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									       COUNTY OF LOS ANGELES - DEPARTMENT OF HEALTH SERVICES

           LAC+USC HEALTHCARE NETWORK
              OUTPATIENT BILLING RATE
                FISCAL YEAR 2004-05


CHG CODE        BILLING DESCRIPTION                            PRICE
1031            CARDIAC EVALUATION                             $ 1,200
1051            AMBULATORY EMERGENCY 1                         $ 200
1052            AMBULATORY EMERGENCY 2                         $ 300
1053            AMBULATORY EMERGENCY 3                         $ 650
1054            AMBULATORY EMERGENCY 4                         $ 800
1055            AMBULATORY EMERGENCY 5                         $ 1,000
1056            AMBULATORY EMERGENCY 6                         $ 1,300
1057            AMBULATORY EMERGENCY 7                         $ 1,700
1058            AMBULATORY EMERGENCY 8                         $ 2,500
1061            MINOR TRAUMA PROC 1                            $ 200
1062            MINOR TRAUMA PROC 2                            $ 300
1063            MINOR TRAUMA PROC 3                            $ 650
1064            MINOR TRAUMA PROC 4                            $ 800
1065            MINOR TRAUMA PROC 5                            $ 1,000
1066            MINOR TRAUMA PROC 6                            $ 1,300
1067            MINOR TRAUMA PROC 7                            $ 1,700
1068            MINOR TRAUMA PROC 8                            $ 2,500
1111            VENOUS THROMBOSIS ANTICO                       $ 400
1121            HEMATOLOGY EXTENSIVE 1                         $ 200
1122            HEMATOLOGY EXTENSIVE 2                         $ 300
1123            HEMATOLOGY EXTENSIVE 3                         $ 650
1124            HEMATOLOGY EXTENSIVE 4                         $ 800
1125            HEMATOLOGY EXTENSIVE 5                         $ 1,000
1126            HEMATOLOGY EXTENSIVE 6                         $ 1,300
1127            HEMATOLOGY EXTENSIVE 7                         $ 1,700
1128            HEMATOLOGY EXTENSIVE 8                         $ 2,500
1151            ONCOLOGY INV 1                                 $ 200
1152            ONCOLOGY INV 2                                 $ 300
1153            ONCOLOGY INV 3                                 $ 650
1154            ONCOLOGY INV 4                                 $ 800
1155            ONCOLOGY INV 5                                 $ 1,000
1156            ONCOLOGY INV 6                                 $ 1,300
1157            ONCOLOGY INV 7                                 $ 1,700
1158            ONCOLOGY INV 8                                 $ 2,500
1161            SPUTUM SCREENING CLINIC                        $    75
1181            DIABETES EVAL 1                                $ 200
1182            DIABETES EVAL 2                                $ 300
1183            DIABETES EVAL 3                                $ 650
1184            DIABETES EVAL 4                                $ 800
1185            DIABETES EVAL 5                                $ 1,000
1186            DIABETES EVAL 6                                $ 1,300
1187            DIABETES EVAL 7                                $ 1,700
1188            DIABETES EVAL 8                                $ 2,500
1201            OBSERVATION CARE/CARDIAC (                     $ 1,000
1221            G I PROCEDURE CLINIC-1                         $ 200
1222            G I PROCEDURE CLINIC-2                         $ 300
1223            G I PROCEDURE CLINIC-3                         $ 650
1224            G I PROCEDURE CLINIC-4                         $ 800
1225            G I PROCEDURE CLINIC-5                         $ 1,000

                              1 of 75
       COUNTY OF LOS ANGELES - DEPARTMENT OF HEALTH SERVICES

           LAC+USC HEALTHCARE NETWORK
              OUTPATIENT BILLING RATE
                FISCAL YEAR 2004-05


CHG CODE        BILLING DESCRIPTION                            PRICE
1226            G I PROCEDURE CLINIC-6                         $ 1,300
1227            G I PROCEDURE CLINIC-7                         $ 1,700
1228            G I PROCEDURE CLINIC-8                         $ 2,500
1271            PERITONEAL DIALYSIS                            $ 650
1311            RHEUMATOLOGY WALK-IN CLIN                      $ 400
1331            OBSERVATION CARE/OTHER                         $ 800
1351            MAIN ADMITTING RM 1                            $ 200
1352            MAIN ADMITTING RM 2                            $ 300
1353            MAIN ADMITTING RM 3                            $ 650
1354            MAIN ADMITTING RM 4                            $ 800
1355            MAIN ADMITTING RM 5                            $ 1,000
1356            MAIN ADMITTING RM 6                            $ 1,300
1357            MAIN ADMITTING RM 7                            $ 1,700
1358            MAIN ADMITTING RM 8                            $ 2,500
1391            POLYSOMNOGRAPHY LEVEL I                        $ 650
1392            POLYSOMNOGRAPHY LEVEL II                       $ 1,400
1393            POLYSOMNOGRAPHY LEVEL III                      $ 1,700
1394            POLYSOMNOGRAPHY LEVEL IV                       $ 2,900
1395            POLYSOMNOGRAPHY LEVEL V                        $ 2,700
1396            POLYSOMNOGRAPHY LEVEL VI                       $ 650
1401            PULMONARY DIAG LEVEL I                         $ 650
1402            PULMONARY DIAG LEVEL II                        $ 1,400
1403            PULMONARY DIAG LEVEL III                       $ 2,500
1411            PULMONARY LAB-WALK-IN                          $ 650
1421            BRONCHOSCOPY                                   $ 2,500
1451            MOVE DISORDER 1                                $ 200
1452            MOVE DISORDER 2                                $ 300
1453            MOVE DISORDER 3                                $ 650
1454            MOVE DISORDER 4                                $ 800
1455            MOVE DISORDER 5                                $ 1,000
1456            MOVE DISRODER 6                                $ 1,300
1457            MOVE DISORDER 7                                $ 1,700
1458            MOVE DISORDER 8                                $ 2,500
1461            MUSCULAR DYSTROPHY                             $ 400
1491            NEUROSURG OUTPATIENT                           $ 650
1501            NON INVASIVE CARDIO 1                          $ 200
1502            NON INVASIVE CARDIO 2                          $ 300
1503            NON INVASIVE CARDIO 3                          $ 650
1504            NON INVASIVE CARDIO 4                          $ 800
1505            NON INVASIVE CARDIO 5                          $ 1,000
1506            NON INVASIVE CARDIO 6                          $ 1,300
1507            NON INVASIVE CARDIO 7                          $ 1,700
1508            NON INVASIVE CARDIO 8                          $ 2,500
1541            FNA BIOPSY SERVICE 1                           $ 200
1542            FNA BIOPSY SERVICE 2                           $ 300
1543            FNA BIOPSY SERVICE 3                           $ 650
1544            FNA BIOPSY SERVICE 4                           $ 800
1545            FNA BIOPSY SERVICE 5                           $ 1,000
1546            FNA BIOPSY SERVICE 6                           $ 1,300

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       COUNTY OF LOS ANGELES - DEPARTMENT OF HEALTH SERVICES

           LAC+USC HEALTHCARE NETWORK
              OUTPATIENT BILLING RATE
                FISCAL YEAR 2004-05


CHG CODE        BILLING DESCRIPTION                            PRICE
1547            FNA BIOPSY SERVICE 7                           $ 1,700
1548            FNA BIOPSY SERVICE 8                           $ 2,500
1551            OUTPATIENT SURGERY 1                           $ 2,700
1552            OUTPATIENT SURGERY 2                           $ 700
1553            OUTPATIENT SURGERY 3                           $ 1,000
1554            OUTPATIENT SURGERY 4                           $ 1,300
1555            OUTPATINET SURGERY 5                           $ 1,500
1556            OUTPATIENT SURGERY 6                           $ 1,700
1557            OUTPATIENT SURGERY 7                           $ 1,900
1558            OUTPATIENT SURGERY 8                           $ 2,500
1559            OUTPATIENT SURGERY 9                           $ 2,700
1561            BURN EVALUATION 1                              $ 200
1562            BURN EVALUATION 2                              $ 300
1563            BURN EVALUATION 3                              $ 650
1564            BURN EVALUATION 4                              $ 800
1565            BURN EVALUATION 5                              $ 1,000
1566            BURN EVALUATION 6                              $ 1,300
1567            BURN EVALUATION 7                              $ 1,700
1568            BURN EVALUATION 8                              $ 2,500
1571            BURN SCHEDULED 1                               $ 200
1572            BURN SCHEDULED 2                               $ 300
1573            BURN SCHEDULED 3                               $ 650
1574            BURN SCHEDULED 4                               $ 800
1575            BURN SCHEDULED 5                               $ 1,000
1576            BURN SCHEDULED 6                               $ 1,300
1577            BURN SCHEDULED 7                               $ 1,700
1578            BURN SCHEDULED 8                               $ 2,500
1581            SURGICAL F/U 1                                 $ 200
1582            SURGICAL F/U 2                                 $ 300
1583            SURGICAL F/U 3                                 $ 650
1584            SURGICAL F/U 4                                 $ 800
1585            SURGICAL F/U 5                                 $ 1,000
1586            SURGICAL F/U 6                                 $ 1,300
1587            SURGICAL F/U 7                                 $ 1,700
1588            SURGICAL F/U 8                                 $ 2,500
1591            MINOR SURGERY CLINIC                           $ 400
1611            CARDIAC CATH PROCEDURE                         $ 2,700
1641            OPHTHAL EVAL 1                                 $ 200
1642            OPHTHAL EVAL 2                                 $ 300
1643            OPHTHAL EVAL 3                                 $ 300
1644            OPHTHAL EVAL 4                                 $ 800
1645            OPHTHAL EVAL 5                                 $ 1,000
1646            OPHTHAL EVAL 6                                 $ 1,300
1647            OPHTHAL EVAL 7                                 $ 1,700
1648            OPHTHAL EVAL 8                                 $ 2,500
1651            OPHTHAL SCHEDULED 1                            $ 200
1652            OPHTHAL SCHEDULED 2                            $ 300
1653            OPHTHAL SCHEDULED 3                            $ 650
1654            OPHTHAL SCHEDULED 4                            $ 800

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       COUNTY OF LOS ANGELES - DEPARTMENT OF HEALTH SERVICES

           LAC+USC HEALTHCARE NETWORK
              OUTPATIENT BILLING RATE
                FISCAL YEAR 2004-05


CHG CODE        BILLING DESCRIPTION                            PRICE
1655            OPHTHAL SCHEDULED 5                            $ 1,000
1656            OPHTHAL SCHEDULED 6                            $ 1,300
1657            OPHTHAL SCHEDULED 7                            $ 1,700
1658            OPHTHAL SCHEDULED 8                            $ 2,500
1661            UROLOGY EVAL 1                                 $ 200
1662            UROLOGY EVAL 2                                 $ 300
1663            UROLOGY EVAL 3                                 $ 650
1664            UROLOGY EVAL 4                                 $ 800
1665            UROLOGY EVAL 5                                 $ 1,000
1666            UROLOGY EVAL 6                                 $ 1,300
1667            UROLOGY EVAL 7                                 $ 1,700
1668            UROLOGY EVAL 8                                 $ 2,500
1681            UROLOGY PROCED 1                               $ 200
1682            UROLOGY PROCED 2                               $ 300
1683            UROLOGY PROCED 3                               $ 650
1684            UROLOGY PROCED 4                               $ 800
1685            UROLOGY PROCED 5                               $ 1,000
1686            UROLOGY PROCED 6                               $ 1,300
1687            UROLOGY PROCED 7                               $ 1,700
1688            UROLOGY PROCED 8                               $ 2,500
1691            ENT EVAL 1                                     $ 200
1692            ENT EVAL 2                                     $ 300
1693            ENT EVAL 3                                     $ 650
1694            ENT EVAL 4                                     $ 800
1695            ENT EVAL 5                                     $ 1,000
1696            ENT EVAL 6                                     $ 1,300
1697            ENT EVAL 7                                     $ 1,700
1698            ENT EVAL 8                                     $ 2,500
1701            ENT PROCED 1                                   $ 200
1702            ENT PROCED 2                                   $ 300
1703            ENT PROCED 3                                   $ 650
1704            ENT PROCED 4                                   $ 800
1705            ENT PROCED 5                                   $ 1,000
1706            ENT PROCED 6                                   $ 1,300
1707            ENT PROCED 7                                   $ 1,700
1708            ENT PROCED 8                                   $ 2,500
1741            MED/SURG 13000 1                               $ 200
1742            MED/SURG 13000 2                               $ 300
1743            MED/SURG 13000 3                               $ 650
1744            MED/SURG 13000 4                               $ 800
1745            MED/SURG 13000 5                               $ 1,000
1746            MED/SURG 13000 6                               $ 1,300
1747            MED/SURG 13000 7                               $ 1,700
1748            MED/SURG 13000 8                               $ 2,500
1751            MED/SURG 13000 CLINIC 1                        $ 200
1752            MED/SURG 13000 CLINIC 2                        $ 300
1753            MED/SURG 13000 CLINIC 3                        $ 650
1754            MED/SURG 13000 CLINIC 4                        $ 800
1755            MED/SURG 13000 CLINIC 5                        $ 1,000

                              4 of 75
       COUNTY OF LOS ANGELES - DEPARTMENT OF HEALTH SERVICES

           LAC+USC HEALTHCARE NETWORK
              OUTPATIENT BILLING RATE
                FISCAL YEAR 2004-05


CHG CODE        BILLING DESCRIPTION                            PRICE
1756            MED/SURG 13000 CLINIC 6                        $ 1,300
1757            MED/SURG 13000 CLINIC 7                        $ 1,700
1758            MED/SURG 13000 CLINIC 8                        $ 2,500
1761            OMF EVAL 1                                     $ 200
1762            OMF EVAL 2                                     $ 300
1763            OMF EVAL 3                                     $ 650
1764            OMF EVAL 4                                     $ 800
1765            OMF EVAL 5                                     $ 1,000
1766            OMF EVAL 6                                     $ 1,300
1767            OMF EVAL 7                                     $ 1,700
1768            OMF EVAL 8                                     $ 2,500
1771            OMF PROCED 1                                   $ 200
1772            OMF PROCED 2                                   $ 300
1773            OMF PROCED 3                                   $ 650
1774            OMF PROCED 4                                   $ 800
1775            OMF PROCED 5                                   $ 1,000
1776            OMF PROCED 6                                   $ 1,300
1777            OMF PROCED 7                                   $ 1,700
1778            OMF PROCED 8                                   $ 2,500
1781            NUCLEAR MEDICINE-SIMPLE                        $ 300
1782            NUCLEAR MEDICINE-INTERMED                      $ 400
1783            NUCLEAR MEDICINE-EXTENDED                      $ 650
1784            NUCLEAR MEDICINE-COMPLEX                       $ 800
1791            NUCLEAR MED IMAGING                            $ 1,400
1792            NUCLEAR MED IMAGING-FU                         $ 200
1801            NUCLEAR MED-SPECIAL STUDY                      $ 1,400
1811            NERVE BLOCK 1                                  $ 200
1812            NERVE BLOCK 2                                  $ 300
1813            NERVE BLOCK 3                                  $ 650
1814            NERVE BLOCK 4                                  $ 800
1815            NERVE BLOCK 5                                  $ 1,000
1816            NERVE BLOCK 6                                  $ 1,300
1817            NERVE BLOCK 7                                  $ 1,700
1818            NERVE BLOCK 8                                  $ 2,500
1851            HYPERBARIC CHAMBER BRIEF                       $ 9,951
1852            HYPERBARIC CHAMBER LIMIT                       $ 9,951
1853            HYPERBARIC CHAMBER INTER                       $ 9,951
1854            HYPERBARIC CHAMBER EXT                         $ 9,951
1855            HYPERBARIC PAT EVALUATION                      $ 1,200
1861            HYPERBARIC CHAMBER                              ######
1862            HYPERBARIC CHAMBER                              ######
1863            HYBERBARIC CHAMBER                              ######
1864            HYPERBARIC CHAMBER                              ######
1865            HYPERBARIC PAT EVALUATION                      $ 1,200
2001            WOMEN'S HOSP EMER RM                           $ 400
2011            ER WOMENS EMERGENCY RM 1                       $ 200
2012            ER WOMENS EMERGENCY RM 2                       $ 300
2013            ER WOMENS EMERGENCY RM 3                       $ 650
2014            ER WOMENS EMERGENCY RM 4                       $ 800

                              5 of 75
       COUNTY OF LOS ANGELES - DEPARTMENT OF HEALTH SERVICES

           LAC+USC HEALTHCARE NETWORK
              OUTPATIENT BILLING RATE
                FISCAL YEAR 2004-05


CHG CODE        BILLING DESCRIPTION                            PRICE
2015            ER WOMENS EMERGENCY RM 5                       $ 1,000
2016            ER WOMENS EMERGENCY RM 6                       $ 1,300
2017            ER WOMENS EMERGENCY RM 7                       $ 1,700
2018            ER WOMENS EMERGENCY RM 8                       $ 2,500
2021            ER GYN EVALUATION 1                            $ 200
2022            ER GYN EVALUATION 2                            $ 300
2023            ER GYN EVALUATION 3                            $ 650
2024            ER GYN EVALUATION 4                            $ 800
2025            ER GYN EVALUATION 5                            $ 1,000
2026            ER GYN EVALUATION 6                            $ 1,300
2027            ER GYN EVALUATION 7                            $ 1,700
2028            ER GYN EVALUATION 8                            $ 2,500
2031            GYN EVAL SCHEDULED 1                           $ 200
2032            GYN EVAL SCHEDULED 2                           $ 300
2033            GYN EVAL SCHEDULED 3                           $ 650
2034            GYN EVAL SCHEDULED 4                           $ 800
2035            GYN EVAL SCHEDULED 5                           $ 1,000
2036            GYN EVAL SCHEDULED 6                           $ 1,300
2037            GYN EVAL SCHEDULED 7                           $ 1,700
2038            GYN EVAL SCHEDULED 8                           $ 2,500
2041            GYN UROL CYSTOMETRICS 1                        $ 200
2042            GYN UROL CYSTOMETRICS 2                        $ 300
2043            GYN UROL CYSTOMETRICS 3                        $ 650
2044            GYN UROL CYSTOMETRICS 4                        $ 800
2045            GYN UROL CYSTOMETRICS 5                        $ 1,000
2046            GYN UROL CYSTOMETRICS 6                        $ 1,300
2047            GYN UROL CYSTOMETRICS 7                        $ 1,700
2048            GYN UROL CYSTOMETRICS 8                        $ 2,500
2051            WM HLTH SRVS CONTINUITY 1                      $ 200
2052            WM HLTH SRVS CONINTUITY 2                      $ 300
2053            WM HLTH SRVS CONTINUITY 3                      $ 650
2054            WM HLTH SRVS CONTINUITY 4                      $ 800
2055            WM HLTH SRVS CONTINUITY 5                      $ 1,000
2056            WM HLTH SRVS CONTINUITY 6                      $ 1,300
2057            WH HLTH SRVS CONTINUITY 7                      $ 1,700
2058            WM HLTH SRVS CONTINUITY 8                      $ 2,500
2061            GYN SURGICAL REFERRAL 1                        $ 200
2062            GYN SURGICAL REFERRAL 2                        $ 300
2063            GYN SURGICAL REFERRAL 3                        $ 650
2064            GYN SURGICAL REFERRAL 4                        $ 800
2065            GYN SURGICAL REFERRAL 5                        $ 1,000
2066            GYN SURGICAL REFERRAL 6                        $ 1,300
2067            GYN SURGICAL REFERRAL 7                        $ 1,700
2068            GYN SURGICAL REFERRAL 8                        $ 2,500
2071            OB HIGH RISK 1                                 $ 200
2072            OB HIGH RISK 2                                 $ 300
2073            OB HIGH RISK 3                                 $ 650
2074            OB HIGH RISK 4                                 $ 800
2075            OB HIGH RISK 5                                 $ 1,000

                              6 of 75
       COUNTY OF LOS ANGELES - DEPARTMENT OF HEALTH SERVICES

           LAC+USC HEALTHCARE NETWORK
              OUTPATIENT BILLING RATE
                FISCAL YEAR 2004-05


CHG CODE        BILLING DESCRIPTION                            PRICE
2076            OB HIGH RISK 6                                 $ 1,300
2077            OB HIGH RISK 7                                 $ 1,700
2078            OB HIGH RISK 8                                 $ 2,500
2081            OB GENETICS 1                                  $ 200
2082            OB GENETICS 2                                  $ 300
2083            OB GENETICS 3                                  $ 650
2084            OB GENETICS 4                                  $ 800
2085            OB GENETICS 5                                  $ 1,000
2086            OB GENETICS 6                                  $ 1,300
2087            OB GENETICS 7                                  $ 1,700
2088            OB GENETICS 8                                  $ 2,500
2091            OB HIGH RISK CONSULTATION 1                    $ 200
2092            OB HIGH RISK CONSULTATION 2                    $ 300
2093            OB HIGH RISK CONSULTATION 3                    $ 650
2094            OB HIGH RISK CONSULTATION 4                    $ 800
2095            OB HIGH RISK CONSULTATION 5                    $ 1,000
2096            OB HIGH RISK CONSULTATION 6                    $ 1,300
2097            OB HIGH RISK CONSULTATION 7                    $ 1,700
2098            OB HIGH HISK CONSULTATION 8                    $ 2,500
2101            GYN WALK-IN 1                                  $ 200
2102            GYN WALK-IN 2                                  $ 300
2103            GYN WALK-IN 3                                  $ 650
2104            GYN WALK-IN 4                                  $ 800
2105            GYN WALK-IN 5                                  $ 1,000
2106            GYN WALK-IN 6                                  $ 1,300
2107            GYN WALK-IN 7                                  $ 1,700
2108            GYN WALK-IN 8                                  $ 2,500
2111            OB-GYN GYNECOLOGY NEW RETUR                    $ 400
2121            OB-GYN BREAST SCREENING                        $ 400
2131            GYN BREAST DIAG/TREATMENT 1                    $ 200
2132            GYN BREAST DIAG/TREATMENT 2                    $ 300
2133            GYN BREAST DIAG/TREATMENT 3                    $ 650
2134            GYN BREAST DIAG/TREATMENT 4                    $ 800
2135            GYN BREAST DIAG/TREATMENT 5                    $ 1,000
2136            GYN BREAST DIAG/TREATMENT 6                    $ 1,300
2137            GYN BREAST DIAG/TREATMENT 7                    $ 1,700
2138            GYN BREAST DIAG/TREATMENT 8                    $ 2,500
2141            GYN BREAST DIAG/TREATMENT 1                    $ 200
2142            GYN BREAST DIAG/TREATMENT 2                    $ 300
2143            GYN BREAST DIAG/TREATMENT 3                    $ 650
2144            GYN BREAST DIAG/TREATMENT 4                    $ 800
2145            GYN BREAST DIAG/TREATMENT 5                    $ 1,000
2146            GYN BREAST DIAG/TREATMENT 6                    $ 1,300
2147            GYN BREAST DIAG/TREATMENT 7                    $ 1,700
2148            GYN BREAST DIAG/TREATMENT 8                    $ 2,500
2161            GYN CONTINUITY 1                               $ 200
2162            GYN CONTINUITY 2                               $ 300
2163            GYN CONTINUITY 3                               $ 650
2164            GYN CONTINUITY 4                               $ 800

                              7 of 75
       COUNTY OF LOS ANGELES - DEPARTMENT OF HEALTH SERVICES

           LAC+USC HEALTHCARE NETWORK
              OUTPATIENT BILLING RATE
                FISCAL YEAR 2004-05


CHG CODE        BILLING DESCRIPTION                            PRICE
2165            GYN CONTINUITY 5                               $ 1,000
2166            GYN CONTINUITY 6                               $ 1,300
2167            GYN CONTINUITY 7                               $ 1,700
2168            GYN CONTINUITY 8                               $ 2,500
2171            GYN ENDOCRINE SCREEN 1                         $ 200
2172            GYN ENDOCRINE SCREEN 2                         $ 300
2173            GYN ENDOCRINE SCREEN 3                         $ 650
2174            GYN ENDOCRINE SCREEN 4                         $ 800
2175            GYN ENDOCRINE SCREEN 5                         $ 1,000
2176            GYN ENDOCRINE SCREEN 6                         $ 1,300
2177            GYN ENDOCRINE SCREEN 7                         $ 1,700
2178            GYN ENDOCRINE SCREEN 8                         $ 2,500
2181            GYN REPRODUCTIVE/ENDO 1                        $ 200
2182            GYN REPRODUCTIVE/ENDO 2                        $ 300
2183            GYN REPRODUCTIVE/ENDO 3                        $ 650
2184            GYN REPRODUCTIVE/ENDO 4                        $ 800
2185            GYN REPRODUCTIVE/ENDO 5                        $ 1,000
2186            GYN REPRODUCTIVE/ENDO 6                        $ 1,300
2187            GYN REPRODUCTIVE/ENDO 7                        $ 1,700
2188            GYN REPRODUCTIVE/ENDO 8                        $ 2,500
2191            GYN REPRODU/INFERTILITY 1                      $ 200
2192            GYN REPRODU/INFERTILITY 2                      $ 300
2193            GYN REPRODU/INFERTILITY 3                      $ 650
2194            GYN REPRODU/INFERTILITY 4                      $ 800
2195            GYN REPRODU/INFERTILITY 5                      $ 1,000
2196            GYN REPRODU/INFERTILITY 6                      $ 1,300
2197            GYN REPRODU/INFERTILITY 7                      $ 1,700
2198            GYN REPRODU/INFERTILITY 8                      $ 2,500
2201            GYNECOLOGY 1                                   $ 200
2202            GYNECOLOGY 2                                   $ 300
2203            GYNECOLOGY 3                                   $ 650
2204            GYNECOLOGY 4                                   $ 800
2205            GYNECOLOGY 5                                   $ 1,000
2206            GYNECOLOGY 6                                   $ 1,300
2207            GYNECOLOGY 7                                   $ 1,700
2208            GYNECOLOGY 8                                   $ 2,500
2211            GYN BREAST SCREENING 1                         $ 200
2212            GYN BREAST SCREENING 2                         $ 300
2213            GYN BREAST SCREENING 3                         $ 650
2214            GYN BREAST SCREENING 4                         $ 800
2215            GYN BREAST SCREENING 5                         $ 1,000
2216            GYN BREAST SCREENING 6                         $ 1,300
2217            GYN BREAST SCREENING 7                         $ 1,700
2218            GYN BREAST SCREENING 8                         $ 2,500
2221            GYN HYSTEROSCOPY 1                             $ 200
2222            GYN HYSTEROSCOPY 2                             $ 300
2223            GYN HYSTEROSCOPY 3                             $ 650
2224            GYN HYSTEROSCOPY 4                             $ 800
2225            GYN HYSTEROSCOPY 5                             $ 1,000

                              8 of 75
       COUNTY OF LOS ANGELES - DEPARTMENT OF HEALTH SERVICES

           LAC+USC HEALTHCARE NETWORK
              OUTPATIENT BILLING RATE
                FISCAL YEAR 2004-05


CHG CODE        BILLING DESCRIPTION                            PRICE
2226            GYN HYSTEROSCOPY 6                             $ 1,300
2227            GYN HYSTEROSCOPY 7                             $ 1,700
2228            GYN HYSTEROSCOPY 8                             $ 2,500
2231            GYN FAM PLAN TYPE III 1                        $ 200
2232            GYN FAM PLAN TYPE III 2                        $ 300
2233            GYN FAM PLAN TYPE III 3                        $ 650
2234            GYN FAM PLAN TYPE III 4                        $ 800
2235            GYN FAM PLAN TYPE III 5                        $ 1,000
2236            GYN FAM PLAN TYPE III 6                        $ 1,300
2237            GYN FAM PLAN TYPE III 7                        $ 1,700
2238            GYN FAM PLAN TYPE III 8                        $ 2,500
2241            GYN FAM PLAN TYPE II 1                         $ 200
2242            GYN FAM PLAN TYPE II 2                         $ 300
2243            GYN FAM PLAN TYPE II 3                         $ 650
2244            GYN FAM PLAN TYPE II 4                         $ 800
2245            GYN FAM PLAN TYPE II 5                         $ 1,000
2246            GYN FAM PLAN TYPE II 6                         $ 1,300
2247            GYN FAM PLAN TYPE II 7                         $ 1,700
2248            GYN FAM PLAN TYPE II 8                         $ 2,500
2251            GYN FAM PLAN TYPE I 1                          $ 200
2252            GYN FAM PLAN TYPE I 2                          $ 300
2253            GYN FAM PLAN TYPE I 3                          $ 650
2254            GYN FAM PLAN TYPE I 4                          $ 800
2255            GYN FAM PLAN TYPE I 5                          $ 1,000
2256            GYN FAM PLAN TYPE I 6                          $ 1,300
2257            GYN FAM PLAN TYPE I 7                          $ 1,700
2258            GYN FAM PLAN TYPE I 8                          $ 2,500
2261            GYN FAM PLAN VASECTOMY 1                       $ 200
2262            GYN FAM PLAN VASECTOMY 2                       $ 300
2263            GYN FAM PLAN VASECTOMY 3                       $ 650
2264            GYN FAM PLAN VASECTOMY 4                       $ 800
2265            GYN FAM PLAN VASECTOMY 5                       $ 1,000
2266            GYN FAM PLAN VASECTOMY 6                       $ 1,300
2267            GYN FAM PLAN VASECTOMY 7                       $ 1,700
2268            GYN FAM PLAN VASECTOMY 8                       $ 2,500
2271            GYN PH FP VASECTOMY 1                          $ 200
2272            GYN PH FP VASECTOMY 2                          $ 300
2273            GYN PH FP VASECTOMY 3                          $ 650
2274            GYN PH FP VASECTOMY 4                          $ 800
2275            GYN PH FP VASECTOMY 5                          $ 1,000
2276            GYN PH FP VASECTOMY 6                          $ 1,300
2277            GYN PH FP VASECTOMY 7                          $ 1,700
2278            GYN PH FP VASECTOMY 8                          $ 2,500
2281            GYN FAM PLAN COLPOSCOPY 1                      $ 200
2282            GYN FAM PLAN COLPOSCOPY 2                      $ 300
2283            GYN FAM PLAN COLPOSCOPY 3                      $ 650
2284            GYN FAM PLAN COLPOSCOPY 4                      $ 800
2285            GYN FAM PLAN COLPOSCOPY 5                      $ 1,000
2286            GYN FAM PLAN COLPOSCOPY 6                      $ 1,300

