**Ad dendum B.-Final OPPS Payment by HCPCS Code for CY 2012** 

**HCPCS Code**  **Short Descriptor CI** **SI AP** **C** 00100 Anesth salivary gland N 00102 Anesth repair of cleft lip N 00103 Anesth blepharoplasty N 00104 Anesth electroshock N 00120 Anesth ear surgery N 00124 Anesth ear exam N 00126 Anesth tympanotomy N 00140 Anesth procedures on eye N 00142 Anesth lens surgery N 00144 Anesth corneal transplant N 00145 Anesth vitreoretinal surg N 00147 Anesth iridectomy N 00148 Anesth eye exam N 00160 Anesth nose/sinus surgery N 00162 Anesth nose/sinus surgery N 00164 Anesth biopsy of nose N 00170 Anesth procedure on mouth N 00172 Anesth cleft palate repair N 00174 Anesth pharyngeal surgery N 00176 Anesth pharyngeal surgery C 00190 Anesth face/skull bone surg N 00192 Anesth facial bone surgery C 00210 Anesth cranial surg nos N 00211 Anesth cran surg hemotoma C 00212 Anesth skull drainage N 00214 Anesth skull drainage C 00215 Anesth skull repair/fract C 00216 Anesth head vessel surgery N 00218 Anesth special head surgery N 00220 Anesth intrcrn nerve N 00222 Anesth head nerve surgery N 00300 Anesth head/neck/ptrunk N 00320 Anesth neck organ 1yr/> N 00322 Anesth biopsy of thyroid N 00326 Anesth larynx/trach < 1 yr N 00350 Anesth neck vessel surgery N 00352 Anesth neck vessel surgery N 00400 Anesth skin ext/per/atrunk N 00402 Anesth surgery of breast N 00404 Anesth surgery of breast N 00406 Anesth surgery of breast N 00410 Anesth correct heart rhy thm N 00450 Anesth surgery of shoulder N 00452 Anesth surgery of shoulder C 00454 Anesth collar bone biopsy N 00470 Anesth removal of rib N 00472 Anesth chest wall repair N 00474 Anesth surgery of rib C 00500 Anesth esophageal surgery N 00520 Anesth chest procedure N 00522 Anesth chest lining biopsy N00524 Anesth chest drainage C

00528 Anes mediascpy & dx thorscpy N 00529 Anes medscpy&thorscpy 1 lung N 00530 Anesth pacemaker insertion N 00532 Anesth vascular access N 00534 Anesth cardioverter/defib N 00537 Anesth cardiac electrophys N 00539 Anesth trach-bronch reconst N 00540 Anesth chest surgery C 00541 Anesth one lung ventilation N 00542 Anesth remvl pleura C 00546 Anesth lung chest wall surg C 00548 Anesth trachea bronchi surg N 00550 Anesth sternal debridement N 00560 Anesth heart surg w/o pump C 00561 Anesth heart surg < 1 yr C 00562 Anesth hrt surg w/pmp age 1+ C 00563 Anesth heart surg w/arrest N 00566 Anesth cabg w/o pump N 00567 Anesth cabg w/pump C 00580 Anesth heart/lung transplnt C 00600 Anesth spine cord surgery N 00604 Anesth sitting procedure C 00620 Anesth spine cord surgery N 00622 Anesth removal of nerves C 00625 Anes spine tranthor w/o vent N 00626 Anes spine transthor w/vent N 00630 Anesth spine cord surgery N 00632 Anesth removal of nerves C 00634 Anesth for chemonucleolysis N 00635 Anesth lumbar puncture N 00640 Anesth spine manipulation N 00670 Anesth spine cord surgery C 00700 Anesth abdominal wall surg N 00702 Anesth for liver biopsy N 00730 Anesth abdominal wall surg N 00740 Anesth upper gi visualize N 00750 Anesth repair of hernia N 00752 Anesth repair of hernia N 00754 Anesth repair of hernia N 00756 Anesth repair of hernia N 00770 Anesth blood vessel repair N 00790 Anesth surg upper abdomen N 00792 Anesth hemorr/excise liver C 00794 Anesth pancreas removal C 00796 Anesth for liver transplant C 00797 Anesth surgery for obesity N 00800 Anesth abdominal wall surg N 00802 Anesth fat layer removal C 00810 Anesth low intestine scope N 00820 Anesth abdominal wall surg N 00830 Anesth repair of hernia N 00832 Anesth repair of hernia N 00834 Anesth hernia repair < 1 yr N 00836 Anesth hernia repair preemie N00840 Anesth surg lower abdomen N

00842 Anesth amniocentesis N 00844 Anesth pelvis surgery C 00846 Anesth hysterectomy C 00848 Anesth pelvic organ surg C 00851 Anesth tubal ligation N 00860 Anesth surgery of abdomen N 00862 Anesth kidney /ureter surg N 00864 Anesth removal of bladder C 00865 Anesth removal of prostate C 00866 Anesth removal of adrenal C 00868 Anesth kidney transplant C 00870 Anesth bladder stone surg N 00872 Anesth kidney stone destruct N 00873 Anesth kidney stone destruct N 00880 Anesth abdomen vessel surg N 00882 Anesth major vein ligation C 00902 Anesth anorectal surgery N 00904 Anesth perineal surgery C 00906 Anesth removal of vulva N 00908 Anesth removal of prostate C 00910 Anesth bladder surgery N 00912 Anesth bladder tumor surg N 00914 Anesth removal of prostate N 00916 Anesth bleeding control N 00918 Anesth stone removal N 00920 Anesth genitalia surgery N 00921 Anesth vasectomy N 00922 Anesth sperm duct surgery N 00924 Anesth testis exploration N 00926 Anesth removal of testis N 00928 Anesth removal of testis N 00930 Anesth testis suspension N 00932 Anesth amputation of penis C 00934 Anesth penis nodes removal C 00936 Anesth penis nodes removal C 00938 Anesth insert penis device N 00940 Anesth vaginal procedures N 00942 Anesth surg on vag/urethral N 00944 Anesth vaginal hysterectomy C 00948 Anesth repair of cervix N 00950 Anesth vaginal endoscopy N 00952 Anesth hysteroscope/graph N 01112 Anesth bone aspirate/bx N 01120 Anesth pelvis surgery N 01130 Anesth body cast procedure N 01140 Anesth amputation at pelvis C 01150 Anesth pelvic tumor surgery C 01160 Anesth pelvis procedure N 01170 Anesth pelvis surgery N 01173 Anesth fx repair pelvis N 01180 Anesth pelvis nerve removal N 01190 Anesth pelvis nerve removal N 01200 Anesth hip joint procedure N 01202 Anesth arthroscopy of hip N01210 Anesth hip joint surgery N

01212 Anesth hip disarticulation C 01214 Anesth hip arthroplasty C 01215 Anesth revise hip repair N 01220 Anesth procedure on femur N 01230 Anesth surgery of femur N 01232 Anesth amputation of femur C 01234 Anesth radical femur surg C 01250 Anesth upper leg surgery N 01260 Anesth upper leg veins surg N 01270 Anesth thigh arteries surg N 01272 Anesth femoral artery surg C 01274 Anesth femoral embolectomy C 01320 Anesth knee area surgery N 01340 Anesth knee area procedure N 01360 Anesth knee area surgery N 01380 Anesth knee joint procedure N 01382 Anesth dx knee arthroscopy N 01390 Anesth knee area procedure N 01392 Anesth knee area surgery N 01400 Anesth knee joint surgery N 01402 Anesth knee arthroplasty C 01404 Anesth amputation at knee C 01420 Anesth knee joint casting N 01430 Anesth knee veins surgery N 01432 Anesth knee vessel surg N 01440 Anesth knee arteries surg N 01442 Anesth knee artery surg C 01444 Anesth knee artery repair C 01462 Anesth lower leg procedure N 01464 Anesth ankle/ft arthroscopy N 01470 Anesth lower leg surgery N 01472 Anesth achilles tendon surg N 01474 Anesth lower leg surgery N 01480 Anesth lower leg bone surg N 01482 Anesth radical leg surgery N 01484 Anesth lower leg revision N 01486 Anesth ankle replacement C 01490 Anesth lower leg casting N 01500 Anesth leg arteries surg N 01502 Anesth lwr leg embolectomy C 01520 Anesth lower leg vein surg N 01522 Anesth lower leg vein surg N 01610 Anesth surgery of shoulder N 01620 Anesth shoulder procedure N 01622 Anes dx shoulder arthroscopy N 01630 Anesth surgery of shoulder N 01634 Anesth shoulder joint amput C 01636 Anesth forequarter amput C 01638 Anesth shoulder replacement C 01650 Anesth shoulder artery surg N 01652 Anesth shoulder vessel surg C 01654 Anesth shoulder vessel surg C 01656 Anesth arm-leg vessel surg C 01670 Anesth shoulder vein surg N01680 Anesth shoulder casting N

01682 Anesth airplane cast N 01710 Anesth elbow area surgery N 01712 Anesth uppr arm tendon surg N 01714 Anesth uppr arm tendon surg N 01716 Anesth biceps tendon repair N 01730 Anesth uppr arm procedure N 01732 Anesth dx elbow arthroscopy N 01740 Anesth upper arm surgery N 01742 Anesth humerus surgery N 01744 Anesth humerus repair N 01756 Anesth radical humerus surg C 01758 Anesth humeral lesion surg N 01760 Anesth elbow replacement N 01770 Anesth uppr arm artery surg N 01772 Anesth uppr arm embolectomy N 01780 Anesth upper arm vein surg N 01782 Anesth uppr arm vein repair N 01810 Anesth lower arm surgery N 01820 Anesth lower arm procedure N 01829 Anesth dx wrist arthroscopy N 01830 Anesth lower arm surgery N 01832 Anesth wrist replacement N 01840 Anesth lwr arm artery surg N 01842 Anesth lwr arm embolectomy N 01844 Anesth vascular shunt surg N 01850 Anesth lower arm vein surg N 01852 Anesth lwr arm vein repair N 01860 Anesth lower arm casting N 01916 Anesth dx arteriography N 01920 Anesth catheterize heart N 01922 Anesth cat or mri scan N 01924 Anes ther interven rad art N 01925 Anes ther interven rad car N 01926 Anes tx interv rad hrt/cran N 01930 Anes ther interven rad vei N 01931 Anes ther interven rad tip N 01932 Anes tx interv rad th vein N 01933 Anes tx interv rad cran vein N 01935 Anesth perc img dx sp proc N 01936 Anesth perc img tx sp proc N 01951 Anesth burn less 4 percent N 01952 Anesth burn 4-9 percent N 01953 Anesth burn each 9 percent N 01958 Anesth antepartum manipul N 01960 Anesth vaginal delivery N 01961 Anesth cs delivery N 01962 Anesth emer hysterectomy N 01963 Anesth cs hysterectomy N 01965 Anesth inc/missed ab proc N 01966 Anesth induced ab procedure N 01967 Anesth/analg vag delivery N 01968 Anes/analg cs deliver add-on N 01969 Anesth/analg cs hyst add-on N 01990 Support for organ donor C01991 Anesth nerve block/inj N

01992 Anesth n block/inj prone N 01996 Hosp manage cont drug admin N 01999 Unlisted anesth procedure N 10021 Fna w/o image T 0002 10022 Fna w/image T 0004 10040 Acne surgery T 0013 10060 Drainage of skin abscess T 0006 10061 Drainage of skin abscess T 0006 10080 Drainage of pilonidal cyst T 0006 10081 Drainage of pilonidal cyst T 0007 10120 Remove foreign body T 0016 10121 Remove foreign body T 0021 10140 Drainage of hematoma/fluid T 0007 10160 Puncture drainage of lesion T 0006 10180 Complex drainage wound T 0008 11000 Debride infected skin T 0016 11001 Debride infected skin add-on T 0013 11004 Debride genitalia & perineum C 11005 Debride abdom wall C 11006 Debride genit/per/abdom wall C 11008 Remove mesh from abd wall C 11010 Debride skin at fx site T 0019 11011 Debride skin musc at fx site T 0019 11012 Deb skin bone at fx site T 0019 11042 Deb subq tissue 20 sq cm/< T 0016 11043 Deb musc/fascia 20 sq cm/< T 0016 11044 Deb bone 20 sq cm/< T 0020 11045 Deb subq tissue add-on T 0016 11046 Deb musc/fascia add-on T 0016 11047 Deb bone add-on T 0020 11055 Trim skin lesion T 0013 11056 Trim skin lesions 2 to 4 T 0013 11057 Trim skin lesions over 4 CHT 0015 11100 Biopsy

skin lesion T 0015 11101 Biopsy

skin add-on T 0013 11200 Removal of skin tags T 0013 11201 Remove skin tags add-on T 0013 11300 Shave skin lesion T 0013 11301 Shave skin lesion T 0013 11302 Shave skin lesion T 0013 11303 Shave skin lesion T 0015 11305 Shave skin lesion T 0013 11306 Shave skin lesion T 0013 11307 Shave skin lesion T 0013 11308 Shave skin lesion CHT 0015 11310 Shave skin lesion T 0013 11311 Shave skin lesion T 0013 11312 Shave skin lesion CHT 0015 11313 Shave skin lesion CHT 0015 11400 Exc tr-ext b9+marg 0.5 < cm T 0019 11401 Exc tr-ext b9+marg 0.6-1 cm T 0019 11402 Exc tr-ext b9+marg 1.1-2 cm T 0019 11403 Exc tr-ext b9+marg 2.1-3 cm T 0020 11404 Exc tr-ext b9+marg 3.1-4 cm T 002111406 Exc tr-ext b9+marg > 4.0 cm T 0021

11420 Exc h-f-nk-sp b9+marg 0.5 < T 0020 11421 Exc h-f-nk-sp b9+marg 0.6-1 T 0020 11422 Exc h-f-nk-sp b9+marg 1.1-2 T 0020 11423 Exc h-f-nk-sp b9+marg 2.1-3 T 0021 11424 Exc h-f-nk-sp b9+marg 3.1-4 T 0021 11426 Exc h-f-nk-sp b9+marg > 4 cm T 0022 11440 Exc face-mm b9+marg 0.5 < cm T 0019 11441 Exc face-mm b9+marg 0.6-1 cm T 0019 11442 Exc face-mm b9+marg 1.1-2 cm T 0020 11443 Exc face-mm b9+marg 2.1-3 cm T 0020 11444 Exc face-mm b9+marg 3.1-4 cm T 0020 11446 Exc face-mm b9+marg > 4 cm T 0022 11450 Removal sweat gland lesion T 0022 11451 Removal sweat gland lesion T 0022 11462 Removal sweat gland lesion T 0022 11463 Removal sweat gland lesion T 0022 11470 Removal sweat gland lesion T 0022 11471 Removal sweat gland lesion T 0022 11600 Exc tr-ext mal+marg 0.5 < cm T 0020 11601 Exc tr-ext mal+marg 0.6-1 cm T 0019 11602 Exc tr-ext mal+marg 1.1-2 cm T 0019 11603 Exc tr-ext mal+marg 2.1-3 cm T 0020 11604 Exc tr-ext mal+marg 3.1-4 cm T 0020 11606 Exc tr-ext mal+marg > 4 cm T 0021 11620 Exc h-f-nk-sp mal+marg 0.5 < T 0020 11621 Exc s/n/h/f/g mal+mrg 0.6-1 T 0019 11622 Exc s/n/h/f/g mal+mrg 1.1-2 T 0020 11623 Exc s/n/h/f/g mal+mrg 2.1-3 T 0021 11624 Exc s/n/h/f/g mal+mrg 3.1-4 T 0021 11626 Exc s/n/h/f/g mal+mrg > 4 cm T 0022 11640 Exc f/e/e/n/l mal+mrg 0.5cm< T 0019 11641 Exc f/e/e/n/l mal+mrg 0.6-1 T 0019 11642 Exc f/e/e/n/l mal+mrg 1.1-2 T 0019 11643 Exc f/e/e/n/l mal+mrg 2.1-3 T 0020 11644 Exc f/e/e/n/l mal+mrg 3.1-4 T 0021 11646 Exc f/e/e/n/l mal+mrg > 4 cm T 0022 11719 Trim nail(s) T 0012 11720 Debride nail 1-5 T 0013 11721 Debride nail 6 or more T 0013 11730 Removal of nail plate T 0013 11732 Remove nail plate add-on T 0013 11740 Drain blood from under nail T 0012 11750 Removal of nail bed T 0019 11752 Remove nail bed/finger tip T 0022 11755 Biopsy

nail unit T 0019 11760 Repair of nail bed T 0133 11762 Reconstruction of nail bed T 0136 11765 Excision of nail fold toe T 0013 11770 Removal of pilonidal lesion T 0022 11771 Removal of pilonidal lesion T 0022 11772 Removal of pilonidal lesion T 0022 11900 Injection into skin lesions T 0013 11901 Added skin lesions injection T 0013 11920 Correct skin color defects T 013411921 Correct skin color defects T 0134

11922 Correct skin color defects T 0134 11950 Therapy

for contour defects CHT 0134 11951 Therapy

for contour defects CHT 0134 11952 Therapy

for contour defects CHT 0134 11954 Therapy

for contour defects T 0133 11960 Insert tissue expander(s) T 0137 11970 Replace tissue expander T 0051 11971 Remove tissue expander(s) T 0022 11975 Insert contraceptive cap CHD 11976 Removal of contraceptive cap T 0019 11977 Removal/reinsert contra cap CHD 11980 Implant hormone pellet(s) X 0340 11981 Insert drug implant device X 0340 11982 Remove drug implant device X 0340 11983 Remove/insert drug implant X 0340 12001 Repair superficial wound(s) T 0133 12002 Repair superficial wound(s) T 0133 12004 Repair superficial wound(s) T 0133 12005 Repair superficial wound(s) T 0133 12006 Repair superficial wound(s) T 0133 12007 Repair superficial wound(s) T 0133 12011 Repair superficial wound(s) T 0133 12013 Repair superficial wound(s) T 0133 12014 Repair superficial wound(s) T 0133 12015 Repair superficial wound(s) T 0133 12016 Repair superficial wound(s) T 0133 12017 Repair superficial wound(s) T 0133 12018 Repair superficial wound(s) CHT 0134 12020 Closure of split wound T 0135 12021 Closure of split wound T 0134 12031 Intmd wnd repair s/a/t/ext CHT 0134 12032 Intmd wnd repair s/a/t/ext T 0134 12034 Intmd wnd repair s/tr/ext CHT 0134 12035 Intmd wnd repair s/a/t/ext CHT 0134 12036 Intmd wnd repair s/a/t/ext T 0134 12037 Intmd wnd repair s/tr/ext T 0134 12041 Intmd wnd repair n-hf/genit T 0133 12042 Intmd wnd repair n-hf/genit CHT 0134 12044 Intmd wnd repair n-hf/genit CHT 0134 12045 Intmd wnd repair n-hf/genit T 0134 12046 Intmd wnd repair n-hf/genit T 0134 12047 Intmd wnd repair n-hf/genit T 0134 12051 Intmd wnd repair face/mm T 0134 12052 Intmd wnd repair face/mm CHT 0134 12053 Intmd wnd repair face/mm CHT 0134 12054 Intmd wnd repair face/mm T 0133 12055 Intmd wnd repair face/mm T 0134 12056 Intmd wnd repair face/mm T 0134 12057 Intmd wnd repair face/mm T 0134 13100 Repair of wound or lesion T 0135 13101 Repair of wound or lesion T 0135 13102 Repair wound/lesion add-on CHT 0134 13120 Repair of wound or lesion T 0134 13121 Repair of wound or lesion T 013413122 Repair wound/lesion add-on T 0133

13131 Repair of wound or lesion T 0134 13132 Repair of wound or lesion T 0135 13133 Repair wound/lesion add-on T 0134 13150 Repair of wound or lesion T 0135 13151 Repair of wound or lesion T 0135 13152 Repair of wound or lesion T 0135 13153 Repair wound/lesion add-on T 0134 13160 Late closure of wound T 0137 14000 Skin tissue rearrangement T 0136 14001 Skin tissue rearrangement T 0136 14020 Skin tissue rearrangement T 0136 14021 Skin tissue rearrangement T 0136 14040 Skin tissue rearrangement T 0136 14041 Skin tissue rearrangement T 0136 14060 Skin tissue rearrangement T 0136 14061 Skin tissue rearrangement T 0136 14301 Skin tissue rearrangement T 0137 14302 Skin tissue rearrange add-on T 0137 14350 Skin tissue rearrangement T 0137 15002 Wound prep trk/arm/leg T 0135 15003 Wound prep addl 100 cm T 0135 15004 Wound prep f/n/hf/g CHT 0134 15005 Wnd prep f/n/hf/g addl cm T 0135 15040 Harvest cultured skin graft T 0134 15050 Skin pinch graft CHT 0134 15100 Skin splt grft trnk/arm/leg T 0137 15101 Skin splt grft t/a/l add-on T 0137 15110 Epidrmautogrft trnk/arm/leg T 0135 15111 Epidrmautogrft t/a/l add-on T 0135 15115 Epidrma-grft face/nck/hf/g T 0135 15116 Epidrma-grft f/n/hf/g addl CHT 0134 15120 Skn splt a-grft fac/nck/hf/g T 0137 15121 Skn splt a-grft f/n/hf/g add T 0137 15130 Derm autograft trnk/arm/leg T 0136 15131 Derm autograft t/a/l add-on T 0136 15135 Derm autograft face/nck/hf/g T 0136 15136 Derm autograft f/n/hf/g add T 0136 15150 Cult skin grft t/arm/leg CHT 0134 15151 Cult skin grft t/a/l addl CHT 0134 15152 Cult skin graft t/a/l +% CHT 0134 15155 Cult skin graft f/n/hf/g CHT 0134 15156 Cult skin grft f/n/hfg add CHT 0134 15157 Cult epiderm grft f/n/hfg +% CHT 0134 15170 Acell graft trunk/arms/legs CHD 15171 Acell graft t/arm/leg add-on CHD 15175 Acellular graft f/n/hf/g CHD 15176 Acell graft f/n/hf/g add-on CHD 15200 Skin full graft trunk T 0136 15201 Skin full graft trunk add-on T 0136 15220 Skin full graft sclp/arm/leg T 0136 15221 Skin full graft add-on T 0135 15240 Skin full grft face/genit/hf T 0136 15241 Skin full graft add-on CHT 0134 15260 Skin full graft een & lips T 013615261 Skin full graft add-on T 0136

15271 Skin sub graft trnk/arm/leg NIT 0134 15272 Skin sub graft t/a/l add-on NIT 0133 15273 Skin sub grft t/arm/lg child NIT 0135 15274 Skn sub grft t/a/l child add NIT 0134 15275 Skin sub graft face/nk/hf/g NIT 0134 15276 Skin sub graft f/n/hf/g addl NIT 0133 15277 Skn sub grft f/n/hf/g child NIT 0135 15278 Skn sub grft f/n/hf/g ch add NIT 0134 15300 Apply

skinallogrft t/arm/lg CHD 15301 Apply

sknallogrft t/a/l addl CHD 15320 Apply

skin allogrft f/n/hf/g CHD 15321 Aply

sknallogrft f/n/hfg add CHD 15330 Aply

acell alogrft t/arm/leg CHD 15331 Aply

acell grft t/a/l add-on CHD 15335 Apply

acell graft f/n/hf/g CHD 15336 Aply

acell grft f/n/hf/g add CHD 15340 Apply

cult skin substitute CHD 15341 Apply

cult skin sub add-on CHD 15360 Apply

cult derm sub t/a/l CHD 15361 Aply

cult derm sub t/a/l add CHD 15365 Apply

cult derm sub f/n/hf/g CHD 15366 Apply

cult derm f/hf/g add CHD 15400 Apply

skin xenograft t/a/l CHD 15401 Apply

skn xenogrft t/a/l add CHD 15420 Apply

skin xgraft f/n/hf/g CHD 15421 Apply

skn xgrft f/n/hf/g add CHD 15430 Apply

acellular xenograft CHD 15431 Apply

acellular xgraft add CHD 15570 Form skin pedicle flap T 0137 15572 Form skin pedicle flap T 0137 15574 Form skin pedicle flap T 0137 15576 Form skin pedicle flap T 0137 15600 Skin graft T 0137 15610 Skin graft T 0137 15620 Skin graft T 0137 15630 Skin graft T 0137 15650 Transfer skin pedicle flap T 0137 15731 Forehead flap w/vasc pedicle T 0137 15732 Muscle-skin graft head/neck T 0137 15734 Muscle-skin graft trunk T 0137 15736 Muscle-skin graft arm T 0137 15738 Muscle-skin graft leg T 0137 15740 Island pedicle flap graft T 0136 15750 Neurovascular pedicle graft T 0137 15756 Free myo/skin flap microvasc C 15757 Free skin flap microvasc C 15758 Free fascial flap microvasc C 15760 Composite skin graft T 0137 15770 Derma-fat-fascia graft T 0137 15775 Hair transplant punch grafts T 0133 15776 Hair transplant punch grafts T 0133 15777 Acellular derm matrix implt NIT 0136 15780 Abrasion treatment of skin T 0022 15781 Abrasion treatment of skin T 001915782 Abrasion treatment of skin T 0019

15783 Abrasion treatment of skin T 0016 15786 Abrasion lesion single T 0013 15787 Abrasion lesions add-on T 0013 15788 Chemical peel face epiderm T 0013 15789 Chemical peel face dermal T 0015 15792 Chemical peel nonfacial T 0015 15793 Chemical peel nonfacial T 0013 15819 Plastic surgery neck T 0134 15820 Revision of lower eyelid T 0137 15821 Revision of lower eyelid T 0137 15822 Revision of upper eyelid T 0137 15823 Revision of upper eyelid T 0137 15824 Removal of forehead wrinkles T 0137 15825 Removal of neck wrinkles T 0137 15826 Removal of brow wrinkles T 0137 15828 Removal of face wrinkles T 0137 15829 Removal of skin wrinkles T 0137 15830 Exc skin abd T 0022 15832 Excise excessive skin tissue T 0022 15833 Excise excessive skin tissue T 0022 15834 Excise excessive skin tissue T 0022 15835 Excise excessive skin tissue T 0022 15836 Excise excessive skin tissue T 0021 15837 Excise excessive skin tissue T 0021 15838 Excise excessive skin tissue T 0021 15839 Excise excessive skin tissue T 0021 15840 Graft for face nerve palsy T 0137 15841 Graft for face nerve palsy T 0137 15842 Flap for face nerve palsy T 0137 15845 Skin and muscle repair face T 0137 15847 Exc skin abd add-on T 0022 15850 Removal of sutures T 0016 15851 Removal of sutures T 0016 15852 Dressing change not for burn X 0340 15860 Test for blood flow in graft X 0340 15876 Suction assisted lipectomy T 0137 15877 Suction assisted lipectomy T 0137 15878 Suction assisted lipectomy T 0137 15879 Suction assisted lipectomy T 0137 15920 Removal of tail bone ulcer T 0019 15922 Removal of tail bone ulcer T 0137 15931 Remove sacrum pressure sore T 0022 15933 Remove sacrum pressure sore T 0022 15934 Remove sacrum pressure sore T 0137 15935 Remove sacrum pressure sore T 0137 15936 Remove sacrum pressure sore T 0136 15937 Remove sacrum pressure sore T 0137 15940 Remove hip pressure sore T 0022 15941 Remove hip pressure sore T 0022 15944 Remove hip pressure sore T 0137 15945 Remove hip pressure sore T 0137 15946 Remove hip pressure sore T 0137 15950 Remove thigh pressure sore T 0022 15951 Remove thigh pressure sore T 002215952 Remove thigh pressure sore T 0136

15953 Remove thigh pressure sore T 0136 15956 Remove thigh pressure sore T 0136 15958 Remove thigh pressure sore T 0136 15999 Removal of pressure sore T 0019 16000 Initial treatment of burn(s) T 0013 16020 Dress/debrid p-thick burn s T 0015 16025 Dress/debrid p-thick burn m T 0015 16030 Dress/debrid p-thick burn l T 0015 16035 Incision of burn scab initi T 0015 16036 Escharotomy addl incision C 17000 Destruct premalg lesion T 0013 17003 Destruct premalg les 2-14 T 0012 17004 Destroy

premal lesions 15/> T 0016 17106 Destruction of skin lesions T 0016 17107 Destruction of skin lesions T 0016 17108 Destruction of skin lesions T 0016 17110 Destruct b9 lesion 1-14 T 0013 17111 Destruct lesion 15 or more T 0015 17250 Chemical cautery tissue T 0015 17260 Destruction of skin lesions T 0015 17261 Destruction of skin lesions T 0015 17262 Destruction of skin lesions T 0015 17263 Destruction of skin lesions T 0015 17264 Destruction of skin lesions T 0015 17266 Destruction of skin lesions T 0016 17270 Destruction of skin lesions T 0015 17271 Destruction of skin lesions T 0015 17272 Destruction of skin lesions T 0015 17273 Destruction of skin lesions T 0016 17274 Destruction of skin lesions T 0016 17276 Destruction of skin lesions T 0016 17280 Destruction of skin lesions T 0015 17281 Destruction of skin lesions T 0016 17282 Destruction of skin lesions T 0016 17283 Destruction of skin lesions T 0016 17284 Destruction of skin lesions T 0016 17286 Destruction of skin lesions T 0016 17311 Mohs 1 stage h/n/hf/g T 0694 17312 Mohs addl stage T 0694 17313 Mohs 1 stage t/a/l T 0694 17314 Mohs addl stage t/a/l T 0694 17315 Mohs surg addl block T 0694 17340 Cryotherapy of skin T 0013 17360 Skin peel therapy CHT 0015 17380 Hair removal by electrolysis CHT 0015 17999 Skin tissue procedure T 0012 19000 Drainage of breast lesion T 0004 19001 Drain breast lesion add-on T 0002 19020 Incision of breast lesion T 0008 19030 Injection for breast x-ray N 19100 Bx breast percut w/o image T 0004 19101 Biopsy

of breast open T 0028 19102 Bx breast percut w/image T 0005 19103 Bx breast percut w/device T 003719105 Cryosurg ablate fa each T 0029

19110 Nipple exploration T 0028 19112 Excise breast duct fistula T 0028 19120 Removal of breast lesion T 0028 19125 Excision breast lesion T 0028 19126 Excision addl breast lesion T 0028 19260 Removal of chest wall lesion T 0021 19271 Revision of chest wall C 19272 Extensive chest wall surgery C 19290 Place needle wire breast N 19291 Place needle wire breast N 19295 Place breast clip percut Q1 0340 19296 Place po breast cath for rad T 0648 19297 Place breast cath for rad T 0648 19298 Place breast rad tube/caths T 0648 19300 Removal of breast tissue T 0028 19301 Partical mastectomy T 0028 19302 P-mastectomy w/ln removal T 0030 19303 Mast simple complete T 0029 19304 Mast subq T 0029 19305 Mast radical C 19306 Mast rad urban type C 19307 Mast mod rad T 0030 19316 Suspension of breast T 0029 19318 Reduction of large breast T 0030 19324 Enlarge breast T 0030 19325 Enlarge breast with implant T 0648 19328 Removal of breast implant T 0029 19330 Removal of implant material T 0029 19340 Immediate breast prosthesis T 0030 19342 Delayed breast prosthesis T 0648 19350 Breast reconstruction T 0028 19355 Correct inverted nipple(s) T 0029 19357 Breast reconstruction T 0648 19361 Breast reconstr w/lat flap C 19364 Breast reconstruction C 19366 Breast reconstruction T 0029 19367 Breast reconstruction C 19368 Breast reconstruction C 19369 Breast reconstruction C 19370 Surgery

of breast capsule T 0029 19371 Removal of breast capsule T 0029 19380 Revise breast reconstruction T 0030 19396 Design custom breast implant T 0029 19499 Breast surgery procedure T 0028 20005 I&d abscess subfascial T 0020 20100 Explore wound neck T 0252 20101 Explore wound chest T 0137 20102 Explore wound abdomen T 0137 20103 Explore wound extremity T 0007 20150 Excise epiphyseal bar T 0051 20200 Muscle biopsy T 0021 20205 Deep muscle biopsy T 0021 20206 Needle biopsy muscle T 0005 20220 Bone biopsy trocar/needle T 002020225 Bone biopsy trocar/needle T 0021 20240 Bone biopsy excisional T 0022 20245 Bone biopsy excisional T 0022 20250 Open bone biopsy CHT 0050 20251 Open bone biopsy CHT 0050 20500 Injection of sinus tract T 0252 20501 Inject sinus tract for x-ray N 20520 Removal of foreign body T 0019 20525 Removal of foreign body T 0022 20526 Ther injection carp tunnel T 0204 20527 Inj dupuy

tren cord w/enzyme NIT 0204 20550 Inj tendon sheath/ligament T 0204 20551 Inj tendon origin/insertion T 0204 20552 Inj trigger point 1/2 muscl T 0204 20553 Inject trigger points =/> 3 T 0204 20555 Place ndl musc/tis for rt T 0050 20600 Drain/inject joint/bursa T 0204 20605 Drain/inject joint/bursa T 0204 20610 Drain/inject joint/bursa T 0204 20612 Aspirate/inj ganglion cyst T 0204 20615 Treatment of bone cyst T 0004 20650 Insert and remove bone pin CHT 0050 20660 Apply

rem fixation device T 0138 20661 Application of head brace C 20662 Application of pelvis brace T 0049 20663 Application of thigh brace CHT 0050 20664 Application of halo C 20665 Removal of fixation device X 0340 20670 Removal of support implant T 0021 20680 Removal of support implant T 0022 20690 Apply

bone fixation device T 0050 20692 Apply

bone fixation device T 0050 20693 Adjust bone fixation device CHT 0050 20694 Remove bone fixation device T 0049 20696 Comp multiplane ext fixation T 0050 20697 Comp ext fixate strut change T 0139 20802 Replantation arm complete C 20805 Replant forearm complete C 20808 Replantation hand complete C 20816 Replantation digit complete C 20822 Replantation digit complete T 0054 20824 Replantation thumb complete C 20827 Replantation thumb complete C 20838 Replantation foot complete C 20900 Removal of bone for graft T 0050 20902 Removal of bone for graft T 0050 20910 Remove cartilage for graft T 0137 20912 Remove cartilage for graft T 0137 20920 Removal of fascia for graft T 0136 20922 Removal of fascia for graft T 0136 20924 Removal of tendon for graft T 0050 20926 Removal of tissue for graft T 0135 20930 Sp bone algrft morsel add-on CHN 20931 Sp bone algrft struct add-on CHN 20936 Sp bone agrft local add-on C20937 Sp bone agrft morsel add-on C

20938 Sp bone agrft struct add-on C 20950 Fluid pressure muscle T 0006 20955 Fibula bone graft microvasc C 20956 Iliac bone graft microvasc C 20957 Mt bone graft microvasc C 20962 Other bone graft microvasc C 20969 Bone/skin graft microvasc C 20970 Bone/skin graft iliac crest C 20972 Bone/skin graft metatarsal T 0056 20973 Bone/skin graft great toe T 0056 20974 Electrical bone stimulation A 20975 Electrical bone stimulation N 20979 Us bone stimulation X 0340 20982 Ablate bone tumor(s) perq T 0051 20985 Cptr-asst dir ms px N 20999 Musculoskeletal surgery T 0049 21010 Incision of jaw joint T 0254 21011 Exc face les sc < 2 cm T 0020 21012 Exc face les sbq 2 cm/> T 0020 21013 Exc face tum deep < 2 cm T 0020 21014 Exc face tum deep 2 cm/> T 0020 21015 Resect face tum < 2 cm T 0021 21016 Resect face tum 2 cm/> T 0022 21025 Excision of bone lower jaw T 0256 21026 Excision of facial bone(s) T 0256 21029 Contour of face bone lesion T 0256 21030 Excise max/zygoma b9 tumor T 0254 21031 Remove exostosis mandible T 0254 21032 Remove exostosis maxilla T 0254 21034 Excise max/zygoma mal tumor T 0256 21040 Excise mandible lesion T 0254 21044 Removal of jaw bone lesion T 0256 21045 Extensive jaw surgery C 21046 Remove mandible cyst complex T 0256 21047 Excise lwr jaw cyst w/repair T 0256 21048 Remove maxilla cyst complex T 0256 21049 Excis uppr jaw cyst w/repair T 0256 21050 Removal of jaw joint T 0256 21060 Remove jaw joint cartilage T 0256 21070 Remove coronoid process T 0256 21073 Mnpj of tmj w/anesth T 0252 21076 Prepare face/oral prosthesis T 0254 21077 Prepare face/oral prosthesis T 0256 21079 Prepare face/oral prosthesis T 0256 21080 Prepare face/oral prosthesis T 0256 21081 Prepare face/oral prosthesis T 0256 21082 Prepare face/oral prosthesis T 0256 21083 Prepare face/oral prosthesis T 0256 21084 Prepare face/oral prosthesis T 0256 21085 Prepare face/oral prosthesis T 0253 21086 Prepare face/oral prosthesis T 0256 21087 Prepare face/oral prosthesis T 0256 21088 Prepare face/oral prosthesis T 0256 21089 Prepare face/oral prosthesis T 025021100 Maxillofacial fixation T 0256

21110 Interdental fixation T 0252 21116 Injection jaw joint x-ray N 21120 Reconstruction of chin T 0254 21121 Reconstruction of chin T 0254 21122 Reconstruction of chin T 0254 21123 Reconstruction of chin T 0254 21125 Augmentation lower jaw bone T 0254 21127 Augmentation lower jaw bone T 0256 21137 Reduction of forehead T 0254 21138 Reduction of forehead T 0256 21139 Reduction of forehead T 0256 21141 Reconstruct midface lefort C 21142 Reconstruct midface lefort C 21143 Reconstruct midface lefort C 21145 Reconstruct midface lefort C 21146 Reconstruct midface lefort C 21147 Reconstruct midface lefort C 21150 Reconstruct midface lefort T 0256 21151 Reconstruct midface lefort C 21154 Reconstruct midface lefort C 21155 Reconstruct midface lefort C 21159 Reconstruct midface lefort C 21160 Reconstruct midface lefort C 21172 Reconstruct orbit/forehead T 0256 21175 Reconstruct orbit/forehead T 0256 21179 Reconstruct entire forehead C 21180 Reconstruct entire forehead C 21181 Contour cranial bone lesion T 0254 21182 Reconstruct cranial bone C 21183 Reconstruct cranial bone C 21184 Reconstruct cranial bone C 21188 Reconstruction of midface C 21193 Reconst lwr jaw w/o graft T 0256 21194 Reconst lwr jaw w/graft C 21195 Reconst lwr jaw w/o fixation T 0256 21196 Reconst lwr jaw w/fixation C 21198 Reconstr lwr jaw segment T 0256 21199 Reconstr lwr jaw w/advance T 0256 21206 Reconstruct upper jaw bone T 0256 21208 Augmentation of facial bones T 0256 21209 Reduction of facial bones T 0256 21210 Face bone graft T 0256 21215 Lower jaw bone graft T 0256 21230 Rib cartilage graft T 0256 21235 Ear cartilage graft T 0254 21240 Reconstruction of jaw joint T 0256 21242 Reconstruction of jaw joint T 0256 21243 Reconstruction of jaw joint T 0256 21244 Reconstruction of lower jaw T 0256 21245 Reconstruction of jaw T 0256 21246 Reconstruction of jaw T 0256 21247 Reconstruct lower jaw bone C 21248 Reconstruction of jaw T 0256 21249 Reconstruction of jaw T 025621255 Reconstruct lower jaw bone C

21256 Reconstruction of orbit T 0256 21260 Revise eye sockets T 0256 21261 Revise eye sockets T 0256 21263 Revise eye sockets T 0256 21267 Revise eye sockets T 0256 21268 Revise eye sockets C 21270 Augmentation cheek bone T 0256 21275 Revision orbitofacial bones T 0256 21280 Revision of eyelid T 0256 21282 Revision of eyelid T 0253 21295 Revision of jaw muscle/bone T 0252 21296 Revision of jaw muscle/bone T 0254 21299 Cranio/maxillofacial surgery T 0250 21310 Treatment of nose fracture T 0250 21315 Treatment of nose fracture T 0253 21320 Treatment of nose fracture T 0253 21325 Treatment of nose fracture T 0254 21330 Treatment of nose fracture T 0254 21335 Treatment of nose fracture T 0254 21336 Treat nasal septal fracture T 0062 21337 Treat nasal septal fracture T 0253 21338 Treat nasoethmoid fracture T 0254 21339 Treat nasoethmoid fracture T 0254 21340 Treatment of nose fracture T 0256 21343 Treatment of sinus fracture C 21344 Treatment of sinus fracture C 21345 Treat nose/jaw fracture T 0254 21346 Treat nose/jaw fracture CHT 0254 21347 Treat nose/jaw fracture C 21348 Treat nose/jaw fracture C 21355 Treat cheek bone fracture T 0256 21356 Treat cheek bone fracture T 0254 21360 Treat cheek bone fracture T 0254 21365 Treat cheek bone fracture T 0256 21366 Treat cheek bone fracture C 21385 Treat eye socket fracture T 0256 21386 Treat eye socket fracture T 0256 21387 Treat eye socket fracture T 0256 21390 Treat eye socket fracture T 0256 21395 Treat eye socket fracture T 0256 21400 Treat eye socket fracture T 0252 21401 Treat eye socket fracture T 0253 21406 Treat eye socket fracture T 0256 21407 Treat eye socket fracture T 0256 21408 Treat eye socket fracture T 0256 21421 Treat mouth roof fracture T 0254 21422 Treat mouth roof fracture C 21423 Treat mouth roof fracture C 21431 Treat craniofacial fracture C 21432 Treat craniofacial fracture C 21433 Treat craniofacial fracture C 21435 Treat craniofacial fracture C 21436 Treat craniofacial fracture C 21440 Treat dental ridge fracture T 025421445 Treat dental ridge fracture T 0254

21450 Treat lower jaw fracture T 0251 21451 Treat lower jaw fracture T 0252 21452 Treat lower jaw fracture T 0253 21453 Treat lower jaw fracture T 0256 21454 Treat lower jaw fracture T 0254 21461 Treat lower jaw fracture T 0256 21462 Treat lower jaw fracture T 0256 21465 Treat lower jaw fracture T 0256 21470 Treat lower jaw fracture T 0256 21480 Reset dislocated jaw T 0250 21485 Reset dislocated jaw T 0253 21490 Repair dislocated jaw T 0256 21495 Treat hyoid bone fracture T 0253 21497 Interdental wiring T 0253 21499 Head surgery procedure T 0250 21501 Drain neck/chest lesion T 0008 21502 Drain chest lesion T 0049 21510 Drainage of bone lesion C 21550 Biopsy

of neck/chest T 0021 21552 Exc neck les sc 3 cm/> T 0022 21554 Exc neck tum deep 5 cm/> T 0022 21555 Exc neck les sc < 3 cm T 0021 21556 Exc neck tum deep < 5 cm T 0022 21557 Resect neck tum < 5 cm T 0021 21558 Resect neck tum 5 cm/> T 0022 21600 Partial removal of rib T 0050 21610 Partial removal of rib T 0050 21615 Removal of rib C 21616 Removal of rib and nerves C 21620 Partial removal of sternum C 21627 Sternal debridement C 21630 Extensive sternum surgery C 21632 Extensive sternum surgery C 21685 Hyoid myotomy & suspension T 0252 21700 Revision of neck muscle T 0049 21705 Revision of neck muscle/rib C 21720 Revision of neck muscle T 0049 21725 Revision of neck muscle T 0006 21740 Reconstruction of sternum C 21742 Repair stern/nuss w/o scope T 0051 21743 Repair sternum/nuss w/scope T 0051 21750 Repair of sternum separation C 21800 Treatment of rib fracture T 0129 21805 Treatment of rib fracture T 0062 21810 Treatment of rib fracture(s) C 21820 Treat sternum fracture T 0129 21825 Treat sternum fracture C 21899 Neck/chest surgery procedure T 0250 21920 Biopsy

soft tissue of back T 0020 21925 Biopsy

soft tissue of back T 0022 21930 Exc back les sc < 3 cm T 0021 21931 Exc back les sc 3 cm/> T 0022 21932 Exc back tum deep < 5 cm T 0021 21933 Exc back tum deep 5 cm/> T 002221935 Resect back tum < 5 cm T 0021

21936 Resect back tum 5 cm/> T 0022 22010 I&d p-spine c/t/cerv-thor C 22015 I&d p-spine l/s/ls C 22100 Remove part of neck vertebra T 0208 22101 Remove part thorax vertebra T 0208 22102 Remove part lumbar vertebra T 0208 22103 Remove extra spine segment T 0208 22110 Remove part of neck vertebra C 22112 Remove part thorax vertebra C 22114 Remove part lumbar vertebra C 22116 Remove extra spine segment C 22206 Cut spine 3 col thor C 22207 Cut spine 3 col lumb C 22208 Cut spine 3 col addl seg C 22210 Revision of neck spine C 22212 Revision of thorax spine C 22214 Revision of lumbar spine C 22216 Revise extra spine segment C 22220 Revision of neck spine C 22222 Revision of thorax spine T 0208 22224 Revision of lumbar spine C 22226 Revise extra spine segment C 22305 Treat spine process fracture T 0129 22310 Treat spine fracture T 0138 22315 Treat spine fracture T 0139 22318 Treat odontoid fx w/o graft C 22319 Treat odontoid fx w/graft C 22325 Treat spine fracture C 22326 Treat neck spine fracture C 22327 Treat thorax spine fracture C 22328 Treat each add spine fx C 22505 Manipulation of spine T 0045 22520 Percut vertebroplasty thor T 0050 22521 Percut vertebroplasty lumb T 0050 22522 Percut vertebroplasty addl T 0050 22523 Percut kyphoplasty thor T 0052 22524 Percut kyphoplasty lumbar T 0052 22525 Percut kyphoplasty add-on T 0052 22526 Idet single level E 22527 Idet 1 or more levels E 22532 Lat thorax spine fusion C 22533 Lat lumbar spine fusion C 22534 Lat thor/lumb addl seg C 22548 Neck spine fusion C 22551 Neck spine fuse&remov bel c2 NIT 0208 22552 Addl neck spine fusion C 22554 Neck spine fusion NIT 0208 22556 Thorax spine fusion C 22558 Lumbar spine fusion C 22585 Additional spinal fusion C 22590 Spine & skull spinal fusion C 22595 Neck spinal fusion C 22600 Neck spine fusion C 22610 Thorax spine fusion C22612 Lumbar spine fusion T 0208

22614 Spine fusion extra segment T 0208 22630 Lumbar spine fusion C 22632 Spine fusion extra segment C 22633 Lumbar spine fusion combined NIC 22634 Spine fusion extra segment NIC 22800 Fusion of spine C 22802 Fusion of spine C 22804 Fusion of spine C 22808 Fusion of spine C 22810 Fusion of spine C 22812 Fusion of spine C 22818 Kyphectomy 1-2 segments C 22819 Kyphectomy 3 or more C 22830 Exploration of spinal fusion C 22840 Insert spine fixation device C 22841 Insert spine fixation device C 22842 Insert spine fixation device C 22843 Insert spine fixation device C 22844 Insert spine fixation device C 22845 Insert spine fixation device C 22846 Insert spine fixation device C 22847 Insert spine fixation device C 22848 Insert pelv fixation device C 22849 Reinsert spinal fixation C 22850 Remove spine fixation device C 22851 Apply

spine prosth device CHT 0050 22852 Remove spine fixation device C 22855 Remove spine fixation device C 22856 Cerv artific diskectomy C 22857 Lumbar artif diskectomy C 22861 Revise cerv artific disc C 22862 Revise lumbar artif disc C 22864 Remove cerv artif disc C 22865 Remove lumb artif disc C 22899 Spine surgery procedure CHT 0050 22900 Exc abdl tum deep < 5 cm T 0022 22901 Exc abdl tum deep 5 cm/> T 0022 22902 Exc abd les sc < 3 cm T 0021 22903 Exc abd les sc 3 cm/> T 0022 22904 Resect abd tum < 5 cm T 0021 22905 Resect abd tum 5 cm/> T 0022 22999 Abdomen surgery procedure T 0049 23000 Removal of calcium deposits T 0021 23020 Release shoulder joint CHT 0050 23030 Drain shoulder lesion T 0008 23031 Drain shoulder bursa T 0008 23035 Drain shoulder bone lesion T 0049 23040 Exploratory shoulder surgery T 0050 23044 Exploratory shoulder surgery T 0050 23065 Biopsy

shoulder tissues T 0020 23066 Biopsy

shoulder tissues T 0022 23071 Exc shoulder les sc 3 cm/> T 0022 23073 Exc shoulder tum deep 5 cm/> T 0022 23075 Exc shoulder les sc < 3 cm T 002123076 Exc shoulder tum deep < 5 cm T 0021

23077 Resect shoulder tum < 5 cm T 0021 23078 Resect shoulder tum 5 cm/> T 0022 23100 Biopsy

of shoulder joint T 0049 23101 Shoulder joint surgery T 0050 23105 Remove shoulder joint lining T 0050 23106 Incision of collarbone joint T 0050 23107 Explore treat shoulder joint T 0050 23120 Partial removal collar bone T 0050 23125 Removal of collar bone T 0050 23130 Remove shoulder bone part T 0051 23140 Removal of bone lesion T 0049 23145 Removal of bone lesion T 0050 23146 Removal of bone lesion T 0050 23150 Removal of humerus lesion T 0050 23155 Removal of humerus lesion T 0050 23156 Removal of humerus lesion T 0050 23170 Remove collar bone lesion T 0050 23172 Remove shoulder blade lesion T 0050 23174 Remove humerus lesion T 0050 23180 Remove collar bone lesion T 0050 23182 Remove shoulder blade lesion T 0050 23184 Remove humerus lesion T 0050 23190 Partial removal of scapula T 0050 23195 Removal of head of humerus T 0050 23200 Resect clavicle tumor C 23210 Resect scapula tumor C 23220 Resect prox humerus tumor C 23330 Remove shoulder foreign body T 0020 23331 Remove shoulder foreign body T 0022 23332 Remove shoulder foreign body C 23350 Injection for shoulder x-ray N 23395 Muscle transfer shoulder/arm T 0051 23397 Muscle transfers T 0052 23400 Fixation of shoulder blade T 0050 23405 Incision of tendon & muscle T 0050 23406 Incise tendon(s) & muscle(s) T 0050 23410 Repair rotator cuff acute T 0051 23412 Repair rotator cuff chronic T 0051 23415 Release of shoulder ligament T 0051 23420 Repair of shoulder T 0051 23430 Repair biceps tendon T 0051 23440 Remove/transplant tendon CHT 0050 23450 Repair shoulder capsule T 0052 23455 Repair shoulder capsule T 0052 23460 Repair shoulder capsule T 0052 23462 Repair shoulder capsule T 0051 23465 Repair shoulder capsule T 0052 23466 Repair shoulder capsule T 0051 23470 Reconstruct shoulder joint T 0425 23472 Reconstruct shoulder joint C 23480 Revision of collar bone T 0051 23485 Revision of collar bone T 0052 23490 Reinforce clavicle T 0052 23491 Reinforce shoulder bones T 005223500 Treat clavicle fracture T 0129

23505 Treat clavicle fracture T 0139 23515 Treat clavicle fracture T 0064 23520 Treat clavicle dislocation T 0138 23525 Treat clavicle dislocation T 0138 23530 Treat clavicle dislocation T 0063 23532 Treat clavicle dislocation T 0062 23540 Treat clavicle dislocation T 0129 23545 Treat clavicle dislocation T 0138 23550 Treat clavicle dislocation T 0063 23552 Treat clavicle dislocation T 0063 23570 Treat shoulder blade fx T 0129 23575 Treat shoulder blade fx T 0138 23585 Treat scapula fracture T 0064 23600 Treat humerus fracture T 0129 23605 Treat humerus fracture T 0139 23615 Treat humerus fracture T 0064 23616 Treat humerus fracture T 0064 23620 Treat humerus fracture T 0129 23625 Treat humerus fracture T 0139 23630 Treat humerus fracture T 0064 23650 Treat shoulder dislocation T 0129 23655 Treat shoulder dislocation T 0045 23660 Treat shoulder dislocation T 0063 23665 Treat dislocation/fracture T 0138 23670 Treat dislocation/fracture T 0064 23675 Treat dislocation/fracture T 0129 23680 Treat dislocation/fracture T 0063 23700 Fixation of shoulder T 0045 23800 Fusion of shoulder joint T 0052 23802 Fusion of shoulder joint T 0052 23900 Amputation of arm & girdle C 23920 Amputation at shoulder joint C 23921 Amputation follow-up surgery T 0136 23929 Shoulder surgery procedure T 0129 23930 Drainage of arm lesion T 0008 23931 Drainage of arm bursa T 0008 23935 Drain arm/elbow bone lesion T 0049 24000 Exploratory elbow surgery T 0050 24006 Release elbow joint T 0050 24065 Biopsy

arm/elbow soft tissue T 0021 24066 Biopsy

arm/elbow soft tissue T 0021 24071 Exc arm/elbow les sc 3 cm/> T 0022 24073 Ex arm/elbow tum deep 5 cm/> T 0022 24075 Exc arm/elbow les sc < 3 cm T 0021 24076 Ex arm/elbow tum deep < 5 cm T 0021 24077 Resect arm/elbow tum < 5 cm T 0021 24079 Resect arm/elbow tum 5 cm/> T 0022 24100 Biopsy

elbow joint lining T 0049 24101 Explore/treat elbow joint T 0050 24102 Remove elbow joint lining T 0050 24105 Removal of elbow bursa T 0049 24110 Remove humerus lesion T 0049 24115 Remove/graft bone lesion T 0050 24116 Remove/graft bone lesion T 005024120 Remove elbow lesion T 0049

24125 Remove/graft bone lesion T 0050 24126 Remove/graft bone lesion T 0050 24130 Removal of head of radius T 0050 24134 Removal of arm bone lesion T 0050 24136 Remove radius bone lesion T 0050 24138 Remove elbow bone lesion T 0050 24140 Partial removal of arm bone T 0050 24145 Partial removal of radius T 0050 24147 Partial removal of elbow T 0050 24149 Radical resection of elbow T 0050 24150 Resect distal humerus tumor T 0051 24152 Resect radius tumor T 0051 24155 Removal of elbow joint CHT 0050 24160 Remove elbow joint implant T 0050 24164 Remove radius head implant T 0050 24200 Removal of arm foreign body T 0019 24201 Removal of arm foreign body T 0021 24220 Injection for elbow x-ray N 24300 Manipulate elbow w/anesth T 0045 24301 Muscle/tendon transfer T 0050 24305 Arm tendon lengthening T 0050 24310 Revision of arm tendon T 0049 24320 Repair of arm tendon CHT 0050 24330 Revision of arm muscles T 0052 24331 Revision of arm muscles T 0051 24332 Tenolysis triceps CHT 0050 24340 Repair of biceps tendon T 0051 24341 Repair arm tendon/muscle T 0051 24342 Repair of ruptured tendon T 0051 24343 Repr elbow lat ligmnt w/tiss T 0050 24344 Reconstruct elbow lat ligmnt T 0052 24345 Repr elbw med ligmnt w/tissu T 0050 24346 Reconstruct elbow med ligmnt T 0052 24357 Repair elbow perc T 0050 24358 Repair elbow w/deb open T 0050 24359 Repair elbow deb/attch open T 0050 24360 Reconstruct elbow joint T 0047 24361 Reconstruct elbow joint T 0425 24362 Reconstruct elbow joint T 0048 24363 Replace elbow joint T 0425 24365 Reconstruct head of radius T 0047 24366 Reconstruct head of radius T 0425 24400 Revision of humerus T 0052 24410 Revision of humerus T 0051 24420 Revision of humerus T 0051 24430 Repair of humerus T 0052 24435 Repair humerus with graft T 0052 24470 Revision of elbow joint T 0051 24495 Decompression of forearm T 0050 24498 Reinforce humerus T 0052 24500 Treat humerus fracture T 0129 24505 Treat humerus fracture T 0129 24515 Treat humerus fracture T 0064 24516 Treat humerus fracture T 006424530 Treat humerus fracture T 0129

24535 Treat humerus fracture T 0138 24538 Treat humerus fracture T 0062 24545 Treat humerus fracture T 0064 24546 Treat humerus fracture T 0064 24560 Treat humerus fracture T 0129 24565 Treat humerus fracture T 0129 24566 Treat humerus fracture T 0062 24575 Treat humerus fracture T 0064 24576 Treat humerus fracture T 0129 24577 Treat humerus fracture T 0129 24579 Treat humerus fracture T 0064 24582 Treat humerus fracture T 0062 24586 Treat elbow fracture T 0064 24587 Treat elbow fracture T 0064 24600 Treat elbow dislocation T 0129 24605 Treat elbow dislocation T 0045 24615 Treat elbow dislocation T 0064 24620 Treat elbow fracture T 0139 24635 Treat elbow fracture T 0064 24640 Treat elbow dislocation T 0129 24650 Treat radius fracture T 0129 24655 Treat radius fracture T 0138 24665 Treat radius fracture T 0063 24666 Treat radius fracture T 0064 24670 Treat ulnar fracture T 0129 24675 Treat ulnar fracture T 0129 24685 Treat ulnar fracture T 0063 24800 Fusion of elbow joint T 0051 24802 Fusion/graft of elbow joint T 0052 24900 Amputation of upper arm C 24920 Amputation of upper arm C 24925 Amputation follow-up surgery T 0049 24930 Amputation follow-up surgery C 24931 Amputate upper arm & implant C 24935 Revision of amputation T 0052 24940 Revision of upper arm C 24999 Upper arm/elbow surgery T 0129 25000 Incision of tendon sheath T 0049 25001 Incise flexor carpi radialis T 0049 25020 Decompress forearm 1 space T 0050 25023 Decompress forearm 1 space T 0050 25024 Decompress forearm 2 spaces T 0050 25025 Decompress forearm 2 spaces T 0050 25028 Drainage of forearm lesion T 0049 25031 Drainage of forearm bursa T 0049 25035 Treat forearm bone lesion T 0049 25040 Explore/treat wrist joint T 0050 25065 Biopsy

forearm soft tissues T 0020 25066 Biopsy

forearm soft tissues T 0022 25071 Exc forearm les sc 3 cm/> T 0022 25073 Exc forearm tum deep 3 cm/> T 0022 25075 Exc forearm les sc < 3 cm T 0021 25076 Exc forearm tum deep < 3 cm T 0021 25077 Resect forearm/wrist tum<3cm T 002125078 Resect forarm/wrist tum 3cm> T 0022

25085 Incision of wrist capsule T 0049 25100 Biopsy

of wrist joint T 0049 25101 Explore/treat wrist joint T 0050 25105 Remove wrist joint lining T 0050 25107 Remove wrist joint cartilage T 0050 25109 Excise tendon forearm/wrist T 0049 25110 Remove wrist tendon lesion T 0049 25111 Remove wrist tendon lesion T 0049 25112 Reremove wrist tendon lesion T 0049 25115 Remove wrist/forearm lesion T 0049 25116 Remove wrist/forearm lesion T 0049 25118 Excise wrist tendon sheath T 0050 25119 Partial removal of ulna T 0050 25120 Removal of forearm lesion T 0050 25125 Remove/graft forearm lesion T 0050 25126 Remove/graft forearm lesion T 0050 25130 Removal of wrist lesion T 0050 25135 Remove & graft wrist lesion T 0050 25136 Remove & graft wrist lesion T 0050 25145 Remove forearm bone lesion T 0050 25150 Partial removal of ulna T 0050 25151 Partial removal of radius T 0050 25170 Resect radius/ulnar tumor CHT 0050 25210 Removal of wrist bone T 0050 25215 Removal of wrist bones T 0050 25230 Partial removal of radius T 0050 25240 Partial removal of ulna T 0050 25246 Injection for wrist x-ray N 25248 Remove forearm foreign body T 0049 25250 Removal of wrist prosthesis T 0050 25251 Removal of wrist prosthesis T 0050 25259 Manipulate wrist w/anesthes T 0139 25260 Repair forearm tendon/muscle T 0050 25263 Repair forearm tendon/muscle T 0050 25265 Repair forearm tendon/muscle T 0050 25270 Repair forearm tendon/muscle T 0050 25272 Repair forearm tendon/muscle T 0050 25274 Repair forearm tendon/muscle T 0050 25275 Repair forearm tendon sheath T 0050 25280 Revise wrist/forearm tendon T 0050 25290 Incise wrist/forearm tendon T 0050 25295 Release wrist/forearm tendon T 0049 25300 Fusion of tendons at wrist T 0050 25301 Fusion of tendons at wrist T 0050 25310 Transplant forearm tendon CHT 0050 25312 Transplant forearm tendon T 0051 25315 Revise palsy hand tendon(s) CHT 0050 25316 Revise palsy hand tendon(s) T 0052 25320 Repair/revise wrist joint T 0051 25332 Revise wrist joint T 0047 25335 Realignment of hand T 0051 25337 Reconstruct ulna/radioulnar T 0051 25350 Revision of radius T 0051 25355 Revision of radius T 005125360 Revision of ulna T 0051

25365 Revise radius & ulna T 0052 25370 Revise radius or ulna T 0051 25375 Revise radius & ulna T 0051 25390 Shorten radius or ulna T 0051 25391 Lengthen radius or ulna T 0052 25392 Shorten radius & ulna T 0050 25393 Lengthen radius & ulna T 0051 25394 Repair carpal bone shorten T 0051 25400 Repair radius or ulna T 0052 25405 Repair/graft radius or ulna T 0052 25415 Repair radius & ulna T 0052 25420 Repair/graft radius & ulna T 0052 25425 Repair/graft radius or ulna T 0052 25426 Repair/graft radius & ulna T 0051 25430 Vasc graft into carpal bone T 0051 25431 Repair nonunion carpal bone T 0051 25440 Repair/graft wrist bone T 0052 25441 Reconstruct wrist joint T 0425 25442 Reconstruct wrist joint T 0425 25443 Reconstruct wrist joint T 0048 25444 Reconstruct wrist joint T 0048 25445 Reconstruct wrist joint T 0048 25446 Wrist replacement T 0425 25447 Repair wrist joints T 0047 25449 Remove wrist joint implant T 0047 25450 Revision of wrist joint T 0051 25455 Revision of wrist joint T 0051 25490 Reinforce radius T 0051 25491 Reinforce ulna T 0051 25492 Reinforce radius and ulna T 0051 25500 Treat fracture of radius T 0129 25505 Treat fracture of radius T 0138 25515 Treat fracture of radius T 0063 25520 Treat fracture of radius T 0138 25525 Treat fracture of radius T 0063 25526 Treat fracture of radius T 0063 25530 Treat fracture of ulna T 0129 25535 Treat fracture of ulna T 0129 25545 Treat fracture of ulna T 0063 25560 Treat fracture radius & ulna T 0129 25565 Treat fracture radius & ulna T 0138 25574 Treat fracture radius & ulna T 0064 25575 Treat fracture radius/ulna T 0064 25600 Treat fracture radius/ulna T 0129 25605 Treat fracture radius/ulna T 0138 25606 Treat fx distal radial T 0062 25607 Treat fx rad extra-articul T 0064 25608 Treat fx rad intra-articul T 0064 25609 Treat fx radial 3+ frag T 0064 25622 Treat wrist bone fracture T 0129 25624 Treat wrist bone fracture T 0138 25628 Treat wrist bone fracture T 0063 25630 Treat wrist bone fracture T 0129 25635 Treat wrist bone fracture T 012925645 Treat wrist bone fracture T 0063

25650 Treat wrist bone fracture T 0129 25651 Pin ulnar styloid fracture T 0062 25652 Treat fracture ulnar styloid T 0063 25660 Treat wrist dislocation T 0129 25670 Treat wrist dislocation T 0062 25671 Pin radioulnar dislocation T 0062 25675 Treat wrist dislocation T 0129 25676 Treat wrist dislocation T 0062 25680 Treat wrist fracture T 0129 25685 Treat wrist fracture T 0062 25690 Treat wrist dislocation T 0139 25695 Treat wrist dislocation T 0062 25800 Fusion of wrist joint T 0052 25805 Fusion/graft of wrist joint T 0052 25810 Fusion/graft of wrist joint T 0052 25820 Fusion of hand bones T 0051 25825 Fuse hand bones with graft T 0052 25830 Fusion radioulnar jnt/ulna T 0052 25900 Amputation of forearm C 25905 Amputation of forearm C 25907 Amputation follow-up surgery T 0049 25909 Amputation follow-up surgery T 0049 25915 Amputation of forearm C 25920 Amputate hand at wrist C 25922 Amputate hand at wrist T 0049 25924 Amputation follow-up surgery C 25927 Amputation of hand C 25929 Amputation follow-up surgery T 0136 25931 Amputation follow-up surgery T 0049 25999 Forearm or wrist surgery T 0129 26010 Drainage of finger abscess T 0006 26011 Drainage of finger abscess T 0007 26020 Drain hand tendon sheath T 0053 26025 Drainage of palm bursa T 0053 26030 Drainage of palm bursas T 0053 26034 Treat hand bone lesion T 0053 26035 Decompress fingers/hand T 0053 26037 Decompress fingers/hand T 0053 26040 Release palm contracture T 0053 26045 Release palm contracture T 0054 26055 Incise finger tendon sheath T 0053 26060 Incision of finger tendon T 0053 26070 Explore/treat hand joint T 0053 26075 Explore/treat finger joint T 0053 26080 Explore/treat finger joint T 0053 26100 Biopsy

hand joint lining T 0053 26105 Biopsy

finger joint lining T 0053 26110 Biopsy

finger joint lining T 0053 26111 Exc hand les sc 1.5 cm/> T 0022 26113 Exc hand tum deep 1.5 cm/> T 0022 26115 Exc hand les sc < 1.5 cm T 0021 26116 Exc hand tum deep < 1.5 cm T 0021 26117 Exc hand tum ra < 3 cm T 0021 26118 Exc hand tum ra 3 cm/> T 002226121 Release palm contracture T 0054

26123 Release palm contracture T 0054 26125 Release palm contracture T 0053 26130 Remove wrist joint lining T 0053 26135 Revise finger joint each T 0054 26140 Revise finger joint each T 0053 26145 Tendon excision palm/finger T 0053 26160 Remove tendon sheath lesion T 0053 26170 Removal of palm tendon each T 0053 26180 Removal of finger tendon T 0053 26185 Remove finger bone T 0053 26200 Remove hand bone lesion T 0053 26205 Remove/graft bone lesion T 0054 26210 Removal of finger lesion T 0053 26215 Remove/graft finger lesion T 0053 26230 Partial removal of hand bone T 0053 26235 Partial removal finger bone T 0053 26236 Partial removal finger bone T 0053 26250 Extensive hand surgery T 0053 26260 Resect prox finger tumor T 0053 26262 Resect distal finger tumor T 0053 26320 Removal of implant from hand T 0021 26340 Manipulate finger w/anesth T 0138 26341 Manipulat palmcord post inj NIT 0138 26350 Repair finger/hand tendon T 0054 26352 Repair/graft hand tendon T 0054 26356 Repair finger/hand tendon T 0054 26357 Repair finger/hand tendon T 0054 26358 Repair/graft hand tendon T 0054 26370 Repair finger/hand tendon T 0054 26372 Repair/graft hand tendon T 0054 26373 Repair finger/hand tendon T 0054 26390 Revise hand/finger tendon T 0054 26392 Repair/graft hand tendon T 0054 26410 Repair hand tendon T 0053 26412 Repair/graft hand tendon T 0054 26415 Excision hand/finger tendon T 0054 26416 Graft hand or finger tendon T 0054 26418 Repair finger tendon T 0053 26420 Repair/graft finger tendon T 0054 26426 Repair finger/hand tendon T 0054 26428 Repair/graft finger tendon T 0054 26432 Repair finger tendon T 0053 26433 Repair finger tendon T 0053 26434 Repair/graft finger tendon T 0054 26437 Realignment of tendons T 0053 26440 Release palm/finger tendon T 0053 26442 Release palm & finger tendon T 0054 26445 Release hand/finger tendon T 0053 26449 Release forearm/hand tendon T 0054 26450 Incision of palm tendon T 0053 26455 Incision of finger tendon T 0053 26460 Incise hand/finger tendon T 0053 26471 Fusion of finger tendons T 0053 26474 Fusion of finger tendons T 005326476 Tendon lengthening T 0053

26477 Tendon shortening T 0053 26478 Lengthening of hand tendon T 0053 26479 Shortening of hand tendon T 0053 26480 Transplant hand tendon T 0054 26483 Transplant/graft hand tendon T 0054 26485 Transplant palm tendon T 0054 26489 Transplant/graft palm tendon T 0054 26490 Revise thumb tendon T 0054 26492 Tendon transfer with graft T 0054 26494 Hand tendon/muscle transfer T 0054 26496 Revise thumb tendon T 0054 26497 Finger tendon transfer T 0054 26498 Finger tendon transfer T 0054 26499 Revision of finger T 0054 26500 Hand tendon reconstruction T 0053 26502 Hand tendon reconstruction T 0054 26508 Release thumb contracture T 0053 26510 Thumb tendon transfer T 0054 26516 Fusion of knuckle joint T 0054 26517 Fusion of knuckle joints T 0054 26518 Fusion of knuckle joints T 0054 26520 Release knuckle contracture T 0053 26525 Release finger contracture T 0053 26530 Revise knuckle joint T 0047 26531 Revise knuckle with implant T 0048 26535 Revise finger joint T 0047 26536 Revise/implant finger joint T 0048 26540 Repair hand joint T 0053 26541 Repair hand joint with graft T 0054 26542 Repair hand joint with graft T 0053 26545 Reconstruct finger joint T 0054 26546 Repair nonunion hand T 0054 26548 Reconstruct finger joint T 0054 26550 Construct thumb replacement T 0054 26551 Great toe-hand transfer C 26553 Single transfer toe-hand C 26554 Double transfer toe-hand C 26555 Positional change of finger T 0054 26556 Toe joint transfer C 26560 Repair of web finger T 0053 26561 Repair of web finger T 0054 26562 Repair of web finger T 0054 26565 Correct metacarpal flaw T 0054 26567 Correct finger deformity T 0054 26568 Lengthen metacarpal/finger T 0054 26580 Repair hand deformity T 0053 26587 Reconstruct extra finger T 0053 26590 Repair finger deformity T 0053 26591 Repair muscles of hand T 0054 26593 Release muscles of hand T 0053 26596 Excision constricting tissue T 0053 26600 Treat metacarpal fracture T 0129 26605 Treat metacarpal fracture T 0129 26607 Treat metacarpal fracture T 013926608 Treat metacarpal fracture T 0062

26615 Treat metacarpal fracture T 0063 26641 Treat thumb dislocation T 0129 26645 Treat thumb fracture T 0138 26650 Treat thumb fracture T 0062 26665 Treat thumb fracture T 0063 26670 Treat hand dislocation T 0129 26675 Treat hand dislocation T 0129 26676 Pin hand dislocation T 0062 26685 Treat hand dislocation T 0062 26686 Treat hand dislocation T 0064 26700 Treat knuckle dislocation T 0129 26705 Treat knuckle dislocation T 0129 26706 Pin knuckle dislocation T 0139 26715 Treat knuckle dislocation T 0062 26720 Treat finger fracture each T 0129 26725 Treat finger fracture each T 0129 26727 Treat finger fracture each T 0062 26735 Treat finger fracture each T 0062 26740 Treat finger fracture each T 0129 26742 Treat finger fracture each T 0129 26746 Treat finger fracture each T 0062 26750 Treat finger fracture each T 0129 26755 Treat finger fracture each T 0129 26756 Pin finger fracture each T 0062 26765 Treat finger fracture each T 0062 26770 Treat finger dislocation T 0129 26775 Treat finger dislocation T 0045 26776 Pin finger dislocation T 0062 26785 Treat finger dislocation T 0062 26820 Thumb fusion with graft T 0054 26841 Fusion of thumb T 0054 26842 Thumb fusion with graft T 0054 26843 Fusion of hand joint T 0054 26844 Fusion/graft of hand joint T 0054 26850 Fusion of knuckle T 0054 26852 Fusion of knuckle with graft T 0054 26860 Fusion of finger joint T 0054 26861 Fusion of finger jnt add-on T 0054 26862 Fusion/graft of finger joint T 0054 26863 Fuse/graft added joint T 0054 26910 Amputate metacarpal bone T 0054 26951 Amputation of finger/thumb T 0053 26952 Amputation of finger/thumb T 0053 26989 Hand/finger surgery T 0129 26990 Drainage of pelvis lesion T 0049 26991 Drainage of pelvis bursa T 0049 26992 Drainage of bone lesion C 27000 Incision of hip tendon T 0049 27001 Incision of hip tendon T 0050 27003 Incision of hip tendon T 0050 27005 Incision of hip tendon C 27006 Incision of hip tendons T 0050 27025 Incision of hip/thigh fascia C 27027 Buttock fasciotomy CHT 005027030 Drainage of hip joint C

27033 Exploration of hip joint T 0051 27035 Denervation of hip joint CHT 0050 27036 Excision of hip joint/muscle C 27040 Biopsy

of soft tissues T 0020 27041 Biopsy

of soft tissues T 0020 27043 Exc hip pelvis les sc 3 cm/> T 0022 27045 Exc hip/pelv tum deep 5 cm/> T 0022 27047 Exc hip/pelvis les sc < 3 cm T 0021 27048 Exc hip/pelv tum deep < 5 cm T 0021 27049 Resect hip/pelv tum < 5 cm T 0021 27050 Biopsy

of sacroiliac joint T 0049 27052 Biopsy

of hip joint T 0049 27054 Removal of hip joint lining C 27057 Buttock fasciotomy w/dbrdmt T 0049 27059 Resect hip/pelv tum 5 cm/> T 0022 27060 Removal of ischial bursa T 0049 27062 Remove femur lesion/bursa T 0049 27065 Remove hip bone les super T 0049 27066 Remove hip bone les deep T 0050 27067 Remove/graft hip bone lesion T 0050 27070 Part remove hip bone super C 27071 Part removal hip bone deep C 27075 Resect hip tumor C 27076 Resect hip tum incl acetabul C 27077 Resect hip tum w/innom bone C 27078 Rsect hip tum incl femur C 27080 Removal of tail bone T 0050 27086 Remove hip foreign body T 0020 27087 Remove hip foreign body T 0049 27090 Removal of hip prosthesis C 27091 Removal of hip prosthesis C 27093 Injection for hip x-ray N 27095 Injection for hip x-ray N 27096 Inject sacroiliac joint B 27097 Revision of hip tendon T 0050 27098 Transfer tendon to pelvis T 0050 27100 Transfer of abdominal muscle T 0051 27105 Transfer of spinal muscle T 0051 27110 Transfer of iliopsoas muscle T 0051 27111 Transfer of iliopsoas muscle T 0051 27120 Reconstruction of hip socket C 27122 Reconstruction of hip socket C 27125 Partial hip replacement C 27130 Total hip arthroplasty C 27132 Total hip arthroplasty C 27134 Revise hip joint replacement C 27137 Revise hip joint replacement C 27138 Revise hip joint replacement C 27140 Transplant femur ridge C 27146 Incision of hip bone C 27147 Revision of hip bone C 27151 Incision of hip bones C 27156 Revision of hip bones C 27158 Revision of pelvis C27161 Incision of neck of femur C

27165 Incision/fixation of femur C 27170 Repair/graft femur head/neck C 27175 Treat slipped epiphysis C 27176 Treat slipped epiphysis C 27177 Treat slipped epiphysis C 27178 Treat slipped epiphysis C 27179 Revise head/neck of femur T 0052 27181 Treat slipped epiphysis C 27185 Revision of femur epiphysis C 27187 Reinforce hip bones C 27193 Treat pelvic ring fracture T 0129 27194 Treat pelvic ring fracture T 0045 27200 Treat tail bone fracture T 0129 27202 Treat tail bone fracture T 0063 27215 Treat pelvic fracture(s) E 27216 Treat pelvic ring fracture E 27217 Treat pelvic ring fracture E 27218 Treat pelvic ring fracture E 27220 Treat hip socket fracture T 0129 27222 Treat hip socket fracture C 27226 Treat hip wall fracture C 27227 Treat hip fracture(s) C 27228 Treat hip fracture(s) C 27230 Treat thigh fracture T 0129 27232 Treat thigh fracture C 27235 Treat thigh fracture T 0050 27236 Treat thigh fracture C 27238 Treat thigh fracture T 0138 27240 Treat thigh fracture C 27244 Treat thigh fracture C 27245 Treat thigh fracture C 27246 Treat thigh fracture T 0138 27248 Treat thigh fracture C 27250 Treat hip dislocation T 0129 27252 Treat hip dislocation T 0045 27253 Treat hip dislocation C 27254 Treat hip dislocation C 27256 Treat hip dislocation T 0129 27257 Treat hip dislocation T 0045 27258 Treat hip dislocation C 27259 Treat hip dislocation C 27265 Treat hip dislocation T 0129 27266 Treat hip dislocation T 0045 27267 Cltx thigh fx T 0129 27268 Cltx thigh fx w/mnpj C 27269 Optx thigh fx C 27275 Manipulation of hip joint T 0045 27280 Fusion of sacroiliac joint C 27282 Fusion of pubic bones C 27284 Fusion of hip joint C 27286 Fusion of hip joint C 27290 Amputation of leg at hip C 27295 Amputation of leg at hip C 27299 Pelvis/hip joint surgery T 012927301 Drain thigh/knee lesion T 0008

27303 Drainage of bone lesion C 27305 Incise thigh tendon & fascia T 0049 27306 Incision of thigh tendon T 0049 27307 Incision of thigh tendons CHT 0050 27310 Exploration of knee joint T 0050 27323 Biopsy

thigh soft tissues T 0020 27324 Biopsy

thigh soft tissues T 0022 27325 Neurectomy hamstring T 0220 27326 Neurectomy popliteal T 0220 27327 Exc thigh/knee les sc < 3 cm T 0022 27328 Exc thigh/knee tum deep <5cm T 0021 27329 Resect thigh/knee tum < 5 cm T 0021 27330 Biopsy

knee joint lining T 0050 27331 Explore/treat knee joint T 0050 27332 Removal of knee cartilage T 0050 27333 Removal of knee cartilage T 0050 27334 Remove knee joint lining T 0050 27335 Remove knee joint lining T 0050 27337 Exc thigh/knee les sc 3 cm/> T 0022 27339 Exc thigh/knee tum dep 5cm/> T 0022 27340 Removal of kneecap bursa T 0049 27345 Removal of knee cyst T 0049 27347 Remove knee cyst T 0049 27350 Removal of kneecap T 0050 27355 Remove femur lesion T 0050 27356 Remove femur lesion/graft T 0050 27357 Remove femur lesion/graft T 0050 27358 Remove femur lesion/fixation T 0050 27360 Partial removal leg bone(s) T 0050 27364 Resect thigh/knee tum 5 cm/> T 0022 27365 Resect femur/knee tumor C 27370 Injection for knee x-ray N 27372 Removal of foreign body T 0022 27380 Repair of kneecap tendon CHT 0050 27381 Repair/graft kneecap tendon CHT 0050 27385 Repair of thigh muscle CHT 0050 27386 Repair/graft of thigh muscle CHT 0050 27390 Incision of thigh tendon T 0049 27391 Incision of thigh tendons T 0049 27392 Incision of thigh tendons CHT 0050 27393 Lengthening of thigh tendon T 0050 27394 Lengthening of thigh tendons T 0050 27395 Lengthening of thigh tendons T 0051 27396 Transplant of thigh tendon T 0050 27397 Transplants of thigh tendons T 0051 27400 Revise thigh muscles/tendons T 0051 27403 Repair of knee cartilage T 0050 27405 Repair of knee ligament T 0051 27407 Repair of knee ligament T 0052 27409 Repair of knee ligaments T 0052 27412 Autochondrocy te implant knee T 0052 27415 Osteochondral knee allograft T 0052 27416 Osteochondral knee autograft T 0051 27418 Repair degenerated kneecap T 005127420 Revision of unstable kneecap T 0051

27422 Revision of unstable kneecap T 0051 27424 Revision/removal of kneecap T 0051 27425 Lat retinacular release open T 0050 27427 Reconstruction knee T 0052 27428 Reconstruction knee T 0052 27429 Reconstruction knee T 0052 27430 Revision of thigh muscles T 0051 27435 Incision of knee joint CHT 0050 27437 Revise kneecap T 0047 27438 Revise kneecap with implant T 0048 27440 Revision of knee joint T 0047 27441 Revision of knee joint T 0047 27442 Revision of knee joint T 0047 27443 Revision of knee joint T 0047 27445 Revision of knee joint C 27446 Revision of knee joint T 0425 27447 Total knee arthroplasty C 27448 Incision of thigh C 27450 Incision of thigh C 27454 Realignment of thigh bone C 27455 Realignment of knee C 27457 Realignment of knee C 27465 Shortening of thigh bone C 27466 Lengthening of thigh bone C 27468 Shorten/lengthen thighs C 27470 Repair of thigh C 27472 Repair/graft of thigh C 27475 Surgery

to stop leg growth T 0050 27477 Surgery

to stop leg growth C 27479 Surgery

to stop leg growth T 0050 27485 Surgery

to stop leg growth C 27486 Revise/replace knee joint C 27487 Revise/replace knee joint C 27488 Removal of knee prosthesis C 27495 Reinforce thigh C 27496 Decompression of thigh/knee T 0050 27497 Decompression of thigh/knee T 0049 27498 Decompression of thigh/knee T 0050 27499 Decompression of thigh/knee T 0050 27500 Treatment of thigh fracture T 0138 27501 Treatment of thigh fracture T 0129 27502 Treatment of thigh fracture T 0139 27503 Treatment of thigh fracture T 0129 27506 Treatment of thigh fracture C 27507 Treatment of thigh fracture C 27508 Treatment of thigh fracture T 0129 27509 Treatment of thigh fracture T 0062 27510 Treatment of thigh fracture T 0138 27511 Treatment of thigh fracture C 27513 Treatment of thigh fracture C 27514 Treatment of thigh fracture C 27516 Treat thigh fx growth plate T 0129 27517 Treat thigh fx growth plate T 0129 27519 Treat thigh fx growth plate C27520 Treat kneecap fracture T 0129

27524 Treat kneecap fracture T 0063 27530 Treat knee fracture T 0129 27532 Treat knee fracture T 0139 27535 Treat knee fracture C 27536 Treat knee fracture C 27538 Treat knee fracture(s) T 0129 27540 Treat knee fracture C 27550 Treat knee dislocation T 0129 27552 Treat knee dislocation T 0045 27556 Treat knee dislocation C 27557 Treat knee dislocation C 27558 Treat knee dislocation C 27560 Treat kneecap dislocation T 0129 27562 Treat kneecap dislocation T 0045 27566 Treat kneecap dislocation T 0063 27570 Fixation of knee joint T 0045 27580 Fusion of knee C 27590 Amputate leg at thigh C 27591 Amputate leg at thigh C 27592 Amputate leg at thigh C 27594 Amputation follow-up surgery T 0049 27596 Amputation follow-up surgery C 27598 Amputate lower leg at knee C 27599 Leg surgery procedure T 0129 27600 Decompression of lower leg T 0049 27601 Decompression of lower leg T 0049 27602 Decompression of lower leg CHT 0050 27603 Drain lower leg lesion T 0008 27604 Drain lower leg bursa CHT 0050 27605 Incision of achilles tendon T 0055 27606 Incision of achilles tendon T 0049 27607 Treat lower leg bone lesion T 0049 27610 Explore/treat ankle joint T 0050 27612 Exploration of ankle joint T 0050 27613 Biopsy

lower leg soft tissue T 0020 27614 Biopsy

lower leg soft tissue T 0022 27615 Resect leg/ankle tum < 5 cm T 0021 27616 Resect leg/ankle tum 5 cm/> T 0022 27618 Exc leg/ankle tum < 3 cm T 0021 27619 Exc leg/ankle tum deep <5 cm T 0021 27620 Explore/treat ankle joint T 0050 27625 Remove ankle joint lining T 0050 27626 Remove ankle joint lining T 0050 27630 Removal of tendon lesion T 0049 27632 Exc leg/ankle les sc 3 cm/> T 0022 27634 Exc leg/ankle tum dep 5 cm/> T 0022 27635 Remove lower leg bone lesion T 0050 27637 Remove/graft leg bone lesion T 0050 27638 Remove/graft leg bone lesion T 0050 27640 Partial removal of tibia CHT 0050 27641 Partial removal of fibula T 0050 27645 Resect tibia tumor C 27646 Resect fibula tumor C 27647 Resect talus/calcaneus tum CHT 005027648 Injection for ankle x-ray N

27650 Repair achilles tendon T 0051 27652 Repair/graft achilles tendon T 0052 27654 Repair of achilles tendon T 0051 27656 Repair leg fascia defect T 0049 27658 Repair of leg tendon each T 0049 27659 Repair of leg tendon each T 0049 27664 Repair of leg tendon each T 0050 27665 Repair of leg tendon each T 0050 27675 Repair lower leg tendons T 0049 27676 Repair lower leg tendons T 0050 27680 Release of lower leg tendon T 0050 27681 Release of lower leg tendons T 0050 27685 Revision of lower leg tendon T 0050 27686 Revise lower leg tendons T 0050 27687 Revision of calf tendon T 0050 27690 Revise lower leg tendon T 0051 27691 Revise lower leg tendon T 0051 27692 Revise additional leg tendon T 0051 27695 Repair of ankle ligament T 0050 27696 Repair of ankle ligaments T 0050 27698 Repair of ankle ligament T 0050 27700 Revision of ankle joint T 0047 27702 Reconstruct ankle joint C 27703 Reconstruction ankle joint C 27704 Removal of ankle implant T 0049 27705 Incision of tibia T 0051 27707 Incision of fibula CHT 0050 27709 Incision of tibia & fibula T 0050 27712 Realignment of lower leg C 27715 Revision of lower leg C 27720 Repair of tibia T 0063 27722 Repair/graft of tibia T 0064 27724 Repair/graft of tibia C 27725 Repair of lower leg C 27726 Repair fibula nonunion T 0063 27727 Repair of lower leg C 27730 Repair of tibia epiphysis T 0050 27732 Repair of fibula epiphysis T 0050 27734 Repair lower leg epiphyses T 0050 27740 Repair of leg epiphyses T 0050 27742 Repair of leg epiphyses T 0051 27745 Reinforce tibia T 0052 27750 Treatment of tibia fracture T 0129 27752 Treatment of tibia fracture T 0139 27756 Treatment of tibia fracture T 0062 27758 Treatment of tibia fracture T 0063 27759 Treatment of tibia fracture T 0064 27760 Cltx medial ankle fx T 0129 27762 Cltx med ankle fx w/mnpj T 0139 27766 Optx medial ankle fx T 0063 27767 Cltx post ankle fx T 0129 27768 Cltx post ankle fx w/mnpj T 0129 27769 Optx post ankle fx T 0063 27780 Treatment of fibula fracture T 012927781 Treatment of fibula fracture T 0139

27784 Treatment of fibula fracture T 0063 27786 Treatment of ankle fracture T 0129 27788 Treatment of ankle fracture T 0129 27792 Treatment of ankle fracture T 0063 27808 Treatment of ankle fracture T 0129 27810 Treatment of ankle fracture T 0129 27814 Treatment of ankle fracture T 0063 27816 Treatment of ankle fracture T 0129 27818 Treatment of ankle fracture T 0138 27822 Treatment of ankle fracture T 0063 27823 Treatment of ankle fracture T 0064 27824 Treat lower leg fracture T 0129 27825 Treat lower leg fracture T 0139 27826 Treat lower leg fracture T 0063 27827 Treat lower leg fracture T 0064 27828 Treat lower leg fracture T 0064 27829 Treat lower leg joint T 0063 27830 Treat lower leg dislocation T 0129 27831 Treat lower leg dislocation T 0139 27832 Treat lower leg dislocation T 0063 27840 Treat ankle dislocation T 0129 27842 Treat ankle dislocation T 0045 27846 Treat ankle dislocation T 0063 27848 Treat ankle dislocation T 0063 27860 Fixation of ankle joint T 0045 27870 Fusion of ankle joint open T 0052 27871 Fusion of tibiofibular joint T 0052 27880 Amputation of lower leg C 27881 Amputation of lower leg C 27882 Amputation of lower leg C 27884 Amputation follow-up surgery T 0049 27886 Amputation follow-up surgery C 27888 Amputation of foot at ankle C 27889 Amputation of foot at ankle T 0050 27892 Decompression of leg T 0050 27893 Decompression of leg T 0050 27894 Decompression of leg T 0050 27899 Leg/ankle surgery procedure T 0129 28001 Drainage of bursa of foot T 0007 28002 Treatment of foot infection T 0049 28003 Treatment of foot infection T 0049 28005 Treat foot bone lesion T 0055 28008 Incision of foot fascia T 0055 28010 Incision of toe tendon T 0055 28011 Incision of toe tendons T 0055 28020 Exploration of foot joint T 0055 28022 Exploration of foot joint T 0055 28024 Exploration of toe joint T 0055 28035 Decompression of tibia nerve T 0220 28039 Exc foot/toe tum sc 1.5 cm/> T 0022 28041 Exc foot/toe tum dep 1.5cm/> T 0022 28043 Exc foot/toe tum sc < 1.5 cm T 0021 28045 Exc foot/toe tum deep <1.5cm T 0021 28046 Resect foot/toe tumor < 3 cm T 002128047 Resect foot/toe tumor 3 cm/> T 0022

28050 Biopsy

of foot joint lining T 0055 28052 Biopsy

of foot joint lining T 0055 28054 Biopsy

of toe joint lining T 0055 28055 Neurectomy foot T 0220 28060 Partial removal foot fascia T 0055 28062 Removal of foot fascia T 0055 28070 Removal of foot joint lining T 0055 28072 Removal of foot joint lining T 0055 28080 Removal of foot lesion T 0055 28086 Excise foot tendon sheath T 0055 28088 Excise foot tendon sheath T 0055 28090 Removal of foot lesion T 0055 28092 Removal of toe lesions T 0055 28100 Removal of ankle/heel lesion T 0055 28102 Remove/graft foot lesion T 0056 28103 Remove/graft foot lesion T 0056 28104 Removal of foot lesion T 0055 28106 Remove/graft foot lesion T 0056 28107 Remove/graft foot lesion T 0056 28108 Removal of toe lesions T 0055 28110 Part removal of metatarsal T 0055 28111 Part removal of metatarsal T 0055 28112 Part removal of metatarsal T 0055 28113 Part removal of metatarsal T 0055 28114 Removal of metatarsal heads T 0055 28116 Revision of foot T 0055 28118 Removal of heel bone T 0055 28119 Removal of heel spur T 0055 28120 Part removal of ankle/heel T 0055 28122 Partial removal of foot bone T 0055 28124 Partial removal of toe T 0055 28126 Partial removal of toe T 0055 28130 Removal of ankle bone T 0055 28140 Removal of metatarsal T 0055 28150 Removal of toe T 0055 28153 Partial removal of toe T 0055 28160 Partial removal of toe T 0055 28171 Resect tarsal tumor T 0055 28173 Resect metatarsal tumor T 0055 28175 Resect phalanx of toe tumor T 0055 28190 Removal of foot foreign body T 0020 28192 Removal of foot foreign body T 0021 28193 Removal of foot foreign body T 0020 28200 Repair of foot tendon T 0055 28202 Repair/graft of foot tendon T 0055 28208 Repair of foot tendon T 0055 28210 Repair/graft of foot tendon T 0056 28220 Release of foot tendon T 0055 28222 Release of foot tendons T 0055 28225 Release of foot tendon T 0055 28226 Release of foot tendons T 0055 28230 Incision of foot tendon(s) T 0055 28232 Incision of toe tendon T 0055 28234 Incision of foot tendon T 005528238 Revision of foot tendon T 0056

