Summary Rate Increase Summary Rate Increase 2005 to 2006 Mills Peninsula Rate by fsd65350

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									Summary Rate Increase 2005 to 2006
Mills Peninsula Rate Increase        7.6%
                                                    c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                               CURRENT CURRENT          DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                   INPATIENT OUTPATIENT CODE
                                                                   PRICE      PRICE
     01490626-6010   OBS VENIPUNCTURE                                   65.00         65.00     6010     Intensive Care Unit
     01490635-6010   OBS INJ IVP SNGL/INIT DRG                         116.00        116.00     6010     Intensive Care Unit
     00102145-6010   Room ICU                                         9010.00          0.00     6010     Intensive Care Unit
     00102178-6010   Room ICU                                         9010.00          0.00     6010     Intensive Care Unit
     00103003-6010   Room Med/Surg/Gyn                                4525.00          0.00     6010     Intensive Care Unit
     00103013-6010   Room Telemetry/Spec Care                         5410.00          0.00     6010     Intensive Care Unit
     00104150-6010   OBSERVATION PER HOUR                              188.00        188.00     6010     Intensive Care Unit
     01490633-6150   OBS INFUSION W/MED 0-60MN                          53.00         53.00     6150     Telemetry Care Unit
     01490631-6150   OBS HYDRAT INF ADD HR 8MX                          53.00         53.00     6150     Telemetry Care Unit
     01490630-6150   OBS HYDRATN INFSN 0-60MN                           53.00         53.00     6150     Telemetry Care Unit
     01490634-6150   OBS INF W/MED ADD HR 8MX                           53.00         53.00     6150     Telemetry Care Unit
     01490617-6150   OBS BLOOD TRANSFSN 2-4 HR                         332.00        332.00     6150     Telemetry Care Unit
     01490625-6150   OBS PLACE NEEDLE IN VEIN                           64.00         64.00     6150     Telemetry Care Unit
     01490662-6150   OBS INSERT CATH TMP SMPL                           57.00         57.00     6150     Telemetry Care Unit
     01490638-6150   OBS INJECTION IM/SQ EA                             42.00         42.00     6150     Telemetry Care Unit
     01490656-6150   GLUCOSE FINGERSTICK                                42.00         42.00     6150     Telemetry Care Unit
     01490628-6150   OBS COLL BLD VNS ACCS DVC                          54.00         54.00     6150     Telemetry Care Unit
     01490635-6150   OBS INJ IVP SNGL/INIT DRG                         116.00        116.00     6150     Telemetry Care Unit
     00103011-6150   Room Telemetry/Spec Care                         3855.00          0.00     6150     Telemetry Care Unit
     01490100-6150   Cardiovert Elective Ext                          2386.00       2386.00     6150     Telemetry Care Unit
     00103013-6150   Room Telemetry/Spec Care                         5410.00          0.00     6150     Telemetry Care Unit
     00104150-6150   OBSERVATION PER HOUR                              188.00        188.00     6150     Telemetry Care Unit
     01490631-6177   OBS HYDRAT INF ADD HR 8MX                          53.00         53.00     6177     Ortho M/S 2FL
     01490656-6177   GLUCOSE FINGERSTICK                                42.00         42.00     6177     Ortho M/S 2FL
     01490630-6177   OBS HYDRATN INFSN 0-60MN                           53.00         53.00     6177     Ortho M/S 2FL
     01490614-6177   OBS BLOOD TRANSFSN LT 2HR                         166.00        166.00     6177     Ortho M/S 2FL
     01490625-6177   OBS PLACE NEEDLE IN VEIN                           64.00         64.00     6177     Ortho M/S 2FL
     01490638-6177   OBS INJECTION IM/SQ EA                             42.00         42.00     6177     Ortho M/S 2FL
     01490635-6177   OBS INJ IVP SNGL/INIT DRG                         116.00        116.00     6177     Ortho M/S 2FL
     01490623-6177   OBS BLOOD TRANSFSN GT 6HR                         998.00        998.00     6177     Ortho M/S 2FL
     00103003-6177   Room Med/Surg/Gyn                                4525.00          0.00     6177     Ortho M/S 2FL
     00104150-6177   OBSERVATION PER HOUR                              188.00        188.00     6177     Ortho M/S 2FL
     00106675-6179   Supportive Care Regular Rate                      630.00        630.00     6179     Recovery Care Inn
     00106670-6179   Supportive Care Spa Rate                          450.00        450.00     6179     Recovery Care Inn
     01590635-6179   OBS INJ IVP SNGL/INIT DRG                          41.00         41.00     6179     Recovery Care Inn
     01590626-6179   OBS VENIPUNCTURE                                   65.00         65.00     6179     Recovery Care Inn
     01590629-6179   OBS INFN W/WO MEDS 0-60MN                          82.00         82.00     6179     Recovery Care Inn
     01590632-6179   OBS INFN W/WO MEDS ADD HR                          82.00         82.00     6179     Recovery Care Inn



8/31/2010                                                                                                                         2
                                                   c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                              CURRENT      CURRENT        DEPARTMENT    DEPARTMENT DESCRIPTION
                                                                  INPATIENT    OUTPATIENT     CODE
                                                                  PRICE        PRICE
     01590638-6179   OBS INJECTION IM/SQ EA                            41.00          41.00          6179   Recovery Care Inn
     01590656-6179   GLUCOSE FINGERSTICK                          41           41             6179          Recovery Care Inn
     01590662-6179   OBS INSERT CATH TMP SMPL                     57           57             6179          Recovery Care Inn
     01520567-6179   OBS PULSE OX MULTIPLE                            132.00         132.00          6179   Recovery Care Inn
     01520557-6179   OBS PULSE-OX OVRNITE CONT                        439.00         439.00          6179   Recovery Care Inn
     01510904-6179   S O2 Oxygen Initial Day                          862.00         862.00          6179   Recovery Care Inn
     01511001-6179   S O2 Oxygen Subsequent Days                      700.00         700.00          6179   Recovery Care Inn
     00103003-6179   Room Med/Surg/Gyn                               4525.00           0.00          6179   Recovery Care Inn
     00104150-6179   OBSERVATION PER HOUR                             188.00         188.00          6179   Recovery Care Inn
     01490626-6187   OBS VENIPUNCTURE                                  65.00          65.00          6187   Med/Surg 7th Floor
     01490634-6187   OBS INF W/MED ADD HR 8MX                          53.00          53.00          6187   Med/Surg 7th Floor
     01490653-6187   OBS DECLOT VASC DEVICE                           119.00         119.00          6187   Med/Surg 7th Floor
     01490656-6187   GLUCOSE FINGERSTICK                               42.00          42.00          6187   Med/Surg 7th Floor
     01490659-6187   OBS BLADDER IRRIG SMPL                            57.00          57.00          6187   Med/Surg 7th Floor
     01490638-6187   OBS INJECTION IM/SQ EA                            42.00          42.00          6187   Med/Surg 7th Floor
     01490630-6187   OBS HYDRATN INFSN 0-60MN                          53.00          53.00          6187   Med/Surg 7th Floor
     01490635-6187   OBS INJ IVP SNGL/INIT DRG                        116.00         116.00          6187   Med/Surg 7th Floor
     01490631-6187   OBS HYDRAT INF ADD HR 8MX                         53.00          53.00          6187   Med/Surg 7th Floor
     01490614-6187   OBS BLOOD TRANSFSN LT 2HR                        166.00         166.00          6187   Med/Surg 7th Floor
     01490633-6187   OBS INFUSION W/MED 0-60MN                         53.00          53.00          6187   Med/Surg 7th Floor
     01490662-6187   OBS INSERT CATH TMP SMPL                          57.00          57.00          6187   Med/Surg 7th Floor
     01490625-6187   OBS PLACE NEEDLE IN VEIN                          64.00          64.00          6187   Med/Surg 7th Floor
     01490623-6187   OBS BLOOD TRANSFSN GT 6HR                        998.00         998.00          6187   Med/Surg 7th Floor
     01490617-6187   OBS BLOOD TRANSFSN 2-4 HR                        332.00         332.00          6187   Med/Surg 7th Floor
     00103003-6187   Room Med/Surg/Gyn                               4525.00           0.00          6187   Med/Surg 7th Floor
     00103001-6187   Room Med/Surg/Gyn                               2950.00           0.00          6187   Med/Surg 7th Floor
     00103002-6187   Room Med/Surg/Gyn                               3635.00           0.00          6187   Med/Surg 7th Floor
     00104150-6187   OBSERVATION PER HOUR                             188.00         188.00          6187   Med/Surg 7th Floor
     01490635-6188   OBS INJ IVP SNGL/INIT DRG                        116.00         116.00          6188   Med/Surg 8th Floor
     01490630-6188   OBS HYDRATN INFSN 0-60MN                          53.00          53.00          6188   Med/Surg 8th Floor
     01490638-6188   OBS INJECTION IM/SQ EA                            42.00          42.00          6188   Med/Surg 8th Floor
     01490623-6188   OBS BLOOD TRANSFSN GT 6HR                        998.00         998.00          6188   Med/Surg 8th Floor
     01490620-6188   OBS BLOOD TRANSFSN 4-6 HR                        666.00         666.00          6188   Med/Surg 8th Floor
     01490631-6188   OBS HYDRAT INF ADD HR 8MX                         53.00          53.00          6188   Med/Surg 8th Floor
     01490617-6188   OBS BLOOD TRANSFSN 2-4 HR                        332.00         332.00          6188   Med/Surg 8th Floor
     01490625-6188   OBS PLACE NEEDLE IN VEIN                          64.00          64.00          6188   Med/Surg 8th Floor
     01490614-6188   OBS BLOOD TRANSFSN LT 2HR                        166.00         166.00          6188   Med/Surg 8th Floor
     01490656-6188   GLUCOSE FINGERSTICK                               42.00          42.00          6188   Med/Surg 8th Floor



8/31/2010                                                                                                                            3
                                                          c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                                     CURRENT CURRENT          DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                         INPATIENT OUTPATIENT CODE
                                                                         PRICE      PRICE
     01490659-6188   OBS BLADDER IRRIG SMPL                                   57.00         57.00     6188     Med/Surg 8th Floor
     01490662-6188   OBS INSERT CATH TMP SMPL                                 57.00         57.00     6188     Med/Surg 8th Floor
     01490633-6188   OBS INFUSION W/MED 0-60MN                                53.00         53.00     6188     Med/Surg 8th Floor
     01490634-6188   OBS INF W/MED ADD HR 8MX                                 53.00         53.00     6188     Med/Surg 8th Floor
     00103001-6188   Room Med/Surg/Gyn                                      2950.00          0.00     6188     Med/Surg 8th Floor
     00103003-6188   Room Med/Surg/Gyn                                      4525.00          0.00     6188     Med/Surg 8th Floor
     00104150-6188   OBSERVATION PER HOUR                                    188.00        188.00     6188     Med/Surg 8th Floor
     00101135-6290   Room Pediatric                                         3805.00          0.00     6290     Pediatrics
     00103003-6290   Room Med/Surg/Gyn                                      4525.00          0.00     6290     Pediatrics
     00104150-6290   OBSERVATION PER HOUR                                    188.00        188.00     6290     Pediatrics
     00102285-6340   Room Behavioral Health                                 3725.00          0.00     6340     Psychiatric Acute-Adult
     00182301-6340   Room Behavioral Health                                 4570.00          0.00     6340     Psychiatric Acute-Adult
     00182301-6360   Room Behavioral Health                                 4570.00          0.00     6360     Adolescent I/P Mental
     06799204-6400   Level 4 New Patient                                    4412.00       4412.00     6400     Family Birth Center
     06776815-6400   US OB Ltd 1/More Fetuses                                275.00        275.00     6400     Family Birth Center
     06776946-6400   US Amniocentesis                                        689.00        689.00     6400     Family Birth Center
     06790784-6400   INJ IVP SNGL/INiT DRG                                   552.00        552.00     6400     Family Birth Center
     06799201-6400   Level 1 New Patient                                     511.00        511.00     6400     Family Birth Center
     06731775-6400   S STRL Fetal Pulse Oximetry Mon Se                     1286.00       1286.00     6400     Family Birth Center
     06743000-6400   Injection IM/SQ Ea                                      275.00        275.00     6400     Family Birth Center
     06799203-6400   Level 3 New Patient                                    1146.00       1146.00     6400     Family Birth Center
     06732441-6400   NST Multi Gest                                          552.00        552.00     6400     Family Birth Center
     06799205-6400   Level 5 New Patient                                    5514.00       5514.00     6400     Family Birth Center
     06799211-6400   Level 1 Est Patient                                     661.00        661.00     6400     Family Birth Center
     06799212-6400   Level 2 Est Patient                                    2205.00       2205.00     6400     Family Birth Center
     06799213-6400   Level 3 Est Patient                                    1285.00       1285.00     6400     Family Birth Center
     06799202-6400   Level 2 New Patient                                    2205.00       2205.00     6400     Family Birth Center
     06703031-6400   Surg Lvl 3 Add 15M                                     2068.00       2068.00     6400     Family Birth Center
     06703301-6400   Cplx Genrl Anes Add 15M                                1241.00       1241.00     6400     Family Birth Center
     06703300-6400   Cplx Genrl Anes First 30M                              2757.00       2757.00     6400     Family Birth Center
     06703201-6400   Stnd Genrl Anes Add 15M                                 966.00        966.00     6400     Family Birth Center
     06703200-6400   Stnd Genrl Anes First 30M                              2205.00       2205.00     6400     Family Birth Center
     06703500-6400   STND PACU LVL 1 FIRST 30M                               552.00        552.00     6400     Family Birth Center
     06703501-6400   STND PACU LVL 1 ADD 15M                                 275.00        275.00     6400     Family Birth Center
     06703100-6400   Reg First 30M                                          1103.00       1103.00     6400     Family Birth Center
     01654150-6400   Circumcision                                            414.00        414.00     6400     Family Birth Center
     06703030-6400   Surg Lvl 3 First 30M                                   8272.00       8272.00     6400     Family Birth Center
     06703021-6400   Surg Lvl 2 Add 15M                                     1103.00       1103.00     6400     Family Birth Center



8/31/2010                                                                                                                                4
                                                          c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                                     CURRENT CURRENT          DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                         INPATIENT OUTPATIENT CODE
                                                                         PRICE      PRICE
     06703020-6400   Surg Lvl 2 First 30M                                   5514.00       5514.00     6400     Family Birth Center
     06703011-6400   Surg Lvl 1 Add 15M                                      552.00        552.00     6400     Family Birth Center
     06703010-6400   Surg Lvl 1 First 30M                                   2482.00       2482.00     6400     Family Birth Center
     06799215-6400   Level 5 Est Patient                                    5514.00       5514.00     6400     Family Birth Center
     06703101-6400   Reg Add 15M                                             414.00        414.00     6400     Family Birth Center
     00101560-6400   Room OB/Maternal                                       7646.00          0.00     6400     Family Birth Center
     06701505-6400   External Version                                       1379.00       1379.00     6400     Family Birth Center
     06750115-6400   Level 1 Consult Minor                                    82.00         82.00     6400     Family Birth Center
     06750130-6400   Level 2 Consult Low                                     151.00        151.00     6400     Family Birth Center
     06750140-6400   Level 3 Consult Moderate                                175.00        175.00     6400     Family Birth Center
     06750160-6400   Level 4 Consult Mod/High                                233.00        233.00     6400     Family Birth Center
     06750180-6400   Level 5 Consult High                                    292.00        292.00     6400     Family Birth Center
     06799214-6400   Level 4 Est Patient                                    4412.00       4412.00     6400     Family Birth Center
     06780308-6400   S STRL Vacuum Extractor                                 239.00        239.00     6400     Family Birth Center
     01631200-6400   S STRL Disp Syringe Breast Feed Sy                      201.00        201.00     6400     Family Birth Center
     06780100-6400   S STRL Intran II Infusion Cath                          356.00        356.00     6400     Family Birth Center
     06732440-6400   NST (Non-Stress Test)                                   414.00        414.00     6400     Family Birth Center
     06731723-6400   S STRL Spiral Electrode                                 312.00        312.00     6400     Family Birth Center
     01613637-6400   S STRL Breast Pump                                      265.00        265.00     6400     Family Birth Center
     00103003-6400   Room Med/Surg/Gyn                                      4525.00          0.00     6400     Family Birth Center
     00101510-6400   Newborn Boarder Baby                                   1650.00          0.00     6400     Family Birth Center
     00101512-6400   Newborn Level I                                        1870.00          0.00     6400     Family Birth Center
     00101514-6400   Newborn Level II                                       4480.00          0.00     6400     Family Birth Center
     00101516-6400   Newborn Level III                                      6170.00          0.00     6400     Family Birth Center
     00101518-6400   Newborn Level IV                                       8390.00          0.00     6400     Family Birth Center
     00101522-6400   NEWBORN LEVEL I                                        1650.00          0.00     6400     Family Birth Center
     00104150-6400   OBSERVATION PER HOUR                                    188.00        188.00     6400     Family Birth Center
     00102343-6420   Room Rehab Acute                                       2280.00          0.00     6420     Chemical Dependency IP
     00102327-6420   Room Detox                                             2780.00          0.00     6420     Chemical Dependency IP
     00101024-6440   Room Rehab Acute                                       5145.00          0.00     6440     Center For Acute Rehab
     00101200-6440   Room Rehab Acute                                       4170.00          0.00     6440     Center For Acute Rehab
     00103003-6580   Room Med/Surg/Gyn                                      4525.00          0.00     6580     Skilled Nursing 2FL
     00102012-6580   Room Snf M/S Dsnct                                     1905.00          0.00     6580     Skilled Nursing 2FL
     00103003-6582   Room Med/Surg/Gyn                                      4525.00          0.00     6582     Skilled Nursing 6FL
     00102012-6582   Room Snf M/S Dsnct                                     1905.00          0.00     6582     Skilled Nursing 6FL
     06090520-7010   ED Proc Major                                          1168.00       1168.00     7010     Emergency Department
     06090510-7010   ED Proc Minor                                           551.00        551.00     7010     Emergency Department
     06091215-7010   Glucose Fingerstick                                      42.00         42.00     7010     Emergency Department



8/31/2010                                                                                                                               5
                                                 c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                            CURRENT CURRENT          DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                INPATIENT OUTPATIENT CODE
                                                                PRICE      PRICE
     06091180-7010   Blood Transfusn GT 6Hr                         998.00        998.00     7010     Emergency Department
     06090450-7010   ED CC Ea Add 30 Mn                            1995.00       1995.00     7010     Emergency Department
     06091105-7010   Cardiovert Elective Ext                        208.00        208.00     7010     Emergency Department
     06091115-7010   EKG 12 LEAD TRACING ONLY                       222.00        222.00     7010     Emergency Department
     06091120-7010   Gastric Lavage                                 208.00        208.00     7010     Emergency Department
     06091125-7010   GI Intub Cont Hem                              208.00        208.00     7010     Emergency Department
     06091130-7010   Ipecac Administration                          105.00        105.00     7010     Emergency Department
     06091198-7010   ADMIN IMMUN EA ADD VACC                         42.00         42.00     7010     Emergency Department
     06091140-7010   Sedation IV/IM                                 105.00        105.00     7010     Emergency Department
     06091194-7010   VX DTP DIP/TETTOX /PERTUS                       42.00         42.00     7010     Emergency Department
     06091145-7010   Sedation PO/PR/Intranasal                      105.00        105.00     7010     Emergency Department
     06091150-7010   Thrombolysis Coro IV                           208.00        208.00     7010     Emergency Department
     06091190-7010   Injection IM/SQ Ea                             120.00        120.00     7010     Emergency Department
     06091185-7010   INJ IV PUSH SNGL/INT                           116.00        116.00     7010     Emergency Department
     06091175-7010   Blood Transfusn 4-6 Hr                         666.00        666.00     7010     Emergency Department
     06090500-7010   Medical Screening                              255.00        255.00     7010     Emergency Department
     06091170-7010   BLOOD TRANSFUSN 2-4 HR                         332.00        332.00     7010     Emergency Department
     06091165-7010   Blood Transfusn LT 2 Hr                        166.00        166.00     7010     Emergency Department
     06091160-7010   INFSN W-W/O MED 0-60 MN                        121.00        121.00     7010     Emergency Department
     06091237-7010   CS SAME MD GT5YR 0-30M                         209.00        209.00     7010     Emergency Department
     06020567-7010   Pulse Oximetry - Multiple                      132.00        132.00     7010     Emergency Department
     06020507-7010   Pulse Oximetry - Single                         98.00         98.00     7010     Emergency Department
     06030160-7010   Aerosol Tx Demo/Eval                           160.00        160.00     7010     Emergency Department
     01410221-7010   INFSN W/MED ADD HR 8 MX                        119.00        119.00     7010     Emergency Department
     01410220-7010   INFUSION W/MED 0-60MN                          178.00        178.00     7010     Emergency Department
     01410218-7010   HYDRATION INFSN 0-60MN                         178.00        178.00     7010     Emergency Department
     06091238-7010   CS SAME MD ADD 15M                             104.00        104.00     7010     Emergency Department
     01410163-7010   INJECTION IM/SQ EA                              59.00         59.00     7010     Emergency Department
     06091236-7010   CS SAME MD LT5YR 0-30M                         209.00        209.00     7010     Emergency Department
     06091235-7010   IRRIG IMPLNTD VNS ACC DVC                       59.00         59.00     7010     Emergency Department
     06091234-7010   HYDRATION INFSN 0-60MN                         119.00        119.00     7010     Emergency Department
     06091233-7010   HYDRATION INFSN 0-60MN                         178.00        178.00     7010     Emergency Department
     06091232-7010   INFSN W/MED ADD SEQ 0-60M                      178.00        178.00     7010     Emergency Department
     06091231-7010   INFSN W/MED ADD HR 8 MX                        119.00        119.00     7010     Emergency Department
     06091230-7010   INFUSION W/MED 0-60MN                          178.00        178.00     7010     Emergency Department
     06091178-7010   ED Level 1                                     295.00        295.00     7010     Emergency Department
     06090105-7010   ED Level 2                                     480.00        480.00     7010     Emergency Department
     06090114-7010   ED Level 3                                    1093.00       1093.00     7010     Emergency Department



8/31/2010                                                                                                                      6
                                                  c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                             CURRENT CURRENT          DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                 INPATIENT OUTPATIENT CODE
                                                                 PRICE      PRICE
     06090213-7010   ED Level 4                                     1775.00       1775.00     7010     Emergency Department
     01491042-7010   BLOOD TRANSFUSN 4-6 HR                          666.00        666.00     7010     Emergency Department
     06090411-7010   ED CC 1st 30-74 Mn                             3252.00       3252.00     7010     Emergency Department
     00103013-7010   Room Telemetry/Spec Care                       5410.00          0.00     7010     Emergency Department
     00103001-7010   Room Med/Surg/Gyn                              2950.00          0.00     7010     Emergency Department
     06090312-7010   ED Level 5                                     2021.00       2021.00     7010     Emergency Department
     07005703-7060   INJECTION IM/SQ EA                               50.00         50.00     7060     BH Psych Emergency
     07005148-7060   PSYC EVAL RCRD/RPRT/TESTS                       500.00        500.00     7060     BH Psych Emergency
     07005045-7060   CONSULTATION W FAMILY                           332.00        332.00     7060     BH Psych Emergency
     07020034-7060   PSYC DX INTERVIEW 15 MIN                        259.00        259.00     7060     BH Psych Emergency
     07004559-7060   OBSERVATION PER-HOUR                            728.00        728.00     7060     BH Psych Emergency
     07004229-7060   PSYC DX INTERVIEW 2 HR                         1746.00       1746.00     7060     BH Psych Emergency
     07004146-7060   PSYC DX INTERVIEW 1.5 HR                       1570.00       1570.00     7060     BH Psych Emergency
     07004062-7060   PSYC DX INTERVIEW 1 HR                          870.00        870.00     7060     BH Psych Emergency
     07004021-7060   PSYC DX INTERVIEW 30 MIN                        526.00        526.00     7060     BH Psych Emergency
     07094121-7060   SMC MEDI-CAL/INDIGENT CRISIS XFER               234.00        234.00     7060     BH Psych Emergency
     08013109-7220   PSYO TX MULTIFAMILY GRP-D                       194.00        194.00     7220     Chemical Dependency OP
     08011113-7220   PSYC TX GROUP-D                                 194.00        194.00     7220     Chemical Dependency OP
     08012031-7220   PSYC TX FAMILY WO PAT-D                         316.00        316.00     7220     Chemical Dependency OP
     08010024-7220   PSYC TX 20-30M OP-D                             146.00        146.00     7220     Chemical Dependency OP
     08012026-7220   PSYC TX FAMILY WO PAT-A                         316.00        316.00     7220     Chemical Dependency OP
     08010005-7220   PSYC TX 45-50M OP-D                             316.00        316.00     7220     Chemical Dependency OP
     08013015-7220   CHEM DEP/RECOVERY GRP ED                         48.00         48.00     7220     Chemical Dependency OP
     08013104-7220   PSYO TX MULTIFAMILY GRP-A                       194.00        194.00     7220     Chemical Dependency OP
     08001000-7220   PSYC SERVICE THERAPY                           1021.00       1021.00     7220     Chemical Dependency OP
     08010019-7220   PSYC TX 20-30M OP-A                             146.00        146.00     7220     Chemical Dependency OP
     08011108-7220   PSYC TX GROUP-A                                 194.00        194.00     7220     Chemical Dependency OP
     08012007-7220   PSYO TX FAM W PATIENT-A                         316.00        316.00     7220     Chemical Dependency OP
     08011116-7220   PSYC TX 45-50M OP-A                             316.00        316.00     7220     Chemical Dependency OP
     08000113-7220   ALCOHOL BREATH                                   76.00         76.00     7220     Chemical Dependency OP
     01410218-7230   HYDRATION INFSN 0-60MN                          178.00        178.00     7230     O/P Procedures
     01491334-7230   LEVEL 3 EST PATIENT                             194.00        194.00     7230     O/P Procedures
     01491331-7230   LEVEL 2 EST PATIENT                             130.00        130.00     7230     O/P Procedures
     01491328-7230   LEVEL 1 EST PATIENT                              66.00         66.00     7230     O/P Procedures
     01491322-7230   LEVEL 4 NEW PATIENT                             259.00        259.00     7230     O/P Procedures
     01491316-7230   LEVEL 2 NEW PATIENT                             130.00        130.00     7230     O/P Procedures
     01491303-7230   INS PICC W/O PORT 5+ YR                         356.00        356.00     7230     O/P Procedures
     01410160-7230   COLLECT BLD VNS ACCES DVC                        59.00         59.00     7230     O/P Procedures



8/31/2010                                                                                                                       7
                                                         c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                                    CURRENT CURRENT          DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                        INPATIENT OUTPATIENT CODE
                                                                        PRICE      PRICE
     01491054-7230   BLOOD TRANSFUSN GT 6HR                                 998.00        998.00     7230     O/P Procedures
     01491048-7230   BLOOD TRANSFUSN 2-4 HR                                 332.00        332.00     7230     O/P Procedures
     01491045-7230   BLOOD TRANSFUSN LT 2 HR                                166.00        166.00     7230     O/P Procedures
     01491337-7230   LEVEL 4 EST PATIENT                                    259.00        259.00     7230     O/P Procedures
     01410217-7230   CHEM IVP SNGL/INIT DRG                                 238.00        238.00     7230     O/P Procedures
     01410219-7230   HYDRATN INFSN ADD HR 8MX                               119.00        119.00     7230     O/P Procedures
     01410220-7230   INFUSION W/MED 0-60MN                                  178.00        178.00     7230     O/P Procedures
     01410222-7230   CHEM IVP EA ADDL DRG                                   238.00        238.00     7230     O/P Procedures
     01410223-7230   INJ IVP ADDL SEQ NEW DRG                               120.00        120.00     7230     O/P Procedures
     01410224-7230   IRRIG IMPLNTD VNS ACC DVC                               59.00         59.00     7230     O/P Procedures
     01410213-7230   INFUSN CHEMO 0-60 MN                                   238.00        238.00     7230     O/P Procedures
     01410310-7230   INFUSN CHEMO EA ADD HR                                 238.00        238.00     7230     O/P Procedures
     01410211-7230   INJ IVP SNGL/INIT DRG                                  238.00        238.00     7230     O/P Procedures
     01410163-7230   INJECTION IM/SQ EA                                      59.00         59.00     7230     O/P Procedures
     01491040-7230   LP DIAGNOSTIC                                          119.00        119.00     7230     O/P Procedures
     01410221-7230   INFSN W/MED ADD HR 8 MX                                119.00        119.00     7230     O/P Procedures
     01491042-7230   BLOOD TRANSFUSN 4-6 HR                                 666.00        666.00     7230     O/P Procedures
     01491059-7230   PHLEBOTOMY THERAPEUTIC                                 178.00        178.00     7230     O/P Procedures
     01520420-7232   Spn/Brn Rfl/Maint Imp Pmp                              552.00        552.00     7232     Rehab Day Hospital
     07000420-7260   PHP FULL DAY EATING DIS                               1624.00       1624.00     7260     Mental Health Outpatient
     07005605-7260   PSYC TX GROUP                                          210.00        210.00     7260     Mental Health Outpatient
     07010007-7260   PSYC TX FAMILY WO PATIENT                              287.00        287.00     7260     Mental Health Outpatient
     07010635-7260   PSYO TX MULTIFAMILY GROUP                              194.00        194.00     7260     Mental Health Outpatient
     07000425-7260   PHP FULL DAY DUAL DX                                  1624.00       1624.00     7260     Mental Health Outpatient
     07010009-7260   INTENSIVE OP EATING DIS                                862.00        862.00     7260     Mental Health Outpatient
     07010630-7260   PSYC TX 75-80M OP                                      327.00        327.00     7260     Mental Health Outpatient
     07000300-7260   PHP FULL DAY                                          1507.00       1507.00     7260     Mental Health Outpatient
     07010004-7260   INTENSIVE OP                                             0.00        829.00     7260     Mental Health Outpatient
     07010002-7260   PSYO TX FAM W PATIENT                                  287.00        287.00     7260     Mental Health Outpatient
     07010620-7260   PSYC TX 20-30M OP                                      130.00        130.00     7260     Mental Health Outpatient
     07010625-7260   PSYC TX 45-50M OP                                      264.00        264.00     7260     Mental Health Outpatient
     08810900-7320   Social Day Assessment                                    0.00         67.00     7320     Adult Day Health
     08810305-7320   Adult Day Health Assessment     P                        0.00         67.00     7320     Adult Day Health
     08810910-7320   Social Day Regular                                       0.00         37.00     7320     Adult Day Health
     08810301-7320   Adult Day Health Assessment                             77.24         77.24     7320     Adult Day Health
     08810103-7320   Adult Day Health Minimal                                73.56         73.56     7320     Adult Day Health
     08810506-7320   Adult Day Health Program Prvt Pay                        0.00         87.00     7320     Adult Day Health
     08810507-7320   Adult Day Health Program Prvt Pay                        0.00         67.00     7320     Adult Day Health



8/31/2010                                                                                                                                8
                                                      c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                                 CURRENT CURRENT          DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                     INPATIENT OUTPATIENT CODE
                                                                     PRICE      PRICE
     08810508-7320   Adult Day Health Program Prvt Pay                     0.00         47.00     7320     Adult Day Health
     08822220-7320   ADHP VA                                               0.00         71.03     7320     Adult Day Health
     00809210-7420   S IMP:C-Taper Head (All Sizes)                     1563.00       1563.00     7420     Operating Room
     00809130-7420   S IMP:Omnifit Eon Plus Cementd Ste                 4317.00       4317.00     7420     Operating Room
     00801800-7420   Cell Saver Service                                 1899.00       1899.00     7420     Operating Room
     00801815-7420   Perfusion Service                                  3178.00       3178.00     7420     Operating Room
     00809125-7420   S IMP:Omnifit Cemented Stem                        4317.00       4317.00     7420     Operating Room
     00809120-7420   S IMP:Odc-Fx Hip Stem                              1700.00       1700.00     7420     Operating Room
     00829548-7420   S STRL:Forcep Biocoag 5+10mm                       2118.00       2118.00     7420     Operating Room
     00809450-7420   S IMP:Cultured Chondrocyte Implant                 2216.00       2216.00     7420     Operating Room
     00829645-7420   S STRL:Morcellator Diva                            1971.00       1971.00     7420     Operating Room
     00809315-7420   S IMP:Outer Shell                                  2378.00       2378.00     7420     Operating Room
     00825240-7420   S STRL:Perfluron Sol Set                           1404.00       1404.00     7420     Operating Room
     00845420-7420   S IMP:Gastric Band                                 7572.00       7572.00     7420     Operating Room
     00825220-7420   S STRL:Ash Split Cath                              1504.00       1504.00     7420     Operating Room
     00829601-7420   S STRL:Forcep Molly 3mm                            1319.00       1319.00     7420     Operating Room
     00809355-7420   S IMP:Cancellous Screw                              509.00        509.00     7420     Operating Room
     00809445-7420   S IMP:Tibial Bearing Insert P/S                    1852.00       1852.00     7420     Operating Room
     00809440-7420   S IMP:Tibial Bearing Insert                        1836.00       1836.00     7420     Operating Room
     00809435-7420   S IMP:Resurfacing Patella Componen                 1534.00       1534.00     7420     Operating Room
     00809430-7420   S IMP:Recessed Patella Component                   1534.00       1534.00     7420     Operating Room
     00809425-7420   S IMP:Standard Tibial Tray M/S                     2632.00       2632.00     7420     Operating Room
     00809420-7420   S IMP:Standard Tibial Tray                         2058.00       2058.00     7420     Operating Room
     00809215-7420   S IMP:Universal Head                               1948.00       1948.00     7420     Operating Room
     00809410-7420   S IMP:Scorpio Femoral Component                    4703.00       4703.00     7420     Operating Room
     00809310-7420   S IMP:Acetabular Shell                             2378.00       2378.00     7420     Operating Room
     00809345-7420   S IMP:Univers Distal Cement Spacer                  538.00        538.00     7420     Operating Room
     00702101-7420   Stnd Genrl Anes First 30M                           796.00        796.00     7420     Operating Room
     00809340-7420   S IMP:Insert 32mm                                  1766.00       1766.00     7420     Operating Room
     00809325-7420   S IMP:Cup Insert                                   1766.00       1766.00     7420     Operating Room
     00809320-7420   S IMP:Acetabular Outer Shell                       2378.00       2378.00     7420     Operating Room
     00845425-7420   S STRL:Gastric Balloon Catheter                    1270.00       1270.00     7420     Operating Room
     00809415-7420   S IMP:Scorpio Femoral Component M/                 4811.00       4811.00     7420     Operating Room
     00802501-7420   Surg Lvl 5 First 30M                               8209.00       8209.00     7420     Operating Room
     00702302-7420   Mac/Reg Add 15M                                     165.00        165.00     7420     Operating Room
     00702402-7420   MAC/Reg Add 15M                                     125.00        125.00     7420     Operating Room
     00802102-7420   Surg Lvl 1 Add 15M                                  821.00        821.00     7420     Operating Room
     00802202-7420   Surg Lvl 2 Add 15M                                  478.00        478.00     7420     Operating Room



8/31/2010                                                                                                                           9
                                                     c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                                CURRENT CURRENT          DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                    INPATIENT OUTPATIENT CODE
                                                                    PRICE      PRICE
     00802301-7420   Surg Lvl 3 First 30M                              5747.00       5747.00     7420     Operating Room
     00836550-7420   S BRACH SOURCE PALLADM103                            0.00          0.00     7420     Operating Room
     00802302-7420   Surg Lvl 3 Add 15M                                1642.00       1642.00     7420     Operating Room
     00702301-7420   Mac/Reg First 30M                                  329.00        329.00     7420     Operating Room
     00802402-7420   Surg Lvl 4 Add 15M                                2462.00       2462.00     7420     Operating Room
     00802101-7420   Surg Lvl 1 First 30M                              3283.00       3283.00     7420     Operating Room
     00802502-7420   Surg Lvl 5 Add 15M                                3283.00       3283.00     7420     Operating Room
     01302101-7420   STND PACU LVL 1 FIRST 30M                          350.00        350.00     7420     Operating Room
     01302102-7420   STND PACU LVL 1 ADD 15M                            150.00        150.00     7420     Operating Room
     01302301-7420   Cplx PACU First 30M                                329.00        329.00     7420     Operating Room
     01302302-7420   Cplx PACU Add 15M                                  165.00        165.00     7420     Operating Room
     00825230-7420   S STRL:Hemo Cath Tray                              924.00        924.00     7420     Operating Room
     00802401-7420   Surg Lvl 4 First 30M                              6567.00       6567.00     7420     Operating Room
     00702102-7420   Stnd Genrl Anes Add 15M                            280.00        280.00     7420     Operating Room
     00809115-7420   S IMP:Primary Secure-Fit Stem                     6210.00       6210.00     7420     Operating Room
     00802201-7420   Surg Lvl 2 First 30M                              4105.00       4105.00     7420     Operating Room
     00702202-7420   Cplx Genrl Anes Add 15M                            248.00        248.00     7420     Operating Room
     00702201-7420   Cplx Genrl Anes First 30M                          494.00        494.00     7420     Operating Room
     00809110-7420   S IMP:Omni Fit Hip Stem                           5806.00       5806.00     7420     Operating Room
     00863757-7420   S PCR 2 CHMBR RR                                 11555.00      11555.00     7420     Operating Room
     00863758-7420   S PCR 1 CHMBR RR                                 10795.00      10795.00     7420     Operating Room
     00863764-7420   S LD PCR NO TV SNGL PAS                          10795.00      10795.00     7420     Operating Room
     00833115-7420   S IOL PRESBYOPIA CORRECT                           925.00        925.00     7420     Operating Room
     00836554-7420   S BRACH SOURCE CESIUM-131                          185.00        185.00     7420     Operating Room
     00895722-7420   S IMP:Breast Implant                                 0.00          0.00     7420     Operating Room
     00895714-7420   S IMP:Tissue/Bone Graft                              0.00          0.00     7420     Operating Room
     00884528-7420   S IMP:AMBI K Wire                                  251.00        251.00     7420     Operating Room
     00868851-7420   S STRL:Interceed                                  1453.00       1453.00     7420     Operating Room
     00863340-7420   S IMP:Gamma Femoral Diagonal Screw                1101.00       1101.00     7420     Operating Room
     00863316-7420   S IMP:Gamma Nail                                  4363.00       4363.00     7420     Operating Room
     00863324-7420   S IMP:Gamma Lag Screw                             2601.00       2601.00     7420     Operating Room
     00879098-7420   S IMP:Kwart Retro Stent                           1198.00       1198.00     7420     Operating Room
     00879304-7420   S NSTRL:Extr Rutner Balln Catheter                2513.00       2513.00     7420     Operating Room
     00879338-7420   S NSTRL:Occlusn Balln Cath MedTec                 1453.00       1453.00     7420     Operating Room
     00883553-7420   S STRL:Corneal Implants All                       6315.00       6315.00     7420     Operating Room
     00883579-7420   S IMP:Implants                                       0.00          0.00     7420     Operating Room
     00894048-7420   S IMP:Cbl.Grip: Cable Vitallium                   2839.00       2839.00     7420     Operating Room
     00884510-7420   S IMP:AMBI Cannula Screws 4.0                     1210.00       1210.00     7420     Operating Room



8/31/2010                                                                                                                          10
                                                      c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                                 CURRENT CURRENT          DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                     INPATIENT OUTPATIENT CODE
                                                                     PRICE      PRICE
     00895656-7420   S IMP:Baerveldt Eye Implant                        3181.00       3181.00     7420     Operating Room
     00880344-7420   S NSTRL:Tracheostomy Tubes                          423.00        423.00     7420     Operating Room
     00860965-7420   S NSTRL:Brace Knee Bledsoe L/R                     1453.00       1453.00     7420     Operating Room
     00837832-7420   S STRL Staple:Linear TRH30 (Reload                  514.00        514.00     7420     Operating Room
     00894030-7420   S IMP:Cbl.Grip: Cable Stainless                    2186.00       2186.00     7420     Operating Room
     00894055-7420   S IMP:Cbl.Grip: Sleeve Stainless                   1440.00       1440.00     7420     Operating Room
     00894063-7420   S IMP:Cbl.Grip: Sleeve Vitallium                   1561.00       1561.00     7420     Operating Room
     00894089-7420   S IMP:Cable Grip;Medium                            2082.00       1933.00     7420     Operating Room
     00895862-7420   S IMP:Screws                                          0.00          0.00     7420     Operating Room
     00895870-7420   S IMP:Plate                                           0.00          0.00     7420     Operating Room
     00895896-7420   S IMP:Nail/Rod                                        0.00          0.00     7420     Operating Room
     00884502-7420   S IMP:AMBI Cannula Screws 6.5                      1722.00       1722.00     7420     Operating Room
     00861120-7420   S STRL:Lap, Bipolar Coag Sci/Frcps                 1377.00       1377.00     7420     Operating Room
     00837820-7420   S STRL Staple:Lin Cuttr Rload TCR5                  737.00        737.00     7420     Operating Room
     00837475-7420   S NSTRL:Iliac Crest Wedge/Alloprep                 4064.00       4064.00     7420     Operating Room
     00879340-7420   S NSTRL:Catheter:Balln Carson O Ti                 2301.00       2301.00     7420     Operating Room
     00827800-7420   S NSTRL:Clip Raney Gun, Disposable                  562.00        562.00     7420     Operating Room
     00827820-7420   S NSTRL:Clip: Raney Cartridge                       340.00        340.00     7420     Operating Room
     00887599-7420   S IMP:Graft, Patch Impra 2 x 9                     1820.00       1820.00     7420     Operating Room
     00883876-7420   S STRL:Staple: GIA 30V/35 (ASU)                    2340.00       2340.00     7420     Operating Room
     00861985-7420   S STRL:Lap Inst.Graspr/Disc/Scissr                 1128.00       1128.00     7420     Operating Room
     00838326-7420   S NSTRL:Clip Applier, Endo (All)                   1612.00       1612.00     7420     Operating Room
     00861122-7420   S STRL:Lap, Endocatch                              1440.00       1440.00     7420     Operating Room
     00862111-7420   S STRL:Port-A-Cath, MRI Dual lumen                 4101.00       4101.00     7420     Operating Room
     00864110-7420   S IMP:Orthopedic Nail System                          0.00          0.00     7420     Operating Room
     00838280-7420   S STRL:Origin Trocar                               1311.00       1311.00     7420     Operating Room
     00838285-7420   S STRL:Origin Balloon (Sng)                        1821.00       1821.00     7420     Operating Room
     00841275-7420   S NSTRL:Cement Inj System/ Syr                     1531.00       1531.00     7420     Operating Room
     00838290-7420   S STRL:Origin Balloon (Bil)                        2039.00       2039.00     7420     Operating Room
     00861464-7420   S STRL:Staple, Endocutter Reloads                  1432.00       1432.00     7420     Operating Room
     00837848-7420   S STRLStaple:Linear TRH90 (Reload)                  788.00        788.00     7420     Operating Room
     00896050-7420   S IMP:Eartube Collar Bobbin                         352.00        352.00     7420     Operating Room
     00837804-7420   S STRL:Staple: Linear Cutter TLC55                 1536.00       1536.00     7420     Operating Room
     00868653-7420   S IMP:Valve, St. Jude Mitrel                      25237.00      25237.00     7420     Operating Room
     00837828-7420   S STRL Staple: Linear TPH30                        1433.00       1433.00     7420     Operating Room
     00852905-7420   S IMP:Plate Semitubular                             467.00        467.00     7420     Operating Room
     00837836-7420   S STRL:Staple: Linear TPH60                        1652.00       1652.00     7420     Operating Room
     00883884-7420   S STRL:Staple: GIA Reload (ASU)                    1024.00       1024.00     7420     Operating Room



8/31/2010                                                                                                                           11
                                                      c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                                 CURRENT CURRENT          DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                     INPATIENT OUTPATIENT CODE
                                                                     PRICE      PRICE
     00837844-7420   S STRL Staple: Linear TPH90                        1566.00       1566.00     7420     Operating Room
     00873380-7420   S IMP:Humeral Nail Implant                            0.00          0.00     7420     Operating Room
     00837864-7420   S STRL Staple:Linear TRV30 (Reload                  530.00        530.00     7420     Operating Room
     00837625-7420   S STRL:Staple: TA55P/90P (All)                     1242.00       1242.00     7420     Operating Room
     00837641-7420   S NSTRL:EEA Pursestring (Disp.)                    1000.00       1000.00     7420     Operating Room
     00837682-7420   S STRL:Staple:RoticultrTA55/3.5-4.                 2783.00       2783.00     7420     Operating Room
     00837799-7420   S STRLL:Staple, Circular CDH                       2434.00       2434.00     7420     Operating Room
     00837823-7420   S STRL:Staple: Linear TPV30                        1476.00       1476.00     7420     Operating Room
     00837922-7420   S NSTRL:Clip Applr, Ligaclip (All)                  799.00        799.00     7420     Operating Room
     00837840-7420   S STRL Staple:Linear TRH60 (Reload                  819.00        819.00     7420     Operating Room
     00831834-7420   S IMP:Graft, Meadox Dbl Wov.Vel.ST                 2418.00       2418.00     7420     Operating Room
     00826792-7420   Cx Case OR                                         1342.00       1342.00     7420     Operating Room
     00830752-7420   S IMP:Eartube Collar Button                         270.00        270.00     7420     Operating Room
     00830851-7420   S IMP:Eartube Reuter Bobbin                         467.00        467.00     7420     Operating Room
     00830497-7420   S IMP:Eartube Shepard                               377.00        377.00     7420     Operating Room
     00831016-7420   S IMP:Eartube Armstrong Bev                         467.00        467.00     7420     Operating Room
     00837617-7420   S STRL:Angioscope 2.3/3.0                          3987.00       3987.00     7420     Operating Room
     00831651-7420   S IMP:Graft, Vasculour-D St.                       3381.00       3381.00     7420     Operating Room
     00887547-7420   S IMP:Graft, Impra Flex T/W 6mm                    4845.00       4845.00     7420     Operating Room
     00831891-7420   S IMP:Greenfield Umbrella Femoral                  8261.00       8261.00     7420     Operating Room
     00832568-7420   S IMP:Greenfield Filter (All)                      4783.00       4783.00     7420     Operating Room
     00832790-7420   S IMP:Shunt: Pruit/Nascushunt                      1688.00       1688.00     7420     Operating Room
     00832816-7420   S IMP:Shunt Javid Bypass                            487.00        487.00     7420     Operating Room
     00833111-7420   S IOL:Lens Intraocular                             2317.00       2317.00     7420     Operating Room
     00849620-7420   S IMP:Plate DCP Narrow (9-16)                      1377.00       1377.00     7420     Operating Room
     00831537-7420   S IMP:Graft, Meadox Hemashield Bif                 3900.00       3900.00     7420     Operating Room
     00887174-7420   S IMP:Glue Half Dose                                495.00        495.00     7420     Operating Room
     00806570-7420   S NSTRL:Quinton Curly Cath                          969.00        969.00     7420     Operating Room
     00886382-7420   S CATH TRNSML ANG NOLSR                            4320.00       4320.00     7420     Operating Room
     00886796-7420   S STRL:Prolene Mesh Small                           467.00        467.00     7420     Operating Room
     00886804-7420   S NSTRL:Prolene Mesh Large                         1342.00       1342.00     7420     Operating Room
     00886838-7420   S IMP:Stent Single J-90 Cm                         3149.00       3149.00     7420     Operating Room
     00887018-7420   S IMP:Graft, Patch Soft Tissue 5x1                 1368.00       1368.00     7420     Operating Room
     00887596-7420   S IMP:Graft Impra St 6-8                           3381.00       3381.00     7420     Operating Room
     00887109-7420   S IMP:Scleral Bckl-276,287,289                      467.00        467.00     7420     Operating Room
     00887562-7420   S STRL:Port-A-Cath MRI Venous                      2661.00       2661.00     7420     Operating Room
     00887281-7420   S IMP:Ambi Bone Screws                              377.00        377.00     7420     Operating Room
     00887398-7420   S IMP:Guide Pin                                     246.00        246.00     7420     Operating Room



8/31/2010                                                                                                                           12
                                                          c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                                     CURRENT CURRENT          DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                         INPATIENT OUTPATIENT CODE
                                                                         PRICE      PRICE
     00887489-7420   S STRL:Mitek Suture                                    1491.00       1491.00     7420     Operating Room
     00887505-7420   S STRL:Suture Passer/Ret. (All)                         467.00        467.00     7420     Operating Room
     00887521-7420   S IMP:Graft, Impra 6mm                                 4483.00       4483.00     7420     Operating Room
     00839498-7420   S NSTRL:Stent Urinary Diversion                        3149.00       3149.00     7420     Operating Room
     00887026-7420   S IMP:Graft Patch Soft Tissue 10x1                     2311.00       2311.00     7420     Operating Room
     00853895-7420   S STRL Steiman Pin Plain                                251.00        251.00     7420     Operating Room
     00852079-7420   S IMP:Ambi Lag Screw                                   1839.00       1839.00     7420     Operating Room
     00852152-7420   S IMP:Ambi Comp Screw                                   467.00        467.00     7420     Operating Room
     00852236-7420   S IMP:Ambi Super Lag Screw                             2181.00       2181.00     7420     Operating Room
     00852277-7420   S IMP:Ambi Screw Clip                                   467.00        467.00     7420     Operating Room
     00852566-7420   S IMP:Rush Pin                                          467.00        467.00     7420     Operating Room
     00836296-7420   S STRL:Pudenz Vent Cath                                1349.00       1349.00     7420     Operating Room
     00853713-7420   S IMP:Staple Bone                                         0.00          0.00     7420     Operating Room
     00849687-7420   S IMP:Plate T (6-8)                                    2071.00       2071.00     7420     Operating Room
     00853929-7420   S IMP:Steiman Pin Threaded                              382.00        382.00     7420     Operating Room
     00853978-7420   S IMP:Screws Herbert                                   1926.00       1926.00     7420     Operating Room
     00856021-7420   S IMP:Washer A-O Metal                                  467.00        467.00     7420     Operating Room
     00863381-7420   S IMP:Absorbable Pin 841050                            3621.00       3621.00     7420     Operating Room
     00863407-7420   S IMP:CE Ring                                         10411.00      10411.00     7420     Operating Room
     00863423-7420   S IMP:Absorbable Pin 841052                            1453.00       1453.00     7420     Operating Room
     00852822-7420   S IMP:Screw Interference                               2242.00       2242.00     7420     Operating Room
     00852848-7420   S IMP:Screws Cortex 1.5-4.5                             270.00        270.00     7420     Operating Room
     00839530-7420   S IMP:Stent Ureteral Infusion                          2817.00       2817.00     7420     Operating Room
     00839571-7420   S IMP:Stent Double J                                   2576.00       2576.00     7420     Operating Room
     00884031-7420   S NSTRL:Endo Dissectors                                1470.00       1364.00     7420     Operating Room
     00863332-7420   S IMP:Gamma Set Screw                                   510.00        510.00     7420     Operating Room
     00843383-7420   S IMP:Bone from Bone Bank                              1800.00       1800.00     7420     Operating Room
     00843664-7420   S IMP:Screw Bone                                          0.00          0.00     7420     Operating Room
     00851998-7420   S IMP:Ambi Comp Plate Reg                              3248.00       3248.00     7420     Operating Room
     00844134-7420   S STRL:Glue Full Dose                                   912.00        912.00     7420     Operating Room
     00850669-7420   S IMP:Knowles Pin                                       467.00        467.00     7420     Operating Room
     00852863-7420   S IMP:Screws Cancel 6.5                                 467.00        467.00     7420     Operating Room
     00852897-7420   S IMP:Screws Cancel 3.5-4.0                             313.00        313.00     7420     Operating Room
     00849612-7420   S IMP:Plate DCP Narrow (2-8)                            870.00        870.00     7420     Operating Room
     00839589-7420   S IMP:Stent Uropass Exchange                           3780.00       3780.00     7420     Operating Room
     00849646-7420   S IMP:Plate T (3-5)                                    1453.00       1453.00     7420     Operating Room
     00868604-7420   S IMP:Valve, Carpenter Edwards                        25449.00      25449.00     7420     Operating Room
     00844084-7420   S STRL:Glue Palacos                                     853.00        853.00     7420     Operating Room



8/31/2010                                                                                                                               13
                                                      c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                                 CURRENT CURRENT          DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                     INPATIENT OUTPATIENT CODE
                                                                     PRICE      PRICE
     00896059-7420   S IMP:St.Jude Aortic Vlv Graft Com                17155.00      17155.00     7420     Operating Room
     00806090-7420   S NSTRL:CVP Tripple (Arrow)                         752.00        752.00     7420     Operating Room
     00806400-7420   S NSTRL:Endo Shear/Cautery                         1085.00       1085.00     7420     Operating Room
     00807880-7420   S NSTRL:Collegan Implant Syringe                   2232.00       2232.00     7420     Operating Room
     00896054-7420   S IMP:Toe Implant, Sqarlato                        1756.00       1756.00     7420     Operating Room
     00896057-7420   S STRL:Versaport                                    983.00        983.00     7420     Operating Room
     00877101-7420   S NSTRL:Space Maker Balloon Desc.                  1927.00       1927.00     7420     Operating Room
     00877071-7420   S NSTRL:Hook Desc. Harmonic                        2114.00       2114.00     7420     Operating Room
     00877061-7420   S STRL:Harmonic Shenss Cog.                        2029.00       2029.00     7420     Operating Room
     00877021-7420   S NSTRL:Scitzinger Tripolar                        1965.00       1965.00     7420     Operating Room
     00103003-7420   Room Med/Surg/Gyn                                  4525.00          0.00     7420     Operating Room
     00103001-7420   Room Med/Surg/Gyn                                  2950.00          0.00     7420     Operating Room
     00822362-7420   S IMP:Ex Fix Clamp 4.0                             2247.00       2247.00     7420     Operating Room
     00827380-7420   S NSTRL:Eye Ahmed Valve                            3230.00       3230.00     7420     Operating Room
     00822343-7420   S STRL:Harmonic Blade Hook                         2311.00       2311.00     7420     Operating Room
     00824259-7420   S STRL:Harmonic Shears                             2347.00       2347.00     7420     Operating Room
     00825290-7420   S IMP:Screw Arthrex Cann                           1674.00       1674.00     7420     Operating Room
     00825524-7420   S IMP:Screw BioScrew                               1742.00       1742.00     7420     Operating Room
     00823353-7420   S IMP:Screw 4.5 Cann Syn                           1475.00       1475.00     7420     Operating Room
     00820254-7420   S IMP:Screw 7.0 Cann Syn                           1779.00       1779.00     7420     Operating Room
     00875851-7420   S IMP:Filtr Vena Cava Jugar Titan                  3443.00       3443.00     7420     Operating Room
     00822373-7420   S IMP:Ex Fix Rod 4.0                                395.00        395.00     7420     Operating Room
     00875856-7420   S NSTRL:Endopath Peanut Disp                        933.00        933.00     7420     Operating Room
     00824450-7420   S STRL:Trocar, Step                                 799.00        799.00     7420     Operating Room
     00826480-7420   S IMP:Screw Revo                                   1603.00       1603.00     7420     Operating Room
     00827312-7420   S IMP:Patella Tib Ligament                         3521.00       3521.00     7420     Operating Room
     00826576-7420   S NSTRL:Kit ACL Arthrex                            1751.00       1751.00     7420     Operating Room
     00860687-7420   S STRL:Tacker, 5mm Origin                          2622.00       2622.00     7420     Operating Room
     00860600-7420   S STRL:Patch, Hemashield                           1184.00       1184.00     7420     Operating Room
     00822376-7420   S IMP:Screw 4.0 Schnz                               395.00        395.00     7420     Operating Room
     00867687-7420   S STNT NOCOAT WDEL SYS                             5697.00       5697.00     7420     Operating Room
     00825585-7420   S IMP:Anchor, Corkscrew                            2404.00       2404.00     7420     Operating Room
     00887243-7420   S NSTRL:Arrow, Meniscus                            1545.00       1545.00     7420     Operating Room
     00810939-7420   S NSTRL:Cath Bal. Dil. Tan                         2174.00       2174.00     7420     Operating Room
     01302102-7427   STND PACU LVL 1 ADD 15M                             150.00        150.00     7427     PostAnesthesia Care
     01302301-7427   Cplx PACU First 30M                                 329.00        329.00     7427     PostAnesthesia Care
     01302101-7427   STND PACU LVL 1 FIRST 30M                           350.00        350.00     7427     PostAnesthesia Care
     01302302-7427   Cplx PACU Add 15M                                   165.00        165.00     7427     PostAnesthesia Care



8/31/2010                                                                                                                           14
                                                 c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                            CURRENT CURRENT          DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                INPATIENT OUTPATIENT CODE
                                                                PRICE      PRICE
     00702501-7427   Stnd Anes First 30M NonOR                      400.00        400.00     7427     PostAnesthesia Care
     01303100-7427   ECT W NECESSRY MONITORING                     1695.00       1695.00     7427     PostAnesthesia Care
     01303477-7429   LP DIAGNOSTIC                                  790.00        790.00     7429     Pre/Post Surgery
     02881015-7500   SUGARS QL EA SPEC                               10.50         10.50     7500     Clinical Laboratory
     02885613-7500   RUSSELL VIPER VENOM DILU                        15.00         15.00     7500     Clinical Laboratory
     02886360-7500   T LYMPH CD4/8 CNT&RATIO                         61.75         61.75     7500     Clinical Laboratory
     02882172-7500   APOLIPOPROTEIN B                                14.00         14.00     7500     Clinical Laboratory
     02416800-7500   ELECTROLYTE PNL                                280.00        280.00     7500     Clinical Laboratory
     02883898-7500   MOL DX AMP PT N ACD EA SQ                       37.27         37.27     7500     Clinical Laboratory
     02386140-7500   C REACTIVE PROTEIN                              42.00         42.00     7500     Clinical Laboratory
     02886641-7500   CRYPTOCOCCUS AB                                 25.00         25.00     7500     Clinical Laboratory
     02343605-7500   TESTOSTERONE TOTAL                             134.00        134.00     7500     Clinical Laboratory
     02317609-7500   Calcium Ionized                                134.00        134.00     7500     Clinical Laboratory
     02380197-7500   TACROLIMUS (FK506)                             199.00        199.00     7500     Clinical Laboratory
     02886617-7500   LYME DISEASE AB IGG WB                          25.00         25.00     7500     Clinical Laboratory
     02887497-7500   CMV DNA QN                                     109.00        109.00     7500     Clinical Laboratory
     02886141-7500   C-REACTIVE PROTEIN HS                           12.11         12.11     7500     Clinical Laboratory
     02888291-7500   CYTGNTC INTERP/RPRT                             33.91         33.91     7500     Clinical Laboratory
     02887901-7500   HIV 1 GENOTYPE                                 396.00        396.00     7500     Clinical Laboratory
     02886615-7500   BORDETELLA AB                                   15.55         15.55     7500     Clinical Laboratory
     02386039-7500   ANA TTR                                        171.00        171.00     7500     Clinical Laboratory
     02886609-7500   PNEUMOCOCCAL AB                                  5.41          5.41     7500     Clinical Laboratory
     02810655-7500   IMMUNOASSAY TUM AG EA                           29.00         29.00     7500     Clinical Laboratory
     02887621-7500   HPV AMP PRB                                     15.81         15.81     7500     Clinical Laboratory
     02386777-7500   TOXOPLAS AB IGG                                143.00        143.00     7500     Clinical Laboratory
     02880176-7500   LIDOCAINE                                       40.55         40.55     7500     Clinical Laboratory
     02387149-7500   CULT TYP BY NA PRB                              90.00         90.00     7500     Clinical Laboratory
     02397116-7500   AFB CULT BLD                                   205.00        205.00     7500     Clinical Laboratory
     02897477-7500   INFECT AGENT DETECT DFA                         25.00         25.00     7500     Clinical Laboratory
     02897478-7500   PARAINFLUENZA DFA                               23.40         23.40     7500     Clinical Laboratory
     02887290-7500   VZV DFA                                         23.00         23.00     7500     Clinical Laboratory
     02882040-7500   ALBUMIN                                          8.00          8.00     7500     Clinical Laboratory
     02384466-7500   TRANSFERRIN                                    134.00        134.00     7500     Clinical Laboratory
     02813351-7500   VISCOSITY                                       15.00         15.00     7500     Clinical Laboratory
     02386778-7500   TOXOPLAS AB IGM                                175.00        175.00     7500     Clinical Laboratory
     02894999-7500   MISC CHEM TEST                                  21.75         21.75     7500     Clinical Laboratory
     02880201-7500   TOPIRAMATE                                      35.00         35.00     7500     Clinical Laboratory
     02886762-7500   RUBELLA AB IGM                                   8.50          8.50     7500     Clinical Laboratory



8/31/2010                                                                                                                      15
                                                 c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                            CURRENT CURRENT         DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                INPATIENT OUTPATIENT CODE
                                                                PRICE      PRICE
     02855293-7500   CATECHOL FRAC UR                                21.50        21.50     7500     Clinical Laboratory
     02886622-7500   BRUCELLA AB                                     10.50        10.50     7500     Clinical Laboratory
     02382390-7500   CERULOPLASMIN                                  134.00       134.00     7500     Clinical Laboratory
     02886038-7500   ANA (ANTI NUCLEAR AB)                            7.27         7.27     7500     Clinical Laboratory
     02885670-7500   THROMBIN TIME                                   37.50        37.50     7500     Clinical Laboratory
     02880299-7500   SIROLIMUS                                       55.00        55.00     7500     Clinical Laboratory
     02886632-7500   CHLAMYDIA AB IGM                                 8.33         8.33     7500     Clinical Laboratory
     02883520-7500   IMMUNOASSAY NOT SPEC                            11.87        11.87     7500     Clinical Laboratory
     02883896-7500   MOL DX NUC ACID PRB                             37.27        37.27     7500     Clinical Laboratory
     02883901-7500   MOL DX AMP NA MLTIP EA SQ                       23.85        23.85     7500     Clinical Laboratory
     02825256-7500   PH FLD                                          20.00        20.00     7500     Clinical Laboratory
     02884238-7500   SOL TRANSFERRIN RECEPTOR                        55.00        55.00     7500     Clinical Laboratory
     02884202-7500   PROTOPORPHYRIN RBC                              15.65        15.65     7500     Clinical Laboratory
     02886376-7500   THYROID PEROXIDASE AB                            8.88         8.88     7500     Clinical Laboratory
     02886431-7500   RHEUMATOID FCTR QN                               7.50         7.50     7500     Clinical Laboratory
     02870299-7500   QN DRG MISC                                     67.55        67.55     7500     Clinical Laboratory
     02884311-7500   SPECTROPHOTOMETRY                               79.00        79.00     7500     Clinical Laboratory
     02883912-7500   MOL DX INTERP & RPT                             14.23        14.23     7500     Clinical Laboratory
     02385379-7500   D DIMER QN                                     121.00       121.00     7500     Clinical Laboratory
     02883721-7500   LDL BY DIRECT MEASURE                           14.00        14.00     7500     Clinical Laboratory
     02816057-7500   CK TOTAL                                         6.00         6.00     7500     Clinical Laboratory
     02883891-7500   HEP C VIRAL RNA GENOTYPE                       145.35       145.35     7500     Clinical Laboratory
     02386708-7500   HAV AB TOTAL                                    93.00        93.00     7500     Clinical Laboratory
     02386688-7500   HTLV 1 AB                                      104.00       104.00     7500     Clinical Laboratory
     02382248-7500   BILIRUBIN DIRECT                                90.00        90.00     7500     Clinical Laboratory
     02484484-7500   TROPONIN I QN                                   72.00        72.00     7500     Clinical Laboratory
     02386316-7500   CA 125                                         152.00       152.00     7500     Clinical Laboratory
     02886713-7500   LEGIONELLA AB IGM                               35.00        35.00     7500     Clinical Laboratory
     02888519-7500   GLUT ACID DECARB AUTO AB                        69.00        69.00     7500     Clinical Laboratory
     02884702-7500   BETA HCG QN                                     11.00        11.00     7500     Clinical Laboratory
     02886664-7500   EBV AB EBNA                                      5.07         5.07     7500     Clinical Laboratory
     02817536-7500   HIV 1 RNA VIRAL LOAD PCR                        79.94        79.94     7500     Clinical Laboratory
     02387077-7500   CULT BACT AEROBIC ID                           134.00       134.00     7500     Clinical Laboratory
     02384144-7500   PROGESTERONE                                   134.00       134.00     7500     Clinical Laboratory
     02831350-7500   HEMOGLOBIN FRACTION QN                          15.40        15.40     7500     Clinical Laboratory
     02821453-7500   TSH                                             11.88        11.88     7500     Clinical Laboratory
     02482565-7500   CREATININE                                      70.00        70.00     7500     Clinical Laboratory
     02887536-7500   HIV 1 QN PCR                                    84.15        84.15     7500     Clinical Laboratory



8/31/2010                                                                                                                     16
                                                c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                           CURRENT CURRENT         DEPARTMENT   DEPARTMENT DESCRIPTION
                                                               INPATIENT OUTPATIENT CODE
                                                               PRICE      PRICE
     02884425-7500   VITAMIN B1 (THIAMINE)                          38.00        38.00     7500     Clinical Laboratory
     02884482-7500   T3 REVERSE                                     29.00        29.00     7500     Clinical Laboratory
     02884260-7500   SEROTONIN BLD                                  49.00        49.00     7500     Clinical Laboratory
     02883825-7500   MERCURY                                        10.00        10.00     7500     Clinical Laboratory
     02807849-7500   MERCURY                                        10.00        10.00     7500     Clinical Laboratory
     02886720-7500   LEPTOSPIRA AN                                  32.00        32.00     7500     Clinical Laboratory
     02886703-7500   HIV AB CONF WESTERN BLOT                       23.00        23.00     7500     Clinical Laboratory
     02888271-7500   DNA PRB CYTGNTC EA                              9.90         9.90     7500     Clinical Laboratory
     02886698-7500   HISTOPLAS AB                                   22.50        22.50     7500     Clinical Laboratory
     02814213-7500   HSV 1 AB IGM                                    4.60         4.60     7500     Clinical Laboratory
     02882633-7500   11 DEOXYCORTICOSTERONE                         49.00        49.00     7500     Clinical Laboratory
     02886644-7500   CMV AB                                         11.00        11.00     7500     Clinical Laboratory
     02811006-7500   AG DETECT EIA MULT STEP                        24.00        24.00     7500     Clinical Laboratory
     02886635-7500   COCCIDIOIDES AB                                43.50        43.50     7500     Clinical Laboratory
     02882784-7500   IGG                                            11.00        11.00     7500     Clinical Laboratory
     02883935-7500   OSMOLALITY UR                                  12.22        12.22     7500     Clinical Laboratory
     02884133-7500   POTASSIUM UR 24HR                              10.68        10.68     7500     Clinical Laboratory
     02884300-7500   SODIUM UR 24HR                                 10.68        10.68     7500     Clinical Laboratory
     02884560-7500   URIC ACID UR 24 HR                             10.68        10.68     7500     Clinical Laboratory
     02322104-7500   CYCLOSPORINE (PROGRAF)                        199.00       199.00     7500     Clinical Laboratory
     02886611-7500   BARTONELLA AB                                   6.25         6.25     7500     Clinical Laboratory
     02339755-7500   MICROALBUMIN UR 24HR                          181.00       181.00     7500     Clinical Laboratory
     02884392-7500   SULFATE UR 24HR                                12.22        12.22     7500     Clinical Laboratory
     02882340-7500   CALCIUM UR 24HR                                12.22        12.22     7500     Clinical Laboratory
     02335020-7500   ALBUMIN FLD                                    90.00        90.00     7500     Clinical Laboratory
     02881002-7500   URNALYSIS PH                                    4.64         4.64     7500     Clinical Laboratory
     02896331-7500   COCCI IMMUNO DIFFUSION                          7.84         7.84     7500     Clinical Laboratory
     02886744-7500   NOCARDIA AB                                    11.47        11.47     7500     Clinical Laboratory
     02387449-7500   INFLUENZA AG A OR B EACH                      303.00       303.00     7500     Clinical Laboratory
     02382570-7500   CREATININE UR TIM                              90.00        90.00     7500     Clinical Laboratory
     02882140-7500   AMMONIA UR 24HR                                20.00        20.00     7500     Clinical Laboratory
     02839781-7500   CARDIOLIPIN IGM AB                             17.50        17.50     7500     Clinical Laboratory
     02333175-7500   RENAL FUNCTION PNL                            229.00       229.00     7500     Clinical Laboratory
     02883615-7500   LDH                                             5.90         5.90     7500     Clinical Laboratory
     02886671-7500   FUNGUS NOT SPECIFIED                           60.00        60.00     7500     Clinical Laboratory
     02387420-7500   RSV AG EIA                                    242.00       242.00     7500     Clinical Laboratory
     02886756-7500   RSV AB                                         36.20        36.20     7500     Clinical Laboratory
     02382803-7500   BLD GAS VEN                                   341.00       341.00     7500     Clinical Laboratory



8/31/2010                                                                                                                    17
                                                c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                           CURRENT CURRENT         DEPARTMENT   DEPARTMENT DESCRIPTION
                                                               INPATIENT OUTPATIENT CODE
                                                               PRICE      PRICE
     02884105-7500   PHOSPHORUS UR 24HR                             12.22        12.22     7500     Clinical Laboratory
     02839780-7500   CARDIOLIPIN IGG AB                             17.50        17.50     7500     Clinical Laboratory
     02882436-7500   CHLORIDE UR 24HR                               12.22        12.22     7500     Clinical Laboratory
     02886148-7500   PHOSPHOLIPID AB                                24.00        24.00     7500     Clinical Laboratory
     02386300-7500   CA 15 3 (27.29)                               152.00       152.00     7500     Clinical Laboratory
     02883894-7500   MOL DX GEL ELECTRO SEP                         17.81        17.81     7500     Clinical Laboratory
     02884181-7500   PROTEIN WESTERN BLOT                           39.60        39.60     7500     Clinical Laboratory
     02882570-7500   CREATININE UR 24HR                              6.00         6.00     7500     Clinical Laboratory
     02384105-7500   PHOSPHORUS UR TIM                              90.00        90.00     7500     Clinical Laboratory
     02886001-7500   ALLERGEN SPECIFIC IGG QN                       10.98        10.98     7500     Clinical Laboratory
     02824588-7500   IGA                                             7.00         7.00     7500     Clinical Laboratory
     02383735-7500   MAGNESIUM UR TIM                               90.00        90.00     7500     Clinical Laboratory
     02887274-7500   HSV TYP 1 DFA                                  19.05        19.05     7500     Clinical Laboratory
     02882175-7500   ARSENIC UR                                     10.00        10.00     7500     Clinical Laboratory
     02882523-7500   NTELOPEPTIDE UR                                33.00        33.00     7500     Clinical Laboratory
     02882525-7500   COPPER                                         15.00        15.00     7500     Clinical Laboratory
     02882533-7500   CORTISOL TOTAL                                 27.20        27.20     7500     Clinical Laboratory
     02887800-7500   CHLAM TRACH/GC DNA PROBE                       14.25        14.25     7500     Clinical Laboratory
     02886340-7500   INTRINSIC FCTR AB                              23.00        23.00     7500     Clinical Laboratory
     02892570-7500   CREATININE UR RAN                               6.00         6.00     7500     Clinical Laboratory
     02883516-7500   CARDIOLIPIN AB                                 26.13        26.13     7500     Clinical Laboratory
     02827292-7500   PTH RELATED PROTEIN                            55.00        55.00     7500     Clinical Laboratory
     02883519-7500   IGFBP 3                                        29.00        29.00     7500     Clinical Laboratory
     02884066-7500   ACID PHOS PROSTATIC                             9.75         9.75     7500     Clinical Laboratory
     02884445-7500   THYR STIM IG                                   71.25        71.25     7500     Clinical Laboratory
     02884585-7500   VMA UR                                         33.04        33.04     7500     Clinical Laboratory
     02886592-7500   VDRL CSF QL                                     6.00         6.00     7500     Clinical Laboratory
     02317773-7500   GTT 2HR 1ST 3 SPEC                            271.00       271.00     7500     Clinical Laboratory
     02322255-7500   HOMOCYSTINE                                   199.00       199.00     7500     Clinical Laboratory
     02384155-7500   PROTEIN UR QN TIM                              90.00        90.00     7500     Clinical Laboratory
     02387338-7500   H PYLORI STL EIA                              303.00       303.00     7500     Clinical Laboratory
     02886707-7500   HBE AB                                         10.00        10.00     7500     Clinical Laboratory
     02384480-7500   T3 TOTAL                                      134.00       134.00     7500     Clinical Laboratory
     02887350-7500   HBE AG                                         10.00        10.00     7500     Clinical Laboratory
     02882017-7500   ACYLCARNITINES QN EA                           86.00        86.00     7500     Clinical Laboratory
     02887522-7500   HEP C VIRUS PCR QN                            209.95       209.95     7500     Clinical Laboratory
     02384300-7500   SODIUM UR TIM                                  90.00        90.00     7500     Clinical Laboratory
     02893520-7500   CCP AB IGG                                     45.00        45.00     7500     Clinical Laboratory



8/31/2010                                                                                                                    18
                                                c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                           CURRENT CURRENT         DEPARTMENT   DEPARTMENT DESCRIPTION
                                                               INPATIENT OUTPATIENT CODE
                                                               PRICE      PRICE
     02860299-7500   OXYCARBAZEPINE                                 12.00        12.00     7500     Clinical Laboratory
     02887591-7500   GC AMP PRB                                     30.00        30.00     7500     Clinical Laboratory
     02880197-7500   TACROLIMUS (FK506)                             49.88        49.88     7500     Clinical Laboratory
     02840642-7500   TRAZODONE (DESYREL)                            24.00        24.00     7500     Clinical Laboratory
     02882139-7500   AMINO ACIDS PLAS >5 QN                         96.50        96.50     7500     Clinical Laboratory
     02887529-7500   HSV DNA QN                                    109.25       109.25     7500     Clinical Laboratory
     02387491-7500   CHLAMYDIA TRACH AMP PRB                       275.00       275.00     7500     Clinical Laboratory
     02819551-7500   MOL DX EXTRACTION HI PUR                        7.13         7.13     7500     Clinical Laboratory
     02886790-7500   PARAINFLUENZA AB                               16.00        16.00     7500     Clinical Laboratory
     02887521-7500   HEP C VIRUS DIR PRB                            98.50        98.50     7500     Clinical Laboratory
     02383718-7500   HDL CHOLESTEROL                                90.00        90.00     7500     Clinical Laboratory
     02340320-7500   PTH INTACT                                    134.00       134.00     7500     Clinical Laboratory
     02897798-7500   AG DETECT NOS DNA AMP                          85.00        85.00     7500     Clinical Laboratory
     02386334-7500   IMMUNOFIX UR                                  143.00       143.00     7500     Clinical Laboratory
     02382105-7500   AFP TUMOR MARKER                              134.00       134.00     7500     Clinical Laboratory
     02322260-7500   NATRIURETIC PEPTIDE                           134.00       134.00     7500     Clinical Laboratory
     02387591-7500   GC AMP PRB                                    275.00       275.00     7500     Clinical Laboratory
     02899001-7500   SPEC HANDL FEE                                  7.00         7.00     7500     Clinical Laboratory
     02885730-7500   PTT PLAS OR WB                                 11.60        11.60     7500     Clinical Laboratory
     02886645-7500   CMV AB IGM                                      4.60         4.60     7500     Clinical Laboratory
     02836003-7500   ALLERGEN SPECIFIC IGE QN                       10.00        10.00     7500     Clinical Laboratory
     02853891-7500   MOL DX EXTRACTION HI PUR                       11.97        11.97     7500     Clinical Laboratory
     02893525-7500   INSULIN                                        10.50        10.50     7500     Clinical Laboratory
     02883021-7500   HEMOGLOBIN FRACTION QN                         14.13        14.13     7500     Clinical Laboratory
     02878291-7500   CYTGNTC INTERP/RPRT                            75.00        75.00     7500     Clinical Laboratory
     02886738-7500   MYCOPLAS AB IGG                                15.00        15.00     7500     Clinical Laboratory
     02386800-7500   THYROGLOBULIN AB                              134.00       134.00     7500     Clinical Laboratory
     02386376-7500   THYROID PEROXIDASE AB                         134.00       134.00     7500     Clinical Laboratory
     02384481-7500   T3 FREE                                       134.00       134.00     7500     Clinical Laboratory
     02873912-7500   MOL DX INTERP & RPT                            29.70        29.70     7500     Clinical Laboratory
     02888230-7500   TISSUE CULT LYMPH                             148.50       148.50     7500     Clinical Laboratory
     02863912-7500   MOL DX INTERP & RPT                            13.96        13.96     7500     Clinical Laboratory
     02319523-7500   MOL DX EXTRACTION                              27.00        27.00     7500     Clinical Laboratory
     02833519-7500   IMMUNOASSAY ANALYTE QN                        120.00       120.00     7500     Clinical Laboratory
     02867798-7500   AG DETECT NOS DNA AMP                         250.00       250.00     7500     Clinical Laboratory
     02863520-7500   IMMUNOASSAY NOT SPEC                           15.00        15.00     7500     Clinical Laboratory
     02853520-7500   IMMUNOASSAY NOT SPEC                           14.25        14.25     7500     Clinical Laboratory
     02874075-7500   ALK PHOSPHATASE                                19.50        19.50     7500     Clinical Laboratory



8/31/2010                                                                                                                    19
                                                 c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                            CURRENT CURRENT         DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                INPATIENT OUTPATIENT CODE
                                                                PRICE      PRICE
     02884481-7500   T3 FREE                                         18.26        18.26     7500     Clinical Laboratory
     02841525-7500   IMMUNOASSAY NOT SPEC                            26.00        26.00     7500     Clinical Laboratory
     02898291-7500   CYTGNTC INTERP/RPRT                             40.50        40.50     7500     Clinical Laboratory
     02843520-7500   IMMUNOASSAY NOT SPEC                           151.75       151.75     7500     Clinical Laboratory
     02383892-7500   MOL DX ENZ DIGESTION                            27.00        27.00     7500     Clinical Laboratory
     02383896-7500   MOL DX NUC ACID PRB                             13.00        13.00     7500     Clinical Laboratory
     02863891-7500   MOL DX EXTRACTION HI PUR                        29.70        29.70     7500     Clinical Laboratory
     02893892-7500   MOL DX ENZ DIGESTION                            11.00        11.00     7500     Clinical Laboratory
     02893789-7500   MASS SPECT/TANDEM QN NES                       228.75       228.75     7500     Clinical Laboratory
     02893898-7500   MOL DX AMP PT N ACD EA SQ                       49.88        49.88     7500     Clinical Laboratory
     02882160-7500   ANDROSTERONE ASSAY                             190.00       190.00     7500     Clinical Laboratory
     02878271-7500   DNA PRB CYTGNTC EA                              60.75        60.75     7500     Clinical Laboratory
     02823891-7500   MOL DX EXTRACTION HI PUR                        21.38        21.38     7500     Clinical Laboratory
     02896765-7500   RUBEOLA AB IGM                                   4.60         4.60     7500     Clinical Laboratory
     02833901-7500   MOL DX AMP NA MLTIP EA SQ                       35.63        35.63     7500     Clinical Laboratory
     02823901-7500   MOL DX AMP NA MLTIP EA SQ                       19.20        19.20     7500     Clinical Laboratory
     02863892-7500   MOL DX ENZ DIGESTION                            21.38        21.38     7500     Clinical Laboratory
     02853892-7500   MOL DX ENZ DIGESTION                            16.00        16.00     7500     Clinical Laboratory
     02853894-7500   MOL DX GEL ELECTRO SEP                          28.50        28.50     7500     Clinical Laboratory
     02843891-7500   MOL DX EXTRACTION HI PUR                        11.51        11.51     7500     Clinical Laboratory
     02823912-7500   MOL DX INTERP & RPT                             32.00        32.00     7500     Clinical Laboratory
     02876710-7500   INFLUENZA B AB                                   4.60         4.60     7500     Clinical Laboratory
     02813891-7500   MOL DX EXTRACTION HI PUR                        12.80        12.80     7500     Clinical Laboratory
     02876360-7500   T LYMPH CD4/8 CNT&RATIO                         13.70        13.70     7500     Clinical Laboratory
     02895520-7500   HEPARIN ASSAY                                   99.00        99.00     7500     Clinical Laboratory
     02384154-7500   PSA FREE                                       134.00       134.00     7500     Clinical Laboratory
     02896696-7500   HSV 2 AB IGM                                     4.60         4.60     7500     Clinical Laboratory
     02886727-7500   LYMPH CHORIOMENINGITIS AB                        4.60         4.60     7500     Clinical Laboratory
     02886654-7500   ENCEPHALITIS WEST EQUINE                         4.60         4.60     7500     Clinical Laboratory
     02843894-7500   MOL DX GEL ELECTRO SEP                          16.00        16.00     7500     Clinical Laboratory
     02853901-7500   MOL DX AMP NA MLTIP EA SQ                       42.39        42.39     7500     Clinical Laboratory
     02893891-7500   MOL DX EXTRACTION HI PUR                        16.50        16.50     7500     Clinical Laboratory
     02893150-7500   HOMOVANILLIC ACID (HVA)                         15.00        15.00     7500     Clinical Laboratory
     02833891-7500   MOL DX EXTRACTION HI PUR                        21.20        21.20     7500     Clinical Laboratory
     02873894-7500   MOL DX GEL ELECTRO SEP                          22.00        22.00     7500     Clinical Laboratory
     02863894-7500   MOL DX GEL ELECTRO SEP                          35.33        35.33     7500     Clinical Laboratory
     02853912-7500   MOL DX INTERP & RPT                             22.00        22.00     7500     Clinical Laboratory
     02843912-7500   MOL DX INTERP & RPT                             21.19        21.19     7500     Clinical Laboratory



8/31/2010                                                                                                                     20
                                                 c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                            CURRENT CURRENT         DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                INPATIENT OUTPATIENT CODE
                                                                PRICE      PRICE
     02886765-7500   RUBEOLA AB IGG                                   4.60         4.60     7500     Clinical Laboratory
     02863901-7500   MOL DX AMP NA MLTIP EA SQ                       38.50        38.50     7500     Clinical Laboratory
     02896735-7500   MUMPS AB IGG                                     4.60         4.60     7500     Clinical Laboratory
     02843901-7500   MOL DX AMP NA MLTIP EA SQ                       26.85        26.85     7500     Clinical Laboratory
     02873892-7500   MOL DX ENZ DIGESTION                            21.20        21.20     7500     Clinical Laboratory
     02895335-7500   FCTR INHIBITOR TEST                            100.80       100.80     7500     Clinical Laboratory
     02896644-7500   CMV AB IGG                                       4.60         4.60     7500     Clinical Laboratory
     02886658-7500   COXSACKIE AB TYP B                               4.60         4.50     7500     Clinical Laboratory
     02896710-7500   INFLUENZA A AB                                   4.60         4.60     7500     Clinical Laboratory
     02894181-7500   PROTEIN WESTERN BLOT                           165.00       165.00     7500     Clinical Laboratory
     02833912-7500   MOL DX INTERP & RPT                             23.01        23.01     7500     Clinical Laboratory
     02387430-7500   STREP GRP A AG EIA                             195.00       195.00     7500     Clinical Laboratory
     02886735-7500   MUMPS AB IGG                                    12.00        12.00     7500     Clinical Laboratory
     02884234-7500   RECEPT ASSAY PROGEST                             0.00         0.00     7500     Clinical Laboratory
     02386063-7500   ASO SCRN                                       130.00       130.00     7500     Clinical Laboratory
     02382731-7500   FETAL FIBRONECTIN                              465.00       465.00     7500     Clinical Laboratory
     02888274-7500   DNA PRB CYTGNTC 25-99                          121.50       121.50     7500     Clinical Laboratory
     02883090-7500   HOMOCYSTINE                                     27.00        27.00     7500     Clinical Laboratory
     02882480-7500   CHOLINESTERASE SER                               6.20         6.20     7500     Clinical Laboratory
     02820307-7500   PROCAINAMIDE & NAPA                             18.00        18.00     7500     Clinical Laboratory
     02823896-7500   MOL DX NUC ACID PRB                             16.00        16.00     7500     Clinical Laboratory
     02397329-7500   GIARDIA AB                                     148.00       148.00     7500     Clinical Laboratory
     02885290-7500   FCTR XIII                                       40.00        40.00     7500     Clinical Laboratory
     02866255-7500   DNA DBL STRAND AB SCRN                          12.50        12.50     7500     Clinical Laboratory
     02896255-7500   ANTI PARIETAL CELLS AB                          17.00        17.00     7500     Clinical Laboratory
     02883716-7500   LIPROPROT BLD HI FRAC/QNT                       32.25        32.25     7500     Clinical Laboratory
     02885014-7500   HEMATOCRIT                                       1.82         1.82     7500     Clinical Laboratory
     02885018-7500   HEMOGLOBIN                                       1.82         1.82     7500     Clinical Laboratory
     02387329-7500   GIARDIA AG EIA                                 261.00       261.00     7500     Clinical Laboratory
     02876003-7500   ALLERGEN SPECIFIC IGE QN                         7.35         7.35     7500     Clinical Laboratory
     02397077-7500   CULT BACT AEROBIC ID                            97.00        97.00     7500     Clinical Laboratory
     02893516-7500   IMMUNOASSAY NONINFECT                           14.25        14.25     7500     Clinical Laboratory
     02886787-7500   VZV AB                                           4.60         4.60     7500     Clinical Laboratory
     02835156-7500   PROTEIN TOTAL FLD                               14.00        14.00     7500     Clinical Laboratory
     02896021-7500   ANTINEUTROPHILIC AB                             18.38        18.38     7500     Clinical Laboratory
     02887254-7500   VIRUS CULT SHELL VIAL                           25.00        25.00     7500     Clinical Laboratory
     02863519-7500   IMMUNOASSAY ANALYTE QN                          46.00        46.00     7500     Clinical Laboratory
     02382270-7500   OCCULT BLD STL SCRN                             40.00        40.00     7500     Clinical Laboratory



8/31/2010                                                                                                                     21
                                                 c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                            CURRENT CURRENT         DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                INPATIENT OUTPATIENT CODE
                                                                PRICE      PRICE
     02886003-7500   ALLERGEN SPECIFIC IGE QN                         6.45         6.45     7500     Clinical Laboratory
     02835073-7500   GLUCOSE FLD                                     12.00        12.00     7500     Clinical Laboratory
     02866003-7500   ALLERGEN SPECIFIC IGE QN                        29.51        29.51     7500     Clinical Laboratory
     02856003-7500   ALLERGEN SPECIFIC IGE QN                         4.28         4.28     7500     Clinical Laboratory
     02846003-7500   ALLERGEN SPECIFIC IGE QN                        21.45        21.45     7500     Clinical Laboratory
     02876790-7500   VIRUS AB NOT SPEC                               25.00        25.00     7500     Clinical Laboratory
     02873516-7500   IMMUNOASSAY NONINFECT                           13.00        13.00     7500     Clinical Laboratory
     02886652-7500   ENCEPHALITIS EAST EQUINE                         4.60         4.60     7500     Clinical Laboratory
     02887799-7500   EBV DNA QNT PCR                                129.00       129.00     7500     Clinical Laboratory
     02896003-7500   ALLERGEN SPECIFIC IGE QN                        14.51        14.51     7500     Clinical Laboratory
     02893883-7500   PROTEIN NEPHELOMET                              33.30        33.30     7500     Clinical Laboratory
     02893655-7500   LEAD UR                                         10.00        10.00     7500     Clinical Laboratory
     02883789-7500   MASS SPECT/TANDEM QN NES                       142.50       142.50     7500     Clinical Laboratory
     02883902-7500   MOL DX REV TRANSCRIPT                           25.92        25.92     7500     Clinical Laboratory
     02894075-7500   ALK PHOSPHATASE                                  5.78         5.78     7500     Clinical Laboratory
     02887904-7500   HIV 1 PHENO EA ADDL DRG                        129.60       129.60     7500     Clinical Laboratory
     02887903-7500   HIV 1 PHENO 1ST 10 DRGS                        460.80       460.80     7500     Clinical Laboratory
     02889001-7500   SPEC HANDL FEE                                  15.00        15.00     7500     Clinical Laboratory
     02887490-7500   CHLAMYDIA TRACH DIR PRB                         15.00        15.00     7500     Clinical Laboratory
     02890102-7500   CANNABINOIDS CONF                               25.00        25.00     7500     Clinical Laboratory
     02883883-7500   PROTEIN NEPHELOMET                              17.00        17.00     7500     Clinical Laboratory
     02888365-7500   IN SITU HYBRIDIZ EA PROBE                        0.00         0.00     7500     Clinical Laboratory
     02873896-7500   MOL DX NUC ACID PRB                              6.48         6.48     7500     Clinical Laboratory
     02863896-7500   MOL DX NUC ACID PRB                              7.67         7.67     7500     Clinical Laboratory
     02843896-7500   MOL DX NUC ACID PRB                             11.97        11.97     7500     Clinical Laboratory
     02896038-7500   CENTROMERE SCREEN                               19.00        19.00     7500     Clinical Laboratory
     02882232-7500   BETA2 MICROGLOB UR                              43.50        43.50     7500     Clinical Laboratory
     02830299-7500   QN DRG MISC                                     32.62        32.62     7500     Clinical Laboratory
     02886064-7500   B CELLS TOTAL CNT                               13.70        13.70     7500     Clinical Laboratory
     02886631-7500   CHLAMYDIA AB IGG                                 8.50         8.50     7500     Clinical Laboratory
     02892523-7500   DEOXYPYRIDINOLINE                               43.00        43.00     7500     Clinical Laboratory
     02886146-7500   BETA 2 GLYCOPROTN I AB EA                       27.25        27.25     7500     Clinical Laboratory
     02888273-7500   DNA PRB CYTGNTC 10 30                           36.90        36.90     7500     Clinical Laboratory
     02884235-7500   RECEPT ASSAY TBII                               44.00        44.00     7500     Clinical Laboratory
     02882239-7500   BILE ACIDS TOTAL                                28.25        28.25     7500     Clinical Laboratory
     02882651-7500   DIHYDROTESTOSTERONE                             30.00        30.00     7500     Clinical Laboratory
     02886021-7500   PROTEIMASE 3                                    16.62        16.62     7500     Clinical Laboratory
     02886653-7500   ENCEPHALITIS ST LOUIS                            4.60         4.60     7500     Clinical Laboratory



8/31/2010                                                                                                                     22
                                                 c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                            CURRENT CURRENT         DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                INPATIENT OUTPATIENT CODE
                                                                PRICE      PRICE
     02887425-7500   ROTAVIRUS AG EIA                                20.00        20.00     7500     Clinical Laboratory
     02885041-7500   BLD CNT RBC AUTO                                 2.42         2.42     7500     Clinical Laboratory
     02866757-7500   RMSF AB SCRN IGG                                13.50        13.50     7500     Clinical Laboratory
     02893835-7500   METANEPHRINES UR 24HR                           28.00        28.00     7500     Clinical Laboratory
     02883897-7500   MOL DX NUC ACID TRANSFER                        16.00        16.00     7500     Clinical Laboratory
     02876757-7500   RMSF AB SCRN IGM                                16.50        16.50     7500     Clinical Laboratory
     02896757-7500   TYPHUS FEVER AB SC IGG                          13.50        13.50     7500     Clinical Laboratory
     02886757-7500   TYPHUS FEVER AB SC IGM                          16.50        16.50     7500     Clinical Laboratory
     02896738-7500   MYCOPLAS AB IGM                                 15.00        15.00     7500     Clinical Laboratory
     02896631-7500   CHLAMYDIA AB IGA                                 8.50         8.50     7500     Clinical Laboratory
     02897522-7500   HEP C VIRAL RNA QN TMA                         200.00       200.00     7500     Clinical Laboratory
     02892912-7500   MOL DX INTERP & RPT                              8.64         8.64     7500     Clinical Laboratory
     02892901-7500   MOL DX AMP NA MLTIP EA SQ                       17.81        17.81     7500     Clinical Laboratory
     02880061-7500   LIPID PNL                                       15.00        15.00     7500     Clinical Laboratory
     02882664-7500   LDL SUBPARTICLES                                61.20        61.20     7500     Clinical Laboratory
     02898275-7500   DNA PRB CYTGNTC >100                            81.00        81.00     7500     Clinical Laboratory
     02895730-7500   PTT PLAS OR WB                                   8.00         8.00     7500     Clinical Laboratory
     02881912-7500   MOL DX INTERP & RPT                             10.91        10.91     7500     Clinical Laboratory
     02882912-7500   MOL DX INTERP & RPT                             82.80        82.80     7500     Clinical Laboratory
     02386703-7500   HIV 1/HIV 2 AB                                 114.00       114.00     7500     Clinical Laboratory
     02803901-7500   MOL DX AMP NA MLTIP EA SQ                      144.90       144.90     7500     Clinical Laboratory
     02385002-7500   PLATELET FUNCTION TEST                         378.00       378.00     7500     Clinical Laboratory
     02885610-7500   PROTHROMBIN TIME                                 6.63         6.63     7500     Clinical Laboratory
     02858271-7500   DNA PRB CYTGNTC EA                              81.00        81.00     7500     Clinical Laboratory
     02810299-7500   QN DRG MISC                                    147.50       147.50     7500     Clinical Laboratory
     02883904-7500   MUTATION ID BY SEQ EA SEG                       60.89        60.89     7500     Clinical Laboratory
     02893902-7500   MOL DX REV TRANSCRIPT                           60.89        60.89     7500     Clinical Laboratory
     02883900-7500   MOL NUCLEIC AMPLI 2 SEQ                         99.00        99.00     7500     Clinical Laboratory
     02883909-7500   NUCLEIC ACID HI RESOLUTE                        13.20        13.20     7500     Clinical Laboratory
     02882382-7500   CATECHOLAMINES TOTAL UR                         27.50        27.50     7500     Clinical Laboratory
     02833894-7500   MOL DX GEL ELECTRO SEP                         124.20       124.20     7500     Clinical Laboratory
     02873898-7500   MOL DX AMP PT N ACD EA SQ                       32.40        32.40     7500     Clinical Laboratory
     02856790-7500   WEST NILE CSF                                   28.00        28.00     7500     Clinical Laboratory
     02893021-7500   HEMOGLOBIN FRACTION QN                          30.00        30.00     7500     Clinical Laboratory
     02893498-7500   17 OH PROGESTRONE                               15.40        15.40     7500     Clinical Laboratory
     02873789-7500   MASS SPECT/TANDEM QN NES                        15.40        15.40     7500     Clinical Laboratory
     02886430-7500   RHEUMATOID FCTR QL                              34.60        34.60     7500     Clinical Laboratory
     02873883-7500   PROTEIN NEPHELOMET                              54.00        54.00     7500     Clinical Laboratory



8/31/2010                                                                                                                     23
                                                 c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                            CURRENT CURRENT         DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                INPATIENT OUTPATIENT CODE
                                                                PRICE      PRICE
     02848291-7500   CYTGNTC INTERP/RPRT                             81.00        81.00     7500     Clinical Laboratory
     02882530-7500   CORTISOL FREE SER                               40.80        40.80     7500     Clinical Laboratory
     02873716-7500   LIPROPROT BLD HI FRAC/QNT                       33.25        33.25     7500     Clinical Laboratory
     02882891-7500   MOL DX EXTRACTION HI PUR                         6.48         6.48     7500     Clinical Laboratory
     02830101-7500   BENZODIAZEPINE SCRN                              2.75         2.75     7500     Clinical Laboratory
     02882103-7500   ALPHA 1 ANTITRYPSIN                             57.00        57.00     7500     Clinical Laboratory
     02485610-7500   PROTHROMBIN TIME                               117.00       117.00     7500     Clinical Laboratory
     02897536-7500   HIV 1 QN PCR                                    99.00        99.00     7500     Clinical Laboratory
     02839551-7500   MOL DX EXTRACTION HI PUR                        50.78        50.78     7500     Clinical Laboratory
     02887516-7500   HEP B VIRUS AMP PRB                             95.00        95.00     7500     Clinical Laboratory
     02853883-7500   KAPPA CHAIN                                     60.00        60.00     7500     Clinical Laboratory
     02863883-7500   LAMBDA CHAIN                                    60.00        60.00     7500     Clinical Laboratory
     02853896-7500   MOL DX NUC ACID PRB                             10.69        10.69     7500     Clinical Laboratory
     02387621-7500   HPV AMP PRB                                     70.00        70.00     7500     Clinical Laboratory
     02288112-7500   CYTOLOGY SEL CELL ENHANCE                       90.00        90.00     7500     Clinical Laboratory
     02386480-7500   TB TEST CELL IMMUNE MEAS                        90.00        90.00     7500     Clinical Laboratory
     02895613-7500   RUSSELL VIPER VENOM DILU                        29.25        29.25     7500     Clinical Laboratory
     02897799-7500   INF AGENT DET NUC ACID QN                      224.40       224.40     7500     Clinical Laboratory
     02829551-7500   MOL DX EXTRACTION HI PUR                         9.54         9.54     7500     Clinical Laboratory
     02888187-7500   CELL MARKR INTERPRET 2-8                        55.70        55.70     7500     Clinical Laboratory
     02888185-7500   CELL MARKR TECH EA ADDL                         55.70        55.70     7500     Clinical Laboratory
     02888184-7500   CELL MARKR TECH ONLY 1ST                        60.50        60.50     7500     Clinical Laboratory
     02884600-7500   DRG SCRN BLD VOLATILES                          16.97        16.97     7500     Clinical Laboratory
     02820101-7500   CANNABINOID SCRN                                 2.75         2.75     7500     Clinical Laboratory
     02865335-7500   FCTR INHIBITOR TEST                            278.10       278.10     7500     Clinical Laboratory
     02882101-7500   VOLATILES SCRN                                   2.75         2.75     7500     Clinical Laboratory
     02384540-7500   UR NITROGEN UR RAN                              90.00        90.00     7500     Clinical Laboratory
     02813912-7500   MOL DX INTERP & RPT                             37.27        37.27     7500     Clinical Laboratory
     02803891-7500   MOL DX EXTRACTION HI PUR                        37.27        37.27     7500     Clinical Laboratory
     02382340-7500   CALCIUM UR RAN                                  90.00        90.00     7500     Clinical Laboratory
     02884244-7500   RENIN                                           86.00        86.00     7500     Clinical Laboratory
     02826790-7500   WEST NILE VIRUS AB IGM                          24.50        24.50     7500     Clinical Laboratory
     02836790-7500   WEST NILE VIRUS AB IGG                          24.50        24.50     7500     Clinical Laboratory
     02393892-7500   MOL DX ENZ DIGESTION                            22.00        22.00     7500     Clinical Laboratory
     02880157-7500   CARBAMAZEPINE FREE                              35.00        35.00     7500     Clinical Laboratory
     02803912-7500   MOL DX INTERP & RPT                             19.08        19.08     7500     Clinical Laboratory
     02833520-7500   VW FACTOR COLL BIND ASSAY                      106.40       106.40     7500     Clinical Laboratory
     02866790-7500   VIRUS AB NOT SPEC                               47.00        47.00     7500     Clinical Laboratory



