DOC Conversion Factor: 60.00 DOC Non-Facility DOC Facility ......xxx: 0001u 00 $ 720.00 $ 720.00...

CPT® codes and descriptions only are copyright 2020 American Medical Association. All Rights Reserved. Applicable FARS/DFARS apply.

DOC Professional Provider Fee Schedule, Effective 1/1/2020Page | 1

DOC Conversion Factor: 60.00$ Link to Legend

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0001F 00 Code Accepted for Tracking Purpose only XXX0001U 00 720.00$ 720.00$ 0002M 00 503.40$ 503.40$ 0002U 00 25.00$ 25.00$ 0003M 00 503.40$ 503.40$ 0003U 00 950.00$ 950.00$ 0004M 00 79.00$ 79.00$ 0005F 00 Code Accepted for Tracking Purpose only XXX0005U 00 760.00$ 760.00$ 0006M 00 150.00$ 150.00$ 0006U 00 246.92$ 246.92$ 0007M 00 375.00$ 375.00$ 0007U 00 114.43$ 114.43$ 0008M 00 2,789.12$ 2,789.12$ 0008U 00 597.91$ 597.91$ 0009U 00 107.00$ 107.00$ 0010U 00 427.26$ 427.26$ 0011M 00 760.00$ 760.00$ 0011U 00 114.43$ 114.43$ 0012F 00 Code Accepted for Tracking Purpose only XXX0012M 00 760.00$ 760.00$ 0012U 00 2,515.60$ 2,515.60$ 0013M 00 760.00$ 760.00$ 0013U 00 2,515.60$ 2,515.60$ 0014F 00 Code Accepted for Tracking Purpose only XXX0014U 00 2,515.60$ 2,515.60$ 0015F 00 Code Accepted for Tracking Purpose only XXX0016U 00 182.18$ 182.18$ 0017U 00 101.85$ 101.85$ 0018U 00 -$ -$ 0019U 00 -$ -$ 0021U 00 -$ -$ 0022U 00 -$ -$ 0023U 00 -$ -$ 0024U 00 35.06$ 35.06$ 0025U 00 95.30$ 95.30$

Department of Corrections (DOC)RBRVS Physician-Related Services Fee Schedule

Effective January 1, 2020



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0026U 00 3,600.00$ 3,600.00$ 0027U 00 150.52$ 150.52$ 0029U 00 -$ -$ 0030U 00 -$ -$ 0031U 00 174.81$ 174.81$ 0032U 00 174.81$ 174.81$ 0033U 00 349.62$ 349.62$ 0034U 00 466.17$ 466.17$ 0035U 00 -$ -$ 0036U 00 4,780.00$ 4,780.00$ 0037U 00 3,500.00$ 3,500.00$ 0038U 00 32.89$ 32.89$ 0039U 00 15.27$ 15.27$ 0040U 00 455.45$ 455.45$ 0041U 00 -$ -$ 0042T 00 Not Covered Not Covered XXX0042U 00 -$ -$ 0043U 00 -$ -$ 0044U 00 -$ -$ 0045U 00 3,873.00$ 3,873.00$ 0046U 00 165.51$ 165.51$ 0047U 00 3,873.00$ 3,873.00$ 0048U 00 -$ -$ 0049U 00 246.52$ 246.52$ 0050U 00 -$ -$ 0051U 00 205.63$ 205.63$ 0052U 00 33.86$ 33.86$ 0053U 00 -$ -$ 0054T 00 Not Covered Not Covered XXX0054U 00 165.52$ 165.52$ 0055T 00 Not Covered Not Covered XXX0055U 00 -$ -$ 0056U 00 -$ -$ 0058T 00 Not Covered Not Covered XXX0058U 00 358.85$ 358.85$ 0059U 00 358.85$ 358.85$ 0060U 00 759.05$ 759.05$ 0061U 00 27.85$ 27.85$ 0071T 00 Not Covered Not Covered XXX0072T 00 Not Covered Not Covered XXX0075T 00 By Report By Report XXX0075T 26 By Report By Report XXX



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0075T TC By Report By Report XXX0076T 00 By Report By Report XXX0076T 26 By Report By Report XXX0076T TC By Report By Report XXX0080U 00 3,520.00$ 3,520.00$ 0084U 00 720.00$ 720.00$ 0085T 00 Not Covered Not Covered XXX0086U 00 -$ -$ 0087U 00 -$ -$ 0088U 00 -$ -$ 0089U 00 760.00$ 760.00$ 0090U 00 1,950.00$ 1,950.00$ 0092U 00 -$ -$ 0093U 00 62.14$ 62.14$ 0094U 00 -$ -$ 0095T 00 Not Covered Not Covered XXX0095U 00 -$ -$ 0096U 00 35.09$ 35.09$ 0097U 00 -$ -$ 0098T 00 Not Covered Not Covered XXX0098U 00 -$ -$ 0099U 00 -$ -$ 0100T 00 Not Covered Not Covered XXX0100U 00 -$ -$ 0101T 00 Not Covered Not Covered XXX0101U 00 1,169.80$ 1,169.80$ 0102T 00 Not Covered Not Covered XXX0102U 00 1,117.98$ 1,117.98$ 0103U 00 1,117.98$ 1,117.98$ 0105U 00 950.00$ 950.00$ 0106T 00 Not Covered Not Covered XXX0106U 00 -$ -$ 0107T 00 Not Covered Not Covered XXX0107U 00 16.00$ 16.00$ 0108T 00 Not Covered Not Covered XXX0108U 00 -$ -$ 0109T 00 Not Covered Not Covered XXX0109U 00 142.63$ 142.63$ 0110T 00 Not Covered Not Covered XXX0110U 00 27.11$ 27.11$ 0111T 00 Not Covered Not Covered XXX0111U 00 682.29$ 682.29$



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0112U 00 -$ -$ 0113U 00 760.00$ 760.00$ 0114U 00 -$ -$ 0115U 00 -$ -$ 0116U 00 246.92$ 246.92$ 0117U 00 -$ -$ 0118U 00 -$ -$ 0119U 00 -$ -$ 0120U 00 2,510.21$ 2,510.21$ 0121U 00 -$ -$ 0122U 00 -$ -$ 0123U 00 -$ -$ 0124U 00 55.54$ 55.54$ 0125U 00 69.52$ 69.52$ 0126T 00 By Report By Report XXX0126U 00 69.52$ 69.52$ 0127U 00 55.54$ 55.54$ 0128U 00 55.54$ 55.54$ 0129U 00 1,117.98$ 1,117.98$ 0130U 00 584.90$ 584.90$ 0131U 00 -$ -$ 0132U 00 -$ -$ 0133U 00 -$ -$ 0134U 00 -$ -$ 0135U 00 -$ -$ 0136U 00 -$ -$ 0137U 00 -$ -$ 0138U 00 -$ -$ 0139U 00 -$ -$ 0140U 00 -$ -$ 0141U 00 -$ -$ 0142U 00 -$ -$ 0143U 00 -$ -$ 0144U 00 -$ -$ 0145U 00 -$ -$ 0146U 00 -$ -$ 0147U 00 -$ -$ 0148U 00 -$ -$ 0149U 00 -$ -$ 0150U 00 -$ -$ 0151U 00 -$ -$ 0152U 00 -$ -$



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0153U 00 -$ -$ 0154U 00 -$ -$ 0155U 00 -$ -$ 0156U 00 -$ -$ 0157U 00 -$ -$ 0158U 00 -$ -$ 0159U 00 -$ -$ 0160U 00 -$ -$ 0161U 00 -$ -$ 0162U 00 -$ -$ 0163T 00 Not Covered Not Covered YYY0164T 00 Not Covered Not Covered YYY0165T 00 Not Covered Not Covered YYY0174T 00 Not Covered Not Covered XXX0175T 00 Not Covered Not Covered XXX0184T 00 238.92$ 238.92$ XXX0191T 00 Not Covered Not Covered XXX0198T 00 Not Covered Not Covered XXX0200T 00 Not Covered Not Covered XXX0201T 00 Not Covered Not Covered XXX0202T 00 Not Covered Not Covered XXX0207T 00 Not Covered Not Covered XXX0208T 00 Not Covered Not Covered XXX0209T 00 Not Covered Not Covered XXX0210T 00 Not Covered Not Covered XXX0211T 00 Not Covered Not Covered XXX0212T 00 Not Covered Not Covered XXX0213T 00 187.36$ 187.36$ XXX0214T 00 94.37$ 94.37$ ZZZ0215T 00 95.48$ 95.48$ ZZZ0216T 00 167.70$ 167.70$ XXX0217T 00 85.90$ 85.90$ ZZZ0218T 00 87.03$ 87.03$ ZZZ0219T 00 Not Covered Not Covered XXX0220T 00 Not Covered Not Covered XXX0221T 00 Not Covered Not Covered XXX0222T 00 Not Covered Not Covered ZZZ0228T 00 59.85$ 59.85$ XXX0229T 00 59.85$ 59.85$ XXX0230T 00 59.85$ 59.85$ XXX0231T 00 59.85$ 59.85$ XXX0232T 00 Not Covered Not Covered XXX



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0234T 00 By Report By Report YYY0235T 00 By Report By Report YYY0236T 00 By Report By Report YYY0237T 00 By Report By Report YYY0238T 00 By Report By Report YYY0253T 00 Not Covered Not Covered YYY0263T 00 Not Covered Not Covered XXX0264T 00 Not Covered Not Covered XXX0265T 00 Not Covered Not Covered XXX0266T 00 Not Covered Not Covered YYY0267T 00 Not Covered Not Covered YYY0268T 00 Not Covered Not Covered YYY0269T 00 Not Covered Not Covered XXX0270T 00 Not Covered Not Covered XXX0271T 00 Not Covered Not Covered XXX0272T 00 Not Covered Not Covered XXX0273T 00 Not Covered Not Covered XXX0274T 00 Not Covered Not Covered YYY0275T 00 Not Covered Not Covered YYY0278T 00 Not Covered Not Covered XXX0290T 00 Not Covered Not Covered ZZZ0295T 00 Not Covered Not Covered XXX0296T 00 26.56$ 26.56$ XXX0297T 00 37.49$ 37.49$ XXX0298T 00 27.04$ 27.04$ XXX0308T 00 Not Covered Not Covered YYY0312T 00 Not Covered Not Covered XXX0313T 00 Not Covered Not Covered XXX0314T 00 Not Covered Not Covered XXX0315T 00 Not Covered Not Covered XXX0316T 00 Not Covered Not Covered XXX0317T 00 Not Covered Not Covered XXX0329T 00 Not Covered Not Covered YYY0330T 00 Not Covered Not Covered YYY0331T 00 Not Covered Not Covered YYY0332T 00 Not Covered Not Covered YYY0333T 00 By Report By Report YYY0335T 00 Not Covered Not Covered YYY0338T 00 Not Covered Not Covered YYY0339T 00 Not Covered Not Covered YYY0342T 00 Not Covered Not Covered YYY0345T 00 Not Covered Not Covered YYY



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0347T 00 Not Covered Not Covered YYY0348T 00 Not Covered Not Covered YYY0349T 00 Not Covered Not Covered YYY0350T 00 Not Covered Not Covered YYY0351T 00 Not Covered Not Covered YYY0352T 00 Not Covered Not Covered YYY0353T 00 Not Covered Not Covered YYY0354T 00 Not Covered Not Covered YYY0355T 00 Not Covered Not Covered YYY0356T 00 Not Covered Not Covered YYY0358T 00 Not Covered Not Covered YYY0362T 00 Not Covered Not Covered YYY0373T 00 Not Covered Not Covered YYY0376T 00 Not Covered Not Covered XXX0378T 00 Not Covered Not Covered XXX0379T 00 Not Covered Not Covered XXX0381T 00 Not Covered Not Covered XXX0382T 00 Not Covered Not Covered XXX0383T 00 Not Covered Not Covered XXX0384T 00 Not Covered Not Covered XXX0385T 00 Not Covered Not Covered XXX0386T 00 Not Covered Not Covered XXX0394T 00 Not Covered Not Covered XXX0395T 00 Not Covered Not Covered XXX0396T 00 Not Covered Not Covered XXX0397T 00 Not Covered Not Covered XXX0398T 00 Not Covered Not Covered XXX0400T 00 Not Covered Not Covered XXX0401T 00 Not Covered Not Covered XXX0402T 00 Not Covered Not Covered XXX0403T 00 Not Covered Not Covered XXX0404T 00 Not Covered Not Covered XXX0405T 00 Not Covered Not Covered XXX0408T 00 Not Covered Not Covered XXX0409T 00 Not Covered Not Covered XXX0410T 00 Not Covered Not Covered XXX0411T 00 Not Covered Not Covered XXX0412T 00 Not Covered Not Covered XXX0413T 00 Not Covered Not Covered XXX0414T 00 Not Covered Not Covered XXX0415T 00 Not Covered Not Covered XXX0416T 00 Not Covered Not Covered XXX



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0417T 00 Not Covered Not Covered XXX0418T 00 Not Covered Not Covered XXX0419T 00 Not Covered Not Covered XXX0420T 00 Not Covered Not Covered XXX0421T 00 Not Covered Not Covered XXX0422T 00 Not Covered Not Covered XXX0423T 00 Not Covered Not Covered XXX0424T 00 Not Covered Not Covered XXX0425T 00 Not Covered Not Covered XXX0426T 00 Not Covered Not Covered XXX0427T 00 Not Covered Not Covered XXX0428T 00 Not Covered Not Covered XXX0429T 00 Not Covered Not Covered XXX0430T 00 Not Covered Not Covered XXX0431T 00 Not Covered Not Covered XXX0432T 00 Not Covered Not Covered XXX0433T 00 Not Covered Not Covered XXX0434T 00 Not Covered Not Covered XXX0435T 00 Not Covered Not Covered XXX0436T 00 Not Covered Not Covered XXX0437T 00 Not Covered Not Covered ZZZ0439T 00 Not Covered Not Covered ZZZ0440T 00 Not Covered Not Covered YYY0441T 00 Not Covered Not Covered YYY0442T 00 Not Covered Not Covered YYY0443T 00 Not Covered Not Covered ZZZ0444T 00 Not Covered Not Covered YYY0445T 00 Not Covered Not Covered YYY0446T 00 Not Covered Not Covered YYY0447T 00 Not Covered Not Covered YYY0448T 00 Not Covered Not Covered YYY0449T 00 Not Covered Not Covered YYY0450T 00 Not Covered Not Covered YYY0451T 00 Not Covered Not Covered YYY0452T 00 Not Covered Not Covered YYY0453T 00 Not Covered Not Covered YYY0454T 00 Not Covered Not Covered YYY0455T 00 Not Covered Not Covered YYY0456T 00 Not Covered Not Covered YYY0457T 00 Not Covered Not Covered YYY0458T 00 Not Covered Not Covered YYY0459T 00 Not Covered Not Covered YYY



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0460T 00 Not Covered Not Covered YYY0461T 00 Not Covered Not Covered YYY0462T 00 Not Covered Not Covered YYY0463T 00 Not Covered Not Covered YYY0464T 00 Not Covered Not Covered YYY0465T 00 Not Covered Not Covered YYY0466T 00 Not Covered Not Covered YYY0467T 00 Not Covered Not Covered YYY0468T 00 Not Covered Not Covered YYY0469T 00 Not Covered Not Covered XXX0470T 00 Not Covered Not Covered XXX0470T 26 Not Covered Not Covered XXX0470T TC Not Covered Not Covered XXX0471T 00 Not Covered Not Covered XXX0471T 26 Not Covered Not Covered XXX0471T TC Not Covered Not Covered XXX0472T 00 Not Covered Not Covered XXX0473T 00 Not Covered Not Covered XXX0474T 00 Not Covered Not Covered XXX0475T 00 Not Covered Not Covered XXX0476T 00 Not Covered Not Covered XXX0477T 00 Not Covered Not Covered XXX0478T 00 Not Covered Not Covered XXX0479T 00 Not Covered Not Covered 0000480T 00 Not Covered Not Covered ZZZ0481T 00 Not Covered Not Covered 0000483T 00 Not Covered Not Covered 0000484T 00 Not Covered Not Covered 0000485T 00 Not Covered Not Covered XXX0485T 26 Not Covered Not Covered XXX0485T TC Not Covered Not Covered XXX0486T 00 Not Covered Not Covered XXX0486T 26 Not Covered Not Covered XXX0486T TC Not Covered Not Covered XXX0487T 00 Not Covered Not Covered XXX0488T 00 Not Covered Not Covered XXX0489T 00 Not Covered Not Covered 0000490T 00 Not Covered Not Covered 0000491T 00 Not Covered Not Covered 0000492T 00 Not Covered Not Covered ZZZ0493T 00 Not Covered Not Covered XXX0494T 00 Not Covered Not Covered XXX



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0495T 00 Not Covered Not Covered XXX0496T 00 Not Covered Not Covered ZZZ0497T 00 Not Covered Not Covered XXX0498T 00 Not Covered Not Covered XXX0499T 00 Not Covered Not Covered 0000500F 00 Not Covered Not Covered XXX0500T 00 Not Covered Not Covered XXX0501F 00 Code Accepted for Tracking Purpose only XXX0501T 00 Not Covered Not Covered XXX0502F 00 Code Accepted for Tracking Purpose only XXX0502T 00 Not Covered Not Covered XXX0503F 00 Code Accepted for Tracking Purpose only XXX0503T 00 Not Covered Not Covered XXX0504T 00 Not Covered Not Covered XXX0505F 00 Code Accepted for Tracking Purpose only XXX0505T 00 Not Covered Not Covered YYY0506T 00 Not Covered Not Covered XXX0506T 26 Not Covered Not Covered XXX0506T TC Not Covered Not Covered XXX0507F 00 Code Accepted for Tracking Purpose only XXX0507T 00 Not Covered Not Covered XXX0507T 26 Not Covered Not Covered XXX0507T TC Not Covered Not Covered XXX0508T 00 Not Covered Not Covered XXX0508T 26 Not Covered Not Covered XXX0508T TC Not Covered Not Covered XXX0509F 00 Code Accepted for Tracking Purpose only XXX0509T 00 2.33$ 140.05$ 2.33$ 140.05$ XXX0509T 26 0.63$ 37.98$ 0.63$ 37.98$ XXX0509T TC 1.70$ 102.07$ 1.70$ 102.07$ XXX0510T 00 Not Covered Not Covered YYY0511T 00 Not Covered Not Covered YYY0512T 00 Not Covered Not Covered YYY0513F 00 Code Accepted for Tracking Purpose only XXX0513T 00 Not Covered Not Covered ZZZ0514F 00 Code Accepted for Tracking Purpose only XXX0514T 00 Not Covered Not Covered ZZZ0515T 00 Not Covered Not Covered YYY0516F 00 Code Accepted for Tracking Purpose only XXX0516T 00 Not Covered Not Covered YYY0517F 00 Code Accepted for Tracking Purpose only XXX0517T 00 Not Covered Not Covered YYY



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0518F 00 Code Accepted for Tracking Purpose only XXX0518T 00 Not Covered Not Covered YYY0519F 00 Code Accepted for Tracking Purpose only XXX0519T 00 Not Covered Not Covered YYY0520F 00 Code Accepted for Tracking Purpose only XXX0520T 00 Not Covered Not Covered YYY0521F 00 Code Accepted for Tracking Purpose only XXX0521T 00 Not Covered Not Covered XXX0521T 26 Not Covered Not Covered XXX0521T TC Not Covered Not Covered XXX0522T 00 Not Covered Not Covered XXX0522T 26 Not Covered Not Covered XXX0522T TC Not Covered Not Covered XXX0523T 00 Not Covered Not Covered ZZZ0524T 00 Not Covered Not Covered YYY0525F 00 Code Accepted for Tracking Purpose only XXX0525T 00 Not Covered Not Covered YYY0526F 00 Code Accepted for Tracking Purpose only XXX0526T 00 Not Covered Not Covered YYY0527T 00 Not Covered Not Covered YYY0528F 00 Code Accepted for Tracking Purpose only XXX0528T 00 Not Covered Not Covered XXX0528T 26 Not Covered Not Covered XXX0528T TC Not Covered Not Covered XXX0529F 00 Code Accepted for Tracking Purpose only XXX0529T 00 Not Covered Not Covered XXX0529T 26 Not Covered Not Covered XXX0529T TC Not Covered Not Covered XXX0530T 00 Not Covered Not Covered YYY0531T 00 Not Covered Not Covered YYY0532T 00 Not Covered Not Covered YYY0533T 00 Not Covered Not Covered XXX0533T 26 Not Covered Not Covered XXX0533T TC Not Covered Not Covered XXX0534T 00 Not Covered Not Covered XXX0534T 26 Not Covered Not Covered XXX0534T TC Not Covered Not Covered XXX0535F 00 Code Accepted for Tracking Purpose only XXX0535T 00 Not Covered Not Covered XXX0535T 26 Not Covered Not Covered XXX0535T TC Not Covered Not Covered XXX0536T 00 Not Covered Not Covered XXX



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0536T 26 Not Covered Not Covered XXX0536T TC Not Covered Not Covered XXX0537T 00 Bundled Bundled XXX0538T 00 Bundled Bundled XXX0539T 00 Bundled Bundled XXX0540F 00 Code Accepted for Tracking Purpose only XXX0540T 00 Not Covered Not Covered YYY0541T 00 Not Covered Not Covered XXX0542T 00 Not Covered Not Covered XXX0545F 00 Code Accepted for Tracking Purpose only XXX0550F 00 Code Accepted for Tracking Purpose only XXX0551F 00 Code Accepted for Tracking Purpose only XXX0555F 00 Code Accepted for Tracking Purpose only XXX0556F 00 Code Accepted for Tracking Purpose only XXX0557F 00 Code Accepted for Tracking Purpose only XXX0575F 00 Code Accepted for Tracking Purpose only XXX0580F 00 Code Accepted for Tracking Purpose only XXX0581F 00 Code Accepted for Tracking Purpose only XXX0582F 00 Code Accepted for Tracking Purpose only XXX0583F 00 Code Accepted for Tracking Purpose only XXX0584F 00 Code Accepted for Tracking Purpose only XXX10004 00 1.52$ 90.97$ 1.26$ 75.84$ ZZZ10005 00 3.69$ 221.36$ 2.12$ 127.40$ XXX10006 00 1.74$ 104.41$ 1.45$ 86.76$ ZZZ10007 00 8.40$ 503.89$ 2.73$ 164.00$ XXX10008 00 4.73$ 283.50$ 1.78$ 106.93$ ZZZ10009 00 13.79$ 827.24$ 3.31$ 198.53$ XXX1000F 00 Code Accepted for Tracking Purpose only XXX10010 00 8.29$ 497.62$ 2.42$ 145.11$ ZZZ10011 00 By Report By Report XXX10012 00 By Report By Report ZZZ10021 00 2.86$ 171.47$ 1.63$ 97.69$ XXX1002F 00 Code Accepted for Tracking Purpose only XXX10030 00 16.95$ 1,016.79$ 4.02$ 241.15$ 00010035 00 14.27$ 856.30$ 2.51$ 150.66$ 00010036 00 12.34$ 740.53$ 1.26$ 75.88$ ZZZ1003F 00 Code Accepted for Tracking Purpose only XXX10040 00 3.19$ 191.42$ 1.69$ 101.24$ 0101004F 00 Code Accepted for Tracking Purpose only XXX1005F 00 Code Accepted for Tracking Purpose only XXX10060 00 3.47$ 208.27$ 2.88$ 172.96$ 01010061 00 6.02$ 361.32$ 5.28$ 316.55$ 010



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1006F 00 Code Accepted for Tracking Purpose only XXX1007F 00 Code Accepted for Tracking Purpose only XXX10080 00 5.42$ 325.23$ 3.00$ 180.19$ 01010081 00 8.08$ 485.08$ 4.96$ 297.80$ 0101008F 00 Code Accepted for Tracking Purpose only XXX1010F 00 Code Accepted for Tracking Purpose only XXX1011F 00 Code Accepted for Tracking Purpose only XXX10120 00 4.47$ 268.10$ 3.04$ 182.33$ 01010121 00 7.99$ 479.55$ 5.42$ 325.05$ 0101012F 00 Code Accepted for Tracking Purpose only XXX10140 00 4.92$ 295.04$ 3.48$ 208.65$ 0101015F 00 Code Accepted for Tracking Purpose only XXX10160 00 3.81$ 228.84$ 2.78$ 167.04$ 01010180 00 7.32$ 438.94$ 5.19$ 311.56$ 0101018F 00 Code Accepted for Tracking Purpose only XXX1019F 00 Code Accepted for Tracking Purpose only XXX1022F 00 Code Accepted for Tracking Purpose only XXX1026F 00 Code Accepted for Tracking Purpose only XXX1030F 00 Code Accepted for Tracking Purpose only XXX1031F 00 Code Accepted for Tracking Purpose only XXX1032F 00 Code Accepted for Tracking Purpose only XXX1033F 00 Code Accepted for Tracking Purpose only XXX1034F 00 Code Accepted for Tracking Purpose only XXX1035F 00 Code Accepted for Tracking Purpose only XXX1036F 00 Code Accepted for Tracking Purpose only XXX1038F 00 Code Accepted for Tracking Purpose only XXX1039F 00 Code Accepted for Tracking Purpose only XXX1040F 00 Code Accepted for Tracking Purpose only XXX1050F 00 Code Accepted for Tracking Purpose only XXX1052F 00 Code Accepted for Tracking Purpose only XXX1055F 00 Code Accepted for Tracking Purpose only XXX1060F 00 Code Accepted for Tracking Purpose only XXX1061F 00 Code Accepted for Tracking Purpose only XXX1065F 00 Code Accepted for Tracking Purpose only XXX1066F 00 Code Accepted for Tracking Purpose only XXX1070F 00 Code Accepted for Tracking Purpose only XXX1071F 00 Code Accepted for Tracking Purpose only XXX1090F 00 Code Accepted for Tracking Purpose only XXX1091F 00 Code Accepted for Tracking Purpose only XXX11000 00 1.62$ 97.04$ 0.83$ 49.74$ 00011001 00 0.63$ 38.07$ 0.41$ 24.83$ ZZZ11004 00 16.80$ 1,007.98$ 16.80$ 1,007.98$ 000



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11005 00 22.73$ 1,363.98$ 22.73$ 1,363.98$ 00011006 00 20.56$ 1,233.48$ 20.56$ 1,233.48$ 00011008 00 7.99$ 479.48$ 7.99$ 479.48$ ZZZ1100F 00 Code Accepted for Tracking Purpose only XXX11010 00 14.24$ 854.55$ 8.14$ 488.17$ 01011011 00 15.69$ 941.40$ 8.77$ 526.47$ 00011012 00 20.32$ 1,219.06$ 12.33$ 739.80$ 0001101F 00 Code Accepted for Tracking Purpose only XXX11042 00 3.58$ 214.57$ 1.79$ 107.37$ 00011043 00 6.73$ 404.06$ 4.51$ 270.38$ 00011044 00 9.12$ 547.26$ 6.65$ 399.06$ 00011045 00 1.21$ 72.45$ 0.77$ 45.96$ ZZZ11046 00 2.13$ 127.63$ 1.62$ 97.36$ ZZZ11047 00 3.59$ 215.10$ 2.87$ 172.22$ ZZZ11055 00 1.65$ 99.19$ 0.47$ 27.94$ 00011056 00 1.97$ 118.27$ 0.66$ 39.45$ 00011057 00 2.18$ 131.04$ 0.86$ 51.59$ 00011102 00 2.90$ 174.11$ 1.16$ 69.43$ 00011103 00 1.56$ 93.82$ 0.67$ 40.22$ ZZZ11104 00 3.65$ 218.91$ 1.45$ 87.11$ 00011105 00 1.79$ 107.43$ 0.79$ 47.52$ ZZZ11106 00 4.41$ 264.85$ 1.77$ 105.94$ 00011107 00 2.11$ 126.66$ 0.94$ 56.66$ ZZZ1110F 00 Code Accepted for Tracking Purpose only XXX1111F 00 Code Accepted for Tracking Purpose only XXX1116F 00 Code Accepted for Tracking Purpose only XXX1118F 00 Code Accepted for Tracking Purpose only XXX1119F 00 Code Accepted for Tracking Purpose only XXX11200 00 2.59$ 155.33$ 2.16$ 129.47$ 01011201 00 0.55$ 32.97$ 0.49$ 29.18$ ZZZ1121F 00 Code Accepted for Tracking Purpose only XXX1123F 00 Code Accepted for Tracking Purpose only XXX1124F 00 Code Accepted for Tracking Purpose only XXX1125F 00 Code Accepted for Tracking Purpose only XXX1126F 00 Code Accepted for Tracking Purpose only XXX1127F 00 Code Accepted for Tracking Purpose only XXX1128F 00 Code Accepted for Tracking Purpose only XXX11300 00 2.87$ 172.46$ 1.02$ 61.47$ 00011301 00 3.52$ 211.07$ 1.55$ 93.15$ 00011302 00 4.12$ 247.01$ 1.83$ 109.54$ 00011303 00 4.53$ 272.10$ 2.16$ 129.58$ 00011305 00 3.00$ 180.22$ 1.13$ 67.98$ 000



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GLOBAL

11306 00 3.57$ 214.16$ 1.51$ 90.56$ 00011307 00 4.23$ 253.56$ 1.95$ 116.72$ 00011308 00 4.48$ 268.65$ 2.17$ 129.92$ 0001130F 00 Code Accepted for Tracking Purpose only XXX11310 00 3.34$ 200.70$ 1.38$ 82.77$ 00011311 00 3.99$ 239.31$ 1.91$ 114.45$ 00011312 00 4.67$ 280.08$ 2.26$ 135.67$ 00011313 00 5.46$ 327.78$ 2.93$ 175.81$ 0001134F 00 Code Accepted for Tracking Purpose only XXX1135F 00 Code Accepted for Tracking Purpose only XXX1136F 00 Code Accepted for Tracking Purpose only XXX1137F 00 Code Accepted for Tracking Purpose only XXX11400 00 3.65$ 219.19$ 2.39$ 143.52$ 01011401 00 4.44$ 266.26$ 3.06$ 183.65$ 01011402 00 4.93$ 295.75$ 3.36$ 201.79$ 01011403 00 5.69$ 341.29$ 4.34$ 260.57$ 01011404 00 6.44$ 386.67$ 4.76$ 285.77$ 01011406 00 9.23$ 553.84$ 7.22$ 433.40$ 01011420 00 3.65$ 219.02$ 2.39$ 143.35$ 01011421 00 4.63$ 277.67$ 3.22$ 193.17$ 01011422 00 5.21$ 312.65$ 3.99$ 239.50$ 01011423 00 5.93$ 355.85$ 4.58$ 274.51$ 01011424 00 6.87$ 412.03$ 5.26$ 315.55$ 01011426 00 9.80$ 587.98$ 8.05$ 483.30$ 01011440 00 4.05$ 242.76$ 3.05$ 182.86$ 01011441 00 4.98$ 298.78$ 3.86$ 231.31$ 01011442 00 5.55$ 333.06$ 4.26$ 255.50$ 01011443 00 6.60$ 395.70$ 5.22$ 313.09$ 01011444 00 8.25$ 495.20$ 6.63$ 398.09$ 01011446 00 11.41$ 684.90$ 9.49$ 569.50$ 01011450 00 11.59$ 695.15$ 7.47$ 447.96$ 09011451 00 14.55$ 873.06$ 9.53$ 571.63$ 09011462 00 11.30$ 678.02$ 7.12$ 427.04$ 09011463 00 14.74$ 884.20$ 9.59$ 575.20$ 09011470 00 12.38$ 742.75$ 8.23$ 493.66$ 09011471 00 15.12$ 907.44$ 10.16$ 609.79$ 0901150F 00 Code Accepted for Tracking Purpose only XXX1151F 00 Code Accepted for Tracking Purpose only XXX1152F 00 Code Accepted for Tracking Purpose only XXX1153F 00 Code Accepted for Tracking Purpose only XXX1157F 00 Code Accepted for Tracking Purpose only XXX1158F 00 Code Accepted for Tracking Purpose only XXX



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

1159F 00 Code Accepted for Tracking Purpose only XXX11600 00 5.71$ 342.50$ 3.52$ 211.34$ 01011601 00 6.72$ 403.21$ 4.38$ 262.58$ 01011602 00 7.27$ 436.49$ 4.79$ 287.67$ 01011603 00 8.30$ 498.01$ 5.74$ 344.14$ 01011604 00 9.20$ 552.01$ 6.30$ 377.96$ 01011606 00 13.16$ 789.81$ 9.37$ 562.16$ 0101160F 00 Code Accepted for Tracking Purpose only XXX11620 00 5.75$ 344.91$ 3.56$ 213.75$ 01011621 00 6.75$ 404.99$ 4.41$ 264.36$ 01011622 00 7.52$ 451.01$ 5.03$ 301.56$ 01011623 00 8.79$ 527.11$ 6.21$ 372.61$ 01011624 00 9.92$ 595.49$ 7.03$ 422.08$ 01011626 00 11.92$ 715.40$ 8.60$ 516.14$ 01011640 00 5.93$ 355.56$ 3.69$ 221.24$ 01011641 00 6.99$ 419.18$ 4.59$ 275.40$ 01011642 00 7.95$ 477.25$ 5.40$ 324.01$ 01011643 00 9.33$ 559.94$ 6.74$ 404.18$ 01011644 00 11.51$ 690.54$ 8.35$ 500.73$ 01011646 00 14.97$ 898.31$ 11.56$ 693.37$ 0101170F 00 Code Accepted for Tracking Purpose only XXX11719 00 0.42$ 25.33$ 0.22$ 13.35$ 00011720 00 0.97$ 58.28$ 0.42$ 25.49$ 00011721 00 1.33$ 79.62$ 0.72$ 43.04$ 00011730 00 3.19$ 191.47$ 1.60$ 96.25$ 00011732 00 0.96$ 57.41$ 0.52$ 30.93$ ZZZ11740 00 1.51$ 90.86$ 0.95$ 56.81$ 00011750 00 4.55$ 273.01$ 2.98$ 179.05$ 01011755 00 3.58$ 214.84$ 1.81$ 108.90$ 0001175F 00 Code Accepted for Tracking Purpose only XXX11760 00 5.64$ 338.59$ 3.34$ 200.49$ 01011762 00 8.40$ 504.00$ 5.44$ 326.17$ 01011765 00 4.98$ 298.78$ 2.74$ 164.47$ 01011770 00 8.32$ 499.22$ 5.39$ 323.28$ 01011771 00 17.19$ 1,031.64$ 12.80$ 768.05$ 09011772 00 20.58$ 1,234.94$ 16.90$ 1,014.23$ 0901180F 00 Code Accepted for Tracking Purpose only XXX1181F 00 Code Accepted for Tracking Purpose only XXX1182F 00 Code Accepted for Tracking Purpose only XXX1183F 00 Code Accepted for Tracking Purpose only XXX11900 00 1.59$ 95.18$ 0.91$ 54.82$ 00011901 00 2.00$ 119.98$ 1.41$ 84.67$ 000



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

11920 00 5.25$ 315.27$ 3.30$ 197.98$ 00011921 00 6.01$ 360.77$ 3.87$ 232.13$ 00011922 00 1.79$ 107.16$ 0.86$ 51.66$ ZZZ11950 00 2.00$ 119.88$ 1.37$ 82.04$ 00011951 00 2.87$ 171.90$ 2.00$ 120.19$ 00011952 00 3.87$ 231.91$ 2.84$ 170.11$ 00011954 00 4.52$ 271.26$ 3.26$ 195.59$ 00011960 00 28.34$ 1,700.61$ 28.34$ 1,700.61$ 09011970 00 17.83$ 1,069.65$ 17.83$ 1,069.65$ 09011971 00 13.98$ 838.99$ 9.40$ 564.04$ 09011976 00 4.23$ 254.00$ 2.71$ 162.56$ 00011980 00 2.76$ 165.79$ 1.63$ 97.68$ 00011981 00 4.16$ 249.39$ 2.42$ 145.34$ 00011982 00 4.60$ 276.03$ 2.90$ 173.87$ 00011983 00 6.69$ 401.21$ 5.17$ 310.41$ 00012001 00 2.61$ 156.45$ 1.28$ 77.00$ 00012002 00 3.17$ 190.02$ 1.69$ 101.11$ 00012004 00 3.71$ 222.34$ 2.11$ 126.48$ 00012005 00 4.81$ 288.40$ 2.73$ 163.54$ 00012006 00 5.67$ 340.33$ 3.35$ 200.97$ 00012007 00 6.51$ 390.51$ 4.18$ 250.52$ 0001200F 00 Code Accepted for Tracking Purpose only XXX12011 00 3.18$ 190.92$ 1.58$ 95.07$ 00012013 00 3.32$ 199.11$ 1.67$ 100.10$ 00012014 00 3.98$ 238.77$ 2.15$ 129.05$ 00012015 00 4.81$ 288.38$ 2.70$ 162.26$ 00012016 00 6.05$ 363.21$ 3.69$ 221.32$ 00012017 00 4.40$ 263.80$ 4.40$ 263.80$ 00012018 00 4.98$ 298.68$ 4.98$ 298.68$ 00012020 00 8.41$ 504.87$ 5.51$ 330.82$ 01012021 00 4.88$ 292.69$ 4.06$ 243.50$ 01012031 00 7.21$ 432.39$ 4.50$ 269.70$ 01012032 00 8.93$ 535.78$ 5.70$ 342.18$ 01012034 00 9.34$ 560.43$ 6.07$ 364.31$ 01012035 00 11.25$ 675.26$ 7.03$ 421.76$ 01012036 00 12.43$ 745.64$ 8.17$ 490.25$ 01012037 00 14.05$ 842.87$ 9.54$ 572.35$ 01012041 00 7.19$ 431.59$ 4.38$ 262.59$ 01012042 00 8.66$ 519.69$ 5.87$ 351.95$ 01012044 00 10.74$ 644.28$ 6.28$ 376.90$ 01012045 00 11.80$ 708.20$ 7.86$ 471.73$ 01012046 00 14.22$ 852.92$ 9.14$ 548.34$ 010



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

12047 00 15.60$ 936.29$ 10.18$ 610.90$ 01012051 00 7.79$ 467.15$ 5.02$ 301.30$ 01012052 00 8.80$ 528.23$ 5.97$ 357.97$ 01012053 00 10.31$ 618.47$ 6.38$ 382.63$ 01012054 00 10.77$ 646.21$ 6.47$ 388.29$ 01012055 00 13.97$ 838.23$ 8.82$ 529.24$ 01012056 00 16.49$ 989.62$ 11.26$ 675.58$ 01012057 00 17.49$ 1,049.23$ 12.53$ 751.59$ 0101205F 00 Code Accepted for Tracking Purpose only XXX1220F 00 Code Accepted for Tracking Purpose only XXX13100 00 9.96$ 597.72$ 6.01$ 360.62$ 01013101 00 11.75$ 704.86$ 7.42$ 445.05$ 01013102 00 3.55$ 213.22$ 2.17$ 129.99$ ZZZ13120 00 10.40$ 623.91$ 6.92$ 415.18$ 01013121 00 12.63$ 757.84$ 7.81$ 468.39$ 01013122 00 3.88$ 232.64$ 2.50$ 150.03$ ZZZ13131 00 11.42$ 685.09$ 7.30$ 437.90$ 01013132 00 14.05$ 843.10$ 9.19$ 551.14$ 01013133 00 5.18$ 310.58$ 3.82$ 229.23$ ZZZ13151 00 12.47$ 748.26$ 8.39$ 503.59$ 01013152 00 14.88$ 892.61$ 10.16$ 609.47$ 01013153 00 5.62$ 337.50$ 4.12$ 247.32$ ZZZ13160 00 23.32$ 1,399.07$ 23.32$ 1,399.07$ 09014000 00 18.28$ 1,096.54$ 14.68$ 880.88$ 09014001 00 23.38$ 1,402.60$ 19.07$ 1,144.05$ 0901400F 00 Code Accepted for Tracking Purpose only XXX14020 00 20.41$ 1,224.71$ 16.62$ 997.07$ 09014021 00 25.42$ 1,525.33$ 21.00$ 1,259.85$ 09014040 00 22.26$ 1,335.55$ 18.48$ 1,108.53$ 09014041 00 27.42$ 1,645.14$ 22.75$ 1,365.15$ 09014060 00 22.65$ 1,359.19$ 19.70$ 1,181.99$ 09014061 00 29.50$ 1,770.09$ 24.35$ 1,461.09$ 09014301 00 31.52$ 1,891.34$ 25.70$ 1,541.99$ 09014302 00 6.41$ 384.72$ 6.41$ 384.72$ ZZZ14350 00 19.99$ 1,199.57$ 19.99$ 1,199.57$ 0901450F 00 Code Accepted for Tracking Purpose only XXX1451F 00 Code Accepted for Tracking Purpose only XXX1460F 00 Code Accepted for Tracking Purpose only XXX1461F 00 Code Accepted for Tracking Purpose only XXX1490F 00 Code Accepted for Tracking Purpose only XXX1491F 00 Code Accepted for Tracking Purpose only XXX1493F 00 Code Accepted for Tracking Purpose only XXX



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

1494F 00 Code Accepted for Tracking Purpose only XXX15002 00 10.20$ 612.11$ 6.55$ 393.29$ 00015003 00 2.16$ 129.65$ 1.33$ 79.83$ ZZZ15004 00 11.68$ 700.60$ 7.79$ 467.28$ 00015005 00 3.59$ 215.24$ 2.66$ 159.75$ ZZZ1500F 00 Code Accepted for Tracking Purpose only XXX1501F 00 Code Accepted for Tracking Purpose only XXX1502F 00 Code Accepted for Tracking Purpose only XXX1503F 00 Code Accepted for Tracking Purpose only XXX15040 00 7.52$ 451.19$ 3.66$ 219.76$ 0001504F 00 Code Accepted for Tracking Purpose only XXX15050 00 16.59$ 995.69$ 13.04$ 782.55$ 0901505F 00 Code Accepted for Tracking Purpose only XXX15100 00 25.14$ 1,508.68$ 20.89$ 1,253.29$ 09015101 00 5.46$ 327.39$ 3.26$ 195.59$ ZZZ15110 00 23.25$ 1,395.19$ 20.10$ 1,206.01$ 09015111 00 3.35$ 201.06$ 3.01$ 180.88$ ZZZ15115 00 23.11$ 1,386.69$ 19.98$ 1,198.77$ 09015116 00 4.88$ 292.71$ 4.44$ 266.22$ ZZZ15120 00 24.85$ 1,491.26$ 20.36$ 1,221.36$ 09015121 00 6.11$ 366.77$ 3.92$ 234.98$ ZZZ15130 00 19.47$ 1,168.13$ 16.25$ 975.17$ 09015131 00 2.89$ 173.67$ 2.66$ 159.79$ ZZZ15135 00 25.08$ 1,504.67$ 21.86$ 1,311.71$ 09015136 00 2.86$ 171.78$ 2.66$ 159.79$ ZZZ15150 00 20.35$ 1,220.97$ 18.53$ 1,111.88$ 09015151 00 3.47$ 208.37$ 3.20$ 191.97$ ZZZ15152 00 4.28$ 256.52$ 3.99$ 239.49$ ZZZ15155 00 23.33$ 1,399.68$ 21.45$ 1,286.80$ 09015156 00 4.68$ 280.59$ 4.39$ 263.56$ ZZZ15157 00 5.20$ 312.23$ 4.79$ 287.64$ ZZZ15200 00 24.43$ 1,465.84$ 19.71$ 1,182.70$ 09015201 00 4.26$ 255.65$ 2.28$ 137.09$ ZZZ15220 00 22.65$ 1,359.23$ 18.04$ 1,082.39$ 09015221 00 3.99$ 239.21$ 2.07$ 124.44$ ZZZ15240 00 27.36$ 1,641.81$ 23.51$ 1,410.38$ 09015241 00 5.36$ 321.77$ 3.22$ 193.13$ ZZZ15260 00 29.62$ 1,776.95$ 25.17$ 1,510.20$ 09015261 00 6.22$ 372.90$ 4.07$ 244.26$ ZZZ15271 00 4.26$ 255.43$ 2.45$ 146.97$ 00015272 00 0.78$ 46.65$ 0.50$ 30.26$ ZZZ15273 00 8.94$ 536.19$ 5.90$ 353.95$ 000



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

15274 00 2.20$ 132.09$ 1.34$ 80.38$ ZZZ15275 00 4.49$ 269.34$ 2.78$ 166.55$ 00015276 00 1.00$ 60.00$ 0.74$ 44.24$ ZZZ15277 00 9.77$ 586.11$ 6.67$ 400.08$ 00015278 00 2.60$ 155.91$ 1.67$ 100.42$ ZZZ15570 00 26.67$ 1,600.28$ 21.45$ 1,286.88$ 09015572 00 25.94$ 1,556.67$ 21.77$ 1,306.32$ 09015574 00 26.47$ 1,587.96$ 22.20$ 1,331.94$ 09015576 00 23.51$ 1,410.54$ 19.56$ 1,173.43$ 09015600 00 9.64$ 578.42$ 6.08$ 364.64$ 09015610 00 10.51$ 630.66$ 7.04$ 422.56$ 09015620 00 12.91$ 774.88$ 9.50$ 569.94$ 09015630 00 13.49$ 809.64$ 10.11$ 606.58$ 09015650 00 14.95$ 896.77$ 11.26$ 675.43$ 09015730 00 45.05$ 2,703.00$ 26.97$ 1,618.37$ 09015731 00 32.75$ 1,964.78$ 29.30$ 1,757.94$ 09015733 00 30.68$ 1,841.02$ 30.68$ 1,841.02$ 09015734 00 44.05$ 2,643.07$ 44.05$ 2,643.07$ 09015736 00 35.93$ 2,155.68$ 35.93$ 2,155.68$ 09015738 00 38.27$ 2,296.02$ 38.27$ 2,296.02$ 09015740 00 29.54$ 1,772.37$ 24.75$ 1,484.82$ 09015750 00 26.86$ 1,611.82$ 26.86$ 1,611.82$ 09015756 00 67.17$ 4,029.92$ 67.17$ 4,029.92$ 09015757 00 66.44$ 3,986.66$ 66.44$ 3,986.66$ 09015758 00 67.06$ 4,023.38$ 67.06$ 4,023.38$ 09015760 00 24.87$ 1,492.22$ 20.67$ 1,239.98$ 09015769 00 14.08$ 844.74$ 14.08$ 844.74$ 09015770 00 19.49$ 1,169.11$ 19.49$ 1,169.11$ 09015771 00 16.92$ 1,015.21$ 13.97$ 838.10$ 09015772 00 5.30$ 318.18$ 4.09$ 245.18$ ZZZ15773 00 17.07$ 1,024.44$ 14.12$ 847.33$ 09015774 00 5.14$ 308.70$ 3.93$ 235.70$ ZZZ15775 00 8.94$ 536.50$ 6.50$ 390.20$ 00015776 00 12.89$ 773.61$ 9.27$ 556.05$ 00015777 00 6.32$ 379.33$ 6.32$ 379.33$ ZZZ15780 00 26.94$ 1,616.12$ 20.60$ 1,235.87$ 09015781 00 16.18$ 970.67$ 12.63$ 757.52$ 09015782 00 16.91$ 1,014.66$ 12.23$ 734.05$ 09015783 00 14.03$ 841.96$ 10.88$ 652.78$ 09015786 00 7.21$ 432.69$ 3.98$ 239.10$ 01015787 00 1.32$ 79.07$ 0.51$ 30.51$ ZZZ15788 00 13.27$ 795.93$ 7.02$ 421.36$ 090



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

15789 00 16.21$ 972.88$ 12.15$ 728.84$ 09015792 00 12.28$ 736.62$ 7.25$ 435.19$ 09015793 00 14.52$ 871.12$ 10.62$ 637.16$ 09015819 00 23.21$ 1,392.56$ 23.21$ 1,392.56$ 09015820 00 16.67$ 1,000.15$ 14.92$ 895.47$ 09015821 00 17.88$ 1,072.88$ 15.95$ 956.85$ 09015822 00 13.12$ 787.35$ 11.42$ 685.19$ 09015823 00 17.88$ 1,073.08$ 15.93$ 955.79$ 09015824 00 Not Covered Not Covered 00015825 00 Not Covered Not Covered 00015826 00 Not Covered Not Covered 00015828 00 Not Covered Not Covered 00015829 00 Not Covered Not Covered 00015830 00 34.30$ 2,057.92$ 34.30$ 2,057.92$ 09015832 00 26.92$ 1,614.92$ 26.92$ 1,614.92$ 09015833 00 25.53$ 1,531.90$ 25.53$ 1,531.90$ 09015834 00 26.01$ 1,560.42$ 26.01$ 1,560.42$ 09015835 00 27.34$ 1,640.45$ 27.34$ 1,640.45$ 09015836 00 23.13$ 1,387.71$ 23.13$ 1,387.71$ 09015837 00 25.32$ 1,519.34$ 21.03$ 1,262.05$ 09015838 00 18.73$ 1,123.56$ 18.73$ 1,123.56$ 09015839 00 25.85$ 1,550.90$ 21.52$ 1,291.09$ 09015840 00 29.37$ 1,762.34$ 29.37$ 1,762.34$ 09015841 00 52.09$ 3,125.67$ 52.09$ 3,125.67$ 09015842 00 79.28$ 4,756.68$ 79.28$ 4,756.68$ 09015845 00 29.51$ 1,770.83$ 29.51$ 1,770.83$ 09015847 00 Not Covered Not Covered YYY15850 00 Bundled Bundled XXX15851 00 2.95$ 176.75$ 1.33$ 79.63$ 00015852 00 1.34$ 80.56$ 1.34$ 80.56$ 00015860 00 3.13$ 187.60$ 3.13$ 187.60$ 00015876 00 Not Covered Not Covered 00015877 00 Not Covered Not Covered 00015878 00 Not Covered Not Covered 00015879 00 Not Covered Not Covered 00015920 00 18.14$ 1,088.57$ 18.14$ 1,088.57$ 09015922 00 22.99$ 1,379.18$ 22.99$ 1,379.18$ 09015931 00 20.21$ 1,212.62$ 20.21$ 1,212.62$ 09015933 00 24.99$ 1,499.49$ 24.99$ 1,499.49$ 09015934 00 27.56$ 1,653.60$ 27.56$ 1,653.60$ 09015935 00 32.14$ 1,928.30$ 32.14$ 1,928.30$ 09015936 00 26.09$ 1,565.52$ 26.09$ 1,565.52$ 090



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

15937 00 30.31$ 1,818.84$ 30.31$ 1,818.84$ 09015940 00 20.44$ 1,226.45$ 20.44$ 1,226.45$ 09015941 00 26.56$ 1,593.48$ 26.56$ 1,593.48$ 09015944 00 26.29$ 1,577.68$ 26.29$ 1,577.68$ 09015945 00 28.98$ 1,738.72$ 28.98$ 1,738.72$ 09015946 00 47.60$ 2,855.84$ 47.60$ 2,855.84$ 09015950 00 17.62$ 1,057.45$ 17.62$ 1,057.45$ 09015951 00 25.90$ 1,554.04$ 25.90$ 1,554.04$ 09015952 00 26.53$ 1,592.05$ 26.53$ 1,592.05$ 09015953 00 29.21$ 1,752.89$ 29.21$ 1,752.89$ 09015956 00 33.91$ 2,034.32$ 33.91$ 2,034.32$ 09015958 00 34.64$ 2,078.57$ 34.64$ 2,078.57$ 09015999 00 By Report By Report YYY16000 00 2.05$ 122.90$ 1.33$ 80.02$ 00016020 00 2.39$ 143.63$ 1.58$ 95.07$ 00016025 00 4.37$ 261.96$ 3.21$ 192.60$ 00016030 00 5.54$ 332.30$ 3.88$ 232.67$ 00016035 00 5.70$ 342.27$ 5.70$ 342.27$ 00016036 00 2.38$ 142.68$ 2.38$ 142.68$ ZZZ17000 00 1.91$ 114.42$ 1.57$ 94.24$ 01017003 00 0.17$ 9.90$ 0.07$ 4.23$ ZZZ17004 00 4.44$ 266.66$ 2.91$ 174.59$ 01017106 00 10.05$ 602.92$ 8.10$ 486.26$ 09017107 00 13.01$ 780.56$ 10.38$ 622.91$ 09017108 00 18.81$ 1,128.42$ 15.51$ 930.41$ 09017110 00 3.25$ 194.82$ 2.02$ 121.04$ 01017111 00 3.84$ 230.36$ 2.47$ 148.38$ 01017250 00 2.40$ 143.79$ 1.07$ 64.34$ 00017260 00 2.79$ 167.24$ 2.07$ 124.36$ 01017261 00 4.24$ 254.60$ 2.64$ 158.12$ 01017262 00 5.16$ 309.79$ 3.37$ 201.96$ 01017263 00 5.63$ 338.01$ 3.73$ 223.87$ 01017264 00 6.02$ 361.50$ 3.98$ 238.53$ 01017266 00 6.85$ 410.96$ 4.68$ 281.05$ 01017270 00 4.37$ 262.16$ 2.90$ 173.88$ 01017271 00 4.81$ 288.67$ 3.20$ 192.19$ 01017272 00 5.49$ 329.23$ 3.70$ 222.03$ 01017273 00 6.11$ 366.64$ 4.19$ 251.24$ 01017274 00 7.20$ 432.05$ 5.13$ 307.82$ 01017276 00 8.32$ 499.25$ 6.12$ 367.46$ 01017280 00 4.09$ 245.69$ 2.63$ 158.04$ 01017281 00 5.24$ 314.22$ 3.61$ 216.48$ 010



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

17282 00 6.01$ 360.36$ 4.18$ 250.63$ 01017283 00 7.18$ 430.57$ 5.22$ 313.28$ 01017284 00 8.18$ 490.55$ 6.07$ 364.43$ 01017286 00 10.46$ 627.62$ 8.16$ 489.52$ 01017311 00 19.55$ 1,173.07$ 10.98$ 658.50$ 00017312 00 11.62$ 697.43$ 5.84$ 350.60$ ZZZ17313 00 18.30$ 1,098.08$ 9.84$ 590.45$ 00017314 00 11.10$ 666.22$ 5.42$ 325.07$ ZZZ17315 00 2.32$ 139.18$ 1.54$ 92.51$ ZZZ17340 00 1.52$ 91.22$ 1.43$ 85.54$ 01017360 00 3.70$ 222.12$ 2.82$ 169.15$ 01017380 00 Not Covered Not Covered 00017999 00 By Report By Report YYY19000 00 3.23$ 193.66$ 1.27$ 76.36$ 00019001 00 0.78$ 47.05$ 0.63$ 37.59$ ZZZ19020 00 13.91$ 834.37$ 9.01$ 540.51$ 09019030 00 4.90$ 293.78$ 2.26$ 135.50$ 00019081 00 19.17$ 1,150.05$ 4.91$ 294.33$ 00019082 00 15.70$ 942.02$ 2.47$ 148.10$ ZZZ19083 00 18.78$ 1,126.75$ 4.62$ 277.33$ 00019084 00 15.14$ 908.40$ 2.31$ 138.43$ ZZZ19085 00 28.59$ 1,715.13$ 5.37$ 322.14$ 00019086 00 22.99$ 1,379.39$ 2.68$ 161.07$ ZZZ19100 00 4.44$ 266.62$ 2.04$ 122.22$ 00019101 00 9.89$ 593.43$ 6.47$ 388.49$ 01019105 00 84.32$ 5,059.33$ 6.16$ 369.56$ 00019110 00 14.33$ 859.87$ 10.11$ 606.37$ 09019112 00 13.53$ 811.68$ 9.21$ 552.50$ 09019120 00 14.58$ 874.89$ 12.08$ 724.81$ 09019125 00 16.14$ 968.17$ 13.39$ 803.58$ 09019126 00 4.69$ 281.68$ 4.69$ 281.68$ ZZZ19281 00 7.14$ 428.44$ 2.95$ 176.83$ 00019282 00 5.01$ 300.61$ 1.48$ 88.73$ ZZZ19283 00 8.01$ 480.53$ 2.96$ 177.84$ 00019284 00 6.11$ 366.49$ 1.52$ 90.92$ ZZZ19285 00 14.40$ 863.78$ 2.53$ 151.84$ 00019286 00 12.47$ 748.10$ 1.26$ 75.88$ ZZZ19287 00 24.35$ 1,460.79$ 3.77$ 226.07$ 00019288 00 19.54$ 1,172.47$ 1.89$ 113.70$ ZZZ19294 00 4.74$ 284.57$ 4.74$ 284.57$ ZZZ19296 00 118.65$ 7,118.90$ 6.13$ 367.70$ 00019297 00 2.76$ 165.53$ 2.76$ 165.53$ ZZZ



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

19298 00 29.32$ 1,759.26$ 9.28$ 556.71$ 00019300 00 15.74$ 944.36$ 12.19$ 731.22$ 09019301 00 19.05$ 1,143.10$ 19.05$ 1,143.10$ 09019302 00 26.23$ 1,573.52$ 26.23$ 1,573.52$ 09019303 00 27.96$ 1,677.53$ 27.96$ 1,677.53$ 09019305 00 33.07$ 1,983.96$ 33.07$ 1,983.96$ 09019306 00 35.11$ 2,106.89$ 35.11$ 2,106.89$ 09019307 00 34.98$ 2,099.02$ 34.98$ 2,099.02$ 09019316 00 22.54$ 1,352.63$ 22.54$ 1,352.63$ 09019318 00 32.13$ 1,927.61$ 32.13$ 1,927.61$ 09019324 00 15.58$ 935.01$ 15.58$ 935.01$ 09019325 00 18.83$ 1,129.70$ 18.83$ 1,129.70$ 09019328 00 14.56$ 873.57$ 14.56$ 873.57$ 09019330 00 18.53$ 1,111.80$ 18.53$ 1,111.80$ 09019340 00 29.12$ 1,746.93$ 29.12$ 1,746.93$ 09019342 00 27.04$ 1,622.50$ 27.04$ 1,622.50$ 09019350 00 24.20$ 1,452.24$ 19.68$ 1,181.08$ 09019355 00 22.09$ 1,325.50$ 18.13$ 1,087.76$ 09019357 00 44.12$ 2,647.48$ 44.12$ 2,647.48$ 09019361 00 45.96$ 2,757.87$ 45.96$ 2,757.87$ 09019364 00 80.41$ 4,824.48$ 80.41$ 4,824.48$ 09019366 00 40.93$ 2,456.00$ 40.93$ 2,456.00$ 09019367 00 52.16$ 3,129.88$ 52.16$ 3,129.88$ 09019368 00 64.18$ 3,850.81$ 64.18$ 3,850.81$ 09019369 00 59.58$ 3,574.89$ 59.58$ 3,574.89$ 09019370 00 20.12$ 1,207.24$ 20.12$ 1,207.24$ 09019371 00 23.00$ 1,379.86$ 23.00$ 1,379.86$ 09019380 00 22.70$ 1,361.91$ 22.70$ 1,361.91$ 09019396 00 8.50$ 510.28$ 4.24$ 254.25$ 0002000F 00 Code Accepted for Tracking Purpose only XXX2001F 00 Code Accepted for Tracking Purpose only XXX2002F 00 Code Accepted for Tracking Purpose only XXX2004F 00 Code Accepted for Tracking Purpose only XXX20100 00 17.68$ 1,061.06$ 17.68$ 1,061.06$ 01020101 00 13.38$ 803.00$ 6.11$ 366.63$ 01020102 00 14.46$ 867.53$ 7.47$ 448.19$ 01020103 00 17.10$ 1,025.75$ 10.14$ 608.30$ 0102010F 00 Code Accepted for Tracking Purpose only XXX2014F 00 Code Accepted for Tracking Purpose only XXX20150 00 29.52$ 1,770.99$ 29.52$ 1,770.99$ 0902015F 00 Code Accepted for Tracking Purpose only XXX2016F 00 Code Accepted for Tracking Purpose only XXX



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

2018F 00 Code Accepted for Tracking Purpose only XXX2019F 00 Code Accepted for Tracking Purpose only XXX20200 00 6.14$ 368.42$ 2.76$ 165.36$ 00020205 00 8.59$ 515.20$ 4.52$ 271.15$ 00020206 00 7.00$ 419.82$ 1.71$ 102.63$ 0002020F 00 Code Accepted for Tracking Purpose only XXX2021F 00 Code Accepted for Tracking Purpose only XXX20220 00 4.96$ 297.86$ 2.10$ 125.70$ 00020225 00 15.35$ 921.28$ 3.12$ 187.26$ 0002022F 00 Code Accepted for Tracking Purpose only XXX20240 00 4.37$ 262.11$ 4.37$ 262.11$ 00020245 00 10.25$ 614.92$ 10.25$ 614.92$ 0002024F 00 Code Accepted for Tracking Purpose only XXX20250 00 11.65$ 699.20$ 11.65$ 699.20$ 01020251 00 12.60$ 756.23$ 12.60$ 756.23$ 0102026F 00 Code Accepted for Tracking Purpose only XXX2027F 00 Code Accepted for Tracking Purpose only XXX2028F 00 Code Accepted for Tracking Purpose only XXX2029F 00 Code Accepted for Tracking Purpose only XXX2030F 00 Code Accepted for Tracking Purpose only XXX2031F 00 Code Accepted for Tracking Purpose only XXX2035F 00 Code Accepted for Tracking Purpose only XXX2040F 00 Code Accepted for Tracking Purpose only XXX2044F 00 Code Accepted for Tracking Purpose only XXX20500 00 3.17$ 190.46$ 2.50$ 150.10$ 01020501 00 3.76$ 225.73$ 1.10$ 66.19$ 0002050F 00 Code Accepted for Tracking Purpose only XXX20520 00 6.05$ 363.08$ 4.30$ 257.77$ 01020525 00 14.09$ 845.17$ 7.23$ 434.02$ 01020526 00 2.25$ 134.96$ 1.68$ 100.91$ 00020527 00 2.44$ 146.62$ 1.93$ 115.72$ 00020550 00 1.54$ 92.53$ 1.14$ 68.57$ 00020551 00 1.56$ 93.87$ 1.17$ 69.91$ 00020552 00 1.61$ 96.71$ 1.11$ 66.44$ 00020553 00 1.86$ 111.53$ 1.26$ 75.59$ 00020555 00 9.61$ 576.83$ 9.61$ 576.83$ 00020560 00 0.76$ 45.63$ 0.47$ 28.49$ XXX20561 00 1.13$ 67.74$ 0.72$ 42.98$ XXX20600 00 1.41$ 84.65$ 1.04$ 62.58$ 00020604 00 2.15$ 129.29$ 1.36$ 81.36$ 00020605 00 1.47$ 88.38$ 1.08$ 65.05$ 00020606 00 2.38$ 142.71$ 1.55$ 92.89$ 000



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

2060F 00 Code Accepted for Tracking Purpose only XXX20610 00 1.75$ 104.79$ 1.34$ 80.19$ 00020611 00 2.67$ 160.49$ 1.77$ 106.26$ 00020612 00 1.75$ 105.27$ 1.22$ 73.11$ 00020615 00 7.16$ 429.65$ 4.72$ 283.35$ 01020650 00 6.24$ 374.12$ 4.67$ 280.16$ 01020660 00 7.09$ 425.18$ 7.09$ 425.18$ 00020661 00 14.79$ 887.49$ 14.79$ 887.49$ 09020662 00 15.05$ 902.75$ 15.05$ 902.75$ 09020663 00 13.83$ 829.74$ 13.83$ 829.74$ 09020664 00 25.60$ 1,535.78$ 25.60$ 1,535.78$ 09020665 00 3.22$ 193.03$ 2.71$ 162.76$ 01020670 00 11.10$ 665.96$ 4.29$ 257.34$ 01020680 00 18.12$ 1,087.34$ 12.36$ 741.77$ 09020690 00 17.46$ 1,047.70$ 17.46$ 1,047.70$ 09020692 00 32.82$ 1,969.20$ 32.82$ 1,969.20$ 09020693 00 13.00$ 780.06$ 13.00$ 780.06$ 09020694 00 12.54$ 752.37$ 9.93$ 595.98$ 09020696 00 35.04$ 2,102.50$ 35.04$ 2,102.50$ 09020697 00 61.92$ 3,715.24$ 61.92$ 3,715.24$ 00020700 00 2.45$ 146.82$ 2.45$ 146.82$ ZZZ20701 00 1.83$ 109.64$ 1.83$ 109.64$ ZZZ20702 00 4.07$ 244.14$ 4.07$ 244.14$ ZZZ20703 00 2.92$ 175.23$ 2.92$ 175.23$ ZZZ20704 00 4.24$ 254.37$ 4.24$ 254.37$ ZZZ20705 00 3.49$ 209.44$ 3.49$ 209.44$ ZZZ20802 00 80.69$ 4,841.62$ 80.69$ 4,841.62$ 09020805 00 96.03$ 5,761.96$ 96.03$ 5,761.96$ 09020808 00 116.11$ 6,966.90$ 116.11$ 6,966.90$ 09020816 00 60.43$ 3,625.97$ 60.43$ 3,625.97$ 09020822 00 51.98$ 3,118.99$ 51.98$ 3,118.99$ 09020824 00 60.54$ 3,632.28$ 60.54$ 3,632.28$ 09020827 00 53.40$ 3,203.73$ 53.40$ 3,203.73$ 09020838 00 81.73$ 4,903.59$ 81.73$ 4,903.59$ 09020900 00 12.12$ 727.04$ 5.44$ 326.61$ 00020902 00 8.30$ 497.97$ 8.30$ 497.97$ 00020910 00 13.75$ 825.03$ 13.75$ 825.03$ 09020912 00 13.88$ 832.51$ 13.88$ 832.51$ 09020920 00 11.72$ 703.12$ 11.72$ 703.12$ 09020922 00 17.38$ 1,043.05$ 14.26$ 855.77$ 09020924 00 14.84$ 890.21$ 14.84$ 890.21$ 09020930 00 Bundled Bundled XXX



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

20931 00 3.26$ 195.87$ 3.26$ 195.87$ ZZZ20932 00 20.78$ 1,246.65$ 20.78$ 1,246.65$ ZZZ20933 00 19.05$ 1,143.18$ 19.05$ 1,143.18$ ZZZ20934 00 20.77$ 1,246.05$ 20.77$ 1,246.05$ ZZZ20936 00 Bundled Bundled XXX20937 00 4.91$ 294.32$ 4.91$ 294.32$ ZZZ20938 00 5.41$ 324.84$ 5.41$ 324.84$ ZZZ20939 00 1.95$ 116.74$ 1.95$ 116.74$ ZZZ20950 00 7.70$ 462.18$ 2.65$ 158.86$ 00020955 00 72.70$ 4,362.22$ 72.70$ 4,362.22$ 09020956 00 77.60$ 4,656.16$ 77.60$ 4,656.16$ 09020957 00 80.74$ 4,844.17$ 80.74$ 4,844.17$ 09020962 00 78.16$ 4,689.36$ 78.16$ 4,689.36$ 09020969 00 80.24$ 4,814.48$ 80.24$ 4,814.48$ 09020970 00 83.87$ 5,032.39$ 83.87$ 5,032.39$ 09020970 00 83.87$ 5,032.39$ 83.87$ 5,032.39$ 09020973 00 88.37$ 5,302.16$ 88.37$ 5,302.16$ 09020974 00 2.31$ 138.39$ 1.49$ 89.21$ 00020975 00 5.24$ 314.23$ 5.24$ 314.23$ 00020979 00 1.53$ 91.69$ 0.94$ 56.37$ 00020982 00 115.34$ 6,920.26$ 10.70$ 642.01$ 00020983 00 171.70$ 10,302.23$ 10.30$ 618.11$ 00020985 00 4.28$ 256.81$ 4.28$ 256.81$ ZZZ20999 00 By Report By Report YYY21010 00 22.48$ 1,348.80$ 22.48$ 1,348.80$ 09021011 00 10.43$ 626.00$ 7.56$ 453.85$ 09021012 00 9.93$ 595.88$ 9.93$ 595.88$ 09021013 00 15.43$ 925.83$ 11.77$ 706.38$ 09021014 00 15.29$ 917.13$ 15.29$ 917.13$ 09021015 00 20.67$ 1,240.15$ 20.67$ 1,240.15$ 09021016 00 29.60$ 1,775.81$ 29.60$ 1,775.81$ 09021025 00 25.47$ 1,528.40$ 21.48$ 1,288.77$ 09021026 00 17.51$ 1,050.60$ 14.17$ 850.06$ 09021029 00 22.66$ 1,359.71$ 18.65$ 1,118.83$ 09021030 00 15.05$ 903.10$ 11.98$ 718.96$ 09021031 00 11.67$ 700.07$ 8.55$ 512.79$ 09021032 00 11.74$ 704.39$ 8.41$ 504.49$ 09021034 00 38.29$ 2,297.15$ 33.57$ 2,014.01$ 09021040 00 15.17$ 909.95$ 12.00$ 720.14$ 09021044 00 25.54$ 1,532.14$ 25.54$ 1,532.14$ 09021045 00 35.72$ 2,143.16$ 35.72$ 2,143.16$ 09021046 00 32.23$ 1,933.98$ 32.23$ 1,933.98$ 090



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

21047 00 38.30$ 2,297.82$ 38.30$ 2,297.82$ 09021048 00 32.73$ 1,963.63$ 32.73$ 1,963.63$ 09021049 00 35.26$ 2,115.53$ 35.26$ 2,115.53$ 09021050 00 26.46$ 1,587.37$ 26.46$ 1,587.37$ 09021060 00 24.04$ 1,442.60$ 24.04$ 1,442.60$ 09021070 00 18.69$ 1,121.43$ 18.69$ 1,121.43$ 09021073 00 11.35$ 681.23$ 7.44$ 446.65$ 09021076 00 28.12$ 1,686.98$ 23.45$ 1,407.00$ 01021077 00 70.06$ 4,203.53$ 58.70$ 3,521.86$ 09021079 00 47.55$ 2,853.07$ 39.34$ 2,360.57$ 09021080 00 53.76$ 3,225.47$ 43.93$ 2,635.86$ 09021081 00 49.48$ 2,968.92$ 40.31$ 2,418.41$ 09021082 00 46.30$ 2,778.08$ 37.43$ 2,245.85$ 09021083 00 44.14$ 2,648.10$ 34.76$ 2,085.61$ 09021084 00 50.56$ 3,033.82$ 40.21$ 2,412.68$ 09021085 00 21.53$ 1,291.70$ 15.92$ 954.96$ 01021086 00 52.04$ 3,122.64$ 43.29$ 2,597.35$ 09021087 00 52.04$ 3,122.64$ 43.29$ 2,597.35$ 09021088 00 By Report By Report 09021089 00 By Report By Report YYY21100 00 20.59$ 1,235.34$ 11.61$ 696.81$ 09021110 00 24.17$ 1,450.40$ 20.19$ 1,211.41$ 09021116 00 5.28$ 317.08$ 1.40$ 83.76$ 00021120 00 19.96$ 1,197.39$ 15.67$ 940.11$ 09021121 00 21.50$ 1,289.87$ 18.27$ 1,096.28$ 09021122 00 22.94$ 1,376.46$ 22.94$ 1,376.46$ 09021123 00 26.70$ 1,601.74$ 26.70$ 1,601.74$ 09021125 00 86.37$ 5,181.92$ 21.80$ 1,308.14$ 09021127 00 117.09$ 7,025.51$ 25.10$ 1,505.87$ 09021137 00 22.04$ 1,322.32$ 22.04$ 1,322.32$ 09021138 00 26.90$ 1,613.81$ 26.90$ 1,613.81$ 09021139 00 32.79$ 1,967.12$ 32.79$ 1,967.12$ 09021141 00 40.16$ 2,409.80$ 40.16$ 2,409.80$ 09021142 00 41.27$ 2,476.33$ 41.27$ 2,476.33$ 09021143 00 43.07$ 2,584.32$ 43.07$ 2,584.32$ 09021145 00 47.00$ 2,819.94$ 47.00$ 2,819.94$ 09021146 00 49.00$ 2,939.80$ 49.00$ 2,939.80$ 09021147 00 51.66$ 3,099.79$ 51.66$ 3,099.79$ 09021150 00 48.47$ 2,908.39$ 48.47$ 2,908.39$ 09021151 00 53.32$ 3,199.49$ 53.32$ 3,199.49$ 09021154 00 57.36$ 3,441.76$ 57.36$ 3,441.76$ 09021155 00 63.61$ 3,816.62$ 63.61$ 3,816.62$ 090



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

21159 00 76.20$ 4,571.71$ 76.20$ 4,571.71$ 09021160 00 82.62$ 4,957.45$ 82.62$ 4,957.45$ 09021172 00 61.10$ 3,665.83$ 61.10$ 3,665.83$ 09021175 00 64.83$ 3,890.02$ 64.83$ 3,890.02$ 09021179 00 44.55$ 2,673.06$ 44.55$ 2,673.06$ 09021180 00 49.85$ 2,991.10$ 49.85$ 2,991.10$ 09021181 00 21.69$ 1,301.41$ 21.69$ 1,301.41$ 09021182 00 62.21$ 3,732.46$ 62.21$ 3,732.46$ 09021183 00 67.77$ 4,066.08$ 67.77$ 4,066.08$ 09021184 00 72.94$ 4,376.66$ 72.94$ 4,376.66$ 09021188 00 49.18$ 2,951.08$ 49.18$ 2,951.08$ 09021193 00 37.51$ 2,250.47$ 37.51$ 2,250.47$ 09021194 00 43.09$ 2,585.65$ 43.09$ 2,585.65$ 09021195 00 41.82$ 2,509.19$ 41.82$ 2,509.19$ 09021196 00 42.97$ 2,577.99$ 42.97$ 2,577.99$ 09021198 00 33.74$ 2,024.41$ 33.74$ 2,024.41$ 09021199 00 31.48$ 1,888.93$ 31.48$ 1,888.93$ 09021206 00 34.89$ 2,093.46$ 34.89$ 2,093.46$ 09021208 00 51.70$ 3,101.82$ 23.70$ 1,421.90$ 09021209 00 26.56$ 1,593.79$ 19.77$ 1,186.43$ 09021210 00 62.58$ 3,754.80$ 24.37$ 1,461.94$ 09021215 00 119.75$ 7,184.76$ 25.39$ 1,523.23$ 09021230 00 21.72$ 1,303.32$ 21.72$ 1,303.32$ 09021235 00 21.35$ 1,281.00$ 16.59$ 995.34$ 09021240 00 32.72$ 1,962.99$ 32.72$ 1,962.99$ 09021242 00 30.56$ 1,833.41$ 30.56$ 1,833.41$ 09021243 00 49.78$ 2,986.66$ 49.78$ 2,986.66$ 09021244 00 30.67$ 1,839.95$ 30.67$ 1,839.95$ 09021245 00 35.81$ 2,148.84$ 28.06$ 1,683.46$ 09021246 00 25.87$ 1,552.43$ 25.87$ 1,552.43$ 09021247 00 48.12$ 2,886.98$ 48.12$ 2,886.98$ 09021248 00 31.85$ 1,910.78$ 25.80$ 1,548.19$ 09021249 00 45.93$ 2,756.09$ 37.32$ 2,239.00$ 09021255 00 41.52$ 2,491.28$ 41.52$ 2,491.28$ 09021256 00 36.44$ 2,186.15$ 36.44$ 2,186.15$ 09021260 00 41.04$ 2,462.66$ 41.04$ 2,462.66$ 09021261 00 72.55$ 4,352.70$ 72.55$ 4,352.70$ 09021263 00 67.11$ 4,026.34$ 67.11$ 4,026.34$ 09021267 00 48.07$ 2,883.94$ 48.07$ 2,883.94$ 09021268 00 60.11$ 3,606.38$ 60.11$ 3,606.38$ 09021270 00 29.83$ 1,789.98$ 22.02$ 1,321.44$ 09021275 00 24.63$ 1,477.65$ 24.63$ 1,477.65$ 090



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

21280 00 16.83$ 1,009.99$ 16.83$ 1,009.99$ 09021282 00 11.32$ 679.07$ 11.32$ 679.07$ 09021295 00 5.52$ 331.46$ 5.52$ 331.46$ 09021296 00 12.06$ 723.54$ 12.06$ 723.54$ 09021299 00 By Report By Report YYY21310 00 3.92$ 234.94$ 0.78$ 47.02$ 00021315 00 8.12$ 487.40$ 4.42$ 265.43$ 01021320 00 7.48$ 448.81$ 3.91$ 234.40$ 01021325 00 13.80$ 828.13$ 13.80$ 828.13$ 09021330 00 16.62$ 997.27$ 16.62$ 997.27$ 09021335 00 21.01$ 1,260.35$ 21.01$ 1,260.35$ 09021336 00 18.89$ 1,133.64$ 18.89$ 1,133.64$ 09021337 00 11.99$ 719.64$ 8.63$ 517.85$ 09021338 00 19.41$ 1,164.53$ 19.41$ 1,164.53$ 09021339 00 22.00$ 1,319.83$ 22.00$ 1,319.83$ 09021340 00 21.70$ 1,302.20$ 21.70$ 1,302.20$ 09021343 00 31.52$ 1,891.07$ 31.52$ 1,891.07$ 09021344 00 40.37$ 2,422.42$ 40.37$ 2,422.42$ 09021345 00 22.81$ 1,368.87$ 18.26$ 1,095.82$ 09021346 00 27.23$ 1,634.08$ 27.23$ 1,634.08$ 09021347 00 29.67$ 1,780.14$ 29.67$ 1,780.14$ 09021348 00 31.53$ 1,891.64$ 31.53$ 1,891.64$ 09021355 00 12.53$ 751.84$ 9.36$ 561.40$ 01021356 00 14.72$ 883.46$ 11.09$ 665.27$ 01021360 00 14.90$ 894.10$ 14.90$ 894.10$ 09021365 00 32.48$ 1,948.90$ 32.48$ 1,948.90$ 09021366 00 37.38$ 2,242.92$ 37.38$ 2,242.92$ 09021385 00 22.15$ 1,328.84$ 22.15$ 1,328.84$ 09021386 00 20.37$ 1,222.27$ 20.37$ 1,222.27$ 09021387 00 23.10$ 1,385.97$ 23.10$ 1,385.97$ 09021390 00 23.44$ 1,406.62$ 23.44$ 1,406.62$ 09021395 00 29.57$ 1,774.31$ 29.57$ 1,774.31$ 09021400 00 5.92$ 355.45$ 4.73$ 283.56$ 09021401 00 15.26$ 915.43$ 9.46$ 567.34$ 09021406 00 16.89$ 1,013.37$ 16.89$ 1,013.37$ 09021407 00 18.91$ 1,134.81$ 18.91$ 1,134.81$ 09021408 00 26.42$ 1,585.21$ 26.42$ 1,585.21$ 09021421 00 20.97$ 1,257.91$ 17.69$ 1,061.16$ 09021422 00 19.36$ 1,161.88$ 19.36$ 1,161.88$ 09021423 00 22.64$ 1,358.67$ 22.64$ 1,358.67$ 09021431 00 21.12$ 1,267.40$ 21.12$ 1,267.40$ 09021432 00 21.12$ 1,266.92$ 21.12$ 1,266.92$ 090



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

21433 00 50.97$ 3,058.26$ 50.97$ 3,058.26$ 09021435 00 41.20$ 2,471.96$ 41.20$ 2,471.96$ 09021436 00 59.81$ 3,588.39$ 59.81$ 3,588.39$ 09021440 00 17.99$ 1,079.17$ 14.54$ 872.33$ 09021445 00 22.98$ 1,378.74$ 18.58$ 1,114.52$ 09021450 00 17.04$ 1,022.47$ 13.92$ 835.19$ 09021451 00 22.48$ 1,348.91$ 18.83$ 1,130.10$ 09021452 00 19.99$ 1,199.22$ 11.84$ 710.51$ 09021453 00 28.59$ 1,715.43$ 24.41$ 1,464.45$ 09021454 00 16.00$ 959.92$ 16.00$ 959.92$ 09021461 00 61.86$ 3,711.67$ 28.92$ 1,735.37$ 09021462 00 65.88$ 3,952.59$ 32.12$ 1,927.10$ 09021465 00 26.36$ 1,581.30$ 26.36$ 1,581.30$ 09021470 00 35.14$ 2,108.48$ 35.14$ 2,108.48$ 09021480 00 3.19$ 191.26$ 0.92$ 55.05$ 00021485 00 24.70$ 1,481.72$ 20.22$ 1,213.08$ 09021490 00 26.00$ 1,559.92$ 26.00$ 1,559.92$ 09021497 00 20.31$ 1,218.63$ 17.04$ 1,022.51$ 09021499 00 By Report By Report YYY21501 00 13.57$ 814.31$ 9.48$ 569.01$ 09021502 00 14.73$ 883.64$ 14.73$ 883.64$ 09021510 00 12.97$ 778.28$ 12.97$ 778.28$ 09021550 00 7.71$ 462.38$ 4.61$ 276.35$ 01021552 00 13.04$ 782.11$ 13.04$ 782.11$ 09021554 00 21.33$ 1,279.76$ 21.33$ 1,279.76$ 09021555 00 12.40$ 744.20$ 8.95$ 536.73$ 09021556 00 15.43$ 926.02$ 15.43$ 926.02$ 09021557 00 27.84$ 1,670.39$ 27.84$ 1,670.39$ 09021558 00 39.19$ 2,351.49$ 39.19$ 2,351.49$ 09021600 00 16.13$ 967.75$ 16.13$ 967.75$ 09021601 00 34.34$ 2,060.56$ 34.34$ 2,060.56$ 09021602 00 46.26$ 2,775.71$ 46.26$ 2,775.71$ 09021603 00 51.11$ 3,066.52$ 51.11$ 3,066.52$ 09021610 00 35.28$ 2,117.00$ 35.28$ 2,117.00$ 09021615 00 17.69$ 1,061.64$ 17.69$ 1,061.64$ 09021616 00 20.65$ 1,239.08$ 20.65$ 1,239.08$ 09021620 00 14.72$ 883.49$ 14.72$ 883.49$ 09021627 00 15.74$ 944.61$ 15.74$ 944.61$ 09021630 00 35.88$ 2,152.94$ 35.88$ 2,152.94$ 09021632 00 35.17$ 2,110.25$ 35.17$ 2,110.25$ 09021685 00 28.70$ 1,721.79$ 28.70$ 1,721.79$ 09021700 00 10.35$ 621.06$ 10.35$ 621.06$ 090



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

21705 00 15.48$ 928.82$ 15.48$ 928.82$ 09021720 00 15.39$ 923.39$ 15.39$ 923.39$ 09021725 00 15.86$ 951.58$ 15.86$ 951.58$ 09021740 00 30.02$ 1,801.35$ 30.02$ 1,801.35$ 09021742 00 1,126.66$ 1,126.66$ 09021743 00 By Report By Report 09021750 00 19.86$ 1,191.49$ 19.86$ 1,191.49$ 09021811 00 17.26$ 1,035.46$ 17.26$ 1,035.46$ 00021812 00 21.18$ 1,270.77$ 21.18$ 1,270.77$ 00021813 00 28.78$ 1,726.63$ 28.78$ 1,726.63$ 00021820 00 4.20$ 251.76$ 4.22$ 253.02$ 09021825 00 15.81$ 948.30$ 15.81$ 948.30$ 09021899 00 By Report By Report YYY21920 00 7.54$ 452.21$ 4.65$ 278.79$ 01021925 00 13.43$ 805.91$ 10.49$ 629.34$ 09021930 00 14.18$ 850.72$ 10.67$ 640.10$ 09021931 00 13.74$ 824.24$ 13.74$ 824.24$ 09021932 00 19.31$ 1,158.82$ 19.31$ 1,158.82$ 09021933 00 21.55$ 1,292.92$ 21.55$ 1,292.92$ 09021935 00 30.00$ 1,799.86$ 30.00$ 1,799.86$ 09021936 00 41.37$ 2,482.42$ 41.37$ 2,482.42$ 09022010 00 28.08$ 1,684.76$ 28.08$ 1,684.76$ 09022015 00 27.76$ 1,665.41$ 27.76$ 1,665.41$ 09022100 00 25.23$ 1,513.50$ 25.23$ 1,513.50$ 09022101 00 25.14$ 1,508.25$ 25.14$ 1,508.25$ 09022102 00 23.85$ 1,430.98$ 23.85$ 1,430.98$ 09022103 00 4.12$ 247.05$ 4.12$ 247.05$ ZZZ22110 00 30.62$ 1,836.92$ 30.62$ 1,836.92$ 09022112 00 32.98$ 1,978.77$ 32.98$ 1,978.77$ 09022114 00 32.98$ 1,978.77$ 32.98$ 1,978.77$ 09022116 00 4.13$ 247.86$ 4.13$ 247.86$ ZZZ22206 00 71.83$ 4,309.58$ 71.83$ 4,309.58$ 09022207 00 70.44$ 4,226.45$ 70.44$ 4,226.45$ 09022208 00 17.32$ 1,039.39$ 17.32$ 1,039.39$ ZZZ22210 00 52.52$ 3,151.32$ 52.52$ 3,151.32$ 09022212 00 43.73$ 2,623.50$ 43.73$ 2,623.50$ 09022214 00 43.90$ 2,633.85$ 43.90$ 2,633.85$ 09022216 00 10.66$ 639.57$ 10.66$ 639.57$ ZZZ22220 00 47.49$ 2,849.53$ 47.49$ 2,849.53$ 09022222 00 51.37$ 3,082.15$ 51.37$ 3,082.15$ 09022224 00 46.46$ 2,787.76$ 46.46$ 2,787.76$ 09022226 00 10.63$ 637.67$ 10.63$ 637.67$ ZZZ



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

22310 00 8.99$ 539.35$ 8.31$ 498.36$ 09022315 00 25.88$ 1,553.00$ 22.57$ 1,354.36$ 09022318 00 47.91$ 2,874.54$ 47.91$ 2,874.54$ 09022319 00 53.79$ 3,227.39$ 53.79$ 3,227.39$ 09022325 00 42.40$ 2,544.04$ 42.40$ 2,544.04$ 09022326 00 43.81$ 2,628.48$ 43.81$ 2,628.48$ 09022327 00 44.29$ 2,657.29$ 44.29$ 2,657.29$ 09022328 00 8.27$ 496.03$ 8.27$ 496.03$ ZZZ22505 00 3.85$ 230.98$ 3.85$ 230.98$ 01022510 00 51.90$ 3,113.92$ 12.71$ 762.41$ 01022511 00 51.41$ 3,084.36$ 11.92$ 715.20$ 01022512 00 26.66$ 1,599.31$ 6.05$ 362.71$ ZZZ22513 00 204.93$ 12,295.71$ 15.13$ 907.70$ 01022514 00 204.31$ 12,258.69$ 14.10$ 846.09$ 01022515 00 118.64$ 7,118.28$ 6.51$ 390.41$ ZZZ22526 00 67.96$ 4,077.80$ 9.90$ 593.74$ 01022527 00 57.23$ 3,433.62$ 4.66$ 279.36$ ZZZ22532 00 52.78$ 3,167.07$ 52.78$ 3,167.07$ 09022533 00 48.66$ 2,919.42$ 48.66$ 2,919.42$ 09022534 00 10.57$ 633.91$ 10.57$ 633.91$ ZZZ22548 00 57.75$ 3,465.25$ 57.75$ 3,465.25$ 09022551 00 49.99$ 2,999.61$ 49.99$ 2,999.61$ 09022552 00 11.66$ 699.86$ 11.66$ 699.86$ ZZZ22554 00 36.74$ 2,204.30$ 36.74$ 2,204.30$ 09022556 00 48.97$ 2,938.16$ 48.97$ 2,938.16$ 09022558 00 44.89$ 2,693.59$ 44.89$ 2,693.59$ 09022585 00 9.59$ 575.21$ 9.59$ 575.21$ ZZZ22586 00 59.81$ 3,588.72$ 59.81$ 3,588.72$ 09022590 00 46.31$ 2,778.72$ 46.31$ 2,778.72$ 09022595 00 44.21$ 2,652.42$ 44.21$ 2,652.42$ 09022600 00 37.83$ 2,270.04$ 37.83$ 2,270.04$ 09022610 00 37.16$ 2,229.66$ 37.16$ 2,229.66$ 09022612 00 46.50$ 2,789.91$ 46.50$ 2,789.91$ 09022614 00 11.46$ 687.43$ 11.46$ 687.43$ ZZZ22630 00 46.14$ 2,768.24$ 46.14$ 2,768.24$ 09022632 00 9.41$ 564.76$ 9.41$ 564.76$ ZZZ22633 00 54.26$ 3,255.56$ 54.26$ 3,255.56$ 09022634 00 14.53$ 871.56$ 14.53$ 871.56$ ZZZ22800 00 39.79$ 2,387.29$ 39.79$ 2,387.29$ 09022802 00 61.70$ 3,702.04$ 61.70$ 3,702.04$ 09022804 00 71.27$ 4,276.50$ 71.27$ 4,276.50$ 09022808 00 54.20$ 3,251.93$ 54.20$ 3,251.93$ 090



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

22810 00 60.70$ 3,642.29$ 60.70$ 3,642.29$ 09022812 00 64.87$ 3,892.12$ 64.87$ 3,892.12$ 09022818 00 63.60$ 3,816.16$ 63.60$ 3,816.16$ 09022819 00 73.14$ 4,388.42$ 73.14$ 4,388.42$ 09022830 00 23.90$ 1,434.24$ 23.90$ 1,434.24$ 09022840 00 22.28$ 1,336.63$ 22.28$ 1,336.63$ ZZZ22841 00 Bundled Bundled XXX22842 00 22.39$ 1,343.51$ 22.39$ 1,343.51$ ZZZ22843 00 23.95$ 1,437.05$ 23.95$ 1,437.05$ ZZZ22844 00 28.96$ 1,737.81$ 28.96$ 1,737.81$ ZZZ22845 00 21.38$ 1,282.85$ 21.38$ 1,282.85$ ZZZ22846 00 22.20$ 1,332.28$ 22.20$ 1,332.28$ ZZZ22847 00 23.73$ 1,423.76$ 23.73$ 1,423.76$ ZZZ22848 00 10.55$ 633.24$ 10.55$ 633.24$ ZZZ22849 00 38.08$ 2,284.77$ 38.08$ 2,284.77$ 09022850 00 21.30$ 1,278.01$ 21.30$ 1,278.01$ 09022852 00 20.47$ 1,228.09$ 20.47$ 1,228.09$ 09022853 00 7.57$ 454.47$ 7.57$ 454.47$ ZZZ22854 00 9.81$ 588.59$ 9.81$ 588.59$ ZZZ22855 00 32.48$ 1,948.75$ 32.48$ 1,948.75$ 09022856 00 48.00$ 2,879.97$ 48.00$ 2,879.97$ 09022857 00 52.10$ 3,125.85$ 52.10$ 3,125.85$ 09022858 00 14.97$ 898.31$ 14.97$ 898.31$ ZZZ22859 00 9.81$ 588.59$ 9.81$ 588.59$ ZZZ22861 00 68.52$ 4,111.23$ 68.52$ 4,111.23$ 09022862 00 55.72$ 3,342.95$ 55.72$ 3,342.95$ 09022864 00 61.07$ 3,664.12$ 61.07$ 3,664.12$ 09022865 00 57.64$ 3,458.17$ 57.64$ 3,458.17$ 09022867 00 28.51$ 1,710.74$ 28.51$ 1,710.74$ 09022868 00 7.08$ 424.89$ 7.08$ 424.89$ ZZZ22869 00 13.49$ 809.18$ 13.49$ 809.18$ 09022870 00 3.66$ 219.89$ 3.66$ 219.89$ ZZZ22899 00 By Report By Report YYY22900 00 16.45$ 987.09$ 16.45$ 987.09$ 09022901 00 19.42$ 1,165.26$ 19.42$ 1,165.26$ 09022902 00 13.17$ 790.43$ 9.68$ 581.07$ 09022903 00 12.85$ 770.77$ 12.85$ 770.77$ 09022904 00 30.81$ 1,848.56$ 30.81$ 1,848.56$ 09022905 00 38.91$ 2,334.34$ 38.91$ 2,334.34$ 09022999 00 By Report By Report YYY23000 00 16.59$ 995.47$ 10.56$ 633.51$ 09023020 00 20.21$ 1,212.30$ 20.21$ 1,212.30$ 090



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

23030 00 12.82$ 769.34$ 7.33$ 439.54$ 01023031 00 11.84$ 710.26$ 6.11$ 366.58$ 01023035 00 19.83$ 1,189.82$ 19.83$ 1,189.82$ 09023040 00 21.01$ 1,260.44$ 21.01$ 1,260.44$ 09023044 00 16.60$ 995.74$ 16.60$ 995.74$ 09023065 00 6.51$ 390.84$ 4.91$ 294.36$ 01023066 00 16.69$ 1,001.66$ 10.62$ 637.17$ 09023071 00 12.27$ 736.06$ 12.27$ 736.06$ 09023073 00 20.32$ 1,219.19$ 20.32$ 1,219.19$ 09023075 00 14.30$ 858.11$ 9.58$ 574.97$ 09023076 00 15.85$ 951.18$ 15.85$ 951.18$ 09023077 00 33.17$ 1,990.42$ 33.17$ 1,990.42$ 09023078 00 41.95$ 2,516.73$ 41.95$ 2,516.73$ 09023100 00 14.72$ 883.38$ 14.72$ 883.38$ 09023101 00 13.40$ 804.02$ 13.40$ 804.02$ 09023105 00 18.69$ 1,121.12$ 18.69$ 1,121.12$ 09023106 00 14.61$ 876.70$ 14.61$ 876.70$ 09023107 00 19.35$ 1,161.27$ 19.35$ 1,161.27$ 09023120 00 17.14$ 1,028.25$ 17.14$ 1,028.25$ 09023125 00 20.80$ 1,248.16$ 20.80$ 1,248.16$ 09023130 00 17.96$ 1,077.80$ 17.96$ 1,077.80$ 09023140 00 16.20$ 972.10$ 16.20$ 972.10$ 09023145 00 20.39$ 1,223.34$ 20.39$ 1,223.34$ 09023146 00 18.23$ 1,094.07$ 18.23$ 1,094.07$ 09023150 00 19.29$ 1,157.26$ 19.29$ 1,157.26$ 09023155 00 23.31$ 1,398.58$ 23.31$ 1,398.58$ 09023156 00 19.90$ 1,194.24$ 19.90$ 1,194.24$ 09023170 00 16.47$ 988.10$ 16.47$ 988.10$ 09023172 00 16.64$ 998.39$ 16.64$ 998.39$ 09023174 00 22.31$ 1,338.33$ 22.31$ 1,338.33$ 09023180 00 19.31$ 1,158.52$ 19.31$ 1,158.52$ 09023182 00 19.31$ 1,158.75$ 19.31$ 1,158.75$ 09023184 00 21.48$ 1,288.90$ 21.48$ 1,288.90$ 09023190 00 16.81$ 1,008.37$ 16.81$ 1,008.37$ 09023195 00 21.84$ 1,310.29$ 21.84$ 1,310.29$ 09023200 00 44.35$ 2,661.22$ 44.35$ 2,661.22$ 09023210 00 52.11$ 3,126.73$ 52.11$ 3,126.73$ 09023220 00 57.06$ 3,423.49$ 57.06$ 3,423.49$ 09023330 00 8.30$ 498.19$ 4.90$ 293.88$ 01023333 00 13.53$ 812.09$ 13.53$ 812.09$ 09023334 00 31.36$ 1,881.35$ 31.36$ 1,881.35$ 09023335 00 37.39$ 2,243.45$ 37.39$ 2,243.45$ 090



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

23350 00 4.12$ 247.01$ 1.49$ 89.36$ 00023395 00 37.56$ 2,253.59$ 37.56$ 2,253.59$ 09023397 00 33.17$ 1,990.05$ 33.17$ 1,990.05$ 09023400 00 28.50$ 1,710.29$ 28.50$ 1,710.29$ 09023405 00 18.09$ 1,085.36$ 18.09$ 1,085.36$ 09023406 00 22.58$ 1,354.64$ 22.58$ 1,354.64$ 09023410 00 24.04$ 1,442.62$ 24.04$ 1,442.62$ 09023412 00 24.94$ 1,496.59$ 24.94$ 1,496.59$ 09023415 00 20.48$ 1,228.53$ 20.48$ 1,228.53$ 09023420 00 28.45$ 1,706.81$ 28.45$ 1,706.81$ 09023430 00 21.79$ 1,307.58$ 21.79$ 1,307.58$ 09023440 00 22.06$ 1,323.73$ 22.06$ 1,323.73$ 09023450 00 27.81$ 1,668.73$ 27.81$ 1,668.73$ 09023455 00 29.17$ 1,750.47$ 29.17$ 1,750.47$ 09023460 00 31.97$ 1,918.27$ 31.97$ 1,918.27$ 09023462 00 30.83$ 1,849.54$ 30.83$ 1,849.54$ 09023465 00 32.80$ 1,967.91$ 32.80$ 1,967.91$ 09023466 00 32.64$ 1,958.56$ 32.64$ 1,958.56$ 09023470 00 35.10$ 2,106.03$ 35.10$ 2,106.03$ 09023472 00 42.52$ 2,551.48$ 42.52$ 2,551.48$ 09023473 00 47.42$ 2,845.29$ 47.42$ 2,845.29$ 09023474 00 51.21$ 3,072.46$ 51.21$ 3,072.46$ 09023480 00 24.08$ 1,444.84$ 24.08$ 1,444.84$ 09023485 00 27.92$ 1,675.50$ 27.92$ 1,675.50$ 09023490 00 25.28$ 1,516.64$ 25.28$ 1,516.64$ 09023491 00 29.77$ 1,786.29$ 29.77$ 1,786.29$ 09023500 00 6.41$ 384.60$ 6.55$ 392.80$ 09023505 00 10.40$ 624.21$ 9.73$ 583.86$ 09023515 00 21.08$ 1,264.55$ 21.08$ 1,264.55$ 09023520 00 6.90$ 413.99$ 6.91$ 414.62$ 09023525 00 11.42$ 684.98$ 10.50$ 630.12$ 09023530 00 16.83$ 1,009.60$ 16.83$ 1,009.60$ 09023532 00 18.33$ 1,099.81$ 18.33$ 1,099.81$ 09023540 00 6.72$ 402.96$ 6.74$ 404.22$ 09023545 00 10.19$ 611.54$ 9.16$ 549.74$ 09023550 00 16.66$ 999.52$ 16.66$ 999.52$ 09023552 00 19.15$ 1,149.29$ 19.15$ 1,149.29$ 09023570 00 6.80$ 407.76$ 7.02$ 421.00$ 09023575 00 11.88$ 712.64$ 11.06$ 663.46$ 09023585 00 28.65$ 1,719.03$ 28.65$ 1,719.03$ 09023600 00 9.64$ 578.60$ 9.07$ 543.91$ 09023605 00 13.66$ 819.56$ 12.44$ 746.41$ 090



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

23615 00 25.89$ 1,553.53$ 25.89$ 1,553.53$ 09023616 00 36.26$ 2,175.67$ 36.26$ 2,175.67$ 09023620 00 7.87$ 471.97$ 7.52$ 451.16$ 09023625 00 11.19$ 671.65$ 10.32$ 619.31$ 09023630 00 22.87$ 1,372.38$ 22.87$ 1,372.38$ 09023650 00 9.34$ 560.29$ 8.49$ 509.21$ 09023655 00 11.83$ 709.68$ 11.83$ 709.68$ 09023660 00 17.07$ 1,024.06$ 17.07$ 1,024.06$ 09023665 00 12.55$ 753.15$ 11.62$ 697.03$ 09023670 00 25.63$ 1,537.90$ 25.63$ 1,537.90$ 09023675 00 16.13$ 967.82$ 14.63$ 877.65$ 09023680 00 27.18$ 1,630.71$ 27.18$ 1,630.71$ 09023700 00 5.75$ 344.74$ 5.75$ 344.74$ 01023800 00 30.08$ 1,805.10$ 30.08$ 1,805.10$ 09023802 00 37.63$ 2,257.73$ 37.63$ 2,257.73$ 09023900 00 40.66$ 2,439.55$ 40.66$ 2,439.55$ 09023920 00 33.02$ 1,981.41$ 33.02$ 1,981.41$ 09023921 00 13.75$ 824.83$ 13.75$ 824.83$ 09023929 00 By Report By Report YYY23930 00 10.47$ 628.10$ 6.23$ 373.97$ 01023931 00 8.48$ 509.03$ 4.58$ 275.07$ 01023935 00 14.91$ 894.51$ 14.91$ 894.51$ 09024000 00 13.99$ 839.12$ 13.99$ 839.12$ 09024006 00 20.93$ 1,255.84$ 20.93$ 1,255.84$ 09024065 00 7.64$ 458.38$ 4.89$ 293.16$ 01024066 00 18.59$ 1,115.23$ 12.28$ 736.87$ 09024071 00 11.88$ 712.51$ 11.88$ 712.51$ 09024073 00 20.27$ 1,216.29$ 20.27$ 1,216.29$ 09024075 00 14.88$ 892.80$ 9.66$ 579.39$ 09024076 00 15.94$ 956.18$ 15.94$ 956.18$ 09024077 00 30.31$ 1,818.44$ 30.31$ 1,818.44$ 09024079 00 38.69$ 2,321.11$ 38.69$ 2,321.11$ 09024100 00 12.28$ 736.80$ 12.28$ 736.80$ 09024101 00 14.67$ 880.47$ 14.67$ 880.47$ 09024102 00 18.06$ 1,083.81$ 18.06$ 1,083.81$ 09024105 00 10.37$ 622.11$ 10.37$ 622.11$ 09024110 00 17.18$ 1,031.04$ 17.18$ 1,031.04$ 09024115 00 21.64$ 1,298.34$ 21.64$ 1,298.34$ 09024116 00 25.27$ 1,516.30$ 25.27$ 1,516.30$ 09024120 00 15.56$ 933.32$ 15.56$ 933.32$ 09024125 00 18.22$ 1,093.20$ 18.22$ 1,093.20$ 09024126 00 19.05$ 1,142.83$ 19.05$ 1,142.83$ 090



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

24130 00 14.97$ 898.11$ 14.97$ 898.11$ 09024134 00 21.93$ 1,315.57$ 21.93$ 1,315.57$ 09024136 00 18.52$ 1,110.94$ 18.52$ 1,110.94$ 09024138 00 19.91$ 1,194.39$ 19.91$ 1,194.39$ 09024140 00 20.58$ 1,234.68$ 20.58$ 1,234.68$ 09024145 00 17.38$ 1,042.84$ 17.38$ 1,042.84$ 09024147 00 18.30$ 1,098.13$ 18.30$ 1,098.13$ 09024149 00 34.47$ 2,068.00$ 34.47$ 2,068.00$ 09024150 00 45.52$ 2,731.18$ 45.52$ 2,731.18$ 09024152 00 39.56$ 2,373.33$ 39.56$ 2,373.33$ 09024155 00 25.01$ 1,500.60$ 25.01$ 1,500.60$ 09024160 00 37.01$ 2,220.69$ 37.01$ 2,220.69$ 09024164 00 21.26$ 1,275.56$ 21.26$ 1,275.56$ 09024200 00 6.21$ 372.68$ 4.08$ 244.67$ 01024201 00 16.29$ 977.17$ 10.66$ 639.80$ 09024220 00 4.88$ 292.62$ 1.98$ 118.58$ 00024300 00 12.41$ 744.50$ 12.41$ 744.50$ 09024301 00 21.99$ 1,319.44$ 21.99$ 1,319.44$ 09024305 00 16.92$ 1,015.33$ 16.92$ 1,015.33$ 09024310 00 13.70$ 822.29$ 13.70$ 822.29$ 09024320 00 22.90$ 1,373.99$ 22.90$ 1,373.99$ 09024330 00 21.06$ 1,263.83$ 21.06$ 1,263.83$ 09024331 00 23.06$ 1,383.68$ 23.06$ 1,383.68$ 09024332 00 17.99$ 1,079.62$ 17.99$ 1,079.62$ 09024340 00 17.93$ 1,076.07$ 17.93$ 1,076.07$ 09024341 00 21.85$ 1,311.06$ 21.85$ 1,311.06$ 09024342 00 22.72$ 1,363.35$ 22.72$ 1,363.35$ 09024343 00 20.81$ 1,248.89$ 20.81$ 1,248.89$ 09024344 00 32.01$ 1,920.31$ 32.01$ 1,920.31$ 09024345 00 20.65$ 1,238.88$ 20.65$ 1,238.88$ 09024346 00 32.25$ 1,934.81$ 32.25$ 1,934.81$ 09024357 00 12.23$ 733.53$ 12.23$ 733.53$ 09024358 00 15.36$ 921.45$ 15.36$ 921.45$ 09024359 00 19.36$ 1,161.49$ 19.36$ 1,161.49$ 09024360 00 26.42$ 1,584.95$ 26.42$ 1,584.95$ 09024361 00 29.53$ 1,771.74$ 29.53$ 1,771.74$ 09024362 00 31.07$ 1,864.37$ 31.07$ 1,864.37$ 09024363 00 42.57$ 2,554.21$ 42.57$ 2,554.21$ 09024365 00 18.76$ 1,125.80$ 18.76$ 1,125.80$ 09024366 00 19.95$ 1,197.04$ 19.95$ 1,197.04$ 09024370 00 45.36$ 2,721.57$ 45.36$ 2,721.57$ 09024371 00 52.08$ 3,125.01$ 52.08$ 3,125.01$ 090



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

24400 00 24.13$ 1,447.82$ 24.13$ 1,447.82$ 09024410 00 31.00$ 1,860.20$ 31.00$ 1,860.20$ 09024420 00 29.10$ 1,746.04$ 29.10$ 1,746.04$ 09024430 00 30.88$ 1,852.90$ 30.88$ 1,852.90$ 09024435 00 31.55$ 1,892.84$ 31.55$ 1,892.84$ 09024470 00 19.70$ 1,181.80$ 19.70$ 1,181.80$ 09024495 00 21.79$ 1,307.66$ 21.79$ 1,307.66$ 09024498 00 25.36$ 1,521.88$ 25.36$ 1,521.88$ 09024500 00 10.50$ 629.92$ 9.59$ 575.69$ 09024505 00 14.62$ 877.48$ 13.14$ 788.56$ 09024515 00 25.71$ 1,542.35$ 25.71$ 1,542.35$ 09024516 00 25.17$ 1,510.39$ 25.17$ 1,510.39$ 09024530 00 11.15$ 668.97$ 10.14$ 608.43$ 09024535 00 18.09$ 1,085.22$ 16.64$ 998.19$ 09024538 00 21.91$ 1,314.41$ 21.91$ 1,314.41$ 09024545 00 27.22$ 1,633.23$ 27.22$ 1,633.23$ 09024546 00 30.43$ 1,825.74$ 30.43$ 1,825.74$ 09024560 00 9.57$ 573.94$ 8.50$ 510.25$ 09024565 00 15.75$ 944.95$ 14.40$ 864.24$ 09024566 00 21.08$ 1,264.54$ 21.08$ 1,264.54$ 09024575 00 21.46$ 1,287.45$ 21.46$ 1,287.45$ 09024576 00 10.09$ 605.64$ 8.99$ 539.43$ 09024577 00 16.21$ 972.40$ 14.79$ 887.27$ 09024579 00 24.48$ 1,469.06$ 24.48$ 1,469.06$ 09024582 00 23.80$ 1,428.10$ 23.80$ 1,428.10$ 09024586 00 31.72$ 1,903.03$ 31.72$ 1,903.03$ 09024587 00 31.91$ 1,914.57$ 31.91$ 1,914.57$ 09024600 00 10.82$ 648.93$ 9.81$ 588.39$ 09024605 00 13.89$ 833.11$ 13.89$ 833.11$ 09024615 00 20.89$ 1,253.47$ 20.89$ 1,253.47$ 09024620 00 16.20$ 971.93$ 16.20$ 971.93$ 09024635 00 19.76$ 1,185.75$ 19.76$ 1,185.75$ 09024640 00 2.94$ 176.45$ 2.28$ 136.73$ 01024650 00 7.67$ 460.48$ 7.09$ 425.16$ 09024655 00 12.99$ 779.62$ 11.74$ 704.57$ 09024665 00 19.16$ 1,149.51$ 19.16$ 1,149.51$ 09024666 00 21.48$ 1,288.70$ 21.48$ 1,288.70$ 09024670 00 8.52$ 511.25$ 7.73$ 463.95$ 09024675 00 13.45$ 806.95$ 12.20$ 731.91$ 09024685 00 19.18$ 1,150.96$ 19.18$ 1,150.96$ 09024800 00 24.36$ 1,461.82$ 24.36$ 1,461.82$ 09024802 00 29.38$ 1,762.68$ 29.38$ 1,762.68$ 090



