHEELCHAIR
NARROWING DEVICE WHEELCHAIR
NO 2 FOOTPLATES EXCEPT FOR ELEVATING LEG REST
ANTI-TIPPING DEVICE WHEELCHAIR
WHEELCHAIR ADJUST HGHT DETACH ARMS DESK/FULL
GRAD-AID FOR WHEELCAHIR
WHEELCHAIR ACCESSORY POSITIONING BELT/SAFTEY, BELT/PELVIC STRAP, EACH
SAFETY VEST, WHEELCHAIR
WHEELCHAIR ACCESS SEAT UPHOLSTERY, REPLACEMENT ONLY, EACH
WHEELCHAIR ACCESS BACK UPHOLSTERY, REPLACEMENT ONLY, EACH
MANUAL WHEELCHAIR ACCESS, POWER ADD-ON TO CONVERT MANUAL TO MOTORIZED, JOYSTICK
MANUAL WHEELCHAIR ACCESS, POWER ADD-ON TO CONVERT MANUAL TO MOTORIZED, TILLER
WHEELCHAIR ACCESSORY, SEAT LIFT MECHANISM
MANUAL WHEELCHAIR ACCESSORY, POWER ASSIST, EACH
ELEVATING LEG REST
SOLID SEAT INSERT
ARM REST, EACH
CALF REST, EACH
WHEELCHAIR ACCESSORY, POWER SEATING SYSTEM, TILT ONLY
WHEELCHAIR ACCESS, POWER SEATING SYSTEM, RECLINE ONLY, W/0 SHEAR REDUCTION
WHEELCHAIR ACCESS, POWER SEATING SYSTEM, RECLINE ONLY, W/MECH SHEAR REDUCTION
WHEELCHAIR ACCESS POWER SEATING SYSTEM, RECLINE ONLY, W/POWER SHEAR REDUCTION
WHEELCHAIR ACCESS, POWER SEATING SYSTEM, COMBINATION TILT AND RECLINE, W/O SHEAR
WHEELCHAIR ACCESS, POWER SEATING SYSTEM, TILT AND RECLINE, W/MECHAN SHEAR REDUCT
WHEELCHAIR ACCESS POWER SEATING SYSTEM, COMB TILT/RECLINE W/POWER SHEAR REDUCT
WHEELCHAIR ACCESS ADDITION TO POWER SEATING MECHANICALLY LINKED LEG ELEVATION
WHEELCHAIR ACCESS ADDIT TO POWER SEATING SYSTEM, POWER LEG ELEV SYSTEM, PAIR
MODIFY PED. SIZE WHEELCHAIR, WIDTH ADJUST PACKAGE (NOT DISPENSED W/INITIAL WC)
RECLINING BACK, ADDITION TO PEDIATRIC SIZE WHEELCHAIR
SHOCK ABSORBER FOR MANUAL WHEELCHAIR, EACH
SHOCK ABSORBER FOR POWER WHEELCHAIR, EACH
HEAVY DUTY SHOCK ABSORBER FOR HEAVY DUTY/EXTRA HD MANUAL WC, EACH
HEAVY DUTY SHOCK ABSORBER FOR HD/EXTRA HD POWER WHEELCHAIR, EACH
RESIDUAL LIMB SUPPORT SYSTEM FOR WHEELCHAIR
WC ACSSRY MNUAL SWNG AWAY, RETRCTBL OR REMVABL MNTNG HRDWR FOR JOY STCK
WHEELCHAIR ACCESSORY, VENTILATOR TRAY, FIXED
WHEELCHAIR ACCESSORY , VENTILATOR TRAY, GIMBALED
MULTI-POSITIONAL PATIENT TRANSFER SYSTEM/SEAT, WT CAPACITY 300#
MULTI-POSITION PT TRANSFER SYS, XTRA-WIDE, INTEG SEAT, WEIGHT CAP GRTR/300 LBS.
TRANSPORT CHAIR, PEDIATRIC SIZE
TRANSPORT CHAIR, ADULT SIZE, PATIENT WEIGHT CAPACITY LESS THAN 250 LBS
TRANSPORT CHAIR, ADULT SIZE HEAVY DUTY PATIENT WEIGHT CAPACITY 250 LBS OR MORE
FUL-RECLIN WHEELCHR FIX FULL LENG ARMS DETACH LEGR
FUL-RECL WHEELCHR DETAC ARMS DESK OR FULL LEN SWIN
POW ATTACH (TO CONV ANY WHEELCHR RO MOTOR WHEELCH)
FUL-REC WHEELCHR DETACH ARMS (DESK OR FULL LEN) SW
HEMI-WHEELCHR, FIX FULL LEN ARMS SW AW DETAC ELEVA
HEMI WHEELCHR DETACH ARM DECK FULL LEN ARM SW AW
HEMI-WHEELCHR, FIX FULL LEN ARM SW AW DETAC FOOR R
HEMI-WHEELCHR DETACH ARM DESK OR FULL LEN SW AW DE
HIGH STREN LIGHTWEI WHEELCH FIX FULL LEN ARM SW AW
HIGH STREN LIGHTWEI WHEELCHR DETACH ARM DESK FLL L
LTWGHT WHEELCAHIR FIX ARMS DETACH FOOT REST
HIGH STREN LIGHTWEI WHEELCHR DETAC ARM FULL LENG S
WIDE HEAVY DUTY WHEELCHAIR DETACH ARM SWING DET LE
WIDE HEAVY DU WHEELCHR DETAC ARM DESK FULL LEN ARM
SEMI-REC WHEELCHR FIX FULL LENG ARM SW AW DETAC EL
SEMI-REC WHEELCHR DETAC ARM (DESK OR FULL LEN) ELE
STANDARD WHEELCHAIR, FIXED ARMS, DETACT FOOTRESTS
WHLCHR DETACH ARM DETACH RESTS (DESK LENGTH)
WHEELCHAIR DETACHABLE ARM
WHLCHR FIX ARM DETACH EL LEG RESTS
MANUAL ADULT SIZE WHEELCHAIR, INCLUDES TILT IN SPACE
AMPU WHEELCHR FIX FULL LEN ARMS SW AW DET ELE LEGR
AMPU WHEELCHR FIX FULL LEN ARMS WITHOUT FOOTRES LE
AMPU WHEELCHR DETACH ARMS (DESK FULL LEN) NO FOOTR
AMPU WHEELCHR DETAC ARMS (DESK FULL LEN SW AW FOO
AMPU WHEELCHR DET ARM (DESK FULL LEN) AW ELE LE
AMPU WHEELCHR FIX FULL LEN ARM SW AW DETAC FOOTRES
AMPUTEE WHEELCHAIR FIXED ARMS DETACH LEG RESTS POW
SPECIAL SIZED WHEELCHAIR
WHEELCHAIR FIX ARM FOOTRESTS
WHEELCH W/FIXED ARM EL LEG RESTS
WHEELCHAIR W/DETACH ARM FOOTRESTS
WHEELCHR WITH DETACH ARMS, ELEVATING LEGRESTS
WHEELCHAIR ACCESS MANUAL SEMI-RECLIN BACK, (> THAN 15 DEG BUT < THAN 80 DEG), EA
WHEELCHAIR ACCESSORY, MANUAL FULLY RECLINING BACK (RECLINE > THAN 80 DEG), EA
SPEC HEIGH ARMS FOR WHEELCHR
SPECIAL BACH HEIGHT FOR WHEELCHAIR
WHEELCHAIR, PEDIATRIC SIZE NOT ELSEWHERE SPECIFIED
POW OPER VEH (3WH NON-HIGHW) IND BRAN NAME, MOD #
WHEELCHAIR, PED. SIZE,TILT-IN-SPACE, RIGID, ADJUSTABLE, W/SITTING SYSTEM
WHEELCHAIR, PED. SIZE,TILT-IN-SPACE, FOLDING, ADJ., W/SEATING SYSTEM
WHEELCHAIR PED. SIZE,TILT-IN-SPACE, RIGID, ADJ. W/O SEATING SYSTEM
WHEELCHAIR PEDIATRIC,TILT-IN-SPACE, FOLDING, ADJUSTABLE
WHEELCHAIR, PED. SIZE, RIGID, ADJUSTABLE W/SEATING SYSTEM
WHEELCHAIR, PED. SIZE, FOLDING, ADJ., W/SEATING SYSTEM
WHEELCHAIR, PED. SIZE, RIGID, ADJ. W/O SEATING SYSTEM
WHEELCHAIR, PED. SIZE, FOLDING, ADJ. W/O SEATING SYSTEM
LIGHTWEIGHT WHEELCHAIR DETACH ARMS/DETACH LEG REST
LGTWGHT WHEELCHAIR FIX ARM SWING DETACH FOOTRESTS
LTWGHT WHEELCHAIR DETACH ARM DETACH FOOT (DESK LNG
LTWGHT WHEELCH FIX ARM DETACH FL LEG REST, HVY DTY
HEAVY DUTY WHEELCHR DETAC ARMS (DESK FULL LEN) LEG
HEAVY DUTY WHEELCHR FIX FULL LEN ARM SW AW DETAC F
HEAVY DUTY WHEELCHR DETACH ARM (DESK FULLLEN) SW A
HEAVY DUTY WHEELCHR FIX FULL LEN ARM ELEVAT LEGRES
SPEC WHEELCHR SEAT HEIGHT FROM FLOOR
SPEC WHEELCHR SEAT DEPTH, BY UPHOLSTERY
SPEC WHEELCHR SEAT DEPTH AND/OR WIDTH BY CONST
REGULATOR RENTAL
O2 ACCESS, WHEEL CRT FOR PORT CYL OR PORT CONC, ANY TYPE, REPLACE ONLY, EA
STAND/RACK
O2 ACCESS, BATT PACK/CARTRIDGE FOR PORT CONCENTRATOR, ANY TYPE, REPLACE ONLY, EA
O2 ACCESSORY, BATRY CHRGR FOR PORT CONCENTRATOR, ANY TYPE, REPLACE ONLY, EA
O2 ACCESS, DC PWR ADAPT FOR PORT CONCENTRATOR, ANY TYPE, REPLACE ONLY, EA
IMMERSION EXTERNAL HEATER FOR NEBULIZER
OXYGEN CONCEN HI HUMID SYS EQUIV TO 1708 CU. FT.
OXYGEN CONCEN HI HUMID SYS EQUIV TO 1952 CU. FT.
OXYGE CONCEN HI HUMID SYS EQUIV TO OVER 1952 CU FT
OXYGEN CONCENTRATOR CAPABLE OF DELIVERING 85% OR < O2 CONCENTRATION
OXYGEN CONCEN DUAL DELIVERY PORT, CAPABLEOF DELIVERING 85% OR GREATER CONCENTR
PORTABLE OXYGEN CONCENTRATOR
DURABLE MEDICAL EQUIP NOT OTHERWISE CLASSIFIED
OXYGEN/H20 VAPOR SYSTEM W/HEATED DELIVERY
OXYGEN/H20 VAPOR SYSTEM WO HEATED DELIVERY
CENTRIFUGE FOR DIALYSIS
KIDNEY DIALYSATE DELIVERY SYSTEM MACHINE, PUMP RECIRCULATING, AIR REMOVAL
HEPARIN INFUSION PUMP FOR DIALYSIS
AIR BUBBLE DETECTOR FOR DIALYSIS
PRESSURE ALARM FOR DIALYSIS
BATH CONDUCTIVITY METER FOR DIALYSIS
BLOOD LEAK DETECTOR FOR DIALYSIS
ADJUSTABLE CHAIR, FOR ESRD PATIENTS
TRANSDUCER PROTECTOR/FLUID BARRIERS, ANY SIZE EA
UNIPUNCTURE CONTROL SYSTEM FOR DIALYSIS
HEMODIALYSIS MACHINE, UNIT OR CYCLER
AUTO INTERMITTENT PERITIONEAL DIALYSIS SYSTEM
CYCLER DIALYSIS MACHINE
DEL AND/OR INSTALL CHARGES FOR RENAL DIAL EQUIP
REV OSMOSIS WAT PURIFIC SYS WAT PURIFIC SYS
DEIONIZER WATER PURIFICATION SYSTEM
BLOODPUMP FOR DIALYSIS
WATER SOFTENING SYSTEM
RECIPROCATING PERITONEAL DIALYSIS SYSTEM
WEARABLE ARTIFICAL KIDNEY
PERITONEAL DIALYSIS CLAMPS, EACH
COMPACT (PORTABLE) TRAVEL HEMODIALYSIS SYS
SORBENT CARTRIDGES, PER CASE
HEMOSTAT FOR DIALYSIS, EACH
HEATING PAD FOR PERITONEAL DIALYSIS, EACH
SCALE FOR DIALYSIS, EACH
DIALYSIS EQUIPMENT, NOT OTHERWISE SPECIFIED
JAW MOTION ON REHAB SYSTEM
REPLACEMENT CUSHIONS-JAW MOTION REHAB.SYS-PKG.OF 6
REPLACEMENT MEASURING SCALES-JAW MOTION REHAB- 200
DYNAMIC ADJUSTABLE ELBOW EXTENSION/FLEXION DEVICE
BI-DIRECTIONAL STATIC PROGRESSIVESTRETCH ELBOW DEVICE RANGE OF MOTION ADJ W/CUFF
DYNAMIC ADJ. FOREARM PRONATION/SUPINATION DEVICE, INC. SOFT INTERFACE MATERIAL
DYNAMIC ADJUSTABLE WRIST EXTENSION/FLEXION DEVICE
BI-DIRECTIONAL STATIC PROGRESSIVE STRETCH WRIST DEVICE W/RANGE OF MOTION ADJ.
DYNAMIC ADJUSTABLE KNEE EXTENSION/FLEXION DEVICE-
BI-DIRECTIONAL PROGRESSIVE STRETCH KNEE DEVICE W/ ROM ADJUSTMENT, INCLUDES CUFF
DYNAMIC KNEE EXTENSION/FLEXION DEVICE WITH ACTIVE RESISTANCE CONTROL
DYNAMIC ADJUSTABLE ANKLE EXTENSION/FLEXION DEVICE
BI-DIRECTIONAL STATIC PROGRESSIVE STRETCH ANKLE DEVICE W/ROM ADJUSTMENT W/CUFFS
BI-DIRECTIONAL STATIC PROGRESSIVE STRETCH FOREARM PRONATION/ SUPINATION DEVICE
SOFT INTERFACE MATERIAL, DYNAMIC ADJ. EXT/FLEX DEV
REPLACEMENT SOFT INTERFACE MATERIAL/CUFFS FOR BI-DIRECTIONAL STRETCH DEVICE
DYNAMIC ADJUSTABLE FINGER EXTENSION/FLEXION DEVICE
DYNAMIC ADJUSTABEL TOE EXTENSION/FLEXION DEVICE
DYNAMIC ADJUSTABLE SHOULDER FLEXION/ABDUCTION/ROTATION DEVICE W/SOFT INTERFACE
COMMUNICATION BOARD NON-ELECTRONIC AUGMENTATION OR ALTERNATIVE COMMUNICATION
GASTRIC SUCTION PUMP, HOME MODEL, PORTABLE OR STATIONARY ELECTRIC
BLOOD GLUCOSE MONITOR WITH INTEGRATED VOICE SYNTHESIZER
BLOOD GLUCOSE MONITOR W/ INTEGRATE LANCING/BLOOD SAMPLE
PULSE GENERATOR SYSTEM FOR TYMPANIC TREATMENT OF INNER EAR ENDOLYMPHATIC FLUID
MANUAL WHEELCHAIR ACCESS, NONSTANDARD SEAT FRAME, WIDTH>= 20 INCH < 24 INCH
MANUAL WHEELCHAIR ACCESS, NONSTANDARD SEAT FRAME WIDTH 24-27 INCHES
MANUAL WHEELCHAIR ACCESS, NONSTANDARD SEAT FRAME DEPTH 20 < 22 INCHES
MANUAL WHEELCHAIR ACCESS, NONSTANDARD SEAT FRAME DEPT 22-25 INCHES
MANUAL WHEELCHAIR ACCESSORY, HANDRIM W/O PROJECTIONS ANY TYPE, REPLACEM, EACH
MANUAL WHEELCHAIR ACCESSORY, WHEEL LOCK ASSEMBLY, COMPLETE, EACH
WHEELCHAIR ACCESSORY, CRUTCH AND CANE HOLDER, EACH
WHEELCHAIR ACCESSORY, CYLINDER TANK CARRIER
WHEELCHAIR ACCESSORY, ARM TROUGH, EACH
WHEELCHAIR ACCESSORY, BEARINGS, ANY TYPE, REPLACEMENT ONLY, EACH
WHEELCHAIR ACCESSORY, PNEUMATIC PROPULSION TIRE, ANY SIZE, EACH
WHEELCHAIR ACCESSORY, TUBE FOR PNEUMATIC PROPULSION TIRE, ANY SIZE, EACH
MANUAL WHEELCHAIR ACCESSORY, INSERT FOR PNEUMATIC PROP TIRE, ANY SIZE, EACH
MANUAL ACCESSORY, PNEUMATIC CASTER TIRE, ANY SIZE, EACH
MANUAL WHEELCHAIR ACCESSORY, TUBE FOR PNEUMATIC CASTER TIRE, EACH
MANUAL WHEELCHAIR ACCESSORY, FOAM FILLED PROPULSION TIRE, EACH
MANUAL WHEELCHAIR ACCESSORY, FOAM FILLED CASTER TIRE, EACH
MANUAL WHEELCHAIR ACCESSORY, FOAM PROPULSION TIRE, EACH
MANUAL WHEELCHAIR ACCESSORY, FOAM CASTER TIRE, EACH
MANUAL WHEELCHAIR ACCESSORY, SOLID RUBBER/PLASTIC PROPLUSION TIRE
MANUAL WHEELCHAIR ACCESSORY, SOLID RUBBER/PLASTIC CASTER TIRE, EACH
MANUAL WHEELCHAIR ACC, SOLID RUBBER/PLASTIC CASTER TIRE W/ INTEGRATED WHEEL
MANUAL WHEELCHAIR ACC, PROPULSION WHEELS, EXCLUDES TIRE, EACH
MANUAL WHEELCHAIR ACC, CASTER WHEEL, EXCLUDES TIRE, EACH
MANUAL WHEELCHAIR ACC, CASTER FORK, ANY SIZE, REPLACEMENT ONLY, EACH
MANUAL WHEELCHAIR ACCESSORY, GEAR REDUCTION DRIVE WHEEL, EA
MANUAL WHEELCHAIR ACCESSORY, WHEEL BRAKING SYSTEM/LOCK, COMPLETE, EA
MANUAL WC ACCESSORY, MANUAL STANDING SYSTEM
MAN WC ACCESS, SOLID SEAT SUPP BASE (REPLACES SLING SEAT), INCL/MOUNTING HARDWR
BACK, PLANAR, FOR PEDIATRIC SIZE WHEELCHAIR INCLUDING FIXED ATTACHING HARDWARE
SEAT, PLANAR, FOR PEDIATRIC SIZE WHEELCHAIR INCLUDING FIXED ATTACHING HARDWARE
BACK CONTOURED, FOR PEDIATRIC SIZE WHEELCHAIR INCL FIXED ATTACHING HARDWARE
SEAT CONTOURED FOR PEDIATRIC SIZE WHEELCHAIR INCL FIXED ATTACHING HARDWARE
MAN WC ACESY, PED WC, DYNAM SEAT FRM, FOR COORD MOV OF MULT POSITION FEATURES
POWER WHEELCHAIR ACCESS POWER SEAT ELEVATION SYSTEM
POWER WHEELCHAIR ACCESS, POWER STANDING SYSTEM
POWER WHEELCHAIR ACCESS, ELECTRONIC CONNECTION BETWEEN CHAIR AND CONTROLLER
POWER WHEELCHAIR ACCESS, ELECTRONIC CONN BETWEEN CHAIR AND CONTROLLER
POWER WHEELCHAIR ACCESS, HAND/CHIN CONTROL INTERFACE, REMOTE JOYSTICK
POWER WHEELCHAIR ACCESSORY, HARNESS FOR UPGRADE TO EXPANDABLE CONTROLLER
POWER WHEELCHAIR ACCESS, HAND OR CONTROL INTERFACE, REMOTE JOYSTICK
POWER WHEELCHAIR ACCESSORY, HAND CONTROL INTERFACE, MULT MECH SWITCHES
POWER WHEELCHAIR ACCESS HAND CONTROL INTERFACE, JOYSTICK PREFAB
POWER WHEELCHAIR ACCESS, CHIN CUP FOR CHIN CONTROL INTERFACE
POWER WHEELCHAIR ACCESS, SIP AND PUFF INTERFACE, NONPROPORT. W/ALL ELECTRONICS
POWER WHEELCHAIR ACCESS, BREATH TUBE KIT FOR SIP AND PUFF INTERFACE
POWER WHEELCHAIR ACCESS, HEAD CONTROL INTERFACE, MECHANICAL W ELECTRONICS
POWER WHEELCHAIR ACCESS, HEAD CONTROL INTERFACE W ELECTRONICS
POWER WHEELCHAIR ACCESS, HEAD CONTROL INTERFACE, CONTROL SWITCH MECHANISM
POWER WHEELCHAIR ACCESS, HEAD CONTROL INTERFACE, PROXIMITY SWITCH MECHANISM
POWER WHEELCHAIR ACCESS, ATTENDANT CONTROL INTERFACE PROPORT. ELECTRONICS
POWER WHEELCHAIR ACCESS NONSTANDARD SEAT FRAME WIDTH 20-23 INCHES
POWER WHEELCHAIR ACCESSORY NONSTANDARD SEAT FRAME WIDTH 24-27 INCHES
POWER WHEELCHAIR ACCESS, NONSTANDARD SEAT FRAME WIDTH 20-21 WIDTH
POWER WHEELCHAIR ACCESS, NONSTANDARD SEAT FRAME WIDTH 22-25 INCHES
POWER WHEELCHAIR ACCESS, ELECTRONIC INTERFACE FOR SPEECH GENERATING DEVICE
POWER WHEELCHAIR ACCESS, 22 NF NON-SEALED LEAD ACID BATTERY, EACH
POWER WHEELCHAIR ACCESS, 22 NF NON-SEALED LEAD ACID BATTERY, (GEL CELL, ABSORBED
POWER WHEELCHAIR ACCESS, GROUP 24 NON-SEALED LEAD ACID BATTERY, EACH
POWER WHEELCHAIR ACCESS, GROUP 24 NON-SEALED LEAD ACID BATTERY, EACH
POWER WHEELCHAIR ACCESS, U-1 NON-SEALED LEAD ACID BATTERY, EACH
POWER WHEELCHAIR ACCESS, U-1 SEALED LEAD ACID BATTERY, EACH (GEL CELL GLASSMAT)
POWER WHEELCHAIR ACCESS, BATTERY CHARGER, DUAL MODE FOR SEALED/NON-SEALED, EACH
POWER WHEELCHAIR ACCESS BATTERY CHARGER, DUAL MODE, FOR USE W/EITHER BATTERY
POWER WHEELCHAIR COMPONENT, MOTOR, REPLACEMENT ONLY
POWER WHEELCHAIR COMPONENT, GEAR BOX, REPLACEMENT ONLY
POWER WHEELCHAIR COMPONENT, MOTOR AND GEAR BOX COMBO, REPLACEMENT ONLY
POWER WHEELCHAIR ACCESSORY GROUP 27 SEALED LEAD ACID BATTERY, EACH
POWER WHEELCHAIR ACCESSORY GROUP 27 NON-SEALED LEAD ACID BATTERY, EACH
POWER WHEELCHAIR ACC, HAND OR CHIN CONTROL INTERFACE
POWER WHEELCHAIR ACC, HAND OR CHIN CONTROL INTERFACE, REPLACEMENT ONLY
POWER WHEELCHAIR ACC, NON-EXPANDABLE CONTROL, INCL/ ELECT& MOUNTING HARDWARE
POWER WHEELCHAIR ACC, EXPANDABLE CONTROLLER, REPLACEMENT ONLY
POWER WHEELCHAIR ACC, UPGRADE PROVIDED AT INITIAL ISSUE
POWER WHEELCHAIR ACC, PNEUMATIC DRIVE WHEEL TIRE, ANY SIZE, REPL ONLY, EA.
POWER WHEELCHAIR ACC, TUBE/PNEUMATIC DRIVE WHEEL TIRE, ANY SZ, REPL ONLY, EA.
POWER WHEELCHAIR ACC, INSERT/PNEUMATIC WHEEL TIRE, ANY TYPE/SIZE, REPL ONLY, EA
POWER WHEELCHAIR ACC, PNEUMATIC CASTER TIRE, ANY SIZE, REPL ONLY, EA.
POWER WHEELCHAIR ACC, TUBE FOR PNEUMATIC CASTER TIRE, ANY SIZE, REPL ONLY, EA
POWER WHEELCHAIR ACC, FOAM FILLED DRIVE WHEEL TIRE, ANY SIZE, REPL ONLY, EA
POWER WHEELCHAIR ACC, FOAM FILLED CASTER TIRE, ANY SIZE, REPL ONLY, EA
POWER WHEELCHAIR ACC, FOAM DRIVE WHEEL TIRE, ANY SIZE, REPL ONLY, EA
POWER WHEELCHAIR ACCESSORY, FOAM CASTER TIRE, ANY SIZE, REPLACEMENT ONLY, EACH
POWER WHEELCHAIR ACC, SOLID RUBBER/PLASTIC WHEEL TIRE, ANY SZ, REPL ONLY, EA
POWER WHEELCHAIR ACC, SOLID RUBBER/PLASTIC CASTER TIRE , ANY SIZE, REPL ONLY, EA
POWER WHEELCHAIR ACC, SOLID RUBBER/PLASTIC CASTER TIRE W/ INTEGRATED WHEEL
POWER WHEELCHAIR ACC, DRIVE WHEEL EXCLUDES TIRE, ANY SIZE, REPLACEMENT EA
POWER WHEELCHAIR ACC, CASTER WHEEL EXCL TIRE, ANY SIZE, REPL ONLY, EA
POWER WHEELCHAIR ACCESSORY, CASTER FORK, ANY SIZE, REPLACEMENT ONLY, EACH
POWER WHEELCHAIR ACCESSORY, LITHIUM-BASED BATTERY, EACH
NEGATIVE PRESSURE WOUND THERAPY ELECTRICAL PUMP, STATIONARY OR PORTABLE
SPEECH GENERATING DEVICE, DIGITIZED SPEECH, USING PRE-RECORDED MESSAGE<=8 MIN
SPEECH GENERATING DEVICE, DIGITIZED SPEECH, USING PRE-RECORDED MESSAGE>8 MINUTES
SPEECH GENERATING DEVICE DIGITIZED SPEECH, PRE-RECORDED > 20 MINUTES<=40 MINUTES
SPEECH GENERATING DEVICE, DIGITIZED SPEECH, PRE-RECORDED > 40 MINUTES
SPEECH GENERATING DEVICE, SYNTH SPEECH REQ MESSAGE FORMULATION BY SPELLING
SPEECH GENERATING DEVICE, SYNTHESIZED SPEECH, PERMITTING MULTIPLE METHODS
SPEECH GENERATING SOFTWARE PROGRAM, FOR PERSONAL COMPUTER OR DIGITAL ASSIST
ACCESSORY FOR SPEECH GENERATING DEVICE, MOUNTING SYSTEM
ACCESSORY FOR SPEECH GENERATING DEVICE, NOT OTHERWISE CLASSIFIED
GENERAL USE WHEELCHAIR SEAT CUSHION, WIDTH LESS THAT 22 INCHES, ANY DEPTH
GENERAL USE WHEELCHAIR SEAT CUSHION, WIDTH 22 INCH OR GREATER, ANY DEPTH
SKIN PROTECTION WHEELCHAIR SEAT CUSHION, WIDTH LESS THAN 22 INCH, ANY DEPTH
SKIN PROTECTION WHEELCHAIR SEAT CUSHION, WIDTH 22 INCH OR GREATER, ANY DEPTH
POSITIONING WHEELCHAIR SEAT CUSHION, WIDTH LESS THAN 22 INCH, ANY DEPTH
POSITIONING WHEELCHAIR SEAT CUSHION WIDTH 22 INCH OR GREATER, ANY DEPTH
SKIN PROTECTION/POSITIONING WHEELCHAIR SEAT CUSHION, WIDTH LESS THAN 22 INCHES
SKIN PROTECTION/POSITIONING WHEELCHAIR SEAT CUSHION, WIDTH 22 INCHES OR GREATER
CUSTOM FABRICATED WHEELCHAIR SEAT CUSHION, ANY SIZE
WHEELCHAIR SEAT CUSHION, POWERED
GENERAL USE WHEELCHAIR BACK CUSHION, WIDTH LESS 22 INCHES, ANY HEIGHT
GENERAL USE WHEELCHAIR BACK CUSHION, WIDTH 22 IN OR GREATER, ANY HEIGHT
POSITIONING WHEELCHAIR BACK CUSHION, POSTERIOR, WIDTH LESS THAN 22 INCH
POSITIONING WHEELCHAIR BACK CUSHION, POSTERIOR, WIDTH MORE THAN 22 INCHES
POSITIONING WHEELCHAIR BACK CUSHION, POSTERIOR LATERAL, WIDTH LESS THAN 22 INCH
POSITIONING WHEELCHAIR BACK CUSHION, POSTERIOR LATERAL, WIDTH MORE THAN 22 INCH
CUSTOM FABRICATED WHEELCHAIR BACK CUSHION, ANY SIZE, INCLUD ANY TYPE MOUNTING
REPLACEMENT COVER FOR WHEELCHAIR SEAT CUSHION OR BACK CUSHION, EACH
POSITIONING WHEELCHAIR BACK CUSHION, PLANAR BACK W LATERAL SUPPORTS LESS 22 INCH
POSITIONING WHEELCHAIR BACK CUSHION, PLANAR BACK W LATERAL SUPP WIDTH > 22
GAIT TRAINER, PEDIATRIC SIZE, POSTERIOR SUPPORT, INCL ALL ACCESSORIES
GAIT TRAINER, PEDIATRIC SIZE, UPRIGHT SUPPORT, INCLUDES ALL ACCESSORIES
GAIT TRAINER, PEDIATRIC SIZE, ANTERIOR SUPPORT, INCL ALL ACCESSORIES
ADMIN OF INFLUENZA VIRUS VACCINE
MEDICARE CROSSOVER-ADMIN PNEUMONOCOL VACCINE
ADMINISTRATION HEPATITIS B VACCINE-MEDICARE XOVER
AUTOMATED TESTING; STAINS AND SMEARS
BLADDER ULTRASOUND
COLORECTAL CANCER SCREENING; HIGH RISK INDIVIDUAL-COLONOSCOPY
COLORECTAL CANCER SCREENING; COLONSCOPY ON PATIENT NOT IN HIGH RISK
SCREENING CYTOPATHOLOGY, CERVICAL/VAGINAL, COLLECTION, BY TECH, PHYS. SUPRVSN
TRIMMING OF DYSTROPHIC NAILS, ANY NUMBER
EXTERNAL COUNTERPULSATION PER TREATMENT
WOUND CLOSURE UTILIZING TISSUE ADHESIVE(S) ONLY
PHYS. RECERT. FOR MEDICARE COVERED HOME HEALTH SERVICES PATIENT NOT PRESENT
PHYSICIAN CERTIFIED SERVICES PROVIDED BY A PARTICIPATING HOME HEALTHY AGENCY
PATIENT UNDER MEDICARE APPROVED HOSPICE - PATIENT NOT PRESENT
SCREENING MAMMOGRAPHY, DIRECT DIGITAL IMAGE, BILATERAL, ALL VIEWS
DIAGNOSTIC MAMMOGRAPHY, PRODUCING DIRECT DIGITAL IMAGE, BILATERAL, ALL VIEWS
DIAGNOSTIC MAMMOGRAPHY, PRODUCING DIRECT DIGITAL IMAGE, UNILATERAL, ALL VIEWS
PET IMAGING WHOLE BODY MELANOMA FOR NON COVERED INDICATIONS
PET IMAGING, ANY SITE, NOS
FOLLOW UP PHYS. EVAL. & MANAGEMENT OF DIABETIC PATIENT W/SENSORY NEUROPATHY
PROSTATE BRACHYTHERAPY USING PERMANENTLY IMPLANTED PALLADIUM SEEDS
PROSTATE BRACHYTHERAPY USING PERMANENTLY IMPLANTED IODINE SEEDS INCLUDING TRANSP
MEDICAL NUTRITION THERAPY REASSESSMENT AND SUBSEQUENT INTERVENTIONS
ELECTRICAL STIMULTATION, (UNATTENDED) 1 OR MORE AREAS, FOR CHRONIC ULCERS
ELECTRICAL STIMULATION UNATTENDED TO ONE OR MORE AREAS OTHER THAN WOUND CARE
ARTHROSCOPY, KNEE; REMOVAL LOOSE BODY, DEBRIDEMENT/SHAVING ARTIC CART (SP)
COMPLETE CBC AUTOMATED
COMPLETE CBC, AUTOMATED (HGB, HCT, RBC, WBC; W/O PLATELET COUNT)
FECAL BLOOD SCREENING IMMUNOASSAY
ELECTROMAG THERAPY, TO 1 OR MORE AREAS FOR CHRONIC STAGE III/IV PRESSURE ULCERS
IMAGE GUIDED ROBOTIC LINEAR ACCELERATOR BASE STEREOTATIC RADIOSURGERY
IMAGE GUIDED ROBOTIC LINEAR ACCELERATOR BASED STEROTATIC RADIOSURGERY
PERCUTANEOUS ISLET CELL TRANSPLANT, INCL PORTAL VEIN CATHETERIZATION & INFUSION
LAPAROSCOPY FOR ISLET CELL TRANSPLANT, INCL PORTAL VEIN CATHERIZATION & INFUSION
LAPAROTOMY FOR ISLET CELL TRANSPLANT,INCL PORTAL VEIN CATHETERIZATION & INFUSION
VESSEL MAPPING OF VESSELS FOR HEMODIALYSIS ACCESS
ULTRASOUND B-SCAN &/OR REAL TIME W/IMAGE DOCUMENTATION; FOR ABD AORTIC ANEURYSM
HOME SLEEP STUDY TEST W/TYPE II PORTABLE MONITOR UNATTENDED MIN 7 CHANNELS
HOME SLEEP STUDY TEST W/TYPE III PORTABLE MONITOR UNATTENDED MIN 4 CHANNELS
HOME SLEEP STUDY TEST W/TYPE IV PORTABLE MONITOR UNATTENDED MIN 3 CHANNELS
OPEN TX ILIAC SPINE UNI/BIL
PELVIC RING FX UNI/BIL
PELVIC RING FX TX INT FIX
OPEN TX POST PELVIC FX
SAT BIOPSY PROSTATE 1-20 SPC
SAT BIOPSY PROSTATE 21-40 SPC
SAT BIOPSY PROSTATE 41-60 SPC
SAT BIOPSY PROSTATE >60 SPC
ADMINISTRATION AND SUPPLY OF TOSITUMOMAB, 450 MG
COORDINATED CARE FEE - INITIAL
COORDINATED CARE FEE - MAINTENANCE RATE
COORDINATED CARE FEE, SCHEDULE TEAM CONFERENCE
CHILDREN'S SERVICE COORDINATION PLAN DEVELOPMENT-PER 15 MINUTES
INFLUENZA A (H1N1) IMMUNIZATION ADMINISTRATION, INCL PHYS COUNSELING THE PT/FAM
BEHAVORIAL HEALTH COUNSELING AND THERAPY. PER 15 MINUTES
BEHAVORIAL HEALTH PREVENTION INFORMATION (ONE-WAY DIRECT OR NON-DIRECT)
MENTAL HEALTH ASSESSMENT, BY NON-PHYSICIAN
MENTAL HEALTH SERVICE PLAN DEVELOPMENT BY NON-PHYSICIAN
COMMTY PSYCHIATRIC SUPP TRETM, FACE-TO-FACE, PER 15 MIN - COMMTY REINTEGRATION
COMPREHENSIVE MULTIDISCIPLINARY EVALUATION
CRISIS INTERVENTION SERVICE, PER 15 MINUTES
SKILLS TRAINING AND DEVELOPMENT, PER 15 MINUTES
COMPREHENSIVE COMMUNITY SUPPORT SERVICES, PER 15 MINUTES
COMPREHENSIVE COMMUNITY SUPPORT SERVICES, PER DIEM
PSYCHOSOCIAL REHABILITATION SERVICES, PER 15 MINUTES
THERAPEUTIC BEHAVIORAL SERVICES, PER 15 MINUTES
THERAPEUTIC BEHAVORIAL SERVICES, PER DIEM
COMMUNITY-BASED WRAP-AROUND SERVICES, PER 15 MINUTES
COMMUNITY BASED SERVICES - WRAP AROUND PER DIEM
SUPPORTED EMPLOYMENT, PER 15 MINUTES
ACTIVITY THERAPY, PER 15 MINUTES
INJ TETRAYCLINE UP TO 250 MG
INJECTION, ABARELIX, 10 MG
INJECTION, ABATACEPT, 10 MG (ORENCIA)
ABCIXIMAB INJECTION 10 MG
INJECTION, ACETLYCYSTEINE, 100MG
INJECTION, ACYCLOVIR, 5 MG
INJECTION, ADALIMUMAB, 20 MG
INJECTION ADENOSINE - ADENOCARD 6 MG
INJECTION ADENOSINE 30 MG (NOT TO BE USED TO REPORT ANY ADENOSINE PHOSPHATE COMP
INJECTION, ADRENALIN, EPINEPHRIN, UP TO 1ML AMPUL
INJECTION, AGALSIDASE BETA, 1 MG
INJECTION BIPERIDEN AKINETON 2 MG
INJECTION, ALGLUCERASE, 10 UNITS
INJECTION AMIFOSTINE, 500 MG.
INJECTION, ALDOMET ESTER HCL, UP TO 250 MG
AMEVIVE 0.5 MG EA
INJECTION, AGLUCOSIDASE ALFA, 10 MG
ALPHA-1-PROTEINOSE INHIBITOR, 10 MG
INJECTION, ALPROSTADIL, PER 1.25 MGG
ALPROSTADIL URETHRAL SUPPOSITORY
INJECTION, AMIKACIN SULFATE, 100 MG
INJECTION, AMINOPHYLLIN, UP TO 250 MG
INJECTION AMIODARONE HYDROCHLORIDE, 30 MG
AMPHOTERICIN B 50 MG
INJECTION AMPHOTERICIN B LIPID COMPLEX, 10 MG
INJECTION AMPHOTERICIN B CHOLESTERYL SULFATE COMPLEX, 10 MG
AMPHOTERICIN B LIPOSOME, 10 MG
INJECTION, AMPICILLIN, UP TO 500 MG
AMPICIL/SULBAC 1.5 GRAMS (UNASYN)
INJECTION AMOBARBITAL UP TO 125 MG
INJ SUCCINYLCHOLINE CHLORIDE UP TO 20 MG
INJECTION, ANADULAFUNGIN, 1 MG (ERAXIS)
ANISTREPLASE (EMINASE) I.V., PER 30 UNITS
INJ HYDRALAZINE HCL UP TO 20 MG
INJECTION, APOMORPHINE HYDROCHLORIDE, 1 MG (IXENSE)
INJECTION, APROTONIN, 10,000 KIU
INJECTION, ARAMINE, UP TO 10 MG
CHLOROQUINE INJECTION 250 MG
ARBUTAMINE HCL INJECTION 1 MG
INJECTION, ARIPIPRAZOLE, INTRAMUSCULAR, 0.25 MG
INJECTION AZITHROMYCIN 500 MG
INJECTION, ATROPINE SULFATE, 0.01 MG
INJECTION, BAL IN OIL, UP TO 100 MG
INJECTION, BACLOFEN, 10 MG
BACLOFEN FOR INTRATHECAL TRIAL 50 MCG
INJECTION, BASILIXIMAB, 20 MG
DICYCLOMINE INJ 20 MG
INJECTION, BENZTROPINE MESYLATE 1MG
BETHANECHOL CHLORIDE INJECT 5 MG
INJECTION, PENICILLIN G BENZATHINE AND PENICILLIN G PROCAINE, 2500 UNITS
PENICILLIN G BENZATHINE INJECT TO 600,000 UNITS
PENICILLIN G BENZATHINE INJECT 1,200,000 UNITS
PENICILLIN G BENZATHINE INJECT 2,400,000 UNITS
INJECTION, BIVALIRUDIN 1 MG
BOTULINUM TOXIN TYPE A, PER UNIT
INJECTION, ABOBOTULINUMTOXINA, 5 UNITS
BOTULINUM TOXIN TYPE B PER, 100 UNITS
BUPRENORPHINE HYDROCHLORIDE, 0.1 MG
INJECTION, BUSULFAN, 1 MG (MYLERAN)
INJECTION, BUTORPHANOL TARTRATE, 1 MG
INJECTION, C1 ESTERASE INHIBITOR (HUMAN), 10 UNITS
EDETATE CLACIUM DISODIUM INJ 1ML
INJECTION, CALCIUM GLUCONATE, 10 ML
INJECT CALCIUM GLYCEROPHOSHATE/LACTATE, PER 10 ML
INJ, CALCIMAR, CALCITONINSALMON, UP TO 400 UNITS
CALCITRIOL, 0.1 MCG
CASPOFUNGIN ACETATE, 5 MG
INJECTION LEUCOVORIN CALCIUM PER 50 MG
INJECTION, LEVOLEUCOVORIN CALCIUM, 0.5 MG
INJECTION, MEPIVACINE HCL 10 ML
INJ, CEFAZOLIN SODIUM, ANCEF, KEFZOL, UP TO 500 MG
INJECTION CEFEPIME HYDROCHLORIDE, 500 MG
INJ CEFOXITIN SODIUM MEFOXIN 1 GM
CEFTRIAXONE SODIUM 250MG
CEFUROXIME SODIUM STERILE 750MG
CEFOTAXIME SOD INJ PER 1GM
BETAMETHASONE ACETATEAND SOD. PHOS. PER 3 MG
BETAMETHASONE SODIUM PHOSPHATE PER 4 MG
INJECTION, CAFFEINE CITRATE, 5MG
INJECTION, CEPHAPRIN SODIUM, CEFADYL, UP TO 1 GM
INJ CEFTAZIDIME PER 500 MG (FORTAZ, TAZIDIME)
CEFTIZOXIME (CEFIZOX) PER 500 MG
INJECTION, CERTOLIZUMAB PEGOL, 1 MG
INJ, CHLORAMPHENICOL SODIUM SUCCINATE, UP TO 1 GM
INJECTION, CHORIONIC GONADOTROPIN,PER 1000 USP UNI
INJECTION, CLONIDINE HUDROCHLORIDE, 1 MG.
INJECTION, CIDOFOVIR, 375 MG.
INJECTION CILASTIN SODIUM IMIPENEM 250 MG
INJECTION CIPROFLOXACIN FOR INTRAVENOUS INFUSION, 200 MG
INJECTION, CODEINE PHOSPHATE, PER 30 MG
INJECTION, COLCHICINE, UP TO 1 MG
INJECTION, COLY-MYCIN M, UP TO 150 MG
INJECTION, COMPAZINE, UP TO 10 MG
INJECTION, CORTICORELIN OVINE TRIFLUTATE, 1 MCG
INJECTION, CORTICOTROPIN, UP TO 40 UNITS
INJECTION, COSYNTROPIN, NOT OTHERWISE SPECIFIED, 0.25 MG
INJECTION, COSYNTROPIN (CORTROSYN), 0.25 MG
CYTOMEGALOVIRUS IMMUNE GLOB. PER VIAL (CYTOGAM)
INJECTION, DAPTOMYCIN, 1 MG
INJECTION, DARBEPOETIN ALFA, 1MCG (NON-ESRD USE)
INJECTION, DARBEPOETIN ALFA, 1MCG (FOR ESRDON DIALYSIS)
INJECTION, EPOETIN ALFA, (FOR NON- ESRD USE) 1000 UNITS
INJECTION, EPOETIN ALFA, (FOR ESRD DIALYSIS), PER 1,000 UNITS
INJECTION, DECITABINE, 1 MG (DACOGEN)
INJECTION, DEFEROXNMINE MESYLATE, 500 MG/6 CC
INJECTION, DELADUMONE, UP TO 1CC
INJECTION, BROMPHERIRAMINE MALEATE 10 MG
INJECTION, ESTRADIOL VALERATE 40 MG
INJECTION, DEPO-ESTRADIOL CYPIONATE, UP TO 5 MG
INJECTION, DEPO - METHYLPREDNISOLONE, 20 MG
INJECTION, DEPO-METHYLPREDNISOLONE 40 MG
INJECTION, DEPO-METHYLPREDNISOLONE 80 MG
MEDROXYPROGESTERONE ACETATE, 50 MG
MEDROXYPROGESTERONE ACETATE 150 MGM FOR CONTRACEP.USE-DEPO-PROVERA-00009737601
MEDROXYPROGESTERONE ACETATE/ESTRADIAOL CYPIONATE, INJECTION 5 MG
INJECTION, DEPO-TESTOSTERONE CYPIONATE 1 ML
INJ, DEPO-TESTOSTERONE CYPIONATE, UP TO 100 MG
INJ, DEPO-TESTOSTERONE CYPIONATE, 1 CC, 200 MG
DEXAMETHASONE ACETATE, 1MG
INJECTION, DEXAMETHOSONE, 1MG
INJECTION, D.H.E.45, UP TO 1 MG
INJECTION, ACETAZOLAMID SODIUM 500 MG
INJECTION, DIGOXIN, UP TO 0.5MG
INJECTION, DIGOXIN IMMUNE FAB (OVINE), PER VIAL
INJECTION, PHENYTOIN SODIUM 50 MG
INJECTION HYDROMORDHONE HCL 4MG
DYPHYLLINE INJECTION, 500 MG
INJ. DEXRAZOXANE HCL, 250MG (ZINECARD) 00013871562
INJ, DIPHENHYDRAMINE HCL, BENADRYL, UP TO 50 MG
CHLOROTHIAZIDE SODIUM/500 MG (DIURIL)-00006325032
INJECTION, DMSO, DIMENTHYL SULFOXIDE, 50%, 50 ML
INJ, DOLOPHINE HCL, METHODONE HCI, UP TO 10 MG
INJECTION, DIMENHYDRINATE/DRAMAMINE, UP TO 50 MG
INJECTION DIPYRIDAMOLE PER 10 MG
INJECTION, DOBUTAMINE HCI 250 MG
INJECTION DOLASETRON MESYTATE-10 MG
INJECTION, DOPAMINE HCL, 40 MG
INJECTION, DORIPENEM, 10 MG
INJECTION, DOXERCALCIFEROL, 1MCG
INJECTION, ECULIZUMAB, 10 MG
AMITRIPTYLINE HCL/20 MG (ELAVIL) 00310004910
INJECTION, ENFUVIRTIDE, 1 MG (FUZEON T-20)
INJECTION, EPOPROSTENOL, .5MG
EPTIFIBATIDE INJECTION 5 MG
INJ, ERGONOVINE MALEATE, ERGOTRATE MALEATE, 0.2 MG
INJECTION, ERTAPENEM SODIUM 500 MG
ERYTHROMICIN LACTOBIONATE PER 500 MG - IV ONLY
ESTRADIOL VALERATE/10 MG-00223760510
ESTRADIOL VALERATE/20 MG - 00223760610
INJECTION, ESTROGEN CONJUGATED, PER 25 MG
INJECTION, ESTATE, UP TO 10 MG
INJECTION, ESTRONE, PER 1 MG
ETIDRONATE DISODIUM 300MG/6ML
INJECTION ETANERCEPT 25 MG NOT FOR SELF ADMINISTRATION. ENBREL
FILGRASTIM, 300 MCG VIALS
FILGRASTIM (NEUPOGEN) 480 MCG
INJECTION, FEMOGEN LA, UP TO 40 MG
INJECTION, FOMEPIZOLE 15 MG
INJECTION FOMIVERSEN SODIUM INTRAOCULAR 1.65 MG
INJECTION, FOSAPREPITANT, 1 MG
INJECTION FOSCARNET SODIUM PER 1000 MG
INJECTION, GALLIUM NITRATE, 1 MG
INJECTION, GALSULFASE, 1 MG (NAGLAZYME)
INJEC, IMMUNE GLOBULIN (PRIVIGEN), INTRAVENOUS, NON-LYOPHILIZED (E.G. LIQ)
INJ GAMMA GLOBULIN IM 1CC
INJECTION, GAMMA GLOBULIN 2 CC
INJECTION, GAMMA GLOBULIN, 3 CC
INJECTION, GAMMA GLOBULIN, 4 CC
INJECTION, GAMMA GLOBULIN, 5 CC
INJECTION, GAMMA GLOBULIN, 6 CC
INJECTION, GAMMA GLOBULIN, 7 CC
INJECTION, GAMMA GLOBULIN, 8 CC
INJECTION, GAMMA GLOBULIN, 9 CC
INJECTION, GAMMA GLOBULIN, 10 CC
INJ GAMMA GLOBULIN IM OVER 10 CC INJ 10 ML
INJECTION, IMMUNE GLOBULIN, IV, NON-LYOPHILIZED 500 MG
INJECTION, IMMUNE GLOBULIN, SUBCUTANEOUS, 100 MG
INJECTION, IMMUNE GLOBULIN, IV, 500 MG (POWDER)
INJECTION, IMMUNE GLOBULIN, IV, NON-LYOPHILIZED, 500 MG
INJECTION, IMMUNE GLOBULIN, IV, NON-LYOPHILIZED 500 MG
INJECTION, GANCICLOVIR SODIUM 500 MG/VIAL
INJECTION, HEPATITIS B IMMUNE GLOBULIN IV, 0.5 ML
INJECTION, IMMUNE GLOBULIN IV NON-LYOPHILIZED 500 MG
INJECTION, HEPATITIS B IMMUNE GLOBULIN IV 0.5 ML
INJECTION, GARAMYCIN, GENTAMICIN, UP TO 80 MG
INJECTION, GATIFLOXACIN, 10 MG
INJECTION, GLATIRAMER ACETATE, 20 MG
INJECTION, GOLD SODIUM THIOMALEATE UP TO 50 MG
GLUCAGON HYDROCHLORIDE, PER 1 MG
GONADORELIN (LUTREPULSE) PER 100 MCG
GRANISETRON HYDROCHLORIDE, 100 MICROGRAMS = 0.1 MG, KYTRIL
INJECTION HALOPERIDOL HALDOL LACT UP TO 5 MG
INJECTION HALOPERIDOL DECANOATE HALDOL PER 50 MG
INJECTION, HEMIN, 1MG
HEPARIN LOCK FLUSH,10 UTS (NO ADMIN FEE INCLUDED)
HEPARIN SODIUM, PER 1000 UNITS
INJ-DALTEPARIN SODIUM, PER 2500 UNITS 00013240691
INJECTION, ENOXAPARIN SODIUM. 10 MG (LOVENOX)
FONDAPARINUX SODIUM, 0.5 MG
INJECTION TINZAPARIN SODIUM, 1000 IU
TETANUS IMMUNE GLOBULIN, 250 UNITS-0026063401
INJECTION, HUMAN FIBRINOGEN CONCENTRATE, 100 MG
HYDROCORTISONE ACETATE BIOSONE CORTEF ACETATE 25MG
HYDROCORTISONE SODIUM PHOSPHATE/50 MG-00006763304
HYDROCORTISONE SODIUM SUCCINATE 100 MG-00223789302
INJECTION, DIAZOXIDE 300 MG
INJECTION, IBANDRONATE SODIUM, 1 MG (BONIVA)
INJECTION, IBUTILIDE FUMARATE, 1 MG.
INJECTION, IDURSULFASE, 1 MG
INFLIXIMAB 10 MGM REMICADE
INJECTION, IRON DEXTRAN (INFED), 50 , MG
IRON SUCROSE, 1 MG
IMIGLUCERASE, PER UNIT (CEREZYME)
INJ DROPERIDOL UP TO 1 MG
INJECTION, PROPRANOLOL UP TO 1 MG
INJ DROPERIDOL-FENTANYL CITRATE UP TO 2 ML AMP
INSULIN, PER 5 UNITS
INSULIN FOR ADMINISTRATION THROUGH DME, I.E, INSULIN PUMP, PER 50 UNITS
INJECTION, INTERFERON BETA-IA KIT AVONEX 59627-001-03
INTERFERON BETA-1B, PER 0.25 MG
INJECTION, ITRACONAZOLE, 50 MG
KANAMYCIN SULFATE/500 MG (KANTREX) 00015351220
INJECTION, KANTREX PEDIATRIC, UP TO 75 MG
INJ KETOROLAC TROMETHAMINE PER 15 MG
INJECTION, CEPHALOTHIN SODIUM UP TO 1 GRAM
INJECTION, LARGON, UP TO 20 MG
INJECTION, LARONIDASE, 0.1 MG
INJECTION, FUROSEMIDE 20 MG
INJECTION, LEPIRUDIN, 50MG
LEUPROLIDE ACETATE (LUPRON) DEPOT SUSP., 3.75 MG
INJECTION, LEVETIRACETAM, 10 MG
LEVOCARNITINE PER 1 GRAM
LEVOFLOXACIN 250 MG
INJECTION, LEVORPHANOL TARTRATE, UP TO 2 MG
INJECTION, HYOSCYAMINE SULFATE 0.25 MG
INJECTION, CHLORDIAZEPOXIDE UP TO 100 MG
INJECTION, LIDOCAINE HCL FOR INTRAVENOUS INFUSION, 10 MG
INJECTION, LINEZOLID, 200 MG
INJECTION-LORAZEPAM 2MG OR LESS (ATIVAN)
INJECTION, MANNITOL, 25% IN 50 ML
INJECTION, MECASERMIN, 1 MG (INCRELEX - growth hormone)
INJECTION, MEPERIDINE HYDROCHLORIDE, PER 100 MG
INJ MEPERDINE-PROMETHAZINE HCL UP TO 50 MG
INJECTION, MEROPENEM, 100MG
METHYLERGONOVINE MALEATE 0.2 MG METHERGINE
INJECTION, MICAFUNGIN SODIUM, 1 MG (MYCAMINE)
INJECTION, MIDAZOLAM HCL 1 MG VERSED
MILRINONE LACTATE (PRIMACOR) I.V. PER 5 ML
MORPHINE SULFATE 10 MG
MORPHINE SULFATE 100 MG
INJ MORPHINE SULFATE PRESERVATIVE-FREE, PER 10 MG
INJECTION, ZICONOTIDE, 1MCG
INJECTION, MOSIFLOXAVIN, 100MG
INJECTION, NALBUPHINE HCL 10 MG-NUBAIN 00590043210
NALOXONE HCL PER 1 MG.
INJECTION, NALTREXONE, DEPOT FORM, 1 MG
NANDROLONE DECANOATE, UP TO 50 MG.
NANDROLONE DECANOATE, UP TO 100 MG
NANDROLONE DECANOATE, UP TO 200 MG.
INJECTION, NATALIZUMAB, 1 MG (TYSABRI)
INJECTION NESIRITIDE 0.1 MG
INJECTION, OCTREOTIDE, NON-DEPOT INJECT 1MG
INJECTION, OCTREOTIDE, NON-DEPOT FORM FOR SUBCUTANEOUS OR INTRAV INJECT 25 MCG
OPRELVEKIN NEUMEGA UP TO 5 MG
INJECTION, OMALIZUMAB, 5 MG
INJECTION, ORPHENADRINE 60 MG
INJECTION, PHENYLEPHRINE HCL 1 ML
INJECTION, CHLOROPROCAINE HCL 30 ML
INJECTION, ONDANSETRON HCL PER IMG (ZOFRAN IV)
OXYMORPHONE HCL/1 MG NUMORPHAN - 00590037010
INJECTION, PALIFERMIN, 50MCG
PAMIDRONATE (QUEDRA) I.V. PER 30 MG
INJECTION, PAPAVERINE HCL, UP TO 60 MG
INJECTION, OXYTETRACYCLINE, UP TO 50 MG
PALONOSERTRON HCL INJECTION, 25MCG
PARICALCITOL, 1 MCG
INJECTION PEGAPTANIB SODIUM 0.3 MG
INJECTION PEGADEMASE BOVINE 25IU
INJECTION, PEGFILGRASTIM, 6MG
INJ, PENICILLIN, PROCAINE AQUEOUS, 600,000 UNITS
INJECTION PENTASTARCH 10% SOLUTION, 100ML
INJECTION, PENTOBARBRTAL SODIUM-PER 50 MG
INJECTION, PFIZERPEN, UP TO 600,000 UNITS
PIPERACILLIN/TAZOBACTAM 1.125 G
PENTAMIDINE INH. SOLUTION,PER 300MG, THRU DME
INJECTION, PROMETHAZINE HCL 50 MG
INJECTION, PHENOBARBITAL, UP TO 120 MG
INJECTION, PLERIXAFOR, 1 MG
OXYTOCIN 10 UNITS (PITOCIN, SYNTOCINON)00071416003
DESMOPRESSIN INJECTION, 1 MCG
PREDNISOLONE ACETATE, DUA-PRED, PANACORT R-P 1 ML
TOLAZOLINE HCL 25 MG (PRISCOLINE HCL) 00083673304
INJECTION, PROGESTERONE, PER 50 MG
INJECTION, FLUPHENAZINE DECANOATE, UP TO 25 MG
INJECTION, PROCAINAMIDE HCL 1 GM
INJECTION, OXACILLIN SODIUM INJECT 250 MG
INJECTION, NEOSTIGMINEMETHYLSULFATE, UP TO 0.5 MG
INJECTION, PROTAMINE SULFATE, PER 10 MG
INJECTION, PROTEIN C CONCENTRATE, INTRAVENOUS, HUMAN, 10 IU
PROTIRELIN INJ. DIAGNOSTIC (RELEFACT TRH) 250 MCG
INJECTION, PRALIDOXIME CHLORIDE, UP TO 1 GM
PHENTOLAMINE MESYLATE 5 MG (REGITINE) 54569225000
INJECTION, METOCLOPRAMIDE HCL INJECT 10 MG
INJECTION, QUINUPRISTIN/DALFOPRISTIN 500 MG
INJECTION, RANIBIZUMAB, 0.1 MG
INJECTION, RESPIREX, UP TO 5 ML
INJECTION, RASBURICASE, 0.5 MG
INJECTION, REGADENOSON, 0.1 MG
RHO D IMMUNE GLOBULIN, HUMAN, MINIDOSE, 50 MCG
RHO D IMMUNE GLOBULIN INJ 300 MCG
INJECTION, RHO(D) IMMUNE GLOBULIN IV OR INTRAVENOUS, 100 IU
RHO D IMMUNE GLOBULIN IV HUMAN SOLVENT DETERGENT 100 IU
INJECTION, RILONACEPT, 1 MG
INJECTION, RISPERIDONE, LONG ACTING, 0.5 MG
INJECTION ROPIVACINE HYDROCHLORIDE 1 MG
INJECTION, ROMIPLOSTIM, 10 MICROGRAMS
INJECTION, METHOCARBAMOL 10 ML
INJECTION SINCALIDE, 5MCG
INJECTION, THEOPHYLLINE, PER 40 MG
INJECTION SARGARMOSTIM 50 MCG
INJECTION, SECRETIN, SYNTHETIC, HUMAN, 1 MCG
AUROTHIOGLUCOSE INJECT 50 MG
SODIUM FERRIC GLUCONATE COMPLEX IN SUCROSE INJECTION, 12.5 MG
METHYLPREDNISOLONE INJ 40 MG
METHYLPREDNISOLONE 125 MG
INJECTION, SOMATREM 1MG,
INJECTION, SOMATROPIN, 1MG
INJECTION, PROMAZINE HCL 25 MG
INJECTION RETEPLASE 18.1 MG
INJECTION, STREPTOKINASE, PER 250,000 IU
INJECTION ALTEPLASE RECOMBINANT 1 MG
INJECTION, STREPTOMYCIN, UP TO 1 GM
INJECTION, FENTANYL CITRATE , 0.1 MG
INJECTION, SUMATRIPTAN SUCCINATE, 6 MG
INJECTION, TALWIN, UP TO 30 MG
INJECTION, TENECTEPLASE, 1 MG
TERBUTALINE SULFATE, UP TO 1 MG
INJECTION, TENECTEPLASE, 50 MG
INJECTION, TESTOSTERONE ENANTHATE, UP TO 100 MG
INJECTION, TESTOSTERONE ENANTHATE, UP TO 200 MG
INJECTION, TESTOSTERONE, AQUEOUS, UP TO 50 MG
INJECTION, TESTOSTERONE PROPIONATE, UP TO 100 MG
INJECTION, THORAZINE, CHLORPROMA ZINE, UP TO 50 MG
INJECTION, THYROTROPIN, 0.9 MG IN 1.1 MG VIAL (PER VIAL)
INJECTION, TIGECYCLINE, 1 MG (TYGACIL)
INJECTIOIN, TIROFIBAN HC1, 0.25 MG
INJECTION, TRIMETHOBENZAMIDE HCL 200 MG
INJECTION, TOBRAMYCIN, SULFATE, NEBCIN UP TO 80 MG
TORSEMINE 10 MG/ML
INJECTION, THIETHYLPERAZINE MALEATE, UP TO 10 MG
INJECTION, TREPROSTINIL 1MG
INJECTION, TRIAMCINOLONE, UP TO 40 MG
TRIAMCINOLONE ACET 10MG
INJECTION OF TRIAMCINOLONE DIACETATE, PER 5MG
INJECT TRIAMCINOLONE HEXACETONIDE PER 5MG
TRIMETREXATE GLUCORONATE 25 MG
PERPHENAZINE/5 MG (TRILAFON) - 00085001204
TRIPTORELIN PAMOATE, 3.75 MG
SPECTINOMYCIN HCL 2 GM (TROBICIN) - 00009056601
UREA 40 G (UREAPHIL) -00074159202
INJECTION, UROFOLLITROPIN, 75IU
DIAZEPAM INJECTION, 5 MG
UROKINASE, 5000 IU VIAL, I.V.
INJECTION IV, UROKIANSE 250,000 IU/VIAL
INJECTION, VANCOMYCIN HCI, UP TO 500 MG
INJECTION, VERTEPORFIN, 0.1 MG
INJECTION, VESPRIN, UP TO 20 MG
HYDROXYZINE HCL INJECTION,, UP TO 25 MG
INJECTION, THIAMINE HCL, 100 MG
INJECTION, PYRIDOXINE HCL, 100MG
INJECTION, VITAMIN B-12, UP TO 1000 MCG
INJECTION, VITAMIN K, PER 1 MG
INJECTION, VORIXONAZOLE, 10MG
HYALURONIDASE 150 UNITS (WYDASE) - 00008017001
INJECTION HYALURONIDA PER 1USP UNIT
INJECTION HYALURONIDA PER 1000 USP UNITS
INJECTION, HYALURONIDASE, RECOMBINANT, 1 USP UNIT
MAGNESIUM SULFATE, PER 500 MG - INJECTION
POTASSIUM CHLORIDE INJECTION PER 2 MEQ
INJECTION ZIDOVUDINE 10 MG
INJECTION, ZIPRASIDONE MESYLATE, 10MG
ZOLEDRONIC ACID, 1 MG
INJECTION, ZOLEDRONIC ACID (RECLAST), 1 MG
UNCLASSIFIED DRUGS
ENDRATE ETHYLENEDIAMINE-TETRA-ACETIC ACID (EDTA)
NASAL VACCINE INHALATION
UNCLASSIFIED BIOLOGICS
INFUSION, NORMAL SALINE SOLUTION, 1000 CC
INFUSION, NORMAL SALINE SOLUTION, (500 ML=1 UNIT)
5% DEXTROSE/NORMAL SALINE (500 ML = 1 UNIT)
INFUSION, NORMAL SALINE SOLUTION, 250 CC
5% DEXTROSE/WATER (500 ML = 1 UNIT)
INFUSION, D5W, 1000 CC
INFUSION, DEXTRAN 40, 500 ML
INFUSION, DEXTRAN 75, 500 ML
RINGERS LACTATE INFUSION UP TO 1000 CC
HYPERTONIC SALINE SOL., 20 CC VIAL
INJECTION, FACTOR VIII (ANTIHEMOPHILIC FACTOR, RECOMBINANT) (XYNTHA), PER I.U.
INJ, ANTIHEMOPHILIC FCTR VIII/VON WILLEBRAND FCTR CMPLX (HUMAN), PER
INJECTION, VON WILLEBRAND FACTOR COMPLEX, HUMAN, RISTOCETIN COFACTOR, PER IU
FACTOR VIIA (ANTIHEMOPHILIC FACTOR, RECOMBINANT) PER 1MCG
FACTOR VIII, ANTIHEMOPHILIAC FACTOR-HUMAN PER UNIT
FACTOR VIII ANTI-HEMOPHILIAC FACTOR PORCINE; PER I.U.
FACTOR VIII, RECOMBINANT, PER IU
FACTOR IX ANTIHEMOPHILIAC FACTOR PURIFIED NON RECOMBINANT PER IU
FACTOR IX, COMPLEX, HEAT TREATED, PER UNIT
FACTOR IX ANTIHEMOPHILIAC RECOMBINANT, PER IU
ANITHROMBIN 3 (HUMAN) PER I UNIT (SOOIU/VIAL)
ANTI-INHIBITOR; PER I.U.
HEMOPHILIA CLOTTING FACTOR; NOT OTHERWISE CLASSIFIED
INTRAUTERINE COPPER CONTRACEPTIVE
LEVONORGESTREL RELEASING INTRAUTERINE CONTRACEPTIVE SYSTEM 52 MG (IUD)
CONTRACEPTIVE SUPPLY, HORMONE CONTAINING VAGINAL RING, EACH
CONTRACEPTIVE SUPPLY, HORMONE CONTAINING PATCH, EACH
LEVONORGESTREL IMPLANT SYSTEM, INCLUDING IMPLANTS AND SUPPLIES
ETONOGESTREL IMPLANT SYSTEM, INCL IMPLANT & SUPPLIES
AMINOLEVULINIC ACID HC FOR TOPICAL ADMINISTRATION, 20%, SUD FORM (354MG)
INJ-GANCILLOVOR 4.5MG LONG ACTING IMPL.61772000201
FLUOCINOLONE ACETONIDE, INTRAVITREAL IMPLANT (RETISERT)
HYALURONANOR DERIVATIVE INTRA-ARTICULAR INJECTION 1MG
HYALURONAN OR DERIVATIVE, HYALGAN OR SUPARTZ, PER DOSE
HYALURONAN OR DERIVATIVE, EUFLEXXA, PER DOSE
HYALURONAN OR DERIVATIVE, ORTHOVISC, PER DOSE
HYALURONAN OR DERIVATIVE, SYNVISC OR SYNVISC-ONE, PER 1 MG
ALATHIOPRINE ORAL 50MG/100S EA
AZATHIOPRINE PAR 100MG
CYCLOSPORINE ORAL 100MG (NEORAL, SANDIMMUNE)
LYMPHOCYTE IMM GLOBULIN ANTILYMPHOCYTE 250 MG
MONOCLONAL ANTIBODIES PAR/AMP 5MG
PREDNISIONE ORAL 100 TABS 5MG
TACROLIMUS (PROGRAF) CAPSULE, 1 MG
METHYLPREDNISOLONE ORAL, PER 4MG., X-OVER ONLY
PREDNISOLONE-ORAL, 5MG X-OVER ONLY DELTA-CORTEF
LYMPHOCYTE IMMUNE GLOBULIN, ANTITHYMOCTYE GLOBULIN, RABBIT, PARENTERAL, 25MG
DACLIZUMAB PARENTERAL 25MG
CYCLOSPORINE, ORAL 25 MG (NEORAL, SANDIMMUNE)
CYCLOSPORIN PARENTERAL 250MG
MYCOPHENOLATE MOFETIL (CELLCEPT) ORAL, 250 MG
MYCOPHENOLIC ACID, ORAL 180 MG
SIROLIMUS ORAL 1 MG
TACROLIMUS PARENTERAL 5 MG
METHYLPREDNISOLONE SODIUM SUCCINATE
ACETYLCYSTEINE, INHALATION SOLUTION, COMPOUNDED PRODUCT, PER GRAM
ARFORMOTEROL, INHALATION SOLUTION, FDA APPROVED FINAL PRODUCT,15 MICROGRAMS
FORMOTEROL FUMARATE, INHAL SOL, NON-COMPOUN, ADMIN THRU DME,
LEVALBUTEROL, INHALATION SOL, COMPOUNDED PROD, ADMIN THROUGH DME, 0.5 MG
ACETYCSTEINE INHALATION SOLUTION ADMINISTERED THRU DME UNIT DOSE, PER GRAM
ALBUTEROL, INHALATION SOL, COMPOUNDED PROD, ADMIN THROUGH DME, UNIT DOSE, 1 MG
ALBUTEROL, INHALATION SOL, COMPOUNDED PROD, ADMIN THRU DME, CONCEN FORM, 1 MG
ALBUTEROL, INHALATION SOL, FDA-APPROVED, NON-COMPOUNDED, ADMIN THRU DME, 1MG
LEVALBUTEROL, INHAL SOL, FDA-APP FINAL PROD, NON-COMPOUND, ADM THRU DME, 0.5 MG
ALBUTEROL, INHALATION SOL, FDA-APP FINAL PROD, NON-COMP, ADM THRU DME, DOSE 1MG
LEVALBUTEROL INHALATION SOL, FDA-APP FINAL PROD, NON-COMP, ADMIN THRU DME 0.5 MG
LEVALBUTEROL, INHALATION SOL, COMPOUNDED PROD, ADMIN THRU DME, UNIT DOSE, 0.5 MG
ALBUTEROL,UP to 2.5 MG & IPRATROPIUM BROMIDE, UP to 0.5 MG, FDA-APP
BETHAMETHASONE, INHALATION SOLUTION ADMIN.THROUGH DME, UNIT DOSE FORM PER MG
BETHAMETHASONE INHALATION SOLUTION ADMINISTERED THROUGH DME UNIT DOSE FORM/ MG.
BUDESONIDE INHALATION SOLUTION ADMIN. THROUGH DME, UNIT DOSE FORM 0.50MG
BUDESONIDE, POWDER, COMPOUNDED FOR INHALATION SOLUTION
BITOLTEROL MESYLATE, INHALATION SOLUTION, PER MILLIGRAM
BITOLTEROL MESYLATE, INHALATION SOLUTION, UNIT DOSE FORM, PER MILLIGRAM
CROMOLYN SODIUM,PER 20 MG,INHALATION THROUGH DME
CROMOLYN SODIUM INHALATION SOLUTION ADMINISTERED THRU DME UNIT DOSE PER 10 MG
CROMOLYN SODIUM, INHALATION SOL, COMPOUNDED PRODUCT, PER 10 ML
BUDESONIDE INHALATION SOLUTION THRU DME, CONCENTRATED FORM, PER 0.25 MILLIGRAM
BUDESONIDE, INHALATION SOL, COMPOUNDED PROD, ADMIN THRU DME, PER 0.25 MG
ATROPINE, INHALATION SOLUTION, ADMINISTERED THROUGH DME, PER MILLIGRAM
ATROPINE INHALATION SOLUTION ADMIN. COMPOUND PROD.THRU DME UNIT DOSE FORM PER MG
DEXAMETHASONE INHALATION SOL, COMPOUND PROD, ADMIN THRU DME CONCENTRATE PER MG
DEXAMETHASONE INHALATION SOL, COMPOUND PROD, ADMIN THRU DME UNIT DOES PER MG.
DORNASE ALPHA INHALATION SOLUTION ADMINISTERED THRU DME UNIT DOSE FORM PER MG.
FORMORTEROL, INHALATION SOLUTION ADMINISTERED THROUGH DME, 12 MCGS
FLUNISOLIDE, INHALATION SOLUTION ADMIN. THROUGH DME, UNIT DOSE PER MILLIGRAM
GLYCOPYRROLATE INHALATION SOL, COMPOUND PROD, ADMIN. THRU DME, PER MG.
GLYCOPYRROLATE INHALATION SOLUTION ADMIN. THRU DME UNIT DOSE FORM PER MG.
IPRATROPIUM BROMIDE INHALATION SOL, FDA APP, THRU DME UNIT DOES FORM PER MG.
IPRATROPIUM BROMIDE, INHALATION SOL, COMPOUNDED, (ADMIN THRU DME) PER MG
ISOETHARINE HCL, INHALATION SOL, COMPOUNDED PROD, ADMIN THRU DME, PER MG
ISOETHARINE HC1 INHALATION SOL FDA APP, ADMIN THRU DME CONCENTRATED FORM PER MG.
ISOETHARINE HC1 INHALATION SOL ADMIN, FDA APP, THRU DME UNIT DOSE FORM PER MG.
ISOETHARINE HCL 0.1% PER ML ADMINISTERED
ISOPROTERENOL HCL, INHALATION SOL, COMPOUNDED PROD, ADMIN THRU DME, PER MG
ISOPROTERENOL HC1 INHALAT SOL ADMIN, FDA APP. THRU DME CONCENTRATE FORM PER MG
ISOPROTERENOL HC1 INHALATION SOL ADMIN, FDA APP, THRU DME UNIT DOSE PER MG.
ISOPROTERENOL HCL, INHAL SOL, COMPOUND PROD, ADMIN THRU DME, UNIT DOSE , PER MG
METAPROTERENOL SULFATE, INHALATION SOL, COMPOUND PROD, CONCENTRATE, PER 10 MG
METAPROTERENOL SULFATE INHAL. SOL, FDA APP ADMIN/DME CONCENTRATED PER 10 MG
METAPROTERENOL SULFATE INHALATION SOLUTION, FDA APP. THRU DME UNIT DOSE 10 MG
METAPROTERENOL SULFATE, INHAL SOL, COMPND, ADM THRU DME, UNIT DOSE, PER 10 MG
METHACHOLINE CHLORIDE ADMIN AS INHAL SOL THROUGH PER 1MG
PENTAMIDINE ISETHIONATE, INHALATION SOLUTION, PER 300 MG
TERBUTALINE SULFATE INHAL SOL, COMPOUND PROD ADMIN. THRU DME CONCENTRATED PER MG
TERBUTALINE SULFATE INHAL SOL, COMPOUND PROD ADMIN. THRU DME UNIT DOSE PER MG.
TOBRAMYCIN, INHAL SOL FDA-APP, NON-COMP, UNIT DOSE , ADMIN THRU DME, PER 300 MG
TRIAMCINOLONE INHAL SOL, COMPOUND PROD. ADMIN. THRU DME CONCENTRATED PER MG.
TRIAMCINOLONE INHALATION SOL, COMPOUNDED. ADMIN. THRU DME UNIT DOSE PER MG
TOBRAMYCIN, INHALATION SOL, COMPOUND, ADMIN THRU DME, UNIT DOSE , PER 300 MG
NOC DRUGS,OTHER THAN INHALATION DRUGS, THROUGH DME
ANTIEMETIC DRUG, RECTAL SUPPOSITORY, NOC
APREPITANT, ORAL 5MG
ORAL BUSALFAN 2 MG
CABERGOLINE, ORAL 0.25 MG (DOSTINEX)
CAPECITABINE, ORAL 150 MG
CAPECITABINE ORAL 500 MG
CYCLOPHOSPHAMIDE (CYTOXAN), ORAL, 25 MG (CYTOXAN)
DEXAMETHASONE, ORAL 0.25 MG
ETOPSODIE (VEPESID) ORAL, 50 MG (VEPESID)
ANTIEMETIC DRUG, ORAL, NOC
MELPHALAN (ALKERON) ORAL, 2 MG (ALKERAN)
METHOTREXATE; ORAL, 2.5 MG (RHEUMATREX DOSE PACK)
NABILONE, ORAL, 1 MG
TEMOZOLMIDE ORAL 5 MG
TOPOTECAN, ORAL, 0.25 MG
DOXORUBICIN HCL, 10 MG VIAL
DOXORUBICIN HYDROCHLORIDE ALL LIPID FORMULATIONS 10 MG
ALEMTUZUMAB, 10 MG
ALDESLIUKIN, PER SINGLE USE VIAL
ARSENIC TRIOXIDE, 1MG
ASPARAGINASE 10,000 UNITS (ELSPAR) 00006461200
INJECTION, AZACITIDINE, 1MG (VIDAZA)
INJECTION, CLOFARABINE, 1 MG (CLOLAR)
BACILLI CALMETTE-GUERIN BCG LIVE IV 1 EACH
INJECTION, BENDAMUSTINE HCL, 1 MG
INJECTION, BEVACIZUMAB, 10MG
BLEOMYCIN SULFATE 15 UNITS (BLENOXANE)-00015301020
INJECTION, BORTEZOMIB, 0.1 MG
CARBOPLATIN, PER 50 MG
CARMUSTINE 100 MG (BICNU) - 00015301238
INJECTION, CETUXIMAB, 10MG
CISPLATIN, PLATINOL, 10 MG VIAL
CISPLATIN, PLATINAL, 50 MG VIAL
CLADRIBINE (LEUSTATIN) IV, PER 1 MG
CYCLOPHOSPHAMIDE, CYTOXAN, 10 CC OR 100 MG
CYCLOPHOSPHAMIDE, CYTOXAN, 20 CC OR 200 MG
CYCLOPHOSPHAMIDE, CYTOXAN, 30 CC OR 500 MG
CYCLOPHOSPHAMIDE 1 G (CYTOXAN) 00015054841
CYCLOPHOSPHAMIDE 2 GM (CYTOXAN) 00015054941
CYCLOPHOSPHAMIDE, LYOPHILIZED 100 MG
CYCLOPHOSPHAMIDE LYOPHILIZED 200MG
CYCLOPHOSPHAMIDE LYOPHILIZED 500MG
CYCLOPHOSPHAMIDE LYOPHILIZED IV 1.0 GM
CYCLOPHOSPHAMIDE LYOPHILIZED IV 2.0 GM
CYTARABINE, LIPOSOME, 10MG
CYTARABINE 100 MG (CYTOSAR-U) 55390013110
CYTARBINE HCL 500 MG 55390013210
DACTINOMYCIN ACTINOMYCIN 0.5 MG (COSMEGEN) 00006329822
DACARBAZINE 100 MG (DTIC-DOME) 00026815110
DACARBAZINE 200 MG (DTIC-DOME) 00026815120
DAUNDRUBICIN HCL/10 MG (CERUBIDINE) 55390028110
DAUNORUBICIN CITRATE, LIPOSOMAL FORMULATION, 10 MG
INJECTION, DEGARELIX, 1 MG
DENILEUKIN DIFITOX 300 MCG
DIETHYLSTILBESTROL DIPHOSPHATE IV/IM 250MG
INJECTION, DOCETAXEL, 1 MG
INJECTION, ELLIOTT'S B SOLUTION, 1 ML
INJ EPIRUBICIN HCL, 2 MG
ETOPOSIDE, PER 10 ML
FLUDARABINE PHOS. 50 MG
FLUOROURACIL, 500 MGM AMP
FLOXURIDINE 500 MG (FUDR) - 00004193508
GEMCITABINE HC1, 200 MG. GEMZAR
GOSERELIN ACETATE IMPLANT PER 3.6 MG
IRINOTECAN, 20 MG. - CAMPTOSAR
INJECTION, IXABEPILONE, 1 MG
IFOSFAMIDE IV IGM/VIAL
MESNA 200 MG
IDARUBICIN HCL, 5 MG (IDAMYCIN)
INJECTION, INTERFERON ALFACON-1, RECOMBINANT, 1 MCG
INTERFERON, ALFA-2A RECOMBINANT, 3 MILLION UNITS
INTERFERON, ALFA-2B RECOMBINANT, 1 MILLION UNITS
INTERFERON ALFA-N3, 250000 IU (ALFERON-N)
INTERFERON, GAMMA 1-B, 3 MILLION UNITS (ACTIMMUNE)
LEUPROLIDE ACETATE FOR DEPOT SUSPENSION 7.5MG
INJECTION OF LEUPROLIDE ACETATE (LUPRON) 1MG
LEUPROLIDE ACETATE IMPLANT 65 MG
HISTRELIN IMPLANT, 50MG
HISTRELIN IMPLANT (SUPPRELIN LA), 50 MG
MECHLORETHAMINE,HCL (NITROGEN MUSTARD) 10 MG
MELPHALAN (ALKERAN) INJ., 50 MG I.V.
METHOTREXATE SODIUM 5MG
METHOTREXATE SODIUM MIX, 2CC OR 50 ML
INJECTION, NELARABINE, 50 MG
INJECTION, OXALIPLATIN, 0.5 MG
INJECTION, PACLITAXEL PROTEIN BOUND PARTICLES, 1MG
PACLITAXEL (TAXOL) 30MG
PEGASPARGASE (ONCASPAR) 1 EACH VIAL
PENTOSTATIN, PER 10 MG
PLICAMYCIN (MITHRAMYCIN), 2.5 MG
MITOMYCIN, 5 MG
MITOMYCIN, 20 MG
MITOMYCIN IV 40 MG
INJECTION, MITOXANTRONE HYDROCHLORIDE, PER 5 MG
GEMTUZUMAB OZOGAMICIN, 5MG
INJECTION, PANITUMUMAB, 10 MG
INJECTION, PEMETREXED 10MG
INJECTION, PANITUMUMAB 10MG
RITUXIMAB CANCER TREATMENT, 100 MG
STREPOZOCIN INJ 1 GM
INJECTION, TEMOZOLOMIDE, 1 MG
TESTLACTONE, TESLAC, 250 MGM
THIOTEPA INJECTION, 15 MG
TOPOTECAN, 4 MG
TRASTUZUMAB, 10 MG
VINBLASTINE SULFATE 1 MG (VELBAN) 49452811201
VINCRISTINE SULFATE 1 MG (ONCOVIN) 49452811401
VINCRISTINE SULFATE 2 MG (ONCOVIN) 61703030916
VINCRISTINE SULFATE 5 MG (ONOCOVIN) 00002719601
VINORELBINE TARTRATE PER 10 MG
INJECTION, FULVESTRANT, 25 MG
PORFIMER SODIUM, 75 MG.