                              9 of 75
       COUNTY OF LOS ANGELES - DEPARTMENT OF HEALTH SERVICES

           LAC+USC HEALTHCARE NETWORK
              OUTPATIENT BILLING RATE
                FISCAL YEAR 2004-05


CHG CODE        BILLING DESCRIPTION                            PRICE
2287            GYN FAM PLAN COLPOSCOPY 7                      $ 1,700
2288            GYN FAM PLAN COLPOSCOPY 8                      $ 2,500
2291            GYN STERILIZATION PRE-OP 1                     $ 550
2292            GYN STERILIZATION PRE-OP 2                     $ 300
2293            GYN STERILIZATION PRE-OP 3                     $ 650
2294            GYN STERILIZATION PRE-OP 4                     $ 800
2295            GYN STERILIZATION PRE-OP 5                     $ 1,000
2296            SYN STERILIZATION PRE-OP 6                     $ 1,300
2297            GYN STERILIZATION PRE-OP 7                     $ 1,700
2298            GYN STERILIZATION PRE-OP 8                     $ 2,500
2301            FP GYN TUBAL DAY SURGERY                       $ 2,500
2305            PH FAMILY PLANNING                             $ 400
2311            GYN STERILIZATION POST-OP 1                    $ 200
2312            GYN STERILIZATION POST-OP 2                    $ 300
2313            GYN STERILIZATION POST-OP 3                    $ 650
2314            GYN STERILIZATION POST-OP 4                    $ 800
2315            GYN STERILIZATION POST-OP 5                    $ 1,000
2316            GYN STERILIZATION POST-OP 6                    $ 1,300
2317            GYN STERILIZATION POST-OP 7                    $ 1,700
2318            GYN STERILIZATION POST-OP 8                    $ 2,500
2321            PH FAMILY PLANG POST INCOMP                    $ 400
2331            PH FAMILY PLANG HIGH RISK/D                    $ 400
2341            PH FAMILY PLANNING VASECTOM                    $ 400
2351            GYN NORPLANT REMOVAL 1                         $ 200
2352            GYN NORPLANT REMOVAL 2                         $ 300
2353            GYN NORPLANT REMOVAL 3                         $ 650
2354            GYN NORPLANT REMOVAL 4                         $ 800
2355            GYN NORPLANT REMOVAL 5                         $ 1,000
2356            GYN NORPLANT REMOVAL 6                         $ 1,300
2357            GYN NORPLANT REMOVAL 7                         $ 1,700
2358            GYN NORPLANT REMOVAL 8                         $ 2,500
2361            GYN NORPLANT INSERT 1                          $ 200
2362            GYN NORPLANT INSERT 2                          $ 300
2363            GYN NORPLANT INSERT 3                          $ 650
2364            GYN NORPLANT INSERT 4                          $ 800
2365            GYN NORPLANT INSERT 5                          $ 1,000
2366            GYN NORPLANT INSERT 6                          $ 1,300
2367            GYN NORPLANT INSERT 7                          $ 1,700
2368            GYN NORPLANT INSERT 8                          $ 2,500
2381            OB-COLPOSCOPY                                  $ 400
2391            GYN ONCOLOGY 1                                 $ 200
2392            GYN ONCOLOGY 2                                 $ 300
2393            GYN ONCOLOGY 3                                 $ 650
2394            GYN ONCOLOGY 4                                 $ 800
2395            GYN ONCOLOGY 5                                 $ 1,000
2396            GYN ONCOLOGY 6                                 $ 1,300
2397            GYN ONCOLOGY 7                                 $ 1,700
2398            GYN ONCOLOGY 8                                 $ 2,500
2401            GYN ONCOLOGY ABNORMAL 1                        $ 200

                             10 of 75
       COUNTY OF LOS ANGELES - DEPARTMENT OF HEALTH SERVICES

           LAC+USC HEALTHCARE NETWORK
              OUTPATIENT BILLING RATE
                FISCAL YEAR 2004-05


CHG CODE        BILLING DESCRIPTION                            PRICE
2402            GYN ONCOLOGY ABNORMAL 2                        $ 300
2403            GYN ONCOLOGY ABNORMAL 3                        $ 650
2404            GYN ONCOLOGY ABNORMAL 4                        $ 800
2405            GYN ONCOLOGY ABNORMAL 5                        $ 1,000
2406            GYN ONCOLOGY ABNORMAL 6                        $ 1,300
2407            GYN ONCOLOGY ABNORMAL 7                        $ 1,700
2408            GYN ONCOLOGY ABNORMAL 8                        $ 2,500
2411            GYN ONCOLOGY CHEMO 1                           $ 200
2412            GYN ONCOLOGY CHEMO 2                           $ 300
2413            GYN ONCOLOGY CHEMO 3                           $ 650
2414            GYN ONCOLOGY CHEMO 4                           $ 800
2415            GYN ONCOLOGY CHEMO 5                           $ 1,000
2416            GYN ONCOLOGY CHEMO 6                           $ 1,300
2417            GYN ONCOLOGY CHEMO 7                           $ 1,700
2418            GYN ONCOLOGY CHEMO 8                           $ 2,500
2421            GYN ONCOLOGY MOLE 1                            $ 200
2422            GYN ONCOLOGY MOLE 2                            $ 300
2423            GYN ONCOLOGY MOLE 3                            $ 650
2424            GYN ONCOLOGY MOLE 4                            $ 800
2425            GYN ONCOLOGY MOLE 5                            $ 1,000
2426            GYN ONCOLOGY MOLE 6                            $ 1,300
2427            GYN ONCOLOGY MOLE 7                            $ 1,700
2428            GYN ONCOLOGY MOLE 8                            $ 2,500
2431            GYN OUTPATIENT SURGERY 1                       $ 450
2432            GYN OUTPATIENT SURGERY 2                       $ 700
2433            GYN OUTPATIENT SURGERY 3                       $ 1,000
2434            GYN OUTPATIENT SURGERY 4                       $ 1,300
2435            GYN OUTPATIENT SURGERY 5                       $ 1,500
2436            GYN OUTPATIENT SURGERY 6                       $ 1,700
2437            GYN OUTPATIENT SURGERY 7                       $ 1,900
2438            GYN OUTPATIENT SURGERY 8                       $ 2,500
2439            GYN OUTPATIENT SURGERY 9                       $ 2,700
2441            GYN PREOP ATTEND STAFF 1                       $ 200
2442            GYN PREOP ATTEND STAFF 2                       $ 300
2443            GYN PREOP ATTEND STAFF 3                       $ 650
2444            GYN PREOP ATTEND STAFF 4                       $ 800
2445            GYN PREOP ATTEND STAFF 5                       $ 1,000
2446            GYN PREOP ATTEND STAFF 6                       $ 1,300
2447            GYN PREOP ATTEND STAFF 7                       $ 1,700
2448            GYN PREOP ATTEND STAFF 8                       $ 2,500
2461            OB EXTEND OBSERVATION 1                        $ 200
2462            OB EXTEND OBSERVATION 2                        $ 300
2463            OB EXTEND OBSERVATION 3                        $ 650
2464            OB EXTEND OBSERVATION 4                        $ 800
2465            OB EXTEND OBSERVATION 5                        $ 1,000
2466            OB EXTEND OBSERVATION 6                        $ 1,300
2467            OB EXTEND OBSERVATION 7                        $ 1,700
2468            OB EXTEND OBSERVATION 8                        $ 2,500
2471            OB DIABETES EVALUATION 1                       $ 200

                             11 of 75
       COUNTY OF LOS ANGELES - DEPARTMENT OF HEALTH SERVICES

           LAC+USC HEALTHCARE NETWORK
              OUTPATIENT BILLING RATE
                FISCAL YEAR 2004-05


CHG CODE        BILLING DESCRIPTION                            PRICE
2472            OB DIABETES EVALUATION 2                       $ 300
2473            OB DIABETES EVALUATION 3                       $ 650
2474            OB DIABETES EVALUATION 4                       $ 800
2475            OB DIABETES EVALUATION 5                       $ 1,000
2476            OB DIABETES EVALUATION 6                       $ 1,300
2477            OB DIABETES EVALUATION 7                       $ 1,700
2478            OB DIABETES EVALUATION 8                       $ 2,500
2481            OB DIABETES 1                                  $ 200
2482            OB DIABETES 2                                  $ 300
2483            OB DIABETES 3                                  $ 650
2484            OB DIABETES 4                                  $ 800
2485            OB DIABETES 5                                  $ 1,000
2486            OB DIABETES 6                                  $ 1,300
2487            OB DIABETES 7                                  $ 1,700
2488            OB DIABETES 8                                  $ 2,500
2491            OB MIDWIFE 1                                   $ 200
2492            OB MIDWIFE 2                                   $ 300
2493            OB MIDWIFE 3                                   $ 650
2494            OB MIDWIFE 4                                   $ 800
2495            OB MIDWIFE 5                                   $ 1,000
2496            OB MIDWIFE 6                                   $ 1,300
2497            OB MIDWIFE 7                                   $ 1,700
2498            OB MIDWIFE 8                                   $ 2,500
2501            GYN-ONCOLOGY PAP                               $ 400
2511            OB DIABETES III                                $ 550
2512            OB DIABETES III 2                              $ 300
2513            OB DIABETES III 3                              $ 650
2514            OB DIABETES III 4                              $ 800
2515            OB DIABETES III 5                              $ 1,000
2516            OB DIABETES III 6                              $ 1,300
2517            OB DIABETES III 7                              $ 1,700
2518            OB DIABETES III 8                              $ 2,500
2521            OB RH/GENETICS 1                               $ 200
2522            OB RH/GENETICS 2                               $ 300
2523            OB RH/GENETICS 3                               $ 650
2524            OB RH/GENETICS 4                               $ 800
2525            OB RH/GENETICS 5                               $ 1,000
2526            OB RH/GENETICS 6                               $ 1,300
2527            OB RH/GENETICS 7                               $ 1,700
2528            OB RH/GENETICS 8                               $ 2,500
2531            GYN-ONCOLOGY CHEMOTHERAPY                      $ 800
2541            OB GENETICS 1                                  $ 550
2542            OB GENETICS 2                                  $ 300
2543            OB GENETICS 3                                  $ 650
2544            OB GENETICS 4                                  $ 800
2545            OB GENETICS 5                                  $ 1,000
2546            OB GENETICS 6                                  $ 1,300
2547            OB GENETICS 7                                  $ 1,700
2548            OB GENETICS 8                                  $ 2,500

                             12 of 75
       COUNTY OF LOS ANGELES - DEPARTMENT OF HEALTH SERVICES

           LAC+USC HEALTHCARE NETWORK
              OUTPATIENT BILLING RATE
                FISCAL YEAR 2004-05


CHG CODE        BILLING DESCRIPTION                            PRICE
2551            OB HIGH RISH I 1                               $ 200
2552            OB HIGH RISK I 2                               $ 300
2553            OB HIGH RISK I 3                               $ 650
2554            OB HIGH RISK I 4                               $ 800
2555            OB HIGH RISK I 5                               $ 1,000
2556            OB HIGH RISK I 6                               $ 1,300
2557            OB HIGH RISK I 7                               $ 1,700
2558            OB HIGH RISK I 8                               $ 2,500
2561            OB HIGH RISK II 1                              $ 200
2562            OB HIGH RISK II 2                              $ 300
2563            OB HIGH RISK II 3                              $ 650
2564            OB HIGH RISK II 4                              $ 800
2565            OB HIGH RISK II 5                              $ 1,000
2566            OB HIGH RISK II 6                              $ 1,300
2567            OB HIGH RISK II 7                              $ 1,700
2568            OB HIGH RISK II 8                              $ 2,500
2571            OB MED SPECIAL PROB I 1                        $ 200
2572            OB MED SPECIAL PROB I 2                        $ 300
2573            OB MED SPECIAL PROB I 3                        $ 650
2574            OB MED SPECIAL PROB I 4                        $ 800
2575            OB MED SPECIAL PROB I 5                        $ 1,000
2576            OB MED SPECIAL PROB I 6                        $ 1,300
2577            OB MED SPECIAL PROB I 7                        $ 1,700
2578            OB MED SPECIAL PROB I 8                        $ 2,500
2581            OB MED SPECIAL PROB II 1                       $ 200
2582            OB MED SPECIAL PROB II 2                       $ 300
2583            OB MED SPECIAL PROB II 3                       $ 650
2584            OB MED SPECIAL PROB II 4                       $ 800
2585            OB MED SPECIAL PROB II 5                       $ 1,000
2586            OB MED SPECIAL PROB II 6                       $ 1,300
2587            OB MED SPECIAL PROB II 7                       $ 1,700
2588            OB MED SPECIAL PROB II 8                       $ 2,500
2591            OB PRE-CONCEPTION 1                            $ 200
2592            OB PRE-CONCEPTION 2                            $ 300
2593            OB PRE-CONCEPTION 3                            $ 650
2594            OB PRE-CONCEPTION 4                            $ 800
2595            OB PRE-CONCEPTION 5                            $ 1,000
2596            OB PRE-CONCEPTION 6                            $ 1,300
2597            OB PRE-CONCEPTION 7                            $ 1,700
2598            OB PRE CONCEPTION 8                            $ 2,500
2611            OB-GYN DIABETES I                              $ 300
2612            OB-GYN DIABETES I                              $ 650
2613            OB-GYN DIABETES I                              $ 1,400
2622            OB DIABETES II-MIDWIFE                         $ 300
2623            OB DIABETES II-MIDWIFE                         $ 650
2626            OB DIABETES II-MIDWIFE                         $ 1,300
2631            OB-GYN RH/GENETRICS I                          $ 300
2632            OB-GYN RH/GENETRICS I                          $ 650
2633            OB-GYN RH/GENETRICS I                          $ 1,400

                             13 of 75
       COUNTY OF LOS ANGELES - DEPARTMENT OF HEALTH SERVICES

           LAC+USC HEALTHCARE NETWORK
              OUTPATIENT BILLING RATE
                FISCAL YEAR 2004-05


CHG CODE        BILLING DESCRIPTION                            PRICE
2641            OB-GYN RH/GENETRICS II                         $ 300
2642            OB-GYN RH/GENETRICS II                         $ 650
2643            OB-GYN RH/GENETRICS II                         $ 1,400
2651            OB-GYN OB HIGH RISK I                          $ 300
2652            OB-GYN OB HIGH RISK I                          $ 650
2653            OB-GYN OB HIGH RISK I                          $ 1,400
2661            OB-GYN OB HIGH RISK II                         $ 300
2662            OB-GYN OB HIGH RISK II                         $ 650
2663            OB-GYN OB HIGH RISK II                         $ 1,400
2671            OB-GYN HIGH RISK III                           $ 300
2672            OB                                             $ 650
2673            OB                                             $ 1,400
2681            OB-GYN MEDICAL SPECIAL PROB                    $ 300
2682            OB-GYN MED SPECIAL PROB I                      $ 650
2683            OB-GYN MEDICAL SPECIAL PROB                    $ 1,400
2691            OB-GYN MED SPECIAL PROB II                     $ 300
2692            OB-GYN MED SPECIAL PROB II                     $ 650
2693            OB-GYN MED SPECIAL PROB II                     $ 1,400
2701            OB-GYN MED SPECIAL PROB III                    $ 300
2702            OB-GYN MED SPECIAL PROB III                    $ 650
2703            OB-GYN MED SPECIAL PROB III                    $ 1,400
2711            OB-GYN OB POST PARTUM-COMP                     $ 300
2712            OB-GYN OB POST PARTUM-COMP                     $ 650
2713            OB-GYN OB POST PARTUM-COMP                     $ 1,400
2721            OB MINOR TREATMENT 1                           $ 200
2722            OB MINOR TREATMENT 2                           $ 300
2723            OB MINOR TREATMENT 3                           $ 650
2724            OB MINOR TREATMENT 4                           $ 800
2725            OB MINOR TREATMENT 5                           $ 1,000
2726            OB MINOR TREATMENT 6                           $ 1,300
2727            OB MINOR TREATMENT 7                           $ 1,700
2728            OB MINOR TREATMENT 8                           $ 2,500
2731            OB-GYN POST TERM PREGNANCY                     $ 300
2732            OB-GYN POST TERM PREGNANCY                     $ 650
2733            OB-GYN POST TERM PREGNANCY                     $ 1,400
2741            OB POST PARTUM COMP 1                          $ 200
2742            OB POST PARTUM COMP 2                          $ 300
2743            OB POST PARTUM COMP 3                          $ 650
2744            OB POST PARTUM COMP 4                          $ 800
2745            OB POST PARTUM COMP 5                          $ 1,000
2746            OB POST PARTUM COMP 6                          $ 1,300
2747            OB POST PARTUM COMP 7                          $ 1,700
2748            OB POST PARTUM COMP 8                          $ 2,500
2781            PH NBC F/U                                     $ 400
2791            PEDIATRIC NURSE PRACTIONER                     $ 400
2801            OK TO USE                                      $ 200
2802            OK TO USE                                      $ 300
2803            OK TO USE                                      $ 650
2804            OK TO USE                                      $ 800

                             14 of 75
       COUNTY OF LOS ANGELES - DEPARTMENT OF HEALTH SERVICES

           LAC+USC HEALTHCARE NETWORK
              OUTPATIENT BILLING RATE
                FISCAL YEAR 2004-05


CHG CODE        BILLING DESCRIPTION                            PRICE
2805            OK TO USE                                      $ 1,000
2806            OK TO USE                                      $ 1,300
2807            OK TO USE                                      $ 1,700
2808            OK TO USE                                      $ 2,500
2811            HIGH RISK INFANT F/U <1YR 1                    $ 200
2812            HIGH RISK INFANT F/U <1YR 2                    $ 300
2813            HIGH RISK INFANT F/U <1YR 3                    $ 650
2814            HIGH RISK INFANT F/U <1YR 4                    $ 800
2815            HIGH RISK INFANT F/U <1YR 5                    $ 1,000
2816            HIGH RISK INFANT F/U <1YR 6                    $ 1,300
2817            HIGH RISK INFANT F/U <1YR 7                    $ 1,700
2818            HIGH RISK INFANT F/U <1YR 8                    $ 2,500
2821            HIGH RISK INFANT F/U >1YR 1                    $ 200
2822            HIGH RISK INFANT F/U >1YR 2                    $ 300
2823            HIGH RISK INFANT F/U >1YR 3                    $ 650
2824            HIGH RISK INFANT F/U >1YR 4                    $ 800
2825            HIGH RISK INFANT F/U >1YR 5                    $ 1,000
2826            HIGH RISK INFANT F/U >1YR 6                    $ 1,300
2827            HIGH RISK INFANT F/U >1YR 7                    $ 1,700
2828            HIGH RISK INFANT F/U >1YR 8                    $ 2,500
2831            OB PROBLEMS 1                                  $ 200
2832            OB PROBLEMS 2                                  $ 300
2833            OB PROBLEMS 3                                  $ 650
2834            OB PROBLEMS 4                                  $ 800
2835            OB PROBLEMS 5                                  $ 1,000
2836            OB PROBLEMS 6                                  $ 1,300
2837            OB PROBLEMS 7                                  $ 1,700
2838            OB PROBLEMS 8                                  $ 2,500
2841            GYN PLAN PREGNANCY 1                           $ 200
2842            GYN PLAN PREGNANCY 2                           $ 300
2843            GYN PLAN PREGNANCY 3                           $ 650
2844            GYN PLAN PREGNANCY 4                           $ 800
2845            GYN PLAN PREGNANCY 5                           $ 1,000
2846            GYN PLAN PREGNANCY 6                           $ 1,300
2847            GYN PLAN PREGNANCY 7                           $ 1,700
2848            GYN PLAN PREGNANCY 8                           $ 2,500
2853            GYN PLAN PREGNANCY II                          $ 650
2861            GYN POST SURG EXAM 1                           $ 200
2862            GYN POST SURG EXAM 2                           $ 300
2863            GYN POST SURG EXAM 3                           $ 650
2864            GYN POST SURG EXAM 4                           $ 800
2865            GYN POST SURG EXAM 5                           $ 1,000
2866            GYN POST SURG EXAM 6                           $ 1,300
2867            GYN POST SURG EXAM 7                           $ 1,700
2868            GYN POST SURG EXAM 8                           $ 2,500
2871            GYN ONC POST OP 1                              $ 200
2872            GYN ONC POST OP 2                              $ 300
2873            GYN ONC POST OP 3                              $ 650
2874            GYN ONC POST OP 4                              $ 800

                             15 of 75
       COUNTY OF LOS ANGELES - DEPARTMENT OF HEALTH SERVICES

           LAC+USC HEALTHCARE NETWORK
              OUTPATIENT BILLING RATE
                FISCAL YEAR 2004-05


CHG CODE        BILLING DESCRIPTION                            PRICE
2875            GYN ONC POST OP 5                              $ 1,000
2876            GYN ONC POST OP 6                              $ 1,300
2877            GYN ONC POST OP 7                              $ 1,700
2878            GYN ONC POST OP 8                              $ 2,500
2881            OB TRIAGE/EVAL 1                               $ 200
2882            OB TRIAGE/EVAL 2                               $ 300
2883            OB TRIAGE/EVAL 3                               $ 650
2884            OB TRIAGE/EVAL 4                               $ 800
2885            OB TRIAGE/EVAL 5                               $ 1,000
2886            OB TRIAGE/EVAL 6                               $ 1,300
2887            OB TRIAGE/EVAL 7                               $ 1,700
2888            OB TRIAGE/EVAL 8                               $ 2,500
2901            GYN FAMILY PLANNING 1                          $ 200
2902            GYN FAMILY PLANNING 2                          $ 300
2903            GYN FAMILY PLANNING 3                          $ 650
2904            GYN FAMILY PLANNING 4                          $ 800
2905            GYN FAMILY PLANNING 5                          $ 1,000
2906            GYN FAMILY PLANNING 6                          $ 1,300
2907            GYN FAMILY PLANNING 7                          $ 1,700
2908            GYN FAMILY PLANNING 8                          $ 2,500
2911            GYN ONC FAMILY PLAN 1                          $ 200
2912            GYN ONC FAMILY PLAN 2                          $ 300
2913            GYN ONC FAMILY PLAN 3                          $ 650
2914            GYN ONC FAMILY PLAN 4                          $ 800
2915            GYN ONC FAMILY PLAN 5                          $ 1,000
2916            GYN ONC FAMILY PLAN 6                          $ 1,300
2917            GYN ONC FAMILY PLAN 7                          $ 1,700
2918            GYN ONC FAMILY PLAN 8                          $ 2,500
2961            DAY SURGERY                                    $ 2,700
2991            WOMEN'S WALK-IN 1                              $ 200
2992            WOMEN'S WALK-IN 2                              $ 300
2993            WOMEN'S WALK-IN 3                              $ 650
2994            WOMEN'S WALK-IN 4                              $ 800
2995            WOMEN'S WALK-IN 5                              $ 1,000
2996            WOMEN'S WALK-IN 6                              $ 1,300
2997            WOMEN'S WALK-IN 7                              $ 1,700
2998            WOMEN'S WALK-IN 8                              $ 2,500
3021            PSY EVAL                                       $ 399
3023            PSY EVAL                                       $ 450
3031            PSYCH EVAL 1                                   $ 200
3032            PSYCH EVAL 2                                   $ 300
3033            PSYCH EVAL 3                                   $ 650
3034            PSYCH EVAL 4                                   $ 800
3035            PSYCH EVAL 5                                   $ 1,000
3036            PSYCH EVAL 6                                   $ 1,300
3037            PSYCH EVAL 7                                   $ 1,700
3038            PSYCH EVAL 8                                   $ 2,500
3501            PSYCH ADULT 1                                  $ 200
3502            PSYCH ADULT 2                                  $ 300

                             16 of 75
       COUNTY OF LOS ANGELES - DEPARTMENT OF HEALTH SERVICES

           LAC+USC HEALTHCARE NETWORK
              OUTPATIENT BILLING RATE
                FISCAL YEAR 2004-05


CHG CODE        BILLING DESCRIPTION                            PRICE
3503            PSYCH ADULT 3                                  $ 650
3504            PSYCH ADULT 4                                  $ 800
3505            PSYCH ADULT 5                                  $ 1,000
3506            PSYCH ADULT 6                                  $ 1,300
3507            PSYCH ADULT 7                                  $ 1,700
3508            PSYCH ADULT 8                                  $ 2,500
3511            PSYCHIATRY ADULT                               $ 417
3514            PSYCHIATRY ADULT                               $ 417
3521            PSYCH CHILD/ADOLESCENT 1                       $ 200
3522            PSYCH CHILD/ADOLESCENT 2                       $ 300
3523            PSYCH CHILD/ADOLESCENT 3                       $ 650
3524            PSYCH CHILD/ADOLESCENT 4                       $ 800
3525            PSYCH CHILD/ADOLESCENT 5                       $ 1,000
3526            PSYCH CHILD/ADOLESCENT 6                       $ 1,300
3527            PSYCH CHILD/ADOLESCENT 7                       $ 1,700
3528            PSYCH CHILD/ADOLESCENT 8                       $ 2,500
3533            PSY ADULT-MEN HTL SER COLL                     $ 517
3534            PSY ADULT-MEN HTL SER ASSES                    $ 517
3535            PSY ADULT-MEN HTL SER IND                      $ 517
3536            PSY ADULT-MEN HTL SER GRP                      $ 517
3537            PSY ADULT - MEDICATION                         $ 404
3538            PSY ADULT - CASE MGT                           $ 174
3543            PSY CLD/ADL-MEN HTL SV COLL                    $ 517
3544            PSY CLD/ADL-MEN HTL SV ASSE                    $ 517
3545            PSY CLD/ADL-MEN HTL SV IND                     $ 517
3546            PSY CLD/ADL-MEN HTL SV GRP                     $ 517
3547            PSY CLD/ADL-MEDICATION                         $ 404
3548            PSY CLD/ADL-CASE MGT                           $ 174
4001            PEDIATRIC PAVILION EMER R                      $ 500
4011            PED EMERGENCY RM 1                             $ 200
4012            PED EMERGENCY RM 2                             $ 300
4013            PED EMERGENCY RM 3                             $ 650
4014            PED EMERGENCY RM 4                             $ 800
4015            PED EMERGENCY RM 5                             $ 1,000
4016            PED EMERGENCY RM 6                             $ 1,300
4017            PED EMERGENCY RM 7                             $ 1,700
4018            PED EMERGENCY RM 8                             $ 2,500
4021            PEDIATRIC FOLLOW-UP                            $ 200
4022            PEDIATRIC FOLLOW-UP 1                          $ 300
4023            PEDIATRIC FOLLOW-UP 2                          $ 650
4024            PEDIATRIC FOLLOW-UP 3                          $ 800
4025            PEDIATRIC FOLLOW-UP 4                          $ 1,000
4026            PEDIATRIC FOLLOW-UP 5                          $ 1,300
4027            PEDIATRIC FOLLOW-UP 6                          $ 1,700
4028            PEDIATRIC FOLLOW-UP 7                          $ 2,500
4031            PED EXTENDED ER 1                              $ 200
4032            PED EXTENDED ER 2                              $ 300
4033            PED EXTENDED ER 3                              $ 650
4034            PED EXTENDED ER 4                              $ 800

                             17 of 75
       COUNTY OF LOS ANGELES - DEPARTMENT OF HEALTH SERVICES

           LAC+USC HEALTHCARE NETWORK
              OUTPATIENT BILLING RATE
                FISCAL YEAR 2004-05


CHG CODE        BILLING DESCRIPTION                            PRICE
4035            PED EXTENDED ER 5                              $ 1,000
4036            PED EXTENDED ER 6                              $ 1,300
4037            PED EXTENDED ER 7                              $ 1,700
4038            PED EXTENDED ER 8                              $ 2,500
4041            DERMATOLOGY 1                                  $ 200
4042            DERMATOLOGY 2                                  $ 300
4043            DERMATOLOGY 3                                  $ 650
4044            DERMATOLOGY 4                                  $ 800
4045            DERMATOLOGY 5                                  $ 1,000
4046            DERMATOLOGY 6                                  $ 1,300
4047            DERMATOLOGY 7                                  $ 1,700
4048            DERMATOLOGY 8                                  $ 2,500
4051            COMUNTY BASE ASSES TREAT/CT                    $ 200
4052            COMUNTY BASE ASSES TREAT/CT                    $ 300
4053            COMUNTY BASE ASSES TREAT/CT                    $ 650
4054            COMUNTY BASE ASSES TREAT/CT                    $ 800
4055            COMUNTY BASE ASSES TREAT/CT                    $ 1,000
4056            COMUNTY BASE ASSES TREAT/CT                    $ 1,300
4057            COMUNTY BASE ASSES TREAT/CT                    $ 1,700
4058            COMUNTY BASE ASSES TREAT/CT                    $ 2,500
4061            ENT                                            $ 650
4071            PEDS OBSERVATION CARD 1                        $ 200
4072            PEDS OBSERVATION CARE 2                        $ 300
4073            PEDS OBSERVATION CARE 3                        $ 650
4074            PEDS OBSERVATION CARE 4                        $ 800
4075            PEDS OBSERVATION CARE 5                        $ 1,000
4076            PEDS OBSERVATION CARE 6                        $ 1,300
4077            PEDS OBSERVATION CARE 7                        $ 1,700
4078            PEDS OBSERVATION CARE 8                        $ 2,500
4101            DIABETES 1                                     $ 200
4102            DIABETES 2                                     $ 300
4103            DIABETES 3                                     $ 650
4104            DIABETES 4                                     $ 800
4105            DIABETES 5                                     $ 1,000
4106            DIABETES 6                                     $ 1,300
4107            DIABETES 7                                     $ 1,700
4108            DIABETES 8                                     $ 2,500
4131            ENDOCRINE 1                                    $ 200
4132            ENDOCRINE 2                                    $ 300
4133            ENDOCRINE 3                                    $ 650
4134            ENDOCRINE 4                                    $ 800
4135            ENDOCRINE 5                                    $ 1,000
4136            ENDOCRINE 6                                    $ 1,300
4137            ENDOCRINE 7                                    $ 1,700
4138            ENDOCRINE 8                                    $ 2,500
4141            ENDOCRINE TESTING                              $ 650
4151            VIP MEDICAL SCREENING 1                        $ 200
4152            VIP MEDICAL SCREENING 2                        $ 300
4153            VIP MEDICAL SCREENING 3                        $ 650