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

24900 00 21.57$ 1,294.10$ 21.57$ 1,294.10$ 09024920 00 21.51$ 1,290.66$ 21.51$ 1,290.66$ 09024925 00 16.62$ 997.16$ 16.62$ 997.16$ 09024930 00 22.69$ 1,361.54$ 22.69$ 1,361.54$ 09024931 00 27.35$ 1,640.89$ 27.35$ 1,640.89$ 09024935 00 34.16$ 2,049.87$ 34.16$ 2,049.87$ 09024940 00 397.70$ 397.70$ 09024999 00 By Report By Report YYY25000 00 9.95$ 596.98$ 9.95$ 596.98$ 09025001 00 10.12$ 607.37$ 10.12$ 607.37$ 09025020 00 16.85$ 1,010.95$ 16.85$ 1,010.95$ 09025023 00 32.49$ 1,949.17$ 32.49$ 1,949.17$ 09025024 00 22.84$ 1,370.13$ 22.84$ 1,370.13$ 09025025 00 35.33$ 2,119.85$ 35.33$ 2,119.85$ 09025028 00 15.52$ 931.20$ 15.52$ 931.20$ 09025031 00 10.22$ 613.31$ 10.22$ 613.31$ 09025035 00 17.14$ 1,028.21$ 17.14$ 1,028.21$ 09025040 00 16.45$ 987.01$ 16.45$ 987.01$ 09025065 00 7.56$ 453.82$ 4.75$ 284.82$ 01025066 00 10.53$ 631.70$ 10.53$ 631.70$ 09025071 00 12.42$ 745.48$ 12.42$ 745.48$ 09025073 00 15.63$ 937.82$ 15.63$ 937.82$ 09025075 00 14.53$ 871.58$ 9.27$ 556.28$ 09025076 00 15.18$ 911.07$ 15.18$ 911.07$ 09025077 00 25.80$ 1,547.74$ 25.80$ 1,547.74$ 09025078 00 34.12$ 2,047.22$ 34.12$ 2,047.22$ 09025085 00 13.17$ 790.27$ 13.17$ 790.27$ 09025100 00 10.18$ 610.90$ 10.18$ 610.90$ 09025101 00 11.87$ 712.11$ 11.87$ 712.11$ 09025105 00 14.19$ 851.38$ 14.19$ 851.38$ 09025107 00 18.08$ 1,084.62$ 18.08$ 1,084.62$ 09025109 00 15.78$ 946.50$ 15.78$ 946.50$ 09025110 00 10.04$ 602.36$ 10.04$ 602.36$ 09025111 00 9.43$ 566.05$ 9.43$ 566.05$ 09025112 00 11.37$ 682.33$ 11.37$ 682.33$ 09025115 00 22.22$ 1,333.39$ 22.22$ 1,333.39$ 09025116 00 17.62$ 1,057.19$ 17.62$ 1,057.19$ 09025118 00 11.19$ 671.44$ 11.19$ 671.44$ 09025119 00 14.52$ 870.90$ 14.52$ 870.90$ 09025120 00 14.60$ 876.26$ 14.60$ 876.26$ 09025125 00 17.41$ 1,044.72$ 17.41$ 1,044.72$ 09025126 00 17.52$ 1,051.39$ 17.52$ 1,051.39$ 090



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

25130 00 13.12$ 787.15$ 13.12$ 787.15$ 09025135 00 16.39$ 983.56$ 16.39$ 983.56$ 09025136 00 14.50$ 869.74$ 14.50$ 869.74$ 09025145 00 15.19$ 911.55$ 15.19$ 911.55$ 09025150 00 16.61$ 996.36$ 16.61$ 996.36$ 09025151 00 17.04$ 1,022.41$ 17.04$ 1,022.41$ 09025170 00 43.28$ 2,596.97$ 43.28$ 2,596.97$ 09025210 00 14.32$ 858.95$ 14.32$ 858.95$ 09025215 00 18.11$ 1,086.76$ 18.11$ 1,086.76$ 09025230 00 12.72$ 762.93$ 12.72$ 762.93$ 09025240 00 12.58$ 754.76$ 12.58$ 754.76$ 09025246 00 5.05$ 302.82$ 2.19$ 131.29$ 00025248 00 12.11$ 726.55$ 12.11$ 726.55$ 09025250 00 15.57$ 933.95$ 15.57$ 933.95$ 09025251 00 21.10$ 1,266.28$ 21.10$ 1,266.28$ 09025259 00 12.36$ 741.43$ 12.36$ 741.43$ 09025260 00 18.47$ 1,108.38$ 18.47$ 1,108.38$ 09025263 00 18.45$ 1,106.87$ 18.45$ 1,106.87$ 09025265 00 21.88$ 1,312.89$ 21.88$ 1,312.89$ 09025270 00 14.36$ 861.55$ 14.36$ 861.55$ 09025272 00 16.24$ 974.48$ 16.24$ 974.48$ 09025274 00 19.52$ 1,171.47$ 19.52$ 1,171.47$ 09025275 00 19.63$ 1,177.60$ 19.63$ 1,177.60$ 09025280 00 16.52$ 991.12$ 16.52$ 991.12$ 09025290 00 12.80$ 767.98$ 12.80$ 767.98$ 09025295 00 15.42$ 925.08$ 15.42$ 925.08$ 09025300 00 19.96$ 1,197.71$ 19.96$ 1,197.71$ 09025301 00 18.84$ 1,130.63$ 18.84$ 1,130.63$ 09025310 00 18.15$ 1,089.06$ 18.15$ 1,089.06$ 09025312 00 21.02$ 1,261.35$ 21.02$ 1,261.35$ 09025315 00 22.59$ 1,355.24$ 22.59$ 1,355.24$ 09025316 00 26.82$ 1,609.16$ 26.82$ 1,609.16$ 09025320 00 28.90$ 1,733.73$ 28.90$ 1,733.73$ 09025332 00 24.65$ 1,479.13$ 24.65$ 1,479.13$ 09025335 00 27.67$ 1,660.02$ 27.67$ 1,660.02$ 09025337 00 26.11$ 1,566.56$ 26.11$ 1,566.56$ 09025350 00 19.76$ 1,185.42$ 19.76$ 1,185.42$ 09025355 00 22.45$ 1,347.05$ 22.45$ 1,347.05$ 09025360 00 19.20$ 1,151.73$ 19.20$ 1,151.73$ 09025365 00 26.85$ 1,611.02$ 26.85$ 1,611.02$ 09025370 00 29.56$ 1,773.59$ 29.56$ 1,773.59$ 09025375 00 27.95$ 1,677.02$ 27.95$ 1,677.02$ 090



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

25390 00 22.52$ 1,351.32$ 22.52$ 1,351.32$ 09025391 00 29.22$ 1,753.24$ 29.22$ 1,753.24$ 09025392 00 29.72$ 1,783.03$ 29.72$ 1,783.03$ 09025393 00 33.14$ 1,988.17$ 33.14$ 1,988.17$ 09025394 00 22.99$ 1,379.69$ 22.99$ 1,379.69$ 09025400 00 23.52$ 1,411.20$ 23.52$ 1,411.20$ 09025405 00 30.39$ 1,823.33$ 30.39$ 1,823.33$ 09025415 00 28.38$ 1,702.98$ 28.38$ 1,702.98$ 09025420 00 34.24$ 2,054.20$ 34.24$ 2,054.20$ 09025425 00 28.24$ 1,694.53$ 28.24$ 1,694.53$ 09025426 00 32.93$ 1,976.09$ 32.93$ 1,976.09$ 09025430 00 21.44$ 1,286.28$ 21.44$ 1,286.28$ 09025431 00 23.12$ 1,387.16$ 23.12$ 1,387.16$ 09025440 00 22.53$ 1,352.09$ 22.53$ 1,352.09$ 09025441 00 27.48$ 1,649.10$ 27.48$ 1,649.10$ 09025442 00 23.66$ 1,419.65$ 23.66$ 1,419.65$ 09025443 00 22.95$ 1,376.73$ 22.95$ 1,376.73$ 09025444 00 24.25$ 1,454.86$ 24.25$ 1,454.86$ 09025445 00 21.16$ 1,269.36$ 21.16$ 1,269.36$ 09025446 00 34.37$ 2,061.97$ 34.37$ 2,061.97$ 09025447 00 24.29$ 1,457.18$ 24.29$ 1,457.18$ 09025449 00 30.22$ 1,813.46$ 30.22$ 1,813.46$ 09025450 00 18.08$ 1,084.66$ 18.08$ 1,084.66$ 09025455 00 21.31$ 1,278.71$ 21.31$ 1,278.71$ 09025490 00 21.08$ 1,264.78$ 21.08$ 1,264.78$ 09025491 00 21.69$ 1,301.33$ 21.69$ 1,301.33$ 09025492 00 26.53$ 1,591.91$ 26.53$ 1,591.91$ 09025500 00 8.10$ 486.05$ 7.35$ 441.27$ 09025505 00 14.66$ 879.42$ 13.33$ 799.97$ 09025515 00 19.62$ 1,177.01$ 19.62$ 1,177.01$ 09025520 00 16.77$ 1,006.24$ 15.84$ 950.12$ 09025525 00 23.11$ 1,386.39$ 23.11$ 1,386.39$ 09025526 00 28.02$ 1,681.24$ 28.02$ 1,681.24$ 09025530 00 7.69$ 461.29$ 6.99$ 419.67$ 09025535 00 14.38$ 862.50$ 13.28$ 796.92$ 09025545 00 18.27$ 1,096.24$ 18.27$ 1,096.24$ 09025560 00 8.27$ 496.16$ 7.42$ 445.08$ 09025565 00 15.08$ 904.75$ 13.54$ 812.68$ 09025574 00 19.76$ 1,185.50$ 19.76$ 1,185.50$ 09025575 00 26.42$ 1,585.17$ 26.42$ 1,585.17$ 09025600 00 9.69$ 581.56$ 9.20$ 551.92$ 09025605 00 15.82$ 949.08$ 14.89$ 893.59$ 090



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

25606 00 19.45$ 1,167.17$ 19.45$ 1,167.17$ 09025607 00 21.55$ 1,293.14$ 21.55$ 1,293.14$ 09025608 00 24.16$ 1,449.50$ 24.16$ 1,449.50$ 09025609 00 30.73$ 1,843.92$ 30.73$ 1,843.92$ 09025622 00 8.96$ 537.48$ 8.20$ 492.07$ 09025624 00 14.18$ 850.95$ 12.87$ 772.13$ 09025628 00 21.11$ 1,266.41$ 21.11$ 1,266.41$ 09025630 00 8.93$ 535.89$ 8.25$ 494.90$ 09025635 00 13.49$ 809.45$ 12.25$ 735.04$ 09025645 00 16.72$ 1,002.90$ 16.72$ 1,002.90$ 09025650 00 9.46$ 567.45$ 8.80$ 527.72$ 09025651 00 14.25$ 855.14$ 14.25$ 855.14$ 09025652 00 18.26$ 1,095.59$ 18.26$ 1,095.59$ 09025660 00 12.10$ 726.18$ 12.10$ 726.18$ 09025670 00 17.73$ 1,063.86$ 17.73$ 1,063.86$ 09025671 00 15.50$ 930.17$ 15.50$ 930.17$ 09025675 00 12.84$ 770.68$ 11.61$ 696.90$ 09025676 00 18.43$ 1,105.72$ 18.43$ 1,105.72$ 09025680 00 15.34$ 920.42$ 15.34$ 920.42$ 09025685 00 21.58$ 1,294.63$ 21.58$ 1,294.63$ 09025690 00 14.20$ 851.95$ 14.20$ 851.95$ 09025695 00 18.58$ 1,114.90$ 18.58$ 1,114.90$ 09025800 00 21.41$ 1,284.42$ 21.41$ 1,284.42$ 09025805 00 24.80$ 1,488.16$ 24.80$ 1,488.16$ 09025810 00 25.42$ 1,525.25$ 25.42$ 1,525.25$ 09025820 00 18.20$ 1,091.96$ 18.20$ 1,091.96$ 09025825 00 22.39$ 1,343.54$ 22.39$ 1,343.54$ 09025830 00 27.73$ 1,663.68$ 27.73$ 1,663.68$ 09025900 00 20.82$ 1,249.50$ 20.82$ 1,249.50$ 09025905 00 20.56$ 1,233.32$ 20.56$ 1,233.32$ 09025907 00 17.98$ 1,078.91$ 17.98$ 1,078.91$ 09025909 00 20.08$ 1,204.82$ 20.08$ 1,204.82$ 09025915 00 34.30$ 2,057.88$ 34.30$ 2,057.88$ 09025920 00 20.58$ 1,234.97$ 20.58$ 1,234.97$ 09025922 00 18.10$ 1,085.84$ 18.10$ 1,085.84$ 09025924 00 20.08$ 1,205.06$ 20.08$ 1,205.06$ 09025927 00 23.76$ 1,425.81$ 23.76$ 1,425.81$ 09025929 00 17.51$ 1,050.39$ 17.51$ 1,050.39$ 09025931 00 21.84$ 1,310.55$ 21.84$ 1,310.55$ 09025999 00 By Report By Report YYY26010 00 8.04$ 482.13$ 4.00$ 239.98$ 01026011 00 11.93$ 715.50$ 5.40$ 323.90$ 010



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

26020 00 12.77$ 765.90$ 12.77$ 765.90$ 09026025 00 12.38$ 742.57$ 12.38$ 742.57$ 09026030 00 14.37$ 862.48$ 14.37$ 862.48$ 09026034 00 15.96$ 957.48$ 15.96$ 957.48$ 09026035 00 25.18$ 1,510.57$ 25.18$ 1,510.57$ 09026037 00 16.58$ 995.03$ 16.58$ 995.03$ 09026040 00 9.18$ 550.97$ 9.18$ 550.97$ 09026045 00 13.78$ 826.66$ 13.78$ 826.66$ 09026055 00 16.79$ 1,007.42$ 9.15$ 548.97$ 09026060 00 7.54$ 452.67$ 7.54$ 452.67$ 09026070 00 9.40$ 564.23$ 9.40$ 564.23$ 09026075 00 9.81$ 588.69$ 9.81$ 588.69$ 09026080 00 11.52$ 691.09$ 11.52$ 691.09$ 09026100 00 9.86$ 591.65$ 9.86$ 591.65$ 09026105 00 9.93$ 595.88$ 9.93$ 595.88$ 09026110 00 9.47$ 568.34$ 9.47$ 568.34$ 09026111 00 12.22$ 733.08$ 12.22$ 733.08$ 09026113 00 16.06$ 963.42$ 16.06$ 963.42$ 09026115 00 15.33$ 920.09$ 9.75$ 585.24$ 09026116 00 15.44$ 926.38$ 15.44$ 926.38$ 09026117 00 21.77$ 1,306.04$ 21.77$ 1,306.04$ 09026118 00 30.78$ 1,847.10$ 30.78$ 1,847.10$ 09026121 00 17.53$ 1,051.58$ 17.53$ 1,051.58$ 09026123 00 24.48$ 1,468.65$ 24.48$ 1,468.65$ 09026125 00 7.98$ 478.70$ 7.98$ 478.70$ ZZZ26130 00 13.48$ 808.94$ 13.48$ 808.94$ 09026135 00 16.16$ 969.34$ 16.16$ 969.34$ 09026140 00 14.83$ 889.61$ 14.83$ 889.61$ 09026145 00 15.06$ 903.31$ 15.06$ 903.31$ 09026160 00 17.27$ 1,035.91$ 9.83$ 590.07$ 09026170 00 11.94$ 716.10$ 11.94$ 716.10$ 09026180 00 13.07$ 784.38$ 13.07$ 784.38$ 09026185 00 16.19$ 971.51$ 16.19$ 971.51$ 09026200 00 13.19$ 791.59$ 13.19$ 791.59$ 09026205 00 17.68$ 1,060.65$ 17.68$ 1,060.65$ 09026210 00 13.02$ 780.96$ 13.02$ 780.96$ 09026215 00 16.55$ 992.91$ 16.55$ 992.91$ 09026230 00 14.62$ 876.92$ 14.62$ 876.92$ 09026235 00 14.44$ 866.56$ 14.44$ 866.56$ 09026236 00 12.94$ 776.48$ 12.94$ 776.48$ 09026250 00 31.33$ 1,879.95$ 31.33$ 1,879.95$ 09026260 00 23.50$ 1,409.92$ 23.50$ 1,409.92$ 090



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

26262 00 18.55$ 1,113.29$ 18.55$ 1,113.29$ 09026320 00 10.21$ 612.54$ 10.21$ 612.54$ 09026340 00 9.97$ 598.45$ 9.97$ 598.45$ 09026341 00 2.98$ 179.10$ 2.22$ 133.06$ 01026350 00 20.65$ 1,238.76$ 20.65$ 1,238.76$ 09026352 00 23.67$ 1,420.34$ 23.67$ 1,420.34$ 09026356 00 23.32$ 1,399.29$ 23.32$ 1,399.29$ 09026357 00 26.10$ 1,565.71$ 26.10$ 1,565.71$ 09026358 00 28.86$ 1,731.60$ 28.86$ 1,731.60$ 09026370 00 21.88$ 1,312.93$ 21.88$ 1,312.93$ 09026372 00 25.63$ 1,537.80$ 25.63$ 1,537.80$ 09026373 00 24.60$ 1,476.03$ 24.60$ 1,476.03$ 09026390 00 24.22$ 1,453.43$ 24.22$ 1,453.43$ 09026392 00 28.19$ 1,691.52$ 28.19$ 1,691.52$ 09026410 00 16.36$ 981.69$ 16.36$ 981.69$ 09026412 00 19.64$ 1,178.40$ 19.64$ 1,178.40$ 09026415 00 23.57$ 1,414.44$ 23.57$ 1,414.44$ 09026416 00 25.64$ 1,538.61$ 25.64$ 1,538.61$ 09026418 00 16.77$ 1,006.39$ 16.77$ 1,006.39$ 09026420 00 20.46$ 1,227.75$ 20.46$ 1,227.75$ 09026426 00 14.70$ 882.01$ 14.70$ 882.01$ 09026428 00 21.93$ 1,315.82$ 21.93$ 1,315.82$ 09026432 00 14.42$ 865.09$ 14.42$ 865.09$ 09026433 00 15.32$ 919.07$ 15.32$ 919.07$ 09026434 00 18.77$ 1,126.46$ 18.77$ 1,126.46$ 09026437 00 18.05$ 1,083.27$ 18.05$ 1,083.27$ 09026440 00 17.95$ 1,076.83$ 17.95$ 1,076.83$ 09026442 00 27.90$ 1,674.20$ 27.90$ 1,674.20$ 09026445 00 16.67$ 1,000.22$ 16.67$ 1,000.22$ 09026449 00 20.39$ 1,223.58$ 20.39$ 1,223.58$ 09026450 00 11.79$ 707.43$ 11.79$ 707.43$ 09026455 00 11.69$ 701.12$ 11.69$ 701.12$ 09026460 00 11.44$ 686.61$ 11.44$ 686.61$ 09026471 00 17.85$ 1,070.76$ 17.85$ 1,070.76$ 09026474 00 17.46$ 1,047.73$ 17.46$ 1,047.73$ 09026476 00 17.22$ 1,033.21$ 17.22$ 1,033.21$ 09026477 00 16.83$ 1,009.96$ 16.83$ 1,009.96$ 09026478 00 17.91$ 1,074.62$ 17.91$ 1,074.62$ 09026479 00 18.17$ 1,090.12$ 18.17$ 1,090.12$ 09026480 00 21.76$ 1,305.54$ 21.76$ 1,305.54$ 09026483 00 24.36$ 1,461.39$ 24.36$ 1,461.39$ 09026485 00 23.33$ 1,399.81$ 23.33$ 1,399.81$ 090



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

26489 00 27.11$ 1,626.71$ 27.11$ 1,626.71$ 09026490 00 23.07$ 1,384.40$ 23.07$ 1,384.40$ 09026492 00 25.62$ 1,537.21$ 25.62$ 1,537.21$ 09026494 00 23.17$ 1,390.47$ 23.17$ 1,390.47$ 09026496 00 24.82$ 1,489.23$ 24.82$ 1,489.23$ 09026497 00 25.07$ 1,504.25$ 25.07$ 1,504.25$ 09026498 00 33.15$ 1,988.81$ 33.15$ 1,988.81$ 09026499 00 24.05$ 1,443.09$ 24.05$ 1,443.09$ 09026500 00 17.94$ 1,076.14$ 17.94$ 1,076.14$ 09026502 00 20.58$ 1,234.87$ 20.58$ 1,234.87$ 09026508 00 18.28$ 1,096.53$ 18.28$ 1,096.53$ 09026510 00 17.23$ 1,033.74$ 17.23$ 1,033.74$ 09026516 00 20.27$ 1,216.22$ 20.27$ 1,216.22$ 09026517 00 23.90$ 1,434.03$ 23.90$ 1,434.03$ 09026518 00 24.21$ 1,452.84$ 24.21$ 1,452.84$ 09026520 00 18.76$ 1,125.89$ 18.76$ 1,125.89$ 09026525 00 18.86$ 1,131.49$ 18.86$ 1,131.49$ 09026530 00 15.76$ 945.40$ 15.76$ 945.40$ 09026531 00 18.33$ 1,099.65$ 18.33$ 1,099.65$ 09026535 00 12.61$ 756.56$ 12.61$ 756.56$ 09026536 00 20.67$ 1,240.37$ 20.67$ 1,240.37$ 09026540 00 19.02$ 1,141.02$ 19.02$ 1,141.02$ 09026541 00 23.13$ 1,387.73$ 23.13$ 1,387.73$ 09026542 00 19.65$ 1,179.25$ 19.65$ 1,179.25$ 09026545 00 20.50$ 1,230.05$ 20.50$ 1,230.05$ 09026546 00 28.83$ 1,729.72$ 28.83$ 1,729.72$ 09026548 00 21.95$ 1,317.06$ 21.95$ 1,317.06$ 09026550 00 47.64$ 2,858.44$ 47.64$ 2,858.44$ 09026551 00 95.97$ 5,758.37$ 95.97$ 5,758.37$ 09026553 00 95.32$ 5,719.40$ 95.32$ 5,719.40$ 09026554 00 111.22$ 6,673.16$ 111.22$ 6,673.16$ 09026555 00 39.72$ 2,383.27$ 39.72$ 2,383.27$ 09026556 00 99.10$ 5,945.79$ 99.10$ 5,945.79$ 09026560 00 17.10$ 1,026.22$ 17.10$ 1,026.22$ 09026561 00 27.38$ 1,642.85$ 27.38$ 1,642.85$ 09026562 00 38.93$ 2,335.78$ 38.93$ 2,335.78$ 09026565 00 19.55$ 1,173.22$ 19.55$ 1,173.22$ 09026567 00 19.71$ 1,182.85$ 19.71$ 1,182.85$ 09026568 00 26.07$ 1,564.45$ 26.07$ 1,564.45$ 09026580 00 43.87$ 2,632.20$ 43.87$ 2,632.20$ 09026587 00 30.49$ 1,829.36$ 30.49$ 1,829.36$ 09026590 00 40.77$ 2,446.47$ 40.77$ 2,446.47$ 090



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

26591 00 12.76$ 765.83$ 12.76$ 765.83$ 09026593 00 17.41$ 1,044.55$ 17.41$ 1,044.55$ 09026596 00 22.14$ 1,328.48$ 22.14$ 1,328.48$ 09026600 00 8.65$ 518.75$ 8.17$ 490.38$ 09026605 00 9.51$ 570.41$ 8.60$ 516.17$ 09026607 00 13.78$ 826.50$ 13.78$ 826.50$ 09026608 00 14.04$ 842.30$ 14.04$ 842.30$ 09026615 00 16.88$ 1,012.51$ 16.88$ 1,012.51$ 09026641 00 11.02$ 661.49$ 9.95$ 597.16$ 09026645 00 12.63$ 757.82$ 11.54$ 692.24$ 09026650 00 14.07$ 844.16$ 14.07$ 844.16$ 09026665 00 18.35$ 1,101.15$ 18.35$ 1,101.15$ 09026670 00 10.12$ 607.02$ 9.07$ 543.96$ 09026675 00 13.43$ 805.94$ 12.30$ 737.83$ 09026676 00 14.79$ 887.59$ 14.79$ 887.59$ 09026685 00 16.85$ 1,010.78$ 16.85$ 1,010.78$ 09026686 00 18.29$ 1,097.45$ 18.29$ 1,097.45$ 09026700 00 9.61$ 576.83$ 8.93$ 535.84$ 09026705 00 12.29$ 737.69$ 11.19$ 671.48$ 09026706 00 12.95$ 777.12$ 12.95$ 777.12$ 09026715 00 16.80$ 1,007.90$ 16.80$ 1,007.90$ 09026720 00 5.79$ 347.59$ 5.41$ 324.89$ 09026725 00 9.92$ 595.31$ 8.87$ 532.25$ 09026727 00 13.84$ 830.10$ 13.84$ 830.10$ 09026735 00 17.46$ 1,047.76$ 17.46$ 1,047.76$ 09026740 00 6.76$ 405.31$ 6.37$ 381.98$ 09026742 00 10.89$ 653.61$ 9.79$ 587.39$ 09026746 00 21.76$ 1,305.38$ 21.76$ 1,305.38$ 09026750 00 5.40$ 324.15$ 5.43$ 326.04$ 09026755 00 9.24$ 554.29$ 7.96$ 477.36$ 09026756 00 12.28$ 736.84$ 12.28$ 736.84$ 09026765 00 14.71$ 882.70$ 14.71$ 882.70$ 09026770 00 8.15$ 488.96$ 7.47$ 447.97$ 09026775 00 11.29$ 677.42$ 10.16$ 609.32$ 09026776 00 13.02$ 780.97$ 13.02$ 780.97$ 09026785 00 16.06$ 963.40$ 16.06$ 963.40$ 09026820 00 22.81$ 1,368.64$ 22.81$ 1,368.64$ 09026841 00 21.03$ 1,261.96$ 21.03$ 1,261.96$ 09026842 00 22.63$ 1,357.86$ 22.63$ 1,357.86$ 09026843 00 21.40$ 1,283.90$ 21.40$ 1,283.90$ 09026844 00 23.73$ 1,423.74$ 23.73$ 1,423.74$ 09026850 00 20.00$ 1,200.20$ 20.00$ 1,200.20$ 090



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

26852 00 22.98$ 1,378.65$ 22.98$ 1,378.65$ 09026860 00 16.39$ 983.22$ 16.39$ 983.22$ 09026861 00 3.01$ 180.74$ 3.01$ 180.74$ ZZZ26862 00 21.00$ 1,260.25$ 21.00$ 1,260.25$ 09026863 00 6.70$ 401.96$ 6.70$ 401.96$ ZZZ26910 00 20.94$ 1,256.50$ 20.94$ 1,256.50$ 09026951 00 18.94$ 1,136.32$ 18.94$ 1,136.32$ 09026952 00 18.66$ 1,119.80$ 18.66$ 1,119.80$ 09026989 00 By Report By Report YYY26990 00 18.69$ 1,121.52$ 18.69$ 1,121.52$ 09026991 00 20.76$ 1,245.69$ 15.30$ 917.77$ 09026992 00 28.38$ 1,702.84$ 28.38$ 1,702.84$ 09027000 00 11.92$ 715.18$ 11.92$ 715.18$ 09027001 00 15.74$ 944.43$ 15.74$ 944.43$ 09027003 00 17.51$ 1,050.41$ 17.51$ 1,050.41$ 09027005 00 21.16$ 1,269.88$ 21.16$ 1,269.88$ 09027006 00 21.14$ 1,268.34$ 21.14$ 1,268.34$ 09027025 00 26.81$ 1,608.72$ 26.81$ 1,608.72$ 09027027 00 25.89$ 1,553.39$ 25.89$ 1,553.39$ 09027030 00 27.43$ 1,645.90$ 27.43$ 1,645.90$ 09027033 00 28.46$ 1,707.73$ 28.46$ 1,707.73$ 09027035 00 33.62$ 2,017.13$ 33.62$ 2,017.13$ 09027036 00 29.63$ 1,777.71$ 29.63$ 1,777.71$ 09027040 00 10.14$ 608.57$ 5.80$ 348.13$ 01027041 00 20.43$ 1,225.66$ 20.43$ 1,225.66$ 09027043 00 13.71$ 822.89$ 13.71$ 822.89$ 09027045 00 21.67$ 1,300.10$ 21.67$ 1,300.10$ 09027047 00 13.96$ 837.69$ 10.57$ 634.01$ 09027048 00 17.85$ 1,071.15$ 17.85$ 1,071.15$ 09027049 00 39.04$ 2,342.48$ 39.04$ 2,342.48$ 09027050 00 11.83$ 709.86$ 11.83$ 709.86$ 09027052 00 16.99$ 1,019.30$ 16.99$ 1,019.30$ 09027054 00 20.10$ 1,205.92$ 20.10$ 1,205.92$ 09027057 00 29.71$ 1,782.86$ 29.71$ 1,782.86$ 09027059 00 53.24$ 3,194.49$ 53.24$ 3,194.49$ 09027060 00 13.64$ 818.52$ 13.64$ 818.52$ 09027062 00 13.37$ 802.05$ 13.37$ 802.05$ 09027065 00 15.24$ 914.30$ 15.24$ 914.30$ 09027066 00 23.53$ 1,411.79$ 23.53$ 1,411.79$ 09027067 00 30.34$ 1,820.26$ 30.34$ 1,820.26$ 09027070 00 25.13$ 1,507.60$ 25.13$ 1,507.60$ 09027071 00 27.16$ 1,629.35$ 27.16$ 1,629.35$ 090



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

27075 00 61.48$ 3,688.71$ 61.48$ 3,688.71$ 09027076 00 74.39$ 4,463.59$ 74.39$ 4,463.59$ 09027077 00 83.01$ 4,980.49$ 83.01$ 4,980.49$ 09027078 00 60.62$ 3,637.24$ 60.62$ 3,637.24$ 09027080 00 14.97$ 898.08$ 14.97$ 898.08$ 09027086 00 8.93$ 535.89$ 4.94$ 296.27$ 01027087 00 17.97$ 1,078.39$ 17.97$ 1,078.39$ 09027090 00 24.33$ 1,460.09$ 24.33$ 1,460.09$ 09027091 00 46.70$ 2,802.20$ 46.70$ 2,802.20$ 09027093 00 5.94$ 356.17$ 2.04$ 122.22$ 00027095 00 7.91$ 474.88$ 2.44$ 146.34$ 00027096 00 4.71$ 282.73$ 2.42$ 145.26$ 00027097 00 20.01$ 1,200.60$ 20.01$ 1,200.60$ 09027098 00 20.36$ 1,221.83$ 20.36$ 1,221.83$ 09027100 00 24.08$ 1,444.87$ 24.08$ 1,444.87$ 09027105 00 25.43$ 1,526.03$ 25.43$ 1,526.03$ 09027110 00 28.44$ 1,706.30$ 28.44$ 1,706.30$ 09027111 00 26.41$ 1,584.67$ 26.41$ 1,584.67$ 09027120 00 38.12$ 2,286.95$ 38.12$ 2,286.95$ 09027122 00 32.24$ 1,934.39$ 32.24$ 1,934.39$ 09027125 00 33.20$ 1,991.87$ 33.20$ 1,991.87$ 09027130 00 39.63$ 2,377.71$ 39.63$ 2,377.71$ 09027132 00 48.99$ 2,939.24$ 48.99$ 2,939.24$ 09027134 00 55.97$ 3,358.27$ 55.97$ 3,358.27$ 09027137 00 43.05$ 2,582.93$ 43.05$ 2,582.93$ 09027138 00 44.73$ 2,683.51$ 44.73$ 2,683.51$ 09027140 00 26.11$ 1,566.80$ 26.11$ 1,566.80$ 09027146 00 37.38$ 2,242.73$ 37.38$ 2,242.73$ 09027147 00 43.07$ 2,584.34$ 43.07$ 2,584.34$ 09027151 00 46.58$ 2,795.06$ 46.58$ 2,795.06$ 09027156 00 50.22$ 3,013.02$ 50.22$ 3,013.02$ 09027158 00 41.09$ 2,465.33$ 41.09$ 2,465.33$ 09027161 00 35.53$ 2,131.63$ 35.53$ 2,131.63$ 09027165 00 40.04$ 2,402.61$ 40.04$ 2,402.61$ 09027170 00 34.30$ 2,058.02$ 34.30$ 2,058.02$ 09027175 00 19.53$ 1,171.77$ 19.53$ 1,171.77$ 09027176 00 26.97$ 1,617.93$ 26.97$ 1,617.93$ 09027177 00 32.70$ 1,961.85$ 32.70$ 1,961.85$ 09027178 00 26.97$ 1,617.93$ 26.97$ 1,617.93$ 09027179 00 28.67$ 1,719.95$ 28.67$ 1,719.95$ 09027181 00 32.93$ 1,975.95$ 32.93$ 1,975.95$ 09027185 00 21.06$ 1,263.83$ 21.06$ 1,263.83$ 090



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

27187 00 29.10$ 1,746.02$ 29.10$ 1,746.02$ 09027197 00 3.64$ 218.66$ 3.64$ 218.66$ 00027198 00 8.80$ 527.84$ 8.80$ 527.84$ 00027200 00 5.40$ 323.80$ 5.53$ 332.00$ 09027202 00 15.57$ 934.07$ 15.57$ 934.07$ 09027215 00 18.27$ 1,096.36$ 18.27$ 1,096.36$ 09027216 00 27.11$ 1,626.40$ 27.11$ 1,626.40$ 09027217 00 25.44$ 1,526.40$ 25.44$ 1,526.40$ 09027218 00 35.10$ 2,105.74$ 35.10$ 2,105.74$ 09027220 00 15.61$ 936.74$ 15.39$ 923.50$ 09027222 00 28.48$ 1,708.53$ 28.48$ 1,708.53$ 09027226 00 30.92$ 1,855.48$ 30.92$ 1,855.48$ 09027227 00 48.59$ 2,915.50$ 48.59$ 2,915.50$ 09027228 00 55.06$ 3,303.55$ 55.06$ 3,303.55$ 09027230 00 14.04$ 842.68$ 13.87$ 831.96$ 09027232 00 21.72$ 1,303.46$ 21.72$ 1,303.46$ 09027235 00 26.64$ 1,598.26$ 26.64$ 1,598.26$ 09027236 00 35.00$ 2,100.19$ 35.00$ 2,100.19$ 09027238 00 13.54$ 812.56$ 13.54$ 812.56$ 09027240 00 28.03$ 1,681.89$ 28.03$ 1,681.89$ 09027244 00 36.03$ 2,161.95$ 36.03$ 2,161.95$ 09027245 00 36.01$ 2,160.77$ 36.01$ 2,160.77$ 09027246 00 11.35$ 680.87$ 11.32$ 678.98$ 09027248 00 21.79$ 1,307.18$ 21.79$ 1,307.18$ 09027250 00 5.19$ 311.29$ 5.19$ 311.29$ 00027252 00 22.14$ 1,328.27$ 22.14$ 1,328.27$ 09027253 00 27.60$ 1,656.25$ 27.60$ 1,656.25$ 09027254 00 36.99$ 2,219.31$ 36.99$ 2,219.31$ 09027256 00 8.90$ 533.76$ 6.85$ 410.79$ 01027257 00 10.63$ 637.75$ 10.63$ 637.75$ 01027258 00 32.59$ 1,955.14$ 32.59$ 1,955.14$ 09027259 00 45.44$ 2,726.35$ 45.44$ 2,726.35$ 09027265 00 11.77$ 706.04$ 11.77$ 706.04$ 09027266 00 17.05$ 1,023.08$ 17.05$ 1,023.08$ 09027267 00 12.70$ 761.79$ 12.70$ 761.79$ 09027268 00 15.83$ 950.03$ 15.83$ 950.03$ 09027269 00 36.34$ 2,180.25$ 36.34$ 2,180.25$ 09027275 00 5.38$ 322.73$ 5.38$ 322.73$ 01027279 00 20.27$ 1,216.10$ 20.27$ 1,216.10$ 09027280 00 39.61$ 2,376.42$ 39.61$ 2,376.42$ 09027282 00 25.13$ 1,507.86$ 25.13$ 1,507.86$ 09027284 00 47.36$ 2,841.40$ 47.36$ 2,841.40$ 090



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

27286 00 48.38$ 2,902.83$ 48.38$ 2,902.83$ 09027290 00 47.65$ 2,858.78$ 47.65$ 2,858.78$ 09027295 00 36.80$ 2,208.29$ 36.80$ 2,208.29$ 09027299 00 By Report By Report YYY27301 00 19.87$ 1,192.22$ 14.75$ 885.12$ 09027303 00 18.76$ 1,125.57$ 18.76$ 1,125.57$ 09027305 00 14.09$ 845.46$ 14.09$ 845.46$ 09027306 00 10.11$ 606.56$ 10.11$ 606.56$ 09027307 00 14.08$ 844.81$ 14.08$ 844.81$ 09027310 00 21.42$ 1,284.98$ 21.42$ 1,284.98$ 09027323 00 8.16$ 489.35$ 5.26$ 315.30$ 01027324 00 11.80$ 708.29$ 11.80$ 708.29$ 09027325 00 16.42$ 984.97$ 16.42$ 984.97$ 09027326 00 15.15$ 909.29$ 15.15$ 909.29$ 09027327 00 13.92$ 835.30$ 9.17$ 550.27$ 09027328 00 18.26$ 1,095.66$ 18.26$ 1,095.66$ 09027329 00 30.31$ 1,818.60$ 30.31$ 1,818.60$ 09027330 00 12.23$ 733.71$ 12.23$ 733.71$ 09027331 00 13.93$ 835.87$ 13.93$ 835.87$ 09027332 00 18.89$ 1,133.40$ 18.89$ 1,133.40$ 09027333 00 17.20$ 1,032.04$ 17.20$ 1,032.04$ 09027334 00 20.07$ 1,204.00$ 20.07$ 1,204.00$ 09027335 00 22.35$ 1,340.91$ 22.35$ 1,340.91$ 09027337 00 12.24$ 734.17$ 12.24$ 734.17$ 09027339 00 22.02$ 1,321.42$ 22.02$ 1,321.42$ 09027340 00 10.92$ 655.03$ 10.92$ 655.03$ 09027345 00 14.10$ 845.87$ 14.10$ 845.87$ 09027347 00 15.49$ 929.43$ 15.49$ 929.43$ 09027350 00 19.06$ 1,143.48$ 19.06$ 1,143.48$ 09027355 00 17.72$ 1,063.42$ 17.72$ 1,063.42$ 09027356 00 21.70$ 1,302.20$ 21.70$ 1,302.20$ 09027357 00 23.84$ 1,430.69$ 23.84$ 1,430.69$ 09027358 00 8.14$ 488.54$ 8.14$ 488.54$ ZZZ27360 00 25.23$ 1,513.53$ 25.23$ 1,513.53$ 09027364 00 45.75$ 2,744.88$ 45.75$ 2,744.88$ 09027365 00 60.39$ 3,623.15$ 60.39$ 3,623.15$ 09027369 00 4.22$ 253.28$ 1.18$ 71.04$ 00027372 00 17.58$ 1,054.51$ 11.69$ 701.37$ 09027380 00 17.53$ 1,051.97$ 17.53$ 1,051.97$ 09027381 00 23.45$ 1,406.87$ 23.45$ 1,406.87$ 09027385 00 16.97$ 1,018.29$ 16.97$ 1,018.29$ 09027386 00 24.43$ 1,465.95$ 24.43$ 1,465.95$ 090



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

27390 00 13.18$ 790.98$ 13.18$ 790.98$ 09027391 00 16.81$ 1,008.78$ 16.81$ 1,008.78$ 09027392 00 20.90$ 1,253.86$ 20.90$ 1,253.86$ 09027393 00 14.96$ 897.63$ 14.96$ 897.63$ 09027394 00 18.86$ 1,131.67$ 18.86$ 1,131.67$ 09027395 00 25.79$ 1,547.17$ 25.79$ 1,547.17$ 09027396 00 18.08$ 1,084.89$ 18.08$ 1,084.89$ 09027397 00 26.87$ 1,612.09$ 26.87$ 1,612.09$ 09027400 00 20.37$ 1,222.43$ 20.37$ 1,222.43$ 09027403 00 18.77$ 1,126.39$ 18.77$ 1,126.39$ 09027405 00 19.80$ 1,188.22$ 19.80$ 1,188.22$ 09027407 00 23.29$ 1,397.35$ 23.29$ 1,397.35$ 09027409 00 28.34$ 1,700.23$ 28.34$ 1,700.23$ 09027412 00 48.46$ 2,907.77$ 48.46$ 2,907.77$ 09027415 00 39.57$ 2,374.18$ 39.57$ 2,374.18$ 09027416 00 28.76$ 1,725.43$ 28.76$ 1,725.43$ 09027418 00 24.25$ 1,455.07$ 24.25$ 1,455.07$ 09027420 00 21.76$ 1,305.58$ 21.76$ 1,305.58$ 09027422 00 21.76$ 1,305.71$ 21.76$ 1,305.71$ 09027424 00 21.95$ 1,316.78$ 21.95$ 1,316.78$ 09027425 00 13.20$ 792.22$ 13.20$ 792.22$ 09027427 00 20.85$ 1,251.05$ 20.85$ 1,251.05$ 09027428 00 32.73$ 1,964.09$ 32.73$ 1,964.09$ 09027429 00 36.80$ 2,207.91$ 36.80$ 2,207.91$ 09027430 00 21.66$ 1,299.32$ 21.66$ 1,299.32$ 09027435 00 23.69$ 1,421.44$ 23.69$ 1,421.44$ 09027437 00 19.35$ 1,161.16$ 19.35$ 1,161.16$ 09027438 00 24.57$ 1,474.33$ 24.57$ 1,474.33$ 09027440 00 23.40$ 1,403.96$ 23.40$ 1,403.96$ 09027441 00 24.19$ 1,451.15$ 24.19$ 1,451.15$ 09027442 00 25.44$ 1,526.23$ 25.44$ 1,526.23$ 09027443 00 23.79$ 1,427.69$ 23.79$ 1,427.69$ 09027445 00 36.65$ 2,198.92$ 36.65$ 2,198.92$ 09027446 00 33.90$ 2,033.72$ 33.90$ 2,033.72$ 09027447 00 39.61$ 2,376.44$ 39.61$ 2,376.44$ 09027448 00 22.74$ 1,364.18$ 22.74$ 1,364.18$ 09027450 00 29.76$ 1,785.69$ 29.76$ 1,785.69$ 09027454 00 38.07$ 2,284.09$ 38.07$ 2,284.09$ 09027455 00 27.74$ 1,664.60$ 27.74$ 1,664.60$ 09027457 00 28.22$ 1,693.23$ 28.22$ 1,693.23$ 09027465 00 36.71$ 2,202.70$ 36.71$ 2,202.70$ 09027466 00 34.74$ 2,084.14$ 34.74$ 2,084.14$ 090



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

27468 00 39.36$ 2,361.48$ 39.36$ 2,361.48$ 09027470 00 34.46$ 2,067.64$ 34.46$ 2,067.64$ 09027472 00 36.96$ 2,217.35$ 36.96$ 2,217.35$ 09027475 00 19.42$ 1,165.40$ 19.42$ 1,165.40$ 09027477 00 21.52$ 1,291.26$ 21.52$ 1,291.26$ 09027479 00 26.98$ 1,618.79$ 26.98$ 1,618.79$ 09027485 00 19.68$ 1,180.95$ 19.68$ 1,180.95$ 09027486 00 41.13$ 2,467.61$ 41.13$ 2,467.61$ 09027487 00 51.41$ 3,084.74$ 51.41$ 3,084.74$ 09027488 00 35.16$ 2,109.84$ 35.16$ 2,109.84$ 09027495 00 33.00$ 1,979.77$ 33.00$ 1,979.77$ 09027496 00 15.98$ 958.52$ 15.98$ 958.52$ 09027497 00 17.07$ 1,024.06$ 17.07$ 1,024.06$ 09027498 00 19.22$ 1,153.36$ 19.22$ 1,153.36$ 09027499 00 20.55$ 1,232.72$ 20.55$ 1,232.72$ 09027500 00 15.24$ 914.52$ 14.03$ 842.00$ 09027501 00 14.78$ 887.06$ 14.58$ 875.08$ 09027502 00 22.18$ 1,330.83$ 22.18$ 1,330.83$ 09027503 00 23.42$ 1,405.18$ 23.42$ 1,405.18$ 09027506 00 39.18$ 2,350.66$ 39.18$ 2,350.66$ 09027507 00 28.45$ 1,706.74$ 28.45$ 1,706.74$ 09027508 00 15.35$ 920.87$ 14.47$ 867.90$ 09027509 00 19.02$ 1,141.42$ 19.02$ 1,141.42$ 09027510 00 19.96$ 1,197.84$ 19.96$ 1,197.84$ 09027511 00 29.17$ 1,750.22$ 29.17$ 1,750.22$ 09027513 00 36.28$ 2,176.51$ 36.28$ 2,176.51$ 09027514 00 28.32$ 1,699.32$ 28.32$ 1,699.32$ 09027516 00 15.02$ 901.01$ 14.07$ 844.25$ 09027517 00 20.15$ 1,208.72$ 20.15$ 1,208.72$ 09027519 00 26.16$ 1,569.83$ 26.16$ 1,569.83$ 09027520 00 9.47$ 568.32$ 8.68$ 521.02$ 09027524 00 22.03$ 1,321.91$ 22.03$ 1,321.91$ 09027530 00 8.89$ 533.25$ 8.28$ 496.68$ 09027532 00 18.07$ 1,084.08$ 16.90$ 1,014.09$ 09027535 00 26.29$ 1,577.49$ 26.29$ 1,577.49$ 09027536 00 34.81$ 2,088.40$ 34.81$ 2,088.40$ 09027538 00 14.02$ 841.21$ 13.05$ 783.20$ 09027540 00 23.84$ 1,430.32$ 23.84$ 1,430.32$ 09027550 00 15.25$ 914.76$ 14.10$ 846.02$ 09027552 00 18.39$ 1,103.69$ 18.39$ 1,103.69$ 09027556 00 25.73$ 1,543.78$ 25.73$ 1,543.78$ 09027557 00 30.72$ 1,843.49$ 30.72$ 1,843.49$ 090



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

27558 00 35.00$ 2,100.16$ 35.00$ 2,100.16$ 09027560 00 10.77$ 646.12$ 9.89$ 593.15$ 09027562 00 14.24$ 854.56$ 14.24$ 854.56$ 09027566 00 26.21$ 1,572.78$ 26.21$ 1,572.78$ 09027570 00 4.43$ 265.95$ 4.43$ 265.95$ 01027580 00 42.21$ 2,532.82$ 42.21$ 2,532.82$ 09027590 00 23.12$ 1,386.94$ 23.12$ 1,386.94$ 09027591 00 28.34$ 1,700.56$ 28.34$ 1,700.56$ 09027592 00 19.84$ 1,190.30$ 19.84$ 1,190.30$ 09027594 00 14.83$ 889.61$ 14.83$ 889.61$ 09027596 00 20.95$ 1,256.94$ 20.95$ 1,256.94$ 09027598 00 20.73$ 1,243.83$ 20.73$ 1,243.83$ 09027599 00 By Report By Report YYY27600 00 11.84$ 710.57$ 11.84$ 710.57$ 09027601 00 13.04$ 782.66$ 13.04$ 782.66$ 09027602 00 14.09$ 845.61$ 14.09$ 845.61$ 09027603 00 15.66$ 939.86$ 11.40$ 683.83$ 09027604 00 14.05$ 843.13$ 9.81$ 588.37$ 09027605 00 10.21$ 612.90$ 5.46$ 327.86$ 01027606 00 8.15$ 488.87$ 8.15$ 488.87$ 01027607 00 17.86$ 1,071.70$ 17.86$ 1,071.70$ 09027610 00 19.08$ 1,144.58$ 19.08$ 1,144.58$ 09027612 00 16.65$ 998.83$ 16.65$ 998.83$ 09027613 00 7.42$ 445.15$ 4.72$ 283.09$ 01027614 00 17.01$ 1,020.32$ 11.86$ 711.33$ 09027615 00 29.97$ 1,797.92$ 29.97$ 1,797.92$ 09027616 00 37.15$ 2,228.84$ 37.15$ 2,228.84$ 09027618 00 13.64$ 818.31$ 9.00$ 540.22$ 09027619 00 13.57$ 813.94$ 13.57$ 813.94$ 09027620 00 13.27$ 795.93$ 13.27$ 795.93$ 09027625 00 16.72$ 1,003.38$ 16.72$ 1,003.38$ 09027626 00 17.84$ 1,070.25$ 17.84$ 1,070.25$ 09027630 00 16.45$ 987.01$ 10.66$ 639.55$ 09027632 00 12.10$ 726.18$ 12.10$ 726.18$ 09027634 00 19.85$ 1,191.11$ 19.85$ 1,191.11$ 09027635 00 17.02$ 1,021.34$ 17.02$ 1,021.34$ 09027637 00 21.86$ 1,311.67$ 21.86$ 1,311.67$ 09027638 00 22.42$ 1,345.49$ 22.42$ 1,345.49$ 09027640 00 24.36$ 1,461.57$ 24.36$ 1,461.57$ 09027641 00 19.42$ 1,165.07$ 19.42$ 1,165.07$ 09027645 00 52.11$ 3,126.73$ 52.11$ 3,126.73$ 09027646 00 45.21$ 2,712.69$ 45.21$ 2,712.69$ 090



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

27647 00 29.77$ 1,786.40$ 29.77$ 1,786.40$ 09027648 00 5.43$ 325.60$ 1.54$ 92.28$ 00027650 00 19.27$ 1,156.48$ 19.27$ 1,156.48$ 09027652 00 19.71$ 1,182.66$ 19.71$ 1,182.66$ 09027654 00 20.79$ 1,247.62$ 20.79$ 1,247.62$ 09027656 00 18.83$ 1,130.00$ 11.67$ 699.93$ 09027658 00 10.92$ 654.94$ 10.92$ 654.94$ 09027659 00 13.85$ 831.11$ 13.85$ 831.11$ 09027664 00 10.63$ 637.66$ 10.63$ 637.66$ 09027665 00 12.17$ 730.42$ 12.17$ 730.42$ 09027675 00 14.38$ 862.83$ 14.38$ 862.83$ 09027676 00 17.59$ 1,055.35$ 17.59$ 1,055.35$ 09027680 00 12.44$ 746.43$ 12.44$ 746.43$ 09027681 00 16.08$ 964.80$ 16.08$ 964.80$ 09027685 00 19.60$ 1,176.09$ 13.61$ 816.65$ 09027686 00 15.99$ 959.46$ 15.99$ 959.46$ 09027687 00 13.33$ 799.93$ 13.33$ 799.93$ 09027690 00 18.75$ 1,124.72$ 18.75$ 1,124.72$ 09027691 00 21.86$ 1,311.76$ 21.86$ 1,311.76$ 09027692 00 3.05$ 182.93$ 3.05$ 182.93$ ZZZ27695 00 13.91$ 834.87$ 13.91$ 834.87$ 09027696 00 16.23$ 973.97$ 16.23$ 973.97$ 09027698 00 18.67$ 1,119.97$ 18.67$ 1,119.97$ 09027700 00 17.90$ 1,074.05$ 17.90$ 1,074.05$ 09027702 00 28.15$ 1,688.94$ 28.15$ 1,688.94$ 09027703 00 32.47$ 1,948.17$ 32.47$ 1,948.17$ 09027704 00 16.82$ 1,009.38$ 16.82$ 1,009.38$ 09027705 00 22.25$ 1,334.93$ 22.25$ 1,334.93$ 09027707 00 11.77$ 706.10$ 11.77$ 706.10$ 09027709 00 34.15$ 2,048.73$ 34.15$ 2,048.73$ 09027712 00 32.40$ 1,943.92$ 32.40$ 1,943.92$ 09027715 00 31.42$ 1,884.92$ 31.42$ 1,884.92$ 09027720 00 25.61$ 1,536.68$ 25.61$ 1,536.68$ 09027722 00 26.17$ 1,570.17$ 26.17$ 1,570.17$ 09027724 00 36.99$ 2,219.40$ 36.99$ 2,219.40$ 09027725 00 35.74$ 2,144.18$ 35.74$ 2,144.18$ 09027726 00 28.12$ 1,687.30$ 28.12$ 1,687.30$ 09027727 00 30.42$ 1,825.45$ 30.42$ 1,825.45$ 09027730 00 17.22$ 1,033.29$ 17.22$ 1,033.29$ 09027732 00 13.19$ 791.24$ 13.19$ 791.24$ 09027734 00 19.26$ 1,155.74$ 19.26$ 1,155.74$ 09027740 00 20.78$ 1,246.97$ 20.78$ 1,246.97$ 090



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

27742 00 22.82$ 1,369.33$ 22.82$ 1,369.33$ 09027745 00 22.11$ 1,326.72$ 22.11$ 1,326.72$ 09027750 00 10.14$ 608.58$ 9.34$ 560.66$ 09027752 00 15.71$ 942.35$ 14.42$ 865.41$ 09027756 00 16.94$ 1,016.28$ 16.94$ 1,016.28$ 09027758 00 26.16$ 1,569.43$ 26.16$ 1,569.43$ 09027759 00 29.26$ 1,755.83$ 29.26$ 1,755.83$ 09027760 00 9.77$ 586.42$ 8.95$ 537.23$ 09027762 00 13.96$ 837.75$ 12.63$ 757.67$ 09027766 00 17.79$ 1,067.44$ 17.79$ 1,067.44$ 09027767 00 8.32$ 498.93$ 8.32$ 498.93$ 09027768 00 12.98$ 778.78$ 12.98$ 778.78$ 09027769 00 21.38$ 1,282.56$ 21.38$ 1,282.56$ 09027780 00 8.97$ 537.92$ 8.20$ 491.89$ 09027781 00 12.61$ 756.74$ 11.62$ 697.46$ 09027784 00 20.97$ 1,258.30$ 20.97$ 1,258.30$ 09027786 00 9.23$ 553.66$ 8.39$ 503.21$ 09027788 00 12.41$ 744.33$ 11.26$ 675.60$ 09027792 00 19.04$ 1,142.24$ 19.04$ 1,142.24$ 09027808 00 9.81$ 588.69$ 8.86$ 531.31$ 09027810 00 13.72$ 823.00$ 12.37$ 742.29$ 09027814 00 22.54$ 1,352.33$ 22.54$ 1,352.33$ 09027816 00 9.54$ 572.36$ 8.50$ 509.93$ 09027818 00 14.24$ 854.50$ 12.70$ 761.81$ 09027822 00 25.20$ 1,512.11$ 25.20$ 1,512.11$ 09027823 00 28.53$ 1,711.90$ 28.53$ 1,711.90$ 09027824 00 9.26$ 555.39$ 8.93$ 535.84$ 09027825 00 16.04$ 962.28$ 14.49$ 869.58$ 09027826 00 24.72$ 1,483.05$ 24.72$ 1,483.05$ 09027827 00 32.32$ 1,939.17$ 32.32$ 1,939.17$ 09027828 00 38.51$ 2,310.46$ 38.51$ 2,310.46$ 09027829 00 20.41$ 1,224.89$ 20.41$ 1,224.89$ 09027830 00 11.32$ 679.16$ 10.47$ 628.08$ 09027831 00 11.83$ 709.88$ 11.83$ 709.88$ 09027832 00 22.21$ 1,332.81$ 22.21$ 1,332.81$ 09027840 00 10.95$ 657.02$ 10.95$ 657.02$ 09027842 00 14.35$ 860.84$ 14.35$ 860.84$ 09027846 00 21.08$ 1,264.88$ 21.08$ 1,264.88$ 09027848 00 23.38$ 1,402.77$ 23.38$ 1,402.77$ 09027860 00 5.02$ 300.98$ 5.02$ 300.98$ 01027870 00 30.03$ 1,801.70$ 30.03$ 1,801.70$ 09027871 00 20.16$ 1,209.36$ 20.16$ 1,209.36$ 090



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

27880 00 26.50$ 1,590.10$ 26.50$ 1,590.10$ 09027881 00 25.18$ 1,511.00$ 25.18$ 1,511.00$ 09027882 00 17.35$ 1,040.89$ 17.35$ 1,040.89$ 09027884 00 16.61$ 996.63$ 16.61$ 996.63$ 09027886 00 19.11$ 1,146.70$ 19.11$ 1,146.70$ 09027888 00 19.31$ 1,158.62$ 19.31$ 1,158.62$ 09027889 00 18.79$ 1,127.34$ 18.79$ 1,127.34$ 09027892 00 16.09$ 965.45$ 16.09$ 965.45$ 09027893 00 17.91$ 1,074.69$ 17.91$ 1,074.69$ 09027894 00 24.66$ 1,479.89$ 24.66$ 1,479.89$ 09027899 00 By Report By Report YYY28001 00 8.29$ 497.27$ 5.00$ 299.89$ 01028002 00 13.14$ 788.48$ 9.37$ 562.09$ 01028003 00 20.66$ 1,239.60$ 16.38$ 982.94$ 09028005 00 16.94$ 1,016.56$ 16.94$ 1,016.56$ 09028008 00 12.90$ 773.76$ 8.64$ 518.37$ 09028010 00 6.87$ 412.19$ 6.13$ 368.05$ 09028011 00 9.37$ 562.13$ 8.32$ 499.07$ 09028020 00 16.07$ 964.27$ 10.63$ 637.62$ 09028022 00 14.49$ 869.55$ 9.52$ 571.28$ 09028024 00 13.56$ 813.50$ 8.86$ 531.62$ 09028035 00 15.76$ 945.74$ 10.48$ 628.55$ 09028039 00 14.81$ 888.41$ 10.13$ 607.79$ 09028041 00 13.33$ 799.88$ 13.33$ 799.88$ 09028043 00 11.86$ 711.32$ 7.72$ 463.49$ 09028045 00 14.66$ 879.33$ 10.21$ 612.59$ 09028046 00 21.17$ 1,270.05$ 21.17$ 1,270.05$ 09028047 00 30.62$ 1,837.21$ 30.62$ 1,837.21$ 09028050 00 12.64$ 758.64$ 8.23$ 493.79$ 09028052 00 13.21$ 792.83$ 8.33$ 499.60$ 09028054 00 11.20$ 672.26$ 6.93$ 415.61$ 09028055 00 11.22$ 672.98$ 11.22$ 672.98$ 09028060 00 15.49$ 929.32$ 10.54$ 632.31$ 09028062 00 17.37$ 1,041.94$ 11.93$ 715.92$ 09028070 00 15.95$ 956.98$ 10.51$ 630.33$ 09028072 00 14.58$ 874.74$ 9.46$ 567.64$ 09028080 00 15.69$ 941.56$ 10.85$ 650.86$ 09028086 00 16.23$ 973.53$ 10.57$ 634.27$ 09028088 00 13.47$ 808.00$ 8.40$ 504.05$ 09028090 00 14.03$ 841.55$ 9.05$ 543.28$ 09028092 00 12.73$ 764.04$ 7.97$ 478.38$ 09028100 00 18.22$ 1,093.48$ 12.22$ 733.40$ 090



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

28102 00 17.84$ 1,070.14$ 17.84$ 1,070.14$ 09028103 00 11.47$ 688.44$ 11.47$ 688.44$ 09028104 00 15.89$ 953.23$ 10.48$ 629.10$ 09028106 00 12.58$ 755.00$ 12.58$ 755.00$ 09028107 00 15.34$ 920.19$ 10.24$ 614.35$ 09028108 00 13.15$ 789.18$ 8.49$ 509.20$ 09028110 00 13.90$ 833.83$ 8.56$ 513.48$ 09028111 00 14.57$ 873.93$ 9.50$ 569.98$ 09028112 00 14.56$ 873.88$ 9.18$ 551.02$ 09028113 00 17.55$ 1,052.90$ 12.48$ 748.95$ 09028114 00 31.58$ 1,894.57$ 24.45$ 1,467.02$ 09028116 00 22.65$ 1,359.12$ 16.92$ 1,015.45$ 09028118 00 17.79$ 1,067.65$ 12.20$ 732.17$ 09028119 00 15.59$ 935.55$ 10.59$ 635.39$ 09028120 00 20.12$ 1,207.41$ 14.63$ 877.61$ 09028122 00 17.77$ 1,065.98$ 12.91$ 774.64$ 09028124 00 14.26$ 855.86$ 9.76$ 585.33$ 09028126 00 11.81$ 708.70$ 7.30$ 438.17$ 09028130 00 18.71$ 1,122.60$ 18.71$ 1,122.60$ 09028140 00 17.55$ 1,052.76$ 12.81$ 768.36$ 09028150 00 12.64$ 758.30$ 8.21$ 492.81$ 09028153 00 12.36$ 741.54$ 7.81$ 468.49$ 09028160 00 12.45$ 747.01$ 7.88$ 472.70$ 09028171 00 32.66$ 1,959.80$ 32.66$ 1,959.80$ 09028173 00 21.65$ 1,299.13$ 21.65$ 1,299.13$ 09028175 00 13.96$ 837.83$ 13.96$ 837.83$ 09028190 00 7.61$ 456.79$ 3.93$ 236.08$ 01028192 00 13.95$ 837.26$ 9.18$ 550.97$ 09028193 00 15.84$ 950.36$ 10.86$ 651.45$ 09028200 00 14.73$ 883.52$ 9.52$ 571.37$ 09028202 00 18.01$ 1,080.56$ 12.68$ 760.85$ 09028208 00 14.36$ 861.41$ 9.29$ 557.46$ 09028210 00 17.53$ 1,052.09$ 12.30$ 738.05$ 09028220 00 13.50$ 810.05$ 8.92$ 535.11$ 09028222 00 15.40$ 923.77$ 10.45$ 626.76$ 09028225 00 12.56$ 753.78$ 7.82$ 469.38$ 09028226 00 18.26$ 1,095.42$ 11.60$ 696.25$ 09028230 00 12.99$ 779.48$ 8.35$ 500.76$ 09028232 00 11.57$ 694.07$ 7.14$ 428.58$ 09028234 00 12.23$ 733.55$ 7.78$ 466.80$ 09028238 00 19.87$ 1,192.32$ 14.27$ 856.21$ 09028240 00 13.62$ 817.14$ 8.77$ 526.43$ 090



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

28250 00 17.18$ 1,030.79$ 11.82$ 709.18$ 09028260 00 20.37$ 1,222.34$ 14.96$ 897.58$ 09028261 00 30.46$ 1,827.38$ 23.82$ 1,429.48$ 09028262 00 41.32$ 2,479.28$ 33.07$ 1,984.26$ 09028264 00 29.88$ 1,793.04$ 22.56$ 1,353.51$ 09028270 00 14.72$ 883.20$ 9.85$ 591.23$ 09028272 00 11.71$ 702.72$ 7.43$ 446.06$ 09028280 00 15.33$ 919.58$ 10.22$ 613.11$ 09028285 00 15.98$ 958.56$ 11.15$ 669.12$ 09028286 00 13.39$ 803.45$ 8.76$ 525.36$ 09028288 00 18.15$ 1,089.03$ 12.75$ 764.90$ 09028289 00 21.73$ 1,303.94$ 13.56$ 813.33$ 09028291 00 21.65$ 1,298.85$ 14.13$ 847.97$ 09028292 00 22.04$ 1,322.60$ 14.29$ 857.22$ 09028295 00 28.53$ 1,711.54$ 15.98$ 958.61$ 09028296 00 27.21$ 1,632.57$ 15.12$ 907.38$ 09028297 00 31.27$ 1,876.04$ 17.69$ 1,061.30$ 09028298 00 25.33$ 1,519.52$ 14.62$ 876.93$ 09028299 00 30.15$ 1,809.03$ 17.13$ 1,027.71$ 09028300 00 19.05$ 1,143.03$ 19.05$ 1,143.03$ 09028302 00 21.00$ 1,260.26$ 21.00$ 1,260.26$ 09028304 00 24.32$ 1,459.28$ 17.69$ 1,061.37$ 09028305 00 19.35$ 1,161.28$ 19.35$ 1,161.28$ 09028306 00 18.22$ 1,093.20$ 11.84$ 710.43$ 09028307 00 19.16$ 1,149.38$ 12.56$ 753.37$ 09028308 00 16.96$ 1,017.70$ 11.16$ 669.60$ 09028309 00 25.98$ 1,558.73$ 25.98$ 1,558.73$ 09028310 00 16.23$ 973.74$ 10.49$ 629.43$ 09028312 00 15.02$ 900.93$ 9.31$ 558.51$ 09028313 00 15.50$ 930.10$ 10.39$ 623.62$ 09028315 00 14.36$ 861.66$ 9.57$ 574.11$ 09028320 00 17.87$ 1,072.49$ 17.87$ 1,072.49$ 09028322 00 23.30$ 1,397.86$ 16.89$ 1,013.20$ 09028340 00 17.16$ 1,029.36$ 12.11$ 726.67$ 09028341 00 19.87$ 1,192.13$ 14.41$ 864.85$ 09028344 00 12.74$ 764.29$ 8.25$ 495.02$ 09028345 00 15.53$ 931.70$ 10.71$ 642.89$ 09028360 00 31.95$ 1,917.15$ 31.95$ 1,917.15$ 09028400 00 7.30$ 438.20$ 6.70$ 402.25$ 09028405 00 11.51$ 690.47$ 10.39$ 623.63$ 09028406 00 15.49$ 929.15$ 15.49$ 929.15$ 09028415 00 32.73$ 1,963.73$ 32.73$ 1,963.73$ 090



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

28420 00 37.47$ 2,248.32$ 37.47$ 2,248.32$ 09028430 00 7.02$ 420.94$ 6.17$ 370.49$ 09028435 00 10.72$ 643.17$ 9.51$ 570.65$ 09028436 00 13.30$ 798.11$ 13.30$ 798.11$ 09028445 00 30.77$ 1,846.07$ 30.77$ 1,846.07$ 09028446 00 35.91$ 2,154.88$ 35.91$ 2,154.88$ 09028450 00 6.28$ 376.53$ 5.62$ 337.43$ 09028455 00 8.51$ 510.67$ 7.60$ 455.81$ 09028456 00 9.52$ 571.05$ 9.52$ 571.05$ 09028465 00 18.54$ 1,112.51$ 18.54$ 1,112.51$ 09028470 00 6.45$ 387.17$ 6.00$ 360.05$ 09028475 00 7.55$ 452.79$ 6.65$ 399.18$ 09028476 00 10.39$ 623.54$ 10.39$ 623.54$ 09028485 00 16.01$ 960.68$ 16.01$ 960.68$ 09028490 00 4.26$ 255.53$ 3.68$ 220.85$ 09028495 00 5.29$ 317.65$ 4.40$ 264.05$ 09028496 00 13.77$ 826.33$ 7.22$ 433.47$ 09028505 00 19.70$ 1,182.19$ 14.62$ 876.98$ 09028510 00 3.62$ 217.23$ 3.54$ 212.19$ 09028515 00 4.82$ 289.12$ 4.20$ 251.92$ 09028525 00 16.96$ 1,017.46$ 11.80$ 707.84$ 09028530 00 3.45$ 206.83$ 3.04$ 182.24$ 09028531 00 10.22$ 613.00$ 5.36$ 321.66$ 09028540 00 5.73$ 343.70$ 5.14$ 308.39$ 09028545 00 8.85$ 531.16$ 7.78$ 466.83$ 09028546 00 17.32$ 1,039.16$ 10.08$ 604.68$ 09028555 00 25.55$ 1,533.20$ 19.25$ 1,154.84$ 09028570 00 6.75$ 404.85$ 5.66$ 339.90$ 09028575 00 10.88$ 652.84$ 9.78$ 586.62$ 09028576 00 11.53$ 691.55$ 11.53$ 691.55$ 09028585 00 25.68$ 1,540.73$ 19.96$ 1,197.68$ 09028600 00 6.46$ 387.36$ 5.50$ 329.98$ 09028605 00 9.80$ 587.92$ 8.74$ 524.23$ 09028606 00 11.49$ 689.24$ 11.49$ 689.24$ 09028615 00 23.77$ 1,426.36$ 23.77$ 1,426.36$ 09028630 00 4.61$ 276.86$ 3.21$ 192.36$ 01028635 00 5.23$ 313.52$ 3.90$ 234.07$ 01028636 00 9.54$ 572.46$ 6.03$ 361.84$ 01028645 00 19.51$ 1,170.33$ 14.27$ 856.29$ 09028660 00 3.47$ 208.50$ 2.61$ 156.79$ 01028665 00 4.56$ 273.85$ 3.84$ 230.34$ 01028666 00 4.62$ 277.29$ 4.62$ 277.29$ 010



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

28675 00 16.96$ 1,017.38$ 11.85$ 710.91$ 09028705 00 36.07$ 2,164.01$ 36.07$ 2,164.01$ 09028715 00 27.60$ 1,655.95$ 27.60$ 1,655.95$ 09028725 00 22.87$ 1,372.26$ 22.87$ 1,372.26$ 09028730 00 21.55$ 1,292.76$ 21.55$ 1,292.76$ 09028735 00 22.84$ 1,370.28$ 22.84$ 1,370.28$ 09028737 00 20.39$ 1,223.38$ 20.39$ 1,223.38$ 09028740 00 24.99$ 1,499.32$ 18.25$ 1,095.10$ 09028750 00 23.78$ 1,427.06$ 17.16$ 1,029.78$ 09028755 00 15.21$ 912.55$ 9.76$ 585.90$ 09028760 00 23.52$ 1,411.00$ 17.04$ 1,022.55$ 09028800 00 15.64$ 938.66$ 15.64$ 938.66$ 09028805 00 21.21$ 1,272.77$ 21.21$ 1,272.77$ 09028810 00 12.56$ 753.30$ 12.56$ 753.30$ 09028820 00 16.65$ 999.16$ 11.56$ 693.32$ 09028825 00 15.96$ 957.48$ 10.86$ 651.64$ 09028890 00 9.61$ 576.55$ 6.54$ 392.42$ 09028899 00 By Report By Report YYY29000 00 10.18$ 610.68$ 5.76$ 345.83$ 00029010 00 7.98$ 478.61$ 4.70$ 281.86$ 00029015 00 8.57$ 514.33$ 5.30$ 318.21$ 00029035 00 7.48$ 448.88$ 4.22$ 253.39$ 00029040 00 8.55$ 513.26$ 5.08$ 304.53$ 00029044 00 8.38$ 502.97$ 4.90$ 294.24$ 00029046 00 9.19$ 551.53$ 5.50$ 330.19$ 00029049 00 2.90$ 174.02$ 2.04$ 122.31$ 00029055 00 6.50$ 390.21$ 4.05$ 243.28$ 00029058 00 3.63$ 217.58$ 2.76$ 165.88$ 00029065 00 2.80$ 168.02$ 1.98$ 118.83$ 00029075 00 2.53$ 152.05$ 1.81$ 108.54$ 00029085 00 2.78$ 166.84$ 1.96$ 117.65$ 00029086 00 2.32$ 139.07$ 1.49$ 89.25$ 00029105 00 2.40$ 143.94$ 1.40$ 84.03$ 00029125 00 1.89$ 113.52$ 1.16$ 69.38$ 00029126 00 2.25$ 135.04$ 1.42$ 85.23$ 00029130 00 1.20$ 71.90$ 0.84$ 50.46$ 00029131 00 1.50$ 90.06$ 0.98$ 58.53$ 00029200 00 0.94$ 56.21$ 0.55$ 32.88$ 00029240 00 0.89$ 53.69$ 0.55$ 32.88$ 00029260 00 0.87$ 52.34$ 0.57$ 34.06$ 00029280 00 0.89$ 53.60$ 0.59$ 35.32$ 00029305 00 7.23$ 433.92$ 4.66$ 279.42$ 000



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

29325 00 7.98$ 478.78$ 5.21$ 312.30$ 00029345 00 3.95$ 237.07$ 2.92$ 175.27$ 00029355 00 4.13$ 247.92$ 3.11$ 186.75$ 00029358 00 4.70$ 281.97$ 3.04$ 182.34$ 00029365 00 3.59$ 215.19$ 2.56$ 153.39$ 00029405 00 2.37$ 141.97$ 1.74$ 104.13$ 00029425 00 2.26$ 135.83$ 1.63$ 97.99$ 00029435 00 3.44$ 206.44$ 2.42$ 145.27$ 00029440 00 1.27$ 76.39$ 0.83$ 49.90$ 00029445 00 3.82$ 228.94$ 2.99$ 179.12$ 00029450 00 4.24$ 254.65$ 3.31$ 198.53$ 00029505 00 2.51$ 150.70$ 1.48$ 88.90$ 00029515 00 2.09$ 125.37$ 1.45$ 86.91$ 00029520 00 1.00$ 59.99$ 0.56$ 33.51$ 00029530 00 0.88$ 53.06$ 0.55$ 32.88$ 00029540 00 0.84$ 50.45$ 0.53$ 31.53$ 00029550 00 0.56$ 33.87$ 0.33$ 20.00$ 00029580 00 1.84$ 110.24$ 0.80$ 47.81$ 00029581 00 2.57$ 154.04$ 0.81$ 48.73$ 00029584 00 2.39$ 143.42$ 0.48$ 28.65$ 00029700 00 1.88$ 112.63$ 0.97$ 58.40$ 00029705 00 1.89$ 113.69$ 1.35$ 80.90$ 00029710 00 3.59$ 215.62$ 2.44$ 146.25$ 00029720 00 2.48$ 149.04$ 1.30$ 77.79$ 00029730 00 1.83$ 110.02$ 1.29$ 77.23$ 00029740 00 2.89$ 173.64$ 2.05$ 123.19$ 00029750 00 3.14$ 188.16$ 2.28$ 137.08$ 00029799 00 By Report By Report YYY29800 00 15.50$ 929.82$ 15.50$ 929.82$ 09029804 00 18.78$ 1,126.71$ 18.78$ 1,126.71$ 09029805 00 13.83$ 829.92$ 13.83$ 829.92$ 09029806 00 31.04$ 1,862.60$ 31.04$ 1,862.60$ 09029807 00 30.36$ 1,821.52$ 30.36$ 1,821.52$ 09029819 00 17.19$ 1,031.25$ 17.19$ 1,031.25$ 09029820 00 15.65$ 938.87$ 15.65$ 938.87$ 09029821 00 17.17$ 1,030.49$ 17.17$ 1,030.49$ 09029822 00 16.68$ 1,000.84$ 16.68$ 1,000.84$ 09029823 00 18.14$ 1,088.13$ 18.14$ 1,088.13$ 09029824 00 19.56$ 1,173.34$ 19.56$ 1,173.34$ 09029825 00 16.93$ 1,015.86$ 16.93$ 1,015.86$ 09029826 00 5.12$ 307.10$ 5.12$ 307.10$ ZZZ29827 00 30.88$ 1,853.03$ 30.88$ 1,853.03$ 090



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

29828 00 26.61$ 1,596.42$ 26.61$ 1,596.42$ 09029830 00 13.35$ 800.83$ 13.35$ 800.83$ 09029834 00 14.26$ 855.48$ 14.26$ 855.48$ 09029835 00 14.92$ 895.41$ 14.92$ 895.41$ 09029836 00 16.78$ 1,006.92$ 16.78$ 1,006.92$ 09029837 00 15.39$ 923.16$ 15.39$ 923.16$ 09029838 00 17.25$ 1,035.18$ 17.25$ 1,035.18$ 09029840 00 13.21$ 792.77$ 13.21$ 792.77$ 09029843 00 14.22$ 853.32$ 14.22$ 853.32$ 09029844 00 14.58$ 874.71$ 14.58$ 874.71$ 09029845 00 16.94$ 1,016.54$ 16.94$ 1,016.54$ 09029846 00 15.27$ 916.24$ 15.27$ 916.24$ 09029847 00 15.95$ 957.17$ 15.95$ 957.17$ 09029848 00 15.02$ 901.05$ 15.02$ 901.05$ 09029850 00 18.32$ 1,098.92$ 18.32$ 1,098.92$ 09029851 00 27.34$ 1,640.43$ 27.34$ 1,640.43$ 09029855 00 22.95$ 1,377.15$ 22.95$ 1,377.15$ 09029856 00 29.23$ 1,753.88$ 29.23$ 1,753.88$ 09029860 00 19.58$ 1,174.60$ 19.58$ 1,174.60$ 09029861 00 21.01$ 1,260.51$ 21.01$ 1,260.51$ 09029862 00 23.60$ 1,416.11$ 23.60$ 1,416.11$ 09029863 00 23.64$ 1,418.30$ 23.64$ 1,418.30$ 09029866 00 30.82$ 1,849.48$ 30.82$ 1,849.48$ 09029867 00 37.52$ 2,251.50$ 37.52$ 2,251.50$ 09029868 00 49.07$ 2,944.17$ 49.07$ 2,944.17$ 09029870 00 16.90$ 1,014.12$ 12.00$ 720.26$ 09029871 00 15.10$ 906.03$ 15.10$ 906.03$ 09029873 00 15.47$ 928.13$ 15.47$ 928.13$ 09029874 00 15.72$ 943.42$ 15.72$ 943.42$ 09029875 00 14.53$ 871.93$ 14.53$ 871.93$ 09029876 00 19.24$ 1,154.54$ 19.24$ 1,154.54$ 09029877 00 18.22$ 1,093.12$ 18.22$ 1,093.12$ 09029879 00 19.40$ 1,164.03$ 19.40$ 1,164.03$ 09029880 00 16.47$ 988.06$ 16.47$ 988.06$ 09029881 00 15.87$ 952.28$ 15.87$ 952.28$ 09029882 00 20.44$ 1,226.53$ 20.44$ 1,226.53$ 09029883 00 24.77$ 1,486.50$ 24.77$ 1,486.50$ 09029884 00 17.99$ 1,079.55$ 17.99$ 1,079.55$ 09029885 00 22.15$ 1,328.83$ 22.15$ 1,328.83$ 09029886 00 18.70$ 1,121.89$ 18.70$ 1,121.89$ 09029887 00 22.06$ 1,323.37$ 22.06$ 1,323.37$ 09029888 00 28.79$ 1,727.51$ 28.79$ 1,727.51$ 090



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

29889 00 35.91$ 2,154.90$ 35.91$ 2,154.90$ 09029891 00 19.69$ 1,181.49$ 19.69$ 1,181.49$ 09029892 00 19.19$ 1,151.68$ 19.19$ 1,151.68$ 09029893 00 18.47$ 1,108.06$ 12.62$ 757.44$ 09029894 00 14.47$ 868.30$ 14.47$ 868.30$ 09029895 00 13.73$ 823.84$ 13.73$ 823.84$ 09029897 00 14.75$ 884.73$ 14.75$ 884.73$ 09029898 00 16.47$ 988.33$ 16.47$ 988.33$ 09029899 00 30.27$ 1,815.99$ 30.27$ 1,815.99$ 09029900 00 14.63$ 877.68$ 14.63$ 877.68$ 09029901 00 15.71$ 942.87$ 15.71$ 942.87$ 09029902 00 16.69$ 1,001.56$ 16.69$ 1,001.56$ 09029904 00 18.73$ 1,123.75$ 18.73$ 1,123.75$ 09029905 00 15.20$ 911.96$ 15.20$ 911.96$ 09029906 00 19.86$ 1,191.59$ 19.86$ 1,191.59$ 09029907 00 25.73$ 1,543.71$ 25.73$ 1,543.71$ 09029914 00 28.78$ 1,726.97$ 28.78$ 1,726.97$ 09029915 00 29.69$ 1,781.19$ 29.69$ 1,781.19$ 09029916 00 29.60$ 1,775.85$ 29.60$ 1,775.85$ 09029999 00 By Report By Report YYY30000 00 7.08$ 425.03$ 3.45$ 206.85$ 01030020 00 7.16$ 429.53$ 3.45$ 206.93$ 0103006F 00 Code Accepted for Tracking Purpose only XXX3008F 00 Code Accepted for Tracking Purpose only XXX30100 00 4.15$ 248.72$ 1.97$ 118.19$ 00030110 00 6.88$ 413.00$ 3.77$ 226.34$ 01030115 00 12.83$ 769.61$ 12.83$ 769.61$ 09030117 00 26.75$ 1,605.13$ 9.84$ 590.49$ 09030118 00 22.64$ 1,358.46$ 22.64$ 1,358.46$ 0903011F 00 Code Accepted for Tracking Purpose only XXX30120 00 15.08$ 904.93$ 12.62$ 757.37$ 09030124 00 8.41$ 504.43$ 8.41$ 504.43$ 09030125 00 18.01$ 1,080.31$ 18.01$ 1,080.31$ 09030130 00 11.37$ 681.94$ 11.37$ 681.94$ 09030140 00 8.14$ 488.17$ 5.19$ 311.60$ 0003014F 00 Code Accepted for Tracking Purpose only XXX30150 00 22.58$ 1,355.00$ 22.58$ 1,355.00$ 0903015F 00 Code Accepted for Tracking Purpose only XXX30160 00 22.74$ 1,364.12$ 22.74$ 1,364.12$ 0903016F 00 Code Accepted for Tracking Purpose only XXX3017F 00 Code Accepted for Tracking Purpose only XXX3018F 00 Code Accepted for Tracking Purpose only XXX



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

3019F 00 Code Accepted for Tracking Purpose only XXX30200 00 3.29$ 197.59$ 1.70$ 101.74$ 0003020F 00 Code Accepted for Tracking Purpose only XXX30210 00 4.40$ 263.75$ 2.89$ 173.57$ 0103021F 00 Code Accepted for Tracking Purpose only XXX30220 00 8.94$ 536.28$ 3.63$ 217.83$ 0103022F 00 Code Accepted for Tracking Purpose only XXX3023F 00 Code Accepted for Tracking Purpose only XXX3025F 00 Code Accepted for Tracking Purpose only XXX3027F 00 Code Accepted for Tracking Purpose only XXX3028F 00 Code Accepted for Tracking Purpose only XXX30300 00 5.46$ 327.71$ 3.23$ 194.02$ 01030310 00 5.94$ 356.32$ 5.94$ 356.32$ 01030320 00 13.40$ 804.16$ 13.40$ 804.16$ 0903035F 00 Code Accepted for Tracking Purpose only XXX3037F 00 Code Accepted for Tracking Purpose only XXX3038F 00 Code Accepted for Tracking Purpose only XXX30400 00 31.85$ 1,911.22$ 31.85$ 1,911.22$ 0903040F 00 Code Accepted for Tracking Purpose only XXX30410 00 36.73$ 2,203.83$ 36.73$ 2,203.83$ 09030420 00 40.36$ 2,421.39$ 40.36$ 2,421.39$ 0903042F 00 Code Accepted for Tracking Purpose only XXX30430 00 28.10$ 1,686.21$ 28.10$ 1,686.21$ 09030435 00 34.69$ 2,081.66$ 34.69$ 2,081.66$ 0903044F 00 Code Accepted for Tracking Purpose only XXX30450 00 45.95$ 2,756.82$ 45.95$ 2,756.82$ 09030460 00 24.02$ 1,441.22$ 24.02$ 1,441.22$ 09030462 00 46.14$ 2,768.30$ 46.14$ 2,768.30$ 09030465 00 28.78$ 1,726.87$ 28.78$ 1,726.87$ 0903046F 00 Code Accepted for Tracking Purpose only XXX3048F 00 Code Accepted for Tracking Purpose only XXX3049F 00 Code Accepted for Tracking Purpose only XXX3050F 00 Code Accepted for Tracking Purpose only XXX30520 00 18.52$ 1,111.03$ 18.52$ 1,111.03$ 09030540 00 20.36$ 1,221.73$ 20.36$ 1,221.73$ 09030545 00 27.79$ 1,667.52$ 27.79$ 1,667.52$ 0903055F 00 Code Accepted for Tracking Purpose only XXX30560 00 8.28$ 496.98$ 4.07$ 244.11$ 0103056F 00 Code Accepted for Tracking Purpose only XXX30580 00 18.81$ 1,128.56$ 14.56$ 873.80$ 09030600 00 16.65$ 998.75$ 12.74$ 764.17$ 0903060F 00 Code Accepted for Tracking Purpose only XXX



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

3061F 00 Code Accepted for Tracking Purpose only XXX30620 00 18.78$ 1,126.59$ 18.78$ 1,126.59$ 0903062F 00 Code Accepted for Tracking Purpose only XXX30630 00 18.53$ 1,111.87$ 18.53$ 1,111.87$ 0903066F 00 Code Accepted for Tracking Purpose only XXX3072F 00 Code Accepted for Tracking Purpose only XXX3073F 00 Code Accepted for Tracking Purpose only XXX3074F 00 Code Accepted for Tracking Purpose only XXX3075F 00 Code Accepted for Tracking Purpose only XXX3077F 00 Code Accepted for Tracking Purpose only XXX3078F 00 Code Accepted for Tracking Purpose only XXX3079F 00 Code Accepted for Tracking Purpose only XXX30801 00 6.57$ 394.34$ 4.11$ 246.78$ 01030802 00 8.31$ 498.49$ 5.63$ 337.68$ 0103080F 00 Code Accepted for Tracking Purpose only XXX3082F 00 Code Accepted for Tracking Purpose only XXX3083F 00 Code Accepted for Tracking Purpose only XXX3084F 00 Code Accepted for Tracking Purpose only XXX3085F 00 Code Accepted for Tracking Purpose only XXX3088F 00 Code Accepted for Tracking Purpose only XXX3089F 00 Code Accepted for Tracking Purpose only XXX30901 00 4.04$ 242.47$ 1.63$ 98.06$ 00030903 00 6.38$ 382.63$ 2.27$ 136.06$ 00030905 00 9.71$ 582.89$ 3.04$ 182.46$ 00030906 00 10.13$ 608.10$ 3.94$ 236.67$ 0003090F 00 Code Accepted for Tracking Purpose only XXX30915 00 16.90$ 1,014.20$ 16.90$ 1,014.20$ 0903091F 00 Code Accepted for Tracking Purpose only XXX30920 00 24.55$ 1,473.15$ 24.55$ 1,473.15$ 0903092F 00 Code Accepted for Tracking Purpose only XXX30930 00 3.52$ 211.40$ 3.52$ 211.40$ 0103093F 00 Code Accepted for Tracking Purpose only XXX3095F 00 Code Accepted for Tracking Purpose only XXX3096F 00 Code Accepted for Tracking Purpose only XXX30999 00 By Report By Report YYY31000 00 5.36$ 321.50$ 3.10$ 185.92$ 01031002 00 5.55$ 333.07$ 5.55$ 333.07$ 0103100F 00 Code Accepted for Tracking Purpose only XXX31020 00 14.19$ 851.67$ 10.78$ 646.73$ 09031030 00 19.73$ 1,183.57$ 15.37$ 922.50$ 09031032 00 16.93$ 1,016.09$ 16.93$ 1,016.09$ 09031040 00 22.56$ 1,353.72$ 22.56$ 1,353.72$ 090



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

31050 00 14.31$ 858.73$ 14.31$ 858.73$ 09031051 00 19.12$ 1,147.37$ 19.12$ 1,147.37$ 09031070 00 13.04$ 782.33$ 13.04$ 782.33$ 09031075 00 23.02$ 1,381.08$ 23.02$ 1,381.08$ 09031080 00 30.33$ 1,819.60$ 30.33$ 1,819.60$ 09031081 00 32.64$ 1,958.41$ 32.64$ 1,958.41$ 09031084 00 33.84$ 2,030.66$ 33.84$ 2,030.66$ 09031085 00 34.94$ 2,096.14$ 34.94$ 2,096.14$ 09031086 00 32.90$ 1,974.20$ 32.90$ 1,974.20$ 09031087 00 31.61$ 1,896.48$ 31.61$ 1,896.48$ 09031090 00 30.49$ 1,829.70$ 30.49$ 1,829.70$ 0903110F 00 Code Accepted for Tracking Purpose only XXX3111F 00 Code Accepted for Tracking Purpose only XXX3112F 00 Code Accepted for Tracking Purpose only XXX3115F 00 Code Accepted for Tracking Purpose only XXX3117F 00 Code Accepted for Tracking Purpose only XXX3118F 00 Code Accepted for Tracking Purpose only XXX3119F 00 Code Accepted for Tracking Purpose only XXX31200 00 17.31$ 1,038.42$ 17.31$ 1,038.42$ 09031201 00 22.03$ 1,321.84$ 22.03$ 1,321.84$ 09031205 00 26.86$ 1,611.56$ 26.86$ 1,611.56$ 0903120F 00 Code Accepted for Tracking Purpose only XXX31225 00 53.79$ 3,227.67$ 53.79$ 3,227.67$ 09031230 00 59.42$ 3,565.26$ 59.42$ 3,565.26$ 09031231 00 5.91$ 354.63$ 1.89$ 113.11$ 00031233 00 7.65$ 459.05$ 3.93$ 235.81$ 00031235 00 8.74$ 524.37$ 4.65$ 279.06$ 00031237 00 7.47$ 448.00$ 4.65$ 279.00$ 00031238 00 7.36$ 441.80$ 4.87$ 292.34$ 00031239 00 17.95$ 1,076.91$ 17.95$ 1,076.91$ 01031240 00 4.63$ 277.63$ 4.63$ 277.63$ 00031241 00 12.98$ 779.05$ 12.98$ 779.05$ 00031253 00 14.61$ 876.61$ 14.61$ 876.61$ 00031254 00 12.11$ 726.71$ 7.10$ 425.91$ 00031255 00 9.45$ 566.71$ 9.45$ 566.71$ 00031256 00 5.26$ 315.56$ 5.26$ 315.56$ 00031257 00 13.03$ 781.91$ 13.03$ 781.91$ 00031259 00 13.80$ 828.01$ 13.80$ 828.01$ 00031267 00 7.75$ 464.71$ 7.75$ 464.71$ 0003126F 00 Code Accepted for Tracking Purpose only XXX31276 00 11.05$ 663.05$ 11.05$ 663.05$ 00031287 00 5.88$ 352.52$ 5.88$ 352.52$ 000



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

31288 00 6.84$ 410.12$ 6.84$ 410.12$ 00031290 00 33.29$ 1,997.46$ 33.29$ 1,997.46$ 01031291 00 35.42$ 2,125.34$ 35.42$ 2,125.34$ 01031292 00 28.81$ 1,728.54$ 28.81$ 1,728.54$ 01031293 00 31.28$ 1,876.72$ 31.28$ 1,876.72$ 01031294 00 35.80$ 2,147.75$ 35.80$ 2,147.75$ 01031295 00 58.30$ 3,497.79$ 4.61$ 276.68$ 00031296 00 59.04$ 3,542.37$ 5.24$ 314.33$ 00031297 00 57.89$ 3,473.57$ 4.20$ 251.83$ 00031298 00 111.76$ 6,705.84$ 7.46$ 447.77$ 00031299 00 By Report By Report YYY31300 00 37.50$ 2,250.23$ 37.50$ 2,250.23$ 0903130F 00 Code Accepted for Tracking Purpose only XXX3132F 00 Code Accepted for Tracking Purpose only XXX31360 00 60.95$ 3,657.11$ 60.95$ 3,657.11$ 09031365 00 75.12$ 4,507.33$ 75.12$ 4,507.33$ 09031367 00 64.56$ 3,873.35$ 64.56$ 3,873.35$ 09031368 00 71.65$ 4,299.17$ 71.65$ 4,299.17$ 09031370 00 60.75$ 3,645.07$ 60.75$ 3,645.07$ 09031375 00 57.64$ 3,458.37$ 57.64$ 3,458.37$ 09031380 00 56.84$ 3,410.51$ 56.84$ 3,410.51$ 09031382 00 62.33$ 3,739.77$ 62.33$ 3,739.77$ 09031390 00 83.44$ 5,006.68$ 83.44$ 5,006.68$ 09031395 00 88.19$ 5,291.29$ 88.19$ 5,291.29$ 09031400 00 28.85$ 1,731.27$ 28.85$ 1,731.27$ 0903140F 00 Code Accepted for Tracking Purpose only XXX3141F 00 Code Accepted for Tracking Purpose only XXX31420 00 24.06$ 1,443.69$ 24.06$ 1,443.69$ 0903142F 00 Code Accepted for Tracking Purpose only XXX31500 00 4.10$ 245.89$ 4.10$ 245.89$ 00031502 00 1.02$ 61.34$ 1.02$ 61.34$ 00031505 00 2.48$ 149.10$ 1.42$ 85.41$ 0003150F 00 Code Accepted for Tracking Purpose only XXX31510 00 6.20$ 371.77$ 3.52$ 210.97$ 00031511 00 6.18$ 370.73$ 3.84$ 230.11$ 00031512 00 6.09$ 365.45$ 3.76$ 225.46$ 00031513 00 3.82$ 229.08$ 3.82$ 229.08$ 00031515 00 5.98$ 358.54$ 3.17$ 190.17$ 00031520 00 4.55$ 272.80$ 4.55$ 272.80$ 00031525 00 7.32$ 439.18$ 4.63$ 277.74$ 00031526 00 4.56$ 273.40$ 4.56$ 273.40$ 00031527 00 5.66$ 339.57$ 5.66$ 339.57$ 000



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

31528 00 4.19$ 251.47$ 4.19$ 251.47$ 00031529 00 4.69$ 281.15$ 4.69$ 281.15$ 00031530 00 5.79$ 347.24$ 5.79$ 347.24$ 00031531 00 6.16$ 369.88$ 6.16$ 369.88$ 00031535 00 5.50$ 329.85$ 5.50$ 329.85$ 00031536 00 6.12$ 367.44$ 6.12$ 367.44$ 00031540 00 7.00$ 420.16$ 7.00$ 420.16$ 00031541 00 7.65$ 458.98$ 7.65$ 458.98$ 00031545 00 10.52$ 631.38$ 10.52$ 631.38$ 00031546 00 15.96$ 957.76$ 15.96$ 957.76$ 00031551 00 41.97$ 2,517.91$ 41.97$ 2,517.91$ 09031552 00 42.29$ 2,537.43$ 42.29$ 2,537.43$ 09031553 00 46.20$ 2,772.22$ 46.20$ 2,772.22$ 09031554 00 48.40$ 2,903.81$ 48.40$ 2,903.81$ 0903155F 00 Code Accepted for Tracking Purpose only XXX31560 00 9.08$ 545.04$ 9.08$ 545.04$ 00031561 00 9.94$ 596.66$ 9.94$ 596.66$ 00031570 00 9.87$ 592.35$ 6.65$ 398.76$ 00031571 00 7.24$ 434.13$ 7.24$ 434.13$ 00031572 00 14.96$ 897.32$ 5.25$ 315.27$ 00031573 00 7.84$ 470.68$ 4.33$ 260.06$ 00031574 00 30.10$ 1,806.29$ 4.33$ 260.06$ 00031575 00 3.42$ 205.21$ 1.95$ 116.93$ 00031576 00 7.81$ 468.41$ 3.45$ 206.71$ 00031577 00 8.15$ 489.21$ 3.90$ 233.81$ 00031578 00 8.87$ 532.48$ 4.33$ 260.06$ 00031579 00 5.38$ 322.77$ 3.48$ 208.63$ 00031580 00 36.68$ 2,200.98$ 36.68$ 2,200.98$ 09031584 00 40.57$ 2,434.35$ 40.57$ 2,434.35$ 09031587 00 33.97$ 2,038.32$ 33.97$ 2,038.32$ 09031590 00 25.85$ 1,551.17$ 25.85$ 1,551.17$ 09031591 00 30.76$ 1,845.73$ 30.76$ 1,845.73$ 09031592 00 50.08$ 3,004.79$ 50.08$ 3,004.79$ 09031599 00 By Report By Report YYY31600 00 8.98$ 538.78$ 8.98$ 538.78$ 00031601 00 13.14$ 788.22$ 13.14$ 788.22$ 00031603 00 9.38$ 562.87$ 9.38$ 562.87$ 00031605 00 9.66$ 579.79$ 9.66$ 579.79$ 0003160F 00 Code Accepted for Tracking Purpose only XXX31610 00 27.85$ 1,671.25$ 27.85$ 1,671.25$ 09031611 00 15.62$ 936.99$ 15.62$ 936.99$ 09031612 00 2.45$ 147.19$ 1.40$ 84.13$ 000



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

31613 00 13.01$ 780.35$ 13.01$ 780.35$ 09031614 00 21.58$ 1,294.94$ 21.58$ 1,294.94$ 09031615 00 4.96$ 297.73$ 3.34$ 200.62$ 00031622 00 7.04$ 422.54$ 3.83$ 229.57$ 00031623 00 7.75$ 464.95$ 3.86$ 231.63$ 00031624 00 7.32$ 439.01$ 3.91$ 234.69$ 00031625 00 9.91$ 594.45$ 4.55$ 272.85$ 00031626 00 24.93$ 1,495.87$ 5.78$ 346.92$ 00031627 00 39.63$ 2,378.09$ 2.83$ 169.73$ ZZZ31628 00 10.51$ 630.44$ 5.13$ 307.57$ 00031629 00 13.02$ 781.48$ 5.45$ 326.82$ 00031630 00 5.77$ 346.46$ 5.77$ 346.46$ 00031631 00 6.65$ 398.90$ 6.65$ 398.90$ 00031632 00 1.85$ 110.81$ 1.43$ 85.59$ ZZZ31633 00 2.31$ 138.82$ 1.85$ 111.07$ ZZZ31634 00 51.70$ 3,102.21$ 5.60$ 335.77$ 00031635 00 8.24$ 494.61$ 5.12$ 307.32$ 00031636 00 6.42$ 385.22$ 6.42$ 385.22$ 00031637 00 2.24$ 134.66$ 2.24$ 134.66$ ZZZ31638 00 7.29$ 437.45$ 7.29$ 437.45$ 00031640 00 7.30$ 438.21$ 7.30$ 438.21$ 00031641 00 7.48$ 448.61$ 7.48$ 448.61$ 00031643 00 5.16$ 309.45$ 5.16$ 309.45$ 00031645 00 7.64$ 458.29$ 4.26$ 255.87$ 00031646 00 4.14$ 248.56$ 4.14$ 248.56$ 00031647 00 6.17$ 370.10$ 6.17$ 370.10$ 00031648 00 5.86$ 351.44$ 5.86$ 351.44$ 00031649 00 1.96$ 117.70$ 1.96$ 117.70$ ZZZ31651 00 2.15$ 129.23$ 2.15$ 129.23$ ZZZ31652 00 28.57$ 1,714.15$ 6.47$ 388.00$ 00031653 00 29.92$ 1,795.14$ 7.16$ 429.89$ 00031654 00 3.63$ 217.98$ 1.96$ 117.72$ ZZZ31660 00 5.69$ 341.47$ 5.69$ 341.47$ 00031661 00 6.00$ 360.29$ 6.00$ 360.29$ 0003170F 00 Code Accepted for Tracking Purpose only XXX31717 00 8.27$ 496.32$ 3.23$ 193.63$ 00031720 00 1.45$ 86.77$ 1.45$ 86.77$ 00031725 00 2.31$ 138.57$ 2.31$ 138.57$ 00031730 00 35.79$ 2,147.29$ 4.34$ 260.53$ 00031750 00 40.54$ 2,432.39$ 40.54$ 2,432.39$ 09031755 00 51.43$ 3,085.95$ 51.43$ 3,085.95$ 09031760 00 39.91$ 2,394.85$ 39.91$ 2,394.85$ 090



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

31766 00 51.69$ 3,101.37$ 51.69$ 3,101.37$ 09031770 00 38.69$ 2,321.47$ 38.69$ 2,321.47$ 09031775 00 40.67$ 2,440.25$ 40.67$ 2,440.25$ 09031780 00 34.79$ 2,087.66$ 34.79$ 2,087.66$ 09031781 00 40.27$ 2,416.29$ 40.27$ 2,416.29$ 09031785 00 31.35$ 1,880.84$ 31.35$ 1,880.84$ 09031786 00 41.93$ 2,515.89$ 41.93$ 2,515.89$ 09031800 00 21.19$ 1,271.17$ 21.19$ 1,271.17$ 09031805 00 23.74$ 1,424.27$ 23.74$ 1,424.27$ 09031820 00 12.70$ 762.29$ 9.53$ 571.84$ 09031825 00 17.58$ 1,055.05$ 13.96$ 837.49$ 09031830 00 13.11$ 786.43$ 10.07$ 604.18$ 09031899 00 By Report By Report YYY3200F 00 Code Accepted for Tracking Purpose only XXX32035 00 21.12$ 1,267.49$ 21.12$ 1,267.49$ 09032036 00 22.61$ 1,356.66$ 22.61$ 1,356.66$ 09032096 00 23.35$ 1,401.14$ 23.35$ 1,401.14$ 09032097 00 23.34$ 1,400.43$ 23.34$ 1,400.43$ 09032098 00 22.12$ 1,327.42$ 22.12$ 1,327.42$ 09032100 00 23.55$ 1,412.79$ 23.55$ 1,412.79$ 0903210F 00 Code Accepted for Tracking Purpose only XXX32110 00 42.72$ 2,563.16$ 42.72$ 2,563.16$ 09032120 00 25.37$ 1,522.21$ 25.37$ 1,522.21$ 09032124 00 26.91$ 1,614.57$ 26.91$ 1,614.57$ 09032140 00 28.86$ 1,731.68$ 28.86$ 1,731.68$ 09032141 00 44.26$ 2,655.59$ 44.26$ 2,655.59$ 09032150 00 29.20$ 1,752.00$ 29.20$ 1,752.00$ 09032151 00 29.27$ 1,756.31$ 29.27$ 1,756.31$ 0903215F 00 Code Accepted for Tracking Purpose only XXX32160 00 23.15$ 1,388.73$ 23.15$ 1,388.73$ 0903216F 00 Code Accepted for Tracking Purpose only XXX3218F 00 Code Accepted for Tracking Purpose only XXX32200 00 33.12$ 1,987.29$ 33.12$ 1,987.29$ 0903220F 00 Code Accepted for Tracking Purpose only XXX32215 00 23.13$ 1,387.98$ 23.13$ 1,387.98$ 09032220 00 46.12$ 2,767.35$ 46.12$ 2,767.35$ 09032225 00 28.89$ 1,733.34$ 28.89$ 1,733.34$ 0903230F 00 Code Accepted for Tracking Purpose only XXX32310 00 26.52$ 1,591.46$ 26.52$ 1,591.46$ 09032320 00 46.43$ 2,785.73$ 46.43$ 2,785.73$ 09032400 00 4.54$ 272.21$ 2.53$ 151.77$ 00032405 00 11.63$ 697.52$ 2.65$ 158.99$ 000



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

32440 00 45.43$ 2,725.54$ 45.43$ 2,725.54$ 09032442 00 89.11$ 5,346.86$ 89.11$ 5,346.86$ 09032445 00 102.91$ 6,174.50$ 102.91$ 6,174.50$ 09032480 00 42.91$ 2,574.43$ 42.91$ 2,574.43$ 09032482 00 45.90$ 2,753.88$ 45.90$ 2,753.88$ 09032484 00 41.55$ 2,493.08$ 41.55$ 2,493.08$ 09032486 00 68.36$ 4,101.56$ 68.36$ 4,101.56$ 09032488 00 69.65$ 4,178.72$ 69.65$ 4,178.72$ 09032491 00 42.92$ 2,574.96$ 42.92$ 2,574.96$ 09032501 00 7.08$ 424.77$ 7.08$ 424.77$ ZZZ32503 00 52.28$ 3,136.96$ 52.28$ 3,136.96$ 09032504 00 59.58$ 3,574.63$ 59.58$ 3,574.63$ 09032505 00 27.07$ 1,623.93$ 27.07$ 1,623.93$ 09032506 00 4.54$ 272.13$ 4.54$ 272.13$ ZZZ32507 00 4.53$ 271.58$ 4.53$ 271.58$ ZZZ3250F 00 Code Accepted for Tracking Purpose only XXX32540 00 49.95$ 2,996.85$ 49.95$ 2,996.85$ 09032550 00 22.13$ 1,327.90$ 6.04$ 362.45$ 00032551 00 4.56$ 273.62$ 4.56$ 273.62$ 00032552 00 5.37$ 322.14$ 4.62$ 277.37$ 01032553 00 15.45$ 927.12$ 5.25$ 314.80$ 00032554 00 6.21$ 372.70$ 2.61$ 156.40$ 00032555 00 8.82$ 529.19$ 3.26$ 195.60$ 00032556 00 18.15$ 1,089.07$ 3.58$ 215.06$ 00032557 00 16.70$ 1,001.80$ 4.44$ 266.52$ 00032560 00 7.44$ 446.15$ 2.26$ 135.90$ 00032561 00 2.71$ 162.89$ 1.99$ 119.38$ 00032562 00 2.43$ 145.71$ 1.78$ 106.61$ 00032601 00 8.95$ 536.71$ 8.95$ 536.71$ 00032604 00 13.99$ 839.50$ 13.99$ 839.50$ 00032606 00 13.40$ 804.16$ 13.40$ 804.16$ 00032607 00 8.93$ 536.08$ 8.93$ 536.08$ 00032608 00 10.96$ 657.49$ 10.96$ 657.49$ 00032609 00 7.50$ 449.83$ 7.50$ 449.83$ 0003260F 00 Code Accepted for Tracking Purpose only XXX32650 00 19.36$ 1,161.68$ 19.36$ 1,161.68$ 09032651 00 31.80$ 1,907.87$ 31.80$ 1,907.87$ 09032652 00 48.22$ 2,893.38$ 48.22$ 2,893.38$ 09032653 00 30.81$ 1,848.53$ 30.81$ 1,848.53$ 09032654 00 33.54$ 2,012.22$ 33.54$ 2,012.22$ 09032655 00 27.76$ 1,665.51$ 27.76$ 1,665.51$ 09032656 00 23.27$ 1,396.22$ 23.27$ 1,396.22$ 090



