MOD CDML 6-1-07 by rqy18723

VIEWS: 511 PAGES: 266

									  Doctors Medical Center - Modesto                                             Page 1 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 2000000   3010 MED/SURG ICU          MED/SURG ICU
 2000002   SEMI-PRIVATE ROOM          SEMI-PRIVATE                 $3,338.00
 2000017   INTENTIVE CARE TRAUMA      ICU TRAUMA                   $8,524.00
 2000022   INTENSIVE CARE UNIT        ICU GEN                      $8,524.00
 2000026   CORONARY CARE UNIT         CCU GEN                      $8,524.00
 2000030   CORONARY CARE UNIT OTHER   CCU OTHER                    $9,537.00
 2000062   INTENSIVE CARE INTERMED    ICU INTERMED                 $7,489.00
 2050000   3020 CORONARY ICU          CORONARY ICU
 2050002   SEMI-PRIVATE ROOM          SEMI-PRIVATE                 $3,338.00
 2050017   INTENSIVE CARE TRAUMA      ICU TRAUMA                   $8,524.00
 2050022   INTENSIVE CARE UNIT        ICU GEN                      $8,524.00
 2050026   CORONARY CARE UNIT         CCU GEN                      $8,524.00
 2050062   INTENSIVE CARE INTERMED    ICU INTERMED                 $7,489.00
 2120000   3092 IP HOLD               IP HOLD
 2120002   SEMI-PRIVATE ROOM          SEMI-PRIVATE                 $3,338.00
 2120017   INTENSIVE CARE TRAUMA      ICU TRAUMA                   $8,524.00
 2120022   INTENSIVE CARE UNIT        ICU GEN                      $8,524.00
 2120025   SEMI-PRIVATE OTHER         SEMI-PRIV OTHER              $5,500.00
 2120026   CORONARY CARE UNIT         CCU GEN                      $8,524.00
 2120030   CORONARY CARE UNIT OTHER   CCU OTHER                    $9,537.00
 2120049   SEMI-PRIVATE PEDIATRICS    SEMI-PRIV PEDS               $3,338.00
 2120061   ISOLATION STERILE ENVIR    ISOLATN STERILE              $4,500.00
 2120062   INTENSIVE CARE INTERMED    ICU INTERMED                 $7,489.00
 2150000   3030 DEF OBSERVATION SUB   DEF OBS SUB ICU
 2150002   SEMI-PRIVATE ROOM          SEMI-PRIVATE                 $3,338.00
 2150062   INTENSIVE CARE INTERMED    ICU INTERMED                 $7,489.00
 2210000   3041 NURSE ICU NEONATAL    NURSE ICU NEO
 2210012   NEWBORN LEVEL II           NEWBORN LVL II               $7,629.00
 2210020   NICU NB LVL IV             NICU NB LVL IV              $12,796.00
 2210070   NICU NB LVL III            NICU NB LVL III              $9,300.00
 2270000   3066 RESPIRATORY ICU       RESPIRATORY ICU
 2270002   SEMI-PRIVATE ROOM          SEMI-PRIVATE                 $3,338.00
 2270025   SEMI-PRIVATE OTHER         SEMI-PRIV OTHER              $5,500.00
 2270061   ISOLATION STERILE ENVIR    ISOLATN STERILE              $4,500.00
 2270062   INTENSIVE CARE INTERMED    ICU INTERMED                 $7,489.00
 2290000   3060 OTHER ICU             OTHER ICU
 2290002   SEMI-PRIVATE ROOM          SEMI-PRIVATE                 $3,338.00
 2290017   INTENSIVE CARE TRAUMA      ICU TRAUMA                   $8,524.00
 2290022   INTENSIVE CARE UNIT        ICU GEN                      $8,524.00
 2290026   CORONARY CARE UNIT         CCU GEN                      $8,524.00
 2290062   INTENSIVE CARE INTERMED    ICU INTERMED                 $7,489.00
 2320000   3082 MED/SURG ACUTE        MED/SURG ACUTE
 2320002   SEMI-PRIVATE ROOM          SEMI-PRIVATE                 $3,338.00
 2320025   SEMI-PRIVATE OTHER         SEMI-PRIV OTHER              $5,500.00
 2330000   3083 MED/SURG ACUTE        MED/SURG ACUTE
 2330002   SEMI-PRIVATE ROOM          SEMI-PRIVATE                 $3,338.00
 2360000   3086 MED/SURG ACUTE        MED/SURG ACUTE
 2360002   SEMI-PRIVATE ROOM          SEMI-PRIVATE                 $3,338.00
 2380000   3088 MED/SURG ACUTE-FAC    MED/SURG ACUTE
 2380002   SEMI-PRIVATE ROOM          SEMI-PRIVATE                 $3,338.00



  CDM Run Date: 06/01/2007
  Doctors Medical Center - Modesto                                                Page 2 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 2380061   ISOLATION STERILE ENVIR    ISOLATN STERILE               $4,500.00
 2380062   INTENSIVE CARE INTERMED    ICU INTERMED                  $7,489.00
 2390000   3089 MED/SURG ACUTE-FAC    MED/SURG ACUTE
 2390002   SEMI-PRIVATE ROOM          SEMI-PRIVATE                  $3,338.00
 2390062   INTENSIVE CARE INTERMED    ICU INTERMED                  $7,489.00
 2400000   3120 PEDIATRIC ACUTE       PEDIATRIC ACUTE
 2400002   SEMI-PRIVATE ROOM          SEMI-PRIVATE                  $3,338.00
 2400044   SEMI-PRIVATE OBSTETRICS    SEMI-PRIV O B                 $3,338.00
 2400049   SEMI-PRIVATE PEDIATRICS    SEMI-PRIV PEDS                $3,338.00
 2400061   ISOLATION STERILE ENVIR    ISOLATN STERILE               $4,500.00
 2500000   3160 OBSTETRICS ACUTE      OBSTETRICS ACUT
 2500002   SEMI-PRIVATE ROOM          SEMI-PRIVATE                  $3,338.00
 2500044   SEMI-PRIVATE OBSTETRICS    SEMI-PRIV O B                 $3,338.00
 2500061   ISOLATION STERILE ENVIR    ISOLATN STERILE               $4,500.00
 2500099   HIGH RISK OB SEMI-PRIV     SEMI-PRIV OB                  $7,489.00
 2550000   3170 NURSERY ACUTE         NURSERY ACUTE
 2550010   NEWBORN LEVEL I            NEWBORN LVL I                 $1,841.00
 2550011   NEWBORN OTHER              NEWBORN OTHER                 $2,547.00
 3080000   4195 LITHOTRIPTER/ESW      LITHO/ESW
 3081501   USE X1 PERCU LITHOTRIP     LITHOTRP PERCU               $24,432.00
 3100000   4010 DELIVERY ROOM         DELIVERY ROOM
 3100001   DELIV SIMPLE/UNCOMPLIC     DELIV UNCOMPLIC                $2,175.00
 3100005   DELIV NON-DEL PER HR       DELIV N/D PR HR                  $125.00
 3100015   OXTOCIN CHALLENGE TEST     TST OXTOCN CHAL                  $956.00
 3100017   STRESS TEST                TST STRESS                       $956.00
 3100021   PROSTEGEL INSERTION        INSRT PROSTGL                  $1,447.00
 3100026   INSERT CERV RIPENING AGN   INS CERV AGENT                   $214.00
 3100029   AMNIOCENTESIS DIAG         AMNIO DIAG                       $667.00
 3100200   OB OBSERVATION PER HR      OB OBSERV EA HR                  $209.00
 3100220   LABOR 1ST HR               LABOR 1ST HR                     $726.00
 3100240   LABOR ADD HR               LABOR ADD HR                     $255.00
 3100405   DELIV COMPLX/COMPLIC       DELIV EXTEND                   $2,896.00
 3100500   US OB LTD 1OR> FETUS       US OB LTD 1OR>                   $255.00
 3100530   MINOR PROCEDR 1ST 1/2HR    PROC MINOR1/2HR                  $430.00
 3100600   OB SURG 1ST HR MAJOR       OB SURG 1ST HR                 $9,337.00
 3100605   OB SURG ADD MIN MAJOR      OB SURG ADD MIN                  $163.00
 3100610   OB SURG 1ST HR MINOR       SURG MINOR 1 HR                $5,805.00
 3100615   OB SURG EA ADD MIN         SURG MIN ADD MN                   $85.00
 3100700   RECOV POST-SURG 1/2 HR     RECOV SURG1/2HR                  $834.00
 3100705   RECOV POST-SURG ADD MIN    RECOV SURG ADD                    $29.00
 3100710   RECOV POST-VAG 1/2 HR      RECOV VAG 1/2HR                  $834.00
 3100715   RECOV POST-VAG ADD MIN     RECOV VAG ADD                     $29.00
 3102010   TOCOLYSIS                  TOCOLYSIS                      $1,447.00
 3102020   EXTERNAL VERSION           VERSION EXTRNAL                  $956.00
 3102070   AMNIO FLUID INDEX          INDEX AMNIO FLD                  $286.00
 3102100   PITOCIN INDUCT/AUGMENT     PITOCN IND/AUG                 $1,447.00
 3102110   MAGNESIUM SULFATE          MAGNESM SULFATE                $1,447.00
 3103205   ANESTHESIA 1ST HR          ANES 1ST HR                    $2,364.00
 3103206   ANESTHESIA ADD MIN         ANES ADD MIN                      $40.00
 3108999   LABOR/DEL MISC             LABOR/DEL MISC         $29.00 - $9,337.00



  CDM Run Date: 06/01/2007
  Doctors Medical Center - Modesto                                                Page 3 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 3109500   DELIV C-SECT 1ST HR        DELIVRY C/S 1HR               $9,337.00
 3109503   DELIV C-SECT ADD MIN       DELIVRY C/S ADD                 $163.00
 3120000   4350 PERINATAL DIAG CTR    PERINT DIAG CTR
 3120027   AMNIO FLUID INDEX          INDEX AMNIO FLD                 $286.00
 3120105   AMNIOCENTESIS DIAGNOSIS    AMNIO FOR DIAG                  $667.00
 3120325   E&M-EST. PATIENT-LVL I     E&M-EP LVL I                    $209.00
 3120330   E&M-EST. PATIENT-LVL II    E&M-EP LVL II                   $450.00
 3120335   E&M-EST. PATIENT-LVL IV    E&M-EP LVL IV                   $850.00
 3120336   E&M-EST. PATIENT-LVL V     E&M-EP LVL V                  $1,050.00
 3120340   E&M-EST. PATIENT-LVL III   E&M-EP LVL III                  $650.00
 3120405   US OB LTD 1OR> FETUS       US OB LTD 1OR>                  $255.00
 3120440   NON-STRESS TEST            N/S TST                         $956.00
 3120455   EXTERNAL VERSION           EXT VERSION                     $956.00
 3129201   E&M-NEW PATIENT-LVL I      E&M-NP LVL I                    $209.00
 3129202   E&M-NEW PATIENT-LVL II     E&M-NP LVL II                   $450.00
 3129203   E&M-NEW PATIENT-LVL III    E&M-NP LVL III                  $650.00
 3129204   E&M-NEW PATIENT-LVL IV     E&M-NP LVL IV                   $850.00
 3129205   E&M-NEW PATIENT-LVL V      E&M-NP LVL V                  $1,050.00
 3210000   4021 SURGERY               SURGERY
 3210002   SURGERY 1/2 HOUR MAJOR     SURGERY 1/2 HR                $5,288.00
 3210004   SURGERY 1 HOUR MAJOR       SURGERY 1 HOUR                $6,678.00
 3210005   SURGERY MAJOR EA ADD MIN   SURGERY ADD MIN                 $110.00
 3210041   SURGERY 1 HOUR MINOR       SURGERY 1 HOUR                $6,678.00
 3210051   SURGERY MINOR EA ADD MIN   SURGERY ADD MIN                 $110.00
 3210100   SURGERY 1/2 HOUR MINOR     SURGERY 1/2 HR                $4,060.00
 3210204   SURGERY 1/2 HR MAJOR       SURG 1/2 HR MAJ               $3,337.00
 3210205   SURGERY ADD MIN MAJOR      SURG ADD MN MAJ                 $110.00
 3210241   SURGERY 1/2 HR MINOR       SURG 1/2 HR MIN               $3,337.00
 3210251   SURGERY ADD MIN MINOR      SURG ADD MN MIN                 $110.00
 3210301   SURG ADD STAFF 1ST HR      SURG ADD STAF/H               $2,301.00
 3210302   SURG ADD STAFF ADD MIN     SURG ADD STAF/M                  $38.00
 3210390   SURG LASER PROC 1/2 HR     SURG LSR 1ST1/2              $15,825.00
 3210400   SURG LASER PROC 1ST HR     SURG LSR 1ST HR              $15,736.00
 3210402   SURG LASER PROC ADD MIN    SURG LSR ADD MN                 $102.00
 3210460   SURG LASER MNR 1ST HR      SURG LSR 1ST HR              $12,520.00
 3210470   SURG LASER MNR 1ST 1/2HR   SURG LSR 1ST1/2               $6,928.00
 3210476   SURG LASER MNR ADD MIN     SURG LSR ADD MN                 $127.00
 3210480   LASER O/S SVC PER MIN      LASER SVC PER/M                  $45.00       Minimum
 3213300   SURGERY PRE-OP MAJOR       SURGERY PRE-OP                   $87.00
 3213318   TEE CONT ASSES/FUNC        TEE CONT ASSES                $1,391.44
 3213400   SURG SIMPLE URODYNAMIC     URODYNAMICS ONL                 $798.00
 3218999   SURGERY-MISCELLANEOUS      SURGERY MISC                     $50.00
 3220000   4027 RECOVERY              RECOVERY
 3220002   RECOVERY RM 1/2 HOUR       RECOVRY 1/2HOUR                  $819.00
 3220003   PACU EACH ADD MIN          RECOVRY ADD MIN                   $24.00
 3221000   SPEC PROC 1ST 1/2HR        SPEC PROC 1/2HR                $1,200.00      Minimum
 3221010   SPEC PROC ADD MIN          SPEC PROC ADD/M                   $40.00      Minimum
 3228999   RECOVERY RM MISCELANEOUS   RECOVRY-MISC           $24.00 - $1,200.00
 3300000   4023 SURG &RECOV OPEN H    SURG&RCV OPN HE
 3300004   SURG 1HR OH                SURG 1HR OH                  $11,078.00



  CDM Run Date: 06/01/2007
  Doctors Medical Center - Modesto                                                Page 4 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 3300005   SURG ADD MIN OH            SURG ADD MIN OH                 $186.00
 3300301   SURG ADD STAF 1HR OH       SURG ADD STAF1H               $2,766.00
 3300302   SURG ADD STAF ADD MIN OH   SURG STAFF ADD                   $46.00
 3530000   4269 DIABETIC SVCS CERT    DIAB SVCS CERT
 3530036   MED NUTRTN TH INIT 15MIN   MED NUTN INIT15                 $141.00
 3530037   MED NUTRTN TH REEVAL15MN   MED NUTN REEVAL                 $141.00
 3530038   MED NUTRTN GRP EA 30 MIN   MED NUTN GRP 30                 $141.00
 3530108   DIAB SLFMGMT IND 30 MIN    DIAB IND MGMT                   $228.00
 3530109   DIAB SLFMGMT GRP 30 MIN    DIAB GRP MGMT                   $228.00
 3531512   PLAN DEVELOPMENT 30 MIN    ASSESS COMB                     $231.00
 3531520   ED ORIENTATN IND 15MIN     EDUC ORNT                        $41.00
 3531522   ED INIT ASSESS 30MIN       ASSESS ED INIT                   $77.00
 3531524   ED INIT ASSESS 15MIN       ASSESS ED INIT                   $41.00
 3531526   ED INTRVNT/ASSESS IND 15   ANTEPART HE 15M                  $41.00
 3531528   ED INTRVNT/ASSESS GRP 15   ANTEPART HE 15M                   $8.00
 3531530   ED POSTPARTUM IND 15MIN    POSTPART ED IND                  $41.00
 3531540   NUT INIT ASSESS IND 30M    ASSESS NUTR INI                  $77.00
 3531542   NUT INIT ASSESS IND 15M    ASSESS NUTR INI                  $41.00
 3531544   NUT INTER/ASSESS IND 15M   ANTEPART NUTRIT                  $41.00
 3531546   NUT INTRVNT GROUP 15MIN    ANTEPART NUTRIT                   $8.00
 3531548   NUT POST PARTUM IND 15M    POSTPART NUTR                    $41.00
 3531550   PSYSC INIT ASSES IND 30M   ASSESS PSYSOC I                  $77.00
 3531552   PSYSC INIT ASSES IND 15M   ASSESS PSYSOC I                  $41.00
 3531556   PS INTER/ASSESS IND 15M    ANTE PSYCHSC 15                  $41.00
 3531558   PS INTRVNT GROUP 15MIN     ANTE PSYCHSC 15                   $8.00
 3531560   PS POST PARTUM IND 15MIN   POST PSYCHOSC 1                  $41.00
 3531570   PE PERINATL ED IND 15M     INST PERINAT IN                  $41.00
 3531572   PE PERINATL ED GRP 15M     INST PERINAT GR                   $8.00
 3539201   E&M-NEW PATIENT-LVL I      E&M-NP LVL I                     $71.00
 3539202   E&M-NEW PATIENT-LVL II     E&M-NP LVL II                   $141.00
 3539203   E&M-NEW PATIENT-LVL III    E&M-NP LVL III                  $240.00
 3539204   E&M-NEW PATIENT-LVL IV     E&M-NP LVL IV                   $455.00
 3539205   E&M-NEW PATIENT-LVL V      E&M-NP LVL V                    $627.00
 3539211   E&M-EST. PATIENT-LVL I     E&M-EP LVL I                     $36.00
 3539212   E&M-EST. PATIENT-LVL II    E&M-EP LVL II                    $71.00
 3539213   E&M-EST. PATIENT-LVL III   E&M-EP LVL III                  $141.00
 3539214   E&M-EST. PATIENT-LVL IV    E&M-EP LVL IV                   $240.00
 3539215   E&M-EST. PATIENT-LVL V     E&M-EP LVL V                    $455.00
 3700000   4040 ANESTHESIA            ANESTHESIOLOGY
 3700002   ANESTHESIA 1/2 HOUR        ANES 1/2 HR                    $1,159.00
 3700004   ANESTHESIA 1 HOUR          ANES 1 HR                      $1,890.00
 3700005   ANESTHESIA EA ADD MIN      ANES ADD MIN                      $33.00
 3700045   NITROUS OXIDE              NITROUS OXIDE                     $97.00
 3700054   OXYGEN                     OXYGEN                            $97.00
 3700204   OP ANES 1ST 1/2 HOUR       ANES 1ST 1/2HR                   $942.00
 3700205   OP ANES ADD MINUTES        ANES ADD MIN                      $33.00
 3708999   ANESTHESIA MISC            ANESTHESIA-MISC        $33.00 - $1,890.00
 3900000   4045 ANESTHESIA OPEN HEA   ANESTH OPN HRT
 3900004   ANES 1 HR OPEN HEART       ANES 1HR OPNHRT               $1,930.00
 3900005   ANES OPEN HEART ADD MIN    ANES OPNHR ADD                   $33.00



  CDM Run Date: 06/01/2007
  Doctors Medical Center - Modesto                                             Page 5 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 3900045   NITROUS OXIDE              NITROUS OXIDE                   $97.00
 3900054   OXYGEN                     OXYGEN                          $97.00
 4000000   4050 C/S IMPLANTS CV       C/S IMPLANTS CV
 4000089   DFIB ATLAS+ HF V340        DFIB ATLAS+ HF              $31,500.00
 4000090   DFIB ATLAS+ HF V343        DFIB ATLAS+ HF              $34,500.00
 4000096   DFIB CONCERTO CRTD         DFIB CONCERTO               $43,650.00
 4000106   DFIB DC ATLAS II+ V268     DFIB DC ATLSII+             $32,010.00
 4000108   DFIB DC ATLAS DR V242      DFIB DC ATLAS               $24,977.92
 4000109   DFIB DC ATLAS+ DR V243     DFIB DC ATLAS+              $24,977.92
 4000111   DFIB DC ATLAS II HFV365    DFIB DC ATLS HF             $37,125.00
 4000114   DFIB DC ENTRUST            DFIB DC ENTRUST             $29,434.50
 4000116   DFIB DC EPIC DR 233        DFIB DC EPIC DR             $29,760.00
 4000117   DFIB DC EPIC+ DR V239      DFIB DC EPIC+               $29,760.00
 4000118   DFIB DC EPIC II+           DFIB DC SPIC II             $32,010.00
 4000126   DFIB DC INTRINSIC DR       DFIB DC INTRNSC             $77,415.35
 4000140   DFIB DC MARQ DR IS-1       DFIB DC MARQUIS             $77,415.35
 4000150   DFIB DC MAXIMO DR          DFIB DC MAXIMO              $77,415.35
 4000176   DFIB DC VENTAK PRIZM HE    DFIB DC VNTK HE             $77,415.35
 4000178   DFIB DC VIRTUOSO           DFIB DC VIRTUOS             $31,950.00
 4000179   DFIB DC VITALTY DS T125    DFIB DC VITALTY             $24,977.00
 4000180   DFIB DC VITALTY EL         DFIB DC VITALTY             $77,415.35
 4000182   DFIB DC VITALITY 2 T165    DFIB DC VITALTY             $32,250.00
 4000185   DFIB DC VITALITY 2 T180    DFIB DC VITALTY             $32,250.00
 4000190   DFIB EPIC HF V338          DFIB EPIC HF                $77,415.35
 4000191   DFIB EPIC HF V337          DFIB EPIC HF                $34,500.00
 4000201   DFIB INSYNC II MARQ 7289   DFIB INSYNC                 $77,415.35
 4000202   DFIB INSYNC MAXIMO 7304    DFIB MAXIMO                 $77,415.35
 4000203   DFIB INSYNC SENTRY 7297    DFIB SENTRY                 $41,850.00
 4000205   DFIB INSYNC SENTRY 7299    DFIB SENTRY                 $38,920.50
 4000224   DFIB RENEWAL 3 CONTK HE    DFIB RENEWAL 3              $27,000.00
 4000226   DFIB RENEWAL 3 H175        DFIB RENEWAL 3              $77,415.35
 4000228   DFIB RENEWAL 3 H170        DFIB RENEWAL 3              $40,500.00
 4000230   DFIB RENEWAL 3 RF          DFIB RENEW 3 RF             $37,875.00
 4000231   DFIB RENEWAL 3 RF H215     DFIB RENEW 3 RF             $35,670.68
 4000295   DFIB SC ATLAS II VR V168   DFIB SC ATLASII             $30,510.00
 4000299   DFIB SC ATLAS+ VR V193     DFIB SC ATLAS+              $77,415.35
 4000314   DFIB SC EPIC+ VR V196      DFIB SC EPIC+               $29,760.00
 4000332   DFIB SC MAXIMO VR7232CX    DFIB SC MAXIMO              $77,415.35
 4000347   DFIB SC VITALTY 2 T175     DFIB SC VITALTY             $24,977.92
 4000349   DFIB SC VITALTY VR T135    DFIB SC VITALTY             $77,415.35
 4000351   DFIB SC VIRTUOSO D154VW    DFIB SC VIRTUOS             $23,875.00
 4000450   PM CONTAK RENEWAL H125     PACEMAKER CONTK             $10,440.51
 4000467   PM DC ENPULSE 2 DR03       PACEMAKER DC RR              $7,790.73
 4000470   PM DC ENPULSE 2 DR06       PACEMAKER DR RR              $7,700.93
 4000493   PM DC RR ADAPTA ADDRS1     PACEMAKER DC RR              $9,185.00
 4000494   PM DC RR ADAPTA ADDR01     PACEMAKER DC RR              $9,185.00
 4000507   PM DC RR ATR/VNT BI/UNI    PACEMAKER DC RR              $7,169.59
 4000517   PM DC RR ENRYTHM P1501     PACEMAKER DC RR              $9,185.00
 4000526   PM DC RR ENPULSE 2         PACEMAKER DC RR             $24,576.65
 4000531   PM DC RR IDENTITY ADX      PACEMAKER DC RR             $24,576.65



  CDM Run Date: 06/01/2007
  Doctors Medical Center - Modesto                                                    Page 6 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION     HOSPITAL CHARGE COMMENTS
 4000533   PM DC RR INSIGN ULTR DR    PACEMAKER DC RR                 $7,790.73
 4000534   PM DC RR INSIGNA ULTRA     PACEMAKER DC RR                 $7,790.73
 4000536   PM DC RR INSIGNA PLUS      PACEMAKER DC RR                 $7,169.59
 4000537   PM DC RR INSIGNA SR        PACEMAKER DC RR                 $6,072.68
 4000538   PM DC RR INSIGNA ENTR      PACEMAKER DC RR                 $6,072.68
 4000540   PM DC RR INTEGRTY AFDR     PACEMAKER DC RR                $24,576.65
 4000555   PM DC RR KAPPA KDR901      PACEMAKER DC RR                $24,576.65
 4000556   PM DC RR KAPPA KDR921      PACEMAKER DC RR                $24,576.65
 4000622   PM DC RR VICTORY DR        PACEMAKER DC RR                 $7,169.59
 4000624   PM DC RR VICTORY XLDR      PACEMAKER DC RR                 $7,169.59
 4000645   PM FRONTIER II 5586        PACEMAKER FRONT                 $8,616.25
 4000700   PM INSYNC III 8042         PACEMAKER INSNC                $10,440.51
 4001047   PM SC RR ADAPTA SR01ID     PACEMAKER SC RR                 $7,169.59
 4001048   PM SC RR ADAPTA SR03       PACEMAKER SC RR                 $6,562.50
 4001080   PM SC RR ENPULSE           PACEMAKER SC RR                $22,222.05
 4001082   PM SC RR ENPULSE 2 SR03    PACEMAKER SC RR                 $6,562.50
 4001090   PM SC RR IDENTITY ADX      PACEMAKER SC RR                $22,222.05
 4001091   PM SC RR IDENTITY UNI/BI   PACEMAKER SC RR                 $4,298.40
 4001096   PM SC RR INSIGNA ENTR      PACEMAKER SC RR                $22,222.05
 4001099   PM SC RR INSIGNIA ULTRA    PACEMAKER SC RR                 $7,169.59
 4001111   PM SC RR KAPPA KSR901      PACEMAKER SC RR                $22,222.05
 4001173   PM SC RR SIGMA SSR303      PACEMAKER SC RR                 $6,072.68
 4001199   PM SC RR VICTORY           PACEMAKER SC RR                 $5,554.64
 4010000   4050 C/S IMPLANTS ORTHO    C/S IMPLNT ORTH
 4010999   BN GRFT INFS LG            BN GRFT INFS LG                    $8,925.00
 4011000   BN GRFT INFS MED 4SPNG     BN GRAFT KIT                       $8,050.00
 4011001   BN GRFT INFS SM 4SPNG      BN GRAFT KIT                       $7,287.70
 4012020   IMP CERV FUSION PRIMARY    IMP CERV FUSION        $1,872.00 - $39,163.50
 4012021   IMP CERV FUSION REFUSION   IMP CERV FUSION        $1,872.00 - $39,163.50
 4012035   IMP DORS/THOR FUSION       IMP DORS/THOR         $24,377.50 - $31,473.75
 4012036   IMP DORS/THOR FUS REFUS    IMP DORS/THOR         $24,377.50 - $31,473.75
 4012096   IMP HIP AUSTIN MOORE       HIP AUSTIN MOOR        $2,926.80 - $10,522.75
 4012097   IMP HIP HYBRID             IMP HIP HYBRID         $2,926.80 - $10,522.75
 4012098   IMP HIP BIPOLAR 2          IMP HIP BIPOLAR          $3,710.74 - $5442.43
 4012099   IMP HIP BIPOLAR            IMP HIP BIPOLAR        $2,926.80 - $10,522.75
 4012100   IMP HIP HIGH DEMAND        IMP HIP HIGH           $2,592.58 - $17,453.00
 4012101   IMP HIP LOW DEMAND         IMP HIP LOW            $2,592.58 - $17,453.00
 4012102   IMP HIP MED DEMAND         IMP HIP MED            $2,592.58 - $17,453.00
 4012103   IMP HIP NON-DEMND MATCH    IMP HIP MATCH          $2,592.58 - $17,453.00
 4012104   IMP HIP REVISION           IMP HIP REVSN          $6,915.38 - $13,029.38
 4012105   IMP HIP UNIPOLAR           IMP HIP UNIPOLR         $2,754.37 - $4,173.02
 4012199   IMP KNEE HYBRID            IMP KNEE HYBRID        $7,910.00 - $13,732.69
 4012201   IMP KNEE HIGH DEMAND       IMP KNEE HIGH          $7,910.00 - $13,732.69
 4012202   IMP KNEE LOW DEMAND        IMP KNEE LOW           $7,910.00 - $13,732.69
 4012203   IMP KNEE MED DEMAND        IMP KNEE MED           $7,910.00 - $13,732.69
 4012204   IMP KNEE NON-DEMND MATCH   IMP KNEE MATCH         $7,910.00 - $13,732.69
 4012205   IMP KNEE REVISION          IMP KNEE REVSN         $3,189.54 - $41,099.67
 4012206   IMP KNEE UNI               IMP KNEE UNI            $6,028.75 - $9,716.00
 4012300   IMP LUMB FUSION PRIMARY    IMP LUMB FUSION        $5,547.28 - $36,558.75
 4012301   IMP LUMB FUSION REFUSION   IMP LUMB FUSION        $5,547.28 - $36,558.75



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  Doctors Medical Center - Modesto                                                 Page 7 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION    HOSPITAL CHARGE COMMENTS
 4012600   IMP SHOULDER PRIMARY       IMP SHOULDER           $6,362.50 - $9,248.75
 4012601   IMP SHOULDER REVISION      IMP SHOULDER          $9,094.40 - $16,397.50
 4012630   IMP SYS SPN DECOMPRESS     SYS SPN DECOMP                   $16,500.00
 4020000   4050 C/S IMPLANTS OTHER    C/S IMPLNTS OTH
 4021019   COIL PV PLATINUM           COIL PV PLATNUM                  $446.00       Minimum
 4021030   ENDOPROSTH THORACIC TAG    ENDOPROS T TAG                $13,750.00
 4022323   GRFT VSC STNT EX CUFF      GRFT VSC STNT                  $3,888.00       Minimum
 4022324   GRFT VSC STNT BIF          GRFT VSC STNT                  $9,250.00       Minimum
 4030000   4050 C/S SPECIAL           C/S SPECIAL
 4031400   CATH FRONTRUNNER XP CTO    CATH FRONTRNR                  $1,504.80
 4031500   CATH REENTRY               CATH REENTRY                   $2,923.20
 4100000   4060 LAB-CLINICAL          LAB CLINCL (IP)
 4100004   ELECTROLYTE PANEL          ELECTROLYTE PAN                   $472.80
 4100025   RESPIRATORY SYNCYT VIRUS   RSV                               $103.20
 4100031   VANCOMYCIN                 VANCOMYCIN                        $767.40
 4100056   CBC WITHOUT DIFF           CBC WO DIFF                       $355.40
 4100062   LIPID PANEL                LIPID PANEL                       $666.30
 4100069   RENAL FUNCTION PANEL       RENAL FUNCT PNL                 $1,185.80
 4100074   ACUTE HEPATITIS PANEL      ACUTE HEP PANEL                   $131.75
 4100101   PHENCYCLINDINE(PCP) QUAL   PHENCYCLINDN QL                   $132.10
 4100102   AMPHETAMINE QUAL           AMPHETAMINE QL                    $132.10
 4100109   HEPATIC FUNCTION PANEL     HEPATC FUNC PNL                   $997.85
 4100111   COMP METABOLIC PANEL       COMP METABLC PN                 $1,732.95
 4100166   BASIC METABOLIC PANEL      BSC METABLC PNL                 $1,011.55
 4101000   UA NON-AUTO W/MICRO        UA W/MICRO                        $327.05
 4101001   UA AUTO W/MICRO            UA AUTO W/MICRO                   $327.05
 4101002   UA NON-AUTO W/O MICRO      UA W/O MICRO                      $163.55
 4101004   URINE W/O MICRO AUTO       UR WO MICRO AUT                   $163.55
 4101005   URINALYSIS CHEMICAL QUAL   URIN CHEM/QUAL                    $163.55
 4101007   URINE SINGLE ITEM          URINE SNGL ITEM                    $32.20
 4101015   URINALYSIS MICRO ONLY      URIN MICRO ONLY                   $163.55
 4101050   VOLUME MEASURMNT URINE     VOL MEAS URINE                    $106.40
 4101098   UA SPEC GRAV NON AUTO      UR SP GR NONAUT                    $60.45
 4101099   MISC URINE PROC            MISC URINE PROC           $32.20 - $327.05
 4102003   ACETAMNOPHN QUANT          ACETAMNOPHN QNT                   $797.05
 4102009   KETONES SERUM QUAL         KETONES SER QL                    $182.35
 4102010   KETONES SERUM QUANT        KETONES SER QN                    $528.20
 4102011   SALICYLATE                 SALICYLATE                        $524.35
 4102040   ALBUMIN SERUM              ALBUMIN SERUM                     $183.75
 4102055   ALCOHOL ETHYL              ALCOHOL ETHYL                     $537.15
 4102065   ALCOHOL ETHYL URINE        ALCOHL ETHYL UR                   $132.10
 4102076   ETHANOL BREATH             ETHANOL BREATH                    $113.30
 4102137   THEOPHYLLINE               THEOPHYLLINE                      $767.40
 4102140   AMMONIA                    AMMONIA                           $767.40
 4102145   AMPHETAMINE QUAN           AMPHETAMINE                       $110.85
 4102150   AMYLASE                    AMYLASE                           $223.35
 4102151   AMYLASE URINE              AMYLASE URINE                     $524.35
 4102213   BARBITURATES QUAL          BARBITURATES QL                   $132.10
 4102250   BILIRUBIN TOTAL            BILIRUBN TOTAL                    $183.75
 4102253   BILIRUBIN DIRECT           BILIRUBN DIRECT                   $183.75



  CDM Run Date: 06/01/2007
  Doctors Medical Center - Modesto                                         Page 8 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 4102256   BILIRUBIN AMNIOTIC FLUID   BILRBN AMNIOTIC                $428.65
 4102270   OCCULT BLD STL 1-3         OCC BL ST1-3SIM                $182.35
 4102272   OCCULT BLD FECES ONE SPC   OCC BLD QL                      $50.00
 4102273   OCCULT BLD OTHR SOURCE     OCC BLD OTH SRC                 $50.00
 4102310   CALCIUM                    CALCIUM                        $183.75
 4102330   CALCIUM IONIZED            CALCIUM IONIZED                $157.50
 4102340   CALCIUM URINE QUAN         CALC URINE QUAN                $412.95
 4102372   CARBAMAZAPINE              CARBAMAZAPINE                  $767.40
 4102374   CARBON DIOXIDE             CARBON DIOXIDE                 $183.75
 4102436   CHLORIDE URINE             CHLORIDE URINE                 $288.95
 4102439   CHLORIDE                   CHLORIDE                        $55.83
 4102465   CHOLESTEROL TOTAL          CHOLESTEROL TOT                $183.75
 4102477   CHOLESTEROL HDL            CHOLESTEROL HDL                $524.35
 4102550   CREATINE KINASE TOTAL      CPK TOTAL                      $524.35
 4102552   CK ISOENZYMES              CK ISOENZYMES                  $585.65
 4102553   CK MB FRACTION             CK MB FRAC                     $630.20
 4102560   COCAINE QL                 COCAINE QL                     $132.10
 4102565   CREATININE BLOOD           CREATININE BLD                 $183.75
 4102570   CREATININE OTHR SRCE       CREATIN OTH SRC                $412.95
 4102573   CREATININE URINE           CREATININE URIN                 $41.05
 4102575   CREATININE CLEARANCE       CREATININ CLEAR                $656.15
 4102611   CYANOCOBLMN(VIT B12)       VIT B12                        $665.95
 4102643   DIGOXIN                    DIGOXIN                        $806.05
 4102655   PHENYTOIN TOTAL            PHENYTOIN TOTAL                $797.05
 4102660   DRG SCR MLT CLS EA PR      DRG SCR MLT CLS                $566.60
 4102661   DRG SCR MLT CLS UR EA PR   DRG SCR MLT CLS                $110.85
 4102662   IMMUNOASSAY NON-RIA        IMMUNASSY NONRI                $656.00
 4102716   FECAL LEUKOCYTE TEST       FECAL LEUKOCYTE                $185.90
 4102726   FERRITIN                   FERRITIN                       $624.90
 4102731   FETAL FIBRONECTIN          FETAL FIBRONECT                $627.45
 4102746   FOLIC ACID                 FOLIC ACID                     $665.95
 4102803   GAS BLD ANY COMB W/CALO2   GS BLD ANY COMB                $315.10
 4102945   GLUCOSE BODY FLUID         GLUCOSE BDY FLD                $183.75
 4102947   GLUCOSE QUANT              GLUCOSE QUANT                  $183.75
 4102949   GLUCOSE I-STAT             GLUC I-STAT                    $183.75
 4102950   GLUCOSE POST DOSE          GLUC POST DOSE                 $431.40
 4102951   GLUCOSE TOLERANCE 3SPEC    GLUCOS TOL 3SPC                $806.05
 4102952   GTT EA ADD >3SPEC          GTT EA ADD >3SP                $106.95
 4102954   GLUCOSE QUANT URINE        GLUCOSE QNT UR                 $412.95
 4102962   GLUCOSE BLD BY MONIT DEV   GLUC BLD MNT DV                 $15.00
 4102980   GGT                        GGT                            $183.75
 4102994   HEMOGLOBIN GLYCATED        HEMOGLOBN GLYCT                $451.55
 4103004   GENTAMYCIN                 GENTAMICIN                     $767.40
 4103013   GONADTOPN CHRONC(HCG)QL    GONA CHR(HCG)QL                $537.15
 4103014   GONADTOPN CHORNC(HCG)QNT   GONA CHR(HCG)QN                $665.95
 4103033   HEMOGLOBN FETAL QUAL-APT   HGB FETL QL APT                $814.85
 4103052   SICKLING OF RBC            SICKLING OF RBC                $326.25
 4103517   H INFLU B AG QUAL          H INFLU B AG QL                $293.65
 4103527   B-TYP NATRIURETC PEPTIDE   B-TYP NATR PEPT                $318.90
 4103531   THYROXINE FREE             THYROXINE FREE                 $630.20



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  Doctors Medical Center - Modesto                                         Page 9 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 4103538   TRIIODTHYRNIN TOTAL T3     TRIIODTH TOT T3                 $501.10
 4103540   IRON                       IRON                            $524.35
 4103550   IRON BINDING CAPCTY        IRON BINDNG CAP                 $524.35
 4103605   LACTATE(LACTIC ACID)       LACTATE                         $765.80
 4103615   LDH-LACTIC DEHYDROGENASE   LDH                             $183.75
 4103625   LDH-ISOENZYMES ELCTROPHR   LDH ISOENZY ELC                 $585.65
 4103630   LACTOFERRIN FECAL QUAL     LACTOFERRIN QL                  $185.90
 4103633   LACTOSE TOLERANCE 3SPEC    LACTOS TOL 3SPC                 $971.25
 4103661   L/S RATIO QUANT            L/S RATIO QUANT               $2,076.95
 4103690   LIPASE                     LIPASE                          $168.65
 4103725   LITHIUM                    LITHIUM                         $183.75
 4103731   METHADONE QUAL             METHADONE QUAL                  $132.10
 4103735   MAGNESIUM                  MAGNESIUM                       $194.95
 4103873   MYOGLOBIN SERUM            MYOGLOBIN SERUM                 $630.20
 4103927   OPIATES QUAL               OPIATES QUAL                    $132.10
 4103930   OSMOLALITY BLOOD           OSMOLALITY BLD                  $778.10
 4103935   OSMOLALITY URINE           OSMOLALITY UR                   $778.10
 4103980   PH BODY FLUID EXCEPT BLD   PH BODY FLUID                   $134.90
 4104020   PHENOBARBITAL              PHENOBARBITAL                   $797.05
 4104075   PHOSPHATASE ALKALINE       PHOSPHA ALKALIN                 $183.75
 4104081   PHOSPHATIDYLGYCEROL        PHOSPHATDYLGYCR                  $53.15
 4104100   PHOSPHORUS                 PHOSPHORUS                      $183.75
 4104102   PHOSPHORUS URINE           PHOSPHORUS URI                  $412.95
 4104132   POTASSIUM SERUM            POTASSIUM SERUM                 $288.95
 4104133   POTASSIUM URINE            POTASSIUM URINE                 $288.95
 4104143   NAPA & PROCAINAMIDE        NAPA &PROCAINMD               $1,196.00
 4104147   PROPOXYPHENE QUAL          PROPOXYPHENE QL                 $132.10
 4104155   PROTEIN TOTAL              PROTEIN TOTAL                   $183.75
 4104176   PRE-ALBUMIN                PRE-ALBUMIN                     $451.55
 4104180   PROTEIN URINE QUAN 24 HR   PROTEIN UR 24HR                 $412.95
 4104195   PROTN SPINAL FLD SEMI QN   PROTEIN FLD QN                  $412.95
 4104230   QUINIDINE                  QUINIDINE                       $797.05
 4104250   TRIIODTHYRN (T-3) UPTAKE   T3 UPTAKE(T3U)                  $392.90
 4104252   ROTAVIRUS AG               ROTAVIRUS AG                    $103.20
 4104254   RSV AB                     RSV AB                          $452.30
 4104295   SODIUM BLOOD               SODIUM BLD                       $55.83
 4104296   SODIUM URINE               SODIUM URINE                    $288.95
 4104315   SP-GR EXCEPT URINE         SPEC GRAV XURIN                 $163.55
 4104408   THC(MARIJUANA) QUAL        THC MARIJUAN QL                 $132.10
 4104436   THYROXINE TOTAL            THYROXIN TOTAL                  $392.90
 4104443   TSH                        TSH                             $392.90
 4104450   TRANSTERASE AST(SGOT)      SGOT(AST)                       $183.75
 4104460   TRANSAMINASE-SGPT (ALT)    SGPT (ALT)                      $183.75
 4104462   TRANSFERRIN                TRANSFERRIN                     $451.55
 4104468   TOBRAMYCIN                 TOBRAMYCIN                      $767.40
 4104475   TRIGLYCERIDES              TRIGLYCER                       $183.75
 4104480   TRICYCLIC DRUGS QUAL       TRYCYCL DRUG QL                 $242.30
 4104520   BLD UREA NITROGEN QUAN     BLD UREA NTRG Q                 $183.75
 4104540   UREA NITROGEN URINE        UREA NTRGN URIN                 $412.95
 4104550   URIC ACID BLOOD            URIC ACID BLOOD                 $183.75



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  Doctors Medical Center - Modesto                                        Page 10 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 4104584   VALPROIC ACID              VALPROIC ACID                     $797.05
 4104999   MISC CHEM/TOX PROC         MISC CHEM/TOX           $55.83 - $1,196.00
 4105002   BLEEDING TIME              BLEED TIME                        $346.05
 4105006   C DIFF SCREEN AG           C DIFF SCRN AG                    $634.25
 4105012   EOSINOPHILE COUNT MANUAL   EOSIN CT MANUAL                   $335.75
 4105014   HEMATOCRIT AUTOMATED       HEMATOCRI AUTOM                    $59.25
 4105018   BLOOD HEMOGLBN             BLOOD HEMOGLOBN                    $59.25
 4105028   CBC/PLT/AUTO DIFF (5)      CBC/DIFF&PLATLT                   $547.30
 4105044   RETICULOCYTE COUNT MAN     RETIC COUNT MAN                   $412.95
 4105045   RETIC COUNT FLOW CYTO      RETC CNT FLW CY                   $382.20
 4105049   STOOL FOR WBC S            STOOL FOR WBC S                   $307.75
 4105347   COAGULATION TIME ACTIVTD   COAGULAT ACTIV                     $35.00
 4105362   FDP/FSP AGGLUTNATN SLIDE   FDP/FSP SLIDE                     $556.50
 4105379   FDP D-DIMER QNT            FDP D-DMR QN                      $556.50
 4105384   FIBRINOGEN ACTIVITY        FIBRINOGN ACTIV                   $355.40
 4105460   HMOGLBN FETAL(KLEIHAUER)   HEMOGLB FETAL                     $814.85
 4105576   PLT FUNCTION TST           PLT FUNCTN TST                    $243.95
 4105577   PLT AGG EA AGN             PLT AGG EA AGN                    $243.95
 4105578   PLT AGGREGATION EPI        PLT AGGREG EPI                    $243.95
 4105579   PLT AGGREGATION ADP        PLT AGGREG ADP                    $243.95
 4105590   PLATELET COUNT (MAN)       PLTLT CNT(MAN)                    $403.30
 4105595   PLATELET COUNT (AUTO)      PLTLT CNT AUTO                     $59.25
 4105610   PROTHROMBIN TIME           PROTHROM TIME                     $346.05
 4105651   SEDIMENTN RATE-NON-AUTO    SED RATE NONAUT                   $287.60
 4105653   SED RATE AUTO              SED RATE AUTO                     $287.60
 4105670   THROMBIN TIME PLASMA       THROMBIN PLASMA                   $335.75
 4105730   PTT PLASM                  PTT PLASMA                        $403.30
 4105999   MISC HEMA PROC             MISC HEMA PROC            $35.00 - $814.85
 4106003   HETEROPHILE AB SCREEN      HETEROPHIL QUAL                   $412.95
 4106004   HEMO & AGGLU AUT SCR EA    HEMO/AGGLU AUTO                   $479.80
 4106011   AGGLUTNS FEBRIL EA QN      AGGLUTNS FEBR Q                 $1,708.10
 4106012   ANTIBDY ABSORP EA SERUM    AB ABSORP                         $451.55
 4106015   COLD AGGLUTINATN TITER     COLD AGGLUTINAT                   $500.00
 4106016   RBC ANTIBODIES SCREEN      RBC AB SCRN                       $490.40
 4106019   RBC ANTIBDY ELUTION EACH   RBC ELUTION EA                    $634.25
 4106021   C-REACTIVE PROTEIN QN      CRP QUANT                         $454.45
 4106024   ANTIBDY IDENT RBC EA PNL   AB RBC EA PNL                   $1,094.15
 4106025   C-REACTIVE PROTEIN QL      C-REACT PRTN QL                   $522.60
 4106026   ANTIBDY ID/ENZYME EACH     AB ID/ENZ EA                    $1,218.20
 4106031   COOMBS DIRECT              COOMBS DIRECT                     $451.55
 4106032   COOMBS INDIRECT            COOMBS INDIRECT                   $451.55
 4106033   DIRECT COOMBS POLY         CMBS DIR POLY                     $451.55
 4106036   DIRECT COOMBS: IGG         DIRCT CMBS: IGG                   $451.55
 4106037   DIRECT COOMBS: C3D         DIRCT CMBS: C3D                   $451.55
 4106038   PREGNANCY TEST-TUBE        PRENANCY T.TUBE                   $537.15
 4106043   ANTINUCLEAR AB(ANA)        ANTINUCL AB(ANA                   $221.60
 4106044   RH ANTIBODY TITRE          RH AB TITER                     $1,332.80
 4106073   BLD TYP AG SCR EA UNIT     BLD TYP AG SCR                    $843.85
 4106080   BLD TYPE ABO ONLY          BLD TYPE ABO                      $249.25
 4106090   RBC AG ROOM TEMP           RBC AG RM TMP                     $156.30



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  Doctors Medical Center - Modesto                                        Page 11 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 4106095   RBC AG EXCPT ABO/RHO EA    RBC AG EX ABO/R                  $307.75
 4106096   BLD TYPE RBC DIRECT(RH)    BLD TYP RBC DIR                  $307.75
 4106100   BLD TYPE RHO(D)ONLY        BLD TYPE RHO D                   $229.15
 4106101   RHO(DU)                    RHO(DU)                          $307.75
 4106151   CARCINO-EMBRYONIC AG       CEA                              $665.95
 4106177   LEGIONELLA AB              LEGION AB                        $823.00
 4106210   COMP TST EA UT SPIN TECH   COMP TST SPN TC                  $541.90
 4106211   COMP TST EA UT INCUB TCH   COMP TST INC TC                  $100.45
 4106212   COMP TST EA UT AHG TECH    COMP TST AHG TC                  $891.30
 4106255   FLUORESCNT SCRN EA AB      FLUR AB SCRN EA                  $616.90
 4106287   HBS ANTIGEN                HBS-AG                            $88.86
 4106291   HEPATITIS A AB(IGG&IGM)    HEP A AB(IGGIGM                   $71.75
 4106292   HEPATITIS B SURF AB        HBS AB                            $92.40
 4106294   HEPATITIS B CORE AB(IGM)   HEP B CR AB IGM                   $83.75
 4106297   HEPATITIS A AB IGM         HEP A AB IGM                      $71.75
 4106304   HEPATITIS C ANTIBODY       HEPATITIS C AB                   $122.76
 4106316   PSA TOTAL                  PSA TOTAL                        $707.50
 4106317   RUBELLA QUALITATIVE        RUBELLA QUAL                     $185.90
 4106319   BENZODIAZEPINES QL         BENZODIAZ QL                     $132.10
 4106403   PARTICLE AGGL AB QL        PARTC AGG AB QL                  $130.55
 4106407   ANTI-RH FETAL SCREEN AB    ANTI-RH FET SCR                  $479.80
 4106414   RSV ANTIGEN BY EIA         RSV AG                           $452.30
 4106431   RHEUMATOID FACTOR QUAL     RA FACTOR QUAL                   $221.70
 4106648   TRANSFUSN REACTION STUDY   TRANSFUS REACTN                  $267.45
 4106703   HIV-1/HIV-2 SNG ASSY       HIV1/HIV2 SNG A                  $115.02
 4106765   RUBEOLA AB                 RUBEOLA AB                       $189.50
 4106902   CHLAMYDIA AG               CLAMYDIA AG                      $467.95
 4106913   HERPES DIRECT AG IFA       HERPES AG IFA                    $609.20
 4106916   CMV DIRECT ANTIGEN IFA     CMV AG IFA                       $609.20
 4106930   STREP B AG                 STREP B AG                       $293.65
 4106934   S PNEUMONIAE AG            S PNEUMO AG                      $293.65
 4106936   N MENINGITIDIS ACYW135     N MENINGIT ACYW                  $293.65
 4106937   N MENING ACYW135           N MENINGTD ACYW                  $293.65
 4106938   N MENING A/Y               N MENING A/Y                     $293.65
 4106939   N MENING C/W135 AG         N MENING C/W AG                  $293.65
 4106999   MISC IMMUN PROC            MISC IMMUN PRC          $293.65 - $609.20
 4107016   CONCENTRATN OTH BDY FLD    CONCENTRATN OTH                   $91.10
 4107019   TB CONCENTRATE             TB CONCENTRATE                   $182.35
 4107022   CULTURE SPUTUM             CULT SPUTUM                      $797.05
 4107024   CULTURE GENITAL            CULT GENITAL                     $752.70
 4107036   BETA LACTAMASE             BETA LACTMSE                     $307.75
 4107040   CULT BLOOD AERO/ANAERO     CULT BLD AER/AN                  $979.65
 4107046   E COLI 0157 CULT FECE      E COLI FECE                       $28.60
 4107047   VIBRIO CULTURE             VIBRIO CULTURE                    $24.85
 4107055   CULTURE STOOL              CULT STOOL                       $797.05
 4107056   CULTURE THROAT             CULT THROAT                      $283.70
 4107057   YERSINIA CULTURE           YERSINIA CULTUR                  $585.65
 4107058   CULTURE CLOST DIFFIC STL   CULTURE CLOS DI                  $479.80
 4107063   CULTURE E.COLI             CULT E.COLI                       $28.60
 4107066   CULTURE RECTAL             CULT RECTAL                      $313.55



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  Doctors Medical Center - Modesto                                        Page 12 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 4107068   CULTURE BIOPSY/SURG SPC    CULT BIOPSY                    $752.70
 4107069   CULTURE CATH TIP           CULT CATH TIP                  $313.55
 4107070   CULTURE OTHER SOURCE       CULT OTH SOURCE                $229.15
 4107071   CULTURE CERVIX             CULT CERVIX                    $790.20
 4107072   CULTURE ENVIORNMTL         CULT ENVIORN                   $529.90
 4107074   CULTURE FLUID EX CSF       CULT FLD EX CSF                $313.55
 4107075   CULTURE ANAEROBIC ISOL     CULT ANAEROBIC                 $630.20
 4107076   CULTURE ANAERO DEF IDWGC   CULT ANAERO IDW                $114.55
 4107077   CLOSTRIDIUM DIFF TOXIN     C.DIF TOX TS CL                $634.25
 4107078   CULTURE CSF                CULT CSF                       $757.00
 4107079   CULTURE PENILE             CULT PENILE                    $752.70
 4107080   CULTURE CAMPYLOBACTERIO    CULT CAMPYL                     $83.45
 4107081   CULTURE STREP SCREENING    CULT STREP SCRN                $307.75
 4107082   CULTURE VAGINAL            CULT VAGINAL                   $313.55
 4107084   HERPES CULTURE             HERPES CULTURE                 $606.95
 4107085   CULTURE MISC               CULT MISC                      $585.65
 4107086   CULTURE URINE COLONY CT    CULT URIN CNT                  $508.60
 4107088   CULTURE URINE IDENT        CULT URIN IDENT                $214.60
 4107090   DIALYSIS ENVIRON CULT      DIALYSIS CULT                  $504.55
 4107091   PHARMACY ENVIRON CULTURE   PHARMACY CULT                  $504.55
 4107092   INF CONTRL ENVIRON CULT    INFCT CONT CULT                $504.55
 4107101   CULTURE FUNGI ISOLT SKIN   CULT FUNGI SKIN                $556.50
 4107102   CULTURE FUNGI OTHER        CULT FUNG OTHER                $556.50
 4107103   CULTURE FUNGI BLOOD        CULT FUNG BLOOD                $479.80
 4107104   ANAEROBIC ID CHG #1        ANARB ID CHG 1                  $57.25
 4107105   ANAEROBIC ID CHG #3        ANARB ID CHG 3                 $170.95
 4107106   CULT FUNGI ID ADD          CULT FUNGI IDEN                $130.00
 4107107   CULTURE FUNGI FLUID XCSF   CULT FUNG X CSF                $585.65
 4107108   ANAEROBIC ID CHG #4        ANARB ID CHG 4                 $228.10
 4107111   CULTURE FUNGI MOLD         CULT FUNGI MLD                 $155.30
 4107116   CULTURE AFB                CULT AFB                       $661.55
 4107133   CULTURE WOUND/ABCESS       CULTURE WOUND                  $790.20
 4107140   CULTURE TYPNG FLUORO EA    CULT TYPING FM                 $229.15
 4107143   CULTURE TYPNG GLC METHOD   CULT TYPING GLC                $412.95
 4107144   EXAM PINWORM TP SITE       EXAM PARASITE                  $100.00
 4107147   CULTURE TYPNG SEROLOGIC    CULT TYPING SM                 $229.15
 4107148   STAPH AGGLUTINATION        STAPH AGGLUTNTN                $130.55
 4107149   CULTURE TYP NUC ACID PER   CULT NUC ACID                  $452.30
 4107151   CULTURE TYP SERO SPCIATN   CULT TYPNG SPEC                 $74.85
 4107158   CULTURE TYPNG OTHER MTHD   CULT TYPNG OTHR                $182.35
 4107160   GC CULTURE                 GC CULTURE                     $451.55
 4107162   LEGIONELLA CULTURE         LEGIONELLA CULT                $585.65
 4107164   PERTUSSIS CULTURE          PERTUSSIS CULT                 $557.80
 4107169   NUCLEIC ACID PROBE AFB     AFB NA PROBE                   $703.30
 4107172   NUCLEIC ACID PROBE FUNG    FUNGUS NA PROBE                $452.30
 4107174   NUCLEIC ACID PROBE GC      GC NA PROBE                    $452.30
 4107175   NUCLEIC ACID PROBE CHLM    CHLMYDIA NA PRB                $464.65
 4107177   O&P DIR SMR CONC & ID      O&P DIRSM CNC&I                $417.60
 4107178   CRYPTOSPORIDIUM            CRYPTOSPORIDIUM                $585.65
 4107180   SCHLICTER TEST             SCHLICTER TTEST                $930.80



  CDM Run Date: 06/01/2007
  Doctors Medical Center - Modesto                                        Page 13 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 4107181   SENSITIVITY ANTBDY AGAR    SENSITVTY AB                      $144.80
 4107184   SENSITV 12 DISKS OR LESS   SENSTVTY DISK12                   $287.60
 4107185   SENS MIC FASTDS OR ANROB   MIC FASTS/ANORB                   $757.00
 4107186   SENSITVTY MIC              SENSITIVTY MIC                    $661.55
 4107187   SENSITIVITY MBC            SENSITIVTY MBC                    $191.05
 4107188   SENSITVTY TUBE DILUTION    SENSITIV TUBE                     $556.50
 4107198   SENSITIVITY ETEST/EA AB    SEN ETEST/EA AB                    $90.70
 4107200   FLUOR STAIN RSV            FLUOR STAIN RSV                   $616.90
 4107201   SMEAR AFB                  SMEAR AFB                         $384.35
 4107202   SMEAR MALARIA              SMEAR MALARIA                     $384.35
 4107205   GRAM STAIN                 GRAM STAIN                        $307.75
 4107206   FLUOR STAIN                FLUOR STAIN                       $335.75
 4107207   SPECIAL STAIN              SPEC STAIN                        $307.75
 4107210   WET MOUNT W/SMPL STAIN     WET MNT W/SMP S                   $249.25
 4107211   SMEAR O&P WET&DRY          SMR O&P WET&DRY                   $335.75
 4107215   INDIA INK PREP             INDIA INK PREP                    $316.50
 4107220   KOH PREP                   KOH PREP                          $316.50
 4107231   C. DIFF TOX AG             C.DIF TOX AG                      $634.25
 4107233   RSV ANTIGEN QUANT          RSV ANTIGEN                       $452.30
 4107235   TROPONIN - I               TROPONIN - I                      $656.00
 4107252   CULTURE SHELL VIAL TISS    CULT SHELL TISS                   $146.05
 4107275   INFLUENZA B VIRUS AG IF    INFLU B AG IF                     $103.20
 4107276   INFLUENZA A DET AG         INFLNZ A DET AG                   $103.20
 4107804   INF A IA DIR               INF A IA DIR                      $103.20
 4107805   INF B IA DIR               INF B IA DIR                      $103.20
 4107999   MISC MICRO PROC            MISC MICRO PRO           $100.00 - $300.00
 4108313   SPEC STAIN TRICHROME O&P   SPEC STN TRICHR                   $335.75
 4108707   CULTURE AEROBIC DEF ID     CULT AEROBIC ID                   $170.95
 4108717   TISSUE GRIND FOR CULTURE   TISS GRIND CULT                   $143.75
 4108999   MISC LAB                   MISC LAB                $35.00 - $1,196.00
 4109051   CELL COUNT MISC W/DIFF     CELL COUNT DIFF                   $412.95
 4109060   CMV AB                     CMV AB                          $1,233.55
 4109125   FAT STAIN FECES/URIN/ETC   FAT STAIN                         $182.35
 4109190   NASAL SMEAR EOSINOPHILES   NASL SMEAR EOS                    $307.75
 4109250   REDUCING SUBSTANCE         REDUCING SUBST                    $144.80
 4109300   SEMEN ANALYSIS PST VAS     SEMEN PST VAS                     $182.35
 4109357   TISS CULT ADD STUDIES      OTHER VIRUS ID                    $239.50
 4109358   STOOL PH                   STOOL PH                          $134.90
 4109359   TISS CULT INOC/OBSERV      HERPES CULTURE                    $606.95
 4109360   TISS CULT ADD STUDIES      HERPES CULT ID                    $239.50
 4109361   TISS CULT INOC/OBSERV      CMV CULTURE                     $1,233.55
 4109362   TISS CULT ADD STUDIES      CMV CULT ID                       $239.50
 4109363   CRYST ID BODY FLD EX URN   CRYST ID EX URN                   $249.25
 4109378   ULTRACENTRIFUGATION        ULTRACNTRIFUG                      $41.05
 4109600   RBC ANTIBODY SCREEN        RBC AB SCRN -NT                   $490.40
 4109602   RBC ANTIBODY ELUTION EA    RBC ELUTN EA-NT                   $634.25
 4109604   ANTIBDY IDENT RBC EA PNL   AB RBC EA PNL-N                 $1,094.15
 4109608   COOMBS DIRECT              CMBS DIRECT -NT                   $451.55
 4109610   COOMBS DIRECT POLY         CMBS DIR POLY-N                   $451.55
 4109614   COOMBS DIRECT IGG          CMBS DIR IGG -N                   $451.55



  CDM Run Date: 06/01/2007
  Doctors Medical Center - Modesto                                            Page 14 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 4109616   COOMBS DIRECT C3D          CMBS DIR C3D-NT                 $451.55
 4109622   COOMBS INDIRCT             CMBS INDIR -NT                  $451.55
 4109624   RH ANTIBODY TITER          RH AB TITER -NT               $1,332.80
 4109626   RHO(DU)                    RHO(DU) -NT                     $307.75
 4109628   BLD TYPE ABO ONLY          BLD TYPE ABO-NT                 $249.25
 4109630   BLD TYPE RHO(D)ONLY        BLD TYPE RHO-NT                 $229.15
 4109632   RBC AG ROOM TEMP           RBC AG RM TMP-N                 $156.30
 4109634   RBC AG EXCPT ABO/RHO EA    RBC AG XABORH-N                 $307.75
 4109636   BLD TYPE RBC DIRECT(RH)    BLD TYPE RBC-NT                 $307.75
 4109642   HEMO & AGGLU AUT SCR EA    HEMO/AGGLU AU-N                 $479.80
 4109652   ANTIBDY ID/ENZYME EACH     AB ID/ENZ EA-NT               $1,218.20
 4120000   4060 LAB-CLIENT OUTPT      LAB-CLIENT OP
 4130000   4060 LAB-CLINICAL REFHSP   LAB-CLINICL REF
 4140000   4060 INHOUSE REF LAB       INHOUSE REF LAB
 4150000   4060 LAB CLINICAL OP       LAB-CLINICAL OP
 4170000   4060 LAB-SHARD SVC INSYS   LAB-SHARED SVC
 4170031   VANCOMYCIN                 VANCOMYCIN                      $6.04
 4172040   ALBUMIN SERUM              ALBUMIN SERUM                   $6.31
 4172150   AMYLASE                    AMYLASE                         $6.61
 4172153   AMYLASE URINE RANDOM       AMYLASE URINE                   $6.61
 4172253   BILIRUBIN DIRECT           BILIRUBN DIRECT                 $6.31
 4172575   CREATININE CLEARANCE       CREATININ CLEAR                 $8.13
 4172746   FOLIC ACID                 FOLIC ACID                      $6.63
 4173605   LACTATE(LACTIC ACID)       LACTATE                         $6.61
 4173690   LIPASE                     LIPASE                          $6.61
 4176403   PARTICLE AGGL AB QL        PARTC AGG AB QL                 $7.58
 4177016   CONCENTRATN OTH BDY FLD    CONCENTRATN OTH                 $6.94
 4177018   SENSITIVITY MIC ANAEROBC   SENS MIC ANEROB                $14.27
 4177022   CULTURE SPUTUM             CULT SPUTUM                     $9.92
 4177024   CULTURE GENITAL            CULT GENITAL                   $12.38
 4177036   BETA LACTAMASE             BETA LACTMSE                    $2.91
 4177039   CULTURE BACTERIAL SCREEN   CULT BAC SCREEN                 $3.82
 4177040   CULT BLOOD AERO/ANAERO     CULT BLD AER/AN                $10.21
 4177048   CULT STOOL ADD PATH EA     CULT STOOL ADD                  $9.48
 4177055   CULTURE STOOL              CULT STOOL                     $13.35
 4177056   CULTURE THROAT             CULT THROAT                     $6.73
 4177068   CULTURE BIOPSY/SURG SPC    CULT BIOPSY                     $8.96
 4177069   CULTURE CATH TIP           CULT CATH TIP                   $6.96
 4177070   CULTURE OTHER SCURCE       CULT OTHR SOURC                 $9.92
 4177071   CULTURE CERVIX             CULT CERVIX                     $8.73
 4177072   CULTURE ENVIORNMTL         CULT ENVIORN                    $5.27
 4177074   CULTURE FLUID EX CSF       CULT FLD EX CSF                 $6.27
 4177075   CULTURE ANAEROBIC ISOL     CULT ANAEROBIC                 $15.06
 4177077   CLOSTRIDIUM DIFF TOXIN     C.DIF TOX TS CL                $12.92
 4177078   CULTURE CSF                CULTURE CSF                     $5.27
 4177079   CULTURE PENILE             CULT PENILE                    $10.92
 4177080   CULTURE CAMPYLOBACTERIO    CULT CAMPYL                     $9.46
 4177081   CULTURE STREP SCREENING    CULT STREP SCRN                 $3.82
 4177082   CULTURE VAGINAL            CULT VAGINAL                   $12.38
 4177085   CULTURE MISC               CULT MISC                       $6.27



  CDM Run Date: 06/01/2007
  Doctors Medical Center - Modesto                                            Page 15 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 4177086   CULTURE URINE COLONY CT    CULT URIN CNT                    $3.08
 4177102   CULTURE FUNGI OTHER        CULT FUNGI OTHE                  $6.60
 4177103   CULTURE FUNGI BLOOD        CULT FUNG BLOOD                  $8.79
 4177106   CULT FUNGI ID ADD          CULT FUNGI IDEN                  $6.04
 4177116   CULTURE AFB                CULT AFB                        $14.58
 4177133   CULTURE WOUND/ABCESS       CULTURE WOUND                   $11.38
 4177147   CULTURE TYPNG SEROLOGIC    CULT TYPING SM                   $2.58
 4177149   CULTURE TYP NUC ACID PER   CULT NUC ACID                   $25.56
 4177160   GC CULTURE                 GC CULTURE                      $10.38
 4177162   LEGIONELLA CULTURE         LEGIONELLA CULT                  $4.04
 4177164   PERTUSSIS CULTURE          PERTUSSIS CULT                   $4.04
 4177174   NUCLEIC ACID PROBE GC      GC NA PROBE                     $20.21
 4177175   NUCLEIC ACID PROBE CHLM    CHLMYDIA NA PRB                 $21.21
 4177184   SENSITV 12 DISKS OR LESS   SENSTVTY DISK12                  $8.27
 4177186   SENSITVTY MIC              SENSITIVTY MIC                   $7.77
 4177198   SENSITIVITY ETEST/EA AB    SEN ETEST/EA AB                 $10.23
 4177201   SMEAR AFB                  SMEAR AFB                       $12.10
 4177202   SMEAR MALARIA              SMEAR MALARIA                   $11.21
 4177205   GRAM STAIN                 GRAM STAIN                       $6.27
 4177206   FLUOR STAIN                FLUOR STAIN                      $7.50
 4177210   WET MOUNT                  WET MOUNT                        $4.81
 4177211   SMEAR O&P WET&DRY          SMR O&P WET&DRY                  $7.00
 4177215   INDIA INK PREP             INDIA INK PREP                   $6.27
 4177220   KOH PREP                   KOH PREP                         $7.00
 4177233   RSV ANTIGEN QUANT          RSV ANTIGEN                     $17.96
 4178707   CULTURE AEROBIC DEF ID     CULT AEROBIC ID                  $7.53
 4178717   TISSUE GRIND FOR CULTURE   TISS GRIND CULT                  $8.85
 4200000   4060 PROCESS/SERVICE       PROCESS/SRVC
 4201050   VOLUME MEASURMNT URINE     VOL MEASR UR                  $106.95
 4201100   SPEC HANDLING: ALIQUOT     LAB SPEC HNDLNG               $131.00
 4201105   SPEC HANDLING: NON-ALIQ    LAB SPEC HNDLNG                $11.40
 4201110   SPEC HANDLING: MAILED      LAB SPEC HNDLNG               $131.00      Minimum
 4201125   SPEC PROCESSING            SPEC PROC                      $11.40      Minimum
 4201300   PKU: MAILED                PKU: MAILED                     $3.00
 4201305   PKU: CAP PUNCTURE I/P      PKU: HEEL STICK                 $3.00
 4202005   PROCESSING BLOOD           PROC BLD                      $101.80
 4202030   POOLING PLATELET CONC      POOL PLTLT CONC               $266.05
 4202045   PROCESS CRYO PRECIPITATE   PROC CRYO/THAW                 $22.75
 4202080   PROCESS RH IMMUNE GLOB     PROC RH IMMUNE                 $22.75
 4202100   PROCESS PLT CONCENTRATE    PROC PLT CONC                  $22.75
 4202110   AUTOLOGS DONOR DRAW ONLY   AUTOLOG DRAW                  $106.00
 4202120   PROCESS AUTOLOG UNIT I/H   PROC AUTLOG I/H               $159.30
 4202125   PROC DIR DONOR UNIT I/H    PROC DIR DONR                 $159.30      Minimum
 4202140   PROCESS AUTOLOG UNIT OS    PROC AUTLOG O/S                $80.05
 4203641   PKU CAPILLARY PUNCTURE     PKU CAP PUNCT                   $6.00
 4204612   VOLUME MEASURMNT FLUID     VOL MEASR FLD                  $10.70
 4206353   PLATELET IRRADIATED        PLTLT IRR                      $45.45
 4206927   PROCESS FFP EA UNIT        PROC FFP EA                   $101.80
 4206985   SPLITTING BLD PROD EA UT   BLD PROD SPLIT                 $66.35
 4208399   TISSUE GRINDING            TISS GRINDING                  $98.50



  CDM Run Date: 06/01/2007
  Doctors Medical Center - Modesto                                                Page 16 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 4209009   CAPILLARY PUNCTURE INPAT   CAPILLARY PUNCT                 $91.65
 4209010   VENIPUNCTURE OUTPT         VENIPUNCT                       $17.15
 4209011   VENIPUNCTURE INPATIENT     VENIPUNCT                       $74.25
 4500000   4100 BLOOD BANK            BLOOD BANK
 4500022   BLOOD RC PACKED/PED        BLD RC PACK/PED                   $35.00
 4508999   00099 BLD MISC CHARGE      BLD MISC CHARGE        $15.00 - $5,865.00      Minimum
 4509012   CRYOPRECIPITTE EA UNIT     CRYOPRECIPITATE                   $89.73
 4509013   FRESH FROZEN PLASMA        FFP SINGLE DNR                    $89.37
 4509015   RBC LEUKOREDUCED           RBC LEUKORED                     $236.37
 4509018   BLD RC PACKED/PED          BLD RC PACK/PED                  $149.86
 4509021   RBC EA UNIT                RED BLD CELLS                    $225.87
 4509023   RBC DIRECTED               RBC DIRECTED                     $225.87
 4509024   RBC AUTOLOGOUS             RBC AUTOLOGOUS                   $333.61
 4509034   PLATELTS PHERSIS EA UNT    PLATELET APHER                   $656.37
 4509035   PLATELTS APHER LEUKRDUC    PLT PHERESIS LR                  $656.00
 4509038   RBC IRRADIATED             RBC IRRAD                        $180.00
 4509041   RBC LEUKORED IRRAD         RBC LR IRRAD                     $236.37
 4510000   4100 BLOOD CLLCTN INHOSE   BLD COLLC INHOS
 4510001   BLOOD WHOLE                BLOOD WHOLE                     $165.00
 4516125   BLOOD PRODUCT IRRAND EA    BLD PROD IRD EA                  $60.00
 4518999   00099 BLD MISC CHARGE      BLD MISC CHARGE                  $10.00
 4519021   BLD RC PACKED/PED          BLD RC PACK/PED                  $10.00
 4519600   BLD WHOLE EA UNIT          BLOOD WHOLE                      $10.00
 4519601   RBC EA UNIT                RED BLD CELLS                    $10.00
 4519604   FRESH FROZEN PLASMA        FFP SINGLE DNR                   $10.00
 4519605   PLATELETS EACH UNIT        PLATELET CONC                    $65.00
 4519606   PLATELTS PHERSIS EA UNIT   PLATELET APHER                   $10.00
 4519607   CRYOPRECIPITATE EA UNIT    CRYOPRECIPITATE                  $10.00
 4519608   RBC AUTOLOGOUS             RBC AUTOLOGOUS                   $10.00
 4519609   RBC DIRECTED               RBC DIRECTED                     $10.00
 4519611   PLATELTS APHER LEUKRDUCD   PLT PHERESIS LR                  $10.00
 4519612   RBC LEUKOREDUCED           RBC LEUKORED                     $10.00
 4519613   RBC IRRADIATED             RBC IRRAD                        $10.00
 4519614   RBC LEUKORED IRRAD         RBC LR IRRAD                     $10.00
 4600000   4110 EKG                   EKG
 4600400   SIGNAL AVERAGED EKG        SIGNAL-AVG EKG                 $1,159.00
 4601100   PERSANTINE STRESS          CARD STRES PERS                $1,599.00
 4601105   ADENOSINE CARDIO STRESS    CARD STRES ADEN                $1,599.00
 4601110   DOBUTAMINE STRESS          CARD STRESS DOB                $1,599.00
 4603000   EKG TRACE ONLY             EKG                              $435.00
 4603015   CARDIO STRESS              CARDIO STRESS T                $1,358.00
 4603020   CARDIO STRESS THALIUM      CARD STRESS THA                $1,599.00
 4603303   ECHOCARDIOGRAM/MMODE/LTD   ECHO M LTD                     $1,225.00
 4603325   DOPPLER ECHO PULSE/CONT    DOPPLER ECHO                   $1,835.00       Minimum
 4603328   CARDIAC DOPPLER FU/LTD     CARD DOPPLER FU                  $921.00
 4603330   DOPPLER ECHO COLOR FLOW    COLORFLOW ANALY                $1,059.00
 4603880   CAROTID IMAGING COMPLETE   CAROTID IMG COM                $2,200.00
 4603882   CARTOID IMAGING LIMITED    CAROTID IMG LTD                $1,047.00
 4608999   MISC CARDIO PROCEDURE      MISC CARD PROC        $435.00 - $2,200.00
 4610000   4111 CARDIAC CATH LAB      CARDIAC CATHLAB



  CDM Run Date: 06/01/2007
  Doctors Medical Center - Modesto                                        Page 17 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 4610100   PERC ANGIOPLSTY TIBIOPER   ANGIO TIBIOPER                $2,092.00
 4610105   PERC ANGIPLSTY RENL/VISC   ANGIO REN/VSC                $11,628.00
 4610115   PERC ANGIOPLASTY ILIAC     ANGIO ILIAC                   $2,092.00
 4610120   PERC ANGIOPLASTY FEM-POP   ANGIO FEM-POP                 $2,092.00
 4610125   PERC ANGIOPLSTY BRACHCEP   ANGIO BRACHCP                 $2,092.00
 4610140   PERC ATHRECTMY RENL/VISC   ATHERCT REN/VSC               $7,645.00
 4610142   PERC ATHRECTMY AORTA       ATHERCT AORTA                 $7,645.00
 4610145   PERC ATHRECTMY ILIAC       ATHERCT ILIAC                 $7,645.00
 4610150   PERC ATHRECTMY FEM/POP     ATHERCT FEM/POP               $7,645.00
 4610152   PERC ATHRECTMY BRACHCEPH   ATHERCT BRACH                 $7,645.00
 4610158   ATHRECTMY PERIPHL INITL    ATHERCT PERIPH               $11,893.00
 4610160   PERC ATHRECTMY TIBIOPER    ATHERCT TIBIOP                $7,645.00
 4610204   E&M-NEW PATIENT-LVL IV     E&M-NP LVL IV                   $850.00
 4610269   PLC VASC CLSURE DEVICE     PLC CLOSE DEVC                  $950.00
 4610275   ABD AORTA W HEART CATH     ABD AORTA W HC                $3,608.00
 4610276   RENL ART UNI W CARD CTH    RENAL ART UNI                 $2,158.00
 4610278   ILIAC ART BI W CARD CTH    ILIAC ART BI                  $3,693.00
 4610279   ILIAC ART UNI W CARD CTH   ILIAC ART UNI                 $2,243.00
 4610290   PLC DRG ELUTNG STNT INIT   PLC DRG ELUT I               $30,990.00
 4610291   PLC DRG ELUTING STNT ADD   PLC DRG ELUT A                $7,635.00
 4610392   PERC DRN/INJ RENL PELV     NEPHROSTOMY                  $14,720.00
 4610512   CORONARY STNT INITL        CORONARY ST INI              $30,990.00
 4610513   CORONARY STNT ADDTNL       CORONARY ST ADD               $7,635.00
 4610514   CORONARY ATHERECTOMY       ATHERECT CORON               $28,235.00
 4610516   COR ATHER EA ADDL VSL      ATHERCT COR ADD               $7,635.00
 4610600   EP CARDIAC MAPPING         EP CARD MAPPING              $10,808.00
 4610604   INDUCTN ARRHYTHMIA BY EP   INDUCTN BY EP                $12,430.00
 4610606   EP ABLATION                EP ABLATION                  $10,808.00
 4610610   COMP EP EVAL/LA FRM CS R   EVAL/LAC CMP EP               $4,144.00
 4610612   COMP EP EVAL/LV RECORD     EP EVAL LV RECD               $4,144.00
 4610615   COMP EP W/O INDUC/ARRYTH   COMP W/O INDUC               $14,500.00
 4610620   EP COMP STUDY W/INDUCTN    EP COMP STUDY                $16,576.00
 4610630   EP DRUG FOLLOW-UP STUDY    EP DRG F/U STDY               $3,521.00
 4610631   EP POST DRUG INFUSION      EP POST DRG INF               $3,878.00
 4610635   EP TEST AICD LEAD & GEN    AICD TST LD&GEN              $11,186.00
 4610640   EP EVAL AICD LEADS INIT    AICD EVAL INIT               $10,358.00
 4610642   EP EVAL AICD SUBSEQ        AICD EVAL SUBSQ               $8,289.00
 4610650   ABLATION-AV NODE           ABLATN-AV NODE               $16,576.00
 4610651   ABLATION-SV NODE           ABLATN-SV NODE               $16,576.00
 4610780   IV INF TX INIT <=1 HR      IV TX INIT 1 HR                 $394.00
 4610781   IV INF TX EA ADD HR        IV INF TX AD HR                  $50.00
 4610782   INJ TX/PROPH/DX SQ/IM      INJ T/P/D SQ/IM                 $252.00
 4610783   INJ TX/PROPH/DX ART        INJ T/P/D ART                   $252.00
 4610784   INJ TX/PROPH/DX IVP        INJ T/P/D IVP                   $252.00
 4611090   PACEMAKER INSERT FL&RAD    PACEMAKER INSRT                 $658.00
 4611110   CARDIOVERSION ELEC         CARDIOVRSN ELEC               $4,594.00
 4611115   TRANSESOPHAGEAL ECHO       ESOPHAGEAL ECHO               $6,210.00
 4611132   TILT TABLE EVAL            EVAL TILT TABLE              $10,358.00
 4612000   CORONARY ROTABLATOR        ROTABLT CORONRY              $28,054.00
 4612005   ARTERIAL CATH MONIT/SAMP   ART CATH MONITR               $1,450.00



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  Doctors Medical Center - Modesto                                         Page 18 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 4612020   PERC CATH INTRVASC STENT   STENT PERIPH                  $2,092.00
 4612021   TRNSCTH PERIPHERAL STENT   PERIPH STENT                 $13,179.00
 4612500   REM PCMKR TRAN ELCT DUAL   REM PM TR EL DL              $10,358.00
 4612503   REM PCMKR PULS GEN ONLY    REM PM PULS GEN              $10,358.00
 4612505   INS/RPL DUAL CHMBR GENER   INS/REP PM DUAL              $10,358.00
 4612507   INSRT TRAN ELCTRD DUAL     INS TR ELC DUAL              $10,358.00
 4612510   INSRT TRAN ELCTRD SNGL     INS TR ELC SNGL               $8,289.00
 4612515   REM TRANSV PM ELCTD SNGL   REM PM ELCTD                 $10,358.00
 4612920   IVUS CORONARY INIT VESSL   IVUS INIT VESSL               $5,969.00
 4612922   IVUS CORONARY EA ADD       IVUS EA ADD                   $2,988.00
 4612953   TEMP TRANSCUTNEOUS PACNG   TRANSCU PACING                $2,922.00
 4612973   PERC CORON THROMBECT       PRC CORON THRMB              $28,235.00
 4612975   COR THROMBLYS-INTRA COR    THROMB-INTR COR               $2,922.00
 4612977   COR THROMBLYS-VEN INFSN    THROMB-VENO COR               $2,922.00
 4612980   PTCA WITH ATRECTOMY SNGL   PTCA W/ATRECTMY               $5,969.00
 4612984   PTCA EA ADDL VSL           PTCA EA ADD VSL               $5,969.00
 4612985   PTCA EA ADDL VSL           PTCA EA ADD VSL               $7,635.00
 4613010   PERICARDIOCENTESIS INTL    PERICARDCENTES               $13,862.00
 4613160   P/M ANALY DUAL W/REPRG     P/M ANALY W/REP               $6,606.00
 4613161   SECOND CLOSE SURG WOUND    2ND CLOSE WOUND                 $250.00
 4613164   PM ANALYS SNGL WO REPRG    P/M ANALY SNGL                $6,006.00
 4613202   INSERT THORACOSTMY TUBE    INSRT CHST TUBE                 $700.00
 4613206   LEAD INSERT/PM PERM/ATR    LD INSRT/PM/ATR              $10,358.00
 4613207   LEAD INSERT/PM PERM/VENT   LD INSR/PM/VENT              $10,358.00
 4613208   LEAD INSERT/PM PERM/A-V    LD INSR/PM/A-V               $12,430.00
 4613211   INS/RPL TEMP LEADS DUAL    IMS/RPLC CMBR                 $9,159.00
 4613212   INS/RPL SNGL CHMBR GENER   INS/REP PLS GEN               $8,289.00
 4613214   UPGRADE TO DUAL CHAMBER    UPGR SNG/DLCHMB              $14,500.00 Minimum
 4613215   REPS TRNSV LD RT ATR/VNT   REPOS TRANSV LD               $3,878.88
 4613221   INSRT LD VEN LTVENT PREV   INSRT LD LTVENT               $3,500.00
 4613222   REVSN/RELOC PM SKN POCKT   REL/REV SKP PM               $14,500.00
 4613223   REVISION SKIN PKT AICD     REV SKN PK AICD              $14,500.00
 4613224   P/M AICD ELECT REPR DUAL   REPR ELECT DUAL               $3,500.00
 4613225   INSRT LD VEN LTVENT INIT   INSRT LD LTVENT               $4,500.00
 4613226   REPS PREV LD VEN LTVENT    REPOS LD LTVENT               $3,878.88
 4613240   INSERTION AICD PULS GEN    INS AICD GEN                 $10,358.00
 4613241   SUBCUT REM AICD PLS GEN    RMV AICD GEN                 $10,358.00
 4613243   REM AICD LDS TRANSVEN      REM AICD LDS TV              $10,358.00
 4613245   INS EPICRD LDS THORACTMY   INSRT AICD ELEC               $8,289.00
 4613246   INS EPICRD LDS&PG THRCTM   AICD INS W/GEN               $16,576.00
 4613248   INSRT/REPO AICD & LDS      INSRT AICD&LDS               $14,500.00
 4613249   INSRT/REPO AICD & LD       INS/REP AICD&LD              $14,500.00
 4613270   IMPL PT ACTIV CARD RCDR    IMPL CARD RCDR               $10,358.00
 4613272   REMV PT ACTIV CARD RCDR    REMV CARD RCDR               $10,358.00
 4613301   TRNSTHOR 2D ECHO CMPLETE   ECHO 2D COMP                  $1,911.00
 4613501   CATH RT HEART ONLY         CATH RT HEART                $14,001.00
 4613503   CATH RT-FLOW CATHETER      CATH RT HRT/FLO              $15,039.00
 4613505   ENDOMYOCARDIAL BIOPSY      BX ENDOCARDIAL               $10,358.00
 4613509   CATH PLCMNT COR ART        CATH PLCMNT COR              $13,978.00
 4613510   CATH LEFT HEART/RETROGRD   CATH LT HRT/RET              $15,278.00



  CDM Run Date: 06/01/2007
  Doctors Medical Center - Modesto                                        Page 19 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 4613511   CATH LT HEART BY CUTDOWN   CATH LT HRT/CTD              $16,779.00
 4613516   CATH LT HRT/TRSEPT&RETRO   CATH LT HRT/TRN              $22,588.00
 4613526   CATH RT HRT/LT HRT RETRO   CATH RT/LT RETR              $26,442.00
 4613527   CATH RT HRT/LT TRANSEPTL   CATH RT/LT TRNS              $28,235.00
 4613528   CATH RT HRT/LT VNTRPNCTR   CATH RT/LT VNPN              $20,721.00
 4613532   CATH RT&LT CNGTL ANOM IN   CATH RT&LT INTC              $28,235.00
 4613533   CATH RT&RTRO LT CNGTL AN   CATH RT&RTRO LT              $26,442.00
 4613534   CATH RT HRT CNGTL ANOM     CATH RT CNGTL                $14,001.00
 4613537   CATH RT HRT/CONG TRNS LT   CATH RT/LT TRNS              $28,235.00
 4613539   CATH INJ ART CONDUITS      CATH INJ ART CO               $2,995.00
 4613540   ANGIO ADD VESSEL COMP      ANGIO ADD VESSL               $1,919.00
 4613541   CATH INJ/PULMONARY ANGIO   CATH INJ/PULANG               $2,995.00
 4613542   CATH INJ/RT VENTR-ANGIO    CATH INJ/RTVNAN                 $658.00
 4613543   CATH INJ/LT VENTR-ANGIO    CATH INJ/LTVNAN                 $658.00
 4613544   CATH INJ/AORTOGRAPHY       CATH INJ/AORTGR                 $658.00
 4613545   CATH INJ/SEL CORO-ANGIO    CATH INJ/CORANG                 $642.00
 4613549   CATH RT-LT/CORO LT VENTR   CATH RT-LT/CORV              $19,337.00
 4613551   CATH ATRIAL PACING         CATH ATRIAL PAC               $3,342.00
 4613552   CATH POST ERGOTR STDY      CATH ERGOTR STD               $3,291.00
 4613553   CATH INTRA-ART MONITOR     CATH INTRART MN              $12,550.00
 4613562   IND DILUT CARDIAC OUTPUT   IND DL CARDOUTP                 $658.00
 4613585   COAGULATION TIME ACTIVTD   COAGULAT ACTIV                  $435.00
 4613588   CATH FLUOROSCOPY TIME      CATH FLURO TIME                 $658.00
 4613592   INSRT/REPL TEMP PM LEAD    INSRT TEMP PM                 $9,159.00
 4613598   PM ANALY DUAL WO REPROG    PM ANALYSIS                   $6,216.00
 4613600   HIS BUNDLE RECORDING       BUNDLE HIS REC               $12,731.00
 4613603   RT VENTRICULAR RECORDING   VENTRCLR REC RT              $12,731.00
 4613610   PTCA INITIAL VESSEL        PTCA                         $34,528.00
 4613612   INTRAVENTRICULAR PACING    INTRAVNT PACING               $3,342.00
 4613613   INTRCRD EP 3DMAP           INTRCRD 3D MAP               $10,808.00
 4613625   INTRA-ATRIAL RECORDING     INT-ATRL REC                 $12,731.00
 4613640   CATH INJ AORTCOR VEN BYP   CATH INJ AORTCO                 $658.00
 4613652   ABLATION-VENTRICULR TACH   ABLATN-VENTRCLR              $16,576.00
 4613656   IMAGE PULM ANG/AOR/COR     IMG ANG/AOR                     $708.00
 4613657   DOPP FLW/PR MSMNT INIT     FLW/MSMNT INIT                $5,969.00
 4613658   DOPP FLW/PR MSMNT ADDL     FLW/MSMNT ADDL                $2,988.00
 4613662   INTRACARD ECHO             INTRACARD ECHO                $5,969.00
 4613724   EVAL ANTITACH PACEMAKER    EVAL ANTITACH P                  $90.32
 4613779   CAROTID PTA PLCMNT         CAROTID PTA PL               $24,414.00
 4613797   CARIOPULMONARY RESUSC      CARDIO RESUSC                 $3,746.00
 4613969   IABP INSERT                IABP INSERT                   $9,159.00
 4613972   IABP MONITOR PER HOUR      MNTR IAB                        $365.00
 4614829   EVSC REP THOR ANEURYSM     RP THOR ANEURSM              $29,658.00
 4615528   IMGE VENT/ATRIAL ANGIOGR   IMAGE CARD CATH                 $708.00
 4615606   THORACIC W/SERL COMPLT     THORACIC W/SERL              $11,545.00
 4615627   ABD AORTOGRPHY BY SERIAL   ABD CATH W/SERL              $13,870.00
 4615631   ABD AORTA W/BI LWR EXT     ABD W/BI ILIFEM              $13,870.00
 4615651   CERVICOCEREBRL CATH COM    CRVICOCRBL CATH              $10,576.00
 4615661   ANGIO EXTRNL CAROTID UNI   EX CAROTD C UNI              $12,420.00
 4615663   ANGIO EXTRNL CAROTID BI    EX CAROTD C BI               $19,396.00



  CDM Run Date: 06/01/2007
  Doctors Medical Center - Modesto                                        Page 20 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 4615669   ANGIO CAROTID CEREB UNI    CAROTD CEREBRAL              $13,870.00
 4615673   ANGIO CAROTID CEREB BI     CAROTID CEREB B              $22,966.00
 4615678   ANGIO CAROTID CERV UNI     CAROTID CERV UN              $15,320.00
 4615682   ANGIO CAROTID CERV BILAT   CAROTID CERV BI              $19,396.00
 4615687   VERTEBRAL CATH COMPLETE    CATH VERTEBRAL                $9,603.00
 4615711   EXTREMITY UNI W/O SERL     EXTRM UNI WO SR              $13,775.00
 4615712   ANGIO EXTREMITY UNILAT     ANGIO EXT UNI                $13,775.00
 4615716   EXTREMITY BI W/O SERIAL    EXTRM BI WO SRL              $16,090.00
 4615718   ANGIO EXTREMITY BILAT      ANGIO EXT BI                 $16,090.00
 4615723   RENAL UNI SELCT W/FLUSH    RENL UNI W/FLUS                 $708.00
 4615725   RENAL BI SELECT W/FLUSH    RENL BI W/FLUS                  $708.00
 4615727   VISCERAL SELECT/SUPRA      VISCRL SEL/SUP                $7,852.00
 4615732   ANGIO ADRENAL UNILAT SEL   ADRENL SEL UNI                $4,828.00
 4615737   ANGIO PELVIC SELECT/SUP    PELVIC SEL/SUP                $7,852.00
 4615742   PULMONARY UNI SELECTIVE    PULM UNI SELECT               $6,441.00
 4615744   PULMONARY BI SELECTIVE     PULM BI SELECT                $8,096.00
 4615747   ANGIO PULM NON-SEL CATH    PULM CATH NON-S               $8,096.00
 4615757   ANGIO INTERNAL MAMMARY     MAMMARY INTERNL               $1,545.00
 4615790   ANGIO A/V DIALYSIS SHUNT   A/V SHUNT                     $5,422.00
 4615821   VENOGRAM EXTREMITY UNI     VENGRM EXT UNI                $5,255.00
 4615823   VENOGRAM EXTREMITY BI      VENGRM EXT BI                 $8,104.00
 4615826   INFERIOR VENACAVAGRAM      INF VENACAVAGRM              $11,545.00
 4615828   SUPERIOR VENACAVAGRAM      SUP VENACAVAGRM              $11,545.00
 4615897   TRNSCTH INFUSION           TCATH TRPY INFU               $4,881.00
 4615898   ANGIO EXIST CATH P THRPY   ANG VIA EXT CTH               $7,249.00
 4615941   PERC PLACE IVC FILTER      PERC PLACE FLTR               $5,664.00
 4615944   US NON CORON PLCMNT INIT   US NON CORON PL               $5,969.00
 4615945   IVUS NON CORONARY INITL    IVUS INITL VESL                 $537.00
 4615946   IVUS NON CORON ADDL VESL   IVUS ADDL VESSL                 $537.00
 4615956   ENDO THOR AO RPR W0 SUBC   THOR AORTA RPR               $13,179.00
 4615961   PERC RETREIVAL FX CATH     PERC FRAC CATH               $10,358.00
 4615963   APLASTY PERIPHERAL ART     APLASTY PER ART              $13,709.00
 4615965   APLASTY ADD PERIPHRL ART   APLASTY EA+PERI               $8,673.00
 4615967   APLASTY VISCERL ART INIT   APLASTY VIS ART              $11,893.00
 4615969   APLASTY VISC ARTERY ADDL   APLASTY EA+VISC               $1,392.00
 4615977   ANGIOPLASTY VENOUS         APLASTY VENOUS                $4,776.00
 4615993   ATHRECTMY PERIPHL ADDL     ATHERCT PERI EA               $8,673.00
 4615994   ATHRECTMY RENAL            ATHERCT RENAL                 $2,092.00
 4615995   ATHRECTMY VISCRL INITL     ATHERCT VISCERL               $2,092.00
 4615996   ATHERCTMY VISCRL ADDL      ATHERCT VISC EA               $8,673.00
 4615997   FLUOROGUID FOR VEIN DVCE   FLUORO CVA DVCE                 $658.00
 4616003   FLUORO BX/ASP/INJ/GUIDE    FLUORO GUIDANCE               $1,159.00
 4616005   TRNSCTH EMBOLIZATN         TCATH TRPY EMBL               $6,712.00
 4616011   PLC CATH VEIN 1ST ORDR     PLC CATH VEIN                 $1,450.00
 4616013   PLC CATH RT HRT/PULM ART   PL CATH ARTR                  $1,450.00
 4616014   PLC CATH MN PULM ART       PL CATH MN ART                $1,450.00
 4616556   INSRT NONTUNNL CV CTH 5>   INSRT CV CATH                 $1,450.00
 4616558   INSRT TNL CV CTH>5WO PMP   INSRT CV CATH                 $8,289.00
 4616569   INSRT CV CATH NO PRT 5>    INSRT CV CATH                 $1,450.00
 4616589   REMV TUNL CVC WO PMP/PRT   REMV CV CATH                  $1,200.00



  CDM Run Date: 06/01/2007
  Doctors Medical Center - Modesto                                                  Page 21 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION    HOSPITAL CHARGE COMMENTS
 4617184   THROMB NONCOR INITL VSL    THROMBECTMY ART                 $28,235.00
 4617206   PERC CATH INTRV STNT ADD   TRANSCATH ADDL                   $2,092.00
 4617690   INJ VENOGRPHY EXTRMTY      INJ VENO EXTRM                   $5,783.00
 4617800   PLC CATH AORTA             PLC CATH AORT                    $1,450.00
 4617810   PLC CATH ART ABD ADD       PLC CATH ARTR                    $1,450.00
 4617815   PLC CATH ART ABD 1ST       PLC CATH ARTR                    $1,450.00
 4617820   PLC CATH ART ABD 2ND       PLC CATH ARTR                    $1,450.00
 4617825   PLC CATH ART ABD 3RD       PLC CATH ARTR                    $1,450.00
 4617830   PLC CATH ART ADD ORDR      PLC CATH ARTR                    $1,450.00
 4617835   PLC CATH ART 1ST ORDR      PLC CATH ARTR                    $1,450.00
 4617840   PLC CATH ART 2ND ORDR      PLC CATH ARTR                    $1,450.00
 4617845   PLC CATH ART 3RD ORDR      PLC CATH ARTR                    $1,450.00
 4617860   PLC CATH EXTRM ARTERY      PLC CATH ARTR                    $1,450.00
 4617870   PLC CATH VENACAVA          PLC CTH VENACAV                    $658.00
 4618007   PERC TRNSCTH RTRVL FB      RTRVL INTRV FB                   $2,092.00
 4618010   TRNSCTH OCCLUSION          TCATH OCCLS                      $2,092.00
 4618900   CONTINUOUS O2 MONITRING    MNTR CONT O                        $503.00
 4618904   SHEATH REMOVAL             REMV SHEATH                        $596.00
 4618908   O2 SAT RUNS                O2 SAT RUNS                        $529.00
 4618999   MISC EKG CARDIO LAB        EKG CARD MISC         $20,498.00-$29,000.00
 4619103   ANGIO STAT FEE             ANGIO STAT FEE                   $2,073.00
 4619105   CANCEL/INCOMPLETE STUDY    CANCEL/INC STDY                  $3,468.00
 4619130   CPR                        CPR                              $3,746.00
 4630000   4026 NON-INVASIVE VASC     NON-INVSV VASCL
 4633301   TRNSTHOR 2D ECHO CMPLETE   ECHO 2D COMP                    $1,911.00
 4633303   ECHOCARDIOGRAM/MMODE/LTD   ECHO M LTD                      $1,225.00
 4633304   ECHOCARD LTD CONG ANOMAL   ECHO LTD CON AN                   $921.00
 4633315   TEE CONGTL CARD ANOMALIE   TEE CONGTL CARD                 $6,210.00
 4633325   DOPPLER ECHO PULSE/CONT    DOPPLER ECHO                    $1,835.00
 4633328   CARDIAC DOPPLER FU/LTD     CARD DOPPLER FU                   $921.00
 4633350   ECHOCARDIOGRAM EX STRESS   ECHO EXER STRES                 $2,293.20
 4633400   TRANSESOPHAGEAL ECHO       ESOPHAGEAL ECHO                 $6,210.00
 4636020   CAROTID DOPPLER BILAT      CAROTID DOP BI                  $2,200.00
 4636026   CAROTID DOPPLER UNILAT     CAROTID DOP LTD                 $1,047.00
 4636050   DOPPLER ECHO COLOR FLOW    COLORFLOW ANALY                 $1,059.00
 4636606   ECHO TRANSTHORACIC COMP    ECHO TT COMP                    $1,835.00
 4700000   4120 EMG                   EMG
 4705860   EMG 1 EXTREMITY            ELECTMGRAPH 1EX                  $1,049.00
 4705861   EMG 2 EXTREMITY            ELECTMGRAPH 2EX                  $1,459.00
 4705900   NERVE CON VEL/LAT EACH     NRV COND VEL/EA                    $294.00
 4705904   NERVE COND SENS EA         NRV COND SENS                      $294.00
 4708999   MISC EMG                   MISC EMG                $294.00 - $1,459.00
 4800000   4130 NEUROPHYSIOLOGY EEG   NEUROPHYS EEG
 4801000   NEUROPHYS TST PER HR       NEUROPHYSIO TST                   $906.00
 4802587   AUDITORY EVOK POTENT COM   AUD EVK PTL COM                 $1,439.00
 4805740   EEG AWAKE/SLEEP W/PORT     EEG AWAKE/SLEEP                 $2,110.00
 4805817   EEG AWAKE/DROWSY           EEG AWAKE/DRWSY                 $1,266.00
 4805824   EEG CEREBRAL DEATH EVAL    EEG CEREB EVAL                  $2,110.00
 4805871   VISUAL EVOKED POTENTIAL    VIS EVKD POTNL                  $1,167.00
 4805916   EEG SURG 1ST HR            EEG SURG 1ST HR                 $1,439.00



  CDM Run Date: 06/01/2007
  Doctors Medical Center - Modesto                                             Page 22 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 4805917   EEG SURG PER HR            EEG SURG PER HR                 $1,439.00
 4805919   EVOKED POTNL SUR PER HR    EVP SURG PER HR                 $1,439.00
 4805960   EEG MONITORING 1> HR       EEG MON 1> HR                   $3,013.00
 4805999   MISC NEUROMUS PRO          MISC NEUROMUS          $906.00 - $2,110.00
 4806040   SOMATOSENSORY EP U/LIMB    SENSORY EPU/LMB                 $1,772.00
 4806042   SOMATOSENSORY EP L/LIMB    SENSORY EPL/LMB                 $1,772.00
 4808999   MISC EEG                   MISC EEG                        $1,015.00
 4900000   4140 RADIOLOGY-DIAGNOSTI   RAD DIAGNS (IP)
 4900030   EYE DETECTION OF FOR/BDY   EYE DTCT FRBDY                 $560.00
 4900100   MANDIBLE LTD/3VW MAX       MANDIBLE UNI                 $1,279.00
 4900110   MANDIBLE 4VW MIN           MANDIBLE CMPL                $1,850.00
 4900130   MASTOID BI 3VWS PR SIDE    MASTOIDS BILAT               $3,141.00
 4900140   FACIAL BONES 2VW MAX       FACL BONES LTD               $1,390.00
 4900150   FACIAL BONES 3VW MIN       FACL BONES COMP              $1,618.00
 4900160   NASAL BONES 3VW MIN        NASL BONES ONLY              $1,221.00
 4900190   OPTIC FORAMINA             OPTIC FORAMINA               $1,618.00
 4900210   SINUSES 2VW MAX            SINUSES LIMITED              $1,090.00
 4900220   SINUSES 3VW MIN            SINUSES COMPL                $1,842.00
 4900250   SKULL < 4 VIEWS            SKULL < 4 VIEWS              $1,198.00
 4900260   SKULL 4VW MIN              SKULL COMPLETE               $2,011.00
 4900320   TEETH COMPLETE EXAM        TEETH COMPLETE                 $683.00
 4900330   TM JOINTS BILATERAL        TM JOINTS BI                 $1,749.00
 4900360   NECK FOR SOFT TISSUES      NECK SOFT TISS               $1,016.00
 4900380   SALIVARY GLAND/CALCULUS    SALIVARY GLAND               $1,680.00
 4900390   SIALOGRAPHY                SIALOGRAPHY                  $2,286.00
 4900608   ASPIR/INJ INTERMED JOINT   ASP/INJ INT JNT                $661.00
 4900610   ASPIR/INJ MAJOR JOINT      ASP/INJ MJR JNT                $661.00
 4901005   CHEST PRE-EMPLMNT          CHEST PR-EMPLOY              $1,288.00
 4901010   CHEST 1 VIEW PA OR AP      CHEST SINGLE VW              $1,030.00
 4901012   CHEST LORDOTIC             CHEST LORDOTIC               $1,030.00
 4901014   CHEST POST BIOPSY          CHEST POST BIOP              No charge
 4901020   CHEST 2VW PA OR AP & LAT   CHEST TWO VIEW               $1,215.00
 4901021   CHEST 2 VIEWS W/LORDOTIC   CHEST W/LORDOTC              $1,390.00
 4901030   CHEST COMP 4 VW MIN        CHEST COMPLETE               $1,531.00
 4901034   CHEST COMPLETE W/FLUORO    CHEST COMP W/FL              $2,351.00
 4901101   RIBS UNI 3V MIN W/PA CXR   UNIRIBS W/PA CH              $1,390.00
 4901111   RIBS BI 4V MIN W/PA CXR    BI RIB W/PA CH               $1,636.00
 4901120   STERNUM 2VW MIN            STERNUM                      $1,198.00
 4901130   STERNCLAVR JNTS 3VW MIN    STERNOCLAVC JNT              $1,262.00
 4901140   TOMOGRAPHY CHEST 1 PLANE   TOMO CHST 1 PLN              $4,327.00
 4902020   SPINE ANY LEVEL SNGL VW    SPINE SNGL VIEW              $1,016.00
 4902040   SPINE CERVICAL 2 VIEWS     SPINE CERV 2VWS              $1,308.00
 4902042   SPINE CERVICAL 3 VIEWS     SPINE CERV 3VWS              $1,478.00
 4902050   SPINE CERVICAL 4VW MIN     SPINE CERV COMP              $2,011.00
 4902052   CERVCAL COMP W FLEX & EX   CERV W FLEX/EXT              $2,420.00
 4902069   SPINE THORACIC 1 VIEW      SPINE THORAC 1V              $1,078.00
 4902070   SPINE THORACIC 2 VIEWS     SPINE THOR 2VWS              $1,580.00
 4902071   SPINE THORACIC 3 VIEWS     SPINE THOR 3VWS              $1,558.00
 4902072   SPINE THORACIC 4VW MIN     SPINE THORC 4VW              $1,789.00
 4902080   SPINE THORACO-LUMBAR JCT   SPINE THOR/LUMB              $1,580.00



  CDM Run Date: 06/01/2007
  Doctors Medical Center - Modesto                                        Page 23 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 4902090   SPINE SCOLIOSIS STUDY      SCOLIOSIS STUDY               $1,188.00
 4902100   SPINE LUMBAR 2 VIEWS       SPINE LUMB 2VWS               $1,188.00
 4902101   SPINE LUMBAR 3 VIEWS       SPINE LUMB 3VWS               $1,580.00
 4902110   SPINE LUMBAR MIN 4VWS      SPINE L/S MIN4V               $2,400.00
 4902114   SPINE LUMBAR AP/LAT/BEND   SPINE L/S BEND                $2,924.00
 4902120   LUMB BENDNG VWS MIN 4VWS   SPINE BEND ONLY               $1,491.00
 4902135   SPINAL PUNCTURE THERAPTC   LUMBAR PUNCTURE                 $661.00
 4902170   PELVIS 1 VIEW              PELVIS 1 VIEW                   $992.00
 4902190   PELVIS MIN 3 VWS           PELVIS MIN 3VWS               $1,614.00
 4902202   SACROILIAC JOINTS 3 VWS    SACROILIAC JNTS               $1,593.00
 4902220   SACRUM COCCYX 2 VWS        SACRUM & COCCYX               $1,301.00
 4903000   CLAVICLE COMPLETE          CLAVICLE COMP                 $1,010.00
 4903010   SCAPULA COMPLETE           SCAPULA COMP                  $1,082.00
 4903020   SHOULDER SINGLE VIEW       SHOULDER 1 VW                   $991.00
 4903030   SHOULDER 2VWS MINIMUM      SHOULDER COMPLT               $1,166.00
 4903050   ACROMIOCLAVICULAR JTS BI   A/C JOINTS BI                 $1,262.00
 4903060   HUMERUS 2 VIEW MINIMUM     HUMERUS                         $990.00
 4903070   ELBOW 2 VIEWS              ELBOW 2 VIEWS                   $806.00
 4903080   ELBOW 3 VIEW MINIMUM       ELBOW COMPLETE                $1,082.00
 4903091   FOREARM 2 VIEWS            FOREARM 2 VWS                   $938.00
 4903092   UPPER EXTREMITY INFANT     UPPER EXT INFNT                 $159.65
 4903100   WRIST 2 VIEWS              WRIST 2 VWS                     $806.00
 4903110   WRIST 3 VIEWS MINIMUM      WRIST 3VWS                    $1,090.00
 4903120   HAND 2 VIEWS               HAND 2 VWS                      $725.00
 4903130   HAND 3 VIEWS MINUMUM       HAND 3 VWS                    $1,090.00
 4903140   FINGER(S) 2 VIEWS          FINGER(S) 2 VWS                 $835.00
 4903500   HIP UNI SINGLE VIEW        HIP UNI LIMITED               $1,090.00
 4903510   HIP UNI 2 VIEWS            HIP UNI 2 VWS                 $1,390.00
 4903520   HIP BI COMP(AP PELVIS)     HIP BI COMP                   $1,870.00
 4903530   HIP IMAGING OPERATVE PRO   HIP IMAGNG OR                 $3,343.00
 4903551   FEMUR 2 VIEWS              FEMUR 2 VWS                   $1,188.00
 4903560   KNEE 1-2 VIEWS             KNEE 1-2VWS                     $790.00
 4903561   KNEES/BILAT AP STANDING    KNEES BI STAND                  $987.00
 4903562   KNEE 3 VIEWS               KNEE 3 VW                       $988.00
 4903570   KNEE COMP 4 VW MIN         KNEE 4 VW MIN                 $1,188.00
 4903590   TIBIA/FIBULA 2 VIEWS       TIB/FIB 2 VWS                 $1,090.00
 4903591   LOWER EXT INFANT AP&LAT    LWR EXT INFANT                  $159.65
 4903600   ANKLE 2 VIEWS              ANKLE 2 VWS                     $790.00
 4903610   ANKLE 3 VIEWS MINIMUM      ANKLE 3 VWS MIN               $1,158.00
 4903620   FOOT 2 VIEWS               FOOT 2VWS                       $722.00
 4903630   FOOT 3 VIEWS MINIMUM       FOOT 3 VWS MIN                $1,082.00
 4903650   OS CALCIS 2 VIEWS          OS CALCIS 2VWS                  $698.00
 4903660   TOE(S) 2 VIEWS             TOE(S) 2 VWS                    $738.00
 4903670   SCANOGRAM LOWER EXTREMTY   SCANOGRAM                     $1,188.00
 4904000   ABDOMEN SINGLE VIEW(KUB)   ABDOMEN ONE VW                  $927.00
 4904010   ABDOMEN ADD OBLIQUE/CONE   ABDOMEN 2 VWS                 $1,226.00
 4904020   ABDOMEN W/DECUB OR ERECT   ABD APW/DCUB/UP               $1,729.00
 4904022   ABDOMEN ACUTE SERIES       ABD ACUTE COMP                $1,729.00
 4904068   JOINT 2 OR MORE SNGL VW    JNT 2 OR MORE                   $725.00
 4904220   ESOPHAGUS                  ESOPHAGUS                     $1,896.00



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  Doctors Medical Center - Modesto                                             Page 24 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 4904230   SWAL FUNC W CINE/VIDEO     SWALLOW FUNCTN                    $927.00
 4904243   UPPER GI W/KUB             UPPER GI W/KUB                  $2,860.00
 4904245   UPPER GI W/SMALL BOWEL     UPPER GI SMBOWL                 $3,462.00
 4904250   SMALL BOWEL                SMALL BOWEL                     $2,687.00
 4904251   ENTERCOLYSIS SM BOWEL      ENTERCOLYSIS                    $3,575.00
 4904270   COLON BARIUM ENEMA         COLON BE                        $2,367.00
 4904271   COLON HYPAQUE ENEMA        COLON HYPAQUE                   $2,882.00
 4904280   COLON BARIUM ENEMA W/AIR   COLON BE W/AIR                  $3,058.00
 4904290   CHOLECYSTROGRAPHY ORAL     CHOLECYSTO ORAL                 $1,550.00
 4904291   CHOLECYSTOGRAPHY REPEAT    CHOLECYS REPEAT                 $1,172.00
 4904300   CHOLANGIOGRPHY OPERATVE    CHOLANGIO OPER                  $3,626.00
 4904305   CHOLANGIOGRPHY EXST CATH   CHOLNG EXST CTH                 $2,578.00
 4904310   CHOLANGIO PERC TRANSHEP    CHOLANG TRANSH                  $4,145.00
 4904340   GI TUBE LOCAL &/OR MANIP   GI TUBE LOCALZT                 $1,003.00
 4904350   PERC PLACE GASTROSTOMY     PERC PL GASTRTB                 $3,575.00
 4904361   INTRALUMINL DILATN ESOPH   DIL STRICT/OBST                   $661.00
 4904400   UROGRAPHY EXCRETORY(IVP)   UROGRAM IVP                     $2,950.00
 4904402   UROGRAM INFUSION           UROGRAM INFUSN                  $4,145.00
 4904415   IVP WITH RENAL TOMOS       IVP WITH TOMOS                  $4,116.00
 4904420   PYELOGRAPHY RETROGRADE     PYELOGRAM RETRO                 $2,367.00
 4904425   ANTEGRADE NEPHROSTOGRAM    ANTE NEPHRSTGRM                 $2,198.00
 4904430   CYSTOGRAPHY CNTRST/CHN     CYSTOGRAM                       $1,925.00
 4904450   URETHROCYSTOGRAPHY RETR    URETHROGRM RETR                 $1,367.00
 4904455   URETHROCYSTOGRAPHY VOID    URETHROGRM VOID                 $2,280.00
 4904710   PELVIMETRY                 PELVIMETRY                      $2,103.00
 4904740   HYSTEROSALPINGOGRAPHY      HYSTEROSALPNGDG                 $2,618.00
 4905998   FLUOROSCOPY <1HOUR         FLUOR (<) 1HR                     $927.00
 4906010   FLUORO BX/ASP/INJ/GUIDE    FLUORO GUIDANCE                 $1,159.00
 4906011   FLUORO GUIDE SPINE INJ     FLUOR SPINE INJ                 $1,159.00
 4906020   BONE AGE STUDIES           BN AGE STUDIES                  $1,455.00
 4906040   BONE LENGTH STUDIES        BONE LGTH STUDY                 $2,412.00
 4906060   BONE SURVEY LIMITED        BONE SURVEY                     $3,216.00
 4906065   BONE SURVEY INFANT         BONE SURV INFNT                 $1,926.00
 4906082   FISTULA-SINUS TRCT STDY    FISTL/SINUS TRC                 $2,370.00
 4906095   SURGICAL SPECIMEN          SURGICL SPECIMN                 $1,238.00
 4906100   TOMOGRAPHY SNGL PLANE      TOMO SNGL PLN                   $2,974.00
 4906140   WRITTEN CONSULTATION       WRITTEN CONSULT                 $1,262.00
 4906499   MISC XRAY PROCEDURE        MISC XRAY PROC         $159.65 - $4,327.00
 4910000   4152 RADIOLOGY-INTERVENT   RAD INTRVNTNL
 4910100   UNLISTED PROC SPINE        UNLSTD PRO SPNE              $1,450.00
 4910142   PERC ATHRECTMY AORTA       ATHERCT AORTA                $7,645.00
 4910159   THROMBECTOMY AV FISTULA    THROMB A/V FIST              $3,905.00
 4910161   PERC ATHRECTMY TIBIOPER    ATHERCT TIBIOP               $7,645.00
 4910269   PLC VASC CLSURE DEVICE     PLC CLOSE DEVC                 $402.00
 4910391   INSTL TX AGNT RENL/URETR   TX AGNT RENAL                  $661.00
 4910393   APLSTY AV FISTGRFT ARTER   APLSTY AV ART                $2,092.00
 4910394   APLSTY AV FISTGRFT VENOU   APLSTY AV VEN                $2,092.00
 4910404   INJ EDIDURAL LUMB/CAUD     INJ LMB/CD SNGL              $1,047.00
 4911040   BRONCHOGRAPHY UNILATERAL   BRONCHOGRPH UNI              $2,157.00
 4911631   BRONCH W/DIL STNT PLCMNT   BRONCH W/DIL                 $2,092.00



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  Doctors Medical Center - Modesto                                        Page 25 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 4912019   INSRT TUNLD PLEURAL CATH   INSRT PLEURL CT                 $700.00
 4912240   MYELOGRAM CERVICAL         MYELOGRAM CERV                $5,376.00
 4912250   MYELOGRAM LUMBAR           MYELOGRAM LUMB                $5,054.00
 4912260   MYELOGRAM THORACIC         MYELOGRAM THORC               $5,054.00
 4912271   MYELOGRAM 2 OR > REGIONS   MYELO 2/> REGNS               $7,804.00
 4912272   SPINAL PUNCTURE THERAPTC   LUMBAR PUNCTURE                 $528.00
 4912285   DISCOGRAPHY CERV/THOR      DISC CERV/THOR                $5,109.00
 4912290   DISCOGRAPHY LUMBAR         DISC LUMBAR                   $5,388.00
 4912291   DISCOGRAPHY LUMB ADD LV    DISC LUMB AD LV               $5,262.00
 4912300   CERV/THORAC FACET BLOCK    CRVL/THORC FACE               $2,193.00
 4912302   CERV/THORAC FACET ADDL     CRVL/THORC ADDL               $1,672.00
 4913040   SHOULDER ARTHROGRAPHY      SHOULDER ARTHRG               $2,844.00
 4913085   ELBOW ARTHROGRAPHY         ELBOW ARTHRG                  $2,844.00
 4913115   WRIST ARTHROGRAPHY         WRIST ARTHRG                  $2,844.00
 4913525   HIP ARTHROGRAPHY           HIP ARTHRG                    $3,302.00
 4913580   KNEE ARTHROGRAPHY          KNEE ARTHRG                   $3,302.00
 4913615   ANKLE ARTHROGRAPHY         ANKLE ARTHRG                  $4,128.00
 4913760   CHANGE GASTROSTOMY TUBE    CHG GASTRO TUBE                 $700.00
 4913779   UNLST PROC VASCULAR        UNLST PROC VASC                  $46.68
 4914100   THROMB NONCOR INITL VSL    THROMBECTMY ART               $7,109.00
 4914101   THROMB NONCOR ADD VESSLS   THROMB ADD ART                $3,554.50
 4914102   THROMB NONCOR SECONDARY    THROM NONCOR AR               $3,554.50
 4914104   PERC MECH THROMBECTMY VN   THROMBECTMY VN                $7,109.00
 4914106   MECH THRMBCTMY VN RPEAT    THRMBCTMY VEIN                $3,554.50
 4914200   ERCP BILIARY&PANCREATIC    ERCP                          $3,682.00
 4914238   REMVE RENL TUBE W/FLUORO   REMVE RENL TUBE               $1,159.00
 4914240   REPOSITN CV CATH W/FLURO   REPS CVCATH W/F               $1,200.00
 4914244   VERTPLSTY KYPHOPL FLUORO   VERT/KYPH FLORO               $4,650.00
 4914320   CHOLANGIO PERC TRANSHEP    CHOLANG TRANSH                $3,570.00
 4914328   PERC POSTOP BIL CALC REM   BILIARY STN REM                 $503.00
 4914363   BILIARY DIL W/WO STENT     BILIARY DUCT DL               $3,342.00
 4914470   TRANSLUMBAR RENAL CYST     TRANSLM RENL CY               $4,181.00
 4914476   RENAL PELVIS INTRACATH     RENL PELV ICATH               $4,181.00
 4914477   PERCUTANEOUS NEPHROSTOMY   PERC NEPHROSTMY               $3,621.00
 4914478   PERC VERTPLSTY 1 BDY T     VRTPLSTY 1BDY T               $1,160.00
 4914479   PERC VERTPLSTY 1 BDY L     VRTPLSTY 1BDY L               $1,160.00
 4914480   PERC VERTPLSTY EA ADD BD   VRTPLS E AD BDY               $1,160.00
 4914481   URETERAL CATH OR STENT     URETERAL STENT                $3,345.00
 4914486   DILAT NEPHRO/URETR/URETH   DIL NEPHRO/URET               $3,342.00
 4915490   PERC ATHRECTMY RENL/VISC   ATHERCT REN/VSC               $7,645.00
 4915492   PERC ATHRECTMY ILIAC       ATHERCT ILIAC                 $7,645.00
 4915493   PERC ARTHRECTMY FEM/POP    ATHERCT FEM/POP               $7,645.00
 4915494   PERC ATHRECTMY BRACHCEPH   ATHERCT BRACHCP               $7,645.00
 4915606   THORACIC W/SERL COMPLT     THORACIC W/SERL               $9,236.00
 4915627   ABD AORTOGRPHY BY SERIAL   ABD CATH W/SERL              $11,096.00
 4915631   ABD AORTA W/BI LWR EXT     ABD W/BI ILIFEM              $11,096.00
 4915651   CERVICOCEREBRL CATH COM    CRVICOCRBL CATH               $8,461.00
 4915661   ANGIO EXTRNL CAROTID UNI   EX CAROTD C UNI               $9,936.00
 4915663   ANGIO EXTRNL CAROTID BI    EX CAROTD C BI               $15,517.00
 4915669   ANGIO CAROTID CEREB UNI    CAROTID CEREBRA              $11,096.00



