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					      PROC    DESCRIPTION                                                                        NONFAC RATE
dme   E0100   CANE, INCLUDES CANES OF ALL MATERIALS, ADJUSTABLE OR FIXED, WITH TIP                     $20.70
dme   E0105   CANE, QUAD OR THREE PRONG, INCLUDES CANES OF ALL MATERIALS, ADJUSTABLE OR                $48.99
dme   E0110   CRUTCHES, FOREARM, INCLUDES CRUTCHES OF VARIOUS MATERIALS, ADJUSTABLE OR FIXED,          $65.79
dme   E0111   CRUTCH FOREARM, INCLUDES CRUTCHES OF VARIOUS MATERIALS, ADJUSTABLE OR FIXED,             $45.15
dme   E0112   CRUTCHES UNDERARM, WOOD, ADJUSTABLE OR FIXED, PAIR, WITH PADS, TIPS AND                  $31.37
dme   E0113   CRUTCH UNDERARM, WOOD, ADJUSTABLE OR FIXED, EACH, WITH PAD, TIP AND HANDGRIP             $17.92
dme   E0114   CRUTCHES UNDERARM, OTHER THAN WOOD, ADJUSTABLE OR FIXED, PAIR, WITH PADS, TIPS           $40.01
dme   E0116   CRUTCH, UNDERARM, OTHER THAN WOOD, ADJUSTABLE OR FIXED, WITH PAD, TIP, HANDGRIP,         $23.52
dme   E0117   CRUTCH, UNDERARM, ARTICULATING, SPRING ASSISTED, EACH                                   $192.23
dme   E0130   WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT                                       $60.38
dme   E0135   WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT                                     $72.09
dme   E0140   WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE                        $310.12
dme   E0141   WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT                                       $96.49
dme   E0143   WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT                                    $103.37
dme   E0144   WALKER, ENCLOSED, FOUR SIDED FRAMED, RIGID OR FOLDING, WHEELED WITH POSTERIOR           $273.79
dme   E0147   WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE                  $494.19
dme   E0148   WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH                    $109.23
dme   E0149   WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE                                 $191.90
dme   E0153   PLATFORM ATTACHMENT, FOREARM CRUTCH, EACH                                                $65.97
dme   E0154   PLATFORM ATTACHMENT, WALKER, EACH                                                        $60.62
dme   E0155   WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR                                         $23.07
dme   E0156   SEAT ATTACHMENT, WALKER                                                                  $22.71
dme   E0157   CRUTCH ATTACHMENT, WALKER, EACH                                                          $70.43
dme   E0158   LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4)                                           $23.51
dme   E0159   BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH                                   $15.36
dme   E0160   SITZ TYPE BATH OR EQUIPMENT, PORTABLE, USED WITH OR WITHOUT COMMODE                      $28.03
dme   E0161   SITZ TYPE BATH OR EQUIPMENT, PORTABLE, USED WITH OR WITHOUT COMMODE, WITH                $22.24
dme   E0162   SITZ BATH CHAIR                                                                         $123.54
dme   E0163   COMMODE CHAIR, MOBILE OR STATIONARY, WITH FIXED ARMS                                    $110.01
dme   E0165   COMMODE CHAIR, MOBILE OR STATIONARY, WITH DETACHABLE ARMS                               $211.81
dme   E0167   PAIL OR PAN FOR USE WITH COMMODE CHAIR, REPLACEMENT ONLY                                 $11.97
dme   E0168   COMMODE CHAIR, EXTRA WIDE AND/OR HEAVY DUTY, STATIONARY OR MOBILE, WITH OR              $150.55
dme   E0170   COMMODE CHAIR WITH INTEGRATED SEAT LIFT MECHANISM, ELECTRIC, ANY TYPE                       BR
dme   E0171   COMMODE CHAIR WITH INTEGRATED SEAT LIFT MECHANISM, NON-ELECTRIC, ANY TYPE                   BR
dme   E0172   SEAT LIFT MECHANISM PLACED OVER OR ON TOP OF TOILET, ANY TYPE                               BR
dme   E0175   FOOT REST, FOR USE WITH COMMODE CHAIR, EACH                                              $56.15
dme   E0181   POWERED PRESSURE REDUCING MATTRESS OVERLAY/PAD, ALTERNATING, WITH PUMP, INCLUDES        $257.41
dme   E0182   PUMP FOR ALTERNATING PRESSURE PAD, FOR REPLACEMENT ONLY                                 $298.45
dme   E0184   DRY PRESSURE MATTRESS                                                                   $165.08
dme   E0185   GEL OR GEL-LIKE PRESSURE PAD FOR MATTRESS, STANDARD MATTRESS LENGTH AND WIDTH        $271.20
dme   E0186   AIR PRESSURE MATTRESS                                                                $231.42
dme   E0187   WATER PRESSURE MATTRESS                                                              $255.47
dme   E0188   SYNTHETIC SHEEPSKIN PAD                                                               $26.36
dme   E0189   LAMBSWOOL SHEEPSKIN PAD, ANY SIZE                                                     $51.83
dme   E0190   POSITIONING CUSHION/PILLOW/WEDGE, ANY SHAPE OR SIZE, INCLUDES ALL COMPONENTS AND         BR
dme   E0191   HEEL OR ELBOW PROTECTOR, EACH                                                          $8.47
dme   E0193   POWERED AIR FLOTATION BED (LOW AIR LOSS THERAPY)                                   $9,628.55
dme   E0194   AIR FLUIDIZED BED                                                                        BR
dme   E0196   GEL PRESSURE MATTRESS                                                                $314.87
dme   E0197   AIR PRESSURE PAD FOR MATTRESS, STANDARD MATTRESS LENGTH AND WIDTH                    $218.63
dme   E0198   WATER PRESSURE PAD FOR MATTRESS, STANDARD MATTRESS LENGTH AND WIDTH                  $218.63
dme   E0199   DRY PRESSURE PAD FOR MATTRESS, STANDARD MATTRESS LENGTH AND WIDTH                     $31.97
dme   E0200   HEAT LAMP, WITHOUT STAND (TABLE MODEL), INCLUDES BULB, OR INFRARED ELEMENT            $67.21
dme   E0202   PHOTOTHERAPY (BILIRUBIN) LIGHT WITH PHOTOMETER                                           BR
dme   E0205   HEAT LAMP, WITH STAND, INCLUDES BULB, OR INFRARED ELEMENT                            $164.54
dme   E0210   ELECTRIC HEAT PAD, STANDARD                                                           $27.67
dme   E0215   ELECTRIC HEAT PAD, MOIST                                                              $63.97
dme   E0217   WATER CIRCULATING HEAT PAD WITH PUMP                                                 $495.23
dme   E0218   WATER CIRCULATING COLD PAD WITH PUMP                                                     BR
dme   E0220   HOT WATER BOTTLE                                                                       $8.45
dme   E0221   INFRARED HEATING PAD SYSTEM                                                        $2,007.79
dme   E0225   HYDROCOLLATOR UNIT, INCLUDES PADS                                                    $387.68
dme   E0230   ICE CAP OR COLLAR                                                                      $7.66
dme   E0235   PARAFFIN BATH UNIT, PORTABLE (SEE MEDICAL SUPPLY CODE A4265 FOR PARAFFIN)            $196.76
dme   E0236   PUMP FOR WATER CIRCULATING PAD                                                       $463.07
dme   E0238   NON-ELECTRIC HEAT PAD, MOIST                                                          $22.91
dme   E0239   HYDROCOLLATOR UNIT, PORTABLE                                                         $448.70
dme   E0240   BATH/SHOWER CHAIR, WITH OR WITHOUT WHEELS, ANY SIZE                                      BR
dme   E0241   BATH TUB WALL RAIL, EACH                                                                 BR
dme   E0242   BATH TUB RAIL, FLOOR BASE                                                                BR
dme   E0243   TOILET RAIL, EACH                                                                        BR
dme   E0244   RAISED TOILET SEAT                                                                       BR
dme   E0245   TUB STOOL OR BENCH                                                                       BR
dme   E0246   TRANSFER TUB RAIL ATTACHMENT                                                             BR
dme   E0247   TRANSFER BENCH FOR TUB OR TOILET WITH OR WITHOUT COMMODE OPENING                         BR
dme   E0248   TRANSFER BENCH, HEAVY DUTY, FOR TUB OR TOILET WITH OR WITHOUT COMMODE OPENING            BR
dme   E0249   PAD FOR WATER CIRCULATING HEAT UNIT, FOR REPLACEMENT ONLY                             $84.45
dme   E0250   HOSPITAL BED, FIXED HEIGHT, WITH ANY TYPE SIDE RAILS, WITH MATTRESS                $1,114.46
dme   E0251   HOSPITAL BED, FIXED HEIGHT, WITH ANY TYPE SIDE RAILS, WITHOUT MATTRESS               $844.51
dme   E0255   HOSPITAL BED, VARIABLE HEIGHT, HI-LO, WITH ANY TYPE SIDE RAILS, WITH MATTRESS      $1,339.27
dme   E0256   HOSPITAL BED, VARIABLE HEIGHT, HI-LO, WITH ANY TYPE SIDE RAILS, WITHOUT MATTRESS     $945.97
dme   E0260   HOSPITAL BED, SEMI-ELECTRIC (HEAD AND FOOT ADJUSTMENT), WITH ANY TYPE SIDE         $1,914.40
dme   E0261   HOSPITAL BED, SEMI-ELECTRIC (HEAD AND FOOT ADJUSTMENT), WITH ANY TYPE SIDE         $1,561.12
dme   E0265   HOSPITAL BED, TOTAL ELECTRIC (HEAD, FOOT AND HEIGHT ADJUSTMENTS), WITH ANY TYPE    $2,278.63
dme   E0266   HOSPITAL BED, TOTAL ELECTRIC (HEAD, FOOT AND HEIGHT ADJUSTMENTS), WITH ANY TYPE    $2,006.97
dme   E0270   HOSPITAL BED, INSTITUTIONAL TYPE INCLUDES: OSCILLATING, CIRCULATING AND STRYKER          BR
dme   E0271   MATTRESS, INNERSPRING                                                                $190.90
dme   E0272   MATTRESS, FOAM RUBBER                                                                $173.98
dme   E0273   BED BOARD                                                                                BR
dme   E0274   OVER-BED TABLE                                                                           BR
dme   E0275   BED PAN, STANDARD, METAL OR PLASTIC                                                   $12.99
dme   E0276   BED PAN, FRACTURE, METAL OR PLASTIC                                                   $11.28
dme   E0277   POWERED PRESSURE-REDUCING AIR MATTRESS                                                   BR
dme   E0280   BED CRADLE, ANY TYPE                                                                  $27.92
dme   E0290   HOSPITAL BED, FIXED HEIGHT, WITHOUT SIDE RAILS, WITH MATTRESS                        $852.04
dme   E0291   HOSPITAL BED, FIXED HEIGHT, WITHOUT SIDE RAILS, WITHOUT MATTRESS                     $576.27
dme   E0292   HOSPITAL BED, VARIABLE HEIGHT, HI-LO, WITHOUT SIDE RAILS, WITH MATTRESS              $947.57
dme   E0293   HOSPITAL BED, VARIABLE HEIGHT, HI-LO, WITHOUT SIDE RAILS, WITHOUT MATTRESS           $815.21
dme   E0294   HOSPITAL BED, SEMI-ELECTRIC (HEAD AND FOOT ADJUSTMENT), WITHOUT SIDE RAILS,        $1,489.41
dme   E0295   HOSPITAL BED, SEMI-ELECTRIC (HEAD AND FOOT ADJUSTMENT), WITHOUT SIDE RAILS,        $1,451.79
dme   E0296   HOSPITAL BED, TOTAL ELECTRIC (HEAD, FOOT AND HEIGHT ADJUSTMENTS). WITHOUT SIDE     $1,591.10
dme   E0297   HOSPITAL BED, TOTAL ELECTRIC (HEAD, FOOT AND HEIGHT ADJUSTMENTS), WITHOUT SIDE     $1,578.44
dme   E0300   PEDIATRIC CRIB, HOSPITAL GRADE, FULLY ENCLOSED                                     $2,440.50
dme   E0301   HOSPITAL BED, HEAVY DUTY, EXTRA WIDE, WITH WEIGHT CAPACITY GREATER THAN 350              BR
dme   E0302   HOSPITAL BED, EXTRA HEAVY DUTY, EXTRA WIDE, WITH WEIGHT CAPACITY GREATER THAN            BR
dme   E0303   HOSPITAL BED, HEAVY DUTY, EXTRA WIDE, WITH WEIGHT CAPACITY GREATER THAN 350              BR
dme   E0304   HOSPITAL BED, EXTRA HEAVY DUTY, EXTRA WIDE, WITH WEIGHT CAPACITY GREATER THAN            BR
dme   E0305   BED SIDE RAILS, HALF LENGTH                                                          $200.75
dme   E0310   BED SIDE RAILS, FULL LENGTH                                                          $166.92
dme   E0315   BED ACCESSORY: BOARD, TABLE, OR SUPPORT DEVICE, ANY TYPE                                 BR