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

32658 00 20.79$ 1,247.28$ 20.79$ 1,247.28$ 09032659 00 21.28$ 1,276.58$ 21.28$ 1,276.58$ 0903265F 00 Code Accepted for Tracking Purpose only XXX32661 00 23.22$ 1,393.23$ 23.22$ 1,393.23$ 09032662 00 25.93$ 1,556.06$ 25.93$ 1,556.06$ 09032663 00 40.63$ 2,437.77$ 40.63$ 2,437.77$ 09032664 00 24.68$ 1,480.83$ 24.68$ 1,480.83$ 09032665 00 35.86$ 2,151.51$ 35.86$ 2,151.51$ 09032666 00 25.30$ 1,517.80$ 25.30$ 1,517.80$ 09032667 00 4.55$ 272.76$ 4.55$ 272.76$ ZZZ32668 00 4.55$ 272.76$ 4.55$ 272.76$ ZZZ32669 00 38.99$ 2,339.61$ 38.99$ 2,339.61$ 0903266F 00 Code Accepted for Tracking Purpose only XXX32670 00 46.51$ 2,790.40$ 46.51$ 2,790.40$ 09032671 00 51.69$ 3,101.48$ 51.69$ 3,101.48$ 09032672 00 44.30$ 2,657.74$ 44.30$ 2,657.74$ 09032673 00 35.22$ 2,113.36$ 35.22$ 2,113.36$ 09032674 00 6.25$ 374.88$ 6.25$ 374.88$ ZZZ3267F 00 Code Accepted for Tracking Purpose only XXX3268F 00 Code Accepted for Tracking Purpose only XXX3269F 00 Code Accepted for Tracking Purpose only XXX32701 00 6.23$ 374.10$ 6.23$ 374.10$ XXX3270F 00 Code Accepted for Tracking Purpose only XXX3271F 00 Code Accepted for Tracking Purpose only XXX3272F 00 Code Accepted for Tracking Purpose only XXX3273F 00 Code Accepted for Tracking Purpose only XXX3274F 00 Code Accepted for Tracking Purpose only XXX3278F 00 Code Accepted for Tracking Purpose only XXX3279F 00 Code Accepted for Tracking Purpose only XXX32800 00 27.26$ 1,635.76$ 27.26$ 1,635.76$ 0903280F 00 Code Accepted for Tracking Purpose only XXX32810 00 26.23$ 1,573.69$ 26.23$ 1,573.69$ 09032815 00 81.40$ 4,883.91$ 81.40$ 4,883.91$ 0903281F 00 Code Accepted for Tracking Purpose only XXX32820 00 38.71$ 2,322.36$ 38.71$ 2,322.36$ 0903284F 00 Code Accepted for Tracking Purpose only XXX32850 00 By Report By Report XXX32851 00 95.67$ 5,739.96$ 95.67$ 5,739.96$ 09032852 00 104.12$ 6,247.07$ 104.12$ 6,247.07$ 09032853 00 133.83$ 8,029.86$ 133.83$ 8,029.86$ 09032854 00 142.01$ 8,520.41$ 142.01$ 8,520.41$ 09032855 00 187.42$ 187.42$ XXX



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

32856 00 191.46$ 191.46$ XXX3285F 00 Code Accepted for Tracking Purpose only XXX3288F 00 Code Accepted for Tracking Purpose only XXX32900 00 41.20$ 2,471.78$ 41.20$ 2,471.78$ 09032905 00 38.87$ 2,332.07$ 38.87$ 2,332.07$ 09032906 00 47.99$ 2,879.58$ 47.99$ 2,879.58$ 0903290F 00 Code Accepted for Tracking Purpose only XXX3291F 00 Code Accepted for Tracking Purpose only XXX3292F 00 Code Accepted for Tracking Purpose only XXX3293F 00 Code Accepted for Tracking Purpose only XXX32940 00 35.91$ 2,154.86$ 35.91$ 2,154.86$ 0903294F 00 Code Accepted for Tracking Purpose only XXX32960 00 3.70$ 221.72$ 2.67$ 159.92$ 00032994 00 167.14$ 10,028.43$ 13.38$ 802.75$ 00032997 00 9.95$ 597.11$ 9.95$ 597.11$ 00032998 00 105.25$ 6,315.08$ 12.97$ 778.41$ 00032999 00 By Report By Report YYY3300F 00 Code Accepted for Tracking Purpose only XXX33016 00 6.82$ 409.43$ 6.82$ 409.43$ 00033017 00 7.08$ 424.92$ 7.08$ 424.92$ 00033018 00 8.09$ 485.20$ 8.09$ 485.20$ 00033019 00 6.56$ 393.47$ 6.56$ 393.47$ 0003301F 00 Code Accepted for Tracking Purpose only XXX33020 00 25.56$ 1,533.33$ 25.56$ 1,533.33$ 09033025 00 23.17$ 1,390.09$ 23.17$ 1,390.09$ 09033030 00 58.09$ 3,485.59$ 58.09$ 3,485.59$ 09033031 00 71.84$ 4,310.25$ 71.84$ 4,310.25$ 09033050 00 29.29$ 1,757.41$ 29.29$ 1,757.41$ 09033120 00 60.88$ 3,652.90$ 60.88$ 3,652.90$ 09033130 00 40.01$ 2,400.89$ 40.01$ 2,400.89$ 09033140 00 45.68$ 2,740.55$ 45.68$ 2,740.55$ 09033141 00 3.81$ 228.37$ 3.81$ 228.37$ ZZZ3315F 00 Code Accepted for Tracking Purpose only XXX3316F 00 Code Accepted for Tracking Purpose only XXX3317F 00 Code Accepted for Tracking Purpose only XXX3318F 00 Code Accepted for Tracking Purpose only XXX3319F 00 Code Accepted for Tracking Purpose only XXX33202 00 22.52$ 1,351.19$ 22.52$ 1,351.19$ 09033203 00 23.57$ 1,414.45$ 23.57$ 1,414.45$ 09033206 00 13.28$ 797.04$ 13.28$ 797.04$ 09033207 00 14.09$ 845.62$ 14.09$ 845.62$ 09033208 00 15.28$ 916.83$ 15.28$ 916.83$ 090



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

3320F 00 Code Accepted for Tracking Purpose only XXX33210 00 4.78$ 286.84$ 4.78$ 286.84$ 00033211 00 4.97$ 298.25$ 4.97$ 298.25$ 00033212 00 9.41$ 564.50$ 9.41$ 564.50$ 09033213 00 9.84$ 590.33$ 9.84$ 590.33$ 09033214 00 14.04$ 842.34$ 14.04$ 842.34$ 09033215 00 9.11$ 546.53$ 9.11$ 546.53$ 09033216 00 10.89$ 653.19$ 10.89$ 653.19$ 09033217 00 10.72$ 643.35$ 10.72$ 643.35$ 09033218 00 11.39$ 683.15$ 11.39$ 683.15$ 0903321F 00 Code Accepted for Tracking Purpose only XXX33220 00 11.47$ 687.99$ 11.47$ 687.99$ 09033221 00 10.56$ 633.36$ 10.56$ 633.36$ 09033222 00 9.94$ 596.70$ 9.94$ 596.70$ 09033223 00 12.00$ 720.09$ 12.00$ 720.09$ 09033224 00 15.10$ 906.28$ 15.10$ 906.28$ 00033225 00 13.74$ 824.41$ 13.74$ 824.41$ ZZZ33226 00 14.53$ 871.69$ 14.53$ 871.69$ 00033227 00 9.92$ 595.46$ 9.92$ 595.46$ 09033228 00 10.37$ 622.09$ 10.37$ 622.09$ 09033229 00 10.99$ 659.27$ 10.99$ 659.27$ 0903322F 00 Code Accepted for Tracking Purpose only XXX33230 00 11.20$ 672.08$ 11.20$ 672.08$ 09033231 00 11.77$ 706.03$ 11.77$ 706.03$ 09033233 00 6.78$ 407.01$ 6.78$ 407.01$ 09033234 00 14.24$ 854.52$ 14.24$ 854.52$ 09033235 00 18.72$ 1,123.01$ 18.72$ 1,123.01$ 09033236 00 22.84$ 1,370.35$ 22.84$ 1,370.35$ 09033237 00 24.54$ 1,472.34$ 24.54$ 1,472.34$ 09033238 00 27.34$ 1,640.34$ 27.34$ 1,640.34$ 0903323F 00 Code Accepted for Tracking Purpose only XXX33240 00 10.71$ 642.85$ 10.71$ 642.85$ 09033241 00 6.33$ 379.69$ 6.33$ 379.69$ 09033243 00 39.93$ 2,396.01$ 39.93$ 2,396.01$ 09033244 00 25.33$ 1,519.76$ 25.33$ 1,519.76$ 09033249 00 26.90$ 1,614.17$ 26.90$ 1,614.17$ 0903324F 00 Code Accepted for Tracking Purpose only XXX33250 00 42.65$ 2,558.75$ 42.65$ 2,558.75$ 09033251 00 47.41$ 2,844.74$ 47.41$ 2,844.74$ 09033254 00 39.61$ 2,376.52$ 39.61$ 2,376.52$ 09033255 00 47.66$ 2,859.73$ 47.66$ 2,859.73$ 09033256 00 56.44$ 3,386.35$ 56.44$ 3,386.35$ 090



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

33257 00 16.95$ 1,016.88$ 16.95$ 1,016.88$ ZZZ33258 00 19.01$ 1,140.35$ 19.01$ 1,140.35$ ZZZ33259 00 24.60$ 1,475.93$ 24.60$ 1,475.93$ ZZZ3325F 00 Code Accepted for Tracking Purpose only XXX33261 00 47.20$ 2,831.92$ 47.20$ 2,831.92$ 09033262 00 10.93$ 656.06$ 10.93$ 656.06$ 09033263 00 11.39$ 683.24$ 11.39$ 683.24$ 09033264 00 11.88$ 712.85$ 11.88$ 712.85$ 09033265 00 39.53$ 2,371.98$ 39.53$ 2,371.98$ 09033266 00 53.72$ 3,223.16$ 53.72$ 3,223.16$ 09033270 00 16.62$ 997.48$ 16.62$ 997.48$ 09033271 00 13.36$ 801.41$ 13.36$ 801.41$ 09033272 00 10.18$ 610.99$ 10.18$ 610.99$ 09033273 00 11.78$ 706.92$ 11.78$ 706.92$ 09033274 00 14.35$ 860.75$ 14.35$ 860.75$ 09033275 00 15.22$ 912.99$ 15.22$ 912.99$ 09033285 00 153.40$ 9,204.20$ 2.61$ 156.35$ 00033286 00 3.88$ 232.82$ 2.56$ 153.36$ 00033289 00 9.56$ 573.47$ 9.56$ 573.47$ 0003328F 00 Code Accepted for Tracking Purpose only XXX33300 00 71.26$ 4,275.73$ 71.26$ 4,275.73$ 09033305 00 119.34$ 7,160.13$ 119.34$ 7,160.13$ 0903330F 00 Code Accepted for Tracking Purpose only XXX33310 00 34.23$ 2,053.93$ 34.23$ 2,053.93$ 09033315 00 55.56$ 3,333.84$ 55.56$ 3,333.84$ 0903331F 00 Code Accepted for Tracking Purpose only XXX33320 00 30.71$ 1,842.82$ 30.71$ 1,842.82$ 09033321 00 34.78$ 2,087.03$ 34.78$ 2,087.03$ 09033322 00 40.25$ 2,415.21$ 40.25$ 2,415.21$ 09033330 00 41.72$ 2,502.94$ 41.72$ 2,502.94$ 09033335 00 54.84$ 3,290.61$ 54.84$ 3,290.61$ 09033340 00 23.13$ 1,387.93$ 23.13$ 1,387.93$ 00033361 00 39.60$ 2,375.72$ 39.60$ 2,375.72$ 00033362 00 43.22$ 2,593.04$ 43.22$ 2,593.04$ 00033363 00 44.76$ 2,685.36$ 44.76$ 2,685.36$ 00033364 00 46.21$ 2,772.72$ 46.21$ 2,772.72$ 00033365 00 51.96$ 3,117.77$ 51.96$ 3,117.77$ 00033366 00 56.17$ 3,370.21$ 56.17$ 3,370.21$ 00033367 00 18.32$ 1,099.20$ 18.32$ 1,099.20$ ZZZ33368 00 21.73$ 1,303.98$ 21.73$ 1,303.98$ ZZZ33369 00 28.69$ 1,721.28$ 28.69$ 1,721.28$ ZZZ33390 00 56.12$ 3,367.38$ 56.12$ 3,367.38$ 090



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

33391 00 66.40$ 3,984.13$ 66.40$ 3,984.13$ 09033404 00 51.22$ 3,073.05$ 51.22$ 3,073.05$ 09033405 00 65.95$ 3,957.18$ 65.95$ 3,957.18$ 09033406 00 83.51$ 5,010.55$ 83.51$ 5,010.55$ 0903340F 00 Code Accepted for Tracking Purpose only XXX33410 00 73.94$ 4,436.18$ 73.94$ 4,436.18$ 09033411 00 97.64$ 5,858.67$ 97.64$ 5,858.67$ 09033412 00 92.39$ 5,543.51$ 92.39$ 5,543.51$ 09033413 00 94.57$ 5,674.29$ 94.57$ 5,674.29$ 09033414 00 62.24$ 3,734.56$ 62.24$ 3,734.56$ 09033415 00 59.04$ 3,542.64$ 59.04$ 3,542.64$ 09033416 00 58.85$ 3,530.94$ 58.85$ 3,530.94$ 09033417 00 48.41$ 2,904.68$ 48.41$ 2,904.68$ 09033418 00 52.66$ 3,159.36$ 52.66$ 3,159.36$ 09033419 00 12.41$ 744.81$ 12.41$ 744.81$ ZZZ3341F 00 Code Accepted for Tracking Purpose only XXX33420 00 42.50$ 2,549.74$ 42.50$ 2,549.74$ 09033422 00 48.75$ 2,924.71$ 48.75$ 2,924.71$ 09033425 00 79.34$ 4,760.19$ 79.34$ 4,760.19$ 09033426 00 69.26$ 4,155.43$ 69.26$ 4,155.43$ 09033427 00 71.06$ 4,263.89$ 71.06$ 4,263.89$ 0903342F 00 Code Accepted for Tracking Purpose only XXX33430 00 81.38$ 4,883.06$ 81.38$ 4,883.06$ 0903343F 00 Code Accepted for Tracking Purpose only XXX33440 00 99.51$ 5,970.57$ 99.51$ 5,970.57$ 0903344F 00 Code Accepted for Tracking Purpose only XXX3345F 00 Code Accepted for Tracking Purpose only XXX33460 00 70.42$ 4,225.14$ 70.42$ 4,225.14$ 09033463 00 89.82$ 5,389.13$ 89.82$ 5,389.13$ 09033464 00 70.99$ 4,259.52$ 70.99$ 4,259.52$ 09033465 00 80.18$ 4,810.66$ 80.18$ 4,810.66$ 09033468 00 71.47$ 4,288.10$ 71.47$ 4,288.10$ 09033470 00 36.09$ 2,165.27$ 36.09$ 2,165.27$ 09033471 00 38.60$ 2,315.86$ 38.60$ 2,315.86$ 09033474 00 63.51$ 3,810.62$ 63.51$ 3,810.62$ 09033475 00 67.87$ 4,072.15$ 67.87$ 4,072.15$ 09033476 00 44.38$ 2,662.63$ 44.38$ 2,662.63$ 09033477 00 39.84$ 2,390.68$ 39.84$ 2,390.68$ 00033478 00 45.85$ 2,750.89$ 45.85$ 2,750.89$ 09033496 00 48.78$ 2,926.70$ 48.78$ 2,926.70$ 09033500 00 45.71$ 2,742.50$ 45.71$ 2,742.50$ 09033501 00 32.69$ 1,961.10$ 32.69$ 1,961.10$ 090



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

33502 00 37.22$ 2,233.34$ 37.22$ 2,233.34$ 09033503 00 38.68$ 2,321.09$ 38.68$ 2,321.09$ 09033504 00 42.74$ 2,564.26$ 42.74$ 2,564.26$ 09033505 00 60.13$ 3,607.75$ 60.13$ 3,607.75$ 09033506 00 59.87$ 3,592.06$ 59.87$ 3,592.06$ 09033507 00 50.22$ 3,013.19$ 50.22$ 3,013.19$ 09033508 00 0.47$ 28.25$ 0.47$ 28.25$ ZZZ3350F 00 Code Accepted for Tracking Purpose only XXX33510 00 56.19$ 3,371.60$ 56.19$ 3,371.60$ 09033511 00 61.71$ 3,702.76$ 61.71$ 3,702.76$ 09033512 00 70.25$ 4,214.92$ 70.25$ 4,214.92$ 09033513 00 72.33$ 4,339.61$ 72.33$ 4,339.61$ 09033514 00 76.05$ 4,563.12$ 76.05$ 4,563.12$ 09033516 00 79.23$ 4,753.86$ 79.23$ 4,753.86$ 09033517 00 5.42$ 325.12$ 5.42$ 325.12$ ZZZ33518 00 11.95$ 716.81$ 11.95$ 716.81$ ZZZ33519 00 15.80$ 948.11$ 15.80$ 948.11$ ZZZ3351F 00 Code Accepted for Tracking Purpose only XXX33521 00 18.96$ 1,137.30$ 18.96$ 1,137.30$ ZZZ33522 00 21.29$ 1,277.21$ 21.29$ 1,277.21$ ZZZ33523 00 24.03$ 1,441.88$ 24.03$ 1,441.88$ ZZZ3352F 00 Code Accepted for Tracking Purpose only XXX33530 00 15.27$ 916.21$ 15.27$ 916.21$ ZZZ33533 00 54.33$ 3,259.83$ 54.33$ 3,259.83$ 09033534 00 63.88$ 3,832.97$ 63.88$ 3,832.97$ 09033535 00 71.25$ 4,275.20$ 71.25$ 4,275.20$ 09033536 00 76.42$ 4,585.34$ 76.42$ 4,585.34$ 0903353F 00 Code Accepted for Tracking Purpose only XXX33542 00 76.45$ 4,587.21$ 76.45$ 4,587.21$ 09033545 00 89.96$ 5,397.42$ 89.96$ 5,397.42$ 09033548 00 86.09$ 5,165.53$ 86.09$ 5,165.53$ 0903354F 00 Code Accepted for Tracking Purpose only XXX33572 00 6.68$ 400.76$ 6.68$ 400.76$ ZZZ33600 00 50.10$ 3,006.12$ 50.10$ 3,006.12$ 09033602 00 48.63$ 2,917.86$ 48.63$ 2,917.86$ 09033606 00 51.83$ 3,109.63$ 51.83$ 3,109.63$ 09033608 00 52.49$ 3,149.59$ 52.49$ 3,149.59$ 09033610 00 51.76$ 3,105.81$ 51.76$ 3,105.81$ 09033611 00 56.89$ 3,413.30$ 56.89$ 3,413.30$ 09033612 00 58.41$ 3,504.55$ 58.41$ 3,504.55$ 09033615 00 58.22$ 3,493.15$ 58.22$ 3,493.15$ 09033617 00 63.09$ 3,785.53$ 63.09$ 3,785.53$ 090



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

33619 00 79.69$ 4,781.58$ 79.69$ 4,781.58$ 09033620 00 48.10$ 2,885.80$ 48.10$ 2,885.80$ 09033621 00 27.14$ 1,628.62$ 27.14$ 1,628.62$ 09033622 00 100.20$ 6,012.23$ 100.20$ 6,012.23$ 09033641 00 47.58$ 2,854.51$ 47.58$ 2,854.51$ 09033645 00 50.46$ 3,027.49$ 50.46$ 3,027.49$ 09033647 00 53.00$ 3,180.30$ 53.00$ 3,180.30$ 09033660 00 51.23$ 3,073.50$ 51.23$ 3,073.50$ 09033665 00 55.80$ 3,347.85$ 55.80$ 3,347.85$ 09033670 00 57.53$ 3,451.89$ 57.53$ 3,451.89$ 09033675 00 57.50$ 3,450.03$ 57.50$ 3,450.03$ 09033676 00 59.02$ 3,541.28$ 59.02$ 3,541.28$ 09033677 00 61.29$ 3,677.54$ 61.29$ 3,677.54$ 09033681 00 53.32$ 3,199.23$ 53.32$ 3,199.23$ 09033684 00 55.07$ 3,304.06$ 55.07$ 3,304.06$ 09033688 00 54.94$ 3,296.57$ 54.94$ 3,296.57$ 09033690 00 35.00$ 2,100.21$ 35.00$ 2,100.21$ 09033692 00 57.05$ 3,423.24$ 57.05$ 3,423.24$ 09033694 00 56.89$ 3,413.30$ 56.89$ 3,413.30$ 09033697 00 59.91$ 3,594.63$ 59.91$ 3,594.63$ 09033702 00 45.08$ 2,704.96$ 45.08$ 2,704.96$ 0903370F 00 Code Accepted for Tracking Purpose only XXX33710 00 59.83$ 3,589.85$ 59.83$ 3,589.85$ 09033720 00 45.11$ 2,706.80$ 45.11$ 2,706.80$ 09033722 00 47.42$ 2,845.30$ 47.42$ 2,845.30$ 09033724 00 44.85$ 2,691.22$ 44.85$ 2,691.22$ 09033726 00 59.28$ 3,556.90$ 59.28$ 3,556.90$ 0903372F 00 Code Accepted for Tracking Purpose only XXX33730 00 58.47$ 3,508.39$ 58.47$ 3,508.39$ 09033732 00 48.05$ 2,883.02$ 48.05$ 2,883.02$ 09033735 00 37.80$ 2,267.70$ 37.80$ 2,267.70$ 09033736 00 41.00$ 2,459.83$ 41.00$ 2,459.83$ 09033737 00 37.85$ 2,270.83$ 37.85$ 2,270.83$ 0903374F 00 Code Accepted for Tracking Purpose only XXX33750 00 36.80$ 2,208.29$ 36.80$ 2,208.29$ 09033755 00 38.40$ 2,304.30$ 38.40$ 2,304.30$ 09033762 00 37.39$ 2,243.13$ 37.39$ 2,243.13$ 09033764 00 38.40$ 2,304.30$ 38.40$ 2,304.30$ 09033766 00 38.86$ 2,331.39$ 38.86$ 2,331.39$ 09033767 00 41.49$ 2,489.25$ 41.49$ 2,489.25$ 09033768 00 12.11$ 726.59$ 12.11$ 726.59$ ZZZ3376F 00 Code Accepted for Tracking Purpose only XXX



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

33770 00 61.73$ 3,703.68$ 61.73$ 3,703.68$ 09033771 00 63.51$ 3,810.69$ 63.51$ 3,810.69$ 09033774 00 52.47$ 3,148.42$ 52.47$ 3,148.42$ 09033775 00 54.07$ 3,244.01$ 54.07$ 3,244.01$ 09033776 00 57.15$ 3,428.99$ 57.15$ 3,428.99$ 09033777 00 55.16$ 3,309.41$ 55.16$ 3,309.41$ 09033778 00 68.52$ 4,111.11$ 68.52$ 4,111.11$ 09033779 00 67.83$ 4,069.76$ 67.83$ 4,069.76$ 09033780 00 69.08$ 4,144.89$ 69.08$ 4,144.89$ 09033781 00 67.43$ 4,045.94$ 67.43$ 4,045.94$ 09033782 00 94.21$ 5,652.85$ 94.21$ 5,652.85$ 09033783 00 101.85$ 6,111.23$ 101.85$ 6,111.23$ 09033786 00 66.39$ 3,983.35$ 66.39$ 3,983.35$ 09033788 00 44.69$ 2,681.46$ 44.69$ 2,681.46$ 0903378F 00 Code Accepted for Tracking Purpose only XXX33800 00 28.78$ 1,727.02$ 28.78$ 1,727.02$ 09033802 00 31.65$ 1,899.13$ 31.65$ 1,899.13$ 09033803 00 33.56$ 2,013.40$ 33.56$ 2,013.40$ 0903380F 00 Code Accepted for Tracking Purpose only XXX33813 00 36.17$ 2,169.94$ 36.17$ 2,169.94$ 09033814 00 44.42$ 2,665.15$ 44.42$ 2,665.15$ 09033820 00 28.25$ 1,695.03$ 28.25$ 1,695.03$ 09033822 00 29.78$ 1,786.87$ 29.78$ 1,786.87$ 09033824 00 34.40$ 2,064.22$ 34.40$ 2,064.22$ 0903382F 00 Code Accepted for Tracking Purpose only XXX33840 00 36.15$ 2,168.73$ 36.15$ 2,168.73$ 09033845 00 38.92$ 2,334.94$ 38.92$ 2,334.94$ 0903384F 00 Code Accepted for Tracking Purpose only XXX33851 00 37.11$ 2,226.44$ 37.11$ 2,226.44$ 09033852 00 40.79$ 2,447.45$ 40.79$ 2,447.45$ 09033853 00 53.45$ 3,207.25$ 53.45$ 3,207.25$ 09033858 00 97.88$ 5,872.57$ 97.88$ 5,872.57$ 09033859 00 70.31$ 4,218.77$ 70.31$ 4,218.77$ 09033863 00 91.63$ 5,497.68$ 91.63$ 5,497.68$ 09033864 00 93.86$ 5,631.78$ 93.86$ 5,631.78$ 09033866 00 29.96$ 1,797.31$ 29.96$ 1,797.31$ ZZZ3386F 00 Code Accepted for Tracking Purpose only XXX33871 00 94.08$ 5,644.59$ 94.08$ 5,644.59$ 09033875 00 79.94$ 4,796.24$ 79.94$ 4,796.24$ 09033877 00 105.26$ 6,315.41$ 105.26$ 6,315.41$ 09033880 00 52.09$ 3,125.18$ 52.09$ 3,125.18$ 09033881 00 44.71$ 2,682.65$ 44.71$ 2,682.65$ 090



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

33883 00 32.41$ 1,944.54$ 32.41$ 1,944.54$ 09033884 00 11.40$ 683.74$ 11.40$ 683.74$ ZZZ33886 00 27.78$ 1,666.57$ 27.78$ 1,666.57$ 09033889 00 22.82$ 1,369.44$ 22.82$ 1,369.44$ 0003388F 00 Code Accepted for Tracking Purpose only XXX33891 00 27.82$ 1,668.97$ 27.82$ 1,668.97$ 0003390F 00 Code Accepted for Tracking Purpose only XXX33910 00 76.51$ 4,590.74$ 76.51$ 4,590.74$ 09033915 00 40.32$ 2,419.44$ 40.32$ 2,419.44$ 09033916 00 123.52$ 7,411.05$ 123.52$ 7,411.05$ 09033917 00 42.51$ 2,550.42$ 42.51$ 2,550.42$ 09033920 00 52.79$ 3,167.60$ 52.79$ 3,167.60$ 09033922 00 40.50$ 2,429.98$ 40.50$ 2,429.98$ 09033924 00 8.32$ 499.03$ 8.32$ 499.03$ ZZZ33925 00 50.07$ 3,004.16$ 50.07$ 3,004.16$ 09033926 00 70.47$ 4,228.17$ 70.47$ 4,228.17$ 09033927 00 74.32$ 4,458.93$ 74.32$ 4,458.93$ XXX33928 00 By Report By Report XXX33929 00 By Report By Report ZZZ33930 00 By Report By Report XXX33933 00 By Report By Report XXX33935 00 144.15$ 8,648.96$ 144.15$ 8,648.96$ 09033940 00 By Report By Report XXX33944 00 199.55$ 199.55$ XXX33945 00 141.72$ 8,503.41$ 141.72$ 8,503.41$ 09033946 00 9.02$ 541.10$ 9.02$ 541.10$ XXX33947 00 10.00$ 599.76$ 10.00$ 599.76$ XXX33948 00 6.96$ 417.33$ 6.96$ 417.33$ XXX33949 00 6.76$ 405.34$ 6.76$ 405.34$ XXX3394F 00 Code Accepted for Tracking Purpose only XXX33951 00 12.39$ 743.61$ 12.39$ 743.61$ 00033952 00 12.46$ 747.52$ 12.46$ 747.52$ 00033953 00 13.85$ 831.27$ 13.85$ 831.27$ 00033954 00 13.90$ 834.21$ 13.90$ 834.21$ 00033955 00 24.28$ 1,456.80$ 24.28$ 1,456.80$ 00033956 00 24.26$ 1,455.63$ 24.26$ 1,455.63$ 00033957 00 5.39$ 323.40$ 5.39$ 323.40$ 00033958 00 5.39$ 323.40$ 5.39$ 323.40$ 00033959 00 6.85$ 410.98$ 6.85$ 410.98$ 0003395F 00 Code Accepted for Tracking Purpose only XXX33962 00 6.85$ 410.98$ 6.85$ 410.98$ 00033963 00 13.69$ 821.63$ 13.69$ 821.63$ 000



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

33964 00 14.45$ 867.26$ 14.45$ 867.26$ 00033965 00 5.39$ 323.40$ 5.39$ 323.40$ 00033966 00 6.93$ 415.65$ 6.93$ 415.65$ 00033967 00 7.58$ 455.01$ 7.58$ 455.01$ 00033968 00 0.98$ 59.06$ 0.98$ 59.06$ 00033969 00 7.99$ 479.42$ 7.99$ 479.42$ 00033970 00 10.30$ 618.18$ 10.30$ 618.18$ 00033971 00 20.66$ 1,239.41$ 20.66$ 1,239.41$ 09033973 00 15.06$ 903.48$ 15.06$ 903.48$ 00033974 00 26.05$ 1,562.85$ 26.05$ 1,562.85$ 09033975 00 38.01$ 2,280.66$ 38.01$ 2,280.66$ XXX33976 00 46.44$ 2,786.38$ 46.44$ 2,786.38$ XXX33977 00 32.76$ 1,965.44$ 32.76$ 1,965.44$ XXX33978 00 38.98$ 2,338.51$ 38.98$ 2,338.51$ XXX33979 00 56.74$ 3,404.37$ 56.74$ 3,404.37$ XXX33980 00 51.93$ 3,115.82$ 51.93$ 3,115.82$ XXX33981 00 24.34$ 1,460.14$ 24.34$ 1,460.14$ XXX33982 00 57.20$ 3,431.73$ 57.20$ 3,431.73$ XXX33983 00 67.20$ 4,032.12$ 67.20$ 4,032.12$ XXX33984 00 8.27$ 495.91$ 8.27$ 495.91$ 00033985 00 15.03$ 902.07$ 15.03$ 902.07$ 00033986 00 15.18$ 910.66$ 15.18$ 910.66$ 00033987 00 6.09$ 365.63$ 6.09$ 365.63$ ZZZ33988 00 22.76$ 1,365.55$ 22.76$ 1,365.55$ 00033989 00 14.45$ 867.26$ 14.45$ 867.26$ 00033990 00 12.44$ 746.36$ 12.44$ 746.36$ XXX33991 00 18.25$ 1,094.88$ 18.25$ 1,094.88$ XXX33992 00 5.82$ 349.02$ 5.82$ 349.02$ XXX33993 00 5.11$ 306.68$ 5.11$ 306.68$ XXX33999 00 By Report By Report YYY34001 00 27.95$ 1,677.16$ 27.95$ 1,677.16$ 09034051 00 29.01$ 1,740.50$ 29.01$ 1,740.50$ 09034101 00 17.38$ 1,042.92$ 17.38$ 1,042.92$ 09034111 00 17.46$ 1,047.67$ 17.46$ 1,047.67$ 09034151 00 40.49$ 2,429.39$ 40.49$ 2,429.39$ 09034201 00 29.83$ 1,789.87$ 29.83$ 1,789.87$ 09034203 00 27.59$ 1,655.61$ 27.59$ 1,655.61$ 09034401 00 42.63$ 2,557.69$ 42.63$ 2,557.69$ 09034421 00 21.42$ 1,285.17$ 21.42$ 1,285.17$ 09034451 00 41.41$ 2,484.90$ 41.41$ 2,484.90$ 09034471 00 31.11$ 1,866.42$ 31.11$ 1,866.42$ 09034490 00 18.68$ 1,120.74$ 18.68$ 1,120.74$ 090



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

34501 00 25.76$ 1,545.67$ 25.76$ 1,545.67$ 09034502 00 44.91$ 2,694.53$ 44.91$ 2,694.53$ 0903450F 00 Code Accepted for Tracking Purpose only XXX34510 00 29.45$ 1,767.11$ 29.45$ 1,767.11$ 0903451F 00 Code Accepted for Tracking Purpose only XXX34520 00 28.54$ 1,712.32$ 28.54$ 1,712.32$ 0903452F 00 Code Accepted for Tracking Purpose only XXX34530 00 27.09$ 1,625.37$ 27.09$ 1,625.37$ 0903455F 00 Code Accepted for Tracking Purpose only XXX34701 00 35.92$ 2,155.35$ 35.92$ 2,155.35$ 09034702 00 53.83$ 3,229.82$ 53.83$ 3,229.82$ 09034703 00 40.40$ 2,423.76$ 40.40$ 2,423.76$ 09034704 00 67.30$ 4,037.79$ 67.30$ 4,037.79$ 09034705 00 44.46$ 2,667.48$ 44.46$ 2,667.48$ 09034706 00 66.95$ 4,016.93$ 66.95$ 4,016.93$ 09034707 00 33.51$ 2,010.84$ 33.51$ 2,010.84$ 09034708 00 53.79$ 3,227.13$ 53.79$ 3,227.13$ 09034709 00 9.38$ 562.55$ 9.38$ 562.55$ ZZZ3470F 00 Code Accepted for Tracking Purpose only XXX34710 00 23.32$ 1,399.43$ 23.32$ 1,399.43$ 09034711 00 8.66$ 519.36$ 8.66$ 519.36$ ZZZ34712 00 20.01$ 1,200.37$ 20.01$ 1,200.37$ 09034713 00 3.74$ 224.48$ 3.74$ 224.48$ ZZZ34714 00 7.87$ 472.03$ 7.87$ 472.03$ ZZZ34715 00 8.82$ 529.16$ 8.82$ 529.16$ ZZZ34716 00 11.08$ 664.82$ 11.08$ 664.82$ ZZZ34717 00 12.78$ 766.77$ 12.78$ 766.77$ ZZZ34718 00 35.74$ 2,144.27$ 35.74$ 2,144.27$ 0903471F 00 Code Accepted for Tracking Purpose only XXX3472F 00 Code Accepted for Tracking Purpose only XXX3475F 00 Code Accepted for Tracking Purpose only XXX3476F 00 Code Accepted for Tracking Purpose only XXX34808 00 6.10$ 366.10$ 6.10$ 366.10$ ZZZ34812 00 6.00$ 359.72$ 6.00$ 359.72$ ZZZ34813 00 6.84$ 410.36$ 6.84$ 410.36$ ZZZ34820 00 10.08$ 604.94$ 10.08$ 604.94$ ZZZ34830 00 50.85$ 3,051.03$ 50.85$ 3,051.03$ 09034831 00 56.01$ 3,360.75$ 56.01$ 3,360.75$ 09034832 00 54.68$ 3,280.63$ 54.68$ 3,280.63$ 09034833 00 11.71$ 702.39$ 11.71$ 702.39$ ZZZ34834 00 3.74$ 224.60$ 3.74$ 224.60$ ZZZ34839 00 Bundled Bundled YYY



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

34841 00 1,431.32$ 1,431.32$ YYY34842 00 1,431.32$ 1,431.32$ YYY34843 00 1,545.82$ 1,545.82$ YYY34844 00 1,717.58$ 1,717.58$ YYY34845 00 1,431.32$ 1,431.32$ YYY34846 00 1,488.58$ 1,488.58$ YYY34847 00 1,488.58$ 1,488.58$ YYY34848 00 1,545.82$ 1,545.82$ YYY3490F 00 Code Accepted for Tracking Purpose only XXX3491F 00 Code Accepted for Tracking Purpose only XXX3492F 00 Code Accepted for Tracking Purpose only XXX3493F 00 Code Accepted for Tracking Purpose only XXX3494F 00 Code Accepted for Tracking Purpose only XXX3495F 00 Code Accepted for Tracking Purpose only XXX3496F 00 Code Accepted for Tracking Purpose only XXX3497F 00 Code Accepted for Tracking Purpose only XXX3498F 00 Code Accepted for Tracking Purpose only XXX35001 00 32.29$ 1,937.45$ 32.29$ 1,937.45$ 09035002 00 32.78$ 1,966.58$ 32.78$ 1,966.58$ 09035005 00 28.69$ 1,721.24$ 28.69$ 1,721.24$ 0903500F 00 Code Accepted for Tracking Purpose only XXX35011 00 29.13$ 1,748.00$ 29.13$ 1,748.00$ 09035013 00 36.46$ 2,187.36$ 36.46$ 2,187.36$ 09035021 00 36.82$ 2,209.47$ 36.82$ 2,209.47$ 09035022 00 42.17$ 2,530.05$ 42.17$ 2,530.05$ 0903502F 00 Code Accepted for Tracking Purpose only XXX3503F 00 Code Accepted for Tracking Purpose only XXX35045 00 28.56$ 1,713.74$ 28.56$ 1,713.74$ 09035081 00 50.27$ 3,015.94$ 50.27$ 3,015.94$ 09035082 00 63.44$ 3,806.29$ 63.44$ 3,806.29$ 09035091 00 51.80$ 3,108.02$ 51.80$ 3,108.02$ 09035092 00 75.54$ 4,532.34$ 75.54$ 4,532.34$ 09035102 00 54.54$ 3,272.43$ 54.54$ 3,272.43$ 09035103 00 65.01$ 3,900.89$ 65.01$ 3,900.89$ 0903510F 00 Code Accepted for Tracking Purpose only XXX35111 00 38.33$ 2,300.02$ 38.33$ 2,300.02$ 09035112 00 47.15$ 2,829.07$ 47.15$ 2,829.07$ 0903511F 00 Code Accepted for Tracking Purpose only XXX35121 00 48.40$ 2,904.08$ 48.40$ 2,904.08$ 09035122 00 54.56$ 3,273.46$ 54.56$ 3,273.46$ 0903512F 00 Code Accepted for Tracking Purpose only XXX35131 00 40.29$ 2,417.26$ 40.29$ 2,417.26$ 090



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

35132 00 47.15$ 2,829.07$ 47.15$ 2,829.07$ 0903513F 00 Code Accepted for Tracking Purpose only XXX35141 00 32.03$ 1,921.76$ 32.03$ 1,921.76$ 09035142 00 38.58$ 2,315.06$ 38.58$ 2,315.06$ 0903514F 00 Code Accepted for Tracking Purpose only XXX35151 00 35.93$ 2,155.95$ 35.93$ 2,155.95$ 09035152 00 40.30$ 2,418.17$ 40.30$ 2,418.17$ 0903515F 00 Code Accepted for Tracking Purpose only XXX3517F 00 Code Accepted for Tracking Purpose only XXX35180 00 25.59$ 1,535.22$ 25.59$ 1,535.22$ 09035182 00 52.14$ 3,128.30$ 52.14$ 3,128.30$ 09035184 00 27.83$ 1,669.78$ 27.83$ 1,669.78$ 09035188 00 37.81$ 2,268.89$ 37.81$ 2,268.89$ 09035189 00 43.54$ 2,612.51$ 43.54$ 2,612.51$ 09035190 00 22.14$ 1,328.55$ 22.14$ 1,328.55$ 09035201 00 27.41$ 1,644.85$ 27.41$ 1,644.85$ 09035206 00 22.80$ 1,368.08$ 22.80$ 1,368.08$ 09035207 00 22.13$ 1,327.83$ 22.13$ 1,327.83$ 0903520F 00 Code Accepted for Tracking Purpose only XXX35211 00 40.24$ 2,414.63$ 40.24$ 2,414.63$ 09035216 00 60.03$ 3,601.73$ 60.03$ 3,601.73$ 09035221 00 42.64$ 2,558.28$ 42.64$ 2,558.28$ 09035226 00 24.23$ 1,454.03$ 24.23$ 1,454.03$ 09035231 00 36.13$ 2,167.50$ 36.13$ 2,167.50$ 09035236 00 29.17$ 1,749.99$ 29.17$ 1,749.99$ 09035241 00 41.99$ 2,519.26$ 41.99$ 2,519.26$ 09035246 00 45.80$ 2,748.02$ 45.80$ 2,748.02$ 09035251 00 50.58$ 3,034.58$ 50.58$ 3,034.58$ 09035256 00 29.78$ 1,786.62$ 29.78$ 1,786.62$ 09035261 00 28.29$ 1,697.54$ 28.29$ 1,697.54$ 09035266 00 25.23$ 1,514.00$ 25.23$ 1,514.00$ 09035271 00 40.23$ 2,413.54$ 40.23$ 2,413.54$ 09035276 00 42.63$ 2,557.84$ 42.63$ 2,557.84$ 09035281 00 46.96$ 2,817.33$ 46.96$ 2,817.33$ 09035286 00 27.06$ 1,623.83$ 27.06$ 1,623.83$ 09035301 00 32.86$ 1,971.82$ 32.86$ 1,971.82$ 09035302 00 32.55$ 1,953.21$ 32.55$ 1,953.21$ 09035303 00 36.01$ 2,160.68$ 36.01$ 2,160.68$ 09035304 00 37.06$ 2,223.89$ 37.06$ 2,223.89$ 09035305 00 35.67$ 2,139.91$ 35.67$ 2,139.91$ 09035306 00 12.86$ 771.63$ 12.86$ 771.63$ ZZZ35311 00 45.60$ 2,736.22$ 45.60$ 2,736.22$ 090



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

35321 00 25.93$ 1,556.01$ 25.93$ 1,556.01$ 09035331 00 42.42$ 2,545.23$ 42.42$ 2,545.23$ 09035341 00 40.00$ 2,400.09$ 40.00$ 2,400.09$ 09035351 00 37.14$ 2,228.11$ 37.14$ 2,228.11$ 09035355 00 29.91$ 1,794.77$ 29.91$ 1,794.77$ 09035361 00 43.91$ 2,634.67$ 43.91$ 2,634.67$ 09035363 00 46.84$ 2,810.59$ 46.84$ 2,810.59$ 09035371 00 23.76$ 1,425.45$ 23.76$ 1,425.45$ 09035372 00 28.42$ 1,705.46$ 28.42$ 1,705.46$ 09035390 00 4.61$ 276.43$ 4.61$ 276.43$ ZZZ35400 00 4.31$ 258.88$ 4.31$ 258.88$ ZZZ35500 00 9.28$ 556.78$ 9.28$ 556.78$ ZZZ35501 00 43.38$ 2,603.03$ 43.38$ 2,603.03$ 09035506 00 36.76$ 2,205.57$ 36.76$ 2,205.57$ 09035508 00 38.33$ 2,299.76$ 38.33$ 2,299.76$ 09035509 00 40.80$ 2,447.75$ 40.80$ 2,447.75$ 0903550F 00 Code Accepted for Tracking Purpose only XXX35510 00 35.49$ 2,129.59$ 35.49$ 2,129.59$ 09035511 00 32.33$ 1,939.62$ 32.33$ 1,939.62$ 09035512 00 34.80$ 2,087.75$ 34.80$ 2,087.75$ 09035515 00 38.33$ 2,299.76$ 38.33$ 2,299.76$ 09035516 00 35.20$ 2,112.19$ 35.20$ 2,112.19$ 09035518 00 32.95$ 1,976.72$ 32.95$ 1,976.72$ 0903551F 00 Code Accepted for Tracking Purpose only XXX35521 00 35.40$ 2,123.91$ 35.40$ 2,123.91$ 09035522 00 35.02$ 2,101.30$ 35.02$ 2,101.30$ 09035523 00 37.21$ 2,232.84$ 37.21$ 2,232.84$ 09035525 00 33.14$ 1,988.65$ 33.14$ 1,988.65$ 09035526 00 50.68$ 3,040.72$ 50.68$ 3,040.72$ 0903552F 00 Code Accepted for Tracking Purpose only XXX35531 00 56.26$ 3,375.71$ 56.26$ 3,375.71$ 09035533 00 43.45$ 2,607.16$ 43.45$ 2,607.16$ 09035535 00 54.92$ 3,295.12$ 54.92$ 3,295.12$ 09035536 00 48.78$ 2,926.51$ 48.78$ 2,926.51$ 09035537 00 60.16$ 3,609.83$ 60.16$ 3,609.83$ 09035538 00 67.40$ 4,044.12$ 67.40$ 4,044.12$ 09035539 00 63.29$ 3,797.55$ 63.29$ 3,797.55$ 09035540 00 70.56$ 4,233.55$ 70.56$ 4,233.55$ 09035556 00 40.58$ 2,434.85$ 40.58$ 2,434.85$ 09035558 00 35.71$ 2,142.63$ 35.71$ 2,142.63$ 0903555F 00 Code Accepted for Tracking Purpose only XXX35560 00 49.19$ 2,951.63$ 49.19$ 2,951.63$ 090



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

35563 00 38.18$ 2,290.77$ 38.18$ 2,290.77$ 09035565 00 38.16$ 2,289.75$ 38.16$ 2,289.75$ 09035566 00 48.40$ 2,903.87$ 48.40$ 2,903.87$ 09035570 00 43.78$ 2,626.55$ 43.78$ 2,626.55$ 09035571 00 38.39$ 2,303.45$ 38.39$ 2,303.45$ 09035572 00 10.05$ 603.08$ 10.05$ 603.08$ ZZZ35583 00 41.89$ 2,513.58$ 41.89$ 2,513.58$ 09035585 00 48.51$ 2,910.90$ 48.51$ 2,910.90$ 09035587 00 39.56$ 2,373.90$ 39.56$ 2,373.90$ 09035600 00 7.44$ 446.38$ 7.44$ 446.38$ ZZZ35601 00 40.52$ 2,431.03$ 40.52$ 2,431.03$ 09035606 00 34.06$ 2,043.55$ 34.06$ 2,043.55$ 09035612 00 30.12$ 1,807.47$ 30.12$ 1,807.47$ 09035616 00 31.81$ 1,908.48$ 31.81$ 1,908.48$ 09035621 00 31.79$ 1,907.49$ 31.79$ 1,907.49$ 09035623 00 37.90$ 2,274.05$ 37.90$ 2,274.05$ 09035626 00 46.16$ 2,769.34$ 46.16$ 2,769.34$ 09035631 00 53.74$ 3,224.65$ 53.74$ 3,224.65$ 09035632 00 52.15$ 3,128.76$ 52.15$ 3,128.76$ 09035633 00 57.81$ 3,468.49$ 57.81$ 3,468.49$ 09035634 00 51.03$ 3,061.87$ 51.03$ 3,061.87$ 09035636 00 46.01$ 2,760.34$ 46.01$ 2,760.34$ 09035637 00 47.88$ 2,872.94$ 47.88$ 2,872.94$ 09035638 00 50.99$ 3,059.23$ 50.99$ 3,059.23$ 09035642 00 28.48$ 1,708.95$ 28.48$ 1,708.95$ 09035645 00 27.31$ 1,638.84$ 27.31$ 1,638.84$ 09035646 00 49.80$ 2,987.93$ 49.80$ 2,987.93$ 09035647 00 45.09$ 2,705.35$ 45.09$ 2,705.35$ 09035650 00 31.47$ 1,888.17$ 31.47$ 1,888.17$ 09035654 00 39.72$ 2,383.22$ 39.72$ 2,383.22$ 09035656 00 31.40$ 1,884.18$ 31.40$ 1,884.18$ 09035661 00 31.51$ 1,890.50$ 31.51$ 1,890.50$ 09035663 00 35.13$ 2,107.74$ 35.13$ 2,107.74$ 09035665 00 34.06$ 2,043.79$ 34.06$ 2,043.79$ 09035666 00 36.73$ 2,204.03$ 36.73$ 2,204.03$ 09035671 00 32.38$ 1,942.89$ 32.38$ 1,942.89$ 09035681 00 2.34$ 140.41$ 2.34$ 140.41$ ZZZ35682 00 10.21$ 612.32$ 10.21$ 612.32$ ZZZ35683 00 11.80$ 707.72$ 11.80$ 707.72$ ZZZ35685 00 5.75$ 344.99$ 5.75$ 344.99$ ZZZ35686 00 4.65$ 278.77$ 4.65$ 278.77$ ZZZ35691 00 27.27$ 1,636.45$ 27.27$ 1,636.45$ 090



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

35693 00 24.09$ 1,445.43$ 24.09$ 1,445.43$ 09035694 00 28.50$ 1,710.00$ 28.50$ 1,710.00$ 09035695 00 29.57$ 1,774.04$ 29.57$ 1,774.04$ 09035697 00 4.29$ 257.62$ 4.29$ 257.62$ ZZZ35700 00 4.41$ 264.90$ 4.41$ 264.90$ ZZZ35701 00 16.62$ 997.03$ 16.62$ 997.03$ 09035702 00 11.89$ 713.46$ 11.89$ 713.46$ 09035703 00 12.03$ 721.74$ 12.03$ 721.74$ 0903570F 00 Code Accepted for Tracking Purpose only XXX3572F 00 Code Accepted for Tracking Purpose only XXX3573F 00 Code Accepted for Tracking Purpose only XXX35800 00 21.05$ 1,262.97$ 21.05$ 1,262.97$ 09035820 00 58.53$ 3,511.92$ 58.53$ 3,511.92$ 09035840 00 34.86$ 2,091.38$ 34.86$ 2,091.38$ 09035860 00 24.34$ 1,460.46$ 24.34$ 1,460.46$ 09035870 00 35.94$ 2,156.25$ 35.94$ 2,156.25$ 09035875 00 17.32$ 1,039.21$ 17.32$ 1,039.21$ 09035876 00 27.49$ 1,649.19$ 27.49$ 1,649.19$ 09035879 00 26.89$ 1,613.55$ 26.89$ 1,613.55$ 09035881 00 29.54$ 1,772.13$ 29.54$ 1,772.13$ 09035883 00 34.85$ 2,091.04$ 34.85$ 2,091.04$ 09035884 00 35.79$ 2,147.33$ 35.79$ 2,147.33$ 09035901 00 13.63$ 817.98$ 13.63$ 817.98$ 09035903 00 16.45$ 986.70$ 16.45$ 986.70$ 09035905 00 48.48$ 2,908.64$ 48.48$ 2,908.64$ 09035907 00 55.26$ 3,315.75$ 55.26$ 3,315.75$ 09036000 00 0.80$ 47.92$ 0.27$ 16.39$ XXX36002 00 4.60$ 275.73$ 3.07$ 184.29$ 00036005 00 9.14$ 548.69$ 1.41$ 84.57$ 00036010 00 14.86$ 891.76$ 3.21$ 192.43$ XXX36011 00 25.05$ 1,502.74$ 4.57$ 274.33$ XXX36012 00 25.52$ 1,531.46$ 5.06$ 303.68$ XXX36013 00 22.80$ 1,368.21$ 3.55$ 212.95$ XXX36014 00 24.05$ 1,442.84$ 4.41$ 264.88$ XXX36015 00 26.05$ 1,562.82$ 5.03$ 301.62$ XXX36100 00 15.34$ 920.25$ 4.54$ 272.62$ XXX36140 00 13.25$ 795.19$ 2.63$ 157.65$ XXX36160 00 15.20$ 912.20$ 3.62$ 217.28$ XXX36200 00 16.86$ 1,011.36$ 4.05$ 243.29$ 00036215 00 30.64$ 1,838.25$ 6.21$ 372.74$ 00036216 00 32.93$ 1,975.91$ 7.97$ 478.24$ 00036217 00 55.39$ 3,323.36$ 9.56$ 573.31$ 000



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

36218 00 7.17$ 430.37$ 1.52$ 91.10$ ZZZ36221 00 30.52$ 1,831.46$ 5.82$ 348.91$ 00036222 00 36.11$ 2,166.37$ 8.24$ 494.65$ 00036223 00 45.76$ 2,745.40$ 9.21$ 552.80$ 00036224 00 59.27$ 3,556.07$ 10.51$ 630.72$ 00036225 00 44.06$ 2,643.62$ 9.19$ 551.29$ 00036226 00 56.03$ 3,361.80$ 10.36$ 621.84$ 00036227 00 7.43$ 446.08$ 3.42$ 205.19$ ZZZ36228 00 39.22$ 2,353.04$ 7.05$ 422.77$ ZZZ36245 00 39.03$ 2,341.87$ 6.93$ 416.02$ XXX36246 00 24.66$ 1,479.73$ 7.42$ 444.91$ 00036247 00 44.37$ 2,662.12$ 8.82$ 529.43$ 00036248 00 4.26$ 255.65$ 1.43$ 86.02$ ZZZ36251 00 40.88$ 2,452.58$ 7.59$ 455.47$ 00036252 00 44.10$ 2,645.90$ 10.53$ 631.76$ 00036253 00 65.37$ 3,922.09$ 10.47$ 628.46$ 00036254 00 63.35$ 3,800.90$ 12.18$ 730.51$ 00036260 00 19.00$ 1,139.80$ 19.00$ 1,139.80$ 09036261 00 11.80$ 708.15$ 11.80$ 708.15$ 09036262 00 9.04$ 542.23$ 9.04$ 542.23$ 09036299 00 By Report By Report YYY36400 00 0.77$ 46.15$ 0.54$ 32.27$ XXX36405 00 0.68$ 40.65$ 0.45$ 26.78$ XXX36406 00 0.48$ 29.09$ 0.25$ 15.22$ XXX36410 00 0.50$ 30.27$ 0.27$ 16.39$ XXX36415 00 3.00$ 3.00$ XXX36416 00 Bundled Bundled XXX36420 00 1.35$ 81.18$ 1.35$ 81.18$ XXX36425 00 1.17$ 70.35$ 1.17$ 70.35$ XXX36430 00 1.04$ 62.26$ 1.04$ 62.26$ XXX36440 00 1.48$ 88.82$ 1.48$ 88.82$ XXX36450 00 5.01$ 300.55$ 5.01$ 300.55$ XXX36455 00 3.68$ 221.00$ 3.68$ 221.00$ XXX36456 00 3.06$ 183.64$ 3.06$ 183.64$ XXX36460 00 9.95$ 597.15$ 9.95$ 597.15$ XXX36465 00 45.70$ 2,741.93$ 3.46$ 207.55$ 00036466 00 48.00$ 2,879.78$ 4.40$ 264.05$ 00036468 00 Not Covered Not Covered 00036470 00 3.12$ 187.33$ 1.11$ 66.89$ 00036471 00 5.65$ 338.88$ 2.22$ 133.31$ 00036473 00 43.26$ 2,595.86$ 5.17$ 309.93$ 00036474 00 8.15$ 488.74$ 2.58$ 154.53$ ZZZ



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

36475 00 42.29$ 2,537.49$ 8.14$ 488.67$ 00036476 00 8.80$ 527.71$ 3.94$ 236.37$ ZZZ36478 00 33.37$ 2,002.15$ 8.10$ 486.19$ 00036479 00 9.31$ 558.31$ 3.97$ 237.97$ ZZZ36481 00 57.88$ 3,473.06$ 9.78$ 586.80$ 00036482 00 60.70$ 3,641.94$ 5.13$ 307.96$ 00036483 00 4.35$ 261.18$ 2.58$ 154.61$ ZZZ36500 00 5.34$ 320.12$ 5.34$ 320.12$ 0003650F 00 Code Accepted for Tracking Purpose only XXX36510 00 2.40$ 144.16$ 1.56$ 93.71$ 00036511 00 3.15$ 189.15$ 3.15$ 189.15$ 00036512 00 3.16$ 189.78$ 3.16$ 189.78$ 00036513 00 3.20$ 192.01$ 3.20$ 192.01$ 00036514 00 21.44$ 1,286.63$ 2.80$ 167.95$ 00036516 00 59.03$ 3,542.09$ 2.48$ 148.83$ 00036522 00 64.25$ 3,855.01$ 2.84$ 170.41$ 00036555 00 5.50$ 329.87$ 2.48$ 148.89$ 00036556 00 6.19$ 371.53$ 2.47$ 148.30$ 00036557 00 30.20$ 1,811.80$ 9.30$ 558.17$ 01036558 00 22.53$ 1,351.60$ 7.64$ 458.67$ 01036560 00 38.58$ 2,314.83$ 11.14$ 668.34$ 01036561 00 31.79$ 1,907.43$ 9.86$ 591.37$ 01036563 00 35.78$ 2,147.05$ 10.70$ 641.81$ 01036565 00 25.69$ 1,541.69$ 9.70$ 581.91$ 01036566 00 142.25$ 8,535.10$ 10.55$ 633.05$ 01036568 00 2.67$ 160.15$ 2.67$ 160.15$ 00036569 00 2.75$ 165.19$ 2.75$ 165.19$ 00036570 00 42.57$ 2,554.29$ 9.65$ 579.25$ 01036571 00 37.36$ 2,241.40$ 9.11$ 546.34$ 01036572 00 12.41$ 744.37$ 2.68$ 161.07$ 00036573 00 11.67$ 700.37$ 2.48$ 148.60$ 00036575 00 4.78$ 286.96$ 1.02$ 61.21$ 00036576 00 9.58$ 574.75$ 5.40$ 323.78$ 01036578 00 13.51$ 810.54$ 5.94$ 356.51$ 01036580 00 6.37$ 381.92$ 1.94$ 116.44$ 00036581 00 22.38$ 1,342.84$ 5.39$ 323.16$ 01036582 00 29.47$ 1,768.07$ 8.48$ 508.76$ 01036583 00 37.35$ 2,241.23$ 9.54$ 572.67$ 01036584 00 10.21$ 612.71$ 1.75$ 105.07$ 00036585 00 31.76$ 1,905.40$ 7.89$ 473.31$ 01036589 00 4.81$ 288.44$ 4.02$ 241.15$ 01036590 00 6.46$ 387.35$ 5.56$ 333.75$ 010



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

36591 00 0.72$ 43.43$ 0.72$ 43.43$ XXX36592 00 0.81$ 48.47$ 0.81$ 48.47$ XXX36593 00 0.93$ 55.96$ 0.93$ 55.96$ XXX36595 00 17.97$ 1,078.40$ 5.36$ 321.68$ 00036596 00 3.71$ 222.35$ 1.30$ 77.94$ 00036597 00 3.81$ 228.48$ 1.79$ 107.40$ 00036598 00 3.43$ 205.60$ 1.07$ 64.35$ 00036600 00 0.90$ 53.78$ 0.45$ 27.30$ XXX36620 00 1.29$ 77.46$ 1.29$ 77.46$ 00036625 00 3.07$ 184.12$ 3.07$ 184.12$ 00036640 00 3.36$ 201.42$ 3.36$ 201.42$ 00036660 00 2.01$ 120.49$ 2.01$ 120.49$ 00036680 00 1.70$ 101.96$ 1.70$ 101.96$ 00036800 00 3.56$ 213.64$ 3.56$ 213.64$ 00036810 00 6.11$ 366.68$ 6.11$ 366.68$ 00036815 00 3.91$ 234.77$ 3.91$ 234.77$ 00036818 00 20.20$ 1,211.98$ 20.20$ 1,211.98$ 09036819 00 21.27$ 1,276.17$ 21.27$ 1,276.17$ 09036820 00 21.35$ 1,281.02$ 21.35$ 1,281.02$ 09036821 00 19.33$ 1,160.02$ 19.33$ 1,160.02$ 09036823 00 40.80$ 2,447.85$ 40.80$ 2,447.85$ 09036825 00 23.15$ 1,389.25$ 23.15$ 1,389.25$ 09036830 00 19.42$ 1,165.11$ 19.42$ 1,165.11$ 09036831 00 17.93$ 1,075.82$ 17.93$ 1,075.82$ 09036832 00 22.00$ 1,320.14$ 22.00$ 1,320.14$ 09036833 00 23.65$ 1,418.71$ 23.65$ 1,418.71$ 09036835 00 13.98$ 839.05$ 13.98$ 839.05$ 09036838 00 33.21$ 1,992.56$ 33.21$ 1,992.56$ 09036860 00 7.38$ 442.92$ 3.21$ 192.57$ 00036861 00 4.03$ 241.88$ 4.03$ 241.88$ 00036901 00 19.05$ 1,143.27$ 4.92$ 295.12$ 00036902 00 37.63$ 2,257.75$ 7.03$ 422.07$ 00036903 00 159.56$ 9,573.90$ 9.29$ 557.58$ 00036904 00 55.35$ 3,321.03$ 10.85$ 651.07$ 00036905 00 69.65$ 4,178.94$ 13.01$ 780.64$ 00036906 00 195.43$ 11,725.66$ 15.01$ 900.78$ 00036907 00 21.28$ 1,277.05$ 4.29$ 257.37$ ZZZ36908 00 71.22$ 4,273.08$ 6.07$ 363.99$ ZZZ36909 00 57.52$ 3,451.29$ 5.88$ 352.52$ ZZZ3700F 00 Code Accepted for Tracking Purpose only XXX37140 00 67.76$ 4,065.31$ 67.76$ 4,065.31$ 09037145 00 62.84$ 3,770.27$ 62.84$ 3,770.27$ 090



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

37160 00 64.57$ 3,873.97$ 64.57$ 3,873.97$ 09037180 00 62.07$ 3,724.02$ 62.07$ 3,724.02$ 09037181 00 67.76$ 4,065.31$ 67.76$ 4,065.31$ 09037182 00 24.07$ 1,444.15$ 24.07$ 1,444.15$ 00037183 00 178.62$ 10,717.30$ 11.01$ 660.50$ 00037184 00 62.71$ 3,762.50$ 13.03$ 781.66$ 00037185 00 19.27$ 1,156.39$ 4.86$ 291.83$ ZZZ37186 00 39.03$ 2,341.55$ 7.12$ 427.05$ ZZZ37187 00 57.90$ 3,473.88$ 11.49$ 689.15$ 00037188 00 48.77$ 2,925.99$ 8.09$ 485.57$ 00037191 00 73.24$ 4,394.50$ 6.55$ 392.71$ 00037192 00 38.87$ 2,332.03$ 9.95$ 597.24$ 00037193 00 45.87$ 2,752.04$ 10.23$ 613.68$ 00037195 00 By Report By Report XXX37197 00 45.22$ 2,713.41$ 8.84$ 530.27$ 00037200 00 6.37$ 382.18$ 6.37$ 382.18$ 0003720F 00 Code Accepted for Tracking Purpose only XXX37211 00 11.26$ 675.74$ 11.26$ 675.74$ 00037212 00 9.87$ 592.06$ 9.87$ 592.06$ 00037213 00 6.80$ 408.23$ 6.80$ 408.23$ 00037214 00 3.59$ 215.42$ 3.59$ 215.42$ 00037215 00 29.34$ 1,760.40$ 29.34$ 1,760.40$ 09037216 00 29.67$ 1,780.14$ 29.67$ 1,780.14$ 09037217 00 31.47$ 1,888.23$ 31.47$ 1,888.23$ 09037218 00 23.86$ 1,431.77$ 23.86$ 1,431.77$ 09037220 00 87.45$ 5,247.24$ 11.70$ 701.88$ 00037221 00 124.22$ 7,453.23$ 14.45$ 867.24$ 00037222 00 23.52$ 1,411.34$ 5.42$ 325.44$ ZZZ37223 00 65.49$ 3,929.58$ 6.21$ 372.36$ ZZZ37224 00 105.18$ 6,310.93$ 12.97$ 778.05$ 00037225 00 362.04$ 21,722.42$ 17.65$ 1,058.92$ 00037226 00 314.02$ 18,840.94$ 15.21$ 912.35$ 00037227 00 466.55$ 27,993.09$ 21.21$ 1,272.68$ 00037228 00 152.60$ 9,156.26$ 15.84$ 950.26$ 00037229 00 362.10$ 21,726.00$ 20.61$ 1,236.55$ 00037230 00 308.14$ 18,488.27$ 20.44$ 1,226.22$ 00037231 00 443.08$ 26,585.06$ 22.22$ 1,333.31$ 00037232 00 32.43$ 1,946.02$ 5.86$ 351.86$ ZZZ37233 00 39.40$ 2,363.92$ 9.55$ 573.02$ ZZZ37234 00 114.94$ 6,896.65$ 8.34$ 500.47$ ZZZ37235 00 124.58$ 7,474.74$ 11.71$ 702.72$ ZZZ37236 00 106.18$ 6,370.71$ 12.98$ 778.55$ 000



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

37237 00 63.11$ 3,786.60$ 6.20$ 371.90$ ZZZ37238 00 107.47$ 6,448.50$ 8.87$ 532.21$ 00037239 00 51.26$ 3,075.35$ 4.43$ 266.02$ ZZZ37241 00 143.76$ 8,625.74$ 12.93$ 776.03$ 00037242 00 221.68$ 13,300.65$ 13.96$ 837.47$ 00037243 00 286.93$ 17,215.62$ 16.52$ 990.91$ 00037244 00 204.88$ 12,292.89$ 19.53$ 1,171.63$ 00037246 00 61.85$ 3,710.81$ 10.18$ 610.78$ 00037247 00 23.52$ 1,411.13$ 5.00$ 300.01$ ZZZ37248 00 44.17$ 2,649.95$ 8.73$ 523.56$ 00037249 00 17.44$ 1,046.33$ 4.25$ 254.92$ ZZZ37252 00 37.47$ 2,248.45$ 2.65$ 159.27$ ZZZ37253 00 5.78$ 346.82$ 2.13$ 128.00$ ZZZ3725F 00 Code Accepted for Tracking Purpose only XXX37500 00 18.35$ 1,101.13$ 18.35$ 1,101.13$ 09037501 00 By Report By Report YYY3750F 00 Code Accepted for Tracking Purpose only XXX3751F 00 Code Accepted for Tracking Purpose only XXX3752F 00 Code Accepted for Tracking Purpose only XXX3753F 00 Code Accepted for Tracking Purpose only XXX3754F 00 Code Accepted for Tracking Purpose only XXX3755F 00 Code Accepted for Tracking Purpose only XXX37565 00 20.99$ 1,259.39$ 20.99$ 1,259.39$ 0903756F 00 Code Accepted for Tracking Purpose only XXX3757F 00 Code Accepted for Tracking Purpose only XXX3758F 00 Code Accepted for Tracking Purpose only XXX3759F 00 Code Accepted for Tracking Purpose only XXX37600 00 21.31$ 1,278.49$ 21.31$ 1,278.49$ 09037605 00 21.32$ 1,279.16$ 21.32$ 1,279.16$ 09037606 00 21.14$ 1,268.35$ 21.14$ 1,268.35$ 09037607 00 10.91$ 654.89$ 10.91$ 654.89$ 09037609 00 9.11$ 546.35$ 6.03$ 361.58$ 0103760F 00 Code Accepted for Tracking Purpose only XXX37615 00 15.39$ 923.14$ 15.39$ 923.14$ 09037616 00 32.26$ 1,935.59$ 32.26$ 1,935.59$ 09037617 00 39.06$ 2,343.69$ 39.06$ 2,343.69$ 09037618 00 11.23$ 673.95$ 11.23$ 673.95$ 09037619 00 50.40$ 3,023.82$ 50.40$ 3,023.82$ 0903761F 00 Code Accepted for Tracking Purpose only XXX3762F 00 Code Accepted for Tracking Purpose only XXX3763F 00 Code Accepted for Tracking Purpose only XXX37650 00 13.26$ 795.37$ 13.26$ 795.37$ 090



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

37660 00 38.41$ 2,304.79$ 38.41$ 2,304.79$ 09037700 00 7.14$ 428.67$ 7.14$ 428.67$ 09037718 00 12.55$ 752.93$ 12.55$ 752.93$ 09037722 00 13.80$ 828.17$ 13.80$ 828.17$ 09037735 00 16.78$ 1,006.97$ 16.78$ 1,006.97$ 0903775F 00 Code Accepted for Tracking Purpose only XXX37760 00 18.19$ 1,091.65$ 18.19$ 1,091.65$ 09037761 00 15.77$ 946.28$ 15.77$ 946.28$ 09037765 00 18.91$ 1,134.79$ 13.07$ 784.18$ 01037766 00 22.44$ 1,346.65$ 15.94$ 956.31$ 0103776F 00 Code Accepted for Tracking Purpose only XXX37780 00 6.80$ 407.87$ 6.80$ 407.87$ 09037785 00 10.29$ 617.40$ 7.54$ 452.18$ 09037788 00 37.08$ 2,224.79$ 37.08$ 2,224.79$ 09037790 00 14.32$ 858.95$ 14.32$ 858.95$ 09037799 00 By Report By Report YYY38100 00 33.68$ 2,020.78$ 33.68$ 2,020.78$ 09038101 00 34.03$ 2,041.89$ 34.03$ 2,041.89$ 09038102 00 7.68$ 460.89$ 7.68$ 460.89$ ZZZ38115 00 37.31$ 2,238.47$ 37.31$ 2,238.47$ 09038120 00 30.78$ 1,846.87$ 30.78$ 1,846.87$ 09038129 00 By Report By Report YYY38200 00 3.89$ 233.41$ 3.89$ 233.41$ 00038204 00 Bundled Bundled XXX38205 00 2.42$ 145.46$ 2.42$ 145.46$ 00038206 00 2.43$ 146.00$ 2.43$ 146.00$ 00038207 00 1.36$ 81.83$ 1.36$ 81.83$ XXX38208 00 0.87$ 52.11$ 0.87$ 52.11$ XXX38209 00 0.36$ 21.83$ 0.36$ 21.83$ XXX38210 00 2.42$ 145.45$ 2.42$ 145.45$ XXX38211 00 2.18$ 130.95$ 2.18$ 130.95$ XXX38212 00 1.44$ 86.66$ 1.44$ 86.66$ XXX38213 00 0.36$ 21.83$ 0.36$ 21.83$ XXX38214 00 1.24$ 74.55$ 1.24$ 74.55$ XXX38215 00 1.44$ 86.66$ 1.44$ 86.66$ XXX38220 00 4.88$ 292.57$ 2.02$ 121.05$ XXX38221 00 4.55$ 272.78$ 2.03$ 122.06$ XXX38222 00 5.04$ 302.55$ 2.28$ 136.70$ XXX38230 00 6.02$ 361.47$ 6.02$ 361.47$ 00038232 00 5.82$ 348.95$ 5.82$ 348.95$ 00038240 00 6.65$ 399.28$ 6.65$ 399.28$ XXX38241 00 4.97$ 298.40$ 4.97$ 298.40$ XXX



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

38242 00 3.52$ 211.02$ 3.52$ 211.02$ 00038243 00 3.54$ 212.23$ 3.54$ 212.23$ 00038300 00 9.49$ 569.28$ 5.98$ 358.65$ 01038305 00 14.20$ 852.08$ 14.20$ 852.08$ 09038308 00 13.16$ 789.61$ 13.16$ 789.61$ 09038380 00 16.62$ 997.06$ 16.62$ 997.06$ 09038381 00 23.38$ 1,402.89$ 23.38$ 1,402.89$ 09038382 00 19.73$ 1,184.09$ 19.73$ 1,184.09$ 09038500 00 9.78$ 587.03$ 7.45$ 447.04$ 01038505 00 3.68$ 220.63$ 2.06$ 123.52$ 00038510 00 15.24$ 914.61$ 12.23$ 733.62$ 01038520 00 13.58$ 814.52$ 13.58$ 814.52$ 09038525 00 12.79$ 767.64$ 12.79$ 767.64$ 09038530 00 16.36$ 981.36$ 16.36$ 981.36$ 09038531 00 12.78$ 766.58$ 12.78$ 766.58$ 09038542 00 15.12$ 907.36$ 15.12$ 907.36$ 09038550 00 14.99$ 899.24$ 14.99$ 899.24$ 09038555 00 29.57$ 1,774.42$ 29.57$ 1,774.42$ 09038562 00 20.75$ 1,245.00$ 20.75$ 1,245.00$ 09038564 00 20.64$ 1,238.38$ 20.64$ 1,238.38$ 09038570 00 14.91$ 894.79$ 14.91$ 894.79$ 01038571 00 19.43$ 1,165.59$ 19.43$ 1,165.59$ 01038572 00 27.00$ 1,620.02$ 27.00$ 1,620.02$ 01038573 00 34.14$ 2,048.45$ 34.14$ 2,048.45$ 01038589 00 By Report By Report YYY38700 00 23.46$ 1,407.89$ 23.46$ 1,407.89$ 09038720 00 39.12$ 2,346.91$ 39.12$ 2,346.91$ 09038724 00 42.26$ 2,535.34$ 42.26$ 2,535.34$ 09038740 00 20.37$ 1,222.26$ 20.37$ 1,222.26$ 09038745 00 25.68$ 1,540.83$ 25.68$ 1,540.83$ 09038746 00 6.24$ 374.25$ 6.24$ 374.25$ ZZZ38747 00 7.80$ 467.89$ 7.80$ 467.89$ ZZZ38760 00 24.61$ 1,476.77$ 24.61$ 1,476.77$ 09038765 00 37.96$ 2,277.44$ 37.96$ 2,277.44$ 09038770 00 23.70$ 1,422.24$ 23.70$ 1,422.24$ 09038780 00 30.14$ 1,808.24$ 30.14$ 1,808.24$ 09038790 00 2.43$ 145.62$ 2.43$ 145.62$ 00038792 00 2.42$ 145.21$ 0.97$ 58.19$ 00038794 00 8.75$ 525.14$ 8.75$ 525.14$ 09038900 00 4.01$ 240.83$ 4.01$ 240.83$ ZZZ38999 00 By Report By Report YYY39000 00 14.54$ 872.15$ 14.54$ 872.15$ 090



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

39010 00 22.90$ 1,374.21$ 22.90$ 1,374.21$ 09039200 00 25.43$ 1,525.78$ 25.43$ 1,525.78$ 09039220 00 33.00$ 1,980.13$ 33.00$ 1,980.13$ 09039401 00 9.00$ 540.23$ 9.00$ 540.23$ 00039402 00 11.78$ 706.62$ 11.78$ 706.62$ 00039499 00 By Report By Report YYY39501 00 24.87$ 1,491.90$ 24.87$ 1,491.90$ 09039503 00 173.72$ 10,423.44$ 173.72$ 10,423.44$ 09039540 00 25.39$ 1,523.38$ 25.39$ 1,523.38$ 09039541 00 27.45$ 1,647.09$ 27.45$ 1,647.09$ 09039545 00 25.92$ 1,555.20$ 25.92$ 1,555.20$ 09039560 00 23.38$ 1,402.92$ 23.38$ 1,402.92$ 09039561 00 36.25$ 2,174.86$ 36.25$ 2,174.86$ 09039599 00 By Report By Report YYY4000F 00 Code Accepted for Tracking Purpose only XXX4001F 00 Code Accepted for Tracking Purpose only XXX4003F 00 Code Accepted for Tracking Purpose only XXX4004F 00 Code Accepted for Tracking Purpose only XXX4005F 00 Code Accepted for Tracking Purpose only XXX4008F 00 Code Accepted for Tracking Purpose only XXX4010F 00 Code Accepted for Tracking Purpose only XXX4011F 00 Code Accepted for Tracking Purpose only XXX4012F 00 Code Accepted for Tracking Purpose only XXX4013F 00 Code Accepted for Tracking Purpose only XXX4014F 00 Code Accepted for Tracking Purpose only XXX4015F 00 Code Accepted for Tracking Purpose only XXX4016F 00 Code Accepted for Tracking Purpose only XXX4017F 00 Code Accepted for Tracking Purpose only XXX4018F 00 Code Accepted for Tracking Purpose only XXX4019F 00 Code Accepted for Tracking Purpose only XXX4025F 00 Code Accepted for Tracking Purpose only XXX4030F 00 Code Accepted for Tracking Purpose only XXX4033F 00 Code Accepted for Tracking Purpose only XXX4035F 00 Code Accepted for Tracking Purpose only XXX4037F 00 Code Accepted for Tracking Purpose only XXX4040F 00 Code Accepted for Tracking Purpose only XXX4041F 00 Code Accepted for Tracking Purpose only XXX4042F 00 Code Accepted for Tracking Purpose only XXX4043F 00 Code Accepted for Tracking Purpose only XXX4044F 00 Code Accepted for Tracking Purpose only XXX4045F 00 Code Accepted for Tracking Purpose only XXX4046F 00 Code Accepted for Tracking Purpose only XXX



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

4047F 00 Code Accepted for Tracking Purpose only XXX4048F 00 Code Accepted for Tracking Purpose only XXX40490 00 3.70$ 221.81$ 2.12$ 127.22$ 0004049F 00 Code Accepted for Tracking Purpose only XXX40500 00 15.11$ 906.50$ 10.72$ 642.91$ 0904050F 00 Code Accepted for Tracking Purpose only XXX40510 00 14.36$ 861.50$ 10.40$ 623.76$ 0904051F 00 Code Accepted for Tracking Purpose only XXX40520 00 14.57$ 874.19$ 10.50$ 630.15$ 09040525 00 16.18$ 970.51$ 16.18$ 970.51$ 09040527 00 18.04$ 1,082.21$ 18.04$ 1,082.21$ 0904052F 00 Code Accepted for Tracking Purpose only XXX40530 00 15.98$ 958.90$ 11.80$ 707.92$ 0904053F 00 Code Accepted for Tracking Purpose only XXX4054F 00 Code Accepted for Tracking Purpose only XXX4055F 00 Code Accepted for Tracking Purpose only XXX4056F 00 Code Accepted for Tracking Purpose only XXX4058F 00 Code Accepted for Tracking Purpose only XXX4060F 00 Code Accepted for Tracking Purpose only XXX4062F 00 Code Accepted for Tracking Purpose only XXX4063F 00 Code Accepted for Tracking Purpose only XXX4064F 00 Code Accepted for Tracking Purpose only XXX40650 00 13.44$ 806.58$ 8.91$ 534.80$ 09040652 00 14.71$ 882.56$ 10.40$ 624.01$ 09040654 00 16.97$ 1,018.25$ 12.51$ 750.87$ 0904065F 00 Code Accepted for Tracking Purpose only XXX4066F 00 Code Accepted for Tracking Purpose only XXX4067F 00 Code Accepted for Tracking Purpose only XXX4069F 00 Code Accepted for Tracking Purpose only XXX40700 00 29.62$ 1,776.98$ 29.62$ 1,776.98$ 09040701 00 35.06$ 2,103.90$ 35.06$ 2,103.90$ 09040702 00 29.43$ 1,765.84$ 29.43$ 1,765.84$ 0904070F 00 Code Accepted for Tracking Purpose only XXX40720 00 30.24$ 1,814.45$ 30.24$ 1,814.45$ 0904073F 00 Code Accepted for Tracking Purpose only XXX4075F 00 Code Accepted for Tracking Purpose only XXX40761 00 31.87$ 1,912.04$ 31.87$ 1,912.04$ 0904077F 00 Code Accepted for Tracking Purpose only XXX40799 00 By Report By Report YYY4079F 00 Code Accepted for Tracking Purpose only XXX40800 00 6.31$ 378.55$ 3.83$ 229.73$ 01040801 00 9.14$ 548.31$ 6.41$ 384.36$ 010



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

40804 00 5.68$ 340.62$ 3.46$ 207.56$ 01040805 00 9.18$ 550.72$ 6.57$ 394.33$ 01040806 00 3.04$ 182.12$ 0.95$ 57.26$ 00040808 00 5.58$ 334.68$ 3.15$ 189.01$ 01040810 00 6.21$ 372.46$ 3.74$ 224.27$ 01040812 00 8.57$ 514.01$ 5.76$ 345.64$ 01040814 00 11.42$ 685.47$ 8.92$ 535.38$ 09040816 00 11.88$ 713.03$ 9.24$ 554.12$ 09040818 00 10.86$ 651.89$ 8.14$ 488.56$ 09040819 00 9.35$ 560.77$ 6.97$ 418.26$ 09040820 00 7.84$ 470.25$ 5.07$ 304.40$ 01040830 00 8.06$ 483.73$ 4.92$ 295.18$ 01040831 00 10.29$ 617.54$ 6.72$ 403.14$ 01040840 00 24.17$ 1,449.99$ 18.42$ 1,105.05$ 09040842 00 23.37$ 1,402.23$ 18.01$ 1,080.63$ 09040843 00 30.80$ 1,847.97$ 23.98$ 1,438.71$ 09040844 00 40.15$ 2,409.25$ 32.33$ 1,940.08$ 09040845 00 43.12$ 2,587.12$ 35.80$ 2,148.22$ 0904084F 00 Code Accepted for Tracking Purpose only XXX4086F 00 Code Accepted for Tracking Purpose only XXX40899 00 By Report By Report YYY4090F 00 Code Accepted for Tracking Purpose only XXX4095F 00 Code Accepted for Tracking Purpose only XXX41000 00 4.80$ 287.98$ 3.30$ 197.81$ 01041005 00 6.58$ 394.57$ 3.63$ 218.00$ 01041006 00 10.50$ 629.89$ 7.51$ 450.80$ 09041007 00 10.31$ 618.44$ 7.27$ 436.20$ 09041008 00 11.42$ 685.07$ 7.91$ 474.45$ 09041009 00 12.22$ 733.20$ 8.65$ 518.79$ 0904100F 00 Code Accepted for Tracking Purpose only XXX41010 00 6.13$ 367.85$ 3.20$ 191.91$ 01041015 00 12.40$ 744.18$ 9.74$ 584.64$ 09041016 00 13.19$ 791.28$ 10.30$ 617.86$ 09041017 00 13.40$ 803.80$ 10.41$ 624.71$ 09041018 00 15.14$ 908.27$ 12.13$ 727.91$ 09041019 00 14.00$ 840.24$ 14.00$ 840.24$ 00041100 00 5.10$ 306.09$ 3.14$ 188.17$ 01041105 00 5.18$ 310.84$ 3.26$ 195.44$ 01041108 00 4.52$ 271.31$ 2.64$ 158.43$ 0104110F 00 Code Accepted for Tracking Purpose only XXX41110 00 6.43$ 385.65$ 3.86$ 231.78$ 01041112 00 9.96$ 597.53$ 7.40$ 444.30$ 090



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

41113 00 10.83$ 649.90$ 8.17$ 490.36$ 09041114 00 18.46$ 1,107.37$ 18.46$ 1,107.37$ 09041115 00 7.42$ 445.34$ 4.27$ 256.16$ 01041116 00 9.87$ 592.45$ 6.47$ 388.13$ 09041120 00 31.73$ 1,903.51$ 31.73$ 1,903.51$ 09041130 00 39.03$ 2,341.86$ 39.03$ 2,341.86$ 09041135 00 64.19$ 3,851.67$ 64.19$ 3,851.67$ 09041140 00 64.44$ 3,866.16$ 64.44$ 3,866.16$ 09041145 00 81.50$ 4,889.81$ 81.50$ 4,889.81$ 09041150 00 64.86$ 3,891.82$ 64.86$ 3,891.82$ 09041153 00 70.24$ 4,214.11$ 70.24$ 4,214.11$ 09041155 00 88.84$ 5,330.40$ 88.84$ 5,330.40$ 0904115F 00 Code Accepted for Tracking Purpose only XXX4120F 00 Code Accepted for Tracking Purpose only XXX4124F 00 Code Accepted for Tracking Purpose only XXX41250 00 8.12$ 487.07$ 4.52$ 271.40$ 01041251 00 9.09$ 545.20$ 5.45$ 327.02$ 01041252 00 9.40$ 564.17$ 6.12$ 367.42$ 0104130F 00 Code Accepted for Tracking Purpose only XXX4131F 00 Code Accepted for Tracking Purpose only XXX4132F 00 Code Accepted for Tracking Purpose only XXX4133F 00 Code Accepted for Tracking Purpose only XXX4134F 00 Code Accepted for Tracking Purpose only XXX4135F 00 Code Accepted for Tracking Purpose only XXX4136F 00 Code Accepted for Tracking Purpose only XXX4140F 00 Code Accepted for Tracking Purpose only XXX4142F 00 Code Accepted for Tracking Purpose only XXX4144F 00 Code Accepted for Tracking Purpose only XXX4145F 00 Code Accepted for Tracking Purpose only XXX4148F 00 Code Accepted for Tracking Purpose only XXX4149F 00 Code Accepted for Tracking Purpose only XXX4150F 00 Code Accepted for Tracking Purpose only XXX41510 00 13.45$ 807.15$ 13.45$ 807.15$ 09041512 00 19.53$ 1,171.58$ 19.53$ 1,171.58$ 0904151F 00 Code Accepted for Tracking Purpose only XXX41520 00 10.45$ 626.79$ 7.29$ 437.61$ 09041530 00 28.62$ 1,717.22$ 11.05$ 662.86$ 0004153F 00 Code Accepted for Tracking Purpose only XXX4155F 00 Code Accepted for Tracking Purpose only XXX4157F 00 Code Accepted for Tracking Purpose only XXX4158F 00 Code Accepted for Tracking Purpose only XXX41599 00 By Report By Report YYY



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

4159F 00 Code Accepted for Tracking Purpose only XXX4163F 00 Code Accepted for Tracking Purpose only XXX4164F 00 Code Accepted for Tracking Purpose only XXX4165F 00 Code Accepted for Tracking Purpose only XXX4167F 00 Code Accepted for Tracking Purpose only XXX4168F 00 Code Accepted for Tracking Purpose only XXX4169F 00 Code Accepted for Tracking Purpose only XXX4171F 00 Code Accepted for Tracking Purpose only XXX4172F 00 Code Accepted for Tracking Purpose only XXX4174F 00 Code Accepted for Tracking Purpose only XXX4175F 00 Code Accepted for Tracking Purpose only XXX4176F 00 Code Accepted for Tracking Purpose only XXX4177F 00 Code Accepted for Tracking Purpose only XXX4178F 00 Code Accepted for Tracking Purpose only XXX4179F 00 Code Accepted for Tracking Purpose only XXX41800 00 8.63$ 518.06$ 4.49$ 269.61$ 01041805 00 8.61$ 516.75$ 5.63$ 337.66$ 01041806 00 11.76$ 705.85$ 8.19$ 491.44$ 0104180F 00 Code Accepted for Tracking Purpose only XXX4181F 00 Code Accepted for Tracking Purpose only XXX41820 00 By Report By Report 00041821 00 By Report By Report 00041822 00 8.43$ 505.62$ 5.18$ 310.77$ 01041823 00 13.00$ 780.25$ 9.49$ 569.63$ 09041825 00 6.41$ 384.77$ 3.62$ 217.03$ 01041826 00 9.39$ 563.64$ 6.25$ 375.09$ 01041827 00 13.23$ 794.05$ 9.05$ 543.08$ 09041828 00 9.27$ 556.33$ 6.15$ 369.04$ 0104182F 00 Code Accepted for Tracking Purpose only XXX41830 00 11.78$ 706.54$ 8.25$ 495.29$ 01041850 00 By Report By Report 0004185F 00 Code Accepted for Tracking Purpose only XXX4186F 00 Code Accepted for Tracking Purpose only XXX41870 00 By Report By Report 00041872 00 11.59$ 695.36$ 7.89$ 473.39$ 09041874 00 11.54$ 692.41$ 7.58$ 454.68$ 0904187F 00 Code Accepted for Tracking Purpose only XXX4188F 00 Code Accepted for Tracking Purpose only XXX41899 00 By Report By Report YYY4189F 00 Code Accepted for Tracking Purpose only XXX4190F 00 Code Accepted for Tracking Purpose only XXX4191F 00 Code Accepted for Tracking Purpose only XXX



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

4192F 00 Code Accepted for Tracking Purpose only XXX4193F 00 Code Accepted for Tracking Purpose only XXX4194F 00 Code Accepted for Tracking Purpose only XXX4195F 00 Code Accepted for Tracking Purpose only XXX4196F 00 Code Accepted for Tracking Purpose only XXX42000 00 4.60$ 275.72$ 3.05$ 183.02$ 0104200F 00 Code Accepted for Tracking Purpose only XXX4201F 00 Code Accepted for Tracking Purpose only XXX42100 00 4.41$ 264.62$ 3.21$ 192.74$ 01042104 00 6.41$ 384.43$ 4.07$ 244.43$ 01042106 00 8.05$ 482.75$ 5.18$ 310.60$ 01042107 00 13.75$ 824.84$ 10.15$ 609.17$ 0904210F 00 Code Accepted for Tracking Purpose only XXX42120 00 29.88$ 1,792.52$ 29.88$ 1,792.52$ 09042140 00 7.95$ 477.18$ 4.58$ 274.76$ 09042145 00 20.40$ 1,223.75$ 20.40$ 1,223.75$ 09042160 00 6.91$ 414.83$ 4.31$ 258.44$ 01042180 00 7.28$ 436.78$ 5.39$ 323.27$ 01042182 00 9.49$ 569.33$ 7.48$ 448.89$ 01042200 00 27.87$ 1,671.95$ 27.87$ 1,671.95$ 09042205 00 29.00$ 1,739.96$ 29.00$ 1,739.96$ 0904220F 00 Code Accepted for Tracking Purpose only XXX42210 00 32.33$ 1,939.98$ 32.33$ 1,939.98$ 09042215 00 21.17$ 1,270.01$ 21.17$ 1,270.01$ 0904221F 00 Code Accepted for Tracking Purpose only XXX42220 00 17.46$ 1,047.71$ 17.46$ 1,047.71$ 09042225 00 29.22$ 1,753.01$ 29.22$ 1,753.01$ 09042226 00 26.11$ 1,566.37$ 26.11$ 1,566.37$ 09042227 00 24.44$ 1,466.60$ 24.44$ 1,466.60$ 09042235 00 21.46$ 1,287.63$ 21.46$ 1,287.63$ 09042260 00 24.09$ 1,445.17$ 19.29$ 1,157.62$ 09042280 00 5.25$ 315.24$ 3.27$ 196.05$ 01042281 00 6.76$ 405.71$ 4.86$ 291.57$ 01042299 00 By Report By Report YYY42300 00 6.20$ 372.16$ 4.48$ 268.74$ 01042305 00 12.53$ 752.09$ 12.53$ 752.09$ 0904230F 00 Code Accepted for Tracking Purpose only XXX42310 00 5.23$ 313.92$ 4.01$ 240.77$ 01042320 00 7.46$ 447.42$ 5.16$ 309.32$ 01042330 00 6.85$ 410.75$ 4.82$ 289.04$ 01042335 00 11.49$ 689.57$ 7.54$ 452.47$ 09042340 00 14.23$ 853.52$ 9.93$ 595.60$ 090



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

42400 00 3.06$ 183.34$ 1.58$ 95.06$ 00042405 00 8.82$ 529.04$ 6.62$ 397.24$ 01042408 00 15.20$ 912.11$ 10.46$ 627.71$ 09042409 00 10.32$ 618.93$ 6.55$ 393.18$ 0904240F 00 Code Accepted for Tracking Purpose only XXX42410 00 18.20$ 1,092.03$ 18.20$ 1,092.03$ 09042415 00 30.77$ 1,845.91$ 30.77$ 1,845.91$ 09042420 00 34.55$ 2,073.24$ 34.55$ 2,073.24$ 09042425 00 24.35$ 1,461.01$ 24.35$ 1,461.01$ 09042426 00 39.34$ 2,360.50$ 39.34$ 2,360.50$ 0904242F 00 Code Accepted for Tracking Purpose only XXX42440 00 12.04$ 722.51$ 12.04$ 722.51$ 09042450 00 13.37$ 802.39$ 10.48$ 628.97$ 0904245F 00 Code Accepted for Tracking Purpose only XXX4248F 00 Code Accepted for Tracking Purpose only XXX42500 00 12.85$ 770.76$ 10.02$ 601.12$ 09042505 00 16.40$ 984.30$ 13.25$ 795.12$ 09042507 00 14.83$ 890.05$ 14.83$ 890.05$ 09042509 00 24.44$ 1,466.46$ 24.44$ 1,466.46$ 0904250F 00 Code Accepted for Tracking Purpose only XXX42510 00 18.16$ 1,089.58$ 18.16$ 1,089.58$ 09042550 00 4.31$ 258.73$ 1.86$ 111.80$ 0004255F 00 Code Accepted for Tracking Purpose only XXX4256F 00 Code Accepted for Tracking Purpose only XXX42600 00 14.56$ 873.59$ 10.21$ 612.52$ 0904260F 00 Code Accepted for Tracking Purpose only XXX4261F 00 Code Accepted for Tracking Purpose only XXX42650 00 2.38$ 142.76$ 1.70$ 101.77$ 0004265F 00 Code Accepted for Tracking Purpose only XXX42660 00 3.70$ 221.96$ 2.61$ 156.38$ 00042665 00 9.73$ 584.05$ 6.10$ 365.86$ 0904266F 00 Code Accepted for Tracking Purpose only XXX4267F 00 Code Accepted for Tracking Purpose only XXX4268F 00 Code Accepted for Tracking Purpose only XXX42699 00 By Report By Report YYY4269F 00 Code Accepted for Tracking Purpose only XXX42700 00 5.60$ 336.09$ 3.97$ 238.35$ 0104270F 00 Code Accepted for Tracking Purpose only XXX4271F 00 Code Accepted for Tracking Purpose only XXX42720 00 13.29$ 797.66$ 11.43$ 686.05$ 01042725 00 23.88$ 1,433.09$ 23.88$ 1,433.09$ 0904274F 00 Code Accepted for Tracking Purpose only XXX



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

4276F 00 Code Accepted for Tracking Purpose only XXX4279F 00 Code Accepted for Tracking Purpose only XXX42800 00 4.64$ 278.29$ 3.30$ 198.20$ 01042804 00 5.86$ 351.36$ 3.37$ 201.91$ 01042806 00 6.54$ 392.32$ 3.90$ 234.04$ 01042808 00 6.70$ 402.23$ 4.76$ 285.57$ 01042809 00 5.93$ 355.53$ 3.59$ 215.54$ 0104280F 00 Code Accepted for Tracking Purpose only XXX42810 00 11.41$ 684.69$ 8.41$ 504.34$ 09042815 00 16.13$ 967.62$ 16.13$ 967.62$ 09042820 00 8.46$ 507.47$ 8.46$ 507.47$ 09042821 00 8.79$ 527.12$ 8.79$ 527.12$ 09042825 00 7.67$ 460.32$ 7.67$ 460.32$ 09042826 00 7.36$ 441.65$ 7.36$ 441.65$ 09042830 00 6.09$ 365.18$ 6.09$ 365.18$ 09042831 00 6.58$ 394.78$ 6.58$ 394.78$ 09042835 00 5.66$ 339.64$ 5.66$ 339.64$ 09042836 00 7.05$ 422.84$ 7.05$ 422.84$ 09042842 00 29.77$ 1,786.19$ 29.77$ 1,786.19$ 09042844 00 40.87$ 2,452.12$ 40.87$ 2,452.12$ 09042845 00 65.58$ 3,934.68$ 65.58$ 3,934.68$ 09042860 00 5.52$ 331.19$ 5.52$ 331.19$ 09042870 00 17.53$ 1,051.77$ 17.53$ 1,051.77$ 09042890 00 42.16$ 2,529.61$ 42.16$ 2,529.61$ 09042892 00 55.32$ 3,319.32$ 55.32$ 3,319.32$ 09042894 00 69.91$ 4,194.34$ 69.91$ 4,194.34$ 09042900 00 9.81$ 588.50$ 9.81$ 588.50$ 0104290F 00 Code Accepted for Tracking Purpose only XXX4293F 00 Code Accepted for Tracking Purpose only XXX42950 00 23.94$ 1,436.62$ 23.94$ 1,436.62$ 09042953 00 28.74$ 1,724.41$ 28.74$ 1,724.41$ 09042955 00 22.68$ 1,360.78$ 22.68$ 1,360.78$ 09042960 00 4.92$ 295.42$ 4.92$ 295.42$ 01042961 00 12.23$ 733.68$ 12.23$ 733.68$ 09042962 00 15.12$ 907.10$ 15.12$ 907.10$ 09042970 00 12.04$ 722.20$ 12.04$ 722.20$ 09042971 00 13.30$ 797.93$ 13.30$ 797.93$ 09042972 00 14.88$ 892.57$ 14.88$ 892.57$ 09042999 00 By Report By Report YYY4300F 00 Code Accepted for Tracking Purpose only XXX4301F 00 Code Accepted for Tracking Purpose only XXX43020 00 16.36$ 981.73$ 16.36$ 981.73$ 090



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

43030 00 15.16$ 909.83$ 15.16$ 909.83$ 09043045 00 37.92$ 2,275.42$ 37.92$ 2,275.42$ 0904305F 00 Code Accepted for Tracking Purpose only XXX4306F 00 Code Accepted for Tracking Purpose only XXX43100 00 18.31$ 1,098.65$ 18.31$ 1,098.65$ 09043101 00 29.32$ 1,759.42$ 29.32$ 1,759.42$ 09043107 00 86.95$ 5,217.17$ 86.95$ 5,217.17$ 09043108 00 130.16$ 7,809.35$ 130.16$ 7,809.35$ 09043112 00 102.10$ 6,126.19$ 102.10$ 6,126.19$ 09043113 00 127.13$ 7,627.71$ 127.13$ 7,627.71$ 09043116 00 145.84$ 8,750.65$ 145.84$ 8,750.65$ 09043117 00 94.82$ 5,689.22$ 94.82$ 5,689.22$ 09043118 00 105.94$ 6,356.66$ 105.94$ 6,356.66$ 09043121 00 83.30$ 4,998.22$ 83.30$ 4,998.22$ 09043122 00 74.54$ 4,472.62$ 74.54$ 4,472.62$ 09043123 00 131.82$ 7,909.10$ 131.82$ 7,909.10$ 09043124 00 111.18$ 6,670.58$ 111.18$ 6,670.58$ 09043130 00 22.93$ 1,375.90$ 22.93$ 1,375.90$ 09043135 00 42.94$ 2,576.68$ 42.94$ 2,576.68$ 09043180 00 15.98$ 958.64$ 15.98$ 958.64$ 09043191 00 4.54$ 272.35$ 4.54$ 272.35$ 00043192 00 4.95$ 297.09$ 4.95$ 297.09$ 00043193 00 4.95$ 297.09$ 4.95$ 297.09$ 00043194 00 5.63$ 338.03$ 5.63$ 338.03$ 00043195 00 5.40$ 323.86$ 5.40$ 323.86$ 00043196 00 5.75$ 344.98$ 5.75$ 344.98$ 00043197 00 5.51$ 330.72$ 2.42$ 145.32$ 00043198 00 6.06$ 363.83$ 2.89$ 173.39$ 00043200 00 6.74$ 404.38$ 2.57$ 154.03$ 00043201 00 6.78$ 406.51$ 3.03$ 182.01$ 00043202 00 9.52$ 571.09$ 3.04$ 182.64$ 00043204 00 4.02$ 241.19$ 4.02$ 241.19$ 00043205 00 4.19$ 251.45$ 4.19$ 251.45$ 00043206 00 8.11$ 486.59$ 3.96$ 237.51$ 0004320F 00 Code Accepted for Tracking Purpose only XXX43210 00 12.68$ 760.57$ 12.68$ 760.57$ 00043211 00 6.96$ 417.43$ 6.96$ 417.43$ 00043212 00 5.59$ 335.54$ 5.59$ 335.54$ 00043213 00 35.28$ 2,117.01$ 7.65$ 459.16$ 00043214 00 5.68$ 341.05$ 5.68$ 341.05$ 00043215 00 10.96$ 657.52$ 4.19$ 251.41$ 00043216 00 11.04$ 662.13$ 3.92$ 235.21$ 000



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

43217 00 11.54$ 692.45$ 4.75$ 285.08$ 00043220 00 30.96$ 1,857.80$ 3.48$ 208.78$ 00043226 00 9.93$ 595.94$ 3.85$ 230.82$ 00043227 00 18.52$ 1,111.11$ 4.91$ 294.48$ 00043229 00 19.85$ 1,190.86$ 5.85$ 350.90$ 0004322F 00 Code Accepted for Tracking Purpose only XXX43231 00 10.12$ 607.36$ 4.72$ 283.23$ 00043232 00 12.28$ 736.99$ 5.90$ 354.22$ 00043233 00 6.76$ 405.62$ 6.76$ 405.62$ 00043235 00 7.87$ 472.14$ 3.63$ 218.01$ 00043236 00 10.37$ 622.38$ 4.11$ 246.54$ 00043237 00 5.81$ 348.69$ 5.81$ 348.69$ 00043238 00 6.90$ 414.25$ 6.90$ 414.25$ 00043239 00 10.56$ 633.73$ 4.11$ 246.54$ 00043240 00 11.65$ 699.02$ 11.65$ 699.02$ 00043241 00 4.23$ 253.60$ 4.23$ 253.60$ 00043242 00 7.80$ 467.77$ 7.80$ 467.77$ 00043243 00 7.03$ 421.92$ 7.03$ 421.92$ 00043244 00 7.27$ 436.17$ 7.27$ 436.17$ 00043245 00 16.85$ 1,011.11$ 5.20$ 311.77$ 00043246 00 5.93$ 355.73$ 5.93$ 355.73$ 00043247 00 10.57$ 634.10$ 5.25$ 315.02$ 00043248 00 10.88$ 652.69$ 4.93$ 295.77$ 00043249 00 31.35$ 1,881.26$ 4.55$ 273.23$ 0004324F 00 Code Accepted for Tracking Purpose only XXX43250 00 12.21$ 732.58$ 5.03$ 301.88$ 00043251 00 13.49$ 809.49$ 5.82$ 349.15$ 00043252 00 9.23$ 553.85$ 5.02$ 300.98$ 00043253 00 7.81$ 468.32$ 7.81$ 468.32$ 00043254 00 8.02$ 481.03$ 8.02$ 481.03$ 00043255 00 19.51$ 1,170.67$ 5.95$ 357.20$ 00043257 00 6.89$ 413.23$ 6.89$ 413.23$ 00043259 00 6.71$ 402.83$ 6.71$ 402.83$ 0004325F 00 Code Accepted for Tracking Purpose only XXX43260 00 9.58$ 574.61$ 9.58$ 574.61$ 00043261 00 10.05$ 603.14$ 10.05$ 603.14$ 00043262 00 10.60$ 636.03$ 10.60$ 636.03$ 00043263 00 10.61$ 636.50$ 10.61$ 636.50$ 00043264 00 10.80$ 648.14$ 10.80$ 648.14$ 00043265 00 12.86$ 771.37$ 12.86$ 771.37$ 00043266 00 6.47$ 388.14$ 6.47$ 388.14$ 0004326F 00 Code Accepted for Tracking Purpose only XXX



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

43270 00 20.41$ 1,224.50$ 6.66$ 399.67$ 00043273 00 3.53$ 211.95$ 3.53$ 211.95$ ZZZ43274 00 13.74$ 824.14$ 13.74$ 824.14$ 00043275 00 11.18$ 671.09$ 11.18$ 671.09$ 00043276 00 14.30$ 858.19$ 14.30$ 858.19$ 00043277 00 11.24$ 674.23$ 11.24$ 674.23$ 00043278 00 12.85$ 770.77$ 12.85$ 770.77$ 00043279 00 37.62$ 2,257.45$ 37.62$ 2,257.45$ 09043280 00 31.56$ 1,893.36$ 31.56$ 1,893.36$ 09043281 00 45.05$ 2,702.78$ 45.05$ 2,702.78$ 09043282 00 50.63$ 3,037.94$ 50.63$ 3,037.94$ 09043283 00 4.61$ 276.67$ 4.61$ 276.67$ ZZZ43284 00 18.98$ 1,138.81$ 18.98$ 1,138.81$ 09043285 00 19.36$ 1,161.39$ 19.36$ 1,161.39$ 09043286 00 91.78$ 5,506.64$ 91.78$ 5,506.64$ 09043287 00 104.93$ 6,295.83$ 104.93$ 6,295.83$ 09043288 00 109.36$ 6,561.57$ 109.36$ 6,561.57$ 09043289 00 By Report By Report YYY4328F 00 Code Accepted for Tracking Purpose only XXX43300 00 17.98$ 1,079.03$ 17.98$ 1,079.03$ 09043305 00 31.79$ 1,907.68$ 31.79$ 1,907.68$ 0904330F 00 Code Accepted for Tracking Purpose only XXX43310 00 43.21$ 2,592.67$ 43.21$ 2,592.67$ 09043312 00 46.44$ 2,786.46$ 46.44$ 2,786.46$ 09043313 00 79.66$ 4,779.81$ 79.66$ 4,779.81$ 09043314 00 85.74$ 5,144.62$ 85.74$ 5,144.62$ 09043320 00 40.85$ 2,450.74$ 40.85$ 2,450.74$ 09043325 00 39.70$ 2,382.12$ 39.70$ 2,382.12$ 09043327 00 23.96$ 1,437.49$ 23.96$ 1,437.49$ 09043328 00 32.84$ 1,970.42$ 32.84$ 1,970.42$ 09043330 00 39.05$ 2,343.02$ 39.05$ 2,343.02$ 09043331 00 39.06$ 2,343.81$ 39.06$ 2,343.81$ 09043332 00 33.82$ 2,029.39$ 33.82$ 2,029.39$ 09043333 00 36.82$ 2,209.12$ 36.82$ 2,209.12$ 09043334 00 36.38$ 2,182.91$ 36.38$ 2,182.91$ 09043335 00 39.00$ 2,340.24$ 39.00$ 2,340.24$ 09043336 00 44.09$ 2,645.12$ 44.09$ 2,645.12$ 09043337 00 45.10$ 2,706.21$ 45.10$ 2,706.21$ 09043338 00 3.38$ 202.53$ 3.38$ 202.53$ ZZZ43340 00 40.32$ 2,419.45$ 40.32$ 2,419.45$ 09043341 00 40.83$ 2,449.51$ 40.83$ 2,449.51$ 09043351 00 38.37$ 2,302.40$ 38.37$ 2,302.40$ 090



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

43352 00 31.10$ 1,865.90$ 31.10$ 1,865.90$ 09043360 00 65.66$ 3,939.79$ 65.66$ 3,939.79$ 09043361 00 78.79$ 4,727.43$ 78.79$ 4,727.43$ 09043400 00 44.52$ 2,671.48$ 44.52$ 2,671.48$ 09043405 00 42.44$ 2,546.21$ 42.44$ 2,546.21$ 0904340F 00 Code Accepted for Tracking Purpose only XXX43410 00 29.95$ 1,796.85$ 29.95$ 1,796.85$ 09043415 00 75.07$ 4,504.07$ 75.07$ 4,504.07$ 09043420 00 29.62$ 1,777.19$ 29.62$ 1,777.19$ 09043425 00 42.06$ 2,523.30$ 42.06$ 2,523.30$ 09043450 00 4.86$ 291.65$ 2.35$ 140.94$ 00043453 00 26.66$ 1,599.64$ 2.54$ 152.42$ 00043460 00 6.31$ 378.42$ 6.31$ 378.42$ 00043496 00 889.08$ 889.08$ 09043499 00 By Report By Report YYY43500 00 22.94$ 1,376.46$ 22.94$ 1,376.46$ 09043501 00 39.32$ 2,359.45$ 39.32$ 2,359.45$ 09043502 00 44.62$ 2,677.30$ 44.62$ 2,677.30$ 0904350F 00 Code Accepted for Tracking Purpose only XXX43510 00 27.70$ 1,661.74$ 27.70$ 1,661.74$ 09043520 00 20.12$ 1,207.50$ 20.12$ 1,207.50$ 09043605 00 24.53$ 1,471.89$ 24.53$ 1,471.89$ 09043610 00 28.73$ 1,723.51$ 28.73$ 1,723.51$ 09043611 00 35.84$ 2,150.31$ 35.84$ 2,150.31$ 09043620 00 57.34$ 3,440.24$ 57.34$ 3,440.24$ 09043621 00 66.34$ 3,980.63$ 66.34$ 3,980.63$ 09043622 00 67.60$ 4,055.78$ 67.60$ 4,055.78$ 09043631 00 42.38$ 2,542.66$ 42.38$ 2,542.66$ 09043632 00 59.42$ 3,565.12$ 59.42$ 3,565.12$ 09043633 00 56.14$ 3,368.36$ 56.14$ 3,368.36$ 09043634 00 62.16$ 3,729.71$ 62.16$ 3,729.71$ 09043635 00 3.27$ 196.23$ 3.27$ 196.23$ ZZZ43640 00 34.45$ 2,066.92$ 34.45$ 2,066.92$ 09043641 00 35.19$ 2,111.26$ 35.19$ 2,111.26$ 09043644 00 50.58$ 3,034.57$ 50.58$ 3,034.57$ 09043645 00 54.11$ 3,246.72$ 54.11$ 3,246.72$ 09043647 00 By Report By Report YYY43648 00 769.38$ 769.38$ YYY43651 00 19.17$ 1,150.16$ 19.17$ 1,150.16$ 09043652 00 22.39$ 1,343.23$ 22.39$ 1,343.23$ 09043653 00 16.82$ 1,009.38$ 16.82$ 1,009.38$ 09043659 00 By Report By Report YYY