                             18 of 75
       COUNTY OF LOS ANGELES - DEPARTMENT OF HEALTH SERVICES

           LAC+USC HEALTHCARE NETWORK
              OUTPATIENT BILLING RATE
                FISCAL YEAR 2004-05


CHG CODE        BILLING DESCRIPTION                            PRICE
4154            VIP MEDICAL SCREENING 4                        $ 800
4155            VIP MEDICAL SCREENING 5                        $ 1,000
4156            VIP MEDICAL SCREENING 6                        $ 1,300
4157            VIP MEDICAL SCREENING 7                        $ 1,700
4158            VIP MEDICAL SCREENING 8                        $ 2,500
4161            VIP MENTAL HLTH ASSESS 1                       $ 200
4162            VIP MENTAL HLTH ASSESS 2                       $ 300
4163            VIP MENTAL HLTH ASSESS 3                       $ 650
4164            VIP MENTAL HLTH ASSESS 4                       $ 800
4165            VIP MENTAL HLTH ASSESS 5                       $ 1,000
4166            VIP MENTAL HLTH ASSESS 6                       $ 1,300
4167            VIP MENTAL HLTH ASSESS 7                       $ 1,700
4168            VIP MENTAL HLTH ASSESS 8                       $ 2,500
4171            VIP MENTAL HLTH F/U 1                          $ 200
4172            VIP MENTAL HLTH F/U 2                          $ 300
4173            VIP MENTAL HLTH F/U 3                          $ 650
4174            VIP MENTAL HLTH F/U 4                          $ 800
4175            VIP MENTAL HLTH F/U 5                          $ 1,000
4176            VIP MENTAL HLTH F/U 6                          $ 1,300
4177            VIP MENTAL HLTH F/U 7                          $ 1,700
4178            VIP MENTAL HLTH F/U 8                          $ 2,500
4181            GASTROENTEROLOGY 1                             $ 200
4182            GASTROENTEROLOGY 2                             $ 300
4183            GASTROENTEROLOGY 3                             $ 650
4184            GASTROENTEROLOGY 4                             $ 800
4185            GASTROENTEROLOGY 5                             $ 1,000
4186            GASTROENTEROLOGY 6                             $ 1,300
4187            GASTROENTEROLOGY 7                             $ 1,700
4188            GASTROENTEROLOGY 8                             $ 2,500
4191            VIP EVIDENCE GATH 1                            $ 200
4192            VIP EVIDENCE GATH 2                            $ 300
4193            VIP EVIDENCE GATH 3                            $ 650
4194            VIP EVIDENCE GATH 4                            $ 800
4195            VIP EVIDENCE GATH 5                            $ 1,000
4196            VIP EVIDENCE GATH 6                            $ 1,300
4197            VIP EVIDENCE GATH 7                            $ 1,700
4198            VIP EVIDENCE GATH 8                            $ 2,500
4201            HEMATOLOGY 1                                   $ 200
4202            HEMATOLOGY 2                                   $ 300
4203            HEMATOLOGY 3                                   $ 650
4204            HEMATOLOGY 4                                   $ 800
4205            HEMATOLOGY 5                                   $ 1,000
4206            HEMATOLOGY 6                                   $ 1,300
4207            HEMATOLOGY 7                                   $ 1,700
4208            HEMATOLOGY 8                                   $ 2,500
4221            CARDIOLOGY ECHO P2C2                           $ 1,000
4231            INFECTIOUS DISEASE-PEDIATRI                    $ 400
4241            PH INF DIS (ADLTS) CD F/U                      $ 400
4251            PH-INFECT DISEASE (ADULTS)-                    $ 800

                             19 of 75
       COUNTY OF LOS ANGELES - DEPARTMENT OF HEALTH SERVICES

           LAC+USC HEALTHCARE NETWORK
              OUTPATIENT BILLING RATE
                FISCAL YEAR 2004-05


CHG CODE        BILLING DESCRIPTION                            PRICE
4271            RENAL 1                                        $ 200
4272            RENAL 2                                        $ 300
4273            RENAL 3                                        $ 650
4274            RENAL 4                                        $ 800
4275            RENAL 5                                        $ 1,000
4276            RENAL 6                                        $ 1,300
4277            RENAL 7                                        $ 1,700
4278            RENAL 8                                        $ 2,500
4301            ONCOLOGY 1                                     $ 200
4302            ONCOLOCY 2                                     $ 300
4303            ONCOLOGY 3                                     $ 650
4304            ONCOLOGY 4                                     $ 800
4305            ONCOLOGY 5                                     $ 1,000
4306            ONCOLOGY 6                                     $ 1,300
4307            ONCOLOGY 7                                     $ 1,700
4308            ONCOLOGY 8                                     $ 2,500
4311            ONCOLOGY CHEMOTHERAPY 1                        $ 200
4312            ONCOLOGY CHEMOTHERAPY 2                        $ 300
4313            ONCOLOGY CHEMOTHERAPY 3                        $ 650
4314            ONCOLOGY CHEMOTHERAPY 4                        $ 800
4315            ONCOLOGY CHEMOTHERAPY 5                        $ 1,000
4316            ONCOLOGY CHEMOTHERAPY 6                        $ 1,300
4317            ONCOLOGY CHEMOTHERAPY 7                        $ 1,700
4318            ONCOLOGY CHEMOTHERAPY 8                        $ 2,500
4331            CHEST MEDICINE 1                               $ 200
4332            CHEST MEDICINE 2                               $ 300
4333            CHEST MEDICINE 3                               $ 650
4334            CHEST MEDICINE 4                               $ 800
4335            CHEST MEDICINE 5                               $ 1,000
4336            CHEST MEDICINE 6                               $ 1,300
4337            CHEST MEDICINE 7                               $ 1,700
4338            CHEST MEDICINE 8                               $ 2,500
4341            PH TB 1                                        $ 200
4342            PH TB 2                                        $ 300
4343            PH TB 3                                        $ 650
4344            PH TB 4                                        $ 800
4345            PH TB 5                                        $ 1,000
4346            PH TB 6                                        $ 1,300
4347            PH TB 7                                        $ 1,700
4348            PH TB 8                                        $ 2,500
4351            TB SCREENING                                   $ 400
4361            RHEUMATOLOGY 1                                 $ 200
4362            RHEUMATOLOGY 2                                 $ 300
4363            RHEUMATOLOGY 3                                 $ 650
4364            RHEUMATOLOGY 4                                 $ 800
4365            RHEUMATOLOGY 5                                 $ 1,000
4366            RHEUMATOLOGY 6                                 $ 1,300
4367            RHEUMATOLOGY 7                                 $ 1,700
4368            RHEUMATOLOGY 8                                 $ 2,500

                             20 of 75
       COUNTY OF LOS ANGELES - DEPARTMENT OF HEALTH SERVICES

           LAC+USC HEALTHCARE NETWORK
              OUTPATIENT BILLING RATE
                FISCAL YEAR 2004-05


CHG CODE        BILLING DESCRIPTION                            PRICE
4371            ASTHMA MOBILE UNIT 1                           $ 200
4372            ASTHMA MOBILE UNIT 2                           $ 300
4373            ASTHMA MOBILE UNIT 3                           $ 650
4374            ASTHMA MOBILE UNIT 4                           $ 800
4375            ASTHMA MOBILE UNIT 5                           $ 1,000
4376            ASTHMA MOBILE UNIT 6                           $ 1,300
4377            ASTHMA MOBILE UNIT 7                           $ 1,700
4378            ASTHMA MOBILE UNIT 8                           $ 2,500
4381            ALLERGY 1                                      $ 200
4382            ALLERGY 2                                      $ 300
4383            ALLERGY 3                                      $ 650
4384            ALLERGY 4                                      $ 800
4385            ALLERGY 5                                      $ 1,000
4386            ALLERGY 6                                      $ 1,300
4387            ALLERGY 7                                      $ 1,700
4388            ALLERGY 8                                      $ 2,500
4391            IMMUNE THERAPY 1                               $ 200
4392            IMMUNE THERAPY 2                               $ 300
4393            IMMUNE THERAPY 3                               $ 650
4394            IMMUNE THERAPY 4                               $ 800
4395            IMMUNE THERAPY 5                               $ 1,000
4396            IMMUNE THERAPY 6                               $ 1,300
4397            IMMUNE THERAPY 7                               $ 1,700
4398            IMMUNE THERAPY 8                               $ 2,500
4421            CARDIOLOGY 1                                   $ 200
4422            CARDIOLOGY 2                                   $ 300
4423            CARDIOLOGY 3                                   $ 650
4424            CARDIOLOGY 4                                   $ 800
4425            CARDIOLOGY 5                                   $ 1,000
4426            CARDIOLOGY 6                                   $ 1,300
4427            CARDIOLOGY 7                                   $ 1,700
4428            CARDIOLOGY 8                                   $ 2,500
4431            CARDIAC PENICILLIN PROPHYLA                    $ 400
4441            CARDIAC                                        $ 650
4451            CARDIAC PENCILLIN PROPHYLAX                    $ 400
4471            CONTINUITY 1                                   $ 200
4472            CONTINUITY 2                                   $ 300
4473            CONTINUITY 3                                   $ 650
4474            CONTINUITY 4                                   $ 800
4475            CONTINUITY 5                                   $ 1,000
4476            CONTINUITY 6                                   $ 1,300
4477            CONTINUITY 7                                   $ 1,700
4478            CONTINUITY 8                                   $ 2,500
4481            CONTINUITY                                     $ 650
4501            MYELOMENINGOCELE 1                             $ 200
4502            MYELOMENINGOCELE 2                             $ 300
4503            MYELOMENINGOCELE 3                             $ 650
4504            MYELOMENINGOCELE 4                             $ 800
4505            MYELOMENINGOCELE 5                             $ 1,000

                             21 of 75
       COUNTY OF LOS ANGELES - DEPARTMENT OF HEALTH SERVICES

           LAC+USC HEALTHCARE NETWORK
              OUTPATIENT BILLING RATE
                FISCAL YEAR 2004-05


CHG CODE        BILLING DESCRIPTION                            PRICE
4506            MYELOMENINGOCELE 6                             $ 1,300
4507            MYELOMENINGOCELE 7                             $ 1,700
4508            MYELOMENINGOCELE 8                             $ 2,500
4531            NEUROMEDICINE 1                                $ 200
4532            NEUROMEDICINE 2                                $ 300
4533            NEUROMEDICINE 3                                $ 650
4534            NEUROMEDICINE 4                                $ 800
4535            NEUROMEDICINE 5                                $ 1,000
4536            NEUROMEDICINE 6                                $ 1,300
4537            NEUROMEDICINE 7                                $ 1,700
4538            NEUROMEDICINE 8                                $ 2,500
4541            SLEEP STUDY 1                                  $ 200
4542            SLEEP STUDY 2                                  $ 300
4543            SLEEP STUDY 3                                  $ 650
4544            SLEEP STUDY 4                                  $ 800
4545            SLEEP STUDY 5                                  $ 1,000
4546            SLEEP STUDY 6                                  $ 1,300
4547            SLEEP STUDY 7                                  $ 1,700
4548            SLEEP STUDY 8                                  $ 2,500
4551            ORTHOPEDIC TUMOR 1                             $ 200
4552            ORTHOPEDIC TUMOR 2                             $ 300
4553            ORTHOPEDIC TUMOR 3                             $ 650
4554            ORTHOPEDIC TUMOR 4                             $ 800
4555            ORTHOPEDIC TUMOR 5                             $ 1,000
4556            ORTHOPEDIC TUMOR 6                             $ 1,300
4557            ORTHOPEDIC TUMOR 7                             $ 1,700
4558            ORTHOPEDIC TUMOR 8                             $ 2,500
4561            ORTHOPEDIC EVALUATION 1                        $ 200
4562            ORTHOPEDIC EVALUATION 2                        $ 300
4563            ORTHOPEDIC EVALUATION 3                        $ 650
4564            ORTHOPEDIC EVALUATION 4                        $ 800
4565            ORTHOPEDIC EVALUATION 5                        $ 1,000
4566            ORTHOPEDIC EVALUATION 6                        $ 1,300
4567            ORTHOPEDIC EVALUATION 7                        $ 1,700
4568            ORTHOPEDIC EVALUATION 8                        $ 2,500
4571            NEUROSURGERY 1                                 $ 200
4572            NEUROSURGERY 2                                 $ 300
4573            NEUROSURGERY 3                                 $ 650
4574            NEUROSURGERY 4                                 $ 800
4575            NEUROSURGERY 5                                 $ 1,000
4576            NEUROSURGERY 6                                 $ 1,300
4577            NEUROSURGERY 7                                 $ 1,700
4578            NEUROSURGERY 8                                 $ 2,500
4581            ORTHOPEDIC SCOLIOSIS 1                         $ 200
4582            ORTHOPEDIC SCOLIOSIS 2                         $ 300
4583            ORTHOPEDIC SCOLIOSIS 3                         $ 650
4584            ORTHOPEDIC SCOLIOSIS 4                         $ 800
4585            ORTHOPEDIC SCOLIOSIS 5                         $ 1,000
4586            ORTHOPEDIC SCOLIOSIS 6                         $ 1,300

                             22 of 75
       COUNTY OF LOS ANGELES - DEPARTMENT OF HEALTH SERVICES

           LAC+USC HEALTHCARE NETWORK
              OUTPATIENT BILLING RATE
                FISCAL YEAR 2004-05


CHG CODE        BILLING DESCRIPTION                            PRICE
4587            ORTHOPEDIC SCOLIOSIS 7                         $ 1,700
4588            ORTHOPEDIC SCOLIOSIS 8                         $ 2,500
4591            ORTHOPEDIC PRE-OP 1                            $ 200
4592            ORTHOPEDIC PRE-OP 2                            $ 300
4593            ORTHOPEDIC PRE-OP 3                            $ 650
4594            ORTHOPEDIC PRE-OP 4                            $ 800
4595            ORTHOPEDIC PRE-OP 5                            $ 1,000
4596            ORTHOPEDIC PRE-OP 6                            $ 1,300
4597            ORTHOPEDIC PRE-OP 7                            $ 1,700
4598            ORTHOPEDIC PRE-OP 8                            $ 2,500
4601            ORTHOPEDIC FRACTURE 1                          $ 200
4602            ORTHOPEDIC FRACTURE 2                          $ 300
4603            ORTHOPEDIC FRACTURE 3                          $ 650
4604            ORTHOPEDIC FRACTURE 4                          $ 800
4605            ORTHOPEDIC FRACTURE 5                          $ 1,000
4606            ORTHOPEDIC FRACTURE 6                          $ 1,300
4607            ORTHOPEDIC FRACTURE 7                          $ 1,700
4608            ORTHOPEDIC FRACTURE 8                          $ 2,500
4611            ORTHOPEDIC GENERAL 1                           $ 200
4612            ORTHOPEDIC GENERAL 2                           $ 300
4613            ORTHOPEDIC GENERAL 3                           $ 650
4614            ORTHOPEDIC GENERAL 4                           $ 800
4615            ORTHOPEDIC GENERAL 5                           $ 1,000
4616            ORTHOPEDIC GENERAL 6                           $ 1,300
4617            ORTHOPEDIC GENERAL 7                           $ 1,700
4618            ORTHOPEDIC GENERAL 8                           $ 2,500
4621            CHILDREN'S HAND 1                              $ 200
4622            CHILDREN'S HAND 2                              $ 300
4623            CHILDREN'S HAND 3                              $ 650
4624            CHILDREN'S HAND 4                              $ 800
4625            CHILDREN'S HAND 5                              $ 1,000
4626            CHILDREN'S HAND 6                              $ 1,300
4627            CHILDREN'S HAND 7                              $ 1,700
4628            CHILDREN'S HAND 8                              $ 2,500
4631            ORTHOPEDIC FOOT 1                              $ 200
4632            ORTHOPEDIC FOOT 2                              $ 300
4633            ORTHOPEDIC FOOT 3                              $ 650
4634            ORTHOPEDIC FOOT 4                              $ 800
4635            ORTHOPEDIC FOOT 5                              $ 1,000
4636            ORTHOPEDIC FOOT 6                              $ 1,300
4637            ORTHOPEDIC FOOT 7                              $ 1,700
4638            ORTHOPEDIC FOOT 8                              $ 2,500
4641            REHAB MED 1                                    $ 200
4642            REHAB MED 2                                    $ 300
4643            REHAB MED 3                                    $ 650
4644            REHAB MED 4                                    $ 800
4645            REHAB MED 5                                    $ 1,000
4646            REHAB MED 6                                    $ 1,300
4647            REHAB MED 7                                    $ 1,700

                             23 of 75
       COUNTY OF LOS ANGELES - DEPARTMENT OF HEALTH SERVICES

           LAC+USC HEALTHCARE NETWORK
              OUTPATIENT BILLING RATE
                FISCAL YEAR 2004-05


CHG CODE        BILLING DESCRIPTION                            PRICE
4648            REHAB MED 8                                    $ 2,500
4661            GENITOURINARY 1                                $ 200
4662            GENITOURINARY 2                                $ 300
4663            GENITOURINARY 3                                $ 650
4664            GENITOURINARY 4                                $ 800
4665            GENITOURINARY 5                                $ 1,000
4666            GENITOURINARY 6                                $ 1,300
4667            GENITOURINARY 7                                $ 1,700
4668            GENITOURINARY 8                                $ 2,500
4701            BREAST FEEDING 1                               $ 200
4702            BREAST FEEDING 2                               $ 300
4703            BREAST FEEDING 3                               $ 650
4704            BREAST FEEDING 4                               $ 800
4705            BREAST FEEDING 5                               $ 1,000
4706            BREAST FEEDING 6                               $ 1,300
4707            BREAST FEEDING 7                               $ 1,700
4708            BREAST FEEDING 8                               $ 2,500
4711            GENETICS 1                                     $ 200
4712            GENETICS 2                                     $ 300
4713            GENETICS 3                                     $ 650
4714            GENETICS 4                                     $ 800
4715            GENETICS 5                                     $ 1,000
4716            GENETICS 6                                     $ 1,300
4717            GENETICS 7                                     $ 1,700
4718            GENETICS 8                                     $ 2,500
4721            PH INFANTS SUBSTANCE ABUSE                     $ 650
4741            PH TEEN/WELL BABY                              $ 650
4751            DEVELOPMENTAL DISABILITY 1                     $ 200
4752            DEVELOPMENTAL DISABILITY 2                     $ 300
4753            DEVELOPMENTAL DISABILITY 3                     $ 650
4754            DEVELOPMENTAL DISABILITY 4                     $ 800
4755            DEVELOPMENTAL DISABILITY 5                     $ 1,000
4756            DEVELOPMENTAL DISABILITY 6                     $ 1,300
4757            DEVELOPMENTAL DISABILITY 7                     $ 1,700
4758            DEVELOPMENTAL DISABILITY 8                     $ 2,500
4761            SCHOOL PROBLEMS 1                              $ 200
4762            SCHOOL PROBLEMS 2                              $ 300
4763            SCHOOL PROBLEMS 3                              $ 650
4764            SCHOOL PROBLEMS 4                              $ 800
4765            SCHOOL PROBLEMS 5                              $ 1,000
4766            SCHOOL PROBLEMS 6                              $ 1,300
4767            SCHOOL PROBLEMS 7                              $ 1,700
4768            SCHOOL PROBLEMS 8                              $ 2,500
4771            PH S.C.A.N.                                    $ 650
4781            HIGH RISK INFANT F/U 1                         $ 200
4782            HIGH RISK INFANT F/U 2                         $ 300
4783            HIGH RISK INFANT F/U 3                         $ 650
4784            HIGH RISK INFANT F/U 4                         $ 800
4785            HIGH RISK INFANT F/U 5                         $ 1,000

                             24 of 75
       COUNTY OF LOS ANGELES - DEPARTMENT OF HEALTH SERVICES

           LAC+USC HEALTHCARE NETWORK
              OUTPATIENT BILLING RATE
                FISCAL YEAR 2004-05


CHG CODE        BILLING DESCRIPTION                            PRICE
4786            HIGH RISK INFANT F/U 6                         $ 1,300
4787            HIGH RISK INFANT F/U 7                         $ 1,700
4788            HIGH RISK INFANT F/U 8                         $ 2,500
4791            MINOR SURGERY                                  $ 200
4801            PRE-OP SCREENING 1                             $ 200
4802            PRE-OP SCREENING 2                             $ 300
4803            PRE-OP SCREENING 3                             $ 650
4804            PRE-OP SCREENING 4                             $ 800
4805            PRE-OP SCREENING 5                             $ 1,000
4806            PRE-OP SCREENING 6                             $ 1,300
4807            PRE-OP SCREENING 7                             $ 1,700
4808            PRE-OP SCREENING 8                             $ 2,500
4811            SURGERY GENERAL 1                              $ 200
4812            SURGERY GENERAL 2                              $ 300
4813            SURGERY GENERAL 3                              $ 650
4814            SURGERY GENERAL 4                              $ 800
4815            SURGERY GENERAL 5                              $ 1,000
4816            SURGERY GENERAL 6                              $ 1,300
4817            SURGERY GENERAL 7                              $ 1,700
4818            SURGERY GENERAL 8                              $ 2,500
4821            SURGERY SPECIAL 1                              $ 200
4822            SURGERY SPECIAL 2                              $ 300
4823            SURGERY SPECIAL 3                              $ 650
4824            SURGERY SPECIAL 4                              $ 800
4825            SURGERY SPECIAL 5                              $ 1,000
4826            SURGERY SPECIAL 6                              $ 1,300
4827            SURGERY SPECIAL 7                              $ 1,700
4828            SURGERY SPECIAL 8                              $ 2,500
4831            PEDIATRIC O/P SURGERY 1                        $ 1,700
4832            PEDIATRIC O/P SURGERY 2                        $ 2,700
4833            PEDIATRIC O/P SURGERY 3                        $ 2,900
4834            PEDIATRIC O/P SURGERY 4                        $ 1,300
4835            PEDIATRIC O/P SURGERY 5                        $ 1,500
4836            PEDIATRIC O/P SURGERY 6                        $ 1,700
4837            PEDIATRIC O/P SURGERY 7                        $ 1,900
4838            PEDIATRIC O/P SURGERY 8                        $ 2,500
4839            PEDIATRIC O/P SURGERY 9                        $ 2,700
4891            WARD DISCHARGE F/U 1                           $ 200
4892            WARD DISCHARGE F/U 2                           $ 300
4893            WARD DISCHARGE F/U 3                           $ 650
4894            WARD DISCHARGE F/U 4                           $ 800
4895            WARD DISCHARGE F/U 5                           $ 1,000
4896            WARD DISCHARGE F/U 6                           $ 1,300
4897            WARD DISCHARGE F/U 7                           $ 1,700
4898            WARD DISCHARGE F/U 8                           $ 2,500
4971            PED NURSE PRACTIONER F/U 1                     $ 400
5001            DERM PHOTOTHERAPY 1                            $ 200
5002            DERM PHOTOTHERAPY 2                            $ 300
5003            DERM PHOTOTHERAPY 3                            $ 650

                             25 of 75
       COUNTY OF LOS ANGELES - DEPARTMENT OF HEALTH SERVICES

           LAC+USC HEALTHCARE NETWORK
              OUTPATIENT BILLING RATE
                FISCAL YEAR 2004-05


CHG CODE        BILLING DESCRIPTION                            PRICE
5004            DERM PHOTOTHERAPY 4                            $ 800
5005            DERM PHOTOTHERAPY 5                            $ 1,000
5006            DERM PHOTOTHERAPY 6                            $ 1,300
5007            DERM PHOTOTHERAPY 7                            $ 1,700
5008            DERM PHOTOTHERAPY 8                            $ 2,500
5021            PH DERM HANSEN'S 1                             $ 200
5022            PH DERM HANSEN'S 2                             $ 300
5023            PH DERM HANSEN'S 3                             $ 650
5024            PH DERM HANSEN'S 4                             $ 800
5025            PH DERM HANSEN'S 5                             $ 1,000
5026            PH DERM HANSEN'S 6                             $ 1,300
5027            PH DERM HANSEN'S 7                             $ 1,700
5028            PH DERM HANSEN'S 8                             $ 2,500
5031            DERMATOLOGY 1                                  $ 200
5032            DERMATOLOGY 2                                  $ 300
5033            DERMATOLOGY 3                                  $ 650
5034            DERMATOLOGY 4                                  $ 800
5035            DERMATOLOGY 5                                  $ 1,000
5036            DERMATOLOGY 6                                  $ 1,300
5037            DERMATOLOGY 7                                  $ 1,700
5038            DERMATOLOGY 8                                  $ 2,500
5041            DERMATOLOGY SURGERY 1                          $ 450
5042            DERMATOLOGY SURGERY 2                          $ 700
5043            DERMATOLOGY SURGERY 3                          $ 1,000
5044            DERMATOLOGY SURGERY 4                          $ 1,300
5045            DERMATOLOGY SURGERY 5                          $ 1,500
5046            DERMATOLOGY SURGERY 6                          $ 1,700
5047            DERMATOLOGY SURGERY 7                          $ 1,900
5048            DERMATOLOGY SURGERY 8                          $ 2,500
5049            DERMATOLOGY SURGERY 9                          $ 2,700
5051            CARDIAC ANTICOAGULANT 1                        $ 200
5052            CARDIAC ANTICOAGULANT 2                        $ 300
5053            CARDIAC ANTICOAGULANT 3                        $ 650
5054            CARDIAC ANTICOAGULANT 4                        $ 800
5055            CARDIAC ANTICOAGULANT 5                        $ 1,000
5056            CARDIAC ANTICOAGULANT 6                        $ 1,300
5057            CARDIAC ANTICOAGULANT 7                        $ 1,700
5058            CARDIAC ANTICOAGULANT 8                        $ 2,500
5061            CARDIAC DIAGNOSTIC 1                           $ 200
5062            CARDIAC DIAGNOSTIC 2                           $ 300
5063            CARDIAC DIAGNOSTIC 3                           $ 650
5064            CARDIAC DIAGNOSTIC 4                           $ 800
5065            CARDIAC DIAGNOSTIC 5                           $ 1,000
5066            CARDIAC DIAGNOSTIC 6                           $ 1,300
5067            CARDIAC DIAGNOSTIC 7                           $ 1,700
5068            CARDIAC DIAGNOSTIC 8                           $ 2,500
5071            CARDIAC PACEMAKER                              $ 650
5072            CARDIAC PACEMAKER                              $ 650
5091            CARD PROSTHETIC VALVE 1                        $ 200

                             26 of 75
       COUNTY OF LOS ANGELES - DEPARTMENT OF HEALTH SERVICES

           LAC+USC HEALTHCARE NETWORK
              OUTPATIENT BILLING RATE
                FISCAL YEAR 2004-05


CHG CODE        BILLING DESCRIPTION                            PRICE
5092            CARD PROSTHETIC VALVE 2                        $ 300
5093            CARD PROSTHETIC VALVE 3                        $ 650
5094            CARD PROSTHETIC VALVE 4                        $ 800
5095            CARD PROSTHETIC VALVE 5                        $ 1,000
5096            CARD PROSTHETIC VALVE 6                        $ 1,300
5097            CARD PROSTHETIC VALVE 7                        $ 1,700
5098            CARD PROSTHETIC VALVE 8                        $ 2,500
5121            CARDIAC SPECIAL 1                              $ 200
5122            CARDIAC SPECIAL 2                              $ 300
5123            CARDIAC SPECIAL 3                              $ 650
5124            CARDIAC SPECIAL 4                              $ 800
5125            CARDIAC SPECIAL 5                              $ 1,000
5126            CARDIAC SPECIAL 6                              $ 1,300
5127            CARDIAC SPECIAL 7                              $ 1,700
5128            CARDIAC SPECIAL 8                              $ 2,500
5131            HEMATOLOGY CHEMOTHERAP 1                       $ 200
5132            HEMATOLOGY CHEMOTHERAP 2                       $ 300
5133            HEMATOLOGY CHEMOTHERAP 3                       $ 650
5134            HEMATOLOGY CHEMOTHERAP 4                       $ 800
5135            HEMATOLOGY CHEMOTHERAP 5                       $ 1,000
5136            HEMATOLOGY CHEMOTHERAP 6                       $ 1,300
5137            HEMATOLOGY CHEMOTHERAP 7                       $ 1,700
5138            HEMATOLOGY CHEMOTHERAP 8                       $ 2,500
5141            HEMATOLOGY ANEMIA-DYSCRACIA                    $ 400
5151            HEMATOLOGY LYMPHOMA 1                          $ 200
5152            HEMATOLOGY LYMPHOMA 2                          $ 300
5153            HEMATOLOGY LYMPHOMA 3                          $ 650
5154            HEMATOLOGY LYMPHOMA 4                          $ 800
5155            HEMATOLOGY LYMPHOMA 5                          $ 1,000
5156            HEMATOLOGY LYMPHOMA 6                          $ 1,300
5157            HEMATOLOGY LYMPHOMA 7                          $ 1,700
5158            HEMATOLOGY LYMPHOMA 8                          $ 2,500
5161            HEMATOLOGY SICKLE CELL 1                       $ 200
5162            HEMATOLOGY SICKLE CELL 2                       $ 300
5163            HEMATOLOGY SICKLE CELL 3                       $ 650
5164            HEMATOLOGY SICKLE CELL 4                       $ 800
5165            HEMATOLOGY SICKLE CELL 5                       $ 1,000
5166            HEMATOLOGY SICKLE CELL 6                       $ 1,300
5167            HEMATOLOGY SICKLE CELL 7                       $ 1,700
5168            HEMATOLOGY SICKLE CELL 8                       $ 2,500
5171            HEMATOLOGY GENERAL                             $ 400
5181            ONCOLOGY CHEMOTHERAPY 1                        $ 200
5182            ONCOLOGY CHEMOTHERAPY 2                        $ 300
5183            ONCOLOGY CHEMOTHERAPY 3                        $ 650
5184            ONCOLOGY CHEMOTHERAPY 4                        $ 800
5185            ONCOLOGY CHEMOTHERAPY 5                        $ 1,000
5186            ONCOLOGY CHEMOTHERAPY 6                        $ 1,300
5187            ONCOLOGY CHEMOTHERAPY 7                        $ 1,700
5188            ONCOLOGY CHEMOTHERAPY 8                        $ 2,500