dme   E0316   SAFETY ENCLOSURE FRAME/CANOPY FOR USE WITH HOSPITAL BED, ANY TYPE                        BR
dme   E0325   URINAL; MALE, JUG-TYPE, ANY MATERIAL                                                   $8.58
dme   E0326   URINAL; FEMALE, JUG-TYPE, ANY MATERIAL                                                 $9.21
dme   E0328   HOSPITAL BED, PEDIATRIC, MANUAL, 360 DEGREE SIDE ENCLOSURES, TOP OF HEADBOARD, F         BR
dme   E0329   HOSPITAL BED, PEDIATRIC, ELECTRIC OR SEMI-ELECTRIC, 360 DEGREE SIDE ENCLOSURES,          BR
dme   E0350   CONTROL UNIT FOR ELECTRONIC BOWEL IRRIGATION/EVACUATION SYSTEM                           BR
dme   E0352   DISPOSABLE PACK (WATER RESERVOIR BAG, SPECULUM, VALVING MECHANISM AND                    BR
dme   E0370   AIR PRESSURE ELEVATOR FOR HEEL                                                        $24.52
dme   E0371   NONPOWERED ADVANCED PRESSURE REDUCING OVERLAY FOR MATTRESS, STANDARD MATTRESS            BR
dme   E0372   POWERED AIR OVERLAY FOR MATTRESS, STANDARD MATTRESS LENGTH AND WIDTH                      BR
dme   E0373   NONPOWERED ADVANCED PRESSURE REDUCING MATTRESS                                            BR
dme   E0424   STATIONARY COMPRESSED GASEOUS OXYGEN SYSTEM, RENTAL; INCLUDES CONTAINER,                  BR
dme   E0425   STATIONARY COMPRESSED GAS SYSTEM, PURCHASE; INCLUDES REGULATOR, FLOWMETER,                BR
dme   E0430   PORTABLE GASEOUS OXYGEN SYSTEM, PURCHASE; INCLUDES REGULATOR, FLOWMETER,                  BR
dme   E0431   PORTABLE GASEOUS OXYGEN SYSTEM, RENTAL; INCLUDES PORTABLE CONTAINER, REGULATOR,           BR
dme   E0433   PORTABLE LIQUID OXYGEN SYSTEM, RENTAL; HOME LIQUEFIER USED TO FILL PORTABLE               BR
dme   E0434   PORTABLE LIQUID OXYGEN SYSTEM, RENTAL; INCLUDES PORTABLE CONTAINER, SUPPLY                BR
dme   E0435   PORTABLE LIQUID OXYGEN SYSTEM, PURCHASE; INCLUDES PORTABLE CONTAINER, SUPPLY              BR
dme   E0439   STATIONARY LIQUID OXYGEN SYSTEM, RENTAL; INCLUDES CONTAINER, CONTENTS,                    BR
dme   E0440   STATIONARY LIQUID OXYGEN SYSTEM, PURCHASE; INCLUDES USE OF RESERVOIR, CONTENTS            BR
dme   E0441   STATIONARY OXYGEN CONTENTS, GASEOUS, 1 MONTH'S SUPPLY = 1 UNIT                         $73.58
dme   E0442   STATIONARY OXYGEN CONTENTS, LIQUID, 1 MONTH'S SUPPLY = 1 UNIT                          $73.58
dme   E0443   PORTABLE OXYGEN CONTENTS, GASEOUS, 1 MONTH'S SUPPLY = 1 UNIT                           $73.58
dme   E0444   PORTABLE OXYGEN CONTENTS, LIQUID, 1 MONTH'S SUPPLY = 1 UNIT                            $73.58
dme   E0445   OXIMETER DEVICE FOR MEASURING BLOOD OXYGEN LEVELS NON-INVASIVELY                          BR
dme   E0450   VOLUME CONTROL VENTILATOR, WITHOUT PRESSURE SUPPORT MODE, MAY INCLUDE PRESSURE     $10,881.53
dme   E0455   OXYGEN TENT, EXCLUDING CROUP OR PEDIATRIC TENTS                                        $85.50
dme   E0457   CHEST SHELL (CUIRASS)                                                                 $612.98
dme   E0459   CHEST WRAP                                                                                BR
dme   E0460   NEGATIVE PRESSURE VENTILATOR; PORTABLE OR STATIONARY                                $7,108.24
dme   E0461   VOLUME CONTROL VENTILATOR, WITHOUT PRESSURE SUPPORT MODE, MAY INCLUDE PRESSURE            BR
dme   E0462   ROCKING BED WITH OR WITHOUT SIDE RAILS                                                    BR
dme   E0463   PRESSURE SUPPORT VENTILATOR WITH VOLUME CONTROL MODE, MAY INCLUDE PRESSURE                BR
dme   E0464   PRESSURE SUPPORT VENTILATOR WITH VOLUME CONTROL MODE, MAY INCLUDE PRESSURE                BR
dme   E0470   RESPIRATORY ASSIST DEVICE, BI-LEVEL PRESSURE CAPABILITY, WITHOUT BACKUP RATE              BR
dme   E0471   RESPIRATORY ASSIST DEVICE, BI-LEVEL PRESSURE CAPABILITY, WITH BACK-UP RATE                BR
dme   E0472   RESPIRATORY ASSIST DEVICE, BI-LEVEL PRESSURE CAPABILITY, WITH BACKUP RATE                 BR
dme   E0480   PERCUSSOR, ELECTRIC OR PNEUMATIC, HOME MODEL                                          $500.92
dme   E0482   COUGH STIMULATING DEVICE, ALTERNATING POSITIVE AND NEGATIVE AIRWAY PRESSURE               BR
dme   E0483   HIGH FREQUENCY CHEST WALL OSCILLATION AIR-PULSE GENERATOR SYSTEM, (INCLUDES               BR
dme   E0484   OSCILLATORY POSITIVE EXPIRATORY PRESSURE DEVICE, NON-ELECTRIC, ANY TYPE, EACH          $36.83
dme   E0485   ORAL DEVICE/APPLIANCE USED TO REDUCE UPPER AIRWAY COLLAPSIBILITY, ADJUSTABLE OR           BR
dme   E0486   ORAL DEVICE/APPLIANCE USED TO REDUCE UPPER AIRWAY COLLAPSIBILITY, ADJUSTABLE OR           BR
dme   E0487   SPIROMETER, ELECTRONIC, INCLUDES ALL ACCESSORIES                                          BR
dme   E0500   IPPB MACHINE, ALL TYPES, WITH BUILT-IN NEBULIZATION; MANUAL OR AUTOMATIC VALVES     $1,207.37
dme   E0550   HUMIDIFIER, DURABLE FOR EXTENSIVE SUPPLEMENTAL HUMIDIFICATION DURING IPPB TREATM      $571.48
dme   E0555   HUMIDIFIER, DURABLE, GLASS OR AUTOCLAVABLE PLASTIC BOTTLE TYPE, FOR USE WITH           $19.21
dme   E0560   HUMIDIFIER, DURABLE FOR SUPPLEMENTAL HUMIDIFICATION DURING IPPB TREATMENT OR          $147.47
dme   E0561   HUMIDIFIER, NON-HEATED, USED WITH POSITIVE AIRWAY PRESSURE DEVICE                      $92.00
dme   E0562   HUMIDIFIER, HEATED, USED WITH POSITIVE AIRWAY PRESSURE DEVICE                        $258.97
dme   E0565   COMPRESSOR, AIR POWER SOURCE FOR EQUIPMENT WHICH IS NOT SELF- CONTAINED OR           $591.20
dme   E0570   NEBULIZER, WITH COMPRESSOR                                                           $205.31
dme   E0571   AEROSOL COMPRESSOR, BATTERY POWERED, FOR USE WITH SMALL VOLUME NEBULIZER                 BR
dme   E0572   AEROSOL COMPRESSOR, ADJUSTABLE PRESSURE, LIGHT DUTY FOR INTERMITTENT USE                 BR
dme   E0574   ULTRASONIC/ELECTRONIC AEROSOL GENERATOR WITH SMALL VOLUME NEBULIZER                      BR
dme   E0575   NEBULIZER, ULTRASONIC, LARGE VOLUME                                                $1,012.21
dme   E0580   NEBULIZER, DURABLE, GLASS OR AUTOCLAVABLE PLASTIC, BOTTLE TYPE, FOR USE WITH         $115.24
dme   E0585   NEBULIZER, WITH COMPRESSOR AND HEATER                                                $339.83
dme   E0600   RESPIRATORY SUCTION PUMP, HOME MODEL, PORTABLE OR STATIONARY, ELECTRIC               $482.45
dme   E0601   CONTINUOUS AIRWAY PRESSURE (CPAP) DEVICE                                           $1,273.49
dme   E0602   BREAST PUMP, MANUAL, ANY TYPE                                                         $29.45
dme   E0603   BREAST PUMP, ELECTRIC (AC AND/OR DC), ANY TYPE                                           BR
dme   E0604   BREAST PUMP, HOSPITAL GRADE, ELECTRIC (AC AND / OR DC), ANY TYPE                         BR
dme   E0605   VAPORIZER, ROOM TYPE                                                                  $24.99
dme   E0606   POSTURAL DRAINAGE BOARD                                                                  BR
dme   E0607   HOME BLOOD GLUCOSE MONITOR                                                            $66.65
dme   E0610   PACEMAKER MONITOR, SELF-CONTAINED, (CHECKS BATTERY DEPLETION, INCLUDES AUDIBLE       $237.26
dme   E0615   PACEMAKER MONITOR, SELF CONTAINED, CHECKS BATTERY DEPLETION AND OTHER PACEMAKER      $472.86
dme   E0616   IMPLANTABLE CARDIAC EVENT RECORDER WITH MEMORY, ACTIVATOR AND PROGRAMMER                 BR
dme   E0617   EXTERNAL DEFIBRILLATOR WITH INTEGRATED ELECTROCARDIOGRAM ANALYSIS                        BR
dme   E0618   APNEA MONITOR, WITHOUT RECORDING FEATURE                                                 BR
dme   E0619   APNEA MONITOR, WITH RECORDING FEATURE                                                    BR
dme   E0620   SKIN PIERCING DEVICE FOR COLLECTION OF CAPILLARY BLOOD, LASER, EACH                  $872.20
dme   E0621   SLING OR SEAT, PATIENT LIFT, CANVAS OR NYLON                                          $92.43
dme   E0625   PATIENT LIFT, BATHROOM OR TOILET, NOT OTHERWISE CLASSIFIED                               BR
dme   E0627   SEAT LIFT MECHANISM INCORPORATED INTO A COMBINATION LIFT-CHAIR MECHANISM             $329.89
dme   E0628   SEPARATE SEAT LIFT MECHANISM FOR USE WITH PATIENT OWNED FURNITURE-ELECTRIC           $329.89
dme   E0629   SEPARATE SEAT LIFT MECHANISM FOR USE WITH PATIENT OWNED FURNITURE-NON-ELECTRIC       $329.89
dme   E0630   PATIENT LIFT, HYDRAULIC OR MECHANICAL, INCLUDES ANY SEAT, SLING, STRAP(S) OR PAD   $1,148.21
dme   E0635   PATIENT LIFT, ELECTRIC WITH SEAT OR SLING                                          $1,394.90
dme   E0636   MULTIPOSITIONAL PATIENT SUPPORT SYSTEM, WITH INTEGRATED LIFT, PATIENT                    BR
dme   E0637   COMBINATION SIT TO STAND SYSTEM, ANY SIZE INCLUDING PEDIATRIC, WITH SEATLIFT FEA   $1,999.72
dme   E0638   STANDING FRAME SYSTEM, ONE POSITION (E.G. UPRIGHT, SUPINE OR PRONE STANDER), ANY     $810.89
dme   E0639   PATIENT LIFT, MOVEABLE FROM ROOM TO ROOM WITH DISASSEMBLY AND REASSEMBLY,                BR
dme   E0640   PATIENT LIFT, FIXED SYSTEM, INCLUDES ALL COMPONENTS/ACCESSORIES                          BR
dme   E0641   STANDING FRAME SYSTEM, MULTI-POSITION (E.G. THREE-WAY STANDER), ANY SIZE INCLUDI         BR
dme   E0642   STANDING FRAME SYSTEM, MOBILE (DYNAMIC STANDER), ANY SIZE INCLUDING PEDIATRIC            BR
dme   E0650   PNEUMATIC COMPRESSOR, NON-SEGMENTAL HOME MODEL                                       $718.42
dme   E0651   PNEUMATIC COMPRESSOR, SEGMENTAL HOME MODEL WITHOUT CALIBRATED GRADIENT PRESSURE      $904.88
dme   E0652   PNEUMATIC COMPRESSOR, SEGMENTAL HOME MODEL WITH CALIBRATED GRADIENT PRESSURE       $5,288.19
dme   E0655   NON-SEGMENTAL PNEUMATIC APPLIANCE FOR USE WITH PNEUMATIC COMPRESSOR, HALF ARM        $107.65
dme   E0656   SEGMENTAL PNEUMATIC APPLIANCE FOR USE WITH PNEUMATIC COMPRESSOR, TRUNK               $576.27
dme   E0657   SEGMENTAL PNEUMATIC APPLIANCE FOR USE WITH PNEUMATIC COMPRESSOR, CHEST               $541.39
dme   E0660   NON-SEGMENTAL PNEUMATIC APPLIANCE FOR USE WITH PNEUMATIC COMPRESSOR, FULL LEG        $159.26
dme   E0665   NON-SEGMENTAL PNEUMATIC APPLIANCE FOR USE WITH PNEUMATIC COMPRESSOR, FULL ARM        $136.65
dme   E0666   NON-SEGMENTAL PNEUMATIC APPLIANCE FOR USE WITH PNEUMATIC COMPRESSOR, HALF LEG        $137.73
dme   E0667   SEGMENTAL PNEUMATIC APPLIANCE FOR USE WITH PNEUMATIC COMPRESSOR, FULL LEG            $322.96
dme   E0668   SEGMENTAL PNEUMATIC APPLIANCE FOR USE WITH PNEUMATIC COMPRESSOR, FULL ARM            $440.77
dme   E0669   SEGMENTAL PNEUMATIC APPLIANCE FOR USE WITH PNEUMATIC COMPRESSOR, HALF LEG            $182.86
dme   E0671   SEGMENTAL GRADIENT PRESSURE PNEUMATIC APPLIANCE, FULL LEG                            $414.31
dme   E0672   SEGMENTAL GRADIENT PRESSURE PNEUMATIC APPLIANCE, FULL ARM                            $321.93
dme   E0673   SEGMENTAL GRADIENT PRESSURE PNEUMATIC APPLIANCE, HALF LEG                            $267.50
dme   E0675   PNEUMATIC COMPRESSION DEVICE, HIGH PRESSURE, RAPID INFLATION/DEFLATION CYCLE,            BR
dme   E0676   INTERMITTENT LIMB COMPRESSION DEVICE (INCLUDES ALL ACCESSORIES), NOT OTHERWISE S         BR
dme   E0691   ULTRAVIOLET LIGHT THERAPY SYSTEM PANEL, INCLUDES BULBS/LAMPS, TIMER AND EYE          $896.34
dme   E0692   ULTRAVIOLET LIGHT THERAPY SYSTEM PANEL, INCLUDES BULBS/LAMPS, TIMER AND EYE        $1,125.55
dme   E0693   ULTRAVIOLET LIGHT THERAPY SYSTEM PANEL, INCLUDES BULBS/LAMPS, TIMER AND EYE        $1,387.50
dme   E0694   ULTRAVIOLET MULTIDIRECTIONAL LIGHT THERAPY SYSTEM IN 6 FOOT CABINET, INCLUDES      $4,416.27
dme   E0700   SAFETY EQUIPMENT, DEVICE OR ACCESSORY, ANY TYPE                                          BR
dme   E0705   TRANSFER DEVICE, ANY TYPE, EACH                                                       $54.99
dme   E0710   RESTRAINTS, ANY TYPE (BODY, CHEST, WRIST OR ANKLE)                                       BR
dme   E0720   TRANSCUTANEOUS ELECTRICAL NERVE STIMULATION (TENS) DEVICE, TWO LEAD, LOCALIZED S     $326.45