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

43752 00 1.18$ 71.02$ 1.18$ 71.02$ 00043753 00 0.63$ 38.06$ 0.63$ 38.06$ 00043754 00 4.84$ 290.22$ 1.07$ 64.46$ 00043755 00 4.60$ 275.92$ 1.77$ 106.29$ 00043756 00 6.81$ 408.32$ 1.51$ 90.50$ 00043757 00 9.47$ 567.99$ 2.27$ 136.03$ 00043761 00 3.48$ 209.01$ 3.01$ 180.63$ 00043762 00 6.58$ 395.05$ 1.10$ 65.88$ 00043763 00 9.76$ 585.55$ 2.44$ 146.66$ 00043770 00 32.87$ 1,971.93$ 32.87$ 1,971.93$ 09043771 00 37.09$ 2,225.43$ 37.09$ 2,225.43$ 09043772 00 27.67$ 1,660.04$ 27.67$ 1,660.04$ 09043773 00 37.41$ 2,244.73$ 37.41$ 2,244.73$ 09043774 00 28.04$ 1,682.59$ 28.04$ 1,682.59$ 09043775 00 32.47$ 1,948.14$ 32.47$ 1,948.14$ 09043800 00 27.20$ 1,631.77$ 27.20$ 1,631.77$ 09043810 00 29.77$ 1,786.15$ 29.77$ 1,786.15$ 09043820 00 39.24$ 2,354.63$ 39.24$ 2,354.63$ 09043825 00 38.30$ 2,297.76$ 38.30$ 2,297.76$ 09043830 00 20.52$ 1,231.04$ 20.52$ 1,231.04$ 09043831 00 17.58$ 1,054.80$ 17.58$ 1,054.80$ 09043832 00 30.31$ 1,818.51$ 30.31$ 1,818.51$ 09043840 00 39.72$ 2,383.25$ 39.72$ 2,383.25$ 09043842 00 35.05$ 2,102.80$ 35.05$ 2,102.80$ 09043843 00 37.50$ 2,249.74$ 37.50$ 2,249.74$ 09043845 00 56.90$ 3,413.72$ 56.90$ 3,413.72$ 09043846 00 47.35$ 2,840.98$ 47.35$ 2,840.98$ 09043847 00 52.76$ 3,165.74$ 52.76$ 3,165.74$ 09043848 00 56.28$ 3,376.93$ 56.28$ 3,376.93$ 09043850 00 47.66$ 2,859.63$ 47.66$ 2,859.63$ 09043855 00 49.42$ 2,964.94$ 49.42$ 2,964.94$ 09043860 00 47.76$ 2,865.39$ 47.76$ 2,865.39$ 09043865 00 50.00$ 2,999.83$ 50.00$ 2,999.83$ 09043870 00 20.80$ 1,247.85$ 20.80$ 1,247.85$ 09043880 00 46.50$ 2,789.74$ 46.50$ 2,789.74$ 09043881 00 By Report By Report YYY43882 00 By Report By Report YYY43886 00 10.70$ 641.93$ 10.70$ 641.93$ 09043887 00 9.63$ 577.84$ 9.63$ 577.84$ 09043888 00 13.57$ 814.02$ 13.57$ 814.02$ 09043999 00 By Report By Report YYY44005 00 31.99$ 1,919.29$ 31.99$ 1,919.29$ 090



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

4400F 00 Code Accepted for Tracking Purpose only XXX44010 00 25.20$ 1,512.15$ 25.20$ 1,512.15$ 09044015 00 4.14$ 248.47$ 4.14$ 248.47$ ZZZ44020 00 28.46$ 1,707.85$ 28.46$ 1,707.85$ 09044021 00 28.52$ 1,711.44$ 28.52$ 1,711.44$ 09044025 00 28.77$ 1,725.97$ 28.77$ 1,725.97$ 09044050 00 27.33$ 1,639.91$ 27.33$ 1,639.91$ 09044055 00 43.68$ 2,620.87$ 43.68$ 2,620.87$ 09044100 00 3.17$ 190.47$ 3.17$ 190.47$ 00044110 00 24.86$ 1,491.58$ 24.86$ 1,491.58$ 09044111 00 28.77$ 1,726.24$ 28.77$ 1,726.24$ 09044120 00 35.73$ 2,143.59$ 35.73$ 2,143.59$ 09044121 00 7.07$ 424.00$ 7.07$ 424.00$ ZZZ44125 00 34.46$ 2,067.76$ 34.46$ 2,067.76$ 09044126 00 72.17$ 4,330.43$ 72.17$ 4,330.43$ 09044127 00 83.42$ 5,005.10$ 83.42$ 5,005.10$ 09044128 00 7.12$ 427.20$ 7.12$ 427.20$ ZZZ44130 00 38.41$ 2,304.72$ 38.41$ 2,304.72$ 09044132 00 By Report By Report XXX44133 00 By Report By Report XXX44135 00 By Report By Report XXX44136 00 By Report By Report XXX44137 00 By Report By Report XXX44139 00 3.52$ 211.47$ 3.52$ 211.47$ ZZZ44140 00 39.22$ 2,353.01$ 39.22$ 2,353.01$ 09044141 00 53.38$ 3,203.02$ 53.38$ 3,203.02$ 09044143 00 48.66$ 2,919.37$ 48.66$ 2,919.37$ 09044144 00 51.73$ 3,103.80$ 51.73$ 3,103.80$ 09044145 00 48.42$ 2,905.22$ 48.42$ 2,905.22$ 09044146 00 61.93$ 3,715.62$ 61.93$ 3,715.62$ 09044147 00 56.73$ 3,403.85$ 56.73$ 3,403.85$ 09044150 00 54.63$ 3,277.86$ 54.63$ 3,277.86$ 09044151 00 63.24$ 3,794.34$ 63.24$ 3,794.34$ 09044155 00 60.77$ 3,646.30$ 60.77$ 3,646.30$ 09044156 00 67.72$ 4,063.39$ 67.72$ 4,063.39$ 09044157 00 64.19$ 3,851.27$ 64.19$ 3,851.27$ 09044158 00 65.79$ 3,947.57$ 65.79$ 3,947.57$ 09044160 00 36.30$ 2,177.83$ 36.30$ 2,177.83$ 09044180 00 26.88$ 1,613.10$ 26.88$ 1,613.10$ 09044186 00 19.03$ 1,142.04$ 19.03$ 1,142.04$ 09044187 00 32.28$ 1,937.07$ 32.28$ 1,937.07$ 09044188 00 35.86$ 2,151.49$ 35.86$ 2,151.49$ 090



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

44202 00 40.44$ 2,426.32$ 40.44$ 2,426.32$ 09044203 00 6.99$ 419.38$ 6.99$ 419.38$ ZZZ44204 00 44.97$ 2,697.90$ 44.97$ 2,697.90$ 09044205 00 39.08$ 2,345.01$ 39.08$ 2,345.01$ 09044206 00 51.11$ 3,066.57$ 51.11$ 3,066.57$ 09044207 00 53.11$ 3,186.64$ 53.11$ 3,186.64$ 09044208 00 57.94$ 3,476.43$ 57.94$ 3,476.43$ 09044210 00 52.05$ 3,122.92$ 52.05$ 3,122.92$ 09044211 00 63.66$ 3,819.78$ 63.66$ 3,819.78$ 09044212 00 59.84$ 3,590.34$ 59.84$ 3,590.34$ 09044213 00 5.48$ 328.77$ 5.48$ 328.77$ ZZZ44227 00 48.63$ 2,917.99$ 48.63$ 2,917.99$ 09044238 00 By Report By Report YYY44300 00 24.64$ 1,478.58$ 24.64$ 1,478.58$ 09044310 00 30.51$ 1,830.30$ 30.51$ 1,830.30$ 09044312 00 17.34$ 1,040.60$ 17.34$ 1,040.60$ 09044314 00 29.40$ 1,764.05$ 29.40$ 1,764.05$ 09044316 00 41.36$ 2,481.68$ 41.36$ 2,481.68$ 09044320 00 35.15$ 2,109.15$ 35.15$ 2,109.15$ 09044322 00 29.52$ 1,770.94$ 29.52$ 1,770.94$ 09044340 00 18.28$ 1,096.61$ 18.28$ 1,096.61$ 09044345 00 30.74$ 1,844.54$ 30.74$ 1,844.54$ 09044346 00 34.59$ 2,075.31$ 34.59$ 2,075.31$ 09044360 00 4.26$ 255.74$ 4.26$ 255.74$ 00044361 00 4.72$ 283.06$ 4.72$ 283.06$ 00044363 00 5.70$ 341.79$ 5.70$ 341.79$ 00044364 00 6.08$ 364.50$ 6.08$ 364.50$ 00044365 00 5.40$ 323.84$ 5.40$ 323.84$ 00044366 00 7.12$ 427.05$ 7.12$ 427.05$ 00044369 00 7.29$ 437.40$ 7.29$ 437.40$ 00044370 00 7.91$ 474.31$ 7.91$ 474.31$ 00044372 00 7.11$ 426.55$ 7.11$ 426.55$ 00044373 00 5.69$ 341.62$ 5.69$ 341.62$ 00044376 00 8.44$ 506.37$ 8.44$ 506.37$ 00044377 00 8.88$ 533.09$ 8.88$ 533.09$ 00044378 00 11.43$ 685.81$ 11.43$ 685.81$ 00044379 00 12.15$ 729.12$ 12.15$ 729.12$ 00044380 00 5.17$ 310.24$ 1.67$ 100.25$ 00044381 00 28.38$ 1,702.51$ 2.48$ 148.71$ 00044382 00 8.13$ 487.51$ 2.18$ 130.59$ 00044384 00 4.53$ 271.75$ 4.53$ 271.75$ 00044385 00 5.81$ 348.61$ 2.12$ 127.27$ 000



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

44386 00 8.69$ 521.55$ 2.64$ 158.32$ 00044388 00 8.67$ 520.34$ 4.62$ 276.92$ 00044388 53 4.33$ 259.66$ 2.29$ 137.33$ 00044389 00 11.46$ 687.30$ 5.09$ 305.16$ 00044390 00 11.29$ 677.46$ 6.26$ 375.40$ 00044391 00 20.04$ 1,202.69$ 6.81$ 408.77$ 00044392 00 10.54$ 632.55$ 5.89$ 353.20$ 00044394 00 12.14$ 728.21$ 6.68$ 400.93$ 00044401 00 90.35$ 5,421.17$ 7.18$ 430.61$ 00044402 00 7.76$ 465.87$ 7.76$ 465.87$ 00044403 00 9.01$ 540.45$ 9.01$ 540.45$ 00044404 00 11.16$ 669.73$ 5.10$ 305.87$ 00044405 00 16.17$ 969.98$ 5.45$ 326.77$ 00044406 00 6.82$ 409.36$ 6.82$ 409.36$ 00044407 00 8.19$ 491.35$ 8.19$ 491.35$ 00044408 00 6.88$ 413.04$ 6.88$ 413.04$ 00044500 00 0.57$ 34.06$ 0.57$ 34.06$ 0004450F 00 Code Accepted for Tracking Purpose only XXX44602 00 41.20$ 2,471.87$ 41.20$ 2,471.87$ 09044603 00 47.32$ 2,839.13$ 47.32$ 2,839.13$ 09044604 00 30.93$ 1,855.53$ 30.93$ 1,855.53$ 09044605 00 38.08$ 2,284.87$ 38.08$ 2,284.87$ 09044615 00 31.38$ 1,882.98$ 31.38$ 1,882.98$ 09044620 00 25.37$ 1,522.40$ 25.37$ 1,522.40$ 09044625 00 29.70$ 1,782.21$ 29.70$ 1,782.21$ 09044626 00 46.75$ 2,804.74$ 46.75$ 2,804.74$ 09044640 00 40.94$ 2,456.60$ 40.94$ 2,456.60$ 09044650 00 42.18$ 2,531.08$ 42.18$ 2,531.08$ 09044660 00 39.07$ 2,343.96$ 39.07$ 2,343.96$ 09044661 00 45.32$ 2,719.26$ 45.32$ 2,719.26$ 09044680 00 31.30$ 1,878.16$ 31.30$ 1,878.16$ 09044700 00 29.48$ 1,768.53$ 29.48$ 1,768.53$ 09044701 00 4.96$ 297.85$ 4.96$ 297.85$ ZZZ44705 00 3.33$ 199.69$ 2.18$ 130.95$ XXX4470F 00 Code Accepted for Tracking Purpose only XXX44715 00 By Report By Report XXX44720 00 8.01$ 480.79$ 8.01$ 480.79$ XXX44721 00 11.20$ 672.12$ 11.20$ 672.12$ XXX44799 00 By Report By Report YYY44800 00 22.46$ 1,347.72$ 22.46$ 1,347.72$ 0904480F 00 Code Accepted for Tracking Purpose only XXX4481F 00 Code Accepted for Tracking Purpose only XXX



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

44820 00 24.48$ 1,469.09$ 24.48$ 1,469.09$ 09044850 00 21.90$ 1,314.23$ 21.90$ 1,314.23$ 09044899 00 By Report By Report YYY44900 00 22.61$ 1,356.30$ 22.61$ 1,356.30$ 09044950 00 18.77$ 1,126.17$ 18.77$ 1,126.17$ 09044955 00 2.46$ 147.69$ 2.46$ 147.69$ ZZZ44960 00 25.60$ 1,536.05$ 25.60$ 1,536.05$ 09044970 00 17.59$ 1,055.48$ 17.59$ 1,055.48$ 09044979 00 By Report By Report YYY45000 00 12.47$ 747.92$ 12.47$ 747.92$ 09045005 00 8.41$ 504.57$ 4.75$ 285.12$ 0104500F 00 Code Accepted for Tracking Purpose only XXX45020 00 16.80$ 1,008.25$ 16.80$ 1,008.25$ 09045100 00 8.80$ 528.03$ 8.80$ 528.03$ 09045108 00 10.85$ 651.12$ 10.85$ 651.12$ 0904510F 00 Code Accepted for Tracking Purpose only XXX45110 00 53.90$ 3,233.90$ 53.90$ 3,233.90$ 09045111 00 31.80$ 1,907.84$ 31.80$ 1,907.84$ 09045112 00 54.54$ 3,272.34$ 54.54$ 3,272.34$ 09045113 00 55.43$ 3,326.04$ 55.43$ 3,326.04$ 09045114 00 53.13$ 3,188.01$ 53.13$ 3,188.01$ 09045116 00 45.67$ 2,740.15$ 45.67$ 2,740.15$ 09045119 00 56.57$ 3,394.20$ 56.57$ 3,394.20$ 09045120 00 46.60$ 2,795.91$ 46.60$ 2,795.91$ 09045121 00 50.91$ 3,054.61$ 50.91$ 3,054.61$ 09045123 00 32.86$ 1,971.60$ 32.86$ 1,971.60$ 09045126 00 81.38$ 4,883.04$ 81.38$ 4,883.04$ 09045130 00 31.83$ 1,910.06$ 31.83$ 1,910.06$ 09045135 00 38.20$ 2,291.91$ 38.20$ 2,291.91$ 09045136 00 54.04$ 3,242.19$ 54.04$ 3,242.19$ 09045150 00 12.20$ 731.76$ 12.20$ 731.76$ 09045160 00 29.96$ 1,797.40$ 29.96$ 1,797.40$ 09045171 00 17.75$ 1,064.89$ 17.75$ 1,064.89$ 09045172 00 23.88$ 1,433.02$ 23.88$ 1,433.02$ 09045190 00 20.50$ 1,230.04$ 20.50$ 1,230.04$ 0904525F 00 Code Accepted for Tracking Purpose only XXX4526F 00 Code Accepted for Tracking Purpose only XXX45300 00 3.59$ 215.66$ 1.43$ 85.76$ 00045303 00 27.59$ 1,655.46$ 2.50$ 150.21$ 00045305 00 4.52$ 271.47$ 2.14$ 128.33$ 00045307 00 5.18$ 310.88$ 2.83$ 169.63$ 00045308 00 5.08$ 304.84$ 2.45$ 147.19$ 000



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

45309 00 5.26$ 315.77$ 2.61$ 156.86$ 00045315 00 5.76$ 345.85$ 3.09$ 185.68$ 00045317 00 5.68$ 340.59$ 3.28$ 196.81$ 00045320 00 5.62$ 337.16$ 3.07$ 183.92$ 00045321 00 3.02$ 180.93$ 3.02$ 180.93$ 00045327 00 3.41$ 204.46$ 3.41$ 204.46$ 00045330 00 5.08$ 304.56$ 1.66$ 99.61$ 00045331 00 7.92$ 475.05$ 2.12$ 126.96$ 00045332 00 7.62$ 457.40$ 3.10$ 186.24$ 00045333 00 9.01$ 540.72$ 2.77$ 166.14$ 00045334 00 16.03$ 961.80$ 3.49$ 209.50$ 00045335 00 7.45$ 446.94$ 1.96$ 117.76$ 00045337 00 3.41$ 204.49$ 3.41$ 204.49$ 00045338 00 8.17$ 489.90$ 3.55$ 213.07$ 00045340 00 13.18$ 791.08$ 2.30$ 137.78$ 00045341 00 3.67$ 219.91$ 3.67$ 219.91$ 00045342 00 5.03$ 301.98$ 5.03$ 301.98$ 00045346 00 86.41$ 5,184.44$ 4.77$ 285.94$ 00045347 00 4.58$ 274.99$ 4.58$ 274.99$ 00045349 00 5.88$ 352.89$ 5.88$ 352.89$ 00045350 00 17.13$ 1,027.83$ 2.98$ 179.05$ 00045378 00 9.44$ 566.62$ 5.48$ 328.88$ 00045378 53 4.72$ 283.31$ 2.74$ 164.12$ 00045379 00 12.20$ 731.89$ 7.09$ 425.42$ 00045380 00 12.17$ 730.34$ 5.95$ 357.03$ 00045381 00 11.89$ 713.32$ 5.95$ 357.03$ 00045382 00 20.98$ 1,258.64$ 7.68$ 460.93$ 00045384 00 13.54$ 812.27$ 6.76$ 405.53$ 00045385 00 12.73$ 763.77$ 7.55$ 452.88$ 00045386 00 17.63$ 1,058.01$ 6.28$ 376.96$ 00045388 00 91.00$ 5,459.72$ 8.02$ 481.13$ 00045389 00 8.60$ 515.90$ 8.60$ 515.90$ 00045390 00 9.87$ 592.15$ 9.87$ 592.15$ 00045391 00 7.65$ 459.18$ 7.65$ 459.18$ 00045392 00 9.03$ 541.79$ 9.03$ 541.79$ 00045393 00 7.49$ 449.57$ 7.49$ 449.57$ 00045395 00 57.78$ 3,466.99$ 57.78$ 3,466.99$ 09045397 00 62.88$ 3,772.85$ 62.88$ 3,772.85$ 09045398 00 21.66$ 1,299.60$ 6.96$ 417.39$ 00045399 00 By Report By Report YYY45400 00 33.34$ 2,000.16$ 33.34$ 2,000.16$ 09045402 00 44.27$ 2,656.13$ 44.27$ 2,656.13$ 090



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

4540F 00 Code Accepted for Tracking Purpose only XXX4541F 00 Code Accepted for Tracking Purpose only XXX45499 00 By Report By Report YYY45500 00 16.39$ 983.40$ 16.39$ 983.40$ 09045505 00 17.46$ 1,047.69$ 17.46$ 1,047.69$ 0904550F 00 Code Accepted for Tracking Purpose only XXX4551F 00 Code Accepted for Tracking Purpose only XXX45520 00 4.60$ 276.00$ 1.18$ 71.06$ 0004552F 00 Code Accepted for Tracking Purpose only XXX4553F 00 Code Accepted for Tracking Purpose only XXX45540 00 30.95$ 1,856.72$ 30.95$ 1,856.72$ 09045541 00 27.67$ 1,660.42$ 27.67$ 1,660.42$ 0904554F 00 Code Accepted for Tracking Purpose only XXX45550 00 42.87$ 2,571.92$ 42.87$ 2,571.92$ 0904555F 00 Code Accepted for Tracking Purpose only XXX45560 00 20.08$ 1,204.76$ 20.08$ 1,204.76$ 09045562 00 32.83$ 1,969.75$ 32.83$ 1,969.75$ 09045563 00 48.39$ 2,903.25$ 48.39$ 2,903.25$ 0904556F 00 Code Accepted for Tracking Purpose only XXX4557F 00 Code Accepted for Tracking Purpose only XXX4558F 00 Code Accepted for Tracking Purpose only XXX4559F 00 Code Accepted for Tracking Purpose only XXX4560F 00 Code Accepted for Tracking Purpose only XXX4561F 00 Code Accepted for Tracking Purpose only XXX4562F 00 Code Accepted for Tracking Purpose only XXX4563F 00 Code Accepted for Tracking Purpose only XXX45800 00 37.01$ 2,220.49$ 37.01$ 2,220.49$ 09045805 00 42.94$ 2,576.12$ 42.94$ 2,576.12$ 09045820 00 37.10$ 2,225.93$ 37.10$ 2,225.93$ 09045825 00 44.85$ 2,690.89$ 44.85$ 2,690.89$ 09045900 00 5.92$ 355.22$ 5.92$ 355.22$ 01045905 00 4.96$ 297.51$ 4.96$ 297.51$ 01045910 00 5.62$ 337.42$ 5.62$ 337.42$ 01045915 00 9.99$ 599.17$ 6.72$ 403.05$ 01045990 00 3.12$ 187.44$ 3.12$ 187.44$ 00045999 00 By Report By Report YYY46020 00 8.20$ 492.04$ 6.93$ 415.73$ 01046030 00 4.16$ 249.66$ 2.64$ 158.23$ 01046040 00 15.90$ 954.17$ 12.27$ 735.98$ 09046045 00 12.81$ 768.45$ 12.81$ 768.45$ 09046050 00 6.20$ 371.97$ 2.88$ 172.70$ 01046060 00 14.10$ 846.07$ 14.10$ 846.07$ 090



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

46070 00 7.69$ 461.39$ 7.69$ 461.39$ 09046080 00 7.61$ 456.49$ 4.64$ 278.66$ 01046083 00 5.41$ 324.68$ 3.14$ 188.47$ 01046200 00 13.42$ 804.97$ 9.69$ 581.11$ 09046220 00 6.42$ 385.48$ 3.50$ 210.17$ 01046221 00 8.01$ 480.86$ 5.64$ 338.35$ 01046230 00 8.35$ 500.71$ 5.07$ 303.96$ 01046250 00 13.83$ 829.67$ 9.30$ 557.88$ 09046255 00 15.11$ 906.58$ 10.43$ 625.97$ 09046257 00 12.46$ 747.42$ 12.46$ 747.42$ 09046258 00 13.76$ 825.54$ 13.76$ 825.54$ 09046260 00 14.02$ 841.06$ 14.02$ 841.06$ 09046261 00 15.32$ 919.42$ 15.32$ 919.42$ 09046262 00 16.29$ 977.51$ 16.29$ 977.51$ 09046270 00 15.21$ 912.83$ 11.60$ 695.90$ 09046275 00 16.06$ 963.33$ 12.23$ 733.79$ 09046280 00 13.91$ 834.62$ 13.91$ 834.62$ 09046285 00 15.98$ 959.08$ 12.23$ 733.96$ 09046288 00 16.15$ 968.73$ 16.15$ 968.73$ 09046320 00 5.59$ 335.66$ 3.27$ 196.30$ 01046500 00 8.54$ 512.14$ 5.27$ 316.03$ 01046505 00 8.56$ 513.64$ 7.07$ 424.10$ 01046600 00 2.82$ 169.35$ 1.20$ 72.24$ 00046601 00 4.08$ 244.71$ 2.74$ 164.62$ 00046604 00 19.17$ 1,150.00$ 1.93$ 115.81$ 00046606 00 7.16$ 429.71$ 2.20$ 132.06$ 00046607 00 5.74$ 344.56$ 3.69$ 221.59$ 00046608 00 7.53$ 451.77$ 2.45$ 147.19$ 00046610 00 7.15$ 429.08$ 2.35$ 140.90$ 00046611 00 5.62$ 337.30$ 2.36$ 141.81$ 00046612 00 8.70$ 522.10$ 2.77$ 166.44$ 00046614 00 4.11$ 246.34$ 1.90$ 113.91$ 00046615 00 4.46$ 267.88$ 2.68$ 160.68$ 00046700 00 19.29$ 1,157.37$ 19.29$ 1,157.37$ 09046705 00 16.36$ 981.61$ 16.36$ 981.61$ 09046706 00 5.17$ 310.35$ 5.17$ 310.35$ 01046707 00 14.43$ 866.03$ 14.43$ 866.03$ 09046710 00 32.44$ 1,946.41$ 32.44$ 1,946.41$ 09046712 00 65.23$ 3,914.04$ 65.23$ 3,914.04$ 09046715 00 15.99$ 959.34$ 15.99$ 959.34$ 09046716 00 35.56$ 2,133.71$ 35.56$ 2,133.71$ 09046730 00 57.60$ 3,456.00$ 57.60$ 3,456.00$ 090



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

46735 00 66.41$ 3,984.79$ 66.41$ 3,984.79$ 09046740 00 62.92$ 3,775.11$ 62.92$ 3,775.11$ 09046742 00 72.82$ 4,369.28$ 72.82$ 4,369.28$ 09046744 00 103.18$ 6,190.75$ 103.18$ 6,190.75$ 09046746 00 113.77$ 6,825.95$ 113.77$ 6,825.95$ 09046748 00 123.44$ 7,406.66$ 123.44$ 7,406.66$ 09046750 00 21.94$ 1,316.22$ 21.94$ 1,316.22$ 09046751 00 19.26$ 1,155.79$ 19.26$ 1,155.79$ 09046753 00 17.98$ 1,078.87$ 17.98$ 1,078.87$ 09046754 00 9.30$ 558.05$ 6.90$ 414.28$ 01046760 00 32.21$ 1,932.81$ 32.21$ 1,932.81$ 09046761 00 26.81$ 1,608.83$ 26.81$ 1,608.83$ 09046900 00 6.98$ 419.09$ 4.00$ 240.00$ 01046910 00 7.64$ 458.48$ 3.93$ 235.88$ 01046916 00 7.06$ 423.59$ 4.23$ 253.96$ 01046917 00 12.78$ 766.55$ 3.80$ 228.02$ 01046922 00 8.27$ 496.44$ 3.99$ 239.16$ 01046924 00 15.69$ 941.43$ 5.30$ 317.76$ 01046930 00 6.23$ 373.54$ 4.40$ 263.81$ 09046940 00 6.98$ 419.09$ 4.26$ 255.77$ 01046942 00 6.68$ 400.60$ 3.84$ 230.34$ 01046945 00 9.39$ 563.44$ 6.72$ 403.27$ 09046946 00 9.46$ 567.69$ 6.66$ 399.32$ 09046947 00 11.25$ 674.97$ 11.25$ 674.97$ 09046948 00 12.93$ 775.67$ 12.93$ 775.67$ 09046999 00 By Report By Report YYY47000 00 9.07$ 544.37$ 2.62$ 157.18$ 00047001 00 3.03$ 181.84$ 3.03$ 181.84$ ZZZ47010 00 35.50$ 2,129.88$ 35.50$ 2,129.88$ 09047015 00 34.09$ 2,045.27$ 34.09$ 2,045.27$ 09047100 00 24.77$ 1,486.38$ 24.77$ 1,486.38$ 09047120 00 68.27$ 4,096.16$ 68.27$ 4,096.16$ 09047122 00 100.23$ 6,013.54$ 100.23$ 6,013.54$ 09047125 00 90.05$ 5,402.87$ 90.05$ 5,402.87$ 09047130 00 96.73$ 5,803.83$ 96.73$ 5,803.83$ 09047133 00 By Report By Report XXX47135 00 157.33$ 9,439.95$ 157.33$ 9,439.95$ 09047140 00 104.35$ 6,261.24$ 104.35$ 6,261.24$ 09047141 00 124.87$ 7,492.05$ 124.87$ 7,492.05$ 09047142 00 137.73$ 8,263.78$ 137.73$ 8,263.78$ 09047143 00 199.55$ 199.55$ XXX47144 00 344.08$ 344.08$ 090



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

47145 00 By Report By Report XXX47146 00 9.47$ 567.92$ 9.47$ 567.92$ XXX47147 00 11.15$ 668.84$ 11.15$ 668.84$ XXX47300 00 33.10$ 1,986.12$ 33.10$ 1,986.12$ 09047350 00 40.04$ 2,402.20$ 40.04$ 2,402.20$ 09047360 00 54.93$ 3,295.85$ 54.93$ 3,295.85$ 09047361 00 88.54$ 5,312.69$ 88.54$ 5,312.69$ 09047362 00 42.46$ 2,547.47$ 42.46$ 2,547.47$ 09047370 00 36.55$ 2,193.12$ 36.55$ 2,193.12$ 09047371 00 36.76$ 2,205.61$ 36.76$ 2,205.61$ 09047379 00 By Report By Report YYY47380 00 42.15$ 2,529.03$ 42.15$ 2,529.03$ 09047381 00 43.30$ 2,597.91$ 43.30$ 2,597.91$ 09047382 00 136.51$ 8,190.51$ 21.81$ 1,308.77$ 01047383 00 205.68$ 12,341.06$ 13.42$ 805.49$ 01047399 00 By Report By Report YYY47400 00 63.01$ 3,780.75$ 63.01$ 3,780.75$ 09047420 00 39.21$ 2,352.77$ 39.21$ 2,352.77$ 09047425 00 40.02$ 2,401.11$ 40.02$ 2,401.11$ 09047460 00 37.16$ 2,229.62$ 37.16$ 2,229.62$ 09047480 00 25.71$ 1,542.84$ 25.71$ 1,542.84$ 09047490 00 9.78$ 587.04$ 9.78$ 587.04$ 01047531 00 10.32$ 619.30$ 2.09$ 125.54$ 00047532 00 24.18$ 1,450.56$ 6.26$ 375.39$ 00047533 00 36.74$ 2,204.32$ 7.84$ 470.17$ 00047534 00 42.73$ 2,564.09$ 10.94$ 656.53$ 00047535 00 29.68$ 1,780.93$ 5.82$ 349.46$ 00047536 00 20.44$ 1,226.68$ 3.89$ 233.48$ 00047537 00 12.00$ 719.73$ 2.83$ 169.85$ 00047538 00 127.75$ 7,664.93$ 6.97$ 418.07$ 00047539 00 141.49$ 8,489.65$ 12.58$ 754.71$ 00047540 00 143.91$ 8,634.43$ 12.98$ 779.04$ 00047541 00 35.16$ 2,109.52$ 9.76$ 585.36$ 00047542 00 14.47$ 868.34$ 3.98$ 239.00$ ZZZ47543 00 13.90$ 833.73$ 4.25$ 254.84$ ZZZ47544 00 30.59$ 1,835.33$ 4.66$ 279.64$ ZZZ47550 00 4.82$ 288.93$ 4.82$ 288.93$ ZZZ47552 00 9.13$ 547.66$ 9.13$ 547.66$ 00047553 00 9.01$ 540.64$ 9.01$ 540.64$ 00047554 00 15.05$ 902.89$ 15.05$ 902.89$ 00047555 00 9.53$ 571.61$ 9.53$ 571.61$ 00047556 00 10.80$ 647.73$ 10.80$ 647.73$ 000



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

47562 00 19.25$ 1,154.88$ 19.25$ 1,154.88$ 09047563 00 20.93$ 1,255.97$ 20.93$ 1,255.97$ 09047564 00 32.55$ 1,952.81$ 32.55$ 1,952.81$ 09047570 00 22.68$ 1,360.91$ 22.68$ 1,360.91$ 09047579 00 By Report By Report YYY47600 00 31.23$ 1,873.51$ 31.23$ 1,873.51$ 09047605 00 32.86$ 1,971.37$ 32.86$ 1,971.37$ 09047610 00 36.65$ 2,199.20$ 36.65$ 2,199.20$ 09047612 00 36.94$ 2,216.40$ 36.94$ 2,216.40$ 09047620 00 40.31$ 2,418.45$ 40.31$ 2,418.45$ 09047700 00 30.91$ 1,854.64$ 30.91$ 1,854.64$ 09047701 00 50.81$ 3,048.62$ 50.81$ 3,048.62$ 09047711 00 45.47$ 2,728.34$ 45.47$ 2,728.34$ 09047712 00 58.47$ 3,507.99$ 58.47$ 3,507.99$ 09047715 00 38.95$ 2,337.19$ 38.95$ 2,337.19$ 09047720 00 33.83$ 2,029.62$ 33.83$ 2,029.62$ 09047721 00 39.67$ 2,379.90$ 39.67$ 2,379.90$ 09047740 00 38.45$ 2,307.08$ 38.45$ 2,307.08$ 09047741 00 43.22$ 2,592.96$ 43.22$ 2,592.96$ 09047760 00 65.89$ 3,953.48$ 65.89$ 3,953.48$ 09047765 00 88.90$ 5,334.02$ 88.90$ 5,334.02$ 09047780 00 72.32$ 4,339.44$ 72.32$ 4,339.44$ 09047785 00 94.94$ 5,696.64$ 94.94$ 5,696.64$ 09047800 00 45.91$ 2,754.88$ 45.91$ 2,754.88$ 09047801 00 32.62$ 1,957.45$ 32.62$ 1,957.45$ 09047802 00 44.69$ 2,681.49$ 44.69$ 2,681.49$ 09047900 00 40.07$ 2,404.22$ 40.07$ 2,404.22$ 09047999 00 By Report By Report YYY48000 00 55.10$ 3,306.10$ 55.10$ 3,306.10$ 09048001 00 67.52$ 4,050.93$ 67.52$ 4,050.93$ 09048020 00 34.47$ 2,067.96$ 34.47$ 2,067.96$ 09048100 00 26.05$ 1,563.06$ 26.05$ 1,563.06$ 09048102 00 15.74$ 944.12$ 7.04$ 422.61$ 01048105 00 82.99$ 4,979.60$ 82.99$ 4,979.60$ 09048120 00 32.33$ 1,939.77$ 32.33$ 1,939.77$ 09048140 00 45.76$ 2,745.67$ 45.76$ 2,745.67$ 09048145 00 47.79$ 2,867.48$ 47.79$ 2,867.48$ 09048146 00 55.10$ 3,306.13$ 55.10$ 3,306.13$ 09048148 00 36.57$ 2,194.26$ 36.57$ 2,194.26$ 09048150 00 91.16$ 5,469.89$ 91.16$ 5,469.89$ 09048152 00 84.55$ 5,073.08$ 84.55$ 5,073.08$ 09048153 00 90.75$ 5,444.96$ 90.75$ 5,444.96$ 090



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

48154 00 84.92$ 5,095.31$ 84.92$ 5,095.31$ 09048155 00 53.12$ 3,186.93$ 53.12$ 3,186.93$ 09048160 00 By Report By Report XXX48400 00 3.13$ 187.77$ 3.13$ 187.77$ ZZZ48500 00 33.73$ 2,023.57$ 33.73$ 2,023.57$ 09048510 00 32.16$ 1,929.71$ 32.16$ 1,929.71$ 09048520 00 31.83$ 1,909.83$ 31.83$ 1,909.83$ 09048540 00 38.32$ 2,299.40$ 38.32$ 2,299.40$ 09048545 00 39.37$ 2,362.39$ 39.37$ 2,362.39$ 09048547 00 52.44$ 3,146.40$ 52.44$ 3,146.40$ 09048548 00 48.55$ 2,912.93$ 48.55$ 2,912.93$ 09048550 00 By Report By Report XXX48551 00 231.90$ 231.90$ XXX48552 00 6.89$ 413.39$ 6.89$ 413.39$ XXX48554 00 74.81$ 4,488.44$ 74.81$ 4,488.44$ 09048556 00 37.34$ 2,240.27$ 37.34$ 2,240.27$ 09048999 00 By Report By Report YYY49000 00 22.52$ 1,351.29$ 22.52$ 1,351.29$ 09049002 00 30.57$ 1,834.07$ 30.57$ 1,834.07$ 09049010 00 27.10$ 1,625.82$ 27.10$ 1,625.82$ 09049013 00 12.71$ 762.89$ 12.71$ 762.89$ 00049014 00 10.53$ 631.66$ 10.53$ 631.66$ 00049020 00 46.50$ 2,790.00$ 46.50$ 2,790.00$ 09049040 00 29.15$ 1,749.15$ 29.15$ 1,749.15$ 09049060 00 32.10$ 1,925.84$ 32.10$ 1,925.84$ 09049062 00 21.58$ 1,294.90$ 21.58$ 1,294.90$ 09049082 00 5.88$ 353.01$ 2.15$ 129.14$ 00049083 00 8.76$ 525.55$ 3.16$ 189.44$ 00049084 00 3.14$ 188.69$ 3.14$ 188.69$ 00049180 00 4.85$ 291.29$ 2.49$ 149.40$ 00049185 00 31.69$ 1,901.55$ 3.53$ 211.54$ 00049203 00 35.00$ 2,100.04$ 35.00$ 2,100.04$ 09049204 00 44.73$ 2,683.56$ 44.73$ 2,683.56$ 09049205 00 51.42$ 3,085.45$ 51.42$ 3,085.45$ 09049215 00 64.81$ 3,888.75$ 64.81$ 3,888.75$ 09049220 00 28.43$ 1,706.01$ 28.43$ 1,706.01$ 09049250 00 17.26$ 1,035.80$ 17.26$ 1,035.80$ 09049255 00 23.18$ 1,390.63$ 23.18$ 1,390.63$ 09049320 00 9.54$ 572.49$ 9.54$ 572.49$ 01049321 00 10.08$ 605.01$ 10.08$ 605.01$ 01049322 00 10.82$ 649.16$ 10.82$ 649.16$ 01049323 00 18.52$ 1,110.97$ 18.52$ 1,110.97$ 090



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

49324 00 11.30$ 678.21$ 11.30$ 678.21$ 01049325 00 12.05$ 723.12$ 12.05$ 723.12$ 01049326 00 5.49$ 329.10$ 5.49$ 329.10$ ZZZ49327 00 3.80$ 228.07$ 3.80$ 228.07$ ZZZ49329 00 By Report By Report YYY49400 00 4.02$ 241.21$ 2.71$ 162.39$ 00049402 00 25.04$ 1,502.13$ 25.04$ 1,502.13$ 09049405 00 24.93$ 1,495.77$ 5.79$ 347.44$ 00049406 00 24.92$ 1,495.14$ 5.79$ 347.44$ 00049407 00 20.18$ 1,210.93$ 6.13$ 367.82$ 00049411 00 14.25$ 855.26$ 5.42$ 324.93$ 00049412 00 2.42$ 145.00$ 2.42$ 145.00$ ZZZ49418 00 37.74$ 2,264.23$ 5.97$ 357.93$ 00049419 00 12.91$ 774.83$ 12.91$ 774.83$ 09049421 00 6.67$ 399.96$ 6.67$ 399.96$ 00049422 00 6.49$ 389.57$ 6.49$ 389.57$ 00049423 00 16.88$ 1,012.93$ 2.09$ 125.68$ 00049424 00 4.53$ 271.76$ 1.11$ 66.82$ 00049425 00 21.08$ 1,264.96$ 21.08$ 1,264.96$ 09049426 00 18.01$ 1,080.75$ 18.01$ 1,080.75$ 09049427 00 1.33$ 79.94$ 1.33$ 79.94$ 00049428 00 12.62$ 757.21$ 12.62$ 757.21$ 01049429 00 13.42$ 805.01$ 13.42$ 805.01$ 01049435 00 3.46$ 207.38$ 3.46$ 207.38$ ZZZ49436 00 5.43$ 325.69$ 5.43$ 325.69$ 01049440 00 28.15$ 1,688.74$ 6.04$ 362.59$ 01049441 00 31.92$ 1,915.25$ 7.09$ 425.14$ 01049442 00 26.58$ 1,594.95$ 6.14$ 368.44$ 01049446 00 27.10$ 1,626.24$ 4.35$ 261.00$ 00049450 00 19.68$ 1,180.93$ 1.94$ 116.47$ 00049451 00 21.39$ 1,283.32$ 2.65$ 158.96$ 00049452 00 26.29$ 1,577.11$ 4.06$ 243.39$ 00049460 00 21.43$ 1,285.63$ 1.41$ 84.34$ 00049465 00 4.67$ 280.49$ 0.90$ 54.10$ 00049491 00 23.25$ 1,395.04$ 23.25$ 1,395.04$ 09049492 00 28.02$ 1,681.04$ 28.02$ 1,681.04$ 09049495 00 11.99$ 719.30$ 11.99$ 719.30$ 09049496 00 17.97$ 1,078.38$ 17.97$ 1,078.38$ 09049500 00 12.07$ 724.22$ 12.07$ 724.22$ 09049501 00 17.72$ 1,063.49$ 17.72$ 1,063.49$ 09049505 00 15.23$ 914.07$ 15.23$ 914.07$ 09049507 00 17.15$ 1,028.70$ 17.15$ 1,028.70$ 090



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

49520 00 18.48$ 1,109.03$ 18.48$ 1,109.03$ 09049521 00 20.95$ 1,257.29$ 20.95$ 1,257.29$ 09049525 00 16.78$ 1,006.75$ 16.78$ 1,006.75$ 09049540 00 19.71$ 1,182.47$ 19.71$ 1,182.47$ 09049550 00 16.85$ 1,010.84$ 16.85$ 1,010.84$ 09049553 00 18.49$ 1,109.30$ 18.49$ 1,109.30$ 09049555 00 17.50$ 1,050.04$ 17.50$ 1,050.04$ 09049557 00 21.15$ 1,269.29$ 21.15$ 1,269.29$ 09049560 00 21.57$ 1,294.12$ 21.57$ 1,294.12$ 09049561 00 27.15$ 1,628.92$ 27.15$ 1,628.92$ 09049565 00 22.46$ 1,347.69$ 22.46$ 1,347.69$ 09049566 00 27.39$ 1,643.50$ 27.39$ 1,643.50$ 09049568 00 7.80$ 467.81$ 7.80$ 467.81$ ZZZ49570 00 12.23$ 733.68$ 12.23$ 733.68$ 09049572 00 15.11$ 906.73$ 15.11$ 906.73$ 09049580 00 9.78$ 586.66$ 9.78$ 586.66$ 09049582 00 14.14$ 848.10$ 14.14$ 848.10$ 09049585 00 13.03$ 781.73$ 13.03$ 781.73$ 09049587 00 13.92$ 835.50$ 13.92$ 835.50$ 09049590 00 16.75$ 1,004.93$ 16.75$ 1,004.93$ 09049600 00 21.43$ 1,285.91$ 21.43$ 1,285.91$ 09049605 00 144.61$ 8,676.86$ 144.61$ 8,676.86$ 09049606 00 33.13$ 1,987.56$ 33.13$ 1,987.56$ 09049610 00 20.17$ 1,210.08$ 20.17$ 1,210.08$ 09049611 00 17.78$ 1,066.69$ 17.78$ 1,066.69$ 09049650 00 12.56$ 753.65$ 12.56$ 753.65$ 09049651 00 16.34$ 980.25$ 16.34$ 980.25$ 09049652 00 21.74$ 1,304.67$ 21.74$ 1,304.67$ 09049653 00 27.15$ 1,628.83$ 27.15$ 1,628.83$ 09049654 00 24.70$ 1,481.79$ 24.70$ 1,481.79$ 09049655 00 30.16$ 1,809.50$ 30.16$ 1,809.50$ 09049656 00 26.77$ 1,606.40$ 26.77$ 1,606.40$ 09049657 00 38.52$ 2,310.94$ 38.52$ 2,310.94$ 09049659 00 By Report By Report YYY49900 00 23.92$ 1,435.03$ 23.92$ 1,435.03$ 09049904 00 41.43$ 2,485.88$ 41.43$ 2,485.88$ 09049905 00 10.30$ 617.82$ 10.30$ 617.82$ ZZZ49906 00 3,220.53$ 3,220.53$ 09049999 00 By Report By Report YYY50010 00 21.51$ 1,290.32$ 21.51$ 1,290.32$ 09050020 00 29.74$ 1,784.21$ 29.74$ 1,784.21$ 09050040 00 27.19$ 1,631.43$ 27.19$ 1,631.43$ 090



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

50045 00 27.36$ 1,641.71$ 27.36$ 1,641.71$ 0905005F 00 Code Accepted for Tracking Purpose only XXX50060 00 33.46$ 2,007.44$ 33.46$ 2,007.44$ 09050065 00 35.46$ 2,127.59$ 35.46$ 2,127.59$ 09050070 00 34.78$ 2,086.89$ 34.78$ 2,086.89$ 09050075 00 42.76$ 2,565.41$ 42.76$ 2,565.41$ 09050080 00 25.51$ 1,530.73$ 25.51$ 1,530.73$ 09050081 00 37.47$ 2,248.14$ 37.47$ 2,248.14$ 09050100 00 31.55$ 1,893.23$ 31.55$ 1,893.23$ 0905010F 00 Code Accepted for Tracking Purpose only XXX50120 00 27.86$ 1,671.35$ 27.86$ 1,671.35$ 09050125 00 28.84$ 1,730.27$ 28.84$ 1,730.27$ 09050130 00 30.32$ 1,819.38$ 30.32$ 1,819.38$ 09050135 00 32.92$ 1,975.28$ 32.92$ 1,975.28$ 0905015F 00 Code Accepted for Tracking Purpose only XXX50200 00 15.92$ 955.48$ 3.76$ 225.88$ 00050205 00 22.06$ 1,323.77$ 22.06$ 1,323.77$ 0905020F 00 Code Accepted for Tracking Purpose only XXX50220 00 30.70$ 1,842.11$ 30.70$ 1,842.11$ 09050225 00 35.30$ 2,117.80$ 35.30$ 2,117.80$ 09050230 00 37.58$ 2,254.70$ 37.58$ 2,254.70$ 09050234 00 38.21$ 2,292.34$ 38.21$ 2,292.34$ 09050236 00 42.99$ 2,579.50$ 42.99$ 2,579.50$ 09050240 00 38.88$ 2,332.62$ 38.88$ 2,332.62$ 09050250 00 35.69$ 2,141.17$ 35.69$ 2,141.17$ 09050280 00 28.05$ 1,682.80$ 28.05$ 1,682.80$ 09050290 00 26.37$ 1,582.31$ 26.37$ 1,582.31$ 09050300 00 By Report By Report XXX50320 00 44.02$ 2,641.44$ 44.02$ 2,641.44$ 09050323 00 191.46$ 191.46$ XXX50325 00 191.46$ 191.46$ XXX50327 00 6.31$ 378.85$ 6.31$ 378.85$ XXX50328 00 5.53$ 331.88$ 5.53$ 331.88$ XXX50329 00 5.26$ 315.77$ 5.26$ 315.77$ XXX50340 00 27.79$ 1,667.31$ 27.79$ 1,667.31$ 09050360 00 70.65$ 4,239.03$ 70.65$ 4,239.03$ 09050365 00 83.79$ 5,027.56$ 83.79$ 5,027.56$ 09050370 00 35.25$ 2,115.12$ 35.25$ 2,115.12$ 09050380 00 58.75$ 3,525.24$ 58.75$ 3,525.24$ 09050382 00 32.66$ 1,959.44$ 7.55$ 452.93$ 00050384 00 26.05$ 1,563.16$ 6.76$ 405.37$ 00050385 00 32.10$ 1,926.02$ 6.42$ 385.46$ 000



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

50386 00 21.17$ 1,270.19$ 4.76$ 285.83$ 00050387 00 15.31$ 918.68$ 2.46$ 147.46$ 00050389 00 9.91$ 594.76$ 1.58$ 94.70$ 00050390 00 2.81$ 168.82$ 2.81$ 168.82$ 00050391 00 3.59$ 215.32$ 2.87$ 172.44$ 00050396 00 3.44$ 206.24$ 3.44$ 206.24$ 00050400 00 34.02$ 2,041.01$ 34.02$ 2,041.01$ 09050405 00 40.97$ 2,457.97$ 40.97$ 2,457.97$ 09050430 00 15.11$ 906.51$ 4.52$ 271.50$ 00050431 00 6.28$ 376.57$ 1.94$ 116.14$ 00050432 00 24.50$ 1,469.91$ 6.06$ 363.84$ 00050433 00 32.57$ 1,953.90$ 7.54$ 452.44$ 00050434 00 25.71$ 1,542.61$ 5.68$ 340.69$ 00050435 00 15.28$ 916.53$ 2.95$ 176.83$ 00050436 00 4.44$ 266.13$ 4.44$ 266.13$ 00050437 00 7.39$ 443.41$ 7.39$ 443.41$ 00050500 00 37.59$ 2,255.48$ 37.59$ 2,255.48$ 0905050F 00 Code Accepted for Tracking Purpose only XXX50520 00 33.86$ 2,031.55$ 33.86$ 2,031.55$ 09050525 00 42.94$ 2,576.22$ 42.94$ 2,576.22$ 09050526 00 46.02$ 2,761.00$ 46.02$ 2,761.00$ 09050540 00 33.68$ 2,020.76$ 33.68$ 2,020.76$ 09050541 00 26.96$ 1,617.39$ 26.96$ 1,617.39$ 09050542 00 34.23$ 2,053.80$ 34.23$ 2,053.80$ 09050543 00 43.66$ 2,619.74$ 43.66$ 2,619.74$ 09050544 00 36.50$ 2,190.09$ 36.50$ 2,190.09$ 09050545 00 39.27$ 2,356.33$ 39.27$ 2,356.33$ 09050546 00 35.31$ 2,118.87$ 35.31$ 2,118.87$ 09050547 00 46.96$ 2,817.59$ 46.96$ 2,817.59$ 09050548 00 39.49$ 2,369.26$ 39.49$ 2,369.26$ 09050549 00 By Report By Report YYY50551 00 10.63$ 638.00$ 8.65$ 518.82$ 00050553 00 11.36$ 681.52$ 9.20$ 552.24$ 00050555 00 12.14$ 728.18$ 10.00$ 600.16$ 00050557 00 12.35$ 741.10$ 10.13$ 608.04$ 00050561 00 13.98$ 838.74$ 11.55$ 693.07$ 00050562 00 17.03$ 1,021.75$ 17.03$ 1,021.75$ 09050570 00 14.40$ 863.94$ 14.40$ 863.94$ 00050572 00 15.58$ 934.90$ 15.58$ 934.90$ 00050574 00 16.57$ 994.29$ 16.57$ 994.29$ 00050575 00 20.92$ 1,255.13$ 20.92$ 1,255.13$ 00050576 00 16.53$ 991.85$ 16.53$ 991.85$ 000



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

50580 00 17.80$ 1,067.76$ 17.80$ 1,067.76$ 00050590 00 21.50$ 1,289.98$ 16.72$ 1,003.06$ 09050592 00 96.74$ 5,804.43$ 10.07$ 604.50$ 01050593 00 131.40$ 7,883.94$ 13.53$ 811.76$ 01050600 00 27.54$ 1,652.54$ 27.54$ 1,652.54$ 09050605 00 28.95$ 1,736.89$ 28.95$ 1,736.89$ 09050606 00 19.58$ 1,175.02$ 4.48$ 268.85$ ZZZ5060F 00 Code Accepted for Tracking Purpose only XXX50610 00 27.74$ 1,664.23$ 27.74$ 1,664.23$ 09050620 00 26.53$ 1,591.97$ 26.53$ 1,591.97$ 0905062F 00 Code Accepted for Tracking Purpose only XXX50630 00 26.20$ 1,571.98$ 26.20$ 1,571.98$ 09050650 00 30.45$ 1,826.91$ 30.45$ 1,826.91$ 09050660 00 33.56$ 2,013.48$ 33.56$ 2,013.48$ 09050684 00 3.21$ 192.85$ 1.48$ 88.80$ 00050686 00 4.10$ 246.29$ 2.59$ 155.48$ 00050688 00 2.30$ 137.87$ 2.30$ 137.87$ 01050690 00 2.95$ 177.07$ 2.06$ 123.46$ 00050693 00 29.99$ 1,799.19$ 6.02$ 361.42$ 00050694 00 33.03$ 1,981.68$ 7.88$ 472.65$ 00050695 00 40.31$ 2,418.55$ 10.08$ 604.95$ 00050700 00 27.17$ 1,630.23$ 27.17$ 1,630.23$ 09050705 00 59.49$ 3,569.56$ 5.76$ 345.31$ ZZZ50706 00 28.60$ 1,715.81$ 5.37$ 322.19$ ZZZ50715 00 35.62$ 2,137.19$ 35.62$ 2,137.19$ 09050722 00 29.53$ 1,771.73$ 29.53$ 1,771.73$ 09050725 00 32.34$ 1,940.68$ 32.34$ 1,940.68$ 09050727 00 14.96$ 897.68$ 14.96$ 897.68$ 09050728 00 21.52$ 1,291.21$ 21.52$ 1,291.21$ 09050740 00 35.75$ 2,144.76$ 35.75$ 2,144.76$ 09050750 00 33.85$ 2,031.09$ 33.85$ 2,031.09$ 09050760 00 33.03$ 1,981.80$ 33.03$ 1,981.80$ 09050770 00 33.85$ 2,031.09$ 33.85$ 2,031.09$ 09050780 00 32.40$ 1,943.77$ 32.40$ 1,943.77$ 09050782 00 31.56$ 1,893.39$ 31.56$ 1,893.39$ 09050783 00 33.08$ 1,985.01$ 33.08$ 1,985.01$ 09050785 00 35.61$ 2,136.32$ 35.61$ 2,136.32$ 09050800 00 27.24$ 1,634.65$ 27.24$ 1,634.65$ 09050810 00 40.90$ 2,453.98$ 40.90$ 2,453.98$ 09050815 00 35.89$ 2,153.60$ 35.89$ 2,153.60$ 09050820 00 38.54$ 2,312.30$ 38.54$ 2,312.30$ 09050825 00 48.70$ 2,922.11$ 48.70$ 2,922.11$ 090



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

50830 00 52.85$ 3,171.30$ 52.85$ 3,171.30$ 09050840 00 36.09$ 2,165.16$ 36.09$ 2,165.16$ 09050845 00 36.71$ 2,202.73$ 36.71$ 2,202.73$ 09050860 00 27.76$ 1,665.38$ 27.76$ 1,665.38$ 09050900 00 24.73$ 1,484.03$ 24.73$ 1,484.03$ 09050920 00 25.88$ 1,552.54$ 25.88$ 1,552.54$ 09050930 00 32.33$ 1,940.08$ 32.33$ 1,940.08$ 09050940 00 26.05$ 1,562.87$ 26.05$ 1,562.87$ 09050945 00 28.54$ 1,712.69$ 28.54$ 1,712.69$ 09050947 00 40.71$ 2,442.46$ 40.71$ 2,442.46$ 09050948 00 37.39$ 2,243.20$ 37.39$ 2,243.20$ 09050949 00 By Report By Report YYY50951 00 11.11$ 666.85$ 9.00$ 540.10$ 00050953 00 11.75$ 705.21$ 9.58$ 574.68$ 00050955 00 12.53$ 752.03$ 10.33$ 619.61$ 00050957 00 12.65$ 758.78$ 10.39$ 623.20$ 00050961 00 11.41$ 684.51$ 9.29$ 557.13$ 00050970 00 10.87$ 652.23$ 10.87$ 652.23$ 00050972 00 10.50$ 629.80$ 10.50$ 629.80$ 00050974 00 13.85$ 831.17$ 13.85$ 831.17$ 00050976 00 13.67$ 820.24$ 13.67$ 820.24$ 00050980 00 10.44$ 626.20$ 10.44$ 626.20$ 0005100F 00 Code Accepted for Tracking Purpose only XXX51020 00 13.75$ 825.04$ 13.75$ 825.04$ 09051030 00 13.85$ 830.96$ 13.85$ 830.96$ 09051040 00 8.52$ 511.48$ 8.52$ 511.48$ 09051045 00 14.43$ 865.56$ 14.43$ 865.56$ 09051050 00 13.89$ 833.45$ 13.89$ 833.45$ 09051060 00 17.10$ 1,025.76$ 17.10$ 1,025.76$ 09051065 00 17.03$ 1,021.97$ 17.03$ 1,021.97$ 09051080 00 12.03$ 721.84$ 12.03$ 721.84$ 09051100 00 1.89$ 113.26$ 1.14$ 68.49$ 00051101 00 3.92$ 235.36$ 1.52$ 90.95$ 00051102 00 6.78$ 406.88$ 4.24$ 254.27$ 00051500 00 18.71$ 1,122.81$ 18.71$ 1,122.81$ 09051520 00 17.48$ 1,048.80$ 17.48$ 1,048.80$ 09051525 00 25.20$ 1,512.01$ 25.20$ 1,512.01$ 09051530 00 22.62$ 1,356.92$ 22.62$ 1,356.92$ 09051535 00 22.89$ 1,373.29$ 22.89$ 1,373.29$ 09051550 00 28.27$ 1,696.19$ 28.27$ 1,696.19$ 09051555 00 37.17$ 2,229.93$ 37.17$ 2,229.93$ 09051565 00 38.05$ 2,283.29$ 38.05$ 2,283.29$ 090



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

51570 00 43.20$ 2,592.24$ 43.20$ 2,592.24$ 09051575 00 53.45$ 3,207.03$ 53.45$ 3,207.03$ 09051580 00 55.62$ 3,337.18$ 55.62$ 3,337.18$ 09051585 00 61.92$ 3,715.00$ 61.92$ 3,715.00$ 09051590 00 56.68$ 3,400.88$ 56.68$ 3,400.88$ 09051595 00 64.16$ 3,849.35$ 64.16$ 3,849.35$ 09051596 00 69.04$ 4,142.69$ 69.04$ 4,142.69$ 09051597 00 67.20$ 4,032.08$ 67.20$ 4,032.08$ 09051600 00 5.80$ 348.22$ 1.31$ 78.32$ 00051605 00 1.13$ 67.76$ 1.13$ 67.76$ 00051610 00 3.31$ 198.87$ 1.89$ 113.11$ 00051700 00 2.19$ 131.64$ 0.88$ 52.81$ 00051701 00 1.31$ 78.38$ 0.74$ 44.32$ 00051702 00 1.82$ 109.28$ 0.74$ 44.32$ 00051703 00 3.89$ 233.23$ 2.26$ 135.49$ 00051705 00 2.75$ 165.21$ 1.52$ 91.43$ 00051710 00 3.80$ 227.95$ 2.34$ 140.30$ 00051715 00 9.31$ 558.80$ 5.83$ 350.07$ 00051720 00 2.47$ 148.34$ 1.28$ 77.09$ 00051725 00 5.90$ 353.74$ 5.90$ 353.74$ 00051725 26 2.22$ 133.11$ 2.22$ 133.11$ 00051725 TC 3.68$ 220.63$ 3.68$ 220.63$ 00051726 00 8.25$ 494.94$ 8.25$ 494.94$ 00051726 26 2.49$ 149.54$ 2.49$ 149.54$ 00051726 TC 5.76$ 345.40$ 5.76$ 345.40$ 00051727 00 9.75$ 585.01$ 9.75$ 585.01$ 00051727 26 3.10$ 186.01$ 3.10$ 186.01$ 00051727 TC 6.65$ 399.00$ 6.65$ 399.00$ 00051728 00 9.92$ 595.18$ 9.92$ 595.18$ 00051728 26 3.05$ 182.94$ 3.05$ 182.94$ 00051728 TC 6.87$ 412.24$ 6.87$ 412.24$ 00051729 00 10.59$ 635.43$ 10.59$ 635.43$ 00051729 26 3.68$ 220.67$ 3.68$ 220.67$ 00051729 TC 6.91$ 414.77$ 6.91$ 414.77$ 00051736 00 0.41$ 24.62$ 0.41$ 24.62$ XXX51736 26 0.24$ 14.61$ 0.24$ 14.61$ XXX51736 TC 0.17$ 10.01$ 0.17$ 10.01$ XXX51741 00 0.42$ 25.25$ 0.42$ 25.25$ XXX51741 26 0.24$ 14.61$ 0.24$ 14.61$ XXX51741 TC 0.18$ 10.64$ 0.18$ 10.64$ XXX51784 00 1.99$ 119.18$ 1.99$ 119.18$ XXX51784 26 1.09$ 65.67$ 1.09$ 65.67$ XXX



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

51784 TC 0.89$ 53.52$ 0.89$ 53.52$ XXX51785 00 9.50$ 570.28$ 9.50$ 570.28$ XXX51785 26 2.67$ 159.93$ 2.67$ 159.93$ XXX51785 TC 6.84$ 410.35$ 6.84$ 410.35$ XXX51792 00 6.84$ 410.54$ 6.84$ 410.54$ 00051792 26 1.61$ 96.67$ 1.61$ 96.67$ 00051792 TC 5.23$ 313.87$ 5.23$ 313.87$ 00051797 00 4.11$ 246.44$ 4.11$ 246.44$ ZZZ51797 26 1.17$ 70.50$ 1.17$ 70.50$ ZZZ51797 TC 2.93$ 175.94$ 2.93$ 175.94$ ZZZ51798 00 0.38$ 22.62$ 0.38$ 22.62$ XXX51800 00 30.80$ 1,848.25$ 30.80$ 1,848.25$ 09051820 00 31.82$ 1,909.42$ 31.82$ 1,909.42$ 09051840 00 19.61$ 1,176.41$ 19.61$ 1,176.41$ 09051841 00 22.84$ 1,370.24$ 22.84$ 1,370.24$ 09051845 00 17.10$ 1,025.70$ 17.10$ 1,025.70$ 09051860 00 21.85$ 1,310.81$ 21.85$ 1,310.81$ 09051865 00 26.31$ 1,578.34$ 26.31$ 1,578.34$ 09051880 00 13.72$ 823.24$ 13.72$ 823.24$ 09051900 00 24.20$ 1,452.08$ 24.20$ 1,452.08$ 09051920 00 22.42$ 1,345.34$ 22.42$ 1,345.34$ 09051925 00 30.00$ 1,799.71$ 30.00$ 1,799.71$ 09051940 00 48.15$ 2,888.95$ 48.15$ 2,888.95$ 09051960 00 40.64$ 2,438.14$ 40.64$ 2,438.14$ 09051980 00 20.94$ 1,256.36$ 20.94$ 1,256.36$ 09051990 00 21.94$ 1,316.50$ 21.94$ 1,316.50$ 09051992 00 24.36$ 1,461.55$ 24.36$ 1,461.55$ 09051999 00 By Report By Report YYY52000 00 5.58$ 334.52$ 2.37$ 142.19$ 00052001 00 11.58$ 694.76$ 8.42$ 504.95$ 00052005 00 8.32$ 499.25$ 3.90$ 233.77$ 00052007 00 13.67$ 820.48$ 4.87$ 292.04$ 0005200F 00 Code Accepted for Tracking Purpose only XXX52010 00 11.37$ 682.38$ 4.86$ 291.41$ 00052204 00 11.21$ 672.64$ 4.14$ 248.25$ 00052214 00 20.81$ 1,248.89$ 5.16$ 309.30$ 00052224 00 21.73$ 1,303.81$ 5.95$ 357.28$ 00052234 00 7.21$ 432.78$ 7.21$ 432.78$ 00052235 00 8.45$ 506.85$ 8.45$ 506.85$ 00052240 00 11.48$ 688.86$ 11.48$ 688.86$ 00052250 00 7.01$ 420.68$ 7.01$ 420.68$ 00052260 00 6.15$ 369.07$ 6.15$ 369.07$ 000



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

52265 00 11.00$ 659.97$ 4.74$ 284.13$ 00052270 00 11.27$ 676.12$ 5.34$ 320.47$ 00052275 00 14.92$ 895.46$ 7.28$ 437.02$ 00052276 00 7.75$ 464.91$ 7.75$ 464.91$ 00052277 00 9.47$ 568.01$ 9.47$ 568.01$ 00052281 00 8.80$ 528.20$ 4.46$ 267.77$ 00052282 00 9.88$ 592.68$ 9.88$ 592.68$ 00052283 00 8.90$ 534.21$ 5.91$ 354.49$ 00052285 00 8.89$ 533.37$ 5.74$ 344.19$ 00052287 00 9.95$ 597.25$ 4.95$ 297.08$ 00052290 00 7.16$ 429.82$ 7.16$ 429.82$ 00052300 00 8.19$ 491.61$ 8.19$ 491.61$ 00052301 00 8.49$ 509.21$ 8.49$ 509.21$ 00052305 00 8.16$ 489.72$ 8.16$ 489.72$ 00052310 00 7.91$ 474.36$ 4.44$ 266.27$ 00052315 00 12.96$ 777.53$ 8.04$ 482.41$ 00052317 00 24.95$ 1,496.85$ 10.17$ 610.23$ 00052318 00 13.87$ 832.30$ 13.87$ 832.30$ 00052320 00 7.22$ 433.23$ 7.22$ 433.23$ 00052325 00 9.38$ 562.99$ 9.38$ 562.99$ 00052327 00 7.67$ 460.39$ 7.67$ 460.39$ 00052330 00 15.96$ 957.31$ 7.73$ 463.55$ 00052332 00 14.05$ 843.24$ 4.56$ 273.81$ 00052334 00 5.37$ 322.33$ 5.37$ 322.33$ 00052341 00 8.32$ 498.96$ 8.32$ 498.96$ 00052342 00 9.04$ 542.66$ 9.04$ 542.66$ 00052343 00 10.09$ 605.13$ 10.09$ 605.13$ 00052344 00 10.82$ 649.37$ 10.82$ 649.37$ 00052345 00 11.55$ 693.15$ 11.55$ 693.15$ 00052346 00 13.08$ 784.62$ 13.08$ 784.62$ 00052351 00 8.86$ 531.65$ 8.86$ 531.65$ 00052352 00 10.39$ 623.28$ 10.39$ 623.28$ 00052353 00 11.48$ 688.86$ 11.48$ 688.86$ 00052354 00 12.23$ 733.65$ 12.23$ 733.65$ 00052355 00 13.69$ 821.58$ 13.69$ 821.58$ 00052356 00 12.20$ 731.76$ 12.20$ 731.76$ 00052400 00 14.03$ 841.64$ 14.03$ 841.64$ 09052402 00 7.82$ 468.99$ 7.82$ 468.99$ 00052441 00 37.75$ 2,265.15$ 6.62$ 397.32$ 00052442 00 28.44$ 1,706.63$ 1.77$ 106.17$ ZZZ52450 00 13.83$ 829.77$ 13.83$ 829.77$ 09052500 00 14.37$ 862.48$ 14.37$ 862.48$ 090



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

5250F 00 Code Accepted for Tracking Purpose only XXX52601 00 21.40$ 1,283.80$ 21.40$ 1,283.80$ 09052630 00 11.80$ 707.92$ 11.80$ 707.92$ 09052640 00 9.33$ 559.56$ 9.33$ 559.56$ 09052647 00 47.99$ 2,879.39$ 19.03$ 1,142.09$ 09052648 00 49.46$ 2,967.88$ 20.28$ 1,216.71$ 09052649 00 24.20$ 1,452.26$ 24.20$ 1,452.26$ 09052700 00 12.97$ 778.35$ 12.97$ 778.35$ 09053000 00 4.36$ 261.70$ 4.36$ 261.70$ 01053010 00 8.68$ 521.04$ 8.68$ 521.04$ 09053020 00 2.84$ 170.32$ 2.84$ 170.32$ 00053025 00 2.00$ 120.22$ 2.00$ 120.22$ 00053040 00 11.55$ 692.78$ 11.55$ 692.78$ 09053060 00 5.36$ 321.46$ 4.78$ 286.78$ 01053080 00 12.37$ 741.94$ 12.37$ 741.94$ 09053085 00 19.08$ 1,145.01$ 19.08$ 1,145.01$ 09053200 00 4.63$ 277.55$ 4.17$ 250.44$ 00053210 00 22.60$ 1,356.26$ 22.60$ 1,356.26$ 09053215 00 27.23$ 1,633.98$ 27.23$ 1,633.98$ 09053220 00 13.28$ 796.91$ 13.28$ 796.91$ 09053230 00 17.79$ 1,067.42$ 17.79$ 1,067.42$ 09053235 00 18.61$ 1,116.66$ 18.61$ 1,116.66$ 09053240 00 12.49$ 749.56$ 12.49$ 749.56$ 09053250 00 11.64$ 698.54$ 11.64$ 698.54$ 09053260 00 5.95$ 356.80$ 5.28$ 317.07$ 01053265 00 6.50$ 389.86$ 5.47$ 328.06$ 01053270 00 6.10$ 366.06$ 5.41$ 324.44$ 01053275 00 7.70$ 461.92$ 7.70$ 461.92$ 01053400 00 23.49$ 1,409.10$ 23.49$ 1,409.10$ 09053405 00 25.64$ 1,538.59$ 25.64$ 1,538.59$ 09053410 00 28.71$ 1,722.69$ 28.71$ 1,722.69$ 09053415 00 33.16$ 1,989.34$ 33.16$ 1,989.34$ 09053420 00 24.70$ 1,481.71$ 24.70$ 1,481.71$ 09053425 00 27.48$ 1,649.09$ 27.48$ 1,649.09$ 09053430 00 28.34$ 1,700.51$ 28.34$ 1,700.51$ 09053431 00 33.87$ 2,032.45$ 33.87$ 2,032.45$ 09053440 00 22.11$ 1,326.63$ 22.11$ 1,326.63$ 09053442 00 23.02$ 1,380.99$ 23.02$ 1,380.99$ 09053444 00 23.29$ 1,397.51$ 23.29$ 1,397.51$ 09053445 00 22.13$ 1,327.98$ 22.13$ 1,327.98$ 09053446 00 18.87$ 1,132.34$ 18.87$ 1,132.34$ 09053447 00 23.73$ 1,423.68$ 23.73$ 1,423.68$ 090



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

53448 00 37.56$ 2,253.34$ 37.56$ 2,253.34$ 09053449 00 17.98$ 1,078.54$ 17.98$ 1,078.54$ 09053450 00 12.03$ 721.60$ 12.03$ 721.60$ 09053460 00 13.46$ 807.78$ 13.46$ 807.78$ 09053500 00 21.87$ 1,312.26$ 21.87$ 1,312.26$ 09053502 00 14.29$ 857.67$ 14.29$ 857.67$ 09053505 00 14.28$ 857.04$ 14.28$ 857.04$ 09053510 00 18.56$ 1,113.67$ 18.56$ 1,113.67$ 09053515 00 23.36$ 1,401.77$ 23.36$ 1,401.77$ 09053520 00 16.39$ 983.25$ 16.39$ 983.25$ 09053600 00 2.44$ 146.50$ 1.86$ 111.82$ 00053601 00 2.35$ 140.96$ 1.57$ 94.29$ 00053605 00 1.89$ 113.44$ 1.89$ 113.44$ 00053620 00 3.89$ 233.31$ 2.55$ 153.22$ 00053621 00 3.66$ 219.75$ 2.12$ 127.05$ 00053660 00 2.05$ 122.99$ 1.22$ 73.17$ 00053661 00 2.02$ 121.07$ 1.19$ 71.25$ 00053665 00 1.13$ 67.91$ 1.13$ 67.91$ 00053850 00 47.41$ 2,844.62$ 10.30$ 617.97$ 09053852 00 45.87$ 2,751.99$ 11.07$ 664.07$ 09053854 00 54.35$ 3,261.18$ 11.09$ 665.63$ 09053855 00 22.80$ 1,367.70$ 2.42$ 144.97$ 00053860 00 55.18$ 3,310.67$ 6.58$ 394.77$ 09053899 00 By Report By Report YYY54000 00 4.53$ 271.85$ 3.21$ 192.39$ 01054001 00 5.59$ 335.17$ 4.09$ 245.62$ 01054015 00 9.06$ 543.54$ 9.06$ 543.54$ 01054050 00 3.91$ 234.87$ 3.13$ 187.58$ 01054055 00 3.59$ 215.51$ 2.75$ 165.06$ 01054056 00 4.15$ 249.29$ 3.26$ 195.69$ 01054057 00 4.10$ 245.76$ 2.82$ 169.46$ 01054060 00 5.44$ 326.55$ 3.83$ 230.07$ 01054065 00 6.48$ 388.76$ 5.07$ 304.26$ 01054100 00 5.81$ 348.66$ 3.66$ 219.38$ 00054105 00 7.86$ 471.72$ 6.26$ 375.87$ 01054110 00 18.35$ 1,101.16$ 18.35$ 1,101.16$ 09054111 00 23.50$ 1,409.91$ 23.50$ 1,409.91$ 09054112 00 27.53$ 1,651.85$ 27.53$ 1,651.85$ 09054115 00 13.35$ 801.06$ 12.50$ 749.98$ 09054120 00 18.58$ 1,114.63$ 18.58$ 1,114.63$ 09054125 00 23.92$ 1,435.07$ 23.92$ 1,435.07$ 09054130 00 35.02$ 2,101.42$ 35.02$ 2,101.42$ 090



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

54135 00 44.34$ 2,660.62$ 44.34$ 2,660.62$ 09054150 00 4.53$ 271.89$ 2.86$ 171.63$ 00054160 00 6.50$ 389.74$ 4.24$ 254.16$ 01054161 00 5.79$ 347.68$ 5.79$ 347.68$ 01054162 00 7.60$ 456.15$ 5.87$ 352.10$ 01054163 00 6.44$ 386.15$ 6.44$ 386.15$ 01054164 00 5.72$ 343.09$ 5.72$ 343.09$ 01054200 00 3.23$ 193.51$ 2.48$ 148.73$ 01054205 00 15.66$ 939.67$ 15.66$ 939.67$ 09054220 00 6.13$ 367.62$ 3.92$ 235.19$ 00054230 00 2.89$ 173.11$ 2.34$ 140.32$ 00054231 00 4.17$ 250.09$ 3.41$ 204.69$ 00054235 00 2.62$ 157.27$ 2.15$ 128.89$ 00054240 00 3.04$ 182.40$ 3.04$ 182.40$ 00054240 26 1.95$ 116.90$ 1.95$ 116.90$ 00054240 TC 1.09$ 65.50$ 1.09$ 65.50$ 00054250 00 3.56$ 213.39$ 3.56$ 213.39$ 00054250 26 3.20$ 192.03$ 3.20$ 192.03$ 00054250 TC 0.36$ 21.36$ 0.36$ 21.36$ 00054300 00 18.94$ 1,136.67$ 18.94$ 1,136.67$ 09054304 00 22.02$ 1,321.25$ 22.02$ 1,321.25$ 09054308 00 21.01$ 1,260.56$ 21.01$ 1,260.56$ 09054312 00 24.04$ 1,442.39$ 24.04$ 1,442.39$ 09054316 00 29.29$ 1,757.17$ 29.29$ 1,757.17$ 09054318 00 20.88$ 1,253.02$ 20.88$ 1,253.02$ 09054322 00 22.94$ 1,376.15$ 22.94$ 1,376.15$ 09054324 00 28.43$ 1,706.08$ 28.43$ 1,706.08$ 09054326 00 27.75$ 1,664.99$ 27.75$ 1,664.99$ 09054328 00 27.57$ 1,654.06$ 27.57$ 1,654.06$ 09054332 00 29.76$ 1,785.65$ 29.76$ 1,785.65$ 09054336 00 34.92$ 2,095.30$ 34.92$ 2,095.30$ 09054340 00 16.75$ 1,005.19$ 16.75$ 1,005.19$ 09054344 00 27.81$ 1,668.67$ 27.81$ 1,668.67$ 09054348 00 29.76$ 1,785.78$ 29.76$ 1,785.78$ 09054352 00 41.57$ 2,494.23$ 41.57$ 2,494.23$ 09054360 00 21.16$ 1,269.52$ 21.16$ 1,269.52$ 09054380 00 23.48$ 1,408.89$ 23.48$ 1,408.89$ 09054385 00 27.28$ 1,636.96$ 27.28$ 1,636.96$ 09054390 00 36.43$ 2,185.83$ 36.43$ 2,185.83$ 09054400 00 15.59$ 935.20$ 15.59$ 935.20$ 09054401 00 19.34$ 1,160.20$ 19.34$ 1,160.20$ 09054405 00 23.75$ 1,424.70$ 23.75$ 1,424.70$ 090



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

54406 00 21.46$ 1,287.36$ 21.46$ 1,287.36$ 09054408 00 23.22$ 1,393.36$ 23.22$ 1,393.36$ 09054410 00 25.27$ 1,516.37$ 25.27$ 1,516.37$ 09054411 00 30.15$ 1,808.74$ 30.15$ 1,808.74$ 09054415 00 15.56$ 933.59$ 15.56$ 933.59$ 09054416 00 20.93$ 1,255.60$ 20.93$ 1,255.60$ 09054417 00 26.40$ 1,583.70$ 26.40$ 1,583.70$ 09054420 00 20.68$ 1,240.60$ 20.68$ 1,240.60$ 09054430 00 18.83$ 1,129.64$ 18.83$ 1,129.64$ 09054435 00 12.25$ 734.74$ 12.25$ 734.74$ 09054437 00 19.81$ 1,188.79$ 19.81$ 1,188.79$ 09054438 00 39.27$ 2,356.17$ 39.27$ 2,356.17$ 09054440 00 By Report By Report 09054450 00 2.03$ 121.51$ 1.69$ 101.33$ 00054500 00 2.19$ 131.57$ 2.19$ 131.57$ 00054505 00 6.17$ 370.47$ 6.17$ 370.47$ 01054512 00 15.85$ 951.14$ 15.85$ 951.14$ 09054520 00 9.61$ 576.70$ 9.61$ 576.70$ 09054522 00 17.33$ 1,039.87$ 17.33$ 1,039.87$ 09054530 00 14.88$ 892.68$ 14.88$ 892.68$ 09054535 00 21.86$ 1,311.47$ 21.86$ 1,311.47$ 09054550 00 14.46$ 867.83$ 14.46$ 867.83$ 09054560 00 20.18$ 1,210.61$ 20.18$ 1,210.61$ 09054600 00 13.32$ 799.40$ 13.32$ 799.40$ 09054620 00 8.80$ 527.87$ 8.80$ 527.87$ 01054640 00 14.08$ 844.83$ 14.08$ 844.83$ 09054650 00 20.90$ 1,253.84$ 20.90$ 1,253.84$ 09054660 00 10.52$ 631.31$ 10.52$ 631.31$ 09054670 00 11.96$ 717.67$ 11.96$ 717.67$ 09054680 00 23.13$ 1,387.89$ 23.13$ 1,387.89$ 09054690 00 19.31$ 1,158.38$ 19.31$ 1,158.38$ 09054692 00 22.26$ 1,335.40$ 22.26$ 1,335.40$ 09054699 00 By Report By Report YYY54700 00 6.26$ 375.89$ 6.26$ 375.89$ 01054800 00 3.69$ 221.34$ 3.69$ 221.34$ 00054830 00 10.97$ 658.49$ 10.97$ 658.49$ 09054840 00 9.46$ 567.36$ 9.46$ 567.36$ 09054860 00 12.33$ 739.89$ 12.33$ 739.89$ 09054861 00 16.66$ 999.54$ 16.66$ 999.54$ 09054865 00 10.56$ 633.75$ 10.56$ 633.75$ 09054900 00 23.52$ 1,411.28$ 23.52$ 1,411.28$ 09054901 00 31.03$ 1,862.00$ 31.03$ 1,862.00$ 090



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

55000 00 3.43$ 205.50$ 2.49$ 149.38$ 00055040 00 9.94$ 596.66$ 9.94$ 596.66$ 09055041 00 15.02$ 901.13$ 15.02$ 901.13$ 09055060 00 11.21$ 672.38$ 11.21$ 672.38$ 09055100 00 6.45$ 387.09$ 4.90$ 293.76$ 01055110 00 11.40$ 683.72$ 11.40$ 683.72$ 09055120 00 10.42$ 625.05$ 10.42$ 625.05$ 09055150 00 14.47$ 868.19$ 14.47$ 868.19$ 09055175 00 10.69$ 641.44$ 10.69$ 641.44$ 09055180 00 20.24$ 1,214.34$ 20.24$ 1,214.34$ 09055200 00 12.48$ 748.98$ 8.18$ 491.06$ 09055250 00 11.01$ 660.33$ 6.72$ 403.05$ 09055300 00 5.49$ 329.48$ 5.49$ 329.48$ 00055400 00 14.66$ 879.76$ 14.66$ 879.76$ 09055500 00 11.61$ 696.45$ 11.61$ 696.45$ 09055520 00 13.29$ 797.56$ 13.29$ 797.56$ 09055530 00 10.35$ 621.03$ 10.35$ 621.03$ 09055535 00 12.67$ 759.91$ 12.67$ 759.91$ 09055540 00 16.18$ 970.66$ 16.18$ 970.66$ 09055550 00 12.61$ 756.73$ 12.61$ 756.73$ 09055559 00 By Report By Report YYY55600 00 12.40$ 744.15$ 12.40$ 744.15$ 09055605 00 15.36$ 921.46$ 15.36$ 921.46$ 09055650 00 21.06$ 1,263.64$ 21.06$ 1,263.64$ 09055680 00 10.19$ 611.39$ 10.19$ 611.39$ 09055700 00 7.34$ 440.27$ 3.82$ 229.02$ 00055705 00 7.80$ 468.21$ 7.80$ 468.21$ 01055706 00 10.97$ 657.96$ 10.97$ 657.96$ 01055720 00 13.29$ 797.19$ 13.29$ 797.19$ 09055725 00 17.47$ 1,048.12$ 17.47$ 1,048.12$ 09055801 00 32.13$ 1,927.63$ 32.13$ 1,927.63$ 09055810 00 38.53$ 2,311.69$ 38.53$ 2,311.69$ 09055812 00 47.21$ 2,832.33$ 47.21$ 2,832.33$ 09055815 00 51.72$ 3,102.91$ 51.72$ 3,102.91$ 09055821 00 25.65$ 1,538.80$ 25.65$ 1,538.80$ 09055831 00 27.74$ 1,664.55$ 27.74$ 1,664.55$ 09055840 00 34.39$ 2,063.18$ 34.39$ 2,063.18$ 09055842 00 34.42$ 2,064.90$ 34.42$ 2,064.90$ 09055845 00 40.02$ 2,401.04$ 40.02$ 2,401.04$ 09055860 00 25.70$ 1,541.74$ 25.70$ 1,541.74$ 09055862 00 32.19$ 1,931.17$ 32.19$ 1,931.17$ 09055865 00 39.18$ 2,350.95$ 39.18$ 2,350.95$ 090



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

55866 00 42.34$ 2,540.64$ 42.34$ 2,540.64$ 09055870 00 5.15$ 308.81$ 4.16$ 249.54$ 00055873 00 184.74$ 11,084.21$ 22.44$ 1,346.48$ 09055874 00 103.49$ 6,209.31$ 4.86$ 291.76$ 00055875 00 22.50$ 1,350.00$ 22.50$ 1,350.00$ 09055876 00 4.16$ 249.42$ 2.96$ 177.53$ 00055899 00 By Report By Report YYY55920 00 13.22$ 793.17$ 13.22$ 793.17$ 00055970 00 By Report By Report YYY55980 00 By Report By Report YYY56405 00 3.33$ 199.50$ 3.29$ 197.61$ 01056420 00 3.97$ 238.18$ 2.80$ 168.19$ 01056440 00 5.24$ 314.28$ 5.24$ 314.28$ 01056441 00 4.43$ 265.74$ 4.18$ 250.60$ 01056442 00 1.37$ 82.07$ 1.37$ 82.07$ 00056501 00 4.21$ 252.79$ 3.49$ 209.28$ 01056515 00 6.87$ 412.29$ 5.90$ 354.27$ 01056605 00 2.49$ 149.22$ 1.73$ 103.82$ 00056606 00 1.11$ 66.64$ 0.86$ 51.51$ ZZZ56620 00 15.77$ 946.41$ 15.77$ 946.41$ 09056625 00 18.84$ 1,130.47$ 18.84$ 1,130.47$ 09056630 00 27.58$ 1,654.79$ 27.58$ 1,654.79$ 09056631 00 34.84$ 2,090.58$ 34.84$ 2,090.58$ 09056632 00 41.16$ 2,469.57$ 41.16$ 2,469.57$ 09056633 00 35.75$ 2,144.99$ 35.75$ 2,144.99$ 09056634 00 38.53$ 2,311.61$ 38.53$ 2,311.61$ 09056637 00 44.36$ 2,661.43$ 44.36$ 2,661.43$ 09056640 00 45.20$ 2,711.93$ 45.20$ 2,711.93$ 09056700 00 5.49$ 329.16$ 5.49$ 329.16$ 01056740 00 8.79$ 527.63$ 8.79$ 527.63$ 01056800 00 7.04$ 422.20$ 7.04$ 422.20$ 01056805 00 32.98$ 1,978.67$ 32.98$ 1,978.67$ 09056810 00 7.61$ 456.80$ 7.61$ 456.80$ 01056820 00 3.35$ 200.95$ 2.49$ 149.24$ 00056821 00 4.45$ 267.13$ 3.32$ 199.03$ 00057000 00 5.55$ 332.86$ 5.55$ 332.86$ 01057010 00 12.67$ 760.10$ 12.67$ 760.10$ 09057020 00 2.82$ 169.29$ 2.32$ 139.03$ 00057022 00 4.95$ 296.74$ 4.95$ 296.74$ 01057023 00 8.97$ 538.42$ 8.97$ 538.42$ 01057061 00 3.62$ 217.19$ 2.99$ 179.35$ 01057065 00 6.01$ 360.57$ 5.17$ 310.12$ 010



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

57100 00 2.70$ 161.79$ 1.93$ 115.75$ 00057105 00 4.29$ 257.55$ 3.83$ 229.80$ 01057106 00 14.79$ 887.21$ 14.79$ 887.21$ 09057107 00 42.39$ 2,543.28$ 42.39$ 2,543.28$ 09057109 00 51.57$ 3,094.29$ 51.57$ 3,094.29$ 09057110 00 25.76$ 1,545.87$ 25.76$ 1,545.87$ 09057111 00 51.57$ 3,094.29$ 51.57$ 3,094.29$ 09057112 00 55.17$ 3,310.29$ 55.17$ 3,310.29$ 09057120 00 14.85$ 891.17$ 14.85$ 891.17$ 09057130 00 5.45$ 326.78$ 4.69$ 281.38$ 01057135 00 5.93$ 355.76$ 5.14$ 308.46$ 01057150 00 1.42$ 85.23$ 0.76$ 45.50$ 00057155 00 10.94$ 656.41$ 8.22$ 493.09$ 00057156 00 6.08$ 364.70$ 4.34$ 260.65$ 00057160 00 1.83$ 109.74$ 1.35$ 80.73$ 00057170 00 1.89$ 113.39$ 1.39$ 83.12$ 00057180 00 4.50$ 269.77$ 3.17$ 190.32$ 01057200 00 9.04$ 542.48$ 9.04$ 542.48$ 09057210 00 10.83$ 649.55$ 10.83$ 649.55$ 09057220 00 9.42$ 565.46$ 9.42$ 565.46$ 09057230 00 11.55$ 692.71$ 11.55$ 692.71$ 09057240 00 17.27$ 1,036.10$ 17.27$ 1,036.10$ 09057250 00 17.31$ 1,038.54$ 17.31$ 1,038.54$ 09057260 00 22.08$ 1,324.98$ 22.08$ 1,324.98$ 09057265 00 24.78$ 1,486.90$ 24.78$ 1,486.90$ 09057267 00 7.33$ 439.89$ 7.33$ 439.89$ ZZZ57268 00 14.19$ 851.46$ 14.19$ 851.46$ 09057270 00 23.35$ 1,401.21$ 23.35$ 1,401.21$ 09057280 00 27.66$ 1,659.37$ 27.66$ 1,659.37$ 09057282 00 14.83$ 889.78$ 14.83$ 889.78$ 09057283 00 19.93$ 1,195.65$ 19.93$ 1,195.65$ 09057284 00 23.68$ 1,420.74$ 23.68$ 1,420.74$ 09057285 00 19.58$ 1,174.61$ 19.58$ 1,174.61$ 09057287 00 20.31$ 1,218.61$ 20.31$ 1,218.61$ 09057288 00 20.97$ 1,258.04$ 20.97$ 1,258.04$ 09057289 00 22.13$ 1,327.91$ 22.13$ 1,327.91$ 09057291 00 15.38$ 922.69$ 15.38$ 922.69$ 09057292 00 23.50$ 1,410.00$ 23.50$ 1,410.00$ 09057295 00 14.01$ 840.52$ 14.01$ 840.52$ 09057296 00 27.28$ 1,636.96$ 27.28$ 1,636.96$ 09057300 00 16.75$ 1,005.00$ 16.75$ 1,005.00$ 09057305 00 27.67$ 1,660.01$ 27.67$ 1,660.01$ 090



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

57307 00 30.40$ 1,824.23$ 30.40$ 1,824.23$ 09057308 00 19.33$ 1,159.94$ 19.33$ 1,159.94$ 09057310 00 13.84$ 830.28$ 13.84$ 830.28$ 09057311 00 15.72$ 942.97$ 15.72$ 942.97$ 09057320 00 15.79$ 947.59$ 15.79$ 947.59$ 09057330 00 21.99$ 1,319.53$ 21.99$ 1,319.53$ 09057335 00 33.29$ 1,997.69$ 33.29$ 1,997.69$ 09057400 00 3.86$ 231.71$ 3.86$ 231.71$ 00057410 00 3.10$ 185.72$ 3.10$ 185.72$ 00057415 00 4.79$ 287.35$ 4.79$ 287.35$ 01057420 00 3.52$ 211.25$ 2.65$ 158.91$ 00057421 00 4.71$ 282.89$ 3.56$ 213.52$ 00057423 00 26.49$ 1,589.26$ 26.49$ 1,589.26$ 09057425 00 28.07$ 1,684.43$ 28.07$ 1,684.43$ 09057426 00 24.60$ 1,475.72$ 24.60$ 1,475.72$ 09057452 00 3.32$ 199.31$ 2.66$ 159.58$ 00057454 00 4.54$ 272.34$ 3.87$ 231.98$ 00057455 00 4.29$ 257.62$ 3.16$ 189.51$ 00057456 00 4.04$ 242.38$ 2.94$ 176.17$ 00057460 00 8.55$ 513.16$ 4.64$ 278.57$ 00057461 00 9.61$ 576.60$ 5.34$ 320.58$ 00057500 00 3.92$ 235.27$ 2.17$ 129.96$ 00057505 00 3.28$ 196.75$ 2.82$ 169.00$ 01057510 00 3.99$ 239.10$ 3.29$ 197.48$ 01057511 00 4.54$ 272.39$ 3.94$ 236.45$ 01057513 00 4.72$ 283.07$ 4.07$ 243.97$ 01057520 00 9.37$ 561.99$ 8.17$ 490.10$ 09057522 00 7.97$ 477.90$ 7.11$ 426.83$ 09057530 00 10.24$ 614.28$ 10.24$ 614.28$ 09057531 00 48.53$ 2,911.93$ 48.53$ 2,911.93$ 09057540 00 22.43$ 1,345.69$ 22.43$ 1,345.69$ 09057545 00 23.65$ 1,419.14$ 23.65$ 1,419.14$ 09057550 00 11.91$ 714.60$ 11.91$ 714.60$ 09057555 00 17.39$ 1,043.57$ 17.39$ 1,043.57$ 09057556 00 16.48$ 988.90$ 16.48$ 988.90$ 09057558 00 3.89$ 233.51$ 3.40$ 203.87$ 01057700 00 9.34$ 560.31$ 9.34$ 560.31$ 09057720 00 9.07$ 544.26$ 9.07$ 544.26$ 09057800 00 1.90$ 113.83$ 1.39$ 83.57$ 00058100 00 2.70$ 162.10$ 2.04$ 122.37$ 00058110 00 1.47$ 87.98$ 1.18$ 70.95$ ZZZ58120 00 7.83$ 469.66$ 6.45$ 387.05$ 010



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

58140 00 26.54$ 1,592.36$ 26.54$ 1,592.36$ 09058145 00 16.03$ 961.85$ 16.03$ 961.85$ 09058146 00 33.02$ 1,981.40$ 33.02$ 1,981.40$ 09058150 00 29.45$ 1,767.20$ 29.45$ 1,767.20$ 09058152 00 36.05$ 2,163.21$ 36.05$ 2,163.21$ 09058180 00 27.75$ 1,665.23$ 27.75$ 1,665.23$ 09058200 00 40.10$ 2,405.87$ 40.10$ 2,405.87$ 09058210 00 53.92$ 3,235.07$ 53.92$ 3,235.07$ 09058240 00 85.66$ 5,139.75$ 85.66$ 5,139.75$ 09058260 00 23.83$ 1,429.95$ 23.83$ 1,429.95$ 09058262 00 26.48$ 1,588.78$ 26.48$ 1,588.78$ 09058263 00 28.46$ 1,707.54$ 28.46$ 1,707.54$ 09058267 00 30.28$ 1,817.08$ 30.28$ 1,817.08$ 09058270 00 25.44$ 1,526.36$ 25.44$ 1,526.36$ 09058275 00 28.32$ 1,699.31$ 28.32$ 1,699.31$ 09058280 00 30.17$ 1,810.14$ 30.17$ 1,810.14$ 09058285 00 42.20$ 2,531.74$ 42.20$ 2,531.74$ 09058290 00 33.03$ 1,981.70$ 33.03$ 1,981.70$ 09058291 00 36.06$ 2,163.83$ 36.06$ 2,163.83$ 09058292 00 37.57$ 2,254.38$ 37.57$ 2,254.38$ 09058293 00 39.07$ 2,344.17$ 39.07$ 2,344.17$ 09058294 00 34.85$ 2,091.24$ 34.85$ 2,091.24$ 09058300 00 2.33$ 140.00$ 1.56$ 93.33$ XXX58301 00 2.76$ 165.73$ 1.93$ 115.91$ 00058321 00 2.26$ 135.43$ 1.40$ 83.73$ 00058322 00 2.53$ 151.83$ 1.67$ 100.12$ 00058323 00 0.44$ 26.27$ 0.35$ 21.23$ 00058340 00 4.65$ 278.77$ 1.67$ 100.31$ 00058345 00 8.07$ 484.03$ 8.07$ 484.03$ 01058346 00 13.54$ 812.13$ 13.54$ 812.13$ 09058350 00 3.16$ 189.85$ 2.40$ 143.82$ 01058353 00 29.28$ 1,756.65$ 6.38$ 382.57$ 01058356 00 54.42$ 3,265.19$ 9.96$ 597.76$ 01058400 00 12.92$ 775.47$ 12.92$ 775.47$ 09058410 00 23.13$ 1,388.01$ 23.13$ 1,388.01$ 09058520 00 22.65$ 1,358.90$ 22.65$ 1,358.90$ 09058540 00 26.09$ 1,565.37$ 26.09$ 1,565.37$ 09058541 00 20.66$ 1,239.89$ 20.66$ 1,239.89$ 09058542 00 23.63$ 1,417.85$ 23.63$ 1,417.85$ 09058543 00 23.89$ 1,433.28$ 23.89$ 1,433.28$ 09058544 00 25.89$ 1,553.38$ 25.89$ 1,553.38$ 09058545 00 25.96$ 1,557.33$ 25.96$ 1,557.33$ 090



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

58546 00 32.08$ 1,924.83$ 32.08$ 1,924.83$ 09058548 00 55.59$ 3,335.54$ 55.59$ 3,335.54$ 09058550 00 25.29$ 1,517.29$ 25.29$ 1,517.29$ 09058552 00 28.43$ 1,705.72$ 28.43$ 1,705.72$ 09058553 00 32.25$ 1,935.16$ 32.25$ 1,935.16$ 09058554 00 38.08$ 2,284.93$ 38.08$ 2,284.93$ 09058555 00 8.67$ 520.10$ 4.41$ 264.70$ 00058558 00 40.60$ 2,436.10$ 6.72$ 403.05$ 00058559 00 8.30$ 498.22$ 8.30$ 498.22$ 00058560 00 9.07$ 543.92$ 9.07$ 543.92$ 00058561 00 10.39$ 623.33$ 10.39$ 623.33$ 00058562 00 10.68$ 640.93$ 6.43$ 385.53$ 00058563 00 52.51$ 3,150.34$ 7.14$ 428.67$ 00058565 00 54.02$ 3,241.25$ 12.62$ 757.32$ 09058570 00 22.74$ 1,364.13$ 22.74$ 1,364.13$ 09058571 00 26.14$ 1,568.55$ 26.14$ 1,568.55$ 09058572 00 29.75$ 1,785.26$ 29.75$ 1,785.26$ 09058573 00 35.39$ 2,123.56$ 35.39$ 2,123.56$ 09058575 00 55.04$ 3,302.47$ 55.04$ 3,302.47$ 09058578 00 By Report By Report YYY58579 00 By Report By Report YYY58600 00 10.51$ 630.37$ 10.51$ 630.37$ 09058605 00 9.51$ 570.86$ 9.51$ 570.86$ 09058611 00 2.19$ 131.67$ 2.19$ 131.67$ ZZZ58615 00 7.07$ 424.32$ 7.07$ 424.32$ 01058660 00 19.46$ 1,167.70$ 19.46$ 1,167.70$ 09058661 00 18.78$ 1,126.79$ 18.78$ 1,126.79$ 01058662 00 20.49$ 1,229.53$ 20.49$ 1,229.53$ 09058670 00 10.51$ 630.45$ 10.51$ 630.45$ 09058671 00 10.52$ 631.00$ 10.52$ 631.00$ 09058672 00 20.99$ 1,259.43$ 20.99$ 1,259.43$ 09058673 00 22.82$ 1,368.93$ 22.82$ 1,368.93$ 09058674 00 23.35$ 1,400.91$ 23.35$ 1,400.91$ 09058679 00 By Report By Report YYY58700 00 22.67$ 1,360.11$ 22.67$ 1,360.11$ 09058720 00 21.59$ 1,295.59$ 21.59$ 1,295.59$ 09058740 00 25.86$ 1,551.87$ 25.86$ 1,551.87$ 09058750 00 25.87$ 1,552.39$ 25.87$ 1,552.39$ 09058752 00 25.80$ 1,547.98$ 25.80$ 1,547.98$ 09058760 00 23.28$ 1,397.05$ 23.28$ 1,397.05$ 09058770 00 24.50$ 1,469.71$ 24.50$ 1,469.71$ 09058800 00 9.55$ 573.24$ 8.71$ 522.79$ 090



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

58805 00 11.82$ 709.26$ 11.82$ 709.26$ 09058820 00 9.20$ 552.14$ 9.20$ 552.14$ 09058822 00 20.16$ 1,209.85$ 20.16$ 1,209.85$ 09058825 00 20.02$ 1,201.10$ 20.02$ 1,201.10$ 09058900 00 12.07$ 724.42$ 12.07$ 724.42$ 09058920 00 20.17$ 1,209.95$ 20.17$ 1,209.95$ 09058925 00 21.75$ 1,305.07$ 21.75$ 1,305.07$ 09058940 00 15.53$ 932.06$ 15.53$ 932.06$ 09058943 00 34.53$ 2,072.06$ 34.53$ 2,072.06$ 09058950 00 33.33$ 1,999.94$ 33.33$ 1,999.94$ 09058951 00 42.56$ 2,553.47$ 42.56$ 2,553.47$ 09058952 00 48.29$ 2,897.16$ 48.29$ 2,897.16$ 09058953 00 59.46$ 3,567.46$ 59.46$ 3,567.46$ 09058954 00 64.54$ 3,872.68$ 64.54$ 3,872.68$ 09058956 00 40.39$ 2,423.25$ 40.39$ 2,423.25$ 09058957 00 46.74$ 2,804.28$ 46.74$ 2,804.28$ 09058958 00 51.72$ 3,102.97$ 51.72$ 3,102.97$ 09058960 00 28.56$ 1,713.70$ 28.56$ 1,713.70$ 09058970 00 6.55$ 392.95$ 5.70$ 341.87$ 00058974 00 Not Covered Not Covered 00058976 00 7.18$ 431.02$ 6.14$ 368.59$ 00058999 00 By Report By Report YYY59000 00 3.61$ 216.39$ 2.35$ 140.72$ 00059001 00 5.18$ 310.55$ 5.18$ 310.55$ 00059012 00 5.85$ 350.74$ 5.85$ 350.74$ 00059015 00 4.52$ 271.50$ 3.80$ 227.99$ 00059020 00 2.04$ 122.44$ 2.04$ 122.44$ 00059020 26 1.06$ 63.88$ 1.06$ 63.88$ 00059020 TC 0.98$ 58.56$ 0.98$ 58.56$ 00059025 00 1.40$ 83.93$ 1.40$ 83.93$ 00059025 26 0.85$ 51.23$ 0.85$ 51.23$ 00059025 TC 0.55$ 32.71$ 0.55$ 32.71$ 00059030 00 3.26$ 195.53$ 3.26$ 195.53$ 00059050 00 1.46$ 87.84$ 1.46$ 87.84$ XXX59051 00 1.21$ 72.80$ 1.21$ 72.80$ XXX59070 00 11.71$ 702.31$ 8.96$ 537.72$ 00059072 00 15.12$ 907.09$ 15.12$ 907.09$ 00059074 00 11.26$ 675.82$ 8.96$ 537.72$ 00059076 00 15.12$ 907.09$ 15.12$ 907.09$ 00059100 00 24.37$ 1,461.95$ 24.37$ 1,461.95$ 09059120 00 23.21$ 1,392.75$ 23.21$ 1,392.75$ 09059121 00 23.24$ 1,394.29$ 23.24$ 1,394.29$ 090



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

59130 00 27.07$ 1,624.19$ 27.07$ 1,624.19$ 09059135 00 26.74$ 1,604.12$ 26.74$ 1,604.12$ 09059136 00 25.64$ 1,538.55$ 25.64$ 1,538.55$ 09059140 00 11.78$ 706.56$ 11.78$ 706.56$ 09059150 00 22.50$ 1,349.88$ 22.50$ 1,349.88$ 09059151 00 21.88$ 1,312.55$ 21.88$ 1,312.55$ 09059160 00 6.31$ 378.60$ 5.15$ 309.24$ 01059200 00 2.28$ 136.91$ 1.29$ 77.63$ 00059300 00 5.87$ 352.43$ 4.29$ 257.21$ 00059320 00 4.40$ 263.88$ 4.40$ 263.88$ 00059325 00 6.99$ 419.69$ 6.99$ 419.69$ 00059350 00 8.10$ 486.20$ 8.10$ 486.20$ 00059400 00 61.06$ 3,663.32$ 61.06$ 3,663.32$ MMM59409 00 23.47$ 1,408.08$ 23.47$ 1,408.08$ MMM59410 00 30.09$ 1,805.68$ 30.09$ 1,805.68$ MMM59412 00 2.97$ 178.00$ 2.97$ 178.00$ MMM59414 00 2.66$ 159.43$ 2.66$ 159.43$ MMM59425 00 13.38$ 802.59$ 10.24$ 614.67$ MMM59426 00 23.89$ 1,433.29$ 18.08$ 1,084.57$ MMM59430 00 5.67$ 340.25$ 3.99$ 239.36$ MMM59510 00 67.61$ 4,056.63$ 67.61$ 4,056.63$ MMM59514 00 26.42$ 1,585.24$ 26.42$ 1,585.24$ MMM59515 00 36.57$ 2,194.21$ 36.57$ 2,194.21$ MMM59525 00 14.00$ 839.91$ 14.00$ 839.91$ ZZZ59610 00 64.00$ 3,840.27$ 64.00$ 3,840.27$ MMM59612 00 26.41$ 1,584.71$ 26.41$ 1,584.71$ MMM59614 00 32.85$ 1,971.01$ 32.85$ 1,971.01$ MMM59618 00 68.48$ 4,108.85$ 68.48$ 4,108.85$ MMM59620 00 27.33$ 1,640.08$ 27.33$ 1,640.08$ MMM59622 00 37.66$ 2,259.82$ 37.66$ 2,259.82$ MMM59812 00 9.50$ 569.93$ 8.68$ 520.74$ 09059820 00 11.43$ 685.98$ 10.59$ 635.53$ 09059821 00 11.42$ 685.37$ 10.52$ 631.14$ 09059830 00 12.89$ 773.45$ 12.89$ 773.45$ 09059840 00 6.59$ 395.66$ 6.15$ 369.17$ 01059841 00 11.37$ 682.04$ 10.55$ 632.85$ 01059850 00 10.40$ 623.83$ 10.40$ 623.83$ 09059851 00 11.23$ 673.60$ 11.23$ 673.60$ 09059852 00 15.36$ 921.60$ 15.36$ 921.60$ 09059855 00 12.10$ 726.27$ 12.10$ 726.27$ 09059856 00 14.20$ 852.25$ 14.20$ 852.25$ 09059857 00 15.33$ 919.98$ 15.33$ 919.98$ 090



