Appendix D.4 - Hospital Inpatient and Outpatient Detail by fanzhongqing

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									                                                                                   DRG Distribution




                                                            Inpatient Claims by Diagnosis-Related Group Code
                     DRG                                              DRG                                       Allowed         Paid   Inpatient   Discharge   Admission
  Year      Region   Code                                          Description                                  Charges       Claims      Days         Count      Count
  2007        1             Unknown                                                                            1,697,622   1,693,782        855          128         127
  2007        1      001    CRANIOTOMY AGE >17 W CC                                                              152,143     150,983        116           15          15
  2007        1      002    CRANIOTOMY AGE >17 W/O CC                                                             26,359      26,159          20           7           7
  2007        1      003    CRANIOTOMY AGE 0-17                                                                  230,108     230,108        167           27          27
  2007        1      007    PERIPH & CRANIAL NERVE & OTHER NERV SYST PROC W CC                                    86,367      85,917          65          11          11
  2007        1      008    PERIPH & CRANIAL NERVE & OTHER NERV SYST PROC W/O CC                                   6,313       6,313           5           2           2
  2007        1      009    SPINAL DISORDERS & INJURIES                                                           20,995      20,835          16           1           1
  2007        1      010    NERVOUS SYSTEM NEOPLASMS W CC                                                         50,856      50,436          42           9           9
  2007        1      011    NERVOUS SYSTEM NEOPLASMS W/O CC                                                        2,877       2,857           2           1           1
  2007        1      012    DEGENERATIVE NERVOUS SYSTEM DISORDERS                                                110,957     110,297          90          14          14
  2007        1      013    MULTIPLE SCLEROSIS & CEREBELLAR ATAXIA                                                26,043      25,943          21           7           7
  2007        1      014    INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION                                       493,718     489,698        411           76          76
  2007        1      015    NONSPECIFIC CVA & PRECEREBRAL OCCLUSION W/O INFARCT                                   43,086      42,726          36           5           5
  2007        1      016    NONSPECIFIC CEREBROVASCULAR DISORDERS W CC                                             2,877       2,857           2           1           1
  2007        1      017    NONSPECIFIC CEREBROVASCULAR DISORDERS W/O CC                                           8,405       8,405           6           2           2
  2007        1      018    CRANIAL & PERIPHERAL NERVE DISORDERS W CC                                             90,066      89,326          74          21          21
  2007        1      019    CRANIAL & PERIPHERAL NERVE DISORDERS W/O CC                                           22,664      22,444          22           8           8
  2007        1      021    VIRAL MENINGITIS                                                                       1,082       1,072           1           1           1
  2007        1      023    NONTRAUMATIC STUPOR & COMA                                                            28,362      28,042          32           6           6
  2007        1      026    SEIZURE & HEADACHE AGE 0-17                                                          268,356     268,356        207           88          88
  2007        1      027    TRAUMATIC STUPOR & COMA, COMA >1 HR                                                   53,104      52,804          30           1           1
  2007        1      028    TRAUMATIC STUPOR & COMA, COMA <1 HR AGE >17 W CC                                      15,824      15,694          13           3           3
  2007        1      030    TRAUMATIC STUPOR & COMA, COMA <1 HR AGE 0-17                                          37,088      37,088          30           1           1
  2007        1      031    CONCUSSION AGE >17 W CC                                                                6,068       5,998           7           2           2
  2007        1      033    CONCUSSION AGE 0-17                                                                    1,264       1,264           1           1           1
  2007        1      034    OTHER DISORDERS OF NERVOUS SYSTEM W CC                                                96,940      96,610          72          13          13
  2007        1      035    OTHER DISORDERS OF NERVOUS SYSTEM W/O CC                                              29,080      28,960          25           8           8
  2007        1      036    RETINAL PROCEDURES                                                                     1,489       1,479           1           1           1
  2007        1      037    ORBITAL PROCEDURES                                                                    21,037      20,877          16           3           3
  2007        1      040    EXTRAOCULAR PROCEDURES EXCEPT ORBIT AGE >17                                           16,618      16,488          13           3           3
  2007        1      044    ACUTE MAJOR EYE INFECTIONS                                                             1,294       1,274           2           1           1
  2007        1      045    NEUROLOGICAL EYE DISORDERS                                                            18,232      18,112          13           3           3
  2007        1      046    OTHER DISORDERS OF THE EYE AGE >17 W CC                                                2,781       2,751           3           2           2
  2007        1      047    OTHER DISORDERS OF THE EYE AGE >17 W/O CC                                              5,754       5,714           4           1           1
  2007        1      048    OTHER DISORDERS OF THE EYE AGE 0-17                                                    2,924       2,924           2           1           1
  2007        1      050    SIALOADENECTOMY                                                                        1,462       1,452           1           1           1
  2007        1      052    CLEFT LIP & PALATE REPAIR                                                              9,331       9,331           7           2           2
  2007        1      055    MISCELLANEOUS EAR, NOSE, MOUTH & THROAT PROCEDURES                                     9,132       9,132           9           5           5
  2007        1      058    T&A PROC, EXCEPT TONSILLECTOMY &/OR ADENOIDECTOMY ONLY, AGE 0-17                       2,924       2,924           2           1           1
  2007        1      059    TONSILLECTOMY &/OR ADENOIDECTOMY ONLY, AGE >17                                         2,752       2,732           2           1           1
  2007        1      060    TONSILLECTOMY &/OR ADENOIDECTOMY ONLY, AGE 0-17                                        9,819       9,819           7           4           4
  2007        1      062    MYRINGOTOMY W TUBE INSERTION AGE 0-17                                                  3,585       3,585           3           3           3
  2007        1      063    OTHER EAR, NOSE, MOUTH & THROAT O.R. PROCEDURES                                       11,407      11,337           7           2           2
  2007        1      064    EAR, NOSE, MOUTH & THROAT MALIGNANCY                                                  33,148      32,888          26           5           5
  2007        1      065    DYSEQUILIBRIUM                                                                        31,216      30,946          27           8           8
  2007        1      066    EPISTAXIS                                                                              2,046       2,026           2           1           1
  2007        1      068    OTITIS MEDIA & URI AGE >17 W CC                                                       38,059      37,719          34          11          11
  2007        1      069    OTITIS MEDIA & URI AGE >17 W/O CC                                                     10,051       9,951          10           4           4
  2007        1      070    OTITIS MEDIA & URI AGE 0-17                                                           94,498      94,498          82          26          26
  2007        1      071    LARYNGOTRACHEITIS                                                                      8,925       8,905           8           4           4
  2007        1      073    OTHER EAR, NOSE, MOUTH & THROAT DIAGNOSES AGE >17                                     32,269      32,009          26           8           8
  2007        1      074    OTHER EAR, NOSE, MOUTH & THROAT DIAGNOSES AGE 0-17                                     9,618       9,618           7           3           3
  2007        1      075    MAJOR CHEST PROCEDURES                                                               139,868     138,838        112           16          16
  2007        1      076    OTHER RESP SYSTEM O.R. PROCEDURES W CC                                               103,255     102,455          80          11          11
  2007        1      077    OTHER RESP SYSTEM O.R. PROCEDURES W/O CC                                               6,327       6,267           6           1           1
  2007        1      078    PULMONARY EMBOLISM                                                                   145,232     144,012        122           18          18
  2007        1      079    RESPIRATORY INFECTIONS & INFLAMMATIONS AGE >17 W CC                                  120,753     119,813          94          15          15
  2007        1      081    RESPIRATORY INFECTIONS & INFLAMMATIONS AGE 0-17                                      107,791     107,791          78           9           9
  2007        1      082    RESPIRATORY NEOPLASMS                                                                285,602     283,182        242           50          50
  2007        1      083    MAJOR CHEST TRAUMA W CC                                                                3,709       3,679           3           1           1
  2007        1      085    PLEURAL EFFUSION W CC                                                                 90,817      90,007          81          12          12
  2007        1      086    PLEURAL EFFUSION W/O CC                                                                3,247       3,217           3           1           1
  2007        1      087    PULMONARY EDEMA & RESPIRATORY FAILURE                                                546,735     543,065        428           70          69
  2007        1      088    CHRONIC OBSTRUCTIVE PULMONARY DISEASE                                                975,435     966,555        916          247         246
  2007        1      089    SIMPLE PNEUMONIA & PLEURISY AGE >17 W CC                                             693,496     687,226        627          139         139
  2007        1      090    SIMPLE PNEUMONIA & PLEURISY AGE >17 W/O CC                                            88,378      87,578          88          27          27
  2007        1      091    SIMPLE PNEUMONIA & PLEURISY AGE 0-17                                                 503,895     503,895        416           95          95
  2007        1      092    INTERSTITIAL LUNG DISEASE W CC                                                        77,457      76,977          63          10          10
  2007        1      093    INTERSTITIAL LUNG DISEASE W/O CC                                                       2,778       2,778           2           1           1
  2007        1      094    PNEUMOTHORAX W CC                                                                     27,165      26,955          21           7           7
  2007        1      095    PNEUMOTHORAX W/O CC                                                                    3,271       3,241           3           1           1
  2007        1      096    BRONCHITIS & ASTHMA AGE >17 W CC                                                     280,315     277,745        262           73          73
  2007        1      097    BRONCHITIS & ASTHMA AGE >17 W/O CC                                                   214,436     212,586        199           63          63
  2007        1      098    BRONCHITIS & ASTHMA AGE 0-17                                                         413,057     413,057        356          123         123
  2007        1      099    RESPIRATORY SIGNS & SYMPTOMS W CC                                                     95,125      94,515          82          21          21
  2007        1      100    RESPIRATORY SIGNS & SYMPTOMS W/O CC                                                    7,323       7,243           8           4           4
  2007        1      101    OTHER RESPIRATORY SYSTEM DIAGNOSES W CC                                               62,097      61,847          49          13          13
  2007        1      102    OTHER RESPIRATORY SYSTEM DIAGNOSES W/O CC                                             69,220      69,190          42           6           6
  2007        1      105    CARDIAC VALVE & OTH MAJOR CARDIOTHORACIC PROC W/O CARD CATH                           89,511      88,891          66          10          10
  2007        1      108    OTHER CARDIOTHORACIC PROCEDURES                                                      229,167     229,167        158            5           5
  2007        1      110    MAJOR CARDIOVASCULAR PROCEDURES W CC                                                 120,690     120,400          90           7           7
  2007        1      111    MAJOR CARDIOVASCULAR PROCEDURES W/O CC                                                 8,773       8,773           6           1           1
  2007        1      113    AMPUTATION FOR CIRC SYSTEM DISORDERS EXCEPT UPPER LIMB & TOE                          94,561      93,801          76           9           9
  2007        1      114    UPPER LIMB & TOE AMPUTATION FOR CIRC SYSTEM DISORDERS                                 45,010      44,640          37           4           4
  2007        1      117    CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT                                   1,438       1,428           1           1           1
  2007        1      118    CARDIAC PACEMAKER DEVICE REPLACEMENT                                                   2,877       2,857           2           1           1
  2007        1      120    OTHER CIRCULATORY SYSTEM O.R. PROCEDURES                                             141,054     140,034        116           12          12
  2007        1      121    CIRCULATORY DISORDERS W AMI & MAJOR COMP, DISCHARGED ALIVE                           174,823     173,363        146           25          25
  2007        1      122    CIRCULATORY DISORDERS W AMI W/O MAJOR COMP, DISCHARGED ALIVE                          88,527      87,787          74          25          25
  2007        1      124    CIRCULATORY DISORDERS EXCEPT AMI, W CARD CATH & COMPLEX DIAG                         254,825     252,845        208           47          47
  2007        1      125    CIRCULATORY DISORDERS EXCEPT AMI, W CARD CATH W/O COMPLEX DIAG                       140,798     139,768        111           35          35
  2007        1      127    HEART FAILURE & SHOCK                                                              1,425,382   1,412,372      1,319          317         316
  2007        1      128    DEEP VEIN THROMBOPHLEBITIS                                                            26,425      26,205          22           1           1
  2007        1      129    CARDIAC ARREST, UNEXPLAINED                                                            3,699       3,679           3           2           2
  2007        1      130    PERIPHERAL VASCULAR DISORDERS W CC                                                   166,249     164,789        146           30          30
  2007        1      131    PERIPHERAL VASCULAR DISORDERS W/O CC                                                  49,748      49,318          43           9           9
  2007        1      132    ATHEROSCLEROSIS W CC                                                                 117,430     116,380        105           36          36
  2007        1      133    ATHEROSCLEROSIS W/O CC                                                                 8,754       8,674           8           2           2
  2007        1      134    HYPERTENSION                                                                         145,450     144,150        134           47          47
  2007        1      135    CARDIAC CONGENITAL & VALVULAR DISORDERS AGE >17 W CC                                   8,659       8,579           8           1           1
  2007        1      137    CARDIAC CONGENITAL & VALVULAR DISORDERS AGE 0-17                                     175,549     175,549        122            7           7
  2007        1      138    CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS W CC                                       111,995     111,035        101           38          38
  2007        1      139    CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS W/O CC                                      79,092      78,432          66          19          19
  2007        1      140    ANGINA PECTORIS                                                                       94,569      93,699          87          33          33
  2007        1      141    SYNCOPE & COLLAPSE W CC                                                               73,160      72,540          62          18          18




5/15/2012                                                                              Milliman                                                                            Page 1
                                                                                  DRG Distribution




                                                            Inpatient Claims by Diagnosis-Related Group Code
                     DRG                                                 DRG                                   Allowed       Paid   Inpatient   Discharge   Admission
  Year      Region   Code                                             Description                              Charges     Claims      Days         Count      Count
  2007        1       142   SYNCOPE & COLLAPSE W/O CC                                                            26,764    26,534          25          12          12
  2007        1       143   CHEST PAIN                                                                          607,966   602,506        546          222         222
  2007        1       144   OTHER CIRCULATORY SYSTEM DIAGNOSES W CC                                             489,209   486,379        386           69          68
  2007        1       145   OTHER CIRCULATORY SYSTEM DIAGNOSES W/O CC                                            14,248    14,128          12           5           5
  2007        1       146   RECTAL RESECTION W CC                                                                22,798    22,628          17           2           2
  2007        1       147   RECTAL RESECTION W/O CC                                                              11,624    11,554          10           2           2
  2007        1       149   MAJOR SMALL & LARGE BOWEL PROCEDURES W/O CC                                          48,901    48,521          38           7           7
  2007        1       150   PERITONEAL ADHESIOLYSIS W CC                                                        129,861   129,531        101            8           8
  2007        1       152   MINOR SMALL & LARGE BOWEL PROCEDURES W CC                                            57,583    57,353          45           5           5
  2007        1       153   MINOR SMALL & LARGE BOWEL PROCEDURES W/O CC                                           7,773     7,773           7           1           1
  2007        1       155   STOMACH, ESOPHAGEAL & DUODENAL PROCEDURES AGE >17 W/O CC                             25,641    25,421          22           7           7
  2007        1       156   STOMACH, ESOPHAGEAL & DUODENAL PROCEDURES AGE 0-17                                  208,185   208,185        144            7           7
  2007        1       157   ANAL & STOMAL PROCEDURES W CC                                                        28,966    28,746          22           5           5
  2007        1       158   ANAL & STOMAL PROCEDURES W/O CC                                                       9,157     9,067           9           3           3
  2007        1       159   HERNIA PROCEDURES EXCEPT INGUINAL & FEMORAL AGE >17 W CC                             18,445    18,295          15           4           4
  2007        1       160   HERNIA PROCEDURES EXCEPT INGUINAL & FEMORAL AGE >17 W/O CC                           21,031    20,861          17           4           4
  2007        1       164   APPENDECTOMY W COMPLICATED PRINCIPAL DIAG W CC                                        8,777     8,747          13           3           3
  2007        1       165   APPENDECTOMY W COMPLICATED PRINCIPAL DIAG W/O CC                                      4,268     4,238           3           1           1
  2007        1       166   APPENDECTOMY W/O COMPLICATED PRINCIPAL DIAG W CC                                     35,373    35,123          30           7           7
  2007        1       167   APPENDECTOMY W/O COMPLICATED PRINCIPAL DIAG W/O CC                                   29,301    29,231          24          12          12
  2007        1       168   MOUTH PROCEDURES W CC                                                                 3,792     3,762           3           3           3
  2007        1       170   OTHER DIGESTIVE SYSTEM O.R. PROCEDURES W CC                                          50,698    50,288          41           6           6
  2007        1       171   OTHER DIGESTIVE SYSTEM O.R. PROCEDURES W/O CC                                         4,315     4,285           3           1           1
  2007        1       172   DIGESTIVE MALIGNANCY W CC                                                           118,492   117,412        108           20          20
  2007        1       174   G.I. HEMORRHAGE W CC                                                                345,080   342,210        292           65          65
  2007        1       175   G.I. HEMORRHAGE W/O CC                                                               19,708    19,518          19           7           7
  2007        1       176   COMPLICATED PEPTIC ULCER                                                             18,885    18,715          17           4           4
  2007        1       177   UNCOMPLICATED PEPTIC ULCER W CC                                                      30,148    29,888          26           5           5
  2007        1       178   UNCOMPLICATED PEPTIC ULCER W/O CC                                                    17,435    17,315          12           3           3
  2007        1       179   INFLAMMATORY BOWEL DISEASE                                                           30,773    30,453          32          11          11
  2007        1       180   G.I. OBSTRUCTION W CC                                                                59,925    59,435          49          14          14
  2007        1       181   G.I. OBSTRUCTION W/O CC                                                              36,835    36,435          40           6           6
  2007        1       182   ESOPHAGITIS, GASTROENT & MISC DIGEST DISORDERS AGE >17 W CC                         609,455   604,115        540          167         167
  2007        1       183   ESOPHAGITIS, GASTROENT & MISC DIGEST DISORDERS AGE >17 W/O CC                       222,704   220,774        193           67          67
  2007        1       184   ESOPHAGITIS, GASTROENT & MISC DIGEST DISORDERS AGE 0-17                             147,164   147,164        126           50          50
  2007        1       185   DENTAL & ORAL DIS EXCEPT EXTRACTIONS & RESTORATIONS, AGE >17                         10,222    10,132           9           2           2
  2007        1       186   DENTAL & ORAL DIS EXCEPT EXTRACTIONS & RESTORATIONS, AGE 0-17                        23,718    23,718          19           6           6
  2007        1       187   DENTAL EXTRACTIONS & RESTORATIONS                                                     1,113     1,113           1           1           1
  2007        1       188   OTHER DIGESTIVE SYSTEM DIAGNOSES AGE >17 W CC                                       116,580   115,580        100           21          20
  2007        1       189   OTHER DIGESTIVE SYSTEM DIAGNOSES AGE >17 W/O CC                                      10,077     9,987           9           5           5
  2007        1       190   OTHER DIGESTIVE SYSTEM DIAGNOSES AGE 0-17                                           111,758   111,758          86          13          13
  2007        1       191   PANCREAS, LIVER & SHUNT PROCEDURES W CC                                              37,744    37,454          29           3           3
  2007        1       197   CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE W/O C.D.E. W CC                                81,407    80,807          64           8           8
  2007        1       201   OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES                                      10,069     9,999           7           1           1
  2007        1       202   CIRRHOSIS & ALCOHOLIC HEPATITIS                                                     125,330   124,290        104           18          18
  2007        1       203   MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS                                       89,676    88,916          76          14          14
  2007        1       204   DISORDERS OF PANCREAS EXCEPT MALIGNANCY                                             512,444   507,974        449           99          99
  2007        1       205   DISORDERS OF LIVER EXCEPT MALIG,CIRR,ALC HEPA W CC                                   67,081    66,531          55          15          15
  2007        1       207   DISORDERS OF THE BILIARY TRACT W CC                                                  25,457    25,237          22           8           8
  2007        1       208   DISORDERS OF THE BILIARY TRACT W/O CC                                                14,478    14,368          12           6           6
  2007        1       210   HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT AGE >17 W CC                              111,446   110,556          89          12          12
  2007        1       211   HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT AGE >17 W/O CC                             21,469    21,299          17           4           4
  2007        1       212   HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT AGE 0-17                                   49,268    49,268          33           9           9
  2007        1       213   AMPUTATION FOR MUSCULOSKELETAL SYSTEM & CONN TISSUE DISORDERS                        53,255    52,895          46           5           5
  2007        1       216   BIOPSIES OF MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE                               16,788    16,638          15           2           2
  2007        1       217   WND DEBRID & SKN GRFT EXCEPT HAND,FOR MUSCSKELET & CONN TISS DIS                     69,961    69,511          47           7           7
  2007        1       218   LOWER EXTREM & HUMER PROC EXCEPT HIP,FOOT,FEMUR AGE >17 W CC                         19,338    19,178          16           5           5
  2007        1       219   LOWER EXTREM & HUMER PROC EXCEPT HIP,FOOT,FEMUR AGE >17 W/O CC                       20,853    20,673          18           8           8
  2007        1       220   LOWER EXTREM & HUMER PROC EXCEPT HIP,FOOT,FEMUR AGE 0-17                              4,975     4,975           4           2           2
  2007        1       224   SHOULDER,ELBOW OR FOREARM PROC,EXC MAJOR JOINT PROC, W/O CC                           2,723     2,703           2           1           1
  2007        1       225   FOOT PROCEDURES                                                                      36,159    35,869          29           4           4
  2007        1       226   SOFT TISSUE PROCEDURES W CC                                                          18,867    18,727          14           3           3
  2007        1       227   SOFT TISSUE PROCEDURES W/O CC                                                        15,339    15,259          13           5           5
  2007        1       228   MAJOR THUMB OR JOINT PROC,OR OTH HAND OR WRIST PROC W CC                              6,990     6,960           5           3           3
  2007        1       229   HAND OR WRIST PROC, EXCEPT MAJOR JOINT PROC, W/O CC                                   7,002     6,952           5           2           2
  2007        1       230   LOCAL EXCISION & REMOVAL OF INT FIX DEVICES OF HIP & FEMUR                           32,606    32,496          24           3           3
  2007        1       232   ARTHROSCOPY                                                                           5,412     5,362           5           1           1
  2007        1       233   OTHER MUSCULOSKELET SYS & CONN TISS O.R. PROC W CC                                   25,249    25,119          18           3           3
  2007        1       234   OTHER MUSCULOSKELET SYS & CONN TISS O.R. PROC W/O CC                                 37,766    37,556          24           7           7
  2007        1       235   FRACTURES OF FEMUR                                                                    5,549     5,549           4           2           2
  2007        1       236   FRACTURES OF HIP & PELVIS                                                             9,348     9,308           7           3           3
  2007        1       237   SPRAINS, STRAINS, & DISLOCATIONS OF HIP, PELVIS & THIGH                               7,028     7,018           7           2           2
  2007        1       238   OSTEOMYELITIS                                                                        72,189    71,649          54           7           7
  2007        1       239   PATHOLOGICAL FRACTURES & MUSCULOSKELETAL & CONN TISS MALIGNANCY                      51,409    51,069          41          12          12
  2007        1       240   CONNECTIVE TISSUE DISORDERS W CC                                                     46,682    46,332          40           7           7
  2007        1       241   CONNECTIVE TISSUE DISORDERS W/O CC                                                   11,502    11,412           9           2           2
  2007        1       242   SEPTIC ARTHRITIS                                                                     16,432    16,282          17           5           5
  2007        1       243   MEDICAL BACK PROBLEMS                                                                75,118    74,528          61          20          20
  2007        1       244   BONE DISEASES & SPECIFIC ARTHROPATHIES W CC                                          67,612    67,122          56          12          12
  2007        1       245   BONE DISEASES & SPECIFIC ARTHROPATHIES W/O CC                                        30,548    30,388          26           5           5
  2007        1       246   NON-SPECIFIC ARTHROPATHIES                                                            1,381     1,361           2           1           1
  2007        1       247   SIGNS & SYMPTOMS OF MUSCULOSKELETAL SYSTEM & CONN TISSUE                             51,790    51,370          46          11          11
  2007        1       248   TENDONITIS, MYOSITIS & BURSITIS                                                      29,485    29,295          25           6           6
  2007        1       249   AFTERCARE, MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE                                11,180    11,080          10           2           2
  2007        1       251   FX, SPRN, STRN & DISL OF FOREARM, HAND, FOOT AGE >17 W/O CC                           2,782     2,762           2           1           1
  2007        1       253   FX, SPRN, STRN & DISL OF UPARM,LOWLEG EX FOOT AGE >17 W CC                           20,942    20,752          19           5           5
  2007        1       254   FX, SPRN, STRN & DISL OF UPARM,LOWLEG EX FOOT AGE >17 W/O CC                         10,384    10,294           9           1           1
  2007        1       256   OTHER MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE DIAGNOSES                           34,950    34,700          30           6           6
  2007        1       257   TOTAL MASTECTOMY FOR MALIGNANCY W CC                                                 30,426    30,176          25          10          10
  2007        1       258   TOTAL MASTECTOMY FOR MALIGNANCY W/O CC                                               24,179    23,969          21          11          11
  2007        1       259   SUBTOTAL MASTECTOMY FOR MALIGNANCY W CC                                                 876       866           1           1           1
  2007        1       260   SUBTOTAL MASTECTOMY FOR MALIGNANCY W/O CC                                             2,308     2,288           2           1           1
  2007        1       262   BREAST BIOPSY & LOCAL EXCISION FOR NON-MALIGNANCY                                     4,209     4,169           4           1           1
  2007        1       263   SKIN GRAFT &/OR DEBRID FOR SKN ULCER OR CELLULITIS W CC                              40,849    40,499          35           6           6
  2007        1       264   SKIN GRAFT &/OR DEBRID FOR SKN ULCER OR CELLULITIS W/O CC                            17,719    17,589          15           4           4
  2007        1       265   SKIN GRAFT &/OR DEBRID EXCEPT FOR SKIN ULCER OR CELLULITIS W CC                      38,666    38,376          29           5           5
  2007        1       266   SKIN GRAFT &/OR DEBRID EXCEPT FOR SKIN ULCER OR CELLULITIS W/O CC                    25,599    25,419          20           5           5
  2007        1       269   OTHER SKIN, SUBCUT TISS & BREAST PROC W CC                                           21,656    21,466          19           3           3
  2007        1       270   OTHER SKIN, SUBCUT TISS & BREAST PROC W/O CC                                         16,692    16,602          16           5           5
  2007        1       271   SKIN ULCERS                                                                          32,690    32,410          39           6           6
  2007        1       272   MAJOR SKIN DISORDERS W CC                                                            51,938    51,518          42           3           2
  2007        1       274   MALIGNANT BREAST DISORDERS W CC                                                      34,750    34,420          33           7           7
  2007        1       276   NON-MALIGNANT BREAST DISORDERS                                                       17,824    17,704          16           4           4
  2007        1       277   CELLULITIS AGE >17 W CC                                                             354,310   351,190        312           66          66
  2007        1       278   CELLULITIS AGE >17 W/O CC                                                           188,036   186,346        169           43          43
  2007        1       279   CELLULITIS AGE 0-17                                                                  78,556    78,556          65          20          20




5/15/2012                                                                             Milliman                                                                          Page 2
                                                                                 DRG Distribution




                                                           Inpatient Claims by Diagnosis-Related Group Code
                     DRG                                               DRG                                     Allowed         Paid   Inpatient   Discharge   Admission
  Year      Region   Code                                           Description                                Charges       Claims      Days         Count      Count
  2007        1       280   TRAUMA TO THE SKIN, SUBCUT TISS & BREAST AGE >17 W CC                                45,075      44,655          42           8           7
  2007        1       281   TRAUMA TO THE SKIN, SUBCUT TISS & BREAST AGE >17 W/O CC                              13,445      13,325          12           4           4
  2007        1       282   TRAUMA TO THE SKIN, SUBCUT TISS & BREAST AGE 0-17                                     6,616       6,616           6           3           3
  2007        1       283   MINOR SKIN DISORDERS W CC                                                            59,292      59,142          45           9           8
  2007        1       284   MINOR SKIN DISORDERS W/O CC                                                           2,110       2,090           2           1           1
  2007        1       285   AMPUTAT OF LOWER LIMB FOR ENDOCRINE,NUTRIT,& METABOL DISORDERS                       13,845      13,725          12           1           1
  2007        1       286   ADRENAL & PITUITARY PROCEDURES                                                       30,848      30,608          24           4           4
  2007        1       287   SKIN GRAFTS & WOUND DEBRID FOR ENDOC, NUTRIT & METAB DISORDERS                       45,237      44,867          60           5           5
  2007        1       289   PARATHYROID PROCEDURES                                                               14,646      14,536          11           3           3
  2007        1       290   THYROID PROCEDURES                                                                   18,349      18,199          15           6           6
  2007        1       292   OTHER ENDOCRINE, NUTRIT & METAB O.R. PROC W CC                                       13,430      13,310          12           2           2
  2007        1       294   DIABETES AGE >35                                                                    587,742     582,472        549          134         134
  2007        1       295   DIABETES AGE 0-35                                                                   222,865     221,315        198           46          46
  2007        1       296   NUTRITIONAL & MISC METABOLIC DISORDERS AGE >17 W CC                                 438,961     435,241        384           94          94
  2007        1       297   NUTRITIONAL & MISC METABOLIC DISORDERS AGE >17 W/O CC                                55,594      55,104          49          16          16
  2007        1       298   NUTRITIONAL & MISC METABOLIC DISORDERS AGE 0-17                                     254,131     254,131        203           43          43
  2007        1       299   INBORN ERRORS OF METABOLISM                                                          44,445      44,215          33           7           7
  2007        1       300   ENDOCRINE DISORDERS W CC                                                            118,490     117,750          97          18          18
  2007        1       302   KIDNEY TRANSPLANT                                                                    38,348      38,048          30           2           2
  2007        1       303   KIDNEY,URETER & MAJOR BLADDER PROCEDURES FOR NEOPLASM                                34,994      34,784          25           6           6
  2007        1       304   KIDNEY,URETER & MAJOR BLADDER PROC FOR NON-NEOPL W CC                                28,564      28,394          22           4           4
  2007        1       305   KIDNEY,URETER & MAJOR BLADDER PROC FOR NON-NEOPL W/O CC                              12,480      12,410           9           3           3
  2007        1       308   MINOR BLADDER PROCEDURES W CC                                                        10,928      10,868           9           2           2
  2007        1       310   TRANSURETHRAL PROCEDURES W CC                                                        16,049      15,929          12           5           5
  2007        1       311   TRANSURETHRAL PROCEDURES W/O CC                                                       2,814       2,794           2           2           2
  2007        1       315   OTHER KIDNEY & URINARY TRACT O.R. PROCEDURES                                        127,885     126,665        122           17          17
  2007        1       316   RENAL FAILURE                                                                       475,698     472,038        395           69          69
  2007        1       318   KIDNEY & URINARY TRACT NEOPLASMS W CC                                                 7,873       7,813           6           1           1
  2007        1       319   KIDNEY & URINARY TRACT NEOPLASMS W/O CC                                               6,391       6,391           5           2           2
  2007        1       320   KIDNEY & URINARY TRACT INFECTIONS AGE >17 W CC                                      212,431     210,451        198           50          50
  2007        1       321   KIDNEY & URINARY TRACT INFECTIONS AGE >17 W/O CC                                    107,310     106,360          95          31          31
  2007        1       322   KIDNEY & URINARY TRACT INFECTIONS AGE 0-17                                           84,026      84,026          69          17          17
  2007        1       323   URINARY STONES W CC, &/OR ESW LITHOTRIPSY                                            96,409      95,699          78          14          14
  2007        1       324   URINARY STONES W/O CC                                                                12,892      12,772          12           4           4
  2007        1       325   KIDNEY & URINARY TRACT SIGNS & SYMPTOMS AGE >17 W CC                                  3,133       3,093           4           2           2
  2007        1       326   KIDNEY & URINARY TRACT SIGNS & SYMPTOMS AGE >17 W/O CC                                1,978       1,958           2           1           1
  2007        1       327   KIDNEY & URINARY TRACT SIGNS & SYMPTOMS AGE 0-17                                      8,008       8,008           6           2           2
  2007        1       331   OTHER KIDNEY & URINARY TRACT DIAGNOSES AGE >17 W CC                                 123,778     122,738        104           23          22
  2007        1       332   OTHER KIDNEY & URINARY TRACT DIAGNOSES AGE >17 W/O CC                                23,670      23,470          20           3           3
  2007        1       333   OTHER KIDNEY & URINARY TRACT DIAGNOSES AGE 0-17                                       2,402       2,402           2           1           1
  2007        1       334   MAJOR MALE PELVIC PROCEDURES W CC                                                     7,933       7,863           7           2           2
  2007        1       335   MAJOR MALE PELVIC PROCEDURES W/O CC                                                  18,567      18,417          15           4           4
  2007        1       337   TRANSURETHRAL PROSTATECTOMY W/O CC                                                    4,268       4,238           3           1           1
  2007        1       340   TESTES PROCEDURES, NON-MALIGNANCY AGE 0-17                                            1,119       1,119           1           1           1
  2007        1       341   PENIS PROCEDURES                                                                     13,778      13,678          10           2           2
  2007        1       343   CIRCUMCISION AGE 0-17                                                                 2,046       2,046           2           1           1
  2007        1       346   MALIGNANCY, MALE REPRODUCTIVE SYSTEM, W CC                                           32,658      32,358          30           2           2
  2007        1       348   BENIGN PROSTATIC HYPERTROPHY W CC                                                     4,456       4,406           5           1           1
  2007        1       350   INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM                                         15,085      14,965          13           5           5
  2007        1       352   OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES                                              2,109       2,089           2           1           1
  2007        1       353   PELVIC EVISCERATION, RADICAL HYSTERECTOMY & RADICAL VULVECTOMY                       10,068       9,988           8           2           2
  2007        1       354   UTERINE,ADNEXA PROC FOR NON-OVARIAN/ADNEXAL MALIG W CC                               14,032      13,912          12           3           3
  2007        1       355   UTERINE,ADNEXA PROC FOR NON-OVARIAN/ADNEXAL MALIG W/O CC                              7,567       7,507           6           4           4
  2007        1       356   FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES                                  5,261       5,221           4           3           3
  2007        1       357   UTERINE & ADNEXA PROC FOR OVARIAN OR ADNEXAL MALIGNANCY                               9,263       9,183           8           1           1
  2007        1       358   UTERINE & ADNEXA PROC FOR NON-MALIGNANCY W CC                                        91,709      90,949          76          24          24
  2007        1       359   UTERINE & ADNEXA PROC FOR NON-MALIGNANCY W/O CC                                     174,605     173,315        140           60          60
  2007        1       360   VAGINA, CERVIX & VULVA PROCEDURES                                                     9,422       9,352           8           3           3
  2007        1       361   LAPAROSCOPY & INCISIONAL TUBAL INTERRUPTION                                           5,153       5,113           4           2           2
  2007        1       363   D&C, CONIZATION & RADIO-IMPLANT, FOR MALIGNANCY                                      17,702      17,552          15           7           7
  2007        1       364   D&C, CONIZATION EXCEPT FOR MALIGNANCY                                                11,260      11,170           9           2           2
  2007        1       365   OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES                                      3,271       3,241           3           1           1
  2007        1       366   MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM W CC                                          28,690      28,460          23           7           7
  2007        1       367   MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM W/O CC                                         7,183       7,123           6           2           2
  2007        1       368   INFECTIONS, FEMALE REPRODUCTIVE SYSTEM                                               50,263      49,893          42           9           9
  2007        1       369   MENSTRUAL & OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS                               29,802      29,522          28          12          12
  2007        1       370   CESAREAN SECTION W CC                                                               247,878     247,878        206           42          42
  2007        1       371   CESAREAN SECTION W/O CC                                                             267,739     267,569        218           58          58
  2007        1       372   VAGINAL DELIVERY W COMPLICATING DIAGNOSES                                           130,289     130,269        109           40          39
  2007        1       373   VAGINAL DELIVERY W/O COMPLICATING DIAGNOSES                                         323,546     323,376        275          121         121
  2007        1       374   VAGINAL DELIVERY W STERILIZATION &/OR D&C                                            39,189      39,159          31          14          14
  2007        1       376   POSTPARTUM & POST ABORTION DIAGNOSES W/O O.R. PROCEDURE                              54,298      53,938          42          15          15
  2007        1       377   POSTPARTUM & POST ABORTION DIAGNOSES W O.R. PROCEDURE                                15,466      15,386          13           4           4
  2007        1       378   ECTOPIC PREGNANCY                                                                     5,984       5,954           5           3           3
  2007        1       379   THREATENED ABORTION                                                                  17,686      17,636          15           9           9
  2007        1       380   ABORTION W/O D&C                                                                      6,041       6,021           5           3           3
  2007        1       381   ABORTION W D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY                                   6,878       6,838           6           4           4
  2007        1       382   FALSE LABOR                                                                           2,782       2,782           2           1           1
  2007        1       383   OTHER ANTEPARTUM DIAGNOSES W MEDICAL COMPLICATIONS                                  173,503     172,963        144           42          42
  2007        1       384   OTHER ANTEPARTUM DIAGNOSES W/O MEDICAL COMPLICATIONS                                  8,056       8,056           6           3           3
  2007        1       385   NEONATES, DIED OR TRANSFERRED TO ANOTHER ACUTE CARE FACILITY                        169,409     169,409        135            8           7
  2007        1       386   EXTREME IMMATURITY OR RESPIRATORY DISTRESS SYNDROME, NEONATE                      2,854,732   2,854,732      2,263           90          78
  2007        1       387   PREMATURITY W MAJOR PROBLEMS                                                         82,966      82,966          64           5           5
  2007        1       388   PREMATURITY W/O MAJOR PROBLEMS                                                       20,544      20,544          18           3           2
  2007        1       389   FULL TERM NEONATE W MAJOR PROBLEMS                                                  194,189     194,189        141            8           8
  2007        1       390   NEONATE W OTHER SIGNIFICANT PROBLEMS                                                  9,793       9,793           7           2           2
  2007        1       392   SPLENECTOMY AGE >17                                                                  14,608      14,478          13           4           4
  2007        1       394   OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS                          27,472      27,282          19           2           2
  2007        1       395   RED BLOOD CELL DISORDERS AGE >17                                                  1,703,500   1,688,620      1,534          335         335
  2007        1       396   RED BLOOD CELL DISORDERS AGE 0-17                                                   650,202     650,202        546          133         133
  2007        1       397   COAGULATION DISORDERS                                                                68,059      67,759          51          16          16
  2007        1       398   RETICULOENDOTHELIAL & IMMUNITY DISORDERS W CC                                       119,465     119,465        108            3           3
  2007        1       399   RETICULOENDOTHELIAL & IMMUNITY DISORDERS W/O CC                                      10,664      10,634          10           3           3
  2007        1       401   LYMPHOMA & NON-ACUTE LEUKEMIA W OTHER O.R. PROC W CC                                 50,525      50,115          41           4           4
  2007        1       403   LYMPHOMA & NON-ACUTE LEUKEMIA W CC                                                   25,608      25,418          19           4           4
  2007        1       404   LYMPHOMA & NON-ACUTE LEUKEMIA W/O CC                                                 24,630      24,470          16           2           2
  2007        1       405   ACUTE LEUKEMIA W/O MAJOR O.R. PROCEDURE AGE 0-17                                     42,183      42,183          33           3           3
  2007        1       406   MYELOPROLIF DISORD OR POORLY DIFF NEOPL W MAJ O.R.PROC W CC                          11,008      10,928           8           1           1
  2007        1       408   MYELOPROLIF DISORD OR POORLY DIFF NEOPL W OTHER O.R.PROC                             29,829      29,599          23           4           4
  2007        1       410   CHEMOTHERAPY W/O ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS                              406,280     404,710        331           86          86
  2007        1       413   OTHER MYELOPROLIF DIS OR POORLY DIFF NEOPL DIAG W CC                                 55,031      54,571          46           7           7
  2007        1       417   SEPTICEMIA AGE 0-17                                                                  25,514      25,514          26           4           4
  2007        1       418   POSTOPERATIVE & POST-TRAUMATIC INFECTIONS                                            63,161      62,731          50          13          13
  2007        1       419   FEVER OF UNKNOWN ORIGIN AGE >17 W CC                                                 21,075      20,875          20           7           7
  2007        1       421   VIRAL ILLNESS AGE >17                                                                 2,288       2,218           7           2           2
  2007        1       422   VIRAL ILLNESS & FEVER OF UNKNOWN ORIGIN AGE 0-17                                     87,078      87,078          89          35          35




5/15/2012                                                                            Milliman                                                                             Page 3
                                                                                 DRG Distribution




                                                           Inpatient Claims by Diagnosis-Related Group Code
                     DRG                                               DRG                                     Allowed         Paid   Inpatient   Discharge   Admission
  Year      Region   Code                                           Description                                Charges       Claims      Days         Count      Count
  2007        1       423   OTHER INFECTIOUS & PARASITIC DISEASES DIAGNOSES                                      69,739      69,099          64           6           6
  2007        1       424   O.R. PROCEDURE W PRINCIPAL DIAGNOSES OF MENTAL ILLNESS                               34,514      34,244          27           1           1
  2007        1       425   ACUTE ADJUSTMENT REACTION & PSYCHOSOCIAL DYSFUNCTION                                 34,730      34,490          36          11          11
  2007        1       426   DEPRESSIVE NEUROSES                                                                 235,613     234,213        219           42          42
  2007        1       427   NEUROSES EXCEPT DEPRESSIVE                                                           43,185      42,955          35           8           8
  2007        1       428   DISORDERS OF PERSONALITY & IMPULSE CONTROL                                          128,180     127,950        113           15          15
  2007        1       429   ORGANIC DISTURBANCES & MENTAL RETARDATION                                            53,720      53,460          57           7           7
  2007        1       430   PSYCHOSES                                                                         5,914,196   5,863,856      5,738          672         670
  2007        1       431   CHILDHOOD MENTAL DISORDERS                                                          282,649     282,139        354           37          37
  2007        1       433   ALCOHOL/DRUG ABUSE OR DEPENDENCE, LEFT AMA                                           43,124      42,684          44          13          13
  2007        1       440   WOUND DEBRIDEMENTS FOR INJURIES                                                      60,511      60,011          53           6           6
  2007        1       442   OTHER O.R. PROCEDURES FOR INJURIES W CC                                              85,310      84,730          69           6           6
  2007        1       443   OTHER O.R. PROCEDURES FOR INJURIES W/O CC                                            16,176      16,056          12           4           4
  2007        1       444   TRAUMATIC INJURY AGE >17 W CC                                                         7,228       7,158           7           2           2
  2007        1       445   TRAUMATIC INJURY AGE >17 W/O CC                                                       3,247       3,217           3           1           1
  2007        1       447   ALLERGIC REACTIONS AGE >17                                                            3,317       3,287           3           2           2
  2007        1       449   POISONING & TOXIC EFFECTS OF DRUGS AGE >17 W CC                                     210,103     208,453        172           50          50
  2007        1       450   POISONING & TOXIC EFFECTS OF DRUGS AGE >17 W/O CC                                    22,675      22,465          22          11          11
  2007        1       451   POISONING & TOXIC EFFECTS OF DRUGS AGE 0-17                                           8,979       8,979           7           3           3
  2007        1       452   COMPLICATIONS OF TREATMENT W CC                                                      39,414      39,094          34           9           9
  2007        1       453   COMPLICATIONS OF TREATMENT W/O CC                                                    17,263      17,133          13           4           4
  2007        1       454   OTHER INJURY, POISONING & TOXIC EFFECT DIAG W CC                                      4,136       4,106           3           2           2
  2007        1       455   OTHER INJURY, POISONING & TOXIC EFFECT DIAG W/O CC                                    1,462       1,462           1           1           1
  2007        1       461   O.R. PROC W DIAGNOSES OF OTHER CONTACT W HEALTH SERVICES                             22,147      21,947          20           2           2
  2007        1       462   REHABILITATION                                                                    1,095,370   1,086,720        933           85          83
  2007        1       463   SIGNS & SYMPTOMS W CC                                                                68,361      67,741          65          15          15
  2007        1       464   SIGNS & SYMPTOMS W/O CC                                                              31,475      31,215          27          10          10
  2007        1       468   EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS                           193,815     192,865        150           17          17
  2007        1       470   UNGROUPABLE                                                                          76,928      76,288          64           9           9
  2007        1       473   ACUTE LEUKEMIA W/O MAJOR O.R. PROCEDURE AGE >17                                     169,846     168,596        125            7           7
  2007        1       476   PROSTATIC O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS                            23,394      23,234          16           1           1
  2007        1       477   NON-EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS                        84,669      84,069          71          12          12
  2007        1       479   OTHER VASCULAR PROCEDURES W/O CC                                                     22,355      22,175          18           9           9
  2007        1       481   BONE MARROW TRANSPLANT                                                                7,670       7,610           6           1           1
  2007        1       482   TRACHEOSTOMY FOR FACE,MOUTH & NECK DIAGNOSES                                         30,530      30,290          24           3           3
  2007        1       484   CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA                                           49,255      48,925          33           2           2
  2007        1       485   LIMB REATTACHMENT, HIP AND FEMUR PROC FOR MULTIPLE SIGNIFICANT TRA                   17,119      17,019          10           1           1
  2007        1       486   OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA                               182,257     181,227        134            6           6
  2007        1       487   OTHER MULTIPLE SIGNIFICANT TRAUMA                                                    28,175      27,985          26           5           4
  2007        1       488   HIV W EXTENSIVE O.R. PROCEDURE                                                       32,698      32,408          29           2           2
  2007        1       489   HIV W MAJOR RELATED CONDITION                                                       304,881     302,281        260           36          36
  2007        1       490   HIV W OR W/O OTHER RELATED CONDITION                                                156,415     155,095        132           21          21
  2007        1       491   MAJOR JOINT & LIMB REATTACHMENT PROCEDURES OF UPPER EXTREMITY                         5,165       5,125           4           1           1
  2007        1       492   CHEMOTHERAPY W ACUTE LEUKEMIA OR W USE OF HI DOSE CHEMOAGENT                        186,523     185,323        146           22          21
  2007        1       493   LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W CC                                        170,562     169,332        149           29          29
  2007        1       494   LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W/O CC                                       40,209      39,869          34           8           8
  2007        1       497   SPINAL FUSION EXCEPT CERVICAL W CC                                                   19,555      19,395          16           2           2
  2007        1       498   SPINAL FUSION EXCEPT CERVICAL W/O CC                                                 18,394      18,244          15           6           6
  2007        1       499   BACK & NECK PROCEDURES EXCEPT SPINAL FUSION W CC                                     63,558      63,068          49          10          10
  2007        1       500   BACK & NECK PROCEDURES EXCEPT SPINAL FUSION W/O CC                                   25,562      25,352          21          12          12
  2007        1       501   KNEE PROCEDURES W PDX OF INFECTION W CC                                              19,216      19,066          15           2           2
  2007        1       503   KNEE PROCEDURES W/O PDX OF INFECTION                                                 19,391      19,241          15           3           3
  2007        1       506   FULL THICKNESS BURN W SKIN GRAFT OR INHAL INJ W CC OR SIG TRAUMA                      6,137       6,077           6           1           1
  2007        1       507   FULL THICKNESS BURN W SKIN GRFT OR INHAL INJ W/O CC OR SIG TRAUMA                    35,403      35,203          20           1           1
  2007        1       508   FULL THICKNESS BURN W/O SKIN GRFT OR INHAL INJ W CC OR SIG TRAUMA                    25,959      25,749          21           2           2
  2007        1       509   FULL THICKNESS BURN W/O SKIN GRFT OR INH INJ W/O CC OR SIG TRAUMA                     1,995       1,995          14           1           1
  2007        1       510   NON-EXTENSIVE BURNS W CC OR SIGNIFICANT TRAUMA                                       33,899      33,719          28           5           5
  2007        1       515   CARDIAC DEFIBRILLATOR IMPLANT W/O CARDIAC CATH                                       72,312      71,732          58           9           9
  2007        1       518   PERC CARDIO PROC W/O CORONARY ARTERY STENT OR AMI                                    70,234      69,714          52          24          24
  2007        1       519   CERVICAL SPINAL FUSION W CC                                                          39,429      39,119          31           6           6
  2007        1       520   CERVICAL SPINAL FUSION W/O CC                                                        38,091      37,791          30          15          15
  2007        1       521   ALCOHOL/DRUG ABUSE OR DEPENDENCE W CC                                             1,372,290   1,359,410      1,352          178         178
  2007        1       522   ALC/DRUG ABUSE OR DEPEND W REHABILITATION THERAPY W/O CC                            403,310     398,910        479           55          55
  2007        1       523   ALC/DRUG ABUSE OR DEPEND W/O REHABILITATION THERAPY W/O CC                          667,446     662,666        563          102         101
  2007        1       524   TRANSIENT ISCHEMIA                                                                   76,716      76,016          74          27          27
  2007        1       529   VENTRICULAR SHUNT PROCEDURES W CC                                                     1,312       1,302           1           1           1
  2007        1       530   VENTRICULAR SHUNT PROCEDURES W/O CC                                                   1,312       1,302           1           1           1
  2007        1       531   SPINAL PROCEDURES W CC                                                               26,158      26,008          21           4           4
  2007        1       532   SPINAL PROCEDURES W/O CC                                                             15,339      15,289          12           3           3
  2007        1       533   EXTRACRANIAL PROCEDURES W CC                                                         19,686      19,536          15           5           5
  2007        1       534   EXTRACRANIAL PROCEDURES W/O CC                                                       10,880      10,800           8           6           6
  2007        1       537   LOCAL EXCIS & REMOV OF INT FIX DEV EXCEPT HIP & FEMUR W CC                           56,578      56,198          42           5           5
  2007        1       538   LOCAL EXCIS & REMOV OF INT FIX DEV EXCEPT HIP & FEMUR W/O CC                          1,312       1,302           1           1           1
  2007        1       542   TRACH W MV 96+HRS OR PDX EXC FACE, MOUTH & NECK W/O MAJ O.R.                        586,210     582,990        445           21          21
  2007        1       543   CRANIOTOMY W/IMPLANT OF CHEMO AGENT OR ACUTE COMPLX CNS PDX                          31,429      31,219          21           2           2
  2007        1       544   MAJOR JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY                          184,176     182,706        147           34          34
  2007        1       545   REVISION OF HIP OR KNEE REPLACEMENT                                                   8,076       8,006           7           1           1
  2007        1       546   SPINAL FUSION EXC CERV WITH CURVATURE OF THE SPINE OR MALIG                           5,143       5,113           7           2           2
  2007        1       549   CORONARY BYPASS W/O CARDIAC CATH W MAJOR CV DX                                      181,523     180,133        139           11          11
  2007        1       550   CORONARY BYPASS W/O CARDIAC CATH W/O MAJOR CV DX                                    114,225     113,365          86          12          12
  2007        1       551   PERMANENT CARDIAC PACEMAKER IMPL W MAJ CV DX OR AICD LEAD OR GNRTR                    4,894       4,854           4           3           3
  2007        1       553   OTHER VASCULAR PROCEDURES W CC W MAJOR CV DX                                         65,499      64,959          54           9           9
  2007        1       554   OTHER VASCULAR PROCEDURES W CC W/O MAJOR CV DX                                       74,716      74,156          65          15          15
  2007        1       555   PERCUTANEOUS CARDIOVASCULAR PROC W MAJOR CV DX                                      147,130     146,040        109           31          31
  2007        1       559   ACUTE ISCHEMIC STROKE WITH USE OF THROMBOLYTIC AGENT                                 12,391      12,321           7           1           1
  2007        1       560   BACTERIAL & TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM                                 46,675      46,525          39           4           3
  2007        1       561   NON-BACTERIAL INFECTIONS OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS                   25,521      25,441          19           5           5
  2007        1       562   SEIZURE AGE > 17 W CC                                                               294,313     291,723        262           81          81
  2007        1       563   SEIZURE AGE > 17 W/O CC                                                              79,946      79,166          78          30          30
  2007        1       564   HEADACHES AGE >17                                                                    63,010      62,510          50          16          16
  2007        1       565   RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT 96+ HOURS                      372,751     371,481        290           20          20
  2007        1       566   RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT < 96 HOURS                     175,424     174,414        140           27          27
  2007        1       567   STOMACH, ESOPHAGEAL & DUODENAL PROC AGE > 17 W CC W MAJOR GI DX                      56,498      55,988          51           5           5
  2007        1       568   STOMACH, ESOPHAGEAL & DUODENAL PROCEDURES PROC AGE > 17 W CC W/O MAJOR GI DX         90,563      89,893          67           5           5
  2007        1       569   MAJOR SMALL & LARGE BOWEL PROCEDURES W CC W MAJOR GI DX                             180,063     178,653        147           15          15
  2007        1       570   MAJOR SMALL & LARGE BOWEL PROCEDURES W CC W/O MAJOR GI DX                            83,633      82,983          65           8           8
  2007        1       571   MAJOR ESOPHAGEAL DISORDERS                                                           31,328      31,058          27           4           4
  2007        1       572   MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS                           54,582      54,162          53           8           8
  2007        1       573   MAJOR BLADDER PROCEDURES                                                                  0           0           9           1           1
  2007        1       574   MAJOR HEMATOLOGIC/IMMUNOLOGIC DIAG EXC SICKLE CELL CRISIS & COAGUL                  137,741     137,211        111           21          21
  2007        1       575   SEPTICEMIA W MV96+ HOURS AGE >17                                                     55,565      55,145          42           3           3
  2007        1       576   SEPTICEMIA W/O MV96+ HOURS AGE >17                                                  589,561     584,341        522           70          70
  2007        1       578   INFECTIOUS & PARASITIC DISEASES W OR PROCEDURE                                       59,381      58,931          45           5           5
  2007        1       579   POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS W OR PROCEDURE                            40,723      40,413          32           5           5
  2007        2       000   Unknown                                                                           1,134,156   1,128,006        975          164         163
  2007        2       001   CRANIOTOMY AGE >17 W CC                                                             129,713     128,413        130           10          10




5/15/2012                                                                            Milliman                                                                             Page 4
                                                                                  DRG Distribution




                                                           Inpatient Claims by Diagnosis-Related Group Code
                     DRG                                              DRG                                      Allowed         Paid   Inpatient   Discharge   Admission
  Year      Region   Code                                          Description                                 Charges       Claims      Days         Count      Count
  2007        2       002   CRANIOTOMY AGE >17 W/O CC                                                            57,366      56,916          45           9           9
  2007        2       003   CRANIOTOMY AGE 0-17                                                                 340,537     340,537        337           43          43
  2007        2       007   PERIPH & CRANIAL NERVE & OTHER NERV SYST PROC W CC                                  102,899     102,189          82          15          15
  2007        2       008   PERIPH & CRANIAL NERVE & OTHER NERV SYST PROC W/O CC                                 20,310      20,270          16           7           7
  2007        2       009   SPINAL DISORDERS & INJURIES                                                         190,658     190,548        170           29          29
  2007        2       010   NERVOUS SYSTEM NEOPLASMS W CC                                                       132,084     131,044        104           13          13
  2007        2       011   NERVOUS SYSTEM NEOPLASMS W/O CC                                                       2,473       2,473           2           1           1
  2007        2       012   DEGENERATIVE NERVOUS SYSTEM DISORDERS                                               172,549     171,789        146           28          28
  2007        2       013   MULTIPLE SCLEROSIS & CEREBELLAR ATAXIA                                                4,507       4,467           4           2           2
  2007        2       014   INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION                                      469,910     466,000        395           72          71
  2007        2       015   NONSPECIFIC CVA & PRECEREBRAL OCCLUSION W/O INFARCT                                  18,731      18,531          20           5           5
  2007        2       016   NONSPECIFIC CEREBROVASCULAR DISORDERS W CC                                            7,443       7,383           6           1           1
  2007        2       018   CRANIAL & PERIPHERAL NERVE DISORDERS W CC                                           155,103     153,613        149           30          29
  2007        2       019   CRANIAL & PERIPHERAL NERVE DISORDERS W/O CC                                          69,279      68,639          64          16          16
  2007        2       021   VIRAL MENINGITIS                                                                      4,199       4,169           3           1           1
  2007        2       022   HYPERTENSIVE ENCEPHALOPATHY                                                           2,481       2,461           2           1           1
  2007        2       023   NONTRAUMATIC STUPOR & COMA                                                           20,841      20,621          22           6           6
  2007        2       026   SEIZURE & HEADACHE AGE 0-17                                                         284,849     284,849        234           63          62
  2007        2       027   TRAUMATIC STUPOR & COMA, COMA >1 HR                                                   3,835       3,815           3           2           2
  2007        2       028   TRAUMATIC STUPOR & COMA, COMA <1 HR AGE >17 W CC                                     60,063      59,573          49           4           4
  2007        2       029   TRAUMATIC STUPOR & COMA, COMA <1 HR AGE >17 W/O CC                                   38,377      38,077          30           5           5
  2007        2       030   TRAUMATIC STUPOR & COMA, COMA <1 HR AGE 0-17                                         15,339      15,339          12           2           2
  2007        2       031   CONCUSSION AGE >17 W CC                                                               1,937       1,917           2           1           1
  2007        2       032   CONCUSSION AGE >17 W/O CC                                                             1,278       1,268           1           1           1
  2007        2       034   OTHER DISORDERS OF NERVOUS SYSTEM W CC                                               59,876      59,606          47          18          18
  2007        2       035   OTHER DISORDERS OF NERVOUS SYSTEM W/O CC                                             17,707      17,637          14           8           7
  2007        2       037   ORBITAL PROCEDURES                                                                    3,803       3,773           3           1           1
  2007        2       042   INTRAOCULAR PROCEDURES EXCEPT RETINA, IRIS & LENS                                     4,911       4,911           4           2           2
  2007        2       044   ACUTE MAJOR EYE INFECTIONS                                                            3,599       3,569           3           1           1
  2007        2       045   NEUROLOGICAL EYE DISORDERS                                                            6,245       6,195          11           3           3
  2007        2       046   OTHER DISORDERS OF THE EYE AGE >17 W CC                                               2,614       2,584           3           1           1
  2007        2       047   OTHER DISORDERS OF THE EYE AGE >17 W/O CC                                             3,954       3,904           5           2           2
  2007        2       048   OTHER DISORDERS OF THE EYE AGE 0-17                                                  12,981      12,981          12           2           2
  2007        2       049   MAJOR HEAD & NECK PROCEDURES                                                          3,513       3,483           3           1           1
  2007        2       050   SIALOADENECTOMY                                                                       2,799       2,779           2           1           1
  2007        2       052   CLEFT LIP & PALATE REPAIR                                                            14,693      14,673          12           4           4
  2007        2       053   SINUS & MASTOID PROCEDURES AGE >17                                                    3,835       3,805           3           1           1
  2007        2       055   MISCELLANEOUS EAR, NOSE, MOUTH & THROAT PROCEDURES                                    2,557       2,557           2           1           1
  2007        2       059   TONSILLECTOMY &/OR ADENOIDECTOMY ONLY, AGE >17                                        8,453       8,373           8           4           4
  2007        2       060   TONSILLECTOMY &/OR ADENOIDECTOMY ONLY, AGE 0-17                                      19,546      19,546          20           7           7
  2007        2       062   MYRINGOTOMY W TUBE INSERTION AGE 0-17                                                21,585      21,585          17           6           6
  2007        2       063   OTHER EAR, NOSE, MOUTH & THROAT O.R. PROCEDURES                                      32,762      32,562          25           7           7
  2007        2       064   EAR, NOSE, MOUTH & THROAT MALIGNANCY                                                 30,513      30,363          26           9           9
  2007        2       065   DYSEQUILIBRIUM                                                                       27,855      27,565          29           9           9
  2007        2       066   EPISTAXIS                                                                             5,882       5,822           6           2           2
  2007        2       068   OTITIS MEDIA & URI AGE >17 W CC                                                      65,843      65,253          59          12          12
  2007        2       069   OTITIS MEDIA & URI AGE >17 W/O CC                                                    16,649      16,459          19           8           8
  2007        2       070   OTITIS MEDIA & URI AGE 0-17                                                          95,762      95,762          88          32          32
  2007        2       071   LARYNGOTRACHEITIS                                                                     3,309       3,309           3           3           3
  2007        2       073   OTHER EAR, NOSE, MOUTH & THROAT DIAGNOSES AGE >17                                    22,070      21,900          17           5           5
  2007        2       074   OTHER EAR, NOSE, MOUTH & THROAT DIAGNOSES AGE 0-17                                   42,066      42,066          35           6           6
  2007        2       075   MAJOR CHEST PROCEDURES                                                               86,934      86,564          76          12          12
  2007        2       076   OTHER RESP SYSTEM O.R. PROCEDURES W CC                                              188,702     187,202        153           17          17
  2007        2       078   PULMONARY EMBOLISM                                                                  210,619     208,859        182           31          31
  2007        2       079   RESPIRATORY INFECTIONS & INFLAMMATIONS AGE >17 W CC                                 150,802     149,532        127           14          14
  2007        2       080   RESPIRATORY INFECTIONS & INFLAMMATIONS AGE >17 W/O CC                                20,688      20,518          17           2           2
  2007        2       081   RESPIRATORY INFECTIONS & INFLAMMATIONS AGE 0-17                                     220,794     220,794        191           24          24
  2007        2       082   RESPIRATORY NEOPLASMS                                                               125,531     124,341        119           27          27
  2007        2       083   MAJOR CHEST TRAUMA W CC                                                              34,553      34,313          24           2           1
  2007        2       085   PLEURAL EFFUSION W CC                                                                 6,669       6,589          12           4           4
  2007        2       086   PLEURAL EFFUSION W/O CC                                                               1,268       1,258           1           1           1
  2007        2       087   PULMONARY EDEMA & RESPIRATORY FAILURE                                               505,524     503,194        398           52          52
  2007        2       088   CHRONIC OBSTRUCTIVE PULMONARY DISEASE                                               918,247     910,117        815          205         205
  2007        2       089   SIMPLE PNEUMONIA & PLEURISY AGE >17 W CC                                            925,437     917,067        840          179         178
  2007        2       090   SIMPLE PNEUMONIA & PLEURISY AGE >17 W/O CC                                          146,585     145,225        143           40          40
  2007        2       091   SIMPLE PNEUMONIA & PLEURISY AGE 0-17                                                586,853     586,853        560          123         123
  2007        2       092   INTERSTITIAL LUNG DISEASE W CC                                                      140,574     140,184        110           10          10
  2007        2       093   INTERSTITIAL LUNG DISEASE W/O CC                                                     72,915      72,785          64           7           7
  2007        2       094   PNEUMOTHORAX W CC                                                                    24,125      23,975          20           6           6
  2007        2       095   PNEUMOTHORAX W/O CC                                                                   9,369       9,289           8           2           2
  2007        2       096   BRONCHITIS & ASTHMA AGE >17 W CC                                                    268,418     265,848        257           80          80
  2007        2       097   BRONCHITIS & ASTHMA AGE >17 W/O CC                                                  310,625     307,685        297           86          86
  2007        2       098   BRONCHITIS & ASTHMA AGE 0-17                                                        407,755     407,755        396          133         133
  2007        2       099   RESPIRATORY SIGNS & SYMPTOMS W CC                                                    84,821      84,511          72          17          17
  2007        2       100   RESPIRATORY SIGNS & SYMPTOMS W/O CC                                                 574,268     574,208        454           25           9
  2007        2       101   OTHER RESPIRATORY SYSTEM DIAGNOSES W CC                                             151,028     150,418        120           25          25
  2007        2       102   OTHER RESPIRATORY SYSTEM DIAGNOSES W/O CC                                            33,634      33,384          33          13          13
  2007        2       103   HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM                                   20,452      20,292          16           1           1
  2007        2       105   CARDIAC VALVE & OTH MAJOR CARDIOTHORACIC PROC W/O CARD CATH                         171,866     170,926        109           12          12
  2007        2       108   OTHER CARDIOTHORACIC PROCEDURES                                                     219,056     219,056          87           9           9
  2007        2       110   MAJOR CARDIOVASCULAR PROCEDURES W CC                                                124,930     124,610          64           8           8
  2007        2       111   MAJOR CARDIOVASCULAR PROCEDURES W/O CC                                               19,921      19,841          15           2           2
  2007        2       113   AMPUTATION FOR CIRC SYSTEM DISORDERS EXCEPT UPPER LIMB & TOE                        203,469     201,859        161           15          15
  2007        2       114   UPPER LIMB & TOE AMPUTATION FOR CIRC SYSTEM DISORDERS                                58,063      57,583          48           9           9
  2007        2       117   CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT                                 37,740      37,700          31           3           3
  2007        2       120   OTHER CIRCULATORY SYSTEM O.R. PROCEDURES                                            128,972     127,942        103           16          16
  2007        2       121   CIRCULATORY DISORDERS W AMI & MAJOR COMP, DISCHARGED ALIVE                           72,265      71,675          59          14          14
  2007        2       122   CIRCULATORY DISORDERS W AMI W/O MAJOR COMP, DISCHARGED ALIVE                         79,680      79,050          63          15          14
  2007        2       123   CIRCULATORY DISORDERS W AMI, EXPIRED                                                 25,290      25,090          20           4           4
  2007        2       124   CIRCULATORY DISORDERS EXCEPT AMI, W CARD CATH & COMPLEX DIAG                        157,945     156,565        138           33          33
  2007        2       125   CIRCULATORY DISORDERS EXCEPT AMI, W CARD CATH W/O COMPLEX DIAG                       85,188      84,518          68          26          26
  2007        2       126   ACUTE & SUBACUTE ENDOCARDITIS                                                         4,934       4,874           6           1           1
  2007        2       127   HEART FAILURE & SHOCK                                                             1,625,401   1,611,231      1,437          317         315
  2007        2       128   DEEP VEIN THROMBOPHLEBITIS                                                            6,330       6,260           7           3           3
  2007        2       129   CARDIAC ARREST, UNEXPLAINED                                                           6,803       6,743           6           2           2
  2007        2       130   PERIPHERAL VASCULAR DISORDERS W CC                                                  237,210     235,390        239           37          36
  2007        2       131   PERIPHERAL VASCULAR DISORDERS W/O CC                                                  8,233       8,153           8           3           3
  2007        2       132   ATHEROSCLEROSIS W CC                                                                 58,191      57,691          50          13          13
  2007        2       133   ATHEROSCLEROSIS W/O CC                                                                7,359       7,289           7           3           3
  2007        2       134   HYPERTENSION                                                                        130,910     129,630        128           43          43
  2007        2       135   CARDIAC CONGENITAL & VALVULAR DISORDERS AGE >17 W CC                                  6,194       6,144           5           2           2
  2007        2       137   CARDIAC CONGENITAL & VALVULAR DISORDERS AGE 0-17                                    165,675     165,675        111            8           8
  2007        2       138   CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS W CC                                      151,338     150,058        128           29          29
  2007        2       139   CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS W/O CC                                     35,427      35,077          35          13          13
  2007        2       140   ANGINA PECTORIS                                                                      21,410      21,190          22           7           7
  2007        2       141   SYNCOPE & COLLAPSE W CC                                                              82,456      81,756          70          28          28




5/15/2012                                                                             Milliman                                                                            Page 5
                                                                                  DRG Distribution




                                                            Inpatient Claims by Diagnosis-Related Group Code
                     DRG                                                DRG                                    Allowed       Paid   Inpatient   Discharge   Admission
  Year      Region   Code                                            Description                               Charges     Claims      Days         Count      Count
  2007        2       142   SYNCOPE & COLLAPSE W/O CC                                                            35,194    34,914          32          10          10
  2007        2       143   CHEST PAIN                                                                          461,174   457,284        391          169         169
  2007        2       144   OTHER CIRCULATORY SYSTEM DIAGNOSES W CC                                             462,961   460,311        409           60          59
  2007        2       145   OTHER CIRCULATORY SYSTEM DIAGNOSES W/O CC                                            13,926    13,786          14           5           5
  2007        2       146   RECTAL RESECTION W CC                                                                10,540    10,450           9           1           1
  2007        2       149   MAJOR SMALL & LARGE BOWEL PROCEDURES W/O CC                                          41,219    40,949          34           6           6
  2007        2       150   PERITONEAL ADHESIOLYSIS W CC                                                         70,292    69,692          60           6           6
  2007        2       152   MINOR SMALL & LARGE BOWEL PROCEDURES W CC                                            35,869    35,579          29           3           3
  2007        2       153   MINOR SMALL & LARGE BOWEL PROCEDURES W/O CC                                           6,511     6,461           5           1           1
  2007        2       155   STOMACH, ESOPHAGEAL & DUODENAL PROCEDURES AGE >17 W/O CC                              3,660     3,630           3           1           1
  2007        2       156   STOMACH, ESOPHAGEAL & DUODENAL PROCEDURES AGE 0-17                                   59,566    59,566          45           8           8
  2007        2       157   ANAL & STOMAL PROCEDURES W CC                                                        24,830    24,740          19           4           4
  2007        2       158   ANAL & STOMAL PROCEDURES W/O CC                                                      12,377    12,277          10           3           3
  2007        2       159   HERNIA PROCEDURES EXCEPT INGUINAL & FEMORAL AGE >17 W CC                             40,176    39,806          37           7           7
  2007        2       160   HERNIA PROCEDURES EXCEPT INGUINAL & FEMORAL AGE >17 W/O CC                           11,101    11,011           9           4           4
  2007        2       161   INGUINAL & FEMORAL HERNIA PROCEDURES AGE >17 W CC                                    13,260    13,150          11           3           3
  2007        2       163   HERNIA PROCEDURES AGE 0-17                                                            4,642     4,642           7           4           4
  2007        2       164   APPENDECTOMY W COMPLICATED PRINCIPAL DIAG W CC                                       40,629    40,499          32           4           4
  2007        2       165   APPENDECTOMY W COMPLICATED PRINCIPAL DIAG W/O CC                                      2,420     2,420           3           1           1
  2007        2       166   APPENDECTOMY W/O COMPLICATED PRINCIPAL DIAG W CC                                      7,651     7,591           6           2           2
  2007        2       167   APPENDECTOMY W/O COMPLICATED PRINCIPAL DIAG W/O CC                                   43,502    43,322          32          12          12
  2007        2       168   MOUTH PROCEDURES W CC                                                                 6,858     6,808           5           1           1
  2007        2       169   MOUTH PROCEDURES W/O CC                                                               2,557     2,557           2           1           1
  2007        2       170   OTHER DIGESTIVE SYSTEM O.R. PROCEDURES W CC                                         115,828   114,878          99          10           9
  2007        2       172   DIGESTIVE MALIGNANCY W CC                                                           159,857   158,567        129           18          18
  2007        2       173   DIGESTIVE MALIGNANCY W/O CC                                                           4,945     4,905           4           1           1
  2007        2       174   G.I. HEMORRHAGE W CC                                                                219,236   217,446        186           51          51
  2007        2       175   G.I. HEMORRHAGE W/O CC                                                               46,218    45,808          44          11          11
  2007        2       176   COMPLICATED PEPTIC ULCER                                                              2,467     2,437           3           1           1
  2007        2       177   UNCOMPLICATED PEPTIC ULCER W CC                                                      10,322    10,202          12           3           3
  2007        2       178   UNCOMPLICATED PEPTIC ULCER W/O CC                                                    15,938    15,818          12           3           3
  2007        2       179   INFLAMMATORY BOWEL DISEASE                                                           67,453    66,883          57          13          13
  2007        2       180   G.I. OBSTRUCTION W CC                                                               141,191   140,331        116           22          22
  2007        2       181   G.I. OBSTRUCTION W/O CC                                                              34,299    34,039          32           9           9
  2007        2       182   ESOPHAGITIS, GASTROENT & MISC DIGEST DISORDERS AGE >17 W CC                         867,192   859,572        765          212         212
  2007        2       183   ESOPHAGITIS, GASTROENT & MISC DIGEST DISORDERS AGE >17 W/O CC                       381,496   378,076        342          107         107
  2007        2       184   ESOPHAGITIS, GASTROENT & MISC DIGEST DISORDERS AGE 0-17                              98,397    98,397          99          43          43
  2007        2       185   DENTAL & ORAL DIS EXCEPT EXTRACTIONS & RESTORATIONS, AGE >17                         80,817    80,177          64          10          10
  2007        2       186   DENTAL & ORAL DIS EXCEPT EXTRACTIONS & RESTORATIONS, AGE 0-17                           822       822           1           1           1
  2007        2       187   DENTAL EXTRACTIONS & RESTORATIONS                                                     9,974     9,944           8           5           5
  2007        2       188   OTHER DIGESTIVE SYSTEM DIAGNOSES AGE >17 W CC                                        65,250    64,660          59          16          16
  2007        2       189   OTHER DIGESTIVE SYSTEM DIAGNOSES AGE >17 W/O CC                                      26,412    26,192          22           8           8
  2007        2       190   OTHER DIGESTIVE SYSTEM DIAGNOSES AGE 0-17                                            30,564    30,564          23           6           6
  2007        2       191   PANCREAS, LIVER & SHUNT PROCEDURES W CC                                              15,373    15,293          13           3           3
  2007        2       192   PANCREAS, LIVER & SHUNT PROCEDURES W/O CC                                             6,553     6,503           5           1           1
  2007        2       193   BILIARY TRACT PROC EXCEPT ONLY CHOLECYST W OR W/O C.D.E. W CC                        40,744    40,414          33           4           4
  2007        2       197   CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE W/O C.D.E. W CC                                43,829    43,499          38           4           4
  2007        2       198   CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE W/O C.D.E. W/O CC                              16,331    16,191          14           5           5
  2007        2       201   OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES                                      11,719    11,629           9           1           1
  2007        2       202   CIRRHOSIS & ALCOHOLIC HEPATITIS                                                     180,513   179,073        145           26          26
  2007        2       203   MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS                                      122,748   121,778          97          13          13
  2007        2       204   DISORDERS OF PANCREAS EXCEPT MALIGNANCY                                             471,244   466,954        432          112         111
  2007        2       205   DISORDERS OF LIVER EXCEPT MALIG,CIRR,ALC HEPA W CC                                  116,542   115,542        102           24          24
  2007        2       206   DISORDERS OF LIVER EXCEPT MALIG,CIRR,ALC HEPA W/O CC                                 12,410    12,320           9           1           1
  2007        2       207   DISORDERS OF THE BILIARY TRACT W CC                                                 113,044   112,154          89          15          15
  2007        2       208   DISORDERS OF THE BILIARY TRACT W/O CC                                                26,996    26,736          26          12          11
  2007        2       210   HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT AGE >17 W CC                              143,820   142,650        117           12          12
  2007        2       211   HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT AGE >17 W/O CC                             40,396    40,096          32           6           6
  2007        2       212   HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT AGE 0-17                                   42,948    42,948          34          11          11
  2007        2       213   AMPUTATION FOR MUSCULOSKELETAL SYSTEM & CONN TISSUE DISORDERS                        92,021    91,271          75           8           8
  2007        2       216   BIOPSIES OF MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE                                7,498     7,438           6           2           2
  2007        2       217   WND DEBRID & SKN GRFT EXCEPT HAND,FOR MUSCSKELET & CONN TISS DIS                     61,751    61,281          47           6           6
  2007        2       218   LOWER EXTREM & HUMER PROC EXCEPT HIP,FOOT,FEMUR AGE >17 W CC                         79,623    79,033          59           8           8
  2007        2       219   LOWER EXTREM & HUMER PROC EXCEPT HIP,FOOT,FEMUR AGE >17 W/O CC                       37,251    36,961          29           6           6
  2007        2       220   LOWER EXTREM & HUMER PROC EXCEPT HIP,FOOT,FEMUR AGE 0-17                             21,302    21,302          18           6           6
  2007        2       223   MAJOR SHOULDER/ELBOW PROC, OR OTHER UPPER EXTREMITY PROC W CC                         3,740     3,720           3           2           2
  2007        2       224   SHOULDER,ELBOW OR FOREARM PROC,EXC MAJOR JOINT PROC, W/O CC                          10,142    10,062           8           3           3
  2007        2       225   FOOT PROCEDURES                                                                      18,418    18,298          14           4           4
  2007        2       226   SOFT TISSUE PROCEDURES W CC                                                          31,025    30,895          23           3           3
  2007        2       227   SOFT TISSUE PROCEDURES W/O CC                                                         2,673     2,673           2           2           2
  2007        2       228   MAJOR THUMB OR JOINT PROC,OR OTH HAND OR WRIST PROC W CC                              3,835     3,815           3           2           2
  2007        2       229   HAND OR WRIST PROC, EXCEPT MAJOR JOINT PROC, W/O CC                                   7,690     7,670           8           2           2
  2007        2       230   LOCAL EXCISION & REMOVAL OF INT FIX DEVICES OF HIP & FEMUR                           11,538    11,518           9           3           3
  2007        2       233   OTHER MUSCULOSKELET SYS & CONN TISS O.R. PROC W CC                                   26,440    26,230          21           6           6
  2007        2       234   OTHER MUSCULOSKELET SYS & CONN TISS O.R. PROC W/O CC                                 21,588    21,408          19           5           5
  2007        2       235   FRACTURES OF FEMUR                                                                   23,427    23,287          20           2           2
  2007        2       236   FRACTURES OF HIP & PELVIS                                                            17,521    17,391          13           4           4
  2007        2       238   OSTEOMYELITIS                                                                        50,663    50,293          51           7           7
  2007        2       239   PATHOLOGICAL FRACTURES & MUSCULOSKELETAL & CONN TISS MALIGNANCY                      61,016    60,536          48           5           5
  2007        2       240   CONNECTIVE TISSUE DISORDERS W CC                                                     86,872    86,262          72          12          12
  2007        2       241   CONNECTIVE TISSUE DISORDERS W/O CC                                                   13,683    13,663          11           4           4
  2007        2       242   SEPTIC ARTHRITIS                                                                      4,704     4,664          23           2           2
  2007        2       243   MEDICAL BACK PROBLEMS                                                               208,277   206,477        188           42          42
  2007        2       244   BONE DISEASES & SPECIFIC ARTHROPATHIES W CC                                          27,958    27,698          26           7           7
  2007        2       245   BONE DISEASES & SPECIFIC ARTHROPATHIES W/O CC                                        18,908    18,838          15           3           3
  2007        2       247   SIGNS & SYMPTOMS OF MUSCULOSKELETAL SYSTEM & CONN TISSUE                             53,564    53,224          41          12          12
  2007        2       248   TENDONITIS, MYOSITIS & BURSITIS                                                      18,954    18,804          15           4           4
  2007        2       249   AFTERCARE, MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE                                 1,241     1,231           1           1           1
  2007        2       253   FX, SPRN, STRN & DISL OF UPARM,LOWLEG EX FOOT AGE >17 W CC                           39,200    38,830          37           5           5
  2007        2       254   FX, SPRN, STRN & DISL OF UPARM,LOWLEG EX FOOT AGE >17 W/O CC                         12,882    12,772          11           4           4
  2007        2       255   FX, SPRN, STRN & DISL OF UPARM,LOWLEG EX FOOT AGE 0-17                                    0         0           1           1           1
  2007        2       256   OTHER MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE DIAGNOSES                           51,268    50,948          41           8           8
  2007        2       257   TOTAL MASTECTOMY FOR MALIGNANCY W CC                                                 17,483    17,343          14           5           5
  2007        2       258   TOTAL MASTECTOMY FOR MALIGNANCY W/O CC                                               23,191    23,021          19          10          10
  2007        2       259   SUBTOTAL MASTECTOMY FOR MALIGNANCY W CC                                               3,512     3,482           3           1           1
  2007        2       260   SUBTOTAL MASTECTOMY FOR MALIGNANCY W/O CC                                             1,226     1,216           1           1           1
  2007        2       261   BREAST PROC FOR NON-MALIGNANCY EXCEPT BIOPSY & LOCAL EXCISION                        13,381    13,291           9           2           2
  2007        2       262   BREAST BIOPSY & LOCAL EXCISION FOR NON-MALIGNANCY                                     3,835     3,805           3           1           1
  2007        2       263   SKIN GRAFT &/OR DEBRID FOR SKN ULCER OR CELLULITIS W CC                             124,938   123,908        103           12          12
  2007        2       264   SKIN GRAFT &/OR DEBRID FOR SKN ULCER OR CELLULITIS W/O CC                            27,470    27,280          22           7           7
  2007        2       265   SKIN GRAFT &/OR DEBRID EXCEPT FOR SKIN ULCER OR CELLULITIS W CC                      15,171    15,051          14           4           4
  2007        2       266   SKIN GRAFT &/OR DEBRID EXCEPT FOR SKIN ULCER OR CELLULITIS W/O CC                    30,075    29,835          24           7           7
  2007        2       268   SKIN, SUBCUTANEOUS TISSUE & BREAST PLASTIC PROCEDURES                                 1,278     1,268           1           1           1
  2007        2       269   OTHER SKIN, SUBCUT TISS & BREAST PROC W CC                                           75,116    74,586          60           9           9
  2007        2       270   OTHER SKIN, SUBCUT TISS & BREAST PROC W/O CC                                         45,344    45,054          36           5           5
  2007        2       271   SKIN ULCERS                                                                         104,711   103,901        101           15          15