dme   E0730   TRANSCUTANEOUS ELECTRICAL NERVE STIMULATION (TENS) DEVICE, FOUR OR MORE LEADS, F     $329.94
dme   E0731   FORM FITTING CONDUCTIVE GARMENT FOR DELIVERY OF TENS OR NMES (WITH CONDUCTIVE        $355.79
dme   E0740   INCONTINENCE TREATMENT SYSTEM, PELVIC FLOOR STIMULATOR, MONITOR, SENSOR AND/OR       $521.56
dme   E0744   NEUROMUSCULAR STIMULATOR FOR SCOLIOSIS                                             $1,043.90
dme   E0745   NEUROMUSCULAR STIMULATOR, ELECTRONIC SHOCK UNIT                                    $1,020.41
dme   E0746   ELECTROMYOGRAPHY (EMG), BIOFEEDBACK DEVICE                                               BR
dme   E0747   OSTEOGENESIS STIMULATOR, ELECTRICAL, NON-INVASIVE, OTHER THAN SPINAL               $3,906.28
dme   E0748   OSTEOGENESIS STIMULATOR, ELECTRICAL, NON-INVASIVE, SPINAL APPLICATIONS             $3,880.98
dme   E0749   OSTEOGENESIS STIMULATOR, ELECTRICAL, SURGICALLY IMPLANTED                                BR
dme   E0755   ELECTRONIC SALIVARY REFLEX STIMULATOR (INTRA-ORAL/NON-INVASIVE)                          BR
dme   E0760   OSTOGENESIS STIMULATOR, LOW INTENSITY ULTRASOUND, NON-INVASIVE                     $3,225.02
dme   E0765   FDA APPROVED NERVE STIMULATOR, WITH REPLACEABLE BATTERIES, FOR TREATMENT OF           $83.92
dme   E0769   ELECTRICAL STIMULATION OR ELECTROMAGNETIC WOUND TREATMENT DEVICE, NOT OTHERWISE          BR
dme   E0770   FUNCTIONAL ELECTRICAL STIMULATOR, TRANSCUTANEOUS STIMULATION OF NERVE AND/OR MUS         BR
dme   E0776   IV POLE                                                                              $121.38
dme   E0779   AMBULATORY INFUSION PUMP, MECHANICAL, REUSABLE, FOR INFUSION 8 HOURS OR GREATER          BR
dme   E0780   AMBULATORY INFUSION PUMP, MECHANICAL, REUSABLE, FOR INFUSION LESS THAN 8 HOURS        $10.35
dme   E0781   AMBULATORY INFUSION PUMP, SINGLE OR MULTIPLE CHANNELS, ELECTRIC OR BATTERY         $2,802.46
dme   E0782   INFUSION PUMP, IMPLANTABLE, NON-PROGRAMMABLE (INCLUDES ALL COMPONENTS, E.G.,       $4,282.68
dme   E0783   INFUSION PUMP SYSTEM, IMPLANTABLE, PROGRAMMABLE (INCLUDES ALL COMPONENTS, E.G.,    $8,166.45
dme   E0784   EXTERNAL AMBULATORY INFUSION PUMP, INSULIN                                               BR
dme   E0785   IMPLANTABLE INTRASPINAL (EPIDURAL/INTRATHECAL) CATHETER USED WITH IMPLANTABLE        $471.32
dme   E0791   PARENTERAL INFUSION PUMP, STATIONARY, SINGLE OR MULTI-CHANNEL                            BR
dme   E0830   AMBULATORY TRACTION DEVICE, ALL TYPES, EACH                                              BR
dme   E0840   TRACTION FRAME, ATTACHED TO HEADBOARD, CERVICAL TRACTION                              $73.09
dme   E0849   TRACTION EQUIPMENT, CERVICAL, FREE-STANDING STAND/FRAME, PNEUMATIC, APPLYING         $514.03
dme   E0850   TRACTION STAND, FREE STANDING, CERVICAL TRACTION                                      $89.07
dme   E0855   CERVICAL TRACTION EQUIPMENT NOT REQUIRING ADDITIONAL STAND OR FRAME                  $492.98
dme   E0856   CERVICAL TRACTION DEVICE, CERVICAL COLLAR WITH INFLATABLE AIR BLADDER                $153.64
dme   E0860   TRACTION EQUIPMENT, OVERDOOR, CERVICAL                                                $37.69
dme   E0870   TRACTION FRAME, ATTACHED TO FOOTBOARD, EXTREMITY TRACTION, (E.G. BUCK'S)             $116.02
dme   E0880   TRACTION STAND, FREE STANDING, EXTREMITY TRACTION, (E.G., BUCK'S)                    $117.09
dme   E0890   TRACTION FRAME, ATTACHED TO FOOTBOARD, PELVIC TRACTION                               $102.10
dme   E0900   TRACTION STAND, FREE STANDING, PELVIC TRACTION, (E.G., BUCK'S)                       $108.63
dme   E0910   TRAPEZE BARS, A/K/A PATIENT HELPER, ATTACHED TO BED, WITH GRAB BAR                   $228.00
dme   E0911   TRAPEZE BAR, HEAVY DUTY, FOR PATIENT WEIGHT CAPACITY GREATER THAN 250 POUNDS, AT         BR
dme   E0912   TRAPEZE BAR, HEAVY DUTY, FOR PATIENT WEIGHT CAPACITY GREATER THAN 250 POUNDS, FR         BR
dme   E0920   FRACTURE FRAME, ATTACHED TO BED, INCLUDES WEIGHTS                                    $526.00
dme   E0930   FRACTURE FRAME, FREE STANDING, INCLUDES WEIGHTS                                      $520.87
dme   E0935   CONTINUOUS PASSIVE MOTION EXERCISE DEVICE FOR USE ON KNEE ONLY                     $6,703.80
dme   E0936   CONTINUOUS PASSIVE MOTION EXERCISE DEVICE FOR USE OTHER THAN KNEE                        BR
dme   E0940   TRAPEZE BAR, FREE STANDING, COMPLETE WITH GRAB BAR                                   $396.38
dme   E0941   GRAVITY ASSISTED TRACTION DEVICE, ANY TYPE                                           $494.87
dme   E0942   CERVICAL HEAD HARNESS/HALTER                                                          $16.82
dme   E0944   PELVIC BELT/HARNESS/BOOT                                                              $39.99
dme   E0945   EXTREMITY BELT/HARNESS                                                                $39.99
dme   E0946   FRACTURE, FRAME, DUAL WITH CROSS BARS, ATTACHED TO BED, (E.G. BALKEN, 4 POSTER)      $674.42
dme   E0947   FRACTURE FRAME, ATTACHMENTS FOR COMPLEX PELVIC TRACTION                              $604.94
dme   E0948   FRACTURE FRAME, ATTACHMENTS FOR COMPLEX CERVICAL TRACTION                            $585.12
dme   E0950   WHEELCHAIR ACCESSORY, TRAY, EACH                                                      $76.97
dme   E0951   HEEL LOOP/HOLDER, ANY TYPE, WITH OR WITHOUT ANKLE STRAP, EACH                         $16.32
dme   E0952   TOE LOOP/HOLDER, ANY TYPE, EACH                                                       $14.78
dme   E0955   WHEELCHAIR ACCESSORY, HEADREST, CUSHIONED, ANY TYPE, INCLUDING FIXED MOUNTING        $173.82
dme   E0956   WHEELCHAIR ACCESSORY, LATERAL TRUNK OR HIP SUPPORT, ANY TYPE, INCLUDING FIXED         $84.75
dme   E0957   WHEELCHAIR ACCESSORY, MEDIAL THIGH SUPPORT, ANY TYPE, INCLUDING FIXED MOUNTING       $118.59
dme   E0958   MANUAL WHEELCHAIR ACCESSORY, ONE-ARM DRIVE ATTACHMENT, EACH                          $497.38
dme   E0959   MANUAL WHEELCHAIR ACCESSORY, ADAPTER FOR AMPUTEE, EACH                                $37.49
dme   E0960   WHEELCHAIR ACCESSORY, SHOULDER HARNESS/STRAPS OR CHEST STRAP, INCLUDING ANY          $78.22
dme   E0961   MANUAL WHEELCHAIR ACCESSORY, WHEEL LOCK BRAKE EXTENSION (HANDLE), EACH               $29.67
dme   E0966   MANUAL WHEELCHAIR ACCESSORY, HEADREST EXTENSION, EACH                                $71.19
dme   E0967   MANUAL WHEELCHAIR ACCESSORY, HAND RIM WITH PROJECTIONS, ANY TYPE, EACH               $64.43
dme   E0968   COMMODE SEAT, WHEELCHAIR                                                            $204.17
dme   E0969   NARROWING DEVICE, WHEELCHAIR                                                        $156.24
dme   E0970   NO.2 FOOTPLATES, EXCEPT FOR ELEVATING LEG REST                                       $45.26
dme   E0971   MANUAL WHEELCHAIR ACCESSORY, ANTI-TIPPING DEVICE, EACH                               $43.28
dme   E0973   WHEELCHAIR ACCESSORY, ADJUSTABLE HEIGHT, DETACHABLE ARMREST, COMPLETE ASSEMBLY,      $98.85
dme   E0974   MANUAL WHEELCHAIR ACCESSORY, ANTI-ROLLBACK DEVICE, EACH                              $66.48
dme   E0978   WHEELCHAIR ACCESSORY, POSITIONING BELT/SAFETY BELT/PELVIC STRAP, EACH                $33.53
dme   E0980   SAFETY VEST, WHEELCHAIR                                                              $28.03
dme   E0981   WHEELCHAIR ACCESSORY, SEAT UPHOLSTERY, REPLACEMENT ONLY, EACH                        $38.01
dme   E0982   WHEELCHAIR ACCESSORY, BACK UPHOLSTERY, REPLACEMENT ONLY, EACH                        $37.66
dme   E0983   MANUAL WHEELCHAIR ACCESSORY, POWER ADD-ON TO CONVERT MANUAL WHEELCHAIR TO               BR
dme   E0984   MANUAL WHEELCHAIR ACCESSORY, POWER ADD-ON TO CONVERT MANUAL WHEELCHAIR TO         $1,905.80
dme   E0985   WHEELCHAIR ACCESSORY, SEAT LIFT MECHANISM                                           $202.34
dme   E0986   MANUAL WHEELCHAIR ACCESSORY, PUSH ACTIVATED POWER ASSIST, EACH                    $4,852.08
dme   E0990   WHEELCHAIR ACCESSORY, ELEVATING LEG REST, COMPLETE ASSEMBLY, EACH                   $100.96
dme   E0992   MANUAL WHEELCHAIR ACCESSORY, SOLID SEAT INSERT                                       $94.91
dme   E0994   ARM REST, EACH                                                                       $17.58
dme   E0995   WHEELCHAIR ACCESSORY, CALF REST/PAD, EACH                                            $25.61
dme   E1002   WHEELCHAIR ACCESSORY, POWER SEATING SYSTEM, TILT ONLY                             $3,484.75
dme   E1003   WHEELCHAIR ACCESSORY, POWER SEATING SYSTEM, RECLINE ONLY, WITHOUT SHEAR           $3,775.42
dme   E1004   WHEELCHAIR ACCESSORY, POWER SEATING SYSTEM, RECLINE ONLY, WITH MECHANICAL SHEAR   $4,186.17
dme   E1005   WHEELCHAIR ACCESSORY, POWER SEATNG SYSTEM, RECLINE ONLY, WITH POWER SHEAR         $4,531.20
dme   E1006   WHEELCHAIR ACCESSORY, POWER SEATING SYSTEM, COMBINATION TILT AND RECLINE,         $5,550.29
dme   E1007   WHEELCHAIR ACCESSORY, POWER SEATING SYSTEM, COMBINATION TILT AND RECLINE, WITH    $7,515.31
dme   E1008   WHEELCHAIR ACCESSORY, POWER SEATING SYSTEM, COMBINATION TILT AND RECLINE, WITH    $7,515.98
dme   E1009   WHEELCHAIR ACCESSORY, ADDITION TO POWER SEATING SYSTEM, MECHANICALLY LINKED LEG         BR
dme   E1010   WHEELCHAIR ACCESSORY, ADDITION TO POWER SEATING SYSTEM, POWER LEG ELEVATION         $983.37
dme   E1011   MODIFICATION TO PEDIATRIC SIZE WHEELCHAIR, WIDTH ADJUSTMENT PACKAGE (NOT TO BE          BR
dme   E1014   RECLINING BACK, ADDITION TO PEDIATRIC SIZE WHEELCHAIR                               $364.23
dme   E1015   SHOCK ABSORBER FOR MANUAL WHEELCHAIR, EACH                                          $114.42
dme   E1016   SHOCK ABSORBER FOR POWER WHEELCHAIR, EACH                                           $112.90
dme   E1017   HEAVY DUTY SHOCK ABSORBER FOR HEAVY DUTY OR EXTRA HEAVY DUTY MANUAL WHEELCHAIR,         BR
dme   E1018   HEAVY DUTY SHOCK ABSORBER FOR HEAVY DUTY OR EXTRA HEAVY DUTY POWER WHEELCHAIR,          BR
dme   E1020   RESIDUAL LIMB SUPPORT SYSTEM FOR WHEELCHAIR                                         $209.28
dme   E1028   WHEELCHAIR ACCESSORY, MANUAL SWINGAWAY, RETRACTABLE OR REMOVABLE MOUNTING           $177.57
dme   E1029   WHEELCHAIR ACCESSORY, VENTILATOR TRAY, FIXED                                        $317.71
dme   E1030   WHEELCHAIR ACCESSORY, VENTILATOR TRAY, GIMBALED                                    $1,001.84
dme   E1031   ROLLABOUT CHAIR, ANY AND ALL TYPES WITH CASTORS 5 OR GREATER                         $572.85
dme   E1035   MULTI-POSITIONAL PATIENT TRANSFER SYSTEM, WITH INTEGRATED SEAT, OPERATED BY CARE         BR
dme   E1036   MULTI-POSITIONAL PATIENT TRANSFER SYSTEM, EXTRA-WIDE, WITH INTEGRATED SEAT,              BR
dme   E1037   TRANSPORT CHAIR, PEDIATRIC SIZE                                                          BR
dme   E1038   TRANSPORT CHAIR, ADULT SIZE, PATIENT WEIGHT CAPACITY UP TO AND INCLUDING 300 POU         BR
dme   E1039   TRANSPORT CHAIR, ADULT SIZE, HEAVY DUTY, PATIENT WEIGHT CAPACITY GREATER THAN 30         BR
dme   E1050   FULLY-RECLINING WHEELCHAIR, FIXED FULL LENGTH ARMS, SWING AWAY DETACHABLE ELEVAT   $1,160.98
dme   E1060   FULLY-RECLINING WHEELCHAIR, DETACHABLE ARMS, DESK OR FULL LENGTH, SWING AWAY       $1,437.20
dme   E1070   FULLY-RECLINING WHEELCHAIR, DETACHABLE ARMS (DESK OR FULL LENGTH) SWING AWAY       $1,248.64
dme   E1083   HEMI-WHEELCHAIR, FIXED FULL LENGTH ARMS, SWING AWAY DETACHABLE ELEVATING LEG         $763.00
dme   E1084   HEMI-WHEELCHAIR, DETACHABLE ARMS DESK OR FULL LENGTH ARMS, SWING AWAY              $1,118.34
dme   E1085   HEMI-WHEELCHAIR, FIXED FULL LENGTH ARMS, SWING AWAY DETACHABLE FOOT RESTS            $545.46
dme   E1086   HEMI-WHEELCHAIR DETACHABLE ARMS DESK OR FULL LENGTH, SWING AWAY DETACHABLE           $677.35
dme   E1087   HIGH STRENGTH LIGHTWEIGHT WHEELCHAIR, FIXED FULL LENGTH ARMS, SWING AWAY           $1,225.84
