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IHS RVU table 2004

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IHS RVU table 2004 Powered By Docstoc
					                             Indian Health Service RVU Table, 2004
            Legend:
            A - CDT-4/ADA developed code
            R - RVSI developed code
            X - Established Value
            I - Interim Value
            BR - By Report
            RNE - Relativity not yet established, treat as "By Report"


CDT-4 INDIC
CODE ATOR DESCRIPTION
D0120   A   ORAL EVALUATION, PERIODIC
D0140   A   LIMITED ORAL EVALUATION - PROBLEM FOCUSED
D0150   A   COMPREHENSIVE ORAL EVALUATION
D0160   A   EXTENSIVE ORAL EVAL-PROBLEM FOCUSED
            RE-EVALUATION - LIMITED, PROBLEM FOCUSED (ESTABLISHED PATIENT; NOT POST-
D0170   A   OPERATIVE VISIT)
D0180   A   COMPREHENSIVE PERIODONTAL EVALUATION - NEW OR ESTABLISHED PATIENT
D0210   A   INTRAORAL COMPLETE SERIES
D0220   A   INTRAORAL PERIAPICAL, SINGLE FILM
D0230   A   INTRAORAL PERIAPICAL, ADDITIONAL FILM
D0240   A   INTRAORAL OCCLUSAL FILM
D0250   A   EXTRAORAL - FIRST FILM
D0260   A   EXTRAORAL - EACH ADDITIONAL FILM
D0270   A   BITEWINGS, SINGLE FILM
D0272   A   BITEWINGS - TWO FILMS
D0274   A   BITEWINGS, FOUR FILMS
D0277   A   VERTICAL BITEWINGS - 7 TO 8 FILMS
D0290   A   POSTERIOR-ANTERIOR OR LATERAL SKULL AND FACIAL BONE SURVEY FILM
D0310   A   SIALOGRAPHY
D0320   A   TEMPOROMANDIBULAR JOINT ARTHROGRAM, INCLUDING INJECTION
D0321   A   OTHER TEMPOROMANDIBULAR JOINT FILMS, BY REPORT
D0322   A   TOMOGRAPHIC SURVEY
D0330   A   PANORAMIC-MAXILLA AND MANDIBLE FILM
D0340   A   CEPHALOMETRIC FILM
D0350   A   ORAL/FACIAL IMAGES (INCLUDES INTRA AND EXTRAORAL IMAGES)
D0415   A   BACTERIOLOGIC STUDIES FOR PATHOLOGIC AGENTS
D0425   A   CARIES SUSCEPTIBILITY TESTS
D0430   R   BIOPSY AND EXAM OF ORAL TISSUE, HARD
D0460   A   PULP VITALITY TESTS (PER VISIT)
D0470   A   DIAGNOSTIC CASTS (PER SET)
            ACCESSION OF TISSUE, GROSS EXAMINATION, PREPARATION AND TRANSMISSION OF
D0472   A   WRITTEN REPORT
            ACCESSION OF TISSUE, GROSS AND MICROSCOPIC EXAMINATION, PREPARATION AND
D0473   A   TRANSMISSION OF WRITTEN REPORT
            ACCESSION OF TISSUE, GROSS AND MICROSCOPIC EXAMINATION, INCLUDING ASSESSMENT
            OF SURGICAL MARGINS FOR PRESENCE OF DISEASE, PREPARATION AND TRANSMISSION OF
D0474   A   WRITTEN REPORT
            PROCESSING AND INTERPRETATION OF CYTOLOGIC SMEARS, INCLUDING THE PREPARATION
D0480   A   AND TRANSMISSION OF WRITTEN REPORT
D0502   A   OTHER ORAL PATHOLOGY PROCEDURES, BY REPORT
D0999   A   UNSPECIFIED DIAGNOSTIC PROCEDURE, BY REPORT
D1110   A   ADULT PROPHYLAXIS, (PERMANENT DENTITION)
D1120   A   PROPHYLAXIS - CHILD
D1201   A   TOPICAL FLUORIDE WITH PROPHY CHILD
D1203   A   TOPICAL FLUORIDE W/O PROPHY-CHILD
D1204   A   TOPICAL FLUORIDE W/O PROPHY-ADULT
D1205   A   TOPICAL APPLICATION OF FLUORIDE (INCLUDING PROPHYLAXIS) - ADULT
D1310   A   NUTRITIONAL COUNSELING FOR ORAL HEALTH
D1320   A   TOBACCO USE INTERVENTION TO PREVENT DISEASE
D1330   A   PREVENTIVE PLAN AND INSTRUCTION
D1351   A   SEALANT - PER TOOTH
D1370   R   GROUP ORAL HEALTH COUNSELING (PER 15
D1510   A   SPACE MAINTAINER - FIXED - UNILATERAL
D1515   A   SPACE MAINTAINER - FIXED - BILATERAL
D1520   A   SPACE MAINTAINER - REMOVABLE - UNILATERAL
D1525   A   SPACE MAINTAINER - REMOVABLE - BILATERAL
D1550   A   RE-CEMENTATION OF SPACE MAINTAINER
D2140   A   AMALGAM - ONE SURFACE, PERMANENT
D2150   A   AMALGAM - TWO SURFACES, PERMANENT
D2160   A   AMALGAM - THREE SURFACES, PERMANENT
D2161   A   AMALGAM - FOUR OR MORE SURFACES, PERMANENT
D2330   A   RESIN-BASED COMPOSITE - ONE SURFACE, ANTERIO
D2331   A   RESIN-BASED COMPOSITE - TWO SURFACES, ANTERI
D2332   A   RESIN-BASED COMPOSITE - THREE SURFACES, ANTE
D2335   A   RESIN-BASED COMPOSITE - FOUR OR MORE SURFACE
D2390   A   RESIN-BASED COMPOSITE CROWN, ANTERIOR
D2391   A   RESIN-BASED COMPOSITE - ONE SURFACE, POSTERIOR
D2392   A   RESIN-BASED COMPOSITE - TWO SURFACES, POSTERIOR
D2393   A   RESIN-BASED COMPOSITE - THREE SURFACES, POSTERIOR