28240 Release of big toe T 0055 28250 Revision of foot fascia T 0055 28260 Release of midfoot joint T 0055 28261 Revision of foot tendon T 0055 28262 Revision of foot and ankle T 0055 28264 Release of midfoot joint T 0056 28270 Release of foot contracture T 0055 28272 Release of toe joint each T 0055 28280 Fusion of toes T 0055 28285 Repair of hammertoe T 0055 28286 Repair of hammertoe T 0055 28288 Partial removal of foot bone T 0055 28289 Repair hallux rigidus T 0055 28290 Correction of bunion T 0057 28292 Correction of bunion T 0057 28293 Correction of bunion T 0057 28294 Correction of bunion T 0057 28296 Correction of bunion T 0057 28297 Correction of bunion T 0057 28298 Correction of bunion T 0057 28299 Correction of bunion T 0057 28300 Incision of heel bone T 0056 28302 Incision of ankle bone T 0055 28304 Incision of midfoot bones T 0056 28305 Incise/graft midfoot bones T 0056 28306 Incision of metatarsal T 0055 28307 Incision of metatarsal T 0055 28308 Incision of metatarsal T 0055 28309 Incision of metatarsals T 0056 28310 Revision of big toe T 0055 28312 Revision of toe T 0055 28313 Repair deformity of toe T 0055 28315 Removal of sesamoid bone T 0055 28320 Repair of foot bones T 0056 28322 Repair of metatarsals T 0056 28340 Resect enlarged toe tissue T 0055 28341 Resect enlarged toe T 0055 28344 Repair extra toe(s) T 0055 28345 Repair webbed toe(s) T 0055 28360 Reconstruct cleft foot T 0056 28400 Treatment of heel fracture T 0129 28405 Treatment of heel fracture T 0139 28406 Treatment of heel fracture T 0062 28415 Treat heel fracture T 0064 28420 Treat/graft heel fracture T 0063 28430 Treatment of ankle fracture T 0129 28435 Treatment of ankle fracture T 0129 28436 Treatment of ankle fracture T 0062 28445 Treat ankle fracture T 0063 28446 Osteochondral talus autogrft T 0056 28450 Treat midfoot fracture each T 0129 28455 Treat midfoot fracture each T 0129 28456 Treat midfoot fracture T 0062 28465 Treat midfoot fracture each T 006328470 Treat metatarsal fracture T 0129

28475 Treat metatarsal fracture T 0129 28476 Treat metatarsal fracture T 0062 28485 Treat metatarsal fracture T 0063 28490 Treat big toe fracture T 0129 28495 Treat big toe fracture T 0129 28496 Treat big toe fracture T 0062 28505 Treat big toe fracture T 0062 28510 Treatment of toe fracture T 0129 28515 Treatment of toe fracture T 0129 28525 Treat toe fracture T 0062 28530 Treat sesamoid bone fracture T 0129 28531 Treat sesamoid bone fracture T 0062 28540 Treat foot dislocation T 0129 28545 Treat foot dislocation T 0062 28546 Treat foot dislocation T 0062 28555 Repair foot dislocation T 0063 28570 Treat foot dislocation T 0129 28575 Treat foot dislocation T 0139 28576 Treat foot dislocation T 0062 28585 Repair foot dislocation T 0062 28600 Treat foot dislocation T 0129 28605 Treat foot dislocation T 0129 28606 Treat foot dislocation T 0062 28615 Repair foot dislocation T 0063 28630 Treat toe dislocation T 0129 28635 Treat toe dislocation T 0045 28636 Treat toe dislocation T 0062 28645 Repair toe dislocation T 0062 28660 Treat toe dislocation T 0129 28665 Treat toe dislocation T 0045 28666 Treat toe dislocation T 0062 28675 Repair of toe dislocation T 0062 28705 Fusion of foot bones T 0056 28715 Fusion of foot bones T 0052 28725 Fusion of foot bones T 0056 28730 Fusion of foot bones T 0056 28735 Fusion of foot bones T 0056 28737 Revision of foot bones T 0056 28740 Fusion of foot bones T 0056 28750 Fusion of big toe joint T 0056 28755 Fusion of big toe joint T 0055 28760 Fusion of big toe joint T 0056 28800 Amputation of midfoot C 28805 Amputation thru metatarsal T 0055 28810 Amputation toe & metatarsal T 0055 28820 Amputation of toe T 0055 28825 Partial amputation of toe T 0055 28890 High energy eswt plantar f T 0050 28899 Foot/toes surgery procedure T 0129 29000 Application of body cast S 0058 29010 Application of body cast S 0426 29015 Application of body cast S 0426 29020 Application of body cast S 0058 29025 Application of body cast S 005829035 Application of body cast S 0426 29040 Application of body cast S 0058 29044 Application of body cast S 0426 29046 Application of body cast S 0426 29049 Application of figure eight S 0058 29055 Application of shoulder cast S 0426 29058 Application of shoulder cast S 0058 29065 Application of long arm cast S 0426 29075 Application of forearm cast S 0426 29085 Apply

hand/wrist cast S 0058 29086 Apply

finger cast S 0058 29105 Apply

long arm splint S 0058 29125 Apply

forearm splint S 0058 29126 Apply

forearm splint S 0058 29130 Application of finger splint S 0058 29131 Application of finger splint S 0058 29200 Strapping of chest S 0058 29240 Strapping of shoulder S 0058 29260 Strapping of elbow or wrist S 0058 29280 Strapping of hand or finger S 0058 29305 Application of hip cast S 0426 29325 Application of hip casts S 0426 29345 Application of long leg cast S 0426 29355 Application of long leg cast S 0426 29358 Apply

long leg cast brace S 0426 29365 Application of long leg cast S 0426 29405 Apply

short leg cast S 0426 29425 Apply

short leg cast S 0426 29435 Apply

short leg cast S 0426 29440 Addition of walker to cast S 0058 29445 Apply

rigid leg cast S 0426 29450 Application of leg cast S 0058 29505 Application long leg splint S 0058 29515 Application lower leg splint S 0058 29520 Strapping of hip S 0058 29530 Strapping of knee S 0058 29540 Strapping of ankle and/or ft S 0058 29550 Strapping of toes S 0058 29580 Application of paste boot S 0058 29581 Apply

multlay comprs lwr leg S 0058 29582 Apply

multlay comprs upr leg NIS 0058 29583 Apply

multlay comprs upr arm NIS 0058 29584 Appl multlay comprs arm/hand NIS 0058 29590 Application of foot splint S 0058 29700 Removal/revision of cast S 0058 29705 Removal/revision of cast S 0058 29710 Removal/revision of cast S 0426 29715 Removal/revision of cast S 0058 29720 Repair of body cast S 0058 29730 Windowing of cast S 0058 29740 Wedging of cast S 0058 29750 Wedging of clubfoot cast S 0058 29799 Casting/strapping procedure S 0058 29800 Jaw arthroscopy /surgery T 0041 29804 Jaw arthroscopy /surgery T 004129805 Shoulder arthroscopy dx T 0041 29806 Shoulder arthroscopy /surgery T 0042 29807 Shoulder arthroscopy /surgery T 0042 29819 Shoulder arthroscopy /surgery T 0042 29820 Shoulder arthroscopy /surgery T 0042 29821 Shoulder arthroscopy /surgery T 0042 29822 Shoulder arthroscopy /surgery T 0041 29823 Shoulder arthroscopy /surgery T 0042 29824 Shoulder arthroscopy /surgery T 0041 29825 Shoulder arthroscopy /surgery T 0042 29826 Shoulder arthroscopy /surgery T 0041 29827 Arthroscop rotator cuff repr T 0042 29828 Arthroscopy biceps tenodesis T 0042 29830 Elbow arthroscopy T 0041 29834 Elbow arthroscopy /surgery T 0041 29835 Elbow arthroscopy /surgery T 0041 29836 Elbow arthroscopy /surgery T 0041 29837 Elbow arthroscopy /surgery T 0041 29838 Elbow arthroscopy /surgery T 0041 29840 Wrist arthroscopy T 0041 29843 Wrist arthroscopy /surgery T 0041 29844 Wrist arthroscopy /surgery T 0041 29845 Wrist arthroscopy /surgery T 0041 29846 Wrist arthroscopy /surgery T 0041 29847 Wrist arthroscopy /surgery T 0042 29848 Wrist endoscopy /surgery T 0041 29850 Knee arthroscopy /surgery T 0041 29851 Knee arthroscopy /surgery T 0042 29855 Tibial arthroscopy /surgery T 0042 29856 Tibial arthroscopy /surgery T 0042 29860 Hip arthroscopy dx T 0042 29861 Hip arthro w/fb removal T 0042 29862 Hip arthr0 w/debridement T 0042 29863 Hip arthr0 w/synovectomy T 0042 29866 Autgrft implnt knee w/scope T 0042 29867 Allgrft implnt knee w/scope T 0042 29868 Meniscal trnspl knee w/scpe T 0042 29870 Knee arthroscopy dx T 0041 29871 Knee arthroscopy /drainage T 0041 29873 Knee arthroscopy /surgery T 0041 29874 Knee arthroscopy /surgery T 0041 29875 Knee arthroscopy /surgery T 0041 29876 Knee arthroscopy /surgery T 0041 29877 Knee arthroscopy /surgery T 0041 29879 Knee arthroscopy /surgery T 0041 29880 Knee arthroscopy /surgery T 0041 29881 Knee arthroscopy /surgery T 0041 29882 Knee arthroscopy /surgery T 0041 29883 Knee arthroscopy /surgery T 0041 29884 Knee arthroscopy /surgery T 0041 29885 Knee arthroscopy /surgery T 0042 29886 Knee arthroscopy /surgery T 0041 29887 Knee arthroscopy /surgery T 0041 29888 Knee arthroscopy /surgery T 0052 29889 Knee arthroscopy /surgery T 005229891 Ankle arthroscopy /surgery T 0042 29892 Ankle arthroscopy /surgery T 0052 29893 Scope plantar fasciotomy T 0055 29894 Ankle arthroscopy /surgery T 0041 29895 Ankle arthroscopy /surgery T 0041 29897 Ankle arthroscopy /surgery T 0041 29898 Ankle arthroscopy /surgery T 0041 29899 Ankle arthroscopy /surgery T 0042 29900 Mcp joint arthroscopy dx T 0041 29901 Mcp joint arthroscopy surg T 0041 29902 Mcp joint arthroscopy surg T 0041 29904 Subtalar arthro w/fb rmvl T 0041 29905 Subtalar arthro w/exc T 0041 29906 Subtalar arthro w/deb T 0041 29907 Subtalar arthro w/fusion T 0042 29914 Hip arthro w/femoroplasty T 0042 29915 Hip arthro acetabuloplasty T 0042 29916 Hip arthro w/labral repair T 0042 29999 Arthroscopy of joint T 0041 30000 Drainage of nose lesion T 0251 30020 Drainage of nose lesion T 0251 30100 Intranasal biopsy T 0252 30110 Removal of nose polyp(s) T 0253 30115 Removal of nose polyp(s) T 0253 30117 Removal of intranasal lesion T 0253 30118 Removal of intranasal lesion T 0254 30120 Revision of nose T 0254 30124 Removal of nose lesion T 0252 30125 Removal of nose lesion T 0256 30130 Excise inferior turbinate T 0253 30140 Resect inferior turbinate T 0254 30150 Partial removal of nose T 0256 30160 Removal of nose T 0256 30200 Injection treatment of nose T 0252 30210 Nasal sinus therapy T 0252 30220 Insert nasal septal button T 0252 30300 Remove nasal foreign body X 0340 30310 Remove nasal foreign body T 0253 30320 Remove nasal foreign body T 0253 30400 Reconstruction of nose T 0256 30410 Reconstruction of nose T 0256 30420 Reconstruction of nose T 0256 30430 Revision of nose T 0254 30435 Revision of nose T 0256 30450 Revision of nose T 0256 30460 Revision of nose T 0256 30462 Revision of nose T 0256 30465 Repair nasal stenosis T 0256 30520 Repair of nasal septum T 0254 30540 Repair nasal defect T 0256 30545 Repair nasal defect T 0256 30560 Release of nasal adhesions T 0251 30580 Repair upper jaw fistula T 0256 30600 Repair mouth/nose fistula T 0256 30620 Intranasal reconstruction T 025630630 Repair nasal septum defect T 0254

30801 Ablate inf turbinate superf T 0252 30802 Ablate inf turbinate submuc T 0253 30901 Control of nosebleed T 0250 30903 Control of nosebleed T 0250 30905 Control of nosebleed T 0250 30906 Repeat control of nosebleed T 0250 30915 Ligation nasal sinus artery T 0092 30920 Ligation upper jaw artery T 0092 30930 Ther fx nasal inf turbinate T 0253 30999 Nasal surgery procedure T 0250 31000 Irrigation maxillary sinus T 0251 31002 Irrigation sphenoid sinus T 0252 31020 Exploration maxillary sinus T 0254 31030 Exploration maxillary sinus T 0256 31032 Explore sinus remove polyps T 0256 31040 Exploration behind upper jaw T 0254 31050 Exploration sphenoid sinus T 0256 31051 Sphenoid sinus surgery T 0256 31070 Exploration of frontal sinus T 0254 31075 Exploration of frontal sinus T 0256 31080 Removal of frontal sinus T 0256 31081 Removal of frontal sinus T 0256 31084 Removal of frontal sinus T 0256 31085 Removal of frontal sinus T 0256 31086 Removal of frontal sinus T 0256 31087 Removal of frontal sinus T 0256 31090 Exploration of sinuses T 0256 31200 Removal of ethmoid sinus T 0256 31201 Removal of ethmoid sinus T 0256 31205 Removal of ethmoid sinus T 0256 31225 Removal of upper jaw C 31230 Removal of upper jaw C 31231 Nasal endoscopy dx T 0072 31233 Nasal/sinus endoscopy dx T 0072 31235 Nasal/sinus endoscopy dx T 0074 31237 Nasal/sinus endoscopy surg T 0074 31238 Nasal/sinus endoscopy surg T 0074 31239 Nasal/sinus endoscopy surg T 0075 31240 Nasal/sinus endoscopy surg T 0074 31254 Revision of ethmoid sinus T 0075 31255 Removal of ethmoid sinus T 0075 31256 Exploration maxillary sinus T 0075 31267 Endoscopy maxillary

sinus T 0075 31276 Sinus endoscopy surgical T 0075 31287 Nasal/sinus endoscopy surg T 0075 31288 Nasal/sinus endoscopy surg T 0075 31290 Nasal/sinus endoscopy surg C 31291 Nasal/sinus endoscopy surg C 31292 Nasal/sinus endoscopy surg T 0075 31293 Nasal/sinus endoscopy surg T 0075 31294 Nasal/sinus endoscopy surg T 0075 31295 Sinus endo w/balloon dil T 0075 31296 Sinus endo w/balloon dil T 0075 31297 Sinus endo w/balloon dil T 007531299 Sinus surgery procedure T 0250 31300 Removal of larynx lesion T 0254 31320 Diagnostic incision larynx T 0256 31360 Removal of larynx C 31365 Removal of larynx C 31367 Partial removal of larynx C 31368 Partial removal of larynx C 31370 Partial removal of larynx C 31375 Partial removal of larynx C 31380 Partial removal of larynx C 31382 Partial removal of larynx C 31390 Removal of larynx & pharynx C 31395 Reconstruct larynx & pharynx C 31400 Revision of larynx T 0256 31420 Removal of epiglottis T 0256 31500 Insert emergency airway S 0094 31502 Change of windpipe airway S 0078 31505 Diagnostic laryngoscopy T 0071 31510 Laryngoscopy with biopsy T 0074 31511 Remove foreign body larynx T 0072 31512 Removal of larynx lesion T 0074 31513 Injection into vocal cord T 0072 31515 Laryngoscopy for aspiration T 0074 31520 Dx laryngoscopy newborn T 0072 31525 Dx laryngoscopy excl nb T 0074 31526 Dx laryngoscopy w/oper scope T 0074 31527 Laryngoscopy for treatment T 0075 31528 Laryngoscopy and dilation T 0074 31529 Laryngoscopy and dilation T 0074 31530 Laryngoscopy w/fb removal T 0074 31531 Laryngoscopy w/fb & op scope T 0074 31535 Laryngoscopy w/biopsy T 0074 31536 Laryngoscopy w/bx & op scope T 0074 31540 Laryngoscopy w/exc of tumor T 0074 31541 Larynscop w/tumr exc + scope T 0074 31545 Remove vc lesion w/scope T 0075 31546 Remove vc lesion scope/graft T 0075 31560 Laryngoscop w/ary tenoidectom T 0075 31561 Larynscop remve cart + scop T 0075 31570 Laryngoscope w/vc inj T 0074 31571 Laryngoscop w/vc inj + scope T 0075 31575 Diagnostic laryngoscopy T 0072 31576 Laryngoscopy with biopsy T 0074 31577 Remove foreign body larynx T 0073 31578 Removal of larynx lesion T 0075 31579 Diagnostic laryngoscopy T 0073 31580 Revision of larynx T 0256 31582 Revision of larynx T 0256 31584 Treat larynx fracture C 31587 Revision of larynx C 31588 Revision of larynx T 0256 31590 Reinnervate larynx T 0256 31595 Larynx nerve surgery T 0256 31599 Larynx surgery procedure T 0250 31600 Incision of windpipe T 025431601 Incision of windpipe T 0254

31603 Incision of windpipe T 0252 31605 Incision of windpipe T 0252 31610 Incision of windpipe T 0254 31611 Surgery

/speech prosthesis T 0254 31612 Puncture/clear windpipe T 0254 31613 Repair windpipe opening T 0254 31614 Repair windpipe opening T 0256 31615 Visualization of windpipe T 0252 31620 Endobronchial us add-on N 31622 Dx bronchoscope/wash T 0076 31623 Dx bronchoscope/brush T 0076 31624 Dx bronchoscope/lavage T 0076 31625 Bronchoscopy w/biopsy(s) T 0076 31626 Bronchoscopy w/markers CHT 0415 31627 Navigational bronchoscopy N 31628 Bronchoscopy /lung bx each T 0076 31629 Bronchoscopy /needle bx each T 0076 31630 Bronchoscopy dilate/fx repr T 0415 31631 Bronchoscopy dilate w/stent T 0415 31632 Bronchoscopy /lung bx addl T 0076 31633 Bronchoscopy /needle bx addl T 0076 31634 Bronch w/balloon occlusion T 0076 31635 Bronchoscopy w/fb removal T 0076 31636 Bronchoscopy bronch stents T 0415 31637 Bronchoscopy stent add-on T 0076 31638 Bronchoscopy revise stent T 0415 31640 Bronchoscopy w/tumor excise T 0415 31641 Bronchoscopy treat blockage T 0415 31643 Diag bronchoscope/catheter T 0076 31645 Bronchoscopy clear airways T 0076 31646 Bronchoscopy reclear airway T 0076 31656 Bronchoscopy inj for x-ray T 0076 31715 Injection for bronchus x-ray N 31717 Bronchial brush biopsy T 0073 31720 Clearance of airways S 0077 31725 Clearance of airways C 31730 Intro windpipe wire/tube T 0073 31750 Repair of windpipe T 0256 31755 Repair of windpipe T 0256 31760 Repair of windpipe C 31766 Reconstruction of windpipe C 31770 Repair/graft of bronchus C 31775 Reconstruct bronchus C 31780 Reconstruct windpipe C 31781 Reconstruct windpipe C 31785 Remove windpipe lesion T 0254 31786 Remove windpipe lesion C 31800 Repair of windpipe injury C 31805 Repair of windpipe injury C 31820 Closure of windpipe lesion T 0254 31825 Repair of windpipe defect T 0254 31830 Revise windpipe scar T 0254 31899 Airways surgical procedure T 0076 32035 Thoracostomy w/rib resection C32036 Thoracostomy w/flap drainage C 32095 Biopsy

through chest wall CHD 32096 Open wedge/bx lung infiltr NIC 32097 Open wedge/bx lung nodule NIC 32098 Open biopsy of lung pleura NIC 32100 Exploration of chest C 32110 Explore/repair chest C 32120 Re-exploration of chest C 32124 Explore chest free adhesions C 32140 Removal of lung lesion(s) C 32141 Remove/treat lung lesions C 32150 Removal of lung lesion(s) C 32151 Remove lung foreign body C 32160 Open chest heart massage C 32200 Drain open lung lesion C 32201 Drain percut lung lesion T 0070 32215 Treat chest lining C 32220 Release of lung C 32225 Partial release of lung C 32310 Removal of chest lining C 32320 Free/remove chest lining C 32400 Needle biopsy chest lining T 0685 32402 Open biopsy chest lining CHD 32405 Percut bx lung/mediastinum T 0685 32420 Puncture/clear lung T 0070 32421 Thoracentesis for aspiration T 0070 32422 Thoracentesis w/tube insert T 0070 32440 Remove lung pneumonectomy C 32442 Sleeve pneumonectomy C 32445 Removal of lung extrapleural C 32480 Partial removal of lung C 32482 Bilobectomy C 32484 Segmentectomy C 32486 Sleeve lobectomy C 32488 Completion pneumonectomy C 32491 Lung volume reduction C 32500 Partial removal of lung CHD 32501 Repair bronchus add-on C 32503 Resect apical lung tumor C 32504 Resect apical lung tum/chest C 32505 Wedge resect of lung initial NIC 32506 Wedge resect of lung add-on NIC 32507 Wedge resect of lung diag NIC 32540 Removal of lung lesion C 32550 Insert pleural cath T 0652 32551 Insertion of chest tube T 0070 32552 Remove lung catheter S 0078 32553 Ins mark thor for rt perq X 0310 32560 Treat pleurodesis w/agent T 0070 32561 Lyse chest fibrin init day T 0070 32562 Lyse chest fibrin subq day T 0070 32601 Thoracoscopy diagnostic T 0069 32602 Thoracoscopy diagnostic CHD 32603 Thoracoscopy diagnostic CHD 32604 Thoracoscopy wbx sac T 006932605 Thoracoscopy diagnostic CHD 32606 Thoracoscopy w/bx med space T 0069 32607 Thoracoscopy w/bx infiltrate NIT 0069 32608 Thoracoscopy w/bx nodule NIT 0069 32609 Thoracoscopy w/bx pleura NIT 0069 32650 Thoracoscopy w/pleurodesis C 32651 Thoracoscopy remove cortex C 32652 Thoracoscopy rem totl cortex C 32653 Thoracoscopy remov fb/fibrin C 32654 Thoracoscopy contrl bleeding C 32655 Thoracoscopy resect bullae C 32656 Thoracoscopy w/pleurectomy C 32657 Thoracoscopy surgical CHD 32658 Thoracoscopy w/sac fb remove C 32659 Thoracoscopy w/sac drainage C 32660 Thoracoscopy surgical CHD 32661 Thoracoscopy w/pericard exc C 32662 Thoracoscopy w/mediast exc C 32663 Thoracoscopy w/lobectomy C 32664 Thoracoscopy w/ th nrv exc C 32665 Thoracoscop w/esoph musc exc C 32666 Thoracoscopy w/wedge resect NIC 32667 Thoracoscopy w/w resect addl NIC 32668 Thoracoscopy w/w resect diag NIC 32669 Thoracoscopy remove segment NIC 32670 Thoracoscopy bilobectomy NIC 32671 Thoracoscopy pneumonectomy NIC 32672 Thoracoscopy for lvrs NIC 32673 Thoracoscopy w/thymus resect NIC 32674 Thoracoscopy lymph node exc NIC 32800 Repair lung hernia C 32810 Close chest after drainage C 32815 Close bronchial fistula C 32820 Reconstruct injured chest C 32850 Donor pneumonectomy C 32851 Lung transplant single C 32852 Lung transplant with bypass C 32853 Lung transplant double C 32854 Lung transplant with bypass C 32855 Prepare donor lung single C 32856 Prepare donor lung double C 32900 Removal of rib(s) C 32905 Revise & repair chest wall C 32906 Revise & repair chest wall C 32940 Revision of lung C 32960 Therapeutic pneumothorax T 0070 32997 Total lung lavage C 32998 Perq rf ablate tx pul tumor T 0423 32999 Chest surgery procedure T 0070 33010 Drainage of heart sac T 0070 33011 Repeat drainage of heart sac T 0070 33015 Incision of heart sac C 33020 Incision of heart sac C 33025 Incision of heart sac C 33030 Partial removal of heart sac C33031 Partial removal of heart sac C

33050 Resect heart sac lesion C 33120 Removal of heart lesion C 33130 Removal of heart lesion C 33140 Heart revascularize (tmr) C 33141 Heart tmr w/other procedure C 33202 Insert epicard eltrd open C 33203 Insert epicard eltrd endo C 33206 Insert heart pm atrial T 0089 33207 Insert heart pm ventricular T 0089 33208 Insrt heart pm atrial & vent T 0655 33210 Insert electrd/pm cath sngl T 0106 33211 Insert card electrodes dual T 0106 33212 Insert pulse gen sngl lead T 0090 33213 Insert pulse gen dual leads T 0654 33214 Upgrade of pacemaker system T 0655 33215 Reposition pacing-defib lead T 0105 33216 Insert 1 electrode pm-defib T 0106 33217 Insert 2 electrode pm-defib T 0106 33218 Repair lead pace-defib one T 0105 33220 Repair lead pace-defib dual T 0105 33221 Insert pulse gen mult leads NIT 0654 33222 Revise pocket pacemaker T 0136 33223 Revise pocket for defib T 0136 33224 Insert pacing lead & connect CHT 0655 33225 L ventric pacing lead add-on CHQ3 0655 33226 Reposition l ventric lead T 0105 33227 Remove&replace pm gen singl NIT 0090 33228 Remv&replc pm gen dual lead NIT 0654 33229 Remv&replc pm gen mult leads NIT 0654 33230 Insrt pulse gen w/dual leads NIT 0107 33231 Insrt pulse gen w/mult leads NIT 0107 33233 Removal of pm generator T 0105 33234 Removal of pacemaker system T 0105 33235 Removal pacemaker electrode T 0105 33236 Remove electrode/thoracotomy C 33237 Remove electrode/thoracotomy C 33238 Remove electrode/thoracotomy C 33240 Insrt pulse gen w/singl lead T 0107 33241 Remove pulse generator T 0105 33243 Remove eltrd/thoracotomy C 33244 Remove eltrd transven T 0105 33249 Nsert pace-defib w/lead Q3 0108 33250 Ablate heart dysrhy thm focus C 33251 Ablate heart dysrhy thm focus C 33254 Ablate atria lmtd C 33255 Ablate atria w/o bypass ext C 33256 Ablate atria w/bypass exten C 33257 Ablate atria lmtd add-on C 33258 Ablate atria x10sv add-on C 33259 Ablate atria w/bypass add-on C 33261 Ablate heart dysrhy thm focus C 33262 Remv&replc cvd gen sing lead NIT 0107 33263 Remv&replc cvd gen dual lead NIT 0107 33264 Remv&replc cvd gen mult lead NIT 010733265 Ablate atria lmtd endo C

33266 Ablate atria x10sv endo C 33282 Implant pat-active ht record S 0680 33284 Remove pat-active ht record T 0020 33300 Repair of heart wound C 33305 Repair of heart wound C 33310 Exploratory heart surgery C 33315 Exploratory heart surgery C 33320 Repair major blood vessel(s) C 33321 Repair major vessel C 33322 Repair major blood vessel(s) C 33330 Insert major vessel graft C 33332 Insert major vessel graft C 33335 Insert major vessel graft C 33400 Repair of aortic valve C 33401 Valvuloplasty open C 33403 Valvuloplasty w/cp bypass C 33404 Prepare heart-aorta conduit C 33405 Replacement of aortic valve C 33406 Replacement of aortic valve C 33410 Replacement of aortic valve C 33411 Replacement of aortic valve C 33412 Replacement of aortic valve C 33413 Replacement of aortic valve C 33414 Repair of aortic valve C 33415 Revision subvalvular tissue C 33416 Revise ventricle muscle C 33417 Repair of aortic valve C 33420 Revision of mitral valve C 33422 Revision of mitral valve C 33425 Repair of mitral valve C 33426 Repair of mitral valve C 33427 Repair of mitral valve C 33430 Replacement of mitral valve C 33460 Revision of tricuspid valve C 33463 Valvuloplasty tricuspid C 33464 Valvuloplasty tricuspid C 33465 Replace tricuspid valve C 33468 Revision of tricuspid valve C 33470 Revision of pulmonary valve C 33471 Valvotomypulmonary valve C 33472 Revision of pulmonary valve C 33474 Revision of pulmonary valve C 33475 Replacement pulmonary valve C 33476 Revision of heart chamber C 33478 Revision of heart chamber C 33496 Repair prosth valve clot C 33500 Repair heart vessel fistula C 33501 Repair heart vessel fistula C 33502 Coronary

artery correction C 33503 Coronary

artery graft C 33504 Coronary

artery graft C 33505 Repair artery w/tunnel C 33506 Repair artery translocation C 33507 Repair art intramural C33508 Endoscopic vein harvest N

33510 Cabg vein single C 33511 Cabg vein two C 33512 Cabg vein three C 33513 Cabg vein four C 33514 Cabg vein five C 33516 Cabg vein six or more C 33517 Cabg artery-vein single C 33518 Cabg artery-vein two C 33519 Cabg artery-vein three C 33521 Cabg artery-vein four C 33522 Cabg artery-vein five C 33523 Cabg art-vein six or more C 33530 Coronary

artery bypass/reop C 33533 Cabg arterial single C 33534 Cabg arterial two C 33535 Cabg arterial three C 33536 Cabg arterial four or more C 33542 Removal of heart lesion C 33545 Repair of heart damage C 33548 Restore/remodel ventricle C 33572 Open coronary endarterectomy C 33600 Closure of valve C 33602 Closure of valve C 33606 Anastomosis/artery-aorta C 33608 Repair anomaly w/conduit C 33610 Repair by

enlargement C 33611 Repair double ventricle C 33612 Repair double ventricle C 33615 Repair modified fontan C 33617 Repair single ventricle C 33619 Repair single ventricle C 33620 Apply

r&l pulmart bands C 33621 Transthor cath for stent C 33622 Redo compl cardiac anomaly C 33641 Repair heart septum defect C 33645 Revision of heart veins C 33647 Repair heart septum defects C 33660 Repair of heart defects C 33665 Repair of heart defects C 33670 Repair of heart chambers C 33675 Close mult vsd C 33676 Close mult vsd w/resection C 33677 Cl mult vsd w/rempul band C 33681 Repair heart septum defect C 33684 Repair heart septum defect C 33688 Repair heart septum defect C 33690 Reinforce pulmonary artery C 33692 Repair of heart defects C 33694 Repair of heart defects C 33697 Repair of heart defects C 33702 Repair of heart defects C 33710 Repair of heart defects C 33720 Repair of heart defect C 33722 Repair of heart defect C33724 Repair venous anomaly C

33726 Repair pul venous stenosis C 33730 Repair heart-vein defect(s) C 33732 Repair heart-vein defect C 33735 Revision of heart chamber C 33736 Revision of heart chamber C 33737 Revision of heart chamber C 33750 Major vessel shunt C 33755 Major vessel shunt C 33762 Major vessel shunt C 33764 Major vessel shunt & graft C 33766 Major vessel shunt C 33767 Major vessel shunt C 33768 Cavopulmonary shunting C 33770 Repair great vessels defect C 33771 Repair great vessels defect C 33774 Repair great vessels defect C 33775 Repair great vessels defect C 33776 Repair great vessels defect C 33777 Repair great vessels defect C 33778 Repair great vessels defect C 33779 Repair great vessels defect C 33780 Repair great vessels defect C 33781 Repair great vessels defect C 33782 Nikaidoh proc C 33783 Nikaidoh proc w/ostia implt C 33786 Repair arterial trunk C 33788 Revision of pulmonary artery C 33800 Aortic suspension C 33802 Repair vessel defect C 33803 Repair vessel defect C 33813 Repair septal defect C 33814 Repair septal defect C 33820 Revise major vessel C 33822 Revise major vessel C 33824 Revise major vessel C 33840 Remove aorta constriction C 33845 Remove aorta constriction C 33851 Remove aorta constriction C 33852 Repair septal defect C 33853 Repair septal defect C 33860 Ascending aortic graft C 33863 Ascending aortic graft C 33864 Ascending aortic graft C 33870 Transverse aortic arch graft C 33875 Thoracic aortic graft C 33877 Thoracoabdominal graft C 33880 Endovasc taa repr incl subcl C 33881 Endovasc taa repr w/o subcl C 33883 Insert endovasc prosth taa C 33884 Endovasc prosth taa add-on C 33886 Endovasc prosth delayed C 33889 Artery

transpose/endovas taa C 33891 Car-car bp grft/endovas taa C 33910 Remove lung artery emboli C33915 Remove lung artery emboli C 33916 Surgery

of great vessel C 33917 Repair pulmonary artery C 33920 Repair pulmonary atresia C 33922 Transect pulmonary artery C 33924 Remove pulmonary shunt C 33925 Rpr pul art unifocal w/o cpb C 33926 Repr pul art unifocal w/cpb C 33930 Removal of donor heart/lung C 33933 Prepare donor heart/lung C 33935 Transplantation heart/lung C 33940 Removal of donor heart C 33944 Prepare donor heart C 33945 Transplantation of heart C 33960 External circulation assist C 33961 External circulation assist C 33967 Insert ia percut device C 33968 Remove aortic assist device C 33970 Aortic circulation assist C 33971 Aortic circulation assist C 33973 Insert balloon device C 33974 Remove intra-aortic balloon C 33975 Implant ventricular device C 33976 Implant ventricular device C 33977 Remove ventricular device C 33978 Remove ventricular device C 33979 Insert intracorporeal device C 33980 Remove intracorporeal device C 33981 Replace vad pump ext C 33982 Replace vad intra w/o bp C 33983 Replace vad intra w/bp C 33999 Cardiac surgery procedure T 0070 34001 Removal of artery clot C 34051 Removal of artery clot C 34101 Removal of artery clot T 0088 34111 Removal of arm artery clot T 0088 34151 Removal of artery clot C 34201 Removal of artery clot T 0088 34203 Removal of leg artery clot T 0088 34401 Removal of vein clot C 34421 Removal of vein clot T 0088 34451 Removal of vein clot C 34471 Removal of vein clot T 0088 34490 Removal of vein clot T 0088 34501 Repair valve femoral vein T 0088 34502 Reconstruct vena cava C 34510 Transposition of vein valve T 0088 34520 Cross-over vein graft T 0088 34530 Leg vein fusion T 0088 34800 Endovas aaa repr w/sm tube C 34802 Endovas aaa repr w/2-p part C 34803 Endovas aaa repr w/3-p part C 34804 Endovas aaa repr w/1-p part C 34805 Endovas aaa repr w/long tube C 34806 Aneurysm press sensor add-on C34808 Endovas iliac a device addon C

34812 Xpose for endoprosth femorl C 34813 Femoral endovas graft add-on C 34820 Xpose for endoprosth iliac C 34825 Endovasc extend prosth init C 34826 Endovasc exten prosth addl C 34830 Open aortic tube prosth repr C 34831 Open aortoiliac prosth repr C 34832 Open aortofemor prosth repr C 34833 Xpose for endoprosth iliac C 34834 Xpose endoprosth brachial C 34900 Endovasc iliac repr w/graft C 35001 Repair defect of artery C 35002 Repair artery rupture neck C 35005 Repair defect of artery C 35011 Repair defect of artery T 0653 35013 Repair artery rupture arm C 35021 Repair defect of artery C 35022 Repair artery rupture chest C 35045 Repair defect of arm artery CHT 0093 35081 Repair defect of artery C 35082 Repair artery rupture aorta C 35091 Repair defect of artery C 35092 Repair artery rupture aorta C 35102 Repair defect of artery C 35103 Repair artery rupture groin C 35111 Repair defect of artery C 35112 Repair artery rupture spleen C 35121 Repair defect of artery C 35122 Repair artery rupture belly C 35131 Repair defect of artery C 35132 Repair artery rupture groin C 35141 Repair defect of artery C 35142 Repair artery rupture thigh C 35151 Repair defect of artery C 35152 Repair artery rupture knee C 35180 Repair blood vessel lesion T 0093 35182 Repair blood vessel lesion C 35184 Repair blood vessel lesion T 0093 35188 Repair blood vessel lesion T 0088 35189 Repair blood vessel lesion C 35190 Repair blood vessel lesion T 0093 35201 Repair blood vessel lesion T 0093 35206 Repair blood vessel lesion T 0093 35207 Repair blood vessel lesion T 0088 35211 Repair blood vessel lesion C 35216 Repair blood vessel lesion C 35221 Repair blood vessel lesion C 35226 Repair blood vessel lesion T 0020 35231 Repair blood vessel lesion T 0093 35236 Repair blood vessel lesion T 0093 35241 Repair blood vessel lesion C 35246 Repair blood vessel lesion C 35251 Repair blood vessel lesion C 35256 Repair blood vessel lesion T 009335261 Repair blood vessel lesion T 0653

35266 Repair blood vessel lesion T 0653 35271 Repair blood vessel lesion C 35276 Repair blood vessel lesion C 35281 Repair blood vessel lesion C 35286 Repair blood vessel lesion T 0653 35301 Rechanneling of artery C 35302 Rechanneling of artery C 35303 Rechanneling of artery C 35304 Rechanneling of artery C 35305 Rechanneling of artery C 35306 Rechanneling of artery C 35311 Rechanneling of artery C 35321 Rechanneling of artery T 0093 35331 Rechanneling of artery C 35341 Rechanneling of artery C 35351 Rechanneling of artery C 35355 Rechanneling of artery C 35361 Rechanneling of artery C 35363 Rechanneling of artery C 35371 Rechanneling of artery C 35372 Rechanneling of artery C 35390 Reoperation carotid add-on C 35400 Angioscopy C 35450 Repair arterial blockage C 35452 Repair arterial blockage C 35458 Repair arterial blockage T 0083 35460 Repair venous blockage T 0083 35471 Repair arterial blockage T 0083 35472 Repair arterial blockage T 0083 35475 Repair arterial blockage T 0083 35476 Repair venous blockage T 0083 35500 Harvest vein for bypass T 0103 35501 Artery

bypass graft C 35506 Artery

bypass graft C 35508 Artery

bypass graft C 35509 Artery

bypass graft C 35510 Artery

bypass graft C 35511 Artery

bypass graft C 35512 Artery

bypass graft C 35515 Artery

bypass graft C 35516 Artery

bypass graft C 35518 Artery

bypass graft C 35521 Artery

bypass graft C 35522 Artery

bypass graft C 35523 Artery

bypass graft C 35525 Artery

bypass graft C 35526 Artery

bypass graft C 35531 Artery

bypass graft C 35533 Artery

bypass graft C 35535 Artery

bypass graft C 35536 Artery

bypass graft C 35537 Artery

bypass graft C 35538 Artery

bypass graft C 35539 Artery

bypass graft C35540 Artery bypass graft C 35548 Artery

bypass graft CHD 35549 Artery

bypass graft CHD 35551 Artery

bypass graft CHD 35556 Artery

bypass graft C 35558 Artery

bypass graft C 35560 Artery

bypass graft C 35563 Artery

bypass graft C 35565 Artery

bypass graft C 35566 Artery

bypass graft C 35570 Artery

bypass graft C 35571 Artery

bypass graft C 35572 Harvest femoropopliteal vein N 35583 Vein bypass graft C 35585 Vein bypass graft C 35587 Vein bypass graft C 35600 Harvest art for cabg add-on C 35601 Artery

bypass graft C 35606 Artery

bypass graft C 35612 Artery

bypass graft C 35616 Artery

bypass graft C 35621 Artery

bypass graft C 35623 Bypass graft not vein C 35626 Artery

bypass graft C 35631 Artery

bypass graft C 35632 Artery

bypass graft C 35633 Artery

bypass graft C 35634 Artery

bypass graft C 35636 Artery

bypass graft C 35637 Artery

bypass graft C 35638 Artery

bypass graft C 35642 Artery

bypass graft C 35645 Artery

bypass graft C 35646 Artery

bypass graft C 35647 Artery

bypass graft C 35650 Artery

bypass graft C 35651 Artery

bypass graft CHD 35654 Artery

bypass graft C 35656 Artery

bypass graft C 35661 Artery

bypass graft C 35663 Artery

bypass graft C 35665 Artery

bypass graft C 35666 Artery

bypass graft C 35671 Artery

bypass graft C 35681 Composite bypass graft C 35682 Composite bypass graft C 35683 Composite bypass graft C 35685 Bypass graft patency /patch T 0093 35686 Bypass graft/av fist patency T 0093 35691 Arterial transposition C 35693 Arterial transposition C 35694 Arterial transposition C 35695 Arterial transposition C 35697 Reimplant artery each C 35700 Reoperation bypass graft C35701 Exploration carotid artery C

35721 Exploration femoral artery C 35741 Exploration popliteal artery C 35761 Exploration of artery /vein T 0093 35800 Explore neck vessels C 35820 Explore chest vessels C 35840 Explore abdominal vessels C 35860 Explore limb vessels T 0093 35870 Repair vessel graft defect C 35875 Removal of clot in graft T 0088 35876 Removal of clot in graft T 0088 35879 Revise graft w/vein T 0088 35881 Revise graft w/vein T 0088 35883 Revise graft w/nonauto graft T 0088 35884 Revise graft w/vein T 0088 35901 Excision graft neck C 35903 Excision graft extremity T 0093 35905 Excision graft thorax C 35907 Excision graft abdomen C 36000 Place needle in vein N 36002 Pseudoaneurysm injection trt S 0267 36005 Injection ext venography N 36010 Place catheter in vein N 36011 Place catheter in vein N 36012 Place catheter in vein N 36013 Place catheter in artery N 36014 Place catheter in artery N 36015 Place catheter in artery N 36100 Establish access to artery N 36120 Establish access to artery N 36140 Establish access to artery N 36147 Access av dial grft for eval CHT 0668 36148 Access av dial grft for proc N 36160 Establish access to aorta N 36200 Place catheter in aorta N 36215 Place catheter in artery N 36216 Place catheter in artery N 36217 Place catheter in artery N 36218 Place catheter in artery N 36245 Ins cath abd/l-ext art 1st N 36246 Ins cath abd/l-ext art 2nd N 36247 Ins cath abd/l-ext art 3rd N 36248 Ins cath abd/l-ext art addl N 36251 Ins cath ren art 1st unilat NIQ2 0279 36252 Ins cath ren art 1st bilat NIQ2 0279 36253 Ins cath ren art 2nd+ unilat NIQ2 0279 36254 Ins cath ren art 2nd+ bilat NIQ2 0279 36260 Insertion of infusion pump T 0623 36261 Revision of infusion pump T 0105 36262 Removal of infusion pump T 0105 36299 Vessel injection procedure N 36400 Bl draw < 3 yrs fem/jugular N 36405 Bl draw < 3 yrs scalp vein N 36406 Bl draw < 3 yrs other vein N 36410 Non-routine bl draw > 3 yrs N36415 Routine venipuncture A

36416 Capillary

blood draw N 36420 Vein access cutdown < 1 yr X 0035 36425 Vein access cutdown > 1 yr X 0035 36430 Blood transfusion service S 0110 36440 Bl push transfuse 2 yr or < S 0110 36450 Bl exchange/transfuse nb S 0110 36455 Bl exchange/transfuse non-nb S 0110 36460 Transfusion service fetal S 0110 36468 Injection(s) spider veins T 0013 36469 Injection(s) spider veins CHT 0015 36470 Injection therapy of vein CHT 0015 36471 Injection therapy of veins CHT 0015 36475 Endovenous rf 1st vein T 0091 36476 Endovenous rf vein add-on T 0092 36478 Endovenous laser 1st vein T 0092 36479 Endovenous laser vein addon T 0092 36481 Insertion of catheter vein N 36500 Insertion of catheter vein N 36510 Insertion of catheter vein N 36511 Apheresis wbc S 0111 36512 Apheresis rbc S 0111 36513 Apheresis platelets S 0111 36514 Apheresis plasma S 0111 36515 Apheresis adsorp/reinfuse S 0112 36516 Apheresis selective S 0112 36522 Photopheresis S 0112 36555 Insert non-tunnel cv cath T 0621 36556 Insert non-tunnel cv cath T 0621 36557 Insert tunneled cv cath T 0622 36558 Insert tunneled cv cath T 0622 36560 Insert tunneled cv cath T 0623 36561 Insert tunneled cv cath T 0623 36563 Insert tunneled cv cath T 0623 36565 Insert tunneled cv cath T 0623 36566 Insert tunneled cv cath T 0623 36568 Insert picc cath T 0621 36569 Insert picc cath T 0621 36570 Insert picvad cath T 0622 36571 Insert picvad cath T 0622 36575 Repair tunneled cv cath T 0121 36576 Repair tunneled cv cath T 0621 36578 Replace tunneled cv cath T 0622 36580 Replace cvad cath T 0621 36581 Replace tunneled cv cath T 0622 36582 Replace tunneled cv cath T 0623 36583 Replace tunneled cv cath T 0623 36584 Replace picc cath T 0621 36585 Replace picvad cath T 0622 36589 Removal tunneled cv cath T 0121 36590 Removal tunneled cv cath T 0621 36591 Draw blood off venous device Q1 0624 36592 Collect blood from picc Q1 0624 36593 Declot vascular device T 0676 36595 Mech remov tunneled cv cath T 062236596 Mech remov tunneled cv cath T 0621

36597 Reposition venous catheter T 0621 36598 Inj w/fluor eval cv device T 0676 36600 Withdrawal of arterial blood Q3 0035 36620 Insertion catheter artery N 36625 Insertion catheter artery N 36640 Insertion catheter artery T 0623 36660 Insertion catheter artery C 36680 Insert needle bone cavity T 0002 36800 Insertion of cannula T 0115 36810 Insertion of cannula T 0115 36815 Insertion of cannula T 0115 36818 Av fuse uppr arm cephalic T 0088 36819 Av fuse uppr arm basilic T 0088 36820 Av fusion/forearm vein T 0088 36821 Av fusion direct any site T 0088 36822 Insertion of cannula(s) C 36823 Insertion of cannula(s) C 36825 Artery-vein autograft T 0088 36830 Artery-vein nonautograft T 0088 36831 Open thrombect av fistula T 0088 36832 Av fistula revision open T 0088 36833 Av fistula revision T 0088 36835 Artery

to vein shunt T 0115 36838 Dist revas ligation hemo T 0088 36860 External cannula declotting T 0676 36861 Cannula declotting T 0115 36870 Percut thrombect av fistula T 0653 37140 Revision of circulation C 37145 Revision of circulation C 37160 Revision of circulation C 37180 Revision of circulation C 37181 Splice spleen/kidney veins C 37182 Insert hepatic shunt (tips) C 37183 Remove hepatic shunt (tips) T 0229 37184 Primart mech thrombectomy T 0088 37185 Primart m-thrombect add-on T 0088 37186 Sec art m-thrombect add-on T 0088 37187 Venous mech thrombectomy T 0088 37188 Venous m-thrombectomy add-on T 0088 37191 Ins endovas vena cava filtr NIT 0091 37192 Redo endovas vena cava filtr NIT 0623 37193 Rem endovas vena cava filter NIT 0623 37195 Thromboly

tic therapy

stroke T 0676 37200 Transcatheter biopsy T 0623 37201 Transcatheter therapy infuse T 0103 37202 Transcatheter therapy infuse T 0103 37203 Transcatheter retrieval T 0623 37204 Transcatheter occlusion T 0082 37205 Transcath iv stent percut T 0229 37206 Transcath iv stent/perc addl T 0229 37207 Transcath iv stent open T 0229 37208 Transcath iv stent/open addl T 0229 37209 Change iv cath at thromb tx T 0623 37210 Embolization uterine fibroid T 022937215 Transcath stent cca w/eps C

37216 Transcath stent cca w/o eps E 37220 Iliac revasc T 0083 37221 Iliac revasc w/stent CHT 0229 37222 Iliac revasc add-on T 0083 37223 Iliac revasc w/stent add-on T 0083 37224 Fem/popl revas w/tla T 0083 37225 Fem/popl revas w/ather T 0229 37226 Fem/popl revasc w/stent T 0229 37227 Fem/popl revasc stnt & ather T 0319 37228 Tib/per revasc w/tla T 0083 37229 Tib/per revasc w/ather T 0229 37230 Tib/per revasc w/stent T 0229 37231 Tib/per revasc stent & ather T 0319 37232 Tib/per revasc add-on T 0083 37233 Tibper revasc w/ather add-on T 0229 37234 Revsc opn/prq tib/pero stent T 0083 37235 Tib/per revasc stnt & ather T 0083 37250 Iv us first vessel add-on N 37251 Iv us each add vessel add-on N 37500 Endoscopy ligate perf veins T 0091 37501 Vascular endoscopy procedure T 0092 37565 Ligation of neck vein T 0093 37600 Ligation of neck artery T 0093 37605 Ligation of neck artery T 0091 37606 Ligation of neck artery T 0092 37607 Ligation of a-v fistula T 0092 37609 Temporal artery procedure T 0021 37615 Ligation of neck artery T 0092 37616 Ligation of chest artery C 37617 Ligation of abdomen artery C 37618 Ligation of extremity artery C 37619 Ligation of inf vena cava NIT 0091 37620 Revision of major vein CHD 37650 Revision of major vein T 0092 37660 Revision of major vein C 37700 Revise leg vein T 0092 37718 Ligate/strip short leg vein T 0092 37722 Ligate/strip long leg vein T 0091 37735 Removal of leg veins/lesion T 0091 37760 Ligate leg veins radical T 0092 37761 Ligate leg veins open T 0092 37765 Stab phleb veins xtr 10-20 T 0092 37766 Phleb veins - extrem 20+ T 0092 37780 Revision of leg vein T 0092 37785 Ligate/divide/excise vein T 0092 37788 Revascularization penis C 37790 Penile venous occlusion T 0181 37799 Vascular surgery procedure X 0624 38100 Removal of spleen total C 38101 Removal of spleen partial C 38102 Removal of spleen total C 38115 Repair of ruptured spleen C 38120 Laparoscopy splenectomy T 0131 38129 Laparoscope proc spleen T 013038200 Injection for spleen x-ray N

38204 Bl donor search management N 38205 Harvest allogenic stem cells B 38206 Harvest auto stem cells S 0111 38207 Cryopreserve stem cells S 0110 38208 Thaw preserved stem cells S 0110 38209 Wash harvest stem cells S 0110 38210 T-cell depletion of harvest S 0393 38211 Tumor cell deplete of harvst S 0393 38212 Rbc depletion of harvest S 0393 38213 Platelet deplete of harvest S 0393 38214 Volume deplete of harvest S 0393 38215 Harvest stem cell concentrte S 0393 38220 Bone marrow aspiration T 0003 38221 Bone marrow biopsy T 0003 38230 Bone marrow harvest allogen S 0112 38232 Bone marrow harvest autolog NIS 0112 38240 Bn marrow/stm transplt allo S 0112 38241 Bn marrow/stm transplt auto S 0112 38242 Lymphocy

te infuse transplant S 0111 38300 Drainage lymph node lesion T 0007 38305 Drainage lymph node lesion T 0008 38308 Incision of lymph channels T 0113 38380 Thoracic duct procedure C 38381 Thoracic duct procedure C 38382 Thoracic duct procedure C 38500 Biopsy

/removal lymph nodes T 0113 38505 Needle biopsy lymph nodes T 0005 38510 Biopsy

/removal lymph nodes T 0113 38520 Biopsy

/removal lymph nodes T 0113 38525 Biopsy

/removal lymph nodes T 0113 38530 Biopsy

/removal lymph nodes T 0113 38542 Explore deep node(s) neck T 0114 38550 Removal neck/armpit lesion T 0113 38555 Removal neck/armpit lesion T 0113 38562 Removal pelvic lymph nodes C 38564 Removal abdomen lymph nodes C 38570 Laparoscopy lymph node biop T 0131 38571 Laparoscopy lymphadenectomy T 0132 38572 Laparoscopy lymphadenectomy T 0131 38589 Laparoscope proc lymphatic T 0130 38700 Removal of lymph nodes neck T 0113 38720 Removal of lymph nodes neck T 0113 38724 Removal of lymph nodes neck C 38740 Remove armpit lymph nodes T 0114 38745 Remove armpit lymph nodes T 0114 38746 Remove thoracic lymph nodes C 38747 Remove abdominal lymph nodes C 38760 Remove groin lymph nodes T 0113 38765 Remove groin lymph nodes C 38770 Remove pelvis lymph nodes C 38780 Remove abdomen lymph nodes C 38790 Inject for lymphatic x-ray N 38792 Ra tracer id of sentinl node Q1 0392 38794 Access thoracic lymph duct N38900 Io map of sent lymph node N

38999 Blood/lymph system procedure S 0110 39000 Exploration of chest C 39010 Exploration of chest C 39200 Resect mediastinal cyst C 39220 Resect mediastinal tumor C 39400 Mediastinoscopy incl biopsy T 0069 39499 Chest procedure C 39501 Repair diaphragm laceration C 39503 Repair of diaphragm hernia C 39540 Repair of diaphragm hernia C 39541 Repair of diaphragm hernia C 39545 Revision of diaphragm C 39560 Resect diaphragm simple C 39561 Resect diaphragm complex C 39599 Diaphragm surgery procedure C 40490 Biopsy

of lip T 0251 40500 Partial excision of lip T 0253 40510 Partial excision of lip T 0254 40520 Partial excision of lip T 0253 40525 Reconstruct lip with flap T 0254 40527 Reconstruct lip with flap T 0254 40530 Partial removal of lip T 0254 40650 Repair lip T 0252 40652 Repair lip T 0252 40654 Repair lip T 0252 40700 Repair cleft lip/nasal T 0256 40701 Repair cleft lip/nasal T 0256 40702 Repair cleft lip/nasal T 0256 40720 Repair cleft lip/nasal T 0256 40761 Repair cleft lip/nasal T 0256 40799 Lip surgery procedure T 0250 40800 Drainage of mouth lesion T 0006 40801 Drainage of mouth lesion T 0252 40804 Removal foreign body mouth X 0340 40805 Removal foreign body mouth T 0252 40806 Incision of lip fold T 0251 40808 Biopsy

of mouth lesion T 0251 40810 Excision of mouth lesion T 0253 40812 Excise/repair mouth lesion T 0253 40814 Excise/repair mouth lesion T 0253 40816 Excision of mouth lesion T 0254 40818 Excise oral mucosa for graft T 0251 40819 Excise lip or cheek fold T 0252 40820 Treatment of mouth lesion T 0253 40830 Repair mouth laceration T 0251 40831 Repair mouth laceration T 0252 40840 Reconstruction of mouth T 0254 40842 Reconstruction of mouth T 0254 40843 Reconstruction of mouth T 0254 40844 Reconstruction of mouth T 0256 40845 Reconstruction of mouth T 0256 40899 Mouth surgery procedure T 0250 41000 Drainage of mouth lesion T 0253 41005 Drainage of mouth lesion T 025141006 Drainage of mouth lesion T 0254

41007 Drainage of mouth lesion T 0253 41008 Drainage of mouth lesion T 0253 41009 Drainage of mouth lesion T 0251 41010 Incision of tongue fold T 0252 41015 Drainage of mouth lesion T 0251 41016 Drainage of mouth lesion T 0252 41017 Drainage of mouth lesion T 0252 41018 Drainage of mouth lesion T 0252 41019 Place needles h&n for rt T 0254 41100 Biopsy

of tongue T 0252 41105 Biopsy

of tongue T 0253 41108 Biopsy

of floor of mouth T 0019 41110 Excision of tongue lesion T 0253 41112 Excision of tongue lesion T 0253 41113 Excision of tongue lesion T 0253 41114 Excision of tongue lesion T 0254 41115 Excision of tongue fold T 0252 41116 Excision of mouth lesion T 0253 41120 Partial removal of tongue T 0254 41130 Partial removal of tongue C 41135 Tongue and neck surgery C 41140 Removal of tongue C 41145 Tongue removal neck surgery C 41150 Tongue mouth jaw surgery C 41153 Tongue mouth neck surgery C 41155 Tongue jaw & neck surgery C 41250 Repair tongue laceration T 0250 41251 Repair tongue laceration T 0251 41252 Repair tongue laceration T 0252 41500 Fixation of tongue T 0254 41510 Tongue to lip surgery T 0253 41512 Tongue suspension T 0252 41520 Reconstruction tongue fold T 0252 41530 Tongue base vol reduction T 0254 41599 Tongue and mouth surgery T 0250 41800 Drainage of gum lesion T 0006 41805 Removal foreign body gum T 0254 41806 Removal foreign body jawbone T 0253 41820 Excision gum each quadrant T 0252 41821 Excision of gum flap T 0252 41822 Excision of gum lesion T 0253 41823 Excision of gum lesion T 0254 41825 Excision of gum lesion T 0253 41826 Excision of gum lesion T 0254 41827 Excision of gum lesion T 0254 41828 Excision of gum lesion T 0253 41830 Removal of gum tissue T 0253 41850 Treatment of gum lesion T 0253 41870 Gum graft T 0254 41872 Repair gum T 0253 41874 Repair tooth socket T 0254 41899 Dental surgery procedure T 0250 42000 Drainage mouth roof lesion T 0251 42100 Biopsy

roof of mouth T 025242104 Excision lesion mouth roof T 0253

42106 Excision lesion mouth roof T 0253 42107 Excision lesion mouth roof T 0254 42120 Remove palate/lesion T 0256 42140 Excision of uvula T 0252 42145 Repair palate pharynx/uvula T 0254 42160 Treatment mouth roof lesion T 0253 42180 Repair palate T 0251 42182 Repair palate T 0256 42200 Reconstruct cleft palate T 0256 42205 Reconstruct cleft palate T 0256 42210 Reconstruct cleft palate T 0256 42215 Reconstruct cleft palate T 0256 42220 Reconstruct cleft palate T 0256 42225 Reconstruct cleft palate T 0256 42226 Lengthening of palate T 0256 42227 Lengthening of palate T 0256 42235 Repair palate T 0253 42260 Repair nose to lip fistula T 0254 42280 Preparation palate mold T 0251 42281 Insertion palate prosthesis T 0253 42299 Palate/uvula surgery T 0250 42300 Drainage of salivary gland T 0253 42305 Drainage of salivary gland T 0253 42310 Drainage of salivary gland T 0251 42320 Drainage of salivary gland T 0251 42330 Removal of salivary stone T 0253 42335 Removal of salivary stone T 0253 42340 Removal of salivary stone T 0253 42400 Biopsy

of salivary

gland T 0005 42405 Biopsy

of salivary

gland T 0254 42408 Excision of salivary cyst T 0253 42409 Drainage of salivary cyst T 0253 42410 Excise parotid gland/lesion T 0256 42415 Excise parotid gland/lesion T 0256 42420 Excise parotid gland/lesion T 0256 42425 Excise parotid gland/lesion T 0256 42426 Excise parotid gland/lesion C 42440 Excise submaxillary gland T 0256 42450 Excise sublingual gland T 0254 42500 Repair salivary duct T 0254 42505 Repair salivary duct T 0256 42507 Parotid duct diversion T 0256 42508 Parotid duct diversion T 0256 42509 Parotid duct diversion T 0256 42510 Parotid duct diversion T 0256 42550 Injection for salivary x-ray N 42600 Closure of salivary fistula T 0253 42650 Dilation of salivary duct T 0252 42660 Dilation of salivary duct T 0251 42665 Ligation of salivary duct T 0254 42699 Salivary

surgery procedure T 0250 42700 Drainage of tonsil abscess T 0251 42720 Drainage of throat abscess T 0253 42725 Drainage of throat abscess T 025642800 Biopsy of throat T 0252 42802 Biopsy

of throat T 0253 42804 Biopsy

of upper nose/throat T 0253 42806 Biopsy

of upper nose/throat T 0254 42808 Excise pharynx lesion T 0254 42809 Remove pharynx foreign body X 0340 42810 Excision of neck cyst T 0254 42815 Excision of neck cyst T 0256 42820 Remove tonsils and adenoids T 0254 42821 Remove tonsils and adenoids T 0254 42825 Removal of tonsils T 0254 42826 Removal of tonsils T 0254 42830 Removal of adenoids T 0254 42831 Removal of adenoids T 0254 42835 Removal of adenoids T 0254 42836 Removal of adenoids T 0254 42842 Extensive surgery of throat T 0254 42844 Extensive surgery of throat T 0256 42845 Extensive surgery of throat C 42860 Excision of tonsil tags T 0254 42870 Excision of lingual tonsil T 0254 42890 Partial removal of pharynx T 0256 42892 Revision of pharyngeal walls T 0256 42894 Revision of pharyngeal walls C 42900 Repair throat wound T 0252 42950 Reconstruction of throat T 0254 42953 Repair throat esophagus C 42955 Surgical opening of throat T 0254 42960 Control throat bleeding T 0250 42961 Control throat bleeding C 42962 Control throat bleeding T 0256 42970 Control nose/throat bleeding T 0250 42971 Control nose/throat bleeding C 42972 Control nose/throat bleeding T 0253 42999 Throat surgery procedure T 0250 43020 Incision of esophagus T 0252 43030 Throat muscle surgery T 0253 43045 Incision of esophagus C 43100 Excision of esophagus lesion C 43101 Excision of esophagus lesion C 43107 Removal of esophagus C 43108 Removal of esophagus C 43112 Removal of esophagus C 43113 Removal of esophagus C 43116 Partial removal of esophagus C 43117 Partial removal of esophagus C 43118 Partial removal of esophagus C 43121 Partial removal of esophagus C 43122 Partial removal of esophagus C 43123 Partial removal of esophagus C 43124 Removal of esophagus C 43130 Removal of esophagus pouch T 0256 43135 Removal of esophagus pouch C 43200 Esophagus endoscopy T 0141 43201 Esoph scope w/submucous inj CHT 041943202 Esophagus endoscopy biopsy T 0141 43204 Esoph scope w/sclerosis inj T 0141 43205 Esophagus endoscopy /ligation CHT 0419 43215 Esophagus endoscopy CHT 0419 43216 Esophagus endoscopy /lesion T 0422 43217 Esophagus endoscopy CHT 0419 43219 Esophagus endoscopy T 0384 43220 Esoph endoscopy dilation CHT 0419 43226 Esoph endoscopy dilation CHT 0419 43227 Esoph endoscopy repair CHT 0419 43228 Esoph endoscopy ablation T 0422 43231 Esoph endoscopy w/us exam CHT 0419 43232 Esoph endoscopy w/us fn bx CHT 0419 43234 Upper gi endoscopy exam T 0141 43235 Uppr gi endoscopy diagnosis T 0141 43236 Uppr gi scope w/submuc inj T 0141 43237 Endoscopic us exam esoph CHT 0419 43238 Uppr gi endoscopy w/us fn bx CHT 0419 43239 Upper gi endoscopy biopsy T 0141 43240 Esoph endoscope w/drain cyst CHT 0419 43241 Upper GI endoscopy with tube T 0141 43242 Uppr gi endoscopy w/us fn bx CHT 0419 43243 Upper gi endoscopy & inject T 0141 43244 Upper GI endoscopy /ligation CHT 0419 43245 Uppr gi scope dilate strictr CHT 0419 43246 Place gastrostomy tube CHT 0419 43247 Operative upper GI endoscopy T 0141 43248 Uppr gi endoscopy /guide wire T 0141 43249 Esoph endoscopy dilation CHT 0419 43250 Upper GI endoscopy /tumor CHT 0419 43251 Operative upper GI endoscopy CHT 0419 43255 Operative upper GI endoscopy CHT 0419 43256 Uppr gi endoscopy w/stent T 0384 43257 Uppr gi scope w/thrml txmnt T 0422 43258 Operative upper GI endoscopy CHT 0419 43259 Endoscopic ultrasound exam CHT 0419 43260 Endo cholangiopancreatograph T 0151 43261 Endo cholangiopancreatograph T 0151 43262 Endo cholangiopancreatograph T 0151 43263 Endo cholangiopancreatograph T 0151 43264 Endo cholangiopancreatograph T 0151 43265 Endo cholangiopancreatograph T 0151 43267 Endo cholangiopancreatograph T 0151 43268 Endo cholangiopancreatograph T 0384 43269 Endo cholangiopancreatograph T 0384 43271 Endo cholangiopancreatograph T 0151 43272 Endo cholangiopancreatograph T 0151 43273 Endoscopic pancreatoscopy T 0151 43279 Lap myotomy heller C 43280 Laparoscopy fundoplasty T 0132 43281 Lap paraesophag hern repair CHT 0132 43282 Lap paraesoph her rpr w/mesh C 43283 Lap esoph lengthening C 43289 Laparoscope proc esoph T 0130 43300 Repair of esophagus C43305 Repair esophagus and fistula C

43310 Repair of esophagus C 43312 Repair esophagus and fistula C 43313 Esophagoplasty congenital C 43314 Tracheo-esophagoplasty cong C 43320 Fuse esophagus & stomach C 43325 Revise esophagus & stomach C 43327 Esoph fundoplasty lap C 43328 Esoph fundoplasty thor C 43330 Esophagomyotomy abdominal C 43331 Esophagomyotomy thoracic C 43332 Transab esoph hiat hern rpr C 43333 Transab esoph hiat hern rpr C 43334 Transthor diaphrag hern rpr C 43335 Transthor diaphrag hern rpr C 43336 Thorabd diaphr hern repair C 43337 Thorabd diaphr hern repair C 43338 Esoph lengthening C 43340 Fuse esophagus & intestine C 43341 Fuse esophagus & intestine C 43350 Surgical opening esophagus C 43351 Surgical opening esophagus C 43352 Surgical opening esophagus C 43360 Gastrointestinal repair C 43361 Gastrointestinal repair C 43400 Ligate esophagus veins C 43401 Esophagus surgery for veins C 43405 Ligate/staple esophagus C 43410 Repair esophagus wound C 43415 Repair esophagus wound C 43420 Repair esophagus opening T 0254 43425 Repair esophagus opening C 43450 Dilate esophagus T 0140 43453 Dilate esophagus T 0140 43456 Dilate esophagus T 0140 43458 Dilate esophagus CHT 0419 43460 Pressure treatment esophagus C 43496 Free jejunum flap microvasc C 43499 Esophagus surgery procedure T 0141 43500 Surgical opening of stomach C 43501 Surgical repair of stomach C 43502 Surgical repair of stomach C 43510 Surgical opening of stomach CHT 0141 43520 Incision of pyloric muscle C 43605 Biopsy

of stomach C 43610 Excision of stomach lesion C 43611 Excision of stomach lesion C 43620 Removal of stomach C 43621 Removal of stomach C 43622 Removal of stomach C 43631 Removal of stomach partial C 43632 Removal of stomach partial C 43633 Removal of stomach partial C 43634 Removal of stomach partial C 43635 Removal of stomach partial C43640 Vagotomy& pylorus repair C

43641 Vagotomy& pylorus repair C 43644 Lap gastric bypass/roux-en-y C 43645 Lap gastr bypass incl smll i C 43647 Lap impl electrode antrum S 0061 43648 Lap revise/remv eltrd antrum T 0130 43651 Laparoscopy vagus nerve T 0132 43652 Laparoscopy vagus nerve T 0132 43653 Laparoscopy gastrostomy T 0131 43659 Laparoscope proc stom T 0130 43752 Nasal/orogastric w/stent Q3 0272 43753 Tx gastro intub w/asp X 0340 43754 Dx gastr intub w/asp spec X 0340 43755 Dx gastr intub w/asp specs S 0097 43756 Dx duod intub w/asp spec X 0272 43757 Dx duod intub w/asp specs X 0272 43760 Change gastrostomy tube T 0676 43761 Reposition gastrostomy tube T 0141 43770 Lap place gastr adj device CHT 0131 43771 Lap revise gastr adj device C 43772 Lap rmvl gastr adj device C 43773 Lap replace gastr adj device C 43774 Lap rmvl gastr adj all parts C 43775 Lap sleeve gastrectomy E 43800 Reconstruction of pylorus C 43810 Fusion of stomach and bowel C 43820 Fusion of stomach and bowel C 43825 Fusion of stomach and bowel C 43830 Place gastrostomy tube T 0422 43831 Place gastrostomy tube T 0141 43832 Place gastrostomy tube C 43840 Repair of stomach lesion C 43842 V-band gastroplasty E 43843 Gastroplasty w/o v-band C 43845 Gastroplasty duodenal switch C 43846 Gastric bypass for obesity C 43847 Gastric bypass incl small i C 43848 Revision gastroplasty C 43850 Revise stomach-bowel fusion C 43855 Revise stomach-bowel fusion C 43860 Revise stomach-bowel fusion C 43865 Revise stomach-bowel fusion C 43870 Repair stomach opening T 0422 43880 Repair stomach-bowel fistula C 43881 Impl/redo electrd antrum C 43882 Revise/remove electrd antrum C 43886 Revise gastric port open T 0137 43887 Remove gastric port open T 0135 43888 Change gastric port open T 0137 43999 Stomach surgery procedure T 0141 44005 Freeing of bowel adhesion C 44010 Incision of small bowel C 44015 Insert needle cath bowel C 44020 Explore small intestine C 44021 Decompress small bowel C44025 Incision of large bowel C

44050 Reduce bowel obstruction C 44055 Correct malrotation of bowel C 44100 Biopsy

of bowel CHT 0419 44110 Excise intestine lesion(s) C 44111 Excision of bowel lesion(s) C 44120 Removal of small intestine C 44121 Removal of small intestine C 44125 Removal of small intestine C 44126 Enterectomy w/o taper cong C 44127 Enterectomy w/taper cong C 44128 Enterectomy cong add-on C 44130 Bowel to bowel fusion C 44132 Enterectomy cadaver donor C 44133 Enterectomy live donor C 44135 Intestine transplnt cadaver C 44136 Intestine transplant live C 44137 Remove intestinal allograft C 44139 Mobilization of colon C 44140 Partial removal of colon C 44141 Partial removal of colon C 44143 Partial removal of colon C 44144 Partial removal of colon C 44145 Partial removal of colon C 44146 Partial removal of colon C 44147 Partial removal of colon C 44150 Removal of colon C 44151 Removal of colon/ileostomy C 44155 Removal of colon/ileostomy C 44156 Removal of colon/ileostomy C 44157 Colectomy

w/ileoanal anast C 44158 Colectomy

w/neo-rectum pouch C 44160 Removal of colon C 44180 Lap enterolysis T 0131 44186 Lap jejunostomy T 0131 44187 Lap ileo/jejuno-stomy C 44188 Lap colostomy C 44202 Lap enterectomy C 44203 Lap resect s/intestine addl C 44204 Laparo partial colectomy C 44205 Lap colectomy part w/ileum C 44206 Lap part colectomy w/stoma T 0132 44207 L colectomy /coloproctostomy T 0132 44208 L colectomy /coloproctostomy T 0132 44210 Laparo total proctocolectomy C 44211 Lap colectomy w/proctectomy C 44212 Laparo total proctocolectomy C 44213 Lap mobil splenic fl add-on T 0130 44227 Lap close enterostomy C 44238 Laparoscope proc intestine T 0130 44300 Open bowel to skin C 44310 Ileostomy

/jejunostomy C 44312 Revision of ileostomy T 0137 44314 Revision of ileostomy C 44316 Devise bowel pouch C44320 Colostomy C

44322 Colostomy

with biopsies C 44340 Revision of colostomy T 0137 44345 Revision of colostomy C 44346 Revision of colostomy C 44360 Small bowel endoscopy T 0142 44361 Small bowel endoscopy /biopsy T 0142 44363 Small bowel endoscopy T 0142 44364 Small bowel endoscopy CHT 0424 44365 Small bowel endoscopy CHT 0424 44366 Small bowel endoscopy CHT 0424 44369 Small bowel endoscopy CHT 0424 44370 Small bowel endoscopy /stent T 0384 44372 Small bowel endoscopy CHT 0424 44373 Small bowel endoscopy CHT 0424 44376 Small bowel endoscopy T 0142 44377 Small bowel endoscopy /biopsy T 0142 44378 Small bowel endoscopy CHT 0424 44379 S bowel endoscope w/stent T 0384 44380 Small bowel endoscopy T 0142 44382 Small bowel endoscopy T 0142 44383 Ileoscopy

w/stent T 0384 44385 Endoscopy of bowel pouch T 0143 44386 Endoscopy bowel pouch/biop T 0143 44388 Colonoscopy T 0143 44389 Colonoscopy with biopsy T 0143 44390 Colonoscopy for foreign body T 0143 44391 Colonoscopy for bleeding T 0143 44392 Colonoscopy & polypectomy T 0143 44393 Colonoscopy lesion removal T 0143 44394 Colonoscopy w/snare T 0143 44397 Colonoscopy w/stent T 0384 44500 Intro gastrointestinal tube T 0121 44602 Suture small intestine C 44603 Suture small intestine C 44604 Suture large intestine C 44605 Repair of bowel lesion C 44615 Intestinal stricturoplasty C 44620 Repair bowel opening C 44625 Repair bowel opening C 44626 Repair bowel opening C 44640 Repair bowel-skin fistula C 44650 Repair bowel fistula C 44660 Repair bowel-bladder fistula C 44661 Repair bowel-bladder fistula C 44680 Surgical revision intestine C 44700 Suspend bowel w/prosthesis C 44701 Intraop colon lavage add-on N 44715 Prepare donor intestine C 44720 Prep donor intestine/venous C 44721 Prep donor intestine/artery C 44799 Unlisted procedure intestine T 0153 44800 Excision of bowel pouch C 44820 Excision of mesentery lesion C 44850 Repair of mesentery C44899 Bowel surgery procedure C 44900 Drain app abscess open C 44901 Drain app abscess percut T 0037 44950 Appendectomy T 0153 44955 Appendectomy add-on T 0153 44960 Appendectomy C 44970 Laparoscopy appendectomy T 0131 44979 Laparoscope proc app T 0130 45000 Drainage of pelvic abscess CHT 0149 45005 Drainage of rectal abscess CHT 0149 45020 Drainage of rectal abscess T 0155 45100 Biopsy

of rectum T 0149 45108 Removal of anorectal lesion T 0149 45110 Removal of rectum C 45111 Partial removal of rectum C 45112 Removal of rectum C 45113 Partial proctectomy C 45114 Partial removal of rectum C 45116 Partial removal of rectum C 45119 Remove rectum w/reservoir C 45120 Removal of rectum C 45121 Removal of rectum and colon C 45123 Partial proctectomy C 45126 Pelvic exenteration C 45130 Excision of rectal prolapse C 45135 Excision of rectal prolapse C 45136 Excise ileoanal reservior C 45150 Excision of rectal stricture T 0149 45160 Excision of rectal lesion T 0149 45171 Exc rect tum transanal part CHT 0149 45172 Exc rect tum transanal full T 0149 45190 Destruction rectal tumor T 0149 45300 Proctosigmoidoscopy dx T 0146 45303 Proctosigmoidoscopy dilate T 0147 45305 Proctosigmoidoscopy w/bx T 0147 45307 Proctosigmoidoscopy fb T 0428 45308 Proctosigmoidoscopy removal T 0147 45309 Proctosigmoidoscopy removal T 0147 45315 Proctosigmoidoscopy removal T 0147 45317 Proctosigmoidoscopy bleed T 0147 45320 Proctosigmoidoscopy ablate T 0428 45321 Proctosigmoidoscopy volvul T 0428 45327 Proctosigmoidoscopy w/stent T 0384 45330 Diagnostic sigmoidoscopy T 0146 45331 Sigmoidoscopy and biopsy T 0146 45332 Sigmoidoscopy w/fb removal T 0146 45333 Sigmoidoscopy & polypectomy CHT 0146 45334 Sigmoidoscopy for bleeding T 0147 45335 Sigmoidoscopy w/submuc inj T 0146 45337 Sigmoidoscopy & decompress T 0146 45338 Sigmoidoscopy w/tumr remove CHT 0146 45339 Sigmoidoscopy w/ablate tumr T 0147 45340 Sig w/balloon dilation T 0147 45341 Sigmoidoscopy w/ultrasound CHT 0146 45342 Sigmoidoscopy w/us guide bx T 014745345 Sigmoidoscopy w/stent T 0384 45355 Surgical colonoscopy T 0143 45378 Diagnostic colonoscopy T 0143 45379 Colonoscopy w/fb removal T 0143 45380 Colonoscopy and biopsy T 0143 45381 Colonoscopy submucous inj T 0143 45382 Colonoscopy /control bleeding T 0143 45383 Lesion removal colonoscopy T 0143 45384 Lesion remove colonoscopy T 0143 45385 Lesion removal colonoscopy T 0143 45386 Colonoscopy dilate stricture T 0143 45387 Colonoscopy w/stent T 0384 45391 Colonoscopy w/endoscope us T 0143 45392 Colonoscopy w/endoscopic fnb T 0143 45395 Lap removal of rectum C 45397 Lap remove rectum w/pouch C 45400 Laparoscopic proc C 45402 Lap proctopexy w/sig resect C 45499 Laparoscope proc rectum T 0130 45500 Repair of rectum T 0149 45505 Repair of rectum T 0150 45520 Treatment of rectal prolapse CHT 0015 45540 Correct rectal prolapse C 45541 Correct rectal prolapse T 0150 45550 Repair rectum/remove sigmoid C 45560 Repair of rectocele T 0150 45562 Exploration/repair of rectum C 45563 Exploration/repair of rectum C 45800 Repair rect/bladder fistula C 45805 Repair fistula w/colostomy C 45820 Repair rectourethral fistula C 45825 Repair fistula w/colostomy C 45900 Reduction of rectal prolapse T 0148 45905 Dilation of anal sphincter T 0149 45910 Dilation of rectal narrowing T 0149 45915 Remove rectal obstruction T 0155 45990 Surg dx exam anorectal T 0149 45999 Rectum surgery procedure T 0148 46020 Placement of seton T 0149 46030 Removal of rectal marker T 0148 46040 Incision of rectal abscess T 0149 46045 Incision of rectal abscess T 0149 46050 Incision of anal abscess CHT 0148 46060 Incision of rectal abscess T 0149 46070 Incision of anal septum T 0155 46080 Incision of anal sphincter T 0149 46083 Incise external hemorrhoid T 0164 46200 Removal of anal fissure T 0149 46220 Excise anal ext tag/papilla T 0155 46221 Ligation of hemorrhoid(s) T 0148 46230 Removal of anal tags T 0149 46250 Remove ext hem groups 2+ T 0149 46255 Remove int/ext hem 1 group T 0149 46257 Remove in/ex hem grp & fiss T 0149 46258 Remove in/ex hem grp w/fistu T 014946260 Remove in/ex hem groups 2+ T 0149

46261 Remove in/ex hem grps & fiss T 0149 46262 Remove in/ex hem grps w/fist T 0149 46270 Remove anal fist subq T 0149 46275 Remove anal fist inter T 0149 46280 Remove anal fist complex T 0149 46285 Remove anal fist 2 stage T 0149 46288 Repair anal fistula T 0149 46320 Removal of hemorrhoid clot T 0149 46500 Injection into hemorrhoid(s) CHT 0148 46505 Chemodenervation anal musc T 0149 46600 Diagnostic anoscopy X 0340 46604 Anoscopy

and dilation T 0147 46606 Anoscopy

and biopsy T 0146 46608 Anoscopy

remove for body CHT 0146 46610 Anoscopy

remove lesion T 0428 46611 Anoscopy T 0147 46612 Anoscopy

remove lesions T 0428 46614 Anoscopy

control bleeding T 0146 46615 Anoscopy T 0428 46700 Repair of anal stricture T 0149 46705 Repair of anal stricture C 46706 Repr of anal fistula w/glue T 0150 46707 Repair anorectal fist w/plug T 0150 46710 Repr per/vag pouch sngl proc C 46712 Repr per/vag pouch dbl proc C 46715 Rep perf anoper fistu C 46716 Rep perf anoper/vestib fistu C 46730 Construction of absent anus C 46735 Construction of absent anus C 46740 Construction of absent anus C 46742 Repair of imperforated anus C 46744 Repair of cloacal anomaly C 46746 Repair of cloacal anomaly C 46748 Repair of cloacal anomaly C 46750 Repair of anal sphincter T 0150 46751 Repair of anal sphincter C 46753 Reconstruction of anus T 0149 46754 Removal of suture from anus T 0149 46760 Repair of anal sphincter T 0150 46761 Repair of anal sphincter T 0150 46762 Implant artificial sphincter T 0150 46900 Destruction anal lesion(s) T 0016 46910 Destruction anal lesion(s) T 0017 46916 Cryosurgery anal lesion(s) T 0015 46917 Laser surgery anal lesions T 0017 46922 Excision of anal lesion(s) T 0017 46924 Destruction anal lesion(s) T 0017 46930 Destroy

internal hemorrhoids T 0148 46940 Treatment of anal fissure T 0149 46942 Treatment of anal fissure T 0148 46945 Remove by ligat int hemgrp CHT 0149 46946 Remove by ligat int hemgrps CHT 0149 46947 Hemorrhoidopexy by stapling T 0150 46999 Anus surgery procedure T 014847000 Needle biopsy of liver T 0685 47001 Needle biopsy liver add-on N 47010 Open drainage liver lesion C 47011 Percut drain liver lesion T 0037 47015 Inject/aspirate liver cyst C 47100 Wedge biopsy of liver C 47120 Partial removal of liver C 47122 Extensive removal of liver C 47125 Partial removal of liver C 47130 Partial removal of liver C 47133 Removal of donor liver C 47135 Transplantation of liver C 47136 Transplantation of liver C 47140 Partial removal donor liver C 47141 Partial removal donor liver C 47142 Partial removal donor liver C 47143 Prep donor liver whole C 47144 Prep donor liver 3-segment C 47145 Prep donor liver lobe split C 47146 Prep donor liver/venous C 47147 Prep donor liver/arterial C 47300 Surgery

for liver lesion C 47350 Repair liver wound C 47360 Repair liver wound C 47361 Repair liver wound C 47362 Repair liver wound C 47370 Laparo ablate liver tumor rf T 0174 47371 Laparo ablate liver cryosurg T 0174 47379 Laparoscope procedure liver T 0130 47380 Open ablate liver tumor rf C 47381 Open ablate liver tumor cryo C 47382 Percut ablate liver rf T 0423 47399 Liver surgery procedure T 0004 47400 Incision of liver duct C 47420 Incision of bile duct C 47425 Incision of bile duct C 47460 Incise bile duct sphincter C 47480 Incision of gallbladder C 47490 Incision of gallbladder T 0152 47500 Injection for liver x-rays N 47505 Injection for liver x-rays N 47510 Insert catheter bile duct T 0152 47511 Insert bile duct drain T 0152 47525 Change bile duct catheter T 0427 47530 Revise/reinsert bile tube T 0427 47550 Bile duct endoscopy add-on C 47552 Biliary

endoscopy

thru skin T 0152 47553 Biliary

endoscopy

thru skin T 0152 47554 Biliary

endoscopy

thru skin T 0152 47555 Biliary

endoscopy

thru skin T 0152 47556 Biliary

endoscopy

thru skin CHT 0423 47560 Laparoscopy w/cholangio T 0130 47561 Laparo w/cholangio/biopsy T 0130 47562 Laparoscopic cholecystectomy T 0131 47563 Laparo cholecystectomy /graph T 013147564 Laparo cholecystectomy /explr T 0131 47570 Laparo cholecystoenterostomy C 47579 Laparoscope proc biliary T 0130 47600 Removal of gallbladder C 47605 Removal of gallbladder C 47610 Removal of gallbladder C 47612 Removal of gallbladder C 47620 Removal of gallbladder C 47630 Remove bile duct stone T 0152 47700 Exploration of bile ducts C 47701 Bile duct revision C 47711 Excision of bile duct tumor C 47712 Excision of bile duct tumor C 47715 Excision of bile duct cyst C 47720 Fuse gallbladder & bowel C 47721 Fuse upper gi structures C 47740 Fuse gallbladder & bowel C 47741 Fuse gallbladder & bowel C 47760 Fuse bile ducts and bowel C 47765 Fuse liver ducts & bowel C 47780 Fuse bile ducts and bowel C 47785 Fuse bile ducts and bowel C 47800 Reconstruction of bile ducts C 47801 Placement bile duct support C 47802 Fuse liver duct & intestine C 47900 Suture bile duct injury C 47999 Bile tract surgery procedure T 0152 48000 Drainage of abdomen C 48001 Placement of drain pancreas C 48020 Removal of pancreatic stone C 48100 Biopsy

of pancreas open C 48102 Needle biopsy pancreas T 0685 48105 Resect/debride pancreas C 48120 Removal of pancreas lesion C 48140 Partial removal of pancreas C 48145 Partial removal of pancreas C 48146 Pancreatectomy C 48148 Removal of pancreatic duct C 48150 Partial removal of pancreas C 48152 Pancreatectomy C 48153 Pancreatectomy C 48154 Pancreatectomy C 48155 Removal of pancreas C 48160 Pancreas removal/transplant E 48400 Injection intraop add-on C 48500 Surgery

of pancreatic cyst C 48510 Drain pancreatic pseudocyst C 48511 Drain pancreatic pseudocyst T 0037 48520 Fuse pancreas cyst and bowel C 48540 Fuse pancreas cyst and bowel C 48545 Pancreatorrhaphy C 48547 Duodenal exclusion C 48548 Fuse pancreas and bowel C 48550 Donor pancreatectomy E 48551 Prep donor pancreas C48552 Prep donor pancreas/venous C

48554 Transpl allograft pancreas C 48556 Removal allograft pancreas C 48999 Pancreas surgery procedure T 0004 49000 Exploration of abdomen C 49002 Reopening of abdomen C 49010 Exploration behind abdomen C 49020 Drain abdominal abscess C 49021 Drain abdominal abscess T 0037 49040 Drain open abdom abscess C 49041 Drain percut abdom abscess T 0037 49060 Drain open retrop abscess C 49061 Drain percut retroper absc T 0037 49062 Drain to peritoneal cavity C 49080 Puncture peritoneal cavity CHD 49081 Removal of abdominal fluid CHD 49082 Abd paracentesis NIT 0070 49083 Abd paracentesis w/imaging NIT 0070 49084 Peritoneal lavage NIT 0070 49180 Biopsy

abdominal mass T 0685 49203 Exc abd tum 5 cm or less C 49204 Exc abd tum over 5 cm C 49205 Exc abd tum over 10 cm C 49215 Excise sacral spine tumor C 49220 Multiple surgery abdomen C 49250 Excision of umbilicus T 0153 49255 Removal of omentum C 49320 Diag laparo separate proc T 0130 49321 Laparoscopy biopsy T 0130 49322 Laparoscopy aspiration T 0130 49323 Laparo drain lymphocele T 0130 49324 Lap insert tunnel ip cath T 0130 49325 Lap revision perm ip cath T 0130 49326 Lap w/omentopexy add-on T 0130 49327 Lap ins device for rt T 0130 49329 Laparo proc abdm/per/oment T 0130 49400 Air injection into abdomen N 49402 Remove foreign body adbomen T 0153 49411 Ins mark abd/pel for rt perq X 0310 49412 Ins device for rt guide open C 49418 Insert tun ip cath perc T 0652 49419 Insert tun ip cath w/port T 0115 49421 Ins tun ip cath for dial opn T 0652 49422 Remove tunneled ip cath T 0105 49423 Exchange drainage catheter T 0427 49424 Assess cyst contrast inject N 49425 Insert abdomen-venous drain C 49426 Revise abdomen-venous shunt T 0153 49427 Injection abdominal shunt N 49428 Ligation of shunt C 49429 Removal of shunt T 0105 49435 Insert subq exten to ip cath T 0427 49436 Embedded ip cath exit-site T 0427 49440 Place gastrostomy tube perc CHT 0419 49441 Place duod/jej tube perc CHT 041949442 Place cecostomy tube perc CHT 0149 49446 Change g-tube to g-j perc CHT 0419 49450 Replace g/c tube perc T 0121 49451 Replace duod/jej tube perc T 0121 49452 Replace g-j tube perc T 0121 49460 Fix g/colon tube w/device T 0121 49465 Fluoro exam of g/colon tube Q1 0277 49491 Rpr hern preemie reduc T 0154 49492 Rpr ing hern premie blocked T 0154 49495 Rpr ing hernia baby reduc T 0154 49496 Rpr ing hernia baby blocked T 0154 49500 Rpr ing hernia init reduce T 0154 49501 Rpr ing hernia init blocked T 0154 49505 Prp i/hern init reduc >5 yr T 0154 49507 Prp i/hern init block >5 yr T 0154 49520 Rerepair ing hernia reduce T 0154 49521 Rerepair ing hernia blocked T 0154 49525 Repair ing hernia sliding T 0154 49540 Repair lumbar hernia T 0154 49550 Rpr rem hernia init reduce T 0154 49553 Rpr fem hernia init blocked T 0154 49555 Rerepair fem hernia reduce T 0154 49557 Rerepair fem hernia blocked T 0154 49560 Rpr ventral hern init reduc T 0154 49561 Rpr ventral hern init block T 0154 49565 Rerepair ventrl hern reduce T 0154 49566 Rerepair ventrl hern block T 0154 49568 Hernia repair w/mesh T 0154 49570 Rpr epigastric hern reduce T 0154 49572 Rpr epigastric hern blocked T 0154 49580 Rpr umbil hern reduc < 5 yr T 0154 49582 Rpr umbil hern block < 5 yr T 0154 49585 Rpr umbil hern reduc > 5 yr T 0154 49587 Rpr umbil hern block > 5 yr T 0154 49590 Repair spigelian hernia T 0154 49600 Repair umbilical lesion T 0154 49605 Repair umbilical lesion C 49606 Repair umbilical lesion C 49610 Repair umbilical lesion C 49611 Repair umbilical lesion C 49650 Lap ing hernia repair init T 0131 49651 Lap ing hernia repair recur T 0131 49652 Lap vent/abd hernia repair T 0132 49653 Lap vent/abd hern proc comp T 0132 49654 Lap inc hernia repair T 0132 49655 Lap inc hern repair comp T 0132 49656 Lap inc hernia repair recur T 0132 49657 Lap inc hern recur comp T 0132 49659 Laparo proc hernia repair T 0130 49900 Repair of abdominal wall C 49904 Omental flap extra-abdom C 49905 Omental flap intra-abdom C 49906 Free omental flap microvasc C 49999 Abdomen surgery procedure T 0153 50010 Exploration of kidney C50020 Renal abscess open drain T 0162