dme   E1088   HIGH STRENGTH LIGHTWEIGHT WHEELCHAIR, DETACHABLE ARMS DESK OR FULL LENGTH,         $1,628.60
dme   E1089   HIGH STRENGTH LIGHTWEIGHT WHEELCHAIR, FIXED LENGTH ARMS, SWING AWAY DETACHABLE       $851.96
dme   E1090   HIGH STRENGTH LIGHTWEIGHT WHEELCHAIR, DETACHABLE ARMS DESK OR FULL LENGTH,           $865.45
dme   E1092   WIDE HEAVY DUTY WHEEL CHAIR, DETACHABLE ARMS (DESK OR FULL LENGTH), SWING AWAY     $1,465.01
dme   E1093   WIDE HEAVY DUTY WHEELCHAIR, DETACHABLE ARMS DESK OR FULL LENGTH ARMS, SWING        $1,259.93
dme   E1100   SEMI-RECLINING WHEELCHAIR, FIXED FULL LENGTH ARMS, SWING AWAY DETACHABLE ELEVATI   $1,088.93
dme   E1110   SEMI-RECLINING WHEELCHAIR, DETACHABLE ARMS (DESK OR FULL LENGTH) ELEVATING LEG     $1,088.93
dme   E1130   STANDARD WHEELCHAIR, FIXED FULL LENGTH ARMS, FIXED OR SWING AWAY DETACHABLE FOOT     $364.09
dme   E1140   WHEELCHAIR, DETACHABLE ARMS, DESK OR FULL LENGTH, SWING AWAY DETACHABLE              $692.08
dme   E1150   WHEELCHAIR, DETACHABLE ARMS, DESK OR FULL LENGTH SWING AWAY DETACHABLE               $930.01
dme   E1160   WHEELCHAIR, FIXED FULL LENGTH ARMS, SWING AWAY DETACHABLE ELEVATING LEGRESTS         $712.50
dme   E1161   MANUAL ADULT SIZE WHEELCHAIR, INCLUDES TILT IN SPACE                               $2,360.17
dme   E1170   AMPUTEE WHEELCHAIR, FIXED FULL LENGTH ARMS, SWING AWAY DETACHABLE ELEVATING LEGR   $1,018.13
dme   E1171   AMPUTEE WHEELCHAIR, FIXED FULL LENGTH ARMS, WITHOUT FOOTRESTS OR LEGREST             $913.71
dme   E1172   AMPUTEE WHEELCHAIR, DETACHABLE ARMS (DESK OR FULL LENGTH) WITHOUT FOOTRESTS OR     $1,116.63
dme   E1180   AMPUTEE WHEELCHAIR, DETACHABLE ARMS (DESK OR FULL LENGTH) SWING AWAY DETACHABLE    $1,155.28
dme   E1190   AMPUTEE WHEELCHAIR, DETACHABLE ARMS (DESK OR FULL LENGTH) SWING AWAY DETACHABLE    $1,334.60
dme   E1195   HEAVY DUTY WHEELCHAIR, FIXED FULL LENGTH ARMS, SWING AWAY DETACHABLE ELEVATING     $1,432.18
dme   E1200   AMPUTEE WHEELCHAIR, FIXED FULL LENGTH ARMS, SWING AWAY DETACHABLE FOOTREST           $991.91
dme   E1220   WHEELCHAIR; SPECIALLY SIZED OR CONSTRUCTED, (INDICATE BRAND NAME, MODEL NUMBER,          BR
dme   E1221   WHEELCHAIR WITH FIXED ARM, FOOTRESTS                                                 $541.61
dme   E1222   WHEELCHAIR WITH FIXED ARM, ELEVATING LEGRESTS                                        $753.08
dme   E1223   WHEELCHAIR WITH DETACHABLE ARMS, FOOTRESTS                                               BR
dme   E1224   WHEELCHAIR WITH DETACHABLE ARMS, ELEVATING LEGRESTS                                      BR
dme   E1225   WHEELCHAIR ACCESSORY, MANUAL SEMI-RECLINING BACK, (RECLINE GREATER THAN 15               BR
dme   E1226   WHEELCHAIR ACCESSORY, MANUAL FULLY RECLINING BACK, (RECLINE GREATER THAN 80          $462.64
dme   E1227   SPECIAL HEIGHT ARMS FOR WHEELCHAIR                                                   $235.29
dme   E1228   SPECIAL BACK HEIGHT FOR WHEELCHAIR                                                       BR
dme   E1229   WHEELCHAIR, PEDIATRIC SIZE, NOT OTHERWISE SPECIFIED                                      BR
dme   E1230   POWER OPERATED VEHICLE (THREE OR FOUR WHEEL NONHIGHWAY) SPECIFY BRAND NAME AND     $2,256.14
dme   E1231   WHEELCHAIR, PEDIATRIC SIZE, TILT-IN-SPACE, RIGID, ADJUSTABLE, WITH SEATING               BR
dme   E1232   WHEELCHAIR, PEDIATRIC SIZE, TILT-IN-SPACE, FOLDING, ADJUSTABLE, WITH SEATING       $2,133.06
dme   E1233   WHEELCHAIR, PEDIATRIC SIZE, TILT-IN-SPACE, RIGID, ADJUSTABLE, WITHOUT SEATING      $2,210.19
dme   E1234   WHEELCHAIR, PEDIATRIC SIZE, TILT-IN-SPACE, FOLDING, ADJUSTABLE, WITHOUT SEATING    $1,924.13
dme   E1235   WHEELCHAIR, PEDIATRIC SIZE, RIGID, ADJUSTABLE, WITH SEATING SYSTEM                 $1,852.79
dme   E1236   WHEELCHAIR, PEDIATRIC SIZE, FOLDING, ADJUSTABLE, WITH SEATING SYSTEM               $1,634.64
dme   E1237   WHEELCHAIR, PEDIATRIC SIZE, RIGID, ADJUSTABLE, WITHOUT SEATING SYSTEM              $1,648.92
dme   E1238   WHEELCHAIR, PEDIATRIC SIZE, FOLDING, ADJUSTABLE, WITHOUT SEATING SYSTEM            $1,634.64
dme   E1239   POWER WHEELCHAIR, PEDIATRIC SIZE, NOT OTHERWISE SPECIFIED                                BR
dme   E1240   LIGHTWEIGHT WHEELCHAIR, DETACHABLE ARMS, (DESK OR FULL LENGTH) SWING AWAY DETACH   $1,124.84
dme   E1250   LIGHTWEIGHT WHEELCHAIR, FIXED FULL LENGTH ARMS, SWING AWAY DETACHABLE FOOTREST       $611.65
dme   E1260   LIGHTWEIGHT WHEELCHAIR, DETACHABLE ARMS (DESK OR FULL LENGTH) SWING AWAY             $851.96
dme   E1270   LIGHTWEIGHT WHEELCHAIR, FIXED FULL LENGTH ARMS, SWING AWAY DETACHABLE ELEVATING      $846.68
dme   E1280   HEAVY DUTY WHEELCHAIR, DETACHABLE ARMS (DESK OR FULL LENGTH) ELEVATING LEGRESTS    $1,496.36
dme   E1285   HEAVY DUTY WHEELCHAIR, FIXED FULL LENGTH ARMS, SWING AWAY DETACHABLE FOOTREST      $1,326.75
dme   E1290   HEAVY DUTY WHEELCHAIR, DETACHABLE ARMS (DESK OR FULL LENGTH) SWING AWAY                  BR
dme   E1295   HEAVY DUTY WHEELCHAIR, FIXED FULL LENGTH ARMS, ELEVATING LEGREST                   $1,384.76
dme   E1296   SPECIAL WHEELCHAIR SEAT HEIGHT FROM FLOOR                                            $416.87
dme   E1297   SPECIAL WHEELCHAIR SEAT DEPTH, BY UPHOLSTERY                                         $104.35
dme   E1298   SPECIAL WHEELCHAIR SEAT DEPTH AND/OR WIDTH, BY CONSTRUCTION                          $422.59
dme   E1300   WHIRLPOOL, PORTABLE (OVERTUB TYPE)                                                       BR
dme   E1310   WHIRLPOOL, NON-PORTABLE (BUILT-IN TYPE)                                            $1,820.72
dme   E1353   REGULATOR                                                                             $28.26
dme   E1354   OXYGEN ACCESSORY, WHEELED CART FOR PORTABLE CYLINDER OR PORTABLE CONCENTRATOR, A         BR
dme   E1355   STAND/RACK                                                                            $21.28
dme   E1356   OXYGEN ACCESSORY, BATTERY PACK/CARTRIDGE FOR PORTABLE CONCENTRATOR, ANY TYPE, RE         BR
dme   E1357   OXYGEN ACCESSORY, BATTERY CHARGER FOR PORTABLE CONCENTRATOR, ANY TYPE, REPLACEME         BR
dme   E1358   OXYGEN ACCESSORY, DC POWER ADAPTER FOR PORTABLE CONCENTRATOR, ANY TYPE, REPLACEM         BR
dme   E1372   IMMERSION EXTERNAL HEATER FOR NEBULIZER                                              $138.23
dme   E1390   OXYGEN CONCENTRATOR, SINGLE DELIVERY PORT, CAPABLE OF DELIVERING 85 PERCENT OR           BR
dme   E1391   OXYGEN CONCENTRATOR, DUAL DELIVERY PORT, CAPABLE OF DELIVERING 85 PERCENT OR             BR
dme   E1392   PORTABLE OXYGEN CONCENTRATOR, RENTAL                                                     BR
dme   E1399   DURABLE MEDICAL EQUIPMENT, MISCELLANEOUS                                                 BR
dme   E1405   OXYGEN AND WATER VAPOR ENRICHING SYSTEM WITH HEATED DELIVERY                       $2,556.91
dme   E1406   OXYGEN AND WATER VAPOR ENRICHING SYSTEM WITHOUT HEATED DELIVERY                    $2,422.39
dme   E1500   CENTRIFUGE, FOR DIALYSIS                                                               BR
dme   E1510   KIDNEY, DIALYSATE DELIVERY SYST. KIDNEY MACHINE, PUMP RECIRCULAT- ING, AIR REMOV       BR
dme   E1520   HEPARIN INFUSION PUMP FOR HEMODIALYSIS                                                 BR
dme   E1530   AIR BUBBLE DETECTOR FOR HEMODIALYSIS, EACH, REPLACEMENT                                BR
dme   E1540   PRESSURE ALARM FOR HEMODIALYSIS, EACH, REPLACEMENT                                     BR
dme   E1550   BATH CONDUCTIVITY METER FOR HEMODIALYSIS, EACH                                         BR
dme   E1560   BLOOD LEAK DETECTOR FOR HEMODIALYSIS, EACH, REPLACEMENT                                BR
dme   E1570   ADJUSTABLE CHAIR, FOR ESRD PATIENTS                                                    BR
dme   E1575   TRANSDUCER PROTECTORS/FLUID BARRIERS, FOR HEMODIALYSIS, ANY SIZE, PER 10               BR
dme   E1580   UNIPUNCTURE CONTROL SYSTEM FOR HEMODIALYSIS                                            BR
dme   E1590   HEMODIALYSIS MACHINE                                                                   BR
dme   E1592   AUTOMATIC INTERMITTENT PERITIONEAL DIALYSIS SYSTEM                                     BR
dme   E1594   CYCLER DIALYSIS MACHINE FOR PERITONEAL DIALYSIS                                        BR
dme   E1600   DELIVERY AND/OR INSTALLATION CHARGES FOR HEMODIALYSIS EQUIPMENT                        BR
dme   E1610   REVERSE OSMOSIS WATER PURIFICATION SYSTEM, FOR HEMODIALYSIS                            BR
dme   E1615   DEIONIZER WATER PURIFICATION SYSTEM, FOR HEMODIALYSIS                                  BR
dme   E1620   BLOOD PUMP FOR HEMODIALYSIS, REPLACEMENT                                               BR
dme   E1625   WATER SOFTENING SYSTEM, FOR HEMODIALYSIS                                               BR
dme   E1630   RECIPROCATING PERITONEAL DIALYSIS SYSTEM                                               BR
dme   E1632   WEARABLE ARTIFICIAL KIDNEY, EACH                                                       BR
dme   E1634   PERITONEAL DIALYSIS CLAMPS, EACH                                                       BR
dme   E1635   COMPACT (PORTABLE) TRAVEL HEMODIALYZER SYSTEM                                          BR
dme   E1636   SORBENT CARTRIDGES, FOR HEMODIALYSIS, PER 10                                           BR
dme   E1637   HEMOSTATS, EACH                                                                        BR
dme   E1639   SCALE, EACH                                                                            BR
dme   E1699   DIALYSIS EQUIPMENT, NOT OTHERWISE SPECIFIED                                            BR
dme   E1700   JAW MOTION REHABILITATION SYSTEM                                                   $343.98
dme   E1701   REPLACEMENT CUSHIONS FOR JAW MOTION REHABILITATION SYSTEM, PKG. OF 6                $10.58
dme   E1702   REPLACEMENT MEASURING SCALES FOR JAW MOTION REHABILITATION SYSTEM, PKG. OF 200      $22.51
dme   E1800   DYNAMIC ADJUSTABLE ELBOW EXTENSION/FLEXION DEVICE, INCLUDES SOFT INTERFACE MATER       BR
dme   E1801   STATIC PROGRESSIVE STRETCH ELBOW DEVICE, EXTENSION AND/OR FLEXION, WITH OR WITH        BR
dme   E1802   DYNAMIC ADJUSTABLE FOREARM PRONATION/SUPINATION DEVICE, INCLUDES SOFT INTERFACE        BR
dme   E1805   DYNAMIC ADJUSTABLE WRIST EXTENSION / FLEXION DEVICE, INCLUDES SOFT INTERFACE           BR
dme   E1806   STATIC PROGRESSIVE STRETCH WRIST DEVICE, FLEXION AND/OR EXTENSION, WITH OR WITHO       BR
dme   E1810   DYNAMIC ADJUSTABLE KNEE EXTENSION / FLEXION DEVICE, INCLUDES SOFT INTERFACE            BR
dme   E1811   STATIC PROGRESSIVE STRETCH KNEE DEVICE, EXTENSION AND/OR FLEXION, WITH OR WITHO        BR
dme   E1812   DYNAMIC KNEE, EXTENSION/FLEXION DEVICE WITH ACTIVE RESISTANCE CONTROL                  BR
dme   E1815   DYNAMIC ADJUSTABLE ANKLE EXTENSION/FLEXION DEVICE, INCLUDES SOFT INTERFACE             BR
dme   E1816   STATIC PROGRESSIVE STRETCH ANKLE DEVICE, FLEXION AND/OR EXTENSION, WITH OR WITHO       BR
dme   E1818   STATIC PROGRESSIVE STRETCH FOREARM PRONATION / SUPINATION DEVICE, WITH OR WITHOU       BR
dme   E1820   REPLACEMENT SOFT INTERFACE MATERIAL, DYNAMIC ADJUSTABLE EXTENSION/FLEXION DEVICE      $76.92
dme   E1821   REPLACEMENT SOFT INTERFACE MATERIAL/CUFFS FOR BI-DIRECTIONAL STATIC PROGRESSIVE      $104.98
dme   E1825   DYNAMIC ADJUSTABLE FINGER EXTENSION/FLEXION DEVICE, INCLUDES SOFT INTERFACE              BR
dme   E1830   DYNAMIC ADJUSTABLE TOE EXTENSION/FLEXION DEVICE, INCLUDES SOFT INTERFACE                 BR
dme   E1840   DYNAMIC ADJUSTABLE SHOULDER FLEXION / ABDUCTION / ROTATION DEVICE, INCLUDES              BR
dme   E1841   STATIC PROGRESSIVE STRETCH SHOULDER DEVICE, WITH OR WITHOUT RANGE OF MOTION ADJU         BR
dme   E1902   COMMUNICATION BOARD, NON-ELECTRONIC AUGMENTATIVE OR ALTERNATIVE COMMUNICATION            BR
dme   E2000   GASTRIC SUCTION PUMP, HOME MODEL, PORTABLE OR STATIONARY, ELECTRIC                       BR
dme   E2100   BLOOD GLUCOSE MONITOR WITH INTEGRATED VOICE SYNTHESIZER                              $641.58