D2394   A   RESIN-BASED COMPOSITE - FOUR OR MORE SURFACES, POSTERIOR
D2410   A   GOLD FOIL - ONE SURFACE
D2420   A   GOLD FOIL - TWO SURFACES
D2430   A   GOLD FOIL - THREE SURFACES
D2510   A   INLAY - METALLIC - ONE SURFACE
D2520   A   INLAY - METALLIC - TWO SURFACES
D2530   A   INLAY - METALLIC - THREE OR MORE SURFACES
D2542   A   ONLAY - METALLIC-TWO SURFACES
D2543   A   ONLAY - METALLIC-THREE SURFACES
D2544   A   ONLAY - METALLIC-FOUR OR MORE SURFACES
D2610   A   INLAY - PORCELAIN/CERAMIC - ONE SURFACE
D2620   A   INLAY - PORCELAIN/CERAMIC - TWO SURFACES
D2630   A   INLAY - PORCELAIN/CERAMIC - THREE OR MORE SURFACES
D2642   A   ONLAY - PORCELAIN/CERAMIC - TWO SURFACES
D2643   A   ONLAY - PORCELAIN/CERAMIC - THREE SURFACES
D2644   A   ONLAY - PORCELAIN/CERAMIC - FOUR OR MORE SURFACES
D2650   A   INLAY - RESIN-BASED COMPOSITE - ONE SURFACE
D2651   A   INLAY - RESIN-BASED COMPOSITE - TWO SURFACES
D2652   A   INLAY - RESIN-BASED COMPOSITE - THREE OR MORE SURFACES
D2662   A   ONLAY - RESIN-BASED COMPOSITE - TWO SURFACES
D2663   A   ONLAY - RESIN-BASED COMPOSITE - THREE SURFACES
D2664   A   ONLAY - - RESIN-BASED COMPOSITE - FOUR OR MORE SURFACES
D2710   A   CROWN - RESIN (INDIRECT)
D2720   A   CROWN - RESIN WITH HIGH NOBLE METAL
D2721   A   CROWN - RESIN WITH PREDOMINANTLY BASE METAL
D2722   A   CROWN - RESIN WITH NOBLE METAL
D2740   A   CROWN - PORCELAIN/CERAMIC SUBSTRATE
D2750   A   CROWN-PORCELAIN WITH GOLD
D2751   A   CROWN - PORCELAIN FUSED TO PREDOMINANTLY BASE METAL
D2752   A   CROWN - PORCELAIN FUSED TO NOBLE METAL
D2780   A   CROWN - 3/4 CAST HIGH NOBLE METAL
D2781   A   CROWN - 3/4 CAST PREDOMINANTLY BASE METAL
D2782   A   CROWN - 3/4 CAST NOBLE METAL
D2783   A   CROWN - 3/4 PORCELAIN/CERAMIC
D2790   A   CROWN-GOLD (FULL CAST)
D2791   A   CROWN - FULL CAST PREDOMINANTLY BASE METAL
D2792   A   CROWN - FULL CAST NOBLE METAL
D2799   A   PROVISIONAL CROWN
D2910   A   RECEMENT INLAY
D2920   A   RECEMENT CROWNS
D2930   A   CROWN-STAINLESS STEEL, PRIMARY TOOTH
D2931   A   CROWN-STAINLESS STEEL, PERMANENT TOOTH
D2932   A   PREFABRICATED RESIN CROWN
D2933   A   PREFABRICATED STAINLESS STEEL CROWN WITH RESIN WINDOW
D2940   A   SEDATIVE FILLING
D2950   A   CORE BUILDUP, INCLUDING ANY PINS
D2951   A   PIN RETENTION - PER TOOTH, IN ADDITION TO RESTORATION
D2952   A   CAST POST AND CORE IN ADDITION TO CROWN
D2953   A   EACH ADDITIONAL CAST POST - SAME TOOTH
D2954   A   POST AND CORE (PREFAB.), EXCLUDING CROWN
D2955   A   POST REMOVAL (NOT IN CONJUNCTION WITH ENDODONTIC THERAPY)
D2957   A   EACH ADDITIONAL PREFABRICATED POST - SAME TOOTH
D2960   A   LABIAL VENEER (RESIN LAMINATE) - CHAIRSIDE
D2961   A   LABIAL VENEER (RESIN LAMINATE) - LABORATORY
D2962   A   LABIAL VENEER (PORCELAIN LAMINATE) - LABORATORY
D2970   A   TEMPORARY RESTORATION (FRACTURED TOOTH)
D2980   A   CROWN REPAIR, BY REPORT
D2999   A   UNSPECIFIED RESTORATIVE PROCEDURE, BY REPORT
D3110   A   PULP CAP DIRECT
D3120   A   PULP CAP - INDIRECT (EXCLUDING FINAL RESTORATION)
D3220   A   THERAPEUTIC PULPOTOMY (EXCLUDING FINAL RESTO
D3221   A   GROSS PULPAL DEBRIDEMENT, PRIMARY AND PERMAN
            PULPAL THERAPY (RESORBABLE FILLING) - ANTERIOR, PRIMARY TOOTH (EXCLUDING FINAL
D3230   A   RESTORATION)
D3240   A   PULPAL THERAPY, POSTERIOR PRIMARY TOOTH
D3310   A   ENDODONTIC FILL, ANTERIOR
D3320   A   ENDODONTIC FILL, BICUSPID
D3330   A   ENDODONTIC FILL, MOLAR
D3331   A   TREATMENT OF ROOT CANAL OBSTRUCTION; NON-SURGICAL ACCESS
D3332   A   INCOMPLETE ENDODONTIC THERAPY; INOPERABLE OR FRACTURED TOOTH
D3333   A   INTERNAL ROOT REPAIR OF PERFORATION DEFECTS
D3346   A   RETREATMENT OF PREVIOUS ROOT CANAL THERAPY - ANTERIOR
D3347   A   RETREATMENT OF PREVIOUS ROOT CANAL THERAPY - BICUSPID
D3348   A   RETREATMENT OF PREVIOUS ROOT CANAL THERAPY - MOLAR
            APEXIFICATION/RECALCIFICATION - INITIAL VISIT (APICAL CLOSURE/CALCIFIC REPAIR OF
D3351   A   PERFORATIONS, ROOT RESORPTION, ETC.)
            APEXIFICATION/RECALCIFICATION - INTERIM MEDICATION REPLACEMENT (APICAL
D3352   A   CLOSURE/CALCIFIC REPAIR OF PERFORATIONS, ROOT RESORPTION, ETC.)