8/31/2010                                                                                                                     24
                                                 c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                            CURRENT CURRENT         DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                INPATIENT OUTPATIENT CODE
                                                                PRICE      PRICE
     02882901-7500   MOL DX AMP NA MLTIP EA SQ                       32.40        32.40     7500     Clinical Laboratory
     02882300-7500   CADMIUM                                         25.50        25.50     7500     Clinical Laboratory
     02387205-7500   SMR WRIGHT STAIN                                90.00        90.00     7500     Clinical Laboratory
     02813901-7500   MOL DX AMP NA MLTIP EA SQ                       15.50        15.50     7500     Clinical Laboratory
     02813894-7500   MOL DX GEL ELECTRO SEP                          14.54        14.54     7500     Clinical Laboratory
     02882896-7500   MOL DX NUC ACID PRB                              1.94         1.94     7500     Clinical Laboratory
     02892525-7500   COPPER                                          76.20        76.20     7500     Clinical Laboratory
     02843892-7500   MOL DX ENZ DIGESTION                            12.75        12.75     7500     Clinical Laboratory
     02881101-7500   SALICYLATE SCRN                                  2.75         2.75     7500     Clinical Laboratory
     02803896-7500   MOL DX NUC ACID PRB                             14.31        14.31     7500     Clinical Laboratory
     02823894-7500   MOL DX GEL ELECTRO SEP                          23.85        23.85     7500     Clinical Laboratory
     02877254-7500   VIRUS CULT SHELL VIAL                           65.00        65.00     7500     Clinical Laboratory
     02883914-7500   MUTATION ID OLA/SBCE/ASPE                       13.20        13.20     7500     Clinical Laboratory
     02810101-7500   COCAINE SCRN                                     2.75         2.75     7500     Clinical Laboratory
     02800101-7500   ETHCHLORVYNOL SCRN                               2.75         2.75     7500     Clinical Laboratory
     02383891-7500   MOL DX EXTRACTION HI PUR                        25.00        25.00     7500     Clinical Laboratory
     02393896-7500   MOL DX NUC ACID PRB                              5.00         5.00     7500     Clinical Laboratory
     02383903-7500   MOL DX NUC ACID PRB                             25.00        25.00     7500     Clinical Laboratory
     02839115-7500   QN DRG MISC                                     30.00        30.00     7500     Clinical Laboratory
     02382746-7500   FOLATE                                         134.00       134.00     7500     Clinical Laboratory
     02833199-7500   MUMPS AB IGM                                     4.60         4.60     7500     Clinical Laboratory
     02886316-7500   CA 15 3 (27.29)                                 15.00        15.00     7500     Clinical Laboratory
     02820778-7500   PSA FREE                                        10.09        10.09     7500     Clinical Laboratory
     02821110-7500   COMPLEMENT C1 Q                                  6.75         6.75     7500     Clinical Laboratory
     02346203-7500   VENIPUNCTURE                                    35.00        35.00     7500     Clinical Laboratory
     02822405-7500   18-HYDROXYCORTICOSTERONE                        55.00        55.00     7500     Clinical Laboratory
     02851525-7500   IMMUNOASSAY NOT SPEC                           147.62       147.62     7500     Clinical Laboratory
     02885572-7500   DRG SCRN QL CHROM EA                             3.00         3.00     7500     Clinical Laboratory
     02885598-7500   FOLATE RBC                                      19.90        19.90     7500     Clinical Laboratory
     02315604-7500   CHOLESTEROL                                     90.00        90.00     7500     Clinical Laboratory
     02315653-7500   ISOENZYMES CPK                                 147.00       147.00     7500     Clinical Laboratory
     02811015-7500   ACETYLCHOLINE BLK AB                            48.00        48.00     7500     Clinical Laboratory
     02822179-7500   CYSTICERCUS AB                                  50.00        50.00     7500     Clinical Laboratory
     02822310-7500   DELTA ALA                                       28.00        28.00     7500     Clinical Laboratory
     02819535-7500   CHRMOSOM HI RESD BND                            69.90        69.90     7500     Clinical Laboratory
     02813333-7500   PLT AB HEPARIN                                  60.00        60.00     7500     Clinical Laboratory
     02824829-7500   RECEPT ASSAY ESTROGEN                            0.00         0.00     7500     Clinical Laboratory
     02845430-7500   CHLAMYDIA PNEUMO AB                              8.50         8.50     7500     Clinical Laboratory



8/31/2010                                                                                                                     25
                                                 c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                            CURRENT CURRENT         DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                INPATIENT OUTPATIENT CODE
                                                                PRICE      PRICE
     02829323-7500   HIV 1 AMP PRB                                  125.00       125.00     7500     Clinical Laboratory
     02829330-7500   HIV 1 QN BDNA                                  113.05       113.05     7500     Clinical Laboratory
     02846450-7500   VITAMIN K                                       60.00        60.00     7500     Clinical Laboratory
     02813520-7500   ADH (VASOPRESSIN)                               25.00        25.00     7500     Clinical Laboratory
     02830635-7500   TSH                                             15.40        15.40     7500     Clinical Laboratory
     02818965-7500   LH PEDI 3RD GENE                                26.00        26.00     7500     Clinical Laboratory
     02818940-7500   FSH PEDI 3RD GENE                               28.50        28.50     7500     Clinical Laboratory
     02840023-7500   RIBOSOMAL P AB                                  33.00        33.00     7500     Clinical Laboratory
     02827459-7500   HEMOGLOBIN GLYCOSYLTD A1C                        8.08         8.08     7500     Clinical Laboratory
     02315307-7500   CO2 (BICARBONATE)                               90.00        90.00     7500     Clinical Laboratory
     02826018-7500   FCTR VIII VW AG                                 59.00        59.00     7500     Clinical Laboratory
     02832286-7500   CULT CMV                                        15.00        15.00     7500     Clinical Laboratory
     02315554-7500   LIPID PNL                                      193.00       193.00     7500     Clinical Laboratory
     02315505-7500   CHLORIDE UR 24HR                                90.00        90.00     7500     Clinical Laboratory
     02315455-7500   CHLORIDE                                        90.00        90.00     7500     Clinical Laboratory
     02320323-7500   PROLACTIN                                      134.00       134.00     7500     Clinical Laboratory
     02315372-7500   BASIC METABOLIC PNL                            218.00       218.00     7500     Clinical Laboratory
     02828940-7500   HEP C VIRUS BDNA QN                            295.00       295.00     7500     Clinical Laboratory
     02315356-7500   CARBON MONOXIDE                                112.00       112.00     7500     Clinical Laboratory
     02814010-7500   NEURONAL AB (HU AB) SCRN                        59.40        59.40     7500     Clinical Laboratory
     02317204-7500   FSH                                            134.00       134.00     7500     Clinical Laboratory
     02315208-7500   CARBAMAZEPINE TOTAL                            134.00       134.00     7500     Clinical Laboratory
     02315158-7500   CALCIUM UR 24HR                                 90.00        90.00     7500     Clinical Laboratory
     02322105-7500   VITAMIN B12                                    134.00       134.00     7500     Clinical Laboratory
     02315109-7500   CALCIUM                                         90.00        90.00     7500     Clinical Laboratory
     02322055-7500   VALPROIC ACID                                  134.00       134.00     7500     Clinical Laboratory
     02321453-7500   TSH                                            234.00       234.00     7500     Clinical Laboratory
     02318970-7500   LH                                             134.00       134.00     7500     Clinical Laboratory
     02822708-7500   DHEA                                            25.00        25.00     7500     Clinical Laboratory
     02828817-7500   HEP C VIRUS PCR QN                              89.00        89.00     7500     Clinical Laboratory
     02821515-7500   COXSACKIE AB TYP A                               4.60         4.60     7500     Clinical Laboratory
     02330150-7500   AB TTR                                         170.00       170.00     7500     Clinical Laboratory
     02484703-7500   PREGNANCY SCRN UR                              225.00       225.00     7500     Clinical Laboratory
     02342756-7500   GLUC PRENAT 50 GM SCRN                          90.00        90.00     7500     Clinical Laboratory
     02485024-7500   CBC AUTO W AUTO DIFF WBC                       238.00       238.00     7500     Clinical Laboratory
     02481003-7500   URNALYSIS AUTO W/O MICRO                        70.00        70.00     7500     Clinical Laboratory
     02886291-7500   HBS AB                                          15.20        15.20     7500     Clinical Laboratory
     02823065-7500   MYELOPEROXIDASE AB                              16.62        16.62     7500     Clinical Laboratory



8/31/2010                                                                                                                     26
                                               c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                          CURRENT CURRENT         DEPARTMENT   DEPARTMENT DESCRIPTION
                                                              INPATIENT OUTPATIENT CODE
                                                              PRICE      PRICE
     02814206-7500   PREALBUMIN                                     9.75         9.75     7500     Clinical Laboratory
     02821544-7500   CREATINE SERUM                                17.50        17.50     7500     Clinical Laboratory
     02821403-7500   CORTISOL FREE UR                              21.25        21.25     7500     Clinical Laboratory
     02825525-7500   EBV VCA AB IGM                                12.00        12.00     7500     Clinical Laboratory
     02841570-7500   PREGNENOLONE                                  36.50        36.50     7500     Clinical Laboratory
     02811165-7500   PROTEIN C ACTIVATED                           45.00        45.00     7500     Clinical Laboratory
     02836215-7500   PARVOVIRUS B19 AB IGG                         15.00        15.00     7500     Clinical Laboratory
     02831824-7500   PROINSULIN                                    40.00        40.00     7500     Clinical Laboratory
     02813615-7500   GANGLIOSIDE GMI AUTO AB                       35.00        35.00     7500     Clinical Laboratory
     02485347-7500   ACTIVATED CLOTTING TIME                      171.00       171.00     7500     Clinical Laboratory
     02316800-7500   ELECTROLYTE PNL                              247.00       247.00     7500     Clinical Laboratory
     02831112-7500   IGM                                            8.00         8.00     7500     Clinical Laboratory
     02318608-7500   IGM                                           90.00        90.00     7500     Clinical Laboratory
     02318558-7500   IGG                                          134.00       134.00     7500     Clinical Laboratory
     02318459-7500   IGA                                           90.00        90.00     7500     Clinical Laboratory
     02318053-7500   GLUCOSE                                       90.00        90.00     7500     Clinical Laboratory
     02317808-7500   GTT 4HR 1ST 3 SPEC                           271.00       271.00     7500     Clinical Laboratory
     02317758-7500   GTT 3HR 1ST 3 SPEC                           271.00       271.00     7500     Clinical Laboratory
     02318855-7500   LDH                                           90.00        90.00     7500     Clinical Laboratory
     02317501-7500   GENTAMICIN                                   134.00       134.00     7500     Clinical Laboratory
     02319101-7500   LITHIUM                                      134.00       134.00     7500     Clinical Laboratory
     02316453-7500   DIGOXIN                                      134.00       134.00     7500     Clinical Laboratory
     02316305-7500   CRYOGLOB QL OR SEMI QL                       134.00       134.00     7500     Clinical Laboratory
     02316255-7500   CREATININE UR                                 90.00        90.00     7500     Clinical Laboratory
     02316206-7500   CREATININE                                    90.00        90.00     7500     Clinical Laboratory
     02316156-7500   CREATININE CLEARANCE                         181.00       181.00     7500     Clinical Laboratory
     02316057-7500   CK TOTAL                                      80.00        80.00     7500     Clinical Laboratory
     02315851-7500   COMPLEMENT C4                                134.00       134.00     7500     Clinical Laboratory
     02317550-7500   GGT                                           90.00        90.00     7500     Clinical Laboratory
     02319861-7500   PHENYTOIN FREE                               134.00       134.00     7500     Clinical Laboratory
     02321354-7500   THEOPHYLLINE                                 134.00       134.00     7500     Clinical Laboratory
     02836872-7500   MYOGLOBIN UR                                  15.00        15.00     7500     Clinical Laboratory
     02841559-7500   17 OH PROGESTRONE                             60.00        60.00     7500     Clinical Laboratory
     02846350-7500   VIRUS CULT SHELL VIAL                         66.00        66.00     7500     Clinical Laboratory
     02320950-7500   SALICYLATE                                   134.00       134.00     7500     Clinical Laboratory
     02320802-7500   QUINIDINE                                    134.00       134.00     7500     Clinical Laboratory
     02320703-7500   PROTEIN TOTAL BLOOD                           90.00        90.00     7500     Clinical Laboratory
     02318756-7500   IRON                                          90.00        90.00     7500     Clinical Laboratory



8/31/2010                                                                                                                   27
                                               c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                          CURRENT CURRENT         DEPARTMENT   DEPARTMENT DESCRIPTION
                                                              INPATIENT OUTPATIENT CODE
                                                              PRICE      PRICE
     02319903-7500   PHOSPHORUS (PO4)                              90.00        90.00     7500     Clinical Laboratory
     02320158-7500   BETA HCG QL                                  114.00       114.00     7500     Clinical Laboratory
     02319853-7500   PHENYTOIN TOTAL                              134.00       134.00     7500     Clinical Laboratory
     02319804-7500   PHENOBARBITAL                                134.00       134.00     7500     Clinical Laboratory
     02319754-7500   PH BLD                                       112.00       112.00     7500     Clinical Laboratory
     02319606-7500   OSMOLALITY UR                                 90.00        90.00     7500     Clinical Laboratory
     02319556-7500   OSMOLALITY SER                                90.00        90.00     7500     Clinical Laboratory
     02319259-7500   MAGNESIUM                                     90.00        90.00     7500     Clinical Laboratory
     02319200-7500   HEPATIC FUNCTION PNL                         118.00       118.00     7500     Clinical Laboratory
     02319952-7500   PHOSPHOROUS UR RAN                            90.00        90.00     7500     Clinical Laboratory
     02387076-7500   CULT BACT ANAEROBIC ID                       225.00       225.00     7500     Clinical Laboratory
     02822260-7500   METHYLMALONIC ACID QN                         31.49        31.49     7500     Clinical Laboratory
     02482947-7500   GLUCOSE                                       70.00        70.00     7500     Clinical Laboratory
     02826050-7500   FCTR II                                       78.00        78.00     7500     Clinical Laboratory
     02826040-7500   FCTR V                                        49.00        49.00     7500     Clinical Laboratory
     02342509-7500   PRENATAL PNL                                 472.00       472.00     7500     Clinical Laboratory
     02826020-7500   Fctr X                                        59.00        59.00     7500     Clinical Laboratory
     02312560-7500   RETICULOCYTE AUTO                            111.00       111.00     7500     Clinical Laboratory
     02315802-7500   COMPLEMENT C3                                134.00       134.00     7500     Clinical Laboratory
     02831750-7500   ISLET CL AB                                   31.51        31.51     7500     Clinical Laboratory
     02335065-7500   CREATININE FLD                                90.00        90.00     7500     Clinical Laboratory
     02387163-7500   CULT BACT AEROBIC ID                         189.00       189.00     7500     Clinical Laboratory
     02387106-7500   CULT FUNGUS YEAST ID                         181.00       181.00     7500     Clinical Laboratory
     02840510-7500   RENIN                                         18.00        18.00     7500     Clinical Laboratory
     02823285-7500   LAMOTRIGINE                                   25.00        25.00     7500     Clinical Laboratory
     02825058-7500   FAT STL QN                                    44.84        44.84     7500     Clinical Laboratory
     02318426-7500   BETA HCG QN                                  134.00       134.00     7500     Clinical Laboratory
     02820255-7500   SOMATOMEDIN C                                 25.00        25.00     7500     Clinical Laboratory
     02823756-7500   RPR QL                                         9.00         9.00     7500     Clinical Laboratory
     02323251-7500   RHEUMATOID FCTR QN                            90.00        90.00     7500     Clinical Laboratory
     02314052-7500   KETONES QL                                    58.00        58.00     7500     Clinical Laboratory
     02324754-7500   URNALYSIS AUTO W/ MICRO                      220.00       220.00     7500     Clinical Laboratory
     02335503-7500   GLUCOSE CSF                                   90.00        90.00     7500     Clinical Laboratory
     02335057-7500   CELL CNT FLD W/O DIFF                         98.00        98.00     7500     Clinical Laboratory
     02332658-7500   CULT GRP B STREP SCRN                        134.00       134.00     7500     Clinical Laboratory
     02330157-7500   AB TTR                                       170.00       170.00     7500     Clinical Laboratory
     02325009-7500   PINWORM CELLOPHANE TAPE                       33.00        33.00     7500     Clinical Laboratory
     02830255-7500   5 HIAA UR                                     15.60        15.60     7500     Clinical Laboratory



8/31/2010                                                                                                                   28
                                             c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                        CURRENT CURRENT         DEPARTMENT   DEPARTMENT DESCRIPTION
                                                            INPATIENT OUTPATIENT CODE
                                                            PRICE      PRICE
     02323657-7500   RUBELLA AB                                 124.00       124.00     7500     Clinical Laboratory
     02817153-7500   CA 19 9                                     15.30        15.30     7500     Clinical Laboratory
     02323152-7500   HETEROPHILE AB SCRN                         84.00        84.00     7500     Clinical Laboratory
     02321206-7500   SODIUM UR RAN                               90.00        90.00     7500     Clinical Laboratory
     02320752-7500   PROTEIN UR QN RAN                           90.00        90.00     7500     Clinical Laboratory
     02321511-7500   FREE T4                                    134.00       134.00     7500     Clinical Laboratory
     02321172-7500   POTASSIUM                                   90.00        90.00     7500     Clinical Laboratory
     02321164-7500   SODIUM                                      90.00        90.00     7500     Clinical Laboratory
     02820250-7500   TRYPTASE                                    49.00        49.00     7500     Clinical Laboratory
     02850519-7500   T3 UPTAKE                                    8.00         8.00     7500     Clinical Laboratory
     02324606-7500   PREGNANCY SCRN UR                          189.00       189.00     7500     Clinical Laboratory
     02816908-7500   C PEPTIDE                                   16.00        16.00     7500     Clinical Laboratory
     02819803-7500   CITRATE UR 24HR                             12.00        12.00     7500     Clinical Laboratory
     02819506-7500   CHRMOSOM CNT/KARY                          150.00       150.00     7500     Clinical Laboratory
     02818607-7500   CHLAMYDIA TRACH AB                           8.50         8.50     7500     Clinical Laboratory
     02818102-7500   CATECHOL FRAC UR                            27.50        27.50     7500     Clinical Laboratory
     02818003-7500   CATECHOL FRAC PLAS                          27.50        27.50     7500     Clinical Laboratory
     02817955-7500   CAROTENE                                    15.00        15.00     7500     Clinical Laboratory
     02817807-7500   CANDIDA AB                                  14.00        14.00     7500     Clinical Laboratory
     02825008-7500   ESTRADIOL (E2)                              18.50        18.50     7500     Clinical Laboratory
     02817005-7500   C1 ESTERASE INHIBITOR                       17.00        17.00     7500     Clinical Laboratory
     02825305-7500   ESTROGEN TOTAL                              26.00        26.00     7500     Clinical Laboratory
     02816254-7500   BETA2 MICROGLOBULIN                         19.95        19.95     7500     Clinical Laboratory
     02815900-7500   ASPERGILLUS AB                               6.17         6.17     7500     Clinical Laboratory
     02826073-7500   FCTR IX                                     67.50        67.50     7500     Clinical Laboratory
     02847606-7500   YERSINIA AB                                  9.00         9.00     7500     Clinical Laboratory
     02840783-7500   RUBELLA AB IGG                               8.50         8.50     7500     Clinical Laboratory
     02820603-7500   COCCIDIOIDES AB                             16.00        16.00     7500     Clinical Laboratory
     02319051-7500   LIPASE                                      90.00        90.00     7500     Clinical Laboratory
     02817401-7500   CALCITONIN                                  27.50        27.50     7500     Clinical Laboratory
     02827137-7500   G6PD QN                                     14.00        14.00     7500     Clinical Laboratory
     02831709-7500   INSULIN ANTIBODIES                          70.00        70.00     7500     Clinical Laboratory
     02831303-7500   IGE                                          6.25         6.25     7500     Clinical Laboratory
     02831204-7500   IGD                                         21.00        21.00     7500     Clinical Laboratory
     02831105-7500   IGA                                          8.00         8.00     7500     Clinical Laboratory
     02830008-7500   HLA B27                                     25.00        25.00     7500     Clinical Laboratory
     02829802-7500   HISTOPLAS AB                                 9.00         9.00     7500     Clinical Laboratory
     02829208-7500   HSV AB                                       4.60         4.60     7500     Clinical Laboratory



8/31/2010                                                                                                                 29
                                                 c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                            CURRENT CURRENT         DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                INPATIENT OUTPATIENT CODE
                                                                PRICE      PRICE
     02819902-7500   BENZODIAZEPINES                                 16.50        16.50     7500     Clinical Laboratory
     02827608-7500   GROWTH HORMONE                                  12.50        12.50     7500     Clinical Laboratory
     02820306-7500   CMV AB IGM                                      11.00        11.00     7500     Clinical Laboratory
     02827103-7500   GLUCAGON                                        25.00        25.00     7500     Clinical Laboratory
     02827004-7500   GASTRIN                                         15.00        15.00     7500     Clinical Laboratory
     02826907-7500   FTA ABS (TPPA)                                   8.85         8.85     7500     Clinical Laboratory
     02826352-7500   FLECAINIDE                                      20.10        20.10     7500     Clinical Laboratory
     02826105-7500   FAT STL QL                                      23.00        23.00     7500     Clinical Laboratory
     02826006-7500   FCTR VIII VW MULTIMER                           69.00        69.00     7500     Clinical Laboratory
     02825503-7500   ESTRONE                                         15.50        15.50     7500     Clinical Laboratory
     02824407-7500   ENTEROVIRUS AB                                   4.60         4.60     7500     Clinical Laboratory
     02828952-7500   HDV (DELTA) AB                                  25.00        25.00     7500     Clinical Laboratory
     02811602-7500   ALDOSTERONE                                     27.00        27.00     7500     Clinical Laboratory
     02813806-7500   ANTI RNP AB                                     18.00        18.00     7500     Clinical Laboratory
     02813608-7500   ANTI DNA DBL STRAND                             12.00        12.00     7500     Clinical Laboratory
     02813350-7500   ACE (ANGIOTN CONVR ENZ)                         12.00        12.00     7500     Clinical Laboratory
     02813301-7500   ANDROSTENEDIONE                                 80.00        80.00     7500     Clinical Laboratory
     02812253-7500   AMIODARONE                                      29.00        29.00     7500     Clinical Laboratory
     02812204-7500   AMINO ACID BLD QNT 2-5                          75.50        75.50     7500     Clinical Laboratory
     02812006-7500   AMIKACIN                                        22.00        22.00     7500     Clinical Laboratory
     02815702-7500   ARSENIC BLD                                     19.00        19.00     7500     Clinical Laboratory
     02811750-7500   ALPHA 1 ANTITRYPSIN                             13.25        13.25     7500     Clinical Laboratory
     02814507-7500   RO(SS A) AB                                     11.50        11.50     7500     Clinical Laboratory
     02811206-7500   ADENOVIRUS AB                                    4.66         4.66     7500     Clinical Laboratory
     02811107-7500   ACTH                                            25.00        25.00     7500     Clinical Laboratory
     02811008-7500   ACETYLCHOLINE RECEPT AB                         45.00        45.00     7500     Clinical Laboratory
     02819555-7500   MOL DX ENZ DIGESTION                             9.50         9.50     7500     Clinical Laboratory
     02382044-7500   MICROALBUMIN UR RAN                             90.00        90.00     7500     Clinical Laboratory
     02482270-7500   OCCLT BLD STL QL MULT SPC                      120.00       120.00     7500     Clinical Laboratory
     02482273-7500   OCCULT BLD OTHER QL                            120.00       120.00     7500     Clinical Laboratory
     02811909-7500   ALUMINUM                                        22.00        22.00     7500     Clinical Laboratory
     02821106-7500   COMPLEMENT TOT (CH50)                           11.00        11.00     7500     Clinical Laboratory
     02824308-7500   ENCEPHALITIS CALIF                               4.60         4.70     7500     Clinical Laboratory
     02823250-7500   DIPTHERIA AB                                    30.25        30.25     7500     Clinical Laboratory
     02823102-7500   DIGITOXIN                                       42.00        42.00     7500     Clinical Laboratory
     02823003-7500   DIBUCAINE NUMBER                                 9.30         9.30     7500     Clinical Laboratory
     02822757-7500   DHEA SULFATE                                    12.00        12.00     7500     Clinical Laboratory
     02822302-7500   DELTA ALA                                       27.50        27.50     7500     Clinical Laboratory



8/31/2010                                                                                                                     30
                                                c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                           CURRENT CURRENT         DEPARTMENT   DEPARTMENT DESCRIPTION
                                                               INPATIENT OUTPATIENT CODE
                                                               PRICE      PRICE
     02822203-7500   CYSTINE UR QN                                  49.00        49.00     7500     Clinical Laboratory
     02813905-7500   GBM AB                                         42.00        42.00     7500     Clinical Laboratory
     02821205-7500   COPPER UR 24HR                                 18.00        18.00     7500     Clinical Laboratory
     02814200-7500   MITOCHONDRIAL AB SCRN                          11.00        11.00     7500     Clinical Laboratory
     02821007-7500   COMPLEMENT C2                                  19.00        19.00     7500     Clinical Laboratory
     02820520-7500   COCAINE QN                                     35.00        35.00     7500     Clinical Laboratory
     02815207-7500   THYROGLOBULIN AB                                8.08         8.08     7500     Clinical Laboratory
     02814804-7500   AT3 ACTIVITY                                   19.00        19.00     7500     Clinical Laboratory
     02814705-7500   STRIATED MUSCLE AB SCRN                        17.00        17.00     7500     Clinical Laboratory
     02814606-7500   SMOOTH MUSCLE AB SCRN                          13.00        13.00     7500     Clinical Laboratory
     02814515-7500   LA (SS B) AB                                   11.50        11.50     7500     Clinical Laboratory
     02832400-7500   LEAD BLD                                        8.08         8.08     7500     Clinical Laboratory
     02821502-7500   COXSACKIE AB TYP B                              5.81         5.81     7500     Clinical Laboratory
     02312452-7500   PROTHROMBIN TIME                              117.00       117.00     7500     Clinical Laboratory
     02311900-7500   HEMATOCRIT SPUN                               233.00       233.00     7500     Clinical Laboratory
     02332476-7500   CULT LEGIONELLA                               134.00       134.00     7500     Clinical Laboratory
     02311801-7500   FIBRINOGEN                                    149.00       149.00     7500     Clinical Laboratory
     02850113-7500   LDH ISOENZYMES                                  8.85         8.85     7500     Clinical Laboratory
     02318228-7500   HAPTOGLOBIN QN                                134.00       134.00     7500     Clinical Laboratory
     02312809-7500   SMR MALARIA                                   103.00       103.00     7500     Clinical Laboratory
     02312759-7500   SICKLE CL SCRN                                 77.00        77.00     7500     Clinical Laboratory
     02831808-7500   INSULIN FREE                                   29.00        29.00     7500     Clinical Laboratory
     02312601-7500   SEDIMENTATION RATE MAN                         58.00        58.00     7500     Clinical Laboratory
     02314151-7500   ALT (SGPT)                                     90.00        90.00     7500     Clinical Laboratory
     02332468-7500   CULT HERPES                                   454.00       454.00     7500     Clinical Laboratory
     02311405-7500   CBC AUTO W AUTO DIFF WBC                      154.00       154.00     7500     Clinical Laboratory
     02323020-7500   C-REACTIVE PROTEIN HS                         211.00       211.00     7500     Clinical Laboratory
     02311207-7500   BLEEDING TIME TEST                             79.00        79.00     7500     Clinical Laboratory
     02332005-7500   IMMUNOASSAY INFEC AG SGL                      208.00       208.00     7500     Clinical Laboratory
     02323053-7500   CEA                                           134.00       134.00     7500     Clinical Laboratory
     02312254-7500   MAN CELL CT EA                                 77.00        77.00     7500     Clinical Laboratory
     02316602-7500   ALCOHOL (ETHANOL) UR                           51.00        51.00     7500     Clinical Laboratory
     02314359-7500   AMMONIA                                       255.00       255.00     7500     Clinical Laboratory
     02314904-7500   BILIRUBIN TOTAL                                90.00        90.00     7500     Clinical Laboratory
     02314854-7500   AST (SGOT)                                     90.00        90.00     7500     Clinical Laboratory
     02314755-7500   BLD GAS CAP                                   341.00       341.00     7500     Clinical Laboratory
     02316958-7500   FERRITIN                                      134.00       134.00     7500     Clinical Laboratory
     02314706-7500   BLD GAS CORD ART                              341.00       341.00     7500     Clinical Laboratory



8/31/2010                                                                                                                    31
                                                c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                           CURRENT CURRENT         DEPARTMENT   DEPARTMENT DESCRIPTION
                                                               INPATIENT OUTPATIENT CODE
                                                               PRICE      PRICE
     02316008-7500   CORTISOL TOTAL                                134.00       134.00     7500     Clinical Laboratory
     02314003-7500   ACETAMINOPHEN                                 134.00       134.00     7500     Clinical Laboratory
     02312007-7500   CBC AUTO                                      154.00       154.00     7500     Clinical Laboratory
     02314508-7500   AMYLASE                                        90.00        90.00     7500     Clinical Laboratory
     02320778-7500   PSA TOTAL DIAG                                134.00       134.00     7500     Clinical Laboratory
     02314250-7500   ALCOHOL (ETHANOL)                             130.00       130.00     7500     Clinical Laboratory
     02322006-7500   VANCOMYCIN                                    134.00       134.00     7500     Clinical Laboratory
     02314300-7500   ALK PHOSPHATASE                                90.00        90.00     7500     Clinical Laboratory
     02312106-7500   PTT PLAS OR WB                                104.00       104.00     7500     Clinical Laboratory
     02335123-7500   PH FLD                                         62.00        62.00     7500     Clinical Laboratory
     02335073-7500   GLUCOSE FLD                                    90.00        90.00     7500     Clinical Laboratory
     02314201-7500   ALBUMIN                                        90.00        90.00     7500     Clinical Laboratory
     02847457-7500   HIV AB CONF WESTERN BLOT                       55.00        55.00     7500     Clinical Laboratory
     02314557-7500   AMYLASE UR RAN                                 90.00        90.00     7500     Clinical Laboratory
     02836708-7500   MYELIN BASIC PROTEIN CSF                       19.00        19.00     7500     Clinical Laboratory
     02323004-7500   ANA (ANTI NUCLEAR AB)                         171.00       171.00     7500     Clinical Laboratory
     02839009-7500   PORPHYRINS UR QN&FX                            41.50        41.50     7500     Clinical Laboratory
     02838902-7500   PROPHOBILINOGEN UR QL                          25.00        25.00     7500     Clinical Laboratory
     02838654-7500   ALK PHOS ISOENZYMES                            11.22        11.22     7500     Clinical Laboratory
     02838308-7500   PHENCYCLIDINE SCRN                              2.75         2.75     7500     Clinical Laboratory
     02837508-7500   OXALATE UR                                      6.00         6.00     7500     Clinical Laboratory
     02837409-7500   OPIATES SCRN                                    2.75         2.75     7500     Clinical Laboratory
     02840007-7500   CHLAMYDIA AB IGG                                8.50         8.50     7500     Clinical Laboratory
     02836856-7500   MYOGLOBIN                                      26.50        26.50     7500     Clinical Laboratory
     02840353-7500   Q FEVER AB                                      7.50         7.50     7500     Clinical Laboratory
     02836393-7500   MYCOPLAS CULT                                  44.50        44.50     7500     Clinical Laboratory
     02835304-7500   METHOTREXATE                                   45.50        45.50     7500     Clinical Laboratory
     02834752-7500   METANEPHRINES UR                               29.00        29.00     7500     Clinical Laboratory
     02834703-7500   MERCURY                                        18.00        18.00     7500     Clinical Laboratory
     02834000-7500   MAGNESIUM UR 24HR                              12.22        12.22     7500     Clinical Laboratory
     02833903-7500   MAGNESIUM RBC                                  29.75        29.75     7500     Clinical Laboratory
     02833804-7500   MURAMIDASE                                     18.00        18.00     7500     Clinical Laboratory
     02480100-7500   DRG SCRN QL CHROM EA                          563.00       563.00     7500     Clinical Laboratory
     02837102-7500   NORTRIPTYLINE                                  16.40        16.40     7500     Clinical Laboratory
     02846202-7500   VZV AB IGM                                     12.50        12.50     7500     Clinical Laboratory
     02831816-7500   INSULIN                                        19.00        19.00     7500     Clinical Laboratory
     02847309-7500   DRG SCRN BLD VOLATILES                         40.55        40.55     7500     Clinical Laboratory
     02847259-7500   VMA UR                                          7.75         7.75     7500     Clinical Laboratory



8/31/2010                                                                                                                    32
                                                 c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                            CURRENT CURRENT         DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                INPATIENT OUTPATIENT CODE
                                                                PRICE      PRICE
     02847200-7500   VITAMIN E                                       25.52        25.52     7500     Clinical Laboratory
     02847002-7500   VITAMIN D 25HYDROXY                             20.19        20.19     7500     Clinical Laboratory
     02846806-7500   VITAMIN D (125 DI HYDROX)                       35.00        35.00     7500     Clinical Laboratory
     02846509-7500   VITAMIN B1 (THIAMINE)                           25.00        25.00     7500     Clinical Laboratory
     02839702-7500   PROTEIN C AG                                    35.00        35.00     7500     Clinical Laboratory
     02846210-7500   VZV AB IGG                                      11.88        11.88     7500     Clinical Laboratory
     02847705-7500   ZINC                                            12.00        12.00     7500     Clinical Laboratory
     02845907-7500   VASOACT INTEST PEPT (VIP)                       49.00        49.00     7500     Clinical Laboratory
     02844652-7500   IMMUNOASSAY NONINFECT                           15.00        15.00     7500     Clinical Laboratory
     02843605-7500   TESTOSTERONE TOTAL                              13.06        13.06     7500     Clinical Laboratory
     02843506-7500   TESTOSTERONE FREE                                8.74         8.74     7500     Clinical Laboratory
     02843407-7500   THYROGLOBULIN                                   11.67        11.67     7500     Clinical Laboratory
     02842904-7500   T3 TOTAL                                        10.00        10.00     7500     Clinical Laboratory
     02842011-7500   SJOGRENS AB                                     11.50        11.50     7500     Clinical Laboratory
     02840403-7500   ALLERGEN SPECIFIC IGE QN                         5.93         5.93     7500     Clinical Laboratory
     02846400-7500   VITAMIN A                                       15.77        15.77     7500     Clinical Laboratory
     02837345-7500   OLIGOCLONAL BANDS CSF                           17.50        17.50     7500     Clinical Laboratory
     02842015-7500   SCLERODERMA AB                                  18.00        18.00     7500     Clinical Laboratory
     02814340-7500   T LYMPH TOT CNT                                 13.70        13.70     7500     Clinical Laboratory
     02837830-7500   RETICULIN AB TTR                                13.20        13.20     7500     Clinical Laboratory
     02815330-7500   ANTIRETICULIN AB W/RFX                          13.20        13.20     7500     Clinical Laboratory
     02813940-7500   MAG AB                                          49.00        49.00     7500     Clinical Laboratory
     02885700-7500   ORGANIC ACIDS QN TOTAL                         125.00       125.00     7500     Clinical Laboratory
     02320455-7500   PROTEIN ELECTRO UR                             189.00       189.00     7500     Clinical Laboratory
     02335859-7500   CRYSTALS FLD                                   133.00       133.00     7500     Clinical Laboratory
     02320406-7500   PROTEIN ELECTRO SER                            189.00       189.00     7500     Clinical Laboratory
     02320604-7500   IMMUNOFIX SER                                  143.00       143.00     7500     Clinical Laboratory
     02825520-7500   EBV VCA AB IGG                                  12.00        12.00     7500     Clinical Laboratory
     02844625-7500   TETANUS AB                                      20.00        20.00     7500     Clinical Laboratory
     02333102-7500   SMR CRYPTOSPORIDIUM                             82.00        82.00     7500     Clinical Laboratory
     02815653-7500   ISOENZYMES CPK                                   9.00         9.00     7500     Clinical Laboratory
     02831110-7500   IGA                                              8.00         8.00     7500     Clinical Laboratory
     02823295-7500   BENZODIAZEPINES                                 26.00        26.00     7500     Clinical Laboratory
     02851520-7500   PSA TOTAL DIAG                                  10.10        10.10     7500     Clinical Laboratory
     02841565-7500   17 OH PREGNENOLONE                              33.25        33.25     7500     Clinical Laboratory
     02885245-7500   FCTR VIII VW                                    60.00        60.00     7500     Clinical Laboratory
     02836820-7500   MYOCARDIAL AB SCRN                              20.00        20.00     7500     Clinical Laboratory
     02828819-7500   HEP C VIRUS BDNA QN                            135.66       135.66     7500     Clinical Laboratory



8/31/2010                                                                                                                     33
                                                c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                           CURRENT CURRENT         DEPARTMENT   DEPARTMENT DESCRIPTION
                                                               INPATIENT OUTPATIENT CODE
                                                               PRICE      PRICE
     02828960-7500   HEPATITIS DELTA AGENT                          38.80        38.80     7500     Clinical Laboratory
     02825830-7500   GABAPENTIN                                     25.00        25.00     7500     Clinical Laboratory
     02825530-7500   ENDOMYSIAL AB SCRN                             43.00        43.00     7500     Clinical Laboratory
     02839779-7500   CARDIOLIPIN IGA AB                             17.50        17.50     7500     Clinical Laboratory
     02814201-7500   ALBUMIN FLD                                    12.50        12.50     7500     Clinical Laboratory
     02811057-7500   ACID PHOS PROSTATIC                            12.00        12.00     7500     Clinical Laboratory
     02837810-7500   MUMPS AB IGM                                   17.25        17.25     7500     Clinical Laboratory
     02827046-7500   GIARDIA AB                                     33.00        33.00     7500     Clinical Laboratory
     02811552-7500   ALDOLASE                                        8.50         8.50     7500     Clinical Laboratory
     02819522-7500   CHRMOSOM CNT/KARY                              96.90        96.90     7500     Clinical Laboratory
     02819530-7500   TISSUE CULT SKIN                              150.00       150.00     7500     Clinical Laboratory
     02825214-7500   ESTRIOL                                        17.00        17.00     7500     Clinical Laboratory
     02818953-7500   CHLAMYDIA AB                                   17.50        17.50     7500     Clinical Laboratory
     02824902-7500   ERYTHROPOIETIN                                 20.43        20.43     7500     Clinical Laboratory
     02886694-7500   HSV AB                                         17.10        17.10     7500     Clinical Laboratory
     02826090-7500   FCTR XII                                       49.00        49.00     7500     Clinical Laboratory
     02826075-7500   FCTR XI                                        49.00        49.00     7500     Clinical Laboratory
     02884210-7500   PYRUVATE BLD                                   15.00        15.00     7500     Clinical Laboratory
     02839728-7500   PROTEIN C ACTIVITY                             33.25        33.25     7500     Clinical Laboratory
     02839756-7500   PROTEIN S AG TOTAL                             35.00        35.00     7500     Clinical Laboratory
     02851500-7500   OSTEOCALCIN                                    30.00        30.00     7500     Clinical Laboratory
     02818979-7500   CHLAMYDIA TRACH AMP PRB                        30.00        30.00     7500     Clinical Laboratory
     02314756-7500   BLD GAS ART                                   341.00       341.00     7500     Clinical Laboratory
     02830529-7500   IGG SUBCLASSES                                  8.93         8.93     7500     Clinical Laboratory
     02843258-7500   THYROXINE (T4)                                  6.50         6.50     7500     Clinical Laboratory
     02826055-7500   FCTR VIII                                      45.00        45.00     7500     Clinical Laboratory
     02822750-7500   ALPHA 1 ANTITRYP PHENO                         22.00        22.00     7500     Clinical Laboratory
     02831311-7500   IGG                                             8.00         8.00     7500     Clinical Laboratory
     02842233-7500   HCV AB CONF                                    66.00        66.00     7500     Clinical Laboratory
     02814051-7500   SPERM AB TEST                                  20.00        20.00     7500     Clinical Laboratory
     02852002-7500   CALC ANALYSIS INFRARED                         25.00        25.00     7500     Clinical Laboratory
     02853356-7500   XYLOSE BLD FASTING                             35.00        35.00     7500     Clinical Laboratory
     02330082-7500   AB ELUTION                                    396.00       396.00     7500     Clinical Laboratory
     02815300-7500   AMEBIC AB                                      19.00        19.00     7500     Clinical Laboratory
     02843200-7500   FREE T4                                        22.00        22.00     7500     Clinical Laboratory
     02811727-7500   ALLERGEN SPECIFIC IGE QN                        3.62         3.62     7500     Clinical Laboratory
     02328809-7500   HCV AB                                        114.00       114.00     7500     Clinical Laboratory
     02829200-7500   HSV 1 AB IGG                                   14.25        14.25     7500     Clinical Laboratory



8/31/2010                                                                                                                    34
                                                 c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                            CURRENT CURRENT         DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                INPATIENT OUTPATIENT CODE
                                                                PRICE      PRICE
     02813811-7500   ENA AB                                          18.00        18.00     7500     Clinical Laboratory
     02813613-7500   ANTI DNA DBL STRAND                             12.50        12.50     7500     Clinical Laboratory
     02816545-7500   BORDETELLA AB                                   20.00        20.00     7500     Clinical Laboratory
     02818975-7500   CHLAMYDIA CULT                                  36.00        36.00     7500     Clinical Laboratory
     02814617-7500   AMYLASE                                          7.25         7.25     7500     Clinical Laboratory
     02815807-7500   COMPLEMENT C3                                    8.00         8.00     7500     Clinical Laboratory
     02815812-7500   COMPLEMENT C4                                    8.00         8.00     7500     Clinical Laboratory
     02846717-7500   VITAMIN B6                                      28.00        28.00     7500     Clinical Laboratory
     02836210-7500   PARVOVIRUS B19 AB IGM                           15.00        15.00     7500     Clinical Laboratory
     02818806-7500   LACTIC ACID                                     15.00        15.00     7500     Clinical Laboratory
     02802845-7500   FRUCTOSAMINE                                    10.25        10.25     7500     Clinical Laboratory
     02846688-7500   VITAMIN B12 BINDING CAP                         15.00        15.00     7500     Clinical Laboratory
     02329227-7500   HIV 1/HIV 2 AB                                 114.00       114.00     7500     Clinical Laboratory
     02321552-7500   TOBRAMYCIN                                     134.00       134.00     7500     Clinical Laboratory
     02850524-7500   T3 UPTAKE                                        8.00         8.00     7500     Clinical Laboratory
     02846618-7500   NIACIN                                          50.00        50.00     7500     Clinical Laboratory
     02839019-7500   PORPHYRIN SCRN UR QL                            21.50        21.50     7500     Clinical Laboratory
     02825819-7500   CREATINE UR 24HR                                13.00        13.00     7500     Clinical Laboratory
     02344840-7500   H PYLORI AB IGG                                134.00       134.00     7500     Clinical Laboratory
     02826209-7500   Q FEVER AB                                       7.14         7.14     7500     Clinical Laboratory
     02321208-7500   POTASSIUM UR RAN                                90.00        90.00     7500     Clinical Laboratory
     02328606-7500   HAV AB IGM                                     114.00       114.00     7500     Clinical Laboratory
     02328309-7500   HB CORE AB IGM                                 114.00       114.00     7500     Clinical Laboratory
     02838808-7500   PLSMG ACTIVATOR INHIBITOR                       82.50        82.50     7500     Clinical Laboratory
     02819523-7500   MOL DX ISOLATE & EXTRACT                        62.10        62.10     7500     Clinical Laboratory
     02816560-7500   LYME DISEASE AB                                 12.93        12.93     7500     Clinical Laboratory
     02819516-7500   TISSUE CULT LYMPH                              188.10       188.10     7500     Clinical Laboratory
     02330410-7500   COMPATIBILITY TEST AHG                         134.00       134.00     7500     Clinical Laboratory
     02314757-7500   METHEMOGLOBIN                                  112.00       112.00     7500     Clinical Laboratory
     02821940-7500   NICOTINE & METABOLITE                           70.20        70.20     7500     Clinical Laboratory
     02318712-7500   IRON BINDING CAPACITY                           90.00        90.00     7500     Clinical Laboratory
     02311400-7500   BLD SMR EXAM W MAN DIFF                         75.00        75.00     7500     Clinical Laboratory
     02317714-7500   GTT ADDED SAMPLE                                90.00        90.00     7500     Clinical Laboratory
     02837360-7500   HEP B VIRUS BDNA QN                            104.98       104.98     7500     Clinical Laboratory
     02323727-7500   SKIN TEST TB                                    72.00        72.00     7500     Clinical Laboratory
     02316612-7500   BARBITURATES SCRN                               51.00        51.00     7500     Clinical Laboratory
     02316617-7500   BENZODIAZEPINE SCRN                             51.00        51.00     7500     Clinical Laboratory
     02316622-7500   CANNABINOID SCRN                                51.00        51.00     7500     Clinical Laboratory



8/31/2010                                                                                                                     35
                                                 c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                            CURRENT CURRENT         DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                INPATIENT OUTPATIENT CODE
                                                                PRICE      PRICE
     02316627-7500   COCAINE SCRN                                    51.00        51.00     7500     Clinical Laboratory
     02316632-7500   METHADONE SCRN                                  51.00        51.00     7500     Clinical Laboratory
     02839763-7500   PROTEIN S ACTIVITY                              91.00        91.00     7500     Clinical Laboratory
     02330211-7500   RH TYP                                          54.00        54.00     7500     Clinical Laboratory
     02829333-7500   SEX HORMONE BIND GLOB                           21.00        21.00     7500     Clinical Laboratory
     02330256-7500   ABO TYP                                         33.00        33.00     7500     Clinical Laboratory
     02327459-7500   HEMOGLOBIN GLYCOSYLTD A1C                      110.00       110.00     7500     Clinical Laboratory
     02328903-7500   HBs AG                                         114.00       114.00     7500     Clinical Laboratory
     02328804-7500   HBS AB                                         114.00       114.00     7500     Clinical Laboratory
     02327020-7500   CRYPTOSPORIDIUM                                148.00       148.00     7500     Clinical Laboratory
     02836911-7500   NB GENETIC SCR GALACT                           15.40        15.40     7500     Clinical Laboratory
     02339405-7500   PROPOXYPHENE SCRN                               51.00        51.00     7500     Clinical Laboratory
     02312907-7500   AMPHETAMINE SCRN                                51.00        51.00     7500     Clinical Laboratory
     02337607-7500   OPIATES SCRN                                    51.00        51.00     7500     Clinical Laboratory
     02338308-7500   PCP SCRN                                        51.00        51.00     7500     Clinical Laboratory
     02840819-7500   RUBEOLA AB IGG                                   8.08         8.08     7500     Clinical Laboratory
     02845819-7500   CARNITINE                                       31.00        31.00     7500     Clinical Laboratory
     02311401-7500   WBC CNT AUTO                                    48.00        48.00     7500     Clinical Laboratory
     02325207-7500   OVA & PARASITES W CONC                         134.00       134.00     7500     Clinical Laboratory
     02332153-7500   CULT BACT ANAEROBIC                            167.00       167.00     7500     Clinical Laboratory
     02332104-7500   CULT AEROBIC                                   151.00       151.00     7500     Clinical Laboratory
     02330801-7500   MISC TS PROC                                    50.00        50.00     7500     Clinical Laboratory
     02330413-7500   FETAL RBC SMR (K B)                             90.00        90.00     7500     Clinical Laboratory
     02330306-7500   COOMBS DIRECT IG                                90.00        90.00     7500     Clinical Laboratory
     02330207-7500   AG TYP PT RBC EA                               114.00       114.00     7500     Clinical Laboratory
     02330108-7500   AB SCRN                                        114.00       114.00     7500     Clinical Laboratory
     02323525-7500   RPR TTR                                         71.00        71.00     7500     Clinical Laboratory
     02325306-7500   PINWORM CELLOPHANE TAPE                         82.00        82.00     7500     Clinical Laboratory
     02332450-7500   CULT GC SCRN                                   104.00       104.00     7500     Clinical Laboratory
     02325157-7500   OCCLT BLD STL QL MULT SPC                       40.00        40.00     7500     Clinical Laboratory
     02324853-7500   URNALYSIS AUTO W/O MICRO                       190.00       190.00     7500     Clinical Laboratory
     02324804-7500   MICRO EXAM UR                                  111.00       111.00     7500     Clinical Laboratory
     02324705-7500   SPECIFIC GRAVITY UR                             39.00        39.00     7500     Clinical Laboratory
     02324556-7500   PH FLD                                          39.00        39.00     7500     Clinical Laboratory
     02324002-7500   URNALYSIS SGL ASSAY                             54.00        54.00     7500     Clinical Laboratory
     02323707-7500   SKIN TEST CANDIDA                               72.00        72.00     7500     Clinical Laboratory
     02330058-7500   AB ID                                          284.00       284.00     7500     Clinical Laboratory
     02333300-7500   SMR WET MOUNT                                   77.00        77.00     7500     Clinical Laboratory



8/31/2010                                                                                                                     36
                                                 c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                            CURRENT CURRENT         DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                INPATIENT OUTPATIENT CODE
                                                                PRICE      PRICE
     02335750-7500   SEMEN ANALYSIS COMPLETE                        188.00       188.00     7500     Clinical Laboratory
     02335701-7500   SEM MOT/CNT (NO HUHNER)                        137.00       137.00     7500     Clinical Laboratory
     02335651-7500   PROTEIN TOTAL CSF                               90.00        90.00     7500     Clinical Laboratory
     02335404-7500   CELL CNT FLD W/ DIFF                            98.00        98.00     7500     Clinical Laboratory
     02335156-7500   PROTEIN TOTAL FLD                               90.00        90.00     7500     Clinical Laboratory
     02335107-7500   LDH FLD                                         90.00        90.00     7500     Clinical Laboratory
     02335008-7500   AMYLASE FLD                                     90.00        90.00     7500     Clinical Laboratory
     02332252-7500   CULT BLD BACTERIA                              181.00       181.00     7500     Clinical Laboratory
     02333474-7500   CRYPTO AG DFA                                  195.00       195.00     7500     Clinical Laboratory
     02332351-7500   CULT FUNG SKIN HAIR NAIL                       134.00       134.00     7500     Clinical Laboratory
     02333250-7500   SPEC STAIN GRP I MICROORG                      334.00       334.00     7500     Clinical Laboratory
     02333151-7500   SMR GRAM STAIN                                  77.00        77.00     7500     Clinical Laboratory
     02333052-7500   SMR AFB STAIN                                   82.00        82.00     7500     Clinical Laboratory
     02332955-7500   SUSCEPT BY MIC                                  76.00        76.00     7500     Clinical Laboratory
     02332757-7500   CULT UR COLONY CT ONLY                         134.00       134.00     7500     Clinical Laboratory
     02332708-7500   CULT NOSE/THROAT                               134.00       134.00     7500     Clinical Laboratory
     02332609-7500   CULT STL SALM & SHIG                           167.00       167.00     7500     Clinical Laboratory
     02330397-7500   COMPATIBILITY TEST IS                           90.00        90.00     7500     Clinical Laboratory
     02333508-7500   AG DETECT EIA MULT STEP                        148.00       148.00     7500     Clinical Laboratory
     02321651-7500   TRIGLYCERIDE                                    90.00        90.00     7500     Clinical Laboratory
     02840814-7500   RUBEOLA AB IGM                                  11.50        11.50     7500     Clinical Laboratory
     02323509-7500   RPR QL                                          71.00        71.00     7500     Clinical Laboratory
     02330454-7500   THAWING PROD PER UNIT                           42.00        42.00     7500     Clinical Laboratory
     02321750-7500   BUN                                             90.00        90.00     7500     Clinical Laboratory
     02321701-7500   UREA CLEARANCE                                  90.00        90.00     7500     Clinical Laboratory
     02321602-7500   TRICYCLIC SCRN                                 134.00       134.00     7500     Clinical Laboratory
     02321800-7500   UR NITROGEN UR 24HR                             90.00        90.00     7500     Clinical Laboratory
     02321859-7500   URIC ACID                                       90.00        90.00     7500     Clinical Laboratory
     02321909-7500   URIC ACID UR 24 HR                              90.00        90.00     7500     Clinical Laboratory
     02323103-7500   COLD AGGLUTININ SCRN                           120.00       120.00     7500     Clinical Laboratory
     02386704-7500   HB CORE AB TOTAL                               114.00       114.00     7500     Clinical Laboratory
     02386879-7500   COOMBS DIRECT C3                                90.00        90.00     7500     Clinical Laboratory
     02813155-7500   ANTINEUTROPHILIC AB                             31.26        31.26     7500     Clinical Laboratory
     02884255-7500   SELENIUM                                        25.00        25.00     7500     Clinical Laboratory
     02387081-7500   CULT MRSA SCRN                                 104.00       104.00     7500     Clinical Laboratory
     02387116-7500   AFB CULT                                       205.00       205.00     7500     Clinical Laboratory
     02819560-7500   TISSUE CULT LYMPH                              111.44       111.44     7500     Clinical Laboratory
     02384315-7500   SPEC GRAVITY FLD                                54.00        54.00     7500     Clinical Laboratory



8/31/2010                                                                                                                     37
                                                c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                           CURRENT CURRENT         DEPARTMENT   DEPARTMENT DESCRIPTION
                                                               INPATIENT OUTPATIENT CODE
                                                               PRICE      PRICE
     02387080-7500   CULT SCRN B PERTUSSUS                         104.00       104.00     7500     Clinical Laboratory
     02482803-7500   BLD GAS ART                                   325.00       325.00     7500     Clinical Laboratory
     02386880-7500   COOMBS DIRECT IG                               90.00        90.00     7500     Clinical Laboratory
     02385008-7500   Bld Smr Exam Wo Man Diff                       54.00        54.00     7500     Clinical Laboratory
     02385595-7500   PLT CNT AUTO                                   77.00        77.00     7500     Clinical Laboratory
     02386406-7500   COCCI IMMUNO DIFFUSION                        195.00       195.00     7500     Clinical Laboratory
     02824455-7500   POLIO AB                                       26.83        26.83     7500     Clinical Laboratory
     02811040-7500   IMMUNOASSAY NOT SPEC                           41.50        41.50     7500     Clinical Laboratory
     02816108-7500   MICROSOMAL AB                                  15.00        15.00     7500     Clinical Laboratory
     02385014-7500   HEMOGLOBIN                                     90.00        90.00     7500     Clinical Laboratory
     02385018-7500   HEMATOCRIT                                     90.00        90.00     7500     Clinical Laboratory
     02849991-7500   MISC LAB PROC                                   0.00         0.00     7500     Clinical Laboratory
     02833110-7500   IMMUNOHISTOCHEMISTRY                            0.00         0.00     7500     Clinical Laboratory
     02829315-7500   VIRUS AB NOT SPEC                              17.50        17.50     7500     Clinical Laboratory
     02838845-7500   PNEUMOCOCCAL AB                                12.25        12.25     7500     Clinical Laboratory
     02831640-7500   VIRUS AB NOT SPEC                              37.50        37.50     7500     Clinical Laboratory
     02822255-7500   HOMOCYSTINE                                    20.19        20.19     7500     Clinical Laboratory
     02384484-7500   Troponin I QN                                 134.00       134.00     7500     Clinical Laboratory
     02820360-7500   PANCREAS POLYPEPTIDE                           52.00        52.00     7500     Clinical Laboratory
     02833225-7500   IMMUNOASSAY NONINFECT                          20.00        20.00     7500     Clinical Laboratory
     02842020-7500   ANTI SM AB                                     18.00        18.00     7500     Clinical Laboratory
     02380012-7500   COMPR MET PNL                                 270.00       270.00     7500     Clinical Laboratory
     02382670-7500   ESTRADIOL (E2)                                134.00       134.00     7500     Clinical Laboratory
     02382273-7500   OCCULT BLD GASTRIC QL                         112.00       112.00     7500     Clinical Laboratory
     02836395-7500   MYCOPLAS CULT                                  30.00        30.00     7500     Clinical Laboratory
     02484132-7500   POTASSIUM                                      70.00        70.00     7500     Clinical Laboratory
     02880188-7500   PRIMIDONE                                      15.00        15.00     7500     Clinical Laboratory
     02820840-7500   DRG SCRN QL CHROM EA                           17.00        17.00     7500     Clinical Laboratory
     02484520-7500   BUN                                            70.00        70.00     7500     Clinical Laboratory
     02484295-7500   SODIUM                                         70.00        70.00     7500     Clinical Laboratory
     02485014-7500   HEMATOCRIT                                     70.00        70.00     7500     Clinical Laboratory
     02811035-7500   THYROTROPIN REL HORMONE                       185.40       185.40     7500     Clinical Laboratory
     02833212-7500   INHIBIN A                                      50.00        50.00     7500     Clinical Laboratory
     02816620-7500   HELMINTH AB                                    31.75        31.75     7500     Clinical Laboratory
     02485018-7500   HEMOGLOBIN                                     70.00        70.00     7500     Clinical Laboratory
     02888275-7520   DNA PRB CYTGNTC >100                            0.00         0.00     7520     Pathology Laboratory
     02288142-7520   PAP DX THN LR SCRN                            149.00       149.00     7520     Pathology Laboratory
     02886696-7520   HSV 2 AB IGG                                   14.25        14.25     7520     Pathology Laboratory



8/31/2010                                                                                                                    38
                                                 c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                            CURRENT CURRENT         DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                INPATIENT OUTPATIENT CODE
                                                                PRICE      PRICE
     02288112-7520   CYTOLOGY SEL CELL ENHANCE                       90.00        90.00     7520     Pathology Laboratory
     02884234-7520   RECEPT ASSAY PROGEST                             0.00         0.00     7520     Pathology Laboratory
     02288175-7520   CYTOPATH CV FLD AUTO REDO                      138.00       138.00     7520     Pathology Laboratory
     02888365-7520   IN SITU HYBRIDIZ EA PROBE                        0.00         0.00     7520     Pathology Laboratory
     02888399-7520   SURG PATH UNLISTED                               0.00         0.00     7520     Pathology Laboratory
     02223352-7520   FNA INTERP & RPT                                85.00        85.00     7520     Pathology Laboratory
     02223305-7520   FNA ADEQUACY EVAL                               70.00        70.00     7520     Pathology Laboratory
     02482947-7520   GLUCOSE                                         70.00        70.00     7520     Pathology Laboratory
     02223260-7520   CYTOLOGY CONCENTRATION                          32.00        32.00     7520     Pathology Laboratory
     02223253-7520   CYTOLOGY FLD                                    42.00        42.00     7520     Pathology Laboratory
     02324754-7520   URNALYSIS AUTO W/ MICRO                        220.00       220.00     7520     Pathology Laboratory
     02824829-7520   RECEPT ASSAY ESTROGEN                            0.00         0.00     7520     Pathology Laboratory
     02833110-7520   IMMUNOHISTOCHEMISTRY                             0.00         0.00     7520     Pathology Laboratory
     02586930-7540   FRZN BLD FREEZING W PREP                       100.00       100.00     7540     Blood Bank
     02561470-7540   RBC PRETRTMT ENZYME                            160.00       160.00     7540     Blood Bank
     02561306-7540   RBC DG PS                                       75.00        75.00     7540     Blood Bank
     02561439-7540   PHER L/D PS                                    615.00       615.00     7540     Blood Bank
     02562205-7540   MISC TS PROC                                   100.00       100.00     7540     Blood Bank
     02562213-7540   AT PS                                          290.00       290.00     7540     Blood Bank
     02560936-7540   RBC L/D PS                                     234.50       234.50     7540     Blood Bank
     02561108-7540   FFP PS                                          72.00        72.00     7540     Blood Bank
     02561603-7540   IG RHO D FULL 300MCG IJ                         79.92        79.92     7540     Blood Bank
     02563609-7540   IRRADIATION BLD PROD EA                         50.00        50.00     7540     Blood Bank
     02563109-7540   SER PRETRTMT ABSORB                            360.00       360.00     7540     Blood Bank
     02563114-7540   SER PRETRTMT ABSORB                            400.00       400.00     7540     Blood Bank
     02530035-7540   AG SCRN PER UNIT RGNT                           40.00        40.00     7540     Blood Bank
     02530045-7540   AB SCRN                                        100.00       100.00     7540     Blood Bank
     02563134-7540   ABO TYP                                         32.00        32.00     7540     Blood Bank
     02563203-7540   AB ID 3                                        160.00       160.00     7540     Blood Bank
     02563154-7540   AB ID 2                                        160.00       160.00     7540     Blood Bank
     02563144-7540   AB ELUTION                                     240.00       240.00     7540     Blood Bank
     02563159-7540   COOMBS DIRECT IG                               150.00       150.00     7540     Blood Bank
     02563164-7540   RH PHENOTYP COMPLETE                           120.00       120.00     7540     Blood Bank
     02563302-7540   MISC LAB PROC                                  175.00       175.00     7540     Blood Bank
     02563252-7540   AG SCRN PER UNIT PT SPEC                        60.00        60.00     7540     Blood Bank
     02563149-7540   AB ID 4                                        320.00       320.00     7540     Blood Bank
     02563139-7540   RH PHENOTYP COMPLETE                           250.00       250.00     7540     Blood Bank
     02586901-7540   RH TYP                                          32.00        32.00     7540     Blood Bank



8/31/2010                                                                                                                     39
                                                 c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                            CURRENT CURRENT          DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                INPATIENT OUTPATIENT CODE
                                                                PRICE      PRICE
     02586978-7540   SER PRETRTMT ABSORB                            350.00        350.00     7540     Blood Bank
     03250410-7570   CA Place Drg El Stnt Addl                     3274.00       3274.00     7570     Cardiac Cath Lab
     03270450-7570   CA ANGIO EXT BIL                              6543.00       6543.00     7570     Cardiac Cath Lab
     03293571-7570   CA DPPLR W STRESS INI                         3732.00       3732.00     7570     Cardiac Cath Lab
     03270444-7570   IRC Inj Ext Venogram                           658.00        658.00     7570     Cardiac Cath Lab
     03280475-7570   CA Angio IL W HC                               617.00        617.00     7570     Cardiac Cath Lab
     03250400-7570   CA Place Drg El Stnt Sngl                    13942.00      13942.00     7570     Cardiac Cath Lab
     03270555-7570   XR Venogram Ext Uni                            529.00        529.00     7570     Cardiac Cath Lab
     03270455-7570   CA ANGIO RENL UNI                             6543.00       6543.00     7570     Cardiac Cath Lab
     03256458-7570   CAC STENT PLCE NONCOR ADD                     1397.00       1397.00     7570     Cardiac Cath Lab
     03280400-7570   CA PLACE OCC DEV VEIN ART                      682.00        682.00     7570     Cardiac Cath Lab
     03233282-7570   CAC IMPLANT CARD EVNT RCD                     3266.00       3266.00     7570     Cardiac Cath Lab
     03280450-7570   CA Angio Renl Bil W HC                         569.00        569.00     7570     Cardiac Cath Lab
     03250420-7570   S Imp Drug Elutting Stent                    10895.00      10895.00     7570     Cardiac Cath Lab
     03280425-7570   CA Angio Renl Uni W HC                         569.00        569.00     7570     Cardiac Cath Lab
     03034235-7570   CAC STENT NOCORO/CAR/VERT                     5390.00       5390.00     7570     Cardiac Cath Lab
     03270144-7570   CA CS SAME MD GT5YR 0-30M                      209.00        209.00     7570     Cardiac Cath Lab
     03200014-7570   S LD PCR NO TV SNGL PAS                      10895.00      10895.00     7570     Cardiac Cath Lab
     03200017-7570   S ICD SNGL CHAMBER                           36665.00      36665.00     7570     Cardiac Cath Lab
     03200029-7570   S LD VENT CORO VEN SYS LT                    10895.00      10895.00     7570     Cardiac Cath Lab
     03200026-7570   S LD ICD ENDOCRD 2 COIL                      11445.00      11445.00     7570     Cardiac Cath Lab
     03296050-7570   CAC REPO LD/PRIOR PACER                       3207.00       3207.00     7570     Cardiac Cath Lab
     03200032-7570   S PCR 1 CHMBR RR                             10895.00      10895.00     7570     Cardiac Cath Lab
     03200020-7570   S ICD DUAL CHAMBER                           41496.00      41496.00     7570     Cardiac Cath Lab
     03270145-7570   CA CS SAME MD ADD 15M                          104.00        104.00     7570     Cardiac Cath Lab
     03297114-7570   CON LOCM 350-399S I 1ML                          2.89          2.89     7570     Cardiac Cath Lab
     03297111-7570   CON LOCM 300-349S I 1ML                          2.69          2.69     7570     Cardiac Cath Lab
     03296044-7570   CAC INSERT PACER W 3RD LD                     5627.00       5627.00     7570     Cardiac Cath Lab
     03292976-7570   CA CARDIOVERT ELCTVE EXT                      1742.00       1742.00     7570     Cardiac Cath Lab
     03296047-7570   CAC INSERT PAC GEN SNGL                       3388.00       3388.00     7570     Cardiac Cath Lab
     03296049-7570   CAC INSERT PAC GEN DUAL                       3388.00       3388.00     7570     Cardiac Cath Lab
     03287500-7570   CA EP 3D MAPPING                              5045.00       5045.00     7570     Cardiac Cath Lab
     03200041-7570   S EVENT RECORDER CARDIAC                     10895.00      10895.00     7570     Cardiac Cath Lab
     03200011-7570   S CATH EP ABLTN 3D VCT MP                    10895.00      10895.00     7570     Cardiac Cath Lab
     03260026-7570   CAC PERICARDIOCENT INI                        1727.00       1727.00     7570     Cardiac Cath Lab
     03200023-7570   S ICD OTHR THAN SNGL/DL                      44963.00      44963.00     7570     Cardiac Cath Lab
     03200045-7570   S WIRE GUIDE                                    10.00         10.00     7570     Cardiac Cath Lab
     03200043-7570   S CATH GUIDING                                  12.00         12.00     7570     Cardiac Cath Lab



8/31/2010                                                                                                                      40
                                                     c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                                CURRENT CURRENT          DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                    INPATIENT OUTPATIENT CODE
                                                                    PRICE      PRICE
     03200038-7570   S PCR NOT 1 OR 2 CHMBR                           19457.00      19457.00     7570     Cardiac Cath Lab
     03200035-7570   S PCR 2 CHMBR RR                                 11662.00      11662.00     7570     Cardiac Cath Lab
     03260812-7570   CA RHC/TS LHC INTCT SEP                           9909.00       9909.00     7570     Cardiac Cath Lab
     03287257-7570   CA EP EVAL W L ATR PACING                        24945.00      24945.00     7570     Cardiac Cath Lab
     03223000-7570   S STRL Cath,SwanGanz Thermodilutio                 464.00        464.00     7570     Cardiac Cath Lab
     03236620-7570   S STRL Cath, Aortic Balloon 9.5                  11603.00      11603.00     7570     Cardiac Cath Lab
     03261229-7570   CA INJ CORO ANGIO                                  730.00        730.00     7570     Cardiac Cath Lab
     03260643-7570   CA HEART CATH LEFT                               21199.00      21199.00     7570     Cardiac Cath Lab
     03296068-7570   CAC Insert Pacer Gen Sngl                         3379.00       3379.00     7570     Cardiac Cath Lab
     03287273-7570   CA EP EVAL W L VENT PACNG                        20853.00      20853.00     7570     Cardiac Cath Lab
     03296084-7570   CAC Insert Elect Sngl                             4917.00       4917.00     7570     Cardiac Cath Lab
     03287281-7570   CA EP ABLTN AV NDE/CNDCTN                         8198.00       8198.00     7570     Cardiac Cath Lab
     03250032-7570   CA EP PRG PCNG POST RX                            3963.00       3963.00     7570     Cardiac Cath Lab
     03296027-7570   CAC Insert Pacer/Elec Vnt                         5610.00       5610.00     7570     Cardiac Cath Lab
     03296043-7570   CAC INSERT PACER DUAL LDS                         5954.00       5954.00     7570     Cardiac Cath Lab
     03260239-7570   CA HEART CATH RIGHT                               9697.00       9697.00     7570     Cardiac Cath Lab
     03260023-7570   CAC INSERT IABP PRC                               3803.00       3803.00     7570     Cardiac Cath Lab
     03260809-7570   CA RHC/LHC RETRO                                 27709.00      27709.00     7570     Cardiac Cath Lab
     03211311-7570   CA PTC ATHERCTMY SNGL VSL                         9331.00       9331.00     7570     Cardiac Cath Lab
     03280005-7570   CA PTCA SNGL VSL                                  8505.00       8505.00     7570     Cardiac Cath Lab
     03285012-7570   S CATH TRNSML ANG NOLSR                           4360.00       4360.00     7570     Cardiac Cath Lab
     03287109-7570   CA EP EVAL COMP W INDUCT                          5132.00       5132.00     7570     Cardiac Cath Lab
     03280021-7570   CA PTCA ADD VSL                                   2328.00       2328.00     7570     Cardiac Cath Lab
     03287497-7570   CA EP MAP VENT/ATR TACHY                          4249.00       4249.00     7570     Cardiac Cath Lab
     03217200-7570   S STRL Cath,SwanGanz Monitoring 7F                 407.00        407.00     7570     Cardiac Cath Lab
     03287345-7570   CAC PTA IL                                        4924.00       4924.00     7570     Cardiac Cath Lab
     03200301-7570   CA EP ABLTN OF SVT                               10734.00      10734.00     7570     Cardiac Cath Lab
     03270477-7570   CA S/I ANGIO PULM/AO/CORO                         5643.00       5643.00     7570     Cardiac Cath Lab
     03211444-7570   CA INJ IMA CONDUIT                                 566.00        566.00     7570     Cardiac Cath Lab
     03211555-7570   CA INJ GRAFT ANGIO                                 566.00        566.00     7570     Cardiac Cath Lab
     03270436-7570   CA INJ AORTOGRAPHY                                 366.00        366.00     7570     Cardiac Cath Lab
     03270428-7570   CA INJ L VENT/ATR ANGIO                            788.00        788.00     7570     Cardiac Cath Lab
     03265022-7570   CA IVUS CORO INI VSL                              3322.00       3322.00     7570     Cardiac Cath Lab
     03270466-7570   CA S/I ANGIO VENTRCLR/ATR                         1806.00       1806.00     7570     Cardiac Cath Lab
     03287307-7570   S STRL Electrophysiology Catheter                 2668.00       2668.00     7570     Cardiac Cath Lab
     03250226-7570   CA STENT IC SNGL VSL PRC                          9876.00       9876.00     7570     Cardiac Cath Lab
     03261204-7570   S STNT NOCOAT WDEL SYS                            5697.00       5697.00     7570     Cardiac Cath Lab
     03250346-7570   CA Stnt Ic Add Vsl Prc                            3274.00       3274.00     7570     Cardiac Cath Lab



8/31/2010                                                                                                                          41
                                                 c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                            CURRENT CURRENT          DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                INPATIENT OUTPATIENT CODE
                                                                PRICE      PRICE
     03287489-7570   CA EP R VENT RECORD                           2292.00       2292.00     7570     Cardiac Cath Lab
     03287422-7570   CA EP INTRA ATR RECORD                         604.00        604.00     7570     Cardiac Cath Lab
     03286053-7570   CA CORO/GRFT/IMA WO LHC                       4304.00       4304.00     7570     Cardiac Cath Lab
     06091115-7590   EKG 12 LEAD TRACING ONLY                       222.00        222.00     7590     Cardiology
     06091185-7590   INJ IV PUSH SNGL/INT                           116.00        116.00     7590     Cardiology
     03065000-7590   CA ECHO TRANSESOPHAGEAL                       1887.00       1887.00     7590     Cardiology
     03523123-7590   NRV MOTOR CONDUCT STDY EA                      127.00        127.00     7590     Cardiology
     03524113-7590   NRV SNSRY CONDUCT STDY EA                      103.00        103.00     7590     Cardiology
     03035185-7590   EKG W SCAN 24HR ANLYS/RPT                     1053.00       1053.00     7590     Cardiology
     03020153-7590   EKG 12 LEAD TRACING                            222.00        222.00     7590     Cardiology
     03530136-7590   Spontaneous Nystagmus Tst                      105.00        105.00     7590     Cardiology
     03050150-7590   CA TILT TABLE TEST                             966.00        966.00     7590     Cardiology
     03530219-7590   POSITIONAL NYSTAGMUS TEST                      119.00        119.00     7590     Cardiology
     03520236-7590   EMG TWO LIMBS                                  333.00        333.00     7590     Cardiology
     03020500-7590   EKG SIGNAL AVERAGED                            582.00        582.00     7590     Cardiology
     03535416-7590   SEP LOWER LIMBS BIL                            413.00        413.00     7590     Cardiology
     03061009-7590   CA ECHO 2D W STRES                             878.00        878.00     7590     Cardiology
     03524709-7590   MTR NRV CNDCT STDY W/F EA                      116.00        116.00     7590     Cardiology
     03050960-7590   CA ECHO 2D LTD                                 963.00        963.00     7590     Cardiology
     03050929-7590   CA ECHO 2D CMPL                               1913.00       1913.00     7590     Cardiology
     03050184-7590   CARDIAC STRESS TEST                            834.00        834.00     7590     Cardiology
     03050515-7590   CA ECHO DPPLER CMPL                            850.00        850.00     7590     Cardiology
     03530391-7590   CALORIC VESTIBULAR TEST                        191.00        191.00     7590     Cardiology
     03535119-7590   AD EVAL ABR                                    842.00        842.00     7590     Cardiology
     03060068-7590   CA ECHO DPPLER COLOR FLOW                     1442.00       1442.00     7590     Cardiology
     03060019-7590   CA ECHO CNGNITL ANOM CMPL                     1913.00       1913.00     7590     Cardiology
     03510740-7590   EEG SLEEP                                      815.00        815.00     7590     Cardiology
     03510336-7590   EEG SLEEP                                      815.00        815.00     7590     Cardiology
     03510179-7590   EEG AWAKE AND ASLEEP                           617.00        617.00     7590     Cardiology
     03020237-7590   EKG 3 LEAD TRACING                              73.00         73.00     7590     Cardiology
     03520152-7590   EMG ONE LIMB                                   170.00        170.00     7590     Cardiology
     03528152-7590   EMG LIMITED                                    252.00        252.00     7590     Cardiology
     03036185-7590   EKG W SCAN 24HR RCRD                           455.00        455.00     7590     Cardiology
     02980000-7593   Massage Therapy 15M                             35.00         35.00     7593     Cardiac Rehab
     02990010-7593   Cardiac Rehab wo EKG                            13.50         13.50     7593     Cardiac Rehab
     02990000-7593   PHASE 1 CARD REHAB 15MN                         54.00         54.00     7593     Cardiac Rehab
     05684720-7593   PT Aqtc Per Prior Auth                         113.00        113.00     7593     Cardiac Rehab
     02990020-7593   Cardiac Rehab w EKG                            215.00        215.00     7593     Cardiac Rehab



8/31/2010                                                                                                                      42
                                                 c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                            CURRENT CURRENT          DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                INPATIENT OUTPATIENT CODE
                                                                PRICE      PRICE
     02906017-7593   Advantage Wt Loss Prg                            0.00        355.00     7593     Cardiac Rehab
     02901516-7593   Diab Trng Svcs Ind Ea 30                        81.00         81.00     7593     Cardiac Rehab
     02901515-7593   Diab Trng Svcs Grp Ea 30                        37.00         37.00     7593     Cardiac Rehab
     02990021-7593   Cardiac Rehab w EKG                            215.00        215.00     7593     Cardiac Rehab
     02906028-7593   MED NUTR TX REASMNT EA 15                        0.00         65.00     7593     Cardiac Rehab
     02906026-7593   MED NUTR TX EA 15                                0.00        127.00     7593     Cardiac Rehab
     02990013-7593   RISK MOD PROGRAM                               107.00        107.00     7593     Cardiac Rehab
     03393667-7610   NI DUPLEX EXT LOW UNI                         1221.00       1221.00     7610     Neurology
     03390218-7610   NI EXT LOW W STRES                            1167.00       1167.00     7610     Neurology
     03520152-7610   EMG ONE LIMB                                   170.00        170.00     7610     Neurology
     03524709-7610   MTR NRV CNDCT STDY W/F EA                      116.00        116.00     7610     Neurology
     03391109-7610   NI DUPLEX EXT VEINS BIL                       2022.00       2022.00     7610     Neurology
     03535119-7610   AD EVAL ABR                                    842.00        842.00     7610     Neurology
     03393600-7610   NI DUPLEX EXTRACRAN UNI                       1210.00       1210.00     7610     Neurology
     03391108-7610   NI DUPLEX EXT VEINS UNI                       1267.00       1267.00     7610     Neurology
     03393675-7610   NI DUPLEX EXT LOW BIL                         1832.00       1832.00     7610     Neurology
     03510179-7610   EEG AWAKE AND ASLEEP                           617.00        617.00     7610     Neurology
     03530391-7610   CALORIC VESTIBULAR TEST                        191.00        191.00     7610     Neurology
     03510336-7610   EEG SLEEP                                      815.00        815.00     7610     Neurology
     03510740-7610   EEG SLEEP                                      815.00        815.00     7610     Neurology
     03391646-7610   NI DUPLEX EXTRACRAN BIL                       1820.00       1820.00     7610     Neurology
     03524113-7610   NRV SNSRY CONDUCT STDY EA                      103.00        103.00     7610     Neurology
     03393691-7610   NI DUPLEX EXT UPP UNI                         1293.00       1293.00     7610     Neurology
     03392008-7610   NI DUPLEX ABD PELV CMPL                       2300.00       2300.00     7610     Neurology
     03393683-7610   NI DUPLEX EXT UPP BIL                         1945.00       1945.00     7610     Neurology
     03392057-7610   NI DUPLEX ABD PELV LTD                        1535.00       1535.00     7610     Neurology
     03392107-7610   NI AORTA IVC IL CMPL                          1887.00       1887.00     7610     Neurology
     03523123-7610   NRV MOTOR CONDUCT STDY EA                      127.00        127.00     7610     Neurology
     03520236-7610   EMG TWO LIMBS                                  333.00        333.00     7610     Neurology
     03530219-7610   POSITIONAL NYSTAGMUS TEST                      119.00        119.00     7610     Neurology
     03390317-7610   NI EXT ART MULTI BIL                          1072.00       1072.00     7610     Neurology
     03393891-7610   NI EXT ART 1 LVL BIL                           570.00        570.00     7610     Neurology
     03393801-7610   NI EXT ART 1 LVL BIL                           570.00        570.00     7610     Neurology
     03391777-7610   NI DIAL ACCES                                 1221.00       1221.00     7610     Neurology
     03392156-7610   NI AORTA IVC IL LTD                           1255.00       1255.00     7610     Neurology
     03530136-7610   Spontaneous Nystagmus Tst                      105.00        105.00     7610     Neurology
     04000105-7630   US OB 1ST TRI 1 GEST                          1164.00       1164.00     7630     Radiology
     04164484-7630   IRC Inj Nrv Blk L/S Add                        211.00        211.00     7630     Radiology



8/31/2010                                                                                                                      43
                                                 c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                            CURRENT CURRENT          DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                INPATIENT OUTPATIENT CODE
                                                                PRICE      PRICE
     04000262-7630   XR Spine Thor 2V                               361.00        361.00     7630     Radiology
     04186919-7630   IRC Verteplasty Thor Prc                      1671.00       1671.00     7630     Radiology
     04176012-7630   IR Vertplasty Ea Fluoro                        262.00        262.00     7630     Radiology
     04774175-7630   CTA Abd W-W/O Con                             3523.00       3523.00     7630     Radiology
     04076986-7630   US In Or                                      1498.00       1498.00     7630     Radiology
     04045822-7630   XR UGI W KUB                                   826.00        826.00     7630     Radiology
     04072200-7630   XR SI Jnt 1 Or 2V                              282.00        282.00     7630     Radiology
     04070140-7630   XR Facial Bone Les 3V                          360.00        360.00     7630     Radiology
     04147000-7630   CTC Bx Liver                                   543.00        543.00     7630     Radiology
     04120220-7630   CTC Bx Bone Super                             1121.00       1121.00     7630     Radiology
     04185920-7630   IRC Inj Facet C/T Add Lvl                      356.00        356.00     7630     Radiology
     04086458-7630   USC Bx Abd Retrope                             413.00        413.00     7630     Radiology
     04086417-7630   USC Paracent Abd Ini                           380.00        380.00     7630     Radiology
     04086490-7630   USC Bx Renl                                    626.00        626.00     7630     Radiology
     04185930-7630   IRC Inj Facet L/S 1 Lvl                        472.00        472.00     7630     Radiology
     04047000-7630   IRC Bx Liver                                   543.00        543.00     7630     Radiology
     04016318-7630   XR Sin Para Les 3V                             343.00        343.00     7630     Radiology
     04132405-7630   CTC Bx Lung Mediastnm                          543.00        543.00     7630     Radiology
     04186928-7630   IRC Verteplasty Add Prc                        472.00        472.00     7630     Radiology
     04132020-7630   CTC Tube Thoracostomy                         1143.00       1143.00     7630     Radiology
     04186920-7630   IRC Verteplasty Lumb Prc                       472.00        472.00     7630     Radiology
     04185940-7630   IRC Inj Facet L/S Add Lvl                      356.00        356.00     7630     Radiology
     04086847-7630   USC SAL INFN SONOHYSTER                        252.00        252.00     7630     Radiology
     04057012-7630   IR Angio Carotd Xtl Uni                       6991.00       6991.00     7630     Radiology
     04120221-7630   CTC Bx Bone Deep                              1265.00       1265.00     7630     Radiology
     04000101-7630   US OB Transvaginal                             843.00        843.00     7630     Radiology
     04016156-7630   XR Eye For FB                                  234.00        234.00     7630     Radiology
     04044514-7630   XR Esoph                                       625.00        625.00     7630     Radiology
     04083214-7630   US OB Ltd 1/More Fetuses                       787.00        787.00     7630     Radiology
     04029530-7630   XR Pelv 3V Or More                             374.00        374.00     7630     Radiology
     04136870-7630   IRC Thrombectomy AVS Fist                     1121.00       1121.00     7630     Radiology
     04083323-7630   US OB AFTR 1ST TRI EA GES                      586.00        586.00     7630     Radiology
     04000107-7630   US OB DTLD FTL EXM EA GES                      586.00        586.00     7630     Radiology
     04046713-7630   XR UGI w Air Con Sm Bowel                     1459.00       1459.00     7630     Radiology
     04711950-7630   CT Spine Cerv W-W/O Con                       4904.00       4904.00     7630     Radiology
     04025920-7630   XR Spine Scoliosis Stndng                      268.00        268.00     7630     Radiology
     04022325-7630   XR Chest Special V Ea                          293.00        293.00     7630     Radiology
     04022320-7630   XR Chest 2V W Obliques                         409.00        409.00     7630     Radiology



8/31/2010                                                                                                                      44
                                                  c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                             CURRENT CURRENT          DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                 INPATIENT OUTPATIENT CODE
                                                                 PRICE      PRICE
     03002300-7630   EKG 12 LEAD TRACING                             222.00        222.00     7630     Radiology
     04186261-7630   IRC EXCHNGE INTRAVAS CATH                       341.00        341.00     7630     Radiology
     04000133-7630   XR Endovas repr abd AO                         6991.00       6991.00     7630     Radiology
     04185900-7630   IR Fluoro Guide Spine Inj                       787.00        787.00     7630     Radiology
     04000134-7630   XR PLACE PROS REPR AAA/IL                      4402.00       4402.00     7630     Radiology
     04149081-7630   USC Paracent Abd Subsq                          315.00        315.00     7630     Radiology
     04029525-7630   XR Pelv 1 Or 2V                                 343.00        343.00     7630     Radiology
     04132002-7630   CTC THORACENTESIS W TUBE                        524.00        524.00     7630     Radiology
     04000103-7630   US OB 1ST TRI EA GEST                           586.00        586.00     7630     Radiology
     04085351-7630   USC Thoracentesis                               437.00        437.00     7630     Radiology
     04185910-7630   IRC Inj Facet C/T 1 Lvl                         472.00        472.00     7630     Radiology
     04082400-7630   US SAL INFN SONOHYSTERGHY                       960.00        960.00     7630     Radiology
     04000123-7630   US Pelv Ltd FU NonOB                            567.00        567.00     7630     Radiology
     04000122-7630   IRC Repr AAA w Pros Add                         581.00        581.00     7630     Radiology
     04000121-7630   IRC Repr AAA/IL Pros Ini                       1925.00       1925.00     7630     Radiology
     04000115-7630   CTA Ext Low w-w/o Con                          3682.00       3682.00     7630     Radiology
     04000110-7630   IRC Repr AAA W Modular                         3231.00       3231.00     7630     Radiology
     04000109-7630   US OB Dtld Ftl Exam 1 Gest                     1164.00       1164.00     7630     Radiology
     04091566-7630   CON GAD-BASE MR 1ML IJ                            3.64          3.64     7630     Radiology
     04715357-7630   CT GUIDANCE TISSUE ABLTN                       4580.00       4580.00     7630     Radiology
     04083937-7630   IR PLACE OCC DEV VEIN ART                       661.00        661.00     7630     Radiology
     04068914-7630   XR FLUORO CVC PLC/RMV/RPR                       665.00        665.00     7630     Radiology
     04164481-7630   IRC INJ EPID L/S                                335.00        335.00     7630     Radiology
     04184979-7630   XRC INJ MAJOR JNT BURSA                         222.00        222.00     7630     Radiology
     04154460-7630   IRC INS TUNN CV DEV 5+                         1285.00       1285.00     7630     Radiology
     04091563-7630   CON LOCM 300-349S I 1ML                           2.69          2.69     7630     Radiology
     04091565-7630   CON LOCM 300-349S I 1ML                           2.72          2.72     7630     Radiology
     04099145-7630   XR CS SAME MD ADD 15M                           104.00        104.00     7630     Radiology
     04099144-7630   XR CS SAME MD GT5YR 0-30M                       209.00        209.00     7630     Radiology
     04099143-7630   XR CS SAME MD LT5YR 0-30M                       209.00        209.00     7630     Radiology
     04064204-7630   IR ATHERECTOMY PERIPH INI                      8371.00       8371.00     7630     Radiology
     04063707-7630   S CATH DRAINAGE                                 250.00        250.00     7630     Radiology
     04715440-7630   CT 3D RENDER W/O POSTPROS                      1958.00       1958.00     7630     Radiology
     04164482-7630   IRC INJ EPID CERV THOR                          378.00        378.00     7630     Radiology
     04091564-7630   CON LOCM 200-249S I 1ML                           3.19          3.19     7630     Radiology
     04082196-7630   USC BX BREAST W IMAG                            410.00        410.00     7630     Radiology
     04091562-7630   CON LOCM 350-399S I 1ML                           2.89          2.89     7630     Radiology
     04186188-7630   XRC INS TUNN CV NO PORT5+                      1058.00       1058.00     7630     Radiology



8/31/2010                                                                                                                       45
                                                  c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                             CURRENT CURRENT          DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                 INPATIENT OUTPATIENT CODE
                                                                 PRICE      PRICE
     04186925-7630   S IMP BONE CEMENT-KYPHX                         473.00        473.00     7630     Radiology
     04186927-7630   S STRL -KYPHO PACK TRAY 15                     9513.00       9513.00     7630     Radiology
     04184980-7630   IRC PTATHER FEM                                1944.00       1944.00     7630     Radiology
     04063702-7630   S STNT NOCOAT WDEL SYS                         5697.00       5697.00     7630     Radiology
     04063705-7630   S CATH TRNSML ANG NOLSR                        4320.00       4320.00     7630     Radiology
     04712311-7630   CT Spine Thor W Con                            3925.00       3925.00     7630     Radiology
     04712550-7630   CT Spine Lumb W/O Con                          3277.00       3277.00     7630     Radiology
     04710919-7630   CT Orbit Sella Fosa W-W/O                      3925.00       3925.00     7630     Radiology
     04712139-7630   CT Spine Thor W/O Con                          3277.00       3277.00     7630     Radiology
     04712857-7630   CT Spine Lumb W Con                            3925.00       3925.00     7630     Radiology
     04711958-7630   CT Spine Cerv W Con                            3925.00       3925.00     7630     Radiology
     04711776-7630   CT Spine Cerv W/O Con                          3277.00       3277.00     7630     Radiology
     04711420-7630   CT Thorax W Con                                3925.00       3925.00     7630     Radiology
     04711107-7630   CT Thorax W/O Con                              3277.00       3277.00     7630     Radiology
     04710950-7630   CT Nec W/O Con                                 2621.00       2621.00     7630     Radiology
     04711008-7630   CT Nec W Con                                   3141.00       3141.00     7630     Radiology
     04031001-7630   XR Myelogram Cerv                              2635.00       2635.00     7630     Radiology
     04711511-7630   CT Thorax W-W/O                                4904.00       4904.00     7630     Radiology
     04031290-7630   XR Myelogram Thor                              2403.00       2403.00     7630     Radiology
     04184974-7630   IRC PTA FemPop                                 1758.00       1758.00     7630     Radiology
     04186482-7630   CTC Abscss Drn Retrope                          883.00        883.00     7630     Radiology
     04184966-7630   IRC PTA IL                                     1444.00       1444.00     7630     Radiology
     04019014-7630   XR Nec Soft Tissue                              234.00        234.00     7630     Radiology
     04184933-7630   IRC PTA Tibeoperoneal Ea                       2064.00       2064.00     7630     Radiology
     04185898-7630   IRC Cath Abd Low Add                            245.00        245.00     7630     Radiology
     04005071-7630   US Bio Profile W NonStres                       899.00        899.00     7630     Radiology
     04075511-7630   XR Tomogram                                     495.00        495.00     7630     Radiology
     04027710-7630   XR Spine Thor Lumb 2V                           374.00        374.00     7630     Radiology
     04028312-7630   XR Spine Lumb 2-3V                              374.00        374.00     7630     Radiology
     04028619-7630   XR Spine Lumb 4V Or More                        509.00        509.00     7630     Radiology
     04030417-7630   XR SI Jnt 3V Or More                            343.00        343.00     7630     Radiology
     04031589-7630   XR Myelogram Lumb                              2260.00       2260.00     7630     Radiology
     04715256-7630   CT Abd W-W/O Con                               4707.00       4707.00     7630     Radiology
     04713335-7630   CT Pelv W Con                                  3795.00       3795.00     7630     Radiology
     04713756-7630   CT Ext Upp W/O Con                             2756.00       2756.00     7630     Radiology
     04714416-7630   CT Ext Low W/O Con                             2756.00       2756.00     7630     Radiology
     04000726-7630   XR Ankle 2V                                     275.00        275.00     7630     Radiology
     04714713-7630   CT Ext Low W Con                               3277.00       3277.00     7630     Radiology



8/31/2010                                                                                                                       46
                                                 c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                            CURRENT CURRENT          DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                INPATIENT OUTPATIENT CODE
                                                                PRICE      PRICE
     04030714-7630   XR Sacrum Coccyx 2 V More                      315.00        315.00     7630     Radiology
     04715074-7630   CT Abd W/Con                                  3498.00       3498.00     7630     Radiology
     04083614-7630   US Pelv Cmpl NonOB                             843.00        843.00     7630     Radiology
     04000759-7630   XR Foot 2V                                     275.00        275.00     7630     Radiology
     04003423-7630   XR UGI W Air Con KUB                           913.00        913.00     7630     Radiology
     04710752-7630   CT Orbit Sella Fossa W                        3141.00       3141.00     7630     Radiology
     04713152-7630   CT Pelv W/O Con                               3277.00       3277.00     7630     Radiology
     04714895-7630   CT Abd W/O Con                                2894.00       2894.00     7630     Radiology
     04051215-7630   XR IVP w-w/o Tomogram                          937.00        937.00     7630     Radiology
     04044368-7630   XR Abd 1V AP                                   315.00        315.00     7630     Radiology
     04044517-7630   XR Abd Cmpl Decub Erect                        343.00        343.00     7630     Radiology
     04045514-7630   XR Swallowing Fnctn                            721.00        721.00     7630     Radiology
     04045811-7630   XR UGI W KUB                                   826.00        826.00     7630     Radiology
     04046413-7630   XR UGI w Sm Bowel                             1324.00       1324.00     7630     Radiology
     04046710-7630   XR Sm Bowel Series                             721.00        721.00     7630     Radiology
     04047312-7630   XR BE                                          948.00        948.00     7630     Radiology
     04048211-7630   XR BE W Air Con                               1243.00       1243.00     7630     Radiology
     04054631-7630   IR Cath Renl Pelv Prc                         2260.00       2260.00     7630     Radiology
     04050548-7630   XR ERCP Bili Panc Duct                        1745.00       1745.00     7630     Radiology
     04042719-7630   XR Foot 3V Or More                             297.00        297.00     7630     Radiology
     04028333-7630   XR Spine Lumb 4V W Bend                        658.00        658.00     7630     Radiology
     04051512-7630   XR IVP w-w/o Tomogram                          937.00        937.00     7630     Radiology
     04052114-7630   XR Urogram Retro                              1459.00       1459.00     7630     Radiology
     04052718-7630   XR Cystogram 3V Or More                        584.00        584.00     7630     Radiology
     04028433-7630   XR Spine Lumb Bend Only                        497.00        497.00     7630     Radiology
     04053310-7630   XR Urethrocystogram                            810.00        810.00     7630     Radiology
     04053617-7630   XR Urethrocystogram Void                       875.00        875.00     7630     Radiology
     04034924-7630   XR Elbow 2V                                    293.00        293.00     7630     Radiology
     04083655-7630   US Ext NonVascular                             787.00        787.00     7630     Radiology
     04049110-7630   XR Chol In Or                                  754.00        754.00     7630     Radiology
     04038212-7630   XR Hip Uni 2V Or More                          315.00        315.00     7630     Radiology
     04032819-7630   XR Scapula Cmpl                                293.00        293.00     7630     Radiology
     04033411-7630   XR Shoulder 2V Or More                         315.00        315.00     7630     Radiology
     04033718-7630   XR Arthro Shoulder                            1164.00       1164.00     7630     Radiology
     04034013-7630   XR AC Jnt                                      374.00        374.00     7630     Radiology
     04034310-7630   XR Humerus 2V Or More                          315.00        315.00     7630     Radiology
     04034914-7630   XR Elbow 3V Or More                            315.00        315.00     7630     Radiology
     04035515-7630   XR Forearm 2V                                  293.00        293.00     7630     Radiology