dme   E2101   BLOOD GLUCOSE MONITOR WITH INTEGRATED LANCING/BLOOD SAMPLE                           $188.09
dme   E2120   PULSE GENERATOR SYSTEM FOR TYMPANIC TREATMENT OF INNER EAR ENDOLYMPHATIC FLUID           BR
dme   E2201   MANUAL WHEELCHAIR ACCESSORY, NONSTANDARD SEAT FRAME, WIDTH GREATER THAN OR EQUAL     $372.17
dme   E2202   MANUAL WHEELCHAIR ACCESSORY, NONSTANDARD SEAT FRAME WIDTH, 24-27 INCHES              $472.80
dme   E2203   MANUAL WHEELCHAIR ACCESSORY, NONSTANDARD SEAT FRAME DEPTH, 20 TO LESS THAN 22        $477.85
dme   E2204   MANUAL WHEELCHAIR ACCESSORY, NONSTANDARD SEAT FRAME DEPTH, 22 TO 25 INCHES           $811.37
dme   E2205   MANUAL WHEELCHAIR ACCESSORY, HANDRIM WITHOUT PROJECTIONS (INCLUDES ERGONOMIC OR       $32.02
dme   E2206   MANUAL WHEELCHAIR ACCESSORY, WHEEL LOCK ASSEMBLY, COMPLETE, EACH                      $39.91
dme   E2207   WHEELCHAIR ACCESSORY, CRUTCH AND CANE HOLDER, EACH                                    $42.51
dme   E2208   WHEELCHAIR ACCESSORY, CYLINDER TANK CARRIER, EACH                                    $100.42
dme   E2209   ACCESSORY, ARM TROUGH, WITH OR WITHOUT HAND SUPPORT, EACH                             $90.61
dme   E2210   WHEELCHAIR ACCESSORY, BEARINGS, ANY TYPE, REPLACEMENT ONLY, EACH                       $5.63
dme   E2211   MANUAL WHEELCHAIR ACCESSORY, PNEUMATIC PROPULSION TIRE, ANY SIZE, EACH                $34.69
dme   E2212   MANUAL WHEELCHAIR ACCESSORY, TUBE FOR PNEUMATIC PROPULSION TIRE, ANY SIZE, EACH        $5.77
dme   E2213   MANUAL WHEELCHAIR ACCESSORY, INSERT FOR PNEUMATIC PROPULSION TIRE (REMOVABLE), A      $29.84
dme   E2214   MANUAL WHEELCHAIR ACCESSORY, PNEUMATIC CASTER TIRE, ANY SIZE, EACH                    $30.52
dme   E2215   MANUAL WHEELCHAIR ACCESSORY, TUBE FOR PNEUMATIC CASTER TIRE, ANY SIZE, EACH            $9.42
dme   E2216   MANUAL WHEELCHAIR ACCESSORY, FOAM FILLED PROPULSION TIRE, ANY SIZE, EACH                 BR
dme   E2217   MANUAL WHEELCHAIR ACCESSORY, FOAM FILLED CASTER TIRE, ANY SIZE, EACH                     BR
dme   E2218   MANUAL WHEELCHAIR ACCESSORY, FOAM PROPULSION TIRE, ANY SIZE, EACH                        BR
dme   E2219   MANUAL WHEELCHAIR ACCESSORY, FOAM CASTER TIRE, ANY SIZE, EACH                         $35.48
dme   E2220   MANUAL WHEELCHAIR ACCESSORY, SOLID (RUBBER/PLASTIC) PROPULSION TIRE, ANY SIZE, E      $28.45
dme   E2221   MANUAL WHEELCHAIR ACCESSORY, SOLID (RUBBER/PLASTIC) CASTER TIRE (REMOVABLE), ANY      $25.06
dme   E2222   MANUAL WHEELCHAIR ACCESSORY, SOLID (RUBBER/PLASTIC) CASTER TIRE WITH INTEGRATED       $21.00
dme   E2224   MANUAL WHEELCHAIR ACCESSORY, PROPULSION WHEEL EXCLUDES TIRE, ANY SIZE, EACH           $83.14
dme   E2225   MANUAL WHEELCHAIR ACCESSORY, CASTER WHEEL EXCLUDES TIRE, ANY SIZE, REPLACEMENT O      $17.36
dme   E2226   MANUAL WHEELCHAIR ACCESSORY, CASTER FORK, ANY SIZE, REPLACEMENT ONLY, EACH            $37.85
dme   E2227   MANUAL WHEELCHAIR ACCESSORY, GEAR REDUCTION DRIVE WHEEL, EACH                      $1,794.22
dme   E2228   MANUAL WHEELCHAIR ACCESSORY, WHEEL BRAKING SYSTEM AND LOCK, COMPLETE, EACH           $933.92
dme   E2230   MANUAL WHEELCHAIR ACCESSORY, MANUAL STANDING SYSTEM                                      BR
dme   E2231   MANUAL WHEELCHAIR ACCESSORY, SOLID SEAT SUPPORT BASE (REPLACES SLING SEAT), INCL     $153.29
dme   E2291   BACK, PLANAR, FOR PEDIATRIC SIZE WHEELCHAIR INCLUDING FIXED ATTACHING HARDWARE           BR
dme   E2292   SEAT, PLANAR, FOR PEDIATRIC SIZE WHEELCHAIR INCLUDING FIXED ATTACHING HARDWARE           BR
dme   E2293   BACK, CONTOURED, FOR PEDIATRIC SIZE WHEELCHAIR INCLUDING FIXED ATTACHING                 BR
dme   E2294   SEAT, CONTOURED, FOR PEDIATRIC SIZE WHEELCHAIR INCLUDING FIXED ATTACHING                 BR
dme   E2295   MANUAL WHEELCHAIR ACCESSORY, FOR PEDIATRIC SIZE WHEELCHAIR, DYNAMIC SEATING FRAM         BR
dme   E2300   POWER WHEELCHAIR ACCESSORY, POWER SEAT ELEVATION SYSTEM                                  BR
dme   E2301   POWER WHEELCHAIR ACCESSORY, POWER STANDING SYSTEM                                        BR
dme   E2310   POWER WHEELCHAIR ACCESSORY, ELECTRONIC CONNECTION BETWEEN WHEELCHAIR CONTROLLER    $1,006.12
dme   E2311   POWER WHEELCHAIR ACCESSORY, ELECTRONIC CONNECTION BETWEEN WHEELCHAIR CONTROLLER    $2,036.92
dme   E2312   POWER WHEELCHAIR ACCESSORY, HAND OR CHIN CONTROL INTERFACE, MINI-PROPORTIONAL RE   $1,934.33
dme   E2313   POWER WHEELCHAIR ACCESSORY, HARNESS FOR UPGRADE TO EXPANDABLE CONTROLLER, INCLUD     $307.16
dme   E2321   POWER WHEELCHAIR ACCESSORY, HAND CONTROL INTERFACE, REMOTE JOYSTICK,               $1,366.23
dme   E2322   POWER WHEELCHAIR ACCESSORY, HAND CONTROL INTERFACE, MULTIPLE MECHANICAL            $1,212.56
dme   E2323   POWER WHEELCHAIR ACCESSORY, SPECIALTY JOYSTICK HANDLE FOR HAND CONTROL                $59.46
dme   E2324   POWER WHEELCHAIR ACCESSORY, CHIN CUP FOR CHIN CONTROL INTERFACE                       $37.68
dme   E2325   POWER WHEELCHAIR ACCESSORY, SIP AND PUFF INTERFACE, NONPROPORTIONAL, INCLUDING     $1,157.94
dme   E2326   POWER WHEELCHAIR ACCESSORY, BREATH TUBE KIT FOR SIP AND PUFF INTERFACE               $298.45
dme   E2327   POWER WHEELCHAIR ACCESSORY, HEAD CONTROL INTERFACE, MECHANICAL, PROPORTIONAL,      $2,245.99
dme   E2328   POWER WHEELCHAIR ACCESSORY, HEAD CONTROL OR EXTREMITY CONTROL INTERFACE,           $4,260.33
dme   E2329   POWER WHEELCHAIR ACCESSORY, HEAD CONTROL INTERFACE, CONTACT SWITCH MECHANISM,      $1,518.43
dme   E2330   POWER WHEELCHAIR ACCESSORY, HEAD CONTROL INTERFACE, PROXIMITY SWITCH MECHANISM,    $2,942.14
dme   E2331   POWER WHEELCHAIR ACCESSORY, ATTENDANT CONTROL, PROPORTIONAL, INCLUDING ALL               BR
dme   E2340   POWER WHEELCHAIR ACCESSORY, NONSTANDARD SEAT FRAME WIDTH, 20-23 INCHES               $357.47
dme   E2341   POWER WHEELCHAIR ACCESSORY, NONSTANDARD SEAT FRAME WIDTH, 24-27 INCHES               $536.24
dme   E2342   POWER WHEELCHAIR ACCESSORY, NONSTANDARD SEAT FRAME DEPTH, 20 OR 21 INCHES            $446.86
dme   E2343   POWER WHEELCHAIR ACCESSORY, NONSTANDARD SEAT FRAME DEPTH, 22-25 INCHES               $714.99
dme   E2351   POWER WHEELCHAIR ACCESSORY, ELECTRONIC INTERFACE TO OPERATE SPEECH GENERATING        $600.65
dme   E2360   POWER WHEELCHAIR ACCESSORY, 22 NF NON-SEALED LEAD ACID BATTERY, EACH                  $95.26
dme   E2361   POWER WHEELCHAIR ACCESSORY, 22NF SEALED LEAD ACID BATTERY, EACH, (E.G. GEL           $117.91
dme   E2362   POWER WHEELCHAIR ACCESSORY, GROUP 24 NON-SEALED LEAD ACID BATTERY, EACH               $90.21
dme   E2363   POWER WHEELCHAIR ACCESSORY, GROUP 24 SEALED LEAD ACID BATTERY, EACH (E.G. GEL        $157.24
dme   E2364   POWER WHEELCHAIR ACCESSORY, U-1 NON-SEALED LEAD ACID BATTERY, EACH                    $95.26
dme   E2365   POWER WHEELCHAIR ACCESSORY, U-1 SEALED LEAD ACID BATTERY, EACH (E.G. GEL CELL,        $94.84
dme   E2366   POWER WHEELCHAIR ACCESSORY, BATTERY CHARGER, SINGLE MODE, FOR USE WITH ONLY ONE      $192.65
dme   E2367   POWER WHEELCHAIR ACCESSORY, BATTERY CHARGER, DUAL MODE, FOR USE WITH EITHER          $360.31
dme   E2368   POWER WHEELCHAIR COMPONENT, MOTOR, REPLACEMENT ONLY                                  $444.13
dme   E2369   POWER WHEELCHAIR COMPONENT, GEAR BOX, REPLACEMENT ONLY                               $386.84
dme   E2370   POWER WHEELCHAIR COMPONENT, MOTOR AND GEAR BOX COMBINATION, REPLACEMENT ONLY         $690.24
dme   E2371   POWER WHEELCHAIR ACCESSORY, GROUP 27 SEALED LEAD ACID BATTERY, (E.G. GEL CELL, A     $129.60
dme   E2372   POWER WHEELCHAIR ACCESSORY, GROUP 27 NON-SEALED LEAD ACID BATTERY, EACH                  BR
dme   E2373   POWER WHEELCHAIR ACCESSORY, HAND OR CHIN CONTROL INTERFACE, COMPACT REMOTE JOYST     $674.23
dme   E2374   POWER WHEELCHAIR ACCESSORY, HAND OR CHIN CONTROL INTERFACE, STANDARD REMOTE JOYS     $459.13
dme   E2375   POWER WHEELCHAIR ACCESSORY, NON-EXPANDABLE CONTROLLER, INCLUDING ALL RELATED ELE     $736.43
dme   E2376   POWER WHEELCHAIR ACCESSORY, EXPANDABLE CONTROLLER, INCLUDING ALL RELATED ELECTRO   $1,154.01
dme   E2377   POWER WHEELCHAIR ACCESSORY, EXPANDABLE CONTROLLER, INCLUDING ALL RELATED ELECTRO     $417.59
dme   E2381   POWER WHEELCHAIR ACCESSORY, PNEUMATIC DRIVE WHEEL TIRE, ANY SIZE, REPLACEMENT ON      $64.39
dme   E2382   POWER WHEELCHAIR ACCESSORY, TUBE FOR PNEUMATIC DRIVE WHEEL TIRE, ANY SIZE, REPLA      $17.55
dme   E2383   POWER WHEELCHAIR ACCESSORY, INSERT FOR PNEUMATIC DRIVE WHEEL TIRE (REMOVABLE), A     $128.39
dme   E2384   POWER WHEELCHAIR ACCESSORY, PNEUMATIC CASTER TIRE, ANY SIZE, REPLACEMENT ONLY, E      $68.41
dme   E2385   POWER WHEELCHAIR ACCESSORY, TUBE FOR PNEUMATIC CASTER TIRE, ANY SIZE, REPLACEMEN      $41.85
dme   E2386   POWER WHEELCHAIR ACCESSORY, FOAM FILLED DRIVE WHEEL TIRE, ANY SIZE, REPLACEMENT      $127.22
dme   E2387   POWER WHEELCHAIR ACCESSORY, FOAM FILLED CASTER TIRE, ANY SIZE, REPLACEMENT ONLY,      $54.89
dme   E2388   POWER WHEELCHAIR ACCESSORY, FOAM DRIVE WHEEL TIRE, ANY SIZE, REPLACEMENT ONLY, E      $43.32
dme   E2389   POWER WHEELCHAIR ACCESSORY, FOAM CASTER TIRE, ANY SIZE, REPLACEMENT ONLY, EACH        $23.52
dme   E2390   POWER WHEELCHAIR ACCESSORY, SOLID (RUBBER/PLASTIC) DRIVE WHEEL TIRE, ANY SIZE, R      $36.78
dme   E2391   POWER WHEELCHAIR ACCESSORY, SOLID (RUBBER/PLASTIC) CASTER TIRE (REMOVABLE), ANY       $17.62
dme   E2392   POWER WHEELCHAIR ACCESSORY, SOLID (RUBBER/PLASTIC) CASTER TIRE WITH INTEGRATED W      $46.32
dme   E2394   POWER WHEELCHAIR ACCESSORY, DRIVE WHEEL EXCLUDES TIRE, ANY SIZE, REPLACEMENT ONL      $65.99
dme   E2395   POWER WHEELCHAIR ACCESSORY, CASTER WHEEL EXCLUDES TIRE, ANY SIZE, REPLACEMENT ON      $46.90
dme   E2396   POWER WHEELCHAIR ACCESSORY, CASTER FORK, ANY SIZE, REPLACEMENT ONLY, EACH             $57.18
dme   E2397   POWER WHEELCHAIR ACCESSORY, LITHIUM-BASED BATTERY, EACH                              $413.10
dme   E2402   NEGATIVE PRESSURE WOUND THERAPY ELECTRICAL PUMP, STATIONARY OR PORTABLE                  BR
dme   E2500   SPEECH GENERATING DEVICE, DIGITIZED SPEECH, USING PRE-RECORDED MESSAGES, LESS TH     $390.08
dme   E2502   SPEECH GENERATING DEVICE, DIGITIZED SPEECH, USING PRE-RECORDED MESSAGES,           $1,192.81
dme   E2504   SPEECH GENERATING DEVICE, DIGITIZED SPEECH, USING PRE-RECORDED MESSAGES,           $1,573.48
dme   E2506   SPEECH GENERATING DEVICE, DIGITIZED SPEECH, USING PRE-RECORDED MESSAGES,           $2,307.18
dme   E2508   SPEECH GENERATING DEVICE, SYNTHESIZED SPEECH, REQUIRING MESSAGE FORMULATION BY     $3,567.67
dme   E2510   SPEECH GENERATING DEVICE, SYNTHESIZED SPEECH, PERMITTING MULTIPLE METHODS OF       $6,751.33
dme   E2511   SPEECH GENERATING SOFTWARE PROGRAM, FOR PERSONAL COMPUTER OR PERSONAL DIGITAL            BR
dme   E2512   ACCESSORY FOR SPEECH GENERATING DEVICE, MOUNTING SYSTEM                                  BR
dme   E2599   ACCESSORY FOR SPEECH GENERATING DEVICE, NOT OTHERWISE CLASSIFIED                         BR
dme   E2601   GENERAL USE WHEELCHAIR SEAT CUSHION, WIDTH LESS THAN 22 INCHES, ANY DEPTH             $52.58
dme   E2602   GENERAL USE WHEELCHAIR SEAT CUSHION, WIDTH 22 INCHES OR GREATER, ANY DEPTH           $102.66
dme   E2603   SKIN PROTECTION WHEELCHAIR SEAT CUSHION, WIDTH LESS THAN 22 INCHES, ANY DEPTH        $130.33
dme   E2604   SKIN PROTECTION WHEELCHAIR SEAT CUSHION, WIDTH 22 INCHES OR GREATER, ANY DEPTH       $161.98
dme   E2605   POSITIONING WHEELCHAIR SEAT CUSHION, WIDTH LESS THAN 22 INCHES, ANY DEPTH            $231.42
dme   E2606   POSITIONING WHEELCHAIR SEAT CUSHION, WIDTH 22 INCHES OR GREATER, ANY DEPTH           $361.04
dme   E2607   SKIN PROTECTION AND POSITIONING WHEELCHAIR SEAT CUSHION, WIDTH LESS THAN 22          $249.19
dme   E2608   SKIN PROTECTION AND POSITIONING WHEELCHAIR SEAT CUSHION, WIDTH 22 INCHES OR          $299.27
dme   E2609   CUSTOM FABRICATED WHEELCHAIR SEAT CUSHION, ANY SIZE                                      BR
dme   E2610   WHEELCHAIR SEAT CUSHION, POWERED                                                        BR