            APEXIFICATION/RECALCIFICATION - FINAL VISIT (INCLUDES COMPLETED ROOT CANAL
D3353   A   THERAPY - APICAL CLOSURE/CALCIFIC REPAIR OF PERFORATIONS, ROOT RESORPTION, ETC.)
D3410   A   APICOECTOMY/PERIRADICULAR SURGERY - ANTERIOR
D3421   A   APICOECTOMY/PERIRADICULAR SURGERY - BICUSPID (FIRST ROOT)
D3425   A   APICOECTOMY/PERIRADICULAR SURGERY - MOLAR (FIRST ROOT)
D3426   A   APICOECTOMY/PERIRADICULAR SURGERY (EACH ADDITIONAL ROOT)
D3430   A   RETROGRADE FILLING - PER ROOT
D3450   A   ROOT AMPUTATION - PER ROOT
D3460   A   ENDODONTIC ENDOSSEOUS IMPLANT
D3470   A   INTENTIONAL REIMPLANTATION (INCLUDING NECESSARY SPLINTING)
D3910   A   SURGICAL PROCEDURE FOR ISOLATION OF TOOTH WITH RUBBER DAM

D3920   A   HEMISECTION (INCLUDING ANY ROOT REMOVAL), NOT INCLUDING ROOT CANAL THERAPY
D3950   A   CANAL PREPARATION AND FITTING OF PREFORMED DOWEL OR POST
D3999   A   UNSPECIFIED ENDODONTIC PROCEDURE, BY REPORT
            GINGIVECTOMY OR GINGIVOPLASTY - FOUR OR MORE CONTIGUOUS TEETH OR BOUNDED
D4210   A   TEETH SPACES PER QUADRANT
D4211   A   GINGIVECTOMY OR GINGIVOPLASTY - ONE TO THREE TEETH, PER QUADRANT
D4240   A   GINGIVAL FLAP PROC W/ ROOT PLANING (QUAD)
            GINGIVAL FLAP PROCEDURE, INCLUDING ROOT PLANING - ONE TO THREE TEETH, PER
D4241   A   QUADRANT
D4245   A   APICALLY POSITIONED FLAP
D4249   A   CLINICAL CROWN LENGTHENING - HARD TISSUE
D4260   A   OSSEOUS SURGERY, PER QUAD.
            OSSEOUS SURGERY (INCLUDING FLAP ENTRY AND CLOSURE) - ONE TO THREE TEETH, PER
D4261   A   QUADRANT
D4263   A   BONE REPLACEMENT GRAFT - FIRST SITE IN QUADRANT
D4264   A   BONE REPLACEMENT GRAFT - EACH ADDITIONAL SITE IN QUADRANT
D4265   A   BIOLOGIC MATERIALS TO AID IN SOFT AND OSSEOUS TISSUE REGENERATION
D4266   A   GUIDED TISSUE REGENERATION - RESORBABLE BARRIER, PER SITE
            GUIDED TISSUE REGENERATION - NONRESORBABLE BARRIER, PER SITE (INCLUDES
D4267   A   MEMBRANE REMOVAL)
D4268   A   SURGICAL REVISION PROCEDURE, PER TOOTH
D4270   A   PEDICLE SOFT TISSUE GRAFT PROCEDURE
D4271   A   FREE SOFT TISSUE GRAFT PROCEDURE (INCLUDING DONOR SITE SURGERY)
D4273   A   SUBEPITHELIAL CONNECTIVE TISSUE GRAFT PROCEDURES
            DISTAL OR PROXIMAL WEDGE PROCEDURE (WHEN NOT PERFORMED IN CONJUNCTION WITH
D4274   A   SURGICAL PROCEDURES IN THE SAME ANATOMICAL AREA)
D4275   A   SOFT TISSUE ALLOGRAFT
D4276   A   COMBINED CONNECTIVE TISSUE AND DOUBLE PEDICLE GRAFT
D4320   A   PROVISIONAL SPLINTING - INTRACORONAL
D4321   A   PROVISIONAL SPLINTING - EXTRACORONAL
D4341   A   PERIODONTAL SCALING AND ROOT PLANING, PER QU
D4342   A   PERIODONTAL SCALING AND ROOT PLANING - ONE TO THREE TEETH, PER QUADRANT
D4355   A   FULL MOUTH DEBRIDEMENT FOR PERIO EVALUATION
D4381   A   CONTROLLED RELEASE OF CHEMO AGENT (BY SITE)
D4910   A   PERIODONTAL MAINTENANCE PROCEDURES (FOLLOWIN
D4920   A   UNSCHEDULED DRESSING CHANGE (BY SOMEONE OTHER THAN TREATING DENTIST)
D4999   A   UNSPECIFIED PERIODONTAL PROCEDURE, BY REPORT
D5110   A   DENTURE - COMPLETE UPPER
D5120   A   DENTURE - COMPLETE LOWER
D5130   A   IMMEDIATE DENTURE - MAXILLARY
D5140   A   IMMEDIATE DENTURE - MANDIBULAR
D5211   A   MAXILLARY PARTIAL DENTURE - RESIN BASE (INCL
            MANDIBULAR PARTIAL DENTURE - RESIN BASE (INCLUDING ANY CONVENTIONAL CLASPS,
D5212   A   RESTS AND TEETH)
D5213   A   UPPER PARTIAL, CAST FRAME, RESIN BASE
D5214   A   LOWER PARTIAL, CAST FRAME, RESIN BASE
            REMOVABLE UNILATERAL PARTIAL DENTURE - ONE PIECE CAST METAL (INCLUDING CLASPS
D5281   A   AND TEETH)
D5410   A   ADJUST FULL DENTURE, UPPER
D5411   A   ADJUST FULL DENTURE, LOWER
D5421   A   ADJUST PARTIAL DENTURE, UPPER
D5422   A   ADJUST PARTIAL DENTURE - MANDIBULAR
D5510   A   REPAIR BROKEN COMPLETE DENTURE BASE
D5520   A   REPLACE MISSING/BROKEN TEETH (PER TOOTH)
D5610   A   REPAIR RESIN DENTURE BASE
D5620   A   REPAIR CAST FRAMEWORK
D5630   A   REPAIR OR REPLACE BROKEN CLASP
D5640   A   REPLACE BROKEN TEETH - PER TOOTH
D5650   A   ADD TOOTH TO EXISTING PARTIAL DENTURE
D5660   A   ADD CLASP TO EXISTING PARTIAL DENTURE
D5670   A   REPLACE ALL TEETH AND ACRYLIC ON CAST METAL FRAMEWORK (MAXILLARY)
D5671   A   REPLACE ALL TEETH AND ACRYLIC ON CAST METAL FRAMEWORK (MANDIBULAR)
D5710   A   REBASE COMPLETE MAXILLARY DENTURE
D5711   A   REBASE COMPLETE MANDIBULAR DENTURE
D5720   A   REBASE MAXILLARY PARTIAL DENTURE
D5721   A   REBASE MANDIBULAR PARTIAL DENTURE
D5730   A   RELINE COMPLETE MAXILLARY DENTURE (CHAIRSIDE)
D5731   A   RELINE COMPLETE MANDIBULAR DENTURE (CHAIRSIDE)
D5740   A   RELINE MAXILLARY PARTIAL DENTURE (CHAIRSIDE)
D5741   A   RELINE MANDIBULAR PARTIAL DENTURE (CHAIRSIDE)
D5750   A   RELINE COMPLETE MAXILLARY DENTURE (LABORATORY)
D5751   A   RELINE COMPLETE MANDIBULAR DENTURE (LABORATORY)
D5760   A   RELINE MAXILLARY PARTIAL DENTURE (LABORATORY)
D5761   A   RELINE MANDIBULAR PARTIAL DENTURE (LABORATORY)
D5810   A   INTERIM COMPLETE DENTURE (MAXILLARY)
D5811   A   INTERIM COMPLETE DENTURE (MANDIBULAR)
D5820   A   INTERIM PARTIAL DENTURE (MAXILLARY)
D5821   A   INTERIM PARTIAL DENTURE (MANDIBULAR)
D5850   A   TISSUE CONDITIONING, MAXILLARY
D5851   A   TISSUE CONDITIONING, MANDIBULAR
D5860   A   OVERDENTURE - COMPLETE, BY REPORT
D5861   A   OVERDENTURE - PARTIAL, BY REPORT
D5862   A   PRECISION ATTACHMENT, BY REPORT
            REPLACEMENT OF REPLACEABLE PART OF SEMI-PRECISION OR PRECISION ATTACHMENT
D5867   A   (MALE OR FEMALE COMPONENT)
D5875   A   MODIFICATION OF REMOVABLE PROSTHESIS FOLLOWING IMPLANT SURGERY
D5899   A   UNSPECIFIED REMOVABLE PROSTHODONTIC PROCEDURE, BY REPORT
D5911   A   FACIAL MOULAGE (SECTIONAL)
D5912   A   FACIAL MOULAGE (COMPLETE)
D5913   A   NASAL PROSTHESIS
D5914   A   AURICULAR PROSTHESIS
D5915   A   ORBITAL PROSTHESIS
D5916   A   OCULAR PROSTHESIS
D5919   A   FACIAL PROSTHESIS
D5922   A   NASAL SEPTAL PROSTHESIS
D5923   A   OCULAR PROSTHESIS, INTERIM
D5924   A   CRANIAL PROSTHESIS
D5925   A   FACIAL AUGMENTATION IMPLANT PROSTHESIS
D5926   A   NASAL PROSTHESIS, REPLACEMENT
D5927   A   AURICULAR PROSTHESIS, REPLACEMENT
D5928   A   ORBITAL PROSTHESIS, REPLACEMENT
D5929   A   FACIAL PROSTHESIS, REPLACEMENT
D5931   A   OBTURATOR PROSTHESIS, SURGICAL
D5932   A   OBTURATOR PROSTHESIS, DEFINITIVE
D5933   A   OBTURATOR PROSTHESIS, MODIFICATION
D5934   A   MANDIBULAR RESECTION PROSTHESIS WITH GUIDE FLANGE
D5935   A   MANDIBULAR RESECTION PROSTHESIS WITHOUT GUIDE FLANGE
D5936   A   OBTURATOR PROSTHESIS, INTERIM
D5937   A   TRISMUS APPLIANCE (NOT FOR TMD TREATMENT)
D5951   A   FEEDING AID
D5952   A   SPEECH AID PROSTHESIS, PEDIATRIC
D5953   A   SPEECH AID PROSTHESIS, ADULT
D5954   A   PALATAL AUGMENTATION PROSTHESIS
D5955   A   PALATAL LIFT PROSTHESIS, DEFINITIVE
D5958   A   PALATAL LIFT PROSTHESIS, INTERIM
D5959   A   PALATAL LIFT PROSTHESIS, MODIFICATION
D5960   A   SPEECH AID PROSTHESIS, MODIFICATION
D5982   A   SURGICAL STENT
D5983   A   RADIATION CARRIER
D5984   A   RADIATION SHIELD
D5985   A   RADIATION CONE LOCATOR
D5986   A   FLUORIDE GEL CARRIER
D5987   A   COMMISSURE SPLINT
D5988   A   SURGICAL SPLINT
D5999   A   UNSPECIFIED MAXILLOFACIAL PROSTHESIS, BY REPORT
D6010   A   SURGICAL PLACEMENT OF IMPLANT BODY: ENDOSTEAL IMPLANT
D6020   A   ABUTMENT PLACEMENT OR SUBSTITUTION: ENDOSTEAL IMPLANT
D6040   A   SURGICAL PLACEMENT: EPOSTEAL IMPLANT
D6050   A   SURGICAL PLACEMENT: TRANSOSTEAL IMPLANT
            IMPLANT/ABUTMENT SUPPORTED REMOVABLE DENTURE FOR COMPLETELY EDENTULOUS
D6053   A   ARCH