5/15/2012                                                                             Milliman                                                                          Page 6
                                                                                 DRG Distribution




                                                           Inpatient Claims by Diagnosis-Related Group Code
                     DRG                                               DRG                                     Allowed         Paid   Inpatient   Discharge   Admission
  Year      Region   Code                                           Description                                Charges       Claims      Days         Count      Count
  2007        2       272   MAJOR SKIN DISORDERS W CC                                                            76,277      75,747          57           6           6
  2007        2       274   MALIGNANT BREAST DISORDERS W CC                                                      50,779      50,389          39           2           2
  2007        2       277   CELLULITIS AGE >17 W CC                                                             372,217     368,707        351           75          75
  2007        2       278   CELLULITIS AGE >17 W/O CC                                                           183,482     181,812        171           40          40
  2007        2       279   CELLULITIS AGE 0-17                                                                  80,945      80,945          70          21          21
  2007        2       280   TRAUMA TO THE SKIN, SUBCUT TISS & BREAST AGE >17 W CC                                43,432      43,082          35           7           7
  2007        2       281   TRAUMA TO THE SKIN, SUBCUT TISS & BREAST AGE >17 W/O CC                              12,452      12,362           9           2           2
  2007        2       283   MINOR SKIN DISORDERS W CC                                                            42,703      42,353          35           8           8
  2007        2       284   MINOR SKIN DISORDERS W/O CC                                                          12,611      12,561          11           4           4
  2007        2       285   AMPUTAT OF LOWER LIMB FOR ENDOCRINE,NUTRIT,& METABOL DISORDERS                       31,064      30,784          28           5           5
  2007        2       286   ADRENAL & PITUITARY PROCEDURES                                                       24,271      24,091          18           3           3
  2007        2       287   SKIN GRAFTS & WOUND DEBRID FOR ENDOC, NUTRIT & METAB DISORDERS                       68,631      68,081          55           5           5
  2007        2       289   PARATHYROID PROCEDURES                                                                5,023       4,973           5           2           2
  2007        2       290   THYROID PROCEDURES                                                                   39,240      38,940          30          10          10
  2007        2       292   OTHER ENDOCRINE, NUTRIT & METAB O.R. PROC W CC                                       13,835      13,725          11           2           2
  2007        2       294   DIABETES AGE >35                                                                    497,591     493,191        446          118         117
  2007        2       295   DIABETES AGE 0-35                                                                   176,639     175,559        155           51          51
  2007        2       296   NUTRITIONAL & MISC METABOLIC DISORDERS AGE >17 W CC                                 481,210     476,960        425          111         111
  2007        2       297   NUTRITIONAL & MISC METABOLIC DISORDERS AGE >17 W/O CC                               142,442     141,102        134           39          39
  2007        2       298   NUTRITIONAL & MISC METABOLIC DISORDERS AGE 0-17                                     261,261     261,261        236           63          63
  2007        2       299   INBORN ERRORS OF METABOLISM                                                          20,144      20,034          16           5           5
  2007        2       300   ENDOCRINE DISORDERS W CC                                                             72,477      72,107          58          10          10
  2007        2       301   ENDOCRINE DISORDERS W/O CC                                                            5,569       5,549           5           2           2
  2007        2       303   KIDNEY,URETER & MAJOR BLADDER PROCEDURES FOR NEOPLASM                                11,278      11,188           9           2           2
  2007        2       304   KIDNEY,URETER & MAJOR BLADDER PROC FOR NON-NEOPL W CC                                50,812      50,402          41           8           8
  2007        2       305   KIDNEY,URETER & MAJOR BLADDER PROC FOR NON-NEOPL W/O CC                               6,461       6,411           5           2           2
  2007        2       308   MINOR BLADDER PROCEDURES W CC                                                        11,294      11,294          11           3           3
  2007        2       310   TRANSURETHRAL PROCEDURES W CC                                                        20,893      20,733          16           3           3
  2007        2       315   OTHER KIDNEY & URINARY TRACT O.R. PROCEDURES                                        119,559     118,669          96          16          16
  2007        2       316   RENAL FAILURE                                                                       545,553     541,353        452          112         112
  2007        2       318   KIDNEY & URINARY TRACT NEOPLASMS W CC                                                16,502      16,372          13           3           3
  2007        2       320   KIDNEY & URINARY TRACT INFECTIONS AGE >17 W CC                                      301,426     298,866        256           63          63
  2007        2       321   KIDNEY & URINARY TRACT INFECTIONS AGE >17 W/O CC                                     97,155      96,235          92          23          23
  2007        2       322   KIDNEY & URINARY TRACT INFECTIONS AGE 0-17                                           70,706      70,706          92          16          16
  2007        2       323   URINARY STONES W CC, &/OR ESW LITHOTRIPSY                                            42,291      41,911          38          12          12
  2007        2       324   URINARY STONES W/O CC                                                                17,513      17,353          16           7           7
  2007        2       325   KIDNEY & URINARY TRACT SIGNS & SYMPTOMS AGE >17 W CC                                  2,557       2,527           3           1           1
  2007        2       331   OTHER KIDNEY & URINARY TRACT DIAGNOSES AGE >17 W CC                                 150,571     149,351        123           28          28
  2007        2       332   OTHER KIDNEY & URINARY TRACT DIAGNOSES AGE >17 W/O CC                                21,487      21,287          20           6           6
  2007        2       333   OTHER KIDNEY & URINARY TRACT DIAGNOSES AGE 0-17                                      60,616      60,616          46           5           5
  2007        2       334   MAJOR MALE PELVIC PROCEDURES W CC                                                     3,633       3,603           3           1           1
  2007        2       335   MAJOR MALE PELVIC PROCEDURES W/O CC                                                  12,643      12,543          10           3           3
  2007        2       336   TRANSURETHRAL PROSTATECTOMY W CC                                                      3,692       3,662           3           2           2
  2007        2       341   PENIS PROCEDURES                                                                     17,575      17,575          14           2           2
  2007        2       343   CIRCUMCISION AGE 0-17                                                                 2,557       2,557           2           1           1
  2007        2       350   INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM                                         26,763      26,533          24           6           6
  2007        2       352   OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES                                             11,743      11,703           9           3           3
  2007        2       354   UTERINE,ADNEXA PROC FOR NON-OVARIAN/ADNEXAL MALIG W CC                               15,295      15,175          12           4           4
  2007        2       355   UTERINE,ADNEXA PROC FOR NON-OVARIAN/ADNEXAL MALIG W/O CC                              7,455       7,395           6           3           3
  2007        2       356   FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES                                 11,571      11,481           9           5           5
  2007        2       357   UTERINE & ADNEXA PROC FOR OVARIAN OR ADNEXAL MALIGNANCY                               3,193       3,173           2           1           1
  2007        2       358   UTERINE & ADNEXA PROC FOR NON-MALIGNANCY W CC                                       158,355     157,075        131           28          28
  2007        2       359   UTERINE & ADNEXA PROC FOR NON-MALIGNANCY W/O CC                                     196,803     195,213        162           61          61
  2007        2       360   VAGINA, CERVIX & VULVA PROCEDURES                                                     5,386       5,346           4           1           1
  2007        2       361   LAPAROSCOPY & INCISIONAL TUBAL INTERRUPTION                                           4,685       4,645           4           1           1
  2007        2       363   D&C, CONIZATION & RADIO-IMPLANT, FOR MALIGNANCY                                       3,722       3,692           3           1           1
  2007        2       364   D&C, CONIZATION EXCEPT FOR MALIGNANCY                                                10,940      10,860           8           2           2
  2007        2       365   OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES                                      5,917       5,867           5           2           2
  2007        2       366   MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM W CC                                          38,444      38,124          32           3           3
  2007        2       368   INFECTIONS, FEMALE REPRODUCTIVE SYSTEM                                               56,274      55,824          49          11          11
  2007        2       369   MENSTRUAL & OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS                               28,556      28,306          25          12          12
  2007        2       370   CESAREAN SECTION W CC                                                               242,580     242,470        195           51          51
  2007        2       371   CESAREAN SECTION W/O CC                                                             331,224     330,984        269           73          72
  2007        2       372   VAGINAL DELIVERY W COMPLICATING DIAGNOSES                                           119,160     119,030        103           37          36
  2007        2       373   VAGINAL DELIVERY W/O COMPLICATING DIAGNOSES                                         387,022     386,612        312          136         136
  2007        2       374   VAGINAL DELIVERY W STERILIZATION &/OR D&C                                            35,240      35,240          28          11          11
  2007        2       376   POSTPARTUM & POST ABORTION DIAGNOSES W/O O.R. PROCEDURE                              37,695      37,525          31          12          12
  2007        2       377   POSTPARTUM & POST ABORTION DIAGNOSES W O.R. PROCEDURE                                10,092      10,012           8           2           2
  2007        2       378   ECTOPIC PREGNANCY                                                                     7,936       7,906           7           2           2
  2007        2       379   THREATENED ABORTION                                                                  42,385      42,315          33          15          15
  2007        2       380   ABORTION W/O D&C                                                                      7,770       7,750           6           4           4
  2007        2       381   ABORTION W D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY                                  10,331      10,291           8           2           2
  2007        2       382   FALSE LABOR                                                                           2,703       2,703           2           1           1
  2007        2       383   OTHER ANTEPARTUM DIAGNOSES W MEDICAL COMPLICATIONS                                  426,079     424,269        360           96          96
  2007        2       384   OTHER ANTEPARTUM DIAGNOSES W/O MEDICAL COMPLICATIONS                                 12,337      12,247          11           4           4
  2007        2       385   NEONATES, DIED OR TRANSFERRED TO ANOTHER ACUTE CARE FACILITY                        216,325     216,325        168            9           9
  2007        2       386   EXTREME IMMATURITY OR RESPIRATORY DISTRESS SYNDROME, NEONATE                      4,860,799   4,860,799      3,822          158         126
  2007        2       387   PREMATURITY W MAJOR PROBLEMS                                                        629,946     629,946        484           14          11
  2007        2       388   PREMATURITY W/O MAJOR PROBLEMS                                                      363,201     363,201        288           13           9
  2007        2       389   FULL TERM NEONATE W MAJOR PROBLEMS                                                   95,316      95,316          94           5           4
  2007        2       392   SPLENECTOMY AGE >17                                                                  15,144      15,034          11           1           1
  2007        2       395   RED BLOOD CELL DISORDERS AGE >17                                                  1,764,589   1,749,019      1,606          339         338
  2007        2       396   RED BLOOD CELL DISORDERS AGE 0-17                                                   667,195     667,195        591          147         146
  2007        2       397   COAGULATION DISORDERS                                                                15,482      15,352          14           6           6
  2007        2       398   RETICULOENDOTHELIAL & IMMUNITY DISORDERS W CC                                        56,443      56,033          47           6           6
  2007        2       399   RETICULOENDOTHELIAL & IMMUNITY DISORDERS W/O CC                                       4,894       4,854           4           2           2
  2007        2       401   LYMPHOMA & NON-ACUTE LEUKEMIA W OTHER O.R. PROC W CC                                 27,060      26,860          22           3           3
  2007        2       403   LYMPHOMA & NON-ACUTE LEUKEMIA W CC                                                  113,055     112,795        100            9           9
  2007        2       404   LYMPHOMA & NON-ACUTE LEUKEMIA W/O CC                                                  6,561       6,511           5           1           1
  2007        2       405   ACUTE LEUKEMIA W/O MAJOR O.R. PROCEDURE AGE 0-17                                      1,236       1,236           1           1           1
  2007        2       406   MYELOPROLIF DISORD OR POORLY DIFF NEOPL W MAJ O.R.PROC W CC                           5,113       5,073           4           1           1
  2007        2       408   MYELOPROLIF DISORD OR POORLY DIFF NEOPL W OTHER O.R.PROC                              5,386       5,346           4           1           1
  2007        2       409   RADIOTHERAPY                                                                         31,612      31,352          26           2           2
  2007        2       410   CHEMOTHERAPY W/O ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS                              750,133     744,843        704          227         226
  2007        2       413   OTHER MYELOPROLIF DIS OR POORLY DIFF NEOPL DIAG W CC                                 26,562      26,362          22           5           5
  2007        2       417   SEPTICEMIA AGE 0-17                                                                 260,121     260,121        205           14          14
  2007        2       418   POSTOPERATIVE & POST-TRAUMATIC INFECTIONS                                           130,149     129,149        110           25          25
  2007        2       419   FEVER OF UNKNOWN ORIGIN AGE >17 W CC                                                 39,547      39,227          32           7           7
  2007        2       420   FEVER OF UNKNOWN ORIGIN AGE >17 W/O CC                                               22,057      21,887          17           4           4
  2007        2       421   VIRAL ILLNESS AGE >17                                                                33,899      33,599          30           5           5
  2007        2       422   VIRAL ILLNESS & FEVER OF UNKNOWN ORIGIN AGE 0-17                                     81,532      81,532          69          25          25
  2007        2       423   OTHER INFECTIOUS & PARASITIC DISEASES DIAGNOSES                                      48,439      48,079          42           8           8
  2007        2       424   O.R. PROCEDURE W PRINCIPAL DIAGNOSES OF MENTAL ILLNESS                                9,890       9,810           8           1           1
  2007        2       425   ACUTE ADJUSTMENT REACTION & PSYCHOSOCIAL DYSFUNCTION                                 69,583      69,363          59          13          13
  2007        2       426   DEPRESSIVE NEUROSES                                                                 368,210     365,070        357           72          72
  2007        2       427   NEUROSES EXCEPT DEPRESSIVE                                                          165,138     164,378        138           22          22




5/15/2012                                                                            Milliman                                                                             Page 7
                                                                                 DRG Distribution




                                                           Inpatient Claims by Diagnosis-Related Group Code
                     DRG                                               DRG                                      Allowed          Paid   Inpatient   Discharge   Admission
  Year      Region   Code                                           Description                                 Charges        Claims      Days         Count      Count
  2007        2       428   DISORDERS OF PERSONALITY & IMPULSE CONTROL                                           115,070      114,090        147           18          18
  2007        2       429   ORGANIC DISTURBANCES & MENTAL RETARDATION                                            239,122      238,282        224           17          17
  2007        2       430   PSYCHOSES                                                                         10,415,842   10,325,572     10,511        1,163       1,155
  2007        2       431   CHILDHOOD MENTAL DISORDERS                                                         1,300,276    1,300,106      1,807          141         139
  2007        2       432   OTHER MENTAL DISORDER DIAGNOSES                                                       10,894       10,894          19           1           1
  2007        2       433   ALCOHOL/DRUG ABUSE OR DEPENDENCE, LEFT AMA                                           124,184      122,854        150           31          31
  2007        2       439   SKIN GRAFTS FOR INJURIES                                                              16,071       15,941          13           1           1
  2007        2       440   WOUND DEBRIDEMENTS FOR INJURIES                                                        3,633        3,603           3           1           1
  2007        2       442   OTHER O.R. PROCEDURES FOR INJURIES W CC                                               52,679       52,269          56           7           7
  2007        2       443   OTHER O.R. PROCEDURES FOR INJURIES W/O CC                                             16,936       16,846          16           3           3
  2007        2       444   TRAUMATIC INJURY AGE >17 W CC                                                         14,766       14,606          16           4           4
  2007        2       445   TRAUMATIC INJURY AGE >17 W/O CC                                                        2,857        2,827           3           1           1
  2007        2       446   TRAUMATIC INJURY AGE 0-17                                                              1,236        1,236           1           1           1
  2007        2       447   ALLERGIC REACTIONS AGE >17                                                            17,179       16,999          18           7           6
  2007        2       448   ALLERGIC REACTIONS AGE 0-17                                                            1,372        1,372           1           1           1
  2007        2       449   POISONING & TOXIC EFFECTS OF DRUGS AGE >17 W CC                                      194,853      193,263        159           40          39
  2007        2       450   POISONING & TOXIC EFFECTS OF DRUGS AGE >17 W/O CC                                     31,604       31,334          27          12          12
  2007        2       451   POISONING & TOXIC EFFECTS OF DRUGS AGE 0-17                                           10,011       10,011          10           6           6
  2007        2       452   COMPLICATIONS OF TREATMENT W CC                                                       73,111       72,791          59           7           7
  2007        2       453   COMPLICATIONS OF TREATMENT W/O CC                                                     16,236       16,116          15           3           3
  2007        2       454   OTHER INJURY, POISONING & TOXIC EFFECT DIAG W CC                                      14,528       14,408          12           2           2
  2007        2       455   OTHER INJURY, POISONING & TOXIC EFFECT DIAG W/O CC                                    24,364       24,364          33           2           2
  2007        2       461   O.R. PROC W DIAGNOSES OF OTHER CONTACT W HEALTH SERVICES                              20,085       19,875          21           3           3
  2007        2       462   REHABILITATION                                                                       833,679      827,289        689           66          66
  2007        2       463   SIGNS & SYMPTOMS W CC                                                                 53,338       52,868          61          17          17
  2007        2       464   SIGNS & SYMPTOMS W/O CC                                                               29,872       29,612          27           9           9
  2007        2       466   AFTERCARE W/O HISTORY OF MALIGNANCY AS SECONDARY DIAGNOSIS                             1,995        1,995          14           1           1
  2007        2       467   OTHER FACTORS INFLUENCING HEALTH STATUS                                                3,835        3,835           3           1           1
  2007        2       468   EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS                            303,737      301,977        239           21          19
  2007        2       470   UNGROUPABLE                                                                            7,670        7,640           6           3           3
  2007        2       473   ACUTE LEUKEMIA W/O MAJOR O.R. PROCEDURE AGE >17                                       28,055       27,835          22           2           2
  2007        2       477   NON-EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS                        222,196      220,476        201           19          19
  2007        2       479   OTHER VASCULAR PROCEDURES W/O CC                                                      52,446       52,016          43           9           9
  2007        2       481   BONE MARROW TRANSPLANT                                                               111,694      111,304          92           4           4
  2007        2       482   TRACHEOSTOMY FOR FACE,MOUTH & NECK DIAGNOSES                                          54,221       53,771          60           7           7
  2007        2       484   CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA                                            37,070       36,780          29           1           1
  2007        2       485   LIMB REATTACHMENT, HIP AND FEMUR PROC FOR MULTIPLE SIGNIFICANT TRA                    29,064       28,834          23           3           3
  2007        2       486   OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA                                138,415      137,515        107           10           9
  2007        2       487   OTHER MULTIPLE SIGNIFICANT TRAUMA                                                     45,697       45,547          35           7           5
  2007        2       488   HIV W EXTENSIVE O.R. PROCEDURE                                                        49,513       49,123          39           5           5
  2007        2       489   HIV W MAJOR RELATED CONDITION                                                        692,947      687,037        591           95          95
  2007        2       490   HIV W OR W/O OTHER RELATED CONDITION                                                 196,939      195,209        173           31          31
  2007        2       491   MAJOR JOINT & LIMB REATTACHMENT PROCEDURES OF UPPER EXTREMITY                         18,393       18,253          14           5           5
  2007        2       492   CHEMOTHERAPY W ACUTE LEUKEMIA OR W USE OF HI DOSE CHEMOAGENT                          87,099       86,679          99          20          20
  2007        2       493   LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W CC                                         114,037      113,167          96          23          23
  2007        2       494   LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W/O CC                                        95,393       94,593          80          24          24
  2007        2       497   SPINAL FUSION EXCEPT CERVICAL W CC                                                    33,119       32,849          27           7           7
  2007        2       498   SPINAL FUSION EXCEPT CERVICAL W/O CC                                                  17,465       17,315          15           6           6
  2007        2       499   BACK & NECK PROCEDURES EXCEPT SPINAL FUSION W CC                                      48,489       48,089          40          10          10
  2007        2       500   BACK & NECK PROCEDURES EXCEPT SPINAL FUSION W/O CC                                    12,076       11,936          14           8           8
  2007        2       501   KNEE PROCEDURES W PDX OF INFECTION W CC                                               18,320       18,180          14           2           2
  2007        2       503   KNEE PROCEDURES W/O PDX OF INFECTION                                                  27,840       27,620          22           5           5
  2007        2       505   EXTEN. BURNS OR FULL THICKNESS BURN W/MV 96+HRS W/O SKIN GFT                          16,816       16,816          14           1           1
  2007        2       506   FULL THICKNESS BURN W SKIN GRAFT OR INHAL INJ W CC OR SIG TRAUMA                      71,133       71,093          59           3           3
  2007        2       507   FULL THICKNESS BURN W SKIN GRFT OR INHAL INJ W/O CC OR SIG TRAUMA                     41,363       41,363          35           3           3
  2007        2       508   FULL THICKNESS BURN W/O SKIN GRFT OR INHAL INJ W CC OR SIG TRAUMA                     14,251       14,121          13           2           2
  2007        2       509   FULL THICKNESS BURN W/O SKIN GRFT OR INH INJ W/O CC OR SIG TRAUMA                     12,445       12,375          12           2           2
  2007        2       510   NON-EXTENSIVE BURNS W CC OR SIGNIFICANT TRAUMA                                         7,467        7,437           6           2           2
  2007        2       511   NON-EXTENSIVE BURNS W/O CC OR SIGNIFICANT TRAUMA                                      17,708       17,608          17           6           6
  2007        2       515   CARDIAC DEFIBRILLATOR IMPLANT W/O CARDIAC CATH                                        45,462       45,082          38          11          11
  2007        2       518   PERC CARDIO PROC W/O CORONARY ARTERY STENT OR AMI                                     81,098       80,578          72          22          22
  2007        2       519   CERVICAL SPINAL FUSION W CC                                                           33,102       32,842          26           6           6
  2007        2       520   CERVICAL SPINAL FUSION W/O CC                                                         26,089       25,869          26          12          12
  2007        2       521   ALCOHOL/DRUG ABUSE OR DEPENDENCE W CC                                              1,321,668    1,307,768      1,396          174         173
  2007        2       522   ALC/DRUG ABUSE OR DEPEND W REHABILITATION THERAPY W/O CC                             769,105      762,315        877           84          84
  2007        2       523   ALC/DRUG ABUSE OR DEPEND W/O REHABILITATION THERAPY W/O CC                           580,933      576,083        591           88          87
  2007        2       524   TRANSIENT ISCHEMIA                                                                    61,029       60,449          58          15          15
  2007        2       528   INTRACRANIAL VASCULAR PROC W PDX HEMORRHAGE                                           94,593       93,853          74           5           5
  2007        2       529   VENTRICULAR SHUNT PROCEDURES W CC                                                     22,836       22,646          19           2           2
  2007        2       531   SPINAL PROCEDURES W CC                                                                31,789       31,579          25           2           2
  2007        2       532   SPINAL PROCEDURES W/O CC                                                               6,391        6,341           5           1           1
  2007        2       533   EXTRACRANIAL PROCEDURES W CC                                                          21,072       20,892          18           5           5
  2007        2       534   EXTRACRANIAL PROCEDURES W/O CC                                                        10,343       10,263           8           4           4
  2007        2       537   LOCAL EXCIS & REMOV OF INT FIX DEV EXCEPT HIP & FEMUR W CC                            69,565       69,125          55           8           8
  2007        2       538   LOCAL EXCIS & REMOV OF INT FIX DEV EXCEPT HIP & FEMUR W/O CC                          35,991       35,761          28           9           9
  2007        2       542   TRACH W MV 96+HRS OR PDX EXC FACE, MOUTH & NECK W/O MAJ O.R.                         419,205      416,565        520           21          18
  2007        2       543   CRANIOTOMY W/IMPLANT OF CHEMO AGENT OR ACUTE COMPLX CNS PDX                           80,630       80,000          63           6           6
  2007        2       544   MAJOR JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY                           275,169      272,909        226           53          53
  2007        2       545   REVISION OF HIP OR KNEE REPLACEMENT                                                   42,070       41,730          34           8           8
  2007        2       546   SPINAL FUSION EXC CERV WITH CURVATURE OF THE SPINE OR MALIG                           52,225       52,155          45          11          11
  2007        2       549   CORONARY BYPASS W/O CARDIAC CATH W MAJOR CV DX                                       115,311      114,411          90           9           9
  2007        2       550   CORONARY BYPASS W/O CARDIAC CATH W/O MAJOR CV DX                                      76,430       75,830          60           9           9
  2007        2       553   OTHER VASCULAR PROCEDURES W CC W MAJOR CV DX                                         112,229      111,329          90          11          11
  2007        2       554   OTHER VASCULAR PROCEDURES W CC W/O MAJOR CV DX                                       155,787      154,497        129           19          19
  2007        2       555   PERCUTANEOUS CARDIOVASCULAR PROC W MAJOR CV DX                                       144,735      143,555        118           31          31
  2007        2       559   ACUTE ISCHEMIC STROKE WITH USE OF THROMBOLYTIC AGENT                                   9,602        9,532           7           1           1
  2007        2       560   BACTERIAL & TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM                                  15,725       15,595          21           5           5
  2007        2       562   SEIZURE AGE > 17 W CC                                                                236,630      234,480        215           48          48
  2007        2       563   SEIZURE AGE > 17 W/O CC                                                              104,247      103,247        100           35          35
  2007        2       564   HEADACHES AGE >17                                                                     32,087       31,807          28          12          12
  2007        2       565   RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT 96+ HOURS                       454,857      452,447        380           26          26
  2007        2       566   RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT < 96 HOURS                      354,851      353,801        273           25          25
  2007        2       567   STOMACH, ESOPHAGEAL & DUODENAL PROC AGE > 17 W CC W MAJOR GI DX                       67,423       66,883          54           4           4
  2007        2       568   STOMACH, ESOPHAGEAL & DUODENAL PROCEDURES PROC AGE > 17 W CC W/O MAJOR GI DX          48,820       48,440          38           3           3
  2007        2       569   MAJOR SMALL & LARGE BOWEL PROCEDURES W CC W MAJOR GI DX                              243,246      241,466        208           15          15
  2007        2       570   MAJOR SMALL & LARGE BOWEL PROCEDURES W CC W/O MAJOR GI DX                            199,579      197,959        162           15          15
  2007        2       571   MAJOR ESOPHAGEAL DISORDERS                                                            32,503       32,243          26           6           6
  2007        2       572   MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS                            63,715       63,515          51           8           8
  2007        2       573   MAJOR BLADDER PROCEDURES                                                              21,429       21,349          17           2           2
  2007        2       574   MAJOR HEMATOLOGIC/IMMUNOLOGIC DIAG EXC SICKLE CELL CRISIS & COAGUL                   186,059      185,309        177           30          30
  2007        2       575   SEPTICEMIA W MV96+ HOURS AGE >17                                                      32,718       32,468          25           2           2
  2007        2       576   SEPTICEMIA W/O MV96+ HOURS AGE >17                                                   397,037      393,817        322           41          39
  2007        2       578   INFECTIOUS & PARASITIC DISEASES W OR PROCEDURE                                       209,265      208,315        169           11          11
  2007        2       579   POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS W OR PROCEDURE                             84,555       84,015          67           6           6
  2007        3       000   Unknown                                                                            1,294,444    1,288,714        832          172         172
  2007        3       001   CRANIOTOMY AGE >17 W CC                                                              105,406      104,586          82          12          12




5/15/2012                                                                            Milliman                                                                               Page 8
                                                                                   DRG Distribution




                                                            Inpatient Claims by Diagnosis-Related Group Code
                     DRG                                              DRG                                       Allowed         Paid   Inpatient   Discharge   Admission
  Year      Region   Code                                          Description                                  Charges       Claims      Days         Count      Count
  2007        3       002   CRANIOTOMY AGE >17 W/O CC                                                             48,008      47,608          40          11          11
  2007        3       003   CRANIOTOMY AGE 0-17                                                                  368,022     368,022        293           29          29
  2007        3       007   PERIPH & CRANIAL NERVE & OTHER NERV SYST PROC W CC                                    73,303      72,813          59           7           7
  2007        3       008   PERIPH & CRANIAL NERVE & OTHER NERV SYST PROC W/O CC                                  17,065      16,965          14           6           6
  2007        3       009   SPINAL DISORDERS & INJURIES                                                           75,066      74,456          61           6           6
  2007        3       010   NERVOUS SYSTEM NEOPLASMS W CC                                                         72,860      72,460          56          13          13
  2007        3       011   NERVOUS SYSTEM NEOPLASMS W/O CC                                                       19,454      19,264          21           6           6
  2007        3       012   DEGENERATIVE NERVOUS SYSTEM DISORDERS                                                 51,894      51,794          40           4           4
  2007        3       013   MULTIPLE SCLEROSIS & CEREBELLAR ATAXIA                                                29,220      29,010          26           7           7
  2007        3       014   INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION                                       437,699     434,119        369           60          58
  2007        3       015   NONSPECIFIC CVA & PRECEREBRAL OCCLUSION W/O INFARCT                                    9,078       9,008           7           2           2
  2007        3       016   NONSPECIFIC CEREBROVASCULAR DISORDERS W CC                                            27,830      27,650          20           2           2
  2007        3       018   CRANIAL & PERIPHERAL NERVE DISORDERS W CC                                            164,380     163,200        129           31          31
  2007        3       019   CRANIAL & PERIPHERAL NERVE DISORDERS W/O CC                                           48,677      48,287          43          13          13
  2007        3       021   VIRAL MENINGITIS                                                                      59,315      58,955          41           6           6
  2007        3       022   HYPERTENSIVE ENCEPHALOPATHY                                                            2,420       2,400           2           1           1
  2007        3       023   NONTRAUMATIC STUPOR & COMA                                                            29,953      29,753          23           7           7
  2007        3       026   SEIZURE & HEADACHE AGE 0-17                                                          151,411     151,411        125           59          59
  2007        3       027   TRAUMATIC STUPOR & COMA, COMA >1 HR                                                   35,108      34,858          27           4           4
  2007        3       028   TRAUMATIC STUPOR & COMA, COMA <1 HR AGE >17 W CC                                      31,578      31,338          24           3           3
  2007        3       030   TRAUMATIC STUPOR & COMA, COMA <1 HR AGE 0-17                                           2,591       2,591           2           1           1
  2007        3       031   CONCUSSION AGE >17 W CC                                                               35,254      34,974          28           2           2
  2007        3       033   CONCUSSION AGE 0-17                                                                    4,893       4,893           4           2           2
  2007        3       034   OTHER DISORDERS OF NERVOUS SYSTEM W CC                                               108,479     107,859        104           18          18
  2007        3       035   OTHER DISORDERS OF NERVOUS SYSTEM W/O CC                                              38,304      38,304          30           6           6
  2007        3       037   ORBITAL PROCEDURES                                                                     2,048       2,028           2           1           1
  2007        3       042   INTRAOCULAR PROCEDURES EXCEPT RETINA, IRIS & LENS                                     12,912      12,812          10           1           1
  2007        3       044   ACUTE MAJOR EYE INFECTIONS                                                            12,578      12,478          13           2           2
  2007        3       045   NEUROLOGICAL EYE DISORDERS                                                             2,582       2,562           2           1           1
  2007        3       046   OTHER DISORDERS OF THE EYE AGE >17 W CC                                                7,085       7,035           5           2           2
  2007        3       047   OTHER DISORDERS OF THE EYE AGE >17 W/O CC                                              7,612       7,552           6           2           2
  2007        3       048   OTHER DISORDERS OF THE EYE AGE 0-17                                                    1,613       1,613           2           1           1
  2007        3       049   MAJOR HEAD & NECK PROCEDURES                                                           1,278       1,278           1           1           1
  2007        3       052   CLEFT LIP & PALATE REPAIR                                                              4,019       4,019           6           3           3
  2007        3       053   SINUS & MASTOID PROCEDURES AGE >17                                                     8,948       8,878           7           1           1
  2007        3       054   SINUS & MASTOID PROCEDURES AGE 0-17                                                   13,280      13,280          10           3           3
  2007        3       056   RHINOPLASTY                                                                            1,278       1,278           1           1           1
  2007        3       057   T&A PROC, EXCEPT TONSILLECTOMY &/OR ADENOIDECTOMY ONLY, AGE >17                        2,787       2,787           2           1           1
  2007        3       058   T&A PROC, EXCEPT TONSILLECTOMY &/OR ADENOIDECTOMY ONLY, AGE 0-17                       2,714       2,714           2           1           1
  2007        3       060   TONSILLECTOMY &/OR ADENOIDECTOMY ONLY, AGE 0-17                                        1,278       1,278           1           1           1
  2007        3       061   MYRINGOTOMY W TUBE INSERTION AGE >17                                                   7,670       7,610           6           1           1
  2007        3       062   MYRINGOTOMY W TUBE INSERTION AGE 0-17                                                  7,590       7,590           6           3           3
  2007        3       063   OTHER EAR, NOSE, MOUTH & THROAT O.R. PROCEDURES                                       36,978      36,728          30           9           9
  2007        3       064   EAR, NOSE, MOUTH & THROAT MALIGNANCY                                                  44,132      43,772          36           6           6
  2007        3       065   DYSEQUILIBRIUM                                                                        28,305      28,095          21           9           9
  2007        3       066   EPISTAXIS                                                                              7,840       7,780           6           1           1
  2007        3       067   EPIGLOTTITIS                                                                           7,136       7,086           5           1           1
  2007        3       068   OTITIS MEDIA & URI AGE >17 W CC                                                       40,367      39,937          43          13          13
  2007        3       069   OTITIS MEDIA & URI AGE >17 W/O CC                                                      8,348       8,238          11           5           5
  2007        3       070   OTITIS MEDIA & URI AGE 0-17                                                           94,780      94,780          82          29          29
  2007        3       071   LARYNGOTRACHEITIS                                                                      1,059       1,059           1           1           1
  2007        3       072   NASAL TRAUMA & DEFORMITY                                                               2,613       2,593           2           1           1
  2007        3       073   OTHER EAR, NOSE, MOUTH & THROAT DIAGNOSES AGE >17                                     40,668      40,388          28           6           6
  2007        3       074   OTHER EAR, NOSE, MOUTH & THROAT DIAGNOSES AGE 0-17                                     2,557       2,557           2           1           1
  2007        3       075   MAJOR CHEST PROCEDURES                                                               242,295     240,925        182           15          15
  2007        3       076   OTHER RESP SYSTEM O.R. PROCEDURES W CC                                               130,960     130,160          99          10          10
  2007        3       077   OTHER RESP SYSTEM O.R. PROCEDURES W/O CC                                              18,953      18,793          16           2           2
  2007        3       078   PULMONARY EMBOLISM                                                                   113,928     112,978          95          13          12
  2007        3       079   RESPIRATORY INFECTIONS & INFLAMMATIONS AGE >17 W CC                                  172,040     170,720        132           18          18
  2007        3       080   RESPIRATORY INFECTIONS & INFLAMMATIONS AGE >17 W/O CC                                  6,209       6,139           7           1           1
  2007        3       081   RESPIRATORY INFECTIONS & INFLAMMATIONS AGE 0-17                                       55,494      55,494          80          13          13
  2007        3       082   RESPIRATORY NEOPLASMS                                                                263,005     260,915        217           32          31
  2007        3       083   MAJOR CHEST TRAUMA W CC                                                                7,840       7,780           6           1           1
  2007        3       085   PLEURAL EFFUSION W CC                                                                119,461     118,681          89          13          13
  2007        3       086   PLEURAL EFFUSION W/O CC                                                               16,692      16,602          13           3           3
  2007        3       087   PULMONARY EDEMA & RESPIRATORY FAILURE                                                332,199     330,289        322           40          40
  2007        3       088   CHRONIC OBSTRUCTIVE PULMONARY DISEASE                                              1,057,291   1,048,901        865          218         218
  2007        3       089   SIMPLE PNEUMONIA & PLEURISY AGE >17 W CC                                             696,821     691,131        569          125         125
  2007        3       090   SIMPLE PNEUMONIA & PLEURISY AGE >17 W/O CC                                           110,039     109,129          91          20          20
  2007        3       091   SIMPLE PNEUMONIA & PLEURISY AGE 0-17                                                 413,335     413,335        352           91          91
  2007        3       092   INTERSTITIAL LUNG DISEASE W CC                                                        52,245      51,885          40          11          11
  2007        3       093   INTERSTITIAL LUNG DISEASE W/O CC                                                       7,981       7,981          41           1           1
  2007        3       094   PNEUMOTHORAX W CC                                                                     48,190      47,930          40          10          10
  2007        3       095   PNEUMOTHORAX W/O CC                                                                   14,756      14,646          11           2           2
  2007        3       096   BRONCHITIS & ASTHMA AGE >17 W CC                                                     212,447     210,757        169           42          42
  2007        3       097   BRONCHITIS & ASTHMA AGE >17 W/O CC                                                   185,318     183,778        154           54          54
  2007        3       098   BRONCHITIS & ASTHMA AGE 0-17                                                         354,100     354,100        291           93          93
  2007        3       099   RESPIRATORY SIGNS & SYMPTOMS W CC                                                     92,137      91,547          75          19          19
  2007        3       100   RESPIRATORY SIGNS & SYMPTOMS W/O CC                                                  488,835     488,635        389           22           8
  2007        3       101   OTHER RESPIRATORY SYSTEM DIAGNOSES W CC                                              124,193     124,033        167           18          18
  2007        3       102   OTHER RESPIRATORY SYSTEM DIAGNOSES W/O CC                                             24,069      23,949          17           5           5
  2007        3       105   CARDIAC VALVE & OTH MAJOR CARDIOTHORACIC PROC W/O CARD CATH                          102,388     101,668          84           9           9
  2007        3       108   OTHER CARDIOTHORACIC PROCEDURES                                                      117,233     117,163          97           7           7
  2007        3       110   MAJOR CARDIOVASCULAR PROCEDURES W CC                                                 165,522     164,582        133           17          17
  2007        3       111   MAJOR CARDIOVASCULAR PROCEDURES W/O CC                                                 1,291       1,281           1           1           1
  2007        3       113   AMPUTATION FOR CIRC SYSTEM DISORDERS EXCEPT UPPER LIMB & TOE                         142,701     141,591        119           14          14
  2007        3       114   UPPER LIMB & TOE AMPUTATION FOR CIRC SYSTEM DISORDERS                                 27,716      27,516          23           4           4
  2007        3       117   CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT                                   1,236       1,226           1           1           1
  2007        3       118   CARDIAC PACEMAKER DEVICE REPLACEMENT                                                   1,196       1,186           1           1           1
  2007        3       120   OTHER CIRCULATORY SYSTEM O.R. PROCEDURES                                             146,050     144,910        114           12          12
  2007        3       121   CIRCULATORY DISORDERS W AMI & MAJOR COMP, DISCHARGED ALIVE                           238,408     236,548        186           30          30
  2007        3       122   CIRCULATORY DISORDERS W AMI W/O MAJOR COMP, DISCHARGED ALIVE                          62,535      62,015          52          18          18
  2007        3       123   CIRCULATORY DISORDERS W AMI, EXPIRED                                                     830         820           1           1           1
  2007        3       124   CIRCULATORY DISORDERS EXCEPT AMI, W CARD CATH & COMPLEX DIAG                         204,754     203,164        163           43          43
  2007        3       125   CIRCULATORY DISORDERS EXCEPT AMI, W CARD CATH W/O COMPLEX DIAG                       173,972     172,802        147           39          39
  2007        3       126   ACUTE & SUBACUTE ENDOCARDITIS                                                         69,833      69,323          51           3           3
  2007        3       127   HEART FAILURE & SHOCK                                                              1,227,638   1,217,988      1,016          226         226
  2007        3       128   DEEP VEIN THROMBOPHLEBITIS                                                             1,706       1,686           2           1           1
  2007        3       129   CARDIAC ARREST, UNEXPLAINED                                                            3,754       3,724           3           2           2
  2007        3       130   PERIPHERAL VASCULAR DISORDERS W CC                                                   125,747     124,757        113           23          23
  2007        3       131   PERIPHERAL VASCULAR DISORDERS W/O CC                                                  64,431      63,951          48          14          14
  2007        3       132   ATHEROSCLEROSIS W CC                                                                  91,487      90,697          79          30          30
  2007        3       133   ATHEROSCLEROSIS W/O CC                                                                15,074      14,944          13           6           6
  2007        3       134   HYPERTENSION                                                                         194,862     193,222        164           50          50
  2007        3       135   CARDIAC CONGENITAL & VALVULAR DISORDERS AGE >17 W CC                                   7,477       7,417           6           2           1
  2007        3       136   CARDIAC CONGENITAL & VALVULAR DISORDERS AGE >17 W/O CC                                 1,164       1,154           1           1           1




5/15/2012                                                                              Milliman                                                                            Page 9
                                                                                 DRG Distribution




                                                           Inpatient Claims by Diagnosis-Related Group Code
                     DRG                                                DRG                                   Allowed       Paid   Inpatient   Discharge   Admission
  Year      Region   Code                                            Description                              Charges     Claims      Days         Count      Count
  2007        3       137   CARDIAC CONGENITAL & VALVULAR DISORDERS AGE 0-17                                    86,366    86,366          73           8           8
  2007        3       138   CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS W CC                                     174,277   172,967        138           36          36
  2007        3       139   CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS W/O CC                                    75,222    74,732          58          21          21
  2007        3       140   ANGINA PECTORIS                                                                     57,528    56,868          66          20          20
  2007        3       141   SYNCOPE & COLLAPSE W CC                                                             64,848    64,338          56          21          21
  2007        3       142   SYNCOPE & COLLAPSE W/O CC                                                           21,668    21,488          18           9           9
  2007        3       143   CHEST PAIN                                                                         492,750   488,800        395          179         179
  2007        3       144   OTHER CIRCULATORY SYSTEM DIAGNOSES W CC                                            486,514   483,204        382           69          69
  2007        3       145   OTHER CIRCULATORY SYSTEM DIAGNOSES W/O CC                                           46,228    45,918          38           8           8
  2007        3       147   RECTAL RESECTION W/O CC                                                              1,201     1,191           1           1           1
  2007        3       149   MAJOR SMALL & LARGE BOWEL PROCEDURES W/O CC                                         71,878    71,268          61          11          11
  2007        3       150   PERITONEAL ADHESIOLYSIS W CC                                                        54,455    53,945          51           7           7
  2007        3       151   PERITONEAL ADHESIOLYSIS W/O CC                                                      29,908    29,718          29           6           6
  2007        3       153   MINOR SMALL & LARGE BOWEL PROCEDURES W/O CC                                          6,751     6,691           6           1           1
  2007        3       155   STOMACH, ESOPHAGEAL & DUODENAL PROCEDURES AGE >17 W/O CC                             5,894     5,844           5           2           2
  2007        3       156   STOMACH, ESOPHAGEAL & DUODENAL PROCEDURES AGE 0-17                                  84,739    84,739          72          11          11
  2007        3       157   ANAL & STOMAL PROCEDURES W CC                                                       41,735    41,465          27           3           3
  2007        3       158   ANAL & STOMAL PROCEDURES W/O CC                                                     38,608    38,308          33           6           6
  2007        3       159   HERNIA PROCEDURES EXCEPT INGUINAL & FEMORAL AGE >17 W CC                            12,605    12,515           9           2           2
  2007        3       160   HERNIA PROCEDURES EXCEPT INGUINAL & FEMORAL AGE >17 W/O CC                          30,921    30,661          26          11          11
  2007        3       161   INGUINAL & FEMORAL HERNIA PROCEDURES AGE >17 W CC                                   16,830    16,680          15           2           2
  2007        3       162   INGUINAL & FEMORAL HERNIA PROCEDURES AGE >17 W/O CC                                  2,922     2,902           2           1           1
  2007        3       163   HERNIA PROCEDURES AGE 0-17                                                          11,503    11,503          14           5           5
  2007        3       165   APPENDECTOMY W COMPLICATED PRINCIPAL DIAG W/O CC                                    16,957    16,857          16           2           2
  2007        3       166   APPENDECTOMY W/O COMPLICATED PRINCIPAL DIAG W CC                                    19,937    19,797          16           4           4
  2007        3       167   APPENDECTOMY W/O COMPLICATED PRINCIPAL DIAG W/O CC                                  32,970    32,860          26          11          11
  2007        3       169   MOUTH PROCEDURES W/O CC                                                              6,493     6,433           6           2           2
  2007        3       170   OTHER DIGESTIVE SYSTEM O.R. PROCEDURES W CC                                        170,409   169,489        129           11          10
  2007        3       171   OTHER DIGESTIVE SYSTEM O.R. PROCEDURES W/O CC                                        4,322     4,292           3           1           1
  2007        3       172   DIGESTIVE MALIGNANCY W CC                                                          130,132   129,082        105           17          17
  2007        3       173   DIGESTIVE MALIGNANCY W/O CC                                                         29,233    29,003          23           6           6
  2007        3       174   G.I. HEMORRHAGE W CC                                                               241,460   239,550        201           50          50
  2007        3       175   G.I. HEMORRHAGE W/O CC                                                              68,855    68,335          52          18          17
  2007        3       176   COMPLICATED PEPTIC ULCER                                                             5,652     5,612           4           1           1
  2007        3       177   UNCOMPLICATED PEPTIC ULCER W CC                                                     23,118    22,958          16           5           5
  2007        3       178   UNCOMPLICATED PEPTIC ULCER W/O CC                                                   22,937    22,737          20           6           6
  2007        3       179   INFLAMMATORY BOWEL DISEASE                                                          85,509    84,849          68          16          16
  2007        3       180   G.I. OBSTRUCTION W CC                                                               83,689    83,049          68          20          20
  2007        3       181   G.I. OBSTRUCTION W/O CC                                                             28,377    28,217          23           8           8
  2007        3       182   ESOPHAGITIS, GASTROENT & MISC DIGEST DISORDERS AGE >17 W CC                        630,152   624,902        525          145         144
  2007        3       183   ESOPHAGITIS, GASTROENT & MISC DIGEST DISORDERS AGE >17 W/O CC                      334,846   332,126        272           92          92
  2007        3       184   ESOPHAGITIS, GASTROENT & MISC DIGEST DISORDERS AGE 0-17                            138,898   138,898        121           46          46
  2007        3       185   DENTAL & ORAL DIS EXCEPT EXTRACTIONS & RESTORATIONS, AGE >17                         7,809     7,749           6           2           2
  2007        3       186   DENTAL & ORAL DIS EXCEPT EXTRACTIONS & RESTORATIONS, AGE 0-17                       25,419    25,419          21           4           4
  2007        3       187   DENTAL EXTRACTIONS & RESTORATIONS                                                    2,557     2,537           2           1           1
  2007        3       188   OTHER DIGESTIVE SYSTEM DIAGNOSES AGE >17 W CC                                       62,752    62,162          59          16          16
  2007        3       189   OTHER DIGESTIVE SYSTEM DIAGNOSES AGE >17 W/O CC                                     18,553    18,413          14           5           5
  2007        3       190   OTHER DIGESTIVE SYSTEM DIAGNOSES AGE 0-17                                           22,909    22,909          18           6           6
  2007        3       191   PANCREAS, LIVER & SHUNT PROCEDURES W CC                                             87,248    86,858          67           7           6
  2007        3       192   PANCREAS, LIVER & SHUNT PROCEDURES W/O CC                                           16,219    16,089          13           2           2
  2007        3       194   BILIARY TRACT PROC EXCEPT ONLY CHOLECYST W OR W/O C.D.E. W/O CC                      3,631     3,601           3           1           1
  2007        3       197   CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE W/O C.D.E. W CC                               52,835    52,445          39           8           8
  2007        3       198   CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE W/O C.D.E. W/O CC                             24,852    24,652          20           6           6
  2007        3       200   HEPATOBILIARY DIAGNOSTIC PROCEDURE FOR NON-MALIGNANCY                                6,981     6,921           6           2           2
  2007        3       202   CIRRHOSIS & ALCOHOLIC HEPATITIS                                                    283,666   281,456        224           44          44
  2007        3       203   MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS                                      88,542    87,782          79          14          14
  2007        3       204   DISORDERS OF PANCREAS EXCEPT MALIGNANCY                                            518,481   515,381        423           84          83
  2007        3       205   DISORDERS OF LIVER EXCEPT MALIG,CIRR,ALC HEPA W CC                                 304,557   302,457        230           40          40
  2007        3       206   DISORDERS OF LIVER EXCEPT MALIG,CIRR,ALC HEPA W/O CC                                18,606    18,476          14           6           6
  2007        3       207   DISORDERS OF THE BILIARY TRACT W CC                                                 36,168    35,868          33           9           9
  2007        3       208   DISORDERS OF THE BILIARY TRACT W/O CC                                                9,773     9,693           8           4           4
  2007        3       210   HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT AGE >17 W CC                             103,849   103,129          78          12          12
  2007        3       211   HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT AGE >17 W/O CC                            74,517    74,027          49           6           6
  2007        3       212   HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT AGE 0-17                                  15,736    15,736          12           5           5
  2007        3       213   AMPUTATION FOR MUSCULOSKELETAL SYSTEM & CONN TISSUE DISORDERS                       47,683    47,313          37           5           5
  2007        3       216   BIOPSIES OF MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE                              13,633    13,553          11           2           2
  2007        3       217   WND DEBRID & SKN GRFT EXCEPT HAND,FOR MUSCSKELET & CONN TISS DIS                    49,195    48,765          43           8           8
  2007        3       218   LOWER EXTREM & HUMER PROC EXCEPT HIP,FOOT,FEMUR AGE >17 W CC                       114,949   114,039          91          10          10
  2007        3       219   LOWER EXTREM & HUMER PROC EXCEPT HIP,FOOT,FEMUR AGE >17 W/O CC                      37,008    36,708          30          14          14
  2007        3       220   LOWER EXTREM & HUMER PROC EXCEPT HIP,FOOT,FEMUR AGE 0-17                            12,689    12,689          10           4           4
  2007        3       223   MAJOR SHOULDER/ELBOW PROC, OR OTHER UPPER EXTREMITY PROC W CC                       52,307    52,217          36           5           5
  2007        3       224   SHOULDER,ELBOW OR FOREARM PROC,EXC MAJOR JOINT PROC, W/O CC                         11,390    11,300           9           4           4
  2007        3       225   FOOT PROCEDURES                                                                     23,152    23,002          17           7           7
  2007        3       226   SOFT TISSUE PROCEDURES W CC                                                         26,944    26,734          21           3           3
  2007        3       227   SOFT TISSUE PROCEDURES W/O CC                                                        7,779     7,719           6           3           3
  2007        3       228   MAJOR THUMB OR JOINT PROC,OR OTH HAND OR WRIST PROC W CC                             2,854     2,834           2           1           1
  2007        3       230   LOCAL EXCISION & REMOVAL OF INT FIX DEVICES OF HIP & FEMUR                         109,559   109,079          82           6           6
  2007        3       233   OTHER MUSCULOSKELET SYS & CONN TISS O.R. PROC W CC                                  16,509    16,449          13           6           6
  2007        3       234   OTHER MUSCULOSKELET SYS & CONN TISS O.R. PROC W/O CC                                28,614    28,414          22           5           5
  2007        3       235   FRACTURES OF FEMUR                                                                   3,709     3,679           3           1           1
  2007        3       236   FRACTURES OF HIP & PELVIS                                                           38,075    37,755          32           6           5
  2007        3       238   OSTEOMYELITIS                                                                       28,283    28,053          23           4           4
  2007        3       239   PATHOLOGICAL FRACTURES & MUSCULOSKELETAL & CONN TISS MALIGNANCY                     97,654    96,964          75           9           9
  2007        3       240   CONNECTIVE TISSUE DISORDERS W CC                                                    31,076    30,856          22           4           4
  2007        3       241   CONNECTIVE TISSUE DISORDERS W/O CC                                                  12,895    12,795          10           2           2
  2007        3       242   SEPTIC ARTHRITIS                                                                    12,493    12,433           9           3           3
  2007        3       243   MEDICAL BACK PROBLEMS                                                              125,425   124,435          99          26          25
  2007        3       244   BONE DISEASES & SPECIFIC ARTHROPATHIES W CC                                         49,879    49,439          44          12          11
  2007        3       245   BONE DISEASES & SPECIFIC ARTHROPATHIES W/O CC                                       20,696    20,526          17           6           6
  2007        3       247   SIGNS & SYMPTOMS OF MUSCULOSKELETAL SYSTEM & CONN TISSUE                            40,348    40,048          30           7           7
  2007        3       248   TENDONITIS, MYOSITIS & BURSITIS                                                     17,527    17,387          14           3           3
  2007        3       249   AFTERCARE, MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE                                6,651     6,631           5           4           4
  2007        3       251   FX, SPRN, STRN & DISL OF FOREARM, HAND, FOOT AGE >17 W/O CC                          3,920     3,890           3           1           1
  2007        3       253   FX, SPRN, STRN & DISL OF UPARM,LOWLEG EX FOOT AGE >17 W CC                          22,154    21,984          17           4           4
  2007        3       254   FX, SPRN, STRN & DISL OF UPARM,LOWLEG EX FOOT AGE >17 W/O CC                        10,587    10,517           7           3           3
  2007        3       255   FX, SPRN, STRN & DISL OF UPARM,LOWLEG EX FOOT AGE 0-17                               3,281     3,281           2           2           2
  2007        3       256   OTHER MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE DIAGNOSES                          57,931    57,521          44           6           6
  2007        3       257   TOTAL MASTECTOMY FOR MALIGNANCY W CC                                                35,298    34,988          31           9           9
  2007        3       258   TOTAL MASTECTOMY FOR MALIGNANCY W/O CC                                              44,814    44,444          37          19          19
  2007        3       260   SUBTOTAL MASTECTOMY FOR MALIGNANCY W/O CC                                            2,922     2,902           2           1           1
  2007        3       261   BREAST PROC FOR NON-MALIGNANCY EXCEPT BIOPSY & LOCAL EXCISION                        5,267     5,227           4           2           2
  2007        3       263   SKIN GRAFT &/OR DEBRID FOR SKN ULCER OR CELLULITIS W CC                            100,634   100,064          74           8           8
  2007        3       264   SKIN GRAFT &/OR DEBRID FOR SKN ULCER OR CELLULITIS W/O CC                           43,039    42,779          29           4           4
  2007        3       265   SKIN GRAFT &/OR DEBRID EXCEPT FOR SKIN ULCER OR CELLULITIS W CC                     14,508    14,398          11           2           2
  2007        3       268   SKIN, SUBCUTANEOUS TISSUE & BREAST PLASTIC PROCEDURES                               12,037    11,947           9           2           2
  2007        3       269   OTHER SKIN, SUBCUT TISS & BREAST PROC W CC                                          79,362    78,762          60          12          12




5/15/2012                                                                            Milliman                                                                          Page 10
                                                                                 DRG Distribution




                                                           Inpatient Claims by Diagnosis-Related Group Code
                     DRG                                               DRG                                     Allowed         Paid   Inpatient   Discharge   Admission
  Year      Region   Code                                           Description                                Charges       Claims      Days         Count      Count
  2007        3       270   OTHER SKIN, SUBCUT TISS & BREAST PROC W/O CC                                         21,562      21,442          18           7           7
  2007        3       271   SKIN ULCERS                                                                         106,281     105,481          98          12          12
  2007        3       272   MAJOR SKIN DISORDERS W CC                                                             1,236       1,226           1           1           1
  2007        3       273   MAJOR SKIN DISORDERS W/O CC                                                           3,376       3,346           3           1           1
  2007        3       274   MALIGNANT BREAST DISORDERS W CC                                                       2,421       2,391           3           1           1
  2007        3       276   NON-MALIGNANT BREAST DISORDERS                                                       16,009      15,819          26           6           6
  2007        3       277   CELLULITIS AGE >17 W CC                                                             400,784     397,294        349           68          68
  2007        3       278   CELLULITIS AGE >17 W/O CC                                                           323,197     320,517        270           61          61
  2007        3       279   CELLULITIS AGE 0-17                                                                  73,172      73,172          60          21          21
  2007        3       280   TRAUMA TO THE SKIN, SUBCUT TISS & BREAST AGE >17 W CC                                31,293      31,033          26           7           7
  2007        3       281   TRAUMA TO THE SKIN, SUBCUT TISS & BREAST AGE >17 W/O CC                              16,025      15,885          14           7           7
  2007        3       283   MINOR SKIN DISORDERS W CC                                                            76,369      75,879          65          11          10
  2007        3       284   MINOR SKIN DISORDERS W/O CC                                                          14,723      14,603          12           4           4
  2007        3       285   AMPUTAT OF LOWER LIMB FOR ENDOCRINE,NUTRIT,& METABOL DISORDERS                       18,430      18,270          16           3           3
  2007        3       286   ADRENAL & PITUITARY PROCEDURES                                                       21,179      21,179          17           3           3
  2007        3       287   SKIN GRAFTS & WOUND DEBRID FOR ENDOC, NUTRIT & METAB DISORDERS                       23,882      23,672          21           5           4
  2007        3       288   O.R. PROCEDURES FOR OBESITY                                                           3,751       3,721           3           2           2
  2007        3       289   PARATHYROID PROCEDURES                                                                3,770       3,740           3           2           2
  2007        3       290   THYROID PROCEDURES                                                                   20,208      20,048          16           9           9
  2007        3       292   OTHER ENDOCRINE, NUTRIT & METAB O.R. PROC W CC                                       47,485      47,105          38           5           5
  2007        3       293   OTHER ENDOCRINE, NUTRIT & METAB O.R. PROC W/O CC                                      6,533       6,483           5           2           2
  2007        3       294   DIABETES AGE >35                                                                    377,412     374,092        332           86          86
  2007        3       295   DIABETES AGE 0-35                                                                   175,930     175,000        147           54          54
  2007        3       296   NUTRITIONAL & MISC METABOLIC DISORDERS AGE >17 W CC                                 399,791     396,271        352           83          83
  2007        3       297   NUTRITIONAL & MISC METABOLIC DISORDERS AGE >17 W/O CC                                87,318      86,538          78          24          24
  2007        3       298   NUTRITIONAL & MISC METABOLIC DISORDERS AGE 0-17                                     206,168     206,168        167           39          39
  2007        3       299   INBORN ERRORS OF METABOLISM                                                          25,482      25,342          20           4           4
  2007        3       300   ENDOCRINE DISORDERS W CC                                                             54,983      54,613          42          12          12
  2007        3       301   ENDOCRINE DISORDERS W/O CC                                                            1,307       1,297           1           1           1
  2007        3       302   KIDNEY TRANSPLANT                                                                    26,373      26,243          19           2           2
  2007        3       303   KIDNEY,URETER & MAJOR BLADDER PROCEDURES FOR NEOPLASM                                29,604      29,404          27           7           7
  2007        3       304   KIDNEY,URETER & MAJOR BLADDER PROC FOR NON-NEOPL W CC                                80,644      79,994          65           8           8
  2007        3       305   KIDNEY,URETER & MAJOR BLADDER PROC FOR NON-NEOPL W/O CC                               6,391       6,341           5           1           1
  2007        3       310   TRANSURETHRAL PROCEDURES W CC                                                        22,192      22,012          18           6           6
  2007        3       311   TRANSURETHRAL PROCEDURES W/O CC                                                       2,849       2,819           3           2           2
  2007        3       315   OTHER KIDNEY & URINARY TRACT O.R. PROCEDURES                                         72,526      72,036          52           9           9
  2007        3       316   RENAL FAILURE                                                                       547,304     543,214        425           79          79
  2007        3       318   KIDNEY & URINARY TRACT NEOPLASMS W CC                                                29,335      29,155          25           2           2
  2007        3       320   KIDNEY & URINARY TRACT INFECTIONS AGE >17 W CC                                      356,545     353,505        307           74          74
  2007        3       321   KIDNEY & URINARY TRACT INFECTIONS AGE >17 W/O CC                                     71,129      70,489          64          17          17
  2007        3       322   KIDNEY & URINARY TRACT INFECTIONS AGE 0-17                                           63,460      63,460          51          15          15
  2007        3       323   URINARY STONES W CC, &/OR ESW LITHOTRIPSY                                            26,402      26,202          20           8           8
  2007        3       324   URINARY STONES W/O CC                                                                10,206      10,146           6           3           3
  2007        3       325   KIDNEY & URINARY TRACT SIGNS & SYMPTOMS AGE >17 W CC                                 20,429      20,289          14           2           2
  2007        3       326   KIDNEY & URINARY TRACT SIGNS & SYMPTOMS AGE >17 W/O CC                                2,826       2,806           2           1           1
  2007        3       331   OTHER KIDNEY & URINARY TRACT DIAGNOSES AGE >17 W CC                                 115,882     115,012          87          15          15
  2007        3       332   OTHER KIDNEY & URINARY TRACT DIAGNOSES AGE >17 W/O CC                                 7,839       7,779           6           2           2
  2007        3       333   OTHER KIDNEY & URINARY TRACT DIAGNOSES AGE 0-17                                      41,277      41,277          28           6           6
  2007        3       334   MAJOR MALE PELVIC PROCEDURES W CC                                                     6,319       6,269           5           1           1
  2007        3       335   MAJOR MALE PELVIC PROCEDURES W/O CC                                                   7,957       7,897           6           4           4
  2007        3       336   TRANSURETHRAL PROSTATECTOMY W CC                                                      3,542       3,512           3           2           2
  2007        3       337   TRANSURETHRAL PROSTATECTOMY W/O CC                                                    1,444       1,434           1           1           1
  2007        3       340   TESTES PROCEDURES, NON-MALIGNANCY AGE 0-17                                            1,476       1,476           1           1           1
  2007        3       341   PENIS PROCEDURES                                                                     17,897      17,787          11           1           1
  2007        3       346   MALIGNANCY, MALE REPRODUCTIVE SYSTEM, W CC                                           13,527      13,427          10           2           2
  2007        3       348   BENIGN PROSTATIC HYPERTROPHY W CC                                                     2,661       2,631           3           1           1
  2007        3       350   INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM                                         10,546      10,486           9           4           4
  2007        3       352   OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES                                             14,679      14,559          12           5           5
  2007        3       353   PELVIC EVISCERATION, RADICAL HYSTERECTOMY & RADICAL VULVECTOMY                        2,481       2,461           2           1           1
  2007        3       354   UTERINE,ADNEXA PROC FOR NON-OVARIAN/ADNEXAL MALIG W CC                               10,718      10,638           8           1           1
  2007        3       355   UTERINE,ADNEXA PROC FOR NON-OVARIAN/ADNEXAL MALIG W/O CC                             13,181      13,081          10           5           5
  2007        3       356   FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES                                 11,879      11,769          11           5           5
  2007        3       357   UTERINE & ADNEXA PROC FOR OVARIAN OR ADNEXAL MALIGNANCY                               8,174       8,104           7           2           2
  2007        3       358   UTERINE & ADNEXA PROC FOR NON-MALIGNANCY W CC                                        85,499      84,859          69          19          19
  2007        3       359   UTERINE & ADNEXA PROC FOR NON-MALIGNANCY W/O CC                                     150,036     148,866        120           49          49
  2007        3       360   VAGINA, CERVIX & VULVA PROCEDURES                                                    40,000      39,760          30           9           9
  2007        3       363   D&C, CONIZATION & RADIO-IMPLANT, FOR MALIGNANCY                                      29,340      29,100          24           7           7
  2007        3       364   D&C, CONIZATION EXCEPT FOR MALIGNANCY                                                 5,227       5,187           4           2           2
  2007        3       365   OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES                                      4,427       4,397           3           1           1
  2007        3       366   MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM W CC                                          39,811      39,481          33           7           7
  2007        3       367   MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM W/O CC                                         2,573       2,543           3           1           1
  2007        3       368   INFECTIONS, FEMALE REPRODUCTIVE SYSTEM                                               15,878      15,748          13           4           4
  2007        3       369   MENSTRUAL & OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS                               36,671      36,361          33          12          12
  2007        3       370   CESAREAN SECTION W CC                                                               111,436     111,356          91          25          25
  2007        3       371   CESAREAN SECTION W/O CC                                                             170,651     170,521        134           47          47
  2007        3       372   VAGINAL DELIVERY W COMPLICATING DIAGNOSES                                            56,333      56,333          43          17          17
  2007        3       373   VAGINAL DELIVERY W/O COMPLICATING DIAGNOSES                                         245,148     244,988        204           93          93
  2007        3       374   VAGINAL DELIVERY W STERILIZATION &/OR D&C                                            20,140      20,120          15           8           8
  2007        3       375   VAGINAL DELIVERY W O.R. PROC EXCEPT STERIL &/OR D&C                                   2,391       2,391           2           1           1
  2007        3       376   POSTPARTUM & POST ABORTION DIAGNOSES W/O O.R. PROCEDURE                              24,531      24,411          19           6           6
  2007        3       377   POSTPARTUM & POST ABORTION DIAGNOSES W O.R. PROCEDURE                                 2,787       2,787           2           1           1
  2007        3       378   ECTOPIC PREGNANCY                                                                     7,678       7,658           5           2           2
  2007        3       379   THREATENED ABORTION                                                                  21,198      21,128          16           7           7
  2007        3       380   ABORTION W/O D&C                                                                      1,307       1,307           1           1           1
  2007        3       381   ABORTION W D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY                                   8,636       8,636           7           2           2
  2007        3       383   OTHER ANTEPARTUM DIAGNOSES W MEDICAL COMPLICATIONS                                  216,789     215,779        167           42          42
  2007        3       384   OTHER ANTEPARTUM DIAGNOSES W/O MEDICAL COMPLICATIONS                                  2,722       2,722           2           2           2
  2007        3       385   NEONATES, DIED OR TRANSFERRED TO ANOTHER ACUTE CARE FACILITY                         24,199      24,199          21           4           3
  2007        3       386   EXTREME IMMATURITY OR RESPIRATORY DISTRESS SYNDROME, NEONATE                      1,882,996   1,882,996      1,525           72          57
  2007        3       387   PREMATURITY W MAJOR PROBLEMS                                                        136,235     136,235        109           14           4
  2007        3       388   PREMATURITY W/O MAJOR PROBLEMS                                                      110,560     110,560          84           8           8
  2007        3       389   FULL TERM NEONATE W MAJOR PROBLEMS                                                   94,843      94,843          76           5           1
  2007        3       392   SPLENECTOMY AGE >17                                                                  32,841      32,601          24           3           3
  2007        3       394   OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS                           4,376       4,346           3           1           1
  2007        3       395   RED BLOOD CELL DISORDERS AGE >17                                                  1,368,959   1,357,499      1,160          254         253
  2007        3       396   RED BLOOD CELL DISORDERS AGE 0-17                                                   442,225     442,225        372          112         112
  2007        3       397   COAGULATION DISORDERS                                                                95,426      94,846          75          23          23
  2007        3       398   RETICULOENDOTHELIAL & IMMUNITY DISORDERS W CC                                        13,584      13,554          12           3           3
  2007        3       399   RETICULOENDOTHELIAL & IMMUNITY DISORDERS W/O CC                                       7,840       7,780           8           3           3
  2007        3       401   LYMPHOMA & NON-ACUTE LEUKEMIA W OTHER O.R. PROC W CC                                 11,189      11,099           9           2           2
  2007        3       403   LYMPHOMA & NON-ACUTE LEUKEMIA W CC                                                  138,271     137,201        107           16          16
  2007        3       404   LYMPHOMA & NON-ACUTE LEUKEMIA W/O CC                                                  2,765       2,735          13           6           6
  2007        3       405   ACUTE LEUKEMIA W/O MAJOR O.R. PROCEDURE AGE 0-17                                    230,938     230,938        181           18          18
  2007        3       406   MYELOPROLIF DISORD OR POORLY DIFF NEOPL W MAJ O.R.PROC W CC                          20,755      20,605          15           2           2
  2007        3       407   MYELOPROLIF DISORD OR POORLY DIFF NEOPL W MAJ O.R.PROC W/O CC                         1,476       1,466           1           1           1
  2007        3       408   MYELOPROLIF DISORD OR POORLY DIFF NEOPL W OTHER O.R.PROC                             65,003      64,663          51           7           7




5/15/2012                                                                            Milliman                                                                             Page 11
                                                                                 DRG Distribution