NOT OTHERWISE CLASSIFIED, ANTINEOPLASTIC DRUGS
STANDARD WHEELCHAIR
STANDARD HEMI W/C (LOW SEAT)-PURCHASE PRICE
LIGHTWEIGHT WHEELCHAIR
HIGH STRENGTH LIGHTWEIGHT WHEELCHAIR
ULTRALIGHT WHEELCHAIR
HEAVY DUTY WHEELCHAIR
EXTRA HEAVY DUTY WHEELCHAIR
OTHER MANUAL WHEELCHAIR BASE
STANDARD-WEIGHT FRAME MOTORIZED W/C
STD-WGHT FRAME W/C-PROGRAMABLE CNTRL
LIGHTWEIGHT PORTABLE WHEELCHAIR-PURCHASE PRICE
OTHER MOTORIZED/POWER WHEELCHAIR BASE
DET, NON-ADJ A/R EA
DET, ADJ-HT A/R BASE EA
DET ADJ HT A/R UPPER EA
ARM PAD EA
FIXED, ADJ HT A/R PAIR
ANTI TIPPING DEVICE EA
HEEL LOOP, EACH
HIGH MOUNT FLIP-UP F/R EACH
LEG STRAP EACH
LEG STRAP, EACH
ADJUSTABLE ANGLE FOOTPLATES; EACH
LARGE SIZE FOOTPLATE, EACH
STD SIZE FOOTPLATE, EACH
FOOTREST, LOWER EXT TUBE EACH
FOOTREST, UPPER BRKT, EACH
FOOTREST, COMPLETE
ELV LEGREST LOW EXT TUB EACH
ELV LEGREST, UPPER BRKT EACH
RATCHET ASSEMBLY
CAM RELEASE F/R OR L/R EA
S/A DETACH FOOTRESTS, EA
ELEV FOOTRESTS, TELESC. EACH
SEAT HT <17" OR < OR = TO 21" FOR ULTRA LT W/C
SPOKE PROTECTORS, EACH
REAR WHEEL ASSMB, COMP-W/SOLID TIRE,SPOKES/MOLD EA
REAR WHEEL ASSMB,COMP W/PNEU TIRE,SPOKES/MOLDED EA
FRONT CASTER ASSMB, COMP W/PNEMATIC TIRE, EA
FRONT CASTER ASSMB, COMP W/SEMI-PNEUMATIC TIRE, EA
CASTER PIN LOCK, EACH
FRONT CASTER ASSEMBLY, COMP. W/SOLID TIRE, EA
FRONT CASTER FOR POWER W/C
IV HANGER
OTHER W/C ACCESSORIES
NON POWER ADJ ZONE PRESSURE REDUCING MATTRESS OVER
NASAL APPLICATION DEVICE USE W/CPAP
NASAL PILLOWS/SEAL REPLACEMENT FOR NASAL APPLIC DE
HEAD GEAR, USE W/CPAP
CHIN STRAP, USE W/CPAP
TUBING, USED WITH/CPAP
FILTER, DISPOS,USE W/CPAP
FILTER, NON-DISPOS-USE W/CPAP
ELEVATING LEG REST, PAIR (USE W/CAPPED RENTAL WC)
INFUSION PUMP FOR UNINTERRUPTED ADMINISTRATION OF EPOPROSTENOL
TEMPORARY REPLACEMENT OF PT OWNED EQUIP BEING REPAIRED ANY TYPE
SUPPLIES FOR EXTERNAL INFUSION PUMP SYRINGE TYPE CARTRIDGE STERILE; EACH
REPLACEMENT BATTERY EXTERNAL INFUSION PUMP OWNED BY PT SILVER OXIDE 1.5 EACH
REPLACEMENT BATTERY FOR EXTERNAL INFUSION PUMP OWNED BY PT SILVER OXIDE 3
REPLACEMENT BATTERY FOR EXTERNAL INFUSION PUMP OWNED BY PT ALKALINE 1.5 EACH
REPLACEMENT BATTERY FOR EXTERNAL INFUSION PUMP OWNED BY PT LITHIUM 3.6V EACH
REPLACEMENT BATTERY FOR EXTERNAL INFUSION PUMP OWNED BY PT LITHIUM 4.5V EACH
AUTOMATIC EXTERNAL DEFIBRILLATOR WITH INTEGRATED ELECTROCARDIOGRAM ANALYSIS
REPLACEMENT BATTERY FOR AUTOMATIC EXTERNAL DEFIBRILLATOR; EACH
REPLACEMENT GARMENT FOR USE WITH AUTOMATIC EXTERNAL DEFIBRILLATOR; EACH
REPLACEMENT ELECTRODES FOR USE WITH AUTOMATIC EXTERNAL DEFIBRILLATOR; EACH
ADDITION TO LOWER EXTREMITY ORTHOSIS, ALL COMPONENTS, REPLACEMENT ONLY, EACH
CONTROLLED DOSE INHALATION DRUG DELIVERY SYSTEM
POWER WHEELCHAIR ACCESSORY, 12-24 AMP HR SEALED LEAD ACID BATTERY, EACH
SKIN PROTECTION WHEELCHAIR SEAT CUSHION, ADJUSTABLE 22 IN OR GREATER
SKIN PROTECTION WHEELCHAIR SEAT CUSHION, ADJUSTABLE, 22 INCHES OR GREATER
SKIN PROTECTION AND POSITIONING WHEELCHAIR SEAT CUSHION, LESS THAN 22 INCHES
SKIN PROTECTION AND POSITIONING WHEELCHAIR SEAT CUSHION 22 INCHES OR GREATER
PORTABLE GASEOUS OXYGEN SYST, RENTAL; HOME COMPRESSOR TO FILL PORTABLE OXYGEN
REPAIR/NONROUTINE SRV FOR DME OTHER THAN OXYG EQUIP REQ SKILL OF TECH, PR 15 MIN
REPAIR/NONROUTINE SVC OXYGEN EQUIP REQ TECHNICIAN, LABOR , PER 15 MIN
POWER OPERATED VEHICLE, GRP 1 STANDARD, PT WEIGHT CAPACITY UP TO & INCL 300 LBS
POWER OPERATED VEHICLE, GRP 1 HVY DUTY, PT WEIGHT CAPACITY 301-450 LBS
POWER OPERATED VEHICLE, GRP 1 VERY HVY DUTY, PT WEIGHT CAPACITY 451-600 LBS
POWER OPERATED VEHICLE, GRP 2 STANDARD, PT WEIGHT CAP UP TO AND INCL 300 LBS
POWER OPERATED VEHICLE, GRP 2 HEAVY DUTY, PT WEIGHT CAPACITY 301-450 LBS
POWER OPERATED VEHICLE, GRP 2 VERY HVY DUTY, PT WEIGHT CAPACITY 451-600 LBS
POWER OPERATED VEHICLE, NOT OTHERWISE CLASSIFIED
POWER WHEELCHAIR, GRP 1 PRTBL SLING/SOLID SEAT/BACK, PT WEIGHT UP TO&INCL 300LBS
POWER WHEELCHAIR, GRP 1 , PORTABLE, CAPT CHAIR, PT WEIGHT CAP UP TO/INCL 300 LBS
POWER WHEELCHAIR, GRP 1 STANDARD, PT WEIGHT CAPACITY UP TO & INCL 300 LB
POWER WHEELCHAIR, GRP 1 STANDARD, CAPT CHAIR, PT WEIGHT CAP UP TO & INCL 300 LBS
POWER WHEELCHAIR, GRP 2 STANDARD, PORTABLE, PT WEIGHT CAP UP TO & INCL 300 LBS
POWER WHEELCHAIR, GRP 2 STANDARD, CAPT CHAIR, PT WEIGHT UP TO & INCL 300 LBS
POWER WHEELCHAIR, GRP 2 STANDARD, PT WEIGHT CAP UP TO & INCL 300 LBS
POWER WHEELCHAIR, GRP 2 STANDARD, CAPT CHAIR, PT WEIGHT CAP UP TO & INCL 300 LBS
POWER WHEELCHAIR, GRP 2 HVY DUTY, PT WEIGHT CAPACITY 301 TO 450 LBS
POWER WHEELCHAIR, GRP 2 HVY DUTY, CAPT CHAIR, PT WEIGHT CAP 301-450 LBS
POWER WHEELCHAIR, GRP 2 VERY HVY DUTY, PT WEIGHT CAP 451-600 LBS
POWER WHEELCHAIR, GRP 2 VERY HVY DUTY, CAPT CHAIR, PT WEIGHT CAP 451-600 LBS
POWER WHEELCHAIR, GRP 2 EXTRA HVY DUTY, PT WEIGHT CAP 601 LBS OR MORE
POWER WHEELCHAIR, GRP 2 EXTRA HVY DUTY, CAPT CHAIR, PT WEIGHT 601 LBS OR MORE
POWER WHEELCHAIR, GRP 2 STNDRD, SEAT ELEV, PT WEIGHT CAP UP TO & INCL 300 LBS
POWER WHEELCHAIR, GRP 2, SEAT ELEV, CAPT CHAIR, PT WEIGHT CAP UP TO/INCL 300 LBS
POWER WHEELCHAIR, GRP 2, SINGLE POWER OPT, PT WEIGHT CAP UP TO & INCL 300 LBS
POWER WHEELCHAIR, GRP 2, SINGLE POWER OPT, PT WEIGHT CAP UP TO & INCL 300 LBS
POWER WHEELCHAIR, GRP 2 HVY DTY, SINGLE POWER OPT, PT WEIGHT CAP 301- 450 LBS
POWER WHEELCHAIR, GRP 2 HVY DTY, SINGLE POWER OPT, PT WEIGHT CAP 301-450 LBS
POWER WHEELCHAIR, GRP 2 VRY HVY DTY, SINGLE PWR OPT. PT WEIGHT CAP 451- 600 LBS
POWER WHEELCHAIR, GRP 2 EX HVY DTY, SINGLE PWR OPT, PT WEIGHT CAP 601 LBS/MORE
POWER WHEELCHAIR, GRP 2 STNDRD, MLTPL PWR OPT, PT WEIGHT CAP UP TO/INCL 300 LBS
POWER WHEELCHAIR, GRP 2, MLTPL PWR OPTIONS, PT WEIGHT CAP UP TO/ INCL 300LBS
POWER WHEELCHAIR, GRP 2 HVY DTY, MULTIPLE PWR OPT, PT WEIGHT CAP 301-450 LBS
POWER WHEELCHAIR, GRP 3, PT WEIGHT CAP UP TO & INCL 300 LBS
POWER WHEELCHAIR, GRP 3 STANDARD, CAPT CHAIR, PT WEIGHT CAP UP TO & INCL 300 LBS
POWER WHEELCHAIR, GRP 3 HVY DTY, SLING/SLD SEAT/BACK, PT WEIGHT CAP 301-450 LBS
POWER WHEELCHAIR, GRP 3 HVY DTY, CAPT CHAIR, PT WEIGHT CAP 301-450 LBS
POWER WHEELCHAIR, GRP 3 VRY HVY DTY, SLING/SOLID SEAT, PT WEIGHT CAP 451-600 LBS
POWER WHEELCHAIR, GRP 3 VRY HVY DTY, CAPT CHAIR, PT WEIGHT CAP 451-600 LBS
POWER WHEELCHAIR, GRP 3 EX HVY DTY, SLING/SOLID SEAT, PT WEIGHT CAP 601 LBS/MORE
POWER WHEELCHAIR, GRP 3 EX HVY DTY, CAPT CHAIR, PT WEIGHT CAP 601 LBS/ MORE
POWER WHEELCHAIR, GRP 3, SLING/SOLID. PT WEIGHT CAP UP TO&INCL 300LBS
POWER WHEELCHAIR, GRP 3 , CAPT CHAIR, PT WEIGHT CAP UP TO & INCL 300 LBS
POWER WHEELCHAIR, GRP 3 HVY DTY, SLING/SOLID SEAT/BACK, PT WEIGHT 301-450 LBS
POWER WHEELCHAIR, GRP 3 HVY DTY, CAPT CHAIR, PT WEIGHT CAP 301-450 LBS
POWER WHEELCHAIR, GRP 3 VRY HVY DTY, SLNG/SLD ST/BCK, PT WEIGHT CAP 451-600LBS
POWER WHEELCHAIR, GRP 3, PT WEIGHT CAP UP TO & INCL 300 LBS
POWER WHEELCHAIR, GRP 3 HVY DTY, MULTIPLE PWR OPT, PT WEIGHT CAP 301-450 LBS
POWER WHEELCHAIR, GRP 3 VRY HVY DTY, MULTIPLE PWR OPT, PT WEIGHT CAP 451-600 LBS
POWER WHEELCHAIR, GRP 3 EX HVY DTY, MULTIPLE PWR OPT, PT WEIGHT CAP 601 LBS/MORE
POWER WHEELCHAIR, GRP 4, PT WEIGHT CAP UP TO & INCL 300 LBS
POWER WHEELCHAIR, GRP 4, CAPT CHAIR, PT WEIGHT CAP UP TO & INCL 300 LBS
POWER WHEELCHAIR, GRP 4 HVY DTY, SLING/SOLID SEAT/BK, PT WEIGHT CAP 301-450 LBS
POWER WHEELCHAIR, GRP 4 VRY HVY DTY, SLING/SOLID SEAT, PT WEIGHT CAP 451-600 LBS
POWER WHEELCHAIR, GRP 4 STANDARD, PT WEIGHT CAP UP TO & INCL 300 LBS
POWER WHEELCHAIR, GRP 4 STANDARD, CAPT CHAIR, PT WEIGHT CAP UP TO/INCL 300LBS
POWER WHEELCHAIR, GRP 4 HVY DTY, PT WEIGHT CAP 301-450 LBS
POWER WHEELCHAIR, GRP 4 VRY HVY DTY, PT WEIGHT 451- 600 LBS
POWER WHEELCHAIR, GRP 4 STANDARD, PT WEIGHT CAP UP TO & INCL 300 LBS
POWER WHEELCHAIR, GRP 4, CAPT CHAIR, PT WEIGHT CAP UP TO & INCL 300 LBS
POWER WHEELCHAIR, GRP 4 HVY DTY, MULTIPLE PWR OPT, PT WEIGHT CAP 301-450 LBS
POWER WHEELCHAIR, GRP 5 PEDIATRIC, PT WEIGHT CAP UP TO & INCL 125 LBS
POWER WHEELCHAIR, GRP 5 PEDIATRIC, PT WEIGHT CAPACITY UP TO & INCL 125 LBS
POWER WHEELCHAIR, NOT OTHERWISE CLASSIFIED
GAUZE,NON-IMPREGNATED 16 SQ.IN. OR LESS W/ADHESIVE
CRANIAL CERVICAL ORTHOSIS, CONGENITAL TORICOLLIS TYPE, W OR W/O SOFT INTERFACE
CRANIAL CERVICAL ORTHOSIS, TORTICOLLIS TYPE, WITH OR WITHOUT JOINT
CERVICAL FLEXIBLE NON-ADJUST (FOAM COLLAR)
FLEXIBLE, THERMOPLASTIC COLLAR, MOLDED
CERVICAL SEMI RIGID ADJUSTABLE PLASTIC COLLAR
SEMI-RIGID, ADJUSTABLE MOLDED CIN CUP PLASTIC COL
SEMI-RIGID, WIRE FRAME OCCIPITAL/MANDIBULAR SUPPOR
CERVICAL, COLLAR, MOLDED TO PATIENT
COLLAR, SEMI-RIGID, THERMOPLASTIC FORM, TWO PIECE
COLLAR, SEMI-RIGID, THERMOPLASTIC FOAM, TWO PIECE
MULTIPLE POST COLLAR, OCCIPITAL/MANDIBULAR SUPPORT
MULTIPLE POST COLLAR, W/ADJ BARS, (SOMI, GUILFORD,
MULTIPLE POST COLLAR, ADJ CERVICAL BARS, THORACIC
RIB BELT, CUSTOM FABRICATED
THORACIC LUMBAR SACRAL OR THOSIS, FLEXIBLE, FITTED
TLSO, FLEXIBLE, CUSTOM FABRICATED
TLSO, FLEXIBLE ELASTIC RIGID POSTERIOR PANEL
TLSO, FLEXIBLE, HYPERTENSION, ELASTIC RIGID POSTER
TLSO, ANTERIOR-POSTERIOR CONTROL (TAYLOR TYPE) APR
TLSO ANTERIOR-POSTERIOR CONTROL W/RIGID OR SEMI-RIGID POSTERIOR PANEL PRE-FAB
TLSO, (KNIGHT TAYLOR TYPE) APRON FRONT
TLSO ANTERIOR-POSTERIOR-LATERAL CONTROL W/RIGID OR SEMI-REGID POSTERIOR PANEL
TLSO,ARNOLD MAGNUSON STEINDLER TYPE,APRON FRONT
FLEXION COMPRESSION JACKET CUSTOM FITTED
TLSO, FLEXION COMPRESSION JACKET, MOLDED
TLSO, ANTER/POST/LATER ROTARY CONTROL, HYPEREXTENS
TLSO, ANTERIOR-POSTERIOR-LATERAL-ROTARY CTRL W/EXT
TLSO, BODY-JACKET, MOLDED
TLSO ANTERIOR-POSTERIOR-LATERAL CONTROL W/RIGID OR SEMI-RIGID POSTERIOR PANEL
TLSO, BODY JACKET MOLDED, INTERFACE MATERIAL
TLSO, BODY JACKET, TWO-PIECE
TLSO, BODY JACKET, 2-PIECE, MOLDED, W/INTERFACE
TLSO, BODY JACKET, W/INTERFACE MATERIAL,CUSTOM FIT
TLSO,BDY JKT,OVERLAP FRNT,SPRING STEEL,CUSTOM FIT
TLSO PREFAB FLEXIBLE UPPER THORACIC INCLUDES SHOULDER STRAP CLOSURE FITTING ADJ
TLSO CUSTOM FAB FLEXIBLE UPPER THORACIC INCLUDES SHOULDER STRAPS CLOSURE FITTING
TLSO PREFAB FLEXIBLE SACRO JUNC TO T-9 INCLUDE SHOULDER STRAP CLOSURE FITTING AD
TLSO PREFAB FLEXIBLE SACRO JUNC TO SCAPULAR SPINE INCLUDES FITTING AND ADJUSTMEN
TLSO PREFAB TRIPLANAR ANT SYMPH PUBIS TO XIPHOID 2 RIGID PLASTIC SHELLS
TLSO PREFAB TRIPLANAR ANT SYMP PUBIS TO STERNAL NOTCH 2 RIGID PLASTIC SHELLS
TLSO PREFAB TRIPLANAR 3 RIGID SHELLS SYMPH PUBIS TO STERNAL NOTCH
TLSO PREFAB TRIPLANAR 4 RIGID SHELLS SYMPH PUBIS TO STERNAL NOTCH
TLSO PREFAB SAGGITAL CONTROL RIGID POST FLEXIBLE ANT INCLUDES FITTING AND ADJUST
TLSO PREFAB SAG-CORONAL CONTROL INCLUDES FITTING AND ADJ
PREFAB TRIPLANAR RIGID POST FRAME FLEXIBLE ANT INCLUDES FITTING AND ADJUSTMENT
TLSO PREFAB TRIPLANER HYPEREXTENSION INCLUDES SHAPING FRAME FITTING AND ADJUST
TLSO CUSTOM FAB SAG CORONAL FLEXION COMPRESSION JACKET W/OUT INTERFACE LINING
TLSO, TRIPLANER CONTROL, ONE PIECE, INC. CARVED PLASTER/CAD-CAM, CUSTOM FABRICAT
TLSO, TRIPLANER CONTROL, TWO PIECE INC CARVED PLASTER/CAD-CAM CUSTOM FABRICATED
TLSO, TRIPLANER CONTROL,TWO PIECE INC. CARVED PLASTER/CAD-CAM, CUSTOM FABRICATED
TLSO, TRIPLANER CONTROL, ONE PIECE, PREFABRICATED, INC. FITTING & ADJUSTMENT
TLSO, SAGITTAL-CORONAL CONTROL, 1 PIECE, PREFABRICATED, INC. FITTING & AJUST
CORONAL CONTROL
TLSO CORONAL CONTROL INCL FITTING AND ADJ.
SACROILIAC ORTHOSIS, INC FITTING AND ADJ
SACROILIAC ORTHOSIS, CUSTOM FABRICATED
SACROILIAC ORTHOSIS, PRE FABRICATED INCL FITTING AND ADJ
SACROILIAC ORTHOSIS, CUSTOM FABRICATED, SEMI RIGID PANELS
LUMBAR ORTHOSIS, PREFABRICATED, FROM L-1 TO BELOW L-5, INCL FITTING AND ADJ
LUMBAR ORTHOSIS, FROM L-1 TO BELOW L-5, INCL FITTING AND ADJ
LUMBAR ORTHOSIS, SAGITTAL CONTROL FROM L-1 TO BELOW L-5, INCL FITTING AND ADJ
LUMBAR SACRAL ORTHOSIS,
LUMBAR SACRAL ORTHOSIS, FLEXIBLE
LUMBAR SACRAL ORTHOSIS, SAGITAL
LUMBAR SACRAL ORTHOSIS, SAGITAL CONTROL WITH RIGID ANTERIOR/POSTERIOR PANELS
LUMBAR SACRAL ORTHOSIS, SAGITAL CONTROL WITH RIGID ANTERIOR/POSTERIOR PANELS
LUMBAR SACRAL ORTHOSIS, SAGITAL CONTROL WITH RIGID POSTERIOR PANELS
LUMBAR SACRAL ORTHOSIS, SAGITAL CONTROL WITH RIGID POSTERIOR FRAME/PANELS
LUMBAR SACRAL ORTHOSIS, SAGITAL CONTROL LUMBAR FLEXION
LUMBAR SACRAL ORTHOSIS, SAGITAL CONTROL TO FLEX THE LUMBAR SPINE
LUMBAR SACRAL ORTHOSIS, SAGITAL CORONAL CONTROL
LUMBAR SACRAL ORTHOSIS, SAGITAL CORONAL CONTROL WITH RIGID
LUMBAR SACRAL ORTHOSIS, SAGITAL CORONAL CONTROL WITH RIGID SHELLS/PANEL
LUMBAR SACRAL ORTHOSIS, SAGITAL CORONAL CONTROL WITH RIGID SHELLS/PANEL
CTLSO, MOLDED (MINERVA TYPE)
CTLSO, MOLDED W/INTERFACE MATERIAL (MINERVAL)
CERVICAL HALO INCORPORATED INTO JACKET
CERVICAL HALO INCORPORATED INTO PLASTER BODY JACKT
CERVICAL HALO INCORPORATED INTO MILWAUKEE ORTHOSIS
BREAST PROSTHESIS, NOS
ADDITION TO HALO PROCEDURE, MAGNETIC RESONANCE IMAGE COMPATIBLE SYSTEMS
ADDITION TO HALO PROCEDURE, REPLACEMENT LINER/INTERFACE MATERIAL
TORSO SUPPORT, PTOSIS SUPPORT, CUSTOM FITTED
TORSO SUPPORT, PTOSIS SUPPORT, CUSTOM FABRICATED
TORSO SUPPORT, PEODULOUS ABDOMEN SUPPORT,CUSTM FIT
TORSO SUPPORT, PENDULOUS ABDOMEN SUPPORT, CUSTOM F
TORSO SUPPORT, POST SURGICAL SUPPORT, CUSTOM FITTE
TORSO SUPPORT, POST-SURGICAL SUPPORT, CUSTOM FABRI
TLSO, CORSET FRONT
LSO CORSET FRONT
TLSO, FULL CORSET
LSO, FULL CORSET
AXILLARY CRUTCH EXTENSION
PERONEAL STRAPS, PAIR
STOCKING SUPPORTER GRIPS (4)
PROTECTIVE BODY SOCK, EACH
RIGID OR SEMI-RIGID ABDOMINAL PANEL PRE-FABRICATED
ADDITION TO SPINAL ORTHOSIS- NOS
CTLSO, (MILWAUKEE) INCLUDING INITIAL ORTHOSIS & MO
CERVICAL THORACIC LUMBAR SACRAL ORTHOSIS, INFANT SIZE, PREFAB, INCL FITTING/ADJ
AND ACCESSORY PADS INCLUDES FITTING AND ADJUSTMENTS
ADDN TO CTLSO, SCHOLIOSIS ORTHO, AXILLA SLING
ADDN TO CTLSO, SCOLIOSIS ORTHO, KYPHOSIS PAD
ADDN TO CTLSO, SCOLIOSIS ORTH, KYPHOSIS PAD, FLOA
ADDN TO CTLSO, SCOLIOSIS ORTHO, LUMBAR
ADDN TO CTLSO, SCOLIOSIS ORTHO, LUMBAR/LUMBAR RIB
ADDN TO CTSLO, SCOLIOSIS ORTHO, STERNAL PAD
ADDN TO CTLSO, SCOLIOSIS ORTHO, THORACIC PAD
ADDN TO CTLSO, SCOLIOSIS ORTHO, TRAPEZIUS SLING
ADDITION TO CTLSO OR SCOLIOSIS ORTHOSIS, OUTRIGGER
ADD. TO CTLSO, OUTRIGGER, BILATERAL, VERTICAL EXT.
ADDITION TO CTLSO, LUMBAR SLING
ADDITION TO CTLSO, RING FLANGE PLASTIC/LEATHER
ADDN. TO CTLSO, RING FLANGE, PLASTIC/LEATHER MOLDE
ADDITION TO CTLSO, COVER FOR UPRIGHT, EACH
TLSO, INCLUDES FURNISHING INITIAL ORTHOSIS ONLY
TLS ORTHOSIS, LATERAL THORACIC EXTENSION
ADDITION TO TLSO, ANTERIOR THORECIC EXTENSION
TLSO, MILWAUKEE TYPE SYPERSTRUCTURE
TLSO, LUMBAR SEROTATION PAD
TLSO, ANTERIOR ASIS PAD
TLSO, ANTERIOR THORACIC DEROTATION PAD
ADDITION TO TLSO ABDOMINAL PAD
TLSO, RIB GUSSETT (ELASTIC) EACH
TLSO LATERAL TROCHANTERIC PAD
BODY JACKETN MOLDED
POST-OPERATIVE BODY JACKET
UNLISTED PROCEDURE FOR SPINAL ORTHOSIS
THKAO, MOBILITY FRAME (NEWINGTON, PARAPODIUM TYPE)
THKAO, STANDING FRAME
THKAO, SWIVEL WALKER
HO,ABDUCTION, FLEXIBLE, FRESKA W/COVER
HO,ABDUCTION, FLEXIBLE, FRESKA COVER ONLY
HO, ABDUCTION, FLEXIBLE, PAVLIK HARNESS
HO,ABDUCTION,SEMI/FLEX (VON-ROSEN TYPE)
HIP ORTHOSIS, PELVIC BAND/SPREADER BAR, THIGH CUFF
HO,ABDUCTION,STATIC,ADJUST,CUSTOM FIT, (ILFLED)
HIP ORTHOSIS, BILATERAL CUFFS, ADULT, PREFABRICATED, INC FITTING AND ADJUSTMENT
HO,ABDUCTION, STATIC, PLASTIC, CUSTOM FIT
HO,ABDUCTION,DUNAMIC,ATTCH TO SHOE,(CRAIG TYPE)
HO, ABDUCT,ADJ HIP MOTION CONTRO,THIGH CUFF,RANCHO
HO, ABDUCTION, POST-OP, CUSTOM FABRICATED
HO,ABDUCTION,POST-OP,CUSTOM FIT
COMBINATION BILATERAL LUMBO-SACRAL HIP FEMUR ORTHOSIS ADDUC. INTERNAL ROTATION
LEGG PERTHES ORTHOSIS, TORONTO TYPE
LEGG PERTHES ORTHOSIS, NEWINGTON TYPE
LEGG PERTHES ORTHOSIS, TRILATERAL (TACHDIJAN TYPE)
LEGG, PERTHES ORTHOSIS, SCOTTISA RITE TYPE
LEGG PERTHES ORTHOSIS, (PATTEN BOTTOM TYPE)
KO ELASTIC WITH JOINTS
KNEE ORTHOSES, ELASTIC W/CONDYLE PADS AND JOINTS
KO, IMMOBILIZER, CANVAS LONGITUDINAL
KNEE ORTHOSIS, LOCKING KNEE JOINT(S) POSITIONAL ORTHO, PREFAB, INCL FIT AND ADJ
KO, ADJUSTABLE, POSITIONAL, RIGID, CUSTOM FITTED
KO, WITHOUT KNEE JOINT, RIGID, MOLDED
KNEE ORTHOSIS, RIGID W/O JOINTS, PREFABRICATED, INC. FITTING AND ADJUSTMENT
KO, CUSTOM, MED/LAT, ANTERIOR CRUCIATE LIGAMENT
KO, SIGNLE UPRIGHT,THEIGH/CALF,W/ADJUST.FLEXION & EXT.JOINT...CUSTOM FITTED
KO SINGLE UPRIGHT THIGH/CALF W/ADJ FLEXION/EXT JOI
KO, DBL UPRIGHT, ADJ FLEX/EXT JOINT, CUSTOM FIT
KO, DBL. UPRIGHT ADJ. FLEX/EXT. JOINT, MOLDED
KNEE ORTHOSIS DOUBLE UPRIGHT W/ ADJUSTABLE JOINT W/ INFLATABLE AIR SUPPORT
KO, SWEDISH TYPE
KO, MODIFIED SUPRACONDYLAR PROSTH. SOCKET, MOLDED
ANKLE-FOOT ORTHOSIS
AFO, ANKLE GAUNTLET, CUSTOM FITTED
AFO, MOLDED ANKLE GAUNTLET
AFO, MULTILAGEMNTUS ANKLE SUPPORT
AFO, SUPRAMALLEOLAR W/STRAPS, W OR W/O INTERFACE/PADS, CUSTOM FABRICATED
AFO POST. SINGLE BAR, CLASP ATTACH TO SHOE COUNTER
AFO, S UPRIGHT STATIC/ADJ STOP (PHELPS/PERLSTEIN)
AFO, CUSTOM FITTED, PLASTIC
AFO, RIGID ANTERIOR TIBIAL SECTION, TOTAL CARBON FIBER/EQUAL MATERIAL, PREFAB
AFO MOLDED TO PATIENT MODEL PLASTIC
AFO, MOLDED PLASTIC, RIGID ANTERIOR TIBIAL SECTION
ACO, SPIRAL, MOLDED (IRM TYPE) PLASTIC
AFO, SPIRAL (INSTITUTE OF REHAB MEDICINE TYPE) PLASTIC OR OTHER MATERIAL, PREFAB
AFO POST SOLID ANKLE MOLDED TO PT MODEL PLASTIC
AFO PLASTIC MOLDED TO PATIENT MODEL W/ ANKLE JOINT
AFO, PLASTIC OR OTHER MAT W/ANKLE JOINING, PREFABRICATION INCL FIT AND ADJ
AFO, S UPRIGHT, STIRRUP CALF BAND/CUFF (SINGLE BK)
AFO, DBL UPRIGHT FREE PLANTAR DORSFLEXION STIRRUP
KAFO, S UPRIGHT, STIRRUP, THIGH & CALF BANDS/CUFFS
KNEE ANKLE FOOT ORTHOSIS, ANY MATERIAL, SINGLE OR DOUBLE UPRIGHT, CUSTOM FAB
KAFO, SINGLE UPRIGHT, STIRRUP, NO KNEE JOINT
KAFO DBL UPRIGHT FREE KNEE & ANKLE SOLID STIRRUP
KAFO D UPRIGHT, FREE ANKLE, STIRRUP NO KNEE JOINTS
KNEE, ANKLE, FOOT ORTHOSIS, FULL PLASTIC, SINGLE UPRIGHT
KAFO, FULL PLASTIC, STATIC, PREFABRICATED (PEDIATRIC SIZE)
KAFO, FULL PLASTIC, DBL UPRIGHT, FREE KNEE, MOLDED
KAFO, PLASTIC SINGLE UPRIGHT, FREE KNEE, MOLDED
KAFO, PLASTIC, NO KNEE JOINT, MULTI-AXIS ANKLE
HKAFO, BILATERAL ROTATION STRAPS, PELVIC BAND/BELT
HKAFO TORSION CONTROL BILATERAL CABLES HIP JOINT
HKAFO, BILATERAL ROTATION STRAPS, PELVIC BAND/BELT
HKAFO, UNILATERAL ROTATION STRAPS, PELVIC BAND/BLT
HKAFO, UNI TORSION CABLE, HIP JOINT, PELVIC BAND
HKAFO UNI TORSION CABLE BALLBEARING HIP, PLVC BND
AFO, TIBIAL FRACTURE CAST, THERMOPLASTIC, MOLDED
AFO, TIBIAL FRACTURE CAST, MOLDED
AFO, TIBIAL FRACTURE ORTHOSIS, CUSTOM FITTED, SOFT
AFO FX ORTHOSIS-TIBIAL FX ORTHOSIS SEMI RIGID
AFO TIBIAL FRACTURE ORTHOSIS, RIGID, CUSTOM FITTED
KAFO FEMORAL FRACTURE CAST, THERMOPLASTIC, MOLDED
KAFO FEMORAL FRACTURE CAST, MOLDED
KAFO FEMORAL FRACTURE CAST, SOFT, CUSTOM FITTED
KAFO FEMORAL FRACTURE CAST, SEMI-RIGID, CUSTOM FIT
KAFO FX ORTHOSIS FEMOR FXCAST ORTHOSIS CUSTOM FIT
PLASTIC SHOE INSERT W/ ANKLE JOINTS
ADDN TO LOWER EXTREMITY DROP LOCK KNEE-JOINT
LIMITED MOTION KNEE JOINT
ADJUSTABLE MOTION KNEE JOINT GERMAN TYPE
ADDITION TO LOWER EXTREMITY, QUADRILATERAL BRIM
ADDITION TO LOWER EXTREMITY, WAIST BELT
HIP JOINT, PELVIC BAND, THIGH FLANGE, PELVIC BELT
ADDN TO LOWER EXTREMITY, THIGH/WGHT BEARING, GLUTE
ADDITIONS TO LOWER EXTREMITY DORSIFLEXION ASSIST
ADD. LOWER EXTREMITY DORSIFLEXION & PLANTAR FELXIO
SPLIT FLAT CALIPER STIRRUPS & PLATE ATTACHMENT
ROCKER BOTTOM FOR TOTAL CONTACT ANKLE FOOT ORTHOSIS, CUSTOM FAB ORTHOSIS ONLY
ROUND CALIPER & PLATE ATTACHMENT
ADD TO LOWER EXTREMITY, FOOT PLATE-STIRRUP ATTACH.
REINFORCED STIRRUP (SCOTTCRAIG TYPE)
ADDN LOWER EXTREMITY, LONG-TONGUE STIRRUP
ADD,VARUS/VALGUS T STRAP OR MALLEOIUS PAD
ADD TO LOWER EXTREM,VARUS/VULGUS CORRECTION PLASTI
ADDITIONS TO LOWER EXTREMITY, MOLDED INNER BOOT
ABDUCTION BAR, BILATERAL HIP, JOINTED, ADJUSTABLE
ABDUCTION BAR-STRAIGHT (ADDN TO LOWER EXTREMITY)
ALL. LOWER EXTREMITY NONMOLDED LACER
LACER, MOLDED MODEL (ADDN TO LOWER EXTREMITY)
ANTERIOR SWING BAND (ADDN TO LOWER EXTREMITY)
ADDITION TO LOWER EXTREMITY PRE-TIBIAL SHELL MOLD
ADDITION TO LOWER EXTREMITY, PROSTHETIC TYPE
EXTENDED STEEL SHANK (ADDN TO LOWER EXTREMITY)
PATTEN BOTTOM (ADDN TO LOWER EXTREMITY)
TORSION CONTROL, ANKLE-JOINT AND HALF SOLID STIRRU
ADD TO LOWER EXT TORSION CONTROL STRAIGHT KNEE JT
SHORT KNEE JOINT HEAVY DUTY
ADDITION TO LOWER EXTREMITY, KNEE JOINT, EACH JOINT
ADD. TO LOWER EXTREMITY OFFSET KNEE JOINT, EACH
ADD TOLWR EXTRM,OFFSET KNEE JOINT,HEAVY DUTY, EA
ADD TO LOWER EXTREM ORTHOSIS,SUSPENSION SLEEVE
DROP LOCK JOINTS
ADD TO KNEE JOINT, CAM LOCK
ADDITION TO KNEE JOINT, DROP LOCK, EACH JOINT
ADDITION TO KNEE JOINT,RATCHET LOCK...,EACH JOINT
ADDN TO KNEE JOINT, LEFT LOOP FOR DROP LOCK RING
ADDN TO LOW EXTREM, THIGH/WGT BEARING, GLUT/ISCHIA
ADDITION TO LOWER EXTREMITY, THIGH, WEIGHT BEARING
THIGH/WEIGHT BEARING QUADRILATERAL BRIM CUSTOM FIT
THIGH/WT BEARING ISCHIAL CONTAINMENT MOLDED
THIGH/WT BEARING, ISCHIALCONTAINMENT/CUSTOM-FITTED
THIGH WEIGHT BEARING LACER NON-MOLDED
THIGH/WEIGHT BEARING LACER MOLDED
THIGH, WEIGHT BEARING, HIGH ROLL CUFF
HIP JOINT CLEVIS TYPE 2-POSITION JOINT, EACH
PELVIC CONTROL, PELVIC SLING
HIP JOINT CLEVIS OR THRUST BEARING, FREE, EACH
HIP JOINT,CLEVIS / THRUST BEARING,LOCK,EACH
ADDITION TO LOWER EXTREMITY, PELVIC CONTROL, HIPIT
HIP JOINT, ADJUSTABLE FLEXION, EACH
ADD LOWER EXT PELVIC CONTROL HIP JOINT ADJ FLEX
PLASTIC MOLDED RECIPROCATING HIP JOINTS & CABLES
METAL FRAME, RECIPROCATING HIP JOINT & CABLES
PELVIC CNTRL, BAND & BELT, UNILATERAL
ADD TOP LOWER EXTREMITY PELVIC CONTROL BAND & BELT
PELVIC & THORACIC CONTROL
THORACIC BAND, ADDN TO LOWER EXTREMITY
PARASPINAL UPRIGHTS ADDN TO LOWER EXTREMITY
THORACIC CONTROL LATERAL SUPPORT OF UPRIGHTS
LOWER EXTREM PLATING, CHROME OR NICKEL, PER BAR
ADD. LOWER EXTREMITY ORTHOSIS;CARBON GRAPHITE LAM.
EXTENSION PER EXTENSION PER BAR (FOR LINEAL GROWTH
ORTHOTIC SIDE BAR DISCONNECT DEVICE PER BAR
ADD TOP LOWER EXTREMITY OR THOSIS NON-CORROSIVE
ORTHOSIS DROP LOCK RETAINER
ADD TO LOWER EXTREMITY OR THOSIS KNEE CONTROL
ADDITION TO LOWER EXTREMITY ORTHOSIS
LOWER EXTREMITY, KNEE CONTROL, CONDYLAR PAD
ADD TO LOWER EXTREMITY. ORTHOSIS BELOW KNEE SECT.
ADDZ TO LOWER EXTREMITY, ORTHOSIS ABOVE KNEE SECTN
12 CAST SOCKS
ADD TO LOWER EXTREMITY OR THOSIS FEMORAL LENGTH
UNLISTED PROCEDURES FOR LOWER EXTREMITY ORTHOSES
FOOT,INSERT,REMOVABLE,MOLDED,UCB,BERKELEY SHELL,EA
FOOT INSERT, REMOVABLE, MOLDED, SPENCO, EACH
FOOT INSERT REMOVABLE MOLDED PLASTAZOTE OR EQUAL E
FOOT INSERT REMOVABLE MOLDED SILICONE GEL EA
FOOT INSERT REMOVABLE MOLDED LONGI ARCH SUPPORT
FOOT INSERT REMOVABLE MOLDED LONGIT/METAT SUPP EA
FOOT INSERT REMOVABLE FOR MED TO FOOT EACH
FOOT, INSERT.PLATE, REMOVABLE, ADDITION TO LOWER EXTREMITY ORTHOSIS, HIGH STRGTH
ARCH SUPPORT REMOVABLE PRE-MOLDED LONGITUDINAL EA
ARCH SUPPORT REMOVABLE PRE-MOLDED METATASSAL EACH
ARCH SUPPORT REMOVABLE PREMOLDED LONGIT/METAT EA
ARCH SUPP NONREMOVABLE ATTACH TO SHOE LONGITUD EA
ARCH SUPP NON-REMOVABLE ATTACH TO SHOE METAT EA
ARCH SUPP NONREMOVABLE ATT TO SHOE LONGITUD/METAT
HALLUS-VALGUS NIGHT SPLINT ABDUCT & ROTATION BARS
FOOT ABDUCT ROTATION BARS ATTCH TO SHOE DENNIS BRN
ABDUCT ROTATION BARS(DENNIS BROWN)CLAMPED TO SHOE
FOOT, ADJ. SHOE STYLED POSITIONING DEVICE, EACH
FOOT PLASTIC HEEL STABILIZER
ORTHOPEDIC SHOE, OXFORD W/SUPINATOR OR PRONATOR, INFANT
ORTHOPEDIC SHOE OXFORD W/SUPINATOR OR PRONATOR, CHILD
ORTHOPEDIC SHOE OXFORD W/SUPINATOR OR PRONATOR, JUNIOR
ORTHOPEDIC SHOE HIGHTOP W/WUPINATOR OR PRONATOR, INFANT
ORTHOPEDIC SHOE HIGHTOP W/SUPINATOR OR PRONATOR, CHILD
ORTHOPEDIC SHOE HIGHTOP W/SUPINATOR OR PRONATOR, JUNIOR
SURGICAL BOOT EA. INFANT
SURGICAL BOOT EA. CHILD
SURGICAL BOOT EA JUNIOR
BENESCH BOOT PAIR INFANT
BENESCH BOOT PAIR CHILD
BENESCH BOOT PAIR JUNIOR
ORTHOPEDIC LADIES SHOES OXFORD, EA
ORTHOPEDIC LADIES SHOE DEPTH INLAY, EA
ORTHOPEDIC LADIES SHOE HIGHTOP DEPTH INLAY, EA
ORTHOPEDIC MENS SHOE OXFORD, EA
ORTHOPEDIC MENS SHOE DEPTH INLAY, EA
ORTHOPEDIC FOOTWEAR MENS SHOES HIGH TOP DEPTH INLAY, EA
ORTH. FOOTWEAR WOMANS SHOE,PART OF BRACE/ORTHOTIC, EA
ORTH. FOOTWEAR MANS SHOE, PART OF BRACE, ORTHOTIC, EA
ORTHOPEDIC FOOTWEAR, CUSTOM SHOE, DEPTH INLAY, EA
ORTHOPEDIC FOOTWEAR, CUSTOM MOLDED SHOE REMOV INNER MOLD, EA
FOOT SHOE MOLDED TO PATIENT MODEL, SILICONE, EA
FOOT SHOE MOLDED TO PATIENT MODEL, PLASTAZOTE, CUSTOM FAB, EA
FOOT, MOLDED SHOE, PLASTAZOTE, CUSTOM FITTED, EA
NON-STANDARD SIZE OR WIDTH
NON-STANDARD SIZE OR LENGTH
ORTHOPEDIC FOOTWEAR, ADDITIONAL CHARGE FOR SPLIT SIZE
SURGICAL BOOT/SHOE, EA
SANDAL, PLASTAZOTE, EA
LIFT,ELEVATION,HEEL,TAPERED TO METATARSALS PER INC
LIFT, ELEVATION HEEL & SOLE NEOPRENE PER INCH
LIFT, ELEVATION, HEEL & SOLE CORK, PER INCH
LIFT METAL EXTENSION (SKATE)
LIFT INSIDE SHOE TAPERED TO 1/2 INCH
LIFT HEEL PER INCH
HEEL WEDGE, SACH
HEEL WEDGE
SHOE WEDGE OUTSIDE SOLE
SOLE WEDGE BETWEEN SOLE
CLUBFOOT WEDGE
OUTFLARE WEDGE
METATARSAL BAR WEDGE ROCKER
METATARSAL BAR WEDGE, BETWEEN SOLE
FULL SOLE & HEEL WEDGE BETWEEN SOLE
HEEL COUNTER PLASTIC REINFORCED
HEEL COUNTER LEATHER REINFORCED
HEEL SACH CUSTOM TYPE
HEEL NEW LEATHER STANDARD
HEEL NEW RUBBER STANDARD
HEEL THOMAS WITH WEDGE
HEEL THOMAS EXTENDED TO BALL
HEEL PAD & DEPRESSION FOR SPUR
HEEL PAD REMOVABLE FOR SPUR
HEEL PAD REMOVABLE FOR SPUR
MISC SHOE ADDN INSOLE LEATHER
MISC SHOE ADDN INSOLE RUBBER
MISC SHOE ADDN INSOLE FELT COVERED W/LEATHER
MISC, SHOE ADDITION, SOLE, HALF
MISC SHOE ADDN SOLE FULL
MISC SHOE ADDN TOE TAP STANDARD
MISC SHOE ADDNITOE TAPI HORSESHOE
MISC SHOE ADDN EXTENSION TO INSTEP LEATHERW/EYELET
MISC SHOE ADDN CONVERT INSTEP TO VELCRO CLOSURE
CONVERT FIRM SHOE COUNTER TO SOFT COUNTER
MISC SHOE ADDN MARCH BAR
TRANSFER OF ORTHOSIS
TRANSFER NEW ORTHOSIS TO OTHER SHOE CALIPER PLATE
TRANS. ORTHOSIS FROM 1 SHOE TO ANOTHER,SOLID STIRR
TRANSFER ORTHOSIS TO OTHER SHOE SOLID STIRRUP
TRANSFER,SHOE TO SHOE,DENNIS BROWNE SPLINT,RIVETON
UNLISTED PROCEDURES FOR FOOT ORTHOPEDIC SHOES
SHOULD ORTHO, (SO), FIGURE OF "8" DESIGN ABDICT RE
SO FIGURE 8 ABDUCTION RESTRAINER CANVAS & WEBBING
SO, ACROMIO CLAVICULAR/CANVAS AND WEBBING TYPE
SHOULDER ARTHSOSIS
SHOULDER ORTHOSIS, ABDUCTION POSITING
SHOULDER ORTHOSIS, ABDUCTION POSITIONING
SO, VEST TYPE ABDUCTION RESTRAINER, PREFACBRICATED, INCL FITTING AND ADJ
SHOULDER STABILIZER PRE-FABRICATED INCLUDES FIT
ELBOW ORTHOSIS
ELBOW ORTHO ELASTIC W METAL JOINTS
EO, DBL UPRIGHT.W FOREARM/ARM CUFF, FREE MOTION
EO, DBL UPRIGHT W/FOREARM/ARM CUFF, EXTENSION
EO DBL UPRIGHT W FOREARM/ARM CUFFS
ELBOW ORTHOSIS W/ADJUSTABLE POSITION LOCKING JOINTS PRE-FAB W/FITTING & ADJUST
ELBOW ORTHOSIS, RIGID, W/O JOINTS, INC. SOFT INTERFACE, PREFAB, INC. FIT & ADJUS
ELBOW, WRIST, HAND ORTHOSIS
ELBOW, WRIST, HAND ORTHOSIS
ELBOW, WRIST, HAND AND FINGERS ORTHOSIS
ELBOW, WRIST, HAND AND FINGERS ORTHOSIS, ONE OR MORE
WRIST HAND FINGER ORTHOSIS, INCL ONE/ MORE NONTORSION JOINT(S), INCL FIT/ ADJ
WHFO W/OUT JOINTS PREFABRICATED INCLUDES FITTING & ADJUSTMENTS
WRIST HAND FINGER ORTHOSIS, INCL FITTING AND ADJUSTMENT
WHFO FLEXOR HINGE WRIST OR FINGER EXTENSION/FLEX
WHFO FLEXOR HINGE CABLE DRIVEN
WHFO EXTERNAL POWERED ELECTRIC
WRIST, HAND ORTHOSIS
WHFO, WRIST GAUNTLET MOLDED
WHFO, WRIST EXTENTION CONTRL COCK-UP CANVAS/LEATHE
WHFO FLEXION GLOVE ELASTIC FINGER CONTROL
HAND, FINGER ORTHOSIS
WRIST HAND ORTHOSIS, INCLUDES ONE OR MORE NONTORSION JOINT(S)
HAND ORTHOSIS, METACARPAL FRACTURE ORTHOSIS, PREFAB, INCL FIT AND ADJ
HAND ORTHOSIS, W/O JOINTS
HAND FINGER ORTHOSIS, INCLUDES ONE OR MORE JOINTS
HAND FINGER ORTHOSIS WITHOUT JOINTS PRE-FAB WITH FITTING
FINGER ORTHOSIS, PROXIMAL INTERP,DISTAL INTERPH, NON TORSION JOINT/SPRING, EXTE
HAND FINGER ORTHOSIS, INCL 1/MORE NONTORSION JOINT(S), TURNBUCKLES
WRIST HAND FINGER ORTHOSIS, INCL 1/MORE NONTORSION JOINT(S), TURNBUCKLES
FINGER ORTHOSIS
FINGER ORTHOSIS, NONTORSION JOINT
ADD.JOINT-UPPER EXTREMITY ORTHOSIS; PER JOINT
SEWHO ABDUCTION AIRPLANE DESIGN
SHOULDER, ELBOW, WRIST ORTHOSIS
SEWHO ABDUCTION ERBS PALSEY DESIGN
SEWHO MOBILE ARM SUPPORT ATTCH TO WHEELCHAIR ADJ
SEWHO RADIAL ARM SUPP ATCH TO W/CH ADJ RANCHO TYPE
SEWHO MOBILE ARM SUPP ATTACH TO W/CH RECLINING
SHOULDER, ELBOW, WRIST ORTHOSIS, THORIACIC COMP AND SUPPORT BAR
SEWHO MOBILE ARM SUPP ATTACH TO W/CH FRICTION SUPP
SEWHO MOBILE ARM SUPP MONO SUPP SLING YOKE TYPE
SEWHO ADDN TO MOBILE ARM SUPP ELEVATING
SHOULDER, ELBOW, WRIST ORTHOSIS, SHOULDER CAP DESIGN
SEWHO ADDN MOBILE ARM SUPP OFFSET/LATERAL ELASTIC
SHOULDER, ELBOW, WRIST, HAND ORTHOSIS, THORACIC COMPONENT
SEWHO ADDN TO MOBILE ARM SUPP SUPINATOR
SHOULDER, ELBOW, WRIST, HAND, FINGER ORTHOSIS,
SHOULDER, ELBOW, WRIST, HAND, FINGER ORTHOSIS,THORACIC COMP AND SUPP BAR
SHOULDER, ELBOW, WRIST, HAND, FINGER ORTHOSIS, SHOULDER CAP DESIGN
SHOULDER, ELBOW, WRIST, HAND, FINGER ORTHOSIS, THORACIC COMP AND SUPP BAR
UP EXTREM FX ORTHO HUMERAL
UP EXTREM ORTHO RADIUS/ULNAR
UP EXTREM FX ORTHO WRIST
ADDN TO UPPER EXTREMITY SOCK FRACTURE OR EQUAL EA
UNLISTED PROC FOR UPPER LIMB ORTHOSIS
REPLACE GIRDLE FOR MILWAUKEE ORTHO
REPLACEMENT STRAP, ANY ORTHOSIS, INCLUDES ALL COMPONENTS, ANY LENGTH/TYPE
REPLACE THRILATERAL SOCKET BRIM
REPLACE QUADRIOLATERAL SOCKET BRIM MOLDED MODEL
REPLACE QUADRILATERAL SOCKET BRIM CUSTOM FITTED
REPLACE MOLDED THIGH LACER
REPLACE NON-MOLDED THIGH LACER
REPLACE MOLDED CALF LEATHER
REPLACE NON-MOLDED CALF LACER
REPLACE HIGH ROLL CUFF
REPLACE PROXIMAL & DISTAL UPRIGHT FOR KAFO
REPLACE METAL BANDS KAFOPROXIMAL THIGH
REPLACE METAL BANDS KAFO-AFO CALF/DISTAL THIGH
REPLACE LEATHER CUFF,KAFO-PROXIMAL THIGH
REPLACE LEATHER CUFF KAFO-AFO CALF OR DISTAL THIGH
REPLACE PRETIBIAL SHELL
REPAIR ORTHOTIC DEVICE, LABOR COMPONENT PER 15 MIN
REPAIR ORTHO, REPLACE MINOR PARTS
PNEUMATIC ANKLE CONTROL SPLINT
PNEUMATIC WALKING SPLINT AIRCAST OR EQUAL
PNEUMATIC FULL LEG SPLINT AIRCAST OR EQUAL
PNEUMATIC KNEE SPLINT AIR CAST OR EQUAL
NON-PNEUMATIC WALKING SPLINT W/WO JOINTS, PREFABRICATED INC. FITTING AND ADJUST
REPLACE SOFT INTERFACE M'TRL. SPLINT,ANKLE CONTRAC
REPLACE SOFT INTERFACE M'TRL. SPLINT, FOOT DROP
STATIC OF DYNAMIC ANKLE-FOOT ORTHOTIC, ADJUSTABLE, PREFABRICATED
FOOT DROP SPLINT, RECUMBANT POSITIONING DEVICE
PARTIAL FOOT,SHOE INSERT W/LONGITUD ARCH,TOE FILL
PARTIAL FOOT MOLDED SOCKET ANKLE HT TOE FILLER
PARTIAL FOOT MOLDED SOCKET TIBIAL TUBERCLE HT TOE
ANKLE,SYMES,MOLDED SOCKET,SACH FOOT
ANKLE SYMES METAL FR MOLDED LEATHER SOCKET AFO
BELOW KNEE,MOLDED SOCKET,SHIN,SACH FOOT
BELOW KNEE PLASTIC SOCKET JOINTS/THIGH LACER SACH
EXTERNAL KNEE JOINT MOLDED SOCKET SHIN SACH FOOT
EXT KNEE JOINT MOLDED SOCKET BENT-KNEE SHIN SACH
ABOVE KNEE,SNGLE AXIS CONT FRX KNEE,SHIN,SACH FT
ABOVE KNEE,SHORT,W/O JNT,W FT BLOCK,W/O ANKLE JNT
ABOVE KNEE,SHORT,NO JNT,W/ARTICUL ANK/FT,DYNAMIC
ABOVE KNEE,PROX FEMORAL,CONT FRX KNEE,SHIN,SACH FT
HIP JNT,CANADIAN TYPE,MOLDED SOCKET,SINGLE AXIS KN
LOCKING HIPJOINT SINGLE AXIS KNEE,SHIN,SACH FOOT
HEMIPELVECTOMY,HIP JOINT,SINGLEAXIS KNEE,SHIN,SACH
BELOW THE KNEE, MOLDED SOCKET, SHIN, SACH FOOT, ENDOSKELETAL SYSTEM
KNEE DISARTICULATION OR THROUGH KNEE MOLDED SOCKET EXTERNAL JOINTS SACH ENDOSKEL
ABOVE KNEE MOLDED SOCKET OPEN END SACH FOOT ENDOSKELETAL SYSTEM SINGLE AXIS KNEE
HIP DISARTICULATION CANADIAN STYLE MOLDED SOCKET ENDOSKELETAL HIP JOINT AXIS KNE
HEMIPELVECTOMY, CANADIAN TYPE MOLDED, SOCKET, ENDOSKELETAL HIP, KNEE, SACH FOOT
BELOW KNEE,RIGID DRSG,W/FIT,ALIGN,SUSP,ONE CHANGE
BELOW KNEE RIGID DRSG EA ADDTL CAST CHG & REALIGN
AK RIGID DSG INCL FIT, ALIGN & ONE CAST CHG
AK RIGID DSG EA ADDTL CAST CHG & REALIGN
BELOW KNEE,RIGID DRSG,NON-WEIGHT BEARING
ABOVE KNEE,RIGID DRGS.NON-WEIGHT BEARING
BELOW KNEE,PTB SOCKET,USMC PYLON,DIRECT FORMED
ABOVE KNEE,ISCHIAL LEVEL SOCKET,USMC PYLON,DIRECT
BELOW KNEE,PREP,PTB SOCKET,USMC PYLON,MOLDED
BELOW KNEE,PREP,PTB SOCKET,THERMOPLASTIC,DIRECT FM
BELOW KNEE,PREP,PTB SOCKET,THERMOPLASTIC,MOLDED
BELOW KNEE,PREP,PTB SOCKET,PREFAB,ADJ/OPEN END
BELOW KNEE,PREP,PTB SOCKET,LAMINATED,MOLDED
ABOVE KNEE,PREP,ISCHIAL LEVEL,PLASTER SOCKET,MOLD
ABOVE KNEE,PREP,ISCHIAL LEVEL,THERMOPLASTIC,DIRECT
ABOVE KNEE,PREP,ISCHIAL SOCKET,THERMOPLASTIC,MOLD
AK,ADJ OPEN END SOCKET, USMC SACH FOOT
ABOVE KNEE,PREP,ISCHIAL SOCKET,LAMINATED,MOLDED
HIP PREP.HEMIPELVECTOMY,THERMOPLASTIC,MOLDED,PYLON
HIP PREP.HEMIPELVECTOMY,LAMINATED,MOLDED, PYLON
ABOVE KNEE, HYDRACADONCE SYSTEM
ABOVE KNEE-DISARTICULATE OCH4-BAR,FRX SWING CONTRL
ABOVE KNEE-DISARTICULATE OHC4-BAR,HYDRAULIC CONTRL
ADD LOWER EXT-AK-KNEE* DISORTIC,4-BAR W/PNEUM SWIN
ABOVE KNEE,UNIVERSAL MULTIPLEX,FRX SWING CONTROL
ADD. TO LOWER EXTREMITY, QUICK CHANGE UNIT; EACH
ADDN TO LOWER EXTREMITY TEST SOCKET, SYMES
ADD TO LWR EXTR, TEST SOCKET, BELOW KNEE
ADD TO LWR EXTRM, TEST SOCKET,KNEE DISARTICULATE
ADD TO LWR EXTREMITY, TEST SOCKET, ABOVE KNEE
ADD TO LWR EXTRM TEST SOCKET,HIP DISARTICULATION
ADD TO LWR EXTRM,TEST SOCKET,HEMIPELVECTOMY
ADD TO LWR EXTRMIBELOW KNEE, ACRYLIC SOCKET
ADD TO LWR EXTRM,SYMES,EXPANDABLE WALL SOCKET
ADD TO LWR EXTRM,ABOVE KNEE/DISARTICULATION,ACRYLC
ADD TO LWR EXTRMISYMES,TPB BRIM SOCKET
ADD TO LWR EXTRM,SYMES,POSTERIOR OPENING SOCKET
ADD TO LWR EXTRMISYMES,MEDIAL OPENING
ADD TO LWR EXTREMITY,BELOW KNEE, TOTAL CONTACT
ADD TO LWR EXTREMITY,BELOW KNEE, LEATHER SOCKET
ADD TO LWR EXTREMITY,BELOW KNEE,WOOD SOCKET
ADD TO LWR EXTRM,KNEE DISARTIC,LEATHER SOCKET
ADD TO LWR EXTRM,ABOVE KNEE,LEATHER SOCKET
ADD TO LWR EXTR,HIP DISARTIC,FLEX SOCKET,EXRTN FRM
ADD TO LWR EXTRM,ABOVE KNEE,WOOD SOCKET
ADD TO LWR EXTRM,BELOW KNEE,FLEX SOCKET EXTRN FRM
ADD TO LWR EXTRM,BELOW KNEE, AIR CUSHION SOCKET
ADD TO LWR EXTRM,BELOW KNEE,SUCTION SOCKET
ADD TO LWR EXTRM,ABOVE KNEE,AIR CUSHION SOCKET
ADD TO LWR EXTRM,ISCHIAL CONTAIN/NARROW M-L SOCKET
ABOVE KNEE/DISARTICULATION SOCKET,TOTAL CONTACT
ABOVE KNEE, FLEX INNER SOCKET, EXTERNAL FRAME
ABOVE KNEE/DISARTICULATION SOCKET,SUCTION SUSP
KNEE DISARTICULATION, EXPANDABLE WALL SOCKET
SOCKET INSERT,LOWR EXTR,SYMES
ADDN TO LOW EXTREM, SOCKET INSERT, BELOW KNEE (KEM
ADD TO LWR EXTRM,SOCKET INSERT,KNEE SIDARTICULATE
ADD TO LWR EXTRM,SOCKET INSERT, ABOVE KNEE
ADD TO LWR EXTRM,SOCKET INSERT,MULTI-DUROMETER
LWR EXTRM,SOCKET INSERT,BELOW KNEE,MULTI-DUROMETER
ADD TO LWR EXTR,BELOW KNEE,CUFF SUSPENSION
ADD TO LWR EXTRM,BELOW KNEE,MOLDED DISTAL CUSHION
BELOW KNEE,MOLDED SUPROCONDYLAR SUSP, PTS
ADDITION TO LOWER EXTREMITY BELOW KNEE/ABOVE KNEE SUSPENSION LOCKING MECHANISM
REMOVABLE MEDIAL BRIM SUSPENSION,BELOW KNEE
ADDITION TO LOWER EXTREMITY, BELOW KNEE/ABOVE KNEE, CUSTOM FABRICATION
BELOW KNEE,KNEE JOINTS,SINGLE AXIS,PAIR
BELOW KNEE JOINTS,POLYCENTRIC,PAIR
BELOW KNEE,JOINT COVERS,PAIR
ADDITION TO LOWER EXTREMITY, BELOW KNEE/ABOVE KNEE, CUSTOM FABRICATION
BELOW KNEE,THIGH LACER,NON-MOLDED
ADDITION TO LOWER EXTREMITY, BELOW KNEE/ABOVE KNEE, CUSTOM FABRICATED SOCKET
BELOW KNEE,THIGH LACER,GLUTEAL/ISCHIAL,MOLDED
ADDITION TO LOWER EXTREMITY, BELOW KNEE/ABOVE KNEE, CUSTOM FABRICATED SOCKET
BELOW KNEE,FORK STRAP
BELOW KNEE, SUSPENSION/SEALING SLEEVE, WITH OR WITHOUT VALVE, ANY MATERIAL, EACH
BELOW KNEE,BACK CHECK,EXTENSION CONTROL
BELOW KNEE,WAIST BELT,WEBBING
BELOW KNEE,WAIST BELT,PADDED/LINED
ABOVE KNEE,PELVIC CONTROL BELT, LIGHT
ABOVE KNEE,PELVIC CONTROL BELT, PADDED/LINED
ABOVE KNEE,PELVIC CONTRL,SLEEVE SUSP,NEOPRENE,EA
ABOVE KNEE/DISARTICULATION,PELVIC JOINT
ABOVE KNEE/DISARTICULATION,PELVIC BAND
ABOVE KNEE/DISARTICULATION,SILESIAN BANDAGE
ALL LOWER EXTREMITY PROSTHESES, SHOULDER HARNESS
REPLACE,SOCKET,BK,MOLDED TO PT MODEL
REPLACE,SOCKET,AK/K DISORTIC,INCL ATTACH PLATE,MOL
REPLACE,SOCKET,HIP DISORTIC,INCL HIP JOINT,MOLDED
ANKLE, SYMES, MOLDED TO PATIENT MODEL, SOCKET WO SOLID ANKLE CUSHION HEEL
REPLACE,CUSTOM SHAPED PROTECTIVE COVER,BK
REPLACEMENT,CUSTOM SHAPED PROTECTIVE COVER AK
REPLACE,CUSTOM SHAPED PROTECTIVE COVER,KNEE DISORT
REPLACE,CUSTOM SHAPED PROTECTIVE COVER,HIP DISORTI
EXOSKEL KNEE-SHIN SYST,SINGLE AXIS,MANUAL LOCK
EXOSKEL KNEE-SHIN SYST,ONE AXIS,MAN LOCK,ULTRA LT
EXOSKEL KNEE-SHIN SYST,SINGLE AXIS,FRX SWING
EXOSKEL KNEE-SHIN SYST,ONE AXIS,VARIB FRX SWG
EXOSKEL KNEE-SHIN SYST POLYCENTRIC,MECH STANCE LCK
EXOSKEL KNEE-SHIN SYST,POLY,FRX SWN/STNCE CONTROL
EXOSKEL KNEE-SHIN SYST,ONE AXISNPNEUM SWG FRX STNC
EXOSKEL KNEE-SHIN,ONE AXIS,FLUID SWG PHASE CONTROL
EXOSKEL KNEE-SHIN,ONE AXIS,EXTRN JNTS,FLUID SWG
EXOSKEL KNEE-SHIN,ONE AXIS, FLUID SWG/STNCE PHASE
EXOSKEL KNEE-SHIN,ONE AXIS,PNEUM/HYDRA,PNEUM/SWG
ADD. TO LOWER LIMB PROSTHESIS, VACUUM PUMP, LIMB MNGMT & MOISTURE EVACUATION
ADD. TO LOWER LIMB PROSTHESIS, VACUUM PUMP, LIMB MNGMT & MOISTURE EVAC. HEAVY DU
EXESKEL,BELOW KNEE,ULTRA-LIGHT
EXOSKEL,ABOVE KNEE,ULTRA-LIGHT
EXOSKEL,HIP DISARTICULATION,ULTRA-LIGHT
ENDOSKEL KNEE-SHIN,ONE AXIS,MANUAL LOCK
ADDITION ENDOSKELETAL KNEE SHIN SYSTEM
ENDOSKEL KNEE-SHIN,ONE AXIS,FRX SWG/STNCE PHASE
PROSTHETICS OR ORTHOTICS
ENDOSKEL KNEE-SHIN,POLY,MECHANICAL STNCE PHASE LCK
ENDOSKEL KNEE-SHIN,POLY,FRX SWG,STANCE PHASE CONTR
ENDOSKEL KNEE-SHIN,ONE AXIS,PHEUM SWG,FRX STNCE
ENDOSKEL KNEE-SHIN,ONE AXIS,FLUID SWG PHASE CONTRL
ADDITION ENDOSKELETAL KNEE-SHIN SYSTEM, SINGLE AXIS, HYDRAULIC SWING PHASE CTRL.
ENDOSKEL KNEE-SHIN,ONE AXIS,FLUID SWG/STNCE PHASE
ENDOSKEL KNEE-SHIN,ONE AXIS,PNEUM/SWG PHASE CONTRL
ADD ENDOSKELETAL KNEE/SHIN SYSTEM,MULTIAXIAL PNEU
ADD ENDOSKELETAL KNEE/SHIN-STANCE FLEXION FEATURE
ADDITION ENDOSKELETAL, KNEE-SHIN, HYDRAULIC EXT. DAMPING FEATURE, ADJUSTABLE
ENDOSKEL ABOVE KNEE/HIP DISARTIC KNEE EXTENSION
ADD ENDOSKELETAL SYSTEM,HIP DISORTIC,MECHANICAL HI
ADDITIONAL TO LOWER EXTREMITY PROSTHESIS, ENDOSKELETAL KNEE
ENDOSKEL BELOW KNEE, ALIGNABLE SYST
ENDOSKEL,ABOVE KNEE/HIP DISARTICULATION,ALIGNABLE
ADD ENDOSKELETAL SYSTEM,AK,KNEE OR HIP DISORTIC MA
ADD ENDOSKELETAL HIGH ACTIVITY KNEE CONTROL FRAME
ENDOSKEL,BELOW KNEE,ULTRA-LIGHT
ENDOSKEL,ABOVE KNEE,ULTRA-LIGHT
ENDOSKEL,HIP DISARTICULATION, ULTRA-LIGHT
ADD ENDOSKELETAL SYS,BK,FLEX PROTECT OUTER SURFACE
ADD ENDOSKEL SYS,AK,FLEX PROTECT OUTER SURFACE COV
ADD ENDOSKEL SYST,HIP DISORT,FLEX PROTECT OUTER SU
ALL LOWER EXTREMITY PROSTHESIS, ANKLE MULTIAXIAL SHOCK ABSORBING SYSTEM
ALL LWR EXTRM PROSTH,FOOT,EXTRN KNEE,SACH FOOT
ALL LOWER EXTREMITY PROSTHESIS, ANKLE SUCHION HEEL
ALL LOWER EXTREMITY PROSTHESIS,FLEXIBLE FOOT
ALL LOWER EXTREMITY PROSTHESIS,FOOT,SINGLE AXIS
ALL LOWER EXTREMITY PROSTHESES COMBINATION SINGLE AXIS ANKLE FLEXIBLE KEEL FOOT
ALL LOWER EXTREMITY PROSTHESIS,ENERGY STORING FOOT
ALL LWR EXTREMITY PROSTH,FOOT,MULTI-AXIAL
ALL LOWER EXTREM PROTHESIS MULTI ANKLE/FOOT,DYNAMI
ALL LWR EXTRM PROSTHESIS,FLEX FOOT SYST
ALL LOWER EXTREM PROTHESIS,FLEX-WALK SYST OR EQUAL
ALL EXOSKEL LWR EXTRM PROSTH,AXIAL ROTATION UNIT
ALL ENDOSKEL LWR EXTRM PROSTH,AXIAL ROTATION UNIT
ALL ENDOSKELETAL LOWER EXT. PROTHESES, DYNAMIC PYL
ALL LWR EXTRM PROSTHIMULTIAXIAL ROTATION,"MCP"
ALL LOWER EXTR.PROSTHESIS SHANK FOOT W/VERTICAL
LOWER EXTREMITY PROSTHESIS COMBINATION VERTICAL SHOCK MULTAXIAL/ROTATION/TORSION
ADDITION TO LOWER EXTREMITY PROSTHESIS USER ADJUSTABLE HEEL HEIGHT
UNLISTED PROCEDURE, LOWER EXTREMITY PROSTHESIS
PARTIAL HAND,ROBIN-AIDS,THUMB REMAINING
PART HAND,ROBIN-AIDS,LITTLE &/OR RING FINGER REM
PART HAND,ROBIN-AIDS,NO FINGER REMAINING
WRIST DISARTIC,MOLDED SOCKET,FLEX ELBOW,TRICEP PAD
WRIST DISAR MOLD SOCKET,EXPAN INTERFACE,FLEX ELBOW
BELOW ELBOW,MOLDED,FLEX ELBOW,TRICEP PAD
BELOW ELBOW,MOLDED,(MUENSTER/NW SUSP)
BELOW ELBOW,MOLDED DBL WALL SPLIT SOCKET,HALF CUFF
BEL ELBOW,MOLD DLB WALL SPLIT SOCKET,STUMP ACTIVAT
ELBOW DISARTICULATION,MOLDED,OUTSIDE LCK HINGE
ELBOW DISARTIC,MLD SOCKET,EXPAND INTERFACE,HINGED
ABOVE ELBOW,MLD DBL-WALL SOCKET.LOCKING ELBOW
SHOULDER DISARTIC,MLD SOCKET,HUMERAL,LOCK ELBOW
SHOULDER DISARTIC,PASSIVE RESTORATION(COMPLETE)
SHOULDER DISARTIC,PASSIVE REST(SHOULDER CAP ONLY)
INTERSCAPULAR THORACIC MLD SOCKET,LOCK ELBOW
INTERSCAPULAR THORACIC,PASSIVE RESTORATION,COMPLET
INTRASCAPULAR THORACIC,PASSIVE RESTR(SHOULDER CAP)
WRIST/BELOW ELBOW,RIGID DRSG,W/FITTING&CAST CHANGE
ELBOW/ABOVE ELBOW,RIGID DRSG,W/FITTING/CAST CHANGE
SHOULDER/INTRASCAPULAR THORACIC,RIGID DRSG.
CAST CHANGE, REALIGNMENT
RIGID DRESSING ONLY
BELOW ELBOW,MLD SOCKET,ENDOSKEL,SOFT TISSUE SHAPE
ELBOW DISARTIC.MLD SOCKET ENDOSKEL,SOFT TISSUE SHA
ABOVE ELBOW,MLD SOCKET,ENDOSKEL,SFT TISSUE SHAPING
SHLDER DISARTIC,MLD SOCKET,ENDO,SFT TISSUE SHAPING
INTERSCAPULAR THORACIC,MLD SOCKET ENDOSKELETAL
PREPARATORY,WRIST OR BELOW ELBOW, MOLDED
PREPARATORY,WRIST OR BELOW ELBOW, DIRECT FORMED
PREPARATORY,WRIST OR BELOW ELBOW, LOCKING,MOLDED
PREPARATORY,ELBOW OR ABOVE,DIRECT FORMED
PREPARATORY,SHOULDER/INTERSCAPULAR THORACIC MOLDED
PREPARATORY,SHOULDER/INTERSCAPULAR THORACIC,DIRECT
UPPER EXTREMITY ADDN,POLYCENTRIC HINGE,PR
UPPER EXTREMITY ADDN.SINGLE PIVOT HINGE.PR
UPPER EXTREMITY ADDN.FLEXIBLE METAL HINGE.PR
UPPER EXTREMITY ADDN.DISCONNECT LOCKING WRIST UNIT
UPPER EXTREM ADDN.ADDNL DISCONNECT INSERT (WRIST)
UPPER EXTRM ADDN.FLEXION-FRICTION WRIST UNIT
UPPER EXTREMITY PROSTHESIS, ADDITION, FLEX EXTENSION
UPPER EXTRM ADDN.SPRING ASSIST ROTATIONAL WRIST
UPPER EXTREMITY ADDITION, FLEXION/EXTENSION & ROTATION WRIST UNIT
UPPER EXTRM ADDN. ROTATION WRIST UNIT W/CBLE
UPPER EXTRM,QUICK DISCONNECT HOOK ADAPTER,OTTO BOK
QUICK DISCONNECT LAMINATION COLLAR W/COUPLING
UPPER EXTREMITY ADDN. STAINLESS STEEL,ANY WRIST
UPPER EXTREMITY ADDN.LATEX SUSPENSION SLEEVE,EA
UPPER EXTREMITY ADDN.LIFT ASSIST.ELBOW
UPPER EXTREMITY ADDN.NUDGE CONTROL ELBOW LOCK
UPPER EXTREMITY ADDN.SHOULDER ABDUCTION JOINT.PR
UPPER EXTREMITY ADDN,EXCURSION AMPLIFIER, PULLEY
UPPER EXTREMITY ADDN, EXCURSION AMPLIFIER. LEVER
SHOULDER FLEXION-ABDUCTION JOINT, EA
SHOULDER UNIVERSAL JOINT, EACH
UPPER EXTREMITY ADDN. STANDARD CONTROL CABLE, EA
UPPER EXTREMITY ADDN.HEAVY DUTY CONTROL CABLE
UPPER EXTREMITY ADDN. TEFLON OR EQUAL CABLE LINING
UPPER EXTREMITY ADDN.HOOK TO HAND CABLE ADAPTER
HARNESS,CHEST OR SHOULDER,SADDLE TYPE
UPPER EXTREMIHARNESS FIG EIGHT TYPE,SINGLE CONTROL
UPPER EXTREMI,HARNESS,FIG EIGHT TYPE,DUAL CONTROL
UPPER EXTREMITY , ADDITION, HARNESS, TRIPLE CONTROL
WRIST OR BELOW ELBOW, TEST SOCKET
ELBOW OR ABOVE, TEST SOCKET
TEST SOCKET, SHOULDER OR INTERSCAPULAR THORACIC
UPPER EXTREMITY ADDN, SUCTION SOCKET
FRAME TYPE SOCKET, BELOW ELBOW OR WRIST DISARTIC
FRAME TYPE SOCKET,ABOVE ELBOW OR ELBOW DISARTIC
FRAME TYPE SOCKET, SHOULDER DISARTICULATION
FRAME TYPE SOCKET, INTERSCAPULAR THORACIC
UPPER EXTREMITY ADDN, REMOVABLE INSERT, EACH
UPPER EXTREMITY ADDNLSILICONE GEL INSERT OR EQUAL
UPPER EXTREMITY ADDITION EXTERNAL LOCKING ELBOW/FOREARM COUNTERBALANCE
BELOW/ABOVE ELBOW, CUSTOM FABRICATED FROM EXISTING MOLD OR PREFAB
BELOW/ABOVE ELBOW, CUSTOM FAB FROM EXISTING MOLD OR PREFAB, SOCKET INSERT
BELOW/ABOVE ELBOW, CUSTOM FABRICATED SOCKET INSERT FOR AMPUTEE, INITIAL ONLY
BELOW/ABOVE ELBOW,CUSTOM FABRICATED SOCKET INSERT FOR AMPUTEE, INITIAL ONLY
BELOW/ABOVE ELBOW, LOCK MECHANISM, EXCLUDES SOCKET INSERT
TERMINAL DEVICE, PASSIVE HAND/MITT
TERMINAL DEVICE, HOOK, MECHANICAL, LINED OR UNLINED
TERMINAL DEVICE, HOOK, MECHANICAL, VOLUNTARY CLOSING, LINED OR UNLINED
TERMINAL DEVICE, HAND, MECHANICAL, VOLUNTARY OPENING, ANY MATERIAL, ANY SIZE
TERMINAL DEVICE, HAND, MECHANICAL, VOLUNTARY CLOSING, ANY MATERIAL, ANY SIZE
TERMINAL DEVICE, HOOK, MECHANICAL, VOLUNTARY OPENING, ANY MATERIAL,
TERMINAL DEVICE, HOOK, MECHANICAL, VOLUNTARY CLOSING, ANY MATERIAL,
TERMINAL DEVICE, HAND, MECHANICAL, VOLUNTARY OPENING, ANY MATERIAL,
TERMINAL DEVICE, HAND, MECHANICAL, VOLUNTARY CLOSING, ANY MATERIAL
TERMINAL DEVICE, HOOK OR HAND, HEAVY DUTY, MECHANICAL, VOLUNTARY
TERMINAL DEVICE, HOOK OR HAND, HEAVY DUTY, MECHANICAL, VOLUNTARY
TERMINAL DEVICE, MODIFIER WRIST FLEXION UNIT
TERMINAL DEVICE, PINCHER TOOL, OTTOBOCK OR EQUAL
AUTOMATIC GRASP FEATURE ADDITION TO UPPER LIMB PROSTHETIC TERMINAL DEVICE
MICRO PROCESSOR CF IN ADDITION TO UPPER LIMB PROSTHETIC TERMINAL DEVICE
REPLACEMENT SOCKET, BELOW ELBOW/WRIST
REPLACEMENT SOCKET, ABOVE ELBOW
REPLACEMENT SOCKET, SHOULDER
TERMINAL DEVICE,GLOVE FOR ABOVE HANDS,PRODUCTION G
TERMINAL DEVICE,GLOVE FOR ABOVE HANDS,CUSTOM GLOVE
PARTIAL HAND, W/GLOVE THUMB OR ONE FINGER REMAIN
PARTIAL HAND, W/GLOVE, MULTIPLE FINGERS REMAINING
PARTIAL HAND, W/GLOVE, NO FINGERS REMAINING
HAND RESTORATION, GLOVE
ADDITIONAL TO UPPER EXTREMITY PROSETHESIS, BELOW WRIST
ADDITIONAL TO UPPER EXTREMITY PROSETHESIS, ABOVE ELBOW
ADDITIONAL TO UPPER EXTREMITY PROSETHESIS, SHOULDER
ADDITIONAL TO UPPER EXTREMITY PROSETHESIS, BELOW ELBOW/WRIST
ADDITIONAL TO UPPER EXTREMITY PROSETHESIS, ABOVE ELBOW
ADDITIONAL TO UPPER EXTREMITY PROSETHESIS, SHOULDER
REPAIR PROSTHETIC DEVICE HRLY RATE
REPAIR PROSTHETIC DEVICE
REPAIR PROSTHETIC DEVICE, LABOR COMPONENT-15 MIN
PROSTHETIC DONNING SLEEVE, ANY MATERIAL
BREAST PROSTHESES MASTECTOMY BRA
BREAST PROSTHESIS MASTECTOMY BRA WITH INTEGRATED BREAST PROSTHESIS FORM UNILATER
BREAST PROSTHESIS MASTECTOMY BRA W/INTEGRATED BREAST PROSTHESIS FORM, BILATERAL
BREAST PROSTHESES MASTECTOMY SLEEVE
EXTERNAL BREAST PROSTHESIS GARMENT W/ MASTECTOMY FORM. POST MASTECTOMY
BREAST PROSTHESES MASTECTOMY FORM
BREAST PROTHESIS, SILICONE OR EQUAL
BREAST PROSTHESIS, SILICONE OR EQUAL, WITH INTEGRAL ADHESIVE
NIPPLE PROSTHESIS, REUSABLE, ANY TYPE, EACH
CUSTOM BREAST PROSTHESIS POST MASTECTOMY MOLDED TO PATIENT MODEL
BREAST PROSTHESIS, NOT OTHERWISE CLASSIFIED
NASAL PROSTHESIS PROVIDED BY NON PHYSICIAN
MIDFACIAL PROSTHESIS PROVIDED BY NON PHYSICIAN
ORBITAL PROSTHESIS PROVIDED BY NON PHYSICIAN
UPPER FACIAL PROSTHESIS PROVIDED BY NON PHYSICIAN
HEMI FACIAL PROSTHESIS PROVIDED BY NON PHYSICIAN
AURICULAR PROSTHESIS PROVIDED BY NON PHYSICIAN
PARTIAL FACIAL PROSTHESIS PROVIDED BY A NON PHYSICIAN
NASAL SEPTAL PROSTHESIS PROVIDED BY NON PHYSICIAN
UNSPECIFIED MAXILLOFACIAL PROSTHESIS BY REPORT PROVIDED BY NON PHYSICIAN
TRUSS, SINGLE WITH STANDARD PAD
TRUSS, DOUBLE W/STANDARD PADS
TRUSS, ADDN TO STANDARD PAD, WATER PAD
TRUSS, ADDN TO STANDARD PAD, SCROTAL PAD
PROSTHETIC SHEATH, BELOW KNEE, EACH
PROSTHETIC SHEATH, ABOVE KNEE, EA.
PROSTHETIC SHEATH, UPPER LIMB, EA.
PROSTHETIC SHEATH/SOCK W/GEL CUSHION; EACH
PROSTHETIC SOCK, MULTIPLE PLY, BELOW KNEE; EACH
PROSTHETIC SOCK, MULTIPLE PLY, ABOVE KNEE; EACH
PROSTHETIC SOCK. WOOL, UPPER LIMB, EA.
PROSTHETIC SHRINKER, BELOW KNEE, EA.
PROSTHETIC SHRINKER, ABOVE KNEE, EA.
PROSTHETIC SHRINKER, UPPER LIMB, EA.
STUMP SOCK, SINGLE PLY, BELOW KNEE, EA.
STUMP SOCK, SINGLE PLY, ABOVE KNEE, EA.