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  Doctors Medical Center - Modesto                                        Page 26 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 4915673   ANGIO CAROTID CEREB BI     CAROTD CEREB BI              $18,373.00
 4915678   ANGIO CAROTID CERV UNI     CAROTD CERV UNI              $12,256.00
 4915682   ANGIO CAROTID CERV BILAT   CAROTD CERV BI               $19,396.00
 4915687   VERTEBRAL CATH COMPLETE    VERTEBRAL CATH                $7,682.00
 4915712   ANGIO EXTREMITY UNILAT     ANGIO EXT UNI                 $9,860.00
 4915718   ANGIO EXTREMITY BILAT      ANGIO EXT BI                 $11,712.00
 4915723   RENAL UNI SELCT W/FLUSH    RENL UNI W/FLUS               $8,142.00
 4915725   RENAL BI SELECT W/FLUSH    RENL BI W/FLUS                $9,456.00
 4915727   VISCERAL SELECTIVE COMP    VISCERAL SELECT               $6,282.00
 4915732   ANGIO ADRENAL UNILAT SEL   ADRENL SEL UNI                $4,828.00
 4915737   ANGIO PELVIC SELECT/SUP    PELVIC SEL/SUP                $6,282.00
 4915742   PULMONARY UNI SELECTIVE    PULM UNI SELECT               $5,153.00
 4915744   PULMONARY BI SELECTIVE     PULM BI SELECT                $6,477.00
 4915747   ANGIO PULM NON-SEL CATH    PULM CATH NON-S               $8,096.00
 4915775   ANGIO ADD VESSL SELECTVE   ANGIO ADD VESSL               $3,127.00
 4915790   ANGIO A/V DIALYSIS SHUNT   A/V SHUNT                     $4,338.00
 4915802   LYMPHNGIO UNI EXT ONLY     LYMPHNG UNI EXT              $10,502.00
 4915804   LYMPHNGIO BI EXT ONLY      LYMPHNG BI EXT                $5,569.00
 4915806   LYMPHNGIO UN PELVIC/ABD    LYMPHN U PEL/AB               $3,533.00
 4915808   LYMPHNGIO BI PELVIC/ABD    LYMPHN B PEL/AB               $5,569.00
 4915809   SHUNTOGRAM PREV NONVASC    SHUNTOGRAM                    $3,414.00
 4915823   VENOGRAM EXTREMITY BI      VENGRM EXT BI                 $6,483.00
 4915826   INFERIOR VENACAVAGRAM      INF VENACAVAGRM               $9,236.00
 4915828   SUPERIOR VENACAVAGRAM      SUP VENACAVAGRM               $9,236.00
 4915832   VENOGRAPHY RENAL UNILAT    VENOGPHY RENL U               $5,674.00
 4915834   VENOGRAPHY RENAL BILAT     VENOGPHY RENL B               $7,208.00
 4915861   VENOGRM VNUS SINUS/JUGUL   VNOGRM SNUS/JUG              $12,467.00
 4915873   VENOGRAPHY EPIDURAL        VENOGPHY EPIDRL              $10,466.00
 4915890   HEPATIC VENGRPHY W/EVAL    HEP VENGPHY W/E               $8,777.00
 4915892   HEPATIC VENGPHY WO/EVAL    HEP VENGPHY WO/               $8,777.00
 4915893   VENOUS SAMPLING VIA CATH   VEN SAMPL CATH                $4,881.00
 4915897   TRNSCTH INFUSION           TCATH TRPY INFU               $4,881.00
 4915898   ANGIO EXIST CATH P THRPY   ANG VIA EXT CTH               $7,249.00
 4915901   REM PERICTH OBST CV CATH   REM OBST CV CTH                 $588.20
 4915941   PERC PLACE IVC FILTER      PERC PLACE FLTR               $4,531.00
 4915951   INTRVASC OCC TEMP W/ANG    INVAS OC TEMP W               $7,749.00
 4915956   INTRVASC OCC PERM W/ANG    INVAS OC PERM W               $6,712.00
 4915960   TRNSCTH PERIPHERAL STENT   PERIPH STENT                  $2,157.00
 4915961   PERC RETREIVAL FX CATH     PERC FRAC CATH                $5,427.00
 4915963   APLASTY PERIPHERAL ART     APLASTY PER ART              $13,021.00
 4915965   APLASTY ADD PERIPHRL ART   APLASTY EA+PERI               $2,092.00
 4915967   APLASTY VISCERL ART INIT   APLASTY VIS ART               $9,514.00
 4915969   APLASTY VISC ARTERY ADDL   APLASTY EA+VISC               $1,392.00
 4915970   EXTREMITY(VENOGRPHY) UN    EXTRMTY(VENO)UN               $4,204.00
 4915979   ANGIOPLASTY VENOUS         APLASTY VENOUS                $3,821.00
 4915981   PERC THEPATIC BIL DRAIN    PERC BILIAR DRN               $3,136.00
 4915983   PERC PLACE DRN CATH/ST     PERC PLACE DRN                $4,177.00
 4915985   CHANGE PERC DRAIN CATH     CHNG PERC D CTH               $1,596.00
 4915990   PERC DRN ABSC W/CATH       DRN ABSC W/CATH                 $588.20
 4915992   ATHRECTMY PERIPHL INITL    ATHERCT PERIPH               $11,893.00



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  Doctors Medical Center - Modesto                                        Page 27 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 4915993   ATHERCTMY PERIPHL ADDL     ATHERCT PERI EA               $8,673.00
 4915994   ATHRECTMY RENAL            ATHERCT RENAL                 $2,092.00
 4915995   ATHRECTMY VISCRL INITL     ATHERCT VISCRL                $2,092.00
 4915996   ATHRECTMY VISCRL ADDL      ATHERCT VISC EA               $8,673.00
 4915997   FLUOROGUID FOR VEIN DVCE   FLUORO CVA DVCE                 $927.00
 4916002   INJ PERC EXT PSEUDANYSM    INJ PSEUDOANYSM               $1,837.00
 4916005   INJ VENOGRPHY EXTRMTY      INJ VENO EXTRM                  $422.00
 4916011   FLUORO GUIDE SPINE INJ     FLUOR SPINE INJ                 $927.00
 4916170   SUBTRACTION STUDY          SUBTRACTN STDY                  $352.00
 4916536   REM PERICTH OBST CV CATH   REM OBST CV CTH               $1,000.00
 4916556   INSRT NONTUNNL CV CTH 5>   INSRT CV CATH                 $1,450.00
 4916558   INSRT TNL CV CTH5>WO PMP   INSRT CV CATH                 $6,600.00
 4916561   INSRT TUNNL VAD 5>W PORT   INSRT CV CATH                 $8,450.00
 4916566   INSR TNL VAD 2STS W PRT    INSRT CVA DVICE               $9,350.00
 4916569   INSRT CV CATH NO PRT 5>    INSRT CV CATH                 $1,450.00
 4916575   REPAIR CV CATH WO SQ PMP   REPAIR CV CATH                $1,300.00
 4916576   REPAIR CVAD W SQ PUMP      REPR CVA DVICE                $2,900.00
 4916578   REPLCE CATH ONLY CVAD      REPLC CVAD CATH               $6,450.00
 4916580   REPLCE NON-TUNNL CV CATH   REPLC CV CATH                 $1,200.00
 4916581   REPLACE TUNNELED CV CATH   REPLC CV CATH                 $1,450.00
 4916582   RPLC TUNNL CVAD W PORT     REPLC CVA DVICE               $8,450.00
 4916589   REMV TUNL CVC WO PMP/PRT   REMV CV CATH                  $1,200.00
 4916590   RMV TUNLD CVAD W SQ PORT   REMV CVA DVICE                $1,159.00
 4917096   INJECT PROC SACRO JNT      INJ SACRO JNT                   $528.00
 4917140   ANASTOMOSIS PORTOCAVAL     TIPS INJ PROCED               $5,050.00
 4917182   TRNSVN INTRHEP PORT SHNT   PORTOSYST SHUNT               $7,500.00
 4917183   REVSN INTRHEP PORTO SHNT   REVS PORTO SHNT               $5,025.00
 4917205   PERC CATH INTRVASC STENT   STENT PERIPH                  $2,092.00
 4917206   PERC CATH INTRV STNT ADD   TCATH STENT ADD               $2,092.00
 4917210   PERC UTERINE FIBR EMBL     PERC UT FIB EMB              $25,305.00
 4917215   PLC CERV CAROTD W/PRD      PL STNT CAROTID              $11,893.00
 4917216   PL ST CERV CAROTD WO/PRD   PL STNT CAROTID              $11,893.00
 4917510   BX LUNG/MEDIAST PERC NDL   BX LUNG/MEDIAST                 $700.00
 4917515   CHANGE BILIARY DRAIN CTH   CHNG BIL CATH                   $700.00
 4917520   CHANGE NEPHROSTOMY TUBE    CHNG NEPHR TUBE                 $700.00
 4917525   CHANGE URETEROSTOMY TUBE   CHNG URETR TUBE               $1,114.00
 4917526   CHANGE URETER STENT PERC   CHANGE URETR ST               $1,840.00
 4917528   REMOVE URETER STENT PERC   REMOVE URETR ST               $1,159.00
 4917530   CHNG EXT/INT URETR STENT   CHNG URETR STNT               $1,840.00
 4917565   DILATE ESOPH FLUORO<30MM   DILATE ESOP FLR                 $700.00
 4917585   ASP/INJ RENL CYST/PELVIS   ASP RENAL CYST                  $700.00
 4917586   DRAIN PERITONEAL ABSCESS   ABSC DRN PERIT                  $700.00
 4917595   EST NEPH TRACT TO KIDNEY   EST KIDNY TRACT                 $700.00
 4917596   EXCH INTRAVASCULR TX CTH   EXCH VASC CATH                  $465.00
 4917600   PERC CHOLECYSTOSTOMY       PERC CHOLECYSTM                 $700.00
 4917605   INJ ANKLE ARTHROGRAM       INJ ANKLE ARTHG                 $528.00
 4917615   INJ F/CYSTO OR VCUG        INJ CYSTO/VCUG                  $422.00
 4917620   INJECT BLADDER RETRO UR    INJ BLADDR RETR                 $528.00
 4917625   INJ PROC SP/POST FOSSA     INJ PROC SP/PST                 $700.00
 4917645   INJ ELBOW ARTHROGRAM       INJ ELBOW ARTHG                 $528.00



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  Doctors Medical Center - Modesto                                        Page 28 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 4917650   INJ HIP ARTHROGRAM         INJ HIP ARTHRG                  $580.00
 4917665   INJ NEPHROSTOGRAM          INJ NEPHRSTGRM                  $529.00
 4917670   INJ KNEE ARTHROGRAM        INJ KNEE ARTHRG                 $528.00
 4917675   INJ PERC TRANSHEP CHOLE    INJ PERC TRNSHE                 $528.00
 4917685   INJECT MYELOGRAM           INJ MYELOGRAM                   $528.00
 4917695   INJ FOR SIALOGRAPHY        INJ SALIVARY                    $528.00
 4917700   INJ SHOULDER ARTH/CT/MRI   INJ SHLDER ARTH                 $528.00
 4917705   INJ SINUS TRACT DIAGNSTC   INJ SINUS TRACT                 $528.00
 4917715   INJECT SPINE DISK LMBR     INJ SPINE DISK                  $528.00
 4917735   INJ URETER/ILEAL CONDUIT   INJ URETER/IL C                 $528.00
 4917740   INJ&CATH HYSTRO/SONOHYST   INJ UTER/TB XRY                 $528.00
 4917745   INJ WRIST ARTHROGRAM       INJ WRIST ARTHG                 $528.00
 4917755   PL STNT INT/EXT BILE DRN   INSRT BILE DRN                $1,946.00
 4917760   INSRT BILIARY DRAIN CATH   INSRT CATH BILI               $1,392.00
 4917765   INSERT CATH PERC VEIN      INSRT CATH VEIN                 $528.00
 4917770   PERC DRN/INJ RENL PELV     PERC KIDNY DRN                  $700.00
 4917772   INSERT THORACOSTMY TUBE    INSRT CHST TUBE                 $700.00
 4917775   INSERT URETERAL TUBE       INSRT URETR TUB                 $528.00
 4917785   MEASURE KIDNEY PRESSURE    MEASR KIDNY PR                  $528.00
 4917786   INTRAVASC TX CATH CHANGE   EXCH VASC CATH                  $588.00
 4917790   OCCLSN/EMBL CATH NON-CNS   OCCLSN/EMBL CTH               $4,881.00
 4917795   OCCLSN/EMBL CATH CNS       OCCLSN/EMBL CTH               $4,881.00
 4917800   PLC CATH AORTA             PLC CATH AORT                 $1,307.00
 4917810   PLC CATH ART ABD ADD       PLC CATH ARTR                 $1,450.00
 4917815   PLC CATH ART ABD 1ST       PLC CATH ARTR                 $1,420.00
 4917820   PLC CATH ART ABD 2ND       PLC CATH ARTR                 $1,450.00
 4917825   PLC CATH ART ABD 3RD       PLC CATH ARTR                 $1,450.00
 4917830   PLC CATH ART ADD ORDR      PLC CATH ARTR                 $1,450.00
 4917835   PLC CATH ART 1ST ORDR      PLC CATH ARTR                 $1,345.00
 4917840   PLC CATH ART 2ND ORDR      PLC CATH ARTR                 $1,450.00
 4917845   PLC CATH ART 3RD ORDR      PLC CATH ARTR                 $1,450.00
 4917850   PLC CATH RT HRT/PULM ART   PLC CATH ARTR                 $1,160.00
 4917855   PLC CATH BRACH ARTERY      PLC CATH ARTR                 $1,160.00
 4917860   PLC CATH CAR/VERT ART      PLC CATH ARTR                 $1,450.00
 4917865   PLC CATH EXTRM ARTERY      PLC CATH ARTR                 $1,186.00
 4917870   PLC CATH VENACAVA          CATH VENACAVA                 $1,179.00
 4917875   PLC CATH ART 1ST ORD       PLC CATH 1ART                 $1,450.00
 4917880   PLC CATH AV SHUNT          PLC CATH SHUNT                $1,160.00
 4917885   PLC CATH VEIN 1ST ORDR     PLC CATH VEIN                 $1,160.00
 4917890   PLC CATH VEIN 2ND ORDR     PLC CATH VEIN                 $1,390.00
 4917900   PLC GASTROSTMY TUBE        PLC GAST TUBE                   $700.00
 4917905   PLC NEEDLE IN VEIN         PLC NEEDLE VN                   $528.00
 4917955   PERC ANGIOPLSTY BRACHCEP   ANGIO BRACHCP                 $2,092.00
 4917960   PERC ANGIOPLASTY FEM-POP   ANGIO FEM-POP                 $2,092.00
 4917965   PERC ANGIOPLASTY ILIAC     ANGIO ILIAC                   $2,092.00
 4917970   PERC ANGIOPLSTY TIBIOPER   ANGIO TIBIOPER                $2,092.00
 4917975   PERC ANGIOPLASTY VENOUS    ANGIO VENOUS                  $2,092.00
 4917980   PERC ANGIPLSTY RENL/VISC   ANGIO RENL/VISC               $2,092.00
 4917990   PLC VENA CAVA FILTER       PLC IVC FILTR                 $2,092.00
 4917991   VENOUS CATH SAMPLING       SAMPL VEN CATH                $2,092.00



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  Doctors Medical Center - Modesto                                             Page 29 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 4917995   TRNSCTH TX NOT THROMBO     TCATH THRPY                   $2,092.00
 4918000   TRNSCTH THRPY NON-CORO     TCATH THRPY                   $1,392.00
 4918005   TRNSCTH BIOPSY             TCATH BX                      $1,392.00
 4918007   PERC TRNSCTH RTRVL FB      RTRVL INTRV FB                $2,026.00
 4918010   TRNSCTH OCCLUSION          TCATH OCCLS                   $2,092.00
 4918015   TUBE JEJUNOSTOMY           TUBE JEJUNOSTMY                 $700.00
 4918200   BILIARY DUCT STONE EXTR    BIL STONE EXTRC               $1,450.00
 4918205   BILIARY ENDO DIL WO STNT   BIL ENDO DILATN               $1,450.00
 4918210   BILIARY ENDO DIL W/STENT   BIL ENDO DIL ST               $1,450.00
 4918225   PLC CATH LT/RT ARTERY      PLC CATH ARTR                 $1,309.00
 4918230   PLC CATH SEGMNTL ARTR      PLC CATH ARTR                 $1,390.00
 4918900   SPINAL PUNCTR LUMB DIAG    LUMBAR PUNCTURE                 $838.00
 4918905   INJ CHOLE THRU EXST CATH   INJ CHOLE                       $528.00
 4918999   MISC RADIOLOGY DIAGNOSTC   MISC RAD DX                     $528.00
 4919427   INJ EVAL PREV PV SHUNT     INJ SHUNT EXIST                 $604.00
 4919718   KYPHOPLSTY 1 BDY THORCIC   KYPHOPLSTY T SP               $1,450.00
 4919719   KYPHOPLSTY EA ADD T OR L   KYPHOPLSTY ADD                $1,450.00
 4919720   KYPHOPLSTY 1 BODY LUMBAR   KYPHOPLSTY LUMB               $1,450.00
 4940000   4140 RADIOLOGY DIAG ER     RAD DIAGNSTC ER
 5040000   4145 OUTPATIENT CT SCAN    OP CT SCAN
 5050000   4145 C-T SCANNER           CT SCANNER(IP)
 5050022   FNA W GUIDANCE             FNA W GUIDANCE                 $308.00
 5050042   CT CEREBRAL PERF W CONT    CT CEREBRL PERF              $5,699.00
 5050066   CT COLONOSCOPY SCREENING   CT COLONOSCOPY                 $300.00
 5050067   CT COLONOSCOPY DIAGNOSTC   CT COLONOSCOPY               $7,088.00
 5050200   CT SINUS WITH CONTRAST     CT SINUS W/CM                $2,444.00
 5050202   CT SINUS W/O CONTRAST      CT SINUS W/O CM              $2,303.00
 5050450   CT HEAD/BRAIN WO CONTRST   CT HD/BRN WO CM              $5,279.00
 5050460   CT HEAD/BRAIN W CONTRAST   CT HD/BRN W/CM               $5,669.00
 5050461   CTA CHEST (NONCOR) WO/W    CTA CHST WO/W                $7,088.00
 5050470   CT HEAD/BRAIN WO/W CONTR   CT HD/BRN WO/W               $6,286.00
 5050480   CT ORBIT W/O CM            CT ORBIT W/O CM              $1,975.00
 5050481   CT ORBIT W/CM              CT ORBIT W/CM                $2,303.00
 5050482   CT ORBIT WO/W CM           CT ORBT WO/W CM              $4,966.00
 5050486   CT MAXILLOFACIAL W/O CM    CT FACIAL WO CM              $1,975.00
 5050487   CT MAXILLOFACIAL W/CM      CT FACIAL W/CM               $2,303.00
 5050488   CT MAXILLOFACIAL WO/W CM   CT FACIAL WO/W               $2,775.00
 5050496   CTA ABD LE RO WO/W CONT    CTA ABD LE RO               $13,946.00
 5050498   CTA ABDOMEN WO/W CM        CTA ABD WO/W CM              $7,088.00
 5050500   CTA HEAD WO/W CONTRAST     CTA HEAD WO/W                $5,669.00
 5050502   CTA NECK WO/W CONTRAST     CTA NK WO/W                  $7,603.00
 5050504   CTA PELVIS WO/W CONTRAST   CTA PELVIS WO/W              $6,858.00
 5050508   CTA UP EXTREMITY WO/W CM   CTA UE WO/W CM               $3,082.00
 5050510   CTA LOWR EXTRMTY WO/W CM   CTA LE WO/W CM               $3,082.00
 5050520   CT ORB/EAR/FOSSA W/O CM    CT ORB/EAR/PFOS              $5,730.00
 5050592   PERC RF ABLATE RENL TUMO   ABLAT RENL TUMR                $659.00
 5050610   ASPIR/INJ MAJOR JOINT      ASP/INJ MJR JNT                $661.00
 5050780   CT EAR W/O CM              CT EAR W/O CM                $5,730.00
 5051250   CT THORAX W/O CONTRAST     CT THORAX WO CM              $5,717.00
 5051260   CT THORAX WITH CONTRAST    CT THORAX W/CM               $7,088.00



  CDM Run Date: 06/01/2007
  Doctors Medical Center - Modesto                                             Page 30 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 5051270   CT THORAX WO/W CONTRAST    CT THORAX WO/W                  $7,432.00
 5052125   CT SPINE CERVICAL W/O CM   CT SP CERV W/O                  $5,717.00
 5052126   CT SPINE CERVICAL W/CM     CT SP CERV W/CM                 $7,603.00
 5052127   CT SPINE CERVICL WO/W CM   CT SP CERV WO/W                 $8,594.00
 5052128   CT SPINE THORACIC W/O CM   CT SP THOR W/O                  $5,717.00
 5052129   CT SPINE THORACIC W/CM     CT SP THOR W/CM                 $7,603.00
 5052131   CT SPINE LUMBAR W/O CM     CT SP LUMB W/O                  $5,717.00
 5052132   CT SPINE LUMBAR W/CM       CT SP LUMB W/CM                 $7,603.00
 5052133   CT SPINE LUMBAR WO/W CM    CT SP LUMB WO/W                 $8,594.00
 5052192   CT PELVIS W/O CONTRAST     CT PELVIS WO CM                 $6,515.00
 5052193   CT PELVIS WITH CONTRAST    CT PELVIS W/CM                  $6,858.00
 5052194   CT PELVIS WO/W CM          CT PELVIS WO/W                  $8,594.00
 5053200   CT UPPER EXTRMTY W/O CM    CT UE W/O CM                    $2,978.00
 5053201   CT UPPER EXTRMTY W/ CM     CT UE W/ CM                     $3,853.00
 5053700   CT LOWER EXTRMTY W/O CM    CT LE W/O CM                    $2,978.00
 5053701   CT LOWER EXTRMTY W/ CM     CT LE W/ CM                     $3,082.00
 5054150   CT ABDOMEN W/O CM          CT ABD W/O CM                   $6,858.00
 5054160   CT ABDOMEN W/ CM           CT ABD W/ CM                    $7,088.00
 5054170   CT ABDOMEN WO/W CM         CT ABD WO/W CM                  $7,432.00
 5056355   CT STEREOTACTIC LOCALZTN   CT STEREOTACTIC                 $2,303.00
 5056361   CT GUIDANCE NDL PLACEMNT   CT GUIDE NDL PL                 $4,595.00
 5056370   CT GUIDE RAD THERAPY FL    CT GUIDE RAD TH                 $1,547.00
 5056499   CT UNLISTED MISC SCAN      CT UNLIST SCAN        $300.00 - $13,946.00
 5056500   CT CARD SCORING WO CONT    CT CARD SCORING                   $431.21
 5056505   CT LTD OR LOC F/U STUDY    CT LTD/LOC F/U                  $1,842.00
 5057013   CT GDE PARENCHYM ABLAT     CT GD PAREN ABL                   $940.00
 5057382   PERC ABLTN LIVR TUMOR(S)   ABLATION LIVER                    $659.00
 5057502   BX ABD/RETROPER PERC NDL   BX ABD MASS                       $661.00
 5057503   BIOPSY BONE DEEP           BX BONE DEEP                      $659.00
 5057510   BX LUNG/MEDIAST PERC NDL   BX LUNG/MEDIAST                   $661.00
 5057511   BX MUSCLE PERC NDL         BX MUSCLE PERC                    $661.00
 5057512   BX PANCREAS PERC NDL       BX PANCRS PERC                    $661.00
 5057514   BX RENAL PERC NDL          BX RENAL PERC                     $661.00
 5057582   PERC DRAIN ABD ABSCESS     DRN ABSCESS ABD                   $661.00
 5057583   PERC DRN LIVER ABSC/CYST   PERC DRN LIVER                    $661.00
 5057584   DRN HEPATOMY ABSC/CYST     ABSC DRN LIVER                    $661.00
 5057585   ASP/INJ RENL CYST/PELVIS   ASP RENAL CYST                    $661.00
 5057588   DRAIN RETROPERI ABSCESS    DRAIN RETROPERI                   $661.00
 5057589   DRAIN SUBDIAPHR ABSCESS    DRAIN SUBDIAPHR                   $661.00
 5057603   CERV/THORAC FACET BLOCK    CRVL/THORC FACE                 $2,193.00
 5057604   CERV/THORAC FACET ADDL     CRVL/THORC ADDL                 $1,672.00
 5057636   3D IMAGNG NO POSTPROCESS   3D IMAGING                      $1,416.00
 5057637   3D IMAGING W POSTPROCESS   3D IMAGING                      $1,416.00
 5058215   BX LIVER PERC NDL          BX LIVR PERC ND                   $661.00
 5058220   LIVER BX W/OTHER PROC      LIVER BX W/PROC                   $661.00
 5060000   4146 ULTRASOUND            ULTRASOUND (IP)
 5060022   FNA W GUIDANCE             FNA W GUIDANCE                 $308.00
 5061125   PERITONEOCENTESIS INIT     PERITONEOCN INI                $308.00
 5061145   AMNIOCENTESIS DIAG         AMNIOCNTESIS DX                $921.00
 5062003   LE ART IMAGING COMP        ART IMG L/E COM              $2,843.00



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  Doctors Medical Center - Modesto                                        Page 31 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 5062007   ART IMAGING U/E COMPLETE   ART IMG U/E COM               $2,843.00
 5062013   DUPLX UE/LE VEINS BILAT    DUPLX EXT VEINS               $2,582.00
 5062015   ART/VEN FLOW ABD COMP      ART/VEN FLW COM               $1,073.00
 5062017   ART/VEN FLOW ABD LTD       ART/VEN FLW LTD                 $694.00
 5062020   DUPLX AORT&IVC&ILIAC COM   AORT/INF/IV/BPG               $1,224.00
 5063330   DOPPLER ECHO COLOR FLOW    COLORFLOW ANALY                 $904.00
 5063400   TRANSESOPHAGEAL ECHO       ESOPHAGEAL ECHO               $6,210.00
 5066536   US SOFT TISSUE HEAD/NECK   US SOFT HEAD/NK               $1,221.00
 5066540   DUPLEX CAROTID UNI/LTD     DUPLX CARTD UNI               $1,047.00
 5066541   DUPLEX CAROTID BI/COMP     DUPLX CARTD BI                $2,136.00
 5066604   US CHEST & OR MEDIASTINM   US CHEST B-SCAN                 $808.00
 5066624   TRNSTHOR 2D ECHO LTD/FU    ECHO 2D LTD/FU                  $980.00
 5066627   TRNSTHOR 2D ECHO CMPLETE   ECHO 2D COMP                  $1,793.00
 5066641   US BREAST BILATERAL        US BREAST BI                  $1,839.00
 5066645   US BREAST UNILATERAL       US BREAST UNI                   $991.00
 5066700   US ABDOMEN COMPLETE        US ABD COMPLETE               $1,590.00
 5066705   US ABD LTD SNGLE/QUAD/FU   US ABD LTD/FU                 $1,278.00
 5066770   US RETROPERITONEAL COMP    US RETROPL COMP               $1,221.00
 5066775   US RETROPERITONEAL LTD     US RETROPL LTD                  $920.00
 5066778   US TRANSPLANT KIDNEY       US TRNSP KIDNEY                 $920.00
 5066782   US SCROTUM CONTENTS        US SCROTUM                    $1,507.00
 5066801   US OB COMP<14WKS 1STGEST   US OB<14WKS                     $204.20
 5066802   US OB COMP<14WK ADD GEST   US OB<14WKS ADD                 $204.20
 5066810   US OB LTD 1OR> FETUS       US OB LTD 1OR>                  $920.00
 5066811   US OB COMP W FETL ANATMY   US OB FETL ANAT                 $509.40
 5066812   US OB FETLANAT ADDL GEST   US OB ADDL GEST                 $333.55
 5066816   US OB TRANSVAGINAL         US OB TRANSVAG                  $204.25
 5066818   FETAL BIOPHYS PROFLE NST   FETAL BIOPHYS                 $1,367.00
 5066825   US OB COMP>14WK SGL GEST   US OB>14WK SGL                $1,474.00
 5066826   US OB F/U PER FETUS        US OB F/U PER                   $920.00
 5066828   INFANT HEAD ECHO           INFANT HD ECHO                $1,132.00
 5066830   US TRANSVAGINAL NOT OB     US TRANSVAGINAL                 $991.00
 5066843   US OB COMP>14WK ADD GEST   US OB>14WK ADD                  $333.55
 5066856   US PELVIC COMPLETE         US PELVIC COMP                $1,666.00
 5066858   US PELVIC LTD/FU           US PELVC LTD/FU                 $950.00
 5066881   US EXTREMITY NON VASCULR   US EXTREMITY                    $920.00
 5066885   US INFANT HIPS DYNAMIC     US INF HIPS DYN                 $920.00
 5066886   US INFANT HIPS LTD STATC   US INF HIPS STA                 $920.00
 5066937   US GUIDE VASCULAR ACCESS   US GUIDANCE VA                  $150.00
 5066960   US GUIDE NEEDLE PLACEMNT   US GUIDANCE                   $1,470.00
 5066970   US STUDY FOLLOW-UP         US STUDY F/U                  $1,526.00
 5066986   US GUIDANCE INTRAOPERATV   US GD INTRAOPTV                 $950.00
 5067108   DOPPLER ECHO PULSE/CONT    DOPPLER ECHO                  $1,468.00
 5067109   CARDIAC DOPPLER FU/LTD     CARD DOPPLER FU                 $737.00
 5067138   DUPLX UE/LE VEIN UNILAT    DUPLX VEINS UNI               $1,590.00
 5067150   AORT/INF/IV/BPG LTD        AORT/INF/IV/BPG               $1,133.00
 5067160   SCAN HEMODIALYSIS ACCESS   SCAN HEMO ACCES                 $838.00
 5067201   LE ART IMAGING LTD         LE ART IMG LTD                $1,961.00
 5067206   ART IMAGING U/E LIMITED    ART IMG U/E LTD               $1,961.00
 5067545   BX THYROID PERC NDL        BX THY PERC NDL                 $308.00



  CDM Run Date: 06/01/2007
  Doctors Medical Center - Modesto                                             Page 32 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 5067570   THORACENTSIS PUNCTRE/ASP   THORACENT ASP                     $308.00
 5068999   UNLISTED US PROC           UNLIST US PROC         $150.00 - $6,210.00
 5070000   4147 ENDOSCOPY             ENDOSCOPY (IP)
 5070765   IV INF TX INIT <=1 HR      IV TX INIT 1 HR                $394.00
 5070766   IV INF TX EA ADD HR        IV INF TX ADD H                 $50.00
 5070784   INJ TX/PROPH/DX IVP        INJ T/P/D IVP                  $100.00
 5071006   ANOSCOPY                   ANOSCOPY                       $549.00
 5071007   RECTAL SENSATION TEST      RECTAL SENS TST              $2,061.00
 5071008   RECTAL MOTILITY            RECTAL MOTILITY              $1,649.00
 5071010   RECTAL DILATATION          RECTAL DILATATN                $406.00
 5071013   BX LIVER PERC NDL          BX LIVR PERC ND              $1,327.00
 5071023   ESOPHAGEAL PROSTHESIS      ESOPH PROSTH                 $1,145.00
 5071026   COLONOSCOPY LIMITED        COLONOSCOPY LTD              $5,175.00
 5071027   COLONOSCOPY                COLONOSCOPY                  $6,831.00
 5071028   COLONOSCOPY W/BX           COLON LTD W BX               $4,967.00
 5071029   COLONOSCOPY W/BIOPSY       COLON W/BIOPSY               $7,660.00
 5071030   COLON W/POLYP SNARE        COLN POLYP SNAR              $1,032.00
 5071039   COLONSCPY W/LSR OR PHTCO   COLN LSR OR PHT              $7,759.00
 5071051   ESPHGSTRDUOSPY/FRN BODY    EGD W/FRN BODY               $1,032.00
 5071052   EGD CNTL HEMORHG           EGD CNTL HEMORH              $7,163.00
 5071054   FULL EGD                   FULL EGD                     $4,905.00
 5071055   FULL EGD W/BIOPSY          FULL EGD W/BIOP              $5,730.00
 5071056   ERCP                       ERCP                         $7,750.00
 5071057   ERCP W/SPHINCTEROTOMY      ERCP W/SPHINCTR              $1,032.00
 5071058   ERCP WITH BIOPSY           ERCP W BIOPSY                $8,574.00
 5071060   EGD W/MALONEY DILITATION   EGD W/DIL MALNY              $1,782.00
 5071062   ESOPHAGEAL MOTILITY        ESOPHO MOTILITY              $4,867.00
 5071063   ESOPH DILATION GUIDEWIRE   ESOPH DIL GDWR               $1,145.00
 5071066   ESOPHAGUS-BERNSTEIN TEST   ESO-BERNSTN TST                $774.00
 5071070   EGD W/LIGATION             EGD W/LIGATION               $1,032.00
 5071073   EGD W/POLYP REMOVAL        EGD W/POLYP RMV              $1,032.00
 5071074   FEEDING TUBE INSERTION     FEEDTUBE INSERT              $1,265.00
 5071075   COLON CAUTERY              COLON CAUTERY                $1,032.00
 5071077   EGD SCLEROTHERAPY          EGD SCLORTHRPY               $1,032.00
 5071082   GASTRIC ANALYSIS           GASTRIC ANALYS               $3,811.00
 5071086   GASTRIC LAVAGE             GASTRIC LAVAGE                 $823.00
 5071098   PERCU ENDSCPC GASTROTOMY   PERCU END GASTM              $1,145.00
 5071124   PARACENTESIS               PARACENTESIS                 $1,730.00
 5071128   PROCTOSCOPY                PROCTOSCOPY                  $2,015.00
 5071132   FLEX SIGMD/POLYPECTOMY     FLEX SIG/POLYPC              $1,032.00
 5071140   COLONSCOPY SCLROTHERAPY    CLN SCLROTHRPY               $1,032.00
 5071143   SIGMOIDSCPY FLEX W/BX      SIGMDSCP FLX/BX              $3,454.00
 5071144   SIGMOIDOSCOPY              SIGMOIDOSCOPY                $2,015.00
 5071145   SIGMOIDOSCOPY FLEXIBLE     SIGMOIDSCP FLEX              $2,633.00
 5071147   SMALL BOWEL BX             SMALL BOWEL BX               $5,743.00
 5071148   SIMPLE EGD                 SIMPLE EGD                   $4,653.00
 5071149   SIMPLE EGD W/BIOPSY        SIMPLE EGD W/BX              $5,693.00
 5071200   ENDO INCOMPLETE            ENDO INCOMPLETE              $2,399.00
 5071210   EGD W/CAUTERY OR PHTCO     EGD CAUTR/PHTGG              $1,032.00
 5071251   ESOPH IMPED FUNCT TST      ESO IMPED TST                  $829.84



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  Doctors Medical Center - Modesto                                             Page 33 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 5071254   ESOPH PH TST W ELECT       ESO REFLX TST                   $2,291.00
 5071400   PAPILLOTOMY                PAPILLOTOMY                     $1,053.00
 5073111   TRANSFUSION BLD/BLD COMP   TRAN BLD/COMP                     $840.88
 5073264   ERCP W/STONE REMOVAL       ERCP W STONE RM                 $1,032.00
 5073265   ERCP W/LITHOTRIPSY         ERCP W/LITHO                   $10,720.00
 5073267   ERCP INSERT NASOBIL TUBE   ERCP NASOBL TUB                 $1,032.00
 5073268   ERCP W/ INSERT STENT       ERCP STENT INSR                 $1,032.00
 5073269   ERCP RMV STENT/FRN BODY    ERCP STENT RMVL                 $1,032.00
 5073271   ERCP W BALLOON DILATION    ERCP W BAL DILT                 $1,032.00
 5073455   ESOPHAGEAL DILATION<30MN   ESOPH DILATION                  $2,291.00
 5073760   CHANGE GASTROSTOMY TUBE    CHG GASTRO TUBE                   $916.00
 5074372   PLACEMENT PEJ              PEJ PLACEMENT                   $1,145.00
 5074373   CONVERSION OF PEG TO PEJ   CONV PEG TO PEJ                 $1,145.00
 5074376   ENDOSCOPY INCL ILEUM       ENDOSCOPY                       $1,840.00
 5074377   ENDOSCPY INCL ILEUM W/BX   ENDOSCOPY W/BX                  $1,984.60
 5074378   ENDOSCPY W/CNTRL BLEED     ENDSCPY W/BLEED                 $1,984.60
 5074388   COLON THRU COLOSTOMY       COLON THRU OSTM                 $6,729.00
 5074400   COLONOSCOPY W/STNT PLC     COLON STNT PLC                  $6,173.12
 5075337   COLON DECOMPRESSION        COLON DECOMPRES                 $7,255.00
 5075388   COLONOSCOPY W SUBMUC INJ   COLON W/INJ                     $1,960.04
 5076221   HEMORRHOID LIGATION        HEMOR LIGATION                  $1,032.00
 5078999   ENDOCOPY/NONDIAGNOSTIC     ENDOSCOPY/NONDX        $50.00 - $10,720.00
 5079102   SPEC PROC PREP             SPEC PROC PREP                    $125.00
 5100000   4150 X-RAY THERAPEUTIC     RAD THERAPEUTIC
 5105859   TRNSPER PLC NDL/CATH PRO   TRNSPER PLC PRO              $5,985.00
 5106965   US GUIDE INTERST RAD APP   US GD INTRST                   $763.00
 5107261   RADTHER TREATMENT SIMPLE   TREAT PLAN SIMP                $362.00      Minimum
 5107262   RADTHER TREATMENT INTERM   TREAT PL INTERM                $544.00      Minimum
 5107280   RADTHER SIMULATION SMPLE   SIMULATION SIMP              $1,197.00      Minimum
 5107285   RADTHER SIMULATION INTER   SIMULATION INTR              $1,911.00      Minimum
 5107290   RADTHER SIMULATION CMPLX   SIMULATION CMPL              $2,229.00      Minimum
 5107300   BASIC RADIATION DOSIMTRY   BASIC DOSIMETRY              $2,166.50      Minimum
 5107305   TELETHER ISODOSE SIMPLE    TELETH ISOD SMP                $631.00      Minimum
 5107310   TELETHER ISODOSE INTERM    TELETH ISOD INT                $804.00      Minimum
 5107315   TELETHER ISODOSE CMPLEX    TELETH ISOD CMP                $906.00      Minimum
 5107328   BRACHYTHERAPY COMPLEX      DOSI BRA COMPLX              $1,894.75      Minimum
 5107332   TX DVC DESIGN SMPL         TX DESIGN SMPL                 $459.00      Minimum
 5107333   TX DVC DESIGN INT          TX DESIGN INT                  $654.00      Minimum
 5107334   TX DVC DESIGN CMPLX        TX DESIGN CMPLX              $1,113.00      Minimum
 5107336   RADPHYSICS CONSULT P/WK    PHYSICS CNSLT                  $470.00      Minimum
 5107401   RAD TX SUPRFCL/ORTHO VLT   ORTHOVLT TR DLY                $667.00      Minimum
 5107402   MEGAVOLT/RX SNGL +20       RADIATN RX +20                 $362.00      Minimum
 5107403   MEGAVOLT/RX SINGLE 6-10    RADIATN RX 6-10                $580.00      Minimum
 5107404   MEGAVOLT/RX SINGLE 11-19   RADIATN RX11-19                $580.00      Minimum
 5107408   MEGAVOLT/RX TWO 6-10       RADIATN RX 6-10                $691.00      Minimum
 5107409   MEGAVOLT/RX TWO 11-19      RADIATN RX11-19                $691.00      Minimum
 5107412   MEGAVOLT/RX 3 +20          RADIATN RX 3+20                $362.00      Minimum
 5107413   MEGAVOLT/RX THREE 6-10     RADIATN RX 6-10                $767.00      Minimum
 5107414   MEGAVOLT/RX THREE 11-19    RADIATN RX11-19                $767.00      Minimum
 5107417   PORT FILMS WEEKLY RX       PORT FILMS RX                $1,172.00



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  Doctors Medical Center - Modesto                                                Page 34 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 5107465   DAILY KILOVLT TREATMENT    ORTHOVLT TR DLY                   $611.00
 5107470   SPCL TX PROCEDURE          SPCL TX PROCED                  $1,785.00
 5107500   SURFACE RADIOACTIVE APPL   RAD SR90 THERPY                   $503.00
 5107799   UNLISTD CLINIC BRACHYTHP   UNLST CLN BRCHY        $362.00 - $5,985.00
 5108999   00000 XRAY THER MISC       XRAY THER MISC         $362.00 - $5,985.00
 5109101   RADPHARM TX IV             RADPHARM TX IV                    $619.50
 5190000   4159 RADIOPHARMACEUTICAL   RADIOPHARMACTCL
 5190014   IODINE 125 SOURCE          IODINE125 SOURC                  $180.00       Minimum
 5190018   PD 103 SOURCE              PD 103 SOURCE                    $195.00       Minimum
 5191080   I-131 TOSITUMOMAB DX DSE   I-131 TOSITU DX                $4,138.00
 5191400   GA67 CITRATE 1MCI          GA67 CITRTE1MCI                  $210.00
 5191724   IN111 DTPA .5MCI           IN111 DTPA.5MCI                $1,828.00
 5191725   IN111 CAPROMAB DOSE        IN111 CPRMB DOS                $3,719.00
 5191729   IN111 OXINE .5MCI          IN111OXINE.5MCI                $2,266.91
 5192180   I 123 MIBG DOSE            I 123 MIBG DOSE                $2,231.25
 5194000   TC99 APCITIDE VIAL         TC99 APCTD VIAL                  $956.00
 5194010   TC99 MEDRONAT UPTO 30MCI   TC99MEDRMT30MCI                  $317.00
 5194026   TC99 EXAMETAZIME DOSE      TC99 EXMTZM DOS                $1,410.00
 5194089   TC99 BICISATE DOSE         TC99 BICISATE                    $637.50
 5194170   TC99 SESTAMIBI DOSE        TC99 SESTAM DOS                $1,283.00
 5194175   TC99 SUCCIMER DOSE         TC99 SUCCIMER                  $1,113.00
 5194800   TL201 CHLORIDE 1MCI        TL201 CHLRD1MCI                  $265.00
 5195100   XENON 133 10 MCI           XENON 133 10 MC                  $430.00
 5196150   P32 CHROMIC 1MCI           P32 CHROMIC1MCI                $4,138.00
 5196160   P32 SODIUM 1MCI            P32 SODIUM 1MCI                $3,800.00
 5196200   SM153 LEXIDRONAM 50MCI     SM153 LXDR50MCI                $7,170.00
 5197214   CESIUM RIBBON              CESIUM RIBBON                  $1,007.00
 5198999   MISCELLANEOUS              MISC RADIOPHARM        $70.00 - $1,726.00
 5199512   TC99 PERTECHN PER MCI      TC99 PERTECHNET                   $11.74
 5199516   I 123 SOD CAP PER 100UCI   I 123 SOD CAP                     $43.10
 5199517   TX I131 SOD CAP PER MCI    I 131 SOD CAP                     $20.00
 5199537   TC99 MEBROFENIN DOSE       TC99 MEBROFENIN                  $128.00
 5199538   TC99 PYROPHOSPHATE DOSE    TC99PYROPHSPHTE                  $122.00
 5199539   TC99 PENTETATE DOSE        TC99 PENTETATE                    $58.00
 5199540   TC99 ALBUMIN MAA DOSE      TC99ALBUMIN MAA                   $58.00
 5199541   TC99 SULFUR COLLOID DOSE   TC99 SULFRCOLLD                   $73.00
 5199560   TC99 RBC DOSE              TC99 RBC DOSE                    $222.00
 5199562   TC99 MERTIATIDE DOSE       TC99 MERTIATIDE                  $285.00
 5200000   4160 NUCLEAR MEDICINE      NUCLEAR MED IP
 5200195   BREAST IMAGING             BREAST IMAGING                $2,903.00
 5200197   BREAST IMAGING MULT AREA   BRST IMG MULT                 $4,118.00
 5202022   TUMOR LOCAL WHOLEBODY      TUMOR LOCL WBDY               $6,183.00
 5202055   ABCESS LOCALIZE SPECT      ABCESS SPECT                  $1,975.00
 5203006   H PYLORI BRTH TST          H PYLORI B TST                  $630.00
 5208000   THYROID UPTAKE SINGLE      THYROID UPT SGL                 $661.00
 5208001   THYROID UPTAKE MULTIPLE    THYROID UPT MLT               $1,023.00
 5208004   THYROID UPTAKE SUPPRESSN   THYROID UPT SUP               $1,324.00
 5208006   THYROID IMAG W/UPTK SNGL   THYRD IMG W/UP                $3,173.00
 5208007   THYROID IMAG W/UPTK MULT   THYROID IMG MLT               $2,490.00
 5208010   THYROID IMAGING ONLY       THYROID IMG ONL               $1,466.00



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  Doctors Medical Center - Modesto                                        Page 35 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 5208018   THYROID C/M IMG WHOL BDY   THY C/M WHL BDY               $4,368.00
 5208031   PARATHYROID IMAGING        PARATHYROID IMG               $1,466.00
 5208130   REDCELL SURVIVAL STUDY     REDCELL SURVIVL               $6,423.00
 5208140   REDCELL SPL/HEP SEQUESTR   RC SPLEN/HEPATC               $6,903.00
 5208192   INFL PR LCL/LTD            INFL PR LCL/LTD               $6,171.00
 5208195   LYMPHATICS & LYMPH NODES   LYMPH NODES IMG               $3,264.00
 5208205   LIVER IMAGING (SPECT)      LIVER SPECT                     $971.00
 5208215   LIVER/SPLEEN IMAG STATIC   LIV/SPLEEN IMAG               $3,264.00
 5208216   LIVER/SPLEEN VASC FLOW     LIV/SPLEEN FLOW               $4,080.00
 5208223   HEPATOBILIARY IMG W/GBLD   HEPATOBILIARY                 $4,584.00
 5208258   ESOPHAGEAL MOTILITY        ESOPH MOTILITY                $2,942.00
 5208276   GASTRIC EMPTYING STUDY     GAST EMPT STDY                $2,942.00
 5208278   GASTROESOPH REFLUX STUDY   GASTROESPH STDY               $3,684.00
 5208280   ACUTE GI BLOOD LOSS IMG    GI BLOOD LOSS                 $4,739.00
 5208290   INTESTINE IMAGING          INTESTINE IMAG                $2,912.00
 5208300   BONE IMAGING LIMITED       BONE IMG LTD                  $2,903.00
 5208307   BONE IMAGING WHOLE BODY    BONE IMG WH/BDY               $4,368.00
 5208310   VASCULAR FLOW BONE IMAG    VASC FLW BONE                   $645.00
 5208320   BONE IMG TOMOGRM (SPECT)   BONE SPECT                      $971.00
 5208403   GATED HEART PLANAR SNGL    GATED HRT PLANR               $4,403.00
 5208405   MYOCARDIUM IMG TL REST     MYOCRD IMG TLRS               $3,576.00
 5208406   MYOCARDIUM IMG INFARCT     MYOCRD IMG INFR               $2,942.00
 5208410   MYOCARDIUM IMG TL STRESS   MYOCRD IMG TLST               $4,224.00
 5208457   VENOGRAM UNILATERAL        VENOGRAM UNILAT               $2,942.00
 5208458   VENOGRAM BILATERAL         VENOGRAM BILAT                $5,347.00
 5208459   RG MYOCARDIAL QUAL REST    MYOCRD QL REST                $2,667.00
 5208464   CARD TOM(SPECT)REST ONLY   CARD SPECT REST               $3,251.00
 5208465   CARD TOM(SPECT)REST&EXCR   CARD SPC RST/EX               $6,323.00
 5208480   MYOCARD PERF W/EJ FRX      MYOCRD PERF EF                  $522.00
 5208482   MYOCARD PERF W/WALL MOTN   MYOCRD PERF W/W                 $348.00
 5208494   CARD GTD SPCT RST W/M EF   CARD GTD SPECT                $5,504.00
 5208580   PULM PERF PARTICULATE      PULM PERFS IMAG               $2,738.00
 5208592   PULM VENT GAS MULTIPLE     PULMVNT GAS MLT               $2,738.00
 5208606   BRAIN IMAG CPLT VASC FLO   BRN IMG CMP FL                $4,675.00
 5208607   BRAIN IMG TOMGRAM(SPECT)   BRAIN SPECT                   $5,005.00
 5208610   BRAIN IMAG VASC FLO ONLY   BRAIN IMG FLOW                $2,942.00
 5208630   CISTERNOGRAM               CISTERNOGRAM                  $5,005.00
 5208645   SHUNT EVALUATION           CEREBROSP SHUNT                 $700.00
 5208700   KIDNEY IMAGING MORPHOLGY   KIDNY IMG MORPH               $4,394.00
 5208701   KIDNEY IMAG VASC FLOW      KIDNEY IMG FLOW               $3,027.00
 5208706   KID IMG FL/FUN SNG W RX    KID IMG W RX                  $4,465.00
 5208707   KID IMG FL/FUN SNG WO RX   KID IMG WO RX                 $4,465.00
 5208720   KIDNEY FUNCTN NON IMAG     KIDNEY NON IMAG               $2,857.00
 5208740   URETERAL REFLUX STUDY      URE REFLUX STDY               $3,040.00
 5208762   TESTICULAR VASC FLOW       TESTICLR FLOW                 $3,316.00
 5208800   TUMOR LOCAL LTD            TUMOR LOCAL LTD               $1,842.00
 5208801   TUMOR LOCAL MULTI AREAS    TUMOR LOCAL MLT               $2,802.00
 5208803   TUMOR LOCALIZATION-SPECT   TUMOR LOC SPECT               $1,026.22
 5208804   TUMR LOC WHLE BDY 2+DAYS   TUMOR LOCL BODY               $4,368.00
 5208825   COMPUTER EVAL 30 MIN       COMP EVAL 30MIN                 $777.00



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  Doctors Medical Center - Modesto                                                   Page 36 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION    HOSPITAL CHARGE COMMENTS
 5208999   MISC NULCEAR MEDICINE      MISC NUCLR MED          $348.00 - $6,903.00
 5209005   RADPHARM TX ORAL           RADPHAR TX ORAL                  $1,835.00
 5209101   RADPHARM TX IV             RADPHARM TX IV                   $1,566.00
 5250000   4165 MAGNETIC RESN IMAGE   MAGN RESN IMAGE
 5250230   MRI SPINE CERV WO/W CM     SP CERV WO/W CM                  $10,138.00
 5250234   MRI SPINE THOR WO/W CM     SP THOR WO/W CM                  $10,138.00
 5250238   MRI SPINE LUMBAR WO/W CM   SP LUMB WO/W CM                   $9,077.00
 5250601   MRA HEAD W/O CONTRAST      MRA HD W/O                        $3,713.00
 5250602   MRA HEAD W/CONTRAST        MRA HD W/CONT                     $4,686.00
 5250603   MRA HEAD WO/W CONTRAST     MRA HD WO/W                       $8,738.00
 5250606   MRA NECK W/O CONTRAST      MRA NECK WO CM                    $3,713.00
 5250607   MRA NECK W CONTRAST        MRA NECK W/CM                     $4,533.00
 5250608   MRA NECK WO/W CONTRAST     MRA NECK WO/W                     $6,990.00
 5250645   MRA SPINE WO/W CONTRAST    MRA SPINE WO/W                    $4,898.00
 5250662   MRI SPINE CERVICL W/O CM   SP CERV W/O CM                    $8,034.00
 5250676   MRI SPINE THORAC W/O CM    SP THOR W/O CM                    $6,990.00
 5250692   MRI SPINE LUMBAR W/O CM    MRI SP LUMB W/O                   $6,990.00
 5250700   MRI STEREOTACTIC LOCAL     MRI STEREO LCL                    $3,677.00
 5250802   MRI BRAIN W/O CONTRAST     MRI BRAIN WO CM                   $5,947.00
 5250810   MRI BRAIN WITH CONTRAST    MRI BRAIN W/CM                   $10,053.00
 5250816   MRI BRAIN WO/W CONTRAST    MRI BRAIN WO/W                   $10,138.00
 5250850   MRI PELVIS W/O CONTRAST    MRI PELVIS W/O                    $4,849.00
 5250852   MRI PELVIS WO/W CONTRAST   MRI PELVIS WO/W                   $7,426.00
 5250974   MRI ABDOMEN W/ CM          MRI ABD W/ CM                     $5,947.00
 5250990   MRA UP EXTRMTY WO&W CM     MRA UE WO&W CM                    $8,738.00
 5251000   MRI ABDOMEN WO/W CM        MRI ABD WO/W CM                   $7,426.00
 5251025   MRI ORB/FACE/NECK WO CM    MRI ORB/FCE/NK                    $5,947.00
 5251035   MRI TMJ                    MRI TMJ                           $5,947.00
 5251040   MRI CHEST W/O CONTRAST     MRI CHEST WO CM                   $6,776.00
 5251055   MRI UP EXT NONJNT WO/WCM   MRI UE/NONJNT                     $8,554.00
 5251060   MRI UP EXT JNT W/O CM      MRI UE/JNT W/O                    $5,840.00
 5251065   MRI LE NONJNT WO/W CM      MRI LE NNJ WO/W                   $5,421.00
 5251070   MRI LOWR EXT JNT W/O CM    MRI LE JNT W/O                    $8,554.00
 5251075   MRI ABDOMEN W/O CM         MRI ABD W/O CM                    $7,994.00
 5256499   MRI ABORTED PROC           MRI ABORTED PRO                   $1,975.00
 5258899   MRA ABDOMEN W/ CM          MRA ABD W/ CM                     $4,533.00
 5258901   MRA ABDOMEN W/O CM         MRA ABD W/ CM                     $3,713.00
 5258902   MRA ABDOMEN WO/W CM        MRA ABD WO/W CM                   $6,990.00
 5258909   MRA CHEST W/CONTRAST       MRA CHEST W/CM                    $5,297.00
 5258910   MRA CHEST W/O CONTRAST     MRA CHEST WO CM                   $4,641.00
 5258911   MRA CHEST WO/W CONTRAST    MRA CHEST WO/W                    $6,990.00
 5258912   MRA LOWR EXTRMTY W/ CM     MRA LWR EXT W                     $4,724.00
 5258913   MRA LOWR EXTRMTY W/O CM    MRA LWR EXT WO                    $4,641.00
 5258914   MRA LOWR EXTRMTY WO/W CM   MRA LWR EX WO/W                   $6,990.00
 5258918   MRA PELVIS WITH CONTRAST   MRA PELVIS W/CM                   $4,533.00
 5258919   MRA PELVIS W/O CONTRAST    MRA PELVIS W/O                    $3,713.00
 5258920   MRA PELVIS WO/W CONTRAST   MRA PELVIS WO/W                   $8,738.00
 5258999   MRI UNLISTED PROC          MRI UNLIST PROC       $1,975.00 - $10,138.00
 5300000   4170 PHARMACY              PHARMACY
 5300001   MISCELNEOUS ORAL TAB/CAP   MISC ORAL SOLID                     $32.00



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  Doctors Medical Center - Modesto                                       Page 37 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION        BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 5300003   ABACAVIR 300MG            ABACAVIR 300MG                 $153.00
 5300005   ACARBOSE 50MG             ACARBOSE 50MG                   $38.00
 5300008   ACEBUTOLOL 200MG CAP      ACEBUTOLOL200MG                 $30.00
 5300009   ACEBUTOLOL 400MG CAP      ACEBUTOLOL400MG                 $67.40
 5300012   ACETAMIN/CAFFEINE/BUTAL   APAP/CAFF/BUTAL                 $21.00
 5300016   ACETAMIN/ISOMETHEP/DIC    APAP/ISOMET/DIC                 $21.00
 5300094   ACETAZOLAMIDE 125MG       ACETZOLAMID 125                 $28.60
 5300098   ACETAZOLAMIDE 250MG       ACETZOLAMID 250                 $21.00
 5300102   ACETAZOLAMIDE 500MG SEQ   ACETZOLAMID 500                 $50.35
 5300129   ACETOHEXAMIDE 500MG       ACETOHEX 500MG                  $44.45
 5300160   ACYCLOVIR 200MG           ACYCLOVIR 200MG                 $40.00
 5300161   ACYCLOVIR 800MG           ACYCLOVIR 800MG                 $76.00
 5300201   ALBENDAZOLE 200MG         ALBENDAZOL200MG                 $66.00
 5300221   ALBUTEROL TAB 2MG         ALBUTEROL 2MG                   $21.00
 5300222   ALBUTEROL REPETAB 4MG     ALBUTEROL RP4MG                 $50.35
 5300230   ALENDRONATE 10MG          ALENDRONATE10MG                 $63.00
 5300233   ALENDRONATE 70MG          ALENDRONATE70MG                $153.00
 5300244   ALLOPURINOL 100MG         ALLOPURINL100MG                 $17.00
 5300248   ALLOPURINOL 300MG         ALLOPURINL300MG                 $26.00
 5300294   ALPRAZOLAM .25MG          ALPRAZOLAM.25MG                $219.00
 5300298   ALPRAZOLAM .5MG           ALPRAZOLAM .5MG                $219.00
 5300476   AMANTADINE 100MG          AMANTADINE100MG                 $26.00
 5300522   AMILORIDE 5MG             AMILORIDE 5 MG                  $21.00
 5300526   AMILORIDE/HCTZ 5/50       AMLRID/HCTZ5/50                 $44.45
 5300549   AMINOCAPROIC ACID 500MG   AMINCAPROIC 500                 $21.00
 5300572   AMINOGLUTETHAMIDE 250MG   AMINOGLUT 250MG                 $94.20
 5300595   AMINOPHYLLINE 100MG       AMINOPHYL 100MG                 $19.30
 5300599   AMINOPHYLLINE 200MG       AMINOPHYLN 200                  $28.60
 5300625   AMIODARONE 200MG          AMIODARON 200MG                 $76.00
 5300634   AMITRIPTYLINE 10MG        AMITRIPTYLN10MG                 $11.00
 5300638   AMITRIPTYLINE 25MG        AMITRIPTYLN25MG                 $17.00
 5300642   AMITRIPTYLINE 50MG        AMITRIPTYLN50MG                 $21.00
 5300646   AMITRIPTYLINE 75MG        AMITRIPTYLN75MG                 $26.00
 5300649   RISPERIDONE .5MG          RISPERIDNE .5MG                 $76.00
 5300650   AMITRIPTYLINE 100MG       AMITRPTYLN100MG                 $26.00
 5300661   AMLODIPINE 5MG            AMLODIPINE 5MG                  $74.00
 5300673   AMMON CHLORIDE 500MG      AMMON CHL 500                   $19.30
 5300700   AMOXAPINE 50MG            AMOXAPINE 50MG                  $21.00
 5300711   AMOXICILLIN/CLAV 125MG    AMOX/CLAV 125MG                 $60.45
 5300712   AMOXICILLIN/CLAV 250MG    AMOX/CLAV 250MG                 $63.00
 5300713   AMOXICILLIN/CLAV 875MG    AMOX/CLAV 875MG                 $78.00
 5300715   AMOXICILLIN/CLAV 500MG    AMOX/CLAV 500MG                 $63.00
 5300723   AMOXICILLIN 250MG         AMOXICILLN250MG                 $17.00
 5300725   AMOXICILLIN 500MG         AMOXICILLN500MG                 $17.00
 5300746   AMPICILLIN 250MG          AMPICILLIN250MG                 $21.00
 5300750   AMPICILLIN 500MG          AMPICILLIN500MG                 $73.00
 5300755   ANAGRELIDE 0.5MG          ANAGRELIDE .5MG                $110.00
 5300760   ANALGESIC OTC TAB/CAP     OTC ANALGESIC                 No charge
 5300762   ANASTROZOLE 1MG           ANASTROZOLE 1MG                $157.00
 5300784   ARIPIPRAZOLE 10MG         ARIPIPRAZL 10MG                 $84.80



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  Doctors Medical Center - Modesto                                        Page 38 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 5300800   ANTACID OTC TAB/CAP        OTC ANTACID                   No charge
 5300895   ASPIRIN SR 800MG           ASA SR 800MG                    $35.50
 5300984   ASA/ORPHEN/CAFF COMBO      ASA/ORPHEN/CAFF                 $35.50
 5301053   ASCORBIC ACID 100MG        ASCORBC AC100MG                 $14.70
 5301057   ASCORBIC ACID 250MG        ASCORBC AC250MG                 $11.00
 5301061   ASCORBIC ACID 500MG        ASCORBC AC500MG                 $73.00
 5301115   ASTEMIZOLE 10MG            ASTEMIZOLE 10MG                $105.15
 5301137   ATENOLOL 25MG              ATENOLOL 25MG                   $73.00
 5301138   ATENOLOL 50MG              ATENOLOL 50MG                   $74.00
 5301140   ATENOLOL/CHLORTHAL 50/25   ATENOLOL/CHLORT                 $77.75
 5301145   ATORVASTATIN 10MG          ATORVASTATN10MG                 $75.00
 5301146   ATORVASTATIN 20MG          ATORVASTATN20MG                 $76.00
 5301161   ATROPINE .4MG              ATROPINE .4MG                   $19.30
 5301165   ATROPINE .6MG              ATROPINE .6MG                   $19.30
 5301172   AURANOFIN 3MG              AURANOFIN 3MG                   $77.75
 5301188   AZATADINE 1MG              AZATADINE 1MG                   $35.50
 5301215   AZATHIOPRINE 50MG          AZATHIOPRNE50MG                 $21.00
 5301220   AZITHROMYCIN 250MG         AZITHROMYC250MG                 $81.00
 5301357   BACLOFEN 10MG              BACLOFEN 10MG                   $73.00
 5301430   BENAZEPRIL 5MG             BENAZEPRIL 5MG                  $46.00
 5301431   BENAZEPRIL 10MG            BENAZEPRIL 10MG                 $74.00
 5301476   BENZOCAINE LOZEN           BENZOCAIN LOZEN                 $23.00
 5301499   BENZONATATE 100MG          BENZONATA 100MG                 $21.00
 5301520   BENZTROPINE .5MG           BENZTROPIN .5MG                 $17.00
 5301522   BENZTROPINE 1MG            BENZTROPIN 1MG                  $17.00
 5301549   BETAMETHASONE .6MG         CELESTONE .6MG                  $50.35
 5301572   BETHANECHOL 5MG            BETHANECHOL 5MG                 $35.50
 5301576   BETHANECHOL 10MG           BETHANECHOL10MG                 $26.00
 5301580   BETHANECHOL 25MG           BETHANECHOL25MG                 $30.00
 5301586   BETAXOLOL 10MG             BETAXOLOL 10MG                  $46.00
 5301590   BICALUTAMIDE 50MG          BICALUTAMDE50MG                 $63.00
 5301607   BISOPROLOL/HCTZ 2.5/6.25   BISOPROLOL/HCTZ                 $63.00
 5301608   BISOPROLOL/HCTZ 5/6.25     BISOPROLOL/HCTZ                 $63.00
 5301609   BISOPROLOL/HCTZ 10/6.25    BISOPROLOL/HCTZ                 $63.00
 5301616   BISMUTH SUBSALICYL TAB     BISMUTH SUBSAL                  $11.00
 5301678   BROMFENAC 25MG             BROMFENAC 25MG                 $105.15
 5301680   BROMOCRIPTINE 2.5MG        BROMOCRIP 2.5MG                 $40.00
 5301707   BROMPHENIRAMINE            BROMPHENIRA EXT                 $35.50
 5301738   BUMETANIDE .5MG            BUMETANIDE .5MG                 $19.00
 5301742   BUMETANIDE 1MG             BUMETANIDE 1MG                  $75.00
 5301745   BUPROPION 75MG             BUPROPION 75MG                  $40.00
 5301746   BUPROPION 100MG            BUPROPION 100MG                 $56.00
 5301749   BUPROPION SR 150MG         BUPROPION 150SR                 $75.00
 5301760   BUSPIRONE 5MG              BUSPRIONE 5MG                   $73.00
 5301761   BUSPIRONE 10MG             BUSPIRONE 10MG                  $74.00
 5301765   BUSULFAN 2MG               BUSULFAN 2MG                    $28.60
 5301791   CALCITRIOL .25MCG          CALCTRIOL.25MCG                 $40.00
 5301794   CAFFEINE 200MG             CAFFEINE 200MG                   $0.85
 5301810   CALCIUM ACETATE 667MG      CA ACET 667MG                   $73.00
 5301811   CALCIUM CARBONATE          CA CARB                         $14.70



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  Doctors Medical Center - Modesto                                        Page 39 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 5301815   CALCIUM CARBONATE 500MG    CA CARB 500MG                   $73.00
 5301819   CALCIUM CARBONATE CHEW     CA CARB CHEW                    $11.00
 5301824   CALCIUM CARBONATE 650MG    CA CARB 650MG                   $13.00
 5301831   CALCIUM CITRATE 950MG      CA CITRATE950MG                 $17.00
 5301833   CALCIUM 250MG/VIT D        CALC 250MG/VITD                 $17.00
 5301834   CALCIUM 500MG/VIT D        CALC 500MG/VITD                 $17.00
 5301842   CALCIUM GLUCONATE 500MG    CA GLUC 500MG                    $8.00
 5301846   CALCIUM GLUCONATE 1000MG   CA GLUC 1000MG                  $22.15
 5301869   CALCIUM LACTATE 325MG      CA LACTATE325MG                 $14.70
 5301873   CALCIUM LACTATE 650MG      CA LACTATE650MG                 $14.70
 5301901   POLYCARBOPHIL 625MG        POLYCARB 625MG                  $16.00
 5301922   CAPTOPRIL 12.5MG           CAPTOPRIL12.5MG                 $73.00
 5301923   CAPTOPRIL 25MG             CAPTOPRIL 25MG                  $73.00
 5301941   CAPTOPRIL/HCTZ 25/15       CAPTOPRIL/HCTZ                  $50.35
 5301943   CAPTOPRIL/HCTZ 25/25       CAPTOPRIL/HCTZ                  $77.30
 5301945   CAPTOPRIL/HCTZ 50/15       CAPTOPRIL/HCTZ                 $105.15
 5301947   CAPTOPRIL/HCTZ 50/25       CAPTOPRIL/HCTZ                 $105.15
 5301975   CARBAMAZEPINE 100MG        CARBMAZPIN 100                  $21.00
 5301976   CARBAMAZEPINE EREL 100MG   TEGRETOL XR 100                 $26.00
 5301981   CARBAMAZEPINE 200MG        CARBMAZPIN 200                  $73.00
 5302004   CARBENICILLIN 382MG        CARBENICLN382MG                 $67.40
 5302027   CARBIDOPA/LEVOD 10/100     CARB/LEV 10/100                 $21.00
 5302031   CARBIDOPA/LEVOD 25/100     CARB/LEV 25/100                 $74.00
 5302035   CARBIDOPA/LEVOD 25/250     CARB/LEV 25/250                 $30.00
 5302036   CARBIDOPA/LEVOD 50/200     CARB/LEVO CR                    $63.00
 5302043   CARBINOX/PSEUDO            CARBIN/PSE TAB                  $35.50
 5302058   CARISOPRODOL 350MG         CARISOPRODOL350                 $75.00
 5302062   CARISOPRODOL/ASA           CARISOPRODL/ASA                 $35.50
 5302070   LEVOCARNITINE 330MG        CARNITINE 330MG                 $44.45
 5302077   CARVEDILOL 3.125MG         CARVEDILOL3.125                 $74.90
 5302078   CARVEDILOL 6.25MG          CARVEDILOL 6.25                 $74.00
 5302080   CARVEDILOL 25MG            CARVEDILOL 25MG                 $74.00
 5302085   CEFACLOR 250MG             CEFACLOR 250MG                  $85.85
 5302089   CEFACLOR 500MG             CEFACLOR 500MG                 $105.15
 5302112   CEFADROXIL 500MG           CEFADROXIL500MG                $105.15
 5302118   CEFIXIME 400MG             CEFIXIME 400MG                 $182.75
 5302121   CEFUROXIME AXETIL 250MG    CEFUROXIME250MG                $368.00
 5302123   CEFPODOXIME 100MG          CEFPODOXME100MG                 $32.70
 5302129   CELECOXIB 100MG            CELECOXIB 100MG                 $75.00
 5302158   CETYLPYRDN/BENZOC TR 18S   CEPACOL TR 18S                  $11.00
 5302204   CEPHALEXIN 250MG           CEPHALEXIN250MG                 $36.00
 5302208   CEPHALEXIN 500MG           CEPHALEXIN500MG                 $73.00
 5302235   CEPHRADINE 250MG           CEPHRADINE250MG                 $50.35
 5302246   CETIRIZINE 10MG            CETIRIZINE 10MG                 $63.00
 5302331   CHLORAMBUCIL 2MG           CHLORAMBUCIL2MG                 $17.00
 5302358   CHLORAMPHENICOL 250MG      CHLORMPHNCL 250                 $67.40
 5302385   CHLORDIAZEPOXIDE 5MG       CHLORDIAZEP 5MG                 $17.00
 5302389   CHLORDIAZEPOXIDE 10MG      CHLORDIAZP 10MG                 $21.00
 5302393   CHLORDIAZEPOXIDE 25MG      CHLORDIAZP 25MG                $218.00
 5302416   CHLOROTHIAZIDE 250MG       CHLOROTHZ 250MG                 $35.50



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  Doctors Medical Center - Modesto                                        Page 40 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 5302420   CHLOROTHIAZIDE 500MG       CHLOROTHZ 500MG                 $17.00
 5302539   CHLORPHENESIN 400MG        MAOLATE 400MG                   $44.45
 5302543   CHLORPHEN PP NYOSCAMINE    RUTUSS CAP                      $35.50
 5302565   CHLORPHENIRAMINE 4MG       CHLORPHENRMN4MG                  $8.00
 5302567   CHLORPHENIRAMINE 8MG SA    CHLORPHENRMN8MG                 $28.60
 5302569   CHLORPHENIRAMINE 12MG SA   CHLORPHNRMN12MG                 $22.15
 5302590   CHLORPROMAZINE 10MG        CHLORPROMZ 10MG                 $17.00
 5302594   CHLORPROMAZINE 25MG        CHLORPROMZ 25MG                 $17.00
 5302598   CHLORPROMAZINE 50MG        CHLORPROMZ 50MG                 $17.00
 5302637   CHLORPROPAMIDE 100MG       CHLORPROPAM 100                 $35.50
 5302641   CHLORPROPAMIDE 250MG       CHLORPROPAM 250                 $26.00
 5302664   CHLORTHALIDONE 25MG        CHLORTHALIDON25                 $26.00
 5302668   CHLORTHALIDONE 50MG        CHLORTHALIDON50                 $35.50
 5302700   CHOLESTYRAMINE RESIN BR    CHOLYBAR                       $105.15
 5302718   CHOLINE-MG                 TRILISATE 500MG                 $21.00
 5302730   CILOSTAZOL 50MG            CILOSTAZOL 50MG                 $74.50
 5302741   CIMETIDINE 200MG           CIMETIDIN 200MG                 $44.45
 5302745   CIMETIDINE 300MG           CIMETIDIN 300MG                 $26.00
 5302747   CIMETIDINE 400MG           CIMETIDIN 400MG                 $51.00
 5302748   CIMETIDINE 800MG           CIMETIDIN 800MG                $105.15
 5302762   CINACALCET 30MG            CINACALCET 30MG                 $83.35
 5302765   CINOXACINE 250MG           CINOXACINE250MG                 $44.45
 5302768   CINOXACINE 500MG           CINOXACINE500MG                 $67.40
 5302773   CITALOPRAM 20MG            CITALOPRAM 20MG                 $75.00
 5302775   CIPROFLOXACIN 250MG        CIPROFLOX 250MG                 $56.00
 5302776   CIPROFLOXACIN 500MG        CIPROFLOX 500MG                 $78.00
 5302777   CIPROFLOXACIN 750MG        CIPROFLOX 750MG                 $63.00
 5302778   CISAPRIDE 10MG             CISAPRIDE 10MG                  $77.30
 5302780   CLARITHROMYCIN 250MG       CLARTHRMCN250MG                 $59.00
 5302781   CLARITHROMYCIN 500MG       CLARTHRMCN500MG                 $59.00
 5302791   CLEMASTINE 1.34 MG         CLEMSTIN 1.34MG                 $44.45
 5302795   CLEMASTINE/P-PROP          CLEMSTINE D TAB                 $77.75
 5302814   CLINDAMYCIN 150MG          CLINDAMYCN150MG                 $75.00
 5302841   CLINDINIUM/CHLORDIAZEPXD   CLINDINIUM/CHLR                 $21.00
 5302864   CLOFIBRATE 500MG           CLOFIBRATE500MG                 $35.50
 5302890   CLOMIPRAMINE 25MG          CLOMIPRAMNE25MG                 $77.75
 5302894   CLOTRIMAZOLE TROCHE        MYCELEX TROCHE                  $74.00
 5302910   CLONAZEPAM .5MG            CLONAZEPAM .5MG                $219.00
 5302941   CLONIDINE .1MG             CLONDINE .1MG                   $73.00
 5302943   CLONIDINE .1MG-CHLORTHAL   CLONID.1CHLORTH                 $35.50
 5302947   CLONIDINE .2MG-CHLORTHAL   CLONID.2CHLORTH                 $50.35
 5302965   CLOPIDOGREL 75MG           CLOPIDOGR 75MG                  $77.00
 5302976   CLORAZEPATE CAP 3.75MG     CLORAZEPA3.75MG                 $35.50
 5302980   CLORAZEPATE CAP 7.5MG      CLORAZEPAT7.5MG                 $26.00
 5303011   CLOXACILL 250MG            CLOXACILLN250MG                 $67.40
 5303015   CLOXACILL 500MG            CLOXACILLN500MG                 $85.85
 5303038   COLCHICINE TAB .5MG        COLCHICINE .5MG                 $28.60
 5303042   COLCHICINE TAB .6MG        COLCHICINE .6MG                 $17.00
 5303044   COLESTIPOL 1G              COLESTID 1G                     $26.00
 5303065   CONJUGATED ESTR .3MG       CONJ EST .3MG                   $17.00



  CDM Run Date: 06/01/2007
  Doctors Medical Center - Modesto                                        Page 41 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 5303069   CONJUGATED ESTR .625MG     CONJ EST .625MG                 $17.00
 5303070   CONJUGATED ESTR .9MG       CONJ EST .9MG                   $36.00
 5303073   CONJUGATED ESTR 1.25MG     CONJ EST 1.25MG                 $21.00
 5303077   CONJUGATED ESTR 2.5MG      CONJ EST 2.5MG                  $35.50
 5303086   CORTISONE 5MG              CORTISONE 5MG                   $19.30
 5303087   CORTISONE 10MG             CORTISONE 10MG                  $19.30
 5303089   CORTISONE 25MG             CORTISONE 25MG                  $35.50
 5303131   SULFAMETHOX/TRIM DS TAB    SULF/TRIM DS TB                 $74.00
 5303158   CRYSTODIGIN .1MG           DIGITOXIN .1MG                  $19.30
 5303210   CYCLANDELATE 200MG         CYCLANDELT200MG                 $50.35
 5303254   CYCLOBENZAPRINE 10MG       CYCLOBNZPRN10MG                 $30.00
 5303277   CYCLOPHOSPHAMIDE 25MG      CYCLOPHOS 25MG                  $26.00
 5303281   CYCLOPHOSPHAMIDE 50MG      CYCLOSPHOS 50MG                 $26.10
 5303285   CYCLOSERINE 250MG          SEROMYCIN 250MG                $160.65
 5303286   CYCLOSPORINE 25MG          SANDIMMUNE 25MG                 $63.00
 5303289   CYCLOSPORIN 25MG SOFTGEL   NEORAL 25MG                     $63.00
 5303292   CYCLOSPORIN 100MG CAP      CYCLOSPORN100MG                 $77.50
 5303304   CYPROHEPTADINE 4MG         CYPROHEPT 4MG                   $21.00
 5303373   DANAZOL 200MG              DANAZOL 200MG                   $63.00
 5303419   DANTROLENE 25MG            DANTROLENE 25MG                 $21.00
 5303442   DAPSONE 25MG               DAPSONE 25MG                    $11.00
 5303519   DEMECLOCY TAB 150MG        DECLOMYC 150MG                  $46.00
 5303542   DESERPIDINE                ENDURONYL                       $44.45
 5303569   DESIPRAMINE 25MG           DESIPRAMIN 25MG                 $21.00
 5303596   DEXAMETHASONE .5MG         DEXAMETH .5MG                   $17.00
 5303600   DEXAMETHASONE .75MG        DEXAMETH .75MG                  $35.50
 5303603   DEXAMETHASONE 2MG          DEXAMETH 2MG                    $26.00
 5303604   DEXAMETHASONE 4MG          DEXAMETH 4MG                    $75.00
 5303610   DEXAMETHASONE 1MG          DEXAMETH 1MG                    $21.00
 5303627   DEXCHLORPHEN 2MG           POLARAMINE 2MG                  $28.60
 5303631   DEXCHLORPHEN 4MG           POLARMN REP4MG                  $35.50
 5303635   DEXCHLORPHEN 6MG           POLARMN REP6MG                  $35.50
 5303708   DIAZEPAM 2MG               DIAZEPAM 2MG                    $21.00
 5303712   DIAZEPAM 5MG               DIAZEPAM 5MG                   $218.00
 5303716   DIAZEPAM 10MG              DIAZEPAM 10MG                   $44.45
 5303745   DICLOFENAC 25MG            DICLOFENAC 25MG                 $30.00
 5303746   DICLOFENAC 50MG            DICLOFENAC 50MG                 $46.00
 5303747   DICLOFENAC 75MG            DICLOFENAC 75MG                 $63.00
 5303766   DICLOXACIL 250MG           DICLOXACIL250MG                 $46.00
 5303793   DICUMAROL 25MG             DICUMAROL 25MG                  $19.30
 5303797   DICUMAROL 50MG             DICUMAROL 50MG                  $19.30
 5303820   DICYCLOMINE 10MG           DICYCLOMINE10MG                 $17.00
 5303824   DICYCLOMINE 20MG           DICYCLOMINE20MG                 $21.00
 5303856   DIETHYLSTIL 1MG            DIETHYLSTIL 1MG                 $28.60
 5303863   DIETHYLSTIL 5MG EN         DIETHYLSTL 5MG                  $28.60
 5303890   DIFLUNISAL 250MG           DOLOBID 250MG                   $50.35
 5303894   DIFLUNISAL 500MG           DOLOBID 500MG                   $50.35
 5303900   DIGESTIVE ENZYME CAP       DIG ENZYME CAP                   $7.00
 5303902   DIGESTIVE ENZYME TAB       DIG ENZYME TAB                   $7.00
 5303940   DIGOXIN .05MG              LANOXICAP .05MG                 $28.60



  CDM Run Date: 06/01/2007
  Doctors Medical Center - Modesto                                        Page 42 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 5303944   DIGOXIN .125MG             DIGOXIN .125MG                  $73.00
 5303948   DIGOXIN .1MG               LANOXICAP .1MG                  $28.60
 5303952   DIGOXIN .25MG              DIGOXIN .25MG                   $73.00
 5303960   DIGOXIN .5MG               DIGOXIN .5MG                    $19.30
 5304010   DIHYDROTACHY .2MG          HYTAKEROL .2MG                  $35.50
 5304033   DILTIAZEM 30MG             DILTIAZEM 30MG                  $73.00
 5304037   DILTIAZEM 60MG             DILTIAZEM 60MG                  $73.00
 5304038   DILTIAZEM 90MG             DILTIAZEM 90MG                  $44.00
 5304040   DILTIAZEM SR 90MG          DILTIAZEM SR 90                 $46.00
 5304041   DILTIAZEM SR 120MG         DILTIAZEM SR120                $105.15
 5304042   DILTIAZEM SR 60MG          DILTIAZEM SR 60                 $46.00
 5304043   DILTIAZEM CD 120MG         CARDIZM CD120MG                 $74.00
 5304044   DILTIAZEM CD 180 MG        CARDIZM CD180MG                 $74.00
 5304045   DILTIAZEM CD 240 MG        CARDIZM CD240MG                 $75.00
 5304046   DILTIAZEM CD 300 MG        CARDIZM CD300MG                 $63.00
 5304060   DIMENHYDRINATE 50MG        DIMENHYRNT 50MG                 $22.15
 5304087   DIPHENHYDRA 25MG           DIPHENHYDRM 25                  $73.00
 5304091   DIPHENHYDRAMINE 50MG       DIPHENHYDR 50MG                 $17.00
 5304098   DIPHENOXYLATE/ATRP TAB     DIPHENOX/ATROP                  $17.00
 5304114   DIPYRIDAMOLE 25MG          DIPYRIDAMOL25MG                 $21.00
 5304118   DIPYRIDAMOLE 50MG          DIPYRIDAMOL50MG                 $26.00
 5304122   DIPYRIDAMOLE 75MG          DIPYRIDAMOL75MG                 $26.00
 5304123   DIPYRIDAMOLE/ASA SR CAP    DIPYRIDAMOL/ASA                 $59.00
 5304145   DISOPYRAMIDE 100MG         DISOPYRAMD100MG                 $26.00
 5304149   DISOPYRAMIDE 150MG         DISOPYRAMD150MG                 $26.00
 5304153   DISOPYRAMIDE CR 100MG      DISOPYRAMD100MG                 $26.00
 5304157   DISOPYRAMIDE CR 150MG      DISOPYRAMD150MG                 $26.00
 5304190   DIVALPROEX NA 125MG        DIVALPROEX125MG                 $31.00
 5304191   DIVALPROEX NA 250MG        DIVALPROEX250MG                 $74.00
 5304195   DIVALPROEX NA 500MG ER     DIVALPROEX500MG                 $63.00
 5304204   DOCUSATE NA/SENNOSIDES     DOCUSATE/SENNA                   $1.00
 5304219   DOCUSATE SOD 100MG         DSS 100MG                        $1.00
 5304223   DOCUSATE SOD 250MG         DSS 250MG                        $1.00
 5304246   DOCUSATE NA/CASANTHRANOL   DOCUSATE NA/CAS                 $27.30
 5304249   DOLASETRON 100MG           DOLASETRON100MG                $318.00
 5304250   DONEPEZIL 5MG              DONEPEZIL 5MG                   $78.00
 5304269   DONNATAL                   DONNATAL                        $11.00
 5304273   DONNATAL EXTENTAB          DONNATL EXTNTAB                 $21.00
 5304335   DOXAZOSIN 1MG              DOXAZOSIN 1MG                   $51.00
 5304337   DOXAZOSIN 4MG              DOXAZOSIN 4MG                   $62.00
 5304342   DOXEPIN 10MG               DOXEPIN 10MG                    $21.00
 5304365   DOXEPIN 25MG               DOXEPIN 25MG                    $21.00
 5304371   DOXEPIN 100MG              DOXEPIN 100MG                   $26.00
 5304380   DOXERCALCIFEROL 2.5MCG     DOXERCAL 2.5MCG                 $77.50
 5304388   DOXYCYCLINE 50MG           DOXYCYCLIN 50MG                 $76.05
 5304392   DOXYCYCLINE 100MG          DOXYCYCLN 100MG                 $87.00
 5304410   DULOXETINE 20MG            DULOXETINE 20MG                 $76.50
 5304411   DULOXETINE 30MG            DULOXETINE 30MG                 $76.90
 5304415   DUTASTERIDE .5MG CAP       DUTASTERIDE.5MG                 $75.90
 5304419   DYPHYLLINE 200MG           DYPHYLLIN 200MG                 $35.50



  CDM Run Date: 06/01/2007
  Doctors Medical Center - Modesto                                        Page 43 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 5304424   EFAVIRENZ 600MG            EFAVIRENZ 600MG                 $91.20
 5304429   EFAVIRENZ 100MG            EFAVIRENZ 100MG                 $99.50
 5304431   EFAVIRENZ 200MG            EFAVIRENZ 200MG                 $64.00
 5304435   ENALAPRIL/HCTZ 10/25       ENALAPRIL/HCTZ                 $105.15
 5304437   ENALAPRIL 5MG              ENALAPRIL 5MG                   $74.00
 5304439   ENALAPRIL 10MG             ENALAPRIL 10MG                  $74.00
 5304446   EPHEDRINE 25MG             EPHEDRINE 25MG                  $28.60
 5304469   ERGOCALCIFEROL 50000U      VITAMIN D 50000                 $11.00
 5304519   ERGOT ALK 1MG              ERGOLOID MES 1                  $35.50
 5304554   ERGOTAMINE/BELL/PB         ERGOT/BELL/PB                   $44.45
 5304585   ERGOTAMINE-CAFF            CAFERGOT                        $35.50
 5304601   ERLOTINIB 100MG            ERLOTINIB 100MG                $171.40
 5304602   ERLOTINIB 150MG            ERLOTINIB 150MG                $184.40
 5304635   ERYTHROMY ET 250MG         ERYC 250MG                      $44.45
 5304639   ERYTHROMY ET 400MG         EES FILMT 400MG                 $44.45
 5304644   ERYTHROMY PART COAT 333M   PCE 333MG                      $105.15
 5304645   ERYTHROMY PART COAT 500M   PCE 500MG                      $105.15
 5304647   ERYTHROMYCIN BASE 250MG    ERYTHRMYCN250MG                 $17.00
 5304649   ERYTHROMYCIN BASE 333MG    ERYTHRMYCN333MG                 $25.00
 5304651   ERYTHROMYCIN BASE FLMTAB   ERYTHRMYCN250MG                 $28.60
 5304655   ERYTHROMYCIN STEAR 250MG   ERYTHROCIN250MG                 $28.60
 5304665   ESCITALOPRAM 10MG          ESCITALOPRM10MG                 $16.45
 5304674   ESTRADIOL 1MG              ESTRACE 1MG                     $17.00
 5304697   ESTRAMUSTINE 140MG         ESTRAMUST 140MG                $105.25
 5304711   ESTROG1.25/METHYLTST 2.5   ESTRATEST                       $56.00
 5304723   ESTRONE SULFATE .625MG     EVEX 625MG                      $50.35
 5304730   ESTROPIPATE 0.625MG        ESTROPIPT.625MG                 $25.00
 5304731   ESTROPIPATE 1.25MG         ESTROPIPT1.25MG                 $30.00
 5304743   ETHACRYNIC ACID 25MG       ETHACRYN AC25MG                 $35.50
 5304770   ETHAMBUTOL 100MG           ETHAMBUTOL100MG                 $21.00
 5304774   ETHAMBUTOL 400MG           ETHAMBUTOL400MG                 $30.00
 5304797   ETHINYL ESTRADI .02MG      ESTINYL .02MG                   $28.60
 5304815   ETHIONAMIDE 250MG          TRECATOR 250MG                 $105.15
 5304865   ETHOTOIN 250MG             ETHOTOIN 250MG                  $44.45
 5304875   EZETIMIBE 10MG             EZETIMIBE 10MG                  $16.85
 5304883   ETODOLAC 200MG             ETODOLAC 200MG                  $56.00
 5304884   ETODOLAC 300MG             ETODOLAC 300MG                 $105.15
 5304890   ETOPOSIDE 50MG             ETOPOSIDE 50MG                 $980.20
 5304893   ETIDRONATE 200MG           ETIDRONATE200MG                $105.15
 5304898   FAMCICLOVIR 500MG          FAMCICLOVR500MG                $210.00
 5304899   FAMOTIDINE AC 10MG         FAMOTIDN AC10MG                 $44.45
 5304900   FAMOTIDINE 20MG            FAMOTIDINE 20MG                 $73.00
 5304901   FAMOTIDINE 40MG            FAMOTIDINE 40MG                $105.15
 5304905   FE SULF-VIT B&C            IRON+VIT B+C                    $35.50
 5304909   FE SULF-VIT B&C/FA         FE+VITBC+FOLIC                  $35.50
 5304915   FELBAMATE 400MG            FELBAMATE 400MG                 $69.70
 5304916   FELBAMATE 600MG            FELBAMATE 600MG                 $77.30
 5304920   FELODIPINE 5MG             FELODIPINE 5MG+                 $26.00
 5304932   FENOFIBRATE 67MG           FENOFIBRAT 67MG                $100.50
 5304933   FENOFIBRATE MIC 48MG       FENOFIBRAT 48MG                 $74.00



  CDM Run Date: 06/01/2007
  Doctors Medical Center - Modesto                                        Page 44 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 5304935   FENOFIBRATE MIC 54MG       FENOFIBRAT 54MG                 $60.00
 5304937   FENOFIBRATE MIC 160MG      FENOFIBRAT160MG                 $63.00
 5304938   FENOFIBRATE MIC 145MG      FENOFIBRAT145MG                 $76.00
 5304955   FENOPROFEN 200MG           FENOPROFN 200MG                 $35.50
 5304959   FENOPROFEN 300MG           FENOPROFN 300MG                 $35.50
 5304982   FERROUS FUMURATE/DSS TAB   FERRO-SEQUEL                    $13.00
 5304990   FERROUS FUM 300-350MG      FERROUS FUMARAT                 $22.15
 5304994   FERROUS FUMURAT COMBO      FE FUMARAT COMB                 $35.50
 5305017   FERROUS GLUCONATE 300MG    FERROUS GLUC300                 $11.00
 5305035   FERROUS SULFATE 195MG      MOLIRON                         $14.70
 5305042   FERROUS SULF 160MG         SLOW FE                         $21.00
 5305044   FERROUS SULF 300-325MG     FE SULF 300-325                  $1.00
 5305048   FERROUS SULF (50MG FE)     FE SULF 50MG FE                 $13.00
 5305059   FEXOFENADINE 180MG         FEXOFEN 180MG                   $10.00
 5305061   FERROUS/VIT C/FOLIC        FERO-FOLIC-500                  $28.60
 5305062   FEXOFENADINE 60MG          FEXOFEN 60MG                    $87.00
 5305065   FIBER                      FIBERCON                        $28.60
 5305066   FINASTERIDE 5MG            FINASTERIDE 5MG                 $63.00
 5305079   FLAVOXATE 100MG            FLAVOXATE 100MG                 $21.00
 5305085   FLECAINIDE 100MG           FLECAINIDE100MG                 $40.00
 5305095   FLUCONAZOLE 50MG           FLUCONAZOLE50MG                $181.85
 5305096   FLUCONAZOLE 100MG          FLUCONAZOL100MG                 $81.00
 5305097   FLUCONAZOLE 200MG          FLUCONAZOL200MG                 $86.00
 5305106   FLUCYTOSINE 500MG          FLUCYTOSNE500MG                 $40.00
 5305129   FLUDROCORTISONE .1MG       FLUDROCORT .1MG                 $21.00
 5305152   FLUORIDE .5MG              FLUORIDE .5MG                   $19.30
 5305159   FLUOXETINE 10MG            FLUOXETINE 10MG                 $75.00
 5305160   FLUOXETINE 20MG            FLUOXETINE 20MG                 $75.00
 5305179   FLUOXYMESTERONE 5MG        HALOTESTIN 5MG                  $50.35
 5305204   FLUPHENAZINE 2.5MG         FLUPHENAZN2.5MG                 $30.00
 5305206   FLUPHENAZINE 1MG           FLUPHENAZN 1MG                  $44.45
 5305221   FLURAZEPAM 15MG            FLURAZEPAM 15MG                 $21.00
 5305223   FLURAZEPAM 30MG            FLURAZEPAM 30MG                 $21.00
 5305225   FLURBIPROFEN 50MG          FLURBIPROFN50MG                 $67.40
 5305228   FLUTAMIDE 125MG            FLUTAMIDE 125MG                 $63.00
 5305230   FLUVASTATIN 20MG           FLUVASTATIN20MG                 $63.00
 5305233   FOLIC ACID 1MG             FOLIC ACID 1MG                  $73.00
 5305236   FLUVOXAMINE 100MG          FLUVOXAMIN100MG                 $63.00
 5305240   FOSINOPRIL 10MG            FOSINOPRIL 10MG                 $51.00
 5305279   FUROSEMIDE 20MG            FUROSEMIDE 20MG                 $73.00
 5305283   FUROSEMIDE 40MG            FUROSEMIDE 40MG                 $73.00
 5305287   FUROSEMIDE 80MG            FUROSEMIDE 80MG                 $73.00
 5305290   GABAPENTIN 100MG           GABAPENTIN100MG                 $73.00
 5305291   GABAPENTIN 300MG           GABAPENTIN300MG                 $74.00
 5305292   GABAPENTIN 400MG           GABAPENTIN400MG                 $74.00
 5305295   GANCICLOVIR 250MG CAP      GANCICLOVR250MG                $105.15
 5305299   GALANTAMINE 4MG            GALANTAMINE 4MG                 $75.80
 5305307   GEFITINIB 250MG            GEFITINIB 250MG                $472.80
 5305310   GEMFIBROZIL 300MG          GEMFIBROZIL 300                 $35.50
 5305311   GEMFIBROZIL 600MG          GEMFIBROZIL 600                 $74.00



  CDM Run Date: 06/01/2007
  Doctors Medical Center - Modesto                                        Page 45 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 5305321   GLIMEPIRIDE 2MG            GLIMEPIRIDE 2MG                 $73.00
 5305345   GLIPIZIDE 5MG              GLIPIZIDE 5MG                   $73.00
 5305346   GLIPIZIDE XL 5MG           GLIPIZIDE XL5MG                 $30.00
 5305356   GLUCOSE                    GLUCOSE TABS                    $19.30
 5305407   GLYBURIDE 3MG MICRONIZED   GLYBURIDE 3MG                   $36.00
 5305411   GLYBURIDE TAB 2.5MG        GLYBURIDE 2.5MG                 $21.00
 5305413   GLYBURIDE TAB 5MG          GLYBURIDE 5MG                   $73.00
 5305429   GLYCOPYRROLATE 1MG         GLYCOPYROLAT1MG                 $28.60
 5305440   GRANISETRON 1MG TAB        GRANISETRON 1MG                $120.00
 5305460   GRISEOFULVIN 250MG         GRISEOFUL 250MG                 $35.50
 5305467   GRISEOFULVIN MICRO 500MG   GRISEO MICRO500                 $60.45
 5305480   GUAIFENESIN 200MG          GUAIFENESIN 200                 $28.60
 5305481   GUAIFENESIN 600MG          GUAIFENESIN 600                 $73.00
 5305484   GUAIFENESIN/DM SR TA       HUMIBID DM                      $18.70
 5305506   GUANABENZ 4MG              GUANABENZ 4MG                   $44.45
 5305529   GUANETHIDINE SU 10MG       GUANETHIDN 10MG                 $35.50
 5305540   GUANFACINE 1MG             GUANFACINE 1MG                  $30.00
 5305610   HALOPERIDOL .5MG           HALOPERIDL .5MG                 $21.00
 5305614   HALOPERIDOL 1MG            HALOPERIDL 1 MG                 $73.00
 5305618   HALOPERIDOL 2 MG           HALOPERIDL 2 MG                 $44.45
 5305622   HALOPERIDOL 5MG            HALOPERIDL 5 MG                 $30.00
 5305672   HYDRALAZINE 10MG           HYDRALAZIN 10MG                 $17.00
 5305676   HYDRALAZINE 25 MG          HYDRALAZIN 25MG                 $21.00
 5305680   HYDRALAZINE 50MG           HYDRALAZIN 50MG                 $21.00
 5305685   HYDRALAZINE-HCTZ 25/15     HYDRALHCTZ25/15                 $35.50
 5305686   HYDRALAZINE-HCTZ 25/25     HYDRALHCTZ25/25                 $35.50
 5305715   HYDROCHLOROTHIA 25MG       HCTZ 25MG                       $73.00
 5305719   HYDROCHLOROTHIA 50MG       HCTZ 50MG                       $17.00
 5305742   HYDROCORTISONE 10MG        HCTS 10MG                       $11.00
 5305745   HYDROCORTISONE 20MG        HCTS 20MG                       $17.00
 5305788   HYDROXYCHLOROQUINE200MG    HDRXYCLRQN200MG                 $21.00
 5305811   HYDROXYUREA 500MG          HYDRXYUREA500MG                 $36.00
 5305830   HYDROXYZINE 10MG           HYDROXYZINE10MG                 $13.00
 5305834   HYDROXYZINE PAMOATE 25MG   HYDROXYZINE25MG                 $73.00
 5305838   HYDROXYZINE PAMOATE 50MG   HYDROXYZINE50MG                 $26.00
 5305865   HYOSCYAMINE .125MG         HYOSCYAM .125MG                 $21.00
 5305888   HYOSCYAMINE .150MG         HYOSCYAM .150MG                 $35.50
 5305893   HYOSCYAMINE LA .375MG      HYOSCYAM .375MG                 $21.00
 5305909   IBUPROFEN TAB 200MG        IBUPROFEN 200MG                  $1.00
 5305911   IBUPROFEN 300MG            IBUPROFEN 300MG                  $2.00
 5305915   IBUPROFEN 400MG            IBUPROFEN 400MG                  $2.00
 5305919   IBUPROFEN 600MG            IBUPROFEN 600MG                  $3.00
 5305920   IBUPROFEN 800MG            IBUPROFEN 800MG                  $7.65
 5305930   IMATINIB 100MG             IMATINIB 100MG                 $159.40
 5305942   IMIPRAMINE PM 75MG         IMIPRAMINE 75MG                 $36.00
 5305949   IMIPRAMINE 10MG            IMIPRAMINE 10MG                 $17.00
 5305950   IMIPRAMINE 25MG            IMIPRAMINE 25MG                 $21.00
 5305954   IMIPRAMINE 50MG            IMIPRAMINE 50MG                 $26.00
 5305977   INDAPAMIDE 2.5MG           INDAPAMIDE2.5MG                 $30.00
 5305989   INDINAVIR 200MG            INDINAVIR 200MG                $105.15



  CDM Run Date: 06/01/2007
  Doctors Medical Center - Modesto                                        Page 46 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 5305990   INDINAVIR 400MG            INDINAVIR 400MG                $105.15
 5306000   INDOMETHACIN 25MG          INDOMETHACIN 25                 $26.00
 5306004   INDOMETHACIN 50MG          INDOMETHACIN 50                 $44.45
 5306008   INDOMETHACIN SR 75MG       INDOMETH SR75MG                 $46.00
 5306051   IRBESARTAN 150 MG          IRBESARTAN 150M                 $74.00
 5306055   IRON POLYSACC/B12/FA CAP   NIFER FORTE 150                 $21.00
 5306075   IRON-VIT12 INTRINSIC FAC   IRON+VIT B12                    $30.00
 5306097   ISONIAZID 100MG            ISONIAZID 100MG                 $11.00
 5306100   ISONIAZID 300MG            ISONIAZID 300MG                 $11.00
 5306119   ISOPROPAMIDE 5MG           DARBID 5MG                      $35.50
 5306173   ISOSORBIDE 5MG             ISOSORBIDE 5MG                  $17.00
 5306177   ISOSORBIDE 10MG            ISOSORBIDE 10MG                 $73.00
 5306181   ISOSORBIDE 20MG            ISOSORBIDE 20MG                 $73.00
 5306182   ISOSORBIDE MONO 20MG       ISOSORB MON20MG                 $51.00
 5306184   ISOSORBIDE MONONITR 30MG   ISOSORB MON30MG                 $74.00
 5306185   ISOSORBIDE SR 40MG         ISOSORB SR 40MG                 $21.00
 5306186   ISOSORBID MONONI ER 60MG   IMDUR 60MG                      $64.00
 5306188   ISOSORBIDE CHEW 5MG        ISOSOR CHW 5MG                  $28.60
 5306193   ISOSORBIDE SL 2.5MG        ISOSOR SL 2.5MG                 $28.60
 5306197   ISOSORBIDE SL 5MG          ISOSOR SL 5MG                   $28.60
 5306247   ISOXSUPRINE 10MG           ISOXSUPRINE10MG                 $35.50
 5306254   ISRADIPINE CR 5MG          ISRADIPN CR 5MG                 $74.90
 5306255   ISRADIPINE 2.5MG           ISRADIPINE2.5MG                 $41.00
 5306256   ISRADIPINE 5MG             ISRADIPINE 5MG                  $51.00
 5306257   ITRACONAZOLE 100MG         INTRACONAZ100MG                $100.00
 5306261   IVERMECTIN 3MG             IVERMECTIN 3MG                 $112.60
 5306293   KETOCONAZOLE 200MG         KETOCONZLE200MG                 $63.00
 5306298   KETOPROFEN 50MG            KETOPROFEN 50MG                 $60.45
 5306299   KETOPROFEN 75MG            KETOPROFEN 75MG                 $67.40
 5306300   KETOROLAC 10MG             KETOROLAC 10MG                  $74.00
 5306315   L-GLUTAMINE 500MG          L-GLUTAMIN500MG                 $21.00
 5306316   L-LYSINE 500MG             L-LYSINE 500MG                  $11.00
 5306320   LABETALOL 100MG TAB        LABETALOL 100MG                 $26.00
 5306321   LABETALOL 200MG TAB        LABETALOL 200MG                 $26.00
 5306335   LACTASE 3000 IU TAB        LACTASE 3000 IU                 $35.50
 5306343   LACTOBACILLUS TABS         LACTINEX TAB                    $22.15
 5306345   LAMIVUDINE 150MG           LAMIVUDINE150MG                 $63.00
 5306347   LAMOTRIGINE 100MG          LAMOTRIGNE100MG                 $59.00
 5306349   LAMOTRIGINE 200MG          LAMOTRIGNE200MG                 $59.00
 5306350   LAXATIVE OTC TAB/CAP       OTC LAXATIVE                  No charge
 5306351   LANSOPRAZOLE 15MG          LANSOPRAZLE15MG                 $63.00
 5306352   LANSOPRAZOLE 30MG          LANSOPRAZLE30MG                 $78.00
 5306354   LANSOPRAZOLE 15MG SOLU-T   LANSOPRAZLE15MG                 $76.20
 5306355   LANSOPRAZOLE 30MG SOLU-T   LANSOPRAZLE30MG                 $76.20
 5306361   LANTHANUMB CARB 500MG      LANTHANUM 500MG                 $75.10
 5306364   LEFLUNOMIDE 20MG           LEFLUNOMIDE20MG                 $91.00
 5306389   LEUCOVORIN CA 5MG          LEUCOVORIN 5MG                 $157.00
 5306393   LEUCOVORIN CA 25MG         LEUCOVORIN 25MG                $301.00
 5306400   LEVAMISOLE 50MG            LEVAMISOLE 50MG                $227.00
 5306406   LEVETIRACETAM 500MG        LEVETIRACETM500                 $16.30



  CDM Run Date: 06/01/2007
  Doctors Medical Center - Modesto                                       Page 47 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION        BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 5306420   LEVODOPA 250MG            LEVODOPA 250MG                  $28.60
 5306428   LEVOFLOXACIN 750MG        LEVOFLOX 750MG                  $93.50
 5306430   LEVOFLOXACIN 250MG        LEVOFLOX 250MG                  $82.00
 5306431   LEVOFLOXACIN 500MG        LEVOFLOX 500MG                  $83.00
 5306432   LEVONORGESTREL .75MG      LEVONORGES.75MG                 $92.00
 5306435   LEVOTHYROXIN .088MG       LEVOTHYRX .088M                 $14.00
 5306447   LEVOTHYROXIN .025MG       LEVOTHYRX.025MG                 $14.00
 5306451   LEVOTHYROXIN .05MG        LEVOTHYRXN.05MG                 $14.00
 5306454   LEVOTHYROXIN .075MG       LEVOTHYRX.075MG                 $14.00
 5306455   LEVOTHYROXIN .15MG        LEVOTHYRXN.15MG                 $18.00
 5306456   LEVOTHYROXIN .112MG       LEVOTHYRX.112MG                 $14.00
 5306457   LEVOTHYROXIN .137MG       LEVOTHYRX.137MG                 $73.20
 5306458   LEVOTHYROXIN .125MG       LEVOTHYRX.125MG                 $18.00
 5306459   LEVOTHYROXIN .1MG         LEVOTHYRXIN.1MG                 $94.00
 5306463   LEVOTHYROXIN .2MG         LEVOTHYRXIN.2MG                 $18.00
 5306467   LEVOTHYROXIN .3MG         LEVOTHYRXIN.3MG                 $30.35
 5306501   LINEZOLID 600MG TABLET    LINEZOLID 600MG                $135.00
 5306513   LIOTHYRONINE 5MCG         CYTOMEL 5MCG                    $21.00
 5306517   LIOTHYRONINE 25MCG        CYTOMEL 25MCG                   $11.00
 5306540   LIOTRIX 30MG              THYROLAR-1/2 30                 $28.60
 5306544   LIOTRIX 60MG              THYROLAR-1 60MG                 $28.60
 5306567   LIOTRIX 120MG             THYROLAR2 120MG                 $28.60
 5306635   LISINOPRIL 5 MG           LISINOPRIL 5 MG                 $74.00
 5306636   LISINOPRIL 10MG           LISINOPRL 10 MG                 $74.00
 5306674   LITHIUM CARBONATE 150MG   LITHIUM 150MG                   $16.00
 5306675   LITHIUM CARBONATE 300MG   LITHIUM 300MG                   $16.00
 5306698   LOMUSTINE 10MG            CEENU 10MG                      $28.60
 5306702   LOMUSTINE 40MG            CEENU 40MG                      $60.45
 5306706   LOMUSTINE 100MG           CEENU 100MG                     $94.20
 5306729   LOPERAMIDE 2MG            LOPERAMIDE 2MG                  $26.00
 5306730   LOPINAVIR/RITONAVIR CAP   KALETRA CAP                     $27.37
 5306731   LOPINAVIR/RITONAVIR TAB   KALETRA TAB                     $79.40
 5306740   LORATADINE 10MG           LORATADINE 10MG                 $63.00
 5306741   LORATADINE/PSE 5/120      LORATADINE/PSE                  $63.00
 5306742   LORATADINE/PSE 10/240     LORATADINE/PSE                  $63.00
 5306749   LORAZEPAM .5MG            LORAZEPAM .5MG                 $219.00
 5306752   LORAZEPAM 1MG             LORAZEPAM 1MG                  $219.00
 5306757   LOSARTAN 50MG             LOSARTAN 50MG                  $105.15
 5306759   LOSARTAN 25MG             LOSARTAN 25MG                   $74.00
 5306760   LOVASTATIN 20MG           LOVASTATIN 20MG                 $75.00
 5306783   LOXAPINE 25MG             LOXAPINE 25MG                   $50.35
 5306832   MAGNESIUM CHLORIDE        SLOW-MAG                        $17.00
 5306856   MAGNESIUM GLUCON 500MG    MAGN GLUCON 500                 $11.00
 5306891   MAPROTILINE 25MG          MAPROTILIN 25MG                 $35.50
 5306941   MEBENDAZOLE 100MG         VERMOX 100MG                   $105.15
 5306968   MECLIZINE TAB 12.5MG      MECLIZINE 12.5M                 $21.00
 5306972   MECLIZINE TAB 25MG        MECLIZINE 25MG                  $21.00
 5306999   MECLOFENAMATE 100MG       MECLOMEN 100MG                  $44.45
 5307022   MEDROXYPROGEST 2.5MG      PROVERA 2.5MG                   $21.00
 5307023   MEDROXYPROGEST 5MG        PROVERA 5MG                     $36.00



  CDM Run Date: 06/01/2007
  Doctors Medical Center - Modesto                                        Page 48 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 5307026   MEDROXYPROGEST 10MG        PROVERA 10MG                    $50.35
 5307076   MEGESTROL 40MG             MEGESTROL 40MG                  $40.00
 5307080   MELATONIN 3MG              MELATONIN 3MG                   $26.00
 5307111   MEMANTINE 10MG             MEMANTINE 10MG                  $75.30
 5307122   MENADIOL 5MG               SYNKAYVITE 5MG                  $19.30
 5307168   MEPHENYTOIN 100MG          MPHENYTOIN100MG                 $28.60
 5307218   MEPRO-BENACTYZ             DEPROL                          $35.50
 5307241   MEPROBAMATE 200MG          MEPROBAMATE 200                 $35.50
 5307249   MEPROBAMATE 400MG          MEPROBAMATE 400                 $21.00
 5307253   MEPROBAMATE ETH            EQUAGESIC                       $35.50
 5307276   MERCAPTOPURINE 50MG        MERCAPTOPRN50MG                 $21.00
 5307280   MESALAMINE 400MG TAB       MESALAMINE400MG                 $74.00
 5307281   MESALAMINE 250MG CAP       MESALAMINE250MG                 $73.00
 5307303   MESORIDAZINE 25MG          MESORIDAZNE25MG                 $35.50
 5307323   METAPROTERENOL 10MG        METAPROTERNL 10                 $21.00
 5307326   METAPROTERENOL 20MG        METAPROTERNL 20                 $21.00
 5307330   METAXOLONE 400MG           METAXOLONE400MG                 $74.00
 5307331   METAXOLONE 800MG           METAXOLONE800MG                 $15.85
 5307360   METFORMIN 500MG            METFORMIN 500MG                 $73.00
 5307361   METFORMIN 850MG            METFORMIN 850MG                 $74.00
 5307362   METFORMIN XR 500MG         METFORMNXR500MG                 $50.00
 5307376   METHANTHELINE 50MG         BANTHINE 50MG                   $35.50
 5307399   METHAZOLAMIDE 50MG         NEPTAZANE 50MG                  $35.50
 5307422   METHCLOTHIAZID 5MG         ENDURONYL 5MG                   $35.50
 5307449   METHDILAZINE 8MG           TACARYL 8MG                     $35.50
 5307472   METHENAMINE 500MG          METHENAMI 500MG                 $19.30
 5307476   METHENAMINE 1GM            METHENAMI 1GM                   $35.50
 5307480   METHENAMINE HIP            HIPREX                          $44.45
 5307484   METHENAMINE ATR            URISED                          $35.50
 5307507   METHIMAZOLE 10MG           METHIMAZOLE10MG                 $11.00
 5307530   METHOCARBAMOL 500MG        METHOCARB 500MG                 $21.00
 5307534   METHOCARBAMOL 750MG        METHOCARB 750MG                 $21.00
 5307538   METHOCARBAMOL/ASA          METHOCARB/ASA                   $35.50
 5307561   METHOTREXATE 2.5MG         METHOTREX 2.5MG                 $30.00
 5307569   METHSCOPALAMINE BR 2.5MG   METHSCOPALMN2.5                 $72.20
 5307572   METHYLCELLULOSE PKT        METHYLCELLU PKT                  $2.00
 5307577   METHYCLOTHIAZIDE 5MG       METHCLOTZ 5MG                   $35.50
 5307584   METHYLDOPA 125MG           METHYLDOPA125MG                 $35.50
 5307588   METHYLDOPA 250MG           METHYLDOPA250MG                 $21.00
 5307592   METHYLDOPA 500MG           METHYLDOPA500MG                 $21.00
 5307604   METHYLDOPA-HYDR-15         METHDOPAHYDR-15                 $35.50
 5307608   METHYLDOPA-HYDR-25         METHDOPAHYDR-25                 $35.50
 5307631   METHYLERGONOVIN .2MG       METHERGINE .2MG                 $17.00
 5307654   METHYLPRED 16MG            METHYLPRED 16MG                 $46.00
 5307658   METHYLPRED 4MG             METHYLPRED 4MG                  $26.00
 5307662   METHYLPRED DOSEPAK         METHYLPRED DSPK                $556.35
 5307685   METHYLTESTOSTERONE 10MG    METESTOSTRON 10                 $28.60
 5307708   METHYSERGIDE 2MG           METHYSERGIDE2MG                 $50.35
 5307731   METOCLOPRAMIDE 10MG        METOCLOPRA 10MG                 $73.00
 5307756   METOLAZONE 0.5 MG          METOLAZONE .5MG                 $44.45



  CDM Run Date: 06/01/2007
  Doctors Medical Center - Modesto                                        Page 49 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 5307758   METOLAZONE 2.5MG           METOLAZON 2.5MG                 $21.00
 5307762   METOLAZONE 5MG             METOLAZONE 5MG                  $21.00
 5307785   METOPROLOL 50MG            METOPROLOL 50MG                 $73.00
 5307786   METOPROLOL EXT REL 50 MG   TOPROL XL 50 MG                 $73.00
 5307789   METOPROLOL 100MG           METOPROLO 100MG                 $73.00
 5307791   METOPROLOL 25MG            METOPROLOL 25MG                 $73.00
 5307812   METRONIDAZOLE 250MG        METRONIDZL250MG                 $73.00
 5307835   METYRAPONE 250MG           METYRAPONE250MG                 $94.20
 5307836   MEXILETINE 150MG           MEXILETINE150MG                 $30.00
 5307837   MEXILETINE 200MG           MEXILETINE200MG                 $36.00
 5307838   MEXILETINE 250MG           MEXILETINE250MG                 $36.00
 5307841   MIDODRINE 2.5MG            MIDODRINE 2.5MG                 $63.00
 5307844   MIDODRINE 10MG             MIDODRINE 10MG                  $77.60
 5307858   MINOCYCLINE CAP 50MG       MINOCYCLINE50MG                 $67.40
 5307880   MIRTAZAPINE 15MG           MIRTAZAPINE15MG                 $75.00
 5307881   MINOXIDIL 2.5MG            MINOXIDIL 2.5MG                 $17.00
 5307889   MINOXIDIL 10MG             MINOXIDIL 10MG                  $30.00
 5307890   MISOPROSTOL 100MCG         MISOPROST100MCG                 $74.00
 5307891   MISOPROSTOL 200MCG         MISOPROST200MCG                 $85.85
 5307903   MONTELUKAST 10MG           MONTELUKAST10MG                 $76.00
 5307904   MONTELUKAST 5MG            MONTELUKAST 5MG                 $21.40
 5307905   MONTELUKAST 4MG            MONTELUKAST 4MG                 $21.90
 5307906   MORICIZINE 200MG           MORICIZINE200MG                 $67.40
 5307907   MORICIZINE 250MG           MORICIZINE250MG                 $77.75
 5307908   MORICIZINE 300MG           MORICIZINE300MG                $105.15
 5307911   MULTIVIT HEMATINIC         MULTIVIT HEMTIN                 $35.50
 5307912   MULTIVIT THERAP            MULTIVIT THERAP                 $73.00
 5307914   MULTIVIT THERAP/IRON       MULTIVIT+IRON                   $35.50
 5307916   MULTIVIT THERAP/MIN        MULTIVIT THERAP                 $13.00
 5307943   MULTIVITAMINS-M            MULTIVIT+MINRAL                 $14.70
 5307947   MULTIVITAMINS-PRENATAL     PRENATAL VITAMN                 $28.60
 5307951   MULTIVITAMINS-S            MULTIVIT+FLUORI                 $28.60
 5307956   MYCOPHENOLATE 250MG        CELLCEPT 250MG                  $76.00
 5307960   NABUMETONE 500MG           NABUMETONE500MG                 $63.00
 5307973   NADOLOL 20 MG              NADOLOL 20MG                    $94.20
 5307974   NADOLOL 40MG               NADOLOL 40MG                    $26.00
 5308028   NAFCILLIN 250MG            NAFCILLIN 250MG                 $50.35
 5308055   NALIDIXIC ACID 500MG       NALIDIXIC 500MG                 $44.45
 5308078   NAPROXEN 250MG             NAPROXEN 250MG                  $30.00
 5308082   NAPROXEN 275MG             NAPROXEN 275MG                  $30.00
 5308086   NAPROXEN 375MG             NAPROXEN 375MG                  $40.00
 5308088   NAPROXEN 500MG             NAPROXEN 500MG                  $51.00
 5308089   NAPROXEN                   NAPROXEN DS                    $105.15
 5308092   NATEGLINIDE 60MG           NATEGLINIDE60MG                $105.15
 5308093   NATEGLINIDE 120MG          NATEGLINID120MG                 $74.00
 5308095   NEFAZODONE 100MG           NEFAZODONE 100                  $63.00
 5308096   NEFAZODONE 150MG           NEFAZODONE 150                  $63.00
 5308099   NELFINAVIR 250MG           NELFINAVIR250MG                 $66.00
 5308105   NEOMYCIN 500MG             NEOMYCIN 500MG                  $74.00
 5308128   NEOSTIGMINE 15MG           NEOSTIGMIN 15MG                 $28.60



  CDM Run Date: 06/01/2007
  Doctors Medical Center - Modesto                                        Page 50 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 5308130   NEVIRAPINE 200MG           NEVIRAPINE200MG                $108.00
 5308174   NIACIN 50MG                NIACIN 50MG                     $11.00
 5308197   NIACIN 100MG               NIACIN 100MG                    $17.90
 5308220   NIACIN 125MG               NIACIN 125MG                    $35.50
 5308224   NIACIN 250MG               NIACIN 250MG                    $67.40
 5308247   NIACIN 500MG               NIACIN 500MG                    $11.00
 5308248   NIACIN ER 500MG            NIACIN ER 500MG                 $46.00
 5308270   NICARDIPINE SR 30MG        NICARDIPINE30MG                 $69.70
 5308271   NICARDIPINE 20MG           NICARDIPINE20MG                 $44.45
 5308272   NICARDIPINE 30MG           NICARDIPINE30MG                 $60.45
 5308273   NICARDIPINE SR 45MG        NICARDIPINE45MG                $105.15
 5308275   NICOTINE RESN 2MG GUM EA   NICORETTE 2MG                   $21.00
 5308305   NIFEDIPINE EXT REL 90MG    ADALAT CC 90MG                  $58.00
 5308306   NIFEDIPINE EXT REL 60MG    ADALAT CC 60MG                 $100.00
 5308307   NIFEDIPINE EXT REL 30MG    ADALAT CC 30MG                  $88.00
 5308308   NIFEDIPINE EXT REL 90MG    PROCARDA XL90MG                $105.15
 5308309   NIFEDIPINE EXT REL 60MG    PROCARDA XL60MG                $105.15
 5308310   NIFEDIPINE EXT REL 30MG    PROCARDA XL30MG                $105.15
 5308312   NIFEDIPINE 10MG            NIFEDIPINE 10MG                 $73.00
 5308320   NIMODIPINE 30MG            NIMODIPINE 30MG                 $81.00
 5308325   NISOLDIPINE 10MG           NISOLDIPINE10MG                 $56.00
 5308335   NITROFURANTOIN TAB 50MG    MACRODANTIN 50                  $26.00
 5308337   NITROFURANTOIN CAP 100MG   MACRODANTIN 100                 $63.00
 5308341   NITROFURANTOIN TAB 50MG    FURADANTIN 50MG                 $35.50
 5308342   NITROFURAN MON/MAC 75/25   NITROFUR 75/25                  $63.00
 5308358   NITROGLYCERIN CAP 2.5MG    NTG CAP 2.5MG                   $21.00
 5308362   NITROGLYCERIN CAP 6.5MG    NTG CAP 6.5MG                   $21.00
 5308366   NITROGLYCERIN CAP 9MG      NTG CAP 9MG                     $44.45
 5308371   NITROGLYCERIN SL .15MG25   NTG SL .15MG 25                $165.75
 5308375   NITROGLYCERIN SL .3MG 25   NTG SL .3MG #25                $165.75
 5308378   NITROGLYCERIN SL .4MG      NTG SL .4MG                     $11.00
 5308379   NITROGLYCERIN SL .4MG 25   NTG SL .4MG #25                 $78.00
 5308383   NITROGLYCERIN SL .6MG 25   NTG SL .6MG #25                $165.75
 5308392   NIZATIDINE 150MG           NIZATIDINE150MG                 $63.00
 5308410   NORFLOXACIN 400MG          NORFLOXACN400MG                 $63.00
 5308428   NORTRIPTYLINE 10MG         NORTRIPTYLN10MG                 $17.00
 5308432   NORTRIPTYLINE 25MG         NORTRIPTYLN25MG                 $21.00
 5308455   NYLIDRIN 6MG               NYLIDRIN 6MG                    $35.50
 5308482   NYSTATIN 500000U TAB       NYSTATIN TAB                    $44.45
 5308483   NYSTATIN PASTIL 200000U    NYSTATIN 200KU                  $85.85
 5308485   OMEPRAZOLE 10MG            OMEPRAZOLE 10MG                 $52.00
 5308486   OMEPRAZOLE 20MG            OMEPRAZOLE 20MG                 $63.00
 5308487   OFLOXACIN 200MG            OFLOXACIN 200MG                 $64.00
 5308488   OFLOXACIN 300MG            OFLOXACIN 300MG                $125.95
 5308489   OFLOXACIN 400MG            OFLOXACIN 400MG                $133.65
 5308492   ONDANSETRON ODT 4MG        ONDANSETRON 4MG                 $73.00
 5308493   ORPHENADRINE 100MG         ORPHENADRN100MG                 $30.00
 5308495   ONDANSETRON 4MG            ONDANSETRON 4MG                 $98.00
 5308496   ONDANSETRON 8MG            ONDANSETRON 8MG                $539.10
 5308497   OLANZAPINE 5MG             OLANZAPINE 5MG                  $79.00



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  Doctors Medical Center - Modesto                                        Page 51 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 5308500   OLANZAPINE 2.5MG           OLANZAPINE2.5MG                 $78.00
 5308504   OSELTAMIVIR 75MG           OSELTAMIVIR75MG                 $88.00
 5308506   OLANZAPINE ZYDIS 5MG       OLANZAPINE 5MG                  $82.10
 5308520   OLMESARTAN 20MG            OLMESARTAN 20MG                 $11.75
 5308540   OXAPROZIN 600MG            OXAPROZIN 600MG                 $63.00
 5308555   OXAZEPAM 10MG              OXAZEPAM 10 MG                  $21.00
 5308559   OXAZEPAM 15MG              OXAZEPAM 15 MG                  $21.00
 5308571   OXCARBAZEPINE 300MG        OXCARBAZPN300MG                 $75.40
 5308590   OXTRIPHYLLINE 200MG        CHOLEDYL 200MG                  $28.60
 5308594   OXTRIPHYLLINE 600MG        CHOLEDYL 600MG                  $35.50
 5308597   OXTRIPHYLLINE SA 400MG     CHOLEDYL SA 400                 $35.50
 5308640   OXYBUTYNIN 5MG             OXYBUTYNIN 5MG                  $21.00
 5308641   OXYBUTYNIN EXT REL 5MG     OXYBUTYN ER 5MG                 $76.40
 5308763   P-EPHEDRINE D-B            DRIXORAL                        $35.50
 5308786   P.E.T.N. 20MG              P.E.T.N. 20MG                   $28.60
 5308870   PANTOPRAZOLE 40MG          PANTOPRZ 40MG                   $76.00
 5308890   PAPAVERINE 150MG           PAPAVERIN 150MG                 $17.00
 5308950   PAROXETINE 20MG            PAROXETINE 20MG                 $76.00
 5308951   PAROXETINE 30MG            PAROXETINE 30MG                $105.15
 5308990   PENICILLAMINE 250MG        PENICILLMN250MG                 $50.35
 5309013   PENICILLIN G 200MU         PEN G 200MU                     $11.00
 5309017   PENICILLIN G 400MU         PEN G 400MU                     $28.60
 5309025   PENICILLIN V POT 250MG     PEN V K 250MG                   $21.00
 5309029   PENICILLIN V POT 500MG     PEN V K 500MG                   $21.00
 5309052   PENTAZOCINE 50MG           PENTAZOCINE50MG                 $35.50
 5309056   PENTAZOCINE/ACETAMINOPHN   PENTAZOCNE/APAP                 $44.45
 5309060   PENTAZOCINE/ASPIRIN        PENTAZOCINE/ASA                 $35.50
 5309063   PENTAZOCINE/NALOXONE       PENTAZOCN/NALOX                 $51.00
 5309065   PENTOSAN POLYSULF 100MG    PENTOSAN 100MG                  $75.80
 5309066   PENTOXIFYLLINE 400MG       PENTOXFYLN400MG                 $26.00
 5309090   PERGOLIDE .05MG            PERGOLIDE .05MG                 $67.40
 5309106   PERPHENAZINE 2MG           PERPHENAZINE2MG                 $21.00
 5309110   PERPHENAZNE/AMITRIP 2/10   PERPHENZN/AMITR                 $35.50
 5309114   PERPHENAZNE/AMITRIP 2/25   PERPHENZN/AMITR                 $44.45
 5309118   PERPHENAZNE/AMITRIP 4/10   PERPHENZN/AMITR                 $44.45
 5309122   PERPHENAZNE/AMITRIP 4/25   PERPHENZN/AMITR                 $44.45
 5309145   PHENAZOPYRIDINE 100MG      PHENAZOPYRD 100                 $21.00
 5309149   PHENAZOPYRIDINE 200MG      PHENAZOPYRD 200                 $21.00
 5309152   PHENAZOPYRIDINE/HYOS/BUT   PYRIDIUM PLUS                   $44.45
 5309172   PHENELZINE 15MG            PHENELZINE 15MG                 $35.50
 5309195   PHENOL-SODIUM              CHLORSPT MN LOZ                 $46.80
 5309245   PHENOXYBENZAMINE 10MG      PHENOXYBENZ10MG                 $11.00
 5309314   PHENYLBUTAZONE 100MG       PHENLBUTZN100MG                 $35.50
 5309337   PHENYLP/PHENYLEPH/GUAIF    ENTEX                           $35.50
 5309341   PHENYLEPHRN/GUAF 30/600    ENTEX LA                        $35.50
 5309345   PHENYLEPH/CPM/PHTOLOX LA   COMHIST-LA                      $35.50
 5309376   PHENYLPROP-APAP            SINUTAB                         $22.15
 5309384   PHENYLPROP-CHLOR           ORNADE SPAN                     $35.50
 5309411   PE/PHENYLP/PHENYLT/CPM     NALDECON                        $44.45
 5309434   PHENYTOIN 50MG             PHENYTOIN 50MG                  $17.00