50021 Renal abscess percut drain T 0037 50040 Drainage of kidney C 50045 Exploration of kidney C 50060 Removal of kidney stone C 50065 Incision of kidney C 50070 Incision of kidney C 50075 Removal of kidney stone C 50080 Removal of kidney stone T 0429 50081 Removal of kidney stone T 0429 50100 Revise kidney blood vessels C 50120 Exploration of kidney C 50125 Explore and drain kidney C 50130 Removal of kidney stone C 50135 Exploration of kidney C 50200 Renal biopsy perq T 0685 50205 Renal biopsy open C 50220 Remove kidney open C 50225 Removal kidney open complex C 50230 Removal kidney open radical C 50234 Removal of kidney & ureter C 50236 Removal of kidney & ureter C 50240 Partial removal of kidney C 50250 Cryoablate renal mass open C 50280 Removal of kidney lesion C 50290 Removal of kidney lesion C 50300 Remove cadaver donor kidney C 50320 Remove kidney living donor C 50323 Prep cadaver renal allograft C 50325 Prep donor renal graft C 50327 Prep renal graft/venous C 50328 Prep renal graft/arterial C 50329 Prep renal graft/ureteral C 50340 Removal of kidney C 50360 Transplantation of kidney C 50365 Transplantation of kidney C 50370 Remove transplanted kidney C 50380 Reimplantation of kidney C 50382 Change ureter stent percut T 0162 50384 Remove ureter stent percut T 0161 50385 Change stent via transureth T 0162 50386 Remove stent via transureth T 0160 50387 Change ext/int ureter stent T 0427 50389 Remove renal tube w/fluoro T 0160 50390 Drainage of kidney lesion T 0685 50391 Instll rx agnt into rnal tub T 0126 50392 Insert kidney drain T 0161 50393 Insert ureteral tube T 0162 50394 Injection for kidney x-ray N 50395 Create passage to kidney T 0162 50396 Measure kidney pressure T 0164 50398 Change kidney tube T 0427 50400 Revision of kidney /ureter C 50405 Revision of kidney /ureter C 50500 Repair of kidney wound C50520 Close kidney-skin fistula C

50525 Repair renal-abdomen fistula C 50526 Repair renal-abdomen fistula C 50540 Revision of horseshoe kidney C 50541 Laparo ablate renal cyst T 0130 50542 Laparo ablate renal mass T 0174 50543 Laparo partial nephrectomy T 0131 50544 Laparoscopy pyeloplasty CHT 0131 50545 Laparo radical nephrectomy C 50546 Laparoscopic nephrectomy C 50547 Laparo removal donor kidney C 50548 Laparo remove w/ureter C 50549 Laparoscope proc renal T 0130 50551 Kidney

endoscopy T 0160 50553 Kidney

endoscopy T 0162 50555 Kidney

endoscopy

& biopsy T 0160 50557 Kidney

endoscopy

& treatment T 0162 50561 Kidney

endoscopy

& treatment T 0162 50562 Renal scope w/tumor resect T 0160 50570 Kidney

endoscopy T 0160 50572 Kidney

endoscopy T 0160 50574 Kidney

endoscopy

& biopsy T 0160 50575 Kidney

endoscopy T 0163 50576 Kidney

endoscopy

& treatment T 0161 50580 Kidney

endoscopy

& treatment T 0161 50590 Fragmenting of kidney stone T 0169 50592 Perc rf ablate renal tumor T 0423 50593 Perc cryo ablate renal tum T 0423 50600 Exploration of ureter C 50605 Insert ureteral support C 50610 Removal of ureter stone C 50620 Removal of ureter stone C 50630 Removal of ureter stone C 50650 Removal of ureter C 50660 Removal of ureter C 50684 Injection for ureter x-ray N 50686 Measure ureter pressure T 0126 50688 Change of ureter tube/stent T 0427 50690 Injection for ureter x-ray N 50700 Revision of ureter C 50715 Release of ureter C 50722 Release of ureter C 50725 Release/revise ureter C 50727 Revise ureter T 0165 50728 Revise ureter C 50740 Fusion of ureter & kidney C 50750 Fusion of ureter & kidney C 50760 Fusion of ureters C 50770 Splicing of ureters C 50780 Reimplant ureter in bladder C 50782 Reimplant ureter in bladder C 50783 Reimplant ureter in bladder C 50785 Reimplant ureter in bladder C 50800 Implant ureter in bowel C 50810 Fusion of ureter & bowel C50815 Urine shunt to intestine C

50820 Construct bowel bladder C 50825 Construct bowel bladder C 50830 Revise urine flow C 50840 Replace ureter by bowel C 50845 Appendico-vesicostomy C 50860 Transplant ureter to skin C 50900 Repair of ureter C 50920 Closure ureter/skin fistula C 50930 Closure ureter/bowel fistula C 50940 Release of ureter C 50945 Laparoscopy ureterolithotomy T 0131 50947 Laparo new ureter/bladder T 0131 50948 Laparo new ureter/bladder T 0131 50949 Laparoscope proc ureter T 0130 50951 Endoscopy of ureter T 0160 50953 Endoscopy of ureter T 0160 50955 Ureter endoscopy & biopsy T 0162 50957 Ureter endoscopy & treatment T 0162 50961 Ureter endoscopy & treatment T 0162 50970 Ureter endoscopy T 0160 50972 Ureter endoscopy & catheter T 0160 50974 Ureter endoscopy & biopsy T 0161 50976 Ureter endoscopy & treatment T 0161 50980 Ureter endoscopy & treatment T 0162 51020 Incise & treat bladder T 0162 51030 Incise & treat bladder T 0162 51040 Incise & drain bladder T 0162 51045 Incise bladder/drain ureter T 0160 51050 Removal of bladder stone T 0162 51060 Removal of ureter stone T 0163 51065 Remove ureter calculus T 0162 51080 Drainage of bladder abscess T 0008 51100 Drain bladder by needle T 0164 51101 Drain bladder by trocar/cath T 0126 51102 Drain bl w/cath insertion T 0165 51500 Removal of bladder cyst T 0154 51520 Removal of bladder lesion T 0162 51525 Removal of bladder lesion C 51530 Removal of bladder lesion C 51535 Repair of ureter lesion T 0162 51550 Partial removal of bladder C 51555 Partial removal of bladder C 51565 Revise bladder & ureter(s) C 51570 Removal of bladder C 51575 Removal of bladder & nodes C 51580 Remove bladder/revise tract C 51585 Removal of bladder & nodes C 51590 Remove bladder/revise tract C 51595 Remove bladder/revise tract C 51596 Remove bladder/create pouch C 51597 Removal of pelvic structures C 51600 Injection for bladder x-ray N 51605 Preparation for bladder xray N 51610 Injection for bladder x-ray N51700 Irrigation of bladder T 0164

51701 Insert bladder catheter X 0340 51702 Insert temp bladder cath X 0340 51703 Insert bladder cath complex T 0126 51705 Change of bladder tube T 0164 51710 Change of bladder tube T 0121 51715 Endoscopic injection/implant T 0168 51720 Treatment of bladder lesion T 0156 51725 Simple cystometrogram T 0156 51726 Complex cystometrogram T 0156 51727 Cystometrogram w/up T 0156 51728 Cystometrogram w/vp T 0156 51729 Cystometrogram w/vp&up T 0156 51736 Urine flow measurement X 0340 51741 Electro-uroflowmetry first T 0126 51784 Anal/urinary muscle study T 0126 51785 Anal/urinary muscle study T 0164 51792 Urinary

reflex study T 0126 51797 Intraabdominal pressure test T 0164 51798 Us urine capacity measure X 0340 51800 Revision of bladder/urethra C 51820 Revision of urinary tract C 51840 Attach bladder/urethra C 51841 Attach bladder/urethra C 51845 Repair bladder neck T 0202 51860 Repair of bladder wound T 0162 51865 Repair of bladder wound C 51880 Repair of bladder opening T 0162 51900 Repair bladder/vagina lesion C 51920 Close bladder-uterus fistula C 51925 Hysterectomy /bladder repair C 51940 Correction of bladder defect C 51960 Revision of bladder & bowel C 51980 Construct bladder opening C 51990 Laparo urethral suspension T 0131 51992 Laparo sling operation T 0131 51999 Laparoscope proc bla T 0130 52000 Cystoscopy T 0160 52001 Cystoscopy removal of clots T 0161 52005 Cystoscopy & ureter catheter T 0162 52007 Cystoscopy and biopsy T 0162 52010 Cystoscopy & duct catheter T 0160 52204 Cystoscopy w/biopsy(s) T 0162 52214 Cystoscopy and treatment T 0162 52224 Cystoscopy and treatment T 0162 52234 Cystoscopy and treatment T 0162 52235 Cystoscopy and treatment T 0162 52240 Cystoscopy and treatment T 0162 52250 Cystoscopy and radiotracer T 0162 52260 Cystoscopy and treatment T 0161 52265 Cystoscopy and treatment T 0160 52270 Cystoscopy & revise urethra T 0161 52275 Cystoscopy & revise urethra T 0162 52276 Cystoscopy and treatment T 0162 52277 Cystoscopy and treatment T 016252281 Cystoscopy and treatment T 0161 52282 Cystoscopy implant stent T 0163 52283 Cystoscopy and treatment T 0162 52285 Cystoscopy and treatment T 0161 52290 Cystoscopy and treatment T 0162 52300 Cystoscopy and treatment T 0162 52301 Cystoscopy and treatment T 0162 52305 Cystoscopy and treatment T 0162 52310 Cystoscopy and treatment T 0161 52315 Cystoscopy and treatment T 0162 52317 Remove bladder stone T 0162 52318 Remove bladder stone T 0162 52320 Cystoscopy and treatment T 0162 52325 Cystoscopy stone removal T 0162 52327 Cystoscopy inject material T 0163 52330 Cystoscopy and treatment T 0162 52332 Cystoscopy and treatment T 0162 52334 Create passage to kidney T 0162 52341 Cysto w/ureter stricture tx T 0162 52342 Cysto w/up stricture tx T 0162 52343 Cysto w/renal stricture tx T 0162 52344 Cysto/uretero stricture tx T 0162 52345 Cysto/uretero w/up stricture T 0162 52346 Cystouretero w/renal strict T 0162 52351 Cystouretero & or pyeloscope T 0162 52352 Cystouretero w/stone remove T 0162 52353 Cystouretero w/lithotripsy T 0163 52354 Cystouretero w/biopsy T 0162 52355 Cystouretero w/excise tumor T 0162 52400 Cystouretero w/congen repr T 0162 52402 Cystourethro cut ejacul duct T 0162 52450 Incision of prostate T 0162 52500 Revision of bladder neck T 0162 52601 Prostatectomy (TURP) T 0163 52630 Remove prostate regrowth T 0163 52640 Relieve bladder contracture T 0162 52647 Laser surgery of prostate T 0429 52648 Laser surgery of prostate T 0429 52649 Prostate laser enucleation T 0429 52700 Drainage of prostate abscess T 0162 53000 Incision of urethra T 0166 53010 Incision of urethra T 0166 53020 Incision of urethra T 0166 53025 Incision of urethra T 0166 53040 Drainage of urethra abscess T 0166 53060 Drainage of urethra abscess T 0166 53080 Drainage of urinary leakage T 0166 53085 Drainage of urinary leakage T 0166 53200 Biopsy

of urethra T 0166 53210 Removal of urethra T 0168 53215 Removal of urethra T 0166 53220 Treatment of urethra lesion T 0168 53230 Removal of urethra lesion T 0168 53235 Removal of urethra lesion T 0166 53240 Surgery

for urethra pouch T 016853250 Removal of urethra gland T 0166

53260 Treatment of urethra lesion T 0166 53265 Treatment of urethra lesion T 0166 53270 Removal of urethra gland T 0166 53275 Repair of urethra defect T 0166 53400 Revise urethra stage 1 T 0168 53405 Revise urethra stage 2 T 0168 53410 Reconstruction of urethra T 0168 53415 Reconstruction of urethra C 53420 Reconstruct urethra stage 1 T 0168 53425 Reconstruct urethra stage 2 T 0168 53430 Reconstruction of urethra T 0168 53431 Reconstruct urethra/bladder T 0168 53440 Male sling procedure S 0385 53442 Remove/revise male sling T 0168 53444 Insert tandem cuff S 0385 53445 Insert uro/ves nck sphincter S 0386 53446 Remove uro sphincter T 0168 53447 Remove/replace ur sphincter S 0386 53448 Remov/replc ur sphinctr comp C 53449 Repair uro sphincter T 0168 53450 Revision of urethra T 0168 53460 Revision of urethra T 0166 53500 Urethrlys transvag w/ scope T 0168 53502 Repair of urethra injury T 0166 53505 Repair of urethra injury T 0168 53510 Repair of urethra injury T 0166 53515 Repair of urethra injury T 0168 53520 Repair of urethra defect T 0168 53600 Dilate urethra stricture T 0156 53601 Dilate urethra stricture T 0126 53605 Dilate urethra stricture T 0161 53620 Dilate urethra stricture T 0165 53621 Dilate urethra stricture T 0164 53660 Dilation of urethra T 0126 53661 Dilation of urethra T 0126 53665 Dilation of urethra T 0166 53850 Prostatic microwave thermotx T 0429 53852 Prostatic rf thermotx T 0429 53855 Insert prost urethral stent T 0164 53860 Transurethral rf treatment T 0165 53899 Urology

surgery procedure T 0126 54000 Slitting of prepuce T 0166 54001 Slitting of prepuce T 0166 54015 Drain penis lesion T 0008 54050 Destruction penis lesion(s) CHT 0015 54055 Destruction penis lesion(s) T 0017 54056 Cryosurgery penis lesion(s) T 0013 54057 Laser surg penis lesion(s) T 0017 54060 Excision of penis lesion(s) T 0017 54065 Destruction penis lesion(s) T 0017 54100 Biopsy

of penis T 0021 54105 Biopsy

of penis T 0022 54110 Treatment of penis lesion T 0181 54111 Treat penis lesion graft T 018154112 Treat penis lesion graft T 0181

54115 Treatment of penis lesion T 0008 54120 Partial removal of penis T 0181 54125 Removal of penis C 54130 Remove penis & nodes C 54135 Remove penis & nodes C 54150 Circumcision w/regionl block T 0183 54160 Circumcision neonate T 0183 54161 Circum 28 days or older T 0183 54162 Lysis penil circumic lesion T 0183 54163 Repair of circumcision T 0183 54164 Frenulotomy of penis T 0183 54200 Treatment of penis lesion T 0164 54205 Treatment of penis lesion T 0181 54220 Treatment of penis lesion T 0164 54230 Prepare penis study N 54231 Dynamic cavernosometry T 0165 54235 Penile injection CHT 0164 54240 Penis study T 0126 54250 Penis study T 0164 54300 Revision of penis T 0181 54304 Revision of penis T 0181 54308 Reconstruction of urethra T 0181 54312 Reconstruction of urethra T 0181 54316 Reconstruction of urethra T 0181 54318 Reconstruction of urethra T 0181 54322 Reconstruction of urethra T 0181 54324 Reconstruction of urethra T 0181 54326 Reconstruction of urethra T 0181 54328 Revise penis/urethra T 0181 54332 Revise penis/urethra T 0181 54336 Revise penis/urethra T 0181 54340 Secondary

urethral surgery T 0181 54344 Secondary

urethral surgery T 0181 54348 Secondary

urethral surgery T 0181 54352 Reconstruct urethra/penis T 0181 54360 Penis plastic surgery T 0181 54380 Repair penis T 0181 54385 Repair penis T 0181 54390 Repair penis and bladder C 54400 Insert semi-rigid prosthesis S 0385 54401 Insert self-contd prosthesis S 0386 54405 Insert multi-comp penis pros S 0386 54406 Remove muti-comp penis pros T 0181 54408 Repair multi-comp penis pros T 0181 54410 Remove/replace penis prosth S 0386 54411 Remov/replc penis pros comp C 54415 Remove self-contd penis pros T 0181 54416 Remv/repl penis contain pros S 0386 54417 Remv/replc penis pros compl C 54420 Revision of penis T 0181 54430 Revision of penis C 54435 Revision of penis T 0181 54440 Repair of penis T 0181 54450 Preputial stretching T 015654500 Biopsy of testis T 0037 54505 Biopsy

of testis T 0183 54512 Excise lesion testis T 0183 54520 Removal of testis T 0183 54522 Orchiectomy partial T 0183 54530 Removal of testis T 0154 54535 Extensive testis surgery T 0181 54550 Exploration for testis T 0154 54560 Exploration for testis T 0183 54600 Reduce testis torsion T 0183 54620 Suspension of testis T 0183 54640 Suspension of testis T 0154 54650 Orchiopexy (Fowler-Stephens) CHT 0154 54660 Revision of testis T 0183 54670 Repair testis injury T 0183 54680 Relocation of testis(es) T 0183 54690 Laparoscopy orchiectomy T 0131 54692 Laparoscopy orchiopexy T 0132 54699 Laparoscope proc testis T 0130 54700 Drainage of scrotum T 0183 54800 Biopsy

of epididymis T 0004 54830 Remove epididymis lesion T 0183 54840 Remove epididymis lesion T 0183 54860 Removal of epididymis T 0183 54861 Removal of epididymis T 0183 54865 Explore epididymis T 0183 54900 Fusion of spermatic ducts T 0183 54901 Fusion of spermatic ducts T 0183 55000 Drainage of hydrocele T 0004 55040 Removal of hydrocele T 0154 55041 Removal of hydroceles T 0154 55060 Repair of hydrocele T 0183 55100 Drainage of scrotum abscess T 0007 55110 Explore scrotum T 0183 55120 Removal of scrotum lesion T 0183 55150 Removal of scrotum T 0183 55175 Revision of scrotum T 0183 55180 Revision of scrotum T 0183 55200 Incision of sperm duct T 0183 55250 Removal of sperm duct(s) T 0183 55300 Prepare sperm duct x-ray N 55400 Repair of sperm duct T 0183 55450 Ligation of sperm duct T 0183 55500 Removal of hydrocele T 0183 55520 Removal of sperm cord lesion T 0183 55530 Revise spermatic cord veins T 0183 55535 Revise spermatic cord veins T 0154 55540 Revise hernia & sperm veins T 0154 55550 Laparo ligate spermatic vein T 0131 55559 Laparo proc spermatic cord T 0130 55600 Incise sperm duct pouch T 0183 55605 Incise sperm duct pouch C 55650 Remove sperm duct pouch C 55680 Remove sperm pouch lesion T 0183 55700 Biopsy

of prostate T 018455705 Biopsy of prostate T 0184 55706 Prostate saturation sampling T 0184 55720 Drainage of prostate abscess T 0162 55725 Drainage of prostate abscess T 0162 55801 Removal of prostate C 55810 Extensive prostate surgery C 55812 Extensive prostate surgery C 55815 Extensive prostate surgery C 55821 Removal of prostate C 55831 Removal of prostate C 55840 Extensive prostate surgery C 55842 Extensive prostate surgery C 55845 Extensive prostate surgery C 55860 Surgical exposure prostate T 0165 55862 Extensive prostate surgery C 55865 Extensive prostate surgery C 55866 Laparo radical prostatectomy C 55870 Electroejaculation T 0189 55873 Cryoablate prostate T 0674 55875 Transperi needle place pros Q3 0163 55876 Place rt device/marker pros X 0310 55899 Genital surgery procedure T 0126 55920 Place needles pelvic for rt T 0153 55970 Sex transformation m to f E 55980 Sex transformation f to m E 56405 I & D of vulva/perineum T 0188 56420 Drainage of gland abscess T 0188 56440 Surgery

for vulva lesion T 0193 56441 Lysis of labial lesion(s) T 0193 56442 Hymenotomy T 0193 56501 Destroy

vulva lesions sim T 0017 56515 Destroy

vulva lesion/s compl T 0017 56605 Biopsy

of vulva/perineum T 0189 56606 Biopsy

of vulva/perineum T 0188 56620 Partial removal of vulva T 0193 56625 Complete removal of vulva T 0193 56630 Extensive vulva surgery C 56631 Extensive vulva surgery C 56632 Extensive vulva surgery C 56633 Extensive vulva surgery C 56634 Extensive vulva surgery C 56637 Extensive vulva surgery C 56640 Extensive vulva surgery C 56700 Partial removal of hymen T 0193 56740 Remove vagina gland lesion T 0193 56800 Repair of vagina T 0193 56805 Repair clitoris T 0193 56810 Repair of perineum T 0193 56820 Exam of vulva w/scope T 0188 56821 Exam/biopsy of vulva w/scope T 0188 57000 Exploration of vagina T 0193 57010 Drainage of pelvic abscess T 0193 57020 Drainage of pelvic fluid T 0192 57022 I & d vaginal hematoma pp T 0007 57023 I & d vag hematoma non-ob T 000857061 Destroy vag lesions simple T 0193 57065 Destroy

vag lesions complex T 0193 57100 Biopsy

of vagina T 0192 57105 Biopsy

of vagina T 0193 57106 Remove vagina wall partial T 0193 57107 Remove vagina tissue part T 0195 57109 Vaginectomy partial w/nodes T 0195 57110 Remove vagina wall complete C 57111 Remove vagina tissue compl C 57112 Vaginectomy w/nodes compl C 57120 Closure of vagina T 0195 57130 Remove vagina lesion T 0193 57135 Remove vagina lesion T 0193 57150 Treat vagina infection T 0188 57155 Insert uteri tandems/ovoids T 0192 57156 Ins vag brachy tx device T 0189 57160 Insert pessary /other device T 0188 57170 Fitting of diaphragm/cap T 0191 57180 Treat vaginal bleeding T 0188 57200 Repair of vagina T 0193 57210 Repair vagina/perineum T 0193 57220 Revision of urethra T 0202 57230 Repair of urethral lesion T 0195 57240 Repair bladder & vagina T 0195 57250 Repair rectum & vagina T 0195 57260 Repair of vagina T 0195 57265 Extensive repair of vagina T 0202 57267 Insert mesh/pelvic flr addon T 0195 57268 Repair of bowel bulge T 0195 57270 Repair of bowel pouch C 57280 Suspension of vagina C 57282 Colpopexy

extraperitoneal T 0202 57283 Colpopexy

intraperitoneal T 0202 57284 Repair paravag defect open T 0202 57285 Repair paravag defect vag T 0202 57287 Revise/remove sling repair T 0195 57288 Repair bladder defect T 0202 57289 Repair bladder & vagina T 0195 57291 Construction of vagina T 0195 57292 Construct vagina with graft T 0195 57295 Revise vag graft via vagina T 0193 57296 Revise vag graft open abd C 57300 Repair rectum-vagina fistula T 0195 57305 Repair rectum-vagina fistula C 57307 Fistula repair & colostomy C 57308 Fistula repair transperine C 57310 Repair urethrovaginal lesion T 0202 57311 Repair urethrovaginal lesion C 57320 Repair bladder-vagina lesion T 0195 57330 Repair bladder-vagina lesion T 0195 57335 Repair vagina T 0195 57400 Dilation of vagina T 0193 57410 Pelvic examination T 0193 57415 Remove vaginal foreign body T 0193 57420 Exam of vagina w/scope T 018957421 Exam/biopsy of vag w/scope T 0189 57423 Repair paravag defect lap T 0202 57425 Laparoscopy surg colpopexy CHT 0131 57426 Revise prosth vag graft lap T 0193 57452 Exam of cervix w/scope T 0188 57454 Bx/curett of cervix w/scope T 0189 57455 Biopsy

of cervix w/scope T 0189 57456 Endocerv curettage w/scope T 0189 57460 Bx of cervix w/scope leep T 0193 57461 Conz of cervix w/scope leep T 0193 57500 Biopsy

of cervix T 0192 57505 Endocervical curettage T 0192 57510 Cauterization of cervix T 0193 57511 Cryocautery of cervix T 0188 57513 Laser surgery of cervix T 0193 57520 Conization of cervix T 0193 57522 Conization of cervix T 0193 57530 Removal of cervix T 0195 57531 Removal of cervix radical C 57540 Removal of residual cervix C 57545 Remove cervix/repair pelvis C 57550 Removal of residual cervix T 0195 57555 Remove cervix/repair vagina T 0195 57556 Remove cervix repair bowel T 0202 57558 D&c of cervical stump T 0193 57700 Revision of cervix T 0193 57720 Revision of cervix T 0193 57800 Dilation of cervical canal T 0193 58100 Biopsy

of uterus lining T 0188 58110 Bx done w/colposcopy add-on N 58120 Dilation and curettage T 0193 58140 Myomectomy abdom method C 58145 Myomectomy vag method T 0195 58146 Myomectomy abdom complex C 58150 Total hysterectomy C 58152 Total hysterectomy C 58180 Partial hysterectomy C 58200 Extensive hysterectomy C 58210 Extensive hysterectomy C 58240 Removal of pelvis contents C 58260 Vaginal hysterectomy T 0195 58262 Vag hyst including t/o T 0195 58263 Vag hyst w/t/o & vag repair T 0195 58267 Vag hyst w/urinary repair C 58270 Vag hyst w/enterocele repair T 0195 58275 Hysterectomy /revise vagina C 58280 Hysterectomy /revise vagina C 58285 Extensive hysterectomy C 58290 Vag hyst complex T 0202 58291 Vag hyst incl t/o complex T 0202 58292 Vag hyst t/o & repair compl T 0202 58293 Vag hyst w/uro repair compl C 58294 Vag hyst w/enterocele compl T 0202 58300 Insert intrauterine device E 58301 Remove intrauterine device T 018858321 Artificial insemination T 0189

58322 Artificial insemination T 0189 58323 Sperm washing T 0189 58340 Catheter for hysterography N 58345 Reopen fallopian tube T 0193 58346 Insert heyman uteri capsule T 0193 58350 Reopen fallopian tube T 0195 58353 Endometr ablate thermal T 0195 58356 Endometrial cryoablation T 0202 58400 Suspension of uterus C 58410 Suspension of uterus C 58520 Repair of ruptured uterus C 58540 Revision of uterus C 58541 Lsh uterus 250 g or less T 0132 58542 Lsh w/t/o ut 250 g or less T 0132 58543 Lsh uterus above 250 g T 0132 58544 Lsh w/t/o uterus above 250 g T 0132 58545 Laparoscopic myomectomy T 0130 58546 Laparo-myomectomy complex T 0131 58548 Lap radical hyst C 58550 Laparo-asst vag hysterectomy T 0132 58552 Laparo-vag hyst incl t/o T 0131 58553 Laparo-vag hyst complex T 0131 58554 Laparo-vag hyst w/t/o compl T 0131 58555 Hysteroscopy dx sep proc T 0190 58558 Hysteroscopy biopsy T 0190 58559 Hysteroscopy lysis T 0190 58560 Hysteroscopy resect septum T 0387 58561 Hysteroscopy remove myoma T 0387 58562 Hysteroscopy remove fb T 0190 58563 Hysteroscopy ablation T 0387 58565 Hysteroscopy sterilization T 0202 58570 Tlh uterus 250 g or less T 0131 58571 Tlh w/t/o 250 g or less T 0131 58572 Tlh uterus over 250 g T 0131 58573 Tlh w/t/o uterus over 250 g T 0131 58578 Laparo proc uterus T 0130 58579 Hysteroscope procedure T 0190 58600 Division of fallopian tube T 0195 58605 Division of fallopian tube C 58611 Ligate oviduct(s) add-on C 58615 Occlude fallopian tube(s) T 0193 58660 Laparoscopy lysis T 0131 58661 Laparoscopy remove adnexa T 0131 58662 Laparoscopy excise lesions T 0131 58670 Laparoscopy tubal cautery T 0131 58671 Laparoscopy tubal block T 0131 58672 Laparoscopy fimbrioplasty T 0131 58673 Laparoscopy salpingostomy T 0131 58679 Laparo proc oviduct-ovary T 0130 58700 Removal of fallopian tube C 58720 Removal of ovary /tube(s) C 58740 Adhesiolysis tube ovary C 58750 Repair oviduct C 58752 Revise ovarian tube(s) C58760 Fimbrioplasty C

58770 Create new tubal opening T 0195 58800 Drainage of ovarian cyst(s) T 0193 58805 Drainage of ovarian cyst(s) T 0195 58820 Drain ovary abscess open T 0195 58822 Drain ovary abscess percut C 58823 Drain pelvic abscess percut T 0193 58825 Transposition ovary(s) C 58900 Biopsy

of ovary(s) T 0193 58920 Partial removal of ovary(s) T 0195 58925 Removal of ovarian cyst(s) T 0195 58940 Removal of ovary(s) C 58943 Removal of ovary(s) C 58950 Resect ovarian malignancy C 58951 Resect ovarian malignancy C 58952 Resect ovarian malignancy C 58953 Tah rad dissect for debulk C 58954 Tah rad debulk/lymph remove C 58956 Bso omentectomy w/tah C 58957 Resect recurrent gyn mal C 58958 Resect recur gyn mal w/lym C 58960 Exploration of abdomen C 58970 Retrieval of oocy te T 0189 58974 Transfer of embryo T 0189 58976 Transfer of embryo T 0189 58999 Genital surgery procedure T 0191 59000 Amniocentesis diagnostic T 0189 59001 Amniocentesis therapeutic T 0192 59012 Fetal cord puncture prenatal T 0189 59015 Chorion biopsy T 0189 59020 Fetal contract stress test T 0188 59025 Fetal non-stress test T 0188 59030 Fetal scalp blood sample T 0189 59050 Fetal monitor w/report M 59051 Fetal monitor/interpret only B 59070 Transabdom amnioinfus w/us T 0188 59072 Umbilical cord occlud w/us T 0189 59074 Fetal fluid drainage w/us T 0189 59076 Fetal shunt placement w/us T 0189 59100 Remove uterus lesion T 0195 59120 Treat ectopic pregnancy C 59121 Treat ectopic pregnancy C 59130 Treat ectopic pregnancy C 59135 Treat ectopic pregnancy C 59136 Treat ectopic pregnancy C 59140 Treat ectopic pregnancy C 59150 Treat ectopic pregnancy T 0131 59151 Treat ectopic pregnancy T 0131 59160 D & c after delivery T 0193 59200 Insert cervical dilator T 0188 59300 Episiotomyor vaginal repair T 0193 59320 Revision of cervix T 0193 59325 Revision of cervix C 59350 Repair of uterus C 59400 Obstetrical care B59409 Obstetrical care T 0193

59410 Obstetrical care B 59412 Antepartum manipulation T 0193 59414 Deliver placenta T 0193 59425 Antepartum care only B 59426 Antepartum care only B 59430 Care after delivery B 59510 Cesarean delivery B 59514 Cesarean delivery only C 59515 Cesarean delivery B 59525 Remove uterus after cesarean C 59610 Vbac delivery B 59612 Vbac delivery only T 0193 59614 Vbac care after delivery B 59618 Attempted vbac delivery B 59620 Attempted vbac delivery only C 59622 Attempted vbac after care B 59812 Treatment of miscarriage T 0193 59820 Care of miscarriage T 0193 59821 Treatment of miscarriage T 0193 59830 Treat uterus infection C 59840 Abortion T 0193 59841 Abortion T 0193 59850 Abortion C 59851 Abortion C 59852 Abortion C 59855 Abortion C 59856 Abortion C 59857 Abortion C 59866 Abortion (mpr) T 0189 59870 Evacuate mole of uterus T 0193 59871 Remove cerclage suture T 0193 59897 Fetal invas px w/us T 0191 59898 Laparo proc ob care/deliver T 0130 59899 Maternity

care procedure T 0191 60000 Drain thyroid/tongue cyst T 0252 60100 Biopsy

of thyroid T 0004 60200 Remove thyroid lesion T 0114 60210 Partial thyroid excision T 0114 60212 Partial thyroid excision T 0114 60220 Partial removal of thyroid T 0114 60225 Partial removal of thyroid T 0114 60240 Removal of thyroid T 0114 60252 Removal of thyroid T 0256 60254 Extensive thyroid surgery C 60260 Repeat thyroid surgery T 0256 60270 Removal of thyroid C 60271 Removal of thyroid T 0256 60280 Remove thyroid duct lesion T 0114 60281 Remove thyroid duct lesion T 0114 60300 Aspir/inj thyroid cyst T 0004 60500 Explore parathyroid glands T 0256 60502 Re-explore parathyroids T 0256 60505 Explore parathyroid glands C 60512 Autotransplant parathyroid T 002260520 Removal of thymus gland T 0256

60521 Removal of thymus gland C 60522 Removal of thymus gland C 60540 Explore adrenal gland C 60545 Explore adrenal gland C 60600 Remove carotid body lesion C 60605 Remove carotid body lesion C 60650 Laparoscopy adrenalectomy C 60659 Laparo proc endocrine T 0130 60699 Endocrine surgery procedure T 0114 61000 Remove cranial cavity fluid T 0207 61001 Remove cranial cavity fluid T 0207 61020 Remove brain cavity fluid T 0207 61026 Injection into brain canal T 0207 61050 Remove brain canal fluid T 0207 61055 Injection into brain canal T 0207 61070 Brain canal shunt procedure T 0121 61105 Twist drill hole C 61107 Drill skull for implantation C 61108 Drill skull for drainage C 61120 Burr hole for puncture C 61140 Pierce skull for biopsy C 61150 Pierce skull for drainage C 61151 Pierce skull for drainage C 61154 Pierce skull & remove clot C 61156 Pierce skull for drainage C 61210 Pierce skull implant device C 61215 Insert brain-fluid device T 0224 61250 Pierce skull & explore C 61253 Pierce skull & explore C 61304 Open skull for exploration C 61305 Open skull for exploration C 61312 Open skull for drainage C 61313 Open skull for drainage C 61314 Open skull for drainage C 61315 Open skull for drainage C 61316 Implt cran bone flap to abdo C 61320 Open skull for drainage C 61321 Open skull for drainage C 61322 Decompressive craniotomy C 61323 Decompressive lobectomy C 61330 Decompress eye socket T 0256 61332 Explore/biopsy eye socket C 61333 Explore orbit/remove lesion C 61334 Explore orbit/remove object T 0256 61340 Subtemporal decompression C 61343 Incise skull (press relief) C 61345 Relieve cranial pressure C 61440 Incise skull for surgery C 61450 Incise skull for surgery C 61458 Incise skull for brain wound C 61460 Incise skull for surgery C 61470 Incise skull for surgery C 61480 Incise skull for surgery C 61490 Incise skull for surgery C61500 Removal of skull lesion C

61501 Remove infected skull bone C 61510 Removal of brain lesion C 61512 Remove brain lining lesion C 61514 Removal of brain abscess C 61516 Removal of brain lesion C 61517 Implt brain chemotx add-on C 61518 Removal of brain lesion C 61519 Remove brain lining lesion C 61520 Removal of brain lesion C 61521 Removal of brain lesion C 61522 Removal of brain abscess C 61524 Removal of brain lesion C 61526 Removal of brain lesion C 61530 Removal of brain lesion C 61531 Implant brain electrodes C 61533 Implant brain electrodes C 61534 Removal of brain lesion C 61535 Remove brain electrodes C 61536 Removal of brain lesion C 61537 Removal of brain tissue C 61538 Removal of brain tissue C 61539 Removal of brain tissue C 61540 Removal of brain tissue C 61541 Incision of brain tissue C 61542 Removal of brain tissue C 61543 Removal of brain tissue C 61544 Remove & treat brain lesion C 61545 Excision of brain tumor C 61546 Removal of pituitary gland C 61548 Removal of pituitary gland C 61550 Release of skull seams C 61552 Release of skull seams C 61556 Incise skull/sutures C 61557 Incise skull/sutures C 61558 Excision of skull/sutures C 61559 Excision of skull/sutures C 61563 Excision of skull tumor C 61564 Excision of skull tumor C 61566 Removal of brain tissue C 61567 Incision of brain tissue C 61570 Remove foreign body brain C 61571 Incise skull for brain wound C 61575 Skull base/brainstem surgery C 61576 Skull base/brainstem surgery C 61580 Craniofacial approach skull C 61581 Craniofacial approach skull C 61582 Craniofacial approach skull C 61583 Craniofacial approach skull C 61584 Orbitocranial approach/skull C 61585 Orbitocranial approach/skull C 61586 Resect nasopharynx skull C 61590 Infratemporal approach/skull C 61591 Infratemporal approach/skull C 61592 Orbitocranial approach/skull C61595 Transtemporal approach/skull C

61596 Transcochlear approach/skull C 61597 Transcondylar approach/skull C 61598 Transpetrosal approach/skull C 61600 Resect/excise cranial lesion C 61601 Resect/excise cranial lesion C 61605 Resect/excise cranial lesion C 61606 Resect/excise cranial lesion C 61607 Resect/excise cranial lesion C 61608 Resect/excise cranial lesion C 61609 Transect artery sinus C 61610 Transect artery sinus C 61611 Transect artery sinus C 61612 Transect artery sinus C 61613 Remove aneurysm sinus C 61615 Resect/excise lesion skull C 61616 Resect/excise lesion skull C 61618 Repair dura C 61619 Repair dura C 61623 Endovasc tempory vessel occl T 0082 61624 Transcath occlusion cns C 61626 Transcath occlusion non-cns T 0082 61630 Intracranial angioplasty C 61635 Intracran angioplsty w/stent C 61640 Dilate ic vasospasm init E 61641 Dilate ic vasospasm add-on E 61642 Dilate ic vasospasm add-on E 61680 Intracranial vessel surgery C 61682 Intracranial vessel surgery C 61684 Intracranial vessel surgery C 61686 Intracranial vessel surgery C 61690 Intracranial vessel surgery C 61692 Intracranial vessel surgery C 61697 Brain aneurysm repr complx C 61698 Brain aneurysm repr complx C 61700 Brain aneurysm repr simple C 61702 Inner skull vessel surgery C 61703 Clamp neck artery C 61705 Revise circulation to head C 61708 Revise circulation to head C 61710 Revise circulation to head C 61711 Fusion of skull arteries C 61720 Incise skull/brain surgery T 0221 61735 Incise skull/brain surgery C 61750 Incise skull/brain biopsy C 61751 Brain biopsy w/ct/mr guide C 61760 Implant brain electrodes C 61770 Incise skull for treatment T 0221 61781 Scan proc cranial intra N 61782 Scan proc cranial extra N 61783 Scan proc spinal N 61790 Treat trigeminal nerve T 0220 61791 Treat trigeminal tract T 0203 61796 Srs cranial lesion simple B 61797 Srs cran les simple addl B61798 Srs cranial lesion complex B

61799 Srs cran les complex addl B 61800 Apply

srs headframe add-on B 61850 Implant neuroelectrodes C 61860 Implant neuroelectrodes C 61863 Implant neuroelectrode C 61864 Implant neuroelectrde addl C 61867 Implant neuroelectrode C 61868 Implant neuroelectrde addl C 61870 Implant neuroelectrodes C 61875 Implant neuroelectrodes C 61880 Revise/remove neuroelectrode T 0687 61885 Insrt/redo neurostim 1 array S 0039 61886 Implant neurostim arrays S 0315 61888 Revise/remove neuroreceiver T 0688 62000 Treat skull fracture T 0254 62005 Treat skull fracture C 62010 Treatment of head injury C 62100 Repair brain fluid leakage C 62115 Reduction of skull defect C 62116 Reduction of skull defect C 62117 Reduction of skull defect C 62120 Repair skull cavity lesion C 62121 Incise skull repair C 62140 Repair of skull defect C 62141 Repair of skull defect C 62142 Remove skull plate/flap C 62143 Replace skull plate/flap C 62145 Repair of skull & brain C 62146 Repair of skull with graft C 62147 Repair of skull with graft C 62148 Retr bone flap to fix skull C 62160 Neuroendoscopy add-on N 62161 Dissect brain w/scope C 62162 Remove colloid cyst w/scope C 62163 Zneuroendoscopy w/fb removal C 62164 Remove brain tumor w/scope C 62165 Remove pituit tumor w/scope C 62180 Establish brain cavity shunt C 62190 Establish brain cavity shunt C 62192 Establish brain cavity shunt C 62194 Replace/irrigate catheter T 0207 62200 Establish brain cavity shunt C 62201 Brain cavity shunt w/scope C 62220 Establish brain cavity shunt C 62223 Establish brain cavity shunt C 62225 Replace/irrigate catheter T 0427 62230 Replace/revise brain shunt T 0224 62252 Csf shunt reprogram S 0691 62256 Remove brain cavity shunt C 62258 Replace brain cavity shunt C 62263 Epidural lysis mult sessions CHT 0203 62264 Epidural lysis on single day T 0203 62267 Interdiscal perq aspir dx T 0004 62268 Drain spinal cord cyst T 020762269 Needle biopsy spinal cord T 0685 62270 Spinal fluid tap diagnostic T 0206 62272 Drain cerebro spinal fluid T 0206 62273 Inject epidural patch T 0207 62280 Treat spinal cord lesion T 0207 62281 Treat spinal cord lesion CHT 0203 62282 Treat spinal canal lesion CHT 0203 62284 Injection for myelogram N 62287 Percutaneous diskectomy T 0221 62290 Inject for spine disk x-ray N 62291 Inject for spine disk x-ray N 62292 Injection into disk lesion T 0207 62294 Injection into spinal artery T 0207 62310 Inject spine c/t T 0207 62311 Inject spine l/s (cd) T 0207 62318 Inject spine w/cath c/t T 0207 62319 Inject spine w/cath l/s (cd) T 0203 62350 Implant spinal canal cath T 0224 62351 Implant spinal canal cath T 0208 62355 Remove spinal canal catheter T 0203 62360 Insert spine infusion device T 0224 62361 Implant spine infusion pump T 0227 62362 Implant spine infusion pump T 0227 62365 Remove spine infusion device T 0221 62367 Analy

ze spine infus pump S 0691 62368 Analy

ze sp inf pump w/reprog S 0691 62369 Anal sp inf pmp w/reprg&fill NIS 0691 62370 Anl sp inf pmp w/mdreprg&fil NIS 0691 63001 Removal of spinal lamina T 0208 63003 Removal of spinal lamina T 0208 63005 Removal of spinal lamina T 0208 63011 Removal of spinal lamina T 0208 63012 Removal of spinal lamina T 0208 63015 Removal of spinal lamina T 0208 63016 Removal of spinal lamina T 0208 63017 Removal of spinal lamina T 0208 63020 Neck spine disk surgery T 0208 63030 Low back disk surgery T 0208 63035 Spinal disk surgery add-on T 0208 63040 Laminotomysingle cervical T 0208 63042 Laminotomysingle lumbar T 0208 63043 Laminotomyaddl cervical C 63044 Laminotomyaddl lumbar C 63045 Removal of spinal lamina T 0208 63046 Removal of spinal lamina T 0208 63047 Removal of spinal lamina T 0208 63048 Remove spinal lamina add-on T 0208 63050 Cervical laminoplasty C 63051 C-laminoplasty w/graft/plate C 63055 Decompress spinal cord T 0208 63056 Decompress spinal cord T 0208 63057 Decompress spine cord add-on T 0208 63064 Decompress spinal cord T 0208 63066 Decompress spine cord add-on T 0208 63075 Neck spine disk surgery T 020863076 Neck spine disk surgery T 0208

63077 Spine disk surgery thorax C 63078 Spine disk surgery thorax C 63081 Removal of vertebral body C 63082 Remove vertebral body add-on C 63085 Removal of vertebral body C 63086 Remove vertebral body add-on C 63087 Removal of vertebral body C 63088 Remove vertebral body add-on C 63090 Removal of vertebral body C 63091 Remove vertebral body add-on C 63101 Removal of vertebral body C 63102 Removal of vertebral body C 63103 Remove vertebral body add-on C 63170 Incise spinal cord tract(s) C 63172 Drainage of spinal cyst C 63173 Drainage of spinal cyst C 63180 Revise spinal cord ligaments C 63182 Revise spinal cord ligaments C 63185 Incise spinal column/nerves C 63190 Incise spinal column/nerves C 63191 Incise spinal column/nerves C 63194 Incise spinal column & cord C 63195 Incise spinal column & cord C 63196 Incise spinal column & cord C 63197 Incise spinal column & cord C 63198 Incise spinal column & cord C 63199 Incise spinal column & cord C 63200 Release of spinal cord C 63250 Revise spinal cord vessels C 63251 Revise spinal cord vessels C 63252 Revise spinal cord vessels C 63265 Excise intraspinal lesion C 63266 Excise intraspinal lesion C 63267 Excise intraspinal lesion C 63268 Excise intraspinal lesion C 63270 Excise intraspinal lesion C 63271 Excise intraspinal lesion C 63272 Excise intraspinal lesion C 63273 Excise intraspinal lesion C 63275 Biopsy

/excise spinal tumor C 63276 Biopsy

/excise spinal tumor C 63277 Biopsy

/excise spinal tumor C 63278 Biopsy

/excise spinal tumor C 63280 Biopsy

/excise spinal tumor C 63281 Biopsy

/excise spinal tumor C 63282 Biopsy

/excise spinal tumor C 63283 Biopsy

/excise spinal tumor C 63285 Biopsy

/excise spinal tumor C 63286 Biopsy

/excise spinal tumor C 63287 Biopsy

/excise spinal tumor C 63290 Biopsy

/excise spinal tumor C 63295 Repair of laminectomy defect C 63300 Removal of vertebral body C 63301 Removal of vertebral body C63302 Removal of vertebral body C

63303 Removal of vertebral body C 63304 Removal of vertebral body C 63305 Removal of vertebral body C 63306 Removal of vertebral body C 63307 Removal of vertebral body C 63308 Remove vertebral body add-on C 63600 Remove spinal cord lesion T 0220 63610 Stimulation of spinal cord T 0220 63615 Remove lesion of spinal cord T 0220 63620 Srs spinal lesion B 63621 Srs spinal lesion addl B 63650 Implant neuroelectrodes S 0040 63655 Implant neuroelectrodes S 0061 63661 Remove spine eltrd perq aray T 0687 63662 Remove spine eltrd plate T 0687 63663 Revise spine eltrd perq aray CHS 0040 63664 Revise spine eltrd plate CHS 0040 63685 Insrt/redo spine n generator S 0039 63688 Revise/remove neuroreceiver T 0688 63700 Repair of spinal herniation C 63702 Repair of spinal herniation C 63704 Repair of spinal herniation C 63706 Repair of spinal herniation C 63707 Repair spinal fluid leakage C 63709 Repair spinal fluid leakage C 63710 Graft repair of spine defect C 63740 Install spinal shunt C 63741 Install spinal shunt T 0224 63744 Revision of spinal shunt T 0224 63746 Removal of spinal shunt T 0203 64400 N block inj trigeminal T 0204 64402 N block inj facial T 0204 64405 N block inj occipital T 0206 64408 N block inj vagus CHT 0204 64410 N block inj phrenic CHT 0204 64412 N block inj spinal accessor CHT 0206 64413 N block inj cervical plexus T 0206 64415 N block inj brachial plexus T 0206 64416 N block cont infuse b plex T 0207 64417 N block inj axillary T 0206 64418 N block inj suprascapular T 0206 64420 N block inj intercost sng T 0206 64421 N block inj intercost mlt T 0207 64425 N block inj ilio-ing/hypogi T 0206 64430 N block inj pudendal T 0207 64435 N block inj paracervical T 0206 64445 N block inj sciatic sng T 0207 64446 N blk inj sciatic cont inf T 0207 64447 N block inj fem single T 0206 64448 N block inj fem cont inf T 0207 64449 N block inj lumbar plexus T 0207 64450 N block other peripheral T 0206 64455 N block inj plantar digit T 0204 64479 Inj foramen epidural c/t T 020764480 Inj foramen epidural add-on T 0206

64483 Inj foramen epidural l/s T 0207 64484 Inj foramen epidural add-on T 0206 64490 Inj paravert f jnt c/t 1 lev T 0207 64491 Inj paravert f jnt c/t 2 lev T 0204 64492 Inj paravert f jnt c/t 3 lev T 0204 64493 Inj paravert f jnt l/s 1 lev T 0207 64494 Inj paravert f jnt l/s 2 lev T 0204 64495 Inj paravert f jnt l/s 3 lev T 0204 64505 N block spenopalatine gangl T 0204 64508 N block carotid sinus s/p T 0204 64510 N block stellate ganglion T 0207 64517 N block inj hypogas plxs T 0207 64520 N block lumbar/thoracic T 0207 64530 N block inj celiac pelus T 0207 64550 Apply

neurostimulator A 64553 Implant neuroelectrodes S 0040 64555 Implant neuroelectrodes S 0040 64560 Implant neuroelectrodes CHD 64561 Implant neuroelectrodes S 0040 64565 Implant neuroelectrodes S 0040 64566 Neuroeltrd stim post tibial T 0204 64568 Inc for vagus n elect impl S 0318 64569 Revise/repl vagus n eltrd T 0687 64570 Remove vagus n eltrd T 0221 64575 Implant neuroelectrodes S 0061 64577 Implant neuroelectrodes CHD 64580 Implant neuroelectrodes S 0061 64581 Implant neuroelectrodes S 0061 64585 Revise/remove neuroelectrode T 0687 64590 Insrt/redo pn/gastr stimul S 0039 64595 Revise/rmv pn/gastr stimul T 0688 64600 Injection treatment of nerve T 0203 64605 Injection treatment of nerve T 0220 64610 Injection treatment of nerve T 0220 64611 Chemodenerv saliv glands T 0204 64612 Destroy

nerve face muscle T 0204 64613 Destroy

nerve neck muscle T 0206 64614 Destroy

nerve extrem musc T 0206 64620 Injection treatment of nerve CHT 0203 64622 Destr paravertebrl nerve l/s CHD 64623 Destr paravertebral n add-on CHD 64626 Destr paravertebrl nerve c/t CHD 64627 Destr paravertebral n add-on CHD 64630 Injection treatment of nerve T 0207 64632 N block inj common digit T 0204 64633 Destroy

cerv/thor facet jnt NIT 0207 64634 Destroy

c/th facet jnt addl NIT 0204 64635 Destroy

lumb/sac facet jnt NIT 0203 64636 Destroy

l/s facet jnt addl NIT 0207 64640 Injection treatment of nerve T 0207 64650 Chemodenerv eccrine glands T 0204 64653 Chemodenerv eccrine glands T 0204 64680 Injection treatment of nerve CHT 0203 64681 Injection treatment of nerve T 020364702 Revise finger/toe nerve T 0220

64704 Revise hand/foot nerve T 0220 64708 Revise arm/leg nerve T 0220 64712 Revision of sciatic nerve T 0220 64713 Revision of arm nerve(s) T 0220 64714 Revise low back nerve(s) T 0220 64716 Revision of cranial nerve T 0220 64718 Revise ulnar nerve at elbow T 0220 64719 Revise ulnar nerve at wrist T 0220 64721 Carpal tunnel surgery T 0220 64722 Relieve pressure on nerve(s) T 0220 64726 Release foot/toe nerve T 0220 64727 Internal nerve revision T 0220 64732 Incision of brow nerve T 0220 64734 Incision of cheek nerve T 0220 64736 Incision of chin nerve T 0220 64738 Incision of jaw nerve T 0220 64740 Incision of tongue nerve T 0220 64742 Incision of facial nerve T 0220 64744 Incise nerve back of head T 0220 64746 Incise diaphragm nerve T 0220 64752 Incision of vagus nerve C 64755 Incision of stomach nerves C 64760 Incision of vagus nerve C 64761 Incision of pelvis nerve T 0220 64763 Incise hip/thigh nerve T 0220 64766 Incise hip/thigh nerve T 0221 64771 Sever cranial nerve T 0220 64772 Incision of spinal nerve T 0220 64774 Remove skin nerve lesion T 0220 64776 Remove digit nerve lesion T 0220 64778 Digit nerve surgery add-on T 0220 64782 Remove limb nerve lesion T 0220 64783 Limb nerve surgery add-on T 0220 64784 Remove nerve lesion T 0220 64786 Remove sciatic nerve lesion T 0221 64787 Implant nerve end T 0220 64788 Remove skin nerve lesion T 0220 64790 Removal of nerve lesion T 0220 64792 Removal of nerve lesion T 0221 64795 Biopsy

of nerve T 0220 64802 Remove sympathetic nerves T 0220 64804 Remove sympathetic nerves T 0220 64809 Remove sympathetic nerves C 64818 Remove sympathetic nerves C 64820 Remove sympathetic nerves T 0220 64821 Remove sympathetic nerves T 0054 64822 Remove sympathetic nerves T 0054 64823 Remove sympathetic nerves T 0054 64831 Repair of digit nerve T 0221 64832 Repair nerve add-on T 0221 64834 Repair of hand or foot nerve T 0221 64835 Repair of hand or foot nerve T 0221 64836 Repair of hand or foot nerve T 0221 64837 Repair nerve add-on T 022164840 Repair of leg nerve T 0221

64856 Repair/transpose nerve T 0221 64857 Repair arm/leg nerve T 0221 64858 Repair sciatic nerve T 0221 64859 Nerve surgery T 0221 64861 Repair of arm nerves T 0221 64862 Repair of low back nerves T 0221 64864 Repair of facial nerve T 0221 64865 Repair of facial nerve T 0221 64866 Fusion of facial/other nerve C 64868 Fusion of facial/other nerve C 64870 Fusion of facial/other nerve T 0221 64872 Subsequent repair of nerve T 0221 64874 Repair & revise nerve add-on T 0221 64876 Repair nerve/shorten bone T 0221 64885 Nerve graft head or neck T 0221 64886 Nerve graft head or neck T 0221 64890 Nerve graft hand or foot T 0221 64891 Nerve graft hand or foot T 0221 64892 Nerve graft arm or leg T 0221 64893 Nerve graft arm or leg T 0221 64895 Nerve graft hand or foot T 0221 64896 Nerve graft hand or foot T 0221 64897 Nerve graft arm or leg T 0221 64898 Nerve graft arm or leg T 0221 64901 Nerve graft add-on T 0221 64902 Nerve graft add-on T 0221 64905 Nerve pedicle transfer T 0221 64907 Nerve pedicle transfer T 0221 64910 Nerve repair w/allograft T 0221 64911 Neurorraphy w/vein autograft T 0221 64999 Nervous system surgery T 0204 65091 Revise eye T 0242 65093 Revise eye with implant T 0242 65101 Removal of eye T 0242 65103 Remove eye/insert implant T 0242 65105 Remove eye/attach implant T 0242 65110 Removal of eye T 0242 65112 Remove eye/revise socket T 0242 65114 Remove eye/revise socket T 0242 65125 Revise ocular implant T 0241 65130 Insert ocular implant T 0241 65135 Insert ocular implant T 0241 65140 Attach ocular implant T 0242 65150 Revise ocular implant T 0241 65155 Reinsert ocular implant T 0242 65175 Removal of ocular implant T 0240 65205 Remove foreign body from eye S 0698 65210 Remove foreign body from eye S 0698 65220 Remove foreign body from eye S 0698 65222 Remove foreign body from eye S 0698 65235 Remove foreign body from eye T 0233 65260 Remove foreign body from eye T 0235 65265 Remove foreign body from eye T 0237 65270 Repair of eye wound T 024065272 Repair of eye wound T 0234

65273 Repair of eye wound C 65275 Repair of eye wound T 0234 65280 Repair of eye wound T 0237 65285 Repair of eye wound T 0672 65286 Repair of eye wound T 0255 65290 Repair of eye socket wound T 0243 65400 Removal of eye lesion T 0233 65410 Biopsy

of cornea T 0233 65420 Removal of eye lesion T 0233 65426 Removal of eye lesion T 0234 65430 Corneal smear S 0698 65435 Curette/treat cornea T 0239 65436 Curette/treat cornea T 0233 65450 Treatment of corneal lesion S 0231 65600 Revision of cornea T 0240 65710 Corneal transplant T 0244 65730 Corneal transplant T 0244 65750 Corneal transplant T 0244 65755 Corneal transplant T 0244 65756 Corneal trnspl endothelial T 0244 65757 Prep corneal endo allograft N 65760 Revision of cornea E 65765 Revision of cornea E 65767 Corneal tissue transplant E 65770 Revise cornea with implant T 0293 65771 Radial keratotomy E 65772 Correction of astigmatism T 0233 65775 Correction of astigmatism T 0233 65778 Cover eye w/membrane CHQ2 0233 65779 Cover eye w/membrane suture CHT 0233 65780 Ocular reconst transplant T 0244 65781 Ocular reconst transplant T 0244 65782 Ocular reconst transplant T 0244 65800 Drainage of eye T 0255 65805 Drainage of eye CHT 0234 65810 Drainage of eye T 0234 65815 Drainage of eye T 0234 65820 Relieve inner eye pressure T 0234 65850 Incision of eye T 0234 65855 Laser surgery of eye T 0247 65860 Incise inner eye adhesions T 0247 65865 Incise inner eye adhesions T 0233 65870 Incise inner eye adhesions T 0234 65875 Incise inner eye adhesions T 0234 65880 Incise inner eye adhesions T 0233 65900 Remove eye lesion T 0232 65920 Remove implant of eye T 0234 65930 Remove blood clot from eye T 0234 66020 Injection treatment of eye T 0233 66030 Injection treatment of eye T 0233 66130 Remove eye lesion T 0234 66150 Glaucoma surgery T 0234 66155 Glaucoma surgery T 0234 66160 Glaucoma surgery T 023466165 Glaucoma surgery T 0234

66170 Glaucoma surgery T 0234 66172 Incision of eye T 0234 66174 Translum dil eye canal T 0673 66175 Trnslum dil eye canal w/stnt T 0673 66180 Implant eye shunt T 0673 66185 Revise eye shunt T 0234 66220 Repair eye lesion T 0672 66225 Repair/graft eye lesion T 0673 66250 Follow-up surgery of eye T 0233 66500 Incision of iris T 0232 66505 Incision of iris T 0255 66600 Remove iris and lesion T 0234 66605 Removal of iris T 0234 66625 Removal of iris T 0255 66630 Removal of iris T 0234 66635 Removal of iris T 0234 66680 Repair iris & ciliary body T 0234 66682 Repair iris & ciliary body T 0234 66700 Destruction ciliary body T 0233 66710 Ciliary

transsleral therapy T 0233 66711 Ciliary

endoscopic ablation CHT 0234 66720 Destruction ciliary body T 0233 66740 Destruction ciliary body T 0234 66761 Revision of iris T 0247 66762 Revision of iris T 0247 66770 Removal of inner eye lesion T 0247 66820 Incision secondary cataract T 0255 66821 After cataract laser surgery T 0247 66825 Reposition intraocular lens T 0234 66830 Removal of lens lesion T 0255 66840 Removal of lens material CHT 0233 66850 Removal of lens material T 0249 66852 Removal of lens material T 0249 66920 Extraction of lens T 0249 66930 Extraction of lens T 0249 66940 Extraction of lens CHT 0255 66982 Cataract surgery complex T 0246 66983 Cataract surg w/iol 1 stage T 0246 66984 Cataract surg w/iol 1 stage T 0246 66985 Insert lens prosthesis T 0246 66986 Exchange lens prosthesis T 0246 66990 Ophthalmic endoscope add-on N 66999 Eye surgery procedure T 0232 67005 Partial removal of eye fluid T 0237 67010 Partial removal of eye fluid T 0672 67015 Release of eye fluid T 0672 67025 Replace eye fluid T 0672 67027 Implant eye drug system T 0672 67028 Injection eye drug T 0238 67030 Incise inner eye strands T 0237 67031 Laser surgery eye strands T 0247 67036 Removal of inner eye fluid T 0672 67039 Laser treatment of retina T 0672 67040 Laser treatment of retina T 067267041 Vit for macular pucker T 0672

67042 Vit for macular hole T 0672 67043 Vit for membrane dissect T 0672 67101 Repair detached retina T 0237 67105 Repair detached retina T 0247 67107 Repair detached retina T 0672 67108 Repair detached retina T 0672 67110 Repair detached retina T 0237 67112 Rerepair detached retina T 0672 67113 Repair retinal detach cplx T 0672 67115 Release encircling material T 0237 67120 Remove eye implant material T 0237 67121 Remove eye implant material T 0672 67141 Treatment of retina T 0235 67145 Treatment of retina T 0247 67208 Treatment of retinal lesion T 0235 67210 Treatment of retinal lesion T 0247 67218 Treatment of retinal lesion T 0237 67220 Treatment of choroid lesion T 0235 67221 Ocular photodynamic ther T 0235 67225 Eye photodynamic ther add-on T 0235 67227 Treatment of retinal lesion T 0237 67228 Treatment of retinal lesion T 0247 67229 Tr retinal les preterm inf T 0247 67250 Reinforce eye wall T 0240 67255 Reinforce/graft eye wall T 0237 67299 Eye surgery procedure T 0235 67311 Revise eye muscle T 0243 67312 Revise two eye muscles T 0243 67314 Revise eye muscle T 0243 67316 Revise two eye muscles T 0243 67318 Revise eye muscle(s) T 0243 67320 Revise eye muscle(s) add-on T 0243 67331 Eye surgery follow-up add-on T 0243 67332 Rerevise eye muscles add-on T 0243 67334 Revise eye muscle w/suture T 0243 67335 Eye suture during surgery T 0243 67340 Revise eye muscle add-on T 0243 67343 Release eye tissue T 0243 67345 Destroy

nerve of eye muscle T 0238 67346 Biopsy

eye muscle T 0699 67399 Eye muscle surgery procedure T 0243 67400 Explore/biopsy eye socket T 0240 67405 Explore/drain eye socket T 0241 67412 Explore/treat eye socket T 0240 67413 Explore/treat eye socket T 0241 67414 Explr/decompress eye socket T 0242 67415 Aspiration orbital contents T 0240 67420 Explore/treat eye socket T 0242 67430 Explore/treat eye socket T 0242 67440 Explore/drain eye socket T 0242 67445 Explr/decompress eye socket T 0242 67450 Explore/biopsy eye socket T 0242 67500 Inject/treat eye socket S 0231 67505 Inject/treat eye socket T 023867515 Inject/treat eye socket T 0238

67550 Insert eye socket implant T 0242 67560 Revise eye socket implant T 0241 67570 Decompress optic nerve T 0242 67599 Orbit surgery procedure T 0238 67700 Drainage of eyelid abscess T 0238 67710 Incision of eyelid T 0239 67715 Incision of eyelid fold T 0240 67800 Remove eyelid lesion T 0238 67801 Remove eyelid lesions T 0239 67805 Remove eyelid lesions T 0238 67808 Remove eyelid lesion(s) T 0240 67810 Biopsy

of eyelid T 0238 67820 Revise eyelashes S 0698 67825 Revise eyelashes T 0238 67830 Revise eyelashes T 0239 67835 Revise eyelashes T 0240 67840 Remove eyelid lesion T 0239 67850 Treat eyelid lesion T 0239 67875 Closure of eyelid by suture T 0239 67880 Revision of eyelid T 0233 67882 Revision of eyelid T 0240 67900 Repair brow defect T 0241 67901 Repair eyelid defect T 0240 67902 Repair eyelid defect T 0241 67903 Repair eyelid defect T 0240 67904 Repair eyelid defect T 0240 67906 Repair eyelid defect T 0240 67908 Repair eyelid defect T 0240 67909 Revise eyelid defect T 0240 67911 Revise eyelid defect T 0240 67912 Correction eyelid w/implant T 0240 67914 Repair eyelid defect T 0240 67915 Repair eyelid defect T 0240 67916 Repair eyelid defect T 0240 67917 Repair eyelid defect T 0240 67921 Repair eyelid defect T 0240 67922 Repair eyelid defect T 0240 67923 Repair eyelid defect T 0240 67924 Repair eyelid defect T 0240 67930 Repair eyelid wound T 0240 67935 Repair eyelid wound T 0240 67938 Remove eyelid foreign body S 0231 67950 Revision of eyelid T 0240 67961 Revision of eyelid T 0240 67966 Revision of eyelid T 0240 67971 Reconstruction of eyelid T 0240 67973 Reconstruction of eyelid T 0241 67974 Reconstruction of eyelid T 0240 67975 Reconstruction of eyelid T 0240 67999 Revision of eyelid T 0238 68020 Incise/drain eyelid lining T 0238 68040 Treatment of eyelid lesions S 0698 68100 Biopsy

of eyelid lining CHT 0239 68110 Remove eyelid lining lesion T 069968115 Remove eyelid lining lesion T 0240

68130 Remove eyelid lining lesion T 0233 68135 Remove eyelid lining lesion T 0239 68200 Treat eyelid by injection CHS 0230 68320 Revise/graft eyelid lining T 0241 68325 Revise/graft eyelid lining T 0241 68326 Revise/graft eyelid lining T 0240 68328 Revise/graft eyelid lining T 0241 68330 Revise eyelid lining T 0234 68335 Revise/graft eyelid lining T 0241 68340 Separate eyelid adhesions T 0240 68360 Revise eyelid lining T 0234 68362 Revise eyelid lining T 0234 68371 Harvest eye tissue alograft CHT 0234 68399 Eyelid lining surgery T 0238 68400 Incise/drain tear gland T 0238 68420 Incise/drain tear sac T 0240 68440 Incise tear duct opening T 0238 68500 Removal of tear gland T 0241 68505 Partial removal tear gland T 0241 68510 Biopsy

of tear gland T 0240 68520 Removal of tear sac T 0241 68525 Biopsy

of tear sac T 0240 68530 Clearance of tear duct T 0238 68540 Remove tear gland lesion T 0240 68550 Remove tear gland lesion T 0241 68700 Repair tear ducts T 0240 68705 Revise tear duct opening T 0238 68720 Create tear sac drain T 0241 68745 Create tear duct drain T 0241 68750 Create tear duct drain T 0241 68760 Close tear duct opening T 0238 68761 Close tear duct opening T 0238 68770 Close tear system fistula T 0241 68801 Dilate tear duct opening S 0698 68810 Probe nasolacrimal duct T 0238 68811 Probe nasolacrimal duct T 0240 68815 Probe nasolacrimal duct T 0240 68816 Probe nl duct w/balloon T 0240 68840 Explore/irrigate tear ducts S 0231 68850 Injection for tear sac x-ray N 68899 Tear duct system surgery T 0238 69000 Drain external ear lesion T 0006 69005 Drain external ear lesion T 0008 69020 Drain outer ear canal lesion T 0006 69090 Pierce earlobes E 69100 Biopsy

of external ear T 0251 69105 Biopsy

of external ear canal T 0253 69110 Remove external ear partial T 0021 69120 Removal of external ear T 0254 69140 Remove ear canal lesion(s) T 0254 69145 Remove ear canal lesion(s) T 0021 69150 Extensive ear canal surgery T 0252 69155 Extensive ear/neck surgery C 69200 Clear outer ear canal X 034069205 Clear outer ear canal T 0022

69210 Remove impacted ear wax X 0340 69220 Clean out mastoid cavity T 0013 69222 Clean out mastoid cavity T 0253 69300 Revise external ear T 0254 69310 Rebuild outer ear canal T 0256 69320 Rebuild outer ear canal T 0256 69399 Outer ear surgery procedure T 0250 69400 Inflate middle ear canal T 0251 69401 Inflate middle ear canal T 0251 69405 Catheterize middle ear canal T 0252 69420 Incision of eardrum T 0251 69421 Incision of eardrum T 0253 69424 Remove ventilating tube T 0253 69433 Create eardrum opening T 0252 69436 Create eardrum opening T 0253 69440 Exploration of middle ear T 0254 69450 Eardrum revision T 0256 69501 Mastoidectomy T 0256 69502 Mastoidectomy T 0254 69505 Remove mastoid structures T 0256 69511 Extensive mastoid surgery T 0256 69530 Extensive mastoid surgery T 0256 69535 Remove part of temporal bone C 69540 Remove ear lesion T 0253 69550 Remove ear lesion T 0256 69552 Remove ear lesion T 0256 69554 Remove ear lesion C 69601 Mastoid surgery revision T 0256 69602 Mastoid surgery revision T 0256 69603 Mastoid surgery revision T 0256 69604 Mastoid surgery revision T 0256 69605 Mastoid surgery revision T 0256 69610 Repair of eardrum T 0254 69620 Repair of eardrum T 0254 69631 Repair eardrum structures T 0256 69632 Rebuild eardrum structures T 0256 69633 Rebuild eardrum structures T 0256 69635 Repair eardrum structures T 0256 69636 Rebuild eardrum structures T 0256 69637 Rebuild eardrum structures T 0256 69641 Revise middle ear & mastoid T 0256 69642 Revise middle ear & mastoid T 0256 69643 Revise middle ear & mastoid T 0256 69644 Revise middle ear & mastoid T 0256 69645 Revise middle ear & mastoid T 0256 69646 Revise middle ear & mastoid T 0256 69650 Release middle ear bone T 0254 69660 Revise middle ear bone T 0256 69661 Revise middle ear bone T 0256 69662 Revise middle ear bone T 0256 69666 Repair middle ear structures T 0256 69667 Repair middle ear structures T 0256 69670 Remove mastoid air cells T 0256 69676 Remove middle ear nerve T 025669700 Close mastoid fistula T 0256

69710 Implant/replace hearing aid E 69711 Remove/repair hearing aid T 0256 69714 Implant temple bone w/stimul T 0425 69715 Temple bne implnt w/stimulat T 0425 69717 Temple bone implant revision T 0425 69718 Revise temple bone implant T 0425 69720 Release facial nerve T 0256 69725 Release facial nerve T 0256 69740 Repair facial nerve T 0256 69745 Repair facial nerve T 0256 69799 Middle ear surgery procedure T 0250 69801 Incise inner ear T 0253 69802 Incise inner ear CHD 69805 Explore inner ear T 0256 69806 Explore inner ear T 0256 69820 Establish inner ear window T 0256 69840 Revise inner ear window T 0256 69905 Remove inner ear T 0256 69910 Remove inner ear & mastoid T 0256 69915 Incise inner ear nerve T 0256 69930 Implant cochlear device T 0259 69949 Inner ear surgery procedure T 0250 69950 Incise inner ear nerve C 69955 Release facial nerve T 0256 69960 Release inner ear canal T 0256 69970 Remove inner ear lesion T 0256 69979 Temporal bone surgery T 0250 69990 Microsurgery add-on N 70010 Contrast x-ray of brain Q2 0274 70015 Contrast x-ray of brain Q2 0274 70030 X-ray

eye for foreign body X 0260 70100 X-ray

exam of jaw X 0260 70110 X-ray

exam of jaw X 0260 70120 X-ray

exam of mastoids X 0260 70130 X-ray

exam of mastoids X 0260 70134 X-ray

exam of middle ear X 0261 70140 X-ray

exam of facial bones X 0260 70150 X-ray

exam of facial bones X 0260 70160 X-ray

exam of nasal bones X 0260 70170 X-ray

exam of tear duct Q2 0263 70190 X-ray

exam of eye sockets X 0260 70200 X-ray

exam of eye sockets X 0260 70210 X-ray

exam of sinuses X 0260 70220 X-ray

exam of sinuses X 0260 70240 X-ray

exam pituitary

saddle X 0260 70250 X-ray

exam of skull X 0260 70260 X-ray

exam of skull X 0261 70300 X-ray

exam of teeth X 0262 70310 X-ray

exam of teeth X 0262 70320 Full mouth x-ray of teeth X 0262 70328 X-ray

exam of jaw joint X 0260 70330 X-ray

exam of jaw joints X 0260 70332 X-ray

exam of jaw joint Q2 0275 70336 Magnetic image jaw joint Q3 033670350 X-ray head for orthodontia X 0260 70355 Panoramic x-ray of jaws X 0262 70360 X-ray

exam of neck X 0260 70370 Throat x-ray & fluoroscopy X 0272 70371 Speech evaluation complex X 0272 70373 Contrast x-ray of larynx Q2 0263 70380 X-ray

exam of salivary

gland X 0260 70390 X-ray

exam of salivary

duct Q2 0263 70450 Ct head/brain w/o dye Q3 0332 70460 Ct head/brain w/dye Q3 0283 70470 Ct head/brain w/o & w/dye Q3 0333 70480 Ct orbit/ear/fossa w/o dye Q3 0332 70481 Ct orbit/ear/fossa w/dye Q3 0283 70482 Ct orbit/ear/fossa w/o&w/dye Q3 0333 70486 Ct maxillofacial w/o dye Q3 0332 70487 Ct maxillofacial w/dye Q3 0283 70488 Ct maxillofacial w/o & w/dye Q3 0333 70490 Ct soft tissue neck w/o dye Q3 0332 70491 Ct soft tissue neck w/dye Q3 0283 70492 Ct sft tsue nck w/o & w/dye Q3 0333 70496 Ct angiography head Q3 0662 70498 Ct angiography neck Q3 0662 70540 Mri orbit/face/neck w/o dye Q3 0336 70542 Mri orbit/face/neck w/dye Q3 0284 70543 Mri orbt/fac/nck w/o & w/dye Q3 0337 70544 Mr angiography head w/o dye Q3 0336 70545 Mr angiography head w/dye Q3 0284 70546 Mr angiograph head w/o&w/dye Q3 0337 70547 Mr angiography neck w/o dye Q3 0336 70548 Mr angiography neck w/dye Q3 0284 70549 Mr angiograph neck w/o&w/dye Q3 0337 70551 Mri brain w/o dye Q3 0336 70552 Mri brain w/dye Q3 0284 70553 Mri brain w/o & w/dye Q3 0337 70554 Fmri brain by tech Q3 0336 70555 Fmri brain by phys/psych S 0336 70557 Mri brain w/o dye S 0336 70558 Mri brain w/dye S 0284 70559 Mri brain w/o & w/dye S 0337 71010 Chest x-ray Q3 0260 71015 Chest x-ray Q3 0260 71020 Chest x-ray Q3 0260 71021 Chest x-ray X 0260 71022 Chest x-ray X 0260 71023 Chest x-ray and fluoroscopy X 0272 71030 Chest x-ray X 0260 71034 Chest x-ray and fluoroscopy X 0272 71035 Chest x-ray X 0260 71040 Contrast x-ray of bronchi Q2 0263 71060 Contrast x-ray of bronchi Q2 0263 71090 X-ray

& pacemaker insertion CHD 71100 X-ray

exam of ribs X 0260 71101 X-ray

exam of ribs/chest X 0260 71110 X-ray

exam of ribs X 0260 71111 X-ray

exam of ribs/chest X 026171120 X-ray exam of breastbone X 0260 71130 X-ray

exam of breastbone X 0260 71250 Ct thorax w/o dye Q3 0332 71260 Ct thorax w/dye Q3 0283 71270 Ct thorax w/o & w/dye Q3 0333 71275 Ct angiography chest Q3 0662 71550 Mri chest w/o dye Q3 0336 71551 Mri chest w/dye Q3 0284 71552 Mri chest w/o & w/dye Q3 0337 71555 Mri angio chest w or w/o dye B 72010 X-ray

exam of spine X 0261 72020 X-ray

exam of spine X 0260 72040 X-ray

exam of neck spine X 0260 72050 X-ray

exam of neck spine X 0261 72052 X-ray

exam of neck spine X 0261 72069 X-ray

exam of trunk spine X 0260 72070 X-ray

exam of thoracic spine X 0260 72072 X-ray

exam of thoracic spine X 0260 72074 X-ray

exam of thoracic spine X 0260 72080 X-ray

exam of trunk spine X 0260 72090 X-ray

exam of trunk spine X 0261 72100 X-ray

exam of lower spine X 0260 72110 X-ray

exam of lower spine X 0261 72114 X-ray

exam of lower spine X 0261 72120 X-ray

exam of lower spine X 0260 72125 Ct neck spine w/o dye Q3 0332 72126 Ct neck spine w/dye Q3 0283 72127 Ct neck spine w/o & w/dye Q3 0333 72128 Ct chest spine w/o dye Q3 0332 72129 Ct chest spine w/dye Q3 0283 72130 Ct chest spine w/o & w/dye Q3 0333 72131 Ct lumbar spine w/o dye Q3 0332 72132 Ct lumbar spine w/dye Q3 0283 72133 Ct lumbar spine w/o & w/dye Q3 0333 72141 Mri neck spine w/o dye Q3 0336 72142 Mri neck spine w/dye Q3 0284 72146 Mri chest spine w/o dye Q3 0336 72147 Mri chest spine w/dye Q3 0284 72148 Mri lumbar spine w/o dye Q3 0336 72149 Mri lumbar spine w/dye Q3 0284 72156 Mri neck spine w/o & w/dye Q3 0337 72157 Mri chest spine w/o & w/dye Q3 0337 72158 Mri lumbar spine w/o & w/dye Q3 0337 72159 Mr angio spine w/o&w/dye B 72170 X-ray

exam of pelvis X 0260 72190 X-ray

exam of pelvis X 0260 72191 Ct angiograph pelv w/o&w/dye Q3 0662 72192 Ct pelvis w/o dye Q3 0332 72193 Ct pelvis w/dye Q3 0283 72194 Ct pelvis w/o & w/dye Q3 0333 72195 Mri pelvis w/o dye Q3 0336 72196 Mri pelvis w/dye Q3 0284 72197 Mri pelvis w/o & w/dye Q3 0337 72198 Mr angio pelvis w/o & w/dye B 72200 X-ray

exam sacroiliac joints X 026072202 X-ray exam sacroiliac joints X 0260 72220 X-ray

exam of tailbone X 0260 72240 Contrast x-ray of neck spine Q2 0274 72255 Contrast x-ray thorax spine Q2 0274 72265 Contrast x-ray lower spine Q2 0274 72270 Contrast x-ray spine Q2 0274 72275 Epidurography N 72285 X-ray

c/t spine disk Q2 0388 72291 Perq verte/sacroplsty fluor N 72292 Perq verte/sacroplsty ct N 72295 X-ray

of lower spine disk Q2 0388 73000 X-ray

exam of collar bone X 0260 73010 X-ray

exam of shoulder blade X 0260 73020 X-ray

exam of shoulder X 0260 73030 X-ray

exam of shoulder X 0260 73040 Contrast x-ray of shoulder Q2 0275 73050 X-ray

exam of shoulders X 0260 73060 X-ray

exam of humerus X 0260 73070 X-ray

exam of elbow X 0260 73080 X-ray

exam of elbow X 0260 73085 Contrast x-ray of elbow Q2 0275 73090 X-ray

exam of forearm X 0260 73092 X-ray

exam of arm infant X 0260 73100 X-ray

exam of wrist X 0260 73110 X-ray

exam of wrist X 0260 73115 Contrast x-ray of wrist Q2 0275 73120 X-ray

exam of hand X 0260 73130 X-ray

exam of hand X 0260 73140 X-ray

exam of finger(s) X 0260 73200 Ct upper extremity w/o dye Q3 0332 73201 Ct upper extremity w/dye Q3 0283 73202 Ct uppr extremity w/o&w/dye Q3 0333 73206 Ct angio upr extrm w/o&w/dye Q3 0662 73218 Mri upper extremity w/o dye Q3 0336 73219 Mri upper extremity w/dye Q3 0284 73220 Mri uppr extremity w/o&w/dye Q3 0337 73221 Mri joint upr extrem w/o dye Q3 0336 73222 Mri joint upr extrem w/dye Q3 0284 73223 Mri joint upr extr w/o&w/dye Q3 0337 73225 Mr angio upr extr w/o&w/dye B 73500 X-ray

exam of hip X 0260 73510 X-ray

exam of hip X 0260 73520 X-ray

exam of hips X 0260 73525 Contrast x-ray of hip Q2 0275 73530 X-ray

exam of hip N 73540 X-ray

exam of pelvis & hips X 0260 73542 X-ray

exam sacroiliac joint CHD 73550 X-ray

exam of thigh X 0260 73560 X-ray

exam of knee 1 or 2 X 0260 73562 X-ray

exam of knee 3 X 0260 73564 X-ray

exam knee 4 or more X 0260 73565 X-ray

exam of knees X 0260 73580 Contrast x-ray of knee joint Q2 0275 73590 X-ray

exam of lower leg X 0260 73592 X-ray

exam of leg infant X 026073600 X-ray exam of ankle X 0260 73610 X-ray

exam of ankle X 0260 73615 Contrast x-ray of ankle Q2 0275 73620 X-ray

exam of foot X 0260 73630 X-ray

exam of foot X 0260 73650 X-ray

exam of heel X 0260 73660 X-ray

exam of toe(s) X 0260 73700 Ct lower extremity w/o dye Q3 0332 73701 Ct lower extremity w/dye Q3 0283 73702 Ct lwr extremity w/o&w/dye Q3 0333 73706 Ct angio lwr extr w/o&w/dye Q3 0662 73718 Mri lower extremity w/o dye Q3 0336 73719 Mri lower extremity w/dye Q3 0284 73720 Mri lwr extremity w/o&w/dye Q3 0337 73721 Mri jnt of lwr extre w/o dye Q3 0336 73722 Mri joint of lwr extr w/dye Q3 0284 73723 Mri joint lwr extr w/o&w/dye Q3 0337 73725 Mr ang lwr ext w or w/o dye B 74000 X-ray

exam of abdomen X 0260 74010 X-ray

exam of abdomen X 0260 74020 X-ray

exam of abdomen X 0260 74022 X-ray

exam series abdomen X 0261 74150 Ct abdomen w/o dye Q3 0332 74160 Ct abdomen w/dye Q3 0283 74170 Ct abdomen w/o & w/dye Q3 0333 74174 Ct angio abd&pelv w/o&w/dye NIS 0334 74175 Ct angio abdom w/o & w/dye Q3 0662 74176 Ct abd & pelvis CHQ3 0331 74177 Ct abd & pelv w/contrast CHQ3 0334 74178 Ct abd & pelv 1/> regns CHQ3 0334 74181 Mri abdomen w/o dye Q3 0336 74182 Mri abdomen w/dye Q3 0284 74183 Mri abdomen w/o & w/dye Q3 0337 74185 Mri angio abdomw orw/o dye B 74190 X-ray

exam of peritoneum Q2 0263 74210 Contrst x-ray exam of throat S 0276 74220 Contrast x-ray esophagus S 0276 74230 Cine/vid x-ray throat/esoph S 0276 74235 Remove esophagus obstruction N 74240 X-ray

exam upper gi tract S 0276 74241 X-ray

exam upper gi tract S 0276 74245 X-ray

exam upper gi tract S 0277 74246 Contrst x-ray uppr gi tract S 0276 74247 Contrst x-ray uppr gi tract S 0276 74249 Contrst x-ray uppr gi tract S 0277 74250 X-ray

exam of small bowel S 0276 74251 X-ray

exam of small bowel S 0277 74260 X-ray

exam of small bowel S 0276 74261 Ct colonography dx Q3 0332 74262 Ct colonography dx w/dye Q3 0283 74263 Ct colonography screening E 74270 Contrast x-ray exam of colon S 0276 74280 Contrast x-ray exam of colon S 0277 74283 Contrast x-ray exam of colon S 0276 74290 Contrast x-ray gallbladder S 027674291 Contrast x-rays gallbladder S 0276

74300 X-ray

bile ducts/pancreas N 74301 X-rays at surgery add-on N 74305 X-ray

bile ducts/pancreas Q2 0263 74320 Contrast x-ray of bile ducts Q2 0317 74327 X-ray

bile stone removal N 74328 X-ray

bile duct endoscopy N 74329 X-ray

for pancreas endoscopy N 74330 X-ray

bile/panc endoscopy N 74340 X-ray

guide for GI tube N 74355 X-ray

guide intestinal tube N 74360 X-ray

guide gi dilation N 74363 X-ray

bile duct dilation N 74400 Contrst x-ray urinary tract S 0278 74410 Contrst x-ray urinary tract S 0278 74415 Contrst x-ray urinary tract S 0278 74420 Contrst x-ray urinary tract S 0278 74425 Contrst x-ray urinary tract Q2 0278 74430 Contrast x-ray bladder Q2 0278 74440 X-ray

male genital tract Q2 0278 74445 X-ray

exam of penis Q2 0278 74450 X-ray

urethra/bladder Q2 0278 74455 X-ray

urethra/bladder Q2 0278 74470 X-ray

exam of kidney

lesion Q2 0263 74475 X-ray

control cath insert Q2 0161 74480 X-ray

control cath insert Q2 0161 74485 X-ray

guide gu dilation Q2 0161 74710 X-ray

measurement of pelvis X 0261 74740 X-ray

female genital tract Q2 0263 74742 X-ray

fallopian tube N 74775 X-ray

exam of perineum S 0278 75557 Cardiac mri for morph Q3 0336 75559 Cardiac mri w/stress img Q3 0336 75561 Cardiac mri for morph w/dye Q3 0337 75563 Card mri w/stress img & dye Q3 0337 75565 Card mri veloc flow mapping N 75571 Ct hrt w/o dye w/ca test X 0340 75572 Ct hrt w/3d image S 0383 75573 Ct hrt w/3d image congen S 0383 75574 Ct angio hrt w/3d image S 0383 75600 Contrast x-ray exam of aorta Q2 0279 75605 Contrast x-ray exam of aorta Q2 0279 75625 Contrast x-ray exam of aorta Q2 0279 75630 X-ray

aorta leg arteries Q2 0279 75635 Ct angio abdominal arteries Q2 0662 75650 Artery

x-rays head & neck Q2 0280 75658 Artery

x-rays arm Q2 0279 75660 Artery

x-rays head & neck Q2 0280 75662 Artery

x-rays head & neck Q2 0280 75665 Artery

x-rays head & neck Q2 0279 75671 Artery

x-rays head & neck Q2 0280 75676 Artery

x-rays neck Q2 0279 75680 Artery

x-rays neck Q2 0279 75685 Artery

x-rays spine Q2 0279 75705 Artery

x-rays spine Q2 027975710 Artery x-rays arm/leg Q2 0279 75716 Artery

x-rays arms/legs Q2 0279 75722 Artery

x-rays kidney CHD 75724 Artery

x-rays kidneys CHD 75726 Artery

x-rays abdomen Q2 0279 75731 Artery

x-rays adrenal gland Q2 0279 75733 Artery

x-rays adrenals Q2 0279 75736 Artery

x-rays pelvis Q2 0279 75741 Artery

x-rays lung Q2 0279 75743 Artery

x-rays lungs Q2 0279 75746 Artery

x-rays lung Q2 0668 75756 Artery

x-rays chest Q2 0668 75774 Artery

x-ray each vessel N 75791 Av dialysis shunt imaging CHQ2 0668 75801 Lymph vessel x-ray arm/leg Q2 0317 75803 Lymph vessel x-ray arms/legs Q2 0317 75805 Lymph vessel x-ray trunk Q2 0317 75807 Lymph vessel x-ray trunk Q2 0317 75809 Nonvascular shunt x-ray Q2 0261 75810 Vein x-ray

spleen/liver Q2 0279 75820 Vein x-ray

arm/leg Q2 0668 75822 Vein x-ray

arms/legs Q2 0668 75825 Vein x-ray

trunk Q2 0279 75827 Vein x-ray

chest Q2 0668 75831 Vein x-ray

kidney Q2 0279 75833 Vein x-ray

kidneys Q2 0279 75840 Vein x-ray

adrenal gland Q2 0279 75842 Vein x-ray

adrenal glands Q2 0279 75860 Vein x-ray

neck Q2 0668 75870 Vein x-ray

skull Q2 0668 75872 Vein x-ray

skull Q2 0668 75880 Vein x-ray

eye socket Q2 0668 75885 Vein x-ray

liver Q2 0279 75887 Vein x-ray

liver Q2 0668 75889 Vein x-ray

liver Q2 0279 75891 Vein x-ray

liver Q2 0279 75893 Venous sampling by catheter Q2 0279 75894 X-rays transcath therapy N 75896 X-rays transcath therapy N 75898 Follow-up angiography Q1 0261 75900 Intravascular cath exchange C 75901 Remove cva device obstruct N 75902 Remove cva lumen obstruct N 75940 X-ray

placement vein filter CHD 75945 Intravascular us Q2 0267 75946 Intravascular us add-on N 75952 Endovasc repair abdom aorta C 75953 Abdomaneurysm endovas rpr C 75954 Iliac aneurysm endovas rpr C 75956 Xray

endovasc thor ao repr C 75957 Xray

endovasc thor ao repr C 75958 Xray

place prox ext thor ao C 75959 Xray

place dist ext thor ao C 75960 Transcath iv stent rs&i N 75961 Retrieval broken catheter N75962 Repair arterial blockage Q2 0083

75964 Repair artery blockage each N 75966 Repair arterial blockage Q2 0083 75968 Repair artery blockage each N 75970 Vascular biopsy N 75978 Repair venous blockage Q2 0093 75980 Contrast xray exam bile duct N 75982 Contrast xray exam bile duct N 75984 Xray

control catheter change N 75989 Abscess drainage under x-ray N 76000 Fluoroscope examination Q1 0272 76001 Fluoroscope exam extensive N 76010 X-ray

nose to rectum X 0260 76080 X-ray

exam of fistula Q2 0263 76098 X-ray

exam breast specimen Q2 0317 76100 X-ray

exam of body

section X 0261 76101 Complex body section x-ray X 0263 76102 Complex body section x-rays X 0263 76120 Cine/video x-rays X 0272 76125 Cine/video x-rays add-on N 76140 X-ray

consultation E 76376 3d render w/o postprocess N 76377 3d rendering w/postprocess N 76380 CAT scan follow-up study S 0282 76390 Mr spectroscopy E 76496 Fluoroscopic procedure X 0272 76497 Ct procedure S 0282 76498 Mri procedure S 0336 76499 Radiographic procedure X 0260 76506 Echo exam of head S 0265 76510 Ophth us b & quant a T 0232 76511 Ophth us quant a only S 0266 76512 Ophth us b w/non-quant a S 0266 76513 Echo exam of eye water bath S 0266 76514 Echo exam of eye thickness X 0035 76516 Echo exam of eye S 0265 76519 Echo exam of eye S 0266 76529 Echo exam of eye S 0265 76536 Us exam of head and neck S 0266 76604 Us exam chest Q3 0265 76645 Us exam breast(s) S 0265 76700 Us exam abdom complete Q3 0266 76705 Echo exam of abdomen Q3 0266 76770 Us exam abdo back wall comp Q3 0266 76775 Us exam abdo back wall lim Q3 0266 76776 Us exam k transpl w/doppler Q3 0266 76800 Us exam spinal canal S 0266 76801 Ob us < 14 wks single fetus S 0266 76802 Ob us < 14 wks addl fetus S 0265 76805 Ob us >/= 14 wks sngl fetus S 0266 76810 Ob us >/= 14 wks addl fetus S 0266 76811 Ob us detailed sngl fetus S 0267 76812 Ob us detailed addl fetus S 0265 76813 Ob us nuchal meas 1 gest S 0265 76814 Ob us nuchal meas add-on S 026576815 Ob us limited fetus(s) S 0265