8/31/2010                                                                                                                      47
                                                 c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                            CURRENT       CURRENT         DEPARTMENT    DEPARTMENT DESCRIPTION
                                                                INPATIENT     OUTPATIENT      CODE
                                                                PRICE         PRICE
     04036117-7630   XR Wrist 3V Or More                             297.00          297.00          7630   Radiology
     04036414-7630   XR Arthro Wrist                                 875.00          875.00          7630   Radiology
     04043618-7630   XR Toe(s) 2V Or More                            234.00          234.00          7630   Radiology
     04037313-7630   XR Finger(s) 2V Or More                         234.00          234.00          7630   Radiology
     04043311-7630   XR CALCANEOUS 2V OR MORE                        264.00          264.00          7630   Radiology
     04038816-7630   XR Hips Bil 2V W Pelv                           374.00          374.00          7630   Radiology
     04039111-7630   XR Arthro Hip                                  1164.00         1164.00          7630   Radiology
     04039715-7630   XR Pelv Hip 2V Inf Chld                         315.00          315.00          7630   Radiology
     04040010-7630   XR Femur 2V                                     315.00          315.00          7630   Radiology
     04040614-7630   XR Knee 4V Or More                              343.00          343.00          7630   Radiology
     04040911-7630   XR Arthro Knee                                 1459.00         1459.00          7630   Radiology
     04041216-7630   XR Tibia Fibula 2V                              293.00          293.00          7630   Radiology
     04041810-7630   XR Ankle 3V Or More                             297.00          297.00          7630   Radiology
     04054698-7630   IR Tube Cath Chng                              1083.00         1083.00          7630   Radiology
     04037016-7630   XR Hand 3V Or More                              297.00          297.00          7630   Radiology
     04082160-7630   US Chest                                        721.00          721.00          7630   Radiology
     04068912-7630   XR FLUORO 1-2 HRS                              3370.00         3370.00          7630   Radiology
     04069514-7630   XR FLUORO 2-3 HRS                              3370.00         3370.00          7630   Radiology
     04070116-7630   XR FLUORO 3-4 HRS                              3370.00         3370.00          7630   Radiology
     04071916-7630   XR Bone Age Stdy                                293.00          293.00          7630   Radiology
     04072211-7630   XR Bone Length Stdy                             440.00          440.00          7630   Radiology
     04072518-7630   XR Bone Survey Cmpl                             796.00          796.00          7630   Radiology
     04074019-7630   XR Specimen Surgical                            234.00          234.00          7630   Radiology
     04080917-7630   XR Fluoro 1Hr Or Les                           1631.00         1631.00          7630   Radiology
     04036417-7630   XR Wrist 2V                                     275.00          275.00          7630   Radiology
     04082111-7630   US Head & Nec Sft Tissue                   787           787             7630          Radiology
     04063905-7630   IR Angio FU Existing Cath                  584           584             7630          Radiology
     04082210-7630   US Abd Cmpl                                    1095.00         1095.00          7630   Radiology
     04082319-7630   US Echo Abd Ltd                                 787.00          787.00          7630   Radiology
     04083218-7630   US OB Aftr 1St Tri 1 Gest                      1164.00         1164.00          7630   Radiology
     04083317-7630   US OB Fu/Reeval Ea Fetus                        787.00          787.00          7630   Radiology
     04083630-7630   US Testicular Scrotum                           843.00          843.00          7630   Radiology
     04083911-7630   US Ndl Place                                    860.00          860.00          7630   Radiology
     04710455-7630   CT Brain W/O Con                               2416.00         2416.00          7630   Radiology
     04710463-7630   CT Brain W Con                                 3141.00         3141.00          7630   Radiology
     04710471-7630   CT Brain W-W/O Con                             3925.00         3925.00          7630   Radiology
     04081667-7630   US Encephalogram                                787.00          787.00          7630   Radiology
     04059408-7630   IR Angio Renl Uni                              6991.00         6991.00          7630   Radiology



8/31/2010                                                                                                                            48
                                                c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                           CURRENT CURRENT          DEPARTMENT   DEPARTMENT DESCRIPTION
                                                               INPATIENT OUTPATIENT CODE
                                                               PRICE      PRICE
     04054771-7630   IR Ureteral Stent Prc                        2260.00       2260.00     7630     Radiology
     04055711-7630   XR Hysterosalpingogram                        721.00        721.00     7630     Radiology
     04056404-7630   IR Aortogram Abd W Ser                       6991.00       6991.00     7630     Radiology
     04040655-7630   XR Knee 1 Or 2V                               293.00        293.00     7630     Radiology
     04000676-7630   XR Knee 3V                                    315.00        315.00     7630     Radiology
     04056701-7630   IR Aortogram Abd Bil Ext                     7280.00       7280.00     7630     Radiology
     04003209-7630   XR Knees Standing AP                          275.00        275.00     7630     Radiology
     04057600-7630   IR Angio Carotd Cere Uni                     6991.00       6991.00     7630     Radiology
     04057907-7630   IR Angio Carotd Cere Bil                     6991.00       6991.00     7630     Radiology
     04065207-7630   CT Drn W Cath Place Prc                      1745.00       1745.00     7630     Radiology
     04059101-7630   IR Angio Ext Uni                             6991.00       6991.00     7630     Radiology
     04064200-7630   IR PTA Periph Art                            8730.00       8730.00     7630     Radiology
     04059705-7630   IR Angio Renl Bil                            6991.00       6991.00     7630     Radiology
     04061800-7630   XR Venogram Ext Uni                           524.00        524.00     7630     Radiology
     04062105-7630   XR Venogram Ext Bil                           823.00        823.00     7630     Radiology
     04062402-7630   IR Venogram IVC                              6991.00       6991.00     7630     Radiology
     04062709-7630   IR Venogram SVC                              6991.00       6991.00     7630     Radiology
     04063004-7630   IR Ven Sampling                              6991.00       6991.00     7630     Radiology
     04063301-7630   IR Embol Tx                                 13388.00      13388.00     7630     Radiology
     04063608-7630   IR Transcatheter Tx IV                      11639.00      11639.00     7630     Radiology
     04710612-7630   CT Orbit/Sella/Fossa W/O                     2621.00       2621.00     7630     Radiology
     04058806-7630   IR Angio Ext Uni                             6991.00       6991.00     7630     Radiology
     04057956-7630   IR Angio Vertebral                           6991.00       6991.00     7630     Radiology
     04186631-7630   IRC Inj Nephrogram                            217.00        217.00     7630     Radiology
     04186854-7630   USC Bx Thyroid                                233.00        233.00     7630     Radiology
     04186201-7630   IRC Chng GT Tube                              264.00        264.00     7630     Radiology
     04715306-7630   CT Guide Ndl Placement                       4580.00       4580.00     7630     Radiology
     04186847-7630   XRC SAL INFN SONOHYSTER                       252.00        252.00     7630     Radiology
     04715355-7630   CT Guide Ndl Placement                       4580.00       4580.00     7630     Radiology
     04083804-7630   US Ndl Place                                  860.00        860.00     7630     Radiology
     04186813-7630   XRC Inj Cysto Retro                           302.00        302.00     7630     Radiology
     04020153-7630   CA Tracing Ecg                                251.00        251.00     7630     Radiology
     04186789-7630   XRC Inj Cysto VCUG                            211.00        211.00     7630     Radiology
     04050654-7630   IR G Tube Prc                                1745.00       1745.00     7630     Radiology
     04064408-7630   IR Pta Ven                                   8730.00       8730.00     7630     Radiology
     04185872-7630   IRC Cath Abd Low 2nd                         1265.00       1265.00     7630     Radiology
     04064259-7630   IR PTA Periph Art Add                        4655.00       4655.00     7630     Radiology
     04061453-7630   IR Angio AVS Shunt                            753.00        753.00     7630     Radiology



8/31/2010                                                                                                                     49
                                                 c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                            CURRENT       CURRENT         DEPARTMENT    DEPARTMENT DESCRIPTION
                                                                INPATIENT     OUTPATIENT      CODE
                                                                PRICE         PRICE
     04186698-7630   IRC Nephrostomy Tube Chng                       348.00          348.00          7630   Radiology
     04064150-7630   IR Retrieval Vascular FB                       5827.00         5827.00          7630   Radiology
     04050639-7630   IR GI Tube Insert Long                         1745.00         1745.00          7630   Radiology
     04064903-7630   IR Tube Cath Chng                              1083.00         1083.00          7630   Radiology
     04185815-7630   IRC Cath Thor 1st Art                          1349.00         1349.00          7630   Radiology
     04186664-7630   IRC Intro Nephrostomy                           810.00          810.00          7630   Radiology
     04015418-7630   XR Nasal Bones 3V Or More                       293.00          293.00          7630   Radiology
     04057006-7630   IR Angio Carotd Cerv Uni                       6991.00         6991.00          7630   Radiology
     04064101-7630   IR IVC Filter Place                            6991.00         6991.00          7630   Radiology
     04072418-7630   XR Bone Survey Cmpl                             796.00          796.00          7630   Radiology
     04185823-7630   IRC Cath Thor 2nd Art                          1524.00         1524.00          7630   Radiology
     04711057-7630   CT Maxillofacial W/O Con                       2621.00         2621.00          7630   Radiology
     04185849-7630   IRC Cath Thor Add Art                           245.00          245.00          7630   Radiology
     04185831-7630   IRC Cath Thor 3rd Art                          1508.00         1508.00          7630   Radiology
     04185864-7630   IRC Cath Abd Low 1st                           1121.00         1121.00          7630   Radiology
     04711065-7630   CT Maxillofacial W Con                         3141.00         3141.00          7630   Radiology
     04184842-7630   IRC Bx Muscle                                   413.00          413.00          7630   Radiology
     04021813-7630   XR Chest 2V W AP Lordotic                       409.00          409.00          7630   Radiology
     04014817-7630   XR Facial Bone 3V Or More                       440.00          440.00          7630   Radiology
     04711032-7630   CT Nec W-W/O Con                               3925.00         3925.00          7630   Radiology
     04186086-7630   IRC IVCH Retrieve FB                           1203.00         1203.00          7630   Radiology
     04186052-7630   IRC Embol Occ NonHead Nec                      4339.00         4339.00          7630   Radiology
     04057055-7630   IR Angio Carotd Cerv Bil                       6991.00         6991.00          7630   Radiology
     04186888-7630   XRC Inj LP                                      225.00          225.00          7630   Radiology
     04016614-7630   XR Sin Para 3V Or More                          440.00          440.00          7630   Radiology
     04016911-7630   XR SELLA TURCICA                                234.00          234.00          7630   Radiology
     04024600-7630   XR Abd Cmpl W 1V Chest                          409.00          409.00          7630   Radiology
     04024755-7630   XR Ribs Uni & PA Chest                          409.00          409.00          7630   Radiology
     04034234-7630   IR STENT NOCORO/CAR/VERT                       8263.00         8263.00          7630   Radiology
     04012712-7630   XR Mandible 4V Or More                          343.00          343.00          7630   Radiology
     04034235-7630   IRC STENT NOCORO/CAR/VERT                      1981.00         1981.00          7630   Radiology
     04186862-7630   XRC Inj Myelogram                          366           366             7630          Radiology
     04713657-7630   CT Ltd Or FU Stdy                              1944.00         1944.00          7630   Radiology
     04055013-7630   IR Venogram Ext Uni                             524.00          524.00          7630   Radiology
     04026514-7630   XR Spine Cerv 2-3V                         334           334             7630          Radiology
     04185674-7630   IRC AVS Dial Shunt                              576.00          576.00          7630   Radiology
     04186607-7630   IRC Intro Stent Cath Uret                  1198          1198            7630          Radiology
     04184982-7630   IRC PTA Brachioceph Ea                         2270.00         2270.00          7630   Radiology



8/31/2010                                                                                                                            50
                                                 c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                            CURRENT       CURRENT         DEPARTMENT    DEPARTMENT DESCRIPTION
                                                                INPATIENT     OUTPATIENT      CODE
                                                                PRICE         PRICE
     04058855-7630   IR Angio Ext Bil                               6991.00         6991.00          7630   Radiology
     04184990-7630   IRC PTA Ven                                    1741.00         1741.00          7630   Radiology
     04185740-7630   IRC Intro Cath Aorta                            869.00          869.00          7630   Radiology
     04186060-7630   IRC Thrombolysis IV NonCo                      1435.00         1435.00          7630   Radiology
     04186128-7630   IRC Intro IVC Filter                           2525.00         2525.00          7630   Radiology
     04186227-7630   IRC Intro G Tube                               1074.00         1074.00          7630   Radiology
     04186243-7630   IRC Bx Liver                                    543.00          543.00          7630   Radiology
     04027116-7630   XR Spine C 4V & Flex/Ext                        626.00          626.00          7630   Radiology
     04025912-7630   XR Spine Survey Entire                          570.00          570.00          7630   Radiology
     04016150-7630   XR Orbits 4V Or More                            440.00          440.00          7630   Radiology
     04185617-7630   IRC Select Cath 1st Ven                         751.00          751.00          7630   Radiology
     04027413-7630   XR Spine Thor 3V                           409           409             7630          Radiology
     04186458-7630   CTC Bx Abd Retrope                              413.00          413.00          7630   Radiology
     04026811-7630   XR Spine Cerv 4V Or More                        497.00          497.00          7630   Radiology
     04186425-7630   CTC Abscss Drn Renl                             810.00          810.00          7630   Radiology
     04186367-7630   IRC Reinsert Bile Tube                     1399          1399            7630          Radiology
     04081887-7630   US Spinal Canal                                 787.00          787.00          7630   Radiology
     04185880-7630   IRC Cath Abd Low 3rd                           1508.00         1508.00          7630   Radiology
     04186391-7630   IRC Bili Cath Chng                         1326          1326            7630          Radiology
     04000015-7630   XR Mandible Les 4V                         293           293             7630          Radiology
     04025318-7630   XR Sternoclavic 3V More                         390.00          390.00          7630   Radiology
     04024410-7630   XR Ribs Uni 2V                                  315.00          315.00          7630   Radiology
     04017216-7630   XR Skull Les 4V                            343           343             7630          Radiology
     04017513-7630   XR Skull 4V Or More                             497.00          497.00          7630   Radiology
     04018412-7630   XR TMJ Bil                                 467           467             7630          Radiology
     04186581-7630   IRC Nephrostomy Tube Chng                       348.00          348.00          7630   Radiology
     04186557-7630   CTC Abscss Drn Peritnl                          808.00          808.00          7630   Radiology
     04037024-7630   XR Hand 2V                                      275.00          275.00          7630   Radiology
     04032512-7630   XR Clavicle Cmpl                                293.00          293.00          7630   Radiology
     04186532-7630   CTC Bx Pancreas                                1349.00         1349.00          7630   Radiology
     04186490-7630   CTC Bx Renl                                     626.00          626.00          7630   Radiology
     04086955-7630   IR Fluoro Ndl Place                             721.00          721.00          7630   Radiology
     04185625-7630   IRC Intro Cath IVC /SVC                         579.00          579.00          7630   Radiology
     04021713-7630   XR Chest 2V                                343           343             7630          Radiology
     04056800-7630   IR Angio Cervicocerebral                       6991.00         6991.00          7630   Radiology
     04071858-7630   XR FB Loc Chld                                  293.00          293.00          7630   Radiology
     04035606-7630   XR Ext Inf Upp Les 1Yr                     275           275             7630          Radiology
     04024717-7630   XR Ribs Bil 3V                             440           440             7630          Radiology



8/31/2010                                                                                                                            51
                                                 c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                            CURRENT      CURRENT        DEPARTMENT    DEPARTMENT DESCRIPTION
                                                                INPATIENT    OUTPATIENT     CODE
                                                                PRICE        PRICE
     04025011-7630   XR Sternum 2V Or More                      361          361            7630          Radiology
     04184925-7630   XRC Inj Arthro Shoulder                    240          240            7630          Radiology
     04185179-7630   XRC Inj Arthro Wrist                       347          347            7630          Radiology
     04185229-7630   XRC Inj Arthro Hip                         312          312            7630          Radiology
     04185351-7630   CTC Thoracentesis                          437          437            7630          Radiology
     04185526-7630   XRC Inj Ext Venogram                       458          458            7630          Radiology
     04035655-7630   XR Ext Inf Low Les 1Yr                         275.00         275.00          7630   Radiology
     04185724-7630   IRC Intro Aorta                            604          604            7630          Radiology
     04021416-7630   XR Chest 1V                                264          264            7630          Radiology
     04166658-7630   IRC INS NON-TUN CV CATH5+                      294.00         294.00          7630   Radiology
     04001672-7630   US Echo Inf Hips                               843.00         843.00          7630   Radiology
     04083219-7630   US Transvaginal                            843          843            7630          Radiology
     04033412-7630   XR Shoulder 1V                             264          264            7630          Radiology
     04151458-7630   IRC Inj Con Abscss                             191.00         191.00          7630   Radiology
     04156458-7630   IRC Stent Place NonCo Add                      988.00         988.00          7630   Radiology
     04154458-7630   IRC INS NON-TUN CV CATH5+                  294          294            7630          Radiology
     04153458-7630   IRC Select Cath 2nd Ven                        839.00         839.00          7630   Radiology
     04044316-7630   XR Spine Sngl V Lumb                           234.00         234.00          7630   Radiology
     04155658-7630   XRC Bx Soft Tiss Nec Thor                  494          494            7630          Radiology
     04000672-7630   XR Hip Uni 1V                                  264.00         264.00          7630   Radiology
     03700494-7632   XR Shoulder 2V Or More                     315          315            7632          Radiology Clinics
     03700270-7632   XR Spine Thor Lumb 2V                          374.00         374.00          7632   Radiology Clinics
     03700262-7632   XR Spine Thor 2V                               361.00         361.00          7632   Radiology Clinics
     03700288-7632   XR Spine Lumb 2-3V                             374.00         374.00          7632   Radiology Clinics
     03703209-7632   XR Knees Standing AP                           275.00         275.00          7632   Radiology Clinics
     03700445-7632   XR Abd Cmpl Decub Erect                        343.00         343.00          7632   Radiology Clinics
     03700437-7632   XR Abd 1V AP                                   315.00         315.00          7632   Radiology Clinics
     03700783-7632   XR Toe(s) 2V Or More                           234.00         234.00          7632   Radiology Clinics
     03700775-7632   XR Calcaneous 2V Or More                       264.00         264.00          7632   Radiology Clinics
     03700742-7632   XR Foot 3V Or More                             297.00         297.00          7632   Radiology Clinics
     03700759-7632   XR Foot 2V                                 275          275            7632          Radiology Clinics
     03700718-7632   XR Ankle 3V Or More                        297          297            7632          Radiology Clinics
     03700478-7632   XR Clavicle Cmpl                           293          293            7632          Radiology Clinics
     03700700-7632   XR Tibia Fibula 2V                         293          293            7632          Radiology Clinics
     03700672-7632   XR Hip Uni 1V                                  264.00         264.00          7632   Radiology Clinics
     03700676-7632   XR Knee 3V                                     315.00         315.00          7632   Radiology Clinics
     03703217-7632   XR Knee 4V Or More                             343.00         343.00          7632   Radiology Clinics
     03700668-7632   XR Knee 1 Or 2V                                293.00         293.00          7632   Radiology Clinics



8/31/2010                                                                                                                          52
                                                 c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                            CURRENT      CURRENT        DEPARTMENT    DEPARTMENT DESCRIPTION
                                                                INPATIENT    OUTPATIENT     CODE
                                                                PRICE        PRICE
     03700650-7632   XR Femur 2V                                    315.00         315.00          7632   Radiology Clinics
     03700627-7632   XR Hip Uni 2V Or More                          315.00         315.00          7632   Radiology Clinics
     03700635-7632   XR Hips Bil 2V W Pelv                          374.00         374.00          7632   Radiology Clinics
     03700619-7632   XR Finger(s) 2V Or More                        234.00         234.00          7632   Radiology Clinics
     03700601-7632   XR Hand 2V                                     275.00         275.00          7632   Radiology Clinics
     03700726-7632   XR Ankle 2V                                275          275            7632          Radiology Clinics
     03400437-7632   XR Abd 1V AP                               315          315            7632          Radiology Clinics
     03700304-7632   XR Spine Lumb 4V W Bend                        658.00         658.00          7632   Radiology Clinics
     03700320-7632   XR SI Jnt 3V Or More                       343          343            7632          Radiology Clinics
     03700338-7632   XR Sacrum Coccyx 2 V More                      315.00         315.00          7632   Radiology Clinics
     03700486-7632   XR Scapula Cmpl                                293.00         293.00          7632   Radiology Clinics
     03700593-7632   XR Hand 3V Or More                         297          297            7632          Radiology Clinics
     03700536-7632   XR Humerus 2V Or More                          315.00         315.00          7632   Radiology Clinics
     03700551-7632   XR Elbow 3V Or More                            315.00         315.00          7632   Radiology Clinics
     03700569-7632   XR Forearm 2V                                  293.00         293.00          7632   Radiology Clinics
     03700395-7632   XR Bone Age Stdy                               293.00         293.00          7632   Radiology Clinics
     03700247-7632   XR Spine Cerv 4V Or More                       497.00         497.00          7632   Radiology Clinics
     03700122-7632   XR Skull Les 4V                                343.00         343.00          7632   Radiology Clinics
     03700585-7632   XR Wrist 2V                                    275.00         275.00          7632   Radiology Clinics
     03700544-7632   XR Elbow 2V                                293          293            7632          Radiology Clinics
     03700072-7632   XR Sin Para Les 3V                             343.00         343.00          7632   Radiology Clinics
     03700382-7632   XR Pelv 1 Or 2V                                343.00         343.00          7632   Radiology Clinics
     03700385-7632   XR Pelv 3V Or More                             374.00         374.00          7632   Radiology Clinics
     03700252-7632   XR Chest 2V W Obliques                         409.00         409.00          7632   Radiology Clinics
     03700804-7632   XR Shoulder 1V                                 264.00         264.00          7632   Radiology Clinics
     03700296-7632   XR Spine Lumb 4V Or More                       509.00         509.00          7632   Radiology Clinics
     03700577-7632   XR Wrist 3V Or More                        297          297            7632          Radiology Clinics
     03400759-7632   XR Foot 2V                                     275.00         275.00          7632   Radiology Clinics
     03400577-7632   XR Wrist 3V Or More                            297.00         297.00          7632   Radiology Clinics
     03700148-7632   XR Chest 1V                                264          264            7632          Radiology Clinics
     03700049-7632   XR Nasal Bones 3V Or More                      293.00         293.00          7632   Radiology Clinics
     03400258-7632   XR Spine Scoliosis Stndng                      268.00         268.00          7632   Radiology Clinics
     03400783-7632   XR Toe(s) 2V Or More                           234.00         234.00          7632   Radiology Clinics
     03400585-7632   XR Wrist 2V                                    275.00         275.00          7632   Radiology Clinics
     03400593-7632   XR Hand 3V Or More                         297          297            7632          Radiology Clinics
     03400619-7632   XR Finger(s) 2V Or More                    234          234            7632          Radiology Clinics
     03700023-7632   XR Mandible 4V Or More                         343.00         343.00          7632   Radiology Clinics
     03400742-7632   XR Foot 3V Or More                             297.00         297.00          7632   Radiology Clinics



8/31/2010                                                                                                                          53
                                                 c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                            CURRENT      CURRENT        DEPARTMENT    DEPARTMENT DESCRIPTION
                                                                INPATIENT    OUTPATIENT     CODE
                                                                PRICE        PRICE
     03400494-7632   XR Shoulder 2V Or More                         315.00         315.00          7632   Radiology Clinics
     03400718-7632   XR Ankle 3V Or More                            297.00         297.00          7632   Radiology Clinics
     03400700-7632   XR Tibia Fibula 2V                             293.00         293.00          7632   Radiology Clinics
     03403209-7632   XR Knees Standing AP                           275.00         275.00          7632   Radiology Clinics
     03400676-7632   XR Knee 3V                                 315          315            7632          Radiology Clinics
     03403217-7632   XR Knee 4V Or More                         343          343            7632          Radiology Clinics
     03400635-7632   XR Hips Bil 2V W Pelv                      374          374            7632          Radiology Clinics
     03400627-7632   XR Hip Uni 2V Or More                      315          315            7632          Radiology Clinics
     03700239-7632   XR Spine Cerv 2-3V                         334          334            7632          Radiology Clinics
     03400650-7632   XR Femur 2V                                315          315            7632          Radiology Clinics
     03400775-7632   XR Calcaneous 2V Or More                   264          264            7632          Radiology Clinics
     03400155-7632   XR Chest 2V                                    343.00         343.00          7632   Radiology Clinics
     03700205-7632   XR Sternoclavic 3V More                        390.00         390.00          7632   Radiology Clinics
     03700171-7632   XR Ribs Uni 2V                                 315.00         315.00          7632   Radiology Clinics
     03700189-7632   XR Ribs Bil 3V                                 440.00         440.00          7632   Radiology Clinics
     03700163-7632   XR Chest 2V W AP Lordotic                      409.00         409.00          7632   Radiology Clinics
     04800252-7632   XR Chest 2V W Obliques                         409.00         409.00          7632   Radiology Clinics
     03700254-7632   XR Spine C 4V & Flex/Ext                       626.00         626.00          7632   Radiology Clinics
     04800072-7632   XR Sin Para Les 3V                             343.00         343.00          7632   Radiology Clinics
     04800382-7632   XR Pelv 1 Or 2V                                343.00         343.00          7632   Radiology Clinics
     03400049-7632   XR Nasal Bones 3V Or More                      293.00         293.00          7632   Radiology Clinics
     03400569-7632   XR Forearm 2V                              293          293            7632          Radiology Clinics
     03400148-7632   XR Chest 1V                                264          264            7632          Radiology Clinics
     03400551-7632   XR Elbow 3V Or More                        315          315            7632          Radiology Clinics
     03700155-7632   XR Chest 2V                                343          343            7632          Radiology Clinics
     03400171-7632   XR Ribs Uni 2V                             315          315            7632          Radiology Clinics
     03400239-7632   XR Spine Cerv 2-3V                         334          334            7632          Radiology Clinics
     03400262-7632   XR Spine Thor 2V                               361.00         361.00          7632   Radiology Clinics
     03400288-7632   XR Spine Lumb 2-3V                         374          374            7632          Radiology Clinics
     03400296-7632   XR Spine Lumb 4V Or More                       509.00         509.00          7632   Radiology Clinics
     03400338-7632   XR Sacrum Coccyx 2 V More                      315.00         315.00          7632   Radiology Clinics
     03400478-7632   XR Clavicle Cmpl                           293          293            7632          Radiology Clinics
     03400668-7632   XR Knee 1 Or 2V                                293.00         293.00          7632   Radiology Clinics
     03400080-7632   XR Orbits 4V Or More                           440.00         440.00          7632   Radiology Clinics
     04800296-7632   XR Spine Lumb 4V Or More                       509.00         509.00          7632   Radiology Clinics
     04800320-7632   XR SI Jnt 3V Or More                       343          343            7632          Radiology Clinics
     04800338-7632   XR Sacrum Coccyx 2 V More                  315          315            7632          Radiology Clinics
     04800478-7632   XR Clavicle Cmpl                               293.00         293.00          7632   Radiology Clinics



8/31/2010                                                                                                                          54
                                                 c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                            CURRENT      CURRENT        DEPARTMENT    DEPARTMENT DESCRIPTION
                                                                INPATIENT    OUTPATIENT     CODE
                                                                PRICE        PRICE
     04800486-7632   XR Scapula Cmpl                                293.00         293.00          7632   Radiology Clinics
     04800536-7632   XR Humerus 2V Or More                      315          315            7632          Radiology Clinics
     04800494-7632   XR Shoulder 2V Or More                         315.00         315.00          7632   Radiology Clinics
     04800601-7632   XR Hand 2V                                 275          275            7632          Radiology Clinics
     04800742-7632   XR Foot 3V Or More                             297.00         297.00          7632   Radiology Clinics
     04800148-7632   XR Chest 1V                                    264.00         264.00          7632   Radiology Clinics
     04800155-7632   XR Chest 2V                                    343.00         343.00          7632   Radiology Clinics
     04800197-7632   XR Sternum 2V Or More                          361.00         361.00          7632   Radiology Clinics
     04800783-7632   XR Toe(s) 2V Or More                           234.00         234.00          7632   Radiology Clinics
     04800262-7632   XR Spine Thor 2V                               361.00         361.00          7632   Radiology Clinics
     04800122-7632   XR Skull Les 4V                                343.00         343.00          7632   Radiology Clinics
     04800726-7632   XR Ankle 2V                                    275.00         275.00          7632   Radiology Clinics
     04800205-7632   XR Sternoclavic 3V More                        390.00         390.00          7632   Radiology Clinics
     04800619-7632   XR Finger(s) 2V Or More                        234.00         234.00          7632   Radiology Clinics
     04800718-7632   XR Ankle 3V Or More                            297.00         297.00          7632   Radiology Clinics
     04803209-7632   XR Knees Standing AP                           275.00         275.00          7632   Radiology Clinics
     04800700-7632   XR Tibia Fibula 2V                             293.00         293.00          7632   Radiology Clinics
     04800627-7632   XR Hip Uni 2V Or More                          315.00         315.00          7632   Radiology Clinics
     04800775-7632   XR Calcaneous 2V Or More                       264.00         264.00          7632   Radiology Clinics
     04800239-7632   XR Spine Cerv 2-3V                             334.00         334.00          7632   Radiology Clinics
     04800650-7632   XR Femur 2V                                    315.00         315.00          7632   Radiology Clinics
     04800270-7632   XR Spine Thor Lumb 2V                          374.00         374.00          7632   Radiology Clinics
     04800585-7632   XR Wrist 2V                                    275.00         275.00          7632   Radiology Clinics
     04800577-7632   XR Wrist 3V Or More                            297.00         297.00          7632   Radiology Clinics
     04800247-7632   XR Spine Cerv 4V Or More                       497.00         497.00          7632   Radiology Clinics
     04800569-7632   XR Forearm 2V                                  293.00         293.00          7632   Radiology Clinics
     04800544-7632   XR Elbow 2V                                    293.00         293.00          7632   Radiology Clinics
     04800437-7632   XR Abd 1V AP                                   315.00         315.00          7632   Radiology Clinics
     04800635-7632   XR Hips Bil 2V W Pelv                          374.00         374.00          7632   Radiology Clinics
     04800593-7632   XR Hand 3V Or More                             297.00         297.00          7632   Radiology Clinics
     04800668-7632   XR Knee 1 Or 2V                                293.00         293.00          7632   Radiology Clinics
     04803217-7632   XR Knee 4V Or More                             343.00         343.00          7632   Radiology Clinics
     04800676-7632   XR Knee 3V                                     315.00         315.00          7632   Radiology Clinics
     04800288-7632   XR Spine Lumb 2-3V                             374.00         374.00          7632   Radiology Clinics
     04800049-7632   XR Nasal Bones 3V Or More                      293.00         293.00          7632   Radiology Clinics
     04800171-7632   XR Ribs Uni 2V                                 315.00         315.00          7632   Radiology Clinics
     04800551-7632   XR Elbow 3V Or More                            315.00         315.00          7632   Radiology Clinics
     03904185-7633   XR SCRN MAMMO DIG W COMP                       157.00         157.00          7633   The Breast Center



8/31/2010                                                                                                                          55
                                                  c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                             CURRENT CURRENT          DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                 INPATIENT OUTPATIENT CODE
                                                                 PRICE      PRICE
     04000101-7633   US OB Transvaginal                              843.00        843.00     7633     The Breast Center
     03937777-7633   S IMP Metal Marking Clip                        171.00        171.00     7633     The Breast Center
     03974631-7633   XR Specimen Surgical                            234.00        234.00     7633     The Breast Center
     03919295-7633   XRC IMAG LOC CLIP W BX                          435.00        435.00     7633     The Breast Center
     03919102-7633   XRC Bx Breast W Imag                            410.00        410.00     7633     The Breast Center
     03984760-7633   XRC Breast Ndl Wire                             372.00        372.00     7633     The Breast Center
     03904184-7633   XR Diag Mammo Dig w Comp                        157.00        157.00     7633     The Breast Center
     03919290-7633   USC Breast Ndl Wire                             372.00        372.00     7633     The Breast Center
     03975119-7633   US Encephalogram                                787.00        787.00     7633     The Breast Center
     03975125-7633   US OB 1ST TRI 1 GEST                           1164.00       1164.00     7633     The Breast Center
     03975129-7633   US OB Aftr 1St Tri 1 Gest                      1164.00       1164.00     7633     The Breast Center
     03904190-7633   XR SCRN MAMMO DIG BILAT                         292.00        292.00     7633     The Breast Center
     03975135-7633   US OB DTLD FTL EXM EA GES                       586.00        586.00     7633     The Breast Center
     03975105-7633   US Bio Profile W NonStres                       899.00        899.00     7633     The Breast Center
     03975115-7633   US Echo Inf Hips                                843.00        843.00     7633     The Breast Center
     03975113-7633   US Echo Abd Ltd                                 787.00        787.00     7633     The Breast Center
     03975109-7633   US Duplex Ext Veins Uni                        2134.00       2134.00     7633     The Breast Center
     03975157-7633   US Transvaginal                                 843.00        843.00     7633     The Breast Center
     03975103-7633   US Amniocentesis                                843.00        843.00     7633     The Breast Center
     03975101-7633   US Abd Cmpl                                    1095.00       1095.00     7633     The Breast Center
     03975165-7633   USC SAL INFN SONOHYSTER                         252.00        252.00     7633     The Breast Center
     03975131-7633   US OB AFTR 1ST TRI EA GES                       586.00        586.00     7633     The Breast Center
     03975153-7633   US Testicular Scrotum                           843.00        843.00     7633     The Breast Center
     03975133-7633   US OB Dtld Ftl Exam 1 Gest                     1164.00       1164.00     7633     The Breast Center
     04407003-7633   MRC IMAG LOC CLIP W BX                          435.00        435.00     7633     The Breast Center
     03975143-7633   US Pelv Cmpl NonOB                              843.00        843.00     7633     The Breast Center
     03975149-7633   US SAL INFN SONOHYSTERGHY                       960.00        960.00     7633     The Breast Center
     03975123-7633   US Head & Nec Sft Tissue                        787.00        787.00     7633     The Breast Center
     03975137-7633   US OB Fu/Reeval Ea Fetus                        787.00        787.00     7633     The Breast Center
     03904186-7633   XR DIAG MAMMO DIG UNILAT                        135.00        135.00     7633     The Breast Center
     03904188-7633   XR DIAG MAMMO DIG BILAT                         292.00        292.00     7633     The Breast Center
     03975141-7633   US OB Transvaginal                              843.00        843.00     7633     The Breast Center
     03905154-7633   US Breast Uni Or Bil                            610.00        610.00     7633     The Breast Center
     03955555-7633   XRC Inj Duct Galactogram                        379.00        379.00     7633     The Breast Center
     03944444-7633   XRC Asp Breast Cyst                             211.00        211.00     7633     The Breast Center
     03974620-7633   XR Stereo Loc                                  2812.00       2812.00     7633     The Breast Center
     03905121-7633   US Ndl Place                                    860.00        860.00     7633     The Breast Center
     03904068-7633   US Ndl Place                                    860.00        860.00     7633     The Breast Center



8/31/2010                                                                                                                       56
                                                 c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                            CURRENT CURRENT          DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                INPATIENT OUTPATIENT CODE
                                                                PRICE      PRICE
     03911111-7633   XRC Bx Breast Vac Assist                       795.00        795.00     7633     The Breast Center
     03973300-7633   XR Galactogram 1 Duct                          529.00        529.00     7633     The Breast Center
     03904074-7633   XR Mammo Bil                                   292.00        292.00     7633     The Breast Center
     03904058-7633   XR Mammo Uni                                   135.00        135.00     7633     The Breast Center
     03904063-7633   XR Scrn Mammo                                  292.00        292.00     7633     The Breast Center
     03974613-7633   XR Breast Mammography Loc                      757.00        757.00     7633     The Breast Center
     04083219-7633   US Transvaginal                                843.00        843.00     7633     The Breast Center
     04201301-7640   RO Level 3 New Patient                           0.00        243.00     7640     Radiation Therapy
     04260013-7640   RO Brachy Hi Int Gt12Cath                     2831.00       2831.00     7640     Radiation Therapy
     04276375-7640   RO IMRT PLAN                                  5794.00       5794.00     7640     Radiation Therapy
     04260012-7640   RO Brachy Hi Int 9-12Cath                     2759.00       2759.00     7640     Radiation Therapy
     04236560-7640   RP TX I-131 CAP PER MCI                          0.00          0.00     7640     Radiation Therapy
     04201201-7640   RO Level 2 New Patient                           0.00        143.00     7640     Radiation Therapy
     04201302-7640   RO Level 3 Est Patient                           0.00        243.00     7640     Radiation Therapy
     04201401-7640   RO Level 4 New Patient                           0.00        264.00     7640     Radiation Therapy
     04232479-7640   US INTRO INTERSTITIAL TX                      1102.00       1102.00     7640     Radiation Therapy
     04201402-7640   RO Level 4 Est Patient                           0.00        264.00     7640     Radiation Therapy
     04260008-7640   RO Brachy Hi Int 5-8Cath                      2686.00       2686.00     7640     Radiation Therapy
     04201102-7640   RO Level 1 Est Patient                           0.00        133.00     7640     Radiation Therapy
     04201101-7640   RO Level 1 New Patient                           0.00        133.00     7640     Radiation Therapy
     04234170-7640   RO RAD TX 3/MORE 11-19MEV                     1115.00       1115.00     7640     Radiation Therapy
     04276370-7640   CT GUIDE RAD TX FIELDS                        2034.00       2034.00     7640     Radiation Therapy
     04234075-7640   RO RAD TX 2 AREA 11-19MEV                      615.00        615.00     7640     Radiation Therapy
     04201202-7640   RO Level 2 Est Patient                           0.00        143.00     7640     Radiation Therapy
     04276380-7640   RO Imrt Dlvr Ea Session                       1392.00       1392.00     7640     Radiation Therapy
     04233975-7640   RO RAD TX SNGL 11-19MEV                        524.00        524.00     7640     Radiation Therapy
     04236425-7640   RP Y90 IBRITUM RX 40MCI                      39195.00      39195.00     7640     Radiation Therapy
     04236420-7640   RP IN111 IBRITUM DX 5MCI                      4676.00       4676.00     7640     Radiation Therapy
     04232112-7640   RO Radiat Dosimetry Calc                       574.00        574.00     7640     Radiation Therapy
     04233912-7640   RO RAD PORT FILM(S)                            329.00        329.00     7640     Radiation Therapy
     04232419-7640   RO ISODOSE PLAN CMPLX                          783.00        783.00     7640     Radiation Therapy
     04232815-7640   RO Brachy Dose Plan Cmplx                     3020.00       3020.00     7640     Radiation Therapy
     04232914-7640   RO DOSIMETRY SPECIAL                          1436.00       1436.00     7640     Radiation Therapy
     04233011-7640   RO DVCS CONSTRUCT SMPL                         394.00        394.00     7640     Radiation Therapy
     04233110-7640   RO DVCS CONSTRUCT INTRM                        558.00        558.00     7640     Radiation Therapy
     04233219-7640   RO DVCS CONSTRUCT CMPLX                       1046.00       1046.00     7640     Radiation Therapy
     04233318-7640   RO CONSULT CONT MED PHYSC                      564.00        564.00     7640     Radiation Therapy
     04233417-7640   RO Radiation Physics Cnsl                     1026.00       1026.00     7640     Radiation Therapy



8/31/2010                                                                                                                      57
                                                 c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                            CURRENT CURRENT          DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                INPATIENT OUTPATIENT CODE
                                                                PRICE      PRICE
     04232013-7640   RO SIMULATION CMPLX                           1912.00       1912.00     7640     Radiation Therapy
     04231817-7640   RO SIMULATION SMPL                             948.00        948.00     7640     Radiation Therapy
     04234415-7640   RO SPECIAL TX PROCEDURE                        615.00        615.00     7640     Radiation Therapy
     04234167-7640   RO RAD TX 3/MORE 6-10MEV                       936.00        936.00     7640     Radiation Therapy
     04233961-7640   RO RAD TX SNGL 6-10MEV                         524.00        524.00     7640     Radiation Therapy
     04235412-7640   RO LOADING RAD SOURCE                          351.00        351.00     7640     Radiation Therapy
     04235214-7640   RO Intrstit Radiat Cmplx                       424.00        424.00     7640     Radiation Therapy
     04234316-7640   RO RAD TX SUPERFICIAL                          524.00        524.00     7640     Radiation Therapy
     04232439-7640   RO SIMULATION 3D                              8217.00       8217.00     7640     Radiation Therapy
     04510155-7650   RP TC99M MAA DX 10MCI                          266.00        266.00     7650     Nuclear Medicine
     04510170-7650   RP TC99M RBC/TAG DX 30MCI                      187.00        187.00     7650     Nuclear Medicine
     04510167-7650   RP TC99M DISFNIN DX 15MCI                      474.00        474.00     7650     Nuclear Medicine
     04510176-7650   RP IN111 DTPA/0.5MCI                          2902.00       2902.00     7650     Nuclear Medicine
     04514008-7650   NM BONE SCAN MULTI AREAS                      1726.00       1726.00     7650     Nuclear Medicine
     04510165-7650   RP TC99M SULFR/C DX 20MCI                      323.00        323.00     7650     Nuclear Medicine
     04510156-7650   RP TC99M CERETEC DX 25MCI                     1710.00       1710.00     7650     Nuclear Medicine
     04510154-7650   RP GALLIUM GA-67 DX 1 MCI                      273.00        273.00     7650     Nuclear Medicine
     04510157-7650   RP TC99M OXIDRON DX 30MCI                      173.00        173.00     7650     Nuclear Medicine
     04510153-7650   RP TC99M PERTEC DX EA MCI                      266.00        266.00     7650     Nuclear Medicine
     04510149-7650   RP TC99M MERTIAT DX 15MCI                      693.00        693.00     7650     Nuclear Medicine
     04530275-7650   NM Heart MP Wall Motion                        768.00        768.00     7650     Nuclear Medicine
     04510159-7650   RP TC99M PENTETA DX 25MCI                      266.00        266.00     7650     Nuclear Medicine
     04510146-7650   RP I123 CAP DX 100UCI                          312.00        312.00     7650     Nuclear Medicine
     04510145-7650   RP TL-201 DX PER MCI                           288.00        288.00     7650     Nuclear Medicine
     04510131-7650   RP I131 BC 1-6MCI                              297.00        297.00     7650     Nuclear Medicine
     04510148-7650   RP IN111 OXYQIN DX 0.5MCI                     2106.00       2106.00     7650     Nuclear Medicine
     04530105-7650   RP TC99M SESTMBI DX 40MCI                      637.00        637.00     7650     Nuclear Medicine
     04518405-7650   NM Lung Perf Vent                             3518.00       3518.00     7650     Nuclear Medicine
     04518007-7650   NM Renogram Sngl W Drg                        2745.00       2745.00     7650     Nuclear Medicine
     04510160-7650   NM Tumor Loc Multi W RP                       2387.00       2387.00     7650     Nuclear Medicine
     04510180-7650   NM TUMOR LOC WB SNGL DAY                      3115.00       3115.00     7650     Nuclear Medicine
     04530101-7650   RP TC99M MYOVIEW DX 40MCI                      532.00        532.00     7650     Nuclear Medicine
     04530150-7650   NM Bone Three Phase                           2691.00       2691.00     7650     Nuclear Medicine
     04530200-7650   NM Heart MP Sngl W SPEC                       3983.00       3983.00     7650     Nuclear Medicine
     04516803-7650   NM Lung Vent Multi                            1579.00       1579.00     7650     Nuclear Medicine
     04530051-7650   NM Heart MP Multi W SPECT                     6642.00       6642.00     7650     Nuclear Medicine
     04517405-7650   NM Brain Cmpl W SPECT                         3690.00       3690.00     7650     Nuclear Medicine
     04513800-7650   NM Bone Scan Ltd                              1403.00       1403.00     7650     Nuclear Medicine



8/31/2010                                                                                                                      58
                                                 c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                            CURRENT CURRENT          DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                INPATIENT OUTPATIENT CODE
                                                                PRICE      PRICE
     04519203-7650   NM Abscss Loc WB                              3621.00       3621.00     7650     Nuclear Medicine
     04530457-7650   NM Gastric Emptying                           2324.00       2324.00     7650     Nuclear Medicine
     04517207-7650   NM Brain Cmpl W Flow                          2184.00       2184.00     7650     Nuclear Medicine
     04514204-7650   NM Bone Scan W SPECT                          3327.00       3327.00     7650     Nuclear Medicine
     04514006-7650   NM Bone Scan WB                               2407.00       2407.00     7650     Nuclear Medicine
     04510400-7650   NM Thyroid Imag Upt Sngl                      1344.00       1344.00     7650     Nuclear Medicine
     04513404-7650   NM Bowel (Meckels)                            1713.00       1713.00     7650     Nuclear Medicine
     04513206-7650   NM GI Bleeding Scan                           2745.00       2745.00     7650     Nuclear Medicine
     04512404-7650   NM Hepatobiliary Ductal                       2063.00       2063.00     7650     Nuclear Medicine
     04510130-7650   RP IN111 OCTREOSC DX 1MCI                     4160.00       4160.00     7650     Nuclear Medicine
     04512406-7650   NM Liver Spleen Static                        1651.00       1651.00     7650     Nuclear Medicine
     04512208-7650   NM Liver W SPECT                              3327.00       3327.00     7650     Nuclear Medicine
     04511002-7650   NM Parathyroid                                1022.00       1022.00     7650     Nuclear Medicine
     04510806-7650   NM Thyroid Mets WB                            3057.00       3057.00     7650     Nuclear Medicine
     04518408-7650   NM VP Shunt Patency                           1711.00       1711.00     7650     Nuclear Medicine
     04530705-7650   NM Heart MP W EF                               877.00        877.00     7650     Nuclear Medicine
     04526055-7650   NM Lymphatic Pathway                          2184.00       2184.00     7650     Nuclear Medicine
     04403604-7660   MR Pelv W/O Con                               2631.00       2631.00     7660     San Mateo Imaging
     04470545-7660   MRA Head W Con                                2350.00       2350.00     7660     San Mateo Imaging
     04473720-7660   MR Ext Low W-W/O Con                          3581.00       3581.00     7660     San Mateo Imaging
     04473222-7660   MR Ext Upp Jnt W Con                          2350.00       2350.00     7660     San Mateo Imaging
     04474183-7660   MR Abd W-W/O Con                              3581.00       3581.00     7660     San Mateo Imaging
     04400127-7660   MR Ext Low W/O Con                            2525.00       2525.00     7660     San Mateo Imaging
     04400126-7660   MR Ext Upp No Jnt w/o con                     2525.00       2525.00     7660     San Mateo Imaging
     04400125-7660   MR Pelv W Con                                 2938.00       2938.00     7660     San Mateo Imaging
     04400555-7660   MRA Nec W/O Con                               2631.00       2631.00     7660     San Mateo Imaging
     04401625-7660   MR Orbit Face Nec W-W/O                       4009.00       4009.00     7660     San Mateo Imaging
     04472197-7660   MR Pelv W-W/O Con                             3581.00       3581.00     7660     San Mateo Imaging
     04400553-7660   MRA Head W/O Con                              3573.00       3573.00     7660     San Mateo Imaging
     04400124-7660   MR Orbit Face Nec W Con                       2938.00       2938.00     7660     San Mateo Imaging
     04473723-7660   MR Ext Low Jnt W-W/O Con                      3581.00       3581.00     7660     San Mateo Imaging
     04400561-7660   MRA NEC W-W/O CON                             3122.00       3122.00     7660     San Mateo Imaging
     04400562-7660   MR GUIDE NDL PLACE                            2343.00       2343.00     7660     San Mateo Imaging
     04400558-7660   MRA NEC W CON                                 2343.00       2343.00     7660     San Mateo Imaging
     04402905-7660   MR BREAST UNI WO CON                          2631.00       2631.00     7660     San Mateo Imaging
     04400133-7660   MR CHEST W-W/O CON                            3883.00       3883.00     7660     San Mateo Imaging
     04499074-7660   CON GAD-BASE MR 1ML IJ                           3.64          3.64     7660     San Mateo Imaging
     04400129-7660   MR EXT UPP JNT W-W/O CON                      3796.00       3796.00     7660     San Mateo Imaging



8/31/2010                                                                                                                      59
                                                  c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                             CURRENT CURRENT          DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                 INPATIENT OUTPATIENT CODE
                                                                 PRICE      PRICE
     04407000-7660   MRC BX BREAST VAC ASSIST                        795.00        795.00     7660     San Mateo Imaging
     04402101-7660   MR Spine Lumb W/O Con                          2921.00       2921.00     7660     San Mateo Imaging
     04401350-7660   MRA Ext Low W-W/O Con                          2631.00       2631.00     7660     San Mateo Imaging
     04402309-7660   MR Chest W/O Con                               2631.00       2631.00     7660     San Mateo Imaging
     04400501-7660   MR Brain W Stem W-W/O Con                      3266.00       3266.00     7660     San Mateo Imaging
     04401830-7660   MR Spine Cerv W/O Con                          3188.00       3188.00     7660     San Mateo Imaging
     04401301-7660   MR Orbit Face Nec W/O                          2631.00       2631.00     7660     San Mateo Imaging
     04400550-7660   MRA Head W-W/O Con                             3507.00       3507.00     7660     San Mateo Imaging
     04402903-7660   MR Breast Uni W-W/O Con                        3270.00       3270.00     7660     San Mateo Imaging
     04402913-7660   MR Breast Bil W-W/O Con                        4009.00       4009.00     7660     San Mateo Imaging
     04402135-7660   MR Spine Lumb W Con                            3161.00       3161.00     7660     San Mateo Imaging
     04401954-7660   MR Spine Thor W Con                            3161.00       3161.00     7660     San Mateo Imaging
     04401848-7660   MR Spine Cerv W Con                            3161.00       3161.00     7660     San Mateo Imaging
     04400402-7660   MR Brain W Stem W Con                          3161.00       3161.00     7660     San Mateo Imaging
     04402314-7660   MRA Chest W-W/O Con                            2631.00       2631.00     7660     San Mateo Imaging
     04405609-7660   MR Dental Partial Exam                         2631.00       2631.00     7660     San Mateo Imaging
     04405492-7660   MR Ext Low Jt W/O Con                          2631.00       2631.00     7660     San Mateo Imaging
     04405419-7660   MR Ext Upp No Jnt W-W/O                        2631.00       2631.00     7660     San Mateo Imaging
     04401137-7660   MR Brain W Stem W/O Con                        2945.00       2945.00     7660     San Mateo Imaging
     04405414-7660   MRA Ext Upp W-W/O Con                          2631.00       2631.00     7660     San Mateo Imaging
     04401855-7660   MR Spine Cerv W-W/O Con                        4009.00       4009.00     7660     San Mateo Imaging
     04403609-7660   MRA Pelv W-W/O Con                             2631.00       2631.00     7660     San Mateo Imaging
     04403213-7660   MRA Abd W-W/O Con                              2631.00       2631.00     7660     San Mateo Imaging
     04405252-7660   MR Ext Upp Jnt W/O Con                         3226.00       3226.00     7660     San Mateo Imaging
     04403208-7660   MR Abd W/O Con                                 2631.00       2631.00     7660     San Mateo Imaging
     04402150-7660   MR Spine Lumb W-W/O                            4009.00       4009.00     7660     San Mateo Imaging
     04402002-7660   MR Spine Thor W-W/O                            4009.00       4009.00     7660     San Mateo Imaging
     04401905-7660   MR Spine Thor W/O Con                          2921.00       2921.00     7660     San Mateo Imaging
     05000197-7710   NA CL 4MEQ/ML VIAL                                0.00          0.00     7710     Pharmacy
     05009047-7710   NA CL 0.65% SPR                                   0.00          0.00     7710     Pharmacy
     05000184-7710   NA CL 0.9% 250ML                                  0.00          0.00     7710     Pharmacy
     05000189-7710   NA CL 1G TAB                                      0.00          0.00     7710     Pharmacy
     05012160-7710   K CL 20MEQ/WATER 50ML                             0.00          0.00     7710     Pharmacy
     05017508-7710   PROGESTERONE 200MG CAP                            0.00          0.00     7710     Pharmacy
     05000195-7710   NA CL 3% 500ML                                    0.00          0.00     7710     Pharmacy
     05000186-7710   NA CL 0.9% VIAL                                   0.00          0.00     7710     Pharmacy
     05001772-7710   NA BICARB 8.4% VIAL                               0.00          0.00     7710     Pharmacy
     05010544-7710   NA CL IRRIG SOLN 0.9% SOLI                        0.00          0.00     7710     Pharmacy



8/31/2010                                                                                                                       60
                                                 c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                            CURRENT CURRENT        DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                INPATIENT OUTPATIENT CODE
                                                                PRICE      PRICE
     05008303-7710   SODIUM HYPOCHLORITE LIQ                          0.00        0.00     7710     Pharmacy
     05008738-7710   EYE IRRIG SOL OPHTH                              0.00        0.00     7710     Pharmacy
     05003393-7710   SORBITOL SOLUTION 70% SOL                        0.00        0.00     7710     Pharmacy
     05015080-7710   SOTALOL HCL 120MG TAB                            0.00        0.00     7710     Pharmacy
     05013081-7710   SOTALOL HCL 80MG TAB                             0.00        0.00     7710     Pharmacy
     05007644-7710   SPIRONOLACTONE 100MG TAB                         0.00        0.00     7710     Pharmacy
     05007645-7710   SPIRONOLACTONE 25MG TAB                          0.00        0.00     7710     Pharmacy
     05008695-7710   NA CL 5% DROP                                    0.00        0.00     7710     Pharmacy
     05001764-7710   NA BICARB 4.2PC SYR DIS                          0.00        0.00     7710     Pharmacy
     05009190-7710   K PHOS TAB                                       0.00        0.00     7710     Pharmacy
     05015479-7710   GEMCITABINE 1GM VIAL                             0.00        0.00     7710     Pharmacy
     05017166-7710   AMOXICILLIN 400MG/5ML SUS                        0.00        0.00     7710     Pharmacy
     05009128-7710   ACETAZOLAMIDE 500MG VIAL                         0.00        0.00     7710     Pharmacy
     05004150-7710   FLUOXYMESTERONE 2MG TAB                          0.00        0.00     7710     Pharmacy
     05017860-7710   FEXOFENADINE 180MG CAP                           0.00        0.00     7710     Pharmacy
     05013809-7710   FELODIPINE 2.5MG TAB                             0.00        0.00     7710     Pharmacy
     05000181-7710   NA CL 0.45% 500ML                                0.00        0.00     7710     Pharmacy
     05017125-7710   ENTCAPONE 200MG TAB PO                           0.00        0.00     7710     Pharmacy
     05001771-7710   NA BICARB 8.4PC SYR DIS                          0.00        0.00     7710     Pharmacy
     05017211-7710   PIOGLITAZONE HCL 30MG TAB                        0.00        0.00     7710     Pharmacy
     05002124-7710   PYRIDOXINE HCL 50MG TAB                          0.00        0.00     7710     Pharmacy
     05009551-7710   DOXORUBICIN 2MG/ML, 50ML                         0.00        0.00     7710     Pharmacy
     05005655-7710   PYRIDOSTIGMINE 60MG TAB                          0.00        0.00     7710     Pharmacy
     05017212-7710   PIOGLITAZONE HCL 45MG TAB                        0.00        0.00     7710     Pharmacy
     05003368-7710   NA BICARB 650MG TAB                              0.00        0.00     7710     Pharmacy
     05013704-7710   STAVUDINE 20MG CAP                               0.00        0.00     7710     Pharmacy
     05016766-7710   COMBIPATCH .05-.14/24 PTC                        0.00        0.00     7710     Pharmacy
     05004572-7710   TEMAZEPAM 15MG CAP                               0.00        0.00     7710     Pharmacy
     05007646-7710   SPIRONOLACTONE 50MG TAB                          0.00        0.00     7710     Pharmacy
     05016928-7710   CELECOXIB 100MG CAP                              0.00        0.00     7710     Pharmacy
     05014626-7710   SUMATRIPTAN 50MG TAB                             0.00        0.00     7710     Pharmacy
     05013170-7710   SUMATRIPTAN 6MG/0.5ML VI                         0.00        0.00     7710     Pharmacy
     05010608-7710   MISC O/P RX                                      0.00        0.00     7710     Pharmacy
     05010666-7710   MISC O/P RX                                      0.00        0.00     7710     Pharmacy
     05005993-7710   TALC PWD                                         0.00        0.00     7710     Pharmacy
     05016929-7710   CELECOXIB 200MG CAP                              0.00        0.00     7710     Pharmacy
     05016066-7710   TAMSULOSIN 0.4MG CAP 24H                         0.00        0.00     7710     Pharmacy
     05016898-7710   CICLOPIROX 0.77% CRM                             0.00        0.00     7710     Pharmacy



8/31/2010                                                                                                                    61
                                                   c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                              CURRENT CURRENT        DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                  INPATIENT OUTPATIENT CODE
                                                                  PRICE      PRICE
     05004573-7710   TEMAZEPAM 30MG CAP                                 0.00        0.00     7710     Pharmacy
     05013162-7710   TEMAZEPAM 7.5MG CAP                                0.00        0.00     7710     Pharmacy
     05017754-7710   RABEPRAZOLE 20MG EC TAB                            0.00        0.00     7710     Pharmacy
     05014080-7710   TERAZOSIN HCL 10MG CAP                             0.00        0.00     7710     Pharmacy
     05016511-7710   REPAGLINIDE 0.5MG TAB                              0.00        0.00     7710     Pharmacy
     05015583-7710   CARBAMAZEPINE XR 100MG TAB                         0.00        0.00     7710     Pharmacy
     05015613-7710   BUSPIRONE 15MG TAB                                 0.00        0.00     7710     Pharmacy
     05009566-7710   TAMOXIFEN CIT 10MG TAB                             0.00        0.00     7710     Pharmacy
     05010160-7710   BACTRIM 800-160MG TB                               0.00        0.00     7710     Pharmacy
     05004024-7710   FLEET SOL                                          0.00        0.00     7710     Pharmacy
     05007327-7710   STREPTOKINASE 250 MU VIAL                          0.00        0.00     7710     Pharmacy
     05005545-7710   SUCCINYLCHOLINE 20MG/MLVL                          0.00        0.00     7710     Pharmacy
     05003643-7710   SUCRALFATE 1G TAB                                  0.00        0.00     7710     Pharmacy
     05013437-7710   SUCRALFATE 1G/10ML SUSP                            0.00        0.00     7710     Pharmacy
     05008867-7710   SULFACETAMIDE 10PC DROP                            0.00        0.00     7710     Pharmacy
     05008868-7710   SULFACETAMIDE 10PC OIN                             0.00        0.00     7710     Pharmacy
     05014940-7710   SUMATRIPTAN 25MG TAB                               0.00        0.00     7710     Pharmacy
     05010159-7710   BACTRIM400-80MGTB                                  0.00        0.00     7710     Pharmacy
     05007716-7710   PREPARATION H SUPP                                 0.00        0.00     7710     Pharmacy
     05010162-7710   BACTRIM SUSP                                       0.00        0.00     7710     Pharmacy
     05010163-7710   BACTRIM VIAL                                       0.00        0.00     7710     Pharmacy
     05010168-7710   SULFASALAZINE 500MG TAB                            0.00        0.00     7710     Pharmacy
     05009287-7710   SULINDAC 200MG TAB                                 0.00        0.00     7710     Pharmacy
     05016079-7710   SUMATRIPTAN 20MG SPR                               0.00        0.00     7710     Pharmacy
     05016596-7710   COSOPT 2%/0.5% OPHTH                               0.00        0.00     7710     Pharmacy
     05016616-7710   CITALOPRAM 40MG TAB                                0.00        0.00     7710     Pharmacy
     05010132-7710   SULFADIAZINE 500MG TAB                             0.00        0.00     7710     Pharmacy
     05015482-7710   RISPERIDONE 1MG/ML SOL                             0.00        0.00     7710     Pharmacy
     05012093-7710   RANITIDINE HCL 25MG/ML VIAL                        0.00        0.00     7710     Pharmacy
     05012094-7710   RANITIDINE HCL 300MG TAB                           0.00        0.00     7710     Pharmacy
     05015471-7710   RANITIDINE HCL 75MG TAB                            0.00        0.00     7710     Pharmacy
     05016512-7710   REPAGLINIDE 1MG TAB                                0.00        0.00     7710     Pharmacy
     05007739-7710   ANUSOL SUPP                                        0.00        0.00     7710     Pharmacy
     05010083-7710   RIFAMPIN 300MG CAP                                 0.00        0.00     7710     Pharmacy
     05010084-7710   RIFAMPIN 600MG VIAL                                0.00        0.00     7710     Pharmacy
     05004783-7710   SELEGILINE HCL 5MG TAB                             0.00        0.00     7710     Pharmacy
     05013446-7710   RISPERIDONE 1MG TAB                                0.00        0.00     7710     Pharmacy
     05012090-7710   RANITIDINE HCL 150MG TAB                           0.00        0.00     7710     Pharmacy



8/31/2010                                                                                                                      62
                                                  c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                             CURRENT CURRENT        DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                 INPATIENT OUTPATIENT CODE
                                                                 PRICE      PRICE
     05013447-7710   RISPERIDONE 2MG TAB                               0.00        0.00     7710     Pharmacy
     05013448-7710   RISPERIDONE 3MG TAB                               0.00        0.00     7710     Pharmacy
     05013637-7710   ROCURONIUM 10MG/ML VIAL                           0.00        0.00     7710     Pharmacy
     05016572-7710   VX RUBELLA                                        0.00        0.00     7710     Pharmacy
     05013565-7710   SALMETEROL 21MCG AER ADP                          0.00        0.00     7710     Pharmacy
     05005283-7710   SALSALATE 750MG TAB                               0.00        0.00     7710     Pharmacy
     05003901-7710   COLYTE SOLN                                       0.00        0.00     7710     Pharmacy
     05001775-7710   LACTATED RINGERS 1000                             0.00        0.00     7710     Pharmacy
     05012439-7710   RAMIPRIL 2.5MG CAP                                0.00        0.00     7710     Pharmacy
     05012695-7710   QUINAPRIL HCL 40MG TAB                            0.00        0.00     7710     Pharmacy
     05012692-7710   QUINAPRIL HCL 5MG TAB                             0.00        0.00     7710     Pharmacy
     05000341-7710   QUINIDINE GLUC 324MGSA TB                         0.00        0.00     7710     Pharmacy
     05010302-7710   QUININE SO4 200MG CAP                             0.00        0.00     7710     Pharmacy
     05013117-7710   QUININE SO4 260MGTAB PO                           0.00        0.00     7710     Pharmacy
     05010306-7710   QUININE SO4 325MG CAP                             0.00        0.00     7710     Pharmacy
     05010409-7710   IG RABIES IM/SUBCU                                0.00        0.00     7710     Pharmacy
     05012091-7710   RANITIDINE HCL 15MG/ML SYP                        0.00        0.00     7710     Pharmacy
     05012438-7710   RAMIPRIL 1.25MG CAP                               0.00        0.00     7710     Pharmacy
     05012739-7710   OCTREOTIDE 0.2MG/ML IJ                            0.00        0.00     7710     Pharmacy
     05012440-7710   RAMIPRIL 5MG CAP                                  0.00        0.00     7710     Pharmacy
     05013087-7710   RANITIDINE .45% 50MG/50ML                         0.00        0.00     7710     Pharmacy
     05017210-7710   PIOGLITAZONE HCL 15MG TAB                         0.00        0.00     7710     Pharmacy
     05012434-7710   PCN G K 3MMU IVPB                                 0.00        0.00     7710     Pharmacy
     05016456-7710   PAROXETINE 10MG/5ML SUSP                          0.00        0.00     7710     Pharmacy
     05015291-7710   OXYCODONE HCL 20MG SA TAB                         0.00        0.00     7710     Pharmacy
     05017464-7710   OSELTAMIVIR 75MG CAP                              0.00        0.00     7710     Pharmacy
     05007026-7710   SELENIUM SULFID 1% SHAM                           0.00        0.00     7710     Pharmacy
     05016342-7710   RALOXIFENE HCL 60MG TAB                           0.00        0.00     7710     Pharmacy
     05016234-7710   QUETIAPINE 100MG TAB                              0.00        0.00     7710     Pharmacy
     05012731-7710   SIMVASTATIN 5MG TAB                               0.00        0.00     7710     Pharmacy
     05016703-7710   SIMVASTATIN 80MG TAB                              0.00        0.00     7710     Pharmacy
     05012983-7710   NEUTRA-PHOS PWDR                                  0.00        0.00     7710     Pharmacy
     05006095-7710   EMOLLIENTS LOT                                    0.00        0.00     7710     Pharmacy
     05012600-7710   EYE LUBE 0.5% DROP                                0.00        0.00     7710     Pharmacy
     05016233-7710   QUETIAPINE 25MG TAB                               0.00        0.00     7710     Pharmacy
     05005868-7710   TERBUTALINE SO4 1MG/ML AMP                        0.00        0.00     7710     Pharmacy
     05005565-7710   SCOPOLAMINE 1.5MG/72HR PC                         0.00        0.00     7710     Pharmacy
     05009062-7710   ACETIC AC/AL ACET/AL ACET DROP                    0.00        0.00     7710     Pharmacy



8/31/2010                                                                                                                     63
                                                  c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                             CURRENT CURRENT        DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                 INPATIENT OUTPATIENT CODE
                                                                 PRICE      PRICE
     05017313-7710   LIDOCAINE 5% PATCH TOP                            0.00        0.00     7710     Pharmacy
     05010317-7710   PYRIMETHAMINE 25MG TAB                            0.00        0.00     7710     Pharmacy
     05013171-7710   LEVOCARNITINE1GM/5MLAMPIV                         0.00        0.00     7710     Pharmacy
     05016023-7710   IMIQUIMOD 5% PACK                                 0.00        0.00     7710     Pharmacy
     05013216-7710   HYDROMORPHONE 1MG/ML LQPO                         0.00        0.00     7710     Pharmacy
     05015965-7710   HYDROCOD/APAP 10-325MG TB                         0.00        0.00     7710     Pharmacy
     05012694-7710   QUINAPRIL HCL 20MG TAB                            0.00        0.00     7710     Pharmacy
     05016235-7710   QUETIAPINE 200MG TAB                              0.00        0.00     7710     Pharmacy
     05003381-7710   SIMETHICONE 80MG TAB CH                           0.00        0.00     7710     Pharmacy
     05007027-7710   SELENIUM SULFID 2.5% SHAM                         0.00        0.00     7710     Pharmacy
     05003836-7710   SENNA 187MG TAB                                   0.00        0.00     7710     Pharmacy
     05003925-7710   SENNA/DOCUSATE TAB                                0.00        0.00     7710     Pharmacy
     05012753-7710   SERTRALINE HCL 100MG TAB                          0.00        0.00     7710     Pharmacy
     05015964-7710   SERTRALINE HCL 25MG TAB                           0.00        0.00     7710     Pharmacy
     05012752-7710   SERTRALINE HCL 50MG TAB                           0.00        0.00     7710     Pharmacy
     05008050-7710   SILVER NIT EA                                     0.00        0.00     7710     Pharmacy
     05012734-7710   SIMVASTATIN 40MG TAB                              0.00        0.00     7710     Pharmacy
     05003378-7710   SIMETHICONE 40MG/0.6MLDRP                         0.00        0.00     7710     Pharmacy
     05012733-7710   SIMVASTATIN 20MG TAB                              0.00        0.00     7710     Pharmacy
     05010599-7710   MISC O/P RX                                       0.00        0.00     7710     Pharmacy
     05012732-7710   SIMVASTATIN 10MG TAB                              0.00        0.00     7710     Pharmacy
     05012693-7710   QUINAPRIL HCL 10MG TAB                            0.00        0.00     7710     Pharmacy
     05005231-7710   NALOXONE 1MG/ML AMP                               0.00        0.00     7710     Pharmacy
     05012751-7710   METOPROLOL SUC 200MG SA TB                        0.00        0.00     7710     Pharmacy
     05016835-7710   LOSARTAN/HCTZ 100-25MG TB                         0.00        0.00     7710     Pharmacy
     05016868-7710   LOSARTAN K 100MG TAB                              0.00        0.00     7710     Pharmacy
     05001784-7710   POLYSTYRENE15G/60MLSU                             0.00        0.00     7710     Pharmacy
     05008609-7710   SILV SULFADIAZN 1% CRM                            0.00        0.00     7710     Pharmacy
     05009322-7710   VECURONIUM BR 10MG VIAL                           0.00        0.00     7710     Pharmacy
     05015054-7710   VALACYCLOVIR 500MG TAB                            0.00        0.00     7710     Pharmacy
     05016106-7710   VALPROATE 100MG/ML VL                             0.00        0.00     7710     Pharmacy
     05005441-7710   VALPROIC ACID250MG/5MLSYP                         0.00        0.00     7710     Pharmacy
     05005440-7710   VALPROIC ACID 250MG CAP                           0.00        0.00     7710     Pharmacy
     05010099-7710   VANCOMYCIN 125MG CAP                              0.00        0.00     7710     Pharmacy
     05010100-7710   VANCOMYCIN 1GM VIAL                               0.00        0.00     7710     Pharmacy
     05010101-7710   VANCOMYCIN 250MG CAP                              0.00        0.00     7710     Pharmacy
     05000806-7710   VERAPAMIL 120MG TAB                               0.00        0.00     7710     Pharmacy
     05007441-7710   VASOPRESSIN 20U/ML VIAL                           0.00        0.00     7710     Pharmacy



8/31/2010                                                                                                                     64
                                                 c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                            CURRENT CURRENT        DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                INPATIENT OUTPATIENT CODE
                                                                PRICE      PRICE
     05012818-7710   MISC TOPICAL/RECTAL                              0.00        0.00     7710     Pharmacy
     05013531-7710   VENLAFAXINE 100MG TAB                            0.00        0.00     7710     Pharmacy
     05016294-7710   VENLAFAXINE 37.5MG 24H CP                        0.00        0.00     7710     Pharmacy
     05013528-7710   VENLAFAXINE 37.5MG TAB                           0.00        0.00     7710     Pharmacy
     05013529-7710   VENLAFAXINE 50MG TAB                             0.00        0.00     7710     Pharmacy
     05016249-7710   VENLAFAXINE 75MG 24H CAP                         0.00        0.00     7710     Pharmacy
     05013530-7710   VENLAFAXINE 75MG TAB                             0.00        0.00     7710     Pharmacy
     05000805-7710   VERAPAMIL 120MG SA CAP                           0.00        0.00     7710     Pharmacy
     05013133-7710   TERBINAFINE HCL 1% CRM                           0.00        0.00     7710     Pharmacy
     05010103-7710   VANCOMYCIN 500MG VIAL                            0.00        0.00     7710     Pharmacy
     05005602-7710   TIGAN 100MG CAP                                  0.00        0.00     7710     Pharmacy
     05007628-7710   TRIAMCINOLONE 10MG/ML VL                         0.00        0.00     7710     Pharmacy
     05007630-7710   TRIAMCINOLONE 40MG/ML VL                         0.00        0.00     7710     Pharmacy
     05009134-7710   TRIAMTERENE 50MG CAP                             0.00        0.00     7710     Pharmacy
     05004580-7710   TRIAZOLAM 0.125MG TAB                            0.00        0.00     7710     Pharmacy
     05004581-7710   TRIAZOLAM 0.25MG TAB                             0.00        0.00     7710     Pharmacy
     05004750-7710   TRIFLUOPERAZINE 10MG TAB                         0.00        0.00     7710     Pharmacy
     05004753-7710   TRIFLUOPERAZINE 2MG TAB                          0.00        0.00     7710     Pharmacy
     05004755-7710   TRIFLUOPERAZINE 5MG TAB                          0.00        0.00     7710     Pharmacy
     05004068-7710   URSODIOL 300MG CAP                               0.00        0.00     7710     Pharmacy
     05005472-7710   TRIHEXYPHENIDYL 5MG TAB                          0.00        0.00     7710     Pharmacy
     05007330-7710   UROKINASE 250MU VIAL                             0.00        0.00     7710     Pharmacy
     05005603-7710   TIGAN 100MG SUPP                                 0.00        0.00     7710     Pharmacy
     05005606-7710   TIGAN 200MG SUPP                                 0.00        0.00     7710     Pharmacy
     05008950-7710   TRIMETHOPRIM 100MG TAB                           0.00        0.00     7710     Pharmacy
     05008831-7710   TROPICAMIDE 0.5% DROP                            0.00        0.00     7710     Pharmacy
     05008832-7710   TROPICAMIDE 1% DROP                              0.00        0.00     7710     Pharmacy
     05012795-7710   MISC ORAL SOLID                                  0.00        0.00     7710     Pharmacy
     05013201-7710   MISC ENT DRUG                                    0.00        0.00     7710     Pharmacy
     05000807-7710   VERAPAMIL 180MG SA TAB                           0.00        0.00     7710     Pharmacy
     05005469-7710   TRIHEXYPHENIDYL 2MG TAB                          0.00        0.00     7710     Pharmacy
     05010111-7710   CLINDAMYCIN 300MG CAP                            0.00        0.00     7710     Pharmacy
     05002986-7710   ZINC OX OIN GM                                   0.00        0.00     7710     Pharmacy
     05000531-7710   ZINC SO4 220MG CAP                               0.00        0.00     7710     Pharmacy
     05013168-7710   ZOLPIDEM 10MG TAB                                0.00        0.00     7710     Pharmacy
     05013167-7710   ZOLPIDEM 5MG TAB                                 0.00        0.00     7710     Pharmacy
     05015728-7710   CETIRIZINE 1MG/ML SYRP                           0.00        0.00     7710     Pharmacy
     05016768-7710   INFLIXIMAB 100MG VIAL IV                         0.00        0.00     7710     Pharmacy



8/31/2010                                                                                                                    65
                                                  c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                             CURRENT CURRENT        DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                 INPATIENT OUTPATIENT CODE
                                                                 PRICE      PRICE
     05013949-7710   FLUCONAZOLE 10MG/ML SUSP                          0.00        0.00     7710     Pharmacy
     05012456-7710   VERAPAMIL 120MG SA TAB                            0.00        0.00     7710     Pharmacy
     05015521-7710   INTERFERON B-1A 33MCG IJ                          0.00        0.00     7710     Pharmacy
     05001756-7710   WATER IRRIG 1000ML FOR IRRIGATION                 0.00        0.00     7710     Pharmacy
     05000034-7710   GLUCOSE 40% GEL                                   0.00        0.00     7710     Pharmacy
     05016539-7710   TOLTERODINE TART 1MG TAB                          0.00        0.00     7710     Pharmacy
     05014835-7710   PREPARATION H OIN                                 0.00        0.00     7710     Pharmacy
     05016681-7710   MIRCETTE 21-2-5 TAB                               0.00        0.00     7710     Pharmacy
     05016673-7710   EPTIFIBATIDE 2MG/ML VIAL                          0.00        0.00     7710     Pharmacy
     05016672-7710   EPTIFIBATIDE 0.75MG/ML VIAL                       0.00        0.00     7710     Pharmacy
     05014601-7710   ACARBOSE 100MG TAB                                0.00        0.00     7710     Pharmacy
     05016328-7710   RITUXIMAB 100MG IJ                                0.00        0.00     7710     Pharmacy
     05005835-7710   ADDERALL 10MG TAB                                 0.00        0.00     7710     Pharmacy
     05007379-7710   WARFARIN NA 1MG TAB                               0.00        0.00     7710     Pharmacy
     05000810-7710   VERAPAMIL 2.5MG/ML VIAL                           0.00        0.00     7710     Pharmacy
     05000811-7710   VERAPAMIL 240MG SA CAP                            0.00        0.00     7710     Pharmacy
     05000812-7710   VERAPAMIL 240MG SA TAB                            0.00        0.00     7710     Pharmacy
     05000813-7710   VERAPAMIL 40MG TAB                                0.00        0.00     7710     Pharmacy
     05000814-7710   VERAPAMIL 80MG TAB                                0.00        0.00     7710     Pharmacy
     05002155-7710   VIT B CMPLX W-C TAB                               0.00        0.00     7710     Pharmacy
     05002139-7710   VIT E 400U CAP                                    0.00        0.00     7710     Pharmacy
     05002142-7710   VIT E 50U/ML DROP                                 0.00        0.00     7710     Pharmacy
     05015706-7710   ZAFIRLUKAST 20MG TAB                              0.00        0.00     7710     Pharmacy
     05007378-7710   WARFARIN NA 10MG TAB                              0.00        0.00     7710     Pharmacy
     05001755-7710   WATER IJ 1000ML                                   0.00        0.00     7710     Pharmacy
     05007380-7710   WARFARIN NA 2.5MG TAB                             0.00        0.00     7710     Pharmacy
     05007381-7710   WARFARIN NA 2MG TAB                               0.00        0.00     7710     Pharmacy
     05015778-7710   WARFARIN NA 3MG TAB                               0.00        0.00     7710     Pharmacy
     05013258-7710   WARFARIN NA 4MG TAB                               0.00        0.00     7710     Pharmacy
     05007383-7710   WARFARIN NA 5MG TAB                               0.00        0.00     7710     Pharmacy
     05015950-7710   WARFARIN NA 6MG TAB                               0.00        0.00     7710     Pharmacy
     05007384-7710   WARFARIN NA 7.5MG TAB                             0.00        0.00     7710     Pharmacy
     05008528-7710   TRIAMCINOLONE 0.1% LOT                            0.00        0.00     7710     Pharmacy
     05006151-7710   VIT A&D OIN GM                                    0.00        0.00     7710     Pharmacy
     05004766-7710   THIORIDAZINE HCL 50MG TAB                         0.00        0.00     7710     Pharmacy
     05017072-7710   MISC ORAL SOLID                                   0.00        0.00     7710     Pharmacy
     05017073-7710   RISPERIDONE 0.5MG TAB                             0.00        0.00     7710     Pharmacy
     05016882-7710   LEFLUNOMIDE 20MG TAB PO                           0.00        0.00     7710     Pharmacy



8/31/2010                                                                                                                     66
                                                 c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                            CURRENT CURRENT        DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                INPATIENT OUTPATIENT CODE
                                                                PRICE      PRICE
     05008585-7710   RID LIQ                                          0.00        0.00     7710     Pharmacy
     05000155-7710   THEOPHYLLINE 80MG/15ML EL                        0.00        0.00     7710     Pharmacy
     05002066-7710   THIAMINE 100MG TAB                               0.00        0.00     7710     Pharmacy
     05002068-7710   THIAMINE HCL 100 MG IJ                           0.00        0.00     7710     Pharmacy
     05015584-7710   TRIAMCINOLONE 55MCG SPR                          0.00        0.00     7710     Pharmacy
     05004760-7710   THIORIDAZINE HCL 100MG TB                        0.00        0.00     7710     Pharmacy
     05014582-7710   TAMOXIFEN CIT 20MG TAB                           0.00        0.00     7710     Pharmacy
     05004889-7710   THIOTHIXENE 10MG CAP                             0.00        0.00     7710     Pharmacy
     05004890-7710   THIOTHIXENE 1MG CAP                              0.00        0.00     7710     Pharmacy
     05004891-7710   THIOTHIXENE 20MG CAP                             0.00        0.00     7710     Pharmacy
     05004893-7710   THIOTHIXENE 5MG CAP                              0.00        0.00     7710     Pharmacy
     05007286-7710   THROMBIN 10MU VIAL                               0.00        0.00     7710     Pharmacy
     05007289-7710   THROMBIN 20MU VIAL                               0.00        0.00     7710     Pharmacy
     05007291-7710   THROMBIN 5MU VIAL                                0.00        0.00     7710     Pharmacy
     05007451-7710   THYROID 120MG TAB                                0.00        0.00     7710     Pharmacy
     05002076-7710   THIAMINE 50MG TAB                                0.00        0.00     7710     Pharmacy
     05008819-7710   TETRACAINE HCL 0.5% DROP                         0.00        0.00     7710     Pharmacy
     05014078-7710   TERAZOSIN HCL 2MG CAP                            0.00        0.00     7710     Pharmacy
     05014079-7710   TERAZOSIN HCL 5MG CAP                            0.00        0.00     7710     Pharmacy
     05015449-7710   TERBINAFINE HCL 250MG TAB                        0.00        0.00     7710     Pharmacy
     05005869-7710   TERBUTALINE SO4 2.5MG TAB                        0.00        0.00     7710     Pharmacy
     05005870-7710   TERBUTALINE SO4 5MG TAB                          0.00        0.00     7710     Pharmacy
     05007858-7710   TERCONAZOLE 0.4% CRM AP                          0.00        0.00     7710     Pharmacy
     05012431-7710   TERCONAZOLE 0.8% CRM AP                          0.00        0.00     7710     Pharmacy
     05010426-7710   VX TETANUS TOXOID                                0.00        0.00     7710     Pharmacy
     05015629-7710   NEVIRAPINE 200 MG TAB                            0.00        0.00     7710     Pharmacy
     05010428-7710   VX TETANUS TOXOID                                0.00        0.00     7710     Pharmacy
     05000144-7710   THEOPHYLLINE 300MG SA TAB                        0.00        0.00     7710     Pharmacy
     05008356-7710   TETRACAINE HCL 2% SOL                            0.00        0.00     7710     Pharmacy
     05008352-7710   CETACAINE SPR                                    0.00        0.00     7710     Pharmacy
     05009929-7710   TETRACYCLINE 250MG CAP                           0.00        0.00     7710     Pharmacy
     05009933-7710   TETRACYCLINE 500MG CAP                           0.00        0.00     7710     Pharmacy
     05008723-7710   TETRAHYDROZOLIN 0.05% DRP                        0.00        0.00     7710     Pharmacy
     05000124-7710   THEOPHYLLINE 100MG SA TAB                        0.00        0.00     7710     Pharmacy
     05000135-7710   THEOPHYLLINE 200MG SA TAB                        0.00        0.00     7710     Pharmacy
     05007460-7710   THYROID 60MG TAB                                 0.00        0.00     7710     Pharmacy
     05010394-7710   IG TETANUS 205 IU IJ                             0.00        0.00     7710     Pharmacy
     05004833-7710   TRAZODONE HCL 150MG TAB                          0.00        0.00     7710     Pharmacy



8/31/2010                                                                                                                    67
                                                  c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                             CURRENT CURRENT        DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                 INPATIENT OUTPATIENT CODE
                                                                 PRICE      PRICE
     05007454-7710   THYROID 180MG TAB                                 0.00        0.00     7710     Pharmacy
     05008947-7710   TOBRA/DEXAMETH .3-0.1% OIN                        0.00        0.00     7710     Pharmacy
     05002622-7710   TOLAZAMIDE 250MG TAB                              0.00        0.00     7710     Pharmacy
     05008250-7710   TOLNAFTATE 1% CRM                                 0.00        0.00     7710     Pharmacy
     05016540-7710   TOLTERODINE TART 2MG TAB                          0.00        0.00     7710     Pharmacy
     05013484-7710   TORSEMIDE 10MG TAB                                0.00        0.00     7710     Pharmacy
     05013485-7710   TORSEMIDE 20MG TAB                                0.00        0.00     7710     Pharmacy
     05014430-7710   TRAMADOL 50MG TAB                                 0.00        0.00     7710     Pharmacy
     05008945-7710   TOBRAMYCIN SO4 0.3% OIN GM                        0.00        0.00     7710     Pharmacy
     05004832-7710   TRAZODONE HCL 100MG TAB                           0.00        0.00     7710     Pharmacy
     05008944-7710   TOBRAMYCIN SO4 0.3% DROP                          0.00        0.00     7710     Pharmacy
     05004835-7710   TRAZODONE HCL 50MG TAB                            0.00        0.00     7710     Pharmacy
     05006764-7710   TRETINOIN 0.025% CRM                              0.00        0.00     7710     Pharmacy
     05006766-7710   TRETINOIN 0.05% CRM                               0.00        0.00     7710     Pharmacy
     05008525-7710   TRIAMCINOLONE OIN .025%GM                         0.00        0.00     7710     Pharmacy
     05000339-7710   TRIAMCINOLONE 100MCGAEADP                         0.00        0.00     7710     Pharmacy
     05008523-7710   TRIAMCINOLONE 0.025% CRM                          0.00        0.00     7710     Pharmacy
     05008526-7710   TRIAMCINOLONE 0.1% CRM                            0.00        0.00     7710     Pharmacy
     05014077-7710   TERAZOSIN HCL 1MG CAP                             0.00        0.00     7710     Pharmacy
     05015507-7710   TRANDOLAPRIL 4MG TAB                              0.00        0.00     7710     Pharmacy
     05005121-7710   APAP/HYDROCOD 2.5-500MGTB                         0.00        0.00     7710     Pharmacy
     05008529-7710   TRIAMCINOLONE 0.1% OIN GM                         0.00        0.00     7710     Pharmacy
     05009748-7710   TICAR/CLAV 3.1GM VL                               0.00        0.00     7710     Pharmacy
     05012681-7710   TICLOPIDINE 250MG TAB                             0.00        0.00     7710     Pharmacy
     05008811-7710   TIMOLOL MAL 0.25% DROP                            0.00        0.00     7710     Pharmacy
     05013477-7710   TIMOLOL MAL 0.25% SOL                             0.00        0.00     7710     Pharmacy
     05008812-7710   TIMOLOL MAL 0.5% DROP                             0.00        0.00     7710     Pharmacy
     05013478-7710   TIMOLOL MAL 0.5% SOL                              0.00        0.00     7710     Pharmacy
     05015935-7710   TIZANIDINE HCL 4MG TAB                            0.00        0.00     7710     Pharmacy
     05008946-7710   TOBRA/DEXAMETH 0.3-0.1%DRP                        0.00        0.00     7710     Pharmacy
     05010067-7710   TOBRAMYCIN 40MG/ML VIAL                           0.00        0.00     7710     Pharmacy
     05007458-7710   THYROID 30MG TAB                                  0.00        0.00     7710     Pharmacy
     05016513-7710   REPAGLINIDE 2MG TAB                               0.00        0.00     7710     Pharmacy
     05015962-7710   VALACYCLOVIR 1000MG TB PO                         0.00        0.00     7710     Pharmacy
     05016900-7710   METFORMIN HCL 1000MG TB PO                        0.00        0.00     7710     Pharmacy
     05016919-7710   OXYBUTYNIN 5MG TAB SA PO                          0.00        0.00     7710     Pharmacy
     05016169-7710   NIACIN 750MG TAB SA PO                            0.00        0.00     7710     Pharmacy
     05010186-7710   ETHAMBUTOL HCL 100MG TB PO                        0.00        0.00     7710     Pharmacy



8/31/2010                                                                                                                     68
                                                  c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                             CURRENT CURRENT        DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                 INPATIENT OUTPATIENT CODE
                                                                 PRICE      PRICE
     05015382-7710   PAROXETINE HCL 40MG TB PO                         0.00        0.00     7710     Pharmacy
     05001968-7710   VIT A 50 MU/ML VIAL                               0.00        0.00     7710     Pharmacy
     05010064-7710   TOBRAMYCIN 1.2GM VIAL                             0.00        0.00     7710     Pharmacy
     05100022-7710   PCN VK 500MG #6 TB-TH                             0.00        0.00     7710     Pharmacy
     05100001-7710   ACETAZOLAMIDE 500MG TB-TH                         0.00        0.00     7710     Pharmacy
     05018823-7710   GALANTAMINE HBR 4MG TAB                           0.00        0.00     7710     Pharmacy
     05017922-7710   FEXOFENADINE HCL 60MG TAB                         0.00        0.00     7710     Pharmacy
     05018510-7710   BUDESONIDE 0.25/2ML AMP-NEB INH                   0.00        0.00     7710     Pharmacy
     05019081-7710   BRIMONIDINE TART .15% DRP                         0.00        0.00     7710     Pharmacy
     05017918-7710   MELOXICAM 15MG TAB                                0.00        0.00     7710     Pharmacy
     05019123-7710   APAP/TRAMADOL 37.5/325MG TAB                      0.00        0.00     7710     Pharmacy
     05018601-7710   IRON SUCROSE CPLX 20MG/ML VL                      0.00        0.00     7710     Pharmacy
     05100023-7710   PHENAZOPY 100MG #4-TH                             0.00        0.00     7710     Pharmacy
     05018851-7710   PANTOPRAZOLE 40MG VIAL                            0.00        0.00     7710     Pharmacy
     05100020-7710   LEVOFLOXACIN 500MG #1-TH                          0.00        0.00     7710     Pharmacy
     05100018-7710   IBUPROFEN 100MG/5ML-TH                            0.00        0.00     7710     Pharmacy
     05100016-7710   ERYTHROMYCIN ST 250MG-TH                          0.00        0.00     7710     Pharmacy
     05100015-7710   ERYTHRO/SULFISOX 150MG-TH                         0.00        0.00     7710     Pharmacy
     05017883-7710   PSYLLIUM SEED S/F PKT                             0.00        0.00     7710     Pharmacy
     05100012-7710   DIAZEPAM 5MG #2 TB-TH                             0.00        0.00     7710     Pharmacy
     05100004-7710   AMOXICILLIN 250MG/5ML-TH                          0.00        0.00     7710     Pharmacy
     05015796-7710   TOPIRAMATE 100MG TAB                              0.00        0.00     7710     Pharmacy
     05100026-7710   PROMETHAZINE/COD 120ML-TH                         0.00        0.00     7710     Pharmacy
     05018862-7710   INSULIN GLARGIN                                   0.00        0.00     7710     Pharmacy
     05017640-7710   BUDESONIDE 32MCG SPR NAS                          0.00        0.00     7710     Pharmacy
     05002175-7710   MAG OXIDE 400MG TAB                               0.00        0.00     7710     Pharmacy
     05003332-7710   DEFEROXAMINE MESYL 500MG VL                       0.00        0.00     7710     Pharmacy
     05017807-7710   LEVETIRACETAM 250MG TAB                           0.00        0.00     7710     Pharmacy
     05012473-7710   AVEENO CRM                                        0.00        0.00     7710     Pharmacy
     05015380-7710   GLIMEPIRIDE 2MG TAB PO                            0.00        0.00     7710     Pharmacy
     05019101-7710   VALSARTAN 80MG TAB                                0.00        0.00     7710     Pharmacy
     05015719-7710   MVI/MIN/FOLIC 460/60 CAP                          0.00        0.00     7710     Pharmacy
     05017603-7710   OXCARBAZEPINE 600 MG TAB                          0.00        0.00     7710     Pharmacy
     05020145-7710   VALSARTAN 40MG TAB                                0.00        0.00     7710     Pharmacy
     05019109-7710   CETIRIZINE D 120-5MG TA                           0.00        0.00     7710     Pharmacy
     05010185-7710   PYRAZINAMIDE 500MG TAB                            0.00        0.00     7710     Pharmacy
     05018561-7710   LEVOFLOXACIN 750MG TAB                            0.00        0.00     7710     Pharmacy
     05016667-7710   CIPRO HC OTIC SUSP                                0.00        0.00     7710     Pharmacy



8/31/2010                                                                                                                     69
                                                  c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                             CURRENT CURRENT        DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                 INPATIENT OUTPATIENT CODE
                                                                 PRICE      PRICE
     05018846-7710   BIMATOPROST 0.03% EYE DROP                        0.00        0.00     7710     Pharmacy
     05005185-7710   B&O ALK 30-16.2MG SUP                             0.00        0.00     7710     Pharmacy
     05017910-7710   GLUCOVANCE 2.5-500MG                              0.00        0.00     7710     Pharmacy
     05019121-7710   FENOFIBRATE 160MG TAB                             0.00        0.00     7710     Pharmacy
     05013640-7710   PILOCARPINE HCL 5MG TAB                           0.00        0.00     7710     Pharmacy
     05017957-7710   ADVAIR DISKUS 100/50                              0.00        0.00     7710     Pharmacy
     05100003-7710   AMOXICILLIN 125MG/5ML-TH                          0.00        0.00     7710     Pharmacy
     05000394-7710   FLECAINIDE 50MG TAB                               0.00        0.00     7710     Pharmacy
     05016001-7710   ETOMIDATE 2MG/ML VL                               0.00        0.00     7710     Pharmacy
     05017099-7710   DILTIAZEM CD 360MG CAP 24H                        0.00        0.00     7710     Pharmacy
     05014949-7710   DIANEAL/DEXT 4.25%                                0.00        0.00     7710     Pharmacy
     05019263-7710   CLOTRI/BETAMETH 1/0.05% TP                        0.00        0.00     7710     Pharmacy
     05017936-7710   CLINDAMYCIN/BEN PER 1-5%                          0.00        0.00     7710     Pharmacy
     05003867-7710   FLEET MINERAL OIL ENEMA                           0.00        0.00     7710     Pharmacy
     05017792-7710   CA CIT W/ VIT D 315-200MG                         0.00        0.00     7710     Pharmacy
     05018297-7710   VX FLU SPLIT GT=3YRS IM                           0.00        0.00     7710     Pharmacy
     05013899-7710   ADENOSINE 3MG/ML 2ML SYR                          0.00        0.00     7710     Pharmacy
     05018723-7710   CAPSOFUNGIN 50MG VL                               0.00        0.00     7710     Pharmacy
     05019220-7710   DARBEPOETIN 40MCG/ML VL                           0.00        0.00     7710     Pharmacy
     05020213-7710   DARBEPOETIN 200MCG/0.4ML                          0.00        0.00     7710     Pharmacy
     05020211-7710   DARBEPOETIN 60MCG/0.3ML                           0.00        0.00     7710     Pharmacy
     05020212-7710   DARBEPOETIN 100MCG/0.5ML                          0.00        0.00     7710     Pharmacy
     05017160-7710   ROSIGLITAZONE 2MG TAB                             0.00        0.00     7710     Pharmacy
     05014910-7710   LOTREL 10-5MG CAP                                 0.00        0.00     7710     Pharmacy
     05020215-7710   CELLULOSE 2X4 IN                                  0.00        0.00     7710     Pharmacy
     05013130-7710   ONDANSETRON HCL 4MG TAB                           0.00        0.00     7710     Pharmacy
     05018667-7710   TOLTERODINE LA 2MG CAP                            0.00        0.00     7710     Pharmacy
     05018581-7710   TAZAROTENE 0.1% CRM                               0.00        0.00     7710     Pharmacy
     05018506-7710   SEVELAMER 400MG TAB                               0.00        0.00     7710     Pharmacy
     05015578-7710   PSEUDO/CHLOR SR 120-8MG                           0.00        0.00     7710     Pharmacy
     05019855-7710   PIMECROLIMUS 1% CRM                               0.00        0.00     7710     Pharmacy
     05018432-7710   PAROXETINE 40MG TAB                               0.00        0.00     7710     Pharmacy
     05018431-7710   PAROXETINE 30MG TAB                               0.00        0.00     7710     Pharmacy
     05004023-7710   FLEET ENEMA                                       0.00        0.00     7710     Pharmacy
     05020155-7710   ORTHO TRI-CYCLE 7-7-7 LO                          0.00        0.00     7710     Pharmacy
     05100013-7710   DIPHENHY 12.5MG/5ML-TH                            0.00        0.00     7710     Pharmacy
     05019424-7710   OMEPRAZOLE CMPD SOLN                              0.00        0.00     7710     Pharmacy
     05018671-7710   NATEGLINIDE 60MG TAB                              0.00        0.00     7710     Pharmacy



8/31/2010                                                                                                                     70
                                               c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                          CURRENT CURRENT        DEPARTMENT   DEPARTMENT DESCRIPTION
                                                              INPATIENT OUTPATIENT CODE
                                                              PRICE      PRICE
     05018695-7710   MIRTAZAPINE SOLTAB 15MG                        0.00        0.00     7710     Pharmacy
     05018558-7710   METFORMIN 500MG XR TAB                         0.00        0.00     7710     Pharmacy
     05013049-7710   K CIT 1080MG SA TAB                            0.00        0.00     7710     Pharmacy
     05018622-7710   INSULIN LIS/NPH 75/25 VL                       0.00        0.00     7710     Pharmacy
     05020002-7710   FULVESTRANT 250MG/5ML                          0.00        0.00     7710     Pharmacy
     05018100-7710   FOLIC ACID-FOLTX TAB                           0.00        0.00     7710     Pharmacy
     05018429-7710   PAROXETINE 10MG TAB                            0.00        0.00     7710     Pharmacy
     05018673-7710   TACROLIMUS 0.1% OINT TOP                       0.00        0.00     7710     Pharmacy
     05018106-7710   LINEZOLID 600MG/300ML IVSL                     0.00        0.00     7710     Pharmacy
     05013229-7710   BISOPROLOL FUMAR 10MG TAB                      0.00        0.00     7710     Pharmacy
     05007531-7710   PREDNISOLONE 5MG TAB                           0.00        0.00     7710     Pharmacy
     05016232-7710   COMBIVIR 300-150 MG                            0.00        0.00     7710     Pharmacy
     05017252-7710   IVERMECTIN 3MG TAB                             0.00        0.00     7710     Pharmacy
     05018465-7710   DIVALPROEX 500 MG SA TAB                       0.00        0.00     7710     Pharmacy
     05100008-7710   APAP/PROPOXY 650-100MG-TH                      0.00        0.00     7710     Pharmacy
     05018716-7710   FLUOXETINE 90MG CAP EC                         0.00        0.00     7710     Pharmacy
     05018103-7710   LINEZOLID 600 MG TAB                           0.00        0.00     7710     Pharmacy
     05018539-7710   BECLOMETHASONE 40MCG AER ADP INH               0.00        0.00     7710     Pharmacy
     05016071-7710   ROPINIROLE HCL 0.25MG TAB                      0.00        0.00     7710     Pharmacy
     05018711-7710   ZIPRASIDONE 20MG CAP PO                        0.00        0.00     7710     Pharmacy
     05018676-7710   ALENDRONATE 35MG TAB                           0.00        0.00     7710     Pharmacy
     05015766-7710   PANAFIL OINT                                   0.00        0.00     7710     Pharmacy
     05009514-7710   CISPLATIN 1MG/ML IJ                            0.00        0.00     7710     Pharmacy
     05017605-7710   GABAPENTIN 600MG TAB                           0.00        0.00     7710     Pharmacy
     05018437-7710   SERTRALINE 20MG/ML CONC                        0.00        0.00     7710     Pharmacy
     05018340-7710   GLUCOVANCE 5-500MG                             0.00        0.00     7710     Pharmacy
     05017917-7710   MELOXICAM 7.5MG TAB                            0.00        0.00     7710     Pharmacy
     05016866-7710   CILOSTAZOL 100MG TAB                           0.00        0.00     7710     Pharmacy
     05019383-7710   AMIFOSTINE 500MG IJ                            0.00        0.00     7710     Pharmacy
     05017161-7710   ROSIGLITAZONE 4MG TAB                          0.00        0.00     7710     Pharmacy
     05017162-7710   ROSIGLITAZONE 8MG TAB                          0.00        0.00     7710     Pharmacy
     05016087-7710   SALMETEROL 50 MCG DISK                         0.00        0.00     7710     Pharmacy
     05004132-7710   TESTOSTERONE CYP200MG/MLVI                     0.00        0.00     7710     Pharmacy
     05015872-7710   TOPIRAMATE 25MG TAB                            0.00        0.00     7710     Pharmacy
     05016133-7710   PRAMIPEXOLE 1.5MG TAB                          0.00        0.00     7710     Pharmacy
     05007370-7710   HEPARIN PORK 50U/ML IVSL                       0.00        0.00     7710     Pharmacy
     05013671-7710   TACROLIMUS/1MG PO                              0.00        0.00     7710     Pharmacy
     05017047-7710   AVALIDE 300-12.5 MG TAB                        0.00        0.00     7710     Pharmacy