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  Doctors Medical Center - Modesto                                        Page 52 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 5309438   PHENYTOIN 100MG            PHENYTOIN 100MG                 $73.00
 5309461   PHYTONADIONE 5MG           PHYTONADIONE5MG                 $21.00
 5309484   PINDOLOL 5MG               PINDOLOL 5MG                    $21.00
 5309487   PINDOLOL 10MG              PINDOLOL 10MG                   $30.00
 5309500   PIOGLITAZONE 15MG TAB      PIOGLITAZN 15MG                 $76.00
 5309502   PIOGLITAZONE 30MG TAB      PIOGLITAZN 30MG                 $78.00
 5309504   PIOGLITAZONE 45MG TAB      PIOGLITAZN 45MG                 $79.00
 5309530   PIROXICAM 10MG             PIROXICAM 10MG                  $67.40
 5309534   PIROXICAM 20MG             PIROXICAM 20MG                  $51.00
 5309603   PLACEBO ORANGE             CEBOCAP OR                      $14.70
 5309649   POTASSIUM ACID 500MG       K-PHOS 500MG                    $11.00
 5309653   POTASSIUM CL 600MG         KCL 600MG                       $28.60
 5309657   POTASSIUM CL 10MEQ         KCL 750MG                       $73.00
 5309658   POTASSIUM CL 20 MEQ        KCL 20MEQ                       $44.45
 5309665   POTASSIUM CL 8MEQ          KCL 600MG                       $73.00
 5309673   POTASSIUM GLUC 5MEQ        POT GLUC 5MEQ                   $28.60
 5309685   POTASSIUM PHOSPHAT 1.45G   NEUTRA-PHOS-K                   $21.00
 5309686   SOD/POT/PHOS NEUTRAL TAB   K PHOS NEUT TAB                 $21.00
 5309690   PRAVASTATIN 10MG           PRAVASTATIN10MG                 $63.00
 5309691   PRAVASTATIN 20MG           PRAVASTATIN20MG                 $76.00
 5309692   PRAMIPEXOLE .25MG          PRAMIPEXOL.25MG                 $74.70
 5309693   PRAMIPEXOLE .125MG         PRAMIPEXL.125MG                 $74.30
 5309696   PRAZEPAM 10MG              PRAZEPAM 10MG                   $60.45
 5309700   PRAZEPAM 5MG               PRAZEPAM 5MG                    $35.50
 5309706   PRAMIPEXOLE .5MG           PRAMIPEXOLE.5MG                 $75.20
 5309715   PRAZIQUANTEL 600MG         PRAZIQUNTL600MG                $105.15
 5309723   PRAZOSIN 1MG               PRAZOSIN 1MG                    $21.00
 5309731   PRAZOSIN 5MG               PRAZOSIN 5MG                    $30.00
 5309754   PREDNISOLONE 5MG           PREDNISOLON 5MG                 $28.60
 5309777   PREDNISONE 1MG             PREDNISONE 1MG                  $11.00
 5309785   PREDNISONE 5MG             PREDNISONE 5MG                  $11.00
 5309789   PREDNISONE 10MG            PREDNISONE 10MG                 $73.00
 5309793   PREDNISONE 20MG            PREDNISONE 20MG                 $73.00
 5309795   PREGABALIN 25MG CAP        PREGABALIN 25MG                 $74.80
 5309796   PREGABALIN 50MG CAP        PREGABALIN 50MG                 $74.80
 5309797   PREDNISONE 50MG            PREDNISONE 50MG                 $26.00
 5309798   PREGABALIN 75MG            PREGABALIN 75MG                 $74.80
 5309800   PRENATAL VITAMINS          STUART PRENATAL                 $73.00
 5309820   PRIMIDONE 50MG             PRIMIDONE 50MG                  $11.00
 5309824   PRIMIDONE 250MG            PRIMIDONE 250MG                 $17.00
 5309847   PROBENECID 500MG           PROBENECID500MG                 $21.00
 5309851   PROBENECID/COLCHICINE      PROBENCID/COLCH                 $35.50
 5309874   PROBUCOL 250MG             PROBUCOL 250MG                  $44.45
 5309897   PROCAINAMIDE 250MG SR      PROCAINMIDSR250                 $35.50
 5309901   PROCAINAMIDE 500MG SR      PROCAINMIDSR500                 $21.00
 5309905   PROCAINAMIDE 750MG SR      PROCAINMIDSR750                 $30.00
 5309906   PROCAINAMIDE 1GM SR        PROCAINMID SR1G                 $85.85
 5309909   PROCAINAMIDE CAP 250MG     PROCAINAM 250MG                 $35.50
 5309913   PROCAINAMIDE CAP 375MG     PROCAINAM 375MG                 $44.45
 5309917   PROCAINAMIDE CAP 500MG     PROCAINAM 500MG                 $46.00



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  Doctors Medical Center - Modesto                                            Page 53 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 5309918   PROCAINAMIDE Q12H 500MG    PROCANBID 500MG                 $46.00
 5309919   PROCAINAMIDE Q12H 1GM      PROCANBID 1GM                   $51.00
 5309921   PROCAINAMIDE TAB 250MG     PROCAIN 250 TAB                 $35.50
 5309929   PROCAINAMIDE TAB 500MG     PROCAIN 500 TAB                 $44.45
 5309956   PROCARBAZINE 50MG          PROCARBAZIN50MG                 $35.50
 5309979   PROCHLORPERAZINE 5MG       PROCHLORP 5MG                   $21.00
 5309983   PROCHLORPERAZINE 10MG      PROCHLORP 10MG                  $21.00
 5309987   PROCHLORPERAZINE 25MG      PROCHLORP 25MG                  $35.50
 5309991   PROCHLORPERAZN 10MG CAP    PROCHLORP 10MG                  $44.45
 5309995   PROCHLORPERAZN 15MG CAP    PROCHLORP 15MG                  $44.45
 5310000   4170 PHARMACY              PHARMACY
 5310045   PROMAZINE 25MG             PROMAZINE 25 MG                $35.50
 5310068   PROMETHAZINE 25MG          PROMETHAZ 25MG                 $17.00
 5310090   PROPAFENONE 150MG          PROPAFENON150MG                $74.00
 5310091   PROPAFENONE 300MG          PROPAFENON300MG               $105.15
 5310138   PROPANTHELINE 15MG         PROPANTHELN15MG                $21.00
 5310173   PROPOXYPHENE 32MG          PROPOXYPHN 32MG                $35.50
 5310177   PROPOXYPHENE 50MG          PROPOXYPHN 50MG                $35.50
 5310181   PROPOXYPHENE 65MG          PROPOXYPHN 65MG                $21.00
 5310185   PROPOXYPHENE 100MG         PROPOXYPHN100MG                $35.50
 5310189   PROPOXYPHENE/APAP100/650   PROPOXYPHN APAP               $219.00
 5310192   PROPOXYPHENE CMPD 32MG     PROPOXYPHCMP32                 $35.50
 5310193   PROPOXYPHENE CMPD 65MG     PROPOXYPHCMP65                 $35.50
 5310199   PROPRANOLOL 10MG           PROPRANOLOL10MG                $17.00
 5310201   PROPRANOLOL 20MG           PROPRANOLOL20MG                $17.00
 5310203   PROPRANOLOL 40MG           PROPRANOLOL40MG                $21.00
 5310207   PROPRANOLOL 80MG           PROPRANOLOL80MG                $21.00
 5310208   PROPRANOLOL LA 60MG        PROPRANOLOL60MG                $30.00
 5310210   PROPRANOLOL LA 80MG        PROPRANOLOL80MG                $30.00
 5310211   PROPRANOLOL LA 120MG       PROPRNOLOL120MG                $40.00
 5310216   PROPYLTHIOURACIL 50MG      PTU 50MG                       $11.00
 5310236   PROTRIPTYLINE 5MG          PROTRIPTYLIN5MG                $60.60
 5310239   PROTRIPTYLINE 10MG         PROTRIPTYLN10MG                $35.50
 5310262   PSEUDOEPHED SA 120MG       PSE SA 120MG                   $13.00
 5310266   PSEUDOEPHED 30MG           PSE 30MG                       $13.00
 5310274   PSEUDOEPHED/PROMETH        PSE/PROMETH                    $35.50
 5310295   PYRAZINAMIDE 500MG         PYRAZNAMID500MG                $46.00
 5310297   PYRIDOSTIGMINE 60MG        PYRIDOSTGMN60MG                $17.00
 5310301   PYRIDOSTIGMINE 180MG       PYRIDSTGMN180MG                $35.50
 5310324   PYRIDOXINE 25MG            PYRIDOXINE 25MG                $14.70
 5310328   PYRIDOXINE 50MG            PYRIDOXINE 50MG                 $8.00
 5310332   PYRIDOXINE 100MG           PYRIDOXINE100MG                $14.70
 5310366   QUAZEPAM 15MG              QUAZEPAM 15MG                  $50.35
 5310370   QUETIAPINE 25MG            QUETIAPINE 25MG                $74.00
 5310371   QUETIAPINE 100MG           QUETIAPINE100MG                $76.00
 5310398   QUINAPRIL 10MG             QUINAPRIL 10MG                 $51.00
 5310399   QUINAPRIL 20MG             QUINAPRIL 20MG                 $51.00
 5310401   QUINESTROL 100MCG          QUINESTRL100MCG                $44.45
 5310447   QUINIDINE 200MG            QUINIDINE 200MG                $21.00
 5310451   QUINIDINE 300MG            QUINIDINE 300MG                $21.00



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  Doctors Medical Center - Modesto                                        Page 54 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 5310455   QUINIDINE EXT 300MG        QUINIDEX 300MG                  $26.00
 5310459   QUINIDINE GLUCONATE        QUINIDIN GLUCON                 $26.00
 5310482   QUININE 200MG              QUININE 200MG                   $21.00
 5310484   QUININE 260MG              QUININE 260MG                   $26.00
 5310485   QUININE 325MG              QUININE 325MG                   $26.00
 5310486   RABEPRAZOLE 20MG           RABEPRAZOLE20MG                 $92.00
 5310487   RALOXIFENE 60 MG           RALOXIFENE 60MG                 $63.00
 5310490   RAMIPRIL 2.5MG             RAMIPRIL 2.5MG                  $74.00
 5310491   RAMIPRIL 5MG               RAMIPRIL 5MG                    $74.00
 5310505   RANITIDINE 150MG           RANITIDINE150MG                 $85.85
 5310507   RANITIDINE 150MG GELDOSE   RANITIDINE150MG                 $75.00
 5310510   RANITIDINE 150MG EFFGRAN   RANITIDINE150MG                 $97.40
 5310532   RAUWOLFIA-BENDR            RAUZIDE                         $60.45
 5310553   REPAGLINIDE 1MG            REPAGLIN 1MG                    $74.10
 5310555   RESERPINE .1MG             RESERPINE .1MG                  $28.60
 5310559   RESERPINE .25MG            RESERPIN .25MG                  $28.60
 5310563   RESERPINE-CHLOR 50MG       REGROTON 50MG                   $35.50
 5310567   RESERPINE-CHLOR 250MG      DIUPRES-250                     $28.60
 5310571   RESERPINE-CHLOR 500MG      DIUPRES-500                     $35.50
 5310575   RESERPINE-HYDRA            SER-AP-ES                       $35.50
 5310579   RESERPINE-HYDRO 25MG       HYDROPRES-25                    $28.60
 5310583   RESERPINE-HYDRO 50MG       HYDROPRES-50                    $35.50
 5310620   RIFABUTIN 150MG            RIFABUTIN 150MG                $173.15
 5310625   RIFAXIMIN 200MG            RIFAXIMIN 200MG                 $76.90
 5310636   RIFAMPIN 150MG             RIFAMPIN 150MG                  $94.20
 5310637   RIFAMPIN 300MG             RIFAMPIN 300MG                  $56.00
 5310648   RISEDRONATE NA 35MG        RISEDRONATE35MG                 $93.80
 5310649   RISEDRONATE NA 5MG         RISEDRONATE 5MG                 $75.60
 5310650   RIMANTADINE 100MG          RIMANTADNE100MG                $105.15
 5310651   RISPERIDONE 1MG            RISPERIDONE 1MG                 $76.00
 5310652   RISPERIDONE 2MG            RISPERIDONE 2MG                 $63.00
 5310660   RITODRINE 10MG             RITODRINE 10MG                  $77.75
 5310663   ROSIGLITAZONE 4MG          ROSIGLITAZ 4MG                  $76.00
 5310664   ROSIGLITAZONE 8MG          ROSIGLITAZ 8MG                  $78.00
 5310665   RIVASTIGMINE 1.5MG         RIVASTIGMIN1.5M                 $66.00
 5310670   RITONAVIR 100 MG           RITONAVIR 100MG                $105.15
 5310683   SALSALATE 500MG            SALSALATE 500MG                 $21.00
 5310690   SAQUINAVIR 200MG           INVIRASE 200MG                 $105.15
 5310693   ROSUVASTATIN CA 10MG       ROSUVASTATN10MG                 $76.00
 5310720   SELEGILINE 5MG             SELEGILINE 5MG                  $63.00
 5310760   SERTRALINE 50MG            SERTRALINE 50MG                 $75.00
 5310762   SEVELAMER 403MG CAP        SEVELAMER 403MG                 $39.00
 5310764   SEVELAMER 800MG            SEVELAMER 800MG                 $74.00
 5310775   SIMETHICONE 40MG           SIMETHICON 40MG                 $22.15
 5310791   SIMVASTATIN 10MG           SIMVASTATIN10MG                 $75.00
 5310833   SODIUM CL 1GM              SODIUM CL 1GM                   $14.70
 5310856   SODIUM FLUORIDE 2.2MG      SOD FLUORID 2.2                 $11.00
 5310863   SOD/POT PHOS 1.25G         NA/K PHOS 1.25G                 $17.00
 5310870   SOTALOL 80MG               SOTALOL 80MG                    $75.00
 5310902   SPIRONOLAC-HCTZ 25MG       SPIRON-HCTZ 25                  $26.00



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  Doctors Medical Center - Modesto                                        Page 55 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 5310910   SPIRONOLACTONE 25MG        SPIRONOL 25MG                   $73.00
 5310914   SPIRONOLACTONE 50MG        SPIRONOL 50MG                   $74.00
 5310937   STANOZOLOL 2MG             STANOZOLOL 2MG                  $35.50
 5310949   STAVUDINE 30MG             STAVUDINE 30MG                  $41.70
 5310950   STAVUDINE 40MG             STAVUDINE 40MG                  $40.50
 5310951   STAVUDINE 20MG             STAVUDINE 20MG                  $21.00
 5310960   STRESSTABS 600             STRESSTABS 600                  $13.00
 5310990   SUCCIMER 100MG             SUCCIMER 100MG                 $158.45
 5311006   SUCRALFATE 1GM             SUCRALFATE 1GM                  $26.00
 5311087   SULFAMETHOXAZOL 500MG      SULFAMETHOX 500                 $35.50
 5311091   SULFAMETH/TRIM SS TAB      SULFA/TRIM TAB                  $73.40
 5311092   SULFAMET/TRIMETH 800/160   SUL/TRIM800/160                 $74.20
 5311110   SULFASALAZINE 500MG        SULFASALAZI 500                 $21.00
 5311111   SULFASALIZINE 500MG EC     SULFASAL 500 EC                 $35.50
 5311133   SULFINPYRAZONE 100MG       SULFINPYRAZ 100                 $35.50
 5311156   SULFISOXAZOLE 500MG        GANTRISIN 500MG                 $28.60
 5311160   SULFISOXAZOLE PHE          AZO-GANTRISIN                   $28.60
 5311183   SULINDAC 150MG             SULINDAC 150 MG                 $36.00
 5311187   SULINDAC 200MG             SULINDAC 200 MG                 $40.00
 5311190   SUMATRIPTAN 25MG           SUMATRIPTAN25MG                $121.00
 5311191   SUMATRIPTAN 50MG           SUMATRIPTAN50MG                $133.00
 5311204   TACROLIMUS ORAL PER 1MG    TACROLIMUS 1MG                  $77.00
 5311210   TAMOXIFEN 10MG             TAMOXIFEN 10MG                  $51.00
 5311215   TAMSULOSIN .4MG            TAMSULOSIN .4MG                 $75.00
 5311226   TELMISARTAN 40MG           TELMISARTAN40MG                  $6.00
 5311227   TELMISARTAN 80MG           TELMISARTAN80MG                  $6.00
 5311233   TEMAZEPAM 15MG             TEMAZEPAM 15MG                 $219.00
 5311234   TEMAZEPAM 7.5MG            TEMAZEPAM 7.5MG                 $41.00
 5311237   TEMAZAPAM 30MG             TEMAZEPAM 30MG                  $21.00
 5311245   TENOFOVIR 300MG            TENOFOVIR 300MG                 $88.50
 5311250   TERAZOSIN 1MG              TERAZOSIN 1MG                   $74.00
 5311252   TERAZOSIN 5MG              TERAZOSIN 5MG                   $63.00
 5311260   TERBUTALINE 2.5MG          TERBUTALINE 2.5                 $21.00
 5311264   TERBUTALINE 5MG            TERBUTALINE 5MG                 $21.00
 5311310   TETRACYCLINE 250MG         TETRACYCLIN 250                 $17.00
 5311314   TETRACYCLINE 500MG         TETRACYCLIN 500                 $21.00
 5311364   THEOPHYLL 100MG            THEOPHYLL 100MG                 $19.30
 5311368   THEOPHYLL 125MG            THEOPHYLL 125MG                 $28.60
 5311376   THEOPHYLL 200MG            THEOPHYLL 200MG                 $28.60
 5311379   THEOPHYLL 250MG            THEOLAIR 250MG                  $28.60
 5311381   THEOPHYLLINE 400MG         UNIPHYL 400                     $46.00
 5311384   THEOPHYLL CAP 200MG        ELIXOPHYLLIN200                 $35.50
 5311385   THEOPHYLL SA 100MG         THEOPH SA 100MG                 $28.60
 5311386   THEOPHYLL SA 200MG         THEOPHY SA200MG                 $21.00
 5311387   THEOPHYLL SA 300MG         THEOPHY SA300MG                 $21.00
 5311388   THEOPHYLL SA 100MG         THEO-DUR 100MG                  $17.00
 5311392   THEOPHYLL SA 200MG         THEO-DUR 200MG                  $21.00
 5311396   THEOPHYLL SA 300MG         THEO-DUR 300MG                  $21.00
 5311400   THEOPHYLL SR 125MG         THEOPHYL-SR 125                 $35.50
 5311404   THEOPHYLL SR 250MG         THEOPHYL-SR 250                 $35.50



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  Doctors Medical Center - Modesto                                        Page 56 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 5311406   THEOPHYLL SR 500MG         THEOLAIR SR 500                 $69.70
 5311416   THEOPHYLL TIM              THEODUR SPRINKL                 $44.45
 5311424   THEOPHYLL EP               TEDRAL                          $28.60
 5311444   THEOPHYLL-HY               MARAX                           $35.50
 5311467   THIAMINE 50MG              THIAMINE 50MG                   $19.30
 5311471   THIAMINE 100MG             THIAMINE 100MG                  $74.00
 5311494   THIETHYLPERAZINE 10MG      THIETHLPRZN10MG                 $35.50
 5311517   THIOGUANINE 40MG           THIOGUANINE40MG                 $50.35
 5311537   THIORIDAZINE 10MG          THIORIDAZIN 10                  $21.00
 5311540   THIORIDAZINE 15MG          THIORIDAZIN 15                  $44.45
 5311548   THIORIDAZINE 25MG          THIORIDAZIN 25                  $35.50
 5311552   THIORIDAZINE 50MG          THIORIDAZIN 50                  $26.00
 5311556   THIORIDAZINE 100MG         THIORIDAZIN 100                 $44.45
 5311583   THIOTHIXENE 1MG            THIOTHIXENE 1MG                 $35.50
 5311587   THIOTHIXENE 2MG            THIOTHIXENE 2MG                 $35.50
 5311591   THIOTHIXENE 5MG            THIOTHIXENE 5MG                 $26.00
 5311618   THYROGLOBULIN 60MG         THYROGLOB 60MG                  $19.30
 5311641   THYROID 15MG               THYROID 15MG                    $19.30
 5311645   THYROID 30MG               THYROID 30MG                    $11.00
 5311649   THYROID 60MG               THYROID 60MG                    $11.00
 5311672   THYROID 120MG              THYROID 120MG                   $19.30
 5311676   THYROID 180MG              THYROID 180MG                   $28.60
 5311682   TICLOPIDINE 250MG          TICLOPIDNE250MG                 $63.00
 5311685   TIMOLOL 10MG               TIMOLOL 10MG                    $44.45
 5311692   TIZANIDINE 4MG TAB         TIZANIDINE 4MG                  $74.00
 5311693   TOCAINIDE HCL 400MG        TOCAINIDE 400MG                 $60.45
 5311695   TOCAINIDE HCL 600MG        TOCAINIDE 600MG                 $67.40
 5311697   TOLAZAMIDE 100MG           TOLAZAMID 100MG                 $21.00
 5311699   TOLAZAMIDE 250MG           TOLAZAMID 250MG                 $44.45
 5311722   TOLBUTAMIDE 500MG          TOLBUTAMID 500                  $21.00
 5311745   TOLMETIN 200MG             TOLMETIN 200MG                  $44.45
 5311747   TOLTERODINE LA 2MG         TOLTEROD LA 2MG                 $22.60
 5311748   TOLTERODINE LA 4MG         TOLTEROD LA 4MG                 $23.45
 5311750   TOLMETIN 600MG             TOLMETIN 600MG                  $60.45
 5311751   TOLTERODINE 1MG            TOLTERODINE 1MG                 $74.00
 5311754   TOPIRAMATE 25MG            TOPIRAMATE 25MG                 $59.00
 5311755   TOPIRAMATE 100MG           TOPIRAMATE100MG                 $59.00
 5311761   TORSEMIDE 10MG             TORSEMIDE 10MG                  $60.60
 5311762   TORSEMIDE 20MG             TORSEMIDE 20MG                  $41.00
 5311763   TORSEMIDE 100MG            TORSEMIDE 100MG                $105.15
 5311764   TRANDOLAPRIL 1MG           TRANDOLAPRIL1MG                 $40.00
 5311768   TRANYLCYPROMINE 10MG       TRANYLCYPR 10MG                 $28.60
 5311770   TRAMADOL 50MG              TRAMADOL 50MG                   $74.00
 5311791   TRAZODONE 50MG             TRAZODONE 50MG                  $74.00
 5311800   TRETINOIN 10 MG            VESANOID 10 MG                 $108.55
 5311857   TRIAMTERENE 50MG           TRIAMTEREN 50MG                 $28.60
 5311861   TRIAMTERENE 100MG          TRIAMTEREN 100                  $35.50
 5311863   TRIAMTREN-HCTZ 37.5/25MG   TRIAM/HCTZ37/25                 $26.00
 5311864   TRIAMTERENE-HCTZ 75/50MG   TRIAM/HCTZ75/50                 $26.00
 5311865   TRIAMTERENE/HCTZ 50/25     TRIAM/HCTZ50/25                 $21.00



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  Doctors Medical Center - Modesto                                        Page 57 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 5311888   TRIAZOLAM .25MG            TRIAZOLAM .25MG                 $21.00
 5311892   TRIAZOLAM .5MG             TRIAZOLAM .5MG                  $35.50
 5311894   TRICHLOROMETHIAZIDE 2MG    TRICHLORMETHZ 2                 $28.60
 5311915   TRIFLUOPERAZINE 1MG        TRIFLUOPERAZ 1                  $35.50
 5311917   TRIFLUOPERAZINE 2MG        TRIFLUOPERAZ 2                  $39.00
 5311919   TRIFLUOPERAZINE 5MG        TRIFLUOPERAZ 5                  $21.00
 5311942   TRIHEXYPHEN 2MG            TRIHEXYPHEN 2MG                 $11.00
 5311946   TRIHEXYPHEN 5MG            TRIHEXYPHEN 5MG                 $28.60
 5311973   TRIMEPRAZINE 2.5MG         TRIMEPRAZN2.5MG                 $28.60
 5311977   TRIMEPRAZINE 5MG SPAN      TRIMEPRAZN 5MG                  $35.50
 5312023   TRIMETHOBENZAMIDE 100MG    TRMBZMIDE 100MG                 $35.50
 5312027   TRIMETHOBENZAMIDE 250MG    TRIMETHOBEN250M                 $21.00
 5312050   TRIMETHOPRIM 100MG         TRIMETHOPRM 100                 $44.45
 5312142   TRIPROLIDINE-PS            ACTIFED                          $2.00
 5312161   TROVAFLOXACIN 200MG        TORVAFLOX 200MG                $302.05
 5312215   TRYPTOPHAN 500MG           TRYPTOPHAN500MG                 $44.45
 5312255   URSODIOL 300MG             URSODIOL 300MG                  $63.00
 5312258   VALACYCLOVIR 500MG         VALACYCLOVR 500                 $63.00
 5312259   VALACYCLOVIR 1GM           VALACYCLOVR 1GM                $139.25
 5312260   VALPROIC SPRINKLE 125MG    DEPAKOTE 125MG                  $26.00
 5312261   VALPROATE 250MG            DEPAKENE 250MG                  $21.00
 5312265   VALSARTAN 80MG             VALSARTAN 80MG                  $74.00
 5312270   VANCOMYCIN 125MG           VANCOCIN 125MG                 $209.25
 5312271   VANCOMYCIN 250MG           VANCOCIN 250MG                 $417.95
 5312273   VENLAFAXINE XR 37.5MG      VENLAFAXINE37.5                 $63.00
 5312274   VENLAFAXINE XR 75MG        VENALFAXINE75MG                 $75.00
 5312275   VENLAFAXINE 25MG           VENLAFAXINE25MG                 $63.00
 5312276   VENLAFAXINE 37.5MG         VENLAFAXINE37.5                 $63.00
 5312278   VENLAFAXINE 75MG           VENLAFAXINE75MG                 $76.00
 5312283   VERAPAMIL 40MG             VERAPAMIL 40MG                  $26.00
 5312284   VERAPAMIL 80MG             VERAPAMIL 80MG                  $26.00
 5312288   VERAPAMIL 120MG            VERAPAMIL 120MG                 $26.00
 5312289   VERAPAMIL SUST REL 240MG   VERAPAMIL SR240                 $75.00
 5312290   VERAPAMIL SR 180MG         VERAPAMIL SR180                 $63.00
 5312291   VERAPAMIL SR 120MG         VERAPAMIL SR120                $105.15
 5312311   VIT A/E                    VITAMIN A+E                     $35.50
 5312320   VALDECOXIB 10MG            VALDECOXIB 10MG                 $23.38
 5312334   VITAMIN A 25MU             VITAMIN A 25MU                  $14.70
 5312335   VITAMIN A 10 MU            VITAMIN A 10 MU                 $13.00
 5312357   VITAMIN B COMPLX           VIT B COMPLEX                   $14.70
 5312359   VITAMIN B&C COMP W/IRON    VIT B+C IRON                    $21.00
 5312361   VITAMIN B-12 50MCG         VIT B12 50MCG                   $11.00
 5312364   VITAMIN B-12 1000MCG       VIT B12 1000MCG                  $8.00
 5312368   VITAMIN B/ZINC             VIT B+ZINC                      $28.60
 5312380   VITAMIN D 25MU             VITAMIN D 25MU                  $14.70
 5312383   VITAMIN D 400U             VIT D 400U                       $8.00
 5312403   VITAMIN E 100IU            VITAMIN E 100IU                  $8.00
 5312407   VITAMIN E 400IU            VITAMIN E 400IU                  $8.00
 5312434   VITAMIN PRENATAL           VITAMIN PRENAT                  $35.50
 5312435   VITAMIN RENAL FORMULA      VITM RENAL FORM                 $75.00



  CDM Run Date: 06/01/2007
  Doctors Medical Center - Modesto                                        Page 58 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 5312450   VORICONAZOLE 50MG TAB      VORICONAZ 50MG                  $61.40
 5312451   VORICONAZOLE 200MG TAB     VORICONAZ 200MG                $245.60
 5312480   WARFARIN 2.5MG             WARFARIN 2.5MG                  $17.00
 5312481   WARFARIN 1 MG              WARFARIN 1MG                    $73.00
 5312484   WARFARIN 2MG               WARFARIN 2MG                    $74.00
 5312488   WARFARIN 5MG               WARFARIN 5MG                    $74.00
 5312492   WARFARIN 7.5MG             WARFARIN 7.5MG                  $21.00
 5312496   WARFARIN 10MG              WARFARIN 10MG                   $21.00
 5312502   ZAFIRLUKAST 20MG           ZAFIRLUKAST20MG                 $74.00
 5312510   ZIDOVUDINE 100MG           ZIDOVUDINE100MG                 $63.00
 5312516   ZILEUTON 600MG             ZILEUTON 600MG                  $77.30
 5312523   ZINC SULFATE 220MG         ZINC SULF 220MG                 $13.00
 5312529   ZOLPIDEM 5MG               ZOLPIDEM 5MG                   $221.00
 5312530   ZOLPIDEM 10MG              ZOLPIDEM 10MG                  $221.00
 5312532   ZIPRASIDONE 20MG           ZIPRASIDONE20MG                 $34.23
 5314000   MISCELNEOUS ORAL LIQUID    MISC ORAL LIQUD                 $21.00
 5314035   ACYCLOVIR 40MG/ML 5ML      ACYCLOVIR 5ML                   $56.00
 5314036   ACTIV CHAR 25GM/120ML      ACHAR 25G/120ML                 $52.00
 5314040   ALBUTEROL 0-5ML            ALBUTEROL 0-5ML                 $26.00
 5314050   AL MG SALTS 360ML          GAVISCON 360ML                  $62.00
 5314070   ALLOPURINOL SUSPENSION     ALLOPURINL SUSP                 $35.00
 5314077   ALUM MG 30ML               MAALOX 30ML                     $11.00
 5314109   ALUM MG HYDROX 360ML       ANTACID 360ML                   $41.65
 5314113   ALUM MG HYDROX 150ML       ANTACID 150ML                    $5.00
 5314115   ALUM/MG HYDRX SIM 180ML    AL/MG HY SM 6OZ               No charge
 5314119   ALUM MG HYDROX II 0-30ML   MYLANTA II 0-30                 $19.30
 5314120   ALUM MG HYDROX CONC SUSP   MAALOX TC 360ML                 $32.95
 5314123   ALUM MG HYDROX II 150ML    MYLANTA II 150M                 $49.35
 5314127   ALUM MG HYDROX SUSP        MYLANTA 0-30ML                  $11.00
 5314131   ALUM MG HYDROX SUSP 30ML   MAALOX PLUS30ML                  $2.00
 5314162   ALUMINUM HYDROXIDE 30ML    ANTACID 0-30ML                  $19.30
 5314166   ALUMINUM HYDROXIDE 360ML   ANTACID 360ML                   $31.00
 5314177   AMANTADINE 10MG/ML 5ML     AMANTADINE 5ML                  $26.00
 5314200   AMINOPHYLLINE 0-15ML       AMINOPHYLN 0-15                 $60.45
 5314228   AMOXICLN/CLAV 400/5 75ML   AMOX/CLAV 75ML                 $414.00
 5314231   AMOXICLN/CLAV 200/5 75ML   AMOX/CLAV 75ML                 $395.25
 5314235   AMOXICLN/CLAV 125/5 75ML   AMOX/CLAV 75ML                 $184.00
 5314239   AMOXICLN/CLAV 250/5 75ML   AMOX/CLAV 75ML                 $326.00
 5314241   AMOXICLN/CLV 600/5 100ML   AMOX/CLAV 100ML                $414.00
 5314245   AMOXICILLIN 50MG/ML 15ML   AMOXICILLIN PED                $318.50
 5314249   AMOXICILLIN 125/5 5ML      AMOXICILLN 5ML                 $105.15
 5314250   AMOXICILLIN 125/5 80ML     AMOXICILLN 80ML                $233.00
 5314253   AMOXICILLIN 250/5 5ML      AMOXICILLN 5ML                 $105.15
 5314254   AMOXICILLIN 250/5 100ML    AMOXICILLN100ML                 $89.00
 5314255   AMOXICILLIN PED DOSE       AMOXICILLIN PD                  $35.50
 5314267   AMPICILLIN PED DOSE        AMPICILLIN PD                   $35.50
 5314268   AMPICILLIN 100MG/ML 20ML   AMPICILLINDROPS                $245.45
 5314272   AMPICILLIN 125MG/5ML       AMPICILLIN 5ML                  $44.45
 5314274   AMPICILLIN 125/5 100ML     AMPICILLIN100ML                $152.00
 5314280   AMPICILLIN 250MG/5ML       AMPICILLIN 5ML                  $44.45



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  Doctors Medical Center - Modesto                                        Page 59 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 5314282   AMPICILLIN 250/5 100ML     AMPICILLIN100ML                 $316.50
 5314284   AMPICILLIN/PROBENCD 30ML   AMPCLN/PRB 30ML                 $752.25
 5314286   ANALGESIC OTC 0-30ML       ANALGESC 0-30ML               No charge
 5314288   ANTACID OTC 0-30ML         ANTACID 0-30ML                No charge
 5314295   ATTAPULGITE 600/15 15ML    ATTAPULGITE15ML                  $35.50
 5314302   AZITHROMYCIN200/5 22.5ML   AZITHROMY22.5ML                 $106.00
 5314303   AZITHROMYCIN 1G SUSP PKT   AZITHROMYCIN1GM                 $496.05
 5314331   BENTIROMIDE 500MG/7.5ML    BENTIROMDE500MG               $1,121.15
 5314364   BISACODYL/TANNIC ACID      CLYSODRAST POWD                 $100.75
 5314381   BOWEL EVACUANT 4000ML      BOWEL EVAC 4L                    $91.00
 5314404   BROMPHEN/PSE 5ML           BROMPH/PSE 5ML                   $28.60
 5314419   BROMPHENIRAMINE 0-10ML     DIMETANE 0-10ML                  $14.70
 5314438   CAFFEINE CITRATE PED DOS   CAFF CITRAT PD                   $21.00
 5314451   CALCIUM CARBONATE 360ML    CA CARB 360ML                    $42.85
 5314464   CALCIUM GLUBIONATE 60ML    CA GLUBION 60ML                  $28.60
 5314482   CARBAMAZEPINE 100MG/5ML    CARBAMAZP 5ML                    $35.50
 5314483   CARBAMAZEPINE 200MG/10ML   CARBAM 200MG/10                  $21.00
 5314494   CARBINOX/PSE/DM 30ML DRP   CARB/PSE/DM30ML                 $358.35
 5314521   CASTOR OIL 30CC            CASTOR OIL 30ML                  $17.00
 5314538   CEFACLOR PED DOSE          CEFACLOR PDOSE                   $35.50
 5314539   CEFACLOR 125MG/5ML 5ML     CEFACLOR 5ML                     $35.50
 5314540   CEFACLOR 125MG/5ML 75ML    CEFACLOR 75ML                   $428.30
 5314543   CEFACLOR 250MG/5ML 5ML     CEFACLOR 5ML                     $60.45
 5314545   CEFACLOR 250MG/5ML 75ML    CEFACLOR 75ML                   $688.85
 5314546   CEFIXIME 100MG/5ML 5ML     CEFIXIME 5ML                     $94.20
 5314547   CEFIXIME 100MG/5ML 100ML   CEFIXIME 100ML                  $845.00
 5314556   CEFPODOXIME 100/5 100ML    CEFPODOXME100ML                 $673.30
 5314562   CEPHALEXIN 125MG/5 5ML     CEPHALEXIN 5ML                   $26.00
 5314564   CEPHALEXIN 125MG/5 100ML   CEPHALEXIN100ML                 $237.00
 5314566   CEPHALEXIN 250MG/5 5ML     CEPHALEXIN 5ML                   $60.45
 5314568   CEPHALEXIN 250MG/5 100ML   CEPHALEXIN100ML                 $382.00
 5314569   CEPHALEXIN PED DOSE        CEPHALEXIN PDOS                  $35.50
 5314590   CEFUROXIME 125MG/5 100ML   CEFUROXIME100ML                 $312.00
 5314594   CETIRIZINE 5MG/5ML 5ML     CETIRIZINE 5ML                   $63.00
 5314595   CETIRIZINE 1MG/ML          CETIRIZNE1MG/ML                 $105.15
 5314615   CHLORAL HYDRAT 500MG/5ML   CHLORAL HYDR500                  $21.00
 5314616   CHLORAL HYDRATE PED DOSE   CHLORAL HYDR PD                  $35.50
 5314644   CHLORPHENIR 2MG/5ML 0-10   CHLORPHENR 10ML                  $28.60
 5314648   CHLORPHEN/COD COMBO        TUSSAR SF 10ML                   $28.60
 5314664   CHLORPROMAZINE 30MG/ML     CHLORPROMAZN 30                 $346.75
 5314666   CHLORPROMAZINE 10MG/5ML    CHLORPROM 0-30M                  $67.40
 5314670   CHLORTHIAZIDE 250MG/5ML    CHLORTHIAZ 10ML                  $28.60
 5314671   CHLORTHIAZIDE 0-5ML        CHLORTHIAZI 0-5                  $35.50
 5314679   CHOLESTYRAMINE 9GM         QUESTRAN PKT 9G                  $40.00
 5314709   CIMETIDINE 300MG/5ML       CIMETIDINE 5ML                   $63.00
 5314715   CISAPRIDE 1MG/ML 5ML       CISAPRIDE 5ML                    $55.65
 5314754   CITRATE MAGNESIUM 300ML    MAGCITRATE300ML                  $11.00
 5314757   CLARITHROMCN 250/5 100ML   CLARTHRMCN100ML                 $514.00
 5314769   CLINDAMYCIN PAL 5ML        CLEOCIN75MG/5ML                 $381.00
 5314784   CLOXACILL 125MG/5ML        CLOXACILLN125/5                 $535.90



  CDM Run Date: 06/01/2007
  Doctors Medical Center - Modesto                                        Page 60 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 5314799   COD-BROMPHENIRA 0-10ML     DIMETAN DC 0-10                  $35.50
 5314818   COD-GUAIFENESIN 0-10ML     COD-GUAIFN 0-10                  $26.00
 5314820   COD-GUAIFEN-PSEUDO 4OZ     COD-GUA-PSU 4OZ                  $26.00
 5314833   COD-TRIPROLIDIN 0-10ML     COUGH/COLD+COD                   $35.50
 5314840   COUGH/COLD PREP 0-5ML      COUGHCOLD 0-5ML                  $35.50
 5314841   COUGH/COLD COD 0-5ML       COUGHCOLD+COD 5                  $35.50
 5314848   COLESTIPOL 5GM             COLESTID 5G PKT                  $44.45
 5314855   SULFAMETH/TRIM SUSP 20ML   SULFA/TRIM 20ML                  $51.00
 5314856   SULFAMETH/TRIM PED DOSE    SULF/TRIM PED D                  $21.00
 5314878   CYPROHEPTADINE 2MG/5ML     CYPROHEPT 2MG/5                  $17.00
 5314908   DEXAMETHASONE .5/5 5ML     DEXAMETH 5ML                     $21.00
 5314923   DEXTROMETHORPHAN-GUAIF     DEXTROMETH GUAI                  $13.00
 5314940   DICLOXACIL 62.5/5 100ML    DICLOXACL 100ML                 $294.00
 5314964   DIGOXIN .05MG/ML 5ML       DIGOXIN 5ML                      $21.00
 5314967   DIGOXIN PED DOSE           DIGOXIN PD                       $21.00
 5314998   DIPHENHYDRA 12.5MG/5ML     DIPHEN 12.5/5ML                  $21.00
 5315016   DIPHENOXYLATE/ATRP 10ML    DIPHENOX/AT10ML                  $11.95
 5315048   DOCUSATE PED DOSE          DOCUSATE PD                      $35.50
 5315081   DONNATAL 0-10ML            DONNATAL 0-10ML                  $17.00
 5315096   DOXYCYCLINE 25MG/5ML 60M   DOXYCY 25M/M 60                 $398.90
 5315126   ERGOCALCIFEROL 8000U/ML    VITAMIN D DROPS                 $323.00
 5315141   ERYTHROMY ET 100MG/2.5ML   EES DROPS 0-200                 $344.65
 5315145   ERYTHROMY ET 200MG/5ML     ESS 200MG/5ML                    $21.00
 5315151   ERYTHROMYCIN-SULF 100ML    ERYTHRO-SULF 10                 $534.70
 5315152   ERYTHROMYCN/SULF PED DSE   PEDIAZOLE PD                     $35.50
 5315153   ERYTHROMYCIN ES 125MG/5M   EES 125MG/5ML                    $35.50
 5315157   ERYTHROMYCIN ES 250MG/5    EES 250MG/5ML                    $44.45
 5315161   ERYTHROMYCIN ET 400MG/5M   EES 400MG/5ML                    $30.00
 5315176   ETHOSUXAMIDE 250MG/5ML     ETHOSUX 250M/5M                  $35.50
 5315185   FAMOTIDINE 40MG/5ML 0-40   FAMOTIDN40MG5ML               $1,781.60
 5315190   FELBAMATE 600MG/5ML        FELBAMATE 600/5                 $105.15
 5315191   FERROUS GLUCO 300MG/5ML    FERROUS GLUC5ML                  $22.15
 5315200   FERROUS SULF DROPS 50 ML   FESO4 DRPS 50ML                  $17.00
 5315207   FERROUS SULF 300MG/5ML     FESO4 300MG/5ML                  $13.00
 5315208   FERROUS SULFATE 90MG/5ML   FESO4 90MG/5ML                   $35.50
 5315210   FERROUS SULF 220MG/5ML     FESO4 220MG/5ML                  $13.00
 5315220   FLUCONAZOLE 10MG/ML 5ML    FLUCONAZOLE 5ML                 $128.00
 5315221   FLUCONAZOLE 40MG/ML 5ML    FLUCONAZOLE 5ML                 $145.30
 5315222   FLUCONAZOLE 40MG/ML 35ML   FLUCONAZOLE35ML                 $888.40
 5315228   FLUOXETINE 20MG/5ML UD     FLUOXETNE20/5ML                  $67.00
 5315238   FOLIC ACID PED DOSE        FOLIC ACID PD                    $35.50
 5315245   FUROSEMIDE 10MG/ML 4ML     FUROSEMIDE 40MG                  $76.65
 5315246   FUROSEMIDE PED DOSE        FUROSEMIDE PD                    $21.00
 5315248   FUROSEMIDE 40MG/5ML UD     FUROSEMIDE 40MG                  $46.00
 5315257   GLUCOSE 31GM               INSTA-GLUCOS31G                  $21.95
 5315285   GUAIFENESIN 100MG/5ML      GUAIFEN 5ML                       $1.00
 5315293   GUAIFENESIN-PHENYL-DEXTR   GUAIFN-PHE-DEXT                  $28.60
 5315295   GUAIFEN100/PSEUDO 30/5ML   GUAIF/PSEUDO5ML                  $10.00
 5315312   HALOPER CONC 2MG/ML 5ML    HALO 2MG/ML 5ML                 $331.00
 5315316   HYDRALAZINE PED DOSE       HYDRALAZINE PD                   $35.50



  CDM Run Date: 06/01/2007
  Doctors Medical Center - Modesto                                        Page 61 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 5315318   HYDROCHLOROTHIAZIDE 0-5M   HCTZ 0-5ML                       $11.00
 5315319   HYDROCHLOROTHIAZ PED DSE   HCTZ PD                          $21.00
 5315325   HYDROXYZINE 10MG/5ML       HYDROXYZINE 5ML                  $21.00
 5315327   HYDROXYZINE 25MG/5ML       HYDROXYZ 0-10ML                  $50.35
 5315336   IBUPROFEN 100MG/5ML 4OZ    IBUPROFEN 120ML                  $20.00
 5315337   IBUPROFEN 100MG/5ML 60ML   IBUPROFEN 60ML                   $27.75
 5315361   IPECAC 15ML                IPECAC 15ML                      $28.60
 5315376   IPECAC 30ML                IPECAC 30ML                      $28.60
 5315383   IRON ELEM 15MG/.6ML DRPS   IRON DROPS                      $190.00
 5315391   ISOPROTER-EPHED            ISUPREL CMP 0-1                  $28.60
 5315410   KAOLIN-PECTIN 30ML         KAOLIN-PECTN 30                  $17.00
 5315440   LACTOBACILLUS GRANULES     LACTINEX GRAN                    $17.00
 5315457   LACTULOSE 240ML            LACTULOSE 8OZ                   $129.00
 5315459   LACTULOSE UD 30ML          LACTULOSE 30ML                   $76.00
 5315465   LAXATIVE OTC 0-30ML        LAXATIVE 0-30ML               No charge
 5315491   LANSOPRAZOLE 15MG PKT      LANSOPRAZLE15MG                  $87.00
 5315492   LANSOPRAZOLE 30MG PKT      LANSOPRAZLE30MG                  $78.00
 5315504   LIDOCAINE VISC 30ML        LIDOCAIN 30ML                    $63.00
 5315505   LIDOCAINE VISC 100ML       LIDOCAIN VIS100                 $130.00
 5315520   LINEZOLID 100MG/5ML 150M   LINEZOLID 150ML               $2,301.05
 5315529   LOPERAMIDE 30ML            LOPERAMIDE 30ML                  $63.00
 5315546   MAGALDRATE 0-30ML          RIOPAN 0-30ML                    $28.60
 5315548   MAGALDRATE 12OZ            RIOPAN 12OZ                      $28.00
 5315549   MAGALDRATE-SIME 0-30ML     RIOPAN+ 0-30                     $28.60
 5315551   MAGALDRATE-SIME 120Z       RIOPAN+ 12OZ                     $28.00
 5315570   MEGESTROL 40MG/ML 20ML     MEGESTROL 20ML                   $85.00
 5315579   METAMUCIL PKT              METAMUCIL PKT                    $22.15
 5315594   METAPROTERENOL 10MG/5ML    METAPROT 10MG/5                  $28.60
 5315654   METHYLDOPA 250MG/5ML       METHYLDOPA250/5                  $50.35
 5315669   METOCLOPRAM 5MG/5ML        METOCLOP 5ML                     $73.00
 5315742   MOM 30ML                   MOM 30ML                          $2.00
 5315760   MOM/MINERAL OIL 30ML       MOM/MIN OIL30ML                  $17.20
 5315772   MOUTH WASH ANTISEPTIC      CHLRASPTC SPRY                   $11.00
 5315787   MOUTHWASH                  MOUTHWASH                         $5.70
 5315791   MOUTHWASH MEDICATED        MOUTHWASH MEDIC                  $35.00
 5315806   MULTIPLE VIT DROPS         MULTI VIT DROPS                  $54.00
 5315808   MULTIVITAMIN COMBO         MULTIVIT COMBIN                  $56.75
 5315821   MULTIVITAMIN FL DROPS      MULTIVIT FL DRP                 $114.25
 5315834   NAPROXEN 125MG/5ML 0-5ML   NAPROXEN 0-5 ML                  $44.45
 5315866   NITROFURANTOIN 25MG/5ML    NITROFURAN 0-10                  $21.00
 5315881   NYSTATIN 5ML               NYSTATIN 5ML                     $74.00
 5315884   NYSTATIN 60ML              NYSTATIN 60ML                    $94.20
 5315886   NYSTATIN 2ML ORAL SUSP     NYSTATIN 2ML                     $35.50
 5315917   OXYBUTYNIN 1MG/ML 5ML      OXYBUTININ 5ML                   $29.00
 5315930   PARALDEHYDE 30ML           PARALDEHYD 30ML                 $198.65
 5315949   PAREGORIC-BILL             DONNAGELPG 0-10                  $28.60
 5315953   PAREGORIC-PECTI            PAREPECTOLIN                     $44.45
 5315968   PECTIN                     PECTIN 90ML                      $18.30
 5315989   PENICLLN VK 125/5 100ML    PEN VK125 100ML                 $220.45
 5315995   PENICLLN VK 250/5 100ML    PEN VK250 100ML                 $149.00



  CDM Run Date: 06/01/2007
  Doctors Medical Center - Modesto                                        Page 62 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 5315996   PEPPERMINT SPIRIT 30ML     PEP SPIRIT 30ML                 $11.00
 5316007   PEPTO-BISMOL 120ML         PEPTOBISMOL 120                 $12.00
 5316040   PHENYLPROP-COD             COUGH/COLD+COD                  $35.50
 5316044   PHENYLPROP-PYRI            COUGH/COLD INFA                $111.85
 5316059   PHENYTOIN 100MG/4ML        PHENYTOIN 4ML                   $76.00
 5316063   PLANTAGO EXT 2.5GM/5ML     SIBLIN 2.5GM                    $28.60
 5316072   POLYETHYLENE GLYCOL 17GM   MIRALAX 17GM                    $11.00
 5316074   POLYSTYRENE 0-30GM         KAYEXELATE 0-30                $116.80
 5316075   POLYSTYRENE 60ML           POLYSTYRENE60ML                 $79.00
 5316089   POTASSIUM CL 10%           KCL 10% 0-30ML                 $292.00
 5316093   POTASSIUM CL 20%           KCL 20% 0-15ML                  $44.45
 5316097   POTASSIUM CL 20MEQ PKT     KCL 20MEQ PKT                   $26.00
 5316100   POTASSIUM CL PED DOSE      POTASSIUM CL PD                 $21.00
 5316101   POTASSIUM GLU 10MEQ/15ML   POTASSIUM GLU                   $35.50
 5316105   POTASSIUM IODID 1GM/ML     POTASSIUM IODID                $139.00
 5316109   POTASSIUM SUPPL            K 25MEQ                         $17.00
 5316110   POTASSIUM SUPPL 25MEQ      KCL CL 25MEQ                    $30.00
 5316120   PREDNISONE 5MG/5ML         PREDNISN5MG/5ML                 $21.00
 5316122   PREDNISOLONE 5MG/5ML       PREDNISOLN5MG/5                 $67.40
 5316123   PREDNISOLONE 15MG/5ML      PREDNISOLO 15/5                 $75.00
 5316125   PRIMIDONE 250MG/5ML 5ML    PRIMIDONE 5ML                   $50.35
 5316128   PROCHLORPERAZN 10MG/10ML   PROCHLORP 10ML                  $28.60
 5316147   PROMETHAZINE /COD          PROMETHAZIN/COD                 $21.00
 5316155   PROMETHAZINE 6.25MG/5ML    PROMETHZ 6.25/5                 $17.00
 5316159   PROMETHAZINE PED           PROMETHAZIN PED                 $19.30
 5316163   PROMETHAZINE-PHEN          PROMETHAZINE VC                 $28.60
 5316165   PROMETHAZINE/DM 4OZ        PROMETH/DM 4OZ                  $31.00
 5316167   PROMETHAZINE-PHEN /COD     PROMETHZ VC COD                 $26.00
 5316171   PROPOXYPH 50MG/5ML SUSP    PROPOXYPH 5ML                   $44.45
 5316184   PSEUDOEPHED 30MG/5ML       PSE 30MG/5ML                    $72.80
 5316201   PSYLLIUM 7GM               EFFERSYLIUM INS                 $22.15
 5316205   PSYLLIUM PKT               PSYLLIUM PKT                    $13.00
 5316220   PYRIDOSTIGMINE 60MG/5ML    MESTINON 0-25ML                 $28.60
 5316245   RANITIDINE 150MG/10ML      RANITIDINE 10ML                 $78.00
 5316258   SALIVA SUBST 120ML         SALIVA SUBS 120                 $24.00
 5316301   SENNA PLANTABO 6GM         PERDIUM 6GM PKT                  $9.05
 5316303   SENNA-PLANTABO             PERDIUM 100GM                    $9.25
 5316333   SIMETHICONE 15ML           SIMETHICON DROP                 $77.00
 5316347   SODIUM CHLORIDE PED DOSE   SODIUM CHLOR PD                 $21.00
 5316348   SOD FLUORIDE DROPS 30ML    NA FLUORID DROP                $364.30
 5316350   SOD/POT PHOS LIQ 0-75ML    NEUTRAPHOS 0-75                 $28.60
 5316356   SOD CITRATECITR AC PEDI    NACIT/CITACPEDI                 $35.50
 5316363   SODIUM PHOSPHAT            PHOSPHO-SODA                    $17.00
 5316373   SORBITOL 30ML              SORBITOL 30ML                    $1.25
 5316385   SPIRONOLACTONE PED DOSE    SPIRONOLACTN PD                 $21.00
 5316390   SUCRALFATE 1G/10ML SUSP    SUCRALFATE 10ML                 $75.00
 5316393   SULFISOXAZOLE 500MG/5ML    GANTRISIN 0-10M                 $35.50
 5316408   TERPIN HYDRATE 0-10ML      TERPIN HYDRATE                  $22.15
 5316423   TETRACYCLINE 125MG/5ML     TETRACYCL 125/5                 $28.60
 5316433   THEOPHYLLINE 80/15 15ML    THEOPHYLLN 15ML                 $75.00



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  Doctors Medical Center - Modesto                                         Page 63 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 5316437   THEOPHYLLINE PED DOSE      THEOPHYLLINE PD                  $21.00
 5316439   THEOPHYLL 50MG/5ML         THEOPHYL 50MG/5                  $44.45
 5316446   THEOPHYLL-GU               THEOPHYLL GUAIF                  $35.50
 5316450   THEOPHYLL-HY               THEOPHYLL HY                     $35.50
 5316473   THIORIDAZINE 30M/M 5ML     THIOR 30M/M 5ML                  $19.30
 5316488   TRIAMINIC EXPECT           TRIAMINIC EXP                    $22.15
 5316492   TRIAMINIC SYRUP            TRIAMINIC SYRUP                  $22.15
 5316507   TRIFLUOPERAZINE 10MG/ML    TRIFLUOPER0-5ML               $1,206.35
 5316537   TRIPROLIDINE-PSE 10ML      TRIPROL PSE10ML                  $28.60
 5316567   TUSSI-ORGANIDIN 0-10ML     TUSSIORGANIDIN                   $21.00
 5316582   VALPROATE 250MG/5ML        DEPAKENE 0-10ML                  $11.00
 5316597   VANCOMYCIN 500MG/6ML       VANCOMYCN 0-500               $8,328.15
 5316598   VANCOMYCIN 1G/20ML         VANCOMYCIN 1G                   $896.90
 5316612   VITAMIN A 5MU/.1ML         VITAMIN A DROPS                 $344.65
 5316616   VITAMIN C 500MG/10ML       ASCRBC AC500/10                  $50.35
 5316627   VITAMINS A D               MULTI VIT DROPS                  $77.75
 5316631   VITAMINS ADC-SO            MULTIVIT FL DRP                  $88.00
 5316637   VITAMIN E 50U/ML           AQUASOL E50U/ML                 $327.75
 5316640   VITAMINS ADC FLUOR         VIDALYN F ADC                   $395.10
 5316649   VITAMINS MULT/FE DROPS     POLY-VI-SOL/FE                   $54.00
 5316655   VITAMINS MULTI             VITAMINS MULTI                   $13.00
 5316660   ZIDOVUDINE 10MG/ML 5ML     ZIDOVUDINE 5ML                   $54.00
 5318000   MISCELLANEOUS INJECTION    MISC INJECTION                  $212.00
 5318001   ACETAZOLAMIDE 250MG        ACETAZOLM 250MG                 $294.00
 5318002   MISCELLANEOUS INJECTION    MISC INJECTION                  $426.00 Minimum
 5318003   MISC BIOTECH INJECTION     MISC BIOTEC INJ                 $852.00 Minimum
 5318008   ABCIXIMAB 10MG             ABCIXIMAB 10MG                  $948.00
 5318011   ACYCLOVIR 500MG INJ        ACYCLOVIR 500MG                 $420.00
 5318016   ACETYLCYSTEINE PER 100MG   ACETYLCYST100MG                   $8.30
 5318018   ADDITIVES TPN STANDARD     ADDS TPN STDRD                  $307.90
 5318023   ADENOSINE 6MG THERAPEUTC   ADENOSINE 6MG                    $97.20
 5318031   ALBUMIN 5% 50ML            ALBUMIN 5% 50ML                 $454.00
 5318032   ALBUMIN 5% 250ML           ALBUMIN5% 250ML                 $203.50
 5318034   ADENOSINE 30MG DIAGNOSTC   ADENOSINE 30MG                  $205.00
 5318036   ABATACEPT PER 10MG         ABATACEPT 10MG                   $33.60
 5318058   ALBUMIN 25% 20ML           ALBUMIN25% 20ML               $1,454.05
 5318063   ALBUMIN 25% 50ML           ALBUMIN25% 50ML                 $462.00
 5318075   ALATROFLOXACIN 5M/M 40ML   ALATROFLOX 40ML                 $688.50
 5318077   ALCOHOL DEHYDRATED 5ML     ALCOHOL DEH 5ML                 $331.00
 5318083   ALPROSTADIL 500MCG/1ML     ALPROSTADIL.5MG               $1,022.00
 5318088   METHOTREXATE 5MG INJ       METHOTREX 5MG                    $18.30
 5318089   METHOTREXATE 50MG          METHOTREX 50MG                   $19.00
 5318090   METHOTREXATE 1GM           METHOTREX 1GM                   $247.00
 5318091   METHOTREXATE 100MG         METHOTREX 100MG                  $36.00
 5318092   ALTEPLASE PER 1MG          ALTEPLASE 1MG                    $33.00
 5318093   METHOTREXATE 200MG         METHOTREX 200MG                  $73.00
 5318094   METHOTREXATE 250MG         METHOTREX 250MG                  $82.00
 5318098   ALEMTUZUMAB PER 10MG       ALEMTUZMAB 10MG                 $760.50
 5318114   AMIKACIN PER 100MG         AMIKACIN 100MG                   $43.10
 5318130   AMIFOSTINE 500MG           AMIFOSTINE500MG               $2,172.60



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  Doctors Medical Center - Modesto                                        Page 64 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 5318146   AMINOCAPROIC ACID 2GM      AMINOCAPROIC 2G                 $343.30
 5318147   AMINOCAPROIC ACID 24GM     AMINOCAPROIC24G               $1,195.00
 5318151   AMINOCAPROIC ACID 5GM      AMINOCAPROIC 5G                 $377.00
 5318182   AMINOPHYLLINE 500MG        AMINOPHYLN500MG                 $364.00
 5318199   AMIODARONE PER 30MG        AMIODARONE 30MG                  $10.50
 5318203   AMITRIPTYLINE 100MG INJ    AMITRPTYLN100MG                 $299.00
 5318224   AMMON CHLORI 100MEQ/20ML   AMMON CHL100MEQ                 $236.35
 5318243   AMPHOTER B LIP COMP 10MG   ABELCET 10MG                    $387.00
 5318245   AMPHOTERICIN B 50MG        AMPHOTER B 50MG                 $404.00
 5318251   AMPHOTER B LIPOSOM 10MG    AMBISOME 10MG                    $49.00
 5318265   AMPICILLIN 500MG           AMPICILLIN500MG                  $76.00
 5318271   AMPICILLIN 1GM             AMPICILLIN 1GM                  $368.00
 5318276   AMPICILLIN 2GM             AMPICILLIN 2GM                  $373.00
 5318281   AMPICILLIN 125MG           AMPICILLIN125MG                 $205.05
 5318286   AMPICILLIN 250MG           AMPICILLIN250MG                 $218.60
 5318292   AMPICILLIN/SULB 1.5GM      AMPICLN/SLB1.5G                 $372.65
 5318293   AMPICILLIN/SULB 3GM        AMPICLN/SLB 3G                  $380.70
 5318297   AMRINONE 5MG/ML 20ML       AMRINONE 20ML                 $1,280.85
 5318310   ANTICOAGULANT SOD CITRAT   ANTICOAG NA CIT                 $224.00
 5318312   ASCORBIC ACID 500MG/2ML    ASCORBC AC500MG                 $109.00
 5318313   APROTININ PER 10000KIU     APROTININ10KKIU                  $16.00
 5318322   ARGATROBAN PER 5MG         ARGATROBAN 5MG                  $114.60
 5318333   ASPARAGINASE 10000U/10ML   ASPARAGNASE 10K               $1,089.20
 5318360   ATENOLOL 5MG/10ML          ATENOLOL 10ML                   $649.00
 5318368   ATRACURIUM 10MG/ML 5ML     ATRACURIUM 5ML                  $935.95
 5318369   ATRACURIUM 10MG/ML 10ML    ATRACURIUM 10ML                  $99.00
 5318374   ATROPINE .4MG/ML 1ML       ATROPINE .4MG                    $75.00
 5318375   ATROPINE .5MG/ML 1ML       ATROPINE .5MG                    $75.00
 5318380   ATROPINE .5MG/5ML PFS      ATROPINE.5MGPFS                 $322.10
 5318385   ATROPINE 1MG/10ML PFS      ATROPINE 1MGPFS                  $73.00
 5318413   AZACITIDINE PER 1MG        AZACITIDINE 1MG                   $9.30
 5318414   AZITHROMYCIN 500MG INJ     AZITHROMYC500MG                 $379.00
 5318417   AZTREONAM 1GM              AZTREONAM 1GM                   $385.00
 5318418   AZTREONAM 2GM              AZTREONAM 2GM                   $422.00
 5318453   BACITRACIN 50000U          BACITRACIN 50KU                 $173.00
 5318468   BACLOFEN IT SCREEN KIT     BACLOFEN IT KIT                 $796.20
 5318472   BACLOFEN PER 10MG          BACLOFEN 10MG                   $332.70
 5318496   BCG VACC (LIVE) INTRAVES   BCG(LIVE)INTRAV               $1,237.00
 5318516   BENZQUINAMIDE 50MG         BENZQUINAM 50MG                 $242.10
 5318537   BENZTROPINE 2MG/2ML        BENZTROP2MG/2ML                 $158.00
 5318558   BETAMETHASONE 6MG/ML       BETAMETH SS 6MG                  $84.00
 5318600   BETHANECHOL 5MG/ML         BETHANECHOL 5MG                 $220.45
 5318607   BEVACIZUMAB PER 10MG       BEVACIZUMAB10MG                 $316.25
 5318617   BIVALIRUDIN PER 1MG        BIVALIRUDIN 1MG                  $75.00
 5318621   BLEOMYCIN 15 UNITS         BLEOMYCIN 15U                 $2,269.00
 5318642   BLK WIDOW SPIDER INJ       ANTIVENIN 2.5ML                 $687.85
 5318644   BORTEZOMIB PER 0.1MG       BORTEZOMIB .1MG                  $50.90
 5318651   BOTULINUM TOXIN A PER U    BOTUL A PER U                    $34.85
 5318663   BRETYLIUM 500MG/10ML       BRETYLIUM 500MG                 $958.75
 5318683   BUMETANIDE 2.5MG/10ML      BUMETANIDE2.5MG                  $79.00



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  Doctors Medical Center - Modesto                                        Page 65 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 5318684   BUMETANIDE .5MG/2ML        BUMETANIDE .5MG                 $119.00
 5318685   BUMETANIDE 1MG/4ML         BUMETANIDE 1MG                   $12.25
 5318705   BUPIVACAINE .25% 50ML      BUPIVCN.25%50ML                  $77.00
 5318709   BUPIVACAINE .5% 50ML       BUPIVCN.5% 50ML                  $77.00
 5318710   BUPIVACAINE .5% 30ML       BUPIVCN.5% 30ML                  $76.00
 5318715   BUPIVACAINE .75% 30ML      BUPIVCN.75%30ML                  $77.00
 5318736   BUPIVACAINE/EPI .25%50ML   BUPIVCN EPI50ML                  $80.00
 5318741   BUPIVACAINE/EPI.5% 30ML    BUPIVCN EPI30ML                  $77.00
 5318747   BUPIVACAINE/DEX .75% 2ML   BUPIVCN DEX 2ML                  $77.50
 5318750   BUPRENORPHINE .3MG         BUPRENORPH .3MG                 $182.75
 5318752   BUTORPHANOL PER 1MG        BUTORPHANOL 1MG                 $201.85
 5318762   CAFFEINE CIT INJ PER 5MG   CAFFEIN CIT 5MG                  $28.50
 5318767   CAFFEINE/SOD BENZ 500MG    CAFFNABENZ500MG                 $178.00
 5318788   CALCITONIN 400IU/2ML       CALCITONIN 400U                 $154.00
 5318790   CALCITRIOL 1MCG/1ML        CALCITRIOL 1MCG                 $227.00
 5318809   CALCIUM CHLOR 10%10MLSYR   CA CHLORIDE SYR                  $77.00
 5318810   CALCIUM CHLOR 10% 10ML     CA CHLORIDE10ML                 $292.00
 5318830   CALCIUM GLUC 10% 10ML      CA GLUCON 10ML                  $292.00
 5318851   CANDIDA SKIN TEST          CANDIDA SKN TST                 $109.00
 5318860   CAPREOMYCIN 1GM            CAPREOMYCIN 1GM                 $662.35
 5318898   CARBENICILLIN 5GM          CARBENICILLN5GM                 $571.20
 5318910   CARBOPROST 250MCG/1ML      CARBOPRST250MCG                 $130.00
 5318911   CARBOPLATIN 50MG           CARBOPLATIN50MG                 $600.00
 5318915   CARDIOPLEGIC SOLN 1000ML   PLEGISOL 1000ML                 $342.00
 5318924   CARMUSTINE 100MG           CARMUSTINE100MG               $1,439.50
 5318933   CASPOFUNGIN PER 5MG        CASPOFUNG 5MG                   $401.00
 5318976   CEFAZOLIN 500MG            CEFAZOLIN 500MG                 $368.00
 5318981   CEFAZOLIN 1GM              CEFAZOLIN 1GM                   $366.00
 5318986   CEFEPIME 1GM               CEFEPIME 1GM                    $126.56
 5318987   CEFEPIME 2GM               CEFEPIME 2GM                    $253.00
 5318993   CEFONOCID 1GM              CEFONOCID 1GM                 $1,079.80
 5318999   CEFOPERAZONE 1GM           CEFOPERAZONE1GM                 $483.00
 5319002   CEFOPERAZONE 2GM           CEFOPERAZONE2GM               $1,479.60
 5319021   CEFOTAXIME 500MG           CEFOTAXIME500MG                 $371.00
 5319023   CEFOTAXIME 1GM             CEFOTAXIME 1GM                  $375.00
 5319028   CEFOTAXIME 2GM             CEFOTAXIME 2GM                $1,223.20
 5319030   CEFOTETAN 1GM              CEFOTETAN 1GM                   $506.25
 5319049   CEFOXITIN 1GM              CEFOXITIN 1GM                   $375.00
 5319054   CEFOXITIN 2GM              CEFOXITIN 2GM                   $386.00
 5319060   CEFTAZIDIME 500MG          CEFTAZIDME500MG                 $371.00
 5319061   CEFTAZIDIME 1GM            CEFTAZIDIME 1GM                 $386.00
 5319062   CEFTAZIDIME 2GM            CEFTAZIDIME 2GM                 $407.00
 5319063   CEFTAZIDIME 1GM PMX        CEFTAZIDME1GPMX                 $353.45
 5319075   CEFTIZOXIME 1GM            CEFTIZOXIME 1GM                 $375.00
 5319080   CEFTIZOXIME 2GM            CEFTIZOXIME 2GM                 $385.00
 5319082   CEFTRIAXONE 250MG          CEFTRIAXNE250MG                 $181.00
 5319083   CEFTRIAXONE 500MG          CEFTRIAXNE500MG                 $392.00
 5319084   CEFTRIAXONE 1GM            CEFTRIAXONE 1GM                 $414.00
 5319085   CEFTRIAXONE 2GM            CEFTRIAXONE 2GM                 $461.00
 5319087   CEFTRIAXONE 2GM PMX        CEFTRIAXNE2GPMX               $1,951.05



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  Doctors Medical Center - Modesto                                        Page 66 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 5319101   CEFUROXIME 750MG           CEFUROXIME750MG                 $376.00
 5319106   CEFUROXIME 1.5GM           CEFUROXIME1.5GM                 $421.00
 5319193   CHLORAMPHENICHOL 1GM       CHLORAMPHEN 1GM                 $496.05
 5319201   CETUXIMAB PER 10MG         CETUXIMAB 10MG                  $276.00
 5319205   CHLORDIAZEPOXIDE 100MG     CLRDIAZPXD100MG                 $231.95
 5319226   CHLOROPROCAINE 1% 30ML     CHLOROPR 1%30ML                 $199.00
 5319231   CHLOROPROCAINE 2% 30ML     CHLOROPR 2%30ML                 $109.00
 5319232   CHLOROPROCAINE 3% 30ML     CHLOROPR 3%30ML                 $109.00
 5319236   CHLOROPROC MPF 2% 20ML     CHLOROPR 2%20ML                 $337.35
 5319241   CHLOROPROC MPF 3% 20ML     CHLOROPR 3%20ML                 $339.00
 5319262   CHLOROTHIAZIDE 500MG       CHLORTHIAZ500MG                 $221.70
 5319283   CHLORPHENIRAMIN 10MG/ML    CTM 10MG/ML                     $182.75
 5319304   CHLORPROMAZINE 25MG/ML     CHLORPROM25MG/M                 $109.00
 5319309   CHLORPROMAZINE 50MG/2ML    CHLORPROMZN50MG                 $182.75
 5319330   CHORIONIC GONAD 5MU/10ML   APL 5MU/10ML                    $873.60
 5319365   CIDOFOVIR 75MG/ML 5ML      CIDOFOVIR 5ML                 $4,597.45
 5319377   CIMETIDINE 150MG/ML 2ML    CIMETIDINE300/2                 $158.00
 5319385   CIPROFLOXACIN 200MG INJ    CIPROFLOX 200MG                 $379.00
 5319386   CIPROFLOXACIN 400MG INJ    CIPROFLOX 400MG                 $394.00
 5319391   CISATRACURIUM 2MG/ML 5ML   CISATRACURM 5ML                  $84.20
 5319392   CISATRACURIUM 2MG/ML 10M   CISATRACURM10ML                  $78.00
 5319398   CISPLATIN PER 10MG         CISPLATIN 10MG                  $481.00
 5319410   CIT/PHOS/DEX 500ML         CPD 0-500ML                     $652.55
 5319421   CLADRIBINE PER 1MG         CLADRIBINE 1MG                  $459.75
 5319424   CLINDAMYCIN 300MG/2ML      CLINDAMYCN300MG                 $367.00
 5319429   CLINDAMYCIN 600MG/4ML      CLINDAMYCN600MG                 $372.00
 5319434   CLINDAMYCIN 900MG/6ML      CLINDAMYCN900MG                 $372.00
 5319450   COCCI SKN TST 1:10         COCCI SKN TST                   $613.55
 5319455   COCCI SKN TST 1:100 .1ML   COCCI SKN TST                   $182.75
 5319481   COLCHICINE 1MG/2ML         COLCHICINE 1MG                  $207.25
 5319590   COSYNTROPIN .25MG/ML       CORTROSYN .25MG                 $210.00
 5319611   SULFAMETHOX/TRIMETH 5ML    SULFA/TRIM 5ML                   $73.00
 5319632   CROTALIDAE 10ML            ANTIVENIN POLY                $3,572.50
 5319634   CROTALIDAE POLYV IMM FAB   CROFAB INJ                    $2,758.00
 5319669   CYANIDE ANTIDOTE KIT       CYNDE ANTID KIT               $1,654.95
 5319671   CYANOCOBALAMIN 100MCG      VITAMN B12.1MG                  $262.70
 5319674   CYANOCOBALAMIN 1000MCG     VITAMIN B12 1MG                 $133.00
 5319695   CYCLOPHOS 100MG            CYCLOPHOS 100MG                 $397.40
 5319699   CYCLOPHOS (LYPH) 100MG     CYCLOPHOS 100MG                  $78.00
 5319715   CYCLOSPORINE 250MG/5ML     CYCLOSPOR 250MG                 $479.00
 5319726   CYTARABINE 100MG           CYTARABNE 100MG                  $20.00
 5319740   DACARBAZINE 100MG          DACARBAZNE100MG                 $215.00
 5319745   DACTINOMYCIN .5MG          DACTINOMYCN.5MG               $1,029.30
 5319752   DANTROLENE 20MG/70ML       DANTROLENE 20MG               $1,519.30
 5319759   DAPTOMYCIN PER 1MG         DAPTOMYCIN 1MG                    $1.10
 5319765   DARBEPOETIN ALFA PER1MCG   DARBPOETIN 1MCG                  $23.00
 5319775   DAUNORUBICIN PER 10MG      DAUNORUBICN10MG                  $67.00
 5319794   DEFEROXAMINE 500MG         DEFEROXAMINE.5G                 $381.00
 5319819   DESMOPRESSIN PER 1MCG      DESMOPRESSN1MCG                  $52.00
 5319836   DEXAMETHA 10MG/ML 1-2ML    DEXAMETH10MG/ML                  $76.00



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  Doctors Medical Center - Modesto                                             Page 67 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 5319854   DEXAMETHASONE 4MG/ML 5ML   DEXAMETH20MG5ML                  $15.35
 5319855   DEXAMETHASONE10MG/ML10ML   DEXAMETH 100MG                   $35.80
 5319857   DEXAMETHASONE 4MG/ML 1ML   DEXAMETH4MG/1ML                   $4.00
 5319866   DEXAMETH LA 8MG/ML 1ML     DEXAMETH LA 8MG               $1,152.60
 5319880   DEXMEDETOMIDINE 200MCG     PRECEDEX 200MCG                 $435.00
 5319892   DEXPANTHENOL 250MG         DEXPANT250MG/ML                 $289.90
 5319896   DEXTRAN 70 IN DEXTROSE     DEXTRAN 100ML                   $688.00
 5319897   DEXTROSE 10% 5ML           DEXTROS 10% 5ML                 $109.00
 5319898   DEXTROSE 25% 10ML SYG      DEXTROSE 25%SYG                 $190.00
 5319901   DEXTROSE 50% 50ML          DEXTROSE 50% 50                  $77.00
 5319913   DEXTROSE SYG 50% 50CC      DEXTROS SYG 50%                 $265.00
 5319931   DIAZEPAM 5MG/ML 10ML VL    DIAZEPAM 10ML                   $521.85
 5319934   DIAZEPAM 10MG/2ML AMP      DIAZEPAM 2ML                    $221.00
 5319939   DIAZEPAM SYG 10MG/2ML      DIAZEPA SYG10MG                 $243.00
 5319960   DIAZOXIDE 300MG            DIAZOXIDE 300MG               $1,019.50
 5319981   DICYCLOMINE 10MG/ML 2ML    DICYCLOMINE20MG                 $109.00
 5320000   4170 PHARMACY              PHARMACY
 5320007   DIETHYLSTILBESTROL 250MG   DIETHYLSTIL250M                $312.65
 5320025   DIGOXIN .1MG/CC PED        DIG PED .1MG/CC                $127.00
 5320028   DIGOXIN .5MG/2ML           DIGOXIN.5MG/2ML                 $75.00
 5320031   DIGOXIN IMMUNE FAB 40MG    DIGOXIN IF 40MG                $673.00
 5320049   DIHYDROERGOTAMI 1MG/ML     DHE-45 1MG/ML                  $118.00
 5320060   DILTIAZEM 25 MG            DILTIAZEM 25 MG                $368.00
 5320061   DILTIAZEM 50 MG            DILTIAZEM 50 MG                $466.00
 5320064   DILTIAZEM 125MG            DILTIAZEM 125MG                $386.00
 5320070   DIMENHYDRINATE 50MG        DIMENHYDRIN50MG                $182.75
 5320099   DINOPROST 20MG/4ML         PROSTIN F2 20MG              $1,207.35
 5320117   DIPHENHYDRA 50MG/ML        DIPHENHYDR 50MG                 $74.00
 5320139   DIPHTHERIA TETANUS <7YR    DIPHTH TT <7YR                 $118.00
 5320140   DIPTHERIA TETANUS >7YR     DIPHTH TT >7YR                  $89.00
 5320141   DIP TT PERT (DTWP) HIB     DTWP/HIB VACC                  $597.70
 5320143   DIPHTH TT PERT (DTWP)      DTWP VACC                      $186.20
 5320146   DIPHTH TT AC PERT < 7YR    DTAP VACC <7YR                 $124.80
 5320170   DIPYRIDAMOLE 10MG/2ML      DIPYRIDAMOL10MG                $300.00
 5320185   DOBUTAMINE 250MG/20ML      DOBUTAMIN 250MG                $374.00
 5320187   DOBUTAMINE PMX 500MG/250   DOBUT PM500/250                $374.00
 5320195   DOCETAXEL 20MG             DOCETAXEL 20MG                 $813.00
 5320200   DOLASETRON 12.5MG/.625ML   DOLASETRN12.5MG                $136.70
 5320206   DOPAMINE 200MG AMP         DOPAMINE 200MG                 $364.00
 5320211   DOPAMINE 400MG AMP         DOPAMINE 400MG               $1,006.10
 5320221   DOPAMINE SYG 200MG         DOPAMINE 200MG                 $604.45
 5320223   DOPAMINE PMX 400           DOPAMINE PMX400                $375.00
 5320247   DOXAPRAM 20MG/ML 20ML      DOXAPRAM 20ML                  $489.00
 5320251   DOXERCALCIFEROL 4MCG/2ML   DOXERCALCIF 2ML                 $91.50
 5320268   DOXORUBICIN PER 10MG       DOXORUBICIN10MG                $481.00
 5320272   DOXORUBICIN LIP PER 10MG   DOXORUBICIN10MG              $2,298.75
 5320294   DOXYCYCLINE 100MG          DOXYCYCLN 100MG                $365.00
 5320299   DOXYCYCLINE 200MG          DOXYCYCLN 200MG              $1,390.75
 5320302   DROPERIDOL 2.5MG/ML        DROPERID2.5MG/M                $301.15
 5320305   DROPERIDOL 5MG/2ML         DROPERI 5MG/2ML                 $74.00



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  Doctors Medical Center - Modesto                                        Page 68 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 5320310   DROTRECOGIN ALFA 5MG       DROTRECOGIN 5MG                 $623.00
 5320311   DROTRECOGIN ALFA 20MG      DROTRECOGIN20MG               $1,402.00
 5320339   EDROPHONIUM 10MG/ML 15ML   EDROPHONIM 15ML                 $109.00
 5320341   EDROPHONIUM 10MG/ML        EDROPHON10MG/ML                  $83.00
 5320342   EDORPHON/ATROP 10/.14 5M   ENLON PLUS 5ML                   $60.62
 5320343   EDORPHON/ATROP 10/.14 15   ENLON PLUS 15ML                  $90.00
 5320362   ESTRADIOL VAL SYR 20MG     DELESTROGEN20MG                 $199.00
 5320395   ENALAPRIL 1.25MG/1ML       ENALAPRIL 1ML                    $77.00
 5320398   ENOXAPARIN 100MG SYR       ENOXAPARN 100MG                 $141.00
 5320399   ENOXAPARIN 60MG SYR        ENOXAPARN 60MG                  $114.00
 5320400   ENOXAPARIN 30MG SYG        ENOXAPARN 30MG                   $93.00
 5320401   ENOXAPARIN 40 MG SYR       ENOXAPARN 40MG                  $100.00
 5320402   ENOXAPARIN 80MG SYR        ENOXAPARN 80MG                  $127.00
 5320404   EPHEDRINE 50MG/ML          EPHEDRIN 50MG/M                  $73.00
 5320425   EPINEPHRINE 1:1000 1ML     EPINEPHRINE 1ML                  $75.00
 5320427   EPINEPHRINE 1:1000 30ML    EPI 1:1000 30ML                 $227.00
 5320431   EPOETIN NON-ESRD 1000U     EPOETIN 1000U                    $68.00
 5320432   EPINEPHRINE IC 1:10000     EPINEPHRINE IC                   $76.00
 5320435   EPINEPHRINE SYR 1MG/10ML   EPINEPH 1MG/10                  $202.00
 5320444   EPOPROSTENOL 1500MCG       EPOPROSTEN1.5MG                 $425.40
 5320449   EPTIFIBATIDE PER 5MG       EPTIFIBATIDE5MG                  $49.00
 5320450   EPOPROSTENOL .5MG          EPOPROSTENL.5MG                 $389.20
 5320451   EPOPROSTENOL DILUENT       EPOPROS DILUENT                  $91.30
 5320477   ERGONOVINE .2MG/ML         ERGONOVINE .2MG                 $211.20
 5320482   ERGONOVINE SYR .2MG        ERGOTRATE .2MG                  $182.75
 5320491   ERTAPENEM 500MG            ERTAPENEM 500MG                 $213.00
 5320508   ERYTHROMY LA 500MG         ERYTHROMY LA500                 $293.00
 5320513   ERYTHROMY LA 1GM           ERYTHROMY LA 1G                 $367.00
 5320524   ESMOLOL 10MG/ML 10ML       ESMOLOL 100MG                   $272.00
 5320525   ESMOLOL 250MG/ML 10ML      ESMOLOL 2500MG                  $389.00
 5320526   ESMOLOL/NACL PMX 250ML     ESMOLOL250MLPMX                 $472.00
 5320534   ESTRADIOL CYP 5MG/ML 1ML   ESTRADIOL 5MG                   $303.00
 5320539   ESTRADIOL VL 40MG/ML 1ML   ESTRADIOL 40MG                  $748.35
 5320542   ESTROGENS CONJ 5M/M 5ML    ESTROGEN 25MG                   $141.00
 5320555   ETHACRYNATE NA 50MG        ETHACRYNATE50MG                 $265.00
 5320576   ETHYL ALCOHOL 1ML          ETHANOL 1ML                     $243.00
 5320605   ETIDRONATE 50MG/ML 6ML     ETIDRONATE300MG               $1,087.00
 5320607   EXENATIDE 5MCG 60 DOSE     EXENATIDE 5MCG                  $267.50
 5320608   EXENATIDE 10MCG 60 DOSE    EXENATIDE 10MCG                 $301.30
 5320611   ETOMIDATE 40MG/20ML AMP    ETOMIDATE 40MG                   $99.00
 5320613   ETOMIDATE 40MG/20ML SYG    ETOMIDATE 40MG                   $99.00
 5320614   ETOPOSIDE PER 10MG         ETOPOSIDE 10MG                    $8.00
 5320622   FACTOR 9 COMPL PER 100IU   FAC9 COMP 100IU                 $173.00
 5320639   FACTOR VIIA PER 1MCG       FACTR VIIA 1MCG                   $1.60
 5320647   FACTOR 8 HUMAN PER 100IU   FAC8 HUM 100IU                  $466.00
 5320661   FAMOTIDINE 10MG/ML 2ML     FAMOTIDN 20M/2M                  $77.00
 5320666   FENOLDOPAM 10MG/ML 1ML     FENOLDOPAM 10MG                 $368.00
 5320667   FENOLDOPAM 10MG/ML 2ML     FENOLDOPAM 20MG               $2,393.00
 5320670   FLOXURIDINE 500MG/5ML      FLOXURIDIN500MG               $2,671.10
 5320672   FLU SPL VACC >3YRS         FLU VAC >3YRS                    $40.00



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  Doctors Medical Center - Modesto                                        Page 69 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 5320677   FLUCONAZOLE 200MG PMX      FLUCONAZL200PMX                 $291.00
 5320678   FLUCONAZOLE 400MG PMX      FLUCONAZL400PMX                 $526.00
 5320680   FLUDARABINE PHOS 50MG      FLUDARABINE50MG               $1,265.00
 5320681   FLUMAZENIL 5ML             FLUMAZENIL 5ML                  $409.00
 5320682   FLUMAZENIL 10ML            FLUMAZENIL 10ML                 $986.00
 5320686   FLU SPL VACC>3YRS PF       FLU VAC>3YR PF                   $74.41
 5320691   FLUORESCEIN 10% 5ML        FLUORESCITE 10%                 $388.30
 5320696   FLUORESCEIN SYG 10% 5ML    FLUORSCIT SYG                   $530.05
 5320708   FLUOROURACIL 50MG/ML10ML   5-FU 500MG                      $440.00
 5320731   FOMEPIZOLE PER 15MG        FOMEPIZOLE 15MG                  $88.90
 5320738   FOLIC ACID 5MG/ML 1ML      FOLIC ACID 1ML                   $74.00
 5320749   FOSPHENYTOIN PER 50MG      FOSPHENYTN 50MG                  $84.00
 5320759   FUROSEMIDE 100MG/10ML      FUROSEMIDE100MG                  $73.00
 5320762   FULVESTRANT PER 25MG       FULVESTRANT25MG                 $142.00
 5320764   FUROSEMIDE 10MG/ML 2ML     FUROSEMIDE 20MG                  $73.00
 5320769   FUROSEMIDE 40MG/4ML        FUROSM 40MG/4ML                  $74.00
 5320784   FILGRASTIM 480MCG/1.6ML    FILGRASTM480MCG                 $403.00
 5320785   FILGRASTIM 300MCG/1.0ML    FILGRASTM300MCG                 $280.00
 5320788   SARGRAMOSTIM PER 50MCG     SARGRAMSTM50MCG                 $226.00
 5320820   GAMMA GLOBULIN PER 1ML     GAMMA GLOB 1ML                  $111.60
 5320830   GANCICLOVIR 500MG          GANCICLOV 500MG                 $482.00
 5320835   GEMTUZUMAB 5MG             GEMTUZUMAB 5MG                $8,399.75
 5320840   GEMCITABINE PER 200MG      GEMCITABIN200MG                 $479.00
 5320842   GENTAMICIN 10MG/ML 2ML     GENTAMICIN 20MG                 $365.00
 5320847   GENTAMICIN 40MG/ML 1.5ML   GENTAMICIN 60MG                 $282.50
 5320848   GENTAMICIN PMX 100MG       GENTAMCN100PMX                  $374.00
 5320852   GENTAMICIN 40MG/ML 2ML     GENTAMICIN 80MG                 $366.00
 5320898   GLUCAGON 1MG               GLUCAGON 1MG                    $520.50
 5320920   GLYCOPYRROLATE .2MG/ML     GLYCOPYROL .2MG                  $74.00
 5320951   GOLD SOD THIOM 50MG/1ML    GOLD NATHIO50MG                 $243.00
 5320965   GOSERELIN IMPLNT 3.6MG     GOSERELIN3.6MG                $2,056.35
 5320968   GRANISETRON INJ .1MG       GRNSTRN INJ.1MG                  $92.00
 5320972   HALOPERIDOL 5MG/ML 1ML     HALOPERIDOL 5MG                  $80.00
 5320980   HAEMOPHIL B/TET TOX .5ML   HAEM B/TT .5ML                   $88.00
 5320991   HEPARIN 10U/ML 1ML         HEPARIN 10U INJ                 $109.00
 5320992   HEPARIN 100U/ML 10ML       HEPARN 100 10ML                  $73.00
 5320993   HEPARIN 100U/ML 1ML        HEPARN 100U INJ                 $182.75
 5321001   HEPARIN 25000 PMX          HEPRN 25000 PMX                 $371.00
 5321003   HEPARIN 1000/NS PMX        HEPRN 1000 PMX                  $367.00
 5321004   HEPARIN 2000 PMX 1000ML    HEPARIN 2000PMX                 $368.00
 5321008   HEPARIN 1000U/ML 2ML       HEPARIN 2000U                    $76.00
 5321010   HEPARIN 10U/ML 1ML PF      HEPARIN 10U INJ                  $73.00
 5321014   HEPARIN 2500U/ML 1ML       HEPARIN 2500U                    $73.00
 5321016   HEPARIN 1000U/ML 5ML       HEPARIN1000 5ML                  $73.00
 5321018   HEPARIN 5000U/ML 1ML       HEPARIN 5000U                    $74.00
 5321020   HEPARIN 10000U/ML 1ML      HEPARN 10000U                    $75.00
 5321045   HEPARIN 1000U/ML 30ML      HEPARN1000 30ML                  $46.00
 5321063   HEPARIN 1000U/ML 1ML       HEPARIN 1000U                    $74.00
 5321065   HEPARIN 1000U/ML 10ML      HEPARN1000 10ML                  $74.00
 5321089   HEPARIN BEEF 1000U 30ML    BEEFLUNG HEPARN                 $409.00



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  Doctors Medical Center - Modesto                                        Page 70 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 5321091   HEPARIN BEEF 10000U 1ML    HEPARN BF10000U                 $294.45
 5321095   HEPARN BEEF1000U/ML 10ML   HEPARN1000 10ML                  $74.00
 5321108   HEPATITS B IMM GLOB .5ML   HEP B I.G. .5ML                 $148.00
 5321113   HEPATITIS B IMM GLOB 1ML   HEP B I.G. 1ML                  $335.00
 5321114   HEPATITIS B VAC ADULT      HEP B VAC ADULT                 $717.00
 5321115   HEPATITIS B VAC PED/ADOL   HEP B VAC PEDI                  $134.00
 5321117   HEPATITIS B VAC DIALYSIS   HEP B VAC DIALY                 $403.40
 5321127   HETASTARCH 500ML           HESPAN 500ML                    $320.00
 5321160   HISTOPLASMIN .1ML          HISTOPL SKN TST                 $662.35
 5321181   HYALURONIDASE 150U         HYALURONIDS150U                 $279.40
 5321187   HYALURONATE 10MG/ML .4ML   HEALON SYR .4ML               $1,792.00
 5321202   HYDRALAZINE 20MG/1ML       HYDRALAZINE20MG                  $91.00
 5321223   HYDROCORTISONE ACET250MG   HCTS ACET 250MG                 $602.70
 5321238   HYDROCORTISONE NAPH100MG   HCTS NAPH 100MG                 $348.60
 5321243   HYDROCORTISONE SS 100MG    HCTS SS 100MG                    $75.00
 5321248   HYDROCORTISONE SS 250MG    HCTS SS 250MG                    $76.00
 5321253   HYDROCORTISONE SS 500MG    HCTS SS 500MG                   $675.00
 5321274   HYDROCORTISONE SS 1GM      HCTS SS 1GM                   $1,021.00
 5321308   IBUPROFEN LYSINE20MG/2ML   IBUPROF LYS 2ML                 $676.90
 5321314   IBUTILIDE PER 1MG          IBUTILIDE 1MG                   $737.00
 5321316   HYDROXYZINE 50MG INJ       HYDROXYZINE50MG                 $115.00
 5321321   IDARUBICIN 5MG             IDARUBICIN 5MG                  $908.00
 5321322   IFOSFAMIDE 1GM             IFOSFAMIDE 1GM                  $606.00
 5321324   IMIPENEM/CILASTATIN 250    IMIPENEM 250MG                  $380.00
 5321337   INDOCYANINE GREEN 25MG     INDOCYANINE25MG                 $563.10
 5321345   INDOMETHACIN 1MG           INDOMETH IV 1MG                 $697.70
 5321356   INFLIXIMAB PER 10MG        INFLIXIMAB 10MG                 $304.00
 5321370   INSULIN HUMAN              HUMULIN INJ                     $109.00
 5321384   INS H REG 500U 20ML        INSULINHR500U20                 $292.20
 5321385   INS HUM 50/50 10ML         INS HUM50/50 10                 $170.00
 5321389   INS NPH PORK 10ML          INS NPH PK 10ML                 $430.90
 5321397   INS ANALG LISP 75/25 3ML   HUMALOG75/253ML                 $170.00
 5321399   INS ANALOG LISPRO 3ML      HUMALOG 3ML                     $158.00
 5321404   INS HUM NPH CART 3ML       HUM NPH CART3ML                 $143.00
 5321406   INS ANALG LISP75/25 10ML   HUMALOG75/2510M                 $212.00
 5321407   INS GLARGINE 10ML          INS GLARGIN10ML                 $131.00
 5321422   INSULIN VELOSULIN 10ML     VELOSULIN 10ML                  $182.75
 5321425   INS REG BF/PK 10ML         INS REG BF/PK10                 $258.00
 5321427   INS REG PORK 10ML          INS REG PORK 10                 $430.90
 5321443   INS ANALG ASPR70/30 10ML   NOVOLG70/3010ML                 $148.00
 5321445   INS ANALOG ASPAR DOSE      NOVOLOG DOSE                     $24.50
 5321446   INS ANALOG ASPAR 10ML      NOVOLOG 10ML                    $430.00
 5321450   INS HUM REG 10ML           HUM REG 10ML                    $102.00
 5321451   INS HUM REG DOSE           HUM REG DOSE                     $91.00
 5321453   INS ANALOG LISPRO 10ML     HUMALOG 10ML                    $137.00
 5321456   INS HUM 70/30 10ML         HUM 70/30 10ML                  $102.00
 5321458   INS HUM LENTE 10ML         INS HUM LENTE10                 $170.00
 5321461   INS HUM NPH 10ML           INS HUM NPH 10                  $102.00
 5321462   INS HUM NPH DOSE           INS HUM NPH DS                   $91.00
 5321463   INS HUM ULTRALENTE 10ML    INS HUM ULTRA10                 $170.00



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  Doctors Medical Center - Modesto                                        Page 71 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 5321486   INTERFERON ALFA 2B 1MU     INTERFRN A2B1MU                 $205.70
 5321489   ETHIODIZED OIL 10ML        ETHIODOL 10ML                   $875.10
 5321502   IRINOTECAN PER 20MG        IRINOTECAN 20MG                 $357.00
 5321507   IRON DEXTRAN 165 50MG      INFED 50MG                      $131.95
 5321529   IRON SUCROSE PER 1MG       IRON SUCROSE1MG                   $4.80
 5321553   ISOPROTERENOL 1:5000 5ML   ISOPROT 1MG/5ML                 $407.15
 5321557   ISOPROTERENOL SYG 1MG      ISOPROT SYG 1MG                 $244.00
 5321583   ISOXSUPRINE 5MG/ML         ISOXSUPRN5MG/ML                 $243.90
 5321591   ITRACONAZOLE PER 50MG      ITRACONAZLE50MG                 $149.70
 5321594   IVIG LYOPH PWD PER 500MG   IVIG PWDR 500MG                  $74.70
 5321604   KANAMYCIN 500MG/2ML        KANAMYCIN 500MG                 $109.00
 5321607   KANAMYCIN 1GM              KANAMYCIN 1 GM                  $373.00
 5321609   KANAMYCIN PED 75MG/2ML     KANAMYCIN 75MG                  $354.70
 5321630   KETAMINE 50MG/ML 10ML      KETAMIN 50 10ML                 $109.00
 5321635   KETAMINE 100MG/ML 5ML      KETAMIN 100 5ML                 $109.00
 5321636   KETOROLAC 15MG/ML 1ML      KETOROLAC 15MG                   $76.00
 5321637   KETOROLAC 30MG/ML 1ML      KETOROLAC 30MG                   $78.00
 5321638   KETOROLAC 30MG/ML 2ML      KETOROLAC 60MG                   $79.00
 5321641   LABETALOL 5MG/ML 20ML      LABETALOL 20ML                  $370.00
 5321642   LABETALOL 5MG/ML 4ML SYR   LABETALOL 4ML                    $33.32
 5321648   LEPIRUDIN 50MG             LEPIRUDIN 50MG                  $522.00
 5321650   LEUCOVORIN 500MG           LEUCOVORN 500MG                 $115.00
 5321651   LEUCOVORIN CAL 50MG        LEUCOVORIN 50MG                 $367.00
 5321652   LEUCOVORIN 100MG           LEUCOVORN 100MG                  $21.00
 5321654   LEUCOVORIN 200MG           LEUCOVORN 200MG                  $63.00
 5321656   LEUCOVORIN CAL 3MG/1ML     LEUCOVORIN 3MG                  $425.65
 5321668   LEUPROLIDE DEPOT 3.75MG    LEUPROLID3.75MG               $2,492.00
 5321676   LEUPROLIDE DEPOT 7.5MG     LEUPROLIDE7.5MG               $4,996.30
 5321698   NOREPINEPHRINE 4MG/4ML     NOREPINEPH 4MG                  $375.00
 5321702   LEVOBUPIV 5MG/ML 30ML      L-BUPIV 5MG30ML                  $75.15
 5321707   LEVOFLOXACIN 750MG PMX     LEVOFLOX 750PMX                 $424.15
 5321711   LEVOFLOXACIN 500MG PMX     LEVOFLOX 500PMX                 $407.00
 5321712   LEVOFLOXACIN 250MG PMX     LEVOFLOX 250PMX                 $386.00
 5321719   LEVOTHYROXINE .5MG         LEVOTHYROX .5MG                 $410.00
 5321735   LIDOCAINE PMX .8%/250 ML   LIDOCAIN.8PM250                 $464.00
 5321740   LIDOCAINE .5% /EPI DOSE    LIDOCAIN .5%EPI                 $226.25
 5321745   LIDOCAINE .5% 50ML         LIDOCAIN .5%SDV                 $127.00
 5321760   LIDOCAINE 1% /EPI 30ML     LIDOCAIN 1%EPI                  $109.00
 5321765   LIDOCAINE 1%/EPI 5ML       LIDO 1%/EPI 5ML                 $109.00
 5321770   LIDOCAINE 1% 30ML          LIDO 1% 30ML                     $77.00
 5321774   LIDOCAINE 1% 2ML           LIDO 1% 2ML                     $109.00
 5321778   LIDOCAINE 1.5%/EPI DOSE    LIDO 1.5%/EPI                   $109.00
 5321780   LIDOCAINE 1.5% /EPI 30ML   LIDOCAIN 1.5%EP                 $409.45
 5321785   LIDOCAINE 1.5% 20ML        LIDOCAIN 1.5%SD                 $393.95
 5321790   LIDOCAINE 1.5% DOSE        LIDOCAIN 1.5%IN                 $182.75
 5321795   LIDOCAINE 2% /EPI 20ML     LIDOCAIN 2%EPIS                 $109.00
 5321800   LIDOCAINE 2%/EPI 5ML       LIDO2%/EPI 5ML                   $74.00
 5321805   LIDOCAINE 2% VIAL 5ML      LIDOCAINE 2%                    $109.00
 5321808   LIDOCAINE SYG 50MG         LIDOCAIN SYR 50                  $29.75
 5321810   LIDOCAINE SYG 100MG        LIDOCAIN PF 100                  $77.00



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  Doctors Medical Center - Modesto                                        Page 72 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 5321815   LIDOCAINE SYG 1GM          LIDOCAIN SYG 1G                $627.85
 5321820   LIDOCAINE SYG 2GM          LIDOCAIN SYG 2G                $464.00
 5321830   LIDOCAINE/GLUCO 5% 2ML     LIDO/GLU 5% 2ML                $132.00
 5321831   LIDOCAINE 4% 25ML          LIDOCAN 4% 25ML                $618.25
 5321853   LINEZOLID INJ PER 200MG    LINEZOLID/200MG                $368.00
 5321855   LIOTHYRONINE 10MCG/1ML     LIOTHYRON 10MCG                $526.00
 5321893   LORAZEPAM 2MG/ML 1ML SYG   LORAZEPAM 2MG                  $222.00
 5321894   LORAZEPAM 2MG/ML 1ML       LORAZEPAM 2MG                  $222.00
 5321898   LORAZEPAM SYG 4MG/ML 1 M   LORAZPAM 4MG/ML                $233.35
 5321937   MAGNESIUM SULF 10% 20ML    MG SO4 10% 20ML                $223.95
 5321938   MAGNESIUM SULF 50% 10ML    MG SO4 50% 10ML                $292.00
 5321939   MAG SULF PMX 40MG/ML 1L    MAG SULF PMX 1L                $299.00
 5321940   MAGNESIUM SULF 50% 2ML     MAG SO4 50% 2ML                $291.00
 5321944   MAGNESIUM SULF 4% 100 ML   MAG SULF 4%100M                $186.60
 5321949   MAGNESIUM SULF 1% 100ML    MAG SULF 1%100M                $370.50
 5321961   MANNITOL 25% 50ML          MANITOL 25%50ML                $293.00
 5321992   MEASLES/MUMPS/RUB VACC     MMR VACC                       $121.00
 5322003   MECHLORETHAMINE 10MG       MECHLORETH 10MG                $606.70
 5322025   MEDROXYPROGEST 150MG/ML    DEPOPROVERA-150                $129.00
 5322055   MENADIOL 75MG/2ML AMP      SYNKAVIT 75MG/2                $182.75
 5322058   MENINGOCOCCAL VACC SQ      MENINGOCOCL VAC                $176.00
 5322102   MEPIVICAINE 1% 30ML        MEPIVICAINE30ML                $171.00
 5322107   MEPIVICAINE 1.5% 30ML      MEPIVICAINE30ML                $278.30
 5322112   MEPIVICAINE 2% 20ML        MEPIVICAINE20ML                $151.00
 5322120   MESNA 200MG                MESNA 200MG                    $628.00
 5322164   METHICILLIN 1GM            METHICILLIN 1G                 $463.60
 5322185   METHOCARBAMOL 1GM/10ML     METHOCARBM 1G                  $136.00
 5322191   METHOTREXATE 20MG          METHOTREX 20MG                   $9.00
 5322227   METHOXAMINE 20MG/ML        VASOXYL 0-20MG                 $182.00
 5322235   METHYLDOPATE 250MG/5ML     METHYLDOPA250MG                $199.00
 5322248   METHYLENE BLUE 1% 10ML     METHYLENE BLUE                 $109.00
 5322249   METHYLENE BLUE 1% 1ML      METHYLEN BL 1ML                 $49.00
 5322269   METHYLERGONOVINE .2MG      METHLERGNVN.2MG                 $77.00
 5322295   METHYLPRED A 40MG/ML       METHYLPRED 40MG                 $76.00
 5322305   METHYLPRED A 80MG/ML       METHYLPRED 80MG                $371.00
 5322315   METHYLPRED SS 40MG         METHYLPRED 40MG                 $76.00
 5322325   METHYLPRED SS 125MG        METHYLPRED125MG                 $76.00
 5322330   METHYLPRED SS 1GM          METHYLPRED 1GM                  $92.00
 5322335   METHYLPRED SS 500MG        METHYLPRED500MG                 $83.00
 5322366   METOCLOPRAM 5MG/ML 2ML     METOCLOPRAM 2ML                 $74.00
 5322377   METOCURINE 2MG/ML 11-20M   METUBIN 11-20ML                $556.35
 5322382   METOPROLOL 5MG/5ML CART    METOPROLOL5MG/5                 $76.00
 5322387   METRONIDAZOLE 500MG        METRONIDZL500MG                $364.00
 5322388   METRONIDAZOLE 500MG PMX    METRONIDZL500MG                $366.00
 5322400   MEZLOCILLIN 1GM            MEZLOCILLIN 1GM                $244.65
 5322401   MEZLOCILLIN 2GM            MEZLOCILLIN 2GM                $396.50
 5322405   MEZLOCILLIN 3GM            MEZLOCILLIN 3GM                $557.60
 5322408   MEZLOCILLIN 4GM            MEZLOCILLIN 4GM                $682.60
 5322429   MICONAZOLE 200MG/20ML      MONISTAT 200MG                 $496.05
 5322435   MIDAZOLAM 5MG/ML 10ML VL   MIDAZ 5M/M 10ML                $246.00



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  Doctors Medical Center - Modesto                                         Page 73 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 5322438   MIDAZOLAM 5MG/ML 2ML       MIDAZ 10MG/2ML                  $513.00
 5322439   MIDAZOLAM 1MG/1ML 2ML VL   MIDAZ2MG/2ML VL                 $219.00
 5322447   MILRINONE LACT PER 5MG     MILRINONE 5MG                   $387.00
 5322448   MIDAZOLAM 5MG/ML 2MLSYRG   MIDAZ 10MG/2ML                  $361.90
 5322471   PLICAMYCIN 2.5MG           PLICAMYCIN2.5MG               $1,320.90
 5322492   MITOMYCIN 5MG              MITOMYCIN 5MG                 $2,238.40
 5322499   MITOXANTRONE PER 5MG       MITOXANTRON 5MG                 $833.00
 5322504   MIVACURIUM 2MG/ML 10ML     MIVACURIUM 10ML                  $91.00
 5322518   MORRHUATE 50MG/ML          MORRHUATE 50MG                  $388.00
 5322565   MULTI-ELECTRO 25ML         ELECTROLYTES                    $289.90
 5322591   MULTIVITAMIN INJ 10ML      MVI 10ML                        $300.00
 5322592   MULTIVITAMIN PEDI 10ML     MVI PEDI 10ML                   $304.00
 5322612   MULTIVITAMINS 5ML INJ      MULTIVITAMN 5ML                 $247.65
 5322633   MUMPS ANTIGEN .1ML         MUMPS SKN TST.1                 $165.00
 5322654   NAFCILLIN 500MG            NAFCILLIN 500MG                 $365.00
 5322659   NAFCILLIN 1GM              NAFCILLIN 1GM                   $367.00
 5322664   NAFCILLIN 2GM              NAFCILLIN 2GM                   $369.00
 5322669   NA FERRIC GLUC 12.5MG      FER GLUC 12.5MG                  $55.65
 5322690   NALBUPHINE 10MG/ML 2ML     NALBUPHINE 20MG                 $155.00
 5322691   NALBUPHINE 20MG/ML 1ML     NALBUPHINE 20MG                  $10.30
 5322701   NALMEFENE 1MG/ML 2ML       NALMEFENE 2ML                   $790.20
 5322710   NALOXONE 1MG/ML 2ML        NALOXONE2MG/2ML                 $109.00
 5322711   NALOXONE .4MG/ML 1ML       NALOXONE.4MG/ML                  $74.00
 5322712   NALOXONE 1MG/ML 10ML       NALOXN10MG/10ML                 $198.00
 5322732   NALOXONE .02MG/ML 2ML      NALOXON.04MG2ML                 $396.50
 5322758   NANDROLONE DEC 50MG/ML     NANDROLONE 50MG                 $655.35
 5322784   NEOMYCIN INJ .5G           NEOMYCIN INJ.5G                 $235.00
 5322800   NESIRITIDE PER 0.1MG       NESIRITIDE .1MG                  $56.20
 5322805   NEOSTIGMINE 1:1000 10ML    NEOSTIG 1:1 10M                  $77.00
 5322810   NEOSTIGMINE 1:2000 1ML     NEOSTIG 1:2 1ML                  $77.00
 5322821   OPRELVEKIN 5MG             OPRELVEKIN 5MG                $1,109.00
 5322860   NICARDIPINE 25MG/10ML      NICARDIPINE10ML                 $462.00
 5322896   NITROGLYC PMX 50MG/250ML   NTG PMX50MG/250                 $515.00
 5322899   NITROGLYCERIN 50MG/10ML    NTG IV 50MG                     $368.00
 5322904   NITROGLYCERIN 8MG          NTG 8MG/10ML                    $842.95
 5322920   OCTREOTIDE PER 25MCG INJ   OCTREOTIDE25MCG                 $374.00
 5322922   OLANZAPINE 1MG/ML 10ML     OLANZAPINE 10MG                  $98.70
 5322925   NITROPRUSSIDE 50MG/5ML     NITROPRUSS 50MG                 $369.00
 5322936   ONDANSETRON PER 1MG        ONDANSETRON 1MG                  $46.80
 5322946   ORPHENADRINE 30MG/ML 2ML   ORPHENADRIN60MG                 $140.00
 5323008   OXALIPLATIN PER 0.5MG      OXALIPLATN .5MG                  $14.70
 5323045   OXYTOCIN 10U/ML 1ML        OXYTOCIN10U/1ML                  $76.00
 5323055   PACLITAXEL PER 30MG        PACLITAXEL 30MG                 $619.00 Minimum
 5323057   PALIVIZUMAB PER 50MG       PALIVIZUMAB50MG                 $767.00
 5323060   PAMIDRONATE 30MG           PAMIDRONATE30MG                 $353.00
 5323066   PANCURONIUM 10MG/10ML      PANCURON10MG/10                  $76.00
 5323070   PANTOPRAZOLE 40MG IV       PANTOPRZ40MG IJ                  $99.00
 5323073   PAPAVERINE 30MG/ML 10ML    PAPAVERINE300MG                  $91.00
 5323077   PAPAVERINE 30MG/ML 2ML     PAPAVERINE 60MG                  $24.50
 5323080   PARICALCITOL 5MCG/ML 1ML   PARICALCITOL1ML                 $241.00



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CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 5323082   PARICALCITOL 2MCG/ML 1ML   PARICALCITOL1ML                 $112.00
 5323101   PEGFILGRASTIM 6MG          PEGFILGRAST 6MG               $8,142.00
 5323109   PENICILLIN G BENZ 600KU    PEN G BENZ600KU                 $187.80
 5323118   PENICILLIN G BENZ 1.2MU    PEN G BENZ1.2MU                 $245.00
 5323123   PENICLLN G BE/PR 900/300   PEN G 900/300KU                 $218.00
 5323128   PENICILLIN G BE/PR 600KU   PENG BE/PR600KU                 $158.00
 5323133   PENICILLIN G BE/PR 1.2MU   PENG BE/PR1.2MU                 $231.00
 5323138   PENICILLIN G POT 1MU       PEN G K 1MU                     $127.00
 5323142   PENICILLIN G POT 2MU PMX   PEN G K 2MU PMX                  $94.64
 5323143   PENICILLIN G POT 20MU      PEN G K 20MU                    $242.00
 5323144   PENICILLIN G POT 3MU PMX   PEN G K 3MU PMX                  $98.21
 5323148   PENICILLIN G POT 5MU       PEN G K 5MU                     $367.00
 5323153   PENICILLIN G NA 5MU        PEN G NA 5MU                    $332.10
 5323158   PENICILLIN G PROC 1.2MU    PEN G PROC1.2MU                 $146.00
 5323163   PENICILLIN G PROC 2.4MU    PEN G PROC2.4MU                 $356.65
 5323173   PENICILLIN G PROC 600KU    PEN G PROC600KU                 $196.10
 5323185   PENTAGASTRIN 0.5MG/2ML     PENTAGASTRIN2ML                 $320.75
 5323189   PENTAMIDINE 300MG VIAL     PENTAMIDIN300MG               $1,094.00
 5323204   PENTAZOCINE SYR 60MG       PENTAZOCIN 60MG                 $198.65
 5323225   PERPHENAZINE 5MG/ML 1ML    PERPHENAZINE5MG                 $217.60
 5323240   PHENOBARB 30 MG INJ        PHENOBARB 30MG                  $119.00
 5323242   PHENOBARB 65MG             PHENOBARB 65MG                  $119.00
 5323246   PHENOBARB SYR 130MG        PHENOBARB 130MG                 $220.00
 5323267   PHENTOLAMINE 5MG/ML        PHENTOLAMINE5MG                 $337.00
 5323288   PHENYLEPHRN 10MG/ML 1ML    PHENYLEPHRN10MG                 $364.00
 5323309   PHENYTOIN 100MG/2ML        PHENYTOIN 100MG                  $74.00
 5323314   PHENYTOIN 250MG/5ML        PHENYTOIN 250MG                  $75.00
 5323319   PHENYTOIN SYG 100MG/2ML    PHENYTOIN 100MG                 $222.00
 5323345   PHYSOSTIGMINE 2ML          PHYSOSTIGMN 2ML                 $118.00
 5323366   PHYTONADIONE 1MG/.5ML      PHYTONADIONE1MG                 $294.00
 5323371   PHYTONADIONE 10MG/ML 1ML   PHYTONADION10MG                  $78.00
 5323392   PIPERACILLIN 2GM           PIPERACILLIN2GM                 $555.20
 5323397   PIPERACILLIN 3GM           PIPERACILLIN3GM                 $911.55
 5323402   PIPERACILLIN 4GM           PIPERACILLIN4GM               $1,124.20
 5323403   PIPERCLLN TAZOBACT 2.25G   PIP/TAZO 2.25GM                 $374.00
 5323404   PIPERCLN TAZOBACT 3.375G   PIP/TAZO3.375GM                 $380.00
 5323405   PIPERCLLN TAZOBACT 4.5G    PIP/TAZO 4.5GM                  $384.00
 5323420   PLASMA PROTEIN 5% 50ML     PLASMAPROT 50ML                 $756.25
 5323423   PLASMA PROTEIN 5% 250ML    PLASMAPROT250ML                 $322.00
 5323448   PNEUMOCOC 7-VAL CONJ VAC   PREVNAR .5ML                    $527.00
 5323449   PNEUMOC VACC POLYS 23VAL   PNEUMOC VACC                    $339.00
 5323455   CARMUSTINE 7.7MG WAFER     CARMUSTINE WAFR               $8,162.55
 5323465   POLIOVIRUS VACCINE SUBQ    POLIO VAC SUBQ                  $280.00
 5323491   POLYMIX B 500MU            POLYMIXIN B 500                 $209.00
 5323533   POTASSIUM ACET 2MEQ/ML     K ACET 0-20MEQ                  $292.00
 5323538   POTASSIUM CL 2MEQ/ML       KCL 0-30MEQ                     $292.00
 5323542   POTASSIUM 40MEQ/20ML       KCL 40MEQ/20ML                  $291.00
 5323543   POTASSIUM CL 2MEQ/ML       KCL 31-80MEQ                    $292.00
 5323549   POTASSIUM CL 10MEQ/100ML   KCL 10MEQ/100ML                 $294.00
 5323550   POTASSIUM CL 40MEQ/100ML   KCL 40MEQ/100ML                 $294.00



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  Doctors Medical Center - Modesto                                        Page 75 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 5323551   POTASSIUM CL 20MEQ/100ML   KCL 20MEQ/100ML                 $294.00
 5323553   POTASSIUM PHOS 3MM/ML      K PHOS 0-15MM                   $292.00
 5323574   PRALIDOXIME 1GM            PRALIDOXIME 1GM                 $279.00
 5323580   PRAMLINTIDE .6MG/ML 5ML    PRAMLINTIDE 5ML                 $172.00
 5323678   PROCAINAMIDE 500MG/ML2ML   PROCAINAMD 1GM                  $365.00
 5323700   PROCAINE 10% 2ML           PROCAINE10% 2ML                   $9.00
 5323720   PROCHLORPERAZINE 10MG IJ   PROCHLORP 10MG                  $124.00
 5323725   PROCHLORPERAZN 10MG SYRD   PROCHLORP 10MG                   $82.00
 5323746   PROGESTERONE 50MG/ML       PROGESTERON50MG                 $275.35
 5323767   PROMAZINE SYR 25MG/ML      PROMAZIN25MG/ML                 $112.00
 5323772   PROMAZINE SYR 50MG/ML      PROMAZIN50MG/ML                 $207.50
 5323793   PROMETHAZINE 25MG/ML       PROMETHZIN 25MG                  $74.00
 5323798   PROMETHAZINE 50MG/ML IM    PROMETHZIN 50MG                  $74.00
 5323819   PROPRANOLOL 1MG/ML         PROPRANOL1MG/ML                 $112.00
 5323845   PROPOFOL 10MG/ML 20ML      PROPOFOL 20ML                   $376.00
 5323846   PROPOFOL 10MG/ML 50ML      PROPOFOL 50ML                   $395.00
 5323847   PROPOFOL 10MG/ML 100ML     PROPOFOL 100ML                  $427.00
 5323861   PROTAMINE 10MG/ML 5ML      PROTAMINE 50MG                   $79.00
 5323866   PROTAMINE 10MG/ML 25ML     PROTAMINE 250MG                  $93.00
 5323908   PYRIDOSTIGMINE 10MG/2ML    PYRIDOSTGMN10MG                 $112.00
 5323929   PYRIDOXINE 100MG/ML        PYRIDOXINE100MG                 $104.00
 5323950   QUINID GLUC 80M/M 3ML      QUIN GLU240M3ML                 $376.50
 5323955   QUINIDINE IM 200MG/ML      QUINIDIN IM 200                 $182.75
 5323967   RANITIDINE 25MG/ML 2ML     RANITIDINE 50MG                 $368.00
 5323970   RABIES IMM GLOB IM/SC      RABIES IMM GLOB                 $551.00
 5323974   RABIES VACCINE IM          RABIES VACC IM                $1,076.75
 5323980   RETEPLASE 18.1MG           RETEPLASE18.1MG               $1,800.00
 5323986   RAPACURONIUM 20MG/ML 5ML   RAPACURON 5ML                   $143.00
 5324010   RHO (D)IMM GLO IM 300MCG   RHO (D) 300MCG                  $199.90
 5324011   RHO (D) IMM GLOB IM50MCG   RHO (D) 50MCG                   $219.25
 5324015   RIFAMPIN 600MG             RIFAMPIN 600MG                  $432.00
 5324018   RITODRINE 10MG/ML          RITODRIN 0-50MG               $1,929.45
 5324019   RITODRINE 150MG SYRINGE    RITODRINE 150MG               $4,188.65
 5324020   RITUXIMAB 100MG/10ML       RITUXIMAB 100MG                 $964.00
 5324024   ROCURONIUM 10ML            ROCURONIUM 10ML                 $105.00
 5324025   ROCURONIUM 5ML             ROCURONIUM 5ML                   $89.00
 5324032   RSV IMMUNE GLOB PER 50MG   RSV IM GLOB50MG                 $107.65
 5324039   RUBELLA VACCINE            RUBELLA VACC                     $93.00
 5324060   SCOPOLAMINE.4MG/ML         SCOPOLAMINE INJ                 $109.00
 5324086   SECRETIN 75U VIAL          SECRETIN 75U                  $1,734.65
 5324090   SELENIUM 40MCG/ML          SELENIUM 1 ML                   $192.15
 5324128   SODIUM ACET 2MEQ/ML 10ML   NA ACET 20MEQ                   $207.25
 5324130   SODIUM ACET 2MEQ/ML 20ML   NA ACET 40MEQ                   $293.00
 5324141   SODIUM BICARB PED 4.2%     SOD BICARB PED                   $78.00
 5324151   SODIUM BICARB 50ML VL      NA BICARB 50ML                  $292.00
 5324154   SODIUM BICARBONATE 8.4%    NA BIC SYG 50ML                  $76.00
 5324175   SODIUM CHLORIDE CONC       SOD CHL CONC IN                 $119.00
 5324190   SODIUM CL.9% 2ML SYRINGE   SOD CL .9% 2ML                   $74.00
 5324194   SODIUM CL .9% 10ML         SOD CL .9% 10ML                  $74.00
 5324196   SODIUM CL .9% INJ          SOD CL .9% INJ                   $55.00



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  Doctors Medical Center - Modesto                                        Page 76 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 5324197   SODIUM CL FLUSH 0.9% 5ML   SODCL FL 0.9%5M                  $91.95
 5324217   SODIUM INDIGOT 5ML         INDIGO CARMN5ML                 $112.00
 5324259   SOD PHOS 3MM/ML 30ML       SODPHOS 30ML                    $139.00
 5324290   SODIUM TETRADECYL 3% 2ML   NATETRADECYL2ML                 $315.20
 5324300   SODIUM THIOSULFA 1G/10ML   SOD THIOSULF 1G                 $680.35
 5324301   SOD THIOSULF 250M/M 50ML   NA THIOSUL250MG                 $426.20
 5324311   SPECTINOMYCIN 2GM          SPECTINOMYCIN2G                 $604.45
 5324337   STREPTOKINASE 250000U      STREPTOKN 250KU               $1,757.05
 5324363   STREPTOMYCIN 1GM           STREPTOMYCIN1GM                 $119.00
 5324384   STREPTOZOCIN 1GM           STREPTOZOCIN1GM                 $922.00
 5324405   SUCCINYLCHL 20MG/ML 1ML    SUCCINYLCHL 1ML                  $74.00
 5324409   SUCCINYLCHOLINE 500MG      SUCCINYLCHL .5G                 $193.35
 5324413   SUCCINYLCHOLINE 1GM FP     SUCCINYLCHL 1G                  $235.80
 5324419   QUINUPR/DALFROPRST 500MG   QUINP/DALF500MG                 $815.50
 5324420   SUMATRIPTAN 6MG INJ        SUMATRIPTAN 6MG                 $522.00
 5324421   SUMATRIPTAN 6MG INJ KIT    SUMATRIPTAN 6MG                 $138.60
 5324424   TENECTEPLASE 50MG          TENECTEPLSE50MG               $2,905.00
 5324426   TERBUTALINE 1MG/ML         TERBUTALINE 1MG                 $105.00
 5324457   TESTOSTERONE CY 100MG/ML   TESTOST CY100MG                 $173.00
 5324462   TESTOSTERONE PR 100MG/ML   TESTOST PR100MG                 $315.20
 5324467   TESTOSTERONE CYP/ESTRADL   DEPOTESTADIOL                   $337.35
 5324499   TETANUS IMMUNE GLOB 250U   TET IMM GLOB250                 $623.00
 5324519   TETANUS TOXOID .5ML        TETANUS TOX.5ML                 $109.00
 5324561   TETRACAINE 1% 2ML          TETRACAIN 1%2ML                 $113.00
 5324587   TETRACYCLINE 250MG IM      TETRACYCLN250MG                 $231.95
 5324592   TETRACYCLINE 250MG IV      TETRACYCLN250MG                 $231.95
 5324597   TETRACYCLINE 500MG IV      TETRACYCLN500MG                 $300.85
 5324618   THIAMINE 100MG/ML 1ML      THIAMINE 100MG                  $182.75
 5324639   THIETHYLPERAZNE 10MG/2ML   THIETHLPRZN10MG                 $199.65
 5324681   THIOTEPA 15MG              THIOTEPA 15MG                   $471.45
 5324702   THYROTROPIC HORMONE 10U    THYTROPAR 10U                 $1,397.20
 5324703   THYROTROPIN ALPHA 1.1MG    THYROTROPN1.1MG               $1,024.30
 5324723   TICARCILLIN 1GM            TICARCILLIN 1GM                 $182.75
 5324728   TICARCILLIN 3GM            TICARCILLIN 3GM                 $662.35
 5324735   TICARCILLIN/CLAV 3.1GM     TICAR/CLAV 3.1G                 $300.00
 5324739   TIGECYCLINE PER 1MG        TIGECYCLINE 1MG                   $8.40
 5324763   TIROFIBAN PER 0.25MG       TIROFIBAN .25MG                  $69.40
 5324780   TOBRAMYCIN 40MG/ML 2ML     TOBRAMYCIN 80MG                 $370.00
 5324795   TOPOTECAN 4MG              TOPOTECAN 4MG                 $1,844.00
 5324801   TOLAZOLINE 25MG/ML         PRISCOLINE 0-50                 $277.80
 5324820   TORSEMIDE 10MG/ML 5ML      TORSEMIDE 50MG                  $101.00
 5324837   TRACE METAL PED 1ML        TRACE METAL PED                 $197.10
 5324843   TRACE METALS SYG 5ML       TRACE METALS5ML                 $322.10
 5324845   TRACE METALS NEONATAL2ML   TRACE METALS2ML                 $292.00
 5324848   TRACE METALS 5ML VIAL      TRACE METALS5ML                 $293.00
 5324850   TRANEXAMIC ACID 1G/10ML    CYCLOKAPRON 1G                  $107.00
 5324855   TRASTUZUMAB PER 10MG       TRASTUZUMAB10MG                 $122.00
 5324864   TRIAMCIN 10MG/ML 5ML       TRIAMCIN 50M/5M                 $244.00
 5324869   TRIAMCIN 40MG/ML           TRIAMCIN40MG/ML                 $244.00
 5324911   TRIFLUPROMAZINE 20MG/ML    TRIFLUPROMZ20MG                 $322.10