STUMP SOCK, SINGLE PLY,FITTING,UPPER LIMB EA
UNLISTED PROCEDURE, PROSTHETIC SERVICES
ARTIFICIAL LARYNX, ANY TYPE
TRACHEOSTOMY SPEAKING VALVE
ARTIFICIAL LARYNX REPLACEMENT BATTERY/ACCESSORY, ANY TYPE
TRACHEO-ESOPHAGEAL VOICE PROSTHESIS, PATIENT INSERTED; ANY TYPE
TRACHEO-ESOPHAGEAL VOICE PROSTHESIS INSERTED BY LICENSED HEALTH CARE PROVIDER
VOICE AMPLIFIER
INSERT FOR INDWELLING TRACHEOSOPHAGEAL PROSTHESIS, W OR W/O VALVE, REPLACEMENT
GELATIN CAPSULES OR EQUIV FOR USE W/ TRACHEOSOPHAGEAL VOICE PROSTHESIS, REPLACE
CLEANING DEVICE USED W/TRACHEOESOPHAGEAL VOICE PROSTHESIS, PIPETTE, BRUSH ETC
TRACHEOESOPHAGEAL PUNCTURE DILATOR, REPLACEMENT ONLY, EACH
GELATIN CAPSULE, APPLICATION DEVICE FOR USE W/ TRACHEOESOPHAGEAL VOICE PROS., EA
IMPLANTABLE BREAST PROSTHESIS, SILICONE OR EQUAL
COLLAGEN IMPLANT, URINARY TRACT, PER 2.5 CC SYRING
INJECTABLE BULKING AGENT, DEXTRANOMER/HYALURONIC ACID COPOLYMER
INJECTABLE BULKING AGENT SYNTHETIC IMPLANT URINARY TRACT 1 ML SYRINGE INCLUSIVE
ARTIFICIAL CORNEA
OCULAR IMPLANT
AQUEOUS SHUNT - IMPLANT
OSSICULA - IMPLANT
COCHLEAR DEVICE/SYSTEM
HEADSET/HEADPIECE FOR USE WITH COCHLEAR IMPLANT DEVICE, REPLACEMENT
MICROPHONE FOR USE WITH COCHLEAR IMPLANT DEVICE, REPLACEMENT
TRANSMITTING COIL FOR USE WITH COCHLEAR IMPLANT DEVICE, REPLACEMENT
TRANSMITTER CABLE FOR USE WITH COCHLEAR IMPLANT DEVICE, REPLACEMENT
COCHLEAR IMPLANT EXTERNAL SPEECH PROC.-REPLACEMENT
ZINC AIR BATTERY FOR USE WITH COCHLEAR IMPLANT DEVICE, REPLACEMENT, EACH
ALKALINE BATTERY FOR USE WITH COCHLEAR IMPLANT DEVICE, ANY SIZE REPLACEMENT, EA
LITHIUM ION BATTERY, FOR USE WITH COCHLEAR IMPLANT DEVICE, OTHER THAN EAR LEVEL
LITHIUM ION BATTERY, FOR USE WITH COCHLEAR IMPLANT DEVICE, EAR LEVEL
COCHLEAR IMPLANT, EXTERNAL SPEECH PROCESSOR, COMPONENT, REPLACEMENT
COCHLEAR IMPLANT, EXTERNAL CONTROLLER COMPONENT, REPLACEMENT
TRANSMITTING COIL & CABLE, INTEGRATED, FOR USE W/COCHLEAR IMPL DEVICE, RPLCMNT
METACARPOPHALANGEAL JOINT, IMPLANT
METATARSAL JOINT
HALLUX, IMPLANT
INTERPHALANGEAL JOINT, IMPLANT
VASCULAR GRAFT MATERIAL, SYNTHETIC - IMPLANT
IMPLANTABLE NEUROSTIMULATOR ELECTRODE, EACH
PATIENT PROGRAMMER FOR USE W/IMPLANTABLE NEUROSTIMULATOR
IMPLANTABLE STIMULATOR RADIOFREQUENCY RECEIVER
RADIOFREQUENCY TRANMITTER FOR USE W/IMPLANABLE NEUROSTIMULATOR
RADIOFREQUENCY TRANMITTER FOR USE W/IMPLANABLE SACRAL ROOT NEUROSTIMULATOR
IMPLANTABLE NEUROSTIMULATOR PULSE GENERATOR, SINGLE ARRAY, RECHARGABLE
IMPLANTABLE NEUROSTIMULATOR PULSE GNRATR, SINGLE ARRAY, NON-RECHARGABLE
IMPLANTABLE NEUROSTIMULATOR PULSE GNRATR, DUAL ARRAY, RECHARGABLE
IMPLANTABLE NEUROSTIMULATOR PULSE GNRATR, DUAL ARRAY, NON-RECHARGABLE
EXTERNAL RECHARGING SYSTEM FOR IMPLANTED NEUROSTIMULATOR, REPLACEMENT ONLY
AUDITORY OSSEOINTEGRATED DEVICE
AUDITORY OSSEOINTEGRATED DEVICE, EXTERNAL , REPLACEMENT
AUDITORY OSSEOINTEGRATED DEVICE, EXTERNAL SOUND PROCESSOR, W/O OSSEOINTEGRATION
PROSTHETIC IMPLANT, NOS
ORTHOTIC AND PROSTHETIC SUPPLY ACCESS AND OR SERVICE COMPONENT OF ANOTHER L CODE
PHYSICAL EXAM, NEW PATIENT, AGE 18 OR OLDER
PERIODIC ROUTINE/ANNUAL PHYS EX 18 OR OVER
NOT OTHERWISE CLASS, OFFICE VISITS
NOC, HOME VISITS
NOT OTHERWISE CLASSIFIED, HOME VISITS
HOSPITAL VISIT, TOTAL RESPIRATORY CARE
PER DIEM INPAT HOSP CARE WHEN ONE OR MORE VIS/24HR
ICU CARE FOLOW-UP WHN ONE OR MOR VISTS AR MAD P 24
ROUTINE NEWBOWN CARE, INHOSPITAL, INTITAL VIS ONLY
EMERGENCY FIRST AID (SURG)(TREAT OF MINOR INJUR)
NOT OTHERWISE CLASS, HOSPITAL VISITS
BRIEF EXAM, TWO OR MORE PAT SEEN IN SAME SNF PER P
NOT OTHERW CLASS, SNF, ECF, OR ICF VISITS
BRIEF EXAM 2 OR MORE PATIENTS,NURSING HOME
NOT OTHERWISE CLASS, NURSING HOME
NOT OTHERW CLASS, NH, BOARD HOME, DOMICILL, CUST C
NOT OTHERW CLASS, EMERG ROOM SERVICES
CLINICAL LAB CONSULTATION
BRIEF OV SOLELY FOR MONITORING/CHANGING MI DRUGS
INS SHOCK THRPY HYPOGLYC SUBCOMA PER TREATMENT
ORTHOMOLECULAR THERAPY
IMMUNOTX FOR MALIGNANCY
CELLULAR THERAPY
PROLOTHERAPY
IV CHELATION THERAPY (CHEMICAL ENDARTERECTOMY)
FABRIC WRAPPING OF ABDOMINAL ANEURYSM (MND)
NOT OTHERW CLASS, CARDIOVASCULAR SERVICES
MUCOPROTEIN, BLOOD (SEROMUCOID) (MED NECESS PROC)
HEPATITIS A VISUR ANTIBODY (HAVAB), RIA
CULTURE AND SENSITIVITY ANY SOURCE
CULTURE, BACTERIAL, URINE; QUANTITATIVE SENSIT STU
PLATELET CONCENTRATE, EACH UNIT
RED BLOOD CELLS, EACH UNIT
PLATELETS LEUKOCYTES REDUCED EACH UNIT
PLATELETS PHERESIS EACH UNIT
PLATELETS PHERESIS LEUKOCYTE REDUCED EACH UNIT
PLATELETS PHERESIS IRRADIATED EACH UNIT
PLATELETS PHERESIS LEUKOCYTE REDUCED IRRADIATED EACH UNIT
RED BLOOD CELLS IRRADIATED EACH UNIT
RED BLOOD CELLS DEGLYCEROLYZED EACH UNIT
RED BLOOD CELLS LEUKOCYTES REDUCED IRRADIATED EACH UNIT
INFUSION ALBUMIN (HUMAN) 5% - 50 ML
INFUSION ALBUMIN (HUMAN) 25% 10 ML
INFUSION PLASMA PROTEIN FRACTION (HUMAN) 5% 50 ML
PLASMA CRYOPRECIPTATE REDUCED EACH UNIT
INFUSION, ALBUMIN (HUMAN) 5%, 250ML
INFUSION, ALBUMIN (HUMAN) 25%, 20ML
INFUSION, ALBUMIN (HUMAN) 5%, 50ML
INFUSION, PLASMA PROTEIN FRACTION (HUMAN), 5%, 250ML
WHOLE BLOOD OR REC BLOOD CELLS, LEUKOCYTES REDUCED, CMV-NEGATIVE, EACH UNIT
PLATELETS, HLA-MATCHED LEUKOCYTES REDUCED, APHERESIS/PHERESIS, EACH UNIT
PLATELETS, PHERESIS LEUKOCYTES REDUCED, CMV-NEGATIVE, IRRADIATED, EACH UNIT
WHOLE BLOOD OR RED BLOOD CELLS, LEUKOCYTES REDUCED, FROZEN, DEGLYCEROL, WASHED
PLATELETS, LEUKOCYTES REDUCED, CMV-NEGATIVE, APHERESIS/PHERESIS, EACH UNIT
WHOLE BLOOD, LEUKOCYTES REDUCED, IRRADIATED, EACH UNIT
RED BLOOD CELLS, FROZEN/DEGLYCEROLIZED/WASHED, LEUKOCYTES REDUCED, EACH UNIT
RED BLOOD CELLS, LEUKOCYTES REDUCED, CMV-NEGATIVE, IRRADIATED EACJ UNIT
FRESH FROZEN PLASMA, HONOR RETESTED, EACH UNIT
FRESH FROZEN PLASMA, DONOR RETESTED, EACH UNIT
CATHETERIZATION FOR COLLECTION OF SPECIMEN SINGLE PATIENT ALL PLACES OF SERVICE
ADMINISTRACTION OF CHEMOTHERAPY BY ANY ROUTE OTHER THAN INFUSION, PER VISIT
BLOOD GLUCOSE MONITER - IDAHO MEDICARE CROSSOVER
WET MOUNTS
TISSUE EXAM FOR FUNGI (EG, KOH SLIDE)
PINWORM EXAM
FERN TEST
INJECTION, FERUMOXYTOL, FOR TX OF IRON DEFICIENCY ANEMIA, 1 MG
INJECTION, FERUMOXYTOL, FOR TX OF IRON DEFICIENCY ANEMIA, 1 MG ESRD USE
DIPHENHYDRAMINE HYDROCHLORID 50 MG ORAL 48 HOUR DOSAGE REGIMINE
PROCHLORPERAZINE MALEATE 5MG ORAL 48 HOUR DOSAGE REGIMEN
PROCHLORPERAZINE MALEATE 10 MG ORAL 48 HOUR DOSAGE REGIMEN
GRANISETRON HYDROCHLORIDE, KYTRIL 1 MG ORAL
DRONABINOL 2.5 MG ORAL 48 HOUR DOSAGE REGIMEN
DRONABINOL 5 MG ORAL 48 HOUR DOSAGE REGIMEN
PROMETHAZINE HYDROCHLORIDE 12.5 MG ORAL 48 HOUR DOSAGE REGIMEN
PROMETHAZINE HYDROCHLORIDE 25 MG ORAL 48 HOUR DOSE (PHENERGAN, AMERGAN)
CHLORPROMAZINE HYDROCHLORIDE 10 MG ORAL 48 HOUR DOSE (THORAZINE)
CHLORPROMAZINE HYDROCHLORIDE 25 MG ORAL 48 HOUR DOSAGE REGIMEN
TRIMETHOBENZAMIDE HYDROCHLORIDE 250MG 48 HOUR DOSAGE REGIMEN
THIETHYLPERAZINE MALEATE 10 MG ORAL 48 HOUR DOSAGE (TORECAN)
PERPHENAZINE 4MG ORAL 48 HOUR DOSAGE REGIMEN (TRILIFON)
PERPHENAZINE 8MG ORAL 48 HR DOSAGE REGIMINE (TRILIFON)
HYDROXYZINE PAMOATE 25 MG ORAL 48 HOUR DOSAGE REGIMEN
HYDROXYZINE PAMOATE 50MG ORAL 48 HR DOSAGE REGIMEN
ONDANSETRON HYDROCHLORIDE 8MG ORAL 48HR DOSAGE REGIMEN
DOLASETRON MESYLATE 100MG ORAL NOT TO EXCEED A 24 HOUR REGIMEN
DRIVER FOR USE WITH PNEUMATIC VENTRICULAR ASSIST DEVICE, REPLACEMENT ONLY
MICROPROCESSOR CNTRL UNIT W/ ELECTRIC VENTRICULAR ASSIST DEVICE, REPLACMNT ONLY
MICROPROSSR UNIT FOR ELECTRIC/PNEUMATIC COMBO VENT ASSIST DEVICE, REPLACMNT ONLY
MONITOR/DISPLAY FOR USE W/ELECTRIC VENTRICULAR ASSIST DEVICE, REPLACEMENT ONLY
MONITOR/DISPLAY USE W/ELECTRIC/PNEUMATIC VENTRICULAR ASSIST DEVICE, REPL ONLY
MONITOR CONTROL CABLE USE W/ELECTRIC VENTRICULAR ASSIST DEVICE, REPL ONLY
MONITOR CONTRL CABLE USE W/ELEC/PNEUMATIC VENTRICULAR ASSIST DEVICE, REPL ONLY
LEADS FOR USE W/ ANY TYPE ELEC/PNEUMATIC VENTRICULAR ASSIST DEVICE, REPL ONLY
POWER PACK BASE FOR USE W/ELECTRIC VENTRICULAR ASSIST DEVICE, REPLACEMENT ONLY
POWER PACK BASE FOR ELECTRIC/PNEUMATIC VENTRICULAR ASSIST DEVICE, REPL ONLY
EMERGENCY POWER SOURCE FOR ELECTRIC VENTRICULAR ASSIST DEVICE, REPL ONLY
EMERG PWR SOURCE FOR ELECTRIC/PNEUMATIC VENTRICULAR ASSIST DEVICE, REPL ONLY
EMERG PWR SUPLLY CABLE FOR ELECTRIC VENTRICULAR ASSIST DEVICE, REPL ONLY
EMERG PWR SUP CABLE FOR ELECTRIC/PNEUMATIC VENTRICULAR ASSIST DEVICE, REPL ONLY
EMERG HAND PUMP FOR ELEC/PNEUMATIC VENTRICULAR ASSIST DEVICE, REPL ONLY
BATTERY PWR CHARGE PACK FOR ELEC/PNEUMATIC VENTRICULAR ASSIST DEVICE, REPL ONLY
BATTERY FOR USE W/ ELEC/PNEUMATIC VENTRICULAR ASSIST DEVICE, REPL ONLY
BATTERY CLIPS FOR USE W/ ELEC/PNEUMATIC VENTRICULAR ASSIST DEVICE, REPL ONLY
HOLSTER FOR USE W/ ELEC/PNEUMATIC VENTRICULAR ASSIST DEVICE, REPL ONLY
BELT/VEST FOR USE W/ ELEC/PNEUMATIC VENTRICULAR ASSIST DEVICE, REPL ONLY
FILTERS FOR USE W/ ELEC/PNEUMATIC VENTRICULAR ASSIST DEVICE, REPL ONLY
SHOWER COVER FOR USE WITH ELECTRIC/PNEUMATIC ASSIST DEVICE
MOBILITY CART FOR PNEUMATIC VENTRICULAR ASSIST DEVICE
BATTERY FOR PNEUMATIC VENTRICULAR DEVICE, EACH
POWER ADAPTER FOR PNEUMATIC ASSIST DEVICE
MISCELLANEOUS SUPPLY OR ACCESSORY FOR USE WITH VENTRICULAR ASSIS DEV
BATTERY, LITHIUM-ION, FOR USE W/ELECTRIC OR ELECTRIC/PNEUMATIC VAD, REPL ONLY
INJECTION, SERMORELIN ACETATE, 1 MICROGRAM
INJECTION, FOSPENYTOIN, 50 MG
INJECTION, TENIPOSIDE, 50 MG
RADIOELEMENTS FOR BRACHTHERAPY, ANY TYPE, EACH
TELEHEALTH ORIGINATING SITE FACILITY FEE
INJECTION, INTERFERON BETA-1A, 11 MCG FOR INTRAMUSCULAR USE
INJ., INTERFERON BETA-1A, 11 MCG FOR SUBCUTANEOUS USE
COLLAGEN SKIN TEST
CASTING SUPPLIES BODY CAST ADULT WITH OR WITHOUT HEAD PLASTER
CAST SUPPLIES BODY CAST ADULT WITH OR WITHOUT HEAD FIBERGLASS
CAST SUPPLIES SHOULDER CAST ADULT PLASTER
CAST SUPPLIES SHOULDER CAST ADULT FIBERGLASS
CAST SUPPLIES LONG ARM CAST ADULT
CAST SUPPLIES LONG ARM CAST ADULT FIBERGLASS
CAST SUPPLIES LONG ARM CAST PEDIATRIC
CAST SUPPLIES LONG ARM CAST PEDIATRIC
CAST SUPPLIES SHORT ARM CAST ADULT PLASTER
CAST SUPPLIES SHORT ARM CAST ADULT FIBERGLASS
CAST SUPPLIES SHORT ARM CAST PEDIATRIC PLASTER
CAST SUPPLIES SHORT ARM CAST PEDIATRIC FIBERGLASS
CAST SUPPLIES GAUNTLET CAST ADULT
CAST SUPPLIES GAUNTLET CAST ADULT FIBERGLASS
CAST SUPPLIES GAUNTLET CAST PEDIATRIC PLASTER
CAST SUPPLIES GAUNTLET CAST PEDIATRIC FIBERGLASS
CAST SUPPLIES LONG ARM SPLINT ADULT PLASTER
CAST SUPPLIES LONG ARM SPLINT ADULT FIBERGLASS
CAST SUPPLIES LONG ARM SPLINT PEDIATRIC PLASTER
CAST SUPPLIES LONG ARM SPLINT PEDIATRIC FIBERGLASS
CAST SUPPLIES SHORT ARM SPLINT ADULT PLASTER
CAST SUPPLIES SHORT ARM SPLINT ADULT FIBERGLASS
CAST SUPPLIES SHORT ARM SPLINT PEDIATRIC PLASTER
CAST SUPPLIES SHORT ARM SPLINT PEDIATRIC FIBERGLASS
CAST SUPPLIES HIP SPICA ADULT PLASTER
CAST SUPPLIES HIP SPICA ADULT FIBERGLASS
CAST SUPPLIES HIP SPICA PEDIATRIC PLASTER
CAST SUPPLIES HIP SPICA PEDIATRIC FIBERGLASS
CAST SUPPLIES LONG LEG CAST ADULT PLASTER
CAST SUPPLIES LONG LEG CAST ADULT FIBERGLASS
CAST SUPPLY LONG LEG CAST PEDIATRIC PLASTER
CAST SUPPLIES LONG LEG CAST PEDIATRIC FIBERGLASS
CAST SUPPLIES LONG LEG CYLINDER CAST ADULT PLASTER
CAST SUPPLIES LONG LEG CYLINDER CAST ADULT FIBERGLASS
CAST SUPPLIES LONG LEG CYLINDER CAST PEDIATRIC PLASTER
CAST SUPPLIES LONG LEG CYLINDER CAST PEDIATRIC FIBERGLASS
CAST SUPPLIES SHORT LEG CAST ADULT PLASTER
CAST SUPPLIES SHORT LEG CAST ADULT FIBERGLASS
CAST SUPPLIES SHORT LEG CAST PEDIATRIC PLASTER
CAST SUPPLIES SHORT LEG CAST PEDIATRIC FIBERGLASS
CAST SUPPLIES LONG LEG SPLINT ADULT PLASTER
CAST SUPPLIES LONG LEG SPLINT ADULT FIBERGLASS
CAST SUPPLIES LONG LEG SPLINT PEDIATRIC PLASTER
CAST SUPPLIES LONG LEG SPLINT PEDIATRIC FIBERGLASS
CAST SUPPLIES SHORT LEG SPLINT ADULT PLASTER
CAST SUPPLIES SHORT LEG SPLINT ADULT FIBERGLASS
CAST SUPPLIES SHORT LEG SPLINT PEDIATRIC PLASTER
CAST SUPPLIES SHORT LEG SPLINT PEDIATRIC FIBERGLASS
FINGER SPLINT STATIC
CAST SUPPLIES FOR UNLISTED TYPES AND MATERIALS OF CASTS
SPLINT SUPPLIES MISC.
ILOPROST, INHALATION SOL, FDA-APPR FINAL PROD,UNIT DOSE, UP TO 20 MCG
INJECTION, EPOETIN ALFA, 100 UNITS
SKIN SUBSTITUTE, NOT OTHERWISE SPECIFIED
SKIN SUBSTITUTE, APLIGRAF, PER SQUARE CENTIMETER
SKIN SUBSTITUTE, OASIS WOUND MATRIX, PER SQUARE CENTIMETER
SKIN SUBSTITUTE, OASIS BURN MATRIX, PER SQUARE CENTIMETER
SKIN SUBSTITUTE, INTEGRA BILAYER MATRIX WOUND DRESSING (BMWD), PER SQ.CM
SKIN SUBSTITUTE, INTEGRA DERMAL REGENERATION TEMPLATE (DRT), PER SQ.CM
SKIN SUBSTITUTE, DERMAGRAFT, PER SQUARE CENTIMETER
SKIN SUBSTITUTE, GRAFTJACKET, PER SQUARE CENTIMETER
SKIN SUBSTITUTE, INTEGRA MATRIX, PER SQUARE CENTIMETER
SKIN SUBSTITUTE, TISSUEMEND, PER SQUARE CENTIMETER
SKIN SUBSTITUTE, PRIMATRIX, PER SQUARE CENTIMETER
SKIN SUBSTITUTE, GAMMAGRAFT, PER SQUARE CENTIMETER
ALLOGRAFT, CYMETRA, INJECTABLE, 1CC
ALLOGRAFT, GRAFTJACKET EXPRESS, INJECTABLE, 1CC
INTEGRA FLOWABLE WOUND MATRIX, INJECTABLE, 1CC
SKIN SUBSTITUTE, ALLOSKIN, PER SQUARE CENTIMETER
SKIN SUBSTITUTE, ALLODERM, PER SQUARE CENTIMETER
LOW OSMOLAR CONTRAST MATERIAL 400 OR GREATER MG/ML
INJECTION, IRON BASED MAGNETIC RESONANCE CONTRAST AGENT PER ML
ORAL MAGNETIC RESONANCE CONTRAST AGENT PER 100 ML
INJECTION PERFLEXANE LIPID MICROSPHERES, PER ML
INJECTION OCTAFLUOROPROPANE MICROSPHERES, MER ML
INJECTION PERFLUTREN LIPID MICROSPHERES, PER ML
HIGH OSMOLAR CONTRAST MATERIAL, UP TO 149 MG/ML
HIGH OSMOLAR CONTRAST MATERIAL, UP TO 150-199 IODINE CONCENTRATE PER ML
HIGH OSMOLAR CONTRAST MATERIAL, 200-249 IODINE CONCENTRATE PER ML
HIGH OSMOLAR CONTRAST MATERIAL, 250-299 IODINE CONCENTRATE PER ML
HIGH OSMOLAR CONTRAST MATERIAL, 300-349 IODINE CONCENTRATE PER ML
HIGH OSMOLAR CONTRAST MATERIAL, 350-399 IODINE CONCENTRATE PER ML
HIGH OSMOLAR CONTRAST MATERIAL, 3400 OR GREATER IODINE CONCENTRATE PER ML
LOW OSMOLAR CONTRAST MATERIAL, 100-199 MG/ML IODINE CONCENTRATION PER ML
LOW OSMOLAR CONTRAST MATERIAL 200-299 MG/ML IODINE CCONCENTRATION PER ML
LOW OSMOLAR CONTRAST MATERIAL, 300-399 MG/ML IODINE CCONCENTRATION PER ML
INJECTION, NON-RADIOACTIVE, NON-CONTRAST, VISUALIZATION ADJUNCT, 1 MG
TRANSPORT/PORTABLE X-RAY EQUIP & PERSONNEL TO HOME/NURSING HM, PER TRP 1 PT SEEN
TRANSPT/PORTABLE X-RAY EQUIP/PERSONNEL/HOME/NUR HM, PER TRP MORE THAN 1 PATIENT
ETONOGESTREL (CONTRACEPTIVE) IMPLANT SYSTEM, INCLUDING IMPLANTS AND SUPPLIES
ONDANSETRON HCL, ORAL 4 MG CIRCUMS FAILING UNDER MEDICARE ST. USE Q0179, ZOFRAN
NON-EMERGENCY TRANSPORTATION; MILEAGE, PER MILE
CRANIAL REMOLDING ORTHOSIS, RIGID W/SOFT MATERIAL, CUSTOM, INCL FITTING & ADJ
NEWBORN METABOLIC SCREENING, INCLUDES TEST KIT, POSTAGE & LAB TESTS SPECIFIED
GENE EXPRESSION PROFILING PANEL FOR USE IN THE MNGMNT OF BREAST CANCER
CONTRACEPTIVE PILLS FOR BIRTH CONTROL
PRESCRIPTION DRUG, GENERIC
PRESCRIPTION DRUG, BRAND NAME
HOME CARE TRAINING, NON-FAMILY; PER 15 MINUTES
CHORE SERVICES, PER 15 MINUTES
CHORE SERVICES; PER DIEM
ATTENDANT CARE SERVICES; PER 15 MINUTES
HOMEMAKER SERVICE, NOS; PER 15 MIN
COMPANION CARE ADULT (E.G. IADHL/ADL); PER 15 MINUTES
FOSTER CARE, ADULT; PER DIEM
FOSTER CARE, THERAPEUTIC, CHILD; PER DIEM
EMERGENCY RESPONSE SYSTEM: INSTALLATION AND TESTING
EMERGENCY RESPONSE SYSTEM; SERVICE FEE/MONTH (EXCLUDES INSTALLATION & TESTING)
HOME MODIFICATIONS; PER SERVICE
HOME DELIVERED MEALS; INCLUDES PREPARATION PER MEAL
HOLDING CHAMBER OR SPACER FOR USE WITH AN INHALER OR NEBULIZER WITHOUT MASK
HOLDING CHAMBER OR SPACER FOR USE WITH AN INHALER OR NEBULIZER WITH MASK
HABERMAN FEEDER FOR CLEFT LIP/PALATE
NURSING CARE IN THE HOME; BY REGISTERED NURSE, PER HOUR (USE FOR GENERAL NURSING
RESPITE CARE, IN THE HOME, PER DIEM
SOCIAL WORK VISIT, IN THE HOME, PER DIEM
NUTRITIONAL COUNSELING; DIETITIAN VISIT
NURSING ASSESSMENT/EVALUATION
RN SERVICES, UP TO 15 MINUTES
LPN/LVN SERVICES, UP TO 15 MINUTES
SERVICES OF A QUALIFIED NURSING AIDE, UP TO 15 MINUTES
RESPITE CARE SERVICES, UP TO 15 MINUTES
SIGN LANGUAGE INTERPRETATION SERVICES, PER 15 MIN
ORAL LANGUAGE INTERPRETATION SERVICES, PER 15 MIN
TELEHEALTH TRANSMISSION, PER MINUTE, PROF SERVICES BILL SEPARATELY
CASE MANAGEMENT MENTAL HEALTH-ONGOING (PER 15 MINUTES)
PERSONAL CARE, PER 15 MIN NOT INPT OR HOSPITL, NH, ICF/MR PART OF INDIV TRTMT
SCREEN FOR INDIV PARTIC IN SPECIFIC PRGM, PROJECT OR TRTMENT PROTOCOL, PER ENCOU
ASSESSMENT OF HOME,PHYSICAL/FAM ENVIRON TO DETERMINE SUITABILITY TO MEET NEEDS
NON-EMERGENCY TRANSAPORTATION; PATIENT ATTENDANT/ESCORT
NON-EMERGENCY TRANSPORTATION; ENCOUNTER/TRIP
NON-EMERGENCY TRANSPORT; COMMERCIAL CARRIER, MULTI-PASS
DAY HABILITATION, WAIVER, PER 15 MINUTES
SERVICE ASSESSMENT/PLAN OF CARE DEVELOPMENT WAIVER (PER SERVICE)
FINANCIAL MANAGEMENT, SELF DIRECTED, WAIVER; PER 15 MIN
ADULT SIZED DISPOSABLE INCONTINENCE PRODUCT, BRIEF/DIAPER, SMALL, EACH
ADULT SIZED DISPOSABLE INCONTINENCE PRODUCT, BRIEF/DIAPER, MEDIUM, EACH
ADULT SIZED DISPOSABLE INCONTINENCE PRODUCT, BRIEF/DIAPER, LARGE, EACH
ADULT SIZED DISPOSABLE INCONTINENCE PRODUCT, BRIEF/DIAPER, EXTRA LARGE, EACH
ADULT SIZED DISPOSABLE INCONTINENCE PRODUCT, PROTECTIVE UNDERWEAR, SM SIZE, EACH
ADULT SIZED DISPOSABLE INCONTINENCE PRODUCT, PROTECTIVE UNDERWEAR. MED SIZE, EA
ADULT SIZED DISPOSABLE INCONTINENCE PRODUCT, PROTECTIVE UNDERWEAR, LG SIZE, EACH
ADULT SIZED DISPOSABLE INCONTINENCE PRODUCT, PROTECTIVE UNDERWEAR, EX LG, EA
ADULT SIZED DISPOSABLE INCONTINENCE PRODUCT, BRIEF/DIAPER, SM/MED SIZE, EACH
PEDIATRIC SIZED DISPOSABLE INCONTINENCE PRODUCT, BRIEF/DIAPER, LG SIZE, EACH
PEDIATRIC SIZED DISPOSABLE INCONTINENCE PRODUCT, PROTEC UNDERWEAR, SM/MED, EA
PEDIATRIC SIZED DISPOSABLE INCONTINENCE PRODUCT, PROTECTIVE UNDERWEAR, LG, EACH
YOUTH SIZED DISPOSABLE INCONTINENCE PRODUCT, BRIEF/DIAPER, EACH
YOUTH SIZED DISPOSABLE INCONTINENCE PRODUCT, PROTECTIVE UNDERWEAR/PULL ON, EA
DISPOSABLE LINER/SHIELD FOR INCONTINENCE, EACH
INCONTINENCE PRODUCT, PROTECTIVE UNDERWEAR/PULL ON, REUSABLE, ANY SIZE, EACH
INCONTINENCE PRODUCT, PROTECTIVE UNDERPAD, REUSABLE, BED SIZE, EACH
INCONTINENCE PRODUCT, DIAPER/BRIEF, REUSABLE, ANY SIZE, EACH
INCONTINENCE PRODUCT, PROTECTIVE UNDERPAD, REUSABLE, CHAIR SIZE, EACH
INCONTINENCE PRODUCT, DISPOSABLE UNDERPAD, LARGE, EACH
INCONTINENCE PRODUCT, DISPOSABLE UNDERPAD, SMALL SIZE, EACH
DISPOSABLE INCONTINENCE PRODUCT, BRIEF/DIAPER, BARIATRIC, EACH
POSITIONING SEAT FOR PERSONS WITH SPECIAL ORTHOPEDIC NEEDS
FRAMES, PURCHASE
DELUXE FRAME, SPECIAL NEEDS FRAME
SPHERE, SINGLE VISION, PLANO TO PLUS OR MINUS 4.00 PER LENS
SPHERE, SINGLE VISION, + OR - 4.12 TO + OR - 7.00D PER LENS
SPHERE, SINGLE VISION, + OR - 7.12 TO + OR - 20.00D PER LENS
SPHEROCYL, SINGLE VISION, PLANO TO + OR - 4.00D SPHERE 0.12-2.00 CYL, PER LENS
SPHEROCYL, SINGLE VISION, PLANO TO + OR - 4.00D SPHERE, 2.12-4.00D CYL, PER LENS
SPHEROCYL, SINGLE VISION, PLANO TO + OR - 4.00D SPHERE, 4.25-6.00D CYL, PER LENS
SPHEROCYLIN, SINGLE VISION, PLANO TO + OR - 4.00D SPHERE, ^ 6.00D CYL, PER LENS
SPHEROCYL, SINGLE VISION, + OR - 4.25 TO + OR - 7.00 SPHERE, 0.12-2.00D CYL,
SPHEROCYL, SINGLE VISION, + OR - 4.25D TO + OR - 7.00D SPHERE, 2.12-4.00D
SPHEROCYL, SINGLE VISION, + OR - 4.25 TO + OR 7.00D SPHERE, 4.25-6.00D CYL
SPHEROCYL, SINGLE VISION, + OR - 4.25-7.00D SPHERE, ^ 6.00D CYL, PER LENS
SPHEROCYL, SINGLE VISION, + OR - 7.25 TO + OR - 12.00D SPHERE, 0.25-2.25D CYL
SPEROCYL, SINGLE VISION + OR - 7.25 TO + OR - 12.00D SPHERE, 2.25-4.00D CYL
SPHEROCYL SINGLE VISION, + OR 7.25 TO + OR - 12.00D SPHERE, 4.25-6.00D CYL
SPHEROCYL, SINGLE VISION, SPHERE ^+ OR - 12.00D, PER LENS
LENTICULAR (MYODISC), PER LENS, SINGLE VISION
ANISEIKONIC LENS, SINGLE VISION
LENTICULAR LENS, PER LENS, SINGLE
NOT OTHERWISE CLASSIFIED, SINGLE VISION LENS
SPHERE, BIFOC, PLANO TO PLUS OR MIN 4.00D PER LENS
SPHERE, BIFOCAL, + OR - 4.12 TO + OR - 7.00D PER LENS
SPHERE, BIFOCAL, + OR - 7.12 TO + OR - 20.00D PER LENS
SPHEROCYL, BIFOCAL, PLANO TO + OR - 4.00D SPHERE, 0.12 TO 2.00D CYL
SPHEROCYL, BIFOCAL, PLANO TO + OR - 4.00D SPHERE, 2.12 TO 4.00D CYL
SPHEROCYL, BIFOCAL, PLANO TO + OR - 4.00D SPHERE, 4.25 TO 6.00D CYL
SPHEROCYL, BIFOCAL, PLANO TO + OR - 4.00D SPHERE, ^ 6.00D CYL
SPHEROCYL, BIFOCAL, + OR - 4.25 TO + OR - 7.00D SPHERE, 0.12 TO 2.00D CYL
SPHEROCYL, BIFOCAL, + OR - 4.25 TO + OR - 7.00D SPHERE, 2.12 TO 4.00D CYL
SPHEROCYL, BIFOCAL,+ OR - 4.25 TO + OR - 7.00D SPHERE, 4.25 TO 6.00D CYL
SPHEROCYL, BIFOCAL,+ OR - 4.25 TO + OR -I 7.00D SPHERE, ^ 6.00D CYL
SPHEROCYL, BIFOCAL, + OR -I 7.25 TO + OR - 12.00D SPHERE, 0.25 TO 2.25D CYL
SPHEROCYL BIFOCAL+ OR - 7.25 TO + OR - 12.00 D SPHERE, 2.25 TO 4.00D CYL
SPHEROCYL, BIFOCAL,+ OR - 7.25 TO + OR - 12.00D SPHERE, 4.25 TO 6.00D CYL
SPHEROCYL, BIFOCAL, SPHERE OVER + OR - 12.00D PER LENS
LENTICULAR (MYODISC), PER LENS, BIFOCAL
ANISEIKONIC, PER LENS, BIFOCAL
BIFOCAL, SEG WIDTH OVER 28MM
BIFOCAL ADD OVER 3.25D
LENTICULAR LENS, PER LENS, BIFOCAL
SPECIALTY BIFOCAL (BY REPORT)
VARIABLE ASPHERICITY LENS, SINGLE VISION, FULL FIELD, GLASS OR PLASTIC, PER LENS
VARIABLE ASPHERICITY LENS, BIFOCAL, FULL FIELD, GLASS OR PLASTIC, PER LENS
VARIABLE SPHERICITY LENS, OTHER TYPE
CONTACT LENS, PMMA, SPHERICAL, PER LENS
CONTACT LENS, PMMA, TORIC OR PRISM BALLAST, PER LENS
CONTACT LENS, PMMA, BIFOCAL, PER LENS
CONTACT LENS, PMMA, COLOR VISION DEFICIENCY, PER LENS
CONTACT LENS, GAS PERMEABLE, SPHERICAL, PER LENS
CONTACT LENS, GAS PERMEABLE, TORIC, PRISM BALLAST, PER LENS
CONTACT LENS, GAS PERMEABLE, BIFOCAL, PER LENS
CONTACT LENS, GAS PERMEABLE, EXTENDED WEAR, PER LENS
CONTACT LENS, HYDROPHILIC, SPHERICAL, PER LENS
CONTACT LENS, HYDROPHILIC, TORIC, OR PRISM BALLAST, PER LENS
CONTACT LENS, HYDROPHILIC, BIFOCAL, PER LENS
CONTACT LENS, HYDROPHILIC, EXTENDED WEAR, PER LENS
CONTACT LENS, SCLERAL, GAS IMPERMEABLE, PER LENS
CONTACT LENS, SCLERAL, GAS PERMEABLE, PER LENS
NOT OTHERWISE CLASSIFIED, CONTACT LENS
SINGLE LENS SPECTACLE MOUNTED LOW VISION AIDS
TELESCOPIC AND OTHER COMPOUND LENS SYSTEM, INCL DIST-NEAR-MICROSCOPIC
PROSTHETIC EYE, PLASTIC, CUSTOM
POLISHING/RESURFACING OF OCULAR PROTHESIS
ENGLARGEMENT OF OCULAR PROTHESIS
REDUCTION OF OCULAR PROSTHESIS
SCLERAL COVER SHELL
FABRICATION & FITTING OF OCULAR CONFORMER
NOT OTHERWISE CLASSIFIED, PROSTHETIC EYE
ANTERIOR CHAMBER INTRAOCULAR LENS
IRIS SUPPORTED INTRAOCULAR LENS
POSTERIOR CHAMBER INTRA0CULAR LENS
BALANCE LENS, PER LENS
DELUXE LENS FEATURE
SLAB OFF PRISM, GLASS OR PLASTIC, PER LENS
PRISM, PER LENS
PRESS-ON LENS, FRESNEL PRISM, PER LENS
SPECIAL BASE CURVE, GLASS OR PLASTIC, PER LENS
TINT, PHOTOCHROMATIC, PER LENS
ADDITION TO LENS; TINT, COLOR, SOLID, GRADIENT OR EQUAL, PER LENS
SCRATCH RESISTANT COATING, PER LENS
OCCLUDER LENS, PER LENS
OVERSIZE LENS, PER LENS
PROGRESSIVE LENS, PER LENS
LENS INDEX 1.54 TO 1.65 PLASTIC OR 1.60 TO 1.79 GLASS, EXCL POLYCARBONATE, EA
Lens, index greater than or = to 1.66 plastic, greater than or = to 1.80 glass
LENS, POLYCARBONATE OR EQUAL, ANY INDEX, PER LENS
CORNEAL TISSUE; PROCESSING, PRESERVING & TRANSPORT
AMNIOTIC MEMBRANE FOR SURGICAL RECONSTRUCTION, PER PROCEDURE
VISION SUPPLY, ACCESSORY AND/OR SERVICE COMPONENT
VISION SERVICE, MISCELLANEOUS
HEARING SCREENING
ASSESSMENT FOR HEARING AID
REPAIR/MODIFICATION OF HEARING AID
HEARING AID, MONAURAL, BODY WORN, AIR CONDUCTION
HEARING AID, MONAURAL, BODY WORN, BONE CONDUC
HEARING AID, MONAURAL, IN THE EAR
HEARING AID, MONAURAL, BEHIND THE EAR
HEARING AID, BILAT, BODY WORN
BINAURAL, BODY
BINAURAL, IN THE EAR
BINAURAL, BEHIND THE EAR
HEARING AID, CROS, IN THE EAR
HEARING AID, CROS, BEHIND THE EAR
HEARING AID, BICROS, IN THE EAR
HEARING AID, BICROS, BEHIND THE EAR
HEARING AID, DIGITAL MONAURAL, CIC
HEARING AID, DIGITAL MONAURAL, ITC
HEARING AID, DIGITAL MONAURAL, ITE
HEARING AID, DIGITAL MONAURAL, BTE
HEARING AID, DIGITAL BINAURAL,CIC
HEARING AID, DIGITAL BINAURAL, ITC
HEARING AID, DIGITAL BINAURAL, ITE
HEARING AID, DIGITAL BINAURAL, BTE
EAR MOLD/INSERT, NOT DISPOSABLE; ANY TYPE
EAR MOLD/INSERT, DISPOSABLE, ANY TYPE
BATTERY FOR USE IN HEARING DEVICE (PER BATTERY)
HEARING AID; NOT OTHERWISE CLASSIFIED
HEARING SERVICE, MISCELLANEOUS
                     Allowed Amount
                     ($0.00 indicates a                                 Technical   Professional
                     Manual Priced                                      Component   Component
Price Eff Date       Code)                 PA Ind   HC Rev              Amount      Amount
          1/1/2008                $46.13   N
                                   $0.00   N
         7/1/2008               $116.96    N        Referral Required
         7/1/2008               $122.59    N        Referral Required
         7/1/2008                 $79.98   N        Referral Required
         7/1/2008                 $87.65   N        Referral Required
         7/1/2008               $151.14    N        Referral Required
         7/1/2008               $138.51    N        Referral Required
         7/1/2008               $213.72    N        Referral Required
         7/1/2008               $112.15    N        Referral Required
         7/1/2008               $214.42    N        Referral Required
         7/1/2008               $122.81    N        Referral Required
         7/1/2008               $100.81    N        Referral Required
         7/1/2008               $186.94    N        Referral Required
         7/1/2008                 $43.21   N        Referral Required
         7/1/2008                 $18.34   N        Referral Required
         7/1/2008               $493.41    N        Referral Required
         7/1/2008               $651.70    N        Referral Required
         7/1/2008               $610.70    N        Referral Required
         7/1/2008               $234.58    N        Referral Required
         7/1/2008               $381.32    N        Referral Required
         7/1/2008               $433.34    N        Referral Required
         7/1/2008               $604.84    N        Referral Required
         7/1/2008                 $37.92   N        Referral Required
         7/1/2008                 $45.11   N        Referral Required
         7/1/2008                 $61.17   N        Referral Required
         7/1/2008               $222.94    N        Referral Required
         7/1/2008               $301.21    N        Referral Required
         7/1/2008                 $38.11   N        Referral Required
         7/1/2008                 $47.26   N        Referral Required
         7/1/2008                 $57.26   N        Referral Required
         7/1/2008                 $79.66   N        Referral Required
         7/1/2008                 $26.44   N        Referral Required
         7/1/2008                 $65.12   N        Referral Required
         7/1/2008                 $15.62   N        Referral Required
         7/1/2008                 $54.08   N        Referral Required
         7/1/2008                 $73.03   N        Referral Required
         7/1/2008                 $87.04   N        Referral Required
         7/1/2008               $103.24    N        Referral Required
         7/1/2008                 $55.83   N        Referral Required
7/1/2008    $76.51   N   Referral Required
7/1/2008    $89.13   N   Referral Required
7/1/2008   $102.42   N   Referral Required
7/1/2008    $66.84   N   Referral Required
7/1/2008    $83.70   N   Referral Required
7/1/2008    $97.23   N   Referral Required
7/1/2008   $123.10   N   Referral Required
7/1/2008    $95.20   N   Referral Required
7/1/2008   $114.53   N   Referral Required
7/1/2008   $127.16   N   Referral Required
7/1/2008   $146.54   N   Referral Required
7/1/2008   $166.45   N   Referral Required
7/1/2008   $232.74   N   Referral Required
7/1/2008    $95.29   N   Referral Required
7/1/2008   $122.25   N   Referral Required
7/1/2008   $136.68   N   Referral Required
7/1/2008   $159.73   N   Referral Required
7/1/2008   $183.45   N   Referral Required
7/1/2008   $262.08   N   Referral Required
7/1/2008   $105.87   N   Referral Required
7/1/2008   $131.49   N   Referral Required
7/1/2008   $147.73   N   Referral Required
7/1/2008   $178.26   N   Referral Required
7/1/2008   $225.03   N   Referral Required
7/1/2008   $303.18   N   Referral Required
7/1/2008   $281.47   N   Referral Required
7/1/2008   $372.50   N   Referral Required
7/1/2008   $278.14   N   Referral Required
7/1/2008   $379.03   N   Referral Required
7/1/2008   $306.09   N   Referral Required
7/1/2008   $393.07   N   Referral Required
7/1/2008   $144.60   N   Referral Required
7/1/2008   $172.51   N   Referral Required
7/1/2008   $187.99   N   Referral Required
7/1/2008   $214.76   N   Referral Required
7/1/2008   $237.33   N   Referral Required
7/1/2008   $333.16   N   Referral Required
7/1/2008   $145.79   N   Referral Required
7/1/2008   $173.89   N   Referral Required
7/1/2008   $196.33   N   Referral Required
7/1/2008   $230.71   N   Referral Required
7/1/2008   $261.19   N   Referral Required
7/1/2008   $321.83   N   Referral Required
7/1/2008   $151.98   N   Referral Required
7/1/2008   $185.37   N   Referral Required
7/1/2008   $213.81   N   Referral Required
7/1/2008   $252.86   N   Referral Required
7/1/2008    $313.83    N   Referral Required
7/1/2008    $414.47    N   Referral Required
7/1/2008      $16.44   N   Referral Required
7/1/2008      $24.77   N   Referral Required
7/1/2008      $35.96   N   Referral Required
7/1/2008      $78.98   N   Referral Required
7/1/2008      $36.73   N   Referral Required
7/1/2008      $35.68   N   Referral Required
7/1/2008    $169.97    N   Referral Required
7/1/2008    $240.99    N   Referral Required
7/1/2008    $106.52    N   Referral Required
7/1/2008   $1,961.73   N   Referral Required
7/1/2008    $158.13    N   Referral Required
7/1/2008    $214.13    N   Referral Required
7/1/2008      $99.92   N   Referral Required
7/1/2008    $210.42    N   Referral Required
7/1/2008    $419.67    N   Referral Required
7/1/2008    $518.80    N   Referral Required
7/1/2008      $43.92   N   Referral Required
7/1/2008      $54.92   N   Referral Required
1/1/2009    $148.46    Y   Referral Required
1/1/2009    $169.59    Y   Referral Required
7/1/2008    $744.38    N   Referral Required
7/1/2008    $488.75    Y   Referral Required
7/1/2008    $389.47    N   Referral Required
7/1/2008      $64.94   N
7/1/2008    $121.18    N
7/1/2008      $91.94   N
7/1/2008      $88.02   N   Referral Required
7/1/2008    $111.85    N   Referral Required
7/1/2008    $129.10    N   Referral Required
7/1/2008    $197.29    N   Referral Required
7/1/2008    $122.43    N   Referral Required
7/1/2008    $130.52    N   Referral Required
7/1/2008    $153.19    N   Referral Required
7/1/2008    $190.97    N   Referral Required
7/1/2008    $237.83    N   Referral Required
7/1/2008    $266.98    N   Referral Required
7/1/2008    $130.24    N   Referral Required
7/1/2008    $143.24    N   Referral Required
7/1/2008    $168.48    N   Referral Required
7/1/2008    $212.07    N   Referral Required
7/1/2008    $251.31    N   Referral Required
7/1/2008    $224.45    N   Referral Required
7/1/2008    $267.78    N   Referral Required
7/1/2008    $219.52    N   Referral Required
7/1/2008    $128.42    N   Referral Required
7/1/2008   $179.08   N   Referral Required
7/1/2008   $237.60   N   Referral Required
7/1/2008   $233.53   N   Referral Required
7/1/2008   $297.99   N   Referral Required
7/1/2008   $329.66   N   Referral Required
7/1/2008   $371.01   N   Referral Required
7/1/2008   $190.70   N   Referral Required
7/1/2008   $225.24   N   Referral Required
7/1/2008   $254.82   N   Referral Required
7/1/2008   $301.89   N   Referral Required
7/1/2008   $355.96   N   Referral Required
7/1/2008   $381.40   N   Referral Required
7/1/2008   $210.33   N   Referral Required
7/1/2008   $232.10   N   Referral Required
7/1/2008   $254.01   N   Referral Required
7/1/2008   $272.40   N   Referral Required
7/1/2008   $332.65   N   Referral Required
7/1/2008   $409.40   N   Referral Required
7/1/2008   $442.88   N   Referral Required
7/1/2008   $251.92   N   Referral Required
7/1/2008   $313.56   N   Referral Required
7/1/2008    $86.03   N   Referral Required
7/1/2008   $261.63   N   Referral Required
7/1/2008   $343.86   N   Referral Required
7/1/2008    $99.27   N   Referral Required
7/1/2008   $289.02   N   Referral Required
7/1/2008   $453.78   N   Referral Required
7/1/2008   $135.99   N   Referral Required
7/1/2008   $294.60   N   Referral Required
7/1/2008   $327.74   N   Referral Required
7/1/2008   $446.69   N   Referral Required
7/1/2008   $150.95   N   Referral Required
7/1/2008   $663.13   N   Referral Required
7/1/2008   $520.40   N   Referral Required
7/1/2008   $678.43   N   Referral Required
7/1/2008   $580.23   N   Referral Required
7/1/2008   $765.26   N   Referral Required
7/1/2008   $611.75   N   Referral Required
7/1/2008   $842.33   N   Referral Required
7/1/2008   $625.55   N   Referral Required
1/1/2011   $903.94   N   Referral Required
1/1/2010   $730.47   N   Referral Required
1/1/2010   $161.51   N   Referral Required
7/1/2008   $622.70   N   Referral Required
7/1/2008   $272.39   N   Referral Required
7/1/2008    $58.78   N   Referral Required
7/1/2008   $328.11   N   Referral Required
7/1/2008    $99.26   N   Referral Required
7/1/2008   $213.40   N   Referral Required
7/1/2008   $433.56   N   Referral Required
7/1/2008   $724.17   N   Referral Required
1/1/2011   $162.82   N   Referral Required
7/1/2008   $713.79   N   Referral Required
7/1/2008   $103.07   N   Referral Required
7/1/2008   $705.01   N   Referral Required
7/1/2008   $136.45   N   Referral Required
7/1/2008   $757.97   N   Referral Required
7/1/2008   $228.82   N   Referral Required
7/1/2008   $564.46   N   Referral Required
7/1/2008    $82.97   N   Referral Required
7/1/2008   $712.41   N   Referral Required
7/1/2008    $79.77   N   Referral Required
7/1/2008   $592.21   N   Referral Required
7/1/2008   $108.73   N   Referral Required
7/1/2008   $133.83   N   Referral Required
7/1/2008   $615.30   N   Referral Required
7/1/2008   $144.07   N   Referral Required
7/1/2008   $160.02   N   Referral Required
7/1/2008   $341.98   N   Referral Required
7/1/2008    $76.77   N   Referral Required
7/1/2008   $448.90   N   Referral Required
7/1/2008   $123.49   N   Referral Required
7/1/2008   $641.85   N   Referral Required
7/1/2008   $124.20   N   Referral Required
7/1/2008   $610.58   N   Referral Required
7/1/2008   $115.11   N   Referral Required
7/1/2008   $729.03   N   Referral Required
7/1/2008   $149.92   N   Referral Required
7/1/2008   $782.84   N   Referral Required
7/1/2008   $173.40   N   Referral Required
7/1/2008   $275.88   N   Referral Required
7/1/2008    $51.53   N   Referral Required
7/1/2008   $314.26   N   Referral Required
7/1/2008    $77.30   N   Referral Required
7/1/2008   $254.45   N   Referral Required
7/1/2008    $51.86   N   Referral Required
7/1/2008   $274.74   N   Referral Required
7/1/2008    $75.49   N   Referral Required
7/1/2008   $261.99   N   Referral Required
7/1/2008    $38.59   N   Referral Required
7/1/2008   $295.45   N   Referral Required
7/1/2008    $59.15   N   Referral Required
7/1/2008   $296.20   N   Referral Required
7/1/2008    $74.68   N   Referral Required
 7/1/2008    $306.11    N   Referral Required
 1/1/2011      $80.69   N   Referral Required
 7/1/2008    $344.55    N   Referral Required
 7/1/2008      $95.65   N   Referral Required
 7/1/2008    $436.92    N   Referral Required
                $0.00   N   Referral Required
 7/1/2008    $718.06    N   Referral Required
 7/1/2008    $677.74    N   Referral Required
 7/1/2008    $729.87    N   Referral Required
 7/1/2008    $650.90    N   Referral Required
 7/1/2008    $286.18    N   Referral Required
 7/1/2008    $260.47    N   Referral Required
 7/1/2008    $366.05    N   Referral Required
 7/1/2008    $374.57    N   Referral Required
 7/1/2008    $404.33    N   Referral Required
 7/1/2008    $894.83    N   Referral Required
 7/1/2008   $1,244.73   N   Referral Required
 7/1/2008   $1,272.23   N   Referral Required
 7/1/2008   $1,142.17   N   Referral Required
 7/1/2008   $1,215.01   N   Referral Required
 7/1/2008    $795.80    N   Referral Required
 7/1/2008    $752.61    N   Referral Required
 7/1/2008   $1,973.03   N   Referral Required
 7/1/2008   $1,972.23   N   Referral Required
 7/1/2008   $1,964.99   N   Referral Required
 7/1/2008    $682.00    N   Referral Required
 7/1/2008    $535.09    N   Referral Required
 7/1/2008    $434.64    N   Referral Required
 7/1/2008    $463.97    N   Referral Required
 7/1/2008    $342.76    N   Referral Required
 7/1/2008    $536.08    N   Referral Required
 7/1/2008    $536.88    Y   Referral Required
 7/1/2008    $950.17    Y   Referral Required
 7/1/2008    $682.91    Y   Referral Required
10/1/2008    $528.02    Y   Referral Required
 7/1/2008    $835.56    N   Referral Required
 7/1/2008   $1,386.20   N   Referral Required
 7/1/2008   $2,189.36   N   Referral Required
 7/1/2008    $781.12    N   Referral Required
 7/1/2008    $796.67    Y   Referral Required
 7/1/2008      $54.03   N   Referral Required
 7/1/2008      $80.47   N   Referral Required
 7/1/2008      $40.34   N   Referral Required
 7/1/2008      $94.34   N   Referral Required
                $0.00   Y   Referral Required
 7/1/2008    $475.10    N   Referral Required
 7/1/2008    $610.09    N   Referral Required
7/1/2008    $545.67    N   Referral Required
7/1/2008    $670.72    N   Referral Required
7/1/2008    $750.99    N   Referral Required
7/1/2008    $887.85    N   Referral Required
7/1/2008    $731.85    N   Referral Required
7/1/2008    $855.51    N   Referral Required
7/1/2008    $563.77    N   Referral Required
7/1/2008    $740.47    N   Referral Required
7/1/2008    $722.02    N   Referral Required
7/1/2008    $798.32    N   Referral Required
7/1/2008   $1,327.10   N   Referral Required
7/1/2008    $465.77    N   Referral Required
7/1/2008    $664.72    N   Referral Required
7/1/2008    $691.52    N   Referral Required
7/1/2008    $770.92    N   Referral Required
7/1/2008    $937.71    N   Referral Required
7/1/2008    $956.30    N   Referral Required
               $0.00   N   Referral Required
7/1/2008      $57.59   N   Referral Required
7/1/2008      $68.22   N   Referral Required
7/1/2008    $121.42    N   Referral Required
7/1/2008    $145.34    N   Referral Required
7/1/2008    $180.78    N   Referral Required
7/1/2008      $71.77   N   Referral Required
7/1/2008      $61.22   N   Referral Required
7/1/2008       $6.15   N   Referral Required
7/1/2008    $142.11    N   Referral Required
1/1/2011    $302.25    Y   Referral Required
1/1/2011    $393.83    Y   Referral Required
1/1/2011    $556.28    Y   Referral Required
7/1/2008      $80.14   N   Referral Required
7/1/2008      $97.96   N   Referral Required
7/1/2008      $60.27   N   Referral Required
7/1/2008      $76.70   N   Referral Required
7/1/2008    $109.34    N   Referral Required
7/1/2008    $133.58    N   Referral Required
7/1/2008    $147.30    N   Referral Required
7/1/2008    $159.17    N   Referral Required
7/1/2008    $181.03    N   Referral Required
7/1/2008    $114.96    N   Referral Required
7/1/2008    $125.87    N   Referral Required
7/1/2008    $144.59    N   Referral Required
7/1/2008    $161.26    N   Referral Required
7/1/2008    $192.60    N   Referral Required
7/1/2008    $225.32    N   Referral Required
7/1/2008    $107.34    N   Referral Required
7/1/2008    $137.01    N   Referral Required
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                $0.00   Y   Referral Required
 7/1/2008      $94.77   N   Referral Required
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 7/1/2008   $1,681.27   N   Referral Required
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 7/1/2008   $1,347.11   N   Referral Required
 7/1/2008   $1,488.60   N   Referral Required
 7/1/2008    $139.75    N   Referral Required
 7/1/2008      $60.75   N   Referral Required
 1/1/2011      $78.71   N   Referral Required
 1/1/2011   $3,384.26   N   Referral Required
 7/1/2008      $78.77   N   Referral Required
 7/1/2008   $1,280.28   N   Referral Required
11/1/2009    $405.27    Y   Referral Required
 7/1/2008    $484.71    N   Referral Required
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7/1/2008    $331.09    Y   Referral Required
7/1/2008    $748.89    Y   Referral Required
7/1/2008    $724.53    Y   Referral Required
7/1/2008   $1,263.22   Y   Referral Required
7/1/2008   $1,320.56   Y   Referral Required
7/1/2008   $2,304.04   Y   Referral Required
7/1/2008   $1,148.40   Y   Referral Required
7/1/2008   $1,501.09   Y   Referral Required
7/1/2008   $1,849.45   Y   Referral Required
7/1/2008   $1,705.96   Y   Referral Required
7/1/2008    $554.76    Y   Referral Required
7/1/2008    $639.40    Y   Referral Required
7/1/2008    $625.39    Y   Referral Required
               $0.00   Y   Referral Required
7/1/2008    $167.78    N   Referral Required
7/1/2008    $247.42    N   Referral Required
7/1/2008    $503.76    N   Referral Required
7/1/2008    $325.41    N   Referral Required
7/1/2008    $382.43    N   Referral Required
7/1/2008    $466.12    N   Referral Required
7/1/2008    $773.54    N   Referral Required
7/1/2008    $155.61    N   Referral Required
7/1/2008    $213.91    N   Referral Required
1/1/2011    $220.96    N   Referral Required
1/1/2011    $151.06    N   Referral Required
1/1/2011    $557.84    N   Referral Required
7/1/2008    $193.71    N   Referral Required
7/1/2008    $524.50    N   Referral Required
7/1/2008    $311.45    N   Referral Required
7/1/2008    $346.17    N   Referral Required
7/1/2008    $104.24    N   Referral Required
1/1/2011    $111.33    N   Referral Required
7/1/2008    $158.93    N   Referral Required
7/1/2008    $398.65    N   Referral Required
7/1/2008      $63.78   N   Referral Required
7/1/2008      $49.21   N   Referral Required
7/1/2008      $48.68   N   Referral Required
7/1/2008      $44.73   N   Referral Required
7/1/2008      $50.26   N   Referral Required
1/1/2008    $282.02    N   Referral Required
7/1/2008      $45.63   N   Referral Required
7/1/2008      $49.40   N   Referral Required
7/1/2008      $62.45   N   Referral Required
7/1/2008      $48.87   N   Referral Required
7/1/2008    $184.89    N   Referral Required
7/1/2008    $161.72    N   Referral Required
1/1/2011    $217.71    N   Referral Required
7/1/2008    $377.08    N   Referral Required
7/1/2008    $393.02    N   Referral Required
7/1/2008    $367.91    N   Referral Required
7/1/2008    $611.82    N   Referral Required
1/1/2011    $103.66    N   Referral Required
1/1/2011    $333.33    N   Referral Required
7/1/2008    $491.31    N   Referral Required
7/1/2008    $425.24    N   Referral Required
7/1/2008    $783.18    N   Referral Required
7/1/2008    $384.82    N   Referral Required
7/1/2008    $362.30    N   Referral Required
1/1/2009    $934.49    N   Referral Required
1/1/2009   $1,053.69   N   Referral Required
7/1/2008   $2,062.01   N   Referral Required
7/1/2008   $2,680.23   N   Referral Required
7/1/2008   $3,447.26   N   Referral Required
7/1/2008   $2,054.64   N   Referral Required
1/1/2011   $1,689.63   N   Referral Required
7/1/2008   $2,032.99   N   Referral Required
7/1/2008   $1,838.39   N   Referral Required
7/1/2008   $2,054.72   N   Referral Required
1/1/2011    $354.56    N   Referral Required
1/1/2011    $301.90    N   Referral Required
7/1/2008    $357.63    N   Referral Required
7/1/2008    $407.50    N   Referral Required
7/1/2008    $337.04    N   Referral Required
7/1/2008    $494.51    N   Referral Required
7/1/2008    $421.88    N   Referral Required
7/1/2008    $361.91    N   Referral Required
7/1/2008    $171.62    N   Referral Required
7/1/2008      $95.44   N   Referral Required
               $0.00   N   Referral Required
7/1/2008    $146.02    N   Referral Required
7/1/2008    $158.54    N   Referral Required
1/1/2011    $209.56    N   Referral Required
7/1/2008   $2,150.16   N   Referral Required
7/1/2008   $2,258.89   N   Referral Required
7/1/2008   $2,135.73   N   Referral Required
7/1/2008   $2,238.67   N   Referral Required
7/1/2008   $2,400.96   N   Referral Required
7/1/2008   $2,383.41   N   Referral Required
7/1/2008   $2,175.82   N   Referral Required
7/1/2008   $2,336.67   N   Referral Required
7/1/2008      $50.73   N   Referral Required
7/1/2008    $149.65    N   Referral Required
7/1/2008      $46.35   N   Referral Required
1/1/2011   $3,161.07   N   Referral Required
1/1/2008    $125.96    N   Referral Required
               $0.00   N   Referral Required
7/1/2008    $609.98    N   Referral Required
1/1/2010    $216.90    N   Referral Required
1/1/2010    $233.50    N   Referral Required
1/1/2010    $337.93    N   Referral Required
1/1/2010    $361.11    N   Referral Required
7/1/2008    $356.20    N   Referral Required
1/1/2010    $724.25    N   Referral Required
1/1/2011    $779.38    N   Referral Required
7/1/2008    $475.88    N   Referral Required
7/1/2008    $610.75    N   Referral Required
7/1/2008    $396.93    N   Referral Required
7/1/2008    $303.29    N   Referral Required
7/1/2008    $309.20    N   Referral Required
7/1/2008   $1,107.09   N   Referral Required
7/1/2008    $398.27    N   Referral Required
7/1/2008    $735.70    N   Referral Required
7/1/2008   $1,023.55   N   Referral Required
7/1/2008    $894.25    N   Referral Required
7/1/2008   $1,100.26   N   Referral Required
7/1/2008    $911.63    N   Referral Required
7/1/2008   $1,059.17   N   Referral Required
7/1/2008    $709.56    N   Referral Required
7/1/2008    $655.87    N   Referral Required
7/1/2008    $532.66    N   Referral Required
1/1/2008    $303.29    N   Referral Required
7/1/2008    $827.49    N   Referral Required
7/1/2008   $1,400.47   N   Referral Required
7/1/2008   $1,590.29   N   Referral Required
7/1/2008   $1,450.35   Y   Referral Required
7/1/2008   $1,329.84   Y   Referral Required
7/1/2008   $1,263.89   N   Referral Required
7/1/2008   $1,451.43   Y   Referral Required
7/1/2008    $579.74    N   Referral Required
7/1/2008   $1,517.23   Y   Referral Required
7/1/2008   $1,506.41   N   Referral Required
               $0.00   N   Referral Required
               $0.00   N   Referral Required
7/1/2008    $599.99    N   Referral Required
7/1/2008    $585.69    N   Referral Required
7/1/2008    $142.29    N   Referral Required
7/1/2008    $516.27    N   Referral Required
7/1/2008    $615.35    N   Referral Required
7/1/2008    $593.24    N   Referral Required
7/1/2008    $700.57    N   Referral Required
7/1/2008   $2,362.57   N   Referral Required
7/1/2008   $2,572.50   N   Referral Required
7/1/2008    $749.22    Y   Referral Required
7/1/2008   $1,117.01   N   Referral Required
7/1/2008   $1,097.82   N   Referral Required
7/1/2008   $1,163.20   N   Referral Required
7/1/2008   $1,295.66   N   Referral Required
7/1/2008   $1,291.14   N   Referral Required
7/1/2008   $1,401.78   N   Referral Required
1/1/2011   $1,472.33   N   Referral Required
7/1/2008   $1,588.27   N   Referral Required
7/1/2008   $1,773.35   N   Referral Required
7/1/2008   $2,001.89   N   Referral Required
7/1/2008   $2,333.10   Y   Referral Required
7/1/2008   $2,499.81   N   Referral Required
7/1/2008   $1,468.06   N   Referral Required
7/1/2008   $1,736.27   N   Referral Required
7/1/2008   $1,232.22   N   Referral Required
7/1/2008   $1,393.81   N   Referral Required
7/1/2008    $604.95    N   Referral Required
7/1/2008   $1,715.90   N   Referral Required
7/1/2008   $1,946.48   N   Referral Required
7/1/2008   $2,026.61   N   Referral Required
7/1/2008   $1,379.07   N   Referral Required
7/1/2008   $1,043.06   N   Referral Required
7/1/2008   $1,193.24   N   Referral Required
7/1/2008   $1,130.05   N   Referral Required
7/1/2008   $1,223.78   N   Referral Required
7/1/2008    $956.93    N   Referral Required
7/1/2008    $862.66    N   Referral Required
7/1/2008    $933.34    N   Referral Required
7/1/2008   $1,320.96   N   Referral Required
7/1/2008    $654.87    N   Referral Required
7/1/2008   $1,547.87   N   Referral Required
7/1/2008   $2,565.41   N   Referral Required
7/1/2008    $646.77    N   Referral Required
7/1/2008    $589.87    N   Referral Required
7/1/2008    $930.54    N   Referral Required
7/1/2008    $857.02    N   Referral Required
7/1/2008   $1,395.16   N   Referral Required
7/1/2008    $865.74    N   Referral Required
7/1/2008    $932.01    N   Referral Required
7/1/2008    $729.11    N   Referral Required
7/1/2008   $1,362.23   N   Referral Required
7/1/2008    $863.05    N   Referral Required
7/1/2008   $1,211.98   N   Referral Required
7/1/2008   $1,157.56   N   Referral Required
7/1/2008    $969.82    N   Referral Required
7/1/2008   $1,042.79   N   Referral Required
7/1/2008   $1,849.01   N   Referral Required
7/1/2008   $1,633.18   N   Referral Required
7/1/2008   $1,316.40   N   Referral Required
7/1/2008   $1,524.31   N   Referral Required
7/1/2008    $747.08    N   Referral Required
7/1/2008    $670.91    N   Referral Required
7/1/2008    $433.13    N   Referral Required
7/1/2008    $286.96    N   Referral Required
7/1/2008    $143.39    N   Referral Required
7/1/2008    $335.51    N   Referral Required
               $0.00   Y   Referral Required
7/1/2008      $91.78   N   Referral Required
7/1/2008    $211.93    N   Referral Required
7/1/2008    $203.02    N   Referral Required
7/1/2008    $402.50    N   Referral Required
7/1/2008    $490.37    N   Referral Required
7/1/2008    $615.02    N   Referral Required
7/1/2008    $535.57    N   Referral Required
7/1/2008    $319.50    N   Referral Required
7/1/2008    $641.94    N   Referral Required
7/1/2008    $695.78    N   Referral Required
7/1/2008    $663.25    N   Referral Required
7/1/2008    $973.19    N   Referral Required
7/1/2008   $1,256.34   N   Referral Required
7/1/2008    $654.29    N   Referral Required
7/1/2008    $785.98    N   Referral Required
7/1/2008    $942.38    N   Referral Required
7/1/2008    $998.78    N   Referral Required
7/1/2008    $353.73    N   Referral Required
7/1/2008    $401.66    N   Referral Required
7/1/2008    $439.03    N   Referral Required
7/1/2008    $919.18    N   Referral Required
7/1/2008   $1,030.48   N   Referral Required
7/1/2008    $592.97    N   Referral Required
7/1/2008    $553.94    N   Referral Required
7/1/2008    $630.03    N   Referral Required
7/1/2008    $635.72    N   Referral Required
7/1/2008    $807.54    N   Referral Required
7/1/2008    $139.98    N   Referral Required
7/1/2008    $377.73    N   Referral Required
7/1/2008    $449.02    N   Referral Required
7/1/2008    $530.08    N   Referral Required
7/1/2008    $725.06    N   Referral Required
7/1/2008    $572.20    N   Referral Required
7/1/2008    $560.17    N   Referral Required
7/1/2008    $662.60    N   Referral Required
7/1/2008    $613.07    N   Referral Required
7/1/2008    $557.31    N   Referral Required
7/1/2008   $1,405.95   N   Referral Required
7/1/2008   $1,106.40   N   Referral Required
7/1/2008   $1,589.16   N   Referral Required
7/1/2008    $403.91    N   Referral Required
7/1/2008    $585.15    N   Referral Required
7/1/2008    $424.11    N   Referral Required
7/1/2008    $567.87    N   Referral Required
7/1/2008    $500.46    N   Referral Required
7/1/2008    $655.30    N   Referral Required
7/1/2008    $456.13    N   Referral Required
7/1/2008   $1,427.33   N   Referral Required
7/1/2008   $1,563.67   N   Referral Required
7/1/2008    $759.75    N   Referral Required
7/1/2008    $986.02    N   Referral Required
7/1/2008      $76.76   N   Referral Required
7/1/2008    $502.18    N   Referral Required
7/1/2008    $760.98    N   Referral Required
7/1/2008    $543.81    N   Referral Required
7/1/2008    $503.81    N   Referral Required
               $0.00   N   Referral Required
7/1/2008    $354.60    N   Referral Required
7/1/2008    $437.72    N   Referral Required
7/1/2008    $393.45    N   Referral Required
7/1/2008    $205.20    N   Referral Required
1/1/2010    $311.10    N   Referral Required
1/1/2010    $512.05    N   Referral Required
7/1/2008    $346.57    N   Referral Required
7/1/2008    $338.75    N   Referral Required
7/1/2008    $484.37    N   Referral Required
1/1/2010    $961.72    N   Referral Required
7/1/2008    $453.60    N   Referral Required
7/1/2008    $883.91    N   Referral Required
7/1/2008    $571.29    N   Referral Required
7/1/2008    $698.65    N   Referral Required
7/1/2008    $438.16    N   Referral Required
7/1/2008    $457.98    N   Referral Required
7/1/2008   $1,057.24   N   Referral Required
7/1/2008   $1,047.64   N   Referral Required
7/1/2008    $832.13    N   Referral Required
7/1/2008    $362.66    N   Referral Required
7/1/2008    $522.89    N   Referral Required
7/1/2008    $319.06    N   Referral Required
7/1/2008    $437.92    N   Referral Required
7/1/2008    $909.84    N   Referral Required
               $0.00   N   Referral Required
               $0.00   N   Referral Required
7/1/2008    $602.37    N   Referral Required
7/1/2008      $79.51   N   Referral Required
7/1/2008    $209.41    N   Referral Required
7/1/2008    $422.34    N   Referral Required
7/1/2008    $107.90    N   Referral Required
7/1/2008    $474.36    N   Referral Required
               $0.00   Y   Referral Required
7/1/2008    $201.15    N   Referral Required
7/1/2008    $339.27    N   Referral Required
7/1/2008    $378.62    N   Referral Required
1/1/2010    $325.36    N   Referral Required
1/1/2010    $467.06    N   Referral Required
1/1/2010    $515.30    N   Referral Required
1/1/2011    $932.79    N   Referral Required
1/1/2010    $999.60    N   Referral Required
7/1/2008    $742.36    N   Referral Required
7/1/2008    $737.17    N   Referral Required
7/1/2008    $665.54    N   Referral Required
7/1/2008    $666.16    N   Referral Required
7/1/2008    $668.26    N   Referral Required
7/1/2008    $121.87    N   Referral Required
7/1/2008    $820.79    N   Referral Required
7/1/2008    $818.84    N   Referral Required
7/1/2008    $820.27    N   Referral Required
7/1/2008    $121.58    N   Referral Required
1/1/2008   $1,951.06   N   Referral Required
1/1/2008   $1,927.25   N   Referral Required
1/1/2008    $487.99    N   Referral Required
7/1/2008   $1,446.97   N   Referral Required
7/1/2008   $1,199.33   N   Referral Required
7/1/2008   $1,211.00   N   Referral Required
7/1/2008    $317.89    N   Referral Required
7/1/2008   $1,308.14   N   Referral Required
7/1/2008   $1,204.91   N   Referral Required
7/1/2008   $1,298.47   N   Referral Required
7/1/2008    $316.56    N   Referral Required
7/1/2008    $151.53    N   Referral Required
7/1/2008    $230.06    N   Referral Required
7/1/2008    $694.56    N   Referral Required
7/1/2008   $1,301.70   N   Referral Required
7/1/2008   $1,428.94   N   Referral Required
7/1/2008   $1,136.41   N   Referral Required
7/1/2008   $1,189.50   N   Referral Required
7/1/2008   $1,176.60   N   Referral Required
7/1/2008    $239.22    N   Referral Required
7/1/2008    $103.73    N   Referral Required
1/1/2011   $1,945.72   N   Referral Required
1/1/2011   $1,901.94   N   Referral Required
7/1/2008    $213.01    N   Referral Required
7/1/2008    $518.14    N   Referral Required
7/1/2008    $496.52    N   Referral Required
7/1/2008    $231.74    N   Referral Required
7/1/2008   $1,426.00   Y   Referral Required
7/1/2008   $1,338.94   Y   Referral Required
7/1/2008    $313.27    Y   Referral Required
7/1/2008   $1,520.73   Y   Referral Required
7/1/2008   $1,057.07   Y   Referral Required
7/1/2008   $1,366.47   Y   Referral Required
7/1/2008   $1,255.20   Y   Referral Required
7/1/2008    $289.98    Y   Referral Required
7/1/2008   $1,255.23   Y   Referral Required
7/1/2008   $1,194.94   Y   Referral Required
7/1/2008   $1,021.73   Y   Referral Required
7/1/2008   $1,011.06   Y   Referral Required
7/1/2008   $1,315.08   Y   Referral Required
7/1/2008    $338.61    Y   Referral Required
7/1/2008   $1,260.80   Y   Referral Required
7/1/2008    $275.03    Y   Referral Required
7/1/2008   $1,118.45   Y   Referral Required
7/1/2008   $1,781.63   Y   Referral Required
7/1/2008   $2,065.76   Y   Referral Required
7/1/2008   $1,516.68   Y   Referral Required
7/1/2008   $1,702.93   Y   Referral Required
7/1/2008   $1,866.17   Y   Referral Required
7/1/2008   $1,861.84   N   Referral Required
7/1/2008   $2,109.67   N   Referral Required
7/1/2008    $667.62    Y   Referral Required
7/1/2008    $661.41    Y   Referral Required
               $0.00   Y   Referral Required
7/1/2008    $662.12    Y   Referral Required
7/1/2008    $701.60    Y   Referral Required
7/1/2008    $864.39    Y   Referral Required
7/1/2008    $630.92    Y   Referral Required
7/1/2008    $655.78    Y   Referral Required
7/1/2008    $722.98    Y   Referral Required
7/1/2008    $314.70    Y   Referral Required
7/1/2008   $1,079.47   Y   Referral Required
7/1/2008    $589.37    N   Referral Required
7/1/2008    $351.51    Y   Referral Required
7/1/2008    $564.27    N   Referral Required
7/1/2008    $910.69    N   Referral Required
5/1/2009   $1,406.73   N   Referral Required
5/1/2009   $1,737.09   N   Referral Required
1/1/2009   $1,582.75   N   Referral Required
               $0.00   Y   Referral Required
7/1/2008    $333.29    N   Referral Required
1/1/2010    $460.38    N   Referral Required
1/1/2010    $289.93    N   Referral Required
1/1/2010    $304.82    N   Referral Required
1/1/2010    $721.22    N   Referral Required
1/1/2010    $934.87    N   Referral Required
               $0.00   N   Referral Required
7/1/2008    $434.27    N   Referral Required
7/1/2008    $573.57    N   Referral Required
7/1/2008    $354.47    N   Referral Required
7/1/2008    $341.20    N   Referral Required
7/1/2008    $576.73    N   Referral Required
7/1/2008    $597.34    N   Referral Required
7/1/2008    $474.13    N   Referral Required
7/1/2008    $171.11    N   Referral Required
7/1/2008    $410.87    N   Referral Required
1/1/2010    $288.88    N   Referral Required
1/1/2010    $479.27    N   Referral Required
7/1/2008    $210.00    N   Referral Required
7/1/2008    $463.54    N   Referral Required
7/1/2008    $981.88    N   Referral Required
1/1/2010    $972.85    N   Referral Required
7/1/2008    $401.78    N   Referral Required
7/1/2008    $372.01    N   Referral Required
7/1/2008    $527.90    N   Referral Required
7/1/2008    $395.88    N   Referral Required
7/1/2008    $549.90    N   Referral Required
7/1/2008    $465.22    N   Referral Required
7/1/2008    $582.90    N   Referral Required
7/1/2008    $501.24    N   Referral Required
7/1/2008    $424.72    N   Referral Required
7/1/2008    $572.09    N   Referral Required
7/1/2008    $510.23    N   Referral Required
7/1/2008    $539.80    N   Referral Required
7/1/2008    $653.92    N   Referral Required
7/1/2008    $558.43    N   Referral Required
7/1/2008    $443.21    N   Referral Required
7/1/2008    $457.55    N   Referral Required
7/1/2008    $622.78    N   Referral Required
7/1/2008    $581.93    N   Referral Required
7/1/2008    $560.12    N   Referral Required
7/1/2008    $629.13    N   Referral Required
7/1/2008    $460.60    N   Referral Required
7/1/2008    $620.67    N   Referral Required
7/1/2008    $726.62    N   Referral Required
7/1/2008    $760.68    N   Referral Required
7/1/2008    $896.04    N   Referral Required
7/1/2008    $184.86    N   Referral Required
7/1/2008    $486.80    N   Referral Required
7/1/2008    $737.46    N   Referral Required
1/1/2011    $134.32    N   Referral Required
7/1/2008   $1,071.27   N   Referral Required
7/1/2008    $959.10    N   Referral Required
7/1/2008    $814.89    N   Referral Required
7/1/2008    $524.42    N   Referral Required
7/1/2008    $656.01    N   Referral Required
1/1/2011    $732.96    N   Referral Required
1/1/2011    $764.01    N   Referral Required
1/1/2011    $612.41    N   Referral Required
1/1/2011    $865.09    N   Referral Required
7/1/2008    $618.44    N   Referral Required
7/1/2008    $638.81    N   Referral Required
7/1/2008    $800.84    N   Referral Required
7/1/2008    $852.46    N   Referral Required
7/1/2008    $922.81    N   Referral Required
7/1/2008    $903.80    N   Referral Required
7/1/2008    $939.71    N   Referral Required
7/1/2008    $925.11    N   Referral Required
7/1/2008   $1,025.59   N   Referral Required
7/1/2008   $1,266.71   N   Referral Required
7/1/2008    $688.54    N   Referral Required
7/1/2008    $808.88    N   Referral Required
7/1/2008    $689.62    N   Referral Required
7/1/2008    $854.28    N   Referral Required
7/1/2008    $169.40    N   Referral Required
7/1/2008    $277.39    N   Referral Required
7/1/2008    $570.13    N   Referral Required
7/1/2008    $174.50    N   Referral Required
7/1/2008    $276.92    N   Referral Required
7/1/2008    $457.54    N   Referral Required
7/1/2008    $514.33    N   Referral Required
7/1/2008    $174.50    N   Referral Required
7/1/2008    $250.34    N   Referral Required
7/1/2008    $473.65    N   Referral Required
7/1/2008    $546.09    N   Referral Required
7/1/2008    $180.17    N   Referral Required
7/1/2008    $307.64    N   Referral Required
7/1/2008    $770.81    N   Referral Required
7/1/2008    $253.49    N   Referral Required
7/1/2008    $374.19    N   Referral Required
7/1/2008    $719.17    N   Referral Required
7/1/2008   $1,090.99   N   Referral Required
7/1/2008    $207.37    N   Referral Required
7/1/2008    $302.92    N   Referral Required
7/1/2008    $606.23    N   Referral Required
7/1/2008    $238.89    N   Referral Required
7/1/2008    $307.71    N   Referral Required
7/1/2008    $479.36    N   Referral Required
7/1/2008    $335.69    N   Referral Required
7/1/2008    $678.52    N   Referral Required
7/1/2008    $441.10    N   Referral Required
7/1/2008    $741.82    N   Referral Required
7/1/2008    $161.76    N   Referral Required
7/1/2008    $855.99    N   Referral Required
7/1/2008   $1,018.00   N   Referral Required
7/1/2008   $1,119.85   N   Referral Required
7/1/2008    $904.46    N   Referral Required
7/1/2008    $368.82    N   Referral Required
               $0.00   N   Referral Required
7/1/2008    $296.10    N   Referral Required
1/1/2011    $235.81    N   Referral Required
7/1/2008    $414.07    N   Referral Required
7/1/2008    $388.68    N   Referral Required
7/1/2008    $590.72    N   Referral Required
7/1/2008    $196.48    N   Referral Required
7/1/2008    $478.84    N   Referral Required
1/1/2010    $280.49    N   Referral Required
1/1/2010    $481.81    N   Referral Required
7/1/2008    $386.15    N   Referral Required
7/1/2008    $388.86    N   Referral Required
7/1/2008    $677.18    N   Referral Required
1/1/2010    $896.89    N   Referral Required
7/1/2008    $327.19    N   Referral Required
7/1/2008    $410.36    N   Referral Required
7/1/2008    $510.32    N   Referral Required
7/1/2008    $275.10    N   Referral Required
7/1/2008    $480.13    N   Referral Required
7/1/2008    $560.05    N   Referral Required
7/1/2008    $724.83    N   Referral Required
7/1/2008    $431.21    N   Referral Required
7/1/2008    $491.93    N   Referral Required
7/1/2008    $524.90    N   Referral Required
7/1/2008    $417.74    N   Referral Required
7/1/2008    $632.73    N   Referral Required
7/1/2008    $521.18    N   Referral Required
7/1/2008    $543.30    N   Referral Required
7/1/2008    $606.45    N   Referral Required
7/1/2008    $510.58    N   Referral Required
7/1/2008    $530.84    N   Referral Required
7/1/2008    $952.41    N   Referral Required
7/1/2008    $812.32    N   Referral Required
7/1/2008    $603.61    N   Referral Required
7/1/2008    $702.10    N   Referral Required
7/1/2008    $501.66    N   Referral Required
7/1/2008    $410.31    N   Referral Required
7/1/2008    $166.37    N   Referral Required
7/1/2008    $462.28    N   Referral Required
7/1/2008    $150.42    N   Referral Required
7/1/2008    $323.38    N   Referral Required
7/1/2008    $626.10    N   Referral Required
7/1/2008    $480.18    N   Referral Required
7/1/2008    $392.68    N   Referral Required
7/1/2008    $636.33    N   Referral Required
7/1/2008    $597.20    N   Referral Required
7/1/2008    $658.16    N   Referral Required
7/1/2008    $495.80    N   Referral Required
7/1/2008    $508.76    N   Referral Required
7/1/2008    $593.50    N   Referral Required
7/1/2008    $655.63    N   Referral Required
7/1/2008    $581.45    N   Referral Required
7/1/2008    $905.45    N   Referral Required
7/1/2008    $578.64    N   Referral Required
7/1/2008    $903.21    N   Referral Required
1/1/2008    $366.64    N   Referral Required
1/1/2008    $430.93    N   Referral Required
1/1/2008    $530.79    N   Referral Required
7/1/2008    $748.26    N   Referral Required
7/1/2008    $843.09    N   Referral Required
7/1/2008    $822.17    N   Referral Required
7/1/2008   $1,243.32   N   Referral Required
7/1/2008    $531.99    N   Referral Required
7/1/2008    $570.57    N   Referral Required
7/1/2008    $684.83    N   Referral Required
7/1/2008    $877.04    N   Referral Required
7/1/2008    $815.00    N   Referral Required
7/1/2008    $864.32    N   Referral Required
7/1/2008    $883.11    N   Referral Required
7/1/2008    $546.95    N   Referral Required
7/1/2008    $553.79    N   Referral Required
7/1/2008    $729.93    N   Referral Required
7/1/2008    $275.12    N   Referral Required
7/1/2008    $400.44    N   Referral Required
7/1/2008    $731.03    N   Referral Required
7/1/2008    $723.12    N   Referral Required
7/1/2008    $296.27    N   Referral Required
7/1/2008    $500.50    N   Referral Required
7/1/2008   $619.45   N   Referral Required
7/1/2008   $749.82   N   Referral Required
7/1/2008   $887.15   N   Referral Required
7/1/2008   $248.21   N   Referral Required
7/1/2008   $416.53   N   Referral Required
7/1/2008   $571.40   N   Referral Required
7/1/2008   $611.73   N   Referral Required
7/1/2008   $260.55   N   Referral Required
7/1/2008   $431.53   N   Referral Required
7/1/2008   $693.07   N   Referral Required
7/1/2008   $648.52   N   Referral Required
7/1/2008   $917.91   N   Referral Required
7/1/2008   $912.33   N   Referral Required
7/1/2008   $298.58   N   Referral Required
7/1/2008   $372.78   N   Referral Required
7/1/2008   $596.38   N   Referral Required
7/1/2008   $453.51   N   Referral Required
1/1/2011   $631.97   N   Referral Required
7/1/2008    $99.42   N   Referral Required
7/1/2008   $201.05   N   Referral Required
7/1/2008   $349.61   N   Referral Required
7/1/2008   $536.48   N   Referral Required
7/1/2008   $608.20   N   Referral Required
7/1/2008   $225.81   N   Referral Required
7/1/2008   $365.99   N   Referral Required
7/1/2008   $538.53   N   Referral Required
7/1/2008   $669.77   N   Referral Required
7/1/2008   $828.31   N   Referral Required
7/1/2008   $590.70   N   Referral Required
7/1/2008   $583.12   N   Referral Required
7/1/2008   $446.97   N   Referral Required
7/1/2008   $615.74   N   Referral Required
7/1/2008   $663.11   N   Referral Required
7/1/2008   $895.92   N   Referral Required
7/1/2008   $998.38   N   Referral Required
             $0.00   N   Referral Required
1/1/2011   $300.47   N   Referral Required
7/1/2008   $270.34   N   Referral Required
7/1/2008   $493.64   N   Referral Required
7/1/2008   $936.58   N   Referral Required
7/1/2008   $624.90   N   Referral Required
7/1/2008   $959.22   N   Referral Required
7/1/2008   $432.85   N   Referral Required
7/1/2008   $342.67   N   Referral Required
7/1/2008   $597.14   N   Referral Required
7/1/2008   $482.47   N   Referral Required
7/1/2008   $196.39   N   Referral Required
1/1/2011   $325.76   N   Referral Required
1/1/2010   $293.93   N   Referral Required
1/1/2010   $366.04   N   Referral Required
7/1/2008   $290.78   N   Referral Required
7/1/2008   $408.79   N   Referral Required
7/1/2008   $664.11   N   Referral Required
1/1/2010   $782.84   N   Referral Required
7/1/2008   $398.28   N   Referral Required
7/1/2008   $294.54   N   Referral Required
7/1/2008   $343.93   N   Referral Required
7/1/2008   $420.43   N   Referral Required
7/1/2008   $513.45   N   Referral Required
7/1/2008   $421.63   N   Referral Required
1/1/2011   $310.89   N   Referral Required
7/1/2008   $264.29   N   Referral Required
7/1/2008   $322.63   N   Referral Required
1/1/2011   $703.74   N   Referral Required
1/1/2011   $562.94   N   Referral Required
7/1/2008   $326.26   N   Referral Required
7/1/2008   $434.00   N   Referral Required
1/1/2011   $474.61   N   Referral Required
7/1/2008   $582.75   N   Referral Required
7/1/2008   $594.71   N   Referral Required
7/1/2008   $379.65   N   Referral Required
7/1/2008   $472.10   N   Referral Required
7/1/2008   $417.04   N   Referral Required
1/1/2011   $489.66   N   Referral Required
7/1/2008   $494.68   N   Referral Required
1/1/2011   $553.51   N   Referral Required
7/1/2008   $790.07   N   Referral Required
7/1/2008   $415.75   N   Referral Required
7/1/2008   $538.45   N   Referral Required
7/1/2008   $369.65   N   Referral Required
7/1/2008   $381.14   N   Referral Required
1/1/2011   $150.81   N   Referral Required
1/1/2011   $383.14   N   Referral Required
7/1/2008   $432.27   N   Referral Required
7/1/2008   $593.82   N   Referral Required
7/1/2008   $322.80   N   Referral Required
1/1/2011   $588.88   N   Referral Required
7/1/2008   $610.52   N   Referral Required
7/1/2008   $719.35   N   Referral Required
1/1/2011   $468.76   N   Referral Required
1/1/2011   $527.34   N   Referral Required
7/1/2008   $655.48   N   Referral Required
7/1/2008   $555.43   N   Referral Required
1/1/2011   $535.96   N   Referral Required
1/1/2011    $443.24    N   Referral Required
1/1/2011    $497.84    N   Referral Required
7/1/2008    $574.07    N   Referral Required
7/1/2008    $546.58    N   Referral Required
1/1/2011    $581.81    N   Referral Required
7/1/2008    $696.77    N   Referral Required
1/1/2011    $724.60    N   Referral Required
1/1/2011    $840.43    N   Referral Required
7/1/2008    $800.47    N   Referral Required
7/1/2008    $704.17    N   Referral Required
7/1/2008    $813.20    N   Referral Required
7/1/2008    $743.17    N   Referral Required
1/1/2011    $637.03    N   Referral Required
1/1/2011    $718.79    N   Referral Required
1/1/2011    $618.88    N   Referral Required
7/1/2008    $867.31    N   Referral Required
1/1/2011    $928.19    N   Referral Required
7/1/2008    $906.75    N   Referral Required
1/1/2011    $723.87    N   Referral Required
7/1/2008    $937.52    N   Referral Required
7/1/2008    $939.70    N   Referral Required
7/1/2008   $1,056.57   N   Referral Required
7/1/2008    $640.00    N   Referral Required
1/1/2011    $758.09    N   Referral Required
1/1/2011    $969.27    N   Referral Required
1/1/2011    $913.18    N   Referral Required
7/1/2008   $1,087.02   N   Referral Required
7/1/2008    $993.78    N   Referral Required
7/1/2008   $1,025.22   N   Referral Required
7/1/2008    $585.15    N   Referral Required
7/1/2008    $656.63    N   Referral Required
7/1/2008    $657.17    N   Referral Required
7/1/2008    $782.94    N   Referral Required
7/1/2008    $671.02    N   Referral Required
7/1/2008    $645.69    N   Referral Required
7/1/2008    $685.88    N   Referral Required
7/1/2008    $601.91    N   Referral Required
7/1/2008    $988.39    N   Referral Required
7/1/2008    $673.74    N   Referral Required
7/1/2008    $866.19    N   Referral Required
7/1/2008    $526.34    N   Referral Required
7/1/2008    $634.96    N   Referral Required
7/1/2008    $688.43    N   Referral Required
7/1/2008    $721.44    N   Referral Required
7/1/2008    $855.41    N   Referral Required
7/1/2008    $205.61    N   Referral Required
7/1/2008    $401.53    N   Referral Required
7/1/2008   $552.67   N   Referral Required
7/1/2008   $443.00   N   Referral Required
7/1/2008   $678.90   N   Referral Required
7/1/2008   $846.81   N   Referral Required
7/1/2008   $199.24   N   Referral Required
7/1/2008   $385.33   N   Referral Required
7/1/2008   $521.91   N   Referral Required
7/1/2008   $208.23   N   Referral Required
7/1/2008   $419.82   N   Referral Required
7/1/2008   $542.43   N   Referral Required
7/1/2008   $738.94   N   Referral Required
7/1/2008   $228.05   N   Referral Required
7/1/2008   $489.64   N   Referral Required
7/1/2008   $556.80   N   Referral Required
7/1/2008   $579.58   N   Referral Required
7/1/2008   $659.39   N   Referral Required
7/1/2008   $841.04   N   Referral Required
7/1/2008   $234.15   N   Referral Required
7/1/2008   $368.67   N   Referral Required
7/1/2008   $675.34   N   Referral Required
7/1/2008   $589.77   N   Referral Required
7/1/2008   $239.67   N   Referral Required
7/1/2008   $348.66   N   Referral Required
7/1/2008   $471.65   N   Referral Required
7/1/2008   $249.43   N   Referral Required
7/1/2008   $384.31   N   Referral Required
7/1/2008   $508.05   N   Referral Required
7/1/2008   $324.10   N   Referral Required
7/1/2008   $505.99   N   Referral Required
7/1/2008   $426.37   N   Referral Required
7/1/2008   $344.17   N   Referral Required
7/1/2008   $523.57   N   Referral Required
7/1/2008   $370.76   N   Referral Required
7/1/2008   $605.43   N   Referral Required
7/1/2008   $376.59   N   Referral Required
7/1/2008   $525.52   N   Referral Required
7/1/2008   $628.79   N   Referral Required
7/1/2008   $722.61   N   Referral Required
7/1/2008   $725.80   N   Referral Required
7/1/2008   $513.26   N   Referral Required
7/1/2008   $628.71   N   Referral Required
7/1/2008   $804.97   N   Referral Required
7/1/2008   $664.32   N   Referral Required
7/1/2008   $651.30   N   Referral Required
7/1/2008   $581.30   N   Referral Required
7/1/2008   $646.55   N   Referral Required
7/1/2008   $565.58   N   Referral Required
7/1/2008   $496.77   N   Referral Required
7/1/2008   $554.10   N   Referral Required
7/1/2008   $664.77   N   Referral Required
7/1/2008   $472.83   N   Referral Required
7/1/2008   $618.05   N   Referral Required
             $0.00   N   Referral Required
1/1/2011   $215.60   N   Referral Required
1/1/2011   $325.12   N   Referral Required
7/1/2008   $349.21   N   Referral Required
7/1/2008   $341.49   N   Referral Required