76816 Ob us follow-up per fetus S 0265 76817 Transvaginal us obstetric S 0265 76818 Fetal biophys profile w/nst S 0266 76819 Fetal biophys profil w/o nst S 0266 76820 Umbilical artery echo S 0265 76821 Middle cerebral artery echo S 0265 76825 Echo exam of fetal heart CHS 0697 76826 Echo exam of fetal heart CHS 0697 76827 Echo exam of fetal heart S 0265 76828 Echo exam of fetal heart S 0265 76830 Transvaginal us non-ob S 0266 76831 Echo exam uterus Q3 0267 76856 Us exam pelvic complete Q3 0266 76857 Us exam pelvic limited Q3 0265 76870 Us exam scrotum Q3 0266 76872 Us transrectal S 0266 76873 Echograp trans r pros study S 0266 76881 Us xtr non-vasc complete S 0266 76882 Us xtr non-vasc lmtd S 0265 76885 Us exam infant hips dynamic S 0265 76886 Us exam infant hips static S 0265 76930 Echo guide cardiocentesis N 76932 Echo guide for heart biopsy N 76936 Echo guide for artery repair S 0096 76937 Us guide vascular access N 76940 Us guide tissue ablation N 76941 Echo guide for transfusion N 76942 Echo guide for biopsy N 76945 Echo guide villus sampling N 76946 Echo guide for amniocentesis N 76948 Echo guide ova aspiration N 76950 Echo guidance radiotherapy N 76965 Echo guidance radiotherapy N 76970 Ultrasound exam follow-up S 0265 76975 GI endoscopic ultrasound Q2 0267 76977 Us bone density measure X 0340 76998 Us guide intraop N 76999 Echo examination procedure S 0265 77001 Fluoroguide for vein device N 77002 Needle localization by xray N 77003 Fluoroguide for spine inject N 77011 Ct scan for localization N 77012 Ct scan for needle biopsy N 77013 Ct guide for tissue ablation N 77014 Ct scan for therapy guide N 77021 Mr guidance for needle place N 77022 Mri for tissue ablation N 77031 Stereotact guide for brst bx N 77032 Guidance for needle breast N 77051 Computer dx mammogram add-on A 77052 Comp screen mammogram add-on A 77053 X-ray

of mammary

duct Q2 0263 77054 X-ray

of mammary

ducts Q2 0263 77055 Mammogram one breast A77056 Mammogram both breasts A

77057 Mammogram screening A 77058 Mri one breast B 77059 Mri both breasts B 77071 X-ray

stress view X 0260 77072 X-rays for bone age X 0260 77073 X-rays bone length studies X 0260 77074 X-rays bone survey limited X 0261 77075 X-rays bone survey complete X 0261 77076 X-rays bone survey infant X 0261 77077 Joint survey single view X 0260 77078 Ct bone density axial S 0288 77079 Ct bone density peripheral CHD 77080 Dxa bone density axial S 0288 77081 Dxa bone density /peripheral S 0665 77082 Dxa bone density vert fx X 0260 77083 Radiographic absorptiometry CHD 77084 Magnetic image bone marrow S 0336 77261 Radiation therapy planning B 77262 Radiation therapy planning B 77263 Radiation therapy planning B 77280 Set radiation therapy field X 0304 77285 Set radiation therapy field X 0305 77290 Set radiation therapy field X 0305 77295 Set radiation therapy field X 0310 77299 Radiation therapy planning X 0304 77300 Radiation therapy dose plan X 0304 77301 Radiotherapy dose plan imrt X 0310 77305 Teletx isodose plan simple X 0304 77310 Teletx isodose plan intermed X 0304 77315 Teletx isodose plan complex X 0305 77321 Special teletx port plan X 0305 77326 Brachy

tx isodose calc simp X 0304 77327 Brachy

tx isodose calc interm X 0305 77328 Brachy

tx isodose plan compl X 0305 77331 Special radiation dosimetry X 0304 77332 Radiation treatment aid(s) X 0303 77333 Radiation treatment aid(s) X 0303 77334 Radiation treatment aid(s) X 0303 77336 Radiation physics consult X 0304 77338 Design mlc device for imrt CHX 0305 77370 Radiation physics consult X 0304 77371 Srs multisource S 0127 77372 Srs linear based B 77373 Sbrt delivery B 77399 External radiation dosimetry X 0304 77401 Radiation treatment delivery S 0300 77402 Radiation treatment delivery S 0300 77403 Radiation treatment delivery S 0300 77404 Radiation treatment delivery S 0300 77406 Radiation treatment delivery S 0300 77407 Radiation treatment delivery S 0300 77408 Radiation treatment delivery CHS 0301 77409 Radiation treatment delivery CHS 0301 77411 Radiation treatment delivery S 030177412 Radiation treatment delivery S 0301

77413 Radiation treatment delivery S 0301 77414 Radiation treatment delivery S 0301 77416 Radiation treatment delivery S 0301 77417 Radiology

port film(s) N 77418 Radiation tx delivery imrt S 0412 77421 Stereoscopic x-ray guidance N 77422 Neutron beam tx simple S 0301 77423 Neutron beam tx complex S 0301 77424 Io rad tx delivery by x-ray NIN 77425 Io rad tx deliver by elctrns NIN 77427 Radiation tx management x5 B 77431 Radiation therapy management B 77432 Stereotactic radiation trmt B 77435 Sbrt management N 77469 Io radiation tx management NIN 77470 Special radiation treatment S 0299 77499 Radiation therapy management B 77520 Proton trmt simple w/o comp S 0664 77522 Proton trmt simple w/comp S 0664 77523 Proton trmt intermediate S 0667 77525 Proton treatment complex S 0667 77600 Hyperthermia treatment S 0299 77605 Hyperthermia treatment S 0299 77610 Hyperthermia treatment S 0299 77615 Hyperthermia treatment S 0299 77620 Hyperthermia treatment S 0299 77750 Infuse radioactive materials S 0301 77761 Apply

intrcav radiat simple S 0312 77762 Apply

intrcav radiat interm S 0312 77763 Apply

intrcav radiat compl S 0312 77776 Apply

interstit radiat simpl S 0312 77777 Apply

interstit radiat inter S 0312 77778 Apply

interstit radiat compl Q3 0651 77785 Hdr brachy tx 1 channel S 0313 77786 Hdr brachy tx 2-12 channel S 0313 77787 Hdr brachy tx over 12 chan S 0313 77789 Apply

surface radiation S 0300 77790 Radiation handling N 77799 Radium/radioisotope therapy S 0312 78000 Thyroid single uptake S 0389 78001 Thyroid multiple uptakes S 0389 78003 Thyroid suppress/stimul S 0389 78006 Thyroid imaging with uptake S 0391 78007 Thyroid image mult uptakes S 0391 78010 Thyroid imaging S 0390 78011 Thyroid imaging with flow S 0390 78015 Thyroid met imaging S 0406 78016 Thyroid met imaging/studies S 0406 78018 Thyroid met imaging body S 0406 78020 Thyroid met uptake N 78070 Parathyroid nuclear imaging S 0391 78075 Adrenal nuclear imaging S 0408 78099 Endocrine nuclear procedure S 0390 78102 Bone marrow imaging ltd S 040078103 Bone marrow imaging mult S 0400

78104 Bone marrow imaging body S 0400 78110 Plasma volume single S 0393 78111 Plasma volume multiple S 0393 78120 Red cell mass single S 0393 78121 Red cell mass multiple S 0393 78122 Blood volume S 0393 78130 Red cell survival study S 0393 78135 Red cell survival kinetics S 0393 78140 Red cell sequestration S 0393 78185 Spleen imaging S 0400 78190 Platelet survival kinetics S 0392 78191 Platelet survival S 0392 78195 Lymph system imaging S 0400 78199 Blood/lymph nuclear exam S 0400 78201 Liver imaging S 0394 78202 Liver imaging with flow S 0394 78205 Liver imaging (3D) S 0394 78206 Liver image (3d) with flow S 0394 78215 Liver and spleen imaging S 0394 78216 Liver & spleen image/flow S 0394 78220 Liver function study CHD 78223 Hepatobiliary imaging CHD 78226 Hepatobiliary system imaging NIS 0394 78227 Hepatobil syst image w/drug NIS 0394 78230 Salivary

gland imaging S 0395 78231 Serial salivary imaging S 0395 78232 Salivary

gland function exam S 0395 78258 Esophageal motility study S 0395 78261 Gastric mucosa imaging S 0395 78262 Gastroesophageal reflux exam S 0395 78264 Gastric emptying study S 0395 78267 Breath tst attain/anal c-14 A 78268 Breath test analysis c-14 A 78270 Vit B-12 absorption exam S 0392 78271 Vit b-12 absrp exam int fac S 0392 78272 Vit b-12 absorp combined S 0392 78278 Acute GI blood loss imaging S 0395 78282 GI protein loss exam S 0395 78290 Meckels divert exam S 0395 78291 Leveen/shunt patency exam S 0395 78299 GI nuclear procedure S 0395 78300 Bone imaging limited area S 0396 78305 Bone imaging multiple areas S 0396 78306 Bone imaging whole body S 0396 78315 Bone imaging 3 phase S 0396 78320 Bone imaging (3D) S 0396 78350 Bone mineral single photon E 78351 Bone mineral dual photon E 78399 Musculoskeletal nuclear exam S 0396 78414 Non-imaging heart function S 0398 78428 Cardiac shunt imaging S 0398 78445 Vascular flow imaging S 0397 78451 Ht muscle image spect sing S 0377 78452 Ht muscle image spect mult S 037778453 Ht muscle image planar sing S 0377

78454 Ht musc image planar mult S 0377 78456 Acute venous thrombus image S 0397 78457 Venous thrombosis imaging S 0397 78458 Ven thrombosis images bilat S 0397 78459 Heart muscle imaging (PET) CHS 0308 78466 Heart infarct image S 0398 78468 Heart infarct image (ef) S 0398 78469 Heart infarct image (3D) S 0398 78472 Gated heart planar single S 0398 78473 Gated heart multiple S 0398 78481 Heart first pass single S 0398 78483 Heart first pass multiple S 0398 78491 Heart image (pet) single CHS 0308 78492 Heart image (pet) multiple CHS 0308 78494 Heart image spect S 0398 78496 Heart first pass add-on N 78499 Cardiovascular nuclear exam S 0398 78579 Lung ventilation imaging NIS 0401 78580 Lung perfusion imaging S 0401 78582 Lung ventilat&perfus imaging NIS 0378 78584 Lung V/Q image single breath CHD 78585 Lung V/Q imaging CHD 78586 Aerosol lung image single CHD 78587 Aerosol lung image multiple CHD 78588 Perfusion lung image CHD 78591 Vent image 1 breath 1 proj CHD 78593 Vent image 1 proj gas CHD 78594 Vent image mult proj gas CHD 78596 Lung differential function CHD 78597 Lung perfusion differential NIS 0401 78598 Lung perf&ventilat diferentl NIS 0378 78599 Respiratory nuclear exam S 0401 78600 Brain image < 4 views S 0403 78601 Brain image w/flow < 4 views S 0402 78605 Brain image 4+ views S 0403 78606 Brain image w/flow 4 + views S 0402 78607 Brain imaging (3D) S 0402 78608 Brain imaging (PET) S 0308 78609 Brain imaging (PET) E 78610 Brain flow imaging only S 0403 78630 Cerebrospinal fluid scan S 0402 78635 CSF ventriculography S 0402 78645 CSF shunt evaluation S 0403 78647 Cerebrospinal fluid scan S 0402 78650 CSF leakage imaging S 0402 78660 Nuclear exam of tear flow S 0403 78699 Nervous system nuclear exam S 0403 78700 Kidney

imaging morphol S 0404 78701 Kidney

imaging with flow S 0404 78707 K flow/funct image w/o drug S 0404 78708 K flow/funct image w/drug S 0404 78709 K flow/funct image multiple S 0404 78710 Kidney

imaging (3D) S 0404 78725 Kidney

function study S 039278730 Urinary bladder retention S 0389 78740 Ureteral reflux study S 0404 78761 Testicular imaging w/flow S 0404 78799 Genitourinary nuclear exam S 0404 78800 Tumor imaging limited area S 0406 78801 Tumor imaging mult areas S 0414 78802 Tumor imaging whole body S 0414 78803 Tumor imaging (3D) S 0414 78804 Tumor imaging whole body S 0408 78805 Abscess imaging ltd area S 0414 78806 Abscess imaging whole body S 0414 78807 Nuclear localization/abscess S 0414 78808 Iv inj ra drug dx study Q1 0392 78811 Pet image ltd area S 0308 78812 Pet image skull-thigh S 0308 78813 Pet image full body S 0308 78814 Pet image w/ct lmtd S 0308 78815 Pet image w/ct skull-thigh S 0308 78816 Pet image w/ct full body S 0308 78999 Nuclear diagnostic exam S 0389 79005 Nuclear rx oral admin S 0407 79101 Nuclear rx iv admin S 0407 79200 Nuclear rx intracav admin S 0413 79300 Nuclr rx interstit colloid S 0407 79403 Hematopoietic nuclear tx S 0413 79440 Nuclear rx intra-articular S 0413 79445 Nuclear rx intra-arterial S 0407 79999 Nuclear medicine therapy S 0407 80047 Metabolic panel ionized ca A 80048 Metabolic panel total ca A 80050 General health panel E 80051 Electroly

te panel A 80053 Comprehen metabolic panel A 80055 Obstetric panel E 80061 Lipid panel A 80069 Renal function panel A 80074 Acute hepatitis panel A 80076 Hepatic function panel A 80100 Drug screen qualitate/multi E 80101 Drug screen single E 80102 Drug confirmation A 80103 Drug analysis tissue prep N 80104 Drug scrn 1+ class nonchromo E 80150 Assay

of amikacin A 80152 Assay

of amitriptyline A 80154 Assay

of benzodiazepines A 80156 Assay

carbamazepine total A 80157 Assay

carbamazepine free A 80158 Assay

of cyclosporine A 80160 Assay

of desipramine A 80162 Assay

of digoxin A 80164 Assay

dipropylacetic acid A 80166 Assay

of doxepin A 80168 Assay

of ethosuximide A 80170 Assay

of gentamicin A80172 Assay of gold A 80173 Assay

of haloperidol A 80174 Assay

of imipramine A 80176 Assay

of lidocaine A 80178 Assay

of lithium A 80182 Assay

of nortriptyline A 80184 Assay

of phenobarbital A 80185 Assay

of pheny

toin total A 80186 Assay

of pheny

toin free A 80188 Assay

of primidone A 80190 Assay

of procainamide A 80192 Assay

of procainamide A 80194 Assay

of quinidine A 80195 Assay

of sirolimus A 80196 Assay

of salicylate A 80197 Assay

of tacrolimus A 80198 Assay

of theophylline A 80200 Assay

of tobramycin A 80201 Assay

of topiramate A 80202 Assay

of vancomycin A 80299 Quantitative assay drug A 80400 Acth stimulation panel A 80402 Acth stimulation panel A 80406 Acth stimulation panel A 80408 Aldosterone suppression eval A 80410 Calcitonin stimul panel A 80412 CRH stimulation panel A 80414 Testosterone response A 80415 Estradiol response panel A 80416 Renin stimulation panel A 80417 Renin stimulation panel A 80418 Pituitary

evaluation panel A 80420 Dexamethasone panel A 80422 Glucagon tolerance panel A 80424 Glucagon tolerance panel A 80426 Gonadotropin hormone panel A 80428 Growth hormone panel A 80430 Growth hormone panel A 80432 Insulin suppression panel A 80434 Insulin tolerance panel A 80435 Insulin tolerance panel A 80436 Metyrapone panel A 80438 TRH stimulation panel A 80439 TRH stimulation panel A 80440 TRH stimulation panel A 80500 Lab pathology consultation CHX 0342 80502 Lab pathology consultation X 0342 81000 Urinalysis nonauto w/scope A 81001 Urinalysis auto w/scope A 81002 Urinalysis nonauto w/o scope A 81003 Urinalysis auto w/o scope A 81005 Urinalysis A 81007 Urine screen for bacteria A 81015 Microscopic exam of urine A 81020 Urinalysis glass test A81025 Urine pregnancy test A 81050 Urinalysis volume measure A 81099 Urinalysis test procedure A 81200 Aspa gene NI B 81205 Bckdhb gene NI B 81206 Bcr/abl1 gene major bp NI B 81207 Bcr/abl1 gene minor bp NI B 81208 Bcr/abl1 gene other bp NI B 81209 Blmgene NI B 81210 Braf gene NI B 81211 Brca1&2 seq & com dup/del NI B 81212 Brca1&2 185&5385&6174 var NI B 81213 Brca1&2 uncom dup/del var NI B 81214 Brca1 full seq & com dup/del NI B 81215 Brca1 gene known fam variant NI B 81216 Brca2 gene full sequence NI B 81217 Brca2 gene known fam variant NI B 81220 Cftr gene com variants NI B 81221 Cftr gene known fam variants NI B 81222 Cftr gene dup/delet variants NI B 81223 Cftr gene full sequence NI B 81224 Cftr gene intron poly t NI B 81225 Cyp2c19 gene com variants NI B 81226 Cyp2d6 gene com variants NI B 81227 Cyp2c9 gene com variants NI B 81228 Cy

togen micrarray

copy nmbr NI B 81229 Cy

togen m array

copy no&snp NI B 81240 F2 gene NI B 81241 F5 gene NI B 81242 Fancc gene NI B 81243 Fmr1 gene detection NI B 81244 Fmr1 gene characterization NI B 81245 Flt3 gene NI B 81250 G6pc gene NI B 81251 Gba gene NI B 81255 Hexa gene NI B 81256 Hfe gene NI B 81257 Hba1/hba2 gene NI B 81260 Ikbkap gene NI B 81261 Igh gene rearrange amp meth NI B 81262 Igh gene rearrang dir probe NI B 81263 Igh vari regional mutation NI B 81264 Igk rearrangeabn clonal pop NI B 81265 Str markers specimen anal NI B 81266 Str markers spec anal addl NI B 81267 Chimerism anal no cell selec NI B 81268 Chimerism anal w/cell select NI B 81270 Jak2 gene NI B 81275 Kras gene NI B 81280 Long qt synd gene full seq NI B 81281 Long qt synd known fam var NI B 81282 Long qt syn gene dup/dlt var NI B 81290 Mcoln1 gene NI B 81291 Mthfr gene NI B 81292 Mlh1 gene full seq NI B81293 Mlh1 gene known variants NI B

81294 Mlh1 gene dup/delete variant NI B 81295 Msh2 gene full seq NI B 81296 Msh2 gene known variants NI B 81297 Msh2 gene dup/delete variant NI B 81298 Msh6 gene full seq NI B 81299 Msh6 gene known variants NI B 81300 Msh6 gene dup/delete variant NI B 81301 Microsatellite instability NI B 81302 Mecp2 gene full seq NI B 81303 Mecp2 gene known variant NI B 81304 Mecp2 gene dup/delet variant NI B 81310 Npm1 gene NI B 81315 Pml/raralpha com breakpoints NI B 81316 Pml/raralpha 1 breakpoint NI B 81317 Pms2 gene full seq analysis NI B 81318 Pms2 known familial variants NI B 81319 Pms2 gene dup/delet variants NI B 81330 Smpd1 gene common variants NI B 81331 Snrpn/ube3a gene NI B 81332 Serpina1 gene NI B 81340 Trb@ gene rearrange amplify NI B 81341 Trb@ gene rearrange dirprobe NI B 81342 Trg gene rearrangement anal NI B 81350 Ugt1a1 gene NI B 81355 Vkorc1 gene NI B 81370 Hla i & ii typing lr NI B 81371 Hla i & ii type verify lr NI B 81372 Hla i typing complete lr NI B 81373 Hla i typing 1 locus lr NI B 81374 Hla i typing 1 antigen lr NI B 81375 Hla ii typing ag equiv lr NI B 81376 Hla ii typing 1 locus lr NI B 81377 Hla ii type 1 ag equiv lr NI B 81378 Hla i & ii typing hr NI B 81379 Hla i typing complete hr NI B 81380 Hla i typing 1 locus hr NI B 81381 Hla i typing 1 allele hr NI B 81382 Hla ii typing 1 loc hr NI B 81383 Hla ii typing 1 allele hr NI B 81400 Mopath procedure level 1 NI B 81401 Mopath procedure level 2 NI B 81402 Mopath procedure level 3 NI B 81403 Mopath procedure level 4 NI B 81404 Mopath procedure level 5 NI B 81405 Mopath procedure level 6 NI B 81406 Mopath procedure level 7 NI B 81407 Mopath procedure level 8 NI B 81408 Mopath procedure level 9 NI B 82000 Assay

of blood acetaldehyde A 82003 Assay

of acetaminophen A 82009 Test for acetone/ketones A 82010 Acetone assay A 82013 Acetylcholinesterase assay A 82016 Acylcarnitines qual A82017 Acylcarnitines quant A

82024 Assay

of acth A 82030 Assay

of adp & amp A 82040 Assay

of serum albumin A 82042 Assay

of urine albumin A 82043 Microalbumin quantitative A 82044 Microalbumin semiquant A 82045 Albumin ischemia modified A 82055 Assay

of ethanol A 82075 Assay

of breath ethanol A 82085 Assay

of aldolase A 82088 Assay

of aldosterone A 82101 Assay

of urine alkaloids A 82103 Alpha-1-antitrypsin total A 82104 Alpha-1-antitrypsin pheno A 82105 Alpha-fetoprotein serum A 82106 Alpha-fetoprotein amniotic A 82107 Alpha-fetoprotein l3 A 82108 Assay

of aluminum A 82120 Amines vaginal fluid qual A 82127 Amino acid single qual A 82128 Amino acids mult qual A 82131 Amino acids single quant A 82135 Assay

aminolevulinic acid A 82136 Amino acids quant 2-5 A 82139 Amino acids quan 6 or more A 82140 Assay

of ammonia A 82143 Amniotic fluid scan A 82145 Assay

of amphetamines A 82150 Assay

of amylase A 82154 Androstanediol glucuronide A 82157 Assay

of androstenedione A 82160 Assay

of androsterone A 82163 Assay

of angiotensin II A 82164 Angiotensin I enzymetest A 82172 Assay

of apolipoprotein A 82175 Assay

of arsenic A 82180 Assay

of ascorbic acid A 82190 Atomic absorption A 82205 Assay

of barbiturates A 82232 Assay

of beta-2 protein A 82239 Bile acids total A 82240 Bile acids cholylglycine A 82247 Bilirubin total A 82248 Bilirubin direct A 82252 Fecal bilirubin test A 82261 Assay

of biotinidase A 82270 Occult blood feces A 82271 Occult blood other sources A 82272 Occult bld feces 1-3 tests A 82274 Assay

test for blood fecal A 82286 Assay

of bradykinin A 82300 Assay

of cadmium A 82306 Vitamin d 25 hydroxy A 82308 Assay

of calcitonin A82310 Assay of calcium A 82330 Assay

of calcium A 82331 Calcium infusion test A 82340 Assay

of calcium in urine A 82355 Calculus analysis qual A 82360 Calculus assay quant A 82365 Calculus spectroscopy A 82370 X-ray

assay calculus A 82373 Assay

c-d transfer measure A 82374 Assay

blood carbon dioxide A 82375 Assay

carboxyhb quant A 82376 Assay

carboxyhb qual A 82378 Carcinoembryonic antigen A 82379 Assay

of carnitine A 82380 Assay

of carotene A 82382 Assay

urine catecholamines A 82383 Assay

blood catecholamines A 82384 Assay

three catecholamines A 82387 Assay

of cathepsin-d A 82390 Assay

of ceruloplasmin A 82397 Chemiluminescent assay A 82415 Assay

of chloramphenicol A 82435 Assay

of blood chloride A 82436 Assay

of urine chloride A 82438 Assay

other fluid chlorides A 82441 Test for chlorohydrocarbons A 82465 Assay

bld/serum cholesterol A 82480 Assay

serum cholinesterase A 82482 Assay

rbc cholinesterase A 82485 Assay

chondroitin sulfate A 82486 Gas/liquid chromatography A 82487 Paper chromatography A 82488 Paper chromatography A 82489 Thin layer chromatography A 82491 Chromotography quant sing A 82492 Chromotography quant mult A 82495 Assay

of chromium A 82507 Assay

of citrate A 82520 Assay

of cocaine A 82523 Collagen crosslinks A 82525 Assay

of copper A 82528 Assay

of corticosterone A 82530 Cortisol free A 82533 Total cortisol A 82540 Assay

of creatine A 82541 Column chromotography qual A 82542 Column chromotography quant A 82543 Column chromotograph/isotope A 82544 Column chromotograph/isotope A 82550 Assay

of ck (cpk) A 82552 Assay

of cpk in blood A 82553 Creatine mb fraction A 82554 Creatine isoforms A 82565 Assay

of creatinine A 82570 Assay

of urine creatinine A82575 Creatinine clearance test A

82585 Assay

of cryofibrinogen A 82595 Assay

of cryoglobulin A 82600 Assay

of cyanide A 82607 Vitamin B-12 A 82608 B-12 binding capacity A 82610 Cystatin c A 82615 Test for urine cystines A 82626 Dehydroepiandrosterone A 82627 Dehydroepiandrosterone A 82633 Desoxycorticosterone A 82634 Deoxycortisol A 82638 Assay

of dibucaine number A 82646 Assay

of dihydrocodeinone A 82649 Assay

of dihydromorphinone A 82651 Assay

of dihydrotestosterone A 82652 Vit d 1 25-dihydroxy A 82654 Assay

of dimethadione A 82656 Pancreatic elastase fecal A 82657 Enzyme cell activity A 82658 Enzyme cell activity ra A 82664 Electrophoretic test A 82666 Assay

of epiandrosterone A 82668 Assay

of ery thropoietin A 82670 Assay

of estradiol A 82671 Assay

of estrogens A 82672 Assay

of estrogen A 82677 Assay

of estriol A 82679 Assay

of estrone A 82690 Assay

of ethchlorvynol A 82693 Assay

of ethylene glycol A 82696 Assay

of etiocholanolone A 82705 Fats/lipids feces qual A 82710 Fats/lipids feces quant A 82715 Assay

of fecal fat A 82725 Assay

of blood fatty

acids A 82726 Long chain fatty acids A 82728 Assay

of ferritin A 82731 Assay

of fetal fibronectin A 82735 Assay

of fluoride A 82742 Assay

of flurazepam A 82746 Blood folic acid serum A 82747 Assay

of folic acid rbc A 82757 Assay

of semen fructose A 82759 Assay

of rbc galactokinase A 82760 Assay

of galactose A 82775 Assay

galactose transferase A 82776 Galactose transferase test A 82784 Assay

iga/igd/igg/igmeach A 82785 Assay

of ige A 82787 Igg 1 2 3 or 4 each A 82800 Blood pH A 82803 Blood gases any combination A 82805 Blood gases w/o2 saturation A 82810 Blood gases o2 sat only A82820 Hemoglobin-oxygen affinity A

82930 Gastric analy w/ph ea spec A 82938 Gastrin test A 82941 Assay

of gastrin A 82943 Assay

of glucagon A 82945 Glucose other fluid A 82946 Glucagon tolerance test A 82947 Assay

glucose blood quant A 82948 Reagent strip/blood glucose A 82950 Glucose test A 82951 Glucose tolerance test (GTT) A 82952 GTT-added samples A 82953 Glucose-tolbutamide test A 82955 Assay

of g6pd enzyme A 82960 Test for G6PD enzyme A 82962 Glucose blood test A 82963 Assay

of glucosidase A 82965 Assay

of gdh enzyme A 82975 Assay

of glutamine A 82977 Assay

of GGT A 82978 Assay

of glutathione A 82979 Assay

rbc glutathione A 82980 Assay

of glutethimide A 82985 Glycated protein A 83001 Gonadotropin (FSH) A 83002 Gonadotropin (LH) A 83003 Assay

growth hormone (hgh) A 83008 Assay

of guanosine A 83009 H pylori (c-13) blood A 83010 Assay

of haptoglobin quant A 83012 Assay

of haptoglobins A 83013 H pylori (c-13) breath A 83014 H pylori drug admin A 83015 Heavy

metal screen A 83018 Quantitative screen metals A 83020 Hemoglobin electrophoresis A 83021 Hemoglobin chromotography A 83026 Hemoglobin copper sulfate A 83030 Fetal hemoglobin chemical A 83033 Fetal hemoglobin assay qual A 83036 Glycosylated hemoglobin test A 83037 Glycosylated hb home device A 83045 Blood methemoglobin test A 83050 Blood methemoglobin assay A 83051 Assay

of plasma hemoglobin A 83055 Blood sulfhemoglobin test A 83060 Blood sulfhemoglobin assay A 83065 Assay

of hemoglobin heat A 83068 Hemoglobin stability screen A 83069 Assay

of urine hemoglobin A 83070 Assay

of hemosiderin qual A 83071 Assay

of hemosiderin quant A 83080 Assay

of b hexosaminidase A 83088 Assay

of histamine A 83090 Assay

of homocystine A83150 Assay of for hva A 83491 Assay

of corticosteroids A 83497 Assay

of 5-hiaa A 83498 Assay

of progesterone A 83499 Assay

of progesterone A 83500 Assay

free hydroxyproline A 83505 Assay

total hydroxyproline A 83516 Immunoassay nonantibody A 83518 Immunoassay dipstick A 83519 Ria nonantibody A 83520 Immunoassay quant nos nonab A 83525 Assay

of insulin A 83527 Assay

of insulin A 83528 Assay

of intrinsic factor A 83540 Assay

of iron A 83550 Iron binding test A 83570 Assay

of idh enzyme A 83582 Assay

of ketogenic steroids A 83586 Assay

17- ketosteroids A 83593 Fractionation ketosteroids A 83605 Assay

of lactic acid A 83615 Lactate (LD) (LDH) enzyme A 83625 Assay

of ldh enzymes A 83630 Lactoferrin fecal (qual) A 83631 Lactoferrin fecal (quant) A 83632 Placental lactogen A 83633 Test urine for lactose A 83634 Assay

of urine for lactose A 83655 Assay

of lead A 83661 L/s ratio fetal lung A 83662 Foam stability fetal lung A 83663 Fluoro polarize fetal lung A 83664 Lamellar bdy fetal lung A 83670 Assay

of lap enzyme A 83690 Assay

of lipase A 83695 Assay

of lipoprotein(a) A 83698 Assay

lipoprotein pla2 A 83700 Lipopro bld electrophoretic A 83701 Lipoprotein bld hr fraction A 83704 Lipoprotein bld by nmr A 83718 Assay

of lipoprotein A 83719 Assay

of blood lipoprotein A 83721 Assay

of blood lipoprotein A 83727 Assay

of lrh hormone A 83735 Assay

of magnesium A 83775 Assay

of md enzyme A 83785 Assay

of manganese A 83788 Mass spectrometry qual A 83789 Mass spectrometry quant A 83805 Assay

of meprobamate A 83825 Assay

of mercury A 83835 Assay

of metanephrines A 83840 Assay

of methadone A 83857 Assay

of methemalbumin A 83858 Assay

of methsuximide A83861 Microfluid analy tears A 83864 Mucopolysaccharides A 83866 Mucopolysaccharides screen A 83872 Assay

synovial fluid mucin A 83873 Assay

of csf protein A 83874 Assay

of myoglobin A 83876 Assay

myeloperoxidase A 83880 Natriuretic peptide A 83883 Assay

nephelometry

not spec A 83885 Assay

of nickel A 83887 Assay

of nicotine A 83890 Molecule isolate A 83891 Molecule isolate nucleic A 83892 Molecular diagnostics A 83893 Molecule dot/slot/blot A 83894 Molecule gel electrophor A 83896 Molecular diagnostics A 83897 Molecule nucleic transfer A 83898 Molecule nucleic ampli each A 83900 Molecule nucleic ampli 2 seq A 83901 Molecule nucleic ampli addon A 83902 Molecular diagnostics A 83903 Molecule mutation scan A 83904 Molecule mutation identify A 83905 Molecule mutation identify A 83906 Molecule mutation identify A 83907 Lyse cells for nucleic ext A 83908 Nucleic acid signal ampli A 83909 Nucleic acid high resolute A 83912 Genetic examination A 83913 Molecular rna stabilization A 83914 Mutation ident ola/sbce/aspe A 83915 Assay

of nucleotidase A 83916 Oligoclonal bands A 83918 Organic acids total quant A 83919 Organic acids qual each A 83921 Organic acid single quant A 83925 Assay

of opiates A 83930 Assay

of blood osmolality A 83935 Assay

of urine osmolality A 83937 Assay

of osteocalcin A 83945 Assay

of oxalate A 83950 Oncoprotein her-2/neu A 83951 Oncoprotein dcp A 83970 Assay

of parathormone A 83986 Assay

ph body fluid nos A 83987 Exhaled breath condensate A 83992 Assay

for phencyclidine A 83993 Assay

for calprotectin fecal A 84022 Assay

of phenothiazine A 84030 Assay

of blood pku A 84035 Assay

of phenylketones A 84060 Assay

acid phosphatase A 84061 Phosphatase forensic exam A 84066 Assay

prostate phosphatase A84075 Assay alkaline phosphatase A 84078 Assay

alkaline phosphatase A 84080 Assay

alkaline phosphatases A 84081 Amniotic fluid enzymetest A 84085 Assay

of rbc pg6d enzyme A 84087 Assay

phosphohexose enzymes A 84100 Assay

of phosphorus A 84105 Assay

of urine phosphorus A 84106 Test for porphobilinogen A 84110 Assay

of porphobilinogen A 84112 Placenta alpha micro ig c/v A 84119 Test urine for porphyrins A 84120 Assay

of urine porphyrins A 84126 Assay

of feces porphyrins A 84127 Assay

of feces porphyrins A 84132 Assay

of serum potassium A 84133 Assay

of urine potassium A 84134 Assay

of prealbumin A 84135 Assay

of pregnanediol A 84138 Assay

of pregnanetriol A 84140 Assay

of pregnenolone A 84143 Assay

of 17-hydroxypregneno A 84144 Assay

of progesterone A 84145 Procalcitonin (pct) A 84146 Assay

of prolactin A 84150 Assay

of prostaglandin A 84152 Assay

of psa complexed A 84153 Assay

of psa total A 84154 Assay

of psa free A 84155 Assay

of protein serum A 84156 Assay

of protein urine A 84157 Assay

of protein other A 84160 Assay

of protein any

source A 84163 Pappa serum A 84165 Protein e-phoresis serum A 84166 Protein e-phoresis/urine/csf A 84181 Western blot test A 84182 Protein western blot test A 84202 Assay

RBC protoporphyrin A 84203 Test RBC protoporphyrin A 84206 Assay

of proinsulin A 84207 Assay

of vitamin b-6 A 84210 Assay

of pyruvate A 84220 Assay

of pyruvate kinase A 84228 Assay

of quinine A 84233 Assay

of estrogen A 84234 Assay

of progesterone A 84235 Assay

of endocrine hormone A 84238 Assay

nonendocrine receptor A 84244 Assay

of renin A 84252 Assay

of vitamin b-2 A 84255 Assay

of selenium A 84260 Assay

of serotonin A 84270 Assay

of sex hormone globul A 84275 Assay

of sialic acid A84285 Assay of silica A 84295 Assay

of serum sodium A 84300 Assay

of urine sodium A 84302 Assay

of sweat sodium A 84305 Assay

of somatomedin A 84307 Assay

of somatostatin A 84311 Spectrophotometry A 84315 Body

fluid specific gravity A 84375 Chromatogram assay sugars A 84376 Sugars single qual A 84377 Sugars multiple qual A 84378 Sugars single quant A 84379 Sugars multiple quant A 84392 Assay

of urine sulfate A 84402 Assay

of testosterone A 84403 Assay

of total testosterone A 84425 Assay

of vitamin b-1 A 84430 Assay

of thiocyanate A 84431 Thromboxane urine A 84432 Assay

of thyroglobulin A 84436 Assay

of total thyroxine A 84437 Assay

of neonatal thyroxine A 84439 Assay

of free thyroxine A 84442 Assay

of thyroid activity A 84443 Assay

thyroid stim hormone A 84445 Assay

of tsi A 84446 Assay

of vitamin e A 84449 Assay

of transcortin A 84450 Transferase (AST) (SGOT) A 84460 Alanine amino (ALT) (SGPT) A 84466 Assay

of transferrin A 84478 Assay

of triglycerides A 84479 Assay

of thyroid (t3 or t4) A 84480 Assay

triiodothyronine (t3) A 84481 Free assay (FT-3) A 84482 T3 reverse A 84484 Assay

of troponin quant A 84485 Assay

duodenal fluid trypsin A 84488 Test feces for trypsin A 84490 Assay

of feces for trypsin A 84510 Assay

of tyrosine A 84512 Assay

of troponin qual A 84520 Assay

of urea nitrogen A 84525 Urea nitrogen semi-quant A 84540 Assay

of urine/urea-n A 84545 Urea-N clearance test A 84550 Assay

of blood/uric acid A 84560 Assay

of urine/uric acid A 84577 Assay

of feces/urobilinogen A 84578 Test urine urobilinogen A 84580 Assay

of urine urobilinogen A 84583 Assay

of urine urobilinogen A 84585 Assay

of urine vma A 84586 Assay

of vip A 84588 Assay

of vasopressin A84590 Assay of vitamin a A 84591 Assay

of nos vitamin A 84597 Assay

of vitamin k A 84600 Assay

of volatiles A 84620 Xylose tolerance test A 84630 Assay

of zinc A 84681 Assay

of c-peptide A 84702 Chorionic gonadotropin test A 84703 Chorionic gonadotropin assay A 84704 Hcg free betachain test A 84830 Ovulation tests A 84999 Clinical chemistry test A 85002 Bleeding time test A 85004 Automated diff wbc count A 85007 Bl smear w/diff wbc count A 85008 Bl smear w/o diff wbc count A 85009 Manual diff wbc count b-coat A 85013 Spun microhematocrit A 85014 Hematocrit A 85018 Hemoglobin A 85025 Complete cbc w/auto diff wbc A 85027 Complete cbc automated A 85032 Manual cell count each A 85041 Automated rbc count A 85044 Manual reticulocy te count A 85045 Automated reticulocy te count A 85046 Reticy

te/hgb concentrate A 85048 Automated leukocy te count A 85049 Automated platelet count A 85055 Reticulated platelet assay A 85060 Blood smear interpretation B 85097 Bone marrow interpretation X 0343 85130 Chromogenic substrate assay A 85170 Blood clot retraction A 85175 Blood clot lysis time A 85210 Blood clot factor II test A 85220 Blood clot factor V test A 85230 Blood clot factor VII test A 85240 Blood clot factor VIII test A 85244 Blood clot factor VIII test A 85245 Blood clot factor VIII test A 85246 Blood clot factor VIII test A 85247 Blood clot factor VIII test A 85250 Blood clot factor IX test A 85260 Blood clot factor X test A 85270 Blood clot factor XI test A 85280 Blood clot factor XII test A 85290 Blood clot factor XIII test A 85291 Blood clot factor XIII test A 85292 Blood clot factor assay A 85293 Blood clot factor assay A 85300 Antithrombin III test A 85301 Antithrombin III test A 85302 Blood clot inhibitor antigen A 85303 Blood clot inhibitor test A85305 Blood clot inhibitor assay A

85306 Blood clot inhibitor test A 85307 Assay

activated protein c A 85335 Factor inhibitor test A 85337 Thrombomodulin A 85345 Coagulation time A 85347 Coagulation time A 85348 Coagulation time A 85360 Euglobulin lysis A 85362 Fibrin degradation products A 85366 Fibrinogen test A 85370 Fibrinogen test A 85378 Fibrin degrade semiquant A 85379 Fibrin degradation quant A 85380 Fibrin degradation vte A 85384 Fibrinogen A 85385 Fibrinogen A 85390 Fibrinolysins screen A 85396 Clotting assay whole blood N 85397 Clotting funct activity A 85400 Fibrinoly

tic plasmin A 85410 Fibrinoly

tic antiplasmin A 85415 Fibrinoly

tic plasminogen A 85420 Fibrinoly

tic plasminogen A 85421 Fibrinoly

tic plasminogen A 85441 Heinz bodies direct A 85445 Heinz bodies induced A 85460 Hemoglobin fetal A 85461 Hemoglobin fetal A 85475 Hemolysin A 85520 Heparin assay A 85525 Heparin neutralization A 85530 Heparin-protamine tolerance A 85536 Iron stain peripheral blood A 85540 Wbc alkaline phosphatase A 85547 RBC mechanical fragility A 85549 Muramidase A 85555 RBC osmotic fragility A 85557 RBC osmotic fragility A 85576 Blood platelet aggregation A 85597 Phospholipid pltlt neutraliz A 85598 Hexagnal phosph pltlt neutrl A 85610 Prothrombin time A 85611 Prothrombin test A 85612 Viper venomprothrombin time A 85613 Russell viper venom diluted A 85635 Reptilase test A 85651 Rbc sed rate nonautomated A 85652 Rbc sed rate automated A 85660 RBC sickle cell test A 85670 Thrombin time plasma A 85675 Thrombin time titer A 85705 Thromboplastin inhibition A 85730 Thromboplastin time partial A 85732 Thromboplastin time partial A85810 Blood viscosity examination A 85999 Hematology procedure A 86000 Agglutinins febrile A 86001 Allergen specific igg A 86003 Allergen specific IgE A 86005 Allergen specific IgE A 86021 WBC antibody identification A 86022 Platelet antibodies A 86023 Immunoglobulin assay A 86038 Antinuclear antibodies A 86039 Antinuclear antibodies (ANA) A 86060 Antistreptolysin o titer A 86063 Antistreptolysin o screen A 86077 Physician blood bank service CHX 0342 86078 Physician blood bank service X 0343 86079 Physician blood bank service CHX 0342 86140 C-reactive protein A 86141 C-reactive protein hs A 86146 Glycoprotein antibody A 86147 Cardiolipin antibody A 86148 Phospholipid antibody A 86155 Chemotaxis assay A 86156 Cold agglutinin screen A 86157 Cold agglutinin titer A 86160 Complement antigen A 86161 Complement/function activity A 86162 Complement total (ch50) A 86171 Complement fixation each A 86185 Counterimmunoelectrophoresis A 86200 Ccp antibody A 86215 Deoxyribonuclease antibody A 86225 DNA antibody A 86226 Dna antibody single strand A 86235 Nuclear antigen antibody A 86243 Fc receptor A 86255 Fluorescent antibody screen A 86256 Fluorescent antibody titer A 86277 Growth hormone antibody A 86280 Hemagglutination inhibition A 86294 Immunoassay tumor qual A 86300 Immunoassay tumor ca 15-3 A 86301 Immunoassay tumor ca 19-9 A 86304 Immunoassay tumor ca 125 A 86305 Human epididymis protein 4 A 86308 Heterophile antibodies A 86309 Heterophile antibodies A 86310 Heterophile antibodies A 86316 Immunoassay tumor other A 86317 Immunoassay infectious agent A 86318 Immunoassay infectious agent A 86320 Serum immunoelectrophoresis A 86325 Other immunoelectrophoresis A 86327 Immunoelectrophoresis assay A 86329 Immunodiffusion A 86331 Immunodiffusion ouchterlony A86332 Immune complex assay A

86334 Immunofix e-phoresis serum A 86335 Immunfix e-phorsis/urine/csf A 86336 Inhibin A A 86337 Insulin antibodies A 86340 Intrinsic factor antibody A 86341 Islet cell antibody A 86343 Leukocy

te histamine release A 86344 Leukocy

te phagocy

tosis A 86352 Cell function assay w/stim A 86353 Lymphocy

te transformation A 86355 B cells total count A 86356 Mononuclear cell antigen A 86357 Nk cells total count A 86359 T cells total count A 86360 T cell absolute count/ratio A 86361 T cell absolute count A 86367 Stemcells total count A 86376 Microsomal antibody A 86378 Migration inhibitory factor A 86382 Neutralization test viral A 86384 Nitroblue tetrazoliumdye A 86386 Nuclear matrix protein 22 NIA 86403 Particle agglutination test A 86406 Particle agglutination test A 86430 Rheumatoid factor test A 86431 Rheumatoid factor quant A 86480 Tb test cell immun measure A 86481 Tb ag response t-cell susp A 86485 Skin test candida X 0341 86486 Skin test nos antigen X 0341 86490 Coccidioidomycosis skin test X 0341 86510 Histoplasmosis skin test X 0341 86580 TB intradermal test X 0341 86590 Streptokinase antibody A 86592 Syphilis test non-trep qual A 86593 Syphilis test non-trep quant A 86602 Antinomyces antibody A 86603 Adenovirus antibody A 86606 Aspergillus antibody A 86609 Bacterium antibody A 86611 Bartonella antibody A 86612 Blastomyces antibody A 86615 Bordetella antibody A 86617 Lymedisease antibody A 86618 Lymedisease antibody A 86619 Borrelia antibody A 86622 Brucella antibody A 86625 Campylobacter antibody A 86628 Candida antibody A 86631 Chlamydia antibody A 86632 Chlamydia igmantibody A 86635 Coccidioides antibody A 86638 Q fever antibody A 86641 Cryptococcus antibody A86644 CMV antibody A

86645 Cmv antibody igm A 86648 Diphtheria antibody A 86651 Encephalitis antibody A 86652 Encephalitis antibody A 86653 Encephalitis antibody A 86654 Encephalitis antibody A 86658 Enterovirus antibody A 86663 Epstein-barr antibody A 86664 Epstein-barr antibody A 86665 Epstein-barr antibody A 86666 Ehrlichia antibody A 86668 Francisella tularensis A 86671 Fungus antibody A 86674 Giardia lamblia antibody A 86677 Helicobacter pylori A 86682 Helminth antibody A 86684 Hemophilus influenza A 86687 Htlv-i antibody A 86688 Htlv-ii antibody A 86689 HTLV/HIV confirmatory test A 86692 Hepatitis delta agent A 86694 Herpes simplex test A 86695 Herpes simplex test A 86696 Herpes simplex type 2 A 86698 Histoplasma A 86701 HIV-1 A 86702 HIV-2 A 86703 Hiv-1/hiv-2 single result A 86704 Hep b core antibody total A 86705 Hep b core antibody igm A 86706 Hep b surface antibody A 86707 Hep be antibody A 86708 Hep a antibody total A 86709 Hep a antibody igm A 86710 Influenza virus antibody A 86713 Legionella antibody A 86717 Leishmania antibody A 86720 Leptospira antibody A 86723 Listeria monocy togenes ab A 86727 Lymph choriomeningitis ab A 86729 Lympho venereum antibody A 86732 Mucormycosis antibody A 86735 Mumps antibody A 86738 Mycoplasma antibody A 86741 Neisseria meningitidis A 86744 Nocardia antibody A 86747 Parvovirus antibody A 86750 Malaria antibody A 86753 Protozoa antibody nos A 86756 Respiratory virus antibody A 86757 Rickettsia antibody A 86759 Rotavirus antibody A 86762 Rubella antibody A 86765 Rubeola antibody A86768 Salmonella antibody A

86771 Shigella antibody A 86774 Tetanus antibody A 86777 Toxoplasma antibody A 86778 Toxoplasma antibody igm A 86780 Treponema pallidum A 86784 Trichinella antibody A 86787 Varicella-zoster antibody A 86788 West nile virus ab igm A 86789 West nile virus antibody A 86790 Virus antibody nos A 86793 Yersinia antibody A 86800 Thyroglobulin antibody A 86803 Hepatitis c ab test A 86804 Hep c ab test confirm A 86805 Lymphocy

totoxicity assay A 86806 Lymphocy

totoxicity assay A 86807 Cy

totoxic antibody

screening A 86808 Cy

totoxic antibody

screening A 86812 Hla typing a b or c A 86813 Hla typing a b or c A 86816 Hla typing dr/dq A 86817 Hla typing dr/dq A 86821 Lymphocy

te culture mixed A 86822 Lymphocy

te culture primed A 86825 Hla x-math non-cy totoxic A 86826 Hla x-match noncy totoxc addl A 86849 Immunology procedure A 86850 RBC antibody screen X 0345 86860 RBC antibody elution X 0346 86870 RBC antibody identification X 0346 86880 Coombs test direct X 0409 86885 Coombs test indirect qual X 0409 86886 Coombs test indirect titer X 0409 86890 Autologous blood process X 0347 86891 Autologous blood op salvage X 0345 86900 Blood typing abo X 0409 86901 Blood typing rh (d) X 0409 86902 Blood type antigen donor ea X 0345 86904 Blood typing patient serum X 0345 86905 Blood typing rbc antigens X 0345 86906 Blood typing rh phenotype X 0345 86910 Blood typing paternity test E 86911 Blood typing antigen system E 86920 Compatibility test spin X 0345 86921 Compatibility test incubate X 0345 86922 Compatibility test antiglob X 0346 86923 Compatibility test electric X 0345 86927 Plasma fresh frozen X 0345 86930 Frozen blood prep X 0347 86931 Frozen blood thaw X 0347 86932 Frozen blood freeze/thaw X 0347 86940 Hemolysins/agglutinins auto A 86941 Hemolysins/agglutinins A 86945 Blood product/irradiation X 034586950 Leukacy te transfusion X 0345 86960 Vol reduction of blood/prod X 0345 86965 Pooling blood platelets X 0346 86970 RBC pretreatment X 0345 86971 RBC pretreatment X 0345 86972 RBC pretreatment X 0345 86975 Rbc pretreatment serum X 0346 86976 Rbc pretreatment serum X 0345 86977 Rbc pretreatment serum X 0347 86978 Rbc pretreatment serum X 0346 86985 Split blood or products X 0345 86999 Transfusion procedure X 0345 87001 Small animal inoculation A 87003 Small animal inoculation A 87015 Specimen concentration A 87040 Blood culture for bacteria A 87045 Feces culture bacteria A 87046 Stool cultr bacteria each A 87070 Culture bacteria other A 87071 Culture bacteri aerobic othr A 87073 Culture bacteria anaerobic A 87075 Cultr bacteria except blood A 87076 Culture anaerobe ident each A 87077 Culture aerobic identify A 87081 Culture screen only A 87084 Culture of specimen by kit A 87086 Urine culture/colony count A 87088 Urine bacteria culture A 87101 Skin fungi culture A 87102 Fungus isolation culture A 87103 Blood fungus culture A 87106 Fungi identification yeast A 87107 Fungi identification mold A 87109 Mycoplasma A 87110 Chlamydia culture A 87116 Mycobacteria culture A 87118 Mycobacteric identification A 87140 Culture type immunofluoresc A 87143 Culture typing glc/hplc A 87147 Culture type immunologic A 87149 Dna/rna direct probe A 87150 Dna/rna amplified probe A 87152 Culture type pulse field gel A 87153 Dna/rna sequencing A 87158 Culture typing added method A 87164 Dark field examination A 87166 Dark field examination A 87168 Macroscopic exam arthropod A 87169 Macroscopic exam parasite A 87172 Pinwormexam A 87176 Tissue homogenization cultr A 87177 Ova and parasites smears A 87181 Microbe susceptible diffuse A 87184 Microbe susceptible disk A 87185 Microbe susceptible enzyme A87186 Microbe susceptible mic A

87187 Microbe susceptible mlc A 87188 Microbe suscept macrobroth A 87190 Microbe suscept mycobacteri A 87197 Bactericidal level serum A 87205 Smear gram stain A 87206 Smear fluorescent/acid stai A 87207 Smear special stain A 87209 Smear complex stain A 87210 Smear wet mount saline/ink A 87220 Tissue exam for fungi A 87230 Assay

toxin or antitoxin A 87250 Virus inoculate eggs/animal A 87252 Virus inoculation tissue A 87253 Virus inoculate tissue addl A 87254 Virus inoculation shell via A 87255 Genet virus isolate hsv A 87260 Adenovirus ag if A 87265 Pertussis ag if A 87267 Enterovirus antibody dfa A 87269 Giardia ag if A 87270 Chlamydia trachomatis ag if A 87271 Cy

tomegalovirus dfa A 87272 Cryptosporidium ag if A 87273 Herpes simplex 2 ag if A 87274 Herpes simplex 1 ag if A 87275 Influenza b ag if A 87276 Influenza a ag if A 87277 Legionella micdadei ag if A 87278 Legion pneumophilia ag if A 87279 Parainfluenza ag if A 87280 Respiratory syncy tial ag if A 87281 Pneumocystis carinii ag if A 87283 Rubeola ag if A 87285 Treponema pallidum ag if A 87290 Varicella zoster ag if A 87299 Antibody

detection nos if A 87300 Ag detection poly val if A 87301 Adenovirus ag eia A 87305 Aspergillus ag eia A 87320 Chylmd trach ag eia A 87324 Clostridium ag eia A 87327 Cryptococcus neoform ag eia A 87328 Cryptosporidium ag eia A 87329 Giardia ag eia A 87332 Cy

tomegalovirus ag eia A 87335 E coli 0157 ag eia A 87336 Entamoeb hist dispr ag eia A 87337 Entamoeb hist group ag eia A 87338 Hpylori stool eia A 87339 H pylori ag eia A 87340 Hepatitis b surface ag eia A 87341 Hepatitis b surface ag eia A 87350 Hepatitis be ag eia A 87380 Hepatitis delta ag eia A87385 Histoplasma capsul ag eia A

87389 Hiv-1 ag w/hiv-1 & hiv-2 ab NIA 87390 Hiv-1 ag eia A 87391 Hiv-2 ag eia A 87400 Influenza a/b ag eia A 87420 Resp syncy tial ag eia A 87425 Rotavirus ag eia A 87427 Shiga-like toxin ag eia A 87430 Strep a ag eia A 87449 Ag detect nos eia mult A 87450 Ag detect nos eia single A 87451 Ag detect poly val eia mult A 87470 Bartonella dna dir probe A 87471 Bartonella dna amp probe A 87472 Bartonella dna quant A 87475 Lymedis dna dir probe A 87476 Lymedis dna amp probe A 87477 Lymedis dna quant A 87480 Candida dna dir probe A 87481 Candida dna amp probe A 87482 Candida dna quant A 87485 Chylmd pneum dna dir probe A 87486 Chylmd pneum dna amp probe A 87487 Chylmd pneum dna quant A 87490 Chylmd trach dna dir probe A 87491 Chylmd trach dna amp probe A 87492 Chylmd trach dna quant A 87493 C diff amplified probe A 87495 Cy

tomeg dna dir probe A 87496 Cy

tomeg dna amp probe A 87497 Cy

tomeg dna quant A 87498 Enterovirus dna amp probe A 87500 Vanomycin dna amp probe A 87501 Influenza dna amp prob 1+ A 87502 Influenza dna amp probe A 87503 Influenza dna amp prob addl A 87510 Gardner vag dna dir probe A 87511 Gardner vag dna amp probe A 87512 Gardner vag dna quant A 87515 Hepatitis b dna dir probe A 87516 Hepatitis b dna amp probe A 87517 Hepatitis b dna quant A 87520 Hepatitis c rna dir probe A 87521 Hepatitis c rna amp probe A 87522 Hepatitis c rna quant A 87525 Hepatitis g dna dir probe A 87526 Hepatitis g dna amp probe A 87527 Hepatitis g dna quant A 87528 Hsv dna dir probe A 87529 Hsv dna amp probe A 87530 Hsv dna quant A 87531 Hhv-6 dna dir probe A 87532 Hhv-6 dna amp probe A 87533 Hhv-6 dna quant A 87534 Hiv-1 dna dir probe A87535 Hiv-1 dna amp probe A

87536 Hiv-1 dna quant A 87537 Hiv-2 dna dir probe A 87538 Hiv-2 dna amp probe A 87539 Hiv-2 dna quant A 87540 Legion pneumo dna dir prob A 87541 Legion pneumo dna amp prob A 87542 Legion pneumo dna quant A 87550 Mycobacteria dna dir probe A 87551 Mycobacteria dna amp probe A 87552 Mycobacteria dna quant A 87555 M.tuberculo dna dir probe A 87556 M.tuberculo dna amp probe A 87557 M.tuberculo dna quant A 87560 M.avium-intra dna dir prob A 87561 M.avium-intra dna amp prob A 87562 M.avium-intra dna quant A 87580 M.pneumon dna dir probe A 87581 M.pneumon dna amp probe A 87582 M.pneumon dna quant A 87590 N.gonorrhoeae dna dir prob A 87591 N.gonorrhoeae dna amp prob A 87592 N.gonorrhoeae dna quant A 87620 Hpv dna dir probe A 87621 Hpv dna amp probe A 87622 Hpv dna quant A 87640 Staph a dna amp probe A 87641 Mr-staph dna amp probe A 87650 Strep a dna dir probe A 87651 Strep a dna amp probe A 87652 Strep a dna quant A 87653 Strep b dna amp probe A 87660 Trichomonas vagin dir probe A 87797 Detect agent nos dna dir A 87798 Detect agent nos dna amp A 87799 Detect agent nos dna quant A 87800 Detect agnt mult dna direc A 87801 Detect agnt mult dna ampli A 87802 Strep b assay w/optic A 87803 Clostridium toxin a w/optic A 87804 Influenza assay w/optic A 87807 Rsv assay

w/optic A 87808 Trichomonas assay w/optic A 87809 Adenovirus assay w/optic A 87810 Chylmd trach assay w/optic A 87850 N. gonorrhoeae assay w/optic A 87880 Strep a assay w/optic A 87899 Agent nos assay w/optic A 87900 Phenotype infect agent drug A 87901 Genotype dna hiv reverse t A 87902 Genotype dna hepatitis c A 87903 Phenotype dna hiv w/culture A 87904 Phenotype dna hiv w/clt add A 87905 Sialidase enzymeassay A 87906 Genotype dna hiv reverse t A87999 Microbiology procedure A 88000 Autopsy

(necropsy) gross E 88005 Autopsy

(necropsy) gross E 88007 Autopsy

(necropsy) gross E 88012 Autopsy

(necropsy) gross E 88014 Autopsy

(necropsy) gross E 88016 Autopsy

(necropsy) gross E 88020 Autopsy

(necropsy) complete E 88025 Autopsy

(necropsy) complete E 88027 Autopsy

(necropsy) complete E 88028 Autopsy

(necropsy) complete E 88029 Autopsy

(necropsy) complete E 88036 Limited autopsy E 88037 Limited autopsy E 88040 Forensic autopsy (necropsy) E 88045 Coroners autopsy (necropsy) E 88099 Necropsy

(autopsy) procedure E 88104 Cy

topath fl nongyn smears X 0433 88106 Cy

topath fl nongyn filter X 0433 88107 Cy

topath fl nongyn sm/fltr CHD 88108 Cy

topath concentrate tech X 0433 88112 Cy

topath cell enhance tech X 0343 88120 Cy

tp urne 3-5 probes ea spec X 0344 88121 Cy

tp urine 3-5 probes cmptr X 0344 88125 Forensic cy topathology X 0433 88130 Sex chromatin identification A 88140 Sex chromatin identification A 88141 Cy

topath c/v interpret N 88142 Cy

topath c/v thin layer A 88143 Cy

topath c/v thin layer redo A 88147 Cy

topath c/v automated A 88148 Cy

topath c/v auto rescreen A 88150 Cy

topath c/v manual A 88152 Cy

topath c/v auto redo A 88153 Cy

topath c/v redo A 88154 Cy

topath c/v select A 88155 Cy

topath c/v index add-on A 88160 Cy

topath smear other source X 0433 88161 Cy

topath smear other source X 0433 88162 Cy

topath smear other source X 0343 88164 Cy

topath tbs c/v manual A 88165 Cy

topath tbs c/v redo A 88166 Cy

topath tbs c/v auto redo A 88167 Cy

topath tbs c/v select A 88172 Cy

tp dx eval fna 1st ea site X 0433 88173 Cy

topath eval fna report X 0343 88174 Cy

topath c/v auto in fluid A 88175 Cy

topath c/v auto fluid redo A 88177 Cy

tp fna eval ea addl X 0342 88182 Cell marker study X 0343 88184 Flowcy

tometry / tc 1 marker X 0433 88185 Flowcy

tometry /tc add-on X 0433 88187 Flowcy

tometry /read 2-8 X 0342 88188 Flowcy

tometry /read 9-15 X 0343 88189 Flowcy

tometry /read 16 & > X 034388199 Cy topathology

procedure X 0342 88230 Tissue culture lymphocy te A 88233 Tissue culture skin/biopsy A 88235 Tissue culture placenta A 88237 Tissue culture bone marrow A 88239 Tissue culture tumor A 88240 Cell cryopreserve/storage A 88241 Frozen cell preparation A 88245 Chromosome analysis 20-25 A 88248 Chromosome analysis 50-100 A 88249 Chromosome analysis 100 A 88261 Chromosome analysis 5 A 88262 Chromosome analysis 15-20 A 88263 Chromosome analysis 45 A 88264 Chromosome analysis 20-25 A 88267 Chromosome analys placenta A 88269 Chromosome analys amniotic A 88271 Cy

togenetics dna probe A 88272 Cy

togenetics 3-5 A 88273 Cy

togenetics 10-30 A 88274 Cy

togenetics 25-99 A 88275 Cy

togenetics 100-300 A 88280 Chromosome karyotype study A 88283 Chromosome banding study A 88285 Chromosome count additional A 88289 Chromosome study additional A 88291 Cy

to/molecular report M 88299 Cy

togenetic study X 0342 88300 Surgical path gross CHX 0342 88302 Tissue exam by pathologist X 0433 88304 Tissue exam by pathologist X 0343 88305 Tissue exam by pathologist X 0343 88307 Tissue exam by pathologist X 0344 88309 Tissue exam by pathologist X 0344 88311 Decalcify

tissue X 0342 88312 Special stains group 1 X 0433 88313 Special stains group 2 X 0433 88314 Histochemical stains add-on X 0433 88318 Chemical histochemistry CHD 88319 Enzyme histochemistry CHX 0433 88321 Microslide consultation X 0433 88323 Microslide consultation X 0343 88325 Comprehensive review of data X 0344 88329 Path consult introp X 0433 88331 Path consult intraop 1 bloc X 0343 88332 Path consult intraop addl CHX 0342 88333 Intraop cy

to path consult 1 X 0433 88334 Intraop cy

to path consult 2 X 0433 88342 Immunohistochemistry X 0343 88346 Immunofluorescent study X 0343 88347 Immunofluorescent study X 0343 88348 Electron microscopy X 0661 88349 Scanning electron microscopy X 0661 88355 Analysis skeletal muscle X 0343 88356 Analysis nerve X 034488358 Analysis tumor X 0343

88360 Tumor immunohistochem/manual X 0343 88361 Tumor immunohistochem/comput X 0344 88362 Nerve teasing preparations X 0344 88363 Xm archive tissue molec anal X 0342 88365 Insitu hybridization (fish) X 0344 88367 Insitu hybridization auto X 0343 88368 Insitu hybridization manual X 0344 88371 Protein western blot tissue A 88372 Protein analysis w/probe A 88380 Microdissection laser N 88381 Microdissection manual N 88384 Eval molecular probes 11-50 X 0433 88385 Eval molecul probes 51-250 X 0343 88386 Eval molecul probes 251-500 X 0344 88387 Tiss exam molecular study N 88388 Tiss ex molecul study add-on N 88399 Surgical pathology procedure X 0342 88720 Bilirubin total transcut A 88738 Hgb quant transcutaneous A 88740 Transcutaneous carboxyhb A 88741 Transcutaneous methb A 88749 In vivo lab service A 89049 Chct for mal hyperthermia X 0342 89050 Body

fluid cell count A 89051 Body

fluid cell count A 89055 Leukocy

te assessment fecal A 89060 Exam synovial fluid crystals A 89125 Specimen fat stain A 89160 Exam feces for meat fibers A 89190 Nasal smear for eosinophils A 89220 Sputumspecimen collection X 0433 89230 Collect sweat for test X 0343 89240 Pathology

lab procedure X 0342 89250 Cultr oocy

te/embryo <4 days X 0344 89251 Cultr oocy

te/embryo <4 days X 0344 89253 Embryo hatching X 0344 89254 Oocy

te identification X 0344 89255 Prepare embryo for transfer X 0344 89257 Sperm identification X 0343 89258 Cryopreservation embryo(s) X 0344 89259 Cryopreservation sperm CHX 0433 89260 Sperm isolation simple X 0343 89261 Sperm isolation complex X 0343 89264 Identify

sperm tissue X 0344 89268 Insemination of oocy tes X 0344 89272 Extended culture of oocy tes X 0344 89280 Assist oocy te fertilization X 0344 89281 Assist oocy te fertilization X 0344 89290 Biopsy

oocy te polar body X 0344 89291 Biopsy

oocy te polar body X 0344 89300 Semen analysis w/huhner A 89310 Semen analysis w/count A 89320 Semen anal vol/count/mot A 89321 Semen anal sperm detection A89322 Semen anal strict criteria A

89325 Sperm antibody test A 89329 Sperm evaluation test A 89330 Evaluation cervical mucus A 89331 Retrograde ejaculation anal A 89335 Cryopreserve testicular tiss X 0344 89342 Storage/year embryo(s) X 0344 89343 Storage/year sperm/semen X 0344 89344 Storage/year reprod tissue X 0344 89346 Storage/year oocy te(s) X 0344 89352 Thawing cryopresrved embryo X 0344 89353 Thawing cryopresrved sperm X 0344 89354 Thaw cryoprsvrd reprod tiss X 0344 89356 Thawing cryopresrved oocy te X 0344 89398 Unlisted reprod med lab proc X 0342 90281 Human ig im E 90283 Human ig iv E 90284 Human ig sc E 90287 Botulinumantitoxin E 90288 Botulismig iv E 90291 Cmv ig iv E 90296 Diphtheria antitoxin E 90371 Hep b ig im K 1630 90375 Rabies ig im/sc K 9133 90376 Rabies ig heat treated K 9134 90378 Rsv mab im 50mg K 9003 90384 Rh ig full-dose im E 90385 Rh ig minidose im N 90386 Rh ig iv E 90389 Tetanus ig im E 90393 Vaccina ig im E 90396 Varicella-zoster ig im K 9135 90399 Immune globulin E 90460 Im admin 1st/only component B 90461 Im admin each addl component B 90471 Immunization admin CHS 0437 90472 Immunization admin each add S 0436 90473 Immune admin oral/nasal S 0436 90474 Immune admin oral/nasal addl S 0436 90476 Adenovirus vaccine type 4 CHN 90477 Adenovirus vaccine type 7 E 90581 Anthrax vaccine sc or im E 90585 Bcg vaccine percut K 9137 90586 Bcg vaccine intravesical B 90632 Hep a vaccine adult im N 90633 Hep a vacc ped/adol 2 dose N 90634 Hep a vacc ped/adol 3 dose N 90636 Hep a/hep b vacc adult im N 90644 Meningoccl hib vac 4 dose im E 90645 Hib vaccine hboc im N 90646 Hib vaccine prp-d im N 90647 Hib vaccine prp-omp im N 90648 Hib vaccine prp-t im N 90649 Hpv vaccine 4 valent im M 90650 Hpv vaccine 2 valent im M90654 Flu vaccine no preserv id L

90655 Flu vaccine no preserv 6-35m L 90656 Flu vaccine no preserv 3 & > L 90657 Flu vaccine 3 yrs im L 90658 Flu vaccine 3 yrs & > im E 90660 Flu vaccine nasal L 90661 Flu vacc cell cult prsv free E 90662 Flu vacc prsv free inc antig L 90664 Flu vacc pandemic intranasal E 90665 Lymedisease vaccine im N 90666 Flu vac pandem prsrv free im E 90667 Flu vac pandemic adjuvant im E 90668 Flu vac pandemic splt im E 90669 Pneumococcal vacc 7 val im L 90670 Pneumococcal vacc 13 val im L 90675 Rabies vaccine im K 9139 90676 Rabies vaccine id K 9140 90680 Rotovirus vacc 3 dose oral CHN 90681 Rotavirus vacc 2 dose oral K 1239 90690 Typhoid vaccine oral N 90691 Typhoid vaccine im N 90692 Typhoid vaccine h-p sc/id N 90693 Typhoid vaccine akd sc B 90696 Dtap-ipv vacc 4-6 yr im N 90698 Dtap-hib-ip vaccine im N 90700 Dtap vaccine < 7 yrs im N 90701 Dtp vaccine im N 90702 Dt vaccine < 7 im N 90703 Tetanus vaccine im N 90704 Mumps vaccine sc N 90705 Measles vaccine sc N 90706 Rubella vaccine sc N 90707 Mmr vaccine sc N 90708 Measles-rubella vaccine sc N 90710 Mmrv vaccine sc N 90712 Oral poliovirus vaccine N 90713 Poliovirus ipv sc/im N 90714 Td vaccine no prsrv >/= 7 im N 90715 Tdap vaccine >7 im N 90716 Chicken pox vaccine sc M 90717 Yellow fever vaccine sc N 90718 Td vaccine > 7 im N 90719 Diphtheria vaccine im N 90720 Dtp/hib vaccine im N 90721 Dtap/hib vaccine im N 90723 Dtap-hep b-ipv vaccine im E 90725 Cholera vaccine injectable E 90727 Plague vaccine im E 90732 Pneumococcal vaccine L 90733 Meningococcal vaccine sc K 9143 90734 Meningococcal vaccine im K 9145 90735 Encephalitis vaccine sc K 9144 90736 Zoster vacc sc M 90738 Inactivated je vacc im M 90740 Hepb vacc ill pat 3 dose im F90743 Hep b vacc adol 2 dose im F

90744 Hepb vacc ped/adol 3 dose im F 90746 Hep b vaccine adult im F 90747 Hepb vacc ill pat 4 dose im F 90748 Hep b/hib vaccine im E 90749 Vaccine toxoid N 90801 Psy

dx interview Q3 0323 90802 Intac psy

dx interview Q3 0323 90804 Psy

tx office 20-30 min Q3 0322 90805 Psy

tx off 20-30 min w/e&m Q3 0322 90806 Psy

tx off 45-50 min Q3 0323 90807 Psy

tx off 45-50 min w/e&m Q3 0323 90808 Psy

tx office 75-80 min Q3 0323 90809 Psy

tx off 75-80 w/e&m Q3 0323 90810 Intac psy

tx off 20-30 min Q3 0322 90811 Intac psy

tx 20-30 w/e&m Q3 0322 90812 Intac psy

tx off 45-50 min Q3 0323 90813 Intac psy

tx 45-50 min w/e&m Q3 0323 90814 Intac psy

tx off 75-80 min Q3 0323 90815 Intac psy

tx 75-80 w/e&m Q3 0323 90816 Psy

tx hosp 20-30 min P 90817 Psy

tx hosp 20-30 min w/e&m P 90818 Psy

tx hosp 45-50 min P 90819 Psy

tx hosp 45-50 min w/e&m P 90821 Psy

tx hosp 75-80 min P 90822 Psy

tx hosp 75-80 min w/e&m P 90823 Intac psy

tx hosp 20-30 min P 90824 Intac psy

tx hsp 20-30 w/e&m P 90826 Intac psy

tx hosp 45-50 min P 90827 Intac psy

tx hsp 45-50 w/e&m P 90828 Intac psy

tx hosp 75-80 min P 90829 Intac psy

tx hsp 75-80 w/e&m P 90845 Psychoanalysis Q3 0323 90846 Family

psy tx w/o patient Q3 0324 90847 Family

psy tx w/patient Q3 0324 90849 Multiple family group psy

tx Q3 0325 90853 Group psychotherapy Q3 0325 90857 Intac group psy tx Q3 0325 90862 Medication management Q3 0605 90865 Narcosynthesis Q3 0323 90867 Tcranial magn stim tx plan S 0218 90868 Tcranial magn stim tx deli S 0218 90869 Tcran magn stim redetemine NIS 0218 90870 Electroconvulsive therapy S 0320 90875 Psychophysiological therapy E 90876 Psychophysiological therapy E 90880 Hypnotherapy Q3 0323 90882 Environmental manipulation E 90885 Psy

evaluation of records N 90887 Consultation with family N 90889 Preparation of report N 90899 Psychiatric service/therapy Q3 0322 90901 Biofeedback train any meth A 90911 Biofeedback peri/uro/rectal T 0126 90935 Hemodialysis one evaluation S 017090937 Hemodialysis repeated eval B

90940 Hemodialysis access study N 90945 Dialysis one evaluation V 0608 90947 Dialysis repeated eval B 90951 Esrd serv 4 visits p mo <2 M 90952 Esrd serv 2-3 vsts p mo <2 M 90953 Esrd serv 1 visit p mo <2 M 90954 Esrd serv 4 vsts p mo 2-11 M 90955 Esrd srv 2-3 vsts p mo 2-11 M 90956 Esrd srv 1 visit p mo 2-11 M 90957 Esrd srv 4 vsts p mo 12-19 M 90958 Esrd srv 2-3 vsts p mo 12-19 M 90959 Esrd serv 1 vst p mo 12-19 M 90960 Esrd srv 4 visits p mo 20+ M 90961 Esrd srv 2-3 vsts p mo 20+ M 90962 Esrd serv 1 visit p mo 20+ M 90963 Esrd home pt serv p mo <2 M 90964 Esrd home pt serv p mo 2-11 M 90965 Esrd home pt serv p mo 12-19 M 90966 Esrd home pt serv p mo 20+ M 90967 Esrd home pt serv p day <2 M 90968 Esrd home pt srv p day 2-11 M 90969 Esrd home pt srv p day 12-19 M 90970 Esrd home pt serv p day 20+ M 90989 Dialysis training complete B 90993 Dialysis training incompl B 90997 Hemoperfusion B 90999 Dialysis procedure B 91010 Esophagus motility study X 0361 91013 Esophgl motil w/stim/perfus X 0361 91020 Gastric motility studies X 0361 91022 Duodenal motility study X 0361 91030 Acid perfusion of esophagus X 0361 91034 Gastroesophageal reflux test X 0361 91035 G-esoph reflx tst w/electrod X 0361 91037 Esoph imped function test X 0360 91038 Esoph imped funct test > 1h X 0361 91040 Esoph balloon distension tst X 0360 91065 Breath hydrogen test X 0360 91110 Gi tract capsule endoscopy T 0142 91111 Esophageal capsule endoscopy CHT 0419 91117 Colon motility 6 hr study T 0156 91120 Rectal sensation test T 0126 91122 Anal pressure record T 0156 91132 Electrogastrography X 0360 91133 Electrogastrography w/test X 0360 91299 Gastroenterology procedure X 0360 92002 Eye exam new patient V 0606 92004 Eye exam new patient V 0606 92012 Eye exam established pat V 0605 92014 Eye exam & treatment V 0605 92015 Refraction E 92018 New eye exam & treatment T 0699 92019 Eye exam & treatment T 0699 92020 Special eye evaluation S 023092025 Corneal topography CHS 0230

92060 Special eye evaluation CHS 0230 92065 Orthoptic/pleoptic training CHS 0230 92070 Fitting of contact lens CHD 92071 Contact lens fitting for tx NIN 92072 Fit contac lens for managmnt NIN 92081 Visual field examination(s) S 0230 92082 Visual field examination(s) CHS 0230 92083 Visual field examination(s) S 0698 92100 Serial tonometry exam(s) N 92120 Tonography & eye evaluation CHD 92130 Water provocation tonography CHD 92132 Cmptr ophth dx img ant segmt S 0230 92133 Cmptr ophth img optic nerve S 0230 92134 Cptr ophth dx img post segmt S 0230 92136 Ophthalmic biometry S 0698 92140 Glaucoma provocative tests S 0230 92225 Special eye exam initial S 0230 92226 Special eye exam subsequent CHS 0230 92227 Remote dx retinal imaging X 0035 92228 Remote retinal imaging mgmt X 0035 92230 Eye exam with photos CHS 0698 92235 Eye exam with photos S 0231 92240 Icg angiography S 0231 92250 Eye exam with photos CHS 0230 92260 Ophthalmoscopy /dynamometry S 0230 92265 Eye muscle evaluation CHS 0230 92270 Electro-oculography S 0230 92275 Electroretinography S 0231 92283 Color vision examination S 0230 92284 Dark adaptation eye exam CHS 0230 92285 Eye photography CHS 0230 92286 Internal eye photography CHS 0698 92287 Internal eye photography CHS 0698 92310 Contact lens fitting E 92311 Contact lens fitting S 0698 92312 Contact lens fitting CHS 0230 92313 Contact lens fitting CHS 0698 92314 Prescription of contact lens E 92315 Prescription of contact lens CHS 0698 92316 Prescription of contact lens S 0698 92317 Prescription of contact lens S 0230 92325 Modification of contact lens CHS 0698 92326 Replacement of contact lens CHS 0230 92340 Fitting of spectacles E 92341 Fitting of spectacles E 92342 Fitting of spectacles E 92352 Special spectacles fitting S 0698 92353 Special spectacles fitting CHS 0698 92354 Special spectacles fitting S 0230 92355 Special spectacles fitting S 0230 92358 Eye prosthesis service S 0230 92370 Repair & adjust spectacles E 92371 Repair & adjust spectacles CHS 0698 92499 Eye service or procedure S 023092502 Ear and throat examination T 0251

92504 Ear microscopy examination N 92506 Speech/hearing evaluation A 92507 Speech/hearing therapy A 92508 Speech/hearing therapy A 92511 Nasopharyngoscopy T 0071 92512 Nasal function studies X 0363 92516 Facial nerve function test CHX 0363 92520 Laryngeal function studies X 0660 92526 Oral function therapy A 92531 Spontaneous nystagmus study N 92532 Positional nystagmus test N 92533 Caloric vestibular test N 92534 Optokinetic nystagmus test N 92540 Basic vestibular evaluation X 0660 92541 Spontaneous nystagmus test X 0363 92542 Positional nystagmus test X 0363 92543 Caloric vestibular test X 0660 92544 Optokinetic nystagmus test X 0363 92545 Oscillating tracking test X 0363 92546 Sinusoidal rotational test X 0660 92547 Supplemental electrical test N 92548 Posturography X 0660 92550 Tympanometry & reflex thresh X 0364 92551 Pure tone hearing test air E 92552 Pure tone audiometry air X 0364 92553 Audiometry air & bone X 0365 92555 Speech threshold audiometry X 0364 92556 Speech audiometry complete X 0364 92557 Comprehensive hearing test X 0365 92558 Evoked auditory test qual NI E 92559 Group audiometric testing E 92560 Bekesy

audiometry

screen E 92561 Bekesy

audiometry

diagnosis CHX 0365 92562 Loudness balance test X 0364 92563 Tone decay hearing test X 0364 92564 Sisi hearing test X 0364 92565 Stenger test pure tone X 0364 92567 Tympanometry X 0364 92568 Acoustic refl threshold tst X 0364 92570 Acoustic immitance testing CHX 0365 92571 Filtered speech hearing test X 0364 92572 Staggered spondaic word test X 0366 92575 Sensorineural acuity test X 0364 92576 Synthetic sentence test X 0364 92577 Stenger test speech X 0366 92579 Visual audiometry (vra) X 0365 92582 Conditioning play audiometry X 0365 92583 Select picture audiometry X 0364 92584 Electrocochleography S 0216 92585 Auditor evoke potent compre S 0216 92586 Auditor evoke potent limit S 0218 92587 Evoked auditory test limited X 0363 92588 Evoked auditory tst complete X 0363 92590 Hearing aid exam one ear E92591 Hearing aid exam both ears E

92592 Hearing aid check one ear E 92593 Hearing aid check both ears E 92594 Electro hearng aid test one E 92595 Electro hearng aid tst both E 92596 Ear protector evaluation X 0364 92597 Oral speech device eval A 92601 Cochlear implt f/up exam < 7 X 0366 92602 Reprogram cochlear implt < 7 X 0366 92603 Cochlear implt f/up exam 7 > X 0366 92604 Reprogram cochlear implt 7 > X 0366 92605 Ex for nonspeech device rx A 92606 Non-speech device service A 92607 Ex for speech device rx 1hr A 92608 Ex for speech device rx addl A 92609 Use of speech device service A 92610 Evaluate swallowing function A 92611 Motion fluoroscopy /swallow A 92612 Endoscopy swallow tst (fees) A 92613 Endoscopy swallow tst (fees) B 92614 Laryngoscopic sensory test A 92615 Eval laryngoscopy sense tst E 92616 Fees w/laryngeal sense test A 92617 Interprt fees/laryngeal test E 92618 Ex for nonspeech dev rx add NIA 92620 Auditory

function 60 min X 0365 92621 Auditory

function + 15 min N 92625 Tinnitus assessment X 0365 92626 Eval aud rehab status X 0366 92627 Eval aud status rehab add-on N 92630 Aud rehab pre-ling hear loss E 92633 Aud rehab postling hear loss E 92640 Aud brainstem implt programg X 0365 92700 Ent procedure/service X 0364 92950 Heart/lung resuscitation cpr S 0094 92953 Temporary

external pacing Q3 0094 92960 Cardioversion electric ext S 0679 92961 Cardioversion electric int S 0679 92970 Cardioassist internal C 92971 Cardioassist external C 92973 Percut coronary thrombectomy T 0088 92974 Cath place cardio brachy tx T 0103 92975 Dissolve clot heart vessel C 92977 Dissolve clot heart vessel T 0676 92978 Intravasc us heart add-on N 92979 Intravasc us heart add-on N 92980 Insert intracoronary stent T 0104 92981 Insert intracoronary stent T 0104 92982 Coronary

artery dilation T 0083 92984 Coronary

artery dilation T 0083 92986 Revision of aortic valve T 0083 92987 Revision of mitral valve T 0083 92990 Revision of pulmonary valve T 0083 92992 Revision of heart chamber C 92993 Revision of heart chamber C92995 Coronary atherectomy T 0082 92996 Coronary

atherectomy

add-on T 0082 92997 Pul art balloon repr percut T 0083 92998 Pul art balloon repr percut T 0083 93000 Electrocardiogram complete M 93005 Electrocardiogram tracing S 0099 93010 Electrocardiogram report B 93015 Cardiovascular stress test B 93016 Cardiovascular stress test B 93017 Cardiovascular stress test X 0100 93018 Cardiovascular stress test B 93024 Cardiac drug stress test X 0100 93025 Microvolt t-wave assess X 0100 93040 Rhy

thm ECG with report B 93041 Rhy

thm ecg tracing X 0035 93042 Rhy

thm ecg report B 93224 Ecg monit/reprt up to 48 hrs M 93225 Ecg monit/reprt up to 48 hrs S 0097 93226 Ecg monit/reprt up to 48 hrs S 0097 93227 Ecg monit/reprt up to 48 hrs M 93228 Remote 30 day ecg rev/report M 93229 Remote 30 day ecg tech supp S 0209 93268 ECG record/review M 93270 Remote 30 day ecg rev/report S 0097 93271 Ecg/monitoring and analysis S 0692 93272 Ecg/review interpret only M 93278 ECG/signal-averaged X 0035 93279 Pmdevice progr eval sngl S 0690 93280 Pmdevice progr eval dual S 0690 93281 Pmdevice progr eval multi S 0690 93282 Icd device prog eval 1 sngl S 0690 93283 Icd device progr eval dual S 0690 93284 Icd device progr eval mult S 0690 93285 Ilr device eval progr S 0690 93286 Pre-op pm device eval N 93287 Pre-op icd device eval N 93288 Pmdevice eval in person S 0690 93289 Icd device interrogate S 0690 93290 Icm device eval X 0035 93291 Ilr device interrogate S 0690 93292 Wcd device interrogate S 0690 93293 Pmphone r-strip device eval S 0690 93294 Pmdevice interrogate remote M 93295 Icd device interrogat remote M 93296 Pm/icd remote tech serv S 0690 93297 Icm device interrogat remote M 93298 Ilr device interrogat remote M 93299 Icm/ilr remote tech serv CHS 0690 93303 Echo transthoracic S 0270 93304 Echo transthoracic S 0269 93306 Tte w/doppler complete S 0269 93307 Tte w/o doppler complete S 0269 93308 Tte f-up or lmtd S 0697 93312 Echo transesophageal S 0270 93313 Echo transesophageal S 026993314 Echo transesophageal N

93315 Echo transesophageal CHS 0269 93316 Echo transesophageal S 0270 93317 Echo transesophageal N 93318 Echo transesophageal intraop S 0270 93320 Doppler echo exam heart N 93321 Doppler echo exam heart N 93325 Doppler color flow add-on N 93350 Stress tte only S 0269 93351 Stress tte complete S 0270 93352 Admin ecg contrast agent M 93451 Right heart cath T 0080 93452 Left hrt cath w/ventrclgrphy T 0080 93453 R&l hrt cath w/ventriclgrphy T 0080 93454 Coronary

artery angio s&i T 0080 93455 Coronary

art/grft angio s&i T 0080 93456 R hrt coronary artery angio T 0080 93457 R hrt art/grft angio T 0080 93458 L hrt artery

/ventricle angio T 0080 93459 L hrt art/grft angio T 0080 93460 R&l hrt art/ventricle angio T 0080 93461 R&l hrt art/ventricle angio T 0080 93462 L hrt cath trnsptl puncture T 0080 93463 Drug admin & hemodynmic meas N 93464 Exercise w/hemodynamic meas N 93503 Insert/place heart catheter T 0103 93505 Biopsy

of heart lining T 0103 93530 Rt heart cath congenital T 0080 93531 R & l heart cath congenital T 0080 93532 R & l heart cath congenital T 0080 93533 R & l heart cath congenital T 0080 93561 Cardiac output measurement N 93562 Card output measure subsq N 93563 Inject congenital card cath N 93564 Inject hrt congntl art/grft N 93565 Inject l ventr/atrial angio N 93566 Inject r ventr/atrial angio N 93567 Inject suprvlv aortography N 93568 Inject pulm art hrt cath N 93571 Heart flow reserve measure N 93572 Heart flow reserve measure N 93580 Transcath closure of asd T 0434 93581 Transcath closure of vsd T 0434 93600 Bundle of His recording S 0084 93602 Intra-atrial recording S 0084 93603 Right ventricular recording S 0084 93609 Map tachycardia add-on N 93610 Intra-atrial pacing S 0084 93612 Intraventricular pacing S 0084 93613 Electrophys map 3d add-on N 93615 Esophageal recording S 0084 93616 Esophageal recording S 0084 93618 Heart rhy

thm pacing S 0084 93619 Electrophysiology evaluation Q3 0085 93620 Electrophysiology evaluation Q3 008593621 Electrophysiology evaluation N 93622 Electrophysiology evaluation N 93623 Stimulation pacing heart N 93624 Electrophysiologic study T 0085 93631 Heart pacing mapping N 93640 Evaluation heart device N 93641 Electrophysiology evaluation N 93642 Electrophysiology evaluation S 0084 93650 Ablate heart dysrhy thm focus Q3 0085 93651 Ablate heart dysrhy thm focus Q3 0086 93652 Ablate heart dysrhy thm focus Q3 0086 93660 Tilt table evaluation S 0101 93662 Intracardiac ecg (ice) N 93668 Peripheral vascular rehab E 93701 Bioimpedance cv analysis S 0099 93720 Total body

plethysmography CHD 93721 Plethysmography tracing CHD 93722 Plethysmography report CHD 93724 Analy

ze pacemaker system S 0690 93740 Temperature gradient studies CHX 0367 93745 Set-up cardiovert-defibrill S 0690 93750 Interrogation vad in person S 0692 93770 Measure venous pressure N 93784 Ambulatory BP monitoring E 93786 Ambulatory BP recording S 0097 93788 Ambulatory BP analysis S 0097 93790 Review/report BP recording M 93797 Cardiac rehab S 0095 93798 Cardiac rehab/monitor S 0095 93799 Cardiovascular procedure S 0097 93875 Extracranial study CHD 93880 Extracranial study S 0267 93882 Extracranial study S 0267 93886 Intracranial study S 0267 93888 Intracranial study S 0265 93890 Tcd vasoreactivity study S 0266 93892 Tcd emboli detect w/o inj S 0266 93893 Tcd emboli detect w/inj S 0266 93922 Upr/l xtremity art 2 levels S 0097 93923 Upr/lxtr art stdy 3+ lvls S 0096 93924 Lwr xtr vasc stdy bilat S 0096 93925 Lower extremity study S 0267 93926 Lower extremity study S 0266 93930 Upper extremity study S 0267 93931 Upper extremity study S 0266 93965 Extremity

study S 0096 93970 Extremity

study S 0267 93971 Extremity

study S 0266 93975 Vascular study S 0267 93976 Vascular study S 0267 93978 Vascular study S 0267 93979 Vascular study S 0266 93980 Penile vascular study S 0267 93981 Penile vascular study S 0267 93982 Aneurysm pressure sens study S 009793990 Doppler flow testing S 0266

93998 Noninvas vasc dx study proc NIX 0035 94002 Vent mgmt inpat init day Q3 0079 94003 Vent mgmt inpat subq day Q3 0079 94004 Vent mgmt nf per day B 94005 Home vent mgmt supervision M 94010 Breathing capacity test CHX 0367 94011 Spirometry

up to 2 yrs old CHX 0367 94012 Spirmtry

w/brnchdil inf-2 yr CHX 0367 94013 Meas lung vol thru 2 yrs X 0369 94014 Patient recorded spirometry X 0367 94015 Patient recorded spirometry X 0367 94016 Review patient spirometry A 94060 Evaluation of wheezing S 0078 94070 Evaluation of wheezing X 0369 94150 Vital capacity test X 0367 94200 Lung function test (MBC/MVV) X 0367 94240 Residual lung capacity CHD 94250 Expired gas collection X 0367 94260 Thoracic gas volume CHD 94350 Lung nitrogen washout curve CHD 94360 Measure airflow resistance CHD 94370 Breath airway closing volume CHD 94375 Respiratory flow volume loop CHX 0367 94400 CO2 breathing response curve X 0367 94450 Hypoxia response curve X 0368 94452 Hast w/report X 0368 94453 Hast w/oxygen titrate CHX 0367 94610 Surfactant admin thru tube S 0077 94620 Pulmonary

stress test/simple X 0368 94621 Pulmstress test/complex X 0369 94640 Airway

inhalation treatment S 0077 94642 Aerosol inhalation treatment S 0078 94644 Cbt 1st hour X 0340 94645 Cbt each addl hour X 0340 94660 Pos airway

pressure cpap Q3 0078 94662 Neg press ventilation cnp Q3 0079 94664 Evaluate pt use of inhaler S 0077 94667 Chest wall manipulation S 0077 94668 Chest wall manipulation S 0077 94680 Exhaled air analysis o2 X 0368 94681 Exhaled air analysis o2/co2 CHX 0369 94690 Exhaled air analysis X 0367 94720 Monoxide diffusing capacity CHD 94725 Membrane diffusion capacity CHD 94726 Pulmfunct tst plethysmograp NIX 0367 94727 Pulmfunction test by gas NIX 0367 94728 Pulmfunct test oscillometry NIX 0367 94729 C02/membane diffuse capacity NIX 0368 94750 Pulmonary

compliance study X 0367 94760 Measure blood oxygen level N 94761 Measure blood oxygen level N 94762 Measure blood oxygen level Q3 0097 94770 Exhaled carbon dioxide test X 0368 94772 Breath recording infant X 036994774 Ped home apnea rec compl B