                                                           Inpatient Claims by Diagnosis-Related Group Code
                     DRG                                               DRG                                     Allowed         Paid   Inpatient   Discharge   Admission
  Year      Region   Code                                           Description                                Charges       Claims      Days         Count      Count
  2007        3       410   CHEMOTHERAPY W/O ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS                              701,119     696,779        584          180         179
  2007        3       411   HISTORY OF MALIGNANCY W/O ENDOSCOPY                                                  11,373      11,283           9           1           1
  2007        3       413   OTHER MYELOPROLIF DIS OR POORLY DIFF NEOPL DIAG W CC                                 21,416      21,256          16           3           3
  2007        3       414   OTHER MYELOPROLIF DIS OR POORLY DIFF NEOPL DIAG W/O CC                                1,024       1,014           1           1           1
  2007        3       417   SEPTICEMIA AGE 0-17                                                                  27,954      27,954          22           2           2
  2007        3       418   POSTOPERATIVE & POST-TRAUMATIC INFECTIONS                                           111,866     111,066          87          11          11
  2007        3       419   FEVER OF UNKNOWN ORIGIN AGE >17 W CC                                                 43,123      42,793          36           8           8
  2007        3       420   FEVER OF UNKNOWN ORIGIN AGE >17 W/O CC                                               17,950      17,810          14           2           2
  2007        3       421   VIRAL ILLNESS AGE >17                                                                21,428      21,248          18           6           6
  2007        3       422   VIRAL ILLNESS & FEVER OF UNKNOWN ORIGIN AGE 0-17                                     90,220      90,220          80          25          25
  2007        3       423   OTHER INFECTIOUS & PARASITIC DISEASES DIAGNOSES                                      39,754      39,474          33           8           8
  2007        3       424   O.R. PROCEDURE W PRINCIPAL DIAGNOSES OF MENTAL ILLNESS                               19,368      19,368          15           1           1
  2007        3       425   ACUTE ADJUSTMENT REACTION & PSYCHOSOCIAL DYSFUNCTION                                 41,196      40,896          36          14          14
  2007        3       426   DEPRESSIVE NEUROSES                                                                 586,693     583,793        506           83          83
  2007        3       427   NEUROSES EXCEPT DEPRESSIVE                                                          698,244     697,414        544           64          63
  2007        3       428   DISORDERS OF PERSONALITY & IMPULSE CONTROL                                           21,407      21,357          16           2           2
  2007        3       429   ORGANIC DISTURBANCES & MENTAL RETARDATION                                            94,595      94,255          90          10          10
  2007        3       430   PSYCHOSES                                                                         6,697,260   6,650,720      6,191          763         754
  2007        3       431   CHILDHOOD MENTAL DISORDERS                                                        1,769,069   1,768,719      1,664          172         172
  2007        3       432   OTHER MENTAL DISORDER DIAGNOSES                                                      23,520      23,420          18           2           2
  2007        3       433   ALCOHOL/DRUG ABUSE OR DEPENDENCE, LEFT AMA                                           99,231      98,331          93          32          32
  2007        3       439   SKIN GRAFTS FOR INJURIES                                                              2,951       2,931           2           1           1
  2007        3       440   WOUND DEBRIDEMENTS FOR INJURIES                                                       7,172       7,092           8           1           1
  2007        3       441   HAND PROCEDURES FOR INJURIES                                                          3,892       3,872           3           2           2
  2007        3       442   OTHER O.R. PROCEDURES FOR INJURIES W CC                                             141,828     141,398          92           9           9
  2007        3       443   OTHER O.R. PROCEDURES FOR INJURIES W/O CC                                             6,319       6,269           5           1           1
  2007        3       444   TRAUMATIC INJURY AGE >17 W CC                                                        41,108      40,758          35           4           4
  2007        3       445   TRAUMATIC INJURY AGE >17 W/O CC                                                       1,249       1,249           1           1           1
  2007        3       447   ALLERGIC REACTIONS AGE >17                                                            3,222       3,192           3           3           3
  2007        3       449   POISONING & TOXIC EFFECTS OF DRUGS AGE >17 W CC                                     214,136     212,436        171           60          60
  2007        3       450   POISONING & TOXIC EFFECTS OF DRUGS AGE >17 W/O CC                                    93,259      92,659          67          20          20
  2007        3       451   POISONING & TOXIC EFFECTS OF DRUGS AGE 0-17                                          11,898      11,898          10           5           5
  2007        3       452   COMPLICATIONS OF TREATMENT W CC                                                     115,975     115,305          89          19          19
  2007        3       453   COMPLICATIONS OF TREATMENT W/O CC                                                    26,662      26,462          20           4           4
  2007        3       454   OTHER INJURY, POISONING & TOXIC EFFECT DIAG W CC                                      3,594       3,564           3           2           2
  2007        3       455   OTHER INJURY, POISONING & TOXIC EFFECT DIAG W/O CC                                   71,282      71,282          77           6           6
  2007        3       461   O.R. PROC W DIAGNOSES OF OTHER CONTACT W HEALTH SERVICES                              2,613       2,613           2           1           1
  2007        3       462   REHABILITATION                                                                      625,612     620,542        524           61          60
  2007        3       463   SIGNS & SYMPTOMS W CC                                                                74,154      73,474          71          19          19
  2007        3       464   SIGNS & SYMPTOMS W/O CC                                                               7,502       7,432           7           4           4
  2007        3       467   OTHER FACTORS INFLUENCING HEALTH STATUS                                              13,067      13,037          10           2           2
  2007        3       468   EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS                           342,130     339,980        261           35          33
  2007        3       470   UNGROUPABLE                                                                          16,815      16,745          13           4           4
  2007        3       473   ACUTE LEUKEMIA W/O MAJOR O.R. PROCEDURE AGE >17                                      13,822      13,732           9           2           2
  2007        3       477   NON-EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS                       121,634     120,794          94          16          16
  2007        3       479   OTHER VASCULAR PROCEDURES W/O CC                                                     41,108      40,758          35          14          14
  2007        3       481   BONE MARROW TRANSPLANT                                                               94,387      94,187          77           3           3
  2007        3       482   TRACHEOSTOMY FOR FACE,MOUTH & NECK DIAGNOSES                                         68,033      67,683          53           7           7
  2007        3       485   LIMB REATTACHMENT, HIP AND FEMUR PROC FOR MULTIPLE SIGNIFICANT TRA                   79,739      79,119          62           5           5
  2007        3       486   OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA                                98,002      97,222          78           8           8
  2007        3       487   OTHER MULTIPLE SIGNIFICANT TRAUMA                                                    88,268      87,578          72           9           8
  2007        3       488   HIV W EXTENSIVE O.R. PROCEDURE                                                       24,364      24,174          19           2           2
  2007        3       489   HIV W MAJOR RELATED CONDITION                                                       242,599     240,679        192           27          27
  2007        3       490   HIV W OR W/O OTHER RELATED CONDITION                                                 80,289      79,649          64          15          15
  2007        3       492   CHEMOTHERAPY W ACUTE LEUKEMIA OR W USE OF HI DOSE CHEMOAGENT                        135,927     135,607        120           16          16
  2007        3       493   LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W CC                                        179,931     178,801        134           30          30
  2007        3       494   LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W/O CC                                       62,949      62,449          53          17          17
  2007        3       497   SPINAL FUSION EXCEPT CERVICAL W CC                                                   44,506      44,156          35          13          13
  2007        3       498   SPINAL FUSION EXCEPT CERVICAL W/O CC                                                 49,533      49,143          39          14          14
  2007        3       499   BACK & NECK PROCEDURES EXCEPT SPINAL FUSION W CC                                     12,509      12,409          10           7           7
  2007        3       500   BACK & NECK PROCEDURES EXCEPT SPINAL FUSION W/O CC                                   50,702      50,312          39          15          15
  2007        3       501   KNEE PROCEDURES W PDX OF INFECTION W CC                                              15,082      14,942          14           2           2
  2007        3       502   KNEE PROCEDURES W PDX OF INFECTION W/O CC                                            20,033      19,883          15           2           2
  2007        3       509   FULL THICKNESS BURN W/O SKIN GRFT OR INH INJ W/O CC OR SIG TRAUMA                    14,253      14,253          11           1           1
  2007        3       510   NON-EXTENSIVE BURNS W CC OR SIGNIFICANT TRAUMA                                       10,408      10,318           9           1           1
  2007        3       511   NON-EXTENSIVE BURNS W/O CC OR SIGNIFICANT TRAUMA                                     13,439      13,329          11           2           2
  2007        3       515   CARDIAC DEFIBRILLATOR IMPLANT W/O CARDIAC CATH                                      115,272     114,322          95          20          20
  2007        3       518   PERC CARDIO PROC W/O CORONARY ARTERY STENT OR AMI                                   140,431     139,351        110           52          52
  2007        3       519   CERVICAL SPINAL FUSION W CC                                                          32,700      32,440          26          12          12
  2007        3       520   CERVICAL SPINAL FUSION W/O CC                                                        25,204      25,004          20          15          15
  2007        3       521   ALCOHOL/DRUG ABUSE OR DEPENDENCE W CC                                               673,273     666,783        661           94          94
  2007        3       522   ALC/DRUG ABUSE OR DEPEND W REHABILITATION THERAPY W/O CC                            446,368     443,258        443           51          51
  2007        3       523   ALC/DRUG ABUSE OR DEPEND W/O REHABILITATION THERAPY W/O CC                          277,689     275,629        253           45          45
  2007        3       524   TRANSIENT ISCHEMIA                                                                   67,649      66,969          68          22          22
  2007        3       529   VENTRICULAR SHUNT PROCEDURES W CC                                                    12,394      12,264          13           3           3
  2007        3       530   VENTRICULAR SHUNT PROCEDURES W/O CC                                                      20           0           2           1           1
  2007        3       531   SPINAL PROCEDURES W CC                                                               45,837      45,437          40           2           2
  2007        3       532   SPINAL PROCEDURES W/O CC                                                             25,275      25,195          25           5           5
  2007        3       533   EXTRACRANIAL PROCEDURES W CC                                                         42,071      41,741          33           7           7
  2007        3       534   EXTRACRANIAL PROCEDURES W/O CC                                                       21,312      21,142          17           9           9
  2007        3       537   LOCAL EXCIS & REMOV OF INT FIX DEV EXCEPT HIP & FEMUR W CC                           70,352      69,912          44           5           5
  2007        3       538   LOCAL EXCIS & REMOV OF INT FIX DEV EXCEPT HIP & FEMUR W/O CC                         11,879      11,859          12           2           2
  2007        3       540   LYMPHOMA & LEUKEMIA W MAJOR OR PROCEDURE W/O CC                                       2,190       2,170           2           1           1
  2007        3       542   TRACH W MV 96+HRS OR PDX EXC FACE, MOUTH & NECK W/O MAJ O.R.                        219,780     218,040        203           10          10
  2007        3       543   CRANIOTOMY W/IMPLANT OF CHEMO AGENT OR ACUTE COMPLX CNS PDX                          54,623      54,223          40           4           4
  2007        3       544   MAJOR JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY                          376,314     373,474        284           63          63
  2007        3       545   REVISION OF HIP OR KNEE REPLACEMENT                                                  82,939      82,229          71          14          14
  2007        3       546   SPINAL FUSION EXC CERV WITH CURVATURE OF THE SPINE OR MALIG                          31,653      31,653          26           3           3
  2007        3       549   CORONARY BYPASS W/O CARDIAC CATH W MAJOR CV DX                                      136,337     135,197        114           15          15
  2007        3       550   CORONARY BYPASS W/O CARDIAC CATH W/O MAJOR CV DX                                    135,392     134,262        113           17          17
  2007        3       551   PERMANENT CARDIAC PACEMAKER IMPL W MAJ CV DX OR AICD LEAD OR GNRTR                    1,196       1,186           1           1           1
  2007        3       553   OTHER VASCULAR PROCEDURES W CC W MAJOR CV DX                                         63,176      62,646          53          10          10
  2007        3       554   OTHER VASCULAR PROCEDURES W CC W/O MAJOR CV DX                                      103,280     102,450          83          21          21
  2007        3       555   PERCUTANEOUS CARDIOVASCULAR PROC W MAJOR CV DX                                      268,716     266,576        214           42          42
  2007        3       560   BACTERIAL & TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM                                 21,676      21,506          17           3           3
  2007        3       561   NON-BACTERIAL INFECTIONS OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS                   12,571      12,541          10           4           4
  2007        3       562   SEIZURE AGE > 17 W CC                                                               194,322     192,752        157           41          41
  2007        3       563   SEIZURE AGE > 17 W/O CC                                                             103,450     102,620          83          26          26
  2007        3       564   HEADACHES AGE >17                                                                    69,645      69,055          59          19          19
  2007        3       565   RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT 96+ HOURS                      251,384     250,564        219           15          15
  2007        3       566   RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT < 96 HOURS                     336,095     334,535        261           37          37
  2007        3       567   STOMACH, ESOPHAGEAL & DUODENAL PROC AGE > 17 W CC W MAJOR GI DX                      48,263      47,873          39           2           2
  2007        3       568   STOMACH, ESOPHAGEAL & DUODENAL PROCEDURES PROC AGE > 17 W CC W/O MAJOR GI DX         31,378      31,148          23           2           2
  2007        3       569   MAJOR SMALL & LARGE BOWEL PROCEDURES W CC W MAJOR GI DX                             161,193     159,953        124           11          11
  2007        3       570   MAJOR SMALL & LARGE BOWEL PROCEDURES W CC W/O MAJOR GI DX                           139,586     138,506        108           16          15
  2007        3       571   MAJOR ESOPHAGEAL DISORDERS                                                           20,804      20,644          16           6           6




5/15/2012                                                                            Milliman                                                                             Page 12
                                                                                   DRG Distribution




                                                            Inpatient Claims by Diagnosis-Related Group Code
                     DRG                                              DRG                                       Allowed         Paid   Inpatient   Discharge   Admission
  Year      Region   Code                                          Description                                  Charges       Claims      Days         Count      Count
  2007        3       572   MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS                            82,719      82,219          68          12          12
  2007        3       574   MAJOR HEMATOLOGIC/IMMUNOLOGIC DIAG EXC SICKLE CELL CRISIS & COAGUL                   344,191     343,271        291           50          50
  2007        3       575   SEPTICEMIA W MV96+ HOURS AGE >17                                                      32,445      32,145          30           2           2
  2007        3       576   SEPTICEMIA W/O MV96+ HOURS AGE >17                                                   328,115     325,555        262           41          39
  2007        3       578   INFECTIOUS & PARASITIC DISEASES W OR PROCEDURE                                       189,139     187,599        154           11          11
  2007        3       579   POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS W OR PROCEDURE                            135,193     134,153        104           11          10
  2008        1       000   Unknown                                                                            2,077,016   2,060,466      1,994          366         363
  2008        1       001   CRANIOTOMY AGE >17 W CC                                                              103,775     102,985          79           8           8
  2008        1       002   CRANIOTOMY AGE >17 W/O CC                                                             20,973      20,823          15           3           3
  2008        1       003   CRANIOTOMY AGE 0-17                                                                  333,283     333,283        234           29          29
  2008        1       007   PERIPH & CRANIAL NERVE & OTHER NERV SYST PROC W CC                                    51,876      51,596          39           6           6
  2008        1       008   PERIPH & CRANIAL NERVE & OTHER NERV SYST PROC W/O CC                                  13,099      13,099          10           5           5
  2008        1       009   SPINAL DISORDERS & INJURIES                                                           19,596      19,596          15           2           2
  2008        1       010   NERVOUS SYSTEM NEOPLASMS W CC                                                         94,187      93,457          73          12          12
  2008        1       011   NERVOUS SYSTEM NEOPLASMS W/O CC                                                       18,861      18,721          14           4           4
  2008        1       012   DEGENERATIVE NERVOUS SYSTEM DISORDERS                                                 43,356      43,106          50          14          14
  2008        1       013   MULTIPLE SCLEROSIS & CEREBELLAR ATAXIA                                                25,764      25,574          19           3           3
  2008        1       014   INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION                                       506,669     502,479        419           79          79
  2008        1       015   NONSPECIFIC CVA & PRECEREBRAL OCCLUSION W/O INFARCT                                    5,184       5,144           4           1           1
  2008        1       016   NONSPECIFIC CEREBROVASCULAR DISORDERS W CC                                            24,464      24,294          17           2           2
  2008        1       017   NONSPECIFIC CEREBROVASCULAR DISORDERS W/O CC                                          16,087      15,967          12           3           3
  2008        1       018   CRANIAL & PERIPHERAL NERVE DISORDERS W CC                                             91,277      90,587          72          18          18
  2008        1       019   CRANIAL & PERIPHERAL NERVE DISORDERS W/O CC                                           48,954      48,534          42           9           9
  2008        1       021   VIRAL MENINGITIS                                                                       8,093       8,023           7           1           1
  2008        1       022   HYPERTENSIVE ENCEPHALOPATHY                                                            7,756       7,696           6           2           2
  2008        1       023   NONTRAUMATIC STUPOR & COMA                                                             8,112       8,052           7           3           3
  2008        1       026   SEIZURE & HEADACHE AGE 0-17                                                          189,897     189,897        145           68          68
  2008        1       027   TRAUMATIC STUPOR & COMA, COMA >1 HR                                                   40,664      40,364          30           1           1
  2008        1       028   TRAUMATIC STUPOR & COMA, COMA <1 HR AGE >17 W CC                                      44,981      44,561          42           4           4
  2008        1       029   TRAUMATIC STUPOR & COMA, COMA <1 HR AGE >17 W/O CC                                     1,156       1,146           1           1           1
  2008        1       031   CONCUSSION AGE >17 W CC                                                                2,724       2,694           3           1           1
  2008        1       032   CONCUSSION AGE >17 W/O CC                                                              5,575       5,525           5           2           2
  2008        1       034   OTHER DISORDERS OF NERVOUS SYSTEM W CC                                                88,757      88,637          85          14          14
  2008        1       035   OTHER DISORDERS OF NERVOUS SYSTEM W/O CC                                              81,217      80,707          61          10          10
  2008        1       042   INTRAOCULAR PROCEDURES EXCEPT RETINA, IRIS & LENS                                        905         895           1           1           1
  2008        1       045   NEUROLOGICAL EYE DISORDERS                                                            11,507      11,427           8           1           1
  2008        1       047   OTHER DISORDERS OF THE EYE AGE >17 W/O CC                                              1,770       1,760           1           1           1
  2008        1       048   OTHER DISORDERS OF THE EYE AGE 0-17                                                    9,488       9,488           7           1           1
  2008        1       049   MAJOR HEAD & NECK PROCEDURES                                                          13,246      13,146          10           2           2
  2008        1       052   CLEFT LIP & PALATE REPAIR                                                              9,597       9,597           7           4           4
  2008        1       053   SINUS & MASTOID PROCEDURES AGE >17                                                     5,317       5,277           4           2           2
  2008        1       055   MISCELLANEOUS EAR, NOSE, MOUTH & THROAT PROCEDURES                                    10,206      10,206           8           2           2
  2008        1       057   T&A PROC, EXCEPT TONSILLECTOMY &/OR ADENOIDECTOMY ONLY, AGE >17                        3,624       3,594           3           2           2
  2008        1       060   TONSILLECTOMY &/OR ADENOIDECTOMY ONLY, AGE 0-17                                        6,041       6,041           4           2           2
  2008        1       063   OTHER EAR, NOSE, MOUTH & THROAT O.R. PROCEDURES                                        8,046       7,996           6           5           5
  2008        1       064   EAR, NOSE, MOUTH & THROAT MALIGNANCY                                                  36,049      35,769          28           8           8
  2008        1       065   DYSEQUILIBRIUM                                                                        31,640      31,340          30          13          13
  2008        1       066   EPISTAXIS                                                                              5,781       5,731           5           1           1
  2008        1       068   OTITIS MEDIA & URI AGE >17 W CC                                                       43,841      43,471          39          15          15
  2008        1       069   OTITIS MEDIA & URI AGE >17 W/O CC                                                     34,125      33,815          32          12          12
  2008        1       070   OTITIS MEDIA & URI AGE 0-17                                                          134,761     134,761          98          24          24
  2008        1       071   LARYNGOTRACHEITIS                                                                     28,966      28,966          21           5           5
  2008        1       072   NASAL TRAUMA & DEFORMITY                                                               2,312       2,292           2           1           1
  2008        1       073   OTHER EAR, NOSE, MOUTH & THROAT DIAGNOSES AGE >17                                     13,598      13,448          15           4           4
  2008        1       074   OTHER EAR, NOSE, MOUTH & THROAT DIAGNOSES AGE 0-17                                     7,756       7,756           6           3           3
  2008        1       075   MAJOR CHEST PROCEDURES                                                               156,119     155,279        115           13          12
  2008        1       076   OTHER RESP SYSTEM O.R. PROCEDURES W CC                                               201,455     200,035        145           18          18
  2008        1       077   OTHER RESP SYSTEM O.R. PROCEDURES W/O CC                                               2,384       2,364           2           1           1
  2008        1       078   PULMONARY EMBOLISM                                                                   102,213     101,353          86          15          15
  2008        1       079   RESPIRATORY INFECTIONS & INFLAMMATIONS AGE >17 W CC                                  266,797     264,377        242           29          29
  2008        1       080   RESPIRATORY INFECTIONS & INFLAMMATIONS AGE >17 W/O CC                                  3,468       3,438           3           2           2
  2008        1       081   RESPIRATORY INFECTIONS & INFLAMMATIONS AGE 0-17                                      491,761     491,761        345           22          22
  2008        1       082   RESPIRATORY NEOPLASMS                                                                181,887     180,627        140           26          26
  2008        1       083   MAJOR CHEST TRAUMA W CC                                                               13,373      13,283           9           1           1
  2008        1       085   PLEURAL EFFUSION W CC                                                                 74,968      74,318          65          10          10
  2008        1       086   PLEURAL EFFUSION W/O CC                                                                3,961       3,931           3           1           1
  2008        1       087   PULMONARY EDEMA & RESPIRATORY FAILURE                                                893,050     889,000        675           94          94
  2008        1       088   CHRONIC OBSTRUCTIVE PULMONARY DISEASE                                                975,490     967,040        846          212         211
  2008        1       089   SIMPLE PNEUMONIA & PLEURISY AGE >17 W CC                                             761,662     754,972        671          141         140
  2008        1       090   SIMPLE PNEUMONIA & PLEURISY AGE >17 W/O CC                                           102,432     101,552          88          26          26
  2008        1       091   SIMPLE PNEUMONIA & PLEURISY AGE 0-17                                                 341,954     341,954        308           88          88
  2008        1       092   INTERSTITIAL LUNG DISEASE W CC                                                       506,162     506,072        338           15          14
  2008        1       094   PNEUMOTHORAX W CC                                                                     48,549      48,189          39           7           7
  2008        1       095   PNEUMOTHORAX W/O CC                                                                   15,230      15,140          13           4           4
  2008        1       096   BRONCHITIS & ASTHMA AGE >17 W CC                                                     287,168     284,548        266           61          61
  2008        1       097   BRONCHITIS & ASTHMA AGE >17 W/O CC                                                   280,308     277,718        259           80          80
  2008        1       098   BRONCHITIS & ASTHMA AGE 0-17                                                         439,507     439,507        372          138         137
  2008        1       099   RESPIRATORY SIGNS & SYMPTOMS W CC                                                     60,269      59,849          54          19          19
  2008        1       100   RESPIRATORY SIGNS & SYMPTOMS W/O CC                                                   36,827      36,577          32           9           9
  2008        1       101   OTHER RESPIRATORY SYSTEM DIAGNOSES W CC                                              487,133     486,903        329           20          10
  2008        1       102   OTHER RESPIRATORY SYSTEM DIAGNOSES W/O CC                                             18,152      18,002          17           7           7
  2008        1       105   CARDIAC VALVE & OTH MAJOR CARDIOTHORACIC PROC W/O CARD CATH                          180,990     179,900        122            9           8
  2008        1       108   OTHER CARDIOTHORACIC PROCEDURES                                                       74,994      74,774          51           5           5
  2008        1       110   MAJOR CARDIOVASCULAR PROCEDURES W CC                                                  90,185      89,755          66           9           9
  2008        1       111   MAJOR CARDIOVASCULAR PROCEDURES W/O CC                                                14,882      14,782          10           3           3
  2008        1       113   AMPUTATION FOR CIRC SYSTEM DISORDERS EXCEPT UPPER LIMB & TOE                          98,145      97,375          77          10          10
  2008        1       114   UPPER LIMB & TOE AMPUTATION FOR CIRC SYSTEM DISORDERS                                 30,534      30,294          24           4           4
  2008        1       117   CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT                                  13,470      13,360          11           4           4
  2008        1       120   OTHER CIRCULATORY SYSTEM O.R. PROCEDURES                                             131,858     131,108        105           13          13
  2008        1       121   CIRCULATORY DISORDERS W AMI & MAJOR COMP, DISCHARGED ALIVE                            87,395      86,655          74          19          19
  2008        1       122   CIRCULATORY DISORDERS W AMI W/O MAJOR COMP, DISCHARGED ALIVE                         109,619     108,679          94          24          23
  2008        1       123   CIRCULATORY DISORDERS W AMI, EXPIRED                                                  25,220      25,030          19           5           5
  2008        1       124   CIRCULATORY DISORDERS EXCEPT AMI, W CARD CATH & COMPLEX DIAG                         299,301     296,991        231           58          58
  2008        1       125   CIRCULATORY DISORDERS EXCEPT AMI, W CARD CATH W/O COMPLEX DIAG                       157,856     156,806        124           31          31
  2008        1       126   ACUTE & SUBACUTE ENDOCARDITIS                                                         12,254      12,164          22           3           3
  2008        1       127   HEART FAILURE & SHOCK                                                              1,323,106   1,311,596      1,163          275         273
  2008        1       128   DEEP VEIN THROMBOPHLEBITIS                                                            11,425      11,345           8           2           2
  2008        1       129   CARDIAC ARREST, UNEXPLAINED                                                           44,725      44,615          32           4           4
  2008        1       130   PERIPHERAL VASCULAR DISORDERS W CC                                                   215,954     214,164        184           36          36
  2008        1       131   PERIPHERAL VASCULAR DISORDERS W/O CC                                                  49,907      49,497          41           9           9
  2008        1       132   ATHEROSCLEROSIS W CC                                                                 111,246     110,356          89          29          29
  2008        1       134   HYPERTENSION                                                                         128,968     127,788        119           45          44
  2008        1       135   CARDIAC CONGENITAL & VALVULAR DISORDERS AGE >17 W CC                                   9,008       8,918           9           3           3
  2008        1       136   CARDIAC CONGENITAL & VALVULAR DISORDERS AGE >17 W/O CC                                31,691      31,451          24           1           1
  2008        1       138   CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS W CC                                       221,659     219,789        187           48          48
  2008        1       139   CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS W/O CC                                      58,681      58,211          48          19          19




5/15/2012                                                                              Milliman                                                                            Page 13
                                                                                  DRG Distribution




                                                            Inpatient Claims by Diagnosis-Related Group Code
                     DRG                                                DRG                                    Allowed       Paid   Inpatient   Discharge   Admission
  Year      Region   Code                                            Description                               Charges     Claims      Days         Count      Count
  2008        1       140   ANGINA PECTORIS                                                                      63,646    63,066          58          25          25
  2008        1       141   SYNCOPE & COLLAPSE W CC                                                             100,730    99,890          84          21          21
  2008        1       142   SYNCOPE & COLLAPSE W/O CC                                                            26,108    25,908          22          10          10
  2008        1       143   CHEST PAIN                                                                          425,398   421,788        363          152         150
  2008        1       144   OTHER CIRCULATORY SYSTEM DIAGNOSES W CC                                             367,823   365,243        300           69          68
  2008        1       145   OTHER CIRCULATORY SYSTEM DIAGNOSES W/O CC                                            54,942    54,892          40           4           4
  2008        1       146   RECTAL RESECTION W CC                                                                42,641    42,341          30           4           4
  2008        1       147   RECTAL RESECTION W/O CC                                                               6,937     6,877           6           1           1
  2008        1       149   MAJOR SMALL & LARGE BOWEL PROCEDURES W/O CC                                          58,440    58,180          45           7           7
  2008        1       150   PERITONEAL ADHESIOLYSIS W CC                                                         35,632    35,432          31           5           5
  2008        1       151   PERITONEAL ADHESIOLYSIS W/O CC                                                       17,377    17,237          14           3           3
  2008        1       152   MINOR SMALL & LARGE BOWEL PROCEDURES W CC                                            66,456    66,456          44           1           1
  2008        1       153   MINOR SMALL & LARGE BOWEL PROCEDURES W/O CC                                           8,303     8,263           6           2           2
  2008        1       155   STOMACH, ESOPHAGEAL & DUODENAL PROCEDURES AGE >17 W/O CC                             25,508    25,318          19           6           6
  2008        1       156   STOMACH, ESOPHAGEAL & DUODENAL PROCEDURES AGE 0-17                                   41,480    41,480          29           4           4
  2008        1       157   ANAL & STOMAL PROCEDURES W CC                                                        50,642    50,272          42           8           8
  2008        1       158   ANAL & STOMAL PROCEDURES W/O CC                                                       7,242     7,182           6           3           3
  2008        1       159   HERNIA PROCEDURES EXCEPT INGUINAL & FEMORAL AGE >17 W CC                             45,013    44,653          36           5           5
  2008        1       160   HERNIA PROCEDURES EXCEPT INGUINAL & FEMORAL AGE >17 W/O CC                           17,944    17,804          14           4           4
  2008        1       163   HERNIA PROCEDURES AGE 0-17                                                           13,584    13,584          10           2           2
  2008        1       165   APPENDECTOMY W COMPLICATED PRINCIPAL DIAG W/O CC                                     19,484    19,334          19           3           3
  2008        1       166   APPENDECTOMY W/O COMPLICATED PRINCIPAL DIAG W CC                                      7,680     7,650           6           2           2
  2008        1       167   APPENDECTOMY W/O COMPLICATED PRINCIPAL DIAG W/O CC                                   15,432    15,352          13           5           5
  2008        1       168   MOUTH PROCEDURES W CC                                                                12,559    12,519           9           2           2
  2008        1       169   MOUTH PROCEDURES W/O CC                                                               6,287     6,237           5           2           2
  2008        1       170   OTHER DIGESTIVE SYSTEM O.R. PROCEDURES W CC                                          72,208    71,568          64           6           6
  2008        1       171   OTHER DIGESTIVE SYSTEM O.R. PROCEDURES W/O CC                                        56,401    55,951          45           2           2
  2008        1       172   DIGESTIVE MALIGNANCY W CC                                                           227,940   226,120        182           23          23
  2008        1       173   DIGESTIVE MALIGNANCY W/O CC                                                           5,944     5,904           4           1           1
  2008        1       174   G.I. HEMORRHAGE W CC                                                                297,580   295,380        237           60          60
  2008        1       175   G.I. HEMORRHAGE W/O CC                                                               34,665    34,315          35          11          11
  2008        1       176   COMPLICATED PEPTIC ULCER                                                             15,167    15,047          12           2           2
  2008        1       177   UNCOMPLICATED PEPTIC ULCER W CC                                                      36,407    36,087          32           7           7
  2008        1       178   UNCOMPLICATED PEPTIC ULCER W/O CC                                                     1,355     1,345           1           1           1
  2008        1       179   INFLAMMATORY BOWEL DISEASE                                                           67,839    67,309          62          10          10
  2008        1       180   G.I. OBSTRUCTION W CC                                                               136,823   136,153        107           24          24
  2008        1       181   G.I. OBSTRUCTION W/O CC                                                              19,615    19,485          18           7           7
  2008        1       182   ESOPHAGITIS, GASTROENT & MISC DIGEST DISORDERS AGE >17 W CC                         513,732   509,222        451          136         135
  2008        1       183   ESOPHAGITIS, GASTROENT & MISC DIGEST DISORDERS AGE >17 W/O CC                       178,441   176,871        157           60          60
  2008        1       184   ESOPHAGITIS, GASTROENT & MISC DIGEST DISORDERS AGE 0-17                             134,647   134,647        107           30          30
  2008        1       185   DENTAL & ORAL DIS EXCEPT EXTRACTIONS & RESTORATIONS, AGE >17                         43,876    43,516          36          10          10
  2008        1       186   DENTAL & ORAL DIS EXCEPT EXTRACTIONS & RESTORATIONS, AGE 0-17                        10,178    10,178           9           4           4
  2008        1       187   DENTAL EXTRACTIONS & RESTORATIONS                                                    10,107    10,067           8           7           7
  2008        1       188   OTHER DIGESTIVE SYSTEM DIAGNOSES AGE >17 W CC                                       178,386   176,856        153           28          28
  2008        1       189   OTHER DIGESTIVE SYSTEM DIAGNOSES AGE >17 W/O CC                                      24,667    24,447          22           6           6
  2008        1       190   OTHER DIGESTIVE SYSTEM DIAGNOSES AGE 0-17                                           137,157   137,157          98          11          11
  2008        1       191   PANCREAS, LIVER & SHUNT PROCEDURES W CC                                              98,462    97,742          76           8           8
  2008        1       192   PANCREAS, LIVER & SHUNT PROCEDURES W/O CC                                             4,409     4,379           3           1           1
  2008        1       193   BILIARY TRACT PROC EXCEPT ONLY CHOLECYST W OR W/O C.D.E. W CC                        18,522    18,332          19           2           2
  2008        1       197   CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE W/O C.D.E. W CC                                66,143    65,663          48           5           5
  2008        1       198   CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE W/O C.D.E. W/O CC                              14,514    14,384          13           3           3
  2008        1       200   HEPATOBILIARY DIAGNOSTIC PROCEDURE FOR NON-MALIGNANCY                                 3,468     3,438           3           1           1
  2008        1       201   OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES                                      44,201    43,841          36           3           3
  2008        1       202   CIRRHOSIS & ALCOHOLIC HEPATITIS                                                     159,209   157,949        126           28          28
  2008        1       203   MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS                                      187,538   186,118        142           17          17
  2008        1       204   DISORDERS OF PANCREAS EXCEPT MALIGNANCY                                             457,047   453,437        396           95          95
  2008        1       205   DISORDERS OF LIVER EXCEPT MALIG,CIRR,ALC HEPA W CC                                  128,828   127,778        108           20          20
  2008        1       206   DISORDERS OF LIVER EXCEPT MALIG,CIRR,ALC HEPA W/O CC                                  8,631     8,571           6           1           1
  2008        1       207   DISORDERS OF THE BILIARY TRACT W CC                                                  41,072    40,712          38          10          10
  2008        1       208   DISORDERS OF THE BILIARY TRACT W/O CC                                                 9,860     9,790           8           4           4
  2008        1       210   HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT AGE >17 W CC                              103,245   102,385          86          12          12
  2008        1       211   HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT AGE >17 W/O CC                             14,321    14,211          11           2           2
  2008        1       212   HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT AGE 0-17                                   59,753    59,753          45           9           9
  2008        1       213   AMPUTATION FOR MUSCULOSKELETAL SYSTEM & CONN TISSUE DISORDERS                         2,711     2,691           2           1           1
  2008        1       216   BIOPSIES OF MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE                               16,983    16,843          14           2           2
  2008        1       217   WND DEBRID & SKN GRFT EXCEPT HAND,FOR MUSCSKELET & CONN TISS DIS                     77,636    77,036          61          11          11
  2008        1       218   LOWER EXTREM & HUMER PROC EXCEPT HIP,FOOT,FEMUR AGE >17 W CC                         59,554    59,124          43           8           8
  2008        1       219   LOWER EXTREM & HUMER PROC EXCEPT HIP,FOOT,FEMUR AGE >17 W/O CC                       40,674    40,374          30          10          10
  2008        1       220   LOWER EXTREM & HUMER PROC EXCEPT HIP,FOOT,FEMUR AGE 0-17                             25,102    25,102          20           6           6
  2008        1       223   MAJOR SHOULDER/ELBOW PROC, OR OTHER UPPER EXTREMITY PROC W CC                        23,275    23,075          20           5           5
  2008        1       224   SHOULDER,ELBOW OR FOREARM PROC,EXC MAJOR JOINT PROC, W/O CC                           2,845     2,825           2           1           1
  2008        1       225   FOOT PROCEDURES                                                                      16,698    16,658          13           3           3
  2008        1       226   SOFT TISSUE PROCEDURES W CC                                                          50,149    49,819          34           4           4
  2008        1       227   SOFT TISSUE PROCEDURES W/O CC                                                        32,975    32,755          25           5           5
  2008        1       228   MAJOR THUMB OR JOINT PROC,OR OTH HAND OR WRIST PROC W CC                             32,244    31,984          26           5           5
  2008        1       229   HAND OR WRIST PROC, EXCEPT MAJOR JOINT PROC, W/O CC                                  12,205    12,105          10           3           3
  2008        1       230   LOCAL EXCISION & REMOVAL OF INT FIX DEVICES OF HIP & FEMUR                           11,884    11,864           9           2           2
  2008        1       233   OTHER MUSCULOSKELET SYS & CONN TISS O.R. PROC W CC                                   42,811    42,751          31           8           8
  2008        1       234   OTHER MUSCULOSKELET SYS & CONN TISS O.R. PROC W/O CC                                  2,594     2,584           2           2           2
  2008        1       235   FRACTURES OF FEMUR                                                                   20,835    20,835          14           2           2
  2008        1       236   FRACTURES OF HIP & PELVIS                                                            10,971    10,911           6           1           1
  2008        1       238   OSTEOMYELITIS                                                                        27,791    27,551          24           4           4
  2008        1       239   PATHOLOGICAL FRACTURES & MUSCULOSKELETAL & CONN TISS MALIGNANCY                      58,267    57,797          47           6           5
  2008        1       240   CONNECTIVE TISSUE DISORDERS W CC                                                     49,672    49,282          41           7           7
  2008        1       241   CONNECTIVE TISSUE DISORDERS W/O CC                                                    3,021     3,021           2           1           1
  2008        1       242   SEPTIC ARTHRITIS                                                                     13,533    13,403          13           1           1
  2008        1       243   MEDICAL BACK PROBLEMS                                                               146,727   145,727        121           26          26
  2008        1       244   BONE DISEASES & SPECIFIC ARTHROPATHIES W CC                                          39,182    38,802          38           7           7
  2008        1       245   BONE DISEASES & SPECIFIC ARTHROPATHIES W/O CC                                        12,874    12,804          10           3           3
  2008        1       247   SIGNS & SYMPTOMS OF MUSCULOSKELETAL SYSTEM & CONN TISSUE                             23,838    23,628          21           8           8
  2008        1       248   TENDONITIS, MYOSITIS & BURSITIS                                                      59,695    59,155          54          11          11
  2008        1       249   AFTERCARE, MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE                                 2,641     2,621           2           1           1
  2008        1       250   FX, SPRN, STRN & DISL OF FOREARM, HAND, FOOT AGE >17 W CC                             7,031     6,981           5           1           1
  2008        1       251   FX, SPRN, STRN & DISL OF FOREARM, HAND, FOOT AGE >17 W/O CC                           7,515     7,465           5           2           2
  2008        1       253   FX, SPRN, STRN & DISL OF UPARM,LOWLEG EX FOOT AGE >17 W CC                           37,270    36,990          28           4           4
  2008        1       255   FX, SPRN, STRN & DISL OF UPARM,LOWLEG EX FOOT AGE 0-17                                2,641     2,641           2           1           1
  2008        1       256   OTHER MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE DIAGNOSES                           65,090    64,650          52          11          11
  2008        1       257   TOTAL MASTECTOMY FOR MALIGNANCY W CC                                                 14,954    14,844          11           5           5
  2008        1       258   TOTAL MASTECTOMY FOR MALIGNANCY W/O CC                                               16,815    16,685          13           7           7
  2008        1       259   SUBTOTAL MASTECTOMY FOR MALIGNANCY W CC                                               4,505     4,465           4           1           1
  2008        1       260   SUBTOTAL MASTECTOMY FOR MALIGNANCY W/O CC                                             6,501     6,451           5           2           2
  2008        1       262   BREAST BIOPSY & LOCAL EXCISION FOR NON-MALIGNANCY                                     1,312     1,302           1           1           1
  2008        1       263   SKIN GRAFT &/OR DEBRID FOR SKN ULCER OR CELLULITIS W CC                              93,302    92,492          81          13          13
  2008        1       264   SKIN GRAFT &/OR DEBRID FOR SKN ULCER OR CELLULITIS W/O CC                            32,869    32,639          26           3           3
  2008        1       265   SKIN GRAFT &/OR DEBRID EXCEPT FOR SKIN ULCER OR CELLULITIS W CC                      12,267    12,167          10           3           3
  2008        1       266   SKIN GRAFT &/OR DEBRID EXCEPT FOR SKIN ULCER OR CELLULITIS W/O CC                     9,844     9,774           7           1           1




5/15/2012                                                                             Milliman                                                                          Page 14
                                                                                 DRG Distribution




                                                           Inpatient Claims by Diagnosis-Related Group Code
                     DRG                                               DRG                                     Allowed         Paid   Inpatient   Discharge   Admission
  Year      Region   Code                                           Description                                Charges       Claims      Days         Count      Count
  2008        1       269   OTHER SKIN, SUBCUT TISS & BREAST PROC W CC                                           62,901      62,381          52           7           7
  2008        1       270   OTHER SKIN, SUBCUT TISS & BREAST PROC W/O CC                                         10,944      10,864           8           4           4
  2008        1       271   SKIN ULCERS                                                                          89,754      89,224          78          12          12
  2008        1       272   MAJOR SKIN DISORDERS W CC                                                             7,311       7,311           5           1           1
  2008        1       273   MAJOR SKIN DISORDERS W/O CC                                                          24,605      24,455          23           2           2
  2008        1       274   MALIGNANT BREAST DISORDERS W CC                                                      17,030      16,900          13           3           3
  2008        1       275   MALIGNANT BREAST DISORDERS W/O CC                                                     4,624       4,584           4           1           1
  2008        1       276   NON-MALIGNANT BREAST DISORDERS                                                       24,228      24,028          20           6           6
  2008        1       277   CELLULITIS AGE >17 W CC                                                             307,585     304,895        273           63          62
  2008        1       278   CELLULITIS AGE >17 W/O CC                                                           147,622     146,292        139           32          32
  2008        1       279   CELLULITIS AGE 0-17                                                                  62,716      62,716          51          18          18
  2008        1       280   TRAUMA TO THE SKIN, SUBCUT TISS & BREAST AGE >17 W CC                                29,999      29,669          33           9           9
  2008        1       281   TRAUMA TO THE SKIN, SUBCUT TISS & BREAST AGE >17 W/O CC                               7,654       7,574           8           2           2
  2008        1       283   MINOR SKIN DISORDERS W CC                                                            33,207      33,017          28           7           7
  2008        1       284   MINOR SKIN DISORDERS W/O CC                                                           9,583       9,503           9           4           4
  2008        1       285   AMPUTAT OF LOWER LIMB FOR ENDOCRINE,NUTRIT,& METABOL DISORDERS                       28,007      27,787          22           2           2
  2008        1       286   ADRENAL & PITUITARY PROCEDURES                                                       40,709      40,389          32           3           3
  2008        1       287   SKIN GRAFTS & WOUND DEBRID FOR ENDOC, NUTRIT & METAB DISORDERS                       74,561      73,921          64           7           6
  2008        1       290   THYROID PROCEDURES                                                                   20,347      20,187          16           8           8
  2008        1       292   OTHER ENDOCRINE, NUTRIT & METAB O.R. PROC W CC                                       39,199      38,869          33           4           4
  2008        1       294   DIABETES AGE >35                                                                    456,549     452,269        428          111         111
  2008        1       295   DIABETES AGE 0-35                                                                   238,759     237,359        193           53          53
  2008        1       296   NUTRITIONAL & MISC METABOLIC DISORDERS AGE >17 W CC                                 308,512     305,832        268           78          78
  2008        1       297   NUTRITIONAL & MISC METABOLIC DISORDERS AGE >17 W/O CC                                60,383      59,853          53          19          19
  2008        1       298   NUTRITIONAL & MISC METABOLIC DISORDERS AGE 0-17                                     213,457     213,457        161           36          36
  2008        1       299   INBORN ERRORS OF METABOLISM                                                          23,129      23,129          18           5           5
  2008        1       300   ENDOCRINE DISORDERS W CC                                                            107,332     106,672          89          18          18
  2008        1       301   ENDOCRINE DISORDERS W/O CC                                                            6,597       6,557           5           3           3
  2008        1       302   KIDNEY TRANSPLANT                                                                    17,980      17,840          14           3           3
  2008        1       303   KIDNEY,URETER & MAJOR BLADDER PROCEDURES FOR NEOPLASM                                27,525      27,345          22           5           5
  2008        1       304   KIDNEY,URETER & MAJOR BLADDER PROC FOR NON-NEOPL W CC                               101,839     101,479          81          12          12
  2008        1       305   KIDNEY,URETER & MAJOR BLADDER PROC FOR NON-NEOPL W/O CC                               3,101       3,091           2           2           2
  2008        1       306   PROSTATECTOMY W CC                                                                   10,401      10,331           7           1           1
  2008        1       308   MINOR BLADDER PROCEDURES W CC                                                         5,019       4,979           4           1           1
  2008        1       310   TRANSURETHRAL PROCEDURES W CC                                                           905         895           1           1           1
  2008        1       311   TRANSURETHRAL PROCEDURES W/O CC                                                       2,972       2,952           2           1           1
  2008        1       315   OTHER KIDNEY & URINARY TRACT O.R. PROCEDURES                                        134,005     133,225        100           14          14
  2008        1       316   RENAL FAILURE                                                                       669,386     664,106        528          100         100
  2008        1       317   ADMIT FOR RENAL DIALYSIS                                                              7,890       7,820           7           3           3
  2008        1       318   KIDNEY & URINARY TRACT NEOPLASMS W CC                                                65,729      65,559          53           8           8
  2008        1       320   KIDNEY & URINARY TRACT INFECTIONS AGE >17 W CC                                      257,568     255,358        221           53          53
  2008        1       321   KIDNEY & URINARY TRACT INFECTIONS AGE >17 W/O CC                                     37,588      37,268          32          13          13
  2008        1       322   KIDNEY & URINARY TRACT INFECTIONS AGE 0-17                                          145,910     145,910        112           20          20
  2008        1       323   URINARY STONES W CC, &/OR ESW LITHOTRIPSY                                            19,483      19,353          16           9           9
  2008        1       324   URINARY STONES W/O CC                                                                 5,498       5,448           5           2           2
  2008        1       325   KIDNEY & URINARY TRACT SIGNS & SYMPTOMS AGE >17 W CC                                 15,713      15,593          12           5           5
  2008        1       327   KIDNEY & URINARY TRACT SIGNS & SYMPTOMS AGE 0-17                                      4,409       4,409           3           1           1
  2008        1       331   OTHER KIDNEY & URINARY TRACT DIAGNOSES AGE >17 W CC                                 127,782     126,672        111           27          27
  2008        1       332   OTHER KIDNEY & URINARY TRACT DIAGNOSES AGE >17 W/O CC                                13,338      13,218          12           5           5
  2008        1       333   OTHER KIDNEY & URINARY TRACT DIAGNOSES AGE 0-17                                      26,836      26,836          20           5           5
  2008        1       334   MAJOR MALE PELVIC PROCEDURES W CC                                                    29,183      28,953          23           2           2
  2008        1       336   TRANSURETHRAL PROSTATECTOMY W CC                                                      3,468       3,438           3           1           1
  2008        1       341   PENIS PROCEDURES                                                                      9,243       9,243           7           1           1
  2008        1       346   MALIGNANCY, MALE REPRODUCTIVE SYSTEM, W CC                                           12,059      11,969           9           4           4
  2008        1       350   INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM                                         16,404      16,274          13           5           5
  2008        1       354   UTERINE,ADNEXA PROC FOR NON-OVARIAN/ADNEXAL MALIG W CC                                4,618       4,588           3           1           1
  2008        1       355   UTERINE,ADNEXA PROC FOR NON-OVARIAN/ADNEXAL MALIG W/O CC                              4,226       4,186           4           1           1
  2008        1       356   FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES                                  5,298       5,258           4           2           2
  2008        1       357   UTERINE & ADNEXA PROC FOR OVARIAN OR ADNEXAL MALIGNANCY                              15,902      15,802          10           1           1
  2008        1       358   UTERINE & ADNEXA PROC FOR NON-MALIGNANCY W CC                                        74,761      74,191          57          20          20
  2008        1       359   UTERINE & ADNEXA PROC FOR NON-MALIGNANCY W/O CC                                     145,338     144,198        120           52          52
  2008        1       361   LAPAROSCOPY & INCISIONAL TUBAL INTERRUPTION                                          13,110      13,000          11           1           1
  2008        1       363   D&C, CONIZATION & RADIO-IMPLANT, FOR MALIGNANCY                                      17,084      16,944          14           6           6
  2008        1       364   D&C, CONIZATION EXCEPT FOR MALIGNANCY                                                 5,944       5,904           4           2           2
  2008        1       365   OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES                                      5,422       5,382           4           1           1
  2008        1       366   MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM W CC                                          10,565      10,485           8           3           3
  2008        1       367   MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM W/O CC                                         1,539       1,529           1           1           1
  2008        1       368   INFECTIONS, FEMALE REPRODUCTIVE SYSTEM                                                9,583       9,493           9           4           4
  2008        1       369   MENSTRUAL & OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS                               63,615      63,085          53          21          21
  2008        1       370   CESAREAN SECTION W CC                                                               225,760     225,690        185           44          43
  2008        1       371   CESAREAN SECTION W/O CC                                                             233,012     232,622        191           59          59
  2008        1       372   VAGINAL DELIVERY W COMPLICATING DIAGNOSES                                           112,111     112,011          93          33          33
  2008        1       373   VAGINAL DELIVERY W/O COMPLICATING DIAGNOSES                                         317,606     317,466        258          104         104
  2008        1       374   VAGINAL DELIVERY W STERILIZATION &/OR D&C                                            15,477      15,477          12           4           4
  2008        1       375   VAGINAL DELIVERY W O.R. PROC EXCEPT STERIL &/OR D&C                                   2,711       2,711           2           1           1
  2008        1       376   POSTPARTUM & POST ABORTION DIAGNOSES W/O O.R. PROCEDURE                              19,494      19,394          16           6           6
  2008        1       377   POSTPARTUM & POST ABORTION DIAGNOSES W O.R. PROCEDURE                                 3,286       3,276           3           2           2
  2008        1       378   ECTOPIC PREGNANCY                                                                     7,672       7,672           7           4           4
  2008        1       379   THREATENED ABORTION                                                                  30,211      30,181          23          12          12
  2008        1       380   ABORTION W/O D&C                                                                      1,126       1,126           1           1           1
  2008        1       381   ABORTION W D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY                                   6,961       6,941           6           3           3
  2008        1       383   OTHER ANTEPARTUM DIAGNOSES W MEDICAL COMPLICATIONS                                  174,077     173,397        144           48          48
  2008        1       384   OTHER ANTEPARTUM DIAGNOSES W/O MEDICAL COMPLICATIONS                                  7,397       7,397           5           3           3
  2008        1       385   NEONATES, DIED OR TRANSFERRED TO ANOTHER ACUTE CARE FACILITY                        290,109     290,109        204            9           8
  2008        1       386   EXTREME IMMATURITY OR RESPIRATORY DISTRESS SYNDROME, NEONATE                      4,234,920   4,234,920      3,449          131         107
  2008        1       387   PREMATURITY W MAJOR PROBLEMS                                                        291,143     291,143        259            8           8
  2008        1       388   PREMATURITY W/O MAJOR PROBLEMS                                                       18,661      18,661          16           1           1
  2008        1       389   FULL TERM NEONATE W MAJOR PROBLEMS                                                  734,148     734,148        502           17           7
  2008        1       390   NEONATE W OTHER SIGNIFICANT PROBLEMS                                                 48,598      48,598          37           3           3
  2008        1       391   NORMAL NEWBORN                                                                       21,385      21,385          16           3           3
  2008        1       392   SPLENECTOMY AGE >17                                                                   3,936       3,906           3           1           1
  2008        1       393   SPLENECTOMY AGE 0-17                                                                  6,041       6,041           4           1           1
  2008        1       394   OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS                          16,149      16,019          13           2           2
  2008        1       395   RED BLOOD CELL DISORDERS AGE >17                                                  1,997,366   1,981,036      1,703          374         373
  2008        1       396   RED BLOOD CELL DISORDERS AGE 0-17                                                   446,990     446,990        362          102         102
  2008        1       397   COAGULATION DISORDERS                                                                62,364      62,084          45          12          12
  2008        1       398   RETICULOENDOTHELIAL & IMMUNITY DISORDERS W CC                                         4,917       4,907           5           2           2
  2008        1       399   RETICULOENDOTHELIAL & IMMUNITY DISORDERS W/O CC                                       3,835       3,835           3           1           1
  2008        1       401   LYMPHOMA & NON-ACUTE LEUKEMIA W OTHER O.R. PROC W CC                                  2,592       2,572           2           1           1
  2008        1       403   LYMPHOMA & NON-ACUTE LEUKEMIA W CC                                                   78,030      77,440          59           9           9
  2008        1       404   LYMPHOMA & NON-ACUTE LEUKEMIA W/O CC                                                 23,265      23,115          15           2           2
  2008        1       405   ACUTE LEUKEMIA W/O MAJOR O.R. PROCEDURE AGE 0-17                                     41,875      41,875          32           5           5
  2008        1       408   MYELOPROLIF DISORD OR POORLY DIFF NEOPL W OTHER O.R.PROC                             34,513      34,243          27           2           2
  2008        1       409   RADIOTHERAPY                                                                          5,282       5,282           4           1           1
  2008        1       410   CHEMOTHERAPY W/O ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS                              290,866     288,936        228           64          63
  2008        1       413   OTHER MYELOPROLIF DIS OR POORLY DIFF NEOPL DIAG W CC                                  6,339       6,279           6           1           1




5/15/2012                                                                            Milliman                                                                             Page 15
                                                                                 DRG Distribution




                                                           Inpatient Claims by Diagnosis-Related Group Code
                     DRG                                               DRG                                     Allowed         Paid   Inpatient   Discharge   Admission
  Year      Region   Code                                           Description                                Charges       Claims      Days         Count      Count
  2008        1       417   SEPTICEMIA AGE 0-17                                                                  85,244      85,244          71          11          11
  2008        1       418   POSTOPERATIVE & POST-TRAUMATIC INFECTIONS                                            85,272      84,612          72          17          17
  2008        1       419   FEVER OF UNKNOWN ORIGIN AGE >17 W CC                                                 17,877      17,717          16           4           4
  2008        1       420   FEVER OF UNKNOWN ORIGIN AGE >17 W/O CC                                               17,097      16,977          12           2           2
  2008        1       421   VIRAL ILLNESS AGE >17                                                                28,814      28,534          28           6           6
  2008        1       422   VIRAL ILLNESS & FEVER OF UNKNOWN ORIGIN AGE 0-17                                     66,701      66,701          53          23          23
  2008        1       423   OTHER INFECTIOUS & PARASITIC DISEASES DIAGNOSES                                      21,731      21,511          22           6           6
  2008        1       425   ACUTE ADJUSTMENT REACTION & PSYCHOSOCIAL DYSFUNCTION                                 76,903      76,393          65          10          10
  2008        1       426   DEPRESSIVE NEUROSES                                                                 224,593     223,233        183           39          39
  2008        1       427   NEUROSES EXCEPT DEPRESSIVE                                                          104,843     104,363          89          14          14
  2008        1       428   DISORDERS OF PERSONALITY & IMPULSE CONTROL                                           28,852      28,602          25           6           6
  2008        1       429   ORGANIC DISTURBANCES & MENTAL RETARDATION                                           138,934     138,424        108           13          13
  2008        1       430   PSYCHOSES                                                                         6,832,559   6,776,889      6,240          704         699
  2008        1       431   CHILDHOOD MENTAL DISORDERS                                                          278,539     278,279        204           27          27
  2008        1       432   OTHER MENTAL DISORDER DIAGNOSES                                                       4,458       4,428           3           1           1
  2008        1       433   ALCOHOL/DRUG ABUSE OR DEPENDENCE, LEFT AMA                                          131,516     130,026        149           32          32
  2008        1       439   SKIN GRAFTS FOR INJURIES                                                             25,945      25,745          20           2           2
  2008        1       440   WOUND DEBRIDEMENTS FOR INJURIES                                                      24,358      24,188          17           2           2
  2008        1       441   HAND PROCEDURES FOR INJURIES                                                          5,879       5,839           4           1           1
  2008        1       442   OTHER O.R. PROCEDURES FOR INJURIES W CC                                              45,654      45,354          31           6           6
  2008        1       443   OTHER O.R. PROCEDURES FOR INJURIES W/O CC                                             8,336       8,266           7           3           2
  2008        1       444   TRAUMATIC INJURY AGE >17 W CC                                                        13,366      13,236          13           3           3
  2008        1       445   TRAUMATIC INJURY AGE >17 W/O CC                                                       2,248       2,228           2           1           1
  2008        1       446   TRAUMATIC INJURY AGE 0-17                                                             9,062       9,062           6           2           2
  2008        1       447   ALLERGIC REACTIONS AGE >17                                                           20,049      19,869          18           8           8
  2008        1       449   POISONING & TOXIC EFFECTS OF DRUGS AGE >17 W CC                                     140,040     138,950        110           33          31
  2008        1       450   POISONING & TOXIC EFFECTS OF DRUGS AGE >17 W/O CC                                    46,447      46,037          41          11          11
  2008        1       451   POISONING & TOXIC EFFECTS OF DRUGS AGE 0-17                                           3,633       3,633           3           2           2
  2008        1       452   COMPLICATIONS OF TREATMENT W CC                                                      67,635      67,035          60          12          12
  2008        1       453   COMPLICATIONS OF TREATMENT W/O CC                                                    10,289      10,239           8           3           3
  2008        1       454   OTHER INJURY, POISONING & TOXIC EFFECT DIAG W CC                                     41,224      41,164          29           4           4
  2008        1       455   OTHER INJURY, POISONING & TOXIC EFFECT DIAG W/O CC                                    1,192       1,182           1           1           1
  2008        1       461   O.R. PROC W DIAGNOSES OF OTHER CONTACT W HEALTH SERVICES                             30,059      29,799          26           1           1
  2008        1       462   REHABILITATION                                                                    1,326,873   1,316,373      1,082           99          99
  2008        1       463   SIGNS & SYMPTOMS W CC                                                               100,957     100,267        110           31          31
  2008        1       464   SIGNS & SYMPTOMS W/O CC                                                              28,552      28,292          37          10          10
  2008        1       466   AFTERCARE W/O HISTORY OF MALIGNANCY AS SECONDARY DIAGNOSIS                            5,622       5,622          19           3           3
  2008        1       467   OTHER FACTORS INFLUENCING HEALTH STATUS                                               4,630       4,630          15           2           2
  2008        1       468   EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS                           441,008     439,578        317           24          23
  2008        1       470   UNGROUPABLE                                                                          52,229      52,169          41           3           3
  2008        1       473   ACUTE LEUKEMIA W/O MAJOR O.R. PROCEDURE AGE >17                                     130,026     129,046          98           6           5
  2008        1       477   NON-EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS                       157,561     156,861        125           13          12
  2008        1       479   OTHER VASCULAR PROCEDURES W/O CC                                                     50,722      50,342          38          11          11
  2008        1       481   BONE MARROW TRANSPLANT                                                               35,727      35,727          30           1           1
  2008        1       482   TRACHEOSTOMY FOR FACE,MOUTH & NECK DIAGNOSES                                        126,613     125,753          94          10          10
  2008        1       485   LIMB REATTACHMENT, HIP AND FEMUR PROC FOR MULTIPLE SIGNIFICANT TRA                   14,628      14,628           8           1           1
  2008        1       486   OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA                               137,995     136,935        106            5           5
  2008        1       487   OTHER MULTIPLE SIGNIFICANT TRAUMA                                                    13,345      13,245          10           4           4
  2008        1       489   HIV W MAJOR RELATED CONDITION                                                       363,247     360,267        309           36          36
  2008        1       490   HIV W OR W/O OTHER RELATED CONDITION                                                 87,021      86,341          68          16          15
  2008        1       492   CHEMOTHERAPY W ACUTE LEUKEMIA OR W USE OF HI DOSE CHEMOAGENT                        177,039     176,399        130           21          21
  2008        1       493   LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W CC                                        127,607     126,737          99          21          20
  2008        1       494   LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W/O CC                                       41,989      41,669          32          13          13
  2008        1       497   SPINAL FUSION EXCEPT CERVICAL W CC                                                   38,823      38,513          31           6           6
  2008        1       499   BACK & NECK PROCEDURES EXCEPT SPINAL FUSION W CC                                     43,696      43,336          36          10          10
  2008        1       500   BACK & NECK PROCEDURES EXCEPT SPINAL FUSION W/O CC                                   31,022      30,772          25          14          14
  2008        1       501   KNEE PROCEDURES W PDX OF INFECTION W CC                                              29,023      28,813          21           3           3
  2008        1       503   KNEE PROCEDURES W/O PDX OF INFECTION                                                 19,541      19,371          17           3           3
  2008        1       506   FULL THICKNESS BURN W SKIN GRAFT OR INHAL INJ W CC OR SIG TRAUMA                     75,116      74,586          53           3           3
  2008        1       507   FULL THICKNESS BURN W SKIN GRFT OR INHAL INJ W/O CC OR SIG TRAUMA                     8,093       8,023           7           1           1
  2008        1       508   FULL THICKNESS BURN W/O SKIN GRFT OR INHAL INJ W CC OR SIG TRAUMA                    50,361      50,001          36           2           2
  2008        1       509   FULL THICKNESS BURN W/O SKIN GRFT OR INH INJ W/O CC OR SIG TRAUMA                     2,509       2,489           2           1           1
  2008        1       510   NON-EXTENSIVE BURNS W CC OR SIGNIFICANT TRAUMA                                        9,500       9,430           7           2           2
  2008        1       511   NON-EXTENSIVE BURNS W/O CC OR SIGNIFICANT TRAUMA                                     14,847      14,737          11           3           3
  2008        1       515   CARDIAC DEFIBRILLATOR IMPLANT W/O CARDIAC CATH                                      133,673     132,653        102           12          12
  2008        1       518   PERC CARDIO PROC W/O CORONARY ARTERY STENT OR AMI                                    59,234      58,804          43          19          19
  2008        1       519   CERVICAL SPINAL FUSION W CC                                                          72,665      72,175          49          11          11
  2008        1       520   CERVICAL SPINAL FUSION W/O CC                                                        30,219      30,119          22          10          10
  2008        1       521   ALCOHOL/DRUG ABUSE OR DEPENDENCE W CC                                             1,204,679   1,190,639      1,404          157         155
  2008        1       522   ALC/DRUG ABUSE OR DEPEND W REHABILITATION THERAPY W/O CC                            507,061     500,841        636           63          63
  2008        1       523   ALC/DRUG ABUSE OR DEPEND W/O REHABILITATION THERAPY W/O CC                          392,888     389,518        339           81          81
  2008        1       524   TRANSIENT ISCHEMIA                                                                   76,402      75,752          65          29          29
  2008        1       528   INTRACRANIAL VASCULAR PROC W PDX HEMORRHAGE                                          46,202      45,862          34           4           4
  2008        1       529   VENTRICULAR SHUNT PROCEDURES W CC                                                    28,917      28,697          22           3           3
  2008        1       530   VENTRICULAR SHUNT PROCEDURES W/O CC                                                   3,358       3,328           3           1           1
  2008        1       531   SPINAL PROCEDURES W CC                                                               89,244      88,954          68           7           7
  2008        1       532   SPINAL PROCEDURES W/O CC                                                             48,356      48,286          35           6           6
  2008        1       533   EXTRACRANIAL PROCEDURES W CC                                                         12,999      12,909           9           3           3
  2008        1       534   EXTRACRANIAL PROCEDURES W/O CC                                                        9,822       9,742           8           3           3
  2008        1       537   LOCAL EXCIS & REMOV OF INT FIX DEV EXCEPT HIP & FEMUR W CC                            1,312       1,302           1           1           1
  2008        1       538   LOCAL EXCIS & REMOV OF INT FIX DEV EXCEPT HIP & FEMUR W/O CC                          5,113       5,073           4           1           1
  2008        1       539   LYMPHOMA & LEUKEMIA W MAJOR OR PROCEDURE W CC                                         5,282       5,242           4           1           1
  2008        1       540   LYMPHOMA & LEUKEMIA W MAJOR OR PROCEDURE W/O CC                                       6,777       6,727           5           1           1
  2008        1       542   TRACH W MV 96+HRS OR PDX EXC FACE, MOUTH & NECK W/O MAJ O.R.                        323,224     321,254        248           13          13
  2008        1       543   CRANIOTOMY W/IMPLANT OF CHEMO AGENT OR ACUTE COMPLX CNS PDX                         127,408     126,418          99           7           7
  2008        1       544   MAJOR JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY                          214,832     213,172        169           40          39
  2008        1       546   SPINAL FUSION EXC CERV WITH CURVATURE OF THE SPINE OR MALIG                          34,576      34,536          26           4           4
  2008        1       549   CORONARY BYPASS W/O CARDIAC CATH W MAJOR CV DX                                      137,556     136,516        104            9           9
  2008        1       550   CORONARY BYPASS W/O CARDIAC CATH W/O MAJOR CV DX                                    166,285     165,085        120           15          15
  2008        1       551   PERMANENT CARDIAC PACEMAKER IMPL W MAJ CV DX OR AICD LEAD OR GNRTR                    1,251       1,241           1           1           1
  2008        1       553   OTHER VASCULAR PROCEDURES W CC W MAJOR CV DX                                         82,728      82,148          58           7           7
  2008        1       554   OTHER VASCULAR PROCEDURES W CC W/O MAJOR CV DX                                      146,694     145,574        112           23          23
  2008        1       555   PERCUTANEOUS CARDIOVASCULAR PROC W MAJOR CV DX                                      186,123     184,813        131           33          33
  2008        1       560   BACTERIAL & TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM                                 24,934      24,724          21           1           1
  2008        1       561   NON-BACTERIAL INFECTIONS OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS                   86,885      86,675          61           6           6
  2008        1       562   SEIZURE AGE > 17 W CC                                                               230,242     228,202        210           72          72
  2008        1       563   SEIZURE AGE > 17 W/O CC                                                             111,984     111,024          99          42          42
  2008        1       564   HEADACHES AGE >17                                                                    45,356      45,016          34          10          10
  2008        1       565   RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT 96+ HOURS                      245,419     244,549        174           14          14
  2008        1       566   RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT < 96 HOURS                     297,705     295,425        240           41          41
  2008        1       567   STOMACH, ESOPHAGEAL & DUODENAL PROC AGE > 17 W CC W MAJOR GI DX                      70,417      69,897          52           4           4
  2008        1       568   STOMACH, ESOPHAGEAL & DUODENAL PROCEDURES PROC AGE > 17 W CC W/O MAJOR GI DX        137,165     136,165        100            6           6
  2008        1       569   MAJOR SMALL & LARGE BOWEL PROCEDURES W CC W MAJOR GI DX                             134,390     133,330        106           10          10
  2008        1       570   MAJOR SMALL & LARGE BOWEL PROCEDURES W CC W/O MAJOR GI DX                           118,741     117,881          86          10          10
  2008        1       571   MAJOR ESOPHAGEAL DISORDERS                                                           22,665      22,485          18           7           7
  2008        1       572   MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS                          104,747     104,107          86          16          16




5/15/2012                                                                            Milliman                                                                             Page 16
                                                                                   DRG Distribution




                                                            Inpatient Claims by Diagnosis-Related Group Code
                     DRG                                              DRG                                       Allowed         Paid   Inpatient   Discharge   Admission
  Year      Region   Code                                          Description                                  Charges       Claims      Days         Count      Count
  2008        1       573   MAJOR BLADDER PROCEDURES                                                                  60           0           6           1           1
  2008        1       574   MAJOR HEMATOLOGIC/IMMUNOLOGIC DIAG EXC SICKLE CELL CRISIS & COAGUL                   136,064     135,684        114           28          26
  2008        1       575   SEPTICEMIA W MV96+ HOURS AGE >17                                                      43,700      43,370          33           3           3
  2008        1       576   SEPTICEMIA W/O MV96+ HOURS AGE >17                                                   616,715     611,685        508           72          72
  2008        1       578   INFECTIOUS & PARASITIC DISEASES W OR PROCEDURE                                       125,379     124,419          96           6           6
  2008        1       579   POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS W OR PROCEDURE                             71,283      70,923          52           6           6
  2008        2       000   Unknown                                                                            6,405,334   6,364,704      6,447          781         777
  2008        2       001   CRANIOTOMY AGE >17 W CC                                                              137,369     136,339        103           10           9
  2008        2       002   CRANIOTOMY AGE >17 W/O CC                                                             20,824      20,664          16           4           4
  2008        2       003   CRANIOTOMY AGE 0-17                                                                  298,765     298,765        233           35          34
  2008        2       007   PERIPH & CRANIAL NERVE & OTHER NERV SYST PROC W CC                                    35,357      35,297          31           7           7
  2008        2       008   PERIPH & CRANIAL NERVE & OTHER NERV SYST PROC W/O CC                                  15,396      15,346          14           6           6
  2008        2       009   SPINAL DISORDERS & INJURIES                                                           60,690      60,280          44           5           4
  2008        2       010   NERVOUS SYSTEM NEOPLASMS W CC                                                        100,472      99,972          79          13          13
  2008        2       011   NERVOUS SYSTEM NEOPLASMS W/O CC                                                        6,027       5,987           4           1           1
  2008        2       012   DEGENERATIVE NERVOUS SYSTEM DISORDERS                                                106,254     105,784          80          10          10
  2008        2       013   MULTIPLE SCLEROSIS & CEREBELLAR ATAXIA                                                41,395      41,265          32          10          10
  2008        2       014   INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION                                       544,608     540,848        415           67          65
  2008        2       015   NONSPECIFIC CVA & PRECEREBRAL OCCLUSION W/O INFARCT                                   75,885      75,355          53           5           5
  2008        2       016   NONSPECIFIC CEREBROVASCULAR DISORDERS W CC                                            25,423      25,283          19           3           3
  2008        2       017   NONSPECIFIC CEREBROVASCULAR DISORDERS W/O CC                                           5,113       5,113           4           1           1
  2008        2       018   CRANIAL & PERIPHERAL NERVE DISORDERS W CC                                            134,637     133,387        125           31          31
  2008        2       019   CRANIAL & PERIPHERAL NERVE DISORDERS W/O CC                                           31,628      31,338          29           9           9
  2008        2       021   VIRAL MENINGITIS                                                                      16,460      16,340          12           1           1
  2008        2       023   NONTRAUMATIC STUPOR & COMA                                                            10,214      10,104          11           5           5
  2008        2       026   SEIZURE & HEADACHE AGE 0-17                                                          274,754     274,754        223           74          74
  2008        2       027   TRAUMATIC STUPOR & COMA, COMA >1 HR                                                   10,772      10,682           9           3           3
  2008        2       028   TRAUMATIC STUPOR & COMA, COMA <1 HR AGE >17 W CC                                      48,792      48,432          36           7           7
  2008        2       029   TRAUMATIC STUPOR & COMA, COMA <1 HR AGE >17 W/O CC                                     5,115       5,075           4           2           2
  2008        2       030   TRAUMATIC STUPOR & COMA, COMA <1 HR AGE 0-17                                          27,730      27,730          21           2           2
  2008        2       033   CONCUSSION AGE 0-17                                                                    1,320       1,320           1           1           1
  2008        2       034   OTHER DISORDERS OF NERVOUS SYSTEM W CC                                                52,923      52,603          56          13          13
  2008        2       035   OTHER DISORDERS OF NERVOUS SYSTEM W/O CC                                              56,275      56,095          47          15          15
  2008        2       037   ORBITAL PROCEDURES                                                                     1,211       1,201           1           1           1
  2008        2       042   INTRAOCULAR PROCEDURES EXCEPT RETINA, IRIS & LENS                                      2,086       2,046           4           2           2
  2008        2       043   HYPHEMA                                                                                1,320       1,320           1           1           1
  2008        2       044   ACUTE MAJOR EYE INFECTIONS                                                             2,557       2,557           2           1           1
  2008        2       045   NEUROLOGICAL EYE DISORDERS                                                             2,782       2,762           2           1           1
  2008        2       046   OTHER DISORDERS OF THE EYE AGE >17 W CC                                                9,243       9,173           7           2           2
  2008        2       048   OTHER DISORDERS OF THE EYE AGE 0-17                                                   17,214      17,214          13           3           3
  2008        2       050   SIALOADENECTOMY                                                                        1,355       1,345           1           1           1
  2008        2       052   CLEFT LIP & PALATE REPAIR                                                              7,754       7,754           6           4           4
  2008        2       053   SINUS & MASTOID PROCEDURES AGE >17                                                     1,251       1,241           1           1           1
  2008        2       054   SINUS & MASTOID PROCEDURES AGE 0-17                                                    3,835       3,835           3           1           1
  2008        2       055   MISCELLANEOUS EAR, NOSE, MOUTH & THROAT PROCEDURES                                     2,641       2,641           2           1           1
  2008        2       057   T&A PROC, EXCEPT TONSILLECTOMY &/OR ADENOIDECTOMY ONLY, AGE >17                       28,583      28,313          27           1           1
  2008        2       059   TONSILLECTOMY &/OR ADENOIDECTOMY ONLY, AGE >17                                         2,500       2,470           3           1           1
  2008        2       060   TONSILLECTOMY &/OR ADENOIDECTOMY ONLY, AGE 0-17                                       10,479      10,479           8           4           4
  2008        2       063   OTHER EAR, NOSE, MOUTH & THROAT O.R. PROCEDURES                                       50,073      50,063          38           4           4
  2008        2       064   EAR, NOSE, MOUTH & THROAT MALIGNANCY                                                  34,885      34,605          28           9           9
  2008        2       065   DYSEQUILIBRIUM                                                                        18,430      18,250          18           5           5
  2008        2       066   EPISTAXIS                                                                              8,231       8,151           8           3           3
  2008        2       068   OTITIS MEDIA & URI AGE >17 W CC                                                       49,187      48,767          42          17          17
  2008        2       069   OTITIS MEDIA & URI AGE >17 W/O CC                                                     35,765      35,425          34          10          10
  2008        2       070   OTITIS MEDIA & URI AGE 0-17                                                          104,302     104,302          86          28          28
  2008        2       072   NASAL TRAUMA & DEFORMITY                                                               4,808       4,758           5           1           1
  2008        2       073   OTHER EAR, NOSE, MOUTH & THROAT DIAGNOSES AGE >17                                     19,299      19,119          18           7           6
  2008        2       074   OTHER EAR, NOSE, MOUTH & THROAT DIAGNOSES AGE 0-17                                     7,881       7,881           6           3           3
  2008        2       075   MAJOR CHEST PROCEDURES                                                               116,724     115,754          99          11          11
  2008        2       076   OTHER RESP SYSTEM O.R. PROCEDURES W CC                                               155,989     154,849        117           17          17
  2008        2       077   OTHER RESP SYSTEM O.R. PROCEDURES W/O CC                                               4,520       4,490           3           1           1
  2008        2       078   PULMONARY EMBOLISM                                                                   111,877     110,957          92          18          18
  2008        2       079   RESPIRATORY INFECTIONS & INFLAMMATIONS AGE >17 W CC                                  211,252     209,562        169           24          24
  2008        2       080   RESPIRATORY INFECTIONS & INFLAMMATIONS AGE >17 W/O CC                                 28,485      28,285          20           2           2
  2008        2       081   RESPIRATORY INFECTIONS & INFLAMMATIONS AGE 0-17                                      395,484     395,484        311           35          35
  2008        2       082   RESPIRATORY NEOPLASMS                                                                180,789     179,389        143           33          33
  2008        2       083   MAJOR CHEST TRAUMA W CC                                                               16,135      16,015          12           3           3
  2008        2       084   MAJOR CHEST TRAUMA W/O CC                                                                833         823           1           1           1
  2008        2       085   PLEURAL EFFUSION W CC                                                                 77,597      76,997          60          11          11
  2008        2       087   PULMONARY EDEMA & RESPIRATORY FAILURE                                                911,376     909,126        696           49          49
  2008        2       088   CHRONIC OBSTRUCTIVE PULMONARY DISEASE                                              1,021,031   1,012,421        874          242         241
  2008        2       089   SIMPLE PNEUMONIA & PLEURISY AGE >17 W CC                                             869,805     862,325        748          143         142
  2008        2       090   SIMPLE PNEUMONIA & PLEURISY AGE >17 W/O CC                                           140,744     139,504        124           37          36
  2008        2       091   SIMPLE PNEUMONIA & PLEURISY AGE 0-17                                                 442,325     442,325        431          114         114
  2008        2       092   INTERSTITIAL LUNG DISEASE W CC                                                        74,184      73,574          61          13          13
  2008        2       093   INTERSTITIAL LUNG DISEASE W/O CC                                                       7,344       7,284           6           2           2
  2008        2       094   PNEUMOTHORAX W CC                                                                     95,538      95,058          77           8           8
  2008        2       095   PNEUMOTHORAX W/O CC                                                                    3,781       3,751           3           1           1
  2008        2       096   BRONCHITIS & ASTHMA AGE >17 W CC                                                     227,486     225,426        206           72          72
  2008        2       097   BRONCHITIS & ASTHMA AGE >17 W/O CC                                                   245,211     242,961        231           73          73
  2008        2       098   BRONCHITIS & ASTHMA AGE 0-17                                                         547,527     547,527        458          130         129
  2008        2       099   RESPIRATORY SIGNS & SYMPTOMS W CC                                                    208,125     207,495        163           22          22
  2008        2       100   RESPIRATORY SIGNS & SYMPTOMS W/O CC                                                  504,703     504,533        388           24          10
  2008        2       101   OTHER RESPIRATORY SYSTEM DIAGNOSES W CC                                              386,174     385,844        305           30          30
  2008        2       102   OTHER RESPIRATORY SYSTEM DIAGNOSES W/O CC                                             23,989      23,869          21          10          10
  2008        2       105   CARDIAC VALVE & OTH MAJOR CARDIOTHORACIC PROC W/O CARD CATH                          140,197     139,517        108            9           9
  2008        2       108   OTHER CARDIOTHORACIC PROCEDURES                                                       51,118      51,118          39           2           2
  2008        2       110   MAJOR CARDIOVASCULAR PROCEDURES W CC                                                 131,983     131,113        101           10          10
  2008        2       111   MAJOR CARDIOVASCULAR PROCEDURES W/O CC                                                30,441      30,361          23           3           3
  2008        2       113   AMPUTATION FOR CIRC SYSTEM DISORDERS EXCEPT UPPER LIMB & TOE                         149,491     148,181        131           13          13
  2008        2       114   UPPER LIMB & TOE AMPUTATION FOR CIRC SYSTEM DISORDERS                                 49,266      48,876          39           3           3
  2008        2       117   CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT                                  39,194      38,904          29           3           3
  2008        2       120   OTHER CIRCULATORY SYSTEM O.R. PROCEDURES                                              84,275      83,655          62          10           9
  2008        2       121   CIRCULATORY DISORDERS W AMI & MAJOR COMP, DISCHARGED ALIVE                           101,170     100,410          76          14          14
  2008        2       122   CIRCULATORY DISORDERS W AMI W/O MAJOR COMP, DISCHARGED ALIVE                          56,055      55,615          44          12          12
  2008        2       123   CIRCULATORY DISORDERS W AMI, EXPIRED                                                  35,589      35,319          27           3           3
  2008        2       124   CIRCULATORY DISORDERS EXCEPT AMI, W CARD CATH & COMPLEX DIAG                         236,566     234,566        200           42          42
  2008        2       125   CIRCULATORY DISORDERS EXCEPT AMI, W CARD CATH W/O COMPLEX DIAG                        82,141      81,591          65          25          25
  2008        2       126   ACUTE & SUBACUTE ENDOCARDITIS                                                         41,782      41,432          35           2           2
  2008        2       127   HEART FAILURE & SHOCK                                                              1,284,902   1,274,042      1,094          270         270
  2008        2       128   DEEP VEIN THROMBOPHLEBITIS                                                             2,070       2,050           2           1           1
  2008        2       129   CARDIAC ARREST, UNEXPLAINED                                                           10,766      10,686           8           3           3
  2008        2       130   PERIPHERAL VASCULAR DISORDERS W CC                                                   191,619     190,279        148           28          28
  2008        2       131   PERIPHERAL VASCULAR DISORDERS W/O CC                                                  68,336      67,786          55          15          15
  2008        2       132   ATHEROSCLEROSIS W CC                                                                 107,584     106,664          92          21          21
  2008        2       133   ATHEROSCLEROSIS W/O CC                                                                 1,281       1,271           1           1           1