                             27 of 75
       COUNTY OF LOS ANGELES - DEPARTMENT OF HEALTH SERVICES

           LAC+USC HEALTHCARE NETWORK
              OUTPATIENT BILLING RATE
                FISCAL YEAR 2004-05


CHG CODE        BILLING DESCRIPTION                            PRICE
5191            ONCOLOGY MEDICAL 1                             $ 200
5192            ONCOLOGY MEDICAL 2                             $ 300
5193            ONCOLOGY MEDICAL 3                             $ 650
5194            ONCOLOGY MEDICAL 4                             $ 800
5195            ONCOLOGY MEDICAL 5                             $ 1,000
5196            ONCOLOGY MEDICAL 6                             $ 1,300
5197            ONCOLOGY MEDICAL 7                             $ 1,700
5198            ONCOLOGY MEDICAL 8                             $ 2,500
5211            DIABETES                                       $ 650
5223            USABLE                                         $ 650
5231            ENDOCRINE                                      $ 650
5241            THYROID 1                                      $ 200
5242            THYROID 2                                      $ 300
5243            THYROID 3                                      $ 650
5244            THYROID 4                                      $ 800
5245            THYROID 5                                      $ 1,000
5246            THYROID 6                                      $ 1,300
5247            THYROID 7                                      $ 1,700
5248            THYROID 8                                      $ 2,500
5251            GASTRO-INTESTINAL                              $ 650
5261            GERIATRIC MEDICINE 1                           $ 200
5262            GERIATRIC MEDICINE 2                           $ 300
5263            GERIATRIC MEDICINE 3                           $ 650
5264            GERIATRIC MEDICINE 4                           $ 800
5265            GERIATRIC MEDICINE 5                           $ 1,000
5266            GERIATRIC MEDICINE 6                           $ 1,300
5267            GERIATRIC MEDICINE 7                           $ 1,700
5268            GERIATRIC MEDICINE 8                           $ 2,500
5271            ADULT PROTEC TEAM 1                            $ 200
5272            ADULT PROTEC TEAM 2                            $ 300
5273            ADULT PROTEC TEAM 3                            $ 650
5274            ADULT PROTEC TEAM 4                            $ 800
5275            ADULT PROTEC TEAM 5                            $ 1,000
5276            ADULT PROTEC TEAM 6                            $ 1,300
5277            ADULT PROTEC TEAM 7                            $ 1,700
5278            ADULT PROTEC TEAM 8                            $ 2,500
5281            LIVER TRANSPLANT 1                             $ 200
5282            LIVER TRANSPLANT 2                             $ 300
5283            LIVER TRANSPLANT 3                             $ 650
5284            LIVER TRANSPLANT 4                             $ 800
5285            LIVER TRANSPLANT 5                             $ 1,000
5286            LIVER TRANSPLANT 6                             $ 1,300
5287            LIVER TRANSPLANT 7                             $ 1,700
5288            LIVER TRANSPLANT 8                             $ 2,500
5291            PH HEPATITIS 1                                 $ 200
5292            PH HEPATITIS 2                                 $ 300
5293            PH HEPATITIS 3                                 $ 650
5294            PH HEPATITIS 4                                 $ 800
5295            PH HEPATITIS 5                                 $ 1,000

                             28 of 75
       COUNTY OF LOS ANGELES - DEPARTMENT OF HEALTH SERVICES

           LAC+USC HEALTHCARE NETWORK
              OUTPATIENT BILLING RATE
                FISCAL YEAR 2004-05


CHG CODE        BILLING DESCRIPTION                            PRICE
5296            PH HEPATITIS 6                                 $ 1,300
5297            PH HEPATITIS 7                                 $ 1,700
5298            PH HEPATITIS 8                                 $ 2,500
5301            GERIATRIC/APT MENTAL HLTH 1                    $ 200
5302            GERIATRIC/APT MENTAL HLTH 2                    $ 300
5303            GERIATRIC/APT MENTAL HLTH 3                    $ 650
5304            GERIATRIC/APT MENTAL HLTH 4                    $ 800
5305            GERIATRIC/APT MENTAL HLTH 5                    $ 1,000
5306            GERIATRIC/APT MENTAL HLTH 6                    $ 1,300
5307            GERIATHRI/APT MENTAL HLTH 7                    $ 1,700
5308            GERIATRIC/APT MENTAL HLTH 8                    $ 2,500
5321            HYPERTENSION 1                                 $ 200
5322            HYPERTENSION 2                                 $ 300
5323            HYPERTENSION 3                                 $ 650
5324            HYPERTENSION 4                                 $ 800
5325            HYPERTENSION 5                                 $ 1,000
5326            HYPERTENSION 6                                 $ 1,300
5327            HYPERTENSION 7                                 $ 1,700
5328            HYPERTENSION 8                                 $ 2,500
5331            HYPERTENSION SERV (5-6 VISI                    $ 650
5341            HYPERTENSION SERV (1-3 VISI                    $ 200
5351            HYPERTENSION SERV(LONGTRM P                    $ 650
5371            RENAL                                          $ 650
5391            RHEUMATIC GOLD THERAPY 1                       $ 200
5392            RHEUMATIC GOLD THERAPY 2                       $ 300
5393            RHEUMATIC GOLD THERAPY 3                       $ 650
5394            RHEUMATIC GOLD THERAPY 4                       $ 800
5395            RHEUMATIC GOLD THERAPY 5                       $ 1,000
5396            RHEUMATIC GOLD THERAPY 6                       $ 1,300
5397            RHEUMATIC GOLD THERAPY 7                       $ 1,700
5398            RHEUMATIC GOLD THERAPY 8                       $ 2,500
5401            RHEUMATOLOGY 1                                 $ 200
5402            RHEUMATOLOGY 2                                 $ 300
5403            RHEUMATOLOGY 3                                 $ 650
5404            RHEUMATOLOGY 4                                 $ 800
5405            RHEUMATOLOGY 5                                 $ 1,000
5406            RHEUMATOLOGY 6                                 $ 1,300
5407            RHEUMATOLOGY 7                                 $ 1,700
5408            RHEUMATOLOGY 8                                 $ 2,500
5411            PAIN CLINIC DR. CUNDIFF                        $ 400
5417            MEDICAL URGENT CARE                            $ 650
5418            PRIMARY CARE OVERFLOW                          $ 400
5419            PRIM CARE TEAM A                               $ 400
5421            PRIM CARE TEAM B                               $ 400
5422            INT MED MED 1 RES-RTN                          $ 400
5423            PRIM CARE TEAM C                               $ 400
5424            PRIM CARE TEAM D                               $ 400
5425            PRIM CARE TEAM E                               $ 400
5426            PRIM CARE TEAM F                               $ 400

                             29 of 75
       COUNTY OF LOS ANGELES - DEPARTMENT OF HEALTH SERVICES

           LAC+USC HEALTHCARE NETWORK
              OUTPATIENT BILLING RATE
                FISCAL YEAR 2004-05


CHG CODE        BILLING DESCRIPTION                            PRICE
5427            PRIM CARE TEAM G                               $ 400
5428            PRIM CARE TEAM H                               $ 400
5431            INT MED RES 1                                  $ 200
5432            INT MED RES 2                                  $ 300
5433            INT MED RES 3                                  $ 650
5434            INT MED RES 4                                  $ 800
5435            INT MED RES 5                                  $ 1,000
5436            INT MED RES 6                                  $ 1,300
5437            INT MED RES 7                                  $ 1,700
5438            INT MED RES 8                                  $ 2,500
5441            INT MED MED 2 RES NEW                          $ 650
5442            INT MED MED 2 RES-RETURN                       $ 400
5451            INT MED MED 3 RESIDENTS-NEW                    $ 650
5452            INT MED MED 3 RESIDENTS-RET                    $ 400
5461            INT MED MED 4 RESIDENTS-NEW                    $ 650
5462            INT MED MED 4 RESIDENTS-RET                    $ 400
5472            PRE-OP MEDICAL CLEARANCE                       $ 300
5481            MAN CARE PRIM CARE NON MD 1                    $ 200
5482            MAN CARE PRIM CARE NON MD 2                    $ 300
5483            MAN CARE PRIM CARE NON MD 3                    $ 650
5484            MAN CARE PRIM CARE NON MD 4                    $ 800
5485            MAN CARE PRIM CARE NON MD 5                    $ 1,000
5486            MAN CARE PRIM CARE NON MD 6                    $ 1,300
5487            MAN CARE PRIM CARE NON MD 7                    $ 1,700
5488            MAN CARE PRIM CARE NON MD 8                    $ 2,500
5491            MANAGED CARE CASE MGT 1                        $ 200
5492            MANAGED CARE CASE MGT 2                        $ 300
5493            MANAGED CARE CASE MGT 3                        $ 650
5494            MANAGED CARE CASE MGT 4                        $ 800
5495            MANAGED CARE CASE MGT 5                        $ 1,000
5496            MANAGED CARE CASE MGT 6                        $ 1,300
5497            MANAGED CARE CASE MGT 7                        $ 1,700
5498            MANAGED CARE CASE MGT 8                        $ 2,500
5501            MAN CARE PEDS PRIM CARE 1                      $ 200
5502            MAN CARE PEDS PRIM CARE 2                      $ 300
5503            MAN CARE PEDS PRIM CARE 3                      $ 650
5504            MAN CARE PEDS PRIM CARE 4                      $ 800
5505            MAN CARE PEDS PRIM CARE 5                      $ 1,000
5506            MAN CARE PEDS PRIM CARE 6                      $ 1,300
5507            MAN CARE PEDS PRIM CARE 7                      $ 1,700
5508            MAN CARE PEDS PRIM CARE 8                      $ 2,500
5511            MAN CARE ADLT PRIM CARE 1                      $ 200
5512            MAN CARE ADLT PRIM CARE 2                      $ 300
5513            MAN CARE ADLT PRIM CARE 3                      $ 650
5514            MAN CARE ADLT PRIM CARE 4                      $ 800
5515            MAN CARE ADLT PRIM CARE 5                      $ 1,000
5516            MAN CARE ADLT PRIM CARE 6                      $ 1,300
5517            MAN CARE ADLT PRIM CARE 7                      $ 1,700
5518            MAN CARE ADLT PRIM CARE 8                      $ 2,500

                             30 of 75
       COUNTY OF LOS ANGELES - DEPARTMENT OF HEALTH SERVICES

           LAC+USC HEALTHCARE NETWORK
              OUTPATIENT BILLING RATE
                FISCAL YEAR 2004-05


CHG CODE        BILLING DESCRIPTION                            PRICE
5521            CHEST MED SARCOID 1                            $ 200
5522            CHEST MED SARCOID 2                            $ 300
5523            CHEST MED SARCOID 3                            $ 650
5524            CHEST MED SARCOID 4                            $ 800
5525            CHEST MED SARCOID 5                            $ 1,000
5526            CHEST MED SARCOID 6                            $ 1,300
5527            CHEST MED SARCOID 7                            $ 1,700
5528            CHEST MED SARCOID 8                            $ 2,500
5551            PH CHEST MEDICINE 1                            $ 200
5552            PH CHEST MEDICINE 2                            $ 300
5553            PH CHEST MEDICINE 3                            $ 650
5554            PH CHEST MEDICINE 4                            $ 800
5555            PH CHEST MEDICINE 5                            $ 1,000
5556            PH CHEST MEDICINE 6                            $ 1,300
5557            PH CHEST MEDICINE 7                            $ 1,700
5558            PH CHEST MEDICINE 8                            $ 2,500
5571            NEUROLOGY NEUROMUSCULAR 1                      $ 200
5572            NEUROLOGY NEUROMUSCULAR 2                      $ 300
5573            NEUROLOGY NEUROMUSCULAR 3                      $ 650
5574            NEUROLOGY NEUROMUSCULAR 4                      $ 800
5575            NEUROLOGY NEUROMUSCULAR 5                      $ 1,000
5576            NEUROLOGY NEUROMUSCULAR 6                      $ 1,300
5577            NEUROLOGY NEUROMUSCULAR 7                      $ 1,700
5578            NEUROLOGY NEUROMUSCULAR 8                      $ 2,500
5581            NEUROLOGY 1                                    $ 200
5582            NEUROLOGY 2                                    $ 300
5583            NEUROLOGY 3                                    $ 650
5584            NEUROLOGY 4                                    $ 800
5585            NEUROLOGY 5                                    $ 1,000
5586            NEUROLOGY 6                                    $ 1,300
5587            NEUROLOGY 7                                    $ 1,700
5588            NEUROLOGY 8                                    $ 2,500
5591            NEUROSURGERY 1                                 $ 200
5592            NEUROSURGERY 2                                 $ 300
5593            NEUROSURGERY 3                                 $ 650
5594            NEUROSURGERY 4                                 $ 800
5595            NEUROSURGERY 5                                 $ 1,000
5596            NEUROSURGERY 6                                 $ 1,300
5597            NEUROSURGERY 7                                 $ 1,700
5598            NEUROSURGERY 8                                 $ 2,500
5601            ORTHOPEDIC TRAUMA                              $ 400
5621            ORTHOPEDIC TRAUMA                              $ 400
5631            ORTHOPEDIC TRAUMA COMPLICAT                    $ 400
5641            ORTHO TRAUMA 1                                 $ 200
5642            ORTHO TRAUMA 2                                 $ 300
5643            ORTHO TRAUMA 3                                 $ 650
5644            ORTHO TRAUMA 4                                 $ 800
5645            ORTHO TRAUMA 5                                 $ 1,000
5646            ORTHO TRAUMA 6                                 $ 1,300

                             31 of 75
       COUNTY OF LOS ANGELES - DEPARTMENT OF HEALTH SERVICES

           LAC+USC HEALTHCARE NETWORK
              OUTPATIENT BILLING RATE
                FISCAL YEAR 2004-05


CHG CODE        BILLING DESCRIPTION                            PRICE
5647            ORTHO TRAUMA 7                                 $ 1,700
5648            ORTHO TRAUMA 8                                 $ 2,500
5651            ORTHO TRAUMA COMPLICA 1                        $ 200
5652            ORTHO TRAUMA COMPLICA 2                        $ 300
5653            ORTHO TRAUMA COMPLICA 3                        $ 650
5654            ORTHO TRAUMA COMPLICA 4                        $ 800
5655            ORTHO TRAUMA COMPLICA 5                        $ 1,000
5656            ORTHO TRAUMA COMPLICA 6                        $ 1,300
5657            ORTHO TRAUMA COMPLICA 7                        $ 1,700
5658            ORTHO TRAUMA COMPLICA 8                        $ 2,500
5661            ORTHO HAND 1                                   $ 200
5662            ORTHO HAND 2                                   $ 300
5663            ORTHO HAND 3                                   $ 650
5664            ORTHO HAND 4                                   $ 800
5665            ORTHO HAND 5                                   $ 1,000
5666            ORTHO HAND 6                                   $ 1,300
5667            ORTHO HAND 7                                   $ 1,700
5668            ORTHO HAND 8                                   $ 2,500
5671            ORTHO INFECTION BONE 1                         $ 200
5672            ORTHO INFECTION BONE 2                         $ 300
5673            ORTHO INFECTION BONE 3                         $ 650
5674            ORTHO INFECTION BONE 4                         $ 800
5675            ORTHO INFECTION BONE 5                         $ 1,000
5676            ORTHO INFECTION BONE 6                         $ 1,300
5677            ORTHO INFECTION BONE 7                         $ 1,700
5678            ORTHO INFECTION BONE 8                         $ 2,500
5681            ORTHO INFECT SOFT TISS 1                       $ 200
5682            ORTHO INFECT SOFT TISS 2                       $ 300
5683            ORTHO INFECT SOFT TISS 3                       $ 650
5684            ORTHO INFECT SOFT TISS 4                       $ 800
5685            ORTHO INFECT SOFT TISS 5                       $ 1,000
5686            ORTHO INFECT SOFT TISS 6                       $ 1,300
5687            ORTHO INFECT SOFT TISS 7                       $ 1,700
5688            ORTHO INFECT SOFT TISS 8                       $ 2,500
5691            ORTHO SPINE 1                                  $ 200
5692            ORTHO SPINE 2                                  $ 300
5693            ORTHO SPINE 3                                  $ 650
5694            ORTHO SPINE 4                                  $ 800
5695            ORTHO SPINE 5                                  $ 1,000
5696            ORTHO SPINE 6                                  $ 1,300
5697            ORTHO SPINE 7                                  $ 1,700
5698            ORTHO SPINE 8                                  $ 2,500
5701            ORTHO SPORTS MEDICINE 1                        $ 200
5702            ORTHO SPORTS MEDICINE 2                        $ 300
5703            ORTHO SPORTS MEDICINE 3                        $ 650
5704            ORTHO SPORTS MEDICINE 4                        $ 800
5705            ORTHO SPORTS MEDICINE 5                        $ 1,000
5706            ORTHO SPORTS MEDICINE 6                        $ 1,300
5707            ORTHO SPORTS MEDICINE 7                        $ 1,700

                             32 of 75
       COUNTY OF LOS ANGELES - DEPARTMENT OF HEALTH SERVICES

           LAC+USC HEALTHCARE NETWORK
              OUTPATIENT BILLING RATE
                FISCAL YEAR 2004-05


CHG CODE        BILLING DESCRIPTION                            PRICE
5708            ORTHO SPORTS MEDICINE 8                        $ 2,500
5711            ORTHO TUMOR 1                                  $ 200
5712            ORTHO TUMOR 2                                  $ 300
5713            ORTHO TUMOR 3                                  $ 650
5714            ORTHO TUMOR 4                                  $ 800
5715            ORTHO TUMOR 5                                  $ 1,000
5716            ORTHO TUMOR 6                                  $ 1,300
5717            ORTHO TUMOR 7                                  $ 1,700
5718            ORTHO TUMOR 8                                  $ 2,500
5721            ORTHO ARTHRITIS 1                              $ 200
5722            ORTHO ARTHRITIS 2                              $ 300
5723            ORTHO ARTHRITIS 3                              $ 650
5724            ORTHO ARTHRITIS 4                              $ 800
5725            ORTHO ARTHRITIS 5                              $ 1,000
5726            ORTHO ARTHRITIS 6                              $ 1,300
5727            ORTHO ARTHRITIS 7                              $ 1,700
5728            ORTHO ARTHRITIS 8                              $ 2,500
5731            ORTHO FOOT 1                                   $ 200
5732            ORTHO FOOT 2                                   $ 300
5733            ORTHO FOOT 3                                   $ 650
5734            ORTHO FOOT 4                                   $ 800
5735            ORTHO FOOT 5                                   $ 1,000
5736            ORTHO FOOT 6                                   $ 1,300
5737            ORTHO FOOT 7                                   $ 1,700
5738            ORTHO FOOT 8                                   $ 2,500
5741            ORTHOPEDIC FRACTURE BRACE                      $ 400
5751            ORTHOPEDIC HAND                                $ 400
5771            ORTHOPEDIC GENERAL ORTHO                       $ 400
5791            SURGERY BURN 1                                 $ 200
5792            SURGERY BURN 2                                 $ 300
5793            SURGERY BURN 3                                 $ 650
5794            SURGERY BURN 4                                 $ 800
5795            SURGERY BURN 5                                 $ 1,000
5796            SURGERY BURN 6                                 $ 1,300
5797            SURGERY BURN 7                                 $ 1,700
5798            SURGERY BURN 8                                 $ 2,500
5801            SURGERY CARDIO 1                               $ 200
5802            SURGERY CARDIO 2                               $ 300
5803            SURGERY CARDIO 3                               $ 650
5804            SURGERY CARDIO 4                               $ 800
5805            SURGERY CARDIO 5                               $ 1,000
5806            SURGERY CARDIO 6                               $ 1,300
5807            SURGERY CARDIO 7                               $ 1,700
5808            SURGERY CARDIO 8                               $ 2,500
5811            PRE-OP SCREENING 1                             $ 200
5812            PRE-OP SCREENING 2                             $ 300
5813            PRE-OP SCREENING 3                             $ 650
5814            PRE-OP SCREENING 4                             $ 800
5815            PRE-OP SCREENING 5                             $ 1,000

                             33 of 75
       COUNTY OF LOS ANGELES - DEPARTMENT OF HEALTH SERVICES

           LAC+USC HEALTHCARE NETWORK
              OUTPATIENT BILLING RATE
                FISCAL YEAR 2004-05


CHG CODE        BILLING DESCRIPTION                            PRICE
5816            PRE-OP SCREENING 6                             $ 1,300
5817            PRE-OP SCREENING 7                             $ 1,700
5818            PRE-OP SCREENING 8                             $ 2,500
5821            SURGERY STOMA                                  $ 400
5831            SURGERY COLORECTAL 1                           $ 200
5832            SURGERY COLORECTAL 2                           $ 300
5833            SURGERY COLORECTAL 3                           $ 650
5834            SURGERY COLORECTAL 4                           $ 800
5835            SURGERY COLORECTAL 5                           $ 1,000
5836            SURGERY COLORECTAL 6                           $ 1,300
5837            SURGERY COLORECTAL 7                           $ 1,700
5838            SURGERY COLORECTAL 8                           $ 2,500
5841            SURG FOREGUT PULMONARY 1                       $ 200
5842            SURG FOREGUT PULMONARY 2                       $ 300
5843            SURG FOREGUT PULMONARY 3                       $ 650
5844            SURG FOREGUT PULMONARY 4                       $ 800
5845            SURG FOREGUT PULMONARY 5                       $ 1,000
5846            SURG FOREGUT PULMONARY 6                       $ 1,300
5847            SURG FOREGUT PULMONARY 7                       $ 1,700
5848            SURG FOREGUT PULMONARY 8                       $ 2,500
5851            SURGERY NON-TRAUMA 1                           $ 200
5852            SURGERY NON-TRAUMA 2                           $ 300
5853            SURGERY NON-TRAUMA 3                           $ 650
5854            SURGERY NON-TRAUMA 4                           $ 800
5855            SURGERY NON-TRAUMA 5                           $ 1,000
5856            SURGERY NON-TRAUMA 6                           $ 1,300
5857            SURGERY NON-TRAUMA 7                           $ 1,700
5858            SURGERY NON-TRAUMA 8                           $ 2,500
5871            SURGERY HEPATOBILIARY 1                        $ 200
5872            SURGERY HEPATOBILIARY 2                        $ 300
5873            SURGERY HEPATOBILIARY 3                        $ 650
5874            SURGERY HEPATOBILIARY 4                        $ 800
5875            SURGERY HEPATOBILIARY 5                        $ 1,000
5876            SURGERY HEPATOBILIARY 6                        $ 1,300
5877            SURGERY HEPATOBILIARY 7                        $ 1,700
5878            SURGERY HEPATOBILIARY 8                        $ 2,500
5881            SURGERY RECONSTRUCTIVE 1                       $ 200
5882            SURGERY RECONSTRUCTIVE 2                       $ 300
5883            SURGERY RECONSTRUCTIVE 3                       $ 650
5884            SURGERY RECONSTRUCTIVE 4                       $ 800
5885            SURGERY RECONSTRUCTIVE 5                       $ 1,000
5886            SURGERY RECONSTRUCTIVE 6                       $ 1,300
5887            SURGERY RECONSTRUCTIVE 7                       $ 1,700
5888            SURGERY RECONSTRUCTIVE 8                       $ 2,500
5891            SURGERY TRAUMA 1                               $ 200
5892            SURGERY TRAUMA 2                               $ 300
5893            SURGERY TRAUMA 3                               $ 650
5894            SURGERY TRAUMA 4                               $ 800
5895            SURGERY TRAUMA 5                               $ 1,000

                             34 of 75
       COUNTY OF LOS ANGELES - DEPARTMENT OF HEALTH SERVICES

           LAC+USC HEALTHCARE NETWORK
              OUTPATIENT BILLING RATE
                FISCAL YEAR 2004-05


CHG CODE        BILLING DESCRIPTION                            PRICE
5896            SURGERY TRAUMA 6                               $ 1,300
5897            SURGERY TRAUMA 7                               $ 1,700
5898            SURGERY TRAUMA 8                               $ 2,500
5901            SURGERY TUMOR 1                                $ 200
5902            SURGERY TUMOR 2                                $ 300
5903            SURGERY TUMOR 3                                $ 650
5904            SURGERY TUMOR 4                                $ 800
5905            SURGERY TUMOR 5                                $ 1,000
5906            SURGERY TUMOR 6                                $ 1,300
5907            SURGERY TUMOR 7                                $ 1,700
5908            SURGERY TUMOR 8                                $ 2,500
5911            SURGERY VASCULAR 1                             $ 200
5912            SURGERY VASCULAR 2                             $ 300
5913            SURGERY VASCULAR 3                             $ 650
5914            SURGERY VASCULAR 4                             $ 800
5915            SURGERY VASCULAR 5                             $ 1,000
5916            SURGERY VASCULAR 6                             $ 1,300
5917            SURGERY VASCULAR 7                             $ 1,700
5918            SURGERY VASCULAR 8                             $ 2,500
5921            RENAL TRANSPLANT                               $ 650
5991            UROLOGY 1                                      $ 200
5992            UROLOGY 2                                      $ 300
5993            UROLOGY 3                                      $ 650
5994            UROLOGY 4                                      $ 800
5995            UROLOGY 5                                      $ 1,000
5996            UROLOGY 6                                      $ 1,300
5997            UROLOGY 7                                      $ 1,700
5998            UROLOGY 8                                      $ 2,500
6001            OPHTHALMOLOGY CMV RETINITIS                    $ 300
6011            OPHTHAL CONTACT LENS 1                         $ 200
6012            OPHTHAL CONTACT LENS 2                         $ 300
6013            OPHTHAL CONTACT LENS 3                         $ 650
6014            OPHTHAL CONTACT LENS 4                         $ 800
6015            OPHTHAL CONTACT LENS 5                         $ 1,000
6016            OPHTHAL CONTACT LENS 6                         $ 1,300
6017            OPHTHAL CONTACT LENS 7                         $ 1,700
6018            OPHTHAL CONTACT LENS 8                         $ 2,500
6021            OPHTHALMOLOGY CORNEA 1                         $ 200
6022            OPHTHALMOLOGY CORNEA 2                         $ 300
6023            OPHTHALMOLOGY CORNEA 3                         $ 650
6024            OPHTHALMOLOGY CORNEA 4                         $ 800
6025            OPHTHALMOLOGY CORNEA 5                         $ 1,000
6026            OPHTHALMOLOGY CORNEA 6                         $ 1,300
6027            OPHTHALMOLOGY CORNEA 7                         $ 1,700
6028            OPHTHALMOLOGY CORNEA 8                         $ 2,500
6031            OPHTHAL DIABETIC RETINA 1                      $ 200
6032            OPHTHAL DIABETIC RETINA 2                      $ 300
6033            OPHTHAL DIABETIC RETINA 3                      $ 650
6034            OPHTHAL DIABETIC RETINA 4                      $ 800

                             35 of 75
       COUNTY OF LOS ANGELES - DEPARTMENT OF HEALTH SERVICES

           LAC+USC HEALTHCARE NETWORK
              OUTPATIENT BILLING RATE
                FISCAL YEAR 2004-05


CHG CODE        BILLING DESCRIPTION                            PRICE
6035            OPHTHAL DIABETIC RETINA 5                      $ 1,000
6036            OPHTHAL DIABETIC RETINA 6                      $ 1,300
6037            OPHTHAL DIABETIC RETINA 7                      $ 1,700
6038            OPHTHAL DIABETIC RETINA 8                      $ 2,500
6041            OPHTHALMOLOGY ER REFERRAL                      $ 650
6051            OPHTHALMOLOGY GLAUCOMA 1                       $ 200
6052            OPHTHALMOLOGY GLAUCOMA 2                       $ 300
6053            OPHTHALMOLOGY GLAUCOMA 3                       $ 650
6054            OPHTHALMOLOGY GLAUCOMA 4                       $ 800
6055            OPHTHALMOLOGY GLAUCOMA 5                       $ 1,000
6056            OPHTHALMOLOGY GLAUCOMA 6                       $ 1,300
6057            OPHTHALMOLOGY GLAUCOMA 7                       $ 1,700
6058            OPHTHALMOLOGY GLAUCOMA 8                       $ 2,500
6061            OPHTHA PHOTO COAG LASER 1                      $ 200
6062            OPHTHA PHOTO COAG LASER 2                      $ 300
6063            OPHTHA PHOTO COAG LASER 3                      $ 650
6064            OPHTHA PHOTO COAG LASER 4                      $ 800
6065            OPHTHA PHOTO COAG LASER 5                      $ 1,000
6066            OPHTHA PHOTO COAG LASER 6                      $ 1,300
6067            OPHTHA PHOTO COAG LASER 7                      $ 1,700
6068            OPHTHA PHOTO COAG LASER 8                      $ 2,500
6071            OPHTHALMOLOGY MOTILITY                         $ 300
6081            OPHTHAL NEURO-OPHTHAL 1                        $ 200
6082            OPHTHAL NEURO-OPHTHAL 2                        $ 300
6083            OPHTHAL NEURO-OPHTHAL 3                        $ 650
6084            OPHTHAL NEURP-OPHTHAL 4                        $ 800
6085            OPHTHAL NEURO-OPHTHAL 5                        $ 1,000
6086            OPHTHAL NEURO-OPHTHAL 6                        $ 1,300
6087            OPHTHAL NEURO-OPHTHAL 7                        $ 1,700
6088            OPHTHAL NEURO-OPHTHAL 8                        $ 2,500
6091            OPHTHALMOLOGY 1                                $ 200
6092            OPHTHALMOLOGY 2                                $ 300
6093            OPHTHALMOLOGY 3                                $ 650
6094            OPHTHALMOLOGY 4                                $ 800
6095            OPHTHALMOLOGY 5                                $ 1,000
6096            OPHTHALMOLOGY 6                                $ 1,300
6097            OPHTHALMOLOGY 7                                $ 1,700
6098            OPHTHALMOLOGY 8                                $ 2,500
6101            OPHTHALMOLOGY MOTILITY 1                       $ 200
6102            OPHTHALMOLOGY MOTILITY 2                       $ 300
6103            OPHTHALMOLOGY MOTILITY 3                       $ 650
6104            OPHTHALMOLOGY MOTILITY 4                       $ 800
6105            OPHTHALMOLOGY MOTILITY 5                       $ 1,000
6106            OPHTHALMOLOGY MOTILITY 6                       $ 1,300
6107            OPHTHALMOLOGY MOTILITY 7                       $ 1,700
6108            OPHTHALMOLOGY MOTILITY 8                       $ 2,500
6111            OPHTHALMOLOGY PHOTO 1                          $ 200
6112            OPHTHALMOLOGY PHOTO 2                          $ 300
6113            OPHTHALMOLOGY PHOTO 3                          $ 650