94775 Ped home apnea rec hk-up S 0097 94776 Ped home apnea rec downld S 0097 94777 Ped home apnea rec report B 94780 Car seat/bed test 60 min NIX 0340 94781 Car seat/bed test + 30 min NIX 0340 94799 Pulmonary

service/procedure X 0367 95004 Percut allergy skin tests X 0381 95010 Percut allergy titrate test X 0381 95012 Exhaled nitric oxide meas X 0367 95015 Id allergy

titrate-drug/bug X 0381 95024 Id allergy

test drug/bug X 0381 95027 Id allergy

titrate-airborne X 0381 95028 Id allergy

test-delayed type X 0381 95044 Allergy

patch tests X 0381 95052 Photo patch test X 0381 95056 Photosensitivity tests X 0370 95060 Eye allergy tests X 0370 95065 Nose allergy test X 0381 95070 Bronchial allergy tests X 0369 95071 Bronchial allergy tests CHX 0368 95075 Ingestion challenge test X 0361 95115 Immunotherapy one injection S 0436 95117 Immunotherapy injections S 0436 95120 Immunotherapy one injection E 95125 Immunotherapy many antigens E 95130 Immunotherapy insect venom E 95131 Immunotherapy insect venoms E 95132 Immunotherapy insect venoms E 95133 Immunotherapy insect venoms E 95134 Immunotherapy insect venoms E 95144 Antigen therapy services S 0437 95145 Antigen therapy services S 0437 95146 Antigen therapy services S 0438 95147 Antigen therapy services S 0438 95148 Antigen therapy services S 0437 95149 Antigen therapy services S 0437 95165 Antigen therapy services S 0436 95170 Antigen therapy services S 0437 95180 Rapid desensitization X 0370 95199 Allergy

immunology

services X 0381 95250 Glucose monitoring cont V 0607 95251 Gluc monitor cont phys i&r B 95800 Slp stdy

unattended S 0213 95801 Slp stdy

unatnd w/anal S 0213 95803 Actigraphy

testing S 0218 95805 Multiple sleep latency test S 0209 95806 Sleep study unatt&resp efft S 0213 95807 Sleep study attended S 0209 95808 Polysomnography 1-3 S 0209 95810 Polysomnography 4 or more S 0209 95811 Polysomnography w/cpap S 0209 95812 Eeg 41-60 minutes S 0213 95813 Eeg over 1 hour S 0213 95816 Eeg awake and drowsy S 021395819 Eeg awake and asleep S 0213

95822 Eeg coma or sleep only S 0213 95824 Eeg cerebral death only S 0216 95827 Eeg all night recording S 0213 95829 Surgery

electrocorticogram N 95830 Insert electrodes for EEG B 95831 Limb muscle testing manual A 95832 Hand muscle testing manual A 95833 Body

muscle testing manual A 95834 Body

muscle testing manual A 95851 Range of motion measurements A 95852 Range of motion measurements A 95857 Cholinesterase challenge S 0218 95860 Muscle test one limb S 0218 95861 Muscle test 2 limbs S 0218 95863 Muscle test 3 limbs S 0218 95864 Muscle test 4 limbs S 0218 95865 Muscle test larynx S 0218 95866 Muscle test hemidiaphragm S 0218 95867 Muscle test cran nerv unilat S 0218 95868 Muscle test cran nerve bilat S 0218 95869 Muscle test thor paraspinal S 0215 95870 Muscle test nonparaspinal S 0215 95872 Muscle test one fiber S 0218 95873 Guide nerv destr elec stim N 95874 Guide nerv destr needle emg N 95875 Limb exercise test S 0218 95885 Musc tst done w/nerv tst lim NIS 0218 95886 Musc test done w/n test comp NIS 0218 95887 Musc tst done w/n tst nonext NIS 0215 95900 Motor nerve conduction test S 0215 95903 Motor nerve conduction test S 0215 95904 Sense nerve conduction test S 0215 95905 Motor/sens nrve conduct test S 0215 95920 Intraop nerve test add-on N 95921 Autonomic nerv function test S 0218 95922 Autonomic nerv function test S 0218 95923 Autonomic nerv function test S 0218 95925 Somatosensory testing S 0216 95926 Somatosensory testing S 0216 95927 Somatosensory testing S 0216 95928 C motor evoked uppr limbs S 0218 95929 C motor evoked lwr limbs S 0218 95930 Visual evoked potential test S 0216 95933 Blink reflex test S 0215 95934 H-reflex test S 0215 95936 H-reflex test S 0215 95937 Neuromuscular junction test S 0218 95938 Somatosensory testing NIS 0216 95939 C motor evoked upr&lwr limbs NIS 0218 95950 Ambulatory eeg monitoring S 0209 95951 EEG monitoring/videorecord S 0209 95953 EEG monitoring/computer S 0209 95954 EEG monitoring/giving drugs S 0218 95955 EEG during surgery N95956 Eeg monitor technol attended S 0209

95957 EEG digital analysis N 95958 EEG monitoring/function test S 0213 95961 Electrode stimulation brain S 0216 95962 Electrode stim brain add-on S 0216 95965 Meg spontaneous CHS 0066 95966 Meg evoked single S 0065 95967 Meg evoked each addl S 0065 95970 Analy

ze neurostimno prog S 0218 95971 Analy

ze neurostimsimple S 0692 95972 Analy

ze neurostimcomplex S 0692 95973 Analy

ze neurostimcomplex CHS 0218 95974 Cranial neurostim complex S 0692 95975 Cranial neurostim complex CHS 0218 95978 Analy

ze neurostimbrain/1h S 0692 95979 Analy

z neurostimbrain addon S 0692 95980 Io anal gast n-stim init N 95981 Io anal gast n-stim subsq S 0218 95982 Io ga n-stim subsq w/reprog S 0692 95990 Spin/brain pump refil & main S 0439 95991 Spin/brain pump refil & main S 0439 95992 Canalith repositioning proc A 95999 Neurological procedure S 0215 96000 Motion analysis video/3d S 0216 96001 Motion test w/ft press meas S 0216 96002 Dynamic surface emg S 0218 96003 Dynamic fine wire emg S 0218 96004 Phys review of motion tests B 96020 Functional brain mapping N 96040 Genetic counseling 30 min B 96101 Psycho testing by psych/phys Q3 0382 96102 Psycho testing by technician CHQ3 0373 96103 Psycho testing admin by comp Q3 0373 96105 Assessment of aphasia A 96110 Developmental screen CHE 96111 Developmental test extend Q3 0373 96116 Neurobehavioral status exam Q3 0382 96118 Neuropsych tst by psych/phys Q3 0382 96119 Neuropsych testing by tec Q3 0382 96120 Neuropsych tst admin w/comp Q3 0382 96125 Cognitive test by hc pro A 96150 Assess hlth/behave init Q3 0432 96151 Assess hlth/behave subseq Q3 0432 96152 Intervene hlth/behave indiv Q3 0432 96153 Intervene hlth/behave group Q3 0432 96154 Interv hlth/behav fam w/pt Q3 0432 96155 Interv hlth/behav fam no pt E 96360 Hydration iv infusion init S 0438 96361 Hydrate iv infusion add-on S 0436 96365 Ther/proph/diag iv inf init S 0439 96366 Ther/proph/diag iv inf addon CHS 0437 96367 Tx/proph/dg addl seq iv inf S 0437 96368 Ther/diag concurrent inf N 96369 Sc ther infusion up to 1 hr S 0439 96370 Sc ther infusion addl hr S 043796371 Sc ther infusion reset pump CHS 0437

96372 Ther/proph/diag inj sc/im CHS 0437 96373 Ther/proph/diag inj ia S 0437 96374 Ther/proph/diag inj iv push S 0437 96375 Tx/pro/dx inj new drug addon S 0437 96376 Tx/pro/dx inj same drug adon N 96379 Ther/prop/diag inj/inf proc S 0436 96401 Chemo anti-neopl sq/im S 0437 96402 Chemo hormon antineopl sq/im S 0437 96405 Chemo intralesional up to 7 S 0437 96406 Chemo intralesional over 7 S 0439 96409 Chemo iv push sngl drug S 0439 96411 Chemo iv push addl drug S 0438 96413 Chemo iv infusion 1 hr S 0440 96415 Chemo iv infusion addl hr S 0437 96416 Chemo prolong infuse w/pump S 0440 96417 Chemo iv infus each addl seq S 0438 96420 Chemo ia push tecnique S 0438 96422 Chemo ia infusion up to 1 hr S 0440 96423 Chemo ia infuse each addl hr S 0438 96425 Chemotherapy infusion method S 0440 96440 Chemotherapy intracavitary S 0439 96446 Chemotx admn prtl cavity S 0439 96450 Chemotherapy into cns S 0440 96521 Refill/maint portable pump S 0439 96522 Refill/maint pump/resvr syst S 0439 96523 Irrig drug delivery device Q1 0624 96542 Chemotherapy injection S 0438 96549 Chemotherapy unspecified S 0436 96567 Photodynamic tx skin T 0015 96570 Photodynmc tx 30 min add-on T 0015 96571 Photodynamic tx addl 15 min T 0015 96900 Ultraviolet light therapy S 0001 96902 Trichogram N 96904 Whole body photography N 96910 Photochemotherapy with UV-B S 0001 96912 Photochemotherapy with UV-A S 0001 96913 Photochemotherapy uv-a or b S 0683 96920 Laser tx skin < 250 sq cm T 0015 96921 Laser tx skin 250-500 sq cm T 0015 96922 Laser tx skin > 500 sq cm T 0015 96999 Dermatological procedure T 0012 97001 Pt evaluation A 97002 Pt re-evaluation A 97003 Ot evaluation A 97004 Ot re-evaluation A 97005 Athletic train eval E 97006 Athletic train reeval E 97010 Hot or cold packs therapy A 97012 Mechanical traction therapy A 97014 Electric stimulation therapy E 97016 Vasopneumatic device therapy A 97018 Paraffin bath therapy A 97022 Whirlpool therapy A 97024 Diathermy

eg microwave A97026 Infrared therapy A

97028 Ultraviolet therapy A 97032 Electrical stimulation A 97033 Electric current therapy A 97034 Contrast bath therapy A 97035 Ultrasound therapy A 97036 Hydrotherapy A 97039 Physical therapy treatment A 97110 Therapeutic exercises A 97112 Neuromuscular reeducation A 97113 Aquatic therapy /exercises A 97116 Gait training therapy A 97124 Massage therapy A 97139 Physical medicine procedure A 97140 Manual therapy A 97150 Group therapeutic procedures A 97530 Therapeutic activities A 97532 Cognitive skills development A 97533 Sensory

integration A 97535 Self care mngment training A 97537 Community /work reintegration A 97542 Wheelchair mngment training A 97545 Work hardening A 97546 Work hardening add-on A 97597 Rmvl devital tis 20 cm/< T 0015 97598 Rmvl devital tis addl 20 cm< T 0015 97602 Wound(s) care non-selective T 0013 97605 Neg press wound tx < 50 cm T 0013 97606 Neg press wound tx > 50 cm T 0015 97750 Physical performance test A 97755 Assistive technology assess A 97760 Orthotic mgmt and training A 97761 Prosthetic training A 97762 C/o for orthotic/prosth use A 97799 Physical medicine procedure A 97802 Medical nutrition indiv in A 97803 Med nutrition indiv subseq A 97804 Medical nutrition group A 97810 Acupunct w/o stimul 15 min E 97811 Acupunct w/o stimul addl 15m E 97813 Acupunct w/stimul 15 min E 97814 Acupunct w/stimul addl 15m E 98925 Osteopathic manipulation S 0060 98926 Osteopathic manipulation S 0060 98927 Osteopathic manipulation S 0060 98928 Osteopathic manipulation S 0060 98929 Osteopathic manipulation S 0060 98940 Chiropractic manipulation S 0060 98941 Chiropractic manipulation S 0060 98942 Chiropractic manipulation S 0060 98943 Chiropractic manipulation E 98960 Self-mgmt educ & train 1 pt E 98961 Self-mgmt educ/train 2-4 pt E 98962 Self-mgmt educ/train 5-8 pt E 98966 Hc pro phone call 5-10 min E98967 Hc pro phone call 11-20 min E

98968 Hc pro phone call 21-30 min E 98969 Online service by hc pro E 99000 Specimen handling E 99001 Specimen handling E 99002 Device handling B 99024 Postop follow-up visit B 99026 In-hospital on call service E 99027 Out-of-hosp on call service E 99050 Medical services after hrs B 99051 Med serv eve/wkend/holiday B 99053 Med serv 10pm-8am 24 hr fac B 99056 Med service out of office B 99058 Office emergency care B 99060 Out of office emerg med serv B 99070 Special supplies B 99071 Patient education materials B 99075 Medical testimony E 99078 Group health education N 99080 Special reports or forms B 99082 Unusual physician travel B 99090 Computer data analysis B 99091 Collect/review data from pt N 99100 Special anesthesia service B 99116 Anesthesia with hypothermia B 99135 Special anesthesia procedure B 99140 Emergency anesthesia B 99143 Mod cs by

same phys < 5 yrs N 99144 Mod cs by

same phys 5 yrs + N 99145 Mod cs by

same phys add-on N 99148 Mod cs diff phys < 5 yrs N 99149 Mod cs diff phys 5 yrs + N 99150 Mod cs diff phys add-on N 99170 Anogenital examchild T 0191 99172 Ocular function screen E 99173 Visual acuity screen E 99174 Ocular photoscreening E 99175 Induction of vomiting N 99183 Hyperbaric oxygen therapy B 99190 Special pump services C 99191 Special pump services C 99192 Special pump services C 99195 Phlebotomy X 0624 99199 Special service/proc/report B 99201 Office/outpatient visit new V 0604 99202 Office/outpatient visit new V 0605 99203 Office/outpatient visit new V 0606 99204 Office/outpatient visit new V 0607 99205 Office/outpatient visit new Q3 0608 99211 Office/outpatient visit est V 0604 99212 Office/outpatient visit est V 0605 99213 Office/outpatient visit est V 0605 99214 Office/outpatient visit est V 0606 99215 Office/outpatient visit est Q3 0607 99217 Observation care discharge B99218 Initial observation care B

99219 Initial observation care B 99220 Initial observation care B 99221 Initial hospital care B 99222 Initial hospital care B 99223 Initial hospital care B 99224 Subsequent observation care B 99225 Subsequent observation care B 99226 Subsequent observation care B 99231 Subsequent hospital care B 99232 Subsequent hospital care B 99233 Subsequent hospital care B 99234 Observ/hosp same date B 99235 Observ/hosp same date B 99236 Observ/hosp same date B 99238 Hospital discharge day B 99239 Hospital discharge day B 99241 Office consultation E 99242 Office consultation E 99243 Office consultation E 99244 Office consultation E 99245 Office consultation E 99251 Inpatient consultation E 99252 Inpatient consultation E 99253 Inpatient consultation E 99254 Inpatient consultation E 99255 Inpatient consultation E 99281 Emergency dept visit V 0609 99282 Emergency dept visit V 0613 99283 Emergency dept visit V 0614 99284 Emergency dept visit Q3 0615 99285 Emergency dept visit Q3 0616 99288 Direct advanced life support B 99291 Critical care first hour Q3 0617 99292 Critical care addl 30 min N 99304 Nursing facility care init B 99305 Nursing facility care init B 99306 Nursing facility care init B 99307 Nursing fac care subseq B 99308 Nursing fac care subseq B 99309 Nursing fac care subseq B 99310 Nursing fac care subseq B 99315 Nursing fac discharge day B 99316 Nursing fac discharge day B 99318 Annual nursing fac assessmnt B 99324 Domicil/r-home visit new pat B 99325 Domicil/r-home visit new pat B 99326 Domicil/r-home visit new pat B 99327 Domicil/r-home visit new pat B 99328 Domicil/r-home visit new pat B 99334 Domicil/r-home visit est pat B 99335 Domicil/r-home visit est pat B 99336 Domicil/r-home visit est pat B 99337 Domicil/r-home visit est pat B 99339 Domicil/r-home care supervis B99340 Domicil/r-home care supervis B

99341 Home visit new patient B 99342 Home visit new patient B 99343 Home visit new patient B 99344 Home visit new patient B 99345 Home visit new patient B 99347 Home visit est patient B 99348 Home visit est patient B 99349 Home visit est patient B 99350 Home visit est patient B 99354 Prolonged service office N 99355 Prolonged service office N 99356 Prolonged service inpatient C 99357 Prolonged service inpatient C 99358 Prolong service w/o contact N 99359 Prolong serv w/o contact add N 99360 Physician standby services B 99363 Anticoag mgmt init B 99364 Anticoag mgmt subseq B 99366 Team conf w/pat by hc pro N 99367 Team conf w/o pat by phys N 99368 Team conf w/o pat by hc pro N 99374 Home health care supervision B 99375 Home health care supervision E 99377 Hospice care supervision B 99378 Hospice care supervision E 99379 Nursing fac care supervision B 99380 Nursing fac care supervision B 99381 Init pme/m new pat inf E 99382 Init pme/m new pat 1-4 yrs E 99383 Prev visit new age 5-11 E 99384 Prev visit new age 12-17 E 99385 Prev visit new age 18-39 E 99386 Prev visit new age 40-64 E 99387 Init pme/m new pat 65+ yrs E 99391 Per pm reeval est pat inf E 99392 Prev visit est age 1-4 E 99393 Prev visit est age 5-11 E 99394 Prev visit est age 12-17 E 99395 Prev visit est age 18-39 E 99396 Prev visit est age 40-64 E 99397 Per pm reeval est pat 65+ yr E 99401 Preventive counseling indiv E 99402 Preventive counseling indiv E 99403 Preventive counseling indiv E 99404 Preventive counseling indiv E 99406 Behav chng smoking 3-10 min X 0031 99407 Behav chng smoking > 10 min X 0031 99408 Audit/dast 15-30 min E 99409 Audit/dast over 30 min E 99411 Preventive counseling group E 99412 Preventive counseling group E 99420 Health risk assessment test E 99429 Unlisted preventive service E 99441 Phone e/mby phys 5-10 min E99442 Phone e/mby phys 11-20 min E 99443 Phone e/mby phys 21-30 min E 99444 Online e/m by phys E 99450 Basic life disability exam E 99455 Work related disability exam B 99456 Disability

examination B 99460 Init nb emper day hosp V 0605 99461 Init nb emper day non-fac M 99462 Sbsq nb em per day hosp C 99463 Same day

nb discharge V 0605 99464 Attendance at delivery N 99465 Nb resuscitation S 0094 99466 Ped crit care transport N 99467 Ped crit care transport addl N 99468 Neonate crit care initial C 99469 Neonate crit care subsq C 99471 Ped critical care initial C 99472 Ped critical care subsq C 99475 Ped crit care age 2-5 init C 99476 Ped crit care age 2-5 subsq C 99477 Init day

hosp neonate care C 99478 Ic lbw inf < 1500 gm subsq C 99479 Ic lbw inf 1500-2500 g subsq C 99480 Ic inf pbw 2501-5000 g subsq C 99499 Unlisted e&m service B 99500 Home visit prenatal E 99501 Home visit postnatal E 99502 Home visit nb care E 99503 Home visit resp therapy E 99504 Home visit mech ventilator E 99505 Home visit stoma care E 99506 Home visit im injection E 99507 Home visit cath maintain E 99509 Home visit day life activity E 99510 Home visit sing/m/fam couns E 99511 Home visit fecal/enema mgmt E 99512 Home visit for hemodialysis E 99600 Home visit nos E 99601 Home infusion/visit 2 hrs E 99602 Home infusion each addtl hr E 99605 Mtms by

pharm np 15 min E 99606 Mtms by

pharm est 15 min E 99607 Mtms by

pharm addl 15 min E 0001F Heart failure composite E 0005F Osteoarthritis composite E 0012F Cap bacterial assess E 0014F Comp preop assess cat surg E 0015F Melan follow-up complete E 0019T Extracorp shock wv tx ms nos A 0030T Antiprothrombin antibody A 0042T Ct perfusion w/contrast cbf N 0048T Implant ventricular device C 0050T Removal circulation assist C 0051T Implant total heart system C 0052T Replace component heart syst C0053T Replace component heart syst C

0054T Bone surgery using computer N 0055T Bone surgery using computer N 0058T Cryopreservation ovary tiss X 0344 0059T Cryopreservation oocy te X 0344 0071T U/s leiomyomata ablate <200 S 0067 0072T U/s leiomyomata ablate >200 S 0067 0073T Delivery

comp imrt S 0412 0075T Perq stent/chest vert art C 0076T S&i stent/chest vert art C 0078T Endovasc aort repr w/device C 0079T Endovasc visc extnsn repr C 0080T Endovasc aort repr rad s&i C 0081T Endovasc visc extnsn s&i C 0085T Breath test heart reject E 0092T Artific disc addl C 0095T Artific diskectomy addl C 0098T Rev artific disc addl C 0099T Implant corneal ring CHT 0234 0100T Prosth retina receive&gen T 0672 0101T Extracorp shockwv tx hi enrg T 0050 0102T Extracorp shockwv tx anesth T 0050 0103T Holotranscobalamin A 0106T Touch quant sensory test X 0341 0107T Vibrate quant sensory test X 0341 0108T Cool quant sensory test X 0341 0109T Heat quant sensory test X 0341 0110T Nos quant sensory test X 0341 0111T Rbc membranes fatty acids A 0123T Scleral fistulization T 0234 0124T Conjunctival drug placement T 0232 0126T Chd risk imt study Q1 0340 0141T Perq islet transplant CHD 0142T Open islet transplant CHD 0143T Laparoscopic islet transplnt CHD 0155T Lap impl gast curve electrd CHD 0156T Lap remv gast curve electrd CHD 0157T Open impl gast curve electrd CHD 0158T Open remv gast curve electrd CHD 0159T Cad breast mri N 0163T Lumb artif diskectomy addl C 0164T Remove lumb artif disc addl C 0165T Revise lumb artif disc addl C 0166T Tcath vsd close w/o bypass CHD 0167T Tcath vsd close w/bypass CHD 0168T Rhinophototx light app bilat CHD 0169T Place stereo cath brain C 0171T Lumbar spine proces distract T 0052 0172T Lumbar spine process addl T 0052 0173T Iop monit io pressure N 0174T Cad cxr with interp N 0175T Cad cxr remote N 0178T 64 lead ecg w/i&r B 0179T 64 lead ecg w/tracing X 0100 0180T 64 lead ecg w/i&r only B0181T Corneal hysteresis S 0230

0182T Hdr elect brachy therapy S 0313 0183T Wound ultrasound T 0015 0184T Exc rectal tumor endoscopic CHT 0149 0185T Comptr probability analysis N 0186T Suprachoroidal drug delivery T 0237 0188T Videoconf crit care 74 min M 0189T Videoconf crit care addl 30 M 0190T Place intraoc radiation src T 0237 0191T Insert ant segment drain int T 0673 0192T Insert ant segment drain ext T 0673 0195T Arthrod presac interbody C 0196T Arthrod presac interbody eac C 0197T Intrafraction track motion N 0198T Ocular blood flow measure CHS 0698 0199T Physiologic tremor record S 0215 0200T Perq sacral augmt unilat inj CHT 0050 0201T Perq sacral augmt bilat inj T 0050 0202T Post vert arthrplst 1 lumbar C 0205T Inirs each vessel add-on N 0206T Remote algorithm analys ecg Q1 0340 0207T Clear eyelid gland w/heat S 0230 0208T Audiometry air only X 0035 0209T Audiometry air & bone X 0035 0210T Speech audiometry threshold X 0035 0211T Speech audiom thresh & recog X 0035 0212T Compre audiometry evaluation CHX 0365 0213T Njx paravert w/us cer/thor T 0207 0214T Njx paravert w/us cer/thor T 0204 0215T Njx paravert w/us cer/thor T 0204 0216T Njx paravert w/us lumb/sac T 0207 0217T Njx paravert w/us lumb/sac T 0204 0218T Njx paravert w/us lumb/sac T 0204 0219T Plmt post facet implt cerv C 0220T Plmt post facet implt thor C 0221T Plmt post facet implt lumb T 0050 0222T Plmt post facet implt addl T 0050 0223T Acoustic ecg w/i&r S 0099 0224T Acoustic ecg 1+ analysis S 0690 0225T Acoustic ecg analy & reprog S 0690 0226T Anoscopy

hra w/spec collect X 0340 0227T Anoscopy

hra w/biopsy T 0146 0228T Njx tfrml eprl w/us cer/thor T 0207 0229T Njx tfrml eprl w/us cer/thor T 0206 0230T Njx tfrml eprl w/us lumb/sac T 0207 0231T Njx tfrml eprl w/us lumb/sac T 0206 0232T Njx platelet plasma X 0340 0233T Skin glycation spectroscopy A 0234T Trluml perip athrc renal art T 0082 0235T Trluml perip athrc visceral C 0236T Trluml perip athrc abd aorta T 0082 0237T Trluml perip athrc brchiocph T 0082 0238T Trluml perip athrc iliac art T 0082 0239T Bioimpedance spectroscopy CHS 0097 0240T Esoph motility 3d topography X 03610241T Esoph motility w/stim/perf X 0361 0242T Gi tract transit & pres meas X 0361 0243T Intm msr bronchodil wheeze S 0078 0244T Cont msr bronchodil wheeze X 0369 0245T Open tx rib fx 1-2 ribs T 0062 0246T Opn tx rib fx 3-4 ribs T 0062 0247T Opn tx rib fx 5-6 ribs T 0062 0248T Open tx rib fx 7/> ribs T 0062 0249T Ligation hemorrhoid w/us T 0155 0250T Insert bronchial valve T 0415 0251T Remov bronchial valve T 0076 0252T Remov bronch valve addl T 0076 0253T Insert aqueous drain device CHT 0673 0254T Evasc rpr iliac art bifur C 0255T Evasc rpr iliac art bifr s&i C 0256T Evasc aortic hrt valve C 0257T Opn tthrc aortic hrt valve C 0258T Aortic hrt valv w/o card byp C 0259T Aortic hrt valve w/card byp C 0260T Hypthrm bdy neonate 28d/< N 0261T Hypthrm head neonate 28d/< N 0262T Impltj pulm vlv evasc appr C 0263T Im B1 mrw cel ther cmpl S 0112 0264T Im B1 mrw cel ther xcl hrvst S 0112 0265T Im B1 mrw cel ther hrvst onl S 0112 0266T Implt/rpl crtd sns dev total C 0267T Implt/rpl crtd sns dev lead T 0687 0268T Implt/rpl crtd sns dev gen S 0039 0269T Rev/remvl crtd sns dev total T 0221 0270T Rev/remvl crtd sns dev lead T 0687 0271T Rev/remvl crtd sns dev gen T 0688 0272T Interrogate crtd sns dev S 0218 0273T Interrogate crtd sns w/pgrmg S 0218 0274T Perq lamot/lam crv/thrc T 0208 0275T Perq lamot/lam lumbar T 0208 0276T Bronch thermoplasty 1 lobe NIT 0415 0277T Bronch thermoplasty lobes NIT 0415 0278T Tempr NIS 0215 0279T Ctc test NIX 0342 0280T Ctc test w/i & r NIX 0342 0281T Laa closure w/implant NIC 0282T Periph field stimul trial NIS 0040 0283T Periph field stimul perm NIS 0318 0284T Periph field stimul revise NIT 0687 0285T Periph field stimul analys NIS 0218 0286T Near ifr spectrsc of wounds NIN 0287T Near ifr guide of vasc site NIN 0288T Anoscopy

w/rf delivery NIT 0148 0289T Laser inc for pkp/lkp donor NIN 0290T Laser inc for pkp/lkp recip NIN 0291T Iv oct for proc init vessel NIN 0292T Iv oct for proc addl vessel NIN 0293T Ins lt atrl press monitor NIC 0294T Ins lt atrl press mont addon NIC 0295T Ext ecg complete NIM0296T Ext ecg recording NIS 0097

0297T Ext ecg scan w/report NIS 0097 0298T Ext ecg review and interp NIM 0299T Esw wound healing init wound NIX 0340 0300T Esw wound healing addl wound NIX 0340 0301T Mw therapy for breast tumor NIS 0065 0500F Initial prenatal care visit E 0501F Prenatal flow sheet E 0502F Subsequent prenatal care E 0503F Postpartum care visit E 0505F Hemodialysis plan docd CHE 0507F Periton dialysis plan docd CHE 0509F Urine incon plan docd M 0513F Elev bp plan of care docd M 0514F Care plan hgb docd esa pt CHE 0516F Anemia plan of care docd E 0517F Glaucoma plan of care docd M 0518F Fall plan of care docd M 0519F Pland chemo docd b/4 txmnt E 0520F Rad dos limts b/4 3d rad M 0521F Plan of care 4 pain docd M 0525F Initial visit for episode E 0526F Subs visit for episode M 0528F Rcmnd flw-up 10 yrs docd E 0529F Intrvl 3+yrs pts clnscp docd M 0535F Dyspnea mngmnt plan docd E 0540F Gluco mngmnt plan docd M 0545F Follow up care plan mdd docd E 0550F Cy

topath report nongyn spcmn NI E 0551F Cy

topath report non routine NI E 0555F Symptom mgmnt plan care docd NI E 0556F Plan care lipid control docd NIM 0557F Plan caremng angnl symptdocd NIM 0575F HIV rna plan care docd M 1000F Tobacco use assessed E 1002F Assess anginal symptom/level CHE 1003F Level of activity assess E 1004F Clin sympvol ovrld assess E 1005F Asthma symptoms evaluate CHE 1006F Osteoarthritis assess M 1007F Anti-inflm/anlgsc otc assess M 1008F Gi/renal risk assess E 1010F Severity

angina by

actvty NIM 1011F Angina present NIM 1012F Angina absent NIM 1015F Copd symptoms assess E 1018F Assess dyspnea not present E 1019F Assess dyspnea present E 1022F Pneumo imm status assess E 1026F Co-morbid condition assess E 1030F Influenza imm status assess E 1031F Smoking & 2nd hand assessed NIM 1032F Smoker/exposed 2nd hnd smoke NIM 1033F Tobacco nonsmoker nor 2ndhnd NIM 1034F Current tobacco smoker E1035F Smokeless tobacco user E

1036F Tobacco non-user M 1038F Persistent asthma M 1039F Intermittent asthma M 1040F Dsm-iv info mdd docd M 1050F History

of mole changes E 1052F Type location activity asses NIM 1055F Visual funct status assess E 1060F Doc perm/cont/parox atr fib E 1061F Doc lack perm+cont+parox fib E 1065F Ischm stroke symplt3 hrsb/4 E 1066F Ischm stroke sympge3 hrsb/4 E 1070F Alarmsympassessed-absent E 1071F Alarmsympassessed-1+ prsnt E 1090F Pres/absn urine incon assess M 1091F Urine incon characterized M 1100F Ptfalls assess-docd ge2+/yr M 1101F Pt falls assess-docd le1/yr M 1110F Pt lft inpt fac w/in 60 days M 1111F Dschrg med/current med merge M 1116F Auric/peri pain assessed M 1118F GERD symps assessed 12 month E 1119F Init eval for condition M 1121F Subs eval for condition M 1123F Acp discuss/dscn mkr docd M 1124F Acp discuss-no dscnmkr docd M 1125F Amnt pain noted pain prsnt M 1126F Amnt pain noted none prsnt M 1127F New episode for condition E 1128F Subs episode for condition E 1130F Bk pain + fxn assessed M 1134F Epsd bk pain for =< 6 wks E 1135F Epsd bk pain for > 6 wks E 1136F Epsd bk pain for <= 12 wks E 1137F Epsd bk pain for > 12 wks E 1150F Doc pt rsk death w/in 1yr E 1151F Doc no pt rsk death w/in 1yr E 1152F Doc advncd dis comfort 1st E 1153F Doc advncd dis cmfrt not 1st E 1157F Advnc care plan in rcrd E 1158F Advnc care plan tlk docd M 1159F Med list docd in rcrd E 1160F Rvw meds by rx/dr in rcrd E 1170F Fxnl status assessed M 1175F Function stat assessed rvwd NIM 1180F Thromboemb risk assessed E 1181F Neuropsychia sympts assessed NIM 1182F Neuropsychi sympt 1+present NI E 1183F Neuropsychiatric sympabsent NI E 1200F Seizure type& frequ docd CHM 1205F EPI etiol synd rvwd and docd CHM 1220F Pt screened for depression CHM 1400F Prkns diag rviewed CHM 1450F Symptoms improved/consist NI E 1451F Sympt show clin import drop NI E1460F Qual card diag prior 12 mons NIM

1461F No qual card diag prior12mon NIM 1490F Dem severity classified mild NIM 1491F Dem severity classified mod NIM 1493F Dem severity class severe NIM 1494F Cognit assessed and reviewed NIM 2000F Blood pressure measure M 2001F Weight record E 2002F Clin sign vol ovrld assess E 2004F Initial examinvolved joints E 2010F Vital signs recorded M 2014F Mental status assess M 2015F Asthma impairment assessed NIM 2016F Asthma risk assessed NIM 2018F Hydration status assess E 2019F Dilated macul exam done M 2020F Dilated fundus eval done E 2021F Dilat macul+ exam done M 2022F Dil retina exam interp rev M 2024F 7 field photo interp doc rev M 2026F Eye image valid to dx rev M 2027F Optic nerve head eval done M 2028F Foot exam performed M 2029F Complete phys skin exam done E 2030F H2o stat docd normal E 2031F H2o stat docd dehydrated E 2035F Tympmemb motion examd M 2040F Bk pn xm on init visit date M 2044F Doc mntl tst b/4 bk trxmnt E 2050F Wound char size etc docd E 2060F Pt talk eval hlthwkr re mdd E 3006F Cxr doc rev E 3008F Body

mass index docd E 3011F Lipid panel doc rev E 3014F Screen mammo doc rev M 3015F Cerv cancer screen docd E 3016F Pt scrnd unhlthy OH use M 3017F Colorectal ca screen doc rev M 3018F Pre-prxd rsk et al docd E 3019F Lvef assess planpost dschrge NI E 3020F Lvf assess CHE 3021F Lvef mod/sever deprs syst M 3022F Lvef >=40% systolic M 3023F Spiromdoc rev M 3025F Spiromfev/fvc<70% w/copd M 3027F Spiromfev/fvc>=70%/w/o copd M 3028F O2 saturation doc rev M 3035F O2 saturation<=88% /pao<=55 E 3037F O2 saturation> 88% /pao>55 E 3038F Pulmfx w/in 12 mon b/4 surg M 3040F Fev<40% predicted value E 3042F Fev>=40% predicted value E 3044F Hg a1c level lt 7.0% M 3045F Hg a1c level 7.0-9.0% M 3046F Hemoglobin a1c level > 9.0% M3048F Ldl-c <100 mg/dl M

3049F Ldl-c 100-129 mg/dl M 3050F Ldl-c >= 130 mg/dl M 3055F Lvef less than/equal to 35% NI E 3056F Lvef greater than 35% NI E 3060F Pos microalbuminuria rev M 3061F Neg microalbuminuria rev M 3062F Pos macroalbuminuria rev M 3066F Nephropathy doc tx M 3072F Low risk for retinopathy M 3073F Pre-surg eye measures docd E 3074F Syst bp lt 130 mm hg M 3075F Syst bp ge 130 - 139mm hg M 3077F Syst bp >= 140 mm hg M 3078F Diast bp < 80 mm hg M 3079F Diast bp 80-89 mm hg M 3080F Diast bp >= 90 mm hg M 3082F Kt/v <1.2 CHE 3083F Kt/v > 1.2 <1.7 CHE 3084F Kt/v ge 1.7 CHE 3085F Suicide risk assessed M 3088F Mdd mild E 3089F Mdd moderate E 3090F Mdd severe w/o psych E 3091F Mdd severe w/psych E 3092F Mdd in remission M 3093F Doc new diag 1st/addl mdd E 3095F Central dexa results docd M 3096F Central dexa ordered M 3100F Image test ref carot diam M 3110F Pres/absn hmrhg/lesion docd M 3111F Ct/mri brain done w/in 24hrs M 3112F Ct/mri brain done >24 hrs M 3115F Quant results activity +symp NI E 3117F Hf assessment tool completed NI E 3118F Ny

heart assoc class docd NI E 3119F No eval activity clin symp NI E 3120F 12-lead ecg performed M 3125F Esoph bx rprt w/dyspl info NIM 3130F Upper gi endoscopy performed E 3132F Doc ref upper gi endoscopy E 3140F Upper gi endo shows barrtts E 3141F Upper gi endo not barrtts E 3142F Bariumswallow test ordered E 3150F Forceps esoph biopsy done E 3155F Cy

togen test marrow b/4 tx M 3160F Doc fe+ stores b/4 epo thx M 3170F Flow cy

to done b/4 tx M 3200F Bariumswallow test not req E 3210F Grp a strep test performed M 3215F Pt immunity to hep a docd M 3216F Pt immunity to hep b docd M 3218F Rna tstng hep c docd done M 3220F Hep c quant rna tstng docd M 3230F Note hring tst w/in 6 mon E3250F Nonprim loc anat bx site tum M

3260F Pt cat/pn cat/hist grd docd M 3265F Rna tstng hepc vir ord/docd M 3266F Hepc gn tstng docd b/4txmnt M 3267F path rprt w/ pt pn cat et al NIM 3268F Psa/t/glsc docd b/4 txmnt E 3269F Bone scn b/4 txmnt/aftr Dx M 3270F No bone scn b/4 txmnt/aftrDx M 3271F Low risk prostate cancer M 3272F Med risk prostate cancer M 3273F High risk prostate cancer M 3274F Prost Cncr rsk not lw/md/hgh M 3278F Serum lvls CA/iPTH/lpd ord CHE 3279F Hgb lvl >/= 13 g/dl CHE 3280F Hgb lvl 11-12.9 g/dL CHE 3281F Hgb lvl < 11 g/dl CHE 3284F Iop down >15% of pre-svc lvl M 3285F IOP down <15% of pre-svc lvl M 3288F Fall risk assessment docd M 3290F Pt=D(Rh)- and unsensitized E 3291F Pt=d(rh)+ or sensitized E 3292F Hiv tstng asked/docd/revwd E 3293F Abo rh blood typing docd E 3294F Grp b strep screening docd E 3300F AJCC stage docd b/4 thxpy M 3301F Cancer stage docd metast M 3315F Er+ or pr+ breast cancer M 3316F ER- or PR- breast cancer M 3317F Path rpt malig cancer docd E 3318F Path rpt malig cancer docd E 3319F X-ray

/ct/ultrsnd et al ord M 3320F No xray

/ct/ et al ordd M 3321F AJCC cncr 0/IA melan docd M 3322F Melanoma>ajcc stage 0 or ia M 3323F Clin node stgng docdb/4 surg M 3324F Mri ct scan ord rvwd rqstd E 3325F Preop asses 4 cataract surg E 3328F Prfrmnc docd 2 wks b/4 surg M 3330F Imaging study ordered (bkp) E 3331F Bk imaging tst not ordered E 3340F Mammoassess inc xray docd M 3341F Mammoassess negative docd M 3342F Mammoassess bengn docd M 3343F Mammoprobably bengn docd M 3344F Mammoassess susp docd M 3345F Mammoassess hghlymalig doc M 3350F Mammobx proven malig docd M 3351F Neg scrn dep sympby deptool E 3352F No sig dep sympby dep tool E 3353F Mild-mod dep sympby deptool E 3354F Clin sig dep sym by dep tool E 3370F AJCC brst cncr stage 0 docd M 3372F Ajcc brst cncr stage 1 docd M 3374F Ajcc brst cncr stage 1 docd M 3376F AJCC brstcncr stage 2 docd M3378F AJCC brstcncr stage 3 docd M

3380F AJCC brstcncr stage 4 docd M 3382F AJCC cln cncr stage 0 docd M 3384F AJCC cln cncr stage 1 docd M 3386F AJCC cln cncr stage 2 docd M 3388F AJCC cln cncr stage 3 docd M 3390F AJCC cln cncr stage 4 docd M 3394F Quant her2 ihc eval brst cx NIM 3395F Quant nonher2 ihc brst cx NIM 3450F Dyspnea scrnd no-mild dysp E 3451F Dyspnea scrnd mod-high dysp E 3452F Dyspnea not screened E 3455F TB scrng done-interpd 6mon M 3470F Ra disease activity low M 3471F Ra disease activity mod M 3472F Ra disease activity high M 3475F Disease progn RA poor docd M 3476F Disease progn RA good docd M 3490F History

aids-defining cond M 3491F HIV unsure baby of HIV+moms E 3492F History

cd4+ cell count <350 M 3493F No hist cd4+ cell count<350 M 3494F CD4+cell count <200cells/mm3 M 3495F Cd4+cell cnt 200-499 cells M 3496F Cd4+ cell count + 500 cells M 3497F CD4+ cell percentage <15% E 3498F Cd4+ cell >=15% (hiv) E 3500F Cd4+cell cnt/% docd as done M 3502F HIV rna vrl ld <lmts quantif M 3503F HIV rna vrl ldnot<lmts quntf M 3510F Doc tb scrng-rslts interpd CHM 3511F Chlmyd/gonrh tsts docd done M 3512F Syph scrng docd as done M 3513F Hep B scrng docd as done E 3514F Hep C scrng docd as done E 3515F Pt has docd immun to hep C E 3517F Hbv assess&results intrp 1yr NIM 3520F Cdifficile testing performe NI E 3550F Low rsk thromboembolism E 3551F Intrmed rsk thromboembolism E 3552F Hgh risk for thromboembolism E 3555F Pt inr measurement performed E 3570F Rprt bone scint xref w xray M 3572F Pt consid poss risk fx E 3573F Pt not consid poss risk fx E 3650F Eeg ordered rvwd reqstd E 3700F Psych disorders assessed CHM 3720F Cognit impairment assessed CHM 3725F Screen depression performed NIM 3750F Ptnotrcvngsteroid>/=10mg/day NIM 4000F Tobacco use txmnt counseling NIM 4001F Tobacco use txmnt pharmacol M 4002F Statin therapy rx CHD 4003F Pt ed write/oral pts w/ hf CHE 4004F Pt tobacco screen rcvd tlk M4005F Pharm thx for op rxd M

4006F Beta-blocker therapy rx CHD 4008F Beta-blocker therapy rxd/tkn NIM 4009F Ace/arb inhibitor therapy rx CHD 4010F ACE/ARB therapy rxd/taken NIM 4011F Oral antiplatelet therapy rx CHE 4012F Warfarin therapy rx M 4013F Statin therapy /currently

tkn NIM 4014F Written discharge instr prvd E 4015F Persist asthma medicine ctrl CHE 4016F Anti-inflm/anlgsc agent rx E 4017F Gi prophylaxis for nsaid rx E 4018F Therapy

exercise joint rx E 4019F Doc recpt counsl vit d/calc+ E 4025F Inhaled bronchodilator rx M 4030F Oxygen therapy rx E 4033F Pulmonary

rehab rec E 4035F Influenza imm rec CHM 4037F Influenza imm order/admin M 4040F Pneumoc vac/admin/rcvd M 4041F Doc order cefazolin/cefurox M 4042F Doc antibio not given M 4043F Doc order given stop antibio M 4044F Doc order given vte prophylx M 4045F Empiric antibiotic rx M 4046F Doc antibio given b/4 surg M 4047F Doc antibio given b/4 surg M 4048F Doc antibio given b/4 surg M 4049F Doc order given stop antibio M 4050F Ht care plan doc CHE 4051F Referred for an AV fistula CHE 4052F Hemodialysis via AV fistula E 4053F Hemodialysis via AV graft E 4054F Hemodialysis via catheter E 4055F Pt rcvng periton dialysis E 4056F Approp oral rehyd recommd E 4058F Ped gastro ed given caregvr E 4060F Psych svcs provided E 4062F Pt referral psych docd E 4063F Antidepres rxthxpy not rxd E 4064F Antidepressant rx E 4065F Antipsychotic rx E 4066F ECT provided E 4067F Pt referral for ect docd E 4069F Vte prophylaxis rcvd NI E 4070F Dvt prophylx recvd day 2 M 4073F Oral antiplat thx rx dischrg CHE 4075F Anticoag thx rx at dischrg M 4077F Doc t-pa admin considered E 4079F Doc rehab svcs considered CHE 4084F Aspirin recvd w/in 24 hrs M 4086F Aspirin/clopidogrel rxd NIM 4090F Pt rcvng epo thxpy M 4095F Pt not rcvng epo thxpy M 4100F Biphos thxpy vein ord/recvd M4110F Int mam art used for cabg M

4115F Beta blckr admin w/in 24 hrs M 4120F Antibiot rxd/given M 4124F Antibiot not rxd/given M 4130F Topical prep rx aoe M 4131F Syst antimicrobial thx rx M 4132F No syst antimicrobial thx rx M 4133F Antihist/decong rx/recom E 4134F No antihist/decong rx/recom E 4135F Systemic corticosteroids rx E 4136F Syst corticosteroids not rx E 4140F Inhaled corticosteroids rxd NIM 4142F Corticoster sparng txmnt rxd NIM 4144F Alt long-term cntrl med rxd NIM 4145F 2+ anti-hyprtnsv agents tkn NIM 4148F Hep A vac injxn admin/recvd M 4149F Hep B vac injxn admin/recvd M 4150F Pt recvng antivir txmnt hepc M 4151F Pt not recvng antiv hep c M 4153F Combo pegintf/rib rx M 4155F Hep A vac series prev recvd E 4157F Hep B vac series prev recvd E 4158F Pt edu re alcoh drnkng done M 4159F Contrcp talk b/4 antiv txmnt M 4163F Pt couns 4 txmnt opt prost E 4164F Adjv hrmnl thxpy rxd M 4165F 3d-crt/imrt received M 4167F Hd bed tilted 1st day vent E 4168F Pt care icu&vent w/in 24hrs E 4169F No pt care ICU/vent in 24hrs E 4171F Pt rcvng esa thxpy M 4172F Pt not rcvng esa thxpy M 4174F Couns potent glauc impct E 4175F Vis of >= 20/40 w/in 90 days M 4176F Talk re uv light pt/crgvr E 4177F Talk pt/crgvr re areds prev M 4178F Antid glbln rcvd w/in 26wks E 4179F Tamoxifen/AI prescribed M 4180F Adjv thxpyrxd/rcvd colon ca M 4181F Conformal radn thxpy rcvd E 4182F No conformal radn thxpy E 4185F Continuous ppi or h2ra rcvd E 4186F No cont ppi or h2ra rcvd E 4187F Anti rheum drugthxpyrxd/gvn M 4188F Approp ACE/ARB tstng done E 4189F Approp digoxin tstng done E 4190F Approp diuretic tstng done E 4191F Approp anticonvuls tstng E 4192F Pt not rcvng glucoco thxpy M 4193F Pt rcvng<10mg daily predniso M 4194F Pt rcvng>10mg daily predniso M 4195F Pt rcvng anti-rheum thxpy RA M 4196F Ptnot rcvng anti-rhm thxpyRA M 4200F External beam to prost only M 4201F Extrnl beam other than prost M4210F Ace/arb thxpy for mos/> E 4220F Digoxin thxpy for 6 mos/> E 4221F Diuretic thxpy for 6 mos/> E 4230F Anticonv thxpy for 6 mos/> E 4240F Instr xrcz 4bk pn >12 weeks E 4242F Sprvsd xrcz bk pn >12 weeks E 4245F Pt instr nrml lifest M 4248F Pt instr no bd rest 4 days/> M 4250F Wrmng 4 surg normothermia M 4255F Anesth 60 min/> as docd M 4256F Anesthe <60 min as docd M 4260F Wound srfc culturetech used CHM 4261F Tech other than surfc cultr CHM 4265F Wet-dry

dressings rx recmd CHM 4266F No wet-dry

drssings rx recmd CHM 4267F Comprssion thxpy prescribed M 4268F Pt ed re comp thxpy rcvd E 4269F Appropos mthd offloading Rxd E 4270F Pt rcvng anti r-viral thxpy M 4271F Pt rcvng anti r-viral thxpy M 4274F Flu immuno admind rcvd CHE 4275F Hep b vac inj admin/rcvd CHD 4276F Potent antivir thxpy Rxd M 4279F PCP prophylaxis Rxd E 4280F PCP prophylax Rxd 3mon low % M 4290F Pt scrned for inj drug use M 4293F Pt scrnd hgh-risk sex behav M 4300F Pt rcvng warf thxpy E 4301F Pt not rcvng warf thxpy E 4305F Pt ed re ft care inspct rcvd E 4306F Pt tlk psych & Rx opd addic E 4320F Pt talk psychsoc&rx oh dpnd CHM 4322F Crgvr prov w/ ed addl rsrcs NIM 4324F Pt queried prkns complic E 4325F Med txmnt options rvwd w/pt CHM 4326F Pt asked re sympauto dysfxn E 4328F Pt asked re sleep disturb CHM 4330F Cnslng epi spec sfty issues CHM 4340F Cnslng chldbrng women epi CHM 4350F Cnslng provided sympmngmnt NI E 4400F Rehab thxpy options w/pt CHM 4450F Self-care ed provided to pt NI E 4470F Icd counseling provided NI E 4480F Pt rcvng ace/arb b-blockertx NI E 4481F Pt rcvng ace/arb blker<3mons NI E 4500F Ref to outpt card rehab prog NIM 4510F Prev cardrehab qualcardevent NIM 4525F Neuropsychia interven order NIM 4526F Neuropsychia interven rcvd NIM 5005F Pt counsld on exam for moles E 5010F Macul result to phy mng dm M 5015F Doc fx & test/txmnt for op M 5020F Txmnts 2 main Dr by 1 mon E 5050F Plan 2 main dr by 1 month M 5060F Fndngs mammo 2pt w/in 3 days E5062F Mammoresult com to pt 5 day E

5100F Rsk fx ref w/n 24 hrs xray E 5200F Eval appros surg thxpy epi E 5250F Asthma discharge plan presnt NI E 6005F Care level rationale doc E 6010F Dysphag test done b/4 eating M 6015F Dysphag test done b/4 eating M 6020F Npo (nothing-mouth) ordered M 6030F Max sterile barriers follwd M 6040F Appro rad ds dvcs techs docd E 6045F Radxps in end rprt4fluro pxd M 6070F Pt asked/cnsld aed effects CHM 6080F Pt/caregiver queried falls E 6090F Pt/caregiver counsel safety CHM 6100F Verify

pt site pxd docd NI E 6101F Safety

counseling dementia NIM 6102F Safety

counseling dem order NIM 6110F Counsel prov driving risks NIM 6150F Pt notrcvng1st antitnf txmnt NIM 7010F Pt info into recall system M 7020F Mammoassess cat in dbase E 7025F Pt infosys alarm 4 nxt mammo M A0021 Outside state ambulance serv E A0080 Noninterest escort in non er E A0090 Interest escort in non er E A0100 Nonemergency transport taxi E A0110 Nonemergency transport bus E A0120 Noner transport mini-bus E A0130 Noner transport wheelch van E A0140 Nonemergency transport air E A0160 Noner transport case worker E A0170 Transport parking fees/tolls E A0180 Noner transport lodgng recip E A0190 Noner transport meals recip E A0200 Noner transport lodgng escrt E A0210 Noner transport meals escort E A0225 Neonatal emergency transport E A0380 Basic life support mileage E A0382 Basic support routine suppls A A0384 Bls defibrillation supplies A A0390 Advanced life support mileag E A0392 Als defibrillation supplies A A0394 Als IV drug therapy supplies A A0396 Als esophageal intub suppls A A0398 Als routine disposble suppls A A0420 Ambulance waiting 1/2 hr A A0422 Ambulance 02 life sustaining A A0424 Extra ambulance attendant A A0425 Ground mileage A A0426 Als 1 A A0427 ALS1-emergency A A0428 bls A A0429 BLS-emergency A A0430 Fixed wing air transport A A0431 Rotary

wing air transport AA0432 PI volunteer ambulance co A

A0433 als 2 A A0434 Specialty

care transport A A0435 Fixed wing air mileage A A0436 Rotary

wing air mileage A A0888 Noncovered ambulance mileage E A0998 Ambulance response/treatment E A0999 Unlisted ambulance service A A4206 1 CC sterile syringe&needle E A4207 2 CC sterile syringe&needle E A4208 3 CC sterile syringe&needle E A4209 5+ CC sterile syringe&needle E A4210 Nonneedle injection device E A4211 Supp for self-adm injections E A4212 Non coring needle or stylet B A4213 20+ CC syringe only E A4215 Sterile needle E A4216 Sterile water/saline, 10 ml A A4217 Sterile water/saline, 500 ml A A4218 Sterile saline or water N A4220 Infusion pump refill kit N A4221 Maint drug infus cath per wk Y A4222 Infusion supplies with pump Y A4223 Infusion supplies w/o pump E A4230 Infus insulin pump non needl N A4231 Infusion insulin pump needle N A4232 Syringe w/needle insulin 3cc E A4233 Alkalin batt for glucose mon Y A4234 J-cell batt for glucose mon Y A4235 Lithiumbatt for glucose mon Y A4236 Silvr oxide batt glucose mon Y A4244 Alcohol or peroxide per pint E A4245 Alcohol wipes per box E A4246 Betadine/phisohex solution E A4247 Betadine/iodine swabs/wipes E A4248 Chlorhexidine antisept N A4250 Urine reagent strips/tablets E A4252 Blood ketone test or strip E A4253 Blood glucose/reagent strips Y A4255 Glucose monitor platforms Y A4256 Calibrator solution/chips Y A4257 Replace Lensshield Cartridge Y A4258 Lancet device each Y A4259 Lancets per box Y A4261 Cervical cap contraceptive E A4262 Temporary tear duct plug N A4263 Permanent tear duct plug N A4264 Intratubal occlusion device E A4265 Paraffin Y A4266 Diaphragm E A4267 Male condom E A4268 Female condom E A4269 Spermicide E A4270 Disposable endoscope sheath N A4280 Brst prsths adhsv attchmnt AA4281 Replacement breastpump tube E

A4282 Replacement breastpump adpt E A4283 Replacement breastpump cap E A4284 Replcmnt breast pump shield E A4285 Replcmnt breast pump bottle E A4286 Replcmnt breastpump lok ring E A4290 Sacral nerve stim test lead B A4300 Cath impl vasc access portal N A4301 Implantable access syst perc N A4305 Drug delivery system >=50 ML N A4306 Drug delivery system <=50 ml N A4310 Insert tray

w/o bag/cath A A4311 Catheter w/o bag 2-way latex A A4312 Cath w/o bag 2-way silicone A A4313 Catheter w/bag 3-way A A4314 Cath w/drainage 2-way latex A A4315 Cath w/drainage 2-way silcne A A4316 Cath w/drainage 3-way A A4320 Irrigation tray A A4321 Cath therapeutic irrig agent A A4322 Irrigation syringe A A4326 Male external catheter A A4327 Fem urinary collect dev cup A A4328 Fem urinary collect pouch A A4330 Stool collection pouch A A4331 Extension drainage tubing A A4332 Lube sterile packet A A4333 Urinary

cath anchor device A A4334 Urinary

cath leg strap A A4335 Incontinence supply A A4336 Urethral insert A A4338 Indwelling catheter latex A A4340 Indwelling catheter special A A4344 Cath indw foley 2 way silicn A A4346 Cath indw foley 3 way A A4349 Disposable male external cat A A4351 Straight tip urine catheter A A4352 Coude tip urinary catheter A A4353 Intermittent urinary cath A A4354 Cath insertion tray w/bag A A4355 Bladder irrigation tubing A A4356 Ext ureth clmp or compr dvc A A4357 Bedside drainage bag A A4358 Urinary

leg or abdomen bag A A4360 Disposable ext urethral dev A A4361 Ostomy

face plate A A4362 Solid skin barrier A A4363 Ostomy

clamp, replacement A A4364 Adhesive, liquid or equal A A4366 Ostomy

vent A A4367 Ostomy

belt A A4368 Ostomy

filter A A4369 Skin barrier liquid per oz A A4371 Skin barrier powder per oz A A4372 Skin barrier solid 4x4 equiv AA4373 Skin barrier with flange A

A4375 Drainable plastic pch w fcpl A A4376 Drainable rubber pch w fcplt A A4377 Drainable plstic pch w/o fp A A4378 Drainable rubber pch w/o fp A A4379 Urinary

plastic pouch w fcpl A A4380 Urinary

rubber pouch w fcplt A A4381 Urinary

plastic pouch w/o fp A A4382 Urinary

hvy plstc pch w/o fp A A4383 Urinary

rubber pouch w/o fp A A4384 Ostomy

faceplt/silicone ring A A4385 Ost skn barrier sld ext wear A A4387 Ost clsd pouch w att st barr A A4388 Drainable pch w ex wear barr A A4389 Drainable pch w st wear barr A A4390 Drainable pch ex wear convex A A4391 Urinary

pouch w ex wear barr A A4392 Urinary

pouch w st wear barr A A4393 Urine pch w ex wear bar conv A A4394 Ostomy

pouch liq deodorant A A4395 Ostomy

pouch solid deodorant A A4396 Peristomal hernia supprt blt A A4397 Irrigation supply sleeve A A4398 Ostomy

irrigation bag A A4399 Ostomy

irrig cone/cath w brs A A4400 Ostomy

irrigation set A A4402 Lubricant per ounce A A4404 Ostomy

ring each A A4405 Nonpectin based ostomy paste A A4406 Pectin based ostomy paste A A4407 Ext wear ost skn barr <=4sq" A A4408 Ext wear ost skn barr >4sq" A A4409 Ost skn barr convex <=4 sq i A A4410 Ost skn barr extnd >4 sq A A4411 Ost skn barr extnd =4sq A A4412 Ost pouch drain high output A A4413 2 pc drainable ost pouch A A4414 Ost sknbar w/o conv<=4 sq in A A4415 Ost skn barr w/o conv >4 sqi A A4416 Ost pch clsd w barrier/filtr A A4417 Ost pch w bar/bltinconv/fltr A A4418 Ost pch clsd w/o bar w filtr A A4419 Ost pch for bar w flange/flt A A4420 Ost pch clsd for bar w lk fl A A4421 Ostomy

supply misc E A4422 Ost pouch absorbent material A A4423 Ost pch for bar w lk fl/fltr A A4424 Ost pch drain w bar & filter A A4425 Ost pch drain for barrier fl A A4426 Ost pch drain 2 piece system A A4427 Ost pch drain/barr lk flng/f A A4428 Urine ost pouch w faucet/tap A A4429 Urine ost pouch w bltinconv A A4430 Ost urine pch w b/bltin conv A A4431 Ost pch urine w barrier/tapv AA4432 Os pch urine w bar/fange/tap A

A4433 Urine ost pch bar w lock fln A A4434 Ost pch urine w lock flng/ft A A4450 Non-waterproof tape A A4452 Waterproof tape A A4455 Adhesive remover per ounce A A4456 Adhesive remover, wipes A A4458 Reusable enema bag E A4461 Surgicl dress hold non-reuse A A4463 Surgical dress holder reuse A A4465 Non-elastic extremity binder N A4466 Elastic garment/covering E A4470 Gravlee jet washer N A4480 Vabra aspirator N A4481 Tracheostoma filter A A4483 Moisture exchanger A A4490 Above knee surgical stocking E A4495 Thigh length surg stocking E A4500 Below knee surgical stocking E A4510 Full length surg stocking E A4520 Incontinence garment any type E A4550 Surgical trays B A4554 Disposable underpads E A4556 Electrodes, pair Y A4557 Lead wires, pair Y A4558 Conductive gel or paste Y A4559 Coupling gel or paste Y A4561 Pessary

rubber, any

type N A4562 Pessary, non rubber,any type N A4565 Slings N A4566 Should sling/vest/abrestrain E A4570 Splint E A4575 Hyperbaric o2 chamber disps E A4580 Cast supplies (plaster) E A4590 Special casting material E A4595 TENS suppl 2 lead per month Y A4600 Sleeve, inter limb comp dev Y A4601 Lith ion batt, non-pros use Y A4604 Tubing with heating element Y A4605 Trach suction cath close sys Y A4606 Oxygen probe used w oximeter A A4608 Transtracheal oxygen cath Y A4611 Heavy

duty battery Y A4612 Battery

cables Y A4613 Battery

charger Y A4614 Hand-held PEFR meter Y A4615 Cannula nasal Y A4616 Tubing (oxygen) per foot Y A4617 Mouth piece Y A4618 Breathing circuits Y A4619 Face tent Y A4620 Variable concentration mask Y A4623 Tracheostomy inner cannula A A4624 Tracheal suction tube Y A4625 Trach care kit for new trach AA4626 Tracheostomy cleaning brush A A4627 Spacer bag/reservoir E A4628 Oropharyngeal suction cath Y A4629 Tracheostomy care kit A A4630 Repl bat t.e.n.s. own by pt Y A4633 Uvl replacement bulb Y A4634 Replacement bulb th lightbox A A4635 Underarm crutch pad Y A4636 Handgrip for cane etc Y A4637 Repl tip cane/crutch/walker Y A4638 Repl batt pulse gen sys Y A4639 Infrared ht sys replcmnt pad Y A4640 Alternating pressure pad Y A4641 Radiopharm dx agent noc N A4642 In111 satumomab N A4648 Implantable tissue marker N A4649 Surgical supplies N A4650 Implant radiation dosimeter N A4651 Calibrated microcap tube A A4652 Microcapillary tube sealant A A4653 PD catheter anchor belt A A4657 Syringe w/wo needle N A4660 Sphyg/bp app w cuff and stet N A4663 Dialysis blood pressure cuff N A4670 Automatic bp monitor, dial E A4671 Disposable cycler set B A4672 Drainage ext line, dialysis B A4673 Ext line w easy lock connect B A4674 Chem/antisept solution, 8oz B A4680 Activated carbon filter, ea N A4690 Dialy

zer, each N A4706 Bicarbonate conc sol per gal N A4707 Bicarbonate conc pow per pac N A4708 Acetate conc sol per gallon N A4709 Acid conc sol per gallon N A4714 Treated water per gallon N A4719 "Y set" tubing N A4720 Dialysat sol fld vol > 249cc N A4721 Dialysat sol fld vol > 999cc N A4722 Dialys sol fld vol > 1999cc N A4723 Dialys sol fld vol > 2999cc N A4724 Dialys sol fld vol > 3999cc N A4725 Dialys sol fld vol > 4999cc N A4726 Dialys sol fld vol > 5999cc N A4728 Dialysate solution, non-dex B A4730 Fistula cannulation set, ea N A4736 Topical anesthetic, per gram N A4737 Inj anesthetic per 10 ml N A4740 Shunt accessory N A4750 Art or venous blood tubing N A4755 Comb art/venous blood tubing N A4760 Dialysate sol test kit, each N A4765 Dialysate conc pow per pack N A4766 Dialysate conc sol add 10 ml N A4770 Blood collection tube/vacuum NA4771 Serum clotting time tube N

A4772 Blood glucose test strips N A4773 Occult blood test strips N A4774 Ammonia test strips N A4802 Protamine sulfate per 50 mg N A4860 Disposable catheter tips N A4870 Plumb/elec wk hm hemo equip N A4890 Repair/maint cont hemo equip N A4911 Drain bag/bottle N A4913 Misc dialysis supplies noc N A4918 Venous pressure clamp N A4927 Non-sterile gloves N A4928 Surgical mask N A4929 Tourniquet for dialysis, ea N A4930 Sterile, gloves per pair N A4931 Reusable oral thermometer N A4932 Reusable rectal thermometer E A5051 Pouch clsd w barr attached A A5052 Clsd ostomy pouch w/o barr A A5053 Clsd ostomy pouch faceplate A A5054 Clsd ostomy pouch w/flange A A5055 Stoma cap A A5056 1 pc ost pouch w filter NIA A5057 1 pc ost pou w built-in conv NIA A5061 Pouch drainable w barrier at A A5062 Drnble ostomy pouch w/o barr A A5063 Drain ostomy pouch w/flange A A5071 Urinary

pouch w/barrier A A5072 Urinary

pouch w/o barrier A A5073 Urinary

pouch on barr w/flng A A5081 Continent stoma plug A A5082 Continent stoma catheter A A5083 Stoma absorptive cover A A5093 Ostomy

accessory

convex inse A A5102 Bedside drain btl w/wo tube A A5105 Urinary

suspensory A A5112 Urinary

leg bag A A5113 Latex leg strap A A5114 Foam/fabric leg strap A A5120 Skin barrier, wipe or swab A A5121 Solid skin barrier 6x6 A A5122 Solid skin barrier 8x8 A A5126 Disk/foam pad +or- adhesive A A5131 Appliance cleaner A A5200 Percutaneous catheter anchor A A5500 Diab shoe for density insert Y A5501 Diabetic custom molded shoe Y A5503 Diabetic shoe w/roller/rockr Y A5504 Diabetic shoe with wedge Y A5505 Diab shoe w/metatarsal bar Y A5506 Diabetic shoe w/off set heel Y A5507 Modification diabetic shoe Y A5508 Diabetic deluxe shoe Y A5510 Compression form shoe insert E A5512 Multi den insert direct form YA5513 Multi den insert custom mold Y

A6000 Wound warming wound cover E A6010 Collagen based wound filler A A6011 Collagen gel/paste wound fil A A6021 Collagen dressing <=16 sq in A A6022 Collagen drsg>16<=48 sq in A A6023 Collagen dressing >48 sq in A A6024 Collagen dsg wound filler A A6025 Silicone gel sheet, each E A6154 Wound pouch each A A6196 Alginate dressing <=16 sq in A A6197 Alginate drsg >16 <=48 sq in A A6198 alginate dressing > 48 sq in A A6199 Alginate drsg wound filler A A6203 Composite drsg <= 16 sq in A A6204 Composite drsg >16<=48 sq in A A6205 Composite drsg > 48 sq in A A6206 Contact layer <= 16 sq in A A6207 Contact layer >16<= 48 sq in A A6208 Contact layer > 48 sq in A A6209 Foam drsg <=16 sq in w/o bdr A A6210 Foam drg >16<=48 sq in w/o b A A6211 Foam drg > 48 sq in w/o brdr A A6212 Foam drg <=16 sq in w/border A A6213 Foam drg >16<=48 sq in w/bdr A A6214 Foam drg > 48 sq in w/border A A6215 Foam dressing wound filler A A6216 Non-sterile gauze<=16 sq in A A6217 Non-sterile gauze>16<=48 sq A A6218 Non-sterile gauze > 48 sq in A A6219 Gauze <= 16 sq in w/border A A6220 Gauze >16 <=48 sq in w/bordr A A6221 Gauze > 48 sq in w/border A A6222 Gauze <=16 in no w/sal w/o b A A6223 Gauze >16<=48 no w/sal w/o b A A6224 Gauze > 48 in no w/sal w/o b A A6228 Gauze <= 16 sq in water/sal A A6229 Gauze >16<=48 sq in watr/sal A A6230 Gauze > 48 sq in water/salne A A6231 Hydrogel dsg<=16 sq in A A6232 Hydrogel dsg>16<=48 sq in A A6233 Hydrogel dressing >48 sq in A A6234 Hydrocolld drg <=16 w/o bdr A A6235 Hydrocolld drg >16<=48 w/o b A A6236 Hydrocolld drg > 48 in w/o b A A6237 Hydrocolld drg <=16 in w/bdr A A6238 Hydrocolld drg >16<=48 w/bdr A A6239 Hydrocolld drg > 48 in w/bdr A A6240 Hydrocolld drg filler paste A A6241 Hydrocolloid drg filler dry A A6242 Hydrogel drg <=16 in w/o bdr A A6243 Hydrogel drg >16<=48 w/o bdr A A6244 Hydrogel drg >48 in w/o bdr A A6245 Hydrogel drg <= 16 in w/bdr A A6246 Hydrogel drg >16<=48 in w/b AA6247 Hydrogel drg > 48 sq in w/b A

A6248 Hydrogel drsg gel filler A A6250 Skin seal protect moisturizr A A6251 Absorpt drg <=16 sq in w/o b A A6252 Absorpt drg >16 <=48 w/o bdr A A6253 Absorpt drg > 48 sq in w/o b A A6254 Absorpt drg <=16 sq in w/bdr A A6255 Absorpt drg >16<=48 in w/bdr A A6256 Absorpt drg > 48 sq in w/bdr A A6257 Transparent film <= 16 sq in A A6258 Transparent film >16<=48 in A A6259 Transparent film > 48 sq in A A6260 Wound cleanser any type/size A A6261 Wound filler gel/paste /oz A A6262 Wound filler dry form / gram A A6266 Impreg gauze no h20/sal/yard A A6402 Sterile gauze <= 16 sq in A A6403 Sterile gauze>16 <= 48 sq in A A6404 Sterile gauze > 48 sq in A A6407 Packing strips, non-impreg A A6410 Sterile eye pad A A6411 Non-sterile eye pad A A6412 Occlusive eye patch A A6413 Adhesive bandage, first-aid E A6441 Pad band w>=3" <5"/yd A A6442 Conform band n/s w<3"/yd A A6443 Conform band n/s w>=3"<5"/yd A A6444 Conform band n/s w>=5"/yd A A6445 Conform band s w <3"/yd A A6446 Conform band s w>=3" <5"/yd A A6447 Conform band s w >=5"/yd A A6448 Lt compres band <3"/yd A A6449 Lt compres band >=3" <5"/yd A A6450 Lt compres band >=5"/yd A A6451 Mod compres band w>=3"<5"/yd A A6452 High compres band w>=3"<5"yd A A6453 Self-adher band w <3"/yd A A6454 Self-adher band w>=3" <5"/yd A A6455 Self-adher band >=5"/yd A A6456 Zinc paste band w >=3"<5"/yd A A6457 Tubular dressing A A6501 Compres burngarment bodysuit A A6502 Compres burngarment chinstrp A A6503 Compres burngarment facehood A A6504 Cmprsburngarment glove-wrist A A6505 Cmprsburngarment glove-elbow A A6506 Cmprsburngrmnt glove-axilla A A6507 Cmprs burngarment foot-knee A A6508 Cmprs burngarment foot-thigh A A6509 Compres burn garment jacket A A6510 Compres burn garment leotard A A6511 Compres burn garment panty A A6512 Compres burn garment, noc A A6513 Compress burn mask face/neck B A6530 Compression stocking BK18-30 EA6531 Compression stocking BK30-40 A

A6532 Compression stocking BK40-50 A A6533 Gc stocking thighlngth 18-30 E A6534 Gc stocking thighlngth 30-40 E A6535 Gc stocking thighlngth 40-50 E A6536 Gc stocking full lngth 18-30 E A6537 Gc stocking full lngth 30-40 E A6538 Gc stocking full lngth 40-50 E A6539 Gc stocking waistlngth 18-30 E A6540 Gc stocking waistlngth 30-40 E A6541 Gc stocking waistlngth 40-50 E A6544 Gc stocking garter belt E A6545 Grad comp non-elastic BK A A6549 G compression stocking E A6550 Neg pres wound ther drsg set Y A7000 Disposable canister for pump Y A7001 Nondisposable pump canister Y A7002 Tubing used w suction pump Y A7003 Nebulizer administration set Y A7004 Disposable nebulizer sml vol Y A7005 Nondisposable nebulizer set Y A7006 Filtered nebulizer admin set Y A7007 Lg vol nebulizer disposable Y A7008 Disposable nebulizer prefill Y A7009 Nebulizer reservoir bottle Y A7010 Disposable corrugated tubing Y A7011 Nondispos corrugated tubing Y A7012 Nebulizer water collec devic Y A7013 Disposable compressor filter Y A7014 Compressor nondispos filter Y A7015 Aerosol mask used w nebulize Y A7016 Nebulizer dome & mouthpiece Y A7017 Nebulizer not used w oxygen Y A7018 Water distilled w/nebulizer Y A7020 Interface, cough stim device Y A7025 Replace chest compress vest Y A7026 Replace chst cmprss sys hose Y A7027 Combination oral/nasal mask Y A7028 Repl oral cushion combo mask Y A7029 Repl nasal pillow comb mask Y A7030 CPAP full face mask Y A7031 Replacement facemask interfa Y A7032 Replacement nasal cushion Y A7033 Replacement nasal pillows Y A7034 Nasal application device Y A7035 Pos airway press headgear Y A7036 Pos airway press chinstrap Y A7037 Pos airway pressure tubing Y A7038 Pos airway pressure filter Y A7039 Filter, non disposable w pap Y A7040 One way

chest drain valve A A7041 Water seal drain container A A7042 Implanted pleural catheter N A7043 Vacuum drainagebottle/tubing A A7044 PAP oral interface YA7045 Repl exhalation port for PAP Y

A7046 Repl water chamber, PAP dev Y A7501 Tracheostoma valve w diaphra A A7502 Replacement diaphragm/fplate A A7503 HMES filter holder or cap A A7504 Tracheostoma HMES filter A A7505 HMES or trach valve housing A A7506 HMES/trachvalve adhesivedisk A A7507 Integrated filter & holder A A7508 Housing & Integrated Adhesiv A A7509 Heat & moisture exchange sys A A7520 Trach/laryn tube non-cuffed A A7521 Trach/laryn tube cuffed A A7522 Trach/laryn tube stainless A A7523 Tracheostomy shower protect A A7524 Tracheostoma stent/stud/bttn A A7525 Tracheostomy mask A A7526 Tracheostomy tube collar A A7527 Trach/laryn tube plug/stop A A8000 Soft protect helmet prefab Y A8001 Hard protect helmet prefab Y A8002 Soft protect helmet custom Y A8003 Hard protect helmet custom Y A8004 Repl soft interface, helmet Y A9150 Misc/exper non-prescript dru B A9152 Single vitamin nos E A9153 Multi-vitamin nos E A9155 Artificial saliva B A9180 Lice treatment, topical E A9270 Non-covered item or service E A9272 Disposable mech wound suct NI E A9273 Hot/cold h2obot/cap/col/wrap Y A9274 Ext amb insulin delivery sys E A9275 Disp home glucose monitor E A9276 Disposable sensor, CGM sys E A9277 External transmitter, CGM E A9278 External receiver, CGM sys E A9279 Monitoring feature/deviceNOC E A9280 Alert device, noc E A9281 Reaching/grabbing device E A9282 Wig any

type E A9283 Foot press off load supp dev E A9284 Non-electronic spirometer N A9300 Exercise equipment E A9500 Tc99m sestamibi N A9501 Technetium TC-99m teboroxime N A9502 Tc99m tetrofosmin N A9503 Tc99m medronate N A9504 Tc99m apcitide N A9505 TL201 thallium N A9507 In111 capromab N A9508 I131 iodobenguate, dx N A9509 Iodine I-123 sod iodide mil N A9510 Tc99m disofenin N A9512 Tc99m pertechnetate NA9516 Iodine I-123 sod iodide mic N

A9517 I131 iodide cap, rx K 1064 A9521 Tc99m exametazime N A9524 I131 serum albumin, dx N A9526 Nitrogen N-13 ammonia N A9527 Iodine I-125 sodium iodide U 2632 A9528 Iodine I-131 iodide cap, dx N A9529 I131 iodide sol, dx N A9530 I131 iodide sol, rx K 1150 A9531 I131 max 100uCi N A9532 I125 serum albumin, dx N A9536 Tc99m depreotide N A9537 Tc99m mebrofenin N A9538 Tc99m pyrophosphate N A9539 Tc99m pentetate N A9540 Tc99m MAA N A9541 Tc99m sulfur colloid N A9542 In111 ibritumomab, dx N A9543 Y90 ibritumomab, rx K 1643 A9544 I131 tositumomab, dx N A9545 I131 tositumomab, rx K 1645 A9546 Co57/58 N A9547 In111 oxyquinoline N A9548 In111 pentetate N A9550 Tc99m gluceptate N A9551 Tc99m succimer N A9552 F18 fdg N A9553 Cr51 chromate N A9554 I125 iothalamate, dx N A9555 Rb82 rubidium N A9556 Ga67 gallium N A9557 Tc99m bicisate N A9558 Xe133 xenon 10mci N A9559 Co57 cyano N A9560 Tc99m labeled rbc N A9561 Tc99m oxidronate N A9562 Tc99m mertiatide N A9563 P32 Na phosphate K 1675 A9564 P32 chromic phosphate K 1676 A9566 Tc99m fanolesomab N A9567 Technetium TC-99m aerosol N A9568 Technetium tc99m arcitumomab N A9569 Technetium TC-99m auto WBC N A9570 IndiumIn-111 auto WBC N A9571 IndiumIN-111 auto platelet N A9572 IndiumIn-111 pentetreotide N A9576 Inj prohance multipack N A9577 Inj multihance N A9578 Inj multihance multipack N A9579 Gad-base MR contrast NOS,1ml N A9580 Sodiumfluoride F-18 N A9581 Gadoxetate disodium inj N A9582 Iodine I-123 iobenguane CHN A9583 Gadofosveset trisodium inj CHN A9584 Iodine i-123 ioflupane NIG 9406A9585 Gadobutrol injection NIN

A9600 Sr89 strontium K 0701 A9604 Sm153 lexidronam K 1295 A9698 Non-rad contrast materialNOC N A9699 Radiopharm rx agent noc N A9700 Echocardiography Contrast B A9900 Supply

/accessory

/service Y A9901 Delivery

/set up/dispensing A A9999 DME supply or accessory, nos Y B4034 Enter feed supkit syr by day Y B4035 Enteral feed supp pump per d Y B4036 Enteral feed sup kit grav by Y B4081 Enteral ng tubing w/ stylet Y B4082 Enteral ng tubing w/o stylet Y B4083 Enteral stomach tube levine Y B4087 Gastro/jejuno tube, std A B4088 Gastro/jejuno tube, low-pro A B4100 Food thickener oral E B4102 EF adult fluids and electro Y B4103 EF ped fluid and electroly te Y B4104 Additive for enteral formula E B4149 EF blenderized foods Y B4150 EF complet w/intact nutrient Y B4152 EF calorie dense>/=1.5Kcal Y B4153 EF hydroly

zed/amino acids Y B4154 EF spec metabolic noninherit Y B4155 EF incomplete/modular Y B4157 EF special metabolic inherit Y B4158 EF ped complete intact nut Y B4159 EF ped complete soy based Y B4160 EF ped caloric dense>/=0.7kc Y B4161 EF ped hydroly zed/amino acid Y B4162 EF ped specmetabolic inherit Y B4164 Parenteral 50% dextrose solu Y B4168 Parenteral sol amino acid 3. Y B4172 Parenteral sol amino acid 5. Y B4176 Parenteral sol amino acid 7- Y B4178 Parenteral sol amino acid > Y B4180 Parenteral sol carb > 50% Y B4185 Parenteral sol 10 gm lipids B B4189 Parenteral sol amino acid & Y B4193 Parenteral sol 52-73 gm prot Y B4197 Parenteral sol 74-100 gm pro Y B4199 Parenteral sol > 100gm prote Y B4216 Parenteral nutrition additiv Y B4220 Parenteral supply kit premix Y B4222 Parenteral supply kit homemi Y B4224 Parenteral administration ki Y B5000 Parenteral sol renal-amirosy Y B5100 Parenteral sol hepatic-fream Y B5200 Parenteral sol stres-brnch c Y B9000 Enter infusion pump w/o alrm Y B9002 Enteral infusion pump w/ ala Y B9004 Parenteral infus pump portab Y B9006 Parenteral infus pump statio YB9998 Enteral supp not otherwise c Y

B9999 Parenteral supp not othrws c Y C1300 HYPERBARIC Oxygen S 0659 C1713 Anchor/screw bn/bn,tis/bn N C1714 Cath, trans atherectomy, dir N C1715 Brachy

therapy needle N C1716 Brachy

tx, non-str, Gold-198 U 1716 C1717 Brachy

tx, non-str,HDR Ir-192 U 1717 C1719 Brachy

tx, NS, Non-HDRIr-192 U 1719 C1721 AICD, dual chamber N C1722 AICD, single chamber N C1724 Cath, trans atherec,rotation N C1725 Cath, translumin non-laser N C1726 Cath, bal dil, non-vascular N C1727 Cath, bal tis dis, non-vas N C1728 Cath, brachy tx seed adm N C1729 Cath, drainage N C1730 Cath, EP, 19 or few elect N C1731 Cath, EP, 20 or more elec N C1732 Cath, EP, diag/abl, 3D/vect N C1733 Cath, EP, othr than cool-tip N C1749 Endo, colon, retro imaging H 1749 C1750 Cath, hemodialysis,long-term N C1751 Cath, inf, per/cent/midline N C1752 Cath,hemodialysis,short-term N C1753 Cath, intravas ultrasound N C1754 Catheter, intradiscal N C1755 Catheter, intraspinal N C1756 Cath, pacing, transesoph N C1757 Cath, thrombectomy /embolect N C1758 Catheter, ureteral N C1759 Cath, intra echocardiography N C1760 Closure dev, vasc N C1762 Conn tiss, human(inc fascia) N C1763 Conn tiss, non-human N C1764 Event recorder, cardiac N C1765 Adhesion barrier N C1766 Intro/sheath,strble,non-peel N C1767 Generator, neuro non-recharg N C1768 Graft, vascular N C1769 Guide wire N C1770 Imaging coil, MR, insertable N C1771 Rep dev, urinary, w/sling N C1772 Infusion pump, programmable N C1773 Ret dev, insertable N C1776 Joint device (implantable) N C1777 Lead, AICD, endo single coil N C1778 Lead, neurostimulator N C1779 Lead, pmkr, transvenous VDD N C1780 Lens, intraocular (new tech) N C1781 Mesh (implantable) N C1782 Morcellator N C1783 Ocular imp, aqueous drain de N C1784 Ocular dev, intraop, det ret N C1785 Pmkr, dual, rate-resp NC1786 Pmkr, single, rate-resp N

C1787 Patient progr, neurostim N C1788 Port, indwelling, imp N C1789 Prosthesis, breast, imp N C1813 Prosthesis, penile, inflatab N C1814 Retinal tamp, silicone oil N C1815 Pros, urinary sph, imp N C1816 Receiver/transmitter, neuro N C1817 Septal defect imp sys N C1818 Integrated keratoprosthesis N C1819 Tissue localization-excision N C1820 Generator neuro rechg bat sy N C1821 Interspinous implant N C1830 Power bone marrow bx needle H 1830 C1840 Telescopic intraocular lens H 1840 C1874 Stent, coated/cov w/del sys N C1875 Stent, coated/cov w/o del sy N C1876 Stent, non-coa/non-cov w/del N C1877 Stent, non-coat/cov w/o del N C1878 Matrl for vocal cord N C1879 Tissue marker, implantable N C1880 Vena cava filter N C1881 Dialysis access system N C1882 AICD, other than sing/dual N C1883 Adapt/ext, pacing/neuro lead N C1884 Embolization Protect syst N C1885 Cath, translumin angio laser N C1886 Catheter, ablation NIH 1886 C1887 Catheter, guiding N C1888 Endovas non-cardiac abl cath N C1891 Infusion pump,non-prog, perm N C1892 Intro/sheath,fixed,peel-away N C1893 Intro/sheath, fixed,non-peel N C1894 Intro/sheath, non-laser N C1895 Lead, AICD, endo dual coil N C1896 Lead, AICD, non sing/dual N C1897 Lead, neurostim test kit N C1898 Lead, pmkr, other than trans N C1899 Lead, pmkr/AICD combination N C1900 Lead, coronary venous N C2614 Probe, perc lumb disc N C2615 Sealant, pulmonary, liquid N C2616 Brachy

tx, non-str,Yttrium-90 U 2616 C2617 Stent, non-cor, tem w/o del N C2618 Probe, cryoablation N C2619 Pmkr, dual, non rate-resp N C2620 Pmkr, single, non rate-resp N C2621 Pmkr, other than sing/dual N C2622 Prosthesis, penile, non-inf N C2625 Stent, non-cor, tem w/del sy N C2626 Infusion pump, non-prog,temp N C2627 Cath, suprapubic/cystoscopic N C2628 Catheter, occlusion N C2629 Intro/sheath, laser N C2630 Cath, EP, cool-tip NC2631 Rep dev, urinary, w/o sling N

C2634 Brachy

tx, non-str, HA, I-125 U 2634 C2635 Brachy

tx, non-str, HA, P-103 U 2635 C2636 Brachy

linear, non-str,P-103 U 2636 C2637 Brachy,non-str,Ytterbium-169 B C2638 Brachy

tx, stranded, I-125 U 2638 C2639 Brachy

tx, non-stranded,I-125 U 2639 C2640 Brachy

tx, stranded, P-103 U 2640 C2641 Brachy

tx, non-stranded,P-103 U 2641 C2642 Brachy

tx, stranded, C-131 U 2642 C2643 Brachy

tx, non-stranded,C-131 U 2643 C2698 Brachy

tx, stranded, NOS U 2698 C2699 Brachy

tx, non-stranded, NOS U 2699 C8900 MRA w/cont, abd Q3 0284 C8901 MRA w/o cont, abd Q3 0336 C8902 MRA w/o fol w/cont, abd Q3 0337 C8903 MRI w/cont, breast, uni Q3 0284 C8904 MRI w/o cont, breast, uni Q3 0336 C8905 MRI w/o fol w/cont, brst, un Q3 0337 C8906 MRI w/cont, breast, bi Q3 0284 C8907 MRI w/o cont, breast, bi Q3 0336 C8908 MRI w/o fol w/cont, breast, Q3 0337 C8909 MRA w/cont, chest Q3 0284 C8910 MRA w/o cont, chest Q3 0336 C8911 MRA w/o fol w/cont, chest Q3 0337 C8912 MRA w/cont, lwr ext Q3 0284 C8913 MRA w/o cont, lwr ext Q3 0336 C8914 MRA w/o fol w/cont, lwr ext Q3 0337 C8918 MRA w/cont, pelvis Q3 0284 C8919 MRA w/o cont, pelvis Q3 0336 C8920 MRA w/o fol w/cont, pelvis Q3 0337 C8921 TTE w or w/o fol w/cont, com S 0128 C8922 TTE w or w/o fol w/cont, f/u S 0128 C8923 2D TTE w or w/o fol w/con,co S 0128 C8924 2D TTE w or w/o fol w/con,fu S 0128 C8925 2D TEE w or w/o fol w/con,in S 0128 C8926 TEE w or w/o fol w/cont,cong S 0128 C8927 TEE w or w/o fol w/cont, mon S 0128 C8928 TTE w or w/o fol w/con,stres S 0128 C8929 TTE w or wo fol wcon,Doppler S 0128 C8930 TTE w or w/o contr, cont ECG S 0128 C8931 MRA, w/dye, spinal canal Q3 0284 C8932 MRA, w/o dye, spinal canal Q3 0336 C8933 MRA, w/o&w/dye, spinal canal Q3 0337 C8934 MRA, w/dye, upper extremity Q3 0284 C8935 MRA, w/o dye, upper extr Q3 0336 C8936 MRA, w/o&w/dye, upper extr Q3 0337 C8957 Prolonged IV inf, req pump S 0440 C9113 Inj pantoprazole sodium, via N C9121 Injection, argatroban K 9121 C9248 Inj, clevidipine butyrate K 9248 C9250 Artiss fibrin sealant CHK 9250 C9254 Injection, lacosamide K 9254 C9257 Bevacizumab injection K 1281 C9270 Gammaplex IVIG CHDC9272 Inj, denosumab CHD

C9274 Crotalidae Poly Immune Fab CHD C9275 Hexaminolevulinate HCl G 9275 C9276 Cabazitaxel injection CHD C9277 Lumizyme, 1 mg CHD C9279 Injection, ibuprofen G 9279 C9280 Injection, eribulin mesylate CHD C9281 Injection, pegloticase CHD C9282 Inj, ceftaroline fosamil CHD C9283 Injection, acetaminophen CHD C9284 Injection, ipilimumab CHD C9285 Patch, lidocaine/tetracaine G 9285 C9286 Injection, belatacept G 9286 C9287 Inj, brentuximab vedotin NIG 9287 C9352 Neuragen nerve guide, per cm N C9353 Neurawrap nerve protector,cm N C9354 Veritas collagen matrix, cm2 N C9355 Neuromatrix nerve cuff, cm N C9356 TenoGlide tendon prot, cm2 N C9358 SurgiMend, fetal K 9358 C9359 Implnt,bon void filler-putty N C9360 SurgiMend, neonatal CHK 9360 C9361 NeuroMend nerve wrap CHN C9362 Implnt,bon void filler-strip CHN C9363 Integra Meshed Bil Wound Mat CHK 9363 C9364 Porcine implant, Permacol CHN C9365 Oasis Ultra Tri-Layer Matrix CHD C9366 EpiFix wound cover NIG 9366 C9367 Endoform Dermal Template G 9367 C9399 Unclassified drugs or biolog A C9406 Dx I-123 ioflupane, per dose CHD C9716 Radiofrequency energy to anu T 0150 C9724 EPS gast cardia plic T 0422 C9725 Place endorectal app T 0148 C9726 Rxt breast appl place/remov T 0028 C9727 Insert palate implants T 0252 C9728 Place device/marker, non pro X 0310 C9730 Bronchial thermo, 1 lobe CHD C9731 Bronchial thermo, >1 lobe CHD C9732 Insert ocular telescope pros NIT 0234 C9800 Dermal filler inj px/suppl T 0135 C9898 Inpnt stay

radiolabeled item N C9899 Inpt implant pros dev,no cov A D0120 Periodic oral evaluation E D0140 Limit oral eval problmfocus E D0145 Oral evaluation, pt < 3yrs E D0150 Comprehensve oral evaluation S 0330 D0160 Extensv oral eval prob focus E D0170 Re-eval,est pt,problem focus E D0180 Comp periodontal evaluation E D0210 Intraor complete film series E D0220 Intraoral periapical first f E D0230 Intraoral periapical ea add E D0240 Intraoral occlusal film S 0330 D0250 Extraoral first film S 0330D0260 Extraoral ea additional film S 0330

D0270 Dental bitewing single film S 0330 D0272 Dental bitewings two films S 0330 D0273 Bitewings - three films E D0274 Dental bitewings four films S 0330 D0277 Vert bitewings-sev to eight S 0330 D0290 Dental film skull/facial bon E D0310 Dental saliography E D0320 Dental tmj arthrogram incl i E D0321 Dental other tmj films E D0322 Dental tomographic survey E D0330 Dental panoramic film E D0340 Dental cephalometric film E D0350 Oral/facial photo images E D0360 Cone beam ct E D0362 Cone beam, two dimensional E D0363 Cone beam, three dimensional E D0415 Collection of microorganisms E D0416 Viral culture B D0417 Collect & prep saliva sample E D0418 Analysis of saliva sample E D0421 Gen tst suscept oral disease B D0425 Caries susceptibility test E D0431 Diag tst detect mucos abnorm B D0460 Pulp vitality test S 0330 D0470 Diagnostic casts E D0472 Gross exam, prep & report B D0473 Micro exam, prep & report B D0474 Micro w exam of surg margins B D0475 Decalcification procedure B D0476 Spec stains for microorganis B D0477 Spec stains not for microorg B D0478 Immunohistochemical stains B D0479 Tissue in-situ hybridization B D0480 Cy

topath smear prep & report B D0481 Electron microscopy diagnost B D0482 Direct immunofluorescence B D0483 Indirect immunofluorescence B D0484 Consult slides prep elsewher B D0485 Consult inc prep of slides B D0486 Access of transep cy tol samp E D0502 Other oral pathology procedu B D0999 Unspecified diagnostic proce B D1110 Dental prophylaxis adult E D1120 Dental prophylaxis child E D1203 Topical app fluoride child E D1204 Topical app fluoride adult E D1206 Topical fluoride varnish E D1310 Nutri counsel-control caries E D1320 Tobacco counseling E D1330 Oral hygiene instruction E D1351 Dental sealant per tooth E D1352 Prev resin rest, perm tooth E D1510 Space maintainer fxd unilat S 0330 D1515 Fixed bilat space maintainer S 0330D1520 Remove unilat space maintain S 0330