5/15/2012                                                                              Milliman                                                                            Page 17
                                                                                 DRG Distribution




                                                           Inpatient Claims by Diagnosis-Related Group Code
                     DRG                                                 DRG                                  Allowed       Paid   Inpatient   Discharge   Admission
  Year      Region   Code                                             Description                             Charges     Claims      Days         Count      Count
  2008        2       134   HYPERTENSION                                                                       117,376   116,326        105           32          32
  2008        2       137   CARDIAC CONGENITAL & VALVULAR DISORDERS AGE 0-17                                   114,842   114,842          88           8           5
  2008        2       138   CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS W CC                                     164,818   163,568        141           34          34
  2008        2       139   CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS W/O CC                                    25,849    25,639          21           6           6
  2008        2       140   ANGINA PECTORIS                                                                     36,287    35,987          30          10          10
  2008        2       141   SYNCOPE & COLLAPSE W CC                                                             75,714    75,094          67          21          21
  2008        2       142   SYNCOPE & COLLAPSE W/O CC                                                           20,228    20,038          19           9           9
  2008        2       143   CHEST PAIN                                                                         392,021   388,631        341          150         148
  2008        2       144   OTHER CIRCULATORY SYSTEM DIAGNOSES W CC                                            353,669   351,719        276           58          56
  2008        2       145   OTHER CIRCULATORY SYSTEM DIAGNOSES W/O CC                                           11,291    11,211          11           7           7
  2008        2       146   RECTAL RESECTION W CC                                                               16,786    16,656          13           2           2
  2008        2       147   RECTAL RESECTION W/O CC                                                             10,252    10,172           8           1           1
  2008        2       149   MAJOR SMALL & LARGE BOWEL PROCEDURES W/O CC                                         74,038    73,468          57           8           8
  2008        2       150   PERITONEAL ADHESIOLYSIS W CC                                                        71,703    71,143          56           6           6
  2008        2       151   PERITONEAL ADHESIOLYSIS W/O CC                                                      31,756    31,516          24           4           4
  2008        2       153   MINOR SMALL & LARGE BOWEL PROCEDURES W/O CC                                         22,065    21,865          20           3           3
  2008        2       155   STOMACH, ESOPHAGEAL & DUODENAL PROCEDURES AGE >17 W/O CC                            13,772    13,682           9           1           1
  2008        2       156   STOMACH, ESOPHAGEAL & DUODENAL PROCEDURES AGE 0-17                                 105,131   105,131          80           7           7
  2008        2       157   ANAL & STOMAL PROCEDURES W CC                                                       48,648    48,258          39           3           3
  2008        2       158   ANAL & STOMAL PROCEDURES W/O CC                                                     24,527    24,337          19           9           9
  2008        2       159   HERNIA PROCEDURES EXCEPT INGUINAL & FEMORAL AGE >17 W CC                            87,500    86,800          70          10          10
  2008        2       160   HERNIA PROCEDURES EXCEPT INGUINAL & FEMORAL AGE >17 W/O CC                          12,484    12,384          10           3           3
  2008        2       162   INGUINAL & FEMORAL HERNIA PROCEDURES AGE >17 W/O CC                                  5,571     5,531           4           2           2
  2008        2       163   HERNIA PROCEDURES AGE 0-17                                                           9,093     9,093           7           3           3
  2008        2       165   APPENDECTOMY W COMPLICATED PRINCIPAL DIAG W/O CC                                     9,243     9,243           7           1           1
  2008        2       166   APPENDECTOMY W/O COMPLICATED PRINCIPAL DIAG W CC                                    34,404    34,274          29           8           8
  2008        2       167   APPENDECTOMY W/O COMPLICATED PRINCIPAL DIAG W/O CC                                  20,562    20,482          16           9           9
  2008        2       168   MOUTH PROCEDURES W CC                                                                2,619     2,599           2           1           1
  2008        2       170   OTHER DIGESTIVE SYSTEM O.R. PROCEDURES W CC                                        112,050   111,130          92           7           7
  2008        2       172   DIGESTIVE MALIGNANCY W CC                                                          198,559   196,859        170           25          25
  2008        2       173   DIGESTIVE MALIGNANCY W/O CC                                                          4,173     4,143           3           1           1
  2008        2       174   G.I. HEMORRHAGE W CC                                                               271,325   269,265        212           50          50
  2008        2       175   G.I. HEMORRHAGE W/O CC                                                              23,185    22,955          23          10          10
  2008        2       176   COMPLICATED PEPTIC ULCER                                                            36,965    36,655          31           6           6
  2008        2       177   UNCOMPLICATED PEPTIC ULCER W CC                                                     43,055    42,715          34           9           9
  2008        2       178   UNCOMPLICATED PEPTIC ULCER W/O CC                                                   17,193    17,043          15           4           4
  2008        2       179   INFLAMMATORY BOWEL DISEASE                                                          74,006    73,536          55          10          10
  2008        2       180   G.I. OBSTRUCTION W CC                                                               94,920    94,140          85          26          25
  2008        2       181   G.I. OBSTRUCTION W/O CC                                                             73,916    73,296          63          16          16
  2008        2       182   ESOPHAGITIS, GASTROENT & MISC DIGEST DISORDERS AGE >17 W CC                        669,415   663,455        596          174         173
  2008        2       183   ESOPHAGITIS, GASTROENT & MISC DIGEST DISORDERS AGE >17 W/O CC                      219,114   217,174        194           77          77
  2008        2       184   ESOPHAGITIS, GASTROENT & MISC DIGEST DISORDERS AGE 0-17                            110,430   110,430          99          44          44
  2008        2       185   DENTAL & ORAL DIS EXCEPT EXTRACTIONS & RESTORATIONS, AGE >17                        37,052    36,742          31           8           8
  2008        2       186   DENTAL & ORAL DIS EXCEPT EXTRACTIONS & RESTORATIONS, AGE 0-17                        5,155     5,155           6           3           3
  2008        2       187   DENTAL EXTRACTIONS & RESTORATIONS                                                   16,647    16,597          12           7           7
  2008        2       188   OTHER DIGESTIVE SYSTEM DIAGNOSES AGE >17 W CC                                      126,667   125,697          97          20          20
  2008        2       189   OTHER DIGESTIVE SYSTEM DIAGNOSES AGE >17 W/O CC                                     24,897    24,677          22          12          12
  2008        2       190   OTHER DIGESTIVE SYSTEM DIAGNOSES AGE 0-17                                          128,366   128,366          99          17          16
  2008        2       191   PANCREAS, LIVER & SHUNT PROCEDURES W CC                                             13,756    13,646          11           1           1
  2008        2       192   PANCREAS, LIVER & SHUNT PROCEDURES W/O CC                                            2,711     2,691           2           1           1
  2008        2       193   BILIARY TRACT PROC EXCEPT ONLY CHOLECYST W OR W/O C.D.E. W CC                       23,568    23,408          16           2           2
  2008        2       194   BILIARY TRACT PROC EXCEPT ONLY CHOLECYST W OR W/O C.D.E. W/O CC                     12,506    12,406          10           1           1
  2008        2       197   CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE W/O C.D.E. W CC                               36,838    36,538          30           5           5
  2008        2       198   CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE W/O C.D.E. W/O CC                             14,900    14,770          13           4           4
  2008        2       200   HEPATOBILIARY DIAGNOSTIC PROCEDURE FOR NON-MALIGNANCY                               24,307    24,127          18           2           2
  2008        2       201   OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES                                     10,000     9,880          12           1           1
  2008        2       202   CIRRHOSIS & ALCOHOLIC HEPATITIS                                                     73,260    72,520          75          21          21
  2008        2       203   MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS                                      83,170    82,530          64          10          10
  2008        2       204   DISORDERS OF PANCREAS EXCEPT MALIGNANCY                                            437,492   434,022        363           81          81
  2008        2       205   DISORDERS OF LIVER EXCEPT MALIG,CIRR,ALC HEPA W CC                                 117,164   116,164        104           28          27
  2008        2       206   DISORDERS OF LIVER EXCEPT MALIG,CIRR,ALC HEPA W/O CC                                10,938    10,838          10           4           4
  2008        2       207   DISORDERS OF THE BILIARY TRACT W CC                                                 80,852    80,162          75          13          13
  2008        2       208   DISORDERS OF THE BILIARY TRACT W/O CC                                               17,633    17,473          16           6           6
  2008        2       210   HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT AGE >17 W CC                              54,995    54,585          41           7           7
  2008        2       211   HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT AGE >17 W/O CC                            24,896    24,706          19           6           6
  2008        2       212   HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT AGE 0-17                                  31,586    31,586          24           6           6
  2008        2       213   AMPUTATION FOR MUSCULOSKELETAL SYSTEM & CONN TISSUE DISORDERS                        9,243     9,173           7           1           1
  2008        2       216   BIOPSIES OF MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE                              55,572    55,152          44           5           5
  2008        2       217   WND DEBRID & SKN GRFT EXCEPT HAND,FOR MUSCSKELET & CONN TISS DIS                    71,056    70,726          56           6           6
  2008        2       218   LOWER EXTREM & HUMER PROC EXCEPT HIP,FOOT,FEMUR AGE >17 W CC                        73,444    72,864          58          12          12
  2008        2       219   LOWER EXTREM & HUMER PROC EXCEPT HIP,FOOT,FEMUR AGE >17 W/O CC                      32,178    31,908          27           9           9
  2008        2       220   LOWER EXTREM & HUMER PROC EXCEPT HIP,FOOT,FEMUR AGE 0-17                             5,240     5,240           4           2           2
  2008        2       223   MAJOR SHOULDER/ELBOW PROC, OR OTHER UPPER EXTREMITY PROC W CC                       10,088    10,038           8           2           2
  2008        2       224   SHOULDER,ELBOW OR FOREARM PROC,EXC MAJOR JOINT PROC, W/O CC                          1,320     1,310           1           1           1
  2008        2       225   FOOT PROCEDURES                                                                     20,567    20,557          15           4           4
  2008        2       226   SOFT TISSUE PROCEDURES W CC                                                         20,786    20,646          14           2           2
  2008        2       227   SOFT TISSUE PROCEDURES W/O CC                                                        9,525     9,485           7           3           3
  2008        2       230   LOCAL EXCISION & REMOVAL OF INT FIX DEVICES OF HIP & FEMUR                           7,953     7,863           9           2           2
  2008        2       233   OTHER MUSCULOSKELET SYS & CONN TISS O.R. PROC W CC                                  25,861    25,731          20           4           4
  2008        2       234   OTHER MUSCULOSKELET SYS & CONN TISS O.R. PROC W/O CC                                43,097    42,897          33           5           5
  2008        2       235   FRACTURES OF FEMUR                                                                   2,420     2,390           3           1           1
  2008        2       236   FRACTURES OF HIP & PELVIS                                                           10,532    10,492          17           3           3
  2008        2       237   SPRAINS, STRAINS, & DISLOCATIONS OF HIP, PELVIS & THIGH                                306       306           2           1           1
  2008        2       238   OSTEOMYELITIS                                                                       39,936    39,606          33           4           3
  2008        2       239   PATHOLOGICAL FRACTURES & MUSCULOSKELETAL & CONN TISS MALIGNANCY                     49,390    49,050          38           9           9
  2008        2       240   CONNECTIVE TISSUE DISORDERS W CC                                                   128,747   127,867          98          17          17
  2008        2       241   CONNECTIVE TISSUE DISORDERS W/O CC                                                   9,220     9,180           8           3           3
  2008        2       242   SEPTIC ARTHRITIS                                                                    36,145    36,045          28           3           3
  2008        2       243   MEDICAL BACK PROBLEMS                                                              159,645   158,365        134           33          33
  2008        2       244   BONE DISEASES & SPECIFIC ARTHROPATHIES W CC                                         72,481    71,861          62          15          15
  2008        2       245   BONE DISEASES & SPECIFIC ARTHROPATHIES W/O CC                                        6,541     6,451           9           4           4
  2008        2       247   SIGNS & SYMPTOMS OF MUSCULOSKELETAL SYSTEM & CONN TISSUE                            30,196    29,956          24          10          10
  2008        2       248   TENDONITIS, MYOSITIS & BURSITIS                                                     19,667    19,497          17           5           5
  2008        2       249   AFTERCARE, MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE                               13,278    13,188          22           3           3
  2008        2       251   FX, SPRN, STRN & DISL OF FOREARM, HAND, FOOT AGE >17 W/O CC                          2,501     2,481           2           1           1
  2008        2       253   FX, SPRN, STRN & DISL OF UPARM,LOWLEG EX FOOT AGE >17 W CC                          16,377    16,247          13           3           3
  2008        2       254   FX, SPRN, STRN & DISL OF UPARM,LOWLEG EX FOOT AGE >17 W/O CC                         2,500     2,470           3           1           1
  2008        2       255   FX, SPRN, STRN & DISL OF UPARM,LOWLEG EX FOOT AGE 0-17                               8,543     8,543           6           2           2
  2008        2       256   OTHER MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE DIAGNOSES                          48,679    48,469          38           8           8
  2008        2       257   TOTAL MASTECTOMY FOR MALIGNANCY W CC                                                45,479    45,139          34          11          11
  2008        2       258   TOTAL MASTECTOMY FOR MALIGNANCY W/O CC                                              28,371    28,151          22          10          10
  2008        2       259   SUBTOTAL MASTECTOMY FOR MALIGNANCY W CC                                              5,386     5,346           4           1           1
  2008        2       261   BREAST PROC FOR NON-MALIGNANCY EXCEPT BIOPSY & LOCAL EXCISION                        1,320     1,310           1           1           1
  2008        2       262   BREAST BIOPSY & LOCAL EXCISION FOR NON-MALIGNANCY                                   12,100    11,950          15           1           1
  2008        2       263   SKIN GRAFT &/OR DEBRID FOR SKN ULCER OR CELLULITIS W CC                            252,797   250,987        194           24          24
  2008        2       264   SKIN GRAFT &/OR DEBRID FOR SKN ULCER OR CELLULITIS W/O CC                           54,957    54,587          46           8           8




5/15/2012                                                                            Milliman                                                                          Page 18
                                                                                   DRG Distribution




                                                             Inpatient Claims by Diagnosis-Related Group Code
                     DRG                                               DRG                                       Allowed         Paid   Inpatient   Discharge   Admission
  Year      Region   Code                                           Description                                  Charges       Claims      Days         Count      Count
  2008        2       265   SKIN GRAFT &/OR DEBRID EXCEPT FOR SKIN ULCER OR CELLULITIS W CC                        44,706      44,486          37           7           7
  2008        2       266   SKIN GRAFT &/OR DEBRID EXCEPT FOR SKIN ULCER OR CELLULITIS W/O CC                      57,598      57,208          44           8           8
  2008        2       267   PERIANAL & PILONIDAL PROCEDURES                                                         5,282       5,242           4           1           1
  2008        2       268   SKIN, SUBCUTANEOUS TISSUE & BREAST PLASTIC PROCEDURES                                   2,693       2,673           2           1           1
  2008        2       269   OTHER SKIN, SUBCUT TISS & BREAST PROC W CC                                             93,693      93,003          75          13          13
  2008        2       270   OTHER SKIN, SUBCUT TISS & BREAST PROC W/O CC                                           12,166      12,076           9           5           5
  2008        2       271   SKIN ULCERS                                                                            59,747      59,387          46           8           7
  2008        2       272   MAJOR SKIN DISORDERS W CC                                                               5,634       5,574           6           1           1
  2008        2       273   MAJOR SKIN DISORDERS W/O CC                                                            19,626      19,476          15           3           3
  2008        2       274   MALIGNANT BREAST DISORDERS W CC                                                        16,258      16,128          13           2           2
  2008        2       275   MALIGNANT BREAST DISORDERS W/O CC                                                       2,511       2,491           2           2           2
  2008        2       276   NON-MALIGNANT BREAST DISORDERS                                                         33,079      32,809          27           6           6
  2008        2       277   CELLULITIS AGE >17 W CC                                                               348,238     345,408        297           59          59
  2008        2       278   CELLULITIS AGE >17 W/O CC                                                             228,039     225,829        221           55          55
  2008        2       279   CELLULITIS AGE 0-17                                                                   100,646     100,646          84          23          23
  2008        2       280   TRAUMA TO THE SKIN, SUBCUT TISS & BREAST AGE >17 W CC                                  36,863      36,563          30           6           6
  2008        2       281   TRAUMA TO THE SKIN, SUBCUT TISS & BREAST AGE >17 W/O CC                                 1,400       1,390           1           1           1
  2008        2       282   TRAUMA TO THE SKIN, SUBCUT TISS & BREAST AGE 0-17                                       1,320       1,320           1           1           1
  2008        2       283   MINOR SKIN DISORDERS W CC                                                              72,016      71,606          62          16          16
  2008        2       284   MINOR SKIN DISORDERS W/O CC                                                            17,517      17,387          14           4           4
  2008        2       285   AMPUTAT OF LOWER LIMB FOR ENDOCRINE,NUTRIT,& METABOL DISORDERS                         34,681      34,461          22           3           3
  2008        2       287   SKIN GRAFTS & WOUND DEBRID FOR ENDOC, NUTRIT & METAB DISORDERS                         25,974      25,694          28           2           2
  2008        2       289   PARATHYROID PROCEDURES                                                                  3,857       3,827           3           2           2
  2008        2       290   THYROID PROCEDURES                                                                     34,070      33,810          26           9           9
  2008        2       292   OTHER ENDOCRINE, NUTRIT & METAB O.R. PROC W CC                                         12,518      12,428           9           1           1
  2008        2       293   OTHER ENDOCRINE, NUTRIT & METAB O.R. PROC W/O CC                                        2,619       2,599           2           1           1
  2008        2       294   DIABETES AGE >35                                                                      484,878     480,598        449          113         113
  2008        2       295   DIABETES AGE 0-35                                                                     159,671     158,441        142           50          50
  2008        2       296   NUTRITIONAL & MISC METABOLIC DISORDERS AGE >17 W CC                                   406,576     403,156        342           90          90
  2008        2       297   NUTRITIONAL & MISC METABOLIC DISORDERS AGE >17 W/O CC                                  82,613      81,853          76          22          22
  2008        2       298   NUTRITIONAL & MISC METABOLIC DISORDERS AGE 0-17                                       349,771     349,771        284           64          64
  2008        2       299   INBORN ERRORS OF METABOLISM                                                            26,072      26,072          20           9           9
  2008        2       300   ENDOCRINE DISORDERS W CC                                                               81,918      81,638          66          10          10
  2008        2       301   ENDOCRINE DISORDERS W/O CC                                                             43,575      43,575          37           3           3
  2008        2       302   KIDNEY TRANSPLANT                                                                      19,385      19,235          15           2           2
  2008        2       303   KIDNEY,URETER & MAJOR BLADDER PROCEDURES FOR NEOPLASM                                   8,948       8,878          15           2           2
  2008        2       304   KIDNEY,URETER & MAJOR BLADDER PROC FOR NON-NEOPL W CC                                  97,955      97,155          80          10          10
  2008        2       305   KIDNEY,URETER & MAJOR BLADDER PROC FOR NON-NEOPL W/O CC                                51,245      51,155          39           3           3
  2008        2       308   MINOR BLADDER PROCEDURES W CC                                                           2,782       2,762           2           1           1
  2008        2       309   MINOR BLADDER PROCEDURES W/O CC                                                         3,961       3,931           3           1           1
  2008        2       310   TRANSURETHRAL PROCEDURES W CC                                                          28,148      27,928          22           3           3
  2008        2       313   URETHRAL PROCEDURES, AGE >17 W/O CC                                                     3,752       3,722           3           1           1
  2008        2       315   OTHER KIDNEY & URINARY TRACT O.R. PROCEDURES                                          105,986     105,176          85          17          17
  2008        2       316   RENAL FAILURE                                                                         754,192     748,782        589          137         134
  2008        2       317   ADMIT FOR RENAL DIALYSIS                                                               11,884      11,884           9           2           2
  2008        2       318   KIDNEY & URINARY TRACT NEOPLASMS W CC                                                  13,676      13,566          11           2           2
  2008        2       320   KIDNEY & URINARY TRACT INFECTIONS AGE >17 W CC                                        256,812     254,502        231           61          61
  2008        2       321   KIDNEY & URINARY TRACT INFECTIONS AGE >17 W/O CC                                       92,126      91,336          81          25          25
  2008        2       322   KIDNEY & URINARY TRACT INFECTIONS AGE 0-17                                             63,707      63,707          50          12          12
  2008        2       323   URINARY STONES W CC, &/OR ESW LITHOTRIPSY                                              23,110      22,910          21           8           8
  2008        2       324   URINARY STONES W/O CC                                                                   6,786       6,716           8           3           3
  2008        2       325   KIDNEY & URINARY TRACT SIGNS & SYMPTOMS AGE >17 W CC                                    2,444       2,424           2           1           1
  2008        2       326   KIDNEY & URINARY TRACT SIGNS & SYMPTOMS AGE >17 W/O CC                                    775         765           1           1           1
  2008        2       331   OTHER KIDNEY & URINARY TRACT DIAGNOSES AGE >17 W CC                                   175,457     174,077        138           22          22
  2008        2       332   OTHER KIDNEY & URINARY TRACT DIAGNOSES AGE >17 W/O CC                                   9,948       9,868           8           3           3
  2008        2       333   OTHER KIDNEY & URINARY TRACT DIAGNOSES AGE 0-17                                        56,656      56,656          43           8           8
  2008        2       334   MAJOR MALE PELVIC PROCEDURES W CC                                                      16,868      16,738          13           3           3
  2008        2       335   MAJOR MALE PELVIC PROCEDURES W/O CC                                                     6,463       6,413           5           2           2
  2008        2       336   TRANSURETHRAL PROSTATECTOMY W CC                                                        2,502       2,482           2           1           1
  2008        2       340   TESTES PROCEDURES, NON-MALIGNANCY AGE 0-17                                              2,563       2,563           2           1           1
  2008        2       341   PENIS PROCEDURES                                                                       16,659      16,529          13           1           1
  2008        2       344   OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY                             833         823           1           1           1
  2008        2       346   MALIGNANCY, MALE REPRODUCTIVE SYSTEM, W CC                                              3,844       3,814           3           1           1
  2008        2       348   BENIGN PROSTATIC HYPERTROPHY W CC                                                       1,613       1,593           2           1           1
  2008        2       350   INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM                                           17,181      17,051          13           4           4
  2008        2       352   OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES                                                6,931       6,911          13           4           4
  2008        2       353   PELVIC EVISCERATION, RADICAL HYSTERECTOMY & RADICAL VULVECTOMY                          6,377       6,327           5           2           2
  2008        2       354   UTERINE,ADNEXA PROC FOR NON-OVARIAN/ADNEXAL MALIG W CC                                 16,679      16,569          11           3           3
  2008        2       355   UTERINE,ADNEXA PROC FOR NON-OVARIAN/ADNEXAL MALIG W/O CC                               14,598      14,478          12           4           4
  2008        2       356   FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES                                   10,310      10,220           9           4           4
  2008        2       357   UTERINE & ADNEXA PROC FOR OVARIAN OR ADNEXAL MALIGNANCY                                21,447      21,277          17           3           3
  2008        2       358   UTERINE & ADNEXA PROC FOR NON-MALIGNANCY W CC                                          77,341      76,761          58          18          18
  2008        2       359   UTERINE & ADNEXA PROC FOR NON-MALIGNANCY W/O CC                                       167,114     165,784        133           55          55
  2008        2       360   VAGINA, CERVIX & VULVA PROCEDURES                                                      40,610      40,320          29          10          10
  2008        2       361   LAPAROSCOPY & INCISIONAL TUBAL INTERRUPTION                                             3,632       3,602           3           1           1
  2008        2       364   D&C, CONIZATION EXCEPT FOR MALIGNANCY                                                  20,725      20,615          16           5           5
  2008        2       365   OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES                                       16,954      16,814          14           1           1
  2008        2       366   MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM W CC                                            13,879      13,699          20           5           5
  2008        2       367   MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM W/O CC                                           3,844       3,814           3           1           1
  2008        2       368   INFECTIONS, FEMALE REPRODUCTIVE SYSTEM                                                 91,493      90,783          71          14          14
  2008        2       369   MENSTRUAL & OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS                                 47,764      47,374          39          20          20
  2008        2       370   CESAREAN SECTION W CC                                                                 246,715     246,545        195           47          47
  2008        2       371   CESAREAN SECTION W/O CC                                                               199,892     199,532        153           47          47
  2008        2       372   VAGINAL DELIVERY W COMPLICATING DIAGNOSES                                             126,823     126,753        102           38          37
  2008        2       373   VAGINAL DELIVERY W/O COMPLICATING DIAGNOSES                                           311,132     310,892        243          113         113
  2008        2       374   VAGINAL DELIVERY W STERILIZATION &/OR D&C                                              34,941      34,901          31          12          12
  2008        2       376   POSTPARTUM & POST ABORTION DIAGNOSES W/O O.R. PROCEDURE                                57,073      56,663          44          13          13
  2008        2       377   POSTPARTUM & POST ABORTION DIAGNOSES W O.R. PROCEDURE                                  32,992      32,772          22           3           3
  2008        2       378   ECTOPIC PREGNANCY                                                                      18,951      18,841          14           6           6
  2008        2       379   THREATENED ABORTION                                                                    30,844      30,834          23          10          10
  2008        2       380   ABORTION W/O D&C                                                                        8,626       8,616           7           3           3
  2008        2       381   ABORTION W D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY                                    15,485      15,415          13           6           6
  2008        2       382   FALSE LABOR                                                                             2,743       2,743           2           1           1
  2008        2       383   OTHER ANTEPARTUM DIAGNOSES W MEDICAL COMPLICATIONS                                    291,307     290,227        229           90          90
  2008        2       384   OTHER ANTEPARTUM DIAGNOSES W/O MEDICAL COMPLICATIONS                                   15,831      15,831          13           5           5
  2008        2       385   NEONATES, DIED OR TRANSFERRED TO ANOTHER ACUTE CARE FACILITY                          231,775     231,775        176            8           6
  2008        2       386   EXTREME IMMATURITY OR RESPIRATORY DISTRESS SYNDROME, NEONATE                        6,974,404   6,974,404      5,506          198         182
  2008        2       387   PREMATURITY W MAJOR PROBLEMS                                                          319,402     319,402        241           11          10
  2008        2       388   PREMATURITY W/O MAJOR PROBLEMS                                                         40,947      40,947          48           3           2
  2008        2       389   FULL TERM NEONATE W MAJOR PROBLEMS                                                    337,390     337,390        262           12          12
  2008        2       391   NORMAL NEWBORN                                                                        319,551     319,551        242            9           9
  2008        2       392   SPLENECTOMY AGE >17                                                                     5,833       5,763           7           1           1
  2008        2       393   SPLENECTOMY AGE 0-17                                                                    5,113       5,113           4           1           1
  2008        2       394   OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS                             8,754       8,684           7           1           1
  2008        2       395   RED BLOOD CELL DISORDERS AGE >17                                                    1,879,317   1,863,277      1,639          355         354
  2008        2       396   RED BLOOD CELL DISORDERS AGE 0-17                                                     740,733     740,733        602          162         161




5/15/2012                                                                              Milliman                                                                             Page 19
                                                                                 DRG Distribution




                                                           Inpatient Claims by Diagnosis-Related Group Code
                     DRG                                               DRG                                     Allowed         Paid   Inpatient   Discharge   Admission
  Year      Region   Code                                           Description                                Charges       Claims      Days         Count      Count
  2008        2       397   COAGULATION DISORDERS                                                                62,593      62,163          55          13          13
  2008        2       398   RETICULOENDOTHELIAL & IMMUNITY DISORDERS W CC                                        49,266      49,106          38           4           4
  2008        2       399   RETICULOENDOTHELIAL & IMMUNITY DISORDERS W/O CC                                      10,716      10,706          10           4           4
  2008        2       401   LYMPHOMA & NON-ACUTE LEUKEMIA W OTHER O.R. PROC W CC                                 26,197      25,997          20           3           3
  2008        2       402   LYMPHOMA & NON-ACUTE LEUKEMIA W OTHER O.R. PROC W/O CC                               11,336      11,256           8           1           1
  2008        2       403   LYMPHOMA & NON-ACUTE LEUKEMIA W CC                                                   70,085      69,605          59          10           9
  2008        2       404   LYMPHOMA & NON-ACUTE LEUKEMIA W/O CC                                                 30,371      30,371          23           1           1
  2008        2       405   ACUTE LEUKEMIA W/O MAJOR O.R. PROCEDURE AGE 0-17                                     72,161      72,161          67           6           6
  2008        2       410   CHEMOTHERAPY W/O ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS                              680,038     676,278        561          178         177
  2008        2       413   OTHER MYELOPROLIF DIS OR POORLY DIFF NEOPL DIAG W CC                                  7,551       7,471           8           4           4
  2008        2       417   SEPTICEMIA AGE 0-17                                                                 146,544     146,544        115           13          12
  2008        2       418   POSTOPERATIVE & POST-TRAUMATIC INFECTIONS                                           313,687     312,577        241           24          24
  2008        2       419   FEVER OF UNKNOWN ORIGIN AGE >17 W CC                                                 26,160      25,950          21           6           6
  2008        2       420   FEVER OF UNKNOWN ORIGIN AGE >17 W/O CC                                                4,189       4,159           3           1           1
  2008        2       421   VIRAL ILLNESS AGE >17                                                                 6,777       6,727           5           1           1
  2008        2       422   VIRAL ILLNESS & FEVER OF UNKNOWN ORIGIN AGE 0-17                                    140,372     140,372        110           35          35
  2008        2       423   OTHER INFECTIOUS & PARASITIC DISEASES DIAGNOSES                                      20,858      20,638          25           5           5
  2008        2       424   O.R. PROCEDURE W PRINCIPAL DIAGNOSES OF MENTAL ILLNESS                               16,127      15,997          13           1           1
  2008        2       425   ACUTE ADJUSTMENT REACTION & PSYCHOSOCIAL DYSFUNCTION                                 42,046      41,706          34          13          13
  2008        2       426   DEPRESSIVE NEUROSES                                                                 262,227     260,177        230           47          47
  2008        2       427   NEUROSES EXCEPT DEPRESSIVE                                                          244,125     243,645        193           23          23
  2008        2       428   DISORDERS OF PERSONALITY & IMPULSE CONTROL                                           44,635      44,315          54           7           7
  2008        2       429   ORGANIC DISTURBANCES & MENTAL RETARDATION                                           153,536     153,066        177           17          17
  2008        2       430   PSYCHOSES                                                                         7,916,457   7,849,337      7,675          879         869
  2008        2       431   CHILDHOOD MENTAL DISORDERS                                                          952,262     951,992      1,100           88          87
  2008        2       432   OTHER MENTAL DISORDER DIAGNOSES                                                      15,623      15,473          19           3           3
  2008        2       433   ALCOHOL/DRUG ABUSE OR DEPENDENCE, LEFT AMA                                          121,506     120,246        135           33          31
  2008        2       439   SKIN GRAFTS FOR INJURIES                                                             15,002      14,952          11           2           2
  2008        2       440   WOUND DEBRIDEMENTS FOR INJURIES                                                      11,862      11,772           9           2           2
  2008        2       442   OTHER O.R. PROCEDURES FOR INJURIES W CC                                              73,117      72,677          53           8           8
  2008        2       443   OTHER O.R. PROCEDURES FOR INJURIES W/O CC                                            30,957      30,707          29           8           8
  2008        2       444   TRAUMATIC INJURY AGE >17 W CC                                                         5,456       5,396           6           2           2
  2008        2       445   TRAUMATIC INJURY AGE >17 W/O CC                                                      52,638      52,208          43           2           2
  2008        2       446   TRAUMATIC INJURY AGE 0-17                                                             3,877       3,877           3           2           2
  2008        2       447   ALLERGIC REACTIONS AGE >17                                                           20,766      20,576          19           7           7
  2008        2       448   ALLERGIC REACTIONS AGE 0-17                                                           3,013       3,013           2           1           1
  2008        2       449   POISONING & TOXIC EFFECTS OF DRUGS AGE >17 W CC                                     194,185     192,695        149           37          37
  2008        2       450   POISONING & TOXIC EFFECTS OF DRUGS AGE >17 W/O CC                                    41,391      41,081          31          11          11
  2008        2       451   POISONING & TOXIC EFFECTS OF DRUGS AGE 0-17                                          14,534      14,534          11           5           5
  2008        2       452   COMPLICATIONS OF TREATMENT W CC                                                      52,778      52,388          42           8           8
  2008        2       453   COMPLICATIONS OF TREATMENT W/O CC                                                    34,961      34,671          29           7           7
  2008        2       454   OTHER INJURY, POISONING & TOXIC EFFECT DIAG W CC                                     11,314      11,244           9           4           4
  2008        2       455   OTHER INJURY, POISONING & TOXIC EFFECT DIAG W/O CC                                   19,569      19,549          32           2           2
  2008        2       461   O.R. PROC W DIAGNOSES OF OTHER CONTACT W HEALTH SERVICES                             13,455      13,345          11           2           1
  2008        2       462   REHABILITATION                                                                      875,447     869,497        676           62          61
  2008        2       463   SIGNS & SYMPTOMS W CC                                                                98,820      98,020          81          23          23
  2008        2       464   SIGNS & SYMPTOMS W/O CC                                                              26,489      26,299          20           8           8
  2008        2       466   AFTERCARE W/O HISTORY OF MALIGNANCY AS SECONDARY DIAGNOSIS                            2,641       2,641           2           1           1
  2008        2       467   OTHER FACTORS INFLUENCING HEALTH STATUS                                              13,506      13,506          10           3           3
  2008        2       468   EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS                           241,284     240,464        178           17          17
  2008        2       469   PRINCIPAL DIAGNOSIS INVALID AS DISCHARGE DIAGNOSIS                                    1,752       1,732           2           1           1
  2008        2       476   PROSTATIC O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS                            13,096      12,996          10           1           1
  2008        2       477   NON-EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS                        96,606      95,936          80          12          12
  2008        2       479   OTHER VASCULAR PROCEDURES W/O CC                                                      8,098       8,028           7           6           6
  2008        2       481   BONE MARROW TRANSPLANT                                                               55,459      55,199          42           2           2
  2008        2       482   TRACHEOSTOMY FOR FACE,MOUTH & NECK DIAGNOSES                                        115,531     114,651          88           9           9
  2008        2       484   CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA                                            6,391       6,391           5           1           1
  2008        2       485   LIMB REATTACHMENT, HIP AND FEMUR PROC FOR MULTIPLE SIGNIFICANT TRA                   25,345      25,175          20           2           2
  2008        2       486   OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA                               161,128     159,958        127            7           7
  2008        2       487   OTHER MULTIPLE SIGNIFICANT TRAUMA                                                    61,652      61,222          48           7           6
  2008        2       488   HIV W EXTENSIVE O.R. PROCEDURE                                                      100,113      99,373          74           5           5
  2008        2       489   HIV W MAJOR RELATED CONDITION                                                       694,152     688,702        545           93          92
  2008        2       490   HIV W OR W/O OTHER RELATED CONDITION                                                190,009     188,529        167           27          27
  2008        2       491   MAJOR JOINT & LIMB REATTACHMENT PROCEDURES OF UPPER EXTREMITY                        10,229      10,159           7           3           3
  2008        2       492   CHEMOTHERAPY W ACUTE LEUKEMIA OR W USE OF HI DOSE CHEMOAGENT                        137,422     136,522        128           21          21
  2008        2       493   LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W CC                                        185,612     184,232        164           30          30
  2008        2       494   LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W/O CC                                       61,671      61,261          44          15          15
  2008        2       497   SPINAL FUSION EXCEPT CERVICAL W CC                                                   54,089      53,659          43          10          10
  2008        2       498   SPINAL FUSION EXCEPT CERVICAL W/O CC                                                 61,805      61,435          47          11          11
  2008        2       499   BACK & NECK PROCEDURES EXCEPT SPINAL FUSION W CC                                     28,840      28,610          23           5           5
  2008        2       500   BACK & NECK PROCEDURES EXCEPT SPINAL FUSION W/O CC                                   28,151      27,941          21           6           6
  2008        2       506   FULL THICKNESS BURN W SKIN GRAFT OR INHAL INJ W CC OR SIG TRAUMA                      8,948       8,948           7           1           1
  2008        2       508   FULL THICKNESS BURN W/O SKIN GRFT OR INHAL INJ W CC OR SIG TRAUMA                     2,840       2,800           4           1           1
  2008        2       509   FULL THICKNESS BURN W/O SKIN GRFT OR INH INJ W/O CC OR SIG TRAUMA                     9,736       9,666           7           1           1
  2008        2       510   NON-EXTENSIVE BURNS W CC OR SIGNIFICANT TRAUMA                                       14,542      14,432          11           3           3
  2008        2       511   NON-EXTENSIVE BURNS W/O CC OR SIGNIFICANT TRAUMA                                      7,639       7,579           6           2           2
  2008        2       515   CARDIAC DEFIBRILLATOR IMPLANT W/O CARDIAC CATH                                       91,456      90,776          68          11          11
  2008        2       518   PERC CARDIO PROC W/O CORONARY ARTERY STENT OR AMI                                    63,179      62,659          52          29          29
  2008        2       519   CERVICAL SPINAL FUSION W CC                                                          82,802      82,262          64          10          10
  2008        2       520   CERVICAL SPINAL FUSION W/O CC                                                        23,468      23,288          18           8           8
  2008        2       521   ALCOHOL/DRUG ABUSE OR DEPENDENCE W CC                                             1,096,413   1,084,493      1,220          148         147
  2008        2       522   ALC/DRUG ABUSE OR DEPEND W REHABILITATION THERAPY W/O CC                            759,469     753,309        882           80          80
  2008        2       523   ALC/DRUG ABUSE OR DEPEND W/O REHABILITATION THERAPY W/O CC                          403,362     399,402        420           85          83
  2008        2       524   TRANSIENT ISCHEMIA                                                                   77,083      76,453          65          22          22
  2008        2       528   INTRACRANIAL VASCULAR PROC W PDX HEMORRHAGE                                          32,674      32,424          25           2           2
  2008        2       529   VENTRICULAR SHUNT PROCEDURES W CC                                                    29,773      29,533          24           2           2
  2008        2       530   VENTRICULAR SHUNT PROCEDURES W/O CC                                                   4,115       4,085           3           1           1
  2008        2       531   SPINAL PROCEDURES W CC                                                               69,752      69,252          58           6           6
  2008        2       532   SPINAL PROCEDURES W/O CC                                                             14,735      14,675          14           3           3
  2008        2       533   EXTRACRANIAL PROCEDURES W CC                                                         96,340      95,570          77           8           8
  2008        2       534   EXTRACRANIAL PROCEDURES W/O CC                                                       20,724      20,554          17           9           9
  2008        2       537   LOCAL EXCIS & REMOV OF INT FIX DEV EXCEPT HIP & FEMUR W CC                           21,642      21,462          18           2           2
  2008        2       538   LOCAL EXCIS & REMOV OF INT FIX DEV EXCEPT HIP & FEMUR W/O CC                         15,002      14,902          11           4           3
  2008        2       539   LYMPHOMA & LEUKEMIA W MAJOR OR PROCEDURE W CC                                        30,603      30,583          24           2           2
  2008        2       542   TRACH W MV 96+HRS OR PDX EXC FACE, MOUTH & NECK W/O MAJ O.R.                        328,333     326,253        239           13          12
  2008        2       543   CRANIOTOMY W/IMPLANT OF CHEMO AGENT OR ACUTE COMPLX CNS PDX                         123,305     122,365          94           6           6
  2008        2       544   MAJOR JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY                          274,512     272,322        219           52          52
  2008        2       545   REVISION OF HIP OR KNEE REPLACEMENT                                                  89,085      88,405          68          13          13
  2008        2       546   SPINAL FUSION EXC CERV WITH CURVATURE OF THE SPINE OR MALIG                          39,065      39,065          34           8           8
  2008        2       549   CORONARY BYPASS W/O CARDIAC CATH W MAJOR CV DX                                      153,777     152,567        121           10          10
  2008        2       550   CORONARY BYPASS W/O CARDIAC CATH W/O MAJOR CV DX                                    114,707     113,797          91          11          11
  2008        2       551   PERMANENT CARDIAC PACEMAKER IMPL W MAJ CV DX OR AICD LEAD OR GNRTR                   37,643      37,373          27           3           3
  2008        2       553   OTHER VASCULAR PROCEDURES W CC W MAJOR CV DX                                        162,755     161,465        129           17          17
  2008        2       554   OTHER VASCULAR PROCEDURES W CC W/O MAJOR CV DX                                      176,971     175,671        137           21          21
  2008        2       555   PERCUTANEOUS CARDIOVASCULAR PROC W MAJOR CV DX                                      172,418     170,978        144           31          31
  2008        2       560   BACTERIAL & TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM                                 15,776      15,656          12           2           2




5/15/2012                                                                            Milliman                                                                             Page 20
                                                                                 DRG Distribution




                                                           Inpatient Claims by Diagnosis-Related Group Code
                     DRG                                              DRG                                      Allowed         Paid   Inpatient   Discharge   Admission
  Year      Region   Code                                          Description                                 Charges       Claims      Days         Count      Count
  2008        2       561   NON-BACTERIAL INFECTIONS OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS                    4,007       4,007           3           1           1
  2008        2       562   SEIZURE AGE > 17 W CC                                                               284,285     282,055        225           52          52
  2008        2       563   SEIZURE AGE > 17 W/O CC                                                             130,268     129,148        112           41          40
  2008        2       564   HEADACHES AGE >17                                                                    50,053      49,633          42          14          14
  2008        2       565   RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT 96+ HOURS                      777,420     776,030        619           36          36
  2008        2       566   RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT < 96 HOURS                     803,260     801,440        610           60          60
  2008        2       568   STOMACH, ESOPHAGEAL & DUODENAL PROCEDURES PROC AGE > 17 W CC W/O MAJOR GI DX        100,984     100,134          85           7           7
  2008        2       569   MAJOR SMALL & LARGE BOWEL PROCEDURES W CC W MAJOR GI DX                             296,110     293,970        243           18          18
  2008        2       570   MAJOR SMALL & LARGE BOWEL PROCEDURES W CC W/O MAJOR GI DX                           151,998     150,828        117           11          11
  2008        2       571   MAJOR ESOPHAGEAL DISORDERS                                                           41,067      40,737          34           9           9
  2008        2       572   MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS                           98,297      97,677          79          12          12
  2008        2       573   MAJOR BLADDER PROCEDURES                                                             31,963      31,813          25           3           3
  2008        2       574   MAJOR HEMATOLOGIC/IMMUNOLOGIC DIAG EXC SICKLE CELL CRISIS & COAGUL                  233,567     233,327        214           30          30
  2008        2       575   SEPTICEMIA W MV96+ HOURS AGE >17                                                     78,128      77,408          72           3           3
  2008        2       576   SEPTICEMIA W/O MV96+ HOURS AGE >17                                                  488,453     484,553        390           54          53
  2008        2       578   INFECTIOUS & PARASITIC DISEASES W OR PROCEDURE                                      359,204     356,094        329           18          18
  2008        2       579   POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS W OR PROCEDURE                           136,004     135,194        110           14          14
  2008        3       000   Unknown                                                                           4,679,655   4,652,655      4,391          720         717
  2008        3       001   CRANIOTOMY AGE >17 W CC                                                              93,400      92,680          72           9           9
  2008        3       002   CRANIOTOMY AGE >17 W/O CC                                                            36,848      36,578          27           5           5
  2008        3       003   CRANIOTOMY AGE 0-17                                                                 116,290     116,290          91          15          14
  2008        3       007   PERIPH & CRANIAL NERVE & OTHER NERV SYST PROC W CC                                   38,044      37,794          29           6           6
  2008        3       008   PERIPH & CRANIAL NERVE & OTHER NERV SYST PROC W/O CC                                 43,078      42,798          33           9           9
  2008        3       009   SPINAL DISORDERS & INJURIES                                                          16,198      16,078          12           2           2
  2008        3       010   NERVOUS SYSTEM NEOPLASMS W CC                                                       170,913     169,943        129           15          15
  2008        3       011   NERVOUS SYSTEM NEOPLASMS W/O CC                                                       2,700       2,680           2           1           1
  2008        3       012   DEGENERATIVE NERVOUS SYSTEM DISORDERS                                                71,316      70,766          57          14          14
  2008        3       013   MULTIPLE SCLEROSIS & CEREBELLAR ATAXIA                                               48,955      48,575          38          10          10
  2008        3       014   INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION                                      295,155     292,935        223           53          52
  2008        3       015   NONSPECIFIC CVA & PRECEREBRAL OCCLUSION W/O INFARCT                                  25,332      25,192          18           4           4
  2008        3       016   NONSPECIFIC CEREBROVASCULAR DISORDERS W CC                                           64,438      63,958          48           5           5
  2008        3       017   NONSPECIFIC CEREBROVASCULAR DISORDERS W/O CC                                          5,282       5,242           4           1           1
  2008        3       018   CRANIAL & PERIPHERAL NERVE DISORDERS W CC                                           102,979     102,189          79          23          23
  2008        3       019   CRANIAL & PERIPHERAL NERVE DISORDERS W/O CC                                          40,826      40,466          36          10          10
  2008        3       021   VIRAL MENINGITIS                                                                     24,038      23,948          17           2           2
  2008        3       022   HYPERTENSIVE ENCEPHALOPATHY                                                          40,349      40,049          30           2           2
  2008        3       023   NONTRAUMATIC STUPOR & COMA                                                           18,568      18,408          16           4           4
  2008        3       026   SEIZURE & HEADACHE AGE 0-17                                                         165,139     165,139        138           60          60
  2008        3       027   TRAUMATIC STUPOR & COMA, COMA >1 HR                                                  14,525      14,525          11           1           1
  2008        3       028   TRAUMATIC STUPOR & COMA, COMA <1 HR AGE >17 W CC                                     13,059      12,959          10           3           3
  2008        3       029   TRAUMATIC STUPOR & COMA, COMA <1 HR AGE >17 W/O CC                                   21,233      21,073          16           3           3
  2008        3       030   TRAUMATIC STUPOR & COMA, COMA <1 HR AGE 0-17                                          5,282       5,282           4           1           1
  2008        3       031   CONCUSSION AGE >17 W CC                                                              10,287      10,207           8           2           2
  2008        3       032   CONCUSSION AGE >17 W/O CC                                                             2,700       2,680           2           1           1
  2008        3       033   CONCUSSION AGE 0-17                                                                   1,307       1,307           1           1           1
  2008        3       034   OTHER DISORDERS OF NERVOUS SYSTEM W CC                                               67,005      66,625          49          10           9
  2008        3       035   OTHER DISORDERS OF NERVOUS SYSTEM W/O CC                                             17,426      17,306          16           8           8
  2008        3       041   EXTRAOCULAR PROCEDURES EXCEPT ORBIT AGE 0-17                                          1,488       1,488           1           1           1
  2008        3       045   NEUROLOGICAL EYE DISORDERS                                                            9,929       9,859           7           2           2
  2008        3       046   OTHER DISORDERS OF THE EYE AGE >17 W CC                                               2,661       2,631           3           1           1
  2008        3       047   OTHER DISORDERS OF THE EYE AGE >17 W/O CC                                            16,663      16,503          16           6           6
  2008        3       048   OTHER DISORDERS OF THE EYE AGE 0-17                                                   2,951       2,951           2           1           1
  2008        3       052   CLEFT LIP & PALATE REPAIR                                                             7,923       7,923           6           2           2
  2008        3       057   T&A PROC, EXCEPT TONSILLECTOMY &/OR ADENOIDECTOMY ONLY, AGE >17                       4,573       4,543           3           1           1
  2008        3       059   TONSILLECTOMY &/OR ADENOIDECTOMY ONLY, AGE >17                                        1,441       1,431           1           1           1
  2008        3       060   TONSILLECTOMY &/OR ADENOIDECTOMY ONLY, AGE 0-17                                      14,539      14,539          12           6           6
  2008        3       062   MYRINGOTOMY W TUBE INSERTION AGE 0-17                                                 1,320       1,320           1           1           1
  2008        3       063   OTHER EAR, NOSE, MOUTH & THROAT O.R. PROCEDURES                                      15,339      15,339          12           2           2
  2008        3       064   EAR, NOSE, MOUTH & THROAT MALIGNANCY                                                 91,382      90,712          67           9           8
  2008        3       065   DYSEQUILIBRIUM                                                                       22,246      22,046          20           6           6
  2008        3       066   EPISTAXIS                                                                            13,141      13,031          11           2           2
  2008        3       068   OTITIS MEDIA & URI AGE >17 W CC                                                      48,695      48,295          40           8           8
  2008        3       069   OTITIS MEDIA & URI AGE >17 W/O CC                                                    20,764      20,584          18           7           7
  2008        3       070   OTITIS MEDIA & URI AGE 0-17                                                          87,465      87,465          72          23          23
  2008        3       071   LARYNGOTRACHEITIS                                                                    20,004      20,004          15           8           8
  2008        3       073   OTHER EAR, NOSE, MOUTH & THROAT DIAGNOSES AGE >17                                    17,208      17,058          15           5           5
  2008        3       074   OTHER EAR, NOSE, MOUTH & THROAT DIAGNOSES AGE 0-17                                   12,783      12,783          10           1           1
  2008        3       075   MAJOR CHEST PROCEDURES                                                              123,381     123,071          94           9           9
  2008        3       076   OTHER RESP SYSTEM O.R. PROCEDURES W CC                                              235,263     233,873        185           21          21
  2008        3       077   OTHER RESP SYSTEM O.R. PROCEDURES W/O CC                                             11,940      11,860           8           2           2
  2008        3       078   PULMONARY EMBOLISM                                                                   81,894      81,224          67          11          11
  2008        3       079   RESPIRATORY INFECTIONS & INFLAMMATIONS AGE >17 W CC                                 179,467     178,037        143           17          17
  2008        3       080   RESPIRATORY INFECTIONS & INFLAMMATIONS AGE >17 W/O CC                                10,564      10,484           8           1           1
  2008        3       081   RESPIRATORY INFECTIONS & INFLAMMATIONS AGE 0-17                                     110,657     110,657          92          14          14
  2008        3       082   RESPIRATORY NEOPLASMS                                                               217,538     215,838        171           28          28
  2008        3       083   MAJOR CHEST TRAUMA W CC                                                              16,198      16,078          12           1           1
  2008        3       085   PLEURAL EFFUSION W CC                                                                37,273      37,003          27           4           4
  2008        3       086   PLEURAL EFFUSION W/O CC                                                               2,700       2,680           2           1           1
  2008        3       087   PULMONARY EDEMA & RESPIRATORY FAILURE                                               681,737     678,537        501           62          60
  2008        3       088   CHRONIC OBSTRUCTIVE PULMONARY DISEASE                                             1,051,570   1,043,200        858          221         221
  2008        3       089   SIMPLE PNEUMONIA & PLEURISY AGE >17 W CC                                            920,959     913,939        702          141         140
  2008        3       090   SIMPLE PNEUMONIA & PLEURISY AGE >17 W/O CC                                           90,172      89,482          69          20          20
  2008        3       091   SIMPLE PNEUMONIA & PLEURISY AGE 0-17                                                492,411     492,411        399          105         104
  2008        3       092   INTERSTITIAL LUNG DISEASE W CC                                                      103,878     103,268          79           9           9
  2008        3       093   INTERSTITIAL LUNG DISEASE W/O CC                                                      6,910       6,870           6           3           3
  2008        3       094   PNEUMOTHORAX W CC                                                                    23,180      23,000          18           5           5
  2008        3       095   PNEUMOTHORAX W/O CC                                                                   7,265       7,225           6           2           2
  2008        3       096   BRONCHITIS & ASTHMA AGE >17 W CC                                                    316,753     314,213        254           61          61
  2008        3       097   BRONCHITIS & ASTHMA AGE >17 W/O CC                                                  200,321     198,681        164           56          56
  2008        3       098   BRONCHITIS & ASTHMA AGE 0-17                                                        311,520     311,520        246           84          84
  2008        3       099   RESPIRATORY SIGNS & SYMPTOMS W CC                                                    69,081      68,631          55          14          14
  2008        3       100   RESPIRATORY SIGNS & SYMPTOMS W/O CC                                                 580,309     580,109        442           29          15
  2008        3       101   OTHER RESPIRATORY SYSTEM DIAGNOSES W CC                                              29,973      29,843          23           9           9
  2008        3       102   OTHER RESPIRATORY SYSTEM DIAGNOSES W/O CC                                            21,292      21,222          16           6           6
  2008        3       103   HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM                                   30,371      30,141          23           1           1
  2008        3       105   CARDIAC VALVE & OTH MAJOR CARDIOTHORACIC PROC W/O CARD CATH                          62,290      61,860          55           7           7
  2008        3       108   OTHER CARDIOTHORACIC PROCEDURES                                                      32,366      32,356          25           3           3
  2008        3       110   MAJOR CARDIOVASCULAR PROCEDURES W CC                                                144,037     143,147        107           14          14
  2008        3       111   MAJOR CARDIOVASCULAR PROCEDURES W/O CC                                               23,992      23,812          18           3           3
  2008        3       113   AMPUTATION FOR CIRC SYSTEM DISORDERS EXCEPT UPPER LIMB & TOE                        107,166     106,336          83           9           8
  2008        3       114   UPPER LIMB & TOE AMPUTATION FOR CIRC SYSTEM DISORDERS                                46,210      45,860          35           7           7
  2008        3       117   CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT                                 36,732      36,502          29           5           5
  2008        3       118   CARDIAC PACEMAKER DEVICE REPLACEMENT                                                 39,186      38,996          30           3           3
  2008        3       120   OTHER CIRCULATORY SYSTEM O.R. PROCEDURES                                             95,478      94,768          71          15          15
  2008        3       121   CIRCULATORY DISORDERS W AMI & MAJOR COMP, DISCHARGED ALIVE                          108,198     107,418          78          18          17
  2008        3       122   CIRCULATORY DISORDERS W AMI W/O MAJOR COMP, DISCHARGED ALIVE                         62,137      61,697          44           9           8




5/15/2012                                                                            Milliman                                                                             Page 21
                                                                                 DRG Distribution




                                                           Inpatient Claims by Diagnosis-Related Group Code
                     DRG                                                 DRG                                   Allowed         Paid   Inpatient   Discharge   Admission
  Year      Region   Code                                             Description                              Charges       Claims      Days         Count      Count
  2008        3       123   CIRCULATORY DISORDERS W AMI, EXPIRED                                                  9,161       9,091           7           2           2
  2008        3       124   CIRCULATORY DISORDERS EXCEPT AMI, W CARD CATH & COMPLEX DIAG                        298,677     296,397        228           40          40
  2008        3       125   CIRCULATORY DISORDERS EXCEPT AMI, W CARD CATH W/O COMPLEX DIAG                      106,706     105,906          80          29          29
  2008        3       126   ACUTE & SUBACUTE ENDOCARDITIS                                                        32,946      32,686          26           2           2
  2008        3       127   HEART FAILURE & SHOCK                                                             1,040,223   1,032,203        811          182         182
  2008        3       128   DEEP VEIN THROMBOPHLEBITIS                                                            7,090       7,040           5           2           2
  2008        3       129   CARDIAC ARREST, UNEXPLAINED                                                           5,227       5,187           4           1           1
  2008        3       130   PERIPHERAL VASCULAR DISORDERS W CC                                                  236,645     234,855        179           34          34
  2008        3       131   PERIPHERAL VASCULAR DISORDERS W/O CC                                                 31,612      31,352          26           9           9
  2008        3       132   ATHEROSCLEROSIS W CC                                                                 83,341      82,621          72          23          23
  2008        3       133   ATHEROSCLEROSIS W/O CC                                                               10,167      10,087           8           3           3
  2008        3       134   HYPERTENSION                                                                        139,701     138,491        121           40          40
  2008        3       135   CARDIAC CONGENITAL & VALVULAR DISORDERS AGE >17 W CC                                  7,865       7,825          28           2           2
  2008        3       137   CARDIAC CONGENITAL & VALVULAR DISORDERS AGE 0-17                                     47,368      47,368          36           3           2
  2008        3       138   CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS W CC                                      239,665     238,065        178           45          45
  2008        3       139   CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS W/O CC                                     41,718      41,418          33          13          13
  2008        3       140   ANGINA PECTORIS                                                                      33,296      32,976          32          13          13
  2008        3       141   SYNCOPE & COLLAPSE W CC                                                              89,927      89,327          65          24          24
  2008        3       142   SYNCOPE & COLLAPSE W/O CC                                                            74,590      74,040          57          21          21
  2008        3       143   CHEST PAIN                                                                          498,718     494,758        397          168         168
  2008        3       144   OTHER CIRCULATORY SYSTEM DIAGNOSES W CC                                             300,999     298,939        244           58          58
  2008        3       145   OTHER CIRCULATORY SYSTEM DIAGNOSES W/O CC                                            49,663      49,273          39           9           9
  2008        3       146   RECTAL RESECTION W CC                                                                17,367      17,237          13           2           2
  2008        3       149   MAJOR SMALL & LARGE BOWEL PROCEDURES W/O CC                                          45,211      44,881          33           5           5
  2008        3       150   PERITONEAL ADHESIOLYSIS W CC                                                         85,111      84,611          65           8           8
  2008        3       151   PERITONEAL ADHESIOLYSIS W/O CC                                                        9,495       9,415           8           2           2
  2008        3       152   MINOR SMALL & LARGE BOWEL PROCEDURES W CC                                            13,205      13,205          10           1           1
  2008        3       153   MINOR SMALL & LARGE BOWEL PROCEDURES W/O CC                                           6,415       6,415           5           1           1
  2008        3       155   STOMACH, ESOPHAGEAL & DUODENAL PROCEDURES AGE >17 W/O CC                             13,792      13,692          10           3           3
  2008        3       156   STOMACH, ESOPHAGEAL & DUODENAL PROCEDURES AGE 0-17                                   35,953      35,953          32           4           4
  2008        3       157   ANAL & STOMAL PROCEDURES W CC                                                        33,017      32,787          25           5           5
  2008        3       158   ANAL & STOMAL PROCEDURES W/O CC                                                      34,960      34,700          26           7           7
  2008        3       159   HERNIA PROCEDURES EXCEPT INGUINAL & FEMORAL AGE >17 W CC                             18,333      18,113          22           1           1
  2008        3       160   HERNIA PROCEDURES EXCEPT INGUINAL & FEMORAL AGE >17 W/O CC                           27,548      27,348          20           6           6
  2008        3       161   INGUINAL & FEMORAL HERNIA PROCEDURES AGE >17 W CC                                     6,860       6,810           5           2           2
  2008        3       164   APPENDECTOMY W COMPLICATED PRINCIPAL DIAG W CC                                       14,232      14,212          10           2           2
  2008        3       165   APPENDECTOMY W COMPLICATED PRINCIPAL DIAG W/O CC                                     25,955      25,795          20           2           2
  2008        3       166   APPENDECTOMY W/O COMPLICATED PRINCIPAL DIAG W CC                                      7,526       7,496           6           3           3
  2008        3       167   APPENDECTOMY W/O COMPLICATED PRINCIPAL DIAG W/O CC                                   24,458      24,368          18           8           8
  2008        3       170   OTHER DIGESTIVE SYSTEM O.R. PROCEDURES W CC                                          75,798      75,408          89           7           7
  2008        3       171   OTHER DIGESTIVE SYSTEM O.R. PROCEDURES W/O CC                                        29,996      29,786          21           5           5
  2008        3       172   DIGESTIVE MALIGNANCY W CC                                                           101,988     101,208          78          14          14
  2008        3       173   DIGESTIVE MALIGNANCY W/O CC                                                          21,860      21,680          18           3           3
  2008        3       174   G.I. HEMORRHAGE W CC                                                                239,619     237,869        178           41          41
  2008        3       175   G.I. HEMORRHAGE W/O CC                                                               24,697      24,517          18           4           4
  2008        3       176   COMPLICATED PEPTIC ULCER                                                              4,160       4,080           8           4           4
  2008        3       177   UNCOMPLICATED PEPTIC ULCER W CC                                                      16,695      16,565          13           3           3
  2008        3       178   UNCOMPLICATED PEPTIC ULCER W/O CC                                                    22,838      22,668          17           5           5
  2008        3       179   INFLAMMATORY BOWEL DISEASE                                                          121,712     120,812          92          22          22
  2008        3       180   G.I. OBSTRUCTION W CC                                                               110,825     109,965          99          23          23
  2008        3       181   G.I. OBSTRUCTION W/O CC                                                              56,584      56,244          50          11          11
  2008        3       182   ESOPHAGITIS, GASTROENT & MISC DIGEST DISORDERS AGE >17 W CC                         691,931     686,241        574          161         160
  2008        3       183   ESOPHAGITIS, GASTROENT & MISC DIGEST DISORDERS AGE >17 W/O CC                       332,827     330,127        270           84          84
  2008        3       184   ESOPHAGITIS, GASTROENT & MISC DIGEST DISORDERS AGE 0-17                             130,004     130,004        101           42          42
  2008        3       185   DENTAL & ORAL DIS EXCEPT EXTRACTIONS & RESTORATIONS, AGE >17                         18,869      18,719          15           7           7
  2008        3       186   DENTAL & ORAL DIS EXCEPT EXTRACTIONS & RESTORATIONS, AGE 0-17                         5,959       5,959           5           3           2
  2008        3       187   DENTAL EXTRACTIONS & RESTORATIONS                                                    16,702      16,592          13           3           3
  2008        3       188   OTHER DIGESTIVE SYSTEM DIAGNOSES AGE >17 W CC                                       181,545     180,165        138           30          30
  2008        3       189   OTHER DIGESTIVE SYSTEM DIAGNOSES AGE >17 W/O CC                                      29,989      29,759          23           6           6
  2008        3       190   OTHER DIGESTIVE SYSTEM DIAGNOSES AGE 0-17                                           140,678     140,678        108           12          12
  2008        3       191   PANCREAS, LIVER & SHUNT PROCEDURES W CC                                              72,107      71,547          56           3           3
  2008        3       192   PANCREAS, LIVER & SHUNT PROCEDURES W/O CC                                             3,752       3,722           3           1           1
  2008        3       197   CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE W/O C.D.E. W CC                                18,406      18,256          15           3           3
  2008        3       198   CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE W/O C.D.E. W/O CC                               6,121       6,081           4           1           1
  2008        3       200   HEPATOBILIARY DIAGNOSTIC PROCEDURE FOR NON-MALIGNANCY                                18,292      18,172          12           2           2
  2008        3       201   OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES                                       6,602       6,552           5           1           1
  2008        3       202   CIRRHOSIS & ALCOHOLIC HEPATITIS                                                     221,408     219,748        166           33          32
  2008        3       203   MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS                                       78,170      77,490          68          14          14
  2008        3       204   DISORDERS OF PANCREAS EXCEPT MALIGNANCY                                             482,553     478,883        371           92          92
  2008        3       205   DISORDERS OF LIVER EXCEPT MALIG,CIRR,ALC HEPA W CC                                  143,438     142,408        106           31          31
  2008        3       207   DISORDERS OF THE BILIARY TRACT W CC                                                  60,681      60,181          50          14          14
  2008        3       208   DISORDERS OF THE BILIARY TRACT W/O CC                                                49,532      49,152          42          11          11
  2008        3       210   HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT AGE >17 W CC                               40,261      39,951          31           5           5
  2008        3       211   HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT AGE >17 W/O CC                             12,062      11,972           9           2           2
  2008        3       212   HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT AGE 0-17                                   13,392      13,392          10           5           5
  2008        3       213   AMPUTATION FOR MUSCULOSKELETAL SYSTEM & CONN TISSUE DISORDERS                        19,213      19,073          14           4           4
  2008        3       216   BIOPSIES OF MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE                               18,897      18,757          14           2           2
  2008        3       217   WND DEBRID & SKN GRFT EXCEPT HAND,FOR MUSCSKELET & CONN TISS DIS                    103,454     102,544          97           9           9
  2008        3       218   LOWER EXTREM & HUMER PROC EXCEPT HIP,FOOT,FEMUR AGE >17 W CC                         55,408      54,988          42          12          12
  2008        3       219   LOWER EXTREM & HUMER PROC EXCEPT HIP,FOOT,FEMUR AGE >17 W/O CC                       26,968      26,768          20           8           8
  2008        3       220   LOWER EXTREM & HUMER PROC EXCEPT HIP,FOOT,FEMUR AGE 0-17                             16,732      16,732          19           6           6
  2008        3       223   MAJOR SHOULDER/ELBOW PROC, OR OTHER UPPER EXTREMITY PROC W CC                         4,986       4,946           4           2           2
  2008        3       224   SHOULDER,ELBOW OR FOREARM PROC,EXC MAJOR JOINT PROC, W/O CC                          18,897      18,757          14           3           3
  2008        3       225   FOOT PROCEDURES                                                                      24,145      24,055          17           3           3
  2008        3       227   SOFT TISSUE PROCEDURES W/O CC                                                         6,009       5,959           5           1           1
  2008        3       228   MAJOR THUMB OR JOINT PROC,OR OTH HAND OR WRIST PROC W CC                              8,854       8,854           6           1           1
  2008        3       229   HAND OR WRIST PROC, EXCEPT MAJOR JOINT PROC, W/O CC                                  13,719      13,629           9           1           1
  2008        3       233   OTHER MUSCULOSKELET SYS & CONN TISS O.R. PROC W CC                                  105,384     104,844          83          11          11
  2008        3       234   OTHER MUSCULOSKELET SYS & CONN TISS O.R. PROC W/O CC                                 16,229      16,129          12           4           4
  2008        3       235   FRACTURES OF FEMUR                                                                    4,001       3,971           3           1           1
  2008        3       236   FRACTURES OF HIP & PELVIS                                                             9,016       8,956           6           2           2
  2008        3       237   SPRAINS, STRAINS, & DISLOCATIONS OF HIP, PELVIS & THIGH                              33,745      33,495          25           1           1
  2008        3       238   OSTEOMYELITIS                                                                        84,311      83,651          66           6           6
  2008        3       239   PATHOLOGICAL FRACTURES & MUSCULOSKELETAL & CONN TISS MALIGNANCY                      47,336      47,016          32           8           8
  2008        3       240   CONNECTIVE TISSUE DISORDERS W CC                                                     49,716      49,346          37           5           5
  2008        3       241   CONNECTIVE TISSUE DISORDERS W/O CC                                                   22,216      22,086          16           5           5
  2008        3       243   MEDICAL BACK PROBLEMS                                                               213,674     212,154        153           38          37
  2008        3       244   BONE DISEASES & SPECIFIC ARTHROPATHIES W CC                                          24,010      23,900          37           6           6
  2008        3       245   BONE DISEASES & SPECIFIC ARTHROPATHIES W/O CC                                         6,386       6,336           5           1           1
  2008        3       246   NON-SPECIFIC ARTHROPATHIES                                                            7,378       7,328           5           1           1
  2008        3       247   SIGNS & SYMPTOMS OF MUSCULOSKELETAL SYSTEM & CONN TISSUE                             48,875      48,545          36           8           8
  2008        3       248   TENDONITIS, MYOSITIS & BURSITIS                                                      45,040      44,730          40           8           8
  2008        3       249   AFTERCARE, MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE                                18,665      18,585          15           4           4
  2008        3       250   FX, SPRN, STRN & DISL OF FOREARM, HAND, FOOT AGE >17 W CC                             5,438       5,398           4           2           2
  2008        3       253   FX, SPRN, STRN & DISL OF UPARM,LOWLEG EX FOOT AGE >17 W CC                           51,732      51,302          43           6           6
  2008        3       254   FX, SPRN, STRN & DISL OF UPARM,LOWLEG EX FOOT AGE >17 W/O CC                          4,229       4,189           4           2           2




5/15/2012                                                                            Milliman                                                                             Page 22
                                                                                    DRG Distribution