7/1/2008   $402.78   N   Referral Required
7/1/2008   $436.28   N   Referral Required
7/1/2008   $668.54   N   Referral Required
7/1/2008   $469.69   N   Referral Required
7/1/2008   $251.38   N   Referral Required
7/1/2008   $382.07   N   Referral Required
1/1/2011   $474.76   N   Referral Required
7/1/2008   $213.60   N   Referral Required
7/1/2008   $241.17   N   Referral Required
7/1/2008   $257.89   N   Referral Required
7/1/2008   $311.96   N   Referral Required
7/1/2008   $264.95   N   Referral Required
7/1/2008   $269.05   N   Referral Required
7/1/2008   $257.47   N   Referral Required
1/1/2010   $285.08   N   Referral Required
1/1/2010   $375.23   N   Referral Required
1/1/2011   $496.04   N   Referral Required
7/1/2008   $392.99   N   Referral Required
7/1/2008   $534.28   N   Referral Required
1/1/2010   $735.52   N   Referral Required
7/1/2008   $492.66   N   Referral Required
7/1/2008   $668.66   N   Referral Required
7/1/2008   $239.65   N   Referral Required
7/1/2008   $372.69   N   Referral Required
7/1/2008   $454.94   N   Referral Required
7/1/2008   $413.79   N   Referral Required
7/1/2008   $420.03   N   Referral Required
1/1/2011   $479.82   N   Referral Required
7/1/2008   $330.11   N   Referral Required
7/1/2008   $359.26   N   Referral Required
7/1/2008   $424.09   N   Referral Required
7/1/2008   $368.87   N   Referral Required
7/1/2008   $497.80   N   Referral Required
7/1/2008   $359.35   N   Referral Required
7/1/2008   $456.84   N   Referral Required
7/1/2008   $414.45   N   Referral Required
7/1/2008   $406.69   N   Referral Required
7/1/2008   $360.73   N   Referral Required
7/1/2008   $478.41   N   Referral Required
7/1/2008   $451.41   N   Referral Required
7/1/2008   $376.87   N   Referral Required
7/1/2008   $281.19   N   Referral Required
7/1/2008   $253.55   N   Referral Required
1/1/2011   $612.89   N   Referral Required
7/1/2008   $705.67   N   Referral Required
7/1/2008   $901.32   N   Referral Required
7/1/2008   $749.29   N   Referral Required
1/1/2011   $794.76   N   Referral Required
1/1/2011   $661.98   N   Referral Required
1/1/2011   $769.25   N   Referral Required
1/1/2011   $733.40   N   Referral Required
7/1/2008   $714.32   N   Referral Required
7/1/2008   $843.44   N   Referral Required
1/1/2011   $485.83   N   Referral Required
7/1/2008   $597.48   N   Referral Required
7/1/2008   $621.80   N   Referral Required
7/1/2008   $726.25   N   Referral Required
1/1/2011   $490.53   N   Referral Required
7/1/2008   $623.63   N   Referral Required
1/1/2011   $485.19   N   Referral Required
7/1/2008   $650.92   N   Referral Required
1/1/2011   $426.16   N   Referral Required
1/1/2011   $456.59   N   Referral Required
7/1/2008   $549.11   N   Referral Required
7/1/2008   $537.54   N   Referral Required
1/1/2011   $534.96   N   Referral Required
7/1/2008   $805.07   N   Referral Required
1/1/2011   $496.35   N   Referral Required
7/1/2008   $684.43   N   Referral Required
7/1/2008   $344.64   N   Referral Required
7/1/2008   $341.97   N   Referral Required
7/1/2008   $332.30   N   Referral Required
7/1/2008   $528.63   N   Referral Required
7/1/2008   $511.97   N   Referral Required
7/1/2008   $495.91   N   Referral Required
7/1/2008   $501.20   N   Referral Required
7/1/2008   $540.97   N   Referral Required
7/1/2008   $534.11   N   Referral Required
1/1/2011   $649.17   N   Referral Required
1/1/2011   $731.68   N   Referral Required
7/1/2008   $707.14   N   Referral Required
7/1/2008   $732.80   N   Referral Required
7/1/2008   $669.89   N   Referral Required
7/1/2008   $742.95   N   Referral Required
7/1/2008    $681.47    N   Referral Required
7/1/2008    $732.42    N   Referral Required
7/1/2008    $735.90    N   Referral Required
7/1/2008    $976.51    N   Referral Required
7/1/2008    $694.60    N   Referral Required
7/1/2008    $539.30    N   Referral Required
7/1/2008    $602.64    N   Referral Required
7/1/2008    $547.40    N   Referral Required
7/1/2008    $515.63    N   Referral Required
7/1/2008    $605.78    N   Referral Required
7/1/2008    $703.04    N   Referral Required
7/1/2008    $705.70    N   Referral Required
1/1/2011    $560.77    N   Referral Required
1/1/2011    $562.29    N   Referral Required
7/1/2008    $439.27    N   Referral Required
7/1/2008    $512.29    N   Referral Required
7/1/2008    $322.17    N   Referral Required
7/1/2008    $549.53    N   Referral Required
7/1/2008    $569.35    N   Referral Required
7/1/2008    $691.42    N   Referral Required
7/1/2008    $586.35    N   Referral Required
7/1/2008    $598.26    N   Referral Required
7/1/2008    $822.23    N   Referral Required
7/1/2008    $655.75    N   Referral Required
7/1/2008   $1,305.52   N   Referral Required
7/1/2008   $2,597.62   N   Referral Required
7/1/2008   $2,488.80   N   Referral Required
7/1/2008   $3,306.73   N   Referral Required
7/1/2008   $1,152.84   N   Referral Required
7/1/2008   $2,564.52   N   Referral Required
7/1/2008    $472.83    N   Referral Required
7/1/2008    $760.59    N   Referral Required
7/1/2008   $1,025.03   N   Referral Required
7/1/2008    $583.50    N   Referral Required
7/1/2008    $585.59    N   Referral Required
7/1/2008    $771.43    N   Referral Required
7/1/2008   $1,087.92   N   Referral Required
7/1/2008    $798.54    N   Referral Required
7/1/2008   $1,113.83   N   Referral Required
1/1/2011    $372.80    N   Referral Required
7/1/2008    $511.35    N   Referral Required
7/1/2008    $601.89    N   Referral Required
7/1/2008    $213.19    N   Referral Required
7/1/2008    $251.35    N   Referral Required
7/1/2008    $384.03    N   Referral Required
7/1/2008    $390.32    N   Referral Required
7/1/2008    $436.79    N   Referral Required
7/1/2008   $285.34   N   Referral Required
7/1/2008   $325.97   N   Referral Required
7/1/2008   $385.14   N   Referral Required
7/1/2008   $493.90   N   Referral Required
7/1/2008   $264.19   N   Referral Required
7/1/2008   $351.89   N   Referral Required
7/1/2008   $409.62   N   Referral Required
7/1/2008   $454.51   N   Referral Required
7/1/2008   $510.57   N   Referral Required
7/1/2008   $249.75   N   Referral Required
7/1/2008   $323.55   N   Referral Required
7/1/2008   $352.97   N   Referral Required
7/1/2008   $439.93   N   Referral Required
7/1/2008   $151.12   N   Referral Required
7/1/2008   $271.78   N   Referral Required
7/1/2008   $384.37   N   Referral Required
7/1/2008   $456.31   N   Referral Required
7/1/2008   $174.98   N   Referral Required
7/1/2008   $296.16   N   Referral Required
7/1/2008   $551.65   N   Referral Required
7/1/2008   $141.54   N   Referral Required
7/1/2008   $249.63   N   Referral Required
7/1/2008   $339.70   N   Referral Required
7/1/2008   $368.25   N   Referral Required
7/1/2008   $214.07   N   Referral Required
7/1/2008   $300.93   N   Referral Required
7/1/2008   $361.56   N   Referral Required
7/1/2008   $400.73   N   Referral Required
7/1/2008   $896.78   N   Referral Required
7/1/2008   $674.99   N   Referral Required
7/1/2008   $631.33   N   Referral Required
7/1/2008   $679.52   N   Referral Required
7/1/2008   $627.98   N   Referral Required
7/1/2008   $698.42   N   Referral Required
7/1/2008   $597.59   N   Referral Required
7/1/2008   $678.84   N   Referral Required
1/1/2011   $481.58   N   Referral Required
7/1/2008    $90.77   N   Referral Required
7/1/2008   $621.08   N   Referral Required
7/1/2008   $203.03   N   Referral Required
7/1/2008   $604.48   N   Referral Required
7/1/2008   $519.29   N   Referral Required
7/1/2008   $558.40   N   Referral Required
             $0.00   N   Referral Required
7/1/2008   $509.91   N   Referral Required
7/1/2008   $584.96   N   Referral Required
7/1/2008   $803.23   N   Referral Required
7/1/2008    $371.82    N   Referral Required
7/1/2008    $448.98    N   Referral Required
7/1/2008    $483.41    N   Referral Required
7/1/2008    $605.52    N   Referral Required
7/1/2008    $613.43    N   Referral Required
7/1/2008    $739.49    N   Referral Required
1/1/2009    $743.56    N   Referral Required
7/1/2008    $792.17    N   Referral Required
7/1/2008    $819.22    N   Referral Required
7/1/2008    $948.55    N   Referral Required
7/1/2008    $834.89    N   Referral Required
7/1/2008    $276.04    N   Referral Required
7/1/2008    $570.06    N   Referral Required
1/1/2010    $324.86    N   Referral Required
1/1/2010    $516.82    N   Referral Required
1/1/2011    $431.93    N   Referral Required
7/1/2008    $390.29    N   Referral Required
7/1/2008    $825.99    N   Referral Required
7/1/2008    $291.32    N   Referral Required
7/1/2008    $456.84    N   Referral Required
7/1/2008    $563.57    N   Referral Required
1/1/2009    $827.60    N   Referral Required
1/1/2010   $1,270.21   N   Referral Required
7/1/2008    $354.90    N   Referral Required
7/1/2008    $370.87    N   Referral Required
7/1/2008    $409.35    N   Referral Required
7/1/2008    $670.16    N   Referral Required
7/1/2008    $849.52    N   Referral Required
7/1/2008    $703.46    N   Referral Required
7/1/2008    $758.33    N   Referral Required
1/1/2011   $1,899.70   N   Referral Required
7/1/2008   $1,340.23   N   Referral Required
7/1/2008   $2,254.66   N   Referral Required
7/1/2008    $842.94    N   Referral Required
7/1/2008    $403.00    N   Referral Required
7/1/2008    $205.11    N   Referral Required
7/1/2008    $523.74    N   Referral Required
7/1/2008    $695.49    N   Referral Required
7/1/2008   $1,332.51   N   Referral Required
1/1/2011    $167.83    N   Referral Required
1/1/2011    $203.50    N   Referral Required
1/1/2011    $159.34    N   Referral Required
7/1/2008    $550.12    N   Referral Required
7/1/2008    $525.78    N   Referral Required
7/1/2008    $679.59    N   Referral Required
7/1/2008    $707.69    N   Referral Required
7/1/2008    $789.02    N   Referral Required
7/1/2008    $742.22    N   Referral Required
7/1/2008   $1,077.48   N   Referral Required
7/1/2008    $926.67    N   Referral Required
7/1/2008    $937.75    Y   Referral Required
7/1/2008   $1,210.03   Y   Referral Required
7/1/2008   $1,417.29   Y   Referral Required
7/1/2008   $1,646.88   Y   Referral Required
7/1/2008   $1,254.88   Y   Referral Required
7/1/2008   $1,305.65   Y   Referral Required
7/1/2008    $753.64    N   Referral Required
7/1/2008   $1,065.25   N   Referral Required
7/1/2008   $1,223.45   N   Referral Required
7/1/2008   $1,224.42   N   Referral Required
7/1/2008   $1,450.44   N   Referral Required
7/1/2008   $1,136.52   N   Referral Required
7/1/2008   $1,026.11   N   Referral Required
7/1/2008   $1,140.55   N   Referral Required
7/1/2008    $990.81    N   Referral Required
7/1/2008    $536.87    N   Referral Required
7/1/2008    $757.88    N   Referral Required
7/1/2008    $927.29    N   Referral Required
7/1/2008    $741.87    N   Referral Required
7/1/2008    $816.89    N   Referral Required
7/1/2008    $898.76    N   Referral Required
1/1/2011    $567.18    N   Referral Required
7/1/2008    $835.28    N   Referral Required
7/1/2008    $381.15    N   Referral Required
7/1/2008    $607.52    N   Referral Required
7/1/2008    $139.91    N   Referral Required
7/1/2008    $626.52    N   Referral Required
7/1/2008    $615.65    N   Referral Required
7/1/2008    $890.40    N   Referral Required
7/1/2008    $850.70    N   Referral Required
7/1/2008   $1,147.76   N   Referral Required
7/1/2008    $429.02    N   Referral Required
7/1/2008    $818.98    N   Referral Required
7/1/2008    $845.04    N   Referral Required
7/1/2008   $1,402.96   N   Referral Required
7/1/2008   $1,607.70   N   Referral Required
7/1/2008    $383.40    N   Referral Required
7/1/2008    $648.11    N   Referral Required
7/1/2008    $763.21    N   Referral Required
7/1/2008    $990.09    N   Referral Required
7/1/2008    $369.73    N   Referral Required
7/1/2008    $794.45    N   Referral Required
7/1/2008    $974.76    N   Referral Required
1/1/2011   $1,116.39   N   Referral Required
7/1/2008    $314.09    N   Referral Required
7/1/2008    $635.09    N   Referral Required
1/1/2011    $199.13    N   Referral Required
7/1/2008    $630.22    N   Referral Required
7/1/2008    $793.79    N   Referral Required
7/1/2008   $1,067.63   N   Referral Required
7/1/2008    $251.97    N   Referral Required
7/1/2008    $281.95    N   Referral Required
7/1/2008    $927.90    N   Referral Required
7/1/2008   $1,292.57   N   Referral Required
7/1/2008    $329.57    N   Referral Required
7/1/2008    $479.50    N   Referral Required
1/1/2008    $344.28    N   Referral Required
1/1/2008    $424.19    N   Referral Required
1/1/2008   $1,014.59   N   Referral Required
7/1/2008    $150.42    N   Referral Required
7/1/2008    $853.99    Y   Referral Required
7/1/2008    $691.53    N   Referral Required
7/1/2008   $1,357.22   N   Referral Required
7/1/2008   $1,371.24   N   Referral Required
7/1/2008   $1,319.98   N   Referral Required
7/1/2008   $1,060.50   N   Referral Required
               $0.00   N   Referral Required
7/1/2008    $548.32    N   Referral Required
7/1/2008    $529.42    N   Referral Required
7/1/2008    $387.87    N   Referral Required
7/1/2008    $319.15    N   Referral Required
7/1/2008    $388.97    N   Referral Required
7/1/2008    $601.57    N   Referral Required
7/1/2008    $210.67    N   Referral Required
7/1/2008    $313.80    N   Referral Required
7/1/2008    $424.24    N   Referral Required
7/1/2008    $406.30    N   Referral Required
7/1/2008    $364.63    N   Referral Required
7/1/2008    $345.32    N   Referral Required
7/1/2008    $858.86    N   Referral Required
7/1/2008    $332.19    N   Referral Required
7/1/2008    $390.40    N   Referral Required
7/1/2008    $527.66    N   Referral Required
7/1/2008    $479.27    N   Referral Required
7/1/2008    $563.95    N   Referral Required
7/1/2008    $637.20    N   Referral Required
1/1/2010    $289.63    N   Referral Required
1/1/2010    $522.08    N   Referral Required
7/1/2008    $298.86    N   Referral Required
7/1/2008    $395.26    N   Referral Required
7/1/2008    $417.35    N   Referral Required
7/1/2008    $538.47    N   Referral Required
7/1/2008    $499.70    N   Referral Required
7/1/2008    $610.72    N   Referral Required
7/1/2008    $676.69    N   Referral Required
7/1/2008    $246.84    N   Referral Required
7/1/2008    $709.47    N   Referral Required
1/1/2010   $1,091.99   N   Referral Required
7/1/2008   $1,023.39   N   Referral Required
1/1/2011    $145.51    N   Referral Required
7/1/2008    $494.05    N   Referral Required
7/1/2008    $492.20    N   Referral Required
7/1/2008    $669.08    N   Referral Required
7/1/2008    $526.58    N   Referral Required
7/1/2008    $695.04    N   Referral Required
7/1/2008    $359.77    N   Referral Required
7/1/2008    $473.18    N   Referral Required
7/1/2008    $586.57    N   Referral Required
7/1/2008    $418.97    N   Referral Required
7/1/2008    $542.19    N   Referral Required
7/1/2008    $732.98    N   Referral Required
7/1/2008    $509.37    N   Referral Required
7/1/2008    $742.93    N   Referral Required
7/1/2008    $563.38    N   Referral Required
7/1/2008    $533.23    N   Referral Required
7/1/2008    $560.81    N   Referral Required
7/1/2008    $646.15    N   Referral Required
7/1/2008    $801.94    N   Referral Required
5/1/2009   $1,152.93   N   Referral Required
5/1/2009    $793.72    N   Referral Required
7/1/2008    $695.21    N   Referral Required
7/1/2008    $623.44    N   Referral Required
7/1/2008    $621.39    N   Referral Required
7/1/2008    $622.15    N   Referral Required
7/1/2008    $365.07    N   Referral Required
7/1/2008    $597.43    N   Referral Required
7/1/2008    $915.78    N   Referral Required
7/1/2008   $1,024.80   N   Referral Required
7/1/2008    $616.63    N   Referral Required
7/1/2008    $658.64    N   Referral Required
7/1/2008    $548.52    N   Referral Required
7/1/2008    $699.49    N   Referral Required
7/1/2008    $619.45    N   Referral Required
7/1/2008    $654.03    N   Referral Required
7/1/2008    $727.21    N   Referral Required
7/1/2008    $683.21    N   Referral Required
7/1/2008   $1,060.06   Y   Referral Required
7/1/2008    $941.90    Y   Referral Required
7/1/2008   $1,298.57   Y   Referral Required
7/1/2008    $687.77    N   Referral Required
7/1/2008    $855.47    N   Referral Required
7/1/2008   $1,083.35   N   Referral Required
7/1/2008    $790.56    N   Referral Required
7/1/2008    $814.65    N   Referral Required
7/1/2008   $1,008.08   N   Referral Required
7/1/2008    $992.63    N   Referral Required
7/1/2008   $1,120.35   N   Referral Required
7/1/2008    $988.68    N   Referral Required
7/1/2008   $1,070.74   N   Referral Required
7/1/2008    $545.71    N   Referral Required
7/1/2008    $608.67    N   Referral Required
1/1/2011    $773.34    N   Referral Required
7/1/2008    $558.76    N   Referral Required
7/1/2008   $1,185.13   Y   Referral Required
7/1/2008   $1,495.92   Y   Referral Required
7/1/2008   $1,002.20   N   Referral Required
7/1/2008    $952.43    N   Referral Required
7/1/2008    $418.54    N   Referral Required
7/1/2008    $453.96    N   Referral Required
7/1/2008    $495.87    N   Referral Required
7/1/2008    $553.84    N   Referral Required
7/1/2008    $419.60    N   Referral Required
7/1/2008    $412.31    N   Referral Required
7/1/2008    $661.05    N   Referral Required
7/1/2008    $667.06    N   Referral Required
7/1/2008   $1,112.22   N   Referral Required
7/1/2008    $828.78    N   Referral Required
7/1/2008    $425.09    N   Referral Required
7/1/2008    $536.30    N   Referral Required
7/1/2008    $580.51    N   Referral Required
7/1/2008    $869.61    N   Referral Required
7/1/2008   $1,094.98   N   Referral Required
7/1/2008    $896.50    N   Referral Required
7/1/2008    $399.76    N   Referral Required
7/1/2008    $556.05    N   Referral Required
7/1/2008    $804.90    N   Referral Required
7/1/2008    $251.35    N   Referral Required
7/1/2008    $630.49    N   Referral Required
7/1/2008    $314.84    N   Referral Required
7/1/2008    $502.63    N   Referral Required
7/1/2008    $776.45    N   Referral Required
7/1/2008    $992.82    N   Referral Required
7/1/2008    $376.57    N   Referral Required
7/1/2008    $699.74    N   Referral Required
7/1/2008    $397.75    N   Referral Required
7/1/2008    $513.09    N   Referral Required
7/1/2008    $794.57    N   Referral Required
7/1/2008    $945.40    N   Referral Required
7/1/2008   $1,043.58   N   Referral Required
7/1/2008    $289.35    N   Referral Required
7/1/2008    $370.91    N   Referral Required
7/1/2008    $750.21    N   Referral Required
7/1/2008    $121.47    N   Referral Required
7/1/2008   $1,215.58   N   Referral Required
7/1/2008    $693.09    N   Referral Required
7/1/2008    $769.09    N   Referral Required
7/1/2008    $585.57    N   Referral Required
7/1/2008    $424.91    N   Referral Required
7/1/2008    $617.44    N   Referral Required
7/1/2008    $623.69    N   Referral Required
               $0.00   N   Referral Required
7/1/2008    $354.37    N   Referral Required
7/1/2008    $364.90    N   Referral Required
7/1/2008    $436.70    N   Referral Required
7/1/2008    $428.42    N   Referral Required
7/1/2008    $374.21    N   Referral Required
1/1/2011    $308.08    N   Referral Required
7/1/2008    $251.92    N   Referral Required
7/1/2008    $508.40    N   Referral Required
7/1/2008    $547.56    N   Referral Required
7/1/2008    $478.21    N   Referral Required
7/1/2008    $196.43    N   Referral Required
7/1/2008    $454.99    N   Referral Required
7/1/2008    $747.11    N   Referral Required
1/1/2010    $891.29    N   Referral Required
1/1/2011    $377.82    N   Referral Required
1/1/2011    $453.96    N   Referral Required
7/1/2008    $388.58    N   Referral Required
7/1/2008    $504.59    N   Referral Required
7/1/2008    $541.32    N   Referral Required
7/1/2008    $435.96    N   Referral Required
1/1/2010    $286.70    N   Referral Required
1/1/2010    $468.65    N   Referral Required
7/1/2008    $496.94    N   Referral Required
7/1/2008    $626.44    N   Referral Required
7/1/2008    $655.63    N   Referral Required
7/1/2008    $738.61    N   Referral Required
7/1/2008    $595.10    N   Referral Required
7/1/2008    $888.97    N   Referral Required
7/1/2008    $793.80    N   Referral Required
7/1/2008    $700.88    N   Referral Required
7/1/2008    $140.66    N   Referral Required
7/1/2008    $591.75    N   Referral Required
7/1/2008    $631.19    N   Referral Required
7/1/2008    $595.50    N   Referral Required
7/1/2008    $443.41    N   Referral Required
7/1/2008    $324.57    N   Referral Required
7/1/2008    $427.53    N   Referral Required
7/1/2008    $311.05    N   Referral Required
7/1/2008    $355.29    N   Referral Required
7/1/2008    $437.96    N   Referral Required
7/1/2008    $522.98    N   Referral Required
7/1/2008    $366.76    N   Referral Required
7/1/2008    $438.45    N   Referral Required
7/1/2008    $507.24    N   Referral Required
7/1/2008    $476.45    N   Referral Required
7/1/2008    $393.91    N   Referral Required
7/1/2008    $521.35    N   Referral Required
7/1/2008    $616.47    N   Referral Required
7/1/2008      $96.30   N   Referral Required
7/1/2008    $420.02    N   Referral Required
7/1/2008    $503.30    N   Referral Required
7/1/2008    $560.27    N   Referral Required
7/1/2008    $526.52    N   Referral Required
7/1/2008    $843.04    N   Referral Required
7/1/2008    $966.72    N   Referral Required
7/1/2008    $469.21    N   Referral Required
7/1/2008    $647.34    N   Referral Required
7/1/2008    $328.16    N   Referral Required
7/1/2008    $915.91    N   Referral Required
7/1/2008    $909.81    N   Referral Required
7/1/2008    $893.57    N   Referral Required
7/1/2008    $738.12    N   Referral Required
7/1/2008    $736.02    N   Referral Required
7/1/2008   $1,081.67   N   Referral Required
7/1/2008   $1,002.26   N   Referral Required
1/1/2008    $759.56    N   Referral Required
7/1/2008    $863.28    N   Referral Required
7/1/2008    $483.21    N   Referral Required
7/1/2008    $346.62    N   Referral Required
7/1/2008    $526.08    N   Referral Required
7/1/2008    $592.82    N   Referral Required
7/1/2008    $555.69    N   Referral Required
7/1/2008    $634.15    N   Referral Required
7/1/2008    $271.26    N   Referral Required
7/1/2008    $435.86    N   Referral Required
7/1/2008    $471.80    N   Referral Required
7/1/2008    $742.02    N   Referral Required
7/1/2008    $842.37    N   Referral Required
7/1/2008    $262.21    N   Referral Required
7/1/2008    $392.00    N   Referral Required
7/1/2008    $509.67    N   Referral Required
1/1/2008    $210.28    N   Referral Required
1/1/2008    $326.09    N   Referral Required
1/1/2008    $566.01    N   Referral Required
7/1/2008    $233.34    N   Referral Required
7/1/2008    $337.12    N   Referral Required
7/1/2008    $564.42    N   Referral Required
7/1/2008    $248.39    N   Referral Required
7/1/2008    $342.84    N   Referral Required
7/1/2008    $575.33    N   Referral Required
7/1/2008    $259.74    N   Referral Required
7/1/2008    $384.57    N   Referral Required
7/1/2008    $649.78    N   Referral Required
7/1/2008    $247.39    N   Referral Required
7/1/2008    $398.76    N   Referral Required
7/1/2008    $721.01    N   Referral Required
7/1/2008    $819.02    N   Referral Required
7/1/2008    $244.76    N   Referral Required
7/1/2008    $447.23    N   Referral Required
7/1/2008    $678.65    N   Referral Required
7/1/2008    $917.76    N   Referral Required
7/1/2008   $1,089.96   N   Referral Required
7/1/2008    $537.48    N   Referral Required
7/1/2008    $280.86    N   Referral Required
7/1/2008    $311.05    N   Referral Required
7/1/2008    $572.03    N   Referral Required
7/1/2008    $288.32    N   Referral Required
7/1/2008    $397.72    N   Referral Required
7/1/2008    $618.67    N   Referral Required
7/1/2008    $709.12    N   Referral Required
7/1/2008    $148.04    N   Referral Required
7/1/2008    $882.42    N   Referral Required
7/1/2008    $581.95    N   Referral Required
7/1/2008    $774.52    N   Referral Required
7/1/2008    $755.57    N   Referral Required
7/1/2008    $539.24    N   Referral Required
7/1/2008    $494.24    N   Referral Required
7/1/2008    $560.87    N   Referral Required
7/1/2008    $597.46    N   Referral Required
7/1/2008    $586.20    N   Referral Required
7/1/2008    $461.87    N   Referral Required
7/1/2008    $458.67    N   Referral Required
7/1/2008    $700.33    N   Referral Required
               $0.00   N   Referral Required
7/1/2008    $214.90    N   Referral Required
7/1/2008   $399.99   N   Referral Required
7/1/2008   $555.34   N   Referral Required
7/1/2008   $527.20   N   Referral Required
7/1/2008   $340.51   N   Referral Required
7/1/2008   $191.01   N   Referral Required
7/1/2008   $270.22   N   Referral Required
7/1/2008   $406.79   N   Referral Required
7/1/2008   $372.44   N   Referral Required
7/1/2008   $356.10   N   Referral Required
7/1/2008   $405.07   N   Referral Required
1/1/2010   $331.22   N   Referral Required
1/1/2010   $315.00   N   Referral Required
7/1/2008   $272.20   N   Referral Required
7/1/2008   $378.82   N   Referral Required
1/1/2011   $684.13   N   Referral Required
1/1/2010   $670.75   N   Referral Required
7/1/2008   $353.29   N   Referral Required
7/1/2008   $330.57   N   Referral Required
7/1/2008   $308.86   N   Referral Required
7/1/2008   $340.49   N   Referral Required
7/1/2008   $400.34   N   Referral Required
7/1/2008   $475.55   N   Referral Required
7/1/2008   $396.68   N   Referral Required
7/1/2008   $386.88   N   Referral Required
7/1/2008   $377.92   N   Referral Required
7/1/2008   $440.92   N   Referral Required
7/1/2008   $355.12   N   Referral Required
7/1/2008   $359.77   N   Referral Required
7/1/2008   $327.96   N   Referral Required
7/1/2008   $475.49   N   Referral Required
7/1/2008   $463.53   N   Referral Required
7/1/2008   $381.61   N   Referral Required
7/1/2008   $398.82   N   Referral Required
7/1/2008   $405.55   N   Referral Required
7/1/2008   $439.84   N   Referral Required
7/1/2008   $333.90   N   Referral Required
7/1/2008   $351.44   N   Referral Required
7/1/2008   $405.83   N   Referral Required
7/1/2008   $380.83   N   Referral Required
7/1/2008   $449.84   N   Referral Required
7/1/2008   $833.68   N   Referral Required
7/1/2008   $590.28   N   Referral Required
7/1/2008   $454.41   N   Referral Required
7/1/2008   $407.01   N   Referral Required
7/1/2008   $460.53   N   Referral Required
7/1/2008   $527.56   N   Referral Required
7/1/2008   $371.38   N   Referral Required
7/1/2008    $297.61    N   Referral Required
7/1/2008    $550.79    N   Referral Required
7/1/2008    $504.18    N   Referral Required
7/1/2008    $335.95    N   Referral Required
7/1/2008    $308.99    N   Referral Required
7/1/2008    $318.04    N   Referral Required
7/1/2008    $533.71    N   Referral Required
7/1/2008    $597.13    N   Referral Required
7/1/2008    $435.25    N   Referral Required
7/1/2008    $193.91    N   Referral Required
7/1/2008    $372.44    N   Referral Required
7/1/2008    $424.01    N   Referral Required
7/1/2008    $367.24    N   Referral Required
7/1/2008    $500.70    N   Referral Required
7/1/2008    $351.05    N   Referral Required
7/1/2008    $461.12    N   Referral Required
7/1/2008    $349.18    N   Referral Required
7/1/2008    $406.38    N   Referral Required
7/1/2008    $304.75    N   Referral Required
7/1/2008    $359.38    N   Referral Required
7/1/2008    $336.56    N   Referral Required
7/1/2008    $297.90    N   Referral Required
7/1/2008    $306.24    N   Referral Required
7/1/2008    $544.28    N   Referral Required
7/1/2008    $341.61    N   Referral Required
7/1/2008    $435.82    N   Referral Required
7/1/2008    $539.45    N   Referral Required
7/1/2008    $784.58    N   Referral Required
7/1/2008   $1,105.51   N   Referral Required
7/1/2008    $683.67    N   Referral Required
7/1/2008    $370.14    N   Referral Required
7/1/2008    $304.65    N   Referral Required
7/1/2008    $415.36    N   Referral Required
7/1/2008    $360.19    N   Referral Required
7/1/2008    $354.33    N   Referral Required
7/1/2008    $449.94    N   Referral Required
7/1/2008    $581.97    N   Referral Required
7/1/2008    $448.46    N   Referral Required
7/1/2008    $607.11    N   Referral Required
7/1/2008    $814.35    N   Referral Required
7/1/2008    $592.15    N   Referral Required
1/1/2011    $627.35    N   Referral Required
7/1/2008    $661.42    N   Referral Required
7/1/2008    $564.10    N   Referral Required
7/1/2008    $730.40    N   Referral Required
7/1/2008    $569.74    N   Referral Required
7/1/2008    $568.17    N   Referral Required
7/1/2008    $627.67    N   Referral Required
7/1/2008    $589.54    N   Referral Required
7/1/2008    $468.62    N   Referral Required
7/1/2008    $570.22    N   Referral Required
7/1/2008    $420.98    N   Referral Required
7/1/2008    $768.04    N   Referral Required
7/1/2008    $419.16    N   Referral Required
7/1/2008    $380.11    N   Referral Required
7/1/2008    $393.30    N   Referral Required
7/1/2008    $369.71    N   Referral Required
7/1/2008    $544.50    N   Referral Required
7/1/2008    $622.04    N   Referral Required
7/1/2008    $494.69    N   Referral Required
7/1/2008    $566.79    N   Referral Required
7/1/2008    $357.30    N   Referral Required
7/1/2008    $446.50    N   Referral Required
7/1/2008    $197.71    N   Referral Required
7/1/2008    $323.77    N   Referral Required
7/1/2008    $443.28    N   Referral Required
7/1/2008    $978.67    N   Referral Required
7/1/2008   $1,020.60   N   Referral Required
7/1/2008    $186.27    N   Referral Required
7/1/2008    $257.38    N   Referral Required
7/1/2008    $353.60    N   Referral Required
7/1/2008    $912.67    N   Referral Required
5/1/2009    $979.23    N   Referral Required
7/1/2008    $171.60    N   Referral Required
7/1/2008    $233.32    N   Referral Required
7/1/2008    $232.00    N   Referral Required
7/1/2008    $517.31    N   Referral Required
7/1/2008    $171.12    N   Referral Required
7/1/2008    $215.93    N   Referral Required
7/1/2008    $281.59    N   Referral Required
7/1/2008    $443.78    N   Referral Required
7/1/2008    $108.77    N   Referral Required
7/1/2008    $135.68    N   Referral Required
7/1/2008    $348.08    N   Referral Required
7/1/2008    $531.06    N   Referral Required
7/1/2008      $94.09   N   Referral Required
7/1/2008    $122.43    N   Referral Required
7/1/2008    $453.44    N   Referral Required
7/1/2008      $89.90   N   Referral Required
7/1/2008    $321.19    N   Referral Required
7/1/2008    $161.49    N   Referral Required
7/1/2008    $187.64    N   Referral Required
7/1/2008    $369.87    N   Referral Required
7/1/2008    $683.87    N   Referral Required
7/1/2008    $143.59    N   Referral Required
7/1/2008    $259.96    N   Referral Required
7/1/2008    $301.04    N   Referral Required
7/1/2008    $705.49    N   Referral Required
7/1/2008    $167.69    N   Referral Required
7/1/2008    $218.04    N   Referral Required
7/1/2008    $329.24    N   Referral Required
7/1/2008    $645.45    N   Referral Required
7/1/2008    $118.37    N   Referral Required
7/1/2008    $141.43    N   Referral Required
7/1/2008    $238.92    N   Referral Required
7/1/2008    $476.86    N   Referral Required
7/1/2008      $87.08   N   Referral Required
7/1/2008    $124.46    N   Referral Required
7/1/2008    $171.05    N   Referral Required
7/1/2008    $448.34    N   Referral Required
7/1/2008   $1,119.10   N   Referral Required
7/1/2008    $828.55    N   Referral Required
7/1/2008    $688.28    N   Referral Required
7/1/2008    $712.92    N   Referral Required
7/1/2008    $682.42    N   Referral Required
7/1/2008    $606.21    N   Referral Required
7/1/2008    $690.60    N   Referral Required
7/1/2008    $680.57    N   Referral Required
7/1/2008    $395.98    N   Referral Required
7/1/2008    $617.35    N   Referral Required
7/1/2008    $492.29    N   Referral Required
7/1/2008    $635.84    N   Referral Required
7/1/2008    $377.46    N   Referral Required
7/1/2008    $429.34    N   Referral Required
7/1/2008    $369.62    N   Referral Required
7/1/2008    $292.04    N   Referral Required
               $0.00   N   Referral Required
7/1/2008    $199.66    N   Referral Required
7/1/2008    $205.29    N   Referral Required
7/1/2008    $195.84    N   Referral Required
7/1/2008    $192.95    N   Referral Required
7/1/2008    $208.52    N   Referral Required
7/1/2008    $186.86    N   Referral Required
7/1/2008    $176.88    N   Referral Required
7/1/2008    $203.67    N   Referral Required
7/1/2008    $217.53    N   Referral Required
7/1/2008      $72.55   N   Referral Required
7/1/2008    $162.27    N   Referral Required
7/1/2008      $94.08   N   Referral Required
7/1/2008      $75.56   N   Referral Required
7/1/2008      $70.08   N   Referral Required
7/1/2008    $74.37   N   Referral Required
7/1/2008    $56.31   N   Referral Required
7/1/2008    $70.31   N   Referral Required
7/1/2008    $54.17   N   Referral Required
7/1/2008    $64.27   N   Referral Required
7/1/2008    $32.91   N   Referral Required
7/1/2008    $40.87   N   Referral Required
7/1/2008    $44.49   N   Referral Required
7/1/2008    $50.49   N   Referral Required
7/1/2008    $42.92   N   Referral Required
7/1/2008    $42.07   N   Referral Required
7/1/2008   $185.28   N   Referral Required
7/1/2008   $199.75   N   Referral Required
7/1/2008   $108.80   N   Referral Required
7/1/2008   $111.75   N   Referral Required
7/1/2008   $120.81   N   Referral Required
7/1/2008    $97.47   N   Referral Required
7/1/2008    $71.98   N   Referral Required
7/1/2008    $77.79   N   Referral Required
7/1/2008    $94.80   N   Referral Required
7/1/2008    $42.92   N   Referral Required
7/1/2008   $120.99   N   Referral Required
7/1/2008   $125.89   N   Referral Required
7/1/2008    $62.46   N   Referral Required
7/1/2008    $56.45   N   Referral Required
7/1/2008    $43.88   N   Referral Required
7/1/2008    $44.02   N   Referral Required
7/1/2008    $34.30   N   Referral Required
7/1/2008    $33.11   N   Referral Required
7/1/2008    $42.30   N   Referral Required
1/1/2010    $61.02   N   Referral Required
7/1/2008    $45.58   N   Referral Required
7/1/2008    $51.26   N   Referral Required
7/1/2008    $54.35   N   Referral Required
7/1/2008    $96.46   N   Referral Required
7/1/2008    $73.03   N   Referral Required
7/1/2008    $63.84   N   Referral Required
7/1/2008    $53.11   N   Referral Required
7/1/2008    $77.50   N   Referral Required
7/1/2008    $81.64   N   Referral Required
             $0.00   N   Referral Required
7/1/2008   $438.22   N   Referral Required
7/1/2008   $540.61   N   Referral Required
7/1/2008   $391.78   N   Referral Required
7/1/2008   $891.15   N   Referral Required
7/1/2008   $868.67   N   Referral Required
7/1/2008   $489.80   N   Referral Required
7/1/2008    $452.21    N   Referral Required
7/1/2008    $494.08    N   Referral Required
7/1/2008    $480.61    N   Referral Required
7/1/2008    $524.90    N   Referral Required
7/1/2008    $557.53    N   Referral Required
7/1/2008    $489.46    N   Referral Required
7/1/2008    $561.95    N   Referral Required
7/1/2008    $916.82    N   Referral Required
1/1/2008    $750.34    N   Referral Required
7/1/2008    $377.63    N   Referral Required
7/1/2008    $411.21    N   Referral Required
7/1/2008    $421.69    N   Referral Required
7/1/2008    $484.27    N   Referral Required
7/1/2008    $441.45    N   Referral Required
7/1/2008    $494.80    N   Referral Required
7/1/2008    $369.54    N   Referral Required
7/1/2008    $395.07    N   Referral Required
7/1/2008    $413.50    N   Referral Required
7/1/2008    $474.41    N   Referral Required
7/1/2008    $435.02    N   Referral Required
7/1/2008    $451.26    N   Referral Required
7/1/2008    $406.98    N   Referral Required
7/1/2008    $460.85    N   Referral Required
7/1/2008    $784.13    N   Referral Required
7/1/2008    $658.50    N   Referral Required
7/1/2008    $842.43    N   Referral Required
7/1/2008    $542.80    N   Referral Required
7/1/2008    $593.13    N   Referral Required
7/1/2008    $668.02    N   Referral Required
7/1/2008    $661.88    N   Referral Required
5/1/2009    $878.64    N   Referral Required
5/1/2009   $1,067.61   N   Referral Required
5/1/2009   $1,428.37   N   Referral Required
7/1/2008    $338.72    N   Referral Required
7/1/2008    $425.50    N   Referral Required
7/1/2008    $427.14    N   Referral Required
7/1/2008    $445.35    N   Referral Required
7/1/2008    $413.21    N   Referral Required
7/1/2008    $539.14    N   Referral Required
7/1/2008    $510.04    N   Referral Required
7/1/2008    $545.66    N   Referral Required
7/1/2008    $570.14    N   Referral Required
7/1/2008    $531.23    N   Referral Required
7/1/2008    $573.99    N   Referral Required
7/1/2008    $703.93    N   Referral Required
7/1/2008    $508.08    N   Referral Required
7/1/2008    $616.63    N   Referral Required
7/1/2008    $519.51    N   Referral Required
7/1/2008    $613.25    N   Referral Required
7/1/2008    $828.55    N   Referral Required
7/1/2008   $1,012.93   N   Referral Required
7/1/2008    $580.33    N   Referral Required
7/1/2008    $600.57    N   Referral Required
7/1/2008    $468.00    N   Referral Required
7/1/2008    $435.43    N   Referral Required
7/1/2008    $424.10    N   Referral Required
7/1/2008    $443.39    N   Referral Required
7/1/2008    $496.30    N   Referral Required
7/1/2008    $885.52    N   Referral Required
7/1/2008    $386.07    N   Referral Required
7/1/2008    $426.03    N   Referral Required
7/1/2008    $444.55    N   Referral Required
1/1/2008    $505.59    N   Referral Required
1/1/2008    $544.70    N   Referral Required
1/1/2008    $573.66    N   Referral Required
1/1/2008    $701.34    N   Referral Required
               $0.00   Y   Referral Required
7/1/2008    $185.83    N   Referral Required
7/1/2008    $175.15    N   Referral Required
7/1/2008    $109.02    N   Referral Required
7/1/2008    $177.00    N   Referral Required
7/1/2008    $351.01    N   Referral Required
7/1/2008    $634.84    N   Referral Required
7/1/2008    $640.20    N   Referral Required
7/1/2008    $414.69    N   Referral Required
7/1/2008    $232.04    N   Referral Required
7/1/2008    $516.43    N   Referral Required
7/1/2008    $307.67    N   Referral Required
7/1/2008    $345.08    N   Referral Required
7/1/2008    $668.86    N   Referral Required
7/1/2008    $666.74    N   Referral Required
7/1/2008      $88.15   N   Referral Required
7/1/2008    $115.73    N   Referral Required
7/1/2008    $222.29    N   Referral Required
7/1/2008    $185.75    N   Referral Required
7/1/2008    $169.74    N   Referral Required
7/1/2008    $384.08    N   Referral Required
3/1/2009    $865.56    Y   Referral Required
3/1/2009   $1,049.65   Y   Referral Required
3/1/2009   $1,148.59   Y   Referral Required
3/1/2009    $770.11    Y   Referral Required
3/1/2009   $1,021.20   Y   Referral Required
3/1/2009   $1,334.93   Y   Referral Required
3/1/2009    $654.10    Y   Referral Required
7/1/2008   $1,305.81   Y   Referral Required
3/1/2009    $813.93    Y   Referral Required
3/1/2009    $483.99    Y   Referral Required
7/1/2008    $572.41    N   Referral Required
7/1/2008    $802.07    N   Referral Required
7/1/2008    $212.76    N   Referral Required
7/1/2008    $509.15    N   Referral Required
7/1/2008    $470.66    N   Referral Required
7/1/2008    $505.75    N   Referral Required
7/1/2008    $513.90    N   Referral Required
7/1/2008    $179.84    N   Referral Required
7/1/2008    $231.80    N   Referral Required
7/1/2008      $86.89   N   Referral Required
7/1/2008    $154.37    N   Referral Required
7/1/2008    $193.58    N   Referral Required
7/1/2008    $222.54    N   Referral Required
7/1/2008    $477.39    N   Referral Required
7/1/2008    $684.34    N   Referral Required
7/1/2008      $99.71   N   Referral Required
               $0.00   N   Referral Required
7/1/2008    $142.04    N   Referral Required
7/1/2008    $166.70    N   Referral Required
7/1/2008    $391.62    N   Referral Required
7/1/2008    $576.67    N   Referral Required
7/1/2008    $470.46    N   Referral Required
7/1/2008    $627.62    N   Referral Required
7/1/2008    $402.11    N   Referral Required
7/1/2008    $529.39    N   Referral Required
7/1/2008    $354.15    N   Referral Required
7/1/2008    $647.60    N   Referral Required
7/1/2008    $846.94    N   Referral Required
7/1/2008   $1,006.39   N   Referral Required
7/1/2008    $957.82    N   Referral Required
7/1/2008   $1,024.70   N   Referral Required
7/1/2008    $930.39    N   Referral Required
7/1/2008    $913.69    N   Referral Required
7/1/2008    $816.18    N   Referral Required
7/1/2008    $452.17    N   Referral Required
7/1/2008    $603.79    N   Referral Required
7/1/2008    $720.92    N   Referral Required
7/1/2008   $1,513.16   N   Referral Required
7/1/2008   $1,707.42   N   Referral Required
7/1/2008    $155.10    N   Referral Required
7/1/2008    $219.73    N   Referral Required
7/1/2008    $252.79    N   Referral Required
7/1/2008    $273.61    N   Referral Required
7/1/2008    $282.27    N   Referral Required
7/1/2008    $562.01    N   Referral Required
7/1/2008    $142.22    N   Referral Required
7/1/2008    $244.09    N   Referral Required
7/1/2008    $360.43    N   Referral Required
7/1/2008    $176.79    N   Referral Required
7/1/2008    $213.34    N   Referral Required
7/1/2008    $330.68    N   Referral Required
7/1/2008    $285.04    N   Referral Required
7/1/2008    $117.35    N   Referral Required
7/1/2008    $320.01    N   Referral Required
7/1/2008    $454.30    N   Referral Required
7/1/2008    $207.51    N   Referral Required
7/1/2008    $240.61    N   Referral Required
7/1/2008    $999.09    N   Referral Required
7/1/2008   $1,051.95   N   Referral Required
7/1/2008    $864.07    N   Referral Required
7/1/2008    $941.70    N   Referral Required
7/1/2008   $1,083.05   N   Referral Required
               $0.00   N   Referral Required
7/1/2008   $1,042.48   N   Referral Required
7/1/2008    $538.61    N   Referral Required
7/1/2008   $1,632.30   N   Referral Required
7/1/2008   $2,051.76   N   Referral Required
7/1/2008   $1,788.98   N   Referral Required
7/1/2008   $2,013.57   N   Referral Required
7/1/2008   $1,688.01   N   Referral Required
7/1/2008   $1,587.40   N   Referral Required
7/1/2008   $1,569.83   N   Referral Required
7/1/2008   $1,718.52   N   Referral Required
7/1/2008   $2,297.27   N   Referral Required
7/1/2008   $2,453.22   N   Referral Required
7/1/2008    $839.27    N   Referral Required
7/1/2008    $698.15    N   Referral Required
7/1/2008      $97.33   N   Referral Required
7/1/2008      $31.00   N   Referral Required
7/1/2008      $69.56   N   Referral Required
7/1/2008    $176.18    N   Referral Required
7/1/2008    $177.08    N   Referral Required
7/1/2008    $175.84    N   Referral Required
7/1/2008    $116.07    N   Referral Required
7/1/2008    $175.66    N   Referral Required
7/1/2008    $135.55    N   Referral Required
7/1/2008    $210.80    N   Referral Required
7/1/2008    $139.45    N   Referral Required
7/1/2008    $169.36    N   Referral Required
7/1/2008    $125.59    N   Referral Required
7/1/2008    $143.45    N   Referral Required
7/1/2008    $175.74    N   Referral Required
7/1/2008    $189.89    N   Referral Required
7/1/2008    $168.22    N   Referral Required
7/1/2008    $188.46    N   Referral Required
7/1/2008    $216.27    N   Referral Required
7/1/2008    $236.70    N   Referral Required
7/1/2008    $318.19    N   Referral Required
7/1/2008    $481.39    N   Referral Required
7/1/2008    $279.42    N   Referral Required
7/1/2008    $305.14    N   Referral Required
7/1/2008    $301.22    N   Referral Required
7/1/2008    $223.23    N   Referral Required
7/1/2008      $98.71   N   Referral Required
7/1/2008    $188.33    N   Referral Required
7/1/2008    $206.14    N   Referral Required
7/1/2008    $237.73    N   Referral Required
7/1/2008    $189.99    N   Referral Required
7/1/2008   $1,000.35   N   Referral Required
7/1/2008   $1,607.67   N   Referral Required
7/1/2008   $1,273.12   N   Referral Required
7/1/2008    $824.35    N   Referral Required
7/1/2008    $946.44    N   Referral Required
7/1/2008    $744.71    N   Referral Required
7/1/2008    $643.58    N   Referral Required
               $0.00   N   Referral Required
7/1/2008    $346.98    N   Referral Required
7/1/2008    $225.60    N   Referral Required
7/1/2008    $195.77    N   Referral Required
7/1/2008    $160.57    N   Referral Required
7/1/2008    $593.51    N   Referral Required
7/1/2008    $443.08    N   Referral Required
7/1/2008      $68.36   N   Referral Required
7/1/2008    $365.91    N   Referral Required
7/1/2008    $600.46    N   Referral Required
7/1/2008    $156.20    N   Referral Required
7/1/2008    $243.46    N   Referral Required
7/1/2008    $278.58    N   Referral Required
7/1/2008    $306.07    N   Referral Required
7/1/2008    $284.72    N   Referral Required
7/1/2008    $304.67    N   Referral Required
1/1/2010    $301.52    N   Referral Required
1/1/2010    $813.16    N   Referral Required
7/1/2008    $364.24    N   Referral Required
1/1/2011    $558.29    N   Referral Required
7/1/2008    $183.78    N   Referral Required
7/1/2008    $205.78    N   Referral Required
7/1/2008      $65.78   N   Referral Required
7/1/2008      $78.92   N   Referral Required
7/1/2008    $316.43    N   Referral Required
7/1/2008    $201.97    N   Referral Required
7/1/2008      $71.43   N   Referral Required
7/1/2008    $226.68    N   Referral Required
7/1/2008    $234.11    N   Referral Required
7/1/2008    $231.40    N   Referral Required
7/1/2008    $158.44    N   Referral Required
7/1/2008    $273.41    N   Referral Required
7/1/2008    $248.88    N   Referral Required
7/1/2008    $292.14    N   Referral Required
7/1/2008      $48.67   N   Referral Required
7/1/2008    $309.11    N   Referral Required
7/1/2008      $46.76   N   Referral Required
7/1/2008      $84.91   N   Referral Required
7/1/2008    $565.70    N   Referral Required
7/1/2008   $1,113.81   N   Referral Required
7/1/2008   $1,410.95   N   Referral Required
7/1/2008   $1,181.61   N   Referral Required
7/1/2008   $1,568.52   N   Referral Required
7/1/2008   $1,155.01   N   Referral Required
7/1/2008   $1,235.09   N   Referral Required
7/1/2008   $1,023.54   N   Referral Required
7/1/2008   $1,237.20   N   Referral Required
7/1/2008    $941.80    N   Referral Required
7/1/2008   $1,291.58   N   Referral Required
7/1/2008    $585.88    N   Referral Required
7/1/2008    $706.58    N   Referral Required
7/1/2008    $352.91    N   Referral Required
7/1/2008    $496.56    N   Referral Required
7/1/2008    $355.91    N   Referral Required
               $0.00   N   Referral Required
7/1/2008    $598.72    N   Referral Required
7/1/2008    $649.20    N   Referral Required
7/1/2008    $535.51    N   Referral Required
7/1/2008    $829.53    N   Referral Required
7/1/2008   $1,248.93   N   Referral Required
7/1/2008    $741.01    N   Referral Required
7/1/2008    $786.91    N   Referral Required
7/1/2008    $844.01    N   Referral Required
7/1/2008   $1,242.97   N   Referral Required
7/1/2008    $850.77    N   Referral Required
7/1/2008    $868.50    N   Referral Required
7/1/2008    $647.31    N   Referral Required
7/1/2008    $950.36    N   Referral Required
7/1/2008    $815.22    N   Referral Required
7/1/2008    $685.20    N   Referral Required
7/1/2008   $1,368.94   N   Referral Required
7/1/2008    $849.25    N   Referral Required
7/1/2008    $670.17    N   Referral Required
7/1/2008    $141.84    N   Referral Required
7/1/2008    $785.44    N   Referral Required
7/1/2008   $1,367.92   N   Referral Required
7/1/2008    $132.34    N   Referral Required
7/1/2008    $482.08    N   Referral Required
7/1/2008      $89.53   N   Referral Required
7/1/2008      $98.77   N   Referral Required
1/1/2011    $143.18    N   Referral Required
1/1/2008    $177.55    N   Referral Required
7/1/2008   $1,379.06   N   Referral Required
7/1/2008   $2,522.81   N   Referral Required
7/1/2008   $2,819.00   N   Referral Required
7/1/2008   $1,300.29   N   Referral Required
7/1/2008   $1,385.44   N   Referral Required
7/1/2008   $1,256.13   N   Referral Required
7/1/2008   $1,967.63   N   Referral Required
7/1/2008   $1,998.98   N   Referral Required
7/1/2008   $1,260.92   N   Referral Required
7/1/2008    $217.34    N   Referral Required
7/1/2008   $1,596.84   N   Referral Required
7/1/2008   $1,821.13   N   Referral Required
7/1/2008   $1,405.43   N   Referral Required
1/1/2011    $706.66    N   Referral Required
1/1/2008    $157.34    N   Referral Required
1/1/2010    $127.61    N   Referral Required
1/1/2010    $406.78    N   Referral Required
1/1/2011    $236.57    N   Referral Required
1/1/2010      $67.02   N   Referral Required
1/1/2010      $59.58   N   Referral Required
7/1/2008    $271.79    N   Referral Required
7/1/2008    $295.22    N   Referral Required
7/1/2008    $379.79    N   Referral Required
7/1/2008    $426.27    N   Referral Required
7/1/2008    $342.41    N   Referral Required
7/1/2008    $409.79    N   Referral Required
7/1/2008    $591.34    N   Referral Required
7/1/2008    $912.13    N   Referral Required
7/1/2008   $1,379.73   N   Referral Required
7/1/2008    $883.61    N   Referral Required
7/1/2008    $975.18    N   Referral Required
7/1/2008    $811.43    N   Referral Required
7/1/2008    $710.25    N   Referral Required
7/1/2008    $697.11    N   Referral Required
7/1/2008    $637.68    N   Referral Required
7/1/2008    $649.68    N   Referral Required
7/1/2008    $918.13    N   Referral Required
7/1/2008    $712.87    N   Referral Required
7/1/2008    $799.84    N   Referral Required
7/1/2008   $1,212.12   N   Referral Required
7/1/2008    $742.09    N   Referral Required
7/1/2008   $1,039.19   N   Referral Required
7/1/2008    $800.05    N   Referral Required
7/1/2008    $776.25    N   Referral Required
7/1/2008   $2,226.03   N   Referral Required
7/1/2008   $1,176.32   N   Referral Required
               $0.00   Y   Referral Required
7/1/2008   $2,322.75   Y   Referral Required
7/1/2008   $2,569.04   Y   Referral Required
7/1/2008   $2,779.32   Y   Referral Required
7/1/2008   $3,024.93   Y   Referral Required
7/1/2008    $164.95    Y   Referral Required
7/1/2008    $164.95    Y   Referral Required
7/1/2008   $1,175.12   N   Referral Required
7/1/2008   $1,165.46   N   Referral Required
7/1/2008   $1,439.99   N   Referral Required
7/1/2008   $1,066.83   N   Referral Required
7/1/2008    $120.80    N   Referral Required
7/1/2008    $318.48    N   Referral Required
1/1/2011   $2,516.18   N   Referral Required
               $0.00   N   Referral Required
7/1/2008    $108.06    N   Referral Required
7/1/2008    $110.25    N   Referral Required
7/1/2008    $463.85    N   Referral Required
7/1/2008    $752.37    N   Referral Required
7/1/2008    $695.80    N   Referral Required
7/1/2008   $1,112.26   N   Referral Required
7/1/2008   $1,235.68   N   Referral Required
7/1/2008    $860.06    N   Referral Required
7/1/2008   $1,356.89   N   Referral Required
7/1/2008   $1,189.30   N   Referral Required
7/1/2008   $1,356.11   N   Referral Required
1/1/2011    $134.15    N   Referral Required
7/1/2008    $676.47    N   Referral Required
7/1/2008    $697.94    N   Referral Required
7/1/2008    $415.00    N   Referral Required
7/1/2008    $444.19    N   Referral Required
7/1/2008    $477.00    N   Referral Required
7/1/2008    $162.97    N   Referral Required
7/1/2008    $166.26    N   Referral Required
7/1/2008    $310.69    N   Referral Required
7/1/2008    $354.31    N   Referral Required
7/1/2008    $443.10    N   Referral Required
7/1/2008    $282.30    N   Referral Required
7/1/2008    $347.66    N   Referral Required
7/1/2008    $345.76    N   Referral Required
7/1/2008    $359.52    N   Referral Required
7/1/2008    $361.19    N   Referral Required
7/1/2008    $319.43    N   Referral Required
7/1/2008    $384.57    N   Referral Required
7/1/2008    $461.93    N   Referral Required
7/1/2008    $414.91    N   Referral Required
7/1/2008    $445.02    N   Referral Required
7/1/2008    $224.89    N   Referral Required
7/1/2008    $447.34    N   Referral Required
7/1/2008    $581.33    N   Referral Required
7/1/2008    $686.64    N   Referral Required
7/1/2008    $755.09    N   Referral Required
7/1/2008    $822.56    N   Referral Required
7/1/2008    $427.14    N   Referral Required
7/1/2008    $212.16    N   Referral Required
7/1/2008   $1,199.02   N   Referral Required
7/1/2008    $789.08    N   Referral Required
7/1/2008    $827.51    N   Referral Required
7/1/2008   $1,291.00   N   Referral Required
7/1/2008   $1,412.13   N   Referral Required
7/1/2008   $1,180.45   N   Referral Required
7/1/2008   $1,424.08   N   Referral Required
7/1/2008   $1,698.23   N   Referral Required
1/1/2008    $522.43    N   Referral Required
1/1/2008    $589.67    N   Referral Required
1/1/2008    $768.32    N   Referral Required
7/1/2008   $1,423.14   N   Referral Required
7/1/2008   $1,180.45   N   Referral Required
7/1/2008   $1,614.56   N   Referral Required
7/1/2008    $299.85    Y   Referral Required
7/1/2008    $219.85    N   Referral Required
7/1/2008   $1,961.61   N   Referral Required
7/1/2008   $3,233.51   N   Referral Required
7/1/2008   $1,026.93   N   Referral Required
7/1/2008   $1,290.51   N   Referral Required
7/1/2008    $929.49    N   Referral Required
7/1/2008   $1,053.07   N   Referral Required
7/1/2008   $1,201.83   N   Referral Required
7/1/2008   $1,227.68   N   Referral Required
7/1/2008   $1,211.40   N   Referral Required
7/1/2008   $1,646.04   N   Referral Required
7/1/2008   $1,970.58   N   Referral Required
7/1/2008   $1,283.56   N   Referral Required
7/1/2008   $1,366.98   N   Referral Required
7/1/2008   $1,573.69   N   Referral Required
7/1/2008   $2,040.43   N   Referral Required
7/1/2008   $2,492.37   N   Referral Required
7/1/2008   $2,193.87   N   Referral Required
7/1/2008   $2,846.57   N   Referral Required
7/1/2008   $2,200.79   N   Referral Required
7/1/2008   $2,868.46   N   Referral Required
7/1/2008   $1,878.94   N   Referral Required
7/1/2008   $1,746.24   N   Referral Required
7/1/2008   $1,755.27   N   Referral Required
7/1/2008   $1,478.92   N   Referral Required
7/1/2008   $1,213.77   N   Referral Required
7/1/2008   $1,485.35   N   Referral Required
7/1/2008   $2,260.57   N   Referral Required
7/1/2008   $2,091.94   N   Referral Required
7/1/2008   $2,200.29   N   Referral Required
7/1/2008   $2,397.45   N   Referral Required
7/1/2008   $1,996.21   N   Referral Required
7/1/2008   $2,528.60   N   Referral Required
7/1/2008   $2,061.40   N   Referral Required
7/1/2008   $2,291.18   N   Referral Required
7/1/2008   $1,660.33   N   Referral Required
7/1/2008   $1,045.13   N   Referral Required
7/1/2008   $1,186.44   N   Referral Required
7/1/2008   $1,180.47   N   Referral Required
7/1/2008   $1,776.07   N   Referral Required
7/1/2008   $2,019.29   N   Referral Required
7/1/2008   $1,304.67   N   Referral Required
7/1/2008   $1,394.06   N   Referral Required
7/1/2008   $1,473.04   N   Referral Required
7/1/2008   $1,382.18   N   Referral Required
7/1/2008    $959.63    N   Referral Required
7/1/2008   $1,125.24   N   Referral Required
7/1/2008   $1,149.55   N   Referral Required
7/1/2008   $1,286.24   N   Referral Required
7/1/2008   $1,796.00   N   Referral Required
7/1/2008   $1,811.75   N   Referral Required
7/1/2008   $1,541.61   N   Referral Required
7/1/2008      $14.38   N   Referral Required
7/1/2008   $1,741.75   N   Referral Required
7/1/2008   $1,893.80   N   Referral Required
7/1/2008   $2,120.09   N   Referral Required
7/1/2008   $2,181.27   N   Referral Required
7/1/2008   $2,290.51   N   Referral Required
7/1/2008   $2,376.42   N   Referral Required
7/1/2008    $160.57    N   Referral Required
7/1/2008    $345.48    N   Referral Required
7/1/2008    $462.81    N   Referral Required
7/1/2008    $562.58    N   Referral Required
7/1/2008    $642.20    N   Referral Required
7/1/2008    $735.35    N   Referral Required
7/1/2008    $437.57    N   Referral Required
7/1/2008   $1,699.42   N   Referral Required
7/1/2008   $1,965.15   N   Referral Required
7/1/2008   $2,167.52   N   Referral Required
7/1/2008   $2,318.75   N   Referral Required
7/1/2008   $2,194.81   N   Referral Required
7/1/2008   $2,605.74   N   Referral Required
7/1/2008   $2,560.14   N   Referral Required
7/1/2008    $207.34    N   Referral Required
7/1/2008   $1,507.10   N   Referral Required
7/1/2008   $1,445.61   N   Referral Required
7/1/2008   $1,563.01   N   Referral Required
7/1/2008   $1,604.12   N   Referral Required
7/1/2008   $1,587.70   N   Referral Required
7/1/2008   $1,715.85   N   Referral Required
7/1/2008   $1,816.45   N   Referral Required
7/1/2008   $1,731.38   N   Referral Required
7/1/2008   $1,914.35   N   Referral Required
7/1/2008   $2,400.41   N   Referral Required
7/1/2008   $1,392.66   N   Referral Required
7/1/2008   $1,385.32   N   Referral Required
7/1/2008   $1,490.23   N   Referral Required
7/1/2008   $1,572.81   N   Referral Required
7/1/2008   $1,676.47   N   Referral Required
7/1/2008   $1,796.11   N   Referral Required
7/1/2008   $1,823.25   N   Referral Required
7/1/2008   $1,876.11   N   Referral Required
7/1/2008   $1,949.97   N   Referral Required
7/1/2008   $1,623.46   N   Referral Required
7/1/2008   $1,663.87   N   Referral Required
7/1/2008   $1,621.55   N   Referral Required
7/1/2008   $1,028.71   N   Referral Required
7/1/2008   $1,698.75   N   Referral Required
7/1/2008   $1,695.81   N   Referral Required
7/1/2008   $1,865.96   N   Referral Required
7/1/2008   $1,364.57   N   Referral Required
7/1/2008   $1,520.82   N   Referral Required
7/1/2008   $1,366.38   N   Referral Required
7/1/2008   $1,407.40   N   Referral Required
7/1/2008   $1,346.49   N   Referral Required
7/1/2008   $1,779.60   N   Referral Required
7/1/2008   $1,753.94   N   Referral Required
7/1/2008   $1,470.70   N   Referral Required
7/1/2008   $1,109.47   N   Referral Required
7/1/2008   $1,268.37   N   Referral Required
7/1/2008   $1,145.71   N   Referral Required
7/1/2008   $1,089.76   N   Referral Required
7/1/2008   $1,091.60   N   Referral Required
7/1/2008   $1,127.02   N   Referral Required
7/1/2008   $1,129.88   N   Referral Required
7/1/2008   $1,191.75   N   Referral Required
7/1/2008   $1,253.64   N   Referral Required
7/1/2008    $365.86    N   Referral Required
7/1/2008   $1,861.72   N   Referral Required
7/1/2008   $1,894.08   N   Referral Required
7/1/2008   $1,597.69   N   Referral Required
7/1/2008   $1,614.84   N   Referral Required
7/1/2008   $1,689.89   N   Referral Required
7/1/2008   $1,669.74   N   Referral Required
7/1/2008   $2,078.63   N   Referral Required
7/1/2008   $1,967.34   N   Referral Required
7/1/2008   $2,078.45   N   Referral Required
7/1/2008   $1,969.42   N   Referral Required
1/1/2010   $2,755.57   N   Referral Required
1/1/2010   $2,994.70   N   Referral Required
7/1/2008   $2,022.96   N   Referral Required
7/1/2008   $1,328.19   N   Referral Required
7/1/2008    $873.86    N   Referral Required
7/1/2008    $941.50    N   Referral Required
7/1/2008   $1,007.33   N   Referral Required
7/1/2008   $1,101.14   N   Referral Required
7/1/2008   $1,343.91   N   Referral Required
7/1/2008    $857.53    N   Referral Required
7/1/2008    $890.71    N   Referral Required
7/1/2008   $1,036.79   N   Referral Required
7/1/2008   $1,080.24   N   Referral Required
7/1/2008   $1,170.95   N   Referral Required
7/1/2008   $1,119.65   N   Referral Required
7/1/2008   $1,291.50   N   Referral Required
7/1/2008   $1,622.16   N   Referral Required
7/1/2008   $2,711.64   N   Referral Required
7/1/2008   $2,152.41   N   Referral Required
7/1/2008   $2,733.52   N   Referral Required
1/1/2008   $2,811.63   N   Referral Required
7/1/2008   $2,245.22   N   Referral Required
7/1/2008   $1,740.57   N   Referral Required
7/1/2008   $3,045.58   N   Referral Required
7/1/2008   $1,615.73   N   Referral Required
7/1/2008   $1,394.11   N   Referral Required
7/1/2008   $1,017.95   N   Referral Required
7/1/2008    $369.10    N   Referral Required
7/1/2008    $880.80    N   Referral Required
7/1/2008    $728.30    N   Referral Required
7/1/2008    $935.90    N   Referral Required
7/1/2008   $1,443.03   N   Referral Required
7/1/2008   $1,173.34   N   Referral Required
7/1/2008   $1,389.03   N   Referral Required
7/1/2008   $1,284.72   N   Referral Required
7/1/2008   $1,564.82   N   Referral Required
7/1/2008   $1,219.85   N   Referral Required
7/1/2008    $256.96    N   Referral Required
7/1/2008   $1,655.09   N   Referral Required
7/1/2008   $2,159.34   N   Referral Required
7/1/2008   $3,200.44   Y   Referral Required
7/1/2008   $1,651.15   N   Referral Required
               $0.00   Y   Referral Required
7/1/2008   $3,970.89   Y   Referral Required
7/1/2008    $868.58    N   Referral Required
7/1/2008    $492.88    N   Referral Required
7/1/2008    $239.98    N   Referral Required
7/1/2008      $30.67   N   Referral Required
7/1/2008    $322.26    N   Referral Required
7/1/2008    $623.86    N   Referral Required
7/1/2008    $472.27    N   Referral Required
7/1/2008    $794.55    N   Referral Required
7/1/2008    $971.79    N   Referral Required
7/1/2008   $1,086.48   N   Referral Required
7/1/2008   $1,068.49   N   Referral Required
7/1/2008   $1,187.93   N   Referral Required
7/1/2008   $2,144.12   N   Referral Required
7/1/2008   $3,145.53   N   Referral Required
               $0.00   Y   Referral Required
               $0.00   Y   Referral Required
               $0.00   Y   Referral Required
               $0.00   N   Referral Required
7/1/2008    $849.87    N   Referral Required
7/1/2008    $863.10    N   Referral Required
7/1/2008    $551.73    N   Referral Required
7/1/2008    $551.21    N   Referral Required
7/1/2008   $1,271.66   N   Referral Required
7/1/2008    $877.28    N   Referral Required
7/1/2008    $880.37    N   Referral Required
7/1/2008    $244.67    N   Referral Required
7/1/2008   $1,277.58   N   Referral Required
7/1/2008    $666.98    N   Referral Required
7/1/2008   $1,373.72   N   Referral Required
7/1/2008    $946.57    N   Referral Required
7/1/2008    $553.35    N   Referral Required
7/1/2008    $855.05    N   Referral Required
7/1/2008   $1,383.42   N   Referral Required
7/1/2008    $991.20    N   Referral Required
7/1/2008    $940.95    N   Referral Required
7/1/2008    $885.77    N   Referral Required
7/1/2008   $1,040.61   N   Referral Required
7/1/2008   $1,139.57   N   Referral Required
7/1/2008   $1,172.47   Y   Referral Required
7/1/2008   $1,137.33   N   Referral Required
7/1/2008   $1,078.09   N   Referral Required
5/1/2009      $91.67   N   Referral Required
7/1/2008    $189.86    N   Referral Required
7/1/2008    $313.77    N   Referral Required
7/1/2008    $218.86    N   Referral Required
7/1/2008    $450.11    N   Referral Required
7/1/2008    $639.46    N   Referral Required
7/1/2008    $188.34    N   Referral Required
7/1/2008   $1,664.95   N   Referral Required
7/1/2008   $1,746.58   N   Referral Required
7/1/2008   $1,802.88   N   Referral Required
7/1/2008    $562.98    N   Referral Required
7/1/2008    $256.21    N   Referral Required
7/1/2008    $828.18    N   Referral Required
7/1/2008   $1,035.77   N   Referral Required
7/1/2008   $1,086.33   N   Referral Required
7/1/2008    $966.93    N   Referral Required
7/1/2008    $907.22    N   Referral Required
7/1/2008   $1,124.66   N   Referral Required
7/1/2008   $1,093.72   N   Referral Required
7/1/2008   $1,260.59   N   Referral Required
7/1/2008    $878.31    N   Referral Required
7/1/2008   $1,565.75   N   Referral Required
7/1/2008   $1,978.20   N   Referral Required
7/1/2008   $1,676.90   N   Referral Required
7/1/2008   $2,362.39   N   Referral Required
7/1/2008   $1,699.94   N   Referral Required
7/1/2008   $2,043.86   N   Referral Required
7/1/2008   $1,260.61   N   Referral Required
7/1/2008   $1,533.52   N   Referral Required
7/1/2008   $1,508.05   N   Referral Required
7/1/2008   $1,779.24   N   Referral Required
7/1/2008   $1,277.38   N   Referral Required
7/1/2008   $1,548.38   N   Referral Required
7/1/2008   $1,018.32   N   Referral Required
7/1/2008   $1,214.04   N   Referral Required
7/1/2008   $1,147.80   N   Referral Required
7/1/2008   $1,333.96   N   Referral Required
7/1/2008    $742.76    N   Referral Required
7/1/2008   $1,536.59   N   Referral Required
7/1/2008    $922.75    N   Referral Required
7/1/2008    $778.00    N   Referral Required
7/1/2008   $1,455.35   N   Referral Required
7/1/2008    $676.93    N   Referral Required
7/1/2008    $848.28    N   Referral Required
7/1/2008    $695.08    N   Referral Required
7/1/2008    $625.46    N   Referral Required
7/1/2008   $1,221.79   N   Referral Required
7/1/2008   $1,650.17   N   Referral Required
7/1/2008   $1,259.22   N   Referral Required
7/1/2008    $769.70    N   Referral Required
7/1/2008   $1,053.87   N   Referral Required
7/1/2008    $884.60    N   Referral Required
7/1/2008   $1,275.65   N   Referral Required
7/1/2008   $1,377.02   N   Referral Required
7/1/2008   $1,500.89   N   Referral Required
7/1/2008    $932.08    N   Referral Required
7/1/2008    $933.32    N   Referral Required
7/1/2008    $776.45    N   Referral Required
7/1/2008   $1,218.69   N   Referral Required
7/1/2008   $1,279.46   N   Referral Required
7/1/2008   $1,429.90   N   Referral Required
7/1/2008    $856.37    N   Referral Required
7/1/2008    $958.37    N   Referral Required
7/1/2008   $1,000.67   N   Referral Required
7/1/2008   $1,099.76   N   Referral Required
7/1/2008   $1,144.47   N   Referral Required
7/1/2008   $1,099.76   N   Referral Required
7/1/2008    $412.00    N   Referral Required
7/1/2008   $1,378.16   N   Referral Required
7/1/2008    $816.17    N   Referral Required
7/1/2008   $1,333.47   N   Referral Required
7/1/2008   $1,266.19   N   Referral Required
7/1/2008   $1,174.07   N   Referral Required
7/1/2008    $955.21    N   Referral Required
7/1/2008   $1,444.05   N   Referral Required
7/1/2008   $1,547.34   N   Referral Required
7/1/2008    $756.36    N   Referral Required
7/1/2008    $907.07    N   Referral Required
7/1/2008    $147.15    N   Referral Required
7/1/2008    $139.10    N   Referral Required
7/1/2008    $469.98    N   Referral Required
7/1/2008    $327.21    N   Referral Required
7/1/2008    $286.87    N   Referral Required
7/1/2008    $347.26    N   Referral Required
7/1/2008    $446.78    N   Referral Required
7/1/2008    $409.21    N   Referral Required
7/1/2008    $285.11    N   Referral Required
1/1/2011   $2,517.19   N   Referral Required
1/1/2011   $2,728.27   N   Referral Required
1/1/2011   $1,933.13   N   Referral Required
1/1/2011   $1,843.72   N   Referral Required
1/1/2011   $2,440.38   N   Referral Required
1/1/2011   $2,051.18   N   Referral Required
1/1/2011   $1,542.47   N   Referral Required
7/1/2008    $530.13    N   Referral Required
7/1/2008    $367.07    N   Referral Required
7/1/2008    $316.16    N   Referral Required
7/1/2008    $386.17    N   Referral Required
7/1/2008    $485.26    N   Referral Required
7/1/2008    $450.50    N   Referral Required
7/1/2008    $549.31    N   Referral Required
7/1/2008    $388.00    N   Referral Required
7/1/2008    $342.43    N   Referral Required
7/1/2008    $411.30    N   Referral Required
7/1/2008    $521.36    N   Referral Required
7/1/2008    $478.64    N   Referral Required
7/1/2008    $294.05    N   Referral Required
7/1/2008   $1,376.41   N   Referral Required
7/1/2008   $1,197.56   N   Referral Required
7/1/2008   $1,228.70   N   Referral Required
7/1/2008   $1,339.80   N   Referral Required
7/1/2008   $1,081.28   N   Referral Required
1/1/2008   $1,167.92   N   Referral Required
7/1/2008   $1,231.37   N   Referral Required
7/1/2008   $1,091.04   N   Referral Required
7/1/2008   $1,086.79   N   Referral Required
7/1/2008   $1,160.99   N   Referral Required
7/1/2008   $1,099.80   N   Referral Required
1/1/2008   $1,153.15   N   Referral Required
7/1/2008   $1,038.33   N   Referral Required
7/1/2008   $1,567.60   N   Referral Required
7/1/2008   $1,839.24   N   Referral Required
7/1/2008   $1,426.33   N   Referral Required
1/1/2009   $1,906.00   N   Referral Required
7/1/2008   $1,589.66   N   Referral Required
7/1/2008   $1,946.46   N   Referral Required
7/1/2008   $2,174.13   N   Referral Required
7/1/2008   $2,039.17   N   Referral Required
7/1/2008   $2,273.50   N   Referral Required
7/1/2008   $1,100.18   N   Referral Required
7/1/2008   $1,198.01   N   Referral Required
7/1/2008   $1,349.44   N   Referral Required
7/1/2008   $1,258.08   N   Referral Required
7/1/2008   $1,118.99   N   Referral Required
7/1/2008   $1,626.72   N   Referral Required
7/1/2008   $1,262.48   N   Referral Required
7/1/2008   $1,206.80   N   Referral Required
7/1/2008   $1,507.79   N   Referral Required
1/1/2011   $1,464.68   N   Referral Required
7/1/2008   $1,232.90   N   Referral Required
7/1/2008    $316.77    N   Referral Required
7/1/2008   $1,300.27   N   Referral Required
7/1/2008   $1,529.76   N   Referral Required
7/1/2008   $1,274.87   N   Referral Required
7/1/2008    $231.96    N   Referral Required
7/1/2008   $1,294.13   N   Referral Required
7/1/2008   $1,073.60   N   Referral Required
7/1/2008    $836.95    N   Referral Required
7/1/2008   $1,025.12   N   Referral Required
7/1/2008   $1,016.22   N   Referral Required
7/1/2008   $1,246.81   N   Referral Required
7/1/2008   $1,423.69   N   Referral Required
7/1/2008   $1,705.43   N   Referral Required
1/1/2009   $1,809.32   N   Referral Required
1/1/2009   $1,954.05   N   Referral Required
1/1/2009   $1,770.66   N   Referral Required
7/1/2008   $1,505.76   N   Referral Required
7/1/2008   $1,544.02   N   Referral Required
7/1/2008   $1,568.50   N   Referral Required
7/1/2008    $924.23    N   Referral Required
7/1/2008    $933.96    N   Referral Required
7/1/2008   $1,579.06   N   Referral Required
7/1/2008   $1,426.96   N   Referral Required
7/1/2008    $980.41    N   Referral Required
7/1/2008   $1,259.34   N   Referral Required
7/1/2008   $1,262.42   N   Referral Required
7/1/2008    $994.94    N   Referral Required
7/1/2008    $996.71    N   Referral Required
7/1/2008   $1,155.80   N   Referral Required
7/1/2008   $1,083.28   N   Referral Required
7/1/2008   $1,168.97   N   Referral Required
7/1/2008   $1,028.96   N   Referral Required
7/1/2008      $73.76   N   Referral Required
7/1/2008    $328.77    N   Referral Required
7/1/2008    $387.48    N   Referral Required
7/1/2008    $185.00    N   Referral Required
7/1/2008    $153.96    N   Referral Required
7/1/2008    $903.22    N   Referral Required
7/1/2008    $797.61    N   Referral Required
7/1/2008    $943.98    N   Referral Required
7/1/2008    $976.70    N   Referral Required
1/1/2008    $137.72    N   Referral Required
7/1/2008    $141.29    N   Referral Required
7/1/2008    $484.60    N   Referral Required
7/1/2008    $414.50    N   Referral Required
7/1/2008    $452.16    N   Referral Required
7/1/2008    $334.16    N   Referral Required
7/1/2008    $429.69    N   Referral Required
7/1/2008   $1,607.18   N   Referral Required
7/1/2008    $558.50    N   Referral Required
7/1/2008    $364.11    N   Referral Required
7/1/2008   $1,170.70   N   Referral Required
7/1/2008    $541.87    N   Referral Required
7/1/2008    $865.16    N   Referral Required
7/1/2008    $850.98    N   Referral Required
7/1/2008    $946.13    N   Referral Required
7/1/2008   $1,118.27   N   Referral Required
7/1/2008   $1,187.42   N   Referral Required
7/1/2008    $457.94    N   Referral Required
7/1/2008    $520.76    N   Referral Required
7/1/2008   $1,602.01   N   Referral Required
7/1/2008   $1,757.57   N   Referral Required
1/1/2011      $22.86   N   Referral Required
7/1/2008    $154.21    N   Referral Required
7/1/2008    $301.86    N   Referral Required
1/1/2011    $518.64    N   Referral Required
1/1/2011    $832.29    N   Referral Required
7/1/2008    $776.34    N   Referral Required
1/1/2011    $723.45    N   Referral Required
7/1/2008    $757.20    N   Referral Required
7/1/2008    $826.34    N   Referral Required
7/1/2008    $495.29    N   Referral Required
7/1/2008    $402.39    N   Referral Required
1/1/2011    $438.49    N   Referral Required
1/1/2010    $538.87    N   Referral Required
1/1/2010    $169.38    N   Referral Required
7/1/2008    $507.22    N   Referral Required
1/1/2011    $591.40    N   Referral Required
1/1/2011   $1,041.19   N   Referral Required
7/1/2008   $1,136.18   N   Referral Required
1/1/2011   $1,846.13   N   Referral Required
1/1/2011    $174.07    N   Referral Required
1/1/2011   $1,123.20   N   Referral Required
1/1/2011   $1,122.30   N   Referral Required
1/1/2011   $1,756.82   N   Referral Required
1/1/2011    $149.26    N   Referral Required
7/1/2008    $512.83    N   Referral Required
7/1/2008    $311.68    N   Referral Required
7/1/2008    $237.34    N   Referral Required
               $0.00   N   Referral Required
7/1/2008      $22.48   N   Referral Required
7/1/2008      $19.86   N   Referral Required
7/1/2008      $14.96   N   Referral Required
7/1/2008      $16.29   N   Referral Required
1/1/2008       $3.00   N
7/1/2008       $3.00   N
7/1/2008      $43.24   N   Referral Required