dme   E2611   GENERAL USE WHEELCHAIR BACK CUSHION, WIDTH LESS THAN 22 INCHES, ANY HEIGHT,         $268.55
dme   E2612   GENERAL USE WHEELCHAIR BACK CUSHION, WIDTH 22 INCHES OR GREATER, ANY HEIGHT,        $363.28
dme   E2613   POSITIONING WHEELCHAIR BACK CUSHION, POSTERIOR, WIDTH LESS THAN 22 INCHES, ANY      $337.92
dme   E2614   POSITIONING WHEELCHAIR BACK CUSHION, POSTERIOR, WIDTH 22 INCHES OR GREATER, ANY     $467.65
dme   E2615   POSITIONING WHEELCHAIR BACK CUSHION, POSTERIOR-LATERAL, WIDTH LESS THAN 22          $388.88
dme   E2616   POSITIONING WHEELCHAIR BACK CUSHION, POSTERIOR-LATERAL, WIDTH 22 INCHES OR          $523.22
dme   E2617   CUSTOM FABRICATED WHEELCHAIR BACK CUSHION, ANY SIZE, INCLUDING ANY TYPE                 BR
dme   E2619   REPLACEMENT COVER FOR WHEELCHAIR SEAT CUSHION OR BACK CUSHION, EACH                  $44.12
dme   E2620   POSITIONING WHEELCHAIR BACK CUSHION, PLANAR BACK WITH LATERAL SUPPORTS, WIDTH       $470.89
dme   E2621   POSITIONING WHEELCHAIR BACK CUSHION, PLANAR BACK WITH LATERAL SUPPORTS, WIDTH       $494.15
dme   E8000   GAIT TRAINER, PEDIATRIC SIZE, POSTERIOR SUPPORT, INCLUDES ALL ACCESSORIES AND           BR
dme   E8001   GAIT TRAINER, PEDIATRIC SIZE, UPRIGHT SUPPORT, INCLUDES ALL ACCESSORIES AND             BR
dme   E8002   GAIT TRAINER, PEDIATRIC SIZE, ANTERIOR SUPPORT, INCLUDES ALL ACCESSORIES AND            BR
dme   K0001   STANDARD WHEELCHAIR                                                                 $600.55
dme   K0002   STANDARD HEMI (LOW SEAT) WHEELCHAIR                                                 $932.86
dme   K0003   LIGHTWEIGHT WHEELCHAIR                                                              $894.44
dme   K0004   HIGH STRENGTH, LIGHTWEIGHT WHEELCHAIR                                             $1,523.50
dme   K0005   ULTRALIGHTWEIGHT WHEELCHAIR                                                       $1,813.29
dme   K0006   HEAVY DUTY WHEELCHAIR                                                             $1,429.67
dme   K0007   EXTRA HEAVY DUTY WHEELCHAIR                                                       $1,882.71
dme   K0009   OTHER MANUAL WHEELCHAIR/BASE                                                            BR
dme   K0010   STANDARD - WEIGHT FRAME MOTORIZED/POWER WHEELCHAIR                                $4,046.91
dme   K0011   STANDARD - WEIGHT FRAME MOTORIZED/POWER WHEELCHAIR WITH PROGRAMMABLE CONTROL      $4,670.01
dme   K0012   LIGHTWEIGHT PORTABLE MOTORIZED/POWER WHEELCHAIR                                   $2,864.73
dme   K0014   OTHER MOTORIZED/POWER WHEELCHAIR BASE                                                   BR
dme   K0015   DETACHABLE, NON-ADJUSTABLE HEIGHT ARMREST, EACH                                     $153.61
dme   K0017   DETACHABLE, ADJUSTABLE HEIGHT ARMREST, BASE, EACH                                    $43.21
dme   K0018   DETACHABLE, ADJUSTABLE HEIGHT ARMREST, UPPER PORTION, EACH                           $24.15
dme   K0019   ARM PAD, EACH                                                                        $14.82
dme   K0020   FIXED, ADJUSTABLE HEIGHT ARMREST, PAIR                                               $39.26
dme   K0037   HIGH MOUNT FLIP-UP FOOTREST, EACH                                                    $41.40
dme   K0038   LEG STRAP, EACH                                                                      $20.50
dme   K0039   LEG STRAP, H STYLE, EACH                                                             $45.56
dme   K0040   ADJUSTABLE ANGLE FOOTPLATE, EACH                                                     $63.12
dme   K0041   LARGE SIZE FOOTPLATE, EACH                                                           $44.75
dme   K0042   STANDARD SIZE FOOTPLATE, EACH                                                        $26.62
dme   K0043   FOOTREST, LOWER EXTENSION TUBE, EACH                                                 $16.51
dme   K0044   FOOTREST, UPPER HANGER BRACKET, EACH                                                 $14.07
dme   K0045   FOOTREST, COMPLETE ASSEMBLY                                                          $48.68
dme   K0046   ELEVATING LEGREST, LOWER EXTENSION TUBE, EACH                                         $16.51
dme   K0047   ELEVATING LEGREST, UPPER HANGER BRACKET, EACH                                         $64.64
dme   K0050   RATCHET ASSEMBLY                                                                      $27.47
dme   K0051   CAM RELEASE ASSEMBLY, FOOTREST OR LEGREST, EACH                                       $44.47
dme   K0052   SWINGAWAY, DETACHABLE FOOTRESTS, EACH                                                 $78.15
dme   K0053   ELEVATING FOOTRESTS, ARTICULATING (TELESCOPING), EACH                                 $86.24
dme   K0056   SEAT HEIGHT LESS THAN 17 OR EQUAL TO OR GREATER THAN 21 FOR A HIGH                    $93.28
dme   K0065   SPOKE PROTECTORS, EACH                                                                $43.61
dme   K0069   REAR WHEEL ASSEMBLY, COMPLETE, WITH SOLID TIRE, SPOKES OR MOLDED, EACH                $97.98
dme   K0070   REAR WHEEL ASSEMBLY, COMPLETE, WITH PNEUMATIC TIRE, SPOKES OR MOLDED, EACH           $179.66
dme   K0071   FRONT CASTER ASSEMBLY, COMPLETE, WITH PNEUMATIC TIRE, EACH                           $107.14
dme   K0072   FRONT CASTER ASSEMBLY, COMPLETE, WITH SEMI-PNEUMATIC TIRE, EACH                       $64.50
dme   K0073   CASTER PIN LOCK,EACH                                                                  $32.82
dme   K0077   FRONT CASTER ASSEMBLY, COMPLETE, WITH SOLID TIRE, EACH                                $57.69
dme   K0105   IV HANGER, EACH                                                                       $97.52
dme   K0108   WHEELCHAIR COMPONENT OR ACCESSORY, NOT OTHERWISE SPECIFIED                               BR
dme   K0195   ELEVATING LEG RESTS, PAIR (FOR USE WITH CAPPED RENTAL WHEELCHAIR BASE)                   BR
dme   K0455   INFUSION PUMP USED FOR UNINTERRUPTED PARENTERAL ADMINISTRATION OF MEDICATION,            BR
dme   K0462   TEMPORARY REPLACEMENT FOR PATIENT OWNED EQUIPMENT BEING REPAIRED, ANY TYPE               BR
dme   K0535   GAUZ,IMPREGNATED,HYDROGEL,FOR DIRECT WOUND CONTACT,PAD SIZE 16SQ IN OR LESS W/O          BR
dme   K0536   GAUZE,IMPREGNATED,HYDROGEL,FOR DIRECT WOULD CONTACT,PAD SIZEMORE>16SQ<48SQ IN            BR
dme   K0537   GAUZE,IMPREGNATED,HYDROGEL,FOR DIRECT WOUND CONTACT,PAD>48SQINCHES W/O ADHESIVE          BR
dme   K0552   SUPPLIES FOR EXTERNAL DRUG INFUSION PUMP, SYRINGE TYPE CARTRIDGE, STERILE, EACH        $2.60
dme   K0601   REPLACEMENT BATTERY FOR EXTERNAL INFUSION PUMP OWNED BY PATIENT, SILVER OXIDE,         $1.10
dme   K0602   REPLACEMENT BATTERY FOR EXTERNAL INFUSION PUMP OWNED BY PATIENT, SILVER OXIDE,         $6.35
dme   K0604   REPLACEMENT BATTERY FOR EXTERNAL INFUSION PUMP OWNED BY PATIENT, LITHIUM, 3.6          $6.07
dme   K0605   REPLACEMENT BATTERY FOR EXTERNAL INFUSION PUMP OWNED BY PATIENT, LITHIUM, 4.5         $14.56
dme   K0606   AUTOMATIC EXTERNAL DEFIBRILLATOR, WITH INTEGRATED ELECTROCARDIOGRAM ANALYSIS,            BR
dme   K0607   REPLACEMENT BATTERY FOR AUTOMATED EXTERNAL DEFIBRILLATOR, GARMENT TYPE ONLY,         $193.74
dme   K0608   REPLACEMENT GARMENT FOR USE WITH AUTOMATED EXTERNAL DEFIBRILLATOR, EACH              $120.91
dme   K0609   REPLACEMENT ELECTRODES FOR USE WITH AUTOMATED EXTERNAL DEFIBRILLATOR, GARMENT        $804.07
dme   K0669   WHEELCHAIR ACCESSORY, WHEELCHAIR SEAT OR BACK CUSHION, DOES NOT MEET SPECIFIC CO         BR
dme   K0672   ADDITION TO LOWER EXTREMITY ORTHOSIS, REMOVABLE SOFT INTERFACE, ALL COMPONENTS        $71.17
dme   K0730   CONTROLLED DOSE INHALATION DRUG DELIVERY SYSTEM                                    $1,719.71
dme   K0733   POWER WHEELCHAIR ACCESSORY, 12-14 AMP HOUR SEALED LEAD ACID BATTERY (E.G.GEL CEL      $25.97
dme   K0734   SKIN PROTECTION WHEELCHAIR SEAT CUSHION ADJ. WIDTH LESS THAN22 INCHES IN DEPTH       $284.98
dme   K0735   SKIN PROTECTION WHEELCHAIR SEAT CUSHION ADJ. 22 IN OR GREATYER IN. DEPTH             $362.62
dme   K0736   SKIN PROTECTION/POSITIONING WHEELCHAIR SEAT CUSHION ADJ. WIDTH LESS THAN 22 IN.      $287.32
dme   K0737   SKIN PROTECTION AND POSITIONING WHEELCHAIR SEAT CUSHION ADJ.22 IN. WIDE OR MORE      $363.73
dme   K0738   PORTABLE GASEOUS OXYTEN SYSTEM, RENTAL, HOME COMPRESSOR USEDTO FILL CYLINDERS            BR
dme   K0739   Repair or nonroutine service for durable medical equipment other than oxygen req         BR
dme   K0740   Repair or nonroutine service for oxygen equipment requiring the skill of a techn         BR
dme   K0800   POWERED OPERATED VEHICLE GRP. 1 STD PT WT UP TO AND INCL. 300 LBS                  $1,111.46
dme   K0801   POWER OPER. VEH. GRP 1 HEAVY DUTY WEIGHT CAPACITY 301 TO 450 LBS                   $1,791.91
dme   K0802   POWER OPERATED VEHICLE, GRP 1 HVY DUTY, PT. WT. CAPACITY 461TO 600 LBD             $2,027.86
dme   K0806   POWER OPERATED VEHICLE, GRP. 2 STD, PATIENT WT CAPACITY UP TO/INCL 300 LBS         $1,344.57
dme   K0807   POWER OPERATED VEHICLE GRP 2 PT WT CAP. 301 TO 450 LBS                             $2,040.23
dme   K0808   POWER VEHICLE GRP. 2 VERY HEAVY DUTY, PT. WEIGHT CAPACITY 451-600 LBS              $3,156.66
dme   K0812   POWER OPERATED VEHICLE, NOT OTHERWISE CLASSIFIED                                         BR
dme   K0813   POWER WHEELCHAIR GRP 1 STD. PORTABLE SLING/SOLID SEAT & BACKUP TO/INCL 300 LBS           BR
dme   K0814   POWER WHEELCHAIR, GRP 1 STANDARD PORTABLE CAPTAINS CHAIR - CAP. UP TO 300 LBS.           BR
dme   K0815   POWER WHEELCHAIR GRP 1, STD. SLING/SOLID SEAT & BACK CAP TO & INCL. 300 LBS              BR
dme   K0816   POWER WHEELCHAIR, GRP 1 STD. CAPTAINS CHAIR PT. WT CAP. UP TO & INCL. 300 LBS.           BR
dme   K0820   POWER WHEELCHAIR, GRP 2 STD, PORTABLE PT. WEIGHT CAP. UP TO & INCL. 300 LBS              BR
dme   K0821   POWER WHEELCHAIR, GRP 2 STD. PORTABLE, CAPTAINS CHAIR PT WT.UP TO/INCL. 300 LBS.         BR
dme   K0822   POWER WHEELCHAIR, GRP 2 STD, SLING/SOLID SEAT/BACK-PT. WT. UP TO/INCL. 300 LBS.          BR
dme   K0823   POWER WHEELCHAIR, GRP 2 STD/ CAPTAINS CHAIR, PT WEIGHT CAP UP TO/INCL 300 LBS            BR
dme   K0824   POWER WHEELCHAIR, GRP 2, HEAVY DUTY, SLING/SOLID SEAT/BACK, PT. WT. 301-450 LBS          BR
dme   K0825   POWER WHEELCHAIR, GRP. 2 HEAVY DUTY, CAPTAINS CHAIR, PT. WGTCAP. 451-600 LBS.            BR
dme   K0826   POWER WHEELCHAIR, GRP 2 VERY HEAVY DUTY, SLING/SOLID SEAT/BACK PT WT CAP 451-600         BR
dme   K0827   POWER WHEELCHAIR, GRP 2, VERY HEAVY DUTY, CAPTAINS CHAIR, PTWT. 451-600 LBS.             BR
dme   K0828   POWER WHEELCHAIR, GRP 2 EXTRA HEAVY DUTY, SLING/SOLID SEAT/BACK PT. WT. 600#             BR
dme   K0829   POWER WHEELCHAIR, GRP. 2 EXTRA HEAVY DUTY, CAPTAINS CHAIR,PTWT CAP. 601# OR MORE         BR
dme   K0830   POWER WHEELCHAIR, GRP 2,STD SEAT ELEVATOR SLING/SOLID SEAT/BACK PT. WT UP TO 300         BR
dme   K0831   POWER WHEELCHAIR, GRP 2 STD SEAT ELEVATOR, CAPTAINS CHAIR WTCAP UP TO/INCL 300#          BR
dme   K0835   POWER WHEELCHAIR, GRP 2 STD, SINGLE POWER OPTION SLING/SOLIDSEAT/BACK-300# CAP           BR
dme   K0836   POWER WHEELCHAIR, GRP 2 STD. SINGLE POWER OPTION, CAPTAINS CHAIR WT CAP 300#             BR
dme   K0837   POWER WHEELCHAIR GRP 2 HEAVY DUTY SINGLE POWER OPTION, SLING/SOLD SEAT/BACK 450#         BR
dme   K0838   POWER WHEELCHAIR, GRP 2 HVY DUTY SINGLE POWER OPTION, CAPT. CHAIR CAP 301-450#           BR
dme   K0839   POWER WHEELCHAIR GRP 2 VERY HEAVY DUTY SINGLE POWER OPTION CAP 451 TO 600 LBS            BR
dme   K0840   POWER WHEELCHAIR GRP 2 EXTRA HEAVY DUTY, SINGLE POWER OPTIONPT. WT. 601# OR MORE         BR
dme   K0841   POWER WHEELCHAIR GRP 2 STD MULTIPLE POWER OPTION SLING/SOLD SEAT/BACK CAP. 300#          BR
dme   K0842   POWER WHEELCHAIR GRP 2 STD MULTIPLE POWER OPTION CAPT. CHAIRWHT CAP 300 LBS.             BR
dme   K0843   POWER WHEELCHAIR GRP 2 HVY DUTY MULTIPLE POWER OPTION SLING/SOLID SEAT/BACK 450#         BR