8/31/2010                                                                                                                  71
                                               c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                          CURRENT CURRENT        DEPARTMENT   DEPARTMENT DESCRIPTION
                                                              INPATIENT OUTPATIENT CODE
                                                              PRICE      PRICE
     05016791-7710   TRASTUZUMAB 440MG VIAL IV                      0.00        0.00     7710     Pharmacy
     05017942-7710   RIVASTIGMINE 1.5 MG CAP                        0.00        0.00     7710     Pharmacy
     05019408-7710   PALIVIZUMAB/50MG IJ                            0.00        0.00     7710     Pharmacy
     05015524-7710   MEROPENEM 1000MG IJ                            0.00        0.00     7710     Pharmacy
     05017612-7710   GATIFLOXACIN 10MG/ML VIAL                      0.00        0.00     7710     Pharmacy
     05017610-7710   GATIFLOXACIN 200MG TAB                         0.00        0.00     7710     Pharmacy
     05017611-7710   GATIFLOXACIN 400MG TAB                         0.00        0.00     7710     Pharmacy
     05017873-7710   GATIFLOX 200MG/100ML D5W                       0.00        0.00     7710     Pharmacy
     05017874-7710   GATIFLOX 400MG/200ML D5W                       0.00        0.00     7710     Pharmacy
     05017602-7710   OXCARBAZEPINE 300 MG TAB                       0.00        0.00     7710     Pharmacy
     05015478-7710   GEMCITABINE 200MG IJ                           0.00        0.00     7710     Pharmacy
     05008282-7710   MICONAZOLE NIT 2% PWD TOP                      0.00        0.00     7710     Pharmacy
     05017808-7710   LEVETIRACETAM 500MG TAB                        0.00        0.00     7710     Pharmacy
     05018666-7710   TOLTERODINE TART 4MG/24HR                      0.00        0.00     7710     Pharmacy
     05016340-7710   ARGININE 10% IVSL                              0.00        0.00     7710     Pharmacy
     05019422-7710   RISEDRONATE 5MG TAB                            0.00        0.00     7710     Pharmacy
     05018765-7710   PANTOPRAZOLE 40MG TAB EC                       0.00        0.00     7710     Pharmacy
     05017048-7710   FLUOXETINE 10MG TAB                            0.00        0.00     7710     Pharmacy
     05017256-7710   FLUOXETINE 40MG CAP                            0.00        0.00     7710     Pharmacy
     05017958-7710   ADVAIR DISKUS 50-250                           0.00        0.00     7710     Pharmacy
     05016250-7710   VENLAFAXINE XR 150MG CAP PO                    0.00        0.00     7710     Pharmacy
     05017861-7710   CAFFEINE CIT ORAL SOL                          0.00        0.00     7710     Pharmacy
     05017035-7710   POLYETHYLENE 3350 PWD PO                       0.00        0.00     7710     Pharmacy
     05017865-7710   Code Box Charge                                0.00        0.00     7710     Pharmacy
     05017376-7710   GLIPIZIDE 2.5MG TAB                            0.00        0.00     7710     Pharmacy
     05004048-7710   PSYLLIUM SEED/SUCROSE PWD                      0.00        0.00     7710     Pharmacy
     05017113-7710   ASA/DIPYR 25-200MG CAP                         0.00        0.00     7710     Pharmacy
     05017124-7710   OLANZAPINE 15MG TAB                            0.00        0.00     7710     Pharmacy
     05017094-7710   TIZANIDINE HCL 2MG TAB                         0.00        0.00     7710     Pharmacy
     05017862-7710   FOLIC ACID 1MG/ML ORAL SOL                     0.00        0.00     7710     Pharmacy
     05017863-7710   NYSTATIN/DIPHENHYDRAMINE MOUTHWASH             0.00        0.00     7710     Pharmacy
     05020217-7710   PAMIDRONATE 60MG/10ML IJ                       0.00        0.00     7710     Pharmacy
     05019375-7710   PARICALCITOL 2MCG/ML VIAL                      0.00        0.00     7710     Pharmacy
     05018584-7710   LEVOCARNITINE 1GM/5ML VL                       0.00        0.00     7710     Pharmacy
     05019240-7710   CADEXOMR IODINE 0.9% GEL                       0.00        0.00     7710     Pharmacy
     05022026-7710   PREGABALIN 75MG CAP                            0.00        0.00     7710     Pharmacy
     05017901-7710   SUMATRIPTAN 100MG TAB                          0.00        0.00     7710     Pharmacy
     05016771-7710   EFAVIRENZ 200MG CAP                            0.00        0.00     7710     Pharmacy



8/31/2010                                                                                                                  72
                                                   c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                              CURRENT CURRENT        DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                  INPATIENT OUTPATIENT CODE
                                                                  PRICE      PRICE
     05020679-7710   DARBEPOETIN 40MCG/0.4ML                            0.00        0.00     7710     Pharmacy
     05020416-7710   ATOMOXETINE 40MG CAP                               0.00        0.00     7710     Pharmacy
     05017407-7710   ZAFIRLUKAST 10MG TAB                               0.00        0.00     7710     Pharmacy
     05017657-7710   OXCARBAZEPINE 150MG TAB                            0.00        0.00     7710     Pharmacy
     05020680-7710   ADALIMUMAB 40MG PFS                                0.00        0.00     7710     Pharmacy
     05018722-7710   PAPAIN/UREA 0.83MMU/G OIN                          0.00        0.00     7710     Pharmacy
     05021554-7710   QUINAPRIL 10MG TAB                                 0.00        0.00     7710     Pharmacy
     05016358-7710   KETOROLAC PF 0.5% OPTH                             0.00        0.00     7710     Pharmacy
     05016831-7710   TELMISARTAN 40MG TAB                               0.00        0.00     7710     Pharmacy
     05020537-7710   PREMPRO LO 0.45-1.5MG TAB                          0.00        0.00     7710     Pharmacy
     05004513-7710   THIOPENTAL 25MG/ML,20ML                            0.00        0.00     7710     Pharmacy
     05020678-7710   DARBEPOETIN 25MCG/0.42ML                           0.00        0.00     7710     Pharmacy
     05019965-7710   PAROXETINE 25MG CR TAB                             0.00        0.00     7710     Pharmacy
     05016726-7710   AMOXICILLIN 875MG TAB                              0.00        0.00     7710     Pharmacy
     05018921-7710   GABAPENTIN 250MG/5ML SOLN                          0.00        0.00     7710     Pharmacy
     05016474-7710   CANDESARTAN 16MG TAB                               0.00        0.00     7710     Pharmacy
     05016923-7710   MIRTAZAPINE 45MG TAB                               0.00        0.00     7710     Pharmacy
     05018839-7710   METOPROLOL 25MG XL TAB                             0.00        0.00     7710     Pharmacy
     05016263-7710   TIAGABINE 4MG TAB                                  0.00        0.00     7710     Pharmacy
     05018580-7710   TAZAROTENE 0.05% CRM                               0.00        0.00     7710     Pharmacy
     05018691-7710   APAP/HYDROCOD 7.5/325MG TAB                        0.00        0.00     7710     Pharmacy
     05012616-7710   UREA (CARMOL) 40 CRM                               0.00        0.00     7710     Pharmacy
     05003213-7710   PHYTONADIONE 2MG/ML SYR                            0.00        0.00     7710     Pharmacy
     05014446-7710   MILRINONE 0.2MG/ML IN D5W                          0.00        0.00     7710     Pharmacy
     05019057-7710   CA ACET 667MG GELCAP                               0.00        0.00     7710     Pharmacy
     05019966-7710   PAROXETINE 12.5MG CR TAB                           0.00        0.00     7710     Pharmacy
     05013486-7710   TORSEMIDE 100MG TAB                                0.00        0.00     7710     Pharmacy
     05017923-7710   ADAPALENE 0.1% CRM                                 0.00        0.00     7710     Pharmacy
     05017710-7710   RANITIDINE 300MB TAB                               0.00        0.00     7710     Pharmacy
     05016353-7710   HYDROCORT 100MG/60ML PR                            0.00        0.00     7710     Pharmacy
     05016051-7710   CARVEDILOL 25MG TAB                                0.00        0.00     7710     Pharmacy
     05019399-7710   DROTRECOGIN 20MG VL                                0.00        0.00     7710     Pharmacy
     05016254-7710   IRBESARTAN 75MG TAB                                0.00        0.00     7710     Pharmacy
     05011770-7710   APAP/HYDROCOD 5/325MG TAB                          0.00        0.00     7710     Pharmacy
     05017951-7710   OLANZAPINE 20MG TAB                                0.00        0.00     7710     Pharmacy
     05001960-7710   VIT A 10000 UNIT CAP                               0.00        0.00     7710     Pharmacy
     05003150-7710   MVI/MIN (L-TONIC) ELX                              0.00        0.00     7710     Pharmacy
     05010082-7710   RIFAMPIN 150MG CAP                                 0.00        0.00     7710     Pharmacy



8/31/2010                                                                                                                      73
                                                   c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                              CURRENT CURRENT        DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                  INPATIENT OUTPATIENT CODE
                                                                  PRICE      PRICE
     05015191-7710   DESMOPRESSIN 0.2MG TAB                             0.00        0.00     7710     Pharmacy
     05018575-7710   ALENDRONATE 70MG TAB                               0.00        0.00     7710     Pharmacy
     05014984-7710   IBUPROFEN (PEDIACARE) DRP                          0.00        0.00     7710     Pharmacy
     05017940-7710   CA CIT (CITRACAL) 200MG TAB                        0.00        0.00     7710     Pharmacy
     05018507-7710   SEVELAMER 800MG TAB                                0.00        0.00     7710     Pharmacy
     05018310-7710   ATORVASTATIN 80MG TAB                              0.00        0.00     7710     Pharmacy
     05016761-7710   LEVOCARNITINE 330MG TAB                            0.00        0.00     7710     Pharmacy
     05018817-7710   CITALOPRAM 10MG TAB                                0.00        0.00     7710     Pharmacy
     05016072-7710   ROPINIROLE 1MG TAB                                 0.00        0.00     7710     Pharmacy
     05018168-7710   FEXOFENADINE 30MG TAB                              0.00        0.00     7710     Pharmacy
     05017959-7710   ADVAIR DISKUS 500/50                               0.00        0.00     7710     Pharmacy
     05019115-7710   ALTEPLASE (CATHFLO) 2MG VL                         0.00        0.00     7710     Pharmacy
     05019100-7710   VALSARTAN 160MG TAB                                0.00        0.00     7710     Pharmacy
     05017948-7710   AZELASTINE 0.05% OP DRP                            0.00        0.00     7710     Pharmacy
     05016805-7710   ZOSYN 3/0.375GM PREMIX IV                          0.00        0.00     7710     Pharmacy
     05019099-7710   VALSARTAN 320MG TAB                                0.00        0.00     7710     Pharmacy
     05019436-7710   DESLORATADINE 5MG TAB                              0.00        0.00     7710     Pharmacy
     05017931-7710   ESTRADIOL 25MCG VAG 8'S                            0.00        0.00     7710     Pharmacy
     05010130-7710   IMIPENEM/CILAST 250MG VL                           0.00        0.00     7710     Pharmacy
     05016478-7710   CIPRO 0.3% OPT OINT                                0.00        0.00     7710     Pharmacy
     05018353-7710   METHYLPHENIDATE 18MG TAB SA                        0.00        0.00     7710     Pharmacy
     05012443-7710   CEFOXITIN 1G INJ                                   0.00        0.00     7710     Pharmacy
     05020662-7710   EZETIMIBE 10MG TAB                                 0.00        0.00     7710     Pharmacy
     05020417-7710   ATOMOXETINE 60MG CAP                               0.00        0.00     7710     Pharmacy
     05020415-7710   ATOMOXETINE 25MG CAP                               0.00        0.00     7710     Pharmacy
     05019927-7710   PEGFILGRASTIM 6MG IJ                               0.00        0.00     7710     Pharmacy
     05018724-7710   CASPOFUNGIN 70MG VL                                0.00        0.00     7710     Pharmacy
     05100017-7710   HYDROCOD/HOMATRO 60ML-TH                           0.00        0.00     7710     Pharmacy
     05015601-7710   CIDOFOVIR 375MG/5ML IJ                             0.00        0.00     7710     Pharmacy
     05020082-7710   ZIPRASIDONE 20MG VL INJ                            0.00        0.00     7710     Pharmacy
     05018828-7710   OLANZAPINE ZYDIS 15MG TAB                          0.00        0.00     7710     Pharmacy
     05012444-7710   CEFOXITIN 2G INJ                                   0.00        0.00     7710     Pharmacy
     05012705-7710   MAG SO4 4% IV SOLN                                 0.00        0.00     7710     Pharmacy
     05020601-7710   BUPROPION XL 150MG TAB                             0.00        0.00     7710     Pharmacy
     05018424-7710   FLUOXETINE 10MG CAP                                0.00        0.00     7710     Pharmacy
     05018685-7710   AMIODARONE 400MG TAB                               0.00        0.00     7710     Pharmacy
     05016696-7710   RIZATRIPTAN 5MG TAB                                0.00        0.00     7710     Pharmacy
     05018705-7710   ESOMEPRAZOLE 40MG DR CAP                           0.00        0.00     7710     Pharmacy



8/31/2010                                                                                                                      74
                                                  c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                             CURRENT CURRENT        DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                 INPATIENT OUTPATIENT CODE
                                                                 PRICE      PRICE
     05019117-7710   AUGMENTIN 600-42.9MG/5ML                          0.00        0.00     7710     Pharmacy
     05015871-7710   HCTZ 12.5MG CAP                                   0.00        0.00     7710     Pharmacy
     05020142-7710   ESCITALOPRAM 20MG TAB                             0.00        0.00     7710     Pharmacy
     05019997-7710   OLMESARTAN MED 20MG TAB                           0.00        0.00     7710     Pharmacy
     05006191-7710   PETROLATUM W/ZINC OXIDE                           0.00        0.00     7710     Pharmacy
     05018827-7710   ZOLEDRONIC ACID 4MG IV VL                         0.00        0.00     7710     Pharmacy
     05020183-7710   BUPREN/NALOXONE 8/2MG SL                          0.00        0.00     7710     Pharmacy
     05016697-7710   RIZATRIPTAN 10MG TAB                              0.00        0.00     7710     Pharmacy
     05020016-7710   RISEDRONATE 35MG TAB                              0.00        0.00     7710     Pharmacy
     05017054-7710   ESTROGENS 0.625 MG TAB                            0.00        0.00     7710     Pharmacy
     05018511-7710   BUDESONIDE 0.5MG/2ML NEB                          0.00        0.00     7710     Pharmacy
     05015231-7710   ESTRADIOL .75MG/24HR PTCH                         0.00        0.00     7710     Pharmacy
     05016030-7710   TESTOSTERONE 5MG/24HR PTCH                        0.00        0.00     7710     Pharmacy
     05020138-7710   ESCITALOPRAM 10MG TAB                             0.00        0.00     7710     Pharmacy
     05004668-7710   DIAZEPAM 5MG/ML SYR                               0.00        0.00     7710     Pharmacy
     05016968-7710   MODAFINIL 200MG TAB                               0.00        0.00     7710     Pharmacy
     05020677-7710   BORTEZOMIB 3.5MG VIAL                             0.00        0.00     7710     Pharmacy
     05020182-7710   BUPREN/NALOXONE 2/0.5MG SL                        0.00        0.00     7710     Pharmacy
     05018763-7710   BUDESONIDE EC 3MG CAP                             0.00        0.00     7710     Pharmacy
     05018559-7710   FLUVASTATIN 80MG TAB XL                           0.00        0.00     7710     Pharmacy
     05012523-7710   RAMIPRIL 10MG CAP                                 0.00        0.00     7710     Pharmacy
     05020079-7710   TEGASEROD 6MG TAB                                 0.00        0.00     7710     Pharmacy
     05019894-7710   TRI-LUMA 30GM CRM                                 0.00        0.00     7710     Pharmacy
     05022025-7710   PREGABALIN 50MG CAP                               0.00        0.00     7710     Pharmacy
     05019887-7710   TIGAN 300 MG CAP                                  0.00        0.00     7710     Pharmacy
     05021979-7710   METRONIDAZOLE 1% GEL 45G                          0.00        0.00     7710     Pharmacy
     05018712-7710   ZIPRASIDONE 40MG CAP                              0.00        0.00     7710     Pharmacy
     05018713-7710   ZIPRASIDONE 60MG CAP                              0.00        0.00     7710     Pharmacy
     05020070-7710   OXALIPLATIN 100MG VIAL                            0.00        0.00     7710     Pharmacy
     05000823-7710   DILTIAZEM 60MG CAP SA                             0.00        0.00     7710     Pharmacy
     05020785-7710   RISPERIDONE LA 50MG/2ML                           0.00        0.00     7710     Pharmacy
     05021065-7710   TIOTROPIUM 18MCG INHALER                          0.00        0.00     7710     Pharmacy
     05021448-7710   FENOFIBRATE 145MG TAB                             0.00        0.00     7710     Pharmacy
     05020216-7710   DIVALPROEX 250MG ER TAB                           0.00        0.00     7710     Pharmacy
     05020300-7710   AVANDAMET 4-1000MG TAB                            0.00        0.00     7710     Pharmacy
     05021149-7710   SALICYLIC ACID 6% CRM                             0.00        0.00     7710     Pharmacy
     05021389-7710   MVI ADULT/VIT K 10ML IJ                           0.00        0.00     7710     Pharmacy
     05016858-7710   MODAFINIL 100MG TAB                               0.00        0.00     7710     Pharmacy



8/31/2010                                                                                                                     75
                                               c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                          CURRENT CURRENT        DEPARTMENT   DEPARTMENT DESCRIPTION
                                                              INPATIENT OUTPATIENT CODE
                                                              PRICE      PRICE
     05021126-7710   OFLOXACIN 0.3% OTIC                            0.00        0.00     7710     Pharmacy
     05020781-7710   CIPRO / DEXA 0.3/0.1% OTIC                     0.00        0.00     7710     Pharmacy
     05020566-7710   ESTRADIOL 0.06MG/24H PTCH                      0.00        0.00     7710     Pharmacy
     05019883-7710   XENADERM TOPICAL                               0.00        0.00     7710     Pharmacy
     05021057-7710   ACETYLCYSTEINE 200MG/ML                        0.00        0.00     7710     Pharmacy
     05020784-7710   RISPERIDONE LA 37.5MG/2ML                      0.00        0.00     7710     Pharmacy
     05021891-7710   IPRATROPIM 17MCG HFA INH                       0.00        0.00     7710     Pharmacy
     05006680-7710   BENZOYL PEROX (BREVOX) 4% WSH                  0.00        0.00     7710     Pharmacy
     05016773-7710   CANDESARTAN 32MG TAB                           0.00        0.00     7710     Pharmacy
     05021535-7710   TOBRAMYCIN 1G BONE CEMENT                      0.00        0.00     7710     Pharmacy
     05019906-7710   CLOTRIMAZOLE 2% VAG CRM                        0.00        0.00     7710     Pharmacy
     05021016-7710   CINACALCET 30MG TAB                            0.00        0.00     7710     Pharmacy
     05009865-7710   CEFTIZOXIME 1MG IJ                             0.00        0.00     7710     Pharmacy
     05001002-7710   DIPHENHYDRAMINE 50MG/ML SYR                    0.00        0.00     7710     Pharmacy
     05021447-7710   FENOFIBRATE 48 MG TAB                          0.00        0.00     7710     Pharmacy
     05014057-7710   LAMOTRIGINE 200MG TAB                          0.00        0.00     7710     Pharmacy
     05021276-7710   DULOXETINE HCL 20MG CAP                        0.00        0.00     7710     Pharmacy
     05021277-7710   DULOXETINE HCL 30MG CAP                        0.00        0.00     7710     Pharmacy
     05018430-7710   PAROXETINE HCL 20MG TAB                        0.00        0.00     7710     Pharmacy
     05010405-7710   IG IMMUNE GLOB 2MG IM                          0.00        0.00     7710     Pharmacy
     05018494-7710   MIRTAZAPINE 45MG TAB                           0.00        0.00     7710     Pharmacy
     05001806-7710   K CL 25MEQ PKT                                 0.00        0.00     7710     Pharmacy
     05018425-7710   FLUOXETINE HCL 20MG CAP                        0.00        0.00     7710     Pharmacy
     05016134-7710   PRAMIPEXOLE 0.125MG TAB                        0.00        0.00     7710     Pharmacy
     05020945-7710   PROPAFENONE SR 225MG CAP                       0.00        0.00     7710     Pharmacy
     05020837-7710   DAPTOMYCIN 500MG IJ                            0.00        0.00     7710     Pharmacy
     05016972-7710   ONDANSETRON 4 MG OD TAB                        0.00        0.00     7710     Pharmacy
     05007293-7710   GELATIN SPONGE POWDER                          0.00        0.00     7710     Pharmacy
     05020066-7710   AZITHROMYCIN 500MG TAB                         0.00        0.00     7710     Pharmacy
     05017203-7710   BENZOYL PEROX 8% LIQ                           0.00        0.00     7710     Pharmacy
     05021568-7710   ACAMPROSATE 333MG DR TAB                       0.00        0.00     7710     Pharmacy
     05021476-7710   LANTHANUM CARBONATE 500MG TAB                  0.00        0.00     7710     Pharmacy
     05020554-7710   OMALIZUMAB 150MG IJ                            0.00        0.00     7710     Pharmacy
     05021517-7710   ESZOPICLONE 1MG TAB                            0.00        0.00     7710     Pharmacy
     05020700-7710   METOPROLOL 25MG TAB                            0.00        0.00     7710     Pharmacy
     05018492-7710   MIRTAZAPINE 15MG TAB                           0.00        0.00     7710     Pharmacy
     05020691-7710   TOPIRAMATE 50MG TAB                            0.00        0.00     7710     Pharmacy
     05015474-7710   CEFEPIME 2GM IJ                                0.00        0.00     7710     Pharmacy



8/31/2010                                                                                                                  76
                                                  c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                             CURRENT CURRENT        DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                 INPATIENT OUTPATIENT CODE
                                                                 PRICE      PRICE
     05018540-7710   BECLOMETHASONE 80MCG INH                          0.00        0.00     7710     Pharmacy
     05016654-7710   CAPECITABINE 500MG TAB                            0.00        0.00     7710     Pharmacy
     05016514-7710   DIOVAN HCT 160/12.5MG TAB                         0.00        0.00     7710     Pharmacy
     05020668-7710   DUTASTERIDE 0.5MG CAP                             0.00        0.00     7710     Pharmacy
     05019370-7710   FENTANYL 250MCG/5ML IJ VL                         0.00        0.00     7710     Pharmacy
     05020699-7710   OLANZAPINE 10MG IJ VL                             0.00        0.00     7710     Pharmacy
     05021150-7710   ACCUZYME SPRAY                                    0.00        0.00     7710     Pharmacy
     05018762-7710   FORMOTEROL 12MCG INHALER                          0.00        0.00     7710     Pharmacy
     05020901-7710   ESTRADIOL-LEV .45-.015MG PATCH                    0.00        0.00     7710     Pharmacy
     05015377-7710   RITONAVIR 100MG CAP                               0.00        0.00     7710     Pharmacy
     05013602-7710   IG IMMUNE GLOB GAMA 12G                           0.00        0.00     7710     Pharmacy
     05018441-7710   BUPROPION 100MG TAB SA                            0.00        0.00     7710     Pharmacy
     05020248-7710   LETROZOLE 2.5MG TAB                               0.00        0.00     7710     Pharmacy
     05020720-7710   ROSUVASTATIN 10MG TAB                             0.00        0.00     7710     Pharmacy
     05016152-7710   MYCOPHENOLATE 500MG TAB                           0.00        0.00     7710     Pharmacy
     05020873-7710   PREMPRO 0.3/1.5 MG TAB                            0.00        0.00     7710     Pharmacy
     05020710-7710   ARIPIPRAZOLE 20MG TAB                             0.00        0.00     7710     Pharmacy
     05020709-7710   ARIPIPRAZOLE 15MG TAB                             0.00        0.00     7710     Pharmacy
     05020708-7710   ARIPIPRAZOLE 10MG TAB                             0.00        0.00     7710     Pharmacy
     05008416-7710   COCAINE 4% TOP SOLN                               0.00        0.00     7710     Pharmacy
     05020780-7710   ARIPIPRAZOLE 5MG TAB                              0.00        0.00     7710     Pharmacy
     05018772-7710   OMEPRAZOLE 20MG CAP DR                            0.00        0.00     7710     Pharmacy
     05018440-7710   BUPROPION 150MG TAB SA                            0.00        0.00     7710     Pharmacy
     05020493-7710   AZELAIC ACID 15% GEL                              0.00        0.00     7710     Pharmacy
     05020715-7710   ESCITALOPRAM 5MG TAB                              0.00        0.00     7710     Pharmacy
     05010400-7710   IG IMMUNE GLOB GAMA 3G                            0.00        0.00     7710     Pharmacy
     05010403-7710   IG IMMUNE GLOB GAMA 6G                            0.00        0.00     7710     Pharmacy
     05020528-7710   METFORMIN XR 750MG SA TAB                         0.00        0.00     7710     Pharmacy
     05020235-7710   ACYCLOVIR 5% CREAM                                0.00        0.00     7710     Pharmacy
     05021316-7710   OMEPRAZOLE 20MG PKT                               0.00        0.00     7710     Pharmacy
     05018664-7710   BIVALIRUDIN 250MG IJ                              0.00        0.00     7710     Pharmacy
     05021299-7710   PALONOSETRON 0.25MG-5ML IJ                        0.00        0.00     7710     Pharmacy
     05013021-7710   APAP 160MG-5ML SUSP                               0.00        0.00     7710     Pharmacy
     05020876-7710   MEMANTINE 5MG TAB                                 0.00        0.00     7710     Pharmacy
     05003435-7710   FLUORIDE NA 1.1% GEL                              0.00        0.00     7710     Pharmacy
     05017040-7710   LEVALBUTEROL 1.25MG-3ML INH                       0.00        0.00     7710     Pharmacy
     05020722-7710   ROSUVASTATIN 40MG TAB                             0.00        0.00     7710     Pharmacy
     05016950-7710   FENTANYL 0.05MG/ML, 20ML                          0.00        0.00     7710     Pharmacy



8/31/2010                                                                                                                     77
                                                    c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                               CURRENT CURRENT         DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                   INPATIENT OUTPATIENT CODE
                                                                   PRICE      PRICE
     05100035-7710   APAP/HYDROCOD 5-500MG#3-TH                          0.00         0.00     7710     Pharmacy
     05100033-7710   GATIFLOXACIN 400MG #1 - TH                          0.00         0.00     7710     Pharmacy
     05100039-7710   BACTRIM DS #2 - TH                                  0.00         0.00     7710     Pharmacy
     05020711-7710   ARIPIPRAZOLE 30MG TAB                               0.00         0.00     7710     Pharmacy
     05021032-7710   GATIFLOXACIN 0.3% OPT DRP                           0.00         0.00     7710     Pharmacy
     05020783-7710   RISPERIDONE LA 25MG/2ML                             0.00         0.00     7710     Pharmacy
     05100030-7710   AMOXICILLIN 250MG #4 - TH                           0.00         0.00     7710     Pharmacy
     05012955-7710   HYDROMORPHONE 10MG/ML VL                            0.00         0.00     7710     Pharmacy
     05020307-7710   SENNA/DOCUSATE 8.6-50MG PO                          0.00         0.00     7710     Pharmacy
     05013805-7710   MORPHINE 50MG/ML, 20ML IJ                           0.00         0.00     7710     Pharmacy
     05000640-7710   TENORETIC 100-25MG TAB                              0.00         0.00     7710     Pharmacy
     05027566-7710   YASMIN 0.03-3MG TAB                                 0.00         0.00     7710     Pharmacy
     05012560-7710   PROMETHAZINE 25MG TAB                               0.00         0.00     7710     Pharmacy
     05021261-7710   EZETIMIBE SIMVAS 10/10MG                            0.00         0.00     7710     Pharmacy
     05016951-7710   FENTANYL 0.05MG/ML, 2ML VIAL                        0.00         0.00     7710     Pharmacy
     05012345-7710   AMIODARONE 900MG/18ML IJ                            0.00         0.00     7710     Pharmacy
     05020328-7710   AMIODARONE 50MG/ML IJ                               0.00         0.00     7710     Pharmacy
     05021532-7710   HYALURONIDASE 200UNIT/ML                            0.00         0.00     7710     Pharmacy
     05012266-7710   IG IMMUN GLOB 20G/200MLIJ                           0.00         0.00     7710     Pharmacy
     05100032-7710   CEPHALEXIN 250MG #4 - TH                            0.00         0.00     7710     Pharmacy
     05024058-7710   VINORELBINE/10MG IJ                                 0.00         0.00     7710     Pharmacy
     05011002-7710   MEDICATIONS                                         0.00         0.00     7710     Pharmacy
     05079991-7710   MISC O/P RX                                         0.00         0.00     7710     Pharmacy
     08413247-7710   EPOETIN 5000U IJ                                  171.61       171.61     7710     Pharmacy
     02818979-7710   CHLAMYDIA TRACH AMP PRB                            30.00        30.00     7710     Pharmacy
     05002707-7710   D50W 500ML                                          0.00         0.00     7710     Pharmacy
     05002706-7710   D50W 50 ML                                          0.00         0.00     7710     Pharmacy
     05000070-7710   D5W 250ML                                           0.00         0.00     7710     Pharmacy
     05002951-7710   D5LR 1000ML                                         0.00         0.00     7710     Pharmacy
     05007603-7710   DEXAMETHASONE 1MG TAB                               0.00         0.00     7710     Pharmacy
     05002702-7710   D20W 500ML                                          0.00         0.00     7710     Pharmacy
     05007604-7710   DEXAMETHASONE 2MG TAB                               0.00         0.00     7710     Pharmacy
     05002698-7710   D10W 500ML                                          0.00         0.00     7710     Pharmacy
     05007605-7710   DEXAMETHASONE 4MG TAB                               0.00         0.00     7710     Pharmacy
     05007602-7710   DEXAMETHASONE 1.5MG TAB                             0.00         0.00     7710     Pharmacy
     05008857-7710   DEXAMETHASONE 1%SP DROP                             0.00         0.00     7710     Pharmacy
     05002939-7710   D51/4NS 500ML                                       0.00         0.00     7710     Pharmacy
     05016114-7710   DESMOPRESSIN 0.1MG/MLNASAL                          0.00         0.00     7710     Pharmacy



8/31/2010                                                                                                                        78
                                                 c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                            CURRENT CURRENT        DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                INPATIENT OUTPATIENT CODE
                                                                PRICE      PRICE
     05015000-7710   CYCLOSPORINE 25MG PO B                           0.00        0.00     7710     Pharmacy
     05002818-7710   CYPROHEPTADINE 4MG TAB                           0.00        0.00     7710     Pharmacy
     05005858-7710   DEXEDRINE 5MG TAB                                0.00        0.00     7710     Pharmacy
     05000874-7710   DELSYM 30MG/5ML SUSP                             0.00        0.00     7710     Pharmacy
     05002929-7710   D51/2NS 500ML                                    0.00        0.00     7710     Pharmacy
     05002925-7710   D5NS 500ML                                       0.00        0.00     7710     Pharmacy
     05002905-7710   PLASMA-LYTE 148/D5W1000                          0.00        0.00     7710     Pharmacy
     05010357-7710   DAPSONE 100MG TAB                                0.00        0.00     7710     Pharmacy
     05009963-7710   DEMECLOCYCLINE 150MG TAB                         0.00        0.00     7710     Pharmacy
     05007598-7710   DEXAMETHASONE .5MG/.5MLDP                        0.00        0.00     7710     Pharmacy
     05004810-7710   DESIPRAMINE 50MG TAB                             0.00        0.00     7710     Pharmacy
     05007599-7710   DEXAMETHASONE .5MG/5ML EL                        0.00        0.00     7710     Pharmacy
     05007446-7710   DESMOPRESSIN ACET 4MCG/ML                        0.00        0.00     7710     Pharmacy
     05007447-7710   DESMOPRESSIN ACET 4MCG/ML                        0.00        0.00     7710     Pharmacy
     05013090-7710   DESOGEN 0.15-0.03 TAB                            0.00        0.00     7710     Pharmacy
     05008559-7710   DESONIDE 0.05% CRM                               0.00        0.00     7710     Pharmacy
     05012872-7710   DESONIDE 0.05% LOT                               0.00        0.00     7710     Pharmacy
     05007613-7710   DEXAMETHASONE 10MG/ML VL                         0.00        0.00     7710     Pharmacy
     05007619-7710   DEXAMETHASONE 4MG/ML VIAL                        0.00        0.00     7710     Pharmacy
     05009294-7710   DICLOFENAC NA 50MG TAB EC                        0.00        0.00     7710     Pharmacy
     05007597-7710   DEXAMETHASONE 0.5MG TAB                          0.00        0.00     7710     Pharmacy
     05002708-7710   D50W 50 ML                                       0.00        0.00     7710     Pharmacy
     05009964-7710   DEMECLOCYCLINE 300MG TAB                         0.00        0.00     7710     Pharmacy
     05014593-7710   DINOPROSTONE 10MG SUPP                           0.00        0.00     7710     Pharmacy
     05004669-7710   DIAZEPAM 5MG/ML VIAL                             0.00        0.00     7710     Pharmacy
     05013461-7710   DILTIAZEM 120MG SA 24H CP                        0.00        0.00     7710     Pharmacy
     05012727-7710   DILTIAZEM 180MG SA 24H CP                        0.00        0.00     7710     Pharmacy
     05012728-7710   DILTIAZEM 240MG SA 24H CP                        0.00        0.00     7710     Pharmacy
     05012729-7710   DILTIAZEM 300MG SA 24H CP                        0.00        0.00     7710     Pharmacy
     05000822-7710   DILTIAZEM 30MG TAB                               0.00        0.00     7710     Pharmacy
     05012698-7710   DILTIAZEM 5MG/ML VIAL                            0.00        0.00     7710     Pharmacy
     05003396-7710   DIGOXIN IMM FAB/38MG IJ                          0.00        0.00     7710     Pharmacy
     05000826-7710   DILTIAZEM 90MG TAB                               0.00        0.00     7710     Pharmacy
     05000018-7710   DIGOXIN 0.25MG/ML AMP                            0.00        0.00     7710     Pharmacy
     05000993-7710   DIPHENHYDRAMINE 12.5MG/5ML ELIX                  0.00        0.00     7710     Pharmacy
     05000996-7710   DIPHENHYDRAMINE 25MG TAB                         0.00        0.00     7710     Pharmacy
     05006549-7710   DIPHENHYDRAMINE 2PC CRM                          0.00        0.00     7710     Pharmacy
     05000997-7710   DIPHENHYDRAMINE 50MG CAP                         0.00        0.00     7710     Pharmacy



8/31/2010                                                                                                                    79
                                                c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                           CURRENT CURRENT        DEPARTMENT   DEPARTMENT DESCRIPTION
                                                               INPATIENT OUTPATIENT CODE
                                                               PRICE      PRICE
     05001003-7710   DIPHENHYDRAMINE 50MG/ML VIAL                    0.00        0.00     7710     Pharmacy
     05003765-7710   LOMOTIL LIQ                                     0.00        0.00     7710     Pharmacy
     05003766-7710   LOMOTIL TAB                                     0.00        0.00     7710     Pharmacy
     05000824-7710   DILTIAZEM 60MG TAB                              0.00        0.00     7710     Pharmacy
     05009719-7710   DICLOXACILLIN 250MG CAP                         0.00        0.00     7710     Pharmacy
     05004097-7710   DIATRIZOATE 30% VIAL                            0.00        0.00     7710     Pharmacy
     05004099-7710   DIATRIZOATE 60% VIAL                            0.00        0.00     7710     Pharmacy
     05004661-7710   DIAZEPAM 10MG TAB                               0.00        0.00     7710     Pharmacy
     05004663-7710   DIAZEPAM 2MG TAB                                0.00        0.00     7710     Pharmacy
     05004664-7710   DIAZEPAM 5MG TAB                                0.00        0.00     7710     Pharmacy
     05012106-7710   CYCLOSPORINE 25MG PO B                          0.00        0.00     7710     Pharmacy
     05015169-7710   DICLOFENAC NA 100MG TAB                         0.00        0.00     7710     Pharmacy
     05005411-7710   DIHYDROERGOT 1MG/ML AMP                         0.00        0.00     7710     Pharmacy
     05009295-7710   DICLOFENAC NA 75MG TAB EC                       0.00        0.00     7710     Pharmacy
     05012260-7710   DIALYSIS SOLUTIONS IPSL                         0.00        0.00     7710     Pharmacy
     05009720-7710   DICLOXACILLIN 500MG CAP                         0.00        0.00     7710     Pharmacy
     05005770-7710   DICYCLOMINE 10MG CAP                            0.00        0.00     7710     Pharmacy
     05005767-7710   DICYCLOMINE 10MG/5ML SYRP                       0.00        0.00     7710     Pharmacy
     05005773-7710   DICYCLOMINE 20MG TAB                            0.00        0.00     7710     Pharmacy
     05000013-7710   DIGOXIN 0.05MG/ML ELIX                          0.00        0.00     7710     Pharmacy
     05000014-7710   DIGOXIN 0.125MG TAB                             0.00        0.00     7710     Pharmacy
     05000017-7710   DIGOXIN 0.25MG TAB                              0.00        0.00     7710     Pharmacy
     05007425-7710   COSYNTROPIN 0.25MG VIAL                         0.00        0.00     7710     Pharmacy
     05010115-7710   CLINDAMYCIN PHOS 150MG/ML IJ                    0.00        0.00     7710     Pharmacy
     05004075-7710   CHOLESTYRAMINE 4G PACK                          0.00        0.00     7710     Pharmacy
     05000483-7710   CHLORTHALIDONE 25MG TAB                         0.00        0.00     7710     Pharmacy
     05002620-7710   CHLORPROPAMIDE 250MG TAB                        0.00        0.00     7710     Pharmacy
     05004699-7710   CHLORPROMAZINE 50MG TAB                         0.00        0.00     7710     Pharmacy
     05004693-7710   CHLORPROMAZINE 25MG/ML AMP                      0.00        0.00     7710     Pharmacy
     05004692-7710   CHLORPROMAZINE 25MG TAB                         0.00        0.00     7710     Pharmacy
     05001931-7710   CYANOCOBALAMIN 1000MCG TB                       0.00        0.00     7710     Pharmacy
     05000764-7710   DIPYRIDAMOLE 50MG TAB                           0.00        0.00     7710     Pharmacy
     05007244-7710   HYLAN G-F 20 DIS SYR                            0.00        0.00     7710     Pharmacy
     05013001-7710   CLINDAMYCIN PHOS 2% CRM AP                      0.00        0.00     7710     Pharmacy
     05010119-7710   CLINDAMYCIN 600MG/50ML PB                       0.00        0.00     7710     Pharmacy
     05012491-7710   CLINDAMYCIN 900MG/50ML PB                       0.00        0.00     7710     Pharmacy
     05008572-7710   CLOBETASOL PROP 0.05% CRM                       0.00        0.00     7710     Pharmacy
     05014616-7710   CLOBETASOL PROP 0.05% GEL                       0.00        0.00     7710     Pharmacy



8/31/2010                                                                                                                   80
                                                c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                           CURRENT CURRENT        DEPARTMENT   DEPARTMENT DESCRIPTION
                                                               INPATIENT OUTPATIENT CODE
                                                               PRICE      PRICE
     05008574-7710   CLOBETASOL PROP 0.05% OIN GM                    0.00        0.00     7710     Pharmacy
     05005464-7710   CLONAZEPAM 0.5MG TAB                            0.00        0.00     7710     Pharmacy
     05014658-7710   EPHEDRINE SO4 50MG/ML VL                        0.00        0.00     7710     Pharmacy
     05008672-7710   CLINDAMYCIN PHOS 1% LOT                         0.00        0.00     7710     Pharmacy
     05012423-7710   CIPRO LACT 10MG/ML VIAL                         0.00        0.00     7710     Pharmacy
     05012422-7710   CIPRO 400MG/0.2L PB                             0.00        0.00     7710     Pharmacy
     05016444-7710   CITALOPRAM 20MG TAB                             0.00        0.00     7710     Pharmacy
     05009189-7710   POLYCITRA-K SOL                                 0.00        0.00     7710     Pharmacy
     05012674-7710   CLARITHROMYCIN 500MG TAB                        0.00        0.00     7710     Pharmacy
     05005758-7710   LIBRAX 2.5-5MG                                  0.00        0.00     7710     Pharmacy
     05010110-7710   CLINDAMYCIN 150MG CAP                           0.00        0.00     7710     Pharmacy
     05004076-7710   CHOLESTYRAMINE PWD                              0.00        0.00     7710     Pharmacy
     05008671-7710   CLINDAMYCIN PHOS 1% GEL                         0.00        0.00     7710     Pharmacy
     05004071-7710   CHOLESTYRAMINE PACK                             0.00        0.00     7710     Pharmacy
     05008673-7710   CLINDAMYCIN PHOS 1% SOL                         0.00        0.00     7710     Pharmacy
     05010266-7710   CIPRO 750MG TAB                                 0.00        0.00     7710     Pharmacy
     05010265-7710   CIPRO 500MG TAB                                 0.00        0.00     7710     Pharmacy
     05010264-7710   CIPRO 250MG TAB                                 0.00        0.00     7710     Pharmacy
     05012087-7710   CIMETIDINE 400MG TAB                            0.00        0.00     7710     Pharmacy
     05012085-7710   CIMETIDINE 300MG TAB                            0.00        0.00     7710     Pharmacy
     05000498-7710   CLONIDINE 0.1MG PTCH                            0.00        0.00     7710     Pharmacy
     05010120-7710   CLINDAMYCIN PALM75MG/5MLSU                      0.00        0.00     7710     Pharmacy
     05017069-7710   COMPOUNDED ORAL                                 0.00        0.00     7710     Pharmacy
     05005465-7710   CLONAZEPAM 1MG TAB                              0.00        0.00     7710     Pharmacy
     05005081-7710   APAP/COD ELIX                                   0.00        0.00     7710     Pharmacy
     05000983-7710   CODEINE PHOS 30MG/ML SYR DI                     0.00        0.00     7710     Pharmacy
     05005106-7710   CODEINE SO4 30MG TAB                            0.00        0.00     7710     Pharmacy
     05009246-7710   COLCHICINE 0.5MG TAB                            0.00        0.00     7710     Pharmacy
     05014912-7710   COLCHICINE 0.5MG/ML VIAL                        0.00        0.00     7710     Pharmacy
     05009248-7710   COLCHICINE 0.6MG TAB                            0.00        0.00     7710     Pharmacy
     05005094-7710   APAP/COD 60/300 TAB                             0.00        0.00     7710     Pharmacy
     05017067-7710   COMPOUNDED EYE DROPS                            0.00        0.00     7710     Pharmacy
     05005087-7710   APAP/COD 30/300 TAB                             0.00        0.00     7710     Pharmacy
     05012372-7710   CIPRO HCL 0.3% DROP                             0.00        0.00     7710     Pharmacy
     05012113-7710   CROMOLYN NA 40MG/ML SP PMPNS                    0.00        0.00     7710     Pharmacy
     05001936-7710   CYANOCOBALAMIN 1000MCG/ML VIAL                  0.00        0.00     7710     Pharmacy
     05001937-7710   CYANOCOBALAMIN 100MCG TAB                       0.00        0.00     7710     Pharmacy
     05005554-7710   CYCLOBENZAPRINE 10MG TAB                        0.00        0.00     7710     Pharmacy



8/31/2010                                                                                                                   81
                                                  c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                             CURRENT CURRENT        DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                 INPATIENT OUTPATIENT CODE
                                                                 PRICE      PRICE
     05008834-7710   CYCLOPENTOLATE 1% DROP                            0.00        0.00     7710     Pharmacy
     05009501-7710   CYCLOPHOSPHAMID 50MG TAB                          0.00        0.00     7710     Pharmacy
     05009250-7710   COLBENEMID TAB                                    0.00        0.00     7710     Pharmacy
     05007849-7710   CLOTRIMAZOLE 1% VAG CRM AP                        0.00        0.00     7710     Pharmacy
     05012104-7710   CYCLOSPORINE 100MG PO                             0.00        0.00     7710     Pharmacy
     05000499-7710   CLONIDINE 0.1MG TAB                               0.00        0.00     7710     Pharmacy
     05000500-7710   CLONIDINE 0.2MG PTCH                              0.00        0.00     7710     Pharmacy
     05000501-7710   CLONIDINE 0.2MG TAB                               0.00        0.00     7710     Pharmacy
     05000502-7710   CLONIDINE 0.3MG PTCH                              0.00        0.00     7710     Pharmacy
     05000503-7710   CLONIDINE 0.3MG TAB                               0.00        0.00     7710     Pharmacy
     05016393-7710   CLOPIDOGREL 75MG TAB                              0.00        0.00     7710     Pharmacy
     05001338-7710   PROMETH/COD SYRP                                  0.00        0.00     7710     Pharmacy
     05008275-7710   CLOTRIMAZOLE 1% CRM                               0.00        0.00     7710     Pharmacy
     05005466-7710   CLONAZEPAM 2MG TAB                                0.00        0.00     7710     Pharmacy
     05008276-7710   CLOTRIMAZOLE 1% LOT                               0.00        0.00     7710     Pharmacy
     05010288-7710   CLOTRIMAZOLE 10MG TROC                            0.00        0.00     7710     Pharmacy
     05008278-7710   CLOTRI/BETAMETH CRM                               0.00        0.00     7710     Pharmacy
     05004886-7710   CLOZAPINE 100MG TAB                               0.00        0.00     7710     Pharmacy
     05008415-7710   COCAINE HCL 10% SOL                               0.00        0.00     7710     Pharmacy
     05006403-7710   DESITIN OIN GM                                    0.00        0.00     7710     Pharmacy
     05005083-7710   APAP/COD 15/300 TAB                               0.00        0.00     7710     Pharmacy
     05004653-7710   CLORAZEPATE 7.5MG TAB                             0.00        0.00     7710     Pharmacy
     05012096-7710   FAMOTIDINE 10MG/ML VIAL                           0.00        0.00     7710     Pharmacy
     05009145-7710   ETHACRYNIC ACID 50MG VIAL                         0.00        0.00     7710     Pharmacy
     05010187-7710   ETHAMBUTOL HCL 400MG TAB                          0.00        0.00     7710     Pharmacy
     05008314-7710   ETHYL CL LOC ANESTH SPRAY                         0.00        0.00     7710     Pharmacy
     05004296-7710   DEMULEN 1/50                                      0.00        0.00     7710     Pharmacy
     05004295-7710   DEMULEN 1/35                                      0.00        0.00     7710     Pharmacy
     05015611-7710   ETODOLAC 500MG XL TAB                             0.00        0.00     7710     Pharmacy
     05012394-7710   FENTANYL 100MCG/HR PATC                           0.00        0.00     7710     Pharmacy
     05014612-7710   FAMOTIDINE 10MG TAB                               0.00        0.00     7710     Pharmacy
     05004197-7710   PREMARIN 0.9MG                                    0.00        0.00     7710     Pharmacy
     05012097-7710   FAMOTIDINE 20MG TAB                               0.00        0.00     7710     Pharmacy
     05012098-7710   FAMOTIDINE 40MG TAB                               0.00        0.00     7710     Pharmacy
     05007206-7710   LIPID EMULSION 20% IVSL                           0.00        0.00     7710     Pharmacy
     05002458-7710   IRON COMPLEX 150MG CAP                            0.00        0.00     7710     Pharmacy
     05012604-7710   FELODIPINE 10MG TAB                               0.00        0.00     7710     Pharmacy
     05012603-7710   FELODIPINE 5MG TAB                                0.00        0.00     7710     Pharmacy



8/31/2010                                                                                                                     82
                                                   c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                              CURRENT CURRENT        DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                  INPATIENT OUTPATIENT CODE
                                                                  PRICE      PRICE
     05016449-7710   ENOXAPARIN 60MG/0.6ML DIS                          0.00        0.00     7710     Pharmacy
     05004528-7710   ETOMIDATE 2MG/ML DIS SYR                           0.00        0.00     7710     Pharmacy
     05004178-7710   ESTRADIOL 2MG TAB                                  0.00        0.00     7710     Pharmacy
     05005933-7710   ESMOLOL HCL 10MG/ML VIAL                           0.00        0.00     7710     Pharmacy
     05005934-7710   ESMOLOL HCL 250MG/ML AMP                           0.00        0.00     7710     Pharmacy
     05014668-7710   ESTRADIOL .05MG/24HR PTCH                          0.00        0.00     7710     Pharmacy
     05014667-7710   ESTRADIOL .1MG/24HR PTCH                           0.00        0.00     7710     Pharmacy
     05007860-7710   ESTRADIOL 0.01% CRM AP                             0.00        0.00     7710     Pharmacy
     05004175-7710   ESTRADIOL 0.05MG/24H PTCH                          0.00        0.00     7710     Pharmacy
     05004176-7710   ESTRADIOL 0.1MG/24HR PTCH                          0.00        0.00     7710     Pharmacy
     05004200-7710   PREMARIN 25MG VIAL                                 0.00        0.00     7710     Pharmacy
     05004177-7710   ESTRADIOL 1MG TAB                                  0.00        0.00     7710     Pharmacy
     05004198-7710   PREMARIN 1.25MG                                    0.00        0.00     7710     Pharmacy
     05004191-7710   ESTRADIOL VAL 20MG/ML VIAL                         0.00        0.00     7710     Pharmacy
     05007862-7710   PREMARIN VAG CRM                                   0.00        0.00     7710     Pharmacy
     05014076-7710   PREMPRO 0.625-2.5                                  0.00        0.00     7710     Pharmacy
     05004219-7710   PREMARIN 0.625MG                                   0.00        0.00     7710     Pharmacy
     05004195-7710   PREMARIN 0.3MG                                     0.00        0.00     7710     Pharmacy
     05004196-7710   PREMARIN 0.625MG                                   0.00        0.00     7710     Pharmacy
     05012391-7710   FENTANYL 25MCG/HR PATC                             0.00        0.00     7710     Pharmacy
     05013488-7710   ESTRADIOL 0.5MG TAB                                0.00        0.00     7710     Pharmacy
     05007663-7710   FLUORESCEIN NA 9MG STRP                            0.00        0.00     7710     Pharmacy
     05009043-7710   FLUNISOLIDE 0.025% SPR NSL                         0.00        0.00     7710     Pharmacy
     05000340-7710   FLUNISOLIDE 250MCG AER AD                          0.00        0.00     7710     Pharmacy
     05008545-7710   FLUOCINOLONE 0.01% OIL                             0.00        0.00     7710     Pharmacy
     05008546-7710   FLUOCINOLONE 0.01% SOL                             0.00        0.00     7710     Pharmacy
     05008548-7710   FLUOCINOLONE 0.025% OIN                            0.00        0.00     7710     Pharmacy
     05008552-7710   FLUOCINONIDE 0.05% CRM                             0.00        0.00     7710     Pharmacy
     05005171-7710   FENTANYL 0.05MG/ML, 2ML AMP                        0.00        0.00     7710     Pharmacy
     05008556-7710   FLUOCINONIDE 0.05% CRM                             0.00        0.00     7710     Pharmacy
     05010298-7710   FLUCONAZOL 400MG/200ML NS                          0.00        0.00     7710     Pharmacy
     05008859-7710   FLUROMETHOLONE .1% DRP SU                          0.00        0.00     7710     Pharmacy
     05004839-7710   FLUOXETINE 20MG CAP                                0.00        0.00     7710     Pharmacy
     05012463-7710   FLUOXETINE 20MG/5ML SOL                            0.00        0.00     7710     Pharmacy
     05004724-7710   FLUPHENAZINE 10MG TAB                              0.00        0.00     7710     Pharmacy
     05004578-7710   FLURAZEPAM HCL 15MG CAP                            0.00        0.00     7710     Pharmacy
     05001221-7710   PSEUDOEPHEDRINE 60MG TAB                           0.00        0.00     7710     Pharmacy
     05008863-7710   FLURBIPROFEN 0.03% DROP                            0.00        0.00     7710     Pharmacy



8/31/2010                                                                                                                      83
                                                 c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                            CURRENT CURRENT        DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                INPATIENT OUTPATIENT CODE
                                                                PRICE      PRICE
     05008554-7710   FLUOCINONIDE 0.05% OIN GM                        0.00        0.00     7710     Pharmacy
     05000392-7710   FLECAINIDE 100MG TAB                             0.00        0.00     7710     Pharmacy
     05012392-7710   FENTANYL 50MCG/HR PATC                           0.00        0.00     7710     Pharmacy
     05012393-7710   FENTANYL 75MCG/HR PATC                           0.00        0.00     7710     Pharmacy
     05002365-7710   FE GLUCONATE 325MG TAB                           0.00        0.00     7710     Pharmacy
     05002467-7710   FE SO4 160MG SA TAB                              0.00        0.00     7710     Pharmacy
     05002471-7710   FE SO4 220MG/5ML ELIX                            0.00        0.00     7710     Pharmacy
     05002474-7710   FE SO4 300MG TAB                                 0.00        0.00     7710     Pharmacy
     05002475-7710   FE SO4 300MG/5ML LIQ                             0.00        0.00     7710     Pharmacy
     05012743-7710   FLUMAZENIL 0.1MG/ML VIAL                         0.00        0.00     7710     Pharmacy
     05012970-7710   FINASTERIDE 5MG TAB                              0.00        0.00     7710     Pharmacy
     05007643-7710   FLUDROCORTISONE 0.1MG TAB                        0.00        0.00     7710     Pharmacy
     05010294-7710   FLUCONAZOLE 100MG TAB                            0.00        0.00     7710     Pharmacy
     05013770-7710   FLUCONAZOLE 150MG TAB                            0.00        0.00     7710     Pharmacy
     05010295-7710   FLUCONAZOLE 200MG TAB                            0.00        0.00     7710     Pharmacy
     05013948-7710   FLUCONAZOLE 40MG/ML SUSP                         0.00        0.00     7710     Pharmacy
     05010296-7710   FLUCONAZOLE 50MG TAB                             0.00        0.00     7710     Pharmacy
     05010297-7710   FLUCONAZOL 200MG/100ML NS                        0.00        0.00     7710     Pharmacy
     05015861-7710   ERYTHROMYCIN BASE/ETH 2% SOL                     0.00        0.00     7710     Pharmacy
     05002481-7710   FE SO4 75MG/0.6ML DROP                           0.00        0.00     7710     Pharmacy
     05009969-7710   DOXYCYCLINE HY 100MG CAP                         0.00        0.00     7710     Pharmacy
     05012335-7710   DOXAZOSIN MESYL 2MG TAB                          0.00        0.00     7710     Pharmacy
     05012336-7710   DOXAZOSIN MESYL 4MG TAB                          0.00        0.00     7710     Pharmacy
     05012337-7710   DOXAZOSIN MESYL 8MG TAB                          0.00        0.00     7710     Pharmacy
     05004822-7710   DOXEPIN 100MG CAP                                0.00        0.00     7710     Pharmacy
     05004823-7710   DOXEPIN 10MG CAP                                 0.00        0.00     7710     Pharmacy
     05004826-7710   DOXEPIN 25MG CAP                                 0.00        0.00     7710     Pharmacy
     05010018-7710   ERYTHROMYCIN ST 250MG TAB                        0.00        0.00     7710     Pharmacy
     05004828-7710   DOXEPIN 75MG CAP                                 0.00        0.00     7710     Pharmacy
     05005831-7710   DOPAMINE 400MG/D5W 250ML                         0.00        0.00     7710     Pharmacy
     05009970-7710   DOXYCYCLINE HY 100MG TAB                         0.00        0.00     7710     Pharmacy
     05009971-7710   DOXYCYCLINE HY 100MG VIAL                        0.00        0.00     7710     Pharmacy
     05009973-7710   DOXYCYCLINE HY 50MG CAP                          0.00        0.00     7710     Pharmacy
     05016214-7710   DP-HYDRAM HCL/ZINC ACET 1-0.1% CRM               0.00        0.00     7710     Pharmacy
     05005614-7710   DRONABINOL 5MG CAP                               0.00        0.00     7710     Pharmacy
     05004856-7710   DROPERIDOL 2.5MG/ML AMP                          0.00        0.00     7710     Pharmacy
     05008286-7710   ECONAZOLE NIT 1% CRM                             0.00        0.00     7710     Pharmacy
     05004827-7710   DOXEPIN 50MG CAP                                 0.00        0.00     7710     Pharmacy



8/31/2010                                                                                                                    84
                                                c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                           CURRENT CURRENT        DEPARTMENT   DEPARTMENT DESCRIPTION
                                                               INPATIENT OUTPATIENT CODE
                                                               PRICE      PRICE
     05003944-7710   DOCUSATE CA 240MG CAP                           0.00        0.00     7710     Pharmacy
     05000765-7710   DIPYRIDAMOLE 75MG TAB                           0.00        0.00     7710     Pharmacy
     05000368-7710   DISOPYRAMIDE 100MG CAP                          0.00        0.00     7710     Pharmacy
     05001782-7710   DISULFIRAM 250MG TAB                            0.00        0.00     7710     Pharmacy
     05005442-7710   DIVALPROEX 125MG CAP SPR                        0.00        0.00     7710     Pharmacy
     05005443-7710   DIVALPROEX 125MG TAB EC                         0.00        0.00     7710     Pharmacy
     05005444-7710   DIVALPROEX 250MG TAB EC                         0.00        0.00     7710     Pharmacy
     05005445-7710   DIVALPROEX 500MG TAB EC                         0.00        0.00     7710     Pharmacy
     05012334-7710   DOXAZOSIN MESYL 1MG TAB                         0.00        0.00     7710     Pharmacy
     05015476-7710   DOCETAXEL 40MG/ML VIAL                          0.00        0.00     7710     Pharmacy
     05014701-7710   DORZOLAMIDE HCL 2% DROP                         0.00        0.00     7710     Pharmacy
     05002421-7710   DOCUSATE NA 100MG CAP                           0.00        0.00     7710     Pharmacy
     05002424-7710   DOCUSATE NA 150MG/15ML LQ                       0.00        0.00     7710     Pharmacy
     05002426-7710   DOCUSATE NA 250MG CAP                           0.00        0.00     7710     Pharmacy
     05002431-7710   DOCUSATE NA 50MG/15ML SYP                       0.00        0.00     7710     Pharmacy
     05015865-7710   DONEPEZIL HCL 5MG TAB                           0.00        0.00     7710     Pharmacy
     05005826-7710   DOPAMINE 80MG/ML VIAL                           0.00        0.00     7710     Pharmacy
     05002202-7710   PEDIALYTE                                       0.00        0.00     7710     Pharmacy
     05013539-7710   DOBUTAMINE 250/D5W250                           0.00        0.00     7710     Pharmacy
     05010002-7710   ERYTHROMYCIN ES 200MG/5ML SUSP                  0.00        0.00     7710     Pharmacy
     05003333-7710   EDTA 150MG/ML AMP                               0.00        0.00     7710     Pharmacy
     05007395-7710   EPOETIN ALFA 10MU/ML VIAL                       0.00        0.00     7710     Pharmacy
     05015791-7710   EPOETIN ALFA 20MU/ML VIAL                       0.00        0.00     7710     Pharmacy
     05007396-7710   EPOETIN ALFA 2MU/ML VIAL                        0.00        0.00     7710     Pharmacy
     05007397-7710   EPOETIN ALFA 3MU/ML VIAL                        0.00        0.00     7710     Pharmacy
     05007398-7710   EPOETIN ALFA 4MU/ML VIAL                        0.00        0.00     7710     Pharmacy
     05001956-7710   ERGOCALCIFEROL 50MU CAP                         0.00        0.00     7710     Pharmacy
     05004338-7710   EPINEPHRINE 1MG/ML VIAL                         0.00        0.00     7710     Pharmacy
     05005408-7710   CAFERGOT 1-100MG TAB                            0.00        0.00     7710     Pharmacy
     05004336-7710   EPINEPHRINE 1MG/ML AMP                          0.00        0.00     7710     Pharmacy
     05009985-7710   ERYTHROMYCIN 250MG TAB                          0.00        0.00     7710     Pharmacy
     05009984-7710   ERYTHROMYCIN 250MG TAB EC                       0.00        0.00     7710     Pharmacy
     05009990-7710   ERYTHROMYCIN 500MG TAB                          0.00        0.00     7710     Pharmacy
     05009989-7710   ERYTHROMYCIN 500MG TAB EC                       0.00        0.00     7710     Pharmacy
     05008906-7710   ERYTHROMYCIN 5MG/GM OP                          0.00        0.00     7710     Pharmacy
     05008625-7710   BENZAMYCIN PER GEL                              0.00        0.00     7710     Pharmacy
     05015020-7710   DIPYRIDAMOLE/10MG IJ                            0.00        0.00     7710     Pharmacy
     05001958-7710   ERGOCALCIFEROL 8MU/ML DRP                       0.00        0.00     7710     Pharmacy



8/31/2010                                                                                                                   85
                                                 c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                            CURRENT CURRENT        DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                INPATIENT OUTPATIENT CODE
                                                                PRICE      PRICE
     05013184-7710   ENOXAPARIN 30MG/0.3ML DIS                        0.00        0.00     7710     Pharmacy
     05010017-7710   ERYTHROMYCIN LA 500MG VL                         0.00        0.00     7710     Pharmacy
     05002230-7710   PLASMA-LYTE 148/D5W1000                          0.00        0.00     7710     Pharmacy
     05002218-7710   ELECTROLYTE-A 1000ML                             0.00        0.00     7710     Pharmacy
     05000567-7710   ENALAPRIL MAL 10MG TAB                           0.00        0.00     7710     Pharmacy
     05000568-7710   ENALAPRIL MAL 2.5MG TAB                          0.00        0.00     7710     Pharmacy
     05000569-7710   ENALAPRIL MAL 20MG TAB                           0.00        0.00     7710     Pharmacy
     05000570-7710   ENALAPRIL MAL 5MG TAB                            0.00        0.00     7710     Pharmacy
     05000297-7710   RACEPINEPHRINE 2.25PC SOL                        0.00        0.00     7710     Pharmacy
     05016451-7710   ENOXAPARIN 100MG/ML DI SY                        0.00        0.00     7710     Pharmacy
     05005658-7710   EDROPHONIUM 10MG/ML VIAL                         0.00        0.00     7710     Pharmacy
     05016577-7710   ENOXAPARIN 40MG/0.4ML DIS                        0.00        0.00     7710     Pharmacy
     05004686-7710   CHLORPROMAZINE 10MG TAB                          0.00        0.00     7710     Pharmacy
     05016450-7710   ENOXAPARIN 80MG/0.8ML DIS                        0.00        0.00     7710     Pharmacy
     05008764-7710   CARBACHOL 3% DROP                                0.00        0.00     7710     Pharmacy
     05004334-7710   EPINEPHRINE 0.1MG/ML SYDI                        0.00        0.00     7710     Pharmacy
     05012960-7710   EPINEPHRINE 0.3MG SYR DIS                        0.00        0.00     7710     Pharmacy
     05008986-7710   EPINEPHRINE 1:1000 SOL                           0.00        0.00     7710     Pharmacy
     05000566-7710   ENALAPRILAT 1.25MG/ML VI                         0.00        0.00     7710     Pharmacy
     05009658-7710   AMPICILLIN NA 125MG VIAL                         0.00        0.00     7710     Pharmacy
     05009735-7710   AUGMENTIN 250MG TAB                              0.00        0.00     7710     Pharmacy
     05009736-7710   AUGMENTIN 250MG/5ML                              0.00        0.00     7710     Pharmacy
     05009737-7710   AUGMENTIN 500MG TAB                              0.00        0.00     7710     Pharmacy
     05009726-7710   AMOXICILLIN 125MG/5ML SUS                        0.00        0.00     7710     Pharmacy
     05009727-7710   AMOXICILLIN 250MG CAP                            0.00        0.00     7710     Pharmacy
     05009729-7710   AMOXICILLIN 250MG/5ML SUS                        0.00        0.00     7710     Pharmacy
     05009674-7710   AMPICILLIN/SULB 3GM VIAL                         0.00        0.00     7710     Pharmacy
     05009945-7710   AMPHO B LIPOSOME 50MG IJ                         0.00        0.00     7710     Pharmacy
     05003651-7710   LACHYDRIN 12% LOT                                0.00        0.00     7710     Pharmacy
     05009661-7710   AMPICILLIN NA 1GM VIAL                           0.00        0.00     7710     Pharmacy
     05009663-7710   AMPICILLIN NA 250MG VIAL                         0.00        0.00     7710     Pharmacy
     05009666-7710   AMPICILLIN NA 2GM VIAL                           0.00        0.00     7710     Pharmacy
     05009670-7710   AMPICILLIN NA 500MG VIAL                         0.00        0.00     7710     Pharmacy
     05009677-7710   AMPICILLIN 250MG CAP                             0.00        0.00     7710     Pharmacy
     05009679-7710   AMPICILLIN 500MG CAP                             0.00        0.00     7710     Pharmacy
     05005463-7710   CARBAMAZEPINE 200MG TAB                          0.00        0.00     7710     Pharmacy
     05009730-7710   AMOXICILLIN 500MG CAP                            0.00        0.00     7710     Pharmacy
     05004796-7710   AMITRIPTYLINE 25MG TAB                           0.00        0.00     7710     Pharmacy



8/31/2010                                                                                                                    86
                                                  c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                             CURRENT CURRENT        DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                 INPATIENT OUTPATIENT CODE
                                                                 PRICE      PRICE
     05002651-7710   AMINO ACIDS 10% 1000ML                            0.00        0.00     7710     Pharmacy
     05007318-7710   AMINOCAPROIC AC250MG/MLVL                         0.00        0.00     7710     Pharmacy
     05000171-7710   AMINOPHYLLINE250MG/10MLVL                         0.00        0.00     7710     Pharmacy
     05000177-7710   AMINOPHYLLINE500MG/20MLVL                         0.00        0.00     7710     Pharmacy
     05000395-7710   AMIODARONE 200MG TAB                              0.00        0.00     7710     Pharmacy
     05014589-7710   AMIODARONE 50MG/ML AMP                            0.00        0.00     7710     Pharmacy
     05004792-7710   AMITRIPTYLINE 100MG TAB                           0.00        0.00     7710     Pharmacy
     05015342-7710   AUGMENTIN 875-125MG TA                            0.00        0.00     7710     Pharmacy
     05004795-7710   AMITRIPTYLINE 150MG TAB                           0.00        0.00     7710     Pharmacy
     05015480-7710   AUGMENTIN 400-57MG/5                              0.00        0.00     7710     Pharmacy
     05004797-7710   AMITRIPTYLINE 50MG TAB                            0.00        0.00     7710     Pharmacy
     05004798-7710   AMITRIPTYLINE 75MG TAB                            0.00        0.00     7710     Pharmacy
     05013004-7710   AMLODIPINE BES 10MG TAB                           0.00        0.00     7710     Pharmacy
     05013002-7710   AMLODIPINE BES 2.5MG TAB                          0.00        0.00     7710     Pharmacy
     05013003-7710   AMLODIPINE 5MG TAB                                0.00        0.00     7710     Pharmacy
     05004499-7710   AMMONIA AMP                                       0.00        0.00     7710     Pharmacy
     05000258-7710   AMRINONE LACT 5MG/ML AMP                          0.00        0.00     7710     Pharmacy
     05004793-7710   AMITRIPTYLINE 10MG TAB                            0.00        0.00     7710     Pharmacy
     05016077-7710   ATORVASTATIN CA 40MG TAB                          0.00        0.00     7710     Pharmacy
     05013044-7710   ASA 81MG TAB EC                                   0.00        0.00     7710     Pharmacy
     05005288-7710   ASA/APAP/CAFF TAB                                 0.00        0.00     7710     Pharmacy
     05005251-7710   ALKA SELTZER 324MG TAB                            0.00        0.00     7710     Pharmacy
     05000638-7710   ATENOLOL 100MG TAB                                0.00        0.00     7710     Pharmacy
     05012375-7710   ATENOLOL 25MG TAB                                 0.00        0.00     7710     Pharmacy
     05000639-7710   ATENOLOL 50MG TAB                                 0.00        0.00     7710     Pharmacy
     05009672-7710   AMPICILLIN/SULB 1.5GM VIAL                        0.00        0.00     7710     Pharmacy
     05015896-7710   ATORVASTATIN CA 20MG TAB                          0.00        0.00     7710     Pharmacy
     05001067-7710   ASA 325MG TAB EC                                  0.00        0.00     7710     Pharmacy
     05003744-7710   ATROPINE 0.1MG/MLSYDI                             0.00        0.00     7710     Pharmacy
     05003752-7710   ATROPINE 0.4MG/ML VL                              0.00        0.00     7710     Pharmacy
     05003761-7710   ATROPINE 1MG/ML VIAL                              0.00        0.00     7710     Pharmacy
     05008824-7710   ATROPINE 1PC DROP                                 0.00        0.00     7710     Pharmacy
     05008825-7710   ATROPINE 1PC OIN                                  0.00        0.00     7710     Pharmacy
     05012103-7710   AZATHIOPRINE 50MG TAB                             0.00        0.00     7710     Pharmacy
     05015185-7710   AZELAIC ACID 20% CRM                              0.00        0.00     7710     Pharmacy
     05015895-7710   ATORVASTATIN CA 10MG TAB                          0.00        0.00     7710     Pharmacy
     05005252-7710   FIORINAL                                          0.00        0.00     7710     Pharmacy
     05014849-7710   PANCREASE 20-4.5-25 CAP EC                        0.00        0.00     7710     Pharmacy



8/31/2010                                                                                                                     87
                                                   c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                              CURRENT CURRENT        DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                  INPATIENT OUTPATIENT CODE
                                                                  PRICE      PRICE
     05003693-7710   PANCREASE 48-16-48 CAP                             0.00        0.00     7710     Pharmacy
     05015301-7710   ANASTROZOLE 1MG TAB                                0.00        0.00     7710     Pharmacy
     05009076-7710   AURALGAN (LOCANESTH)DRO                            0.00        0.00     7710     Pharmacy
     05005379-7710   FIORICET                                           0.00        0.00     7710     Pharmacy
     05004587-7710   APAP/DIPHEN 500-25MG TAB                           0.00        0.00     7710     Pharmacy
     05013371-7710   APRACLONIDINE 0.5% DROP                            0.00        0.00     7710     Pharmacy
     05001083-7710   ASA 81MG TAB CH                                    0.00        0.00     7710     Pharmacy
     05013568-7710   APROTININ 10MU/ML VIAL                             0.00        0.00     7710     Pharmacy
     05001074-7710   ASA 600MG SUPP                                     0.00        0.00     7710     Pharmacy
     05005262-7710   ASA BUFFERED 325MG TAB                             0.00        0.00     7710     Pharmacy
     05001358-7710   ASCORBIC ACID 100MG/MLDRP                          0.00        0.00     7710     Pharmacy
     05001381-7710   ASCORBIC ACID 500MG TAB                            0.00        0.00     7710     Pharmacy
     05012875-7710   ASA 162MG TAB EC                                   0.00        0.00     7710     Pharmacy
     05001066-7710   ASA 325MG SUPP                                     0.00        0.00     7710     Pharmacy
     05001068-7710   ASA 325MG TAB                                      0.00        0.00     7710     Pharmacy
     05005468-7710   AMANTADINE 100MG CAP                               0.00        0.00     7710     Pharmacy
     05008759-7710   APRACLONIDINE 1% DRPETTE                           0.00        0.00     7710     Pharmacy
     05014602-7710   ACARBOSE 50MG TAB                                  0.00        0.00     7710     Pharmacy
     05006504-7710   ALTEPLASE 100MG IJ                                 0.00        0.00     7710     Pharmacy
     05009574-7710   ETOPOSIDE 20MG/ML IJ                               0.00        0.00     7710     Pharmacy
     05003981-7710   FLUOROURACIL 50MG/1ML                              0.00        0.00     7710     Pharmacy
     05008848-7710   MESNA 1GM/10ML VIAL                                0.00        0.00     7710     Pharmacy
     05007680-7710   INTERFERON A-2B 18MMU                              0.00        0.00     7710     Pharmacy
     05005169-7710   VINBLASTINE 1MG/1ML VIAL                           0.00        0.00     7710     Pharmacy
     05009138-7710   AMILORIDE HCL 5MG TAB                              0.00        0.00     7710     Pharmacy
     05008460-7710   HYDROCORT 1% CREAM                                 0.00        0.00     7710     Pharmacy
     05008325-7710   IBUTILIDE FUMAR 1 MG IJ                            0.00        0.00     7710     Pharmacy
     05005929-7710   ACEBUTOLOL HCL 200MG CAP                           0.00        0.00     7710     Pharmacy
     05000919-7710   APAP                                               0.00        0.00     7710     Pharmacy
     05000920-7710   APAP 120MG SUPP                                    0.00        0.00     7710     Pharmacy
     05000925-7710   APAP 130MG/5ML ELIX                                0.00        0.00     7710     Pharmacy
     05000929-7710   APAP 160MG/5ML ELIX                                0.00        0.00     7710     Pharmacy
     05000933-7710   APAP 325MG SUPP                                    0.00        0.00     7710     Pharmacy
     05000934-7710   APAP 325MG TAB                                     0.00        0.00     7710     Pharmacy
     05005170-7710   VINBLASTINE 2MG/2ML VIAL                           0.00        0.00     7710     Pharmacy
     05009496-7710   CYCLOPHOSPHAMIDE 1 GM IJ B                         0.00        0.00     7710     Pharmacy
     05008347-7710   BOTULINUM TOX A/U 100U VIAL                        0.00        0.00     7710     Pharmacy
     05009040-7710   LEUPROLIDE 11.25MG                                 0.00        0.00     7710     Pharmacy



8/31/2010                                                                                                                      88
                                                c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                           CURRENT CURRENT        DEPARTMENT   DEPARTMENT DESCRIPTION
                                                               INPATIENT OUTPATIENT CODE
                                                               PRICE      PRICE
     05004004-7710   BLEOMYCIN 15U IJ                                0.00        0.00     7710     Pharmacy
     05003974-7710   CARBOPLATIN 450MG VIAL                          0.00        0.00     7710     Pharmacy
     05003973-7710   CARBOPLATIN 150MG VIAL                          0.00        0.00     7710     Pharmacy
     05001208-7710   LEUCOVORIN CA 50MG VIAL                         0.00        0.00     7710     Pharmacy
     05003980-7710   METHOTREXATE NA 25MG/ML VL 4ML                  0.00        0.00     7710     Pharmacy
     05005182-7710   ALTEPLASE 50MG VIAL                             0.00        0.00     7710     Pharmacy
     05003979-7710   METHOTREXATE NA 25MG/ML VL 2ML                  0.00        0.00     7710     Pharmacy
     05008345-7710   MILRINONE 20MG/100ML                            0.00        0.00     7710     Pharmacy
     05008688-7710   DOBUTAMINE 250MG IV                             0.00        0.00     7710     Pharmacy
     05008040-7710   MITOMYCIN 5MG IJ                                0.00        0.00     7710     Pharmacy
     05009553-7710   MITOMYCIN 20MG IJ B                             0.00        0.00     7710     Pharmacy
     05005484-7710   FILGRASTIM 300MCG/1ML VIAL                      0.00        0.00     7710     Pharmacy
     05005485-7710   FILGRASTIM 480MCG/1.6ML VIAL                    0.00        0.00     7710     Pharmacy
     05009125-7710   ACETAZOLAMIDE 125MG TAB                         0.00        0.00     7710     Pharmacy
     05004905-7710   LEUCOVORIN CA 100MG VIAL                        0.00        0.00     7710     Pharmacy
     05003315-7710   ALLOPURINOL 100MG TAB                           0.00        0.00     7710     Pharmacy
     05000938-7710   APAP 500MG TAB                                  0.00        0.00     7710     Pharmacy
     05005882-7710   ALBUTEROL 2MG/5ML SYRP                          0.00        0.00     7710     Pharmacy
     05005877-7710   ALBUTEROL 5MG/ML SOL                            0.00        0.00     7710     Pharmacy
     05005879-7710   ALBUTEROL 90MCG AERO                            0.00        0.00     7710     Pharmacy
     05015722-7710   ALBUTEROL SO4 108MCGAEADP                       0.00        0.00     7710     Pharmacy
     05008576-7710   ALCLOMETASONE .05% OIN GM                       0.00        0.00     7710     Pharmacy
     05015065-7710   ALENDRONATE NA 10MG TAB                         0.00        0.00     7710     Pharmacy
     05007157-7710   ALBUMIN 5%/50ML IV                              0.00        0.00     7710     Pharmacy
     05005177-7710   ALFENTANIL 500MCG/ML AMP                        0.00        0.00     7710     Pharmacy
     05007156-7710   ALBUMIN 25%/50ML                                0.00        0.00     7710     Pharmacy
     05003316-7710   ALLOPURINOL 300MG TAB                           0.00        0.00     7710     Pharmacy
     05004676-7710   ALPRAZOLAM 0.25MG TAB                           0.00        0.00     7710     Pharmacy
     05004677-7710   ALPRAZOLAM 0.5MG TAB                            0.00        0.00     7710     Pharmacy
     05004678-7710   ALPRAZOLAM 1MG TAB                              0.00        0.00     7710     Pharmacy
     05002505-7710   ALOH 320MG/5ML SUSP                             0.00        0.00     7710     Pharmacy
     05013116-7710   ALOH 675MG/5ML SUSP                             0.00        0.00     7710     Pharmacy
     05014597-7710   AZITHROMYCIN 200MG/5ML SU                       0.00        0.00     7710     Pharmacy
     05016017-7710   ALENDRONATE NA 5MG TAB                          0.00        0.00     7710     Pharmacy
     05010363-7710   ACYCLOVIR 200MG CAP                             0.00        0.00     7710     Pharmacy
     05010074-7710   AMIKACIN 250MG/ML VIAL                          0.00        0.00     7710     Pharmacy
     05009126-7710   ACETAZOLAMIDE 250MG TAB                         0.00        0.00     7710     Pharmacy
     05009127-7710   ACETAZOLAMIDE 500MG CP SA                       0.00        0.00     7710     Pharmacy



8/31/2010                                                                                                                   89
                                                 c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                            CURRENT CURRENT        DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                INPATIENT OUTPATIENT CODE
                                                                PRICE      PRICE
     05010541-7710   ACETIC ACID 0.25% SOLI                           0.00        0.00     7710     Pharmacy
     05008796-7710   ACETYLCHOLINE CL 1% KIT                          0.00        0.00     7710     Pharmacy
     05000843-7710   ACETYLCYSTEINE 100MG/ML VIA-NEB                  0.00        0.00     7710     Pharmacy
     05000844-7710   ACETYLCYSTEINE 200MG/ML VIA-NEB                  0.00        0.00     7710     Pharmacy
     05005876-7710   ALBUTEROL 0.83MG/MLSL                            0.00        0.00     7710     Pharmacy
     05003353-7710   CHARCOAL 25G LIQ                                 0.00        0.00     7710     Pharmacy
     05000940-7710   APAP 650MG SUPP                                  0.00        0.00     7710     Pharmacy
     05010364-7710   ACYCLOVIR 200MG/5ML SUSP                         0.00        0.00     7710     Pharmacy
     05013219-7710   ACYCLOVIR 400MG TAB                              0.00        0.00     7710     Pharmacy
     05008610-7710   ACYCLOVIR 5% OIN GM                              0.00        0.00     7710     Pharmacy
     05012476-7710   ACYCLOVIR 800MG TAB                              0.00        0.00     7710     Pharmacy
     05010366-7710   ACYCLOVIR NA 500MG VIAL                          0.00        0.00     7710     Pharmacy
     05015512-7710   ADAPALENE 0.1% GEL                               0.00        0.00     7710     Pharmacy
     05015825-7710   COMBIVENT 103-18MCGAE                            0.00        0.00     7710     Pharmacy
     05003804-7710   LACTOBACILLUS                                    0.00        0.00     7710     Pharmacy
     05015447-7710   CARBAMAZEPINE 400MG TAB                          0.00        0.00     7710     Pharmacy
     05000559-7710   CAPTOPRIL 12.5MG TAB                             0.00        0.00     7710     Pharmacy
     05000560-7710   CAPTOPRIL 25MG TAB                               0.00        0.00     7710     Pharmacy
     05000561-7710   CAPTOPRIL 50MG TAB                               0.00        0.00     7710     Pharmacy
     05008765-7710   CARBACHOL 0.01% VIAL                             0.00        0.00     7710     Pharmacy
     05004579-7710   FLURAZEPAM HCL 30MG CAP                          0.00        0.00     7710     Pharmacy
     05015777-7710   CARBAMAZEPINE XR 200MG TAB                       0.00        0.00     7710     Pharmacy
     05006323-7710   CALAMINE LOT                                     0.00        0.00     7710     Pharmacy
     05005461-7710   CARBAMAZEPINE 100MG TB CH                        0.00        0.00     7710     Pharmacy
     05003839-7710   SENNA 8.8MG/5ML                                  0.00        0.00     7710     Pharmacy
     05009083-7710   CARBAMIDE PEROX 6.5% DROP                        0.00        0.00     7710     Pharmacy
     05013444-7710   SINEMET 25/100 TAB                               0.00        0.00     7710     Pharmacy
     05012534-7710   SINEMET 50/200 TAB                               0.00        0.00     7710     Pharmacy
     05003325-7710   SINEMET 10/100 TAB                               0.00        0.00     7710     Pharmacy
     05003326-7710   SINEMET 25/100 TAB                               0.00        0.00     7710     Pharmacy
     05003327-7710   SINEMET 25/250 TAB                               0.00        0.00     7710     Pharmacy
     05004272-7710   CARBOPROST 250MCG/ML                             0.00        0.00     7710     Pharmacy
     05015460-7710   FLUTICASONE 110MCG AER AD                        0.00        0.00     7710     Pharmacy
     05003529-7710   CA CARB 500MG/5ML SUSP                           0.00        0.00     7710     Pharmacy
     05015875-7710   AZELASTINE 137MCG SPR PMP                        0.00        0.00     7710     Pharmacy
     05007511-7710   CALCITONIN                                       0.00        0.00     7710     Pharmacy
     05015095-7710   CALCITONIN                                       0.00        0.00     7710     Pharmacy
     05003080-7710   CALCITRIOL 0.25MCG CAP                           0.00        0.00     7710     Pharmacy



8/31/2010                                                                                                                    90
                                                c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                           CURRENT CURRENT        DEPARTMENT   DEPARTMENT DESCRIPTION
                                                               INPATIENT OUTPATIENT CODE
                                                               PRICE      PRICE
     05003081-7710   CALCITRIOL 0.5MCG CAP                           0.00        0.00     7710     Pharmacy
     05003082-7710   CALCITRIOL 1MCG/ML AMP                          0.00        0.00     7710     Pharmacy
     05007903-7710   CA ACET/AL SO4 PACK                             0.00        0.00     7710     Pharmacy
     05000558-7710   CAPTOPRIL 100MG TAB                             0.00        0.00     7710     Pharmacy
     05003528-7710   CA CARB 500MG CH TAB                            0.00        0.00     7710     Pharmacy
     05007001-7710   LIP BALM OIN GM                                 0.00        0.00     7710     Pharmacy
     05003533-7710   CA CARB 750MG TAB                               0.00        0.00     7710     Pharmacy
     05001843-7710   CA CL 100MG/ML DIS SYR                          0.00        0.00     7710     Pharmacy
     05001844-7710   CA CL 100MG/ML VIAL                             0.00        0.00     7710     Pharmacy
     05002016-7710   CA GLUCONATE 10PC VIAL                          0.00        0.00     7710     Pharmacy
     05002021-7710   CA GLUCONATE 500MG TAB                          0.00        0.00     7710     Pharmacy
     05003905-7710   POLYCARBOPHIL 625MG TAB                         0.00        0.00     7710     Pharmacy
     05016056-7710   CARVEDILOL 12.5MG TAB                           0.00        0.00     7710     Pharmacy
     05001828-7710   CA CARB 1.25GM TAB                              0.00        0.00     7710     Pharmacy
     05004603-7710   CHLORAL HYDRATE 500MG/5ML SYP                   0.00        0.00     7710     Pharmacy
     05012812-7710   CARDIOPLEGIC                                    0.00        0.00     7710     Pharmacy
     05007309-7710   CELLULOSE                                       0.00        0.00     7710     Pharmacy
     05009778-7710   CEPHALEXIN 125MG/5ML SUSP                       0.00        0.00     7710     Pharmacy
     05009780-7710   CEPHALEXIN 250MG CAP                            0.00        0.00     7710     Pharmacy
     05009782-7710   CEPHALEXIN 250MG/5ML SUSP                       0.00        0.00     7710     Pharmacy
     05009783-7710   CEPHALEXIN MH 500MG CAP                         0.00        0.00     7710     Pharmacy
     05015176-7710   CETIRIZINE HCL 10MG TAB                         0.00        0.00     7710     Pharmacy
     05009872-7710   CEFUROXIME 500MG TAB                            0.00        0.00     7710     Pharmacy
     05009871-7710   CEFUROXIME 250MG TAB                            0.00        0.00     7710     Pharmacy
     05009502-7710   CHLORAMBUCIL 2MG TAB                            0.00        0.00     7710     Pharmacy
     05004643-7710   CHLORDIAZEPOXD 10MG CAP                         0.00        0.00     7710     Pharmacy
     05004644-7710   CHLORDIAZEPOXD 25MG CAP                         0.00        0.00     7710     Pharmacy
     05003421-7710   CHLORHEX GLUC 1.2MG/ML                          0.00        0.00     7710     Pharmacy
     05010314-7710   CHLOROQUINE 500MG TAB                           0.00        0.00     7710     Pharmacy
     05009132-7710   CHLOROTHIAZIDE 500MG VIAL                       0.00        0.00     7710     Pharmacy
     05000228-7710   CHLORPHENIRAMIN 4MG TAB                         0.00        0.00     7710     Pharmacy
     05003394-7710   CHARCOAL/SORB SOLN 25G LIQ                      0.00        0.00     7710     Pharmacy
     05009905-7710   CEFTAZIDIME 1G VIAL                             0.00        0.00     7710     Pharmacy
     05013124-7710   CAFF NA BENZ 250MG/ML VL                        0.00        0.00     7710     Pharmacy
     05016067-7710   CARVEDILOL 3.125MG TAB                          0.00        0.00     7710     Pharmacy
     05016068-7710   CARVEDILOL 6.25MG TAB                           0.00        0.00     7710     Pharmacy
     05009843-7710   CEFACLOR 250MG CAP                              0.00        0.00     7710     Pharmacy
     05009846-7710   CEFACLOR 500MG CAP                              0.00        0.00     7710     Pharmacy



8/31/2010                                                                                                                   91
                                                c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                           CURRENT CURRENT        DEPARTMENT   DEPARTMENT DESCRIPTION
                                                               INPATIENT OUTPATIENT CODE
                                                               PRICE      PRICE
     05009799-7710   CEFAZOLIN 1GM VIAL                              0.00        0.00     7710     Pharmacy
     05009805-7710   CEFAZOLIN 500MG VIAL                            0.00        0.00     7710     Pharmacy
     05009880-7710   CEFUROXIME 750MG VIAL                           0.00        0.00     7710     Pharmacy
     05009853-7710   CEFOTAXIME 2GM IV                               0.00        0.00     7710     Pharmacy
     05005102-7710   CARISOPRODOL 350MG TAB                          0.00        0.00     7710     Pharmacy
     05009909-7710   CEFTAZIDIME 2G VIAL                             0.00        0.00     7710     Pharmacy
     05009895-7710   CEFTRIAXONE 1GM VIAL                            0.00        0.00     7710     Pharmacy
     05009897-7710   CEFTRIAXONE 250MG VIAL                          0.00        0.00     7710     Pharmacy
     05009899-7710   CEFTRIAXONE 2GM VIAL                            0.00        0.00     7710     Pharmacy
     05009901-7710   CEFTRIAXONE 500MG VIAL                          0.00        0.00     7710     Pharmacy
     05009875-7710   CEFUROXIME 1.5GM VIAL                           0.00        0.00     7710     Pharmacy
     05013793-7710   CEFUROXIME 125MG/5ML SUSP                       0.00        0.00     7710     Pharmacy
     05009850-7710   CEFOTAXIME 1GM IV                               0.00        0.00     7710     Pharmacy
     05005523-7710   BENZONATATE 100MG CAP                           0.00        0.00     7710     Pharmacy
     05012531-7710   BENAZEPRIL HCL 10MG TAB                         0.00        0.00     7710     Pharmacy
     05012532-7710   BENAZEPRIL HCL 20MG TAB                         0.00        0.00     7710     Pharmacy
     05012533-7710   BENAZEPRIL HCL 40MG TAB                         0.00        0.00     7710     Pharmacy
     05012530-7710   BENAZEPRIL HCL 5MG TAB                          0.00        0.00     7710     Pharmacy
     05014909-7710   LOTREL 20-5MG CAP                               0.00        0.00     7710     Pharmacy
     05000903-7710   BENZOCAINE 10% GEL                              0.00        0.00     7710     Pharmacy
     05015457-7710   CALCIPOTRIENE 0.005% CRM                        0.00        0.00     7710     Pharmacy
     05008374-7710   DERMAPLAST 20% AER                              0.00        0.00     7710     Pharmacy
     05009041-7710   BECLOMETHASONE 0.042PC SP                       0.00        0.00     7710     Pharmacy
     05006674-7710   BENZOYL PEROX 10% GEL                           0.00        0.00     7710     Pharmacy
     05005480-7710   BENZTROPINE MES 0.5MG TAB                       0.00        0.00     7710     Pharmacy
     05005481-7710   BENZTROPINE MES 1MG TAB                         0.00        0.00     7710     Pharmacy
     05005482-7710   BENZTROPINE MES 1MG/ML AMP                      0.00        0.00     7710     Pharmacy
     05005483-7710   BENZTROPINE MES 2MG TAB                         0.00        0.00     7710     Pharmacy
     05012601-7710   BERACTANT 25MG/ML VIAL                          0.00        0.00     7710     Pharmacy
     05007593-7710   BETAMETHASONE NA PH 3-3MG/ML                    0.00        0.00     7710     Pharmacy
     05000908-7710   BENZOCAINE 20% SPR                              0.00        0.00     7710     Pharmacy
     05005552-7710   BACLOFEN 10MG TAB                               0.00        0.00     7710     Pharmacy
     05004684-7710   CHLORPROMAZINE 100MG TAB                        0.00        0.00     7710     Pharmacy
     05015798-7710   AZITHROMYCIN 250MG TAB                          0.00        0.00     7710     Pharmacy
     05016092-7710   AZITHROMYCIN 500MG VIAL                         0.00        0.00     7710     Pharmacy
     05010126-7710   AZTREONAM 1G VIAL                               0.00        0.00     7710     Pharmacy
     05008948-7710   BACITRACIN 500U/G OIN GM                        0.00        0.00     7710     Pharmacy
     05008630-7710   BACITRACIN 50MU VIAL                            0.00        0.00     7710     Pharmacy



8/31/2010                                                                                                                   92
                                                 c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                            CURRENT CURRENT        DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                INPATIENT OUTPATIENT CODE
                                                                PRICE      PRICE
     05014434-7710   BACITRACIN 500U/G OIN GM                         0.00        0.00     7710     Pharmacy
     05005665-7710   DONNATAL 16.2MG/5ML ELIX                         0.00        0.00     7710     Pharmacy
     05008676-7710   BACI/POLYMIX OIN                                 0.00        0.00     7710     Pharmacy
     05005664-7710   DONNATAL 16.2MG TAB                              0.00        0.00     7710     Pharmacy
     05013076-7710   BACLOFEN REFILKIT/2000MCG                        0.00        0.00     7710     Pharmacy
     05005553-7710   BACLOFEN 20MG TAB                                0.00        0.00     7710     Pharmacy
     05013075-7710   BACLOFEN REFIL KIT/500MCG                        0.00        0.00     7710     Pharmacy
     05016262-7710   BACLOFEN SCRN KIT 1AMP                           0.00        0.00     7710     Pharmacy
     05009373-7710   NA CL 0.9% VIAL                                  0.00        0.00     7710     Pharmacy
     05016375-7710   BECAPLERMIN 0.01% GEL                            0.00        0.00     7710     Pharmacy
     05008502-7710   BETAMETHASONE DIP 0.05% CRM                      0.00        0.00     7710     Pharmacy
     05008949-7710   BACI/POLYMIX OIN                                 0.00        0.00     7710     Pharmacy
     05004836-7710   BUPROPION HCL 100MG TAB                          0.00        0.00     7710     Pharmacy
     05008504-7710   BETAMETHASONE DIP 0.05% OIN GM                   0.00        0.00     7710     Pharmacy
     05004347-7710   BUPIVACAINE 0.25PC VIAL                          0.00        0.00     7710     Pharmacy
     05004352-7710   BUPIVACAINE 0.5PC AMP                            0.00        0.00     7710     Pharmacy
     05004353-7710   BUPIVACAINE 0.5PC VIAL                           0.00        0.00     7710     Pharmacy
     05004356-7710   BUPIV/EPI 0.25-.0005 VIA                         0.00        0.00     7710     Pharmacy
     05004359-7710   BUPIV/EPI 0.5-0.0005 VIA                         0.00        0.00     7710     Pharmacy
     05015442-7710   BUPIVACAINE/FENTANYL                             0.00        0.00     7710     Pharmacy
     05009161-7710   BUMETANIDE 1MG TAB                               0.00        0.00     7710     Pharmacy
     05015441-7710   BUPIVACAINE/FENTANYL/NACL 50                     0.00        0.00     7710     Pharmacy
     05009159-7710   BUMETANIDE 0.25MG/ML VIAL                        0.00        0.00     7710     Pharmacy
     05015830-7710   BUPROPION HCL 100MG TB SA                        0.00        0.00     7710     Pharmacy
     05015829-7710   BUPROPION HCL 150MG TB SA                        0.00        0.00     7710     Pharmacy
     05004837-7710   BUPROPION HCL 75MG TAB                           0.00        0.00     7710     Pharmacy
     05004681-7710   BUSPIRONE 10MG TAB                               0.00        0.00     7710     Pharmacy
     05004682-7710   BUSPIRONE 5MG TAB                                0.00        0.00     7710     Pharmacy
     05013773-7710   BUTOCONAZOLE 2% CRM PF                           0.00        0.00     7710     Pharmacy
     05001994-7710   CA CARB/VIT D 250-125 TAB                        0.00        0.00     7710     Pharmacy
     05016839-7710   BUPIVACAINE/FENTANYL/NACL                        0.00        0.00     7710     Pharmacy
     05003769-7710   PINK BISMUTH 262MG/15ML                          0.00        0.00     7710     Pharmacy
     05015132-7710   AZITHROMYCIN 100MG/5ML SU                        0.00        0.00     7710     Pharmacy
     05008503-7710   BETAMETHASONE DIP 0.05% LOT                      0.00        0.00     7710     Pharmacy
     05008510-7710   BETAMETHASONE VAL 0.1% CRM                       0.00        0.00     7710     Pharmacy
     05008511-7710   BETAMETHASONE VAL 0.1% LOT                       0.00        0.00     7710     Pharmacy
     05008813-7710   BETAXOLOL 0.25PC DROP                            0.00        0.00     7710     Pharmacy
     05005628-7710   BETHANECHOL 25MG TAB                             0.00        0.00     7710     Pharmacy