                             36 of 75
       COUNTY OF LOS ANGELES - DEPARTMENT OF HEALTH SERVICES

           LAC+USC HEALTHCARE NETWORK
              OUTPATIENT BILLING RATE
                FISCAL YEAR 2004-05


CHG CODE        BILLING DESCRIPTION                            PRICE
6114            OPHTHALMOLOGY PHOTO 4                          $ 800
6115            OPHTHALMOLOGY PHOTO 5                          $ 1,000
6116            OPHTHALMOLOGY PHOTO 6                          $ 1,300
6117            OPHTHALMOLOGY PHOTO 7                          $ 1,700
6118            OPHTHALMOLOGY PHOTO 8                          $ 2,500
6121            OPHTHALMOLOGY PLASTIC 1                        $ 200
6122            OPHTHALMOLOGY PLASTIC 2                        $ 300
6123            OPHTHALMOLOGY PLASTIC 3                        $ 650
6124            OPHTHALMOLOGY PLASTIC 4                        $ 800
6125            OPHTHALMOLOGY PLASTIC 5                        $ 1,000
6126            OPHTHALMOLOGY PLASTIC 6                        $ 1,300
6127            OPHTHALMOLOGY PLASTIC 7                        $ 1,700
6128            OPHTHALMOLOGY PLASTIC 8                        $ 2,500
6131            OPHTHALMOLOGY RETINA 1                         $ 200
6132            OPHTHALMOLOGY RETINA 2                         $ 300
6133            OPHTHALMOLOGY RETINA 3                         $ 650
6134            OPHTHALMOLOGY RETINA 4                         $ 800
6135            OPHTHALMOLOGY RETINA 5                         $ 1,000
6136            OPHTHALMOLOGY RETINA 6                         $ 1,300
6137            OPHTHALMOLOGY RETINA 7                         $ 1,700
6138            OPHTHALMOLOGY RETINA 8                         $ 2,500
6141            OPHTHALMOLOGY UVEITIS 1                        $ 200
6142            OPHTHALMOLOGY UVEITIS 2                        $ 300
6143            OPHTHALMOLOGY UVEITIS 3                        $ 650
6144            OPHTHALMOLOGY UVEITIS 4                        $ 800
6145            OPHTHALMOLOGY UVEITIS 5                        $ 1,000
6146            OPHTHALMOLOGY UVEITIS 6                        $ 1,300
6147            OPHTHALMOLOGY UVEITIS 7                        $ 1,700
6148            OPHTHALMOLOGY UVEITIS 8                        $ 2,500
6151            OPHTHAL VITRECTOMY 1                           $ 200
6152            OPHTHAL VITRECTOMY 2                           $ 300
6153            OPHTHAL VITRECTOMY 3                           $ 650
6154            OPHTHAL VITRECTOMY 4                           $ 800
6155            OPHTHAL VITRECTOMY 5                           $ 1,000
6156            OPHTHAL VITRECTOMY 6                           $ 1,300
6157            OPHTHAL VITRECTOMY 7                           $ 1,700
6158            OPHTHAL VITRECTOMY 8                           $ 2,500
6301            OTOLARYNGOLOGY ENT 1                           $ 200
6302            OTOLARYNGOLOGY ENT 2                           $ 300
6303            OTOLARYNGOLOGY ENT 3                           $ 650
6304            OTOLARYNGOLOGY ENT 4                           $ 800
6305            OTOLARYNGOLOGY ENT 5                           $ 1,000
6306            OTOLARYNGOLOGY ENT 6                           $ 1,300
6307            OTOLARYNGOLOGY ENT 7                           $ 1,700
6308            OTOLARYNGOLOGY ENT 8                           $ 2,500
6311            OTOLARYNGOLOGY ER/REFERRAL                     $ 650
6321            OTOLARYNGOLOGY OTOLOGY 1                       $ 200
6322            OTOLARYNGOLOGY OTOLOGY 2                       $ 300
6323            OTOLARYNGOLOGY OTOLOGY 3                       $ 650

                             37 of 75
       COUNTY OF LOS ANGELES - DEPARTMENT OF HEALTH SERVICES

           LAC+USC HEALTHCARE NETWORK
              OUTPATIENT BILLING RATE
                FISCAL YEAR 2004-05


CHG CODE        BILLING DESCRIPTION                            PRICE
6324            OTOLARYNGOLOGY OTOLOGY 4                       $ 800
6325            OTOLARYNGOLOGY OTOLOGY 5                       $ 1,000
6326            OTOLARYNGOLOGY OTOLOGY 6                       $ 1,300
6327            OTOLARYNGOLOGY OTOLOGY 7                       $ 1,700
6328            OTOLARYNGOLOGY OTOLOGY 8                       $ 2,500
6331            OTOLARYNGOLOGY PEDS 1                          $ 200
6332            OTOLARYNGOLOGY PEDS 2                          $ 300
6333            OTOLARYNGOLOGY PEDS 3                          $ 650
6334            OTOLARYNGOLOGY PEDS 4                          $ 800
6335            OTOLARYNGOLOGY PEDS 5                          $ 1,000
6336            OTOLARYNGOLOGY PEDS 6                          $ 1,300
6337            OTOLARYNGOLOGY PEDS 7                          $ 1,700
6338            OTOLARYNGOLOGY PEDS 8                          $ 2,500
6351            PODIATRY 1                                     $ 200
6352            PODIATRY 2                                     $ 300
6353            PODIATRY 3                                     $ 650
6354            PODIATRY 4                                     $ 800
6355            PODIATRY 5                                     $ 1,000
6356            PODIATRY 6                                     $ 1,300
6357            PODIATRY 7                                     $ 1,700
6358            PODIATRY 8                                     $ 2,500
6361            RHEUMATIC DISEASE                              $ 650
6371            RAD ONCOLOGY-SIMULATION                        $ 200
6372            RAD ONC SIMULATION                             $ 300
6373            RAD ONC SIMULATION INTER                       $ 650
6374            RAD ONC SIMULATION COMPLX                      $ 800
6381            RAD ONCOLOGY-SUPERFICIAL                       $ 200
6382            RAD ONC SUPERFICIAL SIMP                       $ 300
6383            RAD ONC SUPERFICIAL INTER                      $ 650
6384            RAD ONC SUPERFICIAL COMP                       $ 800
6391            RAD ONCOLOGY COMPLEX                           $ 800
6401            RAD ONCOLOGY SIMPLE                            $ 300
6411            RAD ONC INTERMEDIATE                           $ 650
6421            RAD ONCOLOGY 1                                 $ 200
6422            RAD ONCOLOGY 2                                 $ 300
6423            RAD ONCOLOGY 3                                 $ 650
6424            RAD ONCOLOGY 4                                 $ 800
6425            RAD ONCOLOGY 5                                 $ 1,000
6426            RAD ONCOLOGY 6                                 $ 1,300
6427            RAD ONCOLOGY 7                                 $ 1,700
6428            RAD ONCOLOGY 8                                 $ 2,500
6431            RAD ONCOLOGY-2100MV                            $ 200
6432            RAD ONC 2100-MV SIMPLE                         $ 300
6433            RAD ONC 2100-MV INTER                          $ 650
6434            RAD ONC 2100-MV COMPLEX                        $ 800
6441            RAD ONCOLOGY-4MV                               $ 200
6442            RAD ONC 4-MV SIMPLE                            $ 300
6443            RAD ONC 4-MV INTER                             $ 650
6444            RAD ONC 4-MV COMPLEX                           $ 800

                             38 of 75
       COUNTY OF LOS ANGELES - DEPARTMENT OF HEALTH SERVICES

           LAC+USC HEALTHCARE NETWORK
              OUTPATIENT BILLING RATE
                FISCAL YEAR 2004-05


CHG CODE        BILLING DESCRIPTION                            PRICE
6451            RAD ONCOLOGY-6MV                               $ 200
6452            RAD ONC 6-MV SIMPLE                            $ 300
6453            RAD ONC 6-MV INTER                             $ 650
6454            RAD ONC 6-MV COMPLEX                           $ 800
6471            REHAB MED EMG 1                                $ 200
6472            REHAB MED EMG 2                                $ 300
6473            REHAB MED EMG 3                                $ 650
6474            REHAB MED EMG 4                                $ 800
6475            REHAB MED EMG 5                                $ 1,000
6476            REHAB MED EMG 6                                $ 1,300
6477            REHAB MED EMG 7                                $ 1,700
6478            REHAB MED EMG 8                                $ 2,500
6481            REHAB MED OCCUP THERAPY EVA                    $ 400
6491            REHAB MED OCCUP THERAPY GRO                    $ 400
6501            REHAB MED OCCUP THERAPY IND                    $ 400
6531            REHAB MED PHYSICAL THERAPY                     $ 400
6561            REHAB MED PHYSIATRIST 1                        $ 200
6562            REHAB MED PHYSIATRIST 2                        $ 300
6563            REHAB MED PHYSIATRIST 3                        $ 650
6564            REHAB MED PHYSIATRIST 4                        $ 800
6565            REHAB MED PHYSIATRIST 5                        $ 1,000
6566            REHAB MED PHYSIATRIST 6                        $ 1,300
6567            REHAB MED PHYSIATRIST 7                        $ 1,700
6568            REHAB MED PHYSIATRIST 8                        $ 2,500
6621            DENTAL GENERAL 1                               $ 200
6622            DENTAL GENERAL 2                               $ 300
6623            DENTAL GENERAL 3                               $ 650
6624            DENTAL GENERAL 4                               $ 800
6625            DENTAL GENERAL 5                               $ 1,000
6626            DENTAL GENERAL 6                               $ 1,300
6627            DENTAL GENERAL 7                               $ 1,700
6628            DENTAL GENERAL 8                               $ 2,500
6631            DENTAL ORAL SURGERY 1                          $ 200
6632            DENTAL ORAL SURGERY 2                          $ 300
6633            DENTAL ORAL SURGERY 3                          $ 650
6634            DENTAL ORAL SURGERY 4                          $ 800
6634            DENTAL ORAL SURGERY 5                          $ 1,000
6636            DENTAL ORAL SURGERY 6                          $ 1,300
6637            DENTAL ORAL SURGERY 7                          $ 1,700
6638            DENTAL ORAL SURGERY 8                          $ 2,500
6741            BG FAMILY MEDICINE 1                           $ 100
6742            BG FAMILY MEDICINE 2                           $ 175
6743            BG FAMILY MEDICINE 3                           $ 225
6744            BG FAMILY MEDICINE 4                           $ 275
6745            BG FAMILY MEDICINE 5                           $ 350
6746            BG FAMILY MEDICINE 6                           $ 450
6747            BG FAMILY MEDICINE 7                           $ 550
6748            BG FAMILY MEDICINE 8                           $ 1,200
6751            BG PEDIATRICS 1                                $ 100

                             39 of 75
       COUNTY OF LOS ANGELES - DEPARTMENT OF HEALTH SERVICES

           LAC+USC HEALTHCARE NETWORK
              OUTPATIENT BILLING RATE
                FISCAL YEAR 2004-05


CHG CODE        BILLING DESCRIPTION                            PRICE
6752            BG PEDIATRICS 2                                $ 175
6753            BG PEDIATRICS 3                                $ 225
6754            BG PEDIATRICS 4                                $ 275
6755            BG PEDIATRICS 5                                $ 350
6756            BG PEDIATRICS 6                                $ 450
6757            BG PEDIATRICS 7                                $ 550
6758            BG PEDIATRICS 8                                $ 1,200
6761            BG PRIMARY CARE 1                              $ 100
6762            BG PRIMARY CARE 2                              $ 175
6763            BG PRIMARY CARE 3                              $ 225
6764            BG PRIMARY CARE 4                              $ 275
6765            BG PRIMARY CARE 5                              $ 350
6766            BG PRIMARY CARE 6                              $ 450
6767            BG PRIMARY CARE 7                              $ 550
6768            BG PRIMARY CARE 8                              $ 1,200
6771            BG OB/GYN 1                                    $ 100
6772            BG OB/GYN 2                                    $ 175
6773            BG OB/GYN 3                                    $ 225
6774            BG OB/GYN 4                                    $ 275
6775            BG OB/GYN 5                                    $ 350
6776            BG OB/GYN 6                                    $ 450
6777            BG OB/GYN 7                                    $ 550
6778            BG OB/GYN 8                                    $ 1,200
6811            DIAGNOSTIC RADIOLOGY                           $ 400
6971            MCA PDS INFEC DISEASE 1                        $ 200
6972            MCA PDS INFEC DISEASE 2                        $ 300
6973            MCA PDS INFEC DISEASE 3                        $ 650
6974            MCA PDS INFEC DISEASE 4                        $ 800
6975            MCA PDS INFEC DISEASE 5                        $ 1,000
6976            MCA PDS INFEC DISEASE 6                        $ 1,300
6977            MCA PDS INFEC DISEASE 7                        $ 1,700
6978            MCA PDS INFEC DISEASE 8                        $ 2,500
6981            RS INFECTIOUS DISEASE 1                        $ 200
6982            RS INFECTIOUS DISEASE 2                        $ 300
6983            RS INFECTIOUS DISEASE 3                        $ 650
6984            RS INFECTIOUS DISEASE 4                        $ 800
6985            RS INFECTIOUS DISEASE 5                        $ 1,000
6986            RS INFECTIOUS DISEASE 6                        $ 1,300
6987            RS INFECTIOUS DISEASE 7                        $ 1,700
6988            RS INFECTIOUS DISEASE 8                        $ 2,500
6991            PH INFECT DIS AMPHOTER 1                       $ 200
6992            PH INFECT DIS AMPHOTER 2                       $ 300
6993            PH INFECT DIS AMPHOTER 3                       $ 650
6994            PH INFECT DIS AMPHOTER 4                       $ 800
6995            PH INFECT DIS AMPHOTER 5                       $ 1,000
6996            PH INFECT DIS AMPHOTER 6                       $ 1,300
6997            PH INFECT DIS AMPHOTER 7                       $ 1,700
6998            PH INFECT DIS AMPHOTER 8                       $ 2,500
7001            5P21-LEVEL 1                                   $ 300

                             40 of 75
       COUNTY OF LOS ANGELES - DEPARTMENT OF HEALTH SERVICES

           LAC+USC HEALTHCARE NETWORK
              OUTPATIENT BILLING RATE
                FISCAL YEAR 2004-05


CHG CODE        BILLING DESCRIPTION                            PRICE
7002            5P21-LEVEL 2                                   $ 650
7003            5P21-LEVEL 3                                   $ 800
7004            5P21-LEVEL 4                                   $ 1,000
7005            5P21-LEVEL 5                                   $ 1,300
7006            5P21-LEVEL 6                                   $ 1,700
7007            5P21                                           $ 650
7011            RS DERM 1                                      $ 200
7012            RS DERM 2                                      $ 300
7013            RS DERM 3                                      $ 650
7014            RS DERM 4                                      $ 800
7015            RS DERM 5                                      $ 1,000
7016            RS DERM 6                                      $ 1,300
7017            RS DERM 7                                      $ 1,700
7018            RS DERM 8                                      $ 2,500
7021            RS FUNGAL 1                                    $ 200
7022            RS FUNGAL 2                                    $ 300
7023            RS FUNGAL 3                                    $ 650
7024            RS FUNGAL 4                                    $ 800
7025            RS FUNGAL 5                                    $ 1,000
7026            RS FUNGAL 6                                    $ 1,300
7027            RS FUNGAL 7                                    $ 1,700
7028            RS FUNGAL 8                                    $ 2,500
7031            RS GYN 1                                       $ 200
7032            RS GYN 2                                       $ 300
7033            RS GYN 3                                       $ 650
7034            RS GYN 4                                       $ 800
7035            RS GYN 5                                       $ 1,000
7036            RS GYN 6                                       $ 1,300
7037            RS GYN 7                                       $ 1,700
7038            RS GYN 8                                       $ 2,500
7041            RS HEMATOLOGY 1                                $ 200
7042            RS HEMATOLOGY 2                                $ 300
7043            RS HEMATOLOGY 3                                $ 650
7044            RS HEMATOLOGY 4                                $ 800
7045            RS HEMATOLOGY 5                                $ 1,000
7046            RS HEMATOLOGY 6                                $ 1,300
7047            RS HEMATOLOGY 7                                $ 1,700
7048            RS HEMATOLOGY 8                                $ 2,500
7051            RS KAPOSIS SARCOMA 1                           $ 200
7052            RS KAPOSIS SARCOMA 2                           $ 300
7053            RS KAPOSIS SARCOMA 3                           $ 650
7054            RS KAPOSIS SARCOMA 4                           $ 800
7055            RS KAPOSIS SARCOMA 5                           $ 1,000
7056            RS KAPOSIS SARCOMA 6                           $ 1,300
7057            RS KAPOSIS SARCOMA 7                           $ 1,700
7058            RS KAPOSIS SARCOMA 8                           $ 2,500
7061            RS LIVER 1                                     $ 200
7062            RS LIVER 2                                     $ 300
7063            RS LIVER 3                                     $ 650

                             41 of 75
       COUNTY OF LOS ANGELES - DEPARTMENT OF HEALTH SERVICES

           LAC+USC HEALTHCARE NETWORK
              OUTPATIENT BILLING RATE
                FISCAL YEAR 2004-05


CHG CODE        BILLING DESCRIPTION                            PRICE
7064            RS LIVER 4                                     $ 800
7065            RS LIVER 5                                     $ 1,000
7066            RS LIVER 6                                     $ 1,300
7067            RS LIVER 7                                     $ 1,700
7068            RS LIVER 8                                     $ 2,500
7071            RS METABOLIC 1                                 $ 200
7072            RS METABOLIC 2                                 $ 300
7073            RS METABOLIC 3                                 $ 650
7074            RS METABOLIC 4                                 $ 800
7075            RS METABOLIC 5                                 $ 1,000
7076            RS METABOLIC 6                                 $ 1,300
7077            RS METABOLIC 7                                 $ 1,700
7078            RS METABOLIC 8                                 $ 2,500
7081            RS PAIN 1                                      $ 200
7082            RS PAIN 2                                      $ 300
7083            RS PAIN 3                                      $ 650
7084            RS PAIN 4                                      $ 800
7085            RS PAIN 5                                      $ 1,000
7086            RS PAIN 6                                      $ 1,300
7087            RS PAIN 7                                      $ 1,700
7088            RS PAIN 8                                      $ 2,500
7091            RS NEUROLOGY 1                                 $ 200
7092            RS NEUROLOGY 2                                 $ 300
7093            RS NEUROLOGY 3                                 $ 650
7094            RS NEUROLOGY 4                                 $ 800
7095            RS NEUROLOGY 5                                 $ 1,000
7096            RS NEUROLOGY 6                                 $ 1,300
7097            RS NEUROLOGY 7                                 $ 1,700
7098            RS NEUROLOGY 8                                 $ 2,500
7101            RS NEW PATIENT 1                               $ 200
7102            RS NEW PATIENT 2                               $ 300
7103            RS NEW PATIENT 3                               $ 650
7104            RS NEW PATIENT 4                               $ 800
7105            RS NEW PATIENT 5                               $ 1,000
7106            RS NEW PATIENT 6                               $ 1,300
7107            RS NEW PATIENT 7                               $ 1,700
7108            RS NEW PATIENT 8                               $ 2,500
7111            RS PULMONARY 1                                 $ 200
7112            RS PULMONARY 2                                 $ 300
7113            RS PULMONARY 3                                 $ 650
7114            RS PULMONARY 4                                 $ 800
7115            RS PULMONARY 5                                 $ 1,000
7116            RS PULMONARY 6                                 $ 1,300
7117            RS PULMONARY 7                                 $ 1,700
7118            RS PULMONARY 8                                 $ 2,500
7121            RS RECTAL 1                                    $ 200
7122            RS RECTAL 2                                    $ 300
7123            RS RECTAL 3                                    $ 650
7124            RS RECTAL 4                                    $ 800

                             42 of 75
       COUNTY OF LOS ANGELES - DEPARTMENT OF HEALTH SERVICES

           LAC+USC HEALTHCARE NETWORK
              OUTPATIENT BILLING RATE
                FISCAL YEAR 2004-05


CHG CODE        BILLING DESCRIPTION                            PRICE
7125            RS RECTAL 5                                    $ 1,000
7126            RS RECTAL 6                                    $ 1,300
7127            RS RECTAL 7                                    $ 1,700
7128            RS RECTAL 8                                    $ 2,500
7131            RS PRIMARY CARE 1                              $ 200
7132            RS PRIMARY CARE 2                              $ 300
7133            RS PRIMARY CARE 3                              $ 650
7134            RS PRIMARY CARE 4                              $ 800
7135            RS PRIMARY CARE 5                              $ 1,000
7136            RS PRIMARY CARE 6                              $ 1,300
7137            RS PRIMARY CARE 7                              $ 1,700
7138            RS PRIMARY CARE 8                              $ 2,500
7191            RS OPHTHALMOLOGY 1                             $ 200
7192            RS OPHTHALMOLOGY 2                             $ 300
7193            RS OPHTHALMOLOGY 3                             $ 650
7194            RS OPHTHALMOLOGY 4                             $ 800
7195            RS OPHTHALMOLOGY 5                             $ 1,000
7196            RS OPHTHALMOLOGY 6                             $ 1,300
7197            RS OPHTHALMOLOGY 7                             $ 1,700
7198            RS OPHTHALMOLOGY 8                             $ 2,500
7201            ANCILLARY TEST                                 $ 400
7211            PR TEEN 1                                      $ 100
7212            PR TEEN 2                                      $ 175
7213            PR TEEN 3                                      $ 225
7214            PR TEEN 4                                      $ 275
7215            PR TEEN 5                                      $ 350
7216            PR TEEN 6                                      $ 450
7217            PR TEEN 7                                      $ 550
7218            PR TEEN 8                                      $ 1,200
7221            PR FAMILY MEDICINE 1                           $ 100
7222            PR FAMILY MEDICINE 2                           $ 175
7223            PR FAMILY MEDICINE 3                           $ 225
7224            PR FAMILY MEDICINE 4                           $ 275
7225            PR FAMILY MEDICINE 5                           $ 350
7226            PR FAMILY MEDICINE 6                           $ 450
7227            PR FAMILY MEDICINE 7                           $ 550
7228            PR FAMILY MEDICINE 8                           $ 1,200
7231            PR FAM MED WALK-IN 1                           $ 100
7232            PR FAM MED WALK-IN 2                           $ 175
7233            PR FAM MED WALK-IN 3                           $ 225
7234            PR FAM MED WALK-IN 4                           $ 275
7235            PR FAM MED WALK-IN 5                           $ 350
7236            PR FAM MED WALK-IN 6                           $ 450
7237            PR FAM MED WALK-IN 7                           $ 550
7238            PR FAM MED WALK-IN 8                           $ 1,200
7241            PR FAMILY PLANNING 1                           $ 100
7242            PR FAMILY PLANNING 2                           $ 175
7243            PR FAMILY PLANNING 3                           $ 225
7244            PR FAMILY PLANNING 4                           $ 275

                             43 of 75
       COUNTY OF LOS ANGELES - DEPARTMENT OF HEALTH SERVICES

           LAC+USC HEALTHCARE NETWORK
              OUTPATIENT BILLING RATE
                FISCAL YEAR 2004-05


CHG CODE        BILLING DESCRIPTION                            PRICE
7245            PR FAMILY PLANNING 5                           $ 350
7246            PR FAMILY PLANNING 6                           $ 450
7247            PR FAMILY PLANNING 7                           $ 550
7248            PR FAMILY PLANNING 8                           $ 1,200
7251            PR FAMILY PLAN MD/NP 1                         $ 100
7252            PR FAMILY PLAN MD/NP 2                         $ 175
7253            PR FAMILY PLAN MD/NP 3                         $ 225
7254            PR FAMILY PLAN MD/NP 4                         $ 275
7255            PR FAMILY PLAN MD/NP 5                         $ 350
7256            PR FAMILY PLAN MD/NP 6                         $ 450
7257            PR FAMILY PLAN MD/NP 7                         $ 550
7258            PR FAMILY PLAN MD/NP 8                         $ 1,200
7261            PR PRENATAL 1                                  $ 100
7262            PR PRENATAL 2                                  $ 175
7263            PR PRENATAL 3                                  $ 225
7264            PR PRENATAL 4                                  $ 275
7265            PR PRENATAL 5                                  $ 350
7266            PR PRENATAL 6                                  $ 450
7267            PR PRENATAL 7                                  $ 550
7268            PR PRENATAL 8                                  $ 1,200
7271            PR PEDS PRIM CARE 1                            $ 100
7272            PR PEDS PRIM CARE 2                            $ 175
7273            PR PEDS PRIM CARE 3                            $ 225
7274            PR PEDS PRIM CARE 4                            $ 275
7275            PR PEDS PRIM CARE 5                            $ 350
7276            PR PEDS PRIM CARE 6                            $ 450
7277            PR PEDS PRIM CARE 7                            $ 550
7278            PR PEDS PRIM CARE 8                            $ 1,200
7281            PR PEDS WALK-IN 1                              $ 100
7282            PR PEDS WALK-IN 2                              $ 175
7283            PR PEDS WALK-IN 3                              $ 225
7284            PR PEDS WALK-IN 4                              $ 275
7285            PR PEDS WALK-IN 5                              $ 350
7286            PR PEDS WALK-IN 6                              $ 450
7287            PR PEDS WALK-IN 7                              $ 550
7288            PR PEDS WALK-IN 8                              $ 1,200
7291            PR PRENATAL MD/NP 1                            $ 100
7292            PR PRENATAL MD/NP 2                            $ 175
7293            PR PRENATAL MD/NP 3                            $ 225
7294            PR PRENATAL MD/NP 4                            $ 275
7295            PR PRENATAL MD/NP 5                            $ 350
7296            PR PRENATAL MD/NP 6                            $ 450
7297            PR PRENATAL MD/NP 7                            $ 550
7298            PR PRENATAL MD/NP 8                            $ 1,200
7321            PR PEDS PRIMARY CARE 1                         $ 100
7322            PR PEDS PRIMARY CARE 2                         $ 175
7323            PR PEDS PRIMARY CARE 3                         $ 225
7324            PR PEDS PRIMARY CARE 4                         $ 275
7325            PR PEDS PRIMARY CARE 5                         $ 350

                             44 of 75
       COUNTY OF LOS ANGELES - DEPARTMENT OF HEALTH SERVICES

           LAC+USC HEALTHCARE NETWORK
              OUTPATIENT BILLING RATE
                FISCAL YEAR 2004-05


CHG CODE        BILLING DESCRIPTION                            PRICE
7326            PR PEDS PRIMARY CARE 6                         $ 450
7327            PR PEDS PRIMARY CARE 7                         $ 550
7328            PR PEDS PRIMARY CARE 8                         $ 1,200
7331            PR PEDS WALK-IN 1                              $ 100
7332            PR PEDS WALK-IN 2                              $ 175
7333            PR PEDS WALK-IN 3                              $ 225
7334            PR PEDS WALK-IN 4                              $ 275
7335            PR PEDS WALK-IN 5                              $ 350
7336            PR PEDS WALK-IN 6                              $ 450
7337            PR PEDS WALK-IN 7                              $ 550
7338            PR PEDS WALK-IN 8                              $ 1,200
7341            PR PRIMARY CARE 1                              $ 100
7342            PR PRIMARY CARE 2                              $ 175
7343            PR PRIMARY CARE 3                              $ 225
7344            PR PRIMARY CARE 4                              $ 275
7345            PR PRIMARY CARE 5                              $ 350
7346            PR PRIMARY CARE 6                              $ 450
7347            PR PRIMARY CARE 7                              $ 550
7348            PR PRIMARY CARE 8                              $ 1,200
7371            PR OB/GYN 1                                    $ 100
7372            PR OB/GYN 2                                    $ 175
7373            PR OB/GYN 3                                    $ 225
7374            PR OB/GYN 4                                    $ 275
7375            PR OB/GYN 5                                    $ 350
7376            PR OB/GYN 6                                    $ 450
7377            PR OB/GYN 7                                    $ 550
7378            PR OB/GYN 8                                    $ 1,200
7401            LP FAMILY MEDICINE 1                           $ 100
7402            LP FAMILY MEDICINE 2                           $ 175
7403            LP FAMILY MEDICINE 3                           $ 225
7404            LP FAMILY MEDICINE 4                           $ 275
7405            LP FAMILY MEDICINE 5                           $ 350
7406            LP FAMILY MEDICINE 6                           $ 450
7407            LP FAMILY MEDICINE 7                           $ 550
7408            LP FAMILY MEDICINE 8                           $ 1,200
7411            LP GYN NP 1                                    $ 100
7412            LP GYN NP 2                                    $ 175
7413            LP GYN NP 3                                    $ 225
7414            LP GYN NP 4                                    $ 275
7415            LP GYN NP 5                                    $ 350
7416            LP GYN NP 6                                    $ 450
7417            LP GYN NP 7                                    $ 550
7418            LP GYN NP 8                                    $ 1,200
7421            LP ADULT PRIM CARE EXPANSIO                    $ 100
7422            LP ADULT PRIM CARE EXPANSIO                    $ 175
7423            LP ADULT PRIM CARE EXPANSIO                    $ 225
7424            LP ADULT PRIM CARE EXPANSIO                    $ 275
7425            LP ADULT PRIM CARE EXPANSIO                    $ 350
7426            LP ADULT PRIM CARE EXPANSIO                    $ 450

                             45 of 75
       COUNTY OF LOS ANGELES - DEPARTMENT OF HEALTH SERVICES

           LAC+USC HEALTHCARE NETWORK
              OUTPATIENT BILLING RATE
                FISCAL YEAR 2004-05


CHG CODE        BILLING DESCRIPTION                            PRICE
7427            LP ADULT PRIM CARE EXPANSIO                    $ 550
7428            LP ADULT PRIM CARE EXPANSIO                    $ 1,200
7461            EM FAM MED WLK-IN 1                            $ 100
7462            EM FAM MED WLK-IN 2                            $ 175
7463            EM FAM MED WLK-IN 3                            $ 225
7464            EM FAM MED WLK-IN 4                            $ 275
7465            EM FAM MED WLK-IN 5                            $ 350
7466            EM FAM MED WLK-IN 6                            $ 450
7467            EM FAM MED WLK-IN 7                            $ 550
7468            EM FAM MED WLK-IN 8                            $ 1,200
7471            EM IMMUN/PEDS EXPAN 1                          $ 100
7472            EM IMMUN/PEDS EXPAN 2                          $ 175
7473            EM IMMUN/PEDS EXPAN 3                          $ 225
7474            EM IMMUN/PEDS EXPAN 4                          $ 275
7475            EM IMMUN/PEDS EXPAN 5                          $ 350
7476            EM IMMUN/PEDS EXPAN 6                          $ 450
7477            EM IMMUN/PEDS EXPAN 7                          $ 550
7478            EM IMMUN/PEDS EXPAN 8                          $ 1,200
7481            EM OPTOMETRY 1                                 $ 100
7482            EM OPTOMETRY 2                                 $ 175
7483            EM OPTOMETRY 3                                 $ 225
7484            EM OPTOMETRY 4                                 $ 275
7485            EM OPTOMETRY 5                                 $ 350
7486            EM OPTOMETRY 6                                 $ 450
7487            EM OPTOMETRY 7                                 $ 550
7488            EM OPTOMETRY 8                                 $ 1,200
7501            RY URGENT CARE 1                               $ 100
7502            RY URGENT CARE 2                               $ 175
7503            RY URGENT CARE 3                               $ 225
7504            RY URGENT CARE 4                               $ 275
7505            RY URGENT CARE 5                               $ 350
7506            RY URGENT CARE 6                               $ 450
7507            RY URGENT CARE 7                               $ 550
7508            RY URGENT CARE 8                               $ 1,200
7511            RY EXPANSION 1                                 $ 100
7512            RY EXPANSION 2                                 $ 175
7513            RY EXPANSION 3                                 $ 225
7514            RY EXPANSION 4                                 $ 275
7515            RY EXPANSION 5                                 $ 350
7516            RY EXPANSION 6                                 $ 450
7517            RY EXPANSION 7                                 $ 550
7518            RY EXPANSION 8                                 $ 1,200
7521            RY PODIATRY 1                                  $ 100
7522            RY PODIATRY 2                                  $ 175
7523            RY PODIATRY 3                                  $ 225
7524            RY PODIATRY 4                                  $ 275
7525            RY PODIATRY 5                                  $ 350
7526            RY PODIATRY 6                                  $ 450
7527            RY PODIATRY 7                                  $ 550