7/1/2008      $33.67   N   Referral Required
7/1/2008      $33.51   N   Referral Required
7/1/2008      $45.57   N   Referral Required
7/1/2008    $103.34    N   Referral Required
7/1/2008    $112.39    N   Referral Required
7/1/2008    $303.30    N   Referral Required
7/1/2008      $27.00   N   Referral Required
7/1/2008      $54.03   N   Referral Required
7/1/2008    $123.93    Y   Referral Required
7/1/2008    $151.41    Y   Referral Required
1/1/2011   $1,626.48   Y   Referral Required
7/1/2008    $350.81    Y   Referral Required
1/1/2011   $1,315.48   Y   Referral Required
7/1/2008    $356.48    Y   Referral Required
7/1/2008    $327.45    N   Referral Required
7/1/2008    $165.20    N   Referral Required
1/1/2011      $98.61   N   Referral Required
7/1/2008      $81.48   N   Referral Required
7/1/2008      $82.15   N   Referral Required
7/1/2008      $82.86   N   Referral Required
1/1/2011    $463.34    N   Referral Required
7/1/2008   $1,925.86   N   Referral Required
7/1/2008   $2,272.67   N   Referral Required
7/1/2008   $1,223.54   N   Referral Required
1/1/2011    $246.67    N   Referral Required
1/1/2011    $214.36    N   Referral Required
7/1/2008    $787.14    N   Referral Required
1/1/2011    $732.93    N   Referral Required
1/1/2011   $1,007.58   N   Referral Required
1/1/2011   $1,050.91   N   Referral Required
7/1/2008   $1,056.44   N   Referral Required
1/1/2011    $894.61    N   Referral Required
7/1/2008   $2,522.22   N   Referral Required
1/1/2011    $275.41    N   Referral Required
1/1/2011    $239.18    N   Referral Required
7/1/2008   $1,097.66   N   Referral Required
1/1/2011   $1,119.63   N   Referral Required
1/1/2011    $143.15    N   Referral Required
7/1/2008    $325.94    N   Referral Required
7/1/2008    $460.29    N   Referral Required
1/1/2011    $205.29    N   Referral Required
1/1/2011    $686.86    N   Referral Required
7/1/2008    $972.17    N   Referral Required
7/1/2008    $974.70    N   Referral Required
1/1/2011    $199.17    N   Referral Required
1/1/2011    $986.02    N   Referral Required
7/1/2008    $149.14    N   Referral Required
7/1/2008    $236.37    N   Referral Required
1/1/2008      $18.21   N   Referral Required
1/1/2011      $22.29   N   Referral Required
1/1/2011      $24.33   N   Referral Required
1/1/2011    $543.07    N   Referral Required
1/1/2011    $122.92    N   Referral Required
7/1/2008    $116.15    N   Referral Required
1/1/2011    $103.81    N   Referral Required
7/1/2008      $27.39   N   Referral Required
7/1/2008      $46.14   N   Referral Required
7/1/2008      $93.14   N   Referral Required
7/1/2008    $106.82    N   Referral Required
7/1/2008      $63.53   N   Referral Required
7/1/2008      $55.48   N   Referral Required
7/1/2008    $141.99    N   Referral Required
7/1/2008    $191.54    N   Referral Required
7/1/2008    $131.35    N   Referral Required
7/1/2008    $607.78    N   Referral Required
7/1/2008    $711.73    N   Referral Required
7/1/2008    $713.88    N   Referral Required
7/1/2008    $473.87    N   Referral Required
7/1/2008    $335.23    N   Referral Required
7/1/2008   $1,121.20   N   Referral Required
7/1/2008    $516.07    N   Referral Required
7/1/2008    $590.34    N   Referral Required
7/1/2008    $408.38    N   Referral Required
7/1/2008    $520.86    N   Referral Required
7/1/2008    $587.57    N   Referral Required
7/1/2008    $402.21    N   Referral Required
1/1/2008   $1,087.83   N   Referral Required
7/1/2008    $155.25    N   Referral Required
7/1/2008    $134.74    N   Referral Required
1/1/2011   $1,664.32   N   Referral Required
7/1/2008   $1,204.92   N   Referral Required
7/1/2008   $1,294.13   N   Referral Required
7/1/2008   $1,116.47   N   Referral Required
7/1/2008   $1,266.81   N   Referral Required
7/1/2008   $1,343.90   N   Referral Required
7/1/2008    $794.92    N   Referral Required
7/1/2008    $378.84    N   Referral Required
1/1/2011   $2,163.47   N   Referral Required
7/1/2008    $769.68    N   Referral Required
1/1/2011   $1,436.22   N   Referral Required
1/1/2011   $2,069.97   N   Referral Required
7/1/2008   $1,938.23   N   Referral Required
7/1/2008    $279.89    N   Referral Required
7/1/2008    $210.59    N   Referral Required
7/1/2008    $254.89    N   Referral Required
7/1/2008    $304.67    N   Referral Required
1/1/2011   $1,212.60   N   Referral Required
7/1/2008    $838.19    N   Referral Required
7/1/2008   $2,165.77   N   Referral Required
7/1/2008   $1,277.88   N   Referral Required
7/1/2008    $391.97    N   Referral Required
7/1/2008    $189.19    N   Referral Required
7/1/2008    $104.05    N   Referral Required
7/1/2008   $3,146.35   N   Referral Required
7/1/2008    $995.00    N   Referral Required
7/1/2008   $1,082.96   N   Referral Required
7/1/2008      $99.82   N   Referral Required
7/1/2008      $74.67   N   Referral Required
7/1/2008    $619.81    N   Referral Required
               $0.00   N   Referral Required
7/1/2008    $606.26    N   Referral Required
7/1/2008    $633.70    N   Referral Required
7/1/2008    $720.17    N   Referral Required
7/1/2008    $473.08    N   Referral Required
7/1/2008    $333.53    N   Referral Required
7/1/2008    $253.30    N   Referral Required
7/1/2008    $408.73    N   Referral Required
7/1/2008    $945.01    N   Referral Required
7/1/2008   $1,136.60   N   Referral Required
7/1/2008    $328.78    N   Referral Required
7/1/2008    $588.94    N   Referral Required
7/1/2008    $450.26    N   Referral Required
7/1/2008   $1,069.94   N   Referral Required
7/1/2008    $222.57    Y   Referral Required
7/1/2008    $364.97    Y   Referral Required
7/1/2008    $422.68    Y   Referral Required
7/1/2008   $1,886.13   N   Referral Required
7/1/2008    $560.93    Y   Referral Required
7/1/2008    $549.64    Y   Referral Required
1/1/2010    $517.27    N   Referral Required
7/1/2008    $401.55    N   Referral Required
7/1/2008    $488.41    N   Referral Required
7/1/2008    $227.38    Y   Referral Required
7/1/2008    $308.98    Y   Referral Required
7/1/2008    $450.75    N   Referral Required
               $0.00   N   Referral Required
7/1/2008    $906.96    N   Referral Required
7/1/2008    $916.44    N   Referral Required
7/1/2008    $220.44    N   Referral Required
7/1/2008   $1,005.96   N   Referral Required
7/1/2008    $850.76    N   Referral Required
               $0.00   N   Referral Required
7/1/2008    $124.06    N   Referral Required
               $0.00   N   Referral Required
7/1/2008      $71.63   N   Referral Required
7/1/2008      $71.96   N   Referral Required
1/1/2011    $137.74    N   Referral Required
1/1/2011    $151.89    N   Referral Required
7/1/2008    $276.35    N   Referral Required
7/1/2008    $109.82    Y   Referral Required
7/1/2008    $110.16    Y   Referral Required
7/1/2008      $83.39   Y   Referral Required
7/1/2008    $223.45    N   Referral Required
7/1/2008    $380.65    N   Referral Required
7/1/2008    $363.49    N   Referral Required
7/1/2008    $472.82    N   Referral Required
7/1/2008    $698.19    N   Referral Required
7/1/2008    $565.61    N   Referral Required
7/1/2008    $637.50    N   Referral Required
7/1/2008    $259.51    N   Referral Required
7/1/2008    $109.20    N   Referral Required
7/1/2008    $420.55    N   Referral Required
7/1/2008    $379.21    N   Referral Required
7/1/2008    $340.91    N   Referral Required
7/1/2008    $440.35    N   Referral Required
7/1/2008    $355.99    N   Referral Required
7/1/2008    $388.17    N   Referral Required
7/1/2008    $817.32    N   Referral Required
7/1/2008    $581.76    N   Referral Required
7/1/2008    $578.22    N   Referral Required
7/1/2008    $466.15    N   Referral Required
7/1/2008    $722.27    N   Referral Required
7/1/2008    $819.17    N   Referral Required
               $0.00   N   Referral Required
7/1/2008    $652.01    N   Referral Required
7/1/2008   $1,077.42   N   Referral Required
7/1/2008   $1,166.33   N   Referral Required
7/1/2008    $545.55    N   Referral Required
7/1/2008    $695.03    N   Referral Required
7/1/2008    $227.87    N   Referral Required
7/1/2008    $225.01    N   Referral Required
7/1/2008    $686.08    N   Referral Required
7/1/2008   $1,064.00   N   Referral Required
7/1/2008    $703.37    N   Referral Required
7/1/2008    $894.73    N   Referral Required
7/1/2008      $70.92   N   Referral Required
7/1/2008      $34.01   N   Referral Required
7/1/2008    $267.73    N   Referral Required
               $0.00   N   Referral Required
7/1/2008    $417.13    N   Referral Required
7/1/2008    $704.59    N   Referral Required
7/1/2008    $772.14    N   Referral Required
7/1/2008    $989.64    N   Referral Required
7/1/2008    $433.89    N   Referral Required
               $0.00   N   Referral Required
7/1/2008    $704.56    N   Referral Required
7/1/2008    $843.75    N   Referral Required
7/1/2008   $4,867.91   N   Referral Required
7/1/2008    $847.81    N   Referral Required
7/1/2008    $806.94    N   Referral Required
7/1/2008    $852.94    N   Referral Required
7/1/2008    $719.88    N   Referral Required
7/1/2008    $773.55    N   Referral Required
7/1/2008    $765.63    N   Referral Required
7/1/2008    $662.08    N   Referral Required
7/1/2008   $1,020.28   N   Referral Required
               $0.00   N   Referral Required
7/1/2008    $103.43    N   Referral Required
7/1/2008    $400.00    N   Referral Required
7/1/2008    $391.03    N   Referral Required
7/1/2008    $410.52    N   Referral Required
7/1/2008    $465.55    N   Referral Required
7/1/2008    $552.19    N   Referral Required
7/1/2008    $450.20    N   Referral Required
7/1/2008    $344.22    N   Referral Required
7/1/2008    $404.86    N   Referral Required
7/1/2008    $470.17    N   Referral Required
7/1/2008    $782.50    N   Referral Required
7/1/2008    $922.36    N   Referral Required
7/1/2008    $730.63    N   Referral Required
7/1/2008    $845.76    N   Referral Required
7/1/2008    $889.94    N   Referral Required
               $0.00   N   Referral Required
7/1/2008    $155.91    N   Referral Required
7/1/2008    $240.45    N   Referral Required
7/1/2008    $164.15    N   Referral Required
7/1/2008    $257.98    N   Referral Required
7/1/2008      $82.11   N   Referral Required
7/1/2008    $139.09    N   Referral Required
7/1/2008    $156.81    N   Referral Required
7/1/2008    $221.20    N   Referral Required
7/1/2008    $301.09    N   Referral Required
7/1/2008    $316.62    N   Referral Required
7/1/2008    $278.91    N   Referral Required
7/1/2008    $238.26    N   Referral Required
7/1/2008    $199.66    N   Referral Required
7/1/2008    $192.87    N   Referral Required
7/1/2008    $254.66    N   Referral Required
7/1/2008    $654.00    N   Referral Required
7/1/2008    $661.67    N   Referral Required
7/1/2008    $838.31    N   Referral Required
7/1/2008   $1,110.92   N   Referral Required
7/1/2008   $1,232.22   N   Referral Required
               $0.00   N   Referral Required
7/1/2008    $127.87    N   Referral Required
7/1/2008    $173.11    N   Referral Required
7/1/2008    $287.23    N   Referral Required
7/1/2008    $286.23    N   Referral Required
7/1/2008    $292.04    N   Referral Required
7/1/2008    $311.00    N   Referral Required
7/1/2008    $159.63    N   Referral Required
7/1/2008    $338.01    N   Referral Required
7/1/2008    $345.48    N   Referral Required
7/1/2008    $348.49    N   Referral Required
7/1/2008    $400.68    N   Referral Required
1/1/2008    $416.99    N   Referral Required
7/1/2008    $134.40    N   Referral Required
7/1/2008    $133.92    N   Referral Required
7/1/2008    $114.44    N   Referral Required
7/1/2008    $164.66    N   Referral Required
7/1/2008    $260.75    N   Referral Required
7/1/2008    $285.80    N   Referral Required
7/1/2008    $533.14    N   Referral Required
7/1/2008    $187.24    N   Referral Required
7/1/2008    $252.90    N   Referral Required
7/1/2008    $875.85    N   Referral Required
7/1/2008   $1,073.47   N   Referral Required
7/1/2008   $1,788.90   N   Referral Required
7/1/2008   $1,848.27   N   Referral Required
7/1/2008   $2,300.16   N   Referral Required
7/1/2008   $1,824.47   N   Referral Required
7/1/2008   $1,971.70   N   Referral Required
7/1/2008   $2,427.08   N   Referral Required
7/1/2008    $178.28    N   Referral Required
7/1/2008    $193.90    N   Referral Required
7/1/2008    $247.16    N   Referral Required
7/1/2008    $380.92    N   Referral Required
7/1/2008    $360.15    N   Referral Required
1/1/2009    $521.74    N   Referral Required
7/1/2008    $272.24    N   Referral Required
               $0.00   N   Referral Required
7/1/2008    $166.49    N   Referral Required
7/1/2008    $167.63    N   Referral Required
7/1/2008    $255.60    N   Referral Required
               $0.00   N   Referral Required
               $0.00   N   Referral Required
7/1/2008    $229.88    N   Referral Required
7/1/2008    $331.35    N   Referral Required
7/1/2008    $160.95    N   Referral Required
7/1/2008    $210.00    N   Referral Required
7/1/2008    $334.44    N   Referral Required
7/1/2008    $244.53    N   Referral Required
7/1/2008    $304.38    N   Referral Required
               $0.00   N   Referral Required
7/1/2008    $345.48    N   Referral Required
7/1/2008    $287.34    N   Referral Required
7/1/2008    $288.85    N   Referral Required
               $0.00   N
7/1/2008    $128.26    N   Referral Required
7/1/2008    $119.77    N   Referral Required
7/1/2008    $160.75    N   Referral Required
7/1/2008    $204.10    N   Referral Required
7/1/2008    $363.35    N   Referral Required
7/1/2008    $803.57    N   Referral Required
7/1/2008    $196.16    N   Referral Required
7/1/2008    $585.25    N   Referral Required
7/1/2008    $197.97    N   Referral Required
7/1/2008    $195.99    N   Referral Required
7/1/2008    $267.47    N   Referral Required
7/1/2008    $754.77    N   Referral Required
7/1/2008    $776.16    N   Referral Required
7/1/2008    $903.74    N   Referral Required
7/1/2008    $598.04    N   Referral Required
7/1/2008    $484.73    N   Referral Required
7/1/2008    $829.62    N   Referral Required
7/1/2008    $806.86    N   Referral Required
7/1/2008    $794.48    N   Referral Required
7/1/2008    $649.85    N   Referral Required
7/1/2008    $695.23    N   Referral Required
7/1/2008    $125.86    N   Referral Required
7/1/2008    $163.17    N   Referral Required
               $0.00   N   Referral Required
7/1/2008    $167.98    N   Referral Required
7/1/2008    $364.28    N   Referral Required
7/1/2008    $131.49    N   Referral Required
7/1/2008    $200.71    N   Referral Required
7/1/2008    $187.70    N   Referral Required
7/1/2008    $296.04    N   Referral Required
7/1/2008    $376.64    N   Referral Required
7/1/2008      $88.15   N   Referral Required
7/1/2008    $248.95    N   Referral Required
7/1/2008    $367.92    N   Referral Required
7/1/2008    $264.89    N   Referral Required
7/1/2008    $528.11    N   Referral Required
7/1/2008    $955.83    N   Referral Required
7/1/2008   $1,097.80   N   Referral Required
7/1/2008    $723.95    N   Referral Required
7/1/2008   $1,174.85   N   Referral Required
7/1/2008    $392.22    N   Referral Required
7/1/2008    $369.01    N   Referral Required
7/1/2008    $350.15    N   Referral Required
7/1/2008    $459.79    N   Referral Required
7/1/2008    $430.63    N   Referral Required
7/1/2008    $602.99    N   Referral Required
7/1/2008    $727.44    N   Referral Required
7/1/2008    $534.69    N   Referral Required
7/1/2008    $134.98    N   Referral Required
7/1/2008    $390.74    N   Referral Required
7/1/2008      $66.94   N   Referral Required
7/1/2008      $86.51   N   Referral Required
7/1/2008    $243.60    N   Referral Required
               $0.00   N   Referral Required
7/1/2008    $151.07    N   Referral Required
7/1/2008    $378.96    N   Referral Required
7/1/2008    $684.29    N   Referral Required
7/1/2008    $127.06    N   Referral Required
7/1/2008    $202.94    N   Referral Required
7/1/2008    $166.29    N   Referral Required
7/1/2008    $187.97    N   Referral Required
7/1/2008    $186.75    N   Referral Required
7/1/2008    $140.44    N   Referral Required
7/1/2008    $315.54    N   Referral Required
7/1/2008    $465.76    N   Referral Required
7/1/2008    $248.11    N   Referral Required
7/1/2008    $259.83    N   Referral Required
7/1/2008    $221.97    N   Referral Required
7/1/2008    $214.44    N   Referral Required
7/1/2008    $174.44    N   Referral Required
7/1/2008    $188.11    N   Referral Required
7/1/2008    $152.81    N   Referral Required
7/1/2008    $206.49    N   Referral Required
7/1/2008    $800.84    N   Referral Required
7/1/2008   $1,140.45   N   Referral Required
7/1/2008   $1,863.01   N   Referral Required
7/1/2008    $157.25    N   Referral Required
7/1/2008    $479.08    N   Referral Required
7/1/2008   $1,145.31   N   Referral Required
7/1/2008   $1,495.80   N   Referral Required
7/1/2008   $1,923.36   N   Referral Required
7/1/2008    $296.30    N   Referral Required
7/1/2008    $670.24    N   Referral Required
7/1/2008    $848.98    N   Referral Required
7/1/2008    $627.36    N   Referral Required
7/1/2008    $143.85    N   Referral Required
7/1/2008    $356.86    N   Referral Required
7/1/2008    $441.50    N   Referral Required
7/1/2008    $329.98    N   Referral Required
7/1/2008    $389.58    N   Referral Required
7/1/2008    $442.82    N   Referral Required
               $0.00   N   Referral Required
7/1/2008    $456.47    N   Referral Required
7/1/2008    $445.95    N   Referral Required
7/1/2008   $1,111.14   N   Referral Required
7/1/2008    $528.87    N   Referral Required
7/1/2008    $865.19    N   Referral Required
7/1/2008   $2,150.72   N   Referral Required
7/1/2008   $3,495.65   N   Referral Required
7/1/2008   $2,303.43   N   Referral Required
7/1/2008   $3,437.93   N   Referral Required
7/1/2008   $3,954.71   N   Referral Required
7/1/2008   $2,099.50   N   Referral Required
7/1/2008   $2,910.04   N   Referral Required
7/1/2008   $2,325.34   N   Referral Required
7/1/2008   $2,128.79   N   Referral Required
7/1/2008   $3,525.57   N   Referral Required
7/1/2008   $3,004.59   N   Referral Required
7/1/2008    $670.93    N   Referral Required
7/1/2008   $1,220.03   N   Referral Required
7/1/2008    $186.92    N   Referral Required
7/1/2008   $244.10   N   Referral Required
7/1/2008   $244.91   N   Referral Required
7/1/2008   $190.50   N   Referral Required
7/1/2008   $191.88   N   Referral Required
7/1/2008   $132.78   N   Referral Required
7/1/2008   $153.24   N   Referral Required
7/1/2008   $327.95   N   Referral Required
7/1/2008   $147.02   N   Referral Required
7/1/2008   $108.73   N   Referral Required
7/1/2008   $120.78   N   Referral Required
7/1/2008   $179.40   N   Referral Required
7/1/2008   $189.93   N   Referral Required
7/1/2008   $162.45   N   Referral Required
7/1/2008   $226.60   N   Referral Required
7/1/2008   $242.81   N   Referral Required
7/1/2008   $258.10   N   Referral Required
7/1/2008   $320.75   N   Referral Required
7/1/2008   $204.22   N   Referral Required
7/1/2008   $252.27   N   Referral Required
7/1/2008   $297.06   N   Referral Required
7/1/2008   $338.75   N   Referral Required
7/1/2008   $132.54   N   Referral Required
7/1/2008   $362.09   N   Referral Required
7/1/2008   $228.79   N   Referral Required
7/1/2008   $253.22   N   Referral Required
7/1/2008   $160.31   N   Referral Required
7/1/2008   $214.60   N   Referral Required
7/1/2008   $171.36   N   Referral Required
7/1/2008   $161.26   N   Referral Required
7/1/2008   $148.35   N   Referral Required
7/1/2008   $161.07   N   Referral Required
7/1/2008   $186.02   N   Referral Required
7/1/2008   $241.89   N   Referral Required
7/1/2008   $217.65   N   Referral Required
7/1/2008   $263.60   N   Referral Required
7/1/2008   $228.03   N   Referral Required
7/1/2008   $258.80   N   Referral Required
7/1/2008   $296.85   N   Referral Required
7/1/2008   $312.04   N   Referral Required
7/1/2008   $366.62   N   Referral Required
7/1/2008   $361.19   N   Referral Required
7/1/2008   $440.05   N   Referral Required
7/1/2008   $494.25   N   Referral Required
7/1/2008   $360.94   N   Referral Required
7/1/2008   $370.95   N   Referral Required
7/1/2008   $406.19   N   Referral Required
7/1/2008   $366.28   N   Referral Required
7/1/2008    $367.28    N   Referral Required
1/1/2009    $118.33    N   Referral Required
1/1/2009   $1,102.06   N   Referral Required
7/1/2008    $879.31    N   Referral Required
1/1/2010   $1,095.05   N   Referral Required
1/1/2010   $1,231.84   N   Referral Required
               $0.00   N   Referral Required
7/1/2008    $527.06    N   Referral Required
7/1/2008    $949.87    N   Referral Required
7/1/2008   $1,294.97   N   Referral Required
7/1/2008   $1,426.73   N   Referral Required
7/1/2008   $2,325.38   N   Referral Required
7/1/2008   $2,481.31   N   Referral Required
7/1/2008   $1,126.81   N   Referral Required
7/1/2008   $1,104.85   N   Referral Required
7/1/2008   $1,089.85   N   Referral Required
7/1/2008   $1,105.97   N   Referral Required
7/1/2008   $1,067.71   N   Referral Required
7/1/2008   $1,152.27   N   Referral Required
7/1/2008   $1,118.15   N   Referral Required
7/1/2008   $1,192.12   N   Referral Required
7/1/2008    $961.45    N   Referral Required
7/1/2008   $1,125.25   N   Referral Required
7/1/2008    $904.83    N   Referral Required
7/1/2008   $1,933.15   N   Referral Required
7/1/2008   $2,196.38   N   Referral Required
7/1/2008   $1,275.97   N   Referral Required
7/1/2008   $1,259.71   N   Referral Required
7/1/2008   $1,215.50   N   Referral Required
7/1/2008    $834.16    N   Referral Required
7/1/2008   $1,423.05   N   Referral Required
7/1/2008    $833.82    N   Referral Required
7/1/2008   $1,234.31   N   Referral Required
7/1/2008    $137.31    N   Referral Required
7/1/2008    $259.27    N   Referral Required
1/1/2011    $527.83    N   Referral Required
7/1/2008    $333.57    N   Referral Required
7/1/2008    $187.16    N   Referral Required
               $0.00   N   Referral Required
               $0.00   N   Referral Required
7/1/2008    $624.97    N   Referral Required
7/1/2008   $1,077.79   N   Referral Required
7/1/2008   $1,223.99   N   Referral Required
7/1/2008    $793.94    N   Referral Required
7/1/2008    $569.97    N   Referral Required
7/1/2008      $90.34   N   Referral Required
7/1/2008    $665.01    N   Referral Required
7/1/2008    $785.54    N   Referral Required
7/1/2008    $975.27    N   Referral Required
7/1/2008   $1,594.71   N   Referral Required
7/1/2008   $1,805.26   N   Referral Required
7/1/2008   $1,838.99   N   Referral Required
7/1/2008   $1,170.94   N   Referral Required
7/1/2008   $1,572.14   N   Referral Required
7/1/2008   $1,500.44   N   Referral Required
7/1/2008   $1,652.92   N   Referral Required
7/1/2008      $94.43   N   Referral Required
7/1/2008    $938.27    N   Referral Required
7/1/2008    $953.13    N   Referral Required
7/1/2008   $1,396.58   Y   Referral Required
7/1/2008   $1,494.72   Y   Referral Required
               $0.00   Y   Referral Required
               $0.00   Y   Referral Required
7/1/2008    $521.54    N   Referral Required
7/1/2008    $619.46    N   Referral Required
7/1/2008    $444.45    N   Referral Required
               $0.00   Y   Referral Required
7/1/2008      $36.10   N   Referral Required
7/1/2008    $166.59    N   Referral Required
7/1/2008    $106.59    N   Referral Required
7/1/2008    $892.67    Y   Referral Required
7/1/2008   $1,019.91   Y   Referral Required
7/1/2008    $767.64    Y   Referral Required
7/1/2008   $1,019.76   Y   Referral Required
7/1/2008    $772.98    Y   Referral Required
1/1/2010    $918.68    Y   Referral Required
7/1/2008    $745.11    N   Referral Required
7/1/2008    $805.77    N   Referral Required
7/1/2008   $1,031.86   N   Referral Required
7/1/2008   $1,039.51   N   Referral Required
7/1/2008    $551.64    N   Referral Required
7/1/2008    $458.18    N   Referral Required
7/1/2008    $848.84    N   Referral Required
7/1/2008   $1,049.49   N   Referral Required
7/1/2008   $1,146.60   Y   Referral Required
7/1/2008   $1,013.98   Y   Referral Required
7/1/2008   $1,583.01   Y   Referral Required
7/1/2008   $1,308.05   Y   Referral Required
7/1/2008   $1,434.81   Y   Referral Required
7/1/2008   $1,551.91   Y   Referral Required
7/1/2008   $1,305.32   Y   Referral Required
7/1/2008   $1,358.28   N   Referral Required
7/1/2008   $1,318.89   N   Referral Required
7/1/2008   $1,374.56   N   Referral Required
7/1/2008    $562.87    N   Referral Required
7/1/2008   $1,289.47   N   Referral Required
               $0.00   Y   Referral Required
               $0.00   Y   Referral Required
               $0.00   N   Referral Required
7/1/2008    $879.44    N   Referral Required
7/1/2008    $690.11    N   Referral Required
7/1/2008    $120.67    N   Referral Required
7/1/2008    $775.82    N   Referral Required
7/1/2008    $782.06    N   Referral Required
7/1/2008    $788.82    N   Referral Required
7/1/2008    $749.92    N   Referral Required
7/1/2008   $1,198.88   N   Referral Required
7/1/2008      $97.68   N   Referral Required
7/1/2008    $676.77    N   Referral Required
7/1/2008    $790.63    N   Referral Required
7/1/2008    $975.54    N   Referral Required
7/1/2008    $204.01    N   Referral Required
7/1/2008    $949.88    N   Referral Required
7/1/2008   $1,960.96   N   Referral Required
7/1/2008   $2,279.87   N   Referral Required
7/1/2008    $206.25    N   Referral Required
7/1/2008   $1,010.05   N   Referral Required
               $0.00   N   Referral Required
               $0.00   Y   Referral Required
7/1/2008   $5,526.77   Y   Referral Required
7/1/2008   $5,971.64   Y   Referral Required
7/1/2008   $1,190.30   Y   Referral Required
7/1/2008    $102.00    N   Referral Required
7/1/2008   $1,083.89   N   Referral Required
7/1/2008   $1,411.40   N   Referral Required
7/1/2008   $1,334.73   N   Referral Required
7/1/2008   $1,389.99   N   Referral Required
7/1/2008   $1,355.38   N   Referral Required
7/1/2008   $1,681.09   N   Referral Required
7/1/2008   $1,499.19   N   Referral Required
7/1/2008   $1,474.82   N   Referral Required
7/1/2008   $1,687.25   N   Referral Required
7/1/2008   $1,656.82   N   Referral Required
7/1/2008   $1,816.17   N   Referral Required
7/1/2008   $1,835.59   N   Referral Required
7/1/2008   $1,882.92   N   Referral Required
7/1/2008    $996.69    N   Referral Required
7/1/2008    $745.88    N   Referral Required
7/1/2008    $526.11    N   Referral Required
7/1/2008    $890.22    N   Referral Required
7/1/2008    $978.98    N   Referral Required
7/1/2008   $1,121.90   N   Referral Required
7/1/2008    $203.48    N   Referral Required
7/1/2008   $1,255.23   N   Referral Required
7/1/2008   $1,096.98   N   Referral Required
7/1/2008   $1,422.25   N   Referral Required
7/1/2008   $1,496.28   N   Referral Required
7/1/2008   $1,629.36   N   Referral Required
7/1/2008   $1,451.89   N   Referral Required
7/1/2008   $1,787.87   N   Referral Required
7/1/2008   $1,670.96   N   Referral Required
7/1/2008    $160.39    N   Referral Required
7/1/2008   $1,355.61   N   Referral Required
               $0.00   N   Referral Required
7/1/2008    $672.45    N   Referral Required
7/1/2008    $842.97    N   Referral Required
7/1/2008    $474.73    N   Referral Required
7/1/2008    $813.08    N   Referral Required
7/1/2008   $1,122.80   N   Referral Required
7/1/2008    $959.94    N   Referral Required
7/1/2008    $765.31    N   Referral Required
7/1/2008    $478.17    N   Referral Required
7/1/2008    $839.80    N   Referral Required
7/1/2008    $942.65    N   Referral Required
7/1/2008    $133.83    N   Referral Required
7/1/2008    $147.40    N   Referral Required
7/1/2008    $175.79    N   Referral Required
7/1/2008    $187.79    N   Referral Required
7/1/2008    $167.12    N   Referral Required
7/1/2008    $221.89    N   Referral Required
7/1/2008    $225.89    N   Referral Required
7/1/2008    $243.51    N   Referral Required
7/1/2008    $218.45    N   Referral Required
7/1/2008    $175.12    N   Referral Required
7/1/2008    $259.03    N   Referral Required
7/1/2008    $274.46    N   Referral Required
7/1/2008    $353.47    N   Referral Required
7/1/2008    $376.14    N   Referral Required
7/1/2008      $58.25   N   Referral Required
7/1/2008      $69.30   N   Referral Required
7/1/2008    $150.69    N   Referral Required
7/1/2008    $201.59    N   Referral Required
7/1/2008    $296.90    N   Referral Required
7/1/2008    $286.25    N   Referral Required
7/1/2008    $339.47    N   Referral Required
7/1/2008    $391.97    N   Referral Required
7/1/2008    $446.15    N   Referral Required
7/1/2008    $367.33    N   Referral Required
7/1/2008    $419.10    N   Referral Required
7/1/2008    $427.65    N   Referral Required
7/1/2008    $231.17    N   Referral Required
7/1/2008      $22.62   N   Referral Required
7/1/2008   $1,100.74   N   Referral Required
7/1/2008   $1,256.99   N   Referral Required
7/1/2008    $854.82    N   Referral Required
7/1/2008   $1,056.32   N   Referral Required
7/1/2008    $866.30    N   Referral Required
7/1/2008    $691.01    N   Referral Required
7/1/2008    $820.30    N   Referral Required
7/1/2008   $1,307.36   N   Referral Required
7/1/2008   $1,138.83   N   Referral Required
7/1/2008   $1,182.55   N   Referral Required
7/1/2008   $1,141.76   N   Referral Required
7/1/2008   $1,284.27   N   Referral Required
7/1/2008    $857.16    N   Referral Required
7/1/2008    $832.40    N   Referral Required
7/1/2008    $141.39    N   Referral Required
7/1/2008    $918.45    Y   Referral Required
7/1/2008    $224.34    Y   Referral Required
7/1/2008    $322.82    Y   Referral Required
               $0.00   N   Referral Required
7/1/2008    $609.79    N   Referral Required
7/1/2008    $671.83    N   Referral Required
7/1/2008    $596.97    N   Referral Required
               $0.00   N   Referral Required
7/1/2008    $604.53    N   Referral Required
1/1/2011    $848.24    N   Referral Required
7/1/2008    $517.10    N   Referral Required
7/1/2008      $70.91   N   Referral Required
7/1/2008    $692.77    N   Referral Required
7/1/2008    $473.29    N   Referral Required
               $0.00   N   Referral Required
7/1/2008    $326.96    N   Referral Required
7/1/2008    $205.92    N   Referral Required
7/1/2008    $423.53    N   Referral Required
7/1/2008    $227.72    N   Referral Required
7/1/2008    $278.43    N   Referral Required
7/1/2008   $1,494.00   N   Referral Required
7/1/2008    $875.51    N   Referral Required
7/1/2008   $1,541.99   N   Referral Required
7/1/2008   $1,579.69   N   Referral Required
7/1/2008   $1,444.52   N   Referral Required
7/1/2008   $1,307.52   N   Referral Required
7/1/2008   $1,582.97   N   Referral Required
7/1/2008   $1,259.43   N   Referral Required
7/1/2008   $1,385.01   N   Referral Required
7/1/2008    $892.93    N   Referral Required
7/1/2008   $2,341.01   N   Referral Required
7/1/2008    $874.73    N   Referral Required
7/1/2008   $1,071.95   N   Referral Required
7/1/2008   $1,489.29   N   Referral Required
7/1/2008    $310.20    N   Referral Required
7/1/2008    $792.55    N   Referral Required
1/1/2010    $412.59    N   Referral Required
1/1/2010    $567.78    N   Referral Required
7/1/2008    $535.74    N   Referral Required
7/1/2008      $85.48   N   Referral Required
7/1/2008    $695.49    N   Referral Required
7/1/2008    $141.08    N   Referral Required
7/1/2008    $163.99    N   Referral Required
7/1/2008    $138.64    N   Referral Required
7/1/2008    $160.23    N   Referral Required
7/1/2008    $174.85    N   Referral Required
7/1/2008    $166.65    N   Referral Required
7/1/2008    $168.27    N   Referral Required
7/1/2008      $84.82   N   Referral Required
7/1/2008      $96.77   N   Referral Required
7/1/2008    $113.97    N   Referral Required
7/1/2008    $146.28    N   Referral Required
7/1/2008    $239.05    N   Referral Required
7/1/2008    $238.86    N   Referral Required
7/1/2008    $139.93    N   Referral Required
7/1/2008    $194.03    N   Referral Required
7/1/2008    $120.59    N   Referral Required
7/1/2008    $267.92    N   Referral Required
7/1/2008    $263.93    N   Referral Required
7/1/2008    $340.33    N   Referral Required
7/1/2008    $133.21    N   Referral Required
7/1/2008    $203.41    N   Referral Required
7/1/2008    $146.64    N   Referral Required
7/1/2008    $173.92    N   Referral Required
7/1/2008    $313.15    N   Referral Required
7/1/2008    $334.75    N   Referral Required
7/1/2008    $338.69    N   Referral Required
7/1/2008    $426.92    N   Referral Required
7/1/2008    $404.77    N   Referral Required
7/1/2008    $393.82    N   Referral Required
7/1/2008    $536.89    N   Referral Required
7/1/2008    $480.59    N   Referral Required
7/1/2008    $398.09    N   Referral Required
7/1/2008    $455.78    N   Referral Required
7/1/2008    $573.92    N   Referral Required
7/1/2008    $292.94    N   Referral Required
7/1/2008    $255.03    N   Referral Required
7/1/2008    $322.47    N   Referral Required
7/1/2008   $1,613.11   N   Referral Required
7/1/2008   $1,748.58   N   Referral Required
7/1/2008    $935.03    N   Referral Required
7/1/2008   $1,251.09   N   Referral Required
               $0.00   N   Referral Required
7/1/2008    $404.06    N   Referral Required
7/1/2008    $439.84    N   Referral Required
7/1/2008      $94.30   N   Referral Required
7/1/2008    $850.53    N   Referral Required
7/1/2008    $732.32    N   Referral Required
7/1/2008   $1,180.42   N   Referral Required
7/1/2008    $581.17    N   Referral Required
7/1/2008    $884.52    N   Referral Required
7/1/2008   $1,293.65   N   Referral Required
7/1/2008    $988.82    N   Referral Required
7/1/2008   $1,140.69   N   Referral Required
7/1/2008    $313.33    N   Referral Required
7/1/2008    $987.72    N   Referral Required
7/1/2008   $1,170.97   N   Referral Required
7/1/2008    $157.84    N   Referral Required
7/1/2008    $133.22    N   Referral Required
7/1/2008    $158.56    N   Referral Required
7/1/2008    $253.73    N   Referral Required
7/1/2008      $89.15   N   Referral Required
               $0.00   N   Referral Required
7/1/2008    $197.97    N   Referral Required
7/1/2008      $98.23   N   Referral Required
7/1/2008    $389.00    N   Referral Required
7/1/2008    $318.63    N   Referral Required
7/1/2008    $139.17    N   Referral Required
7/1/2008    $349.64    N   Referral Required
7/1/2008    $168.38    N   Referral Required
7/1/2008    $180.26    N   Referral Required
7/1/2008    $131.87    N   Referral Required
7/1/2008    $293.13    N   Referral Required
7/1/2008    $144.93    N   Referral Required
7/1/2008    $188.13    N   Referral Required
7/1/2008    $202.32    N   Referral Required
7/1/2008    $336.76    N   Referral Required
7/1/2008    $378.01    N   Referral Required
7/1/2008    $314.73    N   Referral Required
7/1/2008    $344.02    N   Referral Required
7/1/2008    $358.77    N   Referral Required
7/1/2008    $402.78    N   Referral Required
7/1/2008    $417.59    N   Referral Required
7/1/2008    $360.09    N   Referral Required
7/1/2008    $375.99    N   Referral Required
7/1/2008    $348.64    N   Referral Required
7/1/2008    $358.45    N   Referral Required
7/1/2008    $411.64    N   Referral Required
7/1/2008    $133.63    N   Referral Required
7/1/2008    $153.31    N   Referral Required
7/1/2008    $213.22    N   Referral Required
7/1/2008      $68.28   N   Referral Required
7/1/2008    $398.28    N   Referral Required
7/1/2008    $169.87    N   Referral Required
7/1/2008    $182.59    N   Referral Required
7/1/2008    $176.35    N   Referral Required
1/1/2011    $144.73    N   Referral Required
7/1/2008    $220.43    N   Referral Required
7/1/2008    $108.39    N   Referral Required
7/1/2008    $126.96    N   Referral Required
7/1/2008    $498.55    N   Referral Required
7/1/2008    $392.11    N   Referral Required
7/1/2008    $131.79    N   Referral Required
1/1/2010    $371.61    N   Referral Required
7/1/2008    $852.06    N   Referral Required
7/1/2008   $1,772.69   N   Referral Required
7/1/2008    $392.53    N   Referral Required
7/1/2008    $898.09    N   Referral Required
7/1/2008   $1,468.05   N   Referral Required
7/1/2008   $1,733.50   N   Referral Required
7/1/2008   $1,642.76   N   Referral Required
7/1/2008   $1,910.75   N   Referral Required
7/1/2008   $2,737.87   N   Referral Required
7/1/2008   $3,072.48   N   Referral Required
7/1/2008   $3,188.02   N   Referral Required
7/1/2008    $604.41    N   Referral Required
7/1/2008    $500.19    N   Referral Required
7/1/2008    $454.25    N   Referral Required
7/1/2008    $220.80    N   Referral Required
7/1/2008    $860.25    N   Referral Required
7/1/2008    $743.89    N   Referral Required
7/1/2008    $725.51    N   Referral Required
7/1/2008    $124.46    N   Referral Required
7/1/2008    $171.32    N   Referral Required
7/1/2008    $179.95    N   Referral Required
7/1/2008    $180.76    N   Referral Required
7/1/2008    $366.17    N   Referral Required
7/1/2008      $59.40   N   Referral Required
7/1/2008    $191.20    N   Referral Required
7/1/2008    $403.21    N   Referral Required
1/1/2009    $172.15    N   Referral Required
7/1/2008    $316.14    N   Referral Required
7/1/2008    $163.20    N   Referral Required
7/1/2008    $149.96    N   Referral Required
7/1/2008    $209.68    N   Referral Required
7/1/2008    $231.82    N   Referral Required
7/1/2008    $295.33    N   Referral Required
               $0.00   N   Referral Required
7/1/2008    $245.06    N   Referral Required
7/1/2008      $87.38   N   Referral Required
7/1/2008    $959.73    N   Referral Required
7/1/2008    $170.01    N   Referral Required
7/1/2008    $912.53    N   Referral Required
7/1/2008    $663.81    N   Referral Required
7/1/2008   $1,878.01   N   Referral Required
7/1/2008   $2,798.68   N   Referral Required
7/1/2008   $2,509.92   N   Referral Required
7/1/2008   $2,698.68   N   Referral Required
               $0.00   N   Referral Required
7/1/2008   $3,972.27   Y   Referral Required
7/1/2008   $3,382.54   Y   Referral Required
7/1/2008   $4,864.88   Y   Referral Required
7/1/2008   $3,572.52   Y   Referral Required
7/1/2008   $3,942.41   Y   Referral Required
7/1/2008    $276.63    Y   Referral Required
7/1/2008    $322.49    Y   Referral Required
7/1/2008    $891.85    N   Referral Required
7/1/2008   $1,093.53   N   Referral Required
7/1/2008   $1,490.92   N   Referral Required
7/1/2008   $2,471.01   N   Referral Required
7/1/2008   $1,133.38   N   Referral Required
7/1/2008   $1,005.85   N   Referral Required
7/1/2008   $1,010.47   N   Referral Required
               $0.00   N   Referral Required
7/1/2008   $1,173.52   N   Referral Required
7/1/2008   $1,199.05   N   Referral Required
7/1/2008    $732.74    N   Referral Required
               $0.00   N   Referral Required
7/1/2008   $1,715.04   N   Referral Required
7/1/2008   $1,074.10   N   Referral Required
7/1/2008   $1,085.76   N   Referral Required
7/1/2008   $1,018.45   N   Referral Required
7/1/2008    $676.47    N   Referral Required
7/1/2008    $459.39    N   Referral Required
7/1/2008      $90.53   N   Referral Required
7/1/2008      $34.95   N   Referral Required
7/1/2008    $435.80    N   Referral Required
7/1/2008    $540.93    N   Referral Required
1/1/2011    $457.21    N   Referral Required
7/1/2008   $1,281.33   N   Referral Required
7/1/2008    $138.96    N   Referral Required
7/1/2008    $291.32    N   Referral Required
7/1/2008    $291.64    N   Referral Required
7/1/2008    $432.60    N   Referral Required
7/1/2008    $348.93    N   Referral Required
7/1/2008    $394.41    N   Referral Required
7/1/2008    $224.53    N   Referral Required
7/1/2008    $244.25    N   Referral Required
7/1/2008    $588.97    N   Referral Required
7/1/2008    $606.26    N   Referral Required
7/1/2008    $701.97    N   Referral Required
7/1/2008    $625.16    N   Referral Required
               $0.00   N   Referral Required
7/1/2008    $839.12    N   Referral Required
7/1/2008    $785.22    N   Referral Required
7/1/2008   $1,006.22   N   Referral Required
7/1/2008   $1,112.19   N   Referral Required
7/1/2008   $1,015.60   N   Referral Required
7/1/2008   $1,101.32   N   Referral Required
7/1/2008    $493.93    N   Referral Required
7/1/2008    $834.58    N   Referral Required
7/1/2008   $1,398.88   N   Referral Required
7/1/2008   $1,248.58   N   Referral Required
7/1/2008   $1,603.16   N   Referral Required
7/1/2008   $1,050.00   N   Referral Required
7/1/2008    $904.33    N   Referral Required
7/1/2008   $1,066.62   N   Referral Required
7/1/2008   $1,032.33   N   Referral Required
7/1/2008   $1,170.62   N   Referral Required
7/1/2008   $1,742.84   N   Referral Required
7/1/2008   $2,269.99   N   Referral Required
7/1/2008   $1,902.45   N   Referral Required
7/1/2008   $2,469.67   N   Referral Required
7/1/2008   $1,262.63   N   Referral Required
7/1/2008    $884.46    N   Referral Required
7/1/2008   $1,209.25   N   Referral Required
7/1/2008   $1,094.48   N   Referral Required
               $0.00   N   Referral Required
7/1/2008   $1,506.48   N   Referral Required
7/1/2008   $1,860.68   N   Referral Required
7/1/2008    $925.18    N   Referral Required
7/1/2008    $705.54    N   Referral Required
7/1/2008    $455.19    N   Referral Required
7/1/2008   $2,290.36   N   Referral Required
7/1/2008    $883.26    N   Referral Required
7/1/2008   $1,251.61   N   Referral Required
7/1/2008   $1,298.33   N   Referral Required
7/1/2008   $1,486.04   N   Referral Required
7/1/2008    $986.85    N   Referral Required
7/1/2008   $2,511.93   N   Referral Required
7/1/2008   $2,320.55   N   Referral Required
7/1/2008   $2,509.65   N   Referral Required
7/1/2008   $2,333.31   N   Referral Required
7/1/2008   $1,438.19   N   Referral Required
7/1/2008   $1,821.80   Y   Referral Required
7/1/2008      $90.05   N   Referral Required
7/1/2008    $594.31    N   Referral Required
7/1/2008    $893.71    N   Referral Required
7/1/2008    $857.82    N   Referral Required
7/1/2008    $823.89    N   Referral Required
7/1/2008    $870.74    N   Referral Required
7/1/2008   $1,048.12   N   Referral Required
7/1/2008   $1,060.08   N   Referral Required
7/1/2008   $1,426.09   N   Referral Required
7/1/2008   $1,334.47   N   Referral Required
               $0.00   N   Referral Required
7/1/2008    $622.50    N   Referral Required
7/1/2008    $804.71    N   Referral Required
7/1/2008    $766.49    N   Referral Required
7/1/2008   $1,276.68   N   Referral Required
1/1/2011    $795.99    N   Referral Required
7/1/2008    $798.60    N   Referral Required
7/1/2008    $796.53    N   Referral Required
7/1/2008    $895.99    N   Referral Required
7/1/2008    $785.25    N   Referral Required
7/1/2008    $608.69    N   Referral Required
1/1/2011    $151.08    N   Referral Required
7/1/2008    $136.08    N   Referral Required
1/1/2011    $152.81    N   Referral Required
1/1/2008    $969.51    N   Referral Required
1/1/2008   $1,237.47   N   Referral Required
1/1/2008   $1,416.33   N   Referral Required
7/1/2008   $1,792.45   N   Referral Required
7/1/2008    $780.94    N   Referral Required
7/1/2008    $463.40    N   Referral Required
7/1/2008    $631.03    N   Referral Required
7/1/2008    $267.75    N   Referral Required
7/1/2008    $280.99    N   Referral Required
7/1/2008    $307.23    N   Referral Required
7/1/2008    $515.73    N   Referral Required
7/1/2008    $317.23    N   Referral Required
7/1/2008    $340.47    N   Referral Required
7/1/2008    $156.38    N   Referral Required
               $0.00   N   Referral Required
7/1/2008    $158.50    N   Referral Required
7/1/2008    $684.68    N   Referral Required
1/1/2010    $357.32    N   Referral Required
7/1/2008    $367.96    N   Referral Required
7/1/2008    $115.97    N   Referral Required
7/1/2008    $315.77    N   Referral Required
7/1/2008    $317.42    N   Referral Required
1/1/2011    $502.39    N   Referral Required
1/1/2011    $136.48    N   Referral Required
7/1/2008    $617.60    N   Referral Required
7/1/2008    $526.44    N   Referral Required
7/1/2008      $41.38   N   Referral Required
7/1/2008    $358.44    N   Referral Required
7/1/2008    $375.23    N   Referral Required
7/1/2008      $66.55   N   Referral Required
7/1/2008    $101.43    N   Referral Required
7/1/2008    $150.98    N   Referral Required
1/1/2011    $972.36    N   Referral Required
1/1/2011   $1,060.57   N   Referral Required
1/1/2008    $954.73    N   Referral Required
1/1/2011    $891.03    N   Referral Required
1/1/2011    $648.32    N   Referral Required
1/1/2008    $494.51    N   Referral Required
1/1/2011    $799.09    N   Referral Required
1/1/2011    $709.29    N   Referral Required
1/1/2008    $151.31    N   Referral Required
7/1/2008    $604.48    N   Referral Required
7/1/2008    $754.12    N   Referral Required
7/1/2008    $320.95    N   Referral Required
7/1/2008    $478.54    N   Referral Required
7/1/2008    $319.39    N   Referral Required
7/1/2008    $473.63    N   Referral Required
7/1/2008    $411.06    N   Referral Required
7/1/2008    $647.90    N   Referral Required
7/1/2008    $507.06    N   Referral Required
7/1/2008    $503.68    N   Referral Required
7/1/2008    $615.16    N   Referral Required
7/1/2008    $455.01    N   Referral Required
7/1/2008    $539.20    N   Referral Required
7/1/2008    $458.15    N   Referral Required
7/1/2008    $896.26    N   Referral Required
7/1/2008    $500.96    N   Referral Required
7/1/2008    $476.30    N   Referral Required
7/1/2008    $578.78    N   Referral Required
7/1/2008    $593.35    N   Referral Required
7/1/2008    $746.87    N   Referral Required
7/1/2008    $612.87    N   Referral Required
7/1/2008    $754.59    N   Referral Required
7/1/2008    $224.34    N   Referral Required
7/1/2008    $323.72    N   Referral Required
7/1/2008    $399.48    N   Referral Required
7/1/2008    $250.10    N   Referral Required
7/1/2008    $372.72    N   Referral Required
7/1/2008    $347.29    N   Referral Required
7/1/2008    $412.63    N   Referral Required
7/1/2008    $453.58    N   Referral Required
7/1/2008    $588.31    N   Referral Required
7/1/2008   $4,027.58   N   Referral Required
7/1/2008    $922.60    N   Referral Required
7/1/2008    $558.55    N   Referral Required
7/1/2008    $511.77    N   Referral Required
7/1/2008    $338.19    N   Referral Required
7/1/2008    $437.54    N   Referral Required
1/1/2009    $666.88    N   Referral Required
1/1/2009    $833.55    N   Referral Required
1/1/2009    $766.95    N   Referral Required
1/1/2009    $923.17    N   Referral Required
1/1/2009    $769.66    N   Referral Required
1/1/2009   $1,112.19   N   Referral Required
               $0.00   N   Referral Required
7/1/2008    $651.05    N   Referral Required
7/1/2008   $1,246.58   N   Referral Required
7/1/2008    $300.06    N   Referral Required
               $0.00   N   Referral Required
               $0.00   N   Referral Required
7/1/2008    $624.00    N   Referral Required
7/1/2008    $896.31    N   Referral Required
7/1/2008    $830.59    N   Referral Required
7/1/2008    $833.17    N   Referral Required
7/1/2008    $828.63    N   Referral Required
7/1/2008   $1,034.94   N   Referral Required
7/1/2008   $1,067.34   N   Referral Required
7/1/2008   $1,081.23   N   Referral Required
7/1/2008   $1,327.49   N   Referral Required
7/1/2008    $791.06    N   Referral Required
7/1/2008   $1,160.96   N   Referral Required
7/1/2008    $858.04    N   Referral Required
7/1/2008    $860.02    N   Referral Required
7/1/2008    $898.12    N   Referral Required
7/1/2008    $936.65    N   Referral Required
7/1/2008   $1,019.18   N   Referral Required
7/1/2008       $2.21   Y   Referral Required
7/1/2008       $0.46   Y   Referral Required
7/1/2008      $19.67   Y   Referral Required
7/1/2008    $132.78    N   Referral Required
7/1/2008    $608.93    N   Referral Required
7/1/2008    $926.88    N   Referral Required
7/1/2008   $1,077.18   N   Referral Required
7/1/2008   $1,160.94   N   Referral Required
7/1/2008   $1,180.33   N   Referral Required
7/1/2008   $1,333.70   N   Referral Required
7/1/2008   $1,195.34   N   Referral Required
7/1/2008   $1,111.15   N   Referral Required
7/1/2008    $853.83    N   Referral Required
7/1/2008    $800.38    N   Referral Required
7/1/2008    $669.95    N   Referral Required
7/1/2008   $1,175.23   N   Referral Required
7/1/2008    $163.16    Y   Referral Required
7/1/2008    $163.16    Y   Referral Required
7/1/2008    $180.29    Y   Referral Required
7/1/2008    $158.29    Y   Referral Required
7/1/2008    $153.10    Y   Referral Required
7/1/2008    $735.02    N   Referral Required
7/1/2008   $1,999.27   Y   Referral Required
7/1/2008   $2,244.18   Y   Referral Required
7/1/2008    $931.11    N   Referral Required
7/1/2008   $1,513.73   Y   Referral Required
7/1/2008   $1,233.78   N   Referral Required
1/1/2011    $986.99    N   Referral Required
1/1/2008   $1,176.34   N   Referral Required
1/1/2008    $761.24    N   Referral Required
7/1/2008    $583.79    N   Referral Required
1/1/2011    $304.46    N   Referral Required
7/1/2008      $90.53   N   Referral Required
7/1/2008    $117.94    N   Referral Required
7/1/2008    $167.64    N   Referral Required
7/1/2008    $203.83    N   Referral Required
1/1/2011      $96.72   N   Referral Required
7/1/2008    $168.16    N   Referral Required
7/1/2008    $108.59    N   Referral Required
1/1/2011    $481.32    N   Referral Required
7/1/2008   $1,048.66   N   Referral Required
7/1/2008   $1,261.24   N   Referral Required
7/1/2008    $993.41    N   Referral Required
7/1/2008   $1,029.91   N   Referral Required
7/1/2008    $934.69    N   Referral Required
7/1/2008   $1,194.04   N   Referral Required
7/1/2008   $1,214.51   N   Referral Required
7/1/2008   $1,044.56   N   Referral Required
7/1/2008    $836.92    N   Referral Required
7/1/2008   $1,059.09   N   Referral Required
7/1/2008   $1,351.27   N   Referral Required
7/1/2008   $1,143.47   N   Referral Required
7/1/2008   $1,224.57   N   Referral Required
7/1/2008   $1,085.33   N   Referral Required
7/1/2008   $1,326.31   N   Referral Required
7/1/2008   $1,235.33   N   Referral Required
               $0.00   N   Referral Required
7/1/2008    $340.81    N   Referral Required
7/1/2008    $355.95    N   Referral Required
7/1/2008    $392.34    N   Referral Required
7/1/2008    $394.77    N   Referral Required
7/1/2008    $446.16    N   Referral Required
7/1/2008    $541.02    N   Referral Required
7/1/2008    $455.28    N   Referral Required
7/1/2008    $493.23    N   Referral Required
7/1/2008    $526.19    N   Referral Required
7/1/2008    $663.44    N   Referral Required
7/1/2008    $523.57    N   Referral Required
7/1/2008    $564.19    N   Referral Required
7/1/2008    $827.86    N   Referral Required
5/1/2009   $3,982.32   N   Referral Required
5/1/2009   $4,139.95   N   Referral Required
7/1/2008    $846.44    N   Referral Required
7/1/2008    $830.24    N   Referral Required
7/1/2008    $867.50    N   Referral Required
7/1/2008    $820.83    N   Referral Required
7/1/2008    $801.63    N   Referral Required
7/1/2008    $936.17    N   Referral Required
7/1/2008   $1,037.94   N   Referral Required
1/1/2011    $165.37    N   Referral Required
7/1/2008    $148.51    N   Referral Required
7/1/2008      $74.64   N   Referral Required
1/1/2011      $94.89   N   Referral Required
7/1/2008    $844.02    N   Referral Required
7/1/2008   $1,016.11   N   Referral Required
7/1/2008    $884.76    N   Referral Required
7/1/2008    $982.82    N   Referral Required
7/1/2008    $452.28    N   Referral Required
7/1/2008    $626.81    N   Referral Required
7/1/2008    $984.15    N   Referral Required
7/1/2008   $1,050.75   N   Referral Required
7/1/2008    $990.50    N   Referral Required
7/1/2008   $1,048.75   N   Referral Required
7/1/2008    $988.27    N   Referral Required
7/1/2008    $996.28    N   Referral Required
7/1/2008   $1,032.08   N   Referral Required
7/1/2008   $1,092.99   N   Referral Required
7/1/2008    $827.83    N   Referral Required
7/1/2008   $1,122.85   N   Referral Required
7/1/2008   $1,101.33   N   Referral Required
7/1/2008   $1,179.52   N   Referral Required
7/1/2008   $1,496.27   N   Referral Required
7/1/2008   $1,634.94   N   Referral Required
7/1/2008   $1,111.86   N   Referral Required
7/1/2008   $1,124.54   N   Referral Required
7/1/2008    $856.69    N   Referral Required
7/1/2008    $756.58    N   Referral Required
7/1/2008    $796.02    N   Referral Required
7/1/2008    $987.88    N   Referral Required
7/1/2008    $789.96    N   Referral Required
7/1/2008    $897.64    N   Referral Required
7/1/2008   $1,267.62   N   Referral Required
7/1/2008   $1,158.70   N   Referral Required
               $0.00   N   Referral Required
7/1/2008    $140.39    N   Referral Required
7/1/2008    $355.33    N   Referral Required
7/1/2008    $161.96    N   Referral Required
7/1/2008    $373.10    N   Referral Required
7/1/2008    $161.96    N   Referral Required
7/1/2008    $428.22    N   Referral Required
7/1/2008    $172.79    N   Referral Required
7/1/2008    $402.34    N   Referral Required
7/1/2008    $194.38    N   Referral Required
7/1/2008    $172.79    N   Referral Required
7/1/2008    $362.24    N   Referral Required
7/1/2008    $344.18    N   Referral Required
7/1/2008    $332.22    N   Referral Required
7/1/2008    $434.32    N   Referral Required
7/1/2008    $430.80    N   Referral Required
7/1/2008    $330.18    N   Referral Required
7/1/2008    $416.75    N   Referral Required
7/1/2008    $416.32    N   Referral Required
7/1/2008    $262.21    N   Referral Required
7/1/2008    $418.84    N   Referral Required
7/1/2008    $422.75    N   Referral Required
7/1/2008    $523.43    N   Referral Required
7/1/2008    $518.28    N   Referral Required
7/1/2008    $365.65    N   Referral Required
1/1/2008      $57.93   N   Referral Required
1/1/2008    $116.59    N   Referral Required
1/1/2011    $223.56    N   Referral Required
7/1/2008    $565.51    N   Referral Required
7/1/2008    $534.52    N   Referral Required
7/1/2008    $775.06    N   Referral Required
7/1/2008    $694.72    N   Referral Required
7/1/2008    $710.29    N   Referral Required
7/1/2008    $856.11    N   Referral Required
7/1/2008   $1,138.75   N   Referral Required
7/1/2008   $1,170.72   N   Referral Required
7/1/2008   $1,336.44   N   Referral Required
7/1/2008   $1,656.76   N   Referral Required
7/1/2008   $1,723.06   N   Referral Required
7/1/2008   $1,918.88   N   Referral Required
7/1/2008   $1,753.86   N   Referral Required
7/1/2008   $1,990.83   N   Referral Required
7/1/2008   $2,136.76   N   Referral Required
7/1/2008   $2,066.93   N   Referral Required
1/1/2011    $178.39    N   Referral Required
7/1/2008      $35.10   N   Referral Required
1/1/2011    $104.86    N   Referral Required
7/1/2008      $82.18   N   Referral Required
1/1/2011      $56.55   N   Referral Required
1/1/2011      $72.19   N   Referral Required
1/1/2011    $132.50    N   Referral Required
1/1/2011    $106.90    N   Referral Required
1/1/2011    $149.59    N   Referral Required
7/1/2008    $269.24    N   Referral Required
7/1/2008    $108.99    N   Referral Required
1/1/2011    $202.93    N   Referral Required    $32.63   $184.89
1/1/2011    $296.19    N   Referral Required    $51.82   $253.01
1/1/2010    $205.89    N   Referral Required   $127.65    $78.24
1/1/2010    $205.84    N   Referral Required   $127.62    $78.22
1/1/2010    $222.24    N   Referral Required   $128.90    $93.45
7/1/2008      $47.07   N   Referral Required     $5.65    $41.42
7/1/2008      $74.55   N   Referral Required     $7.45    $67.10
1/1/2011    $189.38    N   Referral Required    $30.33   $159.26
7/1/2008    $204.41    N   Referral Required    $38.84   $165.57
7/1/2008    $224.92    N   Referral Required   $103.46   $121.46
1/1/2011    $130.79    N   Referral Required    $31.74   $135.29
7/1/2008      $17.20   N   Referral Required
7/1/2008    $941.84    N   Referral Required
7/1/2008    $985.18    N   Referral Required
7/1/2008    $587.23    N   Referral Required
7/1/2008    $700.77    N   Referral Required
7/1/2008    $530.04    N   Referral Required
7/1/2008    $649.57    N   Referral Required
7/1/2008    $800.02    N   Referral Required
7/1/2008    $420.55    N   Referral Required
7/1/2008    $742.87    N   Referral Required
7/1/2008    $695.54    N   Referral Required
7/1/2008    $971.48    Y   Referral Required
7/1/2008   $1,460.57   N   Referral Required
7/1/2008   $1,252.21   N   Referral Required
7/1/2008    $640.96    N   Referral Required
7/1/2008    $672.85    N   Referral Required
7/1/2008    $734.56    N   Referral Required
               $0.00   Y   Referral Required
7/1/2008    $193.42    N   Referral Required
7/1/2008    $358.69    N   Referral Required
7/1/2008    $271.35    N   Referral Required
7/1/2008    $558.59    N   Referral Required
7/1/2008    $419.60    N   Referral Required
1/1/2011    $405.45    N   Referral Required
7/1/2008    $172.79    N   Referral Required
7/1/2008   $1,097.01   N   Referral Required
7/1/2008    $172.79    N   Referral Required
1/1/2011    $737.73    N   Referral Required
7/1/2008    $226.69    N   Referral Required
7/1/2008    $266.27    N   Referral Required
7/1/2008    $466.24    N   Referral Required
7/1/2008    $222.27    N   Referral Required
7/1/2008    $192.07    N   Referral Required
1/1/2011    $392.60    N   Referral Required
7/1/2008    $418.59    N   Referral Required
1/1/2011    $518.30    N   Referral Required
7/1/2008    $244.27    N   Referral Required
7/1/2008    $300.22    N   Referral Required
1/1/2011    $288.69    N   Referral Required
7/1/2008    $309.75    N   Referral Required
7/1/2008    $263.33    N   Referral Required
7/1/2008    $264.82    N   Referral Required
7/1/2008    $224.64    N   Referral Required
7/1/2008    $259.51    N   Referral Required
7/1/2008    $270.84    N   Referral Required
7/1/2008    $257.50    N   Referral Required
1/1/2011    $241.13    N   Referral Required
1/1/2011    $425.33    N   Referral Required
1/1/2011    $880.64    N   Referral Required
7/1/2008    $439.23    N   Referral Required
7/1/2008    $227.64    N   Referral Required
7/1/2008    $296.55    N   Referral Required
1/1/2011    $264.05    N   Referral Required
1/1/2011    $683.07    N   Referral Required
7/1/2008    $401.78    N   Referral Required
7/1/2008    $235.88    N   Referral Required
1/1/2011    $290.91    N   Referral Required
1/1/2011    $316.34    N   Referral Required
1/1/2011    $352.29    N   Referral Required
7/1/2008    $384.28    N   Referral Required
7/1/2008    $407.62    N   Referral Required
7/1/2008    $455.57    N   Referral Required
7/1/2008    $289.03    N   Referral Required
7/1/2008    $339.18    N   Referral Required
7/1/2008    $390.62    N   Referral Required
7/1/2008    $360.99    N   Referral Required
7/1/2008    $430.67    N   Referral Required
1/1/2011    $471.20    N   Referral Required
7/1/2008    $248.40    N   Referral Required
7/1/2008    $419.04    N   Referral Required
1/1/2011    $483.00    N   Referral Required
7/1/2008    $749.43    N   Referral Required
7/1/2008    $226.77    N   Referral Required
7/1/2008    $399.54    N   Referral Required
1/1/2011    $294.53    Y   Referral Required
7/1/2008   $2,322.04   N   Referral Required
1/1/2011   $2,028.59   N   Referral Required
1/1/2008    $907.59    N   Referral Required
7/1/2008    $391.88    N   Referral Required
7/1/2008    $626.29    N   Referral Required
7/1/2008    $863.84    N   Referral Required
7/1/2008    $135.75    N   Referral Required
7/1/2008    $262.88    N   Referral Required
7/1/2008      $88.92   N   Referral Required
7/1/2008      $61.63   N   Referral Required
7/1/2008    $357.21    N   Referral Required
7/1/2008    $163.81    N   Referral Required
7/1/2008    $420.97    N   Referral Required
7/1/2008    $585.29    N   Referral Required
7/1/2008    $141.03    N   Referral Required
7/1/2008    $699.73    N   Referral Required
7/1/2008    $844.50    N   Referral Required
7/1/2008    $406.98    N   Referral Required
7/1/2008    $544.57    N   Referral Required
7/1/2008    $575.01    N   Referral Required
7/1/2008    $384.27    N   Referral Required
7/1/2008    $352.64    N   Referral Required
7/1/2008    $183.72    N   Referral Required
7/1/2008    $204.16    N   Referral Required
7/1/2008    $187.81    N   Referral Required
7/1/2008    $242.19    N   Referral Required
7/1/2008    $724.40    N   Referral Required
7/1/2008    $791.45    N   Referral Required
7/1/2008    $889.08    N   Referral Required
7/1/2008   $1,016.08   N   Referral Required
7/1/2008    $746.09    N   Referral Required
7/1/2008    $854.69    N   Referral Required
7/1/2008    $865.54    N   Referral Required
7/1/2008   $1,049.85   N   Referral Required
7/1/2008    $785.74    N   Referral Required
7/1/2008    $691.45    N   Referral Required
7/1/2008    $721.30    N   Referral Required
7/1/2008    $793.08    N   Referral Required
7/1/2008    $582.82    N   Referral Required
7/1/2008    $739.55    N   Referral Required
7/1/2008   $1,165.25   N   Referral Required
7/1/2008    $551.43    N   Referral Required
7/1/2008    $365.88    N   Referral Required
7/1/2008    $412.03    N   Referral Required
7/1/2008    $675.88    N   Referral Required
7/1/2008    $437.13    N   Referral Required
7/1/2008    $438.27    N   Referral Required
7/1/2008    $577.63    N   Referral Required
7/1/2008    $724.54    N   Referral Required
7/1/2008    $503.24    N   Referral Required
7/1/2008      $80.50   N   Referral Required
7/1/2008      $78.13   N   Referral Required
7/1/2008      $60.10   N   Referral Required
7/1/2008    $118.28    N   Referral Required
7/1/2008    $111.95    N   Referral Required
7/1/2008      $68.65   N   Referral Required
7/1/2008      $68.32   N   Referral Required
7/1/2008      $35.34   N   Referral Required
1/1/2011   $2,250.37   N   Referral Required
7/1/2008   $2,626.77   N   Referral Required
1/1/2010    $455.59    N   Referral Required
               $0.00   N   Referral Required
7/1/2008    $147.69    N   Referral Required
7/1/2008    $181.22    N   Referral Required
7/1/2008    $281.95    N   Referral Required
7/1/2008    $106.52    N   Referral Required
7/1/2008    $101.71    N   Referral Required
7/1/2008    $111.15    N   Referral Required
7/1/2008    $124.73    N   Referral Required
7/1/2008    $171.41    N   Referral Required
7/1/2008    $183.45    N   Referral Required
7/1/2008    $168.27    N   Referral Required
7/1/2008    $260.24    N   Referral Required
7/1/2008    $567.05    N   Referral Required
7/1/2008    $727.63    N   Referral Required
7/1/2008    $854.17    N   Referral Required
7/1/2008    $406.25    N   Referral Required
7/1/2008    $568.00    N   Referral Required
7/1/2008    $734.06    N   Referral Required
7/1/2008   $1,084.57   N   Referral Required
7/1/2008   $1,379.69   N   Referral Required
1/1/2011    $159.92    N   Referral Required
7/1/2008    $219.87    N   Referral Required
7/1/2008    $177.56    N   Referral Required
7/1/2008    $258.16    N   Referral Required
7/1/2008    $194.76    N   Referral Required
7/1/2008    $171.43    N   Referral Required
7/1/2008    $101.43    N   Referral Required
7/1/2008    $486.15    N   Referral Required
1/1/2011    $203.21    N   Referral Required
7/1/2008    $590.68    N   Referral Required
7/1/2008    $693.36    N   Referral Required
7/1/2008    $863.84    N   Referral Required
7/1/2008    $613.79    N   Referral Required
7/1/2008    $769.99    N   Referral Required
7/1/2008    $921.57    N   Referral Required
7/1/2008    $615.35    N   Referral Required
7/1/2008    $863.84    N   Referral Required
7/1/2008    $722.40    N   Referral Required
7/1/2008    $900.48    N   Referral Required
7/1/2008   $1,133.81   N   Referral Required
7/1/2008    $869.71    N   Referral Required
7/1/2008    $858.99    N   Referral Required
7/1/2008   $1,241.77   N   Referral Required
7/1/2008    $930.90    N   Referral Required
7/1/2008   $1,054.77   N   Referral Required
7/1/2008    $523.63    N   Referral Required
7/1/2008    $884.71    N   Referral Required
7/1/2008    $940.77    N   Referral Required
7/1/2008   $1,333.19   N   Referral Required
7/1/2008    $665.16    N   Referral Required
7/1/2008    $732.31    N   Referral Required
7/1/2008    $891.89    N   Referral Required
7/1/2008   $1,067.80   N   Referral Required
7/1/2008    $642.96    N   Referral Required
7/1/2008    $581.29    N   Referral Required
7/1/2008    $376.75    N   Referral Required
               $0.00   N   Referral Required
7/1/2008      $69.26   N   Referral Required
7/1/2008      $67.72   N   Referral Required
7/1/2008    $194.42    N   Referral Required
7/1/2008   $485.89   N   Referral Required
7/1/2008   $293.92   N   Referral Required
7/1/2008   $531.61   N   Referral Required
7/1/2008   $496.71   N   Referral Required
7/1/2008   $663.62   N   Referral Required
7/1/2008   $440.51   N   Referral Required
7/1/2008   $619.10   N   Referral Required
7/1/2008   $407.08   N   Referral Required
7/1/2008   $274.38   N   Referral Required
7/1/2008   $417.32   N   Referral Required
7/1/2008   $617.17   N   Referral Required
7/1/2008   $368.27   N   Referral Required
7/1/2008   $719.54   N   Referral Required
7/1/2008   $583.79   N   Referral Required
7/1/2008   $698.72   N   Referral Required
             $0.00   N   Referral Required
7/1/2008   $192.80   N   Referral Required
7/1/2008   $117.82   N   Referral Required
7/1/2008   $329.98   N   Referral Required
7/1/2008   $292.01   N   Referral Required
7/1/2008   $374.69   N   Referral Required
7/1/2008   $509.23   N   Referral Required
7/1/2008   $317.78   N   Referral Required
7/1/2008   $115.48   N   Referral Required
7/1/2008   $303.21   N   Referral Required
7/1/2008   $454.47   N   Referral Required
7/1/2008   $337.21   N   Referral Required
7/1/2008   $203.04   N   Referral Required
7/1/2008   $344.07   N   Referral Required
7/1/2008   $315.40   N   Referral Required
7/1/2008   $433.99   N   Referral Required
7/1/2008   $322.97   N   Referral Required
7/1/2008   $618.01   N   Referral Required
7/1/2008   $496.42   N   Referral Required
1/1/2011   $403.30   N
7/1/2008   $173.12   N   Referral Required
7/1/2008   $623.91   N   Referral Required
7/1/2008   $360.40   N
7/1/2008   $337.21   N   Referral Required
7/1/2008   $352.20   N   Referral Required
4/1/2009   $317.83   Y   Referral Required
4/1/2009   $383.74   Y   Referral Required
4/1/2009   $427.01   Y   Referral Required
7/1/2008   $379.69   N   Referral Required
             $0.00   N   Referral Required
7/1/2008   $648.82   N   Referral Required
7/1/2008   $311.45   N   Referral Required
7/1/2008    $220.34    N   Referral Required
7/1/2008    $245.33    N   Referral Required
1/1/2009    $369.30    N   Referral Required
7/1/2008    $420.31    N   Referral Required
7/1/2008    $524.95    N   Referral Required
7/1/2008    $982.94    N   Referral Required
7/1/2008   $1,195.19   N   Referral Required
7/1/2008   $1,455.07   N   Referral Required
7/1/2008   $1,607.85   N   Referral Required
7/1/2008    $791.21    N   Referral Required
7/1/2008    $857.93    N   Referral Required
7/1/2008   $1,217.01   N   Referral Required
7/1/2008   $1,304.11   N   Referral Required
7/1/2008   $1,492.50   N   Referral Required
7/1/2008    $795.40    N   Referral Required
7/1/2008   $1,004.95   N   Referral Required
7/1/2008   $1,210.48   N   Referral Required
7/1/2008   $1,584.42   N   Referral Required
7/1/2008   $1,042.68   N   Referral Required
7/1/2008    $691.54    N   Referral Required
7/1/2008    $132.29    N   Referral Required
               $0.00   N   Referral Required
1/1/2008    $394.61    N   Referral Required
               $0.00   N   Referral Required
               $0.00   N   Referral Required
7/1/2008      $96.89   N   Referral Required
1/1/2011    $113.62    N   Referral Required
7/1/2008    $161.55    N   Referral Required
7/1/2008    $133.06    N   Referral Required
7/1/2008      $42.63   N   Referral Required
7/1/2008    $115.65    N   Referral Required
7/1/2008    $196.10    N   Referral Required
7/1/2008      $74.96   N   Referral Required
1/1/2011      $34.62   N   Referral Required
1/1/2011    $457.89    N   Referral Required
7/1/2008    $523.82    N   Referral Required
7/1/2008    $761.51    N   Referral Required
7/1/2008    $973.32    N   Referral Required
7/1/2008   $1,116.80   N   Referral Required
7/1/2008    $993.41    N   Referral Required
7/1/2008   $1,052.63   N   Referral Required
7/1/2008   $1,250.31   N   Referral Required
7/1/2008   $1,242.74   N   Referral Required
7/1/2008    $164.24    N   Referral Required
7/1/2008    $261.91    N   Referral Required
7/1/2008    $214.67    N   Referral Required
7/1/2008   $1,018.20   N   Referral Required
7/1/2008    $231.30    N   Referral Required
7/1/2008      $98.27   N   Referral Required
7/1/2008    $132.61    N   Referral Required
7/1/2008    $168.70    N   Referral Required
7/1/2008    $377.54    N   Referral Required
7/1/2008      $84.87   N   Referral Required
7/1/2008    $148.64    N   Referral Required
7/1/2008    $273.58    N   Referral Required
7/1/2008    $101.52    N   Referral Required
7/1/2008      $21.60   N   Referral Required
7/1/2008    $171.32    N   Referral Required
7/1/2008      $79.38   N   Referral Required
7/1/2008    $121.24    N   Referral Required
7/1/2008    $413.50    N   Referral Required
7/1/2008   $1,232.58   N   Referral Required
7/1/2008   $1,408.62   N   Referral Required
7/1/2008    $796.57    N   Referral Required
7/1/2008   $1,434.64   N   Referral Required
7/1/2008   $1,499.80   N   Referral Required
7/1/2008    $451.12    N   Referral Required
7/1/2008    $160.82    N   Referral Required
7/1/2008    $172.55    N   Referral Required
7/1/2008      $49.07   N   Referral Required
7/1/2008    $381.52    N   Referral Required
7/1/2008      $67.96   N   Referral Required
1/1/2011      $61.31   N
7/1/2008    $128.11    N   Referral Required
7/1/2008    $259.91    N   Referral Required
7/1/2008    $321.86    N   Referral Required
7/1/2008    $279.92    N   Referral Required
7/1/2008    $346.53    N   Referral Required
7/1/2008    $566.61    N   Referral Required
7/1/2008    $555.51    N   Referral Required
7/1/2008    $698.79    N   Referral Required
7/1/2008    $786.30    N   Referral Required
7/1/2008    $241.04    N   Referral Required
7/1/2008    $420.02    N   Referral Required
7/1/2008    $704.21    N   Referral Required
7/1/2008    $853.67    N   Referral Required
7/1/2008    $445.33    N   Referral Required
7/1/2008    $609.84    N   Referral Required
7/1/2008    $745.77    N   Referral Required
7/1/2008    $587.47    N   Referral Required
7/1/2008    $618.10    N   Referral Required
1/1/2011    $678.54    N   Referral Required
7/1/2008    $680.83    N   Referral Required
7/1/2008    $431.79    Y   Referral Required
7/1/2008    $830.60    N   Referral Required
7/1/2008    $463.47    N   Referral Required
7/1/2008    $774.49    N   Referral Required
7/1/2008    $866.51    N   Referral Required
7/1/2008    $557.30    N   Referral Required
7/1/2008    $423.71    N   Referral Required
7/1/2008    $482.47    N   Referral Required
7/1/2008    $482.42    N   Referral Required
7/1/2008    $695.50    N   Referral Required
7/1/2008   $1,013.88   N   Referral Required
7/1/2008    $119.64    N   Referral Required
7/1/2008      $94.87   N   Referral Required
7/1/2008    $139.23    N   Referral Required
7/1/2008    $103.37    N   Referral Required
7/1/2008    $140.51    N   Referral Required
7/1/2008    $809.17    N   Referral Required
7/1/2008    $852.09    N   Referral Required
1/1/2010    $775.15    N   Referral Required
7/1/2008      $97.58   N   Referral Required
7/1/2008    $138.14    N   Referral Required
7/1/2008    $128.69    N   Referral Required
7/1/2008    $121.53    N   Referral Required
1/1/2011    $265.34    N   Referral Required
1/1/2011    $299.10    N   Referral Required
1/1/2011    $118.30    N   Referral Required
7/1/2008      $90.53   N   Referral Required
7/1/2008    $119.17    N   Referral Required
7/1/2008    $129.57    N   Referral Required
7/1/2008    $127.16    N   Referral Required
7/1/2008    $275.83    N   Referral Required
7/1/2008    $234.90    N   Referral Required
7/1/2008    $302.00    N   Referral Required
7/1/2008   $1,507.37   N   Referral Required
7/1/2008    $685.76    N   Referral Required
7/1/2008    $726.58    N   Referral Required
7/1/2008    $356.35    N   Referral Required
7/1/2008    $530.57    N   Referral Required
7/1/2008    $500.31    N   Referral Required
7/1/2008    $110.83    N   Referral Required
7/1/2008      $48.59   N   Referral Required
7/1/2008    $263.60    N   Referral Required
7/1/2008    $269.92    N   Referral Required
7/1/2008      $53.87   N   Referral Required
7/1/2008      $98.76   N   Referral Required
7/1/2008      $44.59   N   Referral Required
7/1/2008    $215.96    N   Referral Required
7/1/2008    $806.04    N   Referral Required
7/1/2008    $478.44    N   Referral Required
7/1/2008   $1,025.88   N   Referral Required
7/1/2008    $872.26    Y   Referral Required
7/1/2008   $1,107.06   Y   Referral Required
7/1/2008    $838.95    Y   Referral Required
7/1/2008   $1,156.11   Y   Referral Required
7/1/2008   $1,540.04   Y   Referral Required
7/1/2008   $2,382.37   N   Referral Required
7/1/2008    $729.72    Y   Referral Required