dme   K0848   POWER WHEELCHAIR GRP 3 STD SLING/SOLID SEAT/BACK PT WT. CAP UP TO/INCL. 300 LBS.         BR
dme   K0849   POWER WHEELCHAIR, GRP 3 STD, CAPTAINS CHAIR PT WT UP TO AND INCL 300 LBS.                BR
dme   K0850   POWER WHEELCHAIR GRP 3 HVY DUTY SLING/DOLID SEAT/BACK PT WT CAP 301 TO 450 LBS.          BR
dme   K0851   POWER WHEELCHAIR, GRP 3 HVY DUTY, CAPTAINS CHAIR, PT. WT CAP301 TO 450 LBS.              BR
dme   K0852   POWER WHEELCHAIR, GRP 3 VERY HVY DUTY SLING/SOLID SEAT/BACK WT CAP. 451-600 LBS          BR
dme   K0853   POWER WHEELCHAIR GRP 3 VERY HVY DUTY CAPTAINS CHAIR PT WT CAP 451-600 LBS                BR
dme   K0854   POWER WHEELCHAIR, GRP 3 EX. HVY DUTY SLING/SOLID SEAR/BACK PT WT. 601# OR MORE            BR
dme   K0855   POWER WHEELCHAIR, GRP 3, EX. HVY DUTY CAPTAINS CHAIR PT WT CAP 601# OR MORE               BR
dme   K0856   POWER WHEELCHAIR, GRP 3 STD. SINGLE POWER OPTION SLING/SOLIDSEAT/BACK-CAP 300#            BR
dme   K0857   POWER WHEELCHAIR, GRP 3 STD SINGLE POWER OPTION CAPTAINS CHAIR WT CAP 300 LBS.            BR
dme   K0858   POWER WHEELCHAIR GRP 3 HVY DTY SINGLE POWER OPT. SLING/SOLIDSEAT/BACK-301-450#            BR
dme   K0859   POWER WHEELCHAIR, GRP 3 HVY DUTY SINGLE POWER OPTION CAPTAINS CHAIR WT 301-450#           BR
dme   K0860   POWER WHEELCHAIR, GRP 3 VRY HVY DUTY SINGLE POWER OPTION-SLING/SOLID-CAP 451-600          BR
dme   K0861   POWER WHEELCHAIR, GRP 3 STD. MULTI POWER OPT. SLING'SOLID SEAT;BACK - CAP 300#            BR
dme   K0862   POWER WHEELCHAIR, GRP 3 HVY DUTY MULTIPLE POWER OPTION SLING/SOLID-301-450 LBS.           BR
dme   K0863   POWR ER WHEELCHAIR, GRP 3 VRY HVY DUTY MULTI POWER OPTION - PT. WEIGHT 451-600#           BR
dme   K0864   POWER WHEELCHAIR GRP 3 EX. HVY DUTY MULTI POWER OPTION - PT WHT 601# OR MORE              BR
dme   K0868   POWER WHEELCHAIR, GRP 4 STD. SLING/SOLID SEAT/BACK - PT WT. UP TO & INCL. 300#            BR
dme   K0869   POWER WHEELCHAIR, GRP 4, STD. CAPTAINS CHAIR-PT WHT CAP UP TO & INCL. 300 LBS             BR
dme   K0870   POWER WHEELCHAIR GRP 4 HVY DUTY SLING/SOLID SEAT/BACK PT WT CAPACITY 301-450 LBS          BR
dme   K0871   POWER WHEELCHAIR, GRP 4 VERY HVY DUTY, SLING/SOLID SEAT/BACKPT WT. CAP 451-600#           BR
dme   K0877   POWER WHEELCHAIR, GRP 4 STD. SINGLE POWER OPTION, SLING/SOLID SEAT/BACK-300# CAP          BR
dme   K0878   POWER WHEELCHAIR, GRP 4 STD. SINGLE POWER OPTION, CAPT. CHAIR WT. UP TO 300#              BR
dme   K0879   POWER WHEELCHAIR, HVY DUTY, SINGLE POWER OPTION SLING/SOLID SEAT BACK 301-450#            BR
dme   K0880   POWER WHEELCHAIR GRP 4 VERY HVY DUTY, SINGLE POWER OPTION PT WT. 451-600 LBS.             BR
dme   K0884   POWER WHEELCHAIR, GRP 4 STD. MULTIPLE POWER OPTION PT WT CAP UP TO 300 LBS.               BR
dme   K0885   POWER WHEELCHAIR, GRP 4 STD MULT. POWER OPTION, CAPT. CHAI R - CAP. TO 300#               BR
dme   K0886   POWER WHEELCHAIR GRP 4 HVY DUTY MULTIPLE POWER OPTION - PT WT. CAP 301-450 LBS.           BR
dme   K0890   POWER WHEELCHAIR GRP 5 PED. SINGLE POWER OPTION SLING/SOLID SEAT/BACK-WT TO 125#          BR
dme   K0891   POWER WHEELCHAIR GRP 5 PED. MULTIPLE POWER OPTION SLING/SOLID SEAT/BACK 125# CAP          BR
dme   K0898   POWER WHEELCHAIR NOT OTHERWISE CLASSIFIED                                                 BR
dme   K0899   POWER MOBILITY DEVICE, NOT CODED BY DME PDAC OR DOES NOT MEET CRITERIA                    BR
dme   Q0036   OXYGEN CONCENTRATOR, HIGH HUMIDITY                                                        BR
dme   Q0480   DRIVER FOR USE WITH PNEUMATIC VENTRICULAR ASSIST DEVICE, REPLACEMENT ONLY          $75,762.98
dme   Q0481   MICROPROCESSOR CONTROL UNIT FOR USE WITH ELECTRIC VENTRICULAR ASSIST DEV.-REPLAC   $12,223.47
dme   Q0482   MICROPROCESSOR CONTROL UNIT FOR USE WITH ELECTRIC/PNEUMATIC COMB. VENTRICULAR AS    $3,828.62
dme   Q0483   MONITOR/DISPLAY MODULE FOR USE WITH ELECTRIC VENTRICULAR ASSIST DEVICE, REPLACEM   $15,772.20
dme   Q0484   MONITOR/DISPLAY MODULE FOR USE WITH ELEC. OR ELEC/PHEUMATIC VENTRICULAR ASSIST      $3,062.91
dme   Q0485   MONITOR CONTROL CABLE FOR USE WITH ELEC. VENTRICULAR ASSIST DEVICE, REPLACEMENT       $295.72
dme   Q0486   MONITOR CONTROL CABLE FOR USE WITH ELEC/PNEUMATIC VENTRICULAR ASSIST DEV. REPLAC      $246.14
dme   Q0487   LEADS (PHEUMTIC/ELEC) FOR USE WITH ANY TYPE ELEC/PNEUMATIC VENTRICULAR DEVICE         $287.15
dme   Q0488   POWER PACK BASE FOR USE WITH ELEC. VENTRICULAR ASSIST DEVICEREPLACEMENT ONLY              BR
dme   Q0489   POWER PACK BASE FOR USE WITH ELEC/PNEUMATIC VENTRICULAR ASSIST DEVICE, REPLACEME   $13,673.65
dme   Q0490   EMERG POWER SOURCE FOR USE WITH ELECTRIC VENTRICULAR ASSIST DEVICE, REPLACEMENT       $591.45
dme   Q0491   EMERG. POWER SOURCE FOR USE WITH ELEC/PHEUMATIC VENTRICULAR ASSIST DEVICE             $929.84
dme   Q0492   EMERG. POWER SUPPLY CABLE FOR USE WITH ELEC VENTRICULAR ASSIST DEVICE-REPLACEMEN       $74.90
dme   Q0493   EMERG. POWER SUPPLY CABLE FOR USE WITH ELEC/PHEUMONIC VENTRICULAR ASSIST DEVICE      $213.30
dme   Q0494   EMERG. HAND PUMP FOR USE WITH ELEC/PNEUMATIC VENTRICULAR ASSIST DEVICE               $180.50
dme   Q0495   BATTERY/POWER PACK CHARGER FOR USE WITH ELEC. OR ELEC/PHEUMATIC VENTRICULAR ASST   $3,513.77
dme   Q0496   BATTERY, OTHER THAN LITHIUM-ION, FOR USE WITH ELECTRIC OR ELECTRIC/PNEUMATIC VEN   $1,261.15
dme   Q0497   BATTERY CLIPS FOR USE WITH ELEC. OR ELEC./PNEUMATIC VENTRICULAR ASSIST DEVICE        $393.80
dme   Q0498   HOLSTER FOR USE WITH ELEC/PNEUMATIC VENTRICULAR ASSIST DEVICE, REPLACEMENT           $432.09
dme   Q0499   BELT/VEST FOR USE WITH ELEC. OR ELEC/PNEUMATIC VENTRICULAR ASST. DEV-REPLACEMENT     $140.39
dme   Q0500   FILTERS FOR USE WITH ELEC. OR ELEC/PNEUMATIC VENTRICULAR ASSIST DEV. REPLACEMENT      $25.69
dme   Q0501   SHOWER COVER FOR USE WITH ELEC. OR ELEC/PNEUMATIC VENTRICUL AR ASSIST DEV-REPLAC     $429.60
dme   Q0502   MOBILITY CART FOR PNEUMATIC VENTRICULAR ASSIST DEVICE-REPLACEMENT ONLY               $546.94
dme   Q0503   BATTERY FOR PNEUMATIC VENTRICULAR ASSIST DEVICE, REPLACEMENTONLY, EACH             $1,093.89
dme   Q0504   POWER ADAPTER FOR PNEUMATIC VENTRICULAR ASSIST DEVICE, REPLACEMENT ONLY, VEHICLE     $577.22
dme   Q0505   MISC. SUPPLY OR ACCESSORY FOR USE WITH VENTRICULAR ASSIST DEVICE                         BR
dme   S5035   HOME INFUSION THERAPY, ROUTINE SERVICE OF INFUSION DEVICE (E.G. PUMP                     BR
dme   S5036   HOME INFUSION THERAPY, REPAIR OF INFUSION DEVICE (E.G. PUMP REPAIR)                      BR
dme   S5160   EMERGENCY RESPONSE SYSTEM; INSTALLATION AND TESTING                                      BR
dme   S5161   EMERGENCY RESPONSE SYSTEM; SERVICE FEE, PER MONTH (EXCLUDES INSTALLATION AND             BR
dme   S8270   ENURESIS ALARM, USING AUDITORY BUZZER AND/OR VIBRATION DEVICE                            BR
FAC RATE    EFF. DATE
   $20.70   10/01/2010
   $48.99   10/01/2010
   $65.79   10/01/2010
   $45.15   10/01/2010
   $31.37   10/01/2010
   $17.92   10/01/2010
   $40.01   10/01/2010
   $23.52   10/01/2010
  $192.23   10/01/2010
   $60.38   10/01/2010
   $72.09   10/01/2010
  $310.12   10/01/2010
   $96.49   10/01/2010
  $103.37   10/01/2010
  $273.79   10/01/2010
  $494.19   10/01/2010
  $109.23   10/01/2010
  $191.90   10/01/2010
   $65.97   10/01/2010
   $60.62   10/01/2010
   $23.07   10/01/2010
   $22.71   10/01/2010
   $70.43   10/01/2010
   $23.51   10/01/2010
   $15.36   10/01/2010
   $28.03   10/01/2010
   $22.24   10/01/2010
  $123.54   10/01/2010
  $110.01   10/01/2010
  $211.81   10/01/2010
   $11.97   10/01/2010
  $150.55   10/01/2010
      BR    01/01/2006
      BR    01/01/2006
      BR    01/01/2006
   $56.15   10/01/2010
  $257.41   10/01/2010
  $298.45   10/01/2010
  $165.08   10/01/2010
  $271.20   10/01/2010
  $231.42   10/01/2010
  $255.47   10/01/2010
   $26.36   10/01/2010
   $51.83   10/01/2010
      BR    01/01/2004
    $8.47   10/01/2010
$9,628.55   10/01/2010
      BR    01/01/1991
  $314.87   10/01/2010
  $218.63   10/01/2010
  $218.63   10/01/2010
   $31.97   10/01/2010
   $67.21   10/01/2010
      BR    10/01/1982
  $164.54   10/01/2010
   $27.67   10/01/2010
   $63.97   10/01/2010
  $495.23   10/01/2010
      BR    01/01/1997
    $8.45   10/01/2010
$2,007.79   10/01/2010
  $387.68   10/01/2010
    $7.66   10/01/2010
  $196.76   10/01/2010
  $463.07   10/01/2010
   $22.91   10/01/2010
  $448.70   10/01/2010
      BR    01/01/2004
      BR    10/01/1982
      BR    03/01/1989
      BR    03/01/1989
      BR    10/01/1982
      BR    10/01/1982
      BR    03/01/1989
      BR    01/01/2004
      BR    01/01/2004
   $84.45   10/01/2010
$1,114.46   10/01/2010
  $844.51   10/01/2010
$1,339.27   10/01/2010
  $945.97   10/01/2010
$1,914.40   10/01/2010
$1,561.12   10/01/2010
$2,278.63   10/01/2010
$2,006.97   10/01/2010
      BR    03/01/1989
  $190.90   10/01/2010
  $173.98   10/01/2010
      BR    03/01/1989
      BR    10/01/1982
   $12.99   10/01/2010
   $11.28   10/01/2010
      BR    01/01/1992
   $27.92   10/01/2010
  $852.04   10/01/2010
  $576.27   10/01/2010
  $947.57   10/01/2010
  $815.21   10/01/2010
$1,489.41   10/01/2010
$1,451.79   10/01/2010
$1,591.10   10/01/2010
$1,578.44   10/01/2010
$2,440.50   10/01/2010
      BR    01/01/2004
      BR    01/01/2004
      BR    01/01/2004
      BR    01/01/2004
  $200.75   10/01/2010
  $166.92   10/01/2010
      BR    03/01/1989
      BR    01/01/2002
    $8.58   10/01/2010
    $9.21   10/01/2010
      BR    01/01/2008
      BR    01/01/2008
      BR    01/01/1995
      BR    01/01/1995
   $24.52   10/01/2010
      BR    01/01/1998
       BR    01/01/1998
       BR    01/01/1998
       BR    01/01/1993
       BR    03/01/1989
       BR    02/15/1989
       BR    01/01/1993
       BR    01/01/2010
       BR    01/01/1993
       BR    10/01/1982
       BR    01/01/1993
       BR    10/01/1982
    $73.58   10/01/2010
    $73.58   10/01/2010
    $73.58   10/01/2010
    $73.58   10/01/2010
       BR    01/01/2003
$10,881.53   10/01/2010
    $85.50   10/01/2010
   $612.98   10/01/2010
       BR    03/01/1989
 $7,108.24   10/01/2010
       BR    01/01/2003
       BR    03/01/1989
       BR    01/01/2005
       BR    01/01/2005
       BR    01/01/2004
       BR    01/01/2004
       BR    01/01/2004
   $500.92   10/01/2010
       BR    01/01/2002
       BR    01/01/2003
    $36.83   10/01/2010
       BR    01/01/2006
       BR    01/01/2006
       BR    01/01/2009
 $1,207.37   10/01/2010
   $571.48   10/01/2010
    $19.21   10/01/2010
   $147.47   10/01/2010
    $92.00   10/01/2010
  $258.97   10/01/2010
  $591.20   10/01/2010
  $205.31   10/01/2010
      BR    01/01/2001
      BR    01/01/2001
      BR    01/01/2001
$1,012.21   10/01/2010
  $115.24   10/01/2010
  $339.83   10/01/2010
  $482.45   10/01/2010
$1,273.49   10/01/2010
   $29.45   10/01/2010
      BR    01/01/2002
      BR    01/01/2002
   $24.99   10/01/2010
      BR    06/01/1991
   $66.65   10/01/2010
  $237.26   10/01/2010
  $472.86   10/01/2010
      BR    01/01/2000
      BR    01/01/2001
      BR    01/01/2003
      BR    01/01/2003
  $872.20   10/01/2010
   $92.43   10/01/2010
      BR    03/01/1989
  $329.89   10/01/2010
  $329.89   10/01/2010
  $329.89   10/01/2010
$1,148.21   10/01/2010
$1,394.90   10/01/2010
      BR    01/01/2003
$1,999.72   10/01/2010
  $810.89   10/01/2010
      BR    01/01/2005
      BR    01/01/2005
      BR    01/01/2006
      BR    01/01/2006
  $718.42   10/01/2010
  $904.88   10/01/2010
$5,288.19   10/01/2010
  $107.65   10/01/2010
  $576.27   10/01/2010
  $541.39   10/01/2010
  $159.26   10/01/2010
  $136.65   10/01/2010
  $137.73   10/01/2010
  $322.96   10/01/2010
  $440.77   10/01/2010
  $182.86   10/01/2010
  $414.31   10/01/2010
  $321.93   10/01/2010
  $267.50   10/01/2010
      BR    01/01/2004
      BR    01/01/2007
  $896.34   10/01/2010
$1,125.55   10/01/2010
$1,387.50   10/01/2010
$4,416.27   10/01/2010
      BR    03/01/1989
   $54.99   10/01/2010