                                                             Inpatient Claims by Diagnosis-Related Group Code
                     DRG                                               DRG                                       Allowed         Paid   Inpatient   Discharge   Admission
  Year      Region   Code                                           Description                                  Charges       Claims      Days         Count      Count
  2008        3       255   FX, SPRN, STRN & DISL OF UPARM,LOWLEG EX FOOT AGE 0-17                                  1,251       1,251           1           1           1
  2008        3       256   OTHER MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE DIAGNOSES                             52,035      51,675          56          12          11
  2008        3       257   TOTAL MASTECTOMY FOR MALIGNANCY W CC                                                   14,178      14,078          10           3           3
  2008        3       258   TOTAL MASTECTOMY FOR MALIGNANCY W/O CC                                                 19,933      19,783          15          11          11
  2008        3       259   SUBTOTAL MASTECTOMY FOR MALIGNANCY W CC                                                 1,059       1,049           1           1           1
  2008        3       260   SUBTOTAL MASTECTOMY FOR MALIGNANCY W/O CC                                               1,350       1,340           1           1           1
  2008        3       262   BREAST BIOPSY & LOCAL EXCISION FOR NON-MALIGNANCY                                       2,554       2,534           2           1           1
  2008        3       263   SKIN GRAFT &/OR DEBRID FOR SKN ULCER OR CELLULITIS W CC                                23,848      23,608          24           5           5
  2008        3       264   SKIN GRAFT &/OR DEBRID FOR SKN ULCER OR CELLULITIS W/O CC                               4,413       4,273          14           3           3
  2008        3       266   SKIN GRAFT &/OR DEBRID EXCEPT FOR SKIN ULCER OR CELLULITIS W/O CC                       5,113       5,083           4           3           3
  2008        3       269   OTHER SKIN, SUBCUT TISS & BREAST PROC W CC                                             81,576      81,006          62          11          11
  2008        3       270   OTHER SKIN, SUBCUT TISS & BREAST PROC W/O CC                                           18,102      17,962          14           4           4
  2008        3       271   SKIN ULCERS                                                                            66,157      65,587          68          13          12
  2008        3       272   MAJOR SKIN DISORDERS W CC                                                              37,733      37,513          27           3           3
  2008        3       273   MAJOR SKIN DISORDERS W/O CC                                                             9,032       8,962           7           3           3
  2008        3       274   MALIGNANT BREAST DISORDERS W CC                                                        15,243      15,143          10           2           2
  2008        3       276   NON-MALIGNANT BREAST DISORDERS                                                         35,726      35,436          29           7           7
  2008        3       277   CELLULITIS AGE >17 W CC                                                               470,205     466,705        350           70          68
  2008        3       278   CELLULITIS AGE >17 W/O CC                                                             174,718     173,378        134           39          39
  2008        3       279   CELLULITIS AGE 0-17                                                                    81,417      81,417          65          22          22
  2008        3       280   TRAUMA TO THE SKIN, SUBCUT TISS & BREAST AGE >17 W CC                                  24,900      24,710          19           3           3
  2008        3       281   TRAUMA TO THE SKIN, SUBCUT TISS & BREAST AGE >17 W/O CC                                13,745      13,635          11           2           2
  2008        3       283   MINOR SKIN DISORDERS W CC                                                             120,907     120,027          92          12          12
  2008        3       284   MINOR SKIN DISORDERS W/O CC                                                             3,060       3,040           2           1           1
  2008        3       285   AMPUTAT OF LOWER LIMB FOR ENDOCRINE,NUTRIT,& METABOL DISORDERS                         38,553      38,283          27           5           4
  2008        3       287   SKIN GRAFTS & WOUND DEBRID FOR ENDOC, NUTRIT & METAB DISORDERS                         47,149      46,779          37           2           2
  2008        3       289   PARATHYROID PROCEDURES                                                                 14,397      14,267          13           4           4
  2008        3       290   THYROID PROCEDURES                                                                      8,696       8,586          16           5           5
  2008        3       292   OTHER ENDOCRINE, NUTRIT & METAB O.R. PROC W CC                                         11,217      11,127           9           2           2
  2008        3       294   DIABETES AGE >35                                                                      401,828     398,628        320           84          84
  2008        3       295   DIABETES AGE 0-35                                                                     103,023     102,433          79          22          22
  2008        3       296   NUTRITIONAL & MISC METABOLIC DISORDERS AGE >17 W CC                                   301,611     298,971        264           74          74
  2008        3       297   NUTRITIONAL & MISC METABOLIC DISORDERS AGE >17 W/O CC                                 141,195     140,105        109           35          35
  2008        3       298   NUTRITIONAL & MISC METABOLIC DISORDERS AGE 0-17                                       168,181     168,181        147           51          51
  2008        3       299   INBORN ERRORS OF METABOLISM                                                            29,907      29,907          23           3           3
  2008        3       300   ENDOCRINE DISORDERS W CC                                                              105,471     105,061          79          11          11
  2008        3       301   ENDOCRINE DISORDERS W/O CC                                                             24,854      24,684          19           3           3
  2008        3       302   KIDNEY TRANSPLANT                                                                      11,884      11,794           9           1           1
  2008        3       303   KIDNEY,URETER & MAJOR BLADDER PROCEDURES FOR NEOPLASM                                  14,525      14,455          11           2           2
  2008        3       304   KIDNEY,URETER & MAJOR BLADDER PROC FOR NON-NEOPL W CC                                   5,113       5,073           4           1           1
  2008        3       305   KIDNEY,URETER & MAJOR BLADDER PROC FOR NON-NEOPL W/O CC                                17,166      17,166          13           4           4
  2008        3       306   PROSTATECTOMY W CC                                                                     18,673      18,533          14           1           1
  2008        3       309   MINOR BLADDER PROCEDURES W/O CC                                                         1,281       1,271           1           1           1
  2008        3       310   TRANSURETHRAL PROCEDURES W CC                                                           2,574       2,534           4           2           2
  2008        3       311   TRANSURETHRAL PROCEDURES W/O CC                                                         9,201       9,131           7           2           2
  2008        3       313   URETHRAL PROCEDURES, AGE >17 W/O CC                                                     3,961       3,931           3           1           1
  2008        3       315   OTHER KIDNEY & URINARY TRACT O.R. PROCEDURES                                           89,399      88,759          64          10          10
  2008        3       316   RENAL FAILURE                                                                         497,397     493,937        364           68          68
  2008        3       320   KIDNEY & URINARY TRACT INFECTIONS AGE >17 W CC                                        258,857     256,787        207           50          50
  2008        3       321   KIDNEY & URINARY TRACT INFECTIONS AGE >17 W/O CC                                       66,782      66,152          63          21          21
  2008        3       322   KIDNEY & URINARY TRACT INFECTIONS AGE 0-17                                             41,806      41,806          33          11          11
  2008        3       323   URINARY STONES W CC, &/OR ESW LITHOTRIPSY                                              71,996      71,416          60          15          15
  2008        3       324   URINARY STONES W/O CC                                                                  23,449      23,289          18           7           7
  2008        3       325   KIDNEY & URINARY TRACT SIGNS & SYMPTOMS AGE >17 W CC                                    2,473       2,453           2           1           1
  2008        3       326   KIDNEY & URINARY TRACT SIGNS & SYMPTOMS AGE >17 W/O CC                                  7,577       7,497           8           2           2
  2008        3       327   KIDNEY & URINARY TRACT SIGNS & SYMPTOMS AGE 0-17                                        1,334       1,334           1           1           1
  2008        3       328   URETHRAL STRICTURE AGE >17 W CC                                                         7,663       7,603           6           1           1
  2008        3       331   OTHER KIDNEY & URINARY TRACT DIAGNOSES AGE >17 W CC                                   104,536     103,736          81          15          15
  2008        3       332   OTHER KIDNEY & URINARY TRACT DIAGNOSES AGE >17 W/O CC                                  16,814      16,694          12           3           3
  2008        3       333   OTHER KIDNEY & URINARY TRACT DIAGNOSES AGE 0-17                                        63,768      63,768          50           8           8
  2008        3       334   MAJOR MALE PELVIC PROCEDURES W CC                                                       6,391       6,341           5           1           1
  2008        3       335   MAJOR MALE PELVIC PROCEDURES W/O CC                                                     3,606       3,576           3           1           1
  2008        3       336   TRANSURETHRAL PROSTATECTOMY W CC                                                       11,645      11,535          11           1           1
  2008        3       337   TRANSURETHRAL PROSTATECTOMY W/O CC                                                      4,033       4,003           3           2           2
  2008        3       338   TESTES PROCEDURES, FOR MALIGNANCY                                                      11,991      11,901           9           3           3
  2008        3       341   PENIS PROCEDURES                                                                       13,440      13,360          10           5           5
  2008        3       343   CIRCUMCISION AGE 0-17                                                                   1,320       1,320           1           1           1
  2008        3       348   BENIGN PROSTATIC HYPERTROPHY W CC                                                       3,548       3,508           4           1           1
  2008        3       350   INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM                                           20,091      19,971          13           5           5
  2008        3       352   OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES                                               10,026       9,956           7           3           3
  2008        3       353   PELVIC EVISCERATION, RADICAL HYSTERECTOMY & RADICAL VULVECTOMY                          3,404       3,374           3           2           2
  2008        3       354   UTERINE,ADNEXA PROC FOR NON-OVARIAN/ADNEXAL MALIG W CC                                  6,407       6,357           5           1           1
  2008        3       355   UTERINE,ADNEXA PROC FOR NON-OVARIAN/ADNEXAL MALIG W/O CC                                9,033       8,963           7           5           5
  2008        3       356   FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES                                    8,613       8,523           9           2           2
  2008        3       357   UTERINE & ADNEXA PROC FOR OVARIAN OR ADNEXAL MALIGNANCY                                21,569      21,399          17           2           2
  2008        3       358   UTERINE & ADNEXA PROC FOR NON-MALIGNANCY W CC                                          41,291      40,981          31          10          10
  2008        3       359   UTERINE & ADNEXA PROC FOR NON-MALIGNANCY W/O CC                                       129,405     128,495          96          41          41
  2008        3       360   VAGINA, CERVIX & VULVA PROCEDURES                                                      34,592      34,372          26           8           8
  2008        3       365   OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES                                       15,534      15,414          12           3           3
  2008        3       366   MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM W CC                                            13,875      13,775          10           3           3
  2008        3       367   MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM W/O CC                                           2,977       2,957           2           1           1
  2008        3       368   INFECTIONS, FEMALE REPRODUCTIVE SYSTEM                                                 41,160      40,840          32           8           8
  2008        3       369   MENSTRUAL & OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS                                 36,437      36,177          28          12          12
  2008        3       370   CESAREAN SECTION W CC                                                                  83,834      83,794          63          14          14
  2008        3       371   CESAREAN SECTION W/O CC                                                               145,345     145,305        107           37          37
  2008        3       372   VAGINAL DELIVERY W COMPLICATING DIAGNOSES                                              45,145      45,095          33          14          14
  2008        3       373   VAGINAL DELIVERY W/O COMPLICATING DIAGNOSES                                           275,015     274,565        207           85          85
  2008        3       374   VAGINAL DELIVERY W STERILIZATION &/OR D&C                                               7,802       7,802           6           3           3
  2008        3       376   POSTPARTUM & POST ABORTION DIAGNOSES W/O O.R. PROCEDURE                                32,271      32,271          25           7           7
  2008        3       377   POSTPARTUM & POST ABORTION DIAGNOSES W O.R. PROCEDURE                                  55,885      55,465          44           3           3
  2008        3       378   ECTOPIC PREGNANCY                                                                      11,052      11,042           8           4           4
  2008        3       379   THREATENED ABORTION                                                                    21,305      21,265          16           8           8
  2008        3       380   ABORTION W/O D&C                                                                        2,613       2,613           2           1           1
  2008        3       383   OTHER ANTEPARTUM DIAGNOSES W MEDICAL COMPLICATIONS                                    174,562     173,882        141           49          49
  2008        3       384   OTHER ANTEPARTUM DIAGNOSES W/O MEDICAL COMPLICATIONS                                   10,967      10,927           8           3           3
  2008        3       385   NEONATES, DIED OR TRANSFERRED TO ANOTHER ACUTE CARE FACILITY                           21,115      21,115          16           3           2
  2008        3       386   EXTREME IMMATURITY OR RESPIRATORY DISTRESS SYNDROME, NEONATE                        2,082,607   2,082,607      1,676           81          69
  2008        3       387   PREMATURITY W MAJOR PROBLEMS                                                           91,003      91,003          67           3           3
  2008        3       388   PREMATURITY W/O MAJOR PROBLEMS                                                        185,884     185,884        135           10           9
  2008        3       389   FULL TERM NEONATE W MAJOR PROBLEMS                                                    416,233     416,233        311           21          21
  2008        3       390   NEONATE W OTHER SIGNIFICANT PROBLEMS                                                    3,049       3,049           2           1           1
  2008        3       394   OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS                             1,350       1,340           1           1           1
  2008        3       395   RED BLOOD CELL DISORDERS AGE >17                                                    1,277,565   1,267,745      1,002          245         245
  2008        3       396   RED BLOOD CELL DISORDERS AGE 0-17                                                     361,146     361,146        296           94          94
  2008        3       397   COAGULATION DISORDERS                                                                  13,815      13,745           9           3           3
  2008        3       399   RETICULOENDOTHELIAL & IMMUNITY DISORDERS W/O CC                                         3,878       3,868           3           2           2




5/15/2012                                                                               Milliman                                                                            Page 23
                                                                                 DRG Distribution




                                                           Inpatient Claims by Diagnosis-Related Group Code
                     DRG                                               DRG                                     Allowed         Paid   Inpatient   Discharge   Admission
  Year      Region   Code                                           Description                                Charges       Claims      Days         Count      Count
  2008        3       401   LYMPHOMA & NON-ACUTE LEUKEMIA W OTHER O.R. PROC W CC                                 18,616      18,456          16           1           1
  2008        3       403   LYMPHOMA & NON-ACUTE LEUKEMIA W CC                                                   55,566      55,136          43           8           7
  2008        3       404   LYMPHOMA & NON-ACUTE LEUKEMIA W/O CC                                                114,613     114,043          87           8           8
  2008        3       405   ACUTE LEUKEMIA W/O MAJOR O.R. PROCEDURE AGE 0-17                                     13,205      13,205          10           1           1
  2008        3       406   MYELOPROLIF DISORD OR POORLY DIFF NEOPL W MAJ O.R.PROC W CC                          20,916      20,756          16           2           2
  2008        3       407   MYELOPROLIF DISORD OR POORLY DIFF NEOPL W MAJ O.R.PROC W/O CC                         2,404       2,384           2           1           1
  2008        3       408   MYELOPROLIF DISORD OR POORLY DIFF NEOPL W OTHER O.R.PROC                             49,041      48,661          38           4           4
  2008        3       409   RADIOTHERAPY                                                                         18,102      17,972          13           3           3
  2008        3       410   CHEMOTHERAPY W/O ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS                              511,208     507,938        410          131         130
  2008        3       411   HISTORY OF MALIGNANCY W/O ENDOSCOPY                                                   5,399       5,359           4           1           1
  2008        3       413   OTHER MYELOPROLIF DIS OR POORLY DIFF NEOPL DIAG W CC                                 30,092      29,862          23           3           3
  2008        3       417   SEPTICEMIA AGE 0-17                                                                 101,662     101,662          77          10          10
  2008        3       418   POSTOPERATIVE & POST-TRAUMATIC INFECTIONS                                            59,884      59,484          61          13          13
  2008        3       419   FEVER OF UNKNOWN ORIGIN AGE >17 W CC                                                 19,376      19,226          15           3           3
  2008        3       420   FEVER OF UNKNOWN ORIGIN AGE >17 W/O CC                                               13,498      13,398          10           1           1
  2008        3       421   VIRAL ILLNESS AGE >17                                                                 4,578       4,528           5           2           2
  2008        3       422   VIRAL ILLNESS & FEVER OF UNKNOWN ORIGIN AGE 0-17                                     93,325      93,325          73          28          27
  2008        3       423   OTHER INFECTIOUS & PARASITIC DISEASES DIAGNOSES                                      83,048      82,488          63          13          13
  2008        3       424   O.R. PROCEDURE W PRINCIPAL DIAGNOSES OF MENTAL ILLNESS                               10,670      10,600           7           1           1
  2008        3       425   ACUTE ADJUSTMENT REACTION & PSYCHOSOCIAL DYSFUNCTION                                 68,165      67,775          55          15          15
  2008        3       426   DEPRESSIVE NEUROSES                                                                 391,572     389,522        301           57          57
  2008        3       427   NEUROSES EXCEPT DEPRESSIVE                                                          975,978     975,678        758           68          68
  2008        3       428   DISORDERS OF PERSONALITY & IMPULSE CONTROL                                          136,523     135,933        126           13          13
  2008        3       429   ORGANIC DISTURBANCES & MENTAL RETARDATION                                            70,697      70,417          57          10          10
  2008        3       430   PSYCHOSES                                                                         5,670,617   5,632,247      4,785          653         645
  2008        3       431   CHILDHOOD MENTAL DISORDERS                                                        1,183,294   1,183,124      1,022          109         109
  2008        3       432   OTHER MENTAL DISORDER DIAGNOSES                                                      12,614      12,614          24           2           2
  2008        3       433   ALCOHOL/DRUG ABUSE OR DEPENDENCE, LEFT AMA                                           84,701      83,981          86          24          24
  2008        3       439   SKIN GRAFTS FOR INJURIES                                                             24,364      24,184          18           3           3
  2008        3       440   WOUND DEBRIDEMENTS FOR INJURIES                                                      20,141      19,981          16           4           4
  2008        3       441   HAND PROCEDURES FOR INJURIES                                                         10,564      10,484           8           1           1
  2008        3       442   OTHER O.R. PROCEDURES FOR INJURIES W CC                                              39,285      39,005          28           7           7
  2008        3       443   OTHER O.R. PROCEDURES FOR INJURIES W/O CC                                             2,522       2,502           2           2           2
  2008        3       444   TRAUMATIC INJURY AGE >17 W CC                                                        13,312      13,182          13           4           4
  2008        3       445   TRAUMATIC INJURY AGE >17 W/O CC                                                       2,644       2,614           3           1           1
  2008        3       447   ALLERGIC REACTIONS AGE >17                                                           12,509      12,409          10           4           4
  2008        3       449   POISONING & TOXIC EFFECTS OF DRUGS AGE >17 W CC                                     266,390     264,490        190           41          41
  2008        3       450   POISONING & TOXIC EFFECTS OF DRUGS AGE >17 W/O CC                                    43,989      43,659          33          12          12
  2008        3       451   POISONING & TOXIC EFFECTS OF DRUGS AGE 0-17                                           9,192       9,192           9           4           4
  2008        3       452   COMPLICATIONS OF TREATMENT W CC                                                      59,087      58,647          44          15          15
  2008        3       453   COMPLICATIONS OF TREATMENT W/O CC                                                    16,854      16,744          12           5           5
  2008        3       454   OTHER INJURY, POISONING & TOXIC EFFECT DIAG W CC                                     11,776      11,756           9           2           2
  2008        3       455   OTHER INJURY, POISONING & TOXIC EFFECT DIAG W/O CC                                   23,809      23,799          18           3           3
  2008        3       461   O.R. PROC W DIAGNOSES OF OTHER CONTACT W HEALTH SERVICES                             10,798      10,718           8           1           1
  2008        3       462   REHABILITATION                                                                      756,522     750,422        620           60          58
  2008        3       463   SIGNS & SYMPTOMS W CC                                                               158,384     157,174        129           21          21
  2008        3       464   SIGNS & SYMPTOMS W/O CC                                                              39,227      38,907          32           8           8
  2008        3       466   AFTERCARE W/O HISTORY OF MALIGNANCY AS SECONDARY DIAGNOSIS                            1,224       1,224           8           1           1
  2008        3       467   OTHER FACTORS INFLUENCING HEALTH STATUS                                              40,327      40,207          29           5           5
  2008        3       468   EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS                           231,341     229,721        171           24          24
  2008        3       473   ACUTE LEUKEMIA W/O MAJOR O.R. PROCEDURE AGE >17                                      92,052      91,322          73           6           5
  2008        3       477   NON-EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS                       159,052     158,162        121           12          12
  2008        3       479   OTHER VASCULAR PROCEDURES W/O CC                                                     36,471      36,161          31           7           7
  2008        3       481   BONE MARROW TRANSPLANT                                                               21,032      20,672          36           3           3
  2008        3       482   TRACHEOSTOMY FOR FACE,MOUTH & NECK DIAGNOSES                                         49,798      49,418          38           7           7
  2008        3       486   OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA                               119,174     118,284          89           4           4
  2008        3       487   OTHER MULTIPLE SIGNIFICANT TRAUMA                                                   126,032     125,372          94           8           8
  2008        3       488   HIV W EXTENSIVE O.R. PROCEDURE                                                       10,798      10,718           8           2           2
  2008        3       489   HIV W MAJOR RELATED CONDITION                                                       192,731     191,271        146           26          26
  2008        3       490   HIV W OR W/O OTHER RELATED CONDITION                                                 89,940      89,240          70          15          15
  2008        3       491   MAJOR JOINT & LIMB REATTACHMENT PROCEDURES OF UPPER EXTREMITY                        16,793      16,673          12           5           5
  2008        3       492   CHEMOTHERAPY W ACUTE LEUKEMIA OR W USE OF HI DOSE CHEMOAGENT                         88,750      88,590          82          13          13
  2008        3       493   LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W CC                                        134,301     133,421        102           22          22
  2008        3       494   LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W/O CC                                      105,874     105,094          78          21          21
  2008        3       497   SPINAL FUSION EXCEPT CERVICAL W CC                                                   58,589      58,139          45           9           9
  2008        3       498   SPINAL FUSION EXCEPT CERVICAL W/O CC                                                 40,693      40,383          31          13          13
  2008        3       499   BACK & NECK PROCEDURES EXCEPT SPINAL FUSION W CC                                      8,248       8,188           6           3           3
  2008        3       500   BACK & NECK PROCEDURES EXCEPT SPINAL FUSION W/O CC                                   23,819      23,689          18          12          12
  2008        3       501   KNEE PROCEDURES W PDX OF INFECTION W CC                                               5,109       5,069           4           1           1
  2008        3       503   KNEE PROCEDURES W/O PDX OF INFECTION                                                  6,467       6,417           5           2           2
  2008        3       506   FULL THICKNESS BURN W SKIN GRAFT OR INHAL INJ W CC OR SIG TRAUMA                     24,567      24,347          22           2           2
  2008        3       510   NON-EXTENSIVE BURNS W CC OR SIGNIFICANT TRAUMA                                        7,808       7,748           6           3           3
  2008        3       511   NON-EXTENSIVE BURNS W/O CC OR SIGNIFICANT TRAUMA                                     12,410      12,320          10           2           2
  2008        3       515   CARDIAC DEFIBRILLATOR IMPLANT W/O CARDIAC CATH                                      121,927     121,037        101           15          15
  2008        3       518   PERC CARDIO PROC W/O CORONARY ARTERY STENT OR AMI                                    90,947      90,237          71          40          40
  2008        3       519   CERVICAL SPINAL FUSION W CC                                                          22,834      22,664          17           8           8
  2008        3       520   CERVICAL SPINAL FUSION W/O CC                                                        49,759      49,379          38          15          15
  2008        3       521   ALCOHOL/DRUG ABUSE OR DEPENDENCE W CC                                               545,830     541,030        480           81          80
  2008        3       522   ALC/DRUG ABUSE OR DEPEND W REHABILITATION THERAPY W/O CC                            375,524     372,654        386           45          45
  2008        3       523   ALC/DRUG ABUSE OR DEPEND W/O REHABILITATION THERAPY W/O CC                          380,477     378,177        322           53          52
  2008        3       524   TRANSIENT ISCHEMIA                                                                   73,656      72,956          70          24          24
  2008        3       528   INTRACRANIAL VASCULAR PROC W PDX HEMORRHAGE                                          30,371      30,141          23           1           1
  2008        3       529   VENTRICULAR SHUNT PROCEDURES W CC                                                    32,719      32,479          24           6           6
  2008        3       530   VENTRICULAR SHUNT PROCEDURES W/O CC                                                   9,371       9,291           8           3           3
  2008        3       531   SPINAL PROCEDURES W CC                                                               26,763      26,573          21           4           4
  2008        3       532   SPINAL PROCEDURES W/O CC                                                             26,847      26,637          21           3           3
  2008        3       533   EXTRACRANIAL PROCEDURES W CC                                                         26,434      26,214          22          11          11
  2008        3       534   EXTRACRANIAL PROCEDURES W/O CC                                                        3,963       3,933           3           2           2
  2008        3       537   LOCAL EXCIS & REMOV OF INT FIX DEV EXCEPT HIP & FEMUR W CC                           25,992      25,812          23           4           4
  2008        3       538   LOCAL EXCIS & REMOV OF INT FIX DEV EXCEPT HIP & FEMUR W/O CC                          8,680       8,640           6           2           2
  2008        3       539   LYMPHOMA & LEUKEMIA W MAJOR OR PROCEDURE W CC                                        22,448      22,278          17           1           1
  2008        3       542   TRACH W MV 96+HRS OR PDX EXC FACE, MOUTH & NECK W/O MAJ O.R.                        357,707     356,077        280           14          14
  2008        3       543   CRANIOTOMY W/IMPLANT OF CHEMO AGENT OR ACUTE COMPLX CNS PDX                          36,502      36,222          28           3           3
  2008        3       544   MAJOR JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY                          223,364     221,574        179           44          44
  2008        3       545   REVISION OF HIP OR KNEE REPLACEMENT                                                  21,456      21,306          15           5           5
  2008        3       546   SPINAL FUSION EXC CERV WITH CURVATURE OF THE SPINE OR MALIG                          65,729      65,579          48           9           9
  2008        3       549   CORONARY BYPASS W/O CARDIAC CATH W MAJOR CV DX                                       52,710      52,160          55           5           5
  2008        3       550   CORONARY BYPASS W/O CARDIAC CATH W/O MAJOR CV DX                                    115,919     115,049          87          16          16
  2008        3       551   PERMANENT CARDIAC PACEMAKER IMPL W MAJ CV DX OR AICD LEAD OR GNRTR                    6,561       6,511           5           2           2
  2008        3       553   OTHER VASCULAR PROCEDURES W CC W MAJOR CV DX                                         41,147      40,837          31           7           6
  2008        3       554   OTHER VASCULAR PROCEDURES W CC W/O MAJOR CV DX                                      135,058     133,938        112           18          18
  2008        3       555   PERCUTANEOUS CARDIOVASCULAR PROC W MAJOR CV DX                                      278,109     276,039        207           46          46
  2008        3       559   ACUTE ISCHEMIC STROKE WITH USE OF THROMBOLYTIC AGENT                                 15,622      15,502          12           2           2
  2008        3       560   BACTERIAL & TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM                                 40,056      39,746          31           2           2
  2008        3       561   NON-BACTERIAL INFECTIONS OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS                   53,704      53,664          41           5           5
  2008        3       562   SEIZURE AGE > 17 W CC                                                               121,629     120,669          96          34          34




5/15/2012                                                                            Milliman                                                                             Page 24
                                                                                 DRG Distribution




                                                           Inpatient Claims by Diagnosis-Related Group Code
                     DRG                                              DRG                                     Allowed       Paid   Inpatient   Discharge   Admission
  Year      Region   Code                                          Description                                Charges     Claims      Days         Count      Count
  2008        3       563   SEIZURE AGE > 17 W/O CC                                                             74,223    73,623          62          27          27
  2008        3       564   HEADACHES AGE >17                                                                   67,743    67,213          53          19          19
  2008        3       565   RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT 96+ HOURS                     332,848   331,218        255           18          18
  2008        3       566   RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT < 96 HOURS                    290,683   289,223        219           38          38
  2008        3       567   STOMACH, ESOPHAGEAL & DUODENAL PROC AGE > 17 W CC W MAJOR GI DX                     42,167    41,877          29           2           2
  2008        3       568   STOMACH, ESOPHAGEAL & DUODENAL PROCEDURES PROC AGE > 17 W CC W/O MAJOR GI DX         7,211     7,151           6           1           1
  2008        3       569   MAJOR SMALL & LARGE BOWEL PROCEDURES W CC W MAJOR GI DX                            210,785   209,655        150           10           9
  2008        3       570   MAJOR SMALL & LARGE BOWEL PROCEDURES W CC W/O MAJOR GI DX                           91,336    90,596          74           9           9
  2008        3       571   MAJOR ESOPHAGEAL DISORDERS                                                          18,800    18,670          13           5           5
  2008        3       572   MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS                         134,212   133,502        103           22          22
  2008        3       573   MAJOR BLADDER PROCEDURES                                                            23,660    23,520          17           3           3
  2008        3       574   MAJOR HEMATOLOGIC/IMMUNOLOGIC DIAG EXC SICKLE CELL CRISIS & COAGUL                 222,461   221,921        168           32          31
  2008        3       575   SEPTICEMIA W MV96+ HOURS AGE >17                                                   161,337   160,207        113            6           6
  2008        3       576   SEPTICEMIA W/O MV96+ HOURS AGE >17                                                 377,998   375,338        283           54          53
  2008        3       578   INFECTIOUS & PARASITIC DISEASES W OR PROCEDURE                                     315,400   313,150        225           14          14
  2008        3       579   POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS W OR PROCEDURE                           82,914    82,324          69          11          10




5/15/2012                                                                            Milliman                                                                          Page 25
                              Inpatient & Outpatient Facility Emergency Room Claims by Provider
                               Pro vid er                     Pro vid er             Allo w ed        Paid    Service
            Year   Reg io n   ID Nu m b er                     Nam e                 Ch arg es      Claim s     Un its
            2007     1           20000       W ALKER REGIONAL MEDICAL CENTER INC           632         632         11
            2007     1           20003       AMORY HMA INC                             64,809       64,809      2,575
            2007     1           20007       FORREST COUNTY GENERAL HOSPITAL            5,018        5,018        313
            2007     1           20008                                                     419         419         15
            2007     1           20010       BAPTIST MEMORIAL HOSPITAL UNION COU      107,076      107,073      4,665
            2007     1           20016       BAPTIST MEMORIAL HOSPITAL- NORTH         220,192      220,162     10,765
            2007     1           20020       MAGNOLIA REGIONAL HEALTH CENTER          324,092      324,089     12,815
            2007     1           20025       GREENW OOD LEFLORE HOSPITAL              727,113      727,065     19,178
            2007     1           20026       GRENADA LAKE MEDICAL CENTER              146,831      146,825      6,518
            2007     1           20027       MEMORIAL HOSPITAL AT GULFPORT             10,078       10,078        215
            2007     1           20032       SOUTH SUNFLOW ER COUNTY HOSPITAL          57,862       57,862      3,458
            2007     1           20034       ST DOMINIC JACKSON MEM                    11,006       11,006        341
            2007     1           20035                                                121,399      121,396      4,159
            2007     1           20042       MAGEE BENEVOLENT ASSOCIATION                  154         154         12
            2007     1           20046       ANDERSON INFIRMARY BENEVOLENT ASSOC           603         603         26
            2007     1           20049       RUSH MEDICAL FOUNDATION                    4,375        4,375        119
            2007     1           20059       SINGING RIVER HOSPITAL SYSTEM              2,126        2,126         54
            2007     1           20079       CLAY COUNTY MEDICAL CORPORATION            1,663        1,663         35
            2007     1           20081       NORTH MISSISSIPPI MEDICAL CENTER         611,186      611,156     20,798
            2007     1           20082       KINGS DAUGHTERS HOSPITAL OF YAZOO          4,767        4,767        148
            2007     1           20084       BAPTIST MEMORIAL HOSPITAL BOONEVILL      132,145      132,142      6,090
            2007     1           20096       PONTOTOC HEALTH SERVICES INC              97,272       97,269      2,589
            2007     1           20111       TIPPAH COUNTY HOSPITAL                   116,886      116,886      3,933
            2007     1           20115       HARDY W ILSON MEMORIAL HOSPITAL                99          99           3
            2007     1           20116       MARION GENERAL HOSPITAL                       233         233           7
            2007     1           20118       NORTH SUNFLOW ER MEDICAL CENTER           86,713       86,707      2,485
            2007     1           20124       HUMPHREYS COUNTY MEMORIAL HOSPITAL        94,839       94,839      3,286
            2007     1           20129       SHARKEY ISSAQUENA COMMUNITY HOSPITA       17,413       17,413        555
            2007     1           20131       W AYNE GENERAL HOSPITAL                       248         248         12
            2007     1           20133       COVINGTON COUNTY HOSPITAL                     211         211           6
            2007     1           20140       CLAIBORNE CO HOSPITAL                         197         197           5
            2007     1           20141       SOUTH CENTRAL REGIONAL MEDICAL CENT        1,307        1,307         46
            2007     1           20143       BAPTIST MEMORIAL HOSPITAL DESOTO, I      277,846      277,837     18,027
            2007     1           20145       DELTA REGIONAL MEDICAL CENTER          1,252,743    1,252,638     27,117
            2007     1           20149       STATE OF MISSISSIPPI-UNIVERSITY OF        82,611       82,611      2,801
            2007     1           20156       TYLER HOLMES MEMORIAL HOSPITAL            57,132       57,132      2,748
            2007     1           20161                                                 37,926       37,920      1,354
            2007     1           20166       HANCOCK MEDICAL CENTER INC                    550         550         24
            2007     1           20167       SIMPSON COMMUNITY HEALTHCARE INC              113         113         18
            2007     1           20170       SOUTH MISSISSIPPI REGIONAL MEDICAL            371         371         12
            2007     1           20172       NATCHEZ REGIONAL MEDICAL CENTER               411         411         17
            2007     1           20178       W EBSTER HEALTH SERVICES INC               9,861        9,861        311
            2007     1           20181       NESHOBA COUNTY HOSPITAL & NURSI HOM        1,596        1,596         58
            2007     1           20182       BILOXI HMA INC.                            1,290        1,290         30
            2007     1           20191       PERRY COUNTY GENERAL HOSPITAL                  71          71           1
            2007     1           20193       JEFFERSON COUNTY HOSPITAL                     191         191           3
            2007     1           20197       UNIVERSITY OF SOUTH ALABAMA                    60          60           3
            2007     1           20213       HILLCREST HOSPITAL                         6,470        6,470        174
            2007     1           20214       H C W ATKINS MEMORIAL HOSPITAL INC            193         193           3
            2007     1           20215       INFIRMARY HEALTH HOSPITALS INC                641         641         24
            2007     1           20219       OKTIBBEHA COUNTY HOSPITAL                  7,751        7,751        309
            2007     1           20226       GULFCOAST COMMUNITY HOSPITAL                  265         265           4
            2007     1           20229       PHYSICIANS AND SURGEONS HOSPITAL GR      176,180      176,180      5,281
            2007     1           20238       ERLANGER MEDICAL CENTER DEW AIN HILD          108         108           4
            2007     1           20280       FORT SANDERS SEVIER MEDICAL CENTER             57          57           1
            2007     1           20290       GEORGE COUNTY HOSPITAL                     1,047        1,047         48
            2007     1           20294       COLBERT COUNTY NW ALABAMA                     438         438         17
            2007     1           20302       CHILDRENS HOSP                                247         247         16
            2007     1           20374       BAPTIST MEMORIAL HOSPITAL                 17,892       17,892        594
            2007     1           20393       TISHOMINGO HEALTH SERVICES INC            99,139       99,139      2,916
            2007     1           20408       COLBERT COUNTY HOSPITAL                   12,465       12,465        313
            2007     1           20410       ELIZA COFFEE MEM HOS                       7,029        7,029        226
            2007     1           20420       THE HEALTH CARE AUTHORITY OF THE CI           566         566         43
            2007     1           20421       SHELBY COUNTY HEALTH CARE                 27,417       27,414        565
            2007     1           20427       HOSPITAL SERVICE DISTRICT 1 OF EAST            99          99           1
            2007     1           20433       OUR LADY OF THE LAKE HOSPITAL                 237         237           5
            2007     1           20461       ALTON OCHSNER MEDICAL FOUNDATION              124         124           5
            2007     1           20469       METHODIST HOSPITAL - CENTRAL             157,876      157,870     17,362
            2007     1           95136       PHILLIPS HOSPITAL CORPORATION              1,739        1,739         67
            2007     1           95142       INGALLS MEMORIAL HOSPITAL                  1,581        1,581         24
            2007     1           95306       NORTHSHORE REG MED CENTER                     132         132           1
            2007     1           95857       MERITER HOSPITAL INC                           89          89           6




5/15/2012                                                       Milliman                                                 Page 26
                              Inpatient & Outpatient Facility Emergency Room Claims by Provider
                               Pro vid er                       Pro vid er           Allo w ed       Paid    Service
            Year   Reg io n   ID Nu m b er                       Nam e               Ch arg es     Claim s     Un its
            2007     1           97767       ARKANSAS CHILDRENS HOSPITAL                   106        106           6
            2007     1           98401       SOUTH BALDW IN HOSP                           263        263           3
            2007     1          220026       LESTER E COX MEDICAL CENTER                   101        101           1
            2007     1          220136       BAPTIST MEMORIAL HOSPITAL                  9,731       9,731        917
            2007     1          220144       MORTON MEDICAL CENTER INC                      52         52           2
            2007     1          220213       SAINT FRANCIS HOSPITAL                     9,930       9,930        465
            2007     1          220220       MARION REGIONAL MEDICAL CENTER                490        490           8
            2007     1          220230       NEW TON HOSPITAL, INC                         289        289         21
            2007     1          220243       W INSTON MEDICAL CENTER                    3,205       3,205        111
            2007     1          220324       INDEPENDENT HEALTHCARE MANAGEMENT             174        174           3
            2007     1          220380       CLARKSDALE HMA INC                       407,849     407,840     14,304
            2007     1          220392       MISSISSIPPI BAPTIST MEDICAL CENTER        19,274      19,274        359
            2007     1          220412       ADVENTIST HEALTH SYSTEM-SUNBELT INC           525        525           9
            2007     1          220415       SOUTHERN HEALTH CORP OF HOUSTON            9,181       9,181        219
            2007     1          220417       RANKIN MEDICAL CENTER                      4,544       4,544        132
            2007     1          220444       DMC-MEMPHIS INC                            4,590       4,590         67
            2007     1          220448       TOURO INFIRMARY                               319        319           8
            2007     1          220462       W ESLEY HEALTH SYSTEMS LLC                 1,148       1,148         30
            2007     1          220467       RIVER OAKS HOSPITAL, INC.                  5,273       5,273        111
            2007     1          220495       MERIDIAN HMA INC                              114        114           3
            2007     1          220498       VANDERBILT UNIVERSITY                      2,580       2,580         35
            2007     1          220528       EAST TENNESSEE CHILDRENS HOSP                  92         92           2
            2007     1          220545       DOCTORS HOSPITAL OF AUGUSTA                   444        444         13
            2007     1          220571       VICKSBURG HEALTHCARE LLC                   6,752       6,752        209
            2007     1          220576       BAPTIST MEMORIAL HOSPITAL                 35,986      35,986      2,192
            2007     1          220606       PHC-CLEVELAND, INC.                      331,245     331,233     10,362
            2007     1          220609       STATE OF MISSISSIPPI-UNIVERSITY OF       281,669     281,669      5,122
            2007     1          220621       ALLIANCE HEALTHCARE SYSTEM INC           127,293     127,281      3,576
            2007     1          220630       JACKSON HMA INC                           19,749      19,749      1,852
            2007     1          220631       NORTH OAK REGIONAL HOSPITAL INC          107,110     107,104      3,754
            2007     1          220682       FORREST COUNTY GENERAL HOSPITAL            2,300       2,300        139
            2007     1          220692       PIONEER HEALTH SERVICES OF MONROE          1,548       1,548         14
            2007     1          220714       STONE COUNTY HOSITAL INC                      802        802         14
            2007     1          220734       GPCH-GP                                       669        669         14
            2007     1          220746       ST JOSEPH MEDICAL CENTER                      612        612         19
            2007     1          220752       SSM REGIONAL HEALTH SERVICES                  409        409           7
            2007     1          220754       ORLANDO REGIONAL HEALTHCARE SYSTEM            525        525         14
            2007     1          220795       ESCAMBIA COUNTY ALABAMA COMMUNITY H        1,074       1,074        116
            2007     1          220809       LEAKE COUNTY BOARD OF TRUSTEES             4,378       4,378        196
            2007     1          737024       LEESBURG REGIONAL MEDICAL CENTER              158        158           6
            2007     1         1084764       JACKSON MADISON COUNTY GENERAL HOSP           136        133           4
            2007     1         1634718       CHRISTIAN HOSPITAL NORTHEAST NORTHW           176        176           5
            2007     1         1856853       PRINCETON BAPTIST MEDICAL CENTER              304        304           4
            2007     1         2032374       DANNY JOE SPREITLER                        2,828       2,828         76
            2007     1         2059744       PIONEER VALLEY HOSPITAL INC                   671        671         14
            2007     1         2083023       NORTHW EST MEDICAL CENTER-W INFIELD L         434        434         10
            2007     1         2224822       HCA HEALTH SERVICES OF TENNESSEE              139        139           4
            2007     1         2658888       COMMUNITY HOSPITAL OF OTTAW A              1,004       1,004        167
            2007     1         2878706       CITIZENS BAPTIST MEDICAL CENTER               314        314           5
            2007     1         4033844       HOSPITAL SKAGGS COMMUNITY INC                 351        351           5
            2007     1         4125505       LAIRD HOPSITAL INC                            152        152           7
            2007     1         5135864       RUSSELLVILLE HOSPITAL LLC                     221        221           5
            2007     1         5323250       W ILLIAMSON COUNTY HOSPITAL DISTRICT          368        368           7
            2007     1         5432201       TENET HEALTHSYSTEMS BARTLETT INC              669        669           6
            2007     1         6202312       COVENANT MEDIAL CENTER                        192        192           3
            2007     1         6779801       UNIVERSITY OF KANSAS HOSPITAL                 817        817           7
            2007     1         7271739       AURORA HEALTH CARE METRO INC                  381        381         12
            2007     1         7539272       QUITMAN COUNTY HOSPITAL, LLC              88,716      88,713      2,340
            2007     1         7589748       PROVENA HOSPITALS                             211        211           4
            2007     1         7771013       MCNAIRY HOSPITAL CORPORATION               5,519       5,519         99
            2007     1         8087360       MADISON HMA INC                           16,616      16,616        318
            2007     1         8227060       HTI MEMORIAL HOSPITAL CORPORATION          2,587       2,587        241
            2007     1         9154257       AURORA SINAI MEDICAL CENTER INC               361        361         11
            2007     1         9386023       NORTHW EST TEXAS HEALTHCARE SYSTEM I          246        246           5
            2007     1         9577070       CHRISTIAN HOSPITAL NORTHEAST                  126        126           4
            2007     2           20003       AMORY HMA INC                            182,712     182,712      5,913
            2007     2           20007       FORREST COUNTY GENERAL HOSPITAL           53,986      53,983      2,095
            2007     2           20008                                                 28,253      28,253      1,168
            2007     2           20010       BAPTIST MEMORIAL HOSPITAL UNION COU        1,312       1,312         36
            2007     2           20016       BAPTIST MEMORIAL HOSPITAL- NORTH          11,878      11,878        912
            2007     2           20020       MAGNOLIA REGIONAL HEALTH CENTER            2,281       2,281         87
            2007     2           20025       GREENW OOD LEFLORE HOSPITAL                9,307       9,307        262
            2007     2           20026       GRENADA LAKE MEDICAL CENTER                4,893       4,893        207




5/15/2012                                                       Milliman                                                Page 27
                              Inpatient & Outpatient Facility Emergency Room Claims by Provider
                               Pro vid er                     Pro vid er             Allo w ed        Paid    Service
            Year   Reg io n   ID Nu m b er                     Nam e                 Ch arg es      Claim s     Un its
            2007     2           20027       MEMORIAL HOSPITAL AT GULFPORT             18,837       18,834        395
            2007     2           20032       SOUTH SUNFLOW ER COUNTY HOSPITAL              907         907         69
            2007     2           20034       ST DOMINIC JACKSON MEM                   241,466      241,451     11,072
            2007     2           20035                                                 15,395       15,395        564
            2007     2           20041       NOXUBEE GENERAL HOSPITAL & NOXUBEE        74,813       74,810      2,039
            2007     2           20042       MAGEE BENEVOLENT ASSOCIATION              61,720       61,717      3,790
            2007     2           20046       ANDERSON INFIRMARY BENEVOLENT ASSOC      129,219      129,219      4,319
            2007     2           20049       RUSH MEDICAL FOUNDATION                  377,712      377,706     14,520
            2007     2           20059       SINGING RIVER HOSPITAL SYSTEM             10,366       10,366        391
            2007     2           20060       BRYAN W W HITFIELD MEM HOSP                   217         217         10
            2007     2           20079       CLAY COUNTY MEDICAL CORPORATION          163,326      163,326      4,239
            2007     2           20081       NORTH MISSISSIPPI MEDICAL CENTER         142,261      142,261      3,649
            2007     2           20082       KINGS DAUGHTERS HOSPITAL OF YAZOO        122,283      122,280      3,669
            2007     2           20084       BAPTIST MEMORIAL HOSPITAL BOONEVILL           671         671         22
            2007     2           20096       PONTOTOC HEALTH SERVICES INC              16,396       16,396        414
            2007     2           20115       HARDY W ILSON MEMORIAL HOSPITAL          146,156      146,156      3,167
            2007     2           20116       MARION GENERAL HOSPITAL                    3,547        3,547        112
            2007     2           20118       NORTH SUNFLOW ER MEDICAL CENTER                66          66           2
            2007     2           20124       HUMPHREYS COUNTY MEMORIAL HOSPITAL         7,539        7,539        241
            2007     2           20129       SHARKEY ISSAQUENA COMMUNITY HOSPITA       52,430       52,424      1,632
            2007     2           20131       W AYNE GENERAL HOSPITAL                   10,834       10,834        632
            2007     2           20133       COVINGTON COUNTY HOSPITAL                  8,347        8,347        324
            2007     2           20140       CLAIBORNE CO HOSPITAL                     53,506       53,497      1,747
            2007     2           20141       SOUTH CENTRAL REGIONAL MEDICAL CENT       99,985       99,985      3,427
            2007     2           20143       BAPTIST MEMORIAL HOSPITAL DESOTO, I        1,969        1,969        213
            2007     2           20145       DELTA REGIONAL MEDICAL CENTER             38,636       38,633        896
            2007     2           20149       STATE OF MISSISSIPPI-UNIVERSITY OF     1,341,707    1,341,707     36,938
            2007     2           20156       TYLER HOLMES MEMORIAL HOSPITAL             2,133        2,133         58
            2007     2           20161                                                      96          96           5
            2007     2           20166       HANCOCK MEDICAL CENTER INC                 1,952        1,952         88
            2007     2           20167       SIMPSON COMMUNITY HEALTHCARE INC          40,538       40,535      3,246
            2007     2           20170       SOUTH MISSISSIPPI REGIONAL MEDICAL         1,993        1,993         72
            2007     2           20172       NATCHEZ REGIONAL MEDICAL CENTER            4,490        4,490        117
            2007     2           20178       W EBSTER HEALTH SERVICES INC             126,090      126,090      3,763
            2007     2           20181       NESHOBA COUNTY HOSPITAL & NURSI HOM      206,000      205,994      7,433
            2007     2           20182       BILOXI HMA INC.                            3,833        3,833         91
            2007     2           20191       PERRY COUNTY GENERAL HOSPITAL                 150         150           5
            2007     2           20193       JEFFERSON COUNTY HOSPITAL                     945         945         29
            2007     2           20197       UNIVERSITY OF SOUTH ALABAMA                    39          39           3
            2007     2           20207       SOUTHW EST MISSISSIPPI REGIONAL MEDI       7,073        7,073        549
            2007     2           20213       HILLCREST HOSPITAL                        63,734       63,734      1,905
            2007     2           20214       H C W ATKINS MEMORIAL HOSPITAL INC        54,813       54,813      1,901
            2007     2           20219       OKTIBBEHA COUNTY HOSPITAL                241,284      241,281      8,914
            2007     2           20226       GULFCOAST COMMUNITY HOSPITAL               1,039        1,039         37
            2007     2           20229       PHYSICIANS AND SURGEONS HOSPITAL GR        5,681        5,678         65
            2007     2           20290       GEORGE COUNTY HOSPITAL                     1,328        1,328         49
            2007     2           20302       CHILDRENS HOSP                                150         150           4
            2007     2           20330       MEDICAL CENTER OF LOUISISANA AT NEW           789         789         21
            2007     2           20364       HOSPITAL SERVICE DISTRICT NO 1                113         113           3
            2007     2           20374       BAPTIST MEMORIAL HOSPITAL                  1,411        1,411         17
            2007     2           20395       UNIVERSITY OF ALABAMA HOSPITAL                816         816         14
            2007     2           20414       DCH REGIONAL MEDICAL CENTER                   210         210           9
            2007     2           20421       SHELBY COUNTY HEALTH CARE                  2,182        2,182         29
            2007     2           20424       SLIDELL MEMORIAL HOSPITAL                     155         155           3
            2007     2           20426       EYE FOUNDATION HOSPITAL INC                    44          44           3
            2007     2           20461       ALTON OCHSNER MEDICAL FOUNDATION              815         815         23
            2007     2           20469       METHODIST HOSPITAL - CENTRAL               3,776        3,776         77
            2007     2           96433       ECTOR COUNTY HOSPITAL DISTRICT                195         195           4
            2007     2           97109       DETROIT RECEIVING HOSPITAL                    132         132           1
            2007     2           97459       CREIGHTON S T JOSEPH REGIONAL              4,601        4,601        134
            2007     2           97684       TEXAS CHILDREN'S HOSPITAL                     505         505           5
            2007     2           97767       ARKANSAS CHILDRENS HOSPITAL                    46          46           2
            2007     2           97779       BAPTIST HOSPITAL                              785         785         18
            2007     2          180578       NORTH BREVARD COUNTY HOSPITAL                 856         856         18
            2007     2          220136       BAPTIST MEMORIAL HOSPITAL                352,418      352,391     22,379
            2007     2          220144       MORTON MEDICAL CENTER INC                 49,596       49,596      2,561
            2007     2          220159       NATCHEZ COMMUNITY HOSPITAL, INC.           1,900        1,900         61
            2007     2          220172       TOUCHETTE REGIONAL HOSPITAL INC               321         321         16
            2007     2          220213       SAINT FRANCIS HOSPITAL                        303         303           9
            2007     2          220220       MARION REGIONAL MEDICAL CENTER                637         637         19
            2007     2          220230       NEW TON HOSPITAL, INC                     52,316       52,316      3,802
            2007     2          220243       W INSTON MEDICAL CENTER                   90,541       90,541      2,938
            2007     2          220279       UNIVERSITY HEALTHCARE SYSTEM               1,255        1,255         19




5/15/2012                                                       Milliman                                                 Page 28
                              Inpatient & Outpatient Facility Emergency Room Claims by Provider
                               Pro vid er                       Pro vid er            Allo w ed        Paid    Service
            Year   Reg io n   ID Nu m b er                       Nam e                Ch arg es      Claim s     Un its
            2007     2          220324       INDEPENDENT HEALTHCARE MANAGEMENT         107,524      107,521      2,174
            2007     2          220380       CLARKSDALE HMA INC                          3,887        3,887        160
            2007     2          220392       MISSISSIPPI BAPTIST MEDICAL CENTER        713,699      713,684     12,550
            2007     2          220415       SOUTHERN HEALTH CORP OF HOUSTON           142,761      142,761      4,001
            2007     2          220417       RANKIN MEDICAL CENTER                     131,404      131,404      4,512
            2007     2          220441       PRENTISS REGIONAL HOSPITAL AND EXTE         1,373        1,373         42
            2007     2          220448       TOURO INFIRMARY                                 99          99           3
            2007     2          220462       W ESLEY HEALTH SYSTEMS LLC                 16,075       16,075        530
            2007     2          220467       RIVER OAKS HOSPITAL, INC.                 143,275      143,275      5,287
            2007     2          220487       PROVIDENCE HOSPITAL                         1,255        1,255         51
            2007     2          220495       MERIDIAN HMA INC                          268,052      268,049     11,661
            2007     2          220522       JEFFERSON PARISH HOSPITAL SERVICE               44          44           1
            2007     2          220565       NORTH PORT HOSPITAL-DCH                        242         242         10
            2007     2          220571       VICKSBURG HEALTHCARE LLC                  332,709      332,706      8,716
            2007     2          220575       AHS SUMMIT HOSPITAL                             70          70           1
            2007     2          220576       BAPTIST MEMORIAL HOSPITAL                      534         534         15
            2007     2          220601       EAST JEFFERSON GENERAL HOSPITAL                367         367           9
            2007     2          220606       PHC-CLEVELAND, INC.                         4,763        4,760        207
            2007     2          220609       STATE OF MISSISSIPPI-UNIVERSITY OF         11,494       11,494        183
            2007     2          220621       ALLIANCE HEALTHCARE SYSTEM INC              2,221        2,221         63
            2007     2          220630       JACKSON HMA INC                           562,133      562,133     18,774
            2007     2          220631       NORTH OAK REGIONAL HOSPITAL INC                495         495         14
            2007     2          220682       FORREST COUNTY GENERAL HOSPITAL                596         596         19
            2007     2          220692       PIONEER HEALTH SERVICES OF MONROE          49,382       49,373        907
            2007     2          220714       STONE COUNTY HOSITAL INC                       427         427         25
            2007     2          220734       GPCH-GP                                        736         736         36
            2007     2          220809       LEAKE COUNTY BOARD OF TRUSTEES             55,116       55,113      2,405
            2007     2          823778       GREENVILLE MEMORIAL HOSPITAL                    95          95           5
            2007     2         2032374       DANNY JOE SPREITLER                        56,842       56,842      1,546
            2007     2         2083023       NORTHW EST MEDICAL CENTER-W INFIELD L          190         190           6
            2007     2         3126743       GLENW OOD REGIONAL MEDICAL CENTER                0            0          1
            2007     2         4125505       LAIRD HOPSITAL INC                         55,077       55,074      2,749
            2007     2         4605843       SACRED HEART HEALTH SYSTEM INC                  49          49           1
            2007     2         5628235       LINCOLN HEALTH SYSTEMS INC                     153         153           2
            2007     2         5953091       CHRISTUS HEALTH NORTHERN LOUISIANA          1,626        1,626         42
            2007     2         6200741       GREENE RURAL HEALTH CENTER                     512         512         16
            2007     2         6259761       OUR LADY OF THE LAKE ASCENSION                 561         561         20
            2007     2         6380033       SAINTJOHN HEALTH SYSTEM                        835         835         24
            2007     2         6934870       FLORIDA HOSPITAL W ATERMAN                     682         682         10
            2007     2         7051779       COLUMBIA MEDICAL CENTER OF LEW ISVIL           940         940         20
            2007     2         7232713       CARILION MEDICAL CENTER                        104         104           5
            2007     2         7771013       MCNAIRY HOSPITAL CORPORATION                   199         199           8
            2007     2         8087360       MADISON HMA INC                           209,723      209,711      5,638
            2007     2         9700515       RUSH UNIVERSITY MEDICAL CENTER                 362         362           1
            2007     2         9957292       CARILION NEW RIVER VALLEY MEDICAL               77          77           1
            2007     3           20000       W ALKER REGIONAL MEDICAL CENTER INC            186         186           6
            2007     3           20003       AMORY HMA INC                                  463         463           9
            2007     3           20007       FORREST COUNTY GENERAL HOSPITAL         1,347,941    1,347,911     56,718
            2007     3           20008                                                 182,561      182,549      6,699
            2007     3           20012       FIELD MEMORIAL COMMUNITY HOSPITAL         118,495      118,495      3,625
            2007     3           20016       BAPTIST MEMORIAL HOSPITAL- NORTH               320         320           9
            2007     3           20019       W EST FELICIANA PARISH HOSPITAL             1,008        1,008         35
            2007     3           20020       MAGNOLIA REGIONAL HEALTH CENTER                893         893         30
            2007     3           20025       GREENW OOD LEFLORE HOSPITAL                 2,888        2,885         58
            2007     3           20026       GRENADA LAKE MEDICAL CENTER                     63          63           2
            2007     3           20027       MEMORIAL HOSPITAL AT GULFPORT           1,102,383    1,102,338     27,192
            2007     3           20032       SOUTH SUNFLOW ER COUNTY HOSPITAL               573         573         40
            2007     3           20034       ST DOMINIC JACKSON MEM                      9,653        9,653        495
            2007     3           20035                                                      205         205           5
            2007     3           20042       MAGEE BENEVOLENT ASSOCIATION               14,502       14,502        937
            2007     3           20046       ANDERSON INFIRMARY BENEVOLENT ASSOC         3,199        3,199        104
            2007     3           20049       RUSH MEDICAL FOUNDATION                    13,123       13,123        352
            2007     3           20059       SINGING RIVER HOSPITAL SYSTEM             549,238      549,232     18,482
            2007     3           20079       CLAY COUNTY MEDICAL CORPORATION             1,135        1,135         28
            2007     3           20081       NORTH MISSISSIPPI MEDICAL CENTER            3,562        3,562         41
            2007     3           20082       KINGS DAUGHTERS HOSPITAL OF YAZOO              430         430         16
            2007     3           20084       BAPTIST MEMORIAL HOSPITAL BOONEVILL         1,513        1,513        161
            2007     3           20096       PONTOTOC HEALTH SERVICES INC                   453         453         14
            2007     3           20115       HARDY W ILSON MEMORIAL HOSPITAL            11,770       11,770        237
            2007     3           20116       MARION GENERAL HOSPITAL                   151,119      151,101      4,550
            2007     3           20124       HUMPHREYS COUNTY MEMORIAL HOSPITAL          1,130        1,130         47
            2007     3           20130                                                  20,112       20,112      1,000
            2007     3           20131       W AYNE GENERAL HOSPITAL                    95,640       95,634      5,198




5/15/2012                                                       Milliman                                                  Page 29
                              Inpatient & Outpatient Facility Emergency Room Claims by Provider
                               Pro vid er                       Pro vid er          Allo w ed        Paid    Service
            Year   Reg io n   ID Nu m b er                       Nam e              Ch arg es      Claim s     Un its
            2007     3           20133       COVINGTON COUNTY HOSPITAL                75,465       75,465      2,999
            2007     3           20140       CLAIBORNE CO HOSPITAL                     5,760        5,760        199
            2007     3           20141       SOUTH CENTRAL REGIONAL MEDICAL CENT     348,720      348,708     11,513
            2007     3           20143       BAPTIST MEMORIAL HOSPITAL DESOTO, I          485         485         17
            2007     3           20145       DELTA REGIONAL MEDICAL CENTER             4,613        4,613        118
            2007     3           20149       STATE OF MISSISSIPPI-UNIVERSITY OF       98,480       98,480      2,434
            2007     3           20156       TYLER HOLMES MEMORIAL HOSPITAL               120         120         10
            2007     3           20166       HANCOCK MEDICAL CENTER INC              123,895      123,895      7,008
            2007     3           20167       SIMPSON COMMUNITY HEALTHCARE INC          2,174        2,174        176
            2007     3           20170       SOUTH MISSISSIPPI REGIONAL MEDICAL       36,324       36,321        973
            2007     3           20172       NATCHEZ REGIONAL MEDICAL CENTER         189,991      189,991      7,991
            2007     3           20174       LA SALLE GENERAL HOSPITAL                    275         275         11
            2007     3           20181       NESHOBA COUNTY HOSPITAL & NURSI HOM       1,338        1,338         31
            2007     3           20182       BILOXI HMA INC.                         151,685      151,679      6,038
            2007     3           20186       LIFEMARK HOSPITALS OF LOUISIANA INC          301         298           6
            2007     3           20191       PERRY COUNTY GENERAL HOSPITAL            28,575       28,572        955
            2007     3           20193       JEFFERSON COUNTY HOSPITAL                54,524       54,524      1,409
            2007     3           20197       UNIVERSITY OF SOUTH ALABAMA               2,785        2,785        229
            2007     3           20207       SOUTHW EST MISSISSIPPI REGIONAL MEDI    262,474      262,474     15,085
            2007     3           20208       W ALTHALL COUNTY GENERAL HOSPITAL        97,128       97,119      3,727
            2007     3           20214       H C W ATKINS MEMORIAL HOSPITAL INC        3,890        3,890        141
            2007     3           20215       INFIRMARY HEALTH HOSPITALS INC            2,005        2,005         78
            2007     3           20219       OKTIBBEHA COUNTY HOSPITAL                 2,407        2,407        156
            2007     3           20226       GULFCOAST COMMUNITY HOSPITAL             73,502       73,499      3,000
            2007     3           20229       PHYSICIANS AND SURGEONS HOSPITAL GR      21,954       21,954         10
            2007     3           20280       FORT SANDERS SEVIER MEDICAL CENTER           503         503         13
            2007     3           20290       GEORGE COUNTY HOSPITAL                   92,188       92,173      4,000
            2007     3           20294       COLBERT COUNTY NW ALABAMA                     48          48           1
            2007     3           20302       CHILDRENS HOSP                            1,608        1,608         63
            2007     3           20330       MEDICAL CENTER OF LOUISISANA AT NEW          339         339           7
            2007     3           20364       HOSPITAL SERVICE DISTRICT NO 1               975         975         34
            2007     3           20395       UNIVERSITY OF ALABAMA HOSPITAL            2,483        2,483         48
            2007     3           20411       UNIVERSITY OF SOUTH ALABAMA               6,539        6,539        467
            2007     3           20414       DCH REGIONAL MEDICAL CENTER                  309         309           9
            2007     3           20424       SLIDELL MEMORIAL HOSPITAL                15,908       15,902        311
            2007     3           20427       HOSPITAL SERVICE DISTRICT 1 OF EAST          509         509           6
            2007     3           20433       OUR LADY OF THE LAKE HOSPITAL             1,882        1,882         47
            2007     3           20441       BATON ROUGE GEN HOSP                         699         699         22
            2007     3           20459       ST. HELENA PARISH HOSPITAL                   143         143           4
            2007     3           20461       ALTON OCHSNER MEDICAL FOUNDATION          2,099        2,099         70
            2007     3           20469       METHODIST HOSPITAL - CENTRAL                 427         427         12
            2007     3           20473       RIVERLAND MEDICAL CENTER                     666         666         20
            2007     3           20482       MOBILE INFIRMARY ASSOCIATION              3,577        3,577        100
            2007     3           95306       NORTHSHORE REG MED CENTER                27,310       27,310        830
            2007     3           97459       CREIGHTON S T JOSEPH REGIONAL                877         877         16
            2007     3           97779       BAPTIST HOSPITAL                          6,512        6,512         64
            2007     3           98401       SOUTH BALDW IN HOSP                       1,007        1,007         11
            2007     3          220136       BAPTIST MEMORIAL HOSPITAL                 1,646        1,646        181
            2007     3          220144       MORTON MEDICAL CENTER INC                 2,721        2,721        128
            2007     3          220159       NATCHEZ COMMUNITY HOSPITAL, INC.        187,048      187,048     10,905
            2007     3          220213       SAINT FRANCIS HOSPITAL                       292         292           3
            2007     3          220230       NEW TON HOSPITAL, INC                     1,089        1,089         89
            2007     3          220243       W INSTON MEDICAL CENTER                      712         712         42
            2007     3          220279       UNIVERSITY HEALTHCARE SYSTEM              1,636        1,636         31
            2007     3          220324       INDEPENDENT HEALTHCARE MANAGEMENT         2,063        2,063         38
            2007     3          220380       CLARKSDALE HMA INC                        2,115        2,115        127
            2007     3          220392       MISSISSIPPI BAPTIST MEDICAL CENTER       14,189       14,186        278
            2007     3          220412       ADVENTIST HEALTH SYSTEM-SUNBELT INC       1,027        1,027         16
            2007     3          220417       RANKIN MEDICAL CENTER                     2,423        2,423         46
            2007     3          220428       W OMANS HOSPITAL FOUNDATION                  156         156         11
            2007     3          220441       PRENTISS REGIONAL HOSPITAL AND EXTE      86,478       86,478      2,454
            2007     3          220448       TOURO INFIRMARY                              451         451         14
            2007     3          220462       W ESLEY HEALTH SYSTEMS LLC              279,177      279,171      9,637
            2007     3          220467       RIVER OAKS HOSPITAL, INC.                 4,556        4,556        122
            2007     3          220487       PROVIDENCE HOSPITAL                       2,412        2,412         82
            2007     3          220489       RIVERSIDE MEDICAL CENTER                  2,310        2,310        133
            2007     3          220495       MERIDIAN HMA INC                             448         448         21
            2007     3          220522       JEFFERSON PARISH HOSPITAL SERVICE            229         229         11
            2007     3          220571       VICKSBURG HEALTHCARE LLC                  6,578        6,578        134
            2007     3          220575       AHS SUMMIT HOSPITAL                          464         464         17
            2007     3          220601       EAST JEFFERSON GENERAL HOSPITAL              591         591         11
            2007     3          220606       PHC-CLEVELAND, INC.                       2,051        2,051         68
            2007     3          220609       STATE OF MISSISSIPPI-UNIVERSITY OF        1,060        1,060           9




5/15/2012                                                       Milliman                                                Page 30
                              Inpatient & Outpatient Facility Emergency Room Claims by Provider
                               Pro vid er                       Pro vid er           Allo w ed        Paid    Service
            Year   Reg io n   ID Nu m b er                       Nam e               Ch arg es      Claim s     Un its
            2007     3          220614       FORSYTH MEMORIAL HOSPITAL                     801         801         16
            2007     3          220621       ALLIANCE HEALTHCARE SYSTEM INC                732         732         23
            2007     3          220630       JACKSON HMA INC                           13,899       13,899        421
            2007     3          220631       NORTH OAK REGIONAL HOSPITAL INC               261         261           8
            2007     3          220682       FORREST COUNTY GENERAL HOSPITAL          204,392      204,389      8,217
            2007     3          220688       CLARK MEMORIAL HOSPITAL                       729         729         38
            2007     3          220692       PIONEER HEALTH SERVICES OF MONROE             367         367           3
            2007     3          220714       STONE COUNTY HOSITAL INC                  65,234       65,231      2,688
            2007     3          220734       GPCH-GP                                   95,784       95,784      3,144
            2007     3          220780       BAY MEDICAL CENTER                            204         204           3
            2007     3          220809       LEAKE COUNTY BOARD OF TRUSTEES             2,081        2,081        151
            2007     3         1856853       PRINCETON BAPTIST MEDICAL CENTER              425         425         13
            2007     3         2703888       MEMORIAL HERMANN HOSPITAL SYSTEM              687         684           7
            2007     3         3126743       GLENW OOD REGIONAL MEDICAL CENTER          4,907        4,907         54
            2007     3         4125505       LAIRD HOPSITAL INC                            838         838         33
            2007     3         4338300       EDMOND REGIONAL MEDICAL CENTER, LLC            64          64           3
            2007     3         4458031       COLUMBIA MEDICAL CENTER OF                    524         524         11
            2007     3         4581000       LOUISIANA HEART HOSPITAL LLC               2,470        2,470         46
            2007     3         4605843       SACRED HEART HEALTH SYSTEM INC                277         277         13
            2007     3         6200741       GREENE RURAL HEALTH CENTER                21,007       21,007        660
            2007     3         6259761       OUR LADY OF THE LAKE ASCENSION                131         131           4
            2007     3         7279500       ST. JOSEPH'S HOSPITA, INC.                    128         128           3
            2007     3         8087360       MADISON HMA INC                            1,747        1,747         37
            2007     3         8171261       HCA HEALTH SERVICES OF TENNESSEE IN        3,827        3,827        295
            2007     3         8227060       HTI MEMORIAL HOSPITAL CORPORATION              77          77           1
            2007     3         8779261       BON SECOURS - ST FRANCIS MEDICAL              156         156           3
            2007     3         9573208       GULF BREEZE HOSPITAL                          294         294         10
            2008     1           20000       W ALKER REGIONAL MEDICAL CENTER INC           363         363         11
            2008     1           20003       AMORY HMA INC                             50,690       50,654      3,054
            2008     1           20007       FORREST COUNTY GENERAL HOSPITAL            5,072        5,066        119
            2008     1           20008                                                     220         220           5
            2008     1           20010       BAPTIST MEMORIAL HOSPITAL UNION COU      123,569      123,302      6,132
            2008     1           20016       BAPTIST MEMORIAL HOSPITAL- NORTH         217,026      216,456     10,170
            2008     1           20020       MAGNOLIA REGIONAL HEALTH CENTER          408,894      408,882     17,207
            2008     1           20025       GREENW OOD LEFLORE HOSPITAL              652,566      651,123     26,214
            2008     1           20026       GRENADA LAKE MEDICAL CENTER              216,198      215,766      9,181
            2008     1           20027       MEMORIAL HOSPITAL AT GULFPORT              3,932        3,920        103
            2008     1           20032       SOUTH SUNFLOW ER COUNTY HOSPITAL          72,369       72,351      5,168
            2008     1           20034       ST DOMINIC JACKSON MEM                    13,587       13,563        771
            2008     1           20035                                                 96,137       95,861      4,440
            2008     1           20042       MAGEE BENEVOLENT ASSOCIATION                  144         144           6
            2008     1           20046       ANDERSON INFIRMARY BENEVOLENT ASSOC           572         569         20
            2008     1           20049       RUSH MEDICAL FOUNDATION                    1,240        1,240         23
            2008     1           20057       MEADOW CREST HOSPITAL LLC                     100          97           2
            2008     1           20059       SINGING RIVER HOSPITAL SYSTEM              4,888        4,882        206
            2008     1           20079       CLAY COUNTY MEDICAL CORPORATION            4,244        4,232        118
            2008     1           20081       NORTH MISSISSIPPI MEDICAL CENTER         557,145      556,242     30,035
            2008     1           20082       KINGS DAUGHTERS HOSPITAL OF YAZOO          3,954        3,939        121
            2008     1           20084       BAPTIST MEMORIAL HOSPITAL BOONEVILL      124,814      124,379      5,439
            2008     1           20096       PONTOTOC HEALTH SERVICES INC             132,332      132,308      3,493
            2008     1           20111       TIPPAH COUNTY HOSPITAL                   122,327      122,006      3,929
            2008     1           20116       MARION GENERAL HOSPITAL                       245         245         10
            2008     1           20118       NORTH SUNFLOW ER MEDICAL CENTER           75,711       75,621      2,300
            2008     1           20124       HUMPHREYS COUNTY MEMORIAL HOSPITAL       131,165      130,856      3,831
            2008     1           20129       SHARKEY ISSAQUENA COMMUNITY HOSPITA        6,080        6,074        206
            2008     1           20131       W AYNE GENERAL HOSPITAL                        61          61           4
            2008     1           20141       SOUTH CENTRAL REGIONAL MEDICAL CENT        1,540        1,540         57
            2008     1           20143       BAPTIST MEMORIAL HOSPITAL DESOTO, I      298,241      297,770     30,134
            2008     1           20145       DELTA REGIONAL MEDICAL CENTER          1,125,483    1,124,097     31,412
            2008     1           20149       STATE OF MISSISSIPPI-UNIVERSITY OF       140,807      140,804      2,445
            2008     1           20156       TYLER HOLMES MEMORIAL HOSPITAL            87,794       87,587      3,116
            2008     1           20161                                                 40,995       40,800      1,377
            2008     1           20166       HANCOCK MEDICAL CENTER INC                 1,686        1,683         56
            2008     1           20167       SIMPSON COMMUNITY HEALTHCARE INC              157         157         12
            2008     1           20170       SOUTH MISSISSIPPI REGIONAL MEDICAL            245         245           4
            2008     1           20178       W EBSTER HEALTH SERVICES INC              12,790       12,775        331
            2008     1           20181       NESHOBA COUNTY HOSPITAL & NURSI HOM        1,092        1,083         29
            2008     1           20182       BILOXI HMA INC.                               847         847         22
            2008     1           20193       JEFFERSON COUNTY HOSPITAL                     791         791         14
            2008     1           20207       SOUTHW EST MISSISSIPPI REGIONAL MEDI          246         246         12
            2008     1           20213       HILLCREST HOSPITAL                         4,108        4,093        148
            2008     1           20219       OKTIBBEHA COUNTY HOSPITAL                  7,242        7,239        157
            2008     1           20229       PHYSICIANS AND SURGEONS HOSPITAL GR      277,007      276,719      5,061




5/15/2012                                                       Milliman                                                 Page 31
                              Inpatient & Outpatient Facility Emergency Room Claims by Provider
                               Pro vid er                       Pro vid er           Allo w ed       Paid    Service
            Year   Reg io n   ID Nu m b er                       Nam e               Ch arg es     Claim s     Un its
            2008     1           20294       COLBERT COUNTY NW ALABAMA                     843        840         24
            2008     1           20363       METHODIST HEALTHCARE - FAYETTE             1,381       1,372         22
            2008     1           20374       BAPTIST MEMORIAL HOSPITAL                 13,716      13,698        836
            2008     1           20393       TISHOMINGO HEALTH SERVICES INC           129,077     128,864      4,522
            2008     1           20395       UNIVERSITY OF ALABAMA HOSPITAL             1,168       1,168         46
            2008     1           20398       REGIONAL MEDICAL CENTER BOARD                  94         94           1
            2008     1           20408       COLBERT COUNTY HOSPITAL                   11,563      11,491        256
            2008     1           20410       ELIZA COFFEE MEM HOS                          139        139           4
            2008     1           20420       THE HEALTH CARE AUTHORITY OF THE CI           177        177           5
            2008     1           20421       SHELBY COUNTY HEALTH CARE                 41,960      41,942      1,328
            2008     1           20433       OUR LADY OF THE LAKE HOSPITAL                 212        209         14
            2008     1           20441       BATON ROUGE GEN HOSP                          102         99           5
            2008     1           20461       ALTON OCHSNER MEDICAL FOUNDATION               50         47           1
            2008     1           20469       METHODIST HOSPITAL - CENTRAL             164,735     164,675     11,142
            2008     1           95136       PHILLIPS HOSPITAL CORPORATION              1,568       1,568         18
            2008     1           95142       INGALLS MEMORIAL HOSPITAL                     682        682         16
            2008     1           95306       NORTHSHORE REG MED CENTER                     417        417           7
            2008     1           95919       ST JOHNS HOSPITAL                             200        200           2
            2008     1           96283       TRUMAN MEDICAL CENTER INCORPORATED             58         55           3
            2008     1           96897       PUBLIC HOSPITAL DISTRICT 1 OF KING            509        506           4
            2008     1          220136       BAPTIST MEMORIAL HOSPITAL                  5,692       5,677        436
            2008     1          220144       MORTON MEDICAL CENTER INC                     221        221         10
            2008     1          220159       NATCHEZ COMMUNITY HOSPITAL, INC.              249        249           8
            2008     1          220213       SAINT FRANCIS HOSPITAL                     7,468       7,462        242
            2008     1          220243       W INSTON MEDICAL CENTER                    3,814       3,814         69
            2008     1          220324       INDEPENDENT HEALTHCARE MANAGEMENT             576        576         14
            2008     1          220380       CLARKSDALE HMA INC                       338,055     337,200     13,883
            2008     1          220392       MISSISSIPPI BAPTIST MEDICAL CENTER        18,530      18,506        248
            2008     1          220412       ADVENTIST HEALTH SYSTEM-SUNBELT INC           377        374           8
            2008     1          220415       SOUTHERN HEALTH CORP OF HOUSTON            4,127       4,124        125
            2008     1          220417       RANKIN MEDICAL CENTER                      2,697       2,697         81
            2008     1          220441       PRENTISS REGIONAL HOSPITAL AND EXTE           215        215           5
            2008     1          220444       DMC-MEMPHIS INC                           10,919      10,913        103
            2008     1          220462       W ESLEY HEALTH SYSTEMS LLC                    684        681           9
            2008     1          220467       RIVER OAKS HOSPITAL, INC.                  3,706       3,706        265
            2008     1          220498       VANDERBILT UNIVERSITY                      4,078       4,075         94
            2008     1          220512       JACKSON HOSPITAL & CLINIC INC                 909        909         27
            2008     1          220571       VICKSBURG HEALTHCARE LLC                   6,251       6,248        190
            2008     1          220576       BAPTIST MEMORIAL HOSPITAL                 43,416      43,356      2,381
            2008     1          220606       PHC-CLEVELAND, INC.                      324,941     324,041     11,161
            2008     1          220609       STATE OF MISSISSIPPI-UNIVERSITY OF       254,417     254,417      6,186
            2008     1          220621       ALLIANCE HEALTHCARE SYSTEM INC            95,445      95,148      3,091
            2008     1          220630       JACKSON HMA INC                            4,671       4,671        182
            2008     1          220631       NORTH OAK REGIONAL HOSPITAL INC          107,819     107,771      5,733
            2008     1          220682       FORREST COUNTY GENERAL HOSPITAL               328        328         15
            2008     1          220692       PIONEER HEALTH SERVICES OF MONROE          1,969       1,966         28
            2008     1          220708       CAMERON REGIONAL MEDICAL CENTER INC           154        151           2
            2008     1          220714       STONE COUNTY HOSITAL INC                      780        780         13
            2008     1          220734       GPCH-GP                                       318        318         12
            2008     1          220778       CANDLER GENERAL HOSPITAL INCORPORAT           325        325           4
            2008     1          220800       THE CHILDREN'S HOSPITAL OF PHILADEL           130        130           4
            2008     1          220809       LEAKE COUNTY BOARD OF TRUSTEES             4,498       4,483        211
            2008     1         1084764       JACKSON MADISON COUNTY GENERAL HOSP        3,191       3,191        122
            2008     1         1634718       CHRISTIAN HOSPITAL NORTHEAST NORTHW           645        645           8
            2008     1         2032374       DANNY JOE SPREITLER                        6,804       6,798        226
            2008     1         2083023       NORTHW EST MEDICAL CENTER-W INFIELD L         193        193           5
            2008     1         3024049       NORTHCREST MEDICAL CENTER                     963        963         24
            2008     1         3884810       LAKEW OOD HOSPITAL ASSOCIATION                167        167           2
            2008     1         4058762       DEMING HOSPITAL CORPORATION                   407        407           5
            2008     1         4125505       LAIRD HOPSITAL INC                            124        121           3
            2008     1         4128826       THE MEDICAL CENTER OF CENTRAL GEORG        2,524       2,524        114
            2008     1         4458031       COLUMBIA MEDICAL CENTER OF                    275        275           4
            2008     1         4935056       EHCA CARTERSVILLE LLC                          67         64           1
            2008     1         5432201       TENET HEALTHSYSTEMS BARTLETT INC           1,365       1,362         14
            2008     1         5558865       PROVENA HOSPITALS                          1,649       1,646         24
            2008     1         7386784       BOLIVAR GENERAL HOSPITAL INC                  781        778         13
            2008     1         7539272       QUITMAN COUNTY HOSPITAL, LLC             103,359     103,101      2,267
            2008     1         7771013       MCNAIRY HOSPITAL CORPORATION               4,988       4,985         63
            2008     1         7781502       VALLEY HOSPITAL MED CTR                       488        485           8
            2008     1         8087360       MADISON HMA INC                            8,271       8,244        215
            2008     1         8408322       GIBSON GENERAL HOSPITAL                       244        244           4
            2008     1         8430040       BANNER ESTRELLA MEDICAL CENTER                230        227           1
            2008     1         9121737       MINIDOKA MEMORIAL HOSPITAL                     52         49           1