8/31/2010                                                                                                                    93
                                                c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                           CURRENT CURRENT        DEPARTMENT   DEPARTMENT DESCRIPTION
                                                               INPATIENT OUTPATIENT CODE
                                                               PRICE      PRICE
     05015109-7710   BICALUTAMIDE 50MG TAB                           0.00        0.00     7710     Pharmacy
     05009162-7710   BUMETANIDE 2MG TAB                              0.00        0.00     7710     Pharmacy
     05003915-7710   BISACODYL 5MG TAB EC                            0.00        0.00     7710     Pharmacy
     05008506-7710   BETAMETHASONE DIP GLY .05% CRM                  0.00        0.00     7710     Pharmacy
     05013230-7710   BISOPROLOL FUMAR 5MG TAB                        0.00        0.00     7710     Pharmacy
     05007202-7710   MISC O/P RX                                     0.00        0.00     7710     Pharmacy
     05015693-7710   BRIMONIDINE 0.2% DROP                           0.00        0.00     7710     Pharmacy
     05016584-7710   BRINZOLAMIDE 1% DROP SU                         0.00        0.00     7710     Pharmacy
     05007429-7710   BROMOCRIPTINE 2.5MG TAB                         0.00        0.00     7710     Pharmacy
     05016055-7710   BUDESONIDE 200MCG AER PWD                       0.00        0.00     7710     Pharmacy
     05013653-7710   BUDESONIDE 32MCG AER ADP                        0.00        0.00     7710     Pharmacy
     05003913-7710   BISACODYL 10MG SUPP                             0.00        0.00     7710     Pharmacy
     05000694-7710   NTG 0.2MG/HR PC                                 0.00        0.00     7710     Pharmacy
     05000818-7710   NIFEDIPINE 60MG TAB SA                          0.00        0.00     7710     Pharmacy
     05013363-7710   NIFEDIPINE 60MG TAB SA                          0.00        0.00     7710     Pharmacy
     05000819-7710   NIFEDIPINE 90MG TAB SA                          0.00        0.00     7710     Pharmacy
     05013364-7710   NIFEDIPINE 90MG TAB SA                          0.00        0.00     7710     Pharmacy
     05000829-7710   NIMODIPINE 30MG CAP                             0.00        0.00     7710     Pharmacy
     05012748-7710   NITROFURANTOIN 100MG                            0.00        0.00     7710     Pharmacy
     05007881-7710   NITROFURANTOIN 25MG/5MLSU                       0.00        0.00     7710     Pharmacy
     05010189-7710   NITROFURANTOIN 100MG CAP                        0.00        0.00     7710     Pharmacy
     05008635-7710   CORTISPORIN OIN GM                              0.00        0.00     7710     Pharmacy
     05000693-7710   NTG 0.1MG/HR PC                                 0.00        0.00     7710     Pharmacy
     05000815-7710   NIFEDIPINE 10MG CAP                             0.00        0.00     7710     Pharmacy
     05000695-7710   NTG 0.3MG TB SL                                 0.00        0.00     7710     Pharmacy
     05000696-7710   NTG 0.3MG/HR PC                                 0.00        0.00     7710     Pharmacy
     05000697-7710   NTG 0.4MG TB SL                                 0.00        0.00     7710     Pharmacy
     05000698-7710   NTG0.4MG/DOSEAE                                 0.00        0.00     7710     Pharmacy
     05000699-7710   NTG 0.4MG/HR PC                                 0.00        0.00     7710     Pharmacy
     05000702-7710   NTG 0.6MG/HR PC                                 0.00        0.00     7710     Pharmacy
     05000709-7710   NTG 2.5MG CP SA                                 0.00        0.00     7710     Pharmacy
     05000712-7710   NTG 2PC                                         0.00        0.00     7710     Pharmacy
     05010191-7710   NITROFURANTOIN 50MG CAP                         0.00        0.00     7710     Pharmacy
     05016170-7710   NIACIN 1000MG TAB SA                            0.00        0.00     7710     Pharmacy
     05013015-7710   METRONIDAZOLE .75% GEL AP                       0.00        0.00     7710     Pharmacy
     05008919-7710   MAXITROL OIN GM                                 0.00        0.00     7710     Pharmacy
     05008660-7710   NEOSPORIN OIN                                   0.00        0.00     7710     Pharmacy
     05008935-7710   NEO/POLY/GRAM DROP                              0.00        0.00     7710     Pharmacy



8/31/2010                                                                                                                   94
                                                   c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                              CURRENT CURRENT        DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                  INPATIENT OUTPATIENT CODE
                                                                  PRICE      PRICE
     05008938-7710   CORTISPORIN DROP SU                                0.00        0.00     7710     Pharmacy
     05009090-7710   CORTISPORIN DROP                                   0.00        0.00     7710     Pharmacy
     05009089-7710   NEO/POLY/HC SOL OTIC                               0.00        0.00     7710     Pharmacy
     05010039-7710   NEOMYCIN SO4 500MGTAB                              0.00        0.00     7710     Pharmacy
     05013362-7710   NIFEDIPINE 30MG TAB SA                             0.00        0.00     7710     Pharmacy
     05005646-7710   NEOSTIGMINE 1:1000 VIAL                            0.00        0.00     7710     Pharmacy
     05000817-7710   NIFEDIPINE 30MG TAB SA                             0.00        0.00     7710     Pharmacy
     05002055-7710   NIACIN 500MG TAB                                   0.00        0.00     7710     Pharmacy
     05016168-7710   NIACIN 500MG TAB SA                                0.00        0.00     7710     Pharmacy
     05013556-7710   NICARDIPINE 2.5MG/ML AMP                           0.00        0.00     7710     Pharmacy
     05012700-7710   NICOTINE 14MG/24HR PATCH                           0.00        0.00     7710     Pharmacy
     05012701-7710   NICOTINE 21MG/24HR PATCH                           0.00        0.00     7710     Pharmacy
     05012699-7710   NICOTINE 7MG/24HR PATCH                            0.00        0.00     7710     Pharmacy
     05005784-7710   NICOTINE 2MG GUM                                   0.00        0.00     7710     Pharmacy
     05013126-7710   NICOTINE 4MG GUM                                   0.00        0.00     7710     Pharmacy
     05012277-7710   NTG 100MG/D5W 250ML                                0.00        0.00     7710     Pharmacy
     05008915-7710   NEOSPORIN OIN GM                                   0.00        0.00     7710     Pharmacy
     05016069-7710   OLANZAPINE 2.5MG TAB                               0.00        0.00     7710     Pharmacy
     05012276-7710   NTG 25MG/D5W 250ML                                 0.00        0.00     7710     Pharmacy
     05008168-7710   NYSTATIN 500MU TAB                                 0.00        0.00     7710     Pharmacy
     05008186-7710   NYSTATIN/TRIAMC CRM                                0.00        0.00     7710     Pharmacy
     05008187-7710   NYSTATIN/TRIAMC OIN GM                             0.00        0.00     7710     Pharmacy
     05007409-7710   OCTREOTIDE 0.05MG/ML IJ                            0.00        0.00     7710     Pharmacy
     05007411-7710   OCTREOTIDE ACET 0.1MG/ML                           0.00        0.00     7710     Pharmacy
     05007413-7710   OCTREOTIDE 0.5MG/ML IJ                             0.00        0.00     7710     Pharmacy
     05013300-7710   OFLOXACIN 0.3% DROP                                0.00        0.00     7710     Pharmacy
     05008185-7710   NYSTATIN 100MU/G PWD                               0.00        0.00     7710     Pharmacy
     05015704-7710   OLANZAPINE 10MG TAB                                0.00        0.00     7710     Pharmacy
     05008184-7710   NYSTATIN 100MU/G OIN GM                            0.00        0.00     7710     Pharmacy
     05015705-7710   OLANZAPINE 5MG TAB                                 0.00        0.00     7710     Pharmacy
     05015703-7710   OLANZAPINE 7.5MG TAB                               0.00        0.00     7710     Pharmacy
     05015981-7710   OLOPATADINE HCL 0.1% DROP                          0.00        0.00     7710     Pharmacy
     05014624-7710   OMEPRAZOLE 10MG CAP DR                             0.00        0.00     7710     Pharmacy
     05003646-7710   OMEPRAZOLE 20MG CAP DR                             0.00        0.00     7710     Pharmacy
     05012380-7710   ONDANSETRON HCL 2MG/ML VIAL                        0.00        0.00     7710     Pharmacy
     05013131-7710   ONDANSETRON HCL 8MG TAB                            0.00        0.00     7710     Pharmacy
     05001497-7710   OPIUM TINCTURE 10%                                 0.00        0.00     7710     Pharmacy
     05005487-7710   ORPHENADRINE 100MG TAB SA                          0.00        0.00     7710     Pharmacy



8/31/2010                                                                                                                      95
                                                 c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                            CURRENT CURRENT        DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                INPATIENT OUTPATIENT CODE
                                                                PRICE      PRICE
     05016362-7710   OFLOXACIN 0.3% DROP                              0.00        0.00     7710     Pharmacy
     05004262-7710   NORETHINDRONE 5MG TAB                            0.00        0.00     7710     Pharmacy
     05014628-7710   NEFAZODONE HCL 100MG TAB                         0.00        0.00     7710     Pharmacy
     05013292-7710   NITROPRUSSIDE 25MG/MLVL                          0.00        0.00     7710     Pharmacy
     05012808-7710   MISC OTHER DRUG                                  0.00        0.00     7710     Pharmacy
     05005787-7710   NOREPINEPHRINE 1MG/ML                            0.00        0.00     7710     Pharmacy
     05004288-7710   LOESTRIN 1-.02MGTB                               0.00        0.00     7710     Pharmacy
     05015952-7710   ESTROSTEP FE 5-7-9-7                             0.00        0.00     7710     Pharmacy
     05004282-7710   NORINYL 1-0.035MG TB                             0.00        0.00     7710     Pharmacy
     05004285-7710   ORTHONOVUM 7-7-7                                 0.00        0.00     7710     Pharmacy
     05008158-7710   NYSTATIN 100MU/ML SUSP                           0.00        0.00     7710     Pharmacy
     05004300-7710   NORETHINDRONE 0.35MG TAB                         0.00        0.00     7710     Pharmacy
     05012162-7710   NTG 50MG/D5W 250ML                               0.00        0.00     7710     Pharmacy
     05004277-7710   ORTHONOVUM 1-0.05MG                              0.00        0.00     7710     Pharmacy
     05012837-7710   ORTHO CYCLEN                                     0.00        0.00     7710     Pharmacy
     05013034-7710   ORTHO TRI-CYCLE 7-7-7                            0.00        0.00     7710     Pharmacy
     05004800-7710   NORTRIPTYLINE 10MG CAP                           0.00        0.00     7710     Pharmacy
     05004801-7710   NORTRIPTYLINE 25MG CAP                           0.00        0.00     7710     Pharmacy
     05004802-7710   NORTRIPTYLINE 50MG CAP                           0.00        0.00     7710     Pharmacy
     05004803-7710   NORTRIPTYLINE 75MG CAP                           0.00        0.00     7710     Pharmacy
     05007846-7710   NYSTATIN 100MU TAB                               0.00        0.00     7710     Pharmacy
     05008183-7710   NYSTATIN 100MU/G CRM                             0.00        0.00     7710     Pharmacy
     05004286-7710   TRI-NORINYL 7-9-5 TAB                            0.00        0.00     7710     Pharmacy
     05008579-7710   MOMETASONE FURO OIN .1%GM                        0.00        0.00     7710     Pharmacy
     05006376-7710   DESITIN OIN GM                                   0.00        0.00     7710     Pharmacy
     05009977-7710   MINOCYCLINE HCL 100MG CAP                        0.00        0.00     7710     Pharmacy
     05000448-7710   MINOXIDIL 10MG TAB                               0.00        0.00     7710     Pharmacy
     05000449-7710   MINOXIDIL 2.5MG TAB                              0.00        0.00     7710     Pharmacy
     05015599-7710   MIRTAZAPINE 15MG TAB                             0.00        0.00     7710     Pharmacy
     05015600-7710   MIRTAZAPINE 30MG TAB                             0.00        0.00     7710     Pharmacy
     05012263-7710   MISOPROSTOL 100MCG TAB                           0.00        0.00     7710     Pharmacy
     05003645-7710   MISOPROSTOL 200MCG TAB                           0.00        0.00     7710     Pharmacy
     05008918-7710   MAXITROL DROP                                    0.00        0.00     7710     Pharmacy
     05008577-7710   MOMETASONE FURO 0.1% CRM                         0.00        0.00     7710     Pharmacy
     05006368-7710   EMOLLIENTS                                       0.00        0.00     7710     Pharmacy
     05016086-7710   MOMETASONE FURO 50MCG SPR                        0.00        0.00     7710     Pharmacy
     05016406-7710   MONTELUKAST NA 10MG TAB                          0.00        0.00     7710     Pharmacy
     05016334-7710   MONTELUKAST NA 5MG TAB                           0.00        0.00     7710     Pharmacy



8/31/2010                                                                                                                    96
                                               c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                          CURRENT CURRENT        DEPARTMENT   DEPARTMENT DESCRIPTION
                                                              INPATIENT OUTPATIENT CODE
                                                              PRICE      PRICE
     05004998-7710   MORPHINE 100MG TAB SA                          0.00        0.00     7710     Pharmacy
     05004999-7710   MORPHINE 10MG SUPP                             0.00        0.00     7710     Pharmacy
     05005001-7710   MORPHINE 10MG/5ML SOL                          0.00        0.00     7710     Pharmacy
     05005002-7710   MORPHINE 10MG/ML AMP                           0.00        0.00     7710     Pharmacy
     05005003-7710   MORPHINE 10MG/ML DIS SYR                       0.00        0.00     7710     Pharmacy
     05009579-7710   MITOXANTRONE HCL 2MG/ML VIAL                   0.00        0.00     7710     Pharmacy
     05007854-7710   MICONAZOLE NIT 2% CRM AP                       0.00        0.00     7710     Pharmacy
     05010325-7710   METRONIDAZOLE 250MG TAB                        0.00        0.00     7710     Pharmacy
     05015462-7710   FLUTICASONE 220MCG AER AD                      0.00        0.00     7710     Pharmacy
     05004249-7710   ESTRATEST 1.25-.625TB                          0.00        0.00     7710     Pharmacy
     05004728-7710   FLUPHENAZINE 5MG TAB                           0.00        0.00     7710     Pharmacy
     05003522-7710   GAVISCON 40-160MG TAB                          0.00        0.00     7710     Pharmacy
     05003601-7710   MAG ALOH SIMETH200-200-20CHTB                  0.00        0.00     7710     Pharmacy
     05003592-7710   MAG ALOH SIMETH 200-200-20 LIQ                 0.00        0.00     7710     Pharmacy
     05003600-7710   MAG ALOH SIMETH 450-500-40 SUSP                0.00        0.00     7710     Pharmacy
     05013234-7710   DESITIN LOT                                    0.00        0.00     7710     Pharmacy
     05008280-7710   MICONAZOLE NIT 2% CRM                          0.00        0.00     7710     Pharmacy
     05003869-7710   MINERAL OIL STERILE PO                         0.00        0.00     7710     Pharmacy
     05007853-7710   MICONAZOLE NIT 200MG SUPP                      0.00        0.00     7710     Pharmacy
     05007278-7710   COLLAGEN HEMOST 1G EA                          0.00        0.00     7710     Pharmacy
     05007280-7710   COLLAGEN HEMOST 70X25MM SH                     0.00        0.00     7710     Pharmacy
     05004519-7710   MIDAZOLAM 1MG/ML VIAL                          0.00        0.00     7710     Pharmacy
     05004520-7710   MIDAZOLAM 5MG/ML VIAL                          0.00        0.00     7710     Pharmacy
     05016808-7710   MIDAZOLAM HCL 10MG/5ML SYP                     0.00        0.00     7710     Pharmacy
     05015759-7710   ISOMETH/DICHOR HCL 2.5MG TAB                   0.00        0.00     7710     Pharmacy
     05015758-7710   ISOMETH/DICHOR HCL 5MG TAB                     0.00        0.00     7710     Pharmacy
     05005009-7710   MORPHINE 15MG/ML DIS SYR                       0.00        0.00     7710     Pharmacy
     05007852-7710   MICONAZOLE NIT 100MG SUPP                      0.00        0.00     7710     Pharmacy
     05005230-7710   NALOXONE 0.4MG/ML VIAL                         0.00        0.00     7710     Pharmacy
     05005005-7710   MORPHINE 15MG TAB                              0.00        0.00     7710     Pharmacy
     05014876-7710   MYCOPHENOLATE MOFETIL 250MG CAP                0.00        0.00     7710     Pharmacy
     05012730-7710   NABUMETONE 500MG TAB                           0.00        0.00     7710     Pharmacy
     05013220-7710   NABUMETONE 750MG TAB                           0.00        0.00     7710     Pharmacy
     05000834-7710   NA CL 0.9% VIA-NEB                             0.00        0.00     7710     Pharmacy
     05000631-7710   NADOLOL 20MG TAB                               0.00        0.00     7710     Pharmacy
     05000632-7710   NADOLOL 40MG TAB                               0.00        0.00     7710     Pharmacy
     05009696-7710   NAFCILLIN NA 1G VIAL                           0.00        0.00     7710     Pharmacy
     05016354-7710   MUPIROCIN CA 2% CRM                            0.00        0.00     7710     Pharmacy



8/31/2010                                                                                                                  97
                                                   c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                              CURRENT CURRENT        DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                  INPATIENT OUTPATIENT CODE
                                                                  PRICE      PRICE
     05005160-7710   NALBUPHINE 10MG/ML AMP                             0.00        0.00     7710     Pharmacy
     05008679-7710   MUPIROCIN 2% OIN GM                                0.00        0.00     7710     Pharmacy
     05005417-7710   NALTREXONE HCL 50MG TAB                            0.00        0.00     7710     Pharmacy
     05001866-7710   NA PHOS                                            0.00        0.00     7710     Pharmacy
     05008714-7710   NAPHCON-A 0.025-0.3%                               0.00        0.00     7710     Pharmacy
     05008719-7710   NAPHAZOLONE HCL .012% DRP                          0.00        0.00     7710     Pharmacy
     05009278-7710   NAPROXEN 250MG TAB                                 0.00        0.00     7710     Pharmacy
     05009280-7710   NAPROXEN 375MG TAB                                 0.00        0.00     7710     Pharmacy
     05009281-7710   NAPROXEN 500MG TAB                                 0.00        0.00     7710     Pharmacy
     05013702-7710   NAPROXEN NA 220MG TAB                              0.00        0.00     7710     Pharmacy
     05009283-7710   NAPROXEN NA 550MG TAB                              0.00        0.00     7710     Pharmacy
     05009702-7710   NAFCILLIN NA 2G VIAL                               0.00        0.00     7710     Pharmacy
     05005033-7710   MORPHINE 8MG/ML DIS SYR                            0.00        0.00     7710     Pharmacy
     05004674-7710   OXAZEPAM 30MG CAP                                  0.00        0.00     7710     Pharmacy
     05005010-7710   MORPHINE 15MG/ML VIAL                              0.00        0.00     7710     Pharmacy
     05005011-7710   MORPHINE 1MG/ML AMP                                0.00        0.00     7710     Pharmacy
     05005017-7710   MORPHINE 20MG/ML SOL                               0.00        0.00     7710     Pharmacy
     05012228-7710   MORPHINE 25MG/ML AMP                               0.00        0.00     7710     Pharmacy
     05012390-7710   MORPHINE 25MG/ML VIAL                              0.00        0.00     7710     Pharmacy
     05005019-7710   MORPHINE 2MG/ML DIS SYR                            0.00        0.00     7710     Pharmacy
     05005023-7710   MORPHINE 30MG TAB SA                               0.00        0.00     7710     Pharmacy
     05015782-7710   MUPIROCIN CA 2% OIN                                0.00        0.00     7710     Pharmacy
     05005031-7710   MORPHINE 60MG TAB SA                               0.00        0.00     7710     Pharmacy
     05005006-7710   MORPHINE 15MG TAB SA                               0.00        0.00     7710     Pharmacy
     05005013-7710   MORPHINE PCA 1MG/ML DIS SYR                        0.00        0.00     7710     Pharmacy
     05004997-7710   MORPHINE PF 0.5MG/ML VIAL                          0.00        0.00     7710     Pharmacy
     05005014-7710   MORPHINE PF 1MG/ML VIAL                            0.00        0.00     7710     Pharmacy
     05003310-7710   MVI/MIN                                            0.00        0.00     7710     Pharmacy
     05003314-7710   MVI THERAPEUTIC                                    0.00        0.00     7710     Pharmacy
     05000042-7710   MVI CAP                                            0.00        0.00     7710     Pharmacy
     05003182-7710   MVI DROP                                           0.00        0.00     7710     Pharmacy
     05000045-7710   MVI LIQ                                            0.00        0.00     7710     Pharmacy
     05002322-7710   MVI                                                0.00        0.00     7710     Pharmacy
     05005027-7710   MORPHINE 4MG/ML DIS SYR                            0.00        0.00     7710     Pharmacy
     05012673-7710   PRAVASTATIN NA 20MG TAB                            0.00        0.00     7710     Pharmacy
     05001820-7710   K CL 8MEQ CAP SA                                   0.00        0.00     7710     Pharmacy
     05001821-7710   K CL 8MEQ TAB SA                                   0.00        0.00     7710     Pharmacy
     05000062-7710   K IODIDE 1G/ML SOL                                 0.00        0.00     7710     Pharmacy



8/31/2010                                                                                                                      98
                                                c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                           CURRENT CURRENT        DEPARTMENT   DEPARTMENT DESCRIPTION
                                                               INPATIENT OUTPATIENT CODE
                                                               PRICE      PRICE
     05002533-7710   LUGOLS SOL                                      0.00        0.00     7710     Pharmacy
     05008091-7710   POVIDONE IODINE 10% OI GM                       0.00        0.00     7710     Pharmacy
     05008095-7710   POVIDONE IODINE 10% SOL                         0.00        0.00     7710     Pharmacy
     05007758-7710   ANUSOL OIN                                      0.00        0.00     7710     Pharmacy
     05016135-7710   PRAMIPEXOLE 0.25MG TAB                          0.00        0.00     7710     Pharmacy
     05004670-7710   OXAZEPAM 10MG CAP                               0.00        0.00     7710     Pharmacy
     05012672-7710   PRAVASTATIN NA 10MG TAB                         0.00        0.00     7710     Pharmacy
     05013881-7710   K CL 20MEQ TAB                                  0.00        0.00     7710     Pharmacy
     05013367-7710   PRAVASTATIN NA 40MG TAB                         0.00        0.00     7710     Pharmacy
     05000435-7710   PRAZOSIN HCL 2MG CAP                            0.00        0.00     7710     Pharmacy
     05000436-7710   PRAZOSIN HCL 5MG CAP                            0.00        0.00     7710     Pharmacy
     05007530-7710   PREDNISOLONE 15MG/5ML SYP                       0.00        0.00     7710     Pharmacy
     05008852-7710   PREDNISOLONE ACET 1% DROP SU                    0.00        0.00     7710     Pharmacy
     05007572-7710   PREDNISONE 10MG TAB                             0.00        0.00     7710     Pharmacy
     05007573-7710   PREDNISONE 1MG TAB                              0.00        0.00     7710     Pharmacy
     05007574-7710   PREDNISONE 2.5MG TAB                            0.00        0.00     7710     Pharmacy
     05015465-7710   CALADRYL 1-8% LOT                               0.00        0.00     7710     Pharmacy
     05002886-7710   D5W 1000ML/KCL 20                               0.00        0.00     7710     Pharmacy
     05002941-7710   D51/4NS 1000ML/KCL 20                           0.00        0.00     7710     Pharmacy
     05002942-7710   D51/4NS 1000ML/KCL 30                           0.00        0.00     7710     Pharmacy
     05002943-7710   D51/4NS 1000ML/KCL 40                           0.00        0.00     7710     Pharmacy
     05002930-7710   D51/2NS 1000ML/KCL 10                           0.00        0.00     7710     Pharmacy
     05002931-7710   D51/2NS 1000ML/KCL 20                           0.00        0.00     7710     Pharmacy
     05002932-7710   D51/2NS 1000ML/KCL 30                           0.00        0.00     7710     Pharmacy
     05002933-7710   D51/2NS 1000ML/KCL 40                           0.00        0.00     7710     Pharmacy
     05001824-7710   NA CL 1000ML/KCL 20                             0.00        0.00     7710     Pharmacy
     05001812-7710   K CL 2MEQ/ML VL                                 0.00        0.00     7710     Pharmacy
     05002926-7710   D5NS 1000ML/KCL 20                              0.00        0.00     7710     Pharmacy
     05001805-7710   K CL 20PC LIQ                                   0.00        0.00     7710     Pharmacy
     05002888-7710   D5W 1000ML/KCL 40                               0.00        0.00     7710     Pharmacy
     05009184-7710   K CIT 540MG TAB SA                              0.00        0.00     7710     Pharmacy
     05001794-7710   K CL 10MEQ CAP SA                               0.00        0.00     7710     Pharmacy
     05013880-7710   K CL 10MEQ TAB                                  0.00        0.00     7710     Pharmacy
     05001795-7710   K CL 10MEQ TAB SA                               0.00        0.00     7710     Pharmacy
     05012157-7710   K CL 10MEQ/WATER 100ML                          0.00        0.00     7710     Pharmacy
     05012158-7710   K CL 10MEQ/WATER 50ML                           0.00        0.00     7710     Pharmacy
     05001796-7710   K CL 10PC LIQ                                   0.00        0.00     7710     Pharmacy
     05007578-7710   PREDNISONE 5MG TAB                              0.00        0.00     7710     Pharmacy



8/31/2010                                                                                                                   99
                                                   c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                              CURRENT CURRENT        DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                  INPATIENT OUTPATIENT CODE
                                                                  PRICE      PRICE
     05012956-7710   NEUTRA-PHOS-K                                      0.00        0.00     7710     Pharmacy
     05000604-7710   PROPRANOLOL 10MG TAB                               0.00        0.00     7710     Pharmacy
     05007575-7710   PREDNISONE 20MG TAB                                0.00        0.00     7710     Pharmacy
     05001184-7710   TENIPOSIDE 6.25MG/5ML SYRP                         0.00        0.00     7710     Pharmacy
     05000402-7710   PROPAFENONE 150MG TAB                              0.00        0.00     7710     Pharmacy
     05008818-7710   PROPARACINE HCL 0.5% DROP                          0.00        0.00     7710     Pharmacy
     05004529-7710   PROPOFOL 10MG/ML AMP                               0.00        0.00     7710     Pharmacy
     05012921-7710   PROPOFOL 10MG/ML VIAL                              0.00        0.00     7710     Pharmacy
     05005211-7710   APAP/PROPOX NAP 100-650TB                          0.00        0.00     7710     Pharmacy
     05005212-7710   APAP/PROPOX NAP 50-325 TB                          0.00        0.00     7710     Pharmacy
     05001188-7710   TENIPOSIDE 50MG SUPP                               0.00        0.00     7710     Pharmacy
     05005208-7710   PROPOXYPHEN NAP 100MG TAB                          0.00        0.00     7710     Pharmacy
     05001178-7710   PROMETHAZINE 25MG/ML AMP                           0.00        0.00     7710     Pharmacy
     05000597-7710   PROPRANOLOL 120MG SA CAP                           0.00        0.00     7710     Pharmacy
     05000605-7710   PROPRANOLOL 1MG/ML AMP                             0.00        0.00     7710     Pharmacy
     05000606-7710   PROPRANOLOL 20MG TAB                               0.00        0.00     7710     Pharmacy
     05000607-7710   PROPRANOLOL 40MG TAB                               0.00        0.00     7710     Pharmacy
     05000610-7710   PROPRANOLOL 80MG SA CAP                            0.00        0.00     7710     Pharmacy
     05000611-7710   PROPRANOLOL 80MG TAB                               0.00        0.00     7710     Pharmacy
     05007504-7710   PROPYLTHIOURACL 50MG TAB                           0.00        0.00     7710     Pharmacy
     05007388-7710   PROTAMINE SO4 10MG/ML VIAL                         0.00        0.00     7710     Pharmacy
     05001217-7710   PSEUDOEPHEDRINE 30MG TAB                           0.00        0.00     7710     Pharmacy
     05005198-7710   PROPOXYPHENE HCL 65MG CAP                          0.00        0.00     7710     Pharmacy
     05004742-7710   PROCHLORPERAZIN 10MG TAB                           0.00        0.00     7710     Pharmacy
     05001884-7710   K BICARB/K CIT 25MEQ TAB EF                        0.00        0.00     7710     Pharmacy
     05007579-7710   PREDNISONE 5MG/5ML SOL                             0.00        0.00     7710     Pharmacy
     05016639-7710   MVI PRENATAL 60-1MG TAB                            0.00        0.00     7710     Pharmacy
     05016640-7710   MVI PRENATAL 65-1MG TAB                            0.00        0.00     7710     Pharmacy
     05005446-7710   PRIMIDONE 250MG TAB                                0.00        0.00     7710     Pharmacy
     05005448-7710   PRIMIDONE 50MG TAB                                 0.00        0.00     7710     Pharmacy
     05009172-7710   PROBENECID 500MG TAB                               0.00        0.00     7710     Pharmacy
     05001181-7710   PROMETHAZINE 50MG/ML AMP                           0.00        0.00     7710     Pharmacy
     05000363-7710   PROCAINAMIDE 500MG SA TAB                          0.00        0.00     7710     Pharmacy
     05007577-7710   PREDNISONE 50MG TAB                                0.00        0.00     7710     Pharmacy
     05004745-7710   PROCHLORPERAZIN 25MG SUPP                          0.00        0.00     7710     Pharmacy
     05004749-7710   PROCHLORPERAZIN 5MG TAB                            0.00        0.00     7710     Pharmacy
     05004740-7710   PROCHLORPERAZIN 5MG/ML VIAL                        0.00        0.00     7710     Pharmacy
     05016429-7710   PROGESTERONE 100MG CAP                             0.00        0.00     7710     Pharmacy



8/31/2010                                                                                                                      100
                                                c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                           CURRENT CURRENT        DEPARTMENT   DEPARTMENT DESCRIPTION
                                                               INPATIENT OUTPATIENT CODE
                                                               PRICE      PRICE
     05004182-7710   PROGESTERONE 50MG/ML VIAL                       0.00        0.00     7710     Pharmacy
     05001176-7710   PROMETHAZINE 12.5MG SUPP                        0.00        0.00     7710     Pharmacy
     05001185-7710   TENIPOSIDE 12.5MG TAB                           0.00        0.00     7710     Pharmacy
     05001186-7710   TENIPOSIDE 25MG SUPP                            0.00        0.00     7710     Pharmacy
     05001187-7710   TENIPOSIDE 25MG TAB                             0.00        0.00     7710     Pharmacy
     05000355-7710   PROCAINAMIDE 100MG/ML VL                        0.00        0.00     7710     Pharmacy
     05015459-7710   PENTOSAN 100MG                                  0.00        0.00     7710     Pharmacy
     05012800-7710   MISC OTHER DRUG                                 0.00        0.00     7710     Pharmacy
     05009610-7710   PCN G BENZ CR 300-300 DIS SY                    0.00        0.00     7710     Pharmacy
     05015802-7710   PENCICLOVIR 1% CRM                              0.00        0.00     7710     Pharmacy
     05009585-7710   PCN G K 1MMU                                    0.00        0.00     7710     Pharmacy
     05009597-7710   PCN G K 5MMU                                    0.00        0.00     7710     Pharmacy
     05009613-7710   PCN V K 125MG/5ML SUSP                          0.00        0.00     7710     Pharmacy
     05009614-7710   PCN V K 250MG TAB                               0.00        0.00     7710     Pharmacy
     05009615-7710   PCN V K 250MG/5ML SUSP                          0.00        0.00     7710     Pharmacy
     05013112-7710   PAROXETINE HCL 30MG TAB                         0.00        0.00     7710     Pharmacy
     05010337-7710   PENTAMIDINE 300MG VIAL                          0.00        0.00     7710     Pharmacy
     05013091-7710   PAROXETINE HCL 20MG TAB                         0.00        0.00     7710     Pharmacy
     05007393-7710   PENTOXIFYLLINE 400MG TBSA                       0.00        0.00     7710     Pharmacy
     05008602-7710   PERMETHRIN 1% LIQ                               0.00        0.00     7710     Pharmacy
     05008603-7710   PERMETHRIN 5% CRM                               0.00        0.00     7710     Pharmacy
     05004731-7710   PERPHENAZINE 2MG TAB                            0.00        0.00     7710     Pharmacy
     05004732-7710   PERPHENAZINE 4MG TAB                            0.00        0.00     7710     Pharmacy
     05004734-7710   PERPHENAZINE 8MG TAB                            0.00        0.00     7710     Pharmacy
     05005317-7710   PETROLATUM                                      0.00        0.00     7710     Pharmacy
     05012805-7710   MISC OTHER DRUG                                 0.00        0.00     7710     Pharmacy
     05002940-7710   D51/4NS 1000ML/KCL 10                           0.00        0.00     7710     Pharmacy
     05009616-7710   PCN V K 500MG TAB                               0.00        0.00     7710     Pharmacy
     05004269-7710   OXYTOCIN 10U/ML VIAL                            0.00        0.00     7710     Pharmacy
     05010326-7710   METRONIDAZOLE 500MG TAB                         0.00        0.00     7710     Pharmacy
     05006850-7710   OXYBENZONE/PDO/PET HY-PHL OIN GM                0.00        0.00     7710     Pharmacy
     05005782-7710   OXYBUTYNIN 5MG TAB                              0.00        0.00     7710     Pharmacy
     05015290-7710   OXYCODONE HCL 10MG SA TAB PO                    0.00        0.00     7710     Pharmacy
     05015292-7710   OXYCODONE HCL 40MG SA TAB PO                    0.00        0.00     7710     Pharmacy
     05005142-7710   OXYCODONE HCL 5MG TAB                           0.00        0.00     7710     Pharmacy
     05016041-7710   OXYCODONE HCL 80MG SA TAB                       0.00        0.00     7710     Pharmacy
     05005145-7710   APAP/OXYCOD 5/325 TAB                           0.00        0.00     7710     Pharmacy
     05009606-7710   PCN G BENZ 600MU/ML DI SY                       0.00        0.00     7710     Pharmacy



8/31/2010                                                                                                                   101
                                                 c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                            CURRENT CURRENT        DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                INPATIENT OUTPATIENT CODE
                                                                PRICE      PRICE
     05009004-7710   OXYMETAZOLINE 0.05% SPR                          0.00        0.00     7710     Pharmacy
     05009938-7710   PHENAZOPYRIDINE 100MG TAB                        0.00        0.00     7710     Pharmacy
     05016326-7710   ALLEGRA-D 120-60MG                               0.00        0.00     7710     Pharmacy
     05013940-7710   CLARITIN-D 120-5MG TAB                           0.00        0.00     7710     Pharmacy
     05015662-7710   CLARITIN-D 240-10MG TAB                          0.00        0.00     7710     Pharmacy
     05012702-7710   PAMIDRONATE/30MG IJ                              0.00        0.00     7710     Pharmacy
     05009318-7710   PANCURONIUM 1MG/ML VIAL                          0.00        0.00     7710     Pharmacy
     05000768-7710   PAPAVERINE 30MG/ML VIAL                          0.00        0.00     7710     Pharmacy
     05003767-7710   PAREGORIC LIQ                                    0.00        0.00     7710     Pharmacy
     05016582-7710   PARICALCITOL 5MCG/ML VIAL                        0.00        0.00     7710     Pharmacy
     05015383-7710   PAROXETINE HCL 10MG TAB                          0.00        0.00     7710     Pharmacy
     05005140-7710   ASA/OXYCOD 4.88/325 TAB                          0.00        0.00     7710     Pharmacy
     05013412-7710   ZOSYN 2.25GM VIAL                                0.00        0.00     7710     Pharmacy
     05012801-7710   MISC OTHER DRUG                                  0.00        0.00     7710     Pharmacy
     05005642-7710   PHYSOSTIGMINE 1MG/ML AM                          0.00        0.00     7710     Pharmacy
     05003209-7710   PHYTONADIONE 10MG/ML AMP                         0.00        0.00     7710     Pharmacy
     05003212-7710   PHYTONADIONE 2MG/ML AMP                          0.00        0.00     7710     Pharmacy
     05003214-7710   PHYTONADIONE 5MG TAB                             0.00        0.00     7710     Pharmacy
     05008771-7710   PILOCARPINE HCL 1% DROP                          0.00        0.00     7710     Pharmacy
     05008773-7710   PILOCARPINE HCL 2% DROP                          0.00        0.00     7710     Pharmacy
     05008776-7710   PILOCARPINE HCL 4% DROP                          0.00        0.00     7710     Pharmacy
     05005426-7710   PHENYTOIN NA 100MG CAP                           0.00        0.00     7710     Pharmacy
     05005928-7710   PINDOLOL 5MG TAB                                 0.00        0.00     7710     Pharmacy
     05005432-7710   PHENYTOIN NA 50MG/ML VL                          0.00        0.00     7710     Pharmacy
     05013413-7710   ZOSYN 3.375GM VIAL                               0.00        0.00     7710     Pharmacy
     05013414-7710   ZOSYN 4.5GM VIAL                                 0.00        0.00     7710     Pharmacy
     05013872-7710   PIRBUTEROL 0.2MG AER                             0.00        0.00     7710     Pharmacy
     05009291-7710   PIROXICAM 10MG CAP                               0.00        0.00     7710     Pharmacy
     05009292-7710   PIROXICAM 20MG CAP                               0.00        0.00     7710     Pharmacy
     05010420-7710   PNEUMOCOCCAL VACC                                0.00        0.00     7710     Pharmacy
     05008952-7710   POLYMYX/TRIMETH DROP                             0.00        0.00     7710     Pharmacy
     05008892-7710   EYE LUBE 1.4% DROP                               0.00        0.00     7710     Pharmacy
     05004672-7710   OXAZEPAM 15MG CAP                                0.00        0.00     7710     Pharmacy
     05005927-7710   PINDOLOL 10MG TAB                                0.00        0.00     7710     Pharmacy
     05005926-7710   PHENTOLAMINE MESYL 5MG VL                        0.00        0.00     7710     Pharmacy
     05009939-7710   PHENAZOPYRIDINE 200MG TAB                        0.00        0.00     7710     Pharmacy
     05000077-7710   PHENOBARBITAL 100MG TAB                          0.00        0.00     7710     Pharmacy
     05003563-7710   PHENOBARBITAL 130MG/ML VL                        0.00        0.00     7710     Pharmacy



8/31/2010                                                                                                                    102
                                               c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                          CURRENT CURRENT        DEPARTMENT   DEPARTMENT DESCRIPTION
                                                              INPATIENT OUTPATIENT CODE
                                                              PRICE      PRICE
     05000079-7710   PHENOBARBITAL 15MG TAB                         0.00        0.00     7710     Pharmacy
     05000082-7710   PHENOBARBITAL 20MG/5ML EL                      0.00        0.00     7710     Pharmacy
     05000083-7710   PHENOBARBITAL 30MG TAB                         0.00        0.00     7710     Pharmacy
     05000084-7710   PHENOBARBITAL 60MG TAB                         0.00        0.00     7710     Pharmacy
     05003567-7710   PHENOBARBITAL 65MG/ML VL                       0.00        0.00     7710     Pharmacy
     05005427-7710   PHENYTOIN NA 30MG CAP                          0.00        0.00     7710     Pharmacy
     05004397-7710   CHLORASEPTIC MTHW                              0.00        0.00     7710     Pharmacy
     05001808-7710   K CL 25MEQ TAB EF                              0.00        0.00     7710     Pharmacy
     05009017-7710   PHENYLEPHRINE HCL .25% SP                      0.00        0.00     7710     Pharmacy
     05009024-7710   PHENYLEPHRINE HCL .5% SPR                      0.00        0.00     7710     Pharmacy
     05008715-7710   PHENYLEPHRINE HCL 10% DRP                      0.00        0.00     7710     Pharmacy
     05001136-7710   PHENYLEPHRINE HCL 10MG/ML VL                   0.00        0.00     7710     Pharmacy
     05008716-7710   PHENYLEPHRINE HCL 2.5%DRP                      0.00        0.00     7710     Pharmacy
     05001489-7710   PROMETH VC/COD SYRP                            0.00        0.00     7710     Pharmacy
     05001488-7710   PROMETH/PHENYL SYRP                            0.00        0.00     7710     Pharmacy
     05005418-7710   PHENYTOIN 125MG/5ML SUSP                       0.00        0.00     7710     Pharmacy
     05005420-7710   PHENYTOIN 50MG TAB CH                          0.00        0.00     7710     Pharmacy
     05015657-7710   PHENOBARBITAL 64.8MG TAB                       0.00        0.00     7710     Pharmacy
     05012793-7710   HYDROMORPHONE 0.2MG/ML 30ML PCA                0.00        0.00     7710     Pharmacy
     05008465-7710   HYDROCORT 2.5% CRM                             0.00        0.00     7710     Pharmacy
     05013036-7710   HYDROCORT 2.5% CRM                             0.00        0.00     7710     Pharmacy
     05008467-7710   HYDROCORT 2.5% OIN GM                          0.00        0.00     7710     Pharmacy
     05006575-7710   HYDROCORT 20MG TAB                             0.00        0.00     7710     Pharmacy
     05006578-7710   HYDROCORT 5MG TAB                              0.00        0.00     7710     Pharmacy
     05007689-7710   HYDROCORT ACET 25MG SUPP                       0.00        0.00     7710     Pharmacy
     05008488-7710   HYDROCORT BUTYR 0.1% CRM                       0.00        0.00     7710     Pharmacy
     05008490-7710   HYDROCORT VAL 0.2% CRM                         0.00        0.00     7710     Pharmacy
     05000752-7710   ISOSORBIDE DN 2.5MG SL                         0.00        0.00     7710     Pharmacy
     05008343-7710   HYDROCORT/PRAM 2.5% CRM                        0.00        0.00     7710     Pharmacy
     05008462-7710   HYDROCORT 1% LOT                               0.00        0.00     7710     Pharmacy
     05000963-7710   HYDROMORPHONE 10MG/ML AMP                      0.00        0.00     7710     Pharmacy
     05000965-7710   HYDROMORPHONE 1MG/ML SYDI                      0.00        0.00     7710     Pharmacy
     05000973-7710   HYDROMORPHONE 2MG TAB                          0.00        0.00     7710     Pharmacy
     05000967-7710   HYDROMORPHONE 2MG/ML SYDI                      0.00        0.00     7710     Pharmacy
     05000968-7710   HYDROMORPHONE 2MG/ML VIAL                      0.00        0.00     7710     Pharmacy
     05000974-7710   HYDROMORPHONE 3MG SUPP                         0.00        0.00     7710     Pharmacy
     05000976-7710   HYDROMORPHONE 4MG TAB                          0.00        0.00     7710     Pharmacy
     05000971-7710   HYDROMORPHONE 4MG/ML SYDI                      0.00        0.00     7710     Pharmacy



8/31/2010                                                                                                                  103
                                                   c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                              CURRENT CURRENT        DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                  INPATIENT OUTPATIENT CODE
                                                                  PRICE      PRICE
     05008491-7710   HYDROCORT VAL 0.2% OIN                             0.00        0.00     7710     Pharmacy
     05000412-7710   HYDRALAZINE 50MG TAB                               0.00        0.00     7710     Pharmacy
     05007351-7710   HEPARIN 10U/ML VIAL                                0.00        0.00     7710     Pharmacy
     05007362-7710   HEPARIN 5000U/ML VIAL                              0.00        0.00     7710     Pharmacy
     05010408-7710   IG HEPATITIS B HUMAN IM VL                         0.00        0.00     7710     Pharmacy
     05007171-7710   HETASTARCH 500ML                                   0.00        0.00     7710     Pharmacy
     05008830-7710   HOMATROPINE 5% DROP                                0.00        0.00     7710     Pharmacy
     05007243-7710   NA HYALURONATE 10MG/MLIA IJ                        0.00        0.00     7710     Pharmacy
     05000408-7710   HYDRALAZINE 10MG TAB                               0.00        0.00     7710     Pharmacy
     05006574-7710   HYDROCORT 10MG TAB                                 0.00        0.00     7710     Pharmacy
     05000411-7710   HYDRALAZINE 25MG TAB                               0.00        0.00     7710     Pharmacy
     05008463-7710   HYDROCORT 1% OIN GM                                0.00        0.00     7710     Pharmacy
     05015515-7710   APAP/HYDROCOD 10-500MG TB                          0.00        0.00     7710     Pharmacy
     05013197-7710   APAP/HYDROCOD 2.5-167/5EL                          0.00        0.00     7710     Pharmacy
     05005124-7710   APAP/HYDROCOD 5-500MG TAB                          0.00        0.00     7710     Pharmacy
     05005125-7710   APAP/HYDROCOD 7.5-500MGTB                          0.00        0.00     7710     Pharmacy
     05005127-7710   HYDROCOD/APAP 7.5-750MGTB                          0.00        0.00     7710     Pharmacy
     05001348-7710   HYCODAN SYRP                                       0.00        0.00     7710     Pharmacy
     05008454-7710   HYDROCORT 0.5% CRM                                 0.00        0.00     7710     Pharmacy
     05008461-7710   HYDROCORT 1% CRM                                   0.00        0.00     7710     Pharmacy
     05010319-7710   PLAQUENIL 200MG TAB                                0.00        0.00     7710     Pharmacy
     05000410-7710   HYDRALAZINE 20MG/ML VIAL                           0.00        0.00     7710     Pharmacy
     05012813-7710   IODINE 1% TOPICAL                                  0.00        0.00     7710     Pharmacy
     05006803-7710   HYDROQUINONE 30MG/ML SOL                           0.00        0.00     7710     Pharmacy
     05009255-7710   INDOMETHACIN 25MG CAP                              0.00        0.00     7710     Pharmacy
     05009257-7710   INDOMETHACIN 50MG CAP                              0.00        0.00     7710     Pharmacy
     05013692-7710   INHALER                                            0.00        0.00     7710     Pharmacy
     05013693-7710   MISC ENT DRUG                                      0.00        0.00     7710     Pharmacy
     05013694-7710   MISC ENT DRUG                                      0.00        0.00     7710     Pharmacy
     05013160-7710   INSULIN REG/NPH 100U/ML                            0.00        0.00     7710     Pharmacy
     05015621-7710   INSULIN LISPRO 100U/ML VL                          0.00        0.00     7710     Pharmacy
     05009163-7710   INDAPAMIDE 2.5MG TAB                               0.00        0.00     7710     Pharmacy
     05002571-7710   INSULIN REG HUM 100U/MLVL                          0.00        0.00     7710     Pharmacy
     05013254-7710   INDAPAMIDE 1.25MG TAB                              0.00        0.00     7710     Pharmacy
     05013611-7710   IPRATROPIUM 0.2MG/ML SOL                           0.00        0.00     7710     Pharmacy
     05000291-7710   IPRATROPIUM 18MCG AER ADP                          0.00        0.00     7710     Pharmacy
     05015244-7710   IPRATROPIUM 21MCG SPR                              0.00        0.00     7710     Pharmacy
     05015243-7710   IPRATROPIUM 42MCG SPR                              0.00        0.00     7710     Pharmacy



8/31/2010                                                                                                                      104
                                                c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                           CURRENT CURRENT        DEPARTMENT   DEPARTMENT DESCRIPTION
                                                               INPATIENT OUTPATIENT CODE
                                                               PRICE      PRICE
     05016252-7710   IRBESARTAN 150MG TAB                            0.00        0.00     7710     Pharmacy
     05000396-7710   MEXILETINE HCL 150MG CAP                        0.00        0.00     7710     Pharmacy
     05005790-7710   ISOPROTERENOL .2MG/ML AMP                       0.00        0.00     7710     Pharmacy
     05010324-7710   METRONIDAZOLE 0.75% GEL                         0.00        0.00     7710     Pharmacy
     05000749-7710   ISOSORBIDE DN 10MG TAB                          0.00        0.00     7710     Pharmacy
     05002596-7710   INSULIN NPH HUM 100U/MLVL                       0.00        0.00     7710     Pharmacy
     05009267-7710   IBUPROFEN 100MG/5ML SUSP                        0.00        0.00     7710     Pharmacy
     05007344-7710   HEPARIN 1000U/ML VIAL                           0.00        0.00     7710     Pharmacy
     05009505-7710   HYDROXYUREA 500MG CAP                           0.00        0.00     7710     Pharmacy
     05004631-7710   HYDROXYZINE HCL 50MG/ML VL                      0.00        0.00     7710     Pharmacy
     05004633-7710   HYDROXYZINE HCL 10MG TAB                        0.00        0.00     7710     Pharmacy
     05004634-7710   HYDROXYZINE HCL 25MG TAB                        0.00        0.00     7710     Pharmacy
     05004636-7710   HYDROXYZINE HCL 50MG TAB                        0.00        0.00     7710     Pharmacy
     05004639-7710   HYDROXYZINE PAM PAM 25MG CAP                    0.00        0.00     7710     Pharmacy
     05004641-7710   HYDROXYZINE PAM 50MG CAP                        0.00        0.00     7710     Pharmacy
     05009195-7710   INDIGO CARMINE 0.8%                             0.00        0.00     7710     Pharmacy
     05004110-7710   HYOSCYAMNE 0.125MG SL                           0.00        0.00     7710     Pharmacy
     05006804-7710   HYDROQUINONE 4% CRM                             0.00        0.00     7710     Pharmacy
     05009266-7710   IBUPROFEN 200MG TAB                             0.00        0.00     7710     Pharmacy
     05009269-7710   IBUPROFEN 400MG TAB                             0.00        0.00     7710     Pharmacy
     05009270-7710   IBUPROFEN 600MG TAB                             0.00        0.00     7710     Pharmacy
     05009271-7710   IBUPROFEN 800MG TAB                             0.00        0.00     7710     Pharmacy
     05016216-7710   HYDROCOD/IBUPR 200-7.5MG                        0.00        0.00     7710     Pharmacy
     05010131-7710   IMIPENEM/CILAST 500MG                           0.00        0.00     7710     Pharmacy
     05004785-7710   IMIPRAMINE HCL 10MG TAB                         0.00        0.00     7710     Pharmacy
     05004786-7710   IMIPRAMINE HCL 25MG TAB                         0.00        0.00     7710     Pharmacy
     05004787-7710   IMIPRAMINE HCL 50MG TAB                         0.00        0.00     7710     Pharmacy
     05004109-7710   HYOSCYAMNE 0.125MG PO                           0.00        0.00     7710     Pharmacy
     05010044-7710   GENTAMICIN 40MG/ML VIAL                         0.00        0.00     7710     Pharmacy
     05002625-7710   GLYBURIDE 2.5MG TAB                             0.00        0.00     7710     Pharmacy
     05007294-7710   GELATIN SPONGE SIZE 100                         0.00        0.00     7710     Pharmacy
     05007304-7710   GELATIN                                         0.00        0.00     7710     Pharmacy
     05007235-7710   GEMFIBROZIL 600MG TAB                           0.00        0.00     7710     Pharmacy
     05010047-7710   GENTAMICIN 100MG/100ML NS                       0.00        0.00     7710     Pharmacy
     05010057-7710   GENTAMICIN 80MG/100ML NS                        0.00        0.00     7710     Pharmacy
     05010054-7710   GENTAMICIN 60MG/50ML NS                         0.00        0.00     7710     Pharmacy
     05010041-7710   GENTAMICIN 10MG/ML VIAL                         0.00        0.00     7710     Pharmacy
     05013492-7710   GABAPENTIN 400MG CAP                            0.00        0.00     7710     Pharmacy



8/31/2010                                                                                                                   105
                                                 c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                            CURRENT CURRENT        DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                INPATIENT OUTPATIENT CODE
                                                                PRICE      PRICE
     05008941-7710   GENTAMICIN 3MG/ML DROP                           0.00        0.00     7710     Pharmacy
     05013491-7710   GABAPENTIN 300MG CAP                             0.00        0.00     7710     Pharmacy
     05015379-7710   GLIMEPIRIDE 1MG TAB                              0.00        0.00     7710     Pharmacy
     05015381-7710   GLIMEPIRIDE 4MG TAB                              0.00        0.00     7710     Pharmacy
     05002627-7710   GLIPIZIDE 10MG TAB                               0.00        0.00     7710     Pharmacy
     05013675-7710   GLIPIZIDE 10MG TAB SA                            0.00        0.00     7710     Pharmacy
     05002628-7710   GLIPIZIDE 5MG TAB                                0.00        0.00     7710     Pharmacy
     05013676-7710   GLIPIZIDE 5MG TAB SA                             0.00        0.00     7710     Pharmacy
     05007276-7710   GLUCAGON 1MG KIT                                 0.00        0.00     7710     Pharmacy
     05007277-7710   GLUCAGON 1MG VIAL                                0.00        0.00     7710     Pharmacy
     05007350-7710   HEPARIN 10U/ML SYR DIS                           0.00        0.00     7710     Pharmacy
     05008940-7710   GENTAMICIN 3MG/GM OIN                            0.00        0.00     7710     Pharmacy
     05015660-7710   DIALYVITE 1MG                                    0.00        0.00     7710     Pharmacy
     05012507-7710   FLUTICASONE 0.05% CRM                            0.00        0.00     7710     Pharmacy
     05015461-7710   FLUTICASONE 44MCG AER                            0.00        0.00     7710     Pharmacy
     05014595-7710   FLUTICASONE 50MCG SPR                            0.00        0.00     7710     Pharmacy
     05013605-7710   FLUVASTATIN NA 20MG CAP                          0.00        0.00     7710     Pharmacy
     05013606-7710   FLUVASTATIN NA 40MG CAP                          0.00        0.00     7710     Pharmacy
     05014023-7710   FLUVOXAMINE MAL 100MG TAB                        0.00        0.00     7710     Pharmacy
     05014022-7710   FLUVOXAMINE MAL 50MG TAB                         0.00        0.00     7710     Pharmacy
     05002279-7710   FOLIC ACID 1MG TAB                               0.00        0.00     7710     Pharmacy
     05010371-7710   GANCICLOVIR NA 500MG VIAL                        0.00        0.00     7710     Pharmacy
     05013221-7710   NEPHROCAPS                                       0.00        0.00     7710     Pharmacy
     05002626-7710   GLYBURIDE 5MG TAB                                0.00        0.00     7710     Pharmacy
     05012509-7710   FOSINOPRIL NA 10MG TAB                           0.00        0.00     7710     Pharmacy
     05012510-7710   FOSINOPRIL NA 20MG TAB                           0.00        0.00     7710     Pharmacy
     05015668-7710   FOSPHENYTOIN 50MG IJ                             0.00        0.00     7710     Pharmacy
     05009149-7710   FUROSEMIDE 10MG/ML VIAL                          0.00        0.00     7710     Pharmacy
     05009150-7710   FUROSEMIDE 20MG TAB                              0.00        0.00     7710     Pharmacy
     05009151-7710   FUROSEMIDE 40MG TAB                              0.00        0.00     7710     Pharmacy
     05009152-7710   FUROSEMIDE 40MG/5ML SOL                          0.00        0.00     7710     Pharmacy
     05009153-7710   FUROSEMIDE 80MG TAB                              0.00        0.00     7710     Pharmacy
     05013490-7710   GABAPENTIN 100MG CAP                             0.00        0.00     7710     Pharmacy
     05002280-7710   FOLIC ACID 5MG/ML VIAL                           0.00        0.00     7710     Pharmacy
     05013628-7710   DYAZIDE 25-37.5MG CAP                            0.00        0.00     7710     Pharmacy
     05002624-7710   GLYBURIDE 1.25MG TAB                             0.00        0.00     7710     Pharmacy
     05007526-7710   HYDROCORT NA SUC 100MG VL                        0.00        0.00     7710     Pharmacy
     05007527-7710   HYDROCORT NA SUC 250MG VL                        0.00        0.00     7710     Pharmacy



8/31/2010                                                                                                                    106
                                                  c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                             CURRENT CURRENT        DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                 INPATIENT OUTPATIENT CODE
                                                                 PRICE      PRICE
     05000424-7710   HCTZ 25MG TAB                                     0.00        0.00     7710     Pharmacy
     05000425-7710   HCTZ 50MG TAB                                     0.00        0.00     7710     Pharmacy
     05009139-7710   AMILORIDE/HCTZ 50-5MG TAB                         0.00        0.00     7710     Pharmacy
     05013401-7710   BISOPROLOL/HCTZ/HCTZ 6.25/10MG TB                 0.00        0.00     7710     Pharmacy
     05013399-7710   BISOPROLOL/HCTZ/HCTZ 6.25/2.5MG TA                0.00        0.00     7710     Pharmacy
     05004869-7710   HALOPERIDOL LA 5MG/ML AMP                         0.00        0.00     7710     Pharmacy
     05007648-7710   HCTZ/SPIRON 25-25MG TAB                           0.00        0.00     7710     Pharmacy
     05004868-7710   HALOPERIDOL LA 2MG/ML CON                         0.00        0.00     7710     Pharmacy
     05009135-7710   DYAZIDE 25-37.5MG TAB                             0.00        0.00     7710     Pharmacy
     05009136-7710   DYAZIDE 25-50MG CAP                               0.00        0.00     7710     Pharmacy
     05009137-7710   DYAZIDE 50-75MG TAB                               0.00        0.00     7710     Pharmacy
     05007366-7710   HEPARIN 20KU/D5W500                               0.00        0.00     7710     Pharmacy
     05010407-7710   IG HEPATITIS B HUMAN IM SYR                       0.00        0.00     7710     Pharmacy
     05007341-7710   HEPARIN 10000U/ML VIAL                            0.00        0.00     7710     Pharmacy
     05005791-7710   ISOPROTERENOL 0.2MG/ML SYR DIS                    0.00        0.00     7710     Pharmacy
     05013400-7710   BISOPROLOL/HCTZ 6.25/5MG TB                       0.00        0.00     7710     Pharmacy
     05000990-7710   GUAIF/COD SYRP                                    0.00        0.00     7710     Pharmacy
     05012885-7710   GLYBURIDE 3MG TAB                                 0.00        0.00     7710     Pharmacy
     05004008-7710   GLYCERIN ADULT SUPP                               0.00        0.00     7710     Pharmacy
     05004009-7710   GLYCERIN PEDIATRIC SUPP                           0.00        0.00     7710     Pharmacy
     05006230-7710   TUCKS MED PAD                                     0.00        0.00     7710     Pharmacy
     05005736-7710   GLYCOPYRROLATE .2MG/ML VL                         0.00        0.00     7710     Pharmacy
     05005737-7710   GLYCOPYRROLATE 1MG TAB                            0.00        0.00     7710     Pharmacy
     05012688-7710   GUAIF/DM 100-10MG/5ML S/F                         0.00        0.00     7710     Pharmacy
     05001171-7710   GUAIF/PSEUD 600-120MG TAB                         0.00        0.00     7710     Pharmacy
     05007677-7710   HYDROCORT/PRAM 1-1% FOAM                          0.00        0.00     7710     Pharmacy
     05000864-7710   GUAIFENESIN 600MG TAB SA                          0.00        0.00     7710     Pharmacy
     05007348-7710   HEPARIN 100U/ML VIAL                              0.00        0.00     7710     Pharmacy
     05015458-7710   VX HEMOPH FLU B PRP-T                             0.00        0.00     7710     Pharmacy
     05012355-7710   HALOBETASOL PROP .05% OIN                         0.00        0.00     7710     Pharmacy
     05004858-7710   HALOPERIDOL 0.5MG TAB                             0.00        0.00     7710     Pharmacy
     05004859-7710   HALOPERIDOL 10MG TAB                              0.00        0.00     7710     Pharmacy
     05004860-7710   HALOPERIDOL 1MG TAB                               0.00        0.00     7710     Pharmacy
     05004862-7710   HALOPERIDOL 2MG TAB                               0.00        0.00     7710     Pharmacy
     05004863-7710   HALOPERIDOL 5MG TAB                               0.00        0.00     7710     Pharmacy
     05004864-7710   HALOPERIDOL DEC100MG/MLAP                         0.00        0.00     7710     Pharmacy
     05004866-7710   HALOPERIDOL DEC50MG/MLAMP                         0.00        0.00     7710     Pharmacy
     05000859-7710   GUAIFENESIN 100MG/5ML SYP                         0.00        0.00     7710     Pharmacy



8/31/2010                                                                                                                     107
                                                c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                           CURRENT CURRENT        DEPARTMENT   DEPARTMENT DESCRIPTION
                                                               INPATIENT OUTPATIENT CODE
                                                               PRICE      PRICE
     05004260-7710   MEDROXYPROGEST 5MG TAB                          0.00        0.00     7710     Pharmacy
     05007565-7710   METHYLPRED 40MG VIAL                            0.00        0.00     7710     Pharmacy
     05007566-7710   METHYLPRED 500MG VIAL                           0.00        0.00     7710     Pharmacy
     05007551-7710   METHYLPRED ACET 80MG/ML VL                      0.00        0.00     7710     Pharmacy
     05007559-7710   METHYLPRED ACET DEPO 40MG/ML VL                 0.00        0.00     7710     Pharmacy
     05010348-7710   MEBENDAZOLE 100MG TAB CH                        0.00        0.00     7710     Pharmacy
     05005592-7710   MECLIZINE 12.5MG TAB                            0.00        0.00     7710     Pharmacy
     05005596-7710   MECLIZINE 25MG TAB                              0.00        0.00     7710     Pharmacy
     05004258-7710   MEDROXYPROGEST 10MG TAB                         0.00        0.00     7710     Pharmacy
     05004658-7710   LORAZEPAM 0.5MG TAB                             0.00        0.00     7710     Pharmacy
     05004259-7710   MEDROXYPROGEST 2.5MG TAB                        0.00        0.00     7710     Pharmacy
     05004265-7710   METHYLERGONOVIN .2MG/MLAP                       0.00        0.00     7710     Pharmacy
     05009561-7710   MEGESTROL ACET 20MG TAB                         0.00        0.00     7710     Pharmacy
     05009562-7710   MEGESTROL ACET 40MG TAB                         0.00        0.00     7710     Pharmacy
     05013391-7710   MEGESTROL ACET 40MG/ML SU                       0.00        0.00     7710     Pharmacy
     05010433-7710   MENINGOCOCCAL VACC                              0.00        0.00     7710     Pharmacy
     05014907-7710   EMOLLIENTS 0.5-0.5% LOT                         0.00        0.00     7710     Pharmacy
     05015754-7710   CEPACOL 2MG LOZG                                0.00        0.00     7710     Pharmacy
     05004389-7710   CEPASTAT LOZG                                   0.00        0.00     7710     Pharmacy
     05004970-7710   MEPERIDINE 100MG/ML SYRDI                       0.00        0.00     7710     Pharmacy
     05013088-7710   MEDROXYPROGEST 150MG/MLVL                       0.00        0.00     7710     Pharmacy
     05003613-7710   GAVISCON SUSP                                   0.00        0.00     7710     Pharmacy
     05004659-7710   LORAZEPAM 1MG TAB                               0.00        0.00     7710     Pharmacy
     05000753-7710   ISOSORBIDE DN 20MG TAB                          0.00        0.00     7710     Pharmacy
     05004575-7710   LORAZEPAM 2MG/ML VIAL                           0.00        0.00     7710     Pharmacy
     05010088-7710   ISONIAZID 300MG TAB                             0.00        0.00     7710     Pharmacy
     05014550-7710   LOSARTAN K 25MG TAB                             0.00        0.00     7710     Pharmacy
     05014551-7710   LOSARTAN K 50MG TAB                             0.00        0.00     7710     Pharmacy
     05012618-7710   LOVASTATIN 10MG TAB                             0.00        0.00     7710     Pharmacy
     05007272-7710   LOVASTATIN 20MG TAB                             0.00        0.00     7710     Pharmacy
     05007562-7710   METHYLPRED 125MG VIAL                           0.00        0.00     7710     Pharmacy
     05002234-7710   SALIVA SUBSTITE SOL                             0.00        0.00     7710     Pharmacy
     05007561-7710   METHYLPRED 1000MG VIAL                          0.00        0.00     7710     Pharmacy
     05001850-7710   MAG CL 64MG TAB SA                              0.00        0.00     7710     Pharmacy
     05003920-7710   MAG CIT SOL                                     0.00        0.00     7710     Pharmacy
     05002165-7710   MAG GLUC 1G/5ML SYRP                            0.00        0.00     7710     Pharmacy
     05003873-7710   MOM80MEQ/30MLSU                                 0.00        0.00     7710     Pharmacy
     05002185-7710   MAG SO4 50PC VIAL                               0.00        0.00     7710     Pharmacy



8/31/2010                                                                                                                   108
                                               c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                          CURRENT CURRENT        DEPARTMENT   DEPARTMENT DESCRIPTION
                                                              INPATIENT OUTPATIENT CODE
                                                              PRICE      PRICE
     05002186-7710   MAG SO4 CRYSTALS                               0.00        0.00     7710     Pharmacy
     05009114-7710   MANNITOL 20% IVSL                              0.00        0.00     7710     Pharmacy
     05009116-7710   MANNITOL 25% VIAL                              0.00        0.00     7710     Pharmacy
     05004977-7710   MEPERIDINE 50MG/ML SY DIS                      0.00        0.00     7710     Pharmacy
     05007273-7710   LOVASTATIN 40MG TAB                            0.00        0.00     7710     Pharmacy
     05009155-7710   METOLAZONE 10MG TAB                            0.00        0.00     7710     Pharmacy
     05004974-7710   MEPERIDINE 25MG/ML SY DIS                      0.00        0.00     7710     Pharmacy
     05004266-7710   METHYLERGONOVIN 0.2MG TAB                      0.00        0.00     7710     Pharmacy
     05004964-7710   METHYLPHENIDATE 10MG TAB                       0.00        0.00     7710     Pharmacy
     05004966-7710   METHYLPHENIDATE 20MGTB SA                      0.00        0.00     7710     Pharmacy
     05004967-7710   METHYLPHENIDATE 5MG TAB                        0.00        0.00     7710     Pharmacy
     05007554-7710   METHYLPRED 4MG TAB                             0.00        0.00     7710     Pharmacy
     05006043-7710   METOCLOPRAMIDE 10MG TAB                        0.00        0.00     7710     Pharmacy
     05006044-7710   METOCLOPRAMIDE 5MG TAB                         0.00        0.00     7710     Pharmacy
     05000513-7710   METHYLDOPA 500MG TAB                           0.00        0.00     7710     Pharmacy
     05006042-7710   METOCLOPRAMIDE 5MG/ML VIAL                     0.00        0.00     7710     Pharmacy
     05000511-7710   METHYLDOPA 250MG TAB                           0.00        0.00     7710     Pharmacy
     05009156-7710   METOLAZONE 2.5MG TAB                           0.00        0.00     7710     Pharmacy
     05009157-7710   METOLAZONE 5MG TAB                             0.00        0.00     7710     Pharmacy
     05012750-7710   METOPROLOL 100MG SA TAB                        0.00        0.00     7710     Pharmacy
     05012749-7710   METOPROLOL SUC 50MG SA TB                      0.00        0.00     7710     Pharmacy
     05000618-7710   METOPROLOL TART 100MG TAB                      0.00        0.00     7710     Pharmacy
     05000619-7710   METOPROLOL TART 1MG/ML AMP                     0.00        0.00     7710     Pharmacy
     05000621-7710   METOPROLOL TART 50MG TAB                       0.00        0.00     7710     Pharmacy
     05010327-7710   METRONID 500MG/100ML NS                        0.00        0.00     7710     Pharmacy
     05015059-7710   METRONIDAZOLE 0.75% CRM                        0.00        0.00     7710     Pharmacy
     05006040-7710   METOCLOPRAMIDE 5MG/5ML SYRP                    0.00        0.00     7710     Pharmacy
     05005161-7710   METHADONE 5MG/5ML SOL                          0.00        0.00     7710     Pharmacy
     05004660-7710   LORAZEPAM 2MG TAB                              0.00        0.00     7710     Pharmacy
     05004979-7710   MEPERIDINE 75MG/ML SY DIS                      0.00        0.00     7710     Pharmacy
     05000742-7710   MEPROBAMATE 400MG TAB                          0.00        0.00     7710     Pharmacy
     05013310-7710   MESALAMINE 250MG CAP SA                        0.00        0.00     7710     Pharmacy
     05012845-7710   MESALAMINE 400MG TAB EC                        0.00        0.00     7710     Pharmacy
     05012330-7710   MESALAMINE 500MG SUPP                          0.00        0.00     7710     Pharmacy
     05013922-7710   METFORMIN HCL 500MG TB                         0.00        0.00     7710     Pharmacy
     05013932-7710   METFORMIN HCL 850MG TB                         0.00        0.00     7710     Pharmacy
     05003344-7710   METHYLENE BLUE 1% AMP                          0.00        0.00     7710     Pharmacy
     05005168-7710   METHADONE 5MG TAB                              0.00        0.00     7710     Pharmacy



8/31/2010                                                                                                                  109
                                                   c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                              CURRENT CURRENT        DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                  INPATIENT OUTPATIENT CODE
                                                                  PRICE      PRICE
     05004983-7710   MEPERIDINE 50MG TAB                                0.00        0.00     7710     Pharmacy
     05007505-7710   METHIMAZOLE 10MG TAB                               0.00        0.00     7710     Pharmacy
     05007506-7710   METHIMAZOLE 5MG TAB                                0.00        0.00     7710     Pharmacy
     05005527-7710   METHOCARBAMOL 500MG TAB                            0.00        0.00     7710     Pharmacy
     05005528-7710   METHOCARBAMOL 750MG TAB                            0.00        0.00     7710     Pharmacy
     05004525-7710   METHOHEXITAL NA 500MG VL                           0.00        0.00     7710     Pharmacy
     05016330-7710   METHOTREXATE NA 2.5MG TAB                          0.00        0.00     7710     Pharmacy
     05006946-7710   ANALGESIC BALM CRM                                 0.00        0.00     7710     Pharmacy
     05004001-7710   METHYLCELLULOSE PACK                               0.00        0.00     7710     Pharmacy
     05004006-7710   METHYLCELLULOSE PWD                                0.00        0.00     7710     Pharmacy
     05005162-7710   METHADONE 10MG TAB                                 0.00        0.00     7710     Pharmacy
     05008816-7710   LEVOBUNOLOL HCL 0.5% DRP                           0.00        0.00     7710     Pharmacy
     05007478-7710   LEVOTHYROXINE 0.05MG TAB                           0.00        0.00     7710     Pharmacy
     05015147-7710   LAMIVUDINE 150MG TAB                               0.00        0.00     7710     Pharmacy
     05013942-7710   LAMOTRIGINE 100MG TAB                              0.00        0.00     7710     Pharmacy
     05013943-7710   LAMOTRIGINE 25MG TAB                               0.00        0.00     7710     Pharmacy
     05008956-7710   EYE LUBE OIN GM                                    0.00        0.00     7710     Pharmacy
     05006920-7710   LANOLIN                                            0.00        0.00     7710     Pharmacy
     05014746-7710   LANSOPRAZOLE 15MG CAP DR                           0.00        0.00     7710     Pharmacy
     05014615-7710   LANSOPRAZOLE 30MG CAP DR                           0.00        0.00     7710     Pharmacy
     05003707-7710   LACTASE 3MU TAB                                    0.00        0.00     7710     Pharmacy
     05008815-7710   LEVOBUNOLOL HCL 0.25% DRP                          0.00        0.00     7710     Pharmacy
     05000593-7710   LABETALOL HCL 5MG/ML VIAL                          0.00        0.00     7710     Pharmacy
     05002787-7710   LEVOCARNITINE 100MG/ML LQ                          0.00        0.00     7710     Pharmacy
     05015880-7710   LEVOFLOXACIN 250MG TAB                             0.00        0.00     7710     Pharmacy
     05015879-7710   LEVOFLOXACIN 25MG/ML VIAL                          0.00        0.00     7710     Pharmacy
     05015881-7710   LEVOFLOXACIN 500MG TAB                             0.00        0.00     7710     Pharmacy
     05015878-7710   LEVOFLOX 250MG/50ML D5W                            0.00        0.00     7710     Pharmacy
     05014661-7710   LOSARTAN/HCTZ 50-12.5MGTB                          0.00        0.00     7710     Pharmacy
     05016015-7710   ALESSE 0.1-0.02                                    0.00        0.00     7710     Pharmacy
     05013134-7710   LORATADINE 10MG TAB                                0.00        0.00     7710     Pharmacy
     05007477-7710   LEVOTHYROXINE 0.025MG TAB                          0.00        0.00     7710     Pharmacy
     05015612-7710   LATANOPROST 0.005% DROP                            0.00        0.00     7710     Pharmacy
     05004531-7710   KETAMINE HCL 10MG/ML VL                            0.00        0.00     7710     Pharmacy
     05000754-7710   ISOSORBIDE DN 30MG TAB                             0.00        0.00     7710     Pharmacy
     05014670-7710   ISOSORBIDE MONO 120MG SA TB                        0.00        0.00     7710     Pharmacy
     05015274-7710   ISOSORBIDE MONO 30MG SA TB                         0.00        0.00     7710     Pharmacy
     05013228-7710   ISOSORBIDE MONO 60MG SA TB                         0.00        0.00     7710     Pharmacy



8/31/2010                                                                                                                      110
                                                  c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                             CURRENT CURRENT        DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                 INPATIENT OUTPATIENT CODE
                                                                 PRICE      PRICE
     05012139-7710   ISOSULFAN BLUE 1% VIAL                            0.00        0.00     7710     Pharmacy
     05015851-7710   ISRADIPINE 5MG TAB SA                             0.00        0.00     7710     Pharmacy
     05013023-7710   ITRACONAZOLE 100MG CAP                            0.00        0.00     7710     Pharmacy
     05001871-7710   K PHOS VIAL                                       0.00        0.00     7710     Pharmacy
     05004124-7710   LACTULOSE 10G/15ML SYRP                           0.00        0.00     7710     Pharmacy
     05004530-7710   KETAMINE HCL 100MG/ML VL                          0.00        0.00     7710     Pharmacy
     05004302-7710   TRIPHASIL 6-5-10 TA                               0.00        0.00     7710     Pharmacy
     05008247-7710   KETOCONAZOLE 2% CRM                               0.00        0.00     7710     Pharmacy
     05012320-7710   KETOCONAZOLE 2% SHAM                              0.00        0.00     7710     Pharmacy
     05013238-7710   KETOROLAC 0.5% DROP                               0.00        0.00     7710     Pharmacy
     05012684-7710   KETOROLAC 10MG TAB                                0.00        0.00     7710     Pharmacy
     05016116-7710   KETOROLAC 15MG/ML VIA                             0.00        0.00     7710     Pharmacy
     05016117-7710   KETOROLAC 30MG/ML VIA                             0.00        0.00     7710     Pharmacy
     05000588-7710   LABETALOL HCL 100MG TAB                           0.00        0.00     7710     Pharmacy
     05000589-7710   LABETALOL HCL 200MG TAB                           0.00        0.00     7710     Pharmacy
     05000590-7710   LABETALOL HCL 300MG TAB                           0.00        0.00     7710     Pharmacy
     05010032-7710   KANAMYCIN 1G/3ML VIAL                             0.00        0.00     7710     Pharmacy
     05000576-7710   LISINOPRIL/HCTZ 20-12.5MG TB                      0.00        0.00     7710     Pharmacy
     05000389-7710   LIDOCAINE 1GM/D5W500                              0.00        0.00     7710     Pharmacy
     05007479-7710   LEVOTHYROXINE 0.075MG TAB                         0.00        0.00     7710     Pharmacy
     05016468-7710   EMLA 2.5-2.5% CRM                                 0.00        0.00     7710     Pharmacy
     05015882-7710   LEVOFLOX 500MG/100ML D5W                          0.00        0.00     7710     Pharmacy
     05007491-7710   LIOTHYRONINE NA 5MCG TAB                          0.00        0.00     7710     Pharmacy
     05000572-7710   LISINOPRIL 10MG TAB                               0.00        0.00     7710     Pharmacy
     05013652-7710   LISINOPRIL 2.5MG TAB                              0.00        0.00     7710     Pharmacy
     05000573-7710   LISINOPRIL 20MG TAB                               0.00        0.00     7710     Pharmacy
     05004438-7710   LIDO/EPI 2-0.001 VIAL                             0.00        0.00     7710     Pharmacy
     05000575-7710   LISINOPRIL 5MG TAB                                0.00        0.00     7710     Pharmacy
     05016413-7710   LIDOCAINE/EPI/TETRACAINE TOP SOL                  0.00        0.00     7710     Pharmacy
     05000577-7710   LISINOPRIL/HCTZ 20-25MGTB                         0.00        0.00     7710     Pharmacy
     05004897-7710   LITHIUM CARB 150MG CAP                            0.00        0.00     7710     Pharmacy
     05004898-7710   LITHIUM CARB 300MG CAP                            0.00        0.00     7710     Pharmacy
     05004900-7710   LITHIUM CARB 300MG SA TAB                         0.00        0.00     7710     Pharmacy
     05004901-7710   LITHIUM CARB 450MG SA TAB                         0.00        0.00     7710     Pharmacy
     05004904-7710   LITHIUM CIT 8MEQ/5ML SYRP                         0.00        0.00     7710     Pharmacy
     05003791-7710   LOPERAMIDE HCL 1MG/5ML LQ                         0.00        0.00     7710     Pharmacy
     05003792-7710   LOPERAMIDE HCL 2MG CAP                            0.00        0.00     7710     Pharmacy
     05003793-7710   LOPERAMIDE HCL 2MG TAB                            0.00        0.00     7710     Pharmacy



8/31/2010                                                                                                                     111
                                                c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                           CURRENT CURRENT          DEPARTMENT   DEPARTMENT DESCRIPTION
                                                               INPATIENT OUTPATIENT CODE
                                                               PRICE      PRICE
     05000574-7710   LISINOPRIL 40MG TAB                             0.00          0.00     7710     Pharmacy
     05007485-7710   LEVOTHYROXINE 0.2MG TAB                         0.00          0.00     7710     Pharmacy
     05012285-7710   LEVOTHYROXINE 0.088MG TAB                       0.00          0.00     7710     Pharmacy
     05007480-7710   LEVOTHYROXINE 0.112MG TAB                       0.00          0.00     7710     Pharmacy
     05007481-7710   LEVOTHYROXINE 0.125MG TAB                       0.00          0.00     7710     Pharmacy
     05013347-7710   LEVOTHYROXINE 0.137MG TAB                       0.00          0.00     7710     Pharmacy
     05007482-7710   LEVOTHYROXINE 0.15MG TAB                        0.00          0.00     7710     Pharmacy
     05007489-7710   LIOTHYRONINE NA 25MCG TAB                       0.00          0.00     7710     Pharmacy
     05007484-7710   LEVOTHYROXINE 0.1MG TAB                         0.00          0.00     7710     Pharmacy
     05004434-7710   LIDO/EPI 1-0.001 VIAL                           0.00          0.00     7710     Pharmacy
     05007487-7710   LEVOTHYROXINE 0.2MG VIAL                        0.00          0.00     7710     Pharmacy
     05004411-7710   LIDOCAINE 1PC AMP                               0.00          0.00     7710     Pharmacy
     05000378-7710   LIDOCAINE 1PC DIS SYR                           0.00          0.00     7710     Pharmacy
     05004423-7710   LIDOCAINE 4PC SOL                               0.00          0.00     7710     Pharmacy
     05004420-7710   LIDOCAINE 2PC VIAL                              0.00          0.00     7710     Pharmacy
     05007483-7710   LEVOTHYROXINE 0.175MG TAB                       0.00          0.00     7710     Pharmacy
     05008324-7710   LIDOCAINE HCL 5% OIN GM                         0.00          0.00     7710     Pharmacy
     05004432-7710   LIDO/EPI 1-0.0005 VIAL                          0.00          0.00     7710     Pharmacy
     05004418-7710   LIDOCAINE 2PC SOL                               0.00          0.00     7710     Pharmacy
     05000384-7710   LIDOCAINE 2PC DIS SYR                           0.00          0.00     7710     Pharmacy
     05004414-7710   LIDOCAINE 2PC AMP                               0.00          0.00     7710     Pharmacy
     05004417-7710   LIDOCAINE 2%                                    0.00          0.00     7710     Pharmacy
     05004413-7710   LIDOCAINE 1PC VIAL                              0.00          0.00     7710     Pharmacy
     05510112-7720   S NSTRL NIV EQUIPMENT CHANGE                  198.00        198.00     7720     Respiratory Care Services
     05530266-7720   BD CONTINUOUS SUBSQ DAY                       150.00        150.00     7720     Respiratory Care Services
     05530260-7720   AEROSOL TX DEMO/EVAL                          150.00        150.00     7720     Respiratory Care Services
     05520557-7720   PULSE OX-OVERNIGHT CONT                       439.00        439.00     7720     Respiratory Care Services
     05510710-7720   VENT MGMNT INIT NEO/PEDS                     2423.00       2423.00     7720     Respiratory Care Services
     05510510-7720   CPAP INITIAL DAY                             2148.00       2148.00     7720     Respiratory Care Services
     05510310-7720   VENT MGMNT INITIAL ADULT                     2423.00       2423.00     7720     Respiratory Care Services
     05530410-7720   CPT SUBSEQUENT                                128.00        128.00     7720     Respiratory Care Services
     05510121-7720   BIPAP SUBSEQUENT DAY                         1831.00       1831.00     7720     Respiratory Care Services
     05510111-7720   BIPAP INITIAL DAY                            2148.00       2148.00     7720     Respiratory Care Services
     05530720-7720   IPPB Demo/Eval                                186.00        186.00     7720     Respiratory Care Services
     05530222-7720   MDI/NEB SUBSQ                                 105.00        105.00     7720     Respiratory Care Services
     05531208-7720   SPUTUM INDCTN VIA AEROSOL                     160.00        160.00     7720     Respiratory Care Services
     05570181-7720   BRONCHOSCOPY INTERVENTN                      1247.00       1247.00     7720     Respiratory Care Services
     05530721-7720   S STRL IPPB Circuit                            82.00         82.00     7720     Respiratory Care Services



8/31/2010                                                                                                                        112
                                                     c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                                CURRENT CURRENT          DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                    INPATIENT OUTPATIENT CODE
                                                                    PRICE      PRICE
     05510161-7720   CPAP INITIAL DAY                                  2148.00       2148.00     7720     Respiratory Care Services
     05550300-7720   THER PROC RESP FNCTN 15M                           106.00        106.00     7720     Respiratory Care Services
     05550325-7720   THER PROC RESP FNCTN GRP                           106.00        106.00     7720     Respiratory Care Services
     05520567-7720   PULSE OXIMETRY MULTIPLE                            132.00        132.00     7720     Respiratory Care Services
     05530161-7720   S NSTRL Aerosol Nebulizer                           66.00         66.00     7720     Respiratory Care Services
     05530220-7720   MDI/Neb Demo/Eval                                  105.00        105.00     7720     Respiratory Care Services
     05530160-7720   Aerosol Tx Demo/Eval                               160.00        160.00     7720     Respiratory Care Services
     05560800-7720   AIRWAY RESISTANCE                                  180.00        180.00     7720     Respiratory Care Services
     05530433-7720   CPT SUBSEQUENT                                     128.00        128.00     7720     Respiratory Care Services
     05510113-7720   BIPAP INITIAL DAY                                 2148.00       2148.00     7720     Respiratory Care Services
     05530257-7720   MDI/NEB SUBSQ                                      105.00        105.00     7720     Respiratory Care Services
     05530211-7720   AEROSOL TX SUBSQ                                   160.00        160.00     7720     Respiratory Care Services
     05510123-7720   BIPAP SUBSEQUENT DAY                              1831.00       1831.00     7720     Respiratory Care Services
     05530255-7720   MDI/Neb Demo/Eval                                  105.00        105.00     7720     Respiratory Care Services
     05540257-7720   CPR                                               1089.00       1089.00     7720     Respiratory Care Services
     05570155-7720   BRONCHOSCOPY                                      1155.00       1155.00     7720     Respiratory Care Services
     05541008-7720   SUCTION NASOTRACHEAL                                74.00         74.00     7720     Respiratory Care Services
     05541107-7720   S STRL Trach Care Cath                             141.00        141.00     7720     Respiratory Care Services
     05550108-7720   Home Mngmnt Training 15M                           122.00        122.00     7720     Respiratory Care Services
     05560156-7720   SPIROMETRY PRE/POST BD                             528.00        528.00     7720     Respiratory Care Services
     05560206-7720   SPIROMETRY                                         263.00        263.00     7720     Respiratory Care Services
     05560305-7720   CO DIFFUSING CAPACITY                              287.00        287.00     7720     Respiratory Care Services
     05560404-7720   FUNCTIONAL RES CAP/VOL                             366.00        366.00     7720     Respiratory Care Services
     05530803-7720   IPPB TX SUBSEQUENT                                 186.00        186.00     7720     Respiratory Care Services
     05560602-7720   VITAL CAPACITY                                      46.00         46.00     7720     Respiratory Care Services
     05530225-7720   MDI/Neb Demo/Eval                                  105.00        105.00     7720     Respiratory Care Services
     05570403-7720   S STRL Passy Muir Valve (1 Pr)                     524.00        524.00     7720     Respiratory Care Services
     05530217-7720   S STRL MDI-Inline Spacer                            72.00         72.00     7720     Respiratory Care Services
     05530233-7720   MDI/NEB SUBSQ                                      105.00        105.00     7720     Respiratory Care Services
     05530407-7720   CPT INITIAL                                        128.00        128.00     7720     Respiratory Care Services
     05511266-7720   S O2 By Head Hood Subsequent Days                  619.00        619.00     7720     Respiratory Care Services
     05511258-7720   S O2 By Head Hood Initial Day                      865.00        865.00     7720     Respiratory Care Services
     05560701-7720   S NSTRL Peak Flow Meter                            118.00        118.00     7720     Respiratory Care Services
     05520153-7720   EKG 12 LEAD TRACING                                222.00        222.00     7720     Respiratory Care Services
     05560503-7720   SPIROMETRY                                         154.00        154.00     7720     Respiratory Care Services
     05530209-7720   AEROSOL TX SUBSQ                                   156.00        156.00     7720     Respiratory Care Services
     05510201-7720   CPAP SUBSEQUENT DAY                               1831.00       1831.00     7720     Respiratory Care Services
     05510409-7720   VENT MGMNT SUBSEQUENT                             2018.00       2018.00     7720     Respiratory Care Services



8/31/2010                                                                                                                             113
                                                     c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                                CURRENT CURRENT          DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                    INPATIENT OUTPATIENT CODE
                                                                    PRICE      PRICE
     05510607-7720   CPAP SUBSEQUENT DAY                               1831.00       1831.00     7720     Respiratory Care Services
     05510805-7720   VENT MGMNT SUBSQ NEO/PEDS                         2018.00       2018.00     7720     Respiratory Care Services
     05510904-7720   S O2 Oxygen Initial Day                            870.00        870.00     7720     Respiratory Care Services
     05511001-7720   S O2 Oxygen Subsequent Days                        706.00        706.00     7720     Respiratory Care Services
     05511100-7720   S O2 By Aerosol Initial Day                        865.00        865.00     7720     Respiratory Care Services
     05520507-7720   PULSE OXIMETRY SINGLE                               98.00         98.00     7720     Respiratory Care Services
     05520606-7720   S STRL Oximetry Sensor-Adult                       256.00        256.00     7720     Respiratory Care Services
     05520705-7720   S STRL Oximetry Sensor-Infant                      256.00        256.00     7720     Respiratory Care Services
     05520804-7720   TCM INITIAL DAY                                    930.00        930.00     7720     Respiratory Care Services
     06511000-7740   DIALYS HEMO IP                                    3752.00       3752.00     7740     Acute Renal Dialysis
     06510002-7740   DIALYS HEMO IP                                    3752.00       3752.00     7740     Acute Renal Dialysis
     06513423-7745   DARBEPOETIN 200 MCG IJ                            2232.95       2232.95     7745     Renal Dialysis
     06513407-7745   DARBEPOETIN 40 MCG IJ                              489.83        489.83     7745     Renal Dialysis
     06513411-7745   DARBEPOETIN 60 MCG IJ                              707.57        707.57     7745     Renal Dialysis
     06513415-7745   DARBEPOETIN 100 MCG IJ                            1143.45       1143.45     7745     Renal Dialysis
     06514520-7745   ADMIN HEPATITIS B VACC                               2.00          2.00     7745     Renal Dialysis
     08514520-7745   ADMIN HEPATITIS B VACC                               2.00          2.00     7745     Renal Dialysis
     06514540-7745   ADMIN PNEUMOCOCCAL VACC                              2.00          2.00     7745     Renal Dialysis
     06513403-7745   DARBEPOETIN 25 MCG IJ                              326.33        326.33     7745     Renal Dialysis
     06513419-7745   DARBEPOETIN 150 MCG IJ                            2232.95       2232.95     7745     Renal Dialysis
     06554117-7745   DIALYS HEMO OP                                    1034.00       1034.00     7745     Renal Dialysis
     06513004-7745   EPOETIN 400U IJ                                    112.77        112.77     7745     Renal Dialysis
     06513139-7745   EPOETIN 7000U IJ                                   348.07        348.07     7745     Renal Dialysis
     06513048-7745   EPOETIN 2500U IJ                                   142.21        142.21     7745     Renal Dialysis
     06513055-7745   EPOETIN 3000U IJ                                   142.21        142.21     7745     Renal Dialysis
     06550008-7745   DIALYS HEMO OP                                    1034.00       1034.00     7745     Renal Dialysis
     06513196-7745   EPOETIN 10000U IJ                                  348.07        348.07     7745     Renal Dialysis
     06510002-7745   DIALYS HEMO IP                                    3752.00       3752.00     7745     Renal Dialysis
     06513071-7745   EPOETIN 4000U IJ                                   171.61        171.61     7745     Renal Dialysis
     06513400-7745   EPOETIN 20000U IJ                                  686.57        686.57     7745     Renal Dialysis
     06514500-7745   S STRL DRUG ADMIN SUPPLIES                           2.00          2.00     7745     Renal Dialysis
     06514510-7745   S STRL BLOOD ADMIN SUPPLIES                         21.00         21.00     7745     Renal Dialysis
     08513207-7746   DARBEPOETIN 40 MCG IJ                              489.83        489.83     7746     Renal Dialysis North
     08513203-7746   DARBEPOETIN 25 MCG IJ                              326.33        326.33     7746     Renal Dialysis North
     08514540-7746   ADMIN PNEUMOCOCCAL VACC                              2.00          2.00     7746     Renal Dialysis North
     08413411-7746   DARBEPOETIN 60 MCG IJ                              707.57        707.57     7746     Renal Dialysis North
     08413423-7746   DARBEPOETIN 200 MCG IJ                            2232.95       2232.95     7746     Renal Dialysis North
     08413407-7746   DARBEPOETIN 40 MCG IJ                              489.83        489.83     7746     Renal Dialysis North



8/31/2010                                                                                                                             114
                                                  c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                             CURRENT CURRENT          DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                 INPATIENT OUTPATIENT CODE
                                                                 PRICE      PRICE
     08513211-7746   DARBEPOETIN 60 MCG IJ                           707.57        707.57     7746     Renal Dialysis North
     08513219-7746   DARBEPOETIN 150 MCG IJ                         2232.95       2232.95     7746     Renal Dialysis North
     08514520-7746   ADMIN HEPATITIS B VACC                            2.00          2.00     7746     Renal Dialysis North
     08513223-7746   DARBEPOETIN 200 MCG IJ                         2232.95       2232.95     7746     Renal Dialysis North
     08513215-7746   DARBEPOETIN 100 MCG IJ                         1143.45       1143.45     7746     Renal Dialysis North
     08513231-7746   DARBEPOETIN 500 MCG IJ                         5611.45       5611.45     7746     Renal Dialysis North
     08513227-7746   DARBEPOETIN 300 MCG IJ                         3322.45       3322.45     7746     Renal Dialysis North
     08550006-7746   DIALYS HEMO OP                                 1034.00       1034.00     7746     Renal Dialysis North
     08513002-7746   EPOETIN 200U IJ                                 112.77        112.77     7746     Renal Dialysis North
     08412447-7746   DIALYS CAPD OP                                  477.00        477.00     7746     Renal Dialysis North
     08513137-7746   EPOETIN 7000U IJ                                348.07        348.07     7746     Renal Dialysis North
     08514500-7746   S STRL DRUG ADMIN SUPPLIES                        2.00          2.00     7746     Renal Dialysis North
     06413411-7747   DARBEPOETIN 60 MCG IJ                           707.57        707.57     7747     CAPD
     06413407-7747   DARBEPOETIN 40 MCG IJ                           489.83        489.83     7747     CAPD
     06413415-7747   DARBEPOETIN 100 MCG IJ                         1143.45       1143.45     7747     CAPD
     06413423-7747   DARBEPOETIN 200 MCG IJ                         2232.95       2232.95     7747     CAPD
     06414540-7747   ADMIN PNEUMOCOCCAL VACC                           2.00          2.00     7747     CAPD
     06414520-7747   ADMIN HEPATITIS B VACC                            2.00          2.00     7747     CAPD
     06413403-7747   DARBEPOETIN 25 MCG IJ                           326.33        326.33     7747     CAPD
     06412340-7747   DIALYS TRAIN EA SESS CAPD                      1144.00       1144.00     7747     CAPD
     06412449-7747   DIALYS CAPD OP                                  477.00        477.00     7747     CAPD
     06414500-7747   S STRL DRUG ADMIN SUPPLIES                        2.00          2.00     7747     CAPD
     08413427-7748   DARBEPOETIN 300 MCG IJ                         3322.45       3322.45     7748     CAPD North
     08413423-7748   DARBEPOETIN 200 MCG IJ                         2232.95       2232.95     7748     CAPD North
     08413411-7748   DARBEPOETIN 60 MCG IJ                           707.57        707.57     7748     CAPD North
     08413415-7748   DARBEPOETIN 100 MCG IJ                         1143.45       1143.45     7748     CAPD North
     08413407-7748   DARBEPOETIN 40 MCG IJ                           489.83        489.83     7748     CAPD North
     08413403-7748   DARBEPOETIN 25 MCG IJ                           326.33        326.33     7748     CAPD North
     08413431-7748   DARBEPOETIN 500 MCG IJ                         5611.45       5611.45     7748     CAPD North
     06413001-7748   EPOETIN 100U IJ                                 112.77        112.77     7748     CAPD North
     08412447-7748   DIALYS CAPD OP                                  477.00        477.00     7748     CAPD North
     08412348-7748   DIALYS TRAIN EA SESS CAPD                      1144.00       1144.00     7748     CAPD North
     08412306-7748   DIALYS TRAIN EA SESS CAPD                      1144.00       1144.00     7748     CAPD North
     08514500-7748   S STRL DRUG ADMIN SUPPLIES                        2.00          2.00     7748     CAPD North
     08414500-7748   S STRL DRUG ADMIN SUPPLIES                        2.00          2.00     7748     CAPD North
     06200050-7760   S STRL Metal Wall Stent                        3920.00       3920.00     7760     Endoscopy Services
     06254007-7760   COLONOSCOPY INTERVENTN                         5346.00       5346.00     7760     Endoscopy Services
     06254056-7760   GASTROSTOMY TUBE CHANGE                         356.00        356.00     7760     Endoscopy Services



8/31/2010                                                                                                                       115
                                                 c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                            CURRENT CURRENT          DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                INPATIENT OUTPATIENT CODE
                                                                PRICE      PRICE
     06254049-7760   SIGMOIDOSCOPY                                 2257.00       2257.00     7760     Endoscopy Services
     06254028-7760   ERCP                                          8316.00       8316.00     7760     Endoscopy Services
     06254021-7760   EGD INTERVENTN                                5346.00       5346.00     7760     Endoscopy Services
     06254000-7760   COLONOSCOPY                                   3802.00       3802.00     7760     Endoscopy Services
     06254014-7760   EGD                                           4158.00       4158.00     7760     Endoscopy Services
     06220773-7760   CA ECHO TRANSESOPHAGEAL                       2138.00       2138.00     7760     Endoscopy Services
     06220181-7760   ERCP INTERVENTN                              13068.00      13068.00     7760     Endoscopy Services
     06200126-7760   S NSTRL PYLORTEK                               238.00        238.00     7760     Endoscopy Services
     05634455-7770   PT Fnx Act Init 30                             299.00        299.00     7770     Physical Therapy
     05624700-7770   PT Aquatc Ther Ea 15                           150.00        150.00     7770     Physical Therapy
     05625015-7770   PT Trn Biofd Any Modal 15                      150.00        150.00     7770     Physical Therapy
     05634489-7770   PT Ther Ex Add 15                              150.00        150.00     7770     Physical Therapy
     05634700-7770   PT Aquatc Ther Ex Init 30                      299.00        299.00     7770     Physical Therapy
     05634701-7770   PT Aquatc Ther Ex Add 15                       150.00        150.00     7770     Physical Therapy
     05624488-7770   PT Ther Ex Ea 15                               138.00        138.00     7770     Physical Therapy
     05634405-7770   PT Neuromusc ReEd Init 30                      299.00        299.00     7770     Physical Therapy
     05634410-7770   PT Gait Train Init 30                          299.00        299.00     7770     Physical Therapy
     05634488-7770   PT Ther Ex Init 30                             299.00        299.00     7770     Physical Therapy
     05624400-7770   PT Manual Ther Ea 15                           138.00        138.00     7770     Physical Therapy
     05634456-7770   PT Fnx Act Add 15                              150.00        150.00     7770     Physical Therapy
     05623045-7770   PT Proc Ther Gp 45                             150.00        150.00     7770     Physical Therapy
     05633030-7770   PT Exer Gp Init 30                             299.00        299.00     7770     Physical Therapy
     05623030-7770   PT Proc Ther Gp 30                             105.00        105.00     7770     Physical Therapy
     05680015-7770   PT Eval Brief                                  150.00        150.00     7770     Physical Therapy
     05680030-7770   PT Eval Ltd                                    299.00        299.00     7770     Physical Therapy
     05623060-7770   PT Proc Ther Gp 60                             200.00        200.00     7770     Physical Therapy
     05638215-7770   PT E-Stim Sup Init 30                          299.00        299.00     7770     Physical Therapy
     05630001-7770   PT Treat Combo Add 15                          150.00        150.00     7770     Physical Therapy
     05624425-7770   PT Orthotic Train Ea 15                        150.00        150.00     7770     Physical Therapy
     05630015-7770   PT Eval Add 15                                 150.00        150.00     7770     Physical Therapy
     05630000-7770   PT Treat Combo Init 30                         299.00        299.00     7770     Physical Therapy
     05624435-7770   PT ADL Train Ea 15                             150.00        150.00     7770     Physical Therapy
     05624440-7770   PT Community Reint Ea 15                       150.00        150.00     7770     Physical Therapy
     05630030-7770   PT Eval Init 30                                299.00        299.00     7770     Physical Therapy
     05625030-7770   PT Trn Biofd Any Modal 30                      299.00        299.00     7770     Physical Therapy
     05634403-7770   PT Myofasc Rel Add 15                          150.00        150.00     7770     Physical Therapy
     05680045-7770   PT Eval Intermediate                           449.00        449.00     7770     Physical Therapy
     05624405-7770   PT Neuromusc ReEd Ea 15                        150.00        150.00     7770     Physical Therapy