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

59866 00 6.33$ 379.59$ 6.33$ 379.59$ 00059870 00 14.25$ 854.93$ 14.25$ 854.93$ 09059871 00 3.86$ 231.49$ 3.86$ 231.49$ 00059897 00 By Report By Report YYY59898 00 By Report By Report YYY59899 00 By Report By Report YYY60000 00 5.01$ 300.88$ 4.47$ 268.09$ 0106005F 00 Code Accepted for Tracking Purpose only XXX60100 00 3.28$ 196.51$ 2.30$ 137.86$ 0006010F 00 Code Accepted for Tracking Purpose only XXX6015F 00 Code Accepted for Tracking Purpose only XXX60200 00 19.31$ 1,158.77$ 19.31$ 1,158.77$ 0906020F 00 Code Accepted for Tracking Purpose only XXX60210 00 20.62$ 1,236.99$ 20.62$ 1,236.99$ 09060212 00 29.40$ 1,763.80$ 29.40$ 1,763.80$ 09060220 00 20.59$ 1,235.12$ 20.59$ 1,235.12$ 09060225 00 27.11$ 1,626.77$ 27.11$ 1,626.77$ 09060240 00 26.76$ 1,605.70$ 26.76$ 1,605.70$ 09060252 00 38.42$ 2,305.31$ 38.42$ 2,305.31$ 09060254 00 48.66$ 2,919.46$ 48.66$ 2,919.46$ 09060260 00 31.81$ 1,908.45$ 31.81$ 1,908.45$ 09060270 00 39.82$ 2,389.01$ 39.82$ 2,389.01$ 09060271 00 30.78$ 1,847.08$ 30.78$ 1,847.08$ 09060280 00 12.94$ 776.61$ 12.94$ 776.61$ 09060281 00 17.12$ 1,027.33$ 17.12$ 1,027.33$ 09060300 00 3.38$ 202.78$ 1.46$ 87.38$ 0006030F 00 Code Accepted for Tracking Purpose only XXX6040F 00 Code Accepted for Tracking Purpose only XXX6045F 00 Code Accepted for Tracking Purpose only XXX60500 00 28.17$ 1,690.19$ 28.17$ 1,690.19$ 09060502 00 37.65$ 2,259.22$ 37.65$ 2,259.22$ 09060505 00 40.60$ 2,436.20$ 40.60$ 2,436.20$ 09060512 00 7.07$ 424.30$ 7.07$ 424.30$ ZZZ60520 00 30.45$ 1,826.96$ 30.45$ 1,826.96$ 09060521 00 32.62$ 1,957.33$ 32.62$ 1,957.33$ 09060522 00 39.76$ 2,385.81$ 39.76$ 2,385.81$ 09060540 00 31.19$ 1,871.49$ 31.19$ 1,871.49$ 09060545 00 35.68$ 2,140.98$ 35.68$ 2,140.98$ 09060600 00 39.83$ 2,389.98$ 39.83$ 2,389.98$ 09060605 00 48.00$ 2,879.82$ 48.00$ 2,879.82$ 09060650 00 34.81$ 2,088.53$ 34.81$ 2,088.53$ 09060659 00 By Report By Report YYY



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

60699 00 By Report By Report YYY6070F 00 Code Accepted for Tracking Purpose only XXX6080F 00 Code Accepted for Tracking Purpose only XXX6090F 00 Code Accepted for Tracking Purpose only XXX61000 00 3.34$ 200.45$ 3.34$ 200.45$ 00061001 00 3.17$ 190.30$ 3.17$ 190.30$ 0006100F 00 Code Accepted for Tracking Purpose only XXX6101F 00 Code Accepted for Tracking Purpose only XXX61020 00 2.90$ 174.15$ 2.90$ 174.15$ 00061026 00 3.09$ 185.28$ 3.09$ 185.28$ 0006102F 00 Code Accepted for Tracking Purpose only XXX61050 00 2.49$ 149.43$ 2.49$ 149.43$ 00061055 00 3.65$ 219.16$ 3.65$ 219.16$ 00061070 00 1.66$ 99.86$ 1.66$ 99.86$ 00061105 00 13.65$ 818.90$ 13.65$ 818.90$ 09061107 00 9.18$ 550.98$ 9.18$ 550.98$ 00061108 00 26.25$ 1,575.22$ 26.25$ 1,575.22$ 0906110F 00 Code Accepted for Tracking Purpose only XXX61120 00 22.04$ 1,322.18$ 22.04$ 1,322.18$ 09061140 00 37.12$ 2,227.19$ 37.12$ 2,227.19$ 09061150 00 39.92$ 2,395.00$ 39.92$ 2,395.00$ 09061151 00 29.31$ 1,758.33$ 29.31$ 1,758.33$ 09061154 00 37.34$ 2,240.55$ 37.34$ 2,240.55$ 09061156 00 36.63$ 2,197.70$ 36.63$ 2,197.70$ 09061210 00 10.83$ 649.88$ 10.83$ 649.88$ 00061215 00 15.05$ 902.83$ 15.05$ 902.83$ 09061250 00 25.55$ 1,532.81$ 25.55$ 1,532.81$ 09061253 00 29.31$ 1,758.33$ 29.31$ 1,758.33$ 09061304 00 48.29$ 2,897.57$ 48.29$ 2,897.57$ 09061305 00 59.25$ 3,555.18$ 59.25$ 3,555.18$ 09061312 00 61.00$ 3,660.08$ 61.00$ 3,660.08$ 09061313 00 58.21$ 3,492.86$ 58.21$ 3,492.86$ 09061314 00 53.45$ 3,207.12$ 53.45$ 3,207.12$ 09061315 00 60.58$ 3,634.68$ 60.58$ 3,634.68$ 09061316 00 2.59$ 155.58$ 2.59$ 155.58$ ZZZ61320 00 55.70$ 3,341.73$ 55.70$ 3,341.73$ 09061321 00 62.80$ 3,768.08$ 62.80$ 3,768.08$ 09061322 00 69.89$ 4,193.12$ 69.89$ 4,193.12$ 09061323 00 69.92$ 4,194.96$ 69.92$ 4,194.96$ 09061330 00 52.93$ 3,175.84$ 52.93$ 3,175.84$ 09061333 00 59.72$ 3,582.90$ 59.72$ 3,582.90$ 09061340 00 42.57$ 2,554.24$ 42.57$ 2,554.24$ 090



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

61343 00 64.21$ 3,852.80$ 64.21$ 3,852.80$ 09061345 00 60.21$ 3,612.73$ 60.21$ 3,612.73$ 09061450 00 56.69$ 3,401.53$ 56.69$ 3,401.53$ 09061458 00 59.02$ 3,541.21$ 59.02$ 3,541.21$ 09061460 00 62.11$ 3,726.32$ 62.11$ 3,726.32$ 09061500 00 38.50$ 2,310.23$ 38.50$ 2,310.23$ 09061501 00 33.48$ 2,009.03$ 33.48$ 2,009.03$ 0906150F 00 Code Accepted for Tracking Purpose only XXX61510 00 64.30$ 3,857.90$ 64.30$ 3,857.90$ 09061512 00 74.93$ 4,496.03$ 74.93$ 4,496.03$ 09061514 00 56.11$ 3,366.35$ 56.11$ 3,366.35$ 09061516 00 54.63$ 3,277.98$ 54.63$ 3,277.98$ 09061517 00 2.58$ 154.98$ 2.58$ 154.98$ ZZZ61518 00 81.19$ 4,871.47$ 81.19$ 4,871.47$ 09061519 00 86.82$ 5,209.05$ 86.82$ 5,209.05$ 09061520 00 110.51$ 6,630.74$ 110.51$ 6,630.74$ 09061521 00 94.24$ 5,654.25$ 94.24$ 5,654.25$ 09061522 00 64.55$ 3,872.85$ 64.55$ 3,872.85$ 09061524 00 61.44$ 3,686.32$ 61.44$ 3,686.32$ 09061526 00 98.42$ 5,905.45$ 98.42$ 5,905.45$ 09061530 00 91.06$ 5,463.34$ 91.06$ 5,463.34$ 09061531 00 36.04$ 2,162.42$ 36.04$ 2,162.42$ 09061533 00 44.60$ 2,675.96$ 44.60$ 2,675.96$ 09061534 00 48.57$ 2,914.24$ 48.57$ 2,914.24$ 09061535 00 29.50$ 1,769.84$ 29.50$ 1,769.84$ 09061536 00 76.17$ 4,570.38$ 76.17$ 4,570.38$ 09061537 00 72.50$ 4,350.13$ 72.50$ 4,350.13$ 09061538 00 78.84$ 4,730.26$ 78.84$ 4,730.26$ 09061539 00 69.71$ 4,182.43$ 69.71$ 4,182.43$ 09061540 00 64.37$ 3,862.20$ 64.37$ 3,862.20$ 09061541 00 63.41$ 3,804.69$ 63.41$ 3,804.69$ 09061543 00 64.12$ 3,847.08$ 64.12$ 3,847.08$ 09061544 00 56.08$ 3,365.01$ 56.08$ 3,365.01$ 09061545 00 94.29$ 5,657.17$ 94.29$ 5,657.17$ 09061546 00 68.10$ 4,086.26$ 68.10$ 4,086.26$ 09061548 00 46.05$ 2,763.13$ 46.05$ 2,763.13$ 09061550 00 35.00$ 2,100.00$ 35.00$ 2,100.00$ 09061552 00 43.68$ 2,620.51$ 43.68$ 2,620.51$ 09061556 00 50.29$ 3,017.32$ 50.29$ 3,017.32$ 09061557 00 49.58$ 2,974.97$ 49.58$ 2,974.97$ 09061558 00 55.41$ 3,324.85$ 55.41$ 3,324.85$ 09061559 00 70.65$ 4,238.89$ 70.65$ 4,238.89$ 090



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

61563 00 58.43$ 3,506.01$ 58.43$ 3,506.01$ 09061564 00 71.04$ 4,262.26$ 71.04$ 4,262.26$ 09061566 00 66.27$ 3,976.40$ 66.27$ 3,976.40$ 09061567 00 75.60$ 4,536.30$ 75.60$ 4,536.30$ 09061570 00 55.11$ 3,306.54$ 55.11$ 3,306.54$ 09061571 00 58.69$ 3,521.28$ 58.69$ 3,521.28$ 09061575 00 73.99$ 4,439.48$ 73.99$ 4,439.48$ 09061576 00 124.81$ 7,488.59$ 124.81$ 7,488.59$ 09061580 00 71.51$ 4,290.45$ 71.51$ 4,290.45$ 09061581 00 77.57$ 4,654.49$ 77.57$ 4,654.49$ 09061582 00 90.07$ 5,404.25$ 90.07$ 5,404.25$ 09061583 00 84.83$ 5,089.62$ 84.83$ 5,089.62$ 09061584 00 84.31$ 5,058.55$ 84.31$ 5,058.55$ 09061585 00 95.69$ 5,741.57$ 95.69$ 5,741.57$ 09061586 00 72.30$ 4,337.93$ 72.30$ 4,337.93$ 09061590 00 89.32$ 5,359.05$ 89.32$ 5,359.05$ 09061591 00 90.18$ 5,411.07$ 90.18$ 5,411.07$ 09061592 00 93.15$ 5,588.89$ 93.15$ 5,588.89$ 09061595 00 69.03$ 4,141.65$ 69.03$ 4,141.65$ 09061596 00 71.19$ 4,271.15$ 71.19$ 4,271.15$ 09061597 00 85.97$ 5,157.92$ 85.97$ 5,157.92$ 09061598 00 84.06$ 5,043.75$ 84.06$ 5,043.75$ 09061600 00 62.50$ 3,749.78$ 62.50$ 3,749.78$ 09061601 00 70.71$ 4,242.30$ 70.71$ 4,242.30$ 09061605 00 63.18$ 3,790.88$ 63.18$ 3,790.88$ 09061606 00 86.24$ 5,174.12$ 86.24$ 5,174.12$ 09061607 00 78.56$ 4,713.40$ 78.56$ 4,713.40$ 09061608 00 96.10$ 5,766.23$ 96.10$ 5,766.23$ 09061611 00 13.84$ 830.37$ 13.84$ 830.37$ ZZZ61613 00 97.31$ 5,838.77$ 97.31$ 5,838.77$ 09061615 00 82.90$ 4,974.07$ 82.90$ 4,974.07$ 09061616 00 97.91$ 5,874.62$ 97.91$ 5,874.62$ 09061618 00 37.80$ 2,268.15$ 37.80$ 2,268.15$ 09061619 00 41.73$ 2,503.64$ 41.73$ 2,503.64$ 09061623 00 16.65$ 998.82$ 16.65$ 998.82$ 00061624 00 33.78$ 2,026.64$ 33.78$ 2,026.64$ 00061626 00 25.74$ 1,544.16$ 25.74$ 1,544.16$ 00061630 00 40.81$ 2,448.53$ 40.81$ 2,448.53$ XXX61635 00 42.84$ 2,570.25$ 42.84$ 2,570.25$ XXX61640 00 13.96$ 837.49$ 13.96$ 837.49$ 00061641 00 4.90$ 294.13$ 4.90$ 294.13$ ZZZ61642 00 9.80$ 588.26$ 9.80$ 588.26$ ZZZ



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

61645 00 24.42$ 1,465.06$ 24.42$ 1,465.06$ 00061650 00 16.14$ 968.55$ 16.14$ 968.55$ 00061651 00 7.02$ 421.34$ 7.02$ 421.34$ ZZZ61680 00 66.26$ 3,975.34$ 66.26$ 3,975.34$ 09061682 00 123.34$ 7,400.20$ 123.34$ 7,400.20$ 09061684 00 84.08$ 5,045.01$ 84.08$ 5,045.01$ 09061686 00 136.59$ 8,195.48$ 136.59$ 8,195.48$ 09061690 00 64.45$ 3,867.10$ 64.45$ 3,867.10$ 09061692 00 108.70$ 6,521.97$ 108.70$ 6,521.97$ 09061697 00 125.34$ 7,520.42$ 125.34$ 7,520.42$ 09061698 00 140.58$ 8,434.83$ 140.58$ 8,434.83$ 09061700 00 100.78$ 6,046.55$ 100.78$ 6,046.55$ 09061702 00 120.01$ 7,200.84$ 120.01$ 7,200.84$ 09061703 00 40.06$ 2,403.79$ 40.06$ 2,403.79$ 09061705 00 76.90$ 4,614.01$ 76.90$ 4,614.01$ 09061708 00 75.22$ 4,513.50$ 75.22$ 4,513.50$ 09061710 00 63.45$ 3,806.86$ 63.45$ 3,806.86$ 09061711 00 75.92$ 4,554.98$ 75.92$ 4,554.98$ 09061720 00 37.45$ 2,247.17$ 37.45$ 2,247.17$ 09061735 00 46.93$ 2,815.51$ 46.93$ 2,815.51$ 09061750 00 41.53$ 2,491.99$ 41.53$ 2,491.99$ 09061751 00 40.65$ 2,439.09$ 40.65$ 2,439.09$ 09061760 00 46.16$ 2,769.79$ 46.16$ 2,769.79$ 09061770 00 47.87$ 2,872.20$ 47.87$ 2,872.20$ 09061781 00 6.93$ 415.53$ 6.93$ 415.53$ ZZZ61782 00 5.07$ 304.41$ 5.07$ 304.41$ ZZZ61783 00 6.80$ 408.21$ 6.80$ 408.21$ ZZZ61790 00 25.93$ 1,555.86$ 25.93$ 1,555.86$ 09061791 00 33.16$ 1,989.52$ 33.16$ 1,989.52$ 09061796 00 29.86$ 1,791.75$ 29.86$ 1,791.75$ 09061797 00 6.46$ 387.81$ 6.46$ 387.81$ ZZZ61798 00 40.66$ 2,439.55$ 40.66$ 2,439.55$ 09061799 00 8.96$ 537.32$ 8.96$ 537.32$ ZZZ61800 00 4.52$ 271.50$ 4.52$ 271.50$ ZZZ61850 00 28.98$ 1,739.04$ 28.98$ 1,739.04$ 09061860 00 46.14$ 2,768.15$ 46.14$ 2,768.15$ 09061863 00 44.16$ 2,649.30$ 44.16$ 2,649.30$ 09061864 00 8.34$ 500.31$ 8.34$ 500.31$ ZZZ61867 00 66.99$ 4,019.59$ 66.99$ 4,019.59$ 09061868 00 14.69$ 881.50$ 14.69$ 881.50$ ZZZ61870 00 34.91$ 2,094.75$ 34.91$ 2,094.75$ 09061880 00 16.84$ 1,010.56$ 16.84$ 1,010.56$ 090



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

61885 00 15.16$ 909.42$ 15.16$ 909.42$ 09061886 00 25.06$ 1,503.45$ 25.06$ 1,503.45$ 09061888 00 11.65$ 698.81$ 11.65$ 698.81$ 01062000 00 30.39$ 1,823.24$ 30.39$ 1,823.24$ 09062005 00 37.47$ 2,248.32$ 37.47$ 2,248.32$ 09062010 00 45.20$ 2,712.06$ 45.20$ 2,712.06$ 09062100 00 46.63$ 2,798.08$ 46.63$ 2,798.08$ 09062115 00 49.40$ 2,964.11$ 49.40$ 2,964.11$ 09062117 00 57.92$ 3,475.04$ 57.92$ 3,475.04$ 09062120 00 62.62$ 3,757.11$ 62.62$ 3,757.11$ 09062121 00 46.27$ 2,776.27$ 46.27$ 2,776.27$ 09062140 00 30.14$ 1,808.35$ 30.14$ 1,808.35$ 09062141 00 33.39$ 2,003.20$ 33.39$ 2,003.20$ 09062142 00 25.98$ 1,558.88$ 25.98$ 1,558.88$ 09062143 00 30.55$ 1,832.80$ 30.55$ 1,832.80$ 09062145 00 41.19$ 2,471.60$ 41.19$ 2,471.60$ 09062146 00 34.51$ 2,070.37$ 34.51$ 2,070.37$ 09062147 00 42.16$ 2,529.71$ 42.16$ 2,529.71$ 09062148 00 3.72$ 223.17$ 3.72$ 223.17$ ZZZ62160 00 5.59$ 335.61$ 5.59$ 335.61$ ZZZ62161 00 44.30$ 2,658.05$ 44.30$ 2,658.05$ 09062162 00 55.74$ 3,344.43$ 55.74$ 3,344.43$ 09062163 00 36.13$ 2,168.00$ 36.13$ 2,168.00$ 09062164 00 61.65$ 3,699.28$ 61.65$ 3,699.28$ 09062165 00 44.91$ 2,694.63$ 44.91$ 2,694.63$ 09062180 00 47.19$ 2,831.10$ 47.19$ 2,831.10$ 09062190 00 27.28$ 1,637.00$ 27.28$ 1,637.00$ 09062192 00 28.76$ 1,725.35$ 28.76$ 1,725.35$ 09062194 00 14.40$ 864.16$ 14.40$ 864.16$ 01062200 00 40.57$ 2,434.44$ 40.57$ 2,434.44$ 09062201 00 35.58$ 2,134.53$ 35.58$ 2,134.53$ 09062220 00 29.43$ 1,765.58$ 29.43$ 1,765.58$ 09062223 00 30.57$ 1,834.32$ 30.57$ 1,834.32$ 09062225 00 15.54$ 932.56$ 15.54$ 932.56$ 09062230 00 24.69$ 1,481.67$ 24.69$ 1,481.67$ 09062252 00 2.39$ 143.30$ 2.39$ 143.30$ XXX62252 26 1.35$ 80.95$ 1.35$ 80.95$ XXX62252 TC 1.04$ 62.35$ 1.04$ 62.35$ XXX62256 00 17.70$ 1,062.25$ 17.70$ 1,062.25$ 09062258 00 32.72$ 1,962.90$ 32.72$ 1,962.90$ 09062263 00 17.72$ 1,063.33$ 9.10$ 546.24$ 01062264 00 12.60$ 756.08$ 7.00$ 419.97$ 010



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

62267 00 7.55$ 452.85$ 4.62$ 276.92$ 00062268 00 7.51$ 450.41$ 7.51$ 450.41$ 00062269 00 7.78$ 466.50$ 7.78$ 466.50$ 00062270 00 4.35$ 261.07$ 2.26$ 135.58$ 00062272 00 5.75$ 345.24$ 2.43$ 145.97$ 00062273 00 5.06$ 303.74$ 3.31$ 198.43$ 00062280 00 9.75$ 585.18$ 4.82$ 289.43$ 01062281 00 7.15$ 428.76$ 4.67$ 279.94$ 01062282 00 8.94$ 536.26$ 4.24$ 254.39$ 01062284 00 5.80$ 348.03$ 2.57$ 154.44$ 00062287 00 17.03$ 1,021.78$ 17.03$ 1,021.78$ 09062290 00 9.95$ 596.71$ 4.89$ 293.39$ 00062291 00 9.59$ 575.59$ 4.73$ 283.62$ 00062292 00 16.80$ 1,008.08$ 16.80$ 1,008.08$ 09062294 00 27.97$ 1,678.24$ 27.97$ 1,678.24$ 09062302 00 7.37$ 442.03$ 3.56$ 213.75$ 00062303 00 7.54$ 452.12$ 3.56$ 213.75$ 00062304 00 7.27$ 436.46$ 3.50$ 210.07$ 00062305 00 7.91$ 474.58$ 3.65$ 219.19$ 00062320 00 4.82$ 289.13$ 2.90$ 173.73$ 00062321 00 7.45$ 447.03$ 3.12$ 187.22$ 00062322 00 4.50$ 269.77$ 2.50$ 149.95$ 00062323 00 7.37$ 442.37$ 2.89$ 173.10$ 00062324 00 4.23$ 253.67$ 2.63$ 157.82$ 00062325 00 6.89$ 413.42$ 3.12$ 187.04$ 00062326 00 4.40$ 264.04$ 2.59$ 155.58$ 00062327 00 6.93$ 415.63$ 2.82$ 169.06$ 00062328 00 7.69$ 461.41$ 2.60$ 156.07$ 00062329 00 9.53$ 571.58$ 3.25$ 195.15$ 00062350 00 11.67$ 699.92$ 11.67$ 699.92$ 01062351 00 25.19$ 1,511.26$ 25.19$ 1,511.26$ 09062355 00 7.87$ 471.99$ 7.87$ 471.99$ 01062360 00 9.27$ 556.25$ 9.27$ 556.25$ 01062361 00 12.63$ 757.88$ 12.63$ 757.88$ 01062362 00 11.20$ 671.74$ 11.20$ 671.74$ 01062365 00 8.66$ 519.40$ 8.66$ 519.40$ 01062367 00 1.17$ 70.23$ 0.73$ 43.74$ XXX62368 00 1.61$ 96.69$ 1.02$ 61.37$ XXX62369 00 3.47$ 208.30$ 1.02$ 61.37$ XXX62370 00 3.60$ 215.82$ 1.35$ 80.88$ XXX62380 00 By Report By Report 09063001 00 36.29$ 2,177.10$ 36.29$ 2,177.10$ 090



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

63003 00 36.25$ 2,174.75$ 36.25$ 2,174.75$ 09063005 00 34.73$ 2,083.79$ 34.73$ 2,083.79$ 09063011 00 32.00$ 1,920.24$ 32.00$ 1,920.24$ 09063012 00 34.93$ 2,095.99$ 34.93$ 2,095.99$ 09063015 00 43.44$ 2,606.39$ 43.44$ 2,606.39$ 09063016 00 44.64$ 2,678.30$ 44.64$ 2,678.30$ 09063017 00 36.95$ 2,216.92$ 36.95$ 2,216.92$ 09063020 00 33.99$ 2,039.44$ 33.99$ 2,039.44$ 09063030 00 28.50$ 1,709.85$ 28.50$ 1,709.85$ 09063035 00 5.60$ 335.94$ 5.60$ 335.94$ ZZZ63040 00 40.79$ 2,447.35$ 40.79$ 2,447.35$ 09063042 00 37.99$ 2,279.44$ 37.99$ 2,279.44$ 09063043 00 417.14$ 417.14$ ZZZ63044 00 388.70$ 388.70$ ZZZ63045 00 37.67$ 2,259.93$ 37.67$ 2,259.93$ 09063046 00 35.95$ 2,156.75$ 35.95$ 2,156.75$ 09063047 00 32.29$ 1,937.15$ 32.29$ 1,937.15$ 09063048 00 6.19$ 371.39$ 6.19$ 371.39$ ZZZ63050 00 43.86$ 2,631.30$ 43.86$ 2,631.30$ 09063051 00 50.09$ 3,005.22$ 50.09$ 3,005.22$ 09063055 00 47.72$ 2,863.32$ 47.72$ 2,863.32$ 09063056 00 43.60$ 2,616.10$ 43.60$ 2,616.10$ 09063057 00 9.35$ 560.90$ 9.35$ 560.90$ ZZZ63064 00 52.17$ 3,129.99$ 52.17$ 3,129.99$ 09063066 00 6.07$ 364.37$ 6.07$ 364.37$ ZZZ63075 00 39.60$ 2,376.11$ 39.60$ 2,376.11$ 09063076 00 7.22$ 433.19$ 7.22$ 433.19$ ZZZ63077 00 44.55$ 2,672.95$ 44.55$ 2,672.95$ 09063078 00 6.11$ 366.76$ 6.11$ 366.76$ ZZZ63081 00 51.49$ 3,089.51$ 51.49$ 3,089.51$ 09063082 00 7.79$ 467.56$ 7.79$ 467.56$ ZZZ63085 00 56.33$ 3,379.68$ 56.33$ 3,379.68$ 09063086 00 5.60$ 335.75$ 5.60$ 335.75$ ZZZ63087 00 70.69$ 4,241.62$ 70.69$ 4,241.62$ 09063088 00 7.56$ 453.45$ 7.56$ 453.45$ ZZZ63090 00 57.47$ 3,448.09$ 57.47$ 3,448.09$ 09063091 00 5.21$ 312.53$ 5.21$ 312.53$ ZZZ63101 00 68.17$ 4,090.30$ 68.17$ 4,090.30$ 09063102 00 66.55$ 3,992.72$ 66.55$ 3,992.72$ 09063103 00 8.62$ 517.20$ 8.62$ 517.20$ ZZZ63170 00 46.96$ 2,817.64$ 46.96$ 2,817.64$ 09063172 00 40.66$ 2,439.86$ 40.66$ 2,439.86$ 090



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

63173 00 50.90$ 3,053.83$ 50.90$ 3,053.83$ 09063180 00 43.83$ 2,629.84$ 43.83$ 2,629.84$ 09063182 00 48.11$ 2,886.40$ 48.11$ 2,886.40$ 09063185 00 33.58$ 2,014.76$ 33.58$ 2,014.76$ 09063190 00 36.59$ 2,195.14$ 36.59$ 2,195.14$ 09063191 00 40.67$ 2,440.27$ 40.67$ 2,440.27$ 09063194 00 47.11$ 2,826.45$ 47.11$ 2,826.45$ 09063195 00 45.26$ 2,715.90$ 45.26$ 2,715.90$ 09063196 00 52.53$ 3,152.04$ 52.53$ 3,152.04$ 09063197 00 50.46$ 3,027.52$ 50.46$ 3,027.52$ 09063198 00 61.69$ 3,701.34$ 61.69$ 3,701.34$ 09063199 00 64.63$ 3,877.78$ 64.63$ 3,877.78$ 09063200 00 44.91$ 2,694.80$ 44.91$ 2,694.80$ 09063250 00 87.83$ 5,269.79$ 87.83$ 5,269.79$ 09063251 00 89.79$ 5,387.18$ 89.79$ 5,387.18$ 09063252 00 89.77$ 5,386.02$ 89.77$ 5,386.02$ 09063265 00 48.87$ 2,932.41$ 48.87$ 2,932.41$ 09063266 00 50.50$ 3,029.74$ 50.50$ 3,029.74$ 09063267 00 40.12$ 2,407.15$ 40.12$ 2,407.15$ 09063268 00 41.46$ 2,487.54$ 41.46$ 2,487.54$ 09063270 00 61.25$ 3,674.99$ 61.25$ 3,674.99$ 09063271 00 60.60$ 3,635.75$ 60.60$ 3,635.75$ 09063272 00 55.41$ 3,324.87$ 55.41$ 3,324.87$ 09063273 00 55.03$ 3,301.76$ 55.03$ 3,301.76$ 09063275 00 52.82$ 3,169.30$ 52.82$ 3,169.30$ 09063276 00 52.48$ 3,148.97$ 52.48$ 3,148.97$ 09063277 00 45.64$ 2,738.12$ 45.64$ 2,738.12$ 09063278 00 46.89$ 2,813.16$ 46.89$ 2,813.16$ 09063280 00 62.12$ 3,726.95$ 62.12$ 3,726.95$ 09063281 00 61.41$ 3,684.50$ 61.41$ 3,684.50$ 09063282 00 57.90$ 3,473.96$ 57.90$ 3,473.96$ 09063283 00 56.05$ 3,363.07$ 56.05$ 3,363.07$ 09063285 00 77.28$ 4,637.01$ 77.28$ 4,637.01$ 09063286 00 75.79$ 4,547.14$ 75.79$ 4,547.14$ 09063287 00 81.13$ 4,867.62$ 81.13$ 4,867.62$ 09063290 00 82.53$ 4,951.77$ 82.53$ 4,951.77$ 09063295 00 9.79$ 587.48$ 9.79$ 587.48$ ZZZ63300 00 53.87$ 3,231.91$ 53.87$ 3,231.91$ 09063301 00 65.07$ 3,904.22$ 65.07$ 3,904.22$ 09063302 00 64.29$ 3,857.62$ 64.29$ 3,857.62$ 09063303 00 63.48$ 3,808.57$ 63.48$ 3,808.57$ 09063304 00 69.36$ 4,161.89$ 69.36$ 4,161.89$ 090



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

63305 00 73.87$ 4,432.02$ 73.87$ 4,432.02$ 09063306 00 72.57$ 4,354.26$ 72.57$ 4,354.26$ 09063307 00 71.07$ 4,264.00$ 71.07$ 4,264.00$ 09063308 00 9.47$ 567.91$ 9.47$ 567.91$ ZZZ63600 00 32.18$ 1,930.66$ 32.18$ 1,930.66$ 09063610 00 17.14$ 1,028.66$ 17.14$ 1,028.66$ 00063620 00 33.00$ 1,980.20$ 33.00$ 1,980.20$ 09063621 00 7.46$ 447.51$ 7.46$ 447.51$ ZZZ63650 00 47.92$ 2,875.34$ 12.02$ 721.21$ 01063655 00 24.35$ 1,460.91$ 24.35$ 1,460.91$ 09063661 00 18.07$ 1,084.10$ 9.46$ 567.64$ 01063662 00 24.65$ 1,479.04$ 24.65$ 1,479.04$ 09063663 00 24.17$ 1,450.07$ 13.14$ 788.57$ 01063664 00 25.54$ 1,532.31$ 25.54$ 1,532.31$ 09063685 00 10.56$ 633.53$ 10.56$ 633.53$ 01063688 00 10.89$ 653.22$ 10.89$ 653.22$ 01063700 00 38.38$ 2,302.92$ 38.38$ 2,302.92$ 09063702 00 42.00$ 2,520.10$ 42.00$ 2,520.10$ 09063704 00 48.77$ 2,926.04$ 48.77$ 2,926.04$ 09063706 00 54.22$ 3,253.19$ 54.22$ 3,253.19$ 09063707 00 27.24$ 1,634.53$ 27.24$ 1,634.53$ 09063709 00 32.35$ 1,941.05$ 32.35$ 1,941.05$ 09063710 00 31.90$ 1,913.90$ 31.90$ 1,913.90$ 09063740 00 28.75$ 1,725.11$ 28.75$ 1,725.11$ 09063741 00 19.88$ 1,192.63$ 19.88$ 1,192.63$ 09063744 00 19.68$ 1,180.57$ 19.68$ 1,180.57$ 09063746 00 17.76$ 1,065.49$ 17.76$ 1,065.49$ 09064400 00 4.00$ 239.71$ 2.10$ 126.20$ 00064405 00 2.42$ 145.35$ 1.55$ 93.01$ 00064408 00 3.44$ 206.69$ 2.49$ 149.30$ 00064415 00 3.47$ 208.32$ 1.88$ 113.10$ 00064416 00 2.30$ 137.93$ 2.30$ 137.93$ 00064417 00 3.87$ 232.38$ 2.04$ 122.66$ 00064418 00 2.78$ 167.05$ 1.66$ 99.57$ 00064420 00 3.24$ 194.67$ 1.95$ 117.11$ 00064421 00 4.60$ 275.74$ 2.68$ 160.97$ ZZZ64425 00 4.03$ 241.88$ 2.76$ 165.58$ 00064430 00 4.27$ 256.13$ 2.33$ 140.10$ 00064435 00 4.12$ 247.07$ 2.38$ 143.02$ 00064445 00 4.00$ 240.23$ 2.11$ 126.72$ 00064446 00 2.30$ 137.93$ 2.30$ 137.93$ 00064447 00 3.56$ 213.31$ 1.93$ 115.57$ 000



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

64448 00 2.07$ 123.98$ 2.07$ 123.98$ 00064449 00 2.46$ 147.68$ 2.46$ 147.68$ 00064450 00 2.26$ 135.58$ 1.30$ 78.19$ 00064451 00 6.23$ 373.74$ 2.31$ 138.87$ 00064454 00 6.29$ 377.55$ 2.39$ 143.31$ 00064455 00 1.39$ 83.32$ 1.01$ 60.62$ 00064461 00 4.07$ 244.03$ 2.35$ 141.24$ 00064462 00 2.25$ 135.14$ 1.49$ 89.10$ ZZZ64463 00 5.29$ 317.34$ 2.44$ 146.44$ 00064479 00 7.18$ 430.68$ 3.83$ 229.52$ 00064480 00 3.53$ 211.56$ 1.82$ 109.40$ ZZZ64483 00 6.67$ 399.94$ 3.25$ 195.00$ 00064484 00 2.88$ 172.69$ 1.51$ 90.71$ ZZZ64486 00 3.21$ 192.63$ 1.62$ 97.41$ 00064487 00 4.64$ 278.31$ 1.88$ 113.10$ 00064488 00 3.94$ 236.30$ 2.04$ 122.16$ 00064489 00 6.89$ 413.53$ 2.29$ 137.33$ 00064490 00 5.56$ 333.85$ 3.08$ 185.03$ 00064491 00 2.75$ 165.17$ 1.74$ 104.63$ ZZZ64492 00 2.77$ 166.43$ 1.76$ 105.89$ ZZZ64493 00 5.08$ 304.61$ 2.63$ 157.68$ 00064494 00 2.56$ 153.68$ 1.51$ 90.62$ ZZZ64495 00 2.56$ 153.68$ 1.53$ 91.88$ ZZZ64505 00 3.44$ 206.27$ 2.73$ 164.02$ 00064510 00 3.91$ 234.38$ 2.17$ 130.33$ 00064517 00 5.59$ 335.31$ 3.67$ 219.91$ 00064520 00 5.97$ 358.02$ 2.38$ 142.99$ 00064530 00 5.94$ 356.17$ 2.68$ 160.68$ 00064553 00 50.93$ 3,055.68$ 10.33$ 619.67$ 01064555 00 46.22$ 2,773.03$ 10.00$ 599.98$ 01064561 00 21.67$ 1,299.97$ 8.88$ 532.53$ 01064566 00 3.77$ 226.23$ 0.88$ 52.81$ 00064568 00 18.61$ 1,116.72$ 18.61$ 1,116.72$ 09064569 00 22.28$ 1,336.90$ 22.28$ 1,336.90$ 09064570 00 21.63$ 1,298.04$ 21.63$ 1,298.04$ 09064575 00 9.75$ 584.98$ 9.75$ 584.98$ 09064580 00 9.01$ 540.59$ 9.01$ 540.59$ 09064581 00 19.34$ 1,160.41$ 19.34$ 1,160.41$ 09064585 00 7.26$ 435.60$ 4.22$ 253.36$ 01064590 00 7.84$ 470.25$ 4.73$ 283.59$ 01064595 00 7.13$ 427.96$ 3.71$ 222.38$ 01064600 00 12.73$ 763.57$ 6.75$ 404.76$ 010



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

64605 00 17.36$ 1,041.77$ 10.22$ 612.96$ 01064610 00 22.57$ 1,353.92$ 14.35$ 860.79$ 01064611 00 3.53$ 211.54$ 3.08$ 185.05$ 01064612 00 3.92$ 235.36$ 3.46$ 207.62$ 01064615 00 4.32$ 259.37$ 3.60$ 215.86$ 01064616 00 3.86$ 231.31$ 3.20$ 192.22$ 01064617 00 4.73$ 284.08$ 3.18$ 190.75$ 01064620 00 6.05$ 363.13$ 5.10$ 305.74$ 01064624 00 12.06$ 723.86$ 4.30$ 257.92$ 01064625 00 14.72$ 883.30$ 5.68$ 340.55$ 01064630 00 6.93$ 415.60$ 5.56$ 333.63$ 01064632 00 2.51$ 150.65$ 2.00$ 119.75$ 01064633 00 12.29$ 737.27$ 6.55$ 392.96$ 01064634 00 5.54$ 332.41$ 1.98$ 118.64$ ZZZ64635 00 12.16$ 729.31$ 6.46$ 387.53$ 01064636 00 5.03$ 302.09$ 1.73$ 104.08$ ZZZ64640 00 3.99$ 239.40$ 2.76$ 165.62$ 01064642 00 4.24$ 254.25$ 3.15$ 189.30$ 00064643 00 2.70$ 161.95$ 2.10$ 126.00$ ZZZ64644 00 4.93$ 295.81$ 3.46$ 207.53$ 00064645 00 3.40$ 203.72$ 2.42$ 145.07$ ZZZ64646 00 4.43$ 266.06$ 3.37$ 202.36$ 00064647 00 5.20$ 312.22$ 3.98$ 239.07$ 00064650 00 2.32$ 138.99$ 1.22$ 73.40$ 00064653 00 2.83$ 169.93$ 1.56$ 93.62$ 00064680 00 9.38$ 563.05$ 4.75$ 284.96$ 01064681 00 16.95$ 1,016.92$ 7.95$ 477.12$ 01064702 00 14.79$ 887.26$ 14.79$ 887.26$ 09064704 00 9.43$ 565.74$ 9.43$ 565.74$ 09064708 00 14.71$ 882.75$ 14.71$ 882.75$ 09064712 00 17.08$ 1,024.77$ 17.08$ 1,024.77$ 09064713 00 22.79$ 1,367.43$ 22.79$ 1,367.43$ 09064714 00 21.15$ 1,269.02$ 21.15$ 1,269.02$ 09064716 00 15.30$ 917.95$ 15.30$ 917.95$ 09064718 00 17.40$ 1,043.97$ 17.40$ 1,043.97$ 09064719 00 11.80$ 708.17$ 11.80$ 708.17$ 09064721 00 12.73$ 763.87$ 12.59$ 755.68$ 09064722 00 10.44$ 626.62$ 10.44$ 626.62$ 09064726 00 7.96$ 477.83$ 7.96$ 477.83$ 09064727 00 5.36$ 321.47$ 5.36$ 321.47$ ZZZ64732 00 13.05$ 783.18$ 13.05$ 783.18$ 09064734 00 14.75$ 885.15$ 14.75$ 885.15$ 090



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

64736 00 10.98$ 658.82$ 10.98$ 658.82$ 09064738 00 13.63$ 817.63$ 13.63$ 817.63$ 09064740 00 14.31$ 858.52$ 14.31$ 858.52$ 09064742 00 14.47$ 867.99$ 14.47$ 867.99$ 09064744 00 14.59$ 875.29$ 14.59$ 875.29$ 09064746 00 12.55$ 753.26$ 12.55$ 753.26$ 09064755 00 26.88$ 1,612.95$ 26.88$ 1,612.95$ 09064760 00 15.09$ 905.19$ 15.09$ 905.19$ 09064763 00 14.93$ 895.89$ 14.93$ 895.89$ 09064766 00 18.40$ 1,103.94$ 18.40$ 1,103.94$ 09064771 00 17.40$ 1,043.98$ 17.40$ 1,043.98$ 09064772 00 16.53$ 991.65$ 16.53$ 991.65$ 09064774 00 11.92$ 715.49$ 11.92$ 715.49$ 09064776 00 11.40$ 683.84$ 11.40$ 683.84$ 09064778 00 5.35$ 320.90$ 5.35$ 320.90$ ZZZ64782 00 13.47$ 808.06$ 13.47$ 808.06$ 09064783 00 6.39$ 383.21$ 6.39$ 383.21$ ZZZ64784 00 21.27$ 1,276.02$ 21.27$ 1,276.02$ 09064786 00 29.28$ 1,756.79$ 29.28$ 1,756.79$ 09064787 00 7.04$ 422.20$ 7.04$ 422.20$ ZZZ64788 00 11.76$ 705.84$ 11.76$ 705.84$ 09064790 00 24.49$ 1,469.51$ 24.49$ 1,469.51$ 09064792 00 31.81$ 1,908.38$ 31.81$ 1,908.38$ 09064795 00 5.68$ 341.00$ 5.68$ 341.00$ 00064802 00 24.53$ 1,472.09$ 24.53$ 1,472.09$ 09064804 00 34.87$ 2,092.41$ 34.87$ 2,092.41$ 09064809 00 32.03$ 1,921.71$ 32.03$ 1,921.71$ 09064818 00 22.91$ 1,374.44$ 22.91$ 1,374.44$ 09064820 00 20.93$ 1,256.04$ 20.93$ 1,256.04$ 09064821 00 20.36$ 1,221.80$ 20.36$ 1,221.80$ 09064822 00 20.36$ 1,221.80$ 20.36$ 1,221.80$ 09064823 00 23.14$ 1,388.20$ 23.14$ 1,388.20$ 09064831 00 20.18$ 1,210.55$ 20.18$ 1,210.55$ 09064832 00 9.84$ 590.51$ 9.84$ 590.51$ ZZZ64834 00 21.75$ 1,304.92$ 21.75$ 1,304.92$ 09064835 00 23.92$ 1,435.19$ 23.92$ 1,435.19$ 09064836 00 23.92$ 1,435.19$ 23.92$ 1,435.19$ 09064837 00 10.75$ 644.80$ 10.75$ 644.80$ ZZZ64840 00 28.23$ 1,693.88$ 28.23$ 1,693.88$ 09064856 00 29.68$ 1,780.68$ 29.68$ 1,780.68$ 09064857 00 30.90$ 1,854.29$ 30.90$ 1,854.29$ 09064858 00 34.53$ 2,071.73$ 34.53$ 2,071.73$ 090



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

64859 00 7.30$ 438.28$ 7.30$ 438.28$ ZZZ64861 00 44.68$ 2,680.62$ 44.68$ 2,680.62$ 09064862 00 40.40$ 2,424.05$ 40.40$ 2,424.05$ 09064864 00 25.31$ 1,518.59$ 25.31$ 1,518.59$ 09064865 00 32.08$ 1,924.84$ 32.08$ 1,924.84$ 09064866 00 37.54$ 2,252.36$ 37.54$ 2,252.36$ 09064868 00 29.38$ 1,762.86$ 29.38$ 1,762.86$ 09064872 00 3.42$ 205.20$ 3.42$ 205.20$ ZZZ64874 00 5.13$ 307.53$ 5.13$ 307.53$ ZZZ64876 00 5.80$ 348.10$ 5.80$ 348.10$ ZZZ64885 00 32.65$ 1,958.74$ 32.65$ 1,958.74$ 09064886 00 37.83$ 2,269.86$ 37.83$ 2,269.86$ 09064890 00 31.70$ 1,901.93$ 31.70$ 1,901.93$ 09064891 00 33.71$ 2,022.71$ 33.71$ 2,022.71$ 09064892 00 30.84$ 1,850.46$ 30.84$ 1,850.46$ 09064893 00 32.89$ 1,973.62$ 32.89$ 1,973.62$ 09064895 00 38.94$ 2,336.31$ 38.94$ 2,336.31$ 09064896 00 42.01$ 2,520.56$ 42.01$ 2,520.56$ 09064897 00 37.21$ 2,232.76$ 37.21$ 2,232.76$ 09064898 00 40.31$ 2,418.30$ 40.31$ 2,418.30$ 09064901 00 17.57$ 1,053.92$ 17.57$ 1,053.92$ ZZZ64902 00 20.33$ 1,219.86$ 20.33$ 1,219.86$ ZZZ64905 00 29.92$ 1,795.29$ 29.92$ 1,795.29$ 09064907 00 38.21$ 2,292.42$ 38.21$ 2,292.42$ 09064910 00 23.36$ 1,401.35$ 23.36$ 1,401.35$ 09064911 00 30.13$ 1,808.07$ 30.13$ 1,808.07$ 09064912 00 22.69$ 1,361.67$ 22.69$ 1,361.67$ 09064913 00 4.54$ 272.33$ 4.54$ 272.33$ ZZZ64999 00 By Report By Report YYY65091 00 18.95$ 1,137.21$ 18.95$ 1,137.21$ 09065093 00 18.76$ 1,125.79$ 18.76$ 1,125.79$ 09065101 00 22.02$ 1,321.14$ 22.02$ 1,321.14$ 09065103 00 22.91$ 1,374.82$ 22.91$ 1,374.82$ 09065105 00 25.21$ 1,512.59$ 25.21$ 1,512.59$ 09065110 00 36.00$ 2,160.17$ 36.00$ 2,160.17$ 09065112 00 41.67$ 2,500.05$ 41.67$ 2,500.05$ 09065114 00 43.65$ 2,618.77$ 43.65$ 2,618.77$ 09065125 00 13.52$ 811.22$ 8.57$ 514.21$ 09065130 00 21.80$ 1,308.13$ 21.80$ 1,308.13$ 09065135 00 22.11$ 1,326.50$ 22.11$ 1,326.50$ 09065140 00 24.01$ 1,440.44$ 24.01$ 1,440.44$ 09065150 00 17.32$ 1,038.95$ 17.32$ 1,038.95$ 090



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

65155 00 25.11$ 1,506.47$ 25.11$ 1,506.47$ 09065175 00 19.63$ 1,177.75$ 19.63$ 1,177.75$ 09065205 00 1.35$ 81.09$ 1.05$ 62.81$ 00065210 00 1.65$ 98.99$ 1.25$ 75.02$ 00065220 00 1.73$ 103.52$ 1.21$ 72.62$ 00065222 00 1.99$ 119.12$ 1.51$ 90.74$ 00065235 00 20.81$ 1,248.89$ 20.81$ 1,248.89$ 09065260 00 28.14$ 1,688.48$ 28.14$ 1,688.48$ 09065265 00 31.60$ 1,895.88$ 31.60$ 1,895.88$ 09065270 00 8.08$ 485.03$ 4.11$ 246.66$ 01065272 00 15.06$ 903.38$ 10.28$ 617.09$ 09065273 00 11.13$ 667.70$ 11.13$ 667.70$ 09065275 00 17.06$ 1,023.63$ 13.49$ 809.23$ 09065280 00 19.59$ 1,175.51$ 19.59$ 1,175.51$ 09065285 00 32.36$ 1,941.77$ 32.36$ 1,941.77$ 09065286 00 20.74$ 1,244.48$ 14.49$ 869.27$ 09065290 00 14.33$ 859.52$ 14.33$ 859.52$ 09065400 00 20.03$ 1,202.00$ 17.62$ 1,056.96$ 09065410 00 4.24$ 254.46$ 3.03$ 181.94$ 00065420 00 15.46$ 927.55$ 11.07$ 663.96$ 09065426 00 19.40$ 1,163.78$ 13.97$ 838.40$ 09065430 00 3.40$ 204.01$ 3.01$ 180.68$ 00065435 00 2.39$ 143.42$ 2.03$ 121.98$ 00065436 00 11.36$ 681.44$ 10.83$ 649.91$ 09065450 00 9.59$ 575.32$ 9.43$ 565.86$ 09065600 00 11.74$ 704.27$ 10.01$ 600.85$ 09065710 00 32.61$ 1,956.68$ 32.61$ 1,956.68$ 09065730 00 36.07$ 2,164.46$ 36.07$ 2,164.46$ 09065750 00 36.22$ 2,173.43$ 36.22$ 2,173.43$ 09065755 00 36.04$ 2,162.36$ 36.04$ 2,162.36$ 09065756 00 34.47$ 2,068.27$ 34.47$ 2,068.27$ 09065757 00 148.81$ 148.81$ ZZZ65760 00 Not Covered Not Covered XXX65765 00 Not Covered Not Covered XXX65767 00 Not Covered Not Covered XXX65770 00 40.61$ 2,436.55$ 40.61$ 2,436.55$ 09065771 00 Not Covered Not Covered XXX65772 00 13.27$ 795.97$ 11.87$ 712.10$ 09065775 00 16.26$ 975.58$ 16.26$ 975.58$ 09065778 00 42.07$ 2,524.36$ 1.61$ 96.55$ 00065779 00 36.14$ 2,168.15$ 4.41$ 264.37$ 00065780 00 19.50$ 1,170.13$ 19.50$ 1,170.13$ 090



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

65781 00 38.88$ 2,332.80$ 38.88$ 2,332.80$ 09065782 00 33.53$ 2,011.58$ 33.53$ 2,011.58$ 09065785 00 72.82$ 4,369.27$ 12.94$ 776.11$ 09065800 00 3.51$ 210.79$ 2.64$ 158.45$ 00065810 00 13.60$ 815.74$ 13.60$ 815.74$ 09065815 00 18.87$ 1,132.38$ 13.94$ 836.63$ 09065820 00 22.16$ 1,329.86$ 22.16$ 1,329.86$ 09065850 00 24.48$ 1,469.05$ 24.48$ 1,469.05$ 09065855 00 7.21$ 432.46$ 6.05$ 363.10$ 01065860 00 9.07$ 544.11$ 7.36$ 441.32$ 09065865 00 13.84$ 830.37$ 13.84$ 830.37$ 09065870 00 17.24$ 1,034.63$ 17.24$ 1,034.63$ 09065875 00 18.42$ 1,105.18$ 18.42$ 1,105.18$ 09065880 00 19.38$ 1,162.70$ 19.38$ 1,162.70$ 09065900 00 28.37$ 1,702.43$ 28.37$ 1,702.43$ 09065920 00 23.02$ 1,381.35$ 23.02$ 1,381.35$ 09065930 00 18.57$ 1,114.07$ 18.57$ 1,114.07$ 09066020 00 5.62$ 337.18$ 3.84$ 230.61$ 01066030 00 5.05$ 302.91$ 3.25$ 195.08$ 01066130 00 20.55$ 1,233.06$ 16.57$ 994.06$ 09066150 00 25.65$ 1,539.17$ 25.65$ 1,539.17$ 09066155 00 25.63$ 1,537.93$ 25.63$ 1,537.93$ 09066160 00 28.87$ 1,732.46$ 28.87$ 1,732.46$ 09066170 00 31.97$ 1,917.98$ 31.97$ 1,917.98$ 09066172 00 34.84$ 2,090.37$ 34.84$ 2,090.37$ 09066174 00 27.63$ 1,657.87$ 27.63$ 1,657.87$ 09066175 00 28.94$ 1,736.15$ 28.94$ 1,736.15$ 09066179 00 31.48$ 1,888.82$ 31.48$ 1,888.82$ 09066180 00 33.20$ 1,992.14$ 33.20$ 1,992.14$ 09066183 00 30.08$ 1,804.91$ 30.08$ 1,804.91$ 09066184 00 22.97$ 1,378.25$ 22.97$ 1,378.25$ 09066185 00 24.72$ 1,482.91$ 24.72$ 1,482.91$ 09066225 00 27.16$ 1,629.60$ 27.16$ 1,629.60$ 09066250 00 22.13$ 1,327.51$ 16.26$ 975.64$ 09066500 00 10.52$ 631.06$ 10.52$ 631.06$ 09066505 00 11.51$ 690.89$ 11.51$ 690.89$ 09066600 00 24.62$ 1,477.41$ 24.62$ 1,477.41$ 09066605 00 31.13$ 1,867.90$ 31.13$ 1,867.90$ 09066625 00 12.54$ 752.38$ 12.54$ 752.38$ 09066630 00 16.61$ 996.53$ 16.61$ 996.53$ 09066635 00 16.77$ 1,006.30$ 16.77$ 1,006.30$ 09066680 00 15.12$ 907.26$ 15.12$ 907.26$ 090



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

66682 00 18.94$ 1,136.31$ 18.94$ 1,136.31$ 09066700 00 13.24$ 794.50$ 11.47$ 687.93$ 09066710 00 12.97$ 778.10$ 11.47$ 687.93$ 09066711 00 18.79$ 1,127.49$ 18.79$ 1,127.49$ 09066720 00 13.58$ 814.67$ 11.97$ 718.19$ 09066740 00 12.86$ 771.80$ 11.47$ 687.93$ 09066761 00 8.77$ 526.42$ 6.89$ 413.54$ 01066762 00 13.98$ 838.57$ 12.42$ 745.24$ 09066770 00 15.51$ 930.80$ 14.08$ 845.04$ 09066820 00 11.83$ 709.97$ 11.83$ 709.97$ 09066821 00 9.72$ 583.10$ 9.12$ 547.16$ 09066825 00 22.49$ 1,349.16$ 22.49$ 1,349.16$ 09066830 00 20.67$ 1,240.35$ 20.67$ 1,240.35$ 09066840 00 20.31$ 1,218.73$ 20.31$ 1,218.73$ 09066850 00 23.11$ 1,386.51$ 23.11$ 1,386.51$ 09066852 00 24.61$ 1,476.48$ 24.61$ 1,476.48$ 09066920 00 21.96$ 1,317.85$ 21.96$ 1,317.85$ 09066930 00 24.96$ 1,497.32$ 24.96$ 1,497.32$ 09066940 00 22.81$ 1,368.77$ 22.81$ 1,368.77$ 09066982 00 23.12$ 1,387.41$ 23.12$ 1,387.41$ 09066983 00 21.63$ 1,297.82$ 21.63$ 1,297.82$ 09066984 00 18.64$ 1,118.15$ 18.64$ 1,118.15$ 09066985 00 22.45$ 1,346.78$ 22.45$ 1,346.78$ 09066986 00 26.50$ 1,589.73$ 26.50$ 1,589.73$ 09066987 00 By Report By Report 09066988 00 By Report By Report 09066990 00 2.61$ 156.61$ 2.61$ 156.61$ ZZZ66999 00 By Report By Report YYY67005 00 13.80$ 828.17$ 13.80$ 828.17$ 09067010 00 15.83$ 949.89$ 15.83$ 949.89$ 09067015 00 17.05$ 1,022.75$ 17.05$ 1,022.75$ 09067025 00 21.48$ 1,289.01$ 18.46$ 1,107.39$ 09067027 00 24.84$ 1,490.36$ 24.84$ 1,490.36$ 09067028 00 2.96$ 177.60$ 2.90$ 173.82$ 00067030 00 15.66$ 939.68$ 15.66$ 939.68$ 09067031 00 11.44$ 686.29$ 10.42$ 625.12$ 09067036 00 26.27$ 1,576.28$ 26.27$ 1,576.28$ 09067039 00 28.13$ 1,687.62$ 28.13$ 1,687.62$ 09067040 00 30.38$ 1,822.87$ 30.38$ 1,822.87$ 09067041 00 33.55$ 2,013.09$ 33.55$ 2,013.09$ 09067042 00 33.55$ 2,013.09$ 33.55$ 2,013.09$ 09067043 00 35.39$ 2,123.33$ 35.39$ 2,123.33$ 090



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

67101 00 9.69$ 581.55$ 8.33$ 499.57$ 01067105 00 8.70$ 522.01$ 8.04$ 482.28$ 01067107 00 32.98$ 1,978.88$ 32.98$ 1,978.88$ 09067108 00 34.93$ 2,095.73$ 34.93$ 2,095.73$ 09067110 00 25.83$ 1,549.51$ 23.75$ 1,425.29$ 09067113 00 38.99$ 2,339.62$ 38.99$ 2,339.62$ 09067115 00 14.59$ 875.36$ 14.59$ 875.36$ 09067120 00 19.45$ 1,166.71$ 16.26$ 975.64$ 09067121 00 26.47$ 1,588.50$ 26.47$ 1,588.50$ 09067141 00 15.35$ 921.29$ 14.22$ 853.19$ 09067145 00 15.45$ 927.08$ 14.53$ 871.58$ 09067208 00 17.53$ 1,052.08$ 16.85$ 1,011.09$ 09067210 00 15.13$ 907.97$ 14.60$ 875.81$ 09067218 00 40.31$ 2,418.43$ 40.31$ 2,418.43$ 09067220 00 15.62$ 936.98$ 14.60$ 875.81$ 09067221 00 8.30$ 497.89$ 6.18$ 370.51$ 00067225 00 0.86$ 51.51$ 0.82$ 48.98$ ZZZ67227 00 8.58$ 514.71$ 7.49$ 449.12$ 01067228 00 9.99$ 599.56$ 8.93$ 535.87$ 01067229 00 33.96$ 2,037.84$ 33.96$ 2,037.84$ 09067250 00 23.25$ 1,395.20$ 23.25$ 1,395.20$ 09067255 00 19.97$ 1,197.96$ 19.97$ 1,197.96$ 09067299 00 By Report By Report YYY67311 00 17.41$ 1,044.75$ 17.41$ 1,044.75$ 09067312 00 20.75$ 1,244.90$ 20.75$ 1,244.90$ 09067314 00 19.61$ 1,176.48$ 19.61$ 1,176.48$ 09067316 00 23.32$ 1,399.15$ 23.32$ 1,399.15$ 09067318 00 20.49$ 1,229.60$ 20.49$ 1,229.60$ 09067320 00 9.35$ 560.97$ 9.35$ 560.97$ ZZZ67331 00 8.87$ 532.19$ 8.87$ 532.19$ ZZZ67332 00 9.62$ 577.50$ 9.62$ 577.50$ ZZZ67334 00 8.76$ 525.55$ 8.76$ 525.55$ ZZZ67335 00 4.29$ 257.55$ 4.29$ 257.55$ ZZZ67340 00 10.39$ 623.49$ 10.39$ 623.49$ ZZZ67343 00 19.03$ 1,141.82$ 19.03$ 1,141.82$ 09067345 00 7.13$ 427.60$ 6.35$ 380.94$ 01067346 00 5.63$ 337.66$ 5.63$ 337.66$ 00067399 00 By Report By Report YYY67400 00 27.56$ 1,653.51$ 27.56$ 1,653.51$ 09067405 00 23.52$ 1,411.10$ 23.52$ 1,411.10$ 09067412 00 25.38$ 1,523.03$ 25.38$ 1,523.03$ 09067413 00 25.41$ 1,524.44$ 25.41$ 1,524.44$ 090



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

67414 00 39.10$ 2,345.80$ 39.10$ 2,345.80$ 09067415 00 3.03$ 181.66$ 3.03$ 181.66$ 00067420 00 47.45$ 2,846.70$ 47.45$ 2,846.70$ 09067430 00 36.96$ 2,217.60$ 36.96$ 2,217.60$ 09067440 00 35.76$ 2,145.87$ 35.76$ 2,145.87$ 09067445 00 41.35$ 2,480.82$ 41.35$ 2,480.82$ 09067450 00 37.17$ 2,230.45$ 37.17$ 2,230.45$ 09067500 00 2.06$ 123.58$ 1.75$ 105.29$ 00067505 00 2.44$ 146.28$ 2.07$ 124.21$ 00067515 00 2.31$ 138.90$ 2.13$ 127.55$ 00067550 00 28.60$ 1,715.98$ 28.60$ 1,715.98$ 09067560 00 29.31$ 1,758.44$ 29.31$ 1,758.44$ 09067570 00 34.76$ 2,085.42$ 34.76$ 2,085.42$ 09067599 00 By Report By Report YYY67700 00 8.14$ 488.59$ 3.40$ 204.19$ 01067710 00 6.84$ 410.24$ 2.85$ 171.24$ 01067715 00 7.36$ 441.38$ 3.16$ 189.77$ 01067800 00 3.75$ 225.06$ 3.00$ 180.29$ 01067801 00 4.77$ 286.49$ 3.88$ 232.89$ 01067805 00 5.93$ 355.94$ 4.79$ 287.21$ 01067808 00 10.73$ 644.00$ 10.73$ 644.00$ 09067810 00 5.17$ 310.45$ 2.06$ 123.79$ 00067820 00 0.96$ 57.65$ 1.02$ 61.44$ 00067825 00 3.82$ 229.42$ 3.56$ 213.66$ 01067830 00 7.94$ 476.17$ 4.03$ 241.59$ 01067835 00 12.80$ 768.12$ 12.80$ 768.12$ 09067840 00 8.20$ 492.07$ 4.61$ 276.40$ 01067850 00 6.34$ 380.56$ 3.94$ 236.15$ 01067875 00 5.14$ 308.37$ 2.82$ 169.01$ 00067880 00 13.54$ 812.54$ 10.76$ 645.43$ 09067882 00 16.60$ 996.04$ 13.77$ 826.41$ 09067900 00 18.84$ 1,130.19$ 14.82$ 889.30$ 09067901 00 22.63$ 1,357.65$ 16.97$ 1,018.39$ 09067902 00 21.06$ 1,263.36$ 21.06$ 1,263.36$ 09067903 00 17.50$ 1,049.76$ 14.09$ 845.45$ 09067904 00 21.58$ 1,294.62$ 17.43$ 1,045.53$ 09067906 00 14.81$ 888.51$ 14.81$ 888.51$ 09067908 00 14.61$ 876.53$ 12.44$ 746.62$ 09067909 00 15.84$ 950.45$ 12.79$ 767.58$ 09067911 00 16.38$ 982.93$ 16.38$ 982.93$ 09067912 00 26.35$ 1,581.28$ 14.23$ 853.57$ 09067914 00 14.02$ 841.17$ 9.56$ 573.80$ 090



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

67915 00 8.85$ 530.77$ 5.80$ 347.90$ 09067916 00 17.62$ 1,057.42$ 12.57$ 754.10$ 09067917 00 17.93$ 1,075.56$ 13.35$ 801.25$ 09067921 00 13.77$ 826.30$ 9.08$ 545.05$ 09067922 00 8.69$ 521.31$ 5.78$ 346.64$ 09067923 00 17.63$ 1,057.51$ 12.58$ 754.82$ 09067924 00 18.77$ 1,126.09$ 13.36$ 801.33$ 09067930 00 10.77$ 645.95$ 6.97$ 418.30$ 01067935 00 17.47$ 1,048.38$ 12.89$ 773.44$ 09067938 00 7.48$ 449.09$ 3.41$ 204.41$ 01067950 00 16.90$ 1,013.98$ 13.50$ 810.30$ 09067961 00 16.99$ 1,019.70$ 13.27$ 796.47$ 09067966 00 22.59$ 1,355.69$ 19.17$ 1,150.12$ 09067971 00 21.09$ 1,265.40$ 21.09$ 1,265.40$ 09067973 00 27.11$ 1,626.84$ 27.11$ 1,626.84$ 09067974 00 27.06$ 1,623.47$ 27.06$ 1,623.47$ 09067975 00 19.96$ 1,197.52$ 19.96$ 1,197.52$ 09067999 00 By Report By Report YYY68020 00 3.54$ 212.42$ 3.24$ 194.14$ 01068040 00 1.83$ 109.63$ 1.44$ 86.30$ 00068100 00 5.15$ 309.09$ 2.82$ 169.09$ 00068110 00 6.80$ 407.89$ 4.34$ 260.33$ 01068115 00 9.40$ 564.22$ 5.37$ 322.07$ 01068130 00 16.00$ 959.90$ 12.06$ 723.43$ 09068135 00 4.62$ 277.09$ 4.40$ 263.84$ 01068200 00 1.21$ 72.81$ 1.01$ 60.83$ 00068320 00 21.53$ 1,291.58$ 15.76$ 945.38$ 09068325 00 19.19$ 1,151.12$ 19.19$ 1,151.12$ 09068326 00 18.84$ 1,130.14$ 18.84$ 1,130.14$ 09068328 00 20.64$ 1,238.17$ 20.64$ 1,238.17$ 09068330 00 17.97$ 1,078.17$ 13.46$ 807.65$ 09068335 00 18.91$ 1,134.45$ 18.91$ 1,134.45$ 09068340 00 16.58$ 995.01$ 11.65$ 699.25$ 09068360 00 15.80$ 947.78$ 12.04$ 722.66$ 09068362 00 19.16$ 1,149.74$ 19.16$ 1,149.74$ 09068371 00 12.07$ 724.08$ 12.07$ 724.08$ 01068399 00 By Report By Report YYY68400 00 8.57$ 514.03$ 3.86$ 231.52$ 01068420 00 9.63$ 577.62$ 4.90$ 293.85$ 01068440 00 3.02$ 180.99$ 2.90$ 174.06$ 01068500 00 28.61$ 1,716.81$ 28.61$ 1,716.81$ 09068505 00 28.48$ 1,708.82$ 28.48$ 1,708.82$ 090



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

68510 00 13.25$ 794.80$ 8.51$ 510.40$ 00068520 00 20.12$ 1,207.44$ 20.12$ 1,207.44$ 09068525 00 7.66$ 459.78$ 7.66$ 459.78$ 00068530 00 12.69$ 761.30$ 7.46$ 447.89$ 01068540 00 27.22$ 1,632.90$ 27.22$ 1,632.90$ 09068550 00 33.38$ 2,002.99$ 33.38$ 2,002.99$ 09068700 00 17.63$ 1,057.56$ 17.63$ 1,057.56$ 09068705 00 7.23$ 434.00$ 4.85$ 290.86$ 01068720 00 22.17$ 1,329.93$ 22.17$ 1,329.93$ 09068745 00 22.27$ 1,336.27$ 22.27$ 1,336.27$ 09068750 00 23.09$ 1,385.53$ 23.09$ 1,385.53$ 09068760 00 6.13$ 367.63$ 4.27$ 256.01$ 01068761 00 4.36$ 261.72$ 3.46$ 207.49$ 01068770 00 18.35$ 1,101.08$ 18.35$ 1,101.08$ 09068801 00 2.66$ 159.53$ 2.29$ 137.46$ 01068810 00 4.62$ 276.98$ 3.74$ 224.64$ 01068811 00 3.97$ 238.38$ 3.97$ 238.38$ 01068815 00 11.64$ 698.17$ 6.49$ 389.18$ 01068816 00 21.43$ 1,285.97$ 4.61$ 276.38$ 01068840 00 3.79$ 227.32$ 3.41$ 204.62$ 01068850 00 1.84$ 110.23$ 1.63$ 97.61$ 00068899 00 By Report By Report YYY69000 00 5.47$ 328.12$ 3.50$ 210.20$ 01069005 00 6.30$ 378.30$ 4.59$ 275.51$ 01069020 00 6.81$ 408.51$ 4.14$ 248.34$ 01069090 00 Not Covered Not Covered XXX69100 00 2.88$ 172.92$ 1.42$ 85.27$ 00069105 00 4.14$ 248.41$ 1.83$ 109.68$ 00069110 00 13.43$ 806.05$ 9.45$ 567.06$ 09069120 00 11.69$ 701.23$ 11.69$ 701.23$ 09069140 00 25.78$ 1,546.93$ 25.78$ 1,546.93$ 09069145 00 11.54$ 692.25$ 7.23$ 433.70$ 09069150 00 30.13$ 1,807.77$ 30.13$ 1,807.77$ 09069155 00 48.01$ 2,880.40$ 48.01$ 2,880.40$ 09069200 00 2.39$ 143.47$ 1.37$ 82.30$ 00069205 00 2.89$ 173.28$ 2.89$ 173.28$ 01069209 00 0.42$ 25.14$ 0.42$ 25.14$ 00069210 00 1.37$ 82.34$ 0.95$ 57.11$ 00069220 00 2.35$ 141.26$ 1.49$ 89.55$ 00069222 00 6.34$ 380.42$ 3.94$ 236.65$ 01069300 00 18.70$ 1,122.30$ 14.15$ 849.25$ YYY69310 00 31.93$ 1,915.56$ 31.93$ 1,915.56$ 090



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

69320 00 44.69$ 2,681.27$ 44.69$ 2,681.27$ 09069399 00 By Report By Report YYY69420 00 5.55$ 332.76$ 3.50$ 209.79$ 01069421 00 4.32$ 259.34$ 4.32$ 259.34$ 01069424 00 3.76$ 225.71$ 1.79$ 107.15$ 00069433 00 5.86$ 351.57$ 3.84$ 230.49$ 01069436 00 4.61$ 276.86$ 4.61$ 276.86$ 01069440 00 20.06$ 1,203.61$ 20.06$ 1,203.61$ 09069450 00 15.90$ 954.05$ 15.90$ 954.05$ 09069501 00 21.09$ 1,265.45$ 21.09$ 1,265.45$ 09069502 00 27.96$ 1,677.80$ 27.96$ 1,677.80$ 09069505 00 35.20$ 2,111.93$ 35.20$ 2,111.93$ 09069511 00 36.06$ 2,163.40$ 36.06$ 2,163.40$ 09069530 00 48.25$ 2,894.74$ 48.25$ 2,894.74$ 09069535 00 78.20$ 4,692.24$ 78.20$ 4,692.24$ 09069540 00 6.09$ 365.43$ 3.69$ 221.65$ 01069550 00 30.46$ 1,827.52$ 30.46$ 1,827.52$ 09069552 00 45.78$ 2,746.80$ 45.78$ 2,746.80$ 09069554 00 73.25$ 4,394.71$ 73.25$ 4,394.71$ 09069601 00 30.16$ 1,809.44$ 30.16$ 1,809.44$ 09069602 00 31.66$ 1,899.66$ 31.66$ 1,899.66$ 09069603 00 36.86$ 2,211.89$ 36.86$ 2,211.89$ 09069604 00 32.38$ 1,942.62$ 32.38$ 1,942.62$ 09069605 00 45.56$ 2,733.38$ 45.56$ 2,733.38$ 09069610 00 11.10$ 666.03$ 8.41$ 504.60$ 01069620 00 20.45$ 1,227.15$ 14.22$ 853.21$ 09069631 00 25.78$ 1,546.67$ 25.78$ 1,546.67$ 09069632 00 31.40$ 1,883.73$ 31.40$ 1,883.73$ 09069633 00 30.45$ 1,826.72$ 30.45$ 1,826.72$ 09069635 00 36.32$ 2,178.95$ 36.32$ 2,178.95$ 09069636 00 40.37$ 2,422.32$ 40.37$ 2,422.32$ 09069637 00 40.93$ 2,455.90$ 40.93$ 2,455.90$ 09069641 00 30.32$ 1,819.04$ 30.32$ 1,819.04$ 09069642 00 38.94$ 2,336.48$ 38.94$ 2,336.48$ 09069643 00 35.58$ 2,134.74$ 35.58$ 2,134.74$ 09069644 00 43.24$ 2,594.59$ 43.24$ 2,594.59$ 09069645 00 42.49$ 2,549.68$ 42.49$ 2,549.68$ 09069646 00 45.19$ 2,711.12$ 45.19$ 2,711.12$ 09069650 00 23.38$ 1,402.70$ 23.38$ 1,402.70$ 09069660 00 26.94$ 1,616.61$ 26.94$ 1,616.61$ 09069661 00 35.10$ 2,105.89$ 35.10$ 2,105.89$ 09069662 00 33.64$ 2,018.43$ 33.64$ 2,018.43$ 090



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

69666 00 23.51$ 1,410.58$ 23.51$ 1,410.58$ 09069667 00 23.60$ 1,415.90$ 23.60$ 1,415.90$ 09069670 00 27.45$ 1,646.89$ 27.45$ 1,646.89$ 09069676 00 24.20$ 1,451.71$ 24.20$ 1,451.71$ 09069700 00 19.76$ 1,185.38$ 19.76$ 1,185.38$ 09069710 00 By Report By Report XXX69711 00 24.86$ 1,491.56$ 24.86$ 1,491.56$ 09069714 00 31.11$ 1,866.35$ 31.11$ 1,866.35$ 09069715 00 38.35$ 2,301.02$ 38.35$ 2,301.02$ 09069717 00 32.58$ 1,955.05$ 32.58$ 1,955.05$ 09069718 00 38.73$ 2,324.08$ 38.73$ 2,324.08$ 09069720 00 34.93$ 2,095.85$ 34.93$ 2,095.85$ 09069725 00 54.55$ 3,272.75$ 54.55$ 3,272.75$ 09069740 00 33.89$ 2,033.22$ 33.89$ 2,033.22$ 09069745 00 36.08$ 2,164.76$ 36.08$ 2,164.76$ 09069799 00 By Report By Report YYY69801 00 6.00$ 359.81$ 3.63$ 217.92$ 00069805 00 30.41$ 1,824.77$ 30.41$ 1,824.77$ 09069806 00 27.19$ 1,631.12$ 27.19$ 1,631.12$ 09069905 00 26.71$ 1,602.66$ 26.71$ 1,602.66$ 09069910 00 29.34$ 1,760.29$ 29.34$ 1,760.29$ 09069915 00 44.40$ 2,663.75$ 44.40$ 2,663.75$ 09069930 00 35.52$ 2,131.19$ 35.52$ 2,131.19$ 09069949 00 By Report By Report YYY69950 00 51.45$ 3,086.75$ 51.45$ 3,086.75$ 09069955 00 57.39$ 3,443.34$ 57.39$ 3,443.34$ 09069960 00 55.56$ 3,333.53$ 55.56$ 3,333.53$ 09069970 00 62.12$ 3,727.14$ 62.12$ 3,727.14$ 09069979 00 By Report By Report YYY69990 00 6.39$ 383.32$ 6.39$ 383.32$ ZZZ70010 00 1.75$ 105.18$ 1.75$ 105.18$ XXX70015 00 4.51$ 270.57$ 4.51$ 270.57$ XXX70015 26 1.73$ 103.54$ 1.73$ 103.54$ XXX70015 TC 2.78$ 167.03$ 2.78$ 167.03$ XXX70030 00 0.86$ 51.73$ 0.86$ 51.73$ XXX70030 26 0.24$ 14.61$ 0.24$ 14.61$ XXX70030 TC 0.62$ 37.12$ 0.62$ 37.12$ XXX70100 00 1.01$ 60.54$ 1.01$ 60.54$ XXX70100 26 0.26$ 15.85$ 0.26$ 15.85$ XXX70100 TC 0.74$ 44.69$ 0.74$ 44.69$ XXX7010F 00 Code Accepted for Tracking Purpose only XXX70110 00 1.17$ 70.44$ 1.17$ 70.44$ XXX



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

70110 26 0.37$ 21.97$ 0.37$ 21.97$ XXX70110 TC 0.81$ 48.47$ 0.81$ 48.47$ XXX70120 00 1.01$ 60.54$ 1.01$ 60.54$ XXX70120 26 0.26$ 15.85$ 0.26$ 15.85$ XXX70120 TC 0.74$ 44.69$ 0.74$ 44.69$ XXX70130 00 1.67$ 100.40$ 1.67$ 100.40$ XXX70130 26 0.50$ 29.85$ 0.50$ 29.85$ XXX70130 TC 1.18$ 70.54$ 1.18$ 70.54$ XXX70134 00 1.57$ 94.18$ 1.57$ 94.18$ XXX70134 26 0.51$ 30.57$ 0.51$ 30.57$ XXX70134 TC 1.06$ 63.61$ 1.06$ 63.61$ XXX70140 00 0.89$ 53.57$ 0.89$ 53.57$ XXX70140 26 0.30$ 17.71$ 0.30$ 17.71$ XXX70140 TC 0.60$ 35.86$ 0.60$ 35.86$ XXX70150 00 1.28$ 76.73$ 1.28$ 76.73$ XXX70150 26 0.39$ 23.21$ 0.39$ 23.21$ XXX70150 TC 0.89$ 53.52$ 0.89$ 53.52$ XXX70160 00 1.01$ 60.56$ 1.01$ 60.56$ XXX70160 26 0.25$ 15.24$ 0.25$ 15.24$ XXX70160 TC 0.76$ 45.32$ 0.76$ 45.32$ XXX70170 00 17.42$ 17.42$ XXX70170 26 0.44$ 26.17$ 0.44$ 26.17$ XXX70170 TC 1.95$ 1.95$ XXX70190 00 1.07$ 64.24$ 1.07$ 64.24$ XXX70190 26 0.32$ 18.92$ 0.32$ 18.92$ XXX70190 TC 0.76$ 45.32$ 0.76$ 45.32$ XXX70200 00 1.29$ 77.30$ 1.29$ 77.30$ XXX70200 26 0.41$ 24.42$ 0.41$ 24.42$ XXX70200 TC 0.88$ 52.89$ 0.88$ 52.89$ XXX7020F 00 Code Accepted for Tracking Purpose only XXX70210 00 0.93$ 55.52$ 0.93$ 55.52$ XXX70210 26 0.25$ 15.24$ 0.25$ 15.24$ XXX70210 TC 0.67$ 40.27$ 0.67$ 40.27$ XXX70220 00 1.14$ 68.55$ 1.14$ 68.55$ XXX70220 26 0.37$ 21.97$ 0.37$ 21.97$ XXX70220 TC 0.78$ 46.58$ 0.78$ 46.58$ XXX70240 00 0.92$ 55.47$ 0.92$ 55.47$ XXX70240 26 0.28$ 17.08$ 0.28$ 17.08$ XXX70240 TC 0.64$ 38.38$ 0.64$ 38.38$ XXX70250 00 1.11$ 66.69$ 1.11$ 66.69$ XXX70250 26 0.37$ 22.00$ 0.37$ 22.00$ XXX70250 TC 0.74$ 44.69$ 0.74$ 44.69$ XXX



CODE MOD

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DOC FacilityRVUs


GLOBAL

7025F 00 Code Accepted for Tracking Purpose only XXX70260 00 1.39$ 83.37$ 1.39$ 83.37$ XXX70260 26 0.51$ 30.48$ 0.51$ 30.48$ XXX70260 TC 0.88$ 52.89$ 0.88$ 52.89$ XXX70300 00 0.41$ 24.80$ 0.41$ 24.80$ XXX70300 26 0.16$ 9.75$ 0.16$ 9.75$ XXX70300 TC 0.25$ 15.05$ 0.25$ 15.05$ XXX70310 00 1.10$ 66.26$ 1.10$ 66.26$ XXX70310 26 0.22$ 13.38$ 0.22$ 13.38$ XXX70310 TC 0.88$ 52.89$ 0.88$ 52.89$ XXX70320 00 1.59$ 95.66$ 1.59$ 95.66$ XXX70320 26 0.36$ 21.34$ 0.36$ 21.34$ XXX70320 TC 1.24$ 74.33$ 1.24$ 74.33$ XXX70328 00 0.92$ 55.49$ 0.92$ 55.49$ XXX70328 26 0.26$ 15.85$ 0.26$ 15.85$ XXX70328 TC 0.66$ 39.64$ 0.66$ 39.64$ XXX70330 00 1.45$ 86.87$ 1.45$ 86.87$ XXX70330 26 0.36$ 21.37$ 0.36$ 21.37$ XXX70330 TC 1.09$ 65.50$ 1.09$ 65.50$ XXX70332 00 2.23$ 133.85$ 2.23$ 133.85$ XXX70332 26 0.78$ 46.91$ 0.78$ 46.91$ XXX70332 TC 1.45$ 86.94$ 1.45$ 86.94$ XXX70336 00 9.23$ 554.05$ 9.23$ 554.05$ XXX70336 26 2.12$ 127.31$ 2.12$ 127.31$ XXX70336 TC 7.11$ 426.75$ 7.11$ 426.75$ XXX70350 00 0.55$ 32.73$ 0.55$ 32.73$ XXX70350 26 0.28$ 17.05$ 0.28$ 17.05$ XXX70350 TC 0.26$ 15.68$ 0.26$ 15.68$ XXX70355 00 0.58$ 34.55$ 0.58$ 34.55$ XXX70355 26 0.31$ 18.86$ 0.31$ 18.86$ XXX70355 TC 0.26$ 15.68$ 0.26$ 15.68$ XXX70360 00 0.88$ 52.99$ 0.88$ 52.99$ XXX70360 26 0.24$ 14.61$ 0.24$ 14.61$ XXX70360 TC 0.64$ 38.38$ 0.64$ 38.38$ XXX70370 00 2.37$ 142.15$ 2.37$ 142.15$ XXX70370 26 0.43$ 25.58$ 0.43$ 25.58$ XXX70370 TC 1.94$ 116.58$ 1.94$ 116.58$ XXX70371 00 2.87$ 171.92$ 2.87$ 171.92$ XXX70371 26 1.23$ 73.63$ 1.23$ 73.63$ XXX70371 TC 1.64$ 98.29$ 1.64$ 98.29$ XXX70380 00 0.99$ 59.30$ 0.99$ 59.30$ XXX70380 26 0.24$ 14.61$ 0.24$ 14.61$ XXX



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

70380 TC 0.74$ 44.69$ 0.74$ 44.69$ XXX70390 00 3.03$ 181.64$ 3.03$ 181.64$ XXX70390 26 0.55$ 32.90$ 0.55$ 32.90$ XXX70390 TC 2.48$ 148.74$ 2.48$ 148.74$ XXX70450 00 3.38$ 202.88$ 3.38$ 202.88$ XXX70450 26 1.23$ 73.69$ 1.23$ 73.69$ XXX70450 TC 2.15$ 129.19$ 2.15$ 129.19$ XXX70460 00 4.79$ 287.12$ 4.79$ 287.12$ XXX70460 26 1.64$ 98.65$ 1.64$ 98.65$ XXX70460 TC 3.14$ 188.47$ 3.14$ 188.47$ XXX70470 00 5.60$ 335.94$ 5.60$ 335.94$ XXX70470 26 1.84$ 110.27$ 1.84$ 110.27$ XXX70470 TC 3.76$ 225.67$ 3.76$ 225.67$ XXX70480 00 6.82$ 409.07$ 6.82$ 409.07$ XXX70480 26 1.85$ 110.88$ 1.85$ 110.88$ XXX70480 TC 4.97$ 298.19$ 4.97$ 298.19$ XXX70481 00 8.08$ 485.03$ 8.08$ 485.03$ XXX70481 26 2.00$ 120.00$ 2.00$ 120.00$ XXX70481 TC 6.08$ 365.03$ 6.08$ 365.03$ XXX70482 00 8.80$ 528.28$ 8.80$ 528.28$ XXX70482 26 2.09$ 125.49$ 2.09$ 125.49$ XXX70482 TC 6.71$ 402.79$ 6.71$ 402.79$ XXX70486 00 4.07$ 244.50$ 4.07$ 244.50$ XXX70486 26 1.24$ 74.32$ 1.24$ 74.32$ XXX70486 TC 2.84$ 170.18$ 2.84$ 170.18$ XXX70487 00 4.89$ 293.51$ 4.89$ 293.51$ XXX70487 26 1.62$ 97.48$ 1.62$ 97.48$ XXX70487 TC 3.27$ 196.03$ 3.27$ 196.03$ XXX70488 00 5.97$ 358.02$ 5.97$ 358.02$ XXX70488 26 1.84$ 110.27$ 1.84$ 110.27$ XXX70488 TC 4.13$ 247.74$ 4.13$ 247.74$ XXX70490 00 4.80$ 287.99$ 4.80$ 287.99$ XXX70490 26 1.85$ 110.88$ 1.85$ 110.88$ XXX70490 TC 2.95$ 177.11$ 2.95$ 177.11$ XXX70491 00 5.93$ 355.76$ 5.93$ 355.76$ XXX70491 26 2.00$ 120.00$ 2.00$ 120.00$ XXX70491 TC 3.93$ 235.76$ 3.93$ 235.76$ XXX70492 00 7.15$ 428.83$ 7.15$ 428.83$ XXX70492 26 2.34$ 140.10$ 2.34$ 140.10$ XXX70492 TC 4.81$ 288.73$ 4.81$ 288.73$ XXX70496 00 8.64$ 518.51$ 8.64$ 518.51$ XXX70496 26 2.53$ 151.66$ 2.53$ 151.66$ XXX



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DOC FacilityRVUs


GLOBAL




CODE MOD

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GLOBAL

70554 TC 9.88$ 592.51$ 9.88$ 592.51$ XXX70555 00 588.10$ 588.10$ XXX70555 26 3.63$ 218.03$ 3.63$ 218.03$ XXX70555 TC 459.22$ 459.22$ XXX70557 00 By Report By Report XXX70557 26 4.52$ 271.16$ 4.52$ 271.16$ XXX70557 TC By Report By Report XXX70558 00 By Report By Report XXX70558 26 4.98$ 298.68$ 4.98$ 298.68$ XXX70558 TC By Report By Report XXX70559 00 By Report By Report XXX70559 26 4.73$ 284.05$ 4.73$ 284.05$ XXX70559 TC By Report By Report XXX71045 00 0.73$ 43.51$ 0.73$ 43.51$ XXX71045 26 0.26$ 15.85$ 0.26$ 15.85$ XXX71045 TC 0.46$ 27.66$ 0.46$ 27.66$ XXX71046 00 0.92$ 55.39$ 0.92$ 55.39$ XXX71046 26 0.31$ 18.90$ 0.31$ 18.90$ XXX71046 TC 0.61$ 36.49$ 0.61$ 36.49$ XXX71047 00 1.16$ 69.76$ 1.16$ 69.76$ XXX71047 26 0.41$ 24.44$ 0.41$ 24.44$ XXX71047 TC 0.76$ 45.32$ 0.76$ 45.32$ XXX71048 00 1.26$ 75.33$ 1.26$ 75.33$ XXX71048 26 0.47$ 28.12$ 0.47$ 28.12$ XXX71048 TC 0.79$ 47.21$ 0.79$ 47.21$ XXX71100 00 1.01$ 60.43$ 1.01$ 60.43$ XXX71100 26 0.33$ 19.53$ 0.33$ 19.53$ XXX71100 TC 0.68$ 40.91$ 0.68$ 40.91$ XXX71101 00 1.15$ 69.05$ 1.15$ 69.05$ XXX71101 26 0.40$ 23.73$ 0.40$ 23.73$ XXX71101 TC 0.76$ 45.32$ 0.76$ 45.32$ XXX71110 00 1.20$ 72.23$ 1.20$ 72.23$ XXX71110 26 0.43$ 25.65$ 0.43$ 25.65$ XXX71110 TC 0.78$ 46.58$ 0.78$ 46.58$ XXX71111 00 1.43$ 85.95$ 1.43$ 85.95$ XXX71111 26 0.48$ 28.64$ 0.48$ 28.64$ XXX71111 TC 0.96$ 57.30$ 0.96$ 57.30$ XXX71120 00 0.91$ 54.81$ 0.91$ 54.81$ XXX71120 26 0.29$ 17.69$ 0.29$ 17.69$ XXX71120 TC 0.62$ 37.12$ 0.62$ 37.12$ XXX71130 00 1.09$ 65.48$ 1.09$ 65.48$ XXX71130 26 0.31$ 18.90$ 0.31$ 18.90$ XXX



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DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL




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GLOBAL




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DOC NonfacRVUs


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DOC NonfacRVUs


DOC FacilityRVUs


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DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL




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DOC NonfacRVUs


DOC FacilityRVUs


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DOC FacilityRVUs


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DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

74182 TC 8.03$ 481.61$ 8.03$ 481.61$ XXX74183 00 11.71$ 702.49$ 11.71$ 702.49$ XXX74183 26 3.18$ 190.61$ 3.18$ 190.61$ XXX74183 TC 8.53$ 511.88$ 8.53$ 511.88$ XXX74185 00 11.60$ 696.21$ 11.60$ 696.21$ XXX74185 26 2.58$ 154.69$ 2.58$ 154.69$ XXX74185 TC 9.03$ 541.52$ 9.03$ 541.52$ XXX74190 00 26.02$ 26.02$ XXX74190 26 0.67$ 40.13$ 0.67$ 40.13$ XXX74190 TC 2.28$ 2.28$ XXX74210 00 2.59$ 155.16$ 2.59$ 155.16$ XXX74210 26 0.85$ 51.20$ 0.85$ 51.20$ XXX74210 TC 1.73$ 103.97$ 1.73$ 103.97$ XXX74220 00 2.83$ 170.01$ 2.83$ 170.01$ XXX74220 26 0.97$ 58.47$ 0.97$ 58.47$ XXX74220 TC 1.86$ 111.53$ 1.86$ 111.53$ XXX74221 00 3.19$ 191.65$ 3.19$ 191.65$ XXX74221 26 1.01$ 60.38$ 1.01$ 60.38$ XXX74221 TC 2.19$ 131.27$ 2.19$ 131.27$ XXX74230 00 3.74$ 224.68$ 3.74$ 224.68$ XXX74230 26 0.77$ 46.31$ 0.77$ 46.31$ XXX74230 TC 2.97$ 178.38$ 2.97$ 178.38$ XXX74235 00 By Report By Report XXX74235 26 1.73$ 103.54$ 1.73$ 103.54$ XXX74235 TC By Report By Report XXX74240 00 3.59$ 215.36$ 3.59$ 215.36$ XXX74240 26 1.01$ 60.31$ 1.01$ 60.31$ XXX74240 TC 2.58$ 155.04$ 2.58$ 155.04$ XXX74246 00 4.00$ 239.95$ 4.00$ 239.95$ XXX74246 26 0.99$ 59.68$ 0.99$ 59.68$ XXX74246 TC 3.00$ 180.27$ 3.00$ 180.27$ XXX74248 00 2.41$ 144.81$ 2.41$ 144.81$ ZZZ74248 26 1.01$ 60.38$ 1.01$ 60.38$ ZZZ74248 TC 1.41$ 84.43$ 1.41$ 84.43$ ZZZ74250 00 3.32$ 198.98$ 3.32$ 198.98$ XXX74250 26 0.68$ 40.79$ 0.68$ 40.79$ XXX74250 TC 2.64$ 158.20$ 2.64$ 158.20$ XXX74251 00 12.74$ 764.61$ 12.74$ 764.61$ XXX74251 26 0.99$ 59.68$ 0.99$ 59.68$ XXX74251 TC 11.75$ 704.93$ 11.75$ 704.93$ XXX74261 00 14.15$ 848.82$ 14.15$ 848.82$ XXX74261 26 3.47$ 208.30$ 3.47$ 208.30$ XXX



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

74261 TC 10.68$ 640.52$ 10.68$ 640.52$ XXX74262 00 15.90$ 953.87$ 15.90$ 953.87$ XXX74262 26 3.61$ 216.87$ 3.61$ 216.87$ XXX74262 TC 12.28$ 737.00$ 12.28$ 737.00$ XXX74263 00 22.28$ 1,336.54$ 22.28$ 1,336.54$ XXX74263 26 3.28$ 196.58$ 3.28$ 196.58$ XXX74263 TC 19.00$ 1,139.96$ 19.00$ 1,139.96$ XXX74270 00 4.73$ 284.09$ 4.73$ 284.09$ XXX74270 26 0.99$ 59.68$ 0.99$ 59.68$ XXX74270 TC 3.74$ 224.41$ 3.74$ 224.41$ XXX74280 00 6.68$ 401.07$ 6.68$ 401.07$ XXX74280 26 1.43$ 85.86$ 1.43$ 85.86$ XXX74280 TC 5.25$ 315.22$ 5.25$ 315.22$ XXX74283 00 6.84$ 410.52$ 6.84$ 410.52$ XXX74283 26 2.99$ 179.18$ 2.99$ 179.18$ XXX74283 TC 3.86$ 231.35$ 3.86$ 231.35$ XXX74290 00 2.24$ 134.50$ 2.24$ 134.50$ XXX74290 26 0.47$ 28.01$ 0.47$ 28.01$ XXX74290 TC 1.77$ 106.49$ 1.77$ 106.49$ XXX74300 00 By Report By Report XXX74300 26 0.53$ 31.61$ 0.53$ 31.61$ XXX74300 TC By Report By Report XXX74301 00 By Report By Report ZZZ74301 26 0.30$ 18.29$ 0.30$ 18.29$ ZZZ74301 TC By Report By Report ZZZ74328 00 41.93$ 41.93$ XXX74328 26 1.03$ 61.55$ 1.03$ 61.55$ XXX74328 TC 5.56$ 5.56$ XXX74329 00 By Report By Report XXX74329 26 1.03$ 61.63$ 1.03$ 61.63$ XXX74329 TC By Report By Report XXX74330 00 52.01$ 52.01$ XXX74330 26 1.31$ 78.61$ 1.31$ 78.61$ XXX74330 TC 5.56$ 5.56$ XXX74340 00 32.27$ 32.27$ XXX74340 26 0.78$ 46.91$ 0.78$ 46.91$ XXX74340 TC 4.55$ 4.55$ XXX74355 00 43.44$ 43.44$ XXX74355 26 1.10$ 65.81$ 1.10$ 65.81$ XXX74355 TC 4.55$ 4.55$ XXX74360 00 34.30$ 34.30$ XXX74360 26 0.81$ 48.63$ 0.81$ 48.63$ XXX



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

74360 TC 5.56$ 5.56$ XXX74363 00 By Report By Report XXX74363 26 1.24$ 74.24$ 1.24$ 74.24$ XXX74363 TC By Report By Report XXX74400 00 3.50$ 210.28$ 3.50$ 210.28$ XXX74400 26 0.71$ 42.63$ 0.71$ 42.63$ XXX74400 TC 2.79$ 167.66$ 2.79$ 167.66$ XXX74410 00 3.56$ 213.43$ 3.56$ 213.43$ XXX74410 26 0.70$ 42.00$ 0.70$ 42.00$ XXX74410 TC 2.86$ 171.44$ 2.86$ 171.44$ XXX74415 00 4.25$ 255.05$ 4.25$ 255.05$ XXX74415 26 0.71$ 42.63$ 0.71$ 42.63$ XXX74415 TC 3.54$ 212.43$ 3.54$ 212.43$ XXX74420 00 2.10$ 125.79$ 2.10$ 125.79$ XXX74420 26 0.74$ 44.52$ 0.74$ 44.52$ XXX74420 TC 1.35$ 81.26$ 1.35$ 81.26$ XXX74425 00 20.28$ 20.28$ XXX74425 26 0.51$ 30.43$ 0.51$ 30.43$ XXX74425 TC 2.28$ 2.28$ XXX74430 00 1.15$ 68.92$ 1.15$ 68.92$ XXX74430 26 0.47$ 28.01$ 0.47$ 28.01$ XXX74430 TC 0.68$ 40.91$ 0.68$ 40.91$ XXX74440 00 2.55$ 152.72$ 2.55$ 152.72$ XXX74440 26 0.53$ 31.73$ 0.53$ 31.73$ XXX74440 TC 2.02$ 120.99$ 2.02$ 120.99$ XXX74445 00 58.58$ 58.58$ XXX74445 26 1.60$ 95.81$ 1.60$ 95.81$ XXX74445 TC 1.95$ 1.95$ XXX74450 00 19.51$ 19.51$ XXX74450 26 0.48$ 28.62$ 0.48$ 28.62$ XXX74450 TC 2.59$ 2.59$ XXX74455 00 2.66$ 159.70$ 2.66$ 159.70$ XXX74455 26 0.48$ 28.62$ 0.48$ 28.62$ XXX74455 TC 2.18$ 131.08$ 2.18$ 131.08$ XXX74470 00 29.27$ 29.27$ XXX74470 26 0.76$ 45.65$ 0.76$ 45.65$ XXX74470 TC 2.28$ 2.28$ XXX74485 00 3.13$ 187.96$ 3.13$ 187.96$ XXX74485 26 1.16$ 69.50$ 1.16$ 69.50$ XXX74485 TC 1.97$ 118.47$ 1.97$ 118.47$ XXX74710 00 1.12$ 66.98$ 1.12$ 66.98$ XXX74710 26 0.50$ 29.85$ 0.50$ 29.85$ XXX



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

74710 TC 0.62$ 37.12$ 0.62$ 37.12$ XXX74712 00 14.10$ 845.76$ 14.10$ 845.76$ XXX74712 26 4.33$ 260.10$ 4.33$ 260.10$ XXX74712 TC 9.76$ 585.66$ 9.76$ 585.66$ XXX74713 00 6.84$ 410.42$ 6.84$ 410.42$ ZZZ74713 26 2.69$ 161.41$ 2.69$ 161.41$ ZZZ74713 TC 4.15$ 249.00$ 4.15$ 249.00$ ZZZ74740 00 2.42$ 145.07$ 2.42$ 145.07$ XXX74740 26 0.55$ 32.90$ 0.55$ 32.90$ XXX74740 TC 1.87$ 112.16$ 1.87$ 112.16$ XXX74742 00 By Report By Report XXX74742 26 0.89$ 53.58$ 0.89$ 53.58$ XXX74742 TC By Report By Report XXX74775 00 34.61$ 34.61$ XXX74775 26 0.90$ 54.19$ 0.90$ 54.19$ XXX74775 TC 2.59$ 2.59$ XXX75557 00 9.51$ 570.56$ 9.51$ 570.56$ XXX75557 26 3.34$ 200.48$ 3.34$ 200.48$ XXX75557 TC 6.17$ 370.08$ 6.17$ 370.08$ XXX75559 00 13.27$ 796.49$ 13.27$ 796.49$ XXX75559 26 4.11$ 246.77$ 4.11$ 246.77$ XXX75559 TC 9.16$ 549.72$ 9.16$ 549.72$ XXX75561 00 12.51$ 750.73$ 12.51$ 750.73$ XXX75561 26 3.69$ 221.19$ 3.69$ 221.19$ XXX75561 TC 8.83$ 529.54$ 8.83$ 529.54$ XXX75563 00 14.84$ 890.32$ 14.84$ 890.32$ XXX75563 26 4.23$ 253.58$ 4.23$ 253.58$ XXX75563 TC 10.61$ 636.74$ 10.61$ 636.74$ XXX75565 00 1.57$ 94.49$ 1.57$ 94.49$ ZZZ75565 26 0.36$ 21.34$ 0.36$ 21.34$ ZZZ75565 TC 1.22$ 73.15$ 1.22$ 73.15$ ZZZ75571 00 3.04$ 182.30$ 3.04$ 182.30$ XXX75571 26 0.83$ 49.96$ 0.83$ 49.96$ XXX75571 TC 2.21$ 132.34$ 2.21$ 132.34$ XXX75572 00 7.81$ 468.77$ 7.81$ 468.77$ XXX75572 26 2.51$ 150.49$ 2.51$ 150.49$ XXX75572 TC 5.30$ 318.29$ 5.30$ 318.29$ XXX75573 00 10.57$ 634.11$ 10.57$ 634.11$ XXX75573 26 3.65$ 218.71$ 3.65$ 218.71$ XXX75573 TC 6.92$ 415.40$ 6.92$ 415.40$ XXX75574 00 11.48$ 688.73$ 11.48$ 688.73$ XXX75574 26 3.41$ 204.68$ 3.41$ 204.68$ XXX



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL




CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

75743 TC 2.48$ 148.74$ 2.48$ 148.74$ XXX75746 00 4.31$ 258.72$ 4.31$ 258.72$ XXX75746 26 1.60$ 96.11$ 1.60$ 96.11$ XXX75746 TC 2.71$ 162.61$ 2.71$ 162.61$ XXX75756 00 4.96$ 297.69$ 4.96$ 297.69$ XXX75756 26 1.63$ 97.96$ 1.63$ 97.96$ XXX75756 TC 3.33$ 199.73$ 3.33$ 199.73$ XXX75774 00 2.43$ 145.67$ 2.43$ 145.67$ ZZZ75774 26 0.50$ 29.72$ 0.50$ 29.72$ ZZZ75774 TC 1.93$ 115.95$ 1.93$ 115.95$ ZZZ75801 00 54.86$ 54.86$ XXX75801 26 1.28$ 76.82$ 1.28$ 76.82$ XXX75801 TC 9.46$ 9.46$ XXX75803 00 69.93$ 69.93$ XXX75803 26 1.71$ 102.33$ 1.71$ 102.33$ XXX75803 TC 9.46$ 9.46$ XXX75805 00 52.49$ 52.49$ XXX75805 26 1.18$ 70.64$ 1.18$ 70.64$ XXX75805 TC 10.74$ 10.74$ XXX75807 00 By Report By Report XXX75807 26 1.62$ 97.29$ 1.62$ 97.29$ XXX75807 TC By Report By Report XXX75809 00 2.80$ 168.08$ 2.80$ 168.08$ XXX75809 26 0.69$ 41.42$ 0.69$ 41.42$ XXX75809 TC 2.11$ 126.67$ 2.11$ 126.67$ XXX75810 00 71.42$ 71.42$ XXX75810 26 1.41$ 84.75$ 1.41$ 84.75$ XXX75810 TC 21.14$ 21.14$ XXX75820 00 3.27$ 196.25$ 3.27$ 196.25$ XXX75820 26 1.00$ 60.12$ 1.00$ 60.12$ XXX75820 TC 2.27$ 136.13$ 2.27$ 136.13$ XXX75822 00 3.81$ 228.49$ 3.81$ 228.49$ XXX75822 26 1.49$ 89.21$ 1.49$ 89.21$ XXX75822 TC 2.32$ 139.28$ 2.32$ 139.28$ XXX75825 00 3.80$ 227.94$ 3.80$ 227.94$ XXX75825 26 1.59$ 95.60$ 1.59$ 95.60$ XXX75825 TC 2.21$ 132.34$ 2.21$ 132.34$ XXX75827 00 3.94$ 236.69$ 3.94$ 236.69$ XXX75827 26 1.61$ 96.78$ 1.61$ 96.78$ XXX75827 TC 2.33$ 139.91$ 2.33$ 139.91$ XXX75831 00 3.97$ 238.29$ 3.97$ 238.29$ XXX75831 26 1.58$ 94.59$ 1.58$ 94.59$ XXX



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

75831 TC 2.39$ 143.69$ 2.39$ 143.69$ XXX75833 00 4.69$ 281.31$ 4.69$ 281.31$ XXX75833 26 2.08$ 125.09$ 2.08$ 125.09$ XXX75833 TC 2.60$ 156.22$ 2.60$ 156.22$ XXX75840 00 4.23$ 253.67$ 4.23$ 253.67$ XXX75840 26 1.65$ 99.26$ 1.65$ 99.26$ XXX75840 TC 2.57$ 154.41$ 2.57$ 154.41$ XXX75842 00 5.12$ 307.38$ 5.12$ 307.38$ XXX75842 26 2.16$ 129.72$ 2.16$ 129.72$ XXX75842 TC 2.96$ 177.66$ 2.96$ 177.66$ XXX75860 00 4.13$ 247.74$ 4.13$ 247.74$ XXX75860 26 1.62$ 97.11$ 1.62$ 97.11$ XXX75860 TC 2.51$ 150.63$ 2.51$ 150.63$ XXX75870 00 5.49$ 329.18$ 5.49$ 329.18$ XXX75870 26 1.84$ 110.44$ 1.84$ 110.44$ XXX75870 TC 3.65$ 218.73$ 3.65$ 218.73$ XXX75872 00 4.23$ 253.67$ 4.23$ 253.67$ XXX75872 26 1.65$ 99.26$ 1.65$ 99.26$ XXX75872 TC 2.57$ 154.41$ 2.57$ 154.41$ XXX75880 00 3.58$ 214.70$ 3.58$ 214.70$ XXX75880 26 1.02$ 60.92$ 1.02$ 60.92$ XXX75880 TC 2.56$ 153.78$ 2.56$ 153.78$ XXX75885 00 4.43$ 266.06$ 4.43$ 266.06$ XXX75885 26 1.94$ 116.69$ 1.94$ 116.69$ XXX75885 TC 2.49$ 149.37$ 2.49$ 149.37$ XXX75887 00 4.46$ 267.32$ 4.46$ 267.32$ XXX75887 26 1.96$ 117.32$ 1.96$ 117.32$ XXX75887 TC 2.50$ 150.00$ 2.50$ 150.00$ XXX75889 00 4.07$ 244.21$ 4.07$ 244.21$ XXX75889 26 1.57$ 94.21$ 1.57$ 94.21$ XXX75889 TC 2.50$ 150.00$ 2.50$ 150.00$ XXX75891 00 4.12$ 247.37$ 4.12$ 247.37$ XXX75891 26 1.59$ 95.48$ 1.59$ 95.48$ XXX75891 TC 2.53$ 151.89$ 2.53$ 151.89$ XXX75893 00 3.46$ 207.55$ 3.46$ 207.55$ XXX75893 26 0.78$ 46.83$ 0.78$ 46.83$ XXX75893 TC 2.68$ 160.72$ 2.68$ 160.72$ XXX75894 00 114.94$ 114.94$ XXX75894 26 2.08$ 124.51$ 2.08$ 124.51$ XXX75894 TC 41.34$ 41.34$ XXX75898 00 93.76$ 93.76$ XXX75898 26 2.59$ 155.29$ 2.59$ 155.29$ XXX



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

75898 TC 1.95$ 1.95$ XXX75901 00 5.88$ 352.80$ 5.88$ 352.80$ XXX75901 26 0.68$ 40.73$ 0.68$ 40.73$ XXX75901 TC 5.20$ 312.06$ 5.20$ 312.06$ XXX75902 00 2.31$ 138.65$ 2.31$ 138.65$ XXX75902 26 0.55$ 32.79$ 0.55$ 32.79$ XXX75902 TC 1.76$ 105.86$ 1.76$ 105.86$ XXX75956 00 By Report By Report XXX75956 26 9.84$ 590.61$ 9.84$ 590.61$ XXX75956 TC By Report By Report XXX75957 00 By Report By Report XXX75957 26 8.45$ 506.88$ 8.45$ 506.88$ XXX75957 TC By Report By Report XXX75958 00 By Report By Report XXX75958 26 5.61$ 336.85$ 5.61$ 336.85$ XXX75958 TC By Report By Report XXX75959 00 By Report By Report XXX75959 26 4.89$ 293.58$ 4.89$ 293.58$ XXX75959 TC By Report By Report XXX75970 00 60.20$ 60.20$ XXX75970 26 1.14$ 68.70$ 1.14$ 68.70$ XXX75970 TC 19.55$ 19.55$ XXX75984 00 3.00$ 179.97$ 3.00$ 179.97$ XXX75984 26 1.00$ 60.24$ 1.00$ 60.24$ XXX75984 TC 2.00$ 119.73$ 2.00$ 119.73$ XXX75989 00 3.53$ 211.84$ 3.53$ 211.84$ XXX75989 26 1.67$ 100.31$ 1.67$ 100.31$ XXX75989 TC 1.86$ 111.53$ 1.86$ 111.53$ XXX76000 00 1.38$ 82.76$ 1.38$ 82.76$ XXX76000 26 0.45$ 26.72$ 0.45$ 26.72$ XXX76000 TC 0.93$ 56.04$ 0.93$ 56.04$ XXX76010 00 0.80$ 47.92$ 0.80$ 47.92$ XXX76010 26 0.26$ 15.85$ 0.26$ 15.85$ XXX76010 TC 0.53$ 32.08$ 0.53$ 32.08$ XXX76080 00 1.66$ 99.80$ 1.66$ 99.80$ XXX76080 26 0.75$ 45.02$ 0.75$ 45.02$ XXX76080 TC 0.91$ 54.78$ 0.91$ 54.78$ XXX76098 00 0.48$ 29.06$ 0.48$ 29.06$ XXX76098 26 0.23$ 14.01$ 0.23$ 14.01$ XXX76098 TC 0.25$ 15.05$ 0.25$ 15.05$ XXX76100 00 2.77$ 166.37$ 2.77$ 166.37$ XXX76100 26 0.90$ 54.21$ 0.90$ 54.21$ XXX