5/15/2012                                                      Milliman                                                 Page 32
                              Inpatient & Outpatient Facility Emergency Room Claims by Provider
                               Pro vid er                    Pro vid er              Allo w ed        Paid    Service
            Year   Reg io n   ID Nu m b er                     Nam e                 Ch arg es      Claim s     Un its
            2008     1         9272727       MARY IMMACULATE HOSPITAL                      914         911         34
            2008     1         9573208       GULF BREEZE HOSPITAL                          219         219           4
            2008     2           20003       AMORY HMA INC                            149,175      149,049      6,027
            2008     2           20007       FORREST COUNTY GENERAL HOSPITAL           52,822       52,813      2,574
            2008     2           20008                                                 29,087       29,081      1,127
            2008     2           20010       BAPTIST MEMORIAL HOSPITAL UNION COU        2,477        2,474        161
            2008     2           20012       FIELD MEMORIAL COMMUNITY HOSPITAL             720         720         21
            2008     2           20016       BAPTIST MEMORIAL HOSPITAL- NORTH          26,279       26,243        566
            2008     2           20020       MAGNOLIA REGIONAL HEALTH CENTER               903         903        116
            2008     2           20025       GREENW OOD LEFLORE HOSPITAL                5,658        5,646        275
            2008     2           20026       GRENADA LAKE MEDICAL CENTER                7,507        7,492        324
            2008     2           20027       MEMORIAL HOSPITAL AT GULFPORT              9,980        9,959        576
            2008     2           20032       SOUTH SUNFLOW ER COUNTY HOSPITAL              285         285         18
            2008     2           20034       ST DOMINIC JACKSON MEM                   230,477      229,763     11,465
            2008     2           20035                                                 10,404       10,371        436
            2008     2           20041       NOXUBEE GENERAL HOSPITAL & NOXUBEE        55,710       55,512      1,974
            2008     2           20042       MAGEE BENEVOLENT ASSOCIATION              70,139       69,854      4,232
            2008     2           20046       ANDERSON INFIRMARY BENEVOLENT ASSOC      125,016      124,524      4,855
            2008     2           20049       RUSH MEDICAL FOUNDATION                  417,309      416,670     17,373
            2008     2           20059       SINGING RIVER HOSPITAL SYSTEM              6,832        6,829        211
            2008     2           20060       BRYAN W W HITFIELD MEM HOSP                   220         220           8
            2008     2           20079       CLAY COUNTY MEDICAL CORPORATION          186,859      186,415      4,739
            2008     2           20081       NORTH MISSISSIPPI MEDICAL CENTER          97,639       97,474      3,845
            2008     2           20082       KINGS DAUGHTERS HOSPITAL OF YAZOO        147,166      146,932      3,880
            2008     2           20096       PONTOTOC HEALTH SERVICES INC              17,939       17,933        579
            2008     2           20111       TIPPAH COUNTY HOSPITAL                         80          80           1
            2008     2           20115       HARDY W ILSON MEMORIAL HOSPITAL          234,608      234,125      3,568
            2008     2           20116       MARION GENERAL HOSPITAL                    1,868        1,859         55
            2008     2           20118       NORTH SUNFLOW ER MEDICAL CENTER               646         646         22
            2008     2           20124       HUMPHREYS COUNTY MEMORIAL HOSPITAL         4,342        4,333        161
            2008     2           20129       SHARKEY ISSAQUENA COMMUNITY HOSPITA       44,518       44,449      1,216
            2008     2           20131       W AYNE GENERAL HOSPITAL                    5,319        5,289        311
            2008     2           20133       COVINGTON COUNTY HOSPITAL                 11,617       11,587        511
            2008     2           20140       CLAIBORNE CO HOSPITAL                     72,002       71,789      2,587
            2008     2           20141       SOUTH CENTRAL REGIONAL MEDICAL CENT       80,741       80,510      2,901
            2008     2           20143       BAPTIST MEMORIAL HOSPITAL DESOTO, I        1,515        1,515        190
            2008     2           20145       DELTA REGIONAL MEDICAL CENTER             27,975       27,957        667
            2008     2           20149       STATE OF MISSISSIPPI-UNIVERSITY OF     1,541,604    1,541,580     33,224
            2008     2           20156       TYLER HOLMES MEMORIAL HOSPITAL            11,948       11,909        350
            2008     2           20166       HANCOCK MEDICAL CENTER INC                 2,835        2,835         55
            2008     2           20167       SIMPSON COMMUNITY HEALTHCARE INC          58,798       58,597      3,183
            2008     2           20170       SOUTH MISSISSIPPI REGIONAL MEDICAL         1,339        1,330         32
            2008     2           20172       NATCHEZ REGIONAL MEDICAL CENTER            1,777        1,774         41
            2008     2           20178       W EBSTER HEALTH SERVICES INC             111,474      111,225      3,553
            2008     2           20181       NESHOBA COUNTY HOSPITAL & NURSI HOM      262,727      262,244      9,224
            2008     2           20182       BILOXI HMA INC.                            5,588        5,570        178
            2008     2           20186       LIFEMARK HOSPITALS OF LOUISIANA INC            57          54           1
            2008     2           20193       JEFFERSON COUNTY HOSPITAL                     462         462           9
            2008     2           20207       SOUTHW EST MISSISSIPPI REGIONAL MEDI       2,025        2,025        157
            2008     2           20213       HILLCREST HOSPITAL                        61,629       61,446      1,813
            2008     2           20214       H C W ATKINS MEMORIAL HOSPITAL INC        65,950       65,746      2,162
            2008     2           20219       OKTIBBEHA COUNTY HOSPITAL                240,088      239,419      9,683
            2008     2           20226       GULFCOAST COMMUNITY HOSPITAL                  867         867         39
            2008     2           20229       PHYSICIANS AND SURGEONS HOSPITAL GR        1,276        1,273         26
            2008     2           20238       ERLANGER MEDICAL CENTER DEW AIN HILD          107         107           1
            2008     2           20290       GEORGE COUNTY HOSPITAL                     1,352        1,343         81
            2008     2           20302       CHILDRENS HOSP                                 82          82           3
            2008     2           20330       MEDICAL CENTER OF LOUISISANA AT NEW        1,056        1,056        127
            2008     2           20364       HOSPITAL SERVICE DISTRICT NO 1                738         738         24
            2008     2           20374       BAPTIST MEMORIAL HOSPITAL                       0            0        14
            2008     2           20393       TISHOMINGO HEALTH SERVICES INC                665         665         19
            2008     2           20395       UNIVERSITY OF ALABAMA HOSPITAL                122         122           5
            2008     2           20408       COLBERT COUNTY HOSPITAL                       106         106           1
            2008     2           20411       UNIVERSITY OF SOUTH ALABAMA                   374         371         16
            2008     2           20414       DCH REGIONAL MEDICAL CENTER                    31          31           2
            2008     2           20420       THE HEALTH CARE AUTHORITY OF THE CI            81          78           2
            2008     2           20421       SHELBY COUNTY HEALTH CARE                     847         847         10
            2008     2           20424       SLIDELL MEMORIAL HOSPITAL                      41          38           2
            2008     2           20429       CHILDRENS HOSPITAL OF BHAM                    197         197           7
            2008     2           20433       OUR LADY OF THE LAKE HOSPITAL                 349         346         16
            2008     2           20441       BATON ROUGE GEN HOSP                       1,638        1,638         42
            2008     2           20459       ST. HELENA PARISH HOSPITAL                    216         216           9
            2008     2           20461       ALTON OCHSNER MEDICAL FOUNDATION              183         183         10




5/15/2012                                                       Milliman                                                 Page 33
                              Inpatient & Outpatient Facility Emergency Room Claims by Provider
                               Pro vid er                       Pro vid er           Allo w ed        Paid    Service
            Year   Reg io n   ID Nu m b er                       Nam e               Ch arg es      Claim s     Un its
            2008     2           20469       METHODIST HOSPITAL - CENTRAL              11,213       11,207        383
            2008     2           20482       MOBILE INFIRMARY ASSOCIATION                  113         110           6
            2008     2           95306       NORTHSHORE REG MED CENTER                     437         437           7
            2008     2           95348       ST LOUIS CHILDRENS HOSP                       311         311           7
            2008     2           95993       BORGESS MEDICAL CENTER                        322         322           3
            2008     2           96542       TRIDENT MEDICAL CENTER                        101         101           2
            2008     2           97684       TEXAS CHILDREN'S HOSPITAL                     248         248           1
            2008     2           97767       ARKANSAS CHILDRENS HOSPITAL                   700         700         32
            2008     2           97779       BAPTIST HOSPITAL                              132         132           5
            2008     2          220136       BAPTIST MEMORIAL HOSPITAL                390,473      389,351     28,836
            2008     2          220144       MORTON MEDICAL CENTER INC                 56,924       56,561      2,634
            2008     2          220159       NATCHEZ COMMUNITY HOSPITAL, INC.           1,902        1,899         64
            2008     2          220213       SAINT FRANCIS HOSPITAL                        521         521         14
            2008     2          220220       MARION REGIONAL MEDICAL CENTER                156         153           3
            2008     2          220230       NEW TON HOSPITAL, INC                     57,985       57,835      3,367
            2008     2          220243       W INSTON MEDICAL CENTER                  129,107      128,786      2,344
            2008     2          220279       UNIVERSITY HEALTHCARE SYSTEM                  762         762           6
            2008     2          220324       INDEPENDENT HEALTHCARE MANAGEMENT        104,102      103,907      2,293
            2008     2          220380       CLARKSDALE HMA INC                         5,655        5,649        157
            2008     2          220392       MISSISSIPPI BAPTIST MEDICAL CENTER       649,996      648,667     11,732
            2008     2          220412       ADVENTIST HEALTH SYSTEM-SUNBELT INC           512         509           9
            2008     2          220415       SOUTHERN HEALTH CORP OF HOUSTON          138,559      138,397      4,099
            2008     2          220417       RANKIN MEDICAL CENTER                    116,750      116,693      4,670
            2008     2          220441       PRENTISS REGIONAL HOSPITAL AND EXTE           577         577           9
            2008     2          220444       DMC-MEMPHIS INC                               424         424           3
            2008     2          220462       W ESLEY HEALTH SYSTEMS LLC                 7,856        7,832        186
            2008     2          220467       RIVER OAKS HOSPITAL, INC.                179,245      179,149      9,302
            2008     2          220487       PROVIDENCE HOSPITAL                           420         420         23
            2008     2          220495       MERIDIAN HMA INC                         228,395      227,924     10,269
            2008     2          220522       JEFFERSON PARISH HOSPITAL SERVICE             823         823         16
            2008     2          220565       NORTH PORT HOSPITAL-DCH                    1,091        1,088         35
            2008     2          220571       VICKSBURG HEALTHCARE LLC                 355,470      355,278      8,948
            2008     2          220576       BAPTIST MEMORIAL HOSPITAL                     707         707         14
            2008     2          220606       PHC-CLEVELAND, INC.                        3,587        3,563        133
            2008     2          220609       STATE OF MISSISSIPPI-UNIVERSITY OF        12,539       12,539        261
            2008     2          220621       ALLIANCE HEALTHCARE SYSTEM INC                229         229         11
            2008     2          220630       JACKSON HMA INC                          492,320      492,176     21,595
            2008     2          220631       NORTH OAK REGIONAL HOSPITAL INC            1,072        1,072         48
            2008     2          220682       FORREST COUNTY GENERAL HOSPITAL               351         351         20
            2008     2          220692       PIONEER HEALTH SERVICES OF MONROE         61,103       60,992      1,063
            2008     2          220714       STONE COUNTY HOSITAL INC                   1,284        1,284         11
            2008     2          220734       GPCH-GP                                    2,141        2,141         61
            2008     2          220746       ST JOSEPH MEDICAL CENTER                      315         315           9
            2008     2          220809       LEAKE COUNTY BOARD OF TRUSTEES            63,819       63,660      3,364
            2008     2         1975899       COLUMBIA HOSPITAL AT MEDICAL CITY             355         355           8
            2008     2         2032374       DANNY JOE SPREITLER                       76,559       76,376      2,515
            2008     2         2703888       MEMORIAL HERMANN HOSPITAL SYSTEM               62          62           1
            2008     2         2857378       STATE UNIVERSITY OF IOW A                  1,172        1,169         30
            2008     2         4101365       BLOOMINGTON HOSPITAL                          451         451         13
            2008     2         4125505       LAIRD HOPSITAL INC                        72,596       72,425      3,394
            2008     2         4952335       SENTARA HOSPITALS                              79          79           3
            2008     2         5953091       CHRISTUS HEALTH NORTHERN LOUISIANA            756         756         23
            2008     2         6409841       TENET SOUTH FULTON INC                        136         136           1
            2008     2         7051779       COLUMBIA MEDICAL CENTER OF LEW ISVIL          128         128           1
            2008     2         7286514       BON SECOURS DEPAUL MEDICAL CENTER             633         630         10
            2008     2         7539272       QUITMAN COUNTY HOSPITAL, LLC                  214         211           3
            2008     2         8087360       MADISON HMA INC                          212,019      211,686      7,587
            2008     3           20003       AMORY HMA INC                              2,224        2,224        452
            2008     3           20007       FORREST COUNTY GENERAL HOSPITAL        1,184,361    1,184,160     46,756
            2008     3           20008                                                188,582      188,486      7,565
            2008     3           20010       BAPTIST MEMORIAL HOSPITAL UNION COU           167         167           9
            2008     3           20012       FIELD MEMORIAL COMMUNITY HOSPITAL        112,959      112,941      3,621
            2008     3           20016       BAPTIST MEMORIAL HOSPITAL- NORTH              516         516         18
            2008     3           20019       W EST FELICIANA PARISH HOSPITAL               442         442         13
            2008     3           20020       MAGNOLIA REGIONAL HEALTH CENTER               279         279         16
            2008     3           20025       GREENW OOD LEFLORE HOSPITAL                2,514        2,508         75
            2008     3           20026       GRENADA LAKE MEDICAL CENTER                   772         766         25
            2008     3           20027       MEMORIAL HOSPITAL AT GULFPORT            993,581      992,147     27,117
            2008     3           20034       ST DOMINIC JACKSON MEM                     5,889        5,850        244
            2008     3           20042       MAGEE BENEVOLENT ASSOCIATION              15,332       15,293        885
            2008     3           20046       ANDERSON INFIRMARY BENEVOLENT ASSOC        3,341        3,332         99
            2008     3           20049       RUSH MEDICAL FOUNDATION                    4,749        4,743        173
            2008     3           20057       MEADOW CREST HOSPITAL LLC                  1,266        1,263         72




5/15/2012                                                       Milliman                                                 Page 34
                              Inpatient & Outpatient Facility Emergency Room Claims by Provider
                               Pro vid er                      Pro vid er           Allo w ed        Paid    Service
            Year   Reg io n   ID Nu m b er                      Nam e               Ch arg es      Claim s     Un its
            2008     3           20059       SINGING RIVER HOSPITAL SYSTEM           592,560      592,233     20,358
            2008     3           20081       NORTH MISSISSIPPI MEDICAL CENTER          1,587        1,581         48
            2008     3           20082       KINGS DAUGHTERS HOSPITAL OF YAZOO            246         246           9
            2008     3           20084       BAPTIST MEMORIAL HOSPITAL BOONEVILL          221         221         10
            2008     3           20096       PONTOTOC HEALTH SERVICES INC                 210         210           4
            2008     3           20111       TIPPAH COUNTY HOSPITAL                       530         530         22
            2008     3           20115       HARDY W ILSON MEMORIAL HOSPITAL           5,753        5,741         94
            2008     3           20116       MARION GENERAL HOSPITAL                 145,361      144,767      4,744
            2008     3           20124       HUMPHREYS COUNTY MEMORIAL HOSPITAL        1,232        1,232         33
            2008     3           20130                                                19,743       19,647      1,091
            2008     3           20131       W AYNE GENERAL HOSPITAL                  87,137       86,723      5,112
            2008     3           20133       COVINGTON COUNTY HOSPITAL                67,847       67,655      3,240
            2008     3           20140       CLAIBORNE CO HOSPITAL                    12,782       12,743        439
            2008     3           20141       SOUTH CENTRAL REGIONAL MEDICAL CENT     296,513      295,751     10,750
            2008     3           20143       BAPTIST MEMORIAL HOSPITAL DESOTO, I       1,579        1,576        219
            2008     3           20145       DELTA REGIONAL MEDICAL CENTER             3,515        3,515        135
            2008     3           20149       STATE OF MISSISSIPPI-UNIVERSITY OF      154,425      154,425      3,410
            2008     3           20156       TYLER HOLMES MEMORIAL HOSPITAL               139         136           5
            2008     3           20166       HANCOCK MEDICAL CENTER INC              176,895      176,637      8,159
            2008     3           20167       SIMPSON COMMUNITY HEALTHCARE INC          6,979        6,970        342
            2008     3           20170       SOUTH MISSISSIPPI REGIONAL MEDICAL       51,135       51,009      1,316
            2008     3           20172       NATCHEZ REGIONAL MEDICAL CENTER         197,489      197,084      9,007
            2008     3           20178       W EBSTER HEALTH SERVICES INC                 374         365         14
            2008     3           20182       BILOXI HMA INC.                         171,320      171,008      8,136
            2008     3           20191       PERRY COUNTY GENERAL HOSPITAL            23,059       22,984        685
            2008     3           20193       JEFFERSON COUNTY HOSPITAL                47,594       47,381      1,835
            2008     3           20197       UNIVERSITY OF SOUTH ALABAMA               1,379        1,379         85
            2008     3           20207       SOUTHW EST MISSISSIPPI REGIONAL MEDI    303,777      303,774     17,807
            2008     3           20208       W ALTHALL COUNTY GENERAL HOSPITAL        98,285       98,024      4,008
            2008     3           20214       H C W ATKINS MEMORIAL HOSPITAL INC        1,739        1,727         64
            2008     3           20215       INFIRMARY HEALTH HOSPITALS INC            1,267        1,264         49
            2008     3           20219       OKTIBBEHA COUNTY HOSPITAL                    196         196           2
            2008     3           20226       GULFCOAST COMMUNITY HOSPITAL             20,904       20,904        963
            2008     3           20229       PHYSICIANS AND SURGEONS HOSPITAL GR          305         305           8
            2008     3           20290       GEORGE COUNTY HOSPITAL                  102,178      102,049      4,862
            2008     3           20302       CHILDRENS HOSP                               856         856         55
            2008     3           20330       MEDICAL CENTER OF LOUISISANA AT NEW          279         279         17
            2008     3           20364       HOSPITAL SERVICE DISTRICT NO 1            1,737        1,731         60
            2008     3           20393       TISHOMINGO HEALTH SERVICES INC                87          87           2
            2008     3           20395       UNIVERSITY OF ALABAMA HOSPITAL               243         243         11
            2008     3           20411       UNIVERSITY OF SOUTH ALABAMA               5,857        5,854        306
            2008     3           20424       SLIDELL MEMORIAL HOSPITAL                12,757       12,736        494
            2008     3           20427       HOSPITAL SERVICE DISTRICT 1 OF EAST          979         979         25
            2008     3           20433       OUR LADY OF THE LAKE HOSPITAL             7,023        7,017        102
            2008     3           20441       BATON ROUGE GEN HOSP                      1,127        1,124         32
            2008     3           20461       ALTON OCHSNER MEDICAL FOUNDATION          7,039        7,033        346
            2008     3           20469       METHODIST HOSPITAL - CENTRAL                 757         757         13
            2008     3           20482       MOBILE INFIRMARY ASSOCIATION                 945         942         38
            2008     3           95136       PHILLIPS HOSPITAL CORPORATION             1,102        1,099         21
            2008     3           95306       NORTHSHORE REG MED CENTER                40,659       40,626        616
            2008     3           96463       BILLINGS CLINIC                              517         517           6
            2008     3           97684       TEXAS CHILDREN'S HOSPITAL                    526         526           2
            2008     3          220136       BAPTIST MEMORIAL HOSPITAL                    483         483         22
            2008     3          220144       MORTON MEDICAL CENTER INC                    132         129           6
            2008     3          220159       NATCHEZ COMMUNITY HOSPITAL, INC.        129,285      129,006      7,781
            2008     3          220230       NEW TON HOSPITAL, INC                     1,430        1,427         86
            2008     3          220243       W INSTON MEDICAL CENTER                      631         628           8
            2008     3          220279       UNIVERSITY HEALTHCARE SYSTEM              3,113        3,104         70
            2008     3          220324       INDEPENDENT HEALTHCARE MANAGEMENT         1,359        1,359         36
            2008     3          220380       CLARKSDALE HMA INC                        2,064        2,061         52
            2008     3          220392       MISSISSIPPI BAPTIST MEDICAL CENTER        9,783        9,768        154
            2008     3          220415       SOUTHERN HEALTH CORP OF HOUSTON              170         170           2
            2008     3          220417       RANKIN MEDICAL CENTER                     3,205        3,205         82
            2008     3          220441       PRENTISS REGIONAL HOSPITAL AND EXTE     102,991      102,742      1,867
            2008     3          220448       TOURO INFIRMARY                              970         967        134
            2008     3          220462       W ESLEY HEALTH SYSTEMS LLC              336,985      336,241      9,990
            2008     3          220467       RIVER OAKS HOSPITAL, INC.                 4,815        4,815        285
            2008     3          220487       PROVIDENCE HOSPITAL                       4,186        4,171        281
            2008     3          220489       RIVERSIDE MEDICAL CENTER                     853         847         35
            2008     3          220495       MERIDIAN HMA INC                          2,700        2,691        319
            2008     3          220522       JEFFERSON PARISH HOSPITAL SERVICE            134         134           3
            2008     3          220571       VICKSBURG HEALTHCARE LLC                  9,470        9,470        220
            2008     3          220601       EAST JEFFERSON GENERAL HOSPITAL              262         262           1




5/15/2012                                                       Milliman                                                Page 35
                              Inpatient & Outpatient Facility Emergency Room Claims by Provider
                               Pro vid er                       Pro vid er          Allo w ed        Paid    Service
            Year   Reg io n   ID Nu m b er                       Nam e              Ch arg es      Claim s     Un its
            2008     3          220606       PHC-CLEVELAND, INC.                          797         797         24
            2008     3          220609       STATE OF MISSISSIPPI-UNIVERSITY OF           412         412           5
            2008     3          220620       MEMORIAL MEDICAL CENTER                      575         575        107
            2008     3          220621       ALLIANCE HEALTHCARE SYSTEM INC               663         663         25
            2008     3          220630       JACKSON HMA INC                           7,462        7,459        271
            2008     3          220682       FORREST COUNTY GENERAL HOSPITAL         225,878      225,806     13,548
            2008     3          220712       SPRINGHILL MEMORIAL HOSPITALS                238         238           7
            2008     3          220714       STONE COUNTY HOSITAL INC                117,742      117,610      2,690
            2008     3          220727       HACKLEY HOSPITAL FISCAL SERVIC               321         321         12
            2008     3          220734       GPCH-GP                                 174,345      173,982      4,928
            2008     3          220809       LEAKE COUNTY BOARD OF TRUSTEES               409         409         15
            2008     3         1170370       HOUSTON NORTHW EST PARTNERS LTD              241         241           4
            2008     3         2004242       DOCTORS MEMORIAL HOSPITAL INC                312         312           8
            2008     3         2703888       MEMORIAL HERMANN HOSPITAL SYSTEM             429         426           4
            2008     3         4125505       LAIRD HOPSITAL INC                        2,295        2,295         83
            2008     3         4458031       COLUMBIA MEDICAL CENTER OF                   171         171           2
            2008     3         4581000       LOUISIANA HEART HOSPITAL LLC              2,633        2,630         29
            2008     3         5725044       HOLMES REGIONAL MEDICAL CENTER               194         191           2
            2008     3         6200741       GREENE RURAL HEALTH CENTER               48,439       48,388        689
            2008     3         7522332       PRESBYTERIAN HEALTHCARE SERVICES             157         157           8
            2008     3         8087360       MADISON HMA INC                              315         315         10
            2008     3         9602562       HCA HEALTH SERVICES OF TENNESSEE IN          123         120           3
            2008     3         9951372       COLUMBIA PLAZA MEDICAL CENTER OF          3,839        3,839         68




5/15/2012                                                       Milliman                                                Page 36
                Inpatient & Outpatient Facility Claims by Provider (includes freestanding dialysis services)

                      Claim       Provider                     Provider                    Allowed         Paid   Service
   Year     Region     Type      ID Number                      Name                       Charges       Claims     Units
   2007       1      Inpatient     20003     AMORY HMA INC                                  150,048     148,888       122
   2007       1      Inpatient     20007     FORREST COUNTY GENERAL HOSPITAL                 77,713      77,473        60
   2007       1      Inpatient     20010     BAPTIST MEMORIAL HOSPITAL UNION COU            511,854     509,134       377
   2007       1      Inpatient     20011     WHITFIELD MEDICAL SURGICAL HO                   28,447      28,067        38
   2007       1      Inpatient     20012     FIELD MEMORIAL COMMUNITY HOSPITAL               18,033      17,883        15
   2007       1      Inpatient     20016     BAPTIST MEMORIAL HOSPITAL- NORTH             1,683,626   1,672,316     1,221
   2007       1      Inpatient     20020     MAGNOLIA REGIONAL HEALTH CENTER              1,628,376   1,616,476     1,319
   2007       1      Inpatient     20025     GREENWOOD LEFLORE HOSPITAL                   3,940,981   3,908,891     3,556
   2007       1      Inpatient     20026     GRENADA LAKE MEDICAL CENTER                  1,083,101   1,075,011       953
   2007       1      Inpatient     20027     MEMORIAL HOSPITAL AT GULFPORT                  127,573     127,203        99
   2007       1      Inpatient     20032     SOUTH SUNFLOWER COUNTY HOSPITAL                444,574     441,104       458
   2007       1      Inpatient     20034     ST DOMINIC JACKSON MEM                         900,855     893,605       732
   2007       1      Inpatient     20035                                                    340,473     337,423       315
   2007       1      Inpatient     20042     MAGEE BENEVOLENT ASSOCIATION                     3,586       3,546         4
   2007       1      Inpatient     20046     ANDERSON INFIRMARY BENEVOLENT ASSOC              5,386       5,346         4
   2007       1      Inpatient     20049     RUSH MEDICAL FOUNDATION                          8,286       8,226         6
   2007       1      Inpatient     20059     SINGING RIVER HOSPITAL SYSTEM                   35,416      35,176        24
   2007       1      Inpatient     20065     ST. JUDE CHILDRENS RESEARCH HOSPITA            452,906     452,516       407
   2007       1      Inpatient     20079     CLAY COUNTY MEDICAL CORPORATION                  6,759       6,739         6
   2007       1      Inpatient     20081     NORTH MISSISSInpatientPI MEDICAL CENTER      5,380,813   5,347,073     4,155
   2007       1      Inpatient     20082     KINGS DAUGHTERS HOSPITAL OF YAZOO               26,456      26,186        27
   2007       1      Inpatient     20084     BAPTIST MEMORIAL HOSPITAL BOONEVILL            240,996     238,846       230
   2007       1      Inpatient     20096     PONTOTOC HEALTH SERVICES INC                    61,243      60,723        52
   2007       1      Inpatient     20111     TInpatientPAH COUNTY HOSPITAL                   86,575      85,725        92
   2007       1      Inpatient     20118     NORTH SUNFLOWER MEDICAL CENTER                  15,780      15,590        19
   2007       1      Inpatient     20124     HUMPHREYS COUNTY MEMORIAL HOSPITAL             252,940     250,590       262
   2007       1      Inpatient     20129     SHARKEY ISSAQUENA COMMUNITY HOSPITA              4,654       4,634         4
   2007       1      Inpatient     20131     WAYNE GENERAL HOSPITAL                           2,661       2,631         3
   2007       1      Inpatient     20141     SOUTH CENTRAL REGIONAL MEDICAL CENT              4,234       4,224         8
   2007       1      Inpatient     20143     BAPTIST MEMORIAL HOSPITAL DESOTO, I          2,454,948   2,438,698     1,723
   2007       1      Inpatient     20145     DELTA REGIONAL MEDICAL CENTER                3,775,005   3,744,295     3,492
   2007       1      Inpatient     20147     KILMICHAEL HOSPITAL                             94,294      93,604       102
   2007       1      Inpatient     20149     STATE OF MISSISSInpatientPI-UNIVERSITY OF    5,391,381   5,378,861     4,263
   2007       1      Inpatient     20156     TYLER HOLMES MEMORIAL HOSPITAL                 210,027     207,637       249
   2007       1      Inpatient     20161                                                     28,840      28,590        26
   2007       1      Inpatient     20166     HANCOCK MEDICAL CENTER INC                       1,481       1,471         1
   2007       1      Inpatient     20167     SIMPSON COMMUNITY HEALTHCARE INC                 2,535       2,505         3
   2007       1      Inpatient     20175     YALOBUSHA GENERAL HOSPITAL                      63,832      62,902        93
   2007       1      Inpatient     20178     WEBSTER HEALTH SERVICES INC                     25,782      25,462        32
   2007       1      Inpatient     20181     NESHOBA COUNTY HOSPITAL & NURSI HOM                687         677         1
   2007       1      Inpatient     20182     BILOXI HMA INC.                                 18,993      18,863        13
   2007       1      Inpatient     20193     JEFFERSON COUNTY HOSPITAL                        4,172       4,122         5
   2007       1      Inpatient     20214     H C WATKINS MEMORIAL HOSPITAL INC               10,989      10,869        12
   2007       1      Inpatient     20219     OKTIBBEHA COUNTY HOSPITAL                       38,903      38,713        32
   2007       1      Inpatient     20223     MISSISSInpatientPI METHODIST HOSPITAL REHA     188,118     186,658       146
   2007       1      Inpatient     20226     GULFCOAST COMMUNITY HOSPITAL                     5,428       5,388         4
   2007       1      Inpatient     20229     PHYSICIANS AND SURGEONS HOSPITAL GR          3,311,258   3,286,138     3,053
   2007       1      Inpatient     20237     ALLIANCE HEALTH CENTER INC                     274,776     273,546       475
   2007       1      Inpatient     20302     CHILDRENS HOSP                                   2,257       2,257         2
   2007       1      Inpatient     20333     GULF HEALTH HOSPITALS INC                        2,168       2,148         2
   2007       1      Inpatient     20374     BAPTIST MEMORIAL HOSPITAL                      719,722     714,722       502
   2007       1      Inpatient     20393     TISHOMINGO HEALTH SERVICES INC                 260,110     257,670       289
   2007       1      Inpatient     20395     UNIVERSITY OF ALABAMA HOSPITAL                  14,798      14,668        13
   2007       1      Inpatient     20408     COLBERT COUNTY HOSPITAL                         11,493      11,353        18
   2007       1      Inpatient     20410     ELIZA COFFEE MEM HOS                             1,499       1,479         2
   2007       1      Inpatient     20411     UNIVERSITY OF SOUTH ALABAMA                      2,402       2,382         2
   2007       1      Inpatient     20421     SHELBY COUNTY HEALTH CARE                      720,069     716,409       413
   2007       1      Inpatient     20429     CHILDRENS HOSPITAL OF BHAM                     168,901     168,901       147
   2007       1      Inpatient     20433     OUR LADY OF THE LAKE HOSPITAL                    8,730       8,630        10
   2007       1      Inpatient     20469     METHODIST HOSPITAL - CENTRAL                 3,764,366   3,758,146     2,605
   2007       1      Inpatient     29003     BAPTIST MEMORIAL HOSPITAL                        2,707       2,707        19
   2007       1      Inpatient     29005     H C WATKINS MEMORIAL HOSPITAL SWBD               1,995       1,995        14
   2007       1      Inpatient     29008     PONTOTOC HEALTH SERVICES INC                       427         427         3
   2007       1      Inpatient     29035     MONTFORT JONES MEMORIAL HOSPITAL                 3,277       3,277        23
   2007       1      Inpatient     29161     TALLAHATCHIE GENERAL HOSPITAL                    3,420       3,420        24
   2007       1      Inpatient     29229     PHYSICIANS AND SURGEONS HOSPITAL                 5,130       5,130        36
   2007       1      Inpatient     29393     TISHOMINGO HEALTH SERVICES INC                   1,140       1,140         8
   2007       1      Inpatient     97767     ARKANSAS CHILDRENS HOSPITAL                  1,227,284   1,227,234       405
   2007       1      Inpatient     220136    BAPTIST MEMORIAL HOSPITAL                       42,304      41,954        35



5/15/2012                                                       Milliman                                          Page 37
                Inpatient & Outpatient Facility Claims by Provider (includes freestanding dialysis services)

                       Claim       Provider                        Provider                Allowed         Paid   Service
   Year     Region      Type      ID Number                         Name                   Charges       Claims     Units
   2007       1       Inpatient     220213    SAINT FRANCIS HOSPITAL                        463,777     460,497       717
   2007       1       Inpatient     220380    CLARKSDALE HMA INC                          2,748,629   2,727,129     2,371
   2007       1       Inpatient     220392    MISSISSInpatientPI BAPTIST MEDICAL CENTER     399,653     396,813       357
   2007       1       Inpatient     220415    SOUTHERN HEALTH CORP OF HOUSTON                 6,013       5,953         6
   2007       1       Inpatient     220417    RANKIN MEDICAL CENTER                          64,335      63,855        48
   2007       1       Inpatient     220444    DMC-MEMPHIS INC                             1,143,844   1,130,904     1,294
   2007       1       Inpatient     220462    WESLEY HEALTH SYSTEMS LLC                       2,250       2,250         2
   2007       1       Inpatient     220466    ROH, INC                                       18,327      18,327        13
   2007       1       Inpatient     220467    RIVER OAKS HOSPITAL, INC.                      32,018      31,868        20
   2007       1       Inpatient     220498    VANDERBILT UNIVERSITY                          22,812      22,722        28
   2007       1       Inpatient     220565    NORTH PORT HOSPITAL-DCH                         2,196       2,176         2
   2007       1       Inpatient     220571    VICKSBURG HEALTHCARE LLC                      772,488     763,418       954
   2007       1       Inpatient     220576    BAPTIST MEMORIAL HOSPITAL                      85,685      84,915        77
   2007       1       Inpatient     220606    PHC-CLEVELAND, INC.                         1,436,179   1,422,519     1,653
   2007       1       Inpatient     220609    STATE OF MISSISSInpatientPI-UNIVERSITY OF     197,217     195,457       191
   2007       1       Inpatient     220621    ALLIANCE HEALTHCARE SYSTEM INC                148,366     146,946       143
   2007       1       Inpatient     220630    JACKSON HMA INC                               237,261     235,661       162
   2007       1       Inpatient     220631    NORTH OAK REGIONAL HOSPITAL INC               434,155     430,065       435
   2007       1       Inpatient     220698    BAPTIST MEMORIAL HOSPITAL FOR WOMEN            98,418      98,228        85
   2007       1       Inpatient     220800    THE CHILDREN'S HOSPITAL OF PHILADEL             5,545       5,545         2
   2007       1       Inpatient     220809    LEAKE COUNTY BOARD OF TRUSTEES                  1,509       1,489         2
   2007       1       Inpatient     383304    GENESIS MEDICAL CENTER                          6,977       6,917         6
   2007       1       Inpatient    1084764    JACKSON MADISON COUNTY GENERAL HOSP            26,425      26,205        22
   2007       1       Inpatient    1329538    CHILDRENS HOSPITAL CORPORATION                 47,612      47,612        47
   2007       1       Inpatient    1634718    CHRISTIAN HOSPITAL NORTHEAST NORTHW               937         927         1
   2007       1       Inpatient    1687505    CHRISTUS SANTA ROSA HEALTHCARE                  6,078       6,078         6
   2007       1       Inpatient    2032374    DANNY JOE SPREITLER                            14,237      14,067        17
   2007       1       Inpatient    2278753    GREENWOOD SPECIALTY HOSPITAL L L C             42,346      41,816        53
   2007       1       Inpatient    5854578    QUITMAN COUNTY HOSP LLC-SWING BED               2,565       2,565        18
   2007       1       Inpatient    7539272    QUITMAN COUNTY HOSPITAL, LLC                  156,868     154,488       270
   2007       1       Inpatient    7771013    MCNAIRY HOSPITAL CORPORATION                      643         633         1
   2007       1       Inpatient    8087360    MADISON HMA INC                               153,172     152,352       113
   2007       1      Outpatient     20000     WALKER REGIONAL MEDICAL CENTER INC                632         632        11
   2007       1      Outpatient     20003     AMORY HMA INC                                 150,525     150,525     5,056
   2007       1      Outpatient     20007     FORREST COUNTY GENERAL HOSPITAL                 5,205       5,205       324
   2007       1      Outpatient     20008                                                     2,703       2,703       148
   2007       1      Outpatient     20010     BAPTIST MEMORIAL HOSPITAL UNION COU           366,547     366,541    14,772
   2007       1      Outpatient     20011     WHITFIELD MEDICAL SURGICAL HO                  11,247      11,223       598
   2007       1      Outpatient     20012     FIELD MEMORIAL COMMUNITY HOSPITAL               4,292       4,292       103
   2007       1      Outpatient     20016     BAPTIST MEMORIAL HOSPITAL- NORTH            1,027,040   1,027,004    37,669
   2007       1      Outpatient     20020     MAGNOLIA REGIONAL HEALTH CENTER             1,335,725   1,335,722    35,089
   2007       1      Outpatient     20025     GREENWOOD LEFLORE HOSPITAL                  2,540,843   2,540,681    67,715
   2007       1      Outpatient     20026     GRENADA LAKE MEDICAL CENTER                   401,347     401,335    11,947
   2007       1      Outpatient     20027     MEMORIAL HOSPITAL AT GULFPORT                  14,515      14,515       265
   2007       1      Outpatient     20032     SOUTH SUNFLOWER COUNTY HOSPITAL               129,678     129,678     5,242
   2007       1      Outpatient     20034     ST DOMINIC JACKSON MEM                        179,802     179,796     4,444
   2007       1      Outpatient     20035                                                   210,030     210,027     5,916
   2007       1      Outpatient     20041     NOXUBEE GENERAL HOSPITAL & NOXUBEE                237         237        22
   2007       1      Outpatient     20042     MAGEE BENEVOLENT ASSOCIATION                      946         946       111
   2007       1      Outpatient     20046     ANDERSON INFIRMARY BENEVOLENT ASSOC               603         603        26
   2007       1      Outpatient     20049     RUSH MEDICAL FOUNDATION                        13,289      13,289       273
   2007       1      Outpatient     20059     SINGING RIVER HOSPITAL SYSTEM                   5,956       5,947       152
   2007       1      Outpatient     20065     ST. JUDE CHILDRENS RESEARCH HOSPITA           755,197     755,197    23,649
   2007       1      Outpatient     20079     CLAY COUNTY MEDICAL CORPORATION                 9,767       9,767       154
   2007       1      Outpatient     20081     NORTH MISSISSInpatientPI MEDICAL CENTER     4,212,695   4,212,578    89,116
   2007       1      Outpatient     20082     KINGS DAUGHTERS HOSPITAL OF YAZOO              10,961      10,961       233
   2007       1      Outpatient     20084     BAPTIST MEMORIAL HOSPITAL BOONEVILL           202,683     202,680    11,318
   2007       1      Outpatient     20096     PONTOTOC HEALTH SERVICES INC                  113,274     113,271     3,141
   2007       1      Outpatient     20111     TInpatientPAH COUNTY HOSPITAL                 160,679     160,676     5,562
   2007       1      Outpatient     20115     HARDY WILSON MEMORIAL HOSPITAL                     99          99         3
   2007       1      Outpatient     20116     MARION GENERAL HOSPITAL                         1,478       1,478        38
   2007       1      Outpatient     20118     NORTH SUNFLOWER MEDICAL CENTER                126,043     126,025     4,284
   2007       1      Outpatient     20124     HUMPHREYS COUNTY MEMORIAL HOSPITAL            100,309     100,309     3,577
   2007       1      Outpatient     20129     SHARKEY ISSAQUENA COMMUNITY HOSPITA            22,205      22,205       795
   2007       1      Outpatient     20131     WAYNE GENERAL HOSPITAL                            434         434        19
   2007       1      Outpatient     20133     COVINGTON COUNTY HOSPITAL                         579         579        27
   2007       1      Outpatient     20140     CLAIBORNE CO HOSPITAL                             197         197         5
   2007       1      Outpatient     20141     SOUTH CENTRAL REGIONAL MEDICAL CENT             4,159       4,159        86
   2007       1      Outpatient     20143     BAPTIST MEMORIAL HOSPITAL DESOTO, I           933,002     932,987    45,935



5/15/2012                                                       Milliman                                          Page 38
                Inpatient & Outpatient Facility Claims by Provider (includes freestanding dialysis services)

                      Claim        Provider                     Provider                    Allowed         Paid   Service
   Year     Region     Type       ID Number                      Name                       Charges       Claims     Units
   2007       1      Outpatient     20145     DELTA REGIONAL MEDICAL CENTER                2,787,277   2,787,085    54,454
   2007       1      Outpatient     20147     KILMICHAEL HOSPITAL                              9,893       9,893     1,030
   2007       1      Outpatient     20149     STATE OF MISSISSInpatientPI-UNIVERSITY OF    2,585,354   2,585,312    40,842
   2007       1      Outpatient     20156     TYLER HOLMES MEMORIAL HOSPITAL                  77,520      77,514     3,317
   2007       1      Outpatient     20161                                                     54,397      54,391     2,312
   2007       1      Outpatient     20166     HANCOCK MEDICAL CENTER INC                       1,746       1,746        30
   2007       1      Outpatient     20167     SIMPSON COMMUNITY HEALTHCARE INC                   163         163        23
   2007       1      Outpatient     20170     SOUTH MISSISSInpatientPI REGIONAL MEDICAL          371         371        12
   2007       1      Outpatient     20172     NATCHEZ REGIONAL MEDICAL CENTER                    448         448        18
   2007       1      Outpatient     20175     YALOBUSHA GENERAL HOSPITAL                      31,842      31,842     1,248
   2007       1      Outpatient     20178     WEBSTER HEALTH SERVICES INC                     16,977      16,977       400
   2007       1      Outpatient     20181     NESHOBA COUNTY HOSPITAL & NURSI HOM              2,574       2,574        95
   2007       1      Outpatient     20182     BILOXI HMA INC.                                  3,737       3,737        54
   2007       1      Outpatient     20191     PERRY COUNTY GENERAL HOSPITAL                       71          71         1
   2007       1      Outpatient     20193     JEFFERSON COUNTY HOSPITAL                          275         275         5
   2007       1      Outpatient     20197     UNIVERSITY OF SOUTH ALABAMA                         60          60         3
   2007       1      Outpatient     20207     SOUTHWEST MISSISSInpatientPI REGIONAL MEDI          21          21         2
   2007       1      Outpatient     20213     HILLCREST HOSPITAL                               7,085       7,085       191
   2007       1      Outpatient     20214     H C WATKINS MEMORIAL HOSPITAL INC                  193         193         3
   2007       1      Outpatient     20215     INFIRMARY HEALTH HOSPITALS INC                     641         641        24
   2007       1      Outpatient     20219     OKTIBBEHA COUNTY HOSPITAL                       44,807      44,807     1,420
   2007       1      Outpatient     20223     MISSISSInpatientPI METHODIST HOSPITAL REHA       8,332       8,332       897
   2007       1      Outpatient     20226     GULFCOAST COMMUNITY HOSPITAL                       265         265         4
   2007       1      Outpatient     20229     PHYSICIANS AND SURGEONS HOSPITAL GR          1,509,863   1,509,836     8,264
   2007       1      Outpatient     20238     ERLANGER MEDICAL CENTER DEWAIN HILD                108         108         4
   2007       1      Outpatient     20256     STATE OF MISSISSInpatientPI UNIVERSITY OF        5,135       5,135     2,441
   2007       1      Outpatient     20280     FORT SANDERS SEVIER MEDICAL CENTER                  57          57         1
   2007       1      Outpatient     20290     GEORGE COUNTY HOSPITAL                           1,122       1,122        50
   2007       1      Outpatient     20294     COLBERT COUNTY NW ALABAMA                        3,252       3,252        31
   2007       1      Outpatient     20302     CHILDRENS HOSP                                     431         431        24
   2007       1      Outpatient     20374     BAPTIST MEMORIAL HOSPITAL                      453,282     453,273     4,274
   2007       1      Outpatient     20393     TISHOMINGO HEALTH SERVICES INC                 140,965     140,962     3,522
   2007       1      Outpatient     20395     UNIVERSITY OF ALABAMA HOSPITAL                  10,226      10,226       212
   2007       1      Outpatient     20408     COLBERT COUNTY HOSPITAL                         15,231      15,231       392
   2007       1      Outpatient     20410     ELIZA COFFEE MEM HOS                             9,732       9,732       228
   2007       1      Outpatient     20411     UNIVERSITY OF SOUTH ALABAMA                        160         160         9
   2007       1      Outpatient     20420     THE HEALTH CARE AUTHORITY OF THE CI                566         566        43
   2007       1      Outpatient     20421     SHELBY COUNTY HEALTH CARE                      195,113     195,101     3,810
   2007       1      Outpatient     20427     HOSPITAL SERVICE DISTRICT 1 OF EAST                 99          99         1
   2007       1      Outpatient     20429     CHILDRENS HOSPITAL OF BHAM                      12,139      12,139       227
   2007       1      Outpatient     20433     OUR LADY OF THE LAKE HOSPITAL                      237         237        14
   2007       1      Outpatient     20461     ALTON OCHSNER MEDICAL FOUNDATION                 4,527       4,521       115
   2007       1      Outpatient     20469     METHODIST HOSPITAL - CENTRAL                   919,762     919,756    45,002
   2007       1      Outpatient     95136     PHILLInpatientS HOSPITAL CORPORATION             1,953       1,953        68
   2007       1      Outpatient     95142     INGALLS MEMORIAL HOSPITAL                        1,581       1,581        24
   2007       1      Outpatient     95306     NORTHSHORE REG MED CENTER                          132         132         1
   2007       1      Outpatient     95857     MERITER HOSPITAL INC                                89          89         6
   2007       1      Outpatient     97747     DUKE UNIVERSITY HEALTH                           1,776       1,776        40
   2007       1      Outpatient     97767     ARKANSAS CHILDRENS HOSPITAL                     27,460      27,460       658
   2007       1      Outpatient     98401     SOUTH BALDWIN HOSP                                 263         263         3
   2007       1      Outpatient     220026    LESTER E COX MEDICAL CENTER                        857         857        56
   2007       1      Outpatient     220082    BIO-MEDICALAPPLICATIONS OF MS, INC.             19,857      19,857     4,381
   2007       1      Outpatient     220136    BAPTIST MEMORIAL HOSPITAL                       58,626      58,626     2,519
   2007       1      Outpatient     220144    MORTON MEDICAL CENTER INC                          139         139         7
   2007       1      Outpatient     220159    NATCHEZ COMMUNITY HOSPITAL, INC.                    44          44         1
   2007       1      Outpatient     220213    SAINT FRANCIS HOSPITAL                         148,039     148,039     3,539
   2007       1      Outpatient     220220    MARION REGIONAL MEDICAL CENTER                   2,617       2,617         9
   2007       1      Outpatient     220230    NEWTON HOSPITAL, INC                               289         289        21
   2007       1      Outpatient     220243    WINSTON MEDICAL CENTER                          13,482      13,476       540
   2007       1      Outpatient     220297    PEARL RIVER HOSPITAL                                88          88        18
   2007       1      Outpatient     220324    INDEPENDENT HEALTHCARE MANAGEMENT                  174         174         3
   2007       1      Outpatient     220350    RCG MISSISSInpatientPI INC                     315,624     315,624    68,474
   2007       1      Outpatient     220357    RCG MISSISSInpatientPI INC                     263,516     263,516    53,180
   2007       1      Outpatient     220358    RCG MISSISSInpatientPI INC.                    196,225     196,225    50,554
   2007       1      Outpatient     220364    NATIONAL RENAL INSTITUTES INC                  104,188     104,188    10,284
   2007       1      Outpatient     220365    NATIONAL RENAL INSTITUTES INC                   32,501      32,501     1,623
   2007       1      Outpatient     220366    RCG MISSISSInpatientPI INC                     253,470     253,470    49,903
   2007       1      Outpatient     220367    RCG MISSISSInpatientPI,INC                      92,454      92,454    20,040
   2007       1      Outpatient     220368    RCG MISSISSInpatientPI INC                     220,890     220,890    73,710



5/15/2012                                                        Milliman                                          Page 39
                Inpatient & Outpatient Facility Claims by Provider (includes freestanding dialysis services)

                      Claim        Provider                        Provider                Allowed         Paid   Service
   Year     Region     Type       ID Number                         Name                   Charges       Claims     Units
   2007       1      Outpatient     220372    BIO-MEDICAL APPLICATIONS OF MS, INC            41,885      41,885    16,166
   2007       1      Outpatient     220380    CLARKSDALE HMA INC                            959,223     959,199    45,176
   2007       1      Outpatient     220392    MISSISSInpatientPI BAPTIST MEDICAL CENTER     236,231     236,231     1,445
   2007       1      Outpatient     220412    ADVENTIST HEALTH SYSTEM-SUNBELT INC               525         525         9
   2007       1      Outpatient     220413    BIO-MEDICAL APPLICATIONS OF                     4,954       4,954     3,989
   2007       1      Outpatient     220415    SOUTHERN HEALTH CORP OF HOUSTON                16,225      16,225       329
   2007       1      Outpatient     220417    RANKIN MEDICAL CENTER                          88,236      88,236       941
   2007       1      Outpatient     220419    MID-DELTA KIDNEY CENTER INC                     3,590       3,590        47
   2007       1      Outpatient     220444    DMC-MEMPHIS INC                               144,300     144,300     1,143
   2007       1      Outpatient     220448    TOURO INFIRMARY                                   319         319         8
   2007       1      Outpatient     220462    WESLEY HEALTH SYSTEMS LLC                       4,002       3,999       100
   2007       1      Outpatient     220466    ROH, INC                                       18,893      18,893       366
   2007       1      Outpatient     220467    RIVER OAKS HOSPITAL, INC.                      38,666      38,666       984
   2007       1      Outpatient     220495    MERIDIAN HMA INC                                1,881       1,881        42
   2007       1      Outpatient     220496    BARNES JEWISH HOSPITAL                          2,720       2,720        54
   2007       1      Outpatient     220498    VANDERBILT UNIVERSITY                          21,711      21,711       384
   2007       1      Outpatient     220521    RCG SOUTHAVEN LLC                             208,109     208,109    27,098
   2007       1      Outpatient     220528    EAST TENNESSEE CHILDRENS HOSP                      92          92         2
   2007       1      Outpatient     220545    DOCTORS HOSPITAL OF AUGUSTA                     4,345       4,345        51
   2007       1      Outpatient     220571    VICKSBURG HEALTHCARE LLC                       11,425      11,425       351
   2007       1      Outpatient     220576    BAPTIST MEMORIAL HOSPITAL                      49,504      49,501     2,584
   2007       1      Outpatient     220604    DVA RENAL HEALTHCARE INC                        4,069       4,069       664
   2007       1      Outpatient     220606    PHC-CLEVELAND, INC.                         1,021,725   1,021,692    25,810
   2007       1      Outpatient     220609    STATE OF MISSISSInpatientPI-UNIVERSITY OF     395,589     395,589     7,828
   2007       1      Outpatient     220621    ALLIANCE HEALTHCARE SYSTEM INC                175,750     175,735     5,005
   2007       1      Outpatient     220630    JACKSON HMA INC                               197,267     197,267     4,028
   2007       1      Outpatient     220631    NORTH OAK REGIONAL HOSPITAL INC               146,885     146,879     4,580
   2007       1      Outpatient     220637    BIO-MEDICAL APPLICATIONS OF MS INC             11,998      11,998     1,092
   2007       1      Outpatient     220682    FORREST COUNTY GENERAL HOSPITAL                 2,312       2,312       141
   2007       1      Outpatient     220692    PIONEER HEALTH SERVICES OF MONROE               1,925       1,925        45
   2007       1      Outpatient     220698    BAPTIST MEMORIAL HOSPITAL FOR WOMEN            15,898      15,898       552
   2007       1      Outpatient     220714    STONE COUNTY HOSITAL INC                          802         802        14
   2007       1      Outpatient     220722    RCG MISSISSInpatientPI INC                     26,079      26,079     4,175
   2007       1      Outpatient     220734    GPCH-GP                                           669         669        14
   2007       1      Outpatient     220742    CHILDRENS HOSPITAL MEDICAL CENTER                 324         324        27
   2007       1      Outpatient     220746    ST JOSEPH MEDICAL CENTER                          612         612        19
   2007       1      Outpatient     220752    SSM REGIONAL HEALTH SERVICES                      409         409         7
   2007       1      Outpatient     220754    ORLANDO REGIONAL HEALTHCARE SYSTEM                525         525        14
   2007       1      Outpatient     220772    RENAL CARE GROUP TUPELO LLC                    60,590      60,590    21,382
   2007       1      Outpatient     220773    RENAL CARE GROUP TUPELO LLC                   164,793     164,793    31,909
   2007       1      Outpatient     220774    RENAL CARE TUPELO LLC                         101,764     101,764    29,259
   2007       1      Outpatient     220775    RENAL CARE GROUP TUPELO LLC                    60,383      60,383    27,191
   2007       1      Outpatient     220776    RENAL CARE GROUP TUPELO LLC                     4,203       4,203     1,631
   2007       1      Outpatient     220777    RENAL CARE GROUP TUPELO LLC                   161,502     161,502    35,968
   2007       1      Outpatient     220795    ESCAMBIA COUNTY ALABAMA COMMUNITY H             1,074       1,074       116
   2007       1      Outpatient     220800    THE CHILDREN'S HOSPITAL OF PHILADEL             1,585       1,585         3
   2007       1      Outpatient     220809    LEAKE COUNTY BOARD OF TRUSTEES                  4,838       4,838       219
   2007       1      Outpatient     220826    RCG TUNICA LLC                                 74,667      74,667    18,050
   2007       1      Outpatient     737024    LEESBURG REGIONAL MEDICAL CENTER                  158         158         6
   2007       1      Outpatient    1084764    JACKSON MADISON COUNTY GENERAL HOSP               317         314        18
   2007       1      Outpatient    1329538    CHILDRENS HOSPITAL CORPORATION                    390         390        12
   2007       1      Outpatient    1457714    NEBRASKA HEALTH SYSTEM                          3,234       3,234       389
   2007       1      Outpatient    1634718    CHRISTIAN HOSPITAL NORTHEAST NORTHW               176         176         5
   2007       1      Outpatient    1856853    PRINCETON BAPTIST MEDICAL CENTER                  304         304         4
   2007       1      Outpatient    2032374    DANNY JOE SPREITLER                             5,121       5,121       261
   2007       1      Outpatient    2059744    PIONEER VALLEY HOSPITAL INC                       671         671        14
   2007       1      Outpatient    2083023    NORTHWEST MEDICAL CENTER-WINFIELD L               461         461        12
   2007       1      Outpatient    2224822    HCA HEALTH SERVICES OF TENNESSEE                  139         139         4
   2007       1      Outpatient    2658888    COMMUNITY HOSPITAL OF OTTAWA                    1,004       1,004       167
   2007       1      Outpatient    2878706    CITIZENS BAPTIST MEDICAL CENTER                   314         314         5
   2007       1      Outpatient    3273578    BIO-MEDICAL APPLICATIONS OF MISS               22,795      22,795     2,874
   2007       1      Outpatient    4033844    HOSPITAL SKAGGS COMMUNITY INC                     351         351         5
   2007       1      Outpatient    4125505    LAIRD HOutpatientSITAL INC                        526         526        10
   2007       1      Outpatient    4753347    GENERAL HOSPITAL CORPORATION                       86          86         2
   2007       1      Outpatient    5135864    RUSSELLVILLE HOSPITAL LLC                         221         221         5
   2007       1      Outpatient    5323250    WILLIAMSON COUNTY HOSPITAL DISTRICT               368         368         7
   2007       1      Outpatient    5432201    TENET HEALTHSYSTEMS BARTLETT INC                  669         669         6
   2007       1      Outpatient    5636023    TOTAL RENAL CARE INC                           64,016      64,016     3,103
   2007       1      Outpatient    6202312    COVENANT MEDIAL CENTER                            192         192         3



5/15/2012                                                       Milliman                                          Page 40
                Inpatient & Outpatient Facility Claims by Provider (includes freestanding dialysis services)

                       Claim       Provider                    Provider                      Allowed          Paid   Service
   Year     Region      Type      ID Number                      Name                        Charges        Claims     Units
   2007       1      Outpatient    6779801    UNIVERSITY OF KANSAS HOSPITAL                       817          817         7
   2007       1      Outpatient    7271739    AURORA HEALTH CARE METRO INC                        381          381        12
   2007       1      Outpatient    7539272    QUITMAN COUNTY HOSPITAL, LLC                    120,815      120,812     2,960
   2007       1      Outpatient    7589748    PROVENA HOSPITALS                                   313          313         6
   2007       1      Outpatient    7771013    MCNAIRY HOSPITAL CORPORATION                      5,519        5,519        99
   2007       1      Outpatient    8087360    MADISON HMA INC                                  98,625       98,625     3,125
   2007       1      Outpatient    8227060    HTI MEMORIAL HOSPITAL CORPORATION                 2,587        2,587       241
   2007       1      Outpatient    9154257    AURORA SINAI MEDICAL CENTER INC                     361          361        11
   2007       1      Outpatient    9386023    NORTHWEST TEXAS HEALTHCARE SYSTEM I                 246          246         5
   2007       1      Outpatient    9577070    CHRISTIAN HOSPITAL NORTHEAST                        126          126         4
   2007       2       Inpatient     20003     AMORY HMA INC                                   418,849      415,909       355
   2007       2       Inpatient     20007     FORREST COUNTY GENERAL HOSPITAL               1,471,455    1,462,765     1,136
   2007       2       Inpatient     20008                                                      84,893       84,423        63
   2007       2       Inpatient     20010     BAPTIST MEMORIAL HOSPITAL UNION COU              11,002       10,982         8
   2007       2       Inpatient     20011     WHITFIELD MEDICAL SURGICAL HO                     3,743        3,693         5
   2007       2       Inpatient     20012     FIELD MEMORIAL COMMUNITY HOSPITAL                10,892       10,802         9
   2007       2       Inpatient     20016     BAPTIST MEMORIAL HOSPITAL- NORTH                259,850      258,020       188
   2007       2       Inpatient     20025     GREENWOOD LEFLORE HOSPITAL                      107,293      106,403        96
   2007       2       Inpatient     20026     GRENADA LAKE MEDICAL CENTER                      45,334       44,964        39
   2007       2       Inpatient     20027     MEMORIAL HOSPITAL AT GULFPORT                   144,399      143,779       128
   2007       2       Inpatient     20032     SOUTH SUNFLOWER COUNTY HOSPITAL                   4,091        4,091         4
   2007       2       Inpatient     20034     ST DOMINIC JACKSON MEM                        5,537,735    5,493,135     4,599
   2007       2       Inpatient     20035                                                      26,735       26,505        25
   2007       2       Inpatient     20041     NOXUBEE GENERAL HOSPITAL & NOXUBEE              227,418      225,488       195
   2007       2       Inpatient     20042     MAGEE BENEVOLENT ASSOCIATION                    331,524      328,164       391
   2007       2       Inpatient     20046     ANDERSON INFIRMARY BENEVOLENT ASSOC           1,997,222    1,982,742     1,526
   2007       2       Inpatient     20049     RUSH MEDICAL FOUNDATION                       1,722,419    1,711,839     1,270
   2007       2       Inpatient     20059     SINGING RIVER HOSPITAL SYSTEM                    83,768       83,218        59
   2007       2       Inpatient     20065     ST. JUDE CHILDRENS RESEARCH HOSPITA              48,963       48,903        44
   2007       2       Inpatient     20079     CLAY COUNTY MEDICAL CORPORATION                 503,021      500,041       452
   2007       2       Inpatient     20081     NORTH MISSISSInpatientPI MEDICAL CENTER       1,982,675    1,970,175     1,525
   2007       2       Inpatient     20082     KINGS DAUGHTERS HOSPITAL OF YAZOO               371,169      367,619       381
   2007       2       Inpatient     20096     PONTOTOC HEALTH SERVICES INC                      1,184        1,174         1
   2007       2       Inpatient     20115     HARDY WILSON MEMORIAL HOSPITAL                  256,029      253,349       277
   2007       2       Inpatient     20116     MARION GENERAL HOSPITAL                           5,810        5,740         7
   2007       2       Inpatient     20124     HUMPHREYS COUNTY MEMORIAL HOSPITAL               20,310       20,100        21
   2007       2       Inpatient     20129     SHARKEY ISSAQUENA COMMUNITY HOSPITA             136,255      135,395       116
   2007       2       Inpatient     20130                                                       4,266        4,216         5
   2007       2       Inpatient     20131     WAYNE GENERAL HOSPITAL                           35,099       34,799        40
   2007       2       Inpatient     20133     COVINGTON COUNTY HOSPITAL                         9,279        9,189        11
   2007       2       Inpatient     20140     CLAIBORNE CO HOSPITAL                           101,052      100,012       114
   2007       2       Inpatient     20141     SOUTH CENTRAL REGIONAL MEDICAL CENT             581,219      576,359       554
   2007       2       Inpatient     20143     BAPTIST MEMORIAL HOSPITAL DESOTO, I              47,089       46,759        33
   2007       2       Inpatient     20145     DELTA REGIONAL MEDICAL CENTER                   151,055      149,735       139
   2007       2       Inpatient     20147     KILMICHAEL HOSPITAL                               9,184        9,134        10
   2007       2       Inpatient     20149     STATE OF MISSISSInpatientPI-UNIVERSITY OF    17,041,254   16,986,924    14,199
   2007       2       Inpatient     20156     TYLER HOLMES MEMORIAL HOSPITAL                    5,952        5,882         7
   2007       2       Inpatient     20166     HANCOCK MEDICAL CENTER INC                       14,326       14,326        10
   2007       2       Inpatient     20167     SIMPSON COMMUNITY HEALTHCARE INC                159,660      157,760       190
   2007       2       Inpatient     20172     NATCHEZ REGIONAL MEDICAL CENTER                  18,587       18,517        13
   2007       2       Inpatient     20177     JASPER GENERAL HOSPITAL                             743          733         1
   2007       2       Inpatient     20178     WEBSTER HEALTH SERVICES INC                     265,873      262,883       309
   2007       2       Inpatient     20181     NESHOBA COUNTY HOSPITAL & NURSI HOM             373,028      368,438       548
   2007       2       Inpatient     20182     BILOXI HMA INC.                                  43,783       43,483        30
   2007       2       Inpatient     20193     JEFFERSON COUNTY HOSPITAL                       160,222      158,322       193
   2007       2       Inpatient     20207     SOUTHWEST MISSISSInpatientPI REGIONAL MEDI       18,424       18,274        15
   2007       2       Inpatient     20213     HILLCREST HOSPITAL                               34,987       34,677        33
   2007       2       Inpatient     20214     H C WATKINS MEMORIAL HOSPITAL INC               198,082      196,102       213
   2007       2       Inpatient     20219     OKTIBBEHA COUNTY HOSPITAL                       564,139      560,889       462
   2007       2       Inpatient     20223     MISSISSInpatientPI METHODIST HOSPITAL REHA      253,114      251,194       205
   2007       2       Inpatient     20226     GULFCOAST COMMUNITY HOSPITAL                     52,749       52,359        39
   2007       2       Inpatient     20229     PHYSICIANS AND SURGEONS HOSPITAL GR             967,314      960,334       895
   2007       2       Inpatient     20230     MISSISSInpatientPI BAND OF CHOCTAW INDIANS       10,356       10,356         6
   2007       2       Inpatient     20237     ALLIANCE HEALTH CENTER INC                    3,115,741    3,089,021     5,490
   2007       2       Inpatient     20302     CHILDRENS HOSP                                    5,643        5,643         5
   2007       2       Inpatient     20305     PICKENS COUNTY MEDICAL CENTER                       738          728         1
   2007       2       Inpatient     20330     MEDICAL CENTER OF LOUISISANA AT NEW               8,883        8,803         8
   2007       2       Inpatient     20374     BAPTIST MEMORIAL HOSPITAL                         6,158        6,118         4
   2007       2       Inpatient     20395     UNIVERSITY OF ALABAMA HOSPITAL                   43,988       43,828        37



5/15/2012                                                       Milliman                                             Page 41
                Inpatient & Outpatient Facility Claims by Provider (includes freestanding dialysis services)

                       Claim       Provider                        Provider                Allowed         Paid   Service
   Year     Region      Type      ID Number                         Name                   Charges       Claims     Units
   2007       2       Inpatient     20411     UNIVERSITY OF SOUTH ALABAMA                     4,968       4,928         4
   2007       2       Inpatient     20414     DCH REGIONAL MEDICAL CENTER                    26,855      26,605        25
   2007       2       Inpatient     20421     SHELBY COUNTY HEALTH CARE                      27,624      27,474        16
   2007       2       Inpatient     20429     CHILDRENS HOSPITAL OF BHAM                    439,813     439,813       397
   2007       2       Inpatient     20433     OUR LADY OF THE LAKE HOSPITAL                   3,492       3,492         7
   2007       2       Inpatient     20461     ALTON OCHSNER MEDICAL FOUNDATION               15,615      15,485        13
   2007       2       Inpatient     20469     METHODIST HOSPITAL - CENTRAL                  317,241     317,211       224
   2007       2       Inpatient     29004     MAGEE BENEVOLENT ASSOCIATION                    3,847       3,847        27
   2007       2       Inpatient     29005     H C WATKINS MEMORIAL HOSPITAL SWBD              5,415       5,415        38
   2007       2       Inpatient     29115     HARDY WILSON MEMORIAL HOSPITAL                  5,415       5,415        38
   2007       2       Inpatient     29167     SIMPSON COMMUNITY HEALTHCARE INC                  427         427         3
   2007       2       Inpatient     29178     WEBSTER HEALTH SERVICES INC                     1,425       1,425        10
   2007       2       Inpatient     29181     NESHOBA COUNTY GENERAL & NURSING HO             1,995       1,995        14
   2007       2       Inpatient     96346     PUBLIC HEALTH TRUST OF DADE COUNTY              4,795       4,795         4
   2007       2       Inpatient     97767     ARKANSAS CHILDRENS HOSPITAL                   558,955     558,955       112
   2007       2       Inpatient     220136    BAPTIST MEMORIAL HOSPITAL                   2,859,208   2,838,318     2,421
   2007       2       Inpatient     220144    MORTON MEDICAL CENTER INC                     220,836     218,886       259
   2007       2       Inpatient     220159    NATCHEZ COMMUNITY HOSPITAL, INC.                3,469       3,439         3
   2007       2       Inpatient     220213    SAINT FRANCIS HOSPITAL                         32,988      32,828        51
   2007       2       Inpatient     220230    NEWTON HOSPITAL, INC                          112,804     111,454       155
   2007       2       Inpatient     220243    WINSTON MEDICAL CENTER                         92,507      91,487       106
   2007       2       Inpatient     220250    WINSTON MEDICAL CENTER                          1,425       1,425        10
   2007       2       Inpatient     220279    UNIVERSITY HEALTHCARE SYSTEM                    1,775       1,765         1
   2007       2       Inpatient     220324    INDEPENDENT HEALTHCARE MANAGEMENT             126,193     124,493       171
   2007       2       Inpatient     220380    CLARKSDALE HMA INC                             27,996      27,756        24
   2007       2       Inpatient     220392    MISSISSInpatientPI BAPTIST MEDICAL CENTER   3,044,736   3,022,436     2,698
   2007       2       Inpatient     220415    SOUTHERN HEALTH CORP OF HOUSTON               235,963     233,583       238
   2007       2       Inpatient     220417    RANKIN MEDICAL CENTER                         934,662     927,892       695
   2007       2       Inpatient     220441    PRENTISS REGIONAL HOSPITAL AND EXTE             6,326       6,246         8
   2007       2       Inpatient     220444    DMC-MEMPHIS INC                                65,413      64,673        74
   2007       2       Inpatient     220448    TOURO INFIRMARY                                 2,591       2,571         2
   2007       2       Inpatient     220462    WESLEY HEALTH SYSTEMS LLC                     148,998     147,738       130
   2007       2       Inpatient     220466    ROH, INC                                      265,350     265,290       187
   2007       2       Inpatient     220467    RIVER OAKS HOSPITAL, INC.                   1,145,827   1,141,457       844
   2007       2       Inpatient     220487    PROVIDENCE HOSPITAL                             2,066       2,046         2
   2007       2       Inpatient     220495    MERIDIAN HMA INC                              879,760     873,250       702
   2007       2       Inpatient     220498    VANDERBILT UNIVERSITY                          16,816      16,816        14
   2007       2       Inpatient     220541    UNIVERSITY OF CHICAGO HOSPITALS                23,985      23,725        26
   2007       2       Inpatient     220545    DOCTORS HOSPITAL OF AUGUSTA                   110,503     110,353        92
   2007       2       Inpatient     220565    NORTH PORT HOSPITAL-DCH                        13,176      13,056        12
   2007       2       Inpatient     220571    VICKSBURG HEALTHCARE LLC                    3,902,416   3,859,276     4,936
   2007       2       Inpatient     220606    PHC-CLEVELAND, INC.                            12,269      12,149        14
   2007       2       Inpatient     220630    JACKSON HMA INC                             5,058,173   5,029,083     3,459
   2007       2       Inpatient     220691    PIONEER HEALTH SERVICES OF MONROE                 997         997         7
   2007       2       Inpatient     220692    PIONEER HEALTH SERVICES OF MONROE              39,136      38,806        33
   2007       2       Inpatient     220734    GPCH-GP                                         6,996       6,956         4
   2007       2       Inpatient     220742    CHILDRENS HOSPITAL MEDICAL CENTER               3,690       3,690         4
   2007       2       Inpatient     220793    LAIRD HOSPITAL INC                                570         570         4
   2007       2       Inpatient     220809    LEAKE COUNTY BOARD OF TRUSTEES                 29,345      28,995        38
   2007       2       Inpatient     888783    BAPTIST HEALTH SYSTEM INC                       1,454       1,434         2
   2007       2       Inpatient    1457714    NEBRASKA HEALTH SYSTEM                         80,693      80,693        70
   2007       2       Inpatient    1934081    AKRON GENERAL MEDICAL CENTER                    1,013       1,003         1
   2007       2       Inpatient    2032374    DANNY JOE SPREITLER                           110,060     108,860       133
   2007       2       Inpatient    2034566    MADISON COUNTY HOSPITAL                         6,982       6,982        49
   2007       2       Inpatient    2703888    MEMORIAL HERMANN HOSPITAL SYSTEM               20,380      20,210        17
   2007       2       Inpatient    4125505    LAIRD HOutpatientSITAL INC                     90,762      89,782       140
   2007       2       Inpatient    4387319    AMORY HMA INC                                     427         427         3
   2007       2       Inpatient    6380033    SAINTJOHN HEALTH SYSTEM                         3,488       3,458         3
   2007       2       Inpatient    8087360    MADISON HMA INC                               851,064     845,774       626
   2007       2      Outpatient     20003     AMORY HMA INC                                 347,556     347,556    11,714
   2007       2      Outpatient     20007     FORREST COUNTY GENERAL HOSPITAL               201,369     201,357     4,797
   2007       2      Outpatient     20008                                                    91,635      91,632     2,526
   2007       2      Outpatient     20010     BAPTIST MEMORIAL HOSPITAL UNION COU             3,093       3,093        63
   2007       2      Outpatient     20011     WHITFIELD MEDICAL SURGICAL HO                  36,861      36,792     1,866
   2007       2      Outpatient     20016     BAPTIST MEMORIAL HOSPITAL- NORTH              110,084     110,081     2,902
   2007       2      Outpatient     20020     MAGNOLIA REGIONAL HEALTH CENTER                 8,184       8,184       207
   2007       2      Outpatient     20025     GREENWOOD LEFLORE HOSPITAL                     36,040      36,040     1,267
   2007       2      Outpatient     20026     GRENADA LAKE MEDICAL CENTER                     9,495       9,495       265
   2007       2      Outpatient     20027     MEMORIAL HOSPITAL AT GULFPORT                  74,408      74,405       935