                             46 of 75
       COUNTY OF LOS ANGELES - DEPARTMENT OF HEALTH SERVICES

           LAC+USC HEALTHCARE NETWORK
              OUTPATIENT BILLING RATE
                FISCAL YEAR 2004-05


CHG CODE        BILLING DESCRIPTION                            PRICE
7528            RY PODIATRY 8                                  $ 1,200
7531            RY OPTOMETRY 1                                 $ 100
7532            RY OPTOMETRY 2                                 $ 175
7533            RY OPTOMETRY 3                                 $ 225
7534            RY OPTOMETRY 4                                 $ 275
7535            RY OPTOMETRY 5                                 $ 350
7536            RY OPTOMETRY 6                                 $ 450
7537            RY OPTOMETRY 7                                 $ 550
7538            RY OPTOMETRY 8                                 $ 1,200
7541            RY OTOLAR 1                                    $ 100
7542            RY OTOLAR 2                                    $ 175
7543            RY OTOLAR 3                                    $ 225
7544            RY OTOLAR 4                                    $ 275
7545            RY OTOLAR 5                                    $ 350
7546            RY OTOLAR 6                                    $ 450
7547            RY OTOLAR 7                                    $ 550
7548            RY OTOLAR 8                                    $ 1,200
7561            RY DIABETIC MANGMT 1                           $ 100
7562            RY DIABETIC MANGMT 2                           $ 175
7563            RY DIABETIC MANGMT 3                           $ 225
7564            RY DIABETIC MANGMT 4                           $ 275
7565            RY DIABETIC MANGMT 5                           $ 350
7566            RY DIABETIC MANGMT 6                           $ 450
7567            RY DIABETIC MANGMT 7                           $ 550
7568            RY DIABETIC MANGMT 8                           $ 1,200
7598            RY DIABETIC MANAGMT 8                          $ 1,200
7671            AZ FAMILY MEDICINE 1                           $ 100
7672            AZ FAMILY MEDICINE 2                           $ 175
7673            AZ FAMILY MEDICINE 3                           $ 225
7674            AZ FAMILY MEDICINE 4                           $ 275
7675            AZ FAMILY MEDICINE 5                           $ 350
7676            AZ FAMILY MEDICINE 6                           $ 450
7677            AZ FAMILY MEDICINE 7                           $ 550
7678            AZ FAMILY MEDICINE 8                           $ 1,200
7681            AZ GYNECOLOGY NP 1                             $ 100
7682            AZ GYNECOLOGY NP 2                             $ 175
7683            AZ GYNECOLOGY NP 3                             $ 225
7684            AZ GYNECOLOGY NP 4                             $ 275
7685            AZ GYNECOLOGY NP 5                             $ 350
7686            AZ GYNECOLOGY NP 6                             $ 450
7687            AZ GYNECOLOGY NP 7                             $ 550
7688            AZ GYNECOLOGY NP 8                             $ 1,200
7691            AZ PRENATAL 1                                  $ 100
7692            AZ PRENATAL 2                                  $ 175
7693            AZ PRENATAL 3                                  $ 225
7694            AZ PRENATAL 4                                  $ 275
7695            AZ PRENATAL 5                                  $ 350
7696            AZ PRENATAL 6                                  $ 450
7697            AZ PRENATAL 7                                  $ 550

                             47 of 75
       COUNTY OF LOS ANGELES - DEPARTMENT OF HEALTH SERVICES

           LAC+USC HEALTHCARE NETWORK
              OUTPATIENT BILLING RATE
                FISCAL YEAR 2004-05


CHG CODE        BILLING DESCRIPTION                            PRICE
7698            AZ PRENATAL 8                                  $ 1,200
7701            AL FAMILY MEDICINE 1                           $ 100
7702            AL FAMILY MEDICINE 2                           $ 175
7703            AL FAMILY MEDICINE 3                           $ 225
7704            AL FAMILY MEDICINE 4                           $ 275
7705            AL FAMILY MEDICINE 5                           $ 350
7706            AL FAMILY MEDICINE 6                           $ 450
7707            AL FAMILY MEDICINE 7                           $ 550
7708            AL FAMILY MEDICINE 8                           $ 1,200
7721            AL GYNECOLOGY NP 1                             $ 100
7722            AL GYNECOLOGY NP 3                             $ 175
7723            AL GYNECOLOGY NP 3                             $ 225
7724            AL GYNECOLOGY NP 4                             $ 275
7725            AL GYNECOLOGY NP 5                             $ 350
7726            AL GYNECOLOGY NP 6                             $ 450
7727            AL GYNECOLOGY NP 7                             $ 550
7728            AL GYNECOLOGY NP 8                             $ 1,200
7731            AL PRENATAL 1                                  $ 100
7732            AL PRENATAL 2                                  $ 175
7733            AL PRENATAL 3                                  $ 225
7734            AL PRENATAL 4                                  $ 275
7735            AL PRENATAL 5                                  $ 350
7736            AL PRENATAL 6                                  $ 450
7737            AL PRENATAL 7                                  $ 550
7738            AL PRENATAL 8                                  $ 1,200
7781            NE PRENATAL 1                                  $ 100
7782            NE PRENATAL 2                                  $ 175
7783            NE PRENATAL 3                                  $ 225
7784            NE PRENATAL 4                                  $ 275
7785            NE PRENATAL 5                                  $ 350
7786            NE PRENATAL 6                                  $ 450
7787            NE PRENATAL 7                                  $ 550
7788            NE PRENATAL 8                                  $ 1,200
7791            NE PEDIATRICS 1                                $ 100
7792            NE PEDIATRICS 2                                $ 175
7793            NE PEDIATRICS 3                                $ 225
7794            NE PEDIATRICS 4                                $ 275
7795            NE PEDIATRICS 5                                $ 350
7796            NE PEDIATRICS 6                                $ 450
7797            NE PEDIATRICS 7                                $ 550
7798            NE PEDIATRICS 8                                $ 1,200
7801            NE GYNECOLOGY 1                                $ 100
7802            NE GYNECOLOGY 2                                $ 175
7803            NE GYNECOLOGY 3                                $ 225
7804            NE GYNECOLOGY 4                                $ 275
7805            NE GYNECOLOGY 5                                $ 350
7806            NE GYNECOLOGY 6                                $ 450
7807            NE GYNECOLOGY 7                                $ 550
7808            NE GYNECOLOGY 8                                $ 1,200

                             48 of 75
       COUNTY OF LOS ANGELES - DEPARTMENT OF HEALTH SERVICES

           LAC+USC HEALTHCARE NETWORK
              OUTPATIENT BILLING RATE
                FISCAL YEAR 2004-05


CHG CODE        BILLING DESCRIPTION                            PRICE
7811            NE PRIMARY CARE 1                              $ 100
7812            NE PRIMARY CARE 2                              $ 175
7813            NE PRIMARY CARE 3                              $ 225
7814            NE PRIMARY CARE 4                              $ 275
7815            NE PRIMARY CARE 5                              $ 350
7816            NE PRIMARY CARE 6                              $ 450
7817            NE PRIMARY CARE 7                              $ 550
7818            NE PRIMARY CARE 8                              $ 1,200
7821            NE FAMILY MEDICINE 1                           $ 100
7822            NE FAMILY MEDICINE 2                           $ 175
7823            NE FAMILY MEDICINE 3                           $ 225
7824            NE FAMILY MEDICINE 4                           $ 275
7825            NE FAMILY MEDICINE 5                           $ 350
7826            NE FAMILY MEDICINE 6                           $ 450
7827            NE FAMILY MEDICINE 7                           $ 550
7828            NE FAMILY MEDICINE 8                           $ 1,200
7851            MCA PDS PRIM CARE 1                            $ 200
7852            MCA PDS PRIM CARE 2                            $ 300
7853            MCA PDS PRIM CARE 3                            $ 650
7854            MCA PDS PRIM CARE 4                            $ 800
7855            MCA PDS PRIM CARE 5                            $ 1,000
7856            MCA PDS PRIM CARE 6                            $ 1,300
7857            MCA PDS PRIM CARE 7                            $ 1,700
7858            MCA PDS PRIM CARE 8                            $ 2,500
7861            MCA NEUROLOGY 1                                $ 200
7862            MCA NEUROLOGY 2                                $ 300
7863            MCA NEUROLOGY 3                                $ 650
7864            MCA NEUROLOGY 4                                $ 800
7865            MCA NEUROLOGY 5                                $ 1,000
7866            MCA NEUROLOGY 6                                $ 1,300
7867            MCA NEUROLOGY 7                                $ 1,700
7868            MCA NEUROLOGY 8                                $ 2,500
7901            MCA OPHTHALMOLOGY 1                            $ 200
7902            MCA OPHTHALMOLOGY 2                            $ 300
7903            MCA OPHTHALMOLOGY 3                            $ 650
7904            MCA OPHTHALMOLOGY 4                            $ 800
7905            MCA OPHTHALMOLOGY 5                            $ 1,000
7906            MCA OPHTHALMOLOGY 6                            $ 1,300
7907            MCA OPHTHALMOLOGY 7                            $ 1,700
7908            MCA OPHTHALMOLOGY 8                            $ 2,500
7931            MCA PRIMARY CARE 1                             $ 200
7932            MCA PRIMARY CARE 2                             $ 300
7933            MCA PRIMARY CARE 3                             $ 650
7934            MCA PRIMARY CARE 4                             $ 800
7935            MCA PRIMARY CARE 5                             $ 1,000
7936            MCA PRIMARY CARE 6                             $ 1,300
7937            MCA PRIMARY CARE 7                             $ 1,700
7938            MCA PRIMARY CARE 8                             $ 2,500
7941            MCA OBSTETRICS 1                               $ 200

                             49 of 75
       COUNTY OF LOS ANGELES - DEPARTMENT OF HEALTH SERVICES

           LAC+USC HEALTHCARE NETWORK
              OUTPATIENT BILLING RATE
                FISCAL YEAR 2004-05


CHG CODE        BILLING DESCRIPTION                            PRICE
7942            MCA OBSTETRICS 2                               $ 300
7943            MCA OBSTETRICS 3                               $ 650
7944            MCA OBSTETRICS 4                               $ 800
7945            MCA OBSTETRICS 5                               $ 1,000
7946            MCA OBSTETRICS 6                               $ 1,300
7947            MCA OBSTETRICS 7                               $ 1,700
7948            MCA OBSTETRICS 8                               $ 2,500
7951            MCA GYNECOLOGY 1                               $ 200
7952            MCA GYNECOLOGY 2                               $ 300
7953            MCA GYNECOLOGY 3                               $ 650
7954            MCA GYNECOLOGY 4                               $ 800
7955            MCA GYNECOLOGY 5                               $ 1,000
7956            MCA GYNECOLOGY 6                               $ 1,300
7957            MCA GYNECOLOGY 7                               $ 1,700
7958            MCA GYNECOLOGY 8                               $ 2,500
8121            RY PRIMARY CARE 1                              $ 100
8122            RY PRIMARY CARE 2                              $ 175
8123            RY PRIMARY CARE 3                              $ 225
8124            RY PRIMARY CARE 4                              $ 275
8125            RY PRIMARY CARE 5                              $ 350
8126            RY PRIMARY CARE 6                              $ 450
8127            RY PRIMARY CARE 7                              $ 550
8128            RY PRIMARY CARE 8                              $ 1,200
8131            RY COLPOSCOPY 1                                $ 100
8132            RY COLPOSCOPY 2                                $ 175
8133            RY COLPOSCOPY 3                                $ 225
8134            RY COLPOSCOPY 4                                $ 275
8135            RY COLPOSCOPY 5                                $ 350
8136            RY COLPOSCOPY 6                                $ 450
8137            RY COLPOSCOPY 7                                $ 550
8138            RY COLPOSCOPY 8                                $ 1,200
8141            RY FAMILY MEDICINE 1                           $ 100
8142            RY FAMILY MEDICINE 2                           $ 175
8143            RY FAMILY MEDICINE 3                           $ 225
8144            RY FAMILY MEDICINE 4                           $ 275
8145            RY FAMILY MEDICINE 5                           $ 350
8146            RY FAMILY MEDICINE 6                           $ 450
8147            RY FAMILY MEDICINE 7                           $ 550
8148            RY FAMILY MEDICINE 8                           $ 1,200
8151            RY DENTAL 1                                    $ 100
8152            RY DENTAL 2                                    $ 175
8153            RY DENTAL 3                                    $ 225
8154            RY DENTAL 4                                    $ 275
8155            RY DENTAL 5                                    $ 350
8156            RY DENTAL 6                                    $ 450
8157            RY DENTAL 7                                    $ 550
8158            RY DENTAL 8                                    $ 1,200
8161            RY DIABETIC 1                                  $ 100
8162            RY DIABETIC 2                                  $ 175

                             50 of 75
       COUNTY OF LOS ANGELES - DEPARTMENT OF HEALTH SERVICES

           LAC+USC HEALTHCARE NETWORK
              OUTPATIENT BILLING RATE
                FISCAL YEAR 2004-05


CHG CODE        BILLING DESCRIPTION                            PRICE
8163            RY DIABETIC 3                                  $ 225
8164            RY DIABETIC 4                                  $ 275
8165            RY DIABETIC 5                                  $ 350
8166            RY DIABETIC 6                                  $ 450
8167            RY DIABETIC 7                                  $ 550
8168            RY DIABETIC 8                                  $ 1,200
8171            RY FAMILY PLANNING 1                           $ 100
8172            RY FAMILY PLANNING 2                           $ 175
8173            RY FAMILY PLANNING 3                           $ 225
8174            RY FAMILY PLANNING 4                           $ 275
8175            RY FAMILY PLANNING 5                           $ 350
8176            RY FAMILY PLANNING 6                           $ 450
8177            RY FAMILY PLANNING 7                           $ 550
8178            RY FAMILY PLANNING 8                           $ 1,200
8181            RY PAP CLINIC NP 1                             $ 100
8182            RY PAP CLINIC NP 2                             $ 175
8183            RY PAP CLINIC NP 3                             $ 225
8184            RY PAP CLINIC NP 4                             $ 275
8185            RY PAP CLINIC NP 5                             $ 350
8186            RY PAP CLINIC NP 6                             $ 450
8187            RY PAP CLINIC NP 7                             $ 550
8188            RY PAP CLINIC NP 8                             $ 1,200
8191            RY PEDS PRIM CARE 1                            $ 100
8192            RY PEDS PRIM CARE 2                            $ 175
8193            RY PEDS PRIM CARE 3                            $ 225
8194            RY PEDS PRIM CARE 4                            $ 275
8195            RY PEDS PRIM CARE 5                            $ 350
8196            RY PEDS PRIM CARE 6                            $ 450
8197            RY PEDS PRIM CARE 7                            $ 550
8198            RY PEDS PRIM CARE 8                            $ 1,200
8201            RY PRENATAL HIGH RISK 1                        $ 100
8202            RY PRENATAL HIGH RISK 2                        $ 175
8203            RY PRENATAL HIGH RISK 3                        $ 225
8204            RY PRENATAL HIGH RISK 4                        $ 275
8205            RY PRENATAL HIGH RISK 5                        $ 350
8206            RY PRENATAL HIGH RISK 6                        $ 450
8207            RY PRENATAL HIGH RISK 7                        $ 550
8208            RY PRENATAL HIGH RISK 8                        $ 1,200
8211            RY PRENATAL INTAKE NP 1                        $ 100
8212            RY PRENATAL INTAKE NP 2                        $ 175
8213            RY PRENATAL INTAKE NP 3                        $ 225
8214            RY PRENATAL INTAKE NP 4                        $ 275
8215            RY PRENATAL INTAKE NP 5                        $ 350
8216            RY PRENATAL INTAKE NP 6                        $ 450
8217            RY PRENATAL INTAKE NP 7                        $ 550
8218            RY PRENATAL INTAKE NP 8                        $ 1,200
8221            RY PRIM CARE GERIATRICS 1                      $ 100
8222            RY PRIM CARE GERIATRICS 2                      $ 175
8223            RY PRIM CARE GERIATRICS 3                      $ 225

                             51 of 75
       COUNTY OF LOS ANGELES - DEPARTMENT OF HEALTH SERVICES

           LAC+USC HEALTHCARE NETWORK
              OUTPATIENT BILLING RATE
                FISCAL YEAR 2004-05


CHG CODE        BILLING DESCRIPTION                            PRICE
8224            RY PRIM CARE GERIATRICS 4                      $ 275
8225            RY PRIM CARE GERIATRICS 5                      $ 350
8226            RY PRIM CARE GERIATRICS 6                      $ 450
8227            RY PRIM CARE GERIATRICS 7                      $ 550
8228            RY PRIM CARE GERIATRICS 8                      $ 1,200
8231            RY WALK-IN 1                                   $ 100
8232            RY WALK-IN 2                                   $ 175
8233            RY WALK-IN 3                                   $ 225
8234            RY WALK-IN 4                                   $ 275
8235            RY WALK-IN 5                                   $ 350
8236            RY WALK-IN 6                                   $ 450
8237            RY WALK-IN 7                                   $ 550
8238            RY WALK-IN 8                                   $ 1,200
8251            RY OPHTHALMOLOGY 1                             $ 100
8252            RY OPHTHALMOLOGY 2                             $ 175
8253            RY OPHTHALMOLOGY 3                             $ 225
8254            RY OPHTHALMOLOGY 4                             $ 275
8255            RY OPHTHALMOLOGY 5                             $ 350
8256            RY OPHTHALMOLOGY 6                             $ 450
8257            RY OPHTHALMOLOGY 7                             $ 550
8258            RY OPHTHALMOLOGY 8                             $ 1,200
8261            RY GYNECOLOGY 1                                $ 100
8262            RY GYNECOLOGY 2                                $ 175
8263            RY GYNECOLOGY 3                                $ 225
8264            RY GYNECOLOGY 4                                $ 275
8265            RY GYNECOLOGY 5                                $ 350
8266            RY GYNECOLOGY 6                                $ 450
8267            RY GYNECOLOGY 7                                $ 550
8268            RY GYNECOLOGY 8                                $ 1,200
8271            RY PRENATAL LOW RISK NP 1                      $ 100
8272            RY PRENATAL LOW RISK NP 2                      $ 175
8273            RY PRENATAL LOW RISK NP 3                      $ 225
8274            RY PRENATAL LOW RISK NP 4                      $ 275
8275            RY PRENATAL LOW RISK NP 5                      $ 350
8276            RY PRENATAL LOW RISK NP 6                      $ 450
8277            RY PRENATAL LOW RISK NP 7                      $ 550
8278            RY PRENATAL LOW RISK NP 8                      $ 1,200
8281            RY DERMATOLOGY 1                               $ 100
8282            RY DERMATOLOGY 2                               $ 175
8283            RY DERMATOLOGY 3                               $ 225
8284            RY DERMATOLOGY 4                               $ 275
8285            RY DERMATOLOGY 5                               $ 350
8286            RY DERMATOLOGY 6                               $ 450
8287            RY DERMATOLOGY 7                               $ 550
8288            RY DERMATOLOGY 8                               $ 1,200
8291            RY ENDOCRINE 1                                 $ 100
8292            RY ENDOCRINE 2                                 $ 175
8293            RY ENDOCRINE 3                                 $ 225
8294            RY ENDOCRINE 4                                 $ 275

                             52 of 75
       COUNTY OF LOS ANGELES - DEPARTMENT OF HEALTH SERVICES

           LAC+USC HEALTHCARE NETWORK
              OUTPATIENT BILLING RATE
                FISCAL YEAR 2004-05


CHG CODE        BILLING DESCRIPTION                            PRICE
8295            RY ENDOCRINE 5                                 $ 350
8296            RY ENDOCRINE 6                                 $ 450
8297            RY ENDOCRINE 7                                 $ 550
8298            RY ENDOCRINE 8                                 $ 1,200
8301            RY FAMILY PLAN COLPO 1                         $ 100
8302            RY FAMILY PLAN COLPO 2                         $ 175
8303            RY FAMILY PLAN COLPO 3                         $ 225
8304            RY FAMILY PLAN COLPO 4                         $ 275
8305            RY FAMILY PLAN COLPO 5                         $ 350
8306            RY FAMILY PLAN COLPO 6                         $ 450
8307            RY FAMILY PLAN COLPO 7                         $ 550
8308            RY FAMILY PLAN COLPO 8                         $ 1,200
8311            RY CARDIOLOGY 1                                $ 100
8312            RY CARDIOLOGY 2                                $ 175
8313            RY CARDIOLOGY 3                                $ 225
8314            RY CARDIOLOGY 4                                $ 275
8315            RY CARDIOLOGY 5                                $ 350
8316            RY CARDIOLOGY 6                                $ 450
8317            RY CARDIOLOGY 7                                $ 550
8318            RY CARDIOLOGY 8                                $ 1,200
8321            RY GASTROENTEROLOGY 1                          $ 100
8322            RY GASTROENTEROLOGY 2                          $ 175
8323            RY GASTROENTEROLOGY 3                          $ 225
8324            RY GASTROENTEROLOGY 4                          $ 275
8325            RY GASTROENTEROLOGY 5                          $ 350
8326            RY GASTROENTEROLOGY 6                          $ 450
8327            RY GASTROENTEROLOGY 7                          $ 550
8328            RY GASTROENTEROLOGY 8                          $ 1,200
8331            RY RHEUMATOLOGY 1                              $ 100
8332            RY RHEUMATOLOGY 2                              $ 175
8333            RY RHEUMATOLOGY 3                              $ 225
8334            RY RHEUMATOLOGY 4                              $ 275
8335            RY RHEUMATOLOGY 5                              $ 350
8336            RY RHEUMATOLOGY 6                              $ 450
8337            RY RHEUMATOLOGY 7                              $ 550
8338            RY RHEUMATOLOGY 8                              $ 1,200
8341            RY LIVER 1                                     $ 100
8342            RY LIVER 2                                     $ 175
8343            RY LIVER 3                                     $ 225
8344            RY LIVER 4                                     $ 275
8345            RY LIVER 5                                     $ 350
8346            RY LIVER 6                                     $ 450
8347            RY LIVER 7                                     $ 550
8348            RY LIVER 8                                     $ 1,200
8351            RY HYPERTENSION 1                              $ 100
8352            RY HYPERTENSION 2                              $ 175
8353            RY HYPERTENSION 3                              $ 225
8354            RY HYPERTENSION 4                              $ 275
8355            RY HYPERTENSION 5                              $ 350

                             53 of 75
       COUNTY OF LOS ANGELES - DEPARTMENT OF HEALTH SERVICES

           LAC+USC HEALTHCARE NETWORK
              OUTPATIENT BILLING RATE
                FISCAL YEAR 2004-05


CHG CODE        BILLING DESCRIPTION                            PRICE
8356            RY HYPERTENSION 6                              $ 450
8357            RY HYPERTENSION 7                              $ 550
8358            RY HYPERTENSION 8                              $ 1,200
8361            RY PEDS WALK-IN 1                              $ 100
8362            RY PEDS WALK-IN 2                              $ 175
8363            RY PEDS WALK-IN 3                              $ 225
8364            RY PEDS WALK-IN 4                              $ 275
8365            RY PEDS WALK-IN 5                              $ 350
8366            RY PEDS WALK-IN 6                              $ 450
8367            RY PEDS WALK-IN 7                              $ 550
8368            RY PEDS WALK-IN 8                              $ 1,200
8381            RY PEDS CARDIOLOGY 1                           $ 100
8382            RY PEDS CARDIOLOGY 2                           $ 175
8383            RY PEDS CARDIOLOGY 3                           $ 225
8384            RY PEDS CARDIOLOGY 4                           $ 275
8385            RY PEDS CARDIOLOGY 5                           $ 350
8386            RY PEDS CARDIOLOGY 6                           $ 450
8387            RY PEDS CARDIOLOGY 7                           $ 550
8388            RY PEDS CARDIOLOGY 8                           $ 1,200
8401            RY PEDS ENDOCRINE 1                            $ 100
8402            RY PEDS ENDOCRINE 2                            $ 175
8403            RY PEDS ENDOCRINE 3                            $ 225
8404            RY PEDS ENDOCRINE 4                            $ 275
8405            RY PEDS ENDOCRINE 5                            $ 350
8406            RY PEDS ENDOCRINE 6                            $ 450
8407            RY PEDS ENDOCRINE 7                            $ 550
8408            RY PEDS ENDOCRINE 8                            $ 1,200
8411            RY PEDS GASTROENTERO 1                         $ 100
8412            RY PEDS GASTROENTERO 2                         $ 175
8413            RY PEDS GASTROENTERO 3                         $ 225
8414            RY PEDS GASTROENTERO 4                         $ 275
8415            RY PEDS GASTROENTERO 5                         $ 350
8416            RY PEDS GASTROENTERO 6                         $ 450
8417            RY PEDS GASTROENTERO 7                         $ 550
8418            RY PEDS GASTROENTERO 8                         $ 1,200
8421            RY PEDS NEPHROLOGY 1                           $ 100
8422            RY PEDS NEPHROLOGY 2                           $ 175
8423            RY PEDS NEPHROLOGY 3                           $ 225
8424            RY PEDS NEPHROLOGY 4                           $ 275
8425            RY PEDS NEPHROLOGY 5                           $ 350
8426            RY PEDS NEPHROLOGY 6                           $ 450
8427            RY PEDS NEPHROLOGY 7                           $ 550
8428            RY PEDS NEPHROLOGY 8                           $ 1,200
8431            RY ALTERNATIVE TESTING 1                       $ 100
8432            RY ALTERNATIVE TESTING 2                       $ 175
8433            RY ALTERNATIVE TESTING 3                       $ 225
8434            RY ALTERNATIVE TESTING 4                       $ 275
8435            RY ALTERNATIVE TESTING 5                       $ 350
8436            RY ALTERNATIVE TESTING 6                       $ 450

                             54 of 75
       COUNTY OF LOS ANGELES - DEPARTMENT OF HEALTH SERVICES

           LAC+USC HEALTHCARE NETWORK
              OUTPATIENT BILLING RATE
                FISCAL YEAR 2004-05


CHG CODE        BILLING DESCRIPTION                            PRICE
8437            RY ALTERNATIVE TESTING 7                       $ 550
8438            RY ALTERNATIVE TESTING 8                       $ 1,200
8441            RY NEUROLOGY 1                                 $ 100
8442            RY NEUROLOGY 2                                 $ 172
8443            RY NEUROLOGY 3                                 $ 225
8444            RY NEUROLOGY 4                                 $ 275
8445            RY NEUROLOGY 5                                 $ 350
8446            RY NEUROLOGY 6                                 $ 450
8447            RY NEUROLOGY 7                                 $ 550
8448            RY NEUROLOGY 8                                 $ 1,200
8491            RY GYN WALK-IN 1                               $ 100
8492            RY GYN WALK-IN 2                               $ 175
8493            RY GYN WALK-IN 3                               $ 225
8494            RY GYN WALK-IN 4                               $ 275
8495            RY GYN WALK-IN 5                               $ 350
8496            RY GYN WALK-IN 6                               $ 450
8497            RY GYN WALK-IN 7                               $ 550
8498            RY GYN WALK-IN 8                               $ 1,200
8501            HH SKILLED NURSING                             $ 208
8511            HH PHYSICAL THERAPY                            $ 200
8521            HH SPEECH THERAPY                              $ 205
8531            HH OCCUP THERAPY                               $ 202
8541            HH MED SOC SERV                                $ 292
8551            HH AIDE                                        $ 112
8561            RY OB WALK-IN 1                                $ 100
8562            RY OB WALK-IN 2                                $ 175
8563            RY OB WALK-IN 3                                $ 225
8564            RY OB WALK-IN 4                                $ 275
8565            RY OB WALK-IN 5                                $ 350
8566            RY OB WALK-IN 6                                $ 450
8567            RY OB WALK-IN 7                                $ 550
8568            RY OB WALK-IN 8                                $ 1,200
8571            RY DERM PHOTOTHERAPY 1                         $ 100
8572            RY DERM PHOTOTHERAPY 2                         $ 175
8573            RY DERM PHOTOTHERAPY 3                         $ 225
8574            RY DERM PHOTOTHERAPY 4                         $ 275
8575            RY DERM PHOTOTHERAPY 5                         $ 350
8576            RY DERM PHOTOTHERAPY 6                         $ 450
8577            RY DERM PHOTOTHERAPY 7                         $ 550
8578            RY DERM PHOTOTHERAPY 8                         $ 1,200
8579            RY DERM PHOTOTHERAPY 9                         $ 2,700
8581            RY DERMATOLOGY SURGERY 1                       $ 450
8582            RY DERMATOLOGY SURGERY 2                       $ 700
8583            RY DERMATOLOGY SURGERY 3                       $ 1,000
8584            RY DERMATOLOGY SURGERY 4                       $ 1,300
8585            RY DERMATOLOGY SURGERY 5                       $ 1,500
8586            RY DERMATOLOGY SURGERY 6                       $ 1,700
8587            RY DERMATOLOGY SURGERY 7                       $ 1,900
8588            RY DERMATOLOGY SURGERY 8                       $ 2,500