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

76100 TC 1.87$ 112.16$ 1.87$ 112.16$ XXX76101 00 2.74$ 164.52$ 2.74$ 164.52$ XXX76101 26 0.80$ 47.94$ 0.80$ 47.94$ XXX76101 TC 1.94$ 116.58$ 1.94$ 116.58$ XXX76102 00 5.09$ 305.40$ 5.09$ 305.40$ XXX76102 26 0.97$ 58.37$ 0.97$ 58.37$ XXX76102 TC 4.12$ 247.03$ 4.12$ 247.03$ XXX76120 00 3.00$ 179.75$ 3.00$ 179.75$ XXX76120 26 0.53$ 31.64$ 0.53$ 31.64$ XXX76120 TC 2.47$ 148.11$ 2.47$ 148.11$ XXX76125 00 16.03$ 16.03$ ZZZ76125 26 0.41$ 24.36$ 0.41$ 24.36$ ZZZ76125 TC 1.64$ 1.64$ ZZZ76140 00 Not Covered Not Covered XXX76376 00 0.67$ 40.31$ 0.67$ 40.31$ XXX76376 26 0.28$ 17.06$ 0.28$ 17.06$ XXX76376 TC 0.39$ 23.25$ 0.39$ 23.25$ XXX76377 00 2.07$ 124.21$ 2.07$ 124.21$ XXX76377 26 1.15$ 68.80$ 1.15$ 68.80$ XXX76377 TC 0.92$ 55.41$ 0.92$ 55.41$ XXX76380 00 4.23$ 253.54$ 4.23$ 253.54$ XXX76380 26 1.40$ 83.99$ 1.40$ 83.99$ XXX76380 TC 2.83$ 169.55$ 2.83$ 169.55$ XXX76390 00 12.87$ 772.24$ 12.87$ 772.24$ XXX76390 26 2.02$ 120.91$ 2.02$ 120.91$ XXX76390 TC 10.86$ 651.33$ 10.86$ 651.33$ XXX76391 00 6.94$ 416.55$ 6.94$ 416.55$ XXX76391 26 1.60$ 96.29$ 1.60$ 96.29$ XXX76391 TC 5.34$ 320.26$ 5.34$ 320.26$ XXX76496 00 By Report By Report XXX76496 26 By Report By Report XXX76496 TC By Report By Report XXX76497 00 By Report By Report XXX76497 26 By Report By Report XXX76497 TC By Report By Report XXX76498 00 By Report By Report XXX76498 26 By Report By Report XXX76498 TC By Report By Report XXX76499 00 By Report By Report XXX76499 26 By Report By Report XXX76499 TC By Report By Report XXX76506 00 3.39$ 203.45$ 3.39$ 203.45$ XXX



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

76506 26 0.92$ 55.34$ 0.92$ 55.34$ XXX76506 TC 2.47$ 148.11$ 2.47$ 148.11$ XXX76510 00 3.28$ 196.67$ 3.28$ 196.67$ XXX76510 26 1.70$ 102.16$ 1.70$ 102.16$ XXX76510 TC 1.58$ 94.51$ 1.58$ 94.51$ XXX76511 00 2.00$ 119.89$ 2.00$ 119.89$ XXX76511 26 1.05$ 63.22$ 1.05$ 63.22$ XXX76511 TC 0.94$ 56.67$ 0.94$ 56.67$ XXX76512 00 1.79$ 107.48$ 1.79$ 107.48$ XXX76512 26 1.02$ 60.90$ 1.02$ 60.90$ XXX76512 TC 0.78$ 46.58$ 0.78$ 46.58$ XXX76513 00 2.89$ 173.44$ 2.89$ 173.44$ XXX76513 26 1.04$ 62.53$ 1.04$ 62.53$ XXX76513 TC 1.85$ 110.90$ 1.85$ 110.90$ XXX76514 00 0.37$ 22.17$ 0.37$ 22.17$ XXX76514 26 0.23$ 14.06$ 0.23$ 14.06$ XXX76514 TC 0.14$ 8.11$ 0.14$ 8.11$ XXX76516 00 1.59$ 95.28$ 1.59$ 95.28$ XXX76516 26 0.66$ 39.87$ 0.66$ 39.87$ XXX76516 TC 0.92$ 55.41$ 0.92$ 55.41$ XXX76519 00 1.94$ 116.36$ 1.94$ 116.36$ XXX76519 26 0.91$ 54.65$ 0.91$ 54.65$ XXX76519 TC 1.03$ 61.71$ 1.03$ 61.71$ XXX76529 00 2.42$ 145.29$ 2.42$ 145.29$ XXX76529 26 0.96$ 57.72$ 0.96$ 57.72$ XXX76529 TC 1.46$ 87.57$ 1.46$ 87.57$ XXX76536 00 3.39$ 203.16$ 3.39$ 203.16$ XXX76536 26 0.81$ 48.75$ 0.81$ 48.75$ XXX76536 TC 2.57$ 154.41$ 2.57$ 154.41$ XXX76604 00 2.61$ 156.53$ 2.61$ 156.53$ XXX76604 26 0.78$ 46.89$ 0.78$ 46.89$ XXX76604 TC 1.83$ 109.64$ 1.83$ 109.64$ XXX76641 00 3.14$ 188.14$ 3.14$ 188.14$ XXX76641 26 1.06$ 63.36$ 1.06$ 63.36$ XXX76641 TC 2.08$ 124.77$ 2.08$ 124.77$ XXX76642 00 2.56$ 153.58$ 2.56$ 153.58$ XXX76642 26 0.98$ 59.08$ 0.98$ 59.08$ XXX76642 TC 1.58$ 94.51$ 1.58$ 94.51$ XXX76700 00 3.56$ 213.79$ 3.56$ 213.79$ XXX76700 26 1.17$ 70.09$ 1.17$ 70.09$ XXX76700 TC 2.39$ 143.69$ 2.39$ 143.69$ XXX76705 00 2.66$ 159.58$ 2.66$ 159.58$ XXX



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

76705 26 0.84$ 50.57$ 0.84$ 50.57$ XXX76705 TC 1.82$ 109.01$ 1.82$ 109.01$ XXX76706 00 3.33$ 200.04$ 3.33$ 200.04$ XXX76706 26 0.79$ 47.52$ 0.79$ 47.52$ XXX76706 TC 2.54$ 152.52$ 2.54$ 152.52$ XXX76770 00 3.30$ 198.20$ 3.30$ 198.20$ XXX76770 26 1.07$ 63.97$ 1.07$ 63.97$ XXX76770 TC 2.24$ 134.23$ 2.24$ 134.23$ XXX76775 00 1.70$ 102.22$ 1.70$ 102.22$ XXX76775 26 0.83$ 49.96$ 0.83$ 49.96$ XXX76775 TC 0.87$ 52.26$ 0.87$ 52.26$ XXX76776 00 4.56$ 273.82$ 4.56$ 273.82$ XXX76776 26 1.10$ 65.81$ 1.10$ 65.81$ XXX76776 TC 3.47$ 208.01$ 3.47$ 208.01$ XXX76800 00 4.18$ 250.50$ 4.18$ 250.50$ XXX76800 26 1.70$ 101.77$ 1.70$ 101.77$ XXX76800 TC 2.48$ 148.74$ 2.48$ 148.74$ XXX76801 00 3.58$ 215.05$ 3.58$ 215.05$ XXX76801 26 1.44$ 86.49$ 1.44$ 86.49$ XXX76801 TC 2.14$ 128.56$ 2.14$ 128.56$ XXX76802 00 1.86$ 111.49$ 1.86$ 111.49$ ZZZ76802 26 1.22$ 73.03$ 1.22$ 73.03$ ZZZ76802 TC 0.64$ 38.47$ 0.64$ 38.47$ ZZZ76805 00 4.12$ 247.12$ 4.12$ 247.12$ XXX76805 26 1.45$ 87.03$ 1.45$ 87.03$ XXX76805 TC 2.67$ 160.09$ 2.67$ 160.09$ XXX76810 00 2.71$ 162.65$ 2.71$ 162.65$ ZZZ76810 26 1.45$ 86.98$ 1.45$ 86.98$ ZZZ76810 TC 1.26$ 75.67$ 1.26$ 75.67$ ZZZ76811 00 5.27$ 316.45$ 5.27$ 316.45$ XXX76811 26 2.81$ 168.43$ 2.81$ 168.43$ XXX76811 TC 2.47$ 148.02$ 2.47$ 148.02$ XXX76812 00 5.91$ 354.68$ 5.91$ 354.68$ ZZZ76812 26 2.65$ 159.28$ 2.65$ 159.28$ ZZZ76812 TC 3.26$ 195.40$ 3.26$ 195.40$ ZZZ76813 00 3.56$ 213.59$ 3.56$ 213.59$ XXX76813 26 1.75$ 105.21$ 1.75$ 105.21$ XXX76813 TC 1.81$ 108.38$ 1.81$ 108.38$ XXX76814 00 2.33$ 139.75$ 2.33$ 139.75$ XXX76814 26 1.48$ 88.76$ 1.48$ 88.76$ XXX76814 TC 0.85$ 50.99$ 0.85$ 50.99$ XXX76815 00 2.47$ 147.99$ 2.47$ 147.99$ XXX



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

76815 26 0.94$ 56.63$ 0.94$ 56.63$ XXX76815 TC 1.52$ 91.35$ 1.52$ 91.35$ XXX76816 00 3.35$ 200.82$ 3.35$ 200.82$ XXX76816 26 1.26$ 75.41$ 1.26$ 75.41$ XXX76816 TC 2.09$ 125.41$ 2.09$ 125.41$ XXX76817 00 2.83$ 169.71$ 2.83$ 169.71$ XXX76817 26 1.10$ 65.75$ 1.10$ 65.75$ XXX76817 TC 1.73$ 103.97$ 1.73$ 103.97$ XXX76818 00 3.55$ 213.29$ 3.55$ 213.29$ XXX76818 26 1.56$ 93.65$ 1.56$ 93.65$ XXX76818 TC 1.99$ 119.65$ 1.99$ 119.65$ XXX76819 00 2.61$ 156.34$ 2.61$ 156.34$ XXX76819 26 1.14$ 68.14$ 1.14$ 68.14$ XXX76819 TC 1.47$ 88.20$ 1.47$ 88.20$ XXX76820 00 1.39$ 83.42$ 1.39$ 83.42$ XXX76820 26 0.74$ 44.41$ 0.74$ 44.41$ XXX76820 TC 0.65$ 39.01$ 0.65$ 39.01$ XXX76821 00 2.70$ 162.19$ 2.70$ 162.19$ XXX76821 26 1.04$ 62.64$ 1.04$ 62.64$ XXX76821 TC 1.66$ 99.55$ 1.66$ 99.55$ XXX76825 00 8.10$ 485.92$ 8.10$ 485.92$ XXX76825 26 2.42$ 144.93$ 2.42$ 144.93$ XXX76825 TC 5.68$ 340.99$ 5.68$ 340.99$ XXX76826 00 4.81$ 288.78$ 4.81$ 288.78$ XXX76826 26 1.19$ 71.30$ 1.19$ 71.30$ XXX76826 TC 3.62$ 217.47$ 3.62$ 217.47$ XXX76827 00 2.19$ 131.22$ 2.19$ 131.22$ XXX76827 26 0.83$ 49.96$ 0.83$ 49.96$ XXX76827 TC 1.35$ 81.26$ 1.35$ 81.26$ XXX76828 00 1.56$ 93.36$ 1.56$ 93.36$ XXX76828 26 0.82$ 49.30$ 0.82$ 49.30$ XXX76828 TC 0.73$ 44.06$ 0.73$ 44.06$ XXX76830 00 3.58$ 214.73$ 3.58$ 214.73$ XXX76830 26 1.01$ 60.31$ 1.01$ 60.31$ XXX76830 TC 2.57$ 154.41$ 2.57$ 154.41$ XXX76831 00 3.48$ 208.89$ 3.48$ 208.89$ XXX76831 26 1.06$ 63.30$ 1.06$ 63.30$ XXX76831 TC 2.43$ 145.58$ 2.43$ 145.58$ XXX76856 00 3.21$ 192.66$ 3.21$ 192.66$ XXX76856 26 0.99$ 59.68$ 0.99$ 59.68$ XXX76856 TC 2.22$ 132.97$ 2.22$ 132.97$ XXX76857 00 1.42$ 85.40$ 1.42$ 85.40$ XXX



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

76857 26 0.72$ 43.23$ 0.72$ 43.23$ XXX76857 TC 0.70$ 42.17$ 0.70$ 42.17$ XXX76870 00 3.09$ 185.22$ 3.09$ 185.22$ XXX76870 26 0.92$ 55.40$ 0.92$ 55.40$ XXX76870 TC 2.16$ 129.82$ 2.16$ 129.82$ XXX76872 00 3.77$ 226.25$ 3.77$ 226.25$ XXX76872 26 0.97$ 57.96$ 0.97$ 57.96$ XXX76872 TC 2.80$ 168.29$ 2.80$ 168.29$ XXX76873 00 5.08$ 305.04$ 5.08$ 305.04$ XXX76873 26 2.26$ 135.49$ 2.26$ 135.49$ XXX76873 TC 2.83$ 169.55$ 2.83$ 169.55$ XXX76881 00 2.61$ 156.32$ 2.61$ 156.32$ XXX76881 26 0.91$ 54.88$ 0.91$ 54.88$ XXX76881 TC 1.69$ 101.44$ 1.69$ 101.44$ XXX76882 00 1.68$ 100.56$ 1.68$ 100.56$ XXX76882 26 0.71$ 42.63$ 0.71$ 42.63$ XXX76882 TC 0.97$ 57.93$ 0.97$ 57.93$ XXX76885 00 4.22$ 253.06$ 4.22$ 253.06$ XXX76885 26 1.08$ 64.60$ 1.08$ 64.60$ XXX76885 TC 3.14$ 188.47$ 3.14$ 188.47$ XXX76886 00 3.09$ 185.27$ 3.09$ 185.27$ XXX76886 26 0.90$ 54.19$ 0.90$ 54.19$ XXX76886 TC 2.18$ 131.08$ 2.18$ 131.08$ XXX76932 00 37.15$ 37.15$ YYY76932 26 0.95$ 57.30$ 0.95$ 57.30$ XXX76932 TC 3.28$ 3.28$ YYY76936 00 7.87$ 472.11$ 7.87$ 472.11$ XXX76936 26 2.79$ 167.69$ 2.79$ 167.69$ XXX76936 TC 5.07$ 304.41$ 5.07$ 304.41$ XXX76937 00 0.99$ 59.60$ 0.99$ 59.60$ ZZZ76937 26 0.42$ 24.91$ 0.42$ 24.91$ ZZZ76937 TC 0.58$ 34.68$ 0.58$ 34.68$ ZZZ76940 00 114.52$ 114.52$ YYY76940 26 2.96$ 177.67$ 2.96$ 177.67$ XXX76940 TC 9.46$ 9.46$ YYY76941 00 73.37$ 73.37$ XXX76941 26 2.00$ 119.76$ 2.00$ 119.76$ XXX76941 TC 2.59$ 2.59$ XXX76942 00 1.66$ 99.46$ 1.66$ 99.46$ XXX76942 26 0.92$ 55.40$ 0.92$ 55.40$ XXX76942 TC 0.73$ 44.06$ 0.73$ 44.06$ XXX76945 00 38.16$ 38.16$ XXX



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

76945 26 1.00$ 60.20$ 1.00$ 60.20$ XXX76945 TC 2.59$ 2.59$ XXX76946 00 0.94$ 56.70$ 0.94$ 56.70$ XXX76946 26 0.56$ 33.45$ 0.56$ 33.45$ XXX76946 TC 0.39$ 23.25$ 0.39$ 23.25$ XXX76948 00 2.19$ 131.37$ 2.19$ 131.37$ XXX76948 26 1.00$ 60.20$ 1.00$ 60.20$ XXX76948 TC 1.19$ 71.17$ 1.19$ 71.17$ XXX76965 00 2.69$ 161.26$ 2.69$ 161.26$ XXX76965 26 1.95$ 117.20$ 1.95$ 117.20$ XXX76965 TC 0.73$ 44.06$ 0.73$ 44.06$ XXX76970 00 2.65$ 158.80$ 2.65$ 158.80$ XXX76970 26 0.56$ 33.40$ 0.56$ 33.40$ XXX76970 TC 2.09$ 125.41$ 2.09$ 125.41$ XXX76975 00 46.56$ 46.56$ XXX76975 26 1.22$ 73.33$ 1.22$ 73.33$ XXX76975 TC 3.28$ 3.28$ XXX76977 00 0.22$ 12.95$ 0.22$ 12.95$ XXX76977 26 0.08$ 4.83$ 0.08$ 4.83$ XXX76977 TC 0.14$ 8.11$ 0.14$ 8.11$ XXX76978 00 9.56$ 573.79$ 9.56$ 573.79$ XXX76978 26 2.33$ 140.02$ 2.33$ 140.02$ XXX76978 TC 7.23$ 433.77$ 7.23$ 433.77$ XXX76979 00 6.50$ 390.25$ 6.50$ 390.25$ ZZZ76979 26 1.23$ 73.69$ 1.23$ 73.69$ ZZZ76979 TC 5.28$ 316.56$ 5.28$ 316.56$ ZZZ76981 00 3.16$ 189.76$ 3.16$ 189.76$ XXX76981 26 0.86$ 51.74$ 0.86$ 51.74$ XXX76981 TC 2.30$ 138.02$ 2.30$ 138.02$ XXX76982 00 2.83$ 169.58$ 2.83$ 169.58$ XXX76982 26 0.86$ 51.74$ 0.86$ 51.74$ XXX76982 TC 1.96$ 117.84$ 1.96$ 117.84$ XXX76983 00 1.73$ 103.77$ 1.73$ 103.77$ ZZZ76983 26 0.73$ 43.86$ 0.73$ 43.86$ ZZZ76983 TC 1.00$ 59.91$ 1.00$ 59.91$ ZZZ76998 00 65.75$ 65.75$ XXX76998 26 1.82$ 109.19$ 1.82$ 109.19$ XXX76998 TC 28.52$ 28.52$ XXX76999 00 By Report By Report XXX76999 26 By Report By Report XXX76999 TC By Report By Report XXX77001 00 2.66$ 159.49$ 2.66$ 159.49$ ZZZ



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

77001 26 0.54$ 32.19$ 0.54$ 32.19$ ZZZ77001 TC 2.12$ 127.30$ 2.12$ 127.30$ ZZZ77002 00 2.98$ 178.62$ 2.98$ 178.62$ ZZZ77002 26 0.80$ 48.17$ 0.80$ 48.17$ ZZZ77002 TC 2.17$ 130.45$ 2.17$ 130.45$ ZZZ77003 00 2.88$ 172.71$ 2.88$ 172.71$ ZZZ77003 26 0.87$ 52.35$ 0.87$ 52.35$ ZZZ77003 TC 2.01$ 120.36$ 2.01$ 120.36$ ZZZ77011 00 6.74$ 404.12$ 6.74$ 404.12$ XXX77011 26 1.82$ 109.08$ 1.82$ 109.08$ XXX77011 TC 4.92$ 295.04$ 4.92$ 295.04$ XXX77012 00 4.41$ 264.56$ 4.41$ 264.56$ XXX77012 26 2.13$ 127.80$ 2.13$ 127.80$ XXX77012 TC 2.28$ 136.76$ 2.28$ 136.76$ XXX77013 00 579.34$ 579.34$ XXX77013 26 5.53$ 332.08$ 5.53$ 332.08$ XXX77013 TC 382.89$ 382.89$ XXX77014 00 3.54$ 212.42$ 3.54$ 212.42$ XXX77014 26 1.29$ 77.56$ 1.29$ 77.56$ XXX77014 TC 2.25$ 134.86$ 2.25$ 134.86$ XXX77021 00 14.05$ 842.90$ 14.05$ 842.90$ XXX77021 26 2.11$ 126.71$ 2.11$ 126.71$ XXX77021 TC 11.94$ 716.19$ 11.94$ 716.19$ XXX77022 00 213.58$ 213.58$ XXX77022 26 6.25$ 374.95$ 6.25$ 374.95$ XXX77022 TC 85.72$ 85.72$ XXX77046 00 7.30$ 438.18$ 7.30$ 438.18$ XXX77046 26 2.09$ 125.49$ 2.09$ 125.49$ XXX77046 TC 5.21$ 312.69$ 5.21$ 312.69$ XXX77047 00 7.49$ 449.69$ 7.49$ 449.69$ XXX77047 26 2.31$ 138.89$ 2.31$ 138.89$ XXX77047 TC 5.18$ 310.80$ 5.18$ 310.80$ XXX77048 00 11.61$ 696.53$ 11.61$ 696.53$ XXX77048 26 3.02$ 181.49$ 3.02$ 181.49$ XXX77048 TC 8.58$ 515.03$ 8.58$ 515.03$ XXX77049 00 11.85$ 711.06$ 11.85$ 711.06$ XXX77049 26 3.31$ 198.55$ 3.31$ 198.55$ XXX77049 TC 8.54$ 512.51$ 8.54$ 512.51$ XXX77053 00 1.68$ 100.98$ 1.68$ 100.98$ XXX77053 26 0.52$ 31.06$ 0.52$ 31.06$ XXX77053 TC 1.17$ 69.91$ 1.17$ 69.91$ XXX77054 00 2.20$ 132.19$ 2.20$ 132.19$ XXX



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

77054 26 0.66$ 39.58$ 0.66$ 39.58$ XXX77054 TC 1.54$ 92.61$ 1.54$ 92.61$ XXX77061 00 Bundled Bundled XXX77061 26 Bundled Bundled XXX77061 TC Bundled Bundled XXX77062 00 Bundled Bundled XXX77062 26 Bundled Bundled XXX77062 TC Bundled Bundled XXX77063 00 1.60$ 95.94$ 1.60$ 95.94$ ZZZ77063 26 0.86$ 51.80$ 0.86$ 51.80$ ZZZ77063 TC 0.74$ 44.14$ 0.74$ 44.14$ ZZZ77065 00 3.92$ 235.14$ 3.92$ 235.14$ XXX77065 26 1.18$ 70.64$ 1.18$ 70.64$ XXX77065 TC 2.74$ 164.50$ 2.74$ 164.50$ XXX77066 00 4.96$ 297.63$ 4.96$ 297.63$ XXX77066 26 1.45$ 87.09$ 1.45$ 87.09$ XXX77066 TC 3.51$ 210.54$ 3.51$ 210.54$ XXX77067 00 4.00$ 239.77$ 4.00$ 239.77$ XXX77067 26 1.10$ 65.81$ 1.10$ 65.81$ XXX77067 TC 2.90$ 173.96$ 2.90$ 173.96$ XXX77071 00 1.48$ 88.53$ 1.48$ 88.53$ XXX77072 00 0.70$ 42.22$ 0.70$ 42.22$ XXX77072 26 0.27$ 16.45$ 0.27$ 16.45$ XXX77072 TC 0.43$ 25.77$ 0.43$ 25.77$ XXX77073 00 1.10$ 65.90$ 1.10$ 65.90$ XXX77073 26 0.42$ 24.99$ 0.42$ 24.99$ XXX77073 TC 0.68$ 40.91$ 0.68$ 40.91$ XXX77074 00 1.98$ 118.95$ 1.98$ 118.95$ XXX77074 26 0.66$ 39.58$ 0.66$ 39.58$ XXX77074 TC 1.32$ 79.37$ 1.32$ 79.37$ XXX77075 00 2.70$ 162.23$ 2.70$ 162.23$ XXX77075 26 0.78$ 46.91$ 0.78$ 46.91$ XXX77075 TC 1.92$ 115.32$ 1.92$ 115.32$ XXX77076 00 2.96$ 177.50$ 2.96$ 177.50$ XXX77076 26 1.02$ 60.92$ 1.02$ 60.92$ XXX77076 TC 1.94$ 116.58$ 1.94$ 116.58$ XXX77077 00 1.13$ 67.68$ 1.13$ 67.68$ XXX77077 26 0.47$ 28.04$ 0.47$ 28.04$ XXX77077 TC 0.66$ 39.64$ 0.66$ 39.64$ XXX77078 00 3.39$ 203.50$ 3.39$ 203.50$ XXX77078 26 0.36$ 21.34$ 0.36$ 21.34$ XXX77078 TC 3.04$ 182.16$ 3.04$ 182.16$ XXX



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

77080 00 1.18$ 70.57$ 1.18$ 70.57$ XXX77080 26 0.28$ 17.06$ 0.28$ 17.06$ XXX77080 TC 0.89$ 53.52$ 0.89$ 53.52$ XXX77081 00 0.98$ 58.59$ 0.98$ 58.59$ XXX77081 26 0.29$ 17.69$ 0.29$ 17.69$ XXX77081 TC 0.68$ 40.91$ 0.68$ 40.91$ XXX77084 00 11.18$ 670.95$ 11.18$ 670.95$ XXX77084 26 2.33$ 139.52$ 2.33$ 139.52$ XXX77084 TC 8.86$ 531.43$ 8.86$ 531.43$ XXX77085 00 1.60$ 96.09$ 1.60$ 96.09$ XXX77085 26 0.44$ 26.17$ 0.44$ 26.17$ XXX77085 TC 1.17$ 69.91$ 1.17$ 69.91$ XXX77086 00 1.03$ 61.82$ 1.03$ 61.82$ XXX77086 26 0.24$ 14.61$ 0.24$ 14.61$ XXX77086 TC 0.79$ 47.21$ 0.79$ 47.21$ XXX77261 00 2.07$ 123.90$ 2.07$ 123.90$ XXX77262 00 3.11$ 186.63$ 3.11$ 186.63$ XXX77263 00 4.86$ 291.39$ 4.86$ 291.39$ XXX77280 00 8.20$ 492.25$ 8.20$ 492.25$ XXX77280 26 1.08$ 64.79$ 1.08$ 64.79$ XXX77280 TC 7.12$ 427.46$ 7.12$ 427.46$ XXX77285 00 13.58$ 814.76$ 13.58$ 814.76$ XXX77285 26 1.64$ 98.48$ 1.64$ 98.48$ XXX77285 TC 11.94$ 716.28$ 11.94$ 716.28$ XXX77290 00 15.09$ 905.26$ 15.09$ 905.26$ XXX77290 26 2.37$ 142.32$ 2.37$ 142.32$ XXX77290 TC 12.72$ 762.94$ 12.72$ 762.94$ XXX77293 00 13.62$ 817.48$ 13.62$ 817.48$ ZZZ77293 26 3.04$ 182.63$ 3.04$ 182.63$ ZZZ77293 TC 10.58$ 634.85$ 10.58$ 634.85$ ZZZ77295 00 14.43$ 866.06$ 14.43$ 866.06$ XXX77295 26 6.52$ 391.00$ 6.52$ 391.00$ XXX77295 TC 7.92$ 475.05$ 7.92$ 475.05$ XXX77299 00 By Report By Report XXX77299 26 By Report By Report XXX77299 TC By Report By Report XXX77300 00 1.95$ 117.25$ 1.95$ 117.25$ XXX77300 26 0.95$ 56.79$ 0.95$ 56.79$ XXX77300 TC 1.01$ 60.45$ 1.01$ 60.45$ XXX77301 00 57.43$ 3,445.97$ 57.43$ 3,445.97$ XXX77301 26 12.14$ 728.21$ 12.14$ 728.21$ XXX77301 TC 45.30$ 2,717.76$ 45.30$ 2,717.76$ XXX



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

77306 00 4.40$ 263.72$ 4.40$ 263.72$ XXX77306 26 2.13$ 127.68$ 2.13$ 127.68$ XXX77306 TC 2.27$ 136.04$ 2.27$ 136.04$ XXX77307 00 8.49$ 509.61$ 8.49$ 509.61$ XXX77307 26 4.40$ 263.93$ 4.40$ 263.93$ XXX77307 TC 4.09$ 245.68$ 4.09$ 245.68$ XXX77316 00 6.00$ 360.12$ 6.00$ 360.12$ XXX77316 26 2.14$ 128.31$ 2.14$ 128.31$ XXX77316 TC 3.86$ 231.81$ 3.86$ 231.81$ XXX77317 00 7.86$ 471.63$ 7.86$ 471.63$ XXX77317 26 2.78$ 166.76$ 2.78$ 166.76$ XXX77317 TC 5.08$ 304.87$ 5.08$ 304.87$ XXX77318 00 11.28$ 677.10$ 11.28$ 677.10$ XXX77318 26 4.40$ 263.93$ 4.40$ 263.93$ XXX77318 TC 6.89$ 413.17$ 6.89$ 413.17$ XXX77321 00 2.75$ 164.87$ 2.75$ 164.87$ XXX77321 26 1.45$ 86.76$ 1.45$ 86.76$ XXX77321 TC 1.30$ 78.11$ 1.30$ 78.11$ XXX77331 00 1.89$ 113.37$ 1.89$ 113.37$ XXX77331 26 1.32$ 79.40$ 1.32$ 79.40$ XXX77331 TC 0.57$ 33.97$ 0.57$ 33.97$ XXX77332 00 1.54$ 92.55$ 1.54$ 92.55$ XXX77332 26 0.69$ 41.55$ 0.69$ 41.55$ XXX77332 TC 0.85$ 50.99$ 0.85$ 50.99$ XXX77333 00 3.22$ 193.22$ 3.22$ 193.22$ XXX77333 26 1.14$ 68.44$ 1.14$ 68.44$ XXX77333 TC 2.08$ 124.77$ 2.08$ 124.77$ XXX77334 00 3.77$ 226.07$ 3.77$ 226.07$ XXX77334 26 1.75$ 105.08$ 1.75$ 105.08$ XXX77334 TC 2.02$ 120.99$ 2.02$ 120.99$ XXX77336 00 2.37$ 142.01$ 2.37$ 142.01$ XXX77338 00 14.66$ 879.85$ 14.66$ 879.85$ XXX77338 26 6.52$ 391.00$ 6.52$ 391.00$ XXX77338 TC 8.15$ 488.84$ 8.15$ 488.84$ XXX77370 00 3.68$ 220.96$ 3.68$ 220.96$ XXX77371 00 2,058.04$ 2,058.04$ XXX77372 00 31.76$ 1,905.59$ 31.76$ 1,905.59$ XXX77373 00 38.45$ 2,306.95$ 38.45$ 2,306.95$ XXX77385 00 Not Covered Not Covered XXX77386 00 Not Covered Not Covered XXX77387 00 By Report By Report XXX77399 00 By Report By Report XXX



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

77399 26 By Report By Report XXX77399 TC By Report By Report XXX77401 00 0.73$ 44.06$ 0.73$ 44.06$ XXX77402 00 By Report By Report XXX77407 00 By Report By Report XXX77412 00 By Report By Report XXX77417 00 0.33$ 20.10$ 0.33$ 20.10$ XXX77423 00 40.10$ 40.10$ XXX77424 00 By Report By Report XXX77425 00 By Report By Report XXX77427 00 5.47$ 327.92$ 5.47$ 327.92$ XXX77431 00 3.01$ 180.90$ 3.01$ 180.90$ XXX77432 00 12.24$ 734.65$ 12.24$ 734.65$ XXX77435 00 18.47$ 1,108.12$ 18.47$ 1,108.12$ XXX77469 00 9.15$ 549.18$ 9.15$ 549.18$ XXX77470 00 3.84$ 230.40$ 3.84$ 230.40$ XXX77470 26 3.08$ 185.08$ 3.08$ 185.08$ XXX77470 TC 0.76$ 45.32$ 0.76$ 45.32$ XXX77499 00 By Report By Report XXX77499 26 By Report By Report XXX77499 TC By Report By Report XXX77520 00 525.00$ 525.00$ XXX77522 00 525.00$ 525.00$ XXX77523 00 680.00$ 680.00$ XXX77525 00 680.00$ 680.00$ XXX77600 00 13.34$ 800.43$ 13.34$ 800.43$ XXX77600 26 2.06$ 123.50$ 2.06$ 123.50$ XXX77600 TC 11.28$ 676.93$ 11.28$ 676.93$ XXX77605 00 23.05$ 1,382.70$ 23.05$ 1,382.70$ XXX77605 26 2.95$ 176.70$ 2.95$ 176.70$ XXX77605 TC 20.10$ 1,206.00$ 20.10$ 1,206.00$ XXX77610 00 20.53$ 1,231.76$ 20.53$ 1,231.76$ XXX77610 26 1.97$ 118.45$ 1.97$ 118.45$ XXX77610 TC 18.56$ 1,113.30$ 18.56$ 1,113.30$ XXX77615 00 31.52$ 1,891.22$ 31.52$ 1,891.22$ XXX77615 26 2.78$ 166.65$ 2.78$ 166.65$ XXX77615 TC 28.74$ 1,724.57$ 28.74$ 1,724.57$ XXX77620 00 15.30$ 918.13$ 15.30$ 918.13$ XXX77620 26 2.47$ 148.50$ 2.47$ 148.50$ XXX77620 TC 12.83$ 769.63$ 12.83$ 769.63$ XXX77750 00 11.09$ 665.42$ 11.09$ 665.42$ 09077750 26 7.59$ 455.13$ 7.59$ 455.13$ 090



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

77750 TC 3.50$ 210.28$ 3.50$ 210.28$ 09077761 00 11.71$ 702.77$ 11.71$ 702.77$ 09077761 26 5.86$ 351.32$ 5.86$ 351.32$ 09077761 TC 5.86$ 351.45$ 5.86$ 351.45$ 09077762 00 15.47$ 928.44$ 15.47$ 928.44$ 09077762 26 8.77$ 525.99$ 8.77$ 525.99$ 09077762 TC 6.71$ 402.45$ 6.71$ 402.45$ 09077763 00 22.01$ 1,320.33$ 22.01$ 1,320.33$ 09077763 26 13.19$ 791.39$ 13.19$ 791.39$ 09077763 TC 8.82$ 528.95$ 8.82$ 528.95$ 09077767 00 6.88$ 412.90$ 6.88$ 412.90$ XXX77767 26 1.60$ 95.96$ 1.60$ 95.96$ XXX77767 TC 5.28$ 316.94$ 5.28$ 316.94$ XXX77768 00 10.58$ 634.89$ 10.58$ 634.89$ XXX77768 26 2.14$ 128.31$ 2.14$ 128.31$ XXX77768 TC 8.44$ 506.58$ 8.44$ 506.58$ XXX77770 00 9.74$ 584.20$ 9.74$ 584.20$ XXX77770 26 2.95$ 177.17$ 2.95$ 177.17$ XXX77770 TC 6.78$ 407.03$ 6.78$ 407.03$ XXX77771 00 17.76$ 1,065.33$ 17.76$ 1,065.33$ XXX77771 26 5.78$ 347.03$ 5.78$ 347.03$ XXX77771 TC 11.97$ 718.30$ 11.97$ 718.30$ XXX77772 00 26.92$ 1,615.12$ 26.92$ 1,615.12$ XXX77772 26 8.19$ 491.14$ 8.19$ 491.14$ XXX77772 TC 18.73$ 1,123.98$ 18.73$ 1,123.98$ XXX77778 00 24.85$ 1,491.09$ 24.85$ 1,491.09$ 00077778 26 13.31$ 798.35$ 13.31$ 798.35$ 00077778 TC 11.55$ 692.74$ 11.55$ 692.74$ 00077789 00 3.61$ 216.63$ 3.61$ 216.63$ 00077789 26 1.74$ 104.47$ 1.74$ 104.47$ 00077789 TC 1.87$ 112.16$ 1.87$ 112.16$ 00077790 00 0.45$ 27.03$ 0.45$ 27.03$ XXX77799 00 By Report By Report XXX77799 26 By Report By Report XXX77799 TC By Report By Report XXX78012 00 2.45$ 146.82$ 2.45$ 146.82$ XXX78012 26 0.27$ 16.45$ 0.27$ 16.45$ XXX78012 TC 2.17$ 130.37$ 2.17$ 130.37$ XXX78013 00 5.80$ 347.98$ 5.80$ 347.98$ XXX78013 26 0.53$ 31.67$ 0.53$ 31.67$ XXX78013 TC 5.27$ 316.31$ 5.27$ 316.31$ XXX78014 00 7.27$ 436.47$ 7.27$ 436.47$ XXX



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

78014 26 0.71$ 42.60$ 0.71$ 42.60$ XXX78014 TC 6.56$ 393.87$ 6.56$ 393.87$ XXX78015 00 6.76$ 405.68$ 6.76$ 405.68$ XXX78015 26 0.96$ 57.84$ 0.96$ 57.84$ XXX78015 TC 5.80$ 347.84$ 5.80$ 347.84$ XXX78016 00 8.49$ 509.51$ 8.49$ 509.51$ XXX78016 26 0.98$ 58.97$ 0.98$ 58.97$ XXX78016 TC 7.51$ 450.54$ 7.51$ 450.54$ XXX78018 00 9.44$ 566.54$ 9.44$ 566.54$ XXX78018 26 1.19$ 71.23$ 1.19$ 71.23$ XXX78018 TC 8.26$ 495.32$ 8.26$ 495.32$ XXX78020 00 2.50$ 150.09$ 2.50$ 150.09$ ZZZ78020 26 0.80$ 48.10$ 0.80$ 48.10$ ZZZ78020 TC 1.70$ 101.99$ 1.70$ 101.99$ ZZZ78070 00 9.00$ 540.29$ 9.00$ 540.29$ XXX78070 26 1.13$ 67.60$ 1.13$ 67.60$ XXX78070 TC 7.88$ 472.70$ 7.88$ 472.70$ XXX78071 00 10.73$ 643.69$ 10.73$ 643.69$ XXX78071 26 1.70$ 101.71$ 1.70$ 101.71$ XXX78071 TC 9.03$ 541.98$ 9.03$ 541.98$ XXX78072 00 11.70$ 701.77$ 11.70$ 701.77$ XXX78072 26 2.22$ 133.30$ 2.22$ 133.30$ XXX78072 TC 9.47$ 568.47$ 9.47$ 568.47$ XXX78075 00 13.62$ 817.11$ 13.62$ 817.11$ XXX78075 26 1.08$ 64.60$ 1.08$ 64.60$ XXX78075 TC 12.54$ 752.52$ 12.54$ 752.52$ XXX78099 00 By Report By Report XXX78099 26 By Report By Report XXX78099 TC By Report By Report XXX78102 00 5.11$ 306.44$ 5.11$ 306.44$ XXX78102 26 0.76$ 45.62$ 0.76$ 45.62$ XXX78102 TC 4.35$ 260.82$ 4.35$ 260.82$ XXX78103 00 6.55$ 392.95$ 6.55$ 392.95$ XXX78103 26 1.01$ 60.87$ 1.01$ 60.87$ XXX78103 TC 5.53$ 332.07$ 5.53$ 332.07$ XXX78104 00 7.47$ 448.23$ 7.47$ 448.23$ XXX78104 26 1.12$ 66.97$ 1.12$ 66.97$ XXX78104 TC 6.35$ 381.26$ 6.35$ 381.26$ XXX78110 00 2.08$ 124.66$ 2.08$ 124.66$ XXX78110 26 0.23$ 13.93$ 0.23$ 13.93$ XXX78110 TC 1.85$ 110.73$ 1.85$ 110.73$ XXX78111 00 2.20$ 132.15$ 2.20$ 132.15$ XXX



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

78111 26 0.27$ 16.37$ 0.27$ 16.37$ XXX78111 TC 1.93$ 115.78$ 1.93$ 115.78$ XXX78120 00 2.13$ 127.71$ 2.13$ 127.71$ XXX78120 26 0.28$ 16.98$ 0.28$ 16.98$ XXX78120 TC 1.85$ 110.73$ 1.85$ 110.73$ XXX78121 00 2.32$ 139.46$ 2.32$ 139.46$ XXX78121 26 0.39$ 23.68$ 0.39$ 23.68$ XXX78121 TC 1.93$ 115.78$ 1.93$ 115.78$ XXX78122 00 2.84$ 170.57$ 2.84$ 170.57$ XXX78122 26 0.61$ 36.51$ 0.61$ 36.51$ XXX78122 TC 2.23$ 134.07$ 2.23$ 134.07$ XXX78130 00 3.71$ 222.50$ 3.71$ 222.50$ XXX78130 26 0.73$ 43.75$ 0.73$ 43.75$ XXX78130 TC 2.98$ 178.75$ 2.98$ 178.75$ XXX78135 00 8.39$ 503.67$ 8.39$ 503.67$ XXX78135 26 0.77$ 46.19$ 0.77$ 46.19$ XXX78135 TC 7.62$ 457.48$ 7.62$ 457.48$ XXX78140 00 3.27$ 196.10$ 3.27$ 196.10$ XXX78140 26 0.73$ 43.75$ 0.73$ 43.75$ XXX78140 TC 2.54$ 152.35$ 2.54$ 152.35$ XXX78185 00 5.10$ 305.73$ 5.10$ 305.73$ XXX78185 26 0.49$ 29.15$ 0.49$ 29.15$ XXX78185 TC 4.61$ 276.58$ 4.61$ 276.58$ XXX78191 00 3.71$ 222.50$ 3.71$ 222.50$ XXX78191 26 0.73$ 43.75$ 0.73$ 43.75$ XXX78191 TC 2.98$ 178.75$ 2.98$ 178.75$ XXX78195 00 10.73$ 643.61$ 10.73$ 643.61$ XXX78195 26 1.69$ 101.63$ 1.69$ 101.63$ XXX78195 TC 9.03$ 541.98$ 9.03$ 541.98$ XXX78199 00 By Report By Report XXX78199 26 By Report By Report XXX78199 TC By Report By Report XXX78201 00 5.74$ 344.64$ 5.74$ 344.64$ XXX78201 26 0.61$ 36.53$ 0.61$ 36.53$ XXX78201 TC 5.14$ 308.11$ 5.14$ 308.11$ XXX78202 00 6.09$ 365.27$ 6.09$ 365.27$ XXX78202 26 0.68$ 40.77$ 0.68$ 40.77$ XXX78202 TC 5.41$ 324.51$ 5.41$ 324.51$ XXX78215 00 5.87$ 352.00$ 5.87$ 352.00$ XXX78215 26 0.70$ 42.00$ 0.70$ 42.00$ XXX78215 TC 5.17$ 310.00$ 5.17$ 310.00$ XXX78216 00 3.83$ 230.09$ 3.83$ 230.09$ XXX



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

78216 26 0.79$ 47.46$ 0.79$ 47.46$ XXX78216 TC 3.04$ 182.62$ 3.04$ 182.62$ XXX78226 00 9.96$ 597.75$ 9.96$ 597.75$ XXX78226 26 1.06$ 63.34$ 1.06$ 63.34$ XXX78226 TC 8.91$ 534.41$ 8.91$ 534.41$ XXX78227 00 13.47$ 808.42$ 13.47$ 808.42$ XXX78227 26 1.29$ 77.34$ 1.29$ 77.34$ XXX78227 TC 12.18$ 731.08$ 12.18$ 731.08$ XXX78230 00 5.26$ 315.53$ 5.26$ 315.53$ XXX78230 26 0.66$ 39.58$ 0.66$ 39.58$ XXX78230 TC 4.60$ 275.95$ 4.60$ 275.95$ XXX78231 00 3.10$ 186.24$ 3.10$ 186.24$ XXX78231 26 0.63$ 37.67$ 0.63$ 37.67$ XXX78231 TC 2.48$ 148.57$ 2.48$ 148.57$ XXX78232 00 3.04$ 182.59$ 3.04$ 182.59$ XXX78232 26 0.57$ 34.02$ 0.57$ 34.02$ XXX78232 TC 2.48$ 148.57$ 2.48$ 148.57$ XXX78258 00 6.59$ 395.41$ 6.59$ 395.41$ XXX78258 26 1.03$ 62.08$ 1.03$ 62.08$ XXX78258 TC 5.56$ 333.34$ 5.56$ 333.34$ XXX78261 00 6.09$ 365.52$ 6.09$ 365.52$ XXX78261 26 0.83$ 49.85$ 0.83$ 49.85$ XXX78261 TC 5.26$ 315.68$ 5.26$ 315.68$ XXX78262 00 7.27$ 436.01$ 7.27$ 436.01$ XXX78262 26 0.95$ 57.27$ 0.95$ 57.27$ XXX78262 TC 6.31$ 378.74$ 6.31$ 378.74$ XXX78264 00 10.10$ 605.82$ 10.10$ 605.82$ XXX78264 26 1.12$ 66.99$ 1.12$ 66.99$ XXX78264 TC 8.98$ 538.83$ 8.98$ 538.83$ XXX78265 00 11.98$ 718.67$ 11.98$ 718.67$ XXX78265 26 1.39$ 83.44$ 1.39$ 83.44$ XXX78265 TC 10.59$ 635.22$ 10.59$ 635.22$ XXX78266 00 14.21$ 852.64$ 14.21$ 852.64$ XXX78266 26 1.53$ 91.93$ 1.53$ 91.93$ XXX78266 TC 12.68$ 760.71$ 12.68$ 760.71$ XXX78267 00 11.06$ 11.06$ XXX78268 00 94.41$ 94.41$ XXX78278 00 10.52$ 631.07$ 10.52$ 631.07$ XXX78278 26 1.41$ 84.68$ 1.41$ 84.68$ XXX78278 TC 9.11$ 546.39$ 9.11$ 546.39$ XXX78282 00 By Report By Report XXX78282 26 0.47$ 27.94$ 0.47$ 27.94$ XXX



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

78282 TC By Report By Report XXX78290 00 9.98$ 598.54$ 9.98$ 598.54$ XXX78290 26 0.96$ 57.82$ 0.96$ 57.82$ XXX78290 TC 9.01$ 540.72$ 9.01$ 540.72$ XXX78291 00 7.72$ 463.16$ 7.72$ 463.16$ XXX78291 26 1.23$ 73.70$ 1.23$ 73.70$ XXX78291 TC 6.49$ 389.46$ 6.49$ 389.46$ XXX78299 00 By Report By Report XXX78299 26 By Report By Report XXX78299 TC By Report By Report XXX78300 00 6.93$ 415.98$ 6.93$ 415.98$ XXX78300 26 0.89$ 53.56$ 0.89$ 53.56$ XXX78300 TC 6.04$ 362.43$ 6.04$ 362.43$ XXX78305 00 8.45$ 506.71$ 8.45$ 506.71$ XXX78305 26 1.19$ 71.22$ 1.19$ 71.22$ XXX78305 TC 7.26$ 435.49$ 7.26$ 435.49$ XXX78306 00 9.11$ 546.45$ 9.11$ 546.45$ XXX78306 26 1.22$ 73.12$ 1.22$ 73.12$ XXX78306 TC 7.89$ 473.33$ 7.89$ 473.33$ XXX78315 00 10.43$ 625.95$ 10.43$ 625.95$ XXX78315 26 1.44$ 86.49$ 1.44$ 86.49$ XXX78315 TC 8.99$ 539.46$ 8.99$ 539.46$ XXX78350 00 0.97$ 57.91$ 0.97$ 57.91$ XXX78350 26 0.33$ 19.53$ 0.33$ 19.53$ XXX78350 TC 0.64$ 38.38$ 0.64$ 38.38$ XXX78351 00 0.45$ 26.80$ 0.45$ 26.80$ XXX78399 00 By Report By Report XXX78399 26 By Report By Report XXX78399 TC By Report By Report XXX78414 00 By Report By Report XXX78414 26 0.64$ 38.40$ 0.64$ 38.40$ XXX78414 TC By Report By Report XXX78428 00 5.52$ 331.07$ 5.52$ 331.07$ XXX78428 26 1.09$ 65.21$ 1.09$ 65.21$ XXX78428 TC 4.43$ 265.86$ 4.43$ 265.86$ XXX78429 00 By Report By Report XXX78429 26 2.41$ 144.46$ 2.41$ 144.46$ XXX78429 TC By Report By Report XXX78430 00 By Report By Report XXX78430 26 2.29$ 137.11$ 2.29$ 137.11$ XXX78430 TC By Report By Report XXX78431 00 By Report By Report XXX



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

78431 26 2.66$ 159.65$ 2.66$ 159.65$ XXX78431 TC By Report By Report XXX78432 00 By Report By Report XXX78432 26 2.83$ 169.94$ 2.83$ 169.94$ XXX78432 TC By Report By Report XXX78433 00 By Report By Report XXX78433 26 3.10$ 185.75$ 3.10$ 185.75$ XXX78433 TC By Report By Report XXX78434 00 By Report By Report ZZZ78434 26 0.90$ 53.74$ 0.90$ 53.74$ ZZZ78434 TC By Report By Report ZZZ78445 00 5.62$ 337.41$ 5.62$ 337.41$ XXX78445 26 0.72$ 43.17$ 0.72$ 43.17$ XXX78445 TC 4.90$ 294.24$ 4.90$ 294.24$ XXX78451 00 10.19$ 611.70$ 10.19$ 611.70$ XXX78451 26 1.94$ 116.38$ 1.94$ 116.38$ XXX78451 TC 8.26$ 495.32$ 8.26$ 495.32$ XXX78452 00 14.21$ 852.43$ 14.21$ 852.43$ XXX78452 26 2.28$ 136.57$ 2.28$ 136.57$ XXX78452 TC 11.93$ 715.86$ 11.93$ 715.86$ XXX78453 00 9.17$ 550.33$ 9.17$ 550.33$ XXX78453 26 1.43$ 85.91$ 1.43$ 85.91$ XXX78453 TC 7.74$ 464.42$ 7.74$ 464.42$ XXX78454 00 13.13$ 787.57$ 13.13$ 787.57$ XXX78454 26 1.92$ 115.14$ 1.92$ 115.14$ XXX78454 TC 11.21$ 672.43$ 11.21$ 672.43$ XXX78456 00 9.33$ 559.87$ 9.33$ 559.87$ XXX78456 26 1.40$ 84.11$ 1.40$ 84.11$ XXX78456 TC 7.93$ 475.77$ 7.93$ 475.77$ XXX78457 00 5.75$ 345.26$ 5.75$ 345.26$ XXX78457 26 1.12$ 67.42$ 1.12$ 67.42$ XXX78457 TC 4.63$ 277.84$ 4.63$ 277.84$ XXX78458 00 6.17$ 370.32$ 6.17$ 370.32$ XXX78458 26 1.30$ 77.97$ 1.30$ 77.97$ XXX78458 TC 4.87$ 292.35$ 4.87$ 292.35$ XXX78459 00 787.40$ 787.40$ XXX78459 26 2.04$ 122.38$ 2.04$ 122.38$ XXX78459 TC 745.67$ 745.67$ XXX78466 00 5.92$ 355.27$ 5.92$ 355.27$ XXX78466 26 1.01$ 60.40$ 1.01$ 60.40$ XXX78466 TC 4.91$ 294.87$ 4.91$ 294.87$ XXX78468 00 6.14$ 368.14$ 6.14$ 368.14$ XXX



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

78468 26 1.14$ 68.23$ 1.14$ 68.23$ XXX78468 TC 5.00$ 299.91$ 5.00$ 299.91$ XXX78469 00 6.78$ 407.01$ 6.78$ 407.01$ XXX78469 26 1.31$ 78.72$ 1.31$ 78.72$ XXX78469 TC 5.47$ 328.29$ 5.47$ 328.29$ XXX78472 00 6.87$ 412.37$ 6.87$ 412.37$ XXX78472 26 1.39$ 83.44$ 1.39$ 83.44$ XXX78472 TC 5.48$ 328.92$ 5.48$ 328.92$ XXX78473 00 8.67$ 520.11$ 8.67$ 520.11$ XXX78473 26 2.05$ 123.08$ 2.05$ 123.08$ XXX78473 TC 6.62$ 397.03$ 6.62$ 397.03$ XXX78481 00 5.27$ 315.97$ 5.27$ 315.97$ XXX78481 26 1.39$ 83.44$ 1.39$ 83.44$ XXX78481 TC 3.88$ 232.52$ 3.88$ 232.52$ XXX78483 00 7.10$ 426.24$ 7.10$ 426.24$ XXX78483 26 2.04$ 122.54$ 2.04$ 122.54$ XXX78483 TC 5.06$ 303.70$ 5.06$ 303.70$ XXX78491 00 1,432.64$ 1,432.64$ XXX78491 26 2.05$ 123.01$ 2.05$ 123.01$ XXX78491 TC 1,390.70$ 1,390.70$ XXX78492 00 1,443.69$ 1,443.69$ XXX78492 26 2.59$ 155.39$ 2.59$ 155.39$ XXX78492 TC 1,390.70$ 1,390.70$ XXX78494 00 6.78$ 406.78$ 6.78$ 406.78$ XXX78494 26 1.68$ 100.56$ 1.68$ 100.56$ XXX78494 TC 5.10$ 306.22$ 5.10$ 306.22$ XXX78496 00 1.29$ 77.28$ 1.29$ 77.28$ ZZZ78496 26 0.70$ 42.05$ 0.70$ 42.05$ ZZZ78496 TC 0.59$ 35.23$ 0.59$ 35.23$ ZZZ78499 00 By Report By Report XXX78499 26 By Report By Report XXX78499 TC By Report By Report XXX78579 00 5.61$ 336.40$ 5.61$ 336.40$ XXX78579 26 0.69$ 41.45$ 0.69$ 41.45$ XXX78579 TC 4.92$ 294.95$ 4.92$ 294.95$ XXX78580 00 7.18$ 430.73$ 7.18$ 430.73$ XXX78580 26 1.06$ 63.34$ 1.06$ 63.34$ XXX78580 TC 6.12$ 367.39$ 6.12$ 367.39$ XXX78582 00 10.07$ 604.30$ 10.07$ 604.30$ XXX78582 26 1.52$ 91.33$ 1.52$ 91.33$ XXX78582 TC 8.55$ 512.97$ 8.55$ 512.97$ XXX78597 00 6.05$ 362.76$ 6.05$ 362.76$ XXX



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

78597 26 1.03$ 61.50$ 1.03$ 61.50$ XXX78597 TC 5.02$ 301.26$ 5.02$ 301.26$ XXX78598 00 9.20$ 552.06$ 9.20$ 552.06$ XXX78598 26 1.19$ 71.25$ 1.19$ 71.25$ XXX78598 TC 8.01$ 480.81$ 8.01$ 480.81$ XXX78599 00 By Report By Report XXX78599 26 By Report By Report XXX78599 TC By Report By Report XXX78600 00 5.56$ 333.84$ 5.56$ 333.84$ XXX78600 26 0.64$ 38.34$ 0.64$ 38.34$ XXX78600 TC 4.92$ 295.50$ 4.92$ 295.50$ XXX78601 00 6.54$ 392.31$ 6.54$ 392.31$ XXX78601 26 0.73$ 43.84$ 0.73$ 43.84$ XXX78601 TC 5.81$ 348.47$ 5.81$ 348.47$ XXX78605 00 6.00$ 360.09$ 6.00$ 360.09$ XXX78605 26 0.77$ 46.31$ 0.77$ 46.31$ XXX78605 TC 5.23$ 313.79$ 5.23$ 313.79$ XXX78606 00 9.95$ 596.83$ 9.95$ 596.83$ XXX78606 26 0.90$ 54.22$ 0.90$ 54.22$ XXX78606 TC 9.04$ 542.61$ 9.04$ 542.61$ XXX78608 00 876.77$ 876.77$ XXX78608 26 2.07$ 124.18$ 2.07$ 124.18$ XXX78608 TC 834.42$ 834.42$ XXX78609 00 2.16$ 129.48$ 2.16$ 129.48$ XXX78609 26 2.16$ 129.48$ 2.16$ 129.48$ XXX78609 TC -$ -$ -$ -$ XXX78610 00 5.28$ 316.63$ 5.28$ 316.63$ XXX78610 26 0.44$ 26.17$ 0.44$ 26.17$ XXX78610 TC 4.84$ 290.45$ 4.84$ 290.45$ XXX78630 00 10.20$ 611.78$ 10.20$ 611.78$ XXX78630 26 0.97$ 58.45$ 0.97$ 58.45$ XXX78630 TC 9.22$ 553.33$ 9.22$ 553.33$ XXX78635 00 10.23$ 613.85$ 10.23$ 613.85$ XXX78635 26 0.89$ 53.58$ 0.89$ 53.58$ XXX78635 TC 9.34$ 560.27$ 9.34$ 560.27$ XXX78645 00 9.81$ 588.81$ 9.81$ 588.81$ XXX78645 26 0.80$ 48.09$ 0.80$ 48.09$ XXX78645 TC 9.01$ 540.72$ 9.01$ 540.72$ XXX78650 00 8.26$ 495.55$ 8.26$ 495.55$ XXX78650 26 0.73$ 43.75$ 0.73$ 43.75$ XXX78650 TC 7.53$ 451.80$ 7.53$ 451.80$ XXX78660 00 5.50$ 329.91$ 5.50$ 329.91$ XXX



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

78660 26 0.76$ 45.76$ 0.76$ 45.76$ XXX78660 TC 4.74$ 284.15$ 4.74$ 284.15$ XXX78699 00 By Report By Report XXX78699 26 By Report By Report XXX78699 TC By Report By Report XXX78700 00 5.14$ 308.67$ 5.14$ 308.67$ XXX78700 26 0.63$ 37.77$ 0.63$ 37.77$ XXX78700 TC 4.52$ 270.91$ 4.52$ 270.91$ XXX78701 00 6.55$ 392.99$ 6.55$ 392.99$ XXX78701 26 0.70$ 42.00$ 0.70$ 42.00$ XXX78701 TC 5.85$ 350.99$ 5.85$ 350.99$ XXX78707 00 6.98$ 418.72$ 6.98$ 418.72$ XXX78707 26 1.34$ 80.34$ 1.34$ 80.34$ XXX78707 TC 5.64$ 338.38$ 5.64$ 338.38$ XXX78708 00 5.28$ 317.01$ 5.28$ 317.01$ XXX78708 26 1.71$ 102.32$ 1.71$ 102.32$ XXX78708 TC 3.58$ 214.70$ 3.58$ 214.70$ XXX78709 00 11.06$ 663.87$ 11.06$ 663.87$ XXX78709 26 1.97$ 118.11$ 1.97$ 118.11$ XXX78709 TC 9.10$ 545.76$ 9.10$ 545.76$ XXX78725 00 3.25$ 194.72$ 3.25$ 194.72$ XXX78725 26 0.53$ 31.64$ 0.53$ 31.64$ XXX78725 TC 2.72$ 163.07$ 2.72$ 163.07$ XXX78730 00 2.32$ 139.44$ 2.32$ 139.44$ ZZZ78730 26 0.23$ 14.03$ 0.23$ 14.03$ ZZZ78730 TC 2.09$ 125.41$ 2.09$ 125.41$ ZZZ78740 00 6.58$ 394.76$ 6.58$ 394.76$ XXX78740 26 0.79$ 47.55$ 0.79$ 47.55$ XXX78740 TC 5.79$ 347.21$ 5.79$ 347.21$ XXX78761 00 6.35$ 380.99$ 6.35$ 380.99$ XXX78761 26 1.03$ 61.52$ 1.03$ 61.52$ XXX78761 TC 5.32$ 319.46$ 5.32$ 319.46$ XXX78799 00 By Report By Report XXX78799 26 By Report By Report XXX78799 TC By Report By Report XXX78800 00 5.85$ 351.22$ 5.85$ 351.22$ XXX78800 26 0.97$ 58.25$ 0.97$ 58.25$ XXX78800 TC 4.88$ 292.98$ 4.88$ 292.98$ XXX78801 00 7.75$ 465.11$ 7.75$ 465.11$ XXX78801 26 1.13$ 68.09$ 1.13$ 68.09$ XXX78801 TC 6.62$ 397.03$ 6.62$ 397.03$ XXX78802 00 9.72$ 582.94$ 9.72$ 582.94$ XXX



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

78802 26 1.20$ 71.86$ 1.20$ 71.86$ XXX78802 TC 8.52$ 511.08$ 8.52$ 511.08$ XXX78803 00 10.25$ 615.05$ 10.25$ 615.05$ XXX78803 26 1.50$ 90.10$ 1.50$ 90.10$ XXX78803 TC 8.75$ 524.95$ 8.75$ 524.95$ XXX78804 00 17.15$ 1,029.15$ 17.15$ 1,029.15$ XXX78804 26 1.50$ 90.15$ 1.50$ 90.15$ XXX78804 TC 15.65$ 939.01$ 15.65$ 939.01$ XXX78808 00 1.17$ 69.99$ 1.17$ 69.99$ XXX78811 00 790.06$ 790.06$ XXX78811 26 2.17$ 130.30$ 2.17$ 130.30$ XXX78811 TC 745.67$ 745.67$ XXX78812 00 889.04$ 889.04$ XXX78812 26 2.67$ 160.11$ 2.67$ 160.11$ XXX78812 TC 834.42$ 834.42$ XXX78813 00 888.88$ 888.88$ XXX78813 26 2.76$ 165.61$ 2.76$ 165.61$ XXX78813 TC 834.42$ 834.42$ XXX78814 00 897.02$ 897.02$ XXX78814 26 3.06$ 183.84$ 3.06$ 183.84$ XXX78814 TC 834.42$ 834.42$ XXX78815 00 904.59$ 904.59$ XXX78815 26 3.43$ 205.84$ 3.43$ 205.84$ XXX78815 TC 834.42$ 834.42$ XXX78816 00 905.41$ 905.41$ XXX78816 26 3.47$ 208.21$ 3.47$ 208.21$ XXX78816 TC 834.42$ 834.42$ XXX78830 00 14.79$ 887.29$ 14.79$ 887.29$ XXX78830 26 2.07$ 124.31$ 2.07$ 124.31$ XXX78830 TC 12.72$ 762.99$ 12.72$ 762.99$ XXX78831 00 21.40$ 1,284.16$ 21.40$ 1,284.16$ XXX78831 26 2.53$ 151.63$ 2.53$ 151.63$ XXX78831 TC 18.88$ 1,132.53$ 18.88$ 1,132.53$ XXX78832 00 27.87$ 1,672.28$ 27.87$ 1,672.28$ XXX78832 26 2.94$ 176.64$ 2.94$ 176.64$ XXX78832 TC 24.93$ 1,495.64$ 24.93$ 1,495.64$ XXX78835 00 3.09$ 185.48$ 3.09$ 185.48$ ZZZ78835 26 0.65$ 38.97$ 0.65$ 38.97$ ZZZ78835 TC 2.44$ 146.50$ 2.44$ 146.50$ ZZZ78999 00 By Report By Report XXX78999 26 By Report By Report XXX78999 TC By Report By Report XXX



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

79005 00 4.02$ 241.08$ 4.02$ 241.08$ XXX79005 26 2.54$ 152.33$ 2.54$ 152.33$ XXX79005 TC 1.48$ 88.75$ 1.48$ 88.75$ XXX79101 00 4.29$ 257.69$ 4.29$ 257.69$ XXX79101 26 2.82$ 169.49$ 2.82$ 169.49$ XXX79101 TC 1.47$ 88.20$ 1.47$ 88.20$ XXX79200 00 3.93$ 235.97$ 3.93$ 235.97$ XXX79200 26 2.39$ 143.44$ 2.39$ 143.44$ XXX79200 TC 1.54$ 92.53$ 1.54$ 92.53$ XXX79300 00 By Report By Report XXX79300 26 1.93$ 116.06$ 1.93$ 116.06$ XXX79300 TC By Report By Report XXX79403 00 5.60$ 336.15$ 5.60$ 336.15$ XXX79403 26 3.16$ 189.47$ 3.16$ 189.47$ XXX79403 TC 2.44$ 146.68$ 2.44$ 146.68$ XXX79440 00 3.53$ 212.09$ 3.53$ 212.09$ XXX79440 26 2.39$ 143.44$ 2.39$ 143.44$ XXX79440 TC 1.14$ 68.65$ 1.14$ 68.65$ XXX79445 00 By Report By Report XXX79445 26 3.30$ 198.29$ 3.30$ 198.29$ XXX79445 TC By Report By Report XXX79999 00 By Report By Report XXX79999 26 By Report By Report XXX79999 TC By Report By Report XXX80047 00 13.73$ 13.73$ XXX80047 QW 13.73$ 13.73$ 80048 00 9.40$ 9.40$ XXX80048 QW 9.40$ 9.40$ 80050 00 36.78$ 36.78$ XXX80051 00 7.79$ 7.79$ XXX80051 QW 7.79$ 7.79$ 80053 00 11.74$ 11.74$ XXX80053 QW 11.74$ 11.74$ 80055 00 53.12$ 53.12$ XXX80061 00 14.88$ 14.88$ XXX80061 QW 14.88$ 14.88$ 80069 00 9.65$ 9.65$ XXX80069 QW 9.65$ 9.65$ 80074 00 52.93$ 52.93$ XXX80076 00 9.08$ 9.08$ XXX80081 00 83.18$ 83.18$ XXX80145 00 38.57$ 38.57$ XXX



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

80150 00 16.75$ 16.75$ XXX80155 00 38.57$ 38.57$ XXX80156 00 16.18$ 16.18$ XXX80157 00 14.73$ 14.73$ XXX80158 00 20.06$ 20.06$ XXX80159 00 20.55$ 20.55$ XXX80162 00 14.75$ 14.75$ XXX80163 00 14.75$ 14.75$ XXX80164 00 15.05$ 15.05$ XXX80165 00 15.05$ 15.05$ XXX80168 00 18.15$ 18.15$ XXX80169 00 15.26$ 15.26$ XXX80170 00 18.20$ 18.20$ XXX80171 00 21.67$ 21.67$ XXX80173 00 16.18$ 16.18$ XXX80175 00 14.73$ 14.73$ XXX80176 00 16.32$ 16.32$ XXX80177 00 14.73$ 14.73$ XXX80178 00 7.35$ 7.35$ XXX80178 QW 7.35$ 7.35$ 80180 00 20.06$ 20.06$ XXX80183 00 14.73$ 14.73$ XXX80184 00 15.30$ 15.30$ XXX80185 00 14.73$ 14.73$ XXX80186 00 15.29$ 15.29$ XXX80187 00 27.11$ 27.11$ XXX80188 00 18.44$ 18.44$ XXX80190 00 60.00$ 60.00$ XXX80192 00 18.61$ 18.61$ XXX80194 00 16.22$ 16.22$ XXX80195 00 15.26$ 15.26$ XXX80197 00 15.26$ 15.26$ XXX80198 00 15.71$ 15.71$ XXX80199 00 27.11$ 27.11$ XXX80200 00 17.92$ 17.92$ XXX80201 00 13.24$ 13.24$ XXX80202 00 15.05$ 15.05$ XXX80203 00 14.73$ 14.73$ XXX80230 00 38.57$ 38.57$ XXX80235 00 27.11$ 27.11$ XXX80280 00 38.57$ 38.57$ XXX80285 00 27.11$ 27.11$ XXX



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

80299 00 18.64$ 18.64$ XXX80305 00 12.60$ 12.60$ XXX80305 QW 12.60$ 12.60$ 80306 00 17.14$ 17.14$ XXX80307 00 64.65$ 64.65$ XXX80320 00 11.21$ 11.21$ XXX80321 00 13.47$ 13.47$ XXX80322 00 11.40$ 11.40$ XXX80323 00 20.35$ 20.35$ XXX80324 00 15.16$ 15.16$ XXX80325 00 13.00$ 13.00$ XXX80326 00 9.23$ 9.23$ XXX80327 00 22.18$ 22.18$ XXX80328 00 24.87$ 24.87$ XXX80329 00 11.46$ 11.46$ XXX80330 00 5.10$ 5.10$ XXX80331 00 8.15$ 8.15$ XXX80332 00 19.81$ 19.81$ XXX80333 00 14.90$ 14.90$ XXX80334 00 9.54$ 9.54$ XXX80335 00 5.00$ 5.00$ XXX80336 00 20.30$ 20.30$ XXX80337 00 10.35$ 10.35$ XXX80338 00 12.75$ 12.75$ XXX80339 00 5.00$ 5.00$ XXX80340 00 7.66$ 7.66$ XXX80341 00 6.62$ 6.62$ XXX80342 00 14.00$ 14.00$ XXX80343 00 32.33$ 32.33$ XXX80344 00 8.25$ 8.25$ XXX80345 00 10.90$ 10.90$ XXX80346 00 16.11$ 16.11$ XXX80347 00 23.04$ 23.04$ XXX80348 00 16.36$ 16.36$ XXX80349 00 13.42$ 13.42$ XXX80350 00 12.80$ 12.80$ XXX80351 00 16.50$ 16.50$ XXX80352 00 16.10$ 16.10$ XXX80353 00 12.20$ 12.20$ XXX80354 00 15.25$ 15.25$ XXX80355 00 9.18$ 9.18$ XXX80356 00 15.90$ 15.90$ XXX



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

80357 00 12.30$ 12.30$ XXX80358 00 13.12$ 13.12$ XXX80359 00 10.12$ 10.12$ XXX80360 00 10.84$ 10.84$ XXX80361 00 17.00$ 17.00$ XXX80362 00 13.80$ 13.80$ XXX80363 00 21.23$ 21.23$ XXX80364 00 15.93$ 15.93$ XXX80365 00 14.18$ 14.18$ XXX80366 00 8.25$ 8.25$ XXX80367 00 12.51$ 12.51$ XXX80368 00 10.50$ 10.50$ XXX80369 00 13.35$ 13.35$ XXX80370 00 11.79$ 11.79$ XXX80371 00 14.06$ 14.06$ XXX80372 00 12.64$ 12.64$ XXX80373 00 12.30$ 12.30$ XXX80374 00 11.80$ 11.80$ XXX80375 00 21.53$ 21.53$ XXX80376 00 22.37$ 22.37$ XXX80377 00 7.77$ 7.77$ XXX80400 00 36.24$ 36.24$ XXX80402 00 96.62$ 96.62$ XXX80406 00 86.95$ 86.95$ XXX80408 00 139.44$ 139.44$ XXX80410 00 89.31$ 89.31$ XXX80412 00 801.62$ 801.62$ XXX80414 00 57.37$ 57.37$ XXX80415 00 62.09$ 62.09$ XXX80416 00 209.32$ 209.32$ XXX80417 00 48.88$ 48.88$ XXX80418 00 643.84$ 643.84$ XXX80420 00 161.88$ 161.88$ XXX80422 00 51.19$ 51.19$ XXX80424 00 56.11$ 56.11$ XXX80426 00 164.90$ 164.90$ XXX80428 00 74.12$ 74.12$ XXX80430 00 129.33$ 129.33$ XXX80432 00 165.61$ 165.61$ XXX80434 00 285.03$ 285.03$ XXX80435 00 114.45$ 114.45$ XXX80436 00 101.29$ 101.29$ XXX



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

80438 00 56.01$ 56.01$ XXX80439 00 74.68$ 74.68$ XXX80500 00 0.66$ 39.87$ 0.57$ 34.19$ XXX80502 00 2.14$ 128.41$ 2.05$ 122.73$ XXX81000 00 4.02$ 4.02$ XXX81001 00 3.52$ 3.52$ XXX81002 00 3.48$ 3.48$ XXX81003 00 2.49$ 2.49$ XXX81003 QW 2.49$ 2.49$ 81005 00 2.41$ 2.41$ XXX81007 00 29.98$ 29.98$ XXX81007 QW 29.98$ 29.98$ 81015 00 3.39$ 3.39$ XXX81020 00 4.70$ 4.70$ XXX81025 00 8.61$ 8.61$ XXX81050 00 3.64$ 3.64$ XXX81099 00 By Report By Report XXX81105 00 135.80$ 135.80$ XXX81106 00 135.80$ 135.80$ XXX81107 00 135.80$ 135.80$ XXX81108 00 135.80$ 135.80$ XXX81109 00 135.80$ 135.80$ XXX81110 00 135.80$ 135.80$ XXX81111 00 135.80$ 135.80$ XXX81112 00 135.80$ 135.80$ XXX81120 00 193.25$ 193.25$ XXX81121 00 295.79$ 295.79$ XXX81161 00 279.00$ 279.00$ XXX81162 00 2,027.64$ 2,027.64$ XXX81163 00 468.00$ 468.00$ XXX81164 00 584.23$ 584.23$ XXX81165 00 282.88$ 282.88$ XXX81166 00 301.35$ 301.35$ XXX81167 00 282.88$ 282.88$ XXX81170 00 300.00$ 300.00$ XXX81171 00 137.00$ 137.00$ XXX81172 00 274.83$ 274.83$ XXX81173 00 301.35$ 301.35$ XXX81174 00 185.20$ 185.20$ XXX81175 00 676.50$ 676.50$ XXX81176 00 268.77$ 268.77$ XXX81177 00 137.00$ 137.00$ XXX



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

81178 00 137.00$ 137.00$ XXX81179 00 137.00$ 137.00$ XXX81180 00 137.00$ 137.00$ XXX81181 00 137.00$ 137.00$ XXX81182 00 137.00$ 137.00$ XXX81183 00 137.00$ 137.00$ XXX81184 00 137.00$ 137.00$ XXX81185 00 846.27$ 846.27$ XXX81186 00 185.20$ 185.20$ XXX81187 00 137.00$ 137.00$ XXX81188 00 137.00$ 137.00$ XXX81189 00 274.83$ 274.83$ XXX81190 00 185.20$ 185.20$ XXX81200 00 47.25$ 47.25$ XXX81201 00 780.00$ 780.00$ XXX81202 00 280.00$ 280.00$ XXX81203 00 200.00$ 200.00$ XXX81204 00 137.00$ 137.00$ XXX81205 00 94.99$ 94.99$ XXX81206 00 182.18$ 182.18$ XXX81207 00 160.93$ 160.93$ XXX81208 00 214.62$ 214.62$ XXX81209 00 39.31$ 39.31$ XXX81210 00 175.40$ 175.40$ XXX81212 00 440.00$ 440.00$ XXX81215 00 375.25$ 375.25$ XXX81216 00 185.12$ 185.12$ XXX81217 00 375.25$ 375.25$ XXX81218 00 268.77$ 268.77$ XXX81219 00 135.14$ 135.14$ XXX81220 00 556.60$ 556.60$ XXX81221 00 97.22$ 97.22$ XXX81222 00 435.07$ 435.07$ XXX81223 00 499.00$ 499.00$ XXX81224 00 168.75$ 168.75$ XXX81225 00 291.36$ 291.36$ XXX81226 00 450.91$ 450.91$ XXX81227 00 174.81$ 174.81$ XXX81228 00 900.00$ 900.00$ XXX81229 00 1,160.00$ 1,160.00$ XXX81230 00 174.81$ 174.81$ XXX81231 00 174.81$ 174.81$ XXX



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL




CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

81274 00 274.83$ 274.83$ XXX81275 00 193.25$ 193.25$ XXX81276 00 193.25$ 193.25$ XXX81277 00 1,160.00$ 1,160.00$ XXX81283 00 73.37$ 73.37$ XXX81284 00 137.00$ 137.00$ XXX81285 00 274.83$ 274.83$ XXX81286 00 274.83$ 274.83$ XXX81287 00 124.64$ 124.64$ XXX81288 00 192.32$ 192.32$ XXX81289 00 185.20$ 185.20$ XXX81290 00 39.31$ 39.31$ XXX81291 00 65.34$ 65.34$ XXX81292 00 675.40$ 675.40$ XXX81293 00 331.00$ 331.00$ XXX81294 00 202.40$ 202.40$ XXX81295 00 381.70$ 381.70$ XXX81296 00 337.73$ 337.73$ XXX81297 00 213.30$ 213.30$ XXX81298 00 641.85$ 641.85$ XXX81299 00 308.00$ 308.00$ XXX81300 00 238.00$ 238.00$ XXX81301 00 348.56$ 348.56$ XXX81302 00 527.87$ 527.87$ XXX81303 00 120.00$ 120.00$ XXX81304 00 150.00$ 150.00$ XXX81305 00 175.40$ 175.40$ XXX81306 00 291.36$ 291.36$ XXX81307 00 282.88$ 282.88$ XXX81308 00 301.35$ 301.35$ XXX81309 00 274.83$ 274.83$ XXX81310 00 246.52$ 246.52$ XXX81311 00 295.79$ 295.79$ XXX81312 00 137.00$ 137.00$ XXX81313 00 255.05$ 255.05$ XXX81314 00 329.51$ 329.51$ XXX81315 00 230.35$ 230.35$ XXX81316 00 230.35$ 230.35$ XXX81317 00 676.50$ 676.50$ XXX81318 00 331.00$ 331.00$ XXX81319 00 203.50$ 203.50$ XXX81320 00 291.36$ 291.36$ XXX



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL




CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

81382 00 137.42$ 137.42$ XXX81383 00 121.26$ 121.26$ XXX81400 00 63.96$ 63.96$ XXX81401 00 137.00$ 137.00$ XXX81402 00 150.33$ 150.33$ XXX81403 00 185.20$ 185.20$ XXX81404 00 274.83$ 274.83$ XXX81405 00 301.35$ 301.35$ XXX81406 00 282.88$ 282.88$ XXX81407 00 846.27$ 846.27$ XXX81408 00 2,000.00$ 2,000.00$ XXX81410 00 504.00$ 504.00$ XXX81411 00 1,350.19$ 1,350.19$ XXX81412 00 2,448.56$ 2,448.56$ XXX81413 00 649.89$ 649.89$ XXX81414 00 649.89$ 649.89$ XXX81415 00 4,780.00$ 4,780.00$ XXX81416 00 12,000.00$ 12,000.00$ XXX81417 00 320.00$ 320.00$ XXX81420 00 759.05$ 759.05$ XXX81422 00 759.05$ 759.05$ XXX81425 00 5,031.20$ 5,031.20$ XXX81426 00 2,709.95$ 2,709.95$ XXX81427 00 2,337.65$ 2,337.65$ XXX81430 00 1,625.00$ 1,625.00$ XXX81431 00 679.57$ 679.57$ XXX81432 00 754.50$ 754.50$ XXX81433 00 487.70$ 487.70$ XXX81434 00 597.91$ 597.91$ XXX81435 00 649.89$ 649.89$ XXX81436 00 649.89$ 649.89$ XXX81437 00 487.70$ 487.70$ XXX81438 00 487.70$ 487.70$ XXX81439 00 649.89$ 649.89$ XXX81440 00 3,324.00$ 3,324.00$ XXX81442 00 2,143.60$ 2,143.60$ XXX81443 00 2,448.56$ 2,448.56$ XXX81445 00 597.91$ 597.91$ XXX81448 00 649.89$ 649.89$ XXX81450 00 759.53$ 759.53$ XXX81455 00 2,919.60$ 2,919.60$ XXX81460 00 1,287.00$ 1,287.00$ XXX



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

81465 00 936.00$ 936.00$ XXX81470 00 Not Covered Not Covered XXX81471 00 Not Covered Not Covered XXX81479 00 By Report By Report XXX81490 00 840.65$ 840.65$ XXX81493 00 1,050.00$ 1,050.00$ XXX81500 00 260.50$ 260.50$ XXX81503 00 897.00$ 897.00$ XXX81504 00 520.00$ 520.00$ XXX81506 00 74.67$ 74.67$ XXX81507 00 795.00$ 795.00$ XXX81508 00 54.30$ 54.30$ XXX81509 00 1,487.37$ 1,487.37$ XXX81510 00 55.54$ 55.54$ XXX81511 00 153.50$ 153.50$ XXX81512 00 69.52$ 69.52$ XXX81518 00 3,873.00$ 3,873.00$ XXX81519 00 3,873.00$ 3,873.00$ XXX81520 00 2,789.12$ 2,789.12$ XXX81521 00 3,873.00$ 3,873.00$ XXX81522 00 3,873.00$ 3,873.00$ XXX81525 00 3,116.00$ 3,116.00$ XXX81528 00 508.87$ 508.87$ XXX81535 00 579.46$ 579.46$ XXX81536 00 177.56$ 177.56$ XXX81538 00 2,871.00$ 2,871.00$ XXX81539 00 760.00$ 760.00$ XXX81540 00 3,750.00$ 3,750.00$ XXX81541 00 3,873.00$ 3,873.00$ XXX81542 00 -$ -$ XXX81545 00 3,600.00$ 3,600.00$ XXX81551 00 2,030.00$ 2,030.00$ XXX81595 00 3,240.00$ 3,240.00$ XXX81596 00 72.19$ 72.19$ XXX81599 00 Not Covered Not Covered XXX82009 00 5.02$ 5.02$ XXX82010 00 9.08$ 9.08$ XXX82010 QW 9.08$ 9.08$ 82013 00 12.41$ 12.41$ XXX82016 00 16.49$ 16.49$ XXX82017 00 18.74$ 18.74$ XXX82024 00 42.91$ 42.91$ XXX



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

82030 00 28.67$ 28.67$ XXX82040 00 5.50$ 5.50$ XXX82040 QW 5.50$ 5.50$ 82042 00 7.78$ 7.78$ XXX82042 QW 7.78$ 7.78$ 82043 00 6.42$ 6.42$ XXX82043 QW 6.42$ 6.42$ 82044 00 6.23$ 6.23$ XXX82044 QW 6.23$ 6.23$ 82045 00 37.71$ 37.71$ XXX82075 00 30.00$ 30.00$ XXX82085 00 10.79$ 10.79$ XXX82088 00 45.28$ 45.28$ XXX82103 00 14.93$ 14.93$ XXX82104 00 16.07$ 16.07$ XXX82105 00 18.64$ 18.64$ XXX82106 00 18.64$ 18.64$ XXX82107 00 71.57$ 71.57$ XXX82108 00 28.31$ 28.31$ XXX82120 00 5.99$ 5.99$ XXX82120 QW 5.99$ 5.99$ 82127 00 15.41$ 15.41$ XXX82128 00 15.41$ 15.41$ XXX82131 00 22.98$ 22.98$ XXX82135 00 18.28$ 18.28$ XXX82136 00 19.61$ 19.61$ XXX82139 00 18.74$ 18.74$ XXX82140 00 16.19$ 16.19$ XXX82143 00 9.35$ 9.35$ XXX82150 00 7.20$ 7.20$ XXX82150 QW 7.20$ 7.20$ 82154 00 32.04$ 32.04$ XXX82157 00 32.53$ 32.53$ XXX82160 00 27.78$ 27.78$ XXX82163 00 22.80$ 22.80$ XXX82164 00 16.22$ 16.22$ XXX82172 00 21.09$ 21.09$ XXX82175 00 21.08$ 21.08$ XXX82180 00 10.98$ 10.98$ XXX82190 00 16.56$ 16.56$ XXX82232 00 17.97$ 17.97$ XXX82239 00 19.03$ 19.03$ XXX



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

82240 00 29.53$ 29.53$ XXX82247 00 5.57$ 5.57$ XXX82247 QW 5.57$ 5.57$ 82248 00 5.57$ 5.57$ XXX82252 00 5.06$ 5.06$ XXX82261 00 18.74$ 18.74$ XXX82270 00 4.38$ 4.38$ XXX82271 00 5.32$ 5.32$ XXX82271 QW 5.32$ 5.32$ 82272 00 4.23$ 4.23$ XXX82274 00 17.67$ 17.67$ XXX82274 QW 17.67$ 17.67$ 82286 00 5.73$ 5.73$ XXX82300 00 25.72$ 25.72$ XXX82306 00 32.89$ 32.89$ XXX82308 00 29.77$ 29.77$ XXX82310 00 5.73$ 5.73$ XXX82310 QW 5.73$ 5.73$ 82330 00 15.20$ 15.20$ XXX82330 QW 15.20$ 15.20$ 82331 00 13.34$ 13.34$ XXX82340 00 6.70$ 6.70$ XXX82355 00 12.86$ 12.86$ XXX82360 00 14.30$ 14.30$ XXX82365 00 14.33$ 14.33$ XXX82370 00 13.92$ 13.92$ XXX82373 00 20.06$ 20.06$ XXX82374 00 5.43$ 5.43$ XXX82374 QW 5.43$ 5.43$ 82375 00 13.69$ 13.69$ XXX82376 00 14.07$ 14.07$ XXX82378 00 21.07$ 21.07$ XXX82379 00 18.74$ 18.74$ XXX82380 00 10.25$ 10.25$ XXX82382 00 27.30$ 27.30$ XXX82383 00 29.08$ 29.08$ XXX82384 00 28.06$ 28.06$ XXX82387 00 20.06$ 20.06$ XXX82390 00 11.93$ 11.93$ XXX82397 00 15.69$ 15.69$ XXX82415 00 14.08$ 14.08$ XXX82435 00 5.11$ 5.11$ XXX



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

82435 QW 5.11$ 5.11$ 82436 00 5.75$ 5.75$ XXX82438 00 5.43$ 5.43$ XXX82441 00 6.67$ 6.67$ XXX82465 00 4.84$ 4.84$ XXX82465 QW 4.84$ 4.84$ 82480 00 8.75$ 8.75$ XXX82482 00 9.81$ 9.81$ XXX82485 00 22.95$ 22.95$ XXX82495 00 22.53$ 22.53$ XXX82507 00 30.89$ 30.89$ XXX82523 00 20.76$ 20.76$ XXX82523 QW 20.76$ 20.76$ 82525 00 13.79$ 13.79$ XXX82528 00 25.02$ 25.02$ XXX82530 00 18.57$ 18.57$ XXX82533 00 18.11$ 18.11$ XXX82540 00 5.15$ 5.15$ XXX82542 00 24.09$ 24.09$ XXX82550 00 7.23$ 7.23$ XXX82550 QW 7.23$ 7.23$ 82552 00 14.88$ 14.88$ XXX82553 00 12.83$ 12.83$ XXX82554 00 13.19$ 13.19$ XXX82565 00 5.69$ 5.69$ XXX82565 QW 5.69$ 5.69$ 82570 00 5.75$ 5.75$ XXX82570 QW 5.75$ 5.75$ 82575 00 10.51$ 10.51$ XXX82585 00 14.14$ 14.14$ XXX82595 00 7.18$ 7.18$ XXX82600 00 21.55$ 21.55$ XXX82607 00 16.75$ 16.75$ XXX82608 00 15.91$ 15.91$ XXX82610 00 18.52$ 18.52$ XXX82615 00 9.55$ 9.55$ XXX82626 00 28.08$ 28.08$ XXX82627 00 24.71$ 24.71$ XXX82633 00 34.43$ 34.43$ XXX82634 00 32.53$ 32.53$ XXX82638 00 13.61$ 13.61$ XXX82642 00 32.53$ 32.53$ XXX



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

82652 00 42.78$ 42.78$ XXX82656 00 12.81$ 12.81$ XXX82657 00 22.17$ 22.17$ XXX82658 00 44.03$ 44.03$ XXX82664 00 61.50$ 61.50$ XXX82668 00 20.88$ 20.88$ XXX82670 00 31.04$ 31.04$ XXX82671 00 35.89$ 35.89$ XXX82672 00 24.11$ 24.11$ XXX82677 00 26.87$ 26.87$ XXX82679 00 27.73$ 27.73$ XXX82679 QW 27.73$ 27.73$ 82693 00 16.56$ 16.56$ XXX82696 00 26.24$ 26.24$ XXX82705 00 5.66$ 5.66$ XXX82710 00 18.67$ 18.67$ XXX82715 00 22.97$ 22.97$ XXX82725 00 18.77$ 18.77$ XXX82726 00 20.06$ 20.06$ XXX82728 00 15.15$ 15.15$ XXX82731 00 71.57$ 71.57$ XXX82735 00 20.60$ 20.60$ XXX82746 00 16.34$ 16.34$ XXX82747 00 19.25$ 19.25$ XXX82757 00 19.26$ 19.26$ XXX82759 00 23.87$ 23.87$ XXX82760 00 12.44$ 12.44$ XXX82775 00 23.41$ 23.41$ XXX82776 00 11.74$ 11.74$ XXX82777 00 44.25$ 44.25$ XXX82784 00 10.34$ 10.34$ XXX82785 00 18.29$ 18.29$ XXX82787 00 8.91$ 8.91$ XXX82800 00 11.00$ 11.00$ XXX82803 00 26.07$ 26.07$ XXX82805 00 78.77$ 78.77$ XXX82810 00 9.77$ 9.77$ XXX82820 00 13.34$ 13.34$ XXX82930 00 6.71$ 6.71$ XXX82938 00 19.66$ 19.66$ XXX82941 00 19.59$ 19.59$ XXX82943 00 15.88$ 15.88$ XXX



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

82945 00 4.37$ 4.37$ XXX82946 00 17.77$ 17.77$ XXX82947 00 4.37$ 4.37$ XXX82947 QW 4.37$ 4.37$ 82948 00 5.04$ 5.04$ XXX82950 00 5.27$ 5.27$ XXX82950 QW 5.27$ 5.27$ 82951 00 14.30$ 14.30$ XXX82951 QW 14.30$ 14.30$ 82952 00 4.36$ 4.36$ XXX82952 QW 4.36$ 4.36$ 82955 00 10.77$ 10.77$ XXX82960 00 6.72$ 6.72$ XXX82962 00 3.28$ 3.28$ XXX82963 00 23.87$ 23.87$ XXX82965 00 13.15$ 13.15$ XXX82977 00 8.00$ 8.00$ XXX82977 QW 8.00$ 8.00$ 82978 00 15.84$ 15.84$ XXX82979 00 10.49$ 10.49$ XXX82985 00 16.76$ 16.76$ XXX82985 QW 16.76$ 16.76$ 83001 00 20.65$ 20.65$ XXX83001 QW 20.65$ 20.65$ 83002 00 20.57$ 20.57$ XXX83002 QW 20.57$ 20.57$ 83003 00 18.52$ 18.52$ XXX83006 00 75.60$ 75.60$ XXX83009 00 74.84$ 74.84$ XXX83010 00 13.97$ 13.97$ XXX83012 00 26.89$ 26.89$ XXX83013 00 74.84$ 74.84$ XXX83014 00 8.73$ 8.73$ XXX83015 00 20.94$ 20.94$ XXX83018 00 24.41$ 24.41$ XXX83020 00 14.30$ 14.30$ XXX83020 26 0.53$ 31.75$ 0.53$ 31.75$ XXX83021 00 20.06$ 20.06$ XXX83026 00 4.01$ 4.01$ XXX83030 00 10.74$ 10.74$ XXX83033 00 8.00$ 8.00$ XXX83036 00 10.79$ 10.79$ XXX



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

83036 QW 10.79$ 10.79$ 83037 00 10.79$ 10.79$ XXX83037 QW 10.79$ 10.79$ 83045 00 6.49$ 6.49$ XXX83050 00 8.20$ 8.20$ XXX83051 00 8.12$ 8.12$ XXX83060 00 9.19$ 9.19$ XXX83065 00 9.00$ 9.00$ XXX83068 00 9.47$ 9.47$ XXX83069 00 4.39$ 4.39$ XXX83070 00 5.27$ 5.27$ XXX83080 00 18.74$ 18.74$ XXX83088 00 32.81$ 32.81$ XXX83090 00 18.74$ 18.74$ XXX83150 00 22.41$ 22.41$ XXX83491 00 19.47$ 19.47$ XXX83497 00 14.33$ 14.33$ XXX83498 00 30.19$ 30.19$ XXX83500 00 25.17$ 25.17$ XXX83505 00 27.01$ 27.01$ XXX83516 00 12.81$ 12.81$ XXX83516 QW 12.81$ 12.81$ 83518 00 9.64$ 9.64$ XXX83518 QW 9.64$ 9.64$ 83519 00 18.40$ 18.40$ XXX83520 00 17.27$ 17.27$ XXX83520 QW 17.27$ 17.27$ 83525 00 12.70$ 12.70$ XXX83527 00 14.39$ 14.39$ XXX83528 00 19.82$ 19.82$ XXX83540 00 7.19$ 7.19$ XXX83550 00 9.71$ 9.71$ XXX83570 00 9.83$ 9.83$ XXX83582 00 15.75$ 15.75$ XXX83586 00 14.22$ 14.22$ XXX83593 00 29.22$ 29.22$ XXX83605 00 11.87$ 11.87$ XXX83605 QW 11.87$ 11.87$ 83615 00 6.71$ 6.71$ XXX83625 00 14.22$ 14.22$ XXX83630 00 21.81$ 21.81$ XXX83631 00 21.81$ 21.81$ XXX



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

83632 00 22.47$ 22.47$ XXX83633 00 11.25$ 11.25$ XXX83655 00 13.45$ 13.45$ XXX83655 QW 13.45$ 13.45$ 83661 00 24.43$ 24.43$ XXX83662 00 21.01$ 21.01$ XXX83663 00 21.01$ 21.01$ XXX83664 00 21.01$ 21.01$ XXX83670 00 10.18$ 10.18$ XXX83690 00 7.65$ 7.65$ XXX83695 00 14.39$ 14.39$ XXX83698 00 46.31$ 46.31$ XXX83700 00 12.51$ 12.51$ XXX83701 00 33.86$ 33.86$ XXX83704 00 35.06$ 35.06$ XXX83718 00 9.10$ 9.10$ XXX83718 QW 9.10$ 9.10$ 83719 00 12.93$ 12.93$ XXX83721 00 10.60$ 10.60$ XXX83721 QW 10.60$ 10.60$ 83722 00 35.06$ 35.06$ XXX83727 00 19.10$ 19.10$ XXX83735 00 7.44$ 7.44$ XXX83775 00 8.19$ 8.19$ XXX83785 00 27.33$ 27.33$ XXX83789 00 24.11$ 24.11$ XXX83825 00 18.06$ 18.06$ XXX83835 00 18.82$ 18.82$ XXX83857 00 11.93$ 11.93$ XXX83861 00 22.48$ 22.48$ XXX83861 QW 22.48$ 22.48$ 83864 00 28.50$ 28.50$ XXX83872 00 6.51$ 6.51$ XXX83873 00 19.12$ 19.12$ XXX83874 00 14.35$ 14.35$ XXX83876 00 50.86$ 50.86$ XXX83880 00 39.26$ 39.26$ XXX83880 QW 39.26$ 39.26$ 83883 00 15.11$ 15.11$ XXX83885 00 27.23$ 27.23$ XXX83915 00 12.39$ 12.39$ XXX83916 00 27.39$ 27.39$ XXX



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

83918 00 23.60$ 23.60$ XXX83919 00 18.28$ 18.28$ XXX83921 00 21.21$ 21.21$ XXX83930 00 7.35$ 7.35$ XXX83935 00 7.57$ 7.57$ XXX83937 00 33.16$ 33.16$ XXX83945 00 14.45$ 14.45$ XXX83950 00 71.57$ 71.57$ XXX83951 00 71.57$ 71.57$ XXX83970 00 45.86$ 45.86$ XXX83986 00 3.98$ 3.98$ XXX83986 QW 3.98$ 3.98$ 83987 00 3.98$ 3.98$ XXX83992 00 16.80$ 16.80$ XXX83993 00 21.81$ 21.81$ XXX84030 00 6.11$ 6.11$ XXX84035 00 4.07$ 4.07$ XXX84060 00 8.21$ 8.21$ XXX84066 00 10.73$ 10.73$ XXX84075 00 5.75$ 5.75$ XXX84075 QW 5.75$ 5.75$ 84078 00 8.26$ 8.26$ XXX84080 00 16.43$ 16.43$ XXX84081 00 18.35$ 18.35$ XXX84085 00 10.49$ 10.49$ XXX84087 00 11.47$ 11.47$ XXX84100 00 5.27$ 5.27$ XXX84105 00 5.78$ 5.78$ XXX84106 00 5.82$ 5.82$ XXX84110 00 9.38$ 9.38$ XXX84112 00 98.11$ 98.11$ XXX84119 00 13.36$ 13.36$ XXX84120 00 16.35$ 16.35$ XXX84126 00 39.11$ 39.11$ XXX84132 00 5.11$ 5.11$ XXX84132 QW 5.11$ 5.11$ 84133 00 4.79$ 4.79$ XXX84134 00 16.21$ 16.21$ XXX84135 00 21.27$ 21.27$ XXX84138 00 21.05$ 21.05$ XXX84140 00 22.97$ 22.97$ XXX84143 00 25.34$ 25.34$ XXX



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

84144 00 23.18$ 23.18$ XXX84145 00 29.77$ 29.77$ XXX84146 00 21.53$ 21.53$ XXX84150 00 41.77$ 41.77$ XXX84152 00 20.44$ 20.44$ XXX84153 00 20.44$ 20.44$ XXX84154 00 20.44$ 20.44$ XXX84155 00 4.07$ 4.07$ XXX84155 QW 4.07$ 4.07$ 84156 00 4.07$ 4.07$ XXX84157 00 4.07$ 4.07$ XXX84157 QW 4.07$ 4.07$ 84160 00 5.75$ 5.75$ XXX84163 00 16.73$ 16.73$ XXX84165 00 11.93$ 11.93$ XXX84165 26 0.53$ 31.75$ 0.53$ 31.75$ XXX84166 00 19.81$ 19.81$ XXX84166 26 0.53$ 31.75$ 0.53$ 31.75$ XXX84181 00 18.92$ 18.92$ XXX84181 26 0.53$ 31.75$ 0.53$ 31.75$ XXX84182 00 29.21$ 29.21$ XXX84182 26 0.53$ 31.75$ 0.53$ 31.75$ XXX84202 00 15.94$ 15.94$ XXX84203 00 9.74$ 9.74$ XXX84206 00 26.69$ 26.69$ XXX84207 00 31.22$ 31.22$ XXX84210 00 14.48$ 14.48$ XXX84220 00 10.49$ 10.49$ XXX84228 00 12.93$ 12.93$ XXX84233 00 87.88$ 87.88$ XXX84234 00 72.09$ 72.09$ XXX84235 00 71.23$ 71.23$ XXX84238 00 40.63$ 40.63$ XXX84244 00 24.44$ 24.44$ XXX84252 00 22.49$ 22.49$ XXX84255 00 28.37$ 28.37$ XXX84260 00 34.43$ 34.43$ XXX84270 00 24.15$ 24.15$ XXX84275 00 14.93$ 14.93$ XXX84285 00 26.15$ 26.15$ XXX84295 00 5.35$ 5.35$ XXX84295 QW 5.35$ 5.35$



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

84300 00 5.40$ 5.40$ XXX84302 00 5.40$ 5.40$ XXX84305 00 23.63$ 23.63$ XXX84307 00 20.31$ 20.31$ XXX84311 00 8.10$ 8.10$ XXX84315 00 3.28$ 3.28$ XXX84375 00 39.00$ 39.00$ XXX84376 00 6.11$ 6.11$ XXX84377 00 6.11$ 6.11$ XXX84378 00 12.81$ 12.81$ XXX84379 00 12.81$ 12.81$ XXX84392 00 5.49$ 5.49$ XXX84402 00 28.30$ 28.30$ XXX84403 00 28.68$ 28.68$ XXX84410 00 56.98$ 56.98$ XXX84425 00 23.59$ 23.59$ XXX84430 00 12.93$ 12.93$ XXX84431 00 35.11$ 35.11$ XXX84432 00 17.84$ 17.84$ XXX84436 00 7.63$ 7.63$ XXX84437 00 7.18$ 7.18$ XXX84439 00 10.02$ 10.02$ XXX84442 00 16.43$ 16.43$ XXX84443 00 18.67$ 18.67$ XXX84443 QW 18.67$ 18.67$ 84445 00 56.51$ 56.51$ XXX84446 00 15.75$ 15.75$ XXX84449 00 20.00$ 20.00$ XXX84450 00 5.75$ 5.75$ XXX84450 QW 5.75$ 5.75$ 84460 00 5.89$ 5.89$ XXX84460 QW 5.89$ 5.89$ 84466 00 14.18$ 14.18$ XXX84478 00 6.38$ 6.38$ XXX84478 QW 6.38$ 6.38$ 84479 00 7.18$ 7.18$ XXX84480 00 15.75$ 15.75$ XXX84481 00 18.82$ 18.82$ XXX84482 00 17.51$ 17.51$ XXX84484 00 12.47$ 12.47$ XXX84485 00 8.00$ 8.00$ XXX84488 00 8.11$ 8.11$ XXX



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

84490 00 9.93$ 9.93$ XXX84510 00 11.56$ 11.56$ XXX84512 00 10.09$ 10.09$ XXX84520 00 4.39$ 4.39$ XXX84520 QW 4.39$ 4.39$ 84525 00 5.13$ 5.13$ XXX84540 00 5.56$ 5.56$ XXX84545 00 7.35$ 7.35$ XXX84550 00 5.02$ 5.02$ XXX84550 QW 5.02$ 5.02$ 84560 00 5.27$ 5.27$ XXX84577 00 18.67$ 18.67$ XXX84578 00 4.47$ 4.47$ XXX84580 00 9.55$ 9.55$ XXX84583 00 6.05$ 6.05$ XXX84585 00 17.22$ 17.22$ XXX84586 00 39.26$ 39.26$ XXX84588 00 37.71$ 37.71$ XXX84590 00 12.90$ 12.90$ XXX84591 00 17.06$ 17.06$ XXX84597 00 15.24$ 15.24$ XXX84600 00 17.87$ 17.87$ XXX84620 00 13.16$ 13.16$ XXX84630 00 12.65$ 12.65$ XXX84681 00 23.13$ 23.13$ XXX84702 00 16.73$ 16.73$ XXX84703 00 8.36$ 8.36$ XXX84703 QW 8.36$ 8.36$ 84704 00 16.73$ 16.73$ XXX84830 00 12.70$ 12.70$ XXX84999 00 By Report By Report XXX85002 00 5.01$ 5.01$ XXX85004 00 7.18$ 7.18$ XXX85007 00 3.82$ 3.82$ XXX85008 00 3.82$ 3.82$ XXX85009 00 5.07$ 5.07$ XXX85013 00 7.00$ 7.00$ XXX85014 00 2.63$ 2.63$ XXX85014 QW 2.63$ 2.63$ 85018 00 2.63$ 2.63$ XXX85018 QW 2.63$ 2.63$ 85025 00 8.63$ 8.63$ XXX



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

85025 QW 8.63$ 8.63$ 85027 00 7.18$ 7.18$ XXX85032 00 4.79$ 4.79$ XXX85041 00 3.35$ 3.35$ XXX85044 00 4.79$ 4.79$ XXX85045 00 4.44$ 4.44$ XXX85046 00 6.19$ 6.19$ XXX85048 00 2.82$ 2.82$ XXX85049 00 4.97$ 4.97$ XXX85055 00 35.74$ 35.74$ XXX85060 00 0.71$ 42.81$ 0.71$ 42.81$ XXX85097 00 2.17$ 130.21$ 1.45$ 86.70$ XXX85130 00 13.21$ 13.21$ XXX85170 00 16.30$ 16.30$ XXX85175 00 20.37$ 20.37$ XXX85210 00 14.43$ 14.43$ XXX85220 00 19.61$ 19.61$ XXX85230 00 19.89$ 19.89$ XXX85240 00 19.89$ 19.89$ XXX85244 00 22.69$ 22.69$ XXX85245 00 25.49$ 25.49$ XXX85246 00 25.49$ 25.49$ XXX85247 00 25.49$ 25.49$ XXX85250 00 21.16$ 21.16$ XXX85260 00 19.89$ 19.89$ XXX85270 00 19.89$ 19.89$ XXX85280 00 21.50$ 21.50$ XXX85290 00 18.15$ 18.15$ XXX85291 00 9.88$ 9.88$ XXX85292 00 21.04$ 21.04$ XXX85293 00 21.04$ 21.04$ XXX85300 00 13.17$ 13.17$ XXX85301 00 12.01$ 12.01$ XXX85302 00 13.35$ 13.35$ XXX85303 00 15.37$ 15.37$ XXX85305 00 12.90$ 12.90$ XXX85306 00 17.03$ 17.03$ XXX85307 00 17.03$ 17.03$ XXX85335 00 14.30$ 14.30$ XXX85337 00 17.27$ 17.27$ XXX85345 00 4.79$ 4.79$ XXX85347 00 4.73$ 4.73$ XXX



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

85348 00 4.49$ 4.49$ XXX85360 00 9.34$ 9.34$ XXX85362 00 7.65$ 7.65$ XXX85366 00 80.46$ 80.46$ XXX85370 00 12.62$ 12.62$ XXX85378 00 9.72$ 9.72$ XXX85379 00 11.31$ 11.31$ XXX85380 00 11.31$ 11.31$ XXX85384 00 9.72$ 9.72$ XXX85385 00 14.46$ 14.46$ XXX85390 00 15.48$ 15.48$ XXX85390 26 1.08$ 64.74$ 1.08$ 64.74$ XXX85396 00 0.59$ 35.45$ 0.59$ 35.45$ XXX85397 00 30.86$ 30.86$ XXX85400 00 8.56$ 8.56$ XXX85410 00 8.56$ 8.56$ XXX85415 00 19.10$ 19.10$ XXX85420 00 7.26$ 7.26$ XXX85421 00 11.32$ 11.32$ XXX85441 00 4.67$ 4.67$ XXX85445 00 7.57$ 7.57$ XXX85460 00 8.59$ 8.59$ XXX85461 00 9.36$ 9.36$ XXX85475 00 9.86$ 9.86$ XXX85520 00 14.55$ 14.55$ XXX85525 00 13.15$ 13.15$ XXX85530 00 14.55$ 14.55$ XXX85536 00 7.18$ 7.18$ XXX85540 00 9.56$ 9.56$ XXX85547 00 9.56$ 9.56$ XXX85549 00 20.83$ 20.83$ XXX85555 00 7.47$ 7.47$ XXX85557 00 14.84$ 14.84$ XXX85576 00 24.91$ 24.91$ XXX85576 26 0.53$ 31.75$ 0.53$ 31.75$ XXX85576 QW 24.91$ 24.91$ 85597 00 19.97$ 19.97$ XXX85598 00 19.97$ 19.97$ XXX85610 00 4.37$ 4.37$ XXX85610 QW 4.37$ 4.37$ 85611 00 4.38$ 4.38$ XXX85612 00 17.49$ 17.49$ XXX



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

85613 00 10.64$ 10.64$ XXX85635 00 10.94$ 10.94$ XXX85651 00 4.27$ 4.27$ XXX85652 00 3.00$ 3.00$ XXX85660 00 6.12$ 6.12$ XXX85670 00 6.41$ 6.41$ XXX85675 00 7.61$ 7.61$ XXX85705 00 10.70$ 10.70$ XXX85730 00 6.67$ 6.67$ XXX85732 00 7.18$ 7.18$ XXX85810 00 12.97$ 12.97$ XXX85999 00 By Report By Report XXX86000 00 7.76$ 7.76$ XXX86001 00 7.82$ 7.82$ XXX86003 00 5.80$ 5.80$ XXX86005 00 8.85$ 8.85$ XXX86008 00 19.93$ 19.93$ XXX86021 00 16.73$ 16.73$ XXX86022 00 20.41$ 20.41$ XXX86023 00 13.84$ 13.84$ XXX86038 00 13.43$ 13.43$ XXX86039 00 12.40$ 12.40$ XXX86060 00 8.11$ 8.11$ XXX86063 00 6.41$ 6.41$ XXX86077 00 1.60$ 96.16$ 1.49$ 89.22$ XXX86078 00 1.60$ 96.16$ 1.49$ 89.22$ XXX86079 00 1.59$ 95.53$ 1.49$ 89.22$ XXX86140 00 5.75$ 5.75$ XXX86141 00 14.39$ 14.39$ XXX86146 00 28.28$ 28.28$ XXX86147 00 28.28$ 28.28$ XXX86148 00 17.85$ 17.85$ XXX86152 00 273.00$ 273.00$ XXX86153 26 1.00$ 59.85$ 1.00$ 59.85$ XXX86155 00 17.76$ 17.76$ XXX86156 00 8.07$ 8.07$ XXX86157 00 8.96$ 8.96$ XXX86160 00 13.33$ 13.33$ XXX86161 00 13.33$ 13.33$ XXX86162 00 22.58$ 22.58$ XXX86171 00 11.12$ 11.12$ XXX86200 00 14.39$ 14.39$ XXX