D6054   A   IMPLANT/ABUTMENT SUPPORTED REMOVABLE DENTURE FOR PARTIALLY EDENTULOUS ARCH
D6055   A   DENTAL IMPLANT SUPPORTED CONNECTING BAR
D6056   A   PREFABRICATED ABUTMENT
D6057   A   CUSTOM ABUTMENT
D6058   A   ABUTMENT SUPPORTED PORCELAIN/CERAMIC CROWN
D6059   A   ABUTMENT SUPPORTED PORCELAIN FUSED TO METAL CROWN (HIGH NOBLE METAL)
            ABUTMENT SUPPORTED PORCELAIN FUSED TO METAL CROWN (PREDOMINANTLY BASE
D6060   A   METAL)
D6061   A   ABUTMENT SUPPORTED PORCELAIN FUSED TO METAL CROWN (NOBLE METAL)
D6062   A   ABUTMENT SUPPORTED CAST METAL CROWN (HIGH NOBLE METAL)
D6063   A   ABUTMENT SUPPORTED CAST METAL CROWN (PREDOMINANTLY BASE METAL)
D6064   A   ABUTMENT SUPPORTED CAST METAL CROWN (NOBLE METAL)
D6065   A   IMPLANT SUPPORTED PORCELAIN/CERAMIC CROWN
            IMPLANT SUPPORTED PORCELAIN FUSED TO METAL CROWN (TITANIUM, TITANIUM ALLOY, HIGH
D6066   A   NOBLE METAL)
D6067   A   IMPLANT SUPPORTED METAL CROWN (TITANIUM, TITANIUM ALLOY, HIGH NOBLE METAL)
D6068   A   ABUTMENT SUPPORTED RETAINER FOR PORCELAIN/CERAMIC FPD
            ABUTMENT SUPPORTED RETAINER FOR PORCELAIN FUSED TO METAL FPD (HIGH NOBLE
D6069   A   METAL)
            ABUTMENT SUPPORTED RETAINER FOR PORCELAIN FUSED TO METAL FPD (PREDOMINANTLY
D6070   A   BASE METAL)

D6071   A   ABUTMENT SUPPORTED RETAINER FOR PORCELAIN FUSED TO METAL FPD (NOBLE METAL)
D6072   A   ABUTMENT SUPPORTED RETAINER FOR CAST METAL FPD (HIGH NOBLE METAL)

D6073   A   ABUTMENT SUPPORTED RETAINER FOR CAST METAL FPD (PREDOMINANTLY BASE METAL)
D6074   A   ABUTMENT SUPPORTED RETAINER FOR CAST METAL FPD (NOBLE METAL)
D6075   A   IMPLANT SUPPORTED RETAINER FOR CERAMIC FPD
            IMPLANT SUPPORTED RETAINER FOR PORCELAIN FUSED TO METAL FPD (TITANIUM, TITANIUM
D6076   A   ALLOY, OR HIGH NOBLE METAL)
            IMPLANT SUPPORTED RETAINER FOR CAST METAL FPD (TITANIUM, TITANIUM ALLOY, OR HIGH
D6077   A   NOBLE METAL)