8/31/2010                                                                                                                      116
                                                 c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                            CURRENT CURRENT          DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                INPATIENT OUTPATIENT CODE
                                                                PRICE      PRICE
     05624455-7770   PT Ther Act Ea 15                              138.00        138.00     7770     Physical Therapy
     05638010-7770   PT Ultrasound Init 30                          299.00        299.00     7770     Physical Therapy
     05634400-7770   PT Joint Mob Init 30                           299.00        299.00     7770     Physical Therapy
     05634401-7770   PT Joint Mob Add 15                            150.00        150.00     7770     Physical Therapy
     05624410-7770   PT Gait Train Ea 15                            150.00        150.00     7770     Physical Therapy
     05631005-7770   PT E-Stim Sup Init 30                          299.00        299.00     7770     Physical Therapy
     05634404-7770   PT Myofasc Rel Init 30                         299.00        299.00     7770     Physical Therapy
     05624420-7770   PT WHLCHR MNG/TRAIN EA 15                      150.00        150.00     7770     Physical Therapy
     05622010-7770   PT Debride Non-Select 15                       150.00        150.00     7770     Physical Therapy
     05684425-7770   PT Orthotic Train Init 30                      299.00        299.00     7770     Physical Therapy
     05628005-7770   PT Iontophoresis Ea 15                         150.00        150.00     7770     Physical Therapy
     05620060-7770   PT Eval 60                                     598.00        598.00     7770     Physical Therapy
     05620045-7770   PT Eval 45                                     449.00        449.00     7770     Physical Therapy
     05620030-7770   PT Eval 30                                     299.00        299.00     7770     Physical Therapy
     05684701-7770   PT Aquatc Ther Ex Add 15                       150.00        150.00     7770     Physical Therapy
     05684405-7770   PT Neuromusc ReEd Init 30                      299.00        299.00     7770     Physical Therapy
     05684411-7770   PT Gait Train Add 15                           150.00        150.00     7770     Physical Therapy
     05620115-7770   PT Re-Eval 15                                  150.00        150.00     7770     Physical Therapy
     05684456-7770   PT Fnx Act Add 15                              150.00        150.00     7770     Physical Therapy
     05621000-7770   PT Mech Tract 15                               150.00        150.00     7770     Physical Therapy
     05628020-7770   PT Contrast Baths Ea 15                        150.00        150.00     7770     Physical Therapy
     05683030-7770   PT Exer Gp Init 30                             299.00        299.00     7770     Physical Therapy
     05683015-7770   PT Exer Gp Add 15                              150.00        150.00     7770     Physical Therapy
     05689360-7770   PT Eval Fnx Capacity 360                      3592.00       3592.00     7770     Physical Therapy
     05682090-7770   PT Job Site Assess 90                          899.00        899.00     7770     Physical Therapy
     05686000-7770   PT Gym Per Prior Auth                          150.00        150.00     7770     Physical Therapy
     05684720-7770   PT Aqtc Per Prior Auth                         113.00        113.00     7770     Physical Therapy
     05684710-7770   EP Aqtc Prior Auth Ind                          75.00         75.00     7770     Physical Therapy
     05684455-7770   PT Fnx Act Init 30                             299.00        299.00     7770     Physical Therapy
     05620015-7770   PT Eval 15                                     150.00        150.00     7770     Physical Therapy
     05681000-7770   PT Mech Tract 15                               150.00        150.00     7770     Physical Therapy
     05681005-7770   PT E-Stim Supervised 15                        150.00        150.00     7770     Physical Therapy
     05688215-7770   PT E-Stim Manual Init 30                       299.00        299.00     7770     Physical Therapy
     05688005-7770   PT Iontophoresis Init 30                       299.00        299.00     7770     Physical Therapy
     05688010-7770   PT Ultrasound Init 30                          299.00        299.00     7770     Physical Therapy
     05684401-7770   PT Joint Mob Ea Visit                          150.00        150.00     7770     Physical Therapy
     05684402-7770   PT Manual Tract Init 30                        299.00        299.00     7770     Physical Therapy
     05620090-7770   PT Eval 90                                     899.00        899.00     7770     Physical Therapy



8/31/2010                                                                                                                      117
                                                 c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                            CURRENT CURRENT         DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                INPATIENT OUTPATIENT CODE
                                                                PRICE      PRICE
     05628215-7770   PT E-Stim Ea 15                                150.00       150.00     7770     Physical Therapy
     05680060-7770   PT Eval Extended                               299.00       299.00     7770     Physical Therapy
     05628010-7770   PT Ultrasound Ea 15                            150.00       150.00     7770     Physical Therapy
     05684488-7770   PT Ther Ex Init 30                             299.00       299.00     7770     Physical Therapy
     05621130-7770   PT Whirlpool 30                                299.00       299.00     7770     Physical Therapy
     05684489-7770   PT Ther Ex Add 15                              150.00       150.00     7770     Physical Therapy
     05621115-7770   PT Whirlpool 15                                150.00       150.00     7770     Physical Therapy
     05684410-7770   PT Gait Train Init 30                          299.00       299.00     7770     Physical Therapy
     05621050-7770   PT Paraffin Bath 15                            150.00       150.00     7770     Physical Therapy
     05621005-7770   PT E-Stim Supervised 15                        150.00       150.00     7770     Physical Therapy
     05684700-7770   PT Aquatc Ther Ex Init 30                      299.00       299.00     7770     Physical Therapy
     05684403-7770   PT Myofac/Soft Mob 30                          299.00       299.00     7770     Physical Therapy
     05600001-7770   Cancellation Charge                             30.00        30.00     7770     Physical Therapy
     05855045-7780   SP Tx Sp/Lang/Com Gp 45                         98.00        98.00     7780     Speech & Audiology
     05890860-7780   AD HEAR AID BIN ITC DIG                          0.00         0.00     7780     Speech & Audiology
     05896200-7780   AD Pure Tone Air                               218.00       218.00     7780     Speech & Audiology
     05886230-7780   AD ACSTC REFLX TST THRHLD                      109.00       109.00     7780     Speech & Audiology
     05896230-7780   AD ACSTC REFLX TST THRHLD                      109.00       109.00     7780     Speech & Audiology
     05896210-7780   AD Scrn OAE                                    437.00       437.00     7780     Speech & Audiology
     05886210-7780   AD Scrn OAE                                    437.00       437.00     7780     Speech & Audiology
     05886200-7780   AD Pure Tone Air                               218.00       218.00     7780     Speech & Audiology
     05854090-7780   SP Eval Mtn Fluor Swal 90                      656.00       656.00     7780     Speech & Audiology
     05897999-7780   AD HEAR AID ACCESSORIES                        218.00       218.00     7780     Speech & Audiology
     05897950-7780   AD HEAR AID MON ITE                              0.00         0.00     7780     Speech & Audiology
     05897940-7780   AD HEAR AID MON BTE                              0.00         0.00     7780     Speech & Audiology
     05897930-7780   AD HEAR AID BIN ITC                              0.00         0.00     7780     Speech & Audiology
     05886240-7780   AD Tympanometry                                218.00       218.00     7780     Speech & Audiology
     05897920-7780   AD Hear Aid Bin BTE                              0.00         0.00     7780     Speech & Audiology
     05860060-7780   SP Eval 60                                     437.00       437.00     7780     Speech & Audiology
     05887910-7780   AD HEAR AID BIN ITC DIG                          0.00         0.00     7780     Speech & Audiology
     05890840-7780   AD Eval Hear Aid Mon                           218.00       218.00     7780     Speech & Audiology
     05880820-7780   AD Eval ABR                                    875.00       875.00     7780     Speech & Audiology
     05890820-7780   AD EVAL ABR                                    875.00       875.00     7780     Speech & Audiology
     05897900-7780   AD CUSTOM EAR MOLD                             218.00       218.00     7780     Speech & Audiology
     05890800-7780   AD Audio Condition Play                        437.00       437.00     7780     Speech & Audiology
     05880810-7780   AD Audiometry Comp                             656.00       656.00     7780     Speech & Audiology
     05880800-7780   AD Audio Condition Play                        437.00       437.00     7780     Speech & Audiology
     05856160-7780   SP Tx Swall/Oral Fnx 60                        437.00       437.00     7780     Speech & Audiology



8/31/2010                                                                                                                     118
                                                 c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                            CURRENT CURRENT         DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                INPATIENT OUTPATIENT CODE
                                                                PRICE      PRICE
     05856145-7780   SP Tx Swall/Oral Fnx 45                        328.00       328.00     7780     Speech & Audiology
     05856130-7780   SP Tx Swall/Oral Fnx 30                        218.00       218.00     7780     Speech & Audiology
     05800003-7780   Cancellation Charge                             32.00        32.00     7780     Speech & Audiology
     05887920-7780   AD Hear Aid Bin BTE                              0.00         0.00     7780     Speech & Audiology
     05854120-7780   SP Eval Mtn Fluor Swa 120                      875.00       875.00     7780     Speech & Audiology
     05856060-7780   SP TX SP/LANG/COM IND 60                       437.00       437.00     7780     Speech & Audiology
     05856045-7780   SP TX SP/LANG/COM IND 45                       328.00       328.00     7780     Speech & Audiology
     05856030-7780   SP TX SP/LANG/COM IND 30                       218.00       218.00     7780     Speech & Audiology
     05856015-7780   SP TX SP/LANG/COM IND 15                       109.00       109.00     7780     Speech & Audiology
     05866060-7780   SP Ther Sp/Lang Ea 60                          437.00       437.00     7780     Speech & Audiology
     05866030-7780   SP Sp/Lang Ther Ea 30                          218.00       218.00     7780     Speech & Audiology
     05853060-7780   SP EVAL SP/LNG/COM/AUD 60                      437.00       437.00     7780     Speech & Audiology
     05853090-7780   SP EVAL SP/LNG/COM/AUD 90                      656.00       656.00     7780     Speech & Audiology
     05853045-7780   SP EVAL SP/LNG/COM/AUD 45                      328.00       328.00     7780     Speech & Audiology
     05853120-7780   SP EVL SP/LNG/COM/AUD 120                      875.00       875.00     7780     Speech & Audiology
     05853105-7780   SP EVL SP/LNG/COM/AUD 105                      765.00       765.00     7780     Speech & Audiology
     05896240-7780   AD Tympanometry                                218.00       218.00     7780     Speech & Audiology
     05856115-7780   SP Tx Swall/Oral Fnx 15                        109.00       109.00     7780     Speech & Audiology
     05855030-7780   SP Tx Sp/Lang/Com Gp 30                         66.00        66.00     7780     Speech & Audiology
     05897955-7780   AD HEAR AID REPAIR                               0.00         0.00     7780     Speech & Audiology
     05897945-7780   AD Eval Hear Aid Mon                           218.00       218.00     7780     Speech & Audiology
     05863060-7780   SP Eval Lang 60                                437.00       437.00     7780     Speech & Audiology
     05887935-7780   AD Eval Hear Aid Bin                           218.00       218.00     7780     Speech & Audiology
     05851090-7780   SP Eval Fnx Swall 90                           656.00       656.00     7780     Speech & Audiology
     05851075-7780   SP Eval Fnx Swall 75                           546.00       546.00     7780     Speech & Audiology
     05851120-7780   SP Eval Fnx Swall 120                          875.00       875.00     7780     Speech & Audiology
     05845305-7780   AD EVAL PEDS >3 VRA                            437.00       437.00     7780     Speech & Audiology
     05842311-7780   AD AUDITORY FUNCTN 60 MIN                      437.00       437.00     7780     Speech & Audiology
     05880832-7780   AD TINNITUS ASSMNT UNI                         656.00       656.00     7780     Speech & Audiology
     05845303-7780   AD EVAL PEDS <3 VRA                            437.00       437.00     7780     Speech & Audiology
     05880812-7780   AD AUDIOMETRY COMP (7-AD)                      656.00       656.00     7780     Speech & Audiology
     05840863-7780   AD TEST ELECTROACOUST BIN                      218.00       218.00     7780     Speech & Audiology
     05785025-7790   OT Tx Phys Med Ea 15                           138.00       138.00     7790     Occupational Therapy
     05786045-7790   OT Job Site Assess 45                          413.00       413.00     7790     Occupational Therapy
     05786075-7790   OT Job Site Assess 75                          687.00       687.00     7790     Occupational Therapy
     05742030-7790   OT Exer GP Init 30                              92.00        92.00     7790     Occupational Therapy
     05742015-7790   OT Exer GP Add 15                               46.00        46.00     7790     Occupational Therapy
     05784035-7790   OT E-Stim Manual Init 30                       274.00       274.00     7790     Occupational Therapy



8/31/2010                                                                                                                     119
                                                 c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                            CURRENT CURRENT          DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                INPATIENT OUTPATIENT CODE
                                                                PRICE      PRICE
     05720060-7790   OT WHLCHR MNG/TRAIN EA 15                      138.00        138.00     7790     Occupational Therapy
     05724090-7790   OT Ultrasound Ea 15                            138.00        138.00     7790     Occupational Therapy
     05720010-7790   OT Neuromusc ReEd Ea 15                        138.00        138.00     7790     Occupational Therapy
     05784120-7790   OT Work Cond Init 120                         1097.00       1097.00     7790     Occupational Therapy
     05786120-7790   OT Job Site Assess 120                        1097.00       1097.00     7790     Occupational Therapy
     05722030-7790   OT Proc Ther Gp 30                              92.00         92.00     7790     Occupational Therapy
     05784060-7790   OT Work Cond Add 60                            549.00        549.00     7790     Occupational Therapy
     05741050-7790   OT Ther Ex Init 30                             274.00        274.00     7790     Occupational Therapy
     05720900-7790   XR DEXA AXIAL SKELETON                         537.00        537.00     7790     Occupational Therapy
     05724015-7790   OT E-Stim Supervised 15                        138.00        138.00     7790     Occupational Therapy
     05720030-7790   OT Community ReInt Ea 15                       138.00        138.00     7790     Occupational Therapy
     05740000-7790   OT ADL Train Init 30                           274.00        274.00     7790     Occupational Therapy
     05720020-7790   OT Cogn Retrain Ea 15                          138.00        138.00     7790     Occupational Therapy
     05740010-7790   OT Neuromusc ReEd Init 30                      274.00        274.00     7790     Occupational Therapy
     05741001-7790   OT Ther Act Add 15                             138.00        138.00     7790     Occupational Therapy
     05741015-7790   OT Eval Add 15                                 138.00        138.00     7790     Occupational Therapy
     05741030-7790   OT Eval Init 30                                274.00        274.00     7790     Occupational Therapy
     05721000-7790   OT Ther Act Ea 15                              138.00        138.00     7790     Occupational Therapy
     05721060-7790   OT Eval 60                                     549.00        549.00     7790     Occupational Therapy
     05720040-7790   OT Orthotic Train Ea 15                        138.00        138.00     7790     Occupational Therapy
     05721005-7790   OT Ther Ex Ea 15                               138.00        138.00     7790     Occupational Therapy
     05721120-7790   OT Eval 120                                   1097.00       1097.00     7790     Occupational Therapy
     05722090-7790   OT Proc Ther Gp 90                             274.00        274.00     7790     Occupational Therapy
     05720000-7790   OT ADL Train Ea 15                             138.00        138.00     7790     Occupational Therapy
     05722060-7790   OT Proc Ther Gp 60                             178.00        178.00     7790     Occupational Therapy
     05721030-7790   OT Eval 30                                     274.00        274.00     7790     Occupational Therapy
     05724071-7790   OT Paraffin Bath 15                             36.00         36.00     7790     Occupational Therapy
     05721045-7790   OT Eval 45                                     413.00        413.00     7790     Occupational Therapy
     05724050-7790   OT Iontophoresis Ea 15                         138.00        138.00     7790     Occupational Therapy
     05721075-7790   OT Eval 75                                     687.00        687.00     7790     Occupational Therapy
     05721090-7790   OT Eval 90                                     823.00        823.00     7790     Occupational Therapy
     05722015-7790   OT Proc Ther Gp 15                              46.00         46.00     7790     Occupational Therapy
     05722045-7790   OT Proc Ther Gp 45                             123.00        123.00     7790     Occupational Therapy
     05722075-7790   OT Proc Ther Gp 75                             254.00        254.00     7790     Occupational Therapy
     05724000-7790   OT E-Stim Ea 15                                138.00        138.00     7790     Occupational Therapy
     05741000-7790   OT Ther Act Init 30                            274.00        274.00     7790     Occupational Therapy
     05721015-7790   OT Eval 15                                     138.00        138.00     7790     Occupational Therapy
     05781360-7790   OT Eval Fnx Capacity 360                      3293.00       3293.00     7790     Occupational Therapy



8/31/2010                                                                                                                      120
                                                 c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                            CURRENT CURRENT          DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                INPATIENT OUTPATIENT CODE
                                                                PRICE      PRICE
     05780040-7790   OT Orthotic Train Init 30                      274.00        274.00     7790     Occupational Therapy
     05781000-7790   OT Ther Act Init 30                            274.00        274.00     7790     Occupational Therapy
     05740001-7790   OT ADL Train Add 15                            138.00        138.00     7790     Occupational Therapy
     05781001-7790   OT Ther Act Add 15                             138.00        138.00     7790     Occupational Therapy
     05781030-7790   OT Eval Ltd                                    274.00        274.00     7790     Occupational Therapy
     05781050-7790   OT Ther Ex Init 30                             274.00        274.00     7790     Occupational Therapy
     05781051-7790   OT Ther Ex Add 15                              138.00        138.00     7790     Occupational Therapy
     05780001-7790   OT ADL Train Add 15                            138.00        138.00     7790     Occupational Therapy
     05781160-7790   OT Eval Fnx Capacity 60                        549.00        549.00     7790     Occupational Therapy
     05780041-7790   OT Orthotic Train Add 15                       138.00        138.00     7790     Occupational Therapy
     05781480-7790   OT Eval Fnx Capacity 480                      4391.00       4391.00     7790     Occupational Therapy
     05784050-7790   OT Iontophoresis Init 30                       274.00        274.00     7790     Occupational Therapy
     05784070-7790   OT Paraffin Bath 15                             36.00         36.00     7790     Occupational Therapy
     05784085-7790   OT Orthotic Fab Init 30                        274.00        274.00     7790     Occupational Therapy
     05784090-7790   OT Ultrasound Init 30                          274.00        274.00     7790     Occupational Therapy
     05786060-7790   OT Job Site Assess 60                          549.00        549.00     7790     Occupational Therapy
     05786090-7790   OT Job Site Assess 90                          823.00        823.00     7790     Occupational Therapy
     05781060-7790   OT Eval Intermediate                           413.00        413.00     7790     Occupational Therapy
     05744070-7790   OT Paraffin Bath Init 30                        36.00         36.00     7790     Occupational Therapy
     05744071-7790   OT Paraffin Bath Add 15                         18.00         18.00     7790     Occupational Therapy
     05780000-7790   OT ADL Train Init 30                           274.00        274.00     7790     Occupational Therapy
     05744085-7790   OT Orthotic Fab Init 30                        274.00        274.00     7790     Occupational Therapy
     05741076-7790   OT EXER GP ADD 15                              138.00        138.00     7790     Occupational Therapy
     05741051-7790   OT Ther Ex Add 15                              138.00        138.00     7790     Occupational Therapy
     05786030-7790   OT JOB SITE ASSESS 30                          274.00        274.00     7790     Occupational Therapy
     05726000-7790   Pre-Driving Evaluation                         270.00        270.00     7790     Occupational Therapy
     05720041-7790   OT APP SPLNT SHRT ARM STA                      275.00        275.00     7790     Occupational Therapy
     05720042-7790   OT APP SPLNT SHRT ARM STA                      414.00        414.00     7790     Occupational Therapy
     05720045-7790   OT APP SPLNT FINGER STA                        414.00        414.00     7790     Occupational Therapy
     05720046-7790   OT APP SPLNT FINGER DYN                        414.00        414.00     7790     Occupational Therapy
     05740011-7790   OT NEUROMUSC REED ADD 15                       138.00        138.00     7790     Occupational Therapy
     05720044-7790   OT APP SPLNT FINGER STA                        275.00        275.00     7790     Occupational Therapy
     05700001-7790   Cancellation Charge                             30.00         30.00     7790     Occupational Therapy
     05854105-7801   SP Eval Mtn Fluor Swa 105                      765.00        765.00     7801     Speech & Audiology
     05886205-7801   AD Pure Tone Air/Bone                          218.00        218.00     7801     Speech & Audiology
     05853105-7801   SP EVL SP/LNG/COM/AUD 105                      765.00        765.00     7801     Speech & Audiology
     05851030-7801   SP Eval Fnx Swall 30                           218.00        218.00     7801     Speech & Audiology
     05854120-7801   SP Eval Mtn Fluor Swa 120                      875.00        875.00     7801     Speech & Audiology



8/31/2010                                                                                                                      121
                                                 c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                            CURRENT CURRENT          DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                INPATIENT OUTPATIENT CODE
                                                                PRICE      PRICE
     05855045-7801   SP Tx Sp/Lang/Com Gp 45                         98.00         98.00     7801     Speech & Audiology
     05851105-7801   SP EVAL FNX SWALL 105                          765.00        765.00     7801     Speech & Audiology
     05853030-7801   SP EVAL SP/LNG/COM/AUD 30                      218.00        218.00     7801     Speech & Audiology
     05853045-7801   SP EVAL SP/LNG/COM/AUD 45                      328.00        328.00     7801     Speech & Audiology
     05851120-7801   SP Eval Fnx Swall 120                          875.00        875.00     7801     Speech & Audiology
     05856160-7801   SP Tx Swall/Oral Fnx 60                        437.00        437.00     7801     Speech & Audiology
     05853120-7801   SP EVL SP/LNG/COM/AUD 120                      875.00        875.00     7801     Speech & Audiology
     05886200-7801   AD Pure Tone Air                               218.00        218.00     7801     Speech & Audiology
     05853075-7801   SP EVAL SP/LNG/COM/AUD 75                      546.00        546.00     7801     Speech & Audiology
     05886210-7801   AD Scrn OAE                                    437.00        437.00     7801     Speech & Audiology
     05854090-7801   SP Eval Mtn Fluor Swal 90                      656.00        656.00     7801     Speech & Audiology
     05853060-7801   SP EVAL SP/LNG/COM/AUD 60                      437.00        437.00     7801     Speech & Audiology
     05856130-7801   SP Tx Swall/Oral Fnx 30                        218.00        218.00     7801     Speech & Audiology
     05856145-7801   SP Tx Swall/Oral Fnx 45                        328.00        328.00     7801     Speech & Audiology
     05856060-7801   SP TX SP/LANG/COM IND 60                       437.00        437.00     7801     Speech & Audiology
     05856115-7801   SP Tx Swall/Oral Fnx 15                        109.00        109.00     7801     Speech & Audiology
     05851015-7801   SP Eval Fnx Swall 15                           109.00        109.00     7801     Speech & Audiology
     05853090-7801   SP EVAL SP/LNG/COM/AUD 90                      656.00        656.00     7801     Speech & Audiology
     05856030-7801   SP TX SP/LANG/COM IND 30                       218.00        218.00     7801     Speech & Audiology
     05851090-7801   SP Eval Fnx Swall 90                           656.00        656.00     7801     Speech & Audiology
     05856045-7801   SP TX SP/LANG/COM IND 45                       328.00        328.00     7801     Speech & Audiology
     05851075-7801   SP Eval Fnx Swall 75                           546.00        546.00     7801     Speech & Audiology
     05851060-7801   SP Eval Fnx Swall 60                           437.00        437.00     7801     Speech & Audiology
     05851045-7801   SP Eval Fnx Swall 45                           328.00        328.00     7801     Speech & Audiology
     03880130-7830   PSYC DX INTERVIEW 1.5 HR                       713.00        713.00     7830     Neuro Psychology
     03880650-7830   Psyc Eval Rcrd/Rprt/Tests                      500.00        500.00     7830     Neuro Psychology
     03880445-7830   Psyc Tx 45-50M                                 321.00        321.00     7830     Neuro Psychology
     03880600-7830   Neuropsyc Test Battery/Hr                      428.00        428.00     7830     Neuro Psychology
     03880615-7830   HLTH/BHVR ASS INIT EA 15                       143.00        143.00     7830     Neuro Psychology
     03880625-7830   Psyo Prep Of Report                            214.00        214.00     7830     Neuro Psychology
     03880170-7830   Consultation w Family                          285.00        285.00     7830     Neuro Psychology
     03880180-7830   Interagency Consult                            285.00        285.00     7830     Neuro Psychology
     03880140-7830   Psyc Testing/Hr                                428.00        428.00     7830     Neuro Psychology
     03880160-7830   Psyo Tx Fam w Patient                          285.00        285.00     7830     Neuro Psychology
     04606010-7872   PS TUMOR FULL BODY                            4450.00       4450.00     7872     Pos Emission Tomog
     04608020-7872   PS TUMOR FULL BODY                            4450.00       4450.00     7872     Pos Emission Tomog
     04608000-7872   PS TUMOR FULL BODY                            4450.00       4450.00     7872     Pos Emission Tomog
     04607020-7872   PS TUMOR FULL BODY                            4450.00       4450.00     7872     Pos Emission Tomog



8/31/2010                                                                                                                      122
                                                      c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                                 CURRENT CURRENT          DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                     INPATIENT OUTPATIENT CODE
                                                                     PRICE      PRICE
     04607010-7872   PS TUMOR FULL BODY                                 4450.00       4450.00     7872     Pos Emission Tomog
     04606020-7872   PS TUMOR FULL BODY                                 4450.00       4450.00     7872     Pos Emission Tomog
     04606000-7872   PS TUMOR FULL BODY                                 4450.00       4450.00     7872     Pos Emission Tomog
     04605020-7872   PS TUMOR FULL BODY                                 4450.00       4450.00     7872     Pos Emission Tomog
     04605010-7872   PS TUMOR FULL BODY                                 4450.00       4450.00     7872     Pos Emission Tomog
     04605000-7872   PS TUMOR FULL BODY                                 4450.00       4450.00     7872     Pos Emission Tomog
     04603020-7872   PS TUMOR FULL BODY                                 4450.00       4450.00     7872     Pos Emission Tomog
     04603010-7872   PS TUMOR FULL BODY                                 4450.00       4450.00     7872     Pos Emission Tomog
     04603000-7872   PS TUMOR FULL BODY                                 4450.00       4450.00     7872     Pos Emission Tomog
     04600000-7872   RP F-18 FDG DX DS 45MCI                            1017.00       1017.00     7872     Pos Emission Tomog
     04607000-7872   PS TUMOR FULL BODY                                 4450.00       4450.00     7872     Pos Emission Tomog
     04608101-7872   PS TUMOR W/CT WHOLE BODY                           4840.00       4840.00     7872     Pos Emission Tomog
     09096029-8320   DIET INSTRUCTION 60                                 112.00        112.00     8320     Food Services
     09097080-8320   Patient Soft Drinks (6 Pack)                          3.00          3.00     8320     Food Services
     09097031-8320   Dinner Tray                                          19.00         19.00     8320     Food Services
     09097023-8320   Lunch Tray                                           13.00         13.00     8320     Food Services
     09097015-8320   Breakfast Tray                                       10.00         10.00     8320     Food Services
     09097090-8320   Patient Bottled Water                                 1.00          1.00     8320     Food Services
     00300100-8720   APHERESIS RBC                                      1250.00       1250.00     8720     Senior Focus
     00088001-9999   ADHP-Start of Care                                    0.00          0.00     9999     Tracking Code
     00029007-9999   CR -Medi-Care Progress Followup Rpt                   0.00          0.00     9999     Tracking Code
     00018102-9999   Aortic Surgery Clinical Pathway                       0.00          0.00     9999     Tracking Code
     00018109-9999   Comfort Care Pathway                                  0.00          0.00     9999     Tracking Code
     00038002-9999   Neuro Psych Encntr - Interim Visit                    0.00          0.00     9999     Tracking Code
     00056001-9999   PT Initial Visit                                      0.00          0.00     9999     Tracking Code
     00056003-9999   PT Final Visit                                        0.00          0.00     9999     Tracking Code
     00052001-9999   IW Encounter--Initial Visit                           0.00          0.00     9999     Tracking Code
     00052002-9999   IW Encounter--Interim Visit                           0.00          0.00     9999     Tracking Code
     00052003-9999   IW Encounter--Final Visit                             0.00          0.00     9999     Tracking Code
     00058001-9999   Spch/Aud Encounter - Initial Visit                    0.00          0.00     9999     Tracking Code
     00057001-9999   OT - Initial Visit                                    0.00          0.00     9999     Tracking Code
     00058002-9999   Spch/Aud Encounter - Interim Visit                    0.00          0.00     9999     Tracking Code
     00057002-9999   OT - Interim Visit                                    0.00          0.00     9999     Tracking Code
     00018117-9999   Gastric Band Clinical Pathway                         0.00          0.00     9999     Tracking Code
     00018119-9999   Knee Clinical Pathway                                 0.00          0.00     9999     Tracking Code
     00090001-9999   DIET-Nutrition Therapy                                0.00          0.00     9999     Tracking Code
     00018118-9999   Esophageal Surgery Clinical Pathway                   0.00          0.00     9999     Tracking Code
     00029008-9999   Massage Therapy Patient                               0.00          0.00     9999     Tracking Code



8/31/2010                                                                                                                           123
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     CHARGE CODE BILLING DESCRIPTION                                 CURRENT CURRENT          DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                     INPATIENT OUTPATIENT CODE
                                                                     PRICE      PRICE
     00069006-9999   Diab-Blood Glucose Monitoring                         0.00          0.00     9999     Tracking Code
     00018114-9999   COPD Clinical Pathway                                 0.00          0.00     9999     Tracking Code
     00018105-9999   Gastric Bypass Clinical Pathway                       0.00          0.00     9999     Tracking Code
     00055001-9999   HOSP-Hospitalist Encounter                            0.00          0.00     9999     Tracking Code
     00018116-9999   Deep Vein Thrombophlebitis Pathway                    0.00          0.00     9999     Tracking Code
     00018115-9999   O.R. Procedure for Obesity                            0.00          0.00     9999     Tracking Code
     00018201-9999   Resp Vent Check                                       0.00          0.00     9999     Tracking Code
     00023203-9999   Labor Induction                                       0.00          0.00     9999     Tracking Code
     04076113-7630   XR Cine/Video                                       584.00        584.00     7630     Radiology
     04074613-7630   XR Breast Mammography Loc                           757.00        757.00     7630     Radiology
     04073110-7630   IR Abscss Fist Sin Tract                            584.00        584.00     7630     Radiology
     04072815-7630   XR Bone Survey Inf                                  409.00        409.00     7630     Radiology
     04076410-7630   XR Cine/Video Complement                            440.00        440.00     7630     Radiology
     04077913-7630   XR Subtraction Series                               538.00        538.00     7630     Radiology
     04060604-7630   IR Angio Pulm Uni Select                           6991.00       6991.00     7630     Radiology
     04060901-7630   IR Angio Pulm Bil Select                           6991.00       6991.00     7630     Radiology
     04061206-7630   IR Angio Pulm NonSelect                            6991.00       6991.00     7630     Radiology
     04061404-7630   IR Angio Add Vessel Ea                             6991.00       6991.00     7630     Radiology
     04061503-7630   XR Lymphangio Pelv Bil                             3386.00       3386.00     7630     Radiology
     04064507-7630   IR Bili Drn Prc                                    3006.00       3006.00     7630     Radiology
     04064887-7630   IR Bili Drn Int Xtl                                3386.00       3386.00     7630     Radiology
     04070181-7630   XR FLUORO 5-6 HRS                                  3370.00       3370.00     7630     Radiology
     04071205-7630   ER Proc/After Hrs Test                              202.00        202.00     7630     Radiology
     04062808-7630   IR Venogram Renl Uni                               6991.00       6991.00     7630     Radiology
     03900007-7630   Tumor Board Report                                    0.00          0.00     7630     Radiology
     04713517-7630   CT Pelv W-W/O Con                                  4707.00       4707.00     7630     Radiology
     04714051-7630   CT Ext Upp W Con                                   3277.00       3277.00     7630     Radiology
     00018111-9999   Acute MI Pathway                                      0.00          0.00     9999     Tracking Code
     00018112-9999   Pneumonia Pathway                                     0.00          0.00     9999     Tracking Code
     00056004-9999   Scheduling Office - Progress Notes                    0.00          0.00     9999     Tracking Code
     00056006-9999   PT Visit                                              0.00          0.00     9999     Tracking Code
     00018101-9999   Fem-Pop Bypass Clinical Pathway                       0.00          0.00     9999     Tracking Code
     00018113-9999   Congestive Heart Failure Pathway                      0.00          0.00     9999     Tracking Code
     00060001-9999   ED -Emergency Dept Visit                              0.00          0.00     9999     Tracking Code
     00088002-9999   ADHP-Interim Visit                                    0.00          0.00     9999     Tracking Code
     00088003-9999   ADHP-Final Visit                                      0.00          0.00     9999     Tracking Code
     00088004-9999   Senior Focus Care Management Evaluation               0.00          0.00     9999     Tracking Code
     00067001-9999   Labor and Delivery Encounter                          0.00          0.00     9999     Tracking Code



8/31/2010                                                                                                                           124
                                                        c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                                   CURRENT CURRENT        DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                       INPATIENT OUTPATIENT CODE
                                                                       PRICE      PRICE
     00067002-9999   Obstetric O.P. Test Encounter                           0.00        0.00     9999     Tracking Code
     00016001-9999   Nursery Encounter                                       0.00        0.00     9999     Tracking Code
     00008001-9999   Surgical Encounter                                      0.00        0.00     9999     Tracking Code
     00000002-9999   AP Encounter Progress Note                              0.00        0.00     9999     Tracking Code
     00023210-9999   Standard Newborn Clinical Pathway                       0.00        0.00     9999     Tracking Code
     00023209-9999   Postpartum Cesarean Delivery Clin Path                  0.00        0.00     9999     Tracking Code
     00023208-9999   Cesarean Birth Clinical Pathway                         0.00        0.00     9999     Tracking Code
     00069007-9999   DIAB-Educational Services                               0.00        0.00     9999     Tracking Code
     00023207-9999   Postpartum Vaginal Delivery Clin Pathway                0.00        0.00     9999     Tracking Code
     00023206-9999   Preterm Labor Intact Membranes Clin Path                0.00        0.00     9999     Tracking Code
     00023205-9999   SROM Management Clinical Pathway                        0.00        0.00     9999     Tracking Code
     00023202-9999   Active Labor Clinical Pathway                           0.00        0.00     9999     Tracking Code
     00023201-9999   Prodromal Labor Clinical Pathway                        0.00        0.00     9999     Tracking Code
     00056005-9999   PT MPMG Visit                                           0.00        0.00     9999     Tracking Code
     00018110-9999   Rule Out MI Pathway                                     0.00        0.00     9999     Tracking Code
     00018104-9999   Cardiac Surgery Clinical Pathway                        0.00        0.00     9999     Tracking Code
     00022501-9999   Outpatient Inotropic Infusion                           0.00        0.00     9999     Tracking Code
     00023216-9999   Not on Perinatal Pathway                                0.00        0.00     9999     Tracking Code
     00018106-9999   CVA Clinical Pathway                                    0.00        0.00     9999     Tracking Code
     00018107-9999   Hip Clinical Pathway                                    0.00        0.00     9999     Tracking Code
     00057004-9999   OT Visit                                                0.00        0.00     9999     Tracking Code
     00087503-9999   UM-Home Care New Patient                                0.00        0.00     9999     Tracking Code
     00053002-9999   Arthritis Encounter - Interim Visit                     0.00        0.00     9999     Tracking Code
     00053003-9999   Arthritis Encounter - Final Visit                       0.00        0.00     9999     Tracking Code
     00029001-9999   CR -Phase II Progress Report                            0.00        0.00     9999     Tracking Code
     00029002-9999   CR -Phase III Progress Report                           0.00        0.00     9999     Tracking Code
     00029006-9999   CR -VIP Index Progress Report                           0.00        0.00     9999     Tracking Code
     00057003-9999   OT - Final Visit                                        0.00        0.00     9999     Tracking Code
     00087501-9999   UM-Case Management Encounter                            0.00        0.00     9999     Tracking Code
     00090100-9999   Diet-Consult No Charge                                  0.00        0.00     9999     Tracking Code
     00000001-9999   MD Encounter Progress Note                              0.00        0.00     9999     Tracking Code
     00053001-9999   Arthritis Encounter - Initial Visit                     0.00        0.00     9999     Tracking Code
     00087502-9999   UM-Home Care Prior Patient                              0.00        0.00     9999     Tracking Code
     00029003-9999   CR -Medi-Care Progress Report                           0.00        0.00     9999     Tracking Code
     00029005-9999   CR -Index Progress Report                               0.00        0.00     9999     Tracking Code
     00018103-9999   Bowel Surgery Clinical Pathway                          0.00        0.00     9999     Tracking Code
     00069001-9999   Diab-Insulin Diabetes Education                         0.00        0.00     9999     Tracking Code
     00069002-9999   Diab-Oral Diabetes Education                            0.00        0.00     9999     Tracking Code



8/31/2010                                                                                                                           125
                                                           c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                                      CURRENT CURRENT          DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                          INPATIENT OUTPATIENT CODE
                                                                          PRICE      PRICE
     00069003-9999   Diab-Gestational Diabetes Education                        0.00          0.00     9999     Tracking Code
     00069004-9999   Diab-Complications of Diabetes                             0.00          0.00     9999     Tracking Code
     00069005-9999   Diab-Diet Management in Diabetes                           0.00          0.00     9999     Tracking Code
     00038004-9999   SWS -Encounter Visit                                       0.00          0.00     9999     Tracking Code
     00053004-9999   Arthritis Encounter - Medicare Form                        0.00          0.00     9999     Tracking Code
     00060002-9999   ED -Left Without Being Seen                                0.00          0.00     9999     Tracking Code
     00056002-9999   PT Interim Visit                                           0.00          0.00     9999     Tracking Code
     00029004-9999   CR -Tune-Up Progress Report                                0.00          0.00     9999     Tracking Code
     00058003-9999   Spch/Aud Encounter - Final Visit                           0.00          0.00     9999     Tracking Code
     00038003-9999   Neuro Psych Encntr - Final Visit                           0.00          0.00     9999     Tracking Code
     00038001-9999   Neuro Psych Encntr - Initial Visit                         0.00          0.00     9999     Tracking Code
     04082194-7630   US Breast Uni Or Bil                                     612.00        612.00     7630     Radiology
     04083010-7630   US Retrope Cmpl                                         1095.00       1095.00     7630     Radiology
     04060000-7630   IR Angio Visc                                           6991.00       6991.00     7630     Radiology
     04023511-7630   IR Bronchogram Uni                                       810.00        810.00     7630     Radiology
     04023818-7630   IR Bronchogram Bil                                      1226.00       1226.00     7630     Radiology
     04019915-7630   XR Salivary Gland Calc                                   374.00        374.00     7630     Radiology
     04031878-7630   XR MYELOGRM 1 OR MORE REG                               3386.00       3386.00     7630     Radiology
     04032165-7630   XR Diskogram Cerv Thor                                  4652.00       4652.00     7630     Radiology
     04032256-7630   XR Diskogram Lumb                                       4357.00       4357.00     7630     Radiology
     03900017-7630   Second Opinion Report                                      0.00          0.00     7630     Radiology
     04155458-7630   IRC REPS PREV PLC CV CATH                                292.00        292.00     7630     Radiology
     04018115-7630   XR Dental Full Exam                                      440.00        440.00     7630     Radiology
     04017810-7630   XR Dental Partial Exam                                   234.00        234.00     7630     Radiology
     04013611-7630   XR Mastoids 3V Or More                                   440.00        440.00     7630     Radiology
     04013918-7630   XR Exam Of Middle Ear                                    409.00        409.00     7630     Radiology
     04186890-7630   XRC Intro G Tube Long                                    130.00        130.00     7630     Radiology
     04020210-7630   XR Sialogram                                             991.00        991.00     7630     Radiology
     04049417-7630   IR Chol Existing Cath                                    440.00        440.00     7630     Radiology
     04050019-7630   IR Chol Transhepat Prc                                  1745.00       1745.00     7630     Radiology
     04050464-7630   IR Bile Stone Extraction                                 981.00        981.00     7630     Radiology
     04000053-7630   Barium Enema Procedure Addendum                            0.00          0.00     7630     Radiology
     04052411-7630   XR Urogram Antegrade                                     721.00        721.00     7630     Radiology
     04048518-7630   XR Cholecystogram Oral                                   409.00        409.00     7630     Radiology
     04055117-7630   CT Pelvimetry                                            584.00        584.00     7630     Radiology
     04056107-7630   IR Aortogram Thor W Ser                                 6991.00       6991.00     7630     Radiology
     04156658-7630   IRC Esoph Dilate Bln <30m                                502.00        502.00     7630     Radiology
     04166458-7630   IRC Cath Portal Vein Prc                                1671.00       1671.00     7630     Radiology



8/31/2010                                                                                                                                126
                                                    c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                               CURRENT CURRENT          DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                   INPATIENT OUTPATIENT CODE
                                                                   PRICE      PRICE
     04062133-7630   IR Venogram Hep W Eval                           6991.00       6991.00     7630     Radiology
     04042115-7630   XR Arthro Ankle                                  1164.00       1164.00     7630     Radiology
     04035218-7630   XR Arthro Elbow                                  1164.00       1164.00     7630     Radiology
     04048815-7630   XR Cholecystogram Oral FU                         234.00        234.00     7630     Radiology
     04000055-7630   US Procedure Addendum                               0.00          0.00     7630     Radiology
     04186850-7630   IRC Intro Cath Fallopn                           1116.00       1116.00     7630     Radiology
     04082920-7630   US Amniocentesis                                  843.00        843.00     7630     Radiology
     04010455-7630   XR Fallopn Tube Transcerv                        1745.00       1745.00     7630     Radiology
     04186565-7630   CTC Abscss Drn Subdiap                            956.00        956.00     7630     Radiology
     04185638-7630   IRC Pulm Art Seg Sub                              839.00        839.00     7630     Radiology
     04186065-7630   IRC NonThrombolysis IV                           1396.00       1359.00     7630     Radiology
     04185369-7630   IRC THORACENTESIS W TUBE                          524.00        524.00     7630     Radiology
     04186318-7630   IRC Abscss Cyst Liver Prc                         883.00        883.00     7630     Radiology
     04186805-7630   IR Tube Cath Chng                                1083.00       1083.00     7630     Radiology
     04185666-7630   IRC Intro Brach Art                               482.00        482.00     7630     Radiology
     04186094-7630   IRC Ven Cath Blood Sample                         839.00        839.00     7630     Radiology
     04186185-7630   XRC Inj Sialogram                                 299.00        299.00     7630     Radiology
     04186219-7630   XRC Inj Dilate Esoph                              361.00        361.00     7630     Radiology
     04186235-7630   IRC Reposition G Tube                             482.00        482.00     7630     Radiology
     04186284-7630   IRC Inj Chol Transhepat                           468.00        468.00     7630     Radiology
     04186370-7630   IRC Inj Chol Via Cath                             217.00        217.00     7630     Radiology
     04186300-7630   IRC Intro Cath Bili Drn                          1873.00       1873.00     7630     Radiology
     04186433-7630   IRC Bili Stone Extract                           2182.00       2182.00     7630     Radiology
     04186516-7630   CTC Asp Renl Cyst                                 471.00        471.00     7630     Radiology
     04186540-7630   CTC Intro Cath Renl Pelv                          810.00        810.00     7630     Radiology
     04712118-7630   CT Stereotactic Loc                              4580.00       4580.00     7630     Radiology
     04184760-7630   XRC Breast Ndl Wire                               372.00        372.00     7630     Radiology
     04186292-7630   IRC Bili Stent Place                             2512.00       2512.00     7630     Radiology
     04050753-7630   IR Bili Duct Dilate Prc                          3386.00       3386.00     7630     Radiology
     04185641-7630   IRC Pulm Art L/R                                  721.00        721.00     7630     Radiology
     04185633-7630   IRC Intro Cath Pulm                               604.00        604.00     7630     Radiology
     04184834-7630   IRC Bx Bone Deep                                  232.00        232.00     7630     Radiology
     04083648-7630   US Transrectal                                    843.00        843.00     7630     Radiology
     04050704-7630   IR Intraluminal Dilate                           1745.00       1745.00     7630     Radiology
     04711073-7630   CT Maxillofacial W-W/O                           3925.00       3925.00     7630     Radiology
     04186417-7630   CTC Paracent Abd Ini                              380.00        380.00     7630     Radiology
     04000001-7630   Radiology Procedure Override                        0.00          0.00     7630     Radiology
     04000002-7630   Radiology Procedure Addendum                        0.00          0.00     7630     Radiology



8/31/2010                                                                                                                         127
                                                    c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                               CURRENT CURRENT          DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                   INPATIENT OUTPATIENT CODE
                                                                   PRICE      PRICE
     04000003-7630   Radiology Cath Procedure Override                   0.00          0.00     7630     Radiology
     04000004-7630   Radiology Cath Procedure Addendum                   0.00          0.00     7630     Radiology
     04716007-7630   CT Guide Rad Tx Fields                           1641.00       1641.00     7630     Radiology
     04064358-7630   IR PTA Visc Add                                  4655.00       4655.00     7630     Radiology
     04054706-7630   IR Dilate Nephrostomy                            1745.00       1745.00     7630     Radiology
     04060505-7630   IR Angio Pelv Select                             6991.00       6991.00     7630     Radiology
     04056958-7630   IR Angio Carotd Xtl Bil                          6991.00       6991.00     7630     Radiology
     04184958-7630   IRC PTA Aortic                                   1653.00       1653.00     7630     Radiology
     04184941-7630   IRC PTA Renl Visc                                2406.00       2406.00     7630     Radiology
     04064309-7630   IR PTA Renl Visc                                 8730.00       8730.00     7630     Radiology
     04056859-7630   IR Angio Brach                                   6991.00       6991.00     7630     Radiology
     04000036-7630   Scapula Procedure Addendum                          0.00          0.00     7630     Radiology
     04000052-7630   Small Bowel Procedure Addendum                      0.00          0.00     7630     Radiology
     04000051-7630   UGI+Small Bowel Procedure Addendum                  0.00          0.00     7630     Radiology
     04000050-7630   UGI Procedure Addendum                              0.00          0.00     7630     Radiology
     04000049-7630   Esophagus Procedure Addendum                        0.00          0.00     7630     Radiology
     04000047-7630   Heel OS Calcis Procedure Addendum                   0.00          0.00     7630     Radiology
     04000045-7630   Abdominal Procedure Addendum                        0.00          0.00     7630     Radiology
     04000044-7630   Ankle Procedure Addendum                            0.00          0.00     7630     Radiology
     04000043-7630   Tib/Fib Procedure Addendum                          0.00          0.00     7630     Radiology
     04000042-7630   Knee Procedure Addendum                             0.00          0.00     7630     Radiology
     04000041-7630   Femur Procedure Addendum                            0.00          0.00     7630     Radiology
     04000040-7630   Fingers Procedure Addendum                          0.00          0.00     7630     Radiology
     04000039-7630   Hand Procedure Addendum                             0.00          0.00     7630     Radiology
     04000023-7630   Ribs Procedure Addendum                             0.00          0.00     7630     Radiology
     04000037-7630   Forearm Procedure Addendum                          0.00          0.00     7630     Radiology
     04186277-7630   IRC Inc Gallbladder                               855.00        855.00     7630     Radiology
     04000035-7630   Elbow Procedure Addendum                            0.00          0.00     7630     Radiology
     04000034-7630   Humerus Procedure Addendum                          0.00          0.00     7630     Radiology
     04000033-7630   ACJ Procedure Addendum                              0.00          0.00     7630     Radiology
     04000032-7630   Shoulder Procedure Addendum                         0.00          0.00     7630     Radiology
     04000031-7630   Pelvis Procedure Addendum                           0.00          0.00     7630     Radiology
     04000030-7630   Clavicle Procedure Addendum                         0.00          0.00     7630     Radiology
     04000029-7630   L-Spine Procedure Addendum                          0.00          0.00     7630     Radiology
     04000028-7630   T-Spine Procedure Addendum                          0.00          0.00     7630     Radiology
     04000027-7630   Spine Procedure Addendum                            0.00          0.00     7630     Radiology
     04000026-7630   C-Spine Procedure Addendum                          0.00          0.00     7630     Radiology
     04000025-7630   Sternoclavicular Procedure Addendu                  0.00          0.00     7630     Radiology



8/31/2010                                                                                                                         128
                                                      c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                                 CURRENT CURRENT          DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                     INPATIENT OUTPATIENT CODE
                                                                     PRICE      PRICE
     04000038-7630   Wrist Procedure Addendum                              0.00          0.00     7630     Radiology
     04700067-7630   CT Thoracic Spine Procedure Addend                    0.00          0.00     7630     Radiology
     04150458-7630   IRC Exchange Drn Cath                               348.00        348.00     7630     Radiology
     04000064-7630   Aortography Procedure Addendum                        0.00          0.00     7630     Radiology
     04000063-7630   Angiogram Procedure Addendum                          0.00          0.00     7630     Radiology
     04700072-7630   CT Mammo Procedure Addendum                           0.00          0.00     7630     Radiology
     04700071-7630   CT Extremity Procedure Addendum                       0.00          0.00     7630     Radiology
     04700070-7630   CT Pelvis Procedure Addendum                          0.00          0.00     7630     Radiology
     04000048-7630   KUB Procedure Addendum                                0.00          0.00     7630     Radiology
     04700068-7630   CT Sinuses Procedure Addend                           0.00          0.00     7630     Radiology
     04000054-7630   Colon Air Procedure Addendum                          0.00          0.00     7630     Radiology
     04700066-7630   CT Lumbar Spine Procedure Addend                      0.00          0.00     7630     Radiology
     04700065-7630   CT Cervical Spine Procedure Addend                    0.00          0.00     7630     Radiology
     04700064-7630   CT Chest Procedure Addendum                           0.00          0.00     7630     Radiology
     04700063-7630   CT Brain Procedure Addendum                           0.00          0.00     7630     Radiology
     04700062-7630   CT Abdomen Procedure Addendum                         0.00          0.00     7630     Radiology
     04000062-7630   Bone Survey Procedure Addendum                        0.00          0.00     7630     Radiology
     04000061-7630   Bone Length Procedure Addendum                        0.00          0.00     7630     Radiology
     04000060-7630   Oral Chole Procedure Addendum                         0.00          0.00     7630     Radiology
     04000059-7630   T Tube Chole Procedure Addendum                       0.00          0.00     7630     Radiology
     04000058-7630   Mammogram Procedure Addendum                          0.00          0.00     7630     Radiology
     04000057-7630   Fluoroscopy Procedure Addendum                        0.00          0.00     7630     Radiology
     04700056-7630   CT Head Procedure Addendum                            0.00          0.00     7630     Radiology
     04000022-7630   Chest Procedure Addendum                              0.00          0.00     7630     Radiology
     04700069-7630   CT Neck Procedure Addendum                            0.00          0.00     7630     Radiology
     04049220-7630   XR Chol In Or Add Set                               378.00        378.00     7630     Radiology
     04012750-7630   XR Orthopantogram                                   315.00        315.00     7630     Radiology
     04186252-7630   IRC Inj Lymphangio                                  960.00        960.00     7630     Radiology
     04184768-7630   XRC Asp Breast Cyst                                 211.00        211.00     7630     Radiology
     04184800-7630   XRC Asp Breast Add                                   99.00         99.00     7630     Radiology
     04184818-7630   XRC Bx Breast Vac Assist                            795.00        795.00     7630     Radiology
     04000024-7630   Sternum Procedure Addendum                            0.00          0.00     7630     Radiology
     04184875-7630   CTC Inj Sinogram                                    181.00        181.00     7630     Radiology
     04185120-7630   XRC Inj Arthro Elbow                                314.00        314.00     7630     Radiology
     04185278-7630   XRC Inj Arthro Knee                                 233.00        233.00     7630     Radiology
     04185328-7630   XRC Inj Arthro Ankle                                232.00        232.00     7630     Radiology
     04185377-7630   IRC Tube Thoracostomy                              1143.00       1143.00     7630     Radiology
     04185427-7630   IRC Bx Lung Mediastnm                               543.00        543.00     7630     Radiology



8/31/2010                                                                                                                           129
                                                          c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                                     CURRENT CURRENT          DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                         INPATIENT OUTPATIENT CODE
                                                                         PRICE      PRICE
     04070157-7630   XR FLUORO 4-5 HRS                                      3370.00       3370.00     7630     Radiology
     04184826-7630   IRC Bx Bone Super                                      1121.00       1121.00     7630     Radiology
     04000006-7630   Foot Procedure Addendum                                   0.00          0.00     7630     Radiology
     04000021-7630   Salivary Gland Procedure Addendum                         0.00          0.00     7630     Radiology
     04000020-7630   Neck Soft Tissue Procedure Addendu                        0.00          0.00     7630     Radiology
     04000019-7630   Teeth Procedure Addendum                                  0.00          0.00     7630     Radiology
     04000018-7630   TMJ Procedure Addendum                                    0.00          0.00     7630     Radiology
     04000017-7630   Skull Procedure Addendum                                  0.00          0.00     7630     Radiology
     04000016-7630   Sella Turcica Procedure Addendum                          0.00          0.00     7630     Radiology
     04000014-7630   Sinuses Procedure Addendum                                0.00          0.00     7630     Radiology
     04000013-7630   Orbits Procedure Addendum                                 0.00          0.00     7630     Radiology
     04000012-7630   Nasal Bone Procedure Addendum                             0.00          0.00     7630     Radiology
     04000011-7630   IAC Procedure Addendum                                    0.00          0.00     7630     Radiology
     04000010-7630   Mastoids Procedure Addendum                               0.00          0.00     7630     Radiology
     04000009-7630   Facial Bone Procedure Addendum                            0.00          0.00     7630     Radiology
     04000007-7630   Mandible Procedure Addendum                               0.00          0.00     7630     Radiology
     04000005-7630   Bone Age Procedure Addendum                               0.00          0.00     7630     Radiology
     04005142-7630   NI Ext Art 1 Lvl Bil                                    661.00        661.00     7630     Radiology
     04005147-7630   US Duplex Extracran Bil                                2117.00       2117.00     7630     Radiology
     04185658-7630   IRC Intro Ext Art                                       482.00        482.00     7630     Radiology
     04000008-7630   Hip Procedure Addendum                                    0.00          0.00     7630     Radiology
     04000046-7630   Toes Procedure Addendum                                   0.00          0.00     7630     Radiology
     04162291-7630   IRC Inj Diskogram Cerv                                  308.00        308.00     7630     Radiology
     04148511-7630   IRC Drn Panc Pseudocyst                                1444.00       1444.00     7630     Radiology
     04162290-7630   IRC Inj Diskogram Lumb                                  335.00        335.00     7630     Radiology
     04083030-7630   US Echo Retrope Ltd                                     787.00        787.00     7630     Radiology
     04164479-7630   IRC Inj Nrv Blk C/T 1 Lvl                               265.00        265.00     7630     Radiology
     04164480-7630   IRC Inj Nrv Blk C/T Add                                 225.00        225.00     7630     Radiology
     04775635-7630   CTA Abd W Runoff W-W/O                                 4402.00       4402.00     7630     Radiology
     04772191-7630   CTA Pelv W-W/O Con                                     4402.00       4402.00     7630     Radiology
     04771275-7630   CTA Chest W-W/O Con                                    4402.00       4402.00     7630     Radiology
     04770496-7630   CTA Head W-W/O Con                                     3804.00       3804.00     7630     Radiology
     04770498-7630   CTA Nec W-W/O Con                                      3804.00       3804.00     7630     Radiology
     04059015-7630   USC Villus Sampling                                     293.00        293.00     7630     Radiology
     04149427-7630   IRC INJ VP SHUNT                                        220.00        220.00     7630     Radiology
     04164483-7630   IRC Inj Nrv Blk L/S 1 Lvl                               254.00        254.00     7630     Radiology
     04073113-7630   IR Abscss Fist Sin Tract                                584.00        584.00     7630     Radiology
     04005145-7630   US Duplex Ext Veins Uni                                2134.00       2134.00     7630     Radiology



8/31/2010                                                                                                                               130
                                                          c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                                     CURRENT CURRENT          DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                         INPATIENT OUTPATIENT CODE
                                                                         PRICE      PRICE
     03904178-7630   XRC Breast Ndl Wire                                     372.00        372.00     7630     Radiology
     04147003-7630   CTC ABLTN LIVER RF PRC                                 1600.00       1600.00     7630     Radiology
     04186935-7630   IRC TRNCTH STNT CCA W/PRO                             11639.00      11639.00     7630     Radiology
     04186924-7630   IRC PRC VRT AUG LUMB 1VRT                              2200.00       2200.00     7630     Radiology
     04186922-7630   IRC PRC VRT AUG THOR 1VRT                              2200.00       2200.00     7630     Radiology
     03984768-7630   XRC Asp Breast Cyst                                     211.00        211.00     7630     Radiology
     04000114-7630   CTA Ext Upp w-w/o Con                                  3682.00       3682.00     7630     Radiology
     04186923-7630   IRC PERC VERT AUG ADD VRT                              1143.00       1143.00     7630     Radiology
     04000111-7630   USC Amniocentesis DX                                    282.00        282.00     7630     Radiology
     04000112-7630   CTA Head w-w/o Con                                     3499.00       3499.00     7630     Radiology
     04186926-7630   IRC BX SALIVARY GLAND NDL                               410.00        410.00     7630     Radiology
     04000116-7630   IRC Destruct Nrv L/S Add                                181.00        181.00     7630     Radiology
     04000117-7630   IRC Destruct Nrv L/S                                    437.00        437.00     7630     Radiology
     04000118-7630   XRC Inj Sinogram                                        181.00        181.00     7630     Radiology
     04000131-7630   IRC Grft Rplc IL Art                                   1925.00       1925.00     7630     Radiology
     04000132-7630   US Villus Sampling                                      787.00        787.00     7630     Radiology
     04000129-7630   XRC Breast Ndl Wire Add                                 211.00        211.00     7630     Radiology
     04032020-7630   USC Tube Thoracostomy                                  1143.00       1143.00     7630     Radiology
     04086557-7630   USC Abscss Drn Peritnl                                  808.00        808.00     7630     Radiology
     04184977-7630   IRC PTATHER TIBIA                                      2160.00       2160.00     7630     Radiology
     04150021-7630   CTC Abscss Drn Renl                                     810.00        810.00     7630     Radiology
     04000067-7630   UltraSound Miscellaneous OverRide                         0.00          0.00     7630     Radiology
     04000066-7630   CT Miscellaneous OverRide                                 0.00          0.00     7630     Radiology
     04000068-7630   Cardiac Cath Miscellaneous OverRid                        0.00          0.00     7630     Radiology
     04700073-7630   Radiation Oncology CT Lung Scan                           0.00          0.00     7630     Radiology
     04064207-7630   IR ATHERECTOMY PERIPH ADD                              4402.00       4402.00     7630     Radiology
     04186937-7630   IRC TRNCTH STNT CCA WO/PR                             11639.00      11639.00     7630     Radiology
     04186933-7630   S STRL -ATHERECTOMY CATH                               8087.00       8087.00     7630     Radiology
     04119290-7630   USC Breast Ndl Wire                                     372.00        372.00     7630     Radiology
     04083930-7630   IR US VASC ACCESS ADD ON                                205.00        205.00     7630     Radiology
     04000065-7630   XR Man App Strs Any Jnt                                 234.00        234.00     7630     Radiology
     04185330-7630   IRC INC GRN UNI ENDO PROS                              1253.00       1253.00     7630     Radiology
     04186258-7630   IRC Abscss Drn Renl                                     810.00        810.00     7630     Radiology
     04711954-7630   CT Ext Upp W-W/O Con                                   4141.00       4141.00     7630     Radiology
     04711952-7630   CT Spine Lumb W-W/O Con                                4904.00       4904.00     7630     Radiology
     04024725-7630   XR Ribs Bil W PA CXR                                    497.00        497.00     7630     Radiology
     04711956-7630   CT Ext Low W-W/O Con                                   4141.00       4141.00     7630     Radiology
     04062816-7630   IR Venogram Renl Bil                                   6991.00       6991.00     7630     Radiology



8/31/2010                                                                                                                               131
                                                      c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                                 CURRENT CURRENT          DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                     INPATIENT OUTPATIENT CODE
                                                                     PRICE      PRICE
     04155958-7630   XRC Inj Celiac Plex Lytic                           612.00        612.00     7630     Radiology
     04063601-7630   IR EXCHNGE INTRAVAS CATH                           6991.00       6991.00     7630     Radiology
     04016162-7630   XR Eye For FB                                       234.00        234.00     7630     Radiology
     04154463-7630   IRC INS PICC W/O PORT 5+                            361.00        361.00     7630     Radiology
     04083918-7630   US Drn W Cath Place Prc                            1745.00       1745.00     7630     Radiology
     04083925-7630   IR Drn W Cath Place Prc                            1745.00       1745.00     7630     Radiology
     04530259-7650   NM Heart MP Multi Planar                           2663.00       2663.00     7650     Nuclear Medicine
     04500002-7650   Nuclear Medicine Procedure Addendu                    0.00          0.00     7650     Nuclear Medicine
     04500001-7650   Nuclear Medicine Procedure Overrid                    0.00          0.00     7650     Nuclear Medicine
     04516001-7650   NM Heart Gated Sngl                                3107.00       3107.00     7650     Nuclear Medicine
     04530358-7650   NM Cystogram Voiding                               1197.00       1197.00     7650     Nuclear Medicine
     04517603-7650   NM Brain Cisternogram                              2838.00       2838.00     7650     Nuclear Medicine
     04518205-7650   NM Renl W SPECT                                    3330.00       3330.00     7650     Nuclear Medicine
     04518403-7650   NM Testicular W Flow                               1801.00       1801.00     7650     Nuclear Medicine
     04516605-7650   NM Lung Perf                                       1934.00       1934.00     7650     Nuclear Medicine
     04530309-7650   NM Heart MP Sngl Planar                            1333.00       1333.00     7650     Nuclear Medicine
     04526555-7650   NMC Node Identification                              36.00         36.00     7650     Nuclear Medicine
     04510608-7650   NM Thyroid Imag Only                                972.00        972.00     7650     Nuclear Medicine
     04510202-7650   NM Thyroid Uptake Sngl                              544.00        544.00     7650     Nuclear Medicine
     04510140-7650   NM Tumor Loc Ltd W RP                              1912.00       1912.00     7650     Nuclear Medicine
     04510200-7650   NM Tumor Loc SPECT W RP                            3690.00       3690.00     7650     Nuclear Medicine
     04500003-7650   Lymphoscintigrapy Inj Only                            0.00          0.00     7650     Nuclear Medicine
     04510161-7650   RP TC99M SUCCIMR DX 10MCI                           807.00        807.00     7650     Nuclear Medicine
     04510162-7650   RP IN111 PRSTSCN DX 10MCI                          4806.00       4806.00     7650     Nuclear Medicine
     04519205-7650   NM INFLAM LOCAL W SPECT                            3294.00       3294.00     7650     Nuclear Medicine
     04517619-7650   NM THYROID UPTAKE MULTI                             700.00        700.00     7650     Nuclear Medicine
     04517605-7650   NM BRAIN LTD W FLOW                                1934.00       1934.00     7650     Nuclear Medicine
     04517617-7650   NM THYROID IMAG UPT MULTI                          1403.00       1403.00     7650     Nuclear Medicine
     04517615-7650   NM HEART BLOOD POOL SPECT                          3700.00       3700.00     7650     Nuclear Medicine
     04517613-7650   NM LUNG QUAN DIFF FNCTN                            3700.00       3700.00     7650     Nuclear Medicine
     04519207-7650   NM ABSCSS LOC LTD                                  1566.00       1566.00     7650     Nuclear Medicine
     04517611-7650   NM BRAIN CSF SHUNT EVAL                            1800.00       1800.00     7650     Nuclear Medicine
     04517607-7650   NM BRAIN LTD                                       1579.00       1579.00     7650     Nuclear Medicine
     04517609-7650   NM CSF LEAKAGE DETECT                              2550.00       2550.00     7650     Nuclear Medicine
     04519209-7650   NM WHOLE BODY 2+ DAYS                              2160.00       2160.00     7650     Nuclear Medicine
     04609000-7872   PS HEART METBLC EVAL                               4450.00       4450.00     7872     PET
     04608010-7872   PS TUMOR FULL BODY                                 4450.00       4450.00     7872     PET
     04604010-7872   PS TUMOR FULL BODY                                 4450.00       4450.00     7872     PET



8/31/2010                                                                                                                           132
                                                  c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                             CURRENT CURRENT          DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                 INPATIENT OUTPATIENT CODE
                                                                 PRICE      PRICE
     04608102-7872   PS TUMOR W/CT LTD                              4840.00       4840.00     7872     PET
     04608103-7872   PS TUMOR W/CT SKULL THIGH                      4840.00       4840.00     7872     PET
     04604020-7872   PS TUMOR FULL BODY                             4450.00       4450.00     7872     PET
     04604000-7872   PS TUMOR FULL BODY                             4450.00       4450.00     7872     PET
     04602004-7872   PS TUMOR LIMITED AREA                          4450.00       4450.00     7872     PET
     04602000-7872   PS TUMOR LIMITED AREA                          4450.00       4450.00     7872     PET
     04601000-7872   PS BRAIN METBLC EVAL                           4450.00       4450.00     7872     PET
     04600001-7872   ddendum/Procedure Override                        0.00          0.00     7872     PET
     04602006-7872   PS TUMOR LIMITED AREA                          4450.00       4450.00     7872     PET
     02814365-7500   PLT AB DIR IGG                                   49.00         49.00     7500     Clinical Laboratory
     02823280-7500   QN DRG MISC                                      25.10         25.15     7500     Clinical Laboratory
     02330009-7500   POOLING BLD PROD                                170.00        170.00     7500     Clinical Laboratory
     02586996-7500   COMPATIBILITY TEST PLT                          400.00        400.00     7500     Clinical Laboratory
     02833759-7500   T LYMPH CD4 (HELPER) CNT                         49.00         49.00     7500     Clinical Laboratory
     02824811-7500   DNA CL CYCLE                                      0.00          0.00     7500     Clinical Laboratory
     02886616-7500   LYME DISEASE AB IGM WB                           20.45         20.45     7500     Clinical Laboratory
     02349991-7500   MISC LAB PROC                                     0.00          0.00     7500     Clinical Laboratory
     02825515-7500   EHRLICHIA AB IGG                                 19.18         19.18     7500     Clinical Laboratory
     02813558-7500   DEOXYRIBNUCLEASE AB                              16.00         16.00     7500     Clinical Laboratory
     02482801-7500   POCT PCO2                                        70.00         70.00     7500     Clinical Laboratory
     02482800-7500   PH BLD                                           70.00         70.00     7500     Clinical Laboratory
     02812895-7500   MANGANESE SERUM                                  40.00         40.00     7500     Clinical Laboratory
     02847315-7500   ISOPROPANOL BLD                                  27.50         27.50     7500     Clinical Laboratory
     02841110-7500   CAMPLYOBACTER AB                                 62.30         62.30     7500     Clinical Laboratory
     02834315-7500   OPIATES                                          40.88         40.88     7500     Clinical Laboratory
     02886382-7500   NEUTRALIZATION TEST                             580.25        580.25     7500     Clinical Laboratory
     02882693-7500   ETHYLENE GLYCOL                                  24.92         24.92     7500     Clinical Laboratory
     02482435-7500   CHLORIDE                                         70.00         70.00     7500     Clinical Laboratory
     02586971-7500   RBC PRETRTMT ENZYME                             180.00        180.00     7500     Clinical Laboratory
     02586922-7500   COMPATIBILITY TEST AHG                          100.00        100.00     7500     Clinical Laboratory
     02586924-7500   COMPATIBILITY TEST AHG                          100.00        100.00     7500     Clinical Laboratory
     02586870-7500   AB ID                                            52.00         52.00     7500     Clinical Laboratory
     02586022-7500   PLT AB DRG INDUCED                              375.00        375.00     7500     Clinical Laboratory
     02586999-7500   MISC TS PROC                                    960.00        960.00     7500     Clinical Laboratory
     02586995-7500   COMPATIBILITY TEST SELECT                       100.00        100.00     7500     Clinical Laboratory
     02821104-7500   COMPLEMENT C5                                    33.00         33.00     7500     Clinical Laboratory
     02821108-7500   COMPLEMENT C6                                    33.25         33.25     7500     Clinical Laboratory
     02482374-7500   CO2 (BICARBONATE)                                70.00         70.00     7500     Clinical Laboratory



8/31/2010                                                                                                                       133
                                               c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                          CURRENT CURRENT         DEPARTMENT   DEPARTMENT DESCRIPTION
                                                              INPATIENT OUTPATIENT CODE
                                                              PRICE      PRICE
     02836870-7500   NTELOPEPTIDE UR                               24.45        24.45     7500     Clinical Laboratory
     02324259-7500   URNALYSIS SGL ASSAY                           36.00        36.00     7500     Clinical Laboratory
     02850505-7500   THYR BINDING GLOB (TBG)                       18.25        18.25     7500     Clinical Laboratory
     02883150-7500   HOMOVANILLIC ACID (HVA)                       22.00        22.00     7500     Clinical Laboratory
     02324200-7500   FAT STAIN QL                                  90.00        90.00     7500     Clinical Laboratory
     02833148-7500   ADRENAL AB SCRN                               25.00        25.00     7500     Clinical Laboratory
     02325074-7500   HEMOGLOBIN F (APT)                            90.00        90.00     7500     Clinical Laboratory
     02333003-7500   SER BACTERICIDAL TTR                         195.00       195.00     7500     Clinical Laboratory
     02826030-7500   FCTR VII                                      59.00        59.00     7500     Clinical Laboratory
     02821177-7500   MISC CHEM TEST                                 8.00         8.00     7500     Clinical Laboratory
     02831386-7500   HEMOGLOBIN PLAS                               14.65        14.65     7500     Clinical Laboratory
     02821182-7500   CHLORIDE OTHER SOURCE                          8.00         8.00     7500     Clinical Laboratory
     02839910-7500   CHOLINESTERASE RBC                            12.38        12.38     7500     Clinical Laboratory
     02821187-7500   SODIUM OTHER SOURCE                            8.00         8.00     7500     Clinical Laboratory
     02840320-7500   PTH Intact                                     9.25         9.25     7500     Clinical Laboratory
     02835200-7500   METHAQUALONE SCRN                              5.01         5.01     7500     Clinical Laboratory
     02823053-7500   CEA                                           39.79        39.79     7500     Clinical Laboratory
     02317857-7500   GTT 5HR 1ST 3 SPEC                           271.00       271.00     7500     Clinical Laboratory
     02317907-7500   GTT 6HR 1ST 3 SPEC                           271.00       271.00     7500     Clinical Laboratory
     02319309-7500   MAGNESIUM UR                                  90.00        90.00     7500     Clinical Laboratory
     02318103-7500   GLUCOSE UR QN                                 90.00        90.00     7500     Clinical Laboratory
     02314760-7500   CARBON MONOXIDE                              112.00       112.00     7500     Clinical Laboratory
     02832010-7500   IRON LIVER TISSUE                             82.55        82.55     7500     Clinical Laboratory
     02851012-7500   BLD FATTY ACIDS                               15.00        15.00     7500     Clinical Laboratory
     02823290-7500   BENZODIAZEPINES                               28.00        28.00     7500     Clinical Laboratory
     02811450-7500   NATURAL KILLER CELLS                          37.50        37.50     7500     Clinical Laboratory
     02839108-7500   QN DRG MISC                                   31.50        31.50     7500     Clinical Laboratory
     02834800-7500   METHADONE                                     35.55        35.55     7500     Clinical Laboratory
     02816675-7500   AMPHETAMINE QN                                97.50        97.50     7500     Clinical Laboratory
     02816510-7500   TOXOPLAS AB                                   47.00        47.00     7500     Clinical Laboratory
     02580900-7500   RBC PS                                       210.00       210.00     7500     Clinical Laboratory
     02561405-7500   PLTC PS                                      100.00       100.00     7500     Clinical Laboratory
     02561207-7500   CRYO PS                                       72.00        72.00     7500     Clinical Laboratory
     02825535-7500   EHRLICHIA AB IGM                              19.18        19.18     7500     Clinical Laboratory
     02811503-7500   METHANOL BLD                                  23.50        23.50     7500     Clinical Laboratory
     02530055-7500   PLTC IRRADIATED PS                            50.00        50.00     7500     Clinical Laboratory
     02812303-7500   AMITRIPTYLINE                                 23.00        23.00     7500     Clinical Laboratory
     02530015-7500   AG SCRN PER UNIT RGNT                         42.00        42.00     7500     Clinical Laboratory



8/31/2010                                                                                                                   134
                                                 c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                            CURRENT CURRENT         DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                INPATIENT OUTPATIENT CODE
                                                                PRICE      PRICE
     02812923-7500   AMPHETAMINE SCRN                                 5.01         5.01     7500     Clinical Laboratory
     02812949-7500   AMPHETAMINE QN                                  36.81        36.81     7500     Clinical Laboratory
     02530030-7500   SER PRETRTMT INC/INHIB                         160.00       160.00     7500     Clinical Laboratory
     02530025-7500   RBC PRETRTMT CHEM/DRG                          180.00       180.00     7500     Clinical Laboratory
     02832550-7500   LEGIONELLA AB IGG                               10.50        10.50     7500     Clinical Laboratory
     02813611-7500   ENZYME CELL ACT NON-RAD                        118.71       118.71     7500     Clinical Laboratory
     02834025-7500   M TB AMP PRB                                    99.00        99.00     7500     Clinical Laboratory
     02811701-7500   ALDOSTERONE UR                                  39.00        39.00     7500     Clinical Laboratory
     02812105-7500   AMINO ACIDS UR MULT QL                          19.00        19.00     7500     Clinical Laboratory
     02845040-7500   LONG CHAIN FATTY ACIDS                         101.18       101.18     7500     Clinical Laboratory
     02828815-7500   MOL DX AMP PT N ACD EA SQ                       37.73        37.73     7500     Clinical Laboratory
     02830302-7500   ENZYME HISTOCHEMISTRY                            0.00         0.00     7500     Clinical Laboratory
     02561215-7500   CRYO PS                                        590.00       590.00     7500     Clinical Laboratory
     02820400-7500   CRYOGLOB QL OR SEMI QL                           5.00         5.00     7500     Clinical Laboratory
     02816245-7500   BENZODIAZEPINES                                 56.87        56.87     7500     Clinical Laboratory
     02823706-7500   ECHINOCOCCUS AB                                 42.85        42.85     7500     Clinical Laboratory
     02812154-7500   AMINO ACID UR QNT 2-5                           75.50        75.50     7500     Clinical Laboratory
     02822005-7500   CYCLIC AMP                                      27.50        27.50     7500     Clinical Laboratory
     02822104-7500   CYCLOSPORINE (PROGRAF)                          32.10        32.10     7500     Clinical Laboratory
     02826355-7500   QN DRG MISC                                     69.65        69.65     7500     Clinical Laboratory
     02822401-7500   11 DEOXYCORTISOL                                27.50        27.50     7500     Clinical Laboratory
     02822609-7500   DESIPRAMINE                                     18.25        18.25     7500     Clinical Laboratory
     02845180-7500   BUPROPION                                       35.00        35.00     7500     Clinical Laboratory
     02823950-7500   BENZODIAZEPINE SCRN                              5.01         5.01     7500     Clinical Laboratory
     02560928-7500   WASHED RBC PS                                  100.00       100.00     7500     Clinical Laboratory
     02820515-7500   NTELOPEPTIDE SERUM                              95.00        95.00     7500     Clinical Laboratory
     02846519-7500   RIBOFLAVIN                                      55.00        55.00     7500     Clinical Laboratory
     02323012-7500   ASO TTR                                        130.00       130.00     7500     Clinical Laboratory
     02561322-7500   MISC TS PROC                                    75.00        75.00     7500     Clinical Laboratory
     02561421-7500   PHER L/D HLA MATCHED PS                        960.00       960.00     7500     Clinical Laboratory
     02838823-7500   T LYMPH CD4 (HELPER) CNT                        29.45        29.45     7500     Clinical Laboratory
     02838804-7500   PLSMG ACTIVATOR INHIBITOR                       55.00        55.00     7500     Clinical Laboratory
     02838605-7500   PHENYLALANINE BLOOD                             37.50        37.50     7500     Clinical Laboratory
     02817609-7500   CALCIUM IONIZED                                 10.00        10.00     7500     Clinical Laboratory
     02817500-7500   CALCIUM                                          5.00         5.00     7500     Clinical Laboratory
     02839405-7500   PROPOXYPHENE SCRN                                5.01         5.01     7500     Clinical Laboratory
     02816239-7500   BENZODIAZEPINES                                 35.00        35.00     7500     Clinical Laboratory
     02839900-7500   CHOLINESTERASE SER                              12.37        12.37     7500     Clinical Laboratory



8/31/2010                                                                                                                     135
                                                 c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                            CURRENT CURRENT         DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                INPATIENT OUTPATIENT CODE
                                                                PRICE      PRICE
     02817203-7500   CADMIUM                                         25.50        25.50     7500     Clinical Laboratory
     02840221-7500   PTH C TERMINAL                                  34.00        34.00     7500     Clinical Laboratory
     02836203-7500   MURAMIDASE                                      42.50        42.50     7500     Clinical Laboratory
     02845420-7500   CHLAMYDIA AB IGA                                 8.50         8.50     7500     Clinical Laboratory
     02837805-7500   FLUOR AB SCRN EA AB SCRN                        17.00        17.00     7500     Clinical Laboratory
     02837201-7500   5 NUCLEOTIDASE                                  37.61        37.61     7500     Clinical Laboratory
     02837300-7500   OPIATES SCRN                                     5.01         5.01     7500     Clinical Laboratory
     02817922-7500   CANNABINOID SCRN                                 5.01         5.01     7500     Clinical Laboratory
     02817708-7500   CALC ANALYSIS CHEM QN                           25.00        25.00     7500     Clinical Laboratory
     02846707-7500   ASCORBIC ACID                                   14.00        14.00     7500     Clinical Laboratory
     02816502-7500   B PERTUSSIS/PARAPERT DFA                        10.00        10.00     7500     Clinical Laboratory
     02816403-7500   BLASTOMYCES AB                                  19.35        19.35     7500     Clinical Laboratory
     02824415-7500   HANTAVIRUS AB                                   25.00        25.00     7500     Clinical Laboratory
     02840502-7500   RENIN                                           16.50        16.50     7500     Clinical Laboratory
     02841906-7500   KETOSTEROIDS 17 TOTAL                           18.50        18.50     7500     Clinical Laboratory
     02843803-7500   PHENOTHIAZINE                                   20.00        20.00     7500     Clinical Laboratory
     02844801-7500   TOXOPLAS AB IGG                                  8.75         8.75     7500     Clinical Laboratory
     02844900-7500   TOXOPLAS AB IGM                                  8.74         8.75     7500     Clinical Laboratory
     02811157-7500   FCTR INHIBITOR TEST                            117.00       117.00     7500     Clinical Laboratory
     02563239-7500   AB TTR                                         250.00       250.00     7500     Clinical Laboratory
     02563224-7500   SER PRETRTMT INCUB/ DRG                        500.00       500.00     7500     Clinical Laboratory
     02563214-7500   RBC PRETRTMT DENSITY GRAD                      400.00       400.00     7500     Clinical Laboratory
     02829307-7500   HSV AB IGM                                      14.72        14.72     7500     Clinical Laboratory
     02830602-7500   IMIPRAMINE                                      22.00        22.00     7500     Clinical Laboratory
     02563199-7500   CMV AB                                          25.00        25.00     7500     Clinical Laboratory
     02814355-7500   PLT AB INDIRECT                                 70.00        70.00     7500     Clinical Laboratory
     02832350-7500   SIALIC ACID                                     18.50        18.50     7500     Clinical Laboratory
     02832103-7500   JO 1 AB                                         31.00        31.00     7500     Clinical Laboratory
     02832517-7500   LEGIONELLA AB                                   11.33        11.33     7500     Clinical Laboratory
     02832806-7500   LEUCINE AMINOPEOTIDASE                          32.00        32.00     7500     Clinical Laboratory
     02830305-7500   HYDROXYPROLINE FREE                             48.30        48.30     7500     Clinical Laboratory
     02830404-7500   HYDROXYPROLINE TOTAL                            50.98        50.98     7500     Clinical Laboratory
     02830800-7500   IMMUNE COMPLEX CIQ BIND                         16.25        16.25     7500     Clinical Laboratory
     02806310-7500   FCTR VIII VW MULTIMER                          187.75       187.75     7500     Clinical Laboratory
     02834802-7500   METHADONE                                       51.55        51.55     7500     Clinical Laboratory
     02825800-7500   ETHOSUXIMIDE                                    20.50        20.50     7500     Clinical Laboratory
     02563129-7500   RBC PRETRTMT ENZYME                            250.00       250.00     7500     Clinical Laboratory
     02825206-7500   ESTRIOL                                         33.50        33.50     7500     Clinical Laboratory



8/31/2010                                                                                                                     136
                                                 c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                            CURRENT CURRENT         DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                INPATIENT OUTPATIENT CODE
                                                                PRICE      PRICE
     02826337-7500   5 HIAA UR                                        7.50         7.50     7500     Clinical Laboratory
     02563179-7500   MISC TS PROC                                    10.00        10.00     7500     Clinical Laboratory
     02824358-7500   HEMOSIDERIN QL                                  12.00        12.00     7500     Clinical Laboratory
     02834042-7500   MAPROTILINE                                     29.26        29.26     7500     Clinical Laboratory
     02833210-7500   APOLIPOPROTEIN A1                               20.00        20.00     7500     Clinical Laboratory
     02821307-7500   CHROMIUM                                        22.25        22.25     7500     Clinical Laboratory
     02823508-7500   DOXEPIN                                         22.00        22.00     7500     Clinical Laboratory
     02823300-7500   DISOPYRAMIDE                                    15.00        15.00     7500     Clinical Laboratory
     02223105-7500   PAP DX TBS SCRN                                 93.00        93.00     7500     Clinical Laboratory
     02821908-7500   CYANIDE                                         35.99        35.99     7500     Clinical Laboratory
     02840304-7500   PTH MID REGION                                  34.00        34.00     7500     Clinical Laboratory
     02886403-7500   BACTERIAL AG EA AG                               6.00         6.00     7500     Clinical Laboratory
     02892491-7500   CHROMAT QN EA ANALTE                            95.00        95.00     7500     Clinical Laboratory
     02288174-7500   PAP DX THN LR AUTO SCRN                        138.00       138.00     7500     Clinical Laboratory
     02823520-7500   IMMUNOASSAY NOT SPEC                           125.00       125.00     7500     Clinical Laboratory
     02853519-7500   IMMUNOASSAY ANALYTE QN                          58.00        58.00     7500     Clinical Laboratory
     02897252-7500   CULT V ZOSTER                                   21.00        21.00     7500     Clinical Laboratory
     02887253-7500   VIRUS CULT ID                                   14.00        14.00     7500     Clinical Laboratory
     02893519-7500   TRYPSIN                                         35.00        35.00     7500     Clinical Laboratory
     02876021-7500   ANTINEUTROPHILIC AB                             75.00        75.00     7500     Clinical Laboratory
     02384133-7500   POTASSIUM UR TIM                                90.00        90.00     7500     Clinical Laboratory
     02843519-7500   IMMUNOASSAY ANALYTE QN                          95.00        95.00     7500     Clinical Laboratory
     02382150-7500   AMYLASE UR 2HR                                 284.00       284.00     7500     Clinical Laboratory
     02873520-7500   IMMUNOASSAY NOT SPEC                            40.00        40.00     7500     Clinical Laboratory
     02857798-7500   AG DETECT NOS DNA AMP                          130.00       130.00     7500     Clinical Laboratory
     02885335-7500   FCTR INHIBITOR TEST                            115.25       115.25     7500     Clinical Laboratory
     02384153-7500   PSA TOTAL SCRN                                 134.00       134.00     7500     Clinical Laboratory
     02866611-7500   BARTONELLA AB IGM                                6.25         6.25     7500     Clinical Laboratory
     02876611-7500   BARTONELLA AB IGG                                6.25         6.25     7500     Clinical Laboratory
     02873519-7500   IMMUNOASSAY ANALYTE QN                         106.20       106.20     7500     Clinical Laboratory
     02893912-7500   MOL DX INTERP & RPT                             10.91        10.91     7500     Clinical Laboratory
     02893901-7500   MOL DX AMP NA MLTIP EA SQ                       31.36        31.36     7500     Clinical Laboratory
     02893896-7500   MOL DX NUC ACID PRB                             10.91        10.91     7500     Clinical Laboratory
     02893894-7500   MOL DX GEL ELECTRO SEP                          16.36        16.36     7500     Clinical Laboratory
     02893893-7500   MOL DX DOT/SLOT BLOT                            21.82        21.82     7500     Clinical Laboratory
     02883892-7500   MOL DX ENZ DIGESTION                            17.14        17.14     7500     Clinical Laboratory
     02873891-7500   MOL DX EXTRACTION HI PUR                        10.91        10.91     7500     Clinical Laboratory
     02840299-7500   SULFAMETHOXAZOLE                                61.20        61.20     7500     Clinical Laboratory



8/31/2010                                                                                                                     137
                                               c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                          CURRENT CURRENT         DEPARTMENT   DEPARTMENT DESCRIPTION
                                                              INPATIENT OUTPATIENT CODE
                                                              PRICE      PRICE
     02888264-7500   CHRMOSOM ANALYZE 20-25                         0.00         0.00     7500     Clinical Laboratory
     02888280-7500   CHRMOSOM ADD KARY EA                           0.00         0.00     7500     Clinical Laboratory
     02299001-7500   STATISTICAL TRACKING                           0.00         0.00     7500     Clinical Laboratory
     02882131-7500   AMINO ACIDS SGL QN                            75.00        75.00     7500     Clinical Laboratory
     02850299-7500   DEXAMETHASONE                                 63.30        63.30     7500     Clinical Laboratory
     02877252-7500   CULTVIRAL                                     59.50        59.50     7500     Clinical Laboratory
     02813519-7500   INSULIN GROWTH FCTR                           70.00        70.00     7500     Clinical Laboratory
     02885292-7500   PREKALLIKREIN ASSAY                          103.50       103.50     7500     Clinical Laboratory
     02883655-7500   LEAD UR 24HR                                  10.00        10.00     7500     Clinical Laboratory
     02887385-7500   HISTO CAPSULATUM AG EIA                       80.00        80.00     7500     Clinical Laboratory
     02882544-7500   FATTY ACIDS MULT ANALY                       169.76       169.76     7500     Clinical Laboratory
     02885520-7500   HEPARIN ASSAY                                 76.50        76.50     7500     Clinical Laboratory
     02850101-7500   PHENCYCLIDINE SCRN                             5.01         5.01     7500     Clinical Laboratory
     02860101-7500   METHADONE SCRN                                 5.01         5.01     7500     Clinical Laboratory
     02870101-7500   BENZOYLECGONINE SCRN                           5.01         5.01     7500     Clinical Laboratory
     02890101-7500   BARBITURATES SCRN                              5.01         5.01     7500     Clinical Laboratory
     02880102-7500   OPIATES CONF                                  25.00        25.00     7500     Clinical Laboratory
     02877798-7500   AG DETECT NOS DNA AMP                        105.00       105.00     7500     Clinical Laboratory
     02896790-7500   VIRUS AB NOT SPEC                             27.56        27.56     7500     Clinical Laboratory
     02314740-7500   O2 SAT ART                                   112.00       112.00     7500     Clinical Laboratory
     02560750-7500   AT PS                                        127.00       127.00     7500     Clinical Laboratory
     02897482-7500   ADENOVIRUS DFA                                22.00        22.00     7500     Clinical Laboratory
     02834710-7500   PHENOTHIAZINE                                 22.50        22.50     7500     Clinical Laboratory
     02887110-7500   CHLAMYDIA CULT                                76.60        76.60     7500     Clinical Laboratory
     02887278-7500   LEGIONELLA PNEUMO DFA                         35.00        35.00     7500     Clinical Laboratory
     02887280-7500   RSV DFA                                       24.00        24.00     7500     Clinical Laboratory
     02811010-7500   ACETYLCHOLINE MODULE AB                       59.00        59.00     7500     Clinical Laboratory
     02887252-7500   CULT RSV                                      65.00        65.00     7500     Clinical Laboratory
     02821300-7500   AMINO ACIDS CSF >5 QN                         62.78        62.78     7500     Clinical Laboratory
     02885475-7500   HEMOLYSIN ACID (HAM'S)                        42.50        42.50     7500     Clinical Laboratory
     02883003-7500   GROWTH HORMONE                                12.50        12.50     7500     Clinical Laboratory
     02805066-7500   FLUXOETINE                                    20.50        20.50     7500     Clinical Laboratory
     02822301-7500   EPINEPHRINE                                   25.00        25.00     7500     Clinical Laboratory
     02886332-7500   IMMUNE COMPLEX CIQ BIND                       34.65        34.65     7500     Clinical Laboratory
     02882030-7500   CYCLIC AMP                                    27.50        27.50     7500     Clinical Laboratory
     02483874-7500   MYOGLOBIN                                     97.00        97.00     7500     Clinical Laboratory
     02482553-7500   CK MB FRACTION                                86.00        86.00     7500     Clinical Laboratory
     02884022-7500   PHENOTHIAZINE                                 36.00        36.00     7500     Clinical Laboratory



8/31/2010                                                                                                                   138
                                                 c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                            CURRENT CURRENT         DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                INPATIENT OUTPATIENT CODE
                                                                PRICE      PRICE
     02884510-7500   TYROSINE                                        37.50        37.50     7500     Clinical Laboratory
     02886668-7500   FRANCISELLA TULARENSIS AB                       24.00        24.00     7500     Clinical Laboratory
     02839925-7500   PROPRANOLOL                                     21.24        21.24     7500     Clinical Laboratory
     02819216-7500   NATRIURETIC PEPTIDE                             73.01        73.01     7500     Clinical Laboratory
     02883088-7500   HISTAMINE                                       66.50        66.50     7500     Clinical Laboratory
     02852308-7500   INFLUENZA B AB                                  16.00        16.00     7500     Clinical Laboratory
     02886710-7500   INFLUENZA A AB                                  16.00        16.00     7500     Clinical Laboratory
     02807716-7500   DEOXYPYRIDINOLINE                               55.00        55.00     7500     Clinical Laboratory
     02877521-7500   HEP C VIRUS AMP PRB                            200.00       200.00     7500     Clinical Laboratory
     02883835-7500   METANEPHRINES BLOOD                            118.40       118.40     7500     Clinical Laboratory
     02318075-7500   GLUCOSE 2HR PP                                  90.00        90.00     7500     Clinical Laboratory
     02887338-7500   H PYLORI STL EIA                                53.00        53.00     7500     Clinical Laboratory
     02880158-7500   CYCLOSPORINE (PROGRAF)                          25.35        25.35     7500     Clinical Laboratory
     02880194-7500   QUINIDINE                                       21.00        21.00     7500     Clinical Laboratory
     02805983-7500   AMINO ACIDS UR >5 QN                           131.00       131.00     7500     Clinical Laboratory
     02860863-7500   NTELOPEPTIDE UR                                 55.00        55.00     7500     Clinical Laboratory
     02876787-7500   VZV AB IGM                                      14.72        14.72     7500     Clinical Laboratory
     02892544-7500   FATTY ACIDS MULT ANALY                         151.62       151.62     7500     Clinical Laboratory
     02846790-7500   VIRUS AB NOT SPEC                               26.25        26.25     7500     Clinical Laboratory
     02886603-7500   ADENOVIRUS AB                                   22.00        22.00     7500     Clinical Laboratory
     02882397-7500   CHEMILUMINESCENT ASSAY                          95.00        95.00     7500     Clinical Laboratory
     02883903-7500   MOL DX MUT SCAN                                 19.90        19.90     7500     Clinical Laboratory
     02876727-7500   LYMPH CHORIOMENINGITIS AB                       14.72        14.72     7500     Clinical Laboratory
     02876765-7500   RUBEOLA AB IGG                                  14.72        14.72     7500     Clinical Laboratory
     02866765-7500   RUBEOLA AB IGM                                  14.72        14.72     7500     Clinical Laboratory
     02876735-7500   MUMPS AB IGM                                    14.72        14.72     7500     Clinical Laboratory
     02866735-7500   MUMPS AB IGG                                    14.72        14.72     7500     Clinical Laboratory
     02896787-7500   VZV AB                                          14.72        14.72     7500     Clinical Laboratory
     02883785-7500   MANGANESE URINE                                 35.00        35.00     7500     Clinical Laboratory
     02876694-7500   HSV AB                                          14.72        14.72     7500     Clinical Laboratory
     02887496-7500   CMV AMP PRB                                     87.50        87.50     7500     Clinical Laboratory
     02870102-7500   METHADONE CONF                                  48.75        48.75     7500     Clinical Laboratory
     02875335-7500   FCTR INHIBITOR TEST                             32.00        32.00     7500     Clinical Laboratory
     02826003-7500   ALLERGEN SPECIFIC IGE QN                        42.71        42.71     7500     Clinical Laboratory
     02833080-7500   B-HEXOSAMINIDASE EA ASSAY                       90.56        90.56     7500     Clinical Laboratory
     02897081-7500   CULT LEGIONELLA                                 30.00        30.00     7500     Clinical Laboratory
     02888188-7500   CELL MARKR INTERPRET 9-15                       10.45        10.45     7500     Clinical Laboratory
     02898185-7500   CELL MARKR TECH EA ADDL                         10.20        10.20     7500     Clinical Laboratory



8/31/2010                                                                                                                     139
                                                 c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                            CURRENT CURRENT         DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                INPATIENT OUTPATIENT CODE
                                                                PRICE      PRICE
     02887476-7500   BORELLIA BURG AMP PRB                          150.00       150.00     7500     Clinical Laboratory
     02895597-7500   HEXAGONAL PHASE NEUTRALIZ                       46.73        46.73     7500     Clinical Laboratory
     02816003-7500   ALLERGEN SPECIFIC IGE QN                         5.08         5.08     7500     Clinical Laboratory
     02896753-7500   BABESIA AB IGM                                  17.50        17.50     7500     Clinical Laboratory
     02863789-7500   MASS SPECT/TANDEM QN NES                        59.51        59.51     7500     Clinical Laboratory
     02840101-7500   DRG SCRN UR SGL 1ST                             32.00        32.00     7500     Clinical Laboratory
     02847798-7500   AG DETECT NOS DNA AMP                          170.50       170.50     7500     Clinical Laboratory
     02867252-7500   CULTVIRAL                                       30.00        30.00     7500     Clinical Laboratory
     02876038-7500   ANA (ANTI NUCLEAR AB)                           42.00        42.00     7500     Clinical Laboratory
     02886753-7500   BABESIA AB 1GG                                  17.50        17.50     7500     Clinical Laboratory
     02868291-7500   CYTGNTC INTERP/RPRT                              0.00         0.00     7500     Clinical Laboratory
     02898274-7500   DNA PRB CYTGNTC 25-99                            0.00         0.00     7500     Clinical Laboratory
     02898271-7500   DNA PRB CYTGNTC EA                               0.00         0.00     7500     Clinical Laboratory
     02823519-7500   IMMUNOASSAY ANALYTE QN                         234.00       234.00     7500     Clinical Laboratory
     02887255-7500   CULT HSV                                        21.00        21.00     7500     Clinical Laboratory
     02898230-7500   TISSUE CULT LYMPH                              132.00       132.00     7500     Clinical Laboratory
     02868271-7500   DNA PRB CYTGNTC EA                              27.50        27.50     7500     Clinical Laboratory
     02898273-7500   DNA PRB CYTGNTC 10 30                           55.00        55.00     7500     Clinical Laboratory
     02863516-7500   IMMUNOASSAY NONINFECT                          155.00       155.00     7500     Clinical Laboratory
     02858291-7500   CYTGNTC INTERP/RPRT                             60.50        60.50     7500     Clinical Laboratory
     02885635-7500   REPTILASE TEST                                  49.50        49.50     7500     Clinical Laboratory
     02882657-7500   ENZYME CELL ACT NON-RAD                        235.00       235.00     7500     Clinical Laboratory
     02896332-7500   IMMUNE COMPLEX CD3 CIRC                         27.35        27.35     7500     Clinical Laboratory
     02856658-7500   ECHO TYPE 7 AB                                  81.29        81.29     7500     Clinical Laboratory
     02882143-7500   DELTA O D AMNIOTIC FLD                          42.39        42.39     7500     Clinical Laboratory
     02894912-7500   MOL DX INTERP & RPT                             50.78        50.78     7500     Clinical Laboratory
     02871901-7500   MOL DX AMP NA MLTIP EA SQ                       50.78        50.78     7500     Clinical Laboratory
     02803894-7500   MOL DX GEL ELECTRO SEP                          50.78        50.78     7500     Clinical Laboratory
     02833892-7500   MOL DX ENZ DIGESTION                            50.78        50.78     7500     Clinical Laboratory
     02896658-7500   ECHO TYPE 11 AB                                 81.29        81.29     7500     Clinical Laboratory
     02883018-7500   HEAVY METALS UR QN EA                           63.00        63.00     7500     Clinical Laboratory
     02866658-7500   ECHO TYPE 9 AB                                  81.29        81.29     7500     Clinical Laboratory
     02846658-7500   ECHO TYPE 6 AB                                  81.29        81.29     7500     Clinical Laboratory
     02886702-7500   HIV-2 AB                                        18.25        18.25     7500     Clinical Laboratory
     02876658-7500   ECHO TYPE 30 AB                                 81.29        81.29     7500     Clinical Laboratory
     02813896-7500   MOL DX NUC ACID PRB                             19.80        19.80     7500     Clinical Laboratory
     02886359-7500   T LYMPH TOT CNT                                 24.75        24.75     7500     Clinical Laboratory
     02896360-7500   T LYMPH CD4/8 CNT&RATIO                         24.75        24.75     7500     Clinical Laboratory