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  Doctors Medical Center - Modesto                                        Page 77 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 5324932   TRIMETHAPHAN 500MG/10ML    TRIMETHAPHAN500                 $572.00
 5324958   TRIMETHOBENZ 200MG SYG     TRMBZMIDE 200MG                 $160.00
 5324965   TROMETHAMINE 18G/500ML     THAM 500ML                    $1,334.10
 5324989   TUBERCULIN PPD 5TU         TB TEST PPD 5TU                 $109.00
 5325010   TUBOCURARINE 3MG/ML 20ML   TUBOCURARI 20ML                 $398.90
 5325011   TUBOCURARINE 3MG/ML 10ML   TUBOCURARI 10ML                 $182.75
 5325052   UROKINASE 250000U          UROKINASE 250MU                 $902.00
 5325055   UROKINASE 5000U/ML 1ML     UROKINASE 5000U               $1,055.85
 5325065   VALPROATE INJ 500MG/5ML    VALPRO 500MG/5                   $81.00
 5325073   VANCOMYCIN 1GM             VANCOMYCIN 1GM                  $384.00
 5325078   VANCOMYCIN 500MG           VANCOMYCIN .5G                  $372.00
 5325082   VARICELLA IMM GLOB 125U    VARICEL IG 125U                 $683.00
 5325099   VASOPRESSIN .5ML           VASOPRESIN .5ML                 $273.70
 5325100   VASOPRESSIN 20U/ML         VASOPRES 20U/ML                 $369.00
 5325114   VECURONIUM 10MG VIAL       VECURONIUM 10MG                 $373.00
 5325125   VERAPAMIL 2.5MG/ML         VERAPAMIL 0-5MG                  $74.00
 5325177   VINBLASTINE 10MG           VINBLASTIN 10MG                  $46.00
 5325198   VINCRISTINE 1MG            VINCRISTINE 1MG                 $537.00
 5325210   VINORELBINE PER 10MG       VINORELBINE10MG                 $242.00
 5325229   VITAMIN A 100000U/2ML      VITAMIN A 2ML                   $471.45
 5325239   VORICONAZOLE PER 10MG      VORICONAZL 10MG                  $38.30
 5325245   WARFARIN 5MG INJ           WARFARIN 5MG IJ                 $278.00
 5325270   ZIDOVUDINE 10MG/ML 20ML    ZIDOVUDINE200MG                 $302.00
 5325292   ZOLEDRONIC ACID PER 1MG    ZOLEDRON AC 1MG               $1,748.95
 5325301   ZIPRASIDONE PER 10MG INJ   ZIPRASIDONE10MG                 $167.50
 5327011   ACETAMINOPH/COD 12MG/5ML   ACETAMN/COD 5ML                  $36.00
 5327015   ACETAMINOPHEN-C 15MG       ACETAMIN/COD #2                  $21.00
 5327019   ACETAMINOPHEN-C 30MG       ACETAMIN/COD #3                 $219.00
 5327023   ACETAMINOPHEN-C 60MG       ACETAMIN/COD #4                  $21.00
 5327041   ALFENTANIL .5MG/ML 2ML     ALFENTANIL 2ML                  $172.00
 5327042   ALFENTANIL .5MG/ML 5ML     ALFENTANIL 5ML                  $248.00
 5327098   AMOBARBITAL 500MG INJ      AMOBARBITL500MG                 $261.45
 5327150   ASA-DIHYDROCODONE-CAFF     SYNALGOS-DC                      $50.35
 5327164   ASA/BUTALBITAL/CAFF CAP    ASA/BUT/CAF CAP                  $35.50
 5327168   ASA/BUTALBITAL/CAFF TAB    ASA/BUT/CAF TAB                  $21.00
 5327189   ASA/CODEINE 15MG           ASA/CODEINE15MG                  $35.50
 5327193   ASA/CODEINE 30MG           ASA/CODEINE30MG                  $35.50
 5327197   ASA/CODEINE 60MG           ASA/CODEINE60MG                  $35.50
 5327209   BROMPTONS SOLN 16-30ML     BROMPTONS SOLN                   $35.50
 5327272   CHLORAL HYDRAT CAP 500MG   CHL HYDRAT500MG                  $35.50
 5327314   COCAINE SOLN 10% 4ML       COCAINE 10% 4ML                 $429.35
 5327318   COCAINE SOLN 4% 4ML        COCAINE 4% 4ML                  $174.00
 5327339   CODEINE INJ 30MG           CODEINE INJ30MG                 $198.65
 5327343   CODEINE INJ 60MG           CODEINE INJ60MG                 $219.00
 5327368   CODEINE TAB 30MG           CODEIN TAB 30MG                  $26.00
 5327372   CODEINE TAB 60MG           CODEIN TAB 60MG                  $50.35
 5327393   CODEINE-BUTAL 15MG         FIORINAL/COD #2                  $35.50
 5327397   CODEINE-BUTAL 30MG         FIORINAL/COD #3                  $26.00
 5327400   CODEINE-PSEUDOEPHED 0-10   NUCOFED 0-10ML                   $38.35
 5327405   DEXTROAMPHETAMINE 5MG      DEXEDRINE TAB 5                  $35.50



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  Doctors Medical Center - Modesto                                        Page 78 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 5327418   DIHYDROCOD-HOMA            HYCOMINE TAB                    $35.50
 5327430   DRONABINOL 2.5MG CAP       DRONABINL 2.5MG                 $70.00
 5327431   DRONABINOL 5MG             DRONABINOL 5MG                 $228.00
 5327432   DRONABINOL 10MG            DRONABINOL 10MG                $156.55
 5327443   DROPERIDOL-FEN 2ML         DROPER/FENT 2ML                $287.50
 5327501   FENTANYL .05MG/ML 2ML      FENTANYL 2ML                   $219.00
 5327504   FENTANYL 12MCG/HR PATCH    DURAGESIC 12                   $232.10
 5327505   FENTANYL .05MG/ML 5ML      FENTANYL 5ML                   $219.30
 5327508   FENTANYL .05MG/ML 50ML     FENTANYL 50ML                   $87.50
 5327509   FENTANYL .05MG/ML 20ML     FENTANYL 20ML                  $231.90
 5327510   FENTANYL 25MCG/HR PATCH    DURAGESIC 25                   $234.00
 5327511   FENTANYL 50MCG/HR PATCH    DURAGESIC 50                   $246.00
 5327512   FENTANYL 75MCG/HR PATCH    DURAGESIC 75                   $261.00
 5327513   FENTANYL 100MCG/HR PATCH   DURAGESIC 100                  $266.00
 5327518   FENTANYL 400MCG LOZ STK    ACTIQ 400MCG                   $240.20
 5327520   FENTANYL 800MCG LOZ STK    ACTIQ 800MCG                   $250.20
 5327544   HYDROCODONE/CPM PK 5ML     TUSSIONEX PK5ML                 $14.70
 5327551   HYDROCOD/HOMATROP 10ML     HYCODAN 10ML                    $21.00
 5327554   HYDROCOD/APAP 5/325        HYD/APAP 5/325                 $219.00
 5327555   HYDROCOD/HOMATROP TAB      HYCODAN TAB                     $35.50
 5327557   HYDROCOD/APAP 7.5/325      HYD/APAP7.5/325                $219.00
 5327561   HYDROCOD COUGH/COLD 1ML    COUGHCOLDHC 1ML                 $60.00
 5327565   HYDROCOD/APAP 10/325       HYD/APAP 10/325                $219.00
 5327567   HYDROCODONE-PP             HYCOMINE 0-10ML                 $35.50
 5327571   HYDROCODONE-PSE            TUSSEND EXPECT                  $21.00
 5327575   HYDROCODONE-PSU SYRUP      TUSSENDSYR 0-10                 $35.50
 5327576   HYDROCODONE/APAP 10/500    HYD/APAP 10/500                $219.00
 5327577   HYDROCODONE/ACET 10ML      HYDROC/ACET10ML                $219.00
 5327578   HYDROCODONE/ACETA 5MG      HYDROCOD/ACT 5                 $220.00
 5327579   HYDROCOD/APAP 7.5/500      HYD/APAP7.5/500                $219.00
 5327581   HYDROCOD/IBUPROF 200/7.5   HYDROC/IBUPROFN                $219.00
 5327582   HYDROCODONE/GUAIFEN 10ML   HYCOTUSS 10ML                   $21.00
 5327586   HYDROMORPHONE 2MG INJ      HYDROMOR2MG INJ                $219.00
 5327587   HYDROMORPHONE 2MG TAB      HYDROMOR2MG TAB                 $21.00
 5327590   HYDROMORPHONE 3MG SUPP     HYDROMOR3MG SUP                $105.15
 5327593   HYDROMORPHONE 4MG TAB      HYDROMOR4MG TAB                 $26.00
 5327594   HYDROMORPH 10MG/ML 10ML    HYDROMOR10MG/ML                $222.00
 5327596   LEVORPHANOL 2MG/ML INJ     LEVORPHANOL 2MG                $198.65
 5327600   LEVORPHANOL TAB 2MG        LEVODROMOR TB 2                 $35.50
 5327625   MEPERIDINE SYG 25MG/ML     MEPERIDINE 25MG                $219.00
 5327629   MEPERIDINE SYG 50MG/ML     MEPERIDINE 50MG                $219.00
 5327633   MEPERIDINE SYG 75ML/ML     MEPERIDINE 75MG                $219.00
 5327637   MEPERIDINE SYG 100MG/ML    MEPERIDIN 100MG                $219.00
 5327641   MEPERIDINE TAB 50MG        MEPERIDINE 50MG                 $21.00
 5327660   METHADONE 20MG/10ML ORAL   METHADON20MG/10                 $36.00
 5327666   METHADONE 10MG/ML 30ML     METHA 10M/M 30M                $198.65
 5327670   METHADONE 10MG TAB         METHADONE 10MG                 $219.00
 5327674   METHADONE 5MG TAB          METHADONE 5MG                   $35.50
 5327680   METHOHEXITAL 500MG         METHOHEX 500MG                 $210.00
 5327695   METHYLPHENIDATE 5MG        METHYLPHEN 5MG                  $21.00



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  Doctors Medical Center - Modesto                                        Page 79 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 5327699   METHYLPHENIDATE 10MG       METHYLPHEN 10MG                  $21.00
 5327730   MIDAZOLAM SYRUP 10MG/5ML   MIDAZ 10MG/5ML                  $178.00
 5327733   MORPHINE PF 0.5M/M 10ML    MORPH .5M/M10ML                 $511.50
 5327736   MORPHINE PF 1MG/ML 2ML     MORPH PF 1M/M 2                 $520.00
 5327739   MORPHINE 200MG/20ML INJ    INFUMORPH 200                 $1,006.00
 5327740   MORPHINE 500MG/20ML INJ    INFUMORPH 500                 $3,227.60
 5327741   MORPHINE PF 0.5M/M 2ML     MORPH 0.5M/M 2M                 $221.00
 5327742   MORPHINE PF 1MG/ML 2ML     MORPH 1MG/ML 2M                 $198.55
 5327743   MORPHINE PF 1MG/ML 10ML    MORPHINE PF10MG                 $521.00
 5327749   MORPHINE 10MG/5ML          MORPHIN SOLN-20                  $21.00
 5327755   MORPHIN CONC 20MG/ML 1ML   MORPHIN 20MG/ML                 $219.00
 5327757   MORPHINE SYG 2MG/ML        MORPHIN INJ 2MG                 $219.00
 5327761   MORPHINE SYG 4MG/ML        MORPHIN INJ 4MG                 $219.00
 5327765   MORPHINE SYG 8MG/ML        MORPHIN INJ 8MG                 $219.00
 5327769   MORPHINE 10MG/ML 1ML SYG   MORPHINE 10MG                   $219.00
 5327773   MORPHINE SYG 15MG/ML       MORPHIN INJ 15M                 $219.00
 5327774   MORPHINE INJ 15MG/ML 20M   MORPHIN IN 15MG                 $219.00
 5327777   MORPHINE TAB 15MG          MORPHINE 15MG                    $35.50
 5327778   MORPHINE SUL CR TAB 60MG   MS CONTIN 60 MG                  $53.00
 5327779   MORPHINE SULCR TAB 100MG   MS CONTIN 100MG                  $74.00
 5327780   MORPHINE SUL CR TAB 15MG   MS CONTIN 15MG                  $219.00
 5327781   MORPHINE TAB 30MG          MORPHINE 30MG                    $21.00
 5327782   MORPHINE SUL CR TAB 30MG   MS CONTIN 30MG                  $220.00
 5327802   OPIUM BELLADONNA 30MG      B&O SUPP 30MG                    $36.00
 5327806   OPIUM BELLADONNA 60MG      B&O SUPP 60MG                    $40.00
 5327831   OPIUM TINCT DOSE           OPIUM TINC DOSE                  $21.00
 5327847   OXYCODONE/ACET 5/325       OXYC/ACET 5/325                 $218.00
 5327852   OXYCODONE-ASA              PERCODAN                         $21.00
 5327855   OXYCODONE 5MG              OXYCODONE 5MG                    $28.00
 5327857   OXYCODONE CONTR REL 10MG   OXYCONTIN 10MG                  $220.00
 5327858   OXYCODONE CONTR REL 20MG   OXYCONTIN 20MG                  $221.00
 5327859   OXYCODONE CONTR REL 40MG   OXYCONTIN 40MG                  $223.00
 5327860   OXYCODONE CONT REL 80MG    OXYCONTIN 80MG                  $229.50
 5327872   OXYCODONE 20MG/ML 1ML      OXYCODONE 1ML                   $218.00
 5327880   PCA MORPHINE 0-30 MG SYR   PCA MORPH0-30MG                 $454.00
 5327882   PCA MEPERIDINE 0-300MG     PCA MEPER 0-300                 $266.05
 5327902   PENTOBARBITAL 100MG        PENTOBARB 100MG                  $35.50
 5327904   PENTOBARBITAL 100MG INJ    PENTOBARB 100MG                 $119.00
 5327905   PENTOBARBITAL 18.2MG/5ML   PENTOBARB 5ML                    $35.50
 5327906   PENTOBARBITAL 30MG SUPP    PENTOBARB SUPP                   $60.45
 5327910   PENTOBARBITAL 60MG SUPP    PENTOBARB SUPP                   $67.40
 5327931   PHENOBARB 15MG             PHENOBARB 15MG                   $21.00
 5327935   PHENOBARB 30MG             PHENOBARB 30MG                   $21.00
 5327939   PHENOBARB 60MG             PHENOBARB 60MG                   $21.00
 5327943   PHENOBARB 100MG            PHENOBARB 100MG                  $21.00
 5327947   PHENOBARB 20MG/5ML         PHENOBAR 0-15ML                  $21.00
 5327948   PHENOBARBITAL PED DOSE     PHENOBARBITL PD                  $21.00
 5327960   REMIFENTANIL 1MG/3ML       REMIFENTANIL1MG                 $231.00
 5327968   SECOBARBITAL 50MG          SECOBARBITL50MG                  $35.50
 5327972   SECOBARBITAL 100MG         SECONAL 100MG                    $35.50



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  Doctors Medical Center - Modesto                                             Page 80 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 5327984   SECOBARBITAL 100MG SYRG    SECOBARBTL100MG                $198.65
 5327993   SUFENTANIL 2ML             SUFENTANIL 2ML                 $229.00
 5327995   SUFENTANIL 5ML             SUFENTANIL 5ML                 $242.00
 5328000   TETRACAIN/EPI/COCAIN 3ML   T.A.C. 3ML                     $248.35
 5328026   TERPIN HYDRATE /COD        TERPN HYDRA/COD                 $35.50
 5328060   THIOPENTAL 0-500MG INJ     PENTOTHAL 0-500                $250.00
 5328066   THIOPENTAL 2.5GM           PENTOTHAL 2.5GM                $398.00
 5330000   4170 PHARMACY              PHARMACY
 5330001   MISC EENT PRODUCT          MISC EENT                      $149.00
 5330016   ACETIC ACID 2% 15ML        VOSOL OTIC SOLN                $214.00
 5330023   ACETIC ACID 2%/HYDROC 1%   VOSOL HC OTIC S                $449.25
 5330044   ACETYLCHOLINE CL 1%        ACETYLCHOL OPHT                $941.80
 5330062   ACETYLCYS SINGLE DOSE      ACETYLCYSTN 5ML                 $26.00
 5330079   ACETYLCYSTEINE 20% 4ML     ACETYLCYS-20% 4                 $79.00
 5330086   ACETYLCYSTEINE 20% 10ML    ACETYLCYS-20%10                 $88.00
 5330093   ACETYLCYSTEINE 20% 30ML    ACETYLCYS-20%30                $116.00
 5330114   ALBUTEROL 90MCG 17GM       ALBUTEROL 17G                  $103.00
 5330115   ALBUTEROL .5% 20ML         ALBUTEROL 20ML                 $176.00
 5330116   ALBUTEROL .0839% 3ML       ALBUTEROL 3ML                   $74.00
 5330118   ALBUTEROL ROTAHALER        ALBUTR ROTAHALR                 $13.00
 5330122   ALBUTEROL SOLN 5MG/ML DS   ALBUTER DOSE                    $73.50
 5330123   ALBUTEROL/IPRATROPIUM3ML   DUO NEB 3ML                     $75.00
 5330156   ALUMINUM ACET OTIC 60ML    AL ACETATE OTIC                $473.35
 5330177   AMYL NITRITE VAP           AMYL NITRIT VAP                 $44.45
 5330240   ARTIF TEARS METHYLC 15ML   ISOPTO PLAIN 15                $165.00
 5330261   ATROPINE .5% 5ML OS        ATROPINE .5%5ML                $315.20
 5330275   ATROPINE 1% 2ML OS         ATROPINE 1% 2ML                $189.65
 5330282   ATROPINE 1% 5ML OS         ATROPINE 1% 5ML                $191.00
 5330289   ATROPINE 1% 15ML OS        ATROPINE 1%15ML                $356.65
 5330351   BACITRACIN 3.5GM OO        BACITRACIN3.5GM                 $33.25
 5330373   BECLOMETH 16.8GM NASAL     BECLOMETH 16.8G                $475.00
 5330374   BECLOMETH .042% SPRY 25G   BECLOME SPY 25G                $487.00
 5330375   BECLOMETHASONE 6.7G INH    BECLOMETH 6.7G                 $278.45
 5330380   BECLOMETH 16.8GM INHAL     BECLOMETH 16.8G                $732.00
 5330401   BENZOCAINE-ANTIPY 15ML     BENZOC/ANTI15ML                $157.00
 5330402   BETAXOLOL .25% 15ML OS     BETAXOLOL 15ML                 $480.15
 5330404   BETAXOLOL .5% 5ML OPHTH    BETAXOLOL 5ML                  $535.50
 5330407   BETAXOLOL .25% 5ML OS      BETAXOLOL 5ML                  $148.00
 5330411   BITOLTEROL AEROSOL 15ML    BITOLEROL 15ML                 $846.00
 5330438   BRIMONIDINE .2% 10ML OS    BRIMONIDINE10ML                $649.40
 5330440   BUTORPHANOL 2.5ML NS       BUTORPHANOL NS                 $717.00
 5330441   BUDESONIDE PWDR 200MCG     BUDESON 200MCG                 $218.00
 5330445   CALCITONIN 200U/SPRAY2ML   CALCITONIN2MLNS                $277.00
 5330447   CALFACTANT 35MG/ML 6ML     CALFACTANT 6ML               $6,878.90
 5330448   BUDESONIDE INH .5MG/2ML    BUDESON.5MG/2ML                 $77.00
 5330449   CARBACHOL .01% 1.5ML       CARBACHL .01%UD                $665.90
 5330451   BRIMONIDINE .15% 5ML OS    BRIMONIDINE 5ML                $266.63
 5330454   CALCITONIN 200U/SPR3.7ML   CALCITONIN3.7ML                $630.30
 5330471   CARBACHOL 3% 15ML          CARBACHOL 3%                   $456.55
 5330492   CARBAMIDE PEROX 15ML       DEBROX 15ML                    $100.00



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  Doctors Medical Center - Modesto                                        Page 81 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 5330513   CHLORAMPHENICOL .5% 15ML   CHLORAMPHEN 15M                 $312.65
 5330520   CHLORAMPHENICOL .5%7.5ML   CHLORAMPHEN 7.5                 $189.30
 5330527   CHLORAMPHENICOL 3.5GM      CHLORAMPHEN 3.5                 $353.90
 5330534   CHLORAMPHENICOL OTIC       CHLORAMPHEN OT                  $591.10
 5330547   CIPROFLOXACIN 5ML OS       CIPROFLOX 5ML                   $278.00
 5330548   COLFSCERIL NEONATAL        EXOSURF NEONATL               $7,961.45
 5330562   CROMOLYN 13ML NASAL SOLN   CROMOLYN 13ML                   $549.00
 5330569   CROMOLYN 10MG/ML 2ML NEB   CROMOLYN20MGNEB                  $83.00
 5330570   CROMOLYN 8.1GM INHALER     CROMOLYN 8.1GM                  $955.20
 5330590   CYCLOPENTOLATE 1% 2ML      CYCLOPENT 1%2ML                 $157.00
 5330597   CYCLOPENTOLATE 1% 5ML      CYCLOPENT 1%5ML                 $363.55
 5330603   CYCLOPENTOLATE 2% 5ML      CYCLOPENT 2%5ML                 $463.05
 5330639   DESMOPRESSIN .01% 2.5ML    DESMOPRESN2.5ML                 $949.00
 5330681   DEXAMTHEASONE .05% 3.5GM   DEXAMETH 3.5GM                  $334.65
 5330695   DEXAMETHASONE .1% 5ML OS   DEXAMETH .1%5ML                 $449.25
 5330709   DEXAMETHASONE .1%15ML OS   DEXAMETH.1%15ML                 $244.00
 5330722   DEXAMETH/NEO/POLY 5ML OS   DEX/NEO/POLY5ML                  $51.00
 5330737   DEXAMETHASONE TURB 12.6G   DEXAMETH 12.6G                  $767.65
 5330744   DEXAMETH/NEOMYCIN 3.5GM    DEXAMTH/NEO3.5G                 $173.00
 5330751   DEXAMETHA/NEO/POLY 3.5GM   DEX/NEO/POLY3.5                 $253.00
 5330772   DIPIVEFRIN .1% 5ML OS      DIPIVEFRIN 5ML                  $274.00
 5330780   DORNASE ALPHA 2.5ML        DORNASE A 2.5ML                 $123.00
 5330785   DORZOLAMIDE 2% 5ML OS      DORZOLAMIDE 5ML                 $267.00
 5330793   ECOTHIOPHATE .03% 5ML      ECOTHIO .03%5ML                 $332.10
 5330807   ECOTHIOPHATE .125% 5ML     ECOTHI .125%5ML                 $381.95
 5330814   ECOTHIOPHATE .25% 5ML      ECOTHIO .25%5ML                 $414.15
 5330835   EPINEPHRINE .25% 15ML      EPINEPHRIN .25%                 $425.65
 5330842   EPINEPHRINE .5% 15ML       EPINEPHRIN .5%                  $552.70
 5330843   EPINEPHRINE 1:1000 30ML    EPINEPHRIN 30ML                 $140.00
 5330849   EPINEPHRINE 1% 15ML        EPINEPHRI 1%15M                 $623.65
 5330863   EPINEPHRINE 2% 15ML        EPINEPHRIN 2%15                 $668.60
 5330870   EPINEPHRINE BORA 1%        EPPY/N 1% 7.5ML                 $315.20
 5330877   EPINEPH INH 0.3MG/15ML     EPI INH 0.3M/15                 $166.70
 5330884   EPINEPHRINE INHL           EPINEPHRIN INHL                 $247.90
 5330891   EPINEHRINE INHL 7.5ML      EPI INH 7.5ML                   $346.75
 5330908   EPINEPHRINE SINGLE DOSE    EPINEPHRIN UDOS                  $73.00
 5330923   ERYTHROMYCIN 1GM UD OPHT   ERYTHROM UD OPT                  $78.00
 5330926   ERYTHROMY OPTH 3.5GM       ERYTHRO 3.5 OPT                 $120.00
 5330944   OFLOXACIN .3% 5ML OTIC     OFLOXACIN 5MLOT                 $313.00
 5330947   FLUNISOLIDE .025% 25ML     FLUNISOLIDE25ML                 $430.00
 5330948   FLUNISOLIDE 7GM            FLUNISOLIDE 7G                  $538.00
 5330965   FLUORESCEIN 2%2ML          FLUORESCEIN 2%2                 $189.65
 5330968   FLUORESCEIN STRIP          FLUOR-I-STRIP                    $11.00
 5330989   FLUOROMETHALONE .1%        FLUOROME .1%5ML                 $407.15
 5330995   FLUTICASONE .05%16GM       FLONASE .05%16G                 $141.00
 5330997   FLUTICASONE 44MCG 13GM     FLOVENT 44/13GM                 $293.00
 5330998   FLUTICASONE 110MCG 13GM    FLOVENT110/13GM                 $542.00
 5330999   FLUTICASONE 220MCG 13GM    FLOVENT220/13GM                 $200.00
 5331010   GELATIN ABS                GELFILM OPTH                    $130.00
 5331031   GENTAMICIN .3% 3.5GM OO    GENTAMICIN3.5GM                 $222.00



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  Doctors Medical Center - Modesto                                        Page 82 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 5331038   GENTAMICIN .3% 5ML OS      GENTAMICIN 5ML                  $222.00
 5331101   HE-CELL-PVA .5% 15ML       ARTF TEARS 15ML                  $48.90
 5331122   HOMATROPINE 2% 15ML        HOMATROPIN 2%15                 $425.65
 5331130   HOMATROPINE 2% 1ML         HOMATROPN 2%1ML                 $182.55
 5331133   HOMATROPINE 5% 1ML         HOMATROPIN5%1ML                 $109.00
 5331136   HOMATROPINE 5% 5ML         HOMATROPIN5%5ML                 $346.75
 5331156   HYALURON SYG 12MG/ML.8ML   AMVISC .8ML                     $210.20
 5331157   HYALURON SYG 4MG/.4ML      HEALON SYG .4ML               $2,987.75
 5331164   HYALURON SYG 7.5MG/.75ML   HEALON SYG.75ML               $4,811.85
 5331221   INHALATION MED DOSE        INHAL MED DOSE                   $51.00
 5331230   IPRATOPIUM 18MCG/PF 14G    IPRATOPIUM 14G                  $404.00
 5331231   IPRATOPIUM .02% SOLN       ATROVENT .02%                    $76.00
 5331233   IPRATROPIUM.03% NAS SPR    ATROVENT .03%NS                 $311.00
 5331234   IPRATROPIUM NAS SPRY30ML   ATROVENT NSPY30                 $362.00
 5331235   IPRATROP/ALBUT INH14.7GM   COMBIVENT 14.7G                 $293.00
 5331245   IRRIGANT OPHTH 120ML       IRRIG OP 120ML                   $97.40
 5331269   ISOETHARINE 10ML           ISOETHARIN 10ML                 $403.35
 5331279   ISOETHARINE SINGLE DOSE    ISOETHARIN UD                   $116.80
 5331355   KETOROLAC 0.5% 5ML OS      KETOROLAC 5ML                   $397.00
 5331360   LANOLIN-CL-BUTA 3.5GM      LUBRICANT 3.5G                   $50.00
 5331365   LATANOPROST .005% 2.5ML    LATANOPRST2.5ML                 $326.00
 5331370   LEVOBUNOLOL .5% 5ML        LEVOBUNL .5%5ML                 $333.00
 5331372   LEVOBUNOLOL .25% 5ML       LEVOBUNL.25%5ML                  $89.45
 5331375   LEVALBUTEROL 0.63MG/3ML    L-ALBUT .63 3ML                 $110.55
 5331376   LEVALBUTEROL 1.25MG/3ML    L-ALBUT1.25 3ML                  $75.00
 5331402   LIPRESSIN 8ML              DIAPID 8ML                      $861.80
 5331441   METAPROTERENOL .6% UD      METAPROTER.6%UD                  $74.00
 5331444   METAPROTERENOL 15ML        METAPROTER 15ML                 $290.00
 5331479   METHYLCELLULOSE            ARTIFICIAL TEAR                 $270.75
 5331489   MOMETASONE 17GM NS         MOMETASONE 17GM                 $389.00
 5331500   NAPHAZOLINE .1% 15ML       NAPHAZL .1%15ML                 $388.30
 5331527   NAPHAZOLINE-PHENIR 15ML    NAPHAZ/PHEN15ML                  $46.00
 5331534   NATURAL LUNG SURFACT 4ML   SURVANTA 4ML                    $532.00
 5331535   NATURAL LUNG SURFACT 8ML   SURVANTA 8ML                    $886.00
 5331545   NEDOCROMIL SOD 16.2GM      NEDOCROMIL16.2G                 $665.90
 5331563   NEO/POLY/HYDROCORTIS OPH   NEO/POLY/HC OPH                 $260.00
 5331577   DEXAMETH/NEOMYCIN 5ML OS   DEXAMETH/NEO5ML                 $137.95
 5331584   NEO/POLY/BAC/HCORTIS3.5G   NEO/POLY/BA3.5G                 $157.00
 5331591   NEOMYCIN-COLIST 10ML OTI   COLY-MYCINS10ML                 $467.75
 5331605   NEOMYC/POLY/GRAMICID10ML   NEO/POLY/GRAM10                 $194.00
 5331612   NEOMYC/POLY/BACITRA 3.5G   NEO/POLY/BA3.5G                 $170.00
 5331625   NITROGLYCERIN 13.8G SPRY   NTG SPRAY                       $347.00
 5331640   OFLOXACIN .3% 5ML OS       OFLOXACIN5MLOS                  $187.00
 5331682   OXYMETAZOLINE 15ML .05%    OXYMETAZOL 15ML                  $37.00
 5331689   OXYMETAZOLINE 20ML .05%    OXYMETAZOL 20ML                  $62.00
 5331731   OXYTOCIN 40U/ML 2ML NS     OXYTOCIN NS 2ML                 $733.25
 5331740   PENTAMIDINE 300MG          PENTAMIDIN300MG               $1,824.90
 5331780   PHENYLEPHRN.125% 30ML DR   PHENYLEPHRN30ML                 $111.30
 5331787   PHENYLEPHRN .25% 15ML DR   PHENYLEPHRN15ML                 $115.85
 5331794   PHENYLEPHRN .25% 15ML SP   PHENYLEPHRN15ML                 $113.80



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  Doctors Medical Center - Modesto                                        Page 83 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 5331798   PHENYLEPRHN .5% 30ML SP    PHENYLEPHRN30ML                  $72.00
 5331801   PHENYLEPHRN .5% 15GM JLY   PHENYLEPHRN15GM                  $95.30
 5331808   PHENYLEPHRN .5% 15ML SP    PHENYLEPHRN15ML                  $74.00
 5331815   PHENYLEPHRINE 1% DROPS     PHENYLEPH 1%DRP                  $75.00
 5331822   PHENYLEPHRN 10% 5ML OS     PHENYLEPHRN 5ML                 $312.15
 5331829   PHENYLEPHRN 2.5% 15ML OS   PHENYLEPHRN 15M                 $191.00
 5331842   PHENYLEPH/CYCLOPENT 2ML    P-EPH/CPENT 2ML                 $116.00
 5331843   PHENYLEPH/CYCLOPENT 5ML    P-EPH/CPENT 5ML                 $356.65
 5331850   PHENYLEPHR-T 22.5ML        NTZ NASAL                       $125.75
 5331871   PHYSOSTIGMINE .25%         PHYSOSTIGMN.25%                 $463.60
 5331892   PILOCARPINE .25% 15ML OS   PILOCARP .25%15                 $332.10
 5331899   PILOCARPINE .5% 15ML OS    PILOCARP.5%15ML                 $332.10
 5331906   PILOCARPINE 1% 15ML OS     PILOCARP 1%15ML                 $332.10
 5331927   PILOCARPINE 2% 15ML OS     PILOCARP 2%15ML                 $203.00
 5331934   PILOCARPINE 2% 2ML OS      PILOCARP 2% 2ML                 $177.55
 5331941   PILOCARPINE 3% 15ML OS     PILOCARP 3%15ML                 $350.60
 5331948   PILOCARPINE 4% 15ML OS     PILOCARP 4%15ML                 $211.00
 5331962   PILOCARPINE 6% 15ML OS     PILOCARP 6%15ML                 $381.00
 5331997   PILOCARPINE-EPI 2% 15ML    P2E1 15ML                       $474.95
 5332004   PILOCARPINE-EPI 3% 15ML    P3E1 15ML                       $483.00
 5332011   PILOCARPINE-EPI 4% 15ML    P4E1 15ML                       $501.55
 5332018   PILOCARPINE-EPI 6% 15ML    P6E1 15ML                       $516.95
 5332025   PIRBUTEROL INHALER         PIRBUTEROL INHL                 $334.00
 5332074   POLYMIX-BACIT OPTH UNG     POLY/CACIT OPHT                 $168.00
 5332095   POLY/NEO/HYDROCORTI OTIC   POLY/NEO/HC OTI                 $274.00
 5332102   POL/NEO/HYDROCORTI SUSP    POLY/NEO/HC SUS                 $224.00
 5332130   POLYVINYL ALCOH 15ML       ARTIF TEAR 15ML                 $140.00
 5332140   PORACTANTALFA120MG/1.5ML   PORACTANT 1.5ML                 $413.40
 5332141   PORACTANT ALFA 240MG/3ML   PORACTANT 3ML                   $739.70
 5332151   PREDNISOLONE-SULF 5ML      PRED/SULFAC 5ML                 $260.00
 5332172   PREDNISOLONE .12% 5ML      PREDNIS .12%5ML                 $395.10
 5332179   PREDNISOLONE .12% 10ML     PREDNIS .12% 10                 $509.35
 5332193   PREDNISOLONE 1% 5ML        PREDNISOL 1%5ML                 $254.00
 5332200   PREDNISOLONE 1% 10ML       PREDNISOL 1% 10                 $546.65
 5332207   PREDNISOLONE/NE            POLY PRED 5ML                   $471.05
 5332242   PROPARACAINE .5% 15ML      PROPARACAIN15ML                 $290.00
 5332263   PROPYLENE GLYCOL INHL 3%   PROPYLEN GLYCOL                 $135.95
 5332270   RIBAVIRIN 6GM/100ML        RIBAVIRIN 6GM                $13,850.50
 5332280   SALMETEROL INHALER         SEREVENT INHALR                 $754.70
 5332281   SALMETEROL INHALER 6.5GM   SEREVENT IN6.5G                 $165.00
 5332282   SALMETEROL DISKUS 50MCG    SALMET DK 50MCG                 $398.72
 5332285   SALMET/FLUT DSK50/100 28   ADVAIR50/100 28                 $630.10
 5332287   SALMET/FLUT DSK50/250 28   ADVAIR50/250 28                 $777.60
 5332289   SALMET/FLUT DSK50/500 28   ADVAIR50/500 28               $1,063.70
 5332326   SCOPOLAMINE .25% 5ML       SCOPOLAMIN .25%                 $325.35
 5332390   SOD K CELLULOSE 15ML       ARTIF TEAR 15ML                  $83.50
 5332392   SODIUM CL.9% 5ML NEB       SOD CL 5ML NEB                    $1.00
 5332396   SODIUM CHLORIDE 45ML       NACL INHL 45ML                   $16.00
 5332403   SODIUM CHLORIDE 5% 15ML    NACL 5% 15ML                     $18.00
 5332452   SODIUM-CALCIUM 15ML        BALANCED SALT15                 $362.40



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  Doctors Medical Center - Modesto                                        Page 84 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 5332457   SODIUM-CA PLUS SOL 500ML   BALANCED SALT                 $1,538.00
 5332473   SULFACETAMIDE 10% 3.5GM    SULFACET 10%3.5                 $176.00
 5332480   SULFACETAMIDE 15%          SULFACETAMI 15%                 $339.00
 5332487   SULFACETAMIDE 30% 15ML     SULFACET30%15ML                 $441.85
 5332494   SULFACETAMIDE S 10%        SULFACET10%3.5G                 $320.75
 5332501   SULFACETAMIDE S 10% 15ML   SULFACET10%15ML                 $253.00
 5332515   SULFACET/PREDNISOL 15ML    SULFA/PRED 15ML                 $632.10
 5332520   SULFACETAMID/PREDNI 3.5G   SULFA/PRED 3.5G                 $490.70
 5332536   SULFISOXAZOLE D 15ML       GANTRISIN 4%15                  $250.25
 5332543   SULFISOXAZOLE D 3.75GM     GANTRISN 4%3.75                 $212.45
 5332545   TALC STERILE POWDER        TALC STERL PDWR                 $639.35
 5332564   TEA-PPO-CL-BUTA 8ML        CERUMENEX 8ML                   $191.00
 5332581   TERBUTALINE INHALR 7.5ML   TERBUTALN 7.5ML                 $334.00
 5332589   TETRACAINE .5% 1ML         TETRACAIN.5%1ML                  $41.00
 5332592   TETRACAINE .5% 2ML         TETRACAIN.5%2ML                 $113.00
 5332599   TETRACAINE .5% 3.5GM       TETRACAIN.5%3.5                 $231.95
 5332634   TETRACYCLINE 3.5GM         TETRACYCLIN 3.5                 $382.65
 5332669   TETRAHYDRAZOL .1% 15ML     TETRAHYD.1%15ML                 $150.00
 5332697   TIMOLOL .25% 5ML OS        TIMOLOL 5ML OS                  $380.00
 5332702   TIMOLOL .5% 5ML GEL        TIMOLOL 5ML GEL                 $340.00
 5332704   TIMOLOL .5% 5ML OS         TIMOLOL 5ML OS                  $437.00
 5332711   TIOTROPIUM 18MCG INH 6     TIOTROPIUM IH 6                 $109.60
 5332725   TOBRAMYCIN OO 3.5GM        TOBRAMYCIN 3.5G                 $278.00
 5332726   TOBRAMYCIN OS 0.3% 5ML     TOBRAMYC OS 5ML                  $43.00
 5332731   TOBRAMYCIN/DEXAMETH3.5GM   TOBRADEX 3.5GM                  $362.00
 5332732   TOBRAMYCIN INH 300MG 5ML   TOBRA INH 5ML                   $425.65
 5332733   TOBRAMYCIN/DEXAMETH 5ML    TOBRADEX 5ML                    $362.00
 5332735   TRIAMCINOLONE 20GINHALER   AZMACORT INHALR                 $150.00
 5332736   TRIAMCINOLONE 10G INHALR   NASACORT INHALR                 $896.90
 5332753   TRIFLURIDINE 1% 7.5ML OS   TRIFLURDNE7.5ML                 $592.00
 5332760   TRIMETHPRM/POLYMYXN 10ML   TRIMETH/POLY 10                 $262.00
 5332774   TROPICAMIDE .5% 15ML       TROPICAMIDE15ML                 $634.25
 5332781   TROPICAMIDE 1% 15ML        TROPICAMIDE15ML                 $431.00
 5332823   VIDARABINE 3.5GM           VIRA-A 3% 3.5GM                 $624.35
 5332839   WATER STER IPPB SNGL DSE   H20 STER IPPBUD                  $35.50
 5334000   MISCELLANEOUS TOPICAL      MISC TOPICAL                    $212.00
 5334037   ACYCLOVIR 5% 15GM          ACYCLOVIR 15GM                  $651.00
 5334105   ALUMINUM ACET 28GM         ACID MANTLE 28G                  $86.75
 5334120   ALUM SULF/CA ACET 120G     AL SULF/CA 120G                  $17.00
 5334210   AQUAPHOR OINT 52.5GM       AQUAPHOR 52.5GM                  $29.00
 5334230   AVEENO OATMEAL 96GM        AVEENO COLL OAT                  $63.95
 5334251   BABY LOTION 120ML          BABY LOTION120M                   $7.65
 5334272   BABY OIL 120ML             BABY OIL 120ML                    $7.65
 5334293   BACITRACIN 30GM            BACITRACIN 30GM                  $10.00
 5334301   BACITRACIN/POLYMXN 15GM    BACIT/POLY 15GM                 $114.25
 5334303   BACITRACIN/POLYMXN 30GM    BACIT/POLY 30GM                  $43.00
 5334304   BACITRACIN/POLY 10G PWD    BACIT/POLY PWDR                  $36.00
 5334324   BALSAM-VIT A&D 30GM        BALSA VITA+D30G                 $103.55
 5334359   BECAPLERMIN GEL 0.01%15G   BECAPLERMIN 15G               $3,241.05
 5334371   BENZALKONIUM-HA            TUCKS PADS                        $1.00



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  Doctors Medical Center - Modesto                                        Page 85 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 5334392   BENZO-TETRA SPRAY 56ML     CETACAINE SPRAY                 $410.00
 5334413   BENZOCAINE 20GM            BENZOCAINE 20G                  $123.40
 5334428   BENZOCAINE 85GM            BENZOCAINE 85G                   $19.00
 5334430   BENZOCAINE 60ML SPRY       BENZOCAIN SPRAY                 $135.00
 5334500   BETAMETHASONE .05% 15G C   BETAMET.05%15 C                 $568.95
 5334515   BETAMETHAS CR 0.05% 45G    BETAMET.05%45 C                 $755.30
 5334520   BETAMETHASONE .05% 45G O   BETAMET.05%45 O                 $755.30
 5334525   BETAMETHASONE .05% 60ML    BETAMET.05%60ML                 $962.45
 5334530   BETAMETHASONE .1% 15GM C   BETAMET.1% 15 C                 $269.00
 5334535   BETAMETHASONE .1% 15GM O   BETAMET.1% 15 O                 $448.00
 5334540   BETAMETHASONE .1% 45GM C   BETAMET.1% 45 C                 $436.00
 5334545   BETAMETHASONE .1% 45GM U   BETAMET.1% 45 O                 $726.30
 5334607   BLISTEX 4.2GM              BLISTEX 4.2GM                    $11.00
 5334647   CADEXOMER PAD 6X8CM BX3    CADEX PAD6X8BX3                  $35.00
 5334648   CADEXOMER IODINE 40G       CADEXOMER 40G                    $98.00
 5334659   CALAMINE 120ML             CALAMINE 120ML                   $11.00
 5334680   CALCIUM UNDECYL 60GM       CALDESEN 10%60G                  $60.45
 5334701   CAMPHOR/PHENOL 22.5ML      CAMPHO-PHENIQUE                  $52.95
 5334748   CHAPSTICK                  CHAPSTICK                         $3.95
 5334770   CHLORHEXIDINE ORAL 1PINT   PERIDEX 1PINT                   $268.00
 5334811   CHLORINE 1000ML            DAKINS ALL STR                   $77.00
 5334867   CLINDAMYCIN LIQ 60ML       CLINDAMYCIN60ML                 $377.00
 5334870   CLOBETASOL .05% 30GM       CLOBETASOL 30GM                 $385.00
 5334874   CLOTRIMAZOLE 1% 30GM       CLOTRIMAZ 1%30G                  $89.00
 5334876   CLOTRIMAZOLE 1% SOLN 10M   CLOTRIM 1% 10ML                 $404.35
 5334879   CLOTRIMAZOLE 1% 30ML       CLOTRIM 1% 30ML                 $340.00
 5334884   CLOTRIMAZOLE 1% 45GM VAG   CLOTRIM1%45G VG                 $337.00
 5334889   CLOTRIMAZOLE 100MG         CLOTRIM VAG 100                 $105.15
 5334890   CLOTRIMAZOLE 500MG VAG     CLOTRIM VAG 500                  $97.00
 5334893   CLOTRIMZOL/BETAMETH 15GM   LOTRISONE 15GM                  $297.00
 5334895   CLOTRIMZOL/BETAMETH 45GM   LOTRISONE 45GM                  $506.00
 5334897   CLONIDINE HCL 0.1MG TTS    CATAPRESTTS.1MG                  $63.00
 5334899   CLONIDINE HCL 0.2MG TTS    CATAPRESTTS.2MG                  $75.00
 5334901   CLONIDINE HCL 0.3MG TTS    CATAPRESTTS.3MG                 $104.00
 5334915   COAL TAR 5%                IONIL T SHAMPOO                  $54.00
 5334936   COD LIVER OIL-Z 28GM       DESITIN 28GM                     $17.00
 5334999   CONJUGATED ESTR CRM 42GM   PREMARIN VAG CR                 $289.00
 5335062   DERMAL WOUND CLENER 16OZ   CARA-KLENZ 16OZ                 $166.70
 5335063   CARRING DERMAL DSG 3 OZ    DERMAL DSG 3 OZ                 $166.70
 5335069   DESONIDE .05% 15GM CRM     DESONIDE 15GM                   $378.20
 5335093   DESOXIMETASONE .25% 15GM   DESOXI .25% 15G                 $373.75
 5335135   DEXAMETHASONE .1% 15GM     DEXAMETH .1%15G                 $322.10
 5335150   DEXAMETHASONE SPRAY 25GM   DEXAMETH 25GM                   $445.95
 5335176   DEXTRANOMER 60GM           DEBRISAN 60GM                 $2,393.45
 5335182   DIAZEPAM GEL PEDI 2.5MG    DIAZ GELP 2.5MG                 $792.85
 5335200   DIBUCAINE 1% 30GM          DIBUCAINE 30GM                   $73.00
 5335202   DIBUCAINE-HC .5% 28GM      DIBUCAINE-HC.5%                 $398.90
 5335245   DINOPROSTONE .5MG GEL      PREPIDIL GEL                    $896.90
 5335270   DIPHENHYDRA 2% 30GM        DIPHENHYD 2%30G                 $154.00
 5335280   DIPHENHYDRA-CALAM LOTION   DIPHEN/C LOT180                  $63.00



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  Doctors Medical Center - Modesto                                         Page 86 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 5335316   ECONAZOLE 1% 30GM          ECONAZOLE 30GM                  $221.00
 5335322   EMOLLIENT LOTION           EMOLIENT LOTION                  $49.00
 5335327   EMOLLIENT 60GM             EMOLLIENT CREAM                  $33.00
 5335358   ESTRADL 24HR PTCH/.025MG   CLIMARA .025MG                   $83.70
 5335360   ESTRADIOL 0.05 PATCH       ESTRADERM 0.05                   $63.00
 5335361   ESTRADIOL 0.1 PATCH        ESTRADERM 0.1                    $63.00
 5335368   ESTRADL 24HR PTCH/.05MG    CLIMARA .05MG                    $83.70
 5335369   ESTRADL 24HR PTCH/.1MG     CLIMARA .1MG                     $83.70
 5335374   ETHYL CHLORIDE             ETHYL CHLR SPRY                 $184.00
 5335395   FIBRIN-DESOXYRI 30GM       ELASE-CHLOR 30G               $1,200.25
 5335396   FIBRIN SEALANT KIT 2ML     FIBRIN KIT 2ML                $1,169.00 Minimum
 5335416   FIBRINOLYSIN-DE            ELASE 30GM                    $1,111.55
 5335437   FLUOCINOLONE .01% 15GM     FLUCIN .01% 15G                 $332.75
 5335452   FLUOCINOLONE .01% 60ML     FLUCIN .01%60ML                 $902.60
 5335457   FLUOCINOLONE .025% 15GM    FLUCIN.025% 15G                 $257.00
 5335462   FLUOCINOLONE .025% 15GM    FLUCIN.025% 15G                 $429.35
 5335467   FLUOCINOLONE .025% 60GM    FLUCIN.025% 60G                 $846.00
 5335477   FLUOCINOLONE-NE .025%      NEO-SYNLAR.025%               $1,025.45
 5335498   FLUOCINONIDE .05% 15GM     FLUCIN .05% 15G                 $280.00
 5335503   FLUOCINONIDE .05% 15GM     FLUCIN .05% 15G                 $280.00
 5335508   FLUOCINONIDE .05% 30GM     FLUCIN .05% 30G                 $374.00
 5335513   FLUOCINONIDE .05% 30GM     FLUCIN .05% 30G                 $374.00
 5335518   FLUOCINONIDE .05% 60GM     FLUCIN .05% 60G                 $922.00
 5335523   FLUOCINONIDE .05% 60GM     FLUCIN .05% 60G                 $922.00
 5335570   FLUOROURACIL 5% 25GM       FLUOROURA 5%25G                 $658.65
 5335591   FLURANDRENOL .05% 60ML     CORDRN .05%60ML                 $887.50
 5335601   FLURANDRENOLI .05% 15GM    CORDRAN.05%15G                  $413.20
 5335606   FLURANDRENOLI .05% 15GM    CORDRAN.05%15G                  $413.20
 5335616   FLURANDRENOLI .05% 60GM    CORDRAN.05%60G                  $887.50
 5335698   GELATIN ABS 100            GELFOAM 100                     $114.00
 5335703   GELATIN ABS 12X7           GELFOAM 12X7                    $112.00
 5335724   GENTAMICIN .1% 15GM CRM    GENTAMICIN 15GM                 $426.65
 5335729   GENTAMICIN .1% 15GM UNG    GENTAMICIN 15GM                 $426.65
 5335751   GENTIAN VIO/BRL GR .66ML   TRIPLE DYE.66ML                   $3.85
 5335792   HALCINONIDE .1% 15GM       HALCINONIDE15GM                 $493.40
 5335818   HALOPROGIN 1% 30ML         HALOTEX 1% 30ML                 $509.35
 5335850   HYALURONAT/CHONDRO .35ML   DUOVISC .35ML                   $237.50
 5335886   HYDROCORTI .5% 30GM CRM    HYDROCORT.5%30G                 $143.00
 5335891   HYDROCORTISONE .2% 15GM    HCTS .2% 15GM                   $397.40
 5335901   HYDROCORTISONE .5% 30GM    HCTS .5% 30GM                   $238.65
 5335903   HYDROCORTISONE 2.5% 60GM   HCTS 2.5% 60GM                  $576.65
 5335905   HYDROCORTISONE 1% 120ML    HCTS 1% 120ML                   $217.00
 5335906   HYDROCORTISONE 1% 10GM     HCTS 1% 10GM                     $76.00
 5335911   HYDROCORTISONE 1% 30GM     HCTS 1% 30GM                    $162.00
 5335913   HYDROCORTISONE 2.5% 30GM   HCTS 2.5% 30GM                  $137.00
 5335917   HYDROCORTISONE 10% CREAM   HCTS 10% CR                      $29.60
 5335942   HYDROGEN PEROXIDE 480ML    HYDROGEN PEROXI                   $2.00
 5336005   IODOCHLORHYDROX 14GM       IODOCHL MILD14G                 $289.90
 5336010   IODOCHLORHYDROX 20GM       IODOCHLORHY 20G                 $207.50
 5336015   IODOCHLORHYDROX 3% 30GM    IODOCHLOR 3%30G                 $151.75



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  Doctors Medical Center - Modesto                                        Page 87 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 5336057   KARAYA GUM                 KARAYA GUM                      $273.70
 5336082   KERI-LOTION                KERI-LOTION                      $43.00
 5336084   KETOCONAZOLE 2% CREAM      KETOCONAZL 2%CR                 $275.00
 5336087   AMMONIUM LACT 12% LOT      LACHYDRIN 12%LT                 $277.00
 5336099   LANOLIN 240GM              LANOLIN 240G                    $180.65
 5336118   LANOLIN 30GM               LANOLIN 30GM                      $9.70
 5336120   LANOLIN 60GM               LANOLIN 60G                      $57.75
 5336141   LANOLIN-MINERAL            ALPHA-KERI 112M                  $97.40
 5336151   LANOLN MINRL B OIL 240ML   LAN MIN BOIL8OZ                  $41.00
 5336198   LIDOCAINE 2% 30GM JELLY    LIDOCAIN 2% 30G                  $88.00
 5336201   LIDOCAINE 2% JEL UROJECT   LIDOCA 2% UROJT                  $80.00
 5336202   LIDOCAINE 2% JELLY 5ML     LIDOC2%JELLY5ML                  $80.00
 5336203   LIDOCAINE 2.5% 35GM        LIDOCAIN2.5%35G                 $237.05
 5336204   LIDOC 2.5/PRILOC 2.5 5G    EMLA 5G                          $62.00
 5336207   LIDOCAINE/EPI/TETRACAINE   LIDO/EPI/TETRCN                  $13.30
 5336208   LIDOCAINE 4% 50ML TOP      LIDOCAIN 4%50ML                 $253.00
 5336212   LIDOCAINE 5% 35GM UNG      LIDOCAIN 5% 35G                 $329.65
 5336214   LIDOCAINE-10% 60ML SPRAY   LIDOCAINE-10%SP               $1,247.35
 5336250   LINDANE LOT 60ML           LINDAN LOT 60ML                 $291.45
 5336271   LINDANE SHAMP 60ML         LINDAN SHAM 60M                 $289.90
 5336389   MEDICATED SOAP             MEDICATED SOAP                   $95.30
 5336391   MEDICATED SOAP             MEDICATED SOAP                   $85.15
 5336401   MERCUROCHROME 30ML         MERCUROCHROM 30                  $18.30
 5336469   METHYLCELLULOSE 150MG PW   METHYLCELL PWDR                  $44.10
 5336477   METHYL SALICYLAT 38GM      METHYL SALICYLA                   $7.00
 5336485   METHYLBENZ 30GM            DIAPERENE 30GM                   $52.95
 5336579   MICONAZOLE 100MG           MICONA VAG100MG                  $63.00
 5336581   MICONAZOLE 200MG VAG TAB   MICONA VAG200MG                 $115.00
 5336584   MICONAZOLE 15GM            MICONAZOLE 15G                  $368.75
 5336589   MICONAZOLE 47GM            MONISTAT 7 CRM                  $308.00
 5336593   MICONAZOLE 2% 15GM CRM     MONISTAT DER CR                 $478.10
 5336594   MICONAZOLE 2% 30GM CRM     MICONZOL DER 30                 $314.00
 5336605   MICROFIB COLLAGEN 100CM    MICROFBCOL 100C                 $277.90
 5336609   MICROFIBRILLAR ENDO 10MM   ENDO AVITEN10MM                 $716.70
 5336610   MICROFIB COLLAGEN 1GM      MICROFIB COL 1G               $1,675.00
 5336616   MICROFIBRILLAR SHEETS      AVITENE SHEETS                $1,675.00
 5336641   MINERAL OIL STERILE 2ML    MIN OIL ST 2ML                   $89.00
 5336644   MINERAL OIL STERILE 10ML   MIN OIL ST 10ML                 $148.80
 5336646   MINERAL OIL STERILE 30ML   MIN OIL ST 30ML                 $102.00
 5336650   MNERL OIL/PETROLAT 240ML   EUCERIN 240ML                    $20.00
 5336672   MOISTURIZING CREAM         MOISTURIZING CR                  $61.00
 5336673   MOISTURIZING CR 120G       MOIST CR 120G                    $31.00
 5336680   MOMETASONE .1% 15GM        MOMETASONE 15GM                 $268.00
 5336683   MUPIROCIN 2% 1GM UD        MUPIROCIN 2%1GM                  $45.10
 5336685   MUPIROCIN 2% 15GM          MUPIROCIN 2%15G                 $105.00
 5336714   NEOMYCIN 5GM               NEOMYCIN 5G PWD                 $211.20
 5336724   NEOMYCIN .5% 28GM          NEOMYCIN .5%28G                 $306.05
 5336734   NEOMYCIN 10GM              NEOMYCIN 10G PW                 $289.90
 5336775   NEOMYC/POLYMY/BACIT 30G    TRIPLE ANTIB30G                  $47.00
 5336779   NEOMYCIN-POLYMY GU 1ML     NEOSPORIN GU IR                 $112.00



  CDM Run Date: 06/01/2007
  Doctors Medical Center - Modesto                                        Page 88 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 5336785   NEOMYCIN/GRAMICIDIN UNG    SPECTROCIN UNG                 $103.55
 5336810   NICOTINE TRANSDERMAL 7MG   HABITROL 7 MG                   $78.00
 5336811   NICOTINE TRANSDERML 14MG   HABITROL 14 MG                  $77.00
 5336812   NICOTINE TRANSDERML 21MG   HABITROL 21 MG                  $78.00
 5336817   NITROFURAZ OINT 0.2% 30G   NITROFUR 0.2%30                $286.00
 5336822   NITROFURAZONE DRESSING     FURACIN SOL DRS                $271.50
 5336825   NITROFURAZONE SOL DRESS    FURACIN SOL DRS                $271.50
 5336835   NITROGLYCERIN 0.1MG/HR     NTG PATCH 0.1MG                 $35.00
 5336836   NITROGLYCERIN 0.2MG/HR     NTG PATCH 0.2MG                 $75.00
 5336837   NITROGLYCERIN 0.3MG/HR     NTG PATCH 0.3MG                 $40.00
 5336838   NITROGLYCERIN 0.4MG/HR     NTG PATCH 0.4MG                 $75.00
 5336840   NITROGLYCERIN 0.6MG/HR     NTG PATCH 0.6MG                 $43.00
 5336842   NITROGLYCERIN 0.8MG/HR     NTG PATCH 0.8MG                 $43.00
 5336868   NITROGLYCERIN 2% 30GM      NTG 2% 30 GM                   $204.00
 5336888   NITROGLYCERIN UNG U-D      NTG 2% UNG U-D                  $73.00
 5336909   NYSTATIN TOP CRM 15GM      NYSTATIN 15G CR                 $75.00
 5336914   NYSTATIN TOP CRM 30GM      NYSTATIN 30G CR                $696.90
 5336919   NYSTATIN TOP POWD 15GM     NYSTATN 15G PWD                $100.00
 5336924   NYSTATIN TOP UNG 15GM      NYSTATN 15G UNG                $245.00
 5336934   NYSTATIN VAG TAB 100MU     NYSTATN VAG TAB                 $60.45
 5336950   OCLUSIV SKINPROTEC 5OZ     BAZA CREAM 5OZ                 $192.15
 5336969   OXYCHLOROSENE 5G           CHLORPACTIN 5G                 $911.55
 5336970   PAPAIN UREA OINT 30G       PAPAIN/UREA 30G                $127.00
 5336979   PAPAIN UREA SPRAY 33ML     PAPAIN/UREA33ML                $127.00
 5336980   PENCICLOVIR 1% 2GM         PENCICLOVIR 2GM                $208.00
 5336996   PERMETHRIN 1% 60ML         PERMETHRIN 60ML                 $53.00
 5336997   PERU-BALSAM 120ML          GRANULEX 120ML                 $130.35
 5336998   PERMETHRIN 5% 60GM         PERMETHRIN 60GM                $296.00
 5337018   PETROLATUM 30GM            VASELINE 30GM                   $18.30
 5337039   PHENYL MERCURIC 30GM       PREPARATION H30                 $27.00
 5337081   NEO/BAC/POLY/HC 15GM       CORTISPORIN15GM                $267.00
 5337107   POVIDONE-IODINE 30GM       BETADINE 30G UN                 $11.00
 5337112   POVIDONE-IODINE-DOUCHE     BETADINE DOUCHE                 $49.35
 5337122   POVIDONE-IODINE SOLN       BETADINE SOLN                   $82.15
 5337139   PRAMOXINE HC TOP 1% 30GM   PRAMHC TOP1%30G                $132.00
 5337190   SALICYL 120ML              SEBULEX 120ML                  $135.95
 5337245   SELENIUM SULFIDE 1%        SELEN SULF SHAM                 $19.30
 5337253   SCOPOLAMINE 1.5MG PATCH    SCOPOLAMN PATCH                 $63.00
 5337272   SILVER SULFADIA 1% 50GM    SSD 1% 50G                     $152.00
 5337274   SILVER SULFADIA 1% 400G    SSD 1% 400G                    $119.00
 5337279   SILVER SULFADIA 1% 20G     SSD CR 1% 20GM                 $189.00
 5337313   STERILE AEROSOL TALC 4G    ST AERO TALC 4G                $207.80
 5337321   SULFANILAMIDE-A VAG SUPP   SULFANIL VAGSUP                 $67.40
 5337326   SULFANILAMIDE-A VAG CR     SULFANL VAG120G                $616.70
 5337347   SULFATHIAZOLE-S            SULTRIN TRP SUL                $364.00
 5337352   SULFATHIAZOLE-S            SULTRIN VAG TAB                 $60.45
 5337360   SURGICEL 1/2 X 2           SURGICEL .5 X22                $192.00
 5337361   SURGICEL 2X3               SURGICEL 2X3                   $245.00
 5337362   SURGICEL 2 X 14            SURGICEL 2 X 14                $385.00
 5337366   SURGICEL 4X8               SURGICEL 4X8                   $437.00



  CDM Run Date: 06/01/2007
  Doctors Medical Center - Modesto                                        Page 89 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 5337373   SUTILAINS 14 GM            TRAVASE 14GM                   $922.65
 5337394   TAC-NEOMYCIN-GR 15GM       MYCOLOG 15G CRM                $310.00
 5337399   TAC-NEOMYCIN-GR 15GM       MYCOLOG 15G UNG                $310.00
 5337414   TALC STERILE 5GM PWDR      TALC STERILE 5G                $595.00
 5337430   TERCONAZOLE 80MG VAG SUP   TERAZOL-3 SUPP                 $140.00
 5337431   TERCONAZOLE .4% VAG CR     TERAZOL-7 VAG C                $430.00
 5337441   TETRACAINE .5% 15ML        TETRACAI .5% 15                $210.00
 5337446   TETRACAINE 2% TOP          TETRACAIN 2%TOP                $448.00
 5337467   THROMBIN 5000U             THROMBIN 5000U                 $140.00
 5337469   THROMBIN 20000U            THROMBIN 20000U                $274.00
 5337470   TOBRAMYCIN POWD 1.2GM      NEBCIN ORTHO CE                $393.00
 5337474   TIOCONAZOLE 4.6GM          VAGISTAT 4.6GM                 $719.00
 5337488   TOLNAFTATE 1% 10ML         TOLNAFT 1% 10ML                 $18.30
 5337493   TOLNAFTATE 1% 15GM         TOLNAFT 1% 15GM                 $13.00
 5337498   TOLNAFTATE 1% 45GM POWD    TOLNAFT 1% 45GM                 $33.00
 5337500   TOPICAL ENZYME COMBO 30G   PANAFIL 30G                    $389.00
 5337503   TOPICAL ENZYME CMBO 33ML   PANAFILSPRY33ML                $161.00
 5337545   TRIAMCIN .025% 15GM CRM    TRIAMCI.025%15G                 $53.00
 5337550   TRIAMCIN .025% 15GM UNG    TRIAMCI.025%15G                 $53.00
 5337560   TRIAMCIN .025% 80GM CRM    TRIAMCI.025%80G                 $53.00
 5337570   TRIAMCIN .1% 15GM CRM      TRIAMCIN.1% 15G                 $53.00
 5337575   TRIAMCIN .1% 15GM UNG      TRIAMCIN.1% 15G                 $53.00
 5337580   TRIAMCIN .1% 60ML          TRIAMCIN.1%60ML                 $53.00
 5337585   TRIAMCIN .1% 80GM CRM      TRIAMCIN.1% 80G                 $53.00
 5337590   TRIAMCIN .1% 80GM UNG      TRIAMCIN.1% 80G                 $53.00
 5337591   TRIAMCIN .1% 240G          TRIAMCIN.1%240G                $687.60
 5337605   TRIAMCIN .5% 20GM UNG      TRIAMCIN.5% 20G                 $53.00
 5337620   TRIAMCIN A 5GM             KENALOG ORABASE                $223.00
 5337625   TRIAMCIN SPRAY .025%       TRIAMCIN SPRAY                 $449.00
 5337651   TROLAMINE SALIC 10% 60GM   TROLAMINE10%60G                $202.65
 5337656   TRYPSIN/BALS/CASTOIL60GM   XENADERM 60GM                  $375.00
 5337672   UNDECYCLINIC ACI 54GM      DESENEX 54GM                    $39.00
 5337689   UREA NA PROPIONATE         AMINOCERV VAGCR                $511.75
 5337735   VIT A & D CREAM/OINT       VIT A&D TOPICAL                 $13.00
 5337756   ZINC OXIDE 30GM            ZINC OXIDE 30GM                 $23.00
 5338016   ACETAMINOPHEN 120MG        ACETAMI SUPP120                 $11.00
 5338020   ACETAMINOPHEN 325MG        ACETAMI SUPP325                 $11.00
 5338024   ACETAMINOPHEN 650MG        ACETAMI SUPP650                 $11.00
 5338049   AMINOPHYLLINE 250MG SUPP   AMINOPHYLN250SP                 $21.00
 5338053   AMINOPHYLLINE 500MG SUPP   AMINOPHYLN500SP                 $35.50
 5338074   ASPIRIN 120MG SUPP         ASA 120MG SUPP                  $34.55
 5338095   ASPIRIN 300MG SUPP         ASA 300MG SUPP                  $20.00
 5338116   ASPIRIN 600MG SUPP         ASA 600MG SUPP                  $20.00
 5338130   BENZOCAINE 20% 30G         AMERICAIN HEMOR                 $40.20
 5338162   BISACODYL 10MG             BISACODYL 10MG                  $73.00
 5338204   STARCH SUPP                ANUSOL SUPP                     $17.00
 5338225   CHLORAL HYDRAT 500MG       CHLORAL HYDR500                 $60.45
 5338246   CHLORPROMAZINE 25MG        CHLORPR 25MGSUP                 $44.45
 5338250   CHLORPROMAZINE 100MG       CHLORPR100MGSUP                 $50.35
 5338260   CLOTRIMAZOLE VAG TAB       LOTRIMIN VAGTAB                $105.15



  CDM Run Date: 06/01/2007
  Doctors Medical Center - Modesto                                        Page 90 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 5338292   DIBUCAINE 1% 30GM          NUPERCAIN 1%30G                  $75.05
 5338300   DIBUCAINE 2.5MG            NUPERCAIN 2.5MG                  $28.60
 5338320   DINOPROSTONE 10MG          CERVIDIL 10MG                   $283.00
 5338321   DINOPROSTONE 20MG          PROSTIN E2 20MG               $1,156.00
 5338342   ERGOTAMINE-CAFF            CAFERGOT P-B                    $105.15
 5338346   ERGOTAMINE-CAFF            CAFERGOT                         $85.85
 5338409   GLYCERIN ADULT             GLYCERIN ADULT                   $17.00
 5338413   GLYCERIN INFANT            GLYCERIN INFANT                  $17.00
 5338455   HC-BISMUTH BENZ 30GM       ANUSOL HC 30GM                  $112.00
 5338459   HC-BISMUTH-BENZ            ANUSOL-HC SUPP                   $40.00
 5338488   HYDROCORTISONE 100MG60ML   HCTS 100MG/60ML                 $149.00
 5338497   INDOMETHACIN 50MG SUPP     INDOCIN 50MG SU                  $85.85
 5338510   MESALAMINE 4G/60ML         MESALAMINE4G/60                 $180.00
 5338511   MESALAMINE 500MG SUPP      MESALAMINE500MG                  $47.00
 5338534   MINERAL OIL ENEMA          FLEET OIL ENEMA                  $53.00
 5338555   PHENYL MERCURIC SUPP       PREPARATI H SUP                  $18.30
 5338560   POLYSTYRENE SULF 30GM      KAYEXELATE 30GM                 $186.20
 5338576   PRAMOXINE HYDRO            PROCTOFOAM-HC                   $486.20
 5338580   PRAMOXINE HYDRO 15GM       PROCTOFOAM 15GM                 $275.35
 5338584   ANUSOL OINT 30GM           ANUSOL OINT 30G                  $23.00
 5338605   PROCHLORPERAZN 2.5MGSUPP   PROCHLORP 2.5MG                  $26.00
 5338609   PROCHLORPERAZN 5MG SUPP    PROCHLORP 5MG                    $44.45
 5338613   PROCHLORPERAZN 25MG SUPP   PROCHLORP 25MG                   $30.00
 5338634   PROMETHAZINE 12.5MG SUPP   PROMETH 12.5SUP                  $40.00
 5338638   PROMETHAZINE 25MG SUPP     PROMETH 25MGSUP                  $40.00
 5338642   PROMETHAZINE 50MG SUPP     PROMETH 50MGSUP                  $51.00
 5338726   SODIUM PHOS ENEMA          FLEET ENEMA                      $18.30
 5338730   SODIUM PHOS PED ENEMA      FLEET PED ENEMA                  $11.00
 5338751   THIETHYLPERAZINE10MGSUPP   THIETHLPRZN10MG                  $60.45
 5338772   TRIMETHOBENZ 100MG SUPP    TRMBZMIDE 100MG                  $40.00
 5338776   TRIMETHOBENZ 200 MG SUPP   TRMBZMIDE 200MG                  $46.00
 5339042   DIONOSIL OILY 20ML         DIONOSIL O 20ML               $1,497.90
 5339049   DIMETHYL SULFOX 50% 50ML   DIMETHLSULF50ML                 $132.70
 5339239   BOWEL EVACUANT             EVAC-Q-KWIK                     $166.70
 5339535   AMIN-AID POWDER 159G       AMIN-AID POWDER                 $534.70
 5339549   CHOICE DM 8 OZ             CHOICE DM 8 OZ                   $75.00
 5339580   COMPLEAT-B 250ML           COMPLEAT B250ML                  $45.60
 5339592   COMPLEAT-MODIF 1500ML      COMPLEAT M 1.5L                 $200.00
 5339620   CRITICARE HN LIQ 8OZ       CRITICAR HN 8OZ                  $84.60
 5339627   DIABETISOURCE AC 250ML     DIABSOURCEAC250                  $24.00
 5339628   DIABETISOURCE AC 1000ML    DIABSOURCE AC1L                  $90.30
 5339657   ENSURE HN 240ML            ENSURE HN 240ML                  $22.95
 5339662   ENSURE LIQUID 240ML        ENSUR LIQ 240ML                  $22.95
 5339664   ENSURE PLUS HN 240ML       ENSURE + HN 240                  $21.05
 5339665   ENSURE PLUS LIQUID 8OZ     ENSURE PLUS 8OZ                  $21.00
 5339667   ENSURE FIBER 240ML         ENSUR FIB 240ML                  $25.15
 5339671   FIBERSOURCE HN 250ML       FIBSORC HN250ML                  $17.00
 5339672   FIBERSOURCE HN 1000ML      FIBSOURCE HN 1L                 $172.00
 5339675   FIBERSOURCE HN 1500ML      FIBSOURC HN1.5L                 $101.00
 5339677   FIBERSOURCE STAND 250ML    FIBSOURCST250ML                  $76.00



  CDM Run Date: 06/01/2007
  Doctors Medical Center - Modesto                                            Page 91 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 5339678   FIBERSOURCE STAND 1000ML   FIBSOURCE ST 1L                $149.00
 5339679   FIBERSOURCE STAND 1500ML   FIBSOURC ST1.5L                 $98.00
 5339685   GLUCERNA                   GLUCERNA                        $38.20
 5339709   IMPACT GLUTAMINE 250ML     IMPACT GL 250ML                $110.00
 5339711   IMPACT GLUTAMINE 1000ML    IMPACT GL1000ML                $273.00
 5339720   ISOCAL HCN LIQUID 8OZ      ISOCAL HCN 8OZ                  $22.15
 5339721   ISOCAL HC 240ML            ISOCAL HC 8OZ                   $22.15
 5339727   ISOCAL LIQ 240ML           ISOCAL LIQ240ML                 $21.45
 5339747   ISOSOURCE VHN 1500ML       ISOSORC VHN1.5L                 $98.00
 5339749   ISOSOURCE VHN 1000ML       ISOSOURC VHN 1L                $171.60
 5339751   ISOSOURCE STAND 250ML      ISOSOURCE250ML                  $13.00
 5339752   ISOSOURCE STAND 1000ML     ISOSOURCE ST 1L                $134.00
 5339753   ISOSOURCE STAND 1500ML     ISOSOURC ST1.5L                 $95.00
 5339759   ISOSOURCE VHN 250ML        ISOSOURC VHN250                 $21.00
 5339766   JEVITY 240 ML              JEVITY 240 ML                   $23.50
 5339767   JEVITY RTH 1000ML          JEVITY RTH 1000                $171.75
 5339768   JEVITY FIBER               JEVITY FIBER                    $26.35
 5339769   JEVITY FIBER RTH 1000ML    JEVITY FIBR RTH                $153.00
 5339800   LIPISORB 240ML             LIPISORB 240ML                  $52.45
 5339857   MAGNACAL LIQUID 250ML      MAGNACAL 250ML                  $26.40
 5339880   NEPRO 240ML                NEPRO 240ML                     $53.75
 5339884   NOVASOURCE RENAL 240ML     NOVASOURCE R240                 $78.00
 5339885   NOVASOURCE 2.0 240ML       NOVASORC2.0 240                 $16.00
 5339886   NOVASOURCE RENAL 1000ML    NOVASOURCE R 1L                $269.20
 5339911   NUTRIHEP 250ML             NUTRIHEP 250ML                 $307.00
 5339915   OPTIMENTAL 240ML           OPTIMENTAL240ML                 $70.50
 5339920   OSMOLITE HN LIQUID 8OZ     OSMOLITE HN 8OZ                 $26.70
 5339926   OSMOLITE RTH 1000ML        OSMOLITE RTH                   $128.80
 5339927   OSMOLITE LIQUID 240ML      OSMOLITE 240ML                  $24.75
 5339928   PEDIASURE FIBER            PEDIASURE FIBER                 $22.95
 5339931   PEDIASURE 240ML            PEDIASURE 240ML                 $28.45
 5339945   PEPTINEX DT 250ML          PEPTINEX DT 250                 $17.00
 5339946   PEPTINEX DT 1000ML         PEPTINEX DT 1L                 $172.00
 5339947   PEPTINEX DT 1500ML         PEPTINEX DT1.5L                $147.00
 5339981   PROMOTE 8OZ                PROMOTE 8OZ                     $22.15
 5339983   PROMOTE FIBER              PROMOTE FIBER                   $22.30
 5339984   PROMOTE FIBER RTH 1000ML   PROMOT FIBR RTH                $146.05
 5339996   PULMOCARE 240ML            PULMOCARE 240ML                 $28.60
 5339997   PULMOCARE RTH 1000ML       PULMOCARE RTH                  $157.10
 5340000   4170 PHARMACY              PHARMACY
 5340011   REABILAN 375ML             REABILAN 375ML                $118.20
 5340012   REABILAN HN 375ML          REABILAN HN 375               $173.00
 5340026   RESOURCE PLUS 240ML        RESOURC PL 240                 $13.00
 5340027   RESOURCE STAND 240ML       RESOURCE ST 240                $11.00
 5340038   RESOURCE FOR KIDS 240ML    RESOURCE KID240                $17.00
 5340108   SUPLENA/REPLENA 240ML      SUPLENA 240ML                  $23.00
 5340130   SUSTACAL LIQUID 240ML      SUSTACAL 240ML                 $22.15
 5340225   TRAVASORB-HEPATIC 96G      TRAVASORBHEPATC               $374.65
 5340240   TRIGLYCERIDES MED CHAIN    MCT OIL 0-10ML                 $13.00
 5340245   TWO CAL HN 240ML           TWO CAL HN240ML                $24.55



  CDM Run Date: 06/01/2007
  Doctors Medical Center - Modesto                                            Page 92 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 5340270   VITANEED LIQ 250ML         VITANEED 250ML                     $32.25
 5340286   VIVONEX PLUS 79.5G         VIVONEX PL PKT                     $67.00
 5340290   VIVONEX STD PWD 100ML      VIVONEX STD 100                   $223.95
 5340292   VIVONEX T E N PKT          VIVONEX T.E.N.                     $81.00
 5348999   MISCELLANEOUS CODE         MISCELLANEOUS           $83.70 - $7,534.20
 5349034   ANTICOAGULATN WKUP         ANTICOAG WKUP             $11.00 - $374.65
 5349035   ANTICOAGULATN MONITORING   ANTICOAG MNTRG            $11.00 - $374.65
 5349094   IVIG PRE-ADMIN FEE         IVIG PRE-ADMIN                     $75.00
 5349231   TAKE HOME MEDICATIONS      TAKE HOME MEDIC          $1.00 - $1,915.00
 5350000   4170 PHARM/DIAGNOSTIC      PHARM/DIAGNSTIC
 5353010   DESFLURANE 240ML           DESFLURANE 240M               $208.00
 5353020   ENFLURANE 125ML            ENFLURANE 125ML                $92.00
 5353050   HALOTHANE 125ML            HALOTHANE 125ML                $34.00
 5353070   ISOFLURANE 100ML           ISOFLURANE 100M                $99.00
 5353115   PERFLUORON PER 5ML         PERFLUORON 5ML                $514.70
 5353120   SEVOFLURANE 125ML          SEVOFLUR 125ML                $207.00
 5355480   DIATR MEGNASOL66/10 120M   DIAMNS66/10120M               $409.00
 5356183   HOCM 200-249MG/ML ID 1ML   HOCM 1ML                        $1.65
 5356184   HOCM 250-299MG/ML ID 1ML   HOCM 1ML                        $1.80
 5356185   HOCM 300-349MG/ML ID 1ML   HOCM 1ML                        $2.00
 5356186   HOCM 350-399MG/ML ID 1ML   HOCM 1ML                        $1.15
 5358200   IPODATE SOD 500MG          IPOSOD 500MG                  $140.35
 5358210   ISOSULFAN BLUE 10M/M 5ML   ISOSUL BL10M/M5               $302.00
 5358214   LOCM 150-199MG/ML ID 1ML   LOCM 1ML                        $6.30
 5358215   LOCM 200-249MG/ML ID 1ML   LOCM 1ML                       $12.50
 5358217   LOCM 300-349MG/ML ID 1ML   LOCM 1ML                       $12.10
 5358218   LOCM 350-399MG/ML ID 1ML   LOCM 1ML                        $2.70
 5358241   MR CONTRAST GAD BASE 1ML   MR CONTRAST 1ML                $11.90
 5358290   SINCALIDE 5MCG             SINCALIDE 5MCG                $121.50
 5360000   4170 PHARMACY ESRD         PHARM ESRD
 5410000   4175 PARNTRL/IRR SOLUTN    TITLE PRNT/IRR
 5412020   ALCOHOL 10% D5% 1000ML     ALCOHOL 19/D51L               $505.00
 5412070   DEXTRAN 40 D5W 500ML       DEXTRAN40D5 .5L               $973.00
 5412130   D5 ELECT48 250ML           D5ELECT48 250ML               $280.00
 5412135   D5 ELECT48 500ML           D5ELECT48 500ML               $284.00
 5412155   D5 ELECT75 1000ML          D5 ELECT 75 1L                $291.00
 5412165   D5 L RINGERS 500ML         D5 L RING 500ML               $278.00
 5412170   D5 LRINGERS 1000ML         D5 L RINGER 1L                 $82.00
 5412205   D5 NACL.2 250ML            D5 NACL.2 250ML               $278.00
 5412210   D5 NACL.2 500ML            D5 NACL.2 500ML               $304.00
 5412215   D5 NACL.2 1000ML           D5 NACL.2 1L                  $308.00
 5412250   D5 NACL.33 500ML           D5NACL.33 500ML               $304.00
 5412280   D5 NACL.45 250ML           D5NACL.45 250ML               $278.00
 5412285   D5 NACL.45 500ML           D5NACL.45 500ML               $304.00
 5412290   D5 NACL.45 1000ML          D5 NACL.45 1L                  $82.00
 5412325   D5 NACL.9 250ML            D5 NACL.9 250ML               $463.35
 5412330   D5 NACL.9 500ML            D5 NACL.9 500ML               $278.00
 5412335   D5 NACL.9 1000ML           D5 NACL.9 1L                   $82.00
 5412350   D5W 25ML                   D5W 25ML                      $304.00
 5412355   D5W 50ML                   D5W 50ML                       $82.00



  CDM Run Date: 06/01/2007
  Doctors Medical Center - Modesto                                        Page 93 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 5412360   D5W 100ML                  D5W 100ML                        $82.00
 5412365   D5W 150ML                  D5W 150ML                        $82.00
 5412370   D5W 250ML                  D5W 250ML                        $83.00
 5412375   D5W 500ML                  D5W 500ML                        $83.00
 5412380   D5W 1000ML                 D5W 1000ML                       $84.00
 5412430   D10W 250ML                 D10W 250ML                      $278.00
 5412435   D10W 500ML                 D10W 500ML                       $82.00
 5412440   D10W 1000ML                D10W 1L                          $82.00
 5412540   L RINGERS 250ML            L RINGERS 250ML                 $278.00
 5412545   L RINGERS 500ML            L RINGERS 500ML                 $278.00
 5412550   L RINGERS 1000ML           LRINGERS 1L                      $84.00
 5412551   L RINGERS 1L/OXYTOCIN10U   LR 1L OXYTCN10U                 $160.00
 5412552   L RINGERS 1L/OXYTOCIN20U   LR 1L OXYTCN20U                 $236.00
 5412553   L RINGERS 1L/OXYTOCIN30U   LR 1L OXYTCN30U                 $312.00
 5412554   L RINGERS 1L/OXYTOCIN40U   LR 1L OXYTCN40U                 $388.00
 5412580   MANNITOL 20% 250ML         MANITOL 20% 250                 $920.00
 5412585   MANNITOL 20% 500ML         MANNITOL 20%.5L               $1,027.00
 5412620   NACL .45 500ML             NACL .45 500ML                   $84.00
 5412625   NACL .45 1000ML            NACL .45 1L                      $85.00
 5412630   NACL .9 25ML               NACL .9 25ML                    $304.00
 5412635   NACL .9 50ML               NACL .9 50ML                     $82.00
 5412640   NACL .9 100ML              NACL .9 100ML                    $82.00
 5412650   NACL .9 150ML              NACL .9 150ML                   $304.00
 5412655   NACL .9 250ML              NACL .9 250ML                    $82.00
 5412665   NACL .9 500ML              NACL .9 500ML                   $304.00
 5412670   NACL .9 1000ML             NACL .9 1L                       $83.00
 5412690   NACL 3% 500ML              NACL 3% 500ML                   $278.00
 5412740   PLASMALYTE R D5W 1000ML    PLYTE R D5W 1L                  $501.65
 5413030   AA 3% WITH ELEC 1000ML     AA 3% ELEC 1L                 $1,164.00
 5413175   AA 10% 500ML               AA 10% 500ML                  $1,188.00
 5413210   AA ESSENT 5.4% 250ML       NEPHRAMIN 250ML               $2,604.20
 5413385   DEXTROSE 50% 500ML         D50% 500ML                      $587.75
 5413415   DEXTROSE 70% 500 IN 1L     D70% 500 IN 1L                  $352.00
 5413435   FAT EMULSION 10% 100ML     FAT EM 10%100ML                 $506.40
 5413445   FAT EMULSION 10% 250ML     FAT EM 10%250ML                 $772.35
 5413450   FAT EMULSION 10% 500ML     FAT EM 10%500ML                 $668.60
 5413460   FAT EMULSION 20% 100ML     FAT EM 20%100ML               $1,201.00
 5413475   FAT EMULSION 20% 500ML     FAT EM 20%500ML               $1,217.00
 5414015   ACETIC ACID.25% IRR 1L     ACETIC A.25% 1L                 $304.00
 5414050   GLYCINE 1.5% UROMATIC 3L   GLYCINE 1.5% 3L                 $407.00
 5414065   L RINGERS IRR 500ML        L RING IR 500ML                  $98.75
 5414070   L RINGERS IRR 1000ML       L RINGERS IR 1L                  $43.00
 5414095   LRINGERS IR ARTHROMAT 5L   LR ARTHROMAT 5L                 $407.00
 5414145   NACL .9 IRR 500ML          NS IRR 500ML                     $55.00
 5414150   NACL .9 IRR 1000ML         NS IRR 1L                       $113.00
 5414165   NACL .9 IRR 3000ML         NS IRR 3000ML                   $392.00
 5414210   SORBITOL 3% UROMATIC 3L    SORB 3% UROM 3L                 $212.00
 5414240   STERILE WATER IRR 500ML    S WATER IRR .5L                  $59.00
 5414245   STERILE WATER IRR 1000ML   S WATER IRR 1L                   $89.00
 5414255   STERILE WATER IRR 2000ML   S WATER IRR 2L                  $107.00



  CDM Run Date: 06/01/2007
  Doctors Medical Center - Modesto                                             Page 94 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 5414275   STERIL WATER UROMATIC 3L   S WATER UROM 3L                   $358.00
 5418999   SOLUTIONS MISC             MISC IV SOLUTN          $43.00 - $2,604.20
 5419001   ANTICOAG CIT/DEX SOL       ACD FORMULA B                      $67.60
 5420000   4175 PARNTRL/IRR MATERL    TITLE PRNT/IRR
 5420003   ST IV ADD 3                ST IV ADD 3                    $298.30
 5420004   ST IV ADD PEDI3            ST IV ADD PEDI3                $326.95
 5420005   ST IV SEC                  ST IV SEC                      $105.65
 5420008   FLTR IN-LINE               FLTR IN-LINE                   $373.60
 5420032   ST DONOR BLOOD             ST DONOR BLOOD                 $166.35
 5420034   ST ADM BLOOD               ST ADM BLOOD                   $219.40
 5420038   Y + 1 INJ SITE SET         SET ADM BLOOD                  $245.45
 5420052   ST IV PEDI                 ST IV PEDI                       $8.55
 5420057   2 INJ S/CLAMP              SET ADD IV 2SIT                $298.30
 5420064   FLTR IN-LINE BLD           FLTR INLINE BLD                $167.95
 5420065   ST IRG CYS CNT/INT         ST IRG CYS C/I                 $525.30
 5420069   ST IRG TUR                 ST IRG TUR                     $534.70
 5420072   ST IRG TUR PK              ST IRG TUR PK                  $999.70
 5420073   ST ADM P-D ADLT            ST ADM P-D ADLT                $767.10
 5420077   ST ADM P-D CNT             ST ADM P-D CNT                 $288.30
 5420078   ST IV EXT AS               ST IV EXT AS                    $76.05
 5420082   COIL BLD WRM               COIL BLD WRM                   $643.15
 5420086   STOPCOCK 3W                STOPCOCK 3W                     $76.05
 5420089   ST IV EXT 3W               ST IV EXT 3W                   $210.00
 5420093   ST IV ADM                  ST IV ADM                      $502.10
 5420097   TB IV CNTRST               TB IV CNTRST                   $295.70
 5420103   TB PRES LINE NDL           TB PRES LN NDL                 $230.80
 5420104   ADPT CAP LL                ADPT CAP LL                    $157.05
 5420109   ST INTRALIPID              ST INTRALIPID                  $316.30
 5420114   LOOP IV                    LOOP IV                         $95.30
 5420115   ST BURTL                   ST BURTL                       $463.60
 5420116   BURETROL                   BURETROL                       $310.25
 5420117   ST IV START PK             ST IV START PK                  $97.45
 5420125   CATH IV                    CATH IV                        $576.15
 5420128   ST ADM SORENSN             ST ADM SORENSN                 $534.20
 5420130   CONT IV EVAC 1M            CONT IV EVAC 1M                $167.95
 5420135   CATH IV PLCM UNT           CATH IV PLC UNT                $144.25
 5420136   ST IV TRNS PK              ST IV TRNS PK                  $246.25
 5420137   KT ART MNTR                KT ART MNTR                  $1,914.00
 5420139   ST IV EXT Y+FLW            ST IV EXT Y+FLW                $345.30
 5420146   CATH IV PLCMNT             CATH IV PLCMNT                 $835.70
 5420159   TB ARTHRO                  TB ARTHRO                      $243.40
 5420161   ST ADM IRG                 ST ADM IRG                     $370.40
 5420170   ST IV ADM                  ST IV ADM                      $178.10
 5420171   ST IV ADM                  ST IV ADM                      $130.35
 5420172   ST IV ADM                  ST IV ADM                       $55.60
 5420178   ST BLD COLCT               ST BLD COLCT                   $450.15
 5420183   BG BLD WRMR                BG BLD WRMR                    $505.20
 5420188   ST IV EXT                  ST IV EXT                       $84.80
 5420197   ST BLD Y                   ST BLD Y                       $300.50
 5420198   CATH IV RDPQ               CATH IV RDPQ                 $1,932.45



  CDM Run Date: 06/01/2007
  Doctors Medical Center - Modesto                                            Page 95 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 5420203   MANI CAPD 12 PRG           MANI CAPD 12PRG                  $490.55
 5420204   ST CAPD TRNSFR             ST CAPD TRNSFR                 $4,230.15
 5420208   ADPT CAPD PD               ADPT CAPD PD                   $1,974.00
 5420211   CP TITANIUM BETA           CP TITANIUM BET                  $140.55
 5420218   FLTR TRNSFR                FLTR TRNSFR                      $155.95
 5420219   ST ADM BLD                 ST ADM BLD                       $283.15
 5420222   MNTR VEN PRES              MNTR VEN PRES                    $502.10
 5420225   CATH IV PLCMNT             CATH IV PLCMNT                    $24.25
 5420227   FLTR IV AIR                FLTR IV AIR                       $82.95
 5420237   CATH IV 16X8               CATH IV 16X8                     $218.15
 5420238   TB PRES LINE               TB PRES LINE                      $11.40
 5420244   ST IV ADM                  ST IV ADM                        $354.65
 5420251   TB ART PRES                TB ART PRES                      $329.95
 5420264   ST IV DYE DEL              ST IV DYE DEL                    $525.30
 5420265   FLTR BLD INFUS             FLTR BLD INFUS                   $678.50
 5420267   CSET IV                    CSET IV                          $611.75
 5420274   ST BLD AUTOTR              ST BLD AUTOTR                  $2,544.30
 5420277   CATH IV CUTDOWN            CATH IV CUTDOWN                  $274.70
 5420297   BAG-A JET                  BAG-A JET                        $279.55
 5420302   KT MNTR ART PRES           KT MNTR ART PRS                  $230.60
 5420322   INST CLMP P-D              INST CLMP P-D                     $73.50
 5420339   ST IV ADM FLTR             ST IV ADM FLTR                 $1,190.25
 5420796   ST CYSTOMTRY               ST CYSTOMTRY                     $412.80
 5420900   ST IV EXT PCA              ST IV EXT PCA                    $202.65
 5420905   ST IV Y PCA                ST IV Y PCA                      $144.80
 5421505   MNTR ART PRES              MNTR ART PRES                    $441.10
 5421507   ST IRG TUR                 ST IRG TUR                       $253.45
 5421508   ST IV NITROUS              ST IV NITROUS                    $333.15
 5421509   ADAPTER AV/LVER            ADAPTER AV/LVER                    $2.90
 5421700   ST INFUS APIS              ST INFUS APIS                    $176.20
 5421705   TB UROPMP                  TB UROPMP                        $165.75
 5428999   MISC-SOL MATERIL           MISC-SOL MATRL          $2.90 - $4,230.15
 5500000   4180 RESPIRATORY THERAPY   RESP THRPY (IP)
 5500100   AEROSOL HR INITIAL         AEROSOL HR INIT               $314.00
 5500101   AEROSOL HR MONITOR/SERV    AERO HR MON/SE                 $85.00
 5500102   AEROSOL HOURS              AEROSOL HOURS                  $68.00
 5500103   AER TX DEMO AND/OR EVAL    AER DEMO/EVAL                 $262.00
 5500104   AEROSOL TX MONITOR/SERV    AERO TX MON/SE                 $85.00
 5500105   AEROSOL TREATMENT          AEROSOL TX                    $133.00
 5500120   HHN TX DEMO AND/OR EVAL    NEB DEMO/EVAL                 $278.00
 5500121   HAND HLD NEB TX MON/SERV   NEB TX MON/SERV                $85.00
 5500122   HAND HELD NEB TREATMENT    HHN TREAT                     $278.00
 5500125   CON NEB BRONCH DEMO/EVAL   NEB DEMO/EVAL                 $238.00
 5500133   USN TX DEMO AND/OR EVAL    US TX DEMO/EVAL               $279.00
 5500134   ULTRASONIC TX MON/SERV     US TX MON/SERV                 $85.00
 5500135   ULTRASONIC TX              US TX                         $306.00
 5500152   ABG ANALYSIS               ABG ANALYSIS                  $650.00      Minimum
 5500200   CPR                        CPR                           $909.00
 5500206   EXTUBATION                 EXTUBATION                    $294.00
 5500208   INTUB/EXTUBATN ASSIST      INTUB/EXTUB AST               $255.00



  CDM Run Date: 06/01/2007
  Doctors Medical Center - Modesto                                         Page 96 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 5500210   POSTURAL DRAINAGE          POSTURL DRAIN                   $345.00
 5500213   POSTURAL DRAIN/PERCUSN     POSTRL DRN/PERC                 $345.00
 5500221   SPTM IND DEMO AND/OR EVA   SPTM IND DEM/EV                 $306.00
 5500230   SUCTION DEEP               SUCTION DEEP                     $99.00
 5500501   IPPB MONITOR/SERVICE       IPPB MON/SERV                    $85.00
 5500502   IPPB TX                    IPPB TX                         $279.00
 5500510   IPPB W/USN DEMO/EVAL       IPPB W/USN D/E                  $314.00
 5500512   IPPB W/USN TX 15 MIN       IPPB USN TX                     $508.00
 5500540   NITROUS OXIDE INITIAL      NITROUS OXIDE                   $384.00
 5500542   NITROUS OXIDE TX           NITROUS OXID TX                 $228.00
 5500544   NITROUS OXIDE M/S          NITROUS OXIDM/S                  $68.00
 5500600   CPAP INIT/MGMT             CPAP INIT/MGMT                  $345.00
 5500601   CPAP MONITORING/SERVICE    CPAP MON/SERV                    $85.00
 5500602   CPAP HOURS                 CPAP HOURS                       $58.00
 5500604   OXIMETRY DAILY SERV        OXIM DLY SERV                    $85.00
 5500607   PULSE OXIMETR MNTR INIT    PULSE OXIM INIT                 $381.00
 5500609   PULSE OXIMETR MNTR/HR      PULSE OXIM/HR                    $58.00
 5500615   PRESSURE VENTILATOR INIT   PRESS VENT INIT               $4,217.00
 5500616   PRESSURE VENT MONITOR/SV   PRES VENT M/S                   $228.00
 5500620   VOLUME VENTILATOR INTL     VOL VENT INIT                 $4,175.00
 5500621   VOLUME VENT MONITOR/SERV   VOL VENT MON/S                  $228.00
 5500626   VOLUME VENT SUBSQ/DLY      VOLUME VENT SUB               $3,479.00
 5500630   WEANING PARAMETERS         WEANING PARAMTR                  $98.00
 5500655   BRONCHOSCOPY DX            BRONCHOSCOPY DX               $2,916.00
 5500663   BRONCH THRU TRACHEOSTMY    BRNCH THRU TRAC               $2,638.00
 5500665   TRANSBRONCH LUNG BIOPSY    TBRNCH LUNG BX                $3,973.00
 5500696   PENTAMIDINE TREATMENT      PENTAMIDINE TRT                 $361.00
 5500700   OXYGEN INITIAL             OXYGEN INITIAL                  $381.00
 5500702   OXYGEN HOURS               OXYGEN HOURS                     $58.00
 5500706   OXYGEN HOOD INITIAL        O2 HOOD INIT                    $381.00
 5500707   OXYGEN HOOD MONITOR/SERV   O2 HOOD MON/SER                  $85.00
 5500708   OXYGEN HOOD HOURS          OXYGEN HOOD HRS                  $66.00
 5500720   OXYGEN HOURS ER            OXYGEN HOURS ER                  $58.00
 5500722   OXYGEN HRS OB/DEL RM       O2 HRS OB/DEL                    $58.00
 5500723   OXYGEN HOURS REC RM        O2 HRS REC RM                    $58.00
 5500735   RIBOVARIN TREATMENT        RIBOVARIN TX                    $162.00
 5500819   PEAK FLOW ONLY             PEAK FLOW ONLY                  $173.00
 5500821   PEAK FLOW ASSESSMENT       PEAK FLOW                       $191.00
 5500825   FLOW VOLUME LOOPS          FLOW VOL LOOPS                  $394.00
 5500900   TENT INITIAL               TENT INITIAL                    $381.00
 5500901   TENT MONITOR/SERVICE       TENT MON/SERV                    $85.00
 5500902   TENT HOURS                 TENT HOURS                       $68.00
 5501025   NITRIC OX R/FAIL NEO P/D   NIT OX R/F NEO                $4,752.00
 5501104   BLOOD GAS ARTERIAL STICK   BD GAS ART STCK                 $141.00
 5501108   CO-OXIMETRY O2 SAT         BLD CO-OX O2SAT                 $432.00 Minimum
 5501192   SPIROMETRY                 SPIROMETRY                    $1,186.00
 5501202   BRONCHOSPASM EVAL PRE/PS   BRONCHO EVAL                  $2,847.00
 5501208   DIFFUSION CAPACITY         DIFF CAPACITY                   $394.00
 5501213   VITAL CAPACITY             VITAL CAPACITY                  $394.00
 5501300   THORACIC GAS VOLUME        THORACIC GAS VO                 $390.00



  CDM Run Date: 06/01/2007
  Doctors Medical Center - Modesto                                             Page 97 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 5501301   AIRWAY RESISTANCE          AIRWAY RESISTNC                   $390.00
 5501805   ART LINE SAMPLE            ART LINE SAMPLE                   $631.00
 5501810   VD/VT STUDY                STDY VD/VT                        $394.00
 5501822   MAX EXP PRESSURE           MAX EXP PRESSR                    $161.00
 5501850   TCPO2-PCO2 HOURS           TCPO2-PCO2                        $114.00
 5501853   TCPO2-PCO2 MON/SERV        M/S TCPO2-PCO2                     $85.00
 5501857   BIPAP INITIAL              BIPAP INIT                        $315.00
 5501860   BIPAP HOURLY               BIPAP HOURLY                       $49.00
 5501863   BIPAP MON/SERV             MNTR/SERV BIPAP                    $79.00
 5501877   GAS/O2 INITIAL             GAS/O2 INIT                       $476.00
 5501880   GAS/O2 MON/SERV            M/S GAS/O2                         $85.00
 5501887   PULMONARY ASSESSMENT       ASSESS PULM                       $383.00
 5502010   FUNCTIONAL RESID CAPAC     FUNC RESID CAP                    $394.00
 5502100   MDI DEMO AND/OR EVAL       MDI DEMO/EVAL                     $262.00
 5502105   MDI TREATMENT              MDI TREATMENT                     $133.00
 5502115   CARDIOVERSION ASSIST       CARDIOVER ASST                    $231.00
 5502315   BEDSIDE SPIRO              BESIDE SPIRO                      $394.00
 5504004   SPAG INITIAL               SPAG INITIAL                      $852.00
 5504007   SPAG HOURS                 SPAG HOURS                        $298.00
 5504009   SPAG MONITOR/SERVE         SPAG MNTR/SRVE                     $79.00
 5504200   MAX VOLUNTRY VENTILATION   MAX VOL VENT                      $394.00
 5504640   SPCL GASES HELOX           SPCL GAS HELOX                    $852.00
 5504644   CONT AER MED OBSTR 1STHR   AER MED 1ST HR                    $450.00
 5504664   CONT NEB BRONCH MON/SRV    CONT NEB MON/SR                    $79.00
 5505025   BLOOD GAS PH ONLY          BLD GAS PH ONLY                   $593.00
 5505083   PORTABLE O2                PORTABLE O2                       $381.00
 5506105   HIGH FREQ VENT INITIAL     HI FRQ VNT INI                  $4,968.00
 5506415   BD GAS CAP STICK           BD GAS CAP STCK                   $141.00
 5508999   MISC RESPIRATORY THERAPY   MISC RSP THRPY          $49.00 - $4,968.00
 5510000   4180 RESPIRATORY THER OP   RESP THERAPY OP
 5510100   AEROSOL HR INITIAL         AEROSOL HR INIT                $350.00
 5510101   AEROSOL HR MONITOR/SERV    AERS HR MON/SEV                 $97.00
 5510102   AEROSOL HOURS              AEROSOL HOURS                   $77.00
 5510103   AER TX DEMO AND/OR EVAL    AER DEMO/EVAL                  $294.00
 5510104   AEROSOL TX MONITOR/SERV    AEROS TX MON/SE                 $97.00
 5510105   AEROSOL TX                 AEROSOL TX                     $315.00
 5510120   HHN TX DEMO AND/OR EVAL    NEB DEMO/EVAL                  $294.00
 5510121   HAND HLD NEB TX MON/SERV   NEB TX MON/SERV                 $97.00
 5510122   HAND HELD NEB TX           NEB TX                         $294.00
 5510125   CON NEB BRONCH DEMO/EVAL   NEB DEMO/EVAL                  $267.00
 5510152   ABG ANALYSIS               ABG ANALYSIS                   $708.00
 5510200   CPR                        CPR                          $1,017.00
 5510205   INTUBATION                 INTUBATION                     $834.00
 5510206   EXTUBATION                 EXTUBATION                     $332.00
 5510208   INTUB/EXTUBATN ASSIST      INTUB/EXTUB ASS                $286.00
 5510210   POSTURAL DRAINAGE          POSTURAL DRAING                $386.00
 5510213   POSTURAL DRAIN/PERCUSN B   POSTRL DRN/PERC                $386.00
 5510215   BREATHING EXERCISE         BREATHING EXER                 $191.00
 5510221   SPTM IND DEM AND/OR EVAL   SPTM IND DEM/EV                $344.00
 5510305   GAS/MIXED OXYGEN/CA HR     GAS/OXYGEN P/HR                $401.00



  CDM Run Date: 06/01/2007
  Doctors Medical Center - Modesto                                        Page 98 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 5510500   IPPB TX DEMO AND/OR EVAL   IPPB DEMO/EVAL                  $315.00
 5510502   IPPB TX                    IPPB TX                         $315.00
 5510504   IPPB TX DEMO AND/OR EVAL   IPPB DEMO/EVAL                  $315.00
 5510600   CPAP INITIAL               CPAP INITIAL                    $386.00
 5510601   CPAP MONITORING/SERVICE    CPAP MON/SERV                    $97.00
 5510602   CPAP HOURS                 CPAP HOURS                       $61.00
 5510604   OXIMETRY DAILY SERV        OXIM DLY SERV                    $97.00
 5510607   PULSE OXIMETR MNTR INIT    PULSE OXIMTR IN                 $426.00
 5510609   PULSE OXIMETR MNTR/HR      PULSE OXIMTR/HR                  $61.00
 5510610   CPAP NEONATAL HRS          CPAP NEO HRS                     $59.00
 5510611   CPAP NEONATAL INTIAL       CPAP NEO INI                    $376.00
 5510612   CPAP NEONATAL MON/SRV      CPAP NEO M/S                     $91.00
 5510615   PRESSURE VENTILATOR INIT   PRESS VENT INIT               $4,217.00
 5510618   HIGH FREQ VENT SUBSQ/DLY   HI FRQ VNT SUB                $4,204.00
 5510619   PRESSURE VENT SUBSQ/DLY    PRESS VENT SUB                $3,479.00
 5510620   VOLUME VENTILATOR INTL     VOLUME VENT INT               $4,175.00
 5510626   VOLUME VENT SUBSQ/DLY      VOLUME VENT SUB               $3,479.00
 5510700   OXYGEN INITIAL             OXYGEN INITIAL                  $426.00
 5510701   OXYGEN MONITOR/SERVICE     OXYGEN MON/SERV                  $97.00
 5510702   OXYGEN HOURS               OXYGEN HOURS                     $61.00
 5510706   OXYGEN HOOD INITIAL        OXYGEN HOOD INI                 $426.00
 5510707   OXYGEN HOOD MONITOR/SERV   O2 HOOD MON/SER                  $97.00
 5510708   OXYGEN HOOD HOURS          OXYGEN HOOD HRS                  $72.00
 5510721   O2 HOURS NSY               OXYGEN HRS NSY                  $317.00
 5510722   OXYGEN HRS OB/DEL RM       O2 HRS OB/DEL                    $61.00
 5510805   PHYSICAL & CLINICAL EVAL   PHYS/CLIN EVAL                  $286.00
 5510814   TECH TRANSPORT OUT         TECH TRANS OUT                  $532.00
 5510821   PEAK FLOW ASSESSMENT       PEAK FLOW                       $212.00
 5510900   TENT INITIAL               TENT INITIAL                    $426.00
 5510901   TENT MONITOR/SERVICE       TENT MON/SERV                    $97.00
 5510902   TENT HOURS                 TENT HOURS                       $77.00
 5511104   BLOOD GAS ARTERIAL STICK   BD GAS ART STCK                 $156.00
 5511108   CO-OXIMETRY O2 SAT         BLD CO-OX O2SAT                 $485.00
 5511805   ART LINE SAMPLE            ART LINE SAMPLE                 $708.00
 5511840   ETCO2 MON INITIAL          MNTR ETCO2 INIT                 $769.00
 5511847   TCPO2-PCO2 INITIAL         TCPO2-PCO2 INIT                 $769.00
 5511850   TCPO2-PCO2 HOURS           TCPO2-PCO2                      $127.00
 5511853   TCPO2-PCO2 MON/SERV        M/S TCPO2-PCO2                   $97.00
 5511855   MDI MON/SERV               MNTR/SERV MDI                    $97.00
 5511877   GAS/O2 INITIAL             GAS/O2 INIT                     $532.00
 5511880   GAS/O2 MON/SERV            M/S GAS/O2                       $97.00
 5511887   PULMONARY ASSESSMENT       ASSESS PULM                     $286.00
 5512100   MDI DEMO AND/OR EVAL       MDI DEMO/EVAL                   $294.00
 5512105   MDI TREATMENT              MDI TREATMENT                   $148.00
 5512115   CARDIOVERSION ASSIST       CARDIOVER ASST                  $286.00
 5512205   EAR OXIMETRY PER MSRMENT   EAR OXMTRY MSRM                 $769.00
 5512315   PULM FUNCTION SCREEN       SCRN PULM FUNC                  $712.00
 5514610   SURFACTANT ADMIN TUBE      SURFACT ADM TB                  $667.00
 5514645   CONT AER MED OBSTR ADDHR   AER MED ADD HR                  $250.00
 5515025   BLOOD GAS PH ONLY          BLD GAS PH ONLY                 $662.00



  CDM Run Date: 06/01/2007
  Doctors Medical Center - Modesto                                                Page 99 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 5515083   PORTABLE O2                PORTABLE O2                        $61.00
 5516105   HIGH FREQ VENT INITIAL     HI FRQ VNT INI                  $4,968.00
 5516415   BD GAS CAP                 BD GAS CAP                        $156.00
 5518907   PULMONARY ASSESS OTHR      ASSESS PULM                       $355.00
 5518999   MISC RESPIRATORY THERAPY   MISC RSP THRPY          $49.00 - $4,968.00
 5520000   4180 RESPIRATORY THERAPY   RESP THERAPY ER
 5520152   ABG ANALYSIS               ABG ANALYSIS                     $631.00
 5521104   BLOOD GAS ARTERIAL STICK   BD GAS ART STIC                  $141.00
 5521108   CO-OXIMETRY O2 SAT         BLD CO-OX O2SAT                  $432.00
 5521805   ART LINE SAMPLE            ART LINE SAMPLE                  $631.00
 5526415   BD GAS CAP                 BD GAS CAP                       $141.00
 5528999   MISC RESPIRATORY THERAPY   MISC RSP THRPY          $141.00 - $631.00
 5600000   4190 DIALYSIS              DIALYSIS
 5600257   UNSCHED DIAL ESRD PT       UNSCH DIAL ESRD                $5,966.00
 5600258   UNSCHED PERIT DIAL ESRD    UNSCH DIAL ESRD                $1,408.00
 5600365   THERAPEUTIC APHERESIS      THERPTC APHERES                $2,874.68
 5600904   IP CAPD                    IP CAPD                        $1,408.00
 5600969   HEMODIALYSIS SET UP        DIALYSIS-SET UP                $1,555.00
 5600970   HEMODIAL RENL FAIL         HEMODIALYS TRT                 $5,966.00       Minimum
 5600977   DIALYSIS PLASMAPHERESIS    PLASMAPHERESIS                 $5,956.00       Minimum
 5600980   EXT CANNULA DECLOTTING     EXT CAN DECLOT                   $300.00
 5601100   CONT RENAL REPLACE THRPY   CONT RENL THRPY                $4,331.00
 5601200   PER DIALYS CATH IRRIG      PD CATH IRRIG                    $922.00
 5608999   DIALYSIS/MISC              DIALYSIS/MISC         $300.00 - $5,966.00
 5700000   4200 PHYSICAL THERAPY      PHYSCL THRPY IP
 5700283   PT E-STIM BASIC            E-STIM BSC                      $144.00
 5704920   PT SPLNT SHRT LEG          SPLINT SHRT LEG                 $257.00
 5705200   PT EVAL LTD                PT EVAL LTD                     $300.00
 5705202   PT EVAL INTERM             PT EVAL INT                     $900.00
 5705204   PT EVAL EXT                PT EVAL EXT                   $1,199.00
 5705208   PT RE-EVAL LTD             PT RE-EVAL LTD                  $300.00
 5705210   PT RE-EVAL INTERM          PT RE-EVAL INT                  $598.00
 5705240   PT HOT/COLD PACKS COMPLX   HOT/CLD PKSCOMP                 $300.00
 5705264   PT MODALITY COMPLX         MODALITY COMP                   $598.00
 5705270   PT E-STIM MANUAL 15 COMP   E-STIM MANL COM                 $300.00
 5705288   PT US EA 15 CMPLX          US EA 15 COMP                   $300.00
 5705298   PT THER EX EA 15 #2        THERAPTC EXER#2                 $300.00
 5705302   PT NEUROMUSC RE-ED EA15#   NEUROMUSCEA15#2                 $300.00
 5705310   PT THERAPEUTC MASSG 15 #   THERPTC MASSG#2                 $300.00
 5705314   PT THERAPEUTC ACT EA15#2   THERPTC ACT15#2                 $300.00
 5705318   PT SLF CR/HM MGMT EA15#2   SLF CARE EA15#2                 $300.00
 5705398   PT GRP4 THERAPTC PROC(2+   GRP 4 THER (2+)                 $598.00
 5705416   PT NEURODEV/PED EVAL COM   NEURODEV COMP                 $1,199.00
 5705422   PT NEURO/PED RE-EVAL COM   NEURO REEVALCOM                 $598.00
 5705424   PT PED THERPTC EXER EA 1   PED THER EXER15                 $300.00
 5705426   PT PED NEURO RE-ED EA15    PED NEURO RE-ED                 $300.00
 5705446   PT EQUIP SETUP 15MIN #3    EQUIP S/U 15M#3                 $300.00
 5705450   PT EQUIP EVAL/MOD 15MIN#   EQUIP EVAL 15#2                 $300.00
 5705648   PT WP ATTEND EA 15 CMPLX   WP ATTEND COMP                  $300.00
 5705654   PT PULSE LAVAGE EA15 CMP   PULSE LAVG COMP                 $300.00



  CDM Run Date: 06/01/2007
  Doctors Medical Center - Modesto                                             Page 100 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 5705658   PT GAIT/STR TRN EA15 #2    GAIT/STR TRN #2                   $300.00
 5705666   PT WHLCHR TRN EA15 #2      WHLCHR TRN 15#2                   $300.00
 5705696   PT MAINT PRGM              MAINT PRGM                        $598.00
 5707597   PT SEL DEB <=20CM BSC      SEL DEB <=20CM                    $300.00
 5707598   PT SEL DEB >20CM BSC       SEL DEB >20CM                     $300.00
 5707761   PT ORTH MGMT/TRN EA15#2    ORTH MGMT 15#2                    $300.00
 5707799   PT PROC UNLISTD            UNLIST PROC PT                    $300.00  Minimum
 5708999   MISC P.T.                  MISC P.T.              $144.00 - $1,199.00
 5709504   PT SPLNT LNG LEG           SPLNT LNG LEG                     $257.00
 5800000   4210 OCCUPATINAL THRPY#1   OCCPATINL THRPY
 5805200   OT EVAL LTD                OT EVAL LTD                       $343.00
 5805202   OT EVAL INTERM             OT EVAL INT                     $1,026.00
 5805204   OT EVAL EXT                OT EVAL EXT                     $1,365.00
 5805208   OT RE-EVAL LTD             OT RE-EVAL LTD                    $343.00
 5805210   OT RE-EVAL INTERM          OT RE-EVAL INT                    $683.00
 5805236   OT HOT/COLD PK BSC         HOT/CLD PK BSC                    $343.00
 5805256   OT WHIRLPOOL INTERM        WHIRLPOOL INT                   $1,365.00
 5805262   OT MODALITY INTERM         OT MODALITY INT                   $683.00
 5805268   OT E-STIM MAN EA 15 INT    E-STIM MAN15INT                   $343.00
 5805296   OT THERAPTC EXER EA 15     OT THER EXER 15                   $343.00
 5805300   OT NEUROMUSC RE-EDUC EA1   NEUROM RE-ED 15                   $343.00
 5805308   OT THERAPTC MASSGE EA15    THERAPTC MSG 15                   $343.00
 5805312   OT THERAPTC ACT EA 15      THERAP ACT EA15                   $343.00
 5805316   OT SLF CARE HM MGMT EA15   SLF CR/HM EA 15                   $343.00
 5805352   OT SPLNT FAB EA 15MN       SPLNT FAB 15MN                    $343.00
 5805368   OT GRP 1 THER PROC 2+      GRP 1 THER 2+                     $683.00
 5805414   OT NEURODEV/PED EVAL INT   NEURO/PED EVAL                  $1,026.00
 5805420   OT NEURO/PED REEVAL INT    NEURO/PEDREEVAL                   $683.00
 5805424   OT PED THER EXER EA 15     PED THER EXER15                   $343.00
 5805426   OT PED NEURO RE-ED EA15    PED NEURO RE-ED                   $343.00
 5805428   OT PED THER ACT EA 15      PED THER ACT 15                   $343.00
 5807535   OT COG SKL DEV EA 15       OT COG SKL E15                    $343.00
 5808999   OCCUP THERAPY MISC         MISC OT                $343.00 - $1,365.00
 5900000   4221 SPEECH THERAPY #2     SPEECH THERPY#2
 5900040   AUDITORY SCREEN            SCRN AUD                         $231.00
 5901001   SPEECH/LANG TX             TX SP/LANG                       $231.00
 5901004   SPEECH/LANG EVAL           EVAL SP/LANG                     $231.00
 5901090   SP SWAL/ORAL TX BASIC      SWALLW TX BASIC                  $231.00
 5902630   SWAL EVAL ORL PHARYN       EVAL ORAL/PHAR                   $231.00
 5902631   EVAL CINE VIDEO            EVAL CINE VIDEO                  $462.00
 5908999   SPEECH THER MISC           MISC SP THRPY                    $231.00
 6000000   4223 ENTEROSTOMY THERAPY   ENTROSTMY THRPY
 6001100   DEBRID ECZMT/INFEC SKIN    DBRD INFECT SKN                 $1,308.00
 6002025   ENTEROST CARE PER VISIT    ENTEROS CR P VT                 $3,138.00
 6003001   SKIN CARE SPECIAL PROC     SKIN CR SPEC PR                 $3,267.00
 6003006   SKIN CARE SPEC PROC F/U    SKN CR SPEC F/U                    $40.00
 6006100   ENTEROSTOMAL-CONSULT       ENTEROSTOM CNSL                 $2,614.00
 6006110   ENTEROSTOMAL-FOLLOW-UP     ENTEROSTOM F/U                  $2,614.00
 6008300   SKIN/EVAL & TX             SKIN/EVAL & TX                  $1,308.00    Minimum
 6008999   ENTEROSTOMY MISC           ENTEROSTMY MISC         $40.00 - $3,267.00



  CDM Run Date: 06/01/2007
  Doctors Medical Center - Modesto                                            Page 101 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 6010000   4224 CARDIAC REHAB         CARDIAC REHAB
 6010103   CARD INST IND 15MIN        CARD INST IND                    $308.00
 6010140   CARDIAC EVAL COMPLETE      CARDIAC EVAL                     $156.00
 6010150   C/R EXER PHASE I           EXER PHASE I                     $308.00
 6010152   C/R EXER PHASE II          EXER PHASE II                    $291.00
 6010153   C/R EXER PHASE III         EXER PHASE III                    $55.00
 6010166   ECP PER TX SESSION         ECP PER TX SESS                  $288.00
 6010300   OXIMETRY MNTR HOURLY       OXIMTRY MON/HR                    $93.00
 6010400   OXYGEN PER HOUR            OXYGEN PER HOUR                   $61.00
 6018999   MISC CARDIAC REHAB         MISC CARD REHAB          $55.00 - $308.00
 6020000   4222 RECREATIONAL REHAB    RECREAT REHAB
 6020927   LEISURE SKILLS-IND         LEISR SKILL IND                 $108.00
 6020980   W/C ORIENT/MOBIL TX        TX WC ORNT/MOB                  $108.00
 6022625   COORD ACTIVITY-IND         COORD ACTIV-IND                 $214.00
 6028500   REC EVAL 15MN              EVAL REC                        $108.00
 6030000   4225 PULMONARY REHAB       PULMONARY REHAB
 6030410   EXER PHASE 3               EXER PHASE 3                     $29.00
 6030800   EXER TRN IND               EXER TRN IND                    $381.00
 6030810   EXER TRN GRP               EXER TRN GRP                    $381.00
 6030925   PULM EVAL INITIAL          PULM EVAL INIT                  $286.00
 6034761   PULSE OXIM MULT DETRM      PULSE OXIM MULT                  $73.00
 6034763   OXIMETRY CHECK             OXIMETRY CHECK                   $49.00
 6038999   MISC PULM REHAB            MISC PULM REHAB                  $10.00
 6060000   4228 ORTHOTIC&PROS S/PRO   ORTHT&PROS S/PR
 6090000   4325 CAST ROOM SERVICES    CAST ROOM SRVCS
 6090010   CASTING MINOR/LEVEL I      CST MINOR/LVL I                 $154.00
 6090011   CASTING LTD/LEVEL II       CST LTD/LVL II                  $175.00
 6090012   CASTING INTER/LEVEL III    CST INT/LVL III                 $196.00
 6090013   CASTING EXT/LEVEL IV       CST EXT/LVL IV                  $217.00
 6090014   CASTING COMPLEX/LEVEL V    CST CMPLX/LVL V                 $238.00
 6100000   4230 EMERGENCY ROOM        EMERGENCY ROOM
 6100008   INFLUENZA VACC ADMIN       FLU VACCINE ADM                  $25.00
 6100009   PNEUMOCOCCAL VACC ADMIN    PNEUM VACC ADM                   $25.00
 6100010   HEPATITIS B VACC ADMIN     HEP B VACC ADM                   $25.00
 6100495   ER VISIT LVL 0 SUB-MINOR   ER VST LVL0 MNR                  $30.00
 6100510   ER VISIT LVL I             ER VISIT LVL I                   $92.00
 6100514   CRIT CARE E&M 30-74 MIN    CRIT CR30-74MIN               $1,998.00
 6100522   ER VISIT LVL II            ER VISIT LVL II                 $248.00
 6100524   ER VISIT LVL III           ER VISIT LVLIII                 $410.00
 6100526   ER VISIT LVL IV            ER VISIT LVL IV                 $659.00
 6100527   ER VISIT LVL V             ER VISIT LVL V                $1,175.00
 6100535   CPR CARDIOPULM RESUSC      CPR CARD RESUSC                 $614.00
 6100572   ER BLOOD ALCOHOL COLLECT   ER BLD ALCH COL                   $4.00
 6100610   TRANSCUTANEOUS PACING      TRANSCUTN PACNG                 $614.00
 6100760   IV INF HYD INIT <=1 HR     IV HYD INIT 1HR                 $394.00
 6100761   IV INF HYD EA ADD HR       IV HYD ADD HR                    $50.00
 6100765   IV INF TX INIT <=1 HR      IV TX INIT 1 HR                 $394.00
 6100766   IV INF TX EA ADD HR        IV INF TX ADD H                  $50.00
 6100767   IV INF SEQUENTL 1 HR       IV SEQUENTL 1HR                  $50.00
 6100768   IV INF CONCURRENT          IV CONCURRENT                    $50.00