      BR    10/01/1982
  $326.45   10/01/2010
  $329.94   10/01/2010
  $355.79   10/01/2010
  $521.56   10/01/2010
$1,043.90   10/01/2010
$1,020.41   10/01/2010
      BR    03/01/1989
$3,906.28   10/01/2010
$3,880.98   10/01/2010
      BR    03/01/1989
      BR    03/01/1989
$3,225.02   10/01/2010
   $83.92   10/01/2010
      BR    01/01/2005
      BR    01/01/2009
  $121.38   10/01/2010
      BR    01/01/2000
   $10.35   10/01/2010
$2,802.46   10/01/2010
$4,282.68   10/01/2010
$8,166.45   10/01/2010
      BR    01/01/1996
  $471.32   10/01/2010
      BR    03/01/1989
      BR    01/01/2001
   $73.09   10/01/2010
  $514.03   10/01/2010
   $89.07   10/01/2010
  $492.98   10/01/2010
  $153.64   10/01/2010
   $37.69   10/01/2010
  $116.02   10/01/2010
  $117.09   10/01/2010
  $102.10   10/01/2010
  $108.63   10/01/2010
  $228.00   10/01/2010
      BR    01/01/2006
      BR    01/01/2006
  $526.00   10/01/2010
  $520.87   10/01/2010
$6,703.80   10/01/2010
      BR    01/01/2007
  $396.38   10/01/2010
  $494.87   10/01/2010
   $16.82   10/01/2010
   $39.99   10/01/2010
   $39.99   10/01/2010
  $674.42   10/01/2010
  $604.94   10/01/2010
  $585.12   10/01/2010
   $76.97   10/01/2010
   $16.32   10/01/2010
   $14.78   10/01/2010
  $173.82   10/01/2010
   $84.75   10/01/2010
  $118.59   10/01/2010
  $497.38   10/01/2010
   $37.49   10/01/2010
   $78.22   10/01/2010
   $29.67   10/01/2010
   $71.19   10/01/2010
   $64.43   10/01/2010
  $204.17   10/01/2010
  $156.24   10/01/2010
   $45.26   10/01/2010
   $43.28   10/01/2010
   $98.85   10/01/2010
   $66.48   10/01/2010
   $33.53   10/01/2010
   $28.03   10/01/2010
   $38.01   10/01/2010
   $37.66   10/01/2010
      BR    01/01/2004
$1,905.80   10/01/2010
  $202.34   10/01/2010
$4,852.08   10/01/2010
  $100.96   10/01/2010
   $94.91   10/01/2010
   $17.58   10/01/2010
   $25.61   10/01/2010
$3,484.75   10/01/2010
$3,775.42   10/01/2010
$4,186.17   10/01/2010
$4,531.20   10/01/2010
$5,550.29   10/01/2010
$7,515.31   10/01/2010
$7,515.98   10/01/2010
      BR    01/01/2004
  $983.37   10/01/2010
      BR    01/01/2003
  $364.23   10/01/2010
  $114.42   10/01/2010
  $112.90   10/01/2010
      BR    01/01/2003
      BR    01/01/2003
  $209.28   10/01/2010
  $177.57   10/01/2010
  $317.71   10/01/2010
$1,001.84   10/01/2010
  $572.85   10/01/2010
      BR    01/01/2001
      BR    01/01/2010
      BR    01/01/2003
      BR    01/01/2003
      BR    01/01/2005
$1,160.98   10/01/2010
$1,437.20   10/01/2010
$1,248.64   10/01/2010
  $763.00   10/01/2010
$1,118.34   10/01/2010
  $545.46   10/01/2010
  $677.35   10/01/2010
$1,225.84   10/01/2010
$1,628.60   10/01/2010
  $851.96   10/01/2010
  $865.45   10/01/2010
$1,465.01   10/01/2010
$1,259.93   10/01/2010
$1,088.93   10/01/2010
$1,088.93   10/01/2010
  $364.09   10/01/2010
  $692.08   10/01/2010
  $930.01   10/01/2010
  $712.50   10/01/2010
$2,360.17   10/01/2010
$1,018.13   10/01/2010
  $913.71   10/01/2010
$1,116.63   10/01/2010
$1,155.28   10/01/2010
$1,334.60   10/01/2010
$1,432.18   10/01/2010
  $991.91   10/01/2010
      BR    03/01/1989
  $541.61   10/01/2010
  $753.08   10/01/2010
      BR    01/01/1991
      BR    01/01/1991
      BR    01/01/1991
  $462.64   10/01/2010
  $235.29   10/01/2010
      BR    01/01/1991
      BR    01/01/2005
$2,256.14   10/01/2010
      BR    01/01/2003
$2,133.06   10/01/2010
$2,210.19   10/01/2010
$1,924.13   10/01/2010
$1,852.79   10/01/2010
$1,634.64   10/01/2010
$1,648.92   10/01/2010
$1,634.64   10/01/2010
      BR    01/01/2005
$1,124.84   10/01/2010
  $611.65   10/01/2010
  $851.96   10/01/2010
  $846.68   10/01/2010
$1,496.36   10/01/2010
$1,326.75   10/01/2010
      BR    01/01/1991
$1,384.76   10/01/2010
  $416.87   10/01/2010
  $104.35   10/01/2010
  $422.59   10/01/2010
      BR    03/01/1989
$1,820.72   10/01/2010
   $28.26   10/01/2010
      BR    01/01/2009
   $21.28   10/01/2010
      BR    01/01/2009
      BR    01/01/2009
      BR    01/01/2009
  $138.23   10/01/2010
      BR    01/01/2000
      BR    01/01/2004
      BR    01/01/2006
      BR    03/01/1989
$2,556.91   10/01/2010
$2,422.39   10/01/2010
    BR    01/01/2002
    BR    03/01/1989
    BR    03/01/1989
    BR    03/01/1989
    BR    03/01/1989
    BR    03/01/1989
    BR    03/01/1989
    BR    10/01/1982
    BR    03/01/1989
    BR    03/01/1989
    BR    03/01/1989
    BR    03/01/1989
    BR    03/01/1989
    BR    03/01/1989
    BR    03/01/1989
    BR    03/01/1989
    BR    03/01/1989
    BR    03/01/1989
    BR    03/01/1989
    BR    03/01/1989
    BR    01/01/2004
    BR    03/01/1989
    BR    03/01/1989
    BR    01/01/2002
    BR    01/01/2002
    BR    03/01/1989
$343.98   10/01/2010
 $10.58   10/01/2010
 $22.51   10/01/2010
    BR    01/01/1996
    BR    01/01/2002
    BR    01/01/2003
    BR    01/01/1996
    BR    01/01/2002
    BR    01/01/1996
    BR    01/01/2002
    BR    01/01/2006
    BR    01/01/1996
    BR    01/01/2002
    BR    01/01/2002
   $76.92   10/01/2010
  $104.98   10/01/2010
      BR    01/01/1996
      BR    01/01/1996
      BR    01/01/2002
      BR    01/01/2005
      BR    01/01/2002
      BR    01/01/2002
  $641.58   10/01/2010
  $188.09   10/01/2010
      BR    01/01/2004
  $372.17   10/01/2010
  $472.80   10/01/2010
  $477.85   10/01/2010
  $811.37   10/01/2010
   $32.02   10/01/2010
   $39.91   10/01/2010
   $42.51   10/01/2010
  $100.42   10/01/2010
   $90.61   10/01/2010
    $5.63   10/01/2010
   $34.69   10/01/2010
    $5.77   10/01/2010
   $29.84   10/01/2010
   $30.52   10/01/2010
    $9.42   10/01/2010
      BR    01/01/2006
      BR    01/01/2006
      BR    01/01/2006
   $35.48   10/01/2010
   $28.45   10/01/2010
   $25.06   10/01/2010
   $21.00   10/01/2010
   $83.14   10/01/2010
   $17.36   10/01/2010
   $37.85   10/01/2010
$1,794.22   10/01/2010
  $933.92   10/01/2010
      BR    01/01/2009
  $153.29   10/01/2010
      BR    01/01/2005
      BR    01/01/2005
      BR    01/01/2005
      BR    01/01/2005
      BR    01/01/2009
      BR    01/01/2004
      BR    01/01/2004
$1,006.12   10/01/2010
$2,036.92   10/01/2010
$1,934.33   10/01/2010
  $307.16   10/01/2010
$1,366.23   10/01/2010
$1,212.56   10/01/2010
   $59.46   10/01/2010
   $37.68   10/01/2010
$1,157.94   10/01/2010
  $298.45   10/01/2010
$2,245.99   10/01/2010
$4,260.33   10/01/2010
$1,518.43   10/01/2010
$2,942.14   10/01/2010
      BR    01/01/2004
  $357.47   10/01/2010
  $536.24   10/01/2010
  $446.86   10/01/2010
  $714.99   10/01/2010
  $600.65   10/01/2010
   $95.26   10/01/2010
  $117.91   10/01/2010
   $90.21   10/01/2010
  $157.24   10/01/2010
   $95.26   10/01/2010
   $94.84   10/01/2010
  $192.65   10/01/2010
  $360.31   10/01/2010
  $444.13   10/01/2010
  $386.84   10/01/2010
  $690.24   10/01/2010
  $129.60   10/01/2010
      BR    01/01/2006
  $674.23   10/01/2010
  $459.13   10/01/2010
  $736.43   10/01/2010
$1,154.01   10/01/2010
  $417.59   10/01/2010
   $64.39   10/01/2010
   $17.55   10/01/2010
  $128.39   10/01/2010
   $68.41   10/01/2010
   $41.85   10/01/2010
  $127.22   10/01/2010
   $54.89   10/01/2010
   $43.32   10/01/2010
   $23.52   10/01/2010
   $36.78   10/01/2010
   $17.62   10/01/2010
   $46.32   10/01/2010
   $65.99   10/01/2010
   $46.90   10/01/2010
   $57.18   10/01/2010
  $413.10   10/01/2010
      BR    01/01/2004
  $390.08   10/01/2010
$1,192.81   10/01/2010
$1,573.48   10/01/2010
$2,307.18   10/01/2010
$3,567.67   10/01/2010
$6,751.33   10/01/2010
      BR    01/01/2004
      BR    01/01/2004
      BR    01/01/2004
   $52.58   10/01/2010
  $102.66   10/01/2010
  $130.33   10/01/2010
  $161.98   10/01/2010
  $231.42   10/01/2010
  $361.04   10/01/2010
  $249.19   10/01/2010
  $299.27   10/01/2010
      BR    01/01/2005
      BR    01/01/2005
  $268.55   10/01/2010
  $363.28   10/01/2010
  $337.92   10/01/2010
  $467.65   10/01/2010
  $388.88   10/01/2010
  $523.22   10/01/2010
      BR    01/01/2005
   $44.12   10/01/2010
  $470.89   10/01/2010
  $494.15   10/01/2010
      BR    01/01/2005
      BR    01/01/2005
      BR    01/01/2005
  $600.55   10/01/2010
  $932.86   10/01/2010
  $894.44   10/01/2010
$1,523.50   10/01/2010
$1,813.29   10/01/2010
$1,429.67   10/01/2010
$1,882.71   10/01/2010
      BR    01/01/1994
$4,046.91   10/01/2010
$4,670.01   10/01/2010
$2,864.73   10/01/2010
      BR    01/01/1994
  $153.61   10/01/2010
   $43.21   10/01/2010
   $24.15   10/01/2010
   $14.82   10/01/2010
   $39.26   10/01/2010
   $41.40   10/01/2010
   $20.50   10/01/2010
   $45.56   10/01/2010
   $63.12   10/01/2010
   $44.75   10/01/2010
   $26.62   10/01/2010
   $16.51   10/01/2010
   $14.07   10/01/2010
   $48.68   10/01/2010
   $16.51   10/01/2010
   $64.64   10/01/2010
   $27.47   10/01/2010
   $44.47   10/01/2010
   $78.15   10/01/2010
   $86.24   10/01/2010
   $93.28   10/01/2010
   $43.61   10/01/2010
   $97.98   10/01/2010
  $179.66   10/01/2010
  $107.14   10/01/2010
   $64.50   10/01/2010
   $32.82   10/01/2010
   $57.69   10/01/2010
   $97.52   10/01/2010
      BR    01/01/1994
      BR    01/01/1995
      BR    01/01/1998
      BR    01/01/2000
      BR    07/01/2000
      BR    07/01/2000
      BR    07/01/2000
    $2.60   10/01/2010
    $1.10   10/01/2010
    $6.35   10/01/2010
    $6.07   10/01/2010
   $14.56   10/01/2010
      BR    07/01/2003
  $193.74   10/01/2010
  $120.91   10/01/2010
  $804.07   10/01/2010
      BR    04/01/2004
   $71.17   10/01/2010
$1,719.71   10/01/2010
   $25.97   10/01/2010
  $284.98   10/01/2010
  $362.62   10/01/2010
  $287.32   10/01/2010
  $363.73   10/01/2010
      BR    10/01/2006
      BR    04/01/2009
      BR    04/01/2009
$1,111.46   10/01/2010
$1,791.91   10/01/2010
$2,027.86   10/01/2010
$1,344.57   10/01/2010
$2,040.23   10/01/2010
$3,156.66   10/01/2010
      BR    10/01/2006
      BR    10/01/2006
      BR    10/01/2006
      BR    10/01/2006
      BR    10/01/2006
      BR    10/01/2006
      BR    10/01/2006
      BR    10/01/2006
      BR    10/01/2006
      BR    10/01/2006
      BR    10/01/2006
      BR    10/01/2006
      BR    10/01/2006
      BR    10/01/2006
      BR    10/01/2006
      BR    10/01/2006
      BR    10/01/2006
      BR    10/01/2006
      BR    10/01/2006
      BR    10/01/2006
      BR    10/01/2006
      BR    10/01/2006
      BR    10/01/2006
      BR    10/01/2006
      BR    10/01/2006
      BR    10/01/2006
      BR    10/01/2006
      BR    10/01/2006
      BR    10/01/2006
      BR    10/01/2006
      BR    10/01/2006
      BR    10/01/2006
       BR    10/01/2006
       BR    10/01/2006
       BR    10/01/2006
       BR    10/01/2006
       BR    10/01/2006
       BR    10/01/2006
       BR    10/01/2006
       BR    10/01/2006
       BR    10/01/2006
       BR    10/01/2006
       BR    10/01/2006
       BR    10/01/2006
       BR    10/01/2006
       BR    10/01/2006
       BR    10/01/2006
       BR    10/01/2006
       BR    10/01/2006
       BR    10/01/2006
       BR    10/01/2006
       BR    10/01/2006
       BR    10/01/2006
       BR    10/01/2006
       BR    10/01/2006
       BR    10/01/2006
       BR    10/01/2006
       BR    10/01/2006
       BR    01/01/2001
$75,762.98   10/01/2010
$12,223.47   10/01/2010
 $3,828.62   10/01/2010
$15,772.20   10/01/2010
 $3,062.91   10/01/2010
   $295.72   10/01/2010
   $246.14   10/01/2010
   $287.15   10/01/2010
       BR    11/01/2005
$13,673.65   10/01/2010
   $591.45   10/01/2010
   $929.84   10/01/2010
    $74.90   10/01/2010
  $213.30   10/01/2010
  $180.50   10/01/2010
$3,513.77   10/01/2010
$1,261.15   10/01/2010
  $393.80   10/01/2010
  $432.09   10/01/2010
  $140.39   10/01/2010
   $25.69   10/01/2010
  $429.60   10/01/2010
  $546.94   10/01/2010
$1,093.89   10/01/2010
  $577.22   10/01/2010
      BR    11/01/2005
      BR    01/01/2002
      BR    01/01/2002
      BR    01/01/2003
      BR    01/01/2003
      BR    07/01/2005

				
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posted:7/27/2011
language:English
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