5/15/2012                                                       Milliman                                          Page 42
                Inpatient & Outpatient Facility Claims by Provider (includes freestanding dialysis services)

                      Claim        Provider                    Provider                     Allowed         Paid   Service
   Year     Region     Type       ID Number                     Name                        Charges       Claims     Units
   2007       2      Outpatient     20032     SOUTH SUNFLOWER COUNTY HOSPITAL                  1,366       1,366       102
   2007       2      Outpatient     20034     ST DOMINIC JACKSON MEM                       1,377,401   1,377,356    37,835
   2007       2      Outpatient     20035                                                     19,971      19,971       644
   2007       2      Outpatient     20041     NOXUBEE GENERAL HOSPITAL & NOXUBEE             173,486     173,480     5,740
   2007       2      Outpatient     20042     MAGEE BENEVOLENT ASSOCIATION                   182,773     182,761     8,683
   2007       2      Outpatient     20046     ANDERSON INFIRMARY BENEVOLENT ASSOC          1,029,869   1,029,866    12,466
   2007       2      Outpatient     20049     RUSH MEDICAL FOUNDATION                      1,039,018   1,038,952    34,942
   2007       2      Outpatient     20059     SINGING RIVER HOSPITAL SYSTEM                   13,202      13,202       464
   2007       2      Outpatient     20060     BRYAN W WHITFIELD MEM HOSP                         217         217        10
   2007       2      Outpatient     20065     ST. JUDE CHILDRENS RESEARCH HOSPITA            146,969     146,969     4,488
   2007       2      Outpatient     20079     CLAY COUNTY MEDICAL CORPORATION                373,662     373,656     8,669
   2007       2      Outpatient     20081     NORTH MISSISSInpatientPI MEDICAL CENTER      1,567,161   1,567,131    31,200
   2007       2      Outpatient     20082     KINGS DAUGHTERS HOSPITAL OF YAZOO              205,620     205,599     6,909
   2007       2      Outpatient     20084     BAPTIST MEMORIAL HOSPITAL BOONEVILL                671         671        22
   2007       2      Outpatient     20096     PONTOTOC HEALTH SERVICES INC                    17,536      17,536       454
   2007       2      Outpatient     20115     HARDY WILSON MEMORIAL HOSPITAL                 247,339     247,330     4,409
   2007       2      Outpatient     20116     MARION GENERAL HOSPITAL                          4,247       4,247       131
   2007       2      Outpatient     20118     NORTH SUNFLOWER MEDICAL CENTER                     129         129         9
   2007       2      Outpatient     20124     HUMPHREYS COUNTY MEMORIAL HOSPITAL               7,914       7,914       302
   2007       2      Outpatient     20129     SHARKEY ISSAQUENA COMMUNITY HOSPITA            102,453     102,447     3,416
   2007       2      Outpatient     20130                                                          0           0         2
   2007       2      Outpatient     20131     WAYNE GENERAL HOSPITAL                          20,783      20,783     1,127
   2007       2      Outpatient     20133     COVINGTON COUNTY HOSPITAL                       16,629      16,629       640
   2007       2      Outpatient     20140     CLAIBORNE CO HOSPITAL                          101,444     101,435     3,038
   2007       2      Outpatient     20141     SOUTH CENTRAL REGIONAL MEDICAL CENT            267,286     267,274     6,717
   2007       2      Outpatient     20143     BAPTIST MEMORIAL HOSPITAL DESOTO, I              6,206       6,203       299
   2007       2      Outpatient     20145     DELTA REGIONAL MEDICAL CENTER                  102,168     102,162     1,790
   2007       2      Outpatient     20147     KILMICHAEL HOSPITAL                                851         851        93
   2007       2      Outpatient     20149     STATE OF MISSISSInpatientPI-UNIVERSITY OF    9,299,756   9,299,603   164,367
   2007       2      Outpatient     20156     TYLER HOLMES MEMORIAL HOSPITAL                   2,150       2,150        59
   2007       2      Outpatient     20161                                                        176         176        12
   2007       2      Outpatient     20166     HANCOCK MEDICAL CENTER INC                       3,341       3,341       199
   2007       2      Outpatient     20167     SIMPSON COMMUNITY HEALTHCARE INC                62,316      62,310     4,593
   2007       2      Outpatient     20170     SOUTH MISSISSInpatientPI REGIONAL MEDICAL        3,081       3,081       123
   2007       2      Outpatient     20172     NATCHEZ REGIONAL MEDICAL CENTER                 11,120      11,120       270
   2007       2      Outpatient     20175     YALOBUSHA GENERAL HOSPITAL                         164         164         7
   2007       2      Outpatient     20177     JASPER GENERAL HOSPITAL                          7,444       7,444       584
   2007       2      Outpatient     20178     WEBSTER HEALTH SERVICES INC                    171,629     171,629     4,460
   2007       2      Outpatient     20181     NESHOBA COUNTY HOSPITAL & NURSI HOM            305,344     305,329    10,116
   2007       2      Outpatient     20182     BILOXI HMA INC.                                  5,319       5,319       215
   2007       2      Outpatient     20191     PERRY COUNTY GENERAL HOSPITAL                      197         197        10
   2007       2      Outpatient     20193     JEFFERSON COUNTY HOSPITAL                          945         945        29
   2007       2      Outpatient     20197     UNIVERSITY OF SOUTH ALABAMA                         39          39         3
   2007       2      Outpatient     20207     SOUTHWEST MISSISSInpatientPI REGIONAL MEDI      18,021      18,021       894
   2007       2      Outpatient     20208     WALTHALL COUNTY GENERAL HOSPITAL                    87          87        10
   2007       2      Outpatient     20213     HILLCREST HOSPITAL                              81,169      81,166     2,480
   2007       2      Outpatient     20214     H C WATKINS MEMORIAL HOSPITAL INC               90,192      90,189     2,379
   2007       2      Outpatient     20219     OKTIBBEHA COUNTY HOSPITAL                      740,716     740,695    24,726
   2007       2      Outpatient     20223     MISSISSInpatientPI METHODIST HOSPITAL REHA     103,629     103,587     3,454
   2007       2      Outpatient     20226     GULFCOAST COMMUNITY HOSPITAL                     5,271       5,271       173
   2007       2      Outpatient     20229     PHYSICIANS AND SURGEONS HOSPITAL GR            640,010     640,004       438
   2007       2      Outpatient     20230     MISSISSInpatientPI BAND OF CHOCTAW INDIANS     777,038     777,038     3,122
   2007       2      Outpatient     20237     ALLIANCE HEALTH CENTER INC                           0           0         0
   2007       2      Outpatient     20256     STATE OF MISSISSInpatientPI UNIVERSITY OF      448,136     448,136    94,158
   2007       2      Outpatient     20290     GEORGE COUNTY HOSPITAL                           1,354       1,354        50
   2007       2      Outpatient     20300     L S U MED CTR                                      127         127         3
   2007       2      Outpatient     20302     CHILDRENS HOSP                                   1,220       1,220        16
   2007       2      Outpatient     20330     MEDICAL CENTER OF LOUISISANA AT NEW                789         789        21
   2007       2      Outpatient     20337     HATTIESBURG CLINIC, PA                          12,224      12,224     1,336
   2007       2      Outpatient     20338     HATTIESBURG CLINIC PA                              111         111         1
   2007       2      Outpatient     20341     HATTIESBURG CLINIC PA                            6,638       6,638       985
   2007       2      Outpatient     20364     HOSPITAL SERVICE DISTRICT NO 1                     113         113         3
   2007       2      Outpatient     20374     BAPTIST MEMORIAL HOSPITAL                        3,461       3,461        35
   2007       2      Outpatient     20389     HILL HOSPITAL OF YORK                               15          15         2
   2007       2      Outpatient     20395     UNIVERSITY OF ALABAMA HOSPITAL                  10,719      10,710       417
   2007       2      Outpatient     20411     UNIVERSITY OF SOUTH ALABAMA                        324         324         2
   2007       2      Outpatient     20414     DCH REGIONAL MEDICAL CENTER                        467         467        16
   2007       2      Outpatient     20421     SHELBY COUNTY HEALTH CARE                        4,574       4,574        92
   2007       2      Outpatient     20424     SLIDELL MEMORIAL HOSPITAL                          155         155         3



5/15/2012                                                        Milliman                                          Page 43
                Inpatient & Outpatient Facility Claims by Provider (includes freestanding dialysis services)

                      Claim        Provider                        Provider                Allowed         Paid   Service
   Year     Region     Type       ID Number                         Name                   Charges       Claims     Units
   2007       2      Outpatient     20426     EYE FOUNDATION HOSPITAL INC                        64          64         4
   2007       2      Outpatient     20429     CHILDRENS HOSPITAL OF BHAM                     32,463      32,463       720
   2007       2      Outpatient     20433     OUR LADY OF THE LAKE HOSPITAL                  16,792      16,792        43
   2007       2      Outpatient     20441     BATON ROUGE GEN HOSP                              245         245        12
   2007       2      Outpatient     20461     ALTON OCHSNER MEDICAL FOUNDATION                8,437       8,437       243
   2007       2      Outpatient     20469     METHODIST HOSPITAL - CENTRAL                   51,458      51,458     2,340
   2007       2      Outpatient     95919     ST JOHNS HOSPITAL                                 281         281        17
   2007       2      Outpatient     96306     UNIVERSITY OF KENTUCKY                          1,473       1,473        30
   2007       2      Outpatient     96433     ECTOR COUNTY HOSPITAL DISTRICT                    195         195         4
   2007       2      Outpatient     97109     DETROIT RECEIVING HOSPITAL                        132         132         1
   2007       2      Outpatient     97459     CREIGHTON S T JOSEPH REGIONAL                   4,601       4,601       134
   2007       2      Outpatient     97684     TEXAS CHILDREN'S HOSPITAL                         505         505         5
   2007       2      Outpatient     97767     ARKANSAS CHILDRENS HOSPITAL                     8,877       8,877       202
   2007       2      Outpatient     97779     BAPTIST HOSPITAL                                  785         785        18
   2007       2      Outpatient     180578    NORTH BREVARD COUNTY HOSPITAL                     856         856        18
   2007       2      Outpatient     220021    RENEX DIALYSIS FACILITIES INC                  41,552      41,552    11,537
   2007       2      Outpatient     220061    RENEX DIALYSIS FACILITIES INC                     319         319        14
   2007       2      Outpatient     220062    NATIONAL RENAL INSTITUTES INC                  39,742      39,742    10,763
   2007       2      Outpatient     220063    HATTIESBURG CLINIC PA                          10,429      10,429     1,774
   2007       2      Outpatient     220082    BIO-MEDICALAPPLICATIONS OF MS, INC.            86,080      86,080    15,681
   2007       2      Outpatient     220105    BIO-MEDICAL APPLICATIONS OF MS, INC             9,829       9,829       718
   2007       2      Outpatient     220136    BAPTIST MEMORIAL HOSPITAL                   1,671,182   1,671,149    86,007
   2007       2      Outpatient     220144    MORTON MEDICAL CENTER INC                      71,292      71,292     3,502
   2007       2      Outpatient     220159    NATCHEZ COMMUNITY HOSPITAL, INC.                9,542       9,542       165
   2007       2      Outpatient     220172    TOUCHETTE REGIONAL HOSPITAL INC                   321         321        16
   2007       2      Outpatient     220213    SAINT FRANCIS HOSPITAL                            303         303         9
   2007       2      Outpatient     220220    MARION REGIONAL MEDICAL CENTER                    637         637        28
   2007       2      Outpatient     220230    NEWTON HOSPITAL, INC                           76,799      76,790     5,285
   2007       2      Outpatient     220243    WINSTON MEDICAL CENTER                        142,461     142,458     4,828
   2007       2      Outpatient     220279    UNIVERSITY HEALTHCARE SYSTEM                   10,924      10,924        96
   2007       2      Outpatient     220297    PEARL RIVER HOSPITAL                              119         119        12
   2007       2      Outpatient     220324    INDEPENDENT HEALTHCARE MANAGEMENT             224,105     224,102     3,056
   2007       2      Outpatient     220350    RCG MISSISSInpatientPI INC                      2,677       2,677     1,567
   2007       2      Outpatient     220351    NATIONAL RENAL INSTITUTES INC                 160,655     160,655    19,853
   2007       2      Outpatient     220353    RCG MISSISSInpatientPI INC                     73,406      73,406    23,347
   2007       2      Outpatient     220355    NATIONAL RENAL INSTITUTES INC                  75,425      75,425    11,114
   2007       2      Outpatient     220356    RCG MISSISSInpatientPI INC                        290         290         4
   2007       2      Outpatient     220359    RCG MISSISSInpatientPI INC                     75,826      75,826    22,055
   2007       2      Outpatient     220360    RCG MISSISSInpatientPI INC                    186,298     186,298    51,612
   2007       2      Outpatient     220361    RCG MISSISSInpatientPI INC                     39,304      39,304    15,941
   2007       2      Outpatient     220362    RCG DBA KIDNEY CARE /MERIDIAN                 141,252     141,252    38,625
   2007       2      Outpatient     220364    NATIONAL RENAL INSTITUTES INC                   4,145       4,145       292
   2007       2      Outpatient     220365    NATIONAL RENAL INSTITUTES INC                 176,405     176,405    15,777
   2007       2      Outpatient     220369    RCG MISSISSInpatientPI INC                    167,805     167,805    53,295
   2007       2      Outpatient     220380    CLARKSDALE HMA INC                              6,466       6,466       276
   2007       2      Outpatient     220392    MISSISSInpatientPI BAPTIST MEDICAL CENTER   2,570,678   2,570,630    25,538
   2007       2      Outpatient     220415    SOUTHERN HEALTH CORP OF HOUSTON               242,268     242,268     5,955
   2007       2      Outpatient     220416    RCG BRANDON LLC                                 4,001       4,001       260
   2007       2      Outpatient     220417    RANKIN MEDICAL CENTER                         395,715     395,712    12,443
   2007       2      Outpatient     220441    PRENTISS REGIONAL HOSPITAL AND EXTE             2,772       2,772        78
   2007       2      Outpatient     220448    TOURO INFIRMARY                                   290         290        10
   2007       2      Outpatient     220462    WESLEY HEALTH SYSTEMS LLC                      31,817      31,817       759
   2007       2      Outpatient     220466    ROH, INC                                       71,685      71,682     1,565
   2007       2      Outpatient     220467    RIVER OAKS HOSPITAL, INC.                     380,584     380,578    12,959
   2007       2      Outpatient     220481    NATIONAL RENAL INSTITUTES INC                  56,988      56,988     8,421
   2007       2      Outpatient     220487    PROVIDENCE HOSPITAL                             2,613       2,613        52
   2007       2      Outpatient     220495    MERIDIAN HMA INC                              586,072     586,069    22,658
   2007       2      Outpatient     220498    VANDERBILT UNIVERSITY                           1,338       1,338        17
   2007       2      Outpatient     220502    HATTIESBURG CLINIC, PA                        121,739     121,739    18,821
   2007       2      Outpatient     220506    BIO-MEDICAL APPLICATIONS OF MISSISS            39,853      39,853     9,553
   2007       2      Outpatient     220522    JEFFERSON PARISH HOSPITAL SERVICE                  44          44         1
   2007       2      Outpatient     220545    DOCTORS HOSPITAL OF AUGUSTA                    10,548      10,548        91
   2007       2      Outpatient     220554    HATTIESBURG CLINIC PA                          26,910      26,910     3,973
   2007       2      Outpatient     220565    NORTH PORT HOSPITAL-DCH                           969         969        21
   2007       2      Outpatient     220571    VICKSBURG HEALTHCARE LLC                      851,319     851,292    19,381
   2007       2      Outpatient     220575    AHS SUMMIT HOSPITAL                                70          70         1
   2007       2      Outpatient     220576    BAPTIST MEMORIAL HOSPITAL                         534         534        15
   2007       2      Outpatient     220598    RCG MISSISSInpatientPI INC                     51,861      51,861    14,960
   2007       2      Outpatient     220601    EAST JEFFERSON GENERAL HOSPITAL                   367         367         9



5/15/2012                                                       Milliman                                          Page 44
                Inpatient & Outpatient Facility Claims by Provider (includes freestanding dialysis services)

                       Claim       Provider                       Provider                 Allowed         Paid   Service
   Year     Region      Type      ID Number                        Name                    Charges       Claims     Units
   2007       2      Outpatient     220606    PHC-CLEVELAND, INC.                             9,724       9,721       306
   2007       2      Outpatient     220609    STATE OF MISSISSInpatientPI-UNIVERSITY OF      19,201      19,201       357
   2007       2      Outpatient     220621    ALLIANCE HEALTHCARE SYSTEM INC                  3,074       3,074        70
   2007       2      Outpatient     220630    JACKSON HMA INC                             1,618,566   1,618,560    42,524
   2007       2      Outpatient     220631    NORTH OAK REGIONAL HOSPITAL INC                 1,364       1,364       115
   2007       2      Outpatient     220632    BIO-MEDICAL APPLICATIONS OF MS, INC            38,231      38,231    16,188
   2007       2      Outpatient     220634    BIO-MEDICAL APPLICATIONS OF MISSISS            79,263      79,263    10,955
   2007       2      Outpatient     220635    BIO-MEDICAL APPLICATIONS OF MISSISS            16,013      16,013     1,059
   2007       2      Outpatient     220636    BIO-MEDICAL APPLICATIONS OF MS, INC            71,255      71,255    10,365
   2007       2      Outpatient     220637    BIO-MEDICAL APPLICATIONS OF MS INC            131,265     131,265    28,300
   2007       2      Outpatient     220682    FORREST COUNTY GENERAL HOSPITAL                   706         706        29
   2007       2      Outpatient     220692    PIONEER HEALTH SERVICES OF MONROE              99,139      99,124     1,844
   2007       2      Outpatient     220714    STONE COUNTY HOSITAL INC                          427         427        25
   2007       2      Outpatient     220722    RCG MISSISSInpatientPI INC                     49,198      49,198    14,349
   2007       2      Outpatient     220734    GPCH-GP                                         8,623       8,623        43
   2007       2      Outpatient     220742    CHILDRENS HOSPITAL MEDICAL CENTER                 896         896         4
   2007       2      Outpatient     220771    RENAL CARE GROUP TUPELO LLC                    57,749      57,749     8,278
   2007       2      Outpatient     220772    RENAL CARE GROUP TUPELO LLC                    25,645      25,645     5,909
   2007       2      Outpatient     220774    RENAL CARE TUPELO LLC                          13,846      13,846     2,980
   2007       2      Outpatient     220776    RENAL CARE GROUP TUPELO LLC                   190,868     190,868    43,209
   2007       2      Outpatient     220800    THE CHILDREN'S HOSPITAL OF PHILADEL            12,903      12,903       109
   2007       2      Outpatient     220809    LEAKE COUNTY BOARD OF TRUSTEES                 64,631      64,628     2,769
   2007       2      Outpatient     823778    GREENVILLE MEMORIAL HOSPITAL                       95          95         5
   2007       2      Outpatient    1457714    NEBRASKA HEALTH SYSTEM                          2,501       2,501       155
   2007       2      Outpatient    1934081    AKRON GENERAL MEDICAL CENTER                    3,340       3,340       132
   2007       2      Outpatient    2032374    DANNY JOE SPREITLER                            65,298      65,298     2,186
   2007       2      Outpatient    2083023    NORTHWEST MEDICAL CENTER-WINFIELD L               190         190         6
   2007       2      Outpatient    3126743    GLENWOOD REGIONAL MEDICAL CENTER                    0           0         1
   2007       2      Outpatient    3273578    BIO-MEDICAL APPLICATIONS OF MISS               44,549      44,549    10,332
   2007       2      Outpatient    4125505    LAIRD HOutpatientSITAL INC                    122,838     122,835     4,555
   2007       2      Outpatient    4605843    SACRED HEART HEALTH SYSTEM INC                     49          49         1
   2007       2      Outpatient    5124825    NORTH VISTA HOSPITAL INC                          428         428        15
   2007       2      Outpatient    5330563    BRIGHAM & WOMENS HOSPITAL INC                     678         678        14
   2007       2      Outpatient    5628235    LINCOLN HEALTH SYSTEMS INC                        153         153         2
   2007       2      Outpatient    5953091    CHRISTUS HEALTH NORTHERN LOUISIANA              1,626       1,626        42
   2007       2      Outpatient    6200741    GREENE RURAL HEALTH CENTER                        512         512        16
   2007       2      Outpatient    6259761    OUR LADY OF THE LAKE ASCENSION                    561         561        20
   2007       2      Outpatient    6380033    SAINTJOHN HEALTH SYSTEM                           835         835        24
   2007       2      Outpatient    6934870    FLORIDA HOSPITAL WATERMAN                         682         682        10
   2007       2      Outpatient    7051779    COLUMBIA MEDICAL CENTER OF LEWISVIL               940         940        20
   2007       2      Outpatient    7232713    CARILION MEDICAL CENTER                           104         104         5
   2007       2      Outpatient    7539272    QUITMAN COUNTY HOSPITAL, LLC                      375         375         1
   2007       2      Outpatient    7771013    MCNAIRY HOSPITAL CORPORATION                      199         199         8
   2007       2      Outpatient    8087360    MADISON HMA INC                               415,231     415,213    14,788
   2007       2      Outpatient    9700515    RUSH UNIVERSITY MEDICAL CENTER                    362         362         1
   2007       2      Outpatient    9957292    CARILION NEW RIVER VALLEY MEDICAL                  77          77         1
   2007       3       Inpatient     20007     FORREST COUNTY GENERAL HOSPITAL             9,998,603   9,939,393     7,883
   2007       3       Inpatient     20008                                                   776,068     772,648       551
   2007       3       Inpatient     20011     WHITFIELD MEDICAL SURGICAL HO                     749         739         1
   2007       3       Inpatient     20012     FIELD MEMORIAL COMMUNITY HOSPITAL             272,361     270,221       227
   2007       3       Inpatient     20025     GREENWOOD LEFLORE HOSPITAL                     31,190      30,910        28
   2007       3       Inpatient     20027     MEMORIAL HOSPITAL AT GULFPORT               6,054,802   6,024,722     4,880
   2007       3       Inpatient     20034     ST DOMINIC JACKSON MEM                        679,967     674,387       559
   2007       3       Inpatient     20042     MAGEE BENEVOLENT ASSOCIATION                   84,981      84,041       100
   2007       3       Inpatient     20043     SOUTH PIKE HOSPITAL ASSOCIATION INC           174,684     171,764       292
   2007       3       Inpatient     20046     ANDERSON INFIRMARY BENEVOLENT ASSOC            38,470      38,180        29
   2007       3       Inpatient     20049     RUSH MEDICAL FOUNDATION                        35,775      35,515        26
   2007       3       Inpatient     20059     SINGING RIVER HOSPITAL SYSTEM               4,269,512   4,241,482     3,020
   2007       3       Inpatient     20065     ST. JUDE CHILDRENS RESEARCH HOSPITA            38,948      38,948        35
   2007       3       Inpatient     20079     CLAY COUNTY MEDICAL CORPORATION                 4,570       4,570         4
   2007       3       Inpatient     20081     NORTH MISSISSInpatientPI MEDICAL CENTER        39,365      39,065        30
   2007       3       Inpatient     20116     MARION GENERAL HOSPITAL                       251,994     248,994       306
   2007       3       Inpatient     20130                                                   120,890     119,650       144
   2007       3       Inpatient     20131     WAYNE GENERAL HOSPITAL                        596,324     590,244       689
   2007       3       Inpatient     20133     COVINGTON COUNTY HOSPITAL                     121,458     120,298       145
   2007       3       Inpatient     20140     CLAIBORNE CO HOSPITAL                          15,020      14,850        17
   2007       3       Inpatient     20141     SOUTH CENTRAL REGIONAL MEDICAL CENT         1,529,948   1,516,498     1,488
   2007       3       Inpatient     20145     DELTA REGIONAL MEDICAL CENTER                  43,578      43,178        40
   2007       3       Inpatient     20149     STATE OF MISSISSInpatientPI-UNIVERSITY OF   7,108,098   7,090,748     5,790



5/15/2012                                                        Milliman                                         Page 45
                Inpatient & Outpatient Facility Claims by Provider (includes freestanding dialysis services)

                      Claim       Provider                        Provider                 Allowed         Paid   Service
   Year     Region     Type      ID Number                         Name                    Charges       Claims     Units
   2007       3      Inpatient     20166     HANCOCK MEDICAL CENTER INC                     452,814     449,914       307
   2007       3      Inpatient     20167     SIMPSON COMMUNITY HEALTHCARE INC                 7,604       7,514         9
   2007       3      Inpatient     20170     SOUTH MISSISSInpatientPI REGIONAL MEDICAL       66,305      65,805        56
   2007       3      Inpatient     20172     NATCHEZ REGIONAL MEDICAL CENTER                837,959     833,449       607
   2007       3      Inpatient     20182     BILOXI HMA INC.                              1,881,319   1,868,409     1,320
   2007       3      Inpatient     20191     PERRY COUNTY GENERAL HOSPITAL                   99,457      98,647        83
   2007       3      Inpatient     20193     JEFFERSON COUNTY HOSPITAL                      175,968     173,898       216
   2007       3      Inpatient     20197     UNIVERSITY OF SOUTH ALABAMA                    489,643     489,303       393
   2007       3      Inpatient     20207     SOUTHWEST MISSISSInpatientPI REGIONAL MEDI   2,024,993   2,010,453     1,676
   2007       3      Inpatient     20208     WALTHALL COUNTY GENERAL HOSPITAL               141,667     139,807       198
   2007       3      Inpatient     20214     H C WATKINS MEMORIAL HOSPITAL INC                2,817       2,787         3
   2007       3      Inpatient     20215     INFIRMARY HEALTH HOSPITALS INC                  21,355      21,175        18
   2007       3      Inpatient     20223     MISSISSInpatientPI METHODIST HOSPITAL REHA     164,937     163,457       148
   2007       3      Inpatient     20226     GULFCOAST COMMUNITY HOSPITAL                   989,860     982,610       733
   2007       3      Inpatient     20229     PHYSICIANS AND SURGEONS HOSPITAL GR            213,634     212,664       188
   2007       3      Inpatient     20237     ALLIANCE HEALTH CENTER INC                   1,149,794   1,141,624     1,994
   2007       3      Inpatient     20290     GEORGE COUNTY HOSPITAL                         499,430     495,090       455
   2007       3      Inpatient     20302     CHILDRENS HOSP                                 427,230     427,230       462
   2007       3      Inpatient     20364     HOSPITAL SERVICE DISTRICT NO 1                     927         917         1
   2007       3      Inpatient     20394     ST. CHARLES PARISH HOSPITAL                     16,540      16,270        27
   2007       3      Inpatient     20395     UNIVERSITY OF ALABAMA HOSPITAL                 109,549     109,149        94
   2007       3      Inpatient     20411     UNIVERSITY OF SOUTH ALABAMA                     95,811      95,031        78
   2007       3      Inpatient     20414     DCH REGIONAL MEDICAL CENTER                      6,445       6,385         6
   2007       3      Inpatient     20420     THE HEALTH CARE AUTHORITY OF THE CI              1,052       1,052         1
   2007       3      Inpatient     20424     SLIDELL MEMORIAL HOSPITAL                       65,110      64,490        67
   2007       3      Inpatient     20429     CHILDRENS HOSPITAL OF BHAM                      18,877      18,877        17
   2007       3      Inpatient     20433     OUR LADY OF THE LAKE HOSPITAL                   59,365      58,755        68
   2007       3      Inpatient     20441     BATON ROUGE GEN HOSP                             4,442       4,402         4
   2007       3      Inpatient     20461     ALTON OCHSNER MEDICAL FOUNDATION               299,754     298,734       262
   2007       3      Inpatient     20469     METHODIST HOSPITAL - CENTRAL                    20,373      20,263        14
   2007       3      Inpatient     20482     MOBILE INFIRMARY ASSOCIATION                   129,291     128,021       127
   2007       3      Inpatient     29002     FIELD MEMORIAL COMMUNITY HOSPITAL                2,850       2,850        20
   2007       3      Inpatient     29010     WAYNE GENERAL HOSPITAL - SWINGBED                6,270       6,270        44
   2007       3      Inpatient     29034     COVINGTON COUNTY HOSPITAL                        1,995       1,995        14
   2007       3      Inpatient     95261     SEVENTH DAY ADVENTIST PARADISE VALL             34,121      33,841        28
   2007       3      Inpatient     95306     NORTHSHORE REG MED CENTER                      131,896     130,996       143
   2007       3      Inpatient     97767     ARKANSAS CHILDRENS HOSPITAL                     34,499      34,499        29
   2007       3      Inpatient     220136    BAPTIST MEMORIAL HOSPITAL                       67,632      67,092        57
   2007       3      Inpatient     220144    MORTON MEDICAL CENTER INC                        4,239       4,239         5
   2007       3      Inpatient     220159    NATCHEZ COMMUNITY HOSPITAL, INC.               881,875     875,335       798
   2007       3      Inpatient     220213    SAINT FRANCIS HOSPITAL                           7,762       7,762        12
   2007       3      Inpatient     220230    NEWTON HOSPITAL, INC                             1,452       1,432         2
   2007       3      Inpatient     220279    UNIVERSITY HEALTHCARE SYSTEM                   963,099     961,839       334
   2007       3      Inpatient     220324    INDEPENDENT HEALTHCARE MANAGEMENT                7,253       7,153        10
   2007       3      Inpatient     220380    CLARKSDALE HMA INC                               5,769       5,719         5
   2007       3      Inpatient     220392    MISSISSInpatientPI BAPTIST MEDICAL CENTER      404,727     402,047       348
   2007       3      Inpatient     220417    RANKIN MEDICAL CENTER                           41,743      41,433        31
   2007       3      Inpatient     220441    PRENTISS REGIONAL HOSPITAL AND EXTE            103,806     102,746       132
   2007       3      Inpatient     220444    DMC-MEMPHIS INC                                 10,608      10,488        12
   2007       3      Inpatient     220457    LEE MEMORIAL HOSPITAL                            8,303       8,213         9
   2007       3      Inpatient     220462    WESLEY HEALTH SYSTEMS LLC                    1,686,262   1,672,802     1,465
   2007       3      Inpatient     220467    RIVER OAKS HOSPITAL, INC.                       27,659      27,489        17
   2007       3      Inpatient     220487    PROVIDENCE HOSPITAL                             61,243      60,413        89
   2007       3      Inpatient     220489    RIVERSIDE MEDICAL CENTER                         2,450       2,410         4
   2007       3      Inpatient     220509    PEARL RIVER HOSPITAL                               997         997         7
   2007       3      Inpatient     220522    JEFFERSON PARISH HOSPITAL SERVICE                4,596       4,546         5
   2007       3      Inpatient     220571    VICKSBURG HEALTHCARE LLC                     1,098,164   1,086,324     1,340
   2007       3      Inpatient     220601    EAST JEFFERSON GENERAL HOSPITAL                 12,463      12,333        13
   2007       3      Inpatient     220630    JACKSON HMA INC                                307,920     306,210       210
   2007       3      Inpatient     220682    FORREST COUNTY GENERAL HOSPITAL                394,602     391,672       306
   2007       3      Inpatient     220714    STONE COUNTY HOSITAL INC                       124,744     124,184        63
   2007       3      Inpatient     220734    GPCH-GP                                        980,120     975,000       553
   2007       3      Inpatient     220824    HCA HEALTH SERVICES OF OKLAHOMA                 10,465      10,465         9
   2007       3      Inpatient    3126743    GLENWOOD REGIONAL MEDICAL CENTER                 8,139       8,069         7
   2007       3      Inpatient    4125505    LAIRD HOutpatientSITAL INC                       3,242       3,192         5
   2007       3      Inpatient    4581000    LOUISIANA HEART HOSPITAL LLC                     6,283       6,193         9
   2007       3      Inpatient    6200741    GREENE RURAL HEALTH CENTER                       1,747       1,727         2
   2007       3      Inpatient    6754821    SHORE HEALTH SYSTEM INC                          2,361       2,341         2
   2007       3      Inpatient    7603524    REGENCY HOSPITAL OF HATTIESBURG LLC             41,505      40,945        56



5/15/2012                                                      Milliman                                           Page 46
                Inpatient & Outpatient Facility Claims by Provider (includes freestanding dialysis services)

                       Claim       Provider                    Provider                     Allowed         Paid     Service
   Year     Region      Type      ID Number                     Name                        Charges       Claims       Units
   2007       3       Inpatient    7781502    VALLEY HOSPITAL MED CTR                          6,210       6,160           5
   2007       3       Inpatient    8087360    MADISON HMA INC                                  2,703       2,683           2
   2007       3       Inpatient    8227060    HTI MEMORIAL HOSPITAL CORPORATION                4,569       4,519           5
   2007       3      Outpatient     20000     WALKER REGIONAL MEDICAL CENTER INC                 186         186           6
   2007       3      Outpatient     20003     AMORY HMA INC                                    2,114       2,114          44
   2007       3      Outpatient     20007     FORREST COUNTY GENERAL HOSPITAL              3,748,755   3,748,638     117,220
   2007       3      Outpatient     20008                                                    427,620     427,587      16,051
   2007       3      Outpatient     20011     WHITFIELD MEDICAL SURGICAL HO                   29,494      29,440   1,023,240
   2007       3      Outpatient     20012     FIELD MEMORIAL COMMUNITY HOSPITAL              251,000     250,994       7,371
   2007       3      Outpatient     20016     BAPTIST MEMORIAL HOSPITAL- NORTH                   320         320           9
   2007       3      Outpatient     20019     WEST FELICIANA PARISH HOSPITAL                   1,688       1,685          74
   2007       3      Outpatient     20020     MAGNOLIA REGIONAL HEALTH CENTER                  9,678       9,678         266
   2007       3      Outpatient     20025     GREENWOOD LEFLORE HOSPITAL                       8,968       8,965         148
   2007       3      Outpatient     20026     GRENADA LAKE MEDICAL CENTER                        839         839          12
   2007       3      Outpatient     20027     MEMORIAL HOSPITAL AT GULFPORT                3,750,946   3,750,832      89,138
   2007       3      Outpatient     20032     SOUTH SUNFLOWER COUNTY HOSPITAL                    573         573          40
   2007       3      Outpatient     20034     ST DOMINIC JACKSON MEM                         187,221     187,221       3,610
   2007       3      Outpatient     20035                                                        205         205           5
   2007       3      Outpatient     20042     MAGEE BENEVOLENT ASSOCIATION                    53,517      53,514       2,886
   2007       3      Outpatient     20043     SOUTH PIKE HOSPITAL ASSOCIATION INC             15,063      15,063         885
   2007       3      Outpatient     20046     ANDERSON INFIRMARY BENEVOLENT ASSOC             38,110      38,110         233
   2007       3      Outpatient     20049     RUSH MEDICAL FOUNDATION                         42,420      42,420         914
   2007       3      Outpatient     20059     SINGING RIVER HOSPITAL SYSTEM                2,926,701   2,926,605      63,109
   2007       3      Outpatient     20065     ST. JUDE CHILDRENS RESEARCH HOSPITA             92,221      92,221       1,144
   2007       3      Outpatient     20079     CLAY COUNTY MEDICAL CORPORATION                  1,135       1,135          28
   2007       3      Outpatient     20081     NORTH MISSISSInpatientPI MEDICAL CENTER          5,065       5,065          94
   2007       3      Outpatient     20082     KINGS DAUGHTERS HOSPITAL OF YAZOO                  430         430          16
   2007       3      Outpatient     20084     BAPTIST MEMORIAL HOSPITAL BOONEVILL              1,513       1,513         161
   2007       3      Outpatient     20096     PONTOTOC HEALTH SERVICES INC                       453         453          14
   2007       3      Outpatient     20115     HARDY WILSON MEMORIAL HOSPITAL                  18,410      18,410         266
   2007       3      Outpatient     20116     MARION GENERAL HOSPITAL                        247,382     247,361       6,870
   2007       3      Outpatient     20124     HUMPHREYS COUNTY MEMORIAL HOSPITAL               1,156       1,156          48
   2007       3      Outpatient     20130                                                     37,280      37,280       1,942
   2007       3      Outpatient     20131     WAYNE GENERAL HOSPITAL                         201,962     201,926       9,800
   2007       3      Outpatient     20133     COVINGTON COUNTY HOSPITAL                      154,028     154,025       5,694
   2007       3      Outpatient     20140     CLAIBORNE CO HOSPITAL                          321,423     321,423       6,826
   2007       3      Outpatient     20141     SOUTH CENTRAL REGIONAL MEDICAL CENT            834,019     833,974      19,764
   2007       3      Outpatient     20143     BAPTIST MEMORIAL HOSPITAL DESOTO, I                545         545          22
   2007       3      Outpatient     20145     DELTA REGIONAL MEDICAL CENTER                   10,480      10,477         307
   2007       3      Outpatient     20149     STATE OF MISSISSInpatientPI-UNIVERSITY OF    3,663,477   3,663,405      49,771
   2007       3      Outpatient     20156     TYLER HOLMES MEMORIAL HOSPITAL                     120         120          10
   2007       3      Outpatient     20166     HANCOCK MEDICAL CENTER INC                     314,130     314,127      21,060
   2007       3      Outpatient     20167     SIMPSON COMMUNITY HEALTHCARE INC                 4,020       4,020         273
   2007       3      Outpatient     20170     SOUTH MISSISSInpatientPI REGIONAL MEDICAL       61,404      61,401       1,405
   2007       3      Outpatient     20172     NATCHEZ REGIONAL MEDICAL CENTER                652,862     652,850      21,883
   2007       3      Outpatient     20174     LA SALLE GENERAL HOSPITAL                          275         275          11
   2007       3      Outpatient     20177     JASPER GENERAL HOSPITAL                          1,091       1,091          90
   2007       3      Outpatient     20178     WEBSTER HEALTH SERVICES INC                        280         280           1
   2007       3      Outpatient     20181     NESHOBA COUNTY HOSPITAL & NURSI HOM              1,338       1,338          31
   2007       3      Outpatient     20182     BILOXI HMA INC.                                689,757     689,736      25,251
   2007       3      Outpatient     20186     LIFEMARK HOSPITALS OF LOUISIANA INC                301         298           6
   2007       3      Outpatient     20191     PERRY COUNTY GENERAL HOSPITAL                   40,682      40,679       1,657
   2007       3      Outpatient     20193     JEFFERSON COUNTY HOSPITAL                       65,048      65,048       2,088
   2007       3      Outpatient     20197     UNIVERSITY OF SOUTH ALABAMA                     65,243      65,243       3,490
   2007       3      Outpatient     20207     SOUTHWEST MISSISSInpatientPI REGIONAL MEDI   1,181,920   1,181,890      50,086
   2007       3      Outpatient     20208     WALTHALL COUNTY GENERAL HOSPITAL               139,835     139,811       8,750
   2007       3      Outpatient     20214     H C WATKINS MEMORIAL HOSPITAL INC                6,473       6,473         177
   2007       3      Outpatient     20215     INFIRMARY HEALTH HOSPITALS INC                   2,670       2,670         120
   2007       3      Outpatient     20219     OKTIBBEHA COUNTY HOSPITAL                        2,869       2,869         251
   2007       3      Outpatient     20223     MISSISSInpatientPI METHODIST HOSPITAL REHA      71,682      71,682       2,643
   2007       3      Outpatient     20226     GULFCOAST COMMUNITY HOSPITAL                   229,558     229,552       7,323
   2007       3      Outpatient     20229     PHYSICIANS AND SURGEONS HOSPITAL GR            149,067     149,067          85
   2007       3      Outpatient     20230     MISSISSInpatientPI BAND OF CHOCTAW INDIANS         242         242           1
   2007       3      Outpatient     20280     FORT SANDERS SEVIER MEDICAL CENTER                 503         503          13
   2007       3      Outpatient     20290     GEORGE COUNTY HOSPITAL                         251,984     251,963       7,255
   2007       3      Outpatient     20294     COLBERT COUNTY NW ALABAMA                           48          48           1
   2007       3      Outpatient     20302     CHILDRENS HOSP                                  92,911      92,911       1,965
   2007       3      Outpatient     20330     MEDICAL CENTER OF LOUISISANA AT NEW              1,091       1,091          20
   2007       3      Outpatient     20337     HATTIESBURG CLINIC, PA                         313,573     313,573      44,542



5/15/2012                                                       Milliman                                             Page 47
                Inpatient & Outpatient Facility Claims by Provider (includes freestanding dialysis services)

                      Claim        Provider                        Provider                Allowed         Paid   Service
   Year     Region     Type       ID Number                         Name                   Charges       Claims     Units
   2007       3      Outpatient     20338     HATTIESBURG CLINIC PA                         102,808     102,808    14,091
   2007       3      Outpatient     20341     HATTIESBURG CLINIC PA                         126,714     126,714    21,663
   2007       3      Outpatient     20345     HATTIESBURG CLINIC PA                           2,869       2,869       366
   2007       3      Outpatient     20364     HOSPITAL SERVICE DISTRICT NO 1                  3,249       3,249       101
   2007       3      Outpatient     20395     UNIVERSITY OF ALABAMA HOSPITAL                 22,275      22,272       844
   2007       3      Outpatient     20411     UNIVERSITY OF SOUTH ALABAMA                    36,397      36,397     3,826
   2007       3      Outpatient     20414     DCH REGIONAL MEDICAL CENTER                       309         309         9
   2007       3      Outpatient     20424     SLIDELL MEMORIAL HOSPITAL                      79,392      79,386       710
   2007       3      Outpatient     20427     HOSPITAL SERVICE DISTRICT 1 OF EAST             3,143       3,143         6
   2007       3      Outpatient     20429     CHILDRENS HOSPITAL OF BHAM                     11,217      11,217       177
   2007       3      Outpatient     20433     OUR LADY OF THE LAKE HOSPITAL                  35,128      35,119       500
   2007       3      Outpatient     20441     BATON ROUGE GEN HOSP                            2,327       2,327        46
   2007       3      Outpatient     20459     ST. HELENA PARISH HOSPITAL                        143         143         4
   2007       3      Outpatient     20461     ALTON OCHSNER MEDICAL FOUNDATION               95,402      95,393     1,719
   2007       3      Outpatient     20469     METHODIST HOSPITAL - CENTRAL                   12,896      12,896       624
   2007       3      Outpatient     20473     RIVERLAND MEDICAL CENTER                          666         666        20
   2007       3      Outpatient     20482     MOBILE INFIRMARY ASSOCIATION                   29,112      29,112     1,085
   2007       3      Outpatient     95306     NORTHSHORE REG MED CENTER                      69,576      69,576     2,101
   2007       3      Outpatient     95450     CHILDREN'S HOSPITAL OF MICHIGAN                    95          95         9
   2007       3      Outpatient     97459     CREIGHTON S T JOSEPH REGIONAL                     877         877        16
   2007       3      Outpatient     97684     TEXAS CHILDREN'S HOSPITAL                         385         385        36
   2007       3      Outpatient     97767     ARKANSAS CHILDRENS HOSPITAL                     1,779       1,779        99
   2007       3      Outpatient     97779     BAPTIST HOSPITAL                               42,712      42,712       455
   2007       3      Outpatient     98401     SOUTH BALDWIN HOSP                              1,007       1,007        11
   2007       3      Outpatient     220063    HATTIESBURG CLINIC PA                          96,134      96,134    15,486
   2007       3      Outpatient     220136    BAPTIST MEMORIAL HOSPITAL                       4,473       4,473       319
   2007       3      Outpatient     220144    MORTON MEDICAL CENTER INC                       2,764       2,764       134
   2007       3      Outpatient     220159    NATCHEZ COMMUNITY HOSPITAL, INC.              524,102     524,099    20,258
   2007       3      Outpatient     220178    BIO-MEDICAL APPLICATIONS OF MISSISS            19,273      19,273     4,485
   2007       3      Outpatient     220213    SAINT FRANCIS HOSPITAL                            292         292         3
   2007       3      Outpatient     220230    NEWTON HOSPITAL, INC                            2,796       2,793       214
   2007       3      Outpatient     220236    HATTIESBURG CLINIC PA                          51,415      51,415     6,401
   2007       3      Outpatient     220243    WINSTON MEDICAL CENTER                            979         979        47
   2007       3      Outpatient     220279    UNIVERSITY HEALTHCARE SYSTEM                  117,480     117,477     1,331
   2007       3      Outpatient     220297    PEARL RIVER HOSPITAL                           16,805      16,805     1,223
   2007       3      Outpatient     220324    INDEPENDENT HEALTHCARE MANAGEMENT               2,452       2,452        43
   2007       3      Outpatient     220329    BIO-MEDICAL APPLICATIONS OF MISSISS            67,664      67,664    30,964
   2007       3      Outpatient     220333    BIO-MEDICAL APPLICATIONS OF MISSISS            82,023      82,023    24,624
   2007       3      Outpatient     220352    RCG MISSISSInpatientPI INC                     86,760      86,760    20,929
   2007       3      Outpatient     220353    RCG MISSISSInpatientPI INC                      8,599       8,599       618
   2007       3      Outpatient     220354    RCG MISSISSInpatientPI INC                     49,947      49,947     6,976
   2007       3      Outpatient     220356    RCG MISSISSInpatientPI INC                    132,289     132,289    23,495
   2007       3      Outpatient     220380    CLARKSDALE HMA INC                              2,512       2,512       142
   2007       3      Outpatient     220392    MISSISSInpatientPI BAPTIST MEDICAL CENTER     231,041     231,038     1,341
   2007       3      Outpatient     220412    ADVENTIST HEALTH SYSTEM-SUNBELT INC             1,027       1,027        16
   2007       3      Outpatient     220417    RANKIN MEDICAL CENTER                          76,577      76,577     1,142
   2007       3      Outpatient     220428    WOMANS HOSPITAL FOUNDATION                        587         587        16
   2007       3      Outpatient     220430    DVA HEALTHCARE RENAL CARE INC                 102,671     102,671    32,243
   2007       3      Outpatient     220431    DVA HEALTHCARE RENAL CARE INC                   2,142       2,142        24
   2007       3      Outpatient     220441    PRENTISS REGIONAL HOSPITAL AND EXTE           126,919     126,910     4,035
   2007       3      Outpatient     220448    TOURO INFIRMARY                                10,879      10,879        81
   2007       3      Outpatient     220462    WESLEY HEALTH SYSTEMS LLC                   1,167,748   1,167,718    25,777
   2007       3      Outpatient     220466    ROH, INC                                        1,958       1,958        36
   2007       3      Outpatient     220467    RIVER OAKS HOSPITAL, INC.                      35,522      35,522       976
   2007       3      Outpatient     220487    PROVIDENCE HOSPITAL                            60,923      60,920       467
   2007       3      Outpatient     220489    RIVERSIDE MEDICAL CENTER                        2,310       2,310       133
   2007       3      Outpatient     220495    MERIDIAN HMA INC                                7,255       7,255       268
   2007       3      Outpatient     220498    VANDERBILT UNIVERSITY                              63          63         5
   2007       3      Outpatient     220502    HATTIESBURG CLINIC, PA                          2,448       2,448       357
   2007       3      Outpatient     220522    JEFFERSON PARISH HOSPITAL SERVICE                 229         229        11
   2007       3      Outpatient     220525    DVA HEALTHCARE RENAL CARE INC                  97,042      97,042    19,063
   2007       3      Outpatient     220554    HATTIESBURG CLINIC PA                          12,225      12,225     1,900
   2007       3      Outpatient     220570    HATTISBURG CLINIC PA                           45,307      45,307    11,079
   2007       3      Outpatient     220571    VICKSBURG HEALTHCARE LLC                       26,674      26,674       565
   2007       3      Outpatient     220575    AHS SUMMIT HOSPITAL                               464         464        17
   2007       3      Outpatient     220600    HATTIESBURG CLINIC PA                          52,320      52,320     6,767
   2007       3      Outpatient     220601    EAST JEFFERSON GENERAL HOSPITAL                11,027      11,027       113
   2007       3      Outpatient     220606    PHC-CLEVELAND, INC.                             3,227       3,227       135
   2007       3      Outpatient     220609    STATE OF MISSISSInpatientPI-UNIVERSITY OF       1,060       1,060         9



5/15/2012                                                       Milliman                                          Page 48
                Inpatient & Outpatient Facility Claims by Provider (includes freestanding dialysis services)

                       Claim       Provider                       Provider                 Allowed         Paid   Service
   Year     Region      Type      ID Number                        Name                    Charges       Claims     Units
   2007       3      Outpatient     220614    FORSYTH MEMORIAL HOSPITAL                         801         801        16
   2007       3      Outpatient     220621    ALLIANCE HEALTHCARE SYSTEM INC                    732         732        23
   2007       3      Outpatient     220630    JACKSON HMA INC                                53,668      53,668     1,846
   2007       3      Outpatient     220631    NORTH OAK REGIONAL HOSPITAL INC                   340         340        13
   2007       3      Outpatient     220636    BIO-MEDICAL APPLICATIONS OF MS, INC             4,782       4,782       754
   2007       3      Outpatient     220638    BIO-MEDICAL APPLICATIONS OF MISSISS            66,927      66,927    30,304
   2007       3      Outpatient     220644    RCG MISSISSInpatientPI INC                     73,260      73,260    22,065
   2007       3      Outpatient     220648    THE EAST ALABAMA HEALTH CARE AUTHOR               132         132         8
   2007       3      Outpatient     220682    FORREST COUNTY GENERAL HOSPITAL               499,602     499,572    15,949
   2007       3      Outpatient     220688    CLARK MEMORIAL HOSPITAL                           938         938        61
   2007       3      Outpatient     220692    PIONEER HEALTH SERVICES OF MONROE                 404         404         6
   2007       3      Outpatient     220712    SPRINGHILL MEMORIAL HOSPITALS                   2,606       2,606        73
   2007       3      Outpatient     220714    STONE COUNTY HOSITAL INC                      131,972     131,960     5,049
   2007       3      Outpatient     220734    GPCH-GP                                       324,962     324,956     6,490
   2007       3      Outpatient     220742    CHILDRENS HOSPITAL MEDICAL CENTER                 156         156         8
   2007       3      Outpatient     220780    BAY MEDICAL CENTER                                204         204         3
   2007       3      Outpatient     220800    THE CHILDREN'S HOSPITAL OF PHILADEL                32          32         2
   2007       3      Outpatient     220809    LEAKE COUNTY BOARD OF TRUSTEES                  2,119       2,119       154
   2007       3      Outpatient     220825    RENAL TREATMENT CENTERS SOUTHEAST L             3,616       3,616     2,912
   2007       3      Outpatient    1457714    NEBRASKA HEALTH SYSTEM                            106         106         4
   2007       3      Outpatient    1856853    PRINCETON BAPTIST MEDICAL CENTER                  425         425        13
   2007       3      Outpatient    2703888    MEMORIAL HERMANN HOSPITAL SYSTEM                  687         684         7
   2007       3      Outpatient    3126743    GLENWOOD REGIONAL MEDICAL CENTER                4,907       4,907        54
   2007       3      Outpatient    4125505    LAIRD HOutpatientSITAL INC                      3,105       3,105       302
   2007       3      Outpatient    4338300    EDMOND REGIONAL MEDICAL CENTER, LLC                64          64         3
   2007       3      Outpatient    4458031    COLUMBIA MEDICAL CENTER OF                        524         524        11
   2007       3      Outpatient    4581000    LOUISIANA HEART HOSPITAL LLC                    3,938       3,938        51
   2007       3      Outpatient    4605843    SACRED HEART HEALTH SYSTEM INC                    486         486        15
   2007       3      Outpatient    5330563    BRIGHAM & WOMENS HOSPITAL INC                     678         678        14
   2007       3      Outpatient    6200741    GREENE RURAL HEALTH CENTER                     21,885      21,885       750
   2007       3      Outpatient    6259761    OUR LADY OF THE LAKE ASCENSION                    131         131         4
   2007       3      Outpatient    7271739    AURORA HEALTH CARE METRO INC                    5,072       5,072       126
   2007       3      Outpatient    7279500    ST. JOSEPH'S HOSPITA, INC.                        128         128         3
   2007       3      Outpatient    8087360    MADISON HMA INC                                 2,065       2,065        58
   2007       3      Outpatient    8171261    HCA HEALTH SERVICES OF TENNESSEE IN             3,827       3,827       295
   2007       3      Outpatient    8227060    HTI MEMORIAL HOSPITAL CORPORATION                  77          77         1
   2007       3      Outpatient    8779261    BON SECOURS - ST FRANCIS MEDICAL                  156         156         3
   2007       3      Outpatient    9137000    DIALYSIS CLINIC INC                            75,245      75,245       576
   2007       3      Outpatient    9573208    GULF BREEZE HOSPITAL                              294         294        10
   2008       1       Inpatient     20003     AMORY HMA INC                                 112,384     111,384       105
   2008       1       Inpatient     20007     FORREST COUNTY GENERAL HOSPITAL                33,098      32,998        25
   2008       1       Inpatient     20010     BAPTIST MEMORIAL HOSPITAL UNION COU           493,647     490,877       355
   2008       1       Inpatient     20011     WHITFIELD MEDICAL SURGICAL HO                   6,960       6,870         9
   2008       1       Inpatient     20016     BAPTIST MEMORIAL HOSPITAL- NORTH            2,228,598   2,214,138     1,533
   2008       1       Inpatient     20020     MAGNOLIA REGIONAL HEALTH CENTER             1,936,153   1,922,463     1,513
   2008       1       Inpatient     20025     GREENWOOD LEFLORE HOSPITAL                  4,737,036   4,698,976     4,131
   2008       1       Inpatient     20026     GRENADA LAKE MEDICAL CENTER                   719,584     714,844       620
   2008       1       Inpatient     20027     MEMORIAL HOSPITAL AT GULFPORT                 116,620     115,980        89
   2008       1       Inpatient     20032     SOUTH SUNFLOWER COUNTY HOSPITAL               567,558     563,318       548
   2008       1       Inpatient     20034     ST DOMINIC JACKSON MEM                        883,370     876,350       703
   2008       1       Inpatient     20035                                                   473,002     468,842       425
   2008       1       Inpatient     20059     SINGING RIVER HOSPITAL SYSTEM                   6,000       5,960         4
   2008       1       Inpatient     20065     ST. JUDE CHILDRENS RESEARCH HOSPITA           325,758     325,748       282
   2008       1       Inpatient     20079     CLAY COUNTY MEDICAL CORPORATION                12,674      12,584        11
   2008       1       Inpatient     20081     NORTH MISSISSInpatientPI MEDICAL CENTER     6,015,313   5,978,773     4,717
   2008       1       Inpatient     20082     KINGS DAUGHTERS HOSPITAL OF YAZOO              21,035      20,825        21
   2008       1       Inpatient     20084     BAPTIST MEMORIAL HOSPITAL BOONEVILL           134,273     133,173       124
   2008       1       Inpatient     20096     PONTOTOC HEALTH SERVICES INC                   75,657      75,037        62
   2008       1       Inpatient     20111     TInpatientPAH COUNTY HOSPITAL                  95,070      94,080        99
   2008       1       Inpatient     20118     NORTH SUNFLOWER MEDICAL CENTER                 11,350      11,220        13
   2008       1       Inpatient     20124     HUMPHREYS COUNTY MEMORIAL HOSPITAL            245,620     243,270       247
   2008       1       Inpatient     20129     SHARKEY ISSAQUENA COMMUNITY HOSPITA            13,286      13,186        11
   2008       1       Inpatient     20143     BAPTIST MEMORIAL HOSPITAL DESOTO, I         2,990,346   2,971,076     2,035
   2008       1       Inpatient     20145     DELTA REGIONAL MEDICAL CENTER               3,934,583   3,902,663     3,532
   2008       1       Inpatient     20147     KILMICHAEL HOSPITAL                            72,006      71,426        75
   2008       1       Inpatient     20149     STATE OF MISSISSInpatientPI-UNIVERSITY OF   7,752,490   7,736,480     6,025
   2008       1       Inpatient     20156     TYLER HOLMES MEMORIAL HOSPITAL                244,527     241,767       281
   2008       1       Inpatient     20161                                                    42,901      42,551        37
   2008       1       Inpatient     20166     HANCOCK MEDICAL CENTER INC                     12,144      12,064         8



5/15/2012                                                        Milliman                                         Page 49
                Inpatient & Outpatient Facility Claims by Provider (includes freestanding dialysis services)

                       Claim       Provider                        Provider                 Allowed         Paid   Service
   Year     Region      Type      ID Number                         Name                    Charges       Claims     Units
   2008       1       Inpatient     20167     SIMPSON COMMUNITY HEALTHCARE INC                 4,364       4,334         5
   2008       1       Inpatient     20175     YALOBUSHA GENERAL HOSPITAL                     130,381     128,591       184
   2008       1       Inpatient     20178     WEBSTER HEALTH SERVICES INC                     19,638      19,408        23
   2008       1       Inpatient     20182     BILOXI HMA INC.                                 16,602      16,492        11
   2008       1       Inpatient     20193     JEFFERSON COUNTY HOSPITAL                       12,737      12,587        15
   2008       1       Inpatient     20213     HILLCREST HOSPITAL                               3,302       3,272         3
   2008       1       Inpatient     20219     OKTIBBEHA COUNTY HOSPITAL                       22,806      22,686        18
   2008       1       Inpatient     20223     MISSISSInpatientPI METHODIST HOSPITAL REHA     143,083     142,003       108
   2008       1       Inpatient     20229     PHYSICIANS AND SURGEONS HOSPITAL GR          2,050,682   2,024,232     2,680
   2008       1       Inpatient     20237     ALLIANCE HEALTH CENTER INC                     191,911     191,041       325
   2008       1       Inpatient     20294     COLBERT COUNTY NW ALABAMA                        7,248       7,148        10
   2008       1       Inpatient     20363     METHODIST HEALTHCARE - FAYETTE                     576         566         1
   2008       1       Inpatient     20374     BAPTIST MEMORIAL HOSPITAL                      905,409     900,379       574
   2008       1       Inpatient     20393     TISHOMINGO HEALTH SERVICES INC                 233,268     230,998       251
   2008       1       Inpatient     20395     UNIVERSITY OF ALABAMA HOSPITAL                  24,376      24,206        19
   2008       1       Inpatient     20408     COLBERT COUNTY HOSPITAL                         10,854      10,684        17
   2008       1       Inpatient     20411     UNIVERSITY OF SOUTH ALABAMA                      2,060       2,040         2
   2008       1       Inpatient     20421     SHELBY COUNTY HEALTH CARE                      373,898     372,028       208
   2008       1       Inpatient     20429     CHILDRENS HOSPITAL OF BHAM                      71,164      71,164        70
   2008       1       Inpatient     20469     METHODIST HOSPITAL - CENTRAL                 5,353,322   5,347,872     3,598
   2008       1       Inpatient     29003     BAPTIST MEMORIAL HOSPITAL                        2,907       2,907        19
   2008       1       Inpatient     29124     HUMPHREYS COUNTY MEMORIAL HOSPITAL               7,804       7,804        51
   2008       1       Inpatient     29147     KILMICHAEL HOSPITAL                              1,530       1,530        10
   2008       1       Inpatient     29150     YALOBUSHA GENERAL HOSPITAL                       2,142       2,142        14
   2008       1       Inpatient     29393     TISHOMINGO HEALTH SERVICES INC                   4,131       4,131        27
   2008       1       Inpatient     97767     ARKANSAS CHILDRENS HOSPITAL                    318,782     318,772       104
   2008       1       Inpatient     220136    BAPTIST MEMORIAL HOSPITAL                       21,917      21,737        18
   2008       1       Inpatient     220213    SAINT FRANCIS HOSPITAL                       1,573,371   1,569,221     1,147
   2008       1       Inpatient     220380    CLARKSDALE HMA INC                           2,754,909   2,733,559     2,341
   2008       1       Inpatient     220392    MISSISSInpatientPI BAPTIST MEDICAL CENTER      310,972     308,582       266
   2008       1       Inpatient     220415    SOUTHERN HEALTH CORP OF HOUSTON                  3,106       3,076         3
   2008       1       Inpatient     220417    RANKIN MEDICAL CENTER                          101,610     100,900        73
   2008       1       Inpatient     220444    DMC-MEMPHIS INC                              1,188,665   1,175,125     1,354
   2008       1       Inpatient     220448    TOURO INFIRMARY                                  4,152       4,122         3
   2008       1       Inpatient     220462    WESLEY HEALTH SYSTEMS LLC                       20,432      20,262        17
   2008       1       Inpatient     220466    ROH, INC                                        32,657      32,607        25
   2008       1       Inpatient     220467    RIVER OAKS HOSPITAL, INC.                      133,666     133,316        85
   2008       1       Inpatient     220496    BARNES JEWISH HOSPITAL                          24,253      24,063        19
   2008       1       Inpatient     220498    VANDERBILT UNIVERSITY                           47,894      47,814        45
   2008       1       Inpatient     220517    ALLIANCE HEALTHCARE SYSTEM                       1,989       1,989        13
   2008       1       Inpatient     220545    DOCTORS HOSPITAL OF AUGUSTA                     40,838      40,588        34
   2008       1       Inpatient     220571    VICKSBURG HEALTHCARE LLC                     1,188,291   1,174,081     1,438
   2008       1       Inpatient     220576    BAPTIST MEMORIAL HOSPITAL                       83,459      82,709        75
   2008       1       Inpatient     220606    PHC-CLEVELAND, INC.                          1,364,207   1,351,767     1,527
   2008       1       Inpatient     220609    STATE OF MISSISSInpatientPI-UNIVERSITY OF      150,490     149,130       141
   2008       1       Inpatient     220621    ALLIANCE HEALTHCARE SYSTEM INC                 196,494     194,694       183
   2008       1       Inpatient     220630    JACKSON HMA INC                                215,576     214,156       145
   2008       1       Inpatient     220631    NORTH OAK REGIONAL HOSPITAL INC                399,401     395,531       390
   2008       1       Inpatient     220698    BAPTIST MEMORIAL HOSPITAL FOR WOMEN             42,841      42,791        37
   2008       1       Inpatient     220809    LEAKE COUNTY BOARD OF TRUSTEES                   3,224       3,194         4
   2008       1       Inpatient     383304    GENESIS MEDICAL CENTER                          12,790      12,680        11
   2008       1       Inpatient    1084764    JACKSON MADISON COUNTY GENERAL HOSP             12,011      11,911        10
   2008       1       Inpatient    1687505    CHRISTUS SANTA ROSA HEALTHCARE                   3,039       3,039         3
   2008       1       Inpatient    2032374    DANNY JOE SPREITLER                             13,703      13,543        16
   2008       1       Inpatient    2278753    GREENWOOD SPECIALTY HOSPITAL L L C             150,347     148,627       172
   2008       1       Inpatient    2857378    STATE UNIVERSITY OF IOWA                         8,883       8,803         8
   2008       1       Inpatient    3884810    LAKEWOOD HOSPITAL ASSOCIATION                   12,420      12,320        10
   2008       1       Inpatient    5432201    TENET HEALTHSYSTEMS BARTLETT INC                 4,611       4,571         4
   2008       1       Inpatient    5854578    QUITMAN COUNTY HOSP LLC-SWING BED                1,530       1,530        10
   2008       1       Inpatient    7539272    QUITMAN COUNTY HOSPITAL, LLC                   202,997     200,027       335
   2008       1       Inpatient    8087360    MADISON HMA INC                                 62,429      62,069        45
   2008       1       Inpatient    9578253    FLORIDA HOSPITAL HEARTLAND DIVISION              6,699       6,649         5
   2008       1       Inpatient    9836844    LUTHERAN HOSPITAL                               34,107      33,837        27
   2008       1      Outpatient     20000     WALKER REGIONAL MEDICAL CENTER INC                 363         363        11
   2008       1      Outpatient     20003     AMORY HMA INC                                  123,659     123,578     5,594
   2008       1      Outpatient     20007     FORREST COUNTY GENERAL HOSPITAL                  5,072       5,066       119
   2008       1      Outpatient     20008                                                      3,248       3,248        76
   2008       1      Outpatient     20010     BAPTIST MEMORIAL HOSPITAL UNION COU            407,349     406,659    19,519
   2008       1      Outpatient     20011     WHITFIELD MEDICAL SURGICAL HO                   34,883      34,448       882



5/15/2012                                                       Milliman                                           Page 50
                Inpatient & Outpatient Facility Claims by Provider (includes freestanding dialysis services)

                      Claim        Provider                    Provider                     Allowed         Paid   Service
   Year     Region     Type       ID Number                     Name                        Charges       Claims     Units
   2008       1      Outpatient     20016     BAPTIST MEMORIAL HOSPITAL- NORTH             1,114,201   1,112,833    35,824
   2008       1      Outpatient     20020     MAGNOLIA REGIONAL HEALTH CENTER              1,683,578   1,681,781    50,328
   2008       1      Outpatient     20025     GREENWOOD LEFLORE HOSPITAL                   2,131,876   2,127,385    77,679
   2008       1      Outpatient     20026     GRENADA LAKE MEDICAL CENTER                    551,164     549,916    14,739
   2008       1      Outpatient     20027     MEMORIAL HOSPITAL AT GULFPORT                    9,181       9,169       140
   2008       1      Outpatient     20032     SOUTH SUNFLOWER COUNTY HOSPITAL                169,362     169,116     8,394
   2008       1      Outpatient     20034     ST DOMINIC JACKSON MEM                         235,599     235,362     5,408
   2008       1      Outpatient     20035                                                    181,153     180,664     6,212
   2008       1      Outpatient     20041     NOXUBEE GENERAL HOSPITAL & NOXUBEE                  29          29         2
   2008       1      Outpatient     20042     MAGEE BENEVOLENT ASSOCIATION                       875         872        92
   2008       1      Outpatient     20046     ANDERSON INFIRMARY BENEVOLENT ASSOC                601         598        23
   2008       1      Outpatient     20049     RUSH MEDICAL FOUNDATION                          3,264       3,264        56
   2008       1      Outpatient     20057     MEADOWCREST HOSPITAL LLC                           100          97         2
   2008       1      Outpatient     20059     SINGING RIVER HOSPITAL SYSTEM                    8,618       8,597       571
   2008       1      Outpatient     20065     ST. JUDE CHILDRENS RESEARCH HOSPITA            707,619     707,451    26,200
   2008       1      Outpatient     20079     CLAY COUNTY MEDICAL CORPORATION                 11,275      11,239       344
   2008       1      Outpatient     20081     NORTH MISSISSInpatientPI MEDICAL CENTER      3,946,272   3,943,350   108,713
   2008       1      Outpatient     20082     KINGS DAUGHTERS HOSPITAL OF YAZOO                4,377       4,362       156
   2008       1      Outpatient     20084     BAPTIST MEMORIAL HOSPITAL BOONEVILL            199,354     198,763     9,531
   2008       1      Outpatient     20096     PONTOTOC HEALTH SERVICES INC                   144,781     144,628     4,482
   2008       1      Outpatient     20111     TInpatientPAH COUNTY HOSPITAL                  146,795     146,327     4,848
   2008       1      Outpatient     20115     HARDY WILSON MEMORIAL HOSPITAL                     624         621         7
   2008       1      Outpatient     20116     MARION GENERAL HOSPITAL                            245         245        10
   2008       1      Outpatient     20118     NORTH SUNFLOWER MEDICAL CENTER                 140,922     140,514     4,703
   2008       1      Outpatient     20124     HUMPHREYS COUNTY MEMORIAL HOSPITAL             147,773     147,422     4,164
   2008       1      Outpatient     20129     SHARKEY ISSAQUENA COMMUNITY HOSPITA             10,495      10,450       396
   2008       1      Outpatient     20130                                                        147         147        14
   2008       1      Outpatient     20131     WAYNE GENERAL HOSPITAL                              76          76         5
   2008       1      Outpatient     20140     CLAIBORNE CO HOSPITAL                               56          56         1
   2008       1      Outpatient     20141     SOUTH CENTRAL REGIONAL MEDICAL CENT              1,540       1,540        57
   2008       1      Outpatient     20143     BAPTIST MEMORIAL HOSPITAL DESOTO, I          1,016,074   1,014,907    65,984
   2008       1      Outpatient     20145     DELTA REGIONAL MEDICAL CENTER                2,493,291   2,489,640    61,961
   2008       1      Outpatient     20147     KILMICHAEL HOSPITAL                              7,614       7,515       787
   2008       1      Outpatient     20149     STATE OF MISSISSInpatientPI-UNIVERSITY OF    3,373,995   3,371,835    38,928
   2008       1      Outpatient     20156     TYLER HOLMES MEMORIAL HOSPITAL                 137,008     136,528     4,037
   2008       1      Outpatient     20161                                                     58,159      57,670     2,576
   2008       1      Outpatient     20166     HANCOCK MEDICAL CENTER INC                       3,803       3,794       111
   2008       1      Outpatient     20167     SIMPSON COMMUNITY HEALTHCARE INC                   230         224        20
   2008       1      Outpatient     20170     SOUTH MISSISSInpatientPI REGIONAL MEDICAL          245         245         4
   2008       1      Outpatient     20175     YALOBUSHA GENERAL HOSPITAL                      43,470      43,191     1,435
   2008       1      Outpatient     20178     WEBSTER HEALTH SERVICES INC                     18,720      18,684       420
   2008       1      Outpatient     20181     NESHOBA COUNTY HOSPITAL & NURSI HOM              3,758       3,746       115
   2008       1      Outpatient     20182     BILOXI HMA INC.                                  1,354       1,354        30
   2008       1      Outpatient     20193     JEFFERSON COUNTY HOSPITAL                        1,130       1,130        36
   2008       1      Outpatient     20207     SOUTHWEST MISSISSInpatientPI REGIONAL MEDI         246         246        12
   2008       1      Outpatient     20213     HILLCREST HOSPITAL                               6,795       6,771       194
   2008       1      Outpatient     20214     H C WATKINS MEMORIAL HOSPITAL INC                   13          10         1
   2008       1      Outpatient     20219     OKTIBBEHA COUNTY HOSPITAL                       49,960      49,921     1,269
   2008       1      Outpatient     20223     MISSISSInpatientPI METHODIST HOSPITAL REHA      11,155      11,116       441
   2008       1      Outpatient     20229     PHYSICIANS AND SURGEONS HOSPITAL GR            488,093     487,520     8,161
   2008       1      Outpatient     20256     STATE OF MISSISSInpatientPI UNIVERSITY OF       52,476      52,476    10,218
   2008       1      Outpatient     20290     GEORGE COUNTY HOSPITAL                              21          21         1
   2008       1      Outpatient     20294     COLBERT COUNTY NW ALABAMA                          843         840        24
   2008       1      Outpatient     20302     CHILDRENS HOSP                                      30          30         2
   2008       1      Outpatient     20338     HATTIESBURG CLINIC PA                              111         111         1
   2008       1      Outpatient     20363     METHODIST HEALTHCARE - FAYETTE                   1,381       1,372        22
   2008       1      Outpatient     20374     BAPTIST MEMORIAL HOSPITAL                      202,902     202,803     4,668
   2008       1      Outpatient     20393     TISHOMINGO HEALTH SERVICES INC                 186,927     186,558     6,167
   2008       1      Outpatient     20395     UNIVERSITY OF ALABAMA HOSPITAL                   3,022       2,989       163
   2008       1      Outpatient     20398     REGIONAL MEDICAL CENTER BOARD                       94          94         1
   2008       1      Outpatient     20408     COLBERT COUNTY HOSPITAL                         14,050      13,966       362
   2008       1      Outpatient     20410     ELIZA COFFEE MEM HOS                               139         139         4
   2008       1      Outpatient     20411     UNIVERSITY OF SOUTH ALABAMA                        127         127         6
   2008       1      Outpatient     20420     THE HEALTH CARE AUTHORITY OF THE CI                177         177         5
   2008       1      Outpatient     20421     SHELBY COUNTY HEALTH CARE                      169,846     169,573     5,626
   2008       1      Outpatient     20429     CHILDRENS HOSPITAL OF BHAM                       6,742       6,742       318
   2008       1      Outpatient     20433     OUR LADY OF THE LAKE HOSPITAL                      212         209        14
   2008       1      Outpatient     20441     BATON ROUGE GEN HOSP                               102          99         5
   2008       1      Outpatient     20461     ALTON OCHSNER MEDICAL FOUNDATION                    50          47         1



5/15/2012                                                        Milliman                                          Page 51
                Inpatient & Outpatient Facility Claims by Provider (includes freestanding dialysis services)