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

86215 00 14.72$ 14.72$ XXX86225 00 15.27$ 15.27$ XXX86226 00 13.45$ 13.45$ XXX86235 00 19.93$ 19.93$ XXX86255 00 13.39$ 13.39$ XXX86255 26 0.53$ 31.75$ 0.53$ 31.75$ XXX86256 00 13.39$ 13.39$ XXX86256 26 0.53$ 31.75$ 0.53$ 31.75$ XXX86277 00 17.49$ 17.49$ XXX86280 00 9.10$ 9.10$ XXX86294 00 25.57$ 25.57$ XXX86294 QW 25.57$ 25.57$ 86300 00 23.13$ 23.13$ XXX86301 00 23.13$ 23.13$ XXX86304 00 23.13$ 23.13$ XXX86305 00 23.13$ 23.13$ XXX86308 00 5.75$ 5.75$ XXX86308 QW 5.75$ 5.75$ 86309 00 7.18$ 7.18$ XXX86310 00 8.19$ 8.19$ XXX86316 00 23.13$ 23.13$ XXX86317 00 16.65$ 16.65$ XXX86318 00 18.09$ 18.09$ XXX86318 QW 18.09$ 18.09$ 86320 00 29.92$ 29.92$ XXX86320 26 0.53$ 31.75$ 0.53$ 31.75$ XXX86325 00 24.85$ 24.85$ XXX86325 26 0.53$ 31.75$ 0.53$ 31.75$ XXX86327 00 29.92$ 29.92$ XXX86327 26 0.65$ 39.19$ 0.65$ 39.19$ XXX86329 00 15.61$ 15.61$ XXX86331 00 13.31$ 13.31$ XXX86332 00 27.08$ 27.08$ XXX86334 00 24.83$ 24.83$ XXX86334 26 0.53$ 31.75$ 0.53$ 31.75$ XXX86335 00 32.61$ 32.61$ XXX86335 26 0.53$ 31.75$ 0.53$ 31.75$ XXX86336 00 17.32$ 17.32$ XXX86337 00 23.79$ 23.79$ XXX86340 00 16.75$ 16.75$ XXX86341 00 23.57$ 23.57$ XXX86343 00 13.84$ 13.84$ XXX



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

86344 00 10.39$ 10.39$ XXX86352 00 150.96$ 150.96$ XXX86353 00 54.47$ 54.47$ XXX86355 00 41.92$ 41.92$ XXX86356 00 29.75$ 29.75$ XXX86357 00 41.92$ 41.92$ XXX86359 00 41.92$ 41.92$ XXX86360 00 52.20$ 52.20$ XXX86361 00 29.75$ 29.75$ XXX86367 00 77.78$ 77.78$ XXX86376 00 16.17$ 16.17$ XXX86382 00 18.79$ 18.79$ XXX86384 00 13.61$ 13.61$ XXX86386 00 21.78$ 21.78$ XXX86386 QW 21.78$ 21.78$ 86403 00 11.54$ 11.54$ XXX86406 00 11.82$ 11.82$ XXX86430 00 6.30$ 6.30$ XXX86431 00 6.30$ 6.30$ XXX86480 00 68.87$ 68.87$ XXX86481 00 100.00$ 100.00$ XXX86485 00 19.09$ 19.09$ XXX86486 00 0.16$ 9.38$ 0.16$ 9.38$ XXX86490 00 2.62$ 156.94$ 2.62$ 156.94$ XXX86510 00 0.20$ 11.90$ 0.20$ 11.90$ XXX86580 00 0.25$ 15.05$ 0.25$ 15.05$ XXX86590 00 12.66$ 12.66$ XXX86592 00 4.75$ 4.75$ XXX86593 00 4.89$ 4.89$ XXX86602 00 11.31$ 11.31$ XXX86603 00 14.30$ 14.30$ XXX86606 00 16.73$ 16.73$ XXX86609 00 14.31$ 14.31$ XXX86611 00 11.31$ 11.31$ XXX86612 00 14.34$ 14.34$ XXX86615 00 14.65$ 14.65$ XXX86617 00 17.21$ 17.21$ XXX86618 00 18.92$ 18.92$ XXX86618 QW 18.92$ 18.92$ 86619 00 14.86$ 14.86$ XXX86622 00 9.92$ 9.92$ XXX86625 00 14.58$ 14.58$ XXX



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

86628 00 13.34$ 13.34$ XXX86631 00 13.14$ 13.14$ XXX86632 00 14.09$ 14.09$ XXX86635 00 12.75$ 12.75$ XXX86638 00 13.47$ 13.47$ XXX86641 00 16.01$ 16.01$ XXX86644 00 15.99$ 15.99$ XXX86645 00 18.72$ 18.72$ XXX86648 00 16.90$ 16.90$ XXX86651 00 14.65$ 14.65$ XXX86652 00 14.65$ 14.65$ XXX86653 00 14.65$ 14.65$ XXX86654 00 14.65$ 14.65$ XXX86658 00 14.47$ 14.47$ XXX86663 00 14.58$ 14.58$ XXX86664 00 16.99$ 16.99$ XXX86665 00 20.16$ 20.16$ XXX86666 00 11.31$ 11.31$ XXX86668 00 14.16$ 14.16$ XXX86671 00 13.62$ 13.62$ XXX86674 00 16.35$ 16.35$ XXX86677 00 16.85$ 16.85$ XXX86682 00 14.45$ 14.45$ XXX86684 00 17.60$ 17.60$ XXX86687 00 9.32$ 9.32$ XXX86688 00 15.56$ 15.56$ XXX86689 00 21.51$ 21.51$ XXX86692 00 19.07$ 19.07$ XXX86694 00 15.99$ 15.99$ XXX86695 00 14.65$ 14.65$ XXX86696 00 21.51$ 21.51$ XXX86698 00 13.88$ 13.88$ XXX86701 00 9.87$ 9.87$ XXX86701 QW 9.87$ 9.87$ 86702 00 15.02$ 15.02$ XXX86703 00 15.23$ 15.23$ XXX86704 00 13.39$ 13.39$ XXX86705 00 13.08$ 13.08$ XXX86706 00 11.93$ 11.93$ XXX86707 00 12.85$ 12.85$ XXX86708 00 13.76$ 13.76$ XXX86709 00 12.51$ 12.51$ XXX



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

86710 00 15.06$ 15.06$ XXX86711 00 16.89$ 16.89$ XXX86713 00 17.00$ 17.00$ XXX86717 00 13.61$ 13.61$ XXX86720 00 16.20$ 16.20$ XXX86723 00 14.65$ 14.65$ XXX86727 00 14.30$ 14.30$ XXX86732 00 15.00$ 15.00$ XXX86735 00 14.50$ 14.50$ XXX86738 00 14.71$ 14.71$ XXX86741 00 14.65$ 14.65$ XXX86744 00 15.99$ 15.99$ XXX86747 00 16.70$ 16.70$ XXX86750 00 14.65$ 14.65$ XXX86753 00 13.76$ 13.76$ XXX86756 00 15.89$ 15.89$ XXX86757 00 21.51$ 21.51$ XXX86759 00 18.23$ 18.23$ XXX86762 00 15.99$ 15.99$ XXX86765 00 14.31$ 14.31$ XXX86768 00 14.65$ 14.65$ XXX86771 00 24.48$ 24.48$ XXX86774 00 16.44$ 16.44$ XXX86777 00 15.99$ 15.99$ XXX86778 00 16.01$ 16.01$ XXX86780 00 14.71$ 14.71$ XXX86780 QW 14.71$ 14.71$ 86784 00 13.96$ 13.96$ XXX86787 00 14.31$ 14.31$ XXX86788 00 18.72$ 18.72$ XXX86789 00 15.99$ 15.99$ XXX86790 00 14.31$ 14.31$ XXX86793 00 14.65$ 14.65$ XXX86794 00 18.72$ 18.72$ XXX86800 00 17.67$ 17.67$ XXX86803 00 15.85$ 15.85$ XXX86803 QW 15.85$ 15.85$ 86804 00 17.21$ 17.21$ XXX86805 00 189.51$ 189.51$ XXX86806 00 52.88$ 52.88$ XXX86807 00 78.65$ 78.65$ XXX86808 00 32.98$ 32.98$ XXX



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

86812 00 28.67$ 28.67$ XXX86813 00 64.44$ 64.44$ XXX86816 00 30.95$ 30.95$ XXX86817 00 106.14$ 106.14$ XXX86821 00 40.62$ 40.62$ XXX86825 00 109.49$ 109.49$ XXX86826 00 36.53$ 36.53$ XXX86828 00 64.19$ 64.19$ XXX86829 00 64.19$ 64.19$ XXX86830 00 95.52$ 95.52$ XXX86831 00 81.88$ 81.88$ XXX86832 00 323.75$ 323.75$ XXX86833 00 325.80$ 325.80$ XXX86834 00 397.29$ 397.29$ XXX86835 00 358.85$ 358.85$ XXX86849 00 By Report By Report XXX86850 00 9.77$ 9.77$ XXX86860 00 By Report By Report XXX86870 00 By Report By Report XXX86880 00 5.99$ 5.99$ XXX86885 00 6.36$ 6.36$ XXX86886 00 5.75$ 5.75$ XXX86890 00 By Report By Report XXX86891 00 By Report By Report XXX86900 00 3.32$ 3.32$ XXX86901 00 3.32$ 3.32$ XXX86902 00 6.35$ 6.35$ XXX86904 00 16.34$ 16.34$ XXX86905 00 4.25$ 4.25$ XXX86906 00 8.61$ 8.61$ XXX86910 00 Not Covered Not Covered XXX86911 00 Not Covered Not Covered XXX86920 00 By Report By Report XXX86921 00 By Report By Report XXX86922 00 By Report By Report XXX86923 00 By Report By Report XXX86927 00 By Report By Report XXX86930 00 By Report By Report XXX86931 00 By Report By Report XXX86932 00 By Report By Report XXX86940 00 9.11$ 9.11$ XXX86941 00 13.45$ 13.45$ XXX



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

86945 00 By Report By Report XXX86950 00 3.74$ 3.74$ XXX86960 00 By Report By Report XXX86965 00 By Report By Report XXX86970 00 By Report By Report XXX86971 00 By Report By Report XXX86972 00 By Report By Report XXX86975 00 By Report By Report XXX86976 00 By Report By Report XXX86977 00 By Report By Report XXX86978 00 By Report By Report XXX86985 00 By Report By Report XXX86999 00 By Report By Report XXX87003 00 18.71$ 18.71$ XXX87015 00 7.42$ 7.42$ XXX87040 00 11.47$ 11.47$ XXX87045 00 10.49$ 10.49$ XXX87046 00 10.49$ 10.49$ XXX87070 00 9.57$ 9.57$ XXX87071 00 10.49$ 10.49$ XXX87073 00 10.49$ 10.49$ XXX87075 00 10.52$ 10.52$ XXX87076 00 8.97$ 8.97$ XXX87077 00 8.97$ 8.97$ XXX87077 QW 8.97$ 8.97$ 87081 00 7.36$ 7.36$ XXX87084 00 27.07$ 27.07$ XXX87086 00 8.97$ 8.97$ XXX87088 00 8.99$ 8.99$ XXX87101 00 8.56$ 8.56$ XXX87102 00 9.34$ 9.34$ XXX87103 00 20.46$ 20.46$ XXX87106 00 11.47$ 11.47$ XXX87107 00 11.47$ 11.47$ XXX87109 00 17.10$ 17.10$ XXX87110 00 21.77$ 21.77$ XXX87116 00 12.00$ 12.00$ XXX87118 00 14.61$ 14.61$ XXX87140 00 6.19$ 6.19$ XXX87143 00 13.92$ 13.92$ XXX87147 00 5.75$ 5.75$ XXX87149 00 22.28$ 22.28$ XXX



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

87150 00 38.99$ 38.99$ XXX87152 00 7.74$ 7.74$ XXX87153 00 128.17$ 128.17$ XXX87158 00 7.74$ 7.74$ XXX87164 00 11.93$ 11.93$ XXX87164 26 0.58$ 34.91$ 0.58$ 34.91$ XXX87166 00 12.56$ 12.56$ XXX87168 00 4.75$ 4.75$ XXX87169 00 4.75$ 4.75$ XXX87172 00 4.75$ 4.75$ XXX87176 00 6.54$ 6.54$ XXX87177 00 9.89$ 9.89$ XXX87181 00 5.27$ 5.27$ XXX87184 00 7.66$ 7.66$ XXX87185 00 5.27$ 5.27$ XXX87186 00 9.61$ 9.61$ XXX87187 00 40.17$ 40.17$ XXX87188 00 7.38$ 7.38$ XXX87190 00 7.31$ 7.31$ XXX87197 00 16.69$ 16.69$ XXX87205 00 4.75$ 4.75$ XXX87206 00 5.99$ 5.99$ XXX87207 00 6.66$ 6.66$ XXX87207 26 0.53$ 31.75$ 0.53$ 31.75$ XXX87209 00 19.97$ 19.97$ XXX87210 00 5.82$ 5.82$ XXX87210 QW 5.82$ 5.82$ 87220 00 4.75$ 4.75$ XXX87230 00 21.93$ 21.93$ XXX87250 00 21.73$ 21.73$ XXX87252 00 28.97$ 28.97$ XXX87253 00 22.45$ 22.45$ XXX87254 00 21.73$ 21.73$ XXX87255 00 37.62$ 37.62$ XXX87260 00 14.43$ 14.43$ XXX87265 00 13.32$ 13.32$ XXX87267 00 13.42$ 13.42$ XXX87269 00 13.61$ 13.61$ XXX87270 00 13.32$ 13.32$ XXX87271 00 13.42$ 13.42$ XXX87272 00 13.32$ 13.32$ XXX87273 00 13.32$ 13.32$ XXX



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

87274 00 13.32$ 13.32$ XXX87275 00 13.32$ 13.32$ XXX87276 00 16.07$ 16.07$ XXX87278 00 15.60$ 15.60$ XXX87279 00 16.43$ 16.43$ XXX87280 00 13.42$ 13.42$ XXX87281 00 13.32$ 13.32$ XXX87283 00 60.80$ 60.80$ XXX87285 00 13.32$ 13.32$ XXX87290 00 13.42$ 13.42$ XXX87299 00 16.10$ 16.10$ XXX87300 00 13.32$ 13.32$ XXX87301 00 13.32$ 13.32$ XXX87305 00 13.32$ 13.32$ XXX87320 00 15.00$ 15.00$ XXX87324 00 13.32$ 13.32$ XXX87327 00 13.42$ 13.42$ XXX87328 00 13.82$ 13.82$ XXX87329 00 13.32$ 13.32$ XXX87332 00 13.32$ 13.32$ XXX87335 00 13.32$ 13.32$ XXX87336 00 16.00$ 16.00$ XXX87337 00 13.32$ 13.32$ XXX87338 00 15.98$ 15.98$ XXX87338 QW 15.98$ 15.98$ 87339 00 16.00$ 16.00$ XXX87340 00 11.48$ 11.48$ XXX87341 00 11.48$ 11.48$ XXX87350 00 12.81$ 12.81$ XXX87380 00 18.36$ 18.36$ XXX87385 00 13.32$ 13.32$ XXX87389 00 26.75$ 26.75$ XXX87389 QW 26.75$ 26.75$ 87390 00 24.06$ 24.06$ XXX87391 00 21.90$ 21.90$ XXX87400 00 14.13$ 14.13$ XXX87420 00 13.91$ 13.91$ XXX87425 00 13.32$ 13.32$ XXX87427 00 13.32$ 13.32$ XXX87430 00 16.81$ 16.81$ XXX87449 00 13.32$ 13.32$ XXX87449 QW 13.32$ 13.32$



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

87450 00 10.66$ 10.66$ XXX87451 00 10.66$ 10.66$ XXX87471 00 38.99$ 38.99$ XXX87472 00 47.60$ 47.60$ XXX87475 00 22.28$ 22.28$ XXX87476 00 38.99$ 38.99$ XXX87480 00 22.28$ 22.28$ XXX87481 00 38.99$ 38.99$ XXX87482 00 55.74$ 55.74$ XXX87483 00 463.09$ 463.09$ XXX87485 00 22.28$ 22.28$ XXX87486 00 38.99$ 38.99$ XXX87487 00 47.60$ 47.60$ XXX87490 00 22.75$ 22.75$ XXX87491 00 38.99$ 38.99$ XXX87492 00 53.47$ 53.47$ XXX87493 00 38.99$ 38.99$ XXX87495 00 30.03$ 30.03$ XXX87496 00 38.99$ 38.99$ XXX87497 00 47.60$ 47.60$ XXX87498 00 38.99$ 38.99$ XXX87500 00 38.99$ 38.99$ XXX87501 00 57.02$ 57.02$ XXX87502 00 95.80$ 95.80$ XXX87502 QW 95.80$ 95.80$ 87503 00 29.22$ 29.22$ XXX87505 00 142.54$ 142.54$ XXX87506 00 262.99$ 262.99$ XXX87507 00 463.09$ 463.09$ XXX87510 00 22.28$ 22.28$ XXX87511 00 38.99$ 38.99$ XXX87512 00 46.40$ 46.40$ XXX87516 00 38.99$ 38.99$ XXX87517 00 47.60$ 47.60$ XXX87520 00 31.22$ 31.22$ XXX87521 00 38.99$ 38.99$ XXX87522 00 47.60$ 47.60$ XXX87525 00 29.80$ 29.80$ XXX87526 00 39.26$ 39.26$ XXX87527 00 46.40$ 46.40$ XXX87528 00 22.28$ 22.28$ XXX87529 00 38.99$ 38.99$ XXX



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

87530 00 47.60$ 47.60$ XXX87531 00 58.00$ 58.00$ XXX87532 00 38.99$ 38.99$ XXX87533 00 46.40$ 46.40$ XXX87534 00 22.28$ 22.28$ XXX87535 00 38.99$ 38.99$ XXX87536 00 94.55$ 94.55$ XXX87537 00 22.28$ 22.28$ XXX87538 00 38.99$ 38.99$ XXX87539 00 58.62$ 58.62$ XXX87540 00 22.28$ 22.28$ XXX87541 00 38.99$ 38.99$ XXX87542 00 46.40$ 46.40$ XXX87550 00 22.28$ 22.28$ XXX87551 00 48.24$ 48.24$ XXX87552 00 47.60$ 47.60$ XXX87555 00 26.88$ 26.88$ XXX87556 00 41.68$ 41.68$ XXX87557 00 47.60$ 47.60$ XXX87560 00 27.29$ 27.29$ XXX87561 00 38.99$ 38.99$ XXX87562 00 47.60$ 47.60$ XXX87563 00 35.09$ 35.09$ XXX87580 00 22.28$ 22.28$ XXX87581 00 38.99$ 38.99$ XXX87582 00 302.62$ 302.62$ XXX87590 00 26.88$ 26.88$ XXX87591 00 38.99$ 38.99$ XXX87592 00 47.60$ 47.60$ XXX87623 00 38.99$ 38.99$ XXX87624 00 38.99$ 38.99$ XXX87625 00 40.55$ 40.55$ XXX87631 00 142.63$ 142.63$ XXX87631 QW 142.63$ 142.63$ 87632 00 237.14$ 237.14$ XXX87633 00 463.09$ 463.09$ XXX87633 QW 463.09$ 463.09$ 87634 00 77.99$ 77.99$ XXX87634 QW 77.99$ 77.99$ 87640 00 38.99$ 38.99$ XXX87641 00 38.99$ 38.99$ XXX87650 00 22.28$ 22.28$ XXX



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

87650 QW 22.28$ 22.28$ 87651 00 38.99$ 38.99$ XXX87651 QW 38.99$ 38.99$ 87652 00 46.40$ 46.40$ XXX87653 00 38.99$ 38.99$ XXX87660 00 22.28$ 22.28$ XXX87661 00 38.99$ 38.99$ XXX87662 00 57.02$ 57.02$ XXX87797 00 30.03$ 30.03$ XXX87798 00 38.99$ 38.99$ XXX87799 00 47.60$ 47.60$ XXX87800 00 44.57$ 44.57$ XXX87801 00 77.99$ 77.99$ XXX87801 QW 77.99$ 77.99$ 87802 00 13.32$ 13.32$ XXX87803 00 16.00$ 16.00$ XXX87804 00 16.55$ 16.55$ XXX87804 QW 16.55$ 16.55$ 87806 00 32.77$ 32.77$ XXX87806 QW 32.77$ 32.77$ 87807 00 13.32$ 13.32$ XXX87807 QW 13.32$ 13.32$ 87808 00 15.29$ 15.29$ XXX87808 QW 15.29$ 15.29$ 87809 00 21.76$ 21.76$ XXX87809 QW 21.76$ 21.76$ 87810 00 35.29$ 35.29$ XXX87850 00 24.56$ 24.56$ XXX87880 00 16.53$ 16.53$ XXX87880 QW 16.53$ 16.53$ 87899 00 16.07$ 16.07$ XXX87899 QW 16.07$ 16.07$ 87900 00 144.83$ 144.83$ XXX87901 00 286.05$ 286.05$ XXX87902 00 286.05$ 286.05$ XXX87903 00 542.95$ 542.95$ XXX87904 00 28.97$ 28.97$ XXX87905 00 13.58$ 13.58$ XXX87905 QW 13.58$ 13.58$ 87906 00 143.03$ 143.03$ XXX87910 00 286.05$ 286.05$ XXX87912 00 286.05$ 286.05$ XXX



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

87999 00 By Report By Report XXX88000 00 Not Covered Not Covered XXX88005 00 Not Covered Not Covered XXX88007 00 Not Covered Not Covered XXX88012 00 Not Covered Not Covered XXX88014 00 Not Covered Not Covered XXX88016 00 Not Covered Not Covered XXX88020 00 Not Covered Not Covered XXX88025 00 Not Covered Not Covered XXX88027 00 Not Covered Not Covered XXX88028 00 Not Covered Not Covered XXX88029 00 Not Covered Not Covered XXX88036 00 Not Covered Not Covered XXX88037 00 Not Covered Not Covered XXX88040 00 Not Covered Not Covered XXX88045 00 Not Covered Not Covered XXX88099 00 Not Covered Not Covered XXX88104 00 2.05$ 123.25$ 2.05$ 123.25$ XXX88104 26 0.84$ 50.18$ 0.84$ 50.18$ XXX88104 TC 1.22$ 73.07$ 1.22$ 73.07$ XXX88106 00 1.88$ 113.02$ 1.88$ 113.02$ XXX88106 26 0.57$ 34.28$ 0.57$ 34.28$ XXX88106 TC 1.31$ 78.74$ 1.31$ 78.74$ XXX88108 00 1.78$ 106.53$ 1.78$ 106.53$ XXX88108 26 0.66$ 39.77$ 0.66$ 39.77$ XXX88108 TC 1.11$ 66.76$ 1.11$ 66.76$ XXX88112 00 1.97$ 118.20$ 1.97$ 118.20$ XXX88112 26 0.83$ 49.55$ 0.83$ 49.55$ XXX88112 TC 1.14$ 68.65$ 1.14$ 68.65$ XXX88120 00 17.69$ 1,061.57$ 17.69$ 1,061.57$ XXX88120 26 1.70$ 101.96$ 1.70$ 101.96$ XXX88120 TC 15.99$ 959.61$ 15.99$ 959.61$ XXX88121 00 14.19$ 851.63$ 14.19$ 851.63$ XXX88121 26 1.45$ 86.80$ 1.45$ 86.80$ XXX88121 TC 12.75$ 764.83$ 12.75$ 764.83$ XXX88125 00 0.77$ 46.46$ 0.77$ 46.46$ XXX88125 26 0.41$ 24.47$ 0.41$ 24.47$ XXX88125 TC 0.37$ 21.99$ 0.37$ 21.99$ XXX88130 00 19.97$ 19.97$ XXX88140 00 8.88$ 8.88$ XXX88141 00 0.93$ 55.50$ 0.93$ 55.50$ XXX88142 00 22.51$ 22.51$ XXX



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

88143 00 23.04$ 23.04$ XXX88147 00 50.56$ 50.56$ XXX88148 00 16.88$ 16.88$ XXX88150 00 14.99$ 14.99$ XXX88152 00 27.64$ 27.64$ XXX88153 00 24.03$ 24.03$ XXX88155 00 14.65$ 14.65$ XXX88160 00 2.09$ 125.29$ 2.09$ 125.29$ XXX88160 26 0.77$ 45.92$ 0.77$ 45.92$ XXX88160 TC 1.32$ 79.37$ 1.32$ 79.37$ XXX88161 00 1.94$ 116.46$ 1.94$ 116.46$ XXX88161 26 0.74$ 44.66$ 0.74$ 44.66$ XXX88161 TC 1.20$ 71.80$ 1.20$ 71.80$ XXX88162 00 2.80$ 167.97$ 2.80$ 167.97$ XXX88162 26 1.13$ 67.87$ 1.13$ 67.87$ XXX88162 TC 1.67$ 100.10$ 1.67$ 100.10$ XXX88164 00 14.99$ 14.99$ XXX88165 00 42.22$ 42.22$ XXX88166 00 14.99$ 14.99$ XXX88167 00 14.99$ 14.99$ XXX88172 00 1.65$ 98.86$ 1.65$ 98.86$ XXX88172 26 1.07$ 64.26$ 1.07$ 64.26$ XXX88172 TC 0.58$ 34.60$ 0.58$ 34.60$ XXX88173 00 4.47$ 268.41$ 4.47$ 268.41$ XXX88173 26 2.09$ 125.43$ 2.09$ 125.43$ XXX88173 TC 2.38$ 142.98$ 2.38$ 142.98$ XXX88174 00 25.37$ 25.37$ XXX88175 00 29.44$ 29.44$ XXX88177 00 0.86$ 51.80$ 0.86$ 51.80$ ZZZ88177 26 0.65$ 39.19$ 0.65$ 39.19$ ZZZ88177 TC 0.21$ 12.61$ 0.21$ 12.61$ ZZZ88182 00 3.94$ 236.59$ 3.94$ 236.59$ XXX88182 26 1.14$ 68.47$ 1.14$ 68.47$ XXX88182 TC 2.80$ 168.12$ 2.80$ 168.12$ XXX88184 00 1.97$ 118.38$ 1.97$ 118.38$ XXX88185 00 0.73$ 43.51$ 0.73$ 43.51$ ZZZ88187 00 1.10$ 65.94$ 1.10$ 65.94$ XXX88188 00 1.86$ 111.80$ 1.86$ 111.80$ XXX88189 00 2.49$ 149.44$ 2.49$ 149.44$ XXX88199 00 By Report By Report XXX88199 26 By Report By Report XXX88199 TC By Report By Report XXX



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

88230 00 129.44$ 129.44$ XXX88233 00 156.36$ 156.36$ XXX88235 00 163.63$ 163.63$ XXX88237 00 143.75$ 143.75$ XXX88239 00 163.91$ 163.91$ XXX88240 00 13.07$ 13.07$ XXX88241 00 12.09$ 12.09$ XXX88245 00 192.42$ 192.42$ XXX88248 00 192.42$ 192.42$ XXX88249 00 192.42$ 192.42$ XXX88261 00 264.34$ 264.34$ XXX88262 00 138.49$ 138.49$ XXX88263 00 166.99$ 166.99$ XXX88264 00 144.61$ 144.61$ XXX88267 00 199.75$ 199.75$ XXX88269 00 184.81$ 184.81$ XXX88271 00 23.80$ 23.80$ XXX88272 00 40.70$ 40.70$ XXX88273 00 35.70$ 35.70$ XXX88274 00 42.38$ 42.38$ XXX88275 00 51.19$ 51.19$ XXX88280 00 33.47$ 33.47$ XXX88283 00 76.22$ 76.22$ XXX88285 00 26.91$ 26.91$ XXX88289 00 38.26$ 38.26$ XXX88291 00 0.96$ 57.77$ 0.96$ 57.77$ XXX88299 00 By Report By Report XXX88300 00 0.47$ 28.00$ 0.47$ 28.00$ XXX88300 26 0.13$ 7.91$ 0.13$ 7.91$ XXX88300 TC 0.33$ 20.10$ 0.33$ 20.10$ XXX88302 00 0.91$ 54.36$ 0.91$ 54.36$ XXX88302 26 0.20$ 12.19$ 0.20$ 12.19$ XXX88302 TC 0.70$ 42.17$ 0.70$ 42.17$ XXX88304 00 1.19$ 71.15$ 1.19$ 71.15$ XXX88304 26 0.34$ 20.16$ 0.34$ 20.16$ XXX88304 TC 0.85$ 50.99$ 0.85$ 50.99$ XXX88305 00 2.01$ 120.78$ 2.01$ 120.78$ XXX88305 26 1.12$ 67.26$ 1.12$ 67.26$ XXX88305 TC 0.89$ 53.52$ 0.89$ 53.52$ XXX88307 00 7.90$ 474.02$ 7.90$ 474.02$ XXX88307 26 2.46$ 147.54$ 2.46$ 147.54$ XXX88307 TC 5.44$ 326.48$ 5.44$ 326.48$ XXX



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

88309 00 11.98$ 719.02$ 11.98$ 719.02$ XXX88309 26 4.35$ 260.82$ 4.35$ 260.82$ XXX88309 TC 7.64$ 458.19$ 7.64$ 458.19$ XXX88311 00 0.63$ 37.68$ 0.63$ 37.68$ XXX88311 26 0.37$ 22.00$ 0.37$ 22.00$ XXX88311 TC 0.26$ 15.68$ 0.26$ 15.68$ XXX88312 00 2.95$ 176.90$ 2.95$ 176.90$ XXX88312 26 0.78$ 47.08$ 0.78$ 47.08$ XXX88312 TC 2.16$ 129.82$ 2.16$ 129.82$ XXX88313 00 2.14$ 128.49$ 2.14$ 128.49$ XXX88313 26 0.36$ 21.37$ 0.36$ 21.37$ XXX88313 TC 1.79$ 107.12$ 1.79$ 107.12$ XXX88314 00 2.71$ 162.63$ 2.71$ 162.63$ XXX88314 26 0.66$ 39.74$ 0.66$ 39.74$ XXX88314 TC 2.05$ 122.88$ 2.05$ 122.88$ XXX88319 00 2.85$ 171.25$ 2.85$ 171.25$ XXX88319 26 0.79$ 47.10$ 0.79$ 47.10$ XXX88319 TC 2.07$ 124.14$ 2.07$ 124.14$ XXX88321 00 2.91$ 174.84$ 2.46$ 147.73$ XXX88323 00 3.36$ 201.78$ 3.36$ 201.78$ XXX88323 26 2.58$ 154.57$ 2.58$ 154.57$ XXX88323 TC 0.79$ 47.21$ 0.79$ 47.21$ XXX88325 00 5.24$ 314.34$ 4.37$ 262.00$ XXX88329 00 1.51$ 90.63$ 1.06$ 63.52$ XXX88331 00 2.83$ 170.01$ 2.83$ 170.01$ XXX88331 26 1.86$ 111.45$ 1.86$ 111.45$ XXX88331 TC 0.98$ 58.56$ 0.98$ 58.56$ XXX88332 00 1.56$ 93.53$ 1.56$ 93.53$ XXX88332 26 0.92$ 55.15$ 0.92$ 55.15$ XXX88332 TC 0.64$ 38.38$ 0.64$ 38.38$ XXX88333 00 2.60$ 156.11$ 2.60$ 156.11$ XXX88333 26 1.86$ 111.42$ 1.86$ 111.42$ XXX88333 TC 0.74$ 44.69$ 0.74$ 44.69$ XXX88334 00 1.63$ 97.58$ 1.63$ 97.58$ ZZZ88334 26 1.13$ 67.95$ 1.13$ 67.95$ ZZZ88334 TC 0.49$ 29.64$ 0.49$ 29.64$ ZZZ88341 00 2.73$ 163.69$ 2.73$ 163.69$ ZZZ88341 26 0.85$ 50.81$ 0.85$ 50.81$ ZZZ88341 TC 1.88$ 112.88$ 1.88$ 112.88$ ZZZ88342 00 3.13$ 187.75$ 3.13$ 187.75$ XXX88342 26 1.05$ 62.98$ 1.05$ 62.98$ XXX88342 TC 2.08$ 124.77$ 2.08$ 124.77$ XXX



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

88344 00 5.05$ 302.97$ 5.05$ 302.97$ XXX88344 26 1.14$ 68.47$ 1.14$ 68.47$ XXX88344 TC 3.91$ 234.50$ 3.91$ 234.50$ XXX88346 00 3.23$ 193.96$ 3.23$ 193.96$ XXX88346 26 1.07$ 64.14$ 1.07$ 64.14$ XXX88346 TC 2.16$ 129.82$ 2.16$ 129.82$ XXX88348 00 10.59$ 635.49$ 10.59$ 635.49$ XXX88348 26 2.25$ 135.21$ 2.25$ 135.21$ XXX88348 TC 8.34$ 500.28$ 8.34$ 500.28$ XXX88350 00 2.26$ 135.86$ 2.26$ 135.86$ ZZZ88350 26 0.85$ 50.73$ 0.85$ 50.73$ ZZZ88350 TC 1.42$ 85.13$ 1.42$ 85.13$ ZZZ88355 00 3.86$ 231.53$ 3.86$ 231.53$ XXX88355 26 2.41$ 144.60$ 2.41$ 144.60$ XXX88355 TC 1.45$ 86.94$ 1.45$ 86.94$ XXX88356 00 6.53$ 391.82$ 6.53$ 391.82$ XXX88356 26 3.69$ 221.18$ 3.69$ 221.18$ XXX88356 TC 2.84$ 170.64$ 2.84$ 170.64$ XXX88358 00 3.75$ 224.94$ 3.75$ 224.94$ XXX88358 26 1.48$ 88.82$ 1.48$ 88.82$ XXX88358 TC 2.27$ 136.13$ 2.27$ 136.13$ XXX88360 00 3.74$ 224.57$ 3.74$ 224.57$ XXX88360 26 1.25$ 75.20$ 1.25$ 75.20$ XXX88360 TC 2.49$ 149.37$ 2.49$ 149.37$ XXX88361 00 3.86$ 231.88$ 3.86$ 231.88$ XXX88361 26 1.34$ 80.62$ 1.34$ 80.62$ XXX88361 TC 2.52$ 151.26$ 2.52$ 151.26$ XXX88362 00 6.12$ 366.96$ 6.12$ 366.96$ XXX88362 26 3.28$ 196.87$ 3.28$ 196.87$ XXX88362 TC 2.83$ 170.09$ 2.83$ 170.09$ XXX88363 00 0.69$ 41.13$ 0.58$ 34.82$ XXX88364 00 3.90$ 233.79$ 3.90$ 233.79$ ZZZ88364 26 1.03$ 61.72$ 1.03$ 61.72$ ZZZ88364 TC 2.87$ 172.07$ 2.87$ 172.07$ ZZZ88365 00 5.20$ 312.15$ 5.20$ 312.15$ XXX88365 26 1.29$ 77.65$ 1.29$ 77.65$ XXX88365 TC 3.91$ 234.50$ 3.91$ 234.50$ XXX88366 00 7.76$ 465.63$ 7.76$ 465.63$ XXX88366 26 1.83$ 110.06$ 1.83$ 110.06$ XXX88366 TC 5.93$ 355.57$ 5.93$ 355.57$ XXX88367 00 3.20$ 192.17$ 3.20$ 192.17$ XXX88367 26 1.02$ 61.09$ 1.02$ 61.09$ XXX



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

88367 TC 2.18$ 131.08$ 2.18$ 131.08$ XXX88368 00 3.73$ 223.86$ 3.73$ 223.86$ XXX88368 26 1.23$ 73.86$ 1.23$ 73.86$ XXX88368 TC 2.50$ 150.00$ 2.50$ 150.00$ XXX88369 00 3.27$ 196.03$ 3.27$ 196.03$ ZZZ88369 26 0.96$ 57.39$ 0.96$ 57.39$ ZZZ88369 TC 2.31$ 138.65$ 2.31$ 138.65$ ZZZ88371 00 24.70$ 24.70$ XXX88371 26 0.58$ 34.91$ 0.58$ 34.91$ XXX88372 00 26.22$ 26.22$ XXX88372 26 0.53$ 31.75$ 0.53$ 31.75$ XXX88373 00 2.19$ 131.48$ 2.19$ 131.48$ ZZZ88373 26 0.79$ 47.61$ 0.79$ 47.61$ ZZZ88373 TC 1.40$ 83.87$ 1.40$ 83.87$ ZZZ88374 00 9.61$ 576.32$ 9.61$ 576.32$ XXX88374 26 1.30$ 78.23$ 1.30$ 78.23$ XXX88374 TC 8.30$ 498.09$ 8.30$ 498.09$ XXX88375 00 1.45$ 86.78$ 1.45$ 86.78$ XXX88377 00 11.42$ 685.30$ 11.42$ 685.30$ XXX88377 26 1.89$ 113.51$ 1.89$ 113.51$ XXX88377 TC 9.53$ 571.79$ 9.53$ 571.79$ XXX88380 00 3.92$ 235.09$ 3.92$ 235.09$ XXX88380 26 1.62$ 97.16$ 1.62$ 97.16$ XXX88380 TC 2.30$ 137.93$ 2.30$ 137.93$ XXX88381 00 4.53$ 272.06$ 4.53$ 272.06$ XXX88381 26 0.74$ 44.58$ 0.74$ 44.58$ XXX88381 TC 3.79$ 227.48$ 3.79$ 227.48$ XXX88387 00 1.02$ 61.21$ 1.02$ 61.21$ XXX88387 26 0.82$ 49.31$ 0.82$ 49.31$ XXX88387 TC 0.20$ 11.90$ 0.20$ 11.90$ XXX88388 00 1.03$ 61.73$ 1.03$ 61.73$ XXX88388 26 0.70$ 42.27$ 0.70$ 42.27$ XXX88388 TC 0.32$ 19.46$ 0.32$ 19.46$ XXX88399 00 By Report By Report XXX88399 26 By Report By Report XXX88399 TC By Report By Report XXX88720 00 5.57$ 5.57$ XXX88738 00 5.57$ 5.57$ XXX88740 00 9.37$ 9.37$ XXX88741 00 9.37$ 9.37$ XXX88749 00 Not Covered Not Covered XXX89049 00 7.34$ 440.58$ 1.78$ 107.00$ XXX



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

89050 00 5.25$ 5.25$ XXX89051 00 6.12$ 6.12$ XXX89055 00 4.75$ 4.75$ XXX89060 00 7.95$ 7.95$ XXX89060 26 0.53$ 31.75$ 0.53$ 31.75$ XXX89125 00 5.88$ 5.88$ XXX89160 00 4.85$ 4.85$ XXX89190 00 5.79$ 5.79$ XXX89220 00 0.48$ 28.92$ 0.48$ 28.92$ XXX89230 00 0.08$ 4.96$ 0.08$ 4.96$ XXX89240 00 Not Covered Not Covered XXX89250 00 Not Covered Not Covered XXX89251 00 Not Covered Not Covered XXX89253 00 Not Covered Not Covered XXX89254 00 Not Covered Not Covered XXX89255 00 Not Covered Not Covered XXX89257 00 Not Covered Not Covered XXX89258 00 Not Covered Not Covered XXX89259 00 Not Covered Not Covered XXX89260 00 Not Covered Not Covered XXX89261 00 Not Covered Not Covered XXX89264 00 Not Covered Not Covered XXX89268 00 Not Covered Not Covered XXX89272 00 Not Covered Not Covered XXX89280 00 Not Covered Not Covered XXX89281 00 Not Covered Not Covered XXX89290 00 Not Covered Not Covered XXX89291 00 Not Covered Not Covered XXX89300 00 9.92$ 9.92$ XXX89300 QW 9.92$ 9.92$ 89310 00 9.57$ 9.57$ XXX89320 00 13.39$ 13.39$ XXX89321 00 13.39$ 13.39$ XXX89321 QW 13.39$ 13.39$ 89322 00 17.22$ 17.22$ XXX89325 00 11.86$ 11.86$ XXX89329 00 21.76$ 21.76$ XXX89330 00 10.99$ 10.99$ XXX89331 00 21.76$ 21.76$ XXX89335 00 Not Covered Not Covered XXX89337 00 Not Covered Not Covered XXX89342 00 Not Covered Not Covered XXX



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

89343 00 Not Covered Not Covered XXX89344 00 Not Covered Not Covered XXX89346 00 Not Covered Not Covered XXX89352 00 Not Covered Not Covered XXX89353 00 Not Covered Not Covered XXX89354 00 Not Covered Not Covered XXX89356 00 Not Covered Not Covered XXX89398 00 Not Covered Not Covered XXX9001F 00 Code Accepted for Tracking Purpose only XXX9002F 00 Code Accepted for Tracking Purpose only XXX9003F 00 Code Accepted for Tracking Purpose only XXX9004F 00 Code Accepted for Tracking Purpose only XXX9005F 00 Code Accepted for Tracking Purpose only XXX9006F 00 Code Accepted for Tracking Purpose only XXX9007F 00 Code Accepted for Tracking Purpose only XXX90281 00 Not Covered Not Covered XXX90283 00 Not Covered Not Covered XXX90460 00 0.49$ 29.12$ 0.49$ 29.12$ XXX90461 00 0.37$ 22.23$ 0.37$ 22.23$ ZZZ90471 00 0.49$ 29.12$ 0.49$ 29.12$ XXX90472 00 0.37$ 22.23$ 0.37$ 22.23$ ZZZ90473 00 Bundled Bundled XXX90474 00 Bundled Bundled ZZZ90689 00 -$ -$ -$ -$ XXX90785 00 Not Covered Not Covered ZZZ90791 00 Not Covered Not Covered XXX90792 00 Not Covered Not Covered XXX90832 00 Not Covered Not Covered XXX90833 00 Not Covered Not Covered ZZZ90834 00 Not Covered Not Covered XXX90836 00 Not Covered Not Covered ZZZ90837 00 Not Covered Not Covered XXX90838 00 Not Covered Not Covered ZZZ90839 00 Not Covered Not Covered XXX90840 00 Not Covered Not Covered ZZZ90845 00 Not Covered Not Covered XXX90846 00 Not Covered Not Covered XXX90847 00 Not Covered Not Covered XXX90849 00 Not Covered Not Covered XXX90853 00 Not Covered Not Covered XXX90863 00 Not Covered Not Covered XXX90865 00 Not Covered Not Covered XXX



CODE MOD

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GLOBAL

90867 00 210.98$ 210.98$ 00090868 00 113.20$ 113.20$ 00090869 00 196.51$ 196.51$ 00090870 00 Not Covered Not Covered 00090875 00 Not Covered Not Covered XXX90876 00 Not Covered Not Covered XXX90880 00 Not Covered Not Covered XXX90882 00 Not Covered Not Covered XXX90885 00 Not Covered Not Covered XXX90887 00 Not Covered Not Covered XXX90889 00 Not Covered Not Covered XXX90899 00 Not Covered Not Covered XXX90901 00 Not Covered Not Covered 00090912 00 2.35$ 140.78$ 1.28$ 76.66$ 00090913 00 0.94$ 56.52$ 0.71$ 42.56$ ZZZ90935 00 2.10$ 125.96$ 2.10$ 125.96$ 00090937 00 2.99$ 179.58$ 2.99$ 179.58$ 00090940 00 By Report By Report XXX90945 00 2.46$ 147.82$ 2.46$ 147.82$ 00090947 00 3.56$ 213.58$ 3.56$ 213.58$ 00090951 00 27.03$ 1,621.75$ 27.03$ 1,621.75$ XXX90952 00 By Report By Report XXX90953 00 By Report By Report XXX90954 00 23.31$ 1,398.65$ 23.31$ 1,398.65$ XXX90955 00 13.14$ 788.40$ 13.14$ 788.40$ XXX90956 00 9.15$ 549.25$ 9.15$ 549.25$ XXX90957 00 18.47$ 1,107.91$ 18.47$ 1,107.91$ XXX90958 00 12.54$ 752.61$ 12.54$ 752.61$ XXX90959 00 8.55$ 512.74$ 8.55$ 512.74$ XXX90960 00 8.16$ 489.86$ 8.16$ 489.86$ XXX90961 00 6.87$ 411.93$ 6.87$ 411.93$ XXX90962 00 5.32$ 318.90$ 5.32$ 318.90$ XXX90963 00 15.67$ 940.48$ 15.67$ 940.48$ XXX90964 00 13.69$ 821.30$ 13.69$ 821.30$ XXX90965 00 13.04$ 782.36$ 13.04$ 782.36$ XXX90966 00 6.85$ 410.76$ 6.85$ 410.76$ XXX90967 00 0.52$ 31.09$ 0.52$ 31.09$ XXX90968 00 0.46$ 27.44$ 0.46$ 27.44$ XXX90969 00 0.44$ 26.20$ 0.44$ 26.20$ XXX90970 00 0.22$ 13.43$ 0.22$ 13.43$ XXX90989 00 Not Covered Not Covered XXX90993 00 Not Covered Not Covered XXX



CODE MOD

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GLOBAL

90997 00 2.57$ 153.95$ 2.57$ 153.95$ 00090999 00 By Report By Report XXX91010 00 5.59$ 335.20$ 5.59$ 335.20$ 00091010 26 1.94$ 116.47$ 1.94$ 116.47$ 00091010 TC 3.65$ 218.73$ 3.65$ 218.73$ 00091013 00 0.76$ 45.49$ 0.76$ 45.49$ ZZZ91013 26 0.27$ 16.48$ 0.27$ 16.48$ ZZZ91013 TC 0.48$ 29.01$ 0.48$ 29.01$ ZZZ91020 00 7.29$ 437.66$ 7.29$ 437.66$ 00091020 26 2.17$ 130.10$ 2.17$ 130.10$ 00091020 TC 5.13$ 307.56$ 5.13$ 307.56$ 00091022 00 4.96$ 297.67$ 4.96$ 297.67$ 00091022 26 2.17$ 130.10$ 2.17$ 130.10$ 00091022 TC 2.79$ 167.57$ 2.79$ 167.57$ 00091030 00 4.06$ 243.80$ 4.06$ 243.80$ 00091030 26 1.37$ 82.45$ 1.37$ 82.45$ 00091030 TC 2.69$ 161.35$ 2.69$ 161.35$ 00091034 00 5.61$ 336.72$ 5.61$ 336.72$ 00091034 26 1.47$ 88.35$ 1.47$ 88.35$ 00091034 TC 4.14$ 248.37$ 4.14$ 248.37$ 00091035 00 14.29$ 857.47$ 14.29$ 857.47$ 00091035 26 2.42$ 144.97$ 2.42$ 144.97$ 00091035 TC 11.87$ 712.49$ 11.87$ 712.49$ 00091037 00 4.85$ 290.77$ 4.85$ 290.77$ 00091037 26 1.47$ 88.43$ 1.47$ 88.43$ 00091037 TC 3.37$ 202.34$ 3.37$ 202.34$ 00091038 00 13.14$ 788.69$ 13.14$ 788.69$ 00091038 26 1.66$ 99.53$ 1.66$ 99.53$ 00091038 TC 11.49$ 689.16$ 11.49$ 689.16$ 00091040 00 14.19$ 851.12$ 14.19$ 851.12$ 00091040 26 1.47$ 88.18$ 1.47$ 88.18$ 00091040 TC 12.72$ 762.94$ 12.72$ 762.94$ 00091065 00 2.23$ 133.63$ 2.23$ 133.63$ 00091065 26 0.29$ 17.69$ 0.29$ 17.69$ 00091065 TC 1.93$ 115.95$ 1.93$ 115.95$ 00091110 00 26.13$ 1,567.81$ 26.13$ 1,567.81$ XXX91110 26 3.75$ 224.71$ 3.75$ 224.71$ XXX91110 TC 22.38$ 1,343.09$ 22.38$ 1,343.09$ XXX91111 00 24.00$ 1,439.73$ 24.00$ 1,439.73$ XXX91111 26 1.52$ 90.96$ 1.52$ 90.96$ XXX91111 TC 22.48$ 1,348.77$ 22.48$ 1,348.77$ XXX91112 00 37.53$ 2,251.92$ 37.53$ 2,251.92$ XXX



CODE MOD

DOC NonfacRVUs


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GLOBAL

91112 26 3.16$ 189.31$ 3.16$ 189.31$ XXX91112 TC 34.38$ 2,062.61$ 34.38$ 2,062.61$ XXX91117 00 4.03$ 241.97$ 4.03$ 241.97$ 00091120 00 13.55$ 812.91$ 13.55$ 812.91$ XXX91120 26 1.44$ 86.54$ 1.44$ 86.54$ XXX91120 TC 12.11$ 726.37$ 12.11$ 726.37$ XXX91122 00 7.10$ 426.22$ 7.10$ 426.22$ 00091122 26 2.62$ 157.12$ 2.62$ 157.12$ 00091122 TC 4.48$ 269.10$ 4.48$ 269.10$ 00091132 00 7.12$ 427.21$ 7.12$ 427.21$ XXX91132 26 0.78$ 47.05$ 0.78$ 47.05$ XXX91132 TC 6.34$ 380.17$ 6.34$ 380.17$ XXX91133 00 7.79$ 467.13$ 7.79$ 467.13$ XXX91133 26 1.00$ 59.84$ 1.00$ 59.84$ XXX91133 TC 6.79$ 407.28$ 6.79$ 407.28$ XXX91200 00 1.14$ 68.50$ 1.14$ 68.50$ XXX91200 26 0.41$ 24.44$ 0.41$ 24.44$ XXX91200 TC 0.73$ 44.06$ 0.73$ 44.06$ XXX91299 00 By Report By Report XXX91299 26 By Report By Report XXX91299 TC By Report By Report XXX92002 00 2.45$ 146.93$ 1.39$ 83.24$ XXX92004 00 4.39$ 263.35$ 2.87$ 171.92$ XXX92012 00 2.57$ 154.31$ 1.52$ 91.25$ XXX92014 00 3.68$ 220.96$ 2.30$ 137.72$ XXX92015 00 0.57$ 34.17$ 0.56$ 33.53$ XXX92018 00 4.22$ 253.06$ 4.22$ 253.06$ XXX92019 00 2.09$ 125.47$ 2.09$ 125.47$ XXX92020 00 0.80$ 48.15$ 0.61$ 36.80$ XXX92025 00 1.11$ 66.40$ 1.11$ 66.40$ XXX92025 26 0.58$ 34.96$ 0.58$ 34.96$ XXX92025 TC 0.52$ 31.45$ 0.52$ 31.45$ XXX92060 00 1.88$ 112.82$ 1.88$ 112.82$ XXX92060 26 1.10$ 66.24$ 1.10$ 66.24$ XXX92060 TC 0.78$ 46.58$ 0.78$ 46.58$ XXX92065 00 1.57$ 94.10$ 1.57$ 94.10$ XXX92065 26 0.52$ 31.12$ 0.52$ 31.12$ XXX92065 TC 1.05$ 62.98$ 1.05$ 62.98$ XXX92071 00 1.10$ 65.73$ 0.97$ 58.17$ XXX92072 00 3.82$ 228.91$ 2.89$ 173.42$ XXX92081 00 0.99$ 59.60$ 0.99$ 59.60$ XXX92081 26 0.47$ 28.15$ 0.47$ 28.15$ XXX



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

92081 TC 0.52$ 31.45$ 0.52$ 31.45$ XXX92082 00 1.40$ 83.93$ 1.40$ 83.93$ XXX92082 26 0.62$ 37.35$ 0.62$ 37.35$ XXX92082 TC 0.78$ 46.58$ 0.78$ 46.58$ XXX92083 00 1.88$ 112.68$ 1.88$ 112.68$ XXX92083 26 0.81$ 48.44$ 0.81$ 48.44$ XXX92083 TC 1.07$ 64.24$ 1.07$ 64.24$ XXX92100 00 2.41$ 144.56$ 0.98$ 58.80$ XXX92132 00 0.92$ 55.18$ 0.92$ 55.18$ XXX92132 26 0.48$ 28.78$ 0.48$ 28.78$ XXX92132 TC 0.44$ 26.40$ 0.44$ 26.40$ XXX92133 00 1.08$ 65.01$ 1.08$ 65.01$ XXX92133 26 0.64$ 38.61$ 0.64$ 38.61$ XXX92133 TC 0.44$ 26.40$ 0.44$ 26.40$ XXX92134 00 1.20$ 71.82$ 1.20$ 71.82$ XXX92134 26 0.75$ 44.79$ 0.75$ 44.79$ XXX92134 TC 0.45$ 27.03$ 0.45$ 27.03$ XXX92136 00 2.05$ 123.30$ 2.05$ 123.30$ XXX92136 26 0.91$ 54.65$ 0.91$ 54.65$ XXX92136 TC 1.14$ 68.65$ 1.14$ 68.65$ XXX92145 00 0.50$ 30.29$ 0.50$ 30.29$ XXX92145 26 0.28$ 16.50$ 0.28$ 16.50$ XXX92145 TC 0.23$ 13.79$ 0.23$ 13.79$ XXX92201 00 0.73$ 43.62$ 0.66$ 39.81$ XXX92202 00 0.46$ 27.67$ 0.43$ 25.76$ XXX92227 00 0.42$ 25.14$ 0.42$ 25.14$ XXX92228 00 1.00$ 60.05$ 1.00$ 60.05$ XXX92228 26 0.60$ 36.17$ 0.60$ 36.17$ XXX92228 TC 0.40$ 23.88$ 0.40$ 23.88$ XXX92230 00 1.89$ 113.60$ 0.97$ 58.11$ XXX92235 00 2.69$ 161.22$ 2.69$ 161.22$ XXX92235 26 1.26$ 75.54$ 1.26$ 75.54$ XXX92235 TC 1.43$ 85.68$ 1.43$ 85.68$ XXX92240 00 6.08$ 365.07$ 6.08$ 365.07$ XXX92240 26 1.38$ 82.65$ 1.38$ 82.65$ XXX92240 TC 4.71$ 282.42$ 4.71$ 282.42$ XXX92242 00 6.80$ 407.90$ 6.80$ 407.90$ XXX92242 26 1.60$ 95.84$ 1.60$ 95.84$ XXX92242 TC 5.20$ 312.06$ 5.20$ 312.06$ XXX92250 00 1.48$ 88.98$ 1.48$ 88.98$ XXX92250 26 0.63$ 37.98$ 0.63$ 37.98$ XXX92250 TC 0.85$ 50.99$ 0.85$ 50.99$ XXX



CODE MOD

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DOC FacilityRVUs


GLOBAL

92260 00 0.57$ 34.08$ 0.32$ 18.95$ XXX92265 00 2.57$ 154.13$ 2.57$ 154.13$ XXX92265 26 1.36$ 81.70$ 1.36$ 81.70$ XXX92265 TC 1.21$ 72.44$ 1.21$ 72.44$ XXX92270 00 2.80$ 167.84$ 2.80$ 167.84$ XXX92270 26 1.22$ 73.33$ 1.22$ 73.33$ XXX92270 TC 1.58$ 94.51$ 1.58$ 94.51$ XXX92273 00 3.94$ 236.42$ 3.94$ 236.42$ XXX92273 26 1.08$ 64.98$ 1.08$ 64.98$ XXX92273 TC 2.86$ 171.44$ 2.86$ 171.44$ XXX92274 00 2.66$ 159.69$ 2.66$ 159.69$ XXX92274 26 0.96$ 57.62$ 0.96$ 57.62$ XXX92274 TC 1.70$ 102.07$ 1.70$ 102.07$ XXX92283 00 1.59$ 95.24$ 1.59$ 95.24$ XXX92283 26 0.26$ 15.87$ 0.26$ 15.87$ XXX92283 TC 1.32$ 79.37$ 1.32$ 79.37$ XXX92284 00 1.82$ 108.94$ 1.82$ 108.94$ XXX92284 26 0.37$ 22.00$ 0.37$ 22.00$ XXX92284 TC 1.45$ 86.94$ 1.45$ 86.94$ XXX92285 00 0.64$ 38.17$ 0.64$ 38.17$ XXX92285 26 0.09$ 5.46$ 0.09$ 5.46$ XXX92285 TC 0.55$ 32.71$ 0.55$ 32.71$ XXX92286 00 1.14$ 68.17$ 1.14$ 68.17$ XXX92286 26 0.64$ 38.61$ 0.64$ 38.61$ XXX92286 TC 0.49$ 29.55$ 0.49$ 29.55$ XXX92287 00 4.30$ 258.10$ 4.30$ 258.10$ XXX92287 26 1.36$ 81.70$ 1.36$ 81.70$ XXX92287 TC 2.94$ 176.40$ 2.94$ 176.40$ XXX92310 00 2.88$ 172.96$ 1.72$ 102.96$ XXX92311 00 3.04$ 182.27$ 1.60$ 95.88$ XXX92312 00 3.51$ 210.82$ 1.84$ 110.55$ XXX92313 00 2.88$ 172.68$ 1.33$ 79.98$ XXX92314 00 2.45$ 146.71$ 1.02$ 60.94$ XXX92315 00 2.28$ 136.77$ 0.63$ 37.77$ XXX92316 00 2.83$ 169.60$ 0.95$ 56.72$ XXX92317 00 2.38$ 143.08$ 0.63$ 37.77$ XXX92325 00 1.30$ 78.11$ 1.30$ 78.11$ XXX92326 00 1.10$ 66.13$ 1.10$ 66.13$ XXX92340 00 1.02$ 61.31$ 0.54$ 32.30$ XXX92341 00 1.17$ 70.42$ 0.69$ 41.42$ XXX92342 00 1.27$ 75.94$ 0.78$ 46.94$ XXX92352 00 Bundled Bundled XXX



CODE MOD

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GLOBAL

92353 00 Bundled Bundled XXX92354 00 Bundled Bundled XXX92355 00 Bundled Bundled XXX92358 00 Bundled Bundled XXX92370 00 0.91$ 54.50$ 0.47$ 28.01$ XXX92371 00 Bundled Bundled XXX92499 00 By Report By Report XXX92499 26 By Report By Report XXX92499 TC By Report By Report XXX92502 00 2.79$ 167.33$ 2.79$ 167.33$ 00092504 00 0.86$ 51.79$ 0.27$ 16.48$ XXX92507 00 2.28$ 136.85$ 2.28$ 136.85$ XXX92508 00 0.69$ 41.31$ 0.69$ 41.31$ XXX92511 00 3.28$ 196.73$ 1.10$ 66.20$ 00092512 00 1.74$ 104.19$ 0.81$ 48.69$ XXX92516 00 2.02$ 120.98$ 0.66$ 39.63$ XXX92520 00 2.31$ 138.35$ 1.17$ 70.25$ XXX92521 00 3.29$ 197.40$ 3.29$ 197.40$ XXX92522 00 2.66$ 159.41$ 2.66$ 159.41$ XXX92523 00 5.68$ 340.69$ 5.68$ 340.69$ XXX92524 00 2.56$ 153.82$ 2.56$ 153.82$ XXX92526 00 2.50$ 149.99$ 2.50$ 149.99$ XXX92531 00 Bundled Bundled XXX92532 00 Bundled Bundled XXX92533 00 Bundled Bundled XXX92534 00 Bundled Bundled XXX92537 00 1.19$ 71.35$ 1.19$ 71.35$ XXX92537 26 0.92$ 55.04$ 0.92$ 55.04$ XXX92537 TC 0.27$ 16.31$ 0.27$ 16.31$ XXX92538 00 0.61$ 36.89$ 0.61$ 36.89$ XXX92538 26 0.46$ 27.52$ 0.46$ 27.52$ XXX92538 TC 0.16$ 9.38$ 0.16$ 9.38$ XXX92540 00 3.03$ 181.65$ 3.03$ 181.65$ XXX92540 26 2.29$ 137.60$ 2.29$ 137.60$ XXX92540 TC 0.73$ 44.06$ 0.73$ 44.06$ XXX92541 00 0.73$ 43.57$ 0.73$ 43.57$ XXX92541 26 0.61$ 36.72$ 0.61$ 36.72$ XXX92541 TC 0.11$ 6.85$ 0.11$ 6.85$ XXX92542 00 0.84$ 50.22$ 0.84$ 50.22$ XXX92542 26 0.73$ 44.00$ 0.73$ 44.00$ XXX92542 TC 0.10$ 6.22$ 0.10$ 6.22$ XXX92544 00 0.50$ 30.03$ 0.50$ 30.03$ XXX



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

92544 26 0.42$ 25.07$ 0.42$ 25.07$ XXX92544 TC 0.08$ 4.96$ 0.08$ 4.96$ XXX92545 00 0.47$ 28.19$ 0.47$ 28.19$ XXX92545 26 0.39$ 23.23$ 0.39$ 23.23$ XXX92545 TC 0.08$ 4.96$ 0.08$ 4.96$ XXX92546 00 3.08$ 185.03$ 3.08$ 185.03$ XXX92546 26 0.44$ 26.28$ 0.44$ 26.28$ XXX92546 TC 2.65$ 158.74$ 2.65$ 158.74$ XXX92547 00 0.22$ 13.24$ 0.22$ 13.24$ ZZZ92548 00 2.83$ 169.98$ 2.83$ 169.98$ XXX92548 26 0.75$ 45.21$ 0.75$ 45.21$ XXX92548 TC 2.08$ 124.77$ 2.08$ 124.77$ XXX92549 00 1.85$ 111.30$ 1.85$ 111.30$ XXX92549 26 1.31$ 78.43$ 1.31$ 78.43$ XXX92549 TC 0.55$ 32.87$ 0.55$ 32.87$ XXX92550 00 0.63$ 38.03$ 0.63$ 38.03$ XXX92551 00 0.35$ 20.73$ 0.35$ 20.73$ XXX92552 00 0.93$ 56.04$ 0.93$ 56.04$ XXX92553 00 1.13$ 68.02$ 1.13$ 68.02$ XXX92555 00 0.71$ 42.80$ 0.71$ 42.80$ XXX92556 00 1.12$ 67.39$ 1.12$ 67.39$ XXX92557 00 1.11$ 66.30$ 0.95$ 56.85$ XXX92558 00 0.29$ 17.13$ 0.25$ 15.24$ XXX92559 00 Not Covered Not Covered XXX92560 00 Not Covered Not Covered XXX92561 00 1.15$ 69.20$ 1.15$ 69.20$ XXX92562 00 1.34$ 80.63$ 1.34$ 80.63$ XXX92563 00 0.91$ 54.78$ 0.91$ 54.78$ XXX92564 00 0.74$ 44.69$ 0.74$ 44.69$ XXX92565 00 0.45$ 27.03$ 0.45$ 27.03$ XXX92567 00 0.44$ 26.52$ 0.32$ 18.95$ XXX92568 00 0.46$ 27.46$ 0.45$ 26.83$ XXX92570 00 0.94$ 56.34$ 0.87$ 51.93$ XXX92571 00 0.80$ 47.84$ 0.80$ 47.84$ XXX92572 00 1.27$ 76.13$ 1.27$ 76.13$ XXX92575 00 1.88$ 112.71$ 1.88$ 112.71$ XXX92576 00 1.08$ 64.87$ 1.08$ 64.87$ XXX92577 00 0.41$ 24.51$ 0.41$ 24.51$ XXX92579 00 1.34$ 80.55$ 1.11$ 66.68$ XXX92582 00 2.16$ 129.74$ 2.16$ 129.74$ XXX92583 00 1.42$ 85.05$ 1.42$ 85.05$ XXX92584 00 2.19$ 131.63$ 2.19$ 131.63$ XXX



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

92585 00 3.98$ 238.63$ 3.98$ 238.63$ XXX92585 26 0.77$ 46.47$ 0.77$ 46.47$ XXX92585 TC 3.20$ 192.17$ 3.20$ 192.17$ XXX92586 00 2.74$ 164.42$ 2.74$ 164.42$ XXX92587 00 0.63$ 38.03$ 0.63$ 38.03$ XXX92587 26 0.53$ 31.80$ 0.53$ 31.80$ XXX92587 TC 0.10$ 6.22$ 0.10$ 6.22$ XXX92588 00 0.96$ 57.69$ 0.96$ 57.69$ XXX92588 26 0.84$ 50.21$ 0.84$ 50.21$ XXX92588 TC 0.12$ 7.48$ 0.12$ 7.48$ XXX92590 00 Not Covered Not Covered XXX92591 00 Not Covered Not Covered XXX92592 00 Not Covered Not Covered XXX92593 00 Not Covered Not Covered XXX92594 00 Not Covered Not Covered XXX92595 00 Not Covered Not Covered XXX92596 00 1.98$ 119.10$ 1.98$ 119.10$ XXX92597 00 2.10$ 126.15$ 2.10$ 126.15$ XXX92601 00 4.81$ 288.51$ 3.64$ 218.52$ XXX92602 00 3.01$ 180.45$ 2.06$ 123.69$ XXX92603 00 4.48$ 269.01$ 3.54$ 212.26$ XXX92604 00 2.67$ 160.31$ 1.98$ 118.69$ XXX92605 00 Bundled Bundled XXX92606 00 Bundled Bundled XXX92607 00 3.79$ 227.33$ 3.79$ 227.33$ XXX92608 00 1.51$ 90.72$ 1.51$ 90.72$ ZZZ92609 00 3.17$ 189.93$ 3.17$ 189.93$ XXX92610 00 2.51$ 150.64$ 2.10$ 126.05$ XXX92611 00 2.61$ 156.67$ 2.61$ 156.67$ XXX92612 00 5.63$ 337.92$ 1.97$ 118.47$ XXX92613 00 1.09$ 65.31$ 1.09$ 65.31$ XXX92614 00 4.17$ 250.18$ 1.93$ 115.87$ XXX92615 00 0.96$ 57.32$ 0.96$ 57.32$ XXX92616 00 6.05$ 363.13$ 2.89$ 173.32$ XXX92617 00 1.20$ 71.95$ 1.20$ 71.95$ XXX92618 00 Bundled Bundled ZZZ92620 00 2.73$ 164.00$ 2.37$ 141.93$ XXX92621 00 0.66$ 39.37$ 0.55$ 33.07$ ZZZ92625 00 2.04$ 122.10$ 1.81$ 108.86$ XXX92626 00 2.61$ 156.77$ 2.20$ 132.18$ XXX92627 00 0.66$ 39.42$ 0.52$ 31.23$ ZZZ92630 00 Not Covered Not Covered XXX



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

92633 00 Not Covered Not Covered XXX92640 00 3.33$ 199.90$ 2.79$ 167.11$ XXX92700 00 By Report By Report XXX92920 00 15.54$ 932.49$ 15.54$ 932.49$ 00092921 00 Bundled Bundled ZZZ92924 00 18.54$ 1,112.21$ 18.54$ 1,112.21$ 00092925 00 Bundled Bundled ZZZ92928 00 17.30$ 1,037.71$ 17.30$ 1,037.71$ 00092929 00 Bundled Bundled ZZZ92933 00 19.40$ 1,164.02$ 19.40$ 1,164.02$ 00092934 00 Bundled Bundled ZZZ92937 00 17.28$ 1,037.02$ 17.28$ 1,037.02$ 00092938 00 Bundled Bundled ZZZ92941 00 19.45$ 1,167.03$ 19.45$ 1,167.03$ 00092943 00 19.44$ 1,166.49$ 19.44$ 1,166.49$ 00092944 00 Bundled Bundled ZZZ92950 00 9.15$ 549.15$ 5.40$ 324.03$ 00092953 00 0.03$ 1.78$ 0.03$ 1.78$ 00092960 00 4.63$ 278.06$ 3.18$ 191.04$ 00092961 00 7.27$ 436.49$ 7.27$ 436.49$ 00092970 00 5.54$ 332.15$ 5.54$ 332.15$ 00092971 00 2.93$ 175.66$ 2.93$ 175.66$ 00092973 00 5.17$ 310.00$ 5.17$ 310.00$ ZZZ92974 00 4.73$ 284.02$ 4.73$ 284.02$ ZZZ92975 00 11.02$ 661.09$ 11.02$ 661.09$ 00092977 00 1.64$ 98.63$ 1.64$ 98.63$ XXX92978 00 107.35$ 107.35$ ZZZ92978 26 2.80$ 168.27$ 2.80$ 168.27$ ZZZ92978 TC 7.82$ 7.82$ ZZZ92979 00 83.45$ 83.45$ ZZZ92979 26 2.23$ 133.93$ 2.23$ 133.93$ ZZZ92979 TC 4.23$ 4.23$ ZZZ92986 00 38.64$ 2,318.17$ 38.64$ 2,318.17$ 09092987 00 39.86$ 2,391.79$ 39.86$ 2,391.79$ 09092990 00 31.84$ 1,910.62$ 31.84$ 1,910.62$ 09092992 00 By Report By Report 00092993 00 By Report By Report 00092997 00 19.15$ 1,149.05$ 19.15$ 1,149.05$ 00092998 00 9.47$ 568.07$ 9.47$ 568.07$ ZZZ93000 00 0.49$ 29.66$ 0.49$ 29.66$ XXX93005 00 0.25$ 15.05$ 0.25$ 15.05$ XXX93010 00 0.24$ 14.61$ 0.24$ 14.61$ XXX



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

93015 00 2.07$ 124.48$ 2.07$ 124.48$ XXX93016 00 0.64$ 38.40$ 0.64$ 38.40$ XXX93017 00 1.01$ 60.45$ 1.01$ 60.45$ XXX93018 00 0.43$ 25.63$ 0.43$ 25.63$ XXX93024 00 3.22$ 193.22$ 3.22$ 193.22$ XXX93024 26 1.65$ 98.80$ 1.65$ 98.80$ XXX93024 TC 1.57$ 94.42$ 1.57$ 94.42$ XXX93025 00 4.41$ 264.47$ 4.41$ 264.47$ XXX93025 26 1.07$ 64.03$ 1.07$ 64.03$ XXX93025 TC 3.34$ 200.45$ 3.34$ 200.45$ XXX93040 00 0.37$ 22.15$ 0.37$ 22.15$ XXX93041 00 0.17$ 10.01$ 0.17$ 10.01$ XXX93042 00 0.20$ 12.14$ 0.20$ 12.14$ XXX93050 00 0.47$ 28.40$ 0.47$ 28.40$ XXX93050 26 0.24$ 14.61$ 0.24$ 14.61$ XXX93050 TC 0.23$ 13.79$ 0.23$ 13.79$ XXX93224 00 2.61$ 156.60$ 2.61$ 156.60$ XXX93225 00 0.77$ 45.95$ 0.77$ 45.95$ XXX93226 00 1.08$ 64.87$ 1.08$ 64.87$ XXX93227 00 0.76$ 45.79$ 0.76$ 45.79$ XXX93228 00 0.75$ 45.07$ 0.75$ 45.07$ XXX93229 00 20.96$ 1,257.54$ 20.96$ 1,257.54$ XXX93260 00 1.99$ 119.18$ 1.99$ 119.18$ XXX93260 26 1.24$ 74.49$ 1.24$ 74.49$ XXX93260 TC 0.74$ 44.69$ 0.74$ 44.69$ XXX93261 00 1.82$ 109.37$ 1.82$ 109.37$ XXX93261 26 1.08$ 64.68$ 1.08$ 64.68$ XXX93261 TC 0.74$ 44.69$ 0.74$ 44.69$ XXX93264 00 1.48$ 88.58$ 1.03$ 62.10$ XXX93268 00 5.96$ 357.76$ 5.96$ 357.76$ XXX93270 00 0.27$ 16.31$ 0.27$ 16.31$ XXX93271 00 4.96$ 297.56$ 4.96$ 297.56$ XXX93272 00 0.73$ 43.89$ 0.73$ 43.89$ XXX93278 00 0.90$ 54.05$ 0.90$ 54.05$ XXX93278 26 0.37$ 21.97$ 0.37$ 21.97$ XXX93278 TC 0.53$ 32.08$ 0.53$ 32.08$ XXX93279 00 1.61$ 96.44$ 1.61$ 96.44$ XXX93279 26 0.94$ 56.17$ 0.94$ 56.17$ XXX93279 TC 0.67$ 40.27$ 0.67$ 40.27$ XXX93280 00 1.88$ 113.08$ 1.88$ 113.08$ XXX93280 26 1.11$ 66.50$ 1.11$ 66.50$ XXX93280 TC 0.78$ 46.58$ 0.78$ 46.58$ XXX



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

93281 00 2.03$ 121.70$ 2.03$ 121.70$ XXX93281 26 1.24$ 74.49$ 1.24$ 74.49$ XXX93281 TC 0.79$ 47.21$ 0.79$ 47.21$ XXX93282 00 1.95$ 117.29$ 1.95$ 117.29$ XXX93282 26 1.23$ 73.86$ 1.23$ 73.86$ XXX93282 TC 0.72$ 43.43$ 0.72$ 43.43$ XXX93283 00 2.46$ 147.33$ 2.46$ 147.33$ XXX93283 26 1.67$ 100.12$ 1.67$ 100.12$ XXX93283 TC 0.79$ 47.21$ 0.79$ 47.21$ XXX93284 00 2.66$ 159.60$ 2.66$ 159.60$ XXX93284 26 1.82$ 109.23$ 1.82$ 109.23$ XXX93284 TC 0.84$ 50.36$ 0.84$ 50.36$ XXX93285 00 1.41$ 84.80$ 1.41$ 84.80$ XXX93285 26 0.76$ 45.79$ 0.76$ 45.79$ XXX93285 TC 0.65$ 39.01$ 0.65$ 39.01$ XXX93286 00 1.02$ 61.49$ 1.02$ 61.49$ XXX93286 26 0.44$ 26.26$ 0.44$ 26.26$ XXX93286 TC 0.59$ 35.23$ 0.59$ 35.23$ XXX93287 00 1.26$ 75.52$ 1.26$ 75.52$ XXX93287 26 0.67$ 40.29$ 0.67$ 40.29$ XXX93287 TC 0.59$ 35.23$ 0.59$ 35.23$ XXX93288 00 1.29$ 77.46$ 1.29$ 77.46$ XXX93288 26 0.62$ 37.19$ 0.62$ 37.19$ XXX93288 TC 0.67$ 40.27$ 0.67$ 40.27$ XXX93289 26 1.08$ 64.66$ 1.08$ 64.66$ XXX93289 TC 0.67$ 40.27$ 0.67$ 40.27$ XXX93290 00 1.23$ 73.68$ 1.23$ 73.68$ XXX93290 26 0.63$ 37.82$ 0.63$ 37.82$ XXX93290 TC 0.60$ 35.86$ 0.60$ 35.86$ XXX93291 00 1.11$ 66.35$ 1.11$ 66.35$ XXX93291 26 0.53$ 31.75$ 0.53$ 31.75$ XXX93291 TC 0.58$ 34.60$ 0.58$ 34.60$ XXX93292 00 1.18$ 70.53$ 1.18$ 70.53$ XXX93292 26 0.62$ 37.19$ 0.62$ 37.19$ XXX93292 TC 0.56$ 33.34$ 0.56$ 33.34$ XXX93293 00 1.54$ 92.36$ 1.54$ 92.36$ XXX93293 26 0.44$ 26.23$ 0.44$ 26.23$ XXX93293 TC 1.10$ 66.13$ 1.10$ 66.13$ XXX93294 00 0.88$ 52.98$ 0.88$ 52.98$ XXX93295 00 1.29$ 77.13$ 1.29$ 77.13$ XXX93296 00 0.76$ 45.32$ 0.76$ 45.32$ XXX93297 00 0.76$ 45.70$ 0.76$ 45.70$ XXX



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

93298 00 0.76$ 45.70$ 0.76$ 45.70$ XXX93303 00 6.92$ 415.41$ 6.92$ 415.41$ XXX93303 26 1.84$ 110.36$ 1.84$ 110.36$ XXX93303 TC 5.08$ 305.04$ 5.08$ 305.04$ XXX93304 00 4.72$ 283.39$ 4.72$ 283.39$ XXX93304 26 1.06$ 63.40$ 1.06$ 63.40$ XXX93304 TC 3.67$ 220.00$ 3.67$ 220.00$ XXX93306 00 6.06$ 363.81$ 6.06$ 363.81$ XXX93306 26 2.11$ 126.87$ 2.11$ 126.87$ XXX93306 TC 3.95$ 236.94$ 3.95$ 236.94$ XXX93307 00 4.13$ 247.64$ 4.13$ 247.64$ XXX93307 26 1.30$ 78.09$ 1.30$ 78.09$ XXX93307 TC 2.83$ 169.55$ 2.83$ 169.55$ XXX93308 00 2.89$ 173.69$ 2.89$ 173.69$ XXX93308 26 0.74$ 44.50$ 0.74$ 44.50$ XXX93308 TC 2.15$ 129.19$ 2.15$ 129.19$ XXX93312 00 7.21$ 432.67$ 7.21$ 432.67$ XXX93312 26 3.16$ 189.43$ 3.16$ 189.43$ XXX93312 TC 4.05$ 243.24$ 4.05$ 243.24$ XXX93313 00 0.33$ 19.97$ 0.33$ 19.97$ XXX93314 00 6.97$ 418.02$ 6.97$ 418.02$ XXX93314 26 2.64$ 158.39$ 2.64$ 158.39$ XXX93314 TC 4.33$ 259.64$ 4.33$ 259.64$ XXX93315 00 341.99$ 341.99$ XXX93315 26 3.72$ 223.02$ 3.72$ 223.02$ XXX93315 TC 210.10$ 210.10$ XXX93316 00 0.80$ 47.85$ 0.80$ 47.85$ XXX93317 00 By Report By Report XXX93317 26 2.67$ 160.47$ 2.67$ 160.47$ XXX93317 TC By Report By Report XXX93318 00 By Report By Report XXX93318 26 3.02$ 181.11$ 3.02$ 181.11$ XXX93318 TC By Report By Report XXX93320 00 1.57$ 94.16$ 1.57$ 94.16$ ZZZ93320 26 0.53$ 31.73$ 0.53$ 31.73$ ZZZ93320 TC 1.04$ 62.43$ 1.04$ 62.43$ ZZZ93321 00 0.79$ 47.45$ 0.79$ 47.45$ ZZZ93321 26 0.21$ 12.77$ 0.21$ 12.77$ ZZZ93321 TC 0.58$ 34.68$ 0.58$ 34.68$ ZZZ93325 00 0.74$ 44.59$ 0.74$ 44.59$ ZZZ93325 26 0.09$ 5.49$ 0.09$ 5.49$ ZZZ93325 TC 0.65$ 39.10$ 0.65$ 39.10$ ZZZ



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

93350 00 5.51$ 330.58$ 5.51$ 330.58$ XXX93350 26 2.05$ 123.19$ 2.05$ 123.19$ XXX93350 TC 3.46$ 207.38$ 3.46$ 207.38$ XXX93351 00 6.82$ 409.12$ 6.82$ 409.12$ XXX93351 26 2.46$ 147.59$ 2.46$ 147.59$ XXX93351 TC 4.36$ 261.53$ 4.36$ 261.53$ XXX93352 00 0.99$ 59.25$ 0.99$ 59.25$ ZZZ93355 00 6.66$ 399.68$ 6.66$ 399.68$ XXX93356 00 1.18$ 70.76$ 0.34$ 20.61$ ZZZ93451 00 23.09$ 1,385.66$ 23.09$ 1,385.66$ 00093451 26 3.81$ 228.68$ 3.81$ 228.68$ 00093451 TC 19.28$ 1,156.98$ 19.28$ 1,156.98$ 00093452 00 25.54$ 1,532.27$ 25.54$ 1,532.27$ 00093452 26 6.95$ 416.99$ 6.95$ 416.99$ 00093452 TC 18.59$ 1,115.28$ 18.59$ 1,115.28$ 00093453 00 33.12$ 1,987.01$ 33.12$ 1,987.01$ 00093453 26 9.33$ 559.66$ 9.33$ 559.66$ 00093453 TC 23.79$ 1,427.34$ 23.79$ 1,427.34$ 00093454 00 25.79$ 1,547.52$ 25.79$ 1,547.52$ 00093454 26 7.05$ 422.78$ 7.05$ 422.78$ 00093454 TC 18.75$ 1,124.74$ 18.75$ 1,124.74$ 00093455 00 29.72$ 1,783.23$ 29.72$ 1,783.23$ 00093455 26 8.21$ 492.65$ 8.21$ 492.65$ 00093455 TC 21.51$ 1,290.59$ 21.51$ 1,290.59$ 00093456 00 32.65$ 1,959.20$ 32.65$ 1,959.20$ 00093456 26 9.16$ 549.43$ 9.16$ 549.43$ 00093456 TC 23.50$ 1,409.77$ 23.50$ 1,409.77$ 00093457 00 36.50$ 2,189.90$ 36.50$ 2,189.90$ 00093457 26 10.29$ 617.52$ 10.29$ 617.52$ 00093457 TC 26.21$ 1,572.38$ 26.21$ 1,572.38$ 00093458 00 30.60$ 1,836.08$ 30.60$ 1,836.08$ 00093458 26 8.69$ 521.61$ 8.69$ 521.61$ 00093458 TC 21.91$ 1,314.47$ 21.91$ 1,314.47$ 00093459 00 33.60$ 2,015.76$ 33.60$ 2,015.76$ 00093459 26 9.84$ 590.31$ 9.84$ 590.31$ 00093459 TC 23.76$ 1,425.45$ 23.76$ 1,425.45$ 00093460 00 36.70$ 2,201.83$ 36.70$ 2,201.83$ 00093460 26 11.01$ 660.35$ 11.01$ 660.35$ 00093460 TC 25.69$ 1,541.48$ 25.69$ 1,541.48$ 00093461 00 41.55$ 2,493.04$ 41.55$ 2,493.04$ 00093461 26 12.18$ 730.85$ 12.18$ 730.85$ 00093461 TC 29.37$ 1,762.19$ 29.37$ 1,762.19$ 000



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

93462 00 6.14$ 368.53$ 6.14$ 368.53$ ZZZ93463 00 2.86$ 171.58$ 2.86$ 171.58$ ZZZ93464 00 7.31$ 438.63$ 7.31$ 438.63$ ZZZ93464 26 2.54$ 152.42$ 2.54$ 152.42$ ZZZ93464 TC 4.77$ 286.21$ 4.77$ 286.21$ ZZZ93503 00 2.57$ 154.22$ 2.57$ 154.22$ 00093505 00 20.68$ 1,240.53$ 20.68$ 1,240.53$ 00093505 26 6.44$ 386.23$ 6.44$ 386.23$ 00093505 TC 14.24$ 854.30$ 14.24$ 854.30$ 00093530 00 919.69$ 919.69$ 00093530 26 6.02$ 361.27$ 6.02$ 361.27$ 00093530 TC 706.06$ 706.06$ 00093531 00 2,462.15$ 2,462.15$ 00093531 26 12.50$ 749.80$ 12.50$ 749.80$ 00093531 TC 2,018.69$ 2,018.69$ 00093532 00 By Report By Report 00093532 26 15.54$ 932.38$ 15.54$ 932.38$ 00093532 TC By Report By Report 00093533 00 By Report By Report 00093533 26 10.38$ 622.73$ 10.38$ 622.73$ 00093533 TC By Report By Report 00093561 00 49.19$ 49.19$ ZZZ93561 26 1.33$ 79.91$ 1.33$ 79.91$ ZZZ93561 TC 1.95$ 1.95$ ZZZ93562 00 39.52$ 39.52$ ZZZ93562 26 1.08$ 64.61$ 1.08$ 64.61$ ZZZ93562 TC 1.32$ 1.32$ ZZZ93563 00 1.70$ 102.03$ 1.70$ 102.03$ ZZZ93564 00 1.79$ 107.69$ 1.79$ 107.69$ ZZZ93565 00 1.32$ 79.13$ 1.32$ 79.13$ ZZZ93566 00 4.54$ 272.39$ 1.36$ 81.32$ ZZZ93567 00 3.83$ 229.60$ 1.54$ 92.13$ ZZZ93568 00 4.11$ 246.48$ 1.39$ 83.16$ ZZZ93571 00 268.98$ 268.98$ ZZZ93571 26 2.26$ 135.43$ 2.26$ 135.43$ ZZZ93571 TC 188.97$ 188.97$ ZZZ93572 00 By Report By Report ZZZ93572 26 1.83$ 109.88$ 1.83$ 109.88$ ZZZ93572 TC By Report By Report ZZZ93580 00 28.57$ 1,714.35$ 28.57$ 1,714.35$ 00093581 00 38.89$ 2,333.69$ 38.89$ 2,333.69$ 00093582 00 19.47$ 1,168.34$ 19.47$ 1,168.34$ 000



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

93583 00 21.71$ 1,302.77$ 21.71$ 1,302.77$ 00093590 00 31.65$ 1,898.72$ 31.65$ 1,898.72$ 00093591 00 26.06$ 1,563.78$ 26.06$ 1,563.78$ 00093592 00 11.55$ 692.91$ 11.55$ 692.91$ ZZZ93600 00 127.40$ 127.40$ 00093600 26 3.47$ 208.48$ 3.47$ 208.48$ 00093600 TC 4.23$ 4.23$ 00093602 00 122.94$ 122.94$ 00093602 26 3.40$ 204.15$ 3.40$ 204.15$ 00093602 TC 2.28$ 2.28$ 00093603 00 124.64$ 124.64$ 00093603 26 3.41$ 204.78$ 3.41$ 204.78$ 00093603 TC 3.61$ 3.61$ 00093609 00 294.70$ 294.70$ ZZZ93609 26 8.16$ 489.34$ 8.16$ 489.34$ ZZZ93609 TC 5.56$ 5.56$ ZZZ93610 00 173.56$ 173.56$ 00093610 26 4.80$ 288.05$ 4.80$ 288.05$ 00093610 TC 3.28$ 3.28$ 00093612 00 172.19$ 172.19$ 00093612 26 4.75$ 285.15$ 4.75$ 285.15$ 00093612 TC 3.61$ 3.61$ 00093613 00 8.68$ 520.55$ 8.68$ 520.55$ ZZZ93615 00 39.93$ 39.93$ 00093615 26 1.11$ 66.57$ 1.11$ 66.57$ 00093615 TC 0.63$ 0.63$ 00093616 00 By Report By Report 00093616 26 1.74$ 104.30$ 1.74$ 104.30$ 00093616 TC By Report By Report 00093618 00 237.33$ 237.33$ 00093618 26 6.47$ 388.35$ 6.47$ 388.35$ 00093618 TC 7.82$ 7.82$ 00093619 00 421.24$ 421.24$ 00093619 26 11.45$ 686.93$ 11.45$ 686.93$ 00093619 TC 15.31$ 15.31$ 00093620 00 By Report By Report 00093620 26 18.40$ 1,104.30$ 18.40$ 1,104.30$ 00093620 TC By Report By Report 00093621 00 By Report By Report ZZZ93621 26 3.41$ 204.83$ 3.41$ 204.83$ ZZZ93621 TC By Report By Report ZZZ93622 00 By Report By Report ZZZ



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

93622 26 5.05$ 303.27$ 5.05$ 303.27$ ZZZ93622 TC By Report By Report ZZZ93623 00 By Report By Report ZZZ93623 26 4.64$ 278.57$ 4.64$ 278.57$ ZZZ93623 TC By Report By Report ZZZ93624 00 By Report By Report 00093624 26 7.07$ 424.31$ 7.07$ 424.31$ 00093624 TC By Report By Report 00093631 00 By Report By Report 00093631 26 11.53$ 691.96$ 11.53$ 691.96$ 00093631 TC By Report By Report 00093640 00 199.30$ 199.30$ 00093640 26 5.23$ 314.04$ 5.23$ 314.04$ 00093640 TC 13.68$ 13.68$ 00093641 00 338.48$ 338.48$ 00093641 26 9.16$ 549.56$ 9.16$ 549.56$ 00093641 TC 13.68$ 13.68$ 00093642 00 9.95$ 596.72$ 9.95$ 596.72$ 00093642 26 7.51$ 450.59$ 7.51$ 450.59$ 00093642 TC 2.44$ 146.13$ 2.44$ 146.13$ 00093644 00 5.79$ 347.44$ 5.79$ 347.44$ 00093644 26 4.25$ 254.82$ 4.25$ 254.82$ 00093644 TC 1.54$ 92.61$ 1.54$ 92.61$ 00093650 00 17.31$ 1,038.30$ 17.31$ 1,038.30$ 00093653 00 24.49$ 1,469.27$ 24.49$ 1,469.27$ 00093654 00 32.77$ 1,966.33$ 32.77$ 1,966.33$ 00093655 00 12.47$ 747.98$ 12.47$ 747.98$ ZZZ93656 00 32.87$ 1,972.42$ 32.87$ 1,972.42$ 00093657 00 12.45$ 746.72$ 12.45$ 746.72$ ZZZ93660 00 4.65$ 278.77$ 4.65$ 278.77$ 00093660 26 2.72$ 162.91$ 2.72$ 162.91$ 00093660 TC 1.93$ 115.86$ 1.93$ 115.86$ 00093662 00 By Report By Report ZZZ93662 26 4.14$ 248.59$ 4.14$ 248.59$ ZZZ93662 TC By Report By Report ZZZ93668 00 0.52$ 31.28$ 0.52$ 31.28$ XXX93701 00 0.74$ 44.69$ 0.74$ 44.69$ XXX93702 00 3.75$ 224.96$ 3.75$ 224.96$ XXX93724 00 8.06$ 483.36$ 8.06$ 483.36$ 00093724 26 7.07$ 424.16$ 7.07$ 424.16$ 00093724 TC 0.99$ 59.19$ 0.99$ 59.19$ 00093740 00 Bundled Bundled XXX



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

93745 00 55.37$ 55.37$ XXX93745 26 36.76$ 36.76$ XXX93745 TC 18.61$ 18.61$ XXX93750 00 1.61$ 96.59$ 1.34$ 80.19$ XXX93770 00 Bundled Bundled XXX93784 00 1.57$ 93.99$ 1.57$ 93.99$ XXX93786 00 0.87$ 52.26$ 0.87$ 52.26$ XXX93788 00 0.16$ 9.38$ 0.16$ 9.38$ XXX93790 00 0.54$ 32.36$ 0.54$ 32.36$ XXX93792 00 1.55$ 93.16$ 1.55$ 93.16$ XXX93793 00 0.35$ 20.89$ 0.35$ 20.89$ XXX93797 00 0.47$ 28.46$ 0.25$ 15.22$ 00093798 00 0.74$ 44.51$ 0.41$ 24.33$ 00093799 00 By Report By Report XXX93799 26 By Report By Report XXX93799 TC By Report By Report XXX93880 00 5.94$ 356.62$ 5.94$ 356.62$ XXX93880 26 1.15$ 69.24$ 1.15$ 69.24$ XXX93880 TC 4.79$ 287.39$ 4.79$ 287.39$ XXX93882 00 3.79$ 227.58$ 3.79$ 227.58$ XXX93882 26 0.71$ 42.89$ 0.71$ 42.89$ XXX93882 TC 3.08$ 184.68$ 3.08$ 184.68$ XXX93886 00 8.01$ 480.65$ 8.01$ 480.65$ XXX93886 26 1.36$ 81.65$ 1.36$ 81.65$ XXX93886 TC 6.65$ 399.00$ 6.65$ 399.00$ XXX93888 00 4.67$ 280.08$ 4.67$ 280.08$ XXX93888 26 0.75$ 44.95$ 0.75$ 44.95$ XXX93888 TC 3.92$ 235.13$ 3.92$ 235.13$ XXX93890 00 8.16$ 489.88$ 8.16$ 489.88$ XXX93890 26 1.48$ 88.98$ 1.48$ 88.98$ XXX93890 TC 6.68$ 400.89$ 6.68$ 400.89$ XXX93892 00 9.19$ 551.67$ 9.19$ 551.67$ XXX93892 26 1.74$ 104.11$ 1.74$ 104.11$ XXX93892 TC 7.46$ 447.56$ 7.46$ 447.56$ XXX93893 00 10.25$ 614.90$ 10.25$ 614.90$ XXX93893 26 1.74$ 104.28$ 1.74$ 104.28$ XXX93893 TC 8.51$ 510.62$ 8.51$ 510.62$ XXX93895 00 Not Covered Not Covered XXX93895 26 Not Covered Not Covered XXX93895 TC Not Covered Not Covered XXX93922 00 2.55$ 152.89$ 2.55$ 152.89$ XXX93922 26 0.36$ 21.80$ 0.36$ 21.80$ XXX



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL




CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

93981 TC 1.61$ 96.40$ 1.61$ 96.40$ XXX93985 00 7.90$ 474.03$ 7.90$ 474.03$ XXX93985 26 1.10$ 66.26$ 1.10$ 66.26$ XXX93985 TC 6.80$ 407.77$ 6.80$ 407.77$ XXX93986 00 4.58$ 274.58$ 4.58$ 274.58$ XXX93986 26 0.71$ 42.52$ 0.71$ 42.52$ XXX93986 TC 3.87$ 232.07$ 3.87$ 232.07$ XXX93990 00 4.61$ 276.60$ 4.61$ 276.60$ XXX93990 26 0.70$ 42.18$ 0.70$ 42.18$ XXX93990 TC 3.91$ 234.42$ 3.91$ 234.42$ XXX93998 00 Not Covered Not Covered XXX94002 00 2.67$ 160.00$ 2.67$ 160.00$ XXX94003 00 1.91$ 114.72$ 1.91$ 114.72$ XXX94004 00 1.42$ 85.03$ 1.42$ 85.03$ XXX94005 00 Not Covered Not Covered XXX94010 00 1.04$ 62.45$ 1.04$ 62.45$ XXX94010 26 0.24$ 14.61$ 0.24$ 14.61$ XXX94010 TC 0.80$ 47.84$ 0.80$ 47.84$ XXX94011 00 2.51$ 150.32$ 2.51$ 150.32$ XXX94012 00 4.07$ 244.01$ 4.07$ 244.01$ XXX94013 00 0.56$ 33.37$ 0.56$ 33.37$ XXX94014 00 1.63$ 98.04$ 1.63$ 98.04$ XXX94015 00 0.90$ 54.15$ 0.90$ 54.15$ XXX94016 00 0.73$ 43.89$ 0.73$ 43.89$ XXX94060 00 1.75$ 105.08$ 1.75$ 105.08$ XXX94060 26 0.38$ 22.55$ 0.38$ 22.55$ XXX94060 TC 1.38$ 82.52$ 1.38$ 82.52$ XXX94070 00 1.74$ 104.69$ 1.74$ 104.69$ XXX94070 26 0.83$ 49.91$ 0.83$ 49.91$ XXX94070 TC 0.91$ 54.78$ 0.91$ 54.78$ XXX94150 00 Bundled Bundled XXX94150 26 Bundled Bundled XXX94150 TC Bundled Bundled XXX94200 00 0.81$ 48.74$ 0.81$ 48.74$ XXX94200 26 0.16$ 9.72$ 0.16$ 9.72$ XXX94200 TC 0.65$ 39.01$ 0.65$ 39.01$ XXX94250 00 0.81$ 48.74$ 0.81$ 48.74$ XXX94250 26 0.16$ 9.72$ 0.16$ 9.72$ XXX94250 TC 0.65$ 39.01$ 0.65$ 39.01$ XXX94375 00 1.16$ 69.66$ 1.16$ 69.66$ XXX94375 26 0.43$ 25.60$ 0.43$ 25.60$ XXX94375 TC 0.73$ 44.06$ 0.73$ 44.06$ XXX



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

94400 00 1.67$ 100.24$ 1.67$ 100.24$ XXX94400 26 0.57$ 34.11$ 0.57$ 34.11$ XXX94400 TC 1.10$ 66.13$ 1.10$ 66.13$ XXX94450 00 2.14$ 128.54$ 2.14$ 128.54$ XXX94450 26 0.58$ 34.74$ 0.58$ 34.74$ XXX94450 TC 1.56$ 93.79$ 1.56$ 93.79$ XXX94452 00 1.61$ 96.78$ 1.61$ 96.78$ XXX94452 26 0.42$ 24.97$ 0.42$ 24.97$ XXX94452 TC 1.20$ 71.80$ 1.20$ 71.80$ XXX94453 00 2.23$ 133.66$ 2.23$ 133.66$ XXX94453 26 0.55$ 32.85$ 0.55$ 32.85$ XXX94453 TC 1.68$ 100.81$ 1.68$ 100.81$ XXX94610 00 1.61$ 96.52$ 1.61$ 96.52$ XXX94617 00 2.76$ 165.51$ 2.76$ 165.51$ XXX94617 26 0.96$ 57.85$ 0.96$ 57.85$ XXX94617 TC 1.79$ 107.66$ 1.79$ 107.66$ XXX94618 00 0.98$ 59.05$ 0.98$ 59.05$ XXX94618 26 0.66$ 39.58$ 0.66$ 39.58$ XXX94618 TC 0.32$ 19.46$ 0.32$ 19.46$ XXX94621 00 4.70$ 281.96$ 4.70$ 281.96$ XXX94621 26 1.99$ 119.43$ 1.99$ 119.43$ XXX94621 TC 2.71$ 162.53$ 2.71$ 162.53$ XXX94640 00 0.53$ 32.08$ 0.53$ 32.08$ XXX94642 00 33.56$ 33.56$ XXX94644 00 1.47$ 88.20$ 1.47$ 88.20$ XXX94645 00 0.49$ 29.55$ 0.49$ 29.55$ XXX94660 00 1.86$ 111.67$ 1.10$ 66.27$ XXX94662 00 1.04$ 62.49$ 1.04$ 62.49$ XXX94664 00 0.50$ 30.18$ 0.50$ 30.18$ XXX94667 00 0.74$ 44.60$ 0.74$ 44.60$ XXX94668 00 0.96$ 57.85$ 0.96$ 57.85$ XXX94669 00 0.94$ 56.50$ 0.94$ 56.50$ XXX94680 00 1.64$ 98.17$ 1.64$ 98.17$ XXX94680 26 0.37$ 21.95$ 0.37$ 21.95$ XXX94680 TC 1.27$ 76.22$ 1.27$ 76.22$ XXX94681 00 1.62$ 97.06$ 1.62$ 97.06$ XXX94681 26 0.29$ 17.69$ 0.29$ 17.69$ XXX94681 TC 1.32$ 79.37$ 1.32$ 79.37$ XXX94690 00 1.56$ 93.61$ 1.56$ 93.61$ XXX94690 26 0.11$ 6.67$ 0.11$ 6.67$ XXX94690 TC 1.45$ 86.94$ 1.45$ 86.94$ XXX94726 00 1.58$ 95.01$ 1.58$ 95.01$ XXX



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

94726 26 0.36$ 21.32$ 0.36$ 21.32$ XXX94726 TC 1.23$ 73.70$ 1.23$ 73.70$ XXX94727 00 1.28$ 76.73$ 1.28$ 76.73$ XXX94727 26 0.36$ 21.32$ 0.36$ 21.32$ XXX94727 TC 0.92$ 55.41$ 0.92$ 55.41$ XXX94728 00 1.19$ 71.68$ 1.19$ 71.68$ XXX94728 26 0.37$ 21.95$ 0.37$ 21.95$ XXX94728 TC 0.83$ 49.73$ 0.83$ 49.73$ XXX94729 00 1.63$ 97.72$ 1.63$ 97.72$ ZZZ94729 26 0.26$ 15.82$ 0.26$ 15.82$ ZZZ94729 TC 1.36$ 81.89$ 1.36$ 81.89$ ZZZ94750 00 2.51$ 150.58$ 2.51$ 150.58$ XXX94750 26 0.31$ 18.87$ 0.31$ 18.87$ XXX94750 TC 2.20$ 131.71$ 2.20$ 131.71$ XXX94760 00 0.07$ 4.33$ 0.07$ 4.33$ XXX94761 00 0.12$ 7.48$ 0.12$ 7.48$ XXX94762 00 0.74$ 44.69$ 0.74$ 44.69$ XXX94770 00 0.21$ 12.77$ 0.21$ 12.77$ XXX94772 00 180.53$ 180.53$ XXX94772 26 81.24$ 81.24$ XXX94772 TC 99.27$ 99.27$ XXX94774 00 By Report By Report YYY94775 00 By Report By Report YYY94776 00 By Report By Report YYY94777 00 By Report By Report YYY94780 00 1.50$ 89.95$ 0.69$ 41.39$ XXX94781 00 0.59$ 35.42$ 0.24$ 14.61$ ZZZ94799 00 By Report By Report XXX94799 26 By Report By Report XXX94799 TC By Report By Report XXX95004 00 0.12$ 7.46$ 0.12$ 7.46$ XXX95012 00 0.60$ 35.86$ 0.60$ 35.86$ XXX95017 00 0.24$ 14.24$ 0.11$ 6.67$ XXX95018 00 0.63$ 38.02$ 0.21$ 12.80$ XXX95024 00 0.24$ 14.39$ 0.03$ 1.78$ XXX95027 00 0.13$ 8.09$ 0.13$ 8.09$ XXX95028 00 0.39$ 23.25$ 0.39$ 23.25$ XXX95044 00 0.17$ 10.01$ 0.17$ 10.01$ XXX95052 00 0.20$ 11.90$ 0.20$ 11.90$ XXX95056 00 1.37$ 82.44$ 1.37$ 82.44$ XXX95060 00 1.04$ 62.35$ 1.04$ 62.35$ XXX95065 00 0.78$ 46.58$ 0.78$ 46.58$ XXX



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

95070 00 0.94$ 56.59$ 0.94$ 56.59$ XXX95071 00 1.10$ 66.13$ 1.10$ 66.13$ XXX95076 00 3.53$ 211.92$ 2.19$ 131.21$ XXX95079 00 2.48$ 148.62$ 2.00$ 120.25$ ZZZ95115 00 0.27$ 16.31$ 0.27$ 16.31$ XXX95117 00 0.31$ 18.83$ 0.31$ 18.83$ XXX95120 00 Not Covered Not Covered XXX95125 00 Not Covered Not Covered XXX95130 00 Not Covered Not Covered XXX95131 00 Not Covered Not Covered XXX95132 00 Not Covered Not Covered XXX95133 00 Not Covered Not Covered XXX95134 00 Not Covered Not Covered XXX95144 00 0.43$ 25.62$ 0.09$ 5.44$ XXX95145 00 0.85$ 50.84$ 0.09$ 5.44$ XXX95146 00 1.57$ 94.35$ 0.09$ 5.44$ XXX95147 00 1.63$ 97.50$ 0.09$ 5.44$ XXX95148 00 2.34$ 140.39$ 0.09$ 5.44$ XXX95149 00 3.12$ 187.05$ 0.09$ 5.44$ XXX95165 00 0.42$ 24.99$ 0.09$ 5.44$ XXX95170 00 0.31$ 18.68$ 0.09$ 5.44$ XXX95180 00 4.02$ 241.34$ 3.01$ 180.80$ XXX95199 00 By Report By Report XXX95249 00 1.64$ 98.12$ 1.64$ 98.12$ XXX95250 00 4.47$ 268.30$ 4.47$ 268.30$ XXX95251 00 1.03$ 61.55$ 1.03$ 61.55$ XXX95700 00 By Report By Report XXX95705 00 By Report By Report XXX95706 00 By Report By Report XXX95707 00 By Report By Report XXX95708 00 By Report By Report XXX95709 00 By Report By Report XXX95710 00 By Report By Report XXX95711 00 By Report By Report XXX95712 00 By Report By Report XXX95713 00 By Report By Report XXX95714 00 By Report By Report XXX95715 00 By Report By Report XXX95716 00 By Report By Report XXX95717 00 2.99$ 179.12$ 2.94$ 176.58$ XXX95718 00 3.93$ 235.88$ 3.87$ 232.07$ XXX95719 00 4.62$ 277.17$ 4.57$ 273.99$ XXX



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

95720 00 6.09$ 365.10$ 5.99$ 359.39$ XXX95721 00 6.14$ 368.27$ 6.01$ 360.66$ XXX95722 00 7.45$ 446.74$ 7.31$ 438.49$ XXX95723 00 7.61$ 456.48$ 7.44$ 446.33$ XXX95724 00 9.51$ 570.57$ 9.32$ 559.14$ XXX95725 00 8.69$ 521.18$ 8.46$ 507.85$ XXX95726 00 12.02$ 721.09$ 11.77$ 706.49$ XXX95782 00 26.81$ 1,608.60$ 26.81$ 1,608.60$ XXX95782 26 3.64$ 218.29$ 3.64$ 218.29$ XXX95782 TC 23.17$ 1,390.31$ 23.17$ 1,390.31$ XXX95783 00 28.54$ 1,712.52$ 28.54$ 1,712.52$ XXX95783 26 3.96$ 237.79$ 3.96$ 237.79$ XXX95783 TC 24.58$ 1,474.72$ 24.58$ 1,474.72$ XXX95800 00 4.99$ 299.44$ 4.99$ 299.44$ XXX95800 26 1.22$ 73.14$ 1.22$ 73.14$ XXX95800 TC 3.77$ 226.30$ 3.77$ 226.30$ XXX95801 00 2.66$ 159.45$ 2.66$ 159.45$ XXX95801 26 1.21$ 72.51$ 1.21$ 72.51$ XXX95801 TC 1.45$ 86.94$ 1.45$ 86.94$ XXX95803 00 4.22$ 253.28$ 4.22$ 253.28$ XXX95803 26 1.27$ 76.17$ 1.27$ 76.17$ XXX95803 TC 2.95$ 177.11$ 2.95$ 177.11$ XXX95805 00 12.41$ 744.42$ 12.41$ 744.42$ XXX95805 26 1.71$ 102.42$ 1.71$ 102.42$ XXX95805 TC 10.70$ 641.99$ 10.70$ 641.99$ XXX95806 00 4.05$ 243.11$ 4.05$ 243.11$ XXX95806 26 1.44$ 86.18$ 1.44$ 86.18$ XXX95806 TC 2.62$ 156.94$ 2.62$ 156.94$ XXX95807 00 12.70$ 761.78$ 12.70$ 761.78$ XXX95807 26 1.79$ 107.18$ 1.79$ 107.18$ XXX95807 TC 10.91$ 654.61$ 10.91$ 654.61$ XXX95808 00 19.83$ 1,189.78$ 19.83$ 1,189.78$ XXX95808 26 2.54$ 152.49$ 2.54$ 152.49$ XXX95808 TC 17.29$ 1,037.30$ 17.29$ 1,037.30$ XXX95810 00 18.10$ 1,085.96$ 18.10$ 1,085.96$ XXX95810 26 3.50$ 210.18$ 3.50$ 210.18$ XXX95810 TC 14.60$ 875.78$ 14.60$ 875.78$ XXX95811 00 18.98$ 1,138.59$ 18.98$ 1,138.59$ XXX95811 26 3.64$ 218.12$ 3.64$ 218.12$ XXX95811 TC 15.34$ 920.47$ 15.34$ 920.47$ XXX95812 00 9.60$ 576.06$ 9.60$ 576.06$ XXX95812 26 1.68$ 100.76$ 1.68$ 100.76$ XXX