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CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 6100774   INJ TX/PRPH/DX IVP INT     INJ T/P/D IVP                    $100.00
 6100775   INJ ADD SEQUENTL IVP       INJ ADD SEQ IVP                  $100.00
 6100783   INJ TX/PROPH/DX ART        INJ T/P/D ART                    $100.00
 6100788   INJ ANTIBIOTIC IM          INJ ANTIBIOTIC                   $100.00
 6101105   GASTRIC INT ASP OR LAVG    GASTRIC INTUBAT                  $381.00
 6102120   INJ TX/PROPH/DX SQ/IM      INJ T/P/D SQ/IM                   $50.00
 6102977   CORONARY THROMBLYSIS IV    CORONARY THROMB                  $582.00
 6103055   CRITICAL CR E&M ADDL 30    CRIT CR ADDL 30                  $810.00
 6103110   TRANSFUSION BLD/BLD COMP   TRAN BLD/COMP                    $840.88
 6103996   IMM ADMIN SNGL/COMBO VAC   ADM SNGL VACC                     $25.00
 6103998   IMM ADM EA ADDL VACCINE    ADM EA ADD VACC                   $25.00
 6106000   SURG PROC SINGLE/MINOR     SURG PRC SGL/MI                   $50.00
 6106001   SURG PROC MULT/INTRMDTE    SURG PRC MLT/IN                   $75.00
 6106002   SURG PROC EXTENSVE/CMPLX   SURG PRC EXT/CM                  $100.00
 6106050   SURG PROC SUBMINOR         SURG PROC SUBMN                   $25.00
 6108999   ER UNLISTED SERVICE        ER UNLISTD SERV         $4.00 - $1,998.00
 6109195   PHLEBOTOMY THERAPEUTIC     PHLEBOTOMY                       $129.00
 6109211   E&M-EST. PATIENT-LVL I     E&M-EP LVL I                      $75.00
 6110000   4235 TRAUMA CENTER         TRAUMA CENTER
 6110010   SURG PROC SINGLE/MINOR     SURG PRC SNGL/M                  $102.93
 6110011   SURG PROC MULT/INTRMDTE    SURG PRC MULT/I                  $184.21
 6110012   SURG PROC EXTENSVE/CMPLX   SURG PRC EXT/CM                  $311.46
 6110471   IMM ADMIN SNGL/COMBO VAC   ADM SNGLE VACC                    $25.00
 6110472   IMM ADM EA ADDL VACCINE    ADM EA ADD VACC                   $25.00
 6110535   CPR CARDIOPULM RESUSC      CPR CARD RESUSC                  $614.00
 6110610   TRANSCUTANEOUS PACING      TRANSCUTN PACNG                  $614.00
 6110760   IV INF HYD INIT <=1 HR     IV HYD INIT 1HR                  $394.00
 6110761   IV INF HYD EA ADD HR       IV HYD ADD HR                     $50.00
 6110765   IV INF TX INIT <=1 HR      IV TX INIT 1 HR                  $394.00
 6110766   IV INF TX EA ADD HR        IV INF TX ADD H                   $50.00
 6110767   IV INF SEQUENTL 1 HR       IV SEQUENTL 1HR                   $50.00
 6110768   IV INF CONCURRENT          IV CONCURRENT                     $50.00
 6110774   INJ TX/PRPH/DX IVP INT     INJ T/P/D IVP                    $100.00
 6110775   INJ ADD SEQUENTL IVP       INJ ADD SEQ IVP                  $100.00
 6110782   INJ TX/PROPH/DX SQ/IM      INJ T/P/D SQ/IM                   $50.00
 6110783   INJ TX/PROPH/DX ART        INJ T/P/D ART                    $100.00
 6110788   INJ ANTIBIOTIC IM          INJ ANTIBIOTIC                   $100.00
 6111105   GASTRIC INT ASP OR LAVG    GASTRIC INTUBAT                  $381.00
 6112977   CORONARY THROMBLYSIS IV    CORONARY THROMB                  $582.00
 6113110   TRANSFUSION BLD/BLD COMP   TRAN BLD/COMP                    $840.88
 6118999   MISCELLANEOUS              MISCELLANEOUS          $25.00 - $7,500.00
 6119003   TRAUMA II-FULL TEAM        TRAUMA II-FULL                 $7,500.00
 6119004   TRAUMA II-PARTIAL TEAM     TRAUMA II-PARTL                $6,500.00
 6119005   TRAUMA II-SMALL TEAM       TRAUMA II-SMALL                $2,598.00
 6119195   PHLEBOTOMY THERAPEUTIC     PHLEBOTOMY                       $129.00
 6119281   ER VISIT LVL I             ER VISIT LVL I                   $198.92
 6119282   ER VISIT LVL II            ER VISIT LVL II                  $462.13
 6119283   ER VISIT LVL III           ER VISIT LVLIII                  $811.79
 6119284   ER VISIT LVL IV            ER VISIT LVL IV                $1,268.41
 6119285   ER VISIT LVL V             ER VISIT LVL V                 $1,692.01



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CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 6119291   CRIT CARE E&M 30-74 MIN    CRIT CR30-74MIN               $2,012.43
 6119292   CRIT CARE E&M ADDL 30MIN   CRIT CR ADDL30M                 $804.40
 6240000   4283 OBSERVATION           OBSERVATION
 6240100   OBS 624 UNIT 1/HR          OBS UNIT 1/HR                   $508.00
 6240305   OBS 624 UNIT ADD HR        OBS UNIT ADD HR                 $125.00
 6240406   OBS 200 ICU 1/HR           OBS 200IC 1/HR                  $508.00
 6240407   OBS 200 ICU ADD HR         OBS 200IC ADHR                  $125.00
 6240510   OBS 205 CIC 1/HR           OBS 205CI 1/HR                  $508.00
 6240515   OBS 205 CIC ADD HR         OBS 205CI ADHR                  $125.00
 6240616   OBS 232 M/S 1/HR           OBS 232MS 1/HR                  $508.00
 6240617   OBS 232 M/S ADD HR         OBS 232MS AD HR                 $125.00
 6240618   OBS 233 M/S ADD HR         OBS 233MS AD HR                 $125.00
 6240619   OBS 233 M/S 1/HR           OBS 233MS 1/HR                  $508.00
 6240640   OBS 236 M/S 1/HR           OBS 236MS 1/HR                  $508.00
 6240641   OBS 236 M/S ADD HR         OBS 236MS ADHR                  $125.00
 6240644   OBS 238 M/S 1/HR           OBS 238MS 1/HR                  $508.00
 6240645   OBS 238 M/S ADD HR         OBS 238MS ADHR                  $125.00
 6240646   OBS 239 M/S 1/HR           OBS 239MS 1/HR                  $508.00
 6240647   OBS 239 M/S ADD HR         OBS 239MS ADHR                  $125.00
 6240652   OBS 215 DOU 1/HR           OBS 215DO 1/HR                  $508.00
 6240653   OBS 215 DOU ADD HR         OBS 215DO ADHR                  $125.00
 6240672   OBS 227 RIC 1/HR           OBS 227RI 1/HR                  $508.00
 6240673   OBS 227 RIC ADD HR         OBS 227RI AD HR                 $125.00
 6240800   OBS 240 PED 1/HR           OBS 240PD 1/HR                  $508.00
 6240805   OBS 240 PED ADD HR         PBS 240PD ADHR                  $125.00
 6241680   OBS 229 OIC 1/HR           OBS 229OI 1/HR                  $508.00
 6241681   OBS 229 OIC ADD HR         OBS 229OI AD HR                 $125.00
 6290000   4239 SPECIAL NURSING SRV   SPECIAL NURS SR
 6290008   INFLUENZA VACC ADMIN       FLU VACCINE ADM                   $25.00
 6290009   PNEUMOCOCCAL VACC ADMIN    PNEUM VACC ADM                    $25.00
 6290010   HEPATITIS B VACC ADMIN     HEP B VAC ADM                     $25.00
 6293600   DSG REMOVAL/MAINT/CHG      DSG MAINT/REMVL                    $7.77
 6298999   MISC SPECIAL PROCEDURES    MISC SPECL PRO             $7.77 - $25.00
 6500000   4375 DME                   DME
 6508999   MISCELLANEOUS              MISCELLANEOUS           $1.00 - $1,000.00
 6570000   4258 NUTRITION SERVICES    NUTRITION SERVC
 6578999   NUTRITIONAL SERV MISC      NUTRI SERV MISC         $1.00 - $1,000.00
 6700000   4284 CLINIC #5             CLINIC #5
 6700040   AUDITORY SCREEN            SCRN AUD                         $210.00
 6708999   MISC CLINIC #5             MISC CLINIC #5          $120.00 - $210.00
 6709725   INIT HEARING SCREEN MCAL   HEARING SCREEN                   $120.00
 6710000   4285 CLINIC #6             CLINIC #6
 6710901   E&M-NEW PATIENT-LVL I      E&M-NP LVL I                    $114.00
 6710902   E&M-NEW PATIENT-LVL II     E&M-NP LVL II                   $133.00
 6710903   E&M-NEW PATIENT-LVL III    E&M-NP LVL III                  $153.00
 6710904   E&M-NEW PATIENT-LVL IV     E&M-NP LVL IV                   $191.00
 6710905   E&M-NEW PATIENT-LVL V      E&M-NP LVL V                    $238.00
 6710911   E&M-EST. PATIENT-LVL I     E&M-EP LVL I                     $85.00
 6710912   E&M-EST. PATIENT-LVL II    E&M-EP LVL II                   $114.00
 6710913   E&M-EST. PATIENT-LVL III   E&M-EP LVL III                  $143.00



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CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 6710914   E&M-EST. PATIENT-LVL IV    E&M-EP LVL IV                    $162.00
 6710915   E&M-EST. PATIENT-LVL V     E&M-EP LVL V                     $191.00
 6718999   MISC CLINIC #6             MISC CLINIC #6           $85.00 - $238.00
 6720000   4286 CLINIC #7             CLINIC #7
 6728999   MISC CLINIC #7             MISC CLINIC #7         $50.00 - $2,500.00
 6780000   4292 CLINIC #13            CLINIC #13
 6788999   MISC CLINIC #13            MISC CLINIC #13         $1.00 - $1,000.00
 6910000   4261 SLEEP DISORDER        SLEEP DISORDER
 6910040   AUDITORY SCREEN            SCRN AUD                        $210.00
 6912105   POLYSOMNOGRAPHY            POLYSOMN                      $4,831.00
 6912110   POLYSOMNOGRAPHY LTD        POLYSOMN LTD                  $3,565.00
 6919725   INIT HEARING SCREEN MCAL   HEARING SCREEN                  $120.00
 6920000   4263 ONCOLOGY SERVICES     ONCOLOGY SERVCS
 6920018   E&M-EST. PATIENT-LVL I     E&M-EP LVL I                    $115.00
 6920020   E&M-EST. PATIENT-LVL II    E&M-EP LVL II                   $115.00
 6920026   E&M-EST. PATIENT-LVL V     E&M-EP LVL V                    $496.00
 6920401   SURG PROC LEVEL I          SURG PROC LVL I                 $483.00
 6920402   SURG PROC LEVEL II         SURG PROC LVLII               $1,017.00
 6920404   SURG PROC LEVEL III        SURG PRO LVLIII               $1,526.00
 6920760   IV INF HYD INIT <=1 HR     IV HYD INIT 1HR                 $394.00
 6920761   IV INF HYD EA ADD HR       IV HYD ADD HR                    $50.00
 6920765   IV INF TX INIT <=1 HR      IV TX INIT 1 HR                 $394.00
 6920766   IV INF TX EA ADD HR        IV INF TX ADD H                  $50.00
 6920767   IV INF SEQUENTL 1 HR       IV SEQUENTL 1HR                  $50.00
 6920768   IV INF CONCURRENT          IV CONCURRENT                   $394.00
 6920774   INJ TX/PRPH/DX IVP INT     INJ T/P/D IVP                   $252.00
 6920775   INJ ADD SEQUENTL IVP       INJ ADD SEQ IVP                 $252.00
 6920782   INJ TX/PROPH/DX SQ/IM      INJ T/P/D SQ/IM                  $50.00
 6920913   E&M-EST. PATIENT-LVL III   E&M-EP LVL III                  $302.00
 6920914   E&M-EST. PATIENT-LVL IV    E&M-EP LVL IV                   $647.00
 6921125   PARACENTESIS ABD           PARACENTES ABD                  $992.00
 6922730   PHLEBOTOMY/THERAPEUT       PHLEBTMY/THERAP                 $320.00
 6923110   TRANSFUSION BLD/BLD COMP   TRAN BLD/COMP                   $840.88
 6923330   PIC LINE INSERT            PIC LN INSERT                 $1,228.00
 6926401   CHEMO SQ/IM NONHORMONAL    CHEMO SQ/IM NH                  $161.72
 6926409   INJ CHEMO INIT DRUG IVP    CHEMO INIT IVP                  $252.00
 6926411   INJ CHEMO ADD DRUG IVP     CHEMO ADD IVP                   $400.00
 6926413   CHEMO IV <=1H INIT         CHEMO IV 1H INT                 $508.00
 6926415   CHEMO INF EA ADD HR        CHEMO INF ADD H                 $400.00
 6926417   CHEMO INF SEQ ADD DRUG     CHEMO INF SEQ                   $508.00
 6926423   CHEMO INF IA EA ADD HR     CHEMO INF IA EA                 $400.00
 7000000   4061 OUTSIDE LAB-QUEST     OUTSIDE LAB
 7000074   ACUTE HEPATITIS PANEL      ACUTE HEP PANEL                   $43.58
 7000102   AMPHETAMINE QUAL           AMPHETAMINE QL                    $19.53
 7000111   DRUG SCREEN/MECONIUM       DRUG SCRN/MEC                     $95.31
 7000250   GABAPENTIN                 GABAPENTIN                        $34.32
 7000282   CARNITINE                  CARNITINE                         $36.96
 7000284   AMIODARONE QUANT           AMIODARONE                        $31.80
 7000297   THC(MARIJUANA) QUANT       THC(MARIJUAN)QN                  $123.53
 7001099   MISC URINE PROC            MISC URINE PRO           $19.53 - $123.53



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CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 7002018   CATECHOLAMINES(TOT)URINE   CATECHL TOT URN                 $31.24
 7002019   CATECHOLAMINES TOTAL BLD   CATECHL TOT BLD                 $32.92
 7002024   ACTH                       ACTH                            $37.93
 7002030   AMP.CYCLIC                 AMP CYCLIC                      $37.93
 7002055   ALCOHOL ETHYL              ALCOHOL ETHYL                   $13.67
 7002060   ETHANOL CONFIRM GC/MS      ETOH CONF GC/MS                 $13.67
 7002062   AMPHETAMINE CONF GC/MS     AMPHET CONF GC                  $19.53
 7002078   ALCOHOL METHYL             ALCOHOL METHYL                  $13.67
 7002085   ALDOLASE                   ALDOLASE                         $9.00
 7002087   ALDOSTERONE                ALDOSTERONE                     $35.00
 7002089   ALDOSTERONE URINE          ALDSTERONE URIN                 $35.00
 7002114   ALPHA FETO PROTEIN SERUM   ALPH FET PRT SR                 $12.99
 7002120   AMINES VAG FLUID QUAL      AMINES VAG FLD                  $20.71
 7002124   AMIKACIN                   AMIKACIN                        $12.03
 7002127   AMINO ACID QNT EA          AMINO QNT                       $36.96
 7002128   AMINO ACIDS QUAL MULT      AMINO ACID QUAL                 $15.41
 7002130   AMINO ACIDS SNGL QUANT     AMIN ACD QUANT                  $15.41
 7002135   ALA(DELTA AMINOLVLN ACID   ALA                             $19.73
 7002138   AMITRYPTALINE              AMITRYPTALINE                   $15.39
 7002145   AMPHETAMINE QUAN           AMPHETAMINE                     $19.53
 7002156   AMYLASE ISOENZYMES         AMYLASE ISOENZY                 $29.01
 7002164   ANGIOTENSIN CONV ENZYME    ACE 1                           $15.13
 7002174   APOLIPOPROTEIN AI          APOLIPOPROTN A                   $8.65
 7002175   ARSENIC QUANTITATIVE       ARSENIC QUAN                    $23.99
 7002180   ASCORBIC ACID(VITAMIN C)   ASCORB ACD-VT C                 $12.27
 7002184   BENZODIAZEPINES QL         BENZODIAZ QL                    $15.13
 7002185   BENZODI CONFIRM GC/MS      BENZ CONF GC/MS                 $19.53
 7002208   BARB CONFIRM GC/MS         BARB CONF GC/MS                 $19.53
 7002210   BARBITURATE IDENT/QUAN     BARBS IDENT/QN                  $19.53
 7002213   BARBITURATES QUAL          BARBITURATES QL                 $15.13
 7002232   BETA-2-MICROGLOBLN         B-2-MICROGLOB                   $17.85
 7002290   BROMIDES                   BROMIDES                        $10.39
 7002305   CAFFEINE QUAL              CAFFEINE QUAL                   $13.67
 7002307   CANNABIN CONFIRM GC/MS     CANN CONF GC/MS                 $19.53
 7002308   CALCITONIN                 CALCITONIN                      $28.18
 7002312   CAFFEINE QUANT             CAFFEINE QUANT                  $13.67
 7002380   CAROTENE                   CAROTENE                        $12.27
 7002384   CATECHOLAMINES FRAC        CATCHOL FRAC                    $31.24
 7002390   CERULOPLASMIN              CERULOPLSMN                      $9.76
 7002420   CHLORDIAZEPOXIDE QUANT     CHLORDIAZPXD                    $20.71
 7002480   CHOLINESTERASE PSEUDO      CHOLINEST PSEUD                  $9.76
 7002482   CHOLINESTERASE RBC         CHOLINESTER RBC                 $23.22
 7002495   CHROMIUM                   CHROMIUM                        $51.00
 7002512   CLONAZEPAM                 CLONAZEPAM                      $19.53
 7002515   COCAINE CONFIRM GC/MS      COCAIN CNF GCMS                 $19.53
 7002525   COPPER                     COPPER                          $10.88
 7002533   CORTISOL TOTAL             CORTISL TOTAL                   $13.62
 7002535   CORTISOL URINE FREE        CORTISL URINFRE                 $67.58
 7002552   CREATINE KINASE ISONZ      CPK ISOENZYMES                  $14.36
 7002560   COCAINE SCREEN             COCAINE SCREEN                  $15.13



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CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 7002596   CRYOGLOBULINS QUAL         CRYOGLOBULIN QL                  $4.81
 7002600   CYANIDE                    CYANIDE                         $10.00
 7002612   AMINOTC FLD SCAN(SPECTRO   AMINOTC FLD SCN                  $8.72
 7002613   CYCLOSPORINE               CYCLOSPORINE                    $26.45
 7002629   DESIPRAMINE                DESIPRAMINE                     $17.31
 7002631   DEHYDROEPIANDRST SULFATE   DHEA-S                          $25.03
 7002632   DEHYDROEPIANDRSTRONE       DHEA                            $41.28
 7002659   IMMUNOELECTRO CSF          IMMUNOELECT CSF                 $29.85
 7002660   DRUG SCREEN QUAL           DRUG SCRN QUAL                  $95.00
 7002661   DRUG SCREEN URINE QUAL     DRUG SCRN UR QL                 $19.53
 7002668   ERYTHROPOIETIN             ERYTHROPOIETIN                  $17.88
 7002670   ESTRADIOL                  ESTRADIOL                       $26.78
 7002671   ESTROGENS FRACTIONATED     ESTROGENS FRACT                 $88.18
 7002672   ESTROGENS TOTAL            ESTROGENS TOTAL                 $17.31
 7002700   FAT OR LIPID FECES QUANT   FT OR LPD FC QN                 $31.68
 7002742   FLURAZEPAM QUANT           FLURAZEPAM                      $16.81
 7002747   FOLIC ACID RBC             FOLIC ACID RBC                  $22.87
 7002926   GAST ACID FREE&TOTAL EA    GAST ACD F&T EA                 $17.85
 7002934   GIARDIA ANTIGEN EIA        GIARDIA AG EIA                  $10.12
 7002941   GASTRIN                    GASTRIN                         $14.37
 7002943   GLUCAGON                   GLUCAGON                        $23.22
 7002955   G6PD QUANT                 G6PD QUANT                      $14.64
 7002985   FRUCTOSAMINE               FRUCTOSAMINE                    $11.86
 7002994   HEMOGLOBIN GLYCATED        HEMOGLOBN GLYCT                  $7.21
 7003001   FOLLICLE STIMLAT HORMONE   FOLCL STIM HORM                  $9.62
 7003002   LUTEINING HORMONE          LUTEINING HORMN                  $9.62
 7003003   GROWTH HORMONE(HGH)        HGH                             $14.64
 7003010   HAPTOGLOBIN QUANT          HAPTOGLOBIN QT                  $13.62
 7003014   GONADTOPN CHORNC(HCG)QNT   GONA CHR(HCG)QN                 $16.11
 7003015   HEAVY METAL SCR UR         HVY METL SCR UR                 $53.76
 7003021   HEMOGLOBN ELECTRPHORESIS   HEMOGLBN ELCTRO                 $14.01
 7003051   HEMOGLOBIN PLASMA          HEMOGLOB PLASMA                 $13.67
 7003084   HIV VIRAL LOAD             HIV VIRAL LOAD                 $100.00
 7003088   HISTAMINE                  HISTAMINE                       $35.43
 7003089   HOMOCYSTINE QUANT          HOMOCYST QUAN                   $28.80
 7003497   HYDRXINDOL ACD5(HIAA)QT    5HIAA QUANT                     $13.67
 7003500   HYDRXYPROLINE REE          HYDROXYPRO FR                   $32.63
 7003512   IG-A SERUM                 IG-A SERUM                       $7.77
 7003513   IG-E SERUM                 IG-E SERUM                      $14.01
 7003514   IG-G SERUM                 IG-G SERUM                       $7.76
 7003515   IG-M SERUM                 IG-M SERUM                       $7.76
 7003523   IMIPRAMINE                 IMIPRAMINE                      $20.08
 7003524   IMMUNE COMPLEX             IMMUNE COMPLEX                 $184.28
 7003525   INSULIN TOTAL              INSULIN TOTAL                   $10.04
 7003610   LIDOCAINE                  LIDOCAINE                       $16.81
 7003625   LDH-ISOENZYMES ELCTROPHR   LDH ISOENZY ELC                 $12.03
 7003655   LEAD QUANTITATIVE          LEAD QUAN                        $9.41
 7003835   METANEPHRINES              METANEPHRNS                     $16.26
 7003842   METHADONE CONFIRM GC/MS    MDON CONF GC/MS                 $19.53
 7003860   METHOTREXATE QUANT         METHOTREXATE                    $18.62



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CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 7003874   MYELIN BASIC PROTEIN CSF   MYELIN BASICPRT                   $21.76
 7003875   MYOGLOBIN URINE            MYOGLOBIN URINE                   $16.53
 7003901   PTH-N-TERMINAL             PTH-N-TERMINAL                    $32.70
 7003902   PTH INTACT                 PTH INTACT                        $27.68
 7003903   DISOPYRAMIDE               DISOPYRAMIDE                      $15.13
 7003904   NORTRIPTYLINE              NORTRIPTYLINE                     $13.47
 7003905   NUCLEOTIDASE 5-            NUCLEOTIDASE 5                    $10.04
 7003908   HIV-1 RNA BY DNA           HIV-1 RNA BY DN                  $208.00
 7003925   OLIGOCLONAL BANDS          OLIGOCLONL BAND                   $18.90
 7003927   OPIATES QUAL               OPIATES QUAL                      $18.55
 7003928   OPIATES CONFIRM GC/MS      OPIAT CONF GCMS                   $15.13
 7003934   HCV RNA PCR QUANT          HCV RNA PCR QNT                  $115.00
 7003945   OXALATE                    OXALATE                           $13.32
 7003970   PARATHORMONE (PTH)         PARATHORMNE                       $34.63
 7003976   C-PEPTIDE                  C-PEPTIDE                         $22.59
 7003992   PHENCYCLIDINE(PCP) QUANT   PCP QUANT                         $19.53
 7004045   PHENYTOIN FREE             PHENYTOIN FREE                    $10.59
 7004060   PHOSPHATASE ACID TOTAL     PHOSPHT ACD TOT                    $8.02
 7004066   PROSTATIC ACID PHOS        PROS ACID PHOS                     $9.76
 7004076   PHOSPHATASE ALKALINE BN    PHOSPH ALKLN BN                    $6.14
 7004080   PHOSPHATASE ISO ALK        PHOSPHA ISO ALK                    $6.13
 7004141   PRIMIDONE                  PRIMIDONE                         $31.66
 7004144   PROGESTERONE               PROGESTERONE                      $11.54
 7004146   PROLACTIN                  PROLACTIN                         $13.47
 7004165   PROTEIN ELCTRC SERUM QN    PROTEIN ELCT QN                   $10.88
 7004191   PROTEIN ELCTRO URINE       PROTEIN ELCT UR                   $16.51
 7004238   VASOACTIVE INTST POLYPEP   VIP                               $41.28
 7004244   RENIN                      RENIN                             $20.08
 7004260   SEROTONIN                  SEROTONIN                         $54.11
 7004403   TESTOSTERONE TOTAL         TESTOSTER TOTL                     $8.02
 7004408   THC(MARIJUANA) QUAL        THC MARIJUAN QL                   $18.55
 7004430   THIOCYANATE                THIOCYANATE                       $19.73
 7004432   THYROGLOBULIN              THYROGLOBULIN                     $25.03
 7004448   DRUG CONFIRMATION          DRUG CONFIRM                      $18.55
 7004462   TRANSFERRIN                TRANSFERRIN                       $12.27
 7004586   VMA URINE                  VMA URINE                         $15.41
 7004588   VASOPRESSIN (ADH)          VASOPRESSIN(ADH                   $41.28
 7004590   VITAMIN A                  VIT A                             $19.73
 7004596   VITAMIN D (CALCIFEROL)     VIT D(CALCIFERL                   $91.14
 7004600   VOLATILES                  VOLATILES                         $17.02
 7004620   XYLOSE ABSORPTION URINE    XYLOSE ABS URIN                   $28.73
 7004630   ZINC QUANTITATIVE SERUM    ZINC QUAN SER                     $10.88
 7004900   CA 19-9                    CA 19-9                           $10.82
 7004905   REVERSE T3                 REVERSE T3                        $26.93
 7004998   CA15-3                     CA15-3                            $12.02
 7004999   MISC CHEM/TOX PROC         MISC CHEM/TOX           $3.70 - $1,260.68
 7005019   BLD HEMOGLBN I-STAT        HEMOGLBN I-STAT           $1.92 - $366.53
 7005220   CLOT FACTOR V (LABILE)     CLOT FACTOR V                     $30.96
 7005230   CLOT FACTOR VII(STABLE)    CLOT FACTOR VII                   $30.96
 7005231   CLOT FCTR VIII RELATE AG   CLOT FCTR VIII                   $112.39



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CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 7005240   CLOT FCTR VIII(AHG)1 STG   CLOT FCTOR VIII                  $112.39
 7005245   FACTR VIII RISTO CO-FCTR   FACT VIII RISTO                   $57.25
 7005246   FACTR VIII VW AG CO-FCTR   FACT VIII VW AG                  $366.53
 7005247   FCTR VIII VW MLT CO-FCTR   FCT VIII VW MLT                  $366.53
 7005250   CLOT FCTR IX(PTC/XMAS)     CLOT FACTOR IX                    $72.60
 7005270   CLOT FCTR XI(PTA)          CLOT FACTOR XI                    $30.96
 7005280   CLOT FCTR XII(HAGEMANN)    CLOT FACTOR XII                   $30.96
 7005300   CLOT INHIB ANT-THRMBNIII   CLOT INHIB/ANTI                   $33.00
 7005301   ANTI-THROMBINE 3 AG        ANTI-THROMB 3AG                  $121.50
 7005302   PROTEIN C AG               PROTEIN C AG                      $30.00
 7005379   FDP D-DIMER QNT            FDP D-DMR QN                      $15.00
 7005460   HMOGLBN FETAL(KLEIHAUER)   HEMOGLB FETAL                    $152.33
 7005540   LEUKOCYTE ALKA-PHSPHTASE   LEUK ALK PHOSPH                   $12.55
 7005545   LE CELL PREP               LE CELL PREP                       $9.76
 7005670   THROMBIN TIME PLASMA       THROMBIN PLASMA                    $3.42
 7005820   VISCOSITY SERUM OR PLSMA   VISCOSTY SR-PLS                   $14.36
 7005822   LUPUS ANTICOAGULANT        LUPUS ANTICOAG                    $89.61
 7005999   MISC HEMA PROC             MISC HEMA PROC            $1.92 - $366.53
 7006006   ANTIBODY QUAL 1ST ANTIGN   ANTIBDY QL 1 AG                   $14.50
 7006014   ANTIBODY ID:PLATELET       ANTIBDY ID:PLT                   $171.11
 7006040   AMOEBIC AB                 AMOEBIC ANTIBOD                   $18.34
 7006041   ANTINUCLEAR AB(ANA)TITER   ANTINCL AB TITR                   $17.50
 7006043   ANTINUCLEAR AB(ANA)        ANTINUCL AB(ANA                    $6.00
 7006051   IGG PLATELET ASSOCIATED    IGG PLATLT ASSC                  $171.12
 7006052   HELICOBACTER PYLORI AB     H PYLORI AB                       $76.50
 7006059   ANTI-NEUTRPHL CYTOPLASM    ANCA                             $108.34
 7006060   ANTI-STREPTOLYSN O TITER   ASO TITER                          $7.18
 7006090   RBC AG ROOM TEMP           RBC AG RM TEMP                    $12.55
 7006157   COMPLEMENT C1Q             COMPLEMENT C1Q                    $58.47
 7006161   COMPLEMENT C2              COMPLEMENT C2                     $68.60
 7006162   COMPLEMENT TOTAL CH50      COMPLMNT TOTAL                    $21.20
 7006163   CRYTOCOCCUS ANTIGEN        CRYPTOCOC ANTIG                   $15.20
 7006166   COMPLEMENT C3 ACTIVATOR    COMPLMNT C-3 AC                   $53.15
 7006168   BLASTOMYCOSIS AB           BLASTOMCOSIS AB                   $13.67
 7006169   BRUCELLOSIS AG(QL)         BRUCELLOS AG(QL                    $8.65
 7006172   COCCIDIOIDOMYCOSIS AB      COCCIDIOIDMC AB                   $17.85
 7006173   CRYPTOCOCCIS AB            CRYPTOCOCCIS AB                   $15.20
 7006174   Q FEVER(COXIELLA BRUNETT   COXIELLA AB                       $20.77
 7006175   THRYOGLOB ANTIBODY         THYROGLOBULN AB                    $6.17
 7006177   LEGIONELLA IFA TITER       LEGIONR TITR                      $85.00
 7006178   LEPTOSPIROSIS              LEPTOSPIROSIS                     $13.67
 7006180   MUMPS                      MUMPS                             $16.81
 7006181   MYCOPLASMA                 MYCOPLASMA                        $13.67
 7006186   COXSACKIE VIRUS            COXSACKIE VIRUS                   $43.52
 7006197   INFLUENZA AB               INFLUENZA AB                      $36.68
 7006204   COCCIDIOIDES IMMUNODIFF    COCCIDIOIDS IMM                   $13.67
 7006215   DESOXYRINUCLEASE AB        DNASE ANTIBODY                    $17.85
 7006220   DNA ANTIBODY DOUBL STRND   DNA ANTIBODY                      $17.16
 7006225   DNA ANTIBODY SNGL STRAND   DNA ANTIBODY                      $23.90
 7006235   EX NUC AB EA               EX NUC AB                         $26.99



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CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 7006250   SJORGEN ANTIBODIES         SJORGEN SSI-SSB                 $75.18
 7006253   VARICELLA ZOSTER           VARICELLA ZOSTE                 $10.35
 7006255   FLUORESCNT SCRN EA AB      FLUR AB SCRN EA                  $6.73
 7006257   LYME DISEASE(CONFIRM)      LYME DISEASE                    $16.83
 7006274   MHA-TP                     MHA-TP                          $10.04
 7006278   RUBELLA TITER              RUBELLA TITER                    $4.33
 7006279   RUBEOLA TITER              RUBEOLA TITER                   $14.50
 7006283   CYSTICERCOSIS IGG          CYSTICERCOS IGG                 $50.16
 7006287   HBS ANTIGEN                HBS-AG                           $7.24
 7006289   HEP B CORE AB(IGG & IGM)   HBC AB(IGG&IGM)                  $8.00
 7006290   PCR HCV QUAL AMP PRB       PCR HCV AMP PRB                $220.00
 7006291   HEPATITIS A AB(IGG&IGM)    HEP A AB IGGIGM                 $11.30
 7006292   HEPATITIS B SURF ANTIBDY   HBS AB                           $8.65
 7006293   HEPATITIS BE ANTIGEN       HEP BE AG                       $10.88
 7006294   HEPATITIS B CORE AB(IGM)   HBC AB(IGM)                     $14.58
 7006296   HEPATITIS BE ANTIBODY      HEPATITIS BE AB                 $10.88
 7006298   HERPES I AB IGG            HERPES I AB IGG                 $13.67
 7006299   HERPES II AB IGG           HERPS II AB IGG                 $13.67
 7006303   HEPATITIS A AB IGM         HEP A AB IGM                    $11.76
 7006304   HEPATITIS C ANTIBODY       HEPATITIS C AB                  $14.46
 7006308   LYME AB WESTERN BLOT SER   LYM AB WST BLT                  $85.00
 7006318   ROTAVIRUS AG EIA           ROTAVIRS AG EIA                 $23.22
 7006320   IEP SERUM                  IEP SERUM                       $47.70
 7006321   HIV POLY CHAIN REACTION    HIV PLY CHN REA                $187.31
 7006322   HIV CONFIRM WESTERN BLOT   HIV CONF WSTBLT                 $98.46
 7006324   RUBELLA VIRUS IGM          RUBELLA VIR IGM                 $18.00
 7006325   IEP OTHR FLUIDS W/CONC     IEP OTHR FLUIDS                 $25.97
 7006329   IMMUNOELECTRO URINE        IMMUNOELEC URIN                $110.20
 7006330   IMMUNODIFF QUAN-EACH       IMMUNODF                        $23.29
 7006332   COMPLEMENT C3              COMPLMNT C3                     $12.30
 7006333   COMPLEMENT C4              COMPLMNT C4                     $11.30
 7006334   COMPLEMENT C-5             COMPLEMENT C-5                  $68.59
 7006340   IMMUNOFIX ELECTPHRS        IMMUNOFIX ELP                   $20.92
 7006343   IMMUNOFIX CSF              IMMUNOFIX CSF                   $29.85
 7006344   IMMUNOFIX URINE            IMMUNOFIX URINE                 $20.92
 7006360   T CELLS T4/T8 INC RATIO    T CELLS T4/T8                   $46.20
 7006377   MICROSOMAL AB(EACH)        MICROSOML AB EA                  $6.17
 7006378   MITOCHONDRIAL AB           MITOCHONDRIL AB                 $13.67
 7006379   SMOOTH MUSCLE AB           SM MUSCLE AB                    $16.53
 7006380   MYOCARDIAL AB              MYOCARDIAL AB                   $17.50
 7006381   CARDIOLIPIN AB QNT         CARDIOLIPIN AB                  $42.63
 7006431   RHEUMATOID FACTOR QUAL     RA FACTOR QUAL                   $4.96
 7006432   RHEUMATOID FACTOR QUANT    RA FACTOR QUANT                  $5.51
 7006592   VDRL/RPR QUAL              VDRL RPR ART QL                  $1.92
 7006594   VDRL-CSF QUAL              VDRL-CSF                         $6.97
 7006598   TISSUE TYPING HLA-B27      TISSUE HLA-B27                  $21.76
 7006600   TOXOPLASMOSIS              TOXOPLASM DYE                   $15.13
 7006650   FTA-ABS                    FTA-ABS                         $10.04
 7006695   H SIMPLEX INDEX 1&2        H SIMPLX IND1&2                 $37.10
 7006701   HIV I AB                   HIV I AB                         $8.23



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CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 7006706   HEP B SURF AB (QUANT)      HEP B AB QUANT                     $8.66
 7006735   MUMPS AB IGG               MUMPS AB IGG                      $16.53
 7006818   IGG SUBCLASSES             IGG SUBCLASSES                    $58.30
 7006900   CANCER ANTIGEN 125         CA-125                            $10.83
 7006906   CHLMYDIA IGM               CHLAMYDIA IGM                     $17.50
 7006907   ASPERGILLUS AB             ASPERGILLS AB                     $18.90
 7006909   TOXOPLSMOSIS IGM AB TITR   TOXPLS IGM AB T                   $21.20
 7006910   CMV AB IGG TITR            CMV IGG TITR                      $15.13
 7006918   CHLAMYDIA PNEUMO IGG AB    CHLAMY PNEU IGG                   $17.50
 7006998   EBV PANEL                  EBV PANEL                         $22.18
 7006999   MISC IMMUN PROC            MISC IMMUN PRC            $1.92 - $220.00
 7007455   INFLUENZA A B AG           INFLUENZAA B AG                   $30.96
 7007466   CSF IGG SYNTHESIS RATE     IGG SYNTHS RATE                   $30.96
 7007468   IGG CSF                    IGG CSF                           $11.58
 7007522   HEP C QUANT                HEP C QUANT                      $103.50
 7007999   MISC MICRO PROC            MISC MICRO PRO            $1.92 - $366.53
 7008232   TISSUE CULTURE             TISS CULT                 $1.92 - $366.53
 7008317   C3 PROACTIVATOR            C3 PROACTIVATOR                   $53.15
 7008320   HISTOCHEM ID ENZYME        HISTOCHEM ID EN           $1.92 - $366.53
 7008752   HSV TYPE 1 & 2 PCR         HSV TYPE 1&2 PC                  $162.00
 7008999   MISC LAB                   MISC LAB                  $1.92 - $366.53
 7010000   4061 OUTSIDE LAB #1        OUTSIDE LAB
 7011099   MISC URINE PROC            MISC URINE PRO           $1.30 - $540.00
 7012726   FERRITIN                   FERRITIN                         $10.00
 7012955   G6PD QUANT                 G6PD QUANT                        $8.80
 7013010   HAPTOGLOBIN                HAPTOGLOBIN                       $9.70
 7013014   GONADTOPN CHORNC(HCG)QNT   GONA CHR(HCG)QN                  $13.00
 7013051   HEMOGLOBIN PLASMA          HEMOGLOB PLASMA                   $5.90
 7013690   LIPASE                     LIPASE                            $4.20
 7014185   PROTEIN BENCE-JONES        PRTN BENCE-JONE                  $19.40
 7014443   TSH                        TSH                              $11.00
 7014540   UREA NITROGEN URINE        UREA NTRGN URIN                   $2.60
 7014584   VALPROIC ACID QUANT        VALPROIC ACID                    $11.00
 7014999   MISC CHEM/TOX PROC         MISC CHEM/TOX            $1.30 - $540.00
 7015999   MISC HEMA PROC             MISC HEMA PROC           $1.30 - $540.00
 7016255   FLUORESCNT SCRN EA AB      FLUR AB SCRN EA                   $9.50
 7016278   RUBELLA TITER              RUBELLA TITER                     $7.40
 7016287   HBS ANTIGEN                HBS-AG                            $7.00
 7016289   HEP B CORE AB(IGG & IGM)   HBC AB                           $11.82
 7016431   RHEUMATOID FACTOR QUAL     RA FACTOR QUAL                    $3.40
 7016592   VDRL/RPR QUAL              VDRL RPR ART QL                   $1.30
 7016999   MISC IMMUN PROC            MISC IMMUN PRC           $1.30 - $540.00
 7017999   MISC MICRO PROC            MISC MICRO PRO           $1.30 - $540.00
 7018267   CHROM ANALY AMNIOTIC FL    KARYOTYPE AMNOT                 $460.00
 7018268   PHILY CHROMOSONE STUDY     PHILY CHROMOSON                 $385.00
 7018999   MISC LAB                   MISC LAB                 $1.30 - $540.00
 7019809   CHRMSM ANALYSIS 5 CELLS    CHRMSM ANALYSIS                 $540.00
 7020000   4061 OUTSIDE LAB #2        OUTSIDE LAB
 7020102   AMPHETAMINE QUAL           AMPHETAMINE QL                  $15.13
 7020297   THC(MARIJUANA) QUANT       THC(MARIJUAN)QN                $123.53



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CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 7021099   MISC URINE PROC            MISC URINE PRO            $1.92 - $366.53
 7022018   CATECHOLAMINES(A-N)URINE   CATECHLAMNS TOT                   $31.24
 7022030   AMP CYCLIC                 AMP CYCLIC                        $37.94
 7022055   ALCOHOL ETHYL              ALCOHOL ETHYL                     $13.67
 7022060   ETHANOL CONFIRM GC/MS      ETOH CONF GC/MS                   $17.48
 7022085   ALDOLASE                   ALDOLASE                           $9.00
 7022087   ALDOSTERONE                ALDOSTERONE                       $37.94
 7022089   ALDOSTERONE URINE          ALDSTERONE URIN                   $41.28
 7022128   AMINO ACIDS QUAL MULT      AMINO ACID QUAL                   $17.50
 7022130   AMINO ACIDS QUANT SNGL     AMINO ACID QUAN                   $15.41
 7022135   ALA(DELTA AMINOLVLN ACID   ALA                               $19.74
 7022175   ARSENIC QUANTITATIVE       ARSENIC QUAN                      $25.73
 7022180   ASCORBIC ACID(VITAMIN C)   ASCORBC ACD-VT                    $12.27
 7022185   BENZODI CONFIRM GC/MS      BENZ CONF GC/MS                   $18.55
 7022208   BARB CONFIRM GC/MS         BARB CONF GC/MS                   $18.55
 7022213   BARBITURATES QUAL          BARBITURATES QL                   $15.13
 7022232   BETA-2-MICROGLOBLN         B-2-MICROGLOB                     $17.85
 7022290   BROMIDES                   BROMIDES                          $10.39
 7022305   CAFFEINE QUAL              CAFFEINE QUAL                     $13.67
 7022390   CERULOPLASMIN              CERULOPLSMN                        $9.76
 7022420   CHLORDIAZEPOXIDE QUANT     CHLORDIAZPXD QN                   $20.71
 7022480   CHOLINESTERASE PSEUDO      CHOLINEST PSEUD                    $9.76
 7022482   CHOLINESTERASE RBC         CHOLINESTER RBC                   $13.67
 7022512   CLONAZEPAM                 CLONAZEPAM                        $19.74
 7022515   COCAINE CONFIRM GC/MS      COCAIN CNF GCMS                   $18.55
 7022525   COPPER                     COPPER                            $10.88
 7022533   CORTISOL TOTAL             CORTISL TOTAL                     $13.00
 7022535   CORTISOL URINE FREE        CORTISL URINFRE                   $67.58
 7022596   CRYOGLOBULINS QUAL         CRYOGLOBULIN QL                    $4.81
 7022600   CYANIDE                    CYANIDE                           $18.62
 7022612   AMINOTC FLD SCAN(SPECTRO   AMINOTC FLD SCN                    $8.72
 7022629   DESIPRAMINE QUANT          DESIPRAMINE                       $17.31
 7022631   DEHYDROEPIANDRST SULFATE   DHEA-S                            $25.04
 7022632   DEHYDROEPIANDRSTRONE       DHEA                              $41.28
 7022660   DRUG SCREEN QUAL           DRUG SCRN QUAL                   $174.15
 7022661   DRUG SCREEN URINE QUAL     DRUG SCRN UR QL                   $19.53
 7022668   ERYTHROPOIETIN             ERYTHROPOIETIN                    $20.79
 7022670   ESTRADIOL                  ESTRADIOL                         $26.78
 7022672   ESTROGENS TOTAL            ESTROGENS TOTAL                   $17.31
 7022673   ESTRIOL                    ESTRIOL                           $15.41
 7022700   FAT OR LIPID FECES QUANT   FT OR LPD FC QN                   $90.87
 7022742   FLURAZEPAM                 FLURAZEPAM                        $16.81
 7022926   GAST ACID FREE&TOTAL EA    GAST ACD F&T EA                   $17.85
 7022934   GIARDIA ANTIGEN EIA        GIARDIA AG EIA                    $36.70
 7022941   GASTRIN                    GASTRIN                           $14.37
 7022943   GLUCAGON                   GLUCAGON                          $23.22
 7022955   G6PD QUANT                 G6PD QUANT                        $14.65
 7022985   FRUCTOSAMINE               FRUCTOSAMINE                      $13.21
 7023001   FOLLICLE STIMLAT HORMONE   FOLCL STIM HORM                    $9.62
 7023003   GROWTH HORMONE(HGH)        HGH                               $14.64



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CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 7023010   HAPTOGLOBIN                HAPTOGLOBIN                       $15.37
 7023015   HEAVY METAL SCR UR         HVY METL SCR UR                  $149.85
 7023020   HEMOGLOBN ELECTRPHORESIS   HEMOGLBN ELCTRO                   $14.02
 7023051   HEMOGLOBIN PLASMA          HEMOGLOB PLASMA                   $13.67
 7023088   HISTAMINE                  HISTAMINE                         $37.94
 7023497   HYDRXINDOL ACD5(HIAA)QT    HYDRXND ACD 5HI                   $13.67
 7023500   HYDRXYPROLINE FREE         HP FREE                           $32.64
 7023523   IMIPRAMINE                 IMIPRAMINE                        $20.08
 7023524   IMMUNE COMPLEX             IMMUNE COMPLEX                   $184.28
 7023525   INSULIN                    INSULIN                           $10.04
 7023835   METANEPHRINES              METANEPHRNS                       $46.03
 7023842   METHADONE CONFIRM GC/MS    MDON CONF GC/MS                   $18.55
 7023855   MEXILETINE QNT             MEXILETINE QN                     $83.03
 7023860   METHOTREXATE QUANT         METHOTREXATE                      $18.62
 7023901   PTH-N-TERMINAL             PTH-N-TERMINAL                    $32.70
 7023903   DISOPYRAMIDE               DISPYRAMIDE                       $15.13
 7023904   NORTRIPTYLINE QUANT        NORTRIPTYLINE                     $13.47
 7023905   NUCLEOTIDASE 5-            NUCLEOTIDASE 5                    $10.04
 7023925   OLIGOCLONAL BANDS          OLIGOCLONL BAND                   $18.90
 7023927   OPIATES QUAL               OPIATES QUAL                      $18.55
 7023945   OXALATE                    OXALATE                           $13.32
 7023970   PARATHORMONE (PTH)         PARATHORMNE                       $34.63
 7023976   C-PEPTIDE                  C-PEPTIDE                         $22.59
 7023992   PHENCYCLIDINE(PCP) QUANT   PCP QUANT                         $84.54
 7024060   PHOSPHATASE ACID TOTAL     PHOSPHT ACD TOT                    $9.76
 7024080   PHOSPHATASE ISO ALK        PHOSPHA ISO ALK                   $12.27
 7024144   PROGESTERONE               PROGESTERONE                      $11.54
 7024146   PROLACTIN                  PROLACTIN                         $13.47
 7024238   VASOACTIVE INTST POLYPEP   VIP                               $41.28
 7024244   RENIN                      RENIN                             $20.08
 7024260   SEROTONIN                  SEROTONIN                         $54.12
 7024408   THC(MARIJUANA) QUAL        THC MARIJUAN QL                   $18.55
 7024430   THIOCYANATE                THIOCYANATE                       $19.74
 7024586   VMA URINE                  VMA URINE                         $15.41
 7024590   VITAMIN A                  VIT A                             $19.74
 7024596   VITAMIN D                  VITAMIN D                         $91.14
 7024600   VOLATILES                  VOLATILES                         $17.02
 7024620   XYLOSE TOLERANCE TEST      XYLOSE ABS TEST                   $28.73
 7024625   LIDOCAINE                  LIDOCAINE                         $16.81
 7024630   ZINC QUANTITATIVE          ZINC QUAN                         $10.88
 7024900   CA 19-9                    CA 19-9                           $12.02
 7024998   CA15-3                     CA15-3                            $12.02
 7024999   MISC CHEM/TOX PROC         MISC CHEM/TOX            $34.32 - $191.98
 7025246   FACTR VIII VW AG CO-FCTR   FACT VIII VW AG                  $366.53
 7025247   FCTR VIII VW MLT CO-FCTR   FCT VIII VW MLT                  $366.53
 7025300   CLOT INHIB ANT-THRMBNIII   CLOT INHIB/ANTI                   $33.00
 7025301   ANTI-THROMBINE 3 AG        ANTI-THROMBIN 3                  $121.50
 7025302   PROTEIN C AG               PROTEIN C AG                     $121.50
 7025379   FDP D-DIMER QNT            FDP D-DMR QN                      $15.00
 7025540   LEUKOCYTE ALKA-PHSPHTASE   LEUK ALK PHOSPH                   $12.55



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CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 7025545   LE CELL PREP               LE CELL PREP                       $9.76
 7025670   THROMBIN TIME PLASMA       THROMBIN PLASMA                    $7.27
 7025820   VISCOSITY SERUM OR PLSMA   VISCOSTY SR-PLS                   $14.37
 7025822   LUPUS ANTICOAGULANT        LUPUS ANTICOAG                    $89.61
 7025999   MISC HEMA PROC             MISC HEMA PROC            $1.92 - $366.53
 7026000   AGGLUTININS FEBRIL EQ QL   AGGLUTNS FEBR E                   $70.88
 7026006   ANTIBODY QUAL 1ST ANTIGN   ANTIBDY QL 1 AN                   $16.11
 7026025   C-REACTIVE PROTEIN QL      C-REACT PRTN QL                    $7.67
 7026040   AMOEBIC AB                 AMOEBIC ANTIBOD                   $18.34
 7026059   ANTI-NEUTRPHL CYTOPLASM    ANCA                             $108.34
 7026157   COMPLEMENT C1Q             COMPLEMENT C1Q                    $58.47
 7026162   COMPLEMENT TOTAL CH50      COMPLMNT TOTAL                    $21.20
 7026163   COMPLEMENT TOTAL CH 100    COMP TOTAL C 10                   $15.20
 7026166   COMPLEMENT C 3 ACTIVATOR   COMPLMNT C-3 AC                   $53.16
 7026168   BLASTOMY COSIS AB          BLASTOMCOSIS AB                   $17.85
 7026169   BRUCELLOSIS AG(QL)         BRUCELLOS AG(QL                    $8.65
 7026170   FEBRILE AGGLUTIN EA QL     FEBRILE AGG EA                    $70.88
 7026172   COCCIDIOIDOMYCOSIS AB      COCCIDIOIDMC AB                   $17.85
 7026174   Q FEVER(COXIELLA BRUNETT   Q FEVER                           $20.77
 7026175   THRYOGLOB ANTIBODY         THYROGLOBULN AB                   $14.02
 7026177   LEGIONELLA IFA TITER       LEGIONR D TITR                    $85.00
 7026178   LEPTOSPIROSIS              LEPTOSPIROSIS                     $13.67
 7026197   INFLUENZA                  INFLUENZA                         $36.82
 7026204   COCCIDIOIDES IMMUNODIFF    COCCIDIOIDS IMM                   $13.67
 7026215   DESOXYRINUCLEASE AB        DN ASE ANTIBODY                   $17.85
 7026220   DNA ANTIBODY DBL STRAND    DNA AB DBL                        $17.16
 7026225   DNA ANTIBODY SNGL STRAND   DNA ANTIBODY                      $23.90
 7026235   ENA ANTIBODY TEST          ENA ANTIBODY                      $80.00
 7026250   SJORGEN ANTIBODIES         SJORGEN SSI-SSB                   $75.18
 7026255   FLUORESCNT SCRN EA AB      FLUR AB SCRN EA                    $6.73
 7026257   LYME DISEASE               LYME DISEASE                      $16.83
 7026264   PANCREATIC POLYPEPTIDE     PANCRTC POLYPEP                  $119.25
 7026270   CYSTICERCOSIS IGG          CYSTICERCOS IGG                   $50.16
 7026274   MHA-TP                     MHA-TP                            $10.88
 7026278   RUBELLA TITER              RUBELLA TITER                      $4.81
 7026279   RUBEOLA TITER              RUBEOLA TITER                     $16.11
 7026284   RUBELLA                    RUBELLA IGM                       $26.50
 7026287   HBS ANTIGEN                HBS-AG                             $7.00
 7026290   HAV ANTIBODY(IGG & IGM)    HAV AB                            $12.55
 7026292   HEPATITIS B SURF ANTIBDY   HBS AB                             $8.00
 7026293   HEPATITIS BE ANTIGEN       HBE AG                            $10.88
 7026298   HERPES I AB IGG            HERPES I AB IGG                   $13.67
 7026299   HERPES II AB IGG           HERPS II AB IGG                   $14.39
 7026304   HEPATITIS C ANTIBODY       HEPATITIS C AB                    $12.00
 7026318   ROTAVIRUS AG EIA           ROTAVIRS AG EIA                   $23.22
 7026320   IEP SERUM                  IEP SERUM                         $47.70
 7026324   RUBELLA VIRUS IGM EIA      RUBELLA VIR IGM                   $26.50
 7026325   IEP EXCPT SERUM            IEP EX SERUM                      $25.97
 7026330   IMMUNODIFF QUAN-EACH       IMMUNODF                          $23.29
 7026334   COMPLEMENT C-5             COMPLEMENT C-5                    $68.60



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  Doctors Medical Center - Modesto                                            Page 114 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 7026377   MICROSOMAL AB(EACH)        MICROSOML AB EA                   $14.02
 7026378   MITOCHONDRIAL AB           MITOCHONDRIL AB                   $13.67
 7026379   SMOOTH MUSCLE ANTIBODY     SM MUSCLE AB                      $16.53
 7026380   MYOCARDIAL AB              MYOCARDIAL AB                     $81.00
 7026381   CARDIOLIPIN AB QNT         CARDIOLIPIN AB                    $43.79
 7026431   RHEUMATOID FACTOR QUAL     RA FACTOR QUAL                     $5.51
 7026592   VDRL/RPR QUAL              VDRL RPR ART QL                    $1.92
 7026594   VDRL-CSF                   VDRL-CSF                           $6.97
 7026598   TISSUE TYPING HLA-B27      TISSUE HLA-B27                    $21.76
 7026600   TOXOPLASMOSIS              TOXOPLASM DYE                     $15.13
 7026650   FTA-ABS                    FTA-ABS                           $10.04
 7026701   HIV 1 AB                   HIV 1 AB                           $8.50
 7026818   IGG SUBCLASSES             IGG SUBCLASSES                    $58.30
 7026894   PROTEIN S ASSAY            PROTEIN S ASSAY                  $121.50
 7026900   CARBOHYDRATE ANTIGEN 125   CA 125                            $12.02
 7026903   CHLAMYDIA SEROLOGY AB      CHLAMYDIA CF                      $17.50
 7026906   CHLAMYDIA IGM BY IFA       CHLAMYDIA TITR                    $17.50
 7026907   ASPERGILLUS AB QL          ASPERGILL AB QL                   $18.90
 7026918   CHLAMYDIA PNEUM SERO AB    CHLMYDIA PNEM S                   $67.00
 7026940   ACUTE LEUKEMIA EVAL        ACUTE LEUK SK                    $306.79
 7026998   EBV PANEL SPEC LAB         EBV PANEL SPEC                    $37.88
 7026999   MISC IMMUN PROC            MISC IMMUN PRC            $1.92 - $366.53
 7027999   MISC MICRO PROC            MISC MICRO PRO            $1.92 - $366.53
 7028999   MISC LAB                   MISC LAB                  $1.92 - $366.53
 7029399   AMIODARONE QUAL HPLC       AMIODRN QL HPLC                   $33.47
 7030000   4061 OUTSIDE LAB #3        OUTSIDE LAB
 7032024   ACTH                       ACTH                             $134.00
 7032030   AMP.CYCLIC                 AMP CYCLIC                       $124.00
 7032330   CALCIUM IONIZED            CALCIUM ION                       $49.00
 7032340   CALCIUM URINE QUAN         CALC URINE QUAN                   $49.00
 7032533   CORTISOL TOTAL             CORTISL TOTAL                     $51.00
 7033531   THYROXINE FREE             THYROXINE FREE                    $62.00
 7033970   PARATHORMONE (PTH)         PARATHORMNE                      $120.00
 7034443   TSH                        TSH                               $62.00
 7034594   VITAMIN D1 25-DIHYDROXY    VIT D1 25DIHYDR                  $161.00
 7034595   VITAMIN D/25-HYDROXY       VIT D/25-HYDROX                  $155.00
 7034999   MISC CHEM/TOX PROC         MISC CHEM/TOX            $35.00 - $166.00
 7035999   MISC HEMA PROC             MISC HEMA PROC           $35.00 - $166.00
 7036192   ENCEPHALITIS AB CA(LCROS   ENCEPHLTS AB CA                  $166.00
 7036209   CYTOXIC SCREEN             CYTOXIC SCREEN                    $36.00
 7036256   FLUORESCNT TITR EA AB      FANA TITR EA AB                   $35.00
 7036257   LYME DISEASE               LYME DISEASE                      $65.00
 7036999   MISC IMMUN PROC            MISC IMMUN PRC           $35.00 - $166.00
 7037999   MISC MICRO PROC            MISC MICRO PRO           $35.00 - $166.00
 7038999   MISC LAB                   MISC LAB                 $35.00 - $166.00
 7040000   4061 OUTSIDE LAB #4        OUTSIDE LAB
 7046999   MISC IMMUN PROC            MISC IMMUN PRC            $34.00 - $40.00
 7047421   IMMUNODIFFUSION GEL QUAL   IMMUNDIF GEL QL                   $34.00
 7047452   COCCIDIOIDES SER CF        COCCIDIOIDES SE                   $40.00
 7048999   MISC LAB                   MISC LAB                  $34.00 - $40.00



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  Doctors Medical Center - Modesto                                            Page 115 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 7050000   4061 OUTSIDE LAB #5        OUTSIDE LAB
 7052662   IMMUNOASSAY NON-RIA        IMMUNASSY NONRI                   $45.00
 7052731   FETAL FIBRONECTIN          FETAL FIBRONECT                  $230.00
 7054999   MISC CHEM/TOX PROC         MISC CHEM/TOX            $45.00 - $230.00
 7056410   PROFILE BREAST CANCER      PROFL BRST CANC                  $250.00
 7058999   MISC LAB                   MISC LAB                 $45.00 - $230.00
 7060000   4061 OUTSIDE LAB #6        OUTSIDE LAB
 7061099   MISC URINE PROC            MISC URINE PRO            $7.50 - $301.75
 7062174   APOLIPOPROTEIN AI          APOLIPOPROTN A                   $125.00
 7062372   CARBAMAZAPINE              CARBAMAZEPINE                     $75.00
 7062553   CK MB FRACTION             CKMB ISO FRACTN                   $76.50
 7062661   DRUG SCREEN URINE QUAL     DRUG SCRN UR QL                  $301.75
 7062662   IMMUNOASSAY NON-RIA        IMMUNASSY NONRI                  $125.00
 7062673   ESTRIOL                    ESTRIOL                           $90.00
 7063089   HOMOCYSTINE QUANT          HOMOCYST QUAN                     $65.00
 7063725   LITHIUM QUANTITATIVE       LITHIUM QUAN                      $49.75
 7063851   BCR/ABL BY PCR             BCR/ABL B PCR                     $34.62
 7063868   A-2 MACROGLOBULIN          A-2 MACROGLOBLN                   $34.62
 7063869   NUC MOLC ENZ DIAG          NMD ENZYMATIC                      $7.50
 7063911   NUC MOLEC DNA PROBE        NMD DNA PROBE                      $7.50
 7063912   NUC MOLC DIAG INTRP/RPT    NMD INTERP/RPT                     $7.50
 7063923   RNA MOLE ISOLATION         RNA MOLE ISOL                      $7.50
 7063924   MOLE MUTATION SCANNING     MOLE MUTATN SCN                    $7.50
 7063934   SEPARATION GEL ELECTRO     SEPARATE GEL EL                   $34.63
 7063952   MUT ID BY ALLELE           MUT ID BY ALLEL                    $7.50
 7064176   PROTEIN S TOTAL            PROTEIN S TOTAL                   $75.00
 7064480   TRICYCLIC DRUGS QUAL       TRYCYCL DRUG QL                   $25.00
 7064999   MISC CHEM/TOX PROC         MISC CHEM/TOX           $136.00 - $720.00
 7065170   CLOT RETRACTION            CLOT RETRAC                       $35.00
 7065210   CLOT FACTOR II PRTHRMBN    CLOT FACTOR II                   $125.00
 7065220   CLOT FACTOR V (LABILE)     CLOT FACTOR V                    $125.00
 7065230   CLOT FACTOR VII(STABLE)    CLOT FACTOR VII                  $125.00
 7065232   FACTOR VII ANTIGEN         FACTOR VII AG                    $110.00
 7065240   CLOT FCTR VIII(AHG)1 STG   CLOT FCTOR VIII                   $85.00
 7065245   FACTR VIII RISTO CO-FCTR   FACT VIII RISTO                  $103.00
 7065246   FACTR VIII VW AG CO-FCTR   FACT VIII VW AG                  $100.00
 7065247   FCTR VIII VW MLT CO-FCTR   FCT VIII VW MLT                  $195.00
 7065250   CLOT FCTR IX(PTC/XMAS)     CLOT FACTOR IX                   $125.00
 7065260   CLOT FCTR X(STUART-PRWR)   CLOT FACTOR X                    $125.00
 7065270   CLOT FCTR XI(PTA)          CLOT FACTOR XI                   $125.00
 7065280   CLOT FCTR XII(HAGEMANN)    CLOT FACTOR XII                  $125.00
 7065290   CLOT FCTR XIII(FBRN STB)   CLOT FACTOR XII                  $150.00
 7065300   CLOT INHIB ANT-THRMBNIII   CLOT INHIB/ANTI                   $90.00
 7065301   ANTI-THROMBIN III AG       ANTI-THROMBIN 3                   $33.00
 7065302   PROTEIN C AG               PROTEIN C AG                     $125.00
 7065303   PROTEIN C ACTIVITY         PROTEIN C ACTIV                  $105.00
 7065306   PROTEIN S ACTIVITY         PROTEIN S ACTVT                  $120.00
 7065307   PROTEIN C RESIST           PROTEIN C RES                     $80.00
 7065330   FACTOR INHIB TEST          CLOT FACTO                       $190.00
 7065335   FACTOR INHIBITOR           FACTOR INHIBIR                   $168.00



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  Doctors Medical Center - Modesto                                            Page 116 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 7065360   EUGLOBULIN LYSIS           EUGLOBULIN LYSI                   $65.00
 7065370   FDP/FSP QUANT              FDP/FSP QUANT                     $45.00
 7065384   FIBRINOGEN ACTIVITY        FIBRINOGN ACTIV                   $35.00
 7065415   FIBRNOLTIC PLSMNOGEN ACT   FIBRNL PLSM ACT                  $150.00
 7065420   FIBRNOLYTIC PLASMINOGEN    FIBRINLYTC PLAS                  $105.00
 7065520   HEPARIN ASSAY              HEPARIN ASSAY                    $195.00
 7065577   PLT AGG EA AGENT           PLT AGG EA AGN                    $60.00
 7065597   PLATELET NEUTRALIZATION    PLTLT NEUTRLZTN                   $83.00
 7065610   PROTHROMBIN TIME           PROTHROM TIME                     $25.00
 7065613   RUSSL VIPR VEN TIME(DIL)   RUS VIP TIME(DI                   $43.00
 7065616   PROTHROMBIN CONSUMPTION    PROTHROM CONSUM                  $150.00
 7065619   LUPUS ANTICOAG II          LUPUS ANTCOG II                  $195.00
 7065620   LUPUS ANTICOAG I           LUPUS ANTCOAG I                  $165.00
 7065635   REPTILASE TEST             REPTILASE TEST                   $100.00
 7065670   THROMBIN TIME PLASMA       THROMBIN PLASMA                   $50.00
 7065730   PTT                        PTT PLASM                         $30.00
 7065732   PTT SUB EA FRACTION        PTT SUB EA FRCT                   $50.00
 7065999   MISC HEMA PROC             MISC HEMA PROC            $7.50 - $301.75
 7066017   HEPARIN INDUCED PLT AB     HEPARN IND PL A                   $60.00
 7066036   PLAT AB DIR                PLAT AB DIR                      $165.00
 7066381   CARDIOLIPIN AB QNT         CARDIOLIPIN AB                    $41.67
 7066382   ANTI-CARDIOLIPIN AB IGG    CARDIOLIPIN IGG                   $41.67
 7066385   CARDIOLIPIN IGA AB         CARDIOLIPIN IGA                   $41.67
 7066386   ANTI-CARDIOLIPIN AB IGM    CARDIOLIPIN IGM                   $41.67
 7068999   MISC LAB                   MISC LAB                  $7.50 - $301.75
 7069363   CRYSTALS SYNOVIAL FLUID    SYN FLUID CRYST                   $45.00
 7070000   4061 OUTSIDE LAB #7        OUTSIDE LAB
 7074999   MISC CHEM/TOX PROC         MISC CHEM/TOX            $25.00 - $180.00
 7075999   MISC HEMA PROC             MISC HEMA PROC           $25.00 - $180.00
 7076012   ANTIBDY ABSORP EA SERUM    AB ABSORP                        $130.00
 7076024   ANTIBDY IDENT RBC EA PNL   ANTBD RBC EA PN                  $150.00
 7076170   FEBRILE AGGLUTIN EA QL     FEBRILE AGG EA                   $180.00
 7076210   COMP TST EA UT SPIN TECH   COMP TST SPN TC                   $25.00
 7076211   COMP TST EA UT INCUB TCH   COMP TST INC TC                   $25.00
 7076212   COMP TST EA UT AHG TECH    COMP TST AHG TC                   $85.00
 7076925   BLD TYP AG SCR EA UNIT     BLD TYP AG SCR                    $40.00
 7076999   MISC IMMUN PROC            MISC IMMUN PRC           $15.00 - $760.00
 7078999   MISC LAB                   MISC LAB                 $25.00 - $180.00
 7079060   CMV(HAI)                   CMV                               $30.00
 7080000   4061 OUTSIDE LAB #8        OUTSIDE LAB
 7080113   DRUG SCREEN/MECONIUM       DRUG SCRN/MEC                    $95.00
 7084030   PHENYLALANINE PKU BLOOD    PKU BLOOD                         $1.00
 7084032   PHENYLKETONES QUAL         PHENYLKETNS QL                    $1.00
 7088999   MISC LAB                   MISC LAB                        $149.00
 7090000   4061 OUTSIDE LAB #9        OUTSIDE LAB
 7092360   CALCULUS QUANT CHEMICAL    CALCULUS QN CHE                  $25.50
 7098999   MISC LAB                   MISC LAB                         $25.50
 7100000   4061 OUTSIDE LAB #10       OUTSIDE LAB
 7100020   CMV CULT EXCEPT URINE      CMV CULT                         $52.65
 7106059   ANTI-NEUTRPHL CYTOPLASM    ANCA                             $78.00



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  Doctors Medical Center - Modesto                                            Page 117 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 7106265   VARICELLA IMMUNITY         VARICELLA IMMUN                   $44.20
 7106630   CHLAMYDIA DFA              CHLAMYDIA DFA                     $38.50
 7106999   MISC IMMUN PROC            MISC IMMUN PRC           $13.00 - $174.20
 7107024   CULTURE GENITAL            CULT GENITAL                      $13.00
 7107084   HERPES CULTURE             HERPES CULTURE                    $41.25
 7107109   CULTURE MYCOPLASMA ANY     CULT MYCOPLASMA                   $66.00
 7107110   CULTURE CHLAMYDIA          CHLAMYDIA CULT                    $75.40
 7107116   CULTURE AFB                CULT AFB                          $49.00
 7107118   CULTURE AFB IDENT          CULT AFB IDENT                    $39.00
 7107177   OVA&PARASITES SMEARS       OVA/PARAS SMEAR                   $31.20
 7107178   CRYPTOSPORIDIUM            CRYPTOSPORIDIUM                   $67.00
 7107195   AFB PRIMARY MIC            AFB PRIMARY MIC                   $52.00
 7107196   AFB RAPID GROWER MIC       AFB RAPD GRW MI                   $84.00
 7107197   AFB SECONDARY MIC          AFB SECNDRY MIC                   $70.00
 7107198   AFB MAC MIC                AFB MAC MIC                      $100.00
 7107210   WET MOUNT                  WET MOUNT                         $74.00
 7107250   VIRUS INOCULATION          VIRUS INOCULATN                   $62.15
 7107265   BORDETELLA PERTUSSIS DFA   BORD PERT DFA                     $70.00
 7107497   CYTOMEGALOVIRUS AMPL PRB   CYTOMEG AMP PRB                  $174.20
 7107556   MTB DNA BY PCR             MTB DNA BY PCR                   $174.20
 7107999   MISC MICRO PROC            MISC MICRO PRO           $16.53 - $650.00
 7108330   SPEC STAINS GROUP I        SPEC STN GRP I                    $31.20
 7108999   MISC LAB                   MISC LAB                 $13.00 - $174.20
 7109356   TISS CULT INOC/OBSERV      OTHR VIRUS CULT                   $53.00
 7109357   TISS CULT ADD STUDIES      OTHR VIRUS CULT                   $53.00
 7110000   4061 OUTSIDE LAB #11       OUTSIDE LAB
 7111099   MISC URINE PROC            MISC. URINE PRO          $20.00 - $118.00
 7114999   MISC CHEM/TOX PROC         MISC CHEM/TOX            $20.00 - $118.00
 7115999   MISC HEMA PROC             MISC HEMA PROC           $20.00 - $118.00
 7116253   VARICELLA ZOSTER           VARICELLA ZOSTE                   $20.00
 7116265   VARICELLA IMMUNITY         VARICELLA IMMUN                   $20.00
 7116313   POLY CHAIN REACTION        POLY CHAIN REAC                  $118.00
 7116902   CHLAMYDIA AG               CHLAMYDIA AG                      $20.00
 7116999   MISC IMMUN PROC            MISC IMMUN PRC           $20.00 - $118.00
 7117077   CLOSTRIDIUM DIFF TOXIN     C.DIF TOX TS CL                   $30.00
 7117109   CULTURE MYCOPLASMA ANY     CULT MYCOPLASMA                   $25.00
 7117110   CHLAMYDIA CULTURE          CHLAMYDIA CULTU                   $30.00
 7117139   DNA PCR AFB/TB             DNA PCR AFB/TB                   $118.00
 7117250   VIRUS INOCULATION          VIRUS INOCULATN                   $65.00
 7117910   MICROBIAL ID NUCL ACID     MICR ID NUC AC                   $118.00
 7117999   MISC MICRO PROC            MISC MICRO PRO           $20.00 - $118.00
 7119356   TISS CULT INOC/OBSERV      OTHR VIRUS CULT                   $65.00
 7119362   TISS CULT ADD STUDIES      CMV ADDL STDY                     $40.00
 7120000   4061 OUTSIDE LAB #12       OUTSIDE LAB
 7120102   AMPHETAMINE QUAL           AMPHETAMINE QL                    $15.13
 7120297   THC(MARIJUANA) QUANT       THC(MARIJUAN)QN                  $123.53
 7121099   MISC URINE PROC            MISC URINE PROC         $3.37 - $1,693.78
 7122018   CATECHOLAMINES(A-N)URINE   CATECHLAMNS TOT                   $31.24
 7122019   CATECHOLAMINES TOTAL BLD   CATECHL TOT BLD                   $32.95
 7122024   ACTH                       ACTH                              $37.94



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CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 7122030   AMP CYCLIC                 AMP CYCLIC                      $37.94
 7122060   ETHANOL CONFIRM GC/MS      ETOH CONF GC/MS                 $17.48
 7122085   ALDOLASE                   ALDOLASE                         $9.00
 7122087   ALDOSTERONE                ALDOSTERONE                     $37.94
 7122089   ALDOSTERONE URINE          ALDSTERONE URIN                 $41.28
 7122124   AMIKACIN                   AMIKACIN                        $12.02
 7122128   AMINO ACIDS QUAL MULT      AMINO ACID QUAL                 $18.42
 7122130   AMINO ACIDS QUANT SNGL     AMINO ACID QUAN                 $15.41
 7122135   ALA(DELTA AMINOLVLN ACID   ALA                             $19.74
 7122138   AMITRYPTALINE QUANT        AMITRYPTALINE                   $18.34
 7122140   AMMONIA                    AMMONIA                         $16.81
 7122164   ANGIOTENSIN CONV ENZYME    ANGIOTNS CN ENZ                 $15.13
 7122180   ASCORBIC ACID(VITAMIN C)   ASCORBC ACD-VT                  $12.27
 7122185   BENZODI CONFIRM GC/MS      BENZ CONF GC/MS                 $18.55
 7122210   BARBITURATE IDENT/QUAN     BARBS IDENT/QUA                 $18.10
 7122213   BARBITURATES QUAL          BARBITURATES QL                 $15.13
 7122232   BETA-2-MICROGLOBLN         B-2-MICROGLOB                   $17.85
 7122290   BROMIDES                   BROMIDES                        $10.39
 7122305   CAFFEINE QUAL              CAFFEINE QUAL                   $13.67
 7122307   CANNABIN CONFIRM GC/MS     CANN CONF GC/MS                 $18.55
 7122308   CALCITONIN                 CALCITONIN                      $28.17
 7122312   CAFFEINE QUANT             CAFFEINE QUANT                  $13.67
 7122330   CALCIUM IONIZED            CALCIUM ION                     $15.41
 7122372   CARBAMAZAPINE              CARBAMAZEPINE                    $9.62
 7122380   CAROTENE                   CAROTENE                        $12.27
 7122390   CERULOPLASMIN              CERULOPLSMN                      $9.76
 7122480   CHOLINESTERASE PSEUDO      CHOLINEST PSEUD                  $9.76
 7122482   CHOLINESTERASE RBC         CHOLINESTER RBC                 $13.67
 7122512   CLONAZEPAM                 CLONAZEPAM                      $19.74
 7122515   COCAINE CONFIRM GC/MS      COCAIN CNF GCMS                 $18.55
 7122525   COPPER                     COPPER                          $10.88
 7122533   CORTISOL TOTAL             CORTISL TOTAL                   $13.00
 7122535   CORTISOL URINE FREE        CORTISL URINFRE                 $67.58
 7122595   CRYOGLOBULINS QUAN         CRYOGLOBULIN QN                  $4.81
 7122600   CYANIDE                    CYANIDE                         $18.62
 7122611   CYANOCOBLMN(VIT B12)       VIT B12                          $9.14
 7122612   AMINOTC FLD SCAN(SPECTRO   AMINOTC FLD SCN                  $9.06
 7122613   CYCLOSPORINE QUANT         CYCLOSPORINE                    $26.45
 7122629   DESIPRAMINE QUANT          DESIPRAMINE                     $17.31
 7122631   DEHYDROEPIANDRST SULFATE   DHEA-S                          $25.04
 7122632   DEHYDROEPIANDRSTRONE       DHEA                            $41.28
 7122660   DRUG SCREEN QUAL           DRUG SCRN QUAL                 $174.15
 7122661   DRUG SCREEN URINE QUAL     DRUG SCRN UR QL                 $19.53
 7122668   ERYTHROPOIETIN             ERYTHROPOIETIN                  $83.03
 7122670   ESTRADIOL                  ESTRADIOL                       $26.78
 7122672   ESTROGENS TOTAL            ESTROGENS TOTAL                 $17.31
 7122673   ESTRIOL                    ESTRIOL                         $17.85
 7122700   FAT OR LIPID FECES QUANT   FT OR LPD FC QN                 $90.87
 7122726   FERRITIN                   FERRITIN                         $8.42
 7122731   FETAL FIBRONECTIN          FETAL FIBRONECT                $212.00



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CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 7122742   FLURAZEPAM                 FLURAZEPAM                      $16.81
 7122746   FOLIC ACID                 FOLIC ACID                       $9.14
 7122747   FOLIC ACID RBC             FOLIC ACID RBC                  $22.87
 7122926   GAST ACID FREE&TOTAL EA    GAST ACD F&T EA                 $17.85
 7122941   GASTRIN                    GASTRIN                         $13.00
 7122943   GLUCAGON                   GLUCAGON                        $23.22
 7122955   G6PD QUANT                 G6PD QUANT                      $14.65
 7122985   FRUCTOSAMINE               FRUCTOSAMINE                    $13.21
 7122994   HEMOGLOBIN GLYCATED        HEMOGLOBN GLYCT                  $7.21
 7123001   FOLLICLE STIMLAT HORMONE   FOLCL STIM HORM                  $9.62
 7123002   LUTEINING HORMONE          LUTEINING HORMN                  $9.62
 7123003   GROWTH HORMONE(HGH)        HGH                             $14.64
 7123010   HAPTOGLOBIN                HAPTOGLOBIN                     $14.50
 7123015   HEAVY METAL SCR UR         HVY METL SCR UR                $149.85
 7123020   HEMOGLOBN ELECTRPHORESIS   HEMOGLBN ELCTRO                 $14.02
 7123051   HEMOGLOBIN PLASMA          HEMOGLOB PLASMA                 $13.67
 7123088   HISTAMINE                  HISTAMINE                       $37.94
 7123497   HYDRXINDOL ACD5(HIAA)QT    HYDRXND ACD 5HI                 $13.67
 7123512   IG-A SERUM                 IG-A SERUM                       $9.65
 7123513   IMMUNOGLOBULINS E SERUM    IG-E SERUM                      $14.02
 7123514   IG-G SERUM                 IG-G SERUM                       $8.65
 7123515   IG-M SERUM                 IG-M IMMUND SER                  $8.65
 7123523   IMIPRAMINE                 IMIPRAMINE                      $20.88
 7123524   IMMUNE COMPLEX             IMMUNE COMPLEX                 $184.28
 7123525   INSULIN                    INSULIN                         $10.04
 7123531   THYROXINE FREE             THYROXINE FREE                  $13.47
 7123537   THYROXINE TOTAL            THYROXIN TOTAL                   $3.37
 7123539   TRIIODTHYRNINE TOTAL T3    TRIIODTH TOT T3                 $11.06
 7123605   LACTATE(LACTIC ACID)       LACTATE                         $14.64
 7123655   LEAD QUANTITATIVE          LEAD QUAN                        $9.41
 7123690   LIPASE                     LIPASE                           $7.18
 7123725   LITHIUM QUANTITATIVE       LITHIUM QUAN                     $5.29
 7123835   METANEPHRINES              METANEPHRNS                     $46.03
 7123842   METHADONE CONFIRM GC/MS    MDON CONF GC/MS                 $18.55
 7123855   MEXILETINE QUANT           MEXILETINE QN                   $83.03
 7123860   METHOTREXATE QUANT         METHOTREXATE                    $18.62
 7123875   MYOGLOBIN URINE            MYOGLOBIN URINE                 $16.53
 7123901   PTH-N-TERMINAL             PTH-N-TERMINAL                  $32.70
 7123902   PTH INTACT                 PTH INTACT                      $27.69
 7123903   DISOPYRAMIDE QUAL          DISPYRAMIDE QL                  $15.13
 7123904   NORTRIPTYLINE QUANT        NORTRIPTYLINE                   $13.47
 7123905   NUCLEOTIDASE 5-            NUCLEOTIDASE 5                  $10.04
 7123928   OPIATES CONFIRM GC/MS      OPIAT CONF GCMS                 $18.55
 7123945   OXALATE                    OXALATE                         $13.32
 7123970   PARATHORMONE (PTH)         PARATHORMNE                     $34.63
 7123976   C-PEPTIDE                  C-PEPTIDE                       $22.59
 7124060   PHOSPHATASE ACID TOTAL     PHOSPHT ACD TOT                  $8.02
 7124066   PHOSPHATASE PROSTATE       PAPHOSPHATASE                    $9.76
 7124080   PHOSPHATASE ISO ALK        PHOSPHA ISO ALK                 $12.27
 7124141   MYSOLINE                   MYSOLINE                        $16.53



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  Doctors Medical Center - Modesto                                       Page 120 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 7124144   PROGESTERONE               PROGESTERONE                       $11.54
 7124146   PROLACTIN                  PROLACTIN                          $13.47
 7124165   PROTEIN ELCTRC SERUM QN    PROTEIN ELCT QN                    $10.88
 7124166   PRE-ALBUMIN                PRE-ALBUMIN                        $16.53
 7124191   PROTEIN ELCTRO URINE       PROTEIN ELCT UR                    $13.81
 7124238   VASOACTIVE INTST POLYPEP   VIP                                $41.28
 7124244   RENIN                      RENIN                              $20.08
 7124260   SEROTONIN                  SEROTONIN                          $54.12
 7124403   TESTOSTERONE TOTAL         TESTOSTER TOTL                     $24.69
 7124408   THC(MARIJUANA) QUAL        THC MARIJUAN QL                    $18.55
 7124430   THIOCYANATE                THIOCYANATE                        $20.77
 7124462   TRANSFERRIN                TRANSFERRIN                        $12.27
 7124584   VALPROIC ACID QUANT        VALPROIC ACID                       $9.59
 7124586   VMA URINE                  VMA URINE                          $15.41
 7124588   VASOPRESSIN (ADH)          VASOPRESSIN(ADH                    $41.28
 7124590   VITAMIN A                  VIT A                              $19.74
 7124620   XYLOSE TOLERANCE TEST      XYLOSE ABS TEST                    $28.73
 7124625   LIDOCAINE                  LIDOCAINE                          $16.81
 7124630   ZINC QUANTITATIVE          ZINC QUAN                          $10.88
 7124900   CA 19-9                    CA 19-9                            $12.01
 7124998   CA15-3                     CA15-3                             $12.02
 7124999   MISC CHEM/TOX PROC         MISC CHEM/TOX          $100.00 - $2,755.00
 7125220   CLOT FACTOR V (LABILE)     CLOT FACTOR V                     $112.39
 7125230   CLOT FACTOR VII(STABLE)    CLOT FACTOR VII                   $112.39
 7125245   FACTR VIII RISTO CO-FCTR   FACT VIII RISTO                   $112.39
 7125246   FACTR VIII VW AG CO-FCTR   FACT VIII VW AG                   $366.53
 7125300   CLOT INHIB ANT-THRMBNIII   CLOT INHIB/ANTI                   $241.99
 7125301   ANTI-THROMBINE 3 AG        ANTI-THROMBIN 3                   $241.99
 7125302   PROTEIN C AG               PROTEIN C AG                      $121.50
 7125379   FDP D-DIMER QNT            FDP D-DMR QN                       $15.00
 7125540   LEUKOCYTE ALKA-PHSPHTASE   LEUK ALK PHOSPH                    $12.55
 7125545   LE CELL PREP               LE CELL PREP                        $9.76
 7125670   THROMBIN TIME PLASMA       THROMBIN PLASMA                     $7.27
 7125820   VISCOSITY SERUM OR PLSMA   VISCOSTY SR-PLS                    $14.37
 7125822   LUPUS ANTICOAGULANT        LUPUS ANTICOAG                     $89.63
 7125999   MISC HEMA PROC             MISC HEMA PROC           $3.37 - $1,693.78
 7126006   ANTIBODY QUAL 1ST ANTIGN   ANTIBDY QL 1 AN                    $16.11
 7126025   C-REACTIVE PROTEIN QL      C-REACT PRTN QL                     $7.67
 7126040   AMOEBIC AB                 AMOEBIC ANTIBOD                    $18.34
 7126041   ANTINUCLEAR AB(ANA)TITER   ANTINCL AB TITR                     $6.73
 7126059   ANTI-NEUTRPHL CYTOPLASM    ANCA                              $108.34
 7126060   ANTI-STREPTOLYSN O TITER   ASO TITER                           $7.18
 7126151   CARCINO-EMBRYONIC AG       CEA                                 $9.62
 7126157   COMPLEMENT C1Q             COMPLEMENT CIQ                     $58.47
 7126162   COMPLEMENT TOTAL CH50      COMPLMNT TOTAL                     $21.20
 7126166   COMPLEMENT C-3 ACTIVATOR   COMPLMNT C-3ACT                    $53.16
 7126168   BLASTOMY COSIS AB          BLASTOMCOSIS AB                    $17.85
 7126169   BRUCELLOSIS AG(QL)         BRUCELLOS AG(QL                     $8.65
 7126170   FEBRILE AGGLUTIN EA QL     FEBRILE AGG EA                     $70.88
 7126172   COCCIDIOIDOMYCOSIS AB      COCCIDIOIDMC AB                    $17.85



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CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 7126174   Q FEVER(COXIELLA BRUNETT   Q FEVER                         $20.77
 7126177   LEGIONELLA IFA TITER       LEGIONR D TITR                  $85.00
 7126178   LEPTOSPIROSIS              LEPTOSPIROSIS                   $13.67
 7126180   MUMPS                      MUMPS                           $16.53
 7126181   MYCOPLASMA                 MYCOPLASMA                      $13.67
 7126197   INFLUENZA                  INFLUENZA                       $36.82
 7126204   COCCIDIOIDES IMMUNODIFF    COCCIDIOIDS IMM                 $13.67
 7126215   DESOXYRINUCLEASE AB        DN ASE ANTIBODY                 $17.85
 7126225   DNA ANTIBODY SNGL STRAND   DNA ANTIBODY                    $23.90
 7126235   ENA ANTIBODY TEST          ENA ANTIBODY                    $75.18
 7126240   ANTI-SMITH ANTIBODY        ANTI-SMITH AB                   $14.39
 7126250   SJORGEN ANTIBODIES         SJORGEN SSI-SSB                 $75.18
 7126255   FLUORESCNT SCRN EA AB      FLUR AB SCRN EA                  $6.73
 7126257   LYME DISEASE               LYME DISEASE                    $16.83
 7126278   RUBELLA TITER              RUBELLA TITER                    $4.86
 7126279   RUBEOLA TITER              RUBEOLA TITER                   $16.11
 7126286   HAA W/CONCENTRATN-SERUM    HAA W/CONC SRM                  $16.75
 7126287   HBS ANTIGEN                HBS-AG                           $7.00
 7126289   HEP B CORE AB(IGG & IGM)   HBC AB                          $10.88
 7126290   HAV ANTIBODY(IGG & IGM)    HAV AB                          $12.00
 7126292   HEPATITIS B SURF ANTIBDY   HBS AB                           $8.00
 7126293   HEPATITIS BE ANTIGEN       HBE AG                          $10.88
 7126298   HERPES I AB IGG            HERPES I AB IGG                 $13.67
 7126299   HERPES II AB IGG           HERPS II AB IGG                 $14.39
 7126303   HEPATITIS A AB IGM         HEP A AB IGM                    $14.00
 7126304   HEPATITIS C ANTIBODY       HEPATITIS C AB                  $15.50
 7126316   PSA TOTAL                  PSA TOTAL                       $11.54
 7126317   RUBELLA QUALITATIVE        RUBELLA QUAL                     $4.61
 7126318   ROTAVIRUS AG EIA           ROTAVIRS AG EIA                 $23.22
 7126320   IEP SERUM                  IEP SERUM                       $25.97
 7126322   HIV CONFIRM WESTERN BLOT   HIV CONF WSTBLT                 $98.47
 7126324   RUBELLA VIRUS IGM EIA      RUBELLA VIR IGM                 $26.50
 7126325   IEP EXCPT SERUM            IEP EX SERUM                    $25.97
 7126330   IMMUNODIFF QUAN-EA         IMMUNODF                        $23.29
 7126332   COMPLEMENT C 3             COMPLMNT C 3                    $13.67
 7126333   COMPLEMENT C 4             COMPLMNT C 4                    $12.55
 7126334   COMPLEMENT C-5             COMPLEMENT C-5                  $68.60
 7126377   MICROSOMAL AB(EACH)        MICROSOML AB EA                 $14.02
 7126378   MITOCHONDRIAL AB           MITOCHONDRL AB                  $13.67
 7126379   SMOOTH MUSCLE ANTIBODY     SM MUSCLE AB                    $16.53
 7126380   MYOCARDIAL AB              MYOCARDIAL AB                   $81.00
 7126381   CARDIOLIPIN AB QNT         CARDIOLIPIN AB                  $43.79
 7126431   RHEUMATOID FACTOR QUAL     RA FACTOR QUAL                   $5.51
 7126592   VDRL/RPR QUAL              VDRL RPR ART QL                  $4.04
 7126594   VDRL-CSF                   VDRL-CSF                         $6.97
 7126598   TISSUE TYPING HLA-B27      TISSUE HLA-B27                  $21.76
 7126600   TOXOPLASMOSIS              TOXOPLASM DYE                   $15.13
 7126650   FTA-ABS                    FTA-ABS                         $10.04
 7126701   HIV 1 AB                   HIV 1 AB                         $8.50
 7126894   PROTEIN S ASSAY            PROTEIN S ASSAY                $121.50



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CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 7126900   CARBOHYDRATE ANTIGEN 125   CA 125                            $12.02
 7126906   CHLAMYDIA IGM BY IFA       CHLAMYDIA TITR                    $17.50
 7126907   ASPERGILLUS AB QL          ASPERGILL AB QL                   $18.90
 7126909   TOXOPLSMOSIS IGM AB TITR   TXPL IGM AB TTR                   $21.20
 7126910   CMV AB IGG TITR            CMV IGG TITR                      $15.50
 7126940   ACUTE LEUKEMIA EVAL        ACUTE LEUK SK                    $306.79
 7126998   EBV PANEL SPEC LAB         EBV PANEL SPEC                    $37.88
 7126999   MISC IMMUN PROC            MISC IMMUN PRC          $3.37 - $1,693.78
 7127999   MISC MICRO PROC            MISC MICRO PROC         $3.37 - $1,693.78
 7128999   MISC LAB                   MISC LAB                       $1,693.78
 7129399   AMIODARONE QUAL HPLC       AMIODRN QL HPLC                   $33.47
 7130000   4061 OUTSIDE LAB #13       OUTSIDE LAB
 7134233   RECEPTOR ASSAY ESTROGEN    ESTRGN REC ASSY                 $175.00
 7134234   RCEPTOR ASSAY PROGESTRN    PRA                             $175.00
 7136999   MISC IMMUN PROC            MISC IMMUN PRC                  $175.00
 7138999   MISC LAB                   MISC LAB                        $175.00
 7140000   4061 OUTSIDE LAB #14       OUTSIDE LAB
 7143605   LACTATE(LACTIC ACID)       LACTATE                          $20.20
 7143725   LITHIUM                    LITHIUM                          $20.21
 7144584   VALPROIC ACID              VALPROIC ACID                    $27.83
 7148999   MISC LAB                   MISC LAB                 $20.20 - $27.83
 7150000   4061 OUTSIDE LAB #15       OUTSIDE LAB
 7155240   CLOT FCTR VIII(AHG)1 STG   CLOT FCTOR VIII                  $96.60
 7155250   CLOT FCTR IX(PTC/XMAS)     CLOT FACTOR IX                   $96.60
 7155270   CLOT FCTR XI(PTA)          CLOT FACTOR XI                   $96.60
 7155280   CLOT FCTR XII(HAGEMANN)    CLOT FACTOR XII                  $96.60
 7155300   CLOT INHIB ANT-THRMBNIII   CLOT INHIB/ANTI                  $67.95
 7160000   4061 OUTSIDE LAB #16       OUTSIDE LAB
 7161099   MISC URINE PROC            MISC URINE PROC         $1.00 - $1,000.00
 7168998   MISC LAB                   MISC LAB                $1.00 - $1,000.00
 7170000   4061 OUTSIDE LAB #17       OUTSIDE LAB
 7170005   MASS SPEC TNDM MS NES      MASS SPEC QNT                    $20.35
 7172660   DRUG SCREEN QUAL           DRUG SCRN QUAL                   $95.00
 7172776   GALAC-1-PUT-SCREEN         G-1-PUT SCREEN                   $20.35
 7173498   HYDRXYPRGSTRONE 17-D       HPS 17-D                         $20.35
 7173940   HEMOGLOBIN F HPLC          HEMOGLBN F HPLC                  $20.35
 7174030   PHENYLALANINE PKU BLOOD    PKU BLOOD                        $15.40
 7174443   TSH                        TSH                              $20.35
 7174510   TYROSINE                   TYROSINE                         $15.40
 7174999   MISC CHEM/TOX PROC         MISC CHEM/TOX            $15.40 - $95.00
 7178999   MISC LAB                   MISC LAB                 $15.40 - $95.00
 7180000   4061 OUTSIDE LAB #18       OUTSIDE LAB
 7183873   MYOGLOBIN                  MYOGLOBIN                        $50.00
 7184999   MISC CHEM/TOX PROC         MISC CHEM/TOX                    $50.00
 7185999   MISC HEMA PROC             MISC HEMA PROC                   $50.00
 7186999   MISC IMMUN PROC            MISC IMMUN PROC                  $50.00
 7187235   TROPONIN - I               TROPONIN - I                     $50.00
 7187999   MISC MICRO PROC            MISC MICRO PROC                  $50.00
 7190000   4061 OUTSIDE LAB #19       OUTSIDE LAB
 7193873   MYOGLOBIN                  MYOGLOBIN                        $50.00



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CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 7194999   MISC CHEM/TOX PROC         MISC CHEM/TOX                   $50.00
 7195999   MISC HEMA PROC             MISC HEMA PROC                  $50.00
 7196999   MISC IMMUN PROC            MISC IMMUN PROC                 $50.00
 7197235   TROPONIN - I               TROPONIN - I                    $50.00
 7197999   MISC MICRO PROC            MISC MICRO PROC                 $50.00
 7300000   4170 PHARMACY BRAND NAME   RX BRAND NAME
 8010000   4050 C/S PERSONAL ITEMS    C/S PERSNL ITEM
 8018999   C/S PERSONAL ITEMS MISC    C/S MISC P/ITEM         $1.00 - $1,000.00
 8020000   4050 C/S DRESS/BANDAGES    C/S DRESS/BANDG
 8022001   ADHES DERMABOND PEN        ADHES DERMABOND                 $228.42
 8024010   BND BIND ABD               BND BIND ABD                    $100.84
 8024030   BND COBAN A/S              BND COBAN A/S                   $106.40
 8024055   BND ESMARK 6IN             BND ESMARK 6IN                  $440.70
 8024067   BND HEMOSTAT DRY PAD       BND HEMOST DRY                  $397.00
 8024075   BND HYG CHST               BND HYG CHST                    $140.85
 8024130   BND SOX STMP               BND SOX STMP                    $719.90     Minimum
 8024150   BND STKNET 2/4             BND STKNET 2/4                   $32.43
 8024160   BND STKNET 5/8             BND STKNET 5/8                  $719.90
 8024165   BND STKNET 5/8             BND STKNET 5/8                   $70.40
 8024170   BND STKNG KNEE             BND STKNG KNEE                   $37.20
 8024175   BND STKNG THGH             BND STKNG THGH                   $53.38
 8024195   BND TBGZ A/S               BND TBGZ A/S                     $67.56
 8024300   DRS ABD PD                 DRS ABD PD                       $31.11
 8024315   DRS ABD 8X7                DRS ABD 8X7                       $1.90
 8024330   DRS AIRSTRIP               DRS AIRSTRIP                    $174.80
 8024341   DRS ANTIMICROBIAL IV       DRS ANTIMICROB                   $64.34
 8024380   DRS BRST SH+CUP            DRS BRST SH+CUP                  $80.50
 8024435   DRS EYE SHIELD             DRS EYE SHIELD                   $24.51
 8024466   DRS GEL PAD                DRS GEL PAD                     $153.00
 8024485   DRS GZ 2X2 BX              DRS GZ 2X2 BX                    $85.45
 8024515   DRS GZ 4X4 BX              DRS GZ 4X4 BX                    $85.45
 8024538   DRS HEMOSTATIC             DRS HEMOSTATIC                  $357.64
 8024540   DRS HIP/KNEE               DRS HIP/KNEE                    $201.49
 8024625   DRS OPSIT 28X45            DRS OPSIT 28X45                 $199.45
 8024650   DRS PET/AD 3X3             DRS PET/AD 3X3                    $3.85
 8024655   DRS PET/AD 3X8             DRS PET/AD 3X8                  $142.50
 8024690   DRS PET/VS 5X72            DRS PET/VS 5X72                   $7.65
 8024715   DRS PK ADAP1/2             DRS PK ADAP1/2                  $315.35
 8024740   DRS PK IODO 1IN            DRS PK IODO 1IN                  $23.45
 8024745   DRS PK IODO 2IN            DRS PK IODO 2IN                  $32.78
 8024750   DRS PK NU-GZ A/S           DRS PK NUGZ A/S                  $20.23
 8024760   DRS PK NU-GZ1              DRS PK NU-GZ1                    $20.53
 8024765   DRS PK NU-GZ2              DRS PK NU-GZ2                    $27.55
 8024806   DRS SORB 2GMS 12IN         DRS SORB 2 GMS                   $36.80
 8024810   DRS SORB 4X4               DRS SORB 4X4                     $32.11
 8024815   DRS SPLIT                  DRS SPLIT                        $32.91
 8024825   DRS SPLIT 2X2BX            DRS SPLIT 2X2BX                 $735.15
 8024835   DRS SPNG 4X4 BX            DRS SPNG 4X4 BX                   $3.85
 8024850   DRS SPNGS 4X3              DRS SPNGS 4X3                     $1.90
 8024860   DRS STICK                  DRS STICK                       $207.00



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CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 8024915   DRS TEGDRM A/S             DRS TEGDRM A/S                     $5.70
 8024960   DRS WND MGT A/S            DRS WND MGT A/S                   $73.65
 8024962   DRS WND 2X2                DRS WND 2X2                      $100.70
 8024964   DRS WND 5X5                DRS WND 5X5                       $42.00
 8024965   DRS WND 7X12               DRS WND 7X12                     $246.64
 8028999   C/S MISC DRESS/BANDAGES    MISC DRESS/BAND           $1.90 - $735.15
 8030000   4050 C/S MEDICAL GENERAL   C/S MEDICL GEN
 8031013   ADPT SEALING               ADPT SEALING                   $423.88
 8031014   ADPT TITANIUM              ADPT TITANIUM                $2,287.00
 8031020   ADPT-Y-CORON               ADPT-Y-CORON                   $499.55
 8031035   SPRT ANTIEMB ELST          SPRT ANTIEMB EL              $1,496.85   Minimum
 8031065   ARMBD DISP (ALL)           ARMBD DISP (ALL                 $32.38
 8031074   ASP MECONIUM               ASP MECONIUM                    $32.48
 8031126   BG FECAL COLLECTION        BG FECAL COLLCT                 $69.00
 8031135   BSN MED                    BSN MED                        $467.30
 8031150   BSN WATER                  BSN WATER                        $5.70
 8031197   BELT ABD RETRACTION        BELT ABD RETRAC                $260.81
 8031205   BETADINE SWAG              BETADINE SWAG                  $112.15
 8031215   BG BILE 19 OZ              BG BILE 19 OZ                   $52.53
 8031220   BG DRN 1 PC                BG DRN 1 PC                    $733.25
 8031235   BG ICE DISP CHM            BG ICE DISP CHM                $174.80
 8031245   BG ICP DRNAGE              BG ICP DRNAGE                  $246.13
 8031250   BG INCNT                   BG INCNT                     $1,532.90
 8031275   BG PAK PROTECT             BG PAK PROTECT                 $230.40
 8031290   BG WND MNGMT               BG WND MNGMT                   $129.00
 8031292   BG WASTE BLD SALVAGE       BG WASTE BLD                   $134.83
 8031305   BITEBLOCK TONGUE           BITEBLCK TONGUE                $246.90
 8031312   BLD CLIPPER DISP           BLD CLIP DISP                   $94.50
 8031330   BLOOD FLTR                 BLOOD FLTR                     $771.25
 8031335   BLOOD INFU ST              BLOOD INFU ST                  $197.80
 8031342   BLOOD REPL BAG             BLOOD REPL BAG                 $114.00
 8031350   BLT RIB M/F A/S            BLT RIB M/F A/S                 $41.58
 8031369   BN GEL/PUTTY 10CC          BN GEL/PTY 10CC              $1,535.04   Minimum
 8031389   BOOT DEMI                  BOOT DEMI                      $329.28
 8031390   BOOT UNNA                  BOOT UNNA                      $109.90
 8031403   BOTL BABY                  BOTL BABY                       $11.50
 8031432   BRSH DENTRE SUCT           BRSH DENTR SUCT                 $55.20
 8031435   BRSH ENDO                  BRSH ENDO                      $302.05
 8031450   BRSH SCRUB ALL             BRSH SCRUB ALL                  $77.85
 8031465   BRST PMP DBL               BRST PMP DBL                   $208.90
 8031470   BRST PMP SNG               BRST PMP SNG                   $174.00
 8031475   BRST PUMP SYS              BRST PUMP SYS                   $61.00
 8031484   CABLE ABLATION/EP          CABLE ABLTN/EP               $1,327.00
 8031490   CAN ERCP                   CAN ERCP                       $312.78
 8031540   CANE QUAD A/S              CANE QUAD A/S                  $596.40
 8031585   CATH BAL PSTNASL           CATH BAL PSTNSL                $385.39
 8031590   CATH CHOLANG A/S           CATH CHOLNG A/S              $1,468.25
 8031605   CATH CYSTO                 CATH CYSTO                     $354.04
 8031618   CATH IRRG/EMBOLEC          CATH IRRG/EMBLC              $1,781.77
 8031625   CATH SUC/SLV50/B           CATH SC/SLV50/B                  $9.55



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CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 8031630   CATH SUCT A/S              CATH SUCT A/S                   $235.50
 8031640   CATH SUCT+SLEV             CATH SUCT+SLEV                   $75.07
 8031650   CATH SUPRAPUBIC            CATH SUPRAPUBIC               $1,363.80
 8031720   CLN WND                    CLN WND                          $44.87
 8031745   COIL EMBOLIC               COIL EMBOLIC                    $325.10
 8031747   COIL EXPANDER              COIL EXPANDER                   $375.74
 8031750   COIL PUSHER                COIL PUSHER                     $563.08
 8031763   COLL FLEXISEAL FECAL       COLL FLEXISEAL                $1,250.00
 8031765   COLLAPSIBLE BAR            COLLAPSIBLE BAR                 $630.70
 8031790   CONEC GROSHONG             CONEC GROSHONG                  $201.25
 8031795   CONEC SIMS                 CONEC SIMS                      $265.90
 8031805   CONEC TB                   CONEC TB                          $3.85
 8031810   CONEC TUBE                 CONEC TUBE                      $105.02
 8031815   CONEC Y                    CONEC Y                         $121.27
 8031880   COV TEMP PRB               COV TEMP PRB                     $77.85
 8031920   CRM SKIN PROTC             CRM SKIN PROTC                   $81.65
 8031922   CRM SURGI PREP             CRM SURGI PREP                  $252.60
 8031928   CUFF UNIVERSAL             CUFF UNIVERSAL                   $80.95
 8031931   CRUTCH ARMPAD CUSHION      CRUTCH ARMPD CU                 $142.50
 8031932   CRUTCH PLATFORM ATTACHMN   CRUTCH PLATFRM                  $894.75
 8031933   CRUTCH TIP PAIR            CRUTCH TIP PAIR                  $77.85
 8031982   CUFF BP INFANT             CUFF BP INF                      $43.16
 8031990   DEODERIZER                 DEODERIZER                       $19.05
 8032007   DEV INFLATION              DEV INFLATION                 $1,930.00
 8032008   DEV SECURE CATH IAB        DEV SECURE CATH                 $180.86
 8032070   DRN CHSTP/VAC              DRN CHSTP/VAC                   $386.44
 8032088   DVC WIRE EXCHANGE          DVC WIRE EXCHNG                 $419.19
 8032105   DRS LYOFOAM 4X4            DRS LYOFOAM 4X4                 $148.10
 8032107   DVC PUNCTURE CLOSUR DIS    DVC PUNCTR CLSR               $1,276.50
 8032108   DVC SUT KNOT TYING DISP    DVC SUT KNT DSP                 $227.70
 8032121   DVCE POCKET ORGANIZER      DVCE PKT ORGNZR                  $68.45
 8032131   EAR MUFFS NOISE REDUCTN    EAR MUFFS                        $40.30
 8032160   ENEMA BA RNG+DRN           ENEMA BA RN+DRN                 $320.90
 8032285   GEL DRML WND               GEL DRML WND                    $104.39
 8032305   GLUCOSCAN                  GLUCOSCAN                       $550.80
 8032325   GLV EXAM 100/B             GLV EXAM 100/B                    $1.90
 8032335   GLV ISOTONER               GLV ISOTONER                     $74.10
 8032351   GLV RADIATION              GLV RADIATION                   $163.35
 8032370   GRIP PWR HAND              GRIP PWR HAND                   $488.20
 8032395   HAND EXER SOFT             HAND EXER SOFT                  $216.50
 8032405   HAND HLPR EXERC            HAND HLPR EXERC                 $463.45
 8032430   HEMOSTAT PRB               HEMOSTAT PRB                    $588.52
 8032431   HEMOSTAT SOFGRIP DISP      HEMOSTAT SOFGRP                 $357.64
 8032436   HEMOSTAT TOPICAL 5ML       HEMOSTAT TOPICL                 $574.90
 8032470   HUMID                      HUMID                           $835.70
 8032490   INCNT STREP A              INCNT STREP A                   $440.70
 8032515   INFL SYR MT                INFL SYR MT                     $390.05
 8032555   IVALON                     IVALON                          $506.90
 8032565   JOINT JACK                 JOINT JACK                      $812.90
 8032571   KT AUTOTRANS WOUND DRAIN   KT AUTOTRANSFUS               $1,737.95



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CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 8032572   KT CATH CENT VEN SGL LUM   KT VEN SGL LUM                  $536.35
 8032585   KT PT ADM OB               KT PT ADM OB                    $421.70
 8032590   KT PT CR                   KT PT CR                         $20.50
 8032593   KT WRENCH DISP             KT WRENCH DISP                  $295.07
 8032610   LAMBSWOOL BOX              LAMBSWOOL BOX                    $31.28
 8032613   LANCER SFTTCH              LANCER SFTTCH                   $224.10
 8032614   LANCET LAB                 LANCET LAB                      $129.15
 8032620   LENS MORGAN                LENS MORGAN                     $164.56
 8032634   KT PN MGMT 120ML 2.08ML    KT PN MGMT                      $920.64
 8032685   MATRESS/CUSH AIR           MATRSS/CUSH AIR                 $847.25
 8032725   MSK FACE ISOL              MSK FACE ISOL                   $670.55
 8032745   NDL ANGIO                  NDL ANGIO                        $36.13
 8032750   NDL ARTERIAL               NDL ARTERIAL                    $210.80
 8032755   NDL ARTERL                 NDL ARTERL                    $1,865.35
 8032765   NDL BLUNT IRR              NDL BLUNT IRR                     $3.85
 8032770   NDL BONE BX                NDL BONE BX                     $587.00
 8032775   NDL BONE BX                NDL BONE BX                     $380.65
 8032782   NDL BOX                    NDL BOX                         $535.65
 8032783   NDL BX BRNCH               NDL BX BRNCH                    $923.30
 8032785   NDL BX FRAN                NDL BX FRAN                     $740.75
 8032807   NDL ELECTRD INSULATED      NDL ELECTRD INS               $1,840.00
 8032850   NDL MYELOGRAM              NDL MYELOGRAM                    $88.44
 8032860   NDL PERCUTAN               NDL PERCUTAN                    $210.80
 8032865   NDL RUBBER                 NDL RUBBER                       $56.69
 8032870   NDL SCLERO                 NDL SCLERO                      $216.00
 8032885   NDL SPINAL SPC             NDL SPINAL SPC                   $33.06
 8032900   NDL SYR BX                 NDL SYR BX                      $784.35
 8032920   NDL WSTCOT                 NDL WSTCOT                      $645.80
 8032935   NURSER PLST                NURSER PLST                     $139.88
 8032970   OST ADHES STMA             OST ADHES STMA                  $243.05
 8033055   OST BLT A/S                OST BLT A/S                      $46.07
 8033070   OST BRIDGE LOOP            OST BRIDGE LOOP                  $74.10
 8033075   OST CAP STOMA              OST CAP STOMA                   $151.90
 8033095   OST DRS DDRM 8X8           OST DRS DDRM8X8                 $393.20
 8033105   OST GASKET ASSE            OST GASKET ASSE                 $129.15
 8033120   OST GRN DDRM               OST GRN DDRM                    $254.50
 8033140   OST PASTE KARYA            OST PASTE KARYA                  $62.15
 8033145   OST PASTE STMA             OST PASTE STMA                  $408.50
 8033185   OST REMVR ADHES            OST REMVR ADHES                  $42.62
 8033195   OST SKIN BARIER            OST SKIN BARIER                  $39.31
 8033205   OST SKIN CLEANS            OST SKIN CLEANS                  $48.52
 8033210   OST SKIN CREM20            OST SKIN CREM20                   $1.98
 8033220   OST SKIN PREP              OST SKIN PREP                   $298.30
 8033240   OST START ST I             OST START ST I                $1,086.60
 8033315   PD BED DRMCR               PD BED DRMCR                    $361.00
 8033365   PD DUOTHERM                PD DUOTHERM                      $42.20
 8033370   PD DUOTHERM                PD DUOTHERM                     $113.02
 8033371   PD DEFIB                   PD DEFIB                        $144.40
 8033450   PD PROTECT SKIN            PD PROTECT SKIN                 $615.40
 8033465   PD RESTON A/S              PD RESTON A/S                   $226.00



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CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 8033525   PILLOW ABDUCTION           PILLW ABDUCTION                 $277.41
 8033530   PILLOW CERV COVR           PILLW CERV COVR                  $54.08
 8033535   PILLOW CERVICAL            PILLOW CERVICAL                  $78.48
 8033565   PIN LOCKING ASSY           PIN LOCKNG ASSY                 $940.25
 8033630   PLEUR EVAC                 PLEUR EVAC                    $1,396.10
 8033640   PLT GUARD                  PLT GUARD                       $135.35
 8033665   PORTACATH                  PORTACATH                     $6,817.20
 8033670   POSTN BODY                 POSTN BODY                      $210.13
 8033705   PRB SKIN TEMP              PRB SKIN TEMP                    $57.31
 8033710   PRB TEMP                   PRB TEMP                        $204.78
 8033730   PRESS INFL SYR             PRESS INFL SYR                  $674.30
 8033780   RCHR                       RCHR                             $44.70
 8033785   RCHR LONG                  RCHR LONG                       $103.61
 8033796   REMOVER FOREIGN BDY DISP   REM FOREIGN BDY                 $269.60
 8033805   RETRIEVER                  RETRIEVER                       $336.01
 8034030   SHOE HORN                  SHOE HORN                        $20.95
 8034035   SHOE LACES ELST            SHOE LACES ELST                   $2.55
 8034052   SLED PULLBACK              SLED PULLBACK                   $314.53
 8034053   SILICONE OIL STERILE       SILICONE OIL                    $118.87
 8034055   SLIDE DIAG/HEMO            SLIDE DIAG/HEMO                   $3.85
 8034065   SOL A/F                    SOL A/F                          $68.78
 8034099   SOL NACL IRRG              SOL NACL IRRG                   $182.35
 8034115   SPLNT NASAL                SPLNT NASAL                     $121.60
 8034125   SPNG LONG                  SPNG LONG                       $172.80
 8034130   SPNG SOFT HAND             SPNG SOFT HAND                  $283.05
 8034135   SPPRT HNDWRIST             SPPRT HNDWRIST                  $247.95
 8034140   SPPRT LUMB/SAC             SPPRT LUMB/SAC                  $814.85
 8034145   SPPRT SCROTAL              SPPRT SCROTAL                    $49.10
 8034161   ST ENTR FEED ADM W/O BAG   ST ENTR FEED                     $70.00
 8034162   ST CAUTERY DISP            ST CAUTERY DISP                 $148.00
 8034170   ST POUCH                   ST POUCH                        $630.70
 8034225   STMP SHRINKER              STMP SHRINKER                   $873.85 Minimum
 8034240   STRP                       STRP                             $34.65
 8034270   STRP TRNSDU                STRP TRNSDU                     $231.85
 8034275   STRP UA CHEM               STRP UA CHEM                     $41.80
 8034290   SUCT CAN ST                SUCT CAN ST                     $159.15
 8034300   SUCT IRRIG                 SUCT IRRIG                      $264.03
 8034310   SUMP SALEM                 SUMP SALEM                       $38.09
 8034364   SYR A/T A/L                SYR A/T A/L                     $495.80
 8034365   SYR ANGIO INJ              SYR ANGIO INJ                    $41.87
 8034415   SYR IRRIGAT GU             SYR IRRIGAT GU                   $40.01
 8034450   SYR 10C CONTRL             SYR 10C CONTRL                  $341.90
 8034505   SYR 50C CATHT              SYR 50C CATHT                    $64.65
 8034540   SYS BX                     SYS BX                          $371.74
 8034545   SYS CLSD FLSH              SYS CLSD FLSH                   $575.60
 8034550   SYS TRACH                  SYS TRACH                       $122.30
 8034569   SYS MGMT HEART FAILURE     SYS HRT FAIL                  $1,838.05
 8034585   TB BKR INT                 TB BKR INT                    $2,216.80
 8034590   TB BLAKEMORE               TB BLAKEMORE                  $3,039.15
 8034655   TB ENTRL FEED              TB ENTRL FEED                   $399.36



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CHARGE
NUMBER     CHARGE DESCRIPTION        BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 8034675   TB FEED                   TB FEED                           $113.95
 8034680   TB FEED                   TB FEED                            $81.48
 8034683   TB FEED ATTCH DEV         TB FEED ATCH DV                    $34.81
 8034685   TB FEED BG                TB FEED BG                         $23.05
 8034688   TB FEED INFANT            TB FEED INFANT                    $184.15
 8034695   TB GASTROS                TB GASTROS                        $368.02
 8034705   TB GI KASLO               TB GI KASLO                     $1,046.60
 8034775   TB REPLACEMENT            TB REPLACEMENT                    $379.87
 8034785   TB STOM LV/EV             TB STOM LV/EV                     $566.10
 8034815   TB VNT                    TB VNT                            $647.75
 8034825   TEST HCG URINE            TEST HCG URINE                    $180.45
 8034835   THERA-BND                 THERA-BND                          $50.10
 8034840   THERAPUTTY                THERAPUTTY                         $53.15
 8034860   THERM ORL/RCTL            THERM ORL/RCTL                     $38.22
 8034890   TORQUE DVCE               TORQUE DVCE                       $307.75
 8034920   TP MICROFOAM A/S          TP MICROFOAM AS                   $195.60
 8034970   TP VIDEO                  TP VIDEO                           $27.85
 8034975   TP VIDEO                  TP VIDEO                          $547.05
 8035040   TRP SPECIMEN              TRP SPECIMEN                      $127.30
 8035065   UNDRPD                    UNDRPD                          $1,137.75
 8035080   UNDRPD SUP ABSR           UNDRPD SUP ABSR                   $161.40
 8035130   UTENSIL HL                UTENSIL HL                         $87.30
 8035135   UTENSIL WEIGHTED          UTENSIL WEIGHTD                   $127.30
 8035165   VLV HEMOST ROT            VLV HEMOST ROT                    $290.16
 8035170   WC CUSH                   WC CUSH                           $651.50
 8035172   WALKER RIGID P/U          WALKER RIGID                      $218.54
 8035180   WGHTS HAND 1LB            WGHTS HAND 1LB                    $214.55
 8035185   WGHTS HAND 2.5LB          WGHTS HND 2.5LB                   $263.95
 8035195   WGHTS HAND 5LB            WGHTS HAND 5LB                    $334.35
 8035220   WIRE GDE                  WIRE GDE                          $501.66
 8035225   WND MNGMT BLNK            WND MNGMT BLNK                    $723.75
 8038999   MISC-MED SUPPLY GEN       MISC MED GEN           $10.00 - $30,991.60
 8040000   4050 C/S UROLOGICALS      C/S UROLOGICALS
 8041005   ADPT CATH                 ADPT CATH                      $647.75
 8041010   ADPT CATH WLL             ADPT CATH WLL                   $72.66
 8041050   BG URINE DRN              BG URINE DRN                    $48.01
 8041055   BG URINE DRN              BG URINE DRN                    $23.61
 8041065   BG URINE METER            BG URINE METER                  $66.78
 8041080   CATH BLN                  CATH BLN                       $949.75
 8041085   CATH BLN DIL              CATH BLN DIL                 $2,239.50
 8041095   CATH CONNECTOR            CATH CONNECTOR                 $400.07   Minimum
 8041115   CATH DRNG                 CATH DRNG                      $227.45
 8041125   CATH EXT                  CATH EXT                        $66.45
 8041140   CATH FOLY COUDE           CATH FOLY COUDE                 $84.45
 8041145   CATH FOLY 2W ALL          CATH FOLY2W ALL                 $35.79
 8041150   CATH FOLY 3W ALL          CATH FOLY3W ALL                $548.90
 8041155   CATH FOLY 30C 2           CATH FOLY 30C 2                 $26.47
 8041160   CATH FOLY 30C 3           CATH FOLY 30C 3                 $63.07
 8041195   CATH RADIAL ART           CATH RADIAL ART                $124.84
 8041265   CUTTING LOOP              CUTTING LOOP                 $2,002.10



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CHARGE
NUMBER     CHARGE DESCRIPTION        BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 8041285   DIL RNL                   DIL RNL                         $1,324.00
 8041295   EVC GU TUR                EVC GU TUR                        $653.35
 8041320   ST BILI DRNG              ST BILI DRNG                    $3,251.90
 8041325   ST DILAT URETH            ST DILAT URETH                    $264.06
 8041335   URINARY APPLIAN           URINARY APPLIAN                   $138.65
 8041365   UROTRACK FOLEY            UROTRACK FOLEY                  $1,386.60
 8041370   VALVE REFLUX CK           VALVE REFLUX CK                    $33.84
 8048999   C/S MISC UROLOGICALS      MISC UROLOGICAL         $23.61 - $3,251.90
 8050000   4050 C/S CATHS PROCEDRL   C/S CATH PROCED
 8056000   BLN                       BLN                          $1,416.21
 8056002   CATH ABLATION             CATH ABLATION                $9,275.10
 8056003   CATH ACCESS DUAL LUMEN    CATH ACCESS DL               $1,304.18
 8056015   CATH ANGIOGRAM            CATH ANGIOGRAM                 $476.80
 8056025   CATH ART DILBALO          CATH ART DILBAL              $7,765.10
 8056030   CATH ART LINE             CATH ART LINE                  $117.25
 8056050   CATH ATHR CORON           CATH ATHR CORON              $6,295.00
 8056065   CATH BALOON SV            CATH BALOON SV               $5,873.30   Minimum
 8056070   CATH BALOON UT            CATH BALOON UT                 $676.10   Minimum
 8056085   CATH BIL                  CATH BIL                       $511.30
 8056095   CATH BILI DIL             CATH BILI DIL                  $660.02
 8056110   CATH BRONCHO              CATH BRONCHO                 $1,829.15
 8056120   CATH CARD ALMNTA          CATH CARD ALMNT              $3,791.30
 8056125   CATH CARD AMPLTZ          CATH CARD AMPLT                $355.30
 8056155   CATH CARD DX              CATH CARD DX                   $695.25
 8056160   CATH CARD ELECTR          CATH CARD ELCTR              $1,396.81
 8056210   CATH CARD MLT/P           CATH CARD MLT/P                $727.45
 8056260   CATH CARD PT              CATH CARD PT                   $752.20
 8056270   CATH CARD SON AB          CATH CRD SON AB              $3,597.65
 8056304   CATH DIL BLN              CATH DIL BLN                   $989.21
 8056313   CATH DLTTN BLLN           CATH DLTTN BLLN                $330.00
 8056320   CATH CEREB/K              CATH CEREB/K                   $814.85
 8056330   CATH CEREB/M/N            CATH CEREB/M/N                 $702.80
 8056335   CATH CEREB/S              CATH CEREB/S                   $761.55
 8056337   CATH ENTEROCLYS           CATH ENTEROCLYS                $625.95
 8056343   CATH EPIDURAL             CATH EPIDURAL                  $579.35
 8056345   CATH CHOLNG               CATH CHOLNG                  $3,567.20
 8056350   CATH CHOLNG               CATH CHOLNG                    $881.40
 8056355   CATH CHOLNG               CATH CHOLNG                    $360.12
 8056357   CATH EXTENDER             CATH EXTENDER                  $548.90
 8056370   CATH COBRA                CATH COBRA                     $702.80
 8056371   CATH CRYO BLN             CATH CRYO BLN                $1,750.51
 8056373   CATH FGRTY EMBLA          CATH FGRT EMBLA                $262.11
 8056380   CATH CVP                  CATH CVP                       $272.13
 8056383   CATH FGRTY OCLSN          CATH FGRT OCLSN                $460.22
 8056390   CATH DIALYS HEMO          CATH DIALY HEMO                $915.65
 8056395   CATH DIL                  CATH DIL                     $1,675.40
 8056430   CATH GDE CARD             CATH GDE CARD                  $315.55
 8056435   CATH GDE CORON            CATH GDE CORON                 $324.07
 8056450   CATH GORSHANG LG          CATH GORSHNG LG                $462.00
 8056465   CATH HD                   CATH HD                        $358.30