D6078   A   IMPLANT/ABUTMENT SUPPORTED FIXED DENTURE FOR COMPLETELY EDENTULOUS ARCH
D6079   A   IMPLANT/ABUTMENT SUPPORTED FIXED DENTURE FOR PARTIALLY EDENTULOUS ARCH
            IMPLANT MAINTENANCE PROCEDURES, INCLUDING REMOVAL OF PROSTHESIS, CLEANSING OF
D6080   A   PROSTHESIS AND ABUTMENTS AND REINSERTION OF PROSTHESIS
D6090   A   REPAIR IMPLANT SUPPORTED PROSTHESIS, BY REPORT
D6095   A   REPAIR IMPLANT ABUTMENT, BY REPORT
D6100   A   IMPLANT REMOVAL, BY REPORT
D6199   A   UNSPECIFIED IMPLANT PROCEDURE, BY REPORT
D6210   A   PONTIC - CAST HIGH NOBLE METAL
D6211   A   PONTIC - CAST PREDOMINANTLY BASE METAL
D6212   A   PONTIC - CAST NOBLE METAL
D6220   R   SLOTTED FACING
D6240   A   PONTIC - PORCELAIN FUSED TO HIGH NOBLE METAL
D6241   A   PONTIC - PORCELAIN FUSED TO PREDOMINANTLY BASE METAL
D6242   A   PONTIC - PORCELAIN FUSED TO NOBLE METAL
D6245   A   PONTIC - PORCELAIN/CERAMIC
D6250   A   PONTIC - RESIN WITH HIGH NOBLE METAL
D6251   A   PONTIC - RESIN WITH PREDOMINANTLY BASE METAL
D6252   A   PONTIC - RESIN WITH NOBLE METAL
D6253   A   PROVISIONAL PONTIC
D6545   A   RETAINER - CAST METAL FOR RESIN BONDED FIXED PROSTHESIS
D6548   A   RETAINER - PORCELAIN/CERAMIC FOR RESIN BONDED FIXED PROSTHESIS
D6600   A   INLAY - PORCELAIN/CERAMIC, TWO SURFACES
D6601   A   INLAY - PORCELAIN/CERAMIC, THREE OR MORE SURFACES
D6602   A   INLAY - CAST HIGH NOBLE METAL, TWO SURFACES"
D6603   A   INLAY - CAST HIGH NOBLE METAL, THREE OR MORE SURFACES
D6604   A   INLAY - CAST PREDOMINANTLY BASE METAL, TWO SURFACES
D6605   A   INLAY - CAST PREDOMINANTLY BASE METAL, THREE OR MORE SURFACES
D6606   A   INLAY - CAST NOBLE METAL, TWO SURFACES
D6607   A   INLAY - CAST NOBLE METAL, THREE OR MORE SURFACES
D6608   A   ONLAY -PORCELAIN/CERAMIC, TWO SURFACES
D6609   A   ONLAY - PORCELAIN/CERAMIC, THREE OR MORE SURFACES
D6610   A   ONLAY - CAST HIGH NOBLE METAL, TWO SURFACES
D6611   A   ONLAY - CAST HIGH NOBLE METAL, THREE OR MORE SURFACES
D6612   A   ONLAY - CAST PREDOMINANTLY BASE METAL, TWO SURFACES
D6613   A   ONLAY - CAST PREDOMINANTLY BASE METAL, THREE OR MORE SURFACES
D6614   A   ONLAY - CAST NOBLE METAL, TWO SURFACES
D6615   A   ONLAY - CAST NOBLE METAL, THREE OR MORE SURFACES
D6720   A   CROWN - RESIN WITH HIGH NOBLE METAL
D6721   A   CROWN - RESIN WITH PREDOMINANTLY BASE METAL
D6722   A   CROWN - RESIN WITH NOBLE METAL
D6740   A   CROWN - PORCELAIN/CERAMIC
D6750   A   CROWN - PORCELAIN FUSED TO HIGH NOBLE METAL
D6751   A   CROWN - PORCELAIN FUSED TO PREDOMINANTLY BASE METAL
D6752   A   CROWN - PORCELAIN FUSED TO NOBLE METAL
D6780   A   CROWN - 3/4 CAST HIGH NOBLE METAL
D6781   A   CROWN - 3/4 CAST PREDOMINANTLY BASE METAL
D6782   A   CROWN - 3/4 CAST NOBLE METAL
D6783   A   CROWN - 3/4 PORCELAIN/CERAMIC
D6790   A   CROWN - FULL CAST HIGH NOBLE METAL
D6791   A   CROWN - FULL CAST PREDOMINANTLY BASE METAL
D6792   A   CROWN - FULL CAST NOBLE METAL
D6793   A   PROVISIONAL RETAINER CROWN
D6920   A   CONNECTOR BAR
D6930   A   RECEMENT BRIDGE
D6940   A   STRESS BREAKER
D6950   A   PRECISION ATTACHMENT
D6970   A   CAST POST AND CORE IN ADDITION TO FIXED PARTIAL DENTURE RETAINER
D6971   A   CAST POST AS PART OF FIXED PARTIAL DENTURE RETAINER
D6972   A   PREFABRICATED POST AND CORE IN ADDITION TO FIXED PARTIAL DENTURE RETAINER
D6973   A   CORE BUILD UP FOR RETAINER, INCLUDING ANY PINS
D6975   A   COPING - METAL
D6976   A   EACH ADDITIONAL CAST POST - SAME TOOTH
D6977   A   EACH ADDITIONAL PREFABRICATED POST - SAME TOOTH
D6980   A   FIXED PARTIAL DENTURE REPAIR, BY REPORT
D6985   A   PEDIATRIC PARTIAL DENTURE, FIXED
D6999   A   UNSPECIFIED FIXED PROSTHODONTIC PROCEDURE, BY REPORT
D7111   A   CORONAL REMNANTS - DECIDUOUS TOOTH

D7140   A   EXTRACTION, ERUPTED TOOTH OR EXPOSED ROOT (ELEVATION AND/OR FORCEPS REMOVAL)
D7210   A   SURGICAL EXTRACTION OF ERUPTED TOOTH
D7220   A   SURGICAL EXTRACTION, SOFT TISSUE IMPACTION
D7230   A   REMOVAL OF IMPACTED TOOTH - PARTIALLY BONY
D7240   A   REMOVAL OF IMPACTED TOOTH - COMPLETELY BONY
            REMOVAL OF IMPACTED TOOTH - COMPLETELY BONY, WITH UNUSUAL SURGICAL
D7241   A   COMPLICATIONS
D7250   A   SURGICAL REMOVAL OF RESIDUAL TOOTH ROOTS (CUTTING PROCEDURE)
D7260   A   OROANTRAL FISTULA CLOSURE
D7261   A   PRIMARY CLOSURE OF A SINUS PERFORATION
            TOOTH REIMPLANTATION AND/OR STABILIZATION OF ACCIDENTALLY EVULSED OR DISPLACED
D7270   A   TOOTH
            TOOTH TRANSPLANTATION (INCLUDES REIMPLANTATION FROM ONE SITE TO ANOTHER AND
D7272   A   SPLINTING AND/OR STABILIZATION)
D7280   A   SURGICAL ACCESS OF AN UNERUPTED TOOTH
D7281   A   SURGICAL EXPOSURE OF IMPACTED OR UNERUPTED TOOTH TO AID ERUPTION
D7282   A   MOBILIZATION OF ERUPTED OR MALPOSITIONED TOOTH TO AID ERUPTION
D7285   A   BIOPSY OF ORAL TISSUE - HARD (BONE, TOOTH)
D7286   A   BIOPSY OF ORAL TISSUE - SOFT (ALL OTHERS)
D7287   A   CYTOLOGY SAMPLE COLLECTION
D7290   A   SURGICAL REPOSITIONING OF TEETH
D7291   A   TRANSSEPTAL FIBEROTOMY/SUPRA CRESTAL FIBEROTOMY, BY REPORT
D7310   A   ALVEOLOPLASTY WITH EXTRACTIONS
D7320   A   ALVEOLOPLASTY WITHOUT EXTRACTIONS
D7340   A   VESTIBULOPLASTY - RIDGE EXTENSION (SECONDARY EPITHELIALIZATION)
            VESTIBULOPLASTY - RIDGE EXTENSION (INCLUDING SOFT TISSUE GRAFTS, MUSCLE
            REATTACHMENT, REVISION OF SOFT TISSUE ATTACHMENT AND MANAGEMENT OF
D7350   A   HYPERTROPHIED AND HYPERPLASTIC TISSUE)
D7410   A   EXCISION OF BENIGN LESION UP TO 1.25 CM
D7411   A   EXCISION OF BENIGN LESION GREATER THAN 1.25 CM
D7412   A   EXCISION OF BENIGN LESION, COMPLICATED
D7413   A   EXCISION OF MALIGNANT LESION UP TO 1.25 CM
D7414   A   EXCISION OF MALIGNANT LESION GREATER THAN 1.25 CM
D7415   A   EXCISION OF MALIGNANT LESION, COMPLICATED
D7440   A   EXCISION OF MALIGNANT TUMOR - LESION DIAMETER UP TO 1.25 CM
D7441   A   EXCISION OF MALIGNANT TUMOR - LESION DIAMETER GREATER THAN 1.25 CM