D1525 Remove bilat space maintain S 0330 D1550 Recement space maintainer S 0330 D1555 Remove fix space maintainer E D2140 Amalgamone surface permanen E D2150 Amalgamtwo surfaces permane E D2160 Amalgamthree surfaces perma E D2161 Amalgam4 or > surfaces perm E D2330 Resin one surface-anterior E D2331 Resin two surfaces-anterior E D2332 Resin three surfaces-anterio E D2335 Resin 4/> surf or w incis an E D2390 Ant resin-based cmpst crown E D2391 Post 1 srfc resinbased cmpst E D2392 Post 2 srfc resinbased cmpst E D2393 Post 3 srfc resinbased cmpst E D2394 Post >=4srfc resinbase cmpst E D2410 Dental gold foil one surface E D2420 Dental gold foil two surface E D2430 Dental gold foil three surfa E D2510 Dental inlay metalic 1 surf E D2520 Dental inlay metallic 2 surf E D2530 Dental inlay metl 3/more sur E D2542 Dental onlay metallic 2 surf E D2543 Dental onlay metallic 3 surf E D2544 Dental onlay metl 4/more sur E D2610 Inlay

porcelain/ceramic 1 su E D2620 Inlay

porcelain/ceramic 2 su E D2630 Dental onlay porc 3/more sur E D2642 Dental onlay porcelin 2 surf E D2643 Dental onlay porcelin 3 surf E D2644 Dental onlay porc 4/more sur E D2650 Inlay

composite/resin one su E D2651 Inlay

composite/resin two su E D2652 Dental inlay resin 3/mre sur E D2662 Dental onlay resin 2 surface E D2663 Dental onlay resin 3 surface E D2664 Dental onlay resin 4/mre sur E D2710 Crown resin-based indirect E D2712 Crown 3/4 resin-based compos E D2720 Crown resin w/ high noble me E D2721 Crown resin w/ base metal E D2722 Crown resin w/ noble metal E D2740 Crown porcelain/ceramic subs E D2750 Crown porcelain w/ h noble m E D2751 Crown porcelain fused base m E D2752 Crown porcelain w/ noble met E D2780 Crown 3/4 cast hi noble met E D2781 Crown 3/4 cast base metal E D2782 Crown 3/4 cast noble metal E D2783 Crown 3/4 porcelain/ceramic E D2790 Crown full cast high noble m E D2791 Crown full cast base metal E D2792 Crown full cast noble metal E D2794 Crown-titanium ED2799 Provisional crown E

D2910 Recement inlay onlay or part E D2915 Recement cast or prefab post E D2920 Dental recement crown E D2930 Prefab stnlss steel crwn pri E D2931 Prefab stnlss steel crown pe E D2932 Prefabricated resin crown E D2933 Prefab stainless steel crown E D2934 Prefab steel crown primary E D2940 Protective restoration E D2950 Core build-up incl any pins E D2951 Tooth pin retention E D2952 Post and core cast + crown E D2953 Each addtnl cast post E D2954 Prefab post/core + crown E D2955 Post removal E D2957 Each addtnl prefab post E D2960 Laminate labial veneer E D2961 Lab labial veneer resin E D2962 Lab labial veneer porcelain E D2970 Temp crown (fractured tooth) E D2971 Add proc construct new crown E D2975 Coping E D2980 Crown repair E D2999 Dental unspec restorative pr S 0330 D3110 Pulp cap direct E D3120 Pulp cap indirect E D3220 Therapeutic pulpotomy E D3221 Gross pulpal debridement E D3222 Part pulp for apexogenesis E D3230 Pulpal therapy anterior prim E D3240 Pulpal therapy posterior pri E D3310 End thxpy, anterior tooth E D3320 End thxpy, bicuspid tooth E D3330 End thxpy, molar E D3331 Non-surg tx root canal obs E D3332 Incomplete endodontic tx E D3333 Internal root repair E D3346 Retreat root canal anterior E D3347 Retreat root canal bicuspid E D3348 Retreat root canal molar E D3351 Apexification/recalc initial E D3352 Apexification/recalc interim E D3353 Apexification/recalc final E D3354 Pulpal regeneration E D3410 Apicoect/perirad surg anter E D3421 Root surgery bicuspid E D3425 Root surgery molar E D3426 Root surgery ea add root E D3430 Retrograde filling E D3450 Root amputation E D3460 Endodontic endosseous implan S 0330 D3470 Intentional replantation E D3910 Isolation- tooth w rubb dam E D3920 Tooth splitting ED3950 Canal prep/fitting of dowel E

D3999 Endodontic procedure S 0330 D4210 Gingivectomy /plasty per quad E D4211 Gingivectomy /plasty per toot E D4230 Ana crown exp 4 or> per quad E D4231 Ana crown exp 1-3 per quad E D4240 Gingival flap proc w/ planin E D4241 Gngvl flap w rootplan 1-3 th E D4245 Apically

positioned flap E D4249 Crown lengthen hard tissue E D4260 Osseous surgery per quadrant S 0330 D4261 Osseous surgl-3teethperquad E D4263 Bone replce graft first site S 0330 D4264 Bone replce graft each add S 0330 D4265 Bio mtrls to aid soft/os reg E D4266 Guided tiss regen resorble E D4267 Guided tiss regen nonresorb E D4268 Surgical revision procedure S 0330 D4270 Pedicle soft tissue graft pr S 0330 D4271 Free soft tissue graft proc S 0330 D4273 Subepithelial tissue graft S 0330 D4274 Distal/proximal wedge proc E D4275 Soft tissue allograft E D4276 Con tissue w dble ped graft E D4320 Provision splnt intracoronal E D4321 Provisional splint extracoro E D4341 Periodontal scaling & root E D4342 Periodontal scaling 1-3teeth E D4355 Full mouth debridement S 0330 D4381 Localized delivery antimicro S 0330 D4910 Periodontal maint procedures E D4920 Unscheduled dressing change E D4999 Unspecified periodontal proc E D5110 Dentures complete maxillary E D5120 Dentures complete mandible E D5130 Dentures immediat maxillary E D5140 Dentures immediat mandible E D5211 Dentures maxill part resin E D5212 Dentures mand part resin E D5213 Dentures maxill part metal E D5214 Dentures mandibl part metal E D5225 Maxillary

part denture flex E D5226 Mandibular part denture flex E D5281 Removable partial denture E D5410 Dentures adjust cmplt maxil E D5411 Dentures adjust cmplt mand E D5421 Dentures adjust part maxill E D5422 Dentures adjust part mandbl E D5510 Dentur repr broken compl bas E D5520 Replace denture teeth complt E D5610 Dentures repair resin base E D5620 Rep part denture cast frame E D5630 Rep partial denture clasp E D5640 Replace part denture teeth E D5650 Add tooth to partial denture ED5660 Add clasp to partial denture E

D5670 Replc tth&acrlc on mtl frmwk E D5671 Replc tth&acrlc mandibular E D5710 Dentures rebase cmplt maxil E D5711 Dentures rebase cmplt mand E D5720 Dentures rebase part maxill E D5721 Dentures rebase part mandbl E D5730 Denture reln cmplt maxil ch E D5731 Denture reln cmplt mand chr E D5740 Denture reln part maxil chr E D5741 Denture reln part mand chr E D5750 Denture reln cmplt max lab E D5751 Denture reln cmplt mand lab E D5760 Denture reln part maxil lab E D5761 Denture reln part mand lab E D5810 Denture interm cmplt maxill E D5811 Denture interm cmplt mandbl E D5820 Denture interm part maxill E D5821 Denture interm part mandbl E D5850 Denture tiss conditn maxill E D5851 Denture tiss condtin mandbl E D5860 Overdenture complete E D5861 Overdenture partial E D5862 Precision attachment E D5867 Replacement of precision att E D5875 Prosthesis modification E D5899 Removable prosthodontic proc E D5911 Facial moulage sectional S 0330 D5912 Facial moulage complete S 0330 D5913 Nasal prosthesis E D5914 Auricular prosthesis E D5915 Orbital prosthesis E D5916 Ocular prosthesis E D5919 Facial prosthesis E D5922 Nasal septal prosthesis E D5923 Ocular prosthesis interim E D5924 Cranial prosthesis E D5925 Facial augmentation implant E D5926 Replacement nasal prosthesis E D5927 Auricular replacement E D5928 Orbital replacement E D5929 Facial replacement E D5931 Surgical obturator E D5932 Postsurgical obturator E D5933 Refitting of obturator E D5934 Mandibular flange prosthesis E D5935 Mandibular denture prosth E D5936 Temp obturator prosthesis E D5937 Trismus appliance E D5951 Feeding aid E D5952 Pediatric speech aid E D5953 Adult speech aid E D5954 Superimposed prosthesis E D5955 Palatal lift prosthesis E D5958 Intraoral con def inter plt ED5959 Intraoral con def mod palat E

D5960 Modify

speech aid prosthesis E D5982 Surgical stent E D5983 Radiation applicator S 0330 D5984 Radiation shield S 0330 D5985 Radiation cone locator S 0330 D5986 Fluoride applicator E D5987 Commissure splint S 0330 D5988 Surgical splint E D5991 Topical medicament carrier E D5992 Adjust max prost appliance E D5993 Main/clean max prosthesis E D5999 Maxillofacial prosthesis E D6010 Odontics endosteal implant E D6012 Endosteal implant E D6040 Odontics eposteal implant E D6050 Odontics transosteal implnt E D6053 Implnt/abtmnt spprt remv dnt E D6054 Implnt/abtmnt spprt remvprtl E D6055 Implant connecting bar E D6056 Prefabricated abutment E D6057 Custom abutment E D6058 Abutment supported crown E D6059 Abutment supported mtl crown E D6060 Abutment supported mtl crown E D6061 Abutment supported mtl crown E D6062 Abutment supported mtl crown E D6063 Abutment supported mtl crown E D6064 Abutment supported mtl crown E D6065 Implant supported crown E D6066 Implant supported mtl crown E D6067 Implant supported mtl crown E D6068 Abutment supported retainer E D6069 Abutment supported retainer E D6070 Abutment supported retainer E D6071 Abutment supported retainer E D6072 Abutment supported retainer E D6073 Abutment supported retainer E D6074 Abutment supported retainer E D6075 Implant supported retainer E D6076 Implant supported retainer E D6077 Implant supported retainer E D6078 Implnt/abut suprtd fixd dent E D6079 Implnt/abut suprtd fixd dent E D6080 Implant maintenance E D6090 Repair implant E D6091 Repl semi/precision attach E D6092 Recement supp crown E D6093 Recement supp part denture E D6094 Abut support crown titanium E D6095 Odontics repr abutment E D6100 Removal of implant E D6190 Radio/surgical implant index E D6194 Abut support retainer titani E D6199 Implant procedure ED6205 Pontic-indirect resin based E

D6210 Prosthodont high noble metal E D6211 Bridge base metal cast E D6212 Bridge noble metal cast E D6214 Pontic titanium E D6240 Bridge porcelain high noble E D6241 Bridge porcelain base metal E D6242 Bridge porcelain nobel metal E D6245 Bridge porcelain/ceramic E D6250 Bridge resin w/high noble E D6251 Bridge resin base metal E D6252 Bridge resin w/noble metal E D6253 Provisional pontic E D6254 Interim pontic E D6545 Dental retainr cast metl E D6548 Porcelain/ceramic retainer E D6600 Porcelain/ceramic inlay 2srf E D6601 Porc/ceram inlay >= 3 surfac E D6602 Cst hgh nble mtl inlay 2 srf E D6603 Cst hgh nble mtl inlay >=3sr E D6604 Cst bse mtl inlay 2 surfaces E D6605 Cst bse mtl inlay >= 3 surfa E D6606 Cast noble metal inlay 2 sur E D6607 Cst noble mtl inlay >=3 surf E D6608 Onlay

porc/crmc 2 surfaces E D6609 Onlay

porc/crmc >=3 surfaces E D6610 Onlay

cst hgh nbl mtl 2 srfc E D6611 Onlay

cst hgh nbl mtl >=3srf E D6612 Onlay

cst base mtl 2 surface E D6613 Onlay

cst base mtl >=3 surfa E D6614 Onlay

cst nbl mtl 2 surfaces E D6615 Onlay

cst nbl mtl >=3 surfac E D6624 Inlay

titanium E D6634 Onlay

titanium E D6710 Crown-indirect resin based E D6720 Retain crown resin w hi nble E D6721 Crown resin w/base metal E D6722 Crown resin w/noble metal E D6740 Crown porcelain/ceramic E D6750 Crown porcelain high noble E D6751 Crown porcelain base metal E D6752 Crown porcelain noble metal E D6780 Crown 3/4 high noble metal E D6781 Crown 3/4 cast based metal E D6782 Crown 3/4 cast noble metal E D6783 Crown 3/4 porcelain/ceramic E D6790 Crown full high noble metal E D6791 Crown full base metal cast E D6792 Crown full noble metal cast E D6793 Provisional retainer crown E D6794 Crown titanium E D6795 Interim retainer crown E D6920 Dental connector bar S 0330 D6930 Dental recement bridge E D6940 Stress breaker ED6950 Precision attachment E

D6970 Post & core plus retainer E D6972 Prefab post & core plus reta E D6973 Core build up for retainer E D6975 Coping metal E D6976 Each addtnl cast post E D6977 Each addtl prefab post E D6980 Bridge repair E D6985 Pediatric partial denture fx E D6999 Fixed prosthodontic proc E D7111 Extraction coronal remnants S 0330 D7140 Extraction erupted tooth/exr S 0330 D7210 Rem imp tooth w mucoper flp S 0330 D7220 Impact tooth remov soft tiss S 0330 D7230 Impact tooth remov part bony S 0330 D7240 Impact tooth remov comp bony S 0330 D7241 Impact tooth rem bony w/comp S 0330 D7250 Tooth root removal S 0330 D7251 Coronectomy E D7260 Oral antral fistula closure S 0330 D7261 Primary

closure sinus perf S 0330 D7270 Tooth reimplantation E D7272 Tooth transplantation E D7280 Exposure impact tooth orthod E D7282 Mobilize erupted/malpos toot E D7283 Place device impacted tooth B D7285 Biopsy

of oral tissue hard E D7286 Biopsy

of oral tissue soft E D7287 Exfoliative cy tolog collect E D7288 Brush biopsy B D7290 Repositioning of teeth E D7291 Transseptal fiberotomy S 0330 D7292 Screw retained plate E D7293 Temp anchorage dev w flap E D7294 Temp anchorage dev w/o flap E D7295 Bone harvest,auto graft proc E D7310 Alveoplasty w/ extraction E D7311 Alveoloplasty w/extract 1-3 E D7320 Alveoplasty w/o extraction E D7321 Alveoloplasty not w/extracts B D7340 Vestibuloplasty ridge extens E D7350 Vestibuloplasty exten graft E D7410 Rad exc lesion up to 1.25 cm E D7411 Excision benign lesion>1.25c E D7412 Excision benign lesion compl E D7413 Excision malig lesion<=1.25c E D7414 Excision malig lesion>1.25cm E D7415 Excision malig les complicat E D7440 Malig tumor exc to 1.25 cm E D7441 Malig tumor > 1.25 cm E D7450 Rem odontogen cyst to 1.25cm E D7451 Rem odontogen cyst > 1.25 cm E D7460 Rem nonodonto cyst to 1.25cm E D7461 Rem nonodonto cyst > 1.25 cm E D7465 Lesion destruction ED7471 Rem exostosis any site E D7472 Removal of torus palatinus E D7473 Remove torus mandibularis E D7485 Surg reduct osseoustuberosit E D7490 Maxilla or mandible resectio E D7510 I&d absc intraoral soft tiss E D7511 Incision/drain abscess intra B D7520 I&d abscess extraoral E D7521 Incision/drain abscess extra B D7530 Removal fb skin/areolar tiss E D7540 Removal of fb reaction E D7550 Removal of sloughed off bone E D7560 Maxillary

sinusotomy E D7610 Maxilla open reduct simple E D7620 Clsd reduct simpl maxilla fx E D7630 Open red simpl mandible fx E D7640 Clsd red simpl mandible fx E D7650 Open red simp malar/zygomfx E D7660 Clsd red simp malar/zygomfx E D7670 Closd rductn splint alveolus E D7671 Alveolus open reduction E D7680 Reduct simple facial bone fx E D7710 Maxilla open reduct compound E D7720 Clsd reduct compd maxilla fx E D7730 Open reduct compd mandble fx E D7740 Clsd reduct compd mandble fx E D7750 Open red comp malar/zygma fx E D7760 Clsd red comp malar/zygma fx E D7770 Open reduc compd alveolus fx E D7771 Alveolus clsd reduc stblz te E D7780 Reduct compnd facial bone fx E D7810 Tmj open reduct-dislocation E D7820 Closed tmp manipulation E D7830 Tmj manipulation under anest E D7840 Removal of tmj condyle E D7850 Tmj meniscectomy E D7852 Tmj repair of joint disc E D7854 Tmj excisn of joint membrane E D7856 Tmj cutting of a muscle E D7858 Tmj reconstruction E D7860 Tmj cutting into joint E D7865 Tmj reshaping components E D7870 Tmj aspiration joint fluid E D7871 Lysis + lavage w catheters E D7872 Tmj diagnostic arthroscopy E D7873 Tmj arthroscopy lysis adhesn E D7874 Tmj arthroscopy disc reposit E D7875 Tmj arthroscopy synovectomy E D7876 Tmj arthroscopy discectomy E D7877 Tmj arthroscopy debridement E D7880 Occlusal orthotic appliance E D7899 Tmj unspecified therapy E D7910 Dent sutur recent wnd to 5cm E D7911 Dental suture wound to 5 cm E D7912 Suture complicate wnd > 5 cm ED7920 Dental skin graft E

D7940 Reshaping bone orthognathic S 0330 D7941 Bone cutting ramus closed E D7943 Cutting ramus open w/graft E D7944 Bone cutting segmented E D7945 Bone cutting body mandible E D7946 Reconstruction maxilla total E D7947 Reconstruct maxilla segment E D7948 Reconstruct midface no graft E D7949 Reconstruct midface w/graft E D7950 Mandible graft E D7951 Sinus aug w bone/bone sup E D7953 Bone replacement graft E D7955 Repair maxillofacial defects E D7960 Frenulectomy /frenectomy E D7963 Frenuloplasty E D7970 Excision hyperplastic tissue E D7971 Excision pericoronal gingiva E D7972 Surg redct fibrous tuberosit E D7980 Sialolithotomy E D7981 Excision of salivary gland E D7982 Sialodochoplasty E D7983 Closure of salivary fistula E D7990 Emergency tracheotomy E D7991 Dental coronoidectomy E D7995 Synthetic graft facial bones E D7996 Implant mandible for augment E D7997 Appliance removal E D7998 Intraoral place of fix dev E D7999 Oral surgery procedure E D8010 Limited dental tx primary E D8020 Limited dental tx transition E D8030 Limited dental tx adolescent E D8040 Limited dental tx adult E D8050 Intercep dental tx primary E D8060 Intercep dental tx transitn E D8070 Compre dental tx transition E D8080 Compre dental tx adolescent E D8090 Compre dental tx adult E D8210 Orthodontic rem appliance tx E D8220 Fixed appliance therapy habt E D8660 Preorthodontic tx visit E D8670 Periodic orthodontc tx visit E D8680 Orthodontic retention E D8690 Orthodontic treatment E D8691 Repair ortho appliance E D8692 Replacement retainer E D8693 Rebond/cement/repair retain E D8999 Orthodontic procedure E D9110 Tx dental pain minor proc N D9120 Fix partial denture section E D9210 Dent anesthesia w/o surgery E D9211 Regional block anesthesia E D9212 Trigeminal block anesthesia E D9215 Local anesthesia ED9220 General anesthesia E

D9221 General anesthesia ea ad 15m E D9230 Analgesia N D9241 Intravenous sedation E D9242 IV sedation ea ad 30 m E D9248 Sedation (non-iv) N D9310 Dental consultation E D9410 Dental house call E D9420 Hospital/ASC call E D9430 Office visit during hours E D9440 Office visit after hours E D9450 Case presentation tx plan E D9610 Dent therapeutic drug inject E D9612 Thera par drugs 2 or > admin E D9630 Other drugs/medicaments S 0330 D9910 Dent appl desensitizing med E D9911 Appl desensitizing resin E D9920 Behavior management E D9930 Treatment of complications S 0330 D9940 Dental occlusal guard S 0330 D9941 Fabrication athletic guard E D9942 Repair/reline occlusal guard E D9950 Occlusion analysis S 0330 D9951 Limited occlusal adjustment S 0330 D9952 Complete occlusal adjustment S 0330 D9970 Enamel microabrasion E D9971 Odontoplasty 1-2 teeth E D9972 Extrnl bleaching per arch E D9973 Extrnl bleaching per tooth E D9974 Intrnl bleaching per tooth E D9999 Adjunctive procedure E E0100 Cane adjust/fixed with tip Y E0105 Cane adjust/fixed quad/3 pro Y E0110 Crutch forearm pair Y E0111 Crutch forearm each Y E0112 Crutch underarm pair wood Y E0113 Crutch underarm each wood Y E0114 Crutch underarm pair no wood Y E0116 Crutch underarm each no wood Y E0117 Underarm springassist crutch Y E0118 Crutch substitute E E0130 Walker rigid adjust/fixed ht Y E0135 Walker folding adjust/fixed Y E0140 Walker w trunk support Y E0141 Rigid wheeled walker adj/fix Y E0143 Walker folding wheeled w/o s Y E0144 Enclosed walker w rear seat Y E0147 Walker variable wheel resist Y E0148 Heavyduty

walker no wheels Y E0149 Heavy

duty wheeled walker Y E0153 Forearm crutch platform atta Y E0154 Walker platform attachment Y E0155 Walker wheel attachment,pair Y E0156 Walker seat attachment Y E0157 Walker crutch attachment YE0158 Walker leg extenders set of4 Y

E0159 Brake for wheeled walker Y E0160 Sitz type bath or equipment Y E0161 Sitz bath/equipment w/faucet Y E0162 Sitz bath chair Y E0163 Commode chair with fixed arm Y E0165 Commode chair with detacharm Y E0167 Commode chair pail or pan Y E0168 Heavyduty

/wide commode chair Y E0170 Commode chair electric Y E0171 Commode chair non-electric Y E0172 Seat lift mechanism toilet E E0175 Commode chair foot rest Y E0181 Press pad alternating w/ pum Y E0182 Replace pump, alt press pad Y E0184 Dry

pressure mattress Y E0185 Gel pressure mattress pad Y E0186 Air pressure mattress Y E0187 Water pressure mattress Y E0188 Synthetic sheepskin pad Y E0189 Lambswool sheepskin pad Y E0190 Positioning cushion E E0191 Protector heel or elbow Y E0193 Powered air flotation bed Y E0194 Air fluidized bed Y E0196 Gel pressure mattress Y E0197 Air pressure pad for mattres Y E0198 Water pressure pad for mattr Y E0199 Dry

pressure pad for mattres Y E0200 Heat lamp without stand Y E0202 Phototherapy light w/ photom Y E0203 Therapeutic lightbox tabletp E E0205 Heat lamp with stand Y E0210 Electric heat pad standard Y E0215 Electric heat pad moist Y E0217 Water circ heat pad w pump Y E0218 Water circ cold pad w pump Y E0221 Infrared heating pad system Y E0225 Hydrocollator unit Y E0231 Wound warming device E E0232 Warming card for NWT E E0235 Paraffin bath unit portable Y E0236 Pump for water circulating p Y E0239 Hydrocollator unit portable Y E0240 Bath/shower chair E E0241 Bath tub wall rail E E0242 Bath tub rail floor E E0243 Toilet rail E E0244 Toilet seat raised E E0245 Tub stool or bench E E0246 Transfer tub rail attachment E E0247 Trans bench w/wo comm open E E0248 HDtrans bench w/wo comm open E E0249 Pad water circulating heat u Y E0250 Hosp bed fixed ht w/ mattres YE0251 Hosp bed fixd ht w/o mattres Y

E0255 Hospital bed var ht w/ mattr Y E0256 Hospital bed var ht w/o matt Y E0260 Hosp bed semi-electr w/ matt Y E0261 Hosp bed semi-electr w/o mat Y E0265 Hosp bed total electr w/ mat Y E0266 Hosp bed total elec w/o matt Y E0270 Hospital bed institutional t E E0271 Mattress innerspring Y E0272 Mattress foam rubber Y E0273 Bed board E E0274 Over-bed table E E0275 Bed pan standard Y E0276 Bed pan fracture Y E0277 Powered pres-redu air mattrs Y E0280 Bed cradle Y E0290 Hosp bed fx ht w/o rails w/m Y E0291 Hosp bed fx ht w/o rail w/o Y E0292 Hosp bed var ht w/o rail w/o Y E0293 Hosp bed var ht w/o rail w/ Y E0294 Hosp bed semi-elect w/ mattr Y E0295 Hosp bed semi-elect w/o matt Y E0296 Hosp bed total elect w/ matt Y E0297 Hosp bed total elect w/o mat Y E0300 Enclosed ped crib hosp grade Y E0301 HD hosp bed, 350-600 lbs Y E0302 Ex hd hosp bed > 600 lbs Y E0303 Hosp bed hvy dty xtra wide Y E0304 Hosp bed xtra hvy dty x wide Y E0305 Rails bed side half length Y E0310 Rails bed side full length Y E0315 Bed accessory brd/tbl/supprt E E0316 Bed safety

enclosure Y E0325 Urinal male jug-type Y E0326 Urinal female jug-type Y E0328 Ped hospital bed, manual Y E0329 Ped hospital bed semi/elect Y E0350 Control unit bowel system E E0352 Disposable pack w/bowel syst E E0370 Air elevator for heel E E0371 Nonpower mattress overlay Y E0372 Powered air mattress overlay Y E0373 Nonpowered pressure mattress Y E0424 Stationary

compressed gas 02 Y E0425 Gas system stationary compre E E0430 Oxygen system gas portable E E0431 Portable gaseous 02 Y E0433 Portable liquid oxygen sys Y E0434 Portable liquid 02 Y E0435 Oxygen system liquid portabl E E0439 Stationary

liquid 02 Y E0440 Oxygen system liquid station E E0441 Stationary

O2 contents, gas Y E0442 Stationary

O2 contents, liq Y E0443 Portable 02 contents, gas YE0444 Portable 02 contents, liquid Y

E0445 Oximeter non-invasive N E0446 Topical Ox Deliver sys, nos E E0450 Vol control vent invasiv int Y E0455 Oxygen tent excl croup/ped t Y E0457 Chest shell Y E0459 Chest wrap Y E0460 Neg press vent portabl/statn Y E0461 Vol control vent noninv int Y E0462 Rocking bed w/ or w/o side r Y E0463 Press supp vent invasive int Y E0464 Press supp vent noninv int Y E0470 RAD w/o backup non-inv intfc Y E0471 RAD w/backup non inv intrfc Y E0472 RAD w backup invasive intrfc Y E0480 Percussor elect/pneum home m Y E0481 Intrpulmnry percuss vent sys E E0482 Cough stimulating device Y E0483 Chest compression gen system Y E0484 Non-elec oscillatory pep dvc Y E0485 Oral device/appliance prefab Y E0486 Oral device/appliance cusfab Y E0487 Electronic spirometer N E0500 Ippb all types Y E0550 Humidif extens supple w ippb Y E0555 Humidifier for use w/ regula Y E0560 Humidifier supplemental w/ i Y E0561 Humidifier nonheated w PAP Y E0562 Humidifier heated used w PAP Y E0565 Compressor air power source Y E0570 Nebulizer with compression Y E0571 Aerosol compressor for svneb CHD E0572 Aerosol compressor adjust pr Y E0574 Ultrasonic generator w svneb Y E0575 Nebulizer ultrasonic Y E0580 Nebulizer for use w/ regulat Y E0585 Nebulizer w/ compressor & he Y E0600 Suction pump portab hom modl Y E0601 Cont airway pressure device Y E0602 Manual breast pump Y E0603 Electric breast pump N E0604 Hosp grade elec breast pump A E0605 Vaporizer roomtype Y E0606 Drainage board postural Y E0607 Blood glucose monitor home Y E0610 Pacemaker monitr audible/vis Y E0615 Pacemaker monitr digital/vis Y E0616 Cardiac event recorder N E0617 Automatic ext defibrillator Y E0618 Apnea monitor Y E0619 Apnea monitor w recorder Y E0620 Cap bld skin piercing laser Y E0621 Patient lift sling or seat Y E0625 Patient lift bathroom or toi E E0627 Seat lift incorp lift-chair YE0628 Seat lift for pt furn-electr Y

E0629 Seat lift for pt furn-non-el Y E0630 Patient lift hydraulic Y E0635 Patient lift electric Y E0636 PT support & positioning sys Y E0637 Combination sit to stand sys E E0638 Standing frame sys E E0639 Moveable patient lift system E E0640 Fixed patient lift system E E0641 Multi-position stnd fram sys E E0642 Dynamic standing frame E E0650 Pneuma compresor non-segment Y E0651 Pneumcompressor segmental Y E0652 Pneumcompres w/cal pressure Y E0655 Pneumatic appliance half arm Y E0656 Segmental pneumatic trunk Y E0657 Segmental pneumatic chest Y E0660 Pneumatic appliance full leg Y E0665 Pneumatic appliance full arm Y E0666 Pneumatic appliance half leg Y E0667 Seg pneumatic appl full leg Y E0668 Seg pneumatic appl full arm Y E0669 Seg pneumatic appli half leg Y E0671 Pressure pneum appl full leg Y E0672 Pressure pneum appl full arm Y E0673 Pressure pneum appl half leg Y E0675 Pneumatic compression device Y E0676 Inter limb compress dev NOS Y E0691 Uvl pnl 2 sq ft or less Y E0692 Uvl sys panel 4 ft Y E0693 Uvl sys panel 6 ft Y E0694 Uvl md cabinet sys 6 ft Y E0700 Safety

equipment E E0705 Transfer device B E0710 Restraints any type E E0720 Tens two lead Y E0730 Tens four lead Y E0731 Conductive garment for tens/ Y E0740 Incontinence treatment systm Y E0744 Neuromuscular stim for scoli Y E0745 Neuromuscular stim for shock Y E0746 Electromyograph biofeedback N E0747 Elec osteogen stim not spine Y E0748 Elec osteogen stim spinal Y E0749 Elec osteogen stim implanted N E0755 Electronic salivary reflex s E E0760 Osteogen ultrasound stimltor Y E0761 Nontherm electromgntc device E E0762 Trans elec jt stim dev sys B E0764 Functional neuromuscularstim Y E0765 Nerve stimulator for tx n&v Y E0769 Electric wound treatment dev B E0770 Functional electric stim NOS Y E0776 Iv pole Y E0779 Amb infusion pump mechanical YE0780 Mech amb infusion pump <8hrs Y

E0781 External ambulatory infus pu Y E0782 Non-programble infusion pump N E0783 Programmable infusion pump N E0784 Ext amb infusn pump insulin Y E0785 Replacement impl pump cathet N E0786 Implantable pump replacement N E0791 Parenteral infusion pump sta Y E0830 Ambulatory traction device N E0840 Tract frame attach headboard Y E0849 Cervical pneum trac equip Y E0850 Traction stand free standing Y E0855 Cervical traction equipment Y E0856 Cervic collar w air bladder Y E0860 Tract equip cervical tract Y E0870 Tract frame attach footboard Y E0880 Trac stand free stand extrem Y E0890 Traction frame attach pelvic Y E0900 Trac stand free stand pelvic Y E0910 Trapeze bar attached to bed Y E0911 HD trapeze bar attach to bed Y E0912 HD trapeze bar free standing Y E0920 Fracture frame attached to b Y E0930 Fracture frame free standing Y E0935 Cont pas motion exercise dev Y E0936 CPM device, other than knee E E0940 Trapeze bar free standing Y E0941 Gravity

assisted traction de Y E0942 Cervical head harness/halter Y E0944 Pelvic belt/harness/boot Y E0945 Belt/harness extremity Y E0946 Fracture frame dual w cross Y E0947 Fracture frame attachmnts pe Y E0948 Fracture frame attachmnts ce Y E0950 Tray Y E0951 Loop heel Y E0952 Toe loop/holder, each Y E0955 Cushioned headrest Y E0956 W/c lateral trunk/hip suppor Y E0957 W/c medial thigh support Y E0958 Whlchr att- conv 1 arm drive Y E0959 Amputee adapter B E0960 W/c shoulder harness/straps Y E0961 Wheelchair brake extension B E0966 Wheelchair head rest extensi B E0967 Manual wc hand rimw project Y E0968 Wheelchair commode seat Y E0969 Wheelchair narrowing device Y E0970 Wheelchair no. 2 footplates E E0971 Wheelchair anti-tipping devi B E0973 W/Ch access det adj armrest B E0974 W/Ch access anti-rollback B E0978 W/C acc,saf belt pelv strap B E0980 Wheelchair safety vest Y E0981 Seat upholstery, replacement YE0982 Back upholstery, replacement Y

E0983 Add pwr joystick Y E0984 Add pwr tiller Y E0985 W/c seat lift mechanism Y E0986 Man w/c push-rim pow assist Y E0988 Lever-activated wheel drive NIY E0990 Wheelchair elevating leg res B E0992 Wheelchair solid seat insert B E0994 Wheelchair arm rest Y E0995 Wheelchair calf rest B E1002 Pwr seat tilt Y E1003 Pwr seat recline Y E1004 Pwr seat recline mech Y E1005 Pwr seat recline pwr Y E1006 Pwr seat combo w/o shear Y E1007 Pwr seat combo w/shear Y E1008 Pwr seat combo pwr shear Y E1009 Add mech leg elevation Y E1010 Add pwr leg elevation Y E1011 Ped wc modify width adjustm Y E1014 Reclining back add ped w/c Y E1015 Shock absorber for man w/c Y E1016 Shock absorber for power w/c Y E1017 HD shck absrbr for hd man wc Y E1018 HD shck absrber for hd powwc Y E1020 Residual limb support system Y E1028 W/c manual swingaway Y E1029 W/c vent tray fixed Y E1030 W/c vent tray gimbaled Y E1031 Rollabout chair with casters Y E1035 Patient transfer system <300 Y E1036 Patient transfer system >300 Y E1037 Transport chair, ped size Y E1038 Transport chair pt wt<=300lb Y E1039 Transport chair pt wt >300lb Y E1050 Whelchr fxd full length arms Y E1060 Wheelchair detachable arms Y E1070 Wheelchair detachable foot r Y E1083 Hemi-wheelchair fixed arms Y E1084 Hemi-wheelchair detachable a Y E1085 Hemi-wheelchair fixed arms E E1086 Hemi-wheelchair detachable a E E1087 Wheelchair lightwt fixed arm Y E1088 Wheelchair lightweight det a Y E1089 Wheelchair lightwt fixed arm E E1090 Wheelchair lightweight det a E E1092 Wheelchair wide w/ leg rests Y E1093 Wheelchair wide w/ foot rest Y E1100 Whchr s-recl fxd arm leg res Y E1110 Wheelchair semi-recl detach Y E1130 Whlchr stand fxd arm ft rest E E1140 Wheelchair standard detach a E E1150 Wheelchair standard w/ leg r Y E1160 Wheelchair fixed arms Y E1161 Manual adult wc w tiltinspac YE1170 Whlchr ampu fxd arm leg rest Y

E1171 Wheelchair amputee w/o leg r Y E1172 Wheelchair amputee detach ar Y E1180 Wheelchair amputee w/ foot r Y E1190 Wheelchair amputee w/ leg re Y E1195 Wheelchair amputee heavy dut Y E1200 Wheelchair amputee fixed arm Y E1220 Whlchr special size/constrc Y E1221 Wheelchair spec size w foot Y E1222 Wheelchair spec size w/ leg Y E1223 Wheelchair spec size w foot Y E1224 Wheelchair spec size w/ leg Y E1225 Manual semi-reclining back Y E1226 Manual fully reclining back B E1227 Wheelchair spec sz spec ht a Y E1228 Wheelchair spec sz spec ht b Y E1229 Pediatric wheelchair NOS Y E1230 Power operated vehicle Y E1231 Rigid ped w/c tilt-in-space Y E1232 Folding ped wc tilt-in-space Y E1233 Rig ped wc tltnspc w/o seat Y E1234 Fld ped wc tltnspc w/o seat Y E1235 Rigid ped wc adjustable Y E1236 Folding ped wc adjustable Y E1237 Rgd ped wc adjstabl w/o seat Y E1238 Fld ped wc adjstabl w/o seat Y E1239 Ped power wheelchair NOS Y E1240 Whchr litwt det arm leg rest Y E1250 Wheelchair lightwt fixed arm E E1260 Wheelchair lightwt foot rest E E1270 Wheelchair lightweight leg r Y E1280 Whchr h-duty det arm leg res Y E1285 Wheelchair heavy duty fixed E E1290 Wheelchair hvy duty detach a E E1295 Wheelchair heavy duty fixed Y E1296 Wheelchair special seat heig Y E1297 Wheelchair special seat dept Y E1298 Wheelchair spec seat depth/w Y E1300 Whirlpool portable E E1310 Whirlpool non-portable Y E1353 Oxygen supplies regulator Y E1354 Wheeled cart, port cyl/conc Y E1355 Oxygen supplies stand/rack Y E1356 Batt pack/cart, port conc Y E1357 Battery

charger, port conc Y E1358 DC power adapter, port conc Y E1372 Oxy

suppl heater for nebuliz Y E1390 Oxygen concentrator Y E1391 Oxygen concentrator, dual Y E1392 Portable oxygen concentrator Y E1399 Durable medical equipment mi Y E1405 O2/water vapor enrich w/heat Y E1406 O2/water vapor enrich w/o he Y E1500 Centrifuge A E1510 Kidney

dialysate delivry

sys AE1520 Heparin infusion pump A

E1530 Replacement air bubble detec A E1540 Replacement pressure alarm A E1550 Bath conductivity meter A E1560 Replace blood leak detector A E1570 Adjustable chair for esrd pt A E1575 Transducer protect/fld bar A E1580 Unipuncture control system A E1590 Hemodialysis machine A E1592 Auto interm peritoneal dialy A E1594 Cycler dialysis machine A E1600 Deli/install chrg hemo equip A E1610 Reverse osmosis h2o puri sys A E1615 Deionizer H2O puri system A E1620 Replacement blood pump A E1625 Water softening system A E1630 Reciprocating peritoneal dia A E1632 Wearable artificial kidney A E1634 Peritoneal dialysis clamp B E1635 Compact travel hemodialyzer A E1636 Sorbent cartridges per 10 A E1637 Hemostats for dialysis, each A E1639 Dialysis scale A E1699 Dialysis equipment noc A E1700 Jaw motion rehab system Y E1701 Repl cushions for jaw motion Y E1702 Repl measr scales jaw motion Y E1800 Adjust elbow ext/flex device Y E1801 SPS elbow device Y E1802 Adjst forearm pro/sup device Y E1805 Adjust wrist ext/flex device Y E1806 SPS wrist device Y E1810 Adjust knee ext/flex device Y E1811 SPS knee device Y E1812 Knee ext/flex w act res ctrl Y E1815 Adjust ankle ext/flex device Y E1816 SPS ankle device Y E1818 SPS forearm device Y E1820 Soft interface material Y E1821 Replacement interface SPSD Y E1825 Adjust finger ext/flex devc Y E1830 Adjust toe ext/flex device Y E1831 Static str toe dev ext/flex Y E1840 Adj shoulder ext/flex device Y E1841 Static str shldr dev rom adj Y E1902 AAC non-electronic board Y E2000 Gastric suction pump hme mdl Y E2100 Bld glucose monitor w voice Y E2101 Bld glucose monitor w lance Y E2120 Pulse gen sys tx endolympfl Y E2201 Man w/ch acc seat w>=20"<24" Y E2202 Seat width 24-27 in Y E2203 Frame depth less than 22 in Y E2204 Frame depth 22 to 25 in Y E2205 Manual wc accessory, handrim YE2206 Complete wheel lock assembly Y

E2207 Crutch and cane holder Y E2208 Cylinder tank carrier Y E2209 Arm trough each Y E2210 Wheelchair bearings Y E2211 Pneumatic propulsion tire Y E2212 Pneumatic prop tire tube Y E2213 Pneumatic prop tire insert Y E2214 Pneumatic caster tire each Y E2215 Pneumatic caster tire tube Y E2216 Foam filled propulsion tire Y E2217 Foam filled caster tire each Y E2218 Foam propulsion tire each Y E2219 Foam caster tire any size ea Y E2220 Solid propulsion tire each Y E2221 Solid caster tire each Y E2222 Solid caster integrated whl Y E2224 Propulsion whl excludes tire Y E2225 Caster wheel excludes tire Y E2226 Caster fork replacement only Y E2227 Gear reduction drive wheel Y E2228 Mwc acc, wheelchair brake Y E2230 Manual standing system E E2231 Solid seat support base Y E2291 Planar back for ped size wc Y E2292 Planar seat for ped size wc Y E2293 Contour back for ped size wc Y E2294 Contour seat for ped size wc Y E2295 Ped dynamic seating frame Y E2300 Pwr seat elevation sys Y E2301 Pwr standing Y E2310 Electro connect btw control Y E2311 Electro connect btw 2 sys Y E2312 Mini-prop remote joystick Y E2313 PWC harness, expand control Y E2321 Hand interface joystick Y E2322 Mult mech switches Y E2323 Special joystick handle Y E2324 Chin cup interface Y E2325 Sip and puff interface Y E2326 Breath tube kit Y E2327 Head control interface mech Y E2328 Head/extremity control inter Y E2329 Head control nonproportional Y E2330 Head control proximity switc Y E2331 Attendant control Y E2340 W/c wdth 20-23 in seat frame Y E2341 W/c wdth 24-27 in seat frame Y E2342 W/c dpth 20-21 in seat frame Y E2343 W/c dpth 22-25 in seat frame Y E2351 Electronic SGD interface Y E2358 Gr 34 nonsealed leadacid NIY E2359 Gr34 sealed leadacid battery NIY E2360 22nf nonsealed leadacid Y E2361 22nf sealed leadacid battery YE2362 Gr24 nonsealed leadacid Y

E2363 Gr24 sealed leadacid battery Y E2364 U1nonsealed leadacid battery Y E2365 U1 sealed leadacid battery Y E2366 Battery

charger, single mode Y E2367 Battery

charger, dual mode Y E2368 Power wc motor replacement Y E2369 Pwr wc gear box replacement Y E2370 Pwr wc motor/gear box combo Y E2371 Gr27 sealed leadacid battery Y E2372 Gr27 non-sealed leadacid Y E2373 Hand/chin ctrl spec joystick Y E2374 Hand/chin ctrl std joystick Y E2375 Non-expandable controller Y E2376 Expandable controller, repl Y E2377 Expandable controller, initl Y E2381 Pneumdrive wheel tire Y E2382 Tube, pneum wheel drive tire Y E2383 Insert, pneum wheel drive Y E2384 Pneumatic caster tire Y E2385 Tube, pneumatic caster tire Y E2386 Foam filled drive wheel tire Y E2387 Foam filled caster tire Y E2388 Foam drive wheel tire Y E2389 Foam caster tire Y E2390 Solid drive wheel tire Y E2391 Solid caster tire Y E2392 Solid caster tire, integrate Y E2394 Drive wheel excludes tire Y E2395 Caster wheel excludes tire Y E2396 Caster fork Y E2397 Pwc acc, lith-based battery Y E2402 Neg press wound therapy pump Y E2500 SGD digitized pre-rec <=8min Y E2502 SGD prerec msg >8min <=20min Y E2504 SGD prerec msg>20min <=40min Y E2506 SGD prerec msg > 40 min Y E2508 SGD spelling phys contact Y E2510 SGD w multi methods msg/accs Y E2511 SGD sftwre prgrm for PC/PDA Y E2512 SGD accessory, mounting sys Y E2599 SGD accessory noc Y E2601 Gen w/c cushion wdth < 22 in Y E2602 Gen w/c cushion wdth >=22 in Y E2603 Skin protect wc cus wd <22in Y E2604 Skin protect wc cus wd>=22in Y E2605 Position wc cush wdth <22 in Y E2606 Position wc cush wdth>=22 in Y E2607 Skin pro/pos wc cus wd <22in Y E2608 Skin pro/pos wc cus wd>=22in Y E2609 Custom fabricate w/c cushion Y E2610 Powered w/c cushion B E2611 Gen use back cush wdth <22in Y E2612 Gen use back cush wdth>=22in Y E2613 Position back cush wd <22in YE2614 Position back cush wd>=22in Y

E2615 Pos back post/lat wdth <22in Y E2616 Pos back post/lat wdth>=22in Y E2617 Custom fab w/c back cushion Y E2619 Replace cover w/c seat cush Y E2620 WCplanar back cush wd <22in Y E2621 WCplanar back cush wd>=22in Y E2622 Adj skin pro w/c cus wd<22in Y E2623 Adj skin pro wc cus wd>=22in Y E2624 Adj skin pro/pos cus<22in Y E2625 Adj skin pro/pos wc cus>=22 Y E2626 Seo mobile armsup att to wc NIY E2627 Arm supp att to wc rancho ty NIY E2628 Mobile armsupports reclinin NIY E2629 Friction dampening arm supp NIY E2630 Monosuspension arm/hand supp NIY E2631 Elevat proximal arm support NIY E2632 Offset/lat rocker arm w/ela NIY E2633 Mobile armsupport supinator NIY E8000 Posterior gait trainer E E8001 Upright gait trainer E E8002 Anterior gait trainer E G0008 Admin influenza virus vac S 0350 G0009 Admin pneumococcal vaccine S 0350 G0010 Admin hepatitis b vaccine CHS 0437 G0027 Semen analysis A G0101 CA screen;pelvic/breast exam V 0604 G0102 Prostate ca screening; dre N G0103 PSA screening A G0104 CA screen;flexi sigmoidscope S 0159 G0105 Colorectal scrn; hi risk ind T 0158 G0106 Colon CA screen;barium enema S 0157 G0108 Diab manage trn per indiv A G0109 Diab manage trn ind/group A G0117 Glaucoma scrn hgh risk direc S 0698 G0118 Glaucoma scrn hgh risk direc S 0230 G0120 Colon ca scrn; barium enema S 0157 G0121 Colon ca scrn not hi rsk ind T 0158 G0122 Colon ca scrn; barium enema E G0123 Screen cerv/vag thin layer A G0124 Screen c/v thin layer by MD B G0127 Trim nail(s) T 0012 G0128 CORF skilled nursing service B G0129 Partial hosp prog service P G0130 Single energy x-ray study X 0260 G0141 Scr c/v cy

to,autosys and md B G0143 Scr c/v cy

to,thinlayer,rescr A G0144 Scr c/v cy

to,thinlayer,rescr A G0145 Scr c/v cy

to,thinlayer,rescr A G0147 Scr c/v cy

to, automated sys A G0148 Scr c/v cy

to, autosys, rescr A G0151 HHCP-serv of pt,ea 15 min B G0152 HHCP-serv of ot,ea 15 min B G0153 HHCP-svs of s/l path,ea 15mn B G0154 HHCP-svs of rn,ea 15 min BG0155 HHCP-svs of csw,ea 15 min B

G0156 HHCP-svs of aide,ea 15 min B G0157 HHC PT assistant ea 15 B G0158 HHC OT assistant ea 15 B G0159 HHC PT maint ea 15 min B G0160 HHC Occup Therapy ea 15 B G0161 HHC SLP ea 15 min B G0162 HHC RN E&M plan svs, 15 min B G0163 HHC LPN/RN obs/asses ea 15 B G0164 HHC lis nurse train ea 15 B G0166 Extrnl counterpulse, per tx T 0678 G0168 Wound closure by adhesive B G0173 Linear acc stereo radsur com S 0067 G0175 OPPS Service,sched team conf V 0607 G0176 OPPS/PHP;activity therapy P G0177 OPPS/PHP; train & educ serv N G0179 MD recertification HHA PT M G0180 MD certification HHA patient M G0181 Home health care supervision M G0182 Hospice care supervision M G0186 Dstry

eye lesn,fdr vssl tech T 0235 G0202 Screeningmammographydigital A G0204 Diagnosticmammographydigital A G0206 Diagnosticmammographydigital A G0219 PET img wholbod melano nonco E G0235 PET not otherwise specified E G0237 Therapeutic procd strg endur S 0077 G0238 Oth resp proc, indiv S 0077 G0239 Oth resp proc, group S 0077 G0245 Initial foot exam pt lops V 0604 G0246 Followup eval of foot pt lop V 0605 G0247 Routine footcare pt w lops T 0013 G0248 Demonstrate use home inr mon V 0607 G0249 Provide INR test mater/equip V 0607 G0250 MD INR test revie inter mgmt M G0251 Linear acc based stero radio S 0065 G0252 PET imaging initial dx E G0255 Current percep threshold tst E G0257 Unsched dialysis ESRD pt hos S 0170 G0259 Inject for sacroiliac joint N G0260 Inj for sacroiliac jt anesth T 0207 G0268 Removal of impacted wax md N G0269 Occlusive device in vein art N G0270 MNT subs tx for change dx A G0271 Group MNT 2 or more 30 mins A G0275 Renal angio, cardiac cath N G0278 Iliac art angio,cardiac cath N G0281 Elec stim unattend for press A G0282 Elect stim wound care not pd E G0283 Elec stim other than wound A G0288 Recon, CTA for surg plan N G0289 Arthro, loose body + chondro N G0290 Drug-eluting stents, single T 0656 G0291 Drug-eluting stents,each add T 0656 G0293 Non-cov surg proc,clin trial X 0340G0294 Non-cov proc, clinical trial X 0340

G0295 Electromagnetic therapy onc E G0302 Pre-op service LVRS complete S 0209 G0303 Pre-op service LVRS 10-15dos S 0209 G0304 Pre-op service LVRS 1-9 dos S 0213 G0305 Post op service LVRS min 6 S 0213 G0306 CBC/diffwbc w/o platelet A G0307 CBC without platelet A G0328 Fecal blood scrn immunoassay A G0329 Electromagntic tx for ulcers A G0333 Dispense fee initial 30 day M G0337 Hospice evaluation preelecti B G0339 Robot lin-radsurg com, first S 0067 G0340 Robt lin-radsurg fractx 2-5 S 0066 G0341 Percutaneous islet celltrans C G0342 Laparoscopy islet cell trans C G0343 Laparotomy islet cell transp C G0364 Bone marrow aspirate &biopsy X 0340 G0365 Vessel mapping hemo access S 0267 G0372 MD service required for PMD M G0378 Hospital observation per hr N G0379 Direct refer hospital observ Q3 0604 G0380 Lev 1 hosp type B ED visit V 0626 G0381 Lev 2 hosp type B ED visit V 0627 G0382 Lev 3 hosp type B ED visit V 0628 G0383 Lev 4 hosp type B ED visit V 0629 G0384 Lev 5 hosp type B ED visit Q3 0630 G0389 Ultrasound exam AAA screen S 0266 G0390 Trauma Respons w/hosp criti S 0618 G0396 Alcohol/subs interv 15-30mn S 0432 G0397 Alcohol/subs interv >30 min CHS 0322 G0398 Home sleep test/type 2 Porta S 0213 G0399 Home sleep test/type 3 Porta S 0213 G0400 Home sleep test/type 4 Porta S 0213 G0402 Initial preventive exam V 0606 G0403 EKG for initial prevent exam M G0404 EKG tracing for initial prev S 0099 G0405 EKG interpret & report preve B G0406 Inpt/tele follow up 15 CHB G0407 Inpt/tele follow up 25 CHB G0408 Inpt/tele follow up 35 CHB G0409 CORF related serv 15 mins ea M G0410 Grp psych partial hosp 45-50 P G0411 Inter active grp psych parti P G0412 Open tx iliac spine uni/bil C G0413 Pelvic ring fracture uni/bil T 0050 G0414 Pelvic ring fx treat int fix C G0415 Open tx post pelvic fxcture C G0416 Sat biopsy

prostate 1-20 spc X 0661 G0417 Sat biopsy

prostate 21-40 CHS 1505 G0418 Sat biopsy

prostate 41-60 CHS 1506 G0419 Sat biopsy

prostate: >60 CHS 1508 G0420 Ed svc CKD ind per session A G0421 Ed svc CKD grp per session A G0422 Intens cardiac rehab w/exerc S 0095G0423 Intens cardiac rehab no exer S 0095

G0424 Pulmonary

rehab w exer S 0102 G0425 Inpt/ED teleconsult30 CHB G0426 Inpt/ED teleconsult50 CHB G0427 Inpt/ED teleconsult70 CHB G0428 Collagen Meniscus Implant E G0429 Dermal filler injection(s) B G0431 Drug screen multiple class A G0432 EIA HIV-1/HIV-2 screen A G0433 ELISA HIV-1/HIV-2 screen A G0434 Drug screen multi drug class A G0435 Oral HIV-1/HIV-2 screen A G0436 Tobacco-use counsel 3-10 min X 0031 G0437 Tobacco-use counsel>10min X 0031 G0438 PPPS, initial visit A G0439 PPPS, subseq visit A G0440 Skin/dermal subs init 25or< CHD G0441 Skin/dermal subs each additi CHD G0448 Place perm pacing cardiovert NI B G0451 Devlopment test interpt&rep NIS 0432 G0908 HgB > 12 g/dL NIM G0909 HbG not doc NIM G0910 HgB < 12 g/dL NIM G0911 Assess activity symptoms NIM G0912 No Assess activity symptoms NIM G0913 Improve visual funct NIM G0914 survey

not complete NIM G0915 No improve visual funct NIM G0916 Satisfy

with care NIM G0917 Satisfy

survey not complete NIM G0918 No satisfy

with care NIM G0919 Flu immunize not avail NIM G0920 type loc act doc NIM G0921 doc pt reas no assess NIM G0922 type loc act not doc NIM G3001 Admin + supply, tositumomab S 0442 G8126 Pt treat w/antidepress12wks M G8127 Pt not treat w/antidepres12w M G8128 Pt inelig for antidepres med M G8395 LVEF>=40% doc normal or mild M G8396 LVEF not performed M G8397 Dil macula/fundus exam/w doc M G8398 Dil macular/fundus not perfo M G8399 Pt w/DXA document or order M G8400 Pt w/DXA no document or orde M G8401 Pt inelig osteo screen measu M G8404 Low extemity neur exam docum M G8405 Low extemity neur not perfor M G8406 Pt inelig lower extremneuro M G8410 Eval on foot documented M G8415 Eval on foot not performed M G8416 Pt inelig footwear evaluatio M G8417 Calc BMI abv up param f/u M G8418 Calc BMI blw low paramf/u M G8419 Calc BMI out nrm param nof/u MG8420 Calc BMI norm parameters M

G8421 BMI not calculated M G8422 Pt inelig BMI calculation M G8427 Doc cur meds by prov M G8428 Cur meds not document M G8430 Pt inelig med check M G8431 Pos clin depres scrn f/u doc M G8432 Clin depression screen not d M G8433 Pt inelig; scrn clin dep M G8440 Pain assess f/u pln document CHD G8441 No document of pain assess CHD G8442 Pt inelig pain assessment M G8447 Pt vis doc use EHR cer ATCB M G8448 Pt vis doc w/PQRI qual EHR M G8450 Beta-bloc rx pt w/abn lvef M G8451 Pt w/abn lvef inelig b-bloc M G8452 Pt w/abn lvef b-bloc no rx M G8458 Pt inelig geno no antvir tx M G8459 Doc pt rec antivir treat M G8460 Pt inelig RNA no antvir tx M G8461 Pt rec antivir treat hep c M G8462 Pt inelig couns no antvir tx M G8463 Pt rec antiviral treat doc M G8464 Pt inelig; lo to no dter rsk M G8465 High risk recurrence pro ca M G8468 ACE/ARB rx pt w/abn lvef M G8469 Pt w/abn lvef inelig ACE/ARB M G8470 Pt w/ normal lvef M G8471 LVEF not performed/doc M G8472 ACE/ARB no rx pt w/abn lvef M G8473 ACE/ARB thxpy rx'd M G8474 ACE/ARB not rx'd; doc reas M G8475 ACE/ARB thxpy not rx'd M G8476 BP sys <130 and dias <80 M G8477 BP sys>=130 and/or dias >=80 M G8478 BP not performed/doc M G8482 Flu immunize order/admin M G8483 Flu imm no ord/admin doc rea M G8484 Flu immunize no order/admin M G8485 Report, Diabetes measures M G8486 Report, Prev Care Measures M G8487 Report CKD Measures M G8489 CAD measures grp M G8490 RA measures grp M G8491 HIV/AIDS measures grp M G8492 Periop Care measures grp M G8493 Back pain measures grp M G8494 DM meas qual act perform M G8495 CKD meas qual act perform M G8496 Prev Care MG qual act perfrm M G8497 CABG meas qual act perform M G8498 CAD meas qual act perform M G8499 RA meas qual act perform M G8500 HIV meas qual act perform M G8501 Perio meas qual act perform MG8502 Back Pain MG qual act perfrm M

G8506 Pt rec ACE/ARB M G8508 Pt inelig; pain asses no f/u CHD G8509 Pos pain assess no f/u doc M G8510 Pt inelig neg scrn depres M G8511 Clin depres scrn no f/u doc M G8524 Patch closure conv CEA M G8525 No patch closure CEA M G8526 No patch closure conv CEA M G8530 Auto AV fistula recd M G8531 Pt inelig; auto AV fistula M G8532 No auto AV fistula; no reas M G8534 Doc elder mal scrn f/u plan CHD G8535 Pt inelig no eld mal scrn M G8536 No doc elder mal scrn M G8537 Pt inelig eldmal scrn no f/u CHD G8538 Eld mal scrn no f/u pln CHD G8539 Doc funct and care plan M G8540 Pt inelig funct assess M G8541 No doc cur funct assess M G8542 Doc funct no deficiencies M G8543 Cur funct asses; no care pln M G8544 CABG measures grp M G8545 HepC measures grp M G8546 CAP measures grp M G8547 IVD measures grp M G8548 HF measures grp M G8549 HepC MG qual act perform M G8550 CAP MG qual act perform M G8551 HF MG qual act perform M G8552 IVD MG qual act perform M G8553 1 Rx via qualified eRx sys M G8556 Ref to doc otolog eval M G8557 Pt inelig ref otolog eval M G8558 No ref to doc otolog eval M G8559 Pt ref doc oto eval M G8560 Pt hx act drain prev 90 days M G8561 Pt inelig for ref oto eval M G8562 Pt no hx act drain 90 d M G8563 Pt no ref oto reas no spec M G8564 Pt ref oto eval M G8565 Ver doc hear loss M G8566 Pt inelig ref oto eval M G8567 Pt no doc hear loss M G8568 Pt no ref otolo no spec M G8569 Prol intubation req M G8570 No prol intub req M G8571 Ster wd ifx 30 d postop M G8572 No ster wd ifx M G8573 Stk CABG M G8574 No strk CABG M G8575 Postop ren fail M G8576 No postop ren fail M G8577 Reop req bld grft oth M G8578 No reop req bld grft oth MG8579 Antplt med disch M

G8580 Antplt med contraind M G8581 no antplt med disch M G8582 Bblock disch M G8583 Bblock contraind M G8584 No bblock disch M G8585 Antilipid treat disch M G8586 Antlip disch contra M G8587 No antlipid treat disch M G8588 Sys BP <140 M G8589 Sys BP >= 140 M G8590 Dia BP < 90 M G8591 Dia BP >= 90 M G8592 No BP measure M G8593 Lipid pn results M G8594 No lipid prof perf M G8595 Ldl < 100 M G8596 No LDL perf M G8597 Ldl >= 100 M G8598 Asp therp used M G8599 No asp therp used M G8600 tPA initi w/in 3 hrs M G8601 No elig tPA init w/in 3 hrs M G8602 No tPA init w/in 3 hrs M G8603 Spok lang comp score M G8604 No high score spok lang M G8605 No spok lang comp score M G8606 Attention score M G8607 No high score attention M G8608 No attention score M G8609 Memory

score M G8610 No high score memory M G8611 No memory score M G8612 Moto speech score M G8613 No high score moto speech M G8614 No moto speech score M G8615 Reading score M G8616 No high score reading M G8617 No reading score M G8618 Spok lang exp score M G8619 No high score spok lang exp M G8620 No spok lang exp score M G8621 Writing score M G8622 No high score writing M G8623 No writing score M G8624 Swallowing score M G8625 No high score swallowing M G8626 No swallowing score M G8627 Surg proc w/in 30 days M G8628 No surg proc w/in 30 days M G8629 Doc antibio order b/4 surg M G8630 Doc antibio given b/4 surg M G8631 Pt no elg 4 order antbi give M G8632 Doc no antibi order b/4 surg M G8633 Pharm ther osteo rx MG8634 Pt no elg phar ther osteo M

G8635 No pharm ther osteo rx M G8636 Flu immun admin/prev rec CHD G8637 Pt no elg receiv flu immun CHD G8638 Flu immun no admin/prev rec CHD G8639 Flu immun admin or prev rec CHD G8640 Pt no elg rec flu immun CHD G8641 Flu immun not admin/pre rec CHD G8642 Hrdshp rural w/o internet M G8643 Hrdshp w/o suff pharm w/eRx M G8644 EP no prescribe priv M G8645 Asthma measures grp M G8646 Asthma MG qual act perform M G8647 Fun stat score knee >= 0 M G8648 Fun stat score knee < 0 M G8649 Fun stat score knee pt noelg M G8650 Fun stat score knee not done M G8651 Fun stat score hip >= 0 M G8652 Fun stat score hip < 0 M G8653 Fun stat score hip pt no elg M G8654 Fun stat score hip not done M G8655 Fun stat score LE >= 0 M G8656 Fun stat score LE < 0 M G8657 Fun stat score LE pt no elg M G8658 Fun stat score LE not done M G8659 Fun stat score LS >= 0 M G8660 Fun stat score LS < 0 M G8661 Fun stat score LS pt no elg M G8662 Fun stat score LS not done M G8663 Fun stat score shdl >=0 M G8664 Fun stat score shdl < 0 M G8665 Fun stat score shdl pt no el M G8666 Fun stat score shdl not done M G8667 Fun stat score UE >=0 M G8668 Fun stat score UE < 0 M G8669 Fun stat score UE pt no elg M G8670 Fun stat score UE not done M G8671 Fun stat score neck/TS >=0 M G8672 Fun stat score neck/TS < 0 M G8673 Fun stat scor nek/TS pt no e M G8674 Fun stat scor nek/TS not don M G8675 BP Syst >= 140 mmHg CHD G8676 BP Diast >= 90 mmHg CHD G8677 BP Syst < 130 mmHg CHD G8678 BP Syst >=130 - 139 mmHg CHD G8679 BP Diast < 80 mmHg CHD G8680 BP Diast 80-89 mmHg CHD G8681 Pt hosp w/HF CHD G8682 LVG test perf M G8683 Pt not elig for LVF test M G8684 Pt not hosp w/HF CHD G8685 LVF test not perf M G8686 Toba smkr curr or 2 hand exp CHD G8687 No tob smkr cur no 2 hnd exp CHD G8688 Smkls tob cur; no 2 hnd exp CHDG8689 Toba use not assess CHD

G8690 Curr toba smkr or 2 hand exp CHD G8691 No cur tob smkr no 2 hnd exp CHD G8692 Curr smkls tob; no 2 hnd exp CHD G8693 Tobacco no assess CHD G8694 Lvef <40% NIM G8695 Lvef >=40% NIM G8696 Antithromb thx presc NIM G8697 Antithromb no presc doc reas NIM G8698 Antithromb no presc no reas NIM G8699 Rehab ordered disch NIM G8700 Rehab not indicated disch NIM G8701 Rehab not ordered NIM G8702 Antiobiotics 4 hr prior surg NIM G8703 Antibiotics not prior surg NIM G8704 ECG performed NIM G8705 Med reas no ECG NIM G8706 Pt reas no ECG NIM G8707 ECG not performed NIM G8708 Antibiotic not pres NIM G8709 Med reas antibiotic pres NIM G8710 Pt pres antibiotic NIM G8711 Pres antibiotic NIM G8712 Not pres antibiotic NIM G8713 SpKt/V great 1.2 Kt/V NIM G8714 Hemodialysis 3 times week NIM G8715 Hemodialysis not 3 times wk NIM G8716 Pt reas not great 1.2Kt/V NIM G8717 Less 1.2 Kt/V NIM G8718 Great 1.7 Kt/V per week NIM G8720 Less 1.7 Kt/V per week NIM G8721 Pt, pn, hist grade doc NIM G8722 Med reas pt, pn, not doc NIM G8723 Spec sit not prim tumor NIM G8724 Pt, pn, hist grade not doc NIM G8725 Lipid profile perf doc NIM G8726 Doc reas no lipid profile NIM G8727 Hemo, perit, or kidney trans NIM G8728 Lipid profile not perf NIM G8730 Pain doc pos and plan NIM G8731 Pain neg no plan NIM G8732 No doc of pain NIM G8733 Doc pos elder mal scrn plan NIM G8734 Doc neg elder mal no plan NIM G8735 Eld mal scrn pos no plan NIM G8736 LDL-C <100mg/dL NIM G8737 LDL-C >=100mg/dL NIM G8738 Lvef < 40% NIM G8739 Lvef >= 40% NIM G8740 LVEF not perfrmd NIM G8741 Not tx spoken lang NIM G8742 Not tx attention NIM G8743 Not tx memory NIM G8744 Not tx motor speech NIM G8745 Not tx reading NIMG8746 Not tx spoken lang express NIM

G8747 Not tx writing NIM G8748 Not tx swallowing NIM G8749 Signs of melanoma absent NIM G8750 Signs of melanoma present NIM G8751 Smkg status not assess NIM G8752 Sys BP less 140 NIM G8753 Sys BP > or = 140 NIM G8754 Dias BP less 90 NIM G8755 Dias BP > or = 90 NIM G8756 No BP measure doc NIM G8757 COPD MG qual act perform NIM G8758 IBD MG qual act perform NIM G8759 OSA MG qual act perform NIM G8760 Epilepsy

MG qual act perform NIM G8761 Dementia MG qual act perform NIM G8762 PD MG qual act perform NIM G8763 Hyperten MG qual act perform NIM G8764 Car Prev MG qual act perform NIM G8765 Cataract MG qual act perform NIM G8767 Lipid panel res doc rev NIM G8768 Doc med reas no lipid profle NIM G8769 Lipid profile not perform NIM G8770 Urine protein test doc rev NIM G8771 Doc dx CKD (not stage 5) NIM G8772 Doc med reas no urine protn NIM G8773 No urine protein test NIM G8774 Serum creatinine doc rev NIM G8775 Doc med reas no serum crtn NIM G8776 No serum creatinine test NIM G8777 Diabetes screen NIM G8778 Doc med reas no diabete scrn NIM G8779 No diabetes screen NIM G8780 Counsel diet phys activity NIM G8781 Doc med reas no counsel diet NIM G8782 No counsel diet phys act NIM G8783 BP scrn perf rec interval NIM G8784 Pt no elig for BP assess NIM G8785 BP scrn no perf at interval NIM G8786 Severity

of angina assess NIM G8787 Angina present NIM G8788 Angina absent NIM G8789 Severity

angina not assess NIM G8790 Systolic <130mmHg NIM G8791 Systolic 130-139mmHg NIM G8792 Systolic >=140mmHg NIM G8793 Diastolic <80mmHg NIM G8794 Diastolic 80-89mmHg NIM G8795 Diastolic >=90mmHg NIM G8796 BP not doc NIM G8797 Specimen site not esophagus NIM G8798 Specimen site not prostate NIM G8799 Anticoag ordered NIM G8800 Doc reas anticoag not order NIM G8801 Anticoag not ordered NIMG8802 Pregnancy test order NIM G8803 Doc reas no pregnancy test NIM G8805 Pregnancy

test not order NIM G8806 Transab or transvag US NIM G8807 Doc reas no US NIM G8808 No transab or transvag US NIM G8809 Rh-immunoglobulin order NIM G8810 Doc reas no Rh-immuno NIM G8811 No Rh-immunoglobulin order NIM G8812 Pt not elig CTA, duplex, MRA NIM G8813 CTA, duplex, MRA performed NIM G8814 No CTA, duplex, MRA NIM G8815 Doc reas no statin therapy NIM G8816 Statin med pres at disch NIM G8817 Doc reas no statin med disch NIM G8818 Pt disch to home by day #7 NIM G8819 Aneurysm <= 5.5 cm NIM G8820 Aneurysm 5.6-6.0 cm NIM G8821 Aneurysm not infarenal NIM G8822 Male aneurysms >6cm NIM G8823 Female aneurysm >6cm NIM G8824 Female aneurysm 5.6-6.0 cm NIM G8825 Pt not disch to home day #7 NIM G8826 Pt disch home day #2 EVAR NIM G8827 Aneurysm≤ 5.5cm for women NIM G8828 Aneurysm <= 5.5cm for men NIM G8829 Aneurysm 5.6-6.0 cm for men NIM G8830 Aneurysm >6cm for men NIM G8831 Aneurysm >-6cm for women NIM G8832 Aneurysm 5.6-6.0 women NIM G8833 Pt not disch home day #2 EVAR NIM G8834 Pt disch home day #2 CEA NIM G8835 Asymptom no trans NIM G8836 Stroke or TIA <120 days CEA NIM G8837 Stroke or TIA >120 days CEA NIM G8838 Not disch home by day #2 NIM G8839 Sleep apnea assess NIM G8840 Doc reas no sleep apnea NIM G8841 No sleep apnea assess NIM G8842 AHI or RDI initial dx NIM G8843 Doc reas no AHI or RDI NIM G8844 No AHI or RDI initial dx NIM G8845 Pos Airway Press prescribed NIM G8846 Mod or severe OSA NIM G8847 Pos Air Press not prescribed NIM G8848 Mild OSA NIM G8849 Doc reas no Pos Air Press NIM G8850 No PAP prescribed NIM G8851 Adhere Pos Air Press therapy NIM G8852 Pos Air Press prescribe NIM G8853 Pos Air Press not prescribe NIM G8854 Reas no adhere Pos Air Pres NIM G8855 Pos Air Press adhere no perf NIM G8856 Ref for oto eval NIM G8857 No elig ref for oto eval NIMG8858 Not ref for oto eval NIM

G8859 Corticosteroids 10mg 60 days NIM G8860 Corticosteroid 10 mg 60 days NIM G8861 DXA ordered for osteo NIM G8862 No corticostrd 10mg 60 days NIM G8863 No assess bone loss NIM G8864 Pneumococcal vaccine admin NIM G8865 Doc med reas no pneumococcal NIM G8866 Doc pt reas no pneumococcal NIM G8867 No pneumococcal admin NIM G8868 1st course antiTNF NIM G8869 Doc immun hep B 1st antiTNF NIM G8870 HepB admin 1st antiTNF NIM G8871 No 1st antiTNF NIM G8872 Intraop image confirm excise NIM G8873 Specimen not intraop image NIM G8874 Tissue not image intraop NIM G8875 Breast cancer dx min invsive NIM G8876 Doc reas no min inv dx NIM G8877 No brst cncr dx min invasive NIM G8878 Sent lymph node biopsy NIM G8879 Node neg inv brst cncr NIM G8880 Doc reas no lymph node biop NIM G8881 Brst cncr stage > T1N0M0 NIM G8882 No sent lymph node biopsy NIM G8883 Rev, comm, track, doc biopsy NIM G8884 Doc reas biopsy not review NIM G8885 No rev, comm, track biopsy NIM G8886 BP under control NIM G8887 Doc med reas BP not control NIM G8888 BP not under control NIM G8889 No doc BP NIM G8890 LDL-C under control NIM G8891 Doc med reas no LDL-C contrl NIM G8892 Doc med reas no LDL-C test NIM G8893 LDL-C not under control NIM G8894 LDL-C not performed NIM G8895 Anticoag prescribe NIM G8896 Doc med reas no anticoag NIM G8897 Anticoag not prescribe NIM G8898 COPD Measures Group NIM G8899 Inflammatory Bowel Dis MG NIM G8900 Obstructive Sleep Apnea MG NIM G8901 Epilepsy

Measures Group NIM G8902 Dementia Measures Group NIM G8903 Parkinson’s Disease MG NIM G8904 Hypertension MG NIM G8905 Cardiovascular Prevention MG NIM G8906 Cataract Measures Group NIM G9001 MCCD, initial rate B G9002 MCCD,maintenance rate B G9003 MCCD, risk adj hi, initial B G9004 MCCD, risk adj lo, initial B G9005 MCCD, risk adj, maintenance B G9006 MCCD, Home monitoring BG9007 MCCD, sch team conf B

G9008 Mccd,phys coor-care ovrsght B G9009 MCCD, risk adj, level 3 B G9010 MCCD, risk adj, level 4 B G9011 MCCD, risk adj, level 5 B G9012 Other Specified Case Mgmt B G9013 ESRD demo bundle level I E G9014 ESRD demo bundle-level II E G9016 Demo-smoking cessation coun E G9017 Amantadine HCL 100mg oral A G9018 Zanamivir,inhalation pwd 10m A G9019 Oseltamivir phosphate 75mg A G9020 Rimantadine HCL 100mg oral A G9033 Amantadine HCL oral brand A G9034 Zanamivir, inh pwdr, brand A G9035 Oseltamivir phosp, brand A G9036 Rimantadine HCL, brand A G9041 Low vision rehab occupationa CHD G9042 Low vision rehab orient/mobi CHD G9043 Low vision lowvision therapi CHD G9044 Low vision rehabilate teache CHD G9050 Oncology

work-up evaluation E G9051 Oncology

tx decision-mgmt E G9052 Onc surveillance for disease E G9053 Onc expectant management pt E G9054 Onc supervision palliative E G9055 Onc visit unspecified NOS E G9056 Onc prac mgmt adheres guide E G9057 Onc pract mgmt differs trial E G9058 Onc prac mgmt disagree w/gui E G9059 Onc prac mgmt pt opt alterna E G9060 Onc prac mgmt dif pt comorb E G9061 Onc prac cond noadd by guide E G9062 Onc prac guide differs nos E G9063 Onc dx nsclc stgI no progres M G9064 Onc dx nsclc stg2 no progres M G9065 Onc dx nsclc stg3A no progre M G9066 Onc dx nsclc stg3B-4 metasta M G9067 Onc dx nsclc dx unknown nos M G9068 Onc dx sclc/nsclc limited M G9069 Onc dx sclc/nsclc ext at dx M G9070 Onc dx sclc/nsclc ext unknwn M G9071 Onc dx brst stg1-2B HR,nopro M G9072 Onc dx brst stg1-2 noprogres M G9073 Onc dx brst stg3-HR, no pro M G9074 Onc dx brst stg3-noprogress M G9075 Onc dx brst metastic/ recur M G9077 Onc dx prostate T1no progres M G9078 Onc dx prostate T2no progres M G9079 Onc dx prostate T3b-T4noprog M G9080 Onc dx prostate w/rise PSA M G9083 Onc dx prostate unknwn nos M G9084 Onc dx colon t1-3,n1-2,no pr M G9085 Onc dx colon T4, N0 w/o prog M G9086 Onc dx colon T1-4 no dx prog MG9087 Onc dx colon metas evid dx M

G9088 Onc dx colon metas noevid dx M G9089 Onc dx colon extent unknown M G9090 Onc dx rectal T1-2 no progr M G9091 Onc dx rectal T3 N0 no prog M G9092 Onc dx rectal T1-3,N1-2noprg M G9093 Onc dx rectal T4,N,M0 no prg M G9094 Onc dx rectal M1 w/mets prog M G9095 Onc dx rectal extent unknwn M G9096 Onc dx esophag T1-T3 noprog M G9097 Onc dx esophageal T4 no prog M G9098 Onc dx esophageal mets recur M G9099 Onc dx esophageal unknown M G9100 Onc dx gastric no recurrence M G9101 Onc dx gastric p R1-R2noprog M G9102 Onc dx gastric unresectable M G9103 Onc dx gastric recurrent M G9104 Onc dx gastric unknown NOS M G9105 Onc dx pancreatc p R0 res no M G9106 Onc dx pancreatc p R1/R2 no M G9107 Onc dx pancreatic unresectab M G9108 Onc dx pancreatic unknwn NOS M G9109 Onc dx head/neck T1-T2no prg M G9110 Onc dx head/neck T3-4 noprog M G9111 Onc dx head/neck M1 mets rec M G9112 Onc dx head/neck ext unknown M G9113 Onc dx ovarian stg1A-B no pr M G9114 Onc dx ovarian stg1A-B or 2 M G9115 Onc dx ovarian stg3/4 noprog M G9116 Onc dx ovarian recurrence M G9117 Onc dx ovarian unknown NOS M G9123 Onc dx CML chronic phase M G9124 Onc dx CML acceler phase M G9125 Onc dx CML blast phase M G9126 Onc dx CML remission M G9128 Onc dx multi myeloma stage I M G9129 Onc dx mult myeloma stg2 hig M G9130 Onc dx multi myeloma unknown M G9131 Onc dx brst unknown NOS M G9132 Onc dx prostate mets no cast M G9133 Onc dx prostate clinical met M G9134 Onc NHLstg 1-2 no relap no M G9135 Onc dx NHL stg 3-4 not relap M G9136 Onc dx NHL trans to lg Bcell M G9137 Onc dx NHL relapse/refractor M G9138 Onc dx NHL stg unknown M G9139 Onc dx CML dx status unknown M G9140 Frontier extended stay demo A G9141 Influenza A H1N1,admin w cou S 0350 G9142 Influenza A H1N1, vaccine E G9143 Warfarin respon genetic test A G9147 Outpt IV insulin tx any mea E G9156 Evaluation for wheelchair NIM J0120 Tetracyclin injection N J0129 Abatacept injection K 9230J0130 Abciximab injection K 1605

J0131 Acetaminophen injection NIG 9283 J0132 Acetylcysteine injection K 1272 J0133 Acyclovir injection N J0135 Adalimumab injection K 1083 J0150 Injection adenosine 6 MG N J0152 Adenosine injection K 0917 J0171 Adrenalin epinephrine inject N J0180 Agalsidase beta injection K 9208 J0190 Inj biperiden lactate/5 mg E J0200 Alatrofloxacin mesylate N J0205 Alglucerase injection K 0900 J0207 Amifostine K 7000 J0210 Methyldopate hcl injection K 2210 J0215 Alefacept K 1633 J0220 Alglucosidase alfa injection K 9234 J0221 Lumizyme injection NIG 1413 J0256 Alpha 1 proteinase inhibitor K 0901 J0257 Glassia injection NI K 1415 J0270 Alprostadil for injection B J0275 Alprostadil urethral suppos B J0278 Amikacin sulfate injection N J0280 Aminophyllin 250 MG inj N J0282 Amiodarone HCl N J0285 Amphotericin B N J0287 Amphotericin b lipid complex K 9024 J0288 Ampho b cholesteryl sulfate K 0735 J0289 Amphotericin b liposome inj K 0736 J0290 Ampicillin 500 MG inj N J0295 Ampicillin sodiumper 1.5 gm N J0300 Amobarbital 125 MG inj CHK 1341 J0330 Succinycholine chloride inj N J0348 Anidulafungin injection K 1349 J0350 Injection anistreplase 30 u E J0360 Hydralazine hcl injection N J0364 Apomorphine hydrochloride CHK 1360 J0365 Aprotonin, 10,000 kiu N J0380 Inj metaraminol bitartrate N J0390 Chloroquine injection N J0395 Arbutamine hcl injection E J0400 Aripiprazole injection N J0456 Azithromycin N J0461 Atropine sulfate injection N J0470 Dimecaprol injection N J0475 Baclofen 10 MG injection K 9032 J0476 Baclofen intrathecal trial K 1631 J0480 Basiliximab K 1683 J0490 Belimumab injection NIG 1353 J0500 Dicyclomine injection N J0515 Inj benztropine mesylate CHN J0520 Bethanechol chloride inject N J0558 PenG benzathine/procaine inj N J0561 Penicillin g benzathine inj N J0583 Bivalirudin K 3041 J0585 Injection,onabotulinumtoxinA K 0902J0586 AbobotulinumtoxinA K 1289

J0587 Inj, rimabotulinumtoxinB K 9018 J0588 Incobotulinumtoxin a NIG 9278 J0592 Buprenorphine hydrochloride N J0594 Busulfan injection K 1178 J0595 Butorphanol tartrate 1 mg N J0597 C-1 esterase, berinert G 9269 J0598 C-1 esterase, cinryze CHK 9251 J0600 Edetate calcium disodium inj K 1274 J0610 Calcium gluconate injection N J0620 Calcium glycer & lact/10 ML N J0630 Calcitonin salmon injection CHN J0636 Inj calcitriol per 0.1 mcg N J0637 Caspofungin acetate K 9019 J0638 Canakinumab injection G 1311 J0640 Leucovorin calcium injection N J0641 Levoleucovorin injection CHK 1236 J0670 Inj mepivacaine HCL/10 ml N J0690 Cefazolin sodiuminjection N J0692 Cefepime HCl for injection N J0694 Cefoxitin sodium injection N J0696 Ceftriaxone sodium injection N J0697 Sterile cefuroxime injection N J0698 Cefotaxime sodium injection N J0702 Betamethasone acet&sod phosp N J0706 Caffeine citrate injection N J0710 Cephapirin sodium injection N J0712 Ceftaroline fosamil inj NIG 9282 J0713 Inj ceftazidime per 500 mg N J0715 Ceftizoxime sodium / 500 MG N J0718 Certolizumab pegol inj CHK 9249 J0720 Chloramphenicol sodium injec N J0725 Chorionic gonadotropin/1000u N J0735 Clonidine hydrochloride CHN J0740 Cidofovir injection K 9033 J0743 Cilastatin sodium injection N J0744 Ciprofloxacin iv N J0745 Inj codeine phosphate /30 MG N J0760 Colchicine injection N J0770 Colistimethate sodium inj N J0775 Collagenase, clost hist inj G 1340 J0780 Prochlorperazine injection N J0795 Corticorelin ovine triflutal K 1684 J0800 Corticotropin injection K 1280 J0833 Cosyntropin injection NOS K 0835 J0834 Cosyntropin cortrosyn inj CHN J0840 Crotalidae poly immune fab NIG 9274 J0850 Cy

tomegalovirus imm IV /vial K 0903 J0878 Daptomycin injection K 9124 J0881 Darbepoetin alfa, non-esrd K 1685 J0882 Darbepoetin alfa, esrd use A J0885 Epoetin alfa, non-esrd K 1686 J0886 Epoetin alfa 1000 units ESRD A J0894 Decitabine injection K 9231 J0895 Deferoxamine mesylate inj NJ0897 Denosumab injection NIG 9272

J0900 Testosterone enanthate inj N J0945 Brompheniramine maleate inj CHN J1000 Depo-estradiol cypionate inj N J1020 Methylprednisolone 20 MG inj N J1030 Methylprednisolone 40 MG inj N J1040 Methylprednisolone 80 MG inj N J1051 Medroxyprogesterone inj N J1055 Medrxyprogester acetate inj E J1056 MA/EC contraceptiveinjection E J1060 Testosterone cypionate 1 ML N J1070 Testosterone cypionat 100 MG N J1080 Testosterone cypionat 200 MG N J1094 Inj dexamethasone acetate N J1100 Dexamethasone sodium phos N J1110 Inj dihydroergotamine mesylt N J1120 Acetazolamid sodium injectio N J1160 Digoxin injection N J1162 Digoxin immune fab (ovine) K 1687 J1165 Pheny

toin sodium injection N J1170 Hydromorphone injection N J1180 Dyphylline injection N J1190 Dexrazoxane HCl injection K 0726 J1200 Diphenhydramine hcl injectio N J1205 Chlorothiazide sodiuminj K 0747 J1212 Dimethyl sulfoxide 50% 50 ML K 1221 J1230 Methadone injection N J1240 Dimenhydrinate injection N J1245 Dipyridamole injection N J1250 Inj dobutamine HCL/250 mg N J1260 Dolasetron mesylate N J1265 Dopamine injection N J1267 Doripenem injection N J1270 Injection, doxercalciferol N J1290 Ecallantide injection G 9263 J1300 Eculizumab injection K 9236 J1320 Amitriptyline injection N J1324 Enfuvirtide injection CHK 1361 J1325 Epoprostenol injection N J1327 Eptifibatide injection K 1607 J1330 Ergonovine maleate injection N J1335 Ertapenem injection N J1364 Ery

thro lactobionate /500 MG N J1380 Estradiol valerate 10 MG inj N J1410 Inj estrogen conjugate 25 MG K 9038 J1430 Ethanolamine oleate 100 mg K 1688 J1435 Injection estrone per 1 MG E J1436 Etidronate disodium inj N J1438 Etanercept injection K 1608 J1440 Filgrastim 300 mcg injection K 0728 J1441 Filgrastim 480 mcg injection K 7049 J1450 Fluconazole N J1451 Fomepizole, 15 mg K 1689 J1452 Intraocular Fomivirsen na E J1453 Fosaprepitant injection K 9242J1455 Foscarnet sodium injection CHK 1359

J1457 Galliumnitrate injection CHN J1458 Galsulfase injection K 9224 J1459 Inj IVIG privigen 500 mg K 1214 J1460 Gamma globulin 1 CC inj K 3043 J1557 Gammaplex injection NIG 9270 J1559 Hizentra injection K 1312 J1560 Gamma globulin > 10 CC inj K 0933 J1561 Gamunex/gamunex c K 0948 J1562 Vivaglobin, inj K 1275 J1566 Immune globulin, powder K 2731 J1568 Octagam injection K 0943 J1569 Gammagard liquid injection K 0944 J1570 Ganciclovir sodium injection CHK 1343 J1571 Hepagam b im injection K 0946 J1572 Flebogamma injection G 0947 J1573 Hepagam b intravenous, inj K 1138 J1580 Garamycin gentamicin inj N J1590 Gatifloxacin injection N J1595 Injection glatiramer acetate K 1015 J1599 Ivig non-lyophilized, NOS N J1600 Gold sodium thiomaleate inj N J1610 Glucagon hydrochloride/1 MG K 9042 J1620 Gonadorelin hydroch/ 100 mcg CHK 1344 J1626 Granisetron hcl injection N J1630 Haloperidol injection N J1631 Haloperidol decanoate inj N J1640 Hemin, 1 mg K 1690 J1642 Inj heparin sodium per 10 u CHK 1362 J1644 Inj heparin sodium per 1000u CHK 1373 J1645 Dalteparin sodium N J1650 Inj enoxaparin sodium N J1652 Fondaparinux sodium N J1655 Tinzaparin sodium injection N J1670 Tetanus immune globulin inj K 1670 J1675 Histrelin acetate B J1680 Human fibrinogen conc inj CHK 1290 J1700 Hydrocortisone acetate inj N J1710 Hydrocortisone sodium ph inj N J1720 Hydrocortisone sodium succ i N J1725 Hydroxyprogesterone caproate NI K 1354 J1730 Diazoxide injection CHN J1740 Ibandronate sodium injection K 9229 J1742 Ibutilide fumarate injection K 9044 J1743 Idursulfase injection K 9232 J1745 Infliximab injection K 7043 J1750 Inj iron dextran K 1237 J1756 Iron sucrose injection K 9046 J1786 Imuglucerase injection K 1327 J1790 Droperidol injection N J1800 Propranolol injection N J1810 Droperidol/fentanyl inj E J1815 Insulin injection N J1817 Insulin for insulin pump use N J1826 Interferon Beta-1A inj EJ1830 Interferon beta-1b / .25 MG K 0910

J1835 Itraconazole injection CHK 1355 J1840 Kanamycin sulfate 500 MG inj N J1850 Kanamycin sulfate 75 MG inj N J1885 Ketorolac tromethamine inj N J1890 Cephalothin sodiuminjection N J1930 Lanreotide injection K 9237 J1931 Laronidase injection K 9209 J1940 Furosemide injection N J1945 Lepirudin K 1693 J1950 Leuprolide acetate /3.75 MG K 0800 J1953 Levetiracetam injection N J1955 Inj levocarnitine per 1 gm B J1956 Levofloxacin injection N J1960 Levorphanol tartrate inj N J1980 Hyoscyamine sulfate inj N J1990 Chlordiazepoxide injection N J2001 Lidocaine injection N J2010 Lincomycin injection N J2020 Linezolid injection K 9001 J2060 Lorazepaminjection N J2150 Mannitol injection N J2170 Mecasermin injection K 1308 J2175 Meperidine hydrochl /100 MG N J2180 Meperidine/promethazine inj N J2185 Meropenem N J2210 Methylergonovin maleate inj N J2248 Micafungin sodium injection K 9227 J2250 Inj midazolam hydrochloride N J2260 Inj milrinone lactate / 5 MG N J2265 Minocycline hydrochloride NI E J2270 Morphine sulfate injection N J2271 Morphine so4 injection 100mg N J2275 Morphine sulfate injection N J2278 Ziconotide injection K 1694 J2280 Inj, moxifloxacin 100 mg N J2300 Inj nalbuphine hydrochloride N J2310 Inj naloxone hydrochloride N J2315 Naltrexone, depot form K 0759 J2320 Nandrolone decanoate 50 MG CHN J2323 Natalizumab injection K 9126 J2325 Nesiritide injection K 1695 J2353 Octreotide injection, depot K 1207 J2354 Octreotide inj, non-depot N J2355 Oprelvekin injection K 7011 J2357 Omalizumab injection K 9300 J2358 Olanzapine long-acting inj K 1331 J2360 Orphenadrine injection N J2370 Phenylephrine hcl injection N J2400 Chloroprocaine hcl injection N J2405 Ondansetron hcl injection N J2410 Oxymorphone hcl injection N J2425 Palifermin injection K 1696 J2426 Paliperidone palmitate inj CHK 9255 J2430 Pamidronate disodium /30 MG NJ2440 Papaverin hcl injection N

J2460 Oxy

tetracycline injection E J2469 Palonosetron hcl K 9210 J2501 Paricalcitol N J2503 Pegaptanib sodiuminjection K 1697 J2504 Pegademase bovine, 25 iu K 1739 J2505 Injection, pegfilgrastim 6mg K 9119 J2507 Pegloticase injection NIG 9281 J2510 Penicillin g procaine inj CHN J2513 Pentastarch 10% solution K 1222 J2515 Pentobarbital sodium inj N J2540 Penicillin g potassium inj N J2543 Piperacillin/tazobactam N J2545 Pentamidine non-comp unit B J2550 Promethazine hcl injection N J2560 Phenobarbital sodium inj N J2562 Plerixafor injection CHK 9252 J2590 Oxy

tocin injection N J2597 Inj desmopressin acetate N J2650 Prednisolone acetate inj N J2670 Totazoline hcl injection N J2675 Inj progesterone per 50 MG N J2680 Fluphenazine decanoate 25 MG N J2690 Procainamide hcl injection N J2700 Oxacillin sodium injeciton K 1347 J2710 Neostigmine methylslfte inj N J2720 Inj protamine sulfate/10 MG N J2724 Protein c concentrate K 1139 J2725 Inj protirelin per 250 mcg CHK 1357 J2730 Pralidoxime chloride inj K 1023 J2760 Phentolaine mesylate inj CHK 1358 J2765 Metoclopramide hcl injection N J2770 Quinupristin/dalfopristin K 2770 J2778 Ranibizumab injection K 9233 J2780 Ranitidine hydrochloride inj N J2783 Rasburicase K 0738 J2785 Regadenoson injection K 9244 J2788 Rho d immune globulin 50 mcg K 9023 J2790 Rho d immune globulin inj K 0884 J2791 Rhophylac injection K 0945 J2792 Rho(D) immune globulin h, sd K 1609 J2793 Rilonacept injection K 1291 J2794 Risperidone, long acting K 9125 J2795 Ropivacaine HCl injection N J2796 Romiplostim injection K 9245 J2800 Methocarbamol injection N J2805 Sincalide injection CHN J2810 Inj theophylline per 40 MG N J2820 Sargramostim injection K 0731 J2850 Inj secretin synthetic human K 1700 J2910 Aurothioglucose injeciton N J2916 Na ferric gluconate complex N J2920 Methylprednisolone injection N J2930 Methylprednisolone injection N J2940 Somatrem injection CHEJ2941 Somatropin injection K 7034