7/1/2008    $815.41    Y   Referral Required
7/1/2008    $878.54    Y   Referral Required
7/1/2008    $933.82    Y   Referral Required
7/1/2008    $782.79    Y   Referral Required
7/1/2008    $868.49    Y   Referral Required
7/1/2008    $930.63    Y   Referral Required
7/1/2008   $1,165.37   Y   Referral Required
7/1/2008   $1,025.00   Y   Referral Required
7/1/2008   $1,112.46   Y   Referral Required
7/1/2008   $1,174.85   Y   Referral Required
7/1/2008   $1,221.45   Y   Referral Required
7/1/2008   $1,081.25   Y   Referral Required
7/1/2008      $59.40   N
7/1/2008      $87.43   N
1/1/2011    $112.37    N   Referral Required
7/1/2008    $401.12    N   Referral Required
1/1/2011    $978.56    N   Referral Required
7/1/2008   $2,037.54   N   Referral Required
7/1/2008    $392.74    N   Referral Required
7/1/2008    $707.39    N   Referral Required
7/1/2008    $982.62    N   Referral Required
7/1/2008    $982.62    N   Referral Required
7/1/2008    $688.91    N   Referral Required
7/1/2008    $799.61    N   Referral Required
7/1/2008    $746.93    Y   Referral Required
7/1/2008    $828.99    Y   Referral Required
7/1/2008    $842.77    Y   Referral Required
7/1/2008    $911.44    Y   Referral Required
7/1/2008    $792.89    N   Referral Required
7/1/2008   $1,005.23   N   Referral Required
7/1/2008   $1,583.84   Y   Referral Required
7/1/2008    $781.57    Y   Referral Required
7/1/2008    $864.27    Y   Referral Required
7/1/2008   $1,009.88   Y   Referral Required
7/1/2008   $1,159.01   Y   Referral Required
7/1/2008    $208.02    N   Referral Required
7/1/2008    $274.42    N   Referral Required
7/1/2008    $309.27    N   Referral Required
7/1/2008    $350.92    N   Referral Required
7/1/2008    $496.11    N   Referral Required
7/1/2008    $293.07    N   Referral Required
1/1/2011   $1,597.90   N   Referral Required
1/1/2011   $1,716.27   N   Referral Required
7/1/2008    $801.81    Y   Referral Required
7/1/2008    $880.84    Y   Referral Required
7/1/2008    $996.14    Y   Referral Required
7/1/2008   $1,128.09   Y   Referral Required
               $0.00   N   Referral Required
               $0.00   N   Referral Required
7/1/2008    $322.94    N
7/1/2008    $292.82    N
7/1/2008      $70.24   N
7/1/2008    $225.61    N
7/1/2008    $593.73    N   Referral Required
7/1/2008    $572.98    N   Referral Required
7/1/2008    $626.56    N   Referral Required
7/1/2008    $322.44    N   Referral Required
7/1/2008    $322.64    N   Referral Required
7/1/2008    $664.57    N   Referral Required
7/1/2008    $717.69    N   Referral Required
               $0.00   N   Referral Required
7/1/2008    $670.56    N
7/1/2008    $631.27    N   Referral Required
7/1/2008    $770.98    N   Referral Required
7/1/2008    $759.30    N   Referral Required
7/1/2008    $283.23    N   Referral Required
7/1/2008    $352.71    N   Referral Required
7/1/2008    $276.40    N   Referral Required
7/1/2008    $605.57    N   Referral Required
1/1/2011    $808.53    N   Referral Required
7/1/2008    $612.78    N   Referral Required
7/1/2008    $360.66    N   Referral Required
7/1/2008    $620.48    N   Referral Required
7/1/2008    $641.67    N   Referral Required
7/1/2008    $438.20    N   Referral Required
7/1/2008    $986.40    N   Referral Required
7/1/2008    $938.97    N   Referral Required
7/1/2008   $1,213.35   Y   Referral Required
7/1/2008   $1,368.21   N   Referral Required
7/1/2008   $1,698.52   Y   Referral Required
7/1/2008   $1,844.54   Y   Referral Required
7/1/2008   $1,186.03   Y   Referral Required
7/1/2008   $1,287.06   N   Referral Required
7/1/2008   $1,424.44   N   Referral Required
7/1/2008    $810.75    N   Referral Required
               $0.00   N   Referral Required
1/1/2011    $114.08    N   Referral Required
7/1/2008    $160.10    N   Referral Required
7/1/2008    $181.00    N   Referral Required
7/1/2008    $137.17    N   Referral Required
7/1/2008      $59.47   N   Referral Required   $15.46   $44.01
7/1/2008      $39.93   N   Referral Required    $7.99   $31.94
7/1/2008      $98.83   N   Referral Required
7/1/2008      $45.37   N   Referral Required
7/1/2008      $37.42   N   Referral Required
7/1/2008    $350.26    N   Referral Required
7/1/2008    $408.68    N   Referral Required
7/1/2008    $326.89    N   Referral Required
7/1/2008    $408.68    N   Referral Required
7/1/2008    $722.26    N   Referral Required
7/1/2008    $687.43    N   Referral Required
7/1/2008    $692.05    N   Referral Required
7/1/2008    $781.87    N   Referral Required
7/1/2008    $788.56    Y   Referral Required
7/1/2008    $748.68    N   Referral Required
7/1/2008    $322.58    N   Referral Required
7/1/2008    $668.45    N   Referral Required
7/1/2008    $656.43    N   Referral Required
1/1/2011    $189.66    N   Referral Required
1/1/2011      $65.84   N   Referral Required
7/1/2008    $169.26    N   Referral Required
7/1/2008    $135.58    N   Referral Required
7/1/2008    $215.09    N   Referral Required
7/1/2008    $246.52    N   Referral Required
7/1/2008   $1,539.21   N   Referral Required
7/1/2008    $683.81    N
7/1/2008    $789.87    N   Referral Required
7/1/2008      $91.82   N   Referral Required
7/1/2008      $81.72   N   Referral Required
7/1/2008    $382.36    N   Referral Required
7/1/2008    $683.73    N   Referral Required
7/1/2008    $123.07    N   Referral Required
7/1/2008   $1,742.30   N   Referral Required
7/1/2008    $808.54    N
7/1/2008    $951.69    N   Referral Required
7/1/2008    $428.40    Y   Referral Required
7/1/2008   $1,619.17   N   Referral Required
7/1/2008    $766.11    N
7/1/2008    $856.32    N   Referral Required
7/1/2008   $1,822.20   N   Referral Required
7/1/2008    $882.55    N
7/1/2008   $1,032.48   N   Referral Required
7/1/2008    $267.37    N   Referral Required
7/1/2008    $326.31    N   Referral Required
7/1/2008    $333.17    N   Referral Required
7/1/2008    $380.52    N   Referral Required
7/1/2008    $188.68    N   Referral Required
7/1/2008    $329.95    N   Referral Required
7/1/2008    $327.39    N   Referral Required
7/1/2008    $350.12    N   Referral Required
7/1/2008    $472.15    N   Referral Required
7/1/2008    $362.66    N   Referral Required
7/1/2008    $429.47    N   Referral Required
7/1/2008    $504.56    N   Referral Required
7/1/2008    $210.78    Y   Referral Required
7/1/2008    $401.35    N   Referral Required
7/1/2008    $118.61    N   Referral Required
               $0.00   N   Referral Required
               $0.00   N   Referral Required
               $0.00   N   Referral Required
7/1/2008    $129.72    N   Referral Required
7/1/2008      $99.46   N   Referral Required
7/1/2008    $543.24    N   Referral Required
7/1/2008    $578.61    N   Referral Required
7/1/2008    $828.34    N   Referral Required
7/1/2008    $634.42    N   Referral Required
7/1/2008    $762.20    N   Referral Required
7/1/2008    $811.38    N   Referral Required
7/1/2008   $1,093.36   N   Referral Required
7/1/2008   $1,421.84   N   Referral Required
7/1/2008    $914.63    N   Referral Required
7/1/2008   $1,148.27   N   Referral Required
7/1/2008    $884.35    N   Referral Required
7/1/2008    $365.76    N   Referral Required
7/1/2008    $492.20    N   Referral Required
1/1/2008      $89.43   N   Referral Required
7/1/2008    $836.04    N   Referral Required
7/1/2008   $1,052.92   N   Referral Required
7/1/2008   $1,157.66   N   Referral Required
7/1/2008    $206.06    N   Referral Required
7/1/2008    $869.58    N   Referral Required
7/1/2008    $989.65    N   Referral Required
7/1/2008   $1,194.43   N   Referral Required
7/1/2008    $898.20    N   Referral Required
7/1/2008   $1,029.35   N   Referral Required
7/1/2008   $1,210.50   N   Referral Required
7/1/2008   $1,523.37   N   Referral Required
7/1/2008   $1,003.90   N   Referral Required
               $0.00   N   Referral Required
               $0.00   N   Referral Required
7/1/2008      $91.78   N   Referral Required
7/1/2008      $88.64   N   Referral Required
7/1/2008    $106.51    N   Referral Required
7/1/2008    $107.74    N   Referral Required
7/1/2008      $93.12   N   Referral Required
7/1/2008    $119.41    N   Referral Required
7/1/2008      $68.98   N   Referral Required
7/1/2008    $353.90    N   Referral Required
7/1/2008    $264.50    N   Referral Required
7/1/2008    $695.05    N   Referral Required
7/1/2008    $572.36    N   Referral Required
7/1/2008    $990.70    N   Referral Required
7/1/2008   $1,064.31   N   Referral Required
7/1/2008    $778.38    N   Referral Required
7/1/2008    $986.65    N   Referral Required
7/1/2008    $989.59    N   Referral Required
7/1/2008    $308.36    N   Referral Required
7/1/2008    $374.96    N   Referral Required
7/1/2008    $673.08    N   Referral Required
7/1/2008    $753.60    N   Referral Required
7/1/2008   $1,312.53   N   Referral Required
7/1/2008   $1,577.47   N   Referral Required
7/1/2008   $1,727.71   N   Referral Required
7/1/2008   $1,634.79   N   Referral Required
7/1/2008   $1,563.24   N   Referral Required
7/1/2008   $1,437.54   N   Referral Required
7/1/2008   $1,652.77   N   Referral Required
7/1/2008      $71.82   N   Referral Required
7/1/2008   $1,526.22   N   Referral Required
7/1/2008   $1,692.72   N   Referral Required
7/1/2008   $1,841.47   N   Referral Required
7/1/2008   $1,881.66   N   Referral Required
7/1/2008   $1,309.58   N   Referral Required
7/1/2008   $1,524.40   N   Referral Required
7/1/2008   $1,528.21   N   Referral Required
7/1/2008   $1,015.25   N   Referral Required
7/1/2008   $1,143.62   N   Referral Required
7/1/2008   $1,755.82   N   Referral Required
7/1/2008   $1,615.04   N   Referral Required
7/1/2008   $1,579.27   N   Referral Required
7/1/2008   $1,508.88   N   Referral Required
7/1/2008   $1,603.85   N   Referral Required
7/1/2008   $1,641.85   N   Referral Required
7/1/2008   $1,500.97   N   Referral Required
7/1/2008   $1,456.18   N   Referral Required
7/1/2008   $1,517.74   N   Referral Required
7/1/2008   $1,076.03   N   Referral Required
7/1/2008    $916.49    N   Referral Required
7/1/2008   $1,728.70   N   Referral Required
7/1/2008   $2,050.00   N   Referral Required
7/1/2008   $1,514.75   N   Referral Required
7/1/2008   $1,480.41   N   Referral Required
7/1/2008      $72.48   N   Referral Required
7/1/2008   $2,205.88   N   Referral Required
7/1/2008   $2,376.60   N   Referral Required
7/1/2008   $3,060.84   N   Referral Required
7/1/2008   $2,561.71   N   Referral Required
7/1/2008   $1,735.76   N   Referral Required
7/1/2008   $1,658.10   N   Referral Required
7/1/2008   $2,810.38   N   Referral Required
7/1/2008   $2,384.33   N   Referral Required
7/1/2008    $945.31    N   Referral Required
7/1/2008   $1,202.95   N   Referral Required
7/1/2008   $1,291.77   N   Referral Required
7/1/2008    $766.38    N   Referral Required
7/1/2008   $2,075.66   N   Referral Required
7/1/2008   $1,881.48   N   Referral Required
7/1/2008   $2,013.73   N   Referral Required
7/1/2008   $1,880.92   N   Referral Required
7/1/2008   $1,767.97   N   Referral Required
7/1/2008   $1,697.82   N   Referral Required
7/1/2008   $1,838.40   N   Referral Required
7/1/2008   $1,694.64   N   Referral Required
7/1/2008   $1,497.26   N   Referral Required
7/1/2008   $2,538.01   N   Referral Required
7/1/2008   $1,834.35   N   Referral Required
7/1/2008   $1,252.77   N   Referral Required
7/1/2008    $746.51    N   Referral Required
7/1/2008   $1,055.03   N   Referral Required
7/1/2008   $1,304.71   N   Referral Required
7/1/2008   $1,341.80   N   Referral Required
7/1/2008   $1,391.63   N   Referral Required
1/1/2011   $1,883.89   N   Referral Required
7/1/2008   $1,522.26   N   Referral Required
7/1/2008   $1,931.22   N   Referral Required
7/1/2008   $1,790.32   N   Referral Required
7/1/2008   $2,023.37   N   Referral Required
7/1/2008   $1,462.83   N   Referral Required
7/1/2008   $1,574.85   N   Referral Required
7/1/2008   $1,919.74   N   Referral Required
7/1/2008   $3,002.93   N   Referral Required
7/1/2008   $2,024.01   N   Referral Required
7/1/2008   $2,234.54   N   Referral Required
7/1/2008   $2,273.09   N   Referral Required
7/1/2008   $2,314.61   N   Referral Required
7/1/2008   $2,261.00   N   Referral Required
7/1/2008   $2,419.41   N   Referral Required
7/1/2008   $1,752.77   N   Referral Required
7/1/2008   $2,564.80   N   Referral Required
7/1/2008   $2,582.81   N   Referral Required
7/1/2008   $2,522.85   N   Referral Required
7/1/2008   $1,927.32   N   Referral Required
7/1/2008   $2,140.69   N   Referral Required
7/1/2008   $2,306.57   N   Referral Required
7/1/2008   $2,086.98   N   Referral Required
7/1/2008   $1,732.71   N   Referral Required
7/1/2008   $1,882.50   N   Referral Required
7/1/2008   $1,832.39   N   Referral Required
7/1/2008   $2,393.80   N   Referral Required
7/1/2008   $2,247.99   N   Referral Required
7/1/2008   $2,611.78   N   Referral Required
7/1/2008    $515.23    N   Referral Required
7/1/2008   $1,543.98   N   Referral Required
7/1/2008    $376.79    N   Referral Required
7/1/2008   $1,344.94   N   Referral Required
7/1/2008   $2,562.85   N   Referral Required
7/1/2008   $2,019.93   N   Referral Required
7/1/2008   $2,653.25   N   Referral Required
7/1/2008   $1,042.27   N   Referral Required
7/1/2008   $1,212.38   N   Referral Required
7/1/2008    $483.76    N   Referral Required
7/1/2008    $948.78    N   Referral Required
7/1/2008    $772.29    N   Referral Required
               $0.00   N   Referral Required
               $0.00   N   Referral Required
               $0.00   N   Referral Required
               $0.00   N   Referral Required
               $0.00   N   Referral Required
7/1/2008   $1,808.21   N   Referral Required
7/1/2008   $3,423.40   N   Referral Required
7/1/2008   $2,295.03   N   Referral Required
7/1/2008   $3,664.02   N   Referral Required
7/1/2008   $1,732.88   N   Referral Required
7/1/2008   $2,946.06   N   Referral Required
7/1/2008   $3,310.22   N   Referral Required
7/1/2008   $3,524.09   N   Referral Required
7/1/2008   $2,804.57   N   Referral Required
7/1/2008   $3,106.54   N   Referral Required
7/1/2008   $1,047.26   N   Referral Required
7/1/2008   $2,069.46   N   Referral Required
7/1/2008   $1,792.09   N   Referral Required
7/1/2008   $1,590.08   N   Referral Required
7/1/2008   $2,098.14   N   Referral Required
7/1/2008    $938.76    N   Referral Required
7/1/2008   $1,153.35   N   Referral Required
7/1/2008   $1,111.46   N   Referral Required
7/1/2008   $1,082.19   N   Referral Required
7/1/2008   $1,195.61   N   Referral Required
7/1/2008   $1,211.59   N   Referral Required
7/1/2008    $666.73    N   Referral Required
7/1/2008    $864.09    N   Referral Required
7/1/2008    $207.97    N   Referral Required
1/1/2009    $659.30    N   Referral Required
1/1/2009    $182.36    N   Referral Required
1/1/2009    $659.30    N   Referral Required
1/1/2009    $252.09    N   Referral Required
1/1/2009    $127.72    N   Referral Required
7/1/2008    $765.75    N   Referral Required
7/1/2008   $1,232.04   N   Referral Required
7/1/2008   $1,196.87   N   Referral Required
7/1/2008    $319.91    N   Referral Required
7/1/2008   $1,779.89   N   Referral Required
7/1/2008    $484.98    N   Referral Required
7/1/2008    $941.98    N   Referral Required
7/1/2008    $836.89    N   Referral Required
7/1/2008    $424.52    N   Referral Required
7/1/2008    $483.99    Y   Referral Required
7/1/2008    $612.15    Y   Referral Required
7/1/2008    $318.88    Y   Referral Required
7/1/2008    $703.29    N   Referral Required
7/1/2008    $968.71    N   Referral Required
7/1/2008   $1,204.76   N   Referral Required
7/1/2008   $1,292.19   N   Referral Required
7/1/2008   $1,292.73   N   Referral Required
7/1/2008   $1,397.35   N   Referral Required
7/1/2008   $1,503.35   N   Referral Required
7/1/2008   $1,472.79   N   Referral Required
7/1/2008   $1,343.85   N   Referral Required
7/1/2008    $833.48    N   Referral Required
7/1/2008    $913.72    N   Referral Required
7/1/2008    $691.99    N   Referral Required
7/1/2008    $815.24    N   Referral Required
7/1/2008   $1,109.02   N   Referral Required
7/1/2008    $964.82    N   Referral Required
7/1/2008   $1,144.03   N   Referral Required
7/1/2008    $102.87    N   Referral Required
7/1/2008    $159.25    N   Referral Required
7/1/2008   $1,211.20   N   Referral Required
7/1/2008   $1,499.33   N   Referral Required
7/1/2008    $946.30    N   Referral Required
7/1/2008   $1,599.48   N   Referral Required
7/1/2008   $1,251.73   N   Referral Required
7/1/2008   $1,259.20   N   Referral Required
7/1/2008    $699.41    N   Referral Required
7/1/2008    $762.89    N   Referral Required
7/1/2008    $301.04    N   Referral Required
7/1/2008   $1,091.56   N   Referral Required
7/1/2008    $933.22    N   Referral Required
7/1/2008    $810.33    N   Referral Required
7/1/2008    $819.59    N   Referral Required
7/1/2008    $391.19    N   Referral Required
7/1/2008    $660.64    N   Referral Required
7/1/2008      $82.81   N   Referral Required   $41.40   $41.40
7/1/2008    $454.48    N   Referral Required
7/1/2008    $892.86    N   Referral Required
7/1/2008    $592.29    N   Referral Required
7/1/2008    $376.17    N   Referral Required
1/1/2009    $220.37    N   Referral Required
7/1/2008    $471.29    N   Referral Required
1/1/2011    $434.22    N   Referral Required
7/1/2008    $137.36    N   Referral Required
7/1/2008    $161.19    N   Referral Required
7/1/2008    $147.53    N   Referral Required
7/1/2008    $286.92    N   Referral Required
7/1/2008    $255.23    N   Referral Required
1/1/2011    $260.17    N   Referral Required
1/1/2011    $193.73    N   Referral Required
7/1/2008    $473.37    N   Referral Required
1/1/2011    $293.04    N   Referral Required
7/1/2008    $272.28    N   Referral Required
7/1/2008    $444.66    N   Referral Required
7/1/2008    $653.61    N   Referral Required
7/1/2008    $196.39    N   Referral Required
1/1/2011    $171.87    N   Referral Required
1/1/2011    $206.13    N   Referral Required
1/1/2011    $188.44    N   Referral Required
1/1/2011    $348.32    N   Referral Required
7/1/2008    $676.37    N   Referral Required
1/1/2011    $262.74    N   Referral Required
7/1/2008    $227.63    N   Referral Required
7/1/2008    $369.26    N   Referral Required
1/1/2011    $363.22    N   Referral Required
1/1/2011    $287.97    N   Referral Required
7/1/2008      $33.92   N   Referral Required
7/1/2008      $47.30   N   Referral Required
7/1/2008    $980.73    Y   Referral Required
7/1/2008    $989.49    Y   Referral Required
7/1/2008    $938.93    Y   Referral Required
7/1/2008    $882.04    Y   Referral Required
7/1/2008    $959.08    Y   Referral Required
7/1/2008   $1,180.67   Y   Referral Required
7/1/2008   $1,213.14   Y   Referral Required
7/1/2008    $991.56    Y   Referral Required
7/1/2008    $935.31    Y   Referral Required
7/1/2008    $778.11    Y   Referral Required
7/1/2008    $166.92    Y   Referral Required
7/1/2008   $1,141.94   Y   Referral Required
7/1/2008   $1,071.38   Y   Referral Required
               $0.00   Y   Referral Required
7/1/2008    $251.77    Y   Referral Required
7/1/2008   $1,018.89   Y   Referral Required
7/1/2008    $975.46    Y   Referral Required
7/1/2008    $893.03    Y   Referral Required
7/1/2008    $179.97    Y   Referral Required
7/1/2008   $1,217.57   Y   Referral Required
7/1/2008   $1,383.25   Y   Referral Required
7/1/2008   $1,313.16   Y   Referral Required
7/1/2008   $1,219.34   Y   Referral Required
7/1/2008    $276.27    Y   Referral Required
7/1/2008   $1,943.70   N   Referral Required
7/1/2008   $1,444.69   Y   Referral Required
7/1/2008    $170.16    Y   Referral Required
7/1/2008   $1,126.72   Y   Referral Required
7/1/2008    $213.59    Y   Referral Required
7/1/2008   $1,237.23   Y   Referral Required
7/1/2008   $1,441.03   N   Referral Required
7/1/2008    $230.41    N   Referral Required
7/1/2008   $1,553.79   N   Referral Required
7/1/2008    $164.30    N   Referral Required
7/1/2008   $1,974.83   N   Referral Required
7/1/2008    $223.07    N   Referral Required
7/1/2008   $1,620.32   N   Referral Required
7/1/2008    $154.21    N   Referral Required
7/1/2008   $1,852.29   N   Referral Required
7/1/2008   $1,848.95   N   Referral Required
7/1/2008    $245.36    N   Referral Required
7/1/2008   $1,205.16   N   Referral Required
7/1/2008   $1,107.13   Y   Referral Required
7/1/2008   $1,359.49   Y   Referral Required
7/1/2008   $1,125.46   Y   Referral Required
7/1/2008   $1,164.90   Y   Referral Required
7/1/2008    $900.77    Y   Referral Required
7/1/2008   $1,020.39   Y   Referral Required
7/1/2008    $994.68    Y   Referral Required
7/1/2008   $1,181.61   Y   Referral Required
7/1/2008   $1,201.47   Y   Referral Required
7/1/2008   $1,406.74   Y   Referral Required
7/1/2008   $1,234.01   Y   Referral Required
7/1/2008   $1,410.31   Y   Referral Required
7/1/2008   $1,482.81   Y   Referral Required
7/1/2008   $1,199.90   Y   Referral Required
7/1/2008   $2,320.18   N   Referral Required
7/1/2008   $2,427.41   N   Referral Required
7/1/2008   $2,414.39   N   Referral Required
7/1/2008   $1,328.01   N   Referral Required
7/1/2008   $1,369.06   N   Referral Required
7/1/2008   $1,101.61   N   Referral Required
7/1/2008   $1,098.41   N   Referral Required
7/1/2008   $1,639.61   N   Referral Required
7/1/2008   $1,646.28   N   Referral Required
7/1/2008   $1,519.41   N   Referral Required
7/1/2008   $1,467.41   N   Referral Required
7/1/2008   $1,432.98   N   Referral Required
7/1/2008   $1,422.50   N   Referral Required
7/1/2008   $1,253.34   N   Referral Required
7/1/2008   $1,229.91   N   Referral Required
7/1/2008   $1,686.82   N   Referral Required
7/1/2008   $1,672.34   N   Referral Required
7/1/2008   $1,574.48   N   Referral Required
7/1/2008   $1,501.42   N   Referral Required
7/1/2008   $2,080.94   N   Referral Required
7/1/2008   $2,077.10   N   Referral Required
7/1/2008   $2,186.48   N   Referral Required
7/1/2008   $2,201.52   N   Referral Required
7/1/2008    $263.97    N   Referral Required
7/1/2008   $1,477.50   N   Referral Required
7/1/2008   $1,653.35   N   Referral Required
7/1/2008   $1,639.92   N   Referral Required
7/1/2008   $1,742.71   N   Referral Required
7/1/2008   $1,834.41   N   Referral Required
7/1/2008   $1,904.07   N   Referral Required
7/1/2008   $1,920.72   N   Referral Required
7/1/2008   $1,780.31   N   Referral Required
7/1/2008    $276.22    N   Referral Required
7/1/2008    $690.32    N   Referral Required
7/1/2008   $1,537.69   N   Referral Required
7/1/2008    $928.61    N   Referral Required
1/1/2009    $659.30    N   Referral Required
1/1/2009    $209.66    N   Referral Required
7/1/2008    $365.89    Y   Referral Required
7/1/2008    $672.23    Y   Referral Required
1/1/2010    $383.53    Y   Referral Required
1/1/2010    $493.00    Y   Referral Required
1/1/2010    $561.51    Y   Referral Required
1/1/2010    $513.32    Y   Referral Required
1/1/2011    $353.19    Y   Referral Required
1/1/2011    $318.63    Y   Referral Required
7/1/2008    $986.03    N   Referral Required
7/1/2008   $1,075.26   N   Referral Required
7/1/2008   $1,243.01   N   Referral Required
7/1/2008   $1,427.75   N   Referral Required
7/1/2008    $727.33    N   Referral Required
7/1/2008    $886.30    N   Referral Required
7/1/2008    $881.49    N   Referral Required
7/1/2008    $735.90    N   Referral Required
7/1/2008    $495.51    N   Referral Required
7/1/2008    $517.10    N   Referral Required
7/1/2008    $429.94    N   Referral Required
7/1/2008      $94.04   N   Referral Required
7/1/2008      $93.99   N   Referral Required
7/1/2008      $89.41   N   Referral Required
7/1/2008      $99.51   N   Referral Required
7/1/2008    $123.44    N   Referral Required
7/1/2008    $120.87    N   Referral Required
7/1/2008    $101.09    N   Referral Required
1/1/2011    $115.13    N   Referral Required
1/1/2011      $79.17   N   Referral Required
1/1/2011    $115.39    N   Referral Required
1/1/2011    $120.77    N   Referral Required
1/1/2011    $142.57    N   Referral Required
1/1/2011    $210.73    N   Referral Required
7/1/2008    $110.18    N   Referral Required
7/1/2008    $132.78    N   Referral Required
1/1/2011    $126.89    N   Referral Required
1/1/2011    $120.68    N   Referral Required
1/1/2011      $81.21   N   Referral Required
7/1/2008      $62.00   N   Referral Required
1/1/2011      $71.80   N   Referral Required
1/1/2011      $81.89   N   Referral Required
7/1/2008      $87.17   N   Referral Required
1/1/2009      $45.38   N   Referral Required
1/1/2011    $247.95    N   Referral Required
1/1/2011    $126.54    N   Referral Required
1/1/2011    $238.81    N   Referral Required
1/1/2011    $122.29    N   Referral Required
1/1/2010    $116.56    N
1/1/2010      $57.81   N
1/1/2010      $58.56   N
1/1/2010    $105.35    N
1/1/2010      $51.85   N
1/1/2010      $52.60   N
7/1/2008      $86.98   N   Referral Required
7/1/2008    $128.46    N   Referral Required
1/1/2011    $122.20    N   Referral Required
7/1/2008    $150.05    N   Referral Required
1/1/2011    $165.16    N   Referral Required
1/1/2011    $170.45    N   Referral Required
1/1/2011      $14.17   N   Referral Required
7/1/2008    $172.92    Y   Referral Required
7/1/2008    $178.64    Y   Referral Required
7/1/2008    $168.25    Y   Referral Required
7/1/2008   $1,075.76   Y   Referral Required
7/1/2008    $158.36    Y   Referral Required
7/1/2008    $477.76    Y   Referral Required
7/1/2008    $237.32    Y   Referral Required
7/1/2008    $310.04    Y   Referral Required
7/1/2008    $250.30    Y   Referral Required
7/1/2008    $694.14    Y   Referral Required
1/1/2011    $277.53    Y   Referral Required
1/1/2011    $267.90    Y   Referral Required
7/1/2008    $343.20    Y   Referral Required
1/1/2011    $357.91    N   Referral Required
7/1/2008    $483.50    N   Referral Required
7/1/2008    $571.36    N   Referral Required
7/1/2008    $136.10    N   Referral Required
7/1/2008    $140.10    N   Referral Required
1/1/2011    $156.17    N   Referral Required
7/1/2008    $239.25    N   Referral Required
1/1/2011    $293.23    N   Referral Required
1/1/2011    $108.27    N   Referral Required
7/1/2008    $340.64    N   Referral Required
1/1/2011    $147.23    N   Referral Required
7/1/2008    $197.25    N   Referral Required
1/1/2009      $74.52   N   Referral Required
1/1/2011    $201.45    N   Referral Required
7/1/2008      $51.11   Y   Referral Required
7/1/2008      $58.54   Y   Referral Required
1/1/2011    $274.34    N   Referral Required
7/1/2008    $367.71    N   Referral Required
7/1/2008    $367.28    N   Referral Required
7/1/2008    $276.35    N   Referral Required
7/1/2008    $378.14    N   Referral Required
7/1/2008   $441.65   N   Referral Required
7/1/2008   $612.29   N   Referral Required
7/1/2008   $515.81   N   Referral Required
7/1/2008   $432.89   N   Referral Required
7/1/2008   $460.42   N   Referral Required
7/1/2008   $323.29   N   Referral Required
7/1/2008   $344.31   N   Referral Required
7/1/2008   $268.72   N   Referral Required
7/1/2008   $245.01   N   Referral Required
7/1/2008   $157.83   N   Referral Required
7/1/2008   $299.60   N   Referral Required
7/1/2008   $341.23   N   Referral Required
7/1/2008   $311.18   N   Referral Required
7/1/2008   $384.90   N   Referral Required
7/1/2008   $386.92   N   Referral Required
7/1/2008   $389.94   N   Referral Required
7/1/2008   $341.84   N   Referral Required
7/1/2008   $371.79   N   Referral Required
7/1/2008   $406.92   N   Referral Required
7/1/2008   $722.87   N   Referral Required
7/1/2008   $387.58   N   Referral Required
7/1/2008   $373.59   N   Referral Required
7/1/2008   $419.94   N   Referral Required
7/1/2008   $499.75   N   Referral Required
7/1/2008   $479.16   N   Referral Required
7/1/2008   $453.90   N   Referral Required
7/1/2008   $336.41   N   Referral Required
7/1/2008   $323.02   N   Referral Required
7/1/2008   $158.16   N   Referral Required
7/1/2008   $376.45   N   Referral Required
7/1/2008   $187.64   N   Referral Required
7/1/2008   $595.07   N   Referral Required
7/1/2008   $895.49   N   Referral Required
7/1/2008   $217.74   N   Referral Required
7/1/2008   $311.89   N   Referral Required
7/1/2008   $678.17   N   Referral Required
7/1/2008   $860.09   N   Referral Required
7/1/2008   $160.55   N   Referral Required
7/1/2008   $512.24   N   Referral Required
7/1/2008   $789.56   N   Referral Required
7/1/2008   $732.28   N   Referral Required
7/1/2008   $853.04   N   Referral Required
7/1/2008   $562.54   N   Referral Required
7/1/2008   $619.80   N   Referral Required
7/1/2008   $563.29   N   Referral Required
7/1/2008   $560.76   N   Referral Required
7/1/2008   $635.66   N   Referral Required
7/1/2008    $598.56    N   Referral Required
7/1/2008    $293.27    N   Referral Required
7/1/2008    $614.36    N   Referral Required
7/1/2008    $665.56    N   Referral Required
7/1/2008    $666.76    N   Referral Required
7/1/2008    $324.71    N   Referral Required
7/1/2008    $754.38    N   Referral Required
7/1/2008    $836.73    N   Referral Required
7/1/2008    $875.59    N   Referral Required
7/1/2008    $996.31    N   Referral Required
7/1/2008    $220.93    N   Referral Required
7/1/2008   $1,136.69   N   Referral Required
7/1/2008   $1,152.60   N   Referral Required
7/1/2008    $741.29    N   Referral Required
7/1/2008    $981.74    N   Referral Required
7/1/2008   $1,004.34   N   Referral Required
7/1/2008    $877.50    N   Referral Required
7/1/2008    $873.65    N   Referral Required
7/1/2008    $103.20    N   Referral Required
7/1/2008    $154.16    N   Referral Required
7/1/2008    $175.12    N   Referral Required
7/1/2008    $960.95    N   Referral Required
7/1/2008   $1,133.92   N   Referral Required
7/1/2008    $900.88    N   Referral Required
7/1/2008    $896.04    N   Referral Required
7/1/2008    $871.20    N   Referral Required
7/1/2008    $936.60    N   Referral Required
7/1/2008   $1,073.92   N   Referral Required
7/1/2008   $1,170.04   N   Referral Required
7/1/2008   $1,047.80   N   Referral Required
7/1/2008   $1,139.10   N   Referral Required
7/1/2008    $516.58    N   Referral Required
7/1/2008    $602.79    N   Referral Required
7/1/2008    $799.22    N   Referral Required
7/1/2008   $1,042.61   N   Referral Required
7/1/2008    $564.53    N   Referral Required
7/1/2008    $690.34    N   Referral Required
               $0.00   Y   Referral Required
7/1/2008    $496.85    N   Referral Required
7/1/2008    $497.71    N   Referral Required
7/1/2008    $570.16    N   Referral Required
7/1/2008    $594.83    N   Referral Required
7/1/2008    $654.22    N   Referral Required
7/1/2008    $951.37    N   Referral Required
7/1/2008   $1,125.65   N   Referral Required
7/1/2008   $1,166.41   N   Referral Required
7/1/2008    $369.17    N   Referral Required
7/1/2008    $563.34    N   Referral Required
7/1/2008    $573.30    N   Referral Required
7/1/2008    $621.88    N   Referral Required
7/1/2008    $455.93    N   Referral Required
7/1/2008    $661.80    N   Referral Required
7/1/2008    $507.04    N   Referral Required
7/1/2008      $44.58   N   Referral Required
7/1/2008      $54.30   N   Referral Required
7/1/2008      $45.63   N   Referral Required
7/1/2008      $59.69   N   Referral Required
7/1/2008    $527.00    N   Referral Required
7/1/2008    $729.91    N   Referral Required
7/1/2008    $820.64    N   Referral Required
7/1/2008    $216.89    N   Referral Required
7/1/2008    $387.61    N   Referral Required
7/1/2008    $288.69    N   Referral Required
7/1/2008    $421.53    N   Referral Required
7/1/2008    $505.88    N   Referral Required
7/1/2008    $789.88    N   Referral Required
7/1/2008    $552.45    N   Referral Required
7/1/2008    $371.95    N   Referral Required
7/1/2008    $512.38    N   Referral Required
7/1/2008    $113.52    N   Referral Required
7/1/2008    $408.31    N   Referral Required
7/1/2008    $508.19    N   Referral Required
7/1/2008      $90.17   N   Referral Required
7/1/2008      $62.64   N   Referral Required
7/1/2008    $293.23    N   Referral Required
7/1/2008      $86.39   N   Referral Required
7/1/2008    $244.52    N   Referral Required
7/1/2008      $86.39   N   Referral Required
7/1/2008    $297.07    N   Referral Required
7/1/2008    $840.27    N   Referral Required
7/1/2008   $1,565.72   N   Referral Required
7/1/2008    $932.95    N   Referral Required
7/1/2008    $947.61    N   Referral Required
7/1/2008    $941.94    N   Referral Required
1/1/2009    $936.20    N   Referral Required
7/1/2008   $1,835.69   N   Referral Required
7/1/2008   $1,836.82   N   Referral Required
               $0.00   N   Referral Required
7/1/2008   $1,082.19   N   Referral Required
7/1/2008    $928.33    N   Referral Required
7/1/2008    $343.60    N   Referral Required
7/1/2008    $419.03    N   Referral Required
7/1/2008    $678.65    N   Referral Required
7/1/2008   $1,028.12   N   Referral Required
7/1/2008    $886.85    N   Referral Required
7/1/2008    $119.08    N   Referral Required
7/1/2008    $130.43    N   Referral Required
7/1/2008    $350.77    N   Referral Required
7/1/2008    $499.85    N   Referral Required
7/1/2008    $576.38    N   Referral Required
7/1/2008    $649.87    N   Referral Required
7/1/2008    $264.38    N   Referral Required
7/1/2008    $244.42    N   Referral Required
7/1/2008    $367.16    N   Referral Required
7/1/2008    $449.94    N   Referral Required
7/1/2008    $476.81    N   Referral Required
7/1/2008    $503.05    N   Referral Required
7/1/2008    $741.25    N   Referral Required
7/1/2008    $595.50    N   Referral Required
7/1/2008    $493.75    N   Referral Required
7/1/2008    $148.03    N   Referral Required
7/1/2008    $131.55    N   Referral Required
7/1/2008    $552.92    N   Referral Required
7/1/2008    $653.97    N   Referral Required
7/1/2008    $652.01    N   Referral Required
7/1/2008    $741.21    N   Referral Required
7/1/2008    $639.97    N   Referral Required
7/1/2008    $896.78    N   Referral Required
7/1/2008   $1,124.33   N   Referral Required
7/1/2008    $892.24    N   Referral Required
7/1/2008    $561.63    N   Referral Required
7/1/2008    $546.77    N   Referral Required
7/1/2008    $706.88    N   Referral Required
7/1/2008    $586.99    N   Referral Required
7/1/2008    $272.25    N   Referral Required
7/1/2008    $297.59    N   Referral Required
7/1/2008    $614.85    N   Referral Required
7/1/2008    $808.86    N   Referral Required
7/1/2008    $328.15    N   Referral Required
7/1/2008    $428.45    N   Referral Required
7/1/2008    $432.50    N   Referral Required
7/1/2008    $386.73    N   Referral Required
7/1/2008    $468.06    N   Referral Required
7/1/2008    $341.59    N   Referral Required
7/1/2008    $337.07    N   Referral Required
7/1/2008    $476.81    N   Referral Required
7/1/2008    $354.14    N   Referral Required
7/1/2008    $334.73    N   Referral Required
7/1/2008    $344.37    N   Referral Required
7/1/2008    $359.84    N   Referral Required
7/1/2008    $399.52    N   Referral Required
7/1/2008    $309.56    N   Referral Required
7/1/2008    $245.43    N   Referral Required
7/1/2008    $584.48    N   Referral Required
7/1/2008    $539.85    N   Referral Required
7/1/2008    $528.23    N   Referral Required
7/1/2008    $600.01    N   Referral Required
7/1/2008    $642.73    N   Referral Required
7/1/2008    $573.81    N   Referral Required
7/1/2008    $651.20    N   Referral Required
7/1/2008    $591.86    N   Referral Required
7/1/2008   $1,349.78   N   Referral Required
7/1/2008    $823.37    N   Referral Required
7/1/2008    $555.22    N   Referral Required
7/1/2008    $585.99    N   Referral Required
7/1/2008    $576.49    N   Referral Required
7/1/2008    $710.37    N   Referral Required
7/1/2008      $72.34   N   Referral Required
               $0.00   N   Referral Required
7/1/2008    $356.29    N   Referral Required
7/1/2008    $413.01    N   Referral Required
7/1/2008    $443.95    N   Referral Required
7/1/2008    $556.87    N   Referral Required
7/1/2008    $650.06    N   Referral Required
7/1/2008    $167.91    N   Referral Required
7/1/2008    $393.80    N   Referral Required
7/1/2008    $294.05    N   Referral Required
7/1/2008    $736.79    N   Referral Required
7/1/2008    $944.80    N   Referral Required
7/1/2008   $1,089.40   N   Referral Required
1/1/2008    $999.56    N   Referral Required
1/1/2008   $1,144.71   N   Referral Required
1/1/2008   $1,201.21   N   Referral Required
7/1/2008    $589.30    N   Referral Required
7/1/2008   $1,349.78   N   Referral Required
7/1/2008   $1,349.78   N   Referral Required
7/1/2008   $1,349.78   N   Referral Required
7/1/2008    $545.56    N   Referral Required
7/1/2008   $1,349.78   N   Referral Required
7/1/2008    $923.69    N   Referral Required
7/1/2008   $1,229.97   N   Referral Required
7/1/2008    $663.94    N   Referral Required
7/1/2008   $1,012.74   N   Referral Required
1/1/2008   $1,318.95   N   Referral Required
7/1/2008    $370.40    N   Referral Required
7/1/2008    $503.39    N   Referral Required
7/1/2008    $687.59    N   Referral Required
7/1/2008    $393.89    N   Referral Required
7/1/2008    $626.29    N   Referral Required
7/1/2008    $626.29    N   Referral Required
7/1/2008    $626.29    N   Referral Required
7/1/2008    $396.46    N   Referral Required
7/1/2008    $626.29    N   Referral Required
7/1/2008    $454.17    N   Referral Required
7/1/2008    $530.03    N   Referral Required
7/1/2008    $755.85    N   Referral Required
7/1/2008    $755.85    N   Referral Required
7/1/2008    $755.85    N   Referral Required
7/1/2008    $755.85    N   Referral Required
7/1/2008   $1,075.87   N   Referral Required
7/1/2008    $816.10    N   Referral Required
7/1/2008    $240.37    Y   Referral Required
7/1/2008    $863.84    N   Referral Required
7/1/2008    $863.84    N   Referral Required
7/1/2008    $863.84    N   Referral Required
7/1/2008      $24.00   N   Referral Required
7/1/2008    $863.84    N   Referral Required
7/1/2008    $463.71    N   Referral Required
7/1/2008    $888.95    N   Referral Required
1/1/2008    $867.79    N   Referral Required
7/1/2008    $607.14    N   Referral Required
7/1/2008    $648.40    N   Referral Required
               $0.00   N   Referral Required
7/1/2008    $453.65    N   Referral Required
7/1/2008    $542.08    N   Referral Required
7/1/2008    $507.23    N   Referral Required
7/1/2008    $609.81    N   Referral Required
7/1/2008    $531.00    N   Referral Required
7/1/2008    $250.21    N   Referral Required
7/1/2008    $236.88    N   Referral Required
7/1/2008    $257.73    N   Referral Required
7/1/2008    $233.35    N   Referral Required
7/1/2008    $119.25    N   Referral Required
7/1/2008    $278.26    N   Referral Required
7/1/2008    $494.94    N   Referral Required
7/1/2008    $182.43    N   Referral Required
7/1/2008    $157.60    N   Referral Required
               $0.00   N   Referral Required
7/1/2008    $723.57    N   Referral Required
7/1/2008    $612.69    N   Referral Required
7/1/2008    $675.03    N   Referral Required
7/1/2008    $673.08    N   Referral Required
7/1/2008   $1,003.85   N   Referral Required
7/1/2008      $83.77   N   Referral Required
7/1/2008   $1,274.90   N   Referral Required
7/1/2008    $965.54    N   Referral Required
7/1/2008    $937.68    N   Referral Required
7/1/2008   $1,087.93   N   Referral Required
7/1/2008    $970.30    N   Referral Required
7/1/2008      $70.01   N   Referral Required
7/1/2008      $65.96   N   Referral Required
7/1/2008      $59.40   N   Referral Required
7/1/2008      $70.11   N   Referral Required
7/1/2008    $752.57    N   Referral Required
7/1/2008    $764.71    N   Referral Required
7/1/2008    $899.80    N   Referral Required
               $0.00   N   Referral Required
1/1/2011    $219.37    N   Referral Required
1/1/2011    $184.84    N   Referral Required
7/1/2008    $196.47    N   Referral Required
7/1/2008      $97.85   N   Referral Required
7/1/2008    $125.66    N   Referral Required
7/1/2008    $155.53    N   Referral Required
7/1/2008    $276.79    N   Referral Required
7/1/2008    $172.10    N   Referral Required
7/1/2008      $42.11   N   Referral Required
7/1/2008    $100.56    N   Referral Required
7/1/2008    $217.85    N   Referral Required
7/1/2008    $339.28    N   Referral Required
7/1/2008    $227.32    N   Referral Required
7/1/2008    $169.95    N   Referral Required
7/1/2008    $141.41    N   Referral Required
7/1/2008    $354.87    N   Referral Required
7/1/2008    $434.89    N   Referral Required
7/1/2008    $505.82    N   Referral Required
7/1/2008    $501.12    N   Referral Required
7/1/2008    $532.78    N   Referral Required
7/1/2008    $494.39    N   Referral Required
7/1/2008    $567.55    N   Referral Required
7/1/2008    $396.52    N   Referral Required
7/1/2008    $382.58    N   Referral Required
7/1/2008    $426.32    N   Referral Required
7/1/2008    $417.29    N   Referral Required
7/1/2008    $749.59    N   Referral Required
7/1/2008    $312.95    N   Referral Required
7/1/2008    $282.66    N   Referral Required
7/1/2008    $426.04    N   Referral Required
7/1/2008    $463.86    N   Referral Required
7/1/2008    $298.38    N   Referral Required
7/1/2008    $274.61    N   Referral Required
7/1/2008    $447.80    N   Referral Required
7/1/2008    $465.72    N   Referral Required
7/1/2008   $293.27   N   Referral Required
7/1/2008   $472.57   N   Referral Required
7/1/2008   $200.28   N   Referral Required
7/1/2008   $459.38   N   Referral Required
7/1/2008   $457.58   N   Referral Required
7/1/2008   $589.96   N   Referral Required
7/1/2008   $565.61   N   Referral Required
7/1/2008   $733.12   N   Referral Required
7/1/2008   $730.35   N   Referral Required
7/1/2008   $533.61   N   Referral Required
             $0.00   N   Referral Required
7/1/2008    $91.65   N   Referral Required
7/1/2008    $51.35   N   Referral Required
7/1/2008   $140.41   N   Referral Required
7/1/2008   $181.67   N   Referral Required
7/1/2008   $254.09   N   Referral Required
7/1/2008   $428.01   N   Referral Required
7/1/2008   $120.90   N   Referral Required
7/1/2008    $33.11   N   Referral Required
7/1/2008   $562.08   N   Referral Required
7/1/2008   $501.85   N   Referral Required
7/1/2008   $488.27   N   Referral Required
7/1/2008   $548.90   N   Referral Required
7/1/2008   $474.41   N   Referral Required
7/1/2008   $488.94   N   Referral Required
7/1/2008   $429.16   N   Referral Required
7/1/2008   $414.85   N   Referral Required
7/1/2008   $495.60   N   Referral Required
7/1/2008   $321.67   N   Referral Required
             $0.00   N   Referral Required
7/1/2008   $231.19   N   Referral Required
7/1/2008   $259.63   N   Referral Required
7/1/2008    $89.04   N   Referral Required
7/1/2008   $750.73   N   Referral Required
7/1/2008   $753.40   N   Referral Required
7/1/2008   $367.83   N   Referral Required
7/1/2008   $527.20   N   Referral Required
7/1/2008   $212.40   N   Referral Required
7/1/2008   $356.33   N   Referral Required
7/1/2008   $708.47   N   Referral Required
7/1/2008   $864.79   N   Referral Required
7/1/2008   $455.69   N   Referral Required
7/1/2008   $191.71   N   Referral Required
7/1/2008   $582.20   N   Referral Required
7/1/2008   $582.73   N   Referral Required
7/1/2008   $601.07   N   Referral Required
7/1/2008   $162.46   N   Referral Required
7/1/2008    $116.01    N   Referral Required
7/1/2008    $426.98    N   Referral Required
7/1/2008      $95.38   N   Referral Required
1/1/2011    $201.56    N   Referral Required
7/1/2008    $158.20    N   Referral Required
7/1/2008    $356.35    N   Referral Required
1/1/2008    $528.99    N   Referral Required
7/1/2008      $95.51   N   Referral Required
7/1/2008      $54.11   N   Referral Required
               $0.00   N   Referral Required
7/1/2008    $147.51    N   Referral Required
7/1/2008    $173.60    N   Referral Required
7/1/2008    $187.35    N   Referral Required
7/1/2008      $87.00   N   Referral Required
7/1/2008    $112.98    N   Referral Required
7/1/2008    $365.48    N   Referral Required
7/1/2008    $336.48    N   Referral Required
7/1/2008    $724.06    N   Referral Required
7/1/2008    $306.61    N   Referral Required
7/1/2008    $890.76    N   Referral Required
7/1/2008   $1,420.20   N   Referral Required
7/1/2008    $102.78    N   Referral Required
7/1/2008      $85.65   N   Referral Required
7/1/2008      $41.54   N   Referral Required
7/1/2008    $111.21    N   Referral Required
7/1/2008    $180.35    N   Referral Required
7/1/2008    $487.27    Y   Referral Required
7/1/2008    $910.41    N   Referral Required
7/1/2008   $1,296.71   N   Referral Required
               $0.00   N   Referral Required
7/1/2008    $112.21    N   Referral Required
7/1/2008      $67.94   N   Referral Required
7/1/2008    $212.19    N   Referral Required
7/1/2008    $155.52    N   Referral Required
7/1/2008    $128.57    N   Referral Required
7/1/2008    $105.30    N   Referral Required
7/1/2008    $161.37    N   Referral Required
7/1/2008    $139.95    N   Referral Required
7/1/2008    $565.79    N   Referral Required
7/1/2008    $441.28    N   Referral Required
7/1/2008    $123.95    N   Referral Required
7/1/2008    $614.68    N   Referral Required
7/1/2008    $813.78    N   Referral Required
7/1/2008   $1,014.13   N   Referral Required
7/1/2008   $1,040.47   N   Referral Required
7/1/2008   $1,397.34   N   Referral Required
7/1/2008   $2,286.05   N   Referral Required
7/1/2008    $170.11    N   Referral Required
7/1/2008    $873.60    N   Referral Required
7/1/2008   $1,339.31   N   Referral Required
7/1/2008   $2,160.28   N   Referral Required
7/1/2008    $877.47    N   Referral Required
7/1/2008    $913.11    N   Referral Required
7/1/2008   $1,074.86   N   Referral Required
7/1/2008    $935.73    N   Referral Required
7/1/2008   $1,322.53   N   Referral Required
7/1/2008    $330.60    N   Referral Required
7/1/2008    $576.01    N   Referral Required
7/1/2008    $727.47    N   Referral Required
7/1/2008    $896.70    N   Referral Required
7/1/2008    $863.36    N   Referral Required
7/1/2008   $1,021.12   N   Referral Required
7/1/2008   $1,161.99   N   Referral Required
7/1/2008   $1,155.70   N   Referral Required
7/1/2008    $869.82    N   Referral Required
7/1/2008   $1,124.17   N   Referral Required
7/1/2008   $1,025.76   N   Referral Required
7/1/2008   $1,252.57   N   Referral Required
7/1/2008   $1,225.61   N   Referral Required
7/1/2008   $1,304.72   N   Referral Required
7/1/2008    $665.13    N   Referral Required
7/1/2008    $780.58    N   Referral Required
7/1/2008   $1,024.08   N   Referral Required
7/1/2008    $981.38    N   Referral Required
7/1/2008    $673.71    N   Referral Required
7/1/2008    $675.09    N   Referral Required
7/1/2008    $790.36    N   Referral Required
7/1/2008    $693.54    N   Referral Required
7/1/2008    $589.69    N   Referral Required
               $0.00   Y   Referral Required
7/1/2008    $722.11    N   Referral Required
7/1/2008    $909.46    Y   Referral Required
7/1/2008   $1,132.34   Y   Referral Required
7/1/2008    $970.87    Y   Referral Required
7/1/2008   $1,179.53   Y   Referral Required
7/1/2008    $987.19    N   Referral Required
7/1/2008   $1,603.76   N   Referral Required
7/1/2008    $984.31    N   Referral Required
7/1/2008   $1,004.54   N   Referral Required
               $0.00   N   Referral Required
7/1/2008    $620.47    N   Referral Required
7/1/2008    $872.94    N   Referral Required
7/1/2008    $889.24    N   Referral Required
7/1/2008    $796.81    N   Referral Required
7/1/2008    $724.35    N   Referral Required
7/1/2008    $770.97    N   Referral Required
7/1/2008    $764.83    N   Referral Required
7/1/2008    $863.82    N   Referral Required
7/1/2008   $1,314.36   N   Referral Required
7/1/2008   $1,081.34   Y   Referral Required
7/1/2008      $97.18   N   Referral Required
7/1/2008   $1,560.68   N   Referral Required
7/1/2008   $1,708.03   N   Referral Required
7/1/2008   $1,655.08   N   Referral Required
7/1/2008   $1,840.56   N   Referral Required
               $0.00   N   Referral Required
7/1/2008    $184.16    N   Referral Required
7/1/2008    $170.92    N                       $121.35   $49.57
7/1/2008    $120.78    N                        $51.94   $68.84
7/1/2008      $24.30   N                        $15.07    $9.23
7/1/2008      $27.02   N                        $17.83    $9.19
7/1/2008      $34.35   N                        $21.30   $13.05
7/1/2008      $30.07   N                        $21.05    $9.02
7/1/2008      $46.79   N                        $28.54   $18.25
7/1/2008      $41.79   N                        $25.07   $16.72
1/1/2011      $26.62   N                        $17.53    $9.09
7/1/2008      $38.26   N                        $25.63   $12.63
7/1/2008      $27.64   N                        $18.80    $8.84
7/1/2008      $46.24   N                        $31.44   $14.80
7/1/2008      $31.50   N                        $21.10   $10.40
7/1/2008      $39.69   N                        $25.80   $13.89
1/1/2011      $27.26   N                        $18.89    $8.37
1/1/2011      $35.24   N                        $23.31   $11.94
7/1/2008      $25.06   N                        $15.04   $10.02
7/1/2008      $31.97   N                        $20.46   $11.51
1/1/2011      $42.91   N                        $26.71   $16.20
1/1/2011      $12.84   N                         $7.67    $5.16
7/1/2008      $27.59   N                        $17.93    $9.66
1/1/2011      $39.60   N                        $28.41   $11.19
7/1/2008      $26.35   N                        $17.13    $9.22
7/1/2008      $41.17   N                        $28.82   $12.35
7/1/2008      $83.67   N                        $56.06   $27.61
1/1/2011    $401.10    N                       $328.85   $72.25
1/1/2011      $19.10   N                        $10.39    $8.71
1/1/2011      $20.18   N                        $10.05   $10.13
7/1/2008      $23.63   N                        $14.65    $8.98
7/1/2008      $63.24   N                        $46.17   $17.07
1/1/2011      $87.32   N                        $47.10   $40.22
1/1/2011      $72.69   N                        $52.20   $20.49
7/1/2008      $32.69   N                        $23.86    $8.83
7/1/2008      $86.11   N                        $65.44   $20.67
1/1/2011   $182.36   N   $140.56    $41.79
1/1/2011   $237.18   N   $181.68    $55.49
1/1/2011   $286.27   N   $223.83    $62.44
7/1/2008   $225.55   N   $160.14    $65.41
7/1/2008   $262.17   N   $191.38    $70.79
7/1/2008   $313.70   N   $238.41    $75.29
7/1/2008   $218.30   N   $159.36    $58.94
1/1/2011   $288.37   N   $224.51    $63.86
7/1/2008   $312.22   N   $240.41    $71.81
7/1/2008   $225.55   N   $160.14    $65.41
1/1/2011   $283.78   N   $216.01    $67.77
7/1/2008   $313.70   N   $238.41    $75.29
7/1/2008   $335.44   N   $251.58    $83.86
7/1/2008   $335.44   N   $251.58    $83.86
1/1/2011   $395.05   N   $328.85    $66.20
1/1/2011   $478.06   N   $398.86    $79.20
7/1/2008   $550.56   N   $506.52    $44.04
1/1/2011   $387.74   N   $328.85    $58.89
7/1/2008   $441.28   N   $383.91    $57.37
7/1/2008   $537.51   N   $483.76    $53.75
1/1/2011   $387.74   N   $328.85    $58.89
7/1/2008   $441.28   N   $383.91    $57.37
7/1/2008   $537.51   N   $483.76    $53.75
1/1/2011   $401.44   N   $328.85    $72.59
1/1/2011   $486.41   N   $398.86    $87.55
7/1/2008   $556.31   N   $456.17   $100.14
7/1/2008   $602.84   N   $500.36   $102.48
7/1/2008   $109.18   N             $109.18
7/1/2008   $999.16   N   $859.28   $139.88
7/1/2008   $155.78   N             $155.78
7/1/2008   $156.16   N             $156.16
1/1/2011    $21.84   N    $13.11     $8.73
7/1/2008    $26.78   N    $16.87     $9.91
1/1/2011    $28.72   N    $17.87    $10.85
1/1/2011    $34.61   N    $21.61    $13.00
7/1/2008    $40.12   N    $24.87    $15.25
7/1/2008    $54.75   N    $31.75    $23.00
7/1/2008    $41.45   N    $26.11    $15.34
7/1/2008    $79.24   N    $53.09    $26.15
7/1/2008    $29.35   N    $19.37     $9.98
7/1/2008    $83.24   N    $51.61    $31.63
7/1/2008   $120.56   N    $79.57    $40.99
7/1/2008    $83.46   N    $55.92    $27.54
7/1/2008    $29.21   N    $18.69    $10.52
7/1/2008    $35.45   N    $21.98    $13.47
1/1/2011    $36.64   N    $23.65    $13.00
7/1/2008    $46.36   N    $30.13    $16.23
1/1/2011    $29.36   N    $19.57     $9.79
7/1/2008    $33.55   N    $23.15    $10.40
1/1/2011   $239.14   N   $182.02    $57.11
1/1/2011   $286.54   N   $225.53    $61.02
1/1/2011   $352.43   N   $284.66    $67.77
7/1/2008   $399.64   N   $335.70    $63.94
1/1/2011   $400.38   N   $328.85    $71.53
7/1/2008   $540.51   N   $454.03    $86.48
1/1/2011   $615.06   N   $503.88   $111.18
7/1/2008   $472.68   N   $382.87    $89.81
7/1/2008    $57.99   N    $34.79    $23.20
7/1/2008    $21.20   N    $13.78     $7.42
7/1/2008    $32.21   N    $20.94    $11.27
7/1/2008    $45.98   N    $30.35    $15.63
7/1/2008    $57.75   N    $39.27    $18.48
7/1/2008    $29.83   N    $18.20    $11.63
1/1/2011    $30.42   N    $19.57    $10.85
7/1/2008    $34.40   N    $24.08    $10.32
1/1/2011    $40.28   N    $29.83    $10.85
7/1/2008    $31.88   N    $21.68    $10.20
7/1/2008    $40.17   N    $24.91    $15.26
7/1/2008    $33.88   N    $23.04    $10.84
7/1/2008    $47.32   N    $31.70    $15.62
7/1/2008    $61.42   N    $42.38    $19.04
7/1/2008    $42.27   N    $31.28    $10.99
1/1/2011   $239.82   N   $182.70    $57.11
1/1/2011   $286.16   N   $226.21    $59.96
1/1/2011   $346.42   N   $284.32    $62.10
1/1/2011   $239.14   N   $182.02    $57.11
1/1/2011   $286.16   N   $226.21    $59.96
1/1/2011   $347.78   N   $285.34    $62.44
1/1/2011   $238.80   N   $181.68    $57.11
1/1/2011   $285.48   N   $225.53    $59.96
1/1/2011   $347.10   N   $284.66    $62.44
1/1/2011   $407.32   N   $328.85    $78.48
1/1/2011   $492.82   N   $398.86    $93.96
1/1/2011   $407.32   N   $328.85    $78.48
1/1/2011   $487.04   N   $392.74    $94.30
1/1/2011   $401.64   N   $328.85    $72.79
1/1/2011   $486.41   N   $398.86    $87.55
1/1/2011   $630.23   N   $503.88   $126.35
1/1/2011   $630.23   N   $503.88   $126.35
1/1/2011   $619.94   N   $503.88   $116.06
7/1/2008   $424.51   N   $352.34    $72.17
1/1/2011    $24.06   N    $15.49     $8.57
7/1/2008    $34.17   N    $23.24    $10.93
7/1/2008   $381.89   N   $316.97    $64.92
1/1/2011   $226.22   N   $172.51    $53.71
1/1/2011   $271.42   N   $214.31    $57.11
1/1/2011   $345.64   N   $285.68    $59.96
1/1/2011   $400.57   N   $328.85    $71.73
1/1/2011   $483.73   N   $398.86    $84.87
1/1/2011   $614.72   N   $503.88   $110.84
7/1/2008   $490.43   N   $411.96    $78.47
7/1/2008    $25.97   N    $17.66     $8.31
7/1/2008    $31.12   N    $21.47     $9.65
1/1/2011    $26.24   N    $17.87     $8.37
1/1/2011   $136.12   N    $91.62    $44.50
7/1/2008   $149.86   N   $112.39    $37.47
1/1/2011   $127.94   N    $87.20    $40.73
1/1/2011   $199.73   N   $134.44    $65.28
1/1/2011    $95.84   N    $59.67    $36.17
7/1/2008   $218.19   N   $189.83    $28.36
7/1/2008    $62.69   N              $62.69
7/1/2008    $61.81   N              $61.81
1/1/2011   $126.58   N    $86.52    $40.05
7/1/2008    $24.59   N    $17.21     $7.38
7/1/2008    $25.64   N    $17.18     $8.46
1/1/2011    $21.44   N    $14.13     $7.31
7/1/2008    $27.06   N    $18.40     $8.66
1/1/2011    $96.40   N    $69.53    $26.87
7/1/2008    $32.16   N    $22.51     $9.65
1/1/2011    $26.24   N    $17.87     $8.37
7/1/2008    $24.21   N    $16.95     $7.26
7/1/2008    $29.69   N    $20.78     $8.91
1/1/2011    $86.69   N    $60.35    $26.33
7/1/2008    $24.59   N    $16.97     $7.62
7/1/2008    $24.59   N    $16.72     $7.87
7/1/2008    $24.92   N    $16.95     $7.97
7/1/2008    $28.97   N    $19.70     $9.27
7/1/2008    $88.63   N    $58.50    $30.13
7/1/2008    $24.25   N    $16.49     $7.76
7/1/2008    $27.30   N    $18.56     $8.74
7/1/2008    $23.78   N    $16.41     $7.37
7/1/2008   $223.71   N   $167.78    $55.93
1/1/2011   $273.80   N   $216.69    $57.11
7/1/2008   $314.23   N   $251.38    $62.85
7/1/2008   $346.72   N   $284.31    $62.41
1/1/2011   $394.51   N   $328.85    $65.67
1/1/2011   $478.40   N   $398.86    $79.54
1/1/2011   $609.39   N   $503.88   $105.51
1/1/2011   $395.25   N   $328.85    $66.40
1/1/2011   $478.40   N   $398.86    $79.54
1/1/2011   $609.05   N   $503.88   $105.17
7/1/2008   $466.98   N   $382.92    $84.06
7/1/2008    $23.30   N    $15.38     $7.92
7/1/2008    $31.50   N    $20.48    $11.02
7/1/2008    $35.40   N    $22.30    $13.10
1/1/2011    $87.90   N    $60.69    $27.21
7/1/2008    $30.94   N    $17.02    $13.92
7/1/2008    $31.83   N    $21.01    $10.82
1/1/2011    $72.52   N    $44.72    $27.80
1/1/2011    $25.42   N    $16.85     $8.57
7/1/2008    $25.64   N    $17.69     $7.95
7/1/2008    $29.73   N    $20.22     $9.51
7/1/2008    $33.88   N    $22.02    $11.86
7/1/2008    $26.30   N    $17.62     $8.68
7/1/2008   $110.94   N    $84.31    $26.63
1/1/2011    $24.88   N    $16.51     $8.57
7/1/2008    $24.59   N    $16.97     $7.62
7/1/2008    $24.25   N    $16.49     $7.76
7/1/2008    $27.30   N    $18.56     $8.74
7/1/2008    $92.54   N    $66.63    $25.91
7/1/2008    $23.92   N    $16.27     $7.65
7/1/2008    $27.30   N    $18.56     $8.74
7/1/2008    $23.59   N    $15.81     $7.78
7/1/2008    $23.11   N    $15.95     $7.16
7/1/2008   $223.71   N   $167.78    $55.93
1/1/2011   $275.84   N   $218.73    $57.11
7/1/2008   $314.04   N   $251.23    $62.81
7/1/2008   $351.54   N   $288.26    $63.28
1/1/2011   $395.05   N   $328.85    $66.20
1/1/2011   $478.06   N   $398.86    $79.20
1/1/2011   $609.39   N   $503.88   $105.51
1/1/2011   $395.25   N   $328.85    $66.40
1/1/2011   $478.93   N   $398.86    $80.08
1/1/2011   $609.39   N   $503.88   $105.51
7/1/2008   $473.06   N   $387.91    $85.15
1/1/2011    $23.20   N    $14.47     $8.73
7/1/2008    $32.59   N    $20.21    $12.38
7/1/2008    $35.45   N    $21.62    $13.83
7/1/2008    $42.17   N    $25.72    $16.45
1/1/2011   $229.34   N   $170.81    $50.53
7/1/2008   $296.94   N   $231.61    $65.33
7/1/2008   $359.12   N   $287.30    $71.82
7/1/2008   $386.70   N   $320.96    $65.74
1/1/2011   $400.38   N   $328.85    $71.53
1/1/2011   $484.07   N   $399.20    $84.87
1/1/2011   $614.38   N   $503.88   $110.50
7/1/2008   $471.95   N   $382.28    $89.67
7/1/2008    $66.58   N    $49.27    $17.31
7/1/2008    $65.09   N    $44.91   $20.18
7/1/2008    $73.19   N    $46.11   $27.08
7/1/2008    $77.00   N    $46.97   $30.03
7/1/2008   $149.49   N    $89.69   $59.80
7/1/2008    $92.06   N    $54.32   $37.74
7/1/2008    $96.73   N    $57.07   $39.66
7/1/2008   $144.48   N    $92.47   $52.01
7/1/2008   $103.78   N    $63.31   $40.47
7/1/2008    $92.61   N    $57.42   $35.19
7/1/2008   $154.34   N   $100.32   $54.02
7/1/2008    $83.06   N    $53.99   $29.07
7/1/2008    $79.49   N    $51.67   $27.82
7/1/2008    $75.76   N    $50.00   $25.76
1/1/2010   $253.25   N   $157.02   $96.24
1/1/2010   $324.02   N   $226.81   $97.21
7/1/2008    $93.31   N    $57.85   $35.46
7/1/2008   $161.49   N    $96.89   $64.60
1/1/2011   $180.58   N    $82.44   $98.14
7/1/2008    $52.18   N    $31.83   $20.35
7/1/2008    $41.46   N    $24.46   $17.00
7/1/2008    $18.58   N    $11.52    $7.06
7/1/2008    $10.61   N     $5.09    $5.52
7/1/2008    $46.13   N    $25.83   $20.30
1/1/2011    $99.60   N    $72.93   $26.67
7/1/2008   $109.02   N    $67.59   $41.43
7/1/2008   $139.63   N   $104.72   $34.91
7/1/2008   $142.73   N   $107.05   $35.68
7/1/2008   $148.65   N   $111.49   $37.16
7/1/2008   $114.42   N    $86.96   $27.46
7/1/2008   $124.15   N    $85.66   $38.49
7/1/2008   $132.81   N   $104.92   $27.89
7/1/2008   $251.91   N   $176.34   $75.57
7/1/2008    $92.92   N    $65.04   $27.88
7/1/2008    $98.93   N    $72.22   $26.71
7/1/2008   $111.80   N    $82.73   $29.07
7/1/2008   $105.96   N    $87.95   $18.01
7/1/2008    $61.06   N    $43.96   $17.10
7/1/2008    $64.24   N    $44.33   $19.91
7/1/2008    $70.14   N    $46.99   $23.15
7/1/2008    $65.11   N    $48.83   $16.28
7/1/2008    $78.06   N    $59.33   $18.73
7/1/2008    $75.53   N    $41.54   $33.99
7/1/2008    $67.55   N    $40.53   $27.02
1/1/2011   $105.04   N    $78.37   $26.67
1/1/2011   $105.38   N    $78.81   $26.67
1/1/2011   $102.32   N    $75.65   $26.67
7/1/2008    $42.98   N    $29.23   $13.75
7/1/2008    $67.67   N    $47.37    $20.30
7/1/2008   $138.77   N   $108.24    $30.53
7/1/2008    $66.25   N    $36.44    $29.81
7/1/2008    $78.49   N    $47.88    $30.61
7/1/2008   $415.93   N   $311.95   $103.98
7/1/2008   $451.52   N   $316.06   $135.46
1/1/2011   $570.03   N   $439.30   $130.73
7/1/2008   $618.56   N   $482.48   $136.08
1/1/2010    $64.08   N    $55.11     $8.97
1/1/2010    $60.35   N    $36.21    $24.14
1/1/2010   $186.44   N   $123.05    $63.39
1/1/2010   $265.12   N   $174.98    $90.14
1/1/2010   $323.51   N   $219.99   $103.52
7/1/2008   $350.10   N   $329.09    $21.01
1/1/2011   $217.00   N   $159.75    $57.75
1/1/2011   $215.36   N   $158.57    $56.78
1/1/2011   $252.40   N   $163.33    $89.07
7/1/2008   $413.22   N   $314.05    $99.17
1/1/2011   $233.42   N   $159.25    $74.17
7/1/2008   $338.10   N   $290.77    $47.33
1/1/2011   $237.02   N   $172.17    $64.85
1/1/2011   $276.74   N   $193.44    $83.31
1/1/2011   $244.46   N   $178.97    $65.49
1/1/2011   $282.58   N   $199.89    $82.68
1/1/2011   $237.32   N   $171.83    $65.49
1/1/2011   $268.45   N   $185.42    $83.02
1/1/2011   $237.61   N   $172.17    $65.44
1/1/2011   $279.34   N   $171.83   $107.51
1/1/2011   $230.06   N   $173.87    $56.19
1/1/2011   $261.79   N   $196.84    $64.96
1/1/2011   $225.50   N   $168.09    $57.41
1/1/2011   $266.68   N   $189.70    $76.98
1/1/2011   $227.74   N   $171.15    $56.69
1/1/2011   $231.90   N   $173.53    $58.37
7/1/2008   $366.27   N   $314.99    $51.28
1/1/2011   $228.36   N   $171.83    $56.53
1/1/2011   $218.58   N   $153.48    $65.10
7/1/2008   $348.24   N   $289.04    $59.20
7/1/2008   $327.01   N   $287.77    $39.24
7/1/2008   $341.50   N   $300.52    $40.98
1/1/2011   $161.76   N   $143.96    $17.80
1/1/2010    $22.06   N    $14.34     $7.72
7/1/2008   $222.83   N   $180.49    $42.34
7/1/2008   $238.14   N   $178.60    $59.53
7/1/2008   $245.84   N   $204.05    $41.79
7/1/2008   $266.59   N   $205.27    $61.32
7/1/2008    $68.33   N    $36.90    $31.43
7/1/2008   $481.88   N   $424.05    $57.83
7/1/2008    $95.06   N    $44.68    $50.38
7/1/2008   $121.31   N    $58.23    $63.08
1/1/2011   $206.66   N   $150.76    $55.91
1/1/2011   $207.49   N   $152.46    $55.03
1/1/2011   $212.09   N   $153.82    $58.27
1/1/2011   $239.00   N   $166.73    $72.27
7/1/2008   $318.04   N   $279.88    $38.16
7/1/2008   $344.53   N   $292.85    $51.68
1/1/2011   $213.46   N   $155.86    $57.61
7/1/2008   $323.34   N   $284.54    $38.80
7/1/2008   $337.39   N   $296.90    $40.49
7/1/2008    $98.73   N    $46.40    $52.33
1/1/2011   $224.96   N   $153.82    $71.15
7/1/2008   $337.15   N   $286.58    $50.57
1/1/2011   $209.87   N   $153.48    $56.39
1/1/2011   $209.87   N   $153.48    $56.39
1/1/2011   $178.93   N   $152.80    $26.14
7/1/2008   $883.37   N   $812.70    $70.67
7/1/2008   $776.34   N   $706.47    $69.87
7/1/2008   $111.57   N    $33.47    $78.10
7/1/2008   $736.65   N   $714.55    $22.10
7/1/2008   $126.32   N    $88.42    $37.90
1/1/2011    $68.90   N    $49.98    $19.42
7/1/2008   $454.85   N   $423.01    $31.84
7/1/2008   $175.70   N   $158.13    $17.57
7/1/2008    $98.73   N    $79.97    $18.76
7/1/2008   $215.89   N             $215.89
7/1/2008    $82.43   N              $82.43
7/1/2008    $78.05   N              $78.05
7/1/2008   $377.05   N             $377.05
7/1/2008   $323.06   N             $323.06
7/1/2008   $215.43   N             $215.43
7/1/2008   $188.60   N             $188.60
1/1/2011   $199.82   N   $158.91    $40.91
1/1/2011   $361.71   N   $152.80   $208.91
1/1/2011   $214.82   N   $188.48    $26.33
1/1/2011   $131.03   N   $113.03    $18.00
1/1/2011   $258.82   N   $192.90    $65.92
7/1/2008   $202.93   N   $190.75    $12.18
7/1/2008   $434.21   N   $390.79    $43.42
1/1/2011   $212.78   N   $186.44    $26.33
7/1/2008   $256.94   N   $182.43    $74.51
7/1/2008   $280.17   N   $204.52    $75.65
7/1/2008   $101.40   N    $64.90    $36.50
1/1/2011   $127.87   N    $69.53    $58.34
7/1/2008   $562.01   N   $533.91    $28.10
7/1/2008   $303.34   N   $285.14   $18.20
7/1/2008   $602.45   N   $536.18   $66.27
7/1/2008   $601.41   N   $535.25   $66.16
7/1/2008   $302.64   N   $284.48   $18.16
7/1/2008    $75.97   N    $63.81   $12.16
7/1/2008   $123.45   N    $88.88   $34.57
7/1/2008    $25.35   N    $16.98    $8.37
1/1/2011    $57.80   N    $31.12   $26.67
1/1/2011    $18.06   N    $10.05    $8.01
7/1/2008    $71.85   N    $42.39   $29.46
7/1/2008   $139.63   N    $86.57   $53.06
7/1/2008    $88.43   N    $58.36   $30.07
7/1/2008    $65.14   N    $42.34   $22.80
7/1/2008    $40.48   N    $26.72   $13.76
7/1/2008    $32.86   N
7/1/2008    $18.73   N
             $0.00   N
1/1/2011    $67.77   N    $57.63   $10.13
1/1/2011    $90.81   N    $52.20   $38.61
1/1/2011   $151.02   N   $103.18   $47.84
7/1/2008   $451.86   N   $379.56   $72.30
             $0.00   N
             $0.00   N
             $0.00   N
             $0.00   N
7/1/2008    $81.94   N    $49.16   $32.78
7/1/2008   $138.78   N    $65.23   $73.55
7/1/2008    $96.57   N    $49.25   $47.32
1/1/2011    $84.66   N    $35.54   $49.12
1/1/2011    $78.24   N    $45.40   $32.85
7/1/2008    $11.10   N     $8.88    $2.22
7/1/2008    $63.51   N    $38.11   $25.40
7/1/2008    $67.18   N    $40.31   $26.87
7/1/2008    $62.99   N    $38.42   $24.57
7/1/2008    $91.97   N    $57.02   $34.95
7/1/2008    $75.38   N    $45.23   $30.15
7/1/2008    $75.52   N    $42.29   $33.23
7/1/2008   $117.65   N    $72.94   $44.71
7/1/2008    $87.96   N    $53.66   $34.30
7/1/2008   $113.17   N    $72.43   $40.74
7/1/2008    $88.58   N    $54.03   $34.55
7/1/2008   $122.61   N    $84.60   $38.01
7/1/2008   $108.29   N    $49.81   $58.48
7/1/2008   $117.92   N    $38.91   $79.01
1/1/2011    $66.22   N    $26.03   $40.20
7/1/2008   $131.67   N    $77.69   $53.98
7/1/2008    $88.42   N    $52.17   $36.25
1/1/2011   $180.67   N    $89.24    $91.43
7/1/2008   $143.99   N    $46.08    $97.91
7/1/2008   $116.96   N    $63.16    $53.80
7/1/2008    $75.12   N    $30.80    $44.32
7/1/2008    $81.19   N    $47.90    $33.29
7/1/2008    $87.94   N    $49.25    $38.69
1/1/2011    $93.92   N    $57.63    $36.29
7/1/2008   $108.30   N    $63.90    $44.40
1/1/2011    $84.79   N    $47.44    $37.35
1/1/2011    $45.62   N    $21.61    $24.01
1/1/2011    $88.38   N    $54.58    $33.81
7/1/2008   $153.37   N    $96.62    $56.75
7/1/2008    $66.65   N    $21.33    $45.32
1/1/2011    $63.12   N    $35.20    $27.92
1/1/2011    $46.77   N    $19.91    $26.86
7/1/2008   $101.11   N    $59.65    $41.46
7/1/2008   $101.54   N    $59.91    $41.63
7/1/2008   $101.45   N    $59.86    $41.59
7/1/2008    $55.15   N    $35.85    $19.30
7/1/2008    $99.87   N    $60.92    $38.95
7/1/2008    $87.04   N    $51.35    $35.69
7/1/2008   $151.04   N    $82.17    $68.87
7/1/2008   $101.97   N    $62.20    $39.77
7/1/2008    $89.43   N    $51.87    $37.56
7/1/2008    $80.15   N    $48.89    $31.26
1/1/2011    $86.42   N    $51.86    $34.57
7/1/2008    $86.95   N    $52.17    $34.78
7/1/2008   $294.14   N   $217.66    $76.48
7/1/2008    $30.73   N    $15.67    $15.06
7/1/2008   $150.71   N    $54.26    $96.45
7/1/2008   $122.34   N    $52.61    $69.73
7/1/2008   $155.40   N    $93.24    $62.16
7/1/2008    $86.24   N
1/1/2011    $37.55   N    $19.23    $18.33
7/1/2008    $49.55   N    $36.17    $13.38
1/1/2011    $64.68   N    $36.22    $28.46
1/1/2011   $121.44   N    $54.58    $66.86
7/1/2008    $67.57   N    $42.57    $25.00
7/1/2008    $93.14   N    $52.16    $40.98
1/1/2011    $10.69   N     $8.01     $2.68
7/1/2008   $146.07   N             $146.07
             $0.00   N
7/1/2008    $84.06   N    $63.89    $20.17
7/1/2008    $65.04   N    $41.63    $23.41
1/1/2011    $55.21   N    $27.39    $27.82
7/1/2008   $532.48   N   $463.26    $69.22
1/1/2011   $161.93   N   $105.22    $56.72
7/1/2008    $522.98    N               $522.98
7/1/2008    $161.16    N    $119.26     $41.90
1/1/2011    $393.91    N    $319.67     $74.24
7/1/2008    $187.92    N               $187.92
1/1/2011    $160.62    N     $82.44     $78.17
1/1/2011      $53.08   N     $25.69     $27.40
1/1/2011      $10.72   N      $7.67      $3.04
1/1/2011      $10.72   N      $7.67      $3.04
1/1/2011      $64.36   N     $46.76     $17.60
1/1/2011      $86.50   N     $64.43     $22.07
7/1/2008      $74.04   N     $40.72     $33.32
7/1/2008      $93.48   N     $52.35     $41.13
7/1/2008      $74.23   N     $42.31     $31.92
1/1/2011    $692.53    N    $612.63     $79.90
1/1/2011    $729.92    N    $650.02     $79.90
7/1/2008      $30.87   N
7/1/2008      $21.06   N     $12.43      $8.63
1/1/2011      $34.66   N     $20.93     $13.73
7/1/2008      $60.13   N     $38.48     $21.65
7/1/2008      $85.58   N     $59.05     $26.53
7/1/2008      $63.97   N     $33.26     $30.71
1/1/2011      $38.48   N     $22.63     $15.85
1/1/2011      $80.45   N     $68.17     $12.28
7/1/2008      $72.44   N     $64.47      $7.97
1/1/2011      $78.34   N     $79.85     $10.51
1/1/2011      $26.68   N     $16.17     $10.51
1/1/2011      $25.37   N     $19.48      $5.49
1/1/2011      $23.24   N     $13.79      $9.45
1/1/2011    $407.66    N    $328.85     $78.82
7/1/2008      $64.15   N
7/1/2008      $96.96   N
7/1/2008    $144.25    N
7/1/2008    $163.60    N    $125.97     $37.63
7/1/2008    $274.25    N    $213.91     $60.33
7/1/2008    $401.35    N    $292.99    $108.36
1/1/2011    $565.62    N    $340.80    $224.82
               $0.00   N
1/1/2011      $65.44   N      $34.86    $30.58
7/1/2008   $1,771.63   N   $1,257.86   $513.77
1/1/2011      $64.59   N      $30.11    $30.49
1/1/2011      $91.55   N      $39.62    $51.93
1/1/2011    $136.31    N      $59.67    $76.64
1/1/2011    $105.08    N      $58.31    $46.76
7/1/2008    $128.75    N      $81.11    $47.64
7/1/2008    $185.02    N    $114.71     $70.31
1/1/2011    $257.16    N    $154.21    $102.95
7/1/2008      $56.83   N      $15.91    $40.92
7/1/2008      $71.23   N    $44.16    $27.07
1/1/2011      $60.32   N    $18.89    $41.43
1/1/2011    $143.94    N    $83.12    $60.82
1/1/2011      $50.16   N
1/1/2010    $340.44    N   $173.62   $166.82
7/1/2008    $112.53    N
7/1/2008   $1,007.07   N
7/1/2008    $764.18    N
7/1/2008   $1,426.13   N
               $0.00   N
7/1/2008      $39.46   N
7/1/2008    $104.19    N
7/1/2008      $94.51   N
7/1/2008    $101.85    N
7/1/2008    $102.52    N
7/1/2008    $133.74    N
7/1/2008    $123.73    N
7/1/2008    $133.41    N
7/1/2008    $133.07    N
7/1/2008    $154.62    N
7/1/2008    $155.95    N
7/1/2008    $170.30    N
7/1/2008    $170.30    N
1/1/2011      $13.79   N
1/1/2011    $470.57    N
1/1/2011    $101.47    N    $82.44    $19.03
7/1/2008    $120.25    N
7/1/2008    $164.63    N
7/1/2008    $168.11    N
7/1/2008      $86.63   N
7/1/2008    $365.03    N
7/1/2008    $607.67    N
1/1/2011    $208.51    N   $105.56   $102.95
               $0.00   N
               $0.00   N
               $0.00   N
               $0.00   N
               $0.00   N
7/1/2008    $286.96    N   $160.70   $126.26
7/1/2008    $464.34    N   $260.03   $204.31
7/1/2008    $415.41    N   $232.63   $182.78
7/1/2008    $587.50    N   $329.00   $258.50
7/1/2008    $293.92    N   $164.60   $129.32
7/1/2008    $296.22    N    $47.40   $248.82
7/1/2008    $300.08    N    $96.03   $204.05
7/1/2008    $419.68    N   $130.10   $289.58
7/1/2008    $594.16    N   $160.42   $433.74
7/1/2008   $344.22   N    $82.61   $261.61
7/1/2008   $505.21   N   $146.51   $358.70
7/1/2008   $726.65   N   $174.40   $552.25
1/1/2009   $167.89   N    $99.06    $68.83
1/1/2009   $500.79   N   $345.55   $155.24
1/1/2009   $744.41   N   $506.20   $238.21
7/1/2008    $86.99   N    $19.14    $67.85
7/1/2008    $74.74   N    $18.68    $56.06
             $0.00   N
7/1/2008    $55.85   N    $43.00    $12.85
7/1/2008    $72.01   N    $55.45    $16.56
7/1/2008    $62.42   N    $41.82    $20.60
7/1/2008   $165.37   N   $109.14    $56.23
7/1/2008   $116.56   N    $89.75    $26.81
7/1/2008   $117.85   N    $88.39    $29.46
7/1/2008   $104.94   N    $81.85    $23.09
7/1/2008   $161.83   N   $116.52    $45.31
7/1/2008   $236.61   N   $175.09    $61.52
7/1/2008   $263.11   N   $207.86    $55.25
7/1/2008    $78.62   N    $47.17    $31.45
1/1/2011   $152.24   N   $112.21    $40.03
7/1/2008   $319.45   N   $265.14    $54.31
             $0.00   N
7/1/2008   $128.05   N    $90.92    $37.13
7/1/2008   $177.08   N   $131.04    $46.04
7/1/2008   $207.92   N   $160.10    $47.82
7/1/2008    $60.52   N    $46.60    $13.92
7/1/2008    $90.17   N    $80.25     $9.92
7/1/2008    $75.30   N    $62.50    $12.80
7/1/2008   $100.94   N    $86.81    $14.13
7/1/2008   $137.29   N   $119.44    $17.85
7/1/2008   $133.24   N   $101.26    $31.98
7/1/2008   $256.54   N   $212.93    $43.61
7/1/2008   $143.25   N   $116.03    $27.22
7/1/2008   $144.64   N   $115.71    $28.93
7/1/2008   $250.47   N
7/1/2008   $212.69   N   $189.29    $23.40
7/1/2008   $265.24   N   $209.54    $55.70
             $0.00   N
7/1/2008   $136.49   N   $106.46    $30.03
7/1/2008   $160.32   N   $125.05    $35.27