D7450   A   REMOVAL OF BENIGN ODONTOGENIC CYST OR TUMOR - LESION DIAMETER UP TO 1.25 CM
            REMOVAL OF BENIGN ODONTOGENIC CYST OR TUMOR - LESION DIAMETER GREATER THAN
D7451   A   1.25 CM

D7460   A   REMOVAL OF BENIGN NONODONTOGENIC CYST OR TUMOR - LESION DIAMETER UP TO 1.25 CM
            REMOVAL OF BENIGN NONODONTOGENIC CYST OR TUMOR - LESION DIAMETER GREATER
D7461   A   THAN 1.25 CM
D7465   A   DESTRUCTION OF LESION(S) BY PHYSICAL OR CHEMICAL METHOD, BY REPORT
D7471   A   REMOVAL OF LATERAL EXOSTOSIS (MAXILLA OR MANDIBLE)
D7472   A   REMOVAL OF TORUS PALATINUS
D7473   A   REMOVAL OF TORUS MANDIBULARIS
D7485   A   SURGICAL REDUCTION OF OSSEOUS TUBEROSITY
D7490   A   RADICAL RESECTION OF MANDIBLE WITH BONE GRAFT
D7510   A   INCISION AND DRAINAGE OF ABSCESS/INTRAORAL
D7520   A   INCISION AND DRAINAGE OF ABSCESS - EXTRAORAL SOFT TISSUE

D7530   A   REMOVAL OF FOREIGN BODY FROM MUCOSA, SKIN, OR SUBCUTANEOUS ALVEOLAR TISSUE
D7540   A   REMOVAL OF REACTION PRODUCING FOREIGN BODIES, MUSCULOSKELETAL SYSTEM
D7550   A   PARTIAL OSTECTOMY/SEQUESTRECTOMY FOR REMOVAL OF NON-VITAL BONE
D7560   A   MAXILLARY SINUSOTOMY FOR REMOVAL OF TOOTH FRAGMENT OR FOREIGN BODY
D7610   A   MAXILLA - OPEN REDUCTION (TEETH IMMOBILIZED, IF PRESENT)
D7620   A   MAXILLA - CLOSED REDUCTION (TEETH IMMOBILIZED, IF PRESENT)
D7630   A   MANDIBLE - OPEN REDUCTION (TEETH IMMOBILIZED, IF PRESENT)
D7640   A   MANDIBLE - CLOSED REDUCTION (TEETH IMMOBILIZED, IF PRESENT)
D7650   A   MALAR AND/OR ZYGOMATIC ARCH - OPEN REDUCTION
D7660   A   MALAR AND/OR ZYGOMATIC ARCH - CLOSED REDUCTION
D7670   A   ALVEOLUS - CLOSED REDUCTION, MAY INCLUDE STABILIZATION OF TEETH
D7671   A   ALVEOLUS - OPEN REDUCTION, MAY INCLUDE STABILIZATION OF TEETH
            FACIAL BONES - COMPLICATED REDUCTION WITH FIXATION AND MULTIPLE SURGICAL
D7680   A   APPROACHES
D7710   A   MAXILLA - OPEN REDUCTION
D7720   A   MAXILLA - CLOSED REDUCTION
D7730   A   MANDIBLE - OPEN REDUCTION
D7740   A   MANDIBLE - CLOSED REDUCTION
D7750   A   MALAR AND/OR ZYGOMATIC ARCH - OPEN REDUCTION
D7760   A   MALAR AND/OR ZYGOMATIC ARCH - CLOSED REDUCTION
D7770   A   ALVEOLUS - OPEN REDUCTION STABILIZATION OF TEETH
D7771   A   ALVEOLUS, CLOSED REDUCTION STABILIZATION OF TEETH
            FACIAL BONES - COMPLICATED REDUCTION WITH FIXATION AND MULTIPLE SURGICAL
D7780   A   APPROACHES
D7810   A   OPEN REDUCTION OF DISLOCATION
D7820   A   CLOSED REDUCTION OF DISLOCATION
D7830   A   MANIPULATION UNDER ANESTHESIA
D7840   A   CONDYLECTOMY
D7850   A   SURGICAL DISCECTOMY, WITH/WITHOUT IMPLANT
D7852   A   DISC REPAIR
D7854   A   SYNOVECTOMY
D7856   A   MYOTOMY
D7858   A   JOINT RECONSTRUCTION
D7860   A   ARTHROTOMY
D7865   A   ARTHROPLASTY
D7870   A   ARTHROCENTESIS
D7871   A   NON-ARTHROSCOPIC LYSIS AND LAVAGE
D7872   A   ARTHROSCOPY - DIAGNOSIS, WITH OR WITHOUT BIOPSY
D7873   A   ARTHROSCOPY - SURGICAL: LAVAGE AND LYSIS OF ADHESIONS
D7874   A   ARTHROSCOPY - SURGICAL: DISC REPOSITIONING AND STABILIZATION
D7875   A   ARTHROSCOPY - SURGICAL: SYNOVECTOMY
D7876   A   ARTHROSCOPY - SURGICAL: DISCECTOMY
D7877   A   ARTHROSCOPY - SURGICAL: DEBRIDEMENT
D7880   A   OCCLUSAL ORTHOTIC DEVICE, BY REPORT"
D7899   A   UNSPECIFIED TMD THERAPY, BY REPORT"
D7910   A   SUTURE OF RECENT SMALL WOUNDS UP TO 5 CM
D7911   A   COMPLICATED SUTURE - UP TO 5 CM
D7912   A   COMPLICATED SUTURE - GREATER THAN 5 CM
D7920   A   SKIN GRAFT (IDENTIFY DEFECT COVERED, LOCATION AND TYPE OF GRAFT)
D7940   A   OSTEOPLASTY - FOR ORTHOGNATHIC DEFORMITIES
D7941   A   OSTEOTOMY - MANDIBULAR RAMI
D7943   A   OSTEOTOMY - MANDIBULAR RAMI WITH BONE GRAFT; INCLUDES OBTAINING THE GRAFT
D7944   A   OSTEOTOMY - SEGMENTED OR SUBAPICAL – PER SEXTANT OR QUADRANT
D7945   A   OSTEOTOMY - BODY OF MANDIBLE
D7946   A   LEFORT I (MAXILLA - TOTAL)
D7947   A   LEFORT I (MAXILLA - SEGMENTED)
            LEFORT II OR LEFORT III (OSTEOPLASTY OF FACIAL BONES FOR MIDFACE HYPOPLASIA OR
D7948   A   RETRUSION)-WITHOUT BONE GRAFT
D7949   A   LEFORT II OR LEFORT III - WITH BONE GRAFT
            OSSEOUS, OSTEOPERIOSTEAL, OR CARTILAGE GRAFT OF THE MANDIBLE OR FACIAL BONES -
D7950   A   AUTOGENOUS OR NONAUTOGENOUS, BY REPORT"
D7955   A   REPAIR OF MAXILLOFACIAL SOFT AND HARD TISSUE DEFECT
D7960   A   FRENULECTOMY (FRENECTOMY OR FRENOTOMY) - SEPARATE PROCEDURE
D7970   A   EXCISION OF HYPERPLASTIC TISSUE - PER ARCH
D7971   A   EXCISION OF PERICORONAL GINGIVA
D7972   A   SURGICAL REDUCTION OF FIBROUS TUBEROSITY
D7980   A   SIALOLITHOTOMY
D7981   A   EXCISION OF SALIVARY GLAND, BY REPORT
D7982   A   SIALODOCHOPLASTY
D7983   A   CLOSURE OF SALIVARY FISTULA
D7990   A   EMERGENCY TRACHEOTOMY
D7991   A   CORONOIDECTOMY
D7995   A   SYNTHETIC GRAFT - MANDIBLE OR FACIAL BONES, BY REPORT
            IMPLANT-MANDIBLE FOR AUGMENTATION PURPOSES (EXCLUDING ALVEOLAR RIDGE), BY
D7996   A   REPORT
            APPLIANCE REMOVAL (NOT BY DENTIST WHO PLACED APPLIANCE), INCLUDES REMOVAL OF
D7997   A   ARCHBAR
D7999   A   UNSPECIFIED ORAL SURGERY PROCEDURE, BY REPORT
D8010   A   LIMITED ORTHODONTIC TREATMENT OF THE PRIMARY DENTITION
D8020   A   LIMITED ORTHODONTIC TREATMENT OF THE TRANSITIONAL DENTITION
D8030   A   LIMITED ORTHODONTIC TREATMENT OF THE ADOLESCENT DENTITION
D8040   A   LIMITED ORTHODONTIC TREATMENT OF THE ADULT DENTITION
D8050   A   INTERCEPTIVE ORTHODONTIC TREATMENT OF THE PRIMARY DENTITION
D8060   A   INTERCEPTIVE ORTHODONTIC TREATMENT OF THE TRANSITIONAL DENTITION
D8070   A   COMPREHENSIVE ORTHODONTIC TREATMENT OF THE TRANSITIONAL DENTITION
D8080   A   COMPREHENSIVE ORTHODONTIC TREATMENT OF THE ADOLESCENT DENTITION
D8090   A   COMPREHENSIVE ORTHODONTIC TREATMENT OF THE ADULT DENTITION
D8210   A   REMOVABLE APPLIANCE THERAPY
D8220   A   FIXED APPLIANCE THERAPY
D8660   A   PRE-ORTHODONTIC TX VISIT
D8670   A   PERIODIC ORTHODONTIC TREATMENT VISIT
            ORTHODONTIC RETENTION (REMOVAL OF APPLIANCES, CONSTRUCTION AND PLACEMENT OF
D8680   A   RETAINER(S))
D8690   A   ORTHODONTIC TREATMENT (ALTERNATIVE BILLING TO A CONTRACT FEE)
D8691   A   REPAIR OF ORTHODONTIC APPLIANCE
D8692   A   REPLACEMENT OF LOST OR BROKEN RETAINER
D8999   A   UNSPECIFIED ORTHODONTIC PROCEDURE, BY REPORT
D9110   A   EMERGENCY TX DENTAL PAIN (PALLIATIVE)