J2950 Promazine hcl injection N J2993 Reteplase injection K 9005 J2995 Inj streptokinase /250000 IU K 1226 J2997 Alteplase recombinant K 7048 J3000 Streptomycin injection N J3010 Fentanyl citrate injeciton N J3030 Sumatriptan succinate / 6 MG CHK 1374 J3070 Pentazocine injection N J3095 Telavancin injection G 9258 J3101 Tenecteplase injection K 9002 J3105 Terbutaline sulfate inj N J3110 Teriparatide injection B J3120 Testosterone enanthate inj N J3130 Testosterone enanthate inj N J3140 Testosterone suspension inj N J3150 Testosteron propionate inj N J3230 Chlorpromazine hcl injection N J3240 Thyrotropin injection K 9108 J3243 Tigecycline injection K 9228 J3246 Tirofiban HCl K 7041 J3250 Trimethobenzamide hcl inj N J3260 Tobramycin sulfate injection N J3262 Tocilizumab injection G 9264 J3265 Injection torsemide 10 mg/ml N J3280 Thiethylperazine maleate inj N J3285 Treprostinil injection K 1701 J3300 Triamcinolone A inj PRS-free K 1253 J3301 Triamcinolone acet inj NOS N J3302 Triamcinolone diacetate inj N J3303 Triamcinolone hexacetonl inj N J3305 Inj trimetrexate glucoronate CHE J3310 Perphenazine injeciton K 1304 J3315 Triptorelin pamoate K 9122 J3320 Spectinomycn di-hcl inj E J3350 Urea injection K 1306 J3355 Urofollitropin, 75 iu K 1741 J3357 Ustekinumab injection G 9261 J3360 Diazepaminjection N J3364 Urokinase 5000 IU injection N J3365 Urokinase 250,000 IU inj K 7036 J3370 Vancomycin hcl injection N J3385 Velaglucerase alfa G 9271 J3396 Verteporfin injection K 1203 J3400 Triflupromazine hcl inj E J3410 Hydroxy

zine hcl injection N J3411 Thiamine hcl 100 mg N J3415 Pyridoxine hcl 100 mg N J3420 Vitamin b12 injection N J3430 Vitamin k phy tonadione inj N J3465 Injection, voriconazole K 1052 J3470 Hyaluronidase injection N J3471 Ovine, up to 999 USP units N J3472 Ovine, 1000 USP units N J3473 Hyaluronidase recombinant NJ3475 Inj magnesium sulfate N

J3480 Inj potassium chloride N J3485 Zidovudine N J3486 Ziprasidone mesylate N J3487 Zoledronic acid K 9115 J3488 Reclast injection K 0951 J3490 Drugs unclassified injection N J3520 Edetate disodiumper 150 mg E J3530 Nasal vaccine inhalation N J3535 Metered dose inhaler drug E J3570 Laetrile amygdalin vit B17 E J3590 Unclassified biologics N J7030 Normal saline solution infus N J7040 Normal saline solution infus N J7042 5% dextrose/normal saline N J7050 Normal saline solution infus N J7060 5% dextrose/water N J7070 D5w infusion N J7100 Dextran 40 infusion N J7110 Dextran 75 infusion N J7120 Ringers lactate infusion N J7130 Hypertonic saline solution CHD J7131 Hypertonic saline sol NI N J7180 Factor XIII anti-hem factor NIG 1416 J7183 Wilate injection NIG 1352 J7184 Wilate injection CHD J7185 Xyntha inj K 1268 J7186 Antihemophilic viii/vwf comp K 1213 J7187 Humate-P, inj K 1704 J7189 Factor viia K 1705 J7190 Factor viii K 0925 J7191 Factor VIII (porcine) K 1279 J7192 Factor viii recombinant NOS K 0927 J7193 Factor IX non-recombinant K 0931 J7194 Factor ix complex K 0928 J7195 Factor IX recombinant K 0932 J7196 Antithrombin recombinant K 1332 J7197 Antithrombin iii injection K 1263 J7198 Anti-inhibitor K 0929 J7199 Hemophilia clot factor noc B J7300 Intraut copper contraceptive E J7302 Levonorgestrel iu contracept E J7303 Contraceptive vaginal ring E J7304 Contraceptive hormone patch E J7306 Levonorgestrel implant sys E J7307 Etonogestrel implant system E J7308 Aminolevulinic acid hcl top K 7308 J7309 Methyl aminolevulinate, top K 1338 J7310 Ganciclovir long act implant K 0913 J7311 Fluocinolone acetonide implt K 9225 J7312 Dexamethasone intra implant CHK 9256 J7321 Hyalgan/supartz inj per dose K 0873 J7323 Euflexxa inj per dose K 0875 J7324 Orthovisc inj per dose K 0877 J7325 Synvisc or Synvisc-One K 0874J7326 Gel-one NI K 1417

J7330 Cultured chondrocy tes implnt B J7335 Capsaicin 8% patch G 9268 J7500 Azathioprine oral 50mg N J7501 Azathioprine parenteral K 0887 J7502 Cyclosporine oral 100 mg N J7504 Lymphocy

te immune globulin K 0890 J7505 Monoclonal antibodies K 7038 J7506 Prednisone oral N J7507 Tacrolimus oral per 1 MG N J7509 Methylprednisolone oral N J7510 Prednisolone oral per 5 mg N J7511 Antithymocy te globuln rabbit K 9104 J7513 Daclizumab, parenteral K 1612 J7515 Cyclosporine oral 25 mg N J7516 Cyclosporin parenteral 250mg N J7517 Mycophenolate mofetil oral N J7518 Mycophenolic acid N J7520 Sirolimus, oral N J7525 Tacrolimus injection K 9006 J7599 Immunosuppressive drug noc N J7604 Acetylcysteine comp unit M J7605 Arformoterol non-comp unit M J7606 Formoterol fumarate, inh M J7607 Levalbuterol comp con M J7608 Acetylcysteine non-comp unit M J7609 Albuterol comp unit M J7610 Albuterol comp con M J7611 Albuterol non-comp con M J7612 Levalbuterol non-comp con M J7613 Albuterol non-comp unit M J7614 Levalbuterol non-comp unit M J7615 Levalbuterol comp unit M J7620 Albuterol ipratrop non-comp M J7622 Beclomethasone comp unit M J7624 Betamethasone comp unit M J7626 Budesonide non-comp unit M J7627 Budesonide comp unit M J7628 Bitolterol mesylate comp con M J7629 Bitolterol mesylate comp unt M J7631 Cromolyn sodium noncomp unit M J7632 Cromolyn sodium comp unit M J7633 Budesonide non-comp con M J7634 Budesonide comp con M J7635 Atropine comp con M J7636 Atropine comp unit M J7637 Dexamethasone comp con M J7638 Dexamethasone comp unit M J7639 Dornase alfa non-comp unit M J7640 Formoterol comp unit E J7641 Flunisolide comp unit M J7642 Glycopyrrolate comp con M J7643 Glycopyrrolate comp unit M J7644 Ipratropium bromide non-comp M J7645 Ipratropium bromide comp MJ7647 Isoetharine comp con M

J7648 Isoetharine non-comp con M J7649 Isoetharine non-comp unit M J7650 Isoetharine comp unit M J7657 Isoproterenol comp con M J7658 Isoproterenol non-comp con M J7659 Isoproterenol non-comp unit M J7660 Isoproterenol comp unit M J7665 Mannitol for inhaler NIM J7667 Metaproterenol comp con M J7668 Metaproterenol non-comp con M J7669 Metaproterenol non-comp unit M J7670 Metaproterenol comp unit M J7674 Methacholine chloride, neb N J7676 Pentamidine comp unit dose M J7680 Terbutaline sulf comp con M J7681 Terbutaline sulf comp unit M J7682 Tobramycin non-comp unit M J7683 Triamcinolone comp con M J7684 Triamcinolone comp unit M J7685 Tobramycin comp unit M J7686 Treprostinil, non-comp unit M J7699 Inhalation solution for DME M J7799 Non-inhalation drug for DME N J8498 Antiemetic rectal/supp NOS B J8499 Oral prescrip drug non chemo E J8501 Oral aprepitant K 0868 J8510 Oral busulfan K 1307 J8515 Cabergoline, oral 0.25mg E J8520 Capecitabine, oral, 150 mg K 7042 J8521 Capecitabine, oral, 500 mg K 0934 J8530 Cyclophosphamide oral 25 MG N J8540 Oral dexamethasone N J8560 Etoposide oral 50 MG K 0802 J8561 Oral everolimus NI K 1418 J8562 Oral fludarabine phosphate G 1339 J8565 Gefitinib oral E J8597 Antiemetic drug oral NOS N J8600 Melphalan oral 2 MG N J8610 Methotrexate oral 2.5 MG N J8650 Nabilone oral CHE J8700 Temozolomide K 1086 J8705 Topotecan oral CHK 1238 J8999 Oral prescription drug chemo B J9000 Doxorubicin hcl injection N J9001 Doxorubicin hcl liposome inj K 7046 J9010 Alemtuzumab injection K 9110 J9015 Aldesleukin injection K 0807 J9017 Arsenic trioxide injection K 9012 J9020 Asparaginase injection K 0814 J9025 Azacitidine injection K 1709 J9027 Clofarabine injection K 1710 J9031 Bcg live intravesical vac K 0809 J9033 Bendamustine injection K 9243 J9035 Bevacizumab injection K 9214J9040 Bleomycin sulfate injection N

J9041 Bortezomib injection K 9207 J9043 Cabazitaxel injection NIG 9276 J9045 Carboplatin injection N J9050 Carmustine injection K 0812 J9055 Cetuximab injection K 9215 J9060 Cisplatin 10 MG injection N J9065 Inj cladribine per 1 MG K 0858 J9070 Cyclophosphamide 100 MG inj CHK 1408 J9098 Cy

tarabine liposome inj K 1166 J9100 Cy

tarabine hcl 100 MG inj N J9120 Dactinomycin injection K 0752 J9130 Dacarbazine 100 mg inj N J9150 Daunorubicin injection K 0820 J9151 Daunorubicin citrate inj K 0821 J9155 Degarelix injection CHK 1296 J9160 Denileukin diftitox inj K 1084 J9165 Diethylstilbestrol injection CHE J9171 Docetaxel injection K 0823 J9175 Elliotts b solution per ml N J9178 Inj, epirubicin hcl, 2 mg K 1167 J9179 Eribulin mesylate injection NIG 1426 J9181 Etoposide injection N J9185 Fludarabine phosphate inj K 0842 J9190 Fluorouracil injection N J9200 Floxuridine injection K 0827 J9201 Gemcitabine hcl injection K 0828 J9202 Goserelin acetate implant K 0810 J9206 Irinotecan injection K 0830 J9207 Ixabepilone injection K 9240 J9208 Ifosfamide injection K 0831 J9209 Mesna injection N J9211 Idarubicin hcl injection K 0832 J9212 Interferon alfacon-1 inj CHN J9213 Interferon alfa-2a inj N J9214 Interferon alfa-2b inj K 0836 J9215 Interferon alfa-n3 inj K 0865 J9216 Interferon gamma 1-b inj K 0838 J9217 Leuprolide acetate suspnsion K 9217 J9218 Leuprolide acetate injeciton K 0861 J9219 Leuprolide acetate implant K 7051 J9225 Vantas implant K 1711 J9226 Supprelin LA implant K 1142 J9228 Ipilimumab injection NIG 9284 J9230 Mechlorethamine hcl inj K 0751 J9245 Inj melphalan hydrochl 50 MG K 0840 J9250 Methotrexate sodium inj N J9260 Methotrexate sodium inj N J9261 Nelarabine injection K 0825 J9263 Oxaliplatin K 1738 J9264 Paclitaxel protein bound K 1712 J9265 Paclitaxel injection CHN J9266 Pegaspargase injection K 0843 J9268 Pentostatin injection K 0844 J9270 Plicamycin (mithramycin) inj NJ9280 Mitomycin 5 MG inj K 1232

J9293 Mitoxantrone hydrochl / 5 MG K 0864 J9300 Gemtuzumab ozogamicin inj K 9004 J9302 Ofatumumab injection G 9260 J9303 Panitumumab injection K 9235 J9305 Pemetrexed injection K 9213 J9307 Pralatrexate injection G 9259 J9310 Rituximab injection K 0849 J9315 Romidepsin injection G 9265 J9320 Streptozocin injection K 0850 J9328 Temozolomide injection CHK 9253 J9330 Temsirolimus injection K 1168 J9340 Thiotepa injection K 0851 J9351 Topotecan injection K 1350 J9355 Trastuzumab injection K 1613 J9357 Valrubicin injection K 1235 J9360 Vinblastine sulfate inj N J9370 Vincristine sulfate 1 MG inj N J9390 Vinorelbine tartrate inj CHK 1412 J9395 Injection, Fulvestrant K 9120 J9600 Porfimer sodium injection K 0856 J9999 Chemotherapy drug N K0001 Standard wheelchair Y K0002 Stnd hemi (low seat) whlchr Y K0003 Lightweight wheelchair Y K0004 High strength ltwt whlchr Y K0005 Ultralightweight wheelchair Y K0006 Heavy

duty wheelchair Y K0007 Extra heavy duty wheelchair Y K0009 Other manual wheelchair/base Y K0010 Stnd wt frame power whlchr Y K0011 Stnd wt pwr whlchr w control Y K0012 Ltwt portbl power whlchr Y K0014 Other power whlchr base Y K0015 Detach non-adjus hght armrst Y K0017 Detach adjust armrest base Y K0018 Detach adjust armrst upper Y K0019 Arm pad each Y K0020 Fixed adjust armrest pair Y K0037 High mount flip-up footrest Y K0038 Leg strap each Y K0039 Leg strap h style each Y K0040 Adjustable angle footplate Y K0041 Large size footplate each Y K0042 Standard size footplate each Y K0043 Ftrst lower extension tube Y K0044 Ftrst upper hanger bracket Y K0045 Footrest complete assembly Y K0046 Elevat legrst low extension Y K0047 Elevat legrst up hangr brack Y K0050 Ratchet assembly Y K0051 Cam relese assem ftrst/lgrst Y K0052 Swingaway detach footrest Y K0053 Elevate footrest articulate Y K0056 Seat ht <17 or >=21 ltwt wc YK0065 Spoke protectors Y

K0069 Rear whl complete solid tire Y K0070 Rear whl compl pneum tire Y K0071 Front castr compl pneum tire Y K0072 Frnt cstr cmpl sem-pneum tir Y K0073 Caster pin lock each Y K0077 Front caster assem complete Y K0098 Drive belt power wheelchair Y K0105 Iv hanger Y K0108 W/c component-accessory NOS Y K0195 Elevating whlchair leg rests Y K0455 Pump uninterrupted infusion Y K0462 Temporary

replacement eqpmnt Y K0552 Supply

/ext inf pump syr type Y K0601 Repl batt silver oxide 1.5 v Y K0602 Repl batt silver oxide 3 v Y K0603 Repl batt alkaline 1.5 v Y K0604 Repl batt lithium3.6 v Y K0605 Repl batt lithium4.5 v Y K0606 AED garment w elec analysis Y K0607 Repl batt for AED Y K0608 Repl garment for AED Y K0609 Repl electrode for AED Y K0669 Seat/back cus no dmepdac ver Y K0672 Removable soft interface LE A K0730 Ctrl dose inh drug deliv sys Y K0733 12-24hr sealed lead acid Y K0738 Portable gas oxygen system Y K0739 Repair/svc DME non-oxygen eq Y K0740 Repair/svc oxygen equipment E K0741 Portable gaseous oxygen sys Y K0742 Portable gaseous oxygen Y K0743 Portable home suction pump Y K0744 Absorp drg <= 16 suc pump A K0745 Absorp drg >16<=48 suc pump A K0746 Absorp drg >48 suc pump A K0800 POV group 1 std up to 300lbs Y K0801 POV group 1 hd 301-450 lbs Y K0802 POV group 1 vhd 451-600 lbs Y K0806 POV group 2 std up to 300lbs Y K0807 POV group 2 hd 301-450 lbs Y K0808 POV group 2 vhd 451-600 lbs Y K0812 Power operated vehicle NOC Y K0813 PWC gp 1 std port seat/back Y K0814 PWC gp 1 std port cap chair Y K0815 PWC gp 1 std seat/back Y K0816 PWC gp 1 std cap chair Y K0820 PWC gp 2 std port seat/back Y K0821 PWC gp 2 std port cap chair Y K0822 PWC gp 2 std seat/back Y K0823 PWC gp 2 std cap chair Y K0824 PWC gp 2 hd seat/back Y K0825 PWC gp 2 hd cap chair Y K0826 PWC gp 2 vhd seat/back Y K0827 PWC gp vhd cap chair YK0828 PWC gp 2 xtra hd seat/back Y

K0829 PWC gp 2 xtra hd cap chair Y K0830 PWC gp2 std seat elevate s/b Y K0831 PWC gp2 std seat elevate cap Y K0835 PWC gp2 std sing pow opt s/b Y K0836 PWC gp2 std sing pow opt cap Y K0837 PWC gp 2 hd sing pow opt s/b Y K0838 PWC gp 2 hd sing pow opt cap Y K0839 PWC gp2 vhd sing pow opt s/b Y K0840 PWC gp2 xhd sing pow opt s/b Y K0841 PWC gp2 std mult pow opt s/b Y K0842 PWC gp2 std mult pow opt cap Y K0843 PWC gp2 hd mult pow opt s/b Y K0848 PWC gp 3 std seat/back Y K0849 PWC gp 3 std cap chair Y K0850 PWC gp 3 hd seat/back Y K0851 PWC gp 3 hd cap chair Y K0852 PWC gp 3 vhd seat/back Y K0853 PWC gp 3 vhd cap chair Y K0854 PWC gp 3 xhd seat/back Y K0855 PWC gp 3 xhd cap chair Y K0856 PWC gp3 std sing pow opt s/b Y K0857 PWC gp3 std sing pow opt cap Y K0858 PWC gp3 hd sing pow opt s/b Y K0859 PWC gp3 hd sing pow opt cap Y K0860 PWC gp3 vhd sing pow opt s/b Y K0861 PWC gp3 std mult pow opt s/b Y K0862 PWC gp3 hd mult pow opt s/b Y K0863 PWC gp3 vhd mult pow opt s/b Y K0864 PWC gp3 xhd mult pow opt s/b Y K0868 PWC gp 4 std seat/back Y K0869 PWC gp 4 std cap chair Y K0870 PWC gp 4 hd seat/back Y K0871 PWC gp 4 vhd seat/back Y K0877 PWC gp4 std sing pow opt s/b Y K0878 PWC gp4 std sing pow opt cap Y K0879 PWC gp4 hd sing pow opt s/b Y K0880 PWC gp4 vhd sing pow opt s/b Y K0884 PWC gp4 std mult pow opt s/b Y K0885 PWC gp4 std mult pow opt cap Y K0886 PWC gp4 hd mult pow s/b Y K0890 PWC gp5 ped sing pow opt s/b Y K0891 PWC gp5 ped mult pow opt s/b Y K0898 Power wheelchair NOC Y K0899 Pow mobil dev no dmepdac Y L0112 Cranial cervical orthosis A L0113 Cranial cervical torticollis A L0120 Cerv flexible non-adjustable A L0130 Flex thermoplastic collar mo A L0140 Cervical semi-rigid adjustab A L0150 Cerv semi-rig adj molded chn A L0160 Cerv semi-rig wire occ/mand A L0170 Cervical collar molded to pt A L0172 Cerv col thermplas foam 2 pi A L0174 Cerv col foam 2 piece w thor AL0180 Cer post col occ/man sup adj A

L0190 Cerv collar supp adj cerv ba A L0200 Cerv col supp adj bar & thor A L0220 Thor rib belt custom fabrica A L0430 Dewall posture protector A L0450 TLSO flex prefab thoracic A L0452 tlso flex custom fab thoraci A L0454 TLSO flex prefab sacrococ-T9 A L0456 TLSO flex prefab A L0458 TLSO 2Mod symphis-xipho pre A L0460 TLSO2Mod symphysis-stern pre A L0462 TLSO 3Mod sacro-scap pre A L0464 TLSO 4Mod sacro-scap pre A L0466 TLSO rigid frame pre soft ap A L0468 TLSO rigid frame prefab pelv A L0470 TLSO rigid frame pre subclav A L0472 TLSO rigid frame hyperex pre A L0480 TLSO rigid plastic custom fa A L0482 TLSO rigid lined custom fab A L0484 TLSO rigid plastic cust fab A L0486 TLSO rigidlined cust fab two A L0488 TLSO rigid lined pre one pie A L0490 TLSO rigid plastic pre one A L0491 TLSO 2 piece rigid shell A L0492 TLSO 3 piece rigid shell A L0621 SIO flex pelvisacral prefab A L0622 SIO flex pelvisacral custom A L0623 SIO panel prefab A L0624 SIO panel custom A L0625 LO flexibl L1-below L5 pre A L0626 LO sag stays/panels pre-fab A L0627 LO sagitt rigid panel prefab A L0628 LO flex w/o rigid stays pre A L0629 LSO flex w/rigid stays cust A L0630 LSO post rigid panel pre A L0631 LSO sag-coro rigid frame pre A L0632 LSO sag rigid frame cust A L0633 LSO flexion control prefab A L0634 LSO flexion control custom A L0635 LSO sagit rigid panel prefab A L0636 LSO sagittal rigid panel cus A L0637 LSO sag-coronal panel prefab A L0638 LSO sag-coronal panel custom A L0639 LSO s/c shell/panel prefab A L0640 LSO s/c shell/panel custom A L0700 Ctlso a-p-l control molded A L0710 Ctlso a-p-l control w/ inter A L0810 Halo cervical into jckt vest A L0820 Halo cervical into body jack A L0830 Halo cerv into milwaukee typ A L0859 MRI compatible system A L0861 Halo repl liner/interface A L0970 Tlso corset front A L0972 Lso corset front A L0974 Tlso full corset AL0976 Lso full corset A

L0978 Axillary

crutch extension A L0980 Peroneal straps pair A L0982 Stocking supp grips set of f A L0984 Protective body sock each A L0999 Add to spinal orthosis NOS A L1000 Ctlso milwauke initial model A L1001 CTLSO infant immobilizer A L1005 Tension based scoliosis orth A L1010 Ctlso axilla sling A L1020 Kyphosis pad A L1025 Kyphosis pad floating A L1030 Lumbar bolster pad A L1040 Lumbar or lumbar rib pad A L1050 Sternal pad A L1060 Thoracic pad A L1070 Trapezius sling A L1080 Outrigger A L1085 Outrigger bil w/ vert extens A L1090 Lumbar sling A L1100 Ring flange plastic/leather A L1110 Ring flange plas/leather mol A L1120 Covers for upright each A L1200 Furnsh initial orthosis only A L1210 Lateral thoracic extension A L1220 Anterior thoracic extension A L1230 Milwaukee type superstructur A L1240 Lumbar derotation pad A L1250 Anterior asis pad A L1260 Anterior thoracic derotation A L1270 Abdominal pad A L1280 Rib gusset (elastic) each A L1290 Lateral trochanteric pad A L1300 Body

jacket mold to patient A L1310 Post-operative body jacket A L1499 Spinal orthosis NOS A L1500 Thkao mobility frame CHD L1510 Thkao standing frame CHD L1520 Thkao swivel walker CHD L1600 Abduct hip flex frejka w cvr A L1610 Abduct hip flex frejka covr A L1620 Abduct hip flex pavlik harne A L1630 Abduct control hip semi-flex A L1640 Pelv band/spread bar thigh c A L1650 HO abduction hip adjustable A L1652 HO bi thighcuffs w sprdr bar A L1660 HO abduction static plastic A L1680 Pelvic & hip control thigh c A L1685 Post-op hip abduct custom fa A L1686 HO post-op hip abduction A L1690 Combination bilateral HO A L1700 Leg perthes orth toronto typ A L1710 Legg perthes orth newington A L1720 Legg perthes orthosis trilat A L1730 Legg perthes orth scottish r AL1755 Legg perthes patten bottom t A

L1810 Ko elastic with joints A L1820 Ko elas w/ condyle pads & jo A L1830 Ko immobilizer canvas longit A L1831 Knee orth pos locking joint A L1832 KO adj jnt pos rigid support A L1834 Ko w/0 joint rigid molded to A L1836 Rigid KO wo joints A L1840 Ko derot ant cruciate custom A L1843 KO single upright custom fit A L1844 Ko w/adj jt rot cntrl molded A L1845 Ko w/ adj flex/ext rotat cus A L1846 Ko w adj flex/ext rotat mold A L1847 KO adjustable w air chambers A L1850 Ko swedish type A L1860 Ko supracondylar socket mold A L1900 Afo sprng wir drsflx calf bd A L1902 Afo ankle gauntlet A L1904 Afo molded ankle gauntlet A L1906 Afo multiligamentus ankle su A L1907 AFO supramalleolar custom A L1910 Afo sing bar clasp attach sh A L1920 Afo sing upright w/ adjust s A L1930 Afo plastic A L1932 Afo rig ant tib prefab TCF/= A L1940 Afo molded to patient plasti A L1945 Afo molded plas rig ant tib A L1950 Afo spiral molded to pt plas A L1951 AFO spiral prefabricated A L1960 Afo pos solid ank plastic mo A L1970 Afo plastic molded w/ankle j A L1971 AFO w/ankle joint, prefab A L1980 Afo sing solid stirrup calf A L1990 Afo doub solid stirrup calf A L2000 Kafo sing fre stirr thi/calf A L2005 KAFO sng/dbl mechanical act A L2010 Kafo sng solid stirrup w/o j A L2020 Kafo dbl solid stirrup band/ A L2030 Kafo dbl solid stirrup w/o j A L2034 KAFO pla sin up w/wo k/a cus A L2035 KAFO plastic pediatric size A L2036 Kafo plas doub free knee mol A L2037 Kafo plas sing free knee mol A L2038 Kafo w/o joint multi-axis an A L2040 Hkafo torsion bil rot straps A L2050 Hkafo torsion cable hip pelv A L2060 Hkafo torsion ball bearing j A L2070 Hkafo torsion unilat rot str A L2080 Hkafo unilat torsion cable A L2090 Hkafo unilat torsion ball br A L2106 Afo tib fx cast plaster mold A L2108 Afo tib fx cast molded to pt A L2112 Afo tibial fracture soft A L2114 Afo tib fx semi-rigid A L2116 Afo tibial fracture rigid AL2126 Kafo fem fx cast thermoplas A

L2128 Kafo fem fx cast molded to p A L2132 Kafo femoral fx cast soft A L2134 Kafo fem fx cast semi-rigid A L2136 Kafo femoral fx cast rigid A L2180 Plas shoe insert w ank joint A L2182 Drop lock knee A L2184 Limited motion knee joint A L2186 Adj motion knee jnt lerman t A L2188 Quadrilateral brim A L2190 Waist belt A L2192 Pelvic band & belt thigh fla A L2200 Limited ankle motion ea jnt A L2210 Dorsiflexion assist each joi A L2220 Dorsi & plantar flex ass/res A L2230 Split flat caliper stirr & p A L2232 Rocker bottom, contact AFO A L2240 Round caliper and plate atta A L2250 Foot plate molded stirrup at A L2260 Reinforced solid stirrup A L2265 Long tongue stirrup A L2270 Varus/valgus strap padded/li A L2275 Plastic mod low ext pad/line A L2280 Molded inner boot A L2300 Abduction bar jointed adjust A L2310 Abduction bar-straight A L2320 Non-molded lacer A L2330 Lacer molded to patient mode A L2335 Anterior swing band A L2340 Pre-tibial shell molded to p A L2350 Prosthetic type socket molde A L2360 Extended steel shank A L2370 Patten bottom A L2375 Torsion ank & half solid sti A L2380 Torsion straight knee joint A L2385 Straight knee joint heavy du A L2387 Add LE poly knee custom KAFO A L2390 Offset knee joint each A L2395 Offset knee joint heavy duty A L2397 Suspension sleeve lower ext A L2405 Knee joint drop lock ea jnt A L2415 Knee joint cam lock each joi A L2425 Knee disc/dial lock/adj flex A L2430 Knee jnt ratchet lock ea jnt A L2492 Knee lift loop drop lock rin A L2500 Thi/glut/ischia wgt bearing A L2510 Th/wght bear quad-lat brim m A L2520 Th/wght bear quad-lat brim c A L2525 Th/wght bear nar m-l brim mo A L2526 Th/wght bear nar m-l brim cu A L2530 Thigh/wght bear lacer non-mo A L2540 Thigh/wght bear lacer molded A L2550 Thigh/wght bear high roll cu A L2570 Hip clevis type 2 posit jnt A L2580 Pelvic control pelvic sling AL2600 Hip clevis/thrust bearing fr A

L2610 Hip clevis/thrust bearing lo A L2620 Pelvic control hip heavy dut A L2622 Hip joint adjustable flexion A L2624 Hip adj flex ext abduct cont A L2627 Plastic mold recipro hip & c A L2628 Metal frame recipro hip & ca A L2630 Pelvic control band & belt u A L2640 Pelvic control band & belt b A L2650 Pelv & thor control gluteal A L2660 Thoracic control thoracic ba A L2670 Thorac cont paraspinal uprig A L2680 Thorac cont lat support upri A L2750 Plating chrome/nickel pr bar A L2755 Carbon graphite lamination A L2760 Extension per extension per A L2768 Ortho sidebar disconnect A L2780 Non-corrosive finish A L2785 Drop lock retainer each A L2795 Knee control full kneecap A L2800 Knee cap medial or lateral p A L2810 Knee control condylar pad A L2820 Soft interface below knee se A L2830 Soft interface above knee se A L2840 Tibial length sock fx or equ A L2850 Femoral lgth sock fx or equa A L2861 Torsion mechanism knee/ankle E L2999 Lower extremity orthosis NOS A L3000 Ft insert ucb berkeley shell A L3001 Foot insert remov molded spe A L3002 Foot insert plastazote or eq A L3003 Foot insert silicone gel eac A L3010 Foot longitudinal arch suppo A L3020 Foot longitud/metatarsal sup A L3030 Foot arch support remov prem A L3031 Foot lamin/prepreg composite A L3040 Ft arch suprt premold longit A L3050 Foot arch supp premold metat A L3060 Foot arch supp longitud/meta A L3070 Arch suprt att to sho longit A L3080 Arch supp att to shoe metata A L3090 Arch supp att to shoe long/m A L3100 Hallus-valgus nght dynamic s A L3140 Abduction rotation bar shoe A L3150 Abduct rotation bar w/o shoe A L3160 Shoe styled positioning dev A L3170 Foot plastic heel stabilizer A L3201 Oxford w supinat/pronat inf A L3202 Oxford w/ supinat/pronator c A L3203 Oxford w/ supinator/pronator A L3204 Hightop w/ supp/pronator inf A L3206 Hightop w/ supp/pronator chi A L3207 Hightop w/ supp/pronator jun A L3208 Surgical boot each infant A L3209 Surgical boot each child AL3211 Surgical boot each junior A

L3212 Benesch boot pair infant A L3213 Benesch boot pair child A L3214 Benesch boot pair junior A L3215 Orthopedic ftwear ladies oxf E L3216 Orthoped ladies shoes dpth i E L3217 Ladies shoes hightop depth i E L3219 Orthopedic mens shoes oxford E L3221 Orthopedic mens shoes dpth i E L3222 Mens shoes hightop depth inl E L3224 Woman's shoe oxford brace A L3225 Man's shoe oxford brace A L3230 Custom shoes depth inlay A L3250 Custom mold shoe remov prost A L3251 Shoe molded to pt silicone s A L3252 Shoe molded plastazote cust A L3253 Shoe molded plastazote cust A L3254 Orth foot non-stndard size/w A L3255 Orth foot non-standard size/ A L3257 Orth foot add charge split s A L3260 Ambulatory surgical boot eac E L3265 Plastazote sandal each A L3300 Sho lift taper to metatarsal A L3310 Shoe lift elev heel/sole neo A L3320 Shoe lift elev heel/sole cor A L3330 Lifts elevation metal extens A L3332 Shoe lifts tapered to one-ha A L3334 Shoe lifts elevation heel /i A L3340 Shoe wedge sach A L3350 Shoe heel wedge A L3360 Shoe sole wedge outside sole A L3370 Shoe sole wedge between sole A L3380 Shoe clubfoot wedge A L3390 Shoe outflare wedge A L3400 Shoe metatarsal bar wedge ro A L3410 Shoe metatarsal bar between A L3420 Full sole/heel wedge btween A L3430 Sho heel count plast reinfor A L3440 Heel leather reinforced A L3450 Shoe heel sach cushion type A L3455 Shoe heel new leather standa A L3460 Shoe heel new rubber standar A L3465 Shoe heel thomas with wedge A L3470 Shoe heel thomas extend to b A L3480 Shoe heel pad & depress for A L3485 Shoe heel pad removable for A L3500 Ortho shoe add leather insol A L3510 Orthopedic shoe add rub insl A L3520 O shoe add felt w leath insl A L3530 Ortho shoe add half sole A L3540 Ortho shoe add full sole A L3550 O shoe add standard toe tap A L3560 O shoe add horseshoe toe tap A L3570 O shoe add instep extension A L3580 O shoe add instep velcro clo AL3590 O shoe convert to sof counte A

L3595 Ortho shoe add march bar A L3600 Trans shoe calip plate exist A L3610 Trans shoe caliper plate new A L3620 Trans shoe solid stirrup exi A L3630 Trans shoe solid stirrup new A L3640 Shoe dennis browne splint bo A L3649 Orthopedic shoe modifica NOS A L3650 Shlder fig 8 abduct restrain A L3660 Abduct restrainer canvas&web A L3670 Acromio/clavicular canvas&we A L3671 SO cap design w/o jnts CF A L3674 SO airplane w/wo joint CF A L3675 Canvas vest SO A L3677 SO hard plastic stabilizer A L3702 EO w/o joints CF A L3710 Elbow elastic with metal joi A L3720 Forearm/arm cuffs free motio A L3730 Forearm/arm cuffs ext/flex a A L3740 Cuffs adj lock w/ active con A L3760 EO withjoint, Prefabricated A L3762 Rigid EO wo joints A L3763 EWHO rigid w/o jnts CF A L3764 EWHO w/joint(s) CF A L3765 EWHFO rigid w/o jnts CF A L3766 EWHFO w/joint(s) CF A L3806 WHFO w/joint(s) custom fab A L3807 WHFO,no joint, prefabricated A L3808 WHFO, rigid w/o joints A L3891 Torsion mechanism wrist/elbo E L3900 Hinge extension/flex wrist/f A L3901 Hinge ext/flex wrist finger A L3904 Whfo electric custom fitted A L3905 WHO w/nontorsion jnt(s) CF A L3906 WHO w/o joints CF A L3908 Wrist cock-up non-molded A L3912 Flex glove w/elastic finger A L3913 HFO w/o joints CF A L3915 WHO w nontor jnt(s) prefab A L3917 Prefab metacarpl fx orthosis A L3919 HO w/o joints CF A L3921 HFO w/joint(s) CF A L3923 HFO w/o joints PF A L3925 FO pip/dip with joint/spring A L3927 FO pip/dip w/o joint/spring A L3929 HFO nontorsion joint, prefab A L3931 WHFO nontorsion joint prefab A L3933 FO w/o joints CF A L3935 FO nontorsion joint CF A L3956 Add joint upper ext orthosis A L3960 Sewho airplan desig abdu pos A L3961 SEWHO cap design w/o jnts CF A L3962 Sewho erbs palsey design abd A L3964 Seo mobile armsup att to wc CHD L3965 Arm supp att to wc rancho ty CHDL3966 Mobile armsupports reclinin CHD

L3967 SEWHO airplane w/o jnts CF A L3968 Friction dampening arm supp CHD L3969 Monosuspension arm/hand supp CHD L3970 Elevat proximal arm support CHD L3971 SEWHO cap design w/jnt(s) CF A L3972 Offset/lat rocker arm w/ ela CHD L3973 SEWHO airplane w/jnt(s) CF A L3974 Mobile armsupport supinator CHD L3975 SEWHFO cap design w/o jnt CF A L3976 SEWHFO airplane w/o jnts CF A L3977 SEWHFO cap desgn w/jnt(s) CF A L3978 SEWHFO airplane w/jnt(s) CF A L3980 Upp ext fx orthosis humeral A L3982 Upper ext fx orthosis rad/ul A L3984 Upper ext fx orthosis wrist A L3995 Sock fracture or equal each A L3999 Upper limb orthosis NOS A L4000 Repl girdle milwaukee orth A L4002 Replace strap, any orthosis A L4010 Replace trilateral socket br A L4020 Replace quadlat socket brim A L4030 Replace socket brim cust fit A L4040 Replace molded thigh lacer A L4045 Replace non-molded thigh lac A L4050 Replace molded calf lacer A L4055 Replace non-molded calf lace A L4060 Replace high roll cuff A L4070 Replace prox & dist upright A L4080 Repl met band kafo-afo prox A L4090 Repl met band kafo-afo calf/ A L4100 Repl leath cuff kafo prox th A L4110 Repl leath cuff kafo-afo cal A L4130 Replace pretibial shell A L4205 Ortho dvc repair per 15 min A L4210 Orth dev repair/repl minor p A L4350 Ankle control orthosi prefab A L4360 Pneumati walking boot prefab A L4370 Pneumatic full leg splint A L4380 Pneumatic knee splint CHD L4386 Non-pneum walk boot prefab A L4392 Replace AFO soft interface A L4394 Replace foot drop spint A L4396 Static AFO A L4398 Foot drop splint recumbent A L4631 Afo, walk boot type, cus fab A L5000 Sho insert w arch toe filler A L5010 Mold socket ank hgt w/ toe f A L5020 Tibial tubercle hgt w/ toe f A L5050 Ank symes mold sckt sach ft A L5060 Symes met fr leath socket ar A L5100 Molded socket shin sach foot A L5105 Plast socket jts/thgh lacer A L5150 Mold sckt ext knee shin sach A L5160 Mold socket bent knee shin s AL5200 Kne sing axis fric shin sach A

L5210 No knee/ankle joints w/ ft b A L5220 No knee joint with artic ali A L5230 Fem focal defic constant fri A L5250 Hip canad sing axi cons fric A L5270 Tilt table locking hip sing A L5280 Hemipelvect canad sing axis A L5301 BK mold socket SACH ft endo A L5311 Knee disart, SACH ft, endo CHD L5312 Knee disart, SACH ft, endo NIA L5321 AK open end SACH A L5331 Hip disart canadian SACH ft A L5341 Hemipelvectomy canadian SACH A L5400 Postop dress & 1 cast chg bk A L5410 Postop dsg bk ea add cast ch A L5420 Postop dsg & 1 cast chg ak/d A L5430 Postop dsg ak ea add cast ch A L5450 Postop app non-wgt bear dsg A L5460 Postop app non-wgt bear dsg A L5500 Init bk ptb plaster direct A L5505 Init ak ischal plstr direct A L5510 Prep BK ptb plaster molded A L5520 Perp BK ptb thermopls direct A L5530 Prep BK ptb thermopls molded A L5535 Prep BK ptb open end socket A L5540 Prep BK ptb laminated socket A L5560 Prep AK ischial plast molded A L5570 Prep AK ischial direct form A L5580 Prep AK ischial thermo mold A L5585 Prep AK ischial open end A L5590 Prep AK ischial laminated A L5595 Hip disartic sach thermopls A L5600 Hip disart sach laminat mold A L5610 Above knee hydracadence A L5611 Ak 4 bar link w/fric swing A L5613 Ak 4 bar ling w/hydraul swig A L5614 4-bar link above knee w/swng A L5616 Ak univ multiplex sys frict A L5617 AK/BK self-aligning unit ea A L5618 Test socket symes A L5620 Test socket below knee A L5622 Test socket knee disarticula A L5624 Test socket above knee A L5626 Test socket hip disarticulat A L5628 Test socket hemipelvectomy A L5629 Below knee acrylic socket A L5630 Symetyp expandabl wall sckt A L5631 Ak/knee disartic acrylic soc A L5632 Symes type ptb brim design s A L5634 Symes type poster opening so A L5636 Symes type medial opening so A L5637 Below knee total contact A L5638 Below knee leather socket A L5639 Below knee wood socket A L5640 Knee disarticulat leather so AL5642 Above knee leather socket A

L5643 Hip flex inner socket ext fr A L5644 Above knee wood socket A L5645 Bk flex inner socket ext fra A L5646 Below knee cushion socket A L5647 Below knee suction socket A L5648 Above knee cushion socket A L5649 Isch containmt/narrow m-l so A L5650 Tot contact ak/knee disart s A L5651 Ak flex inner socket ext fra A L5652 Suction susp ak/knee disart A L5653 Knee disart expand wall sock A L5654 Socket insert symes A L5655 Socket insert below knee A L5656 Socket insert knee articulat A L5658 Socket insert above knee A L5661 Multi-durometer symes A L5665 Multi-durometer below knee A L5666 Below knee cuff suspension A L5668 Socket insert w/o lock lower A L5670 Bk molded supracondylar susp A L5671 BK/AK locking mechanism A L5672 Bk removable medial brim sus A L5673 Socket insert w lock mech A L5676 Bk knee joints single axis p A L5677 Bk knee joints polycentric p A L5678 Bk joint covers pair A L5679 Socket insert w/o lock mech A L5680 Bk thigh lacer non-molded A L5681 Intl custm cong/latyp insert A L5682 Bk thigh lacer glut/ischia m A L5683 Initial custom socket insert A L5684 Bk fork strap A L5685 Below knee sus/seal sleeve A L5686 Bk back check A L5688 Bk waist belt webbing A L5690 Bk waist belt padded and lin A L5692 Ak pelvic control belt light A L5694 Ak pelvic control belt pad/l A L5695 Ak sleeve susp neoprene/equa A L5696 Ak/knee disartic pelvic join A L5697 Ak/knee disartic pelvic band A L5698 Ak/knee disartic silesian ba A L5699 Shoulder harness A L5700 Replace socket below knee A L5701 Replace socket above knee A L5702 Replace socket hip A L5703 Symes ankle w/o (SACH) foot A L5704 Custom shape cover BK A L5705 Custom shape cover AK A L5706 Custom shape cvr knee disart A L5707 Custom shape cvr hip disart A L5710 Kne-shin exo sng axi mnl loc A L5711 Knee-shin exo mnl lock ultra A L5712 Knee-shin exo frict swg & st AL5714 Knee-shin exo variable frict A

L5716 Knee-shin exo mech stance ph A L5718 Knee-shin exo frct swg & sta A L5722 Knee-shin pneum swg frct exo A L5724 Knee-shin exo fluid swing ph A L5726 Knee-shin ext jnts fld swg e A L5728 Knee-shin fluid swg & stance A L5780 Knee-shin pneum/hydra pneum A L5781 Lower limb pros vacuum pump A L5782 HD low limb pros vacuum pump A L5785 Exoskeletal bk ultralt mater A L5790 Exoskeletal ak ultra-light m A L5795 Exoskel hip ultra-light mate A L5810 Endoskel knee-shin mnl lock A L5811 Endo knee-shin mnl lck ultra A L5812 Endo knee-shin frct swg & st A L5814 Endo knee-shin hydral swg ph A L5816 Endo knee-shin polyc mch sta A L5818 Endo knee-shin frct swg & st A L5822 Endo knee-shin pneum swg frc A L5824 Endo knee-shin fluid swing p A L5826 Miniature knee joint A L5828 Endo knee-shin fluid swg/sta A L5830 Endo knee-shin pneum/swg pha A L5840 Multi-axial knee/shin system A L5845 Knee-shin sys stance flexion A L5848 Knee-shin sys hydraul stance A L5850 Endo ak/hip knee extens assi A L5855 Mech hip extension assist A L5856 Elec knee-shin swing/stance A L5857 Elec knee-shin swing only A L5858 Stance phase only A L5910 Endo below knee alignable sy A L5920 Endo ak/hip alignable system A L5925 Above knee manual lock A L5930 High activity knee frame A L5940 Endo bk ultra-light material A L5950 Endo ak ultra-light material A L5960 Endo hip ultra-light materia A L5961 Endo poly

hip, pneu/hyd/rot A L5962 Below knee flex cover system A L5964 Above knee flex cover system A L5966 Hip flexible cover system A L5968 Multiaxial ankle w dorsiflex A L5970 Foot external keel sach foot A L5971 SACH foot, replacement A L5972 Flexible keel foot A L5973 Ank-foot sys dors-plant flex A L5974 Foot single axis ankle/foot A L5975 Combo ankle/foot prosthesis A L5976 Energy

storing foot A L5978 Ft prosth multiaxial ankl/ft A L5979 Multi-axial ankle/ft prosth A L5980 Flex foot system A L5981 Flex-walk sys low ext prosth AL5982 Exoskeletal axial rotation u A

L5984 Endoskeletal axial rotation A L5985 Lwr ext dynamic prosth pylon A L5986 Multi-axial rotation unit A L5987 Shank ft w vert load pylon A L5988 Vertical shock reducing pylo A L5990 User adjustable heel height A L5999 Lowr extremity prosthes NOS A L6000 Part hand thumb rem A L6010 Part hand little/ring A L6020 Part hand no fingers A L6025 Part hand disart myoelectric A L6050 Wrst MLd sck flx hng tri pad A L6055 Wrst mold sock w/exp interfa A L6100 Elb mold sock flex hinge pad A L6110 Elbow mold sock suspension t A L6120 Elbow mold doub splt soc ste A L6130 Elbow stump activated lock h A L6200 Elbow mold outsid lock hinge A L6205 Elbow molded w/ expand inter A L6250 Elbow inter loc elbow forarm A L6300 Shlder disart int lock elbow A L6310 Shoulder passive restor comp A L6320 Shoulder passive restor cap A L6350 Thoracic intern lock elbow A L6360 Thoracic passive restor comp A L6370 Thoracic passive restor cap A L6380 Postop dsg cast chg wrst/elb A L6382 Postop dsg cast chg elb dis/ A L6384 Postop dsg cast chg shlder/t A L6386 Postop ea cast chg & realign A L6388 Postop applicat rigid dsg on A L6400 Below elbow prosth tiss shap A L6450 Elb disart prosth tiss shap A L6500 Above elbow prosth tiss shap A L6550 Shldr disar prosth tiss shap A L6570 Scap thorac prosth tiss shap A L6580 Wrist/elbow bowden cable mol A L6582 Wrist/elbow bowden cbl dir f A L6584 Elbow fair lead cable molded A L6586 Elbow fair lead cable dir fo A L6588 Shdr fair lead cable molded A L6590 Shdr fair lead cable direct A L6600 Polycentric hinge pair A L6605 Single pivot hinge pair A L6610 Flexible metal hinge pair A L6611 Additional switch, ext power A L6615 Disconnect locking wrist uni A L6616 Disconnect insert locking wr A L6620 Flexion/extension wrist unit A L6621 Flex/ext wrist w/wo friction A L6623 Spring-ass rot wrst w/ latch A L6624 Flex/ext/rotation wrist unit A L6625 Rotation wrst w/ cable lock A L6628 Quick disconn hook adapter o AL6629 Lamination collar w/ couplin A

L6630 Stainless steel any wrist A L6632 Latex suspension sleeve each A L6635 Lift assist for elbow A L6637 Nudge control elbow lock A L6638 Elec lock on manual pw elbow A L6640 Shoulder abduction joint pai A L6641 Excursion amplifier pulley t A L6642 Excursion amplifier lever ty A L6645 Shoulder flexion-abduction j A L6646 Multipo locking shoulder jnt A L6647 Shoulder lock actuator A L6648 Ext pwrd shlder lock/unlock A L6650 Shoulder universal joint A L6655 Standard control cable extra A L6660 Heavy

duty control cable A L6665 Teflon or equal cable lining A L6670 Hook to hand cable adapter A L6672 Harness chest/shlder saddle A L6675 Harness figure of 8 sing con A L6676 Harness figure of 8 dual con A L6677 UE triple control harness A L6680 Test sock wrist disart/bel e A L6682 Test sock elbw disart/above A L6684 Test socket shldr disart/tho A L6686 Suction socket A L6687 Frame typ socket bel elbow/w A L6688 Frame typ sock above elb/dis A L6689 Frame typ socket shoulder di A L6690 Frame typ sock interscap-tho A L6691 Removable insert each A L6692 Silicone gel insert or equal A L6693 Lockingelbow forearm cntrbal A L6694 Elbow socket ins use w/lock A L6695 Elbow socket ins use w/o lck A L6696 Cus elbo skt in for con/atyp A L6697 Cus elbo skt in not con/atyp A L6698 Below/above elbow lock mech A L6703 Term dev, passive hand mitt A L6704 Term dev, sport/rec/work att A L6706 Term dev mech hook vol open A L6707 Term dev mech hook vol close A L6708 Term dev mech hand vol open A L6709 Term dev mech hand vol close A L6711 Ped term dev, hook, vol open A L6712 Ped term dev, hook, vol clos A L6713 Ped term dev, hand, vol open A L6714 Ped term dev, hand, vol clos A L6715 Term device, multi art digit NIA L6721 Hook/hand, hvy dty, vol open A L6722 Hook/hand, hvy dty, vol clos A L6805 Term dev modifier wrist unit A L6810 Term dev precision pinch dev A L6880 Elec hand ind art digits NIA L6881 Term dev auto grasp feature AL6882 Microprocessor control uplmb A

L6883 Replc sockt below e/w disa A L6884 Replc sockt above elbow disa A L6885 Replc sockt shldr dis/interc A L6890 Prefab glove for term device A L6895 Custom glove for term device A L6900 Hand restorat thumb/1 finger A L6905 Hand restoration multiple fi A L6910 Hand restoration no fingers A L6915 Hand restoration replacmnt g A L6920 Wrist disarticul switch ctrl A L6925 Wrist disart myoelectronic c A L6930 Below elbow switch control A L6935 Below elbow myoelectronic ct A L6940 Elbow disarticulation switch A L6945 Elbow disart myoelectronic c A L6950 Above elbow switch control A L6955 Above elbow myoelectronic ct A L6960 Shldr disartic switch contro A L6965 Shldr disartic myoelectronic A L6970 Interscapular-thor switch ct A L6975 Interscap-thor myoelectronic A L7007 Adult electric hand A L7008 Pediatric electric hand A L7009 Adult electric hook A L7040 Prehensile actuator A L7045 Pediatric electric hook A L7170 Electronic elbow hosmer swit A L7180 Electronic elbow sequential A L7181 Electronic elbo simultaneous A L7185 Electron elbow adolescent sw A L7186 Electron elbow child switch A L7190 Elbow adolescent myoelectron A L7191 Elbow child myoelectronic ct A L7260 Electron wrist rotator otto A L7261 Electron wrist rotator utah A L7266 Servo control steeper or equ CHD L7272 Analogue control unb or equa CHD L7274 Proportional ctl 12 volt uta CHD L7360 Six volt bat otto bock/eq ea A L7362 Battery

chrgr six volt otto A L7364 Twelve volt battery utah/equ A L7366 Battery

chrgr 12 volt utah/e A L7367 Replacemnt lithium ionbatter A L7368 Lithiumion battery charger A L7400 Add UE prost be/wd, ultlite A L7401 Add UE prost a/e ultlite mat A L7402 Add UE prost s/d ultlite mat A L7403 Add UE prost b/e acrylic A L7404 Add UE prost a/e acrylic A L7405 Add UE prost s/d acrylic A L7499 Upper extremity prosthes NOS A L7500 Prosthetic dvc repair hourly CHD L7510 Prosthetic device repair rep A L7520 Repair prosthesis per 15 min AL7600 Prosthetic donning sleeve E

L7900 Male vacuum erection system A L8000 Mastectomy bra A L8001 Breast prosthesis bra & form A L8002 Brst prsth bra & bilat form A L8010 Mastectomy sleeve A L8015 Ext breastprosthesis garment A L8020 Mastectomy form A L8030 Breast prosthes w/o adhesive A L8031 Breast prosthesis w adhesive A L8032 Reusable nipple prosthesis A L8035 Custom breast prosthesis A L8039 Breast prosthesis NOS A L8040 Nasal prosthesis A L8041 Midfacial prosthesis A L8042 Orbital prosthesis A L8043 Upper facial prosthesis A L8044 Hemi-facial prosthesis A L8045 Auricular prosthesis A L8046 Partial facial prosthesis A L8047 Nasal septal prosthesis A L8048 Unspec maxillofacial prosth A L8049 Repair maxillofacial prosth A L8300 Truss single w/ standard pad A L8310 Truss double w/ standard pad A L8320 Truss addition to std pad wa A L8330 Truss add to std pad scrotal A L8400 Sheath below knee A L8410 Sheath above knee A L8415 Sheath upper limb A L8417 Pros sheath/sock w gel cushn A L8420 Prosthetic sock multi ply BK A L8430 Prosthetic sock multi ply AK A L8435 Pros sock multi ply upper lm A L8440 Shrinker below knee A L8460 Shrinker above knee A L8465 Shrinker upper limb A L8470 Pros sock single ply BK A L8480 Pros sock single ply AK A L8485 Pros sock single ply upper l A L8499 Unlisted misc prosthetic ser A L8500 Artificial larynx A L8501 Tracheostomy speaking valve A L8505 Artificial larynx, accessory A L8507 Trach-esoph voice pros pt in A L8509 Trach-esoph voice pros md in A L8510 Voice amplifier A L8511 Indwelling trach insert A L8512 Gel cap for trach voice pros A L8513 Trach pros cleaning device A L8514 Repl trach puncture dilator A L8515 Gel cap app device for trach A L8600 Implant breast silicone/eq N L8603 Collagen imp urinary 2.5 ml N L8604 Dextranomer/hyaluronic acid NL8606 Synthetic implnt urinary 1ml N L8609 Artificial cornea N L8610 Ocular implant N L8612 Aqueous shunt prosthesis N L8613 Ossicular implant N L8614 Cochlear device N L8615 Coch implant headset replace A L8616 Coch implant microphone repl A L8617 Coch implant trans coil repl A L8618 Coch implant tran cable repl A L8619 Coch imp ext proc/contr rplc A L8621 Repl zinc air battery A L8622 Repl alkaline battery A L8623 Lith ion batt CID,non-earlvl A L8624 Lith ion batt CID, ear level A L8627 CID ext speech process repl A L8628 CID ext controller repl A L8629 CID transmit coil and cable A L8630 Metacarpophalangeal implant N L8631 MCP joint repl 2 pc or more N L8641 Metatarsal joint implant N L8642 Hallux implant N L8658 Interphalangeal joint spacer N L8659 Interphalangeal joint repl N L8670 Vascular graft, synthetic N L8680 Implt neurostim elctr each N L8681 Pt prgrm for implt neurostim A L8682 Implt neurostim radiofq rec N L8683 Radiofq trsmtr for implt neu A L8684 Radiof trsmtr implt scrl neu A L8685 Implt nrostm pls gen sng rec N L8686 Implt nrostm pls gen sng non N L8687 Implt nrostm pls gen dua rec N L8688 Implt nrostm pls gen dua non N L8689 External recharg sys intern A L8690 Aud osseo dev, int/ext comp N L8691 Osseointegrated snd proc rpl A L8692 Non-osseointegrated snd proc E L8693 Aud osseo dev, abutment A L8695 External recharg sys extern A L8699 Prosthetic implant NOS N L9900 O&P supply /accessory

/service N M0064 Visit for drug monitoring Q3 0607 M0075 Cellular therapy E M0076 Prolotherapy E M0100 Intragastric hypothermia E M0300 IV chelationtherapy E M0301 Fabric wrapping of aneurysm E P2028 Cephalin floculation test A P2029 Congo red blood test A P2031 Hair analysis E P2033 Blood thymol turbidity A P2038 Blood mucoprotein A P3000 Screen pap by tech w md supv A P3001 Screening pap smear by phys BP7001 Culture bacterial urine E

P9010 Whole blood for transfusion R 0950 P9011 Blood split unit R 0967 P9012 Cryoprecipitate each unit R 0952 P9016 RBC leukocy tes reduced R 0954 P9017 Plasma 1 donor frz w/in 8 hr R 9508 P9019 Platelets, each unit R 0957 P9020 Plaelet rich plasma unit R 0958 P9021 Red blood cells unit R 0959 P9022 Washed red blood cells unit R 0960 P9023 Frozen plasma, pooled, sd R 0949 P9031 Platelets leukocy tes reduced R 1013 P9032 Platelets, irradiated R 9500 P9033 Platelets leukoreduced irrad R 0968 P9034 Platelets, pheresis R 9507 P9035 Platelet pheres leukoreduced R 9501 P9036 Platelet pheresis irradiated R 9502 P9037 Plate pheres leukoredu irrad R 1019 P9038 RBC irradiated R 9505 P9039 RBC deglycerolized R 9504 P9040 RBC leukoreduced irradiated R 0969 P9041 Albumin (human),5%, 50ml K 0961 P9043 Plasma protein fract,5%,50ml R 0956 P9044 Cryoprecipitatereducedplasma R 1009 P9045 Albumin (human), 5%, 250 ml K 0963 P9046 Albumin (human), 25%, 20 ml K 0964 P9047 Albumin (human), 25%, 50ml K 0965 P9048 Plasmaprotein fract,5%,250ml R 0966 P9050 Granulocy

tes, pheresis unit R 9506 P9051 Blood, l/r, cmv-neg R 1010 P9052 Platelets, hla-m, l/r, unit R 1011 P9053 Plt, pher, l/r cmv-neg, irr R 1020 P9054 Blood, l/r, froz/degly /wash R 1016 P9055 Plt, aph/pher, l/r, cmv-neg R 1017 P9056 Blood, l/r, irradiated R 1018 P9057 RBC, frz/deg/wsh, l/r, irrad R 1021 P9058 RBC, l/r, cmv-neg, irrad R 1022 P9059 Plasma, frz between 8-24hour R 0955 P9060 Fr frz plasma donor retested R 9503 P9603 One-way

allow prorated miles A P9604 One-way

allow prorated trip A P9612 Catheterize for urine spec A P9615 Urine specimen collect mult N Q0035 Cardiokymography X 0100 Q0081 Infusion ther other than che B Q0083 Chemo by

other than infusion B Q0084 Chemotherapy by infusion B Q0085 Chemo by

both infusion and o B Q0091 Obtaining screen pap smear T 0191 Q0092 Set up port xray equipment N Q0111 Wet mounts/ w preparations A Q0112 Potassium hydroxide preps A Q0113 Pinwormexaminations A Q0114 Fern test A Q0115 Post-coital mucous exam AQ0138 Ferumoxy tol, non-esrd CHK 1297 Q0139 Ferumoxy

tol, esrd use A Q0144 Azithromycin dihydrate, oral E Q0162 Ondansetron oral NIN Q0163 Diphenhydramine HCl 50mg N Q0164 Prochlorperazine maleate 5mg N Q0165 Prochlorperazine maleate10mg N Q0166 Granisetron hcl 1 mg oral N Q0167 Dronabinol 2.5mg oral N Q0168 Dronabinol 5mg oral N Q0169 Promethazine HCl 12.5mg oral N Q0170 Promethazine HCl 25 mg oral N Q0171 Chlorpromazine HCl 10mg oral N Q0172 Chlorpromazine HCl 25mg oral N Q0173 Trimethobenzamide HCl 250mg N Q0174 Thiethylperazine maleate10mg E Q0175 Perphenazine 4mg oral N Q0176 Perphenazine 8mg oral N Q0177 Hydroxy

zine pamoate 25mg N Q0178 Hydroxy

zine pamoate 50mg N Q0179 Ondansetron hcl 8 mg oral CHD Q0180 Dolasetron mesylate oral N Q0181 Unspecified oral anti-emetic E Q0478 Power adapter, combo vad A Q0479 Power module combo vad, rep A Q0480 Driver pneumatic vad, rep A Q0481 Microprcsr cu elec vad, rep A Q0482 Microprcsr cu combo vad, rep A Q0483 Monitor elec vad, rep A Q0484 Monitor elec or comb vad rep A Q0485 Monitor cable elec vad, rep A Q0486 Mon cable elec/pneum vad rep A Q0487 Leads any

type vad, rep only A Q0488 Pwr pack base elec vad, rep A Q0489 Pwr pck base combo vad, rep A Q0490 Emr pwr source elec vad, rep A Q0491 Emr pwr source combo vad rep A Q0492 Emr pwr cbl elec vad, rep A Q0493 Emr pwr cbl combo vad, rep A Q0494 Emr hd pmp elec/combo, rep A Q0495 Charger elec/combo vad, rep A Q0496 Battery

elec/combo vad, rep A Q0497 Bat clps elec/comb vad, rep A Q0498 Holster elec/combo vad, rep A Q0499 Belt/vest elec/combo vad rep A Q0500 Filters elec/combo vad, rep A Q0501 Shwr cov elec/combo vad, rep A Q0502 Mobility

cart pneum vad, rep A Q0503 Battery

pneum vad replacemnt A Q0504 Pwr adpt pneumvad, rep veh A Q0505 Miscl supply /accessory

vad A Q0506 Lith-ion batt elec/pneum VAD A Q0510 Dispens fee immunosupressive B Q0511 Sup fee antiem,antica,immuno B Q0512 Px sup fee anti-can sub pres BQ0513 Disp fee inhal drugs/30 days B

Q0514 Disp fee inhal drugs/90 days B Q0515 Sermorelin acetate injection K 3050 Q1004 Ntiol category 4 E Q1005 Ntiol category 5 E Q2004 Bladder calculi irrig sol N Q2009 Fospheny

toin inj PE N Q2017 Teniposide, 50 mg K 7035 Q2026 Radiesse injection B Q2027 Sculptra injection B Q2035 Afluria vacc, 3 yrs & >, im L Q2036 Flulaval vacc, 3 yrs & >, im L Q2037 Fluvirin vacc, 3 yrs & >, im L Q2038 Fluzone vacc, 3 yrs & >, im L Q2039 NOS flu vacc, 3 yrs & >, im L Q2040 Incobotulinumtoxin A CHD Q2041 Wilate injection CHD Q2042 Hydroxyprogesterone caproate CHD Q2043 Sipuleucel-T auto CD54+ G 9273 Q2044 Belimumab injection CHD Q3001 Brachy

therapy Radioelements B Q3014 Telehealth facility fee A Q3025 IM inj interferon beta 1-a K 9022 Q3026 Subc inj interferon beta-1a E Q3031 Collagen skin test N Q4001 Cast sup body cast plaster B Q4002 Cast sup body cast fiberglas B Q4003 Cast sup shoulder cast plstr B Q4004 Cast sup shoulder cast fbrgl B Q4005 Cast sup long arm adult plst B Q4006 Cast sup long arm adult fbrg B Q4007 Cast sup long arm ped plster B Q4008 Cast sup long arm ped fbrgls B Q4009 Cast sup sht arm adult plstr B Q4010 Cast sup sht arm adult fbrgl B Q4011 Cast sup sht arm ped plaster B Q4012 Cast sup sht arm ped fbrglas B Q4013 Cast sup gauntlet plaster B Q4014 Cast sup gauntlet fiberglass B Q4015 Cast sup gauntlet ped plster B Q4016 Cast sup gauntlet ped fbrgls B Q4017 Cast sup lng arm splint plst B Q4018 Cast sup lng arm splint fbrg B Q4019 Cast sup lng arm splnt ped p B Q4020 Cast sup lng arm splnt ped f B Q4021 Cast sup sht arm splint plst B Q4022 Cast sup sht arm splint fbrg B Q4023 Cast sup sht arm splnt ped p B Q4024 Cast sup sht arm splnt ped f B Q4025 Cast sup hip spica plaster B Q4026 Cast sup hip spica fiberglas B Q4027 Cast sup hip spica ped plstr B Q4028 Cast sup hip spica ped fbrgl B Q4029 Cast sup long leg plaster B Q4030 Cast sup long leg fiberglass BQ4031 Cast sup lng leg ped plaster B

Q4032 Cast sup lng leg ped fbrgls B Q4033 Cast sup lng leg cylinder pl B Q4034 Cast sup lng leg cylinder fb B Q4035 Cast sup lngleg cylndr ped p B Q4036 Cast sup lngleg cylndr ped f B Q4037 Cast sup shrt leg plaster B Q4038 Cast sup shrt leg fiberglass B Q4039 Cast sup shrt leg ped plster B Q4040 Cast sup shrt leg ped fbrgls B Q4041 Cast sup lng leg splnt plstr B Q4042 Cast sup lng leg splnt fbrgl B Q4043 Cast sup lng leg splnt ped p B Q4044 Cast sup lng leg splnt ped f B Q4045 Cast sup sht leg splnt plstr B Q4046 Cast sup sht leg splnt fbrgl B Q4047 Cast sup sht leg splnt ped p B Q4048 Cast sup sht leg splnt ped f B Q4049 Finger splint, static B Q4050 Cast supplies unlisted B Q4051 Splint supplies misc B Q4074 Iloprost non-comp unit dose Y Q4081 Epoetin alfa, 100 units ESRD A Q4082 Drug/bio NOC part B drug CAP B Q4100 Skin substitute, NOS N Q4101 Apligraf K 1240 Q4102 Oasis wound matrix K 1241 Q4103 Oasis burn matrix K 1242 Q4104 Integra BMWD K 1243 Q4105 Integra DRT K 1244 Q4106 Dermagraft K 1245 Q4107 Graftjacket K 1246 Q4108 Integra matrix K 1247 Q4110 Primatrix K 1248 Q4111 Gammagraft K 1252 Q4112 Cymetra injectable K 1249 Q4113 Graftjacket xpress K 1250 Q4114 Integra flowable wound matri K 1251 Q4115 Alloskin K 1287 Q4116 Alloderm K 1270 Q4117 Hyalomatrix E Q4118 Matristem micromatrix K 1342 Q4119 Matristem wound matrix K 1351 Q4120 Matristem burn matrix E Q4121 Theraskin K 1345 Q4122 Dermacell NI K 1419 Q4123 Alloskin NI E Q4124 Oasis tri-layer wound matrix NIG 9365 Q4125 Arthroflex NI E Q4126 Memoderm NI E Q4127 Talymed NI E Q4128 Flexhd or allopatch hd NI E Q4129 Unite biomatrix NI E Q4130 Strattice TM NIN Q5001 Hospice in patient home BQ5002 Hospice in assisted living B

Q5003 Hospice in LT/non-skilled NF B Q5004 Hospice in SNF B Q5005 Hospice, inpatient hospital B Q5006 Hospice in hospice facility B Q5007 Hospice in LTCH B Q5008 Hospice in inpatient psych B Q5009 Hospice care, NOS B Q5010 Hospice home care in hospice B Q9951 LOCM >= 400 mg/ml iodine,1ml N Q9953 Inj Fe-based MR contrast,1ml N Q9954 Oral MR contrast, 100 ml N Q9955 Inj perflexane lip micros,ml N Q9956 Inj octafluoropropane mic,ml N Q9957 Inj perflutren lip micros,ml N Q9958 HOCM <=149 mg/ml iodine, 1ml N Q9959 HOCM 150-199mg/ml iodine,1ml N Q9960 HOCM 200-249mg/ml iodine,1ml N Q9961 HOCM 250-299mg/ml iodine,1ml N Q9962 HOCM 300-349mg/ml iodine,1ml N Q9963 HOCM 350-399mg/ml iodine,1ml N Q9964 HOCM>= 400mg/ml iodine, 1ml N Q9965 LOCM 100-199mg/ml iodine,1ml N Q9966 LOCM 200-299mg/ml iodine,1ml N Q9967 LOCM 300-399mg/ml iodine,1ml N Q9968 Visualization adjunct CHN R0070 Transport portable x-ray B R0075 Transport port x-ray multipl B R0076 Transport portable EKG B V2020 Vision svcs frames purchases A V2025 Eyeglasses delux frames E V2100 Lens spher single plano 4.00 A V2101 Single visn sphere 4.12-7.00 A V2102 Singl visn sphere 7.12-20.00 A V2103 Spherocylindr 4.00d/12-2.00d A V2104 Spherocylindr 4.00d/2.12-4d A V2105 Spherocylinder 4.00d/4.25-6d A V2106 Spherocylinder 4.00d/>6.00d A V2107 Spherocylinder 4.25d/12-2d A V2108 Spherocylinder 4.25d/2.12-4d A V2109 Spherocylinder 4.25d/4.25-6d A V2110 Spherocylinder 4.25d/over 6d A V2111 Spherocylindr 7.25d/.25-2.25 A V2112 Spherocylindr 7.25d/2.25-4d A V2113 Spherocylindr 7.25d/4.25-6d A V2114 Spherocylinder over 12.00d A V2115 Lens lenticular bifocal A V2118 Lens aniseikonic single A V2121 Lenticular lens, single A V2199 Lens single vision not oth c A V2200 Lens spher bifoc plano 4.00d A V2201 Lens sphere bifocal 4.12-7.0 A V2202 Lens sphere bifocal 7.12-20. A V2203 Lens sphcyl bifocal 4.00d/.1 A V2204 Lens sphcy bifocal 4.00d/2.1 AV2205 Lens sphcy bifocal 4.00d/4.2 A V2206 Lens sphcy bifocal 4.00d/ove A V2207 Lens sphcy bifocal 4.25-7d/. A V2208 Lens sphcy bifocal 4.25-7/2. A V2209 Lens sphcy bifocal 4.25-7/4. A V2210 Lens sphcy bifocal 4.25-7/ov A V2211 Lens sphcy bifo 7.25-12/.25- A V2212 Lens sphcyl bifo 7.25-12/2.2 A V2213 Lens sphcyl bifo 7.25-12/4.2 A V2214 Lens sphcyl bifocal over 12. A V2215 Lens lenticular bifocal A V2218 Lens aniseikonic bifocal A V2219 Lens bifocal seg width over A V2220 Lens bifocal add over 3.25d A V2221 Lenticular lens, bifocal A V2299 Lens bifocal speciality A V2300 Lens sphere trifocal 4.00d A V2301 Lens sphere trifocal 4.12-7. A V2302 Lens sphere trifocal 7.12-20 A V2303 Lens sphcy trifocal 4.0/.12- A V2304 Lens sphcy trifocal 4.0/2.25 A V2305 Lens sphcy trifocal 4.0/4.25 A V2306 Lens sphcyl trifocal 4.00/>6 A V2307 Lens sphcy trifocal 4.25-7/. A V2308 Lens sphc trifocal 4.25-7/2. A V2309 Lens sphc trifocal 4.25-7/4. A V2310 Lens sphc trifocal 4.25-7/>6 A V2311 Lens sphc trifo 7.25-12/.25- A V2312 Lens sphc trifo 7.25-12/2.25 A V2313 Lens sphc trifo 7.25-12/4.25 A V2314 Lens sphcyl trifocal over 12 A V2315 Lens lenticular trifocal A V2318 Lens aniseikonic trifocal A V2319 Lens trifocal seg width > 28 A V2320 Lens trifocal add over 3.25d A V2321 Lenticular lens, trifocal A V2399 Lens trifocal speciality A V2410 Lens variab asphericity sing A V2430 Lens variable asphericity bi A V2499 Variable asphericity lens A V2500 Contact lens pmma spherical A V2501 Cntct lens pmma-toric/prism A V2502 Contact lens pmma bifocal A V2503 Cntct lens pmma color vision A V2510 Cntct gas permeable sphericl A V2511 Cntct toric prism ballast A V2512 Cntct lens gas permbl bifocl A V2513 Contact lens extended wear A V2520 Contact lens hydrophilic A V2521 Cntct lens hydrophilic toric A V2522 Cntct lens hydrophil bifocl A V2523 Cntct lens hydrophil extend A V2530 Contact lens gas impermeable A V2531 Contact lens gas permeable A V2599 Contact lens/es other type AV2600 Hand held low vision aids A

V2610 Single lens spectacle mount A V2615 Telescop/othr compound lens A V2623 Plastic eye prosth custom A V2624 Polishing artifical eye A V2625 Enlargemnt of eye prosthesis A V2626 Reduction of eye prosthesis A V2627 Scleral cover shell A V2628 Fabrication & fitting A V2629 Prosthetic eye other type A V2630 Anter chamber intraocul lens N V2631 Iris support intraoclr lens N V2632 Post chmbr intraocular lens N V2700 Balance lens A V2702 Deluxe lens feature E V2710 Glass/plastic slab off prism A V2715 Prism lens/es A V2718 Fresnell prism press-on lens A V2730 Special base curve A V2744 Tint photochromatic lens/es A V2745 Tint, any

color/solid/grad A V2750 Anti-reflective coating A V2755 UV lens/es A V2756 Eye glass case E V2760 Scratch resistant coating A V2761 Mirror coating B V2762 Polarization, any lens A V2770 Occluder lens/es A V2780 Oversize lens/es A V2781 Progressive lens per lens B V2782 Lens, 1.54-1.65 p/1.60-1.79g A V2783 Lens, >= 1.66 p/>=1.80 g A V2784 Lens polycarb or equal A V2785 Corneal tissue processing F V2786 Occupational multifocal lens A V2787 Astigmatism-correct function E V2788 Presbyopia-correct function E V2790 Amniotic membrane N V2797 Vis item/svc in other code A V2799 Miscellaneous vision service A V5008 Hearing screening E V5010 Assessment for hearing aid E V5011 Hearing aid fitting/checking E V5014 Hearing aid repair/modifying E V5020 Conformity evaluation E V5030 Body-worn hearing aid air E V5040 Body-worn hearing aid bone E V5050 Hearing aid monaural in ear E V5060 Behind ear hearing aid E V5070 Glasses air conduction E V5080 Glasses bone conduction E V5090 Hearing aid dispensing fee E V5095 Implant mid ear hearing pros E V5100 Body-worn bilat hearing aid E V5110 Hearing aid dispensing fee EV5120 Body-worn binaur hearing aid E

V5130 In ear binaural hearing aid E V5140 Behind ear binaur hearing ai E V5150 Glasses binaural hearing aid E V5160 Dispensing fee binaural E V5170 Within ear cros hearing aid E V5180 Behind ear cros hearing aid E V5190 Glasses cros hearing aid E V5200 Cros hearing aid dispens fee E V5210 In ear bicros hearing aid E V5220 Behind ear bicros hearing ai E V5230 Glasses bicros hearing aid E V5240 Dispensing fee bicros E V5241 Dispensing fee, monaural E V5242 Hearing aid, monaural, cic E V5243 Hearing aid, monaural, itc E V5244 Hearing aid, prog, mon, cic E V5245 Hearing aid, prog, mon, itc E V5246 Hearing aid, prog, mon, ite E V5247 Hearing aid, prog, mon, bte E V5248 Hearing aid, binaural, cic E V5249 Hearing aid, binaural, itc E V5250 Hearing aid, prog, bin, cic E V5251 Hearing aid, prog, bin, itc E V5252 Hearing aid, prog, bin, ite E V5253 Hearing aid, prog, bin, bte E V5254 Hearing id, digit, mon, cic E V5255 Hearing aid, digit, mon, itc E V5256 Hearing aid, digit, mon, ite E V5257 Hearing aid, digit, mon, bte E V5258 Hearing aid, digit, bin, cic E V5259 Hearing aid, digit, bin, itc E V5260 Hearing aid, digit, bin, ite E V5261 Hearing aid, digit, bin, bte E V5262 Hearing aid, disp, monaural E V5263 Hearing aid, disp, binaural E V5264 Ear mold/insert E V5265 Ear mold/insert, disp E V5266 Battery

for hearing device E V5267 Hearing aid supply /accessory E V5268 ALD Telephone Amplifier E V5269 Alerting device, any type E V5270 ALD, TV amplifier, any type E V5271 ALD, TV caption decoder E V5272 Tdd E V5273 ALD for cochlear implant E V5274 ALD unspecified E V5275 Ear impression E V5298 Hearing aid noc E V5299 Hearing service B V5336 Repair communication device E V5362 Speech screening E V5363 Language screening E V5364 Dysphagia screening E**Relative**

**Weight Payment** 

**Rate National** 

**Unadjusted Copayment** **Minimum**

**Unadjusted Copayment** 1.6118 $112.85

. $22.57

4.5721 $320.12

. $64.03 0.8768 $61.39

. $12.28 1.4209 $99.49

. $19.90 1.4209 $99.49

. $19.90 1.4209 $99.49

. $19.90 12.8082 $896.78

. $179.36 2.7597 $193.22

. $38.65 16.9957$1,189.97

. $238.00 12.8082 $896.78

. $179.36 1.4209 $99.49

. $19.90 20.5510 $1,438.90

. $287.78 2.7597 $193.22

. $38.65 0.8768 $61.39

. $12.28

4.3953 $307.74

. $61.55 4.3953 $307.74

. $61.55 4.3953 $307.74

. $61.55 2.7597 $193.22

. $38.65 2.7597 $193.22

. $38.65 8.2918 $580.56

. $116.12 2.7597 $193.22

. $38.65 2.7597 $193.22

. $38.65 8.2918 $580.56

. $116.12 0.8768 $61.39

. $12.28 0.8768 $61.39

. $12.28 1.4966 $104.79

. $20.96 1.4966 $104.79

. $20.96 0.8768 $61.39

. $12.28 0.8768 $61.39

. $12.28 0.8768 $61.39

. $12.28 0.8768 $61.39

. $12.28 0.8768 $61.39

. $12.28 0.8768 $61.39

. $12.28 1.4966 $104.79

. $20.96 0.8768 $61.39

. $12.28 0.8768 $61.39

. $12.28 0.8768 $61.39

. $12.28 1.4966 $104.79

. $20.96 0.8768 $61.39

. $12.28 0.8768 $61.39

. $12.28 1.4966 $104.79

. $20.96 1.4966 $104.79

. $20.96 4.3953 $307.74

. $61.55 4.3953 $307.74

. $61.55 4.3953 $307.74

. $61.55 8.2918 $580.56

. $116.12 16.9957$1,189.97

. $238.0016.9957$1,189.97

. $238.00

8.2918 $580.56

. $116.12 8.2918 $580.56

. $116.12 8.2918 $580.56

. $116.12 16.9957$1,189.97

. $238.00 16.9957$1,189.97

. $238.00 23.2636 $1,628.82 $350.74 $325.77 4.3953 $307.74

. $61.55 4.3953 $307.74

. $61.55 8.2918 $580.56

. $116.12 8.2918 $580.56

. $116.12 8.2918 $580.56

. $116.12 23.2636 $1,628.82 $350.74 $325.77 23.2636 $1,628.82 $350.74 $325.77 23.2636 $1,628.82 $350.74 $325.77 23.2636 $1,628.82 $350.74 $325.77 23.2636 $1,628.82 $350.74 $325.77 23.2636 $1,628.82 $350.74 $325.77 23.2636 $1,628.82 $350.74 $325.77 8.2918 $580.56

. $116.12 4.3953 $307.74

. $61.55 4.3953 $307.74

. $61.55 8.2918 $580.56

. $116.12 8.2918 $580.56

. $116.12 16.9957$1,189.97

. $238.00 8.2918 $580.56

. $116.12 4.3953 $307.74

. $61.55 8.2918 $580.56

. $116.12 16.9957$1,189.97

. $238.00 16.9957$1,189.97

. $238.00 23.2636 $1,628.82 $350.74 $325.77 4.3953 $307.74

. $61.55 4.3953 $307.74

. $61.55 4.3953 $307.74

. $61.55 8.2918 $580.56

. $116.12 16.9957$1,189.97

. $238.00 23.2636 $1,628.82 $350.74 $325.77 0.3878 $27.15

. $5.43 0.8768 $61.39

. $12.28 0.8768 $61.39

. $12.28 0.8768 $61.39

. $12.28 0.8768 $61.39

. $12.28 0.3878 $27.15

. $5.43 4.3953 $307.74

. $61.55 23.2636 $1,628.82 $350.74 $325.77 4.3953 $307.74

. $61.55 1.1922 $83.47 $23.34 $16.70 16.7703$1,174.19

. $234.84 0.8768 $61.39

. $12.28 23.2636 $1,628.82 $350.74 $325.77 23.2636 $1,628.82 $350.74 $325.77 23.2636 $1,628.82 $350.74 $325.77 0.8768 $61.39

. $12.28 0.8768 $61.39

. $12.28 3.2354 $226.53

. $45.313.2354 $226.53

. $45.31

3.2354 $226.53

. $45.31 3.2354 $226.53

. $45.31 3.2354 $226.53

. $45.31 3.2354 $226.53

. $45.31 1.1922 $83.47 $23.34 $16.70 21.4409$1,501.21

. $300.25 47.5032 $3,325.98

. $665.20 23.2636 $1,628.82 $350.74 $325.77

4.3953 $307.74

. $61.55

0.6499 $45.50

. $9.10 0.6499 $45.50

. $9.10 0.6499 $45.50

. $9.10 0.6499 $45.50

. $9.10 1.1922 $83.47 $23.34 $16.70 1.1922 $83.47 $23.34 $16.70 1.1922 $83.47 $23.34 $16.70 1.1922 $83.47 $23.34 $16.70 1.1922 $83.47 $23.34 $16.70 1.1922 $83.47 $23.34 $16.70 1.1922 $83.47 $23.34 $16.70 1.1922 $83.47 $23.34 $16.70 1.1922 $83.47 $23.34 $16.70 1.1922 $83.47 $23.34 $16.70 1.1922 $83.47 $23.34 $16.70 1.1922 $83.47 $23.34 $16.70 3.2354 $226.53

. $45.31 4.9271 $344.98

. $69.00 3.2354 $226.53

. $45.31 3.2354 $226.53

. $45.31 3.2354 $226.53

. $45.31 3.2354 $226.53

. $45.31 3.2354 $226.53

. $45.31 3.2354 $226.53

. $45.31 3.2354 $226.53

. $45.31 1.1922 $83.47 $23.34 $16.70 3.2354 $226.53

. $45.31 3.2354 $226.53

. $45.31 3.2354 $226.53

. $45.31 3.2354 $226.53

. $45.31 3.2354 $226.53

. $45.31 3.2354 $226.53

. $45.31 3.2354 $226.53

. $45.31 3.2354 $226.53

. $45.31 1.1922 $83.47 $23.34 $16.70 3.2354 $226.53

. $45.31 3.2354 $226.53

. $45.31 3.2354 $226.53

. $45.31 4.9271 $344.98

. $69.00 4.9271 $344.98

. $69.00 3.2354 $226.53

. $45.31 3.2354 $226.53

. $45.31 3.2354 $226.53

. $45.311.1922 $83.47 $23.34 $16.70

3.2354 $226.53

. $45.31 4.9271 $344.98

. $69.00 3.2354 $226.53

. $45.31 4.9271 $344.98

. $69.00 4.9271 $344.98

. $69.00 4.9271 $344.98

. $69.00 3.2354 $226.53

. $45.31 21.4409$1,501.21

. $300.25 16.7703$1,174.19

. $234.84 16.7703$1,174.19

. $234.84 16.7703$1,174.19

. $234.84 16.7703$1,174.19

. $234.84 16.7703$1,174.19

. $234.84 16.7703$1,174.19

. $234.84 16.7703$1,174.19

. $234.84 16.7703$1,174.19

. $234.84 21.4409$1,501.21

. $300.25 21.4409$1,501.21

. $300.25 21.4409$1,501.21

. $300.25 4.9271 $344.98

. $69.00 4.9271 $344.98

. $69.00 3.2354 $226.53

. $45.31 4.9271 $344.98

. $69.00 3.2354 $226.53

. $45.31 3.2354 $226.53

. $45.31 21.4409$1,501.21

. $300.25 21.4409$1,501.21

. $300.25 4.9271 $344.98

. $69.00 4.9271 $344.98

. $69.00 4.9271 $344.98

. $69.00 3.2354 $226.53

. $45.31 21.4409$1,501.21

. $300.25 21.4409$1,501.21

. $300.25 16.7703$1,174.19

. $234.84 16.7703$1,174.19

. $234.84 16.7703$1,174.19

. $234.84 16.7703$1,174.19

. $234.84 3.2354 $226.53

. $45.31 3.2354 $226.53

. $45.31 3.2354 $226.53

. $45.31 3.2354 $226.53

. $45.31 3.2354 $226.53

. $45.31 3.2354 $226.53

. $45.31

16.7703$1,174.19

. $234.84 16.7703$1,174.19

. $234.84 16.7703$1,174.19

. $234.84 4.9271 $344.98

. $69.00 16.7703$1,174.19

. $234.84 3.2354 $226.53

. $45.31 16.7703$1,174.19

. $234.8416.7703$1,174.19

. $234.84

3.2354 $226.53

. $45.31 1.1922 $83.47 $23.34 $16.70 4.9271 $344.98

. $69.00 3.2354 $226.53

. $45.31 3.2354 $226.53

. $45.31 1.1922 $83.47 $23.34 $16.70 4.9271 $344.98

. $69.00 3.2354 $226.53

. $45.31

21.4409$1,501.21

. $300.25 21.4409$1,501.21

. $300.25 21.4409$1,501.21

. $300.25 21.4409$1,501.21

. $300.25 21.4409$1,501.21

. $300.25 21.4409$1,501.21

. $300.25 21.4409$1,501.21

. $300.25 21.4409$1,501.21

. $300.25 21.4409$1,501.21

. $300.25 21.4409$1,501.21

. $300.25 21.4409$1,501.21

. $300.25 21.4409$1,501.21

. $300.25 21.4409$1,501.21

. $300.25 21.4409$1,501.21

. $300.25 16.7703$1,174.19

. $234.84 21.4409$1,501.21

. $300.25

21.4409$1,501.21

. $300.25 21.4409$1,501.21

. $300.25 1.1922 $83.47 $23.34 $16.70 1.1922 $83.47 $23.34 $16.70 16.7703$1,174.19

. $234.84 23.2636 $1,628.82 $350.74 $325.77 4.3953 $307.74

. $61.554.3953 $307.74

. $61.55

2.7597 $193.22

. $38.65 0.8768 $61.39

. $12.28 0.8768 $61.39

. $12.28 0.8768 $61.39

. $12.28 1.4966 $104.79

. $20.96 1.4966 $104.79

. $20.96 0.8768 $61.39

. $12.28 3.2354 $226.53

. $45.31 21.4409$1,501.21

. $300.25 21.4409$1,501.21

. $300.25 21.4409$1,501.21

. $300.25 21.4409$1,501.21

. $300.25 21.4409$1,501.21

. $300.25 21.4409$1,501.21

. $300.25 21.4409$1,501.21

. $300.25 21.4409$1,501.21

. $300.25 21.4409$1,501.21

. $300.25 23.2636 $1,628.82 $350.74 $325.77 23.2636 $1,628.82 $350.74 $325.77 23.2636 $1,628.82 $350.74 $325.77 23.2636 $1,628.82 $350.74 $325.77 23.2636 $1,628.82 $350.74 $325.77 16.9957$1,189.97

. $238.00 16.9957$1,189.97

. $238.00 16.9957$1,189.97

. $238.00 16.9957$1,189.97

. $238.00 21.4409$1,501.21

. $300.25 21.4409$1,501.21

. $300.25 21.4409$1,501.21

. $300.25 21.4409$1,501.21

. $300.25 23.2636 $1,628.82 $350.74 $325.77 2.7597 $193.22

. $38.65 2.7597 $193.22

. $38.65 0.6499 $45.50

. $9.10 0.6499 $45.50

. $9.10 21.4409$1,501.21

. $300.25 21.4409$1,501.21

. $300.25 21.4409$1,501.21

. $300.25 21.4409$1,501.21

. $300.25 4.3953 $307.74

. $61.55 21.4409$1,501.21

. $300.25 23.2636 $1,628.82 $350.74 $325.77 23.2636 $1,628.82 $350.74 $325.77 21.4409$1,501.21

. $300.25 21.4409$1,501.21

. $300.25 16.7703$1,174.19

. $234.84 21.4409$1,501.21

. $300.25 23.2636 $1,628.82 $350.74 $325.77 23.2636 $1,628.82 $350.74 $325.77 21.4409$1,501.21

. $300.25 21.4409$1,501.21

. $300.25 21.4409$1,501.21

. $300.25 23.2636 $1,628.82 $350.74 $325.77 23.2636 $1,628.82 $350.74 $325.7716.7703$1,174.19

. $234.84

16.7703$1,174.19

. $234.84 16.7703$1,174.19

. $234.84 16.7703$1,174.19

. $234.84 4.3953 $307.74

. $61.55 0.8768 $61.39

. $12.28 1.4966 $104.79

. $20.96 1.4966 $104.79

. $20.96 1.4966 $104.79

. $20.96 1.4966 $104.79

. $20.96

0.8768 $61.39

. $12.28 0.3878 $27.15

. $5.43 2.7597 $193.22

. $38.65 2.7597 $193.22

. $38.65 2.7597 $193.22

. $38.65 2.7597 $193.22

. $38.65 0.8768 $61.39

. $12.28 1.4966 $104.79

. $20.96 1.4966 $104.79

. $20.96 1.4966 $104.79

. $20.96 1.4966 $104.79

. $20.96 1.4966 $104.79

. $20.96 1.4966 $104.79

. $20.96 1.4966 $104.79

. $20.96 2.7597 $193.22

. $38.65 1.4966 $104.79

. $20.96 1.4966 $104.79

. $20.96 1.4966 $104.79

. $20.96 2.7597 $193.22

. $38.65 2.7597 $193.22

. $38.65 2.7597 $193.22

. $38.65 1.4966 $104.79

. $20.96 2.7597 $193.22

. $38.65 2.7597 $193.22

. $38.65 2.7597 $193.22

. $38.65 2.7597 $193.22

. $38.65 2.7597 $193.22

. $38.65 5.0714 $355.08 $88.08 $71.02 5.0714 $355.08 $88.08 $71.02 5.0714 $355.08 $88.08 $71.02 5.0714 $355.08 $88.08 $71.02 5.0714 $355.08 $88.08 $71.02 0.8768 $61.39