8/31/2010                                                                                                                     140
                                                     c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                                CURRENT CURRENT          DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                    INPATIENT OUTPATIENT CODE
                                                                    PRICE      PRICE
     02873901-7500   MOL DX AMP NA MLTIP EA SQ                           99.00         99.00     7500     Clinical Laboratory
     02883921-7500   METHYLMALONIC ACID UR                               53.00         53.00     7500     Clinical Laboratory
     02892017-7500   ACYLCARNITINES QN EA                                86.00         86.00     7500     Clinical Laboratory
     02837798-7500   AG DETECT NOS DNA AMP                               85.00         85.00     7500     Clinical Laboratory
     02896403-7500   BACTERIAL AG EA AG                                  42.00         42.00     7500     Clinical Laboratory
     02384560-7500   URIC ACID UR RAN                                    90.00         90.00     7500     Clinical Laboratory
     02896334-7500   IMMUNOFIXATION OTHER FLDS                          119.04        119.04     7500     Clinical Laboratory
     02894311-7500   SPECTROPH ADENO DEAMINASE                          125.00        125.00     7500     Clinical Laboratory
     02813280-7500   QN DRG MISC                                         59.00         59.00     7500     Clinical Laboratory
     03000001-7590   Cardiology Procedure Override                        0.00          0.00     7590     Cardiology
     03000002-7590   Cardiology Procedure Addendum                        0.00          0.00     7590     Cardiology
     03000004-7590   EKG Procedure Addendum                               0.00          0.00     7590     Cardiology
     03000003-7590   EKG Procedure Override                               0.00          0.00     7590     Cardiology
     03050888-7590   CA PACER ANLYS DL W/RPRG                           256.00        256.00     7590     Cardiology
     03050854-7590   CA PACER ANLYS SGL W/RPRG                          221.00        221.00     7590     Cardiology
     03050754-7590   CA PACER ANLYS SNGL                                176.00        176.00     7590     Cardiology
     03050788-7590   CA PACER ANLYS DUAL                                246.00        246.00     7590     Cardiology
     05633015-7770   PT Exer Gp Add 15                                  150.00        150.00     7770     Physical Therapy
     05684998-7770   PT Unlisted Proc Init 30                           299.00        299.00     7770     Physical Therapy
     05684999-7770   PT Unlisted Proc Ea 15                             150.00        150.00     7770     Physical Therapy
     05634426-7770   PT Orthotic Train Add 15                           150.00        150.00     7770     Physical Therapy
     05682120-7770   PT Job Site Assess 120                            1198.00       1198.00     7770     Physical Therapy
     05634451-7770   PT Ort/Pro/ADL Ck Add 15                           150.00        150.00     7770     Physical Therapy
     05682060-7770   PT Job Site Assess 60                              598.00        598.00     7770     Physical Therapy
     05682030-7770   PT Job Site Assess 30                              299.00        299.00     7770     Physical Therapy
     05684495-7770   PT Manual Lymph Drain 30                           299.00        299.00     7770     Physical Therapy
     05684496-7770    PT Manual Lymph Drain 15                          150.00        150.00     7770     Physical Therapy
     05682045-7770   PT Job Site Assess 45                              449.00        449.00     7770     Physical Therapy
     05682075-7770   PT Job Site Assess 75                              748.00        748.00     7770     Physical Therapy
     05689006-7770   PT Work Cond Add 60                                598.00        598.00     7770     Physical Therapy
     05634998-7770   PT Unlisted Service                                299.00        299.00     7770     Physical Therapy
     05634436-7770   PT ADL Train Add 15                                150.00        150.00     7770     Physical Therapy
     05634435-7770   PT ADL Train Init 30                               299.00        299.00     7770     Physical Therapy
     05634402-7770   PT Trac Man Init 30                                299.00        299.00     7770     Physical Therapy
     05689012-7770   PT Work Cond Init 120                             1198.00       1198.00     7770     Physical Therapy
     05634450-7770   PT Ort/Pro/ADL Ck Init 30                          299.00        299.00     7770     Physical Therapy
     05634411-7770   PT Gait Train Add 15                               150.00        150.00     7770     Physical Therapy
     05634425-7770   PT Orthotic Train Init 30                          299.00        299.00     7770     Physical Therapy



8/31/2010                                                                                                                          141
                                                 c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                            CURRENT CURRENT          DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                INPATIENT OUTPATIENT CODE
                                                                PRICE      PRICE
     05681115-7770   PT Whirlpool 15                                150.00        150.00     7770     Physical Therapy
     05688041-7770   PT Hubbard Tank Add 15                         150.00        150.00     7770     Physical Therapy
     05688040-7770   PT Hubbard Tank Init 30                        299.00        299.00     7770     Physical Therapy
     05688020-7770   PT Contrast Bath Init 30                       299.00        299.00     7770     Physical Therapy
     05684426-7770   Pt Orthotic Train Add 15                       150.00        150.00     7770     Physical Therapy
     05681050-7770   PT Paraffin Bath 30                            299.00        299.00     7770     Physical Therapy
     05681030-7770   PT Vasopneumatic 30                            299.00        299.00     7770     Physical Therapy
     05680090-7770   PT Eval Comprehensive                          598.00        598.00     7770     Physical Therapy
     05689240-7770   PT Eval Fnx Capacity 240                      2395.00       2395.00     7770     Physical Therapy
     05689120-7770   PT Eval Fnx Capacity 120                      1198.00       1198.00     7770     Physical Therapy
     05689060-7770   PT Eval Fnx Capacity 60                        598.00        598.00     7770     Physical Therapy
     05685160-7770   PT Biofd Peri/Uro/Rect 60                      598.00        598.00     7770     Physical Therapy
     05685145-7770   PT Biofd Peri/Uro/Rect 45                      449.00        449.00     7770     Physical Therapy
     05685130-7770   PT Biofd Peri/Uro/Rect 30                      299.00        299.00     7770     Physical Therapy
     05685115-7770   PT Biofd Peri/Uro/Rect 15                      150.00        150.00     7770     Physical Therapy
     05685060-7770   PT Trn Biofd Any Modal 60                      598.00        598.00     7770     Physical Therapy
     05685045-7770   PT Trn Biofd Any Modal 45                      449.00        449.00     7770     Physical Therapy
     05685015-7770   PT Trn Biofd Any Modal 15                      150.00        150.00     7770     Physical Therapy
     05684436-7770   PT ADL Train Add 15                            150.00        150.00     7770     Physical Therapy
     05684435-7770   PT ADL Train Init 30                           299.00        299.00     7770     Physical Therapy
     05684451-7770   PT Ort/Pro/ADL Ck Add 15                       150.00        150.00     7770     Physical Therapy
     05684450-7770   PT Ort/Pro/ADL Ck Init 30                      299.00        299.00     7770     Physical Therapy
     05689480-7770   PT Eval Fnx Capacity 480                      4790.00       4790.00     7770     Physical Therapy
     05685030-7770   PT Trn Biofd Any Modal 30                      299.00        299.00     7770     Physical Therapy
     05625060-7770   PT Trn Biofd Any Modal 60                      598.00        598.00     7770     Physical Therapy
     05686010-7770   EP Land Prgm Per Auth Ind                       75.00         75.00     7770     Physical Therapy
     05621015-7770   PT Vasopneumatic 15                            150.00        150.00     7770     Physical Therapy
     05623090-7770   PT Proc Ther Gp 90                             315.00        315.00     7770     Physical Therapy
     05686012-7770   EP Land Prgm Per Auth Grp                      113.00        113.00     7770     Physical Therapy
     05625045-7770   PT Trn Biofd Any Modal 45                      449.00        449.00     7770     Physical Therapy
     05628040-7770   PT Hubbard Tank Ea 15                          150.00        150.00     7770     Physical Therapy
     05684712-7770   EP Aqtc Prior Auth Grp                         150.00        150.00     7770     Physical Therapy
     05621030-7770   PT Vasopneumatic 30                            299.00        299.00     7770     Physical Therapy
     05624450-7770   PT Prosthetic FU Ea 15M                        150.00        150.00     7770     Physical Therapy
     05631001-7770   PT Traction Mech Init 30                       299.00        299.00     7770     Physical Therapy
     05631030-7770   PT Compress Pump Init 30                       299.00        299.00     7770     Physical Therapy
     05631115-7770   PT Whirlpool Sup Add 15                        150.00        150.00     7770     Physical Therapy
     05631015-7770   PT Compress Pump Add 15                        150.00        150.00     7770     Physical Therapy



8/31/2010                                                                                                                      142
                                                          c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                                     CURRENT CURRENT          DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                         INPATIENT OUTPATIENT CODE
                                                                         PRICE      PRICE
     05686005-7770   Ea Prior Auth Ind 15 Min                                150.00        150.00     7770     Physical Therapy
     05638041-7770   PT Hubbard Tank Add 15                                  138.00        138.00     7770     Physical Therapy
     05638040-7770   PT Hubbard Tank Init 30                                 299.00        299.00     7770     Physical Therapy
     05638020-7770   PT Contrast Bath Init 30                                299.00        299.00     7770     Physical Therapy
     05638005-7770   PT Iontophoresis Init 30                                299.00        299.00     7770     Physical Therapy
     05631130-7770   PT Whirlpool Sup Init 30                                299.00        299.00     7770     Physical Therapy
     05622500-7770   PT Unlisted Phys Med Proc                               150.00        150.00     7770     Physical Therapy
     05631050-7770   PT Paraffin Bath Init 30                                299.00        299.00     7770     Physical Therapy
     05622515-7770   PT Phys Perfrm Test Ea 15                               150.00        150.00     7770     Physical Therapy
     05625160-7770   PT Biofd Peri/Uro/Rect 60                               598.00        598.00     7770     Physical Therapy
     05625115-7770   PT Biofd Peri/Uro/Rect 15                               150.00        150.00     7770     Physical Therapy
     05625145-7770   PT Biofd Peri/Uro/Rect 45                               449.00        449.00     7770     Physical Therapy
     05625130-7770   PT Biofd Peri/Uro/Rect 30                               299.00        299.00     7770     Physical Therapy
     03800001-7830   Cancellation Charge                                      30.00         30.00     7830     Neuro Psychology
     03880220-7830   Psyc Tx 20-30M OP                                       214.00        214.00     7830     Neuro Psychology
     03880120-7830   Hlth/Bhvr Intrv Ind Ea 15                               143.00        143.00     7830     Neuro Psychology
     03880100-7830   Psyo Med Team Conf 60M                                  428.00        428.00     7830     Neuro Psychology
     03880190-7830   PSYC NEUROBEHAVR EXAM/HR                                428.00        428.00     7830     Neuro Psychology
     03880420-7830   Psyc Tx 20-30M                                          214.00        214.00     7830     Neuro Psychology
     03880245-7830   Psyc Tx 45-50M OP                                       321.00        321.00     7830     Neuro Psychology
     03880110-7830   Hlth/Bhvr Intrv Grp                                     143.00        143.00     7830     Neuro Psychology
     03880050-7830   No Show Visit                                             0.00        858.00     7830     Neuro Psychology
     03880275-7830   Psyc Tx 75-80M OP                                       535.00        535.00     7830     Neuro Psychology
     03880545-7830   Psychophys Tx 45-50M                                    321.00        321.00     7830     Neuro Psychology
     03880475-7830   Psyc Tx 75-80M                                          535.00        535.00     7830     Neuro Psychology
     03880162-7830   Psyc Tx Group                                           143.00        143.00     7830     Neuro Psychology
     09096033-8320   Level 2 Consult Low                                       0.00        112.00     8320     Food Services
     09096025-8320   Level 3 Est Patient                                       0.00         29.00     8320     Food Services
     05511407-7720   S O2 By Pedi Tent Subsequent Days                       649.00        649.00     7720     Respiratory Care Services
     05560149-7720   Spiro w/Bronch & Diffusion Capacit                        0.00          0.00     7720     Respiratory Care Services
     05560131-7720   Spiro w Lung Volumes No Bronchodil                        0.00          0.00     7720     Respiratory Care Services
     05560123-7720   Spiro w/Bronchodilator & Lung Vols                        0.00          0.00     7720     Respiratory Care Services
     05560115-7720   Complete Exam No Bronchodilator                           0.00          0.00     7720     Respiratory Care Services
     05560107-7720   Complete Exam w/ Bronchodilator                           0.00          0.00     7720     Respiratory Care Services
     05511308-7720   S O2 By Pedi Tent Initial Day                          1083.00       1083.00     7720     Respiratory Care Services
     05500001-7720   Respiratory Procedure Override                            0.00          0.00     7720     Respiratory Care Services
     05560164-7720   Spiro N/Bronch & Diffusing Capacit                        0.00          0.00     7720     Respiratory Care Services
     05500002-7720   Respiratory Procedure Addendum                            0.00          0.00     7720     Respiratory Care Services



8/31/2010                                                                                                                                  143
                                               c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                          CURRENT CURRENT          DEPARTMENT   DEPARTMENT DESCRIPTION
                                                              INPATIENT OUTPATIENT CODE
                                                              PRICE      PRICE
     05520903-7720   TCM SUBSEQUENT DAY                           762.00        762.00     7720     Respiratory Care Services
     05510171-7720   Adult CPAP Mask/Circuit                      198.00        198.00     7720     Respiratory Care Services
     05510163-7720   CPAP INITIAL DAY                            2148.00       2148.00     7720     Respiratory Care Services
     05520922-7720   TCM PT ASSESS ELECTRODE REPOSIT                0.00          0.00     7720     Respiratory Care Services
     05530920-7720   INHALATION TX PENTAMIDINE                    160.00        160.00     7720     Respiratory Care Services
     05510511-7720   S STRL Infant CPAP Mask/Circuit              198.00        198.00     7720     Respiratory Care Services
     05510233-7720   NIV NON-EMERGENT SETTING ADJUST                0.00          0.00     7720     Respiratory Care Services
     05510222-7720   NIV NON-EMERGENT PT/SYS ASSESS                 0.00          0.00     7720     Respiratory Care Services
     05510422-7720   VENTILATOR SETTING ADJUSTMENT                  0.00          0.00     7720     Respiratory Care Services
     05560650-7720   SPECIALTY GAS CYLINDER CHANGE                  0.00          0.00     7720     Respiratory Care Services
     05550315-7720   THER PROC STRNTH/ENDR 15M                    106.00        106.00     7720     Respiratory Care Services
     05530422-7720   CPT INITIAL                                  128.00        128.00     7720     Respiratory Care Services
     05541022-7720   SUCTION AIRWAY W/INLINE CATH                   0.00          0.00     7720     Respiratory Care Services
     05541011-7720   SUCTIONING OF ARTICIAL AIRWAY                  0.00          0.00     7720     Respiratory Care Services
     05510884-7720   PLACE/REMOVE SPEECH VALVE                      0.00          0.00     7720     Respiratory Care Services
     05530922-7720   S NSTRL Pentamidine Nebulizer                126.00        126.00     7720     Respiratory Care Services
     05510826-7720   EXTUBATION OF AIRWAY                           0.00          0.00     7720     Respiratory Care Services
     05560655-7720   PULMONARY MECHANICS                            0.00          0.00     7720     Respiratory Care Services
     05510815-7720   S STRL VENT EQUIPMENT CHANGE                   0.00          0.00     7720     Respiratory Care Services
     05510861-7720   PLACEMENT OF NASAL AIRWAY                      0.00          0.00     7720     Respiratory Care Services
     05510411-7720   VENTILATOR PATIENT ASSESSMENT                  0.00          0.00     7720     Respiratory Care Services
     05510235-7720   NIV EMERGENT SETTING ADJUSTMENT                0.00          0.00     7720     Respiratory Care Services
     05510225-7720   NIV EMERGENT PT/SYS ASSESSMENT                 0.00          0.00     7720     Respiratory Care Services
     05510203-7720   CPAP SUBSEQUENT DAY                         1831.00       1831.00     7720     Respiratory Care Services
     05510841-7720   MONITOR CUFF PRESSURE                          0.00          0.00     7720     Respiratory Care Services
     05510824-7720   ET RESTABILIZE AND POSITION                    0.00          0.00     7720     Respiratory Care Services
     05510822-7720   ET INTUBATION ASSIST                           0.00          0.00     7720     Respiratory Care Services
     05510814-7720   TRACH TUBE CARE                                0.00          0.00     7720     Respiratory Care Services
     05510801-7720   TRACH TUBE CHANGE                              0.00          0.00     7720     Respiratory Care Services
     05510014-7720   Patient Assessment Subsequent                  0.00          0.00     7720     Respiratory Care Services
     05510012-7720   Patient Assessment Initial                     0.00          0.00     7720     Respiratory Care Services
     05530180-7720   Aerosol Tx Demo/Eval                         160.00        160.00     7720     Respiratory Care Services
     05511111-7720   S 02 AEROSOL PT/SYSTEM CHECK                   0.00          0.00     7720     Respiratory Care Services
     05531020-7720   AEROSOL TX SUBSQ                             156.00        156.00     7720     Respiratory Care Services
     05511022-7720   S 02 EQUIPMENT CHANGE                          0.00          0.00     7720     Respiratory Care Services
     05511011-7720   SUPPLEMENTAL 02 PT/SYSTEM CHECK                0.00          0.00     7720     Respiratory Care Services
     05511122-7720   S 02 AEROSOL EQUIP CHANGE ADULT                0.00          0.00     7720     Respiratory Care Services
     05550330-7720   ASTHMA EDUCATION                              16.00         16.00     7720     Respiratory Care Services



8/31/2010                                                                                                                       144
                                                  c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                             CURRENT CURRENT         DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                 INPATIENT OUTPATIENT CODE
                                                                 PRICE      PRICE
     05520588-7720   PULSE OX DOWNLOAD OF STUDY DATA                   0.00         0.00     7720     Respiratory Care Services
     05540298-7720   INHOUSE TRANSPORT W/VENTILATOR                    0.00         0.00     7720     Respiratory Care Services
     05540278-7720   RAPID RESPNSE TEAM CALL                           0.00         0.00     7720     Respiratory Care Services
     05540223-7720   BLOOD GAS PROCUREMENT                             0.00         0.00     7720     Respiratory Care Services
     05520190-7720   ETCO2 INIT DAY                                  748.00       748.00     7720     Respiratory Care Services
     05530244-7720   MDI/Neb Demo/Eval                               105.00       105.00     7720     Respiratory Care Services
     05530711-7720   INCENTIVE SPIROMETRY INSTRUCT                     0.00         0.00     7720     Respiratory Care Services
     03890399-8360   CONSULTATION W FAMILY                            91.00        91.00     8360     Social Work Services
     03890084-8360   PF INIT IP CONSULT 20 MIN                       370.00       370.00     8360     Social Work Services
     03890407-8360   CONSULTATION W FAMILY                           187.00       187.00     8360     Social Work Services
     03890381-8360   CONSULTATION W FAMILY                           187.00       187.00     8360     Social Work Services
     03890035-8360   PF F/U IP CONSULT 30 MIN                        363.00       363.00     8360     Social Work Services
     03890514-8360   LCSW Non-Revenue Counseling                       0.00         0.00     8360     Social Work Services
     03890530-8360   LCSW Rounds                                       0.00         0.00     8360     Social Work Services
     03890614-8360   LCSW Non-Revenue Discharge Plannin                0.00         0.00     8360     Social Work Services
     03890506-8360   LCSW Case Management                              0.00         0.00     8360     Social Work Services
     03890507-8360   LCSW I/P Case Management                          0.00         0.00     8360     Social Work Services
     03890515-8360   LCSW I/P Non-Revenue Counseling                   0.00         0.00     8360     Social Work Services
     03890100-8360   PF INIT IP CONSULT 80 MIN                       658.00       658.00     8360     Social Work Services
     05854030-7801   SP Eval Mtn Fluor Swal 30                       218.00       218.00     7801     Speech & Audiology
     05856998-7801   SP Unlisted Service/Proc                        218.00       218.00     7801     Speech & Audiology
     05856999-7801   SP Unlisted Service/Proc                        218.00       218.00     7801     Speech & Audiology
     05866999-7801   SP Unlisted Service/Proc                        218.00       218.00     7801     Speech & Audiology
     05856250-7801   SP Cogn Retrain Ea 15                           109.00       109.00     7801     Speech & Audiology
     05862060-7801   SP EVAL APHASIA HR                              437.00       437.00     7801     Speech & Audiology
     05855090-7801   SP Tx Sp/Lang/Com Gp 90                         198.00       198.00     7801     Speech & Audiology
     05867030-7801   SP Adj Com Device 30                            218.00       218.00     7801     Speech & Audiology
     05867045-7801   SP Adj Com Device 45                            328.00       328.00     7801     Speech & Audiology
     05867060-7801   SP Adj Com Device 60                            437.00       437.00     7801     Speech & Audiology
     05852060-7801   SP EVAL APHASIA HR                              437.00       437.00     7801     Speech & Audiology
     05867015-7801   SP Adj Com Device 15                            109.00       109.00     7801     Speech & Audiology
     05854045-7801   SP Eval Mtn Fluor Swal 45                       328.00       328.00     7801     Speech & Audiology
     05855075-7801   SP Tx Sp/Lang/Com Gp 75                         164.00       164.00     7801     Speech & Audiology
     05855060-7801   SP Tx Sp/Lang/Com Gp 60                         131.00       131.00     7801     Speech & Audiology
     05854060-7801   SP Eval Mtn Fluor Swal 60                       437.00       437.00     7801     Speech & Audiology
     05854075-7801   SP Eval Mtn Fluor Swal 75                       546.00       546.00     7801     Speech & Audiology
     05853015-7801   SP EVAL SP/LNG/COM/AUD 15                       109.00       109.00     7801     Speech & Audiology
     05840970-7801   AD TEST ELECTROACOUST BIN                       218.00       218.00     7801     Speech & Audiology



8/31/2010                                                                                                                         145
                                                 c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                            CURRENT CURRENT          DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                INPATIENT OUTPATIENT CODE
                                                                PRICE      PRICE
     05842232-7801   AD CUSTOM EAR MOLD                             109.00        109.00     7801     Speech & Audiology
     05840870-7801   AD ASSESS FOR HEARING AID                      218.00        218.00     7801     Speech & Audiology
     05840855-7801   AD TEST ELECTROACOUST MON                      109.00        109.00     7801     Speech & Audiology
     05890850-7801   AD Eval OAE                                    656.00        656.00     7801     Speech & Audiology
     05880850-7801   AD Eval OAE                                    656.00        656.00     7801     Speech & Audiology
     05845152-7801   AD AUDIOMETRY SCREENING                        109.00        109.00     7801     Speech & Audiology
     05886211-7801   AD OTOACOUSTC SCR INIT OP                      437.00        437.00     7801     Speech & Audiology
     05896220-7801   AD ACSTC REFLX TEST DECAY                      218.00        218.00     7801     Speech & Audiology
     05886220-7801   AD ACSTC REFLX TEST DECAY                      218.00        218.00     7801     Speech & Audiology
     05842314-7801   AD AUDITORY FUNCTN ADD 15                      109.00        109.00     7801     Speech & Audiology
     06000004-7010   No Room Charge                                   0.00          0.00     7010     Emergency Department
     06091118-7010   Rhythm EKG 3 Lead Tracing                      105.00        105.00     7010     Emergency Department
     06091155-7010   Venipuncture                                    65.00         65.00     7010     Emergency Department
     06091135-7010   Observation Per Hour                             0.00          0.00     7010     Emergency Department
     04232211-7640   RO ISODOSE PLAN SMPL                           547.00        547.00     7640     Radiation Therapy
     04232310-7640   RO ISODOSE PLAN INTRM                          689.00        689.00     7640     Radiation Therapy
     04232617-7640   RO Brachy Dose Plan Smpl                      1948.00       1948.00     7640     Radiation Therapy
     04232518-7640   RO SPECIAL PORT PLAN BODY                     2526.00       2526.00     7640     Radiation Therapy
     04234183-7640   RO RAD TX 3/MORE GT 19MEV                      689.00        689.00     7640     Radiation Therapy
     04232716-7640   RO Brachy Dose Plan Intrm                     2839.00       2839.00     7640     Radiation Therapy
     04234613-7640   RO APLY INTRACV RAD SMPL                       424.00        424.00     7640     Radiation Therapy
     04231916-7640   RO SIMULATION INTRM                           1640.00       1640.00     7640     Radiation Therapy
     04234811-7640   RO APLY INTRACV RAD CMPLX                      424.00        424.00     7640     Radiation Therapy
     04234068-7640   RO RAD TX 2 AREA 6-10MEV                       615.00        615.00     7640     Radiation Therapy
     04234712-7640   RO APLY INTRACV RAD INTRM                      424.00        424.00     7640     Radiation Therapy
     04236531-7640   S BRACH SOURCE CESIUM-131                      188.00        188.00     7640     Radiation Therapy
     04260004-7640   RO Brachy Hi Int 1-4Cath                      2614.00       2614.00     7640     Radiation Therapy
     04236532-7640   S BRACH SOURCE HI IRID192                      650.00        650.00     7640     Radiation Therapy
     04236510-7640   S Brach Source Iodine 125                        0.00          0.00     7640     Radiation Therapy
     04232469-7640   US TRANSRECTAL                                 488.00        488.00     7640     Radiation Therapy
     04234200-7640   RO RAD TX 2 AREA GT 19MEV                      615.00        615.00     7640     Radiation Therapy
     04201502-7640   RO Level 5 Est Patient                           0.00        331.00     7640     Radiation Therapy
     04201501-7640   RO Level 5 New Patient                           0.00        331.00     7640     Radiation Therapy
     04236500-7640   S BRACH SOURCE PALLADM103                        0.00          0.00     7640     Radiation Therapy
     04236533-7640   S BRACH SOURCE YTTRIUM 90                    14000.00      14000.00     7640     Radiation Therapy
     02910700-7593   NI Ext Low W Stres                             107.00        107.00     7593     Cardiac Rehab
     02999999-7593   Missed Appointment                             107.00        107.00     7593     Cardiac Rehab
     02970120-7593   Level 2 Est Patient                            192.00        192.00     7593     Cardiac Rehab



8/31/2010                                                                                                                      146
                                                          c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                                     CURRENT CURRENT          DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                         INPATIENT OUTPATIENT CODE
                                                                         PRICE      PRICE
     02970130-7593   Level 3 Est Patient                                     276.00        276.00     7593     Cardiac Rehab
     02970140-7593   Level 4 Est Patient                                     416.00        416.00     7593     Cardiac Rehab
     02970150-7593   Level 5 Est Patient                                     447.00        447.00     7593     Cardiac Rehab
     02970020-7593   Level 2 New Patient                                     491.00        491.00     7593     Cardiac Rehab
     02970131-7593   AMB GLUC MNTR SQ TO 72HR                                 40.00         40.00     7593     Cardiac Rehab
     03526019-7610   NEURMSC JUNCTION TEST EA                                152.00        152.00     7610     Neurology
     03525509-7610   H REFLX TEST GSTR/SOL UNI                               116.00        116.00     7610     Neurology
     03535317-7610   VISUAL EVOKED POTENT TEST                               117.00        117.00     7610     Neurology
     03510252-7610   EEG CEREBRAL DEATH EVAL                                 190.00        190.00     7610     Neurology
     03500002-7610   Neurology Procedure Addendum                              0.00          0.00     7610     Neurology
     03535515-7610   SEP UPPER LIMBS BIL                                     413.00        413.00     7610     Neurology
     03500001-7610   Neurology Procedure Override                              0.00          0.00     7610     Neurology
     03520491-7610   EMG FOUR LIMBS                                          805.00        805.00     7610     Neurology
     03520319-7610   EMG THREE LIMBS                                         419.00        419.00     7610     Neurology
     03537107-7610   NRV TEST IOP EA HOUR                                    697.00        697.00     7610     Neurology
     03510666-7610   EEG UP TO 1HR                                           617.00        617.00     7610     Neurology
     03287505-7570   CA EP INTRA VENT PACING                                1638.00       1638.00     7570     Cardiac Cath Lab
     03225480-7570   S STRL Bag, Resuscitation Adult                         464.00        464.00     7570     Cardiac Cath Lab
     03287539-7570   CA EP INDUCT ARR BY PACNG                              4481.00       4481.00     7570     Cardiac Cath Lab
     03200002-7570   Cardiac Cath Procedure Addendum                           0.00          0.00     7570     Cardiac Cath Lab
     03200001-7570   Cardiac Cath Procedure Override                           0.00          0.00     7570     Cardiac Cath Lab
     03211333-7570   CA PTC ATHERCTMY ADD VSL                               1967.00       1967.00     7570     Cardiac Cath Lab
     03290004-7570   CA THROMBLYSIS CORO INFSN                              9713.00       9713.00     7570     Cardiac Cath Lab
     03287391-7570   CA EP EVAL PACING ICD                                  3875.00       3875.00     7570     Cardiac Cath Lab
     03299257-7570   CA VALVULOPLSTY AORTC PRC                             15373.00      15373.00     7570     Cardiac Cath Lab
     03287158-7570   CA EP EVAL COMP WO INDUCT                             23672.00      23672.00     7570     Cardiac Cath Lab
     03287301-7570   CA EP EVAL ICD LEADS/GEN                               3875.00       3875.00     7570     Cardiac Cath Lab
     03287455-7570   CA EP INTRA ATR PACING                                  535.00        535.00     7570     Cardiac Cath Lab
     03260015-7570   CA BIOPSY ENDOMYOCARDIAL                               1905.00       1905.00     7570     Cardiac Cath Lab
     03270212-7570   CAC Insert Pacer Tmp Sngl                              3209.00       3209.00     7570     Cardiac Cath Lab
     03270402-7570   CA INJ PULM ANGIO                                      1967.00       1967.00     7570     Cardiac Cath Lab
     03270410-7570   CA INJ R VENT/ATR ANGIO                                1856.00       1856.00     7570     Cardiac Cath Lab
     03285053-7570   S STRL Catheter Balloon-on-a-Wire                      6875.00       6875.00     7570     Cardiac Cath Lab
     03287208-7570   CA EP FOLLOW UP STUDY                                  1074.00       1074.00     7570     Cardiac Cath Lab
     03200306-7570   CA EP ABLTN OF VT                                     11603.00      11603.00     7570     Cardiac Cath Lab
     03218020-7570   S STRL Cath, IV Angio, 18G x 1.25                        52.00         52.00     7570     Cardiac Cath Lab
     03224160-7570   S STRL Cath, IV Angio, 22G x 1                           59.00         59.00     7570     Cardiac Cath Lab
     03223380-7570   S STRL Electrode,Zucker Bipolar 6F                     1742.00       1742.00     7570     Cardiac Cath Lab



8/31/2010                                                                                                                               147
                                                         c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                                    CURRENT CURRENT          DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                        INPATIENT OUTPATIENT CODE
                                                                        PRICE      PRICE
     03296001-7570   CAC Insert Pacer/Elecatr                              4871.00       4871.00     7570     Cardiac Cath Lab
     03218030-7570   S STRL Cath, IV Angio 20G x 1.25                        59.00         59.00     7570     Cardiac Cath Lab
     03250057-7570   CA EP EVAL ICD LEADS                                  7713.00       7713.00     7570     Cardiac Cath Lab
     03296142-7570   CAC Rmvl Perm Pacer Gen                               4639.00       4639.00     7570     Cardiac Cath Lab
     03296100-7570   S STRL Pacemaker Repair Electrode                     2681.00       2681.00     7570     Cardiac Cath Lab
     03296052-7570   CAC INSERT ELECT DUAL                                 3630.00       3630.00     7570     Cardiac Cath Lab
     03296054-7570   CAC EP REPAIR SNGL LEAD                               3025.00       3025.00     7570     Cardiac Cath Lab
     03296056-7570   CAC REPR ELECT DUAL                                   3388.00       3388.00     7570     Cardiac Cath Lab
     03296060-7570   CAC RVSN PCKT PACING ICD                              4917.00       4917.00     7570     Cardiac Cath Lab
     03297113-7570   CON LOCM 300-349S I 1ML                                  2.72          2.72     7570     Cardiac Cath Lab
     03296058-7570   CAC RVSN/REL POCKET/PACER                             4917.00       4917.00     7570     Cardiac Cath Lab
     03085864-7570   CAC CATH ABD LOW 1ST                                  2818.00       2818.00     7570     Cardiac Cath Lab
     03034234-7570   CA STENT NOCORO/CAR/VERT                              8150.00       8150.00     7570     Cardiac Cath Lab
     03296145-7570   CAC RMVL CARD EVNT RCDR                               5283.00       5283.00     7570     Cardiac Cath Lab
     03293572-7570   CA DPPLR W STRESS ADD VSL                             1246.00       1246.00     7570     Cardiac Cath Lab
     03292973-7570   CA THROMBECTOMY CORO PRC                              4857.00       4857.00     7570     Cardiac Cath Lab
     03270625-7570   IR Retrieval Vascular FB                              1246.00       1246.00     7570     Cardiac Cath Lab
     03297112-7570   CON LOCM 200-249S I 1ML                                  3.19          3.19     7570     Cardiac Cath Lab
     03296046-7570   CAC REPO PRIOR LV LEAD                                3388.00       3388.00     7570     Cardiac Cath Lab
     03270600-7570   CAC IVCH RETRIEVE FB                                  3732.00       3732.00     7570     Cardiac Cath Lab
     03292975-7570   CA PLACE RAD DEL DEVICE                               9876.00       9876.00     7570     Cardiac Cath Lab
     03265030-7570   CA IVUS Coro Add Vsl                                  1296.00       1296.00     7570     Cardiac Cath Lab
     03200005-7570   S Strl                                                5845.00       5845.00     7570     Cardiac Cath Lab
     03285658-7570   CAC INTRO EXT ART                                      682.00        682.00     7570     Cardiac Cath Lab
     01611243-6400   S STRL Infant Gavage Tray                               79.00         79.00     6400     Family Birth Center
     06745988-6400   S STRL Endotracheal Tube (Infant)                       91.00         91.00     6400     Family Birth Center
     06703600-6400   Cplx PACU First 30M                                    689.00        689.00     6400     Family Birth Center
     06762273-6400   Inj Blood Patch                                        689.00        689.00     6400     Family Birth Center
     06759320-6400   Cerclage, Vaginal                                     3446.00       3446.00     6400     Family Birth Center
     06733060-6400   OCT (Oxytocin Chlng Test)                              966.00        966.00     6400     Family Birth Center
     06703601-6400   Cplx PACU Add 15M                                      346.00        346.00     6400     Family Birth Center
     07010222-7260   OT SERVICES PER DAY PHP                                287.00        287.00     7260     Mental Health Outpatient
     07000102-7260   PHP HALF DAY                                           833.00        833.00     7260     Mental Health Outpatient
     07000013-7260   Senior Day                                               0.00          0.00     7260     Mental Health Outpatient
     07004484-7260   PSYC DX INTERVIEW 3 HR                                2094.00       2094.00     7260     Mental Health Outpatient
     07004302-7260   PSYC DX INTERVIEW 2.5 HR                              1921.00       1921.00     7260     Mental Health Outpatient
     07010008-7260   PHP HALF DAY EATING DIS                                874.00        874.00     7260     Mental Health Outpatient
     07005046-7260   PSYO PREP OF REPORT                                    214.00        214.00     7260     Mental Health Outpatient



8/31/2010                                                                                                                                148
                                                      c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                                 CURRENT CURRENT          DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                     INPATIENT OUTPATIENT CODE
                                                                     PRICE      PRICE
     08002409-7220   PSYC DX INTERVIEW-D                                 546.00        546.00     7220     Chemical Dependency OP
     01303300-7231   ECT w/ Anesthesia First 30 Minutes                    0.00          0.00     7231     Pre/Post Surgery
     01361215-7231   S IMP:APLIGRAF Artificial Skin                     2648.00       2648.00     7231     Pre/Post Surgery
     01303400-7231   Bx Bone Marrow Ndl/Trocar                           550.00        550.00     7231     Pre/Post Surgery
     01402302-7231   Cplx PACU Add 15M                                   165.00        165.00     7231     Pre/Post Surgery
     01402301-7231   Cplx PACU First 30M                                 329.00        329.00     7231     Pre/Post Surgery
     01402102-7231   STND PACU LVL 1 ADD 15M                              83.00         83.00     7231     Pre/Post Surgery
     01402101-7231   STND PACU LVL 1 FIRST 30M                           165.00        165.00     7231     Pre/Post Surgery
     01303475-7231   Thoracentesis                                       775.00        775.00     7231     Pre/Post Surgery
     00837674-7420   S STRL Staple:Roticltr TA30/3.5-4.                 2527.00       2527.00     7420     Operating Room
     00896070-7420   S NSTRL:Perm Quinton                                976.00        976.00     7420     Operating Room
     00837690-7420   S STRL Staple:Roticulator 30V                      2900.00       2900.00     7420     Operating Room
     00806562-7420   S NSTRL:Quinton Cath Double Lumen                   923.00        923.00     7420     Operating Room
     00837880-7420   S STRL Staple:Powered LDS15W                       2058.00       2058.00     7420     Operating Room
     00831414-7420   S IMP:Graft, Patch Impra 2.5x15                    2328.00       2328.00     7420     Operating Room
     00880350-7420   S NSTRL:Tube: Trach 'Univent'                      1558.00       1558.00     7420     Operating Room
     00887590-7420   S IMP:Graft, Impra Stepped                         3069.00       3069.00     7420     Operating Room
     00863475-7420   S STRL:Suretac Absorb. Fixation                    2186.00       2186.00     7420     Operating Room
     00879100-7420   S NSTRL:Catheter:Balln Dil (Entrac                 1456.00       1456.00     7420     Operating Room
     00895635-7420   S IMP:Graft, Meadox Hemashield St.                 3022.00       3022.00     7420     Operating Room
     00861111-7420   S NSTRL:Catheter Thermodilution                     497.00        497.00     7420     Operating Room
     00863110-7420   S IMP:Hip/Leg Implants                                0.00          0.00     7420     Operating Room
     00885490-7420   S STRL:Port-A-Cath MRI Peritoneal                  3167.00       3167.00     7420     Operating Room
     00830968-7420   S IMP:Eartube T-Tube .045                           467.00        467.00     7420     Operating Room
     00832824-7420   S IMP:Shunt Sundt/Loop                              975.00        975.00     7420     Operating Room
     00832782-7420   S IMP:Vena Cava Clip                               1759.00       1759.00     7420     Operating Room
     00833194-7420   S NSTRL:Lith ESWL Electrode                        3358.00       3358.00     7420     Operating Room
     00833731-7420   S NSTRL:Mesh Teflon                                1119.00       1119.00     7420     Operating Room
     00836205-7420   S IMP:Prosthesis Penile                               0.00          0.00     7420     Operating Room
     00830984-7420   S IMP:Eartube .035 Teflon                           313.00        313.00     7420     Operating Room
     00831057-7420   S IMP:Eartube Arm Bev w/Tab                         467.00        467.00     7420     Operating Room
     00831305-7420   S IMP:Gortex 4.5-6.5                               5008.00       5008.00     7420     Operating Room
     00831354-7420   S IMP:Graft USCI Bif                               3410.00       3410.00     7420     Operating Room
     00831404-7420   S IMP:Graft, Patch CV Goretex 4mm                  2390.00       2390.00     7420     Operating Room
     00832436-7420   S IMP:Hulka Clip                                    467.00        467.00     7420     Operating Room
     00831396-7420   S IMP:Graft, Patch CV Goretex 6mm                  3381.00       3381.00     7420     Operating Room
     00836890-7420   S IMP:Graft, Gortex St 6mm                         2745.00       2745.00     7420     Operating Room
     00884874-7420   S STRL:Staytak Suture                              1688.00       1688.00     7420     Operating Room



8/31/2010                                                                                                                           149
                                                     c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                                CURRENT CURRENT          DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                    INPATIENT OUTPATIENT CODE
                                                                    PRICE      PRICE
     00836791-7420   S NSTRL:Shunt Assembly                            3406.00       3406.00     7420     Operating Room
     00884577-7420   S NSTRL:Helistat                                   467.00        467.00     7420     Operating Room
     00887539-7420   S IMP:Graft, Impra Centfex                        3873.00       3873.00     7420     Operating Room
     00887554-7420   S STRL:Infusaid Peritoneal Cath                   3818.00       3818.00     7420     Operating Room
     00887588-7420   S NSTRL:Hickman Cath Single/Double                1794.00       1794.00     7420     Operating Room
     00827998-7420   S NSTRL:Clips Yasargil                            2817.00       2817.00     7420     Operating Room
     00822270-7420   S NSTRL:Quinton Cath Adapter                      2412.00       2412.00     7420     Operating Room
     00826578-7420   S STRL:Groshung Single Lumen Cath                 2979.00       2979.00     7420     Operating Room
     00826586-7420   S STRL:Groshung Double Lumen Cath                 3149.00       3149.00     7420     Operating Room
     00854075-7420   S IMP:Tibial Nail (Synthes)                       4157.00       4157.00     7420     Operating Room
     00851063-7420   S NSTRL:Liq Graft Passer                           467.00        467.00     7420     Operating Room
     00849695-7420   S IMP:Plate T Buttress                            2326.00       2326.00     7420     Operating Room
     00849638-7420   S IMP:Plate DCP Broad                             1401.00       1401.00     7420     Operating Room
     00852855-7420   S IMP:Screws Malleolar                             467.00        467.00     7420     Operating Room
     00853945-7420   S IMP:Steiman Pin with Hole                        251.00        251.00     7420     Operating Room
     00839902-7420   S IMP:LUHR Plate                                     0.00          0.00     7420     Operating Room
     00852004-7420   S IMP:Ambi Comp Plate Long                        3457.00       3457.00     7420     Operating Room
     00842799-7420   S IMP:Beath Pin                                    164.00        164.00     7420     Operating Room
     00844738-7420   S IMP:Kurasaka Screws                             2090.00       2090.00     7420     Operating Room
     00844167-7420   S STRL:Syringe Harris/Plug                         467.00        467.00     7420     Operating Room
     00843748-7420   S IMP:Seal Acetabular/Femoral                      467.00        467.00     7420     Operating Room
     00869909-7420   S IMP:Prosthesis/Implant                             0.00          0.00     7420     Operating Room
     00838896-7420   S STRLL:Viscoat                                   1045.00       1045.00     7420     Operating Room
     00860312-7420   S NSTRL:IABP Catheter                             6096.00       6096.00     7420     Operating Room
     00864520-7420   S PCR:External D Pacemaker LE                      467.00        467.00     7420     Operating Room
     00863456-7420   S IMP:Absorbable Pin 841070                       1210.00       1210.00     7420     Operating Room
     00863100-7420   S IMP:Graft Meadox Dbl.Wov.Vel.BIF                2930.00       2930.00     7420     Operating Room
     00863084-7420   S IMP:Cooley Patch Graft                          1210.00       1210.00     7420     Operating Room
     00864546-7420   S STRL:Pericardial Patch                          2400.00       2400.00     7420     Operating Room
     00812632-7420   S NSTRL:Pin Bevel-Point Hook                       423.00        423.00     7420     Operating Room
     00821685-7420   S IMP:Screw Guardsman                             2184.00       2184.00     7420     Operating Room
     00894071-7420   S IMP:Cbl.Grip: Vitallium Grip(ALL                3128.00       3128.00     7420     Operating Room
     00885285-7420   S IMP:AICD Generator                             98589.00      98589.00     7420     Operating Room
     00868687-7420   S STRL:Sepraflim                                  1820.00       1820.00     7420     Operating Room
     00824299-7420   S NSTRL:Blade Endotrac Hook                        882.00        882.00     7420     Operating Room
     00885434-7420   S STRL:Needle Biopsy Sterotatic                    467.00        467.00     7420     Operating Room
     00853970-7420   S IMP:Screw, Acutrack, Bone                       2182.00       2182.00     7420     Operating Room
     00887430-7420   S IMP:Graft Gortex Thin 6-8mm                     5550.00       5550.00     7420     Operating Room



8/31/2010                                                                                                                          150
                                                        c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                                   CURRENT CURRENT          DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                       INPATIENT OUTPATIENT CODE
                                                                       PRICE      PRICE
     00880310-7420   S IMP:Marlex Mesh                                    2311.00       2311.00     7420     Operating Room
     00887083-7420   S IMP:Scleral Bckl-240,220,42                         377.00        377.00     7420     Operating Room
     00887091-7420   S IMP:Scleral Bckl-70,270                             208.00        208.00     7420     Operating Room
     00887117-7420   S IMP:Scleral Buckl All 500'S                         467.00        467.00     7420     Operating Room
     00887380-7420   S IMP:Ambi Compression Set                           1169.00       1169.00     7420     Operating Room
     00887042-7420   S NSTRL:TEC Rr Ext Cath Dr                            467.00        467.00     7420     Operating Room
     00880336-7420   S IMP:VP Shunt Lumb Peritoneal                       2566.00       2566.00     7420     Operating Room
     00860478-7420   S NSTRL:IABP Wire Only                                733.00        733.00     7420     Operating Room
     00887448-7420   S IMP:Graft Gortex 6-8 Cm                            5527.00       5527.00     7420     Operating Room
     00863762-7420   S ICD DUAL CHAMBER                                  41116.00      41116.00     7420     Operating Room
     00702502-7420   Stnd Anes Add 15M NonOR                               201.00        201.00     7420     Operating Room
     00801810-7420   Cell Saver 1/2Hr-Non-OR                               132.00        132.00     7420     Operating Room
     00801805-7420   Cell Saver 1Hr-Non-OR                                 185.00        185.00     7420     Operating Room
     00827440-7420   S IMP:Unilateral Condylar Spacer                     7695.00       7695.00     7420     Operating Room
     00825260-7420   S STRL:Distraction Pin                               1366.00       1366.00     7420     Operating Room
     00825250-7420   S STRL:Fibrin Sealant                                1162.00       1162.00     7420     Operating Room
     00830987-7420   S IMP IN KERATOPROSTHESIS                            8640.00       8640.00     7420     Operating Room
     00863759-7420   S LD VENT CORO VEN SYS LT                           10795.00      10795.00     7420     Operating Room
     00863760-7420   S LD ICD ENDOCRD 2 COIL                             11340.00      11340.00     7420     Operating Room
     00863761-7420   S ICD OTHR THAN SNGL/DL                             44550.00      44550.00     7420     Operating Room
     00863763-7420   S ICD SNGL CHAMBER                                  36329.00      36329.00     7420     Operating Room
     00863765-7420   S CATH GUIDING                                      10795.00      10795.00     7420     Operating Room
     00809350-7420   S IMP:Apical Plug                                     478.00        478.00     7420     Operating Room
     00863754-7420   S CATH EP ABLTN 3D VCT MP                           10795.00      10795.00     7420     Operating Room
     00863755-7420   S EVENT RECORDER CARDIAC                            10795.00      10795.00     7420     Operating Room
     00863756-7420   S PCR NOT 1 OR 2 CHMBR                              19278.00      19278.00     7420     Operating Room
     01520075-6179   IRC Inj Epid L/S                                     1533.00       1533.00     6179     Recovery Care Inn
     01590620-6179   OBS BLOOD TRANSFSN 4-6 HR                             653.00        653.00     6179     Recovery Care Inn
     01590641-6179   OBS INJECTION IM/SQ EA                                 41.00         41.00     6179     Recovery Care Inn
     01590644-6179   INFUSN CHEMO 0-60 MN                                  238.00        238.00     6179     Recovery Care Inn
     01590647-6179   INFUSN CHEMO EA ADD HR                                238.00        238.00     6179     Recovery Care Inn
     01590650-6179   CARDIOVERT ELECTIVE EXT                               204.00        204.00     6179     Recovery Care Inn
     01590653-6179   OBS DECLOT VASC DEVICE                                119.00        119.00     6179     Recovery Care Inn
     01590614-6179   OBS BLOOD TRANSFSN LT 2HR                             163.00        163.00     6179     Recovery Care Inn
     01590623-6179   OBS BLOOD TRANSFSN GT 6HR                             980.00        980.00     6179     Recovery Care Inn
     01590659-6179   OBS BLADDER IRRIG SMPL                                 57.00         57.00     6179     Recovery Care Inn
     01530209-6179   AEROSOL TX SUBSQ                                      160.00        160.00     6179     Recovery Care Inn
     01520507-6179   PULSE OXIMETRY - SINGLE                                98.00         98.00     6179     Recovery Care Inn



8/31/2010                                                                                                                             151
                                                    c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                               CURRENT CURRENT          DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                   INPATIENT OUTPATIENT CODE
                                                                   PRICE      PRICE
     01590617-6179   OBS BLOOD TRANSFSN 2-4 HR                         326.00        326.00     6179     Recovery Care Inn
     06220088-7760   S STRL ERCP Stone Crusher                        1782.00       1782.00     7760     Endoscopy Services
     06200430-7760   S STRL Hot Biopsy Forceps                         356.00        356.00     7760     Endoscopy Services
     06250351-7760   PARACENT ABD INI                                 1782.00       1782.00     7760     Endoscopy Services
     06240048-7760   S STRL Sclerothpy Needle                          356.00        356.00     7760     Endoscopy Services
     06200002-7760   Endoscopy Procedure Addendum                        0.00          0.00     7760     Endoscopy Services
     06200042-7760   S STRL Biliary Stent                             1782.00       1782.00     7760     Endoscopy Services
     06200001-7760   Endoscopy Procedure Override                        0.00          0.00     7760     Endoscopy Services
     06214830-7760   BX LIVER                                          594.00        594.00     7760     Endoscopy Services
     06254042-7760   SCLEROTHERAPY                                    5346.00       5346.00     7760     Endoscopy Services
     06513105-7745   EPOETIN 5500U IJ                                  348.07        348.07     7745     Renal Dialysis
     06513063-7745   EPOETIN 3500U IJ                                  171.61        171.61     7745     Renal Dialysis
     06410203-7745   DIALYS CAPD IP                                     90.00         90.00     7745     Renal Dialysis
     08513194-7745   EPOETIN 10000U IJ                                 348.07        348.07     7745     Renal Dialysis
     08513186-7745   EPOETIN 9500U IJ                                  348.07        348.07     7745     Renal Dialysis
     08513178-7745   EPOETIN 9000U IJ                                  348.07        348.07     7745     Renal Dialysis
     06513113-7745   EPOETIN 6000U IJ                                  348.07        348.07     7745     Renal Dialysis
     08513160-7745   EPOETIN 8500U IJ                                  348.07        348.07     7745     Renal Dialysis
     08513111-7745   EPOETIN 6000U IJ                                  348.07        348.07     7745     Renal Dialysis
     08513145-7745   EPOETIN 7500U IJ                                  348.07        348.07     7745     Renal Dialysis
     08513129-7745   EPOETIN 6500U IJ                                  348.07        348.07     7745     Renal Dialysis
     08413056-7745   EPOETIN 3000U IJ                                  142.21        142.21     7745     Renal Dialysis
     06413066-7745   EPOETIN 3500U IJ                                  171.61        171.61     7745     Renal Dialysis
     06513147-7745   EPOETIN 7500U IJ                                  348.07        348.07     7745     Renal Dialysis
     08513152-7745   EPOETIN 8000U IJ                                  348.07        348.07     7745     Renal Dialysis
     08413072-7745   EPOETIN 4000U IJ                                  171.61        171.61     7745     Renal Dialysis
     06513188-7745   EPOETIN 9500U IJ                                  348.07        348.07     7745     Renal Dialysis
     08413197-7745   EPOETIN 10000U IJ                                 348.07        348.07     7745     Renal Dialysis
     06413140-7745   EPOETIN 7500U IJ                                  348.07        348.07     7745     Renal Dialysis
     06413157-7745   EPOETIN 8000U IJ                                  348.07        348.07     7745     Renal Dialysis
     06413199-7745   EPOETIN 10000U IJ                                 348.07        348.07     7745     Renal Dialysis
     06413181-7745   EPOETIN 9500U IJ                                  348.07        348.07     7745     Renal Dialysis
     08413049-7745   EPOETIN 2500U IJ                                  142.21        142.21     7745     Renal Dialysis
     08413064-7745   EPOETIN 3500U IJ                                  171.61        171.61     7745     Renal Dialysis
     06413124-7745   EPOETIN 6500U IJ                                  348.07        348.07     7745     Renal Dialysis
     06513006-7745   EPOETIN 500U IJ                                   112.77        112.77     7745     Renal Dialysis
     06513014-7745   EPOETIN 1000U IJ                                  112.77        112.77     7745     Renal Dialysis
     06513022-7745   EPOETIN 1500U IJ                                  112.77        112.77     7745     Renal Dialysis



8/31/2010                                                                                                                         152
                                        c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                   CURRENT CURRENT         DEPARTMENT   DEPARTMENT DESCRIPTION
                                                       INPATIENT OUTPATIENT CODE
                                                       PRICE      PRICE
     06513030-7745   EPOETIN 2000U IJ                      112.77       112.77     7745     Renal Dialysis
     08513020-7745   EPOETIN 1500U IJ                      112.77       112.77     7745     Renal Dialysis
     08513053-7745   EPOETIN 3000U IJ                      142.21       142.21     7745     Renal Dialysis
     08410151-7745   DIALYS CAPD IP                        291.00       291.00     7745     Renal Dialysis
     08413130-7745   EPOETIN 7000U IJ                      348.07       348.07     7745     Renal Dialysis
     08413122-7745   EPOETIN 6500U IJ                      348.07       348.07     7745     Renal Dialysis
     08413114-7745   EPOETIN 6000U IJ                      348.07       348.07     7745     Renal Dialysis
     08513012-7745   EPOETIN 1000U IJ                      112.77       112.77     7745     Renal Dialysis
     08513038-7745   EPOETIN 2000U IJ                      112.77       112.77     7745     Renal Dialysis
     08413163-7745   EPOETIN 8500U IJ                      348.07       348.07     7745     Renal Dialysis
     08513079-7745   EPOETIN 4000U IJ                      171.61       171.61     7745     Renal Dialysis
     08413148-7745   EPOETIN 7500U IJ                      348.07       348.07     7745     Renal Dialysis
     08513061-7745   EPOETIN 3500U IJ                      171.61       171.61     7745     Renal Dialysis
     08513087-7745   EPOETIN 4500U IJ                      348.07       348.07     7745     Renal Dialysis
     06413082-7745   EPOETIN 4500U IJ                      348.07       348.07     7745     Renal Dialysis
     06410153-7745   DIALYS CAPD IP                        291.00       291.00     7745     Renal Dialysis
     08513103-7745   EPOETIN 5500U IJ                      348.07       348.07     7745     Renal Dialysis
     08513046-7745   EPOETIN 2500U IJ                      142.21       142.21     7745     Renal Dialysis
     06513162-7745   EPOETIN 8500U IJ                      348.07       348.07     7745     Renal Dialysis
     08413015-7745   EPOETIN 1000U IJ                      112.77       112.77     7745     Renal Dialysis
     08413007-7745   EPOETIN 500U IJ                       112.77       112.77     7745     Renal Dialysis
     08413023-7745   EPOETIN 1500U IJ                      112.77       112.77     7745     Renal Dialysis
     08413031-7745   EPOETIN 2000U IJ                      112.77       112.77     7745     Renal Dialysis
     08413080-7745   EPOETIN 4500U IJ                      348.07       348.07     7745     Renal Dialysis
     08413155-7745   EPOETIN 8000U IJ                      348.07       348.07     7745     Renal Dialysis
     08413106-7745   EPOETIN 5500U IJ                      348.07       348.07     7745     Renal Dialysis
     06513154-7745   EPOETIN 8000U IJ                      348.07       348.07     7745     Renal Dialysis
     06513170-7745   EPOETIN 9000U IJ                      348.07       348.07     7745     Renal Dialysis
     08513005-7745   EPOETIN 500U IJ                       112.77       112.77     7745     Renal Dialysis
     08413189-7745   EPOETIN 9500U IJ                      348.07       348.07     7745     Renal Dialysis
     08413171-7745   EPOETIN 9000U IJ                      348.07       348.07     7745     Renal Dialysis
     08513095-7745   EPOETIN 5000U IJ                      348.07       348.07     7745     Renal Dialysis
     08410201-7745   DIALYS CAPD IP                         90.00        90.00     7745     Renal Dialysis
     08413098-7745   EPOETIN 5000U IJ                      348.07       348.07     7745     Renal Dialysis
     06413249-7745   EPOETIN 5000U IJ                      348.07       348.07     7745     Renal Dialysis
     06413231-7745   EPOETIN 4000U IJ                      171.61       171.61     7745     Renal Dialysis
     06413223-7745   EPOETIN 3000U IJ                      142.21       142.21     7745     Renal Dialysis
     06413215-7745   EPOETIN 2000U IJ                      112.77       112.77     7745     Renal Dialysis



8/31/2010                                                                                                            153
                                                 c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                            CURRENT CURRENT          DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                INPATIENT OUTPATIENT CODE
                                                                PRICE      PRICE
     06413207-7745   EPOETIN 1000U IJ                               112.77        112.77     7745     Renal Dialysis
     06513121-7745   EPOETIN 6500U IJ                               348.07        348.07     7745     Renal Dialysis
     06413041-7745   EPOETIN 2500U IJ                               142.21        142.21     7745     Renal Dialysis
     06413272-7745   EPOETIN 8000U IJ                               348.07        348.07     7745     Renal Dialysis
     08412405-7745   DIALYS TRAIN EA SESS CCPD                     1717.00       1717.00     7745     Renal Dialysis
     06413173-7745   EPOETIN 9000U IJ                               348.07        348.07     7745     Renal Dialysis
     08412454-7745   DIALYS CAPD OP                                3357.00       3357.00     7745     Renal Dialysis
     06413165-7745   EPOETIN 8500U IJ                               348.07        348.07     7745     Renal Dialysis
     08413239-7745   EPOETIN 4000U IJ                               171.61        171.61     7745     Renal Dialysis
     08413296-7745   EPOETIN 10000U IJ                              348.07        348.07     7745     Renal Dialysis
     08413288-7745   EPOETIN 9000U IJ                               348.07        348.07     7745     Renal Dialysis
     08413270-7745   EPOETIN 8000U IJ                               348.07        348.07     7745     Renal Dialysis
     08413262-7745   EPOETIN 7000U IJ                               348.07        348.07     7745     Renal Dialysis
     06413256-7745   EPOETIN 6000U IJ                               348.07        348.07     7745     Renal Dialysis
     06413264-7745   EPOETIN 7000U IJ                               348.07        348.07     7745     Renal Dialysis
     08413221-7745   EPOETIN 3000U IJ                               142.21        142.21     7745     Renal Dialysis
     08413213-7745   EPOETIN 2000U IJ                               112.77        112.77     7745     Renal Dialysis
     08413205-7745   EPOETIN 1000U IJ                               112.77        112.77     7745     Renal Dialysis
     06413298-7745   EPOETIN 10000U IJ                              348.07        348.07     7745     Renal Dialysis
     06413280-7745   EPOETIN 9000U IJ                               348.07        348.07     7745     Renal Dialysis
     08413254-7745   EPOETIN 6000U IJ                               348.07        348.07     7745     Renal Dialysis
     06413033-7745   EPOETIN 2000U IJ                               112.77        112.77     7745     Renal Dialysis
     06413132-7745   EPOETIN 7000U IJ                               348.07        348.07     7745     Renal Dialysis
     06513097-7745   EPOETIN 5000U IJ                               348.07        348.07     7745     Renal Dialysis
     06413116-7745   EPOETIN 6000U IJ                               348.07        348.07     7745     Renal Dialysis
     06413025-7745   EPOETIN 1500U IJ                               112.77        112.77     7745     Renal Dialysis
     06413009-7745   EPOETIN 500U IJ                                112.77        112.77     7745     Renal Dialysis
     06413017-7745   EPOETIN 1000U IJ                               112.77        112.77     7745     Renal Dialysis
     06413058-7745   EPOETIN 3000U IJ                               142.21        142.21     7745     Renal Dialysis
     06413108-7745   EPOETIN 5500U IJ                               348.07        348.07     7745     Renal Dialysis
     06413074-7745   EPOETIN 4000U IJ                               171.61        171.61     7745     Renal Dialysis
     06513089-7745   EPOETIN 4500U IJ                               348.07        348.07     7745     Renal Dialysis
     08511008-7745   DIALYS HEMO IP                                3752.00       3752.00     7745     Renal Dialysis
     06413090-7745   EPOETIN 5000U IJ                               348.07        348.07     7745     Renal Dialysis
     08554115-7745   DIALYS HEMO OP                                1034.00       1034.00     7745     Renal Dialysis
     08410003-7745   DIALYS CAPD IP                                1087.00       1087.00     7745     Renal Dialysis
     08552002-7745   DIALYS CAPD OP                                1012.00       1012.00     7745     Renal Dialysis
     06413365-7745   EPOETIN 16500U IJ                              686.57        686.57     7745     Renal Dialysis



8/31/2010                                                                                                                      154
                                                   c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                              CURRENT CURRENT         DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                  INPATIENT OUTPATIENT CODE
                                                                  PRICE      PRICE
     08414510-7745   S STRL BLOOD ADMIN SUPPLIES                       21.00        21.00     7745     Renal Dialysis
     08514510-7745   S STRL BLOOD ADMIN SUPPLIES                       21.00        21.00     7745     Renal Dialysis
     06413305-7745   EPOETIN 10500U IJ                                686.57       686.57     7745     Renal Dialysis
     06413310-7745   EPOETIN 11000U IJ                                686.57       686.57     7745     Renal Dialysis
     06413315-7745   EPOETIN 11500U IJ                                686.57       686.57     7745     Renal Dialysis
     06413320-7745   EPOETIN 12000U IJ                                686.57       686.57     7745     Renal Dialysis
     06413325-7745   EPOETIN 12500U IJ                                686.57       686.57     7745     Renal Dialysis
     06413330-7745   EPOETIN 13000U IJ                                686.57       686.57     7745     Renal Dialysis
     06413335-7745   EPOETIN 13500U IJ                                686.57       686.57     7745     Renal Dialysis
     06413340-7745   EPOETIN 14000U IJ                                686.57       686.57     7745     Renal Dialysis
     06413345-7745   EPOETIN 14500U IJ                                686.57       686.57     7745     Renal Dialysis
     06413350-7745   EPOETIN 15000U IJ                                686.57       686.57     7745     Renal Dialysis
     06513340-7745   EPOETIN 14000U IJ                                686.57       686.57     7745     Renal Dialysis
     06413395-7745   EPOETIN 19500U IJ                                686.57       686.57     7745     Renal Dialysis
     06413002-7745   EPOETIN 200U IJ                                  112.77       112.77     7745     Renal Dialysis
     06513330-7745   EPOETIN 13000U IJ                                686.57       686.57     7745     Renal Dialysis
     06513325-7745   EPOETIN 12500U IJ                                686.57       686.57     7745     Renal Dialysis
     06513320-7745   EPOETIN 12000U IJ                                686.57       686.57     7745     Renal Dialysis
     06513315-7745   EPOETIN 11500U IJ                                686.57       686.57     7745     Renal Dialysis
     06413355-7745   EPOETIN 15500U IJ                                686.57       686.57     7745     Renal Dialysis
     06513305-7745   EPOETIN 10500U IJ                                686.57       686.57     7745     Renal Dialysis
     06413360-7745   EPOETIN 16000U IJ                                686.57       686.57     7745     Renal Dialysis
     06413390-7745   EPOETIN 19000U IJ                                686.57       686.57     7745     Renal Dialysis
     06413385-7745   EPOETIN 18500U IJ                                686.57       686.57     7745     Renal Dialysis
     06413380-7745   EPOETIN 18000U IJ                                686.57       686.57     7745     Renal Dialysis
     06413375-7745   EPOETIN 17500U IJ                                686.57       686.57     7745     Renal Dialysis
     06413370-7745   EPOETIN 17000U IJ                                686.57       686.57     7745     Renal Dialysis
     06513310-7745   EPOETIN 11000U IJ                                686.57       686.57     7745     Renal Dialysis
     08413003-7745   EPOETIN 300U IJ                                  112.77       112.77     7745     Renal Dialysis
     06414510-7745   S STRL BLOOD ADMIN SUPPLIES                       21.00        21.00     7745     Renal Dialysis
     08513004-7745   EPOETIN 400U IJ                                  112.77       112.77     7745     Renal Dialysis
     08513003-7745   EPOETIN 300U IJ                                  112.77       112.77     7745     Renal Dialysis
     08413004-7745   EPOETIN 400U IJ                                  112.77       112.77     7745     Renal Dialysis
     08413002-7745   EPOETIN 200U IJ                                  112.77       112.77     7745     Renal Dialysis
     08413001-7745   EPOETIN 100U IJ                                  112.77       112.77     7745     Renal Dialysis
     06513003-7745   EPOETIN 300U IJ                                  112.77       112.77     7745     Renal Dialysis
     06513001-7745   EPOETIN 100U IJ                                  112.77       112.77     7745     Renal Dialysis
     06413004-7745   EPOETIN 400U IJ                                  112.77       112.77     7745     Renal Dialysis



8/31/2010                                                                                                                       155
                                         c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                    CURRENT CURRENT         DEPARTMENT   DEPARTMENT DESCRIPTION
                                                        INPATIENT OUTPATIENT CODE
                                                        PRICE      PRICE
     06413003-7745   EPOETIN 300U IJ                        112.77       112.77     7745     Renal Dialysis
     08513001-7745   EPOETIN 100U IJ                        112.77       112.77     7745     Renal Dialysis
     06513345-7745   EPOETIN 14500U IJ                      686.57       686.57     7745     Renal Dialysis
     06413400-7745   EPOETIN 20000U IJ                      610.90       610.90     7745     Renal Dialysis
     08513325-7745   EPOETIN 12500U IJ                      686.57       686.57     7745     Renal Dialysis
     08513330-7745   EPOETIN 13000U IJ                      686.57       686.57     7745     Renal Dialysis
     08513335-7745   EPOETIN 13500U IJ                      686.57       686.57     7745     Renal Dialysis
     08513340-7745   EPOETIN 14000U IJ                      686.57       686.57     7745     Renal Dialysis
     08513345-7745   EPOETIN 14500U IJ                      686.57       686.57     7745     Renal Dialysis
     08513350-7745   EPOETIN 15000U IJ                      686.57       686.57     7745     Renal Dialysis
     08513355-7745   EPOETIN 15500U IJ                      686.57       686.57     7745     Renal Dialysis
     08513360-7745   EPOETIN 16000U IJ                      686.57       686.57     7745     Renal Dialysis
     08513365-7745   EPOETIN 16500U IJ                      686.57       686.57     7745     Renal Dialysis
     08513370-7745   EPOETIN 17000U IJ                      686.57       686.57     7745     Renal Dialysis
     08513375-7745   EPOETIN 17500U IJ                      686.57       686.57     7745     Renal Dialysis
     08513380-7745   EPOETIN 18000U IJ                      686.57       686.57     7745     Renal Dialysis
     08513385-7745   EPOETIN 18500U IJ                      686.57       686.57     7745     Renal Dialysis
     06513335-7745   EPOETIN 13500U IJ                      686.57       686.57     7745     Renal Dialysis
     06413225-7745   EPOETIN 3500U IJ                       171.61       171.61     7745     Renal Dialysis
     06513002-7745   EPOETIN 200U IJ                        112.77       112.77     7745     Renal Dialysis
     06413285-7745   EPOETIN 9500U IJ                       348.07       348.07     7745     Renal Dialysis
     06413275-7745   EPOETIN 8500U IJ                       348.07       348.07     7745     Renal Dialysis
     06413270-7745   EPOETIN 7500U IJ                       348.07       348.07     7745     Renal Dialysis
     06413260-7745   EPOETIN 6500U IJ                       348.07       348.07     7745     Renal Dialysis
     08513390-7745   EPOETIN 19000U IJ                      686.57       686.57     7745     Renal Dialysis
     06413235-7745   EPOETIN 4500U IJ                       348.07       348.07     7745     Renal Dialysis
     08513395-7745   EPOETIN 19500U IJ                      686.57       686.57     7745     Renal Dialysis
     06413220-7745   EPOETIN 2500U IJ                       142.21       142.21     7745     Renal Dialysis
     06413210-7745   EPOETIN 1500U IJ                       112.77       112.77     7745     Renal Dialysis
     08513400-7745   EPOETIN 20000U IJ                      686.57       686.57     7745     Renal Dialysis
     08413400-7745   EPOETIN 20000U IJ                      686.57       686.57     7745     Renal Dialysis
     08513310-7745   EPOETIN 11000U IJ                      686.57       686.57     7745     Renal Dialysis
     06413253-7745   EPOETIN 5500U IJ                       348.07       348.07     7745     Renal Dialysis
     06513380-7745   EPOETIN 18000U IJ                      686.57       686.57     7745     Renal Dialysis
     08513320-7745   EPOETIN 12000U IJ                      686.57       686.57     7745     Renal Dialysis
     08413320-7745   EPOETIN 12000U IJ                      686.57       686.57     7745     Renal Dialysis
     08413315-7745   EPOETIN 11500U IJ                      686.57       686.57     7745     Renal Dialysis
     08413310-7745   EPOETIN 11000U IJ                      686.57       686.57     7745     Renal Dialysis



8/31/2010                                                                                                             156
                                                 c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                            CURRENT CURRENT          DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                INPATIENT OUTPATIENT CODE
                                                                PRICE      PRICE
     08413305-7745   EPOETIN 10500U IJ                              686.57        686.57     7745     Renal Dialysis
     08413330-7745   EPOETIN 13000U IJ                              686.57        686.57     7745     Renal Dialysis
     06513385-7745   EPOETIN 18500U IJ                              686.57        686.57     7745     Renal Dialysis
     08413335-7745   EPOETIN 13500U IJ                              686.57        686.57     7745     Renal Dialysis
     06513375-7745   EPOETIN 17500U IJ                              686.57        686.57     7745     Renal Dialysis
     06513370-7745   EPOETIN 17000U IJ                              686.57        686.57     7745     Renal Dialysis
     06513365-7745   EPOETIN 16500U IJ                              686.57        686.57     7745     Renal Dialysis
     06513360-7745   EPOETIN 16000U IJ                              686.57        686.57     7745     Renal Dialysis
     06513355-7745   EPOETIN 15500U IJ                              686.57        686.57     7745     Renal Dialysis
     06513350-7745   EPOETIN 15000U IJ                              686.57        686.57     7745     Renal Dialysis
     06513390-7745   EPOETIN 19000U IJ                              686.57        686.57     7745     Renal Dialysis
     08413370-7745   EPOETIN 17000U IJ                              686.57        686.57     7745     Renal Dialysis
     06513395-7745   EPOETIN 19500U IJ                              686.57        686.57     7745     Renal Dialysis
     08513305-7745   EPOETIN 10500U IJ                              686.57        686.57     7745     Renal Dialysis
     08413395-7745   EPOETIN 19500U IJ                              686.57        686.57     7745     Renal Dialysis
     08413390-7745   EPOETIN 19000U IJ                              686.57        686.57     7745     Renal Dialysis
     08413385-7745   EPOETIN 18500U IJ                              686.57        686.57     7745     Renal Dialysis
     08413325-7745   EPOETIN 12500U IJ                              686.57        686.57     7745     Renal Dialysis
     08413375-7745   EPOETIN 17500U IJ                              686.57        686.57     7745     Renal Dialysis
     08513315-7745   EPOETIN 11500U IJ                              686.57        686.57     7745     Renal Dialysis
     08413365-7745   EPOETIN 16500U IJ                              686.57        686.57     7745     Renal Dialysis
     08413360-7745   EPOETIN 16000U IJ                              686.57        686.57     7745     Renal Dialysis
     08413355-7745   EPOETIN 15500U IJ                              686.57        686.57     7745     Renal Dialysis
     08413350-7745   EPOETIN 15000U IJ                              686.57        686.57     7745     Renal Dialysis
     08413345-7745   EPOETIN 14500U IJ                              686.57        686.57     7745     Renal Dialysis
     08413340-7745   EPOETIN 14000U IJ                              686.57        686.57     7745     Renal Dialysis
     08413380-7745   EPOETIN 18000U IJ                              686.57        686.57     7745     Renal Dialysis
     06412407-7745   DIALYS TRAIN EA SESS CCPD                     1717.00       1717.00     7745     Renal Dialysis
     06412308-7745   DIALYS TRAIN EA SESS CAPD                     1144.00       1144.00     7745     Renal Dialysis
     06410005-7745   DIALYS CAPD IP                                1087.00       1087.00     7745     Renal Dialysis
     06412456-7745   DIALYS CAPD OP                                3357.00       3357.00     7745     Renal Dialysis
     06513427-7745   DARBEPOETIN 300 MCG IJ                        3322.45       3322.45     7745     Renal Dialysis
     06514530-7745   ADMIN INFLUENZA VACC                             2.00          2.00     7745     Renal Dialysis
     06513431-7745   DARBEPOETIN 500 MCG IJ                        5611.45       5611.45     7745     Renal Dialysis
     06414530-7745   ADMIN INFLUENZA VACC                             2.00          2.00     7745     Renal Dialysis
     08414530-7745   ADMIN INFLUENZA VACC                             2.00          2.00     7745     Renal Dialysis
     08413419-7745   DARBEPOETIN 150 MCG IJ                        2232.95       2232.95     7745     Renal Dialysis
     08414520-7745   ADMIN HEPATITIS B VACC                           2.00          2.00     7745     Renal Dialysis



8/31/2010                                                                                                                      157
                                                          c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                                     CURRENT CURRENT          DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                         INPATIENT OUTPATIENT CODE
                                                                         PRICE      PRICE
     08514530-7745   ADMIN INFLUENZA VACC                                      2.00          2.00     7745     Renal Dialysis
     08414540-7745   ADMIN PNEUMOCOCCAL VACC                                   2.00          2.00     7745     Renal Dialysis
     08510002-7745   DIALYS HEMO IP                                         3752.00       3752.00     7745     Renal Dialysis
     06413431-7745   DARBEPOETIN 500 MCG IJ                                 5611.45       5611.45     7745     Renal Dialysis
     06413427-7745   DARBEPOETIN 300 MCG IJ                                 3322.45       3322.45     7745     Renal Dialysis
     06413419-7745   DARBEPOETIN 150 MCG IJ                                 2232.95       2232.95     7745     Renal Dialysis
     08822222-7320   Care Management Travel Time                               0.00          0.00     7320     Adult Day Health
     08800138-7320   Insurance Claims Assistance 30 Min                       15.00         15.00     7320     Adult Day Health
     08800153-7320   Insurance Claims Assistance 60 Min                       30.00         30.00     7320     Adult Day Health
     08821522-7320   Care Coordination 45 Minutes                              0.00         56.25     7320     Adult Day Health
     08830010-7320   Nursing Evaluation 30 mins                                0.00        110.00     7320     Adult Day Health
     08830028-7320   Nursing Evaluation Addl 15 Minutes                        0.00         55.00     7320     Adult Day Health
     08830036-7320   Nursing Treatment 15 Minutes                              0.00         55.00     7320     Adult Day Health
     08830044-7320   Nursing Family Teaching 30 Minutes                        0.00         65.00     7320     Adult Day Health
     08840019-7320   SW Evaluation 30 Mins                                     0.00        110.00     7320     Adult Day Health
     08840043-7320   SW Family Confer. 30 Minutes                              0.00         65.00     7320     Adult Day Health
     08821530-7320   Care Coordination 60 Minutes                              0.00         75.00     7320     Adult Day Health
     08821415-7320   Care Visit 30 Minutes                                     0.00         37.50     7320     Adult Day Health
     08821514-7320   Care Coordination 30 Minutes                              0.00         37.50     7320     Adult Day Health
     08821506-7320   Care Coordination 15 Minutes                              0.00         18.75     7320     Adult Day Health
     08821480-7320   Family Meeting 60 Minutes                                 0.00         75.00     7320     Adult Day Health
     08821407-7320   Care Visit 15 Minutes                                     0.00         18.75     7320     Adult Day Health
     08840035-7320   SW Consultation 15 Minutes                                0.00         55.00     7320     Adult Day Health
     08821431-7320   Care Visit 60 Minutes                                     0.00         75.00     7320     Adult Day Health
     08840021-7320   SW Evaluation Addl 15 Minutes                             0.00         55.00     7320     Adult Day Health
     08821555-7320   Care Calls 15 Minutes                                     0.00         18.75     7320     Adult Day Health
     08810530-7320   Private Pay A County Sponsored                           17.00         17.00     7320     Adult Day Health
     08810915-7320   Social Day Regular County Sponsore                       12.00         12.00     7320     Adult Day Health
     08821590-7320   Family Calls 15 Minutes                                   0.00         18.75     7320     Adult Day Health
     08821592-7320   Family Calls 30 Minutes                                   0.00         37.50     7320     Adult Day Health
     08821596-7320   Family Calls 45 Minutes                                   0.00         56.25     7320     Adult Day Health
     08821597-7320   Family Calls 60 Minutes                                   0.00         75.00     7320     Adult Day Health
     08810905-7320   Assessment Day County Sponsored                          17.00         17.00     7320     Adult Day Health
     05009845-7710   CEFACLOR 375MG/5ML SUSP                                   0.00          0.00     7710     Pharmacy
     05009786-7710   CEPHALEXIN HCL 500MG TAB                                  0.00          0.00     7710     Pharmacy
     05008817-7710   METIPRANOLOL 0.3% DROP                                    0.00          0.00     7710     Pharmacy
     05012081-7710   METHYSERGIDE MAL 2MG TAB                                  0.00          0.00     7710     Pharmacy
     05007550-7710   METHYLPRED 16MG TAB                                       0.00          0.00     7710     Pharmacy



8/31/2010                                                                                                                               158
                                                  c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                             CURRENT CURRENT        DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                 INPATIENT OUTPATIENT CODE
                                                                 PRICE      PRICE
     05004965-7710   METHYLPHENIDATE 20MG TAB                          0.00        0.00     7710     Pharmacy
     05010027-7710   CHLORAMPHENICOL 1G VIAL                           0.00        0.00     7710     Pharmacy
     05003395-7710   CHARCOAL/SORB SOLN 50G LIQ                        0.00        0.00     7710     Pharmacy
     05000897-7710   CEPACOL 0.05% MTH                                 0.00        0.00     7710     Pharmacy
     05014776-7710   METRONIDAZOLE 375MG CAP                           0.00        0.00     7710     Pharmacy
     05000620-7710   METOPROLOL 1MG/ML DIS SYR                         0.00        0.00     7710     Pharmacy
     05006950-7710   ANALGESIC BALM OIN GM                             0.00        0.00     7710     Pharmacy
     05012376-7710   CELLULOSE 75% PWD PO                              0.00        0.00     7710     Pharmacy
     05012737-7710   CEFPROZIL 250MG TAB                               0.00        0.00     7710     Pharmacy
     05000520-7710   METHYLDOPATE 250MG/5ML VL                         0.00        0.00     7710     Pharmacy
     05009918-7710   CEFOTETAN 2GM IV                                  0.00        0.00     7710     Pharmacy
     05005526-7710   METHOCARBAMOL 100MG/ML VL                         0.00        0.00     7710     Pharmacy
     05012506-7710   ANALGESIC BALM 14-3 LIN                           0.00        0.00     7710     Pharmacy
     05005457-7710   METHSUXIMIDE 300MG CAP                            0.00        0.00     7710     Pharmacy
     05007142-7710   METHOXSALEN 10MG CAP                              0.00        0.00     7710     Pharmacy
     05009919-7710   CEFIXIME 100MG/5ML SUSP                           0.00        0.00     7710     Pharmacy
     05009828-7710   CEFADROXIL 250MG/5ML                              0.00        0.00     7710     Pharmacy
     05014908-7710   METHADONE HCL 40MG TB DSP                         0.00        0.00     7710     Pharmacy
     05009129-7710   METHAZOLAMIDE 25MG TAB                            0.00        0.00     7710     Pharmacy
     05009796-7710   CEFAZOLIN 10GM VIAL                               0.00        0.00     7710     Pharmacy
     05009921-7710   CEFIXIME 400MG TAB                                0.00        0.00     7710     Pharmacy
     05009916-7710   CEFOTETAN 1GM IV                                  0.00        0.00     7710     Pharmacy
     05009130-7710   METHAZOLAMIDE 50MG TAB                            0.00        0.00     7710     Pharmacy
     05000225-7710   CHLORPHENIRAMIN 12MG SATB                         0.00        0.00     7710     Pharmacy
     05004842-7710   CLOMIPRAIME HCL 75MG CAP                          0.00        0.00     7710     Pharmacy
     05004841-7710   CLOMIPRAIME HCL 50MG CAP                          0.00        0.00     7710     Pharmacy
     05004840-7710   CLOMIPRAIME HCL 25MG CAP                          0.00        0.00     7710     Pharmacy
     05007399-7710   CLOMIPHENE CIT 50MG TAB                           0.00        0.00     7710     Pharmacy
     05008573-7710   CLOBETASOL PROP 0.05% SOL                         0.00        0.00     7710     Pharmacy
     05013769-7710   CLINDAMYCIN PHOS 1% SWB                           0.00        0.00     7710     Pharmacy
     05003415-7710   CLOVE OIL OIL                                     0.00        0.00     7710     Pharmacy
     05012796-7710   MISC OTHER DRUG                                   0.00        0.00     7710     Pharmacy
     05005068-7710   FIORINAL/COD 30MG CAP                             0.00        0.00     7710     Pharmacy
     05005055-7710   FIORICET/COD 30MG CAP                             0.00        0.00     7710     Pharmacy
     05015956-7710   COAL TAR 1% EMUL                                  0.00        0.00     7710     Pharmacy
     05014619-7710   CLOBETASOL 0.05% CRM                              0.00        0.00     7710     Pharmacy
     05015773-7710   CLOTRIMAZOLE 200MG VAG TAB                        0.00        0.00     7710     Pharmacy
     05007848-7710   CLOTRIMAZOLE 100MG TAB                            0.00        0.00     7710     Pharmacy



8/31/2010                                                                                                                     159
                                               c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                          CURRENT CURRENT        DEPARTMENT   DEPARTMENT DESCRIPTION
                                                              INPATIENT OUTPATIENT CODE
                                                              PRICE      PRICE
     05004887-7710   CLOZAPINE 25MG TAB                             0.00        0.00     7710     Pharmacy
     05000227-7710   CHLORPHENIRAMIN2MG/5MLSYP                      0.00        0.00     7710     Pharmacy
     05002619-7710   CHLORPROPAMIDE 100MG TAB                       0.00        0.00     7710     Pharmacy
     05004698-7710   CHLORPROMAZINE 30MG/ML CONC                    0.00        0.00     7710     Pharmacy
     05004690-7710   CHLORPROMAZINE 200MG TAB                       0.00        0.00     7710     Pharmacy
     05004687-7710   CHLORPROMAZINE 10MG/5ML SYRP                   0.00        0.00     7710     Pharmacy
     05004685-7710   CHLORPROMAZINE 100MG/ML CONC                   0.00        0.00     7710     Pharmacy
     05013643-7710   CLARITHROMYCIN250MG/5MLSU                      0.00        0.00     7710     Pharmacy
     05000484-7710   CHLORTHALIDONE 50MG TAB                        0.00        0.00     7710     Pharmacy
     05009844-7710   CEFACLOR 250MG/5ML SUSP                        0.00        0.00     7710     Pharmacy
     05000459-7710   CHLOROTHIAZIDE 500MG TAB                       0.00        0.00     7710     Pharmacy
     05000457-7710   CHLOROTHIAZIDE 250MG TAB                       0.00        0.00     7710     Pharmacy
     05010313-7710   CHLOROQUINE 250MG TAB                          0.00        0.00     7710     Pharmacy
     05004403-7710   CHLOROPROCAINE 20MG/ML VL                      0.00        0.00     7710     Pharmacy
     05004401-7710   CHLOROPROCAINE 10MG/ML VL                      0.00        0.00     7710     Pharmacy
     05007966-7710   LUBRICANTS JEL                                 0.00        0.00     7710     Pharmacy
     05004642-7710   CHLORDIAZEPOXD AMP 100MG                       0.00        0.00     7710     Pharmacy
     05012077-7710   ANA-KIT KIT                                    0.00        0.00     7710     Pharmacy
     05004645-7710   CHLORDIAZEPOXD 5MG CAP                         0.00        0.00     7710     Pharmacy
     05012086-7710   CIMETIDINE 300MG/5ML LIQ                       0.00        0.00     7710     Pharmacy
     05012083-7710   CIMETIDINE 150MG/ML VIAL                       0.00        0.00     7710     Pharmacy
     05000482-7710   CHLORTHALIDONE 100MG TAB                       0.00        0.00     7710     Pharmacy
     05012084-7710   CIMETIDINE 200MG TAB                           0.00        0.00     7710     Pharmacy
     05004072-7710   CHOLESTYRAMINE PWD                             0.00        0.00     7710     Pharmacy
     05005361-7710   TRILISATE 750MG TAB                            0.00        0.00     7710     Pharmacy
     05005359-7710   TRILISATE 500MG TAB                            0.00        0.00     7710     Pharmacy
     05005358-7710   TRILISATE 1000MG TAB                           0.00        0.00     7710     Pharmacy
     05005532-7710   CHLORZOXAZONE 500MG TAB                        0.00        0.00     7710     Pharmacy
     05000641-7710   TENORETIC 25-50MG TA                           0.00        0.00     7710     Pharmacy
     05012679-7710   CLARITHROMYCIN 250MG TAB                       0.00        0.00     7710     Pharmacy
     05012088-7710   CIMETIDINE 800MG TAB                           0.00        0.00     7710     Pharmacy
     05004000-7710   DOCUSATE/CASAN 100/30 CAP                      0.00        0.00     7710     Pharmacy
     05006678-7710   BENZOYL PEROX 2.5% GEL                         0.00        0.00     7710     Pharmacy
     05006675-7710   BENZOYL PEROX 10% LIQ                          0.00        0.00     7710     Pharmacy
     05001333-7710   BENZOIN TINC                                   0.00        0.00     7710     Pharmacy
     05006517-7710   BENZOIN TINC COMPOUND                          0.00        0.00     7710     Pharmacy
     05004474-7710   ANBESOL LIQ                                    0.00        0.00     7710     Pharmacy
     05012201-7710   CHLORASEPTIC LOZG                              0.00        0.00     7710     Pharmacy



8/31/2010                                                                                                                  160
                                                 c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                            CURRENT CURRENT        DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                INPATIENT OUTPATIENT CODE
                                                                PRICE      PRICE
     05012436-7710   BENZOYL PEROX 4% GEL                             0.00        0.00     7710     Pharmacy
     05006684-7710   BENZOYL PEROX 5% GEL                             0.00        0.00     7710     Pharmacy
     05005671-7710   DONNATAL 48.6MG SA TAB                           0.00        0.00     7710     Pharmacy
     05009042-7710   BECLOMETHASONE 42MCG AE NS                       0.00        0.00     7710     Pharmacy
     05000337-7710   BECLOMETHASONE 42MCG AE IH                       0.00        0.00     7710     Pharmacy
     05015594-7710   BECLOMETHASONE 84MCG SPR                         0.00        0.00     7710     Pharmacy
     05008376-7710   BENZOCAINE SPR                                   0.00        0.00     7710     Pharmacy
     05008508-7710   BETAMETHASONE DIP/PROP GLY .05% OI               0.00        0.00     7710     Pharmacy
     05005631-7710   BETHANECHOL 5MG/ML VIAL                          0.00        0.00     7710     Pharmacy
     05005630-7710   BETHANECHOL 5MG TAB                              0.00        0.00     7710     Pharmacy
     05005629-7710   BETHANECHOL 50MG TAB                             0.00        0.00     7710     Pharmacy
     05005627-7710   BETHANECHOL 10MG TAB                             0.00        0.00     7710     Pharmacy
     05005931-7710   BETAXOLOL HCL 10MG TAB                           0.00        0.00     7710     Pharmacy
     05008512-7710   BETAMETHASONE VAL 0.1% OIN                       0.00        0.00     7710     Pharmacy
     05012565-7710   BENZOYL PEROX 2.5% LIQ                           0.00        0.00     7710     Pharmacy
     05008507-7710   BETAMETHASONE DIP/PROP GLY .05% LO               0.00        0.00     7710     Pharmacy
     05002976-7710   BETA-CAROTENE 25MU CAP                           0.00        0.00     7710     Pharmacy
     05015195-7710   BENZOYL PEROX 8% GEL                             0.00        0.00     7710     Pharmacy
     05015073-7710   BENZOYL PEROX 6% GEL                             0.00        0.00     7710     Pharmacy
     05012703-7710   BETAMETHASONE DIP 0.05% GEL                      0.00        0.00     7710     Pharmacy
     05009324-7710   ATRACURIUM 10MG/ML VIAL                          0.00        0.00     7710     Pharmacy
     05014568-7710   ATOVAQUONE 750MG/5ML SUSP                        0.00        0.00     7710     Pharmacy
     05000637-7710   ATENOLOL 0.5MG/ML AMP                            0.00        0.00     7710     Pharmacy
     05015870-7710   BECLOMETHASONE 84MCGAE ADP                       0.00        0.00     7710     Pharmacy
     05001370-7710   ASCORBIC ACID 250MG TAB                          0.00        0.00     7710     Pharmacy
     05015697-7710   ASA BUFFERED 325MG                               0.00        0.00     7710     Pharmacy
     05005260-7710   ASA BUFFERED 324MG                               0.00        0.00     7710     Pharmacy
     05005248-7710   ASA/CAFF 400-32MG TAB                            0.00        0.00     7710     Pharmacy
     05008674-7710   BACITRACIN 500U/G OIN GM                         0.00        0.00     7710     Pharmacy
     05003753-7710   ATROPINE 0.5MG/ML VL                             0.00        0.00     7710     Pharmacy
     05012778-7710   AZITHROMYCIN 250MG CAP                           0.00        0.00     7710     Pharmacy
     05012102-7710   AZATHIOPRINE NA 100MG VIAL                       0.00        0.00     7710     Pharmacy
     05012763-7710   ATTAPULGITE 600MG/15ML LQ                        0.00        0.00     7710     Pharmacy
     05004460-7710   CEPACOL 10-2MG LO                                0.00        0.00     7710     Pharmacy
     05008761-7710   CARBACHOL 0.75% DROP                             0.00        0.00     7710     Pharmacy
     05000565-7710   CAPTOPRIL/HCTZ 50-25MG TB                        0.00        0.00     7710     Pharmacy
     05000562-7710   CAPTOPRIL/HCTZ 25-15MG TAB                       0.00        0.00     7710     Pharmacy
     05003059-7710   CAPSAICIN 0.075% CRM                             0.00        0.00     7710     Pharmacy



8/31/2010                                                                                                                    161
                                                   c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                              CURRENT CURRENT        DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                  INPATIENT OUTPATIENT CODE
                                                                  PRICE      PRICE
     05003058-7710   CAPSAICIN 0.025% CRM                               0.00        0.00     7710     Pharmacy
     05002010-7710   CA GLUBIONATE 1.8G/5MLSYP                          0.00        0.00     7710     Pharmacy
     05003554-7710   CA CARB 500-20 SU                                  0.00        0.00     7710     Pharmacy
     05001839-7710   CA CARB 650MG TAB                                  0.00        0.00     7710     Pharmacy
     05006992-7710   CAMPHO-PHENIQUE LIQ                                0.00        0.00     7710     Pharmacy
     05009842-7710   CEFACLOR 187MG/5ML SUSP                            0.00        0.00     7710     Pharmacy
     05009841-7710   CEFACLOR 125MG/5ML SUSP                            0.00        0.00     7710     Pharmacy
     05003953-7710   CASTOR OIL 36.4% EMUL                              0.00        0.00     7710     Pharmacy
     05003875-7710   MOM/CASCARA SUSP                                   0.00        0.00     7710     Pharmacy
     05003815-7710   CASCARA FEXT                                       0.00        0.00     7710     Pharmacy
     05000981-7710   CODEINE PHOS 15MG/ML SYR DI                        0.00        0.00     7710     Pharmacy
     05003999-7710   DOCUSATE/CASAN 100/30 CA                           0.00        0.00     7710     Pharmacy
     05012858-7710   CARTEOLOL HCL 1% DROP                              0.00        0.00     7710     Pharmacy
     05009512-7710   CARMUSTINE 100MG VIAL                              0.00        0.00     7710     Pharmacy
     05008762-7710   CARBACHOL 1.5% DROP                                0.00        0.00     7710     Pharmacy
     05009717-7710   CARBENICILLIN 382MG TAB                            0.00        0.00     7710     Pharmacy
     05005462-7710   CARBAMAZEPINE 100MG/5MLSU                          0.00        0.00     7710     Pharmacy
     05015771-7710   CARVEDILOL 25MG TAB                                0.00        0.00     7710     Pharmacy
     05004361-7710   BUPIV/EPI 0.75-.0005 VIA                           0.00        0.00     7710     Pharmacy
     05004350-7710   BUPIVACAINE 0.75PC VIAL                            0.00        0.00     7710     Pharmacy
     05007904-7710   CA ACET/AL SO4 TAB EF                              0.00        0.00     7710     Pharmacy
     05005196-7710   BUPRENORPHINE 0.3MG/MLAMP                          0.00        0.00     7710     Pharmacy
     05005918-7710   BRETYLIUM TOSYL 50MG/MLVL                          0.00        0.00     7710     Pharmacy
     05003768-7710   PINK BISMUTH 262MG TAB CH                          0.00        0.00     7710     Pharmacy
     05003982-7710   FLEET PREP KIT #1                                  0.00        0.00     7710     Pharmacy
     05003983-7710   FLEET PREP KIT #2                                  0.00        0.00     7710     Pharmacy
     05009160-7710   BUMETANIDE 0.5MG TAB                               0.00        0.00     7710     Pharmacy
     05013443-7710   CALCIPOTRIENE OIN .005%GM                          0.00        0.00     7710     Pharmacy
     05000027-7710   CAFFEINE 200MG TAB                                 0.00        0.00     7710     Pharmacy
     05001997-7710   CA CARB/VIT D 500-125 TAB                          0.00        0.00     7710     Pharmacy
     05013008-7710   IV Additives                                       0.00        0.00     7710     Pharmacy
     05005220-7710   BUTORPHANOL TART 2MG IJ                            0.00        0.00     7710     Pharmacy
     05005218-7710   BUTORPHANOL TART 1MG IJ                            0.00        0.00     7710     Pharmacy
     05012893-7710   BUTORPHANOL 10MG/ML SPR                            0.00        0.00     7710     Pharmacy
     05015863-7710   BUTENAFINE HCL 1% CRM                              0.00        0.00     7710     Pharmacy
     05000371-7710   DISOPYRAMIDE 150MG SA CAP                          0.00        0.00     7710     Pharmacy
     05000370-7710   DISOPYRAMIDE 150MG CAP                             0.00        0.00     7710     Pharmacy
     05000763-7710   DIPYRIDAMOLE 25MG TAB                              0.00        0.00     7710     Pharmacy