D9210   A   LOCAL ANESTHESIA NOT IN CONJUNCTION WITH OPERATIVE OR SURGICAL PROCEDURES
D9211   A   REGIONAL BLOCK ANESTHESIA
D9212   A   TRIGEMINAL DIVISION BLOCK
D9215   A   LOCAL ANESTHESIA
D9220   A   GENERAL ANESTHESIA
D9221   A   DEEP SEDATION/GENERAL ANESTHESIA - EACH ADDITIONAL 15 MINUTES
D9230   A   ANALGESIA, ANXIOLYSIS, INHALATION OF NITROUS
D9241   A   INTRAVENOUS SEDATION/ANALGESIA - FIRST 30 MI
D9242   A   INTRAVENOUS SEDATION/ANALGESIA - EACH ADDITI
D9248   A   NON-INTRAVENOUS CONSCIOUS SEDATION
D9310   A   CONSULTATION BY DENTIST OR MD (PER SESSION)
D9410   A   HOUSE/EXTENDED CARE FACILITY CALL
D9420   A   HOSPITAL CALL
D9430   A   OFFICE VISIT, OBSERVATION ONLY
D9440   A   OFFICE VISIT - AFTER REGULARLY SCHEDULED HOURS
D9450   A   CASE PRESENTATION, DETAILED AND EXTENSIVE TREATMENT PLANNING
D9610   A   THERAPEUTIC DRUG INJECTION
D9630   A   OTHER DRUGS AND/OR MEDICAMENTS, BY REPORT
D9910   A   APPLICATION OF DESENSITIZING MEDICAMENT

D9911   A   APPLICATION OF DESENSITIZING RESIN FOR CERVICAL AND/OR ROOT SURFACE, PER TOOTH
D9920   A   BEHAVIOR MANAGEMENT (BY REPORT)
D9930   A   COMPLICATIONS (POSTSURGICAL)
D9940   A   OCCLUSAL GUARD (BY REPORT)
D9941   A   FABRICATION OF ATHLETIC MOUTHGUARD
D9950   A   OCCLUSION ANALYSIS - MOUNTED CASE
D9951   A   OCCLUSAL ADJUSTMENT - LIMITED
D9952   A   OCCLUSAL ADJUSTMENT - COMPLETE
D9970   A   ENAMEL MICROABRASION
D9971   A   ODONTOPLASTY 1 - 2 TEETH; INCLUDES REMOVAL OF ENAMEL PROJECTIONS
D9972   A   EXTERNAL BLEACHING - PER ARCH
D9973   A   EXTERNAL BLEACHING - PER TOOTH
D9974   A   INTERNAL BLEACHING - PER TOOTH
D9999   A   UNSPECIFIED ADJUNCTIVE PROCEDURE, BY REPORT



            Legend:
            A - CDT/ADA developed code
            R - RVSI developed code
            X - Established Value
            I - Interim Value
            BR - By Report
            RNE - Relativity not yet established, treat as "By Report"
                I=      Interim Value
                BR =    By Report

                RNE =   Relativity Not Yet
IHS
Final   Flag
RVU     Value
0.70     X
0.92     X
1.00     X
2.27     I

 1.00    I
 1.12    I
 1.95    X
 0.45    X
 0.23    X
 0.54    X
 1.12    X
 0.78    X
 0.46    X
 0.67    X
 0.91    X
 1.34    X
 2.01    X
 4.69    X
11.17    X
 3.46    I
 6.25    X
 1.44    I
 1.39    X
 1.12    X
 1.55    I
 1.45    X
 3.57    X
 0.76    X
 1.25    X

1.67      I

0.00    RNE


0.00    RNE

0.00    RNE
3.01     I
 0.30   BR
 1.99    X
 1.02    X
 1.58    X
 0.56    X
 0.56    X
 2.23    X
 1.43    X
 0.69    I
 1.03    X
 0.80    X
 0.84    X
 4.47    X
 6.70    X
 5.58    X
 7.82    X
 1.34    X
 2.00    X
 2.20    X
 2.70    X
 3.30    X
 2.00    X
 3.00    X
 3.50    X
 4.00    X
 3.13    I
 2.34    I
 3.01    I
 3.46    I
 3.80    I
 8.93    X
10.61    X
13.18    X
12.73    X
14.40    X
13.40    X
16.53    I
17.31    X
18.98    X
13.96    X
14.52    X
18.98    X
15.63    X
17.87    X
20.66    X
12.84    I
14.52    X
18.98    X
14.52    X
17.87    X
18.98    X
11.17    X
22.33    X
16.75    X
18.98    X
22.33    X
14.96    X
17.87    X
20.10    X
20.10    I
14.52    I
16.75    I
21.22    I
13.36    X
15.63    X
17.87    X
11.17    I
 1.67    X
 1.43    X
 4.00    X
 2.26    X
 5.36    X
 5.02    X
 1.43    X
 3.54    X
 1.12    X
 8.93    X
 7.26    I
 4.05    X
 4.47    I
 3.91    I
 6.70    X
11.17    X
16.08    X
 3.85    X
 4.58    I
 0.53   BR
 0.74    X
 1.12    X
 3.00    X
 3.64    I