                             55 of 75
       COUNTY OF LOS ANGELES - DEPARTMENT OF HEALTH SERVICES

           LAC+USC HEALTHCARE NETWORK
              OUTPATIENT BILLING RATE
                FISCAL YEAR 2004-05


CHG CODE        BILLING DESCRIPTION                            PRICE
8589            RY DERMATOLOGY SURGERY 9                       $ 2,700
8601            HH SKILLED NURSING NON AGEN                    $ 208
8611            HH PHYS THER NON AGENCY                        $ 200
8621            HH SPEECH THER NON AGENCY                      $ 205
8631            HH OCCUP THER NON AGENCY                       $ 202
8641            HH MED SOC WKR NON AGENCY                      $ 292
8651            HH AIDE NON AGENCY                             $ 112
8661            HH CASE EVAL NON AGENCY                        $    35
8671            HH CASE RE-EVAL NON AGENCY                     $    18
8681            HD PRIMARY CARE 1                              $ 100
8682            HD PRIMARY CARE 2                              $ 175
8683            HD PRIMARY CARE 3                              $ 225
8684            HD PRIMARY CARE 4                              $ 275
8685            HD PRIMARY CARE 5                              $ 350
8686            HD PRIMARY CARE 6                              $ 450
8687            HD PRIMARY CARE 7                              $ 550
8688            HD PRIMARY CARE 8                              $ 1,200
8691            HD GENERAL SURGERY 1                           $ 100
8692            HD GENERAL SURGERY 2                           $ 175
8693            HD GENERAL SURGERY 3                           $ 225
8694            HD GENERAL SURGERY 4                           $ 275
8695            HD GENERAL SURGERY 5                           $ 350
8696            HD GENERAL SURGERY 6                           $ 450
8697            HD GENERAL SURGERY 7                           $ 550
8698            HD GENERAL SURGERY 8                           $ 1,200
8701            HD COLPOSCOPY MD/NP 1                          $ 100
8702            HD COLPOSCOPY MD/NP 2                          $ 175
8703            HD COLPOSCOPY MD/NP 3                          $ 225
8704            HD COLPOSCOPY MD/NP 4                          $ 275
8705            HD COLPOSCOPY MD/NP 5                          $ 350
8706            HD COLPOSCOPY MD/NP 6                          $ 450
8707            HD COLPOSCOPY MD/NP 7                          $ 550
8708            HD COLPOSCOPY MD/NP 8                          $ 1,200
8711            HD CHP ADULT 1                                 $ 100
8712            HD CHP ADULT 2                                 $ 175
8713            HD CHP ADULT 3                                 $ 225
8714            HD CHP ADULT 4                                 $ 275
8715            HD CHP ADULT 5                                 $ 350
8716            HD CHP ADULT 6                                 $ 450
8717            HD CHP ADULT 7                                 $ 550
8718            HD CHP ADULT 8                                 $ 1,200
8721            HD DENTAL 1                                    $ 100
8722            HD DENTAL 2                                    $ 175
8723            HD DENTAL 3                                    $ 225
8724            HD DENTAL 4                                    $ 275
8725            HD DENTAL 5                                    $ 350
8726            HD DENTAL 6                                    $ 450
8727            HD DENTAL 7                                    $ 550
8728            HD DENTAL 8                                    $ 1,200

                             56 of 75
       COUNTY OF LOS ANGELES - DEPARTMENT OF HEALTH SERVICES

           LAC+USC HEALTHCARE NETWORK
              OUTPATIENT BILLING RATE
                FISCAL YEAR 2004-05


CHG CODE        BILLING DESCRIPTION                            PRICE
8731            HD DERMATOLOGY 1                               $ 100
8732            HD DERMATOLOGY 2                               $ 175
8733            HD DERMATOLOGY 3                               $ 225
8734            HD DERMATOLOGY 4                               $ 275
8735            HD DERMATOLOGY 5                               $ 350
8736            HD DERMATOLOGY 6                               $ 450
8737            HD DERMATOLOGY 7                               $ 550
8738            HD DERMATOLOGY 8                               $ 1,200
8741            HD DIABETIC 1                                  $ 100
8742            HD DIABETIC 2                                  $ 175
8743            HD DIABETIC 3                                  $ 225
8744            HD DIABETIC 4                                  $ 275
8745            HD DIABETIC 5                                  $ 350
8746            HD DIABETIC 6                                  $ 450
8747            HD DIABETIC 7                                  $ 550
8748            HD DIABETIC 8                                  $ 1,200
8751            HW PRIMARY CARE 1                              $ 100
8752            HW PRIMARY CARE 2                              $ 175
8753            HW PRIMARY CARE 3                              $ 225
8754            HW PRIMARY CARE 4                              $ 275
8755            HW PRIMARY CARE 5                              $ 350
8756            HW PRIMARY CARE 6                              $ 450
8757            HW PRIMARY CARE 7                              $ 550
8758            HW PRIMARY CARE 8                              $ 1,200
8761            HD FAMILY PLAN MD/NP 1                         $ 100
8762            HD FAMILY PLAN MD/NP 2                         $ 175
8763            HD FAMILY PLAN MD/NP 3                         $ 225
8764            HD FAMILY PLAN MD/NP 4                         $ 275
8765            HD FAMILY PLAN MD/NP 5                         $ 350
8766            HD FAMILY PLAN MD/NP 6                         $ 450
8767            HD FAMILY PLAN MD/NP 7                         $ 550
8768            HD FAMILY PLAN MD/NP 8                         $ 1,200
8771            HD GYNECOLOGY NP 1                             $ 100
8772            HD GYNECOLOGY NP 2                             $ 175
8773            HD GYNECOLOGY NP 3                             $ 225
8774            HD GYNECOLOGY NP 4                             $ 275
8775            HD GYNECOLOGY NP 5                             $ 350
8776            HD GYNECOLOGY NP 6                             $ 450
8777            HD GYNECOLOGY NP 7                             $ 550
8778            HD GYNECOLOGY NP 8                             $ 1,200
8781            HD PED MAN CAR PRI CAR 1                       $ 100
8782            HD PED MAN CAR PRI CAR 2                       $ 175
8783            HD PED MAN CAR PRI CAR 3                       $ 225
8784            HD PED MAN CAR PRI CAR 4                       $ 275
8785            HD PED MAN CAR PRI CAR 5                       $ 350
8786            HD PED MAN CAR PRI CAR 6                       $ 450
8787            HD PED MAN CAR PRI CAR 7                       $ 550
8788            HD PED MAN CAR PRI CAR 8                       $ 1,200
8791            HD PODIATRY 1                                  $ 100

                             57 of 75
       COUNTY OF LOS ANGELES - DEPARTMENT OF HEALTH SERVICES

           LAC+USC HEALTHCARE NETWORK
              OUTPATIENT BILLING RATE
                FISCAL YEAR 2004-05


CHG CODE        BILLING DESCRIPTION                            PRICE
8792            HD PODIATRY 2                                  $ 175
8793            HD PODIATRY 3                                  $ 225
8794            HD PODIATRY 4                                  $ 275
8795            HD PODIATRY 5                                  $ 350
8796            HD PODIATRY 6                                  $ 450
8797            HD PODIATRY 7                                  $ 550
8798            HD PODIATRY 8                                  $ 1,200
8801            HD PRENATAL 1                                  $ 100
8802            HD PRENATAL 2                                  $ 175
8803            HD PRENATAL 3                                  $ 225
8804            HD PRENATAL 4                                  $ 275
8805            HD PRENATAL 5                                  $ 350
8806            HD PRENATAL 6                                  $ 450
8807            HD PRENATAL 7                                  $ 550
8808            HD PRENATAL 8                                  $ 1,200
8811            HD PRENATAL NP 1                               $ 100
8812            HD PRENATAL NP 2                               $ 175
8813            HD PRENATAL NP 3                               $ 225
8814            HD PRENATAL NP 4                               $ 275
8815            HD PRENATAL NP 5                               $ 350
8816            HD PRENATAL NP 6                               $ 450
8817            HD PRENATAL NP 7                               $ 550
8818            HD PRENATAL NP 8                               $ 1,200
8821            HD TRIAGE WALK-IN 1                            $ 100
8822            HD TRIAGE WALK-IN 2                            $ 175
8823            HD TRIAGE WALK-IN 3                            $ 225
8824            HD TRIAGE WALK-IN 4                            $ 275
8825            HD TRIAGE WALK-IN 5                            $ 275
8826            HD TRIAGE WALK-IN 6                            $ 450
8827            HD TRIAGE WALK-IN 7                            $ 550
8828            HD TRIAGE WALK-IN 8                            $ 1,200
8831            HD URGENT CARE 1                               $ 100
8832            HD URGENT CARE 2                               $ 175
8833            HD URGENT CARE 3                               $ 225
8834            HD URGENT CARE 4                               $ 275
8835            HD URGENT CARE 5                               $ 350
8836            HD URGENT CARE 6                               $ 450
8837            HD URGENT CARE 7                               $ 550
8838            HD URGENT CARE 8                               $ 1,200
8841            HD GYNECOLOGY MD 1                             $ 100
8842            HD GYNECOLOGY MD 2                             $ 175
8843            HD GYNECOLOGY MD 3                             $ 225
8844            HD GYNECOLOGY MD 4                             $ 275
8845            HD GYNECOLOGY MD 5                             $ 350
8846            HD GYNECOLOGY MD 6                             $ 450
8847            HD GYNECOLOGY MD 7                             $ 550
8848            HD GYNECOLOGY MD 8                             $ 1,200
8851            HD CARDIOLOGY 1                                $ 100
8852            HD CARDIOLOGY 2                                $ 175

                             58 of 75
       COUNTY OF LOS ANGELES - DEPARTMENT OF HEALTH SERVICES

           LAC+USC HEALTHCARE NETWORK
              OUTPATIENT BILLING RATE
                FISCAL YEAR 2004-05


CHG CODE        BILLING DESCRIPTION                            PRICE
8853            HD CARDIOLOGY 3                                $ 225
8854            HD CARDIOLOGY 4                                $ 275
8855            HD CARDIOLOGY 5                                $ 350
8856            HD CARDIOLOGY 6                                $ 450
8857            HD CARDIOLOGY 7                                $ 550
8858            HD CARDIOLOGY 8                                $ 1,200
8861            HD EIC 1                                       $ 100
8862            HD EIC 2                                       $ 175
8863            HD EIC 3                                       $ 225
8864            HD EIC 4                                       $ 275
8865            HD EIC 5                                       $ 350
8866            HD EIC 6                                       $ 450
8867            HD EIC 7                                       $ 550
8868            HD EIC 8                                       $ 1,200
8881            HD GYN SURGERY PREOP 1                         $ 100
8882            HD GYN SURGERY PREOP 2                         $ 175
8883            HD GYN SURGERY PREOP 3                         $ 225
8884            HD GYN SURGERY PREOP 4                         $ 275
8885            HD GYN SURGERY PREOP 5                         $ 350
8886            HD GYN SURGERY PREOP 6                         $ 450
8887            HD GYN SURGERY PREOP 7                         $ 550
8888            HD GYN SURGERY PREOP 8                         $ 1,200
8891            HW PEDS PRIMARY CARE 1                         $ 100
8892            HW PEDS PRIMARY CARE 2                         $ 175
8893            HW PEDS PRIMARY CARE 3                         $ 225
8894            HW PEDS PRIMARY CARE 4                         $ 275
8895            HW PEDS PRIMARY CARE 5                         $ 350
8896            HW PEDS PRIMARY CARE 6                         $ 450
8897            HW PEDS PRIMARY CARE 7                         $ 550
8898            HW PEDS PRIMARY CARE 8                         $ 1,200
8901            HD NEPHROLOGY 1                                $ 100
8902            HD NEPHROLOGY 2                                $ 175
8903            HD NEPHROLOGY 3                                $ 225
8904            HD NEPHROLOGY 4                                $ 275
8905            HD NEPHROLOGY 5                                $ 350
8906            HD NEPHROLOGY 6                                $ 450
8907            HD NEPHROLOGY 7                                $ 550
8908            HD NEPHROLOGY 8                                $ 1,200
8911            HD ENDOCRINE 1                                 $ 100
8912            HD ENDOCRINE 2                                 $ 175
8913            HD ENDOCRINE 3                                 $ 225
8914            HD ENDOCRINE 4                                 $ 275
8915            HD ENDOCRINE 5                                 $ 350
8916            HD ENDOCRINE 6                                 $ 450
8917            HD ENDOCRINE 7                                 $ 550
8918            HD ENDOCRINE 8                                 $ 1,200
8921            HD OTOLARYNGOLOGY PREOP 1                      $ 100
8922            HD OTOLARYNGOLOGY PREOP 2                      $ 175
8923            HD OTOLARYNGOLOGY PREOP 3                      $ 225

                             59 of 75
       COUNTY OF LOS ANGELES - DEPARTMENT OF HEALTH SERVICES

           LAC+USC HEALTHCARE NETWORK
              OUTPATIENT BILLING RATE
                FISCAL YEAR 2004-05


CHG CODE        BILLING DESCRIPTION                            PRICE
8924            HD OTOLARYNGOLOGY PREOP 4                      $ 275
8925            HD OTOLARYNGOLOGY PREOP 5                      $ 350
8926            HD OTOLARYNGOLOGY PREOP 6                      $ 450
8927            HD OTOLARYNGOLOGY PREOP 7                      $ 550
8928            HD OTOLARYNGOLOGY PREOP 8                      $ 1,200
8931            HD OTOLARYNGOLOGY POSTOP 1                     $ 100
8932            HD OTOLARYNGOLOGY POSTOP 2                     $ 175
8933            HD OTOLARYNGOLOGY POSTOP 3                     $ 225
8934            HD OTOLARYNGOLOGY POSTOP 4                     $ 275
8935            HD OTOLARYNGOLOGY POSTOP 5                     $ 350
8936            HD OTOLARYNGOLOGY POSTOP 6                     $ 450
8937            HD OTOLARYNGOLOGY POSTOP 7                     $ 550
8938            HD OTOLARYNGOLOGY POSTOP 8                     $ 1,200
8941            HD PEDS CARDIOLOGY 1                           $ 100
8942            HD PEDS CARDIOLOGY 2                           $ 175
8943            HD PEDS CARDIOLOGY 3                           $ 225
8944            HD PEDS CARDIOLOGY 4                           $ 275
8945            HD PEDS CARDIOLOGY 5                           $ 350
8946            HD PEDS CARDIOLOGY 6                           $ 450
8947            HD PEDS CARDIOLOGY 7                           $ 550
8948            HD PEDS CARDIOLOGY 8                           $ 1,200
8951            HD FP TUBAL SURGERY 1                          $ 100
8952            HD FP TUBAL SURGERY 2                          $ 175
8953            HD FP TUBAL SURGERY 3                          $ 225
8954            HD FP TUBAL SURGERY 4                          $ 275
8955            HD FP TUBAL SURGERY 5                          $ 350
8956            HD FP TUBAL SURGERY 6                          $ 450
8957            HD FP TUBAL SURGERY 7                          $ 550
8958            HD FP TUBAL SURGERY 8                          $ 1,200
8961            HD COLORECT SURG PREOP 1                       $ 100
8962            HD COLORECT SURG PREOP 2                       $ 175
8963            HD COLORECT SURG PREOP 3                       $ 225
8964            HD COLORECT SURG PREOP 4                       $ 275
8965            HD COLORECT SURG PREOP 5                       $ 350
8966            HD COLORECT SURG PREOP 6                       $ 450
8967            HD COLORECT SURG PREOP 7                       $ 550
8968            HD COLORECT SURG PREOP 8                       $ 1,200
8971            HD COLORECT SURG POSTOP 1                      $ 100
8972            HD COLORECT SURG POSTOP 2                      $ 175
8973            HD COLORECT SURG POSTOP 3                      $ 225
8974            HD COLORECT SURG POSTOP 4                      $ 275
8975            HD COLORECT SURG POSTOP 5                      $ 350
8976            HD COLORECT SURG POSTOP 6                      $ 450
8977            HD COLORECT SURG POSTOP 7                      $ 550
8978            HD COLORECT SURG POSTOP 8                      $ 1,200
8981            HD COLORECT SURGERY 1                          $ 100
8982            HD COLORECT SURGERY 2                          $ 175
8983            HD COLORECT SURGERY 3                          $ 225
8984            HD COLORECT SURGERY 4                          $ 275

                             60 of 75
       COUNTY OF LOS ANGELES - DEPARTMENT OF HEALTH SERVICES

           LAC+USC HEALTHCARE NETWORK
              OUTPATIENT BILLING RATE
                FISCAL YEAR 2004-05


CHG CODE        BILLING DESCRIPTION                            PRICE
8985            HD COLORECT SURGERY 5                          $ 350
8986            HD COLORECT SURGERY 6                          $ 450
8987            HD COLORECT SURGERY 7                          $ 550
8988            HD COLORECT SURGERY 8                          $ 1,200
8991            HD ORTHO SURG PREOP 1                          $ 100
8992            HD ORTHO SURG PREOP 2                          $ 175
8993            HD ORTHO SURG PREOP 3                          $ 225
8994            HD ORTHO SURG PREOP 4                          $ 275
8995            HD ORTHO SURG PREOP 5                          $ 350
8996            HD ORTHO SURG PREOP 6                          $ 450
8997            HD ORTHO SURG PREOP 7                          $ 550
8998            HD ORTHO SURG PREOP 8                          $ 1,200
9001            HD ORTHO SURGERY 1                             $ 100
9002            HD ORTHO SURGERY 2                             $ 175
9003            HD ORTHO SURGERY 3                             $ 225
9004            HD ORTHO SURGERY 4                             $ 275
9005            HD ORTHO SURGERY 5                             $ 350
9006            HD ORTHO SURGERY 6                             $ 450
9007            HD ORTHO SURGERY 7                             $ 550
9008            HD ORTHO SURGERY 8                             $ 1,200
9011            HD ORTHO SURG POSTOP 1                         $ 100
9012            HD ORTHO SURG POSTOP 2                         $ 175
9013            HD ORTHO SURG POSTOP 3                         $ 225
9014            HD ORTHO SURG POSTOP 4                         $ 275
9015            HD ORTHO SURG POSTOP 5                         $ 350
9016            HD ORTHO SURG POSTOP 6                         $ 450
9017            HD ORTHO SURG POSTOP 7                         $ 550
9018            HD ORTHO SURG POSTOP 8                         $ 1,200
9021            HD PODIATRY SURGERY 1                          $ 100
9022            HD PODIATRY SURGERY 2                          $ 175
9023            HD PODIATRY SURGERY 3                          $ 225
9024            HD PODIATRY SURGERY 4                          $ 275
9025            HD PODIATRY SURGERY 5                          $ 350
9026            HD PODIATRY SURGERY 6                          $ 450
9027            HD PODIATRY SURGERY 7                          $ 550
9028            HD PODIATRY SURGERY 8                          $ 1,200
9031            HD GYN SURGERY 1                               $ 100
9032            HD GYN SURGERY 2                               $ 175
9033            HD GYN SURGERY 3                               $ 225
9034            HD GYN SURGERY 4                               $ 275
9035            HD GYN SURGERY 5                               $ 350
9036            HD GYN SURGERY 6                               $ 450
9037            HD GYN SURGERY 7                               $ 550
9038            HD GYN SURGERY 8                               $ 1,200
9041            HD GEN SURG PREOP 1                            $ 100
9042            HD GEN SURG PREOP 2                            $ 175
9043            HD GEN SURG PREOP 3                            $ 225
9044            HD GEN SURG PREOP 4                            $ 275
9045            HD GEN SURG PREOP 5                            $ 350

                             61 of 75
       COUNTY OF LOS ANGELES - DEPARTMENT OF HEALTH SERVICES

           LAC+USC HEALTHCARE NETWORK
              OUTPATIENT BILLING RATE
                FISCAL YEAR 2004-05


CHG CODE        BILLING DESCRIPTION                            PRICE
9046            HD GEN SURG PREOP 6                            $ 450
9047            HD GEN SURG PREOP 7                            $ 550
9048            HD GEN SURG PREOP 8                            $ 1,200
9051            HD GEN SURG POSTOP 1                           $ 100
9052            HD GEN SURG POSTOP 2                           $ 175
9053            HD GEN SURG POSTOP 3                           $ 225
9054            HD GEN SURG POSTOP 4                           $ 275
9055            HD GEN SURG POSTOP 5                           $ 350
9056            HD GEN SURG POSTOP 6                           $ 450
9057            HD GEN SURG POSTOP 7                           $ 550
9058            HD GEN SURG POSTOP 8                           $ 1,200
9081            HD CHP OB/GYN 1                                $ 100
9082            HD CHP OB/GYN 2                                $ 175
9083            HD CHP OB/GYN 3                                $ 225
9084            HD CHP OB/GYN 4                                $ 275
9085            HD CHP OB/GYN 5                                $ 350
9086            HD CHP OB/GYN 6                                $ 450
9087            HD CHP OB/GYN 7                                $ 550
9088            HD CHP OB/GYN 8                                $ 1,200
9111            HD FP TUBAL SURG PREOP 1                       $ 100
9112            HD FP TUBAL SURG PREOP 2                       $ 175
9113            HD FP TUBAL SURG PREOP 3                       $ 225
9114            HD FP TUBAL SURG PREOP 4                       $ 275
9115            HD FP TUBAL SURG PREOP 5                       $ 350
9116            HD FP TUBAL SURG PREOP 6                       $ 450
9117            HD FP TUBAL SURG PREOP 7                       $ 550
9118            HD FP TUBAL SURG PREOP 8                       $ 1,200
9121            HD FP TUBAL SURG POSTOP 1                      $ 100
9122            HD FP TUBAL SURG POSTOP 2                      $ 175
9123            HD FP TUBAL SURG POSTOP 3                      $ 225
9124            HD FP TUBAL SURG POSTOP 4                      $ 275
9125            HD FP TUBAL SURG POSTOP 5                      $ 350
9126            HD FP TUBAL SURG POSTOP 6                      $ 450
9127            HD FP TUBAL SURG POSTOP 7                      $ 550
9128            HD FP TUBAL SURG POSTOP 8                      $ 1,200
9131            HD BREAST NP 1                                 $ 100
9132            HD BREAST NP 2                                 $ 175
9133            HD BREAST NP 3                                 $ 225
9134            HD BREAST NP 4                                 $ 275
9135            HD BREAST NP 5                                 $ 350
9136            HD BREAST NP 6                                 $ 450
9137            HD BREAST NP 7                                 $ 550
9138            HD BREAST NP 8                                 $ 1,200
9141            HD OPHTHALMOLOGY 1                             $ 100
9142            HD OPHTHALMOLOGY 2                             $ 175
9143            HD OPHTHALMOLOGY 3                             $ 225
9144            HD OPHTHALMOLOGY 4                             $ 275
9145            HD OPHTHALMOLOGY 5                             $ 350
9146            HD OPHTHALMOLOGY 6                             $ 450

                             62 of 75
       COUNTY OF LOS ANGELES - DEPARTMENT OF HEALTH SERVICES

           LAC+USC HEALTHCARE NETWORK
              OUTPATIENT BILLING RATE
                FISCAL YEAR 2004-05


CHG CODE        BILLING DESCRIPTION                            PRICE
9147            HD OPHTHALMOLOGY 7                             $ 550
9148            HD OPHTHALMOLOGY 8                             $ 1,200
9151            HD PODIATRY PREOP 1                            $ 100
9152            HD PODIATRY PREOP 2                            $ 175
9153            HD PODIATRY PREOP 3                            $ 225
9154            HD PODIATRY PREOP 4                            $ 275
9155            HD PODIATRY PREOP 5                            $ 350
9156            HD PODIATRY PREOP 6                            $ 450
9157            HD PODIATRY PREOP 7                            $ 550
9158            HD PODIATRY PREOP 8                            $ 1,200
9161            HD PODIATRY POSTOP 1                           $ 100
9162            HD PODIATRY POSTOP 2                           $ 175
9163            HD PODIATRY POSTOP 3                           $ 225
9164            HD PODIATRY POSTOP 4                           $ 275
9165            HD PODIATRY POSTOP 5                           $ 350
9166            HD PODIATRY POSTOP 6                           $ 450
9167            HD PODIATRY POSTOP 7                           $ 550
9168            HD PODIATRY POSTOP 8                           $ 1,200
9171            HD O/P SURGERY 1                               $ 2,700
9172            HD O/P SURGERY 2                               $ 700
9173            HD O/P SURGERY 3                               $ 1,000
9174            HD O/P SURGERY 4                               $ 1,300
9175            HD O/P SURGERY 5                               $ 1,500
9176            HD O/P SURGERY 6                               $ 1,700
9177            HD O/P SURGERY 7                               $ 1,900
9178            HD O/P SURGERY 8                               $ 2,500
9179            HD O/P SURGERY 9                               $ 2,700
9181            HD O/P SURGERY PREOP 1                         $ 100
9182            HD O/P SURGERY PREOP 2                         $ 175
9183            HD O/P SURGERY PREOP 3                         $ 225
9184            HD O/P SURGERY PREOP 4                         $ 275
9185            HD O/P SURGERY PREOP 5                         $ 350
9186            HD O/P SURGERY PREOP 6                         $ 450
9187            HD O/P SURGERY PREOP 7                         $ 550
9188            HD O/P SURGERY PREOP 8                         $ 1,200
9191            HD O/P SURGERY POSTOP 1                        $ 100
9192            HD O/P SURGERY POSTOP 2                        $ 175
9193            HD O/P SURGERY POSTOP 3                        $ 225
9194            HD O/P SURGERY POSTOP 4                        $ 275
9195            HD O/P SURGERY POSTOP 5                        $ 350
9196            HD O/P SURGERY POSTOP 6                        $ 450
9197            HD O/P SURGERY POSTOP 7                        $ 550
9198            HD O/P SURGERY POSTOP 8                        $ 1,200
9221            HD RADIOLOGY 1                                 $ 100
9222            HD RADIOLOGY 2                                 $ 175
9223            HD RADIOLOGY 3                                 $ 225
9224            HD RADIOLOGY 4                                 $ 275
9225            HD RADIOLOGY 5                                 $ 350
9226            HD RADIOLOGY 6                                 $ 450

                             63 of 75
       COUNTY OF LOS ANGELES - DEPARTMENT OF HEALTH SERVICES

           LAC+USC HEALTHCARE NETWORK
              OUTPATIENT BILLING RATE
                FISCAL YEAR 2004-05


CHG CODE        BILLING DESCRIPTION                            PRICE
9227            HD RADIOLOGY 7                                 $ 550
9228            HD RADIOLOGY 8                                 $ 1,200
9231            EM PRIMARY CARE 1                              $ 100
9232            EM PRIMARY CARE 2                              $ 175
9233            EM PRIMARY CARE 3                              $ 225
9234            EM PRIMARY CARE 4                              $ 275
9235            EM PRIMARY CARE 5                              $ 350
9236            EM PRIMARY CARE 6                              $ 450
9237            EM PRIMARY CARE 7                              $ 550
9238            EM PRIMARY CARE 8                              $ 1,200
9241            EM PRIMARY CARE NP 1                           $ 100
9242            EM PRIMARY CARE NP 2                           $ 175
9243            EM PRIMARY CARE NP 3                           $ 225
9244            EM PRIMARY CARE NP 4                           $ 275
9245            EM PRIMARY CARE NP 5                           $ 350
9246            EM PRIMARY CARE NP 6                           $ 450
9247            EM PRIMARY CARE NP 7                           $ 550
9248            EM PRIMARY CARE NP 8                           $ 1,200
9251            EM DERM LASER SURGERY 1                        $ 100
9252            EM DERM LASER SURGERY 2                        $ 175
9253            EM DERM LASER SURGERY 3                        $ 225
9254            EM DERM LASER SURGERY 4                        $ 275
9255            EM DERM LASER SURGERY 5                        $ 350
9256            EM DERM LASER SURGERY 6                        $ 450
9257            EM DERM LASER SURGERY 7                        $ 550
9258            EM DERM LASER SURGERY 8                        $ 1,200
9261            EM CARDIOLOGY 1                                $ 100
9262            EM CARDIOLOGY 2                                $ 175
9263            EM CARDIOLOGY 3                                $ 225
9264            EM CARDIOLOGY 4                                $ 275
9265            EM CARDIOLOGY 5                                $ 350
9266            EM CARDIOLOGY 6                                $ 450
9267            EM CARDIOLOGY 7                                $ 550
9268            EM CARDIOLOGY 8                                $ 1,200
9271            EM COLPOSCOPY 1                                $ 100
9272            EM COLPOSCOPY 2                                $ 175
9273            EM COLPOSCOPY 3                                $ 225
9274            EM COLPOSCOPY 4                                $ 275
9275            EM COLPOSCOPY 5                                $ 350
9276            EM COLPOSCOPY 6                                $ 450
9277            EM COLPOSCOPY 7                                $ 550
9278            EM COLPOSCOPY 8                                $ 1,200
9281            EM DENTAL WALK-IN 1                            $ 100
9282            EM DENTAL WALK-IN 2                            $ 175
9283            EM DENTAL WALK-IN 3                            $ 225
9284            EM DENTAL WALK-IN 4                            $ 275
9285            EM DENTAL WALK-IN 5                            $ 350
9286            EM DENTAL WALK-IN 6                            $ 450
9287            EM DENTAL WALK-IN 7                            $ 550

                             64 of 75
       COUNTY OF LOS ANGELES - DEPARTMENT OF HEALTH SERVICES

           LAC+USC HEALTHCARE NETWORK
              OUTPATIENT BILLING RATE
                FISCAL YEAR 2004-05


CHG CODE        BILLING DESCRIPTION                            PRICE
9288            EM DENTAL WALK-IN 8                            $ 1,200
9291            EM DENTAL 1                                    $ 100
9292            EM DENTAL 2                                    $ 175
9293            EM DENTAL 3                                    $ 225
9294            EM DENTAL 4                                    $ 275
9295            EM DENTAL 5                                    $ 350
9296            EM DENTAL 6                                    $ 450
9297            EM DENTAL 7                                    $ 550
9298            EM DENTAL 8                                    $ 1,200
9301            EM DENTAL HYGENIST 1                           $ 100
9302            EM DENTAL HYGENIST 2                           $ 175
9303            EM DENTAL HYGENIST 3                           $ 225
9304            EM DENTAL HYGENIST 4                           $ 275
9305            EM DENTAL HYGENIST 5                           $ 350
9306            EM DENTAL HYGENIST 6                           $ 450
9307            EM DENTAL HYGENIST 7                           $ 550
9308            EM DENTAL HYGENIST 8                           $ 1,200
9311            EM FAMILY PLAN MD/NP 1                         $ 100
9312            EM FAMILY PLAN MD/NP 2                         $ 175
9313            EM FAMILY PLAN MD/NP 3                         $ 225
9314            EM FAMILY PLAN MD/NP 4                         $ 275
9315            EM FAMILY PLAN MD/NP 5                         $ 350
9316            EM FAMILY PLAN MD/NP 6                         $ 450
9317            EM FAMILY PLAN MD/NP 7                         $ 550
9318            EM FAMILY PLAN MD/NP 8                         $ 1,200
9321            EM PAP CLINIC MD/NP 1                          $ 100
9322            EM PAP CLINIC MD/NP 2                          $ 175
9323            EM PAP CLINIC MD/NP 3                          $ 225
9324            EM PAP CLINIC MD/NP 4                          $ 275
9325            EM PAP CLINIC MD/NP 5                          $ 350
9326            EM PAP CLINIC MD/NP 6                          $ 450
9327            EM PAP CLINIC MD/NP 7                          $ 550
9328            EM PAP CLINIC MD/NP 8                          $ 1,200
9331            EM PRIM CARE WELL BABY 1                       $ 100
9332            EM PRIM CARE WELL BABY 2                       $ 175
9333            EM PRIM CARE WELL BABY 3                       $ 225
9334            EM PRIM CARE WELL BABY 4                       $ 275
9335            EM PRIM CARE WELL BABY 5                       $ 350
9336            EM PRIM CARE WELL BABY 6                       $ 450
9337            EM PRIM CARE WELL BABY 7                       $ 550
9338            EM PRIM CARE WELL BABY 8                       $ 1,200
9341            EM PRENATAL MD/NP 1                            $ 100
9342            EM PRENATAL MD/NP 2                            $ 175
9343            EM PRENATAL MD/NP 3                            $ 225
9344            EM PRENATAL MD/NP 4                            $ 275
9345            EM PRENATAL MD/NP 5                            $ 350
9346            EM PRENATAL MD/NP 6                            $ 450
9347            EM PRENATAL MD/NP 7                            $ 550
9348            EM PRENATAL MD/NP 8                            $ 1,200