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CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 8056495   CATH INF DVCE              CATH INF DVCE                     $356.00
 8056515   CATH INFU SYS              CATH INFU SYS                   $3,688.85
 8056535   CATH INTRO ST              CATH INTRO ST                     $813.40
 8056542   CATHETER IVUS              CATH IVUS                       $3,675.45
 8056560   CATH KT TRIP               CATH KT TRIP                      $417.12
 8056570   CATH LIT CEN VEI           CATH LIT CEN VN                   $323.34
 8056595   CATH MUSHROOM              CATH MUSHROOM                     $188.90
 8056610   CATH NEPHRO                CATH NEPHRO                     $2,879.60
 8056615   CATH NEPHROSTOMY           CATH NEPHROSTMY                   $480.00
 8056625   CATH OC BLN                CATH OC BLN                       $747.01
 8056650   CATH PGTL                  CATH PGTL                         $158.14
 8056655   CATH PGTL                  CATH PGTL                         $814.85
 8056665   CATH PTCA                  CATH PTCA                       $1,000.73
 8056692   CATH REF STAR              CATH REF STAR                   $1,576.30
 8056700   CATH SIALOGRAPHY           CATH SIALOGRPHY                   $833.85
 8056710   CATH ST                    CATH ST                           $752.20
 8056730   CATH SUBCLV JUG            CATH SUBCLV JUG                 $1,508.25
 8056740   CATH SW-GZ ANGIO           CATH SW-GZ ANGI                 $1,240.40
 8056745   CATH SW-GZ BIPOL           CATH SW-GZ BIPL                 $1,785.50
 8056746   CATH SW-GZ CCO/SVO2/VIP    CATH SW-GZ CCO                    $969.73
 8056750   CATH SW-GZ DIAGP           CATH SW-GZ DIAG                 $4,214.90
 8056755   CATH SW-GZ MNTR            CATH SW-GZ MNTR                   $362.99
 8056760   CATH SW-GZ TH/PC           CATH SW-GZ TH/P                 $2,944.25
 8056765   CATH SW-GZ THERM           CATH SW-GZ THRM                   $346.58
 8056780   CATH THORACIC              CATH THORACIC                      $58.74
 8056782   CATH THROMBOSIS            CATH THROMBOSIS                 $5,738.40
 8056820   CATH VAS                   CATH VAS                        $1,417.05
 8056825   CATH VESL UMBLCL           CATH VESL UMBLC                   $249.13
 8056835   CATH VISCR/C               CATH VISCR/C                      $327.42
 8056840   CATH VISCR/M/H/S           CATH VISC/M/H/S                   $659.10
 8056850   CATH VISCR/S               CATH VISCR/S                      $702.80
 8056890   CATH-PHER BALOON           CATH-PHER BALLN                   $405.05
 8056915   CV CATH DIL                CV CATH DIL                     $2,000.15
 8056931   GCATH MICRO                GCATH MICRO                     $1,247.50
 8056950   KT CANULA ARTHO            KT CANULA ARTHO                   $454.00
 8056965   KT CARTRIDGE               KT CARTRIDGE                    $1,177.70
 8056975   KT CATH B AORTC            KT CATH B AORTC                 $7,596.10
 8057000   KT HEART PORT              KT HRT PORT                   $16,409.65
 8057015   SLEEVE CATH                SLEEVE CATH                        $93.04
 8058999   MISC-CATH SUPPLY           MISC-CATH SUPPL        $656.50 - $6,934.00
 8060000   4050 C/S STENTS PROCEDRL   C/S STNTS/PROC
 8062030   LONG RETREIVER             LONG RETREIVER               $1,059.27
 8062035   LOOP NEPH COOP             LOOP NEPH COOP               $3,339.30
 8062045   ST STENT                   ST STENT                       $294.66   Minimum
 8062050   ST STENT MZR UR            ST STENT MZR UR              $4,137.05
 8062055   STNT BIL                   STNT BIL                     $2,382.00   Minimum
 8062070   STNT COIL                  STNT COIL                    $4,986.15
 8062076   STNT CORN ART              STNT CORN ART                $2,778.44   Minimum
 8062080   STNT DBL J                 STNT DBL J                   $3,329.85   Minimum
 8062095   STNT DLT NPH/TRT           STNT DLT NPH/TR              $5,033.60



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CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION    HOSPITAL CHARGE COMMENTS
 8062100   STNT DLT TRN/DTR           STNT DLT TRN/DT                   $2,188.20
 8062105   STNT LACRIMAL              STNT LACRIMAL                     $3,680.00
 8062115   STNT NEPHR MALEC           STNT NEPHR MALC                   $3,865.45
 8062135   STNT TRACHAEL              STNT TRACHAEL                     $1,665.90
 8062150   STNT URETERAL              STNT URETERAL                       $524.05  Minimum
 8062155   STNT URETERAL              STNT URETERAL                       $845.25  Minimum
 8062175   STNT VAR LNTH              STNT VAR LNTH                     $1,654.50
 8062180   STNT VASC EXPND            STNT VASC EXPND                   $2,450.65  Minimum
 8068999   C/S MISC STENTS PROCEDRL   MISC STENT PROC       $9,185.00 - $27,555.00
 8070000   4050 C/S GUIDES PROCEDRL   C/S GIUDES/PROC
 8073005   GDE CALIBRATED             GDE CALIBRATED                   $2,160.00
 8073025   GDE INJ WIRE               GDE INJ WIRE                       $520.04
 8073030   GDE OPEN END               GDE OPEN END                       $930.80
 8073055   GW                         GW                                 $338.35
 8073060   GW                         GW                                 $354.09
 8073075   GW                         GW                                 $323.89
 8073080   GW                         GW                                 $271.67
 8073090   GW AMPTO                   GW AMPTO                         $2,399.00
 8073105   GW CV/HG                   GW CV/HG                           $505.94
 8073125   GW CV/SD                   GW CV/SD                            $59.05
 8073130   GW CV/SD                   GW CV/SD                           $164.56
 8073145   GW EXT                     GW EXT                           $2,000.15
 8073150   GW F/TIP                   GW F/TIP                         $1,248.55
 8073190   GW ST&CV                   GW ST&CV                         $7,020.50
 8073195   GW ST/BC                   GW ST/BC                         $1,865.35
 8073200   GW ST/CE                   GW ST/CE                         $1,757.05
 8073205   GW ST/CE                   GW ST/CE                           $577.83
 8073220   GW ST/HD                   GW ST/HD                           $413.55
 8073235   GW ST/NC                   GW ST/NC                           $447.92
 8073240   GW ST/SD                   GW ST/SD                           $550.99
 8073245   GW ST/SD                   GW ST/SD                           $904.30
 8073248   GW TRQ PLX                 GW TRQ PLX                         $693.45
 8073249   GW TAD                     GW TAD                             $543.70
 8073255   SHTH PEELAWAY              SHTH PEELAWAY                      $593.05
 8073260   SHTH PEEAWAY               SHTH PEEAWAY                       $805.40
 8073269   OBTURATOR SHTH SHORT       OBTUR SHTH SHRT                     $60.49
 8073270   ST COPE INTRO              ST COPE INTRO                      $384.05
 8073275   WIRE EXCH                  WIRE EXCH                        $2,188.20
 8073280   WIRE FPLY                  WIRE FPLY                        $2,431.20
 8073300   WIRE TIP DFLCT             WIRE TIP DFLCT                     $450.03
 8078999   C/S MISC GUIDES PROCEDRL   MISC GUIDE PROC          $59.05 - $7,020.50
 8080000   4050 C/S TRAYS/INSTRMNTS   C/S TRAYS/INSTR
 8081005   ANOSCOPE                   ANOSCOPE                           $85.45
 8081009   BSK BILIARY LITHTRP        BSK BIL LITHTRP                   $607.06
 8081045   CLMP BROVIAC               CLMP BROVIAC                        $7.65
 8081055   CLMP CORD UMBIL            CLMP CORD UMBL                     $11.40
 8081110   DVCE TORQUE                DVCE TORQUE                       $228.05
 8081115   ENDO FORCEP DISP           ENDO FORCP DISP                   $181.13
 8081119   ENDO DISSECTOR             ENDO DISSECTOR                  $3,544.40
 8081130   ENDO SHEARS                ENDO SHEARS                     $1,855.80



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CHARGE
NUMBER     CHARGE DESCRIPTION        BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 8081155   FRCP GRSP                 FRCP GRSP                       $700.10
 8081160   FRCP GRSPNG               FRCP GRSPNG                   $1,838.70
 8081180   HOOK DURA                 HOOK DURA                       $533.75 Minimum
 8081185   INDEFLATOR                INDEFLATOR                    $1,855.80
 8081194   GAUGE SIZING              GAUGE SIZING                    $123.50
 8081233   INST BLT ADPT             INST BLT ADPT                   $543.30
 8081275   INST CLAMP CV             INST CLAMP CV                    $43.31
 8081320   INST DERMACARIER          INST DERMACARIE                 $858.55
 8081330   INST DIL RENL             INST DIL RENL                 $4,346.00
 8081345   INST DISP NDL HL          INST DISP NDL H                 $115.85
 8081360   INST DRILL BIT            INST DRILL BIT                  $472.86 Minimum
 8081390   INST DRILL PRFTR          INST DRILL PRFT                 $600.14
 8081400   INST DRILL TWIST          INST DRILL TWST                 $470.01
 8081405   INST ENDARSECTOR          INST ENDARSECTR                 $320.90
 8081422   TRY REAM INST             TRY REAM INST                   $174.80
 8081435   INST ERSR WT FLD          INST ERSR WT FL                 $391.30
 8081446   INST FEE LOANR MAJ        INST SYS LN MJ                $2,030.00 Minimum
 8081450   INST EXTR STN GU          INST EXT STN GU               $2,239.50
 8081460   INST FORCEP               INST FORCEP                     $531.80
 8081490   INST HEMOSTAT             INST HEMOSTAT                    $23.62
 8081515   INST INSERT CV            INST INSERT CV                  $141.92
 8081530   INST INSERT SU            INST INSERT SU                  $397.05
 8081555   INST MED/SURG             INST MED/SURG                   $784.35
 8081604   INST REDUCER ENDO         INST REDUC ENDO                  $46.16
 8081630   INST RETRAC WILK          INST RETRCT EYE                 $700.85
 8081632   INST RETRACTOR            INST RETRACTOR                  $194.00
 8081660   INST SHAVE PATLA          INST SHAVE PATL               $1,785.50
 8081670   INST SIGMOIDSCOP          INST SIGMOIDSCP                 $377.95
 8081690   INST SPEC EAR             INST SPEC EAR                   $391.30
 8081740   INST SUT PASSER           INST SUT PASSER               $1,684.90
 8081750   INST TAP E SCREW          INST TAP E SCRW               $1,477.75
 8081800   INST WIRE CUTTER          INST WIRE CUTTR                 $940.25
 8081805   INST WIRE SNARE           INST WIRE SNARE                 $467.30
 8081810   INTRODUCER                INTRODUCER                    $1,223.20
 8081812   INTROD CHK FLO SET VCFN   INTROD CHK FLO                $1,454.75
 8081815   KT ACCESS                 KT ACCESS                       $457.80
 8081865   KT BLOOD GS               KT BLOOD GS                      $79.80
 8081870   KT BLOOD SAMPLE           KT BLOOD SAMPLE                  $39.59
 8081895   KT CATH INT JUG           KT CATH INT JUG               $3,286.05
 8081900   KT CATH PERC              KT CATH PERC                    $396.18
 8081905   KT CATH PERCUTN           KT CATH PERCUTN               $3,732.50
 8081915   KT CHEMO DISP             KT CHEMO DISP                   $112.00
 8081940   KT CV CATH PED            KT CV CATH PED                  $704.70
 8081965   KT DISP ICP               KT DISP ICP                   $3,455.10
 8081980   KT DRAIN SCHS             KT DRAIN SCHS                 $1,850.05
 8081985   KT DRN BILIARY            KT DRN BILIARY                  $515.64
 8081990   KT DRN CATH               KT DRN CATH                     $442.46
 8081993   KT DRN PLEURAL            KT DRN PLEURAL                  $452.58
 8081995   KT DRN SUMP               KT DRN SUMP                     $420.15
 8082000   KT DRN VENTRCUL           KT DRN VENTRCUL               $2,266.10



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  Doctors Medical Center - Modesto                                       Page 133 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION        BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 8082012   KT DRS SMALL 3.9X3        KT DRS SMALL                    $180.60
 8082020   KT DUOFLO                 KT DUOFLO                       $396.36
 8082025   KT EAR DRS                KT EAR DRS                      $260.30
 8082035   KT EMERG INFU             KT EMERG INFU                   $782.60
 8082040   KT ENDO ACCESS            KT ENDO ACCESS                  $869.85
 8082065   KT FEM CATH               KT FEM CATH                     $428.54
 8082070   KT FETAL BLOOD            KT FETAL BLOOD                  $854.85
 8082090   KT GASTROSTOMY            KT GASTROSTOMY                $2,837.85
 8082100   KT GROSHNG DRAW           KT GROSHNG DRAW                 $434.20
 8082110   KT HEMOCONC               KT HEMOCONC                   $4,376.52
 8082125   KT ICP DRN SY             KT ICP DRN SY                 $1,170.60
 8082155   KT INTRAUTERINE           KT INTRAUTERINE                 $208.39
 8082160   KT IRR EYE                KT IRR EYE                       $58.72
 8082170   KT IRR WND                KT IRR WND                      $256.40
 8082253   KT NDL GUIDE DISP         KT NDL GDE                      $155.85
 8082270   KT NUCLEOTOME             KT NUCLEOTOME                $16,083.00 Minimum
 8082285   KT PAC BALECTR            KT PAC BALECTR                  $305.90
 8082360   KT PERCARDIOCNT           KT PERCARDIOCNT               $1,006.70
 8082365   KT PERCU NEPHRO           KT PERCU NEPHR                $3,008.70
 8082395   KT PNEUMOTHORAX           KT PNEUMOTHORAX                 $509.25
 8082398   KT PIN PLUG DFIB/PM       KT PIN PLUG                     $595.37
 8082442   KT PMP REFILL             KT PMP REFILL                 $3,147.45
 8082465   KT SALIVA TEST            KT SALIVA TEST                  $165.30
 8082485   KT SHAVE PREP             KT SHAVE PREP                   $123.50
 8082490   KT SHEATH/CATH            KT SHEATH/CATH                  $333.95
 8082505   KT SHROUD/MORGU           KT SHROUD/MORGU                  $90.90
 8082550   KT THORCENTESIS           KT THORCENTESIS                 $285.91
 8082552   KT THORACIC VNT PROC      KT THORACIC VNT               $1,092.81
 8082570   KT TRNSDU                 KT TRNSDU                       $856.75
 8082571   KT TRAUMA                 KT TRAUMA                       $485.28
 8082580   KT VITRECTOMY             KT VITRECTOMY                   $520.05
 8082581   KT VENT ORAL CR W/SUCT    KT VNT ORL CR W                 $214.00
 8082610   NDL BX LIVER              NDL BX LIVER                    $708.45
 8082615   NDL LAPSCOPE              NDL LAPSCOPE                    $173.47
 8082616   OBTURATOR/LNG SHTH        OBTURATOR                        $93.04
 8082620   PAPILLOTOME               PAPILLOTOME                     $425.72
 8082660   RETR STONE                RETR STONE                    $3,457.05
 8082661   RETRACTOR ABD DISP        RETRCTR ABD DIS                 $500.00
 8082670   SNARE OV/CRS/HEX          SNARE OV/CRS/HX                 $275.16
 8082675   ST ART PUNCTURE           ST ART PUNCTURE                 $269.71
 8082680   ST CATH DRN               ST CATH DRN                     $404.43
 8082685   ST COLON DECOM            ST COLON DECOM                $2,173.00
 8082705   ST DRS DISP               ST DRS DISP                     $120.06
 8082718   ST FLUID DELIV            ST FLUID DELIV                $1,878.00
 8082720   ST GASTROSTOMY            ST GASTROSTOMY                $2,577.60
 8082730   ST NASAL BILARY           ST NASAL BILARY               $2,382.00
 8082735   ST NDL ACCESS             ST NDL ACCESS                 $2,099.00
 8082745   ST NEPHROSTOMY            ST NEPHROSTOMY                  $800.21
 8082755   ST PNEUMOTHORAX           ST PNEUMOTHORAX                 $774.78
 8082760   ST PRES MTR               ST PRES MTR                   $1,794.00



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  Doctors Medical Center - Modesto                                      Page 134 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION        BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 8082782   ST THROMB/EMB PMP         ST THROMB/EMB                 $3,147.45
 8082789   STYLET                    STYLET                          $339.06
 8082805   TB/ANGIOSCOPE             TB/ANGIOSCOPE                   $697.15
 8082810   TOOL GDWR                 TOOL GDWR                       $617.30
 8082815   TROCAR LAPSCOPE           TROCAR LAPSCOPE                 $811.20
 8082820   TRY AMNIOCENTES           TRY AMNIOCENTES                  $95.44
 8082870   TRY ANS EPIDRL            TRY ANS EPIDRL                  $236.74
 8082880   TRY ANS LTA 11            TRY ANS LTA 11                  $228.05
 8082885   TRY ANS PARACR            TRY ANS PARACR                  $533.75
 8082910   TRY ANS SPINAL            TRY ANS SPINAL                  $161.26
 8082960   TRY ARTHROGRAM            TRY ARTHROGRAM                   $86.97
 8082970   TRY ATRIOGRM H/P          TRY ATRIOGRM HP                 $402.31
 8082980   TRY ARTRL LN H/P          TRY ARTRL LN HP               $1,536.75
 8083002   TRY BN ACCESS             TRY BN ACCESS                 $1,171.85
 8083005   TRY BN MARROW             TRY BN MARROW                   $223.72
 8083025   TRY BRNCSCPY H/P          TRY BRNCSCPY HP                 $188.05
 8083040   TRY BX BASIC              TRY BX BASIC                    $101.25
 8083055   TRY BX LVR H/P            TRY BX LVR H/P                $1,481.50
 8083100   TRY CATH CRD              TRY CATH CRD                  $1,766.50
 8083115   TRY CATH CVP H/P          TRY CATH CVP HP                 $272.10
 8083125   TRY CATH FO+B+            TRY CATH FO+B+                   $58.69
 8083130   TRY CATH FO+BA            TRY CATH FO+BA                  $145.65
 8083170   TRY CATH INTRAV           TRY CATH INTRAV                 $252.21
 8083200   TRY CATH W/O C            TRY CATH W/O C                  $133.00
 8083235   TRY CIRCUM H/P            TRY CIRCUM H/P                  $514.58
 8083270   TRY CRSHC ADT HP          TRY CRSH ADT HP                 $558.45
 8083276   TRY CATH FO+URIMETER      TRY CATH FO+UR                  $176.00
 8083300   TRY CTH UMBL H/P          TRY CTH UMBL HP                 $683.80
 8083305   TRY CUTDOWN H/P           TRY CUTDOWN HP                  $558.45
 8083345   TRY DENTAL H/P            TRY DENTAL H/P                $2,516.05
 8083365   TRY DIALYSIS H/P          TRY DIALYSIS HP                 $287.54
 8083375   TRY DOUCHE STER           TRY DOUCHE STER                 $216.50
 8083415   TRY DRS MAJ               TRY DRS MAJ                      $70.40
 8083425   TRY DRS MIN H/P           TRY DRS MIN H/P                  $15.20
 8083450   TRY EMER OB H/P           TRY EMER OB H/P                 $558.45
 8083455   TRY EMERG OB              TRY EMERG OB                    $670.55
 8083460   TRY ENDO TROCAR           TRY ENDO TROCAR                 $372.05
 8083465   TRY ENT H/P               TRY ENT H/P                     $558.45
 8083500   TRY EXM PELV H/P          TRY EXM PELV HP                 $364.80
 8083515   TRY EXM VAG H/P           TRY EXM VAG H/P                 $558.45
 8083565   TRY GASTRC LAV            TRY GASTRC LAV                  $664.80
 8083585   TRY GSTRC LAV HP          TRY GSTR LAV HP                 $335.50
 8083610   TRY HED TRCT H/P          TRY HED TRCT HP              $13,733.30
 8083640   TRY HYSTSLPGR HP          TRY HYSTSLPG HP                 $558.45
 8083645   TRY I&D                   TRY I&D                          $59.73
 8083785   TRY LAVAGE                TRY LAVAGE                      $224.58
 8083805   TRY LUMB PUNCT            TRY LUMB PUNCT                   $79.05
 8083845   TRY MANOMETR LP           TRY MANOMETR LP                 $260.30
 8083900   TRY MYELOGRAM             TRY MYELOGRAM                    $84.19
 8083990   TRY PEG                   TRY PEG                         $585.62



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CHARGE
NUMBER     CHARGE DESCRIPTION        BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 8084005   TRY PERI-CRD H/P          TRY PERI-CRD HP                  $280.04
 8084018   TRY PICC                  TRY PICC                         $373.09
 8084055   TRY PREP E-Z              TRY PREP E-Z                      $32.05
 8084085   TRY PREP W RAZ            TRY PREP W RAZ                   $262.10
 8084223   TRY SPECIALTY             TRY SPECIALTY                    $288.80
 8084225   TRY SPEC PRO H/P          TRY SPEC PR H/P                $2,801.80
 8084235   TRY STEINM PN HP          TRY STEIN PN HP                $2,000.15
 8084240   TRY STERNTMY H/P          TRY STERNTM H/P                  $558.45
 8084245   TRY STRNO SFT HP          TRY STRNO SFTHP                $2,043.85
 8084260   TRY SUT MIN H/P           TRY SUT MIN H/P                   $70.53
 8084265   TRY SUT PLS H/P           TRY SUT PLS H/P                  $200.08
 8084285   TRU TB CHST H/P           TRU TB CHST H/P                  $226.00
 8084305   TRY TB TRC ST HP          TRY TB TRC STHP                  $452.80
 8084310   TRY THORACENTES           TRY THORACENTS                   $173.66
 8084330   TRY THORCTMY H/P          TRY THORCTM H/P                  $558.45
 8084350   TRY TRACH CLEAN           TRY TRACH CLEAN                  $119.60
 8084360   TRY TRACHSTMY HP          TRY TRACHSTM HP                  $558.45
 8084365   TRY TRANSF XCHA           TRY TRANSF XCHA                  $243.34
 8084400   TRY URIN RETN HP          TRY URIN RET HP                $3,645.10
 8084405   TRY UROLOGIST             TRY UROLOGIST                  $2,500.04
 8084440   ULTRATOME                 ULTRATOME                        $486.22
 8084601   FEM COMP ARCH             FEM COMP ARCH                    $376.98
 8088999   MISC-TRY                  MISC TRAYS/INST           $10.00 - $12.00
 8090000   4050 C/S EQUIP/SUPPLIES   C/S EQ/SUPPLIES
 8091010   EQ AUTOTRANS COL          EQ AUTOTRAN COL              $1,156.85   Minimum
 8091015   BG AUTOTRANS              BG AUTOTRANS                   $949.75
 8091020   BG FEEDING                BG FEEDING                     $140.55
 8091037   BLNKT BAIR HUGG           BLNKT BAIR HUGG                $129.15
 8091070   COPPER DYE LZ             COPPER DYE LZ                  $271.55
 8091076   CANN CRD AST PMP          CANN CRD AST PM             $31,000.60
 8091080   CRUTCH ACCES KT           CRUTCH ACCES KT                $237.55
 8091095   CRUTCH ATTACHMNT          CRUTCH ATTACHMN                $298.30
 8091110   CUFF BLOOD                CUFF BLOOD                      $91.15
 8091130   CUSH WHEEL CHR            CUSH WHEL CHR                  $993.45
 8091205   EQ AUDIOMETRY             EQ AUDIOMETRY                  $260.30
 8091220   EQ BD AIR FLD D           EQ BD AIR FLD D                $271.55
 8091225   EQ BD AIR FLD SU          EQ BD AIR FL SU              $4,864.55
 8091230   EQ BD AIR SPPRT           EQ BD AIR SPPRT                $392.04
 8091255   EQ BD DIODYN D            EQ BD DIODYN D                 $668.60
 8091265   EQ BD NELSON D            EQ BD NELSON D                 $271.55
 8091280   EQ BD ROT BDY D           EQ BD ROT BDY D                $598.30
 8091300   EQ BD THRPLSE D           EQ BD THRPLSE D                $452.10
 8091325   EQ BLOOD WARMER           EQ BLOOD WARMER                $271.55
 8091405   EQ CRASH CRT              EQ CRASH CRT                 $1,120.46
 8091411   EQ CRD AST PMP S/U        EQ CRD AST PMP                 $271.55
 8091413   EQ CRD AST PMP D          EQ CRD AST PMP                 $271.55
 8091440   EQ CRUTCH                 EQ CRUTCH                      $122.42
 8091475   EQ CT BI-POLAR            EQ CT BI-POLAR                 $212.75
 8091510   EQ CT SURG                EQ CT SURG                     $640.20
 8091520   EQ CUT/VAC PLSTR          EQ CUT/VAC PLST                $271.55



  CDM Run Date: 06/01/2007
  Doctors Medical Center - Modesto                                       Page 136 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION        BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 8091540   EQ DEFIBRILLATOR          EQ DEFIBRILLATO                 $271.55
 8091600   EQ ELEC PULSE             EQ ELEC PULSE                   $519.80
 8091605   EQ EMERSN PMP D           EQ EMERSN PMP D                 $271.55
 8091610   EQ EMERSN PMP SU          EQ EMERSN PMP S                 $632.55
 8091635   EQ EYE ASP/OCUTM          EQ EYE ASP/OCUT               $1,099.80
 8091640   EQ EYE IRG SUC            EQ EYE IRG SUC                  $814.85
 8091655   EQ FLOSWITCH              EQ FLOSWITCH                     $45.87
 8091715   EQ HYPOTHRM D             EQ HYPOTHRM D                   $271.55
 8091720   EQ EQ HYPOTHRM SU         EQ HYPOTHRM SU                  $271.55
 8091820   EQ LAMP SLIT              EQ LAMP SLIT                    $735.15
 8091905   EQ LZ MODEL 8             EQ LZ MODEL 8                   $271.55
 8091920   EQ LZ YAG LIM             EQ LZ YAG LIM                   $271.55
 8091980   EQ MNTR                   EQ MNTR                         $271.55
 8092005   EQ MNTR ARTRL D           EQ MNTR ARTRL D                 $271.55
 8092035   EQ MNTR CRD D             EQ MNTR CRD D                   $193.80
 8092050   EQ MNTR CRD SU            EQ MNTR CRD SU                  $271.55
 8092130   EQ MNTR NB O2 SU          EQ MNT NB O2 SU               $3,307.05
 8092175   EQ MNTR RESPIRAT          EQ MNTR RESPIRA                 $271.55
 8092245   EQ OH PMP OX SU           EQ OH PMP OX SU                 $271.55
 8092250   EQ OH PMP OX USE          EQ OH PMP OX US                 $271.55
 8092275   EQ OXISENSOR              EQ OXISENSOR                    $374.35
 8092295   EQ PD AQUA D              EQ PD AQUA D                    $148.10
 8092300   EQ PD AQUA SU             EQ PD AQUA SU                   $271.55
 8092365   EQ PIN SKULL              EQ PIN SKULL                  $1,232.75
 8092395   EQ PUMP BRST              EQ PUMP BRST                     $95.00
 8092430   EQ PMP FEED D             EQ PMP FEED D                   $271.55
 8092470   EQ PMP INTRAOR D          EQ PMP INTRAR D                 $271.55 Minimum
 8092475   EQ PMP IRRG               EQ PMP IRRG                     $271.55
 8092480   EQ PMP IV D               EQ PMP IV D                     $134.90
 8092535   EQ PROBE LTHOTRP          EQ PROBE LTHTRP                 $875.75
 8092555   EQ PUMP BRST              EQ PUMP BRST                    $461.65
 8092562   EQ PWR PAK TEC            EQ PWR PAK TEC                $1,284.10
 8092620   EQ SCD D                  EQ SCD D                        $271.55
 8092705   EQ SUC INT D              EQ SUC INT D                    $271.55
 8092720   EQ SUC INT SU             EQ SUC INT SU                   $359.05
 8092785   EQ SYS CELLSAVER          EQ SYS CELLSAVR               $1,126.35 Minimum
 8092790   EQ SYS RECOV BLD          EQ SYS RECV BLD                 $240.01 Minimum
 8092825   EQ TELEMTRY D             EQ TELEMTRY D                    $27.85
 8092905   EQ TRNSFSR AUT            EQ TRNSFSR AUT                  $271.55
 8092917   EQ T U N A GENERATOR      EQ TUNA GENERAT                 $697.05
 8092942   EQ VACUUM WND             EQ VACUUM WND                   $204.00
 8092950   EQ VIBRATOR               EQ VIBRATOR                     $336.30
 8092970   EQ WALKER A/S             EQ WALKER A/S                   $325.93
 8093000   EQ WARMR RADIANT          EQ WARMR RADNT                  $271.55
 8093050   HL TB/CORD                HL TB/CORD                        $7.65
 8093080   EQ LGHT FLEXI-LUM         EQ LGHT FLEX-LM                 $288.80
 8093115   PD DEFIB                  PD DEFIB                        $723.75
 8093210   TB ENDO LZ                TB ENDO LZ                      $528.05
 8094000   EQ ANS MNTR ART           EQ ANS MNTR ART                 $271.55
 8094005   EQ ANS MNTR BP            EQ ANS MNTR BP                  $271.55



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  Doctors Medical Center - Modesto                                         Page 137 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION        BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 8094010   EQ ANS MNTR CRD           EQ ANS MNTR CRD                  $271.55
 8094015   EQ ANS MNTR CO2           EQ ANS MNTR CO2                  $271.55
 8094020   EQ ANS MNTR CVP           EQ ANS MNTR CVP                  $271.55
 8094025   ANS DOPPLER               ANS DOPPLER                      $271.55
 8094030   EQ ANS PMP INF            EQ ANS PMP INF                   $271.55  Minimum
 8094035   ANS STIM NERVE            ANS STIM NERVE                   $271.55
 8094040   EQ ANS PULSE OXM          EQ ANS PULSE OX                  $271.55
 8094045   ANS BAIR HUGGER           ANS BAIR HUGGER                  $271.55
 8094050   ANS BLOOD WARMER          ANS BLOOD WARMR                  $271.55
 8094055   EQ ANS MNTR CRD OP        EQ ANS MNTR CRD                  $271.55
 8094105   PACU MNTR BP              R/R MNTR BP                      $271.55
 8094110   PACU MNTR CARDIAC         R/R MNTR CARD                    $271.55
 8094115   PACU PULSE OXIMTR         R/R PULS OXMTR                   $271.55
 8094120   PACU                      R/R BAIR HUGGE                   $271.55
 8094125   PACU GLUCOMTR             R/R GLUCOMTR                     $271.55
 8094130   PACU EMRSN SUCT           R/R EMRSN SUCT                   $167.10
 8094135   PACU DOPPLER              R/R DOPPLER                      $271.55
 8094140   PACU BLOOD WARMR          R/R BLOOD WARM                   $271.55
 8094145   PACU MNTR ART LINE        R/R ART LINE                     $271.55
 8094150   PACU MNTR CVP             R/R MNTR CVP                     $271.55
 8094155   PACU SEQ COMP DEV         R/R SEQ COMP D                   $271.55
 8094160   PACU PMP INFUSN           R/R PMP INFUSN                   $271.55
 8094165   PACU MNTR SW GZ           R/R MNTR SW GZ                   $271.55
 8094170   PACU PMP PCA              R/R PMP PCA                      $271.55
 8094175   PACU WARM LIGHT           R/R WARM LIGHT                   $341.90
 8094180   PACU MNTR CO2             R/R MNTR CO2                     $271.55
 8094185   PACU MNTR CARD OUTPUT     R/R CARD OUTPUT                  $193.80
 8094190   PACU K-THERM UT           R/R K-THERM UT                   $271.55
 8094195   PACU DEFIBRILTR           R/R DEFIBRILTR                   $271.55
 8098999   EQ MISC                   EQ MISC                 $7.65 - $31,00.60
 8100000   4050 C/S CASTS/SPLINTS    C/S CASTS/SPLNT
 8103000   BND CSTPAD2/3W            BND CSTPAD2/3W                  $125.35
 8103005   BND CSTPAD4/5W            BND CSTPAD4/5W                  $647.75
 8103015   BUCKET 2GAL               BUCKET 2GAL                      $60.90
 8103025   CST ARM LNG A             CST ARM LNG A                   $528.10
 8103030   CST ARM LNG C             CST ARM LNG C                   $387.50
 8103035   CST ARM SHRT A            CST ARM SHRT A                  $387.50
 8103040   CST ARM SHRT C            CST ARM SHRT C                  $292.45
 8103060   CST BODY FULL C           CST BODY FULL C               $1,340.95
 8103120   CST FT CLUB BIL           CST FT CLUB BIL                 $590.75
 8103130   CST HIP SPIKA A           CST HIP SPIKA A               $1,992.60
 8103140   CST HIP SPIKA C           CST HIP SPIKA C               $2,138.85
 8103160   CST LEG LNG A             CST LEG LNG A                 $1,622.20
 8103165   CST LEG LNG A/FG          CST LEG LNG A/F               $1,867.15
 8103170   CST LEG LNG BRCE          CST LEG LNG BRC               $2,180.65
 8103175   CST LEG LNG C/FG          CST LEG LNG C/F                 $780.70
 8103190   CST LEG SHRT A            CST LEG SHRT A                  $714.25
 8103195   CST LEG SHRT C            CST LEG SHRT C                  $664.80
 8103200   CST LEG SHT A/FG          CST LEG SHT A/F                 $200.10
 8103205   CST LEG SHT C/FG          CST LEG SHT C/F                 $712.30



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  Doctors Medical Center - Modesto                                         Page 138 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION        BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 8103210   CST LEG SYL ADLT          CST LEG SYL ADL                 $1,179.55
 8103230   CST HIP SPIKA A           CST HIP SPIKA A                 $1,992.60  Minimum
 8103235   CST REMVL/BIVL            CST REMVL/BIVL                    $271.55
 8103275   CST THMB GNTLT C          CST THMB GNTLT                    $469.20
 8103295   CST/ARM LNG A/FG          CST/ARM LN A/FG                   $100.01
 8103300   CST/ARM LNG C/FG          CST/ARM LN C/FG                   $712.30
 8103305   CST/ARM SHT A/FG          CST/ARM SH A/FG                   $712.30
 8103310   CST/ARM SHT C/FG          CST/ARM SH C/FG                   $476.80
 8103405   PLAST ROLL 2IN            PLAST ROLL 2IN                     $11.40
 8103410   PLAST ROLL 3IN            PLAST ROLL 3IN                     $79.80
 8103415   PLAST ROLL 4IN            PLAST ROLL 4IN                    $149.95
 8103425   PLAST ROLL 6IN            PLAST ROLL 6IN                    $165.30
 8103476   SPLNT ANTI-SPAST          SPLNT ANTI-SPST                   $359.25
 8103490   SPLNT AR LONG A           SPLNT AR LONG A                   $250.02
 8103495   SPLNT AR LONG C           SPLNT AR LONG C                   $964.47
 8103500   SPLNT AR SHORT A          SPLNT AR SHRT A                   $491.95
 8103505   SPLNT AR SHORT C          SPLNT AR SHRT C                   $412.30
 8103515   SPLNT CLAV A/S            SPLNT CLAV A/S                     $35.25
 8103525   SPLNT DYNM MED            SPLNT DYNM MED                    $144.40
 8103530   SPLNT DYNM LG             SPLNT DYNM LG                     $184.40
 8103535   SPLNT DYNM SM             SPLNT DYNM SM                     $115.85
 8103540   SPLNT ELBO A/Y            SPLNT ELBO A/Y                    $450.25
 8103555   SPLNT ELBOW               SPLNT ELBOW                       $169.00
 8103560   SPLNT EXTENSN             SPLNT EXTENSN                     $640.20
 8103565   SPLNT FIBGLS LG           SPLNT FIBGLS LG                   $514.80
 8103571   SPLNT FUNCTION            SPLNT FUNCTION                    $268.20
 8103575   SPLNT HAND ADULT          SPLNT HAND ADLT                   $146.30
 8103576   SPLNT HAND                SPLNT HAND                        $281.20
 8103590   SPLNT IND                 SPLNT IND                          $15.20
 8103605   SPLNT LEG LONG A          SPLNT LEG LNG A                   $735.15
 8103610   SPLNT LEG LONG C          SPLNT LEG LNG C                   $450.25
 8103611   SPLNT LEG PADDED          SPLNT LEG PAD                   $1,487.35
 8103615   SPLNT LEG SHT A           SPLNT LEG SHT A                   $537.55
 8103620   SPLNT LEG SHT C           SPLNT LEG SHT C                   $393.20
 8103621   SPLNT MATERIAL ALL        SPLNT MATERL AL                   $136.60  Minimum
 8103624   SPLNT NEUTRAL             SPLNT NEUTRAL                     $311.20
 8103630   SPLNT REPAIR              SPLNT REPAIR                       $49.40
 8103654   SPLNT ULNAR DEV           SPLNT ULNAR DEV                    $83.55
 8103660   SPLNT WRIST C/V           SPLNT WRIST C/V                   $790.20
 8103665   SPLNT WRST LTHET          SPLNT WRST LTHT                   $389.45
 8103709   STRAP SPLNT               STRAP SPLNT                        $42.10
 8108999   CST MISC                  CST MISC                $11.40 - $2,180.65
 8110000   4050 C/S TRACTION/ORTHO   C/S TRACTN/ORTH
 8114015   BLT TRAC PELVIC           BLT TRAC PELVIC                 $659.10
 8114020   BOOT BUCK TRX LG          BOOT BUCK TRXLG                 $398.95
 8114040   BRCE ADJUST/VAR           BRCE ADJUST/VAR               $7,206.65
 8114045   BRCE ANKLE                BRCE ANKLE                    $5,333.70
 8114065   BRCE FOOTDROP             BRCE FOOTDROP                   $674.30
 8114075   BRCE FUTURO MD            BRCE FUTURO MD                  $223.90
 8114090   BRCE LONG LEG             BRCE LONG LEG                $14,724.75



  CDM Run Date: 06/01/2007
  Doctors Medical Center - Modesto                                       Page 139 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION        BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 8114095   BRCE LSO W/EXT            BRCE LSO W/EXT               $14,724.75
 8114100   BRCE ORTHOPEDIC           BRCE ORTHOPEDIC                 $600.02 Minimum
 8114105   BRCE ORTHOPEDIC           BRCE ORTHOPEDIC               $3,995.55 Minimum
 8114110   BRCE ORTHOPEDIC           BRCE ORTHOPEDIC               $1,000.12 Minimum
 8114115   BRCE ORTHOPEDIC           BRCE ORTHOPEDIC               $2,000.03 Minimum
 8114120   BRCE ORTHOPEDIC           BRCE ORTHOPEDIC               $1,875.08 Minimum
 8114125   BRCE ORTHOPEDIC           BRCE ORTHOPEDIC               $2,062.70 Minimum
 8114130   BRCE ORTHOPEDIC           BRCE ORTHOPEDIC               $3,807.65 Minimum
 8114135   BRCE ORTHOPEDIC           BRCE ORTHOPEDIC               $6,345.13 Minimum
 8114140   BRCE ORTHOPEDIC           BRCE ORTHOPEDIC               $5,825.23 Minimum
 8114170   COLLAR CERV               COLLAR CERV                      $40.01
 8114175   COLLAR CERV A/S           COLLAR CERV A/S                  $44.40 Minimum
 8114185   COLLAR CERV PLST          COLLR CERV PLST                 $651.50
 8114195   COLLAR HARD CERV          COLLR HARD CERV               $1,864.27
 8114200   COLLAR PHIL               COLLAR PHIL                     $590.75
 8114210   CORSET LUMBO-SAC          CORSET LUMB-SAC               $1,555.65 Minimum
 8114220   DISC COMP DISP            DISC COMP DISP                  $398.95
 8114240   ELEVAT FOOT               ELEVAT FOOT                     $567.95
 8114265   FOOT BOARD D              FOOT BOARD D                    $727.45
 8114285   HALTER HD A/S             HALTER HD A/S                   $433.05
 8114290   HEEL-RUBR/CST             HEEL-RUBR/CST                   $228.05
 8114300   HINGE BRACE EXTR          HINGE BRAC EXTR               $2,984.10
 8114325   HL LIMB PR                HL LIMB PR                       $52.02
 8114330   HL VEST                   HL VEST                         $114.04 Minimum
 8114371   PD PASSIVE LEG            PD PASSIVE LEG                  $100.01
 8114390   PRT HL/EL                 PRT HL/EL                        $40.44
 8114395   RESTR LIMB                RESTR LIMB                       $85.45
 8114400   ROPE/PULLEY ST            ROPE/PULLEY ST                  $679.90
 8114405   SHOE BUNNY BOOT           SHOE BUNNY BOOT                 $539.40
 8114410   SHOE CST A/S              SHOE CST A/S                     $35.73
 8114415   SHOE CST WALKNG           SHOE CST WALKNG                 $784.35
 8114420   SHOE ORTHOPEDIC           SHOE ORTHOPEDIC                 $388.40
 8114423   SHOE POST-OP SPEC1        SHOE PSTOP SPC1                 $389.45
 8114425   SHOE POST-OP A/S          SHOE POSTOP A/S                 $381.80
 8114445   SLING ARM FASHON          SLING ARM FASHN                  $48.06
 8114450   SLING ARM HEMI            SLING ARM HEMI                  $124.55
 8114472   SLING CUFF/CLR            SLING CUFF/CLR                  $541.30
 8114480   SLING HANG CST            SLING HANG CST                  $419.80
 8114500   SLING TOMSP               SLING TOMSP                     $330.05
 8114545   SPLNT FNGER A/S           SPLNT FNGER A/S                  $52.70
 8114565   SPLNT HAND A/T            SPLNT HAND A/T                   $82.50
 8114575   SPLNT IMOBL SHLD          SPLNT IMOBL SHL                 $123.60
 8114590   SPLNT KNEE UNN            SPLNT KNEE UNN                  $149.44
 8114605   SPLNT NASAL               SPLNT NASAL                     $881.40
 8114615   SPLNT REST HAND           SPLNT REST HAND               $1,031.40
 8114645   SPLNT VARIOUS             SPLNT VARIOUS                   $719.90 Minimum
 8114650   SPLNT WRIST DLX           SPLNT WRIST DLX                 $769.25
 8114655   SPLNT WRST COLES          SPLNT WRST COLS                 $228.05
 8114665   SPPRT ANKLE               SPPRT ANKLE                     $976.40
 8114705   SPPRT KNEE HINGD          SPPRT KNEE HNGD               $2,469.30



  CDM Run Date: 06/01/2007
  Doctors Medical Center - Modesto                                            Page 140 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 8114715   SPPRT KNEE SS              SPPRT KNEE SS                  $2,155.58
 8114795   TRAC BRYN DBL D            TRAC BRYN DBL D                $2,372.45
 8114830   TRAC BUCK SNGL D           TRAC BCK SNGL D                  $727.45
 8114850   TRAC CERV SKLT D           TRAC CRV SKLT D                  $727.45
 8114870   TRAC EX/CPM DLYM           TRAC EX/CPM DLY                  $727.45
 8114885   TRAC EXT SKLT SU           TRAC EXT SKLT S                  $240.09
 8114890   TRAC EXTR SKLT D           TRAC EXT SKLT D                  $727.45
 8114895   TRAC FRAM OVRH D           TRAC FRM OVRH D                  $727.45
 8114915   TRAC KNEE EXRC D           TRAC KNEE EXRC                 $2,372.45
 8114925   TRAC LEG UNLR D            TRAC LEG UNLR D                  $727.45
 8114950   TRAC PLVC D                TRAC PLVC D                      $727.45
 8114960   TRAC PLVC SNG D            TRAC PLVC SNG D                  $727.45
 8114990   TRAC SIDE ARM D            TRAC SIDE ARM D                  $294.45
 8115050   TRAC TOMSPLT S D           TRAC TOMSPLT S                   $727.45
 8115065   VEST TRAC GLR              VEST TRAC GLR                    $727.45
 8118999   C/S MISC TRACT/ORTHO       MISC TRACT/ORTH         $240.00 - $564.00
 8120000   4050 C/S PROSTH ENT/EYE    C/S PRSTH/ENT/E
 8121003   EAR COUPLR                 EAR COUPLR                        $94.31    Minimum
 8121005   IMP EAR CUP TE             IMP EAR CUP TE                   $500.04    Minimum
 8121015   IMP EAR INC/AT             IMP EAR INC/AT                   $845.25    Minimum
 8121020   IMP EAR INC/ST             IMP EAR INC/ST                   $594.55    Minimum
 8121025   IMP EAR INCUS              IMP EAR INCUS                  $1,312.33    Minimum
 8121030   EAR LOOP                   EAR LOOP                       $1,578.55    Minimum
 8121040   EAR OSICUL                 EAR OSICUL                     $1,116.48    Minimum
 8121050   EAR STAPES                 EAR STAPES                     $1,200.42    Minimum
 8121070   EAR TUBE                   EAR TUBE                          $49.40    Minimum
 8121115   EAR TUBE T                 EAR TUBE T                       $896.65    Minimum
 8122010   EYE CONFRM                 EYE CONFRM                     $1,305.00    Minimum
 8122041   EYE IOL                    EYE IOL                          $685.90
 8122115   EYE SILICONE SP            EYE SILICONE SP                  $478.70    Minimum
 8122125   EYE TIRE/S                 EYE TIRE/S                       $520.45    Minimum
 8128999   C/S MISC PROSTH ENT/EYE    MISC PROS ENT          $49.40 - $1,578.55
 8130000   4050 C/S PROSTH ORTHO      C/S PROSTH/ORTH
 8130041   UE FX HUMERAL              UE FX HUMERAL                 $1,215.00
 8130044   ABDCT HIP FLX PAVLIK HRN   ABD HIP FLX PAV                 $597.17
 8130045   HO POST-OP HIP ABDUCTION   HO POSTOP ABDCT               $1,650.00
 8130047   KO ADJ JNT POS RIGD SPPT   KO ADJ JT POS R               $1,990.00
 8130050   SOFT INTERFC BLW KNEE SE   SFT INTFC BLW K                 $468.28
 8130057   PNEUMATC WALK SPLNT        PNEUM WLK SPLNT               $1,092.00
 8130078   HALO CERV INTO JCKT VEST   HALO CRV JCKT V               $3,500.00
 8130079   AFO PLSTC/OTHER PREFAB     AFO PLST/OTHER                  $949.00
 8130081   ORTH ADD BODY SOCK         BODY SOCK                       $205.00
 8130086   ORTH HIP ADJ FLX EXT ABD   HIP ADJ FLX EXT               $1,492.60
 8130104   ORTH LSO PST RGD PAN PF    LSO PST RGD PAN                 $627.62
 8130150   ORTH SO ELASTIC PREFAB     SO ELAST PREFAB                 $188.00
 8130151   ORTH SOFT INTERFCE AB      SOFT INTRFC AB                  $506.67
 8130152   ORTH SO VEST ABDUCT PREF   SO VEST ABDUCT                  $618.91
 8130970   TLSO CORSET FRONT          TLSO CORST FRNT                 $458.00
 8131000   ACETABULR COMP             ACETABULR COMP                $3,750.03     Minimum
 8131005   ACETABULR SEAL             ACETABULR SEAL                $2,000.00     Minimum



  CDM Run Date: 06/01/2007
  Doctors Medical Center - Modesto                                        Page 141 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 8131010   ADPT & CAP                 ADPT & CAP                       $64.58 Minimum
 8131260   BN BLOCKS                  BN BLOCKS                     $1,480.06 Minimum
 8131265   BN CADAVAR                 BN CADAVAR                   $12,437.50 Minimum
 8131275   BN CHIPS                   BN CHIPS                      $5,090.60 Minimum
 8131282   BN GRANUELS 15CC           BN GRANUELS15CC               $1,252.00 Minimum
 8131283   BN GRANUELS 30CC           BN GRANUELS30CC               $1,592.00 Minimum
 8131285   BN GRFT                    BN GRFT                       $1,600.15 Minimum
 8131286   BN GRFT 2                  BN GRFT 2                     $1,889.28 Minimum
 8131290   BN PLUGS                   BN PLUGS                        $450.05 Minimum
 8131500   CABLE FX SPINE             CABLE FX SPINE                $3,448.80 Minimum
 8131530   CEMT PLUG                  CEMT PLUG                       $633.40 Minimum
 8131542   CLLAR CERV ADJ BR TH EX    COLLAR CER ADJ                $1,865.88
 8131550   COMPRESS CLAMP             COMPRESS CLAMP                $1,984.95 Minimum
 8131560   CUP SELF CENT              CUP SELF CENT                 $5,774.45 Minimum
 8131571   DVC TROCHANTER FIX W CBL   DVC TROCH FIX                 $2,404.80 Minimum
 8132007   EXFX CAP TIP               EXFX CAP TIP                     $60.90
 8132010   EXFX CLAMP LG              EXFX CLAMP LG                 $3,694.50 Minimum
 8132015   EXFX CLAMP SM              EXFX CLAMP SM                 $1,523.40 Minimum
 8132090   EXFX SET LG                EXFX SET LG                  $10,948.60 Minimum
 8132155   EXFX PIN HOLD              EXFX PIN HOLD                 $3,888.40 Minimum
 8132165   EXFX RD LG                 EXFX RD LG                    $1,514.00 Minimum
 8132505   FEM COMP                   FEM COMP                      $5,305.25 Minimum
 8132510   FEM NAIL                   FEM NAIL                      $2,036.92 Minimum
 8132585   FIX ROD EXTNL D            FIX ROD EXTNL D                 $630.70 Minimum
 8132835   HOOK HARINGTNS+B           HOOK HARINGTN+B               $1,132.05 Minimum
 8132840   HOOK LUMB-LAM              HOOK LUMB-LAM                 $2,104.55 Minimum
 8132845   HOOK THOR-LAM              HOOK THOR-LAM                 $2,735.30 Minimum
 8132938   IMP SUBTALAR MBA           IMP SUBTALAR                  $2,056.32
 8132975   LUQUE WIRE                 LUQUE WIRE                      $881.40 Minimum
 8132985   MISC-OR PROSTH             MISC-OR PROSTH                $6,046.00
 8133001   NAIL INTRAMEDULLARY TYP1   NAIL INTRAMEDUL               $2,708.35 Minimum
 8133075   NAIL TIBIA                 NAIL TIBIA                    $2,500.14 Minimum
 8133200   ORTH ELBOW ADJ LCK JNT     ELBOW ADJ LCK                 $1,300.00
 8133203   ORTH BOOT NONPNEU PREFAB   BOOT NONPNEU                    $614.41
 8133204   ORTH CRAN HELMT MLD        CRAN HELMET                   $1,800.00
 8133241   ORTH ADD NONCORRS EA BAR   NONCORRSIVE FIN                 $425.46
 8133263   ORTH SO FIG8 RESTRN PRF    SO FIG8 RESTRN                  $416.00
 8133265   NUT BARR BLT               NUT BARR BLT                  $1,776.00 Minimum
 8133267   ORTH TSLO TRPL CTRL 2PC    TSLO TPLNR 2P                 $2,250.00
 8133270   NUT HARINGTN HEX           NUT HARINGTN HX                 $256.40 Minimum
 8133308   PROS LE AK SILESIAN BAN    LE AK SILESIAN                  $591.14
 8133590   PIN KNOWLES AS             PIN KNOWLES AS                $1,156.85 Minimum
 8133595   PIN MLT FIXATN             PIN MLT FIXATN                $9,504.31 Minimum
 8133605   PIN RUSH 1/8IN             PIN RUSH1/8IN                   $860.45 Minimum
 8133610   PIN RUSH3/16&1/4           PIN RSH3/16&1/4                 $995.35 Minimum
 8133615   PIN RUSH 3/32IN            PIN RSH 3/32IN                  $645.80 Minimum
 8133635   PIN STEINMAN PL            PIN STEINMAN PL                 $288.80 Minimum
 8133640   PIN STEINMAN THR           PIN STEINMN THR                 $556.55 Minimum
 8133645   PINS LG EXT FIX            PINS LG EXT FIX                 $679.90 Minimum
 8133650   PINS SM EXT FIX            PINS SM EXT FIX                 $512.90 Minimum



  CDM Run Date: 06/01/2007
  Doctors Medical Center - Modesto                                       Page 142 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION        BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 8133685   PLT CERV SPINE            PLT CERV SPINE                $2,398.53 Minimum
 8133695   PLT COMP TUBE             PLT COMP TUBE                   $400.00 Minimum
 8133700   PLT COMPRESION            PLT COMPRESION                  $923.50 Minimum
 8133705   PLT DANEK                 PLT DANEK                     $6,592.50 Minimum
 8133715   PLT E CLOVLEAF            PLT E CLOVLEAF                $3,269.10 Minimum
 8133725   PLT E COMP DCP            PLT E COMP DCP                  $632.05 Minimum
 8133740   PLT E COMP SPN            PLT E COMP SPN                $2,125.12 Minimum
 8133745   PLT E COMP BUT            PLT E COMP BUT                $6,148.70 Minimum
 8133750   PLT E CONDYLR             PLT E CONDYLR                 $1,468.64 Minimum
 8133765   PLT E MINI                PLT E MINI                    $2,000.15 Minimum
 8133770   PLT E MINI DC             PLT E MINI DC                   $456.19 Minimum
 8133780   PLT E MULT FRG            PLT E MULT FRG                  $412.11 Minimum
 8133785   PLT E SEM TUBE            PLT E SEM TUBE                $1,181.50 Minimum
 8133795   PLT E T                   PLT E T                       $5,379.35 Minimum
 8133800   PLT E T BUTRES            PLT E T BUTRES                $2,949.40 Minimum
 8133820   PLT E Y HUMCND            PLT E Y HUMCND                $3,238.65 Minimum
 8133825   PLT E 1/3 TUBE            PLT E 1/3 TUBE                  $517.16 Minimum
 8133845   PLT RECONTSRCT            PLT RECONTSRCT                $1,200.16 Minimum
 8133865   PLT SPINAL                PLT SPINAL                    $2,191.87 Minimum
 8134260   PROS BN PLUG              PROS BN PLUG                  $4,131.45 Minimum
 8134270   PROS CARPL SCAP           PROS CARPL SCAP               $2,533.85 Minimum
 8134280   PROS FINGER JNT           PROS FINGER JNT               $3,768.60 Minimum
 8134290   PROS HIP                  PROS HIP                      $8,250.29 Minimum
 8134295   PROS HIP                  PROS HIP                      $6,013.80 Minimum
 8134300   813S HIP ACTBCU           PROS HIP ACTBCU               $3,750.49 Minimum
 8134310   PROS HIP CENTRA           PROS HIP CENTRA               $2,038.05 Minimum
 8134315   PROS HIP FEMSTE           PROS HIP FEMSTE               $8,250.47 Minimum
 8134320   PROS HIP FEMSTE           PROS HIP FEMSTE              $16,932.05 Minimum
 8134325   PROS HIP FEMSTE           PROS HIP FEMSTE              $14,016.25 Minimum
 8134335   PROS HIP HD/NEC           PROS HIP HD/NEC               $2,900.29 Minimum
 8134340   PROS HIP RING             PROS HIP RING                 $1,500.16 Minimum
 8134345   PROS HIP/FEMSTE           PROS HIP/FEMSTE               $8,250.07 Minimum
 8134352   PROS HUMERAL HD           PROS HUMERAL HD               $2,001.60 Minimum
 8134354   PROS HUMERAL STEM         PROS HUMERL STM               $3,067.20 Minimum
 8134360   PROS KNE/FEMORA           PROS KNE/FEMORA               $4,250.15 Minimum
 8134365   PROS KNE/FEMORA           PROS KNE/FEMORA               $7,554.35 Minimum
 8134380   PROS KNE/INSERT           PROS KNE/INSERT               $2,500.19 Minimum
 8134385   PROS KNE/PATELA           PROS KNE/PATELA               $1,400.00 Minimum
 8134390   PROS KNE/PATELA           PROS KNE/PATELA               $8,110.90 Minimum
 8134400   PROS KNE/TIBIAL           PROS KNE/TIBIAL               $2,142.95 Minimum
 8134405   PROS KNE/TIBIAL           PROS KNE/TIBIAL               $2,537.50 Minimum
 8134435   PROS RADIAL HEA           PROS RADIAL HEA               $1,760.25 Minimum
 8134445   #ROS SHOLDR TOT           PROS SHOLDR TOT               $6,605.67 Minimum
 8134450   PROS SHOULDER             PROS SHOULDER                 $6,779.20 Minimum
 8134462   PROS TENDON               PROS TENDON                   $2,584.80 Minimum
 8134470   PROS TIB                  PROS TIB                      $5,538.90 Minimum
 8134480   PROS TIB STEM             PROS TIB STEM                 $2,500.20 Minimum
 8134500   PROS TOE HINGE            PROS TOE HINGE                $2,533.85 Minimum
 8134510   PROS ULNAR HEAD           PROS ULNAR HEAD              $10,468.05 Minimum
 8134515   PROS WIRE/SU HI           PROS WIRE/SU HI               $2,121.80 Minimum



  CDM Run Date: 06/01/2007
  Doctors Medical Center - Modesto                                        Page 143 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 8134750   PROTECT CAPS 2P            PROTECT CAPS 2P                 $573.90 Minimum
 8135000   RD ASSMBLY FUS             RD ASSMBLY FUS                $2,796.10 Minimum
 8135005   RD HARINGTN                RD HARINGTN                   $1,324.00 Minimum
 8135025   RD SM EXT FIX              RD SM EXT FIX                   $752.20 Minimum
 8135030   RD SPINAL                  RD SPINAL                       $913.88 Minimum
 8135060   RD TIBIAL GK               RD TIBIAL GK                  $2,032.28 Minimum
 8135095   RINGS OPEN-CLSD            RINGS OPEN-CLSD               $2,735.30 Minimum
 8136005   SCRW BN                    SCRW BN                         $600.01 Minimum
 8136006   SCRW BN                    SCRW BN                         $600.03 Minimum
 8136007   SCRW BN                    SCRW BN                         $573.70 Minimum
 8136020   SCRW CANCL                 SCRW CANCL                      $426.16 Minimum
 8136030   SCRW CANN                  SCRW CANN                     $1,112.44 Minimum
 8136031   SCREW CANN                 SCREW CANN                      $591.84 Minimum
 8136035   SCRW CERV EXPAN            SCRW CERV EXPAN               $1,080.49 Minimum
 8136040   SCRW CERV PLSMA            SCRW CERV PLSMA               $5,050.70 Minimum
 8136050   SCRW COMPRESS              SCRW COMPRESS                   $486.03 Minimum
 8136060   SCRW COMPRS/LAG            SCRW COMPRS/LAG                 $762.70 Minimum
 8136076   SCRW DISTRACTION           SCRW DISTRACTN                  $507.45
 8136085   SCRW E CANCL6.5            SCRW E CANCL6.5                 $855.17 Minimum
 8136090   SCRW E CORTX               SCRW E CORTX                    $207.28 Minimum
 8136105   SCRW E MALEOLA             SCRW E MALEOLA                  $254.22 Minimum
 8136110   SCRW E NUT CRTX            SCRW E NUT CRTX                 $541.30 Minimum
 8136115   SCRW E SCHANZ              SCRW E SCHANZ                   $368.00 Minimum
 8136120   SCRW E WASHER              SCRW E WASHER                   $216.84 Minimum
 8136130   SCRW F/X SPINE             SCRW F/X SPINE                $1,117.04 Minimum
 8136150   SCRW HERBERT               SCRW HERBERT                    $800.22 Minimum
 8136175   SCRW HIP COMP              SCRW HIP COMP                   $535.59 Minimum
 8136190   SCRW ISOTEK STR            SCRW ISOTEK STR                 $940.25 Minimum
 8136200   SCRW MANDBL MSH            SCRW MANDBL MSH               $1,384.65 Minimum
 8136215   SCRW ORAL                  SCRW ORAL                       $440.70 Minimum
 8136245   SCRW SET SPINAL            SCRW SET SPINAL               $3,937.65 Minimum
 8136290   SCRW TRANSVERS             SCRW TRANSVERS                  $520.12 Minimum
 8136312   SO ACR/CLAV PREFAB         SO ACR/CLAV                     $596.70
 8136525   SPINAL FIXATN              SPINAL FIXATN                 $5,002.09 Minimum
 8136545   SPINAL HOOK SPC            SPINAL HOOK SPC                 $450.06 Minimum
 8136565   SPINAL RECON               SPINAL RECON                  $5,250.64 Minimum
 8136568   SPINAL RECON $1000-$3000   SPINAL RECON                  $7,877.25 Minimum
 8136570   SPINAL RECON $3000-$4000   SPINAL RECON                  $9,189.70 Minimum
 8136595   STEM SPACER                STEM SPACER                   $3,001.20 Minimum
 8136610   STPL BARB                  STPL BARB                       $833.85 Minimum
 8136625   STPL COVENTRY              STPL COVENTRY                   $833.85 Minimum
 8136630   STPL EPIPHYS AS            STPL EPIPHYS AS                 $843.35 Minimum
 8136640   STPL FIXATION              STPL FIXATION                 $9,501.11 Minimum
 8136645   STPL FX AS                 STPL FX AS                      $843.35 Minimum
 8136670   STPL STONE TBL             STPL STONE TBL                  $890.80 Minimum
 8137015   #OTAL HEAD                 TOTAL HEAD                    $6,918.05 Minimum
 8137048   UE FX ADD SOCK             UE FX ADD SOCK                  $115.00
 8137050   UNIVERSAL HEAD             UNIVERSAL HEAD                $1,463.84 Minimum
 8137060   UNI-JOINT EXT FX           UP LUM ROD SLV                $1,996.27 Minimum
 8137075   WASHER HARINGTN            WASHER HARINGTN                 $361.00 Minimum



  CDM Run Date: 06/01/2007
  Doctors Medical Center - Modesto                                         Page 144 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION        BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 8137090   WIRE GUIDEPINCAL          WIRE GUIDEPINCL                   $693.35  Minimum
 8137095   WIRE KIRCHNER PL          WIRE KIRCHNR PL                   $279.40  Minimum
 8137100   WIRE KIRCHNER TH          WIRE KIRCHNR TH                   $168.58  Minimum
 8138999   C/S MISC PROSTH ORTHO     MISC PROS ORTHO        $60.90 - $16,932.05
 8140000   4050 C/S PROSTHESIS CV    C/S PROSTH/CV
 8140990   AICD GENERATOR            AICD GENERATOR               $55,761.78   Minimum
 8141275   CATH VENTR                CATH VENTR                      $744.65   Minimum
 8141290   CLIP ANEURP               CLIP ANEURP                   $3,039.15   Minimum
 8141600   GEL GRFTN                 GEL GRFTN                     $1,575.79   Minimum
 8141605   GEL GRFTN 10CC            GEL GRFTN 10CC                $2,347.64   Minimum
 8142000   GREENFIELD V-C            GREENFIELD V-C                $1,967.11   Minimum
 8142025   GRFT ALL/TYPES            GRFT ALL/TYPES                $1,500.00   Minimum
 8142030   GRFT CV FABR 4IN          GRFT CV FABR 4                $1,600.19   Minimum
 8142040   GRFT CV FELT 4IN          GRFT CV FELT 4                  $966.90   Minimum
 8142045   GRFT CV FELT 6IN          GRFT CV FELT 6                  $567.06   Minimum
 8142055   GRFT CV PLEDGET           GRFT CV PLEDGET                 $112.15   Minimum
 8142065   GRFT GRTX PTCH            GRFT GRTX PTCH                $1,600.12   Minimum
 8142075   GRFT MESH ACETB           GRFT MESH ACETB               $2,072.30   Minimum
 8142080   GRFT MESH MARLX           GRFT MESH MARLX               $2,740.95   Minimum
 8142090   GRFT MESH PROLN           GRFT MESH PROLN               $2,326.95   Minimum
 8142115   GRFT PATCH                GRFT PATCH                    $4,391.60   Minimum
 8142125   GRFT PTCH                 GRFT PTCH                     $1,600.63   Minimum
 8142145   GRFT VASC BIF D           GRFT VASC BIF D               $1,421.70   Minimum
 8142150   GRFT VASC BIF G           GRFT VASC BIF G               $7,094.60   Minimum
 8142155   GRFT VASC BIF M           GRFT VASC BIF M               $6,843.80   Minimum
 8142170   GRFT VASC BOV             GRFT VASC BOV                 $1,500.10   Minimum
 8142215   GRFT VASC STR B           GRFT VASC STR B               $2,652.99   Minimum
 8142230   GRFT VASC STR G           GRFT VASC STR G               $5,347.05   Minimum
 8142240   GRFT VASC STR G           GRFT VASC STR G               $1,600.13   Minimum
 8142245   GRFT VASC STR G           GRFT VASC STR G               $2,304.16   Minimum
 8142250   GRFT VASC STR I           GRFT VASC STR I               $2,506.41   Minimum
 8143005   HOLTR VLAVE SET           HOLTR VLAVE SET               $6,038.40   Minimum
 8143025   HOLTR VENTRL RS           HOLTR VENTRL RS                 $756.30   Minimum
 8143450   MEDIPORT                  MEDIPORT                      $6,834.35   Minimum
 8143505   OH RING MITRAL            OH RING MITRAL                $4,574.29   Minimum
 8143510   OH VALVE AOR/MIT          OH VALVE AOR/MT              $12,118.16   Minimum
 8143515   OH VALVE AORTIC           OH VALVE AORTIC               $8,391.00   Minimum
 8143525   OH VALVE MITRAL           OH VALVE MITRAL               $5,993.75   Minimum
 8144005   P/M BIOTRONC              P/M BIOTRONC                 $22,222.05   Minimum
 8144015   P/M GEN                   P/M GEN                      $18,822.00   Minimum
 8144025   P/M LD IMP                P/M LD IMP                    $4,056.72   Minimum
 8144030   P/M LD INTRM              P/M LD INTRM                  $5,479.90   Minimum
 8144035   P/M LD MEDTR              P/M LD MEDTR                  $2,347.41   Minimum
 8144040   P/M LD PACES              P/M LD PACES                  $6,285.40   Minimum
 8144045   P/M LEAD                  P/M LEAD                      $6,697.55   Minimum
 8144050   P/M MEDTRONC              P/M MEDTRONC                 $24,146.20   Minimum
 8144055   P/M PACESETR              P/M PACESETR                 $12,025.20   Minimum
 8144065   PACE ADAPTOR KT           PACE ADAPTOR KT               $2,410.45   Minimum
 8144075   PACE LD ELECTR            PACE LD ELECTR                $7,267.50   Minimum
 8144115   PACE LD PERMD             PACE LD PERMD                 $1,875.00   Minimum



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  Doctors Medical Center - Modesto                                              Page 145 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 8144120   PACE LD PERMN              PACE LD PERMN                  $15,000.00  Minimum
 8144150   PARHAN BANDS               PARHAN BANDS                      $281.20  Minimum
 8145005   SHNT CAROTD BYP            SHNT CAROTD BYP                   $455.62  Minimum
 8145035   SHNT CATH PERT             SHNT CATH PERT                  $1,956.45  Minimum
 8145045   SHNT CATH VENT             SHNT CATH VENT                  $1,800.32  Minimum
 8145050   SHNT CATH VENT             SHNT CATH VENT                    $860.27  Minimum
 8145055   SHNT CATH VENT             SHNT CATH VENT                    $239.45  Minimum
 8145065   SHNT CONN                  SHNT CONN                         $630.70  Minimum
 8145135   SHNT VALVE FL              SHNT VALVE FL                   $1,800.23  Minimum
 8145150   SHNT VALVE PERI            SHNT VALVE PERI                $12,722.75  Minimum
 8145765   VENA CAVA KT               VENA CAVA KT                    $6,408.85  Minimum
 8145794   VLV HAKIM PROGRAMABLE      VLV HAKIM PROG                  $5,073.12
 8145795   VLV HAKIM STD              VLV HAKIM STD                   $7,041.40  Minimum
 8148999   C/S MISC PROSTHESIS CV     MISC PROSTH CV        $112.15 - $55,761.78
 8150000   4050 C/S PROSTH OTHER      C/S PROSTH/OTHR
 8151500   FALLOPIAN RING             FALLOPIAN RING                   $1,223.20    Minimum
 8152003   IMP COLLAGEN A/S           IMP COLLAGN A/S                  $2,221.90    Minimum
 8152005   IMP DEX MESH               IMP DEX MESH                     $1,675.14    Minimum
 8152020   IMPL FASCIA SLING          IMPL FASCIASLNG                  $3,145.50    Minimum
 8152022   IMPL SCRW BIOABSORB I      IMP SCRW BIO I                   $1,500.00    Minimum
 8152030   IMP RING/TUBE              IMP RING/TUBE                  $10,580.15     Minimum
 8152034   IMPLT SFT TISS LG          IMPLT SFT TIS L                $10,580.15     Minimum
 8152035   IMPLT SFT TIS SM           IMPLT SFTTIS SM                  $4,296.65    Minimum
 8152065   INTERPORE                  INTERPORE                        $1,180.12    Minimum
 8153005   KT ANUERO/CRAN             KT ANUERO/CRAN                     $948.14    Minimum
 8153065   KT VEN ACCESS              KT VEN ACCESS                      $216.50    Minimum
 8153264   LD AICD                    LD AICD                          $5,907.45    Minimum
 8153500   MAMMARY IMP                MAMMARY IMP                      $7,533.40    Minimum
 8154005   PENILE JONAS PR            PENILE JONAS PR                $24,077.90     Minimum
 8154022   PESSARY NON-RUBBER         PESSARY NON-RUB                    $152.00
 8154055   PROS BLOCK SILAS           PROS BLCK SILAS                  $1,180.00    Minimum
 8154065   PROS BURHOLE CO            PROS BURHOLE CO                  $1,040.90    Minimum
 8154095   PROS DURA SUBST            PROS DURA SUBST                  $6,298.80    Minimum
 8154096   PROS DURA SUBST 2          PROS DURA SUBST                  $1,524.00    Minimum
 8154100   PROS DURAFILM 6IN          PROS DURAFLM 6                     $959.25    Minimum
 8154115   PROS MAMRY GEL             PROS MAMRY GEL                   $9,064.30    Minimum
 8154135   PROS PENILE                PROS PENILE                    $11,876.96     Minimum
 8154140   PROS PENILE BOD            PROS PENILE BOD                  $8,401.35    Minimum
 8154145   PROS PENILE CON            PROS PENILE CON                $11,812.95     Minimum
 8154150   PROS PENILE IMP            PROS PENILE IMP                  $6,674.85    Minimum
 8154155   PROS PENILE PUM            PROS PENILE PUM                $13,391.35     Minimum
 8154165   PROS PENILE TIP            PROS PENILE TIP                  $2,100.90    Minimum
 8154180   PROS SHEET SILA            PROS SHEET SILA                  $1,426.50    Minimum
 8154185   PROS SHEET SILA            PROS SHEET SILA                    $342.17    Minimum
 8154190   PROS TESTICULAR            PROS TESTICULAR                  $2,976.50    Minimum
 8156035   SUT CLIP SPRING            SUT CLIP SPRING                  $3,436.20    Minimum
 8156270   TMJ PROS FOSSA             TMJ PROS FOSSA                   $2,674.40    Minimum
 8156500   VENT RESER                 VENT RESER                         $960.27    Minimum
 8158999   MISC-OR PROSTH             MISC-OR PROSTH        $1,993.85 - $5,104.05
 8160000   4050 C/S SURG PACKS/GWNS   C/S SURG PCK/GW



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  Doctors Medical Center - Modesto                                      Page 146 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION        BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 8161100   CATH URETERAL             CATH URETERAL                   $495.80
 8161105   CATH URETERAL WV          CATH URETERL WV               $1,388.50
 8162005   DRP ANGIO FEM             DRP ANGIO FEM                   $455.90
 8162015   DRP BARR ADHESN           DRP BARR ADHESN               $2,934.70
 8162020   DRP BARRIER               DRP BARRIER                   $1,208.20
 8162030   DRP BUTTOCK               DRP BUTTOCK                      $48.32
 8162065   DRP DRILL COVR            DRP DRILL COVR                  $326.85
 8162095   DRP GOWN AS               DRP GOWN AS                     $229.85
 8162120   DRP LAP                   DRP LAP                         $166.80
 8162125   DRP LAP PEDI              DRP LAP PEDI                    $385.60
 8162160   DRP LASER                 DRP LASER                       $520.45
 8162165   DRP LEGGING               DRP LEGGING                     $131.00
 8162170   DRP LIMB ISL AS           DRP LIMB ISL AS                  $57.85
 8162190   DRP MICRO                 DRP MICRO                       $714.25
 8162200   DRP MICRO W AR            DRP MICRO W AR                  $649.65
 8162245   DRP SHEET                 DRP SHEET                        $40.00
 8162260   DRP SHEET CRAN            DRP SHEET CRAN                  $814.85
 8162300   DRP SHEET SPLT            DRP SHEET SPLT                   $67.11
 8162315   DRP SHT HIP AS            DRP SHT HIP AS                  $153.85
 8162320   DRP SLEEVE S              DRP SLEEVE S                     $39.23
 8162335   DRP STRI AP/LG            DRP STRI AP/LG                  $395.10
 8162340   DRP STRI AP/SS            DRP STRI AP/SS                  $176.65
 8162345   DRP STRI ARTH             DRP STRI ARTH                   $199.45
 8162350   DRP STRI BETAD            DRP STRI BETAD                  $165.45
 8162355   DRP STRI EYE              DRP STRI EYE                    $442.60
 8162365   DRP STRI FLURO            DRP STRI FLURO                  $286.75
 8162370   DRP STRI INCLG            DRP STRI INCLG                   $32.95
 8162375   DRP STRI INCSM            DRP STRI INCSM                  $258.30
 8162390   DRP STRI POUCH            DRP STRI POUCH                   $83.14
 8162410   DRP STRI URO              DRP STRI URO                    $326.85
 8162415   DRP STRI VAG              DRP STRI VAG                    $524.35
 8162420   DRP STRI X-LG             DRP STRI X-LG                   $560.30
 8162450   DRP TABLEOVRHD            DRP TABLEOVRHD                  $397.05
 8162505   DRP URODRAIN              DRP URODRAIN                    $120.39
 8162510   DRP VERTL CARM            DRP VERTL CARM                  $269.85
 8162515   DRP VI 9IN                DRP VI 9IN                      $467.30
 8162525   DRP XRAY CASET            DRP XRAY CASET                  $233.60
 8165015   PK ARTHROSCOPY            PK ARTHROSCOPY                  $348.58
 8165030   PK BASIC UNIV             PK BASIC UNIV                   $700.85
 8165035   PK BURN                   PK BURN                         $756.00
 8165060   PK CUSA                   PK CUSA                         $336.00
 8165067   PK CUSTOM HEART           PK CUSTOM HEART                 $468.26
 8165080   PK CYSTO                  PK CYSTO                         $51.58
 8165100   PK EXTREMITY              PK EXTREMITY                    $160.73
 8165125   PK GOWN/TOWXL3            PK GOWN/TOWXL3                   $25.36
 8165135   PK HEAD+NECK              PK HEAD+NECK                    $717.95
 8165140   PK HIP                    PK HIP                          $564.00
 8165150   PK LAP                    PK LAP                          $146.83
 8165155   PK LAPAROS                PK LAPAROS                    $1,165.80
 8165180   PK MINOR                  PK MINOR                        $317.30



  CDM Run Date: 06/01/2007
  Doctors Medical Center - Modesto                                         Page 147 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 8165185   PK NASAL                   PK NASAL                          $474.95
 8165200   PK OB CEASARA              PK OB CEASARA                     $192.60
 8165210   PK OB/GYN                  PK OB/GYN                         $149.45
 8165230   PK ORTHO/NEURO             PK ORTHO/NEURO                  $1,025.75
 8165234   PK PM/ICD                  PK PM/ICD                       $1,045.23
 8165250   PK PERI/GYN                PK PERI/GYN                        $44.84
 8165265   PK SHL                     PK SHL                          $1,014.35
 8165285   PK SURG SYST               PK SURG SYST                    $6,412.75
 8165310   PK TOTAL KNEE              PK TOTAL KNEE                     $406.89
 8165313   PK TUBAL LIGATION          PK TUBAL LIGATN                   $530.71
 8165315   PK VAGINAL                 PK VAGINAL                        $248.90
 8168999   C/S MISC SURG PKS/GOWNS    MISC SURG PK/GW         $25.36 - $6,412.75
 8170000   4050 C/S SURGICAL SPCLTY   C/S SURG SPEC
 8171105   ANS BAS GEN SU             ANS BAS GEN SU                 $598.30
 8171155   ANS ESPH/NG STH            ANS ESPH/NG STH                 $76.06
 8171165   ANS FLTR                   ANS FLTR                        $93.10
 8171175   MSK ANS DISP               MSK ANS DISP                   $170.95
 8171325   ELCTRD ARGON               ELCTRD ARGON                   $921.25
 8171370   AS TROCAR                  AS TROCAR                    $1,512.00   Minimum
 8172008   BARRIER GEL ANTI ADHESN    GEL BARRIER ADH                $780.22
 8172010   BARS ARCH                  BARS ARCH                      $222.35   Minimum
 8172055   BG INTESTINE               BG INTESTINE                   $505.30
 8172230   BLD ARTHROSCPY             BLD ARTHROSCPY                 $406.85
 8172235   BLD BEVR                   BLD BEVR                       $133.92   Minimum
 8172240   BLD BEVR                   BLD BEVR                       $107.57
 8172245   BLD BEVR                   BLD BEVR                       $490.00
 8172255   BLD BONE GRAFT             BLD BONE GRAFT                 $350.45
 8172280   BLD CRANIO                 BLD CRANIO                   $2,028.60
 8172285   BLD DERM GRAFT             BLD DERM GRAFT                 $604.00
 8172290   BLD DISP                   BLD DISP                        $27.51
 8172305   BLD EYE THE                BLD EYE THE                     $34.47
 8172320   BLD OSCILLATOR             BLD OSCILLATOR                 $959.25
 8172329   BLD RADNOID DISP           BLD RADNOID                  $1,077.84
 8172340   BLD SAW BONE               BLD SAW BONE                   $396.78
 8172350   BLD SAW GIGLE              BLD SAW GIGLE                  $695.25
 8172555   BLOOD DISP CARIR           BLOOD DISP CARI                $112.15
 8172725   BOWL & SPATULA             BOWL & SPATULA                 $385.26
 8172775   BRSH BONE INTRA            BRSH BONE INTRA                $630.70   Minimum
 8172780   BRSH BRONCHIAL             BRSH BRONCHIAL                 $541.30
 8172782   BRSH BIL CYSTO             BRSH CIL CYSTO                 $549.43
 8172785   BRSH CYTOLOGY              BRSH CYTOLOGY                  $649.65
 8172845   BURR BON S                 BURR BON S                     $254.38
 8172850   BURR BONE                  BURR BONE                      $374.37   Minimum
 8172851   BURR BN DIAMOND            BURR BN DIAMOND              $2,011.50
 8172855   BURR DENTA                 BURR DENTA                     $122.81
 8172872   BURR ROTABLADER            BURR ROTABLADER              $3,599.18
 8172900   BUTTON GASTRO              BUTTON GASTRO                $1,857.65
 8173000   CABLE DALL MILE            CABLE DALL MILE                $312.03   Minimum
 8173010   CAN ACUFEX                 CAN ACUFEX                     $642.05
 8173025   CAN KIT                    CAN KIT                        $230.31   Minimum



  CDM Run Date: 06/01/2007
  Doctors Medical Center - Modesto                                       Page 148 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION        BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 8173045   CANN REPLACE V            CANN REPLACE                    $228.05
 8173160   CARTRIDGE CRYO            CARTRIDGE CRYO                  $395.00
 8173310   CATH DBLE LUMEN           CATH DBLE LUMEN               $1,986.85 Minimum
 8173315   CATH DRN LMBR             CATH DRN LMBR                   $486.45
 8173325   CATH HOLTR VENT           CATH HOLTR VENT                 $594.30 Minimum
 8173330   CATH INTRO SET            CATH INTRO SET                  $365.65 Minimum
 8173340   CATH OCC                  CATH OCC                        $418.86
 8173350   CATH PASSER               CATH PASSER                     $468.10 Minimum
 8173360   CATH PERITNL              CATH PERITNL                    $788.25 Minimum
 8173365   CATH PERTNL A             CATH PERTNL A                 $1,441.70 Minimum
 8173375   CATH REDDICK              CATH REDDICK                  $1,983.05 Minimum
 8173500   CEMENT                    CEMENT                        $1,496.85
 8173507   CEMT BN IMAGING MATRIX    CEMT BN MATRIX                  $511.85
 8173530   CEMT MIX CHAM             CEMT MIX CHAM                   $670.55
 8173555   CEMT RESTRC LG            CEMT RESTRC LG                $1,320.00 Minimum
 8173560   CEMT RESTRC RG            CEMT RESTRC RG                  $529.30 Minimum
 8173570   CEMT SURG SIMP            CEMT SURG SIMP                  $416.06 Minimum
 8173575   CEMT SYR                  CEMT SYR                        $604.90
 8173702   CLIPPER LEAD              CLIPPER LEAD                    $318.10
 8173800   COMPRESR DISC             COMPRESR DISC                   $138.46
 8173840   CONEC ENDOTUBE            CONEC ENDOTUBE                  $501.03
 8173860   CONEC Y PARALLEL          CONEC Y PARALLE                 $560.05
 8173930   CRANIAL PRES SET          CRANL PRES SET                $1,550.00
 8173940   CRNY MDV                  CRNY MDV                      $2,287.64
 8173950   CRNY UMISHTH              CRNY UMISHTH                  $1,802.65
 8174020   DVCE SOFT TIS             DVCE SOFT TIS                    $27.50 Minimum
 8174035   DIL VESSEL                DIL VESSEL                       $54.61
 8174065   DRILL OPHA                DRILL OPHA                    $1,221.30
 8174075   DRN LUM SET               DRN LUM SET                   $3,977.50 Minimum
 8174100   DVCE CIRC AS              DVCE CIRC AS                    $195.60
 8174103   DV VASC OBST              DV VASC OBST                    $512.90
 8174300   ELCTRD ARTHROA            ELCTRD ARTHROA                  $744.02
 8174316   ELCTRD NDL ABLATION       ELCTD NDL ABLTN               $1,937.50
 8174400   ENDO BLADE SYS            ENDO BLADE SYS                  $847.25
 8174405   ENDO DISSECT              ENDO DISSECT                  $1,838.70
 8174410   ENDOFLO                   ENDOFLO                       $4,290.90
 8174420   ENDOPOUCH SPEC            ENDOPOUCH SPEC                  $533.72
 8174500   EVC SMOKE                 EVC SMOKE                       $402.75
 8174630   FLOW CNTL VALVE           FLOW CNTL VALVE               $8,162.15 Minimum
 8174645   FLTR BLD PALL             FLTR BLD PALL                   $168.92
 8174650   FLTR BLOOD PLTLT          FLTR BLD PLTLT                  $366.84
 8174660   FLTR KIDNEYSTO            FLTR KIDNEYSTO                    $1.90
 8174715   GRIPS DALL MILE           GRIPS DALL MILE               $6,213.15
 8174820   HNDBPC COAG ARGO          HNDBPC COAG ARG                 $985.90
 8174825   HNDBPD BM ARGON           HNDBPD BM ARGON                 $250.09
 8174840   HYSTEROCATH 250           HYSTEROCATH 250               $1,103.60
 8174905   INJECTR/MAN UTR           INJECTR/MAN UTR                 $782.60
 8174910   INJECTR/NEDL GI           INJECTR/NEDL GI                 $201.25
 8174920   INSRT ANK/SHOE            INSRT ANK/SHOE                $4,241.50 Minimum
 8174929   INTRODUCER NEEDLE         INTRODUCER NDL                  $240.70



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  Doctors Medical Center - Modesto                                       Page 149 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION        BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 8174930   INTRODUCER SET            INTRODUCER SET                  $486.75 Minimum
 8175005   KIT ACL                   KIT ACL                       $1,122.75
 8175025   KNF ARTHRO                KNF ARTHRO                      $342.17
 8175063   KNF URETHROT              KNF URETHROT                    $600.01
 8175081   KT LZ TMR                 KT LZ TMR                     $4,024.80
 8175100   LAPSP ELECTRD             LAPSP ELECTRD                 $1,570.90
 8175147   LD SPINE EXT              LD SPINE EXT                  $3,350.03 Minimum
 8175148   LD SPINE STIM             LD SPINE STIM                $11,750.36 Minimum
 8175152   LENS MICROSCOPE DISP      LENS MICRO DISP                 $400.00
 8175200   LZ CATH                   LZ CATH                      $11,628.70
 8175205   LZ FIBER                  LZ FIBER                      $1,487.61
 8175225   LZ PROBE                  LZ PROBE                      $9,415.75 Minimum
 8175317   MNFLD PRCPTR              MNFLD PRCPTR                    $814.85
 8175325   HEART HUGGER              HEART HUGGER                    $404.58 Minimum
 8175475   NOZZLE INJ CMN            NOZZLE INJ CMN                  $721.70
 8175766   MARKER GI SPOT            MARKER GI SPOT                  $193.00
 8175805   OH ALVAD INSRT            OH ALVAD INSRT                $3,525.50
 8175810   OH ALVAD MONT/HR          OH ALVAD MNT/HR                 $501.50
 8175818   OH BLOWER MISTER          OH BLOWR MSTR                   $751.87
 8175820   OH CANULA PRFUSN          OH CANULA PRFUS               $4,391.60
 8175825   OH CANULA PRFUSN          OH CANULA PRFUS                 $233.57
 8175830   OH CANULA PRFUSN          OH CANULA PRFUS               $7,248.45
 8175840   OH CATH B AORTIC          OH CATH B AORTC               $1,336.12
 8175845   OH CATH VENT A/V          OH CATH VENT AV                 $860.45
 8175850   OH CATH VENT LV           OH CATH VENT LV                 $811.20
 8175860   OH FLTR BLD               OH FLTR BLD                   $1,629.65
 8175870   OH HEAT EXCHG OK          OH HEAT EXCH OK               $2,146.40
 8175875   OH INST DIL/PROB          OH INST DIL/PRB                 $424.12
 8175880   OH LVAD SUPPLIES          OH LVAD SUPPLIE               $1,964.46
 8175885   OH MEMEBRANE OX           OH MEMEBRANE OX               $5,489.45
 8175905   OH PD INSUL CRD           OH PD INSUL CRD                 $727.45
 8175915   OH PUNCH AORTIC           OH PUNCH AORTIC                 $192.56
 8175920   OH RESEVIOR CARD          OH RESEVIOR CRD                 $304.75
 8175930   OH TUBING PUMP            OH TUBING PUMP                $1,190.33
 8175935   OH TUBING PUMP            OH TUBING PUMP                  $537.55
 8175940   OH VALV VAC RELS          OH VALV VAC REL                 $750.25
 8176015   PACE ADAPTER CBL          PACE ADAPTR CBL                 $266.70
 8176032   PACE LEAD BIPOLAR         PACE LEAD BPLR                $1,238.50
 8176035   PACE LEAD PERVEN          PACE LEAD PERVN                 $357.14
 8176040   PACE LEAD SUTWIR          PACE LEAD SUTWR                 $613.55
 8176055   PD KNEE                   PD KNEE                         $188.29
 8176060   PEN ABL TRANSPOLAR        PEN ABL TRNSPLR               $4,449.60
 8176100   PLEDGET CV TEF            PLEDGET CV TEF                $1,399.90 Minimum
 8176120   IMP PMP CNTRL UR SPHINE   PMP CONTROL                     $294.45 Minimum
 8176125   PMP DRUG THERP            PMP DRUG THERP               $27,500.28 Minimum
 8176130   PRB ENDO PH               PRB ENDO PH                     $675.72
 8176147   PRB THERMAL ELECTRO       PRB THRML ELECT                 $384.01
 8176190   PUSHER KNOT               PUSHER KNOT                     $227.70
 8176305   RETRACTOR ENDO            RETRACTOR ENDO                $2,055.35
 8176306   RETRACTOR DISP            RETRACTOR DISP                $1,798.90



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CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 8177010   SEAL FEM PRES              SEAL FEM PRES                      $651.88
 8177018   SEALANT HEMOSTAT MATRIX    SEALNT HEMOSTAT                  $1,860.00
 8177060   SHNT CANULA T              SHNT CANULA T                      $581.65  Minimum
 8177150   SOCK AID                   SOCK AID                           $579.35
 8177200   ST BASIN                   ST BASIN                           $896.65
 8177230   ST GASTRO JEJUN            ST GASTRO JEJUN                  $2,592.80
 8177270   ST URET ACCESS             ST URET ACCESS                   $2,875.90
 8177290   STIM SPINE PRG PRT         STM SPIN PRG PR                $11,751.50
 8177294   STIM SPINE                 STIM SPINE                     $12,211.80   Minimum
 8177300   STONE EXTRACTOR            STONE EXTRACTOR                  $2,782.85
 8177310   STRIPPER VEIN              STRIPPER VEIN                      $640.20
 8177355   SUCT VACURET SET           SUCT VACURET ST                    $155.37
 8177360   SUCT/IRR HDL/TUB           SUCT/IRR HDL/TB                    $304.02
 8177410   SUT RETREIVER              SUT RETREIVER                      $306.00
 8177415   SUT SURGPRT CNVR           SUT SURGPRT CNV                    $467.30
 8177518   TB ENDO FLO                TB ENDO FLO                        $334.60
 8177520   TB EYE CAN/INT             TB EYE CAN/INT                     $597.00  Minimum
 8177535   TB JEJUNOSTOMY             TB JEJUNOSTOMY                     $552.13  Minimum
 8177555   TENDON PASSER              TENDON PASSER                      $940.22
 8177630   TOURNIQUET VASC            TOURNIQUET VASC                    $835.70
 8177715   TUBING PRESR MN            TUBING PRESR MN                    $306.00
 8177800   U-CHANNEL STRIP            U-CHANNEL STRIP                    $313.50  Minimum
 8177960   URET DILAT BLN             URET DILAT BLN                   $2,847.40
 8178999   C/S MISC SURG SPECIALTY    MISC SURG SPECL        $ 138.46 - $8,442.28
 8180000   4050 C/S SURGICAL GENRAL   C/S SURG GENRAL
 8180010   ADHES SURG CV              ADHES SURG CV                   $780.00
 8181275   BND STCKIMP ALL            BND STCKIMP ALL                 $425.50
 8181400   CAUT ACCU TEMP             CAUT ACCU TEMP                  $547.05
 8181410   CAUT COAG SUCT             CAUT COAG SUCT                  $433.05
 8181415   CAUT CORDELERTRO           CAUT CORDELERTR                 $233.60
 8181430   CAUT PEN+CRD               CAUT PEN+CRD                     $75.23
 8181440   CAUT PEN+TIP               CAUT PEN+TIP                     $25.01
 8181450   CAUT TIP BAL/NED           CAUT TIP BAL/ND                 $108.35
 8181455   CAUT TIP CLEANER           CAUT TIP CLEANR                   $5.70
 8181460   CAUT TIP EXTEND            CAUT TIP EXTEND                 $359.05
 8181485   CLMP COVER                 CLMP COVER                      $277.40
 8181500   COTTON ROLL 1LB            COTTON ROLL 1LB                  $54.80
 8181508   COV RIGID SOLE FOOT        COV RIGID FOOT                  $375.51
 8181510   COV HD SCRUB               COV HD SCRUB                    $828.15
 8182031   DEV TUNNELER               DEV TUNNELER                  $1,909.01
 8182040   DRAINAGE SYSTEM            DRAINAGE SYSTEM               $1,850.05
 8182050   DRN ABRAMSON               DRN ABRAMSON                  $1,648.70
 8182065   DRN CHEST                  DRN CHEST                       $135.96
 8182100   DRN HEMOVAC                DRN HEMOVAC                      $81.01
 8182105   DRN JACKPRAT               DRN JACKPRAT                     $45.64
 8182130   DRN SUMP                   DRN SUMP                      $3,136.10
 8182150   DRN SUMP SARA              DRN SUMP SARA                   $491.95
 8182155   DRN SUMP SHIRL             DRN SUMP SHIRL                  $811.20
 8182195   DRSG BIOPATCH 1IN DSK      DRSG 1IN DSK                     $32.10
 8182274   WND FILL GEL/PST FL OZ     WND FILL GEL OZ                 $585.05



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CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 8182505   GLV PROCD PR S             GLV PROCD PR S                   $260.30
 8182515   GLV SUR/SPC                GLV SUR/SPC                      $296.00
 8182530   HELMET SURG                HELMET SURG                      $170.08
 8182610   IMPERVS STOCKIN            IMPERVS STOCKIN                  $107.13
 8182615   INSERTER PENILE DILATING   INSERTER PENILE                $1,980.00
 8182630   INTRO CATH                 INTRO CATH                       $254.94
 8182635   INTRO CATH CD              INTRO CATH CD                    $130.02
 8182645   INTRO CATHVAS              INTRO CATHVAS                  $1,802.65
 8182882   KT CRYOABLAT W/O PROB      KT CRYOABLATION                $4,320.00
 8183000   NDL BX                     NDL BX                           $249.74
 8183010   NDL BX CHIBA               NDL BX CHIBA                     $419.80
 8183020   NDL BX T CUT               NDL BX T CUT                     $754.15
 8184550   PD CAUTERY GRO             PD CAUTERY GRO                    $41.25
 8184620   PRB ANO-RECTAL             PRB ANO-RECTAL                 $1,730.45
 8184820   RESECTOSCOPE ASPIRATN      RESECTOSCP ASP                 $3,683.10
 8184825   RETAINER VISCERA           RETAINER VISCER                  $693.35
 8185080   SKIN GRAFT AID             SKIN GRAFT AID                 $1,600.01
 8185095   SLEVE DALL MILE            SLEVE DALL MILE                $2,478.75
 8185110   SLEVE TH PR COM            SLEVE TH PR COM                  $116.69
 8185120   SLEVE/CATH-DL CV           SLEV/CATH-DL CV                  $241.40
 8185165   SPNG CHERRIES              SPNG CHERRIES                     $83.55
 8185205   SPNG LAP 4X18              SPNG LAP 4X18                      $3.85
 8185235   SPNG SCLERALS              SPNG SCLERALS                  $1,358.15  Minimum
 8185245   SPNG SPEAR                 SPNG SPEAR                        $25.26
 8185260   SPNG TNSL TRI              SPNG TNSL TRI                    $184.40
 8185290   ST BASIN                   ST BASIN                          $72.15
 8185330   STIM/LOC111 NERV           STIM/LOC111NERV                  $328.20
 8185565   SUCT HANDLE VACU           SUCT HNDL VACU                   $281.20
 8185570   SUCT RESRVR                SUCT RESRVR                      $188.05
 8185575   SUCT TIS TRAP              SUCT TIS TRAP                    $188.05
 8185585   SUCT TUBNG                 SUCT TUBNG                       $132.97
 8185590   SUCT TUBNG VAC             SUCT TUBNG VAC                   $782.60
 8185595   SUCT/IRR TIP LG            SUCT/IRR TIP LG                  $661.00
 8186010   TB CON 12FT                TB CON 12FT                       $60.03
 8186030   TB T DISP                  TB T DISP                        $459.75
 8186035   TB VACURETTE               TB VACURETTE                     $285.05
 8186060   TEMP PROBE SKIN            TEMP PROBE SKIN                  $283.05
 8186090   THERM O/R KITDRY           THERM O/R KITDR                  $110.05
 8186095   THERM PROBE REC            THERM PROBE REC                   $66.36
 8186105   TIPS/IRRIGATOR             TIPS/IRRIGATOR                   $193.80
 8186116   ADHES SURG 5ML             ADHES SURG 5ML                   $200.00
 8186117   ADHES SURG 10ML            ADHES SURG 10ML                  $961.50
 8186120   TP DERMATOME               TP DERMATOME                     $349.50
 8186130   TP GLOW & TELL             TP GLOW & TELL                    $21.50
 8188999   MISC-SURG OTHER            MISC-SURG OTHER         $3.85 - $4,320.00
 8190000   4050 C/S SURGICAL SUTURE   C/S SURG SUTURE
 8191010   AS DEEA-25/31              AS DEEA-25/31                 $5,863.80
 8191035   AS ENDOCLIP                AS ENDOCLIP                   $2,347.85
 8191050   AS GIA A/T                 AS GIA A/T                    $2,657.30   Minimum
 8191060   AS LDSXX A/T               AS LDSXX A/T                  $2,771.40   Minimum



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CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 8191090   PREM-25+W35                PREM-25+W35                       $147.32
 8191095   AS PSS25+25W3              AS PSS25+25W3                     $535.65
 8191103   AS SKN GUN RELD            AS SKN GUN RELD                   $801.60
 8191130   AS STPL AUTO               AS STPL AUTO                    $4,537.90
 8191155   AS STPL INTR               AS STPL INTR                    $4,602.40
 8191160   AS STPL SKN/A              AS STPL SKN/A                     $526.20
 8191170   AS STPL SKN                AS STPL SKN                       $433.05
 8191185   AS STPL TA30/90            AS STPL TA30-90                 $2,169.35
 8191190   AS 30/55/90                AS 30/55/90                       $500.10
 8192005   BND LIGATOR                BND LIGATOR                       $712.11
 8192100   KT SUT GIA                 KT SUT GIA                      $1,105.55
 8193005   NDL SUTR 2/PK              NDL SUTR 2/PK                      $85.45
 8194020   SUT BASIC/GEN              SUT BASIC/GEN                      $20.22
 8194030   SUT BUTTON                 SUT BUTTON                         $72.15
 8194040   SUT CARD ETHIBN            SUT CARD ETHIBN                   $165.30
 8194075   SUT CAT I-IV               SUT CAT I-IV                       $32.25
 8194081   SUT CATG I                 SUT CATG I                        $229.85
 8194082   SUT CATG II                SUT CATG II                        $56.69
 8194083   SUT CATG III               SUT CATG III                      $528.10
 8194084   SUT CATG IV                SUT CATG IV                       $146.37
 8194085   SUT CATG V                 SUT CATG V                        $311.53
 8194086   SUT CATG VI                SUT CATG VI                     $1,286.00
 8194087   SUT CATG VII               SUT CATG VII                      $898.30
 8194088   SUT CATG VIII              SUT CATG VIII                   $1,827.30
 8194090   SUT CAT V-X                SUT CAT V-X                     $1,778.00
 8194105   SUT CLIP AUTO              SUT CLIP AUTO                   $2,019.05
 8194120   SUT CLIP SCALP             SUT CLIP SCALP                     $77.80
 8194125   SUT CLIP SKIN              SUT CLIP SKIN                      $98.80
 8194140   SUT CLOS ETHIBN            SUT CLOS ETHIBN                   $518.82
 8194195   SUT CV SURGLENE            SUT CV SURGLENE                   $738.90
 8194220   SUT ENDOLOOP               SUT ENDOLOOP                      $698.95
 8194610   SUT TENDON STEL            SUT TENDON STEL                    $89.30
 8194625   SUT WIRE                   SUT WIRE                          $279.40  Minimum
 8194630   SUT WIRE P/TUBE            SUT WIRE P/TUBE                   $258.30
 8195250   WAX BONE 2.5GMS            WAX BONE 2.5GMS                   $269.85
 8195265   WIRE SUTR 28-40            WIRE SUTR 28-40                   $271.55  Minimum
 8198999   C/S MISC SURG SUTURES      MISC SURG SUT           $20.22 - $5,863.80
 8200000   4050 C/S CARDIOPULMONARY   C/S CARDIPLMNRY
 8201000   ADPT CIRC                  ADPT CIRC                       $48.83
 8201010   ADPT PRESSR                ADPT PRESSR                    $188.60
 8201012   ADPT RT                    ADPT RT                        $169.00
 8201016   ADPT TUBE A/S              ADPT TUBE A/S                  $277.40
 8201030   AEROCHAMBER                AEROCHAMBER                    $389.45
 8201055   ARMBD ART                  ARMBD ART                       $22.52
 8201095   AW ESPH                    AW ESPH                        $458.00
 8201108   AW LARYNGEAL MSK DISP      AW LARYNGL MSK                 $157.00
 8201110   AW NASL                    AW NASL                         $37.20
 8201120   AW ORAL                    AW ORAL                          $9.55
 8202000   CAN NASAL                  CAN NASAL                       $39.00
 8202010   CAN NASL CPAP              CAN NASL CPAP                  $100.73



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CHARGE
NUMBER     CHARGE DESCRIPTION        BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 8202015   CAN NASL PED              CAN NASL PED                     $33.06
 8202035   CHIN STRP BI-PAP          CHIN STRP BIPAP                 $218.45
 8202037   CIRCUIT BI-PAP            CIRCUIT BI-PAP                   $76.30
 8202055   CIRT MA-1                 CIRT MA-1                        $98.44
 8202063   CIRT NSL VENT ASSEMBLY    CIRT NSL ASSMBL                 $619.30
 8202065   CIRT NEO                  CIRT NEO                         $83.55
 8202095   CONCHA COLUMN             CONCHA COLUMN                   $885.20
 8202100   CONCHA W/SOL              CONCHA W/SOL                     $71.28
 8202130   CUP ULTRSONC .45          CUP ULTRSONC.45                 $397.05
 8202200   DETR CP CO2               DETR CP CO2                     $118.60
 8202510   DISP HANIFOLD             DISP HANIFOLD                   $374.35
 8203000   ELCTRD                    ELCTRD                          $193.11
 8203030   ELCTRD EKG 4              ELCTRD EKG 4                      $1.90
 8203035   ELCTRD EKG 5              ELCTRD EKG 5                      $1.90
 8203050   ELCTRD FETAL              ELCTRD FETAL                     $32.11
 8203053   ELCTRD IONTPHORS          ELCTRD IONTPHOR                 $550.80
 8203055   ELCTRD PACING             ELCTRD PACING                   $201.84
 8203060   ELCTRD PROTEC             ELCTRD PROTEC                   $155.85
 8203065   ELCTRD SPIRAL             ELCTRD SPIRAL                   $480.60
 8203090   EQ MNTR CO2               EQ MNTR CO2                     $119.25
 8203545   FLTR BACTRA               FLTR BACTRA                      $32.08
 8204747   HD GEAR CPAP              HD GEAR CPAP                    $215.10
 8204749   HDSTRP BI-PAP             HDSTRP BI-PAP                   $108.35
 8204755   HL TUBE T                 HL TUBE T                        $40.60
 8204780   HUMIDFR REFIL             HUMIDFR REFIL                   $695.25
 8204785   HUMIDFR O2                HUMIDFR O2                       $44.95
 8204810   INCENT EXRCSR             INCENT EXRCSR                    $35.13
 8204830   INF PERCUSSOR             INF PERCUSSOR                    $26.15
 8204835   INTRODUCER ENDOTRACH TB   INTRO ENDOTRACH                  $88.00
 8204840   IPPB MINI UT              IPPB MINI UT                    $228.05
 8205013   KT HUMIDIFIER W CIRC      KT HUMIDIFIER                   $278.75
 8205025   KT TRACHEOS               KT TRACHEOS                     $541.70
 8205510   METER PEK FLO             METER PEK FLO                   $661.00
 8205520   MISC-RT SUPPLY            MISC-RT SUPPLY                $3,726.80 Minimum
 8205545   MOUTHSEAL DIS             MOUTHSEAL DIS                    $72.15
 8205585   MSK ARSOL ADLT            MSK ARSOL ADLT                    $1.35
 8205595   MSK ARSOL PED             MSK ARSOL PED                     $1.70
 8205605   MSK BABY                  MSK BABY                         $76.50
 8205615   MSK BILI NB               MSK BILI NB                      $40.15
 8205627   MSK BI-PAP                MSK BI-PAP                      $630.70
 8205665   MSK FACE ISOLBX           MSK FACE ISOLBX                 $547.05
 8205695   MASK MULT VNT             MASK MULT VNT                   $157.60
 8205705   MSK O2 ADLT               MSK O2 ADLT                      $57.86
 8205715   MSK O2 PED                MSK O2 PED                       $59.49
 8205720   MSK O2+TUBE ADL           MSK O2+TUBE ADL                 $265.90
 8205735   MSK RESUSTAT              MSK RESUSTAT                    $136.22
 8205750   MSK-MOUTH RESUS           MSK-MOUTH RESUS                  $70.40
 8206000   NEB ARESOL                NEB ARESOL                       $38.35
 8206003   NEB HEART CONT            NEB HEART CONT                  $501.50
 8206010   NEB PREFIL 400CC          NEB PREFIL400CC                 $286.75



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CHARGE
NUMBER     CHARGE DESCRIPTION        BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 8206020   NEB PREFL 1000CC          NEB PREFL1000CC                   $50.83
 8206035   NEB HI FLOW               NEB HI FLOW                       $39.00
 8206055   NOT ARTERIAL              NOT ARTERIAL                     $398.95
 8206250   OXISENSOR                 OXISENSOR                        $327.08
 8206256   OXISENSOR FOREHEAD        OXISENSOR FORHD                  $196.21
 8206260   OXYHOOD                   OXYHOOD                          $109.21
 8206500   PD OXIMTER                PD OXIMTER                       $744.65
 8206510   PEEP-FLO VALVE            PEEP-FLO VALVE                   $373.63
 8206512   PILLOW NASAL DILATOR      PILLOW NSL DIL                   $543.30
 8206520   PLUG TUBE TRACH           PLUG TUBE TRACH                   $89.82
 8206761   SENSOR INHALE FLO         SENSR INHALE FL                  $178.50
 8206765   STYLET ENDO TUBE          STYLET ENDO TB                    $38.56
 8207000   ST AMBU                   ST AMBU                          $122.68
 8207004   ST BI-BAP ASSMBLY         ST BIPAP ASSMBL                  $520.45
 8207005   ST BRONC                  ST BRONC                         $304.01
 8207060   ST VENT TRAN              ST VENT TRAN                     $283.05
 8207070   ST INTUBT                 ST INTUBT                         $21.63
 8207078   SYS HI FLOW O2 W/PEEP     SYS H FLW/PEEP                   $449.00
 8207080   SYS PEP DEVICE            SYS PEP DEVICE                    $44.75
 8207260   TB ENDOTRA RT             TB ENDOTRA RT                    $329.40
 8207265   TB ENDOTRACH              TB ENDOTRACH                      $29.61
 8207300   TB TRACH FN               TB TRACH FN                      $288.33
 8207313   TB TRACH RT               TB TRACH RT                    $1,542.45
 8207320   TB TRACH SHILY            TB TRACH SHILY                   $288.62
 8207340   TB TRCH OCUF RAE          TB TRCH OCF RAE                  $288.80
 8207425   TUBING CONEC              TUBING CONEC                     $457.80
 8207430   TUBING CORR               TUBING CORR                      $381.80
 8207508   VEST VIBRATORY            VEST VIBRATORY                 $1,600.00
 8207530   VLV DEVICE                VLV DEVICE                       $108.35
 8207536   VLV FLUTTER               VLV FLUTTER                      $890.80
 8207541   VLV ONE-WAY               VLV ONE-WAY                       $93.10
 8207551   VLV TRACH SPEAK           VLV TRACH SPEAK                  $460.92
 8208999   MISC-RT SUPPLY            MISC-RT SUPPLY          $1.35 - $3,726.80
 8210000   4050 C/S REHAB SUPPLIES   C/S REHAB SUPPL
 8211016   AID HLDR PENCIL           AID HLDR PENCIL                $48.15
 8211090   AID TOILET TONGS          AID TOILET TONG                $16.45
 8211117   AID CARD HLDR             AID CARD HLDR                  $10.50
 8212013   CONE HAND                 CONE HAND                      $37.65
 8212133   CRUTCHES                  CRUTCHES                      $213.25
 8212170   DYCEM MATERIAL            DYCEM MATERIAL                $232.35
 8212205   EXT FORK                  EXT FORK                       $44.00
 8212213   FABRICATION SPLY          FABRICAT SPLY                   $5.25
 8212280   FORK WGHTD                FORK WGHTD                    $161.65
 8213100   GRIPS                     GRIPS                          $55.80
 8214020   KNF ROCKER/SOLID          KNF ROCKR/SOLID                $72.30
 8214098   LIFT LEG                  LEG LIFT                      $260.40
 8214525   MIRR QUAD                 MIRR QUAD                      $56.65
 8215515   SPOON LONG                SPOON LONG                     $44.00
 8216030   TRAY LAP                  TRAY LAP                       $44.00
 8216049   AID UTNCL EXT             AID UTNCL EXT                 $125.30



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CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 8216115   WGHTS CUFF                 WGHTS CUFF                      $40.90
 8220000   4050 C/S RADIOLOGY         C/S RADIOLOGY
 8222530   KT BI CARE                 KT BI CARE                     $1,110.45
 8222589   KT ESOPHAGEAL              KT ESOPHAGEAL                    $514.85
 8226750   CATH SMART                 CATH SMART                       $672.10
 8228999   MISCELLANEOUS              MISCELLANEOUS         $514.85 - $1,110.45
 8230000   4050 C/S DIAGNOSTIC        C/S DIAGNOSTIC
 8231260   COMPRESSOR DISC DISP       COMP DISC                        $138.46
 8232874   LUBRICNT ROTABLTR ROTGLD   LUBRCNT ROTAGLD                  $445.10
 8238999   MISCELLANEOUS              MISCELLANEOUS           $138.46 - $445.10
 8240000   4050 COMPLEX MDCL EQUIP    COMPLX MDCL EQ
 8240005   ANCH/SCRW BN/BN TISS/BN    ANCH/SCRW BN/BN                 $924.48     Minimum
 8240006   ANCH/SCRW BN/BN TISS/BN2   ANCH/SCRW BN/B2               $1,778.00     Minimum
 8240010   BLN DISSECT SPACEMAKER     BLN DISCT SPCMK               $1,838.70     Minimum
 8240011   CARDIOVERTER/DFIB DC       CARDIOVRTR/DFIB              $77,415.35     Minimum
 8240012   CARDIOVERTER/DFIB OTHER    CARDIOVRTR/DFIB              $57,500.26     Minimum
 8240020   IMP ANCH MITEK GII         IMP ANCH MITEK                $1,753.92     Minimum
 8240021   ANCH/SCRW BN/BN TISS/BN9   ANCH/SCRW BN/B9               $5,402.20     Minimum
 8240045   CATH PRPH DIL POLARCATH    CATH PRPH POLAR               $1,421.00     Minimum
 8240050   CATH DIAL VAXCEL CHRON     CATH DIAL VAXCL                 $915.65     Minimum
 8240082   CATH DRAINAGE              CATH DRAINAGE                 $2,399.00     Minimum
 8240084   CATH EP DIAG NOT3D 19OR<   CATH EP DX NOT3                 $888.43     Minimum
 8240086   CATH EP DIAG NOT3D 20OR>   CATH EP DX NOT3               $5,964.40     Minimum
 8240091   CATH THROMB/EMBOLECTMY 2   CATH THRMB/EMB2                 $432.00     Minimum
 8240093   CATH THROMB/EMBOLECTMY 3   CATH THRMB/EMB3               $1,745.50     Minimum
 8240096   CATH GUIDING               CATH GUIDING                    $431.70     Minimum
 8240097   CATH GUIDING 2             CATH GUIDING 2                $1,963.00     Minimum
 8240098   CATH HEMODIAL LONG TERM    CATH HEMODIAL                   $928.00     Minimum
 8240099   CATH GUIDING 3             CATH GUIDING 3                $1,984.40     Minimum
 8240101   CATH ABL RF CONDUC MCEXT   CATH ABL RF CON                 $536.35     Minimum
 8240104   CATH INF PERPH/CENTRL/ML   CATH INF P/C/M                $1,004.58     Minimum
 8240105   CATH INF PERPH/CNTRL/ML2   CATH INF P/C/M                $1,583.58     Minimum
 8240107   CATH OCCLUSION 2           CATH OCCLUSN 2                $1,107.00
 8240108   CATH INTRADISCAL           CATH INTRADISCL               $3,688.85     Minimum
 8240109   CATH THROMB/EMBOLECT 4     CATH THRMB/EMB4               $1,099.80
 8240113   CATH US INTRAVASCULAR      CATH US INTRVAS               $3,675.45     Minimum
 8240115   CATH OCCLUSION             CATH OCCLUSION                  $595.37     Minimum
 8240121   CATH THROMB/EMBOLECTOMY    CATH THROMB/EMB               $5,514.20     Minimum
 8240125   CATH ANG TRANSLUMNL NLSR   CATH ANG TRNSLU               $1,800.00     Minimum
 8240126   CATH ANG TRANSLUM NLSR2    CATH ANG NLSR2                $7,765.10     Minimum
 8240127   CATH ATHR TRANSLUM DIREC   CATH ATHR TRNSL               $2,900.00     Minimum
 8240128   CATH ANG TRANSLUM NLSR3    CATH ANG NLSR3                  $940.75     Minimum
 8240129   CATH ATHR TRANSLUM ROTAT   CATH ATHR TRNSL               $5,514.20     Minimum
 8240135   DEV REP URINARY W/SLING    DEV REP URINARY               $6,412.75     Minimum
 8240137   DEV REP URINARY W/OSLING   DEV REP URINARY               $1,547.57     Minimum
 8240139   DEV RETRIEVAL INSERTABLE   DEV RETRIEV INS               $1,387.41     Minimum
 8240141   CATH ANG TRANSLUM NLSR4    CATH ANG NLSR4                $5,873.30     Minimum
 8240143   FILTER VENA CAVA           FILTER VENACAVA               $4,845.65     Minimum
 8240149   IMP JOINT TOE              IMP JOINT TOE                 $2,189.50     Minimum
 8240161   GUIDEWIRE IV               GUIDEWIRE IV                    $752.20     Minimum



  CDM Run Date: 06/01/2007
  Doctors Medical Center - Modesto                                        Page 156 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 8240163   GUIDEWIRE II               GUIDEWIRE II                  $2,079.47 Minimum
 8240175   GINTRO EP IC FC PEELAWAY   GINTRO EP IC FC               $3,160.70 Minimum
 8240177   GRFT VASCULAR              GRFT VASCULAR                   $822.00 Minimum
 8240179   GUIDEWIRE                  GUIDEWIRE                     $1,766.50 Minimum
 8240180   IMP ADAP/EXT LD PM NSTIM   IMP ADAP/EXT LD               $6,215.05 Minimum
 8240183   IMP PMP INF TEMP N-PRGRM   IMP PMP INF                     $672.00 Minimum
 8240184   IMP SYS DIALYSIS ACCESS    IMP SYS DIAL AC               $4,212.95 Minimum
 8240186   IMP GEN NEUROSTIMULATOR    IMP GEN NSTIM                $16,179.75 Minimum
 8240188   IMP LD CARDV/DFIB EC DC    IMP LD CARDV/DF              $15,000.00 Minimum
 8240193   IMP LD NEUROSTIMULATOR     IMP LD NSTIM                 $21,500.65 Minimum
 8240197   IMP LD PM/CARD-DFIB COMB   LD PM/CARD-DFIB              $15,000.00 Minimum
 8240199   IMP MESH                   IMP MESH                      $1,462.36 Minimum
 8240200   KIT STIM INTERSTIM TEST    KT STM INTERSTM              $12,211.80 Minimum
 8240201   IMP PORT INDWELLING        IMP PORT INDWEL               $1,443.83 Minimum
 8240215   IMP SCREW/PIN              IMP SCREW/PIN                 $3,888.40 Minimum
 8240223   INTRO EP IC N-LSR N-GUID   INTRO EP IC N-L                 $429.16 Minimum
 8240227   INTRO/SHTH STRBLE N/PEEL   INT/SHTH STRBLE               $1,945.10 Minimum
 8240228   LD PM TENDRL SDX1488T/46   LD TNDRL1488T46               $1,437.59 Minimum
 8240235   IMP GEN NEUROSTIMULATR2    IMP GEN NSTIM                $16,179.77 Minimum
 8240240   LD PM PASS+ DX 1342T/46    LD PASS+DX1342T               $6,285.40 Minimum
 8240244   LD PM PASS+ DX 1346T/58    LD PASS+DX1346T               $1,437.59 Minimum
 8240257   LD PM EXTENSION            LD PM EXTENSION               $1,149.56 Minimum
 8240258   LD PM ADAPTOR              LD PM ADAPTOR                   $550.80 Minimum
 8240268   NDL BRACHYTHERAPY          NDL BRACHYTHRPY                  $86.25 Minimum
 8240319   PM DC RATE-RESPONSIVE      PM DC RATE-RESP              $24,576.65 Minimum
 8240355   PROBE CRYOABLATION         PROBE CRYOABLAT               $1,577.05 Minimum
 8240357   PROGRAMMER PT NEUROSTIM    PROGRMR PT NSTM              $21,500.37 Minimum
 8240358   PROGRMR SYNERGY EZ PT      PROGM SYNRGY EZ              $16,179.75 Minimum
 8240360   PROS PENILE AMS 700        PROS PENILE AMS               $7,399.35 Minimum
 8240365   IMP PROS URINARY SPHINCT   PROS URINRY SPH               $5,212.03 Minimum
 8240369   RECORDER EVENT CARDIAC     RCRDR EVNT CARD               $5,144.54 Minimum
 8240375   STNT COAT/COV W DELV SYS   STNT COAT/COV                 $6,797.00 Minimum
 8240377   STNT NCOR TEMP W DEL SYS   STNT NCOR TEMP                $3,329.85 Minimum
 8240378   STNT NCOR TEMP WO DELSYS   STNT NCOR TEMP                $3,250.83 Minimum
 8240379   STNT NCOAT/COV W DEL SYS   STNT NCOAT/COV                $3,827.83 Minimum
 8240387   STNT NCOAT/COV DEL SYS4    STNT NCOAT/COV4               $6,308.25 Minimum
 8240395   STNT COAT/COV W DEL SYS2   STNT COAT/COV 2               $3,240.00 Minimum
 8240407   TISS CONNECTIVE HUMAN      TISS CONN HUMAN               $1,400.05 Minimum
 8240451   APLIGRAF PER SQ CM         APLIGRAF SQ CM                  $259.40
 8240505   ANCH SCRW SUTR ARTHREX     ANCH SCRW SUT                 $1,322.35 Minimum
 8240507   ANCH SUT BIO-FAST ARTHRX   ANCH SUT BIOFAS               $1,321.34 Minimum
 8240637   CATH ABL BLAZER II HTORQ   CATH ABL IIHTRQ               $5,964.40 Minimum
 8240646   CATH ABL NAVISTAR DS       CATH ABL NAV DS               $4,173.02 Minimum
 8240647   CATH ABL NAVISTAR THERMO   CATH ABL THERMO               $4,173.02 Minimum
 8240739   CATH ATHER SILVERHAWK      CATH ATHER DIR                $4,312.80 Minimum
 8240750   CATH BLN DIL BLUE MAX20    CATH BLN BLUMAX               $4,796.25 Minimum
 8240762   CATH BLN DIL DIA ULT THN   CATH BLN DILDIA               $4,496.15 Minimum
 8240772   CATH CARD ULT ICE 9F9MHZ   CATH CARD ULT9F               $3,675.45 Minimum
 8240846   CATH PTCA MAVERICK OTW     CATH PTCA MAV                 $7,765.10 Minimum
 8240865   DFIB SC PRELIFE            DFIB SC PRELIFE                   $0.01



  CDM Run Date: 06/01/2007
  Doctors Medical Center - Modesto                                        Page 157 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 8240866   DFIB SC PRELIFE W UPGRD    DFIB SC PRELIFE               $5,144.54
 8240944   DEV VAG TP TENSN FR SNGL   DEV VAG TP FR                 $1,875.30 Minimum
 8241040   FASCIA LATA SUSPTUTOPL14   FASCIA LATA 14                $3,145.50 Minimum
 8241044   FASCIA LATA SUSPTUTOPL28   FASCIA LATA 28                $3,145.50 Minimum
 8241046   FASCIA LATA SUSPTUTOPL36   FASCIA LATA 36                $3,145.50 Minimum
 8241161   GINTRO FASTCATH 406197     GINTRO FASTCATH               $1,945.00
 8241206   GRFT V IMPRACRBFLO STP45   GRFT V IMPCRB45               $5,347.05 Minimum
 8241223   GRFT V IMPRA VNFL C ST10   GRFT V IMP VEN                $7,785.95 Minimum
 8241350   IMP ADAP/EXT LD NSTM       IMP ADAP/EXT LD               $2,098.80 Minimum
 8241420   IMP ANCH MITEK FSTIN       IMP ANCH FSTN                 $3,208.15 Minimum
 8241430   IMP ANCH MITEK MINI        IMP ANCH MINI                 $1,040.05 Minimum
 8241432   IMP ANCH MITEK PANALOK     IMP ANCH PANALK               $1,080.05 Minimum
 8241436   IMP ANCH MITEK ROTATRCUF   IMP ANCH ROTATR               $3,208.15 Minimum
 8241438   IMP ANCH MITEK SUPER       IMP ANCH SUPER                $1,000.05 Minimum
 8241456   IMP LD NEUROSTIMULATOR3    IMP LD NSTIM                  $4,259.00 Minimum
 8241474   IMP PMP INF SYNCHROMED P   IMP PMP SYNCHRO              $48,290.50 Minimum
 8241505   INTR NDL TLA               INTR NDL TLA                    $310.35 Minimum
 8241740   LD DFIB TRANSVENE 6937     LD DFIB TRN6937               $1,745.50 Minimum
 8241775   LD LFT VENT COR VEN SYS    LD LFT VENT COR               $6,697.00 Minimum
 8241820   LD NSTIM PISCES QUAD3887   LD NSTIM PISCES               $2,060.00 Minimum
 8241830   LD NSTIM SPECIFY 3998      LD NSTIM SPECIF               $8,272.25 Minimum
 8241838   LD NSTIM PISCES QD 3487A   LD NSTIM PISCES               $2,060.00 Minimum
 8241866   LD PM CAPSURE Z NOVUS      LD PM CPSR ZNOV               $2,038.50 Minimum
 8241894   LD PM 4058M                LD PM 4058M                   $6,245.55 Minimum
 8241998   LD PM TENDRL DX 1388T/52   LD PMDX1388T/52               $1,437.59 Minimum
 8242060   MATRX COLLGN PELV ACEL14   MATRX COLLGN 14               $3,145.50 Minimum
 8242100   MESH GRTX DUAL 150CM1OVL   MESH DUAL 150CM               $1,600.65 Minimum
 8242102   MESH GRTX DUAL 285CM1OVL   MESH DUAL 285CM               $1,600.27 Minimum
 8242106   MESH GRTX DUAL 600CM1THK   MESH DUAL 600CM                 $940.07 Minimum
 8242110   MESH GRTX DUAL 884CM1OVL   MESH DUAL 884CM               $3,167.55 Minimum
 8242400   NEURSTIM+EXT ITRL2 ISTIM   NEURSTM+EXT ITR              $16,179.77 Minimum
 8242600   PM DC PRELIFE              PM DC PRELIFE                     $0.01
 8242744   PM SC PRELIFE              PM SC PRELIFE                     $0.01
 8242820   PROGRAMMER PT NSTIM 2      PROGRMR PT NSTM               $1,796.90 Minimum
 8242870   PROS BRST MENTR SILTX GL   PROS BRST SILTX               $1,750.09 Minimum
 8242872   PROS BRST MNTRCNTR SALIN   PROS BRST SALIN               $7,533.40 Minimum
 8242874   PROS BRST MNTRSPEC SALIN   PROS BRST SALIN               $7,533.40 Minimum
 8242883   PROS PENILE MNTR ACUFORM   PROS PNILE ACUF               $6,674.85 Minimum
 8243096   SHTH SOFT TIPS             SHTH SOFT TIPS                $1,945.10 Minimum
 8243121   STNT B TH SMART NITINOL8   STNT TH NITNL80               $1,500.00 Minimum
 8243145   STNT B NCOAT/COV W DEL     STNT B NCOAT/CO               $6,308.25 Minimum
 8243147   STNT B NITINOL W/RAD MRK   STNT B NITINOL                $2,382.00 Minimum
 8243151   STNT B PALMAZ MED DLVY     STNT B PALMAZ                 $2,625.16 Minimum
 8243152   STNT B PALMAZ XL 40        STNT B PALMZ XL               $7,305.45 Minimum
 8243153   STNT B PALMAZ XL 50        STNT B PALMZ XL               $7,305.45 Minimum
 8243170   STNT U TEMP WO DEL SYS     STNT U TEMP                     $845.25 Minimum
 8243530   SYS EMBOLIZATN PROTECT     EMBOLZN PROTECT               $3,428.60 Minimum
 8243662   SYS SLNG FIX F INFST WOS   SYS F INFST WOS               $2,500.29 Minimum
 8243664   SYS SLNG FIX M INVNC W/S   SYS SLNG FIX M                $3,145.50 Minimum
 8243680   SYS TRNSVG ANCH PRCIS TK   SYS PRCIS TK                  $6,412.75 Minimum



  CDM Run Date: 06/01/2007
  Doctors Medical Center - Modesto                                        Page 158 of 266



CHARGE
NUMBER     CHARGE DESCRIPTION         BILLING DESCRIPTION   HOSPITAL CHARGE COMMENTS
 8243809   #ISS MATRIX TENDON 16CM    TISS MTRX TENDN               $3,434.50 Minimum
 8243810   #ISS MATRIX ULCER 16CM     TISS MATRX ULCR               $2,283.75 Minimum
 8243880   UNIV SLITTER               UNIV SLITTER                    $268.40
 8243900   VAS CLS VASOSEAL ES        VAS CLS VASOSL                $1,161.50 Minimum
 8245095   CATH BLN CUT INTERVENTNL   CATH BLN CUT                  $1,584.70 Minimum
 8245533   CATH DRN PLEURAL           CATH DRN PLEURL               $1,436.00 Minimum
 8245755   CATH INF PICC              CATH INF PICC                   $822.00
 8245820   CATH ASH SPLIT MEDCOMP     CATH ASH SPLIT                $1,476.00 Minimum
 8245850   CATH PICC BARD GROSHONG    CATH PICC BARD                  $750.76 Minimum
 8245870   CATH PICC BS VAXCEL        CATH PICC VAXCL                 $610.70 Minimum
 8246130   DFIB DC PRELIFE            DFIB DC PRELIFE                   $0.01
 8246131   DFIB DC PRELIFE W UPGRD    DFIB DC PRELIFE               $5,144.54
 8246170   DFIB PRELIFE W UPGRD       DFIB PRELIFE                  $5,144.54
 8246575   GRFT V PTFE ADVANTA ATRI   GRFT V PTFE ADV               $7,785.95 Minimum
 8246830   GW RADI PRESS 3 SENSOR     GW RADI PRESS 3               $1,766.50 Minimum
 8247015   IMP BN GRFT SUB OSTEO 10   IMP BN GRFT SUB               $3,009.82 Minimum
 8247017   IMP BN GRFT SUB OSTEO 20   IMP BN GRFT SUB               $5,876.85 Minimum
 8247019   IMP BN GRFT SUB OSTEO 5    IMP BN GRFT SUB               $1,868.43 Minimum
 8247129   IMP PRT BARDPRT MRI DUAL   IMP PRT BARDPRT               $6,817.20 Minimum
 8247131   IMP PRT BARDPRT MRI HARD   IMP PRT BARDPRT               $1,752.00 Minimum
 8247157   IMP SCRW CORTICAL FT 4.5   IMP SCRW CORT                   $514.80 Minimum
 8247230   INJ BULK AGNT URINARY      INJ BULK AGNT                 $2,221.90
 8247250   INTR HEMOSTASIS FASTCATH   INTR HEMOSTASIS               $1,945.10 Minimum
 8247424   LD PM FINELN2 STEROX4457   LD PM FINELN II               $2,114.00 Minimum
 8247842   MESH H PTCH BRDK LO14X18   MESH H PTCH BRD               $2,326.95 Minimum
 8247844   MESH H PTCH BRDK MO11X14   MESH H PTCH BRD               $2,326.95 Minimum
 8247860   MESH PLUG PERFIX BARD      MESH PLUG PERFX                 $612.12 Minimum
 8247996   OASIS WND MATRIX SQ CM     OASIS WND MATRX                   $7.19
 8248272   PROS BRST SLCF S MEGN110   PROS BRST SLCF                $7,533.40 Minimum
 8248400   SCRW ACL LAG ARTHRX AVUL   SCRW ACL LAG                  $2,431.20 Minimum
 8248690   STNT FETAL BLADDR HARRSN   STNT FETL BLDDR                 $102.00 Minimum
 8248752   STNT U DIVERSN PERCUFLEX   STNT U DIVERSN                  $845.25 Minimum
 8248842   STNT U SVL FLEXIMA H+      STNT U SVL FLEX               $2,875.00 Minimum




  CDM Run Date: 06/01/2007
                                    AB 1045 - List of 25 Common
                                   Outpatient Procedures for 2007
Hospital Name: Doctors Medical Center - Modesto
OSHPD Facility No: 106500852
Effective Date of Charges: June 1, 2007

In response to requests from hospitals and the public, OSHPD has developed this form to assist hospitals in
collecting and submitting the average charge for 25 common outpatient procedures performed by hospitals, as
required by AB 1045 (Chapter 532, Statutes of 2005). In developing this form, OSHPD compiled the outpatient
procedures reported by hospitals in 2006, analyzed 2005 hospital ambulatory surgery data collected by OSHPD,
and compared outpatient data obtained from CMS and DHS. Use of the OSHPD form is voluntary, but highly
encouraged, as it allows hospitals to report and the public to compare uniform information regarding common
outpatient procedures.
Evaluation & Management Services (CPT Codes 99201-99499)                  2007 CPT Code        Average Charge
  Emergency Room Visit, Level 2 (low to moderate severity)                     99282
  Emergency Room Visit, Level 3 (moderate severity)                            99283
  Emergency Room Visit, Level 4 (high severity)                                99284
  Outpatient Visit, established patient, 15 minutes                            99213
Laboratory & Pathology Services (CPT Codes 80048-89356)                   2007 CPT Code        Average Charge
  Basic Metabolic Panel                                                        80048                    $1,011.55
  Blood Gas Analysis, including 02 saturation                                  82805                      $642.40
  Complete Blood Count, automated                                              85027                      $355.40
  Complete Blood Count, with differential WBC, automated                       85025                      $547.30
  Comprehensive Metabolic Panel                                                80053                    $1,732.95
  Creatine Kinase (CK), (CPK), Total                                           82550
  Lipid Panel                                                                  80061                      $666.30
  Partial Thromboplastin Time                                                  85730                      $402.86
  Prothrombin Time                                                             85610                      $346.05
  Thyroid Stimulating Hormone                                                  84443                      $392.11
  Troponin, Quantitative                                                       84484                      $656.00
  Urinalysis, without microscopy                                           81002 or 81003
  Urinalysis, with microscopy                                              81000 or 81001
Radiology Services (CPT Codes 70010-79999)                                2007 CPT Code        Average Charge
  CT Scan, Abdomen, with contrast                                              74160
  CT Scan, Head or Brain, without contrast                                     70450                    $5,279.00
  CT Scan, Pelvis, with contrast                                               72193                    $6,858.00
  Mammography, Screening, Bilateral                                            77056
  MRI, Head or Brain, without contrast, followed by contrast                   70553                   $10,138.00
  Ultrasound, Abdomen, Complete                                                76700                    $1,590.00
  Ultrasound, OB, 14 weeks or more, transabdominal                             76805
  X-Ray, Lower Back, four views                                                72110                    $2,400.00
  X-Ray, Chest, two views                                                      71020                    $1,215.00
Medicine Services (CPT Codes 90281-99602)                                 2007 CPT Code        Average Charge
  Cardiac Catheterization, Left Heart, percutaneous                            93510
  Echocardiography, complete                                                   93307                    $1,911.00
  Electrocardiogram, routine, with interpretation and report                   93000
  Inhalation Treatment, pressurized or nonpressurized                          94640
  Physical Therapy, Evaluation                                                 97001                      $300.00
  Physical Therapy, Gait Training                                              97116                      $300.00
  Physical Therapy, Therapeutic Exercise                                       97110                      $300.00

     Office of Statewide Health Planning and Development                                 AB 1045 (May2007)
                                       AB 1045 - List of 25 Common
                                      Outpatient Procedures for 2007
Hospital Name: Doctors Medical Center - Modesto
OSHPD Facility No: 106500852
Effective Date of Charges: June 1, 2007

Surgery Services (CPT Codes 10021-69990)                                      2007 CPT Code          Average Charge
 Arthroscopy, Knee, with meniscectomy (medial or lateral)                         29881
 Arthroscopy, Shoulder, with partial acromioplasty                                29826
 Carpal Tunnel Surgery                                                            64721                       $16,553.96
 Cataract Removal with Insertion of Intraocular Lens, 1 Stage                     66984
 Colonoscopy, diagnostic                                                          45378
 Colonoscopy, with biopsy                                                         45380
 Colonoscopy, with lesion removal, by snare technique                             45385
 Discission, secondary membranous cataract, laser surgery                         66821
 Endoscopy, Upper GI, with biopsy                                                 43239
 Endoscopy, Upper GI, diagnostic                                                  43235                        $6,974.44
 Excision, Breast Lesion                                                          19120                       $16,447.83
 Hernia Repair, Inguinal, 5 years and older                                       49505                       $22,547.48
 Injection, Diagnostic or Therapeutic substance, epidural                         62311                        $2,325.63
 Injection, Anesthetic or Steroid, transforaminal epidural                        64483
 Laparoscopic Cholecystectomy                                                     47562
 Tympanostomy (insert ventilating tube, general anesthesia)                       69436
 Tonsillectomy with Adenoidectomy, less than 12 years old                         42820
                                                                              2007 CPT Code
Other Common Outpatient Procedures (list as needed)                                                  Average Charge




  Count of Reported Procedures (minimum 25 required)                                                                     25
Instructions for Completing AB 1045 Common Outpatient Procedure Form
1. Enter Hospital Name and OSHPD Facility Number. Revise Effective Date of Charges, if necessary.
2. Enter Average Charge for at least 25 commonly performed outpatient procedures. For Evaluation & Management
   Services, do not include related ancillary charges. For all other procedures, include related ancillary charges.
   NOTE: The CPT codes are included on this form to help identify the listed procedures based on the principal
  procedure appearing on the patient's medical record. The average charge for all related services and procedures
   (e.g., supplies, drugs, lab, use of operating room, etc.) should be included in the average charge for that procedure.
3. Do not change procedure descriptions or CPT code references. Use "Other Common Outpatient Procedures"
   (rows 62-71) if you are unable to select procedures from list.
4. Submit completed form as Excel (.xls) file, along with chargemaster and percent change in gross revenue
   calculation, by e-mail to chargemaster@oshpd.ca.gov or by standard mail on CD.