1/1/2011   $206.05   N   $171.35    $34.70
7/1/2008   $282.79   N   $234.72    $48.07
7/1/2008   $151.88   N   $121.50    $30.38
1/1/2011   $120.25   N    $92.50    $27.76
1/1/2011   $124.65   N   $100.99    $23.65
7/1/2008   $240.42   N   $177.91    $62.51
7/1/2008    $126.53    N    $96.16   $30.37
7/1/2008    $123.57    N    $98.86   $24.71
7/1/2008    $127.52    N   $105.84   $21.68
7/1/2008    $172.46    N   $124.17   $48.29
7/1/2008    $200.49    N   $160.39   $40.10
7/1/2008    $201.77    N   $161.42   $40.35
7/1/2008    $223.89    N   $174.63   $49.26
1/1/2008      $10.98   N
7/1/2008      $94.11   N
7/1/2008      $68.34   N    $56.72   $11.62
7/1/2008      $69.01   N    $57.97   $11.04
7/1/2008      $86.54   N    $73.56   $12.98
7/1/2008    $215.89    N   $164.08   $51.81
7/1/2008      $19.34   N
7/1/2008    $223.65    N   $167.74   $55.91
7/1/2008    $191.95    N   $134.37   $57.58
               $0.00   N
7/1/2008    $139.63    N   $101.93   $37.70
7/1/2008    $189.33    N   $140.10   $49.23
7/1/2008    $211.40    N   $162.78   $48.62
7/1/2008    $214.59    N   $163.09   $51.50
1/1/2011    $221.89    N   $171.01   $50.89
7/1/2008      $37.19   N    $26.03   $11.16
7/1/2008      $18.66   N
               $0.00   N
7/1/2008      $23.03   N
7/1/2008    $159.45    N   $105.24   $54.21
7/1/2008    $127.62    N    $91.89   $35.73
1/1/2010    $157.23    N   $108.49   $48.74
1/1/2010    $267.00    N   $208.26   $58.74
1/1/2010    $136.37    N   $100.91   $35.46
1/1/2010    $132.07    N    $84.52   $47.55
7/1/2008    $187.97    N   $142.67   $45.30
7/1/2008    $155.59    N   $108.91   $46.68
7/1/2008    $182.65    N   $136.99   $45.66
7/1/2008   $1,058.94   N   $984.81   $74.13
7/1/2008    $150.59    N   $108.42   $42.17
7/1/2008    $194.34    N   $145.76   $48.58
7/1/2008    $234.27    N   $185.07   $49.20
1/1/2011    $229.05    N   $179.84   $49.20
1/1/2011    $309.12    N   $234.56   $74.56
7/1/2008    $216.49    N   $168.86   $47.63
7/1/2008    $312.79    N   $243.98   $68.81
7/1/2008   $1,059.77   N   $985.59   $74.18
7/1/2008   $1,079.00   N   $981.89   $97.11
7/1/2008    $275.54    N   $217.68   $57.86
7/1/2008    $158.31    N   $113.98   $44.33
               $0.00   N
7/1/2008    $175.89    N    $131.92     $43.97
1/1/2011    $139.88    N     $91.14     $48.74
7/1/2008    $287.45    N    $221.34     $66.11
7/1/2008    $131.15    N    $106.23     $24.92
7/1/2008    $159.89    N    $126.31     $33.58
7/1/2008    $244.80    N    $176.26     $68.54
7/1/2008    $135.82    N    $111.37     $24.45
7/1/2008    $160.65    N    $131.73     $28.92
7/1/2008    $197.54    N    $167.91     $29.63
7/1/2008    $320.57    N    $250.04     $70.53
               $0.00   N
7/1/2008    $141.68    N    $114.76     $26.92
7/1/2008    $170.09    N    $137.77     $32.32
7/1/2008    $162.51    N    $130.01     $32.50
7/1/2008    $236.43    N    $189.14     $47.29
7/1/2008    $309.33    N    $241.28     $68.05
1/1/2011   $1,017.28   N    $943.57     $73.71
7/1/2008   $1,133.81   N   $1,054.44    $79.37
7/1/2008    $153.46    N    $119.70     $33.76
7/1/2008    $260.78    N    $216.45     $44.33
7/1/2008    $216.79    N    $158.26     $58.53
7/1/2008    $145.81    N    $116.65     $29.16
7/1/2008    $282.98    N    $232.04     $50.94
7/1/2008    $249.58    N    $207.15     $42.43
7/1/2008    $130.00    N      $93.60    $36.40
               $0.00   N
7/1/2008    $145.45    N    $119.27     $26.18
7/1/2008    $172.33    N    $143.03     $29.30
7/1/2008    $209.01    N    $158.85     $50.16
1/1/2011    $168.55    N    $109.49     $59.06
7/1/2008    $283.30    N    $201.14     $82.16
1/1/2011    $201.47    N    $169.65     $31.83
7/1/2008      $86.44   N     $65.69     $20.75
7/1/2008      $66.24   N     $49.02     $17.22
7/1/2008    $154.69    N    $109.83     $44.86
7/1/2008    $169.27    N    $126.95     $42.32
               $0.00   N
7/1/2008    $159.40    N    $124.33     $35.07
7/1/2008    $207.63    N    $161.95     $45.68
7/1/2008    $268.30    N    $217.32     $50.98
7/1/2008    $302.42    N    $241.94     $60.48
7/1/2008    $480.68    N    $355.70    $124.98
7/1/2008    $159.83    N    $123.07     $36.76
7/1/2008    $287.94    N    $233.23     $54.71
7/1/2008    $301.90    N    $241.52     $60.38
1/1/2009      $39.44   N
7/1/2008   $1,137.09   N   $1,057.49    $79.60
1/1/2011   $1,587.65   N    $943.57     $95.45
7/1/2008   $1,688.23   N   $1,570.05   $118.18
7/1/2008   $1,172.21   N   $1,054.99   $117.22
1/1/2011   $2,109.75   N    $943.57    $120.75
1/1/2011   $2,112.74   N    $943.57    $123.60
7/1/2008      $48.65   N      $46.22     $2.43
7/1/2008      $98.40   N      $92.50     $5.90
               $0.00   N
1/1/2011    $137.84    N     $50.84     $87.00
7/1/2008    $161.16    N    $128.93     $32.23
7/1/2008    $163.45    N     $76.82     $86.63
7/1/2008    $371.27    N               $371.27
7/1/2008    $214.77    N    $118.12     $96.65
7/1/2008    $157.26    N     $73.91     $83.35
7/1/2008    $229.05    N    $183.24     $45.81
               $0.00   N
1/1/2009      $12.36   N
7/1/2008      $11.83   N
7/1/2008      $51.11   N
7/1/2008       $9.80   N
7/1/2008      $14.77   N
7/1/2008      $31.55   N
7/1/2008      $15.85   N
7/1/2008      $12.13   N
7/1/2008      $66.54   N
7/1/2008      $11.42   N
7/1/2008      $20.32   N
7/1/2008      $19.24   N
7/1/2008      $18.51   N
7/1/2008      $19.64   N
7/1/2008      $21.06   N
7/1/2008      $25.01   N
7/1/2008      $25.84   N
7/1/2008      $20.34   N
7/1/2008      $18.52   N
7/1/2008      $25.23   N
7/1/2008      $24.05   N
7/1/2008      $18.55   N
7/1/2008      $18.93   N
7/1/2008      $21.66   N
7/1/2008      $22.83   N
7/1/2008      $22.90   N
7/1/2008      $22.76   N
7/1/2008      $20.34   N
7/1/2008      $24.05   N
7/1/2008      $20.52   N
7/1/2008     $9.24   N
7/1/2008    $18.93   N
7/1/2008    $16.01   N
7/1/2008    $18.52   N
7/1/2008    $19.23   N
7/1/2008    $23.18   N
7/1/2008    $23.41   N
7/1/2008    $23.41   N
7/1/2008    $20.39   N
9/1/2008    $19.17   N
7/1/2008     $9.92   N
7/1/2008    $19.17   N
7/1/2008    $19.77   N
7/1/2008    $22.52   N
7/1/2008    $16.66   N
7/1/2008    $18.93   N
7/1/2008    $19.13   N
7/1/2008    $40.54   N
7/1/2008   $116.44   N
7/1/2008   $104.32   N
7/1/2008   $175.34   N
7/1/2008   $112.23   N
7/1/2008   $445.44   N
7/1/2008    $65.64   N
7/1/2008    $78.08   N
7/1/2008   $184.38   N
7/1/2008    $61.46   N
7/1/2008   $766.68   N
7/1/2008    $95.62   N
7/1/2008    $64.38   N
7/1/2008    $70.56   N
7/1/2008   $180.32   N
7/1/2008    $93.16   N
7/1/2008   $109.60   N
7/1/2008   $188.73   N
7/1/2008   $128.75   N
7/1/2008   $143.85   N
7/1/2008   $122.34   N
7/1/2008    $65.94   N
7/1/2008    $87.92   N
7/1/2008    $81.24   N
7/1/2008    $19.43   N
7/1/2008    $59.67   N
7/1/2008     $4.43   N
7/1/2008     $4.43   N
7/1/2008     $3.57   N
7/1/2008     $3.14   N
7/1/2008    $3.03   N
7/1/2008    $3.59   N
7/1/2008    $4.24   N
7/1/2008    $5.15   N
7/1/2008    $8.84   N
7/1/2008    $4.19   N
            $0.00   N
7/1/2008   $17.31   N
7/1/2008   $28.28   N
7/1/2008    $6.31   N
7/1/2008   $11.42   N
7/1/2008   $15.61   N
7/1/2008   $19.37   N
7/1/2008   $19.21   N
7/1/2008   $53.97   N
7/1/2008   $36.05   N
7/1/2008    $6.92   N
7/1/2008    $7.23   N
7/1/2008    $8.09   N
7/1/2008    $4.83   N
7/1/2008   $47.43   N
7/1/2008   $15.10   N
7/1/2008   $16.84   N
7/1/2008   $13.56   N
7/1/2008   $56.94   N
7/1/2008   $41.94   N
7/1/2008   $18.77   N
7/1/2008   $20.20   N
7/1/2008   $23.44   N
7/1/2008   $23.44   N
7/1/2008   $89.99   N
7/1/2008   $28.13   N
7/1/2008    $5.25   N
7/1/2008   $19.37   N
7/1/2008   $19.37   N
7/1/2008   $23.57   N
7/1/2008   $23.00   N
7/1/2008   $19.21   N
7/1/2008   $19.21   N
7/1/2008   $20.36   N
7/1/2008    $9.61   N
7/1/2008   $21.72   N
7/1/2008    $9.06   N
7/1/2008   $40.29   N
7/1/2008   $40.90   N
7/1/2008   $34.94   N
7/1/2008   $28.68   N
7/1/2008   $20.39   N
7/1/2008   $26.51   N
7/1/2008   $13.81   N
7/1/2008   $17.61   N
7/1/2008   $16.01   N
7/1/2008   $22.61   N
7/1/2008   $23.94   N
7/1/2008   $37.13   N
7/1/2008    $7.02   N
7/1/2008    $7.02   N
7/1/2008    $6.35   N
7/1/2008   $19.21   N
7/1/2008    $4.54   N
9/1/2008    $4.54   N
7/1/2008    $4.54   N
7/1/2008   $22.22   N
7/1/2008    $9.62   N
7/1/2008   $32.33   N
7/1/2008   $41.36   N
7/1/2008   $37.41   N
7/1/2008    $7.20   N
7/1/2008   $19.09   N
7/1/2008    $7.23   N
7/1/2008    $8.43   N
7/1/2008   $16.17   N
7/1/2008   $17.99   N
7/1/2008   $18.01   N
7/1/2008   $17.51   N
7/1/2008   $25.23   N
7/1/2008    $6.83   N
7/1/2008   $17.22   N
7/1/2008    $8.37   N
7/1/2008   $26.51   N
7/1/2008   $19.21   N
7/1/2008   $12.89   N
7/1/2008   $24.02   N
7/1/2008   $35.01   N
7/1/2008   $35.28   N
7/1/2008   $29.07   N
7/1/2008   $15.01   N
7/1/2008   $19.74   N
7/1/2008   $17.70   N
7/1/2008    $6.42   N
7/1/2008    $7.02   N
7/1/2008    $6.83   N
7/1/2008    $8.38   N
7/1/2008    $6.08   N
7/1/2008   $11.01   N
7/1/2008   $10.74   N
7/1/2008   $28.85   N
7/1/2008   $25.23   N
7/1/2008   $22.30   N
7/1/2008   $29.85   N
7/1/2008   $20.67   N
7/1/2008   $25.23   N
7/1/2008   $25.23   N
7/1/2008   $28.34   N
7/1/2008   $38.85   N
7/1/2008   $21.17   N
7/1/2008   $20.48   N
7/1/2008   $17.34   N
7/1/2008   $31.45   N
7/1/2008   $23.35   N
7/1/2008   $20.27   N
7/1/2008    $6.48   N
7/1/2008   $25.23   N
7/1/2008   $25.23   N
7/1/2008   $25.23   N
7/1/2008   $25.23   N
7/1/2008    $9.10   N
7/1/2008   $18.71   N
7/1/2008   $16.13   N
7/1/2008   $16.58   N
7/1/2008    $7.16   N
7/1/2008    $7.23   N
7/1/2008   $13.20   N
7/1/2008   $11.98   N
7/1/2008    $9.04   N
7/1/2008   $27.11   N
7/1/2008   $21.06   N
7/1/2008   $20.01   N
1/1/2009   $13.39   N
7/1/2008   $11.41   N
7/1/2008   $35.31   N
7/1/2008   $25.62   N
7/1/2008   $43.28   N
7/1/2008   $40.90   N
7/1/2008   $17.11   N
7/1/2008   $28.85   N
7/1/2008   $35.91   N
7/1/2008   $36.07   N
7/1/2008   $53.78   N
7/1/2008   $19.34   N
7/1/2008   $15.10   N
7/1/2008   $25.23   N
7/1/2008   $25.23   N
7/1/2008   $48.00   N
7/1/2008   $30.01   N
7/1/2008   $26.26   N
7/1/2008   $39.04   N
7/1/2008   $45.13   N
7/1/2008   $30.30   N
7/1/2008   $33.79   N
7/1/2008   $34.88   N
7/1/2008   $24.15   N
7/1/2008   $20.82   N
7/1/2008   $32.95   N
7/1/2008    $7.11   N
7/1/2008   $23.47   N
7/1/2008   $24.05   N
7/1/2008   $18.60   N
7/1/2008   $25.23   N
7/1/2008   $19.03   N
7/1/2008   $89.99   N
7/1/2008   $25.91   N
7/1/2008   $27.66   N
7/1/2008   $20.54   N
7/1/2008   $24.20   N
7/1/2008   $24.24   N
7/1/2008   $30.01   N
7/1/2008   $11.68   N
7/1/2008   $29.43   N
7/1/2008   $11.71   N
7/1/2008   $12.99   N
7/1/2008   $23.01   N
7/1/2008    $3.45   N
7/1/2008   $11.31   N
7/1/2008   $27.04   N
7/1/2008   $39.65   N
7/1/2008   $12.20   N
7/1/2008   $13.96   N
7/1/2008    $7.61   N
7/1/2008    $9.15   N
7/1/2008   $24.72   N
7/1/2008   $24.64   N
7/1/2008   $19.97   N
7/1/2008    $5.48   N
7/1/2008   $21.06   N
7/1/2008    $5.48   N
7/1/2008    $3.72   N
7/1/2008    $6.64   N
7/1/2008   $17.99   N
7/1/2008    $5.48   N
7/1/2008   $21.16   N
7/1/2008   $13.55   N
7/1/2008    $8.47   N
7/1/2008    $3.27   N
7/1/2008   $30.01   N
7/1/2008   $10.80   N
7/1/2008   $22.13   N
7/1/2008   $10.06   N
7/1/2008   $19.91   N
7/1/2008    $9.62   N
7/1/2008   $25.60   N
7/1/2008   $21.06   N
7/1/2008   $25.97   N
7/1/2008   $19.11   N
7/1/2008   $23.29   N
7/1/2008   $23.45   N
7/1/2008   $94.11   N
7/1/2008   $17.58   N
7/1/2008   $24.02   N
7/1/2008   $94.11   N
7/1/2008   $10.98   N
7/1/2008   $12.22   N
7/1/2008   $30.68   N
7/1/2008   $97.04   N
7/1/2008   $17.99   N   $17.99
7/1/2008   $25.23   N
7/1/2008    $3.30   N
7/1/2008   $11.56   N
7/1/2008    $6.50   N
7/1/2008    $9.77   N
1/1/2009   $10.21   N
7/1/2008    $6.93   N
7/1/2008   $10.23   N
7/1/2008   $10.21   N
7/1/2008    $6.87   N
7/1/2008   $11.56   N
7/1/2008    $9.62   N
7/1/2008   $11.83   N
7/1/2008    $5.51   N
7/1/2008    $6.64   N
7/1/2008    $9.61   N
7/1/2008   $19.21   N
7/1/2008   $41.26   N
7/1/2008   $23.57   N
7/1/2008   $27.04   N
7/1/2008   $24.47   N
7/1/2008   $18.01   N
7/1/2008   $37.95   N
7/1/2008   $35.22   N
7/1/2008   $31.65   N
7/1/2008   $33.96   N
7/1/2008   $15.10   N
7/1/2008    $9.55   N
7/1/2008   $18.88   N
7/1/2008   $18.09   N
7/1/2008   $15.98   N
7/1/2008   $18.09   N
7/1/2008   $22.22   N
7/1/2008    $9.05   N
7/1/2008   $12.21   N
7/1/2008   $12.36   N
7/1/2008   $16.64   N
7/1/2008   $17.89   N
7/1/2008   $36.75   N
7/1/2008   $13.13   N
7/1/2008    $8.44   N
7/1/2008   $17.88   N
7/1/2008   $18.51   N
7/1/2008   $27.42   N
9/1/2008   $27.42   N
7/1/2008   $28.24   N
7/1/2008    $7.69   N
7/1/2008   $16.10   N
7/1/2008   $16.91   N
7/1/2008   $30.71   N
7/1/2008   $26.43   N
7/1/2008   $26.43   N
7/1/2008   $26.43   N
7/1/2008   $12.80   N
7/1/2008    $9.62   N
9/1/2008   $18.09   N
9/1/2008   $47.43   N
9/1/2008   $15.73   N
9/1/2008   $34.68   N
9/1/2008   $44.08   N
7/1/2008   $11.44   N
7/1/2008   $16.26   N
7/1/2008   $13.33   N
7/1/2008   $24.02   N
7/1/2008    $9.36   N
7/1/2008   $10.30   N
7/1/2008   $34.36   N
7/1/2008   $25.23   N
7/1/2008   $25.23   N
7/1/2008   $24.63   N
7/1/2008   $22.72   N
7/1/2008   $23.67   N
7/1/2008   $22.81   N
7/1/2008   $15.01   N
7/1/2008   $20.71   N
7/1/2008   $27.82   N
7/1/2008   $13.76   N
7/1/2008    $7.78   N
7/1/2008   $24.04   N
7/1/2008   $18.04   N
1/1/2009   $18.09   N
7/1/2008   $47.43   N
7/1/2008   $12.81   N
7/1/2008   $34.23   N
7/1/2008   $33.09   N
7/1/2008    $5.60   N
7/1/2008    $5.60   N
7/1/2008    $5.60   N
7/1/2008    $5.60   N
7/1/2008    $5.60   N
7/1/2008    $5.60   N
7/1/2008    $5.60   N
7/1/2008    $5.75   N
7/1/2008   $11.50   N
7/1/2008    $5.75   N
7/1/2008    $5.75   N
7/1/2008    $5.75   N
7/1/2008    $5.75   N
7/1/2008    $5.75   N
7/1/2008    $5.75   N
9/1/2008   $18.66   N
9/1/2008    $5.75   N
7/1/2008    $5.75   N
7/1/2008    $5.60   N   $5.60
9/1/2008   $18.66   N
7/1/2008    $5.75   N
7/1/2008   $15.58   N
7/1/2008   $28.09   N
7/1/2008   $23.00   N
7/1/2008   $23.00   N
7/1/2008   $23.00   N
7/1/2008   $27.19   N
7/1/2008    $9.24   N
7/1/2008    $9.52   N
7/1/2008   $41.71   N
7/1/2008   $17.99   N
7/1/2008   $89.99   N
1/1/2009   $43.32   N
7/1/2008   $57.67   N
7/1/2008   $15.15   N
7/1/2008    $5.00   N
1/1/2010    $5.22   N
7/1/2008   $20.54   N
1/1/2008   $28.66   N
7/1/2008   $21.76   N
7/1/2008    $7.69   N
7/1/2008    $5.11   N
7/1/2008   $10.32   N
7/1/2008   $11.06   N
7/1/2008   $13.50   N
7/1/2008    $7.23   N
7/1/2008   $10.20   N
7/1/2008   $20.66   N
7/1/2008   $23.09   N
7/1/2008    $9.42   N
7/1/2008   $14.42   N
7/1/2008    $6.63   N
7/1/2008    $6.88   N
7/1/2008    $5.99   N
7/1/2008   $11.80   N
7/1/2008   $12.03   N
7/1/2008   $20.55   N
7/1/2008   $35.59   N
7/1/2008   $16.28   N
7/1/2008    $6.42   N
7/1/2008    $6.01   N
7/1/2008   $18.95   N
7/1/2008   $26.73   N
7/1/2008   $26.46   N
7/1/2008   $28.89   N
7/1/2008   $31.89   N
7/1/2008   $29.15   N
1/1/2010   $27.76   N
7/1/2008   $27.08   N
7/1/2008   $34.88   N
7/1/2008   $25.70   N
7/1/2008   $25.70   N
7/1/2008   $25.70   N
7/1/2008    $5.12   N
7/1/2008    $5.12   N
7/1/2008    $5.12   N
7/1/2008    $4.02   N
7/1/2008   $21.03   N
7/1/2008   $15.01   N   $15.01
7/1/2008   $24.92   N   $24.92
7/1/2008   $23.80   N   $23.80
7/1/2008   $25.15   N   $25.15
7/1/2008   $20.05   N
7/1/2008   $12.03   N
7/1/2008   $24.89   N
7/1/2008   $39.25   N
7/1/2008   $15.17   N
7/1/2008   $13.18   N
7/1/2008   $16.26   N
7/1/2008   $89.99   N
7/1/2008   $90.64   N
7/1/2008   $73.12   N
7/1/2008   $51.09   N
7/1/2008   $30.73   N
7/1/2008   $28.28   N
7/1/2008   $35.67   N
7/1/2008   $43.28   N
7/1/2008   $30.36   N
7/1/2008   $18.77   N
7/1/2008   $32.90   N
7/1/2008    $6.72   N
7/1/2008    $6.79   N
7/1/2008    $6.79   N
7/1/2008   $29.70   N
7/1/2008   $25.54   N
7/1/2008    $9.77   N
7/1/2008    $3.50   N
7/1/2008   $27.39   N
7/1/2008    $7.69   N
7/1/2008    $7.69   N
7/1/2008   $16.10   N
7/1/2008   $16.10   N
7/1/2008    $6.64   N
7/1/2008   $32.76   N
7/1/2008   $32.82   N
7/1/2008   $29.67   N
7/1/2008   $16.26   N
1/1/2010   $18.54   N
7/1/2008   $20.28   N
7/1/2008    $9.61   N
7/1/2008    $9.04   N
7/1/2008   $12.60   N
7/1/2008   $20.66   N
7/1/2008   $21.98   N
7/1/2008   $71.05   N
7/1/2008   $19.81   N
7/1/2008   $25.15   N
7/1/2008    $7.22   N
7/1/2008    $7.40   N
7/1/2008   $17.84   N
7/1/2008    $8.04   N
7/1/2008    $9.04   N
7/1/2008   $19.81   N
7/1/2008   $23.67   N
7/1/2008   $22.02   N
7/1/2008   $13.75   N
7/1/2008   $10.49   N
7/1/2008    $6.50   N
7/1/2008   $10.63   N
7/1/2008   $14.53   N
7/1/2008    $8.69   N
7/1/2008    $5.51   N
7/1/2008    $5.25   N
7/1/2008    $6.64   N
7/1/2008    $9.23   N
7/1/2008    $6.31   N
7/1/2008    $6.64   N
7/1/2008   $17.43   N
7/1/2008    $4.54   N
7/1/2008    $9.92   N
7/1/2008    $7.02   N
7/1/2008   $21.66   N
7/1/2008   $49.37   N
7/1/2008   $47.43   N
7/1/2008   $16.20   N
7/1/2008   $16.20   N
7/1/2008   $19.15   N
7/1/2008   $22.45   N
7/1/2008   $16.55   N
7/1/2008   $15.91   N
7/1/2008    $8.10   N
7/1/2008   $29.07   N
7/1/2008   $21.03   N
7/1/2008   $10.49   N
1/1/2008   $21.98   N
7/1/2008   $14.02   N
            $0.00   N
7/1/2008    $6.29   N
7/1/2008    $8.58   N
7/1/2008    $4.81   N
7/1/2008    $4.81   N
7/1/2008    $4.02   N
7/1/2008    $3.31   N
7/1/2008    $3.31   N
7/1/2008    $3.31   N
7/1/2008   $10.86   N
7/1/2008    $8.58   N
7/1/2008    $6.01   N
7/1/2008    $4.20   N
7/1/2008    $6.01   N
7/1/2008    $5.59   N
7/1/2008    $7.80   N
7/1/2008    $3.55   N
7/1/2008    $6.25   N
7/1/2008   $20.95   N
1/1/2011   $80.58   N   $85.09
7/1/2008   $16.62   N
7/1/2008    $5.05   N
7/1/2008    $6.35   N
7/1/2008   $18.14   N
7/1/2008   $24.66   N
7/1/2008   $25.02   N
7/1/2008   $14.56   N
7/1/2008   $28.53   N
7/1/2008   $32.06   N
7/1/2008   $32.06   N
7/1/2008   $32.06   N
7/1/2008   $26.60   N
7/1/2008   $25.02   N
7/1/2008   $25.02   N
7/1/2008   $27.04   N
7/1/2008   $22.83   N
7/1/2008   $12.42   N
7/1/2008   $26.46   N
7/1/2008   $26.46   N
7/1/2008   $16.55   N
7/1/2008   $15.11   N
7/1/2008   $16.80   N
7/1/2008   $19.32   N
7/1/2008   $16.20   N
7/1/2008   $21.41   N
7/1/2008   $21.41   N
7/1/2008   $14.68   N
7/1/2008   $17.99   N
7/1/2008   $14.56   N
7/1/2008    $6.01   N
7/1/2008    $5.95   N
7/1/2008    $5.20   N
7/1/2008   $11.31   N
7/1/2008    $9.62   N
7/1/2008    $8.97   N
7/1/2008   $15.87   N
7/1/2008    $9.97   N
7/1/2008   $14.22   N
7/1/2008   $14.22   N
7/1/2008   $11.87   N
7/1/2008   $11.87   N
7/1/2008    $7.22   N    $7.22
1/1/2009   $25.02   N
7/1/2008   $12.36   N
7/1/2008   $10.77   N
7/1/2008   $24.02   N
7/1/2008    $9.13   N
7/1/2008   $14.23   N
7/1/2008    $5.88   N
7/1/2008    $9.52   N
7/1/2008   $10.81   N
7/1/2008    $9.26   N
7/1/2008   $12.40   N
7/1/2008   $18.29   N
7/1/2008    $9.08   N
7/1/2008   $19.81   N
7/1/2008    $8.06   N
7/1/2008   $12.02   N
7/1/2008   $12.02   N
7/1/2008   $26.21   N
7/1/2008    $9.34   N
7/1/2008   $18.66   N
7/1/2008   $30.01   N   $30.01
7/1/2008   $25.12   N
7/1/2008    $5.49   N
7/1/2008    $5.51   N
7/1/2008    $9.77   N
7/1/2008    $9.77   N
7/1/2008   $10.53   N
7/1/2008    $4.96   N
7/1/2008    $3.77   N
7/1/2008    $7.71   N
7/1/2008    $8.07   N
7/1/2008    $9.58   N
7/1/2008   $13.45   N
7/1/2008    $8.38   N
7/1/2008    $9.04   N
7/1/2008   $16.32   N
            $0.00   N
7/1/2008    $8.97   N
7/1/2008    $5.78   N
7/1/2008    $5.78   N
7/1/2008    $3.94   N
7/1/2008   $16.85   N
7/1/2008   $25.66   N
7/1/2008   $17.40   N
7/1/2008   $13.78   N
7/1/2008   $15.60   N
7/1/2008   $10.20   N
7/1/2008    $8.07   N
7/1/2008   $45.20   N
7/1/2008   $46.20   N
7/1/2008   $46.20   N
7/1/2008    $7.23   N
7/1/2008   $18.09   N
7/1/2008   $35.54   N
7/1/2008   $35.54   N
7/1/2008   $20.86   N
7/1/2008   $22.33   N
7/1/2008    $9.36   N
7/1/2008   $11.27   N
7/1/2008   $16.78   N
7/1/2008   $16.78   N
7/1/2008   $28.39   N
7/1/2008   $14.00   N
7/1/2008   $12.50   N
9/1/2008   $18.09   N
7/1/2008   $18.51   N
7/1/2008   $19.20   N
7/1/2008   $16.92   N
7/1/2008   $25.06   N
7/1/2008   $28.68   N
7/1/2008   $16.84   N   $16.84
7/1/2008   $16.84   N   $16.84
7/1/2008   $21.99   N
7/1/2008   $11.44   N
7/1/2008   $27.41   N
7/1/2008   $17.28   N
7/1/2008   $29.07   N
7/1/2008   $29.07   N
7/1/2008   $29.07   N
1/1/2010   $29.81   N
7/1/2008    $7.23   N
7/1/2008    $9.04   N
7/1/2008   $10.30   N
7/1/2008   $29.07   N
7/1/2008   $11.31   N
7/1/2008   $18.09   N
7/1/2008   $31.32   N   $31.32
7/1/2008   $31.24   N   $31.24
7/1/2008   $31.70   N   $31.70
7/1/2008   $13.78   N
7/1/2008   $16.75   N
7/1/2008   $33.85   N
7/1/2008   $31.21   N   $31.21
7/1/2008   $41.00   N   $41.00
7/1/2008   $20.95   N
7/1/2008   $29.92   N
7/1/2008   $21.06   N
7/1/2008   $27.65   N
7/1/2008   $17.41   N
7/1/2008   $11.16   N
1/1/2010   $97.30   N
7/1/2008   $68.49   N
9/1/2008   $52.70   N
1/1/2008   $39.09   N
9/1/2008   $52.70   N
7/1/2008   $52.70   N
7/1/2008   $65.65   N
7/1/2008   $37.41   N
            $0.00   N
7/1/2008   $20.33   N
7/1/2008   $27.51   N
7/1/2008   $23.62   N
7/1/2008   $15.91   N
7/1/2008   $14.24   N
7/1/2008   $14.87   N
7/1/2008    $7.93   N
7/1/2008    $7.93   N
9/1/2008   $86.59   N
7/1/2008    $9.05   N
1/1/2011    $4.28   N
7/1/2008    $7.39   N
7/1/2008    $7.72   N
1/1/2011    $6.31   N
7/1/2008   $15.41   N
7/1/2008    $5.96   N
7/1/2008    $6.16   N
7/1/2008   $14.22   N
7/1/2008   $17.98   N
7/1/2008   $17.61   N
7/1/2008   $18.00   N
7/1/2008   $14.22   N
7/1/2008   $17.61   N
7/1/2008   $18.43   N
7/1/2008   $21.64   N
7/1/2008   $23.80   N
7/1/2008   $18.69   N
7/1/2008   $11.75   N
7/1/2008   $18.33   N
7/1/2008   $16.78   N
7/1/2008   $16.52   N
7/1/2008   $17.74   N
7/1/2008   $14.94   N
7/1/2008   $16.94   N
7/1/2008   $20.14   N
7/1/2008   $13.72   N
7/1/2008   $16.01   N
7/1/2008   $20.28   N
7/1/2008   $18.43   N
7/1/2008   $18.43   N
7/1/2008   $18.43   N
7/1/2008   $18.43   N
7/1/2008   $18.20   N
7/1/2008   $18.33   N
7/1/2008   $21.38   N
7/1/2008   $24.55   N
7/1/2008   $14.22   N
7/1/2008   $10.68   N
7/1/2008   $17.13   N
7/1/2008   $20.56   N
7/1/2008   $20.28   N
7/1/2008   $18.17   N
7/1/2008    $3.73   N
7/1/2008   $22.14   N
7/1/2008   $11.72   N
7/1/2008   $19.57   N
7/1/2008   $27.05   N
7/1/2008   $17.87   N
7/1/2008   $13.72   N
7/1/2008    $8.53   N
7/1/2008   $27.05   N
7/1/2008   $17.46   N
7/1/2008   $12.41   N
7/1/2008   $17.08   N
7/1/2008   $19.17   N
7/1/2008   $16.84   N
7/1/2008   $16.44   N
7/1/2008   $15.01   N
7/1/2008   $16.16   N
7/1/2008   $17.31   N
7/1/2008   $15.73   N
7/1/2008   $13.87   N
7/1/2008   $12.27   N
7/1/2008   $17.12   N
7/1/2008   $12.27   N
7/1/2008   $18.43   N
7/1/2008   $17.98   N
7/1/2008   $16.69   N
7/1/2008   $18.43   N
7/1/2008   $18.23   N
7/1/2008   $18.51   N
7/1/2008   $18.43   N
7/1/2008   $18.43   N
7/1/2008   $21.00   N
7/1/2008   $18.43   N
7/1/2008   $17.32   N
7/1/2008   $18.01   N
7/1/2008   $27.05   N
7/1/2008   $18.43   N
7/1/2008   $13.72   N
7/1/2008   $18.00   N
7/1/2008   $18.43   N
7/1/2008   $18.43   N
7/1/2008   $20.68   N
7/1/2008   $13.72   N
7/1/2008   $14.94   N
1/1/2010   $18.97   N
7/1/2008   $16.01   N
7/1/2008   $18.00   N
9/1/2008   $16.01   N
9/1/2008   $13.72   N
7/1/2008   $18.00   N
7/1/2008   $18.43   N
7/1/2008   $22.22   N
7/1/2008   $19.94   N
7/1/2008   $21.64   N
7/1/2008   $61.66   N   $33.91   $27.75
7/1/2008   $30.84   N
7/1/2008   $55.29   N
7/1/2008   $41.47   N
7/1/2008   $36.06   N
7/1/2008   $81.02   N
7/1/2008   $38.92   N
7/1/2008   $89.95   N
7/1/2008   $78.88   N
7/1/2008    $51.07   N
1/1/2010   $115.04   N
             $0.00   N
             $0.00   Y
7/1/2008    $11.16   N
7/1/2008    $19.60   N
7/1/2008    $11.80   N
7/1/2008     $7.50   N
7/1/2008     $5.73   N
7/1/2008     $7.23   N
7/1/2008    $39.80   N
7/1/2008    $25.02   N
7/1/2008     $4.17   N
7/1/2008     $4.17   N
7/1/2008    $13.19   N
7/1/2008    $13.28   N
7/1/2008     $5.34   N
7/1/2008    $10.83   N
7/1/2008    $25.24   N
7/1/2008     $8.24   N
7/1/2008    $19.18   N
7/1/2008    $21.60   N
7/1/2008    $22.60   N
             $0.00   N
7/1/2008    $17.06   N
7/1/2008    $25.02   N
7/1/2008    $25.02   N
7/1/2008    $25.02   N
7/1/2008     $9.71   N
7/1/2008    $16.92   N
             $0.00   N
             $0.00   N
             $0.00   N
7/1/2008     $4.67   N
             $0.00   N
             $0.00   N
             $0.00   N
             $0.00   N
             $0.00   N
             $0.00   N
             $0.00   N
             $0.00   N
             $0.00   N
7/1/2008     $6.50   N
7/1/2008    $23.52   N
7/1/2008     $9.33   N
7/1/2008    $14.42   N
7/1/2008    $13.18   N
7/1/2008    $13.18   N
7/1/2008    $12.03   N
7/1/2008    $13.18   N
7/1/2008    $13.18   N
7/1/2008    $13.22   N
7/1/2008    $11.29   N
7/1/2008    $11.29   N
7/1/2008     $6.88   N
7/1/2008     $9.77   N
7/1/2008    $11.28   N
7/1/2008    $11.31   N
7/1/2008    $10.77   N
7/1/2008    $10.39   N
7/1/2008    $12.60   N
7/1/2008    $14.42   N
7/1/2008    $14.42   N
7/1/2008    $10.39   N
7/1/2008    $27.37   N
7/1/2008    $15.10   N
7/1/2008    $15.29   N
7/1/2008     $5.73   N
7/1/2008    $17.51   N
7/1/2008     $7.23   N
7/1/2008    $28.02   N
1/1/2010    $50.27   N
7/1/2008     $7.31   N
1/1/2010   $127.04   N
7/1/2008     $7.31   N
7/1/2008    $15.01   N   $15.01
7/1/2008    $15.78   N
7/1/2008     $5.96   N
7/1/2008     $5.96   N
7/1/2008     $5.96   N
7/1/2008     $8.22   N
7/1/2008    $12.43   N
7/1/2008     $6.64   N
7/1/2008     $9.63   N
7/1/2008     $6.64   N
7/1/2008    $12.08   N
7/1/2008    $12.33   N
7/1/2008     $9.27   N
7/1/2008     $7.90   N
7/1/2008    $20.99   N
7/1/2008     $5.96   N
7/1/2008     $7.50   N
7/1/2008     $8.37   N    $8.37
7/1/2008   $25.11   N
7/1/2008    $5.96   N
7/1/2008    $5.96   N
7/1/2008   $16.26   N
7/1/2008   $27.32   N
7/1/2008   $22.20   N
7/1/2008   $28.22   N
7/1/2008   $27.32   N
7/1/2008   $37.02   N
7/1/2008   $16.28   N
7/1/2008   $16.28   N
7/1/2008   $16.28   N
7/1/2008   $16.28   N
7/1/2008   $16.28   N
7/1/2008   $16.28   N
7/1/2008   $16.28   N
7/1/2008   $16.28   N
7/1/2008   $16.28   N
7/1/2008   $16.28   N
7/1/2008   $16.28   N
7/1/2008   $16.28   N
7/1/2008   $16.28   N
7/1/2008   $16.28   N
7/1/2008   $16.28   N
7/1/2008   $16.28   N
7/1/2008   $16.28   N
7/1/2008   $16.28   N
7/1/2008   $16.28   N
7/1/2008   $16.28   N
7/1/2008   $16.28   N
9/1/2008   $16.28   N
7/1/2008   $16.28   N
7/1/2008   $16.28   N
7/1/2008   $16.28   N
7/1/2008   $16.28   N
7/1/2008   $16.28   N
7/1/2008   $16.28   N
7/1/2008   $16.28   N
7/1/2008   $16.28   N
7/1/2008   $16.28   N
7/1/2008   $20.10   N
7/1/2008   $16.28   N
7/1/2008   $14.43   N
7/1/2008   $14.43   N
7/1/2008   $16.10   N
7/1/2008   $22.94   N
7/1/2008   $16.28   N
7/1/2008   $24.65   N
7/1/2008   $24.65   N
7/1/2008   $16.28   N
7/1/2008   $16.28   N
7/1/2008   $16.28   N
7/1/2008   $16.28   N
7/1/2008   $16.28   N
7/1/2008   $16.28   N
7/1/2008    $9.88   N
7/1/2008    $9.88   N
7/1/2008   $28.02   N
7/1/2008   $49.04   N
7/1/2008   $59.85   N
7/1/2008   $28.02   N
7/1/2008   $49.04   N
7/1/2008   $59.85   N
7/1/2008   $28.02   N
7/1/2008   $49.04   N
7/1/2008   $58.33   N
7/1/2008   $28.02   N
7/1/2008   $49.04   N
7/1/2008   $59.85   N
7/1/2008   $28.02   N
7/1/2008   $49.04   N
7/1/2008   $48.84   N
1/1/2010   $50.27   N
7/1/2008   $28.02   N
7/1/2008   $49.04   N
7/1/2008   $59.85   N
            $0.00   N
1/1/2008   $51.25   N
7/1/2008   $28.02   N
7/1/2008   $49.04   N
7/1/2008   $58.33   N
7/1/2008   $28.02   N
7/1/2008   $49.04   N
7/1/2008   $59.85   N
7/1/2008   $28.02   N
7/1/2008   $49.04   N
7/1/2008   $59.85   N
7/1/2008   $28.02   N
7/1/2008   $49.04   N
7/1/2008   $58.33   N
7/1/2008   $28.02   N
7/1/2008   $49.04   N
7/1/2008   $59.85   N
7/1/2008   $28.02   N
7/1/2008    $49.04   N
7/1/2008    $58.33   N
7/1/2008    $28.02   N
7/1/2008    $49.04   N
7/1/2008   $118.89   N
7/1/2008    $28.02   N
7/1/2008    $49.04   N
7/1/2008    $59.85   N
7/1/2008    $28.02   N
7/1/2008    $49.04   N
7/1/2008    $58.33   N
7/1/2008    $28.02   N
7/1/2008    $49.04   N
7/1/2008    $59.85   N
7/1/2008    $28.02   N
7/1/2008    $49.04   N
7/1/2008    $59.85   N
7/1/2008    $28.02   N
7/1/2008    $49.04   N
7/1/2008    $59.85   N
7/1/2008    $28.02   N
7/1/2008    $49.04   N
7/1/2008    $58.33   N
7/1/2008    $28.02   N
7/1/2008    $49.04   N
7/1/2008    $59.85   N
7/1/2008    $28.02   N
7/1/2008    $49.04   N
7/1/2008    $58.33   N
9/1/2008    $49.04   N
9/1/2008    $49.04   N
7/1/2008    $28.02   N
7/1/2008    $49.04   N
7/1/2008    $58.33   N
9/1/2008    $49.04   N
7/1/2008    $28.02   N
7/1/2008    $28.02   N
7/1/2008    $49.04   N
7/1/2008    $59.85   N
7/1/2008    $56.03   N
7/1/2008    $98.07   N
7/1/2008    $16.28   N
7/1/2008    $16.28   N
7/1/2008    $16.28   N
7/1/2008    $16.28   N
9/1/2008    $16.28   N
9/1/2008    $16.28   N
7/1/2008    $16.28   N
7/1/2008    $16.28   N
7/1/2008    $16.28   N
7/1/2008    $16.28   N
7/1/2008   $111.00   N
7/1/2008   $194.37   N
7/1/2008   $194.37   N
7/1/2008   $544.68   Y
7/1/2008    $22.20   Y
             $0.00   N
             $0.00   N
7/1/2008    $53.46   N    $6.95    $46.51
7/1/2008    $67.47   N    $8.10    $59.37
7/1/2008    $85.53   N    $9.41    $76.12
7/1/2008    $64.13   N    $8.98    $55.15
1/1/2011    $95.70   N   $40.30    $55.40
7/1/2008    $17.15   N    $1.03    $16.12
7/1/2008    $21.02   N
7/1/2008    $11.17   N
7/1/2008    $23.15   N
7/1/2008    $28.31   N
7/1/2008    $28.31   N
7/1/2008    $14.76   N
7/1/2008    $14.76   N
7/1/2008    $14.76   N
7/1/2008    $14.76   N
7/1/2008    $14.76   N
7/1/2008    $14.76   N
7/1/2008     $8.37   N
7/1/2008    $46.55   N    $5.12    $41.43
1/1/2011    $49.70   N   $26.37    $23.33
7/1/2008    $69.84   N   $17.46    $52.38
7/1/2008    $14.76   N
7/1/2008    $14.76   N
7/1/2008    $14.76   N
7/1/2008    $14.76   N
7/1/2008    $46.64   N    $7.00    $39.64
7/1/2008   $119.87   N   $14.38   $105.49
7/1/2008    $29.85   N
7/1/2008    $36.31   N
7/1/2008    $93.63   N   $14.98    $78.65
7/1/2008    $63.44   N
7/1/2008    $36.08   N
7/1/2008    $59.91   N             $66.62
7/1/2008    $73.96   N
7/1/2008    $95.19   N
             $0.00   N
7/1/2008   $162.77   N
7/1/2008   $196.63   N
7/1/2008   $205.74   N
7/1/2008   $176.47   N
7/1/2008   $206.12   N
7/1/2008    $14.11   N
7/1/2008    $14.11   N
7/1/2008   $207.98   N
7/1/2008   $241.96   N
7/1/2008   $241.96   N
7/1/2008   $246.93   N
7/1/2008   $174.14   N
7/1/2008   $130.45   N
7/1/2008   $174.14   N
7/1/2008   $251.17   N
7/1/2008   $232.38   N
7/1/2008    $20.22   N
7/1/2008    $25.28   N
7/1/2008    $35.39   N
7/1/2008    $45.50   N
7/1/2008    $56.11   N
7/1/2008    $35.07   N
7/1/2008    $95.84   N
7/1/2008    $26.54   N
7/1/2008    $48.11   N
7/1/2008    $25.24   N
             $0.00   N
7/1/2008    $20.06   N     $6.62    $13.44
7/1/2008    $43.46   N    $16.95    $26.51
7/1/2008    $54.18   N    $20.59    $33.59
7/1/2008    $92.20   N    $26.74    $65.46
7/1/2008   $182.06   N    $45.51   $136.54
7/1/2008   $272.90   N    $62.77   $210.13
7/1/2008    $16.05   N     $3.53    $12.52
7/1/2008    $82.25   N    $11.52    $70.74
7/1/2008    $61.76   N    $13.59    $48.17
7/1/2008    $83.06   N    $21.60    $61.46
7/1/2008    $91.40   N    $16.45    $74.95
1/1/2011   $128.13   N   $102.50    $25.63
7/1/2008    $80.82   N
7/1/2008   $129.38   N    $20.70   $108.68
7/1/2008   $174.21   N
7/1/2008    $44.87   N    $11.22    $33.65
7/1/2008    $80.22   N    $20.06    $60.17
7/1/2008    $36.25   N     $8.70    $27.55
7/1/2008    $81.93   N    $18.84    $63.09
7/1/2008    $48.16   N    $13.00    $35.16
7/1/2008    $86.90   N    $18.25    $68.65
7/1/2008    $87.95   N    $16.71    $71.24
7/1/2008    $72.94   N    $16.05    $56.89
7/1/2008   $513.89   N   $149.03   $364.86
7/1/2008   $243.43   N    $82.77   $160.66
7/1/2008   $264.74   N    $60.89   $203.85
7/1/2008   $264.08   N    $60.74   $203.34
7/1/2008    $67.59   N    $15.55    $52.04
7/1/2008   $104.53   N    $21.95    $82.58
1/1/2011   $137.50   N    $82.78    $54.72
7/1/2008   $237.42   N    $56.98   $180.44
7/1/2008   $132.41   N    $29.13   $103.28
7/1/2008   $199.18   N   $125.48    $73.70
7/1/2008   $172.25   N    $77.51    $94.74
7/1/2008    $31.05   N              $31.05
7/1/2008    $31.79   N              $31.79
             $0.00   N
1/1/2011   $182.85   N   $128.33    $54.52
             $0.00   N
7/1/2008   $430.24   N   $361.40    $68.84
7/1/2008   $441.62   N   $357.71    $83.91
1/1/2010    $28.61   N     $5.44    $23.17
1/1/2010    $17.18   N     $2.58    $14.60
             $0.00   N
1/1/2009     $7.19   N
1/1/2010     $7.19   N
             $0.00   N
             $0.00   N
7/1/2008   $166.77   N
7/1/2008     $6.61   N
7/1/2008     $7.70   N
7/1/2008     $5.96   N
7/1/2008     $9.99   N               $9.99
7/1/2008   $183.24   N
7/1/2008   $185.29   N
7/1/2008     $6.03   N
7/1/2008   $154.08   N
7/1/2008   $172.49   N
7/1/2008   $206.25   N
7/1/2008   $135.16   N
7/1/2008   $170.84   N
7/1/2008   $181.94   N
7/1/2008     $5.15   N
7/1/2008     $6.64   N
             $0.00   N
1/1/2008     $4.67   N
1/1/2009     $3.26   N
  1/1/2008       $7.69   N
  7/1/2008      $16.26   N
                 $0.00   Y
  1/1/2008      $28.00   N   Referral Required
                 $0.00   N   Referral Required
                 $0.00   N   Referral Required
                 $0.00   N   Referral Required
                 $0.00   N   Referral Required
                 $0.00   N   Referral Required
                 $0.00   N   Referral Required
  1/1/2009    $123.87    N   Referral Required
  1/1/2009      $90.90   N   Referral Required
  1/1/2009      $98.08   N   Referral Required
 12/1/2010   $1,031.27   N   Referral Required
  1/1/2008    $113.05    N   Referral Required
  1/1/2009      $25.99   N   Referral Required
                 $0.00   N   Referral Required
                 $0.00   N   Referral Required
                 $0.00   N   Referral Required
  1/1/2008    $109.82    N   Referral Required
                 $0.00   N   Referral Required
  1/1/2009      $19.07   N
  1/1/2009       $7.52   N
  1/1/2009      $12.70   N
  1/1/2009       $9.43   N
  1/1/2009      $19.07   N
  1/1/2009       $9.75   N                       $0.29
  1/1/2009      $12.70   N
  1/1/2009       $8.47   N
                 $0.00   N
                 $0.00   N
  1/1/2008       $1.92   N   Referral Required
                 $0.00   N
  1/1/2009    $118.11    N
  1/1/2009    $114.49    N
  1/1/2009      $46.86   N
  1/1/2009      $25.15   N
  1/1/2008      $24.28   N
  1/1/2008      $85.00   N
  1/1/2009      $23.34   N
  1/1/2008      $24.00   N
  1/1/2009      $23.34   N
  1/1/2009      $21.78   N
  1/1/2008    $131.73    N
10/15/2008      $16.88   N
10/15/2008      $18.20   N
  1/1/2008       $6.61   N
  1/1/2008    $13.22   N
10/15/2008    $22.32   N
  1/1/2008    $63.70   N
  1/1/2008    $78.80   N
  1/1/2009   $146.88   N
               $0.00   N
  1/1/2008    $68.75   N
               $0.00   N
  1/1/2008    $30.00   N
  1/1/2009    $53.32   N
               $0.00   N
               $0.00   N
               $0.00   N
  1/1/2009    $56.64   N
  1/1/2009    $17.58   N
  1/1/2008    $17.23   N
  1/1/2009    $24.96   N
  1/1/2009    $21.99   N
  1/1/2009    $22.20   N
  1/1/2009    $17.14   N
  1/1/2009    $18.92   N
  1/1/2009    $44.82   N
  1/1/2008    $22.30   N
  1/1/2008    $16.22   N
  1/1/2009    $26.52   N
  1/1/2009    $19.70   N
  1/1/2009    $34.70   N
  1/1/2009    $77.33   N
  1/1/2009    $57.75   N
  1/1/2009    $12.21   N
  1/1/2008     $5.00   N
  1/1/2008    $28.34   N
  1/1/2009    $42.89   N
  1/1/2008    $75.53   N
  1/1/2008     $5.00   N
  1/1/2008     $4.00   N
10/15/2008    $32.70   N
  1/1/2009    $93.87   N
  1/1/2008    $90.20   N
  1/1/2009   $102.08   N
               $0.00   N
               $0.00   N
  1/1/2009   $119.42   N
  1/1/2009    $24.22   N
  1/1/2009    $24.22   N
  1/1/2009    $59.71   N
  1/1/2009   $119.42   N
1/1/2008    $39.75   N
             $0.00   N
1/1/2011   $149.50   N   Referral Required
7/1/2008   $159.77   N   Referral Required
7/1/2008    $40.39   N   Referral Required
7/1/2008    $74.72   N   Referral Required
7/1/2008    $60.60   N   Referral Required
7/1/2008   $107.45   N   Referral Required
7/1/2008    $90.38   N   Referral Required
7/1/2008   $155.32   N   Referral Required
7/1/2008    $43.72   N   Referral Required
7/1/2008    $80.42   N   Referral Required
7/1/2008    $64.55   N   Referral Required
1/1/2011   $111.20   N   Referral Required
7/1/2008    $94.36   N   Referral Required
7/1/2008   $160.99   N   Referral Required
1/1/2011    $59.76   N   Referral Required
1/1/2011    $67.44   N   Referral Required
1/1/2011    $89.05   N   Referral Required
1/1/2011    $97.10   N   Referral Required
1/1/2011   $131.49   N   Referral Required
1/1/2011   $140.11   N   Referral Required
7/1/2008    $76.47   N   Referral Required
7/1/2008    $84.48   N   Referral Required
1/1/2011    $94.31   N   Referral Required
1/1/2011   $101.99   N   Referral Required
7/1/2008   $183.05   N   Referral Required
7/1/2008   $165.39   N   Referral Required
7/1/2008    $95.49   N   Referral Required
9/1/2008    $71.55   N   Referral Required
7/1/2008    $71.55   N   Referral Required
7/1/2008    $34.12   N   Referral Required
7/1/2008    $21.69   N   Referral Required
1/1/2011    $34.34   N   Referral Required
7/1/2008    $52.91   N   Referral Required
1/1/2011   $150.94   N   Referral Required
7/1/2008   $100.04   N   Referral Required
7/1/2008   $118.32   N   Referral Required
7/1/2008    $34.50   N   Referral Required
7/1/2008    $48.59   N   Referral Required
7/1/2008    $48.55   N   Referral Required
             $0.00   Y   Referral Required
7/1/2008    $63.38   N   Referral Required
7/1/2008   $104.24   N   Referral Required
             $0.00   N   Referral Required
7/1/2008    $66.42   N   Referral Required
7/1/2008   $106.49   N   Referral Required
1/1/2009   $919.84   N   Referral Required
1/1/2009   $689.88   N   Referral Required
1/1/2009   $229.96   N   Referral Required
1/1/2009   $756.48   N   Referral Required
1/1/2009   $427.91   N   Referral Required
1/1/2009   $289.87   N   Referral Required
1/1/2009   $606.76   N   Referral Required
1/1/2009   $409.17   N   Referral Required
1/1/2009   $268.59   N   Referral Required
1/1/2009   $268.52   N   Referral Required
1/1/2009   $216.91   N   Referral Required
1/1/2009   $156.98   N   Referral Required
1/1/2009   $519.80   N   Referral Required
1/1/2009   $434.24   N   Referral Required
1/1/2009   $413.08   N   Referral Required
1/1/2009   $214.68   N   Referral Required
1/1/2009    $18.55   N   Referral Required
1/1/2009    $14.52   N   Referral Required
1/1/2009    $14.16   N   Referral Required
1/1/2009     $7.48   N   Referral Required
7/1/2008   $518.25   N   Referral Required
7/1/2008    $20.73   N   Referral Required
7/1/2008   $151.18   N   Referral Required
7/1/2008    $68.17   N   Referral Required     $2.73    $65.44
1/1/2011   $171.01   N   Referral Required    $36.87   $147.47
1/1/2011   $229.11   N   Referral Required    $49.66   $186.81
7/1/2008   $245.60   N   Referral Required    $54.03   $191.57
7/1/2008   $212.86   N   Referral Required    $36.19   $176.67
7/1/2008   $181.59   N   Referral Required   $123.48    $58.11
7/1/2008   $124.31   N   Referral Required    $14.92   $109.39
1/1/2011   $178.19   N   Referral Required   $131.90    $64.97
1/1/2011   $425.94   N   Referral Required   $355.37    $83.36
1/1/2011   $145.28   N   Referral Required    $96.14    $49.52
7/1/2008   $127.01   N   Referral Required    $69.86    $57.15
7/1/2008   $359.76   N   Referral Required   $316.59    $43.17
7/1/2008   $120.54   N   Referral Required    $15.67   $104.87
7/1/2008   $128.78   N   Referral Required    $18.03   $110.75
7/1/2008    $55.76   N   Referral Required    $14.50    $41.26
1/1/2011    $75.60   N   Referral Required
1/1/2011   $816.68   N   Referral Required   $744.05   $121.12
7/1/2008   $682.94   N   Referral Required   $628.30    $54.64
1/1/2011   $353.81   N   Referral Required   $331.84    $45.25
1/1/2011   $208.86   N   Referral Required    $47.64   $179.20
             $0.00   N   Referral Required
5/1/2009    $28.26   N   Referral Required
5/1/2009    $35.45   N   Referral Required
             $0.00   N   Referral Required
7/1/2008    $63.24   N
7/1/2008   $119.56   N
7/1/2008    $66.88   N
7/1/2008    $97.40   N
7/1/2008    $17.80   N
7/1/2008   $120.66   N
7/1/2008    $61.51   N
7/1/2008    $23.10   N   Referral Required
7/1/2008    $29.40   N   Referral Required    $11.76   $17.64
7/1/2008    $50.29   N                        $10.06   $40.23
             $0.00   Y   Referral Required
7/1/2008    $58.74   N
7/1/2008    $45.59   N   Referral Required    $10.03   $35.56
7/1/2008    $59.34   N   Referral Required    $12.46   $46.88
7/1/2008    $68.17   N   Referral Required    $13.63   $54.54
7/1/2008    $76.50   N
7/1/2008    $63.29   N   Referral Required
7/1/2008    $70.51   N   Referral Required
7/1/2008    $39.71   N   Referral Required    $14.69   $25.02
1/1/2011    $72.56   N   Referral Required    $27.13   $46.20
7/1/2008    $49.76   N   Referral Required
7/1/2008    $21.04   N   Referral Required
7/1/2008    $19.14   N   Referral Required
7/1/2008    $58.99   N   Referral Required
1/1/2011   $113.08   N   Referral Required    $47.57   $65.70
7/1/2008   $230.55   N   Referral Required   $145.25   $85.30
6/1/2009    $64.15   N   Referral Required    $23.09   $41.06
7/1/2008    $15.50   N   Referral Required
7/1/2008    $71.65   N   Referral Required    $15.05   $56.60
7/1/2008    $77.63   N   Referral Required    $15.53   $62.10
7/1/2008   $110.81   N   Referral Required    $23.27   $87.54
7/1/2008    $37.55   N   Referral Required     $7.89   $29.66
7/1/2008    $60.18   N   Referral Required    $12.64   $47.54
1/1/2011    $37.38   N   Referral Required     $8.37   $29.67
7/1/2008   $111.51   N   Referral Required    $23.42   $88.09
7/1/2008   $101.78   N   Referral Required
7/1/2008    $81.55   N
7/1/2008    $78.40   N   Referral Required
7/1/2008    $87.78   N
7/1/2008    $74.78   N
7/1/2008    $81.55   N
7/1/2008    $53.00   N
7/1/2008    $67.58   N
7/1/2008    $54.37   N
7/1/2008    $23.62   N
7/1/2008    $23.62   N
7/1/2008    $23.62   N
7/1/2008    $20.90   N
7/1/2008    $28.18   N
7/1/2008   $264.64   N   Referral Required
7/1/2008   $128.20   N   Referral Required
7/1/2008    $30.10   N
7/1/2008     $4.37   N
7/1/2008    $18.95   N
             $0.00   N   Referral Required
7/1/2008    $87.87   N   Referral Required
7/1/2008    $25.37   N   Referral Required
7/1/2009   $133.20   N   Referral Required
7/1/2009    $56.09   N   Referral Required
1/1/2011   $139.99   N   Referral Required
7/1/2008    $55.99   N   Referral Required
7/1/2008    $56.68   N   Referral Required
7/1/2008    $51.22   N   Referral Required
7/1/2009    $71.19   N   Referral Required
7/1/2008    $34.94   N   Referral Required
7/1/2008    $53.91   N   Referral Required
7/1/2008    $12.15   N   Referral Required   $12.15
7/1/2008    $34.94   N   Referral Required
1/1/2010    $87.86   N   Referral Required   $14.94   $72.92
1/1/2011    $47.45   N   Referral Required   $10.39   $41.58
1/1/2011    $48.33   N   Referral Required   $15.09   $38.80
1/1/2011    $22.69   N   Referral Required    $8.46   $16.42
1/1/2011    $39.34   N   Referral Required   $12.02   $30.92
1/1/2011    $36.56   N   Referral Required   $12.99   $26.38
7/1/2008    $76.09   N   Referral Required   $22.07   $54.02
1/1/2011     $3.94   N   Referral Required    $4.27
1/1/2011    $86.41   N   Referral Required   $52.95   $35.30
1/1/2010    $15.03   N   Referral Required
7/1/2008    $14.59   N   Referral Required
7/1/2008    $18.65   N   Referral Required   $18.65
7/1/2008    $25.57   N   Referral Required   $25.57
1/1/2011    $14.47   N   Referral Required   $14.53
7/1/2008    $19.73   N   Referral Required   $19.73
1/1/2011    $39.03   N   Referral Required   $48.57
7/1/2008    $25.57   N   Referral Required   $25.57
7/1/2008    $18.31   N   Referral Required   $18.31
7/1/2008    $16.59   N   Referral Required   $16.59
7/1/2008    $17.13   N   Referral Required   $17.13
1/1/2011    $11.07   N   Referral Required   $12.12
7/1/2008    $25.30   N   Referral Required
1/1/2011    $14.89   N   Referral Required   $19.58
1/1/2011    $16.10   N   Referral Required   $19.23
7/1/2008    $16.09   N   Referral Required   $16.09
1/1/2010    $22.93   N
7/1/2008    $14.87   N   Referral Required   $14.87
7/1/2008    $11.88   N   Referral Required   $11.88
7/1/2008    $25.48   N   Referral Required   $25.48
7/1/2008    $18.51   N   Referral Required   $18.51
1/1/2011    $13.79   N   Referral Required   $18.21
1/1/2011    $41.62   N   Referral Required   $44.05
7/1/2008    $33.83   N   Referral Required   $33.83
7/1/2008    $29.41   N   Referral Required   $29.41
1/1/2011    $55.93   N   Referral Required   $70.10
7/1/2008    $92.07   N   Referral Required   $43.27   $48.80
1/1/2011    $55.93   N   Referral Required   $59.10
1/1/2011    $32.61   N   Referral Required   $34.76    $6.62
1/1/2011    $56.55   N   Referral Required   $43.28   $19.45
7/1/2008    $19.15   N   Referral Required   $19.15
7/1/2008    $48.58   N   Referral Required
7/1/2008    $97.15   N   Referral Required
7/1/2008    $24.26   N   Referral Required
7/1/2008    $48.58   N   Referral Required
7/1/2008    $17.72   N   Referral Required
             $0.00   N   Referral Required
7/1/2008    $28.66   N   Referral Required   $28.66
7/1/2009    $91.80   N   Referral Required
1/1/2011   $145.05   N   Referral Required
1/1/2011    $91.05   N   Referral Required
1/1/2011   $134.07   N   Referral Required
1/1/2011    $78.85   N   Referral Required
7/1/2009   $132.19   N   Referral Required
7/1/2009    $25.19   N   Referral Required
7/1/2009    $70.21   N   Referral Required
7/1/2009    $67.82   N   Referral Required
7/1/2008    $94.01   N   Referral Required
7/1/2008   $143.01   N   Referral Required
7/1/2008   $129.27   N   Referral Required
7/1/2008   $179.01   N   Referral Required
7/1/2008    $54.10   N   Referral Required
7/1/2008    $12.86   N   Referral Required
7/1/2008    $53.76   N   Referral Required
7/1/2009    $74.53   N   Referral Required
7/1/2009    $18.15   N   Referral Required
             $0.00   N   Referral Required
             $0.00   N   Referral Required
7/1/2008    $46.25   N   Referral Required
1/1/2011   $259.35   N   Referral Required
7/1/2008    $10.64   N   Referral Required
1/1/2011   $232.69   N   Referral Required
7/1/2008   $241.84   N   Referral Required
7/1/2008   $167.65   N   Referral Required
7/1/2008      $95.71   N   Referral Required
7/1/2008    $170.13    N   Referral Required
7/1/2008    $155.80    N   Referral Required
7/1/2008    $374.53    N   Referral Required
7/1/2008    $177.07    N   Referral Required
1/1/2011    $244.28    N   Referral Required   $154.30   $94.57
1/1/2011    $149.06    N   Referral Required    $75.93   $75.93
7/1/2008    $775.80    N   Referral Required
7/1/2008    $215.59    N   Referral Required
7/1/2008    $575.27    N   Referral Required
7/1/2008    $153.99    N   Referral Required
7/1/2008   $1,280.84   N   Referral Required
7/1/2008   $1,326.66   N   Referral Required
7/1/2008   $1,012.88   N   Referral Required
               $0.00   N   Referral Required
               $0.00   N   Referral Required
7/1/2008    $632.80    N   Referral Required
7/1/2008    $166.44    N   Referral Required
7/1/2008    $601.11    N   Referral Required
7/1/2008    $301.58    N   Referral Required
1/1/2011      $18.76   N   Referral Required
1/1/2011      $10.05   N   Referral Required    $12.76
7/1/2008       $8.15   N   Referral Required              $8.15
7/1/2008    $178.45    N   Referral Required   $178.45
7/1/2008      $25.66   N   Referral Required    $25.66
1/1/2011      $88.15   N   Referral Required
7/1/2008      $22.96   N   Referral Required    $22.96
1/1/2011      $49.48   N   Referral Required    $57.48
7/1/2008      $14.86   N   Referral Required    $14.86
7/1/2008    $110.81    N   Referral Required    $31.03   $79.78
7/1/2008    $226.93    N   Referral Required   $179.27   $47.66
1/1/2011      $12.62   N   Referral Required
1/1/2011       $4.96   N   Referral Required     $5.36
7/1/2008       $7.41   N   Referral Required              $7.41
1/1/2011      $99.90   N   Referral Required
1/1/2011      $29.09   N   Referral Required
1/1/2011      $43.70   N   Referral Required
7/1/2008      $26.34   N   Referral Required
1/1/2009      $24.56   N   Referral Required
               $0.00   N   Referral Required
1/1/2011    $101.60    N   Referral Required
1/1/2011      $27.73   N   Referral Required
1/1/2011      $47.78   N   Referral Required
7/1/2008      $25.66   N   Referral Required
1/1/2011    $111.54    N   Referral Required
7/1/2008      $92.14   N   Referral Required
7/1/2008      $22.61   N   Referral Required
1/1/2011   $230.75   N   Referral Required
1/1/2011    $15.49   N   Referral Required
1/1/2011   $189.16   N   Referral Required
7/1/2008    $25.31   N   Referral Required
7/1/2008    $42.94   N   Referral Required    $21.90    $21.04
1/1/2011    $51.23   N   Referral Required    $16.96    $34.42
1/1/2011    $60.66   N   Referral Required    $19.49    $41.43
1/1/2011    $70.45   N   Referral Required    $22.79    $48.43
1/1/2011    $64.90   N   Referral Required    $21.05    $44.74
1/1/2009    $80.21   N   Referral Required    $24.06    $56.15
1/1/2011    $92.79   N   Referral Required    $27.29    $66.82
1/1/2011    $43.29   N   Referral Required    $15.89    $28.25
1/1/2009    $24.98   N   Referral Required    $10.49    $14.49
1/1/2009    $33.14   N   Referral Required    $11.93    $21.21
1/1/2011    $38.68   N   Referral Required    $16.56    $22.86
1/1/2009    $61.28   N   Referral Required    $19.61    $41.67
1/1/2009    $29.43   N   Referral Required     $9.12    $20.31
1/1/2011    $37.32   N   Referral Required    $14.75    $23.08
1/1/2009    $34.33   N   Referral Required    $11.33    $23.00
1/1/2011    $51.70   N   Referral Required    $36.32    $16.32
1/1/2011    $34.58   N   Referral Required
1/1/2009    $63.05   N   Referral Required
1/1/2009    $32.04   N   Referral Required
1/1/2009    $24.56   N   Referral Required
1/1/2009    $28.07   N   Referral Required
             $0.00   N   Referral Required
1/1/2011   $193.83   N   Referral Required   $126.99    $74.58
7/1/2008   $120.59   N   Referral Required    $69.94    $50.65
1/1/2011   $225.78   N   Referral Required   $168.48    $68.81
1/1/2011   $146.28   N   Referral Required   $112.65    $60.66
1/1/2011    $98.02   N   Referral Required    $62.93    $40.23
7/1/2008   $288.86   N   Referral Required   $161.76   $127.10
7/1/2008    $39.97   N   Referral Required
7/1/2008   $246.54   N   Referral Required   $172.58    $73.96
1/1/2011   $268.71   N   Referral Required   $134.14   $139.62
7/1/2008    $42.53   N   Referral Required
1/1/2011   $219.59   N   Referral Required   $136.47    $87.25
7/1/2008   $117.83   N   Referral Required    $70.70    $47.13
1/1/2011    $63.72   N   Referral Required    $46.56    $29.76
1/1/2011    $28.58   N   Referral Required    $26.96    $10.49
1/1/2011    $37.59   N   Referral Required    $32.89    $35.64
7/1/2008   $182.02   N   Referral Required    $87.37    $94.65
1/1/2011   $230.51   N   Referral Required
1/1/2011    $33.90   N   Referral Required
1/1/2011   $698.06   N   Referral Required   $542.18   $221.46
7/1/2008   $104.35   N   Referral Required
7/1/2008   $582.40   N   Referral Required   $122.30   $460.10
7/1/2008    $910.01    N   Referral Required    $609.71     $300.30
1/1/2011   $1,116.78   N   Referral Required   $1,100.84    $258.22
7/1/2008   $1,536.02   N   Referral Required   $1,259.54    $276.48
7/1/2008   $1,627.28   N   Referral Required               $1,627.28
7/1/2008   $2,021.05   N   Referral Required   $1,616.84    $404.21
1/1/2011   $1,429.84   N   Referral Required   $1,389.75    $369.43
1/1/2011   $2,000.52   N   Referral Required   $1,548.96    $489.15
7/1/2008   $2,125.43   N   Referral Required   $1,657.84    $467.59
7/1/2008   $1,912.00   N   Referral Required   $1,644.32    $267.68
1/1/2011    $801.74    N   Referral Required    $547.26     $269.55
1/1/2011   $2,092.48   N   Referral Required   $1,641.49    $490.31
7/1/2008   $2,175.94   N   Referral Required   $1,539.18   $2,175.94
7/1/2008   $1,990.29   N   Referral Required   $1,600.72   $1,990.29
7/1/2008      $58.95   N   Referral Required
7/1/2008    $165.96    N   Referral Required
7/1/2008      $14.86   N   Referral Required
7/1/2008    $101.47    N   Referral Required
7/1/2008      $57.47   N   Referral Required
7/1/2008      $42.16   N   Referral Required
7/1/2008    $117.37    N   Referral Required
1/1/2011      $86.91   N   Referral Required    $134.72      $23.77
1/1/2011    $118.22    N   Referral Required    $202.36      $27.60
7/1/2008      $42.25   N   Referral Required      $9.30      $32.96
7/1/2008      $18.99   N   Referral Required      $5.13      $13.86
1/1/2011    $243.28    N   Referral Required    $163.58      $84.27
7/1/2008    $157.57    N   Referral Required    $110.30      $47.27
7/1/2008    $933.80    N   Referral Required
7/1/2008    $175.18    N   Referral Required     $45.55     $129.63
7/1/2008    $144.98    N   Referral Required     $31.90     $113.08
7/1/2008    $164.95    N   Referral Required     $44.54     $120.41
1/1/2011    $338.88    N   Referral Required     $55.24     $290.01
7/1/2008    $198.31    N   Referral Required     $39.66     $158.65
7/1/2008    $207.51    N   Referral Required     $47.73     $159.78
7/1/2008    $362.26    N   Referral Required     $84.96     $284.41
7/1/2008      $55.92   N   Referral Required     $10.62       $45.30
7/1/2008      $87.86   N   Referral Required      $9.66       $78.20
1/1/2011    $345.22    N   Referral Required     $94.96     $256.74
7/1/2008    $647.05    N   Referral Required    $187.64     $459.41
1/1/2011    $900.53    N   Referral Required    $238.54     $678.91
7/1/2008   $1,739.67   N   Referral Required    $452.31    $1,287.36
7/1/2008   $1,016.63   N   Referral Required               $1,016.63
7/1/2008    $462.57    N   Referral Required                $462.57
7/1/2008    $320.47    N   Referral Required     $64.09     $256.38
7/1/2008    $598.44    N   Referral Required    $191.50     $406.94
7/1/2008    $427.14    N   Referral Required    $170.86     $256.28
1/1/2011    $537.52    N   Referral Required    $197.14     $350.48
1/1/2011    $418.97    N   Referral Required    $168.43     $299.42
7/1/2008   $552.75   N   Referral Required   $144.20   $410.40
7/1/2008   $838.09   N   Referral Required
7/1/2008   $912.80   N   Referral Required
1/1/2011   $158.76   N   Referral Required    $76.71    $83.10
1/1/2011   $284.39   N   Referral Required   $141.97   $147.77
1/1/2011    $24.33   N   Referral Required    $25.65     $9.49
7/1/2008    $40.59   N   Referral Required
7/1/2008    $32.80   N   Referral Required    $24.08
7/1/2008     $7.80   N   Referral Required
7/1/2008   $332.70   N   Referral Required   $109.79   $222.91
7/1/2008    $19.90   N   Referral Required     $4.78    $15.12
7/1/2008    $72.23   N   Referral Required
1/1/2010    $38.06   N
7/1/2008    $24.26   N   Referral Required    $15.04     $9.22
7/1/2008    $44.68   N   Referral Required    $29.94    $14.74
7/1/2008    $18.77   N   Referral Required     $1.50    $17.27
1/1/2011    $60.86   N   Referral Required
7/1/2008    $29.75   N   Referral Required
7/1/2008    $16.70   N   Referral Required
7/1/2008    $17.61   N   Referral Required
7/1/2008    $17.13   N   Referral Required
7/1/2008    $25.47   N   Referral Required
             $0.00   N   Referral Required
7/1/2008    $93.66   N   Referral Required    $54.32    $39.34
7/1/2008   $163.72   N   Referral Required   $126.06    $37.66
1/1/2011   $149.66   N   Referral Required   $130.59    $19.51
1/1/2011   $191.38   N   Referral Required   $138.33    $62.15
1/1/2011    $89.23   N   Referral Required   $102.28    $30.55
7/1/2008   $227.15   N   Referral Required   $181.72    $45.43
7/1/2008   $242.76   N   Referral Required   $148.08    $94.68
1/1/2011   $147.30   N   Referral Required   $145.21    $92.84
1/1/2011   $109.67   N   Referral Required    $74.52    $36.71
1/1/2011   $168.60   N   Referral Required   $114.09    $56.19
7/1/2008   $207.34   N   Referral Required   $138.92    $68.42
7/1/2008   $162.93   N   Referral Required   $125.46    $37.47
7/1/2008   $108.88   N   Referral Required    $94.73    $14.15
7/1/2008   $164.53   N   Referral Required   $131.62    $32.91
1/1/2011   $106.60   N   Referral Required    $97.62    $12.06
1/1/2011   $111.78   N   Referral Required    $65.30    $49.27
1/1/2011   $179.33   N   Referral Required   $134.72    $47.34
1/1/2011   $113.89   N   Referral Required   $102.90    $18.16
1/1/2011   $234.32   N   Referral Required   $148.62   $112.11
7/1/2008   $174.52   N   Referral Required   $127.40    $47.12
7/1/2008   $170.52   N   Referral Required   $127.89    $42.63
1/1/2011   $113.18   N   Referral Required    $98.10    $15.97
7/1/2008   $159.98   N   Referral Required    $84.79    $75.19
7/1/2008   $120.06   N   Referral Required    $99.65    $20.41
7/1/2008   $101.47   N   Referral Required   $86.25    $15.22
7/1/2008    $82.10   N   Referral Required
7/1/2008    $59.64   N   Referral Required
7/1/2008    $43.21   N   Referral Required
1/1/2011    $30.66   N   Referral Required   $14.82    $16.05
1/1/2010    $71.22   N
1/1/2010   $109.66   N
1/1/2010    $29.36   N
7/1/2008    $45.44   N   Referral Required   $17.27    $28.17
7/1/2008    $21.85   N   Referral Required
7/1/2008    $23.60   N   Referral Required   $23.60
7/1/2008    $52.86   N   Referral Required   $30.13    $22.73
7/1/2008    $54.27   N   Referral Required   $32.56    $21.71
7/1/2008     $9.71   N   Referral Required    $2.62     $7.09
7/1/2008    $20.66   N   Referral Required    $9.71    $10.95
1/1/2011    $35.60   N   Referral Required   $20.67    $14.96
7/1/2008    $24.25   N   Referral Required    $8.24    $16.00
7/1/2008    $27.97   N   Referral Required   $16.50    $11.47
1/1/2011    $31.53   N   Referral Required   $18.54    $15.17
7/1/2008    $38.57   N   Referral Required   $26.23    $12.34
1/1/2011    $30.85   N   Referral Required   $13.24    $19.05
7/1/2008    $33.87   N   Referral Required   $16.60    $17.27
7/1/2008    $47.80   N   Referral Required   $12.43    $35.37
7/1/2008    $46.13   N   Referral Required   $17.07    $29.06
1/1/2011    $56.43   N   Referral Required
1/1/2011    $61.75   N   Referral Required   $38.01    $42.87
7/1/2008   $144.62   N   Referral Required   $82.43    $62.19
7/1/2008    $12.07   N   Referral Required
7/1/2008    $37.37   N   Referral Required
1/1/2011    $32.48   N   Referral Required
1/1/2011    $12.09   N   Referral Required
7/1/2008    $52.16   N   Referral Required
7/1/2008    $34.09   N   Referral Required
1/1/2011    $13.11   N   Referral Required
1/1/2011    $18.21   N   Referral Required
7/1/2008    $16.89   N   Referral Required
1/1/2011    $51.92   N   Referral Required   $29.07    $31.49
7/1/2008    $71.12   N   Referral Required   $48.36    $22.76
1/1/2011    $45.06   N   Referral Required   $46.12     $9.45
1/1/2011    $46.48   N   Referral Required   $29.93    $17.58
1/1/2011    $55.32   N   Referral Required   $62.59    $15.65
7/1/2008    $62.09   N   Referral Required   $32.91    $29.18
7/1/2008     $2.11   N   Referral Required
1/1/2011     $3.60   N   Referral Required
1/1/2011    $20.93   N   Referral Required
1/1/2011    $32.32   N   Referral Required   $17.41    $16.07
7/1/2008   $205.09   N   Referral Required   $98.44   $106.65
             $0.00   N   Referral Required
7/1/2008     $5.06   N   Referral Required
1/1/2011    $16.14   N   Referral Required
7/1/2008    $17.04   N   Referral Required
7/1/2008    $11.48   N   Referral Required
7/1/2008     $6.09   N   Referral Required
7/1/2008     $4.72   N   Referral Required     $4.72
7/1/2008     $9.48   N   Referral Required     $9.48
1/1/2011     $5.29   N   Referral Required
7/1/2008     $7.07   N   Referral Required
7/1/2008    $24.60   N   Referral Required
7/1/2008    $18.95   N   Referral Required    $18.95
7/1/2008    $15.66   N   Referral Required    $15.66
7/1/2008    $53.66   N   Referral Required    $53.66
7/1/2008    $67.40   N   Referral Required    $67.40
7/1/2008    $59.32   N   Referral Required
1/1/2011     $9.03   N   Referral Required
1/1/2011    $11.07   N   Referral Required
7/1/2008    $18.03   N   Referral Required
7/1/2008    $24.05   N   Referral Required
7/1/2008    $18.03   N   Referral Required
7/1/2008    $24.05   N   Referral Required
7/1/2008    $30.04   N   Referral Required
7/1/2008    $36.04   N   Referral Required
7/1/2008    $42.07   N   Referral Required
7/1/2008    $10.06   N   Referral Required
7/1/2008    $13.84   N   Referral Required
7/1/2008    $21.40   N   Referral Required
7/1/2008    $20.71   N   Referral Required
7/1/2008    $28.96   N   Referral Required
7/1/2008    $38.24   N   Referral Required
7/1/2008    $10.06   N   Referral Required
7/1/2008     $8.00   N   Referral Required
7/1/2008   $133.80   N   Referral Required
             $0.00   N   Referral Required
1/1/2011   $122.55   N   Referral Required
7/1/2008    $37.38   N   Referral Required
1/1/2011   $366.45   N   Referral Required   $333.70   $157.04
7/1/2008   $190.01   N   Referral Required   $102.61    $87.40
1/1/2011   $442.22   N   Referral Required   $284.51   $197.71
7/1/2008   $599.80   N   Referral Required   $317.89   $281.91
1/1/2011   $711.03   N   Referral Required   $391.15   $346.87
1/1/2011   $784.58   N   Referral Required   $421.92   $389.47
7/1/2008   $211.40   N   Referral Required    $99.36   $112.04
7/1/2008   $261.84   N   Referral Required   $102.12   $159.72
7/1/2008   $194.70   N   Referral Required    $95.40    $99.30
7/1/2008   $197.11   N   Referral Required    $88.70   $108.41
7/1/2008    $214.88    N   Referral Required   $111.74    $103.14
7/1/2008      $57.25   N   Referral Required    $17.75      $39.50
7/1/2008    $285.67    N   Referral Required   $151.41    $134.26
7/1/2008   $1,182.79   N   Referral Required    $23.66   $1,159.13
7/1/2008    $168.57    N   Referral Required
7/1/2009      $23.35   N   Referral Required
7/1/2009      $22.00   N   Referral Required
7/1/2009      $32.63   N   Referral Required
7/1/2009      $38.79   N   Referral Required
7/1/2009      $14.88   N   Referral Required
7/1/2009      $11.49   N   Referral Required
7/1/2009      $37.98   N   Referral Required
7/1/2009      $74.22   N   Referral Required    $13.36     $60.86
7/1/2009    $108.10    N   Referral Required    $22.70     $85.40
7/1/2009    $129.00    N   Referral Required    $28.38    $100.62
7/1/2009    $147.24    N   Referral Required    $47.12    $100.12
7/1/2008    $105.09    N   Referral Required    $27.32     $77.77
7/1/2008      $80.52   N   Referral Required    $20.13     $60.39
7/1/2009      $64.27   N   Referral Required    $20.57     $43.70
7/1/2009      $88.48   N   Referral Required    $17.70     $70.78
7/1/2009      $40.57   N   Referral Required     $9.33     $31.24
7/1/2009      $39.61   N   Referral Required     $9.11     $30.50
7/1/2009    $155.48    N   Referral Required    $34.21    $121.27
7/1/2009      $41.20   N   Referral Required     $9.89     $31.31
7/1/2009      $38.97   N   Referral Required     $9.35     $29.62
7/1/2009      $84.51   N   Referral Required    $17.75     $66.76
7/1/2009      $47.46   N   Referral Required    $12.81     $34.65
7/1/2009      $56.06   N   Referral Required    $11.77     $44.29
7/1/2009      $41.71   N   Referral Required    $10.01     $31.70
1/1/2010      $67.14   N                        $64.45      $2.69
1/1/2011    $143.78    N   Referral Required    $37.93    $107.94
7/1/2008      $92.96   N   Referral Required    $39.97     $52.99
7/1/2008      $91.73   N   Referral Required    $40.36     $51.37
7/1/2008      $94.68   N   Referral Required    $41.66     $53.02
7/1/2008    $173.14    N   Referral Required    $86.57     $86.57
7/1/2008    $182.07    N   Referral Required   $103.78     $78.29
7/1/2008      $96.94   N   Referral Required    $21.33     $75.61
7/1/2008      $59.13   N   Referral Required    $24.24     $34.89
7/1/2008      $40.43   N   Referral Required     $8.09     $32.34
7/1/2008      $37.68   N   Referral Required     $7.54     $30.14
7/1/2008      $50.44   N   Referral Required    $12.11     $38.33
7/1/2008    $214.42    N   Referral Required   $150.09     $64.33
1/1/2011   $1,580.35   N   Referral Required   $949.93    $660.12
7/1/2008    $381.26    N   Referral Required   $228.76    $152.50
7/1/2008    $236.23    N   Referral Required    $23.62    $212.61
7/1/2008    $126.51    N   Referral Required    $61.99     $64.52
7/1/2008    $662.92    N   Referral Required   $417.64    $245.28
7/1/2008   $217.10   N   Referral Required   $84.67   $132.43
7/1/2008   $328.26   N   Referral Required   $59.09   $269.17
7/1/2008   $211.17   N   Referral Required   $46.46   $164.71
7/1/2008   $202.87   N   Referral Required   $42.60   $160.27
7/1/2008   $427.77   N   Referral Required   $94.11   $333.66
7/1/2008   $215.68   N   Referral Required   $47.45   $168.23
7/1/2008   $188.98   N   Referral Required   $41.58   $147.40
7/1/2008    $46.17   N   Referral Required
7/1/2008    $50.09   N   Referral Required
7/1/2008    $95.08   N   Referral Required
7/1/2008    $52.05   N   Referral Required
7/1/2008   $160.66   N   Referral Required
7/1/2008    $89.03   N   Referral Required
7/1/2008   $189.65   N   Referral Required
7/1/2008    $85.55   N   Referral Required
5/1/2009    $40.03   N   Referral Required
1/1/2009    $25.23   N   Referral Required
1/1/2009    $38.19   N   Referral Required
7/1/2008    $54.79   N   Referral Required
7/1/2008    $81.12   N   Referral Required
             $0.00   N   Referral Required
             $0.00   N   Referral Required
7/1/2008    $81.03   N   Referral Required
7/1/2008    $97.07   N   Referral Required
7/1/2008    $18.98   N   Referral Required
7/1/2008    $16.78   N   Referral Required
7/1/2008   $103.06   N   Referral Required
7/1/2008    $62.45   N   Referral Required
7/1/2008    $43.89   N   Referral Required
7/1/2008    $27.36   N   Referral Required
7/1/2008    $62.29   N   Referral Required
1/1/2011     $6.65   N   Referral Required
7/1/2008   $123.26   N   Referral Required
1/1/2011    $89.22   N   Referral Required
1/1/2011    $98.00   N   Referral Required
1/1/2011    $64.56   N   Referral Required
7/1/2008    $59.63   N   Referral Required
1/1/2011    $21.98   N   Referral Required
7/1/2008    $21.49   N   Referral Required
1/1/2011    $20.19   N   Referral Required
7/1/2008     $4.76   N   Referral Required
7/1/2008    $20.35   N   Referral Required
7/1/2008    $23.86   N   Referral Required
1/1/2009    $49.87   N   Referral Required
1/1/2011    $14.32   N   Referral Required
1/1/2009    $60.86   N   Referral Required
1/1/2011    $19.61   N   Referral Required
1/1/2011    $30.50   N   Referral Required
1/1/2011    $18.23   N   Referral Required
1/1/2009   $132.32   N   Referral Required
1/1/2011    $14.17   N   Referral Required
1/1/2009    $63.89   N   Referral Required
1/1/2009    $19.07   N   Referral Required
1/1/2009    $16.40   N   Referral Required
1/1/2009    $48.36   N   Referral Required
1/1/2011    $20.80   N   Referral Required
             $0.00   N   Referral Required
7/1/2008    $59.15   N   Referral Required
1/1/2011    $33.22   N   Referral Required
1/1/2011    $77.95   N   Referral Required
7/1/2008   $141.80   N   Referral Required
1/1/2011   $100.87   N   Referral Required
1/1/2011    $56.89   N   Referral Required
1/1/2011   $131.88   N   Referral Required
1/1/2011    $28.80   N   Referral Required
1/1/2011   $144.17   N   Referral Required
1/1/2011    $65.41   N   Referral Required
7/1/2008   $100.93   N   Referral Required
7/1/2008   $167.59   N   Referral Required
7/1/2008    $72.94   N   Referral Required
7/1/2008   $164.50   N   Referral Required
7/1/2008   $320.38   N   Referral Required
7/1/2008   $310.13   N   Referral Required
1/1/2011   $188.64   N   Referral Required
1/1/2011   $116.10   N   Referral Required
7/1/2008   $101.37   N   Referral Required
1/1/2011    $22.71   N   Referral Required
7/1/2008   $161.29   N   Referral Required
             $0.00   N   Referral Required
7/1/2008    $98.73   N   Referral Required
7/1/2008    $53.27   N   Referral Required
7/1/2008    $25.95   N   Referral Required
7/1/2008    $17.57   N   Referral Required
7/1/2008     $9.71   N   Referral Required
7/1/2008    $52.33   N   Referral Required
7/1/2008    $66.96   N   Referral Required
7/1/2008    $90.28   N   Referral Required
7/1/2008   $145.17   N   Referral Required
7/1/2008   $143.06   N   Referral Required
7/1/2008   $212.88   N   Referral Required
             $0.00   N   Referral Required
7/1/2009    $66.24   N   Referral Required
7/1/2009    $35.41   N   Referral Required
7/1/2009    $69.94   N   Referral Required
7/1/2009   $40.19   N   Referral Required
7/1/2009   $13.67   N   Referral Required
7/1/2009   $14.01   N   Referral Required
7/1/2009    $7.14   N   Referral Required
7/1/2009   $15.88   N   Referral Required
7/1/2009    $4.91   N   Referral Required
7/1/2009    $4.59   N   Referral Required
7/1/2009    $5.63   N   Referral Required
7/1/2009   $15.26   N   Referral Required
7/1/2009   $22.31   N   Referral Required
7/1/2009   $13.82   N   Referral Required
7/1/2009   $10.96   N   Referral Required
7/1/2009   $23.35   N   Referral Required
6/1/2008   $10.12   Y   Referral Required
7/1/2009   $26.50   N   Referral Required
7/1/2009   $27.25   N   Referral Required
7/1/2009   $31.99   N   Referral Required
7/1/2009   $23.22   N   Referral Required
6/1/2008   $15.32   Y   Referral Required
7/1/2009   $24.62   N   Referral Required
7/1/2009   $27.85   N   Referral Required
7/1/2009   $27.89   N   Referral Required
7/1/2009   $25.34   N   Referral Required
7/1/2009   $25.66   N   Referral Required
7/1/2009   $53.43   N   Referral Required
7/1/2009   $66.46   N   Referral Required
            $0.00   N   Referral Required
7/1/2009   $32.65   N   Referral Required
7/1/2009   $34.97   N   Referral Required
7/1/2009   $27.13   N   Referral Required
7/1/2009   $29.88   N   Referral Required
7/1/2009   $26.81   N   Referral Required
7/1/2009   $30.11   N   Referral Required
            $0.00   Y   Referral Required
7/1/2008   $48.82   N   Referral Required
7/1/2008   $26.39   N   Referral Required
7/1/2008   $36.35   N   Referral Required
7/1/2008   $47.29   N   Referral Required
7/1/2008   $55.38   N   Referral Required
7/1/2008   $63.48   N   Referral Required
7/1/2008   $23.45   N   Referral Required
7/1/2008   $32.53   N   Referral Required
7/1/2008   $42.63   N   Referral Required
7/1/2008    $8.09   N
7/1/2008   $13.59   N   Referral Required
7/1/2008    $6.33   N   Referral Required
7/1/2008   $10.93   N   Referral Required
             $0.00   N   Referral Required
1/1/2011    $22.86   N   Referral Required
1/1/2011    $18.79   N   Referral Required
1/1/2011     $9.15   N   Referral Required
1/1/2011    $29.84   N   Referral Required
1/1/2011    $29.84   N   Referral Required
1/1/2011    $14.92   N   Referral Required
7/1/2008   $123.84   N   Referral Required
             $0.00   N   Referral Required
7/1/2008    $26.32   N   Referral Required
7/1/2008    $31.86   N   Referral Required
7/1/2008   $184.30   N   Referral Required
7/1/2008    $97.15   N   Referral Required
7/1/2008    $72.84   N   Referral Required
7/1/2008    $48.58   N   Referral Required
7/1/2008    $51.94   N   Referral Required
7/1/2008    $34.15   N   Referral Required
7/1/2008    $59.02   N   Referral Required
7/1/2008    $86.54   N   Referral Required
7/1/2008   $133.19   N   Referral Required
7/1/2008   $167.67   N   Referral Required
1/1/2011    $18.25   N   Referral Required
7/1/2008    $35.18   N   Referral Required
7/1/2008    $57.45   N   Referral Required
7/1/2008    $86.45   N   Referral Required
7/1/2008   $117.01   N   Referral Required
7/1/2008    $63.04   N   Referral Required
7/1/2008    $59.60   N   Referral Required
7/1/2008    $98.05   N   Referral Required
7/1/2008   $137.88   N   Referral Required
7/1/2008    $83.68   N   Referral Required
7/1/2008   $114.97   N   Referral Required
7/1/2008   $169.27   N   Referral Required
7/1/2008    $34.77   N   Referral Required
7/1/2008    $62.39   N   Referral Required
7/1/2008    $89.47   N   Referral Required
7/1/2008   $119.34   N   Referral Required
7/1/2008   $157.60   N   Referral Required
7/1/2008   $196.20   N   Referral Required
7/1/2008    $63.18   N   Referral Required
7/1/2008    $90.94   N   Referral Required
7/1/2008    $45.29   N   Referral Required
7/1/2008    $84.68   N   Referral Required
7/1/2008   $116.47   N   Referral Required
7/1/2008   $172.09   N   Referral Required
7/1/2008   $212.37   N   Referral Required
7/1/2008    $44.78   N   Referral Required
7/1/2008    $70.73   N   Referral Required
7/1/2008   $106.05   N   Referral Required
7/1/2008   $153.43   N   Referral Required
7/1/2008   $188.70   N   Referral Required
7/1/2008    $19.18   N   Referral Required
7/1/2008    $36.14   N   Referral Required
7/1/2008    $57.68   N   Referral Required
7/1/2008   $107.16   N   Referral Required
7/1/2008   $159.64   N   Referral Required
7/1/2008    $57.59   N   Referral Required
7/1/2008   $242.64   N   Referral Required