                             65 of 75
       COUNTY OF LOS ANGELES - DEPARTMENT OF HEALTH SERVICES

           LAC+USC HEALTHCARE NETWORK
              OUTPATIENT BILLING RATE
                FISCAL YEAR 2004-05


CHG CODE        BILLING DESCRIPTION                            PRICE
9351            EM PRENATAL INTAKE MD/NP 1                     $ 100
9352            EM PRENATAL INTAKE MD/NP 2                     $ 175
9353            EM PRENATAL INTAKE MD/NP 3                     $ 225
9354            EM PRENATAL INTAKE MD/NP 4                     $ 275
9355            EM PRENATAL INTAKE MD/NP 5                     $ 350
9356            EM PRENATAL INTAKE MD/NP 6                     $ 450
9357            EM PRENATAL INTAKE MD/NP 7                     $ 550
9358            EM PRENATAL INTAKE MD/NP 8                     $ 1,200
9361            EM OB/GYN WALK-IN 1                            $ 100
9362            EM OB/GYN WALK-IN 2                            $ 175
9363            EM OB/GYN WALK-IN 3                            $ 225
9364            EM OB/GYN WALK-IN 4                            $ 275
9365            EM OB/GYN WALK-IN 5                            $ 350
9366            EM OB/GYN WALK-IN 6                            $ 450
9367            EM OB/GYN WALK-IN 7                            $ 550
9368            EM OB/GYN WALK-IN 8                            $ 1,200
9371            EM GYNECOLOGY 1                                $ 100
9372            EM GYNECOLOGY 2                                $ 175
9373            EM GYNECOLOGY 3                                $ 225
9374            EM GYNECOLOGY 4                                $ 275
9375            EM GYNECOLOGY 5                                $ 350
9376            EM GYNECOLOGY 6                                $ 450
9377            EM GYNECOLOGY 7                                $ 550
9378            EM GYNECOLOGY 8                                $ 1,200
9381            EM GYNECOLOGY NP 1                             $ 100
9382            EM GYNECOLOGY NP 2                             $ 175
9383            EM GYNECOLOGY NP 3                             $ 225
9384            EM GYNECOLOGY NP 4                             $ 275
9385            EM GYNECOLOGY NP 5                             $ 350
9386            EM GYNECOLOGY NP 6                             $ 450
9387            EM GYNECOLOGY NP 7                             $ 550
9388            EM GYNECOLOGY NP 8                             $ 1,200
9391            EM FMLE STRL PROC 1                            $ 100
9392            EM FMLE STRL PROC 2                            $ 175
9393            EM FMLE STRL PROC 3                            $ 225
9394            EM FMLE STRL PROC 4                            $ 275
9395            EM FMLE STRL PROC 5                            $ 350
9396            EM FMLE STRL PROC 6                            $ 450
9397            EM FMLE STRL PROC 7                            $ 550
9398            EM FMLE STRL PROC 8                            $ 1,200
9401            EM RADIOLOGY 1                                 $ 100
9402            EM RADIOLOGY 2                                 $ 175
9403            EM RADIOLOGY 3                                 $ 225
9404            EM RADIOLOGY 4                                 $ 275
9405            EM RADIOLOGY 5                                 $ 350
9406            EM RADIOLOGY 6                                 $ 450
9407            EM RADIOLOGY 7                                 $ 550
9408            EM RADIOLOGY 8                                 $ 1,200
9411            EM DERMATOLOGY 1                               $ 100

                             66 of 75
       COUNTY OF LOS ANGELES - DEPARTMENT OF HEALTH SERVICES

           LAC+USC HEALTHCARE NETWORK
              OUTPATIENT BILLING RATE
                FISCAL YEAR 2004-05


CHG CODE        BILLING DESCRIPTION                            PRICE
9412            EM DERMATOLOGY 2                               $ 175
9413            EM DERMATOLOGY 3                               $ 225
9414            EM DERMATOLOGY 4                               $ 275
9415            EM DERMATOLOGY 5                               $ 350
9416            EM DERMATOLOGY 6                               $ 450
9417            EM DERMATOLOGY 7                               $ 550
9418            EM DERMATOLOGY 8                               $ 1,200
9421            EM NEPHROLOGY 1                                $ 100
9422            EM NEPHROLOGY 2                                $ 175
9423            EM NEPHROLOGY 3                                $ 225
9424            EM NEPHROLOGY 4                                $ 275
9425            EM NEPHROLOGY 5                                $ 350
9426            EM NEPHROLOGY 6                                $ 450
9427            EM NEPHROLOGY 7                                $ 550
9428            EM NEPHROLOGY 8                                $ 1,200
9431            EM ENDOCRINE 1                                 $ 100
9432            EM ENDOCRINE 2                                 $ 175
9433            EM ENDOCRINE 3                                 $ 225
9434            EM ENDOCRINE 4                                 $ 275
9435            EM ENDOCRINE 5                                 $ 350
9436            EM ENDOCRINE 6                                 $ 450
9437            EM ENDOCRINE 7                                 $ 550
9438            EM ENDOCRINE 8                                 $ 1,200
9441            EM DIABETIC 1                                  $ 100
9442            EM DIABETIC 2                                  $ 175
9443            EM DIABETIC 3                                  $ 225
9444            EM DIABETIC 4                                  $ 275
9445            EM DIABETIC 5                                  $ 350
9446            EM DIABETIC 6                                  $ 450
9447            EM DIABETIC 7                                  $ 550
9448            EM DIABETIC 8                                  $ 1,200
9451            EM INFECTIOUS DISEASE 1                        $ 100
9452            EM INFECTIOUS DISEASE 2                        $ 175
9453            EM INFECTIOUS DISEASE 3                        $ 225
9454            EM INFECTIOUS DISEASE 4                        $ 275
9455            EM INFECTIOUS DISEASE 5                        $ 350
9456            EM INFECTIOUS DISEASE 6                        $ 450
9457            EM INFECTIOUS DISEASE 7                        $ 550
9458            EM INFECTIOUS DISEASE 8                        $ 1,200
9461            EM PEDS WALK-IN 1                              $ 100
9462            EM PEDS WALK-IN 2                              $ 175
9463            EM PEDS WALK-IN 3                              $ 225
9464            EM PEDS WALK-IN 4                              $ 275
9465            EM PEDS WALK-IN 5                              $ 350
9466            EM PEDS WALK-IN 6                              $ 450
9467            EM PEDS WALK-IN 7                              $ 550
9468            EM PEDS WALK-IN 8                              $ 1,200
9471            EM PEDS ALLERGY 1                              $ 100
9472            EM PEDS ALLERGY 2                              $ 175

                             67 of 75
       COUNTY OF LOS ANGELES - DEPARTMENT OF HEALTH SERVICES

           LAC+USC HEALTHCARE NETWORK
              OUTPATIENT BILLING RATE
                FISCAL YEAR 2004-05


CHG CODE        BILLING DESCRIPTION                            PRICE
9473            EM PEDS ALLERGY 3                              $ 225
9474            EM PEDS ALLERGY 4                              $ 275
9475            EM PEDS ALLERGY 5                              $ 350
9476            EM PEDS ALLERGY 6                              $ 450
9477            EM PEDS ALLERGY 7                              $ 550
9478            EM PEDS ALLERGY 8                              $ 1,200
9481            EM PEDS CARDIOLOGY 1                           $ 100
9482            EM PEDS CARDIOLOGY 2                           $ 175
9483            EM PEDS CARDIOLOGY 3                           $ 225
9484            EM PEDS CARDIOLOGY 4                           $ 275
9485            EM PEDS CARDIOLOGY 5                           $ 350
9486            EM PEDS CARDIOLOGY 6                           $ 450
9487            EM PEDS CARDIOLOGY 7                           $ 550
9488            EM PEDS CARDIOLOGY 8                           $ 1,200
9491            EM PEDS GASTROENTERO 1                         $ 100
9492            EM PEDS GASTROENTERO 2                         $ 175
9493            EM PEDS GASTROENTERO 3                         $ 225
9494            EM PEDS GASTROENTERO 4                         $ 275
9495            EM PEDS GASTROENTERO 5                         $ 350
9496            EM PEDS GASTROENTERO 6                         $ 450
9497            EM PEDS GASTROENTERO 7                         $ 550
9498            EM PEDS GASTROENTERO 8                         $ 1,200
9501            EM PEDS ENDOCRINE 1                            $ 100
9502            EM PEDS ENDOCRINE 2                            $ 175
9503            EM PEDS ENDOCRINE 3                            $ 225
9504            EM PEDS ENDOCRINE 4                            $ 275
9505            EM PEDS ENDOCRINE 5                            $ 350
9506            EM PEDS ENDOCRINE 6                            $ 450
9507            EM PEDS ENDOCRINE 7                            $ 550
9508            EM PEDS ENDOCRINE 8                            $ 1,200
9511            EM PEDS ORTHOPEDICS 1                          $ 100
9512            EM PEDS ORTHOPEDICS 2                          $ 175
9513            EM PEDS ORTHOPEDICS 3                          $ 225
9514            EM PEDS ORTHOPEDICS 4                          $ 275
9515            EM PEDS ORTHOPEDICS 5                          $ 350
9516            EM PEDS ORTHOPEDICS 6                          $ 450
9517            EM PEDS ORTHOPEDICS 7                          $ 550
9518            EM PEDS ORTHOPEDICS 8                          $ 1,200
9521            EM FP TUB SUR PREOP MD/NP 1                    $ 100
9522            EM FP TUB SUR PREOP MD/NP 2                    $ 175
9523            EM FP TUB SUR PREOP MD/NP 3                    $ 225
9524            EM FP TUB SUR PREOP MD/NP 4                    $ 275
9525            EM FP TUB SUR PREOP MD/NP 5                    $ 350
9526            EM FP TUB SUR PREOP MD/NP 6                    $ 450
9527            EM FP TUB SUR PREOP MD/NP 7                    $ 550
9528            EM FP TUB SUR PREOP MD/NP 8                    $ 1,200
9531            EM PEDS NEPHROLOGY 1                           $ 100
9532            EM PEDS NEPHROLOGY 2                           $ 175
9533            EM PEDS NEPHROLOGY 3                           $ 225

                             68 of 75
       COUNTY OF LOS ANGELES - DEPARTMENT OF HEALTH SERVICES

           LAC+USC HEALTHCARE NETWORK
              OUTPATIENT BILLING RATE
                FISCAL YEAR 2004-05


CHG CODE        BILLING DESCRIPTION                            PRICE
9534            EM PEDS NEPHROLOGY 4                           $ 275
9535            EM PEDS NEPHROLOGY 5                           $ 350
9536            EM PEDS NEPHROLOGY 6                           $ 450
9537            EM PEDS NEPHROLOGY 7                           $ 550
9538            EM PEDS NEPHROLOGY 8                           $ 1,200
9541            EM FP TUB SUR POSTOP MD/NP                     $ 100
9542            EM FP TUB SUR POSTOP MD/NP                     $ 175
9543            EM FP TUB SUR POSTOP MD/NP                     $ 225
9544            EM FP TUB SUR POSTOP MD/NP                     $ 275
9545            EM FP TUB SUR POSTOP MD/NP                     $ 350
9546            EM FP TUB SUR POSTOP MD/NP                     $ 450
9547            EM FP TUB SUR POSTOP MD/NP                     $ 550
9548            EM FP TUB SUR POSTOP MD/NP                     $ 1,200
9551            EM FP TUBAL SURG MD/NP 1                       $ 100
9552            EM FP TUBAL SURG MD/NP 2                       $ 175
9553            EM FP TUBAL SURG MD/NP 3                       $ 225
9554            EM FP TUBAL SURG MD/NP 4                       $ 275
9555            EM FP TUBAL SURG MD/NP 5                       $ 350
9556            EM FP TUBAL SURG MD/NP 6                       $ 450
9557            EM FP TUBAL SURG MD/NP 7                       $ 550
9558            EM FP TUBAL SURG MD/NP 8                       $ 1,200
9561            EM OPHTHALMOLOGY 1                             $ 100
9562            EM OPHTHALMOLOGY 2                             $ 175
9563            EM OPHTHALMOLOGY 3                             $ 225
9564            EM OPHTHALMOLOGY 4                             $ 275
9565            EM OPHTHALMOLOGY 5                             $ 350
9566            EM OPHTHALMOLOGY 6                             $ 450
9567            EM OPHTHALMOLOGY 7                             $ 550
9568            EM OPHTHALMOLOGY 8                             $ 1,200
9571            EM CHDP MOB WELL BABY NP 1                     $ 100
9572            EM CHDP MOB WELL BABY NP 2                     $ 175
9573            EM CHDP MOB WELL BABY NP 3                     $ 225
9574            EM CHDP MOB WELL BABY NP 4                     $ 275
9575            EM CHDP MOB WELL BABY NP 5                     $ 350
9576            EM CHDP MOB WELL BABY NP 6                     $ 450
9577            EM CHDP MOB WELL BABY NP 7                     $ 550
9578            EM CHDP MOB WELL BABY NP 8                     $ 1,200
9591            EM PEDS MANAGED CARE 1                         $ 100
9592            EM PEDS MANAGED CARE 2                         $ 175
9593            EM PEDS MANAGED CARE 3                         $ 225
9594            EM PEDS MANAGED CARE 4                         $ 275
9595            EM PEDS MANAGED CARE 5                         $ 350
9596            EM PEDS MANAGED CARE 6                         $ 450
9597            EM PEDS MANAGED CARE 7                         $ 550
9598            EM PEDS MANAGED CARE 8                         $ 1,200
9601            EM PRIM CARE SICK BABY 1                       $ 100
9602            EM PRIM CARE SICK BABY 2                       $ 175
9603            EM PRIM CARE SICK BABY 3                       $ 225
9604            EM PRIM CARE SICK BABY 4                       $ 275

                             69 of 75
       COUNTY OF LOS ANGELES - DEPARTMENT OF HEALTH SERVICES

           LAC+USC HEALTHCARE NETWORK
              OUTPATIENT BILLING RATE
                FISCAL YEAR 2004-05


CHG CODE        BILLING DESCRIPTION                            PRICE
9605            EM PRIM CARE SICK BABY 5                       $ 350
9606            EM PRIM CARE SICK BABY 6                       $ 450
9607            EM PRIM CARE SICK BABY 7                       $ 550
9608            EM PRIM CARE SICK BABY 8                       $ 1,200
9611            EM WALK-IN 1                                   $ 100
9612            EM WALK-IN 2                                   $ 175
9613            EM WALK-IN 3                                   $ 225
9614            EM WALK-IN 4                                   $ 275
9615            EM WALK-IN 5                                   $ 350
9616            EM WALK-IN 6                                   $ 450
9617            EM WALK-IN 7                                   $ 550
9618            EM WALK-IN 8                                   $ 1,200
9701            EM PODIATRY 1                                  $ 100
9702            EM PODIATRY 2                                  $ 175
9703            EM PODIATRY 3                                  $ 225
9704            EM PODIATRY 4                                  $ 275
9705            EM PODIATRY 5                                  $ 350
9706            EM PODIATRY 6                                  $ 450
9707            EM PODIATRY 7                                  $ 550
9708            EM PODIATRY 8                                  $ 1,200
9721            EM FAMILY MEDICINE 1                           $ 100
9722            EM FAMILY MEDICINE 2                           $ 175
9723            EM FAMILY MEDICINE 3                           $ 225
9724            EM FAMILY MEDICINE 4                           $ 275
9725            EM FAMILY MEDICINE 5                           $ 350
9726            EM FAMILY MEDICINE 6                           $ 450
9727            EM FAMILY MEDICINE 7                           $ 550
9728            EM FAMILY MEDICINE 8                           $ 1,200
9751            AL PRIMARY CARE 1                              $ 100
9752            AL PRIMARY CARE 2                              $ 175
9753            AL PRIMARY CARE 3                              $ 225
9754            AL PRIMARY CARE 4                              $ 275
9755            AL PRIMARY CARE 5                              $ 350
9756            AL PRIMARY CARE 6                              $ 450
9757            AL PRIMARY CARE 7                              $ 550
9758            AL PRIMARY CARE 8                              $ 1,200
9761            AL PEDIATRIC 1                                 $ 100
9762            AL PEDIATRIC 2                                 $ 175
9763            AL PEDIATRIC 3                                 $ 225
9764            AL PEDIATRIC 4                                 $ 275
9765            AL PEDIATRIC 5                                 $ 350
9766            AL PEDIATRIC 6                                 $ 450
9767            AL PEDIATRIC 7                                 $ 550
9768            AL PEDIATRIC 8                                 $ 1,200
9771            AL PRENATAL INTAKE NP 1                        $ 100
9772            AL PRENATAL INTAKE NP 2                        $ 175
9773            AL PRENATAL INTAKE NP 3                        $ 225
9774            AL PRENATAL INTAKE NP 4                        $ 275
9775            AL PRENATAL INTAKE NP 5                        $ 350

                             70 of 75
       COUNTY OF LOS ANGELES - DEPARTMENT OF HEALTH SERVICES

           LAC+USC HEALTHCARE NETWORK
              OUTPATIENT BILLING RATE
                FISCAL YEAR 2004-05


CHG CODE        BILLING DESCRIPTION                            PRICE
9776            AL PRENATAL INTAKE NP 6                        $ 450
9777            AL PRENATAL INTAKE NP 7                        $ 550
9778            AL PRENATAL INTAKE NP 8                        $ 1,200
9781            AL PRENATAL NP 1                               $ 100
9782            AL PRENATAL NP 2                               $ 175
9783            AL PRENATAL NP 3                               $ 225
9784            AL PRENATAL NP 4                               $ 275
9785            AL PRENATAL NP 5                               $ 350
9786            AL PRENATAL NP 6                               $ 450
9787            AL PRENATAL NP 7                               $ 550
9788            AL PRENATAL NP 8                               $ 1,200
9791            AL FAMILY PLAN NP 1                            $ 100
9792            AL FAMILY PLAN NP 2                            $ 175
9793            AL FAMILY PLAN NP 3                            $ 225
9794            AL FAMILY PLAN NP 4                            $ 275
9795            AL FAMILY PLAN NP 5                            $ 350
9796            AL FAMILY PLAN NP 6                            $ 450
9797            AL FAMILY PLAN NP 7                            $ 550
9798            AL FAMILY PLAN NP 8                            $ 1,200
9801            AL GYNECOLOGY 1                                $ 100
9802            AL GYNECOLOGY 2                                $ 175
9803            AL GYNECOLOGY 3                                $ 225
9804            AL GYNECOLOGY 4                                $ 275
9805            AL GYNECOLOGY 5                                $ 350
9806            AL GYNECOLOGY 6                                $ 450
9807            AL GYNECOLOGY 7                                $ 550
9808            AL GYNECOLOGY 8                                $ 1,200
9811            AZ PRIMARY CARE 1                              $ 100
9812            AZ PRIMARY CARE 2                              $ 175
9813            AZ PRIMARY CARE 3                              $ 225
9814            AZ PRIMARY CARE 4                              $ 275
9815            AZ PRIMARY CARE 5                              $ 350
9816            AZ PRIMARY CARE 6                              $ 450
9817            AZ PRIMARY CARE 7                              $ 550
9818            AZ PRIMARY CARE 8                              $ 1,200
9821            AZ PEDIATRICS 1                                $ 100
9822            AZ PEDIATRICS 2                                $ 175
9823            AZ PEDIATRICS 3                                $ 225
9824            AZ PEDIATRICS 4                                $ 275
9825            AZ PEDIATRICS 5                                $ 350
9826            AZ PEDIATRICS 6                                $ 450
9827            AZ PEDIATRICS 7                                $ 550
9828            AZ PEDIATRICS 8                                $ 1,200
9831            AZ PRENATAL INTAKE NP 1                        $ 100
9832            AZ PRENATAL INTAKE NP 2                        $ 175
9833            AZ PRENATAL INTAKE NP 3                        $ 225
9834            AZ PRENATAL INTAKE NP 4                        $ 275
9835            AZ PRENATAL INTAKE NP 5                        $ 350
9836            AZ PRENATAL INTAKE NP 6                        $ 450

                             71 of 75
       COUNTY OF LOS ANGELES - DEPARTMENT OF HEALTH SERVICES

           LAC+USC HEALTHCARE NETWORK
              OUTPATIENT BILLING RATE
                FISCAL YEAR 2004-05


CHG CODE        BILLING DESCRIPTION                            PRICE
9837            AZ PRENATAL INTAKE NP 7                        $ 550
9838            AZ PRENATAL INTAKE NP 8                        $ 1,200
9841            AZ PRENATAL NP 1                               $ 100
9842            AZ PRENATAL NP 2                               $ 175
9843            AZ PRENATAL NP 3                               $ 225
9844            AZ PRENATAL NP 4                               $ 275
9845            AZ PRENATAL NP 5                               $ 350
9846            AZ PRENATAL NP 6                               $ 450
9847            AZ PRENATAL NP 7                               $ 550
9848            AZ PRENATAL NP 8                               $ 1,200
9851            AZ PRENATAL NP 1                               $ 100
9852            AZ PRENATAL NP 2                               $ 175
9853            AZ PRENATAL NP 3                               $ 225
9854            AZ PRENATAL NP 4                               $ 275
9855            AZ PRENATAL NP 5                               $ 350
9856            AZ PRENATAL NP 6                               $ 450
9857            AZ PRENATAL NP 7                               $ 550
9858            AZ PRENATAL NP 8                               $ 1,200
9861            AZ GYNECOLOGY 1                                $ 100
9862            AZ GYNECOLOGY 2                                $ 175
9863            AZ GYNECOLOGY 3                                $ 225
9864            AZ GYNECOLOGY 4                                $ 275
9865            AZ GYNECOLOGY 5                                $ 350
9866            AZ GYNECOLOGY 6                                $ 450
9867            AZ GYNECOLOGY 7                                $ 550
9868            AZ GYNECOLOGY 8                                $ 1,200
9871            AZ FAMILY PLAN 1                               $ 100
9872            AZ FAMILY PLAN 2                               $ 175
9873            AZ FAMILY PLAN 3                               $ 225
9874            AZ FAMILY PLAN 4                               $ 275
9875            AZ FAMILY PLAN 5                               $ 350
9876            AZ FAMILY PLAN 6                               $ 450
9877            AZ FAMILY PLAN 7                               $ 550
9878            AZ FAMILY PLAN 8                               $ 1,200
9881            AZ FAMILY PLAN NP 1                            $ 100
9882            AZ FAMILY PLAN NP 2                            $ 175
9883            AZ FAMILY PLAN NP 3                            $ 225
9884            AZ FAMILY PLAN NP 4                            $ 275
9885            AZ FAMILY PLAN NP 5                            $ 350
9886            AZ FAMILY PLAN NP 6                            $ 450
9887            AZ FAMILY PLAN NP 7                            $ 550
9888            AZ FAMILY PLAN NP 8                            $ 1,200
9911            LP PEDIATRICS 1                                $ 100
9912            LP PEDIATRICS 2                                $ 175
9913            LP PEDIATRICS 3                                $ 225
9914            LP PEDIATRICS 4                                $ 275
9915            LP PEDIATRICS 5                                $ 350
9916            LP PEDIATRICS 6                                $ 450
9917            LP PEDIATRICS 7                                $ 550

                             72 of 75
       COUNTY OF LOS ANGELES - DEPARTMENT OF HEALTH SERVICES

           LAC+USC HEALTHCARE NETWORK
              OUTPATIENT BILLING RATE
                FISCAL YEAR 2004-05


CHG CODE        BILLING DESCRIPTION                            PRICE
9918            LP PEDIATRICS 8                                $ 1,200
9921            LP PRENATAL INTAKE NP 1                        $ 100
9922            LP PRENATAL INTAKE NP 2                        $ 175
9923            LP PRENATAL INTAKE NP 3                        $ 225
9924            LP PRENATAL INTAKE NP 4                        $ 275
9925            LP PRENATAL INTAKE NP 5                        $ 350
9926            LP PRENATAL INTAKE NP 6                        $ 450
9927            LP PRENATAL INTAKE NP 7                        $ 550
9928            LP PRENATAL INTAKE NP 8                        $ 1,200
9931            LP PRENATAL 1                                  $ 100
9932            LP PRENATAL 2                                  $ 175
9933            LP PRENATAL 3                                  $ 225
9934            LP PRENATAL 4                                  $ 275
9935            LP PRENATAL 5                                  $ 350
9936            LP PRENATAL 6                                  $ 450
9937            LP PRENATAL 7                                  $ 550
9938            LP PRENATAL 8                                  $ 1,200
9941            LP PRENATAL NP 1                               $ 100
9942            LP PRENATAL NP 2                               $ 175
9943            LP PRENATAL NP 3                               $ 225
9944            LP PRENATAL NP 4                               $ 275
9945            LP PRENATAL NP 5                               $ 350
9946            LP PRENATAL NP 6                               $ 450
9947            LP PRENATAL NP 7                               $ 550
9948            LP PRENATAL NP 8                               $ 1,200
9951            LP GYNECOLOGY 1                                $ 100
9952            LP GYNECOLOGY 2                                $ 175
9953            LP GYNECOLOGY 3                                $ 225
9954            LP GYNECOLOGY 4                                $ 275
9955            LP GYNECOLOGY 5                                $ 350
9956            LP GYNECOLOGY 6                                $ 450
9957            LP GYNECOLOGY 7                                $ 550
9958            LP GYNECOLOGY 8                                $ 1,200
9961            LP FAMILY PLAN 1                               $ 100
9962            LP FAMILY PLAN 2                               $ 175
9963            LP FAMILY PLAN 3                               $ 225
9964            LP FAMILY PLAN 4                               $ 275
9965            LP FAMILY PLAN 5                               $ 350
9966            LP FAMILY PLAN 6                               $ 450
9967            LP FAMILY PLAN 7                               $ 550
9968            LP FAMILY PLAN 8                               $ 1,200
9971            LP FAMILY PLAN NP 1                            $ 100
9972            LP FAMILY PLAN NP 2                            $ 175
9973            LP FAMILY PLAN NP 3                            $ 225
9974            LP FAMILY PLAN NP 4                            $ 275
9975            LP FAMILY PLAN NP 5                            $ 350
9976            LP FAMILY PLAN NP 6                            $ 450
9977            LP FAMILY PLAN NP 7                            $ 550
9978            LP FAMILY PLAN NP 8                            $ 1,200

                             73 of 75
                               COUNTY OF LOS ANGELES - DEPARTMENT OF HEALTH SERVICES

                       LAC+USC MEDICAL CENTER
         INCLUSIVE HOSPITAL AND RELATED STAFF SERVICES RATES
                          FISCAL YEAR 2004-05

     (No change has been made to these rates since October 1, 2001 except for the elimination of
                      the Observation Inpatient rate as of November 1, 2004)

                                                                                         HOSPITAL &
                                                                                       RELATED STAFF
                                                                                          SERVICES

    INPATIENT SERVICES
    Acute Medical                                                                             $5,207
    Surgical                                                                                   6,082
    Clinical Study Center                                                                      5,207
    Nursery Acute (no related delivery)                                                        5,501
    Pediatrics                                                                                 5,501
    Intensive Care - Pediatrics                                                               12,612
    Burn ICU                                                                                  15,147
    Nursery-Newborn (mother is ineligible)                                                     3,900
    Psychiatric                                                                                1,384
    OB Mother                                                                                  5,789
    OB Nursery                                                                                 3,900
    Skilled Nursing Administrative Days - Routine                                                  -
    Jail                                                                                       3,077
    Neonatal Intensive Care - Level 2                                                          5,981
    Neonatal Intensive Care - Level 1                                                          5,186
    Cadaver Organ Harvest                                                                     17,807
    Intensive Care - Adults                                                                   12,612
    Neonatal Intensive Care Unit                                                              12,612




File: b6be768b-960c-4470-ba54-460b8427082c.xls Tab: IP/rmm Date: 3/25/2010
                COUNTY OF LOS ANGELES - DEPARTMENT OF HEALTH SERVICES
                       LAC+USC MEDICAL CENTER
           INPATIENT & OUTPATIENT CHARGEABLE DAYS & VISITS
                         JULY 2004 TO MAY 2005

                              TOP 25 BY VOLUME


                                                                            YTD
CHG CODE        DESCRIPTION                               RATE          DAYS / VISITS
1062            MINOR TRAUMA PROCEDUR                   $    300           14,945
6093            OPHTHALMOLOGY                           $    650           13,092
1063            MINOR TRAUMA PROCEDUR                   $    650            8,601
1052            AMBULATORY EMERGENCY                    $    300            7,799
4012            PED EMERGENCY RM                        $    300            7,227
0190702         INGLE PSY ADULT/EPAV                    $ 1,384             7,044
5643            ORTHO TRAUMA                            $    650            6,902
3034            PSYCH EVAL                              $    800            6,830
0172908         W&C NICU/X4L7                           $ 12,612            6,565
3503            PSYCH ADULT                             $    650            6,543
0113035         GH ACUTE MEDICAL/82                     $ 5,207             6,451
0116038         GH ACUTE MEDICAL/87                     $ 5,207             6,328
0110031         GH ACUTE MEDICAL/73                     $ 5,207             6,299
0127290         GH SURGICAL/30                          $ 6,082             6,044
1064            MINOR TRAUMA PROCEDUR                   $    800            5,931
0122036         GH ACUTE MEDICAL/83                     $ 5,207             5,845
0108035         GH ACUTE MEDICAL/67                     $ 5,207             5,688
6635            DENTAL ORAL SURGERY                     $ 1,000             5,565
0128298         GH SURGICAL/32                          $ 6,082             5,312
6303            OTOLARYNGOLOGY ENT                      $    650            5,088
0130294         GH SURGICAL/38                          $ 6,082             5,038
0111039         GH ACUTE MEDICAL/77                     $ 5,207             4,967
0182683         W&C PEDIATRICS/6K                       $ 5,501             4,827
0121756         GH INTENSIVE CARE/X70                   $ 12,612            4,798
0106765         GH INTENSIVE CARE/X62                   $ 12,612            4,789




SOURCE: AFFINITY PVC REPORT

								
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