      Office of Statewide Health Planning and Development                                        AB 1045 (May2007)
Doctors Medical Center - Modesto
2006 Charge Data                           2,361,524,341
2007 Charge Data                           2,360,412,767

% increase                                           0%


                                                               2007         2007 Total     2007 Avg.
Hospital    Charge                                          Utilization      Charge       Charge per 2006 Unit Price x   2006 Unit Price 2007 Unit Price
 Code      Number                  Charge Desc             (ShowCase)      (ShowCase)        Unit    2007 Utilization     (6-1-06 CDM)    (6-1-07 CDM)
MOD        2000002   SEMI-PRIVATE ROOM                                20        66,760.00   3,338.00        66,760.00           3,338.00        3,338.00
MOD        2000017   INTENTIVE CARE TRAUMA                           371     3,162,404.00   8,524.00     3,162,404.00           8,524.00        8,524.00
MOD        2000022   INTENSIVE CARE UNIT                          2,837     24,182,588.00   8,524.00    24,182,588.00           8,524.00        8,524.00
MOD        2000026   CORONARY CARE UNIT                               49       417,676.00   8,524.00       417,676.00           8,524.00        8,524.00
MOD        2000030   CORONARY CARE UNIT OTHER                     1,183     11,282,271.00   9,537.00    11,282,271.00           9,537.00        9,537.00
MOD        2000062   INTENSIVE CARE INTERMED                          24       179,736.00   7,489.00       179,736.00           7,489.00        7,489.00
MOD        2050002   SEMI-PRIVATE ROOM                                16        53,408.00   3,338.00        53,408.00           3,338.00        3,338.00
MOD        2050017   INTENSIVE CARE TRAUMA                            11        93,764.00   8,524.00        93,764.00           8,524.00        8,524.00
MOD        2050022   INTENSIVE CARE UNIT                              11        93,764.00   8,524.00        93,764.00           8,524.00        8,524.00
MOD        2050026   CORONARY CARE UNIT                           2,400     20,457,600.00   8,524.00    20,457,600.00           8,524.00        8,524.00
MOD        2050062   INTENSIVE CARE INTERMED                         184     1,377,976.00   7,489.00     1,377,976.00           7,489.00        7,489.00
MOD        2120002   SEMI-PRIVATE ROOM                               341     1,138,258.00   3,338.00     1,138,258.00           3,338.00        3,338.00
MOD        2120017   INTENSIVE CARE TRAUMA                            35       298,340.00   8,524.00       298,340.00           8,524.00        8,524.00
MOD        2120022   INTENSIVE CARE UNIT                              92       784,208.00   8,524.00       784,208.00           8,524.00        8,524.00
MOD        2120025   SEMI-PRIVATE OTHER                               98       539,000.00   5,500.00       539,000.00           5,500.00        5,500.00
MOD        2120026   CORONARY CARE UNIT                               42       358,008.00   8,524.00       358,008.00           8,524.00        8,524.00
MOD        2120049   SEMI-PRIVATE PEDIATRICS                          70       233,660.00   3,338.00       233,660.00           3,338.00        3,338.00
MOD        2120062   INTENSIVE CARE INTERMED                          65       486,785.00   7,489.00       486,785.00           7,489.00        7,489.00
MOD        2150002   SEMI-PRIVATE ROOM                               267       891,246.00   3,338.00       891,246.00           3,338.00        3,338.00
MOD        2150062   INTENSIVE CARE INTERMED                      9,852     73,781,628.00   7,489.00    73,781,628.00           7,489.00        7,489.00
MOD        2210012   NEWBORN LEVEL II                             5,663     43,203,027.00   7,629.00    43,203,027.00           7,629.00        7,629.00
MOD        2210020   NICU NB LVL IV                               1,936     24,773,056.00 12,796.00     24,773,056.00          12,796.00       12,796.00
MOD        2210070   NICU NB LVL III                              4,033     37,506,900.00   9,300.00    37,506,900.00           9,300.00        9,300.00
MOD        2270002   SEMI-PRIVATE ROOM                            5,431     18,128,678.00   3,338.00    18,128,678.00           3,338.00        3,338.00
MOD        2270025   SEMI-PRIVATE OTHER                              280     1,540,000.00   5,500.00     1,540,000.00           5,500.00        5,500.00
MOD        2270061   ISOLATION STERILE ENVIR                         186       837,000.00   4,500.00       837,000.00           4,500.00        4,500.00
MOD        2270062   INTENSIVE CARE INTERMED                         458     3,429,962.00   7,489.00     3,429,962.00           7,489.00        7,489.00
MOD        2290002   SEMI-PRIVATE ROOM                                12        40,056.00   3,338.00        40,056.00           3,338.00        3,338.00
MOD        2290017   INTENSIVE CARE TRAUMA                           763     6,503,812.00   8,524.00     6,503,812.00           8,524.00        8,524.00
MOD        2290022   INTENSIVE CARE UNIT                          1,548     13,195,152.00   8,524.00    13,195,152.00           8,524.00        8,524.00
MOD        2290026   CORONARY CARE UNIT                                1         8,524.00   8,524.00         8,524.00           8,524.00        8,524.00
                                                    2007        2007 Total       2007 Avg.
Hospital Charge                                  Utilization     Charge         Charge per 2006 Unit Price x   2006 Unit Price 2007 Unit Price
 Code Number                 Charge Desc        (ShowCase)     (ShowCase)          Unit    2007 Utilization     (6-1-06 CDM)    (6-1-07 CDM)
MOD    2290062    INTENSIVE CARE INTERMED                22        164,758.00     7,489.00        164,758.00         7,489.00        7,489.00
MOD    2320002    SEMI-PRIVATE ROOM                   4,441     14,824,058.00     3,338.00     14,824,058.00         3,338.00        3,338.00
MOD    2320025    SEMI-PRIVATE OTHER                  9,222     50,721,000.00     5,500.00     50,721,000.00         5,500.00        5,500.00
MOD    2330002    SEMI-PRIVATE ROOM                  10,826     36,137,188.00     3,338.00     36,137,188.00         3,338.00        3,338.00
MOD    2360002    SEMI-PRIVATE ROOM                   4,353     14,530,314.00     3,338.00     14,530,314.00         3,338.00        3,338.00
MOD    2380002    SEMI-PRIVATE ROOM                   3,108     10,374,504.00     3,338.00     10,374,504.00         3,338.00        3,338.00
MOD    2380061    ISOLATION STERILE ENVIR               115        517,500.00     4,500.00        517,500.00         4,500.00        4,500.00
MOD    2380062    INTENSIVE CARE INTERMED             3,209     24,032,201.00     7,489.00     24,032,201.00         7,489.00        7,489.00
MOD    2390002    SEMI-PRIVATE ROOM                   8,423     28,115,974.00     3,338.00     28,115,974.00         3,338.00        3,338.00
MOD    2400002    SEMI-PRIVATE ROOM                     212        707,656.00     3,338.00        707,656.00         3,338.00        3,338.00
MOD    2400044    SEMI-PRIVATE OBSTETRICS                79        263,702.00     3,338.00        263,702.00         3,338.00        3,338.00
MOD    2400049    SEMI-PRIVATE PEDIATRICS             2,728      9,106,064.00     3,338.00      9,106,064.00         3,338.00        3,338.00
MOD    2500002    SEMI-PRIVATE ROOM                       6         20,028.00     3,338.00         20,028.00         3,338.00        3,338.00
MOD    2500044    SEMI-PRIVATE OBSTETRICS            12,372     41,297,736.00     3,338.00     41,297,736.00         3,338.00        3,338.00
MOD    2500099    HIGH RISK OB SEMI-PRIV              1,443     10,806,627.00     7,489.00     10,806,627.00         7,489.00        7,489.00
MOD    2550010    NEWBORN LEVEL I                     9,631     17,730,671.00     1,841.00     17,730,671.00         1,841.00        1,841.00
MOD    2550011    NEWBORN OTHER                          68        173,196.00     2,547.00        173,196.00         2,547.00        2,547.00
MOD    3081501    USE X1 PERCU LITHOTRIP                 82      2,003,424.00    24,432.00      2,003,424.00        24,432.00       24,432.00
MOD    3100001    DELIV SIMPLE/UNCOMPLIC              3,141      6,831,675.00     2,175.00      6,831,675.00         2,175.00        2,175.00
MOD    3100005    DELIV NON-DEL PER HR               11,291      1,411,375.00       125.00      1,411,375.00           125.00          125.00
MOD    3100026    INSERT CERV RIPENING AGN              480        102,720.00       214.00        102,720.00           214.00          214.00
MOD    3100200    OB OBSERVATION PER HR 99218             1            209.00       209.00            209.00           209.00          209.00
MOD    3100220    LABOR 1ST HR                        4,970      3,608,220.00       726.00      3,608,220.00           726.00          726.00
MOD    3100240    LABOR ADD HR                       31,002      7,905,510.00       255.00      7,905,510.00           255.00          255.00
MOD    3100405    DELIV COMPLX/COMPLIC                   59        170,864.00     2,896.00        170,864.00         2,896.00        2,896.00
MOD    3100500    US OB LTD 1OR> FETUS 76815            177         45,135.00       255.00         45,135.00           255.00          255.00
MOD    3100600    OB SURG 1ST HR MAJOR                  232      2,166,184.00     9,337.00      2,166,184.00         9,337.00        9,337.00
MOD    3100605    OB SURG ADD MIN MAJOR                 216         35,208.00       163.00         35,208.00           163.00          163.00
MOD    3100610    OB SURG 1ST HR MINOR                   21        121,905.00     5,805.00        121,905.00         5,805.00        5,805.00
MOD    3100615    OB SURG EA ADD MIN                     52          4,420.00        85.00          4,420.00            85.00           85.00
MOD    3100700    RECOV POST-SURG 1/2 HR              1,798      1,499,532.00       834.00      1,499,532.00           834.00          834.00
MOD    3100705    RECOV POST-SURG ADD MIN           130,004      3,770,116.00        29.00      3,770,116.00            29.00           29.00
MOD    3100710    RECOV POST-VAG 1/2 HR               3,223      2,687,982.00       834.00      2,687,982.00           834.00          834.00
MOD    3100715    RECOV POST-VAG ADD MIN            235,472      6,828,688.00        29.00      6,828,688.00            29.00           29.00
MOD    3102010    TOCOLYSIS                              49         70,903.00     1,447.00         70,903.00         1,447.00        1,447.00
MOD    3102100    PITOCIN INDUCT/AUGMENT              2,136      3,090,792.00     1,447.00      3,090,792.00         1,447.00        1,447.00
MOD    3102110    MAGNESIUM SULFATE                     585        846,495.00     1,447.00        846,495.00         1,447.00        1,447.00
MOD    3103205    ANESTHESIA 1ST HR                   1,790      4,231,560.00     2,364.00      4,231,560.00         2,364.00        2,364.00
MOD    3103206    ANESTHESIA ADD MIN                  8,069        322,760.00        40.00        322,760.00            40.00           40.00
MOD    3109500    DELIV C-SECT 1ST HR                 1,536     14,341,632.00     9,337.00     14,341,632.00         9,337.00        9,337.00
                                                        2007        2007 Total       2007 Avg.
Hospital Charge                                      Utilization     Charge         Charge per 2006 Unit Price x   2006 Unit Price 2007 Unit Price
 Code Number                  Charge Desc           (ShowCase)     (ShowCase)          Unit    2007 Utilization     (6-1-06 CDM)    (6-1-07 CDM)
MOD    3109503    DELIV C-SECT ADD MIN                    7,918      1,290,634.00       163.00      1,290,634.00           163.00          163.00
MOD    3120027    AMNIO FLUID INDEX                          21          6,006.00       286.00          6,006.00           286.00          286.00
MOD    3120325    E&M-EST. PATIENT-LVL I 99211               12          2,508.00       209.00          2,508.00           209.00          209.00
MOD    3120330    E&M-EST. PATIENT-LVL II 99212           1,244        559,800.00       450.00        559,800.00           450.00          450.00
MOD    3120335    E&M-EST. PATIENT-LVL IV 99214             590        501,500.00       850.00        501,500.00           850.00          850.00
MOD    3120336    E&M-EST. PATIENT-LVL V 99215              153        160,650.00     1,050.00        160,650.00         1,050.00        1,050.00
MOD    3120340    E&M-EST. PATIENT-LVL III 99213          1,711      1,112,150.00       650.00      1,112,150.00           650.00          650.00
MOD    3120405    US OB LTD 1OR> FETUS 76815                 63         16,065.00       255.00         16,065.00           255.00          255.00
MOD    3120440    NON-STRESS TEST                         1,127      1,077,412.00       956.00      1,077,412.00           956.00          956.00
MOD    3120455    EXTERNAL VERSION                           16         15,296.00       956.00         15,296.00           956.00          956.00
MOD    3129201    E&M-NEW PATIENT-LVL I 99201                 5          1,045.00       209.00          1,045.00           209.00          209.00
MOD    3129202    E&M-NEW PATIENT-LVL II 99202              268        120,600.00       450.00        120,600.00           450.00          450.00
MOD    3129203    E&M-NEW PATIENT-LVL III 99203             385        250,250.00       650.00        250,250.00           650.00          650.00
MOD    3129204    E&M-NEW PATIENT-LVL IV 99204              172        146,200.00       850.00        146,200.00           850.00          850.00
MOD    3129205    E&M-NEW PATIENT-LVL V 99205                46         48,300.00     1,050.00         48,300.00         1,050.00        1,050.00
MOD    3210004    SURGERY 1 HOUR MAJOR Z7506              3,719     24,835,482.00     6,678.00     24,835,482.00         6,678.00        6,678.00
MOD    3210005    SURGERY MAJOR EA ADD MIN Z7506        204,014     22,441,540.00       110.00     22,441,540.00           110.00          110.00
MOD    3210041    SURGERY 1 HOUR MINOR Z7506                 34        227,052.00     6,678.00        227,052.00         6,678.00        6,678.00
MOD    3210051    SURGERY MINOR EA ADD MIN Z7506            876         96,360.00       110.00         96,360.00           110.00          110.00
MOD    3210100    SURGERY 1/2 HOUR MINOR Z7506                1          4,060.00     4,060.00          4,060.00         4,060.00        4,060.00
MOD    3210204    SURGERY 1/2 HR MAJOR Z7508              3,291     10,982,067.00     3,337.00     10,982,067.00         3,337.00        3,337.00
MOD    3210205    SURGERY ADD MIN MAJOR Z7508           137,274     15,100,140.00       110.00     15,100,140.00           110.00          110.00
MOD    3210241    SURGERY 1/2 HR MINOR Z7508                446      1,488,302.00     3,337.00      1,488,302.00         3,337.00        3,337.00
MOD    3210251    SURGERY ADD MIN MINOR Z7508             6,035        663,850.00       110.00        663,850.00           110.00          110.00
MOD    3210301    SURG ADD STAFF 1ST HR Z7506                87        200,187.00     2,301.00        200,187.00         2,301.00        2,301.00
MOD    3210302    SURG ADD STAFF ADD MIN Z7506            5,806        220,628.00        38.00        220,628.00            38.00           38.00
MOD    3210390    SURG LASER PROC 1/2 HR                      6         94,950.00    15,825.00         94,950.00        15,825.00       15,825.00
MOD    3210402    SURG LASER PROC ADD MIN                   589         60,078.00       102.00         60,078.00           102.00          102.00
MOD    3210470    SURG LASER MNR 1ST 1/2HR                   63        436,464.00     6,928.00        436,464.00         6,928.00        6,928.00
MOD    3210476    SURG LASER MNR ADD MIN                  4,240        538,480.00       127.00        538,480.00           127.00          127.00
MOD    3210480    LASER O/S SVC PER MIN                   6,451        287,595.00        44.58        290,295.00            45.00           45.00
MOD    3213300    SURGERY PRE-OP MAJOR                    5,894        512,778.00        87.00        512,778.00            87.00           87.00
MOD    3213318    TEE CONT ASSES/FUNC       93318           375        521,790.00     1,391.44        521,790.00         1,391.44        1,391.44
MOD    3220002    RECOVERY RM 1/2 HOUR Z7512              7,624      6,244,056.00       819.00      6,244,056.00           819.00          819.00
MOD    3220003    PACU EACH ADD MIN       Z7512         461,065     11,065,560.00        24.00     11,065,560.00            24.00           24.00
MOD    3221000    SPEC PROC 1ST 1/2HR                        16         19,200.00     1,200.00         19,200.00         1,200.00        1,200.00
MOD    3221010    SPEC PROC ADD MIN                         168          6,720.00        40.00          6,720.00            40.00           40.00
MOD    3300004    SURG 1HR OH        Z7506                  383      4,242,874.00    11,078.00      4,242,874.00        11,078.00       11,078.00
MOD    3300005    SURG ADD MIN OH       Z7506            96,756     17,996,616.00       186.00     17,996,616.00           186.00          186.00
MOD    3530037    MED NUTRTN TH REEVAL15MN 97803              1            141.00       141.00            141.00           141.00          141.00
                                                       2007        2007 Total       2007 Avg.
Hospital Charge                                     Utilization     Charge         Charge per 2006 Unit Price x   2006 Unit Price 2007 Unit Price
 Code Number                  Charge Desc          (ShowCase)     (ShowCase)          Unit    2007 Utilization     (6-1-06 CDM)    (6-1-07 CDM)
MOD    3531520    ED ORIENTATN IND 15MIN Z6400             938         38,458.00        41.00         38,458.00            41.00           41.00
MOD    3531522    ED INIT ASSESS 30MIN Z6402               127          9,779.00        77.00          9,779.00            77.00           77.00
MOD    3531524    ED INIT ASSESS 15MIN Z6404               825         33,825.00        41.00         33,825.00            41.00           41.00
MOD    3531526    ED INTRVNT/ASSESS IND 15 Z6406           205          8,405.00        41.00          8,405.00            41.00           41.00
MOD    3531530    ED POSTPARTUM IND 15MIN Z6414            102          4,182.00        41.00          4,182.00            41.00           41.00
MOD    3531540    NUT INIT ASSESS IND 30M Z6200            130         10,010.00        77.00         10,010.00            77.00           77.00
MOD    3531542    NUT INIT ASSESS IND 15M Z6202            736         30,176.00        41.00         30,176.00            41.00           41.00
MOD    3531544    NUT INTER/ASSESS IND 15M Z6204           224          9,184.00        41.00          9,184.00            41.00           41.00
MOD    3531546    NUT INTRVNT GROUP 15MIN Z6206              2             16.00         8.00             16.00             8.00            8.00
MOD    3531548    NUT POST PARTUM IND 15M Z6208             63          2,583.00        41.00          2,583.00            41.00           41.00
MOD    3531550    PSYSC INIT ASSES IND 30M Z6300            48          3,696.00        77.00          3,696.00            77.00           77.00
MOD    3531552    PSYSC INIT ASSES IND 15M Z6302           310         12,710.00        41.00         12,710.00            41.00           41.00
MOD    3531556    PS INTER/ASSESS IND 15M Z6304             70          2,870.00        41.00          2,870.00            41.00           41.00
MOD    3531560    PS POST PARTUM IND 15MIN Z6308            28          1,148.00        41.00          1,148.00            41.00           41.00
MOD    3531570    PE PERINATL ED IND 15M Z6410              52          2,132.00        41.00          2,132.00            41.00           41.00
MOD    3539202    E&M-NEW PATIENT-LVL II 99202               1            141.00       141.00            141.00           141.00          141.00
MOD    3539203    E&M-NEW PATIENT-LVL III 99203             13          3,120.00       240.00          3,120.00           240.00          240.00
MOD    3539204    E&M-NEW PATIENT-LVL IV 99204              70         31,850.00       455.00         31,850.00           455.00          455.00
MOD    3539205    E&M-NEW PATIENT-LVL V 99205              126         79,002.00       627.00         79,002.00           627.00          627.00
MOD    3539213    E&M-EST. PATIENT-LVL III 99213            30          4,230.00       141.00          4,230.00           141.00          141.00
MOD    3539214    E&M-EST. PATIENT-LVL IV 99214            643        154,320.00       240.00        154,320.00           240.00          240.00
MOD    3539215    E&M-EST. PATIENT-LVL V 99215             368        167,440.00       455.00        167,440.00           455.00          455.00
MOD    3700004    ANESTHESIA 1 HOUR                      3,769      7,123,410.00     1,890.00      7,123,410.00         1,890.00        1,890.00
MOD    3700005    ANESTHESIA EA ADD MIN                206,685      6,820,605.00        33.00      6,820,605.00            33.00           33.00
MOD    3700045    NITROUS OXIDE                          4,547        441,059.00        97.00        441,059.00            97.00           97.00
MOD    3700054    OXYGEN                                 7,795        756,115.00        97.00        756,115.00            97.00           97.00
MOD    3700204    OP ANES 1ST 1/2 HOUR                   3,922      3,694,524.00       942.00      3,694,524.00           942.00          942.00
MOD    3700205    OP ANES ADD MINUTES                  153,765      5,074,245.00        33.00      5,074,245.00            33.00           33.00
MOD    3900004    ANES 1 HR OPEN HEART                     383        739,190.00     1,930.00        739,190.00         1,930.00        1,930.00
MOD    3900005    ANES OPEN HEART ADD MIN               96,248      3,176,184.00        33.00      3,176,184.00            33.00           33.00
MOD    4000114    DFIB DC ENTRUST       C1721                7        206,041.50    29,434.50        206,041.50        29,434.50       29,434.50
MOD    4000117    DFIB DC EPIC+ DR V239 C1721                1         29,760.00    29,760.00         29,760.00        29,760.00       29,760.00
MOD    4000191    DFIB EPIC HF V337    C1882                 4        138,000.00    34,500.00        138,000.00        34,500.00       34,500.00
MOD    4000205    DFIB INSYNC SENTRY 7299 C1882              6        233,523.00    38,920.50        233,523.00        38,920.50       38,920.50
MOD    4000226    DFIB RENEWAL 3 PRIZM SE C1882              1         77,415.35    77,415.35         77,415.35        77,415.35       77,415.35
MOD    4000228    DFIB RENEWAL PRIZM       C1882             1         40,500.00    40,500.00         40,500.00        40,500.00       40,500.00
MOD    4000230    DFIB RENEWAL 3 RF      C1882               9        340,875.00    37,875.00        340,875.00        37,875.00       37,875.00
MOD    4000299    DFIB SC ATLAS+ VR V193 C1722               3        232,246.05    77,415.35        232,246.05        77,415.35       77,415.35
MOD    4000314    DFIB SC EPIC+ VR V196 C1722                4        119,040.00    29,760.00        119,040.00        29,760.00       29,760.00
MOD    4000332    DFIB SC MAXIMO VR7232CX C1722             10        774,153.50    77,415.35        774,153.50        77,415.35       77,415.35
                                                           2007        2007 Total       2007 Avg.
Hospital Charge                                         Utilization     Charge         Charge per 2006 Unit Price x   2006 Unit Price 2007 Unit Price
 Code Number                   Charge Desc             (ShowCase)     (ShowCase)          Unit    2007 Utilization     (6-1-06 CDM)    (6-1-07 CDM)
MOD    4000347    DFIB SC VITALTY 2 T175 C1722                   9        224,801.28    24,977.92        224,801.28        24,977.92       24,977.92
MOD    4000349    DFIB SC VITALTY VR T135 C1722                  3        232,246.05    77,415.35        232,246.05        77,415.35       77,415.35
MOD    4000507    PM DC RR ATR/VNT BI/UNI C1785                  6         43,017.54     7,169.59         43,017.54         7,169.59        7,169.59
MOD    4000517    PM DC RR ENRYTHM P1501 C1785                   1          9,185.00     9,185.00          9,185.00         9,185.00        9,185.00
MOD    4000526    PM DC RR ENPULSE 2       C1785                 5        122,883.25    24,576.65        122,883.25        24,576.65       24,576.65
MOD    4000533    PM DC RR INSIGN ULTR DR C1785                  6         46,744.38     7,790.73         46,744.38         7,790.73        7,790.73
MOD    4000534    PM DC RR INSIGNA ULTRA C1785                  18        140,233.14     7,790.73        140,233.14         7,790.73        7,790.73
MOD    4000540    PM DC RR INTEGRTY AFDR C1785                   3         73,729.95    24,576.65         73,729.95        24,576.65       24,576.65
MOD    4000622    PM DC RR VICTORY DR       C1785                6         43,017.54     7,169.59         43,017.54         7,169.59        7,169.59
MOD    4000624    PM DC RR VICTORY XLDR C1785                   13         93,204.67     7,169.59         93,204.67         7,169.59        7,169.59
MOD    4000700    PM INSYNC III 8042    C2621                    1         10,440.51    10,440.51         10,440.51        10,440.51       10,440.51
MOD    4001080    PM SC RR ENPULSE         C1786                 3         66,666.15    22,222.05         66,666.15        22,222.05       22,222.05
MOD    4001099    PM SC RR INSIGNIA ULTRA C1786                  6         43,017.54     7,169.59         43,017.54         7,169.59        7,169.59
MOD    4021019    COIL PV PLATINUM                             129         57,534.00       446.00         57,534.00           446.00          446.00
MOD    4100004    ELECTROLYTE PANEL         80051            3,233      1,528,562.40       472.80      1,528,562.40           472.80          472.80
MOD    4100025    RESPIRATORY SYNCYT VIRUS 87807             1,101        113,623.20       103.20        113,623.20           103.20          103.20
MOD    4100031    VANCOMYCIN           80202                 4,335      3,326,679.00       767.40      3,326,679.00           767.40          767.40
MOD    4100056    CBC WITHOUT DIFF        85027             20,901      7,428,215.40       355.40      7,428,215.40           355.40          355.40
MOD    4100062    LIPID PANEL        80061                   3,166      2,109,505.80       666.30      2,109,505.80           666.30          666.30
MOD    4100069    RENAL FUNCTION PANEL 80069                   257        304,750.60     1,185.80        304,750.60         1,185.80        1,185.80
MOD    4100101    PHENCYCLINDINE(PCP) QUAL 80101             8,508      1,123,906.80       132.10      1,123,906.80           132.10          132.10
MOD    4100102    AMPHETAMINE QUAL          80101            8,506      1,123,642.60       132.10      1,123,642.60           132.10          132.10
MOD    4100109    HEPATIC FUNCTION PANEL 80076               4,699      4,688,897.15       997.85      4,688,897.15           997.85          997.85
MOD    4100111    COMP METABOLIC PANEL 80053                22,377     38,778,222.15     1,732.95     38,778,222.15         1,732.95        1,732.95
MOD    4100166    BASIC METABOLIC PANEL 80048               60,865     61,567,990.75     1,011.55     61,567,990.75         1,011.55        1,011.55
MOD    4101001    UA AUTO W/MICRO         81001             19,253      6,296,693.65       327.05      6,296,693.65           327.05          327.05
MOD    4101004    URINE W/O MICRO AUTO 81003                 8,550      1,398,352.50       163.55      1,398,352.50           163.55          163.55
MOD    4101007    URINE SINGLE ITEM       81002                 59          1,899.80        32.20          1,899.80            32.20           32.20
MOD    4101015    URINALYSIS MICRO ONLY 81015                  641        104,835.55       163.55        104,835.55           163.55          163.55
MOD    4101098    UA SPEC GRAV NON AUTO 81002                   19          1,148.55        60.45          1,148.55            60.45           60.45
MOD    4102003    ACETAMNOPHN QUANT           82003          1,074        856,031.70       797.05        856,031.70           797.05          797.05
MOD    4102009    KETONES SERUM QUAL          82009            750        136,762.50       182.35        136,762.50           182.35          182.35
MOD    4102010    KETONES SERUM QUANT          82010            45         23,769.00       528.20         23,769.00           528.20          528.20
MOD    4102011    SALICYLATE          80196                    886        464,574.10       524.35        464,574.10           524.35          524.35
MOD    4102040    ALBUMIN SERUM          82040                 894        164,272.50       183.75        164,272.50           183.75          183.75
MOD    4102055    ALCOHOL ETHYL          82055               2,566      1,378,326.90       537.15      1,378,326.90           537.15          537.15
MOD    4102065    ALCOHOL ETHYL URINE        82055           8,503      1,123,246.30       132.10      1,123,246.30           132.10          132.10
MOD    4102137    THEOPHYLLINE          80198                  196        150,410.40       767.40        150,410.40           767.40          767.40
MOD    4102140    AMMONIA            82140                   1,502      1,152,634.80       767.40      1,152,634.80           767.40          767.40
MOD    4102150    AMYLASE            82150                   5,026      1,122,557.10       223.35      1,122,557.10           223.35          223.35
                                                          2007        2007 Total       2007 Avg.
Hospital Charge                                        Utilization     Charge         Charge per 2006 Unit Price x   2006 Unit Price 2007 Unit Price
 Code Number                  Charge Desc             (ShowCase)     (ShowCase)          Unit    2007 Utilization     (6-1-06 CDM)    (6-1-07 CDM)
MOD    4102151    AMYLASE URINE        82150                    2          1,048.70      524.35           1,048.70          524.35           524.35
MOD    4102213    BARBITURATES QUAL        80101            8,508      1,123,906.80      132.10       1,123,906.80          132.10           132.10
MOD    4102250    BILIRUBIN TOTAL      82247               10,775      1,979,906.25      183.75       1,979,906.25          183.75           183.75
MOD    4102253    BILIRUBIN DIRECT     82248                1,265        232,443.75      183.75         232,443.75          183.75           183.75
MOD    4102272    OCCULT BLD FECES ONE SPC 82272            2,527        126,350.00       50.00         126,350.00           50.00            50.00
MOD    4102273    OCCULT BLD OTHR SOURCE 82271                 69          3,450.00       50.00           3,450.00           50.00            50.00
MOD    4102310    CALCIUM          82310                      471         86,546.25      183.75          86,546.25          183.75           183.75
MOD    4102330    CALCIUM IONIZED       82330               3,707        583,852.50      157.50         583,852.50          157.50           157.50
MOD    4102340    CALCIUM URINE QUAN       82340               13          5,368.35      412.95           5,368.35          412.95           412.95
MOD    4102372    CARBAMAZAPINE         80156                 239        183,408.60      767.40         183,408.60          767.40           767.40
MOD    4102374    CARBON DIOXIDE        82374                  33          6,063.75      183.75           6,063.75          183.75           183.75
MOD    4102436    CHLORIDE URINE        82436                 915        264,389.25      288.95         264,389.25          288.95           288.95
MOD    4102465    CHOLESTEROL TOTAL         82465             217         39,873.75      183.75          39,873.75          183.75           183.75
MOD    4102477    CHOLESTEROL HDL         83718                 5          2,621.75      524.35           2,621.75          524.35           524.35
MOD    4102550    CREATINE KINASE TOTAL 82550              20,194     10,588,723.90      524.35      10,588,723.90          524.35           524.35
MOD    4102553    CK MB FRACTION        82553              19,249     12,130,719.80      630.20      12,130,719.80          630.20           630.20
MOD    4102560    COCAINE QL         80101                  8,507      1,123,774.70      132.10       1,123,774.70          132.10           132.10
MOD    4102565    CREATININE BLOOD        82565               564        103,635.00      183.75         103,635.00          183.75           183.75
MOD    4102570    CREATININE OTHR SRCE 82570                  666        275,024.70      412.95         275,024.70          412.95           412.95
MOD    4102575    CREATININE CLEARANCE 82575                  175        114,826.25      656.15         114,826.25          656.15           656.15
MOD    4102611    CYANOCOBLMN(VIT B12) 82607                  952        633,984.40      665.95         633,984.40          665.95           665.95
MOD    4102643    DIGOXIN          80162                    1,481      1,193,760.05      806.05       1,193,760.05          806.05           806.05
MOD    4102655    PHENYTOIN TOTAL        80185              1,639      1,306,364.95      797.05       1,306,364.95          797.05           797.05
MOD    4102726    FERRITIN         82728                    1,257        785,499.30      624.90         785,499.30          624.90           624.90
MOD    4102731    FETAL FIBRONECTIN       82731               126         79,058.70      627.45          79,058.70          627.45           627.45
MOD    4102746    FOLIC ACID        82746                     775        516,111.25      665.95         516,111.25          665.95           665.95
MOD    4102803    GAS BLD ANY COMB W/CALO2 82803            1,030        324,553.00      315.10         324,553.00          315.10           315.10
MOD    4102945    GLUCOSE BODY FLUID       82945              593        108,963.75      183.75         108,963.75          183.75           183.75
MOD    4102947    GLUCOSE QUANT          82947              3,844        706,335.00      183.75         706,335.00          183.75           183.75
MOD    4102949    GLUCOSE I-STAT       82947                1,030        189,262.50      183.75         189,262.50          183.75           183.75
MOD    4102950    GLUCOSE POST DOSE         82950              30         12,942.00      431.40          12,942.00          431.40           431.40
MOD    4102951    GLUCOSE TOLERANCE 3SPEC 82951                20         16,121.00      806.05          16,121.00          806.05           806.05
MOD    4102952    GTT EA ADD >3SPEC       82952                14          1,497.30      106.95           1,497.30          106.95           106.95
MOD    4102954    GLUCOSE QUANT URINE        82945              5          2,064.75      412.95           2,064.75          412.95           412.95
MOD    4102962    GLUCOSE BLD BY MONIT DEV 82962          182,085      2,731,275.00       15.00       2,731,275.00           15.00            15.00
MOD    4102980    GGT            82977                        539         99,041.25      183.75          99,041.25          183.75           183.75
MOD    4102994    HEMOGLOBIN GLYCATED         83036         2,833      1,279,241.15      451.55       1,279,241.15          451.55           451.55
MOD    4103004    GENTAMYCIN          80170                 1,086        833,396.40      767.40         833,396.40          767.40           767.40
MOD    4103013    GONADTOPN CHRONC(HCG)QL 84703             1,394        748,787.10      537.15         748,787.10          537.15           537.15
MOD    4103014    GONADTOPN CHORNC(HCG)QNT 84702            1,540      1,025,563.00      665.95       1,025,563.00          665.95           665.95
                                                         2007        2007 Total       2007 Avg.
Hospital Charge                                       Utilization     Charge         Charge per 2006 Unit Price x   2006 Unit Price 2007 Unit Price
 Code Number                  Charge Desc            (ShowCase)     (ShowCase)          Unit    2007 Utilization     (6-1-06 CDM)    (6-1-07 CDM)
MOD    4103052    SICKLING OF RBC       85660                  1            326.25      326.25             326.25          326.25           326.25
MOD    4103527    B-TYP NATRIURETC PEPTIDE 83880           8,893      2,835,977.70      318.90       2,835,977.70          318.90           318.90
MOD    4103531    THYROXINE FREE         84439             1,967      1,239,603.40      630.20       1,239,603.40          630.20           630.20
MOD    4103538    TRIIODTHYRNIN TOTAL T3 84480               358        179,393.80      501.10         179,393.80          501.10           501.10
MOD    4103540    IRON           83540                     1,880        985,778.00      524.35         985,778.00          524.35           524.35
MOD    4103550    IRON BINDING CAPCTY       83550          1,871        981,058.85      524.35         981,058.85          524.35           524.35
MOD    4103605    LACTATE(LACTIC ACID) 83605                 498        381,368.40      765.80         381,368.40          765.80           765.80
MOD    4103615    LDH-LACTIC DEHYDROGENASE 83615           1,589        291,978.75      183.75         291,978.75          183.75           183.75
MOD    4103630    LACTOFERRIN FECAL QUAL 83630               646        120,091.40      185.90         120,091.40          185.90           185.90
MOD    4103690    LIPASE          83690                    5,407        911,890.55      168.65         911,890.55          168.65           168.65
MOD    4103725    LITHIUM         80178                      138         25,357.50      183.75          25,357.50          183.75           183.75
MOD    4103731    METHADONE QUAL           80101           8,506      1,123,642.60      132.10       1,123,642.60          132.10           132.10
MOD    4103735    MAGNESIUM          83735                14,311      2,789,929.45      194.95       2,789,929.45          194.95           194.95
MOD    4103873    MYOGLOBIN SERUM          83874             102         64,280.40      630.20          64,280.40          630.20           630.20
MOD    4103927    OPIATES QUAL        80101                8,504      1,123,378.40      132.10       1,123,378.40          132.10           132.10
MOD    4103930    OSMOLALITY BLOOD         83930           2,759      2,146,777.90      778.10       2,146,777.90          778.10           778.10
MOD    4103935    OSMOLALITY URINE        83935              514        399,943.40      778.10         399,943.40          778.10           778.10
MOD    4103980    PH BODY FLUID EXCEPT BLD 83986           8,404      1,133,699.60      134.90       1,133,699.60          134.90           134.90
MOD    4104020    PHENOBARBITAL          80184               234        186,509.70      797.05         186,509.70          797.05           797.05
MOD    4104075    PHOSPHATASE ALKALINE 84075                 330         60,637.50      183.75          60,637.50          183.75           183.75
MOD    4104100    PHOSPHORUS            84100              7,714      1,417,447.50      183.75       1,417,447.50          183.75           183.75
MOD    4104102    PHOSPHORUS URINE          84105              6          2,477.70      412.95           2,477.70          412.95           412.95
MOD    4104132    POTASSIUM SERUM          84132           6,480      1,872,396.00      288.95       1,872,396.00          288.95           288.95
MOD    4104133    POTASSIUM URINE         84133              899        259,766.05      288.95         259,766.05          288.95           288.95
MOD    4104155    PROTEIN TOTAL         84155                 93         17,088.75      183.75          17,088.75          183.75           183.75
MOD    4104176    PRE-ALBUMIN         84134                1,414        638,491.70      451.55         638,491.70          451.55           451.55
MOD    4104180    PROTEIN URINE QUAN 24 HR 84156             406        167,657.70      412.95         167,657.70          412.95           412.95
MOD    4104195    PROTN SPINAL FLD SEMI QN 84157             629        259,745.55      412.95         259,745.55          412.95           412.95
MOD    4104296    SODIUM URINE         84300                 921        266,122.95      288.95         266,122.95          288.95           288.95
MOD    4104315    SP-GR EXCEPT URINE        84315              7          1,144.85      163.55           1,144.85          163.55           163.55
MOD    4104408    THC(MARIJUANA) QUAL        80101         8,508      1,123,906.80      132.10       1,123,906.80          132.10           132.10
MOD    4104436    THYROXINE TOTAL         84436            1,284        504,483.60      392.90         504,483.60          392.90           392.90
MOD    4104443    TSH           84443                      4,651      1,827,377.90      392.90       1,827,377.90          392.90           392.90
MOD    4104450    TRANSTERASE AST(SGOT) 84450                294         54,022.50      183.75          54,022.50          183.75           183.75
MOD    4104460    TRANSAMINASE-SGPT (ALT) 84460              329         60,453.75      183.75          60,453.75          183.75           183.75
MOD    4104462    TRANSFERRIN          84466                 336        151,720.80      451.55         151,720.80          451.55           451.55
MOD    4104468    TOBRAMYCIN          80200                  161        123,551.40      767.40         123,551.40          767.40           767.40
MOD    4104475    TRIGLYCERIDES         84478              1,612        296,205.00      183.75         296,205.00          183.75           183.75
MOD    4104520    BLD UREA NITROGEN QUAN 84520             1,324        243,285.00      183.75         243,285.00          183.75           183.75
MOD    4104540    UREA NITROGEN URINE        84540            48         19,821.60      412.95          19,821.60          412.95           412.95
                                                        2007        2007 Total       2007 Avg.
Hospital Charge                                      Utilization     Charge         Charge per 2006 Unit Price x   2006 Unit Price 2007 Unit Price
 Code Number                  Charge Desc           (ShowCase)     (ShowCase)          Unit    2007 Utilization     (6-1-06 CDM)    (6-1-07 CDM)
MOD    4104550    URIC ACID BLOOD      84550              1,992        366,030.00       183.75        366,030.00           183.75          183.75
MOD    4104584    VALPROIC ACID       80164                 585        466,274.25       797.05        466,274.25           797.05          797.05
MOD    4105006    C DIFF SCREEN AG      87324             1,656      1,050,318.00       634.25      1,050,318.00           634.25          634.25
MOD    4105012    EOSINOPHILE COUNT MANUAL 85032              1            335.75       335.75            335.75           335.75          335.75
MOD    4105014    HEMATOCRIT AUTOMATED 85014              3,871        229,356.75        59.25        229,356.75            59.25           59.25
MOD    4105028    CBC/PLT/AUTO DIFF (5) 85025            79,934     43,747,878.20       547.30     43,747,878.20           547.30          547.30
MOD    4105045    RETIC COUNT FLOW CYTO 85045             1,602        612,284.40       382.20        612,284.40           382.20          382.20
MOD    4105049    STOOL FOR WBC S        89055              163         50,163.25       307.75         50,163.25           307.75          307.75
MOD    4105362    FDP/FSP AGGLUTNATN SLIDE 85362            966        537,579.00       556.50        537,579.00           556.50          556.50
MOD    4105379    FDP D-DIMER QNT       85379             1,419        789,673.50       556.50        789,673.50           556.50          556.50
MOD    4105384    FIBRINOGEN ACTIVITY     85384           2,332        828,792.80       355.40        828,792.80           355.40          355.40
MOD    4105460    HMOGLBN FETAL(KLEIHAUER) 85460             34         27,704.90       814.85         27,704.90           814.85          814.85
MOD    4105576    PLT FUNCTION TST      85576               140         34,153.00       243.95         34,153.00           243.95          243.95
MOD    4105577    PLT AGG EA AGN       85576                 30          7,318.50       243.95          7,318.50           243.95          243.95
MOD    4105610    PROTHROMBIN TIME        85610          24,948      8,633,255.40       346.05      8,633,255.40           346.05          346.05
MOD    4105653    SED RATE AUTO        85652              2,533        728,490.80       287.60        728,490.80           287.60          287.60
MOD    4105730    PTT PLASM         85730                22,177      8,943,984.10       403.30      8,943,984.10           403.30          403.30
MOD    4106003    HETEROPHILE AB SCREEN 86308               103         42,533.85       412.95         42,533.85           412.95          412.95
MOD    4106004    HEMO & AGGLU AUT SCR EA 86940             302        144,899.60       479.80        144,899.60           479.80          479.80
MOD    4106015    COLD AGGLUTINATN TITER 86157               18          9,000.00       500.00          9,000.00           500.00          500.00
MOD    4106016    RBC ANTIBODIES SCREEN 86850             7,935      3,891,324.00       490.40      3,891,324.00           490.40          490.40
MOD    4106019    RBC ANTIBDY ELUTION EACH 86860              1            634.25       634.25            634.25           634.25          634.25
MOD    4106024    ANTIBDY IDENT RBC EA PNL 86870            313        342,468.95     1,094.15        342,468.95         1,094.15        1,094.15
MOD    4106025    C-REACTIVE PROTEIN QL 86140             5,370      2,806,362.00       522.60      2,806,362.00           522.60          522.60
MOD    4106031    COOMBS DIRECT         86880             2,195        991,152.25       451.55        991,152.25           451.55          451.55
MOD    4106038    PREGNANCY TEST-TUBE       84703           658        353,444.70       537.15        353,444.70           537.15          537.15
MOD    4106044    RH ANTIBODY TITRE      86886                9         11,995.20     1,332.80         11,995.20         1,332.80        1,332.80
MOD    4106073    BLD TYP AG SCR EA UNIT 86904              125        105,481.25       843.85        105,481.25           843.85          843.85
MOD    4106080    BLD TYPE ABO ONLY      86900           10,126      2,523,905.50       249.25      2,523,905.50           249.25          249.25
MOD    4106090    RBC AG ROOM TEMP        86905             354         55,330.20       156.30         55,330.20           156.30          156.30
MOD    4106095    RBC AG EXCPT ABO/RHO EA 86905             140         43,085.00       307.75         43,085.00           307.75          307.75
MOD    4106100    BLD TYPE RHO(D)ONLY      86901         10,058      2,304,790.70       229.15      2,304,790.70           229.15          229.15
MOD    4106151    CARCINO-EMBRYONIC AG 82378                331        220,429.45       665.95        220,429.45           665.95          665.95
MOD    4106210    COMP TST EA UT SPIN TECH 86920         16,881      9,147,813.90       541.90      9,147,813.90           541.90          541.90
MOD    4106212    COMP TST EA UT AHG TECH 86922           1,093        974,190.90       891.30        974,190.90           891.30          891.30
MOD    4106287    HBS ANTIGEN        87340                1,215        107,964.90        88.86        107,964.90            88.86           88.86
MOD    4106292    HEPATITIS B SURF AB    86706            1,035         95,634.00        92.40         95,634.00            92.40           92.40
MOD    4106304    HEPATITIS C ANTIBODY 86803                953        116,990.28       122.76        116,990.28           122.76          122.76
MOD    4106316    PSA TOTAL         84153                   238        168,385.00       707.50        168,385.00           707.50          707.50
MOD    4106319    BENZODIAZEPINES QL      80101           8,515      1,124,831.50       132.10      1,124,831.50           132.10          132.10
                                                        2007        2007 Total       2007 Avg.
Hospital Charge                                      Utilization     Charge         Charge per 2006 Unit Price x   2006 Unit Price 2007 Unit Price
 Code Number                 Charge Desc            (ShowCase)     (ShowCase)          Unit    2007 Utilization     (6-1-06 CDM)    (6-1-07 CDM)
MOD    4106403    PARTICLE AGGL AB QL     86403           5,325        695,178.75      130.55         695,178.75          130.55           130.55
MOD    4106648    TRANSFUSN REACTION STUDY 86078             31          8,290.95      267.45           8,290.95          267.45           267.45
MOD    4106703    HIV-1/HIV-2 SNG ASSY 86703                755         86,840.10      115.02          86,840.10          115.02           115.02
MOD    4107016    CONCENTRATN OTH BDY FLD 87015             570         51,927.00       91.10          51,927.00           91.10            91.10
MOD    4107019    TB CONCENTRATE         87015              472         86,069.20      182.35          86,069.20          182.35           182.35
MOD    4107022    CULTURE SPUTUM         87070            1,547      1,233,036.35      797.05       1,233,036.35          797.05           797.05
MOD    4107024    CULTURE GENITAL        87070              150        112,905.00      752.70         112,905.00          752.70           752.70
MOD    4107036    BETA LACTAMASE        87185               156         48,009.00      307.75          48,009.00          307.75           307.75
MOD    4107040    CULT BLOOD AERO/ANAERO 87040           14,518     14,222,558.70      979.65      14,222,558.70          979.65           979.65
MOD    4107046    E COLI 0157 CULT FECE 87046               729         20,849.40       28.60          20,849.40           28.60            28.60
MOD    4107055    CULTURE STOOL         87045               729        581,049.45      797.05         581,049.45          797.05           797.05
MOD    4107056    CULTURE THROAT         87070              135         38,299.50      283.70          38,299.50          283.70           283.70
MOD    4107057    YERSINIA CULTURE       87046                9          5,270.85      585.65           5,270.85          585.65           585.65
MOD    4107066    CULTURE RECTAL        87070                72         22,575.60      313.55          22,575.60          313.55           313.55
MOD    4107068    CULTURE BIOPSY/SURG SPC 87070              16         12,043.20      752.70          12,043.20          752.70           752.70
MOD    4107069    CULTURE CATH TIP       87070              263         82,463.65      313.55          82,463.65          313.55           313.55
MOD    4107070    CULTURE OTHER SOURCE 87070                 98         22,456.70      229.15          22,456.70          229.15           229.15
MOD    4107074    CULTURE FLUID EX CSF 87070                  4          1,254.20      313.55           1,254.20          313.55           313.55
MOD    4107075    CULTURE ANAEROBIC ISOL 87075            1,121        706,454.20      630.20         706,454.20          630.20           630.20
MOD    4107076    CULTURE ANAERO DEF IDWGC 87076            522         59,795.10      114.55          59,795.10          114.55           114.55
MOD    4107078    CULTURE CSF         87070                 429        324,753.00      757.00         324,753.00          757.00           757.00
MOD    4107080    CULTURE CAMPYLOBACTERIO 87046             731         61,001.95       83.45          61,001.95           83.45            83.45
MOD    4107081    CULTURE STREP SCREENING 87081              64         19,696.00      307.75          19,696.00          307.75           307.75
MOD    4107086    CULTURE URINE COLONY CT 87086           7,985      4,061,171.00      508.60       4,061,171.00          508.60           508.60
MOD    4107088    CULTURE URINE IDENT      87088          4,460        957,116.00      214.60         957,116.00          214.60           214.60
MOD    4107102    CULTURE FUNGI OTHER       87102           366        203,679.00      556.50         203,679.00          556.50           556.50
MOD    4107103    CULTURE FUNGI BLOOD       87103           101         48,459.80      479.80          48,459.80          479.80           479.80
MOD    4107106    CULT FUNGI ID ADD     87106               520         67,600.00      130.00          67,600.00          130.00           130.00
MOD    4107111    CULTURE FUNGI MOLD       87107             64          9,939.20      155.30           9,939.20          155.30           155.30
MOD    4107116    CULTURE AFB         87116                 549        363,190.95      661.55         363,190.95          661.55           661.55
MOD    4107133    CULTURE WOUND/ABCESS 87070              2,369      1,871,983.80      790.20       1,871,983.80          790.20           790.20
MOD    4107147    CULTURE TYPNG SEROLOGIC 87147              17          3,895.55      229.15           3,895.55          229.15           229.15
MOD    4107149    CULTURE TYP NUC ACID PER 87149             46         20,805.80      452.30          20,805.80          452.30           452.30
MOD    4107160    GC CULTURE          87081                   6          2,709.30      451.55           2,709.30          451.55           451.55
MOD    4107162    LEGIONELLA CULTURE       87070             24         14,055.60      585.65          14,055.60          585.65           585.65
MOD    4107164    PERTUSSIS CULTURE       87081              24         13,387.20      557.80          13,387.20          557.80           557.80
MOD    4107174    NUCLEIC ACID PROBE GC 87590             1,053        476,271.90      452.30         476,271.90          452.30           452.30
MOD    4107175    NUCLEIC ACID PROBE CHLM 87490           1,070        497,175.50      464.65         497,175.50          464.65           464.65
MOD    4107177    O&P DIR SMR CONC & ID 87177               328        136,972.80      417.60         136,972.80          417.60           417.60
MOD    4107181    SENSITIVITY ANTBDY AGAR 87181               7          1,013.60      144.80           1,013.60          144.80           144.80
                                                         2007        2007 Total       2007 Avg.
Hospital Charge                                       Utilization     Charge         Charge per 2006 Unit Price x   2006 Unit Price 2007 Unit Price
 Code Number                  Charge Desc            (ShowCase)     (ShowCase)          Unit    2007 Utilization     (6-1-06 CDM)    (6-1-07 CDM)
MOD    4107184    SENSITV 12 DISKS OR LESS 87184           1,088        312,908.80       287.60        312,908.80           287.60          287.60
MOD    4107185    SENS MIC FASTDS OR ANROB 87186             103         77,971.00       757.00         77,971.00           757.00          757.00
MOD    4107186    SENSITVTY MIC        87186               4,655      3,079,515.25       661.55      3,079,515.25           661.55          661.55
MOD    4107198    SENSITIVITY ETEST/EA AB 87181              123         11,156.10        90.70         11,156.10            90.70           90.70
MOD    4107201    SMEAR AFB          87206                   528        202,936.80       384.35        202,936.80           384.35          384.35
MOD    4107202    SMEAR MALARIA         87207                  5          1,921.75       384.35          1,921.75           384.35          384.35
MOD    4107205    GRAM STAIN         87205                 5,303      1,631,998.25       307.75      1,631,998.25           307.75          307.75
MOD    4107206    FLUOR STAIN         87206                   31         10,408.25       335.75         10,408.25           335.75          335.75
MOD    4107207    SPECIAL STAIN       87207                    2            615.50       307.75            615.50           307.75          307.75
MOD    4107210    WET MOUNT W/SMPL STAIN 87210               562        140,078.50       249.25        140,078.50           249.25          249.25
MOD    4107215    INDIA INK PREP      87210                   30          9,495.00       316.50          9,495.00           316.50          316.50
MOD    4107220    KOH PREP          87210                     13          4,114.50       316.50          4,114.50           316.50          316.50
MOD    4107235    TROPONIN - I      84484                 20,712     13,587,072.00       656.00     13,587,072.00           656.00          656.00
MOD    4107804    INF A IA DIR     87804                     295         30,444.00       103.20         30,444.00           103.20          103.20
MOD    4107805    INF B IA DIR     87804                     295         30,444.00       103.20         30,444.00           103.20          103.20
MOD    4108313    SPEC STAIN TRICHROME O&P 87209             329        110,461.75       335.75        110,461.75           335.75          335.75
MOD    4108707    CULTURE AEROBIC DEF ID 87077             3,896        666,021.20       170.95        666,021.20           170.95          170.95
MOD    4108717    TISSUE GRIND FOR CULTURE 87176             318         45,712.50       143.75         45,712.50           143.75          143.75
MOD    4109051    CELL COUNT MISC W/DIFF 89051               756        312,190.20       412.95        312,190.20           412.95          412.95
MOD    4109190    NASAL SMEAR EOSINOPHILES 89190              40         12,310.00       307.75         12,310.00           307.75          307.75
MOD    4109250    REDUCING SUBSTANCE        81005            331         47,928.80       144.80         47,928.80           144.80          144.80
MOD    4109363    CRYST ID BODY FLD EX URN 89060              27          6,729.75       249.25          6,729.75           249.25          249.25
MOD    4109378    ULTRACENTRIFUGATION        84999            49          2,011.45        41.05          2,011.45            41.05           41.05
MOD    4109624    RH ANTIBODY TITER      86886                 1          1,332.80     1,332.80          1,332.80         1,332.80        1,332.80
MOD    4109626    RHO(DU)          86905                     166         51,086.50       307.75         51,086.50           307.75          307.75
MOD    4109628    BLD TYPE ABO ONLY       86900              971        242,021.75       249.25        242,021.75           249.25          249.25
MOD    4109630    BLD TYPE RHO(D)ONLY      86901             971        222,504.65       229.15        222,504.65           229.15          229.15
MOD    4152962    GLUCOSE BLD BY MONIT DEV 82962               1             15.00        15.00             15.00            15.00           15.00
MOD    4201050    VOLUME MEASURMNT URINE 81050             8,750        935,812.50       106.95        935,812.50           106.95          106.95
MOD    4201100    SPEC HANDLING: ALIQUOT 99001             5,156        675,436.00       131.00        675,436.00           131.00          131.00
MOD    4201105    SPEC HANDLING: NON-ALIQ 99001              347          3,955.80        11.40          3,955.80            11.40           11.40
MOD    4203641    PKU CAPILLARY PUNCTURE 36416             4,323         25,938.00         6.00         25,938.00             6.00            6.00
MOD    4206985    SPLITTING BLD PROD EA UT 86985             270         17,914.50        66.35         17,914.50            66.35           66.35
MOD    4209009    CAPILLARY PUNCTURE INPAT                 2,629        240,947.85        91.65        240,947.85            91.65           91.65
MOD    4209010    VENIPUNCTURE OUTPT        36415            644         11,044.60        17.15         11,044.60            17.15           17.15
MOD    4209011    VENIPUNCTURE INPATIENT 36415           125,173      9,294,095.25        74.25      9,294,095.25            74.25           74.25
MOD    4500022    BLOOD RC PACKED/PED       P9021            270          9,450.00        35.00          9,450.00            35.00           35.00
MOD    4509012    CRYOPRECIPITTE EA UNIT P9012             1,367        103,116.63        75.43         80,653.00            59.00           89.73
MOD    4509013    FRESH FROZEN PLASMA       P9017          2,205        177,289.98        80.40        130,095.00            59.00           89.37
MOD    4509015    RBC LEUKOREDUCED         P9016           8,407      1,861,063.65       221.37      1,588,923.00           189.00          236.37
                                                         2007        2007 Total       2007 Avg.
Hospital Charge                                       Utilization     Charge         Charge per 2006 Unit Price x   2006 Unit Price 2007 Unit Price
 Code Number                  Charge Desc            (ShowCase)     (ShowCase)          Unit    2007 Utilization     (6-1-06 CDM)    (6-1-07 CDM)
MOD    4509021    RBC EA UNIT        P9021                     3            677.61       225.87            540.00           180.00          225.87
MOD    4509023    RBC DIRECTED         P9021                   2            360.00       180.00            360.00           180.00          225.87
MOD    4509035    PLATELTS APHER LEUKRDUC P9035              889        561,529.00       631.64        520,065.00           585.00          656.00
MOD    4516125    BLOOD PRODUCT IRRAND EA 86945               18          1,080.00        60.00          1,080.00            60.00           60.00
MOD    4519601    RBC EA UNIT        P9021                    11            110.00        10.00            110.00            10.00           10.00
MOD    4519604    FRESH FROZEN PLASMA        P9017         2,204         22,040.00        10.00         22,040.00            10.00           10.00
MOD    4519607    CRYOPRECIPITATE EA UNIT P9012            1,367         13,670.00        10.00         13,670.00            10.00           10.00
MOD    4519609    RBC DIRECTED         P9021                   2             20.00        10.00             20.00            10.00           10.00
MOD    4519611    PLATELTS APHER LEUKRDUCD P9035             889          8,890.00        10.00          8,890.00            10.00           10.00
MOD    4519612    RBC LEUKOREDUCED          P9016          8,406         84,060.00        10.00         84,060.00            10.00           10.00
MOD    4601100    PERSANTINE STRESS        93017             785      1,255,215.00     1,599.00      1,255,215.00         1,599.00        1,599.00
MOD    4601105    ADENOSINE CARDIO STRESS 93017               17         27,183.00     1,599.00         27,183.00         1,599.00        1,599.00
MOD    4601110    DOBUTAMINE STRESS         93017             72        115,128.00     1,599.00        115,128.00         1,599.00        1,599.00
MOD    4603000    EKG TRACE ONLY         93005            29,420     12,797,700.00       435.00     12,797,700.00           435.00          435.00
MOD    4603015    CARDIO STRESS         93017                 21         28,518.00     1,358.00         28,518.00         1,358.00        1,358.00
MOD    4603020    CARDIO STRESS THALIUM 93017                140        223,860.00     1,599.00        223,860.00         1,599.00        1,599.00
MOD    4603325    DOPPLER ECHO PULSE/CONT 93320                1          1,835.00     1,835.00          1,835.00         1,835.00        1,835.00
MOD    4610105    ANGIOPLSTY RENAL/VISC                        1         11,628.00    11,628.00         11,628.00        11,628.00       11,628.00
MOD    4610115    ANGIOPLSTY ILIAC                             4          8,368.00     2,092.00          8,368.00         2,092.00        2,092.00
MOD    4610120    ANGIOPLSTY FEM-POP                          17         35,564.00     2,092.00         35,564.00         2,092.00        2,092.00
MOD    4610150    ATHERECTOMY FEM/POP                         13         99,385.00     7,645.00         99,385.00         7,645.00        7,645.00
MOD    4610158    ATHRECTMY PERIPHL INITL 75992               10        118,930.00    11,893.00        118,930.00        11,893.00       11,893.00
MOD    4610160    ATHERECTOMY TIBIOPERONEL                    10         76,450.00     7,645.00         76,450.00         7,645.00        7,645.00
MOD    4610269    PLCE VASC CLSURE DEVICE G0269            1,001        950,950.00       950.00        950,950.00           950.00          950.00
MOD    4610275    RENL ART BIL W CARD CATH G0275              40        144,320.00     3,608.00        144,320.00         3,608.00        3,608.00
MOD    4610278    ILIAC ART BIL W CARD CTH G0278              70        258,510.00     3,693.00        258,510.00         3,693.00        3,693.00
MOD    4610279    ILIAC ART UNI W CARD CTH G0278               6         13,458.00     2,243.00         13,458.00         2,243.00        2,243.00
MOD    4610290    PLC DRG ELUTNG STNT INIT G0290             563     17,447,370.00    30,990.00     17,447,370.00        30,990.00       30,990.00
MOD    4610291    PLC DRG ELUTING STNT ADD G0291              60        458,100.00     7,635.00        458,100.00         7,635.00        7,635.00
MOD    4610512    CORONARY STNT INITL      92980              55      1,704,450.00    30,990.00      1,704,450.00        30,990.00       30,990.00
MOD    4610513    CORONARY STNT ADDTNL 92981                   9         68,715.00     7,635.00         68,715.00         7,635.00        7,635.00
MOD    4610514    CORONARY ATHERECTOMY 92995                   3         84,705.00    28,235.00         84,705.00        28,235.00       28,235.00
MOD    4610600    EP CARDIAC MAPPING       93609              32        345,856.00    10,808.00        345,856.00        10,808.00       10,808.00
MOD    4610610    COMP EP EVAL/LA FRM CS R 93621              47        194,768.00     4,144.00        194,768.00         4,144.00        4,144.00
MOD    4610612    COMP EP EVAL/LV RECORD 93622                 1          4,144.00     4,144.00          4,144.00         4,144.00        4,144.00
MOD    4610620    EP COMP STUDY W/INDUCTN 93620               61      1,011,136.00    16,576.00      1,011,136.00        16,576.00       16,576.00
MOD    4610631    EP POST DRUG INFUSION 93623                 42        162,876.00     3,878.00        162,876.00         3,878.00        3,878.00
MOD    4610635    EP TEST AICD LEAD & GEN 93641              125      1,398,250.00    11,186.00      1,398,250.00        11,186.00       11,186.00
MOD    4610640    EP EVAL AICD LEADS INIT 93640                1         10,358.00    10,358.00         10,358.00        10,358.00       10,358.00
MOD    4610642    EP EVAL AICD SUBSEQ      93642               1          8,289.00     8,289.00          8,289.00         8,289.00        8,289.00
                                                       2007        2007 Total       2007 Avg.
Hospital Charge                                     Utilization     Charge         Charge per 2006 Unit Price x   2006 Unit Price 2007 Unit Price
 Code Number                 Charge Desc           (ShowCase)     (ShowCase)          Unit    2007 Utilization     (6-1-06 CDM)    (6-1-07 CDM)
MOD    4610650    ABLATION-AV NODE      93650                5         82,880.00    16,576.00         82,880.00        16,576.00       16,576.00
MOD    4610651    ABLATION-SV NODE      93651               45        745,920.00    16,576.00        745,920.00        16,576.00       16,576.00
MOD    4611090    PACEMAKER INSERT FLUORO 71090            218        143,444.00       658.00        143,444.00           658.00          658.00
MOD    4611110    CARDIOVERSION ELEC       92960           124        569,656.00     4,594.00        569,656.00         4,594.00        4,594.00
MOD    4611115    TRANSESOPHOGEAL ECHO 93312               104        645,840.00     6,210.00        645,840.00         6,210.00        6,210.00
MOD    4611132    TILT TABLE EVAL     93660                 22        227,876.00    10,358.00        227,876.00        10,358.00       10,358.00
MOD    4612005    ARTERIAL CATH MONIT/SAMP                  12         17,400.00     1,450.00         17,400.00         1,450.00        1,450.00
MOD    4612020    PERIPHERAL STENT                          33         69,036.00     2,092.00         69,036.00         2,092.00        2,092.00
MOD    4612021    TRNSCTH INTRO INTRVSC ST 75960            42        553,518.00    13,179.00        553,518.00        13,179.00       13,179.00
MOD    4612500    REM PCMKR TRAN ELCT DUAL                   2         20,716.00    10,358.00         20,716.00        10,358.00       10,358.00
MOD    4612503    REM PCMKR PULS GEN ONLY                   43        445,394.00    10,358.00        445,394.00        10,358.00       10,358.00
MOD    4612505    INSRT/REP PCMKR DUAL                      21        217,518.00    10,358.00        217,518.00        10,358.00       10,358.00
MOD    4612510    INSRT TRAN ELCTRD SNGL                     6         49,734.00     8,289.00         49,734.00         8,289.00        8,289.00
MOD    4612515    REM TRANSV PM ELCTD SNGL                   8         82,864.00    10,358.00         82,864.00        10,358.00       10,358.00
MOD    4612920    INTRAVASC US INIT VESSEL 92978            81        483,489.00     5,969.00        483,489.00         5,969.00        5,969.00
MOD    4612922    INTRAVASC US EA ADD     92979              3          8,964.00     2,988.00          8,964.00         2,988.00        2,988.00
MOD    4612973    PERC CORON THROMBECT 92973                92      2,597,620.00    28,235.00      2,597,620.00        28,235.00       28,235.00
MOD    4612977    COR THROMBLYS-VEN INFSN 92977              2          5,844.00     2,922.00          5,844.00         2,922.00        2,922.00
MOD    4612984    PTCA EA ADDL VSL     92984                19        113,411.00     5,969.00        113,411.00         5,969.00        5,969.00
MOD    4613010    PERICARDIOCENTESIS INTL                    6         83,172.00    13,862.00         83,172.00        13,862.00       13,862.00
MOD    4613161    SECOND CLOSE SURG WOUND                    3            750.00       250.00            750.00           250.00          250.00
MOD    4613206    LEAD INSERT/PM PERM/ATR                    1         10,358.00    10,358.00         10,358.00        10,358.00       10,358.00
MOD    4613207    LEAD INSERT/PM PERM/VENT                  15        155,370.00    10,358.00        155,370.00        10,358.00       10,358.00
MOD    4613208    LEAD INSERT/PM PERM/A-V                   58        720,940.00    12,430.00        720,940.00        12,430.00       12,430.00
MOD    4613211    INS/RPLC TEMP DUAL CMBR                    3         27,477.00     9,159.00         27,477.00         9,159.00        9,159.00
MOD    4613212    INSERT/REPL PULSE GEN                      6         49,734.00     8,289.00         49,734.00         8,289.00        8,289.00
MOD    4613215    REPS TRNSV LD RT ATR/VNT                   3         11,636.64     3,878.88         11,636.64         3,878.88        3,878.88
MOD    4613221    INSRT LD VEN LTVENT PREV                   1          3,500.00     3,500.00          3,500.00         3,500.00        3,500.00
MOD    4613225    INSRT LD VEN LTVENT INIT                  43        193,500.00     4,500.00        193,500.00         4,500.00        4,500.00
MOD    4613226    REPS PREV LD VEN LTVENT                    1          3,878.88     3,878.88          3,878.88         3,878.88        3,878.88
MOD    4613240    INSERTION AICD PULS GEN                   21        217,518.00    10,358.00        217,518.00        10,358.00       10,358.00
MOD    4613241    SUBCUT REM AICD PLS GEN                   25        258,950.00    10,358.00        258,950.00        10,358.00       10,358.00
MOD    4613243    REM AICD LDS TRANSVEN                      3         31,074.00    10,358.00         31,074.00        10,358.00       10,358.00
MOD    4613248    INSRT/REPO AICD & LDS                      2         29,000.00    14,500.00         29,000.00        14,500.00       14,500.00
MOD    4613249    INSRT/REPO AICD & LD                     101      1,464,500.00    14,500.00      1,464,500.00        14,500.00       14,500.00
MOD    4613270    IMPL PT ACTIV CARD RCDR                    1         10,358.00    10,358.00         10,358.00        10,358.00       10,358.00
MOD    4613272    REMV PT ACTIV CARD RCDR                    3         31,074.00    10,358.00         31,074.00        10,358.00       10,358.00
MOD    4613501    CATH RT HEART ONLY      93501             57        798,057.00    14,001.00        798,057.00        14,001.00       14,001.00
MOD    4613509    CATH PLCMNT COR ART 93508                117      1,635,426.00    13,978.00      1,635,426.00        13,978.00       13,978.00
MOD    4613510    CATH LEFT HEART/RETROGRD 93510         1,217     18,593,326.00    15,278.00     18,593,326.00        15,278.00       15,278.00
                                                       2007        2007 Total       2007 Avg.
Hospital Charge                                     Utilization     Charge         Charge per 2006 Unit Price x   2006 Unit Price 2007 Unit Price
 Code Number                 Charge Desc           (ShowCase)     (ShowCase)          Unit    2007 Utilization     (6-1-06 CDM)    (6-1-07 CDM)
MOD    4613526    CATH RT HRT/LT HRT RETRO 93526           308      8,144,136.00    26,442.00      8,144,136.00        26,442.00       26,442.00
MOD    4613539    CATH INJ ART CONDUITS 93539              271        811,645.00     2,995.00        811,645.00         2,995.00        2,995.00
MOD    4613540    ANGIO ADD VESSEL COMP 75774               89        170,791.00     1,919.00        170,791.00         1,919.00        1,919.00
MOD    4613543    CATH INJ/LT VENTR-ANGIO 93543          1,472        968,576.00       658.00        968,576.00           658.00          658.00
MOD    4613544    CATH INJ/AORTOGRAPHY 93544               215        141,470.00       658.00        141,470.00           658.00          658.00
MOD    4613545    CATH INJ/SEL CORO-ANGIO 93545          1,639      1,052,238.00       642.00      1,052,238.00           642.00          642.00
MOD    4613585    COAGULATION TIME ACTIVTD 85347           758        329,730.00       435.00        329,730.00           435.00          435.00
MOD    4613588    CATH FLUOROSCOPY TIME 76000                2          1,316.00       658.00          1,316.00           658.00          658.00
MOD    4613592    TEMP PACEMAKER INSER/BUN                  45        412,155.00     9,159.00        412,155.00         9,159.00        9,159.00
MOD    4613600    HIS BUNDLE RECORDING 93600                 1         12,731.00    12,731.00         12,731.00        12,731.00       12,731.00
MOD    4613610    PERCU TRNSL CORON ANGOPL 92982            51      1,760,928.00    34,528.00      1,760,928.00        34,528.00       34,528.00
MOD    4613612    INTRAVENTRICULAR PACING 93612              5         16,710.00     3,342.00         16,710.00         3,342.00        3,342.00
MOD    4613613    INTRCRD EP 3DMAP      93613               23        248,584.00    10,808.00        248,584.00        10,808.00       10,808.00
MOD    4613640    CATH INJ AORTCOR VEN BYP 93540           234        153,972.00       658.00        153,972.00           658.00          658.00
MOD    4613652    ABLATION-VENTRICULR TACH 93652             6         99,456.00    16,576.00         99,456.00        16,576.00       16,576.00
MOD    4613656    IMAGE PULM ANG/AOR/COR 93556           1,642      1,162,536.00       708.00      1,162,536.00           708.00          708.00
MOD    4613797    CARIOPULMONARY RESUSC 92950                4         14,984.00     3,746.00         14,984.00         3,746.00        3,746.00
MOD    4613969    IABP INSERT                               52        476,268.00     9,159.00        476,268.00         9,159.00        9,159.00
MOD    4615528    IMGE VENT\ATRIAL ANGIOGR 93555         1,472      1,042,176.00       708.00      1,042,176.00           708.00          708.00
MOD    4615606    THORACIC W/SERL COMPLT 75605               3         34,635.00    11,545.00         34,635.00        11,545.00       11,545.00
MOD    4615627    ABD AORTOGRAPHY        75625              56        776,720.00    13,870.00        776,720.00        13,870.00       13,870.00
MOD    4615631    ABD AORTA W/BIL LWR EXT 75630             29        402,230.00    13,870.00        402,230.00        13,870.00       13,870.00
MOD    4615651    CERVICOCEREBRL CATH COM 75650             22        232,672.00    10,576.00        232,672.00        10,576.00       10,576.00
MOD    4615669    CAROTID CEREB UNI CATH 75665               2         27,740.00    13,870.00         27,740.00        13,870.00       13,870.00
MOD    4615673    CAROTID CEREB BI CATH 75671                9        206,694.00    22,966.00        206,694.00        22,966.00       22,966.00
MOD    4615678    CAROTID CERV UNI CATH 75676                1         15,320.00    15,320.00         15,320.00        15,320.00       15,320.00
MOD    4615682    CAROTID CERV BI CATH 75680                14        271,544.00    19,396.00        271,544.00        19,396.00       19,396.00
MOD    4615687    VERTEBRAL CATH COMPLETE 75685             11        105,633.00     9,603.00        105,633.00         9,603.00        9,603.00
MOD    4615712    EXTRMITY ARTERIOGRAM UNI 75710            28        385,700.00    13,775.00        385,700.00        13,775.00       13,775.00
MOD    4615718    EXTRMITY ARTERIOGRAM BIL 75716            71      1,142,390.00    16,090.00      1,142,390.00        16,090.00       16,090.00
MOD    4615723    RENAL UNI SELCT W/FLUSH 75722              7          4,956.00       708.00          4,956.00           708.00          708.00
MOD    4615725    RENAL BI SELECT W/FLUSH 75724             11          7,788.00       708.00          7,788.00           708.00          708.00
MOD    4615727    SEL VISCERAL ARTERIGRAM 75726              3         23,556.00     7,852.00         23,556.00         7,852.00        7,852.00
MOD    4615823    VENOGRAM EXTREMITY BIL 75822               1          8,104.00     8,104.00          8,104.00         8,104.00        8,104.00
MOD    4615945    INTRAVASC US NON CORON 75945               1            537.00       537.00            537.00           537.00          537.00
MOD    4615961    PERC RETREIVAL FX CATH 75961               1         10,358.00    10,358.00         10,358.00        10,358.00       10,358.00
MOD    4615963    ANGIO PERIF ARTERY     75962              32        438,688.00    13,709.00        438,688.00        13,709.00       13,709.00
MOD    4615965    APLASTY PERIPHL ART ADDL 75964             8         69,384.00     8,673.00         69,384.00         8,673.00        8,673.00
MOD    4615967    APLASTY VISC ARTERY INIT 75966             1         11,893.00    11,893.00         11,893.00        11,893.00       11,893.00
MOD    4615993    ATHRECTMY PERIPHL ADDL 75993               6         52,038.00     8,673.00         52,038.00         8,673.00        8,673.00
                                                        2007        2007 Total       2007 Avg.
Hospital Charge                                      Utilization     Charge         Charge per 2006 Unit Price x   2006 Unit Price 2007 Unit Price
 Code Number                 Charge Desc            (ShowCase)     (ShowCase)          Unit    2007 Utilization     (6-1-06 CDM)    (6-1-07 CDM)
MOD    4615997    FLUOROGUID FOR VEIN DVCE 75998              2          1,316.00       658.00          1,316.00           658.00          658.00
MOD    4616556    INSRT NONTUNNL CV CTH 5>                    7         10,150.00     1,450.00         10,150.00         1,450.00        1,450.00
MOD    4616589    REMV TUNL CVC WO PMP/PRT                    1          1,200.00     1,200.00          1,200.00         1,200.00        1,200.00
MOD    4617206    TRANSCATH STENT ADDL                        7         14,644.00     2,092.00         14,644.00         2,092.00        2,092.00
MOD    4617800    PLACE CATH AORTA                           21         30,450.00     1,450.00         30,450.00         1,450.00        1,450.00
MOD    4617815    PLACE CATH ART ABD 1ST                     59         85,550.00     1,450.00         85,550.00         1,450.00        1,450.00
MOD    4617820    PLACE CATH ART ABD 2ND                     13         18,850.00     1,450.00         18,850.00         1,450.00        1,450.00
MOD    4617825    PL CATH ART ABO 3RD                        41         59,450.00     1,450.00         59,450.00         1,450.00        1,450.00
MOD    4617830    PLACE CATH ART ADD ORDR                     2          2,900.00     1,450.00          2,900.00         1,450.00        1,450.00
MOD    4617835    PLACE CATH ART 1ST ORDR                    33         47,850.00     1,450.00         47,850.00         1,450.00        1,450.00
MOD    4617840    PLACE CATH ART 2ND ORDR                    15         21,750.00     1,450.00         21,750.00         1,450.00        1,450.00
MOD    4617860    PLACE CATH EXTRM ARTERY                    10         14,500.00     1,450.00         14,500.00         1,450.00        1,450.00
MOD    4617870    PLACE CATH VENACAVA                         1            658.00       658.00            658.00           658.00          658.00
MOD    4618007    TRANSCATH RTRVL PERC FB                     1          2,092.00     2,092.00          2,092.00         2,092.00        2,092.00
MOD    4618908    O2 SAT RUNS       82810                     6          3,174.00       529.00          3,174.00           529.00          529.00
MOD    4633301    ECHOCARDIOGRAM 2-D      93307           2,769      5,291,559.00     1,911.00      5,291,559.00         1,911.00        1,911.00
MOD    4633303    ECHOCARDIOGRAM/MMODE/LTD 93308             60         73,500.00     1,225.00         73,500.00         1,225.00        1,225.00
MOD    4633304    ECHOCARD LTD CONG ANOMAL 93304            123        113,283.00       921.00        113,283.00           921.00          921.00
MOD    4633325    DOPPLER ECHO PULE/CONT W 93320          2,780      5,101,300.00     1,835.00      5,101,300.00         1,835.00        1,835.00
MOD    4633328    CARDIAC DOPPLER FU/LTD 93321              139        128,019.00       921.00        128,019.00           921.00          921.00
MOD    4633350    ECHOCARDIOGRAM EX STRESS 93350             11         25,225.20     2,293.20         25,225.20         2,293.20        2,293.20
MOD    4633400    TRANSESOPHAGEAL ECHO 93312                  3         18,630.00     6,210.00         18,630.00         6,210.00        6,210.00
MOD    4636020    CAROTID DOPPLER BILAT 93880               593      1,304,600.00     2,200.00      1,304,600.00         2,200.00        2,200.00
MOD    4636026    CAROTID DOPPLER UNILAT 93882               12         12,564.00     1,047.00         12,564.00         1,047.00        1,047.00
MOD    4636050    DOPPLER ECHO COLOR FLOW 93325           2,797      2,962,023.00     1,059.00      2,962,023.00         1,059.00        1,059.00
MOD    4636606    ECHO TRANSTHOR COMP       93303             1          1,835.00     1,835.00          1,835.00         1,835.00        1,835.00
MOD    4705860    EMG 1 EXTREMITY     95860                   1          1,049.00     1,049.00          1,049.00         1,049.00        1,049.00
MOD    4805740    EEG AWAKE/SLEEP W/PORT 95819              142        299,620.00     2,110.00        299,620.00         2,110.00        2,110.00
MOD    4805817    EEG AWAKE/DROWSY        95816              70         88,620.00     1,266.00         88,620.00         1,266.00        1,266.00
MOD    4805960    EEG MONITORING 1> HR 95813                 16         48,208.00     3,013.00         48,208.00         3,013.00        3,013.00
MOD    4900030    EYE DETECTION OF FOR/BDY 70030             11          6,160.00       560.00          6,160.00           560.00          560.00
MOD    4900100    MANDIBLE LTD/3VW MAX 70100                  1          1,279.00     1,279.00          1,279.00         1,279.00        1,279.00
MOD    4900110    MANDIBLE 4VW MIN     70110                 77        142,450.00     1,850.00        142,450.00         1,850.00        1,850.00
MOD    4900140    FACIAL BONES 2VW MAX 70140                 16         22,240.00     1,390.00         22,240.00         1,390.00        1,390.00
MOD    4900150    FACIAL BONES 3VW MIN 70150                 54         87,372.00     1,618.00         87,372.00         1,618.00        1,618.00
MOD    4900160    NASAL BONES 3VW MIN    70160               57         69,597.00     1,221.00         69,597.00         1,221.00        1,221.00
MOD    4900190    OPTIC FORAMINA      70190                   3          4,854.00     1,618.00          4,854.00         1,618.00        1,618.00
MOD    4900210    SINUSES 2VW MAX      70210                  9          9,810.00     1,090.00          9,810.00         1,090.00        1,090.00
MOD    4900220    SINUSES 3VW MIN     70220                  13         23,946.00     1,842.00         23,946.00         1,842.00        1,842.00
MOD    4900250    SKULL < 4 VIEWS    70250                   41         49,118.00     1,198.00         49,118.00         1,198.00        1,198.00
                                                         2007        2007 Total       2007 Avg.
Hospital Charge                                       Utilization     Charge         Charge per 2006 Unit Price x   2006 Unit Price 2007 Unit Price
 Code Number                  Charge Desc            (ShowCase)     (ShowCase)          Unit    2007 Utilization     (6-1-06 CDM)    (6-1-07 CDM)
MOD    4900260    SKULL 4VW MIN        70260                   9         18,099.00     2,011.00         18,099.00         2,011.00        2,011.00
MOD    4900360    NECK FOR SOFT TISSUES 70360                166        168,656.00     1,016.00        168,656.00         1,016.00        1,016.00
MOD    4900610    ASPIR/INJ MAJOR JOINT                       10          6,610.00       661.00          6,610.00           661.00          661.00
MOD    4901005    CHEST PRE-EMPLMNT         71010             35         45,080.00     1,288.00         45,080.00         1,288.00        1,288.00
MOD    4901010    CHEST 1 VIEW PA OR AP 71010             23,555     24,261,650.00     1,030.00     24,261,650.00         1,030.00        1,030.00
MOD    4901020    CHEST 2VW PA OR AP & LAT 71020          13,920     16,912,800.00     1,215.00     16,912,800.00         1,215.00        1,215.00
MOD    4901021    CHEST W/LORDOTIC         71021              36         50,040.00     1,390.00         50,040.00         1,390.00        1,390.00
MOD    4901030    CHEST COMP 4 VW MIN 71030                   21         32,151.00     1,531.00         32,151.00         1,531.00        1,531.00
MOD    4901034    CHEST FLUOROSCOPY          71034             3          7,053.00     2,351.00          7,053.00         2,351.00        2,351.00
MOD    4901101    UNI RIBS WITH PA CHEST 71101                82        113,980.00     1,390.00        113,980.00         1,390.00        1,390.00
MOD    4901111    BIL RIBS WITH PA CHEST 71111                13         21,268.00     1,636.00         21,268.00         1,636.00        1,636.00
MOD    4901120    STERNUM 2VW MIN         71120               11         13,178.00     1,198.00         13,178.00         1,198.00        1,198.00
MOD    4902020    SPINE ANY LEVEL SNGL VW 72020              422        428,752.00     1,016.00        428,752.00         1,016.00        1,016.00
MOD    4902040    SPINE CERV 2VWS        72040               244        319,152.00     1,308.00        319,152.00         1,308.00        1,308.00
MOD    4902042    SPINE CERVICAL 3VW       72040           1,007      1,488,346.00     1,478.00      1,488,346.00         1,478.00        1,478.00
MOD    4902050    SPINE CERVICAL 4VW MIN 72050                36         72,396.00     2,011.00         72,396.00         2,011.00        2,011.00
MOD    4902052    CERVCAL COMP W FLEX & EX 72052               2          4,840.00     2,420.00          4,840.00         2,420.00        2,420.00
MOD    4902070    SPINE THORACIC 2 VWS 72070                  59         93,220.00     1,580.00         93,220.00         1,580.00        1,580.00
MOD    4902071    SPINE 3 VIEW T      72072                  231        359,898.00     1,558.00        359,898.00         1,558.00        1,558.00
MOD    4902072    SPINE THORACIC 4VW MIN 72074                 2          3,578.00     1,789.00          3,578.00         1,789.00        1,789.00
MOD    4902080    SPINE THORACO-LUMBAR JCT 72080               8         12,640.00     1,580.00         12,640.00         1,580.00        1,580.00
MOD    4902090    SPINE SCOLIOSIS STUDY 72090                 18         21,384.00     1,188.00         21,384.00         1,188.00        1,188.00
MOD    4902100    SPINE LUMBAR 2 VWS       72100             355        421,740.00     1,188.00        421,740.00         1,188.00        1,188.00
MOD    4902101    SPINE LUMBAR 3 VIEWS 72100                 506        799,480.00     1,580.00        799,480.00         1,580.00        1,580.00
MOD    4902110    SPINE LUMBAR MIN 4VWS 72110                 57        136,800.00     2,400.00        136,800.00         2,400.00        2,400.00
MOD    4902120    LUMB BENDNG VWS MIN 4VWS 72120               9         13,419.00     1,491.00         13,419.00         1,491.00        1,491.00
MOD    4902135    SPINAL PUNCTURE THERAPTC                   109         72,049.00       661.00         72,049.00           661.00          661.00
MOD    4902170    PELVIS LIMITED      72170                  756        749,952.00       992.00        749,952.00           992.00          992.00
MOD    4902190    PELVIS MIN 3 VWS      72190                 15         24,210.00     1,614.00         24,210.00         1,614.00        1,614.00
MOD    4902202    SACRO-ILIAC JOINTS CMPL 72202                4          6,372.00     1,593.00          6,372.00         1,593.00        1,593.00
MOD    4902220    SACRUM & COCCYX         72220               44         57,244.00     1,301.00         57,244.00         1,301.00        1,301.00
MOD    4903000    CLAVICLE          73000                    132        133,320.00     1,010.00        133,320.00         1,010.00        1,010.00
MOD    4903010    SCAPULA           73010                     27         29,214.00     1,082.00         29,214.00         1,082.00        1,082.00
MOD    4903020    SHOULDER SNGL VIEW        73020            142        140,722.00       991.00        140,722.00           991.00          991.00
MOD    4903030    SHOULDER 2VW MIN         73030             791        922,306.00     1,166.00        922,306.00         1,166.00        1,166.00
MOD    4903050    ACROMIO-CLVICULAR JTS BI 73050               2          2,524.00     1,262.00          2,524.00         1,262.00        1,262.00
MOD    4903060    HUMERUS 2VW MIN         73060              306        302,940.00       990.00        302,940.00           990.00          990.00
MOD    4903070    ELBOW LIMITED        73070                 521        419,926.00       806.00        419,926.00           806.00          806.00
MOD    4903080    ELBOW 3VW MIN         73080                  8          8,656.00     1,082.00          8,656.00         1,082.00        1,082.00
MOD    4903091    FOREARM 2 VWS         73090                615        576,870.00       938.00        576,870.00           938.00          938.00
                                                          2007        2007 Total       2007 Avg.
Hospital Charge                                        Utilization     Charge         Charge per 2006 Unit Price x   2006 Unit Price 2007 Unit Price
 Code Number                  Charge Desc             (ShowCase)     (ShowCase)          Unit    2007 Utilization     (6-1-06 CDM)    (6-1-07 CDM)
MOD    4903092    UPPER EXTREMITY INFANT 73092                 27          4,310.55       159.65          4,310.55           159.65          159.65
MOD    4903100    WRIST LIMITED       73100                   269        216,814.00       806.00        216,814.00           806.00          806.00
MOD    4903110    WRIST 3VW MIN        73110                  544        592,960.00     1,090.00        592,960.00         1,090.00        1,090.00
MOD    4903120    HAND LIMITED        73120                   162        117,450.00       725.00        117,450.00           725.00          725.00
MOD    4903130    HAND 3VW MIN         73130                  911        992,990.00     1,090.00        992,990.00         1,090.00        1,090.00
MOD    4903140    FINGER(S)         73140                     399        333,165.00       835.00        333,165.00           835.00          835.00
MOD    4903500    HIP SINGLE VIEW      73500                   50         54,500.00     1,090.00         54,500.00         1,090.00        1,090.00
MOD    4903510    HIP UNILATERAL 2 VIEWS 73510                867      1,205,130.00     1,390.00      1,205,130.00         1,390.00        1,390.00
MOD    4903520    HIP BI CMPLT(AP PELVIS) 73520                97        181,390.00     1,870.00        181,390.00         1,870.00        1,870.00
MOD    4903530    HIP IMAGING OPERATVE PRO 73530               34        113,662.00     3,343.00        113,662.00         3,343.00        3,343.00
MOD    4903551    FEMUR 2 VWS         73550                   557        661,716.00     1,188.00        661,716.00         1,188.00        1,188.00
MOD    4903560    KNEE 1-2 VWS        73560                   572        451,880.00       790.00        451,880.00           790.00          790.00
MOD    4903561    KNEES/BILAT AP STANDING 73565                 3          2,961.00       987.00          2,961.00           987.00          987.00
MOD    4903562    KNEE W/OBLIQUES 3 VW 73562                   69         68,172.00       988.00         68,172.00           988.00          988.00
MOD    4903570    KNEE COMP 4 VW MIN       73564              686        814,968.00     1,188.00        814,968.00         1,188.00        1,188.00
MOD    4903590    TIB/FIB 2 VWS      73590                    729        794,610.00     1,090.00        794,610.00         1,090.00        1,090.00
MOD    4903591    LOWER EXT INFANT AP&LAT 73592                33          5,268.45       159.65          5,268.45           159.65          159.65
MOD    4903600    ANKLE LIMITED       73600                   393        310,470.00       790.00        310,470.00           790.00          790.00
MOD    4903610    ANKLE 3VW MIN        73610                  832        963,456.00     1,158.00        963,456.00         1,158.00        1,158.00
MOD    4903620    FOOT LIMITED        73620                   222        160,284.00       722.00        160,284.00           722.00          722.00
MOD    4903630    FOOT 3VW MIN         73630                  866        937,012.00     1,082.00        937,012.00         1,082.00        1,082.00
MOD    4903650    OS CALCIS (HEEL)      73650                  67         46,766.00       698.00         46,766.00           698.00          698.00
MOD    4903660    TOE(S)          73660                        89         65,682.00       738.00         65,682.00           738.00          738.00
MOD    4904000    ABDOMEN SINGLE VIEW(KUB) 74000            1,290      1,195,830.00       927.00      1,195,830.00           927.00          927.00
MOD    4904010    ABDOMEN ADD OBLIQUE/CONE 74010            2,631      3,225,606.00     1,226.00      3,225,606.00         1,226.00        1,226.00
MOD    4904020    ABD W/DECUB OR ERECT 74020                   20         34,580.00     1,729.00         34,580.00         1,729.00        1,729.00
MOD    4904022    COMP ACUTE ABD         74022                 14         24,206.00     1,729.00         24,206.00         1,729.00        1,729.00
MOD    4904068    JNT 2 OR MORE SNGL VW 76066                   3          2,175.00       725.00          2,175.00           725.00          725.00
MOD    4904220    ESOPHAGUS           74220                    68        128,928.00     1,896.00        128,928.00         1,896.00        1,896.00
MOD    4904230    SWAL FUNC W CINE/VIDEO 74230                 78         72,306.00       927.00         72,306.00           927.00          927.00
MOD    4904243    UPPER GI W/KUB        74241                 129        368,940.00     2,860.00        368,940.00         2,860.00        2,860.00
MOD    4904245    UPPER GI W/SMALL BOWEL 74245                 31        107,322.00     3,462.00        107,322.00         3,462.00        3,462.00
MOD    4904250    SMALL BOWEL          74250                   34         91,358.00     2,687.00         91,358.00         2,687.00        2,687.00
MOD    4904270    COLON BARIUM ENEMA        74270              27         63,909.00     2,367.00         63,909.00         2,367.00        2,367.00
MOD    4904271    COLON HYPAQUE ENEMA         74270            25         72,050.00     2,882.00         72,050.00         2,882.00        2,882.00
MOD    4904280    COLON BE W/AIR        74280                   2          6,116.00     3,058.00          6,116.00         3,058.00        3,058.00
MOD    4904300    CHOLANGIOGRPHY OPERATV 74300                 14         50,764.00     3,626.00         50,764.00         3,626.00        3,626.00
MOD    4904305    CHOLANGIOGRPHY EXST CATH 74305                8         20,624.00     2,578.00         20,624.00         2,578.00        2,578.00
MOD    4904340    GI TUBE LOCAL &/OR MANIP 74340                3          3,009.00     1,003.00          3,009.00         1,003.00        1,003.00
MOD    4904350    PERC PLACE GASTROSTOMY 74350                  1          3,575.00     3,575.00          3,575.00         3,575.00        3,575.00
                                                        2007        2007 Total      2007 Avg.
Hospital Charge                                      Utilization     Charge        Charge per 2006 Unit Price x   2006 Unit Price 2007 Unit Price
 Code Number                 Charge Desc            (ShowCase)     (ShowCase)         Unit    2007 Utilization     (6-1-06 CDM)    (6-1-07 CDM)
MOD    4904361    INTRALUMINAL DILATION 74360                26        17,186.00       661.00         17,186.00           661.00          661.00
MOD    4904400    UROGRAPHY EXCRETORY(IVP) 74400              8        23,600.00     2,950.00         23,600.00         2,950.00        2,950.00
MOD    4904415    IVP WITH RENAL TOMOS 74415                  5        20,580.00     4,116.00         20,580.00         4,116.00        4,116.00
MOD    4904420    PYELOGRAPHY RETROGRADE 74420               10        23,670.00     2,367.00         23,670.00         2,367.00        2,367.00
MOD    4904425    ANTEGRADE NEPHROSTOGRAM 74425              98       215,404.00     2,198.00        215,404.00         2,198.00        2,198.00
MOD    4904430    CYSTOGRAPHY CNTRST/CHN 74430               13        25,025.00     1,925.00         25,025.00         1,925.00        1,925.00
MOD    4904450    URETHROCYSTOGRAPHY RETR 74450              16        21,872.00     1,367.00         21,872.00         1,367.00        1,367.00
MOD    4904455    URETHROCYSTOGRAPHY VOID 74455              76       173,280.00     2,280.00        173,280.00         2,280.00        2,280.00
MOD    4904740    HYSTEROSALPINGOGRAPHY 74740                 3         7,854.00     2,618.00          7,854.00         2,618.00        2,618.00
MOD    4905998    FLUOROSCOPY LESS THAN 1H 76000            491       455,157.00       927.00        455,157.00           927.00          927.00
MOD    4906010    FLUORO BX/ASP/INJ/GUIDE 76003             200       231,800.00     1,159.00        231,800.00         1,159.00        1,159.00
MOD    4906020    BONE AGE STUDIES      76020                 5         7,275.00     1,455.00          7,275.00         1,455.00        1,455.00
MOD    4906040    BONE LENGTH STUDIES      76040              1         2,412.00     2,412.00          2,412.00         2,412.00        2,412.00
MOD    4906060    BONE SURVEY LTD       76061                27        86,832.00     3,216.00         86,832.00         3,216.00        3,216.00
MOD    4906065    BONE SURVEY INFANT      76065               5         9,630.00     1,926.00          9,630.00         1,926.00        1,926.00
MOD    4906082    FISTULA-SINUS TRCT STDY 76080               1         2,370.00     2,370.00          2,370.00         2,370.00        2,370.00
MOD    4906095    SURGICAL SPECIMEN      76098                3         3,714.00     1,238.00          3,714.00         1,238.00        1,238.00
MOD    4910159    THROMBECTOMY AV FISTULA                    28       109,340.00     3,905.00        109,340.00         3,905.00        3,905.00
MOD    4910161    ATHERECTOMY TIBIOPERONEL                   20       152,900.00     7,645.00        152,900.00         7,645.00        7,645.00
MOD    4910269    PLCE VASC CLSURE DEVICE G0269              17         6,834.00       402.00          6,834.00           402.00          402.00
MOD    4912240    MYELOGRAM CERVICAL COMP 72240               7        37,632.00     5,376.00         37,632.00         5,376.00        5,376.00
MOD    4912250    MYELOGRAM LUMBAR         72265             13        65,702.00     5,054.00         65,702.00         5,054.00        5,054.00
MOD    4912290    DISCOGRAPHY LUMBAR        72295             6        32,328.00     5,388.00         32,328.00         5,388.00        5,388.00
MOD    4912291    DISCOGRAPHY LUMB ADD LV 72295              11        57,882.00     5,262.00         57,882.00         5,262.00        5,262.00
MOD    4912300    CERVI/THORA FACET BLOCK                     2         4,386.00     2,193.00          4,386.00         2,193.00        2,193.00
MOD    4913779    UNLISTED VASCULAR PROC                      6           280.08        46.68            280.08            46.68           46.68
MOD    4914100    THROMB NONCOR INITL VSL                    18       127,962.00     7,109.00        127,962.00         7,109.00        7,109.00
MOD    4914101    THROMB NONCOR ADD VESSLS                    2         7,109.00     3,554.50          7,109.00         3,554.50        3,554.50
MOD    4914200    ERCP            74330                     102       375,564.00     3,682.00        375,564.00         3,682.00        3,682.00
MOD    4914238    REMVE RENL TUBE W/FLUORO                   10        11,590.00     1,159.00         11,590.00         1,159.00        1,159.00
MOD    4914240    REPOSITN CV CATH W/FLURO                    3         3,600.00     1,200.00          3,600.00         1,200.00        1,200.00
MOD    4914244    VERTPLSTY EA VERTBDY FLU 76012             44       204,600.00     4,650.00        204,600.00         4,650.00        4,650.00
MOD    4914320    CHOLANG PERC/TRNSHP/TRJ 74320               8        28,560.00     3,570.00         28,560.00         3,570.00        3,570.00
MOD    4914363    BILIARY DIL W/WO STENT 74363                7        23,394.00     3,342.00         23,394.00         3,342.00        3,342.00
MOD    4914477    PERC NEPHROSTOMY         74475             59       213,639.00     3,621.00        213,639.00         3,621.00        3,621.00
MOD    4914478    PERC VERTPLSTY 1 BDY T                     19        22,040.00     1,160.00         22,040.00         1,160.00        1,160.00
MOD    4914479    PERC VERTPLSTY 1 BDY L                     23        26,680.00     1,160.00         26,680.00         1,160.00        1,160.00
MOD    4914480    PERC VERTPLSTY EA ADD BD                    3         3,480.00     1,160.00          3,480.00         1,160.00        1,160.00
MOD    4914481    URETERAL CATH OR STENT 74480               22        73,590.00     3,345.00         73,590.00         3,345.00        3,345.00
MOD    4914486    DILATION NEPHRO/URETER 74485                1         3,342.00     3,342.00          3,342.00         3,342.00        3,342.00
                                                       2007        2007 Total       2007 Avg.
Hospital Charge                                     Utilization     Charge         Charge per 2006 Unit Price x   2006 Unit Price 2007 Unit Price
 Code Number                 Charge Desc           (ShowCase)     (ShowCase)          Unit    2007 Utilization     (6-1-06 CDM)    (6-1-07 CDM)
MOD    4915493    ATHERECTOMY FEM/POP                       16        122,320.00     7,645.00        122,320.00         7,645.00        7,645.00
MOD    4915494    ATHERECTOMY BRACHCEPH                      2         15,290.00     7,645.00         15,290.00         7,645.00        7,645.00
MOD    4915606    THORACIC W/SERL COMPLT 75605               3         27,708.00     9,236.00         27,708.00         9,236.00        9,236.00
MOD    4915627    ABD CATHETER W/SERIAL 75625              181      2,008,376.00    11,096.00      2,008,376.00        11,096.00       11,096.00
MOD    4915631    ABD W/BILAT ILIOFEMORAL 75630              3         33,288.00    11,096.00         33,288.00        11,096.00       11,096.00
MOD    4915651    CERVICOCEREBRL CATH COM 75650             71        600,731.00     8,461.00        600,731.00         8,461.00        8,461.00
MOD    4915661    EXTERN CAROTID CEREB UN 75660              3         29,808.00     9,936.00         29,808.00         9,936.00        9,936.00
MOD    4915663    EXTERN CAROTID CEREB BIL 75662            14        217,238.00    15,517.00        217,238.00        15,517.00       15,517.00
MOD    4915669    CAROTID CEREB UNI CATH 75665               3         33,288.00    11,096.00         33,288.00        11,096.00       11,096.00
MOD    4915673    CAROTID CEREB BI CATH 75671               57      1,047,261.00    18,373.00      1,047,261.00        18,373.00       18,373.00
MOD    4915687    VERTEBRAL CATH COMPLETE 75685             27        207,414.00     7,682.00        207,414.00         7,682.00        7,682.00
MOD    4915712    EXTREMITY UNI W/SERIAL 75710             158      1,557,880.00     9,860.00      1,557,880.00         9,860.00        9,860.00
MOD    4915718    EXTREMITY BI W/SERIAL 75716               99      1,159,488.00    11,712.00      1,159,488.00        11,712.00       11,712.00
MOD    4915723    RENAL UNI SELCT W/FLUSH 75722             15        122,130.00     8,142.00        122,130.00         8,142.00        8,142.00
MOD    4915725    RENAL BI SELECT W/FLUSH 75724             12        113,472.00     9,456.00        113,472.00         9,456.00        9,456.00
MOD    4915727    VISCERAL SELECTIVE COMP 75726             20        125,640.00     6,282.00        125,640.00         6,282.00        6,282.00
MOD    4915737    PELVIC SELECTIVE     75736                16        100,512.00     6,282.00        100,512.00         6,282.00        6,282.00
MOD    4915742    PULMONARY UNI SELECTIVE 75741              1          5,153.00     5,153.00          5,153.00         5,153.00        5,153.00
MOD    4915744    PULMONARY BI SELECTIVE 75743               2         12,954.00     6,477.00         12,954.00         6,477.00        6,477.00
MOD    4915775    ANGIO ADD VESSEL COMP 75774               27         84,429.00     3,127.00         84,429.00         3,127.00        3,127.00
MOD    4915790    ARTERIOVENOUS SHUNT      75790            73        316,674.00     4,338.00        316,674.00         4,338.00        4,338.00
MOD    4915809    SHUNTOGRAM PREV NONVASC 75809              2          6,828.00     3,414.00          6,828.00         3,414.00        3,414.00
MOD    4915823    VENOGRAM EXTREMITY BIL 75822              53        343,599.00     6,483.00        343,599.00         6,483.00        6,483.00
MOD    4915826    INFERIOR VENACAVAGRAM 75825              113      1,043,668.00     9,236.00      1,043,668.00         9,236.00        9,236.00
MOD    4915828    SUPERIOR VENACAVAGRAM 75827                6         55,416.00     9,236.00         55,416.00         9,236.00        9,236.00
MOD    4915832    VENOGRAPHY RENAL UNILA 75831               2         11,348.00     5,674.00         11,348.00         5,674.00        5,674.00
MOD    4915834    VENOGRAPHY RENAL BILAT 75833               2         14,416.00     7,208.00         14,416.00         7,208.00        7,208.00
MOD    4915861    VENOGRM VNUS SINUS/JUGUL 75860             1         12,467.00    12,467.00         12,467.00        12,467.00       12,467.00
MOD    4915897    TCATH THERPY INFS W/ANG 75896             35        170,835.00     4,881.00        170,835.00         4,881.00        4,881.00
MOD    4915898    ANGIO EXIST CATH P THRPY 75898            62        449,438.00     7,249.00        449,438.00         7,249.00        7,249.00
MOD    4915941    PERC PLACE IVC FILTER 75940              110        498,410.00     4,531.00        498,410.00         4,531.00        4,531.00
MOD    4915956    INTRVASC OCC PERM W/ANG 75894             45        302,040.00     6,712.00        302,040.00         6,712.00        6,712.00
MOD    4915960    TRNSCTH INTRO INTRVSC ST 75960           131        282,567.00     2,157.00        282,567.00         2,157.00        2,157.00
MOD    4915961    PERC RETREIVAL FX CATH 75961               2         10,854.00     5,427.00         10,854.00         5,427.00        5,427.00
MOD    4915963    ANGIO PERIF ARTERY     75962             106      1,380,226.00    13,021.00      1,380,226.00        13,021.00       13,021.00
MOD    4915965    APLASTY ADD PERIL ART 75964               42         87,864.00     2,092.00         87,864.00         2,092.00        2,092.00
MOD    4915967    APLASTY VISCERAL ARTERY 75966             10         95,140.00     9,514.00         95,140.00         9,514.00        9,514.00
MOD    4915969    APLASTY ADD VISCL ART 75968                1          1,392.00     1,392.00          1,392.00         1,392.00        1,392.00
MOD    4915970    EXTREMITY(VENOGRPHY) UN 75820             28        117,712.00     4,204.00        117,712.00         4,204.00        4,204.00
MOD    4915979    ANGIOPLASTY VENOUS      75978             68        259,828.00     3,821.00        259,828.00         3,821.00        3,821.00
                                                       2007        2007 Total       2007 Avg.
Hospital Charge                                     Utilization     Charge         Charge per 2006 Unit Price x   2006 Unit Price 2007 Unit Price
 Code Number                 Charge Desc           (ShowCase)     (ShowCase)          Unit    2007 Utilization     (6-1-06 CDM)    (6-1-07 CDM)
MOD    4915981    PERC THEPATIC BIL DRAIN 75980              3          9,408.00     3,136.00          9,408.00         3,136.00        3,136.00
MOD    4915983    PERC PLACE DRN CATH/ST 75982               8         33,416.00     4,177.00         33,416.00         4,177.00        4,177.00
MOD    4915985    CHANGE PERC DRAIN CATH 75984               8         12,768.00     1,596.00         12,768.00         1,596.00        1,596.00
MOD    4915990    PERC DRN ABSC W/CATH 75989               105         61,761.00       588.20         61,761.00           588.20          588.20
MOD    4915992    ATHERECTMY PERIPH S&I 75992               28        333,004.00    11,893.00        333,004.00        11,893.00       11,893.00
MOD    4915993    ATHERCT EA ADD PERI ART 75993             13        112,749.00     8,673.00        112,749.00         8,673.00        8,673.00
MOD    4915997    FLUOROGUID FOR VEIN DVCE 75998           362        335,574.00       927.00        335,574.00           927.00          927.00
MOD    4916002    INJ PERC EXT PSEUDANYSM                    1          1,837.00     1,837.00          1,837.00         1,837.00        1,837.00
MOD    4916005    INJECT VENOGRPHY EXTRMTY                 121         51,062.00       422.00         51,062.00           422.00          422.00
MOD    4916011    FLUORO GUIDE SPINE INJ 76005             176        163,152.00       927.00        163,152.00           927.00          927.00
MOD    4916536    REM PERICTH OBST CV CATH                   3          3,000.00     1,000.00          3,000.00         1,000.00        1,000.00
MOD    4916556    INSRT NONTUNNL CV CTH 5>                  40         58,000.00     1,450.00         58,000.00         1,450.00        1,450.00
MOD    4916558    INSRT TNL CV CTH5>WO PMP                 206      1,359,600.00     6,600.00      1,359,600.00         6,600.00        6,600.00
MOD    4916561    INSRT TUNNL VAD 5>W PORT                  23        194,350.00     8,450.00        194,350.00         8,450.00        8,450.00
MOD    4916569    INSRT CV CATH NO PRT 5>                  104        150,800.00     1,450.00        150,800.00         1,450.00        1,450.00
MOD    4916580    REPLCE NON-TUNNL CV CATH                   9         10,800.00     1,200.00         10,800.00         1,200.00        1,200.00
MOD    4916581    REPLACE TUNNELED CV CATH                  28         40,600.00     1,450.00         40,600.00         1,450.00        1,450.00
MOD    4916589    REMV TUNL CVC WO PMP/PRT                   1          1,200.00     1,200.00          1,200.00         1,200.00        1,200.00
MOD    4916590    RMV TUNLD CVAD W SQ PORT                   2          2,318.00     1,159.00          2,318.00         1,159.00        1,159.00
MOD    4917182    TRNSVN INTRHEP PORT SHNT                  10         75,000.00     7,500.00         75,000.00         7,500.00        7,500.00
MOD    4917205    PERC CATH INTRVASC STENT                 119        248,948.00     2,092.00        248,948.00         2,092.00        2,092.00
MOD    4917206    TRANSCATH STNT ADDL                        5         10,460.00     2,092.00         10,460.00         2,092.00        2,092.00
MOD    4917515    CHANGE BILE DUCT CATH                      1            700.00       700.00            700.00           700.00          700.00
MOD    4917520    CHANGE KIDNEY TUBE                        24         16,800.00       700.00         16,800.00           700.00          700.00
MOD    4917565    DILATE ESOPH FLUORO<30MM                  26         18,200.00       700.00         18,200.00           700.00          700.00
MOD    4917586    DRAIN PERITONL ABSCESS                    38         26,600.00       700.00         26,600.00           700.00          700.00
MOD    4917596    EXCH INTRAVASCULR TX CTH                   1            465.00       465.00            465.00           465.00          465.00
MOD    4917615    INJECT F/CYSTO OR VCUG                    89         37,558.00       422.00         37,558.00           422.00          422.00
MOD    4917625    INJECT BRAIN CANAL                         7          4,900.00       700.00          4,900.00           700.00          700.00
MOD    4917650    INJECT HIP XRAY                            3          1,740.00       580.00          1,740.00           580.00          580.00
MOD    4917665    INJECT KIDNEY XRAY                        97         51,313.00       529.00         51,313.00           529.00          529.00
MOD    4917675    INJECT LIVER XRAY                         22         11,616.00       528.00         11,616.00           528.00          528.00
MOD    4917685    INJECT MYELOGRAM                          16          8,448.00       528.00          8,448.00           528.00          528.00
MOD    4917700    INJ SHOULDER XRAY/CT/MRI                   3          1,584.00       528.00          1,584.00           528.00          528.00
MOD    4917705    INJECT SINUS TRACT XRAY                    1            528.00       528.00            528.00           528.00          528.00
MOD    4917715    INJECT SPINE DISK LMBR                    17          8,976.00       528.00          8,976.00           528.00          528.00
MOD    4917740    INJECT UTERUS/TUBE XRAY                    3          1,584.00       528.00          1,584.00           528.00          528.00
MOD    4917755    INSERT BILE DUCT DRAIN                     9         17,514.00     1,946.00         17,514.00         1,946.00        1,946.00
MOD    4917760    INSERT CATH BILE DUCT                      4          5,568.00     1,392.00          5,568.00         1,392.00        1,392.00
MOD    4917770    INSERT KIDNEY DRAIN                       50         35,000.00       700.00         35,000.00           700.00          700.00
                                                       2007        2007 Total       2007 Avg.
Hospital Charge                                     Utilization     Charge         Charge per 2006 Unit Price x   2006 Unit Price 2007 Unit Price
 Code Number                 Charge Desc           (ShowCase)     (ShowCase)          Unit    2007 Utilization     (6-1-06 CDM)    (6-1-07 CDM)
MOD    4917772    INSERT THORACOSTMY TUBE                   37         25,900.00       700.00         25,900.00           700.00          700.00
MOD    4917775    INSERT URETERAL TUBE                      21         11,088.00       528.00         11,088.00           528.00          528.00
MOD    4917786    INTRAVASC TX CATH CHANGE 75900             1            588.00       588.00            588.00           588.00          588.00
MOD    4917790    OCCLSN/EMBL CATH NON-CNS                   1          4,881.00     4,881.00          4,881.00         4,881.00        4,881.00
MOD    4917795    OCCLSN/EMBL CATH CNS                       2          9,762.00     4,881.00          9,762.00         4,881.00        4,881.00
MOD    4917800    PLACE CATH AORTA                          94        122,858.00     1,307.00        122,858.00         1,307.00        1,307.00
MOD    4917815    PLACE CATH ART ABD 1ST                    71        100,820.00     1,420.00        100,820.00         1,420.00        1,420.00
MOD    4917820    PLACE CATH ART ABD 2ND                    66         95,700.00     1,450.00         95,700.00         1,450.00        1,450.00
MOD    4917825    PLACE CATH ART ABD 3RD                    97        140,650.00     1,450.00        140,650.00         1,450.00        1,450.00
MOD    4917835    PLACE CATH ART 1ST ORDR                   66         88,770.00     1,345.00         88,770.00         1,345.00        1,345.00
MOD    4917840    PLACE CATH ART 2ND ORDR                   91        131,950.00     1,450.00        131,950.00         1,450.00        1,450.00
MOD    4917845    PLACE CATH ART 3RD ORDR                   48         69,600.00     1,450.00         69,600.00         1,450.00        1,450.00
MOD    4917855    PLACE CATH BRACH ARTERY                    2          2,320.00     1,160.00          2,320.00         1,160.00        1,160.00
MOD    4917865    PLACE CATH EXTRM ARTERY                   41         48,626.00     1,186.00         48,626.00         1,186.00        1,186.00
MOD    4917870    PLACE CATH VENACAVA                      112        132,048.00     1,179.00        132,048.00         1,179.00        1,179.00
MOD    4917880    PLACE CATH VEIN SHUNT                     96        111,360.00     1,160.00        111,360.00         1,160.00        1,160.00
MOD    4917885    PLACE CATH VEIN 1ST ORD                  107        124,120.00     1,160.00        124,120.00         1,160.00        1,160.00
MOD    4917890    PLACE CATH VEIN 2ND ORD                    5          6,950.00     1,390.00          6,950.00         1,390.00        1,390.00
MOD    4917900    PLACE GASTROSTMY TUBE                      1            700.00       700.00            700.00           700.00          700.00
MOD    4917955    REPAIR BLOCKG PERC BRACH                  10         20,920.00     2,092.00         20,920.00         2,092.00        2,092.00
MOD    4917960    REPAIR BLOCKG PERC FEMRL                  56        117,152.00     2,092.00        117,152.00         2,092.00        2,092.00
MOD    4917965    REPAIR BLOCKG PERC ILIAC                  37         77,404.00     2,092.00         77,404.00         2,092.00        2,092.00
MOD    4917970    REPAIR BLOCKG PERC TIBIO                  35         73,220.00     2,092.00         73,220.00         2,092.00        2,092.00
MOD    4917975    REPAIR BLOCKG PERC VENOS                  38         79,496.00     2,092.00         79,496.00         2,092.00        2,092.00
MOD    4917980    REPAIR BLOCKG PERC VISCR                  12         25,104.00     2,092.00         25,104.00         2,092.00        2,092.00
MOD    4917990    REVISN OF MAJOR VEIN                     110        230,120.00     2,092.00        230,120.00         2,092.00        2,092.00
MOD    4918000    TRANSCATH THRPY NON-CORO                  33         45,936.00     1,392.00         45,936.00         1,392.00        1,392.00
MOD    4918007    TRANSCATH RTRVL PERC FB                    2          4,052.00     2,026.00          4,052.00         2,026.00        2,026.00
MOD    4918010    TRANSCATHETER OCCLUSION                   42         87,864.00     2,092.00         87,864.00         2,092.00        2,092.00
MOD    4918205    BILIARY ENDO DIL WO STNT                   2          2,900.00     1,450.00          2,900.00         1,450.00        1,450.00
MOD    4918210    BILIARY ENDO DIL W/STENT                   5          7,250.00     1,450.00          7,250.00         1,450.00        1,450.00
MOD    4918225    PLACE CATH LT/RT ARTERY                    4          5,236.00     1,309.00          5,236.00         1,309.00        1,309.00
MOD    4918900    SPINAL PUNCTR LUMB DIAG                   58         48,604.00       838.00         48,604.00           838.00          838.00
MOD    4918905    INJ CHOLE THRU EXST CATH                   8          4,224.00       528.00          4,224.00           528.00          528.00
MOD    5050200    CT SINUS W/CM       70487                  1          2,444.00     2,444.00          2,444.00         2,444.00        2,444.00
MOD    5050202    CT SINUS W/O CM      70486                41         94,423.00     2,303.00         94,423.00         2,303.00        2,303.00
MOD    5050450    CT HEAD/BR W/O CM      70450           5,934     31,325,586.00     5,279.00     31,325,586.00         5,279.00        5,279.00
MOD    5050460    CT HEAD/BR W/CM       70460               16         90,704.00     5,669.00         90,704.00         5,669.00        5,669.00
MOD    5050461    CTA CHEST WO/W CONTRAST 71275             33        233,904.00     7,088.00        233,904.00         7,088.00        7,088.00
MOD    5050470    CT HEAD/BR WO/W CM      70470            106        666,316.00     6,286.00        666,316.00         6,286.00        6,286.00
                                                         2007        2007 Total       2007 Avg.
Hospital Charge                                       Utilization     Charge         Charge per 2006 Unit Price x   2006 Unit Price 2007 Unit Price
 Code Number                  Charge Desc            (ShowCase)     (ShowCase)          Unit    2007 Utilization     (6-1-06 CDM)    (6-1-07 CDM)
MOD    5050480    CT ORBIT W/O CM       70480                 46         90,850.00     1,975.00         90,850.00         1,975.00        1,975.00
MOD    5050481    CT ORBIT W/CM        70481                   5         11,515.00     2,303.00         11,515.00         2,303.00        2,303.00
MOD    5050482    CT ORBIT WO/W CM        70482                1          4,966.00     4,966.00          4,966.00         4,966.00        4,966.00
MOD    5050486    CT FACIAL W/O CM       70486               345        681,375.00     1,975.00        681,375.00         1,975.00        1,975.00
MOD    5050487    CT FACIAL W/CM       70487                  34         78,302.00     2,303.00         78,302.00         2,303.00        2,303.00
MOD    5050496    CTA ABD LE RO WO/W CONT 75635               31        432,326.00    13,946.00        432,326.00        13,946.00       13,946.00
MOD    5050498    CTA ABD WO/W CONTRAST 74175                 41        290,608.00     7,088.00        290,608.00         7,088.00        7,088.00
MOD    5050500    CTA HEAD WO/W CONTRAST 70496                51        289,119.00     5,669.00        289,119.00         5,669.00        5,669.00
MOD    5050502    CTA NK WO/W CONTRAST 70498                  59        448,577.00     7,603.00        448,577.00         7,603.00        7,603.00
MOD    5050504    CTA PELVIS WO/W CONTRAST 72191               8         54,864.00     6,858.00         54,864.00         6,858.00        6,858.00
MOD    5050508    CTA UE WO/W CONTRAST 73206                   3          9,246.00     3,082.00          9,246.00         3,082.00        3,082.00
MOD    5050510    CTA LE WO/W CONTRAST 73706                  11         33,902.00     3,082.00         33,902.00         3,082.00        3,082.00
MOD    5050520    CT ORB/EAR/P FOS WO CM 70480                 1          5,730.00     5,730.00          5,730.00         5,730.00        5,730.00
MOD    5050610    ASPIR/INJ MAJOR JOINT                       11          7,271.00       661.00          7,271.00           661.00          661.00
MOD    5050780    CT EAR W/O CM        70480                   2         11,460.00     5,730.00         11,460.00         5,730.00        5,730.00
MOD    5051250    CT CHEST W/O CM        71250               168        960,456.00     5,717.00        960,456.00         5,717.00        5,717.00
MOD    5051260    CT CHEST W/CM         71260              2,013     14,268,144.00     7,088.00     14,268,144.00         7,088.00        7,088.00
MOD    5051270    CT CHEST WO/W CM         71270               5         37,160.00     7,432.00         37,160.00         7,432.00        7,432.00
MOD    5052125    CT SP CERV W/O CM       72125            1,063      6,077,171.00     5,717.00      6,077,171.00         5,717.00        5,717.00
MOD    5052126    CT SP CERV W/CM        72126               112        851,536.00     7,603.00        851,536.00         7,603.00        7,603.00
MOD    5052127    CT SP CERV WO/W CM        72127              3         25,782.00     8,594.00         25,782.00         8,594.00        8,594.00
MOD    5052128    CT SP THOR W/O CM       72128               95        543,115.00     5,717.00        543,115.00         5,717.00        5,717.00
MOD    5052129    CT SP THOR W/CM        72129                 4         30,412.00     7,603.00         30,412.00         7,603.00        7,603.00
MOD    5052131    CT SP LUMB W/O CM       72131              165        943,305.00     5,717.00        943,305.00         5,717.00        5,717.00
MOD    5052132    CT SP LUMB W/CM        72132                21        159,663.00     7,603.00        159,663.00         7,603.00        7,603.00