8/31/2010                                                                                                                      162
                                                c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                           CURRENT CURRENT        DEPARTMENT   DEPARTMENT DESCRIPTION
                                                               INPATIENT OUTPATIENT CODE
                                                               PRICE      PRICE
     05008842-7710   DIPIVEFRIN 0.1% DROP                            0.00        0.00     7710     Pharmacy
     05001001-7710   DIPHENHYDRAMINE 50MG/ML AMP                     0.00        0.00     7710     Pharmacy
     05000369-7710   DISOPYRAMIDE 100MG SA CAP                       0.00        0.00     7710     Pharmacy
     05015157-7710   DOXORUBICN LIPO 2MG/ML                          0.00        0.00     7710     Pharmacy
     05013625-7710   DOXEPIN HCL 5% CRM                              0.00        0.00     7710     Pharmacy
     05004824-7710   DOXEPIN 10MG/ML CONC                            0.00        0.00     7710     Pharmacy
     05004492-7710   DOXAPRAM HCL 20MG/ML VIAL                       0.00        0.00     7710     Pharmacy
     05005824-7710   DOPAMINE HCL 40 MG IJ                           0.00        0.00     7710     Pharmacy
     05005819-7710   DOPAMINE HCL 40 MG IJ                           0.00        0.00     7710     Pharmacy
     05002429-7710   DOCUSATE NA 50MG CAP                            0.00        0.00     7710     Pharmacy
     05015194-7710   FAMCICLOVIR 250MG TAB                           0.00        0.00     7710     Pharmacy
     05013709-7710   FAMCICLOVIR 500MG TAB                           0.00        0.00     7710     Pharmacy
     05012958-7710   DILTIAZEM 240MG                                 0.00        0.00     7710     Pharmacy
     05003521-7710   GAVISCON 20-80MG TAB                            0.00        0.00     7710     Pharmacy
     05000821-7710   DILTIAZEM 120MG TAB                             0.00        0.00     7710     Pharmacy
     05000995-7710   DIPHENHYDRAMINE 25MG CAP                        0.00        0.00     7710     Pharmacy
     05000016-7710   DIGOXIN 0.1MG/ML AMP                            0.00        0.00     7710     Pharmacy
     05005370-7710   DIFLUNISAL 500MG TAB                            0.00        0.00     7710     Pharmacy
     05008568-7710   DIFLORASONE 0.05% OIN GM                        0.00        0.00     7710     Pharmacy
     05006028-7710   DIETHYLPROPION 75MG TB SA                       0.00        0.00     7710     Pharmacy
     05006029-7710   DIETHYLPROPION 25MG TAB                         0.00        0.00     7710     Pharmacy
     05007866-7710   DIENESTROL 0.01% CRM AP                         0.00        0.00     7710     Pharmacy
     05005769-7710   DICYCLOMINE 10MG/ML VIAL                        0.00        0.00     7710     Pharmacy
     05004723-7710   FLUPHENAZINE 5MG/ML CONC                        0.00        0.00     7710     Pharmacy
     05000021-7710   DIGOXIN 0.5MG TAB                               0.00        0.00     7710     Pharmacy
     05015789-7710   DIPHENHYDRAMINE 2-0.1%CRM                       0.00        0.00     7710     Pharmacy
     05013191-7710   VX DTP-HIB DTP-HEMOPH B                         0.00        0.00     7710     Pharmacy
     05016600-7710   HYDROQUINONE 3-5-4% CRM                         0.00        0.00     7710     Pharmacy
     05007784-7710   DINOPROSTONE 20MG SUPP                          0.00        0.00     7710     Pharmacy
     05003582-7710   MAG ALOH HYD 200-225 SUSP                       0.00        0.00     7710     Pharmacy
     05003581-7710   MAG ALOH HYD 200-200 CHTB                       0.00        0.00     7710     Pharmacy
     05010269-7710   DMSO 50% SOL                                    0.00        0.00     7710     Pharmacy
     05005576-7710   DIMENHYDRINATE 50MG TAB                         0.00        0.00     7710     Pharmacy
     05015264-7710   DILTIAZEM 360MG CAP SA                          0.00        0.00     7710     Pharmacy
     05009575-7710   ETOPOSIDE 50MG PO B                             0.00        0.00     7710     Pharmacy
     05000825-7710   DILTIAZEM 90MG SA 12HR CP                       0.00        0.00     7710     Pharmacy
     05007508-7710   ETIDRONATE NA 200MG TAB                         0.00        0.00     7710     Pharmacy
     05007509-7710   ETIDRONATE DISODIUM 400MG TAB                   0.00        0.00     7710     Pharmacy



8/31/2010                                                                                                                   163
                                                 c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                            CURRENT CURRENT        DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                INPATIENT OUTPATIENT CODE
                                                                PRICE      PRICE
     05013346-7710   ETODOLAC 400MG TAB                               0.00        0.00     7710     Pharmacy
     05015788-7710   ETODOLAC 400MG XL TABLET                         0.00        0.00     7710     Pharmacy
     05012457-7710   ETODOLAC 200MG CAP                               0.00        0.00     7710     Pharmacy
     05012458-7710   ETODOLAC 300MG CAP                               0.00        0.00     7710     Pharmacy
     05012894-7710   DIPHENHYDRAMINE 12.5MG/5ML LIQ                   0.00        0.00     7710     Pharmacy
     05008622-7710   ERYTHROMYCIN BASE 2% OIN GM                      0.00        0.00     7710     Pharmacy
     05015318-7710   ESTRADIOL .0375MG/24 PTCH                        0.00        0.00     7710     Pharmacy
     05010014-7710   ERYTHROMYCIN LA 1GM VIAL                         0.00        0.00     7710     Pharmacy
     05010005-7710   ERYTHROMYCIN ES 400MG                            0.00        0.00     7710     Pharmacy
     05010009-7710   EES/SULFISOX SUSP                                0.00        0.00     7710     Pharmacy
     05012271-7710   ERYTHROMYCIN 500MG PARTTB                        0.00        0.00     7710     Pharmacy
     05013432-7710   ERYTHROMYCIN 400MG/5ML SUSP                      0.00        0.00     7710     Pharmacy
     05009987-7710   ERYTHROMYCIN 333MG TAB EC                        0.00        0.00     7710     Pharmacy
     05012442-7710   DOXYCYCLINE MH 100MG CAP                         0.00        0.00     7710     Pharmacy
     05008620-7710   ERYTHROMYCIN BASE/ETH 2% GEL                     0.00        0.00     7710     Pharmacy
     05004199-7710   PREMARIN 2.5MG                                   0.00        0.00     7710     Pharmacy
     05004228-7710   ESTROPIPATE 0.625MG TAB                          0.00        0.00     7710     Pharmacy
     05004229-7710   ESTROPIPATE 1.25MG TAB                           0.00        0.00     7710     Pharmacy
     05009144-7710   ETHACRYNIC ACID 50MG TAB                         0.00        0.00     7710     Pharmacy
     05003162-7710   ESTRADIOL ETH 0.02MG TAB                         0.00        0.00     7710     Pharmacy
     05003163-7710   ESTRADIOL ETH 0.05MG TAB                         0.00        0.00     7710     Pharmacy
     05014075-7710   PREMPRO 0.625-5MG                                0.00        0.00     7710     Pharmacy
     05009564-7710   ESTRAMUSTINE 140MG CAP                           0.00        0.00     7710     Pharmacy
     05004174-7710   ETHIODIZED OIL 37% AMP                           0.00        0.00     7710     Pharmacy
     05004187-7710   ESTRADIOL CYP 5MG/ML VIAL                        0.00        0.00     7710     Pharmacy
     05000055-7710   ETOH 98% AMP                                     0.00        0.00     7710     Pharmacy
     05010004-7710   ERYTHROMYCIN ES 40MG/ML DROP                     0.00        0.00     7710     Pharmacy
     05000571-7710   ENALAPRIL/HCTZ 10-25MG TAB                       0.00        0.00     7710     Pharmacy
     05013431-7710   ERYTHROMYCIN 200MG/5ML SUSP                      0.00        0.00     7710     Pharmacy
     05012870-7710   ENLON-PLUS VIAL                                  0.00        0.00     7710     Pharmacy
     05005657-7710   EDROPHONIUM 10MG/ML AMP                          0.00        0.00     7710     Pharmacy
     05008805-7710   ECHOTHIP IODIDE 0.25% DRP                        0.00        0.00     7710     Pharmacy
     05008804-7710   ECHOTHIP IODIDE .125% DRP                        0.00        0.00     7710     Pharmacy
     05008803-7710   ECHOTHIP IODIDE 0.06% DRP                        0.00        0.00     7710     Pharmacy
     05005613-7710   DRONABINOL 2.5MG CAP                             0.00        0.00     7710     Pharmacy
     05005612-7710   DRONABINOL 10MG CAP                              0.00        0.00     7710     Pharmacy
     05001780-7710   NUTRILYTE 20ML SDV                               0.00        0.00     7710     Pharmacy
     05008840-7710   EPINEPHRINE 2PC DROP                             0.00        0.00     7710     Pharmacy



8/31/2010                                                                                                                    164
                                                c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                           CURRENT CURRENT        DEPARTMENT   DEPARTMENT DESCRIPTION
                                                               INPATIENT OUTPATIENT CODE
                                                               PRICE      PRICE
     05010003-7710   ERYTHROMYCIN ES 400MG/5ML SUSP                  0.00        0.00     7710     Pharmacy
     05005407-7710   CAFERGOT 2-100MG SUPP                           0.00        0.00     7710     Pharmacy
     05005404-7710   ERGOTAMINE TART 2MG TB SL                       0.00        0.00     7710     Pharmacy
     05014098-7710   ERGONOVINE MAL .2MG/ML VL                       0.00        0.00     7710     Pharmacy
     05004337-7710   EPINEPHRINE 1MG/ML SY DIS                       0.00        0.00     7710     Pharmacy
     05000294-7710   EPINEPHRINE 0.2MG AER ADP                       0.00        0.00     7710     Pharmacy
     05012959-7710   EPINEPHRINE 0.15MG SY DIS                       0.00        0.00     7710     Pharmacy
     05005892-7710   EPHEDRINE SO4 25MG CAP                          0.00        0.00     7710     Pharmacy
     05005771-7710   DICYCLOMINE 10MG/ML AMP                         0.00        0.00     7710     Pharmacy
     05002477-7710   FE SO4 325MG EC TAB                             0.00        0.00     7710     Pharmacy
     05002478-7710   FE SO4 325MG TAB                                0.00        0.00     7710     Pharmacy
     05015633-7710   FEXOFENADINE 60MG CAP                           0.00        0.00     7710     Pharmacy
     05016356-7710   FINASTERIDE 1MG TAB                             0.00        0.00     7710     Pharmacy
     05005781-7710   FLAVOXATE HCL 100MG TAB                         0.00        0.00     7710     Pharmacy
     05000393-7710   FLECAINIDE 150MG TAB                            0.00        0.00     7710     Pharmacy
     05010281-7710   FLUCYTOSINE 250MG CAP                           0.00        0.00     7710     Pharmacy
     05010282-7710   FLUCYTOSINE 500MG CAP                           0.00        0.00     7710     Pharmacy
     05013078-7710   FLUNISOLIDE 250MCG AER AD                       0.00        0.00     7710     Pharmacy
     05008544-7710   FLUOCINOLONE 0.01% CRM                          0.00        0.00     7710     Pharmacy
     05011529-7710   CONTAINER                                       0.00        0.00     7710     Pharmacy
     05014977-7710   CONTAINER                                       0.00        0.00     7710     Pharmacy
     05014975-7710   CONTAINER                                       0.00        0.00     7710     Pharmacy
     05014974-7710   CONTAINER                                       0.00        0.00     7710     Pharmacy
     05012099-7710   FAMOTIDINE 40MG/5ML SUSP                        0.00        0.00     7710     Pharmacy
     05007204-7710   LIPID EMULSION 10% IVSL                         0.00        0.00     7710     Pharmacy
     05016412-7710   MISC OTHER DRUG                                 0.00        0.00     7710     Pharmacy
     05017066-7710   COMPOUNDED CREAM/OINT                           0.00        0.00     7710     Pharmacy
     05016541-7710   FENOFIBRATE 67MG CAP                            0.00        0.00     7710     Pharmacy
     05012227-7710   FE GLUCONATE 300MG TAB                          0.00        0.00     7710     Pharmacy
     05004722-7710   FLUPHENAZINE 2.5MG/ML VL                        0.00        0.00     7710     Pharmacy
     05004718-7710   FLUPHENAZINE 25MG/ML DIS SYR                    0.00        0.00     7710     Pharmacy
     05004719-7710   FLUPHENAZINE DEC 25MG/MLVL                      0.00        0.00     7710     Pharmacy
     05004725-7710   FLUPHENAZINE 1MG TAB                            0.00        0.00     7710     Pharmacy
     05004727-7710   FLUPHENAZINE 2.5MG TAB                          0.00        0.00     7710     Pharmacy
     05012143-7710   MISC OTHER DRUG                                 0.00        0.00     7710     Pharmacy
     05012972-7710   OATMEAL COLL PACK                               0.00        0.00     7710     Pharmacy
     05006521-7710   COLLODION LIQ                                   0.00        0.00     7710     Pharmacy
     05006236-7710   COLLAGEN HEMOST                                 0.00        0.00     7710     Pharmacy



8/31/2010                                                                                                                   165
                                                  c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                             CURRENT CURRENT        DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                 INPATIENT OUTPATIENT CODE
                                                                 PRICE      PRICE
     05004078-7710   COLESTIPOL HCL GRAN                               0.00        0.00     7710     Pharmacy
     05013504-7710   COLESTIPOL HCL 7.5G PACK                          0.00        0.00     7710     Pharmacy
     05013879-7710   COLESTIPOL HCL 1G TAB                             0.00        0.00     7710     Pharmacy
     05006076-7710   EMOLLIENTS CRM                                    0.00        0.00     7710     Pharmacy
     05005061-7710   ASA/COD 60/325 TAB                                0.00        0.00     7710     Pharmacy
     05005060-7710   ASA/COD 30/325 TAB                                0.00        0.00     7710     Pharmacy
     05005108-7710   CODEINE SO4 60MG TAB                              0.00        0.00     7710     Pharmacy
     05004077-7710   COLESTIPOL HCL 5G PACK                            0.00        0.00     7710     Pharmacy
     05003169-7710   MVI/FLUORIDE 0.25MG/ML DR                         0.00        0.00     7710     Pharmacy
     05012156-7710   CONTAINER FOR 3/1                                 0.00        0.00     7710     Pharmacy
     05012314-7710   FLUOCINOLONE 0.01% SHAM                           0.00        0.00     7710     Pharmacy
     05008547-7710   FLUOCINOLONE 0.025% CRM                           0.00        0.00     7710     Pharmacy
     05008553-7710   FLUOCINONIDE 0.05% GEL                            0.00        0.00     7710     Pharmacy
     05008555-7710   FLUOCINONIDE 0.05% SOL                            0.00        0.00     7710     Pharmacy
     05007654-7710   FLUORESCEIN NA 10% AMP                            0.00        0.00     7710     Pharmacy
     05004149-7710   FLUOXYMESTERONE 10MG TAB                          0.00        0.00     7710     Pharmacy
     05003166-7710   MVI/FLUORIDE 0.5MG TAB CH                         0.00        0.00     7710     Pharmacy
     05003167-7710   MVI/FLUORIDE 1MG TAB                              0.00        0.00     7710     Pharmacy
     05003196-7710   MVI/FLUORIDE FE 0.25MG/ML DROP                    0.00        0.00     7710     Pharmacy
     05003190-7710   MVI/FLUORIDE                                      0.00        0.00     7710     Pharmacy
     05008437-7710   FLUOROURACIL 1% CRM                               0.00        0.00     7710     Pharmacy
     05008438-7710   FLUOROURACIL 1% SOL                               0.00        0.00     7710     Pharmacy
     05008439-7710   FLUOROURACIL 2% SOL                               0.00        0.00     7710     Pharmacy
     05008440-7710   FLUOROURACIL 5% CRM                               0.00        0.00     7710     Pharmacy
     05008441-7710   FLUOROURACIL 5% SOL                               0.00        0.00     7710     Pharmacy
     05013119-7710   FLUOXETINE 10MG CAP                               0.00        0.00     7710     Pharmacy
     05007661-7710   FLUORESCEIN NA 2% DROP                            0.00        0.00     7710     Pharmacy
     05002912-7710   D40W 500ML                                        0.00        0.00     7710     Pharmacy
     05002714-7710   D25W 10ML                                         0.00        0.00     7710     Pharmacy
     05002697-7710   D10W 5ML                                          0.00        0.00     7710     Pharmacy
     05008883-7710   EYE LUBE 70/HP-M-CELL DRP                         0.00        0.00     7710     Pharmacy
     05010535-7710   DEXTRAN 70 70/D10W 32% SL                         0.00        0.00     7710     Pharmacy
     05007161-7710   DEXTRAN 1 50MG/ML IVSL                            0.00        0.00     7710     Pharmacy
     05001213-7710   POLARMINE 2MG TA                                  0.00        0.00     7710     Pharmacy
     05001212-7710   POLARMINE 6MG TAB SA                              0.00        0.00     7710     Pharmacy
     05008558-7710   DESONIDE 0.05% OIN GM                             0.00        0.00     7710     Pharmacy
     05007601-7710   DEXAMETHASONE 0.75MG TAB                          0.00        0.00     7710     Pharmacy
     05008521-7710   DESOXIMETASONE OIN .25%GM                         0.00        0.00     7710     Pharmacy



8/31/2010                                                                                                                     166
                                                c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                           CURRENT CURRENT        DEPARTMENT   DEPARTMENT DESCRIPTION
                                                               INPATIENT OUTPATIENT CODE
                                                               PRICE      PRICE
     05000397-7710   MEXILETINE HCL 200MG CAP                        0.00        0.00     7710     Pharmacy
     05011524-7710   CONTAINER                                       0.00        0.00     7710     Pharmacy
     05009721-7710   DICLOXACILLIN62.5MG/5MLSU                       0.00        0.00     7710     Pharmacy
     05009293-7710   DICLOFENAC NA 25MG TAB EC                       0.00        0.00     7710     Pharmacy
     05012500-7710   DICLOFENAC NA 0.1% DROP                         0.00        0.00     7710     Pharmacy
     05013470-7710   DICLOFENAC K 50MG TAB                           0.00        0.00     7710     Pharmacy
     05016289-7710   DICLOFEN/MISOPR 75-0.2MG TAB EC                 0.00        0.00     7710     Pharmacy
     05016054-7710   DICLOFEN/MISOPR 50-0.2MG TAB EC                 0.00        0.00     7710     Pharmacy
     05000445-7710   DIAZOXIDE 300MG/20ML AMP                        0.00        0.00     7710     Pharmacy
     05004665-7710   DIAZEPAM 5MG/5ML SOL                            0.00        0.00     7710     Pharmacy
     05002918-7710   D70W 500ML                                      0.00        0.00     7710     Pharmacy
     05100005-7710   DIBUCAINE 1% OIN GM                             0.00        0.00     7710     Pharmacy
     05005855-7710   DEXEDRINE 15MG CAP SA                           0.00        0.00     7710     Pharmacy
     05005853-7710   DEXEDRINE 10MG TAB                              0.00        0.00     7710     Pharmacy
     05009537-7710   CYTARABINE 1G IJ                                0.00        0.00     7710     Pharmacy
     05012107-7710   CYCLOSPORINE 50MG/ML AMP                        0.00        0.00     7710     Pharmacy
     05012105-7710   CYCLOSPORINE 100MG/ML SOL                       0.00        0.00     7710     Pharmacy
     05015001-7710   CYCLOSPORINE MICROEM 100MG/ML SOL               0.00        0.00     7710     Pharmacy
     05008520-7710   DESOXIMETASONE 0.25% CRM                        0.00        0.00     7710     Pharmacy
     05008835-7710   CYCLOPENTOLATE 2% DROP                          0.00        0.00     7710     Pharmacy
     05004250-7710   ESTRATEST2.5-1.25MGTB                           0.00        0.00     7710     Pharmacy
     05012114-7710   CROMOLYN NA 800MCG AERO                         0.00        0.00     7710     Pharmacy
     05008693-7710   CROMOLYN NA 4% DROP                             0.00        0.00     7710     Pharmacy
     05012110-7710   CROMOLYN NA 10MG/ML AMP-NEB                     0.00        0.00     7710     Pharmacy
     05007514-7710   CORTISONE ACET 25MG TAB                         0.00        0.00     7710     Pharmacy
     05000982-7710   CODEINE PHOS 30MGSO TAB                         0.00        0.00     7710     Pharmacy
     05009498-7710   CYCLOPHOSPHAMID 25MG TAB                        0.00        0.00     7710     Pharmacy
     05010358-7710   DAPSONE 25MG TAB                                0.00        0.00     7710     Pharmacy
     05004808-7710   DESIPRAMINE 25MG TAB                            0.00        0.00     7710     Pharmacy
     05004806-7710   DESIPRAMINE 150MG TAB                           0.00        0.00     7710     Pharmacy
     05004805-7710   DESIPRAMINE 10MG TAB                            0.00        0.00     7710     Pharmacy
     05004804-7710   DESIPRAMINE 100MG TAB                           0.00        0.00     7710     Pharmacy
     05013098-7710   DESFLURANE LIQ                                  0.00        0.00     7710     Pharmacy
     05010329-7710   METRONIDAZOLE 500MG VIAL                        0.00        0.00     7710     Pharmacy
     05005542-7710   DANTROLENE NA 50MG CAP                          0.00        0.00     7710     Pharmacy
     05005541-7710   DANTROLENE NA 25MG CAP                          0.00        0.00     7710     Pharmacy
     05005540-7710   DANTROLENE NA 20MG VIAL                         0.00        0.00     7710     Pharmacy
     05007427-7710   DANAZOL 200MG CAP                               0.00        0.00     7710     Pharmacy



8/31/2010                                                                                                                   167
                                                c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                           CURRENT CURRENT        DEPARTMENT   DEPARTMENT DESCRIPTION
                                                               INPATIENT OUTPATIENT CODE
                                                               PRICE      PRICE
     05002945-7710   D10NS 1000ML                                    0.00        0.00     7710     Pharmacy
     05014972-7710   CONTAINER                                       0.00        0.00     7710     Pharmacy
     05010519-7710   HYDROGEN PEROX 3% SOL                           0.00        0.00     7710     Pharmacy
     05002604-7710   INSULIN LENTE 100U/ML VL                        0.00        0.00     7710     Pharmacy
     05012262-7710   HYDROCORT ACET 1% CRM                           0.00        0.00     7710     Pharmacy
     05012874-7710   HYDROCORT ACET 1% OIN GM                        0.00        0.00     7710     Pharmacy
     05013944-7710   HYDROCORT ACET 10% FOAM                         0.00        0.00     7710     Pharmacy
     05008019-7710   VYTONE 1-1% CRM                                 0.00        0.00     7710     Pharmacy
     05008339-7710   HYDROCORT 1% LO                                 0.00        0.00     7710     Pharmacy
     05012977-7710   HYDROCOD/APAP 10-650MG TB                       0.00        0.00     7710     Pharmacy
     05015672-7710   HYDROCOD/APAP 10-660MG TB                       0.00        0.00     7710     Pharmacy
     05001403-7710   HYDROCOD/CHLORP SUSP                            0.00        0.00     7710     Pharmacy
     05008457-7710   HYDROCORT 0.5% OIN GM                           0.00        0.00     7710     Pharmacy
     05007683-7710   HYDROCORT 100MG/60ML ENEM                       0.00        0.00     7710     Pharmacy
     05008466-7710   HYDROCORT 2.5% LOT                              0.00        0.00     7710     Pharmacy
     05004788-7710   IMIPRAMINE PAM 100MG CAP                        0.00        0.00     7710     Pharmacy
     05015393-7710   INDINAVIR 400MG CAP                             0.00        0.00     7710     Pharmacy
     05009258-7710   INDOMETHACIN 50MG SUPP                          0.00        0.00     7710     Pharmacy
     05009259-7710   INDOMETHACIN 75MG CAP SA                        0.00        0.00     7710     Pharmacy
     05013878-7710   FLU VACC >3YRS                                  0.00        0.00     7710     Pharmacy
     05012942-7710   INSULIN REG/NPH S-S/INS                         0.00        0.00     7710     Pharmacy
     05002580-7710   INSULIN PRK REG                                 0.00        0.00     7710     Pharmacy
     05002610-7710   INSULIN ULTRA 100U/ML VI                        0.00        0.00     7710     Pharmacy
     05009261-7710   INDOMETHACIN 1MG INJ                            0.00        0.00     7710     Pharmacy
     05000849-7710   HYOSCYAMNE 0.15MG TAB                           0.00        0.00     7710     Pharmacy
     05000427-7710   SER-AP-ES25-.1-15TB                             0.00        0.00     7710     Pharmacy
     05004627-7710   HYDROXYZINE HCL 10MG/5ML SYP                    0.00        0.00     7710     Pharmacy
     05004114-7710   HYOSCYAMNE .375MGSACP                           0.00        0.00     7710     Pharmacy
     05014867-7710   HYOSCYAMNE SO4 0.375MG TB                       0.00        0.00     7710     Pharmacy
     05008565-7710   HALCINONIDE 0.1% SOL                            0.00        0.00     7710     Pharmacy
     05001191-7710   GUAIF/COD/PSEUD 10MG SYRP                       0.00        0.00     7710     Pharmacy
     05001110-7710   DURATEX                                         0.00        0.00     7710     Pharmacy
     05000861-7710   GUAIFENESIN 200MG TAB                           0.00        0.00     7710     Pharmacy
     05001224-7710   GUAIF/PSEUD 600-60MG                            0.00        0.00     7710     Pharmacy
     05000508-7710   GUANABENZ ACET 4MG TAB                          0.00        0.00     7710     Pharmacy
     05000522-7710   GUANFACINE HCL 1MG TAB                          0.00        0.00     7710     Pharmacy
     05008563-7710   HALCINONIDE 0.1% CRM                            0.00        0.00     7710     Pharmacy
     05012838-7710   GUAIF/HYDROCOD100-5/5MLSY                       0.00        0.00     7710     Pharmacy



8/31/2010                                                                                                                   168
                                               c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                          CURRENT CURRENT        DEPARTMENT   DEPARTMENT DESCRIPTION
                                                              INPATIENT OUTPATIENT CODE
                                                              PRICE      PRICE
     05012354-7710   HALOBETASOL PROP .05% CRM                      0.00        0.00     7710     Pharmacy
     05004861-7710   HALOPERIDOL 20MG TAB                           0.00        0.00     7710     Pharmacy
     05008708-7710   GLYCERIN DROP                                  0.00        0.00     7710     Pharmacy
     05013759-7710   GLUCOSAMINE SO4 500MG CAP                      0.00        0.00     7710     Pharmacy
     05013420-7710   GLYBURIDE 6MG TAB                              0.00        0.00     7710     Pharmacy
     05001164-7710   GUAIF/PSEUD 250-120MG CAP                      0.00        0.00     7710     Pharmacy
     05007670-7710   GLYCERIN PEDIATRIC ENEM                        0.00        0.00     7710     Pharmacy
     05010277-7710   GRISEOFULVIN 250MG                             0.00        0.00     7710     Pharmacy
     05001015-7710   GUAIF/DM 600-30MG                              0.00        0.00     7710     Pharmacy
     05001041-7710   NALDECON DX 100MG/5ML SYP                      0.00        0.00     7710     Pharmacy
     05003453-7710   GLYCERIN 50% SOL                               0.00        0.00     7710     Pharmacy
     05014009-7710   HEPARIN BEEF 1000U/ML VL                       0.00        0.00     7710     Pharmacy
     05007342-7710   HEPARIN 1000U/ML AMP                           0.00        0.00     7710     Pharmacy
     05007354-7710   HEPARIN 20000U/ML VIAL                         0.00        0.00     7710     Pharmacy
     05008131-7710   HEXACHLOROPHENE 3% LIQ                         0.00        0.00     7710     Pharmacy
     05003272-7710   MVI LIQ                                        0.00        0.00     7710     Pharmacy
     05008829-7710   HOMATROPINE 2% DROP                            0.00        0.00     7710     Pharmacy
     05008888-7710   ISOPTO TEARS 0.5% DROP                         0.00        0.00     7710     Pharmacy
     05006072-7710   HYALURONIDASE 150U VIAL                        0.00        0.00     7710     Pharmacy
     05006073-7710   HYALURONIDASE 150U/ML VL                       0.00        0.00     7710     Pharmacy
     05012122-7710   INTERFERON A-2A                                0.00        0.00     7710     Pharmacy
     05005253-7710   ASA/BUT/CAFF                                   0.00        0.00     7710     Pharmacy
     05016108-7710   HYDROCORT/PRAM ACET/PRAM 1-1% CRM              0.00        0.00     7710     Pharmacy
     05007525-7710   HYDROCORT NA SUC 1000MG VL                     0.00        0.00     7710     Pharmacy
     05007528-7710   HYDROCORT NA SUC 500MG VL                      0.00        0.00     7710     Pharmacy
     05004155-7710   GONADOTROPIN                                   0.00        0.00     7710     Pharmacy
     05015437-7710   VX HEP A ADULT IM                              0.00        0.00     7710     Pharmacy
     05000622-7710   METOPROLOL/HCTZ25-100MGTB                      0.00        0.00     7710     Pharmacy
     05007649-7710   HCTZ/SPIRON 50-50MG TAB                        0.00        0.00     7710     Pharmacy
     05013232-7710   LODOXAMIDE 0.1% DROP                           0.00        0.00     7710     Pharmacy
     05009508-7710   LOMUSTINE 100MG CAP                            0.00        0.00     7710     Pharmacy
     05005148-7710   LEVORPHANAL TART 2MG TAB                       0.00        0.00     7710     Pharmacy
     05004899-7710   LITHIUM CARB 300MG TAB                         0.00        0.00     7710     Pharmacy
     05015951-7710   LORATADINE 10MG TAB LN                         0.00        0.00     7710     Pharmacy
     05015450-7710   LORATADINE 5MG/5ML SYRP                        0.00        0.00     7710     Pharmacy
     05013489-7710   LEVOCABASTINE .05% DRP SU                      0.00        0.00     7710     Pharmacy
     05000381-7710   LIDOCAINE 20PC VIAL                            0.00        0.00     7710     Pharmacy
     05004431-7710   LIDO/EPI 1-0.0005 AMP                          0.00        0.00     7710     Pharmacy



8/31/2010                                                                                                                  169
                                                 c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                            CURRENT CURRENT        DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                INPATIENT OUTPATIENT CODE
                                                                PRICE      PRICE
     05004427-7710   LIDO/EPI 0.5-0.0005 VIAL                         0.00        0.00     7710     Pharmacy
     05008322-7710   LIDOCAINE HCL 2.5% OIN GM                        0.00        0.00     7710     Pharmacy
     05004421-7710   LIDOCAINE 4PC AMP                                0.00        0.00     7710     Pharmacy
     05004436-7710   LIDO/EPI 2-0.0005 VIAL                           0.00        0.00     7710     Pharmacy
     05004409-7710   LIDOCAINE 1.5PC VIAL                             0.00        0.00     7710     Pharmacy
     05004408-7710   LIDOCAINE 1.5PC AMP                              0.00        0.00     7710     Pharmacy
     05007486-7710   LEVOTHYROXINE 0.3MG TAB                          0.00        0.00     7710     Pharmacy
     05004406-7710   LIDOCAINE 0.5PC VIAL                             0.00        0.00     7710     Pharmacy
     05008589-7710   LINDANE 1% LOT                                   0.00        0.00     7710     Pharmacy
     05004872-7710   LOXAPINE HCL 25MG/ML CONC                        0.00        0.00     7710     Pharmacy
     05007501-7710   LIOTRIX 60MG TAB                                 0.00        0.00     7710     Pharmacy
     05007497-7710   LIOTRIX 120MG TAB                                0.00        0.00     7710     Pharmacy
     05007490-7710   LIOTHYRONINE NA 50MCG TAB                        0.00        0.00     7710     Pharmacy
     05008590-7710   LINDANE 1% SHAM                                  0.00        0.00     7710     Pharmacy
     05004429-7710   LIDO/EPI 1.5-0.0005 VIAL                         0.00        0.00     7710     Pharmacy
     05016764-7710   EMLA 2.5-2.5% KIT                                0.00        0.00     7710     Pharmacy
     05004440-7710   LIDO/DEXTROSE 50MG/ML AMP                        0.00        0.00     7710     Pharmacy
     05000758-7710   ISOSORBIDE DN 40MG SA TB                         0.00        0.00     7710     Pharmacy
     05000757-7710   ISOSORBIDE DN 40MG TAB                           0.00        0.00     7710     Pharmacy
     05000761-7710   ISOSORBIDE DN 5MG SL                             0.00        0.00     7710     Pharmacy
     05000760-7710   ISOSORBIDE DN 5MG TAB                            0.00        0.00     7710     Pharmacy
     05012784-7710   ISOSORBIDE MONO 20MG TAB                         0.00        0.00     7710     Pharmacy
     05015795-7710   IVERMECTIN 6MG TAB                               0.00        0.00     7710     Pharmacy
     05006776-7710   ISOTRETINOIN 10MG CAP                            0.00        0.00     7710     Pharmacy
     05006777-7710   ISOTRETINOIN 20MG CAP                            0.00        0.00     7710     Pharmacy
     05006778-7710   ISOTRETINOIN 40MG CAP                            0.00        0.00     7710     Pharmacy
     05000799-7710   ISOSUPRINE 20MG TAB                              0.00        0.00     7710     Pharmacy
     05012398-7710   ISRADIPINE 2.5MG CAP                             0.00        0.00     7710     Pharmacy
     05012399-7710   ISRADIPINE 5MG CAP                               0.00        0.00     7710     Pharmacy
     05012124-7710   LEVAMISOLE HCL 50MG TAB                          0.00        0.00     7710     Pharmacy
     05012123-7710   INTERFERON A-2A                                  0.00        0.00     7710     Pharmacy
     05013710-7710   MISC INJECTION                                   0.00        0.00     7710     Pharmacy
     05013921-7710   MISC ENT DRUG                                    0.00        0.00     7710     Pharmacy
     05013711-7710   MISC OTHER DRUG                                  0.00        0.00     7710     Pharmacy
     05008084-7710   IODINE TC 2%                                     0.00        0.00     7710     Pharmacy
     05004081-7710   IOPANOIC ACID 500MG TAB                          0.00        0.00     7710     Pharmacy
     05003387-7710   IPECAC SYRP                                      0.00        0.00     7710     Pharmacy
     05015477-7710   IRINOTECAN 20MG IJ                               0.00        0.00     7710     Pharmacy



8/31/2010                                                                                                                    170
                                                c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                           CURRENT CURRENT        DEPARTMENT   DEPARTMENT DESCRIPTION
                                                               INPATIENT OUTPATIENT CODE
                                                               PRICE      PRICE
     05002348-7710   IRON DEXTRAN CPX50MG/MLVL                       0.00        0.00     7710     Pharmacy
     05005807-7710   ISOETHERINE 10MG/ML SOL                         0.00        0.00     7710     Pharmacy
     05015064-7710   ISOFLURANE LIQ                                  0.00        0.00     7710     Pharmacy
     05005413-7710   MIDRIN                                          0.00        0.00     7710     Pharmacy
     05010086-7710   ISONIAZID 100MG TAB                             0.00        0.00     7710     Pharmacy
     05004950-7710   ISOPROPYL ETOH 70% SOL                          0.00        0.00     7710     Pharmacy
     05006090-7710   LANOLIN OINTMENT                                0.00        0.00     7710     Pharmacy
     05015801-7710   ITRACONAZOLE 10MG/ML SOL                        0.00        0.00     7710     Pharmacy
     05003250-7710   LEUCOVORIN CA 5MG TAB                           0.00        0.00     7710     Pharmacy
     05003906-7710   LACTULOSE 10GM/15ML SYR                         0.00        0.00     7710     Pharmacy
     05013883-7710   MAGAL/SIMETH 540-40 SUSP                        0.00        0.00     7710     Pharmacy
     05003635-7710   MAGALDRATE 540MG/5ML SUSP                       0.00        0.00     7710     Pharmacy
     05002233-7710   SALIVA SUBSTITE AERO                            0.00        0.00     7710     Pharmacy
     05016240-7710   IG ANTITHYMO 250MG/5ML                          0.00        0.00     7710     Pharmacy
     05004878-7710   LOXAPINE 5MG CAP                                0.00        0.00     7710     Pharmacy
     05004876-7710   LOXAPINE 25MG CAP                               0.00        0.00     7710     Pharmacy
     05012792-7710   MISC TOPICAL/RECTAL                             0.00        0.00     7710     Pharmacy
     05003732-7710   KAOLIN-PECTIN SUSP                              0.00        0.00     7710     Pharmacy
     05011006-7710   KARAYA GUM PWD                                  0.00        0.00     7710     Pharmacy
     05010283-7710   KETOCONAZOLE 200MG TAB                          0.00        0.00     7710     Pharmacy
     05013947-7710   KETOPROFEN 100MG CAP 24H                        0.00        0.00     7710     Pharmacy
     05009303-7710   KETOPROFEN 75MG CAP                             0.00        0.00     7710     Pharmacy
     05004301-7710   NORDETTE 0.15-0.03 TAB                          0.00        0.00     7710     Pharmacy
     05013218-7710   KETOPROFEN 200MG CAP 24H                        0.00        0.00     7710     Pharmacy
     05009063-7710   ACETIC ACID/HC/HYDROCORT DRP                    0.00        0.00     7710     Pharmacy
     05000931-7710   APAP 167MG/5ML LIQ                              0.00        0.00     7710     Pharmacy
     05003359-7710   CHARCOAL 50G LIQ                                0.00        0.00     7710     Pharmacy
     05014019-7710   CHARCOAL 250MG TAB                              0.00        0.00     7710     Pharmacy
     05003805-7710   LACTOBACILLUS TAB                               0.00        0.00     7710     Pharmacy
     05000943-7710   APAP 80MG TAB CH                                0.00        0.00     7710     Pharmacy
     05005884-7710   ALBUTEROL 4MG TAB SA                            0.00        0.00     7710     Pharmacy
     05005883-7710   ALBUTEROL 4MG TAB                               0.00        0.00     7710     Pharmacy
     05005881-7710   ALBUTEROL 2MG TAB                               0.00        0.00     7710     Pharmacy
     05007158-7710   ALBUMIN 5%/250ML                                0.00        0.00     7710     Pharmacy
     05000930-7710   APAP 160MG/5ML LIQ                              0.00        0.00     7710     Pharmacy
     05003640-7710   ROLAIDS 334MG TB CH                             0.00        0.00     7710     Pharmacy
     05016043-7710   AETNA                                           0.00        0.00     7710     Pharmacy
     05009299-7710   ADENOSINE 3MG/ML VIAL                           0.00        0.00     7710     Pharmacy



8/31/2010                                                                                                                   171
                                               c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                          CURRENT CURRENT        DEPARTMENT   DEPARTMENT DESCRIPTION
                                                              INPATIENT OUTPATIENT CODE
                                                              PRICE      PRICE
     05005902-7710   METARAMINOL 10MG/ML VIA                        0.00        0.00     7710     Pharmacy
     05005813-7710   METAPROTERENOL 6MG/ML SOL                      0.00        0.00     7710     Pharmacy
     05005815-7710   METAPROTERENOL 10MG/5MLSY                      0.00        0.00     7710     Pharmacy
     05005814-7710   METAPROTERENOL 10MG TAB                        0.00        0.00     7710     Pharmacy
     05012525-7710   METAPROTERENOL 650MCG AER                      0.00        0.00     7710     Pharmacy
     05004771-7710   MESORIDAZINE 10MG TAB                          0.00        0.00     7710     Pharmacy
     05007558-7710   METHYLPRED 80MG VIAL                           0.00        0.00     7710     Pharmacy
     05005371-7710   MESALAMINE 4G/60ML ENEM                        0.00        0.00     7710     Pharmacy
     05008445-7710   INTERFERON A-2A 3MMU                           0.00        0.00     7710     Pharmacy
     05009534-7710   MERCAPTOPURINE 50MG TAB                        0.00        0.00     7710     Pharmacy
     05008042-7710   MERBROMIN 2% LIQ                               0.00        0.00     7710     Pharmacy
     05000740-7710   MEPROBAMATE 200MG TAB                          0.00        0.00     7710     Pharmacy
     05004387-7710   MEPIVACAINE 20MG/ML VIAL                       0.00        0.00     7710     Pharmacy
     05004386-7710   MEPIVACAINE 10MG/ML VIAL                       0.00        0.00     7710     Pharmacy
     05005424-7710   MEPHOBARBITAL 50MG TAB                         0.00        0.00     7710     Pharmacy
     05005421-7710   MEPHOBARBITAL 100MG TAB                        0.00        0.00     7710     Pharmacy
     05009580-7710   FLUTAMIDE 125MG CAP                            0.00        0.00     7710     Pharmacy
     05005930-7710   ACEBUTOLOL HCL 400MG CAP                       0.00        0.00     7710     Pharmacy
     05014096-7710   ABCIXIMAB 2MG/ML VIAL                          0.00        0.00     7710     Pharmacy
     05014058-7710   BETAMETHASONE 10MG/1ML 1% CRM                  0.00        0.00     7710     Pharmacy
     05007007-7710   INTERFERON A-2B 10MMU                          0.00        0.00     7710     Pharmacy
     05004606-7710   INTERFERON A-2B 25MMU                          0.00        0.00     7710     Pharmacy
     05009284-7710   FLURBIPROFEN 100MG TAB                         0.00        0.00     7710     Pharmacy
     05008575-7710   ALCLOMETASONE DIPROP .05%                      0.00        0.00     7710     Pharmacy
     05015188-7710   AMPHO B LIPID 100MG/ML SUSP                    0.00        0.00     7710     Pharmacy
     05009728-7710   AMOXICILLIN 250MG CH TAB                       0.00        0.00     7710     Pharmacy
     05009678-7710   AMPICILLIN 250MG/5ML SUSP                      0.00        0.00     7710     Pharmacy
     05009734-7710   AUGMENTIN 250MG CH TAB                         0.00        0.00     7710     Pharmacy
     05009733-7710   AUGMENTIN 125MG/5ML                            0.00        0.00     7710     Pharmacy
     05009732-7710   AUGMENTIN 125MG CH TAB                         0.00        0.00     7710     Pharmacy
     05006831-7710   ANTHRALIN 1% CRM                               0.00        0.00     7710     Pharmacy
     05011574-7710   MISC OTHER DRUG                                0.00        0.00     7710     Pharmacy
     05003652-7710   LACHYDRIN 5% LOT                               0.00        0.00     7710     Pharmacy
     05016010-7710   ANAGRELIDE HCL 0.5MG CAP                       0.00        0.00     7710     Pharmacy
     05003699-7710   PROGESTERONE 30-8-30 TA                        0.00        0.00     7710     Pharmacy
     05013799-7710   CREON 33.2-10-38 CAP                           0.00        0.00     7710     Pharmacy
     05006828-7710   ANTHRALIN 0.5% CRM AP                          0.00        0.00     7710     Pharmacy
     05015835-7710   ALPROSTADIL 500MCG PEL                         0.00        0.00     7710     Pharmacy



8/31/2010                                                                                                                  172
                                                c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                           CURRENT CURRENT        DEPARTMENT   DEPARTMENT DESCRIPTION
                                                               INPATIENT OUTPATIENT CODE
                                                               PRICE      PRICE
     05005467-7710   AMANTADINE 50MG/5ML SYRP                        0.00        0.00     7710     Pharmacy
     05006606-7710   ALUM CL 20% SOL                                 0.00        0.00     7710     Pharmacy
     05002507-7710   ALOH 400MG CAP                                  0.00        0.00     7710     Pharmacy
     05015574-7710   AUGMENTIN 400-57MG TAB                          0.00        0.00     7710     Pharmacy
     05000801-7710   ALPROSTADIL 500MCG/ML AMP                       0.00        0.00     7710     Pharmacy
     05015834-7710   ALPROSTADIL 250MCG PEL                          0.00        0.00     7710     Pharmacy
     05014613-7710   ALPROSTADIL 20MCG KIT                           0.00        0.00     7710     Pharmacy
     05015737-7710   LACHYDRIN 12% CRM                               0.00        0.00     7710     Pharmacy
     05016236-7710   AMLEXANOX 5% PST                                0.00        0.00     7710     Pharmacy
     05004847-7710   ETRAFON 25-2MG                                  0.00        0.00     7710     Pharmacy
     05002653-7710   AMINO ACIDS 15% 2000ML                          0.00        0.00     7710     Pharmacy
     05002666-7710   AMINO ACIDS 8% 500ML                            0.00        0.00     7710     Pharmacy
     05007436-7710   AMINOGLUTETHIMD 250MG TAB                       0.00        0.00     7710     Pharmacy
     05007320-7710   AMINOCAPROIC AC 500MG TAB                       0.00        0.00     7710     Pharmacy
     05015576-7710   AUGMENTIN 200/5ML                               0.00        0.00     7710     Pharmacy
     05004845-7710   ETRAFON 10-2MG                                  0.00        0.00     7710     Pharmacy
     05008588-7710   METHOTREXATE NA 25MG/ML VL                      0.00        0.00     7710     Pharmacy
     05012125-7710   PROTEINASE INHB 1GM                             0.00        0.00     7710     Pharmacy
     05012585-7710   FLUTICASONE 0.005% OIN                          0.00        0.00     7710     Pharmacy
     05008080-7710   INTERFERON A-2B 3MMU VSD                        0.00        0.00     7710     Pharmacy
     05009548-7710   DOXORUBICIN 10MG IJ B                           0.00        0.00     7710     Pharmacy
     05002868-7710   MCT OIL OIL                                     0.00        0.00     7710     Pharmacy
     05005595-7710   MECLIZINE 25MG CH TAB                           0.00        0.00     7710     Pharmacy
     05016575-7710   VX MEASLES SUBCU                                0.00        0.00     7710     Pharmacy
     05016571-7710   VX MEASLES SUBCU                                0.00        0.00     7710     Pharmacy
     05006071-7710   CARBOPLATIN 1.5MU 50MG VIAL                     0.00        0.00     7710     Pharmacy
     05003978-7710   METHOTREXATE NA 25MG/ML VL W/P                  0.00        0.00     7710     Pharmacy
     05009526-7710   CLONAZEPAM 25MG/ML VL 8ML                       0.00        0.00     7710     Pharmacy
     05004933-7710   METHOTREXATE NA 25MG/ML VL 10M                  0.00        0.00     7710     Pharmacy
     05003977-7710   METHOTREXATE NA 25MG/ML VIAL                    0.00        0.00     7710     Pharmacy
     05007159-7710   INTERFERON A-2B 5MMU VIAL                       0.00        0.00     7710     Pharmacy
     05006025-7710   LEUPROLIDE/3.75MG IJ                            0.00        0.00     7710     Pharmacy
     05009087-7710   LEUPROLIDE ACET 3.75MG PFS                      0.00        0.00     7710     Pharmacy
     05004020-7710   LEUPROLIDE 7.5MG IJ                             0.00        0.00     7710     Pharmacy
     05004015-7710   ASPARAGINASE 10MMU VIAL                         0.00        0.00     7710     Pharmacy
     05008455-7710   ALDESLEUKIN 22MMIU VIAL                         0.00        0.00     7710     Pharmacy
     05006794-7710   INTERFERON A-N3 5MMU VAIL                       0.00        0.00     7710     Pharmacy
     05009552-7710   DOXORUBICIN 50MG IJ                             0.00        0.00     7710     Pharmacy



8/31/2010                                                                                                                   173
                                                 c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                            CURRENT CURRENT        DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                INPATIENT OUTPATIENT CODE
                                                                PRICE      PRICE
     05006000-7710   INTERFERON A-2B 3MMU VIAL                        0.00        0.00     7710     Pharmacy
     05004018-7710   LEUPROLIDE ACET 1MG/0.2ML 2-WK                   0.00        0.00     7710     Pharmacy
     05010194-7710   FURAZOLIDONE 50MG/15ML SU                        0.00        0.00     7710     Pharmacy
     05009148-7710   FUROSEMIDE 10MG/ML SOL                           0.00        0.00     7710     Pharmacy
     05008942-7710   PRED/GENT 0.3-0.6% OIN                           0.00        0.00     7710     Pharmacy
     05008943-7710   PRED/GENT 1% DROP                                0.00        0.00     7710     Pharmacy
     05004829-7710   MAPROTILINE 25MG TAB                             0.00        0.00     7710     Pharmacy
     05008265-7710   GENTIAN VIOLET 1% SOL                            0.00        0.00     7710     Pharmacy
     05002184-7710   MAG SO4 50% SYR DIS                              0.00        0.00     7710     Pharmacy
     05002514-7710   MAG HYDROXIDE 325MG TAB                          0.00        0.00     7710     Pharmacy
     05016581-7710   FOLLITROPIN 75U AMP                              0.00        0.00     7710     Pharmacy
     05010320-7710   MEFLOQUINE HCL 250MG TAB                         0.00        0.00     7710     Pharmacy
     05004971-7710   MEPERIDINE 100MG/ML VIAL                         0.00        0.00     7710     Pharmacy
     05004981-7710   MEPERIDINE 100MG TAB                             0.00        0.00     7710     Pharmacy
     05004736-7710   CYTARABINE 100MG IJ                              0.00        0.00     7710     Pharmacy
     05001737-7710   MENTHOL LOZG                                     0.00        0.00     7710     Pharmacy
     05017929-7710   DACTINOMYCIN 0.5MG VIAL                          0.00        0.00     7710     Pharmacy
     05008351-7710   IG IMMUN GLOB HUMAN 2ML                          0.00        0.00     7710     Pharmacy
     05001506-7710   DES 250MG/5ML AMPUL                              0.00        0.00     7710     Pharmacy
     05005867-7710   FOSCARNET 6000MG/250 ML                          0.00        0.00     7710     Pharmacy
     05007017-7710   FLUDARABINE 50MG IJ                              0.00        0.00     7710     Pharmacy
     05008999-7710   IG IMMUN GLOB GAMA 10GM                          0.00        0.00     7710     Pharmacy
     05004448-7710   GANCICLOVIR 500MG VIAL                           0.00        0.00     7710     Pharmacy
     05009093-7710   IFEX 5GM 3GM KIT                                 0.00        0.00     7710     Pharmacy
     05007265-7710   GRANISETRON 1MG/1ML VIAL                         0.00        0.00     7710     Pharmacy
     05009568-7710   DACARBAZINE 200MG IJ B                           0.00        0.00     7710     Pharmacy
     05003945-7710   MECHLORETHAMINE 10MG IJ                          0.00        0.00     7710     Pharmacy
     05005938-7710    PAMIDRONATE/30MG IJ                             0.00        0.00     7710     Pharmacy
     05009497-7710   CYCLOPHOSPHAMIDE 200MG IJ B                      0.00        0.00     7710     Pharmacy
     05004021-7710   MITOXANTRONE HCL 2MG/ML VIAL INJ                 0.00        0.00     7710     Pharmacy
     05009955-7710   CYCLOPHOSPHAMIDE 200MG IJ B                      0.00        0.00     7710     Pharmacy
     05006444-7710   PACLITAXEL 30MG IJ B                             0.00        0.00     7710     Pharmacy
     05009957-7710   CYCLOPHOSPHAMIDE 2 GM IJ B                       0.00        0.00     7710     Pharmacy
     05010401-7710   IG IMMUN GLOB GAMA 5GM                           0.00        0.00     7710     Pharmacy
     05009495-7710   CYCLOPHOSPHAMID 100MG IJ                         0.00        0.00     7710     Pharmacy
     05007402-7710   MENOTROPINS 75U AMP                              0.00        0.00     7710     Pharmacy
     05009503-7710   MELPHALAN 2MG PO                                 0.00        0.00     7710     Pharmacy
     05003996-7710   PLICAMYCIN 2.5MG IJ                              0.00        0.00     7710     Pharmacy



8/31/2010                                                                                                                    174
                                                c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                           CURRENT CURRENT        DEPARTMENT   DEPARTMENT DESCRIPTION
                                                               INPATIENT OUTPATIENT CODE
                                                               PRICE      PRICE
     05007688-7710   MILRINONE 10MG/10ML VIAL                        0.00        0.00     7710     Pharmacy
     05005167-7710   VINBLASTINE SO4 10MG VIAL                       0.00        0.00     7710     Pharmacy
     05015581-7710   TOPOTECAN HCL 4MG VIAL                          0.00        0.00     7710     Pharmacy
     05003962-7710   THIOTEPA 15MG IJ                                0.00        0.00     7710     Pharmacy
     05000602-7710   PROPRANOLOL 40MG/5ML SOL                        0.00        0.00     7710     Pharmacy
     05017167-7710   AMOXICILLIN 200MG/5ML SUS                       0.00        0.00     7710     Pharmacy
     05017071-7710   ALTEPLASE 1MG IJ                                0.00        0.00     7710     Pharmacy
     05013217-7710   ALBUTEROL 8MG TAB SA                            0.00        0.00     7710     Pharmacy
     05002401-7710   ASCORBIC ACID 500MG/ML AMP IJ                   0.00        0.00     7710     Pharmacy
     05017539-7710   CAFF CIT/1ML IJ                                 0.00        0.00     7710     Pharmacy
     05020623-7710   SEASONALE 0.03-0.15MG TAB                       0.00        0.00     7710     Pharmacy
     05008774-7710   PILOCARPINE HCL 3% DROP                         0.00        0.00     7710     Pharmacy
     05002770-7710   ARGININE 500MG TAB                              0.00        0.00     7710     Pharmacy
     05019847-7710   ADVICOR 20-1000MG TAB                           0.00        0.00     7710     Pharmacy
     05008567-7710   DIFLORASONE 0.05% CREAM                         0.00        0.00     7710     Pharmacy
     05012654-7710   DIDANOSINE 20MG/ML SOLN                         0.00        0.00     7710     Pharmacy
     05017068-7710   COMPOUNDED TOPICAL SOLUTION                     0.00        0.00     7710     Pharmacy
     05005360-7710   TRILISATE 500MG/ML LI                           0.00        0.00     7710     Pharmacy
     05017063-7710   COCAINE/MORPHINE/ZINC OXIDE/PETROL              0.00        0.00     7710     Pharmacy
     05010361-7710   CLOFAZIMINE 50MG CAP PO                         0.00        0.00     7710     Pharmacy
     05003748-7710   ATROPINE 0.4MG TAB                              0.00        0.00     7710     Pharmacy
     05020606-7710   CLOZAPINE 12.5MG TAB                            0.00        0.00     7710     Pharmacy
     05100040-7710   ZIDOVUDINE 100MG #18 - TH                       0.00        0.00     7710     Pharmacy
     05100038-7710   BACTRIM PEDI SUSP - TH                          0.00        0.00     7710     Pharmacy
     05100037-7710   NELFINAVIR 250MG #27 - TH                       0.00        0.00     7710     Pharmacy
     05100036-7710   LAMIVUDINE 150MG #6 - TH                        0.00        0.00     7710     Pharmacy
     05100034-7710   GATIFLOXACIN 0.3% OPT-TH                        0.00        0.00     7710     Pharmacy
     05100031-7710   APAP/COD 30MG #3 - TH                           0.00        0.00     7710     Pharmacy
     05020767-7710   OLMESARTAN/HCTZ 20-12.5MG                       0.00        0.00     7710     Pharmacy
     05008777-7710   PILOCARPINE HCL 4% GEL                          0.00        0.00     7710     Pharmacy
     05015567-7710   ZIDOVUDINE 300MG CAP                            0.00        0.00     7710     Pharmacy
     05020927-7710   EPINASTINE HCL 0.05% OPTH                       0.00        0.00     7710     Pharmacy
     05016405-7710   EMEDASTINE 0.05% DROP                           0.00        0.00     7710     Pharmacy
     05016967-7710   MICONAZOLE 4% VAG CRM                           0.00        0.00     7710     Pharmacy
     05004405-7710   CHLOROPROCAINE 30MG/ML IJ                       0.00        0.00     7710     Pharmacy
     05008543-7710   FLURANDRENOLIDE 4MCG/SQ CM                      0.00        0.00     7710     Pharmacy
     05007973-7710   FORMALDEHYDE 10% SOLN                           0.00        0.00     7710     Pharmacy
     05004884-7710   MOLINDONE HCL 500MG TAB                         0.00        0.00     7710     Pharmacy



8/31/2010                                                                                                                   175
                                               c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                          CURRENT      CURRENT        DEPARTMENT    DEPARTMENT DESCRIPTION
                                                              INPATIENT    OUTPATIENT     CODE
                                                              PRICE        PRICE
     05008779-7710   PILOCARPINE HCL 6% DROP                  0            0              7710          Pharmacy
     05012432-7710   PCN G K 1MMU IVPB                        0            0              7710          Pharmacy
     05012433-7710   PCN G K 2MMU IVPB                        0            0              7710          Pharmacy
     05004493-7710   PEMOLINE 18.75MG TAB                     0            0              7710          Pharmacy
     05017486-7710   APAP/OXYCOD 10/650 TAB                   0            0              7710          Pharmacy
     05005647-7710   NEOSTIGMINE 1:2000 VIAL                  0            0              7710          Pharmacy
     05014932-7710   NALMEFENE 1MG/ML AMP INJ                 0            0              7710          Pharmacy
     05009550-7710   DOXORUBICIN 20MG IJ                      0            0              7710          Pharmacy
     05017155-7710   ROFECOXIB 12.5MG TAB                     0            0              7710          Pharmacy
     05016676-7710   REBETRON A-2B-KIT                        0            0              7710          Pharmacy
     05017370-7710   SYNERCID 500MG IN                        0            0              7710          Pharmacy
     05010315-7710   PRIMAQUINE 26.3MG TAB                    0            0              7710          Pharmacy
     05017154-7710   ROFECOXIB 25MG TAB                       0            0              7710          Pharmacy
     05003181-7710   MVI PEDI (PED) VIAL                      0            0              7710          Pharmacy
     05014060-7710   GANCICLOVIR 250MG CAP                    0            0              7710          Pharmacy
     05016237-7710   FOLLITROPIN 75U VIAL                     0            0              7710          Pharmacy
     05016020-7710   FLUVOXAMINE MAL 25MG TAB                 0            0              7710          Pharmacy
     05004721-7710   FLUPHENAZINE2.5MG/5MLELX                 0            0              7710          Pharmacy
     05016217-7710   GLUCOS/CHOND CAP                         0            0              7710          Pharmacy
     05016841-7710   GLYCERYL TRINITRATE 0.2% OINT            0            0              7710          Pharmacy
     05015234-7710   FAMCICLOVIR 125MG TAB                    0            0              7710          Pharmacy
     05017597-7710   ORTHO-PREFEST 1-1-0.09 TA                0            0              7710          Pharmacy
     05004192-7710   ESTRADIOL VAL 40MG/ML VIAL               0            0              7710          Pharmacy
     05008624-7710   ERYTHROMYCIN BASE/ETH 2% SWB             0            0              7710          Pharmacy
     05017751-7710   PREVPAC 30-500-500                       0            0              7710          Pharmacy
     05015432-7710   MEDROXYPROGEST 150MG/ML DIS SYR          0            0              7710          Pharmacy
     05017039-7710   LEVALBUTEROL 0.63MG/3ML SOL INH          0            0              7710          Pharmacy
     05012996-7710   EMOLLIENTS 15 HAND/BDY CR                0            0              7710          Pharmacy
     05016880-7710   PREVEN EC 0.25-0.05 KIT                        0.00           0.00          7710   Pharmacy
     05012925-7710   MISC TOPICAL/RECTAL                            0.00           0.00          7710   Pharmacy
     05010384-7710   VX TETANUS DIPTHERIA TOX                       0.00           0.00          7710   Pharmacy
     05010274-7710   GRISEOFULVIN MICSZ500MGTB                      0.00           0.00          7710   Pharmacy
     05003246-7710   LEUCOVORIN CA 25MG TAB                   0            0              7710          Pharmacy
     05020013-7710   SULFACETAMIDE 10% TOPICAL                0            0              7710          Pharmacy
     05020498-7710   CICLOPIROX 1% TOPICAL                    0            0              7710          Pharmacy
     05012965-7710   POVIDONE IODINE 7.5% SOAP                0            0              7710          Pharmacy
     05015473-7710   CEFEPIME 1GM IJ                          0            0              7710          Pharmacy
     05001626-7710   DIMETAPP ELIX                            0            0              7710          Pharmacy



8/31/2010                                                                                                                        176
                                                c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                           CURRENT      CURRENT        DEPARTMENT    DEPARTMENT DESCRIPTION
                                                               INPATIENT    OUTPATIENT     CODE
                                                               PRICE        PRICE
     05001638-7710   ORNADE SPANSULE 75-12MG CP SA             0            0              7710          Pharmacy
     05007837-7710   POVIDONE IODINE 10% SOL                   0            0              7710          Pharmacy
     05001802-7710   K CL 20MEQ PACK                                 0.00           0.00          7710   Pharmacy
     05013305-7710   PROPAFENONE 225MG TAB                           0.00           0.00          7710   Pharmacy
     05015100-7710   PSEUD/DM 2.5-7.5/.8 DROP                  0            0              7710          Pharmacy
     05013418-7710   PREDNICARBATE 0.1% CRM                          0.00           0.00          7710   Pharmacy
     05000434-7710   PRAZOSIN HCL 1MG CAP                            0.00           0.00          7710   Pharmacy
     05007545-7710   PREDNISOLONE 6.7MG/5ML SL                       0.00           0.00          7710   Pharmacy
     05008851-7710   PREDNISOLONE ACET 0.12% DRP SU                  0.00           0.00          7710   Pharmacy
     05009289-7710   MECLOFENAMATE 100MG CP PO                 0            0              7710          Pharmacy
     05005537-7710   METAXALONE 400MG TAB PO                   0            0              7710          Pharmacy
     05016088-7710   HYDROQUINONE 4% CRM                       0            0              7710          Pharmacy
     05001222-7710   PSEUD/TRIP 9.4MG/ML DROP                  0            0              7710          Pharmacy
     05016819-7710   ETANERCEPT 25MG IJ                        0            0              7710          Pharmacy
     05016884-7710   ORLISTAT 120MG CAP PO                     0            0              7710          Pharmacy
     05015980-7710   GLATIRAMER                                0            0              7710          Pharmacy
     05001576-7710   DIMETAPP DC SYRP                          0            0              7710          Pharmacy
     05009143-7710   ETHACRYNIC ACID25MG/MLTBP                 0            0              7710          Pharmacy
     05016989-7710   VERAPAMIL 100MG CAP PEL                   0            0              7710          Pharmacy
     05015179-7710   DIDANOSINE 100MG TAB CH                   0            0              7710          Pharmacy
     05013946-7710   NAPROXEN 500MG EC TAB                           0.00           0.00          7710   Pharmacy
     05010551-7710   OXYCHLOROSENE PWD                               0.00           0.00          7710   Pharmacy
     05012203-7710   ANBESOL BABY GEL MM                             0.00           0.00          7710   Pharmacy
     05007152-7710   PLASMAPROT FRAC 5% 250ML                        0.00           0.00          7710   Pharmacy
     05007153-7710   PLASMAPROT FRAC 5% 250ML                        0.00           0.00          7710   Pharmacy
     05016182-7710   NEFAZODONE HCL 50MG TAB                         0.00           0.00          7710   Pharmacy
     05009618-7710   PIPERACILLIN NA 2G VIAL                   0            0              7710          Pharmacy
     05009621-7710   PIPERACILLIN NA 3G VIAL                         0.00           0.00          7710   Pharmacy
     05020745-7710   GEFITINIB 250MG TAB                             0.00           0.00          7710   Pharmacy
     05009625-7710   PIPERACILLIN NA 4G VIAL                         0.00           0.00          7710   Pharmacy
     05015180-7710   DIDANOSINE 150MG TAB CH                   0            0              7710          Pharmacy
     05005887-7710   PIRBUTEROL 0.2MG AER ADP                        0.00           0.00          7710   Pharmacy
     05009414-7710   MISC OTHER DRUG                           0            0              7710          Pharmacy
     05015840-7710   VALSARTAN 160MG CAP                       0            0              7710          Pharmacy
     05000458-7710   CHLOROTHIAZIDE250MG/5MLSU                       0.00           0.00          7710   Pharmacy
     05009980-7710   MINOCYCLINE HCL 50MG CAP                        0.00           0.00          7710   Pharmacy
     05001878-7710   K ACET 2MEQ/ML VIAL                       0            0              7710          Pharmacy
     05010419-7710   PNEUMOCOCCAL VACC                         0            0              7710          Pharmacy



8/31/2010                                                                                                                         177
                                                 c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                            CURRENT      CURRENT        DEPARTMENT    DEPARTMENT DESCRIPTION
                                                                INPATIENT    OUTPATIENT     CODE
                                                                PRICE        PRICE
     05012441-7710   PODOFILOX 0.5% SOL                         0            0              7710          Pharmacy
     05016576-7710   POLIO VACC                                 0            0              7710          Pharmacy
     05009094-7710   POLYMYX/HC DROP                                  0.00           0.00          7710   Pharmacy
     05015904-7710   EYE LUBE 1% DRPETTE                              0.00           0.00          7710   Pharmacy
     05001883-7710   K BICARB/K CIT 50MEQ TAB EF                      0.00           0.00          7710   Pharmacy
     05001816-7710   K CL 50MEQ TAB EF                                0.00           0.00          7710   Pharmacy
     05008893-7710   EYE LUBE 1% DROP                                 0.00           0.00          7710   Pharmacy
     05007417-7710   GOSERELIN/3.6MG IP                         0            0              7710          Pharmacy
     05019388-7710   DOLASETRON 100 MG PO                             0.00           0.00          7710   Pharmacy
     05015698-7710   PORFIMER 75MG IJ                                 0.00           0.00          7710   Pharmacy
     05016907-7710   VALRUBICIN 40MG/ML VIAL IVS                      0.00           0.00          7710   Pharmacy
     05009558-7710   STREPTOZOCIN 1GM IJ                        0            0              7710          Pharmacy
     05013669-7710   PEGASPARGASE 750U/ML VLIJ                  0            0              7710          Pharmacy
     05016869-7710   SARGRAMOSTIM ACET 0.5MG VIAL SQ            0            0              7710          Pharmacy
     05016988-7710   INTERFERON AC-1 15MCG/0.5ML                0            0              7710          Pharmacy
     05012270-7710   PEGADEMASE 250U/ML VL IM                   0            0              7710          Pharmacy
     05015311-7710   GOSERELIN/3.6MG IP                         0            0              7710          Pharmacy
     05013161-7710   CLADRIBINE/1MG IJ                          0            0              7710          Pharmacy
     05016980-7710   BUSULFAN 6MG IJ                            0            0              7710          Pharmacy
     05009507-7710   BUSULFAN 2MG PO                            0            0              7710          Pharmacy
     05016343-7710   DACLIZUMAB 5MG/ML VIAL IV                  0            0              7710          Pharmacy
     05013173-7710   MELPHALAN 50MG IJ                          0            0              7710          Pharmacy
     05019377-7710   DENILEUKIN 300MCG IJ                       0            0              7710          Pharmacy
     05019384-7710   ALGLUCERASE                                      0.00           0.00          7710   Pharmacy
     05019382-7710   AMPHO B LIPID 50MG IJ                            0.00           0.00          7710   Pharmacy
     05019381-7710   VERTEPORFIN 15MG IJ                              0.00           0.00          7710   Pharmacy
     05019380-7710   EPOETIN HCL 2 MG                                 0.00           0.00          7710   Pharmacy
     05016146-7710   CORTICORELIN/.1MG DOSE IJ                        0.00           0.00          7710   Pharmacy
     05019378-7710   TEMOZOLOMIDE 5MG PO                              0.00           0.00          7710   Pharmacy
     05007191-7710   FACTOR 9 CMPLX 1IU VIAL                          0.00           0.00          7710   Pharmacy
     05019376-7710   SYNERCID 10 ML                                   0.00           0.00          7710   Pharmacy
     05000804-7710   ETHANOLOMINE 100MG IJ                      0            0              7710          Pharmacy
     05016333-7710   FOMEPIZOLE 15MG IJ                               0.00           0.00          7710   Pharmacy
     05007193-7710   HEMIN 313MG VIAL IV                              0.00           0.00          7710   Pharmacy
     05019379-7710   CYTARABINE LIPO 10MG IJ                          0.00           0.00          7710   Pharmacy
     05016500-7710   DOLASETRON MESYL 20MG/ML                         0.00           0.00          7710   Pharmacy
     05015824-7710   IG CMV-IVIG 1.0 GM VIAL                          0.00           0.00          7710   Pharmacy
     05014625-7710   IG CMV-IVG 2.5 GM VIAL                           0.00           0.00          7710   Pharmacy



8/31/2010                                                                                                                          178
                                                c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                           CURRENT      CURRENT        DEPARTMENT    DEPARTMENT DESCRIPTION
                                                               INPATIENT    OUTPATIENT     CODE
                                                               PRICE        PRICE
     05007333-7710   ANISTREPLASE/30U                          0            0              7710          Pharmacy
     05015293-7710   OXYCODONE HCL 5MG CAP                           0.00           0.00          7710   Pharmacy
     05007510-7710   ETIDRONATE DISODIUM 50MG/ML AMP                 0.00           0.00          7710   Pharmacy
     05020589-7710   KETOROLAC 0.4% DROPS                      0            0              7710          Pharmacy
     05018021-7710   MONTELUKAST 4MG CH TAB                          0.00           0.00          7710   Pharmacy
     05012427-7710   SARGRAMOSTIM 250MCG VIAL INJ                    0.00           0.00          7710   Pharmacy
     05019389-7710   ELLIOT'S B SOLUTION, PER ML                     0.00           0.00          7710   Pharmacy
     05017038-7710   TRIMETREXATE/25MG IJ                            0.00           0.00          7710   Pharmacy
     05013481-7710   TRIMETREXATE/25MG IJ                      0            0              7710          Pharmacy
     05016655-7710   TIROFIBAN 12.5MG/50ML IJ                  0            0              7710          Pharmacy
     05016892-7710   THYROTROPIN 1.1MG IJ                            0.00           0.00          7710   Pharmacy
     05015949-7710   RETEPLASE 20U KIT IV                            0.00           0.00          7710   Pharmacy
     05015258-7710   EPOPROSTENOL NA 1.5MG VIAL IV                   0.00           0.00          7710   Pharmacy
     05012428-7710   SARGRAMOSTIM 500MCG VIAL INJ                    0.00           0.00          7710   Pharmacy
     05015183-7710   EPOPROSTENOL NA 0.5MG VIAL IV                   0.00           0.00          7710   Pharmacy
     05016341-7710   OPRELVEKIN 5MG IJ                               0.00           0.00          7710   Pharmacy
     05016578-7710   INTERFERON B-1B BETA-1B 30MCG                   0.00           0.00          7710   Pharmacy
     05013697-7710   IMIGLUCERASE 200U VIAL IV                       0.00           0.00          7710   Pharmacy
     05017375-7710   IMIGLUCERASE 400U VIAL IV                 0            0              7710          Pharmacy
     05007415-7710   GONADORELIN HCL/100MCG IJ                       0.00           0.00          7710   Pharmacy
     05015335-7710   IG RESP SYNC VIRUS 50MG                         0.00           0.00          7710   Pharmacy
     05015400-7710   GANCICLOVIR 4.5MG IP                            0.00           0.00          7710   Pharmacy
     05015853-7710   SARGRAMOSTIM 500MCG/ML VIAL INJ                 0.00           0.00          7710   Pharmacy
     05008290-7710   OXICONAZOLE 1% CRM                              0.00           0.00          7710   Pharmacy
     05019386-7710   GRANISETRON 1MG PO                              0.00           0.00          7710   Pharmacy
     05005255-7710   ASA/CAFF/ORPH 50-770-60 TA                      0.00           0.00          7710   Pharmacy
     05013085-7710   OXAPROZIN 600MG TAB                             0.00           0.00          7710   Pharmacy
     05005486-7710   ORPHENADRINE 30MG/ML AMP                        0.00           0.00          7710   Pharmacy
     05020883-7710   METFORMIN 500MG/5ML SOL                         0.00           0.00          7710   Pharmacy
     05020721-7710   ROSUVASTATIN 20MG TAB                           0.00           0.00          7710   Pharmacy
     05012280-7710   OLSALAZINE NA 250MG CAP                         0.00           0.00          7710   Pharmacy
     05012349-7710   OFLOXACIN 200MG TAB                       0            0              7710          Pharmacy
     05012350-7710   OFLOXACIN 300MG TAB                       0            0              7710          Pharmacy
     05005254-7710   ASA/CAFF/ORPH 25-385-30 TA                0            0              7710          Pharmacy
     05015452-7710   ALBENDAZOLE 200MG TAB                           0.00           0.00          7710   Pharmacy
     05020544-7710   IMATINIB 400MG TAB                        0            0              7710          Pharmacy
     05019407-7710   TENECTEPLASE 50 MG VIAL                   0            0              7710          Pharmacy
     05019406-7710   LINEZOLID INJECTION, PER 200MG            0            0              7710          Pharmacy



8/31/2010                                                                                                                         179
                                                  c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                             CURRENT      CURRENT        DEPARTMENT    DEPARTMENT DESCRIPTION
                                                                 INPATIENT    OUTPATIENT     CODE
                                                                 PRICE        PRICE
     05019405-7710   ADENOSINE 6MG INJ                           0            0              7710          Pharmacy
     05019404-7710   VX BCG IVSCL PER INSTILL                    0            0              7710          Pharmacy
     05019403-7710   ANTITHROMBIN 3 (HUMAN),PER I.U.                   0.00           0.00          7710   Pharmacy
     05018385-7710   AMOXAPINE 50MG TAB                                0.00           0.00          7710   Pharmacy
     05019411-7710   TACROLIMUS PER 5 MG ONE AMP                       0.00           0.00          7710   Pharmacy
     05019396-7710   LEPIRUDIN 50MG IJ                           0            0              7710          Pharmacy
     05019393-7710   TENIPOSIDE 50MG IJ                          0            0              7710          Pharmacy
     05000827-7710   NICARDIPINE 20MG CAP                        0            0              7710          Pharmacy
     05019391-7710   PENTASTARCH 10% 100ML IJ                          0.00           0.00          7710   Pharmacy
     05019390-7710   IRRIGATION SOLUTION, BLADDER 500 M          0            0              7710          Pharmacy
     05006312-7710   COAL TAR SHAMPOO                            0            0              7710          Pharmacy
     05009002-7710   OXYMETAZOLINE 0.05% DROP                          0.00           0.00          7710   Pharmacy
     05016197-7710   DIAZEPAM 5MG PEDI JELLY PR                        0.00           0.00          7710   Pharmacy
     05018418-7710   CITALOPRAM 20MG TAB                         0            0              7710          Pharmacy
     05016998-7710   DIPYRIDAMOLE 25MG TAB                             0.00           0.00          7710   Pharmacy
     05019409-7710   GEMTUZUMAB OZOGAMACIN 5 MG                  0            0              7710          Pharmacy
     05019410-7710   RETEPLASE 18.1MG IJ                         0            0              7710          Pharmacy
     05019418-7710   HYLAN G-F 20 16MG IA                        0            0              7710          Pharmacy
     05019417-7710   MUROMONAB/5MG IJ                            0            0              7710          Pharmacy
     05019415-7710   THIETHYLPERAZN MAL 10 MG                    0            0              7710          Pharmacy
     05019414-7710   CAPECITABINE 150MG PO                             0.00           0.00          7710   Pharmacy
     05019413-7710   SIROLIMUS PER 1 MG/ML                       0            0              7710          Pharmacy
     05010365-7710   ACYCLOVIR NA 1000MG VIAL                    0            0              7710          Pharmacy
     05020069-7710   OXALIPLATIN 50MG IJ                         0            0              7710          Pharmacy
     05004730-7710   PERPHENAZINE 16MG/5ML CONC                  0            0              7710          Pharmacy
     05020898-7710   SULFACETAMIDE 10% CRM                       0            0              7710          Pharmacy
     05005620-7710   METHYL SALICYLA LIQUID                      0            0              7710          Pharmacy
     05004781-7710   PHENELZINE SO4 15MG TB                      0            0              7710          Pharmacy
     05009968-7710   DOXYCYCLINE HY 100MG CAP                    0            0              7710          Pharmacy
     05020636-7710   METAXALONE 800MG TAB                              0.00           0.00          7710   Pharmacy
     05015658-7710   PHENOBARBITAL 97.2MG TAB                          0.00           0.00          7710   Pharmacy
     05012806-7710   MISC OTHER DRUG                                   0.00           0.00          7710   Pharmacy
     05004733-7710   PERPHENAZINE 5MG/ML AMP                           0.00           0.00          7710   Pharmacy
     05012802-7710   MISC OTHER DRUG                                   0.00           0.00          7710   Pharmacy
     05014475-7710   APAP 160MG/5ML ORAL SOLN                          0.00           0.00          7710   Pharmacy
     05012807-7710   MISC OTHER DRUG                             0            0              7710          Pharmacy
     05004398-7710   CHLORASEPTIC SPR                            0            0              7710          Pharmacy
     05012803-7710   MISC OTHER DRUG                             0            0              7710          Pharmacy



8/31/2010                                                                                                                           180
                                                c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                           CURRENT      CURRENT        DEPARTMENT    DEPARTMENT DESCRIPTION
                                                               INPATIENT    OUTPATIENT     CODE
                                                               PRICE        PRICE
     05012804-7710   MISC OTHER DRUG                                 0.00           0.00          7710   Pharmacy
     05018527-7710   KALETRA ORAL SOLN                               0.00           0.00          7710   Pharmacy
     05018776-7710   CLOTRI/BETAMETH 1-0.05% CRM               0            0              7710          Pharmacy
     05008768-7710   PILOCARPINE HCL 0.5% DROP                 0            0              7710          Pharmacy
     05017729-7710   OMEPRAZOLE 40MG CAP DR                    0            0              7710          Pharmacy
     05001533-7710   NALDECON PEDI SYRP                        0            0              7710          Pharmacy
     05004729-7710   PERPHENAZINE 16MG TAB                           0.00           0.00          7710   Pharmacy
     05006017-7710   PHENTERMINE HCL 15MG CAP                  0            0              7710          Pharmacy
     05006020-7710   PHENTERMINE HCL 30MG CAP                  0            0              7710          Pharmacy
     05006023-7710   PHENTERMINE HCL 37.5MG TB                       0.00           0.00          7710   Pharmacy
     05006026-7710   PHENTERMINE 15MG RESIN CAP SA                   0.00           0.00          7710   Pharmacy
     05006027-7710   PHENTERMINE 30MG RESIN CP SA                    0.00           0.00          7710   Pharmacy
     05008845-7710   CYCLOMYDRIL DROP                                0.00           0.00          7710   Pharmacy
     05009021-7710   PHENYLEPHRINE HCL .5% DRP                       0.00           0.00          7710   Pharmacy
     05009027-7710   PHENYLEPHRINE HCL 1% SPR                  0            0              7710          Pharmacy
     05001728-7710   PSEUD/TRIP 60-2.5MG                       0            0              7710          Pharmacy
     05001730-7710   PSEUD/AZATA 120-1MG TAB SA                0            0              7710          Pharmacy
     05001721-7710   DRIXORAL 120-6MG TA                       0            0              7710          Pharmacy
     05001661-7710   PSEUDO/CHLOR SR LIQ                             0.00           0.00          7710   Pharmacy
     05016666-7710   PAPAIN/UREA 1.1MMU/G OIN GM                     0.00           0.00          7710   Pharmacy
     05006064-7710   PAPAIN/UREA 521.7MU/G OIN GM              0            0              7710          Pharmacy
     05000770-7710   PAPAVERINE 150MG CAP SA                   0            0              7710          Pharmacy
     05006213-7710   CETAPHIL LOT                              0            0              7710          Pharmacy
     05016727-7710   PALIVIZUMAB 100MG VIAL                    0            0              7710          Pharmacy
     05021001-7710   BEVACIZUMAB 100MG/4ML IJ                        0.00           0.00          7710   Pharmacy
     05016318-7710   VX RABIES INTRAMUSCULAR                         0.00           0.00          7710   Pharmacy
     05012265-7710   IG IMMUN GLOB 10/G100MLIJ                 0            0              7710          Pharmacy
     05001727-7710   PSEUD/TRIP 30-1.25/5 SY                         0.00           0.00          7710   Pharmacy
     05019337-7710   SALICYLIC ACID 1.5% LOTION                0            0              7710          Pharmacy
     05012381-7710   TENOFOVIR 300MG TAB                       0            0              7710          Pharmacy
     05004267-7710   OXYTOCIN 10U/ML AMP                             0.00           0.00          7710   Pharmacy
     05001704-7710   PSEUDO/CHLOR SR 120-8MGCP                       0.00           0.00          7710   Pharmacy
     05001709-7710   PSEUDO/CHLOR SR 60-4MG CP                       0.00           0.00          7710   Pharmacy
     05020820-7710   IG IMMUNE GLOB 1GM                              0.00           0.00          7710   Pharmacy
     05012704-7710   PENTOSTATIN/10MG IJ                             0.00           0.00          7710   Pharmacy
     05010336-7710   PENTAMIDINE 300MG VIAL                    0            0              7710          Pharmacy
     05005233-7710   PENTAZOC/NALOX 50-0.5MG                         0.00           0.00          7710   Pharmacy
     05005234-7710   PENTAZOCINE 30MG/ML AMP                         0.00           0.00          7710   Pharmacy



8/31/2010                                                                                                                         181
                                               c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                          CURRENT      CURRENT        DEPARTMENT    DEPARTMENT DESCRIPTION
                                                              INPATIENT    OUTPATIENT     CODE
                                                              PRICE        PRICE
     05004552-7710   PENTOBARBITAL 100MG CAP                        0.00           0.00          7710   Pharmacy
     05007431-7710   PERGOLIDE 0.05MG TAB                           0.00           0.00          7710   Pharmacy
     05007432-7710   PERGOLIDE 0.25MG TAB                           0.00           0.00          7710   Pharmacy
     05007433-7710   PERGOLIDE 1MG TAB                              0.00           0.00          7710   Pharmacy
     05004558-7710   PENTOBARBITAL 50MG/ML DIS                      0.00           0.00          7710   Pharmacy
     05005935-7710   PENBUTOLOL SO4 20MG TAB                  0            0              7710          Pharmacy
     05004369-7710   TETRACAINE HCL 10MG/ML INJ               0            0              7710          Pharmacy
     05001531-7710   WEST-DECON SR TAB SA                     0            0              7710          Pharmacy
     05006416-7710   ORBASE B PST                             0            0              7710          Pharmacy
     05004495-7710   PEMOLINE 37.5MG TAB                      0            0              7710          Pharmacy
     05009602-7710   PCN G PROC 600MU/ML DI SY                      0.00           0.00          7710   Pharmacy
     05003330-7710   PENICILLAMINE 250MG CAP                  0            0              7710          Pharmacy
     05009589-7710   PCN G K 20MMU                            0            0              7710          Pharmacy
     05009583-7710   PCN G NA 5MMU                            0            0              7710          Pharmacy
     05013376-7710   TACROLIMUS HCL 10MG CAP                  0            0              7710          Pharmacy
     05016111-7710   TAZAROTENE 0.05% GEL                     0            0              7710          Pharmacy
     05010667-7710   MISC O/P RX                              0            0              7710          Pharmacy
     05013169-7710   SUMATRIPTAN 6MG/0.5ML KI                 0            0              7710          Pharmacy
     05004137-7710   TESTOSTERONE ENANT 200MG/ML              0            0              7710          Pharmacy
     05007859-7710   TERCONAZOLE 80MG SUPP                          0.00           0.00          7710   Pharmacy
     05004131-7710   TESTOSTERONE CYP100MG/MLVI                     0.00           0.00          7710   Pharmacy
     05007329-7710   STREPTOKINASE 750 MU VIAL                      0.00           0.00          7710   Pharmacy
     05007325-7710   STREPTOKINASE 1.5MMU INF                       0.00           0.00          7710   Pharmacy
     05013706-7710   STAVUDINE 40MG CAP                             0.00           0.00          7710   Pharmacy
     05004154-7710   STANOZOLOL 2MG TAB                       0            0              7710          Pharmacy
     05008291-7710   SULCONAZOLE 1% CRM                             0.00           0.00          7710   Pharmacy
     05012834-7710   SOTALOL HCL 160MG TAB                          0.00           0.00          7710   Pharmacy
     05009286-7710   SULINDAC 150MG TAB                       0            0              7710          Pharmacy
     05010007-7710   SULFISOXAZOLE 500MG/5MLSU                      0.00           0.00          7710   Pharmacy
     05010147-7710   SULFISOXAZOLE 500MG TAB                  0            0              7710          Pharmacy
     05007872-7710   TRIPLE SULFA VAG CRM                     0            0              7710          Pharmacy
     05010167-7710   SULFASALAZINE 500MG TB EC                      0.00           0.00          7710   Pharmacy
     05005176-7710   SUFENTANIL 50MCG/ML AMP                        0.00           0.00          7710   Pharmacy
     05008606-7710   SULFACETAMIDE 10% LOT                          0.00           0.00          7710   Pharmacy
     05000625-7710   TIMOLOL MAL 10MG TAB                     0            0              7710          Pharmacy
     05014872-7710   TIMOLOL 0.5% DROP                        0            0              7710          Pharmacy
     05009742-7710   TICARCILLIN 3GM VIAL                     0            0              7710          Pharmacy
     05014871-7710   TIMOLOL 0.25% DROP                             0.00           0.00          7710   Pharmacy



8/31/2010                                                                                                                        182
                                                 c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                            CURRENT      CURRENT        DEPARTMENT    DEPARTMENT DESCRIPTION
                                                                INPATIENT    OUTPATIENT     CODE
                                                                PRICE        PRICE
     05008253-7710   TOLNAFTATE 1% SOL                                0.00           0.00          7710   Pharmacy
     05008252-7710   TOLNAFTATE 1% PWD                                0.00           0.00          7710   Pharmacy
     05009276-7710   TOLMETIN NA 400MG CAP                            0.00           0.00          7710   Pharmacy
     05002618-7710   TOLBUTAMIDE 500MG TAB                            0.00           0.00          7710   Pharmacy
     05016351-7710   TOBRAMYCIN 0.2% 300MG/5ML AMP-NEB                0.00           0.00          7710   Pharmacy
     05002621-7710   TOLAZAMIDE 100MG TAB                             0.00           0.00          7710   Pharmacy
     05016280-7710   TOLCAPONE 100MG TAB                              0.00           0.00          7710   Pharmacy
     05013590-7710   THEOPHYLLINE 200MG24HSACP                        0.00           0.00          7710   Pharmacy
     05000150-7710   THEOPHYLLINE 50MG SPRK CP                  0            0              7710          Pharmacy
     05000146-7710   THEOPHYLLINE 450MG SA TAB                  0            0              7710          Pharmacy
     05000142-7710   THEOPHYLLINE 300MG SA CAP                  0            0              7710          Pharmacy
     05013591-7710   THEOPHYLLINE 300MG24HSACP                        0.00           0.00          7710   Pharmacy
     05000134-7710   THEOPHYLLINE 200MG TAB                           0.00           0.00          7710   Pharmacy
     05000132-7710   THEOPHYLLINE 200MG SA CAP                        0.00           0.00          7710   Pharmacy
     05000158-7710   THEOPHYLLINE 80MG/15MLSYP                        0.00           0.00          7710   Pharmacy
     05000125-7710   THEOPHYLLINE 125MG SA CAP                        0.00           0.00          7710   Pharmacy
     05000121-7710   THEOPHYLLINE 100MG SA CAP                        0.00           0.00          7710   Pharmacy
     05008612-7710   TETRACYCLINE 3PC OIN                             0.00           0.00          7710   Pharmacy
     05004761-7710   THIORIDAZINE HCL 10MG TAB                        0.00           0.00          7710   Pharmacy
     05004892-7710   THIOTHIXENE 2MG CAP                              0.00           0.00          7710   Pharmacy
     05004763-7710   THIORIDAZINE HCL 15MG TAB                        0.00           0.00          7710   Pharmacy
     05000157-7710   THEOPHYLLINE 80MG/15ML SL                        0.00           0.00          7710   Pharmacy
     05004757-7710   THIORIDAZINE HCL 100MG/ML CON                    0.00           0.00          7710   Pharmacy
     05015302-7710   THEOPHYLLINE 400MG TAB                           0.00           0.00          7710   Pharmacy
     05004765-7710   THIORIDAZINE HCL 25MG TAB                        0.00           0.00          7710   Pharmacy
     05013120-7710   RIFABUTIN 150MG CAP                              0.00           0.00          7710   Pharmacy
     05000414-7710   RESERPINE 0.1MG TAB                              0.00           0.00          7710   Pharmacy
     05016299-7710   IG RABIES IM/SUBCU                               0.00           0.00          7710   Pharmacy
     05010093-7710   RIFAMPIN/INH 300-150MG CP                        0.00           0.00          7710   Pharmacy
     05005281-7710   SALSALATE 500MG CAP                              0.00           0.00          7710   Pharmacy
     05012364-7710   SALICYLIC ACID 17% GEL                           0.00           0.00          7710   Pharmacy
     05002192-7710   LACTATED RINGERS 1000                            0.00           0.00          7710   Pharmacy
     05015067-7710   RIMEXOLONE 1% DROP SU                            0.00           0.00          7710   Pharmacy
     05013380-7710   RIMANTADINE HCL 100MG TAB                        0.00           0.00          7710   Pharmacy
     05015294-7710   RILUZOLE 50MG TAB                                0.00           0.00          7710   Pharmacy
     05010392-7710   VX RABIES INTRAMUSCULAR                          0.00           0.00          7710   Pharmacy
     05002111-7710   PYRIDOXINE HCL 100 MG IJ                         0.00           0.00          7710   Pharmacy
     05005654-7710   PYRIDOSTIGMINE 5MG/ML VL                         0.00           0.00          7710   Pharmacy



8/31/2010                                                                                                                          183
                                                  c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                             CURRENT CURRENT        DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                 INPATIENT OUTPATIENT CODE
                                                                 PRICE      PRICE
     05008896-7710   EYE LUBE 1.4-0.6% DROP                            0.00        0.00     7710     Pharmacy
     05004030-7710   PSYLLIUM                                          0.00        0.00     7710     Pharmacy
     05005911-7710   PSEUDOEPHEDRINE 120MG TAB                         0.00        0.00     7710     Pharmacy
     05004813-7710   PROTRIPTYLINE HCL 5MG TAB                         0.00        0.00     7710     Pharmacy
     05004812-7710   PROTRIPTYLINE HCL 10MG TAB                        0.00        0.00     7710     Pharmacy
     05007418-7710   PROTIRELIN 500MCG/ML IJ                           0.00        0.00     7710     Pharmacy
     05003877-7710   MISC ORAL SOLID                                   0.00        0.00     7710     Pharmacy
     05000350-7710   QUINIDINE SO4 300MG TAB                           0.00        0.00     7710     Pharmacy
     05000351-7710   QUINIDINE SO4 300MGSA TB                          0.00        0.00     7710     Pharmacy
     05000347-7710   QUINIDINE SO4 200MG TAB                           0.00        0.00     7710     Pharmacy
     05002119-7710   PYRIDOXINE HCL 25MG TAB                           0.00        0.00     7710     Pharmacy
     05015256-7710   SAQUINAVIR MESYL 200MG CP                         0.00        0.00     7710     Pharmacy
     05000343-7710   QUINIDINE GLUC 80MG/ML VL                         0.00        0.00     7710     Pharmacy
     05001765-7710   NA BICARB 4.2PC VIAL                              0.00        0.00     7710     Pharmacy
     05001788-7710   NA ACET 2MEQ/ML VIAL                              0.00        0.00     7710     Pharmacy
     05009188-7710   POLYCITRA SYRP                                    0.00        0.00     7710     Pharmacy
     05005282-7710   SALSALATE 500MG TAB                               0.00        0.00     7710     Pharmacy
     05003434-7710   FLUORIDE NA 1.1PC GEL                             0.00        0.00     7710     Pharmacy
     05008736-7710   EYE IRRIG DROP                                    0.00        0.00     7710     Pharmacy
     05003340-7710   NA THIOSULFATE 25% VIAL                           0.00        0.00     7710     Pharmacy
     05009436-7710   TETRADECYL NA 3% AMP                              0.00        0.00     7710     Pharmacy
     05009435-7710   TETRADECYL NA 1% AMP                              0.00        0.00     7710     Pharmacy
     05000803-7710   MORRHUATE 50MG/ML VIAL                            0.00        0.00     7710     Pharmacy
     05000198-7710   NA CL 5% 500ML                                    0.00        0.00     7710     Pharmacy
     05003438-7710   FLUORIDE NA 1MG TAB CH                            0.00        0.00     7710     Pharmacy
     05015102-7710   STANNOUS FLUORD 1.1% CRM                          0.00        0.00     7710     Pharmacy
     05003432-7710   FLUORIDE NA 0.5MG/ML DROP                         0.00        0.00     7710     Pharmacy
     05003431-7710   FLUORIDE NA 0.5MG TAB CH                          0.00        0.00     7710     Pharmacy
     05000835-7710   NA CL FOR INHL 10% VIA-N                          0.00        0.00     7710     Pharmacy
     05015770-7710   COLYTE SOL                                        0.00        0.00     7710     Pharmacy
     05016821-7710   SEVELAMER HCL 403MG CAP                           0.00        0.00     7710     Pharmacy
     05003342-7710   CYANIDE KIT KI                                    0.00        0.00     7710     Pharmacy
     05016347-7710   SIBUTRAMINE HCL 5MG CAP                           0.00        0.00     7710     Pharmacy
     05015550-7710   SELEGILINE HCL 5MG CAP                            0.00        0.00     7710     Pharmacy
     05000327-7710   SECOBARBITAL 50MG/MLDI SY                         0.00        0.00     7710     Pharmacy
     05000322-7710   SECOBARBITAL 100MG CAP                            0.00        0.00     7710     Pharmacy
     05008828-7710   SCOPOLAMINE 0.25% DRO                             0.00        0.00     7710     Pharmacy
     05005692-7710   SCOPOLAMINE 0.4MG/ML VIAL                         0.00        0.00     7710     Pharmacy



8/31/2010                                                                                                                     184
                                                      c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                                 CURRENT CURRENT        DEPARTMENT   DEPARTMENT DESCRIPTION
                                                                     INPATIENT OUTPATIENT CODE
                                                                     PRICE      PRICE
     05013293-7710   COLYTE SOLN                                           0.00        0.00     7710     Pharmacy
     05016348-7710   SIBUTRAMINE HCL 10MG CAP                              0.00        0.00     7710     Pharmacy
     05016349-7710   SIBUTRAMINE HCL 15MG CAP                              0.00        0.00     7710     Pharmacy
     05019288-7710   RIBAVIRIN 200MG CAP                                   0.00        0.00     7710     Pharmacy
     05021018-7710   CINACALCET 90MG TAB                                   0.00        0.00     7710     Pharmacy
     05021017-7710   CINACALCET 60MG TAB                                   0.00        0.00     7710     Pharmacy
     05018493-7710   MIRTAZAPINE 30MG TAB                                  0.00        0.00     7710     Pharmacy
     05012880-7710   LIOTHYRONINE 10MCG/1ML IJ                             0.00        0.00     7710     Pharmacy
     05017664-7710   NTG 0.4MG SPRAY                                       0.00        0.00     7710     Pharmacy
     05018135-7710   TRETINOIN 0.05% CRM 60G                               0.00        0.00     7710     Pharmacy
     05013892-7710   FENTANYL 200MCG LOZG                                  0.00        0.00     7710     Pharmacy
     05016112-7710   TAZAROTENE 0.1% GEL 30G                               0.00        0.00     7710     Pharmacy
     05021274-7710   TRUVADA 200-300MG TAB                                 0.00        0.00     7710     Pharmacy
     05005423-7710   MEPHOBARBITAL 32MG TAB                                0.00        0.00     7710     Pharmacy
     05020317-7710   ELETRIPTAN 40MG TAB                                   0.00        0.00     7710     Pharmacy
     05004217-7710   DES 250MG AMP                                         0.00        0.00     7710     Pharmacy
     05019079-7710   ANTIVENIN-CROFAB IJ                                   0.00        0.00     7710     Pharmacy
     05000403-7710   PROPAFENONE 300MG TAB                                 0.00        0.00     7710     Pharmacy
     05005731-7710   PROPANTHELINE BR 15MG TAB                             0.00        0.00     7710     Pharmacy
     05021278-7710   DULOXETINE 60MG CAP                                   0.00        0.00     7710     Pharmacy
     05004877-7710   LOXAPINE 50MG CAP                                     0.00        0.00     7710     Pharmacy
     05018370-7710   NORTRIPTYLINE 50MG CAP                                0.00        0.00     7710     Pharmacy
     05079993-7710   MISC O/P RX                                           0.00        0.00     7710     Pharmacy
     05079992-7710   MISC O/P RX                                           0.00        0.00     7710     Pharmacy
     05009530-7710   METHOTREXATE 1G/40ML IJ                               0.00        0.00     7710     Pharmacy
     05007238-7710   FISH OIL 1000MG CAP                                   0.00        0.00     7710     Pharmacy
     05018871-7710   VALGANCICLOVIR 450MG TAB                              0.00        0.00     7710     Pharmacy
     05021887-7710   EXENATIDE PEN 2.4ML                                   0.00        0.00     7710     Pharmacy
     05003599-7710   MAG ALOH SIMETH 400-400-40 LIQ                        0.00        0.00     7710     Pharmacy
     05000598-7710   PROPRANOLOL 160MG SA CAP                              0.00        0.00     7710     Pharmacy
     05020037-7710   ADDERALL XR 15MG CAP                                  0.00        0.00     7710     Pharmacy
     05016325-7710   NICOTINE 10MG CARTRID INH                             0.00        0.00     7710     Pharmacy
     05013389-7710   MICONAZOLE NIT 2% TINC                                0.00        0.00     7710     Pharmacy
     05015299-7710   LEUPROLIDE 22.5MG VIAL                                0.00        0.00     7710     Pharmacy
     05013631-7710   ALATROFLOXACIN 5MG/ML VIA                             0.00        0.00     7710     Pharmacy
     05020552-7710   ATAZANAVIR 150MG CAP                                  0.00        0.00     7710     Pharmacy
     05014630-7710   NEFAZODONE HCL 200MG TAB                              0.00        0.00     7710     Pharmacy
     05015376-7710   RITONAVIR 80MG/ML                                     0.00        0.00     7710     Pharmacy



8/31/2010                                                                                                                         185
                                               c880aef3-0c99-4796-8371-0b343814c458.xls



     CHARGE CODE BILLING DESCRIPTION                          CURRENT CURRENT        DEPARTMENT   DEPARTMENT DESCRIPTION
                                                              INPATIENT OUTPATIENT CODE
                                                              PRICE      PRICE
     05016050-7710   ACITRETIN 25MG CAP                             0.00        0.00     7710     Pharmacy
     05022024-7710   PREGABALIN 25MG CAP                            0.00        0.00     7710     Pharmacy
     05005207-7710   APAP/PROPOX HCL65-650MGTB                      0.00        0.00     7710     Pharmacy
     05007895-7710   POLYMYXIN B 500MU VIAL                         0.00        0.00     7710     Pharmacy
     05016533-7710   LOTEPREDNOL 0.2% DROP                          0.00        0.00     7710     Pharmacy
     05004738-7710   PROCHLORPERAZIN 5MG/5ML SYRP                   0.00        0.00     7710     Pharmacy
     05004741-7710   PROCHLORPERAZIN 10MG SA CAP                    0.00        0.00     7710     Pharmacy
     05004743-7710   PROCHLORPERAZIN 15MG S