 3.68   I
 3.70   I
10.20   X
10.00   X
11.24   X
11.28   I
 6.03   I
 2.90   I
12.28   I
14.96   I
18.42   I
12.73   I

15.41   I


 8.93   X
10.16   I
11.72   I
13.06   I
10.83   I
 3.35   X
 5.58   X
17.31   I
11.17   I
 2.90   X

7.03     X
3.35     X
1.37    BR

10.61   X
 9.16   I
 7.54   X

 3.46   I
14.40   I
11.39   I
10.63   X

 8.93   I
10.61   I
 8.71   I
 5.25   I
15.52   I

17.87   I
14.85   I
13.62   X
14.07   X
18.42   I

11.39   I
 9.71   I
10.61   I
 7.59   X
 6.70   X
 4.55   X
 3.01   I
 2.71   I
 2.38   I
 3.29   X
 1.45   X
 1.00   BR
17.96    X
18.06    X
30.71    X
30.71    X
13.40    X

19.76   X
20.28   X
20.18   X

14.96   X
 1.21   X
 1.21   X
 1.20   X
 1.34   X
 3.35   X
 1.92   X
 3.35   X
 4.58   X
 4.13   X
 3.35   X
 3.35   X
 5.58   X
16.64   I
16.64   I
11.17   X
11.17   X
 8.93   X
 8.93   X
 6.70   X
 6.70   X
 5.58   X
 5.58   X
 8.93   X
 8.93   X
 8.93   X
 8.93   X
13.40   X
13.40   X
11.17   X
11.17   X
 2.52   X
 2.90   X
29.59   I
30.15   I
 9.94   I

4.24     X
5.47     I
1.00    BR
4.47     X
  6.70    X
111.66    X
111.66    X
150.74    X
156.32    X
156.32   BR
 72.58    I
 89.33    I
156.32   RNE
156.32   RNE
 55.83    X
 55.83    X
 75.37    X
 75.37   RNE
 35.73    X
 83.75    X
 16.75    X
 83.75    X
 83.75    X
 30.71    I
 55.83   RNE
 33.50    X
 33.50    X
 33.50    X
 75.37   BR
 72.58    X
 42.43    I
 13.40    I
  8.93    I
  6.03    X
 55.83   BR
 55.83   BR
 31.26    X
  3.35    X
 55.83   RNE
 11.95    I
 55.83   BR
 36.85    I
 17.31    I
164.14    I
106.08    I

 4.47     I

 3.35     I
41.87     X
14.40     I
16.53     I
21.33     I
22.78     I

15.74     I
20.66   I
19.88   I
19.54   I
20.55   I
27.92   I

27.92   I
27.92   I
19.88   I

19.54   I

17.53   I

17.75   I
19.88   I

18.87   I
19.09   I
22.56   I

21.89   I

24.34   I

55.83   I
48.13   I

 3.91    I
12.51    I
13.51    I
14.40    I
21.89   BR
22.33    X
15.63    X
17.87    X
 4.47    X
24.57    X
20.10    X
22.33    X
16.86    I
22.33    X
15.63    X
20.10    X
 2.79    I
10.61    I
15.30    I
 8.49    I
 9.04    I
 9.38    I
11.05    I
 6.03    I
 7.70    I
 7.59    I
 8.26    I
 9.27    I
 9.71    I
11.05    I
11.84    I
 7.70    I
 8.49    I
 8.26    I
 8.82    I
22.33    X
16.75    X
18.98    X
17.87    I
26.80    X
17.87    X
22.33    X
21.22    X
17.42    I
17.53    I
17.64    I
21.22    X
15.63    X
18.98    X
 1.67    I
14.96    I
 1.92    X
 5.58    X
 8.93    X
 8.93    X
 6.25    X
 6.70    X
 4.58    I
11.72    I
 4.80    I
 2.57    I
 5.81    I
 1.50   RNE
 3.83   BR
 2.23    I

2.46     I
3.72     X
4.60     X
6.00     X
7.20     X

11.17    X
 4.47    X
13.40    X
13.40   RNE
 8.04     X

11.17     X
 6.70     X
 4.47     X
 2.23     I
 5.81     X
 4.00     X
 0.17    RNE
 7.26     X
 4.24     X
 4.20     X
 5.30     X
13.40     X


31.26     X
 5.58     X
 5.47     I
 7.59     I
11.17     I
 9.83     I
15.86     I
 8.82     X
17.87     X

 7.59     X

 9.83     X

 7.48     X

 10.61    X
  5.86    X
  9.49    I
  7.82    I
  8.04    I
  8.82    I
138.46    I
  2.48    X
  6.70    X

 4.69     I
 9.49     X
 7.82     X
14.52     X
64.76     X
53.60     X
73.70     X
44.66     X
70.35     X
42.43     X
22.33    X
42.43    I

106.08   X
 77.05   X
 49.13   X
 85.98   X
 50.25   X
 72.58   X
 67.00   X
 42.43   X
  4.02   I

136.23  I
 70.35  X
 21.77  I
 10.16  X
 96.03  X
 91.56  X
109.43  I
111.66 RNE
111.66 RNE
125.06  I
 33.50  X
 93.79  I
  4.47  X
 43.88  I
 29.03  I
 31.82  I
 40.20  I
 42.99  I
 44.66  I
 41.31  I
 15.86  I
  4.47 BR
 15.41  I
  6.03  X
  8.93  X
 36.85  I
 59.18  X
156.32  I
158.56  I
125.06  I
126.18  I
139.58  X
139.58  X

156.32   X
227.79   I

48.01    I
50.25    I
 6.70    X
53.60    I
13.51    I
 6.70   RNE
 9.27    X
44.66    X
27.36    X
18.98    X
18.54    X
69.23    X
27.36   BR

27.36   BR

  1.00 RNE
  1.00 BR
 24.57  I
 29.03  I
 39.08  I
 37.96  I
 36.85  I
 41.31  I
101.61  X
101.61  X
106.08  X
 13.29  X
 15.97  X
  3.23  I
  1.85  I

 9.38    I
37.07    I
 3.63    I
 5.69    I
 2.50   BR
 1.87    X

1.00     X
0.91     X
2.24     X
0.52     X
3.82     X
2.23     X
1.94     X
4.05     I
1.70     I
4.97     I
1.77     X
3.35     X
3.35     X
1.19     X
2.23     X
0.50   RNE
0.96    X
0.52    I
1.50    X

1.23    I
1.51    I
1.72    I
8.87    X
3.24    I
5.02    X
1.91    X
8.93    X
3.01    I
3.01    I
6.25    I
4.02    X
4.58    X
0.33   BR




             I=      Interim Value
             BR =    By Report
             RNE =   Relativity Not Yet
                     Established (treat as
                     By Report

				
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