MOD    5052192    CT PELVIS W/O CM       72192             1,181      7,694,215.00     6,515.00      7,694,215.00         6,515.00        6,515.00
MOD    5052193    CT PELVIS W/CM       72193               2,612     17,913,096.00     6,858.00     17,913,096.00         6,858.00        6,858.00
MOD    5052194    CT PELVIS WO/W CM       72194               46        395,324.00     8,594.00        395,324.00         8,594.00        8,594.00
MOD    5053200    CT UE W/O CM        73200                   35        104,230.00     2,978.00        104,230.00         2,978.00        2,978.00
MOD    5053201    CT UE W/CM         73201                     6         23,118.00     3,853.00         23,118.00         3,853.00        3,853.00
MOD    5053700    CT LE W/O CM        73700                  114        339,492.00     2,978.00        339,492.00         2,978.00        2,978.00
MOD    5053701    CT LE W/CM        73701                     14         43,148.00     3,082.00         43,148.00         3,082.00        3,082.00
MOD    5054150    CT ABDOMEN W/O CM         74150          1,127      7,728,966.00     6,858.00      7,728,966.00         6,858.00        6,858.00
MOD    5054160    CT ABDOMEN W/CM         74160            2,798     19,832,224.00     7,088.00     19,832,224.00         7,088.00        7,088.00
MOD    5054170    CT ABDOMEN WO/W CM         74170            72        535,104.00     7,432.00        535,104.00         7,432.00        7,432.00
MOD    5056355    CT STEREOTACTIC LOCALZTN 76355               1          2,303.00     2,303.00          2,303.00         2,303.00        2,303.00
MOD    5056360    CT GUIDE TISSUE ABLATION 76362               4          3,760.00       940.00          3,760.00           940.00          940.00
MOD    5056361    CT GUIDANCE NDL PLACEMNT 76360             240      1,102,800.00     4,595.00      1,102,800.00         4,595.00        4,595.00
MOD    5056500    CT CARD SCORING WO CONT 0144T                1            200.00       200.00            200.00           200.00          431.21
MOD    5056505    CT LTD OR LOC F/U STUDY 76380                3          5,526.00     1,842.00          5,526.00         1,842.00        1,842.00
                                                        2007        2007 Total       2007 Avg.
Hospital Charge                                      Utilization     Charge         Charge per 2006 Unit Price x   2006 Unit Price 2007 Unit Price
 Code Number                 Charge Desc            (ShowCase)     (ShowCase)          Unit    2007 Utilization     (6-1-06 CDM)    (6-1-07 CDM)
MOD    5057382    PERC ABLTN LIVR TUMOR(S)                    2          1,318.00       659.00          1,318.00           659.00          659.00
MOD    5057502    BIOPSY ABDOMINAL MASS                       8          5,288.00       661.00          5,288.00           661.00          661.00
MOD    5057503    BIOPSY BONE DEEP                           40         26,360.00       659.00         26,360.00           659.00          659.00
MOD    5057510    BIOPSY LUNG OR MEDISTNM                    62         40,982.00       661.00         40,982.00           661.00          661.00
MOD    5057511    BIOPSY MUSCLE PERC                          3          1,983.00       661.00          1,983.00           661.00          661.00
MOD    5057512    BIOPSY PANCREAS PERC                        5          3,305.00       661.00          3,305.00           661.00          661.00
MOD    5057514    BIOPSY RENAL PERC                          35         23,135.00       661.00         23,135.00           661.00          661.00
MOD    5057583    PERC DRAIN LIVER ABSCESS                    5          3,305.00       661.00          3,305.00           661.00          661.00
MOD    5057585    DRAIN KIDNEY LESION                         2          1,322.00       661.00          1,322.00           661.00          661.00
MOD    5057588    DRAIN RETROPERI ABSCESS                    32         21,152.00       661.00         21,152.00           661.00          661.00
MOD    5057589    DRAIN SUBDIAPHR ABSCESS                     5          3,305.00       661.00          3,305.00           661.00          661.00
MOD    5057636    3D IMAGNG NO POSTPROCESS 76376              1          1,416.00     1,416.00          1,416.00         1,416.00        1,416.00
MOD    5057637    3D IMAGING W POSTPROCESS 76377             27         38,232.00     1,416.00         38,232.00         1,416.00        1,416.00
MOD    5058215    BX LIVER PERC NDL                          56         37,016.00       661.00         37,016.00           661.00          661.00
MOD    5058220    LIVER BX W/OTHER PROC                       2          1,322.00       661.00          1,322.00           661.00          661.00
MOD    5060022    FNA W GUIDANCE                             10          3,080.00       308.00          3,080.00           308.00          308.00
MOD    5061125    PARACENTESIS ABD INIT                     100         30,800.00       308.00         30,800.00           308.00          308.00
MOD    5062003    LE ART IMAGING COMP    93925               48        136,464.00     2,843.00        136,464.00         2,843.00        2,843.00
MOD    5062013    VENOUS IMAGING COMP      93970            720      1,859,040.00     2,582.00      1,859,040.00         2,582.00        2,582.00
MOD    5062020    AORT/INF/IV/BPG COMP 93978                 23         28,152.00     1,224.00         28,152.00         1,224.00        1,224.00
MOD    5066536    SOFT TISSUE HEAD/NECK 76536                37         45,177.00     1,221.00         45,177.00         1,221.00        1,221.00
MOD    5066604    US CHEST B-SCAN      76604                 30         24,240.00       808.00         24,240.00           808.00          808.00
MOD    5066641    US BREAST BILATERAL    76645                4          7,356.00     1,839.00          7,356.00         1,839.00        1,839.00
MOD    5066645    US BREAST UNILATERAL 76645                 25         24,775.00       991.00         24,775.00           991.00          991.00
MOD    5066700    US ABDOMEN COMPLETE       76700         1,720      2,734,800.00     1,590.00      2,734,800.00         1,590.00        1,590.00
MOD    5066705    US ABDOMEN LTD/QUAD/FU 76705              189        241,542.00     1,278.00        241,542.00         1,278.00        1,278.00
MOD    5066770    US RETROPERITONEAL COMP 76770             779        951,159.00     1,221.00        951,159.00         1,221.00        1,221.00
MOD    5066775    US RETROPERITONEAL LTD 76775               12         11,040.00       920.00         11,040.00           920.00          920.00
MOD    5066782    US SCROTUM CONTENTS       76870           181        272,767.00     1,507.00        272,767.00         1,507.00        1,507.00
MOD    5066801    US OB COMP<14WKS 1STGEST 76801            763        155,804.60       204.20        155,804.60           204.20          204.20
MOD    5066802    US OB COMP<14WK ADD GEST 76802             14          2,858.80       204.20          2,858.80           204.20          204.20
MOD    5066810    US OB LTD 1OR> FETUS 76815                116        106,720.00       920.00        106,720.00           920.00          920.00
MOD    5066816    US OB TRANSVAGINAL     76817              582        118,873.50       204.25        118,873.50           204.25          204.25
MOD    5066818    FETAL BIOPHYSICAL PROF 76818              158        215,986.00     1,367.00        215,986.00         1,367.00        1,367.00
MOD    5066825    US OB COMP>14WK SGL GEST 76805            707      1,042,118.00     1,474.00      1,042,118.00         1,474.00        1,474.00
MOD    5066828    INFANT HEAD ECHO      76506               517        585,244.00     1,132.00        585,244.00         1,132.00        1,132.00
MOD    5066830    US TRANSVAGINAL NOT OB 76830              277        274,507.00       991.00        274,507.00           991.00          991.00
MOD    5066843    US OB COMP>14WK ADD GEST 76810             40         13,342.00       333.55         13,342.00           333.55          333.55
MOD    5066856    US PELVIC COMPLETE     76856              402        669,732.00     1,666.00        669,732.00         1,666.00        1,666.00
MOD    5066858    US PELVIC LTD/FU    76857                   8          7,600.00       950.00          7,600.00           950.00          950.00
                                                       2007        2007 Total       2007 Avg.
Hospital Charge                                     Utilization     Charge         Charge per 2006 Unit Price x   2006 Unit Price 2007 Unit Price
 Code Number                 Charge Desc           (ShowCase)     (ShowCase)          Unit    2007 Utilization     (6-1-06 CDM)    (6-1-07 CDM)
MOD    5066881    US EXTREMITY NON VASCULR 76880            53         48,760.00       920.00         48,760.00           920.00          920.00
MOD    5066937    US GUIDE VASCULAR ACCESS 76937           502         75,300.00       150.00         75,300.00           150.00          150.00
MOD    5066960    US GUIDE NEEDLE PLACEMNT 76942           293        430,710.00     1,470.00        430,710.00         1,470.00        1,470.00
MOD    5067138    VENOUS IMAGING LTD     93971             872      1,386,480.00     1,590.00      1,386,480.00         1,590.00        1,590.00
MOD    5067150    AORT/INF/IV/BPG LTD  93979                21         23,793.00     1,133.00         23,793.00         1,133.00        1,133.00
MOD    5067160    SCAN HEMODIALYSIS ACCESS 93990             2          1,676.00       838.00          1,676.00           838.00          838.00
MOD    5067201    LE ART IMAGING LTD   93926                54        105,894.00     1,961.00        105,894.00         1,961.00        1,961.00
MOD    5067206    UE ART IMAGING LTD    93931                9         17,649.00     1,961.00         17,649.00         1,961.00        1,961.00
MOD    5067545    BX THYROID PERC NDL                        4          1,232.00       308.00          1,232.00           308.00          308.00
MOD    5067570    THORACENTESIS ASP                        156         48,048.00       308.00         48,048.00           308.00          308.00
MOD    5071006    ANOSCOPY                                 409        224,541.00       549.00        224,541.00           549.00          549.00
MOD    5071007    RECTAL SENSATION TEST 91120                4          8,244.00     2,061.00          8,244.00         2,061.00        2,061.00
MOD    5071010    RECTAL DILATATION                          3          1,218.00       406.00          1,218.00           406.00          406.00
MOD    5071013    BX LIVER PERC NDL                         26         34,502.00     1,327.00         34,502.00         1,327.00        1,327.00
MOD    5071023    ESOPHAGEAL PROSTHESIS                      2          2,290.00     1,145.00          2,290.00         1,145.00        1,145.00
MOD    5071026    COLONOSCOPY LIMITED                       16         82,800.00     5,175.00         82,800.00         5,175.00        5,175.00
MOD    5071027    COLONOSCOPY                              879      6,004,449.00     6,831.00      6,004,449.00         6,831.00        6,831.00
MOD    5071028    COLONOSCOPY W/BX                           3         14,901.00     4,967.00         14,901.00         4,967.00        4,967.00
MOD    5071029    COLONOSCOPY W/BIOPSY                     521      3,990,860.00     7,660.00      3,990,860.00         7,660.00        7,660.00
MOD    5071030    COLON W/POLYP SNARE                      349        360,168.00     1,032.00        360,168.00         1,032.00        1,032.00
MOD    5071039    COLONSCPY W/LSR OR PHTCO                   1          7,759.00     7,759.00          7,759.00         7,759.00        7,759.00
MOD    5071051    ESPHGSTRDUOSPY/FRN BODY                   13         13,416.00     1,032.00         13,416.00         1,032.00        1,032.00
MOD    5071054    FULL EGD                                 259      1,270,395.00     4,905.00      1,270,395.00         4,905.00        4,905.00
MOD    5071055    FULL EGD W/BIOPSY                        602      3,449,460.00     5,730.00      3,449,460.00         5,730.00        5,730.00
MOD    5071056    ERCP                                      96        744,000.00     7,750.00        744,000.00         7,750.00        7,750.00
MOD    5071058    ERCP WITH BIOPSY                           7         60,018.00     8,574.00         60,018.00         8,574.00        8,574.00
MOD    5071060    EGD W/MALONEY DILITATION                   1          1,782.00     1,782.00          1,782.00         1,782.00        1,782.00
MOD    5071062    ESOPHAGEAL MOTILITY     91010             51        248,217.00     4,867.00        248,217.00         4,867.00        4,867.00
MOD    5071063    ESOPH DILATION GUIDEWIRE                  97        111,065.00     1,145.00        111,065.00         1,145.00        1,145.00
MOD    5071066    ESOPHAGUS-BERNSTEIN TEST 91030             1            774.00       774.00            774.00           774.00          774.00
MOD    5071070    EGD W/LIGATION                            22         22,704.00     1,032.00         22,704.00         1,032.00        1,032.00
MOD    5071074    FEEDING TUBE INSERTION                     5          6,325.00     1,265.00          6,325.00         1,265.00        1,265.00
MOD    5071075    COLON CAUTERY                            337        347,784.00     1,032.00        347,784.00         1,032.00        1,032.00
MOD    5071077    EGD SCLEROTHERAPY                         16         16,512.00     1,032.00         16,512.00         1,032.00        1,032.00
MOD    5071086    GASTRIC LAVAGE      91105                  9          7,407.00       823.00          7,407.00           823.00          823.00
MOD    5071098    PERCU ENDSCPC GASTROTOMY                  68         77,860.00     1,145.00         77,860.00         1,145.00        1,145.00
MOD    5071124    PARACENTESIS                               3          5,190.00     1,730.00          5,190.00         1,730.00        1,730.00
MOD    5071140    COLONSCOPY SCLROTHERAPY                    8          8,256.00     1,032.00          8,256.00         1,032.00        1,032.00
MOD    5071143    SIGMOIDSCPY FLEX W/BX                      8         27,632.00     3,454.00         27,632.00         3,454.00        3,454.00
MOD    5071145    SIGMOIDOSCOPY FLEXIBLE                    18         47,394.00     2,633.00         47,394.00         2,633.00        2,633.00
                                                        2007        2007 Total       2007 Avg.
Hospital Charge                                      Utilization     Charge         Charge per 2006 Unit Price x   2006 Unit Price 2007 Unit Price
 Code Number                  Charge Desc           (ShowCase)     (ShowCase)          Unit    2007 Utilization     (6-1-06 CDM)    (6-1-07 CDM)
MOD    5071148    SIMPLE EGD                                 31        144,243.00     4,653.00        144,243.00         4,653.00        4,653.00
MOD    5071149    SIMPLE EGD W/BIOPSY                        10         56,930.00     5,693.00         56,930.00         5,693.00        5,693.00
MOD    5071200    ENDO INCOMPLETE                             5         11,995.00     2,399.00         11,995.00         2,399.00        2,399.00
MOD    5071210    EGD W/CAUTERY OR PHTCO                     99        102,168.00     1,032.00        102,168.00         1,032.00        1,032.00
MOD    5071254    ESOPH PH TST W ELECT 91035                 25         57,275.00     2,291.00         57,275.00         2,291.00        2,291.00
MOD    5071400    PAPILLOTOMY                                67         70,551.00     1,053.00         70,551.00         1,053.00        1,053.00
MOD    5072064    IV INF TX INIT <=1 HR 90765                40         15,760.00       394.00         15,760.00           394.00          394.00
MOD    5072065    IV INF TX EA ADD HR    90766               25          1,250.00        50.00          1,250.00            50.00           50.00
MOD    5073111    TRANSFUSION BLD/BLD COMP                    1            840.88       840.88            840.88           840.88          840.88
MOD    5073264    ERCP W/STONE REMOVAL                       64         66,048.00     1,032.00         66,048.00         1,032.00        1,032.00
MOD    5073268    ERCP W/ INSERT STENT                       17         17,544.00     1,032.00         17,544.00         1,032.00        1,032.00
MOD    5073269    ERCP RMV STENT/FRN BODY                     6          6,192.00     1,032.00          6,192.00         1,032.00        1,032.00
MOD    5073271    ERCP W BALLOON DILATION                     4          4,128.00     1,032.00          4,128.00         1,032.00        1,032.00
MOD    5073455    ESOPHAGEAL DILATION<30MN                   35         80,185.00     2,291.00         80,185.00         2,291.00        2,291.00
MOD    5073760    CHANGE GASTROSTOMY TUBE                     6          5,496.00       916.00          5,496.00           916.00          916.00
MOD    5074373    CONVERSION OF PEG TO PEJ                    1          1,145.00     1,145.00          1,145.00         1,145.00        1,145.00
MOD    5074377    ENDOSCPY INCL ILEUM W/BX                    3          5,953.80     1,984.60          5,953.80         1,984.60        1,984.60
MOD    5074378    ENDOSCPY W/CNTRL BLEED                     19         37,707.40     1,984.60         37,707.40         1,984.60        1,984.60
MOD    5074388    COLON THRU COLOSTOMY                        4         26,916.00     6,729.00         26,916.00         6,729.00        6,729.00
MOD    5075337    COLON DECOMPRESSION                         1          7,255.00     7,255.00          7,255.00         7,255.00        7,255.00
MOD    5075388    COLONOSCOPY W SUBMUC INJ                    9         17,640.36     1,960.04         17,640.36         1,960.04        1,960.04
MOD    5076221    HEMORRHOID LIGATION                         1          1,032.00     1,032.00          1,032.00         1,032.00        1,032.00
MOD    5191400    GA67 CITRATE 1MCI       A9556              52         10,920.00       210.00         10,920.00           210.00          210.00
MOD    5191724    IN111 DTPA .5MCI      A9548                 1          1,828.00     1,828.00          1,828.00         1,828.00        1,828.00
MOD    5191725    IN111 CAPROMAB DOSE       A9507             6         22,314.00     3,719.00         22,314.00         3,719.00        3,719.00
MOD    5191729    IN111 OXINE .5MCI     A9547                50        113,345.50     2,266.91        113,345.50         2,266.91        2,266.91
MOD    5192180    I 123 MIBG DOSE                             1          2,231.25     2,231.25          2,231.25         2,231.25        2,231.25
MOD    5194010    TC99 MEDRONAT UPTO 30MCI A9503            200         63,400.00       317.00         63,400.00           317.00          317.00
MOD    5194170    TC99 SESTAMIBI DOSE      A9500            994      1,275,302.00     1,283.00      1,275,302.00         1,283.00        1,283.00
MOD    5194175    TC99 SUCCIMER DOSE        A9551             3          3,339.00     1,113.00          3,339.00         1,113.00        1,113.00
MOD    5194800    TL201 CHLORIDE 1MCI      A9505             29          7,685.00       265.00          7,685.00           265.00          265.00
MOD    5195100    XENON 133 10 MCI       A9558              290        124,700.00       430.00        124,700.00           430.00          430.00
MOD    5196200    SM153 LEXIDRONAM 50MCI A9605                2         14,340.00     7,170.00         14,340.00         7,170.00        7,170.00
MOD    5199512    TC99 PERTECHN PER MCI A9512               549          6,445.26        11.74          6,445.26            11.74           11.74
MOD    5199516    I 123 SOD CAP PER 100UCI A9516             33          1,422.30        43.10          1,422.30            43.10           43.10
MOD    5199517    TX I131 SOD CAP PER MCI A9517           5,354        107,080.00        20.00        107,080.00            20.00           20.00
MOD    5199537    TC99 MEBROFENIN DOSE A9537                140         17,920.00       128.00         17,920.00           128.00          128.00
MOD    5199540    TC99 ALBUMIN MAA DOSE A9540               314         18,212.00        58.00         18,212.00            58.00           58.00
MOD    5199541    TC99 SULFUR COLLOID DOSE A9541            102          7,446.00        73.00          7,446.00            73.00           73.00
MOD    5199560    TC99 RBC DOSE         A9560                76         16,872.00       222.00         16,872.00           222.00          222.00
                                                       2007        2007 Total       2007 Avg.
Hospital Charge                                     Utilization     Charge         Charge per 2006 Unit Price x   2006 Unit Price 2007 Unit Price
 Code Number                 Charge Desc           (ShowCase)     (ShowCase)          Unit    2007 Utilization     (6-1-06 CDM)    (6-1-07 CDM)
MOD    5199562    TC99 MERTIATIDE DOSE A9562               239         68,115.00       285.00         68,115.00           285.00          285.00
MOD    5200195    BREAST IMAGING       78800                41        119,023.00     2,903.00        119,023.00         2,903.00        2,903.00
MOD    5200197    BREAST IMAGING MULT AREA 78801             1          4,118.00     4,118.00          4,118.00         4,118.00        4,118.00
MOD    5208001    THYROID UPTAKE MULTIPLE 78001              2          2,046.00     1,023.00          2,046.00         1,023.00        1,023.00
MOD    5208007    THYROID IMAG W/UPTK MULT 78007            29         72,210.00     2,490.00         72,210.00         2,490.00        2,490.00
MOD    5208010    THYROID IMAGING ONLY 78010                26         38,116.00     1,466.00         38,116.00         1,466.00        1,466.00
MOD    5208018    THYROID C/M IMG WHOL BDY 78018            98        428,064.00     4,368.00        428,064.00         4,368.00        4,368.00
MOD    5208031    PARATHYROID IMAGING      78070            14         20,524.00     1,466.00         20,524.00         1,466.00        1,466.00
MOD    5208192    INFL PR LCL/LTD    78805                  38        234,498.00     6,171.00        234,498.00         6,171.00        6,171.00
MOD    5208195    LYMPHATICS & LYMPH NODES 78195             1          3,264.00     3,264.00          3,264.00         3,264.00        3,264.00
MOD    5208205    LIVER IMAGING (SPECT) 78205                2          1,942.00       971.00          1,942.00           971.00          971.00
MOD    5208215    LIVER/SPLEEN IMAG STATIC 78215            12         39,168.00     3,264.00         39,168.00         3,264.00        3,264.00
MOD    5208216    LIVER/SPLEEN VASC FLOW 78216               2          8,160.00     4,080.00          8,160.00         4,080.00        4,080.00
MOD    5208223    HEPATOBILIARY IMG W/GBLD 78223           140        641,760.00     4,584.00        641,760.00         4,584.00        4,584.00
MOD    5208276    GASTRIC EMPTYING STDY-DM 78264            26         76,492.00     2,942.00         76,492.00         2,942.00        2,942.00
MOD    5208280    GI BLOOD LOSS STUDY     78278             21         99,519.00     4,739.00         99,519.00         4,739.00        4,739.00
MOD    5208290    INTESTINE IMAGING     78290                2          5,824.00     2,912.00          5,824.00         2,912.00        2,912.00
MOD    5208300    BONE IMAGING LIMITED 78300                76        220,628.00     2,903.00        220,628.00         2,903.00        2,903.00
MOD    5208307    BONE IMAGING WHOLE BODY 78306            123        537,264.00     4,368.00        537,264.00         4,368.00        4,368.00
MOD    5208310    VASCULAR FLOW BONE IMAG 78445             54         34,830.00       645.00         34,830.00           645.00          645.00
MOD    5208320    BONE IMG TOMOGRM (SPECT) 78320             5          4,855.00       971.00          4,855.00           971.00          971.00
MOD    5208403    GATED HEART PLANAR SNGL 78472             22         96,866.00     4,403.00         96,866.00         4,403.00        4,403.00
MOD    5208459    RG MYOCARDIAL QUAL REST 78460              6         16,002.00     2,667.00         16,002.00         2,667.00        2,667.00
MOD    5208464    CARD TOM(SPECT)REST ONLY 78464            18         58,518.00     3,251.00         58,518.00         3,251.00        3,251.00
MOD    5208465    CARD TOM(SPECT)REST&EXCR 78465           962      6,082,726.00     6,323.00      6,082,726.00         6,323.00        6,323.00
MOD    5208480    MYOCARD PERF W/EJ FRX 78480              979        511,038.00       522.00        511,038.00           522.00          522.00
MOD    5208482    MYOCARD PERF W/WM        78478           978        340,344.00       348.00        340,344.00           348.00          348.00
MOD    5208494    CARD GTD SPCT RST W/M EF 78494            30        165,120.00     5,504.00        165,120.00         5,504.00        5,504.00
MOD    5208580    PULM PERF PARTICULATE 78580              317        867,946.00     2,738.00        867,946.00         2,738.00        2,738.00
MOD    5208592    PULM VENT GAS MULTIPLE 78594             290        794,020.00     2,738.00        794,020.00         2,738.00        2,738.00
MOD    5208610    BRAIN IMAG VASC FLO ONLY 78610             4         11,768.00     2,942.00         11,768.00         2,942.00        2,942.00
MOD    5208630    CISTERNOGRAM         78630                 2         10,010.00     5,005.00         10,010.00         5,005.00        5,005.00
MOD    5208701    KIDNEY IMAG VASC FLOW 78701                4         12,108.00     3,027.00         12,108.00         3,027.00        3,027.00
MOD    5208704    KIDNEY IMAG FUNCTION 78704                 3          8,808.00     2,936.00          8,808.00         2,936.00        2,936.00
MOD    5208707    KIDNEY IMG VASC/FUNCTION 78707             5         22,325.00     4,465.00         22,325.00         4,465.00        4,465.00
MOD    5208720    KIDNEY FUNCTN NON IMAG 78725              14         39,998.00     2,857.00         39,998.00         2,857.00        2,857.00
MOD    5208800    TUMOR LOCAL LTD       78800                1          1,842.00     1,842.00          1,842.00         1,842.00        1,842.00
MOD    5208801    TUMOR LOCAL MULTI AREAS 78801              1          2,802.00     2,802.00          2,802.00         2,802.00        2,802.00
MOD    5208803    TUMOR LOCALIZATION-SPECT 78803             2          2,606.22     1,303.11          3,160.00         1,580.00        1,026.22
MOD    5208804    TUMR LOC WHLE BDY 2+DAYS 78804             4         17,472.00     4,368.00         17,472.00         4,368.00        4,368.00
                                                          2007        2007 Total       2007 Avg.
Hospital Charge                                        Utilization     Charge         Charge per 2006 Unit Price x   2006 Unit Price 2007 Unit Price
 Code Number                   Charge Desc            (ShowCase)     (ShowCase)          Unit    2007 Utilization     (6-1-06 CDM)    (6-1-07 CDM)
MOD    5208825    COMPUTER EVAL 30 MIN 78890                1,253        973,581.00       777.00        973,581.00           777.00          777.00
MOD    5209005    RADPHARM TX ORAL        79005                69        126,615.00     1,835.00        126,615.00         1,835.00        1,835.00
MOD    5250230    MRI SP CERV W/WO CM      72156               65        658,970.00    10,138.00        658,970.00        10,138.00       10,138.00
MOD    5250234    MRI SP THOR W/WO CM       72157              56        567,728.00    10,138.00        567,728.00        10,138.00       10,138.00
MOD    5250238    MRI SP LUMB W/WO CM      72158              111      1,007,547.00     9,077.00      1,007,547.00         9,077.00        9,077.00
MOD    5250601    MRA HEAD W/O CONTRAST 70544                 109        404,717.00     3,713.00        404,717.00         3,713.00        3,713.00
MOD    5250602    MRA HEAD W/CONTRAST        70545              1          4,686.00     4,686.00          4,686.00         4,686.00        4,686.00
MOD    5250607    MRA NECK W/CONTRAST        70548              1          4,533.00     4,533.00          4,533.00         4,533.00        4,533.00
MOD    5250608    MRA NECK WO/W CONTRAST 70549                 29        202,710.00     6,990.00        202,710.00         6,990.00        6,990.00
MOD    5250662    MRI SP CERV W/O CM     72141                 52        417,768.00     8,034.00        417,768.00         8,034.00        8,034.00
MOD    5250676    MRI SP THOR W/O CM     72146                 19        132,810.00     6,990.00        132,810.00         6,990.00        6,990.00
MOD    5250692    MRI SP LUMB W/O CM     72148                 95        664,050.00     6,990.00        664,050.00         6,990.00        6,990.00
MOD    5250802    MRI BR/HEAD W/O CM     70551                272      1,617,584.00     5,947.00      1,617,584.00         5,947.00        5,947.00
MOD    5250810    MRI BR/HEAD W/CM      70552                  15        150,795.00    10,053.00        150,795.00        10,053.00       10,053.00
MOD    5250816    MRI BR/HEAD W/WO CM      70553              339      3,436,782.00    10,138.00      3,436,782.00        10,138.00       10,138.00
MOD    5250850    MRI PELVIS W/O CONTRAST 72195                12         58,188.00     4,849.00         58,188.00         4,849.00        4,849.00
MOD    5250852    MRI PELVIS WO/W CONTRAST 72197               18        133,668.00     7,426.00        133,668.00         7,426.00        7,426.00
MOD    5250974    MRI ABD W/CONTRAST       74182                1          5,947.00     5,947.00          5,947.00         5,947.00        5,947.00
MOD    5251000    MRI ABD WO/W CONTRAST 74183                   6         44,556.00     7,426.00         44,556.00         7,426.00        7,426.00
MOD    5251025    MRI ORBIT/FACE/NECK WO 70540                  8         47,576.00     5,947.00         47,576.00         5,947.00        5,947.00
MOD    5251040    MRI CHEST WO       71550                      1          6,776.00     6,776.00          6,776.00         6,776.00        6,776.00
MOD    5251055    MRI UE/NOT JNT WO/W CTRS 73220               12        102,648.00     8,554.00        102,648.00         8,554.00        8,554.00
MOD    5251060    MRI UE/JNT WO CTRS     73221                 40        233,600.00     5,840.00        233,600.00         5,840.00        5,840.00
MOD    5251065    MRI LE/NOT JNT WO/W CTRS 73720               57        308,997.00     5,421.00        308,997.00         5,421.00        5,421.00
MOD    5251070    MRI LE/JNT WO CTRS     73721                 96        821,184.00     8,554.00        821,184.00         8,554.00        8,554.00
MOD    5251075    MRI ABD WO CTRS      74181                   38        303,772.00     7,994.00        303,772.00         7,994.00        7,994.00
MOD    5258899    MRA ABDOMEN W CONT         74185             12         54,396.00     4,533.00         54,396.00         4,533.00        4,533.00
MOD    5258901    MRA ABDOMEN WO CONT         74185             1          3,713.00     3,713.00          3,713.00         3,713.00        3,713.00
MOD    5258902    MRA ABDOMEN WO/W CONT 74185                  10         69,900.00     6,990.00         69,900.00         6,990.00        6,990.00
MOD    5258912    MRA LWR EXT W CONT       73725                7         33,068.00     4,724.00         33,068.00         4,724.00        4,724.00
MOD    5258914    MRA LWR EXT WO/W CONT 73725                   2         13,980.00     6,990.00         13,980.00         6,990.00        6,990.00
MOD    5258918    MRA PELVIS WITH CONT 72198                    3         13,599.00     4,533.00         13,599.00         4,533.00        4,533.00
MOD    5258919    MRA PELVIS WO CONT       72198                2          7,426.00     3,713.00          7,426.00         3,713.00        3,713.00
MOD    5258920    MRA PELVIS WO/W CONT 72198                    1          8,738.00     8,738.00          8,738.00         8,738.00        8,738.00
MOD    5300001    MISCELNEOUS ORAL TAB/CAP                  9,122        291,904.00        32.00        291,904.00            32.00           32.00
MOD    5300003    ABACAVIR 300MG      J8499                    82         12,546.00       153.00         12,546.00           153.00          153.00
MOD    5300005    ACARBOSE 50MG        J8499                  165          6,270.00        38.00          6,270.00            38.00           38.00
MOD    5300008    ACEBUTOLOL 200MG CAP J8499                    2             60.00        30.00             60.00            30.00           30.00
MOD    5300012    ACETAMIN/CAFFEINE/BUTAL J8499                24            504.00        21.00            504.00            21.00           21.00
MOD    5300016    ACETAMIN/ISOMETHEP/DIC J8499                 16            336.00        21.00            336.00            21.00           21.00
                                                        2007        2007 Total      2007 Avg.
Hospital Charge                                      Utilization     Charge        Charge per 2006 Unit Price x   2006 Unit Price 2007 Unit Price
 Code Number                  Charge Desc           (ShowCase)     (ShowCase)         Unit    2007 Utilization     (6-1-06 CDM)    (6-1-07 CDM)
MOD    5300098    ACETAZOLAMIDE 250MG       J8499           262         5,502.00       21.00           5,502.00           21.00            21.00
MOD    5300160    ACYCLOVIR 200MG       J8499               133         5,320.00       40.00           5,320.00           40.00            40.00
MOD    5300161    ACYCLOVIR 800MG       J8499               188        14,288.00       76.00          14,288.00           76.00            76.00
MOD    5300201    ALBENDAZOLE 200MG        J8499             66         4,356.00       66.00           4,356.00           66.00            66.00
MOD    5300221    ALBUTEROL TAB 2MG       J8499              37           777.00       21.00             777.00           21.00            21.00
MOD    5300222    ALBUTEROL REPETAB 4MG J8499                 5           251.75       50.35             251.75           50.35            50.35
MOD    5300230    ALENDRONATE 10MG        J8499              88         5,544.00       63.00           5,544.00           63.00            63.00
MOD    5300233    ALENDRONATE 70MG        J8499              67        10,251.00      153.00          10,251.00          153.00           153.00
MOD    5300244    ALLOPURINOL 100MG       J8499           1,360        23,120.00       17.00          23,120.00           17.00            17.00
MOD    5300248    ALLOPURINOL 300MG       J8499             877        22,802.00       26.00          22,802.00           26.00            26.00
MOD    5300294    ALPRAZOLAM .25MG       J8499            2,746       601,374.00      219.00         601,374.00          219.00           219.00
MOD    5300298    ALPRAZOLAM .5MG       J8499             4,260       932,940.00      219.00         932,940.00          219.00           219.00
MOD    5300476    AMANTADINE 100MG       J8499               98         2,548.00       26.00           2,548.00           26.00            26.00
MOD    5300522    AMILORIDE 5MG       J8499                  27           567.00       21.00             567.00           21.00            21.00
MOD    5300625    AMIODARONE 200MG        J8499          12,861       977,436.00       76.00         977,436.00           76.00            76.00
MOD    5300634    AMITRIPTYLINE 10MG     J8499              228         2,508.00       11.00           2,508.00           11.00            11.00
MOD    5300638    AMITRIPTYLINE 25MG     J8499              614        10,472.00       17.05          10,438.00           17.00            17.00
MOD    5300642    AMITRIPTYLINE 50MG     J8499              454         9,534.00       21.00           9,534.00           21.00            21.00
MOD    5300646    AMITRIPTYLINE 75MG     J8499              102         2,652.00       26.00           2,652.00           26.00            26.00
MOD    5300649    RISPERIDONE .5MG      J8499               724        55,024.00       76.00          55,024.00           76.00            76.00
MOD    5300650    AMITRIPTYLINE 100MG     J8499             167         4,342.00       26.00           4,342.00           26.00            26.00
MOD    5300661    AMLODIPINE 5MG       J8499              7,670       567,580.00       74.00         567,580.00           74.00            74.00
MOD    5300712    AMOXICILLIN/CLAV 250MG J8499                7           441.00       63.00             441.00           63.00            63.00
MOD    5300713    AMOXICILLIN/CLAV 875MG J8499              284        22,152.00       78.00          22,152.00           78.00            78.00
MOD    5300715    AMOXICILLIN/CLAV 500MG J8499              215        13,545.00       63.00          13,545.00           63.00            63.00
MOD    5300723    AMOXICILLIN 250MG     J8499                72         1,224.00       17.00           1,224.00           17.00            17.00
MOD    5300725    AMOXICILLIN 500MG     J8499               503         8,551.00       17.00           8,551.00           17.00            17.00
MOD    5300746    AMPICILLIN 250MG     J8499                429         9,009.00       21.00           9,009.00           21.00            21.00
MOD    5300750    AMPICILLIN 500MG     J8499                572        41,756.00       73.00          41,756.00           73.00            73.00
MOD    5300755    ANAGRELIDE 0.5MG      J8499                 7           770.00      110.00             770.00          110.00           110.00
MOD    5300762    ANASTROZOLE 1MG        J8499              123        19,311.00      157.00          19,311.00          157.00           157.00
MOD    5300784    ARIPIPRAZOLE 10MG      J8499              415        35,192.00       84.80          35,192.00           84.80            84.80
MOD    5301057    ASCORBIC ACID 250MG      A9150             15           165.00       11.00             165.00           11.00            11.00
MOD    5301061    ASCORBIC ACID 500MG      A9150          6,276       458,148.00       73.00         458,148.00           73.00            73.00
MOD    5301137    ATENOLOL 25MG        J8499              4,817       351,641.00       73.00         351,641.00           73.00            73.00
MOD    5301138    ATENOLOL 50MG        J8499              3,381       250,194.00       74.00         250,194.00           74.00            74.00
MOD    5301145    ATORVASTATIN 10MG       J8499           2,773       207,975.00       75.00         207,975.00           75.00            75.00
MOD    5301146    ATORVASTATIN 20MG       J8499          11,884       903,184.00       76.00         903,184.00           76.00            76.00
MOD    5301215    AZATHIOPRINE 50MG      J7500              157         3,297.00       21.00           3,297.00           21.00            21.00
MOD    5301220    AZITHROMYCIN 250MG       J8499          5,612       454,572.00       81.00         454,572.00           81.00            81.00
                                                         2007        2007 Total      2007 Avg.
Hospital Charge                                       Utilization     Charge        Charge per 2006 Unit Price x   2006 Unit Price 2007 Unit Price
 Code Number                  Charge Desc            (ShowCase)     (ShowCase)         Unit    2007 Utilization     (6-1-06 CDM)    (6-1-07 CDM)
MOD    5301357    BACLOFEN 10MG        J8499               3,492       254,916.00       73.00         254,916.00            73.00           73.00
MOD    5301430    BENAZEPRIL 5MG       J8499                 400        18,400.00       46.00          18,400.00            46.00           46.00
MOD    5301431    BENAZEPRIL 10MG       J8499              6,526       482,924.00       74.00         482,924.00            74.00           74.00
MOD    5301476    BENZOCAINE LOZEN        A9150               16           368.00       23.00             368.00            23.00           23.00
MOD    5301499    BENZONATATE 100MG        J8499             655        13,755.00       21.00          13,755.00            21.00           21.00
MOD    5301520    BENZTROPINE .5MG       J8499               207         3,519.00       17.00           3,519.00            17.00           17.00
MOD    5301522    BENZTROPINE 1MG        J8499               539         9,163.00       17.00           9,163.00            17.00           17.00
MOD    5301572    BETHANECHOL 5MG         J8499                1            35.50       35.50              35.50            35.50           35.50
MOD    5301576    BETHANECHOL 10MG         J8499              84         2,184.00       26.00           2,184.00            26.00           26.00
MOD    5301580    BETHANECHOL 25MG         J8499             790        23,700.00       30.00          23,700.00            30.00           30.00
MOD    5301586    BETAXOLOL 10MG        J8499                  2            92.00       46.00              92.00            46.00           46.00
MOD    5301590    BICALUTAMIDE 50MG       J8499              130         8,190.00       63.00           8,190.00            63.00           63.00
MOD    5301607    BISOPROLOL/HCTZ 2.5/6.25 J8499               7           441.00       63.00             441.00            63.00           63.00
MOD    5301608    BISOPROLOL/HCTZ 5/6.25 J8499                26         1,638.00       63.00           1,638.00            63.00           63.00
MOD    5301609    BISOPROLOL/HCTZ 10/6.25 J8499                3           189.00       63.00             189.00            63.00           63.00
MOD    5301616    BISMUTH SUBSALICYL TAB A9150                49           539.00       11.00             539.00            11.00           11.00
MOD    5301680    BROMOCRIPTINE 2.5MG       J8499             41         1,640.00       40.00           1,640.00            40.00           40.00
MOD    5301738    BUMETANIDE .5MG       J8499                 49           931.00       19.00             931.00            19.00           19.00
MOD    5301742    BUMETANIDE 1MG        J8499              2,004       150,300.00       75.00         150,300.00            75.00           75.00
MOD    5301745    BUPROPION 75MG        J8499                835        33,400.00       40.00          33,400.00            40.00           40.00
MOD    5301746    BUPROPION 100MG        J8499               877        49,112.00       56.00          49,112.00            56.00           56.00
MOD    5301749    BUPROPION SR 150MG       J8499           1,814       136,050.00       75.00         136,050.00            75.00           75.00
MOD    5301760    BUSPIRONE 5MG        J8499                 866        63,218.00       73.00          63,218.00            73.00           73.00
MOD    5301761    BUSPIRONE 10MG        J8499              1,848       136,752.00       74.00         136,752.00            74.00           74.00
MOD    5301791    CALCITRIOL .25MCG     J8499              1,015        40,600.00       40.00          40,600.00            40.00           40.00
MOD    5301794    CAFFEINE 200MG      A9150                   88            74.80        0.85              74.80             0.85            0.85
MOD    5301810    CALCIUM ACETATE 667MG A9150              4,022       293,606.00       73.00         293,606.00            73.00           73.00
MOD    5301815    CALCIUM CARBONATE 500MG A9150            2,309       168,557.00       73.00         168,557.00            73.00           73.00
MOD    5301819    CALCIUM CARBONATE CHEW A9150                21           231.00       11.00             231.00            11.00           11.00
MOD    5301824    CALCIUM CARBONATE 650MG A9150            3,341        43,433.00       13.00          43,433.00            13.00           13.00
MOD    5301831    CALCIUM CITRATE 950MG A9150                373         6,341.00       17.00           6,341.00            17.00           17.00
MOD    5301833    CALCIUM 250MG/VIT D    A9150               214         3,638.00       17.00           3,638.00            17.00           17.00
MOD    5301834    CALCIUM 500MG/VIT D    A9150             1,357        23,069.00       17.00          23,069.00            17.00           17.00
MOD    5301842    CALCIUM GLUCONATE 500MG A9150              304         2,432.00        8.00           2,432.00             8.00            8.00
MOD    5301873    CALCIUM LACTATE 650MG A9150                 48           705.60       14.70             705.60            14.70           14.70
MOD    5301901    POLYCARBOPHIL 625MG       A9150             22           352.00       16.00             352.00            16.00           16.00
MOD    5301922    CAPTOPRIL 12.5MG      J8499              1,016        74,168.00       73.00          74,168.00            73.00           73.00
MOD    5301923    CAPTOPRIL 25MG       J8499               1,265        92,345.00       73.00          92,345.00            73.00           73.00
MOD    5301975    CARBAMAZEPINE 100MG        J8499           101         2,121.00       21.00           2,121.00            21.00           21.00
MOD    5301976    CARBAMAZEPINE EREL 100MG J8499             121         3,146.00       26.00           3,146.00            26.00           26.00
                                                         2007        2007 Total       2007 Avg.
Hospital Charge                                       Utilization     Charge         Charge per 2006 Unit Price x   2006 Unit Price 2007 Unit Price
 Code Number                  Charge Desc            (ShowCase)     (ShowCase)          Unit    2007 Utilization     (6-1-06 CDM)    (6-1-07 CDM)
MOD    5301981    CARBAMAZEPINE 200MG       J8499          1,363         99,499.00       73.00          99,499.00           73.00            73.00
MOD    5302027    CARBIDOPA/LEVOD 10/100 J8499               178          3,738.00       21.00           3,738.00           21.00            21.00
MOD    5302031    CARBIDOPA/LEVOD 25/100 J8499             1,679        124,246.00       74.00         124,246.00           74.00            74.00
MOD    5302035    CARBIDOPA/LEVOD 25/250 J8499               269          8,070.00       30.00           8,070.00           30.00            30.00
MOD    5302036    CARBIDOPA/LEVOD 50/200 J8499               230         14,490.00       63.00          14,490.00           63.00            63.00
MOD    5302058    CARISOPRODOL 350MG        J8499            888         66,600.00       75.00          66,600.00           75.00            75.00
MOD    5302078    CARVEDILOL 6.25MG      J8499            11,134        823,916.00       74.00         823,916.00           74.00            74.00
MOD    5302080    CARVEDILOL 25MG       J8499              1,725        127,650.00       74.00         127,650.00           74.00            74.00
MOD    5302121    CEFUROXIME AXETIL 250MG J8499               83         30,544.00      368.00          30,544.00          368.00           368.00
MOD    5302123    CEFPODOXIME 100MG        J8499             852         27,860.40       32.70          27,860.40           32.70            32.70
MOD    5302129    CELECOXIB 100MG      J8499               1,232         92,400.00       75.00          92,400.00           75.00            75.00
MOD    5302158    CETYLPYRDN/BENZOC TR 18S A9150             121          1,331.00       11.00           1,331.00           11.00            11.00
MOD    5302204    CEPHALEXIN 250MG       J8499               155          5,580.00       36.00           5,580.00           36.00            36.00
MOD    5302208    CEPHALEXIN 500MG       J8499             2,205        160,965.00       73.00         160,965.00           73.00            73.00
MOD    5302246    CETIRIZINE 10MG     J8499                    8            504.00       63.00             504.00           63.00            63.00
MOD    5302331    CHLORAMBUCIL 2MG        J8499               12            204.00       17.00             204.00           17.00            17.00
MOD    5302385    CHLORDIAZEPOXIDE 5MG J8499                  19            323.00       17.00             323.00           17.00            17.00
MOD    5302389    CHLORDIAZEPOXIDE 10MG J8499                114          2,394.00       21.00           2,394.00           21.00            21.00
MOD    5302393    CHLORDIAZEPOXIDE 25MG J8499              1,549        337,682.00      218.00         337,682.00          218.00           218.00
MOD    5302416    CHLOROTHIAZIDE 250MG J8499                  17            603.50       35.50             603.50           35.50            35.50
MOD    5302420    CHLOROTHIAZIDE 500MG J8499                   9            153.00       17.00             153.00           17.00            17.00
MOD    5302565    CHLORPHENIRAMINE 4MG A9150                  90            720.00        8.00             720.00            8.00             8.00
MOD    5302590    CHLORPROMAZINE 10MG        J8499           146          2,482.00       17.00           2,482.00           17.00            17.00
MOD    5302594    CHLORPROMAZINE 25MG J8499                  148          2,516.00       17.00           2,516.00           17.00            17.00
MOD    5302598    CHLORPROMAZINE 50MG J8499                   38            646.00       17.00             646.00           17.00            17.00
MOD    5302641    CHLORPROPAMIDE 250MG J8499                   4            104.00       26.00             104.00           26.00            26.00
MOD    5302664    CHLORTHALIDONE 25MG J8499                   11            286.00       26.00             286.00           26.00            26.00
MOD    5302718    CHOLINE-MG        J8499                     68          1,428.00       21.00           1,428.00           21.00            21.00
MOD    5302730    CILOSTAZOL 50MG      J8499                 182         13,559.00       74.50          13,559.00           74.50            74.50
MOD    5302745    CIMETIDINE 300MG     J8499                 295          7,670.00       26.00           7,670.00           26.00            26.00
MOD    5302747    CIMETIDINE 400MG     J8499                 151          7,701.00       51.00           7,701.00           51.00            51.00
MOD    5302762    CINACALCET 30MG       J8499                502         41,841.70       83.35          41,841.70           83.35            83.35
MOD    5302773    CITALOPRAM 20MG       J8499                969         72,675.00       75.00          72,675.00           75.00            75.00
MOD    5302775    CIPROFLOXACIN 250MG      J8499             165          9,240.00       56.00           9,240.00           56.00            56.00
MOD    5302776    CIPROFLOXACIN 500MG      J8499             488         38,064.00       78.00          38,064.00           78.00            78.00
MOD    5302777    CIPROFLOXACIN 750MG      J8499              39          2,457.00       63.00           2,457.00           63.00            63.00
MOD    5302781    CLARITHROMYCIN 500MG J8499                 137          8,083.00       59.00           8,083.00           59.00            59.00
MOD    5302814    CLINDAMYCIN 150MG       J8499            1,531        114,825.00       75.00         114,825.00           75.00            75.00
MOD    5302894    CLOTRIMAZOLE TROCHE        J8499           881         65,194.00       74.00          65,194.00           74.00            74.00
MOD    5302910    CLONAZEPAM .5MG        J8499             4,818      1,055,142.00      219.00       1,055,142.00          219.00           219.00
                                                        2007        2007 Total       2007 Avg.
Hospital Charge                                      Utilization     Charge         Charge per 2006 Unit Price x   2006 Unit Price 2007 Unit Price
 Code Number                  Charge Desc           (ShowCase)     (ShowCase)          Unit    2007 Utilization     (6-1-06 CDM)    (6-1-07 CDM)
MOD    5302941    CLONIDINE .1MG     J8499                9,264        676,272.00       73.00         676,272.00           73.00            73.00
MOD    5302965    CLOPIDOGREL 75MG       J8499            7,739        595,903.00       77.00         595,903.00           77.00            77.00
MOD    5302980    CLORAZEPATE CAP 7.5MG J8499                 1             26.00       26.00              26.00           26.00            26.00
MOD    5303042    COLCHICINE TAB .6MG J8499                 360          6,120.00       17.00           6,120.00           17.00            17.00
MOD    5303044    COLESTIPOL 1G      J8499                   55          1,430.00       26.00           1,430.00           26.00            26.00
MOD    5303065    CONJUGATED ESTR .3MG J8499                 76          1,292.00       17.00           1,292.00           17.00            17.00
MOD    5303069    CONJUGATED ESTR .625MG J8499              399          6,783.00       17.00           6,783.00           17.00            17.00
MOD    5303070    CONJUGATED ESTR .9MG J8499                 50          1,800.00       36.00           1,800.00           36.00            36.00
MOD    5303073    CONJUGATED ESTR 1.25MG J8499              193          4,053.00       21.00           4,053.00           21.00            21.00
MOD    5303131    SULFAMETHOX/TRIM DS TAB J8499           2,115        156,510.00       74.00         156,510.00           74.00            74.00
MOD    5303254    CYCLOBENZAPRINE 10MG J8499                804         24,120.00       30.00          24,120.00           30.00            30.00
MOD    5303277    CYCLOPHOSPHAMIDE 25MG J8530                82          2,132.00       26.00           2,132.00           26.00            26.00
MOD    5303289    CYCLOSPORIN 25MG SOFTGEL J7515            151          9,513.00       63.00           9,513.00           63.00            63.00
MOD    5303292    CYCLOSPORIN 100MG CAP J7502               210         16,275.00       77.50          16,275.00           77.50            77.50
MOD    5303373    DANAZOL 200MG       J8499                  28          1,764.00       63.00           1,764.00           63.00            63.00
MOD    5303419    DANTROLENE 25MG       J8499                43            903.00       21.00             903.00           21.00            21.00
MOD    5303442    DAPSONE 25MG        J8499                 377          4,147.00       11.00           4,147.00           11.00            11.00
MOD    5303519    DEMECLOCY TAB 150MG      J8499            167          7,682.00       46.00           7,682.00           46.00            46.00
MOD    5303569    DESIPRAMINE 25MG      J8499                25            525.00       21.00             525.00           21.00            21.00
MOD    5303596    DEXAMETHASONE .5MG       J8499             14            238.00       17.00             238.00           17.00            17.00
MOD    5303600    DEXAMETHASONE .75MG       J8499            12            426.00       35.50             426.00           35.50            35.50
MOD    5303603    DEXAMETHASONE 2MG        J8499            249          6,474.00       26.00           6,474.00           26.00            26.00
MOD    5303604    DEXAMETHASONE 4MG        J8499          1,854        139,050.00       75.00         139,050.00           75.00            75.00
MOD    5303610    DEXAMETHASONE 1MG        J8499             85          1,785.00       21.00           1,785.00           21.00            21.00
MOD    5303708    DIAZEPAM 2MG       J8499                  508         10,668.00       21.00          10,668.00           21.00            21.00
MOD    5303712    DIAZEPAM 5MG       J8499                5,424      1,182,432.00      218.00       1,182,432.00          218.00           218.00
MOD    5303745    DICLOFENAC 25MG      J8499                 13            390.00       30.00             390.00           30.00            30.00
MOD    5303746    DICLOFENAC 50MG      J8499                 15            690.00       46.00             690.00           46.00            46.00
MOD    5303747    DICLOFENAC 75MG      J8499                 77          4,851.00       63.00           4,851.00           63.00            63.00
MOD    5303766    DICLOXACIL 250MG     J8499                119          5,474.00       46.00           5,474.00           46.00            46.00
MOD    5303820    DICYCLOMINE 10MG      J8499               190          3,230.00       17.00           3,230.00           17.00            17.00
MOD    5303824    DICYCLOMINE 20MG      J8499               389          8,169.00       21.00           8,169.00           21.00            21.00
MOD    5303900    DIGESTIVE ENZYME CAP J8499                794          5,558.00        7.00           5,558.00            7.00             7.00
MOD    5303902    DIGESTIVE ENZYME TAB J8499                373          2,611.00        7.00           2,611.00            7.00             7.00
MOD    5303944    DIGOXIN .125MG     J8499                3,034        221,482.00       73.00         221,482.00           73.00            73.00
MOD    5303952    DIGOXIN .25MG     J8499                 1,887        137,751.00       73.00         137,751.00           73.00            73.00
MOD    5304033    DILTIAZEM 30MG     J8499                1,345         98,185.00       73.00          98,185.00           73.00            73.00
MOD    5304037    DILTIAZEM 60MG     J8499                1,269         92,637.00       73.00          92,637.00           73.00            73.00
MOD    5304038    DILTIAZEM 90MG     J8499                  287         12,628.00       44.00          12,628.00           44.00            44.00
MOD    5304040    DILTIAZEM SR 90MG    J8499                 52          2,392.00       46.00           2,392.00           46.00            46.00
                                                         2007        2007 Total      2007 Avg.
Hospital Charge                                       Utilization     Charge        Charge per 2006 Unit Price x   2006 Unit Price 2007 Unit Price
 Code Number                  Charge Desc            (ShowCase)     (ShowCase)         Unit    2007 Utilization     (6-1-06 CDM)    (6-1-07 CDM)
MOD    5304042    DILTIAZEM SR 60MG      J8499                30         1,380.00       46.00           1,380.00           46.00            46.00
MOD    5304043    DILTIAZEM CD 120MG      J8499            1,265        93,610.00       74.00          93,610.00           74.00            74.00
MOD    5304044    DILTIAZEM CD 180 MG     J8499              864        63,936.00       74.00          63,936.00           74.00            74.00
MOD    5304045    DILTIAZEM CD 240 MG     J8499              691        51,825.00       75.00          51,825.00           75.00            75.00
MOD    5304046    DILTIAZEM CD 300 MG     J8499               87         5,481.00       63.00           5,481.00           63.00            63.00
MOD    5304087    DIPHENHYDRA 25MG         A9150           5,642       411,866.00       73.00         411,866.00           73.00            73.00
MOD    5304091    DIPHENHYDRAMINE 50MG J8499               1,142        19,414.00       17.00          19,414.00           17.00            17.00
MOD    5304098    DIPHENOXYLATE/ATRP TAB J8499               688        11,696.00       17.00          11,696.00           17.00            17.00
MOD    5304118    DIPYRIDAMOLE 50MG        J8499              37           962.00       26.00             962.00           26.00            26.00
MOD    5304122    DIPYRIDAMOLE 75MG        J8499              14           364.00       26.00             364.00           26.00            26.00
MOD    5304123    DIPYRIDAMOLE/ASA SR CAP J8499              643        37,937.00       59.00          37,937.00           59.00            59.00
MOD    5304149    DISOPYRAMIDE 150MG        J8499             33           858.00       26.00             858.00           26.00            26.00
MOD    5304157    DISOPYRAMIDE CR 150MG J8499                 47         1,222.00       26.00           1,222.00           26.00            26.00
MOD    5304190    DIVALPROEX NA 125MG       J8499             56         1,736.00       31.00           1,736.00           31.00            31.00
MOD    5304191    DIVALPROEX NA 250MG       J8499          3,266       241,684.00       74.00         241,684.00           74.00            74.00
MOD    5304195    DIVALPROEX NA 500MG ER J8499               429        27,027.00       63.00          27,027.00           63.00            63.00
MOD    5304204    DOCUSATE NA/SENNOSIDES A9150             9,936         9,936.00        1.00           9,936.00            1.00             1.00
MOD    5304219    DOCUSATE SOD 100MG         A9150        61,551        61,551.00        1.00          61,551.00            1.00             1.00
MOD    5304223    DOCUSATE SOD 250MG         A9150         4,107         4,107.00        1.00           4,107.00            1.00             1.00
MOD    5304250    DONEPEZIL 5MG        J8499               1,736       135,408.00       78.00         135,408.00           78.00            78.00
MOD    5304269    DONNATAL          J8499                     90           990.00       11.00             990.00           11.00            11.00
MOD    5304335    DOXAZOSIN 1MG         J8499                486        24,786.00       51.00          24,786.00           51.00            51.00
MOD    5304337    DOXAZOSIN 4MG         J8499                385        23,870.00       62.00          23,870.00           62.00            62.00
MOD    5304342    DOXEPIN 10MG        J8499                   41           861.00       21.00             861.00           21.00            21.00
MOD    5304365    DOXEPIN 25MG        J8499                  135         2,835.00       21.00           2,835.00           21.00            21.00
MOD    5304371    DOXEPIN 100MG        J8499                  69         1,794.00       26.00           1,794.00           26.00            26.00
MOD    5304380    DOXERCALCIFEROL 2.5MCG J8499               101         7,827.50       77.50           7,827.50           77.50            77.50
MOD    5304392    DOXYCYCLINE 100MG        J8499             497        43,239.00       87.00          43,239.00           87.00            87.00
MOD    5304415    DUTASTERIDE .5MG CAP J8499                 319        24,212.10       75.90          24,212.10           75.90            75.90
MOD    5304429    EFAVIRENZ 100MG        J8499                 9           895.50       99.50             895.50           99.50            99.50
MOD    5304431    EFAVIRENZ 200MG        J8499               393        25,152.00       64.00          25,152.00           64.00            64.00
MOD    5304437    ENALAPRIL 5MG       J8499                2,942       217,708.00       74.00         217,708.00           74.00            74.00
MOD    5304439    ENALAPRIL 10MG       J8499               4,984       368,816.00       74.00         368,816.00           74.00            74.00
MOD    5304469    ERGOCALCIFEROL 50000U J8499                 35           385.00       11.00             385.00           11.00            11.00
MOD    5304601    ERLOTINIB 100MG      J8999                  17         2,913.80      171.40           2,913.80          171.40           171.40
MOD    5304639    ERYTHROMY ET 400MG         J8499            24         1,066.80       44.45           1,066.80           44.45            44.45
MOD    5304647    ERYTHROMYCIN BASE 250MG J8499              472         8,024.00       17.00           8,024.00           17.00            17.00
MOD    5304649    ERYTHROMYCIN BASE 333MG J8499                9           225.00       25.00             225.00           25.00            25.00
MOD    5304665    ESCITALOPRAM 10MG         J8499          3,206        52,738.70       16.45          52,738.70           16.45            16.45
MOD    5304674    ESTRADIOL 1MG        J8499                 279         4,743.00       17.00           4,743.00           17.00            17.00
                                                       2007        2007 Total       2007 Avg.
Hospital Charge                                     Utilization     Charge         Charge per 2006 Unit Price x   2006 Unit Price 2007 Unit Price
 Code Number                 Charge Desc           (ShowCase)     (ShowCase)          Unit    2007 Utilization     (6-1-06 CDM)    (6-1-07 CDM)
MOD    5304711    ESTROG1.25/METHYLTST 2.5 J8499            28          1,568.00       56.00           1,568.00           56.00            56.00
MOD    5304730    ESTROPIPATE 0.625MG      J8499             5            125.00       25.00             125.00           25.00            25.00
MOD    5304731    ESTROPIPATE 1.25MG      J8499             25            750.00       30.00             750.00           30.00            30.00
MOD    5304770    ETHAMBUTOL 100MG        J8499             26            546.00       21.00             546.00           21.00            21.00
MOD    5304774    ETHAMBUTOL 400MG        J8499            712         21,360.00       30.00          21,360.00           30.00            30.00
MOD    5304875    EZETIMIBE 10MG     J8499               1,817         30,616.45       16.85          30,616.45           16.85            16.85
MOD    5304883    ETODOLAC 200MG        J8499               88          4,928.00       56.00           4,928.00           56.00            56.00
MOD    5304884    ETODOLAC 300MG        J8499               22          2,313.30      105.15           2,313.30          105.15           105.15
MOD    5304893    ETIDRONATE 200MG       J8499              13          1,366.95      105.15           1,366.95          105.15           105.15
MOD    5304900    FAMOTIDINE 20MG      J8499            14,408      1,051,784.00       73.00       1,051,784.00           73.00            73.00
MOD    5304920    FELODIPINE 5MG      J8499                487         12,662.00       26.00          12,662.00           26.00            26.00
MOD    5304933    FENOFIBRATE MIC 48MG J8499               145         10,730.00       74.00          10,730.00           74.00            74.00
MOD    5304938    FENOFIBRATE MIC 145MG J8499              431         32,756.00       76.00          32,756.00           76.00            76.00
MOD    5305017    FERROUS GLUCONATE 300MG A9150            206          2,266.00       11.00           2,266.00           11.00            11.00
MOD    5305042    FERROUS SULF 160MG       A9150            16            336.00       21.00             336.00           21.00            21.00
MOD    5305044    FERROUS SULF 300-325MG A9150          16,417         16,417.00        1.00          16,417.00            1.00             1.00
MOD    5305048    FERROUS SULF (50MG FE) A9150             240          3,120.00       13.00           3,120.00           13.00            13.00
MOD    5305059    FEXOFENADINE 180MG       J8499             7             70.00       10.00              70.00           10.00            10.00
MOD    5305066    FINASTERIDE 5MG      J8499               356         22,428.00       63.00          22,428.00           63.00            63.00
MOD    5305079    FLAVOXATE 100MG       J8499              194          4,074.00       21.00           4,074.00           21.00            21.00
MOD    5305085    FLECAINIDE 100MG     J8499                77          3,080.00       40.00           3,080.00           40.00            40.00
MOD    5305096    FLUCONAZOLE 100MG        J8499         1,152         93,312.00       81.00          93,312.00           81.00            81.00
MOD    5305097    FLUCONAZOLE 200MG        J8499           992         85,312.00       86.00          85,312.00           86.00            86.00
MOD    5305106    FLUCYTOSINE 500MG       J8499            584         23,360.00       40.00          23,360.00           40.00            40.00
MOD    5305129    FLUDROCORTISONE .1MG J8499               349          7,329.00       21.00           7,329.00           21.00            21.00
MOD    5305159    FLUOXETINE 10MG      J8499               427         32,025.00       75.00          32,025.00           75.00            75.00
MOD    5305160    FLUOXETINE 20MG      J8499             1,903        142,725.00       75.00         142,725.00           75.00            75.00
MOD    5305204    FLUPHENAZINE 2.5MG      J8499            152          4,560.00       30.00           4,560.00           30.00            30.00
MOD    5305206    FLUPHENAZINE 1MG       J8499               1             44.45       44.45              44.45           44.45            44.45
MOD    5305221    FLURAZEPAM 15MG        J8499             128          2,688.00       21.00           2,688.00           21.00            21.00
MOD    5305228    FLUTAMIDE 125MG      J8499                41          2,583.00       63.00           2,583.00           63.00            63.00
MOD    5305230    FLUVASTATIN 20MG      J8499              247         15,561.00       63.00          15,561.00           63.00            63.00
MOD    5305233    FOLIC ACID 1MG     J8499               4,788        349,524.00       73.00         349,524.00           73.00            73.00
MOD    5305236    FLUVOXAMINE 100MG       J8499             18          1,134.00       63.00           1,134.00           63.00            63.00
MOD    5305240    FOSINOPRIL 10MG      J8499               407         20,757.00       51.00          20,757.00           51.00            51.00
MOD    5305279    FUROSEMIDE 20MG        J8499           4,862        354,926.00       73.00         354,926.00           73.00            73.00
MOD    5305283    FUROSEMIDE 40MG        J8499           9,901        722,773.00       73.00         722,773.00           73.00            73.00
MOD    5305287    FUROSEMIDE 80MG        J8499           1,904        138,992.00       73.00         138,992.00           73.00            73.00
MOD    5305290    GABAPENTIN 100MG       J8499           1,715        125,195.00       73.00         125,195.00           73.00            73.00
MOD    5305291    GABAPENTIN 300MG       J8499          10,718        793,132.00       74.00         793,132.00           74.00            74.00
                                                          2007        2007 Total      2007 Avg.
Hospital Charge                                        Utilization     Charge        Charge per 2006 Unit Price x   2006 Unit Price 2007 Unit Price
 Code Number                  Charge Desc             (ShowCase)     (ShowCase)         Unit    2007 Utilization     (6-1-06 CDM)    (6-1-07 CDM)
MOD    5305292    GABAPENTIN 400MG       J8499              2,900       214,600.00       74.00         214,600.00           74.00            74.00
MOD    5305299    GALANTAMINE 4MG        J8499                153        11,597.40       75.80          11,597.40           75.80            75.80
MOD    5305311    GEMFIBROZIL 600MG      J8499              1,304        96,496.00       74.00          96,496.00           74.00            74.00
MOD    5305321    GLIMEPIRIDE 2MG      J8499                2,348       171,404.00       73.00         171,404.00           73.00            73.00
MOD    5305345    GLIPIZIDE 5MG     J8499                   3,626       264,698.00       73.00         264,698.00           73.00            73.00
MOD    5305346    GLIPIZIDE XL 5MG    J8499                   110         3,300.00       30.00           3,300.00           30.00            30.00
MOD    5305411    GLYBURIDE TAB 2.5MG      J8499              612        12,852.00       21.00          12,852.00           21.00            21.00
MOD    5305413    GLYBURIDE TAB 5MG       J8499             2,777       202,721.00       73.00         202,721.00           73.00            73.00
MOD    5305440    GRANISETRON 1MG TAB        J8499             14         1,680.00      120.00           1,680.00          120.00           120.00
MOD    5305481    GUAIFENESIN 600MG      J8499              2,608       190,384.00       73.00         190,384.00           73.00            73.00
MOD    5305540    GUANFACINE 1MG        J8499                  10           300.00       30.00             300.00           30.00            30.00
MOD    5305610    HALOPERIDOL .5MG       J8499                177         3,717.00       21.00           3,717.00           21.00            21.00
MOD    5305614    HALOPERIDOL 1MG        J8499              1,636       119,428.00       73.00         119,428.00           73.00            73.00
MOD    5305622    HALOPERIDOL 5MG        J8499                456        13,680.00       30.00          13,680.00           30.00            30.00
MOD    5305672    HYDRALAZINE 10MG       J8499              1,361        23,137.00       17.00          23,137.00           17.00            17.00
MOD    5305676    HYDRALAZINE 25 MG      J8499              1,122        23,562.00       21.00          23,562.00           21.00            21.00
MOD    5305680    HYDRALAZINE 50MG       J8499              1,792        37,632.00       21.00          37,632.00           21.00            21.00
MOD    5305715    HYDROCHLOROTHIA 25MG J8499                3,642       265,866.00       73.00         265,866.00           73.00            73.00
MOD    5305719    HYDROCHLOROTHIA 50MG J8499                  163         2,771.00       17.00           2,771.00           17.00            17.00
MOD    5305742    HYDROCORTISONE 10MG         J8499           569         6,259.00       11.00           6,259.00           11.00            11.00
MOD    5305745    HYDROCORTISONE 20MG         J8499           233         3,961.00       17.00           3,961.00           17.00            17.00
MOD    5305788    HYDROXYCHLOROQUINE200MG J8499               274         5,754.00       21.00           5,754.00           21.00            21.00
MOD    5305811    HYDROXYUREA 500MG         J8499              70         2,520.00       36.00           2,520.00           36.00            36.00
MOD    5305830    HYDROXYZINE 10MG        J8499               255         3,315.00       13.00           3,315.00           13.00            13.00
MOD    5305834    HYDROXYZINE PAMOATE 25MG J8499              806        58,838.00       73.00          58,838.00           73.00            73.00
MOD    5305838    HYDROXYZINE PAMOATE 50MG J8499              302         7,852.00       26.00           7,852.00           26.00            26.00
MOD    5305865    HYOSCYAMINE .125MG       J8499              184         3,864.00       21.00           3,864.00           21.00            21.00
MOD    5305893    HYOSCYAMINE LA .375MG J8499                  11           231.00       21.00             231.00           21.00            21.00
MOD    5305909    IBUPROFEN TAB 200MG       A9150             223           223.00        1.00             223.00            1.00             1.00
MOD    5305915    IBUPROFEN 400MG       J8499               9,841        19,682.00        2.00          19,682.00            2.00             2.00
MOD    5305919    IBUPROFEN 600MG       J8499              11,984        35,952.00        3.00          35,952.00            3.00             3.00
MOD    5305930    IMATINIB 100MG     J8499                    275        43,835.00      159.40          43,835.00          159.40           159.40
MOD    5305942    IMIPRAMINE PM 75MG      J8499                 7           252.00       36.00             252.00           36.00            36.00
MOD    5305949    IMIPRAMINE 10MG      J8499                   30           510.00       17.00             510.00           17.00            17.00
MOD    5305950    IMIPRAMINE 25MG      J8499                  131         2,751.00       21.00           2,751.00           21.00            21.00
MOD    5305954    IMIPRAMINE 50MG      J8499                   76         1,976.00       26.00           1,976.00           26.00            26.00
MOD    5305977    INDAPAMIDE 2.5MG      J8499                  33           990.00       30.00             990.00           30.00            30.00
MOD    5305989    INDINAVIR 200MG     J8499                     7           736.05      105.15             736.05          105.15           105.15
MOD    5306000    INDOMETHACIN 25MG        J8499              605        15,730.00       26.00          15,730.00           26.00            26.00
MOD    5306008    INDOMETHACIN SR 75MG J8499                    9           414.00       46.00             414.00           46.00            46.00
                                                         2007        2007 Total      2007 Avg.
Hospital Charge                                       Utilization     Charge        Charge per 2006 Unit Price x   2006 Unit Price 2007 Unit Price
 Code Number                  Charge Desc            (ShowCase)     (ShowCase)         Unit    2007 Utilization     (6-1-06 CDM)    (6-1-07 CDM)
MOD    5306051    IRBESARTAN 150 MG       J8499              658        48,692.00       74.00          48,692.00           74.00            74.00
MOD    5306055    IRON POLYSACC/B12/FA CAP J8499              22           462.00       21.00             462.00           21.00            21.00
MOD    5306075    IRON-VIT12 INTRINSIC FAC J8499             743        22,290.00       30.00          22,290.00           30.00            30.00
MOD    5306097    ISONIAZID 100MG      J8499                  28           308.00       11.00             308.00           11.00            11.00
MOD    5306100    ISONIAZID 300MG      J8499                 206         2,266.00       11.00           2,266.00           11.00            11.00
MOD    5306173    ISOSORBIDE 5MG        J8499              1,294        21,998.00       17.00          21,998.00           17.00            17.00
MOD    5306177    ISOSORBIDE 10MG        J8499             2,780       202,940.00       73.00         202,940.00           73.00            73.00
MOD    5306181    ISOSORBIDE 20MG        J8499             1,521       111,033.00       73.00         111,033.00           73.00            73.00
MOD    5306182    ISOSORBIDE MONO 20MG J8499                  59         3,009.00       51.00           3,009.00           51.00            51.00
MOD    5306184    ISOSORBIDE MONONITR 30MG J8499             667        49,358.00       74.00          49,358.00           74.00            74.00
MOD    5306186    ISOSORBID MONONI ER 60MG J8499             408        26,112.00       64.00          26,112.00           64.00            64.00
MOD    5306254    ISRADIPINE CR 5MG      J8499                69         5,168.10       74.90           5,168.10           74.90            74.90
MOD    5306257    ITRACONAZOLE 100MG        J8499             36         3,600.00      100.00           3,600.00          100.00           100.00
MOD    5306261    IVERMECTIN 3MG        J8499                  7           788.20      112.60             788.20          112.60           112.60
MOD    5306293    KETOCONAZOLE 200MG         J8499           102         6,426.00       63.00           6,426.00           63.00            63.00
MOD    5306300    KETOROLAC 10MG         J8499               501        37,074.00       74.00          37,074.00           74.00            74.00
MOD    5306316    L-LYSINE 500MG       A9150                  58           638.00       11.00             638.00           11.00            11.00
MOD    5306320    LABETALOL 100MG TAB      J8499             656        17,056.00       26.00          17,056.00           26.00            26.00
MOD    5306321    LABETALOL 200MG TAB      J8499           1,154        30,004.00       26.00          30,004.00           26.00            26.00
MOD    5306335    LACTASE 3000 IU TAB    A9150                40         1,420.00       35.50           1,420.00           35.50            35.50
MOD    5306343    LACTOBACILLUS TABS       J8499             429         9,502.35       22.15           9,502.35           22.15            22.15
MOD    5306345    LAMIVUDINE 150MG       J8499               263        16,569.00       63.00          16,569.00           63.00            63.00
MOD    5306347    LAMOTRIGINE 100MG       J8499              238        14,042.00       59.00          14,042.00           59.00            59.00
MOD    5306349    LAMOTRIGINE 200MG       J8499              100         5,900.00       59.00           5,900.00           59.00            59.00
MOD    5306351    LANSOPRAZOLE 15MG         J8499             46         2,898.00       63.00           2,898.00           63.00            63.00
MOD    5306352    LANSOPRAZOLE 30MG         J8499            197        15,366.00       78.00          15,366.00           78.00            78.00
MOD    5306354    LANSOPRAZOLE 15MG SOLU-T J8499              54         4,114.80       76.20           4,114.80           76.20            76.20
MOD    5306355    LANSOPRAZOLE 30MG SOLU-T J8499           2,859       217,855.80       76.20         217,855.80           76.20            76.20
MOD    5306361    LANTHANUMB CARB 500MG J8499                217        16,296.70       75.10          16,296.70           75.10            75.10
MOD    5306389    LEUCOVORIN CA 5MG        J8999              10         1,570.00      157.00           1,570.00          157.00           157.00
MOD    5306406    LEVETIRACETAM 500MG        J8499           755        12,306.50       16.30          12,306.50           16.30            16.30
MOD    5306428    LEVOFLOXACIN 750MG       J8499             743        69,470.50       93.50          69,470.50           93.50            93.50
MOD    5306430    LEVOFLOXACIN 250MG       J8499           1,305       107,010.00       82.00         107,010.00           82.00            82.00
MOD    5306431    LEVOFLOXACIN 500MG       J8499           3,866       320,878.00       83.00         320,878.00           83.00            83.00
MOD    5306432    LEVONORGESTREL .75MG J8499                  97         8,924.00       92.00           8,924.00           92.00            92.00
MOD    5306435    LEVOTHYROXIN .088MG       J8499            301         4,214.00       14.00           4,214.00           14.00            14.00
MOD    5306447    LEVOTHYROXIN .025MG       J8499          1,312        18,368.00       14.00          18,368.00           14.00            14.00
MOD    5306451    LEVOTHYROXIN .05MG       J8499           1,643        23,002.00       14.00          23,002.00           14.00            14.00
MOD    5306454    LEVOTHYROXIN .075MG       J8499          1,481        20,734.00       14.00          20,734.00           14.00            14.00
MOD    5306455    LEVOTHYROXIN .15MG       J8499             816        14,688.00       18.00          14,688.00           18.00            18.00
                                                          2007        2007 Total       2007 Avg.
Hospital Charge                                        Utilization     Charge         Charge per 2006 Unit Price x   2006 Unit Price 2007 Unit Price
 Code Number                   Charge Desc            (ShowCase)     (ShowCase)          Unit    2007 Utilization     (6-1-06 CDM)    (6-1-07 CDM)
MOD    5306456    LEVOTHYROXIN .112MG       J8499             357          4,998.00       14.00           4,998.00           14.00            14.00
MOD    5306457    LEVOTHYROXIN .137MG       J8499              82          6,002.40       73.20           6,002.40           73.20            73.20
MOD    5306458    LEVOTHYROXIN .125MG       J8499             944         16,992.00       18.00          16,992.00           18.00            18.00
MOD    5306459    LEVOTHYROXIN .1MG       J8499             1,816        170,704.00       94.00         170,704.00           94.00            94.00
MOD    5306463    LEVOTHYROXIN .2MG       J8499               461          8,298.00       18.00           8,298.00           18.00            18.00
MOD    5306501    LINEZOLID 600MG TABLET J8499              1,421        191,835.00      135.00         191,835.00          135.00           135.00
MOD    5306513    LIOTHYRONINE 5MCG       J8499                 1             21.00       21.00              21.00           21.00            21.00
MOD    5306517    LIOTHYRONINE 25MCG       J8499               73            803.00       11.00             803.00           11.00            11.00
MOD    5306635    LISINOPRIL 5 MG    J8499                  2,790        206,460.00       74.00         206,460.00           74.00            74.00
MOD    5306636    LISINOPRIL 10MG     J8499                13,084        968,216.00       74.00         968,216.00           74.00            74.00
MOD    5306674    LITHIUM CARBONATE 150MG J8499                33            528.00       16.00             528.00           16.00            16.00
MOD    5306675    LITHIUM CARBONATE 300MG J8499               402          6,432.00       16.00           6,432.00           16.00            16.00
MOD    5306729    LOPERAMIDE 2MG        A9150                 823         21,398.00       26.00          21,398.00           26.00            26.00
MOD    5306740    LORATADINE 10MG       J8499               1,274         80,262.00       63.00          80,262.00           63.00            63.00
MOD    5306741    LORATADINE/PSE 5/120 J8499                   25          1,575.00       63.00           1,575.00           63.00            63.00
MOD    5306742    LORATADINE/PSE 10/240 J8499                  34          2,142.00       63.00           2,142.00           63.00            63.00
MOD    5306749    LORAZEPAM .5MG        J8499               2,908        636,852.00      219.00         636,852.00          219.00           219.00
MOD    5306752    LORAZEPAM 1MG         J8499               6,402      1,402,038.00      219.00       1,402,038.00          219.00           219.00
MOD    5306759    LOSARTAN 25MG        J8499                3,261        241,314.00       74.00         241,314.00           74.00            74.00
MOD    5306760    LOVASTATIN 20MG       J8499               2,476        185,700.00       75.00         185,700.00           75.00            75.00
MOD    5306783    LOXAPINE 25MG       J8499                     4            201.40       50.35             201.40           50.35            50.35
MOD    5306832    MAGNESIUM CHLORIDE        A9150             184          3,128.00       17.00           3,128.00           17.00            17.00
MOD    5306856    MAGNESIUM GLUCON 500MG A9150                513          5,643.00       11.00           5,643.00           11.00            11.00
MOD    5306968    MECLIZINE TAB 12.5MG J8499                   19            399.00       21.00             399.00           21.00            21.00
MOD    5306972    MECLIZINE TAB 25MG     J8499                705         14,805.00       21.00          14,805.00           21.00            21.00
MOD    5307022    MEDROXYPROGEST 2.5MG J8499                   51          1,071.00       21.00           1,071.00           21.00            21.00
MOD    5307023    MEDROXYPROGEST 5MG          J8499            82          2,952.00       36.00           2,952.00           36.00            36.00
MOD    5307076    MEGESTROL 40MG         J8499                637         25,480.00       40.00          25,480.00           40.00            40.00
MOD    5307080    MELATONIN 3MG        J8499                   60          1,560.00       26.00           1,560.00           26.00            26.00
MOD    5307111    MEMANTINE 10MG        J8499                 592         44,577.60       75.30          44,577.60           75.30            75.30
MOD    5307276    MERCAPTOPURINE 50MG        J8999              2             42.00       21.00              42.00           21.00            21.00
MOD    5307280    MESALAMINE 400MG TAB J8499                  429         31,746.00       74.00          31,746.00           74.00            74.00
MOD    5307281    MESALAMINE 250MG CAP J8499                  954         69,642.00       73.00          69,642.00           73.00            73.00
MOD    5307331    METAXOLONE 800MG         J8499            1,427         22,617.95       15.85          22,617.95           15.85            15.85
MOD    5307360    METFORMIN 500MG        J8499              6,240        455,520.00       73.00         455,520.00           73.00            73.00
MOD    5307361    METFORMIN 850MG        J8499              1,062         78,588.00       74.00          78,588.00           74.00            74.00
MOD    5307362    METFORMIN XR 500MG       J8499               13            650.00       50.00             650.00           50.00            50.00
MOD    5307507    METHIMAZOLE 10MG        J8499               152          1,672.00       11.00           1,672.00           11.00            11.00
MOD    5307530    METHOCARBAMOL 500MG         J8499            47            987.00       21.00             987.00           21.00            21.00
MOD    5307534    METHOCARBAMOL 750MG         J8499            39            819.00       21.00             819.00           21.00            21.00
                                                          2007        2007 Total      2007 Avg.
Hospital Charge                                        Utilization     Charge        Charge per 2006 Unit Price x   2006 Unit Price 2007 Unit Price
 Code Number                  Charge Desc             (ShowCase)     (ShowCase)         Unit    2007 Utilization     (6-1-06 CDM)    (6-1-07 CDM)
MOD    5307561    METHOTREXATE 2.5MG        J8610              68         2,040.00       30.00           2,040.00            30.00           30.00
MOD    5307588    METHYLDOPA 250MG         J8499              612        12,852.00       21.00          12,852.00            21.00           21.00
MOD    5307592    METHYLDOPA 500MG         J8499              538        11,298.00       21.00          11,298.00            21.00           21.00
MOD    5307631    METHYLERGONOVIN .2MG J8499                  272         4,624.00       17.00           4,624.00            17.00           17.00
MOD    5307654    METHYLPRED 16MG         J8499                 4           184.00       46.00             184.00            46.00           46.00
MOD    5307658    METHYLPRED 4MG         J8499                 37           962.00       26.00             962.00            26.00           26.00
MOD    5307685    METHYLTESTOSTERONE 10MG J8499               112         3,203.20       28.60           3,203.20            28.60           28.60
MOD    5307731    METOCLOPRAMIDE 10MG J8499                10,444       762,412.00       73.00         762,412.00            73.00           73.00
MOD    5307758    METOLAZONE 2.5MG        J8499               384         8,064.00       21.00           8,064.00            21.00           21.00
MOD    5307762    METOLAZONE 5MG         J8499              1,110        23,310.00       21.00          23,310.00            21.00           21.00
MOD    5307785    METOPROLOL 50MG         J8499             5,281       385,513.00       73.00         385,513.00            73.00           73.00
MOD    5307786    METOPROLOL EXT REL 50 MG J8499            3,838       280,174.00       73.00         280,174.00            73.00           73.00
MOD    5307789    METOPROLOL 100MG         J8499            1,409       102,857.00       73.00         102,857.00            73.00           73.00
MOD    5307791    METOPROLOL 25MG         J8499            11,147       813,731.00       73.00         813,731.00            73.00           73.00
MOD    5307812    METRONIDAZOLE 250MG        J8499         10,562       771,026.00       73.00         771,026.00            73.00           73.00
MOD    5307836    MEXILETINE 150MG      J8499                 111         3,330.00       30.00           3,330.00            30.00           30.00
MOD    5307837    MEXILETINE 200MG      J8499                  30         1,080.00       36.00           1,080.00            36.00           36.00
MOD    5307841    MIDODRINE 2.5MG      J8499                4,146       261,198.00       63.00         261,198.00            63.00           63.00
MOD    5307858    MINOCYCLINE CAP 50MG J8499                    3           202.20       67.40             202.20            67.40           67.40
MOD    5307880    MIRTAZAPINE 15MG      J8499               1,353       101,475.00       75.00         101,475.00            75.00           75.00
MOD    5307881    MINOXIDIL 2.5MG     J8499                   323         5,491.00       17.00           5,491.00            17.00           17.00
MOD    5307889    MINOXIDIL 10MG      J8499                   130         3,900.00       30.00           3,900.00            30.00           30.00
MOD    5307890    MISOPROSTOL 100MCG        J8499           1,118        82,732.00       74.00          82,732.00            74.00           74.00
MOD    5307903    MONTELUKAST 10MG         J8499            2,609       198,284.00       76.00         198,284.00            76.00           76.00
MOD    5307904    MONTELUKAST 5MG         J8499                20           428.00       21.40             428.00            21.40           21.40
MOD    5307905    MONTELUKAST 4MG         J8499                26           569.40       21.90             569.40            21.90           21.90
MOD    5307912    MULTIVIT THERAP      A9150                9,123       665,979.00       73.00         665,979.00            73.00           73.00
MOD    5307916    MULTIVIT THERAP/MIN     A9150               279         3,627.00       13.00           3,627.00            13.00           13.00
MOD    5307956    MYCOPHENOLATE 250MG         J7517         1,740       132,240.00       76.00         132,240.00            76.00           76.00
MOD    5307960    NABUMETONE 500MG         J8499              166        10,458.00       63.00          10,458.00            63.00           63.00
MOD    5307974    NADOLOL 40MG        J8499                    72         1,872.00       26.00           1,872.00            26.00           26.00
MOD    5308078    NAPROXEN 250MG        J8499                  78         2,340.00       30.00           2,340.00            30.00           30.00
MOD    5308082    NAPROXEN 275MG        J8499                   1            30.00       30.00              30.00            30.00           30.00
MOD    5308086    NAPROXEN 375MG        J8499                  24           960.00       40.00             960.00            40.00           40.00
MOD    5308088    NAPROXEN 500MG        J8499                 394        20,094.00       51.00          20,094.00            51.00           51.00
MOD    5308093    NATEGLINIDE 120MG      J8499              1,257        93,018.00       74.00          93,018.00            74.00           74.00
MOD    5308095    NEFAZODONE 100MG         J8499               14           882.00       63.00             882.00            63.00           63.00
MOD    5308096    NEFAZODONE 150MG         J8499                4           252.00       63.00             252.00            63.00           63.00
MOD    5308099    NELFINAVIR 250MG     J8499                  147         9,702.00       66.00           9,702.00            66.00           66.00
MOD    5308105    NEOMYCIN 500MG        J8499                 488        36,112.00       74.00          36,112.00            74.00           74.00
                                                          2007        2007 Total       2007 Avg.
Hospital Charge                                        Utilization     Charge         Charge per 2006 Unit Price x   2006 Unit Price 2007 Unit Price
 Code Number                   Charge Desc            (ShowCase)     (ShowCase)          Unit    2007 Utilization     (6-1-06 CDM)    (6-1-07 CDM)
MOD    5308130    NEVIRAPINE 200MG       J8499                 19          2,052.00      108.00           2,052.00          108.00           108.00
MOD    5308174    NIACIN 50MG        A9150                     95          1,045.00       11.00           1,045.00           11.00            11.00
MOD    5308247    NIACIN 500MG        A9150                   267          2,937.00       11.00           2,937.00           11.00            11.00
MOD    5308248    NIACIN ER 500MG      A9150                  674         31,004.00       46.00          31,004.00           46.00            46.00
MOD    5308305    NIFEDIPINE EXT REL 90MG J8499               227         13,166.00       58.00          13,166.00           58.00            58.00
MOD    5308306    NIFEDIPINE EXT REL 60MG J8499             1,150        115,000.00      100.00         115,000.00          100.00           100.00
MOD    5308307    NIFEDIPINE EXT REL 30MG J8499             1,008         88,704.00       88.00          88,704.00           88.00            88.00
MOD    5308312    NIFEDIPINE 10MG      J8499                2,846        207,758.00       73.00         207,758.00           73.00            73.00
MOD    5308320    NIMODIPINE 30MG       J8499               1,127         91,287.00       81.00          91,287.00           81.00            81.00
MOD    5308325    NISOLDIPINE 10MG      J8499                 126          7,056.00       56.00           7,056.00           56.00            56.00
MOD    5308335    NITROFURANTOIN TAB 50MG J8499                66          1,716.00       26.00           1,716.00           26.00            26.00
MOD    5308337    NITROFURANTOIN CAP 100MG J8499              224         14,112.00       63.00          14,112.00           63.00            63.00
MOD    5308342    NITROFURAN MON/MAC 75/25 J8499              950         59,850.00       63.00          59,850.00           63.00            63.00
MOD    5308358    NITROGLYCERIN CAP 2.5MG J8499                16            336.00       21.00             336.00           21.00            21.00
MOD    5308362    NITROGLYCERIN CAP 6.5MG J8499                36            756.00       21.00             756.00           21.00            21.00
MOD    5308378    NITROGLYCERIN SL .4MG J8499                 712          7,832.00       11.00           7,832.00           11.00            11.00
MOD    5308379    NITROGLYCERIN SL .4MG 25 J8499              394         30,732.00       78.00          30,732.00           78.00            78.00
MOD    5308428    NORTRIPTYLINE 10MG       J8499              210          3,570.00       17.00           3,570.00           17.00            17.00
MOD    5308432    NORTRIPTYLINE 25MG       J8499              361          7,581.00       21.00           7,581.00           21.00            21.00
MOD    5308486    OMEPRAZOLE 20MG         J8499               156          9,828.00       63.00           9,828.00           63.00            63.00
MOD    5308492    ONDANSETRON ODT 4MG         J8499         2,604        190,092.00       73.00         190,092.00           73.00            73.00
MOD    5308495    ONDANSETRON 4MG          J8499              648         63,504.00       98.00          63,504.00           98.00            98.00
MOD    5308497    OLANZAPINE 5MG        J8499               2,098        165,742.00       79.00         165,742.00           79.00            79.00
MOD    5308500    OLANZAPINE 2.5MG       J8499                584         45,552.00       78.00          45,552.00           78.00            78.00
MOD    5308504    OSELTAMIVIR 75MG       J8499                  5            440.00       88.00             440.00           88.00            88.00
MOD    5308520    OLMESARTAN 20MG         J8499               569          6,685.75       11.75           6,685.75           11.75            11.75
MOD    5308540    OXAPROZIN 600MG        J8499                 21          1,323.00       63.00           1,323.00           63.00            63.00
MOD    5308571    OXCARBAZEPINE 300MG        J8499            279         21,036.60       75.40          21,036.60           75.40            75.40
MOD    5308640    OXYBUTYNIN 5MG         J8499                748         15,708.00       21.00          15,708.00           21.00            21.00
MOD    5308641    OXYBUTYNIN EXT REL 5MG J8499                415         31,706.00       76.40          31,706.00           76.40            76.40
MOD    5308870    PANTOPRAZOLE 40MG         J8499          27,391      2,081,716.00       76.00       2,081,716.00           76.00            76.00
MOD    5308950    PAROXETINE 20MG        J8499              2,553        194,028.00       76.00         194,028.00           76.00            76.00
MOD    5309025    PENICILLIN V POT 250MG J8499                 19            399.00       21.00             399.00           21.00            21.00
MOD    5309029    PENICILLIN V POT 500MG J8499                135          2,835.00       21.00           2,835.00           21.00            21.00
MOD    5309063    PENTAZOCINE/NALOXONE J8499                    5            255.00       51.00             255.00           51.00            51.00
MOD    5309065    PENTOSAN POLYSULF 100MG J8499                39          2,956.20       75.80           2,956.20           75.80            75.80
MOD    5309066    PENTOXIFYLLINE 400MG J8499                  373          9,698.00       26.00           9,698.00           26.00            26.00
MOD    5309090    PERGOLIDE .05MG       J8499                   8            539.20       67.40             539.20           67.40            67.40
MOD    5309145    PHENAZOPYRIDINE 100MG J8499                 510         10,710.00       21.00          10,710.00           21.00            21.00
MOD    5309149    PHENAZOPYRIDINE 200MG J8499                 279          5,859.00       21.00           5,859.00           21.00            21.00
                                                       2007        2007 Total       2007 Avg.
Hospital Charge                                     Utilization     Charge         Charge per 2006 Unit Price x   2006 Unit Price 2007 Unit Price
 Code Number                 Charge Desc           (ShowCase)     (ShowCase)          Unit    2007 Utilization     (6-1-06 CDM)    (6-1-07 CDM)
MOD    5309434    PHENYTOIN 50MG      J8499                147          2,499.00       17.00           2,499.00           17.00            17.00
MOD    5309438    PHENYTOIN 100MG      J8499             9,051        660,723.00       73.00         660,723.00           73.00            73.00
MOD    5309461    PHYTONADIONE 5MG        J8499            850         17,850.00       21.00          17,850.00           21.00            21.00
MOD    5309484    PINDOLOL 5MG       J8499                 228          4,788.00       21.00           4,788.00           21.00            21.00
MOD    5309500    PIOGLITAZONE 15MG TAB J8499              437         33,212.00       76.00          33,212.00           76.00            76.00
MOD    5309502    PIOGLITAZONE 30MG TAB J8499            1,137         88,686.00       78.00          88,686.00           78.00            78.00
MOD    5309504    PIOGLITAZONE 45MG TAB J8499            1,013         80,027.00       79.00          80,027.00           79.00            79.00
MOD    5309530    PIROXICAM 10MG      J8499                  2            134.80       67.40             134.80           67.40            67.40
MOD    5309534    PIROXICAM 20MG      J8499                 16            816.00       51.00             816.00           51.00            51.00
MOD    5309649    POTASSIUM ACID 500MG J8499               146          1,606.00       11.00           1,606.00           11.00            11.00
MOD    5309657    POTASSIUM CL 10MEQ      J8499         53,537      3,908,201.00       73.00       3,908,201.00           73.00            73.00
MOD    5309665    POTASSIUM CL 8MEQ      J8499           2,876        209,948.00       73.00         209,948.00           73.00            73.00
MOD    5309685    POTASSIUM PHOSPHAT 1.45G J8499           199          4,179.00       21.00           4,179.00           21.00            21.00
MOD    5309686    SOD/POT/PHOS NEUTRAL TAB J8499            52          1,092.00       21.00           1,092.00           21.00            21.00
MOD    5309690    PRAVASTATIN 10MG      J8499               83          5,229.00       63.00           5,229.00           63.00            63.00
MOD    5309691    PRAVASTATIN 20MG      J8499            2,455        186,580.00       76.00         186,580.00           76.00            76.00
MOD    5309723    PRAZOSIN 1MG       J8499                   6            126.00       21.00             126.00           21.00            21.00
MOD    5309731    PRAZOSIN 5MG       J8499                  17            510.00       30.00             510.00           30.00            30.00
MOD    5309777    PREDNISONE 1MG       J8499               139          1,529.00       11.00           1,529.00           11.00            11.00
MOD    5309785    PREDNISONE 5MG       J7506             1,234         13,574.00       11.00          13,574.00           11.00            11.00
MOD    5309789    PREDNISONE 10MG       J8499            1,831        133,663.00       73.00         133,663.00           73.00            73.00
MOD    5309793    PREDNISONE 20MG       J8499            7,700        562,100.00       73.00         562,100.00           73.00            73.00
MOD    5309795    PREGABALIN 25MG CAP      J8499            38          2,842.40       74.80           2,842.40           74.80            74.80
MOD    5309796    PREGABALIN 50MG CAP      J8499         1,098         82,130.40       74.80          82,130.40           74.80            74.80
MOD    5309797    PREDNISONE 50MG       J8499              207          5,382.00       26.00           5,382.00           26.00            26.00
MOD    5309798    PREGABALIN 75MG      J8499               538         40,242.40       74.80          40,242.40           74.80            74.80
MOD    5309800    PRENATAL VITAMINS     A9150            2,229        162,717.00       73.00         162,717.00           73.00            73.00
MOD    5309820    PRIMIDONE 50MG      J8499                227          2,497.00       11.00           2,497.00           11.00            11.00
MOD    5309824    PRIMIDONE 250MG      J8499                85          1,445.00       17.00           1,445.00           17.00            17.00
MOD    5309847    PROBENECID 500MG       J8499              61          1,281.00       21.00           1,281.00           21.00            21.00
MOD    5309901    PROCAINAMIDE 500MG SR J8499                4             84.00       21.00              84.00           21.00            21.00
MOD    5309905    PROCAINAMIDE 750MG SR J8499                1             30.00       30.00              30.00           30.00            30.00
MOD    5309917    PROCAINAMIDE CAP 500MG J8499               6            276.00       46.00             276.00           46.00            46.00
MOD    5309918    PROCAINAMIDE Q12H 500MG J8499            130          5,980.00       46.00           5,980.00           46.00            46.00
MOD    5309919    PROCAINAMIDE Q12H 1GM J8499                5            255.00       51.00             255.00           51.00            51.00
MOD    5309979    PROCHLORPERAZINE 5MG J8499                76          1,596.00       21.00           1,596.00           21.00            21.00
MOD    5309983    PROCHLORPERAZINE 10MG J8499              451          9,471.00       21.00           9,471.00           21.00            21.00
MOD    5310068    PROMETHAZINE 25MG       J8499            775         13,175.00       17.00          13,175.00           17.00            17.00
MOD    5310090    PROPAFENONE 150MG        J8499           535         39,590.00       74.00          39,590.00           74.00            74.00
MOD    5310189    PROPOXYPHENE/APAP100/650 J8499         7,232      1,583,808.00      219.00       1,583,808.00          219.00           219.00
                                                         2007        2007 Total      2007 Avg.
Hospital Charge                                       Utilization     Charge        Charge per 2006 Unit Price x   2006 Unit Price 2007 Unit Price
 Code Number                   Charge Desc           (ShowCase)     (ShowCase)         Unit    2007 Utilization     (6-1-06 CDM)    (6-1-07 CDM)
MOD    5310199    PROPRANOLOL 10MG          J8499            393         6,681.00       17.00           6,681.00           17.00            17.00
MOD    5310201    PROPRANOLOL 20MG          J8499          1,001        17,017.00       17.00          17,017.00           17.00            17.00
MOD    5310203    PROPRANOLOL 40MG          J8499            309         6,489.00       21.00           6,489.00           21.00            21.00
MOD    5310207    PROPRANOLOL 80MG          J8499            554        11,634.00       21.00          11,634.00           21.00            21.00
MOD    5310208    PROPRANOLOL LA 60MG        J8499            46         1,380.00       30.00           1,380.00           30.00            30.00
MOD    5310210    PROPRANOLOL LA 80MG        J8499             3            90.00       30.00              90.00           30.00            30.00
MOD    5310211    PROPRANOLOL LA 120MG J8499                   8           320.00       40.00             320.00           40.00            40.00
MOD    5310216    PROPYLTHIOURACIL 50MG J8499                350         3,850.00       11.00           3,850.00           11.00            11.00
MOD    5310262    PSEUDOEPHED SA 120MG A9150                  26           338.00       13.00             338.00           13.00            13.00
MOD    5310266    PSEUDOEPHED 30MG          A9150            646         8,398.00       13.00           8,398.00           13.00            13.00
MOD    5310295    PYRAZINAMIDE 500MG       J8499             499        22,954.00       46.00          22,954.00           46.00            46.00
MOD    5310297    PYRIDOSTIGMINE 60MG J8499                   64         1,088.00       17.00           1,088.00           17.00            17.00
MOD    5310328    PYRIDOXINE 50MG       A9150                290         2,320.00        8.00           2,320.00            8.00             8.00
MOD    5310370    QUETIAPINE 25MG       J8499                712        52,688.00       74.00          52,688.00           74.00            74.00
MOD    5310371    QUETIAPINE 100MG       J8499             2,181       165,756.00       76.00         165,756.00           76.00            76.00
MOD    5310398    QUINAPRIL 10MG       J8499                 129         6,579.00       51.00           6,579.00           51.00            51.00
MOD    5310399    QUINAPRIL 20MG       J8499                 249        12,699.00       51.00          12,699.00           51.00            51.00
MOD    5310447    QUINIDINE 200MG      J8499                   8           168.00       21.00             168.00           21.00            21.00
MOD    5310451    QUINIDINE 300MG      J8499                  19           399.00       21.00             399.00           21.00            21.00
MOD    5310482    QUININE 200MG       A9150                   94         1,974.00       21.00           1,974.00           21.00            21.00
MOD    5310484    QUININE 260MG       J8499                   60         1,560.00       26.00           1,560.00           26.00            26.00
MOD    5310485    QUININE 325MG       A9150                  286         7,436.00       26.00           7,436.00           26.00            26.00
MOD    5310486    RABEPRAZOLE 20MG         J8499              16         1,472.00       92.00           1,472.00           92.00            92.00
MOD    5310487    RALOXIFENE 60 MG       J8499               182        11,466.00       63.00          11,466.00           63.00            63.00
MOD    5310490    RAMIPRIL 2.5MG      J8499                  677        50,098.00       74.00          50,098.00           74.00            74.00
MOD    5310491    RAMIPRIL 5MG       J8499                 1,510       111,740.00       74.00         111,740.00           74.00            74.00
MOD    5310507    RANITIDINE 150MG GELDOSE J8499             154        11,550.00       75.00          11,550.00           75.00            75.00
MOD    5310553    REPAGLINIDE 1MG       J8499                173        12,819.30       74.10          12,819.30           74.10            74.10
MOD    5310620    RIFABUTIN 150MG      J8499                   4           692.60      173.15             692.60          173.15           173.15
MOD    5310637    RIFAMPIN 300MG       J8499                 720        40,320.00       56.00          40,320.00           56.00            56.00
MOD    5310648    RISEDRONATE NA 35MG        J8499            45         4,221.00       93.80           4,221.00           93.80            93.80
MOD    5310649    RISEDRONATE NA 5MG        J8499              6           453.60       75.60             453.60           75.60            75.60
MOD    5310651    RISPERIDONE 1MG        J8499             1,077        81,852.00       76.00          81,852.00           76.00            76.00
MOD    5310652    RISPERIDONE 2MG        J8499               688        43,344.00       63.00          43,344.00           63.00            63.00
MOD    5310663    ROSIGLITAZONE 4MG        J8499             835        63,460.00       76.00          63,460.00           76.00            76.00
MOD    5310664    ROSIGLITAZONE 8MG        J8499             677        52,806.00       78.00          52,806.00           78.00            78.00
MOD    5310665    RIVASTIGMINE 1.5MG      J8499              732        48,312.00       66.00          48,312.00           66.00            66.00
MOD    5310670    RITONAVIR 100 MG      J8499                 95         9,989.25      105.15           9,989.25          105.15           105.15
MOD    5310683    SALSALATE 500MG        J8499                71         1,491.00       21.00           1,491.00           21.00            21.00
MOD    5310693    ROSUVASTATIN CA 10MG J8499                 607        46,132.00       76.00          46,132.00           76.00            76.00
                                                         2007        2007 Total       2007 Avg.
Hospital Charge                                       Utilization     Charge         Charge per 2006 Unit Price x   2006 Unit Price 2007 Unit Price
 Code Number                  Charge Desc            (ShowCase)     (ShowCase)          Unit    2007 Utilization     (6-1-06 CDM)    (6-1-07 CDM)
MOD    5310720    SELEGILINE 5MG     J8499                     8            504.00       63.00             504.00           63.00            63.00
MOD    5310760    SERTRALINE 50MG       J8499              4,270        320,250.00       75.00         320,250.00           75.00            75.00
MOD    5310762    SEVELAMER 403MG CAP       J8499            201          7,839.00       39.00           7,839.00           39.00            39.00
MOD    5310764    SEVELAMER 800MG        J8499             9,726        719,724.00       74.00         719,724.00           74.00            74.00
MOD    5310791    SIMVASTATIN 10MG      J8499             17,309      1,298,175.00       75.00       1,298,175.00           75.00            75.00
MOD    5310856    SODIUM FLUORIDE 2.2MG J8499                  3             33.00       11.00              33.00           11.00            11.00
MOD    5310863    SOD/POT PHOS 1.25G     J8499             1,770         30,090.00       17.00          30,090.00           17.00            17.00
MOD    5310870    SOTALOL 80MG       J8499                   239         17,925.00       75.00          17,925.00           75.00            75.00
MOD    5310902    SPIRONOLAC-HCTZ 25MG J8499                  20            520.00       26.00             520.00           26.00            26.00
MOD    5310910    SPIRONOLACTONE 25MG        J8499         2,141        156,293.00       73.00         156,293.00           73.00            73.00
MOD    5310914    SPIRONOLACTONE 50MG        J8499         2,229        164,946.00       74.00         164,946.00           74.00            74.00
MOD    5310951    STAVUDINE 20MG       J8499                  34            714.00       21.00             714.00           21.00            21.00
MOD    5310960    STRESSTABS 600      A9150                   39            507.00       13.00             507.00           13.00            13.00
MOD    5311006    SUCRALFATE 1GM        J8499                655         17,030.00       26.00          17,030.00           26.00            26.00
MOD    5311110    SULFASALAZINE 500MG      J8499             185          3,885.00       21.00           3,885.00           21.00            21.00
MOD    5311183    SULINDAC 150MG      J8499                    2             72.00       36.00              72.00           36.00            36.00
MOD    5311187    SULINDAC 200MG      J8499                    2             80.00       40.00              80.00           40.00            40.00
MOD    5311190    SUMATRIPTAN 25MG        J8499                4            484.00      121.00             484.00          121.00           121.00
MOD    5311191    SUMATRIPTAN 50MG        J8499               55          7,315.00      133.00           7,315.00          133.00           133.00
MOD    5311204    TACROLIMUS ORAL PER 1MG J7507              963         74,151.00       77.00          74,151.00           77.00            77.00
MOD    5311210    TAMOXIFEN 10MG       J8999                 105          5,355.00       51.00           5,355.00           51.00            51.00
MOD    5311215    TAMSULOSIN .4MG      J8499               2,372        177,900.00       75.00         177,900.00           75.00            75.00
MOD    5311221    TEGASEROD 6MG         J8499                366          7,393.20       20.20           7,393.20           20.20            20.20
MOD    5311226    TELMISARTAN 40MG       J8499               229          1,374.00        6.00           1,374.00            6.00             6.00
MOD    5311227    TELMISARTAN 80MG       J8499               131            786.00        6.00             786.00            6.00             6.00
MOD    5311233    TEMAZEPAM 15MG        J8499              3,478        761,682.00      219.00         761,682.00          219.00           219.00
MOD    5311234    TEMAZEPAM 7.5MG       J8499                 51          2,091.00       41.00           2,091.00           41.00            41.00
MOD    5311237    TEMAZAPAM 30MG        J8499              1,065         22,365.00       21.00          22,365.00           21.00            21.00
MOD    5311245    TENOFOVIR 300MG       J8499                254         22,479.00       88.50          22,479.00           88.50            88.50
MOD    5311250    TERAZOSIN 1MG       J8499                  908         67,192.00       74.00          67,192.00           74.00            74.00
MOD    5311252    TERAZOSIN 5MG       J8499                  361         22,743.00       63.00          22,743.00           63.00            63.00
MOD    5311260    TERBUTALINE 2.5MG      J8499               105          2,205.00       21.00           2,205.00           21.00            21.00
MOD    5311264    TERBUTALINE 5MG       J8499                 38            798.00       21.00             798.00           21.00            21.00
MOD    5311310    TETRACYCLINE 250MG       J8499               7            119.00       17.00             119.00           17.00            17.00
MOD    5311314    TETRACYCLINE 500MG       J8499              66          1,386.00       21.00           1,386.00           21.00            21.00
MOD    5311381    THEOPHYLLINE 400MG       J8499              22          1,012.00       46.00           1,012.00           46.00            46.00
MOD    5311386    THEOPHYLL SA 200MG       J8499              49          1,029.00       21.00           1,029.00           21.00            21.00
MOD    5311387    THEOPHYLL SA 300MG       J8499              28            588.00       21.00             588.00           21.00            21.00
MOD    5311388    THEOPHYLL SA 100MG       J8499             133          2,261.00       17.00           2,261.00           17.00            17.00
MOD    5311392    THEOPHYLL SA 200MG       J8499             931         19,551.00       21.00          19,551.00           21.00            21.00
                                                       2007        2007 Total      2007 Avg.
Hospital Charge                                     Utilization     Charge        Charge per 2006 Unit Price x   2006 Unit Price 2007 Unit Price
 Code Number                  Charge Desc          (ShowCase)     (ShowCase)         Unit    2007 Utilization     (6-1-06 CDM)    (6-1-07 CDM)
MOD    5311396    THEOPHYLL SA 300MG       J8499           625        13,125.00       21.00          13,125.00           21.00            21.00
MOD    5311471    THIAMINE 100MG      A9150              2,869       212,306.00       74.00         212,306.00           74.00            74.00
MOD    5311537    THIORIDAZINE 10MG     J8499               12           252.00       21.00             252.00           21.00            21.00
MOD    5311552    THIORIDAZINE 50MG     J8499              178         4,628.00       26.00           4,628.00           26.00            26.00
MOD    5311583    THIOTHIXENE 1MG      J8499                44         1,562.00       35.50           1,562.00           35.50            35.50
MOD    5311591    THIOTHIXEME 5MG       J8499              111         2,886.00       26.00           2,886.00           26.00            26.00
MOD    5311645    THYROID 30MG       J8499                  50           550.00       11.00             550.00           11.00            11.00
MOD    5311649    THYROID 60MG       J8499                 201         2,211.00       11.00           2,211.00           11.00            11.00
MOD    5311682    TICLOPIDINE 250MG     J8499               37         2,331.00       63.00           2,331.00           63.00            63.00
MOD    5311685    TIMOLOL 10MG       J8499                  10           444.50       44.45             444.50           44.45            44.45
MOD    5311692    TIZANIDINE 4MG TAB    J8499              470        34,780.00       74.00          34,780.00           74.00            74.00
MOD    5311747    TOLTERODINE LA 2MG       J8499            61         1,378.60       22.60           1,378.60           22.60            22.60
MOD    5311748    TOLTERODINE LA 4MG       J8499           640        15,008.00       23.45          15,008.00           23.45            23.45
MOD    5311751    TOLTERODINE 1MG        J8499             546        40,404.00       74.00          40,404.00           74.00            74.00
MOD    5311754    TOPIRAMATE 25MG       J8499              479        28,261.00       59.00          28,261.00           59.00            59.00
MOD    5311755    TOPIRAMATE 100MG       J8499             216        12,744.00       59.00          12,744.00           59.00            59.00
MOD    5311762    TORSEMIDE 20MG       J8499               287        11,767.00       41.00          11,767.00           41.00            41.00
MOD    5311764    TRANDOLAPRIL 1MG        J8499             60         2,400.00       40.00           2,400.00           40.00            40.00
MOD    5311770    TRAMADOL 50MG        J8499               952        70,448.00       74.00          70,448.00           74.00            74.00
MOD    5311791    TRAZODONE 50MG         J8499           1,851       136,974.00       74.00         136,974.00           74.00            74.00
MOD    5311800    TRETINOIN 10 MG     J8499                 18         1,953.90      108.55           1,953.90          108.55           108.55
MOD    5311863    TRIAMTREN-HCTZ 37.5/25MG J8499           390        10,140.00       26.00          10,140.00           26.00            26.00
MOD    5311864    TRIAMTERENE-HCTZ 75/50MG J8499           228         5,928.00       26.00           5,928.00           26.00            26.00
MOD    5311865    TRIAMTERENE/HCTZ 50/25 J8499              54         1,134.00       21.00           1,134.00           21.00            21.00
MOD    5311888    TRIAZOLAM .25MG      J8499                36           756.00       21.00             756.00           21.00            21.00
MOD    5311917    TRIFLUOPERAZINE 2MG J8499                  2            78.00       39.00              78.00           39.00            39.00
MOD    5311919    TRIFLUOPERAZINE 5MG J8499                 42           882.00       21.00             882.00           21.00            21.00
MOD    5311942    TRIHEXYPHEN 2MG        J8499              89           979.00       11.00             979.00           11.00            11.00
MOD    5312255    URSODIOL 300MG       J8499               182        11,466.00       63.00          11,466.00           63.00            63.00
MOD    5312258    VALACYCLOVIR 500MG       J8499           237        14,931.00       63.00          14,931.00           63.00            63.00
MOD    5312260    VALPROIC SPRINKLE 125MG J8499            324         8,424.00       26.00           8,424.00           26.00            26.00
MOD    5312261    VALPROATE 250MG        J8499           1,158        24,318.00       21.00          24,318.00           21.00            21.00
MOD    5312265    VALSARTAN 80MG       J8499             4,565       337,810.00       74.00         337,810.00           74.00            74.00
MOD    5312273    VENLAFAXINE XR 37.5MG J8499              104         6,552.00       63.00           6,552.00           63.00            63.00
MOD    5312274    VENLAFAXINE XR 75MG      J8499         1,579       118,425.00       75.00         118,425.00           75.00            75.00
MOD    5312275    VENLAFAXINE 25MG       J8499              54         3,402.00       63.00           3,402.00           63.00            63.00
MOD    5312276    VENLAFAXINE 37.5MG      J8499            117         7,371.00       63.00           7,371.00           63.00            63.00
MOD    5312278    VENLAFAXINE 75MG       J8499           1,077        81,852.00       76.00          81,852.00           76.00            76.00
MOD    5312283    VERAPAMIL 40MG       J8499               101         2,626.00       26.00           2,626.00           26.00            26.00
MOD    5312284    VERAPAMIL 80MG       J8499                39         1,014.00       26.00           1,014.00           26.00            26.00
                                                           2007        2007 Total       2007 Avg.
Hospital Charge                                         Utilization     Charge         Charge per 2006 Unit Price x   2006 Unit Price 2007 Unit Price
 Code Number                   Charge Desc             (ShowCase)     (ShowCase)          Unit    2007 Utilization     (6-1-06 CDM)    (6-1-07 CDM)
MOD    5312288    VERAPAMIL 120MG          J8499                45          1,170.00       26.00           1,170.00           26.00            26.00
MOD    5312289    VERAPAMIL SUST REL 240MG J8499               368         27,600.00       75.00          27,600.00           75.00            75.00
MOD    5312290    VERAPAMIL SR 180MG         J8499             124          7,812.00       63.00           7,812.00           63.00            63.00
MOD    5312335    VITAMIN A 10 MU      A9150                   203          2,639.00       13.00           2,639.00           13.00