                      Claim        Provider                        Provider                Allowed         Paid   Service
   Year     Region     Type       ID Number                         Name                   Charges       Claims     Units
   2008       1      Outpatient     20469     METHODIST HOSPITAL - CENTRAL                  704,342     704,108    30,647
   2008       1      Outpatient     95136     PHILLInpatientS HOSPITAL CORPORATION            1,568       1,568        18
   2008       1      Outpatient     95142     INGALLS MEMORIAL HOSPITAL                         682         682        16
   2008       1      Outpatient     95306     NORTHSHORE REG MED CENTER                         417         417         7
   2008       1      Outpatient     95919     ST JOHNS HOSPITAL                                 200         200         2
   2008       1      Outpatient     96283     TRUMAN MEDICAL CENTER INCORPORATED                 58          55         3
   2008       1      Outpatient     96897     PUBLIC HOSPITAL DISTRICT 1 OF KING                509         506         4
   2008       1      Outpatient     97747     DUKE UNIVERSITY HEALTH                            202         202         6
   2008       1      Outpatient     97767     ARKANSAS CHILDRENS HOSPITAL                    30,894      30,894       828
   2008       1      Outpatient     220026    LESTER E COX MEDICAL CENTER                       281         281         2
   2008       1      Outpatient     220082    BIO-MEDICALAPPLICATIONS OF MS, INC.             1,739       1,739       581
   2008       1      Outpatient     220136    BAPTIST MEMORIAL HOSPITAL                      40,034      40,004     1,197
   2008       1      Outpatient     220144    MORTON MEDICAL CENTER INC                         221         221        10
   2008       1      Outpatient     220159    NATCHEZ COMMUNITY HOSPITAL, INC.                  249         249         8
   2008       1      Outpatient     220213    SAINT FRANCIS HOSPITAL                         50,267      50,234     1,913
   2008       1      Outpatient     220230    NEWTON HOSPITAL, INC                               18          15         1
   2008       1      Outpatient     220243    WINSTON MEDICAL CENTER                          7,698       7,692       192
   2008       1      Outpatient     220279    UNIVERSITY HEALTHCARE SYSTEM                       62          59         3
   2008       1      Outpatient     220297    PEARL RIVER HOSPITAL                               21          21         4
   2008       1      Outpatient     220324    INDEPENDENT HEALTHCARE MANAGEMENT                 576         576        14
   2008       1      Outpatient     220350    RCG MISSISSInpatientPI INC                    342,863     342,863   171,446
   2008       1      Outpatient     220355    NATIONAL RENAL INSTITUTES INC                   2,386       2,386       605
   2008       1      Outpatient     220357    RCG MISSISSInpatientPI INC                    445,497     445,497    89,060
   2008       1      Outpatient     220358    RCG MISSISSInpatientPI INC.                   236,532     236,532    86,613
   2008       1      Outpatient     220362    RCG DBA KIDNEY CARE /MERIDIAN                  11,207      11,207     3,192
   2008       1      Outpatient     220364    NATIONAL RENAL INSTITUTES INC                 155,718     155,718    26,708
   2008       1      Outpatient     220365    NATIONAL RENAL INSTITUTES INC                   1,912       1,912        56
   2008       1      Outpatient     220366    RCG MISSISSInpatientPI INC                    200,098     200,098    59,381
   2008       1      Outpatient     220367    RCG MISSISSInpatientPI,INC                     50,456      50,456    12,244
   2008       1      Outpatient     220368    RCG MISSISSInpatientPI INC                    257,936     257,936   139,638
   2008       1      Outpatient     220372    BIO-MEDICAL APPLICATIONS OF MS, INC            69,798      69,798    36,484
   2008       1      Outpatient     220380    CLARKSDALE HMA INC                            817,129     815,011    43,676
   2008       1      Outpatient     220392    MISSISSInpatientPI BAPTIST MEDICAL CENTER     213,476     213,185     1,363
   2008       1      Outpatient     220412    ADVENTIST HEALTH SYSTEM-SUNBELT INC               377         374         8
   2008       1      Outpatient     220413    BIO-MEDICAL APPLICATIONS OF                    31,302      31,302    18,747
   2008       1      Outpatient     220415    SOUTHERN HEALTH CORP OF HOUSTON                 6,385       6,370       237
   2008       1      Outpatient     220417    RANKIN MEDICAL CENTER                          28,980      28,965       739
   2008       1      Outpatient     220419    MID-DELTA KIDNEY CENTER INC                    15,746      15,746     9,764
   2008       1      Outpatient     220441    PRENTISS REGIONAL HOSPITAL AND EXTE             2,848       2,842        46
   2008       1      Outpatient     220444    DMC-MEMPHIS INC                               216,379     216,355     1,387
   2008       1      Outpatient     220462    WESLEY HEALTH SYSTEMS LLC                         684         681         9
   2008       1      Outpatient     220466    ROH, INC                                       18,091      18,076       543
   2008       1      Outpatient     220467    RIVER OAKS HOSPITAL, INC.                      17,156      17,147       841
   2008       1      Outpatient     220495    MERIDIAN HMA INC                                3,906       3,897       195
   2008       1      Outpatient     220496    BARNES JEWISH HOSPITAL                         22,889      22,811       453
   2008       1      Outpatient     220498    VANDERBILT UNIVERSITY                          27,189      27,183       382
   2008       1      Outpatient     220512    JACKSON HOSPITAL & CLINIC INC                     909         909        27
   2008       1      Outpatient     220521    RCG SOUTHAVEN LLC                             209,479     209,479    72,454
   2008       1      Outpatient     220526    RCG OF MAYERSVILLE LLC                          1,037       1,037       374
   2008       1      Outpatient     220571    VICKSBURG HEALTHCARE LLC                       15,272      15,263       360
   2008       1      Outpatient     220576    BAPTIST MEMORIAL HOSPITAL                      56,230      56,152     2,774
   2008       1      Outpatient     220604    DVA RENAL HEALTHCARE INC                       18,030      18,030     3,068
   2008       1      Outpatient     220606    PHC-CLEVELAND, INC.                         1,009,509   1,007,691    25,645
   2008       1      Outpatient     220609    STATE OF MISSISSInpatientPI-UNIVERSITY OF     373,542     372,915     9,628
   2008       1      Outpatient     220621    ALLIANCE HEALTHCARE SYSTEM INC                161,976     161,298     4,920
   2008       1      Outpatient     220630    JACKSON HMA INC                               116,510     116,456     2,463
   2008       1      Outpatient     220631    NORTH OAK REGIONAL HOSPITAL INC               153,409     153,322     7,008
   2008       1      Outpatient     220632    BIO-MEDICAL APPLICATIONS OF MS, INC             1,060       1,060       628
   2008       1      Outpatient     220682    FORREST COUNTY GENERAL HOSPITAL                   328         328        15
   2008       1      Outpatient     220692    PIONEER HEALTH SERVICES OF MONROE               3,094       3,088        42
   2008       1      Outpatient     220698    BAPTIST MEMORIAL HOSPITAL FOR WOMEN             4,504       4,504       130
   2008       1      Outpatient     220708    CAMERON REGIONAL MEDICAL CENTER INC               154         151         2
   2008       1      Outpatient     220714    STONE COUNTY HOSITAL INC                          780         780        13
   2008       1      Outpatient     220722    RCG MISSISSInpatientPI INC                     23,164      23,164     5,548
   2008       1      Outpatient     220734    GPCH-GP                                           366         366        20
   2008       1      Outpatient     220771    RENAL CARE GROUP TUPELO LLC                     6,997       6,997     2,615
   2008       1      Outpatient     220772    RENAL CARE GROUP TUPELO LLC                    56,954      56,954    24,406
   2008       1      Outpatient     220773    RENAL CARE GROUP TUPELO LLC                   174,613     174,613    81,679
   2008       1      Outpatient     220774    RENAL CARE TUPELO LLC                          58,991      58,991    30,768



5/15/2012                                                       Milliman                                          Page 52
                Inpatient & Outpatient Facility Claims by Provider (includes freestanding dialysis services)

                       Claim       Provider                       Provider                  Allowed          Paid   Service
   Year     Region      Type      ID Number                        Name                     Charges        Claims     Units
   2008       1      Outpatient     220775    RENAL CARE GROUP TUPELO LLC                     73,396       73,396    34,220
   2008       1      Outpatient     220776    RENAL CARE GROUP TUPELO LLC                     27,919       27,919    16,173
   2008       1      Outpatient     220777    RENAL CARE GROUP TUPELO LLC                    136,309      136,309    52,195
   2008       1      Outpatient     220778    CANDLER GENERAL HOSPITAL INCORPORAT                325          325         4
   2008       1      Outpatient     220800    THE CHILDREN'S HOSPITAL OF PHILADEL                130          130         4
   2008       1      Outpatient     220809    LEAKE COUNTY BOARD OF TRUSTEES                   5,341        5,311       241
   2008       1      Outpatient     220826    RCG TUNICA LLC                                 130,822      130,822    31,977
   2008       1      Outpatient    1084764    JACKSON MADISON COUNTY GENERAL HOSP              3,867        3,867       177
   2008       1      Outpatient    1382390    CHILDRENS MEMORIAL HOSPITAL                        126          123         6
   2008       1      Outpatient    1457714    NEBRASKA HEALTH SYSTEM                             129          129         6
   2008       1      Outpatient    1634718    CHRISTIAN HOSPITAL NORTHEAST NORTHW                645          645         8
   2008       1      Outpatient    2032374    DANNY JOE SPREITLER                              7,891        7,870       313
   2008       1      Outpatient    2083023    NORTHWEST MEDICAL CENTER-WINFIELD L                193          193         5
   2008       1      Outpatient    3024049    NORTHCREST MEDICAL CENTER                          963          963        24
   2008       1      Outpatient    3273578    BIO-MEDICAL APPLICATIONS OF MISS                12,992       12,992     3,596
   2008       1      Outpatient    3884810    LAKEWOOD HOSPITAL ASSOCIATION                      167          167         2
   2008       1      Outpatient    4058762    DEMING HOSPITAL CORPORATION                        407          407         5
   2008       1      Outpatient    4125505    LAIRD HOutpatientSITAL INC                         137          134         5
   2008       1      Outpatient    4128826    THE MEDICAL CENTER OF CENTRAL GEORG              2,524        2,524       114
   2008       1      Outpatient    4458031    COLUMBIA MEDICAL CENTER OF                         275          275         4
   2008       1      Outpatient    4935056    EHCA CARTERSVILLE LLC                               67           64         1
   2008       1      Outpatient    5432201    TENET HEALTHSYSTEMS BARTLETT INC                 1,365        1,362        14
   2008       1      Outpatient    5558865    PROVENA HOSPITALS                                1,649        1,646        24
   2008       1      Outpatient    5636023    TOTAL RENAL CARE INC                             2,295        2,295       906
   2008       1      Outpatient    7386784    BOLIVAR GENERAL HOSPITAL INC                       781          778        13
   2008       1      Outpatient    7539272    QUITMAN COUNTY HOSPITAL, LLC                   133,485      133,137     2,764
   2008       1      Outpatient    7771013    MCNAIRY HOSPITAL CORPORATION                     5,006        5,003        65
   2008       1      Outpatient    7781502    VALLEY HOSPITAL MED CTR                            488          485         8
   2008       1      Outpatient    8087360    MADISON HMA INC                                 66,468       66,381     3,008
   2008       1      Outpatient    8408322    GIBSON GENERAL HOSPITAL                            244          244         4
   2008       1      Outpatient    8430040    BANNER ESTRELLA MEDICAL CENTER                     230          227         1
   2008       1      Outpatient    9121737    MINIDOKA MEMORIAL HOSPITAL                          52           49         1
   2008       1      Outpatient    9272727    MARY IMMACULATE HOSPITAL                           914          911        34
   2008       1      Outpatient    9573208    GULF BREEZE HOSPITAL                               219          219         4
   2008       1      Outpatient    9836844    LUTHERAN HOSPITAL                                4,972        4,951        44
   2008       2       Inpatient     20003     AMORY HMA INC                                  535,897      532,197       429
   2008       2       Inpatient     20007     FORREST COUNTY GENERAL HOSPITAL              1,158,747    1,153,337       870
   2008       2       Inpatient     20008                                                    100,073       99,653        68
   2008       2       Inpatient     20010     BAPTIST MEMORIAL HOSPITAL UNION COU              4,219        4,189         3
   2008       2       Inpatient     20011     WHITFIELD MEDICAL SURGICAL HO                   10,678       10,558        14
   2008       2       Inpatient     20016     BAPTIST MEMORIAL HOSPITAL- NORTH               279,598      277,728       192
   2008       2       Inpatient     20020     MAGNOLIA REGIONAL HEALTH CENTER                  8,865        8,815         7
   2008       2       Inpatient     20025     GREENWOOD LEFLORE HOSPITAL                      26,406       26,176        23
   2008       2       Inpatient     20026     GRENADA LAKE MEDICAL CENTER                     31,326       31,106        26
   2008       2       Inpatient     20027     MEMORIAL HOSPITAL AT GULFPORT                  161,949      161,699       134
   2008       2       Inpatient     20034     ST DOMINIC JACKSON MEM                       5,935,967    5,892,667     4,725
   2008       2       Inpatient     20035                                                     82,740       82,290        74
   2008       2       Inpatient     20041     NOXUBEE GENERAL HOSPITAL & NOXUBEE             207,427      205,717       172
   2008       2       Inpatient     20042     MAGEE BENEVOLENT ASSOCIATION                   266,566      263,756       300
   2008       2       Inpatient     20046     ANDERSON INFIRMARY BENEVOLENT ASSOC          1,961,149    1,946,869     1,471
   2008       2       Inpatient     20049     RUSH MEDICAL FOUNDATION                      1,983,638    1,971,288     1,443
   2008       2       Inpatient     20059     SINGING RIVER HOSPITAL SYSTEM                  109,573      108,843        73
   2008       2       Inpatient     20065     ST. JUDE CHILDRENS RESEARCH HOSPITA             86,974       86,754        75
   2008       2       Inpatient     20079     CLAY COUNTY MEDICAL CORPORATION                462,877      459,687       403
   2008       2       Inpatient     20081     NORTH MISSISSInpatientPI MEDICAL CENTER      3,125,931    3,111,431     2,408
   2008       2       Inpatient     20082     KINGS DAUGHTERS HOSPITAL OF YAZOO              246,568      244,348       245
   2008       2       Inpatient     20096     PONTOTOC HEALTH SERVICES INC                    19,565       19,405        16
   2008       2       Inpatient     20115     HARDY WILSON MEMORIAL HOSPITAL                 163,162      161,512       171
   2008       2       Inpatient     20124     HUMPHREYS COUNTY MEMORIAL HOSPITAL               9,894        9,794        10
   2008       2       Inpatient     20129     SHARKEY ISSAQUENA COMMUNITY HOSPITA             91,067       90,347        75
   2008       2       Inpatient     20131     WAYNE GENERAL HOSPITAL                          27,282       27,002        30
   2008       2       Inpatient     20133     COVINGTON COUNTY HOSPITAL                       12,932       12,782        15
   2008       2       Inpatient     20140     CLAIBORNE CO HOSPITAL                          128,272      126,902       140
   2008       2       Inpatient     20141     SOUTH CENTRAL REGIONAL MEDICAL CENT            433,030      429,560       406
   2008       2       Inpatient     20145     DELTA REGIONAL MEDICAL CENTER                  182,522      180,982       164
   2008       2       Inpatient     20147     KILMICHAEL HOSPITAL                              6,752        6,752         7
   2008       2       Inpatient     20149     STATE OF MISSISSInpatientPI-UNIVERSITY OF   20,267,539   20,217,539    15,787
   2008       2       Inpatient     20166     HANCOCK MEDICAL CENTER INC                      13,772       13,682         9
   2008       2       Inpatient     20167     SIMPSON COMMUNITY HEALTHCARE INC               170,116      168,336       197



5/15/2012                                                        Milliman                                           Page 53
                Inpatient & Outpatient Facility Claims by Provider (includes freestanding dialysis services)

                      Claim       Provider                        Provider                 Allowed         Paid   Service
   Year     Region     Type      ID Number                         Name                    Charges       Claims     Units
   2008       2      Inpatient     20172     NATCHEZ REGIONAL MEDICAL CENTER                 11,716      11,636         8
   2008       2      Inpatient     20177     JASPER GENERAL HOSPITAL                          3,837       3,787         5
   2008       2      Inpatient     20178     WEBSTER HEALTH SERVICES INC                    255,540     252,740       286
   2008       2      Inpatient     20181     NESHOBA COUNTY HOSPITAL & NURSI HOM            291,569     287,759       415
   2008       2      Inpatient     20182     BILOXI HMA INC.                                 34,712      34,482        23
   2008       2      Inpatient     20193     JEFFERSON COUNTY HOSPITAL                      354,859     350,669       419
   2008       2      Inpatient     20207     SOUTHWEST MISSISSInpatientPI REGIONAL MEDI      20,435      20,275        16
   2008       2      Inpatient     20213     HILLCREST HOSPITAL                              51,415      50,955        47
   2008       2      Inpatient     20214     H C WATKINS MEMORIAL HOSPITAL INC              160,027     158,377       167
   2008       2      Inpatient     20219     OKTIBBEHA COUNTY HOSPITAL                      516,879     514,139       409
   2008       2      Inpatient     20223     MISSISSInpatientPI METHODIST HOSPITAL REHA     381,517     379,247       297
   2008       2      Inpatient     20226     GULFCOAST COMMUNITY HOSPITAL                    20,760      20,610        15
   2008       2      Inpatient     20229     PHYSICIANS AND SURGEONS HOSPITAL GR            547,391     540,201       719
   2008       2      Inpatient     20230     MISSISSInpatientPI BAND OF CHOCTAW INDIANS       3,452       3,452         2
   2008       2      Inpatient     20237     ALLIANCE HEALTH CENTER INC                   3,424,520   3,396,060     5,874
   2008       2      Inpatient     20290     GEORGE COUNTY HOSPITAL                           4,678       4,638         4
   2008       2      Inpatient     20302     CHILDRENS HOSP                                  19,644      19,644        16
   2008       2      Inpatient     20374     BAPTIST MEMORIAL HOSPITAL                           10           0         1
   2008       2      Inpatient     20395     UNIVERSITY OF ALABAMA HOSPITAL                 311,611     311,091       116
   2008       2      Inpatient     20414     DCH REGIONAL MEDICAL CENTER                      3,223       3,193         3
   2008       2      Inpatient     20426     EYE FOUNDATION HOSPITAL INC                      2,066       2,046         2
   2008       2      Inpatient     20429     CHILDRENS HOSPITAL OF BHAM                     306,682     306,652       244
   2008       2      Inpatient     20433     OUR LADY OF THE LAKE HOSPITAL                      873         863         1
   2008       2      Inpatient     20441     BATON ROUGE GEN HOSP                             2,221       2,201         2
   2008       2      Inpatient     20469     METHODIST HOSPITAL - CENTRAL                   426,062     425,912       285
   2008       2      Inpatient     29005     H C WATKINS MEMORIAL HOSPITAL SWBD               6,120       6,120        40
   2008       2      Inpatient     29115     HARDY WILSON MEMORIAL HOSPITAL                   3,213       3,213        21
   2008       2      Inpatient     29178     WEBSTER HEALTH SERVICES INC                      2,142       2,142        14
   2008       2      Inpatient     95289     ST LUKES EPISCOutpatientAL HOSP                 26,942      26,732        21
   2008       2      Inpatient     96517     BAYLOR MEDICAL CENTER AT GARLAND                 1,283       1,273         1
   2008       2      Inpatient     97026     YORK HOSPITAL                                    2,566       2,546         2
   2008       2      Inpatient     97459     CREIGHTON S T JOSEPH REGIONAL                    2,221       2,201         2
   2008       2      Inpatient     97684     TEXAS CHILDREN'S HOSPITAL                       13,325      13,325        12
   2008       2      Inpatient     97767     ARKANSAS CHILDRENS HOSPITAL                    181,274     181,274        68
   2008       2      Inpatient     98401     SOUTH BALDWIN HOSP                                 822         822         1
   2008       2      Inpatient     220136    BAPTIST MEMORIAL HOSPITAL                    2,784,677   2,765,527     2,267
   2008       2      Inpatient     220144    MORTON MEDICAL CENTER INC                      193,959     192,239       222
   2008       2      Inpatient     220159    NATCHEZ COMMUNITY HOSPITAL, INC.                 9,557       9,517         8
   2008       2      Inpatient     220213    SAINT FRANCIS HOSPITAL                         144,210     143,920       102
   2008       2      Inpatient     220230    NEWTON HOSPITAL, INC                           105,279     104,289       142
   2008       2      Inpatient     220243    WINSTON MEDICAL CENTER                          75,637      74,817        84
   2008       2      Inpatient     220250    WINSTON MEDICAL CENTER                           1,989       1,989        13
   2008       2      Inpatient     220324    INDEPENDENT HEALTHCARE MANAGEMENT              173,117     170,937       227
   2008       2      Inpatient     220380    CLARKSDALE HMA INC                              32,420      32,170        28
   2008       2      Inpatient     220392    MISSISSInpatientPI BAPTIST MEDICAL CENTER    3,352,452   3,330,212     2,832
   2008       2      Inpatient     220415    SOUTHERN HEALTH CORP OF HOUSTON                220,353     218,163       219
   2008       2      Inpatient     220417    RANKIN MEDICAL CENTER                          940,776     934,676       680
   2008       2      Inpatient     220428    WOMANS HOSPITAL FOUNDATION                       2,780       2,750         3
   2008       2      Inpatient     220441    PRENTISS REGIONAL HOSPITAL AND EXTE                791         781         1
   2008       2      Inpatient     220444    DMC-MEMPHIS INC                                 28,287      27,967        32
   2008       2      Inpatient     220448    TOURO INFIRMARY                                  5,183       5,143         4
   2008       2      Inpatient     220450    ADVOCATE HEALTH AND HOSPITALS CORPO              9,302       9,222         8
   2008       2      Inpatient     220462    WESLEY HEALTH SYSTEMS LLC                       40,596      40,326        34
   2008       2      Inpatient     220466    ROH, INC                                       114,907     114,657        95
   2008       2      Inpatient     220467    RIVER OAKS HOSPITAL, INC.                    1,384,801   1,379,911     1,005
   2008       2      Inpatient     220487    PROVIDENCE HOSPITAL                              3,431       3,401         3
   2008       2      Inpatient     220495    MERIDIAN HMA INC                             1,259,647   1,250,567       974
   2008       2      Inpatient     220498    VANDERBILT UNIVERSITY                           15,615      15,615        13
   2008       2      Inpatient     220522    JEFFERSON PARISH HOSPITAL SERVICE                4,596       4,546         5
   2008       2      Inpatient     220545    DOCTORS HOSPITAL OF AUGUSTA                      2,402       2,382         2
   2008       2      Inpatient     220571    VICKSBURG HEALTHCARE LLC                     4,033,858   3,989,838     4,938
   2008       2      Inpatient     220606    PHC-CLEVELAND, INC.                              2,716       2,686         3
   2008       2      Inpatient     220609    STATE OF MISSISSInpatientPI-UNIVERSITY OF        3,230       3,230         3
   2008       2      Inpatient     220630    JACKSON HMA INC                              5,171,576   5,140,716     3,484
   2008       2      Inpatient     220692    PIONEER HEALTH SERVICES OF MONROE               42,795      42,475        35
   2008       2      Inpatient     220734    GPCH-GP                                         22,418      22,298        12
   2008       2      Inpatient     220793    LAIRD HOSPITAL INC                               5,355       5,355        35
   2008       2      Inpatient     220800    THE CHILDREN'S HOSPITAL OF PHILADEL            192,570     192,570        96
   2008       2      Inpatient     220808    LEAKE COUNTY BOARD OF TRUSTEES                     612         612         4



5/15/2012                                                      Milliman                                           Page 54
                Inpatient & Outpatient Facility Claims by Provider (includes freestanding dialysis services)

                       Claim       Provider                       Provider                   Allowed          Paid   Service
   Year     Region      Type      ID Number                        Name                      Charges        Claims     Units
   2008       2       Inpatient     220809    LEAKE COUNTY BOARD OF TRUSTEES                   50,268       49,688        63
   2008       2       Inpatient    1457714    NEBRASKA HEALTH SYSTEM                           38,488       38,488        30
   2008       2       Inpatient    2032374    DANNY JOE SPREITLER                              88,193       87,183       103
   2008       2       Inpatient    2034566    MADISON COUNTY HOSPITAL                          12,088       12,088        79
   2008       2       Inpatient    2857378    STATE UNIVERSITY OF IOWA                          5,552        5,502         5
   2008       2       Inpatient    4125505    LAIRD HOutpatientSITAL INC                      134,181      132,921       157
   2008       2       Inpatient    4581000    LOUISIANA HEART HOSPITAL LLC                        698          688         1
   2008       2       Inpatient    4952335    SENTARA HOSPITALS                                 7,704        7,634         7
   2008       2       Inpatient    6854080    DANNY JOE SPREITLER                               1,683        1,683        11
   2008       2       Inpatient    7176518    REGENCY HOSPITAL COMPANY OF MERIDIA               1,038        1,028         1
   2008       2       Inpatient    8087360    MADISON HMA INC                                 878,694      873,174       637
   2008       2      Outpatient     20003     AMORY HMA INC                                   263,438      263,210    11,119
   2008       2      Outpatient     20007     FORREST COUNTY GENERAL HOSPITAL                 165,466      165,403     4,450
   2008       2      Outpatient     20008                                                      90,040       89,947     2,691
   2008       2      Outpatient     20010     BAPTIST MEMORIAL HOSPITAL UNION COU               9,460        9,451       473
   2008       2      Outpatient     20011     WHITFIELD MEDICAL SURGICAL HO                    42,623       41,756     1,776
   2008       2      Outpatient     20012     FIELD MEMORIAL COMMUNITY HOSPITAL                   740          740        22
   2008       2      Outpatient     20016     BAPTIST MEMORIAL HOSPITAL- NORTH                149,253      149,154     3,576
   2008       2      Outpatient     20020     MAGNOLIA REGIONAL HEALTH CENTER                   4,118        4,118       198
   2008       2      Outpatient     20025     GREENWOOD LEFLORE HOSPITAL                       70,587       70,503     2,204
   2008       2      Outpatient     20026     GRENADA LAKE MEDICAL CENTER                      21,904       21,865       544
   2008       2      Outpatient     20027     MEMORIAL HOSPITAL AT GULFPORT                    10,817       10,796       591
   2008       2      Outpatient     20032     SOUTH SUNFLOWER COUNTY HOSPITAL                     994          994        19
   2008       2      Outpatient     20034     ST DOMINIC JACKSON MEM                        1,542,452    1,539,950    42,207
   2008       2      Outpatient     20035                                                      18,089       18,035       576
   2008       2      Outpatient     20041     NOXUBEE GENERAL HOSPITAL & NOXUBEE              161,557      160,330     6,926
   2008       2      Outpatient     20042     MAGEE BENEVOLENT ASSOCIATION                    202,046      201,374     8,907
   2008       2      Outpatient     20046     ANDERSON INFIRMARY BENEVOLENT ASSOC             960,775      959,554    12,599
   2008       2      Outpatient     20049     RUSH MEDICAL FOUNDATION                         960,489      958,683    39,955
   2008       2      Outpatient     20059     SINGING RIVER HOSPITAL SYSTEM                    10,366       10,354       413
   2008       2      Outpatient     20060     BRYAN W WHITFIELD MEM HOSP                          220          220         8
   2008       2      Outpatient     20065     ST. JUDE CHILDRENS RESEARCH HOSPITA             256,048      256,030    10,862
   2008       2      Outpatient     20079     CLAY COUNTY MEDICAL CORPORATION                 397,819      396,895     9,092
   2008       2      Outpatient     20081     NORTH MISSISSInpatientPI MEDICAL CENTER       1,454,375    1,453,535    44,534
   2008       2      Outpatient     20082     KINGS DAUGHTERS HOSPITAL OF YAZOO               236,681      236,087     6,191
   2008       2      Outpatient     20096     PONTOTOC HEALTH SERVICES INC                     18,723       18,708       620
   2008       2      Outpatient     20111     TInpatientPAH COUNTY HOSPITAL                       137          134         2
   2008       2      Outpatient     20115     HARDY WILSON MEMORIAL HOSPITAL                  355,090      354,397     4,901
   2008       2      Outpatient     20116     MARION GENERAL HOSPITAL                           2,779        2,767        76
   2008       2      Outpatient     20118     NORTH SUNFLOWER MEDICAL CENTER                      658          658        23
   2008       2      Outpatient     20124     HUMPHREYS COUNTY MEMORIAL HOSPITAL                5,117        5,105       214
   2008       2      Outpatient     20129     SHARKEY ISSAQUENA COMMUNITY HOSPITA              68,846       68,618     2,366
   2008       2      Outpatient     20130                                                          74           74         9
   2008       2      Outpatient     20131     WAYNE GENERAL HOSPITAL                           12,727       12,676       772
   2008       2      Outpatient     20133     COVINGTON COUNTY HOSPITAL                        22,730       22,646       776
   2008       2      Outpatient     20140     CLAIBORNE CO HOSPITAL                           121,006      120,577     4,024
   2008       2      Outpatient     20141     SOUTH CENTRAL REGIONAL MEDICAL CENT             251,131      250,642     6,532
   2008       2      Outpatient     20143     BAPTIST MEMORIAL HOSPITAL DESOTO, I               1,515        1,515       190
   2008       2      Outpatient     20145     DELTA REGIONAL MEDICAL CENTER                    89,468       89,417     1,537
   2008       2      Outpatient     20147     KILMICHAEL HOSPITAL                                 727          718        72
   2008       2      Outpatient     20149     STATE OF MISSISSInpatientPI-UNIVERSITY OF    11,565,201   11,553,504   164,921
   2008       2      Outpatient     20156     TYLER HOLMES MEMORIAL HOSPITAL                   12,895       12,856       386
   2008       2      Outpatient     20166     HANCOCK MEDICAL CENTER INC                        5,886        5,877       189
   2008       2      Outpatient     20167     SIMPSON COMMUNITY HEALTHCARE INC                 89,442       89,013     4,740
   2008       2      Outpatient     20170     SOUTH MISSISSInpatientPI REGIONAL MEDICAL         1,873        1,858        45
   2008       2      Outpatient     20172     NATCHEZ REGIONAL MEDICAL CENTER                   6,867        6,864       247
   2008       2      Outpatient     20175     YALOBUSHA GENERAL HOSPITAL                           58           58         4
   2008       2      Outpatient     20177     JASPER GENERAL HOSPITAL                           8,116        8,038       614
   2008       2      Outpatient     20178     WEBSTER HEALTH SERVICES INC                     171,297      170,823     5,040
   2008       2      Outpatient     20181     NESHOBA COUNTY HOSPITAL & NURSI HOM             398,275      397,474    12,994
   2008       2      Outpatient     20182     BILOXI HMA INC.                                   5,965        5,938       197
   2008       2      Outpatient     20186     LIFEMARK HOSPITALS OF LOUISIANA INC                  57           54         1
   2008       2      Outpatient     20191     PERRY COUNTY GENERAL HOSPITAL                        38           38         3
   2008       2      Outpatient     20193     JEFFERSON COUNTY HOSPITAL                           578          572        16
   2008       2      Outpatient     20207     SOUTHWEST MISSISSInpatientPI REGIONAL MEDI       17,662       17,653       758
   2008       2      Outpatient     20208     WALTHALL COUNTY GENERAL HOSPITAL                    348          348         3
   2008       2      Outpatient     20213     HILLCREST HOSPITAL                               80,754       80,439     2,297
   2008       2      Outpatient     20214     H C WATKINS MEMORIAL HOSPITAL INC               106,171      105,829     2,977
   2008       2      Outpatient     20219     OKTIBBEHA COUNTY HOSPITAL                       904,672      903,310    30,977



5/15/2012                                                       Milliman                                             Page 55
                Inpatient & Outpatient Facility Claims by Provider (includes freestanding dialysis services)

                      Claim        Provider                        Provider                 Allowed         Paid   Service
   Year     Region     Type       ID Number                         Name                    Charges       Claims     Units
   2008       2      Outpatient     20223     MISSISSInpatientPI METHODIST HOSPITAL REHA      70,777      70,654     1,906
   2008       2      Outpatient     20226     GULFCOAST COMMUNITY HOSPITAL                       867         867        39
   2008       2      Outpatient     20229     PHYSICIANS AND SURGEONS HOSPITAL GR             44,044      44,035       182
   2008       2      Outpatient     20230     MISSISSInpatientPI BAND OF CHOCTAW INDIANS     775,295     775,295     3,032
   2008       2      Outpatient     20238     ERLANGER MEDICAL CENTER DEWAIN HILD                107         107         1
   2008       2      Outpatient     20256     STATE OF MISSISSInpatientPI UNIVERSITY OF      539,616     539,616   150,267
   2008       2      Outpatient     20290     GEORGE COUNTY HOSPITAL                           1,594       1,573        94
   2008       2      Outpatient     20302     CHILDRENS HOSP                                   4,449       4,449        48
   2008       2      Outpatient     20330     MEDICAL CENTER OF LOUISISANA AT NEW              1,261       1,252       144
   2008       2      Outpatient     20337     HATTIESBURG CLINIC, PA                          17,687      17,687     2,156
   2008       2      Outpatient     20338     HATTIESBURG CLINIC PA                              359         359        10
   2008       2      Outpatient     20364     HOSPITAL SERVICE DISTRICT NO 1                     738         738        24
   2008       2      Outpatient     20374     BAPTIST MEMORIAL HOSPITAL                        2,933       2,930        53
   2008       2      Outpatient     20393     TISHOMINGO HEALTH SERVICES INC                     665         665        19
   2008       2      Outpatient     20395     UNIVERSITY OF ALABAMA HOSPITAL                  20,622      20,502       659
   2008       2      Outpatient     20408     COLBERT COUNTY HOSPITAL                            106         106         1
   2008       2      Outpatient     20411     UNIVERSITY OF SOUTH ALABAMA                        374         371        16
   2008       2      Outpatient     20414     DCH REGIONAL MEDICAL CENTER                      2,542       2,533        59
   2008       2      Outpatient     20420     THE HEALTH CARE AUTHORITY OF THE CI                 81          78         7
   2008       2      Outpatient     20421     SHELBY COUNTY HEALTH CARE                        1,344       1,338        24
   2008       2      Outpatient     20424     SLIDELL MEMORIAL HOSPITAL                           41          38         2
   2008       2      Outpatient     20426     EYE FOUNDATION HOSPITAL INC                      2,389       2,389        42
   2008       2      Outpatient     20429     CHILDRENS HOSPITAL OF BHAM                      15,820      15,820       515
   2008       2      Outpatient     20433     OUR LADY OF THE LAKE HOSPITAL                      349         346        16
   2008       2      Outpatient     20441     BATON ROUGE GEN HOSP                             1,638       1,638        42
   2008       2      Outpatient     20459     ST. HELENA PARISH HOSPITAL                         216         216         9
   2008       2      Outpatient     20461     ALTON OCHSNER MEDICAL FOUNDATION                   611         602        38
   2008       2      Outpatient     20469     METHODIST HOSPITAL - CENTRAL                    67,637      67,631     2,677
   2008       2      Outpatient     20482     MOBILE INFIRMARY ASSOCIATION                       113         110         6
   2008       2      Outpatient     95306     NORTHSHORE REG MED CENTER                          437         437         7
   2008       2      Outpatient     95348     ST LOUIS CHILDRENS HOSP                            311         311         7
   2008       2      Outpatient     95919     ST JOHNS HOSPITAL                                  239         239        12
   2008       2      Outpatient     95993     BORGESS MEDICAL CENTER                             322         322         3
   2008       2      Outpatient     96542     TRIDENT MEDICAL CENTER                             101         101         2
   2008       2      Outpatient     97684     TEXAS CHILDREN'S HOSPITAL                          775         775        33
   2008       2      Outpatient     97767     ARKANSAS CHILDRENS HOSPITAL                      8,949       8,949       501
   2008       2      Outpatient     97779     BAPTIST HOSPITAL                                   132         132         5
   2008       2      Outpatient     220021    RENEX DIALYSIS FACILITIES INC                   14,367      14,367     5,023
   2008       2      Outpatient     220061    RENEX DIALYSIS FACILITIES INC                   19,194      19,194     4,954
   2008       2      Outpatient     220062    NATIONAL RENAL INSTITUTES INC                   87,601      87,601    15,012
   2008       2      Outpatient     220063    HATTIESBURG CLINIC PA                            4,616       4,616       794
   2008       2      Outpatient     220082    BIO-MEDICALAPPLICATIONS OF MS, INC.            137,042     137,042    53,077
   2008       2      Outpatient     220105    BIO-MEDICAL APPLICATIONS OF MS, INC              8,506       8,506     3,469
   2008       2      Outpatient     220136    BAPTIST MEMORIAL HOSPITAL                    1,825,092   1,822,887    89,866
   2008       2      Outpatient     220144    MORTON MEDICAL CENTER INC                      106,629     105,945     4,316
   2008       2      Outpatient     220159    NATCHEZ COMMUNITY HOSPITAL, INC.                 5,048       5,045       308
   2008       2      Outpatient     220213    SAINT FRANCIS HOSPITAL                             666         666        17
   2008       2      Outpatient     220220    MARION REGIONAL MEDICAL CENTER                     156         153         3
   2008       2      Outpatient     220230    NEWTON HOSPITAL, INC                            75,245      74,975     4,273
   2008       2      Outpatient     220236    HATTIESBURG CLINIC PA                            4,436       4,436     1,141
   2008       2      Outpatient     220243    WINSTON MEDICAL CENTER                         191,988     191,364     4,933
   2008       2      Outpatient     220279    UNIVERSITY HEALTHCARE SYSTEM                     8,986       8,899       332
   2008       2      Outpatient     220297    PEARL RIVER HOSPITAL                                 4           1         1
   2008       2      Outpatient     220324    INDEPENDENT HEALTHCARE MANAGEMENT              199,698     199,278     3,427
   2008       2      Outpatient     220350    RCG MISSISSInpatientPI INC                      10,430      10,430     7,202
   2008       2      Outpatient     220351    NATIONAL RENAL INSTITUTES INC                  194,760     194,760    35,525
   2008       2      Outpatient     220352    RCG MISSISSInpatientPI INC                         856         856       206
   2008       2      Outpatient     220353    RCG MISSISSInpatientPI INC                      81,893      81,893    20,863
   2008       2      Outpatient     220354    RCG MISSISSInpatientPI INC                       4,626       4,626     2,461
   2008       2      Outpatient     220355    NATIONAL RENAL INSTITUTES INC                  102,586     102,586    20,168
   2008       2      Outpatient     220356    RCG MISSISSInpatientPI INC                       1,138       1,138        10
   2008       2      Outpatient     220358    RCG MISSISSInpatientPI INC.                     12,711      12,711     4,543
   2008       2      Outpatient     220359    RCG MISSISSInpatientPI INC                      94,056      94,056    42,660
   2008       2      Outpatient     220360    RCG MISSISSInpatientPI INC                     275,420     275,420    80,342
   2008       2      Outpatient     220361    RCG MISSISSInpatientPI INC                      27,930      27,930     7,372
   2008       2      Outpatient     220362    RCG DBA KIDNEY CARE /MERIDIAN                  200,780     200,780    69,397
   2008       2      Outpatient     220365    NATIONAL RENAL INSTITUTES INC                  193,382     193,382    19,744
   2008       2      Outpatient     220369    RCG MISSISSInpatientPI INC                      92,511      92,511    41,006
   2008       2      Outpatient     220380    CLARKSDALE HMA INC                              10,080      10,071       572



5/15/2012                                                       Milliman                                           Page 56
                Inpatient & Outpatient Facility Claims by Provider (includes freestanding dialysis services)

                       Claim       Provider                        Provider                 Allowed          Paid   Service
   Year     Region      Type      ID Number                         Name                    Charges        Claims     Units
   2008       2      Outpatient     220392    MISSISSInpatientPI BAPTIST MEDICAL CENTER    2,390,689    2,387,236    24,067
   2008       2      Outpatient     220412    ADVENTIST HEALTH SYSTEM-SUNBELT INC                512          509         9
   2008       2      Outpatient     220415    SOUTHERN HEALTH CORP OF HOUSTON                186,223      185,866     4,872
   2008       2      Outpatient     220416    RCG BRANDON LLC                                  5,077        5,077     1,194
   2008       2      Outpatient     220417    RANKIN MEDICAL CENTER                          378,858      378,426    13,215
   2008       2      Outpatient     220441    PRENTISS REGIONAL HOSPITAL AND EXTE                739          739        26
   2008       2      Outpatient     220444    DMC-MEMPHIS INC                                 12,479       12,473        83
   2008       2      Outpatient     220450    ADVOCATE HEALTH AND HOSPITALS CORPO                  7            7         2
   2008       2      Outpatient     220462    WESLEY HEALTH SYSTEMS LLC                       54,967       54,862       892
   2008       2      Outpatient     220466    ROH, INC                                        76,154       76,088     2,007
   2008       2      Outpatient     220467    RIVER OAKS HOSPITAL, INC.                      462,392      462,095    18,866
   2008       2      Outpatient     220481    NATIONAL RENAL INSTITUTES INC                   79,546       79,546    11,425
   2008       2      Outpatient     220487    PROVIDENCE HOSPITAL                                420          420        23
   2008       2      Outpatient     220495    MERIDIAN HMA INC                               542,852      541,514    22,399
   2008       2      Outpatient     220502    HATTIESBURG CLINIC, PA                         161,114      161,114    27,256
   2008       2      Outpatient     220506    BIO-MEDICAL APPLICATIONS OF MISSISS             33,835       33,835    10,488
   2008       2      Outpatient     220522    JEFFERSON PARISH HOSPITAL SERVICE                  823          823        16
   2008       2      Outpatient     220526    RCG OF MAYERSVILLE LLC                           7,903        7,903     2,552
   2008       2      Outpatient     220554    HATTIESBURG CLINIC PA                            5,434        5,434       853
   2008       2      Outpatient     220565    NORTH PORT HOSPITAL-DCH                          2,676        2,670        42
   2008       2      Outpatient     220571    VICKSBURG HEALTHCARE LLC                       946,234      945,313    19,572
   2008       2      Outpatient     220576    BAPTIST MEMORIAL HOSPITAL                          707          707        14
   2008       2      Outpatient     220578    CLEVELAND CLINIC FOUNDATION                     98,813       98,813         1
   2008       2      Outpatient     220598    RCG MISSISSInpatientPI INC                      68,440       68,440    29,292
   2008       2      Outpatient     220606    PHC-CLEVELAND, INC.                              3,969        3,942       139
   2008       2      Outpatient     220609    STATE OF MISSISSInpatientPI-UNIVERSITY OF       18,660       18,639       417
   2008       2      Outpatient     220621    ALLIANCE HEALTHCARE SYSTEM INC                     274          274        13
   2008       2      Outpatient     220630    JACKSON HMA INC                              1,301,691    1,300,614    47,075
   2008       2      Outpatient     220631    NORTH OAK REGIONAL HOSPITAL INC                  1,230        1,230        71
   2008       2      Outpatient     220632    BIO-MEDICAL APPLICATIONS OF MS, INC             59,675       59,675    29,506
   2008       2      Outpatient     220634    BIO-MEDICAL APPLICATIONS OF MISSISS            128,896      128,896    49,149
   2008       2      Outpatient     220635    BIO-MEDICAL APPLICATIONS OF MISSISS             26,827       26,827     2,357
   2008       2      Outpatient     220636    BIO-MEDICAL APPLICATIONS OF MS, INC             50,436       50,436    15,602
   2008       2      Outpatient     220637    BIO-MEDICAL APPLICATIONS OF MS INC              86,898       86,898    36,740
   2008       2      Outpatient     220682    FORREST COUNTY GENERAL HOSPITAL                    434          434        27
   2008       2      Outpatient     220692    PIONEER HEALTH SERVICES OF MONROE              107,310      106,905     2,255
   2008       2      Outpatient     220714    STONE COUNTY HOSITAL INC                         1,284        1,284        11
   2008       2      Outpatient     220722    RCG MISSISSInpatientPI INC                      13,725       13,725     2,719
   2008       2      Outpatient     220732    UNIV OF ARK FOR MED SCIENCES                        10           10         1
   2008       2      Outpatient     220734    GPCH-GP                                          2,666        2,660        68
   2008       2      Outpatient     220742    CHILDRENS HOSPITAL MEDICAL CENTER                3,021        3,021        69
   2008       2      Outpatient     220746    ST JOSEPH MEDICAL CENTER                           458          458        19
   2008       2      Outpatient     220771    RENAL CARE GROUP TUPELO LLC                     47,212       47,212    14,710
   2008       2      Outpatient     220772    RENAL CARE GROUP TUPELO LLC                     76,665       76,665    41,356
   2008       2      Outpatient     220774    RENAL CARE TUPELO LLC                            8,493        8,493     4,188
   2008       2      Outpatient     220776    RENAL CARE GROUP TUPELO LLC                    184,227      184,227   104,348
   2008       2      Outpatient     220800    THE CHILDREN'S HOSPITAL OF PHILADEL              1,434        1,434        22
   2008       2      Outpatient     220809    LEAKE COUNTY BOARD OF TRUSTEES                  79,335       78,993     4,151
   2008       2      Outpatient    1457714    NEBRASKA HEALTH SYSTEM                           1,330        1,330       161
   2008       2      Outpatient    1975899    COLUMBIA HOSPITAL AT MEDICAL CITY                  355          355         8
   2008       2      Outpatient    2032374    DANNY JOE SPREITLER                             82,765       82,459     3,063
   2008       2      Outpatient    2703888    MEMORIAL HERMANN HOSPITAL SYSTEM                    62           62         1
   2008       2      Outpatient    2857378    STATE UNIVERSITY OF IOWA                         1,172        1,169        30
   2008       2      Outpatient    3273578    BIO-MEDICAL APPLICATIONS OF MISS                17,891       17,891     8,699
   2008       2      Outpatient    4101365    BLOOMINGTON HOSPITAL                               451          451        13
   2008       2      Outpatient    4125505    LAIRD HOutpatientSITAL INC                     156,012      155,640     6,582
   2008       2      Outpatient    4605843    SACRED HEART HEALTH SYSTEM INC                      99           99         2
   2008       2      Outpatient    4952335    SENTARA HOSPITALS                                   79           79         3
   2008       2      Outpatient    5953091    CHRISTUS HEALTH NORTHERN LOUISIANA                 756          756        23
   2008       2      Outpatient    6409841    TENET SOUTH FULTON INC                             136          136         1
   2008       2      Outpatient    7051779    COLUMBIA MEDICAL CENTER OF LEWISVIL                128          128         1
   2008       2      Outpatient    7286514    BON SECOURS DEPAUL MEDICAL CENTER                  633          630        10
   2008       2      Outpatient    7539272    QUITMAN COUNTY HOSPITAL, LLC                       214          211         3
   2008       2      Outpatient    8087360    MADISON HMA INC                                382,795      382,063    16,985
   2008       3       Inpatient     20007     FORREST COUNTY GENERAL HOSPITAL             10,303,778   10,245,328     7,811
   2008       3       Inpatient     20008                                                    858,907      854,377       590
   2008       3       Inpatient     20011     WHITFIELD MEDICAL SURGICAL HO                    7,733        7,633        10
   2008       3       Inpatient     20012     FIELD MEMORIAL COMMUNITY HOSPITAL              323,914      321,424       264
   2008       3       Inpatient     20016     BAPTIST MEMORIAL HOSPITAL- NORTH                19,106       18,976        13



5/15/2012                                                       Milliman                                            Page 57
                Inpatient & Outpatient Facility Claims by Provider (includes freestanding dialysis services)

                      Claim       Provider                     Provider                    Allowed         Paid   Service
   Year     Region     Type      ID Number                       Name                      Charges       Claims     Units
   2008       3      Inpatient     20025     GREENWOOD LEFLORE HOSPITAL                      24,241      24,081        21
   2008       3      Inpatient     20027     MEMORIAL HOSPITAL AT GULFPORT                6,282,864   6,249,874     4,830
   2008       3      Inpatient     20034     ST DOMINIC JACKSON MEM                         607,735     602,875       488
   2008       3      Inpatient     20042     MAGEE BENEVOLENT ASSOCIATION                    87,643      86,683        97
   2008       3      Inpatient     20043     SOUTH PIKE HOSPITAL ASSOCIATION INC            179,906     177,026       290
   2008       3      Inpatient     20046     ANDERSON INFIRMARY BENEVOLENT ASSOC             41,636      41,336        30
   2008       3      Inpatient     20049     RUSH MEDICAL FOUNDATION                         28,339      28,139        20
   2008       3      Inpatient     20059     SINGING RIVER HOSPITAL SYSTEM                4,010,729   3,985,659     2,762
   2008       3      Inpatient     20065     ST. JUDE CHILDRENS RESEARCH HOSPITA            121,491     120,951       103
   2008       3      Inpatient     20081     NORTH MISSISSInpatientPI MEDICAL CENTER         95,631      95,471        71
   2008       3      Inpatient     20084     BAPTIST MEMORIAL HOSPITAL BOONEVILL              2,180       2,160         2
   2008       3      Inpatient     20115     HARDY WILSON MEMORIAL HOSPITAL                   7,692       7,612         8
   2008       3      Inpatient     20116     MARION GENERAL HOSPITAL                        153,794     152,094       181
   2008       3      Inpatient     20130                                                    145,545     143,935       167
   2008       3      Inpatient     20131     WAYNE GENERAL HOSPITAL                         568,694     563,034       628
   2008       3      Inpatient     20133     COVINGTON COUNTY HOSPITAL                       91,960      91,170       107
   2008       3      Inpatient     20140     CLAIBORNE CO HOSPITAL                           11,022      10,922        12
   2008       3      Inpatient     20141     SOUTH CENTRAL REGIONAL MEDICAL CENT          1,458,145   1,445,795     1,389
   2008       3      Inpatient     20145     DELTA REGIONAL MEDICAL CENTER                    2,253       2,233         2
   2008       3      Inpatient     20149     STATE OF MISSISSInpatientPI-UNIVERSITY OF    6,879,162   6,860,702     5,472
   2008       3      Inpatient     20166     HANCOCK MEDICAL CENTER INC                     535,614     532,384       353
   2008       3      Inpatient     20167     SIMPSON COMMUNITY HEALTHCARE INC                13,964      13,804        16
   2008       3      Inpatient     20170     SOUTH MISSISSInpatientPI REGIONAL MEDICAL       81,016      80,356        66
   2008       3      Inpatient     20172     NATCHEZ REGIONAL MEDICAL CENTER                846,928     842,268       583
   2008       3      Inpatient     20182     BILOXI HMA INC.                              2,556,120   2,540,080     1,724
   2008       3      Inpatient     20191     PERRY COUNTY GENERAL HOSPITAL                   59,135      58,655        48
   2008       3      Inpatient     20193     JEFFERSON COUNTY HOSPITAL                      247,603     244,993       290
   2008       3      Inpatient     20197     UNIVERSITY OF SOUTH ALABAMA                  1,001,642   1,001,372       748
   2008       3      Inpatient     20207     SOUTHWEST MISSISSInpatientPI REGIONAL MEDI   2,159,957   2,144,427     1,712
   2008       3      Inpatient     20208     WALTHALL COUNTY GENERAL HOSPITAL               185,977     183,457       261
   2008       3      Inpatient     20214     H C WATKINS MEMORIAL HOSPITAL INC                6,666       6,596         7
   2008       3      Inpatient     20215     INFIRMARY HEALTH HOSPITALS INC                  53,124      52,694        43
   2008       3      Inpatient     20223     MISSISSInpatientPI METHODIST HOSPITAL REHA     142,145     141,065       108
   2008       3      Inpatient     20226     GULFCOAST COMMUNITY HOSPITAL                   567,566     563,716       413
   2008       3      Inpatient     20229     PHYSICIANS AND SURGEONS HOSPITAL GR             36,644      36,164        48
   2008       3      Inpatient     20237     ALLIANCE HEALTH CENTER INC                   1,175,479   1,168,239     2,004
   2008       3      Inpatient     20290     GEORGE COUNTY HOSPITAL                         435,087     431,947       381
   2008       3      Inpatient     20302     CHILDRENS HOSP                                 437,384     437,264       363
   2008       3      Inpatient     20330     MEDICAL CENTER OF LOUISISANA AT NEW              3,331       3,301         3
   2008       3      Inpatient     20395     UNIVERSITY OF ALABAMA HOSPITAL                 161,133     160,933       128
   2008       3      Inpatient     20411     UNIVERSITY OF SOUTH ALABAMA                    112,204     111,164       104
   2008       3      Inpatient     20424     SLIDELL MEMORIAL HOSPITAL                       66,803      66,153        65
   2008       3      Inpatient     20429     CHILDRENS HOSPITAL OF BHAM                      31,431      31,431         8
   2008       3      Inpatient     20433     OUR LADY OF THE LAKE HOSPITAL                   44,091      43,651        44
   2008       3      Inpatient     20441     BATON ROUGE GEN HOSP                             3,331       3,301         3
   2008       3      Inpatient     20461     ALTON OCHSNER MEDICAL FOUNDATION               303,870     302,650       241
   2008       3      Inpatient     20469     METHODIST HOSPITAL - CENTRAL                     9,062       9,012         6
   2008       3      Inpatient     20482     MOBILE INFIRMARY ASSOCIATION                   124,571     123,391       118
   2008       3      Inpatient     29002     FIELD MEMORIAL COMMUNITY HOSPITAL               14,689      14,689        96
   2008       3      Inpatient     29005     H C WATKINS MEMORIAL HOSPITAL SWBD               5,202       5,202        34
   2008       3      Inpatient     29010     WAYNE GENERAL HOSPITAL - SWINGBED                3,213       3,213        21
   2008       3      Inpatient     29034     COVINGTON COUNTY HOSPITAL                        2,295       2,295        15
   2008       3      Inpatient     95306     NORTHSHORE REG MED CENTER                      102,472     101,722       106
   2008       3      Inpatient     97767     ARKANSAS CHILDRENS HOSPITAL                    207,075     207,075        71
   2008       3      Inpatient     220136    BAPTIST MEMORIAL HOSPITAL                       19,376      19,216        16
   2008       3      Inpatient     220159    NATCHEZ COMMUNITY HOSPITAL, INC.               769,880     764,610       654
   2008       3      Inpatient     220213    SAINT FRANCIS HOSPITAL                          38,913      38,913        25
   2008       3      Inpatient     220230    NEWTON HOSPITAL, INC                             2,250       2,220         3
   2008       3      Inpatient     220243    WINSTON MEDICAL CENTER                           2,645       2,615         3
   2008       3      Inpatient     220250    WINSTON MEDICAL CENTER                           1,224       1,224         8
   2008       3      Inpatient     220279    UNIVERSITY HEALTHCARE SYSTEM                   288,323     287,483       168
   2008       3      Inpatient     220324    INDEPENDENT HEALTHCARE MANAGEMENT                3,873       3,823         5
   2008       3      Inpatient     220380    CLARKSDALE HMA INC                               3,576       3,546         3
   2008       3      Inpatient     220392    MISSISSInpatientPI BAPTIST MEDICAL CENTER      267,189     265,409       218
   2008       3      Inpatient     220417    RANKIN MEDICAL CENTER                           78,080      77,520        56
   2008       3      Inpatient     220441    PRENTISS REGIONAL HOSPITAL AND EXTE            122,454     121,194       151
   2008       3      Inpatient     220444    DMC-MEMPHIS INC                                 31,823      31,463        36
   2008       3      Inpatient     220448    TOURO INFIRMARY                                 12,103      12,013         9
   2008       3      Inpatient     220462    WESLEY HEALTH SYSTEMS LLC                    1,799,499   1,785,409     1,526



5/15/2012                                                      Milliman                                           Page 58
                Inpatient & Outpatient Facility Claims by Provider (includes freestanding dialysis services)

                       Claim       Provider                       Provider                 Allowed         Paid   Service
   Year     Region      Type      ID Number                        Name                    Charges       Claims     Units
   2008       3       Inpatient     220487    PROVIDENCE HOSPITAL                            65,915      65,175        74
   2008       3       Inpatient     220495    MERIDIAN HMA INC                                3,929       3,899         3
   2008       3       Inpatient     220509    PEARL RIVER HOSPITAL                            1,530       1,530        10
   2008       3       Inpatient     220545    DOCTORS HOSPITAL OF AUGUSTA                    20,419      20,419        17
   2008       3       Inpatient     220571    VICKSBURG HEALTHCARE LLC                      940,601     930,751     1,143
   2008       3       Inpatient     220578    CLEVELAND CLINIC FOUNDATION                    16,678      16,678        13
   2008       3       Inpatient     220630    JACKSON HMA INC                               466,178     463,148       317
   2008       3       Inpatient     220682    FORREST COUNTY GENERAL HOSPITAL               530,571     526,831       404
   2008       3       Inpatient     220714    STONE COUNTY HOSITAL INC                       57,474      57,204        28
   2008       3       Inpatient     220734    GPCH-GP                                       849,491     845,191       463
   2008       3       Inpatient     220742    CHILDRENS HOSPITAL MEDICAL CENTER               3,690       3,690         4
   2008       3       Inpatient     220780    BAY MEDICAL CENTER                                937         927         1
   2008       3       Inpatient     220793    LAIRD HOSPITAL INC                                918         918         6
   2008       3       Inpatient     220800    THE CHILDREN'S HOSPITAL OF PHILADEL            56,335      56,335        32
   2008       3       Inpatient    4125505    LAIRD HOutpatientSITAL INC                      5,610       5,550         6
   2008       3       Inpatient    4581000    LOUISIANA HEART HOSPITAL LLC                    3,736       3,686         5
   2008       3       Inpatient    5330563    BRIGHAM & WOMENS HOSPITAL INC                  26,081      25,871        21
   2008       3       Inpatient    6200741    GREENE RURAL HEALTH CENTER                      4,368       4,318         5
   2008       3       Inpatient    7603524    REGENCY HOSPITAL OF HATTIESBURG LLC             3,007       2,967         4
   2008       3       Inpatient    8087360    MADISON HMA INC                                 2,792       2,772         2
   2008       3       Inpatient    9357759    THE CHILDREN'S INSTITUTE OF PITTSBU            80,384      80,384        69
   2008       3      Outpatient     20003     AMORY HMA INC                                   2,224       2,224       452
   2008       3      Outpatient     20007     FORREST COUNTY GENERAL HOSPITAL             3,857,345   3,855,701   121,780
   2008       3      Outpatient     20008                                                   410,552     409,925    14,948
   2008       3      Outpatient     20010     BAPTIST MEMORIAL HOSPITAL UNION COU               167         167         9
   2008       3      Outpatient     20011     WHITFIELD MEDICAL SURGICAL HO                  32,619      32,028     1,196
   2008       3      Outpatient     20012     FIELD MEMORIAL COMMUNITY HOSPITAL             276,626     276,332     8,560
   2008       3      Outpatient     20016     BAPTIST MEMORIAL HOSPITAL- NORTH                  724         724        24
   2008       3      Outpatient     20019     WEST FELICIANA PARISH HOSPITAL                    442         442        13
   2008       3      Outpatient     20020     MAGNOLIA REGIONAL HEALTH CENTER                   351         351        20
   2008       3      Outpatient     20025     GREENWOOD LEFLORE HOSPITAL                     10,165      10,153       227
   2008       3      Outpatient     20026     GRENADA LAKE MEDICAL CENTER                     1,475       1,466        40
   2008       3      Outpatient     20027     MEMORIAL HOSPITAL AT GULFPORT               2,806,054   2,802,649    81,757
   2008       3      Outpatient     20034     ST DOMINIC JACKSON MEM                        139,034     138,839     2,717
   2008       3      Outpatient     20042     MAGEE BENEVOLENT ASSOCIATION                   38,238      38,124     2,131
   2008       3      Outpatient     20043     SOUTH PIKE HOSPITAL ASSOCIATION INC            14,065      13,852       873
   2008       3      Outpatient     20046     ANDERSON INFIRMARY BENEVOLENT ASSOC            17,380      17,362       152
   2008       3      Outpatient     20049     RUSH MEDICAL FOUNDATION                        22,750      22,729       880
   2008       3      Outpatient     20057     MEADOWCREST HOSPITAL LLC                        1,266       1,263        72
   2008       3      Outpatient     20059     SINGING RIVER HOSPITAL SYSTEM               2,544,510   2,542,347    69,672
   2008       3      Outpatient     20065     ST. JUDE CHILDRENS RESEARCH HOSPITA            67,550      67,517     1,996
   2008       3      Outpatient     20081     NORTH MISSISSInpatientPI MEDICAL CENTER         7,187       7,181       201
   2008       3      Outpatient     20082     KINGS DAUGHTERS HOSPITAL OF YAZOO                 246         246         9
   2008       3      Outpatient     20084     BAPTIST MEMORIAL HOSPITAL BOONEVILL               221         221        10
   2008       3      Outpatient     20096     PONTOTOC HEALTH SERVICES INC                      210         210         4
   2008       3      Outpatient     20111     TInpatientPAH COUNTY HOSPITAL                     530         530        22
   2008       3      Outpatient     20115     HARDY WILSON MEMORIAL HOSPITAL                  8,660       8,645       115
   2008       3      Outpatient     20116     MARION GENERAL HOSPITAL                       252,254     251,030     7,772
   2008       3      Outpatient     20124     HUMPHREYS COUNTY MEMORIAL HOSPITAL              1,353       1,353        37
   2008       3      Outpatient     20130                                                    29,655      29,475     1,585
   2008       3      Outpatient     20131     WAYNE GENERAL HOSPITAL                        176,391     175,515     9,692
   2008       3      Outpatient     20133     COVINGTON COUNTY HOSPITAL                     143,107     142,540     5,620
   2008       3      Outpatient     20140     CLAIBORNE CO HOSPITAL                         283,575     282,939     7,015
   2008       3      Outpatient     20141     SOUTH CENTRAL REGIONAL MEDICAL CENT           805,197     803,706    22,062
   2008       3      Outpatient     20143     BAPTIST MEMORIAL HOSPITAL DESOTO, I             1,579       1,576       219
   2008       3      Outpatient     20145     DELTA REGIONAL MEDICAL CENTER                   4,464       4,458       188
   2008       3      Outpatient     20149     STATE OF MISSISSInpatientPI-UNIVERSITY OF   4,463,942   4,460,906    53,484
   2008       3      Outpatient     20156     TYLER HOLMES MEMORIAL HOSPITAL                    139         136         5
   2008       3      Outpatient     20166     HANCOCK MEDICAL CENTER INC                    445,072     444,115    22,240
   2008       3      Outpatient     20167     SIMPSON COMMUNITY HEALTHCARE INC                8,704       8,686       447
   2008       3      Outpatient     20170     SOUTH MISSISSInpatientPI REGIONAL MEDICAL      79,734      79,473     1,810
   2008       3      Outpatient     20172     NATCHEZ REGIONAL MEDICAL CENTER               611,507     610,682    24,927
   2008       3      Outpatient     20177     JASPER GENERAL HOSPITAL                         2,064       2,046        99
   2008       3      Outpatient     20178     WEBSTER HEALTH SERVICES INC                       439         430        16
   2008       3      Outpatient     20182     BILOXI HMA INC.                               662,304     660,924    29,769
   2008       3      Outpatient     20186     LIFEMARK HOSPITALS OF LOUISIANA INC                77          68         5
   2008       3      Outpatient     20191     PERRY COUNTY GENERAL HOSPITAL                  37,624      37,285     1,423
   2008       3      Outpatient     20193     JEFFERSON COUNTY HOSPITAL                      56,327      56,063     2,455
   2008       3      Outpatient     20197     UNIVERSITY OF SOUTH ALABAMA                   103,786     103,765     5,714



5/15/2012                                                       Milliman                                          Page 59
                Inpatient & Outpatient Facility Claims by Provider (includes freestanding dialysis services)

                      Claim        Provider                        Provider                 Allowed         Paid   Service
   Year     Region     Type       ID Number                         Name                    Charges       Claims     Units
   2008       3      Outpatient     20207     SOUTHWEST MISSISSInpatientPI REGIONAL MEDI   1,312,651   1,311,355    60,730
   2008       3      Outpatient     20208     WALTHALL COUNTY GENERAL HOSPITAL               153,954     153,534     5,666
   2008       3      Outpatient     20213     HILLCREST HOSPITAL                                  12          12         2
   2008       3      Outpatient     20214     H C WATKINS MEMORIAL HOSPITAL INC                3,422       3,407        73
   2008       3      Outpatient     20215     INFIRMARY HEALTH HOSPITALS INC                   8,889       8,883        77
   2008       3      Outpatient     20219     OKTIBBEHA COUNTY HOSPITAL                        5,015       5,015        71
   2008       3      Outpatient     20223     MISSISSInpatientPI METHODIST HOSPITAL REHA      57,910      57,877     1,631
   2008       3      Outpatient     20226     GULFCOAST COMMUNITY HOSPITAL                   111,890     111,887     2,438
   2008       3      Outpatient     20229     PHYSICIANS AND SURGEONS HOSPITAL GR              2,330       2,330        26
   2008       3      Outpatient     20290     GEORGE COUNTY HOSPITAL                         296,013     295,179     8,661
   2008       3      Outpatient     20302     CHILDRENS HOSP                                  99,743      99,719     2,528
   2008       3      Outpatient     20330     MEDICAL CENTER OF LOUISISANA AT NEW              1,132       1,120        45
   2008       3      Outpatient     20337     HATTIESBURG CLINIC, PA                         298,135     298,135    45,227
   2008       3      Outpatient     20338     HATTIESBURG CLINIC PA                           98,110      98,110    16,734
   2008       3      Outpatient     20341     HATTIESBURG CLINIC PA                          151,457     151,457    25,277
   2008       3      Outpatient     20345     HATTIESBURG CLINIC PA                            4,029       4,029       669
   2008       3      Outpatient     20364     HOSPITAL SERVICE DISTRICT NO 1                  13,200      13,191       132
   2008       3      Outpatient     20393     TISHOMINGO HEALTH SERVICES INC                      87          87         2
   2008       3      Outpatient     20395     UNIVERSITY OF ALABAMA HOSPITAL                  33,813      33,789     1,434
   2008       3      Outpatient     20411     UNIVERSITY OF SOUTH ALABAMA                     18,135      18,117       883
   2008       3      Outpatient     20424     SLIDELL MEMORIAL HOSPITAL                      182,986     182,806     3,876
   2008       3      Outpatient     20427     HOSPITAL SERVICE DISTRICT 1 OF EAST              7,802       7,793        29
   2008       3      Outpatient     20429     CHILDRENS HOSPITAL OF BHAM                      13,614      13,614       728
   2008       3      Outpatient     20433     OUR LADY OF THE LAKE HOSPITAL                   14,787      14,778       197
   2008       3      Outpatient     20441     BATON ROUGE GEN HOSP                             1,796       1,793        58
   2008       3      Outpatient     20461     ALTON OCHSNER MEDICAL FOUNDATION                81,789      81,642     1,918
   2008       3      Outpatient     20469     METHODIST HOSPITAL - CENTRAL                     5,018       5,018       139
   2008       3      Outpatient     20482     MOBILE INFIRMARY ASSOCIATION                    22,388      22,331     1,086
   2008       3      Outpatient     95136     PHILLInpatientS HOSPITAL CORPORATION             1,102       1,099        21
   2008       3      Outpatient     95306     NORTHSHORE REG MED CENTER                      104,574     104,517     1,806
   2008       3      Outpatient     96463     BILLINGS CLINIC                                    517         517         6
   2008       3      Outpatient     97684     TEXAS CHILDREN'S HOSPITAL                        5,679       5,676         9
   2008       3      Outpatient     97747     DUKE UNIVERSITY HEALTH                             300         297         8
   2008       3      Outpatient     97779     BAPTIST HOSPITAL                                27,416      27,413       309
   2008       3      Outpatient     150391    DUKE UNIVERSITY HEALTH SYSTEM INC                   37          37         1
   2008       3      Outpatient     220021    RENEX DIALYSIS FACILITIES INC                   17,249      17,249     5,262
   2008       3      Outpatient     220063    HATTIESBURG CLINIC PA                          108,873     108,873    20,383
   2008       3      Outpatient     220136    BAPTIST MEMORIAL HOSPITAL                        5,818       5,809       255
   2008       3      Outpatient     220144    MORTON MEDICAL CENTER INC                          180         174        11
   2008       3      Outpatient     220159    NATCHEZ COMMUNITY HOSPITAL, INC.               401,551     401,029    13,999
   2008       3      Outpatient     220178    BIO-MEDICAL APPLICATIONS OF MISSISS             22,910      22,910     4,963
   2008       3      Outpatient     220230    NEWTON HOSPITAL, INC                             2,548       2,539       104
   2008       3      Outpatient     220236    HATTIESBURG CLINIC PA                           43,680      43,680     3,184
   2008       3      Outpatient     220243    WINSTON MEDICAL CENTER                             774         771        11
   2008       3      Outpatient     220279    UNIVERSITY HEALTHCARE SYSTEM                   185,545     185,254     2,014
   2008       3      Outpatient     220297    PEARL RIVER HOSPITAL                            10,357      10,264       905
   2008       3      Outpatient     220324    INDEPENDENT HEALTHCARE MANAGEMENT                1,458       1,455        45
   2008       3      Outpatient     220329    BIO-MEDICAL APPLICATIONS OF MISSISS             70,231      70,231    50,419
   2008       3      Outpatient     220330    BIO-MEDICAL APPLICATIONS OF MS, INC              5,260       5,260     2,465
   2008       3      Outpatient     220333    BIO-MEDICAL APPLICATIONS OF MISSISS             60,011      60,011    28,495
   2008       3      Outpatient     220352    RCG MISSISSInpatientPI INC                      83,218      83,218    27,448
   2008       3      Outpatient     220354    RCG MISSISSInpatientPI INC                      67,012      67,012    10,782
   2008       3      Outpatient     220356    RCG MISSISSInpatientPI INC                     111,036     111,036    22,055
   2008       3      Outpatient     220362    RCG DBA KIDNEY CARE /MERIDIAN                    4,788       4,788     2,130
   2008       3      Outpatient     220380    CLARKSDALE HMA INC                               3,654       3,651       107
   2008       3      Outpatient     220392    MISSISSInpatientPI BAPTIST MEDICAL CENTER      258,652     258,406     1,610
   2008       3      Outpatient     220415    SOUTHERN HEALTH CORP OF HOUSTON                    170         170         2
   2008       3      Outpatient     220417    RANKIN MEDICAL CENTER                           19,749      19,728       232
   2008       3      Outpatient     220428    WOMANS HOSPITAL FOUNDATION                         146         146         6
   2008       3      Outpatient     220430    DVA HEALTHCARE RENAL CARE INC                  105,977     105,977    40,355
   2008       3      Outpatient     220431    DVA HEALTHCARE RENAL CARE INC                   12,423      12,423     9,402
   2008       3      Outpatient     220441    PRENTISS REGIONAL HOSPITAL AND EXTE            157,051     156,544     3,523
   2008       3      Outpatient     220448    TOURO INFIRMARY                                 14,444      14,441       196
   2008       3      Outpatient     220462    WESLEY HEALTH SYSTEMS LLC                    1,343,656   1,341,571    38,192
   2008       3      Outpatient     220466    ROH, INC                                        15,926      15,911     1,520
   2008       3      Outpatient     220467    RIVER OAKS HOSPITAL, INC.                       38,728      38,701     1,539
   2008       3      Outpatient     220487    PROVIDENCE HOSPITAL                             41,891      41,852       845
   2008       3      Outpatient     220489    RIVERSIDE MEDICAL CENTER                           853         847        35
   2008       3      Outpatient     220495    MERIDIAN HMA INC                                10,674      10,647       535



5/15/2012                                                       Milliman                                           Page 60
                Inpatient & Outpatient Facility Claims by Provider (includes freestanding dialysis services)

                      Claim        Provider                       Provider                Allowed         Paid   Service
   Year     Region     Type       ID Number                        Name                   Charges       Claims     Units
   2008       3      Outpatient     220498    VANDERBILT UNIVERSITY                          3,413       3,407        59
   2008       3      Outpatient     220522    JEFFERSON PARISH HOSPITAL SERVICE                134         134         3
   2008       3      Outpatient     220525    DVA HEALTHCARE RENAL CARE INC                 42,615      42,615    16,757
   2008       3      Outpatient     220554    HATTIESBURG CLINIC PA                         14,405      14,405     2,145
   2008       3      Outpatient     220570    HATTISBURG CLINIC PA                          48,759      48,759    12,508
   2008       3      Outpatient     220571    VICKSBURG HEALTHCARE LLC                      45,760      45,718       995
   2008       3      Outpatient     220578    CLEVELAND CLINIC FOUNDATION                      594         594        20
   2008       3      Outpatient     220600    HATTIESBURG CLINIC PA                         49,307      49,307     4,000
   2008       3      Outpatient     220601    EAST JEFFERSON GENERAL HOSPITAL                4,259       4,259        37
   2008       3      Outpatient     220606    PHC-CLEVELAND, INC.                              797         797        24
   2008       3      Outpatient     220609    STATE OF MISSISSInpatientPI-UNIVERSITY OF      1,326       1,323        11
   2008       3      Outpatient     220620    MEMORIAL MEDICAL CENTER                          575         575       107
   2008       3      Outpatient     220621    ALLIANCE HEALTHCARE SYSTEM INC                   663         663        25
   2008       3      Outpatient     220630    JACKSON HMA INC                              107,482     107,443     1,242
   2008       3      Outpatient     220631    NORTH OAK REGIONAL HOSPITAL INC                  166         166         2
   2008       3      Outpatient     220637    BIO-MEDICAL APPLICATIONS OF MS INC               337         337         3
   2008       3      Outpatient     220638    BIO-MEDICAL APPLICATIONS OF MISSISS          137,134     137,134    70,724
   2008       3      Outpatient     220644    RCG MISSISSInpatientPI INC                    47,157      47,157    25,368
   2008       3      Outpatient     220648    THE EAST ALABAMA HEALTH CARE AUTHOR              263         263        16
   2008       3      Outpatient     220682    FORREST COUNTY GENERAL HOSPITAL              458,264     457,343    19,202
   2008       3      Outpatient     220685    BIO-MEDICAL APPLICATIONS OF MISSISS            3,046       3,046     1,832
   2008       3      Outpatient     220712    SPRINGHILL MEMORIAL HOSPITALS                  3,926       3,923       205
   2008       3      Outpatient     220714    STONE COUNTY HOSITAL INC                     187,667     187,328     4,381
   2008       3      Outpatient     220727    HACKLEY HOSPITAL FISCAL SERVIC                   571         571        30
   2008       3      Outpatient     220734    GPCH-GP                                      510,371     509,576     8,280
   2008       3      Outpatient     220742    CHILDRENS HOSPITAL MEDICAL CENTER                435         435        26
   2008       3      Outpatient     220800    THE CHILDREN'S HOSPITAL OF PHILADEL            1,200       1,200         9
   2008       3      Outpatient     220809    LEAKE COUNTY BOARD OF TRUSTEES                   443         443        18
   2008       3      Outpatient    1170370    HOUSTON NORTHWEST PARTNERS LTD                   241         241         4
   2008       3      Outpatient    1457714    NEBRASKA HEALTH SYSTEM                            54          54         2
   2008       3      Outpatient    2004242    DOCTORS MEMORIAL HOSPITAL INC                    352         352         9
   2008       3      Outpatient    2703888    MEMORIAL HERMANN HOSPITAL SYSTEM                 429         426         4
   2008       3      Outpatient    4125505    LAIRD HOutpatientSITAL INC                     2,610       2,610        84
   2008       3      Outpatient    4458031    COLUMBIA MEDICAL CENTER OF                       171         171         2
   2008       3      Outpatient    4581000    LOUISIANA HEART HOSPITAL LLC                  25,669      25,660        73
   2008       3      Outpatient    4753347    GENERAL HOSPITAL CORPORATION                     568         565         3
   2008       3      Outpatient    5073750    HATTIESBURG CLINIC PA                          3,195       3,195       560
   2008       3      Outpatient    5330563    BRIGHAM & WOMENS HOSPITAL INC                  1,421       1,406        22
   2008       3      Outpatient    5725044    HOLMES REGIONAL MEDICAL CENTER                   194         191         2
   2008       3      Outpatient    6200741    GREENE RURAL HEALTH CENTER                    50,417      50,333       836
   2008       3      Outpatient    7522332    PRESBYTERIAN HEALTHCARE SERVICES                 157         157         8
   2008       3      Outpatient    8087360    MADISON HMA INC                                7,253       7,253       138
   2008       3      Outpatient    9137000    DIALYSIS CLINIC INC                            4,050       4,050        31
   2008       3      Outpatient    9602562    HCA HEALTH SERVICES OF TENNESSEE IN              123         120         3
   2008       3      Outpatient    9951372    COLUMBIA PLAZA MEDICAL CENTER OF               3,839       3,839        68




5/15/2012                                                        Milliman                                        Page 61

								
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