7/1/2008   $109.05   N   Referral Required
7/1/2008    $74.90   N   Referral Required
7/1/2008   $104.38   N   Referral Required
7/1/2008   $133.86   N   Referral Required
7/1/2008    $36.84   N   Referral Required
7/1/2008    $56.61   N   Referral Required
7/1/2008    $75.49   N   Referral Required
7/1/2008   $110.95   N   Referral Required
7/1/2008    $54.99   N   Referral Required
7/1/2008    $71.86   N   Referral Required
7/1/2008    $78.43   N   Referral Required
7/1/2008    $51.71   N   Referral Required
7/1/2008    $75.25   N   Referral Required
7/1/2008   $122.87   N   Referral Required
7/1/2008   $159.66   N   Referral Required
7/1/2008   $188.70   N   Referral Required
7/1/2008    $52.10   N   Referral Required
7/1/2008    $80.35   N   Referral Required
7/1/2008   $114.04   N   Referral Required
7/1/2008   $163.58   N   Referral Required
             $0.00   N   Referral Required
7/1/2008    $51.36   N   Referral Required
7/1/2008    $75.25   N   Referral Required
7/1/2008   $119.69   N   Referral Required
7/1/2008   $156.91   N   Referral Required
7/1/2008   $188.70   N   Referral Required
7/1/2008    $49.40   N   Referral Required
7/1/2008    $74.51   N   Referral Required
7/1/2008   $108.99   N   Referral Required
7/1/2008   $152.70   N   Referral Required
7/1/2008    $87.17   N   Referral Required
7/1/2008    $85.94   N   Referral Required
7/1/2008    $79.86   N   Referral Required
7/1/2008    $80.05   N   Referral Required
7/1/2008    $38.88   N   Referral Required
7/1/2008   $108.25   N   Referral Required
7/1/2008   $121.50   N   Referral Required
7/1/2008   $120.72   N   Referral Required
7/1/2008   $134.65   N   Referral Required
7/1/2008   $134.65   N   Referral Required
7/1/2008   $134.65   N   Referral Required
7/1/2008   $134.65   N   Referral Required
7/1/2008    $89.46   N   Referral Required
7/1/2008   $102.99   N   Referral Required
7/1/2008   $102.60   N   Referral Required
7/1/2008   $116.24   N   Referral Required
7/1/2008   $116.63   N   Referral Required
7/1/2008   $116.63   N   Referral Required
7/1/2008   $116.63   N   Referral Required
7/1/2008    $41.90   N   Referral Required
7/1/2008    $70.86   N   Referral Required
7/1/2008    $97.94   N   Referral Required
7/1/2008   $126.13   N   Referral Required
1/1/2009    $30.01   N   Referral Required
1/1/2009    $58.62   N   Referral Required
             $0.00   N   Referral Required
7/1/2008    $47.50   N   Referral Required
1/1/2009    $54.01   N   Referral Required
1/1/2009    $78.99   N   Referral Required
1/1/2009    $28.81   N   Referral Required
1/1/2009    $72.16   N   Referral Required
1/1/2009    $68.02   N   Referral Required
1/1/2009   $138.93   N   Referral Required
1/1/2009   $222.07   N   Referral Required
1/1/2009   $110.90   N   Referral Required
1/1/2009   $832.58   N   Referral Required
1/1/2009   $364.86   N   Referral Required
1/1/2009   $740.75   N   Referral Required
1/1/2009   $367.42   N   Referral Required
1/1/2009   $511.43   N   Referral Required
1/1/2009   $305.07   N   Referral Required
1/1/2008   $306.77   N   Referral Required
1/1/2009   $131.51   N   Referral Required
1/1/2009   $115.93   N   Referral Required
1/1/2009   $111.49   N   Referral Required
             $0.00   N   Referral Required
             $0.00   N   Referral Required
             $0.00   N   Referral Required
             $0.00   Y
             $0.00   Y
             $0.00   N
             $0.00   Y
             $0.00   N
             $0.00   Y
1/1/2008     $7.00   Y
             $0.00   Y
1/1/2008     $7.00   Y
1/1/2008   $146.47   Y
1/1/2008     $1.47   Y
1/1/2008     $1.47   Y
1/1/2008     $5.97   N
1/1/2008     $6.81   N
             $0.00   N
1/1/2008     $4.42   Y
1/1/2008    $17.81   Y
1/1/2008   $145.21   Y
1/1/2008     $4.24   Y
1/1/2008   $102.50   Y
1/1/2008   $162.30   Y
1/1/2008    $85.42   Y
1/1/2008   $136.67   Y
1/1/2008   $773.33   Y
1/1/2008   $899.11   Y
1/1/2008   $234.91   Y
1/1/2008   $397.21   Y
1/1/2008     $6.57   Y
1/1/2008    $17.51   Y
             $0.00   Y
             $0.00   Y
1/1/2008     $0.21   N   Referral Required
1/1/2008     $0.14   N   Referral Required
1/1/2008     $0.14   N   Referral Required
1/1/2008     $0.28   N   Referral Required
1/1/2008    $38.40   N   Referral Required
1/1/2008    $12.50   N   Referral Required
1/1/2008     $0.60   N   Referral Required
1/1/2008     $0.25   N   Referral Required
1/1/2008     $0.45   N   Referral Required
1/1/2008     $3.13   N   Referral Required
             $0.00   N   Referral Required
             $0.00   N   Referral Required
1/1/2008    $21.23   N   Referral Required
1/1/2008    $42.13   N   Referral Required
1/1/2008    $42.13   N   Referral Required
1/1/2008     $2.49   N   Referral Required
1/1/2008     $6.28   N   Referral Required
1/1/2008     $6.28   N   Referral Required
1/1/2008     $6.28   N   Referral Required
1/1/2008     $1.68   N   Referral Required
1/1/2008     $0.86   N   Referral Required
 1/1/2008    $1.65   N   Referral Required
 1/1/2008   $10.91   N   Referral Required
 1/1/2008   $10.98   N   Referral Required
 1/1/2008    $1.73   N   Referral Required
 1/1/2008   $33.00   N   Referral Required
 1/1/2008   $34.70   N   Referral Required
 1/1/2008    $3.92   N   Referral Required
 1/1/2008   $10.92   N   Referral Required
 1/1/2008   $12.69   Y   Referral Required
 1/1/2008   $16.93   N   Referral Required
 1/1/2008   $10.38   N   Referral Required
             $0.00   N
             $0.00   N   Referral Required
 1/1/2008   $31.59   N   Referral Required
             $0.00   N   Referral Required
 1/1/2008   $25.07   N
 1/1/2008    $4.57   N   Referral Required
 1/1/2008    $7.50   Y   Referral Required
 1/1/2008    $1.12   Y   Referral Required
 1/1/2008   $17.25   Y   Referral Required
 1/1/2008    $3.50   Y   Referral Required
             $0.00   Y   Referral Required
             $0.00   N   Referral Required
             $0.00   N   Referral Required
             $0.00   N   Referral Required
 1/1/2008    $8.80   N   Referral Required
 1/1/2008    $8.80   N   Referral Required
12/1/2008    $5.01   N   Referral Required
 1/1/2008   $12.04   N   Referral Required
12/1/2008   $12.79   N   Referral Required
12/1/2008   $12.79   N   Referral Required
12/1/2008   $17.05   N   Referral Required
 1/1/2008   $21.39   N   Referral Required
12/1/2008   $18.42   N   Referral Required
12/1/2008    $4.83   N   Referral Required
 1/1/2008    $2.53   N   Referral Required
12/1/2008    $8.23   N   Referral Required
12/1/2008   $34.05   N   Referral Required
12/1/2008    $8.13   N   Referral Required
 1/1/2008    $3.04   N   Referral Required
12/1/2008    $0.10   N   Referral Required
 1/1/2008    $2.10   N   Referral Required
12/1/2008    $4.19   N   Referral Required
             $0.00   Y   Referral Required
             $0.00   N   Referral Required
12/1/2008    $9.36   N   Referral Required
12/1/2008   $24.22   N   Referral Required
12/1/2008   $11.58   N   Referral Required
 1/1/2008   $15.89   N   Referral Required
12/1/2008    $1.72   N   Referral Required
12/1/2008    $1.31   N   Referral Required
12/1/2008    $4.90   N   Referral Required
 1/1/2008    $6.67   N   Referral Required
12/1/2008    $8.46   N   Referral Required
12/1/2008    $6.43   N   Referral Required
12/1/2008   $29.59   N   Referral Required
12/1/2008    $6.54   N   Referral Required
12/1/2008    $4.30   N   Referral Required
 1/1/2008   $17.52   N   Referral Required
 1/1/2008    $3.30   N   Referral Required
 1/1/2008    $2.36   N   Referral Required
 1/1/2008    $2.80   N   Referral Required
 1/1/2008    $2.81   N   Referral Required
 1/1/2008    $6.58   N   Referral Required
 1/1/2008    $0.25   N   Referral Required
 1/1/2008    $1.96   N   Referral Required
 1/1/2008    $3.22   N   Referral Required
 1/1/2008    $3.43   N   Referral Required
 1/1/2008    $3.98   N   Referral Required
 1/1/2008    $5.99   N   Referral Required
 1/1/2008    $8.05   N   Referral Required
 1/1/2008   $16.38   N   Referral Required
 1/1/2008   $45.38   N   Referral Required
 1/1/2008    $4.09   N   Referral Required
 1/1/2008   $29.33   N   Referral Required
 1/1/2008   $14.33   N   Referral Required
 1/1/2008   $35.60   N   Referral Required
 1/1/2008    $4.40   N   Referral Required
 1/1/2008   $23.48   N   Referral Required
 1/1/2008   $26.89   N   Referral Required
 1/1/2008    $9.18   N   Referral Required
 1/1/2008    $4.86   N   Referral Required
 1/1/2008    $6.41   N   Referral Required
 1/1/2008    $3.83   N   Referral Required
 1/1/2008    $4.16   N   Referral Required
 1/1/2008    $5.93   N   Referral Required
 1/1/2008    $9.17   N   Referral Required
 1/1/2008    $6.74   N   Referral Required
 1/1/2008    $6.34   N   Referral Required
 1/1/2008    $8.75   N   Referral Required
 1/1/2008    $2.46   N   Referral Required
 1/1/2008    $0.05   N   Referral Required
 1/1/2008   $38.61   N   Referral Required
 1/1/2008    $4.57   N   Referral Required
1/1/2008    $13.17   N   Referral Required
1/1/2008     $9.95   N   Referral Required
1/1/2008     $1.32   N   Referral Required
1/1/2008     $1.61   N   Referral Required
1/1/2008     $3.36   N   Referral Required
1/1/2008     $5.68   N   Referral Required
1/1/2008     $8.91   N   Referral Required
1/1/2008     $6.13   N   Referral Required
1/1/2008     $6.15   N   Referral Required
1/1/2008     $8.94   N   Referral Required
1/1/2008     $5.10   N   Referral Required
1/1/2008     $2.70   N   Referral Required
1/1/2008     $5.44   N   Referral Required
1/1/2008     $4.89   N   Referral Required
1/1/2008     $5.93   N   Referral Required
1/1/2008     $2.81   N   Referral Required
1/1/2008     $3.80   N   Referral Required
1/1/2008     $1.85   N   Referral Required
1/1/2008     $1.78   N   Referral Required
1/1/2008     $4.16   N   Referral Required
             $0.00   N   Referral Required
1/1/2008     $0.12   N   Referral Required
1/1/2008     $4.16   N   Referral Required
1/1/2008     $4.85   N   Referral Required
1/1/2008     $3.66   N   Referral Required
1/1/2008     $2.41   N   Referral Required
1/1/2008     $3.66   N   Referral Required
1/1/2008     $6.65   N   Referral Required
1/1/2008     $8.42   N   Referral Required
1/1/2008     $8.70   N   Referral Required
1/1/2008     $6.35   N   Referral Required
1/1/2008     $3.67   N   Referral Required
1/1/2008     $3.41   N   Referral Required
1/1/2008     $3.84   N   Referral Required
1/1/2008     $0.09   N   Referral Required
1/1/2008     $0.36   N   Referral Required
1/1/2008     $2.12   N   Referral Required
1/1/2008     $1.36   N   Referral Required
1/1/2010     $0.26   N   Referral Required
1/1/2008     $9.00   N   Referral Required
1/1/2008     $1.14   N   Referral Required
4/1/2009     $3.45   N   Referral Required
4/1/2009    $13.98   N   Referral Required
             $0.00   N   Referral Required
             $0.00   Y   Referral Required
1/1/2008    $24.41   N   Referral Required
1/1/2008   $112.50   N   Referral Required
1/1/2008     $0.37   N   Referral Required
1/1/2008     $8.18   N   Referral Required
1/1/2008     $8.27   N   Referral Required
1/1/2008    $12.80   N   Referral Required
1/1/2008     $8.27   N   Referral Required
1/1/2008    $13.80   N   Referral Required
1/1/2008    $16.98   N   Referral Required
1/1/2008     $0.56   N   Referral Required
1/1/2008     $9.84   N   Referral Required
1/1/2008    $20.13   N   Referral Required
1/1/2008     $5.20   N   Referral Required
4/1/2009     $0.11   N   Referral Required
1/1/2008    $17.78   N   Referral Required
1/1/2008    $44.25   N   Referral Required
1/1/2008     $9.73   N   Referral Required
             $0.00   N   Referral Required
1/1/2008    $14.91   N   Referral Required
1/1/2008    $36.30   N   Referral Required
1/1/2008    $27.04   N   Referral Required
1/1/2008    $66.81   N   Referral Required
1/1/2008    $14.30   N   Referral Required
1/1/2008   $190.00   Y   Referral Required
1/1/2008    $58.32   N   Referral Required
1/1/2008   $159.27   N   Referral Required
1/1/2008    $76.24   N   Referral Required
1/1/2008   $137.55   N   Referral Required
1/1/2008    $27.00   N   Referral Required
1/1/2008     $2.59   N   Referral Required
1/1/2008     $0.18   N   Referral Required
1/1/2008     $0.95   N   Referral Required
1/1/2008     $7.21   N   Referral Required
1/1/2008     $1.21   N   Referral Required
1/1/2008     $2.75   N   Referral Required
1/1/2008     $5.31   N   Referral Required
1/1/2008     $2.51   N   Referral Required
1/1/2008     $5.62   N   Referral Required
1/1/2008     $2.59   N   Referral Required
1/1/2008     $3.48   N   Referral Required
1/1/2008     $4.40   N   Referral Required
1/1/2008     $5.96   N   Referral Required
1/1/2008    $41.04   Y   Referral Required
             $0.00   Y   Referral Required
1/1/2008     $4.15   N   Referral Required
1/1/2008     $4.01   N   Referral Required
1/1/2008     $1.73   N   Referral Required
             $0.00   Y   Referral Required
1/1/2008    $51.34   N   Referral Required
             $0.00   N
             $0.00   N
             $0.00   N
1/1/2008     $2.07   N
1/1/2008     $1.65   N
             $0.00   N
1/1/2008     $0.48   N
             $0.00   N
             $0.00   N
1/1/2008    $56.28   N
             $0.00   Y
1/1/2008     $3.05   N
1/1/2008     $2.96   N
             $0.00   N
1/1/2008   $110.25   N
1/1/2008   $103.92   N
1/1/2008    $11.99   N
1/1/2008     $4.27   N
             $0.00   N
1/1/2008     $9.23   N
             $0.00   N
1/1/2008     $7.12   N
1/1/2008    $14.73   N
1/1/2008    $20.38   N
1/1/2008    $18.79   N
1/1/2008    $28.19   N
1/1/2008    $28.45   N
1/1/2008    $27.90   N
1/1/2008    $33.48   N
             $0.00   N
1/1/2008     $1.37   N
             $0.00   N
             $0.00   N
             $0.00   N
1/1/2008     $7.35   N
1/1/2008     $9.37   N
             $0.00   N
1/1/2008     $4.49   N
             $0.00   N
1/1/2008    $22.06   N
1/1/2008    $71.70   N
1/1/2008    $57.44   N
1/1/2008    $26.68   N
             $0.00   N
1/1/2008     $0.42   N   Referral Required
1/1/2008     $5.64   N
1/1/2008    $30.61   N
             $0.00   N
             $0.00   N
1/1/2008    $12.53   N
             $0.00   N
             $0.00   N
1/1/2008     $6.65   N
1/1/2008     $7.64   N
1/1/2008     $0.20   N
             $0.00   N
1/1/2008     $2.00   N   Referral Required
1/1/2008     $1.59   N   Referral Required
1/1/2008     $1.66   N   Referral Required
1/1/2008     $1.61   N   Referral Required
1/1/2008     $1.32   N   Referral Required
1/1/2008     $2.45   N   Referral Required
1/1/2008     $2.00   N   Referral Required
1/1/2008     $2.07   N   Referral Required
1/1/2008     $4.07   N   Referral Required
1/1/2008     $2.86   N   Referral Required
1/1/2008     $2.77   N   Referral Required
1/1/2008     $2.67   N   Referral Required
1/1/2008     $9.68   N   Referral Required
4/1/2009     $0.66   N   Referral Required
1/1/2008     $1.60   N   Referral Required
1/1/2008    $21.39   N   Referral Required
1/1/2008    $38.88   N   Referral Required
1/1/2008    $33.02   N   Referral Required
1/1/2008     $3.81   N   Referral Required
1/1/2008     $7.24   N   Referral Required
1/1/2008     $0.25   N   Referral Required
1/1/2008     $6.05   N   Referral Required
1/1/2008    $10.42   N   Referral Required
1/1/2008     $4.60   N   Referral Required
1/1/2008     $1.07   N   Referral Required
1/1/2008    $12.86   N   Referral Required
1/1/2008    $92.50   N   Referral Required
1/1/2008   $210.00   N   Referral Required
1/1/2008    $93.00   N   Referral Required
1/1/2008    $46.00   N   Referral Required
1/1/2008    $41.00   N   Referral Required
1/1/2008    $30.00   N   Referral Required
4/1/2009    $29.69   N   Referral Required
             $0.00   N   Referral Required
             $0.00   N   Referral Required
1/1/2008    $24.22   N   Referral Required
1/1/2008    $36.14   N   Referral Required
1/1/2008    $30.62   N   Referral Required
1/1/2008     $2.28   N   Referral Required
1/1/2008    $21.04   N   Referral Required
1/1/2008    $20.50   N   Referral Required
1/1/2008   $181.05   N   Referral Required
1/1/2008     $5.90   N   Referral Required
             $0.00   N   Referral Required
1/1/2008    $13.69   N   Referral Required
1/1/2008     $7.01   N   Referral Required
1/1/2008    $15.68   N   Referral Required
1/1/2008   $112.50   N   Referral Required
1/1/2008     $5.04   N   Referral Required
1/1/2008     $3.19   N   Referral Required
1/1/2008     $5.94   N   Referral Required
1/1/2008     $4.57   N   Referral Required
1/1/2008     $0.97   N   Referral Required
1/1/2008     $7.00   N   Referral Required
1/1/2008     $3.42   N   Referral Required
1/1/2008     $7.14   N   Referral Required
1/1/2008    $19.00   N   Referral Required
1/1/2008    $28.01   N   Referral Required
1/1/2008     $9.25   N   Referral Required
1/1/2008    $14.63   N   Referral Required
1/1/2008     $9.82   N   Referral Required
1/1/2008     $2.33   N   Referral Required
1/1/2008     $0.05   N   Referral Required
1/1/2008     $0.40   N   Referral Required
1/1/2008     $0.58   N   Referral Required
1/1/2008     $0.91   N   Referral Required
1/1/2008     $2.46   N   Referral Required
1/1/2008     $1.09   N   Referral Required
1/1/2008     $2.03   N   Referral Required
1/1/2008     $2.30   N   Referral Required
1/1/2008     $3.44   N   Referral Required
1/1/2008     $1.31   N   Referral Required
1/1/2008     $3.44   N   Referral Required
1/1/2008     $1.46   N   Referral Required
1/1/2008     $4.68   N   Referral Required
1/1/2008     $6.88   N   Referral Required
1/1/2008    $19.19   N   Referral Required
1/1/2008     $6.24   N   Referral Required
1/1/2008    $16.05   N   Referral Required
1/1/2008    $25.99   N   Referral Required
1/1/2008     $7.54   N   Referral Required
1/1/2008    $21.74   N   Referral Required
1/1/2008    $18.24   N   Referral Required
1/1/2008    $11.68   N   Referral Required
1/1/2008     $2.45   N   Referral Required
1/1/2008    $5.79   N   Referral Required
1/1/2008   $11.75   N   Referral Required
1/1/2008   $37.46   N   Referral Required
1/1/2008    $6.93   N   Referral Required
1/1/2008    $9.46   N   Referral Required
1/1/2008   $22.68   N   Referral Required
1/1/2008   $15.49   N   Referral Required
            $0.00   N   Referral Required
1/1/2008    $1.90   N   Referral Required
1/1/2008    $3.10   N   Referral Required
1/1/2008    $6.05   N   Referral Required
1/1/2008    $1.16   N   Referral Required
1/1/2008    $2.89   N   Referral Required
1/1/2008    $4.45   N   Referral Required
1/1/2008    $1.46   N   Referral Required
1/1/2008    $4.10   N   Referral Required
1/1/2008   $10.43   N   Referral Required
            $0.00   N   Referral Required
1/1/2008    $2.58   N   Referral Required
1/1/2008    $0.99   N   Referral Required
1/1/2008    $0.28   N   Referral Required
1/1/2008    $0.46   N   Referral Required
1/1/2008    $0.12   N   Referral Required
1/1/2008    $1.83   N   Referral Required
1/1/2008    $0.12   N   Referral Required
1/1/2008    $0.41   N   Referral Required
1/1/2008    $0.58   N   Referral Required
1/1/2008    $0.32   N   Referral Required
1/1/2008    $0.76   N   Referral Required
1/1/2008    $1.88   N   Referral Required
1/1/2008    $0.39   N   Referral Required
            $0.00   N   Referral Required
            $0.00   N   Referral Required
1/1/2008    $0.67   N   Referral Required
1/1/2008    $0.17   N   Referral Required
1/1/2008    $0.29   N   Referral Required
1/1/2008    $0.56   N   Referral Required
1/1/2008    $0.32   N   Referral Required
1/1/2008    $0.41   N   Referral Required
1/1/2008    $0.67   N   Referral Required
1/1/2008    $1.16   N   Referral Required
1/1/2008    $1.75   N   Referral Required
            $0.00   N   Referral Required
            $0.00   N   Referral Required
1/1/2008    $5.91   N   Referral Required
1/1/2008    $0.61   N   Referral Required
1/1/2008    $0.77   N   Referral Required
1/1/2008     $1.39   N   Referral Required
1/1/2008     $1.28   N   Referral Required
1/1/2008     $1.14   N   Referral Required
             $0.00   N   Referral Required
             $0.00   N   Referral Required
             $0.00   N   Referral Required
             $0.00   N   Referral Required
             $0.00   N   Referral Required
             $0.00   N   Referral Required
             $0.00   N   Referral Required
             $0.00   N   Referral Required
             $0.00   N   Referral Required
             $0.00   N   Referral Required
             $0.00   N   Referral Required
             $0.00   Y   Referral Required
             $0.00   N   Referral Required
1/1/2008     $5.97   N   Referral Required
1/1/2010    $45.43   N   Referral Required
1/1/2010    $64.01   N   Referral Required
1/1/2008    $34.87   N   Referral Required
1/1/2008    $42.66   N   Referral Required
1/1/2008    $48.75   N   Referral Required
1/1/2008    $72.37   N   Referral Required
1/1/2008   $117.00   N   Referral Required
1/1/2008   $136.00   N   Referral Required
1/1/2008    $35.90   N   Referral Required
1/1/2008    $63.80   N   Referral Required
1/1/2008   $136.00   N   Referral Required
1/1/2008    $25.00   N   Referral Required
             $0.00   N   Referral Required
             $0.00   N   Referral Required
1/1/2008    $26.23   N   Referral Required
1/1/2008     $9.10   N   Referral Required
1/1/2008    $31.55   N   Referral Required
1/1/2008     $3.65   N   Referral Required
1/1/2008     $2.61   N   Referral Required
1/1/2008     $1.72   N   Referral Required
1/1/2008    $29.40   N   Referral Required
1/1/2008     $9.10   N   Referral Required
1/1/2008     $4.40   N   Referral Required
1/1/2008    $10.49   N   Referral Required
1/1/2008    $40.10   N   Referral Required
1/1/2008    $22.50   N   Referral Required
             $0.00   N   Referral Required
1/1/2008     $3.61   N   Referral Required
1/1/2008     $0.79   N   Referral Required
1/1/2008     $4.28   N   Referral Required
1/1/2008     $1.79   N   Referral Required
1/1/2008     $6.91   N   Referral Required
1/1/2008   $127.85   N   Referral Required
1/1/2008     $0.37   N   Referral Required
1/1/2008   $434.94   Y   Referral Required
1/1/2008    $28.75   Y   Referral Required
1/1/2008   $179.35   N   Referral Required
1/1/2008    $49.54   N   Referral Required
1/1/2008    $20.24   N   Referral Required
1/1/2008   $188.64   N   Referral Required
1/1/2008    $69.77   N   Referral Required
1/1/2008    $40.53   N   Referral Required
1/1/2008    $23.49   N   Referral Required
1/1/2008    $76.66   N   Referral Required
1/1/2008    $37.92   N   Referral Required
1/1/2008    $17.36   N   Referral Required
1/1/2008    $39.12   N   Referral Required
1/1/2008     $5.39   N   Referral Required
1/1/2008    $14.62   N   Referral Required
4/1/2009    $41.45   N   Referral Required
4/1/2009    $77.90   N   Referral Required
4/1/2009   $188.23   N   Referral Required
4/1/2009    $29.52   N   Referral Required
1/1/2008   $120.91   N   Referral Required
1/1/2008    $19.47   N   Referral Required
1/1/2008    $19.51   N   Referral Required
1/1/2008   $100.18   N   Referral Required
1/1/2008    $10.81   N   Referral Required
1/1/2008    $10.81   N   Referral Required
1/1/2008     $0.64   N   Referral Required
1/1/2008     $4.46   N   Referral Required
1/1/2008     $0.32   N   Referral Required
1/1/2008     $2.37   N   Referral Required
1/1/2008     $2.74   N   Referral Required
1/1/2008     $1.34   N   Referral Required
1/1/2008    $50.67   N   Referral Required
1/1/2008    $47.05   N   Referral Required
1/1/2008    $45.16   N   Referral Required
1/1/2008     $1.39   N   Referral Required
1/1/2008     $3.37   N   Referral Required
1/1/2008     $3.58   N   Referral Required
4/1/2009   $161.02   N   Referral Required
4/1/2009   $161.02   N   Referral Required
             $0.00   N   Referral Required
             $0.00   N   Referral Required
             $0.00   N   Referral Required
             $0.00   N   Referral Required
             $0.00   Y
             $0.00   Y
1/1/2008     $4.65   N
             $0.00   N   Referral Required
             $0.00   N   Referral Required
1/1/2008    $64.28   N
1/1/2008    $58.06   N
1/1/2008    $50.65   N
             $0.00   N
1/1/2008    $19.89   N
1/1/2008   $687.71   N
1/1/2008   $165.82   N
             $0.00   N
             $0.00   N
             $0.00   N
1/1/2008     $5.48   N
1/1/2008   $210.65   N
1/1/2008     $0.36   N
1/1/2008   $143.89   N
             $0.00   N
1/1/2008     $5.48   N
1/1/2008     $6.49   N
1/1/2008     $6.49   N
             $0.00   N
             $0.00   N
             $0.00   N
             $0.00   N
             $0.00   N
             $0.00   N
             $0.00   N
             $0.00   N
             $0.00   N
             $0.00   N
             $0.00   N
             $0.00   N
             $0.00   N
             $0.00   N
             $0.00   N
             $0.00   N
             $0.00   N
             $0.00   N
             $0.00   N
             $0.00   N
             $0.00   N
             $0.00   N
             $0.00   N
             $0.00   N
             $0.00   N
             $0.00   N
             $0.00   N
             $0.00   N
             $0.00   N
             $0.00   N
             $0.00   N
             $0.00   N
             $0.00   N
             $0.00   N
             $0.00   N
             $0.00   N
             $0.00   N
1/1/2008     $2.46   N
1/1/2008     $2.85   N
1/1/2008     $2.67   N
1/1/2008     $2.54   N
             $0.00   N
1/1/2010    $13.50   N
             $0.00   N
             $0.00   N
1/1/2008   $402.85   N
             $0.00   N
             $0.00   N
             $0.00   N
1/1/2008   $118.60   N
             $0.00   Y   Referral Required
             $0.00   N   Referral Required
             $0.00   N   Referral Required
             $0.00   N   Referral Required
             $0.00   N   Referral Required
             $0.00   Y   Referral Required
1/1/2008     $5.93   N   Referral Required
1/1/2008    $11.30   N   Referral Required
1/1/2008     $7.74   N   Referral Required
1/1/2008    $20.00   N   Referral Required
1/1/2008    $15.59   N   Referral Required
1/1/2008     $2.38   N   Referral Required
1/1/2008    $38.22   N   Referral Required
1/1/2008    $38.22   N   Referral Required
1/1/2008     $0.55   N   Referral Required
1/1/2008     $2.45   N   Referral Required
             $0.00   N   Referral Required
1/1/2008     $1.57   N   Referral Required
1/1/2008     $0.61   N   Referral Required
1/1/2008     $0.51   N   Referral Required
1/1/2009     $1.85   N   Referral Required
1/1/2008       $1.12   N   Referral Required
1/1/2009       $0.92   N   Referral Required
               $0.00   N   Referral Required
1/1/2008       $0.61   N   Referral Required
               $0.00   N   Referral Required
4/1/2010       $0.70   N   Referral Required
4/1/2010       $1.93   N   Referral Required
               $0.00   N   Referral Required
1/1/2008      $15.96   N   Referral Required
1/1/2008      $21.96   N   Referral Required
1/1/2008      $47.78   N   Referral Required
1/1/2008      $37.43   N   Referral Required
1/1/2008      $52.47   N   Referral Required
1/1/2008      $22.88   N   Referral Required
1/1/2008      $10.89   N   Referral Required
1/1/2008    $166.94    N   Referral Required
1/1/2008    $215.72    N   Referral Required
1/1/2008    $254.94    N   Referral Required
1/1/2008    $283.73    N   Referral Required
1/1/2008       $7.04   N   Referral Required
1/1/2008       $7.51   N   Referral Required
1/1/2008       $7.71   N   Referral Required
1/1/2008      $23.50   N   Referral Required
1/1/2008      $10.84   N   Referral Required
1/1/2008       $4.36   N   Referral Required
               $0.00   N   Referral Required
1/1/2008   $1,090.00   N   Referral Required
1/1/2008   $1,150.50   N   Referral Required
1/1/2008   $3,751.50   N   Referral Required
1/1/2008   $3,751.50   N   Referral Required
               $0.00   N   Referral Required
               $0.00   N   Referral Required
               $0.00   N
               $0.00   N   Referral Required
               $0.00   N   Referral Required
               $0.00   N   Referral Required
               $0.00   N   Referral Required
               $0.00   N   Referral Required
               $0.00   N   Referral Required
               $0.00   N   Referral Required
               $0.00   N   Referral Required
               $0.00   N
               $0.00   N
               $0.00   N
               $0.00   N
               $0.00   N
               $0.00   N
             $0.00   N
             $0.00   N
             $0.00   N
             $0.00   N
             $0.00   N
             $0.00   N
             $0.00   N
             $0.00   N
             $0.00   N
             $0.00   N
             $0.00   N
             $0.00   N
             $0.00   N
             $0.00   N
             $0.00   N   Referral Required
             $0.00   N   Referral Required
             $0.00   N   Referral Required
             $0.00   N   Referral Required
1/1/2008    $17.09   N   Referral Required
1/1/2008    $44.28   N   Referral Required
1/1/2008    $66.09   N   Referral Required
1/1/2008    $43.18   N   Referral Required
1/1/2008    $35.29   N   Referral Required
1/1/2008    $20.15   N   Referral Required
1/1/2008    $41.00   N   Referral Required
1/1/2008    $26.46   N   Referral Required
             $0.00   Y   Referral Required
1/1/2008    $66.99   N   Referral Required
1/1/2008    $77.48   N   Referral Required
4/1/2009   $326.44   Y   Referral Required
1/1/2008   $109.97   N   Referral Required
1/1/2008   $101.58   N   Referral Required
1/1/2008   $303.75   N   Referral Required
1/1/2008   $548.27   Y   Referral Required
1/1/2008   $121.55   N   Referral Required
1/1/2008   $222.09   N   Referral Required
1/1/2008    $66.18   N   Referral Required
1/1/2008    $67.25   N   Referral Required
1/1/2008    $25.59   N   Referral Required
1/1/2008    $25.21   N   Referral Required
1/1/2008    $78.14   N   Referral Required
1/1/2008    $30.69   Y   Referral Required
1/1/2008    $17.05   N   Referral Required
1/1/2008    $31.53   N   Referral Required
1/1/2008    $25.01   N   Referral Required
1/1/2008   $105.20   N   Referral Required
1/1/2008   $177.20   N   Referral Required
1/1/2008       $11.45   N   Referral Required
1/1/2008     $144.38    N   Referral Required
1/1/2008     $160.72    N   Referral Required
1/1/2008       $28.92   N   Referral Required
                $0.00   N   Referral Required
1/1/2008       $63.17   N   Referral Required
1/1/2008     $229.70    N   Referral Required
1/1/2008     $249.80    N   Referral Required
1/1/2008     $185.71    N   Referral Required
1/1/2008     $305.09    N   Referral Required
1/1/2008     $193.60    N   Referral Required
1/1/2008     $221.14    N   Referral Required
1/1/2008       $23.19   N   Referral Required
1/1/2008       $55.40   N   Referral Required
                $0.00   Y   Referral Required
1/1/2008        $9.53   N   Referral Required
1/1/2008    $8,617.50   Y   Referral Required
1/1/2008   $31,133.90   Y   Referral Required
1/1/2008     $263.40    N   Referral Required
1/1/2008     $211.35    N   Referral Required
1/1/2008     $211.35    N   Referral Required
1/1/2008       $30.57   N   Referral Required
1/1/2008       $75.62   Y   Referral Required
1/1/2008     $507.60    N   Referral Required
1/1/2008     $157.34    Y   Referral Required
1/1/2008       $26.46   Y   Referral Required
1/1/2008       $67.57   Y   Referral Required
1/1/2008     $496.47    Y   Referral Required
1/1/2008        $8.08   Y   Referral Required
1/1/2008     $370.70    Y   Referral Required
1/1/2008        $8.09   Y   Referral Required
1/1/2008       $25.79   Y   Referral Required
1/1/2008     $364.70    Y   Referral Required
1/1/2008       $66.70   N   Referral Required
1/1/2008       $19.99   N   Referral Required
1/1/2008       $63.50   N   Referral Required
1/1/2008       $16.62   N   Referral Required
1/1/2008       $27.43   N   Referral Required
1/1/2008       $66.70   N   Referral Required
1/1/2008       $39.79   N   Referral Required
                $0.00   N   Referral Required
                $0.00   N   Referral Required
1/1/2008       $95.00   Y   Referral Required
1/1/2008     $877.90    N   Referral Required
1/1/2008     $671.70    Y   Referral Required
1/1/2008     $952.40    N   Referral Required
1/1/2008     $726.46    Y   Referral Required
1/1/2008   $1,601.70   Y   Referral Required
1/1/2008   $1,306.20   Y   Referral Required
1/1/2008   $1,906.60   Y   Referral Required
1/1/2008   $1,598.70   Y   Referral Required
1/1/2008    $211.78    N   Referral Required
1/1/2008    $164.08    N   Referral Required
1/1/2008      $25.19   N   Referral Required
1/1/2008      $14.60   N   Referral Required
1/1/2008      $10.85   N   Referral Required
1/1/2008   $7,243.00   Y   Referral Required
1/1/2008      $34.18   N   Referral Required
1/1/2008    $662.90    N   Referral Required
1/1/2008    $473.70    N   Referral Required
1/1/2008    $734.60    N   Referral Required
1/1/2008    $592.80    N   Referral Required
1/1/2008   $1,246.20   Y   Referral Required
1/1/2008   $1,214.70   Y   Referral Required
1/1/2008   $1,566.20   Y   Referral Required
1/1/2008   $1,331.80   Y   Referral Required
1/1/2008   $2,838.62   N   Referral Required
1/1/2008   $2,707.20   N   Referral Required
1/1/2008   $7,154.40   N   Referral Required
1/1/2008   $3,024.70   N   Referral Required
1/1/2008    $770.67    N   Referral Required
1/1/2008    $161.90    Y   Referral Required
1/1/2008    $165.24    Y   Referral Required
1/1/2008   $2,002.70   Y   Referral Required
1/1/2008       $9.64   N   Referral Required
1/1/2008       $9.15   N   Referral Required
1/1/2008   $4,239.50   Y   Referral Required
1/1/2008   $5,144.40   Y   Referral Required
1/1/2008   $5,860.90   Y   Referral Required
4/1/2010   $1,757.90   N   Referral Required
4/1/2010    $287.70    N   Referral Required
1/1/2010      $51.63   N   Referral Required
4/1/2010    $287.70    N   Referral Required
1/1/2008      $67.25   Y   Referral Required
4/1/2010   $1,757.90   N   Referral Required
5/1/2009      $77.45   N   Referral Required
5/1/2009      $77.45   N   Referral Required
5/1/2009      $77.45   N   Referral Required
5/1/2009      $77.45   N   Referral Required
               $0.00   Y   Referral Required
1/1/2008   $6,506.80   Y   Referral Required
               $0.00   Y   Referral Required
1/1/2008    $586.13    N   Referral Required
1/1/2008    $485.40    N   Referral Required
1/1/2008    $6,997.00   Y   Referral Required
1/1/2008   $10,020.50   Y   Referral Required
1/1/2008    $2,779.50   Y   Referral Required
1/1/2008   $14,001.40   Y   Referral Required
1/1/2008    $1,406.38   Y   Referral Required
1/1/2008    $2,619.90   Y   Referral Required
1/1/2008    $6,556.60   Y   Referral Required
1/1/2008    $6,556.60   Y   Referral Required
1/1/2008     $419.10    N   Referral Required
1/1/2008    $4,278.90   Y   Referral Required
1/1/2008   $10,631.30   Y   Referral Required
1/1/2008       $36.92   Y   Referral Required
                $0.00   Y   Referral Required
                $0.00   Y   Referral Required
1/1/2008     $961.70    Y   Referral Required
1/1/2008     $478.10    N   Referral Required
1/1/2008        $4.04   N   Referral Required
1/1/2008     $152.74    Y   Referral Required
1/1/2008     $102.06    N   Referral Required
1/1/2008     $287.31    N   Referral Required
1/1/2008     $560.05    N   Referral Required
1/1/2008     $188.20    N   Referral Required
1/1/2008     $286.70    Y   Referral Required
1/1/2008       $36.45   N   Referral Required
1/1/2008       $38.53   N   Referral Required
1/1/2008     $953.50    Y   Referral Required
1/1/2008     $127.85    N   Referral Required
1/1/2008     $284.30    N   Referral Required
1/1/2008     $436.70    N   Referral Required
1/1/2008    $1,065.50   Y   Referral Required
1/1/2008       $22.83   N   Referral Required
1/1/2008     $394.34    N   Referral Required
1/1/2008       $25.21   Y   Referral Required
1/1/2008     $218.80    Y   Referral Required
1/1/2008       $63.73   N   Referral Required
1/1/2008     $214.30    Y   Referral Required
1/1/2008     $456.71    Y   Referral Required
                $0.00   Y   Referral Required
4/1/2009    $3,192.50   N   Referral Required
1/1/2008    $2,228.40   Y   Referral Required
1/1/2008       $83.58   N   Referral Required
                $0.00   N   Referral Required
1/1/2008     $321.75    N   Referral Required
1/1/2008     $321.75    N   Referral Required
1/1/2008     $315.44    N   Referral Required
1/1/2008     $947.90    N   Referral Required
1/1/2008    $1,167.10   N   Referral Required
1/1/2008   $10,545.60   Y   Referral Required
                $0.00   Y   Referral Required
                $0.00   Y   Referral Required
                $0.00   Y   Referral Required
                $0.00   Y   Referral Required
                $0.00   Y   Referral Required
                $0.00   Y   Referral Required
1/1/2008     $686.96    N   Referral Required
1/1/2008     $876.02    Y   Referral Required
1/1/2008    $4,311.06   Y   Referral Required
1/1/2008     $102.94    Y   Referral Required
1/1/2008     $152.37    Y   Referral Required
1/1/2008     $130.67    Y   Referral Required
1/1/2008     $131.71    Y   Referral Required
1/1/2008     $308.82    N   Referral Required
1/1/2008     $358.26    N   Referral Required
1/1/2008     $183.31    N   Referral Required
1/1/2008     $415.35    Y   Referral Required
1/1/2008     $322.72    Y   Referral Required
1/1/2008     $268.17    Y   Referral Required
                $0.00   Y   Referral Required
1/1/2008     $898.59    Y   Referral Required
1/1/2008    $1,128.37   Y   Referral Required
1/1/2008    $1,390.98   Y   Referral Required
1/1/2008    $4,427.34   Y   Referral Required
                $0.00   N   Referral Required
1/1/2008       $48.34   N   Referral Required
                $0.00   Y   Referral Required
1/1/2008     $350.61    Y   Referral Required
1/1/2008     $353.45    Y   Referral Required
1/1/2008     $297.45    Y   Referral Required
4/1/2009     $549.01    Y   Referral Required
1/1/2008     $870.34    Y   Referral Required
1/1/2008     $873.40    Y   Referral Required
                $0.00   N   Referral Required
1/1/2008    $3,364.35   Y   Referral Required
1/1/2008    $3,342.55   Y   Referral Required
1/1/2008    $2,443.00   Y   Referral Required
1/1/2008    $2,778.50   Y   Referral Required
4/1/2009    $1,154.54   Y   Referral Required
1/1/2008    $1,077.87   Y   Referral Required
4/1/2009       $88.34   N   Referral Required
                $0.00   Y   Referral Required
                $0.00   N   Referral Required
1/1/2008     $250.00    N   Referral Required
1/1/2008       $16.01   N   Referral Required
1/1/2008        $9.92   N   Referral Required
1/1/2008   $2,648.70   N   Referral Required
1/1/2008   $3,688.52   Y   Referral Required
1/1/2008   $6,811.54   Y   Referral Required
1/1/2008   $4,495.00   Y   Referral Required
1/1/2008   $6,831.39   N   Referral Required
1/1/2008   $3,016.00   N   Referral Required
               $0.00   N   Referral Required
1/1/2008      $69.89   N   Referral Required
1/1/2008    $515.31    N   Referral Required
1/1/2008      $88.99   N   Referral Required
1/1/2008    $471.40    N   Referral Required
4/1/2009    $161.73    N   Referral Required
1/1/2008      $36.75   N   Referral Required
1/1/2008    $110.94    N   Referral Required
1/1/2008    $119.74    N   Referral Required
1/1/2008    $114.85    N   Referral Required
1/1/2008    $122.21    N   Referral Required
1/1/2008    $177.20    N   Referral Required
1/1/2008      $49.85   N   Referral Required
1/1/2008   $1,201.94   N   Referral Required
1/1/2008    $374.10    N   Referral Required
1/1/2008    $435.80    N   Referral Required
1/1/2008    $184.30    Y   Referral Required
1/1/2008    $331.60    N   Referral Required
1/1/2008    $352.00    N   Referral Required
1/1/2008      $18.93   N   Referral Required
1/1/2008      $43.36   N   Referral Required
1/1/2008      $38.74   Y   Referral Required
1/1/2008    $564.30    Y   Referral Required
1/1/2008    $491.69    Y   Referral Required
1/1/2008    $559.51    Y   Referral Required
1/1/2008      $99.15   Y   Referral Required
1/1/2008      $17.97   Y   Referral Required
1/1/2008      $17.97   Y   Referral Required
1/1/2008    $202.18    Y   Referral Required
1/1/2008      $98.58   Y   Referral Required
1/1/2008    $137.93    Y   Referral Required
1/1/2008    $416.20    Y   Referral Required
1/1/2008      $84.34   Y   Referral Required
1/1/2008      $63.80   Y   Referral Required
1/1/2008      $24.11   Y   Referral Required
1/1/2008      $68.07   Y   Referral Required
1/1/2008      $64.59   Y   Referral Required
1/1/2008    $145.40    Y   Referral Required
1/1/2008    $149.40    Y   Referral Required
1/1/2008      $39.05   Y   Referral Required
1/1/2008      $53.30   Y   Referral Required
1/1/2008    $109.66    Y   Referral Required
1/1/2008      $75.36   Y   Referral Required
1/1/2008      $41.61   Y   Referral Required
1/1/2008      $31.53   Y   Referral Required
1/1/2008      $47.15   Y   Referral Required
1/1/2008      $51.53   Y   Referral Required
1/1/2008   $2,383.90   Y   Referral Required
1/1/2008   $1,628.99   Y   Referral Required
1/1/2008    $202.85    Y   Referral Required
1/1/2008   $4,864.24   Y   Referral Required
1/1/2008    $112.01    Y   Referral Required
1/1/2008      $90.75   Y   Referral Required
1/1/2008      $16.82   Y   Referral Required
1/1/2008    $202.18    Y   Referral Required
1/1/2008   $4,113.02   Y   Referral Required
1/1/2008   $4,391.30   Y   Referral Required
1/1/2008   $4,869.05   Y   Referral Required
1/1/2008   $5,270.36   Y   Referral Required
1/1/2008   $6,455.70   Y   Referral Required
1/1/2008   $8,741.27   Y   Referral Required
1/1/2008   $8,742.05   Y   Referral Required
               $0.00   Y   Referral Required
1/1/2008    $863.51    Y   Referral Required
               $0.00   Y   Referral Required
1/1/2008    $365.14    Y   Referral Required
1/1/2008    $114.70    Y   Referral Required
1/1/2008    $131.31    Y   Referral Required
               $0.00   Y   Referral Required
               $0.00   Y   Referral Required
1/1/2008    $243.41    Y   Referral Required
1/1/2008    $206.54    Y   Referral Required
1/1/2008    $369.54    Y   Referral Required
1/1/2008   $1,165.27   Y   Referral Required
1/1/2010    $643.86    Y   Referral Required
               $0.00   Y   Referral Required
1/1/2008   $1,084.90   Y   Referral Required
1/1/2008    $400.10    Y   Referral Required
1/1/2008      $34.20   Y   Referral Required
1/1/2008    $825.70    Y   Referral Required
1/1/2008   $1,173.30   Y   Referral Required
1/1/2008   $2,773.02   Y   Referral Required
1/1/2008   $1,044.70   Y   Referral Required
1/1/2008    $751.00    Y   Referral Required
1/1/2008    $795.30    Y   Referral Required
1/1/2008    $561.10    Y   Referral Required
1/1/2008    $681.14    Y   Referral Required
1/1/2008   $1,206.70   Y   Referral Required
1/1/2008   $1,438.81   Y   Referral Required
1/1/2008   $1,146.50   Y   Referral Required
1/1/2008   $1,298.80   Y   Referral Required
1/1/2008   $1,225.70   Y   Referral Required
1/1/2008   $1,054.20   Y   Referral Required
1/1/2008    $990.20    Y   Referral Required
1/1/2008    $969.60    Y   Referral Required
1/1/2008    $381.20    Y   Referral Required
1/1/2008    $665.20    Y   Referral Required
1/1/2008    $720.10    Y   Referral Required
1/1/2008    $549.50    Y   Referral Required
1/1/2008   $2,366.09   Y   Referral Required
1/1/2008    $851.90    Y   Referral Required
1/1/2008    $764.50    Y   Referral Required
1/1/2008    $934.20    Y   Referral Required
1/1/2008    $966.60    Y   Referral Required
1/1/2008   $1,116.70   Y   Referral Required
1/1/2008   $1,198.30   Y   Referral Required
1/1/2008    $829.90    Y   Referral Required
1/1/2008    $446.42    Y   Referral Required
1/1/2008    $385.10    Y   Referral Required
1/1/2008    $646.60    Y   Referral Required
1/1/2008    $706.00    Y   Referral Required
1/1/2008    $662.50    Y   Referral Required
1/1/2008    $431.10    Y   Referral Required
1/1/2008    $520.45    Y   Referral Required
1/1/2008    $254.80    Y   Referral Required
1/1/2008    $267.30    Y   Referral Required
               $0.00   Y   Referral Required
1/1/2008   $1,833.76   Y   Referral Required
               $0.00   Y   Referral Required
1/1/2008   $2,134.20   Y   Referral Required
1/1/2008   $2,208.50   Y   Referral Required
1/1/2008   $1,923.20   Y   Referral Required
1/1/2008   $1,851.90   Y   Referral Required
1/1/2008   $1,633.40   Y   Referral Required
1/1/2008   $1,648.10   Y   Referral Required
1/1/2008   $1,718.60   Y   Referral Required
1/1/2008    $982.60    Y   Referral Required
1/1/2008    $616.20    Y   Referral Required
1/1/2008    $755.70    Y   Referral Required
1/1/2008    $752.90    Y   Referral Required
1/1/2008    $125.20    Y   Referral Required
1/1/2008   $1,150.30   Y   Referral Required
1/1/2008   $1,014.60   Y   Referral Required
1/1/2008   $1,158.60   Y   Referral Required
1/1/2008    $411.68    Y   Referral Required
1/1/2008      $99.78   Y   Referral Required
1/1/2008    $343.48    Y   Referral Required
1/1/2008      $10.00   N   Referral Required
               $0.00   N   Referral Required
4/1/2009      $22.40   N   Referral Required
               $0.00   N   Referral Required
               $0.00   N   Referral Required
               $0.00   N   Referral Required
1/1/2008    $155.51    N   Referral Required
1/1/2008   $3,104.70   N   Referral Required
1/1/2008   $3,104.70   N   Referral Required
1/1/2008   $3,104.70   N   Referral Required
4/1/2010   $1,757.90   N   Referral Required
4/1/2010   $1,757.90   Y   Referral Required
5/1/2009    $516.30    N   Referral Required
               $0.00   Y   Referral Required
4/1/2010   $2,070.90   N   Referral Required
4/1/2010   $1,927.20   N   Referral Required
               $0.00   Y   Referral Required
1/1/2008   $1,984.50   Y   Referral Required
               $0.00   Y   Referral Required
               $0.00   Y   Referral Required
               $0.00   Y   Referral Required
               $0.00   Y   Referral Required
               $0.00   Y   Referral Required
1/1/2008    $100.49    Y   Referral Required
1/1/2008      $26.87   Y   Referral Required
               $0.00   Y   Referral Required
1/1/2008   $1,721.69   Y   Referral Required
               $0.00   Y   Referral Required
1/1/2008   $3,640.00   N   Referral Required
1/1/2008    $461.86    Y   Referral Required
1/1/2008    $614.64    Y   Referral Required
               $0.00   Y   Referral Required
               $0.00   Y   Referral Required
               $0.00   Y   Referral Required
               $0.00   Y   Referral Required
               $0.00   Y   Referral Required
               $0.00   Y   Referral Required
               $0.00   Y   Referral Required
               $0.00   Y   Referral Required
1/1/2008       $3.99   N   Referral Required
1/1/2008      $36.12   N   Referral Required
1/1/2008    $223.34    N   Referral Required
               $0.00   Y   Referral Required
1/1/2008    $328.92    Y   Referral Required
1/1/2008      $10.61   Y   Referral Required
1/1/2008      $22.57   Y   Referral Required
1/1/2008   $1,111.70   Y   Referral Required
1/1/2008   $1,283.70   Y   Referral Required
1/1/2008    $326.80    N   Referral Required
1/1/2008   $1,140.90   Y   Referral Required
1/1/2008   $1,053.90   Y   Referral Required
1/1/2008   $1,272.00   Y   Referral Required
1/1/2008   $1,334.60   Y   Referral Required
4/1/2009    $902.90    N   Referral Required
1/1/2008   $1,140.90   Y   Referral Required
1/1/2008   $1,355.70   Y   Referral Required
1/1/2008   $1,384.10   Y   Referral Required
4/1/2009      $80.97   Y   Referral Required
1/1/2008    $104.72    Y   Referral Required
1/1/2008   $1,140.90   Y   Referral Required
1/1/2008   $1,140.90   Y   Referral Required
1/1/2008   $3,808.20   Y   Referral Required
               $0.00   Y   Referral Required
1/1/2008    $515.80    N   Referral Required
1/1/2008    $544.01    Y   Referral Required
1/1/2008    $187.63    Y   Referral Required
1/1/2008    $283.52    Y   Referral Required
1/1/2008    $373.10    Y   Referral Required
1/1/2008    $473.98    Y   Referral Required
1/1/2008    $479.05    Y   Referral Required
1/1/2008    $813.40    Y   Referral Required
4/1/2009      $33.71   Y   Referral Required
4/1/2009      $42.01   Y   Referral Required
1/1/2008      $42.62   Y   Referral Required
1/1/2008    $116.80    Y   Referral Required
1/1/2008    $105.39    Y   Referral Required
1/1/2008       $6.55   Y   Referral Required
1/1/2008      $34.77   Y   Referral Required
1/1/2008       $5.78   Y   Referral Required
1/1/2008      $29.91   Y   Referral Required
1/1/2008      $36.00   Y   Referral Required
1/1/2008       $9.45   Y   Referral Required
               $0.00   Y   Referral Required
               $0.00   Y   Referral Required
               $0.00   Y   Referral Required
1/1/2008      $41.85   Y   Referral Required
1/1/2008      $28.52   Y   Referral Required
1/1/2008      $25.12   Y   Referral Required
1/1/2008      $21.06   Y   Referral Required
1/1/2008      $92.46   Y   Referral Required
1/1/2008      $17.40   Y   Referral Required
1/1/2008      $37.94   Y   Referral Required
4/1/2009   $1,647.59   N   Referral Required
4/1/2009    $983.07    N   Referral Required
               $0.00   Y   Referral Required
4/1/2009    $161.36    N   Referral Required
               $0.00   Y   Referral Required
               $0.00   Y   Referral Required
               $0.00   Y   Referral Required
               $0.00   Y   Referral Required
               $0.00   Y   Referral Required
               $0.00   Y   Referral Required
               $0.00   Y   Referral Required
1/1/2008   $1,170.02   Y   Referral Required
1/1/2008   $2,369.20   Y   Referral Required
1/1/2008   $1,939.18   N   Referral Required
1/1/2008    $307.93    N   Referral Required
1/1/2008   $1,532.90   Y   Referral Required
1/1/2008   $1,410.36   Y   Referral Required
1/1/2008      $69.16   Y   Referral Required
1/1/2008      $44.49   Y   Referral Required
1/1/2008   $1,346.83   Y   Referral Required
1/1/2008    $319.60    Y   Referral Required
1/1/2008   $2,306.14   Y   Referral Required
1/1/2008   $3,877.33   Y   Referral Required
1/1/2008   $1,730.31   Y   Referral Required
4/1/2009   $3,096.99   Y   Referral Required
               $0.00   Y   Referral Required
1/1/2008    $314.22    Y   Referral Required
1/1/2008    $462.97    Y   Referral Required
1/1/2008    $448.03    Y   Referral Required
1/1/2008    $259.27    Y   Referral Required
1/1/2008    $698.63    Y   Referral Required
1/1/2008    $107.16    Y   Referral Required
1/1/2008    $130.82    Y   Referral Required
1/1/2008      $86.27   Y   Referral Required
1/1/2008    $174.45    Y   Referral Required
1/1/2008    $112.34    Y   Referral Required
1/1/2008    $110.31    Y   Referral Required
1/1/2008    $228.79    Y   Referral Required
1/1/2008    $419.08    Y   Referral Required
4/1/2009    $467.50    Y   Referral Required
4/1/2009    $407.20    Y   Referral Required
1/1/2008    $802.84    Y   Referral Required
1/1/2008    $150.74    Y   Referral Required
               $0.00   Y   Referral Required
1/1/2008   $1,209.93   Y   Referral Required
1/1/2008    $534.02    Y   Referral Required
1/1/2008    $856.56    Y   Referral Required
1/1/2008    $1,342.27   Y   Referral Required
1/1/2008     $485.71    Y   Referral Required
1/1/2008       $74.90   N   Referral Required
1/1/2008       $20.41   N   Referral Required
1/1/2008     $149.34    N   Referral Required
1/1/2008       $79.57   N   Referral Required
1/1/2008       $48.67   N   Referral Required
1/1/2008     $147.98    N   Referral Required
1/1/2008       $63.84   N   Referral Required
1/1/2008       $50.39   N   Referral Required
1/1/2008       $27.36   N   Referral Required
1/1/2008       $42.79   N   Referral Required
1/1/2008       $20.50   N   Referral Required
1/1/2008       $53.88   N   Referral Required
1/1/2008       $76.75   N   Referral Required
1/1/2008       $54.55   N   Referral Required
1/1/2008       $63.62   N   Referral Required
4/1/2009     $434.84    N   Referral Required
1/1/2008   $17,164.60   Y   Referral Required
1/1/2008     $374.13    Y   Referral Required
1/1/2008    $1,195.80   Y   Referral Required
1/1/2008    $1,577.42   Y   Referral Required
1/1/2008    $2,312.96   Y   Referral Required
1/1/2008    $3,576.61   N   Referral Required
1/1/2008    $6,475.12   Y   Referral Required
                $0.00   Y   Referral Required
                $0.00   Y   Referral Required
                $0.00   Y   Referral Required
1/1/2008       $61.16   Y   Referral Required
1/1/2008     $119.40    Y   Referral Required
1/1/2008     $151.59    Y   Referral Required
1/1/2008     $188.41    Y   Referral Required
1/1/2008     $269.17    Y   Referral Required
1/1/2008     $419.93    Y   Referral Required
1/1/2008     $289.85    Y   Referral Required
1/1/2008     $348.09    Y   Referral Required
1/1/2008     $799.47    Y   Referral Required
                $0.00   Y   Referral Required
1/1/2008     $308.01    Y   Referral Required
4/1/2009     $382.40    Y   Referral Required
1/1/2008     $393.04    Y   Referral Required
1/1/2008     $543.93    Y   Referral Required
1/1/2008     $447.03    Y   Referral Required
1/1/2008     $576.84    Y   Referral Required
1/1/2008     $791.41    Y   Referral Required
4/1/2009       $46.44   Y   Referral Required
4/1/2009     $495.67    Y   Referral Required
4/1/2009    $520.16    Y   Referral Required
               $0.00   Y   Referral Required
               $0.00   Y   Referral Required
               $0.00   Y   Referral Required
1/1/2008      $16.83   N
1/1/2008      $16.83   N
1/1/2008      $16.83   N
1/1/2008       $5.90   N   Referral Required
1/1/2008      $27.13   N   Referral Required
1/1/2011    $353.68    N
1/1/2011    $353.68    N
1/1/2008      $28.00   N
1/1/2011      $18.57   N   Referral Required
1/1/2008    $172.25    N   Referral Required
1/1/2011      $74.75   N   Referral Required
1/1/2011      $37.36   N   Referral Required
1/1/2011      $49.23   N   Referral Required
1/1/2011      $99.82   N   Referral Required
1/1/2008    $102.61    N                          $69.77   $32.84
1/1/2008    $108.90    N                          $70.79   $38.12
1/1/2008      $87.85   N                          $57.10   $30.75
1/1/2008   $1,981.45   N                       $1,902.19   $79.26
               $0.00   N
1/1/2008      $31.81   N   Referral Required
               $0.00   N   Referral Required
               $0.00   N   Referral Required
1/1/2008      $15.04   N   Referral Required
7/1/2009      $10.83   N   Referral Required
7/1/2009      $10.83   N   Referral Required
1/1/2008      $74.20   N
1/1/2008      $10.74   N   Referral Required
1/1/2008       $8.46   N   Referral Required
1/1/2008       $9.45   N   Referral Required
1/1/2008       $7.08   N   Referral Required
               $0.00   Y   Referral Required
               $0.00   Y   Referral Required
1/1/2008    $462.67    N   Referral Required
1/1/2008    $652.35    N   Referral Required
1/1/2008   $1,077.75   N   Referral Required
1/1/2008    $145.98    N                        $134.30    $11.68
1/1/2008      $74.06   N                         $50.36    $23.70
1/1/2009    $163.02    N   Referral Required    $109.22    $53.80
1/1/2009    $157.72    N   Referral Required    $105.67    $52.05
1/1/2009    $152.41    N   Referral Required    $102.11    $50.30
1/1/2009    $629.58    N   Referral Required
1/1/2009    $922.82    N   Referral Required
1/1/2009    $872.52    N   Referral Required
 1/1/2009   $1,195.57   N   Referral Required
 1/1/2009    $566.66    N   Referral Required    $391.00    $175.66
 1/1/2009   $1,100.37   N   Referral Required    $770.26    $330.11
 1/1/2009   $1,889.72   N   Referral Required   $1,303.91   $585.81
 1/1/2009   $2,240.23   N   Referral Required   $1,568.16   $672.07
                $0.00   N   Referral Required
 1/1/2008      $30.75   Y   Referral Required
                $0.00   Y   Referral Required
 7/1/2009      $11.04   Y   Referral Required
 7/1/2009      $11.04   Y   Referral Required
10/1/2009      $19.07   N
                $0.00   N   Referral Required
                $0.00   Y
                $0.00   N   Referral Required
                $0.00   Y   Referral Required
 5/8/2009      $11.35   N   Referral Required
                $0.00   N   Referral Required
 7/1/2009      $11.04   Y
                $0.00   N   Referral Required
                $0.00   Y   Referral Required
                $0.00   Y
 5/6/2009      $11.35   N   Referral Required
                $0.00   Y   Referral Required
                $0.00   Y
                $0.00   N   Referral Required
 1/1/2008    $225.32    Y
                $0.00   Y   Referral Required
                $0.00   Y   Referral Required
 1/1/2008      $13.00   N   Referral Required
 1/1/2008      $68.62   N   Referral Required
 1/1/2008      $18.69   N   Referral Required
 1/1/2008    $420.77    N   Referral Required
 1/1/2008       $2.13   N   Referral Required
 1/1/2008       $0.02   N   Referral Required
 1/1/2008    $330.68    N   Referral Required
 1/1/2008      $22.74   N   Referral Required
 1/1/2008      $68.54   N   Referral Required
 1/1/2008       $1.04   N   Referral Required
 1/1/2008    $127.20    N   Referral Required
 1/1/2008       $6.00   N   Referral Required
 1/1/2008      $39.22   N   Referral Required
 1/1/2008    $496.28    N   Referral Required
 1/1/2008      $16.77   N   Referral Required
 1/1/2008      $26.56   N   Referral Required
 1/1/2008    $127.19    N   Referral Required
 1/1/2008       $3.38   N   Referral Required
 1/1/2008       $1.98   N   Referral Required
1/1/2008      $23.24   N   Referral Required
1/1/2008       $1.07   N   Referral Required
1/1/2008       $0.42   N   Referral Required
1/1/2008       $0.17   N
1/1/2008      $11.89   N   Referral Required
1/1/2008      $10.37   N   Referral Required
1/1/2008      $12.00   N   Referral Required
1/1/2008      $16.51   N   Referral Required
1/1/2008       $2.37   N   Referral Required
1/1/2008       $4.66   N   Referral Required
1/1/2008       $7.66   N   Referral Required
1/1/2008       $0.16   N   Referral Required
1/1/2008       $1.86   N   Referral Required
1/1/2008   $2,458.00   N   Referral Required
1/1/2008       $6.86   N   Referral Required
1/1/2008       $3.34   N   Referral Required
1/1/2008       $2.69   N   Referral Required
1/1/2008       $1.07   N   Referral Required
1/1/2008      $17.27   N   Referral Required
1/1/2008    $160.00    N   Referral Required
1/1/2008       $0.28   N   Referral Required
1/1/2008      $17.61   N   Referral Required
1/1/2010       $0.04   N   Referral Required
1/1/2008      $26.49   N   Referral Required
1/1/2008    $196.92    N   Referral Required
1/1/2008      $70.96   N   Referral Required
1/1/2008   $1,502.90   N   Referral Required
1/1/2008      $13.81   N   Referral Required
1/1/2008      $22.33   N   Referral Required
1/1/2008       $4.49   N   Referral Required
1/1/2010       $0.07   N   Referral Required
1/1/2008      $23.77   N   Referral Required
1/1/2008      $40.89   N   Referral Required
1/1/2008      $46.53   N   Referral Required
1/1/2008       $1.98   N   Referral Required
1/1/2008       $5.26   N   Referral Required
1/1/2010       $8.08   N   Referral Required
1/1/2008       $8.71   N   Referral Required
1/1/2008       $0.71   N   Referral Required
1/1/2008       $9.67   N   Referral Required
1/1/2008       $0.59   N   Referral Required
1/1/2010   $2,129.21   Y   Referral Required
1/1/2008      $50.19   N   Referral Required
1/1/2008       $0.63   N   Referral Required
1/1/2008       $8.53   N   Referral Required
1/1/2008      $44.53   N   Referral Required
1/1/2008       $0.33   N   Referral Required
1/1/2008    $21.18   N   Referral Required
1/1/2008     $0.86   N   Referral Required
1/1/2009     $1.05   N   Referral Required
1/1/2008     $1.33   N   Referral Required
1/1/2008     $1.42   N   Referral Required
1/1/2008     $5.72   N   Referral Required
1/1/2008     $8.28   N   Referral Required
1/1/2008     $1.25   N   Referral Required
1/1/2008     $3.97   N   Referral Required
1/1/2008     $3.63   N   Referral Required
1/1/2008     $5.60   N   Referral Required
1/1/2008     $1.13   N   Referral Required
1/1/2008     $2.51   N   Referral Required
1/1/2008     $7.00   N   Referral Required
1/1/2008     $3.61   N   Referral Required
1/1/2008     $4.75   N   Referral Required
1/1/2010     $3.86   N   Referral Required
1/1/2008    $14.93   N   Referral Required
1/1/2008     $3.71   N   Referral Required
1/1/2008    $64.97   N   Referral Required
1/1/2008   $760.92   N   Referral Required
1/1/2008    $14.23   N   Referral Required
1/1/2008     $2.41   N   Referral Required
1/1/2008     $1.53   N   Referral Required
1/1/2008     $5.09   N   Referral Required
1/1/2008    $23.01   N   Referral Required
1/1/2008     $1.11   N   Referral Required
1/1/2008     $4.25   N   Referral Required
1/1/2008   $871.25   N   Referral Required
1/1/2010    $65.42   N   Referral Required
1/1/2010    $91.20   N   Referral Required
1/1/2008   $878.83   N   Referral Required
1/1/2008     $0.35   N   Referral Required
1/1/2008     $2.89   N   Referral Required
1/1/2008     $2.89   N   Referral Required
1/1/2008     $8.96   N   Referral Required
1/1/2008     $8.96   N   Referral Required
1/1/2008    $27.11   N   Referral Required
1/1/2008    $12.35   N   Referral Required
1/1/2008     $1.38   N   Referral Required
1/1/2008     $0.80   N   Referral Required
1/1/2008    $37.04   N   Referral Required
1/1/2008     $6.15   N   Referral Required
1/1/2008     $2.27   N   Referral Required
1/1/2008     $4.63   N   Referral Required
1/1/2008     $8.71   N   Referral Required
1/1/2008     $6.51   N   Referral Required
1/1/2008    $51.62   N
1/1/2008    $21.59   N
1/1/2008     $4.14   N   Referral Required
1/1/2008     $4.88   N   Referral Required
1/1/2008    $12.44   N   Referral Required
1/1/2008     $0.23   N   Referral Required
1/1/2008     $0.11   N   Referral Required
1/1/2008    $23.44   N   Referral Required
1/1/2008    $17.53   N   Referral Required
1/1/2008     $3.85   N   Referral Required
1/1/2008   $491.58   N   Referral Required
1/1/2008     $0.54   N   Referral Required
1/1/2008     $2.02   N   Referral Required
1/1/2008     $4.00   N   Referral Required
1/1/2008   $163.84   N   Referral Required
1/1/2008     $0.80   N   Referral Required
1/1/2008   $148.86   N   Referral Required
1/1/2008    $49.84   N   Referral Required
1/1/2008     $3.37   N   Referral Required
1/1/2008     $3.36   N   Referral Required
1/1/2008     $0.96   N   Referral Required
1/1/2008     $5.53   N   Referral Required
1/1/2008     $4.80   N   Referral Required
1/1/2008     $0.85   N   Referral Required
1/1/2009     $0.65   N   Referral Required
1/1/2008     $2.40   N   Referral Required
1/1/2008   $176.38   N   Referral Required
1/1/2008     $1.79   N   Referral Required
             $0.00   N   Referral Required
1/1/2008    $14.53   N   Referral Required
1/1/2008    $17.64   N   Referral Required
1/1/2008     $4.75   N   Referral Required
1/1/2008    $25.30   N   Referral Required
1/1/2008     $6.91   N   Referral Required
1/1/2008    $13.98   N   Referral Required
1/1/2008    $18.52   N   Referral Required
1/1/2008    $71.32   N   Referral Required
1/1/2008    $76.48   N   Referral Required
1/1/2008     $0.14   N   Referral Required
1/1/2008    $71.41   N   Referral Required
1/1/2008   $168.75   N
1/1/2008   $199.04   N   Referral Required
1/1/2008   $305.39   N   Referral Required
1/1/2008     $9.04   N   Referral Required
1/1/2008    $13.73   N   Referral Required
1/1/2008   $200.00   N   Referral Required
1/1/2009     $1.57   N   Referral Required
1/1/2008    $10.68   N   Referral Required
1/1/2008     $1.62   N   Referral Required
1/1/2008   $313.72   N   Referral Required
1/1/2009    $34.16   N   Referral Required
1/1/2008    $11.76   N   Referral Required
1/1/2008    $23.52   N   Referral Required
1/1/2008    $35.27   N   Referral Required
1/1/2008    $47.04   N   Referral Required
1/1/2008    $58.80   N   Referral Required
1/1/2008    $70.58   N   Referral Required
1/1/2008    $82.26   N   Referral Required
1/1/2008    $94.07   N   Referral Required
1/1/2008   $105.89   N   Referral Required
1/1/2008   $117.59   N   Referral Required
1/1/2008   $117.59   N   Referral Required
1/1/2008    $32.88   N   Referral Required
             $0.00   N   Referral Required
1/1/2008    $27.67   N   Referral Required
1/1/2008    $33.80   N   Referral Required
1/1/2008    $31.65   N   Referral Required
1/1/2008    $43.34   N   Referral Required
1/1/2008    $59.25   N   Referral Required
1/1/2008    $32.61   N   Referral Required
1/1/2008    $59.25   N   Referral Required
1/1/2008     $1.33   N   Referral Required
1/1/2008     $0.80   N   Referral Required
1/1/2008    $52.58   N   Referral Required
1/1/2008     $8.21   N   Referral Required
1/1/2008    $72.96   N   Referral Required
1/1/2008   $180.30   Y   Referral Required
1/1/2008     $4.72   N   Referral Required
1/1/2008     $1.79   N   Referral Required
1/1/2008     $5.39   N   Referral Required
1/1/2008     $7.31   N   Referral Required
1/1/2008     $0.37   N   Referral Required
1/1/2008     $0.22   N   Referral Required
1/1/2008    $11.17   N   Referral Required
1/1/2008     $5.81   N   Referral Required
1/1/2008     $6.07   N   Referral Required
1/1/2008     $2.29   N   Referral Required
1/1/2008   $101.19   N   Referral Required
             $0.00   N   Referral Required
1/1/2008     $0.66   N   Referral Required
1/1/2008     $4.69   N   Referral Required
1/1/2008     $2.13   N   Referral Required
1/1/2008   $111.85   N   Referral Required
1/1/2008   $139.04   N   Referral Required
1/1/2008   $319.51   N   Referral Required
1/1/2008   $455.03   N   Referral Required
1/1/2008    $55.21   N   Referral Required
1/1/2009    $11.78   N   Referral Required
1/1/2008     $0.37   N   Referral Required
1/1/2008     $3.92   N   Referral Required
1/1/2008     $1.18   N   Referral Required
1/1/2008     $3.27   N   Referral Required
1/1/2008     $5.92   N   Referral Required
1/1/2008     $0.28   N   Referral Required
1/1/2008     $2.76   N   Referral Required
1/1/2008   $852.00   N   Referral Required
1/1/2008   $116.23   N   Referral Required
1/1/2008    $40.28   N   Referral Required
1/1/2008     $4.09   N   Referral Required
1/1/2008     $0.61   N   Referral Required
1/1/2008     $0.41   N   Referral Required
1/1/2008     $8.64   N   Referral Required
1/1/2009    $26.85   N   Referral Required
1/1/2008    $23.87   N   Referral Required
1/1/2008     $0.25   N   Referral Required
1/1/2008   $160.19   N   Referral Required
1/1/2008   $453.31   N   Referral Required
1/1/2009     $0.43   N   Referral Required
1/1/2008     $5.74   N   Referral Required
1/1/2008     $6.01   N   Referral Required
1/1/2008     $3.63   N   Referral Required
1/1/2008     $9.99   N   Referral Required
1/1/2008    $21.05   N   Referral Required
1/1/2008     $0.02   N   Referral Required
1/1/2008    $26.72   N   Referral Required
1/1/2008     $0.95   N   Referral Required
1/1/2008     $0.88   N   Referral Required
             $0.00   Y   Referral Required
1/1/2008     $2.06   N   Referral Required
1/1/2008     $3.79   N   Referral Required
1/1/2008     $3.77   N   Referral Required
1/1/2008     $5.04   N   Referral Required
1/1/2008     $1.36   N   Referral Required
1/1/2008     $0.24   N
1/1/2008     $3.40   N   Referral Required
1/1/2008     $2.75   N   Referral Required
1/1/2008     $4.54   N   Referral Required
1/1/2008     $4.28   N   Referral Required
1/1/2008     $6.51   N   Referral Required
1/1/2008     $2.81   N   Referral Required
1/1/2008     $1.18   N   Referral Required
1/1/2008       $3.06   N   Referral Required
1/1/2008       $1.88   N   Referral Required
1/1/2008       $4.71   N   Referral Required
1/1/2008       $7.13   N   Referral Required
1/1/2008      $18.84   N   Referral Required
1/1/2008       $7.72   N   Referral Required
1/1/2008      $33.52   N   Referral Required
1/1/2008    $101.71    N   Referral Required
1/1/2008       $2.33   N   Referral Required
1/1/2008    $249.02    N   Referral Required
1/1/2008      $17.42   N   Referral Required
1/1/2008       $9.82   N   Referral Required
1/1/2008       $0.67   N   Referral Required
1/1/2008      $13.92   N   Referral Required
1/1/2008       $0.28   N   Referral Required
1/1/2008       $2.27   N   Referral Required
1/1/2008      $11.36   N   Referral Required
1/1/2008      $29.63   N   Referral Required
1/1/2008       $0.45   N   Referral Required
1/1/2008       $0.94   N   Referral Required
1/1/2008      $16.64   N   Referral Required
1/1/2008       $3.80   N   Referral Required
1/1/2008   $1,045.48   Y   Referral Required
1/1/2008    $199.39    N   Referral Required
1/1/2008   $2,191.41   N   Referral Required
1/1/2008      $10.32   N   Referral Required
1/1/2008      $12.72   N   Referral Required
1/1/2008       $7.69   N   Referral Required
1/1/2008       $0.80   N   Referral Required
1/1/2008       $5.08   N   Referral Required
1/1/2008      $47.30   N   Referral Required
1/1/2008       $1.52   N   Referral Required
1/1/2008       $3.62   N   Referral Required
1/1/2010    $268.72    N   Referral Required
1/1/2008       $2.07   N   Referral Required
1/1/2008       $2.13   N   Referral Required
1/1/2008       $0.17   N   Referral Required
1/1/2008       $3.44   N   Referral Required
1/1/2008       $1.58   N   Referral Required
1/1/2008       $2.11   N   Referral Required
1/1/2008       $2.65   N   Referral Required
1/1/2008       $1.48   N   Referral Required
1/1/2008       $0.08   N   Referral Required
1/1/2008       $0.51   N   Referral Required
1/1/2008      $12.19   N   Referral Required
1/1/2008      $20.55   N   Referral Required
1/1/2008      $88.94   N   Referral Required
1/1/2008    $24.00   N   Referral Required
1/1/2008     $0.40   N   Referral Required
1/1/2008   $127.81   N   Referral Required
1/1/2008   $405.88   N   Referral Required
1/1/2008     $0.61   N   Referral Required
1/1/2008   $149.54   N   Referral Required
1/1/2009    $47.40   N   Referral Required
1/1/2008    $27.37   N   Referral Required
1/1/2008    $81.03   N   Referral Required
1/1/2008     $5.33   N   Referral Required
1/1/2008    $15.65   N   Referral Required
             $0.00   N   Referral Required
1/1/2008     $4.91   N   Referral Required
1/1/2008     $0.07   N   Referral Required
1/1/2010    $43.60   N   Referral Required
1/1/2008    $10.45   N   Referral Required
1/1/2008    $55.16   N   Referral Required
1/1/2008     $0.02   N   Referral Required
1/1/2008    $24.57   N   Referral Required
1/1/2008    $20.31   N   Referral Required
1/1/2008    $14.62   N   Referral Required
1/1/2008     $4.85   N   Referral Required
1/1/2008     $1.98   N   Referral Required
1/1/2008     $3.49   N   Referral Required
1/1/2008    $40.16   N   Referral Required
1/1/2008    $49.24   N   Referral Required
1/1/2008     $0.38   N   Referral Required
1/1/2008   $854.55   N   Referral Required
1/1/2008    $76.32   N   Referral Required
1/1/2008    $34.37   N   Referral Required
1/1/2008     $7.02   N   Referral Required
1/1/2008     $0.33   N
1/1/2008    $65.85   N   Referral Required
1/1/2008     $5.77   N   Referral Required
1/1/2009    $41.06   N   Referral Required
1/1/2008     $2.52   N   Referral Required
1/1/2008     $6.99   N   Referral Required
1/1/2008     $5.29   N   Referral Required
1/1/2008    $10.28   N   Referral Required
1/1/2008     $0.56   N   Referral Required
1/1/2008     $0.79   N   Referral Required
1/1/2008     $3.33   N   Referral Required
1/1/2008   $839.58   N   Referral Required
1/1/2008     $1.02   N   Referral Required
1/1/2008     $7.57   N   Referral Required
1/1/2008     $4.45   N   Referral Required
1/1/2008     $1.73   N   Referral Required
1/1/2008     $2.62   N   Referral Required
1/1/2008     $4.76   N   Referral Required
1/1/2008    $55.89   N   Referral Required
1/1/2009     $3.25   N   Referral Required
1/1/2008     $1.50   N   Referral Required
1/1/2008     $0.28   N   Referral Required
1/1/2008     $1.51   N   Referral Required
1/1/2008   $145.06   N   Referral Required
1/1/2008     $5.96   N   Referral Required
1/1/2008   $146.72   N   Referral Required
1/1/2008    $18.30   N   Referral Required
1/1/2008    $73.77   N   Referral Required
1/1/2008    $54.01   N   Referral Required
1/1/2008     $0.86   N   Referral Required
1/1/2008     $9.16   N   Referral Required
1/1/2008   $457.73   N   Referral Required
1/1/2008     $3.45   N   Referral Required
1/1/2008     $9.12   N   Referral Required
1/1/2008     $9.00   N   Referral Required
1/1/2008     $0.18   N   Referral Required
1/1/2008     $2.36   N   Referral Required
1/1/2008     $3.88   N   Referral Required
1/1/2008     $0.55   N   Referral Required
1/1/2008     $3.62   N   Referral Required
1/1/2008     $5.13   N   Referral Required
1/1/2008    $16.63   N   Referral Required
1/1/2008     $0.12   N   Referral Required
1/1/2008   $135.04   N   Referral Required
1/1/2008     $0.41   N   Referral Required
1/1/2008     $0.13   N   Referral Required
1/1/2008     $0.04   N   Referral Required
1/1/2008     $1.15   N   Referral Required
1/1/2008     $5.09   N   Referral Required
1/1/2008   $208.76   N   Referral Required
1/1/2008   $2