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

95812 TC 7.92$ 475.30$ 7.92$ 475.30$ XXX95813 00 11.92$ 714.93$ 11.92$ 714.93$ XXX95813 26 2.52$ 151.43$ 2.52$ 151.43$ XXX95813 TC 9.39$ 563.50$ 9.39$ 563.50$ XXX95816 00 10.73$ 644.08$ 10.73$ 644.08$ XXX95816 26 1.68$ 100.76$ 1.68$ 100.76$ XXX95816 TC 9.06$ 543.33$ 9.06$ 543.33$ XXX95819 00 12.64$ 758.14$ 12.64$ 758.14$ XXX95819 26 1.68$ 100.76$ 1.68$ 100.76$ XXX95819 TC 10.96$ 657.38$ 10.96$ 657.38$ XXX95822 00 11.40$ 683.81$ 11.40$ 683.81$ XXX95822 26 1.69$ 101.39$ 1.69$ 101.39$ XXX95822 TC 9.71$ 582.42$ 9.71$ 582.42$ XXX95824 00 By Report By Report XXX95824 26 1.15$ 69.01$ 1.15$ 69.01$ XXX95824 TC By Report By Report XXX95829 00 56.04$ 3,362.43$ 56.04$ 3,362.43$ XXX95829 26 9.84$ 590.18$ 9.84$ 590.18$ XXX95829 TC 46.20$ 2,772.24$ 46.20$ 2,772.24$ XXX95830 00 11.44$ 686.21$ 2.68$ 160.92$ XXX95836 00 3.17$ 190.21$ 3.17$ 190.21$ XXX95851 00 0.61$ 36.71$ 0.22$ 13.38$ XXX95852 00 0.55$ 33.05$ 0.17$ 10.35$ XXX95857 00 1.59$ 95.41$ 0.86$ 51.90$ XXX95860 00 3.56$ 213.40$ 3.56$ 213.40$ XXX95860 26 1.50$ 89.89$ 1.50$ 89.89$ XXX95860 TC 2.06$ 123.51$ 2.06$ 123.51$ XXX95861 00 5.07$ 304.18$ 5.07$ 304.18$ XXX95861 26 2.40$ 144.09$ 2.40$ 144.09$ XXX95861 TC 2.67$ 160.09$ 2.67$ 160.09$ XXX95863 00 6.37$ 382.15$ 6.37$ 382.15$ XXX95863 26 2.90$ 174.14$ 2.90$ 174.14$ XXX95863 TC 3.47$ 208.01$ 3.47$ 208.01$ XXX95864 00 7.33$ 439.69$ 7.33$ 439.69$ XXX95864 26 3.10$ 186.27$ 3.10$ 186.27$ XXX95864 TC 4.22$ 253.42$ 4.22$ 253.42$ XXX95865 00 4.39$ 263.20$ 4.39$ 263.20$ XXX95865 26 2.42$ 145.36$ 2.42$ 145.36$ XXX95865 TC 1.96$ 117.84$ 1.96$ 117.84$ XXX95866 00 4.03$ 241.95$ 4.03$ 241.95$ XXX95866 26 1.97$ 118.44$ 1.97$ 118.44$ XXX95866 TC 2.06$ 123.51$ 2.06$ 123.51$ XXX



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

95867 00 3.11$ 186.64$ 3.11$ 186.64$ XXX95867 26 1.23$ 73.84$ 1.23$ 73.84$ XXX95867 TC 1.88$ 112.79$ 1.88$ 112.79$ XXX95868 00 4.07$ 244.19$ 4.07$ 244.19$ XXX95868 26 1.84$ 110.59$ 1.84$ 110.59$ XXX95868 TC 2.23$ 133.60$ 2.23$ 133.60$ XXX95869 00 2.79$ 167.16$ 2.79$ 167.16$ XXX95869 26 0.58$ 34.82$ 0.58$ 34.82$ XXX95869 TC 2.21$ 132.34$ 2.21$ 132.34$ XXX95870 00 2.69$ 161.49$ 2.69$ 161.49$ XXX95870 26 0.58$ 34.82$ 0.58$ 34.82$ XXX95870 TC 2.11$ 126.67$ 2.11$ 126.67$ XXX95872 00 5.77$ 346.46$ 5.77$ 346.46$ XXX95872 26 4.48$ 268.98$ 4.48$ 268.98$ XXX95872 TC 1.29$ 77.48$ 1.29$ 77.48$ XXX95873 00 2.22$ 133.28$ 2.22$ 133.28$ ZZZ95873 26 0.58$ 34.91$ 0.58$ 34.91$ ZZZ95873 TC 1.64$ 98.37$ 1.64$ 98.37$ ZZZ95874 00 2.27$ 136.35$ 2.27$ 136.35$ ZZZ95874 26 0.58$ 34.82$ 0.58$ 34.82$ ZZZ95874 TC 1.69$ 101.53$ 1.69$ 101.53$ ZZZ95875 00 3.88$ 233.05$ 3.88$ 233.05$ XXX95875 26 1.72$ 103.23$ 1.72$ 103.23$ XXX95875 TC 2.16$ 129.82$ 2.16$ 129.82$ XXX95885 00 1.80$ 108.02$ 1.80$ 108.02$ ZZZ95885 26 0.55$ 32.98$ 0.55$ 32.98$ ZZZ95885 TC 1.25$ 75.04$ 1.25$ 75.04$ ZZZ95886 00 2.77$ 166.45$ 2.77$ 166.45$ ZZZ95886 26 1.34$ 80.68$ 1.34$ 80.68$ ZZZ95886 TC 1.43$ 85.76$ 1.43$ 85.76$ ZZZ95887 00 2.41$ 144.76$ 2.41$ 144.76$ ZZZ95887 26 1.10$ 65.94$ 1.10$ 65.94$ ZZZ95887 TC 1.31$ 78.83$ 1.31$ 78.83$ ZZZ95905 00 1.89$ 113.21$ 1.89$ 113.21$ XXX95905 26 0.08$ 4.83$ 0.08$ 4.83$ XXX95905 TC 1.81$ 108.38$ 1.81$ 108.38$ XXX95907 00 2.81$ 168.44$ 2.81$ 168.44$ XXX95907 26 1.56$ 93.48$ 1.56$ 93.48$ XXX95907 TC 1.25$ 74.96$ 1.25$ 74.96$ XXX95908 00 3.64$ 218.16$ 3.64$ 218.16$ XXX95908 26 1.97$ 117.98$ 1.97$ 117.98$ XXX95908 TC 1.67$ 100.18$ 1.67$ 100.18$ XXX



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

95909 00 4.34$ 260.31$ 4.34$ 260.31$ XXX95909 26 2.34$ 140.58$ 2.34$ 140.58$ XXX95909 TC 2.00$ 119.73$ 2.00$ 119.73$ XXX95910 00 5.69$ 341.38$ 5.69$ 341.38$ XXX95910 26 3.13$ 187.59$ 3.13$ 187.59$ XXX95910 TC 2.56$ 153.78$ 2.56$ 153.78$ XXX95911 00 6.83$ 409.92$ 6.83$ 409.92$ XXX95911 26 3.90$ 234.06$ 3.90$ 234.06$ XXX95911 TC 2.93$ 175.85$ 2.93$ 175.85$ XXX95912 00 7.67$ 460.08$ 7.67$ 460.08$ XXX95912 26 4.64$ 278.55$ 4.64$ 278.55$ XXX95912 TC 3.03$ 181.53$ 3.03$ 181.53$ XXX95913 00 8.85$ 530.99$ 8.85$ 530.99$ XXX95913 26 5.50$ 329.91$ 5.50$ 329.91$ XXX95913 TC 3.35$ 201.08$ 3.35$ 201.08$ XXX95921 00 2.43$ 146.08$ 2.43$ 146.08$ XXX95921 26 1.31$ 78.69$ 1.31$ 78.69$ XXX95921 TC 1.12$ 67.39$ 1.12$ 67.39$ XXX95922 00 2.79$ 167.28$ 2.79$ 167.28$ XXX95922 26 1.39$ 83.50$ 1.39$ 83.50$ XXX95922 TC 1.40$ 83.79$ 1.40$ 83.79$ XXX95923 00 3.78$ 226.71$ 3.78$ 226.71$ XXX95923 26 1.33$ 79.87$ 1.33$ 79.87$ XXX95923 TC 2.45$ 146.85$ 2.45$ 146.85$ XXX95924 00 4.37$ 262.45$ 4.37$ 262.45$ XXX95924 26 2.58$ 154.70$ 2.58$ 154.70$ XXX95924 TC 1.80$ 107.75$ 1.80$ 107.75$ XXX95925 00 3.89$ 233.40$ 3.89$ 233.40$ XXX95925 26 0.80$ 48.17$ 0.80$ 48.17$ XXX95925 TC 3.09$ 185.23$ 3.09$ 185.23$ XXX95926 00 3.76$ 225.83$ 3.76$ 225.83$ XXX95926 26 0.79$ 47.54$ 0.79$ 47.54$ XXX95926 TC 2.97$ 178.29$ 2.97$ 178.29$ XXX95927 00 3.90$ 233.95$ 3.90$ 233.95$ XXX95927 26 0.79$ 47.54$ 0.79$ 47.54$ XXX95927 TC 3.11$ 186.41$ 3.11$ 186.41$ XXX95928 00 6.44$ 386.43$ 6.44$ 386.43$ XXX95928 26 2.31$ 138.69$ 2.31$ 138.69$ XXX95928 TC 4.13$ 247.74$ 4.13$ 247.74$ XXX95929 00 6.60$ 395.89$ 6.60$ 395.89$ XXX95929 26 2.32$ 139.32$ 2.32$ 139.32$ XXX95929 TC 4.28$ 256.57$ 4.28$ 256.57$ XXX



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

95930 00 2.02$ 121.27$ 2.02$ 121.27$ XXX95930 26 0.55$ 33.07$ 0.55$ 33.07$ XXX95930 TC 1.47$ 88.20$ 1.47$ 88.20$ XXX95933 00 2.39$ 143.18$ 2.39$ 143.18$ XXX95933 26 0.92$ 54.98$ 0.92$ 54.98$ XXX95933 TC 1.47$ 88.20$ 1.47$ 88.20$ XXX95937 00 2.57$ 154.38$ 2.57$ 154.38$ XXX95937 26 1.00$ 59.87$ 1.00$ 59.87$ XXX95937 TC 1.58$ 94.51$ 1.58$ 94.51$ XXX95938 00 10.24$ 614.47$ 10.24$ 614.47$ XXX95938 26 1.34$ 80.60$ 1.34$ 80.60$ XXX95938 TC 8.90$ 533.87$ 8.90$ 533.87$ XXX95939 00 15.17$ 910.37$ 15.17$ 910.37$ XXX95939 26 3.48$ 208.85$ 3.48$ 208.85$ XXX95939 TC 11.69$ 701.52$ 11.69$ 701.52$ XXX95940 00 0.95$ 56.76$ 0.95$ 56.76$ XXX95941 00 Not Covered Not Covered XXX95943 00 165.98$ 165.98$ XXX95943 26 By Report By Report XXX95943 TC By Report By Report XXX95954 00 11.77$ 706.09$ 11.77$ 706.09$ XXX95954 26 3.35$ 200.77$ 3.35$ 200.77$ XXX95954 TC 8.42$ 505.32$ 8.42$ 505.32$ XXX95955 00 6.20$ 372.01$ 6.20$ 372.01$ XXX95955 26 1.58$ 94.63$ 1.58$ 94.63$ XXX95955 TC 4.62$ 277.38$ 4.62$ 277.38$ XXX95957 00 7.91$ 474.32$ 7.91$ 474.32$ XXX95957 26 3.00$ 180.08$ 3.00$ 180.08$ XXX95957 TC 4.90$ 294.24$ 4.90$ 294.24$ XXX95958 00 16.94$ 1,016.10$ 16.94$ 1,016.10$ XXX95958 26 6.58$ 394.75$ 6.58$ 394.75$ XXX95958 TC 10.36$ 621.35$ 10.36$ 621.35$ XXX95961 00 8.97$ 537.98$ 8.97$ 537.98$ XXX95961 26 4.71$ 282.67$ 4.71$ 282.67$ XXX95961 TC 4.26$ 255.31$ 4.26$ 255.31$ XXX95962 00 7.67$ 460.21$ 7.67$ 460.21$ ZZZ95962 26 5.03$ 302.02$ 5.03$ 302.02$ ZZZ95962 TC 2.64$ 158.20$ 2.64$ 158.20$ ZZZ95965 00 By Report By Report XXX95965 26 12.28$ 736.99$ 12.28$ 736.99$ XXX95965 TC By Report By Report XXX95966 00 By Report By Report XXX



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

95966 26 6.22$ 373.15$ 6.22$ 373.15$ XXX95966 TC By Report By Report XXX95967 00 By Report By Report ZZZ95967 26 5.44$ 326.14$ 5.44$ 326.14$ ZZZ95967 TC By Report By Report ZZZ95970 00 0.55$ 32.90$ 0.54$ 32.27$ XXX95971 00 1.47$ 88.21$ 1.19$ 71.18$ XXX95972 00 1.66$ 99.42$ 1.21$ 72.31$ XXX95976 00 1.18$ 70.68$ 1.16$ 69.42$ XXX95977 00 1.56$ 93.85$ 1.54$ 92.59$ XXX95980 00 1.33$ 79.75$ 1.33$ 79.75$ XXX95981 00 1.00$ 60.06$ 0.52$ 31.05$ XXX95982 00 1.59$ 95.31$ 1.05$ 63.15$ XXX95983 00 1.48$ 88.88$ 1.46$ 87.62$ XXX95984 00 1.29$ 77.35$ 1.28$ 76.72$ ZZZ95990 00 2.75$ 164.97$ 2.75$ 164.97$ XXX95991 00 3.43$ 205.52$ 1.16$ 69.31$ XXX95992 00 1.28$ 76.55$ 1.09$ 65.20$ XXX95999 00 By Report By Report XXX96000 00 2.76$ 165.70$ 2.76$ 165.70$ XXX96001 00 3.68$ 221.01$ 3.68$ 221.01$ XXX96002 00 0.64$ 38.42$ 0.64$ 38.42$ XXX96003 00 0.50$ 29.86$ 0.50$ 29.86$ XXX96004 00 3.32$ 199.17$ 3.32$ 199.17$ XXX96020 00 Not Covered Not Covered XXX96020 26 4.74$ 284.30$ 4.74$ 284.30$ XXX96020 TC Not Covered Not Covered XXX96040 00 Bundled Bundled XXX96105 00 3.02$ 181.39$ 3.02$ 181.39$ XXX96110 00 0.29$ 17.57$ 0.29$ 17.57$ XXX96112 00 3.90$ 233.74$ 3.66$ 219.87$ XXX96113 00 1.74$ 104.25$ 1.67$ 100.47$ ZZZ96116 00 2.75$ 164.71$ 2.44$ 146.42$ XXX96121 00 2.35$ 141.22$ 2.24$ 134.28$ ZZZ96125 00 3.20$ 191.77$ 3.20$ 191.77$ XXX96127 00 0.16$ 9.38$ 0.16$ 9.38$ XXX96130 00 3.34$ 200.65$ 3.13$ 188.04$ XXX96131 00 2.54$ 152.64$ 2.39$ 143.18$ ZZZ96132 00 3.78$ 226.59$ 3.07$ 184.34$ XXX96133 00 2.88$ 172.82$ 2.35$ 141.29$ ZZZ96136 00 1.37$ 82.20$ 0.71$ 42.47$ XXX96137 00 1.27$ 76.21$ 0.56$ 33.33$ ZZZ



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

96138 00 1.13$ 68.02$ 1.13$ 68.02$ XXX96139 00 1.13$ 68.02$ 1.13$ 68.02$ ZZZ96146 00 0.06$ 3.70$ 0.06$ 3.70$ XXX96156 00 Not Covered Not Covered XXX96158 00 Not Covered Not Covered XXX96159 00 Not Covered Not Covered ZZZ96160 00 0.09$ 5.68$ 0.09$ 5.68$ ZZZ96161 00 0.09$ 5.68$ 0.09$ 5.68$ ZZZ96164 00 Not Covered Not Covered XXX96165 00 Not Covered Not Covered ZZZ96167 00 Not Covered Not Covered XXX96168 00 Not Covered Not Covered ZZZ96170 00 Not Covered Not Covered XXX96171 00 Not Covered Not Covered ZZZ96360 00 1.11$ 66.87$ 1.11$ 66.87$ XXX96361 00 0.39$ 23.65$ 0.39$ 23.65$ ZZZ96365 00 2.11$ 126.50$ 2.11$ 126.50$ XXX96366 00 0.63$ 37.92$ 0.63$ 37.92$ ZZZ96367 00 0.91$ 54.83$ 0.91$ 54.83$ ZZZ96368 00 0.61$ 36.68$ 0.61$ 36.68$ ZZZ96369 00 4.92$ 295.04$ 4.92$ 295.04$ XXX96370 00 0.45$ 27.20$ 0.45$ 27.20$ ZZZ96371 00 1.93$ 116.03$ 1.93$ 116.03$ ZZZ96372 00 0.49$ 29.12$ 0.49$ 29.12$ XXX96373 00 0.55$ 32.90$ 0.55$ 32.90$ XXX96374 00 1.15$ 68.73$ 1.15$ 68.73$ XXX96375 00 0.49$ 29.30$ 0.49$ 29.30$ ZZZ96376 00 Bundled Bundled ZZZ96377 00 0.59$ 35.42$ 0.59$ 35.42$ XXX96379 00 By Report By Report XXX96401 00 2.34$ 140.29$ 2.34$ 140.29$ XXX96402 00 0.90$ 54.29$ 0.90$ 54.29$ XXX96405 00 2.40$ 144.08$ 0.86$ 51.38$ 00096406 00 3.59$ 215.62$ 1.33$ 80.04$ 00096409 00 3.19$ 191.13$ 3.19$ 191.13$ XXX96411 00 1.72$ 103.28$ 1.72$ 103.28$ ZZZ96413 00 4.15$ 248.95$ 4.15$ 248.95$ XXX96415 00 0.89$ 53.57$ 0.89$ 53.57$ ZZZ96416 00 4.16$ 249.85$ 4.16$ 249.85$ XXX96417 00 2.00$ 120.20$ 2.00$ 120.20$ ZZZ96420 00 3.08$ 184.92$ 3.08$ 184.92$ XXX96422 00 5.08$ 304.56$ 5.08$ 304.56$ XXX



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

96423 00 2.34$ 140.40$ 2.34$ 140.40$ ZZZ96425 00 5.38$ 322.68$ 5.38$ 322.68$ XXX96440 00 24.75$ 1,484.85$ 3.60$ 216.09$ 00096446 00 6.03$ 361.60$ 0.78$ 46.93$ XXX96450 00 5.31$ 318.54$ 2.30$ 138.19$ 00096521 00 4.32$ 259.22$ 4.32$ 259.22$ XXX96522 00 3.54$ 212.48$ 3.54$ 212.48$ XXX96523 00 0.80$ 48.29$ 0.80$ 48.29$ XXX96542 00 3.92$ 235.21$ 1.21$ 72.52$ XXX96549 00 By Report By Report XXX96567 00 3.68$ 220.63$ 3.68$ 220.63$ XXX96570 00 1.50$ 89.82$ 1.50$ 89.82$ ZZZ96571 00 0.84$ 50.58$ 0.84$ 50.58$ ZZZ96573 00 5.97$ 357.95$ 5.97$ 357.95$ 00096574 00 7.57$ 454.16$ 7.57$ 454.16$ 00096900 00 0.64$ 38.38$ 0.64$ 38.38$ XXX96902 00 Bundled Bundled XXX96904 00 1.91$ 114.60$ 1.91$ 114.60$ XXX96910 00 3.40$ 204.15$ 3.40$ 204.15$ XXX96912 00 2.89$ 173.25$ 2.89$ 173.25$ XXX96913 00 4.11$ 246.40$ 4.11$ 246.40$ XXX96920 00 4.82$ 289.13$ 1.94$ 116.34$ 00096921 00 5.28$ 317.03$ 2.18$ 131.01$ 00096922 00 7.16$ 429.40$ 3.50$ 209.95$ 00096931 00 5.02$ 300.92$ 5.02$ 300.92$ XXX96932 00 3.69$ 221.17$ 3.69$ 221.17$ XXX96933 00 1.35$ 80.84$ 1.35$ 80.84$ XXX96934 00 2.84$ 170.49$ 2.84$ 170.49$ ZZZ96935 00 1.32$ 79.37$ 1.32$ 79.37$ ZZZ96936 00 1.29$ 77.16$ 1.29$ 77.16$ ZZZ96999 00 By Report By Report XXX97010 00 Bundled Bundled XXX97012 00 0.43$ 25.76$ 0.43$ 25.76$ XXX97014 00 0.43$ 25.94$ 0.43$ 25.94$ XXX97016 00 0.37$ 22.15$ 0.37$ 22.15$ XXX97018 00 0.21$ 12.37$ 0.21$ 12.37$ XXX97022 00 0.53$ 31.64$ 0.53$ 31.64$ XXX97024 00 0.21$ 12.37$ 0.21$ 12.37$ XXX97026 00 0.19$ 11.11$ 0.19$ 11.11$ XXX97028 00 0.24$ 14.21$ 0.24$ 14.21$ XXX97032 00 0.43$ 25.76$ 0.43$ 25.76$ XXX97033 00 0.61$ 36.45$ 0.61$ 36.45$ XXX



CODE MOD

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GLOBAL

97034 00 0.44$ 26.49$ 0.44$ 26.49$ XXX97035 00 0.40$ 23.97$ 0.40$ 23.97$ XXX97036 00 1.03$ 61.62$ 1.03$ 61.62$ XXX97039 00 6.55$ 6.55$ XXX97110 00 0.89$ 53.53$ 0.89$ 53.53$ XXX97112 00 1.02$ 60.97$ 1.02$ 60.97$ XXX97113 00 1.13$ 67.96$ 1.13$ 67.96$ XXX97116 00 0.88$ 52.90$ 0.88$ 52.90$ XXX97124 00 0.83$ 50.09$ 0.83$ 50.09$ XXX97129 00 Not Covered Not Covered XXX97130 00 Not Covered Not Covered ZZZ97139 00 8.80$ 8.80$ XXX97140 00 0.81$ 48.62$ 0.81$ 48.62$ XXX97150 00 0.53$ 31.96$ 0.53$ 31.96$ XXX97151 00 Not Covered Not Covered XXX97152 00 Not Covered Not Covered XXX97153 00 Not Covered Not Covered XXX97154 00 Not Covered Not Covered XXX97155 00 Not Covered Not Covered XXX97156 00 Not Covered Not Covered XXX97157 00 Not Covered Not Covered XXX97158 00 Not Covered Not Covered XXX97161 00 2.46$ 147.83$ 2.46$ 147.83$ XXX97162 00 2.46$ 147.83$ 2.46$ 147.83$ XXX97163 00 2.46$ 147.83$ 2.46$ 147.83$ XXX97164 00 1.68$ 100.60$ 1.68$ 100.60$ XXX97165 00 2.65$ 159.18$ 2.65$ 159.18$ XXX97166 00 2.65$ 159.18$ 2.65$ 159.18$ XXX97167 00 2.65$ 159.18$ 2.65$ 159.18$ XXX97168 00 1.82$ 109.43$ 1.82$ 109.43$ XXX97169 00 Not Covered Not Covered XXX97170 00 Not Covered Not Covered XXX97171 00 Not Covered Not Covered XXX97172 00 Not Covered Not Covered XXX97530 00 1.17$ 69.95$ 1.17$ 69.95$ XXX97533 00 1.25$ 74.90$ 1.25$ 74.90$ XXX97535 00 1.00$ 59.84$ 1.00$ 59.84$ XXX97537 00 0.95$ 57.24$ 0.95$ 57.24$ XXX97542 00 0.96$ 57.87$ 0.96$ 57.87$ XXX97545 00 Not Covered Not Covered XXX97546 00 Not Covered Not Covered ZZZ97597 00 2.62$ 157.43$ 0.69$ 41.40$ 000



CODE MOD

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GLOBAL

97598 00 0.82$ 49.11$ 0.32$ 19.48$ ZZZ97602 00 Bundled Bundled XXX97605 00 1.28$ 76.61$ 0.75$ 45.08$ XXX97606 00 1.51$ 90.35$ 0.81$ 48.73$ XXX97607 00 43.59$ 43.59$ XXX97608 00 46.29$ 46.29$ XXX97610 00 6.70$ 401.88$ 0.49$ 29.20$ XXX97750 00 1.02$ 61.10$ 1.02$ 61.10$ XXX97755 00 1.11$ 66.34$ 1.11$ 66.34$ XXX97760 00 1.39$ 83.67$ 1.39$ 83.67$ XXX97761 00 1.19$ 71.69$ 1.19$ 71.69$ XXX97763 00 1.48$ 88.77$ 1.48$ 88.77$ XXX97799 00 By Report By Report XXX97802 00 1.08$ 64.68$ 0.98$ 59.00$ XXX97803 00 0.93$ 56.06$ 0.84$ 50.38$ XXX97804 00 0.49$ 29.54$ 0.46$ 27.65$ XXX97810 00 Not Covered Not Covered XXX97811 00 Not Covered Not Covered ZZZ97813 00 Not Covered Not Covered XXX97814 00 Not Covered Not Covered ZZZ98925 00 0.91$ 54.68$ 0.69$ 41.44$ 00098926 00 1.31$ 78.55$ 1.04$ 62.15$ 00098927 00 1.72$ 103.04$ 1.37$ 82.23$ 00098928 00 2.08$ 125.02$ 1.72$ 102.95$ 00098929 00 2.49$ 149.51$ 2.08$ 124.92$ 00098940 00 0.82$ 49.09$ 0.65$ 39.00$ 00098941 00 1.19$ 71.15$ 1.00$ 59.80$ 00098942 00 1.53$ 91.86$ 1.35$ 81.14$ 00098943 00 Not Covered Not Covered XXX98960 00 Bundled Bundled XXX98961 00 Bundled Bundled XXX98962 00 Bundled Bundled XXX98966 00 Not Covered Not Covered XXX98967 00 Not Covered Not Covered XXX98968 00 Not Covered Not Covered XXX98970 00 Not Covered Not Covered XXX98971 00 Not Covered Not Covered XXX98972 00 Not Covered Not Covered XXX99000 00 Bundled Bundled XXX99001 00 Bundled Bundled XXX99002 00 Bundled Bundled XXX99024 00 Bundled Bundled XXX



CODE MOD

DOC NonfacRVUs


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GLOBAL

99026 00 Not Covered Not Covered XXX99027 00 Not Covered Not Covered XXX99050 00 Bundled Bundled XXX99051 00 Bundled Bundled XXX99053 00 Bundled Bundled XXX99056 00 Bundled Bundled XXX99058 00 Bundled Bundled XXX99060 00 Bundled Bundled XXX99070 00 Bundled Bundled XXX99071 00 Bundled Bundled XXX99075 00 10.00$ 10.00$ XXX99078 00 Not Covered Not Covered XXX99080 00 Bundled Bundled XXX99082 00 5.60$ 5.60$ XXX99091 00 Bundled Bundled XXX99100 00 Bundled Bundled ZZZ99116 00 Bundled Bundled ZZZ99135 00 Bundled Bundled ZZZ99140 00 Bundled Bundled ZZZ99151 00 2.20$ 131.98$ 0.73$ 43.69$ XXX99152 00 1.50$ 89.99$ 0.35$ 21.26$ XXX99153 00 0.31$ 18.83$ 0.31$ 18.83$ ZZZ99155 00 2.56$ 153.76$ 2.56$ 153.76$ XXX99156 00 2.26$ 135.74$ 2.26$ 135.74$ XXX99157 00 1.85$ 110.70$ 1.85$ 110.70$ ZZZ99170 00 4.62$ 277.07$ 2.51$ 150.32$ 00099172 00 Not Covered Not Covered XXX99173 00 0.08$ 4.96$ 0.08$ 4.96$ XXX99174 00 0.17$ 10.01$ 0.17$ 10.01$ XXX99175 00 0.77$ 45.95$ 0.77$ 45.95$ XXX99177 00 0.14$ 8.11$ 0.14$ 8.11$ XXX99183 00 3.15$ 189.20$ 3.15$ 189.20$ XXX99184 00 6.42$ 385.04$ 6.42$ 385.04$ XXX99188 00 0.36$ 21.47$ 0.29$ 17.69$ XXX99190 00 By Report By Report XXX99191 00 By Report By Report XXX99192 00 By Report By Report XXX99195 00 3.00$ 179.85$ 3.00$ 179.85$ XXX99199 00 Not Covered Not Covered XXX99201 00 1.33$ 79.69$ 0.77$ 46.27$ XXX99202 00 2.21$ 132.51$ 1.45$ 87.10$ XXX99203 00 3.12$ 187.49$ 2.18$ 130.74$ XXX



CODE MOD

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GLOBAL

99204 00 4.73$ 283.93$ 3.69$ 221.51$ XXX99205 00 5.94$ 356.56$ 4.82$ 289.09$ XXX99211 00 0.66$ 39.81$ 0.26$ 15.85$ XXX99212 00 1.31$ 78.51$ 0.73$ 43.83$ XXX99213 00 2.15$ 128.70$ 1.46$ 87.72$ XXX99214 00 3.14$ 188.25$ 2.25$ 135.28$ XXX99215 00 4.20$ 251.84$ 3.18$ 190.67$ XXX99217 00 2.10$ 125.85$ 2.10$ 125.85$ XXX99218 00 2.85$ 170.90$ 2.85$ 170.90$ XXX99219 00 3.89$ 233.22$ 3.89$ 233.22$ XXX99220 00 5.31$ 318.52$ 5.31$ 318.52$ XXX99221 00 2.90$ 173.80$ 2.90$ 173.80$ XXX99222 00 3.92$ 234.91$ 3.92$ 234.91$ XXX99223 00 5.79$ 347.13$ 5.79$ 347.13$ XXX99224 00 1.14$ 68.16$ 1.14$ 68.16$ XXX99225 00 2.09$ 125.48$ 2.09$ 125.48$ XXX99226 00 3.00$ 179.78$ 3.00$ 179.78$ XXX99231 00 1.13$ 67.53$ 1.13$ 67.53$ XXX99232 00 2.08$ 124.85$ 2.08$ 124.85$ XXX99233 00 2.97$ 178.43$ 2.97$ 178.43$ XXX99234 00 3.80$ 228.19$ 3.80$ 228.19$ XXX99235 00 4.84$ 290.51$ 4.84$ 290.51$ XXX99236 00 6.22$ 373.37$ 6.22$ 373.37$ XXX99238 00 2.10$ 125.85$ 2.10$ 125.85$ XXX99239 00 3.08$ 184.53$ 3.08$ 184.53$ XXX99241 00 1.38$ 82.51$ 0.93$ 56.03$ XXX99242 00 2.58$ 154.78$ 1.96$ 117.58$ XXX99243 00 3.53$ 211.78$ 2.74$ 164.49$ XXX99244 00 5.27$ 316.09$ 4.41$ 264.38$ XXX99245 00 6.42$ 385.07$ 5.45$ 327.06$ XXX99251 00 1.40$ 83.94$ 1.40$ 83.94$ XXX99252 00 2.14$ 128.43$ 2.14$ 128.43$ XXX99253 00 3.30$ 197.91$ 3.30$ 197.91$ XXX99254 00 4.79$ 287.48$ 4.79$ 287.48$ XXX99255 00 5.76$ 345.84$ 5.76$ 345.84$ XXX99281 00 0.61$ 36.34$ 0.61$ 36.34$ XXX99282 00 1.18$ 70.84$ 1.18$ 70.84$ XXX99283 00 1.76$ 105.89$ 1.76$ 105.89$ XXX99284 00 3.35$ 200.82$ 3.35$ 200.82$ XXX99285 00 4.93$ 295.62$ 4.93$ 295.62$ XXX99288 00 Bundled Bundled XXX99291 00 7.97$ 478.24$ 6.35$ 381.13$ XXX



CODE MOD

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GLOBAL

99292 00 3.51$ 210.70$ 3.19$ 191.15$ ZZZ99304 00 2.58$ 154.93$ 2.58$ 154.93$ XXX99305 00 3.73$ 224.02$ 3.73$ 224.02$ XXX99306 00 4.78$ 286.89$ 4.78$ 286.89$ XXX99307 00 1.26$ 75.81$ 1.26$ 75.81$ XXX99308 00 1.98$ 118.67$ 1.98$ 118.67$ XXX99309 00 2.63$ 157.77$ 2.63$ 157.77$ XXX99310 00 3.89$ 233.48$ 3.89$ 233.48$ XXX99315 00 2.11$ 126.48$ 2.11$ 126.48$ XXX99316 00 3.03$ 181.92$ 3.03$ 181.92$ XXX99318 00 2.75$ 164.93$ 2.75$ 164.93$ XXX99324 00 Not Covered Not Covered XXX99325 00 Not Covered Not Covered XXX99326 00 Not Covered Not Covered XXX99327 00 Not Covered Not Covered XXX99328 00 Not Covered Not Covered XXX99334 00 Not Covered Not Covered XXX99335 00 Not Covered Not Covered XXX99336 00 Not Covered Not Covered XXX99337 00 Not Covered Not Covered XXX99339 00 Not Covered Not Covered XXX99340 00 Not Covered Not Covered XXX99341 00 Not Covered Not Covered XXX99342 00 Not Covered Not Covered XXX99343 00 Not Covered Not Covered XXX99344 00 Not Covered Not Covered XXX99345 00 Not Covered Not Covered XXX99347 00 Not Covered Not Covered XXX99348 00 Not Covered Not Covered XXX99349 00 Not Covered Not Covered XXX99350 00 Not Covered Not Covered XXX99354 00 Not Covered Not Covered ZZZ99355 00 Not Covered Not Covered ZZZ99356 00 2.64$ 158.62$ 2.64$ 158.62$ ZZZ99357 00 2.65$ 159.25$ 2.65$ 159.25$ ZZZ99358 00 3.20$ 191.96$ 3.20$ 191.96$ XXX99359 00 1.54$ 92.68$ 1.54$ 92.68$ ZZZ99360 00 1.76$ 105.41$ 1.76$ 105.41$ XXX99366 00 1.23$ 73.77$ 1.21$ 72.51$ XXX99367 00 1.62$ 97.47$ 1.62$ 97.47$ XXX99368 00 1.06$ 63.39$ 1.06$ 63.39$ XXX99374 00 Not Covered Not Covered XXX



CODE MOD

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GLOBAL

99375 00 Not Covered Not Covered XXX99377 00 Not Covered Not Covered XXX99378 00 Not Covered Not Covered XXX99379 00 Not Covered Not Covered XXX99380 00 Not Covered Not Covered XXX99381 00 Not Covered Not Covered XXX99382 00 Not Covered Not Covered XXX99383 00 Not Covered Not Covered XXX99384 00 Not Covered Not Covered XXX99385 00 3.81$ 228.71$ 2.80$ 168.17$ XXX99386 00 4.42$ 265.23$ 3.41$ 204.69$ XXX99387 00 4.79$ 287.41$ 3.67$ 219.94$ XXX99391 00 Not Covered Not Covered XXX99392 00 Not Covered Not Covered XXX99393 00 Not Covered Not Covered XXX99394 00 Not Covered Not Covered XXX99395 00 3.44$ 206.53$ 2.57$ 154.19$ XXX99396 00 3.67$ 219.93$ 2.78$ 166.96$ XXX99397 00 3.94$ 236.61$ 2.92$ 175.44$ XXX99401 00 Not Covered Not Covered XXX99402 00 Not Covered Not Covered XXX99403 00 Not Covered Not Covered XXX99404 00 Not Covered Not Covered XXX99406 00 Not Covered Not Covered XXX99407 00 Not Covered Not Covered XXX99408 00 Not Covered Not Covered XXX99409 00 Not Covered Not Covered XXX99411 00 Not Covered Not Covered XXX99412 00 Not Covered Not Covered XXX99415 00 Not Covered Not Covered ZZZ99416 00 Not Covered Not Covered ZZZ99421 00 Not Covered Not Covered XXX99422 00 Not Covered Not Covered XXX99423 00 Not Covered Not Covered XXX99429 00 Not Covered Not Covered XXX99441 00 Not Covered Not Covered XXX99442 00 Not Covered Not Covered XXX99443 00 Not Covered Not Covered XXX99446 00 Not Covered Not Covered XXX99447 00 Not Covered Not Covered XXX99448 00 Not Covered Not Covered XXX99449 00 Not Covered Not Covered XXX



CODE MOD

DOC NonfacRVUs


DOC FacilityRVUs


GLOBAL

99450 00 Not Covered Not Covered XXX99451 00 1.06$ 63.36$ 1.06$ 63.36$ XXX99452 00 1.06$ 63.36$ 1.06$ 63.36$ XXX99453 00 0.57$ 33.97$ 0.57$ 33.97$ XXX99454 00 1.87$ 112.16$ 1.87$ 112.16$ XXX99455 00 Not Covered Not Covered XXX99456 00 Not Covered Not Covered XXX99457 00 1.47$ 88.27$ 0.91$ 54.84$ XXX99458 00 Not Covered Not Covered ZZZ99460 00 2.75$ 164.93$ 2.75$ 164.93$ XXX99461 00 2.65$ 158.77$ 1.81$ 108.32$ XXX99462 00 1.20$ 71.82$ 1.20$ 71.82$ XXX99463 00 3.18$ 190.71$ 3.18$ 190.71$ XXX99464 00 Not Covered Not Covered XXX99465 00 Not Covered Not Covered XXX99466 00 Not Covered Not Covered XXX99467 00 Not Covered Not Covered ZZZ99468 00 Not Covered Not Covered XXX99469 00 Not Covered Not Covered XXX99471 00 Not Covered Not Covered XXX99472 00 Not Covered Not Covered XXX99473 00 Not Covered Not Covered XXX99474 00 Not Covered Not Covered XXX99475 00 Not Covered Not Covered XXX99476 00 Not Covered Not Covered XXX99477 00 Not Covered Not Covered XXX99478 00 3.92$ 235.44$ 3.92$ 235.44$ XXX99479 00 3.57$ 214.18$ 3.57$ 214.18$ XXX99480 00 3.42$ 205.06$ 3.42$ 205.06$ XXX99483 00 7.51$ 450.71$ 5.17$ 310.08$ XXX99484 00 1.39$ 83.22$ 0.92$ 55.47$ XXX99485 00 Not Covered Not Covered XXX99486 00 Not Covered Not Covered XXX99487 00 2.66$ 159.61$ 1.49$ 89.61$ XXX99489 00 1.33$ 79.81$ 0.75$ 45.12$ ZZZ99490 00 1.20$ 71.87$ 0.91$ 54.84$ XXX99491 00 2.37$ 142.43$ 2.37$ 142.43$ XXX99492 00 4.64$ 278.46$ 2.55$ 152.97$ XXX99493 00 3.69$ 221.60$ 2.31$ 138.36$ XXX99494 00 1.91$ 114.76$ 1.24$ 74.40$ ZZZ99495 00 4.75$ 284.80$ 3.16$ 189.58$ XXX99496 00 6.69$ 401.60$ 4.58$ 274.85$ XXX



CODE MOD

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GLOBAL

99497 00 2.44$ 146.63$ 2.27$ 135.91$ XXX99498 00 2.14$ 128.69$ 2.13$ 128.06$ ZZZ99499 00 By Report By Report XXX99500 00 Not Covered Not Covered XXX99501 00 Not Covered Not Covered XXX99502 00 Not Covered Not Covered XXX99503 00 Not Covered Not Covered XXX99504 00 Not Covered Not Covered XXX99505 00 Not Covered Not Covered XXX99506 00 Not Covered Not Covered XXX99507 00 Not Covered Not Covered XXX99509 00 Not Covered Not Covered XXX99510 00 Not Covered Not Covered XXX99511 00 Not Covered Not Covered XXX99512 00 Not Covered Not Covered XXX99600 00 Not Covered Not Covered XXX99601 00 Not Covered Not Covered XXX99602 00 Not Covered Not Covered XXX99605 00 Not Covered Not Covered XXX99606 00 Not Covered Not Covered XXX99607 00 Not Covered Not Covered XXXA4206 00 Bundled Bundled XXXA4207 00 Bundled Bundled XXXA4208 00 Bundled Bundled XXXA4209 00 Bundled Bundled XXXA4211 00 Bundled Bundled XXXA4212 00 Bundled Bundled XXXA4213 00 Bundled Bundled XXXA4215 00 Bundled Bundled XXXA4220 00 Bundled Bundled XXXA4244 00 Bundled Bundled XXXA4245 00 Bundled Bundled XXXA4246 00 Bundled Bundled XXXA4247 00 Bundled Bundled XXXA4250 00 By Report By Report XXXA4252 00 Bundled Bundled XXXA4253 00 Bundled Bundled XXXA4261 00 53.76$ 53.76$ XXXA4262 00 Bundled Bundled XXXA4263 00 Bundled Bundled XXXA4264 00 602.85$ 602.85$ XXXA4270 00 Bundled Bundled XXX



CODE MOD

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GLOBAL

A4335 00 Bundled Bundled XXXA4337 00 Not Covered Not Covered XXXA4338 00 Bundled Bundled XXXA4340 00 Bundled Bundled XXXA4344 00 Bundled Bundled XXXA4346 00 Bundled Bundled XXXA4352 00 Bundled Bundled XXXA4356 00 Bundled Bundled XXXA4357 00 Bundled Bundled XXXA4358 00 Bundled Bundled XXXA4361 00 Bundled Bundled XXXA4362 00 Bundled Bundled XXXA4364 00 Bundled Bundled XXXA4367 00 Bundled Bundled XXXA4368 00 Bundled Bundled XXXA4398 00 Bundled Bundled XXXA4399 00 Bundled Bundled XXXA4400 00 Bundled Bundled XXXA4402 00 Bundled Bundled XXXA4404 00 Bundled Bundled XXXA4421 00 Bundled Bundled XXXA4461 00 Bundled Bundled XXXA4463 00 Bundled Bundled XXXA4559 00 Bundled Bundled XXXA4570 00 13.45$ 13.45$ XXXA4627 00 23.70$ 23.70$ XXXA4648 00 By Report By Report XXXA4649 00 Bundled Bundled XXXA4650 00 By Report By Report XXXA5051 00 Bundled Bundled XXXA5052 00 Bundled Bundled XXXA5053 00 Bundled Bundled XXXA5054 00 Bundled Bundled XXXA5055 00 Bundled Bundled XXXA5061 00 Bundled Bundled XXXA5062 00 Bundled Bundled XXXA5063 00 Bundled Bundled XXXA5071 00 Bundled Bundled XXXA5072 00 Bundled Bundled XXXA5073 00 Bundled Bundled XXXA5081 00 Bundled Bundled XXXA5082 00 Bundled Bundled XXX



CODE MOD

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GLOBAL

A5083 00 Bundled Bundled XXXA5093 00 Bundled Bundled XXXA5102 00 Bundled Bundled XXXA5105 00 Bundled Bundled XXXA5112 00 Bundled Bundled XXXA5113 00 Bundled Bundled XXXA5114 00 Bundled Bundled XXXA5121 00 Bundled Bundled XXXA5122 00 Bundled Bundled XXXA5126 00 Bundled Bundled XXXA5131 00 Bundled Bundled XXXA6025 00 Bundled Bundled XXXA6412 00 Bundled Bundled XXXA6413 00 Bundled Bundled XXXA9150 00 Not Covered Not Covered XXXA9152 00 Not Covered Not Covered XXXA9153 00 Not Covered Not Covered XXXA9155 00 Not Covered Not Covered XXXA9180 00 Not Covered Not Covered XXXA9270 00 Not Covered Not Covered XXXA9300 00 Not Covered Not Covered XXXA9500 00 121.70$ 121.70$ XXXA9501 00 By Report By Report XXXA9502 00 111.10$ 111.10$ XXXA9503 00 14.82$ 14.82$ XXXA9504 00 475.00$ 475.00$ XXXA9505 00 158.00$ 158.00$ XXXA9507 00 835.24$ 835.24$ XXXA9508 00 1,325.25$ 1,325.25$ XXXA9509 00 204.90$ 204.90$ XXXA9510 00 79.80$ 79.80$ XXXA9512 00 13.52$ 13.52$ XXXA9516 00 209.28$ 209.28$ XXXA9517 00 40.70$ 40.70$ XXXA9521 00 1,659.80$ 1,659.80$ XXXA9524 00 90.25$ 90.25$ XXXA9526 00 By Report By Report XXXA9527 00 By Report By Report XXXA9528 00 By Report By Report XXXA9529 00 By Report By Report XXXA9530 00 By Report By Report XXXA9531 00 By Report By Report XXX



CODE MOD

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GLOBAL

A9532 00 By Report By Report XXXA9536 00 781.15$ 781.15$ XXXA9537 00 63.06$ 63.06$ XXXA9538 00 45.60$ 45.60$ XXXA9539 00 35.72$ 35.72$ XXXA9540 00 34.20$ 34.20$ XXXA9541 00 60.96$ 60.96$ XXXA9542 00 3,990.00$ 3,990.00$ XXXA9543 00 55,880.37$ 55,880.37$ XXXA9546 00 By Report By Report XXXA9547 00 2,038.46$ 2,038.46$ XXXA9548 00 471.04$ 471.04$ XXXA9550 00 By Report By Report XXXA9551 00 683.34$ 683.34$ XXXA9552 00 250.00$ 250.00$ XXXA9553 00 439.40$ 439.40$ XXXA9554 00 39.90$ 39.90$ XXXA9555 00 520.75$ 520.75$ XXXA9556 00 124.54$ 124.54$ XXXA9557 00 242.18$ 242.18$ XXXA9558 00 43.47$ 43.47$ XXXA9559 00 85.84$ 85.84$ XXXA9560 00 106.48$ 106.48$ XXXA9561 00 50.16$ 50.16$ XXXA9562 00 883.24$ 883.24$ XXXA9563 00 347.56$ 347.56$ XXXA9564 00 331.13$ 331.13$ XXXA9566 00 By Report By Report XXXA9567 00 By Report By Report XXXA9568 00 1,235.00$ 1,235.00$ XXXA9569 00 1,659.80$ 1,659.80$ XXXA9570 00 4,076.93$ 4,076.93$ XXXA9571 00 4,076.93$ 4,076.93$ XXXA9572 00 3,405.60$ 3,405.60$ XXXA9580 00 Not Covered Not Covered XXXA9584 00 2,813.52$ 2,813.52$ XXXA9600 00 2,200.10$ 2,200.10$ XXXA9698 00 By Report By Report XXXA9699 00 Not Covered Not Covered XXXA9700 00 By Report By Report XXXA9900 00 By Report By Report XXXG0008 00 10.02$ 10.02$ XXX



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GLOBAL

G0009 00 10.02$ 10.02$ XXXG0010 00 10.02$ 10.02$ XXXG0027 00 7.23$ 7.23$ XXXG0101 00 1.13$ 67.79$ 0.79$ 47.61$ XXXG0102 00 0.65$ 39.21$ 0.25$ 15.24$ XXXG0103 00 20.44$ 20.44$ XXXG0104 00 5.08$ 304.56$ 1.66$ 99.61$ 000G0105 00 9.43$ 566.07$ 5.47$ 328.33$ 000G0105 53 4.71$ 282.76$ 2.73$ 163.58$ 000G0106 00 6.76$ 405.45$ 6.76$ 405.45$ XXXG0106 26 1.50$ 90.23$ 1.50$ 90.23$ XXXG0106 TC 5.25$ 315.22$ 5.25$ 315.22$ XXXG0108 00 1.60$ 95.72$ 1.60$ 95.72$ XXXG0109 00 0.44$ 26.39$ 0.44$ 26.39$ XXXG0117 00 1.64$ 98.22$ 1.64$ 98.22$ XXXG0118 00 1.23$ 73.80$ 1.23$ 73.80$ XXXG0120 00 6.73$ 403.81$ 6.73$ 403.81$ XXXG0120 26 1.48$ 88.59$ 1.48$ 88.59$ XXXG0120 TC 5.25$ 315.22$ 5.25$ 315.22$ XXXG0121 00 9.44$ 566.62$ 5.48$ 328.88$ 000G0121 53 4.72$ 283.31$ 2.74$ 164.12$ 000G0122 00 8.56$ 513.57$ 8.56$ 513.57$ XXXG0122 26 1.42$ 85.48$ 1.42$ 85.48$ XXXG0122 TC 7.13$ 428.09$ 7.13$ 428.09$ XXXG0123 00 22.51$ 22.51$ XXXG0124 00 0.93$ 55.50$ 0.93$ 55.50$ XXXG0127 00 0.71$ 42.36$ 0.22$ 13.35$ 000G0128 00 0.23$ 13.79$ 0.23$ 13.79$ XXXG0129 00 Not Covered Not Covered XXXG0130 00 1.03$ 61.69$ 1.03$ 61.69$ XXXG0130 26 0.33$ 19.53$ 0.33$ 19.53$ XXXG0130 TC 0.70$ 42.17$ 0.70$ 42.17$ XXXG0141 00 0.93$ 55.50$ 0.93$ 55.50$ XXXG0143 00 27.05$ 27.05$ XXXG0144 00 43.97$ 43.97$ XXXG0145 00 29.44$ 29.44$ XXXG0147 00 14.99$ 14.99$ XXXG0148 00 31.94$ 31.94$ XXXG0151 00 Not Covered Not Covered XXXG0152 00 Not Covered Not Covered XXXG0153 00 Not Covered Not Covered XXXG0155 00 Not Covered Not Covered XXX



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G0156 00 Not Covered Not Covered XXXG0157 00 Not Covered Not Covered XXXG0158 00 Not Covered Not Covered XXXG0159 00 Not Covered Not Covered XXXG0160 00 Not Covered Not Covered XXXG0161 00 Not Covered Not Covered XXXG0162 00 Not Covered Not Covered XXXG0166 00 3.38$ 202.80$ 3.38$ 202.80$ XXXG0168 00 2.82$ 169.13$ 0.67$ 40.48$ 000G0175 00 Not Covered Not Covered XXXG0176 00 Not Covered Not Covered XXXG0177 00 Not Covered Not Covered XXXG0179 00 1.20$ 71.74$ 1.20$ 71.74$ XXXG0180 00 1.54$ 92.44$ 1.54$ 92.44$ XXXG0181 00 3.10$ 186.23$ 3.10$ 186.23$ XXXG0182 00 3.11$ 186.32$ 3.11$ 186.32$ XXXG0186 00 987.22$ 987.22$ YYYG0219 00 Not Covered Not Covered XXXG0219 26 Not Covered Not Covered XXXG0219 TC Not Covered Not Covered XXXG0235 00 Not Covered Not Covered XXXG0235 26 Not Covered Not Covered XXXG0235 TC Not Covered Not Covered XXXG0237 00 0.28$ 16.94$ 0.28$ 16.94$ XXXG0238 00 0.29$ 17.57$ 0.29$ 17.57$ XXXG0239 00 0.37$ 21.99$ 0.37$ 21.99$ XXXG0245 00 1.93$ 115.78$ 1.24$ 74.16$ XXXG0246 00 1.14$ 68.58$ 0.61$ 36.42$ XXXG0247 00 2.25$ 135.30$ 0.66$ 39.45$ ZZZG0248 00 2.12$ 127.21$ 2.12$ 127.21$ XXXG0249 00 2.13$ 127.93$ 2.13$ 127.93$ XXXG0250 00 0.26$ 15.85$ 0.26$ 15.85$ XXXG0252 00 Not Covered Not Covered XXXG0252 26 2.16$ 129.48$ 2.16$ 129.48$ XXXG0252 TC Not Covered Not Covered XXXG0255 00 Not Covered Not Covered XXXG0255 26 Not Covered Not Covered XXXG0255 TC Not Covered Not Covered XXXG0257 00 Not Covered Not Covered XXXG0259 00 Not Covered Not Covered XXXG0260 00 Not Covered Not Covered XXXG0268 00 1.43$ 85.95$ 0.97$ 58.21$ 000



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G0269 00 Bundled Bundled XXXG0270 00 0.93$ 56.06$ 0.84$ 50.38$ XXXG0271 00 0.49$ 29.54$ 0.46$ 27.65$ XXXG0276 00 Not Covered Not Covered 000G0277 00 3.26$ 195.32$ 3.26$ 195.32$ XXXG0278 00 0.40$ 24.08$ 0.40$ 24.08$ ZZZG0279 00 1.60$ 95.94$ 1.60$ 95.94$ ZZZG0279 26 0.86$ 51.80$ 0.86$ 51.80$ ZZZG0279 TC 0.74$ 44.14$ 0.74$ 44.14$ ZZZG0281 00 0.41$ 24.68$ 0.41$ 24.68$ XXXG0282 00 Not Covered Not Covered XXXG0283 00 0.41$ 24.68$ 0.41$ 24.68$ XXXG0288 00 1.05$ 62.85$ 1.05$ 62.85$ XXXG0289 00 2.53$ 151.94$ 2.53$ 151.94$ ZZZG0293 00 Not Covered Not Covered XXXG0294 00 Not Covered Not Covered XXXG0295 00 Not Covered Not Covered XXXG0296 00 0.82$ 49.49$ 0.76$ 45.70$ XXXG0297 00 6.98$ 418.65$ 6.98$ 418.65$ XXXG0297 26 1.48$ 88.93$ 1.48$ 88.93$ XXXG0297 TC 5.50$ 329.72$ 5.50$ 329.72$ XXXG0299 00 Not Covered Not Covered XXXG0300 00 Not Covered Not Covered XXXG0302 00 By Report By Report XXXG0303 00 By Report By Report XXXG0304 00 By Report By Report XXXG0305 00 By Report By Report XXXG0306 00 8.63$ 8.63$ XXXG0307 00 7.18$ 7.18$ XXXG0328 00 18.05$ 18.05$ XXXG0328 QW 18.05$ 18.05$ G0329 00 0.32$ 19.31$ 0.32$ 19.31$ XXXG0333 00 Bundled Bundled XXXG0337 00 2.08$ 124.94$ 2.08$ 124.94$ XXXG0339 00 Not Covered Not Covered XXXG0340 00 Not Covered Not Covered XXXG0341 00 62.16$ 3,729.87$ 10.90$ 653.80$ 000G0342 00 20.52$ 1,231.34$ 20.52$ 1,231.34$ 090G0343 00 33.88$ 2,032.77$ 33.88$ 2,032.77$ 090G0372 00 0.25$ 15.24$ 0.25$ 15.24$ XXXG0378 00 Not Covered Not Covered XXXG0379 00 Not Covered Not Covered XXX



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G0380 00 Not Covered Not Covered XXXG0381 00 Not Covered Not Covered XXXG0382 00 Not Covered Not Covered XXXG0383 00 Not Covered Not Covered XXXG0384 00 Not Covered Not Covered XXXG0390 00 Bundled Bundled XXXG0396 00 1.03$ 61.59$ 0.95$ 57.18$ XXXG0397 00 1.92$ 115.07$ 1.85$ 111.29$ XXXG0398 00 Not Covered Not Covered XXXG0398 26 Not Covered Not Covered XXXG0398 TC Not Covered Not Covered XXXG0399 00 Not Covered Not Covered XXXG0399 26 Not Covered Not Covered XXXG0399 TC Not Covered Not Covered XXXG0400 00 Not Covered Not Covered XXXG0400 26 Not Covered Not Covered XXXG0400 TC Not Covered Not Covered XXXG0402 00 4.80$ 288.22$ 3.64$ 218.23$ XXXG0403 00 0.49$ 29.66$ 0.49$ 29.66$ XXXG0404 00 0.25$ 15.05$ 0.25$ 15.05$ XXXG0405 00 0.24$ 14.61$ 0.24$ 14.61$ XXXG0406 00 1.11$ 66.44$ 1.11$ 66.44$ XXXG0407 00 2.06$ 123.75$ 2.06$ 123.75$ XXXG0408 00 2.96$ 177.88$ 2.96$ 177.88$ XXXG0409 00 0.48$ 28.92$ 0.48$ 28.92$ XXXG0410 00 Not Covered Not Covered XXXG0411 00 Not Covered Not Covered XXXG0412 00 21.19$ 1,271.46$ 21.19$ 1,271.46$ 090G0413 00 31.18$ 1,870.79$ 31.18$ 1,870.79$ 090G0414 00 29.35$ 1,760.74$ 29.35$ 1,760.74$ 090G0415 00 40.21$ 2,412.35$ 40.21$ 2,412.35$ 090G0416 00 11.10$ 665.79$ 11.10$ 665.79$ XXXG0416 26 5.25$ 314.80$ 5.25$ 314.80$ XXXG0416 TC 5.85$ 350.99$ 5.85$ 350.99$ XXXG0420 00 3.17$ 190.19$ 3.17$ 190.19$ XXXG0421 00 0.74$ 44.49$ 0.74$ 44.49$ XXXG0422 00 3.36$ 201.43$ 3.36$ 201.43$ XXXG0423 00 3.36$ 201.43$ 3.36$ 201.43$ XXXG0424 00 0.86$ 51.45$ 0.40$ 23.70$ XXXG0425 00 2.85$ 171.07$ 2.85$ 171.07$ XXXG0426 00 3.88$ 232.73$ 3.88$ 232.73$ XXXG0427 00 5.76$ 345.49$ 5.76$ 345.49$ XXX



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G0428 00 Not Covered Not Covered XXXG0429 00 2.87$ 172.15$ 2.06$ 123.60$ 000G0432 00 19.57$ 19.57$ XXXG0433 00 18.29$ 18.29$ XXXG0433 QW 18.29$ 18.29$ G0435 00 13.32$ 13.32$ XXXG0438 00 4.96$ 297.60$ 4.96$ 297.60$ XXXG0439 00 3.37$ 202.13$ 3.37$ 202.13$ XXXG0442 00 0.53$ 31.61$ 0.27$ 16.48$ XXXG0443 00 0.75$ 45.25$ 0.68$ 40.84$ XXXG0444 00 0.53$ 31.61$ 0.27$ 16.48$ XXXG0445 00 0.80$ 47.77$ 0.68$ 40.84$ XXXG0446 00 0.75$ 45.25$ 0.68$ 40.84$ XXXG0447 00 0.74$ 44.62$ 0.68$ 40.84$ XXXG0448 00 Not Covered Not Covered XXXG0451 00 0.29$ 17.57$ 0.29$ 17.57$ XXXG0452 26 0.53$ 31.75$ 0.53$ 31.75$ XXXG0453 00 0.94$ 56.68$ 0.94$ 56.68$ XXXG0454 00 0.26$ 15.85$ 0.26$ 15.85$ XXXG0455 00 3.75$ 224.74$ 2.13$ 127.62$ 000G0458 00 By Report By Report XXXG0459 00 1.17$ 70.36$ 1.17$ 70.36$ XXXG0460 00 6.20$ 372.22$ 3.72$ 223.40$ 000G0463 00 Not Covered Not Covered XXXG0466 00 Not Covered Not Covered XXXG0467 00 Not Covered Not Covered XXXG0468 00 Not Covered Not Covered XXXG0469 00 Not Covered Not Covered XXXG0470 00 Not Covered Not Covered XXXG0471 00 5.00$ 5.00$ XXXG0472 00 46.35$ 46.35$ XXXG0472 QW 46.35$ 46.35$ G0473 00 Not Covered Not Covered XXXG0475 00 26.75$ 26.75$ XXXG0475 QW 26.75$ 26.75$ G0476 00 38.99$ 38.99$ XXXG0480 00 114.43$ 114.43$ XXXG0481 00 156.59$ 156.59$ XXXG0482 00 198.74$ 198.74$ XXXG0483 00 246.92$ 246.92$ XXXG0490 00 Not Covered Not Covered XXXG0491 00 Not Covered Not Covered XXX



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G0492 00 Not Covered Not Covered XXXG0493 00 Not Covered Not Covered XXXG0494 00 Not Covered Not Covered XXXG0495 00 Not Covered Not Covered XXXG0496 00 Not Covered Not Covered XXXG0498 00 Not Covered Not Covered YYYG0499 00 31.41$ 31.41$ XXXG0500 00 1.71$ 102.36$ 0.16$ 9.66$ XXXG0501 00 Not Covered Not Covered ZZZG0506 00 1.80$ 108.24$ 1.31$ 78.60$ ZZZG0508 00 5.98$ 358.96$ 5.98$ 358.96$ XXXG0509 00 5.64$ 338.68$ 5.64$ 338.68$ XXXG0511 00 Not Covered Not Covered XXXG0512 00 Not Covered Not Covered XXXG0513 00 1.86$ 111.63$ 1.76$ 105.32$ ZZZG0514 00 1.86$ 111.63$ 1.76$ 105.32$ ZZZG0516 00 7.07$ 423.90$ 3.13$ 188.06$ 000G0517 00 7.62$ 457.07$ 3.58$ 214.92$ 000G0518 00 13.35$ 801.00$ 5.80$ 348.23$ 000G0659 00 64.65$ 64.65$ XXXG0913 00 Code Accepted for Tracking Purpose only XXXG0914 00 Code Accepted for Tracking Purpose only XXXG0915 00 Code Accepted for Tracking Purpose only XXXG0916 00 Code Accepted for Tracking Purpose only XXXG0917 00 Code Accepted for Tracking Purpose only XXXG0918 00 Code Accepted for Tracking Purpose only XXXG6001 00 2.42$ 145.18$ 2.42$ 145.18$ XXXG6001 26 0.91$ 54.46$ 0.91$ 54.46$ XXXG6001 TC 1.51$ 90.72$ 1.51$ 90.72$ XXXG6002 00 2.24$ 134.32$ 2.24$ 134.32$ XXXG6002 26 0.60$ 36.03$ 0.60$ 36.03$ XXXG6002 TC 1.64$ 98.29$ 1.64$ 98.29$ XXXG6003 00 5.81$ 348.64$ 5.81$ 348.64$ XXXG6004 00 4.26$ 255.31$ 4.26$ 255.31$ XXXG6005 00 4.26$ 255.31$ 4.26$ 255.31$ XXXG6006 00 4.24$ 254.68$ 4.24$ 254.68$ XXXG6007 00 8.05$ 482.96$ 8.05$ 482.96$ XXXG6008 00 5.87$ 352.42$ 5.87$ 352.42$ XXXG6009 00 5.84$ 350.53$ 5.84$ 350.53$ XXXG6010 00 5.84$ 350.53$ 5.84$ 350.53$ XXXG6011 00 7.94$ 476.65$ 7.94$ 476.65$ XXXG6012 00 7.79$ 467.19$ 7.79$ 467.19$ XXX



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G6013 00 7.80$ 467.82$ 7.80$ 467.82$ XXXG6014 00 7.80$ 467.82$ 7.80$ 467.82$ XXXG6015 00 10.57$ 634.05$ 10.57$ 634.05$ XXXG6016 00 10.54$ 632.41$ 10.54$ 632.41$ XXXG6017 00 By Report By Report YYYG8395 00 Code Accepted for Tracking Purpose only XXXG8396 00 Code Accepted for Tracking Purpose only XXXG8397 00 Code Accepted for Tracking Purpose only XXXG8398 00 Code Accepted for Tracking Purpose only XXXG8399 00 Code Accepted for Tracking Purpose only XXXG8400 00 Code Accepted for Tracking Purpose only XXXG8404 00 Code Accepted for Tracking Purpose only XXXG8405 00 Code Accepted for Tracking Purpose only XXXG8410 00 Code Accepted for Tracking Purpose only XXXG8415 00 Code Accepted for Tracking Purpose only XXXG8416 00 Code Accepted for Tracking Purpose only XXXG8417 00 Code Accepted for Tracking Purpose only XXXG8418 00 Code Accepted for Tracking Purpose only XXXG8419 00 Code Accepted for Tracking Purpose only XXXG8420 00 Code Accepted for Tracking Purpose only XXXG8421 00 Code Accepted for Tracking Purpose only XXXG8422 00 Code Accepted for Tracking Purpose only XXXG8427 00 Code Accepted for Tracking Purpose only XXXG8428 00 Code Accepted for Tracking Purpose only XXXG8430 00 Code Accepted for Tracking Purpose only XXXG8431 00 Code Accepted for Tracking Purpose only XXXG8432 00 Code Accepted for Tracking Purpose only XXXG8433 00 Code Accepted for Tracking Purpose only XXXG8442 00 Code Accepted for Tracking Purpose only XXXG8450 00 Code Accepted for Tracking Purpose only XXXG8451 00 Code Accepted for Tracking Purpose only XXXG8452 00 Code Accepted for Tracking Purpose only XXXG8465 00 Code Accepted for Tracking Purpose only XXXG8473 00 Code Accepted for Tracking Purpose only XXXG8474 00 Code Accepted for Tracking Purpose only XXXG8475 00 Code Accepted for Tracking Purpose only XXXG8476 00 Code Accepted for Tracking Purpose only XXXG8477 00 Code Accepted for Tracking Purpose only XXXG8478 00 Code Accepted for Tracking Purpose only XXXG8482 00 Code Accepted for Tracking Purpose only XXXG8483 00 Code Accepted for Tracking Purpose only XXXG8484 00 Code Accepted for Tracking Purpose only XXX



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G8506 00 Code Accepted for Tracking Purpose only XXXG8509 00 Code Accepted for Tracking Purpose only XXXG8510 00 Code Accepted for Tracking Purpose only XXXG8511 00 Code Accepted for Tracking Purpose only XXXG8535 00 Code Accepted for Tracking Purpose only XXXG8536 00 Code Accepted for Tracking Purpose only XXXG8539 00 Code Accepted for Tracking Purpose only XXXG8540 00 Code Accepted for Tracking Purpose only XXXG8541 00 Code Accepted for Tracking Purpose only XXXG8542 00 Code Accepted for Tracking Purpose only XXXG8543 00 Code Accepted for Tracking Purpose only XXXG8559 00 Code Accepted for Tracking Purpose only XXXG8560 00 Code Accepted for Tracking Purpose only XXXG8561 00 Code Accepted for Tracking Purpose only XXXG8562 00 Code Accepted for Tracking Purpose only XXXG8563 00 Code Accepted for Tracking Purpose only XXXG8564 00 Code Accepted for Tracking Purpose only XXXG8565 00 Code Accepted for Tracking Purpose only XXXG8566 00 Code Accepted for Tracking Purpose only XXXG8567 00 Code Accepted for Tracking Purpose only XXXG8568 00 Code Accepted for Tracking Purpose only XXXG8569 00 Code Accepted for Tracking Purpose only XXXG8570 00 Code Accepted for Tracking Purpose only XXXG8571 00 Code Accepted for Tracking Purpose only XXXG8572 00 Code Accepted for Tracking Purpose only XXXG8573 00 Code Accepted for Tracking Purpose only XXXG8574 00 Code Accepted for Tracking Purpose only XXXG8575 00 Code Accepted for Tracking Purpose only XXXG8576 00 Code Accepted for Tracking Purpose only XXXG8577 00 Code Accepted for Tracking Purpose only XXXG8578 00 Code Accepted for Tracking Purpose only XXXG8598 00 Code Accepted for Tracking Purpose only XXXG8599 00 Code Accepted for Tracking Purpose only XXXG8600 00 Code Accepted for Tracking Purpose only XXXG8601 00 Code Accepted for Tracking Purpose only XXXG8602 00 Code Accepted for Tracking Purpose only XXXG8627 00 Code Accepted for Tracking Purpose only XXXG8628 00 Code Accepted for Tracking Purpose only XXXG8633 00 Code Accepted for Tracking Purpose only XXXG8635 00 Code Accepted for Tracking Purpose only XXXG8647 00 Code Accepted for Tracking Purpose only XXXG8648 00 Code Accepted for Tracking Purpose only XXX



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G9104 00 Code Accepted for Tracking Purpose only XXXG9105 00 Code Accepted for Tracking Purpose only XXXG9106 00 Code Accepted for Tracking Purpose only XXXG9107 00 Code Accepted for Tracking Purpose only XXXG9108 00 Code Accepted for Tracking Purpose only XXXG9109 00 Code Accepted for Tracking Purpose only XXXG9110 00 Code Accepted for Tracking Purpose only XXXG9111 00 Code Accepted for Tracking Purpose only XXXG9112 00 Code Accepted for Tracking Purpose only XXXG9113 00 Code Accepted for Tracking Purpose only XXXG9114 00 Code Accepted for Tracking Purpose only XXXG9115 00 Code Accepted for Tracking Purpose only XXXG9116 00 Code Accepted for Tracking Purpose only XXXG9117 00 Code Accepted for Tracking Purpose only XXXG9123 00 Code Accepted for Tracking Purpose only XXXG9124 00 Code Accepted for Tracking Purpose only XXXG9125 00 Code Accepted for Tracking Purpose only XXXG9126 00 Code Accepted for Tracking Purpose only XXXG9128 00 Code Accepted for Tracking Purpose only XXXG9129 00 Code Accepted for Tracking Purpose only XXXG9130 00 Code Accepted for Tracking Purpose only XXXG9131 00 Code Accepted for Tracking Purpose only XXXG9132 00 Code Accepted for Tracking Purpose only XXXG9133 00 Code Accepted for Tracking Purpose only XXXG9134 00 Code Accepted for Tracking Purpose only XXXG9135 00 Code Accepted for Tracking Purpose only XXXG9136 00 Code Accepted for Tracking Purpose only XXXG9137 00 Code Accepted for Tracking Purpose only XXXG9138 00 Code Accepted for Tracking Purpose only XXXG9139 00 Code Accepted for Tracking Purpose only XXXG9140 00 Code Accepted for Tracking Purpose only XXXG9143 00 134.13$ 134.13$ XXXG9147 00 Code Accepted for Tracking Purpose only XXXG9148 00 Not Covered Not Covered XXXG9149 00 Not Covered Not Covered XXXG9150 00 Not Covered Not Covered XXXG9151 00 Not Covered Not Covered XXXG9152 00 Not Covered Not Covered XXXG9153 00 Not Covered Not Covered XXXG9156 00 Not Covered Not Covered XXXG9157 00 2.78$ 166.94$ 2.78$ 166.94$ XXXG9187 00 1.29$ 77.48$ 1.29$ 77.48$ XXX



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G9312 00 Code Accepted for Tracking Purpose only XXXG9313 00 Code Accepted for Tracking Purpose only XXXG9314 00 Code Accepted for Tracking Purpose only XXXG9315 00 Code Accepted for Tracking Purpose only XXXG9316 00 Code Accepted for Tracking Purpose only XXXG9317 00 Code Accepted for Tracking Purpose only XXXG9318 00 Code Accepted for Tracking Purpose only XXXG9319 00 Code Accepted for Tracking Purpose only XXXG9321 00 Code Accepted for Tracking Purpose only XXXG9322 00 Code Accepted for Tracking Purpose only XXXG9326 00 Code Accepted for Tracking Purpose only XXXG9327 00 Code Accepted for Tracking Purpose only XXXG9329 00 Code Accepted for Tracking Purpose only XXXG9340 00 Code Accepted for Tracking Purpose only XXXG9341 00 Code Accepted for Tracking Purpose only XXXG9342 00 Code Accepted for Tracking Purpose only XXXG9344 00 Code Accepted for Tracking Purpose only XXXG9345 00 Code Accepted for Tracking Purpose only XXXG9347 00 Code Accepted for Tracking Purpose only XXXG9348 00 Code Accepted for Tracking Purpose only XXXG9349 00 Code Accepted for Tracking Purpose only XXXG9350 00 Code Accepted for Tracking Purpose only XXXG9351 00 Code Accepted for Tracking Purpose only XXXG9352 00 Code Accepted for Tracking Purpose only XXXG9353 00 Code Accepted for Tracking Purpose only XXXG9354 00 Code Accepted for Tracking Purpose only XXXG9355 00 Code Accepted for Tracking Purpose only XXXG9356 00 Code Accepted for Tracking Purpose only XXXG9357 00 Code Accepted for Tracking Purpose only XXXG9358 00 Code Accepted for Tracking Purpose only XXXG9359 00 Code Accepted for Tracking Purpose only XXXG9360 00 Code Accepted for Tracking Purpose only XXXG9361 00 Not Covered Not Covered XXXG9364 00 Code Accepted for Tracking Purpose only XXXG9365 00 Code Accepted for Tracking Purpose only XXXG9366 00 Code Accepted for Tracking Purpose only XXXG9367 00 Code Accepted for Tracking Purpose only XXXG9368 00 Code Accepted for Tracking Purpose only XXXG9380 00 Code Accepted for Tracking Purpose only XXXG9382 00 Code Accepted for Tracking Purpose only XXXG9383 00 Code Accepted for Tracking Purpose only XXXG9384 00 Code Accepted for Tracking Purpose only XXX



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G9434 00 Code Accepted for Tracking Purpose only XXXG9448 00 Code Accepted for Tracking Purpose only XXXG9449 00 Code Accepted for Tracking Purpose only XXXG9450 00 Code Accepted for Tracking Purpose only XXXG9451 00 Code Accepted for Tracking Purpose only XXXG9452 00 Code Accepted for Tracking Purpose only XXXG9453 00 Code Accepted for Tracking Purpose only XXXG9454 00 Code Accepted for Tracking Purpose only XXXG9455 00 Code Accepted for Tracking Purpose only XXXG9456 00 Code Accepted for Tracking Purpose only XXXG9457 00 Code Accepted for Tracking Purpose only XXXG9458 00 Code Accepted for Tracking Purpose only XXXG9459 00 Code Accepted for Tracking Purpose only XXXG9460 00 Code Accepted for Tracking Purpose only XXXG9468 00 Code Accepted for Tracking Purpose only XXXG9469 00 Code Accepted for Tracking Purpose only XXXG9470 00 Code Accepted for Tracking Purpose only XXXG9471 00 Code Accepted for Tracking Purpose only XXXG9473 00 Not Covered Not Covered XXXG9474 00 Not Covered Not Covered XXXG9475 00 Not Covered Not Covered XXXG9476 00 Not Covered Not Covered XXXG9477 00 Not Covered Not Covered XXXG9478 00 Not Covered Not Covered XXXG9479 00 Not Covered Not Covered XXXG9480 00 Not Covered Not Covered XXXG9481 00 Not Covered Not Covered XXXG9482 00 Not Covered Not Covered XXXG9483 00 Not Covered Not Covered XXXG9484 00 Not Covered Not Covered XXXG9485 00 Not Covered Not Covered XXXG9486 00 Not Covered Not Covered XXXG9487 00 Not Covered Not Covered XXXG9488 00 Not Covered Not Covered XXXG9489 00 Not Covered Not Covered XXXG9490 00 Not Covered Not Covered XXXG9497 00 Code Accepted for Tracking Purpose only XXXG9498 00 Code Accepted for Tracking Purpose only XXXG9500 00 Code Accepted for Tracking Purpose only XXXG9501 00 Code Accepted for Tracking Purpose only XXXG9502 00 Code Accepted for Tracking Purpose only XXXG9503 00 Code Accepted for Tracking Purpose only XXX



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G9662 00 Code Accepted for Tracking Purpose only XXXG9663 00 Code Accepted for Tracking Purpose only XXXG9664 00 Code Accepted for Tracking Purpose only XXXG9665 00 Code Accepted for Tracking Purpose only XXXG9666 00 Code Accepted for Tracking Purpose only XXXG9674 00 Code Accepted for Tracking Purpose only XXXG9675 00 Code Accepted for Tracking Purpose only XXXG9676 00 Code Accepted for Tracking Purpose only XXXG9678 00 Not Covered Not Covered XXXG9679 00 By Report By Report XXXG9680 00 By Report By Report XXXG9681 00 By Report By Report XXXG9682 00 By Report By Report XXXG9683 00 By Report By Report XXXG9684 00 By Report By Report XXXG9685 00 Not Covered Not Covered XXXG9687 00 Code Accepted for Tracking Purpose only XXXG9688 00 Code Accepted for Tracking Purpose only XXXG9689 00 Code Accepted for Tracking Purpose only XXXG9690 00 Code Accepted for Tracking Purpose only XXXG9691 00 Code Accepted for Tracking Purpose only XXXG9692 00 Code Accepted for Tracking Purpose only XXXG9693 00 Code Accepted for Tracking Purpose only XXXG9694 00 Code Accepted for Tracking Purpose only XXXG9695 00 Code Accepted for Tracking Purpose only XXXG9696 00 Code Accepted for Tracking Purpose only XXXG9697 00 Code Accepted for Tracking Purpose only XXXG9698 00 Code Accepted for Tracking Purpose only XXXG9699 00 Code Accepted for Tracking Purpose only XXXG9700 00 Code Accepted for Tracking Purpose only XXXG9701 00 Code Accepted for Tracking Purpose only XXXG9702 00 Code Accepted for Tracking Purpose only XXXG9703 00 Code Accepted for Tracking Purpose only XXXG9704 00 Code Accepted for Tracking Purpose only XXXG9705 00 Code Accepted for Tracking Purpose only XXXG9706 00 Code Accepted for Tracking Purpose only XXXG9707 00 Code Accepted for Tracking Purpose only XXXG9708 00 Code Accepted for Tracking Purpose only XXXG9709 00 Code Accepted for Tracking Purpose only XXXG9710 00 Code Accepted for Tracking Purpose only XXXG9711 00 Code Accepted for Tracking Purpose only XXXG9712 00 Code Accepted for Tracking Purpose only XXX



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G9841 00 Code Accepted for Tracking Purpose only XXXG9842 00 Code Accepted for Tracking Purpose only XXXG9843 00 Code Accepted for Tracking Purpose only XXXG9844 00 Code Accepted for Tracking Purpose only XXXG9845 00 Code Accepted for Tracking Purpose only XXXG9846 00 Code Accepted for Tracking Purpose only XXXG9847 00 Code Accepted for Tracking Purpose only XXXG9848 00 Code Accepted for Tracking Purpose only XXXG9849 00 Code Accepted for Tracking Purpose only XXXG9850 00 Code Accepted for Tracking Purpose only XXXG9851 00 Code Accepted for Tracking Purpose only XXXG9852 00 Code Accepted for Tracking Purpose only XXXG9853 00 Code Accepted for Tracking Purpose only XXXG9854 00 Code Accepted for Tracking Purpose only XXXG9855 00 Code Accepted for Tracking Purpose only XXXG9856 00 Code Accepted for Tracking Purpose only XXXG9857 00 Code Accepted for Tracking Purpose only XXXG9858 00 Code Accepted for Tracking Purpose only XXXG9859 00 Code Accepted for Tracking Purpose only XXXG9860 00 Code Accepted for Tracking Purpose only XXXG9861 00 Code Accepted for Tracking Purpose only XXXG9862 00 Code Accepted for Tracking Purpose only XXXG9868 00 Not Covered Not Covered XXXG9869 00 Not Covered Not Covered XXXG9870 00 Not Covered Not Covered XXXG9890 00 Code Accepted for Tracking Purpose only XXXG9890 00 Code Accepted for Tracking Purpose only XXXG9891 00 Code Accepted for Tracking Purpose only XXXG9891 00 Code Accepted for Tracking Purpose only XXXG9892 00 Code Accepted for Tracking Purpose only XXXG9893 00 Code Accepted for Tracking Purpose only XXXG9894 00 Code Accepted for Tracking Purpose only XXXG9895 00 Code Accepted for Tracking Purpose only XXXG9896 00 Code Accepted for Tracking Purpose only XXXG9897 00 Code Accepted for Tracking Purpose only XXXG9898 00 Code Accepted for Tracking Purpose only XXXG9899 00 Code Accepted for Tracking Purpose only XXXG9900 00 Code Accepted for Tracking Purpose only XXXG9901 00 Code Accepted for Tracking Purpose only XXXG9902 00 Code Accepted for Tracking Purpose only XXXG9903 00 Code Accepted for Tracking Purpose only XXXG9904 00 Code Accepted for Tracking Purpose only XXX



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G9954 00 Code Accepted for Tracking Purpose only XXXG9955 00 Code Accepted for Tracking Purpose only XXXG9956 00 Code Accepted for Tracking Purpose only XXXG9957 00 Code Accepted for Tracking Purpose only XXXG9958 00 Code Accepted for Tracking Purpose only XXXG9959 00 Code Accepted for Tracking Purpose only XXXG9960 00 Code Accepted for Tracking Purpose only XXXG9961 00 Code Accepted for Tracking Purpose only XXXG9962 00 Code Accepted for Tracking Purpose only XXXG9963 00 Code Accepted for Tracking Purpose only XXXG9964 00 Code Accepted for Tracking Purpose only XXXG9965 00 Code Accepted for Tracking Purpose only XXXG9966 00 Code Accepted for Tracking Purpose only XXXG9967 00 Code Accepted for Tracking Purpose only XXXG9968 00 Code Accepted for Tracking Purpose only XXXG9969 00 Code Accepted for Tracking Purpose only XXXG9970 00 Code Accepted for Tracking Purpose only XXXG9974 00 Code Accepted for Tracking Purpose only XXXG9975 00 Code Accepted for Tracking Purpose only XXXH0001 00 Not Covered Not Covered XXXH0002 00 Not Covered Not Covered XXXH0003 00 Not Covered Not Covered XXXH0004 00 Not Covered Not Covered XXXH0005 00 Not Covered Not Covered XXXH0006 00 Not Covered Not Covered XXXH0007 00 Not Covered Not Covered XXXH0008 00 Not Covered Not Covered XXXH0009 00 Not Covered Not Covered XXXH0010 00 Not Covered Not Covered XXXH0011 00 Not Covered Not Covered XXXH0012 00 Not Covered Not Covered XXXH0013 00 Not Covered Not Covered XXXH0014 00 Not Covered Not Covered XXXH0015 00 Not Covered Not Covered XXXH0016 00 Not Covered Not Covered XXXH0017 00 Not Covered Not Covered XXXH0018 00 Not Covered Not Covered XXXH0019 00 Not Covered Not Covered XXXH0020 00 Not Covered Not Covered XXXH0021 00 Not Covered Not Covered XXXH0022 00 Not Covered Not Covered XXXH0023 00 Not Covered Not Covered XXX



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H0024 00 Not Covered Not Covered XXXH0025 00 Not Covered Not Covered XXXH0026 00 Not Covered Not Covered XXXH0027 00 Not Covered Not Covered XXXH0028 00 Not Covered Not Covered XXXH0029 00 Not Covered Not Covered XXXH0030 00 Not Covered Not Covered XXXH0031 00 Not Covered Not Covered XXXH0032 00 Not Covered Not Covered XXXH0033 00 Not Covered Not Covered XXXH0034 00 Not Covered Not Covered XXXH0035 00 Not Covered Not Covered XXXH0036 00 Not Covered Not Covered XXXH0037 00 Not Covered Not Covered XXXH0038 00 Not Covered Not Covered XXXH0039 00 Not Covered Not Covered XXXH0040 00 Not Covered Not Covered XXXH0041 00 Not Covered Not Covered XXXH0042 00 Not Covered Not Covered XXXH0043 00 Not Covered Not Covered XXXH0044 00 Not Covered Not Covered XXXH0045 00 Not Covered Not Covered XXXH0046 00 Not Covered Not Covered XXXH0047 00 Not Covered Not Covered XXXH0048 00 Not Covered Not Covered XXXH0049 00 Not Covered Not Covered XXXH0050 00 Not Covered Not Covered XXXH1000 00 Not Covered Not Covered XXXH1001 00 Not Covered Not Covered XXXH1002 00 Not Covered Not Covered XXXH1003 00 Not Covered Not Covered XXXH1004 00 Not Covered Not Covered XXXH1005 00 Not Covered Not Covered XXXH1010 00 Not Covered Not Covered XXXH1011 00 Not Covered Not Covered XXXH2000 00 Not Covered Not Covered XXXH2001 00 Not Covered Not Covered XXXH2010 00 Not Covered Not Covered XXXH2011 00 Not Covered Not Covered XXXH2012 00 Not Covered Not Covered XXXH2013 00 Not Covered Not Covered XXXH2014 00 Not Covered Not Covered XXX



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H2015 00 Not Covered Not Covered XXXH2016 00 Not Covered Not Covered XXXH2017 00 Not Covered Not Covered XXXH2018 00 Not Covered Not Covered XXXH2019 00 Not Covered Not Covered XXXH2020 00 Not Covered Not Covered XXXH2021 00 Not Covered Not Covered XXXH2022 00 Not Covered Not Covered XXXH2023 00 Not Covered Not Covered XXXH2024 00 Not Covered Not Covered XXXH2025 00 Not Covered Not Covered XXXH2026 00 Not Covered Not Covered XXXH2027 00 Not Covered Not Covered XXXH2028 00 Not Covered Not Covered XXXH2029 00 Not Covered Not Covered XXXH2030 00 Not Covered Not Covered XXXH2031 00 Not Covered Not Covered XXXH2032 00 Not Covered Not Covered XXXH2033 00 Not Covered Not Covered XXXH2034 00 Not Covered Not Covered XXXH2035 00 Not Covered Not Covered XXXH2036 00 Not Covered Not Covered XXXH2037 00 Not Covered Not Covered XXXM0075 00 Not Covered Not Covered XXXM0076 00 Not Covered Not Covered XXXM0100 00 Not Covered Not Covered XXXM0300 00 Not Covered Not Covered XXXM0301 00 Not Covered Not Covered XXXP2028 00 5.50$ 5.50$ XXXP2029 00 5.50$ 5.50$ XXXP2031 00 5.50$ 5.50$ XXXP2033 00 5.50$ 5.50$ XXXP2038 00 5.50$ 5.50$ XXXP3000 00 14.99$ 14.99$ XXXP3001 00 0.93$ 55.50$ 0.93$ 55.50$ XXXP7001 00 Not Covered Not Covered XXXP9010 00 55.11$ 55.11$ XXXP9011 00 By Report By Report XXXP9012 00 26.20$ 26.20$ XXXP9016 00 45.53$ 45.53$ XXXP9017 00 47.82$ 47.82$ XXXP9019 00 By Report By Report XXX



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P9020 00 By Report By Report XXXP9021 00 66.64$ 66.64$ XXXP9022 00 20.50$ 20.50$ XXXP9023 00 By Report By Report XXXP9031 00 By Report By Report XXXP9032 00 By Report By Report XXXP9033 00 By Report By Report XXXP9034 00 By Report By Report XXXP9035 00 By Report By Report XXXP9036 00 By Report By Report XXXP9037 00 By Report By Report XXXP9038 00 By Report By Report XXXP9039 00 By Report By Report XXXP9040 00 By Report By Report XXXP9050 00 By Report By Report XXXP9073 00 By Report By Report XXXP9100 00 By Report By Report XXXP9603 00 Not Covered Not Covered XXXP9604 00 Not Covered Not Covered XXXP9612 00 3.00$ 3.00$ XXXP9615 00 3.00$ 3.00$ XXXQ0035 00 0.59$ 35.34$ 0.59$ 35.34$ XXXQ0035 26 0.25$ 15.24$ 0.25$ 15.24$ XXXQ0035 TC 0.33$ 20.10$ 0.33$ 20.10$ XXXQ0081 00 Not Covered Not Covered XXXQ0083 00 Not Covered Not Covered XXXQ0084 00 Not Covered Not Covered XXXQ0085 00 Not Covered Not Covered XXXQ0091 00 1.27$ 76.27$ 0.56$ 33.39$ XXXQ0092 00 0.71$ 42.80$ 0.71$ 42.80$ XXXQ0111 00 14.99$ 14.99$ XXXQ0112 00 5.83$ 5.83$ XXXQ0113 00 4.75$ 4.75$ XXXQ0114 00 9.74$ 9.74$ XXXQ0115 00 25.00$ 25.00$ XXXQ0507 00 By Report By Report XXXQ0508 00 By Report By Report XXXQ0509 00 By Report By Report XXXQ0510 00 Not Covered Not Covered XXXQ0511 00 Not Covered Not Covered XXXQ0512 00 Not Covered Not Covered XXXQ0513 00 Not Covered Not Covered XXX



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Q0514 00 Not Covered Not Covered XXXQ3014 00 24.63$ 24.63$ XXXQ3031 00 Not Covered Not Covered XXXQ4001 00 47.85$ 47.85$ XXXQ4002 00 180.82$ 180.82$ XXXQ4003 00 34.36$ 34.36$ XXXQ4004 00 118.96$ 118.96$ XXXQ4005 00 12.67$ 12.67$ XXXQ4006 00 28.55$ 28.55$ XXXQ4007 00 6.34$ 6.34$ XXXQ4008 00 14.27$ 14.27$ XXXQ4009 00 8.46$ 8.46$ XXXQ4010 00 19.04$ 19.04$ XXXQ4011 00 4.22$ 4.22$ XXXQ4012 00 9.53$ 9.53$ XXXQ4013 00 15.40$ 15.40$ XXXQ4014 00 25.97$ 25.97$ XXXQ4015 00 7.71$ 7.71$ XXXQ4016 00 12.98$ 12.98$ XXXQ4017 00 8.91$ 8.91$ XXXQ4018 00 14.19$ 14.19$ XXXQ4019 00 4.46$ 4.46$ XXXQ4020 00 7.11$ 7.11$ XXXQ4021 00 6.59$ 6.59$ XXXQ4022 00 11.89$ 11.89$ XXXQ4023 00 3.31$ 3.31$ XXXQ4024 00 5.95$ 5.95$ XXXQ4025 00 36.94$ 36.94$ XXXQ4026 00 115.34$ 115.34$ XXXQ4027 00 18.48$ 18.48$ XXXQ4028 00 57.69$ 57.69$ XXXQ4029 00 28.25$ 28.25$ XXXQ4030 00 74.36$ 74.36$ XXXQ4031 00 14.12$ 14.12$ XXXQ4032 00 37.18$ 37.18$ XXXQ4033 00 26.35$ 26.35$ XXXQ4034 00 65.54$ 65.54$ XXXQ4035 00 13.17$ 13.17$ XXXQ4036 00 32.78$ 32.78$ XXXQ4037 00 16.07$ 16.07$ XXXQ4038 00 40.27$ 40.27$ XXXQ4039 00 8.05$ 8.05$ XXX



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Q4040 00 20.13$ 20.13$ XXXQ4041 00 19.55$ 19.55$ XXXQ4042 00 33.37$ 33.37$ XXXQ4043 00 9.78$ 9.78$ XXXQ4044 00 16.69$ 16.69$ XXXQ4045 00 11.35$ 11.35$ XXXQ4046 00 18.25$ 18.25$ XXXQ4047 00 5.66$ 5.66$ XXXQ4048 00 9.13$ 9.13$ XXXQ4049 00 2.07$ 2.07$ XXXQ5001 00 Not Covered Not Covered XXXQ5002 00 Not Covered Not Covered XXXQ5003 00 Not Covered Not Covered XXXQ5004 00 Not Covered Not Covered XXXQ5005 00 Not Covered Not Covered XXXQ5006 00 Not Covered Not Covered XXXQ5007 00 Not Covered Not Covered XXXQ5008 00 Not Covered Not Covered XXXQ5009 00 Not Covered Not Covered XXXQ5010 00 Not Covered Not Covered XXXR0070 00 97.60$ 97.60$ XXXR0075 00 Not Covered Not Covered XXXR0076 00 Bundled Bundled XXXS0199 00 Not Covered Not Covered XXXS0201 00 Not Covered Not Covered XXXS0207 00 Not Covered Not Covered XXXS0208 00 Not Covered Not Covered XXXS0209 00 Not Covered Not Covered XXXS0215 00 Not Covered Not Covered XXXS0220 00 Not Covered Not Covered XXXS0221 00 Not Covered Not Covered XXXS0250 00 Not Covered Not Covered XXXS0255 00 Not Covered Not Covered XXXS0257 00 Not Covered Not Covered XXXS0260 00 Not Covered Not Covered XXXS0265 00 Not Covered Not Covered XXXS0270 00 Not Covered Not Covered XXXS0271 00 Not Covered Not Covered XXXS0272 00 Not Covered Not Covered XXXS0273 00 Not Covered Not Covered XXXS0274 00 Not Covered Not Covered XXXS0280 00 Not Covered Not Covered XXX



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S0281 00 Not Covered Not Covered XXXS0285 00 Not Covered Not Covered XXXS0302 00 Not Covered Not Covered XXXS0310 00 Not Covered Not Covered XXXS0311 00 Not Covered Not Covered XXXS0315 00 Not Covered Not Covered XXXS0316 00 Not Covered Not Covered XXXS0317 00 Not Covered Not Covered XXXS0320 00 Not Covered Not Covered XXXS0340 00 Not Covered Not Covered XXXS0341 00 Not Covered Not Covered XXXS0342 00 Not Covered Not Covered XXXS0353 00 Not Covered Not Covered XXXS0354 00 Not Covered Not Covered XXXS0390 00 Not Covered Not Covered XXXS0395 00 Not Covered Not Covered XXXS0400 00 Not Covered Not Covered XXXS0500 00 Not Covered Not Covered XXXS0504 00 Not Covered Not Covered XXXS0506 00 Not Covered Not Covered XXXS0508 00 Not Covered Not Covered XXXS0510 00 Not Covered Not Covered XXXS0512 00 Not Covered Not Covered XXXS0514 00 Not Covered Not Covered XXXS0515 00 Not Covered Not Covered XXXS0516 00 Not Covered Not Covered XXXS0518 00 Not Covered Not Covered XXXS0580 00 Not Covered Not Covered XXXS0581 00 Not Covered Not Covered XXXS0590 00 Not Covered Not Covered XXXS0592 00 Not Covered Not Covered XXXS0595 00 Not Covered Not Covered XXXS0596 00 Not Covered Not Covered XXXS0601 00 Not Covered Not Covered XXXS0610 00 Not Covered Not Covered XXXS0612 00 Not Covered Not Covered XXXS0613 00 Not Covered Not Covered XXXS0618 00 Not Covered Not Covered XXXS0620 00 Not Covered Not Covered XXXS0621 00 Not Covered Not Covered XXXS0622 00 Not Covered Not Covered XXXS0630 00 Not Covered Not Covered XXX



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S0800 00 Not Covered Not Covered XXXS0810 00 Not Covered Not Covered XXXS0812 00 Not Covered Not Covered XXXS1001 00 Not Covered Not Covered XXXS1002 00 Not Covered Not Covered XXXS1015 00 Not Covered Not Covered XXXS1016 00 Not Covered Not Covered XXXS1030 00 Not Covered Not Covered XXXS1031 00 Not Covered Not Covered XXXS1034 00 Not Covered Not Covered XXXS1035 00 Not Covered Not Covered XXXS1036 00 Not Covered Not Covered XXXS1037 00 Not Covered Not Covered XXXS1040 00 Not Covered Not Covered XXXS2053 00 Not Covered Not Covered XXXS2054 00 Not Covered Not Covered XXXS2055 00 Not Covered Not Covered XXXS2060 00 Not Covered Not Covered XXXS2061 00 Not Covered Not Covered XXXS2065 00 Not Covered Not Covered XXXS2066 00 1,564.72$ 1,564.72$ XXXS2067 00 780.13$ 780.13$ XXXS2068 00 By Report By Report XXXS2070 00 Not Covered Not Covered XXXS2079 00 Not Covered Not Covered XXXS2080 00 Not Covered Not Covered XXXS2083 00 Not Covered Not Covered XXXS2095 00 Not Covered Not Covered XXXS2102 00 Not Covered Not Covered XXXS2103 00 Not Covered Not Covered XXXS2107 00 Not Covered Not Covered XXXS2112 00 Not Covered Not Covered XXXS2115 00 Not Covered Not Covered XXXS2117 00 Not Covered Not Covered XXXS2118 00 Not Covered Not Covered XXXS2120 00 Not Covered Not Covered XXXS2140 00 Not Covered Not Covered XXXS2142 00 Not Covered Not Covered XXXS2150 00 Not Covered Not Covered XXXS2152 00 Not Covered Not Covered XXXS2202 00 Not Covered Not Covered XXXS2205 00 Not Covered Not Covered XXX



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S2206 00 Not Covered Not Covered XXXS2207 00 Not Covered Not Covered XXXS2208 00 Not Covered Not Covered XXXS2209 00 Not Covered Not Covered XXXS2225 00 Not Covered Not Covered XXXS2230 00 Not Covered Not Covered XXXS2235 00 Not Covered Not Covered XXXS2260 00 Not Covered Not Covered XXXS2265 00 Not Covered Not Covered XXXS2266 00 Not Covered Not Covered XXXS2267 00 Not Covered Not Covered XXXS2300 00 Not Covered Not Covered XXXS2325 00 By Report By Report XXXS2340 00 Not Covered Not Covered XXXS2341 00 Not Covered Not Covered XXXS2342 00 Not Covered Not Covered XXXS2348 00 Not Covered Not Covered XXXS2350 00 Not Covered Not Covered XXXS2351 00 Not Covered Not Covered XXXS2400 00 Not Covered Not Covered XXXS2401 00 Not Covered Not Covered XXXS2402 00 Not Covered Not Covered XXXS2403 00 Not Covered Not Covered XXXS2404 00 Not Covered Not Covered XXXS2405 00 Not Covered Not Covered XXXS2409 00 Not Covered Not Covered XXXS2411 00 Not Covered Not Covered XXXS2900 00 Not Covered Not Covered XXXS3000 00 Not Covered Not Covered XXXS3005 00 Not Covered Not Covered XXXS3600 00 Not Covered Not Covered XXXS3601 00 Not Covered Not Covered XXXS3620 00 Not Covered Not Covered XXXS3630 00 Not Covered Not Covered XXXS3645 00 Not Covered Not Covered XXXS3650 00 Not Covered Not Covered XXXS3652 00 Not Covered Not Covered XXXS3655 00 Not Covered Not Covered XXXS3708 00 Not Covered Not Covered XXXS3722 00 Not Covered Not Covered XXXS3800 00 Not Covered Not Covered XXXS3840 00 Not Covered Not Covered XXX



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S3841 00 Not Covered Not Covered XXXS3842 00 Not Covered Not Covered XXXS3844 00 Not Covered Not Covered XXXS3845 00 Not Covered Not Covered XXXS3846 00 Not Covered Not Covered XXXS3849 00 Not Covered Not Covered XXXS3850 00 Not Covered Not Covered XXXS3852 00 Not Covered Not Covered XXXS3853 00 Not Covered Not Covered XXXS3854 00 By Report By Report XXXS3861 00 Not Covered Not Covered XXXS3865 00 Not Covered Not Covered XXXS3866 00 Not Covered Not Covered XXXS3870 00 Not Covered Not Covered XXXS3900 00 Not Covered Not Covered XXXS3902 00 Not Covered Not Covered XXXS3904 00 Not Covered Not Covered XXXS4005 00 Not Covered Not Covered XXXS4011 00 Not Covered Not Covered XXXS4013 00 Not Covered Not Covered XXXS4014 00 Not Covered Not Covered XXXS4015 00 Not Covered Not Covered XXXS4016 00 Not Covered Not Covered XXXS4017 00 Not Covered Not Covered XXXS4018 00 Not Covered Not Covered XXXS4020 00 Not Covered Not Covered XXXS4021 00 Not Covered Not Covered XXXS4022 00 Not Covered Not Covered XXXS4023 00 Not Covered Not Covered XXXS4025 00 Not Covered Not Covered XXXS4026 00 Not Covered Not Covered XXXS4027 00 Not Covered Not Covered XXXS4028 00 Not Covered Not Covered XXXS4030 00 Not Covered Not Covered XXXS4031 00 Not Covered Not Covered XXXS4035 00 Not Covered Not Covered XXXS4037 00 Not Covered Not Covered XXXS4040 00 Not Covered Not Covered XXXS4042 00 Not Covered Not Covered XXXS4981 00 Not Covered Not Covered XXXS4989 00 Not Covered Not Covered XXXS4990 00 Not Covered Not Covered XXX



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S5181 00 Not Covered Not Covered XXXS5185 00 Not Covered Not Covered XXXS5190 00 Not Covered Not Covered XXXS5199 00 Not Covered Not Covered XXXS5497 00 Not Covered Not Covered XXXS5498 00 Not Covered Not Covered XXXS5501 00 Not Covered Not Covered XXXS5502 00 Not Covered Not Covered XXXS5517 00 Not Covered Not Covered XXXS5518 00 Not Covered Not Covered XXXS5520 00 Not Covered Not Covered XXXS5521 00 Not Covered Not Covered XXXS5522 00 Not Covered Not Covered XXXS5523 00 Not Covered Not Covered XXXS5550 00 Not Covered Not Covered XXXS5551 00 Not Covered Not Covered XXXS5552 00 Not Covered Not Covered XXXS5553 00 Not Covered Not Covered XXXS5560 00 Not Covered Not Covered XXXS5561 00 Not Covered Not Covered XXXS5565 00 Not Covered Not Covered XXXS5566 00 Not Covered Not Covered XXXS5570 00 Not Covered Not Covered XXXS5571 00 Not Covered Not Covered XXXS8030 00 By Report By Report XXXS8035 00 Not Covered Not Covered XXXS8037 00 Not Covered Not Covered XXXS8040 00 Not Covered Not Covered XXXS8042 00 Not Covered Not Covered XXXS8055 00 Not Covered Not Covered XXXS8080 00 Not Covered Not Covered XXXS8085 00 Not Covered Not Covered XXXS8092 00 Not Covered Not Covered XXXS8096 00 Not Covered Not Covered XXXS8097 00 Not Covered Not Covered XXXS8100 00 Not Covered Not Covered XXXS8101 00 Not Covered Not Covered XXXS8110 00 Not Covered Not Covered XXXS8120 00 Not Covered Not Covered XXXS8121 00 Not Covered Not Covered XXXS8130 00 Not Covered Not Covered XXXS8131 00 Not Covered Not Covered XXX



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S9097 00 Not Covered Not Covered XXXS9098 00 Not Covered Not Covered XXXS9110 00 Not Covered Not Covered XXXS9117 00 Not Covered Not Covered XXXS9122 00 Not Covered Not Covered XXXS9123 00 Not Covered Not Covered XXXS9124 00 Not Covered Not Covered XXXS9125 00 Not Covered Not Covered XXXS9126 00 Not Covered Not Covered XXXS9127 00 Not Covered Not Covered XXXS9128 00 Not Covered Not Covered XXXS9129 00 Not Covered Not Covered XXXS9131 00 Not Covered Not Covered XXXS9140 00 Not Covered Not Covered XXXS9141 00 Not Covered Not Covered XXXS9145 00 Not Covered Not Covered XXXS9150 00 Not Covered Not Covered XXXS9152 00 49.60$ 49.60$ XXXS9208 00 Not Covered Not Covered XXXS9209 00 Not Covered Not Covered XXXS9211 00 Not Covered Not Covered XXXS9212 00 Not Covered Not Covered XXXS9213 00 Not Covered Not Covered XXXS9214 00 Not Covered Not Covered XXXS9325 00 Not Covered Not Covered XXXS9326 00 Not Covered Not Covered XXXS9327 00 Not Covered Not Covered XXXS9328 00 Not Covered Not Covered XXXS9329 00 Not Covered Not Covered XXXS9330 00 Not Covered Not Covered XXXS9331 00 Not Covered Not Covered XXXS9335 00 Not Covered Not Covered XXXS9336 00 Not Covered Not Covered XXXS9338 00 Not Covered Not Covered XXXS9339 00 Not Covered Not Covered XXXS9340 00 Not Covered Not Covered XXXS9341 00 Not Covered Not Covered XXXS9342 00 Not Covered Not Covered XXXS9343 00 Not Covered Not Covered XXXS9345 00 Not Covered Not Covered XXXS9346 00 Not Covered Not Covered XXXS9347 00 Not Covered Not Covered XXX



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S9982 00 Not Covered Not Covered XXXS9986 00 Not Covered Not Covered XXXS9988 00 Not Covered Not Covered XXXS9989 00 Not Covered Not Covered XXXS9990 00 Not Covered Not Covered XXXS9991 00 Not Covered Not Covered XXXS9992 00 Not Covered Not Covered XXXS9994 00 Not Covered Not Covered XXXS9996 00 Not Covered Not Covered XXXS9999 00 Not Covered Not Covered XXXT1000 00 Not Covered Not Covered XXXT1001 00 Not Covered Not Covered XXXT1002 00 Not Covered Not Covered XXXT1003 00 Not Covered Not Covered XXXT1004 00 Not Covered Not Covered XXXT1005 00 Not Covered Not Covered XXXT1006 00 Not Covered Not Covered XXXT1007 00 Not Covered Not Covered XXXT1009 00 Not Covered Not Covered XXXT1010 00 Not Covered Not Covered XXXT1012 00 Not Covered Not Covered XXXT1013 00 Not Covered Not Covered XXXT1014 00 Not Covered Not Covered XXXT1015 00 Not Covered Not Covered XXXT1016 00 Not Covered Not Covered XXXT1017 00 Not Covered Not Covered XXXT1018 00 Not Covered Not Covered XXXT1019 00 Not Covered Not Covered XXXT1020 00 Not Covered Not Covered XXXT1021 00 Not Covered Not Covered XXXT1022 00 Not Covered Not Covered XXXT1023 00 Not Covered Not Covered XXXT1024 00 Not Covered Not Covered XXXT1025 00 Not Covered Not Covered XXXT1026 00 Not Covered Not Covered XXXT1027 00 Not Covered Not Covered XXXT1028 00 Not Covered Not Covered XXXT1029 00 Not Covered Not Covered XXXT1030 00 Not Covered Not Covered XXXT1031 00 Not Covered Not Covered XXXT1040 00 Not Covered Not Covered XXXT1041 00 Not Covered Not Covered XXX



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T1502 00 Not Covered Not Covered XXXT1503 00 Not Covered Not Covered XXXT1505 00 Not Covered Not Covered XXXT1999 00 Not Covered Not Covered XXXT2001 00 Not Covered Not Covered XXXT2002 00 Not Covered Not Covered XXXT2003 00 Not Covered Not Covered XXXT2004 00 Not Covered Not Covered XXXT2005 00 Not Covered Not Covered XXXT2007 00 Not Covered Not Covered XXXT2010 00 Not Covered Not Covered XXXT2011 00 Not Covered Not Covered XXXT2012 00 Not Covered Not Covered XXXT2013 00 Not Covered Not Covered XXXT2014 00 Not Covered Not Covered XXXT2015 00 Not Covered Not Covered XXXT2016 00 Not Covered Not Covered XXXT2017 00 Not Covered Not Covered XXXT2018 00 Not Covered Not Covered XXXT2019 00 Not Covered Not Covered XXXT2020 00 Not Covered Not Covered XXXT2021 00 Not Covered Not Covered XXXT2022 00 Not Covered Not Covered XXXT2023 00 Not Covered Not Covered XXXT2024 00 Not Covered Not Covered XXXT2025 00 Not Covered Not Covered XXXT2026 00 Not Covered Not Covered XXXT2027 00 Not Covered Not Covered XXXT2028 00 Not Covered Not Covered XXXT2029 00 Not Covered Not Covered XXXT2030 00 Not Covered Not Covered XXXT2031 00 Not Covered Not Covered XXXT2032 00 Not Covered Not Covered XXXT2033 00 Not Covered Not Covered XXXT2034 00 Not Covered Not Covered XXXT2035 00 Not Covered Not Covered XXXT2036 00 Not Covered Not Covered XXXT2037 00 Not Covered Not Covered XXXT2038 00 Not Covered Not Covered XXXT2039 00 Not Covered Not Covered XXXT2040 00 Not Covered Not Covered XXXT2041 00 Not Covered Not Covered XXX



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T2042 00 Not Covered Not Covered XXXT2043 00 Not Covered Not Covered XXXT2044 00 Not Covered Not Covered XXXT2045 00 Not Covered Not Covered XXXT2046 00 Not Covered Not Covered XXXT2048 00 Not Covered Not Covered XXXT2049 00 Not Covered Not Covered XXXT2101 00 Not Covered Not Covered XXXT4521 00 Not Covered Not Covered XXXT4522 00 Not Covered Not Covered XXXT4523 00 Not Covered Not Covered XXXT4524 00 Not Covered Not Covered XXXT4525 00 Not Covered Not Covered XXXT4526 00 Not Covered Not Covered XXXT4527 00 Not Covered Not Covered XXXT4528 00 Not Covered Not Covered XXXT4529 00 Not Covered Not Covered XXXT4530 00 Not Covered Not Covered XXXT4531 00 Not Covered Not Covered XXXT4532 00 Not Covered Not Covered XXXT4533 00 Not Covered Not Covered XXXT4534 00 Not Covered Not Covered XXXT4535 00 Not Covered Not Covered XXXT4536 00 Not Covered Not Covered XXXT4537 00 Not Covered Not Covered XXXT4538 00 Not Covered Not Covered XXXT4539 00 Not Covered Not Covered XXXT4540 00 Not Covered Not Covered XXXT4541 00 Not Covered Not Covered XXXT4542 00 Not Covered Not Covered XXXT4543 00 Not Covered Not Covered XXXT4544 00 Not Covered Not Covered XXXT5001 00 Not Covered Not Covered XXXT5999 00 Not Covered Not Covered XXX

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