. $12.28 1.4966 $104.79

. $20.96 1.4966 $104.79

. $20.96 0.3878 $27.15

. $5.43 4.5721 $320.12

. $64.03 1.6118 $112.85

. $22.57 20.5510 $1,438.90

. $287.78

4.5721 $320.12

. $64.03 25.5066 $1,785.87

. $357.18 8.1596 $571.30

. $114.26 15.3535$1,074.99 $227.40 $215.0033.3398$2,334.32 $580.94 $466.87

25.5066 $1,785.87

. $357.18 25.5066 $1,785.87

. $357.18 25.5066 $1,785.87

. $357.18 25.5066 $1,785.87

. $357.18 25.5066 $1,785.87

. $357.18 16.9957$1,189.97

. $238.00

0.6499 $45.50

. $9.10 62.4125$4,369.87

. $873.98 62.4125$4,369.87

. $873.98 62.4125$4,369.87

. $873.98 25.5066 $1,785.87

. $357.18 25.5066 $1,785.87

. $357.18 45.0217$3,152.24 $747.07 $630.45 33.3398$2,334.32 $580.94 $466.87 33.3398$2,334.32 $580.94 $466.87

45.0217$3,152.24 $747.07 $630.45 33.3398$2,334.32 $580.94 $466.87 45.0217$3,152.24 $747.07 $630.45 45.0217$3,152.24 $747.07 $630.45 62.4125$4,369.87

. $873.98 33.3398$2,334.32 $580.94 $466.87 33.3398$2,334.32 $580.94 $466.87 45.0217$3,152.24 $747.07 $630.45 62.4125$4,369.87

. $873.98 25.5066 $1,785.87

. $357.18 33.3398$2,334.32 $580.94 $466.87 62.4125$4,369.87

. $873.98

33.3398$2,334.32 $580.94 $466.87

33.3398$2,334.32 $580.94 $466.87 33.3398$2,334.32 $580.94 $466.87 45.0217$3,152.24 $747.07 $630.45 33.3398$2,334.32 $580.94 $466.87 25.5066 $1,785.87

. $357.18 8.2918 $580.56

. $116.12 7.4614 $522.42 $104.55 $104.49 21.4409$1,501.21

. $300.25 21.4409$1,501.21

. $300.25 12.8082 $896.78

. $179.36 47.5032 $3,325.98

. $665.20 16.9957$1,189.97

. $238.00 16.9957$1,189.97

. $238.00 8.1596 $571.30

. $114.26 8.2918 $580.56

. $116.1216.9957$1,189.97

. $238.00

23.2636 $1,628.82 $350.74 $325.77 23.2636 $1,628.82 $350.74 $325.77 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 7.4614 $522.42 $104.55 $104.49

4.3953 $307.74

. $61.55 23.2636 $1,628.82 $350.74 $325.77 2.6055 $182.43

. $36.49 2.6055 $182.43

. $36.49 2.6055 $182.43

. $36.49 2.6055 $182.43

. $36.49 2.6055 $182.43

. $36.49 2.6055 $182.43

. $36.49 32.4461 $2,271.75

. $454.35 2.6055 $182.43

. $36.49 2.6055 $182.43

. $36.49 2.6055 $182.43

. $36.49 2.6055 $182.43

. $36.49 4.5721 $320.12

. $64.03 32.4461 $2,271.75

. $454.35 5.0454 $353.26

. $70.66

22.0797$1,545.93

. $309.19 32.4461 $2,271.75

. $454.35

0.6499 $45.50

. $9.10 16.9957$1,189.97

. $238.00 23.2636 $1,628.82 $350.74 $325.77 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 22.0797$1,545.93

. $309.19 32.4461 $2,271.75

. $454.35 18.9489$1,326.73

. $265.35

28.8625$2,020.84

. $404.17

32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 21.4409$1,501.21

. $300.25 21.4409$1,501.21

. $300.25 16.7703$1,174.19

. $234.84 16.7703$1,174.19

. $234.84 32.4461 $2,271.75

. $454.35 4.9271 $344.98

. $69.001.4209 $99.49

. $19.90

58.4586 $4,093.04

. $818.61 58.4586 $4,093.04

. $818.61

0.6499 $45.50

. $9.10 47.5032 $3,325.98

. $665.20

22.0797$1,545.93

. $309.19 24.8895$1,742.66

. $348.54 8.2918 $580.56

. $116.12 8.2918 $580.56

. $116.12 8.2918 $580.56

. $116.12 8.2918 $580.56

. $116.12 16.9957$1,189.97

. $238.00 23.2636 $1,628.82 $350.74 $325.77 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 24.8895$1,742.66

. $348.54 24.8895$1,742.66

. $348.54 24.8895$1,742.66

. $348.54 45.0377$3,153.36

. $630.68 24.8895$1,742.66

. $348.54 45.0377$3,153.36

. $630.68

45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 7.4614 $522.42 $104.55 $104.49 24.8895$1,742.66

. $348.54 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 16.8699$1,181.16 $279.20 $236.24 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 1.0709 $74.98 $24.12 $15.0045.0377$3,153.36

. $630.68

7.4614 $522.42 $104.55 $104.49

24.8895$1,742.66

. $348.54 24.8895$1,742.66

. $348.54 24.8895$1,742.66

. $348.54 24.8895$1,742.66

. $348.54 24.8895$1,742.66

. $348.54 45.0377$3,153.36

. $630.68 24.8895$1,742.66

. $348.54 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68

45.0377$3,153.36

. $630.68

45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68

24.8895$1,742.66

. $348.54

45.0377$3,153.36

. $630.68

45.0377$3,153.36

. $630.68

45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 24.8895$1,742.66

. $348.54 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68

45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.6845.0377$3,153.36

. $630.68

45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68

45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 16.8699$1,181.16 $279.20 $236.24 7.4614 $522.42 $104.55 $104.49 24.8895$1,742.66

. $348.54 1.0709 $74.98 $24.12 $15.00 1.0709 $74.98 $24.12 $15.00 16.8699$1,181.16 $279.20 $236.24 16.8699$1,181.16 $279.20 $236.24 24.8895$1,742.66

. $348.54 24.8895$1,742.66

. $348.54 24.8895$1,742.66

. $348.54 26.1202 $1,828.83 $372.85 $365.77 16.8699$1,181.16 $279.20 $236.24 24.8895$1,742.66

. $348.54 24.8895$1,742.66

. $348.54 45.0377$3,153.36

. $630.68

24.8895$1,742.66

. $348.54 24.8895$1,742.66

. $348.54

45.0377$3,153.36

. $630.68 24.8895$1,742.66

. $348.54 24.8895$1,742.66

. $348.54 45.0377$3,153.36

. $630.68

45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 7.4614 $522.42 $104.55 $104.49 16.8699$1,181.16 $279.20 $236.24 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 24.8895$1,742.66

. $348.54

24.8895$1,742.66

. $348.5424.8895$1,742.66

. $348.54

3.1150 $218.10

. $43.62 7.4614 $522.42 $104.55 $104.49 16.8699$1,181.16 $279.20 $236.24 45.0377$3,153.36

. $630.68 24.8895$1,742.66

. $348.54 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 1.0709 $74.98 $24.12 $15.00 16.8699$1,181.16 $279.20 $236.24 45.0377$3,153.36

. $630.68 16.8699$1,181.16 $279.20 $236.24 16.8699$1,181.16 $279.20 $236.24 1.0709 $74.98 $24.12 $15.00 20.5510 $1,438.90

. $287.78 22.0797$1,545.93

. $309.19

16.9957$1,189.97

. $238.00 23.2636 $1,628.82 $350.74 $325.77 23.2636 $1,628.82 $350.74 $325.77 16.9957$1,189.97

. $238.00 23.2636 $1,628.82 $350.74 $325.77 16.9957$1,189.97

. $238.00 23.2636 $1,628.82 $350.74 $325.77 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35

7.4614 $522.42 $104.55 $104.49 22.0797$1,545.93

. $309.19

22.0797$1,545.93

. $309.19 1.4209 $99.49

. $19.90

47.5032 $3,325.98

. $665.20 47.5032 $3,325.98

. $665.20

1.5020 $105.16

. $21.04 26.1202 $1,828.83 $372.85 $365.77

1.5020 $105.16

. $21.04

1.0709 $74.98 $24.12 $15.00 8.2918 $580.56

. $116.12 23.2636 $1,628.82 $350.74 $325.77 16.9957$1,189.97

. $238.00 23.2636 $1,628.82 $350.74 $325.77 16.9957$1,189.97

. $238.00 23.2636 $1,628.82 $350.74 $325.7716.9957$1,189.97

. $238.00

23.2636 $1,628.82 $350.74 $325.77

50.7343$3,552.21

. $710.45 50.7343$3,552.21

. $710.45 50.7343$3,552.21

. $710.45 50.7343$3,552.21

. $710.45

50.7343$3,552.21

. $710.45

1.5020 $105.16

. $21.04 5.0454 $353.26

. $70.66 18.9489$1,326.73

. $265.35

15.4596 $1,082.42 $268.44 $216.49 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 88.8483$6,220.80

. $1,244.16 88.8483$6,220.80

. $1,244.16 88.8483$6,220.80

. $1,244.16

50.7343$3,552.21

. $710.45

50.7343$3,552.21

. $710.4550.7343$3,552.21

. $710.45

50.7343$3,552.21

. $710.45

32.4461 $2,271.75

. $454.35

32.4461 $2,271.75

. $454.35 23.2636 $1,628.82 $350.74 $325.77 23.2636 $1,628.82 $350.74 $325.77 16.9957$1,189.97

. $238.00 23.2636 $1,628.82 $350.74 $325.77 16.9957$1,189.97

. $238.00 23.2636 $1,628.82 $350.74 $325.77 22.0797$1,545.93

. $309.19 16.9957$1,189.97

. $238.00 32.4461 $2,271.75

. $454.35 20.5510 $1,438.90

. $287.78 20.5510 $1,438.90

. $287.78 22.0797$1,545.93

. $309.19 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 8.2918 $580.56

. $116.12 23.2636 $1,628.82 $350.74 $325.77 23.2636 $1,628.82 $350.74 $325.77 23.2636 $1,628.82 $350.74 $325.77 16.9957$1,189.97

. $238.0016.9957$1,189.97

. $238.00

16.9957$1,189.97

. $238.00 23.2636 $1,628.82 $350.74 $325.77 22.0797$1,545.93

. $309.19 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 47.5032 $3,325.98

. $665.20 22.0797$1,545.93

. $309.19 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35

8.2918 $580.56

. $116.12 23.2636 $1,628.82 $350.74 $325.77

47.5032 $3,325.98

. $665.20 88.8483$6,220.80

. $1,244.16 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 47.5032 $3,325.98

. $665.20 47.5032 $3,325.98

. $665.20 47.5032 $3,325.98

. $665.20 47.5032 $3,325.98

. $665.20 47.5032 $3,325.98

. $665.20 32.4461 $2,271.75

. $454.35 88.8483$6,220.80

. $1,244.16 88.8483$6,220.80

. $1,244.16 88.8483$6,220.80

. $1,244.16 47.5032 $3,325.98

. $665.20 88.8483$6,220.80

. $1,244.16 47.5032 $3,325.98

. $665.20 132.5319$9,279.35

. $1,855.87

47.5032 $3,325.98

. $665.20 88.8483$6,220.80

. $1,244.16 88.8483$6,220.80

. $1,244.16 88.8483$6,220.80

. $1,244.161.5020 $105.16

. $21.04

18.9489$1,326.73

. $265.35 68.1203$4,769.51

. $953.91 5.0454 $353.26

. $70.66 5.0454 $353.26

. $70.66 49.8979$3,493.65

. $698.73 26.1202 $1,828.83 $372.85 $365.77 1.5020 $105.16

. $21.04 5.0454 $353.26

. $70.66 49.8979$3,493.65

. $698.73 49.8979$3,493.65

. $698.73 1.5020 $105.16

. $21.04 5.0454 $353.26

. $70.66 68.1203$4,769.51

. $953.91 1.5020 $105.16

. $21.04 18.9489$1,326.73

. $265.35 68.1203$4,769.51

. $953.91 68.1203$4,769.51

. $953.91 1.5020 $105.16

. $21.04 18.9489$1,326.73

. $265.35 68.1203$4,769.51

. $953.91 1.5020 $105.16

. $21.04 15.4596 $1,082.42 $268.44 $216.49 49.8979$3,493.65

. $698.73 5.0454 $353.26

. $70.66 68.1203$4,769.51

. $953.91 1.5020 $105.16

. $21.04 49.8979$3,493.65

. $698.73 15.4596 $1,082.42 $268.44 $216.49 88.8483$6,220.80

. $1,244.16 88.8483$6,220.80

. $1,244.16

16.7703$1,174.19

. $234.84 1.5020 $105.16

. $21.04 20.5510 $1,438.90

. $287.78 20.5510 $1,438.90

. $287.78 22.0797$1,545.93

. $309.19 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 16.9957$1,189.97

. $238.00 16.9957$1,189.97

. $238.00 23.2636 $1,628.82 $350.74 $325.77 23.2636 $1,628.82 $350.74 $325.77 16.9957$1,189.97

. $238.00 16.9957$1,189.97

. $238.00 16.9957$1,189.97

. $238.00 23.2636 $1,628.82 $350.74 $325.77 22.0797$1,545.93

. $309.19 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 22.0797$1,545.93

. $309.19 22.0797$1,545.93

. $309.19 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.3522.0797$1,545.93

. $309.19

32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 47.5032 $3,325.98

. $665.20 47.5032 $3,325.98

. $665.20 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 4.3953 $307.74

. $61.55 16.9957$1,189.97

. $238.00

15.4596 $1,082.42 $268.44 $216.49 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 22.0797$1,545.93

. $309.19 32.4461 $2,271.75

. $454.35 88.8483$6,220.80

. $1,244.16 47.5032 $3,325.98

. $665.20 32.4461 $2,271.75

. $454.35 47.5032 $3,325.98

. $665.20 47.5032 $3,325.98

. $665.20 47.5032 $3,325.98

. $665.20 32.4461 $2,271.75

. $454.35 88.8483$6,220.80

. $1,244.16 32.4461 $2,271.75

. $454.35 88.8483$6,220.80

. $1,244.16 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 41.2873$2,890.77

. $578.16 132.5319$9,279.35

. $1,855.87 60.9147$4,265.00

. $853.00 132.5319$9,279.35

. $1,855.87 41.2873$2,890.77

. $578.16 132.5319$9,279.35

. $1,855.87 88.8483$6,220.80

. $1,244.16 47.5032 $3,325.98

. $665.20 47.5032 $3,325.98

. $665.20 88.8483$6,220.80

. $1,244.16 88.8483$6,220.80

. $1,244.16 47.5032 $3,325.98

. $665.20 32.4461 $2,271.75

. $454.35 88.8483$6,220.80

. $1,244.16 1.5020 $105.16

. $21.04 1.5020 $105.16

. $21.04 68.1203$4,769.51

. $953.91 68.1203$4,769.51

. $953.911.5020 $105.16

. $21.04

5.0454 $353.26

. $70.66 26.1202 $1,828.83 $372.85 $365.77 68.1203$4,769.51

. $953.91 68.1203$4,769.51

. $953.91 1.5020 $105.16

. $21.04 1.5020 $105.16

. $21.04 26.1202 $1,828.83 $372.85 $365.77 68.1203$4,769.51

. $953.91 1.5020 $105.16

. $21.04 1.5020 $105.16

. $21.04 68.1203$4,769.51

. $953.91 26.1202 $1,828.83 $372.85 $365.77 68.1203$4,769.51

. $953.91 68.1203$4,769.51

. $953.91 1.5020 $105.16

. $21.04 15.4596 $1,082.42 $268.44 $216.49 68.1203$4,769.51

. $953.91 18.9489$1,326.73

. $265.35 68.1203$4,769.51

. $953.91 1.5020 $105.16

. $21.04 1.5020 $105.16

. $21.04 5.0454 $353.26

. $70.66 49.8979$3,493.65

. $698.73 68.1203$4,769.51

. $953.91 1.5020 $105.16

. $21.04 1.5020 $105.16

. $21.04 49.8979$3,493.65

. $698.73 47.5032 $3,325.98

. $665.20 88.8483$6,220.80

. $1,244.16

22.0797$1,545.93

. $309.19

88.8483$6,220.80

. $1,244.16

1.5020 $105.16

. $21.04 22.0797$1,545.93

. $309.19 22.0797$1,545.93

. $309.19 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 22.0797$1,545.93

. $309.19 22.0797$1,545.93

. $309.19 22.0797$1,545.93

. $309.19 32.4461 $2,271.75

. $454.35 8.2918 $580.56

. $116.12 23.2636 $1,628.82 $350.74 $325.77 23.2636 $1,628.82 $350.74 $325.77 23.2636 $1,628.82 $350.74 $325.77 16.9957$1,189.97

. $238.00 16.9957$1,189.97

. $238.00 16.9957$1,189.97

. $238.0023.2636 $1,628.82 $350.74 $325.77

22.0797$1,545.93

. $309.19 22.0797$1,545.93

. $309.19 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 22.0797$1,545.93

. $309.19 22.0797$1,545.93

. $309.19 22.0797$1,545.93

. $309.19 22.0797$1,545.93

. $309.19 22.0797$1,545.93

. $309.19 22.0797$1,545.93

. $309.19 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35

22.0797$1,545.93

. $309.19 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 18.9489$1,326.73

. $265.35 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 22.0797$1,545.93

. $309.19 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 47.5032 $3,325.98

. $665.20 32.4461 $2,271.75

. $454.35 88.8483$6,220.80

. $1,244.16 47.5032 $3,325.98

. $665.20 41.2873$2,890.77

. $578.16 47.5032 $3,325.98

. $665.20 47.5032 $3,325.98

. $665.20 47.5032 $3,325.98

. $665.20 47.5032 $3,325.98

. $665.2047.5032 $3,325.98

. $665.20

88.8483$6,220.80

. $1,244.16 47.5032 $3,325.98

. $665.20 47.5032 $3,325.98

. $665.20 47.5032 $3,325.98

. $665.20 88.8483$6,220.80

. $1,244.16 32.4461 $2,271.75

. $454.35 47.5032 $3,325.98

. $665.20 47.5032 $3,325.98

. $665.20 88.8483$6,220.80

. $1,244.16 88.8483$6,220.80

. $1,244.16 88.8483$6,220.80

. $1,244.16 88.8483$6,220.80

. $1,244.16 88.8483$6,220.80

. $1,244.16 47.5032 $3,325.98

. $665.20 47.5032 $3,325.98

. $665.20 47.5032 $3,325.98

. $665.20 88.8483$6,220.80

. $1,244.16 132.5319$9,279.35

. $1,855.87 132.5319$9,279.35

. $1,855.87 60.9147$4,265.00

. $853.00 60.9147$4,265.00

. $853.00 60.9147$4,265.00

. $853.00 132.5319$9,279.35

. $1,855.87 41.2873$2,890.77

. $578.16 41.2873$2,890.77

. $578.16 47.5032 $3,325.98

. $665.20 47.5032 $3,325.98

. $665.20 47.5032 $3,325.98

. $665.20 47.5032 $3,325.98

. $665.20 47.5032 $3,325.98

. $665.20 1.5020 $105.16

. $21.04 5.0454 $353.26

. $70.66 49.8979$3,493.65

. $698.73 5.0454 $353.26

. $70.66 49.8979$3,493.65

. $698.73 49.8979$3,493.65

. $698.73 1.5020 $105.16

. $21.04 1.5020 $105.16

. $21.04 49.8979$3,493.65

. $698.73 1.5020 $105.16

. $21.04 5.0454 $353.26

. $70.66 68.1203$4,769.51

. $953.91 68.1203$4,769.51

. $953.91 1.5020 $105.16

. $21.04 5.0454 $353.26

. $70.66 26.1202 $1,828.83 $372.85 $365.77 68.1203$4,769.51

. $953.91 68.1203$4,769.51

. $953.91 68.1203$4,769.51

. $953.91 1.5020 $105.16

. $21.04 5.0454 $353.26

. $70.66 49.8979$3,493.65

. $698.73 1.5020 $105.16

. $21.04 1.5020 $105.16

. $21.0449.8979$3,493.65

. $698.73

1.5020 $105.16

. $21.04 26.1202 $1,828.83 $372.85 $365.77 49.8979$3,493.65

. $698.73 1.5020 $105.16

. $21.04 26.1202 $1,828.83 $372.85 $365.77 26.1202 $1,828.83 $372.85 $365.77 1.5020 $105.16

. $21.04 26.1202 $1,828.83 $372.85 $365.77 1.5020 $105.16

. $21.04 26.1202 $1,828.83 $372.85 $365.77 18.9489$1,326.73

. $265.35 26.1202 $1,828.83 $372.85 $365.77 88.8483$6,220.80

. $1,244.16 88.8483$6,220.80

. $1,244.16 88.8483$6,220.80

. $1,244.16 47.5032 $3,325.98

. $665.20 88.8483$6,220.80

. $1,244.16 88.8483$6,220.80

. $1,244.16

22.0797$1,545.93

. $309.19 22.0797$1,545.93

. $309.19

22.0797$1,545.93

. $309.19

16.7703$1,174.19

. $234.84 22.0797$1,545.93

. $309.19 1.5020 $105.16

. $21.04 1.4209 $99.49

. $19.90 12.8082 $896.78

. $179.36 17.1902 $1,203.59 $253.49 $240.72 17.1902 $1,203.59 $253.49 $240.72 17.1902 $1,203.59 $253.49 $240.72 17.1902 $1,203.59 $253.49 $240.72 17.1902 $1,203.59 $253.49 $240.72 17.1902 $1,203.59 $253.49 $240.72 17.1902 $1,203.59 $253.49 $240.72 28.8625$2,020.84

. $404.17 17.1902 $1,203.59 $253.49 $240.72 17.1902 $1,203.59 $253.49 $240.72 17.1902 $1,203.59 $253.49 $240.72 17.1902 $1,203.59 $253.49 $240.72 17.1902 $1,203.59 $253.49 $240.72 17.1902 $1,203.59 $253.49 $240.72 17.1902 $1,203.59 $253.49 $240.72 17.1902 $1,203.59 $253.49 $240.72 23.2636 $1,628.82 $350.74 $325.77 23.2636 $1,628.82 $350.74 $325.77 16.9957$1,189.97

. $238.00 16.9957$1,189.97

. $238.00 16.9957$1,189.97

. $238.00 23.2636 $1,628.82 $350.74 $325.7728.8625$2,020.84

. $404.17

28.8625$2,020.84

. $404.17 17.1902 $1,203.59 $253.49 $240.72 17.1902 $1,203.59 $253.49 $240.72 28.8625$2,020.84

. $404.17 17.1902 $1,203.59 $253.49 $240.72 17.1902 $1,203.59 $253.49 $240.72 17.1902 $1,203.59 $253.49 $240.72 17.1902 $1,203.59 $253.49 $240.72 17.1902 $1,203.59 $253.49 $240.72 17.1902 $1,203.59 $253.49 $240.72 17.1902 $1,203.59 $253.49 $240.72 28.8625$2,020.84

. $404.17 17.1902 $1,203.59 $253.49 $240.72 17.1902 $1,203.59 $253.49 $240.72 17.1902 $1,203.59 $253.49 $240.72 17.1902 $1,203.59 $253.49 $240.72 17.1902 $1,203.59 $253.49 $240.72 17.1902 $1,203.59 $253.49 $240.72 17.1902 $1,203.59 $253.49 $240.72 17.1902 $1,203.59 $253.49 $240.72 16.9957$1,189.97

. $238.00 5.0454 $353.26

. $70.66 5.0454 $353.26

. $70.66 28.8625$2,020.84

. $404.17 28.8625$2,020.84

. $404.17 28.8625$2,020.84

. $404.17 28.8625$2,020.84

. $404.17 28.8625$2,020.84

. $404.17 28.8625$2,020.84

. $404.17 28.8625$2,020.84

. $404.17 28.8625$2,020.84

. $404.17 28.8625$2,020.84

. $404.17 28.8625$2,020.84

. $404.17 17.1902 $1,203.59 $253.49 $240.72 28.8625$2,020.84

. $404.17 28.8625$2,020.84

. $404.17 28.8625$2,020.84

. $404.17 17.1902 $1,203.59 $253.49 $240.72 28.8625$2,020.84

. $404.17 28.8625$2,020.84

. $404.17 28.8625$2,020.84

. $404.17 17.1902 $1,203.59 $253.49 $240.72 17.1902 $1,203.59 $253.49 $240.72 28.8625$2,020.84

. $404.17 17.1902 $1,203.59 $253.49 $240.72 17.1902 $1,203.59 $253.49 $240.72 28.8625$2,020.84

. $404.17 17.1902 $1,203.59 $253.49 $240.72 28.8625$2,020.84

. $404.17 17.1902 $1,203.59 $253.49 $240.72 17.1902 $1,203.59 $253.49 $240.72 17.1902 $1,203.59 $253.49 $240.72 17.1902 $1,203.59 $253.49 $240.72 17.1902 $1,203.59 $253.49 $240.7217.1902 $1,203.59 $253.49 $240.72

17.1902 $1,203.59 $253.49 $240.72 17.1902 $1,203.59 $253.49 $240.72 17.1902 $1,203.59 $253.49 $240.72 28.8625$2,020.84

. $404.17 28.8625$2,020.84

. $404.17 28.8625$2,020.84

. $404.17 28.8625$2,020.84

. $404.17 28.8625$2,020.84

. $404.17 28.8625$2,020.84

. $404.17 28.8625$2,020.84

. $404.17 28.8625$2,020.84

. $404.17 28.8625$2,020.84

. $404.17 28.8625$2,020.84

. $404.17 28.8625$2,020.84

. $404.17 17.1902 $1,203.59 $253.49 $240.72 28.8625$2,020.84

. $404.17 17.1902 $1,203.59 $253.49 $240.72 28.8625$2,020.84

. $404.17 28.8625$2,020.84

. $404.17 28.8625$2,020.84

. $404.17 28.8625$2,020.84

. $404.17 17.1902 $1,203.59 $253.49 $240.72 17.1902 $1,203.59 $253.49 $240.72 41.2873$2,890.77

. $578.16 60.9147$4,265.00

. $853.00 41.2873$2,890.77

. $578.16 60.9147$4,265.00

. $853.00 17.1902 $1,203.59 $253.49 $240.72 28.8625$2,020.84

. $404.17 17.1902 $1,203.59 $253.49 $240.72 28.8625$2,020.84

. $404.17 28.8625$2,020.84

. $404.17 28.8625$2,020.84

. $404.17 28.8625$2,020.84

. $404.17

28.8625$2,020.84

. $404.17

17.1902 $1,203.59 $253.49 $240.72 28.8625$2,020.84

. $404.17 28.8625$2,020.84

. $404.17 28.8625$2,020.84

. $404.17 28.8625$2,020.84

. $404.17 28.8625$2,020.84

. $404.17 17.1902 $1,203.59 $253.49 $240.72 17.1902 $1,203.59 $253.49 $240.72 17.1902 $1,203.59 $253.49 $240.72 28.8625$2,020.84

. $404.17 17.1902 $1,203.59 $253.49 $240.72 17.1902 $1,203.59 $253.49 $240.72 1.5020 $105.16

. $21.04 1.5020 $105.16

. $21.04 18.9489$1,326.73

. $265.3526.1202 $1,828.83 $372.85 $365.77

49.8979$3,493.65

. $698.73 1.5020 $105.16

. $21.04 5.0454 $353.26

. $70.66 26.1202 $1,828.83 $372.85 $365.77 49.8979$3,493.65

. $698.73 1.5020 $105.16

. $21.04 1.5020 $105.16

. $21.04 26.1202 $1,828.83 $372.85 $365.77 26.1202 $1,828.83 $372.85 $365.77 68.1203$4,769.51

. $953.91 1.5020 $105.16

. $21.04 1.5020 $105.16

. $21.04 18.9489$1,326.73

. $265.35 26.1202 $1,828.83 $372.85 $365.77 1.5020 $105.16

. $21.04 1.5020 $105.16

. $21.04 26.1202 $1,828.83 $372.85 $365.77 26.1202 $1,828.83 $372.85 $365.77 1.5020 $105.16

. $21.04 1.5020 $105.16

. $21.04 26.1202 $1,828.83 $372.85 $365.77 1.5020 $105.16

. $21.04 1.5020 $105.16

. $21.04 26.1202 $1,828.83 $372.85 $365.77 26.1202 $1,828.83 $372.85 $365.77 1.5020 $105.16

. $21.04 15.4596 $1,082.42 $268.44 $216.49 26.1202 $1,828.83 $372.85 $365.77 26.1202 $1,828.83 $372.85 $365.77 28.8625$2,020.84

. $404.17 28.8625$2,020.84

. $404.17 28.8625$2,020.84

. $404.17 28.8625$2,020.84

. $404.17 28.8625$2,020.84

. $404.17 28.8625$2,020.84

. $404.17 28.8625$2,020.84

. $404.17 28.8625$2,020.84

. $404.17 28.8625$2,020.84

. $404.17 28.8625$2,020.84

. $404.17 28.8625$2,020.84

. $404.17 28.8625$2,020.84

. $404.17 17.1902 $1,203.59 $253.49 $240.72 17.1902 $1,203.59 $253.49 $240.72 1.5020 $105.16

. $21.04 22.0797$1,545.93

. $309.19 22.0797$1,545.93

. $309.19

22.0797$1,545.93

. $309.19 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35

32.4461 $2,271.75

. $454.35

32.4461 $2,271.75

. $454.3547.5032 $3,325.98

. $665.20

32.4461 $2,271.75

. $454.35

8.2918 $580.56

. $116.12 8.2918 $580.56

. $116.12 23.2636 $1,628.82 $350.74 $325.77 23.2636 $1,628.82 $350.74 $325.77 16.9957$1,189.97

. $238.00 16.9957$1,189.97

. $238.00 16.9957$1,189.97

. $238.00 22.0797$1,545.93

. $309.19 22.0797$1,545.93

. $309.19

22.0797$1,545.93

. $309.19 23.2636 $1,628.82 $350.74 $325.77 22.0797$1,545.93

. $309.19 22.0797$1,545.93

. $309.19 22.0797$1,545.93

. $309.19 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35

32.4461 $2,271.75

. $454.35 8.2918 $580.56

. $116.12 22.0797$1,545.93

. $309.19

32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 47.5032 $3,325.98

. $665.20 47.5032 $3,325.98

. $665.20 47.5032 $3,325.98

. $665.20 47.5032 $3,325.98

. $665.2088.8483$6,220.80

. $1,244.16

1.5020 $105.16

. $21.04 15.4596 $1,082.42 $268.44 $216.49 1.5020 $105.16

. $21.04 49.8979$3,493.65

. $698.73

1.5020 $105.16

. $21.04

1.5020 $105.16

. $21.04

32.4461 $2,271.75

. $454.35

5.0454 $353.26

. $70.66

5.0454 $353.26

. $70.66

1.5020 $105.16

. $21.04 15.4596 $1,082.42 $268.44 $216.49

1.5020 $105.16

. $21.04 15.4596 $1,082.42 $268.44 $216.49

1.5020 $105.16

. $21.04 15.4596 $1,082.42 $268.44 $216.49 1.5020 $105.16

. $21.04

15.4596 $1,082.42 $268.44 $216.49

1.5020 $105.16

. $21.0420.5510 $1,438.90

. $287.78

22.0797$1,545.93

. $309.19 22.0797$1,545.93

. $309.19 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 8.2918 $580.56

. $116.12 23.2636 $1,628.82 $350.74 $325.77 18.8921 $1,322.75

. $264.55 18.8921 $1,322.75

. $264.55 23.2636 $1,628.82 $350.74 $325.77 16.9957$1,189.97

. $238.00 16.9957$1,189.97

. $238.00 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 23.2636 $1,628.82 $350.74 $325.77 23.2636 $1,628.82 $350.74 $325.77 22.0797$1,545.93

. $309.19 22.0797$1,545.93

. $309.19 22.0797$1,545.93

. $309.19 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 23.2636 $1,628.82 $350.74 $325.77

23.2636 $1,628.82 $350.74 $325.77 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 22.0797$1,545.93

. $309.19 22.0797$1,545.93

. $309.19 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 47.5032 $3,325.98

. $665.20 32.4461 $2,271.75

. $454.35 47.5032 $3,325.98

. $665.20 47.5032 $3,325.98

. $665.20 32.4461 $2,271.75

. $454.35 47.5032 $3,325.98

. $665.20 88.8483$6,220.80

. $1,244.16 88.8483$6,220.80

. $1,244.16 88.8483$6,220.80

. $1,244.16 88.8483$6,220.80

. $1,244.16 47.5032 $3,325.98

. $665.20 47.5032 $3,325.98

. $665.2047.5032 $3,325.98

. $665.20

47.5032 $3,325.98

. $665.20 47.5032 $3,325.98

. $665.20 32.4461 $2,271.75

. $454.35 88.8483$6,220.80

. $1,244.16 88.8483$6,220.80

. $1,244.16 88.8483$6,220.80

. $1,244.16 47.5032 $3,325.98

. $665.20 32.4461 $2,271.75

. $454.35 41.2873$2,890.77

. $578.16 60.9147$4,265.00

. $853.00 41.2873$2,890.77

. $578.16 41.2873$2,890.77

. $578.16 41.2873$2,890.77

. $578.16 41.2873$2,890.77

. $578.16

132.5319$9,279.35

. $1,855.87

32.4461 $2,271.75

. $454.35

32.4461 $2,271.75

. $454.35

32.4461 $2,271.75

. $454.35 22.0797$1,545.93

. $309.19 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 5.0454 $353.26

. $70.66 1.5020 $105.16

. $21.04 18.9489$1,326.73

. $265.35 1.5020 $105.16

. $21.04

1.5020 $105.16

. $21.04 26.1202 $1,828.83 $372.85 $365.77 5.0454 $353.26

. $70.66

1.5020 $105.16

. $21.04 1.5020 $105.16

. $21.041.5020 $105.16

. $21.04

49.8979$3,493.65

. $698.73 1.5020 $105.16

. $21.04 18.9489$1,326.73

. $265.35

1.5020 $105.16

. $21.04

1.5020 $105.16

. $21.04 15.4596 $1,082.42 $268.44 $216.49

1.5020 $105.16

. $21.04 15.4596 $1,082.42 $268.44 $216.49 49.8979$3,493.65

. $698.73 15.4596 $1,082.42 $268.44 $216.49

22.0797$1,545.93

. $309.19

1.5020 $105.16

. $21.04 22.0797$1,545.93

. $309.19 22.0797$1,545.93

. $309.19 32.4461 $2,271.75

. $454.35 20.5510 $1,438.90

. $287.78 32.4461 $2,271.75

. $454.35 22.0963$1,547.09 $353.25 $309.42 22.0797$1,545.93

. $309.19 22.0797$1,545.93

. $309.19 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 8.2918 $580.56

. $116.12 23.2636 $1,628.82 $350.74 $325.77 16.9957$1,189.97

. $238.00 23.2636 $1,628.82 $350.74 $325.77 16.9957$1,189.97

. $238.00 16.9957$1,189.97

. $238.00 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 22.0797$1,545.93

. $309.19 23.2636 $1,628.82 $350.74 $325.77 23.2636 $1,628.82 $350.74 $325.77 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35

32.4461 $2,271.75

. $454.3547.5032 $3,325.98

. $665.20

88.8483$6,220.80

. $1,244.16 47.5032 $3,325.98

. $665.20 22.0797$1,545.93

. $309.19 22.0797$1,545.93

. $309.19 22.0797$1,545.93

. $309.19 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 22.0797$1,545.93

. $309.19 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 47.5032 $3,325.98

. $665.20 47.5032 $3,325.98

. $665.20 47.5032 $3,325.98

. $665.20 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 41.2873$2,890.77

. $578.16

22.0797$1,545.93

. $309.19 47.5032 $3,325.98

. $665.20 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35

49.8979$3,493.65

. $698.73 68.1203$4,769.51

. $953.91

49.8979$3,493.65

. $698.73

32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 47.5032 $3,325.98

. $665.20 88.8483$6,220.80

. $1,244.16 1.5020 $105.16

. $21.04 18.9489$1,326.73

. $265.35 26.1202 $1,828.83 $372.85 $365.77 49.8979$3,493.65

. $698.73 68.1203$4,769.51

. $953.91 1.5020 $105.16

. $21.04 18.9489$1,326.73

. $265.35 49.8979$3,493.65

. $698.73 1.5020 $105.16

. $21.04 1.5020 $105.16

. $21.04 49.8979$3,493.65

. $698.73 1.5020 $105.16

. $21.0418.9489$1,326.73

. $265.35

49.8979$3,493.65

. $698.73 1.5020 $105.16

. $21.04 1.5020 $105.16

. $21.04 49.8979$3,493.65

. $698.73 1.5020 $105.16

. $21.04 1.5020 $105.16

. $21.04 49.8979$3,493.65

. $698.73 1.5020 $105.16

. $21.04 5.0454 $353.26

. $70.66 49.8979$3,493.65

. $698.73 68.1203$4,769.51

. $953.91 1.5020 $105.16

. $21.04 18.9489$1,326.73

. $265.35 49.8979$3,493.65

. $698.73 68.1203$4,769.51

. $953.91 68.1203$4,769.51

. $953.91 49.8979$3,493.65

. $698.73 1.5020 $105.16

. $21.04 18.9489$1,326.73

. $265.35 49.8979$3,493.65

. $698.73 1.5020 $105.16

. $21.04 15.4596 $1,082.42 $268.44 $216.49 49.8979$3,493.65

. $698.73 49.8979$3,493.65

. $698.73 15.4596 $1,082.42 $268.44 $216.49 88.8483$6,220.80

. $1,244.16 88.8483$6,220.80

. $1,244.16

22.0797$1,545.93

. $309.19

32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 1.5020 $105.16

. $21.04 12.8082 $896.78

. $179.36 22.0797$1,545.93

. $309.19 22.0797$1,545.93

. $309.19 22.0963$1,547.09 $353.25 $309.42 22.0963$1,547.09 $353.25 $309.42 22.0963$1,547.09 $353.25 $309.42 22.0963$1,547.09 $353.25 $309.42 22.0963$1,547.09 $353.25 $309.42 22.0963$1,547.09 $353.25 $309.42 22.0963$1,547.09 $353.25 $309.42 18.8921 $1,322.75

. $264.55 23.2636 $1,628.82 $350.74 $325.77 23.2636 $1,628.82 $350.74 $325.77 16.9957$1,189.97

. $238.00 16.9957$1,189.97

. $238.00 16.9957$1,189.97

. $238.0023.2636 $1,628.82 $350.74 $325.77

22.0963$1,547.09 $353.25 $309.42 22.0963$1,547.09 $353.25 $309.42 22.0963$1,547.09 $353.25 $309.42 18.8921 $1,322.75

. $264.55 22.0963$1,547.09 $353.25 $309.42 22.0963$1,547.09 $353.25 $309.42 22.0963$1,547.09 $353.25 $309.42 22.0963$1,547.09 $353.25 $309.42 22.0963$1,547.09 $353.25 $309.42 22.0963$1,547.09 $353.25 $309.42 22.0963$1,547.09 $353.25 $309.42 22.0963$1,547.09 $353.25 $309.42 22.0963$1,547.09 $353.25 $309.42 22.0963$1,547.09 $353.25 $309.42 58.4586 $4,093.04

. $818.61 58.4586 $4,093.04

. $818.61 22.0963$1,547.09 $353.25 $309.42 58.4586 $4,093.04

. $818.61 58.4586 $4,093.04

. $818.61 22.0963$1,547.09 $353.25 $309.42 22.0963$1,547.09 $353.25 $309.42 22.0963$1,547.09 $353.25 $309.42 22.0963$1,547.09 $353.25 $309.42 22.0963$1,547.09 $353.25 $309.42 22.0963$1,547.09 $353.25 $309.42 22.0963$1,547.09 $353.25 $309.42 22.0963$1,547.09 $353.25 $309.42 22.0963$1,547.09 $353.25 $309.42 22.0963$1,547.09 $353.25 $309.42 22.0963$1,547.09 $353.25 $309.42 22.0963$1,547.09 $353.25 $309.42 22.0963$1,547.09 $353.25 $309.42 22.0963$1,547.09 $353.25 $309.42 22.0963$1,547.09 $353.25 $309.42 22.0963$1,547.09 $353.25 $309.42 22.0963$1,547.09 $353.25 $309.42 22.0963$1,547.09 $353.25 $309.42 22.0963$1,547.09 $353.25 $309.42 22.0963$1,547.09 $353.25 $309.42 22.0963$1,547.09 $353.25 $309.42 8.2918 $580.56

. $116.12 16.9957$1,189.97

. $238.00 8.2918 $580.56

. $116.12 22.0963$1,547.09 $353.25 $309.42 22.0963$1,547.09 $353.25 $309.42 22.0963$1,547.09 $353.25 $309.42 58.4586 $4,093.04

. $818.61 22.0963$1,547.09 $353.25 $309.42 22.0963$1,547.09 $353.25 $309.42 22.0963$1,547.09 $353.25 $309.42 22.0963$1,547.09 $353.25 $309.42 22.0963$1,547.09 $353.25 $309.42 22.0963$1,547.09 $353.25 $309.42 22.0963$1,547.09 $353.25 $309.4258.4586 $4,093.04

. $818.61

22.0963$1,547.09 $353.25 $309.42 22.0963$1,547.09 $353.25 $309.42 22.0963$1,547.09 $353.25 $309.42 22.0963$1,547.09 $353.25 $309.42 22.0963$1,547.09 $353.25 $309.42 58.4586 $4,093.04

. $818.61 22.0963$1,547.09 $353.25 $309.42 22.0963$1,547.09 $353.25 $309.42 22.0963$1,547.09 $353.25 $309.42 22.0963$1,547.09 $353.25 $309.42 22.0963$1,547.09 $353.25 $309.42 22.0963$1,547.09 $353.25 $309.42 22.0963$1,547.09 $353.25 $309.42 32.7262 $2,291.36 $475.91 $458.28 32.7262 $2,291.36 $475.91 $458.28 32.7262 $2,291.36 $475.91 $458.28 32.7262 $2,291.36 $475.91 $458.28 32.7262 $2,291.36 $475.91 $458.28 32.7262 $2,291.36 $475.91 $458.28 32.7262 $2,291.36 $475.91 $458.28 32.7262 $2,291.36 $475.91 $458.28 58.4586 $4,093.04

. $818.61 22.0963$1,547.09 $353.25 $309.42 58.4586 $4,093.04

. $818.61 58.4586 $4,093.04

. $818.61 22.0963$1,547.09 $353.25 $309.42 22.0963$1,547.09 $353.25 $309.42 22.0963$1,547.09 $353.25 $309.42 58.4586 $4,093.04

. $818.61 22.0963$1,547.09 $353.25 $309.42 22.0963$1,547.09 $353.25 $309.42 22.0963$1,547.09 $353.25 $309.42 22.0963$1,547.09 $353.25 $309.42 58.4586 $4,093.04

. $818.61 58.4586 $4,093.04

. $818.61 22.0963$1,547.09 $353.25 $309.42 22.0963$1,547.09 $353.25 $309.42 22.0963$1,547.09 $353.25 $309.42 22.0963$1,547.09 $353.25 $309.42 58.4586 $4,093.04

. $818.61 1.5020 $105.16

. $21.04 18.9489$1,326.73

. $265.35 26.1202 $1,828.83 $372.85 $365.77 68.1203$4,769.51

. $953.91 49.8979$3,493.65

. $698.73 1.5020 $105.16

. $21.04 1.5020 $105.16

. $21.04 26.1202 $1,828.83 $372.85 $365.77 49.8979$3,493.65

. $698.73 58.4586 $4,093.04

. $818.61 1.5020 $105.16

. $21.04 1.5020 $105.16

. $21.04 26.1202 $1,828.83 $372.85 $365.77 49.8979$3,493.65

. $698.731.5020 $105.16

. $21.04

1.5020 $105.16

. $21.04 26.1202 $1,828.83 $372.85 $365.77 49.8979$3,493.65

. $698.73 1.5020 $105.16

. $21.04 1.5020 $105.16

. $21.04 26.1202 $1,828.83 $372.85 $365.77 26.1202 $1,828.83 $372.85 $365.77 1.5020 $105.16

. $21.04 1.5020 $105.16

. $21.04 26.1202 $1,828.83 $372.85 $365.77 1.5020 $105.16

. $21.04 26.1202 $1,828.83 $372.85 $365.77 1.5020 $105.16

. $21.04 26.1202 $1,828.83 $372.85 $365.77 26.1202 $1,828.83 $372.85 $365.77 49.8979$3,493.65

. $698.73 1.5020 $105.16

. $21.04 18.9489$1,326.73

. $265.35 26.1202 $1,828.83 $372.85 $365.77 26.1202 $1,828.83 $372.85 $365.77 1.5020 $105.16

. $21.04 1.5020 $105.16

. $21.04 26.1202 $1,828.83 $372.85 $365.77 49.8979$3,493.65

. $698.73 1.5020 $105.16

. $21.04 15.4596 $1,082.42 $268.44 $216.49 26.1202 $1,828.83 $372.85 $365.77 26.1202 $1,828.83 $372.85 $365.77 1.5020 $105.16

. $21.04 15.4596 $1,082.42 $268.44 $216.49 26.1202 $1,828.83 $372.85 $365.77 26.1202 $1,828.83 $372.85 $365.77 58.4586 $4,093.04

. $818.61 88.8483$6,220.80

. $1,244.16 58.4586 $4,093.04

. $818.61 58.4586 $4,093.04

. $818.61 58.4586 $4,093.04

. $818.61 58.4586 $4,093.04

. $818.61 58.4586 $4,093.04

. $818.61 58.4586 $4,093.04

. $818.61 22.0963$1,547.09 $353.25 $309.42 58.4586 $4,093.04

. $818.61

22.0963$1,547.09 $353.25 $309.42 22.0963$1,547.09 $353.25 $309.42 22.0963$1,547.09 $353.25 $309.42 22.0963$1,547.09 $353.25 $309.42 32.4461 $2,271.75

. $454.35 1.5020 $105.16

. $21.04 1.1255 $78.80

. $15.76 2.5699 $179.93

. $35.99 2.5699 $179.93

. $35.99 1.1255 $78.80

. $15.76 1.1255 $78.80

. $15.762.5699 $179.93

. $35.99

1.1255 $78.80

. $15.76 2.5699 $179.93

. $35.99 2.5699 $179.93

. $35.99 1.1255 $78.80

. $15.76 2.5699 $179.93

. $35.99 1.1255 $78.80

. $15.76 2.5699 $179.93

. $35.99 2.5699 $179.93

. $35.99 1.1255 $78.80

. $15.76 1.1255 $78.80

. $15.76 1.1255 $78.80

. $15.76 1.1255 $78.80

. $15.76 1.1255 $78.80

. $15.76 1.1255 $78.80

. $15.76 1.1255 $78.80

. $15.76 1.1255 $78.80

. $15.76 1.1255 $78.80

. $15.76 1.1255 $78.80

. $15.76 1.1255 $78.80

. $15.76 2.5699 $179.93

. $35.99 2.5699 $179.93

. $35.99 2.5699 $179.93

. $35.99 2.5699 $179.93

. $35.99 2.5699 $179.93

. $35.99 2.5699 $179.93

. $35.99 2.5699 $179.93

. $35.99 2.5699 $179.93

. $35.99 2.5699 $179.93

. $35.99 1.1255 $78.80

. $15.76 2.5699 $179.93

. $35.99 1.1255 $78.80

. $15.76 1.1255 $78.80

. $15.76 1.1255 $78.80

. $15.76 1.1255 $78.80

. $15.76 1.1255 $78.80

. $15.76 1.1255 $78.80

. $15.76 1.1255 $78.80

. $15.76 1.1255 $78.80

. $15.76 1.1255 $78.80

. $15.76 1.1255 $78.80

. $15.76 1.1255 $78.80

. $15.76 1.1255 $78.80

. $15.76 1.1255 $78.80

. $15.76 1.1255 $78.80

. $15.76 1.1255 $78.80

. $15.76 2.5699 $179.93

. $35.99 1.1255 $78.80

. $15.76 1.1255 $78.80

. $15.76 1.1255 $78.80

. $15.76 1.1255 $78.80

. $15.76 1.1255 $78.80

. $15.76 1.1255 $78.80

. $15.76 29.7721 $2,084.52

. $416.91 29.7721 $2,084.52

. $416.9129.7721 $2,084.52

. $416.91

57.0707$3,995.86 $804.74 $799.18 57.0707$3,995.86 $804.74 $799.18 57.0707$3,995.86 $804.74 $799.18 57.0707$3,995.86 $804.74 $799.18 57.0707$3,995.86 $804.74 $799.18 29.7721 $2,084.52

. $416.91 57.0707$3,995.86 $804.74 $799.18 29.7721 $2,084.52

. $416.91 57.0707$3,995.86 $804.74 $799.18 29.7721 $2,084.52

. $416.91 57.0707$3,995.86 $804.74 $799.18 57.0707$3,995.86 $804.74 $799.18 29.7721 $2,084.52

. $416.91 29.7721 $2,084.52

. $416.91 29.7721 $2,084.52

. $416.91 29.7721 $2,084.52

. $416.91 29.7721 $2,084.52

. $416.91 29.7721 $2,084.52

. $416.91 29.7721 $2,084.52

. $416.91 29.7721 $2,084.52

. $416.91 29.7721 $2,084.52

. $416.91 29.7721 $2,084.52

. $416.91 29.7721 $2,084.52

. $416.91 57.0707$3,995.86 $804.74 $799.18 29.7721 $2,084.52

. $416.91 29.7721 $2,084.52

. $416.91 57.0707$3,995.86 $804.74 $799.18 57.0707$3,995.86 $804.74 $799.18 57.0707$3,995.86 $804.74 $799.18 57.0707$3,995.86 $804.74 $799.18 57.0707$3,995.86 $804.74 $799.18 57.0707$3,995.86 $804.74 $799.18 57.0707$3,995.86 $804.74 $799.18 57.0707$3,995.86 $804.74 $799.18 57.0707$3,995.86 $804.74 $799.18 57.0707$3,995.86 $804.74 $799.18 29.7721 $2,084.52

. $416.91 29.7721 $2,084.52

. $416.91 29.7721 $2,084.52

. $416.91 29.7721 $2,084.52

. $416.91 29.7721 $2,084.52

. $416.91 29.7721 $2,084.52

. $416.91 29.7721 $2,084.52

. $416.91 29.7721 $2,084.52

. $416.91 29.7721 $2,084.52

. $416.91 29.7721 $2,084.52

. $416.91 29.7721 $2,084.52

. $416.91 29.7721 $2,084.52

. $416.91 29.7721 $2,084.52

. $416.91 57.0707$3,995.86 $804.74 $799.18 29.7721 $2,084.52

. $416.91 29.7721 $2,084.52

. $416.91 88.8483$6,220.80

. $1,244.16 88.8483$6,220.80

. $1,244.1657.0707$3,995.86 $804.74 $799.18

88.8483$6,220.80

. $1,244.16 22.0963$1,547.09 $353.25 $309.42 29.7721 $2,084.52

. $416.91 29.7721 $2,084.52

. $416.91 29.7721 $2,084.52

. $416.91 29.7721 $2,084.52

. $416.91 57.0707$3,995.86 $804.74 $799.18 29.7721 $2,084.52

. $416.91 29.7721 $2,084.52

. $416.91 29.7721 $2,084.52

. $416.91 29.7721 $2,084.52

. $416.91 29.7721 $2,084.52

. $416.91 29.7721 $2,084.52

. $416.91 57.0707$3,995.86 $804.74 $799.18 57.0707$3,995.86 $804.74 $799.18 57.0707$3,995.86 $804.74 $799.18 57.0707$3,995.86 $804.74 $799.18 29.7721 $2,084.52

. $416.91 3.1150 $218.10

. $43.62 3.1150 $218.10

. $43.62 7.4614 $522.42 $104.55 $104.49 16.8699$1,181.16 $279.20 $236.24 16.8699$1,181.16 $279.20 $236.24 16.8699$1,181.16 $279.20 $236.24 24.8895$1,742.66

. $348.54 24.8895$1,742.66

. $348.54 7.4614 $522.42 $104.55 $104.49 45.0377$3,153.36

. $630.68 16.8699$1,181.16 $279.20 $236.24 24.8895$1,742.66

. $348.54 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 7.4614 $522.42 $104.55 $104.49 7.4614 $522.42 $104.55 $104.49 7.4614 $522.42 $104.55 $104.49 0.6499 $45.50

. $9.10 16.8699$1,181.16 $279.20 $236.24 16.8699$1,181.16 $279.20 $236.24 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 24.8895$1,742.66

. $348.54 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 24.8895$1,742.66

. $348.54 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 3.1150 $218.10

. $43.62 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.6824.8895$1,742.66

. $348.54

7.4614 $522.42 $104.55 $104.49 16.8699$1,181.16 $279.20 $236.24 1.0709 $74.98 $24.12 $15.00 1.0709 $74.98 $24.12 $15.00 1.0709 $74.98 $24.12 $15.00 1.0709 $74.98 $24.12 $15.00 26.8120 $1,877.27

. $375.46 26.8120 $1,877.27

. $375.46 16.8699$1,181.16 $279.20 $236.24 1.0709 $74.98 $24.12 $15.00 3.1150 $218.10

. $43.62 7.4614 $522.42 $104.55 $104.49 24.8895$1,742.66

. $348.54 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 24.8895$1,742.66

. $348.54 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 24.8895$1,742.66

. $348.54 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68

1.8643 $130.53

. $26.11 1.8643 $130.53

. $26.11 21.2774 $1,489.76

. $297.96 21.2774 $1,489.76

. $297.96 21.2774 $1,489.76

. $297.96 30.3487$2,124.89 $444.55 $424.98 21.2774 $1,489.76

. $297.96 30.3487$2,124.89 $444.55 $424.98 30.3487$2,124.89 $444.55 $424.98 30.3487$2,124.89 $444.55 $424.98 30.3487$2,124.89 $444.55 $424.98 30.3487$2,124.89 $444.55 $424.98 30.3487$2,124.89 $444.55 $424.98 30.3487$2,124.89 $444.55 $424.98

30.3487$2,124.89 $444.55 $424.98 30.3487$2,124.89 $444.55 $424.98 30.3487$2,124.89 $444.55 $424.98 30.3487$2,124.89 $444.55 $424.98 30.3487$2,124.89 $444.55 $424.98 30.3487$2,124.89 $444.55 $424.981.0709 $74.98 $24.12 $15.00

24.8895$1,742.66

. $348.54 45.0377$3,153.36

. $630.68

45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 2.2326 $156.32 $43.83 $31.27 1.4089 $98.65

. $19.73 1.0729 $75.12

. $15.03 21.2774 $1,489.76

. $297.96 1.8643 $130.53

. $26.11 21.2774 $1,489.76

. $297.96 1.8643 $130.53

. $26.11 21.2774 $1,489.76

. $297.96 1.8643 $130.53

. $26.11 21.2774 $1,489.76

. $297.96 21.2774 $1,489.76

. $297.96 30.3487$2,124.89 $444.55 $424.98 21.2774 $1,489.76

. $297.96 21.2774 $1,489.76

. $297.96 21.2774 $1,489.76

. $297.96 21.2774 $1,489.76

. $297.96 21.2774 $1,489.76

. $297.96 21.2774 $1,489.76

. $297.96 21.2774 $1,489.76

. $297.96 21.2774 $1,489.76

. $297.96 30.3487$2,124.89 $444.55 $424.98 30.3487$2,124.89 $444.55 $424.98 30.3487$2,124.89 $444.55 $424.98 30.3487$2,124.89 $444.55 $424.98 21.2774 $1,489.76

. $297.96 30.3487$2,124.89 $444.55 $424.98 1.8643 $130.53

. $26.11 21.2774 $1,489.76

. $297.96 4.4119 $308.90 $67.83 $61.78 30.3487$2,124.89 $444.55 $424.98 4.4119 $308.90 $67.83 $61.78 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68

45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 1.0709 $74.98 $24.12 $15.00 24.8895$1,742.66

. $348.5424.8895$1,742.66

. $348.54

7.4614 $522.42 $104.55 $104.49 7.4614 $522.42 $104.55 $104.49 24.8895$1,742.66

. $348.54 24.8895$1,742.66

. $348.54 24.8895$1,742.66

. $348.54 24.8895$1,742.66

. $348.54 45.0377$3,153.36

. $630.68 7.4614 $522.42 $104.55 $104.49

10.4689 $732.99 $189.82 $146.60 10.4689 $732.99 $189.82 $146.60 10.4689 $732.99 $189.82 $146.60 10.4689 $732.99 $189.82 $146.60 28.9051 $2,023.82 $459.92 $404.77

10.4689 $732.99 $189.82 $146.60 10.4689 $732.99 $189.82 $146.60 28.9051 $2,023.82 $459.92 $404.77 28.9051 $2,023.82 $459.92 $404.77 10.4689 $732.99 $189.82 $146.60 10.4689 $732.99 $189.82 $146.60 10.4689 $732.99 $189.82 $146.60 10.4689 $732.99 $189.82 $146.60 28.9051 $2,023.82 $459.92 $404.77 10.4689 $732.99 $189.82 $146.60 28.9051 $2,023.82 $459.92 $404.77 28.9051 $2,023.82 $459.92 $404.77 28.9051 $2,023.82 $459.92 $404.77 10.4689 $732.99 $189.82 $146.60 10.4689 $732.99 $189.82 $146.60 10.4689 $732.99 $189.82 $146.60 10.4689 $732.99 $189.82 $146.60

4.4119 $308.90 $67.83 $61.78 0.4237 $29.67 $7.74 $5.94

4.4119 $308.90 $67.83 $61.78 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68

24.8895$1,742.66

. $348.54

24.8895$1,742.66

. $348.54 24.8895$1,742.66

. $348.54 24.8895$1,742.66

. $348.54 10.4689 $732.99 $189.82 $146.605.5061 $385.52

. $77.11

9.6713 $677.15

. $135.43

9.6713 $677.15

. $135.43 5.5061 $385.52

. $77.11 5.5061 $385.52

. $77.11 5.5061 $385.52

. $77.11

30.8430 $2,159.50

. $431.90 5.5061 $385.52

. $77.11 1.4089 $98.65

. $19.73 13.6332 $954.54 $325.27 $190.91 5.5061 $385.52

. $77.11 5.5061 $385.52

. $77.11 5.5061 $385.52

. $77.11 34.5272 $2,417.46 $591.64 $483.50

34.5272 $2,417.46 $591.64 $483.5034.5272 $2,417.46 $591.64 $483.50

34.5272 $2,417.46 $591.64 $483.50 34.5272 $2,417.46 $591.64 $483.50 34.5272 $2,417.46 $591.64 $483.50

5.5061 $385.52

. $77.11

58.4890 $4,095.17

. $819.04 5.5061 $385.52

. $77.11 5.5061 $385.52

. $77.11 5.5061 $385.52

. $77.11112.1218$7,850.32 $1,643.98 $1,570.07

112.1218$7,850.32 $1,643.98 $1,570.07 137.6558$9,638.11

. $1,927.63 47.1769$3,303.14

. $660.63 47.1769$3,303.14

. $660.63 94.2220 $6,597.05 $1,593.50 $1,319.41 103.3418$7,235.58

. $1,447.12 137.6558$9,638.11

. $1,927.63 21.7420 $1,522.29

. $304.46 47.1769$3,303.14

. $660.63 47.1769$3,303.14

. $660.63 21.7420 $1,522.29

. $304.46 21.7420 $1,522.29

. $304.46 103.3418$7,235.58

. $1,447.12 16.7703$1,174.19

. $234.84 16.7703$1,174.19

. $234.84 137.6558$9,638.11

. $1,927.63 137.6558$9,638.11

. $1,927.63 21.7420 $1,522.29

. $304.46 94.2220 $6,597.05 $1,593.50 $1,319.41 103.3418$7,235.58

. $1,447.12 103.3418$7,235.58

. $1,447.12 341.5859$23,916.48

. $4,783.30 341.5859$23,916.48

. $4,783.30 21.7420 $1,522.29

. $304.46 21.7420 $1,522.29

. $304.46 21.7420 $1,522.29

. $304.46

341.5859$23,916.48

. $4,783.30 21.7420 $1,522.29

. $304.46

21.7420 $1,522.29

. $304.46 426.1201$29,835.22

. $5,967.05

341.5859$23,916.48

. $4,783.30 341.5859$23,916.48

. $4,783.30 341.5859$23,916.48

. $4,783.3080.3579$5,626.34

. $1,125.27

8.2918 $580.56

. $116.125.5061 $385.52

. $77.11

41.0387$2,873.37 $655.18 $574.68 41.0387$2,873.37 $655.18 $574.68

41.0387$2,873.37 $655.18 $574.68 41.0387$2,873.37 $655.18 $574.68

41.0387$2,873.37 $655.18 $574.68

41.0387$2,873.37 $655.18 $574.68 41.0387$2,873.37 $655.18 $574.68 41.0387$2,873.37 $655.18 $574.68

41.0387$2,873.37 $655.18 $574.68 41.0387$2,873.37 $655.18 $574.68 41.0387$2,873.37 $655.18 $574.6843.8023$3,066.86

. $613.38

31.1505$2,181.03

. $436.21

31.1505$2,181.03

. $436.21

31.1505$2,181.03

. $436.21 41.0387$2,873.37 $655.18 $574.68

31.1505$2,181.03

. $436.21 31.1505$2,181.03

. $436.21 31.1505$2,181.03

. $436.21 41.0387$2,873.37 $655.18 $574.68

8.2918 $580.56

. $116.12 31.1505$2,181.03

. $436.21 31.1505$2,181.03

. $436.21

31.1505$2,181.03

. $436.2143.8023$3,066.86

. $613.38

43.8023$3,066.86

. $613.38

43.8023$3,066.86

. $613.38

31.1505$2,181.03

. $436.21

65.8519$4,610.69

. $922.14 65.8519$4,610.69

. $922.14 65.8519$4,610.69

. $922.14 65.8519$4,610.69

. $922.14 65.8519$4,610.69

. $922.14 65.8519$4,610.69

. $922.14 16.3852 $1,147.23

. $229.4531.1505$2,181.03

. $436.21

31.1505$2,181.03

. $436.2131.1505$2,181.03

. $436.21

31.1505$2,181.03

. $436.21

41.0387$2,873.37 $655.18 $574.68 41.0387$2,873.37 $655.18 $574.68 41.0387$2,873.37 $655.18 $574.68 41.0387$2,873.37 $655.18 $574.68 41.0387$2,873.37 $655.18 $574.68 41.0387$2,873.37 $655.18 $574.68

31.1505$2,181.03

. $436.21

2.1681 $151.80 $59.37 $30.36

9.4045 $658.47

. $131.70

29.7209$2,080.94

. $416.19 29.7209$2,080.94

. $416.19 29.7209$2,080.94

. $416.19 29.7209$2,080.94

. $416.19 30.3507$2,125.03

. $425.01 21.7420 $1,522.29

. $304.46 21.7420 $1,522.29

. $304.460.2673 $18.72

. $3.75

0.2673 $18.72

. $3.75 3.4217 $239.57

. $47.92 3.4217 $239.57

. $47.92 3.4217 $239.57

. $47.92 3.4217 $239.57

. $47.92 3.4217 $239.57

. $47.92 0.8768 $61.39

. $12.28 1.4966 $104.79

. $20.96 1.4966 $104.79

. $20.96 1.4966 $104.79

. $20.96 44.2272 $3,096.61

. $619.33 26.8120 $1,877.27

. $375.46 26.8120 $1,877.27

. $375.46 26.8120 $1,877.27

. $375.46

11.6629 $816.59 $189.89 $163.32 11.6629 $816.59 $189.89 $163.32 11.6629 $816.59 $189.89 $163.32 11.6629 $816.59 $189.89 $163.32 35.6252 $2,494.33

. $498.87 35.6252 $2,494.33

. $498.87 35.6252 $2,494.33

. $498.87 11.0639 $774.65

. $154.93 11.0639 $774.65

. $154.93 25.2672 $1,769.11

. $353.83 25.2672 $1,769.11

. $353.83 30.3507$2,125.03

. $425.01 30.3507$2,125.03

. $425.01 30.3507$2,125.03

. $425.01 30.3507$2,125.03

. $425.01 30.3507$2,125.03

. $425.01 11.0639 $774.65

. $154.93 11.0639 $774.65

. $154.93 25.2672 $1,769.11

. $353.83 25.2672 $1,769.11

. $353.83 6.2123 $434.96

. $87.00 11.0639 $774.65

. $154.93 25.2672 $1,769.11

. $353.83 11.0639 $774.65

. $154.93 25.2672 $1,769.11

. $353.83 30.3507$2,125.03

. $425.01 30.3507$2,125.03

. $425.01 11.0639 $774.65

. $154.93 25.2672 $1,769.11

. $353.83 6.2123 $434.96

. $87.00 11.0639 $774.65

. $154.93 0.6068 $42.49 $12.33 $8.50 0.6068 $42.49 $12.33 $8.50 2.3021 $161.18

. $32.24 25.2672 $1,769.11

. $353.8311.0639 $774.65

. $154.93

11.0639 $774.65

. $154.93 2.3021 $161.18

. $32.24 0.2673 $18.72

. $3.75

30.3507$2,125.03

. $425.01

1.6118 $112.85

. $22.57 37.4593$2,622.75

. $524.55 37.4593$2,622.75

. $524.55 37.4593$2,622.75

. $524.55 41.0387$2,873.37 $655.18 $574.68 41.0387$2,873.37 $655.18 $574.68 41.0387$2,873.37 $655.18 $574.68 41.0387$2,873.37 $655.18 $574.68

41.0387$2,873.37 $655.18 $574.68 41.0387$2,873.37 $655.18 $574.68 41.0387$2,873.37 $655.18 $574.68 41.0387$2,873.37 $655.18 $574.68 41.0387$2,873.37 $655.18 $574.68 37.4593$2,622.75

. $524.55 41.0387$2,873.37 $655.18 $574.68 2.3021 $161.18

. $32.24 37.4593$2,622.75

. $524.55 43.8023$3,066.86

. $613.38

115.5014 $8,086.95

. $1,617.39 41.0387$2,873.37 $655.18 $574.68 41.0387$2,873.37 $655.18 $574.68 41.0387$2,873.37 $655.18 $574.68 41.0387$2,873.37 $655.18 $574.68 41.0387$2,873.37 $655.18 $574.68 44.2272 $3,096.61

. $619.33 30.3507$2,125.03

. $425.01 30.3507$2,125.03

. $425.01 2.3021 $161.18

. $32.24 30.3507$2,125.03

. $425.01 16.3852 $1,147.23

. $229.45 16.3852 $1,147.23

. $229.45 30.3507$2,125.03

. $425.01 105.0651 $7,356.24

. $1,471.25 115.5014 $8,086.95

. $1,617.39 115.5014 $8,086.95

. $1,617.39 115.5014 $8,086.95

. $1,617.39 115.5014 $8,086.95

. $1,617.39 30.3507$2,125.03

. $425.01 115.5014 $8,086.95

. $1,617.3965.8519$4,610.69

. $922.14

115.5014 $8,086.95

. $1,617.39 65.8519$4,610.69

. $922.14 65.8519$4,610.69

. $922.14 65.8519$4,610.69

. $922.14 115.5014 $8,086.95

. $1,617.39 115.5014 $8,086.95

. $1,617.39 203.0553$14,217.12 $5,559.48 $2,843.43 65.8519$4,610.69

. $922.14 115.5014 $8,086.95

. $1,617.39 115.5014 $8,086.95

. $1,617.39 203.0553$14,217.12 $5,559.48 $2,843.43 65.8519$4,610.69

. $922.14 115.5014 $8,086.95

. $1,617.39 65.8519$4,610.69

. $922.14 65.8519$4,610.69

. $922.14

44.2272 $3,096.61

. $619.33 26.8120 $1,877.27

. $375.46 31.1505$2,181.03

. $436.21 31.1505$2,181.03

. $436.21 44.2272 $3,096.61

. $619.33 26.8120 $1,877.27

. $375.46 26.8120 $1,877.27

. $375.46 16.9957$1,189.97

. $238.00 26.8120 $1,877.27

. $375.46

44.2272 $3,096.61

. $619.33

26.8120 $1,877.27

. $375.46

26.8120 $1,877.27

. $375.46 26.8120 $1,877.27

. $375.46 44.2272 $3,096.61

. $619.33 44.2272 $3,096.61

. $619.33 26.8120 $1,877.27

. $375.46 26.8120 $1,877.27

. $375.46 26.8120 $1,877.27

. $375.46 26.8120 $1,877.27

. $375.46 26.8120 $1,877.27

. $375.46 26.8120 $1,877.27

. $375.46

34.6069$2,423.04 $607.60 $484.61 0.6068 $42.49 $12.33 $8.50

47.9394 $3,356.53 $1,001.89 $671.31 38.9223$2,725.18 $659.53 $545.0411.6629 $816.59 $189.89 $163.32

3.4217 $239.57

. $47.92 3.4217 $239.57

. $47.92 3.4217 $239.57

. $47.92 6.9196 $484.48

. $96.90 6.9196 $484.48

. $96.90 6.9196 $484.48

. $96.90 6.9196 $484.48

. $96.90 6.9196 $484.48

. $96.90 6.9196 $484.48

. $96.90 3.5548 $248.89

. $49.78 3.5548 $248.89

. $49.78 35.6252 $2,494.33

. $498.87 35.6252 $2,494.33

. $498.87 35.6252 $2,494.33

. $498.87 35.6252 $2,494.33

. $498.87 11.6629 $816.59 $189.89 $163.32 12.8082 $896.78

. $179.36 20.5510 $1,438.90

. $287.78 25.2738$1,769.57

. $353.92

25.2738$1,769.57

. $353.92 8.1596 $571.30

. $114.26 25.2738$1,769.57

. $353.92 25.2738$1,769.57

. $353.92 25.2738$1,769.57

. $353.92 25.2738$1,769.57

. $353.92 51.2792 $3,590.36

. $718.08 25.2738$1,769.57

. $353.92 25.2738$1,769.57

. $353.92

47.9394 $3,356.53 $1,001.89 $671.31 71.5658$5,010.75 $1,236.99 $1,002.15 47.9394 $3,356.53 $1,001.89 $671.31 38.9223$2,725.18 $659.53 $545.04 25.2738$1,769.57

. $353.92 25.2738$1,769.57

. $353.92

51.2792 $3,590.36

. $718.08 51.2792 $3,590.36

. $718.08

25.2738$1,769.57

. $353.92

2.2892 $160.28 $39.07 $32.063.4217 $239.57

. $47.92

34.5272 $2,417.46 $591.64 $483.50

3.1150 $218.10

. $43.62 16.8699$1,181.16 $279.20 $236.24 24.8895$1,742.66

. $348.54 16.8699$1,181.16 $279.20 $236.24 24.8895$1,742.66

. $348.54 24.8895$1,742.66

. $348.54 24.8895$1,742.66

. $348.54 7.4614 $522.42 $104.55 $104.49 7.4614 $522.42 $104.55 $104.49 7.4614 $522.42 $104.55 $104.49 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 1.0709 $74.98 $24.12 $15.00 1.4209 $99.49

. $19.90 7.4614 $522.42 $104.55 $104.49 0.6499 $45.50

. $9.10 7.4614 $522.42 $104.55 $104.49 3.1150 $218.10

. $43.62 3.1150 $218.10

. $43.62 16.8699$1,181.16 $279.20 $236.24 16.8699$1,181.16 $279.20 $236.24 16.8699$1,181.16 $279.20 $236.24 24.8895$1,742.66

. $348.54 3.1150 $218.10

. $43.62 7.4614 $522.42 $104.55 $104.49 16.8699$1,181.16 $279.20 $236.24 3.1150 $218.10

. $43.62 7.4614 $522.42 $104.55 $104.49 24.8895$1,742.66

. $348.54 24.8895$1,742.66

. $348.54 24.8895$1,742.66

. $348.54 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 1.0709 $74.98 $24.12 $15.00 16.8699$1,181.16 $279.20 $236.24 3.1150 $218.10

. $43.6224.8895$1,742.66

. $348.54

16.8699$1,181.16 $279.20 $236.24 16.8699$1,181.16 $279.20 $236.24 3.1150 $218.10

. $43.62 7.4614 $522.42 $104.55 $104.49 3.1150 $218.10

. $43.62 7.4614 $522.42 $104.55 $104.49 7.4614 $522.42 $104.55 $104.49 7.4614 $522.42 $104.55 $104.49 24.8895$1,742.66

. $348.54 7.4614 $522.42 $104.55 $104.49 16.8699$1,181.16 $279.20 $236.24 4.3953 $307.74

. $61.55 16.8699$1,181.16 $279.20 $236.24 16.8699$1,181.16 $279.20 $236.24 16.8699$1,181.16 $279.20 $236.24 24.8895$1,742.66

. $348.54 7.4614 $522.42 $104.55 $104.49 16.8699$1,181.16 $279.20 $236.24 24.8895$1,742.66

. $348.54

1.0709 $74.98 $24.12 $15.00 3.1150 $218.10

. $43.62 7.4614 $522.42 $104.55 $104.49 24.8895$1,742.66

. $348.54 16.8699$1,181.16 $279.20 $236.24 7.4614 $522.42 $104.55 $104.49 7.4614 $522.42 $104.55 $104.49 24.8895$1,742.66

. $348.54 1.0709 $74.98 $24.12 $15.00 1.4209 $99.49

. $19.90 24.8895$1,742.66

. $348.54 16.8699$1,181.16 $279.20 $236.24 7.4614 $522.42 $104.55 $104.49 7.4614 $522.42 $104.55 $104.49 16.8699$1,181.16 $279.20 $236.24 24.8895$1,742.66

. $348.54 16.8699$1,181.16 $279.20 $236.24 24.8895$1,742.66

. $348.54 24.8895$1,742.66

. $348.54 16.8699$1,181.16 $279.20 $236.24 16.8699$1,181.16 $279.20 $236.24 16.8699$1,181.16 $279.20 $236.24 24.8895$1,742.66

. $348.54 16.8699$1,181.16 $279.20 $236.24 24.8895$1,742.66

. $348.54 1.0709 $74.98 $24.12 $15.00 3.1150 $218.10

. $43.62 7.4614 $522.42 $104.55 $104.4916.8699$1,181.16 $279.20 $236.24

16.8699$1,181.16 $279.20 $236.24 24.8895$1,742.66

. $348.54 45.0377$3,153.36

. $630.68 7.4614 $522.42 $104.55 $104.49 24.8895$1,742.66

. $348.54 16.8699$1,181.16 $279.20 $236.24 3.1150 $218.10

. $43.62 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 16.8699$1,181.16 $279.20 $236.24 24.8895$1,742.66

. $348.54 3.1150 $218.10

. $43.62 16.8699$1,181.16 $279.20 $236.24 1.0709 $74.98 $24.12 $15.00 16.8699$1,181.16 $279.20 $236.24 16.8699$1,181.16 $279.20 $236.24 3.1150 $218.10

. $43.62 3.1150 $218.10

. $43.62 16.8699$1,181.16 $279.20 $236.24 16.8699$1,181.16 $279.20 $236.24 16.8699$1,181.16 $279.20 $236.24 8.1596 $571.30

. $114.26 24.8895$1,742.66

. $348.54 16.8699$1,181.16 $279.20 $236.24 16.8699$1,181.16 $279.20 $236.24 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68

45.0377$3,153.36

. $630.68 24.8895$1,742.66

. $348.54 24.8895$1,742.66

. $348.54 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68

16.8699$1,181.16 $279.20 $236.24 7.4614 $522.42 $104.55 $104.49 3.1150 $218.10

. $43.62 24.8895$1,742.66

. $348.54 1.0709 $74.98 $24.12 $15.00 3.1150 $218.10

. $43.62 16.8699$1,181.16 $279.20 $236.24 45.0377$3,153.36

. $630.687.4614 $522.42 $104.55 $104.49

16.8699$1,181.16 $279.20 $236.24 16.8699$1,181.16 $279.20 $236.24 24.8895$1,742.66

. $348.54 24.8895$1,742.66

. $348.54 0.6499 $45.50

. $9.10 24.8895$1,742.66

. $348.54 45.0377$3,153.36

. $630.68 24.8895$1,742.66

. $348.54 24.8895$1,742.66

. $348.54 24.8895$1,742.66

. $348.54 24.8895$1,742.66

. $348.54 24.8895$1,742.66

. $348.54 24.8895$1,742.66

. $348.54 24.8895$1,742.66

. $348.54 24.8895$1,742.66

. $348.54 24.8895$1,742.66

. $348.54 45.0377$3,153.36

. $630.68

24.8895$1,742.66

. $348.54 24.8895$1,742.66

. $348.54 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68

7.4614 $522.42 $104.55 $104.49 24.8895$1,742.66

. $348.54

24.8895$1,742.66

. $348.54 1.0709 $74.98 $24.12 $15.00

45.0377$3,153.36

. $630.68 1.0709 $74.98 $24.12 $15.00

16.8699$1,181.16 $279.20 $236.24 1.0709 $74.98 $24.12 $15.00 7.4614 $522.42 $104.55 $104.49 16.8699$1,181.16 $279.20 $236.24

45.0377$3,153.36

. $630.68

8.4511 $591.71 $138.69 $118.35 12.6671 $886.90 $207.88 $177.388.4511 $591.71 $138.69 $118.35

8.4511 $591.71 $138.69 $118.35 12.6671 $886.90 $207.88 $177.38 12.6671 $886.90 $207.88 $177.38 25.9792 $1,818.96

. $363.80 12.6671 $886.90 $207.88 $177.38 29.2172 $2,045.67

. $409.14 12.6671 $886.90 $207.88 $177.38 12.6671 $886.90 $207.88 $177.38 12.6671 $886.90 $207.88 $177.38 25.9792 $1,818.96

. $363.80 12.6671 $886.90 $207.88 $177.38 12.6671 $886.90 $207.88 $177.38 8.4511 $591.71 $138.69 $118.35 8.4511 $591.71 $138.69 $118.35 8.4511 $591.71 $138.69 $118.35 12.6671 $886.90 $207.88 $177.38 12.6671 $886.90 $207.88 $177.38 8.4511 $591.71 $138.69 $118.35 12.6671 $886.90 $207.88 $177.38 8.4511 $591.71 $138.69 $118.35 12.6671 $886.90 $207.88 $177.38 8.4511 $591.71 $138.69 $118.35 12.6671 $886.90 $207.88 $177.38 12.6671 $886.90 $207.88 $177.38 12.6671 $886.90 $207.88 $177.38 8.4511 $591.71 $138.69 $118.35 8.4511 $591.71 $138.69 $118.35 12.6671 $886.90 $207.88 $177.38 12.6671 $886.90 $207.88 $177.38 12.6671 $886.90 $207.88 $177.38 12.6671 $886.90 $207.88 $177.38 29.2172 $2,045.67

. $409.14 25.9792 $1,818.96

. $363.80 12.6671 $886.90 $207.88 $177.38 12.6671 $886.90 $207.88 $177.38 24.6966 $1,729.16

. $345.84 24.6966 $1,729.16

. $345.84 24.6966 $1,729.16

. $345.84 24.6966 $1,729.16

. $345.84 24.6966 $1,729.16

. $345.84 24.6966 $1,729.16

. $345.84 24.6966 $1,729.16

. $345.84 29.2172 $2,045.67

. $409.14 29.2172 $2,045.67

. $409.14 24.6966 $1,729.16

. $345.84 24.6966 $1,729.16

. $345.84 24.6966 $1,729.16

. $345.84

71.5658$5,010.75 $1,236.99 $1,002.15 71.5658$5,010.75 $1,236.99 $1,002.15

38.9223$2,725.18 $659.53 $545.0424.8895$1,742.66

. $348.54

6.5866 $461.17

. $92.24 6.5866 $461.17

. $92.24 6.5866 $461.17

. $92.24 12.6671 $886.90 $207.88 $177.38

8.4511 $591.71 $138.69 $118.35

8.4511 $591.71 $138.69 $118.3588.6050 $6,203.77

. $1,240.76

38.9223$2,725.18 $659.53 $545.04 71.5658$5,010.75 $1,236.99 $1,002.15 71.5658$5,010.75 $1,236.99 $1,002.15 47.9394 $3,356.53 $1,001.89 $671.31 38.9223$2,725.18 $659.53 $545.04 1.2171 $85.22 $30.47 $17.05 0.6499 $45.50

. $9.10 0.6499 $45.50

. $9.10 0.9350 $65.46

. $13.10 1.2171 $85.22 $30.47 $17.05 1.2171 $85.22 $30.47 $17.05 2.3021 $161.18

. $32.24 8.4511 $591.71 $138.69 $118.35 47.9394 $3,356.53 $1,001.89 $671.31

25.9792 $1,818.96

. $363.80 8.4511 $591.71 $138.69 $118.35

25.9792 $1,818.96

. $363.80

21.4409$1,501.21

. $300.25 4.9271 $344.98

. $69.00 21.4409$1,501.21

. $300.25 8.4511 $591.71 $138.69 $118.3512.6671 $886.90 $207.88 $177.38

47.9394 $3,356.53 $1,001.89 $671.31 47.9394 $3,356.53 $1,001.89 $671.31

71.5658$5,010.75 $1,236.99 $1,002.15 71.5658$5,010.75 $1,236.99 $1,002.15 71.5658$5,010.75 $1,236.99 $1,002.15

38.9223$2,725.18 $659.53 $545.04

38.9223$2,725.18 $659.53 $545.04

21.4409$1,501.21

. $300.2521.4409$1,501.21

. $300.25

10.4394 $730.93 $152.78 $146.19 10.4394 $730.93 $152.78 $146.19 10.4394 $730.93 $152.78 $146.19 15.7819$1,104.99 $240.64 $221.00 15.7819$1,104.99 $240.64 $221.00 15.7819$1,104.99 $240.64 $221.00 15.7819$1,104.99 $240.64 $221.00 29.2172 $2,045.67

. $409.14 15.7819$1,104.99 $240.64 $221.00 15.7819$1,104.99 $240.64 $221.00 10.4394 $730.93 $152.78 $146.19 10.4394 $730.93 $152.78 $146.19 15.7819$1,104.99 $240.64 $221.00 29.2172 $2,045.67

. $409.14 10.4394 $730.93 $152.78 $146.19 10.4394 $730.93 $152.78 $146.19 29.2172 $2,045.67

. $409.14 9.3693 $656.00 $186.06 $131.20 9.3693 $656.00 $186.06 $131.20 9.3693 $656.00 $186.06 $131.20 9.3693 $656.00 $186.06 $131.20 9.3693 $656.00 $186.06 $131.20 9.3693 $656.00 $186.06 $131.20 9.3693 $656.00 $186.06 $131.20 9.3693 $656.00 $186.06 $131.20 9.3693 $656.00 $186.06 $131.20 29.2172 $2,045.67

. $409.14 6.2123 $434.96

. $87.00

27.2798$1,910.02

. $382.0115.3535$1,074.99 $227.40 $215.00

27.2798$1,910.02

. $382.01 27.2798$1,910.02

. $382.01

47.9394 $3,356.53 $1,001.89 $671.31 38.9223$2,725.18 $659.53 $545.04 24.4382 $1,711.07

. $342.22 24.4382 $1,711.07

. $342.22 15.4175$1,079.47

. $215.90 24.4382 $1,711.07

. $342.22 24.4382 $1,711.07

. $342.22

24.4382 $1,711.07

. $342.22 24.4382 $1,711.07

. $342.22 24.4382 $1,711.07

. $342.22 24.4382 $1,711.07

. $342.22 24.4382 $1,711.07

. $342.22 6.2205 $435.53

. $87.11 11.0417 $773.10

. $154.62 11.0417 $773.10

. $154.62 23.9777$1,678.82

. $335.77 11.0417 $773.10

. $154.62 11.0417 $773.10

. $154.62 11.0417 $773.10

. $154.62 11.0417 $773.10

. $154.62 23.9777$1,678.82

. $335.77 23.9777$1,678.82

. $335.77 29.2172 $2,045.67

. $409.14 6.2205 $435.53

. $87.11 6.2205 $435.53

. $87.11 6.2205 $435.53

. $87.11 6.2205 $435.53

. $87.11 11.0417 $773.10

. $154.62 6.2205 $435.53

. $87.11 6.2205 $435.53

. $87.11 6.2205 $435.53

. $87.11 11.0417 $773.10

. $154.62 11.0417 $773.10

. $154.62 6.2205 $435.53

. $87.11 11.0417 $773.10

. $154.6229.2172 $2,045.67

. $409.14

9.3693 $656.00 $186.06 $131.20 9.3693 $656.00 $186.06 $131.20 9.3693 $656.00 $186.06 $131.20 9.3693 $656.00 $186.06 $131.20 9.3693 $656.00 $186.06 $131.20 9.3693 $656.00 $186.06 $131.20 9.3693 $656.00 $186.06 $131.20 9.3693 $656.00 $186.06 $131.20 9.3693 $656.00 $186.06 $131.20 9.3693 $656.00 $186.06 $131.20 29.2172 $2,045.67

. $409.14 9.3693 $656.00 $186.06 $131.20 9.3693 $656.00 $186.06 $131.20

38.9223$2,725.18 $659.53 $545.04 24.4382 $1,711.07

. $342.22 32.9805$2,309.16

. $461.84 1.4966 $104.79

. $20.96

32.9805$2,309.16

. $461.84

32.9805$2,309.16

. $461.84

5.5158 $386.19

. $77.24 24.4382 $1,711.07

. $342.22 24.4382 $1,711.07

. $342.22 15.4175$1,079.47

. $215.90 24.4382 $1,711.07

. $342.22 5.5158 $386.19

. $77.24 24.4382 $1,711.07

. $342.22 5.5158 $386.19

. $77.24 24.4382 $1,711.07

. $342.22 24.4382 $1,711.07

. $342.22 5.5158 $386.19

. $77.24 24.4382 $1,711.07

. $342.22 15.4175$1,079.47

. $215.90 24.4382 $1,711.07

. $342.22 1.9499 $136.52

. $27.31 24.4382 $1,711.07

. $342.22 15.4175$1,079.47

. $215.90 5.5158 $386.19

. $77.24 24.4382 $1,711.07

. $342.22 24.4382 $1,711.07

. $342.22 24.4382 $1,711.07

. $342.22 24.4382 $1,711.07

. $342.22 24.4382 $1,711.07

. $342.2224.4382 $1,711.07

. $342.22

24.4382 $1,711.07

. $342.22 24.4382 $1,711.07

. $342.22 24.4382 $1,711.07

. $342.22 24.4382 $1,711.07

. $342.22 24.4382 $1,711.07

. $342.22 24.4382 $1,711.07

. $342.22 24.4382 $1,711.07

. $342.22 24.4382 $1,711.07

. $342.22 5.5158 $386.19

. $77.24 24.4382 $1,711.07

. $342.22 0.6499 $45.50

. $9.10 11.0417 $773.10

. $154.62 6.2205 $435.53

. $87.11 6.2205 $435.53

. $87.11 23.9777$1,678.82

. $335.77 11.0417 $773.10

. $154.62 23.9777$1,678.82

. $335.77 6.2205 $435.53

. $87.11 23.9777$1,678.82

. $335.77 24.4382 $1,711.07

. $342.22

32.9805$2,309.16

. $461.84 32.9805$2,309.16

. $461.84

32.9805$2,309.16

. $461.84

24.4382 $1,711.07

. $342.22 24.4382 $1,711.07

. $342.22 32.9805$2,309.16

. $461.84 32.9805$2,309.16

. $461.84 32.9805$2,309.16

. $461.84 2.7597 $193.22

. $38.65 21.6700 $1,517.25

. $303.45 1.4966 $104.79

. $20.96 21.6700 $1,517.25

. $303.45 21.6700 $1,517.25

. $303.45 21.6700 $1,517.25

. $303.45 5.5158 $386.19

. $77.24 24.4382 $1,711.07

. $342.22 5.5158 $386.19

. $77.24 24.4382 $1,711.07

. $342.22 24.4382 $1,711.07

. $342.22 32.9805$2,309.16

. $461.84 5.5158 $386.19

. $77.249.6713 $677.15

. $135.43

15.3535$1,074.99 $227.40 $215.00

111.6495$7,817.25 $2,055.58 $1,563.45 111.6495$7,817.25 $2,055.58 $1,563.45 38.9223$2,725.18 $659.53 $545.04

58.4890 $4,095.17

. $819.04 4.5721 $320.12

. $64.03

29.1415$2,040.37

. $408.08

29.1415$2,040.37

. $408.08 29.1415$2,040.37

. $408.08 16.2412 $1,137.14

. $227.43 16.2412 $1,137.14

. $227.43

29.1415$2,040.37

. $408.08 29.1415$2,040.37

. $408.08 29.1415$2,040.37

. $408.08 29.1415$2,040.37

. $408.08 58.4890 $4,095.17

. $819.04 38.9223$2,725.18 $659.53 $545.04 38.9223$2,725.18 $659.53 $545.04 47.9394 $3,356.53 $1,001.89 $671.31 47.9394 $3,356.53 $1,001.89 $671.3147.9394 $3,356.53 $1,001.89 $671.31

38.9223$2,725.18 $659.53 $545.04

29.1415$2,040.37

. $408.08

29.1415$2,040.37

. $408.08

9.6713 $677.15

. $135.43

15.3535$1,074.99 $227.40 $215.004.5721 $320.12

. $64.03

15.3535$1,074.99 $227.40 $215.00

15.3535$1,074.99 $227.40 $215.00

15.3535$1,074.99 $227.40 $215.00

5.5061 $385.52

. $77.11 5.5061 $385.52

. $77.11 5.5061 $385.52

. $77.11 9.6713 $677.15

. $135.43

27.2798$1,910.02

. $382.01

38.9223$2,725.18 $659.53 $545.04 38.9223$2,725.18 $659.53 $545.04 38.9223$2,725.18 $659.53 $545.04 38.9223$2,725.18 $659.53 $545.04 38.9223$2,725.18 $659.53 $545.04 38.9223$2,725.18 $659.53 $545.04 38.9223$2,725.18 $659.53 $545.04 38.9223$2,725.18 $659.53 $545.04 38.9223$2,725.18 $659.53 $545.04

27.2798$1,910.02

. $382.01 13.6332 $954.54 $325.27 $190.91

30.8430 $2,159.50

. $431.90 37.4593$2,622.75

. $524.55 30.8430 $2,159.50

. $431.90 21.7420 $1,522.29

. $304.46 16.2412 $1,137.14

. $227.43

27.2798$1,910.02

. $382.01

21.7420 $1,522.29

. $304.46 16.2412 $1,137.14

. $227.43 16.2412 $1,137.14

. $227.43 12.6671 $886.90 $207.88 $177.38 12.6671 $886.90 $207.88 $177.3824.4382 $1,711.07

. $342.22

12.6671 $886.90 $207.88 $177.38 6.2123 $434.96

. $87.00 6.2123 $434.96

. $87.00 6.2123 $434.96

. $87.00 6.2123 $434.96

. $87.00 2.0340 $142.41 $53.90 $28.49 32.9294 $2,305.58 $464.85 $461.12 32.9294 $2,305.58 $464.85 $461.12 32.9294 $2,305.58 $464.85 $461.12 32.9294 $2,305.58 $464.85 $461.12 32.9294 $2,305.58 $464.85 $461.12 32.9294 $2,305.58 $464.85 $461.12 32.9294 $2,305.58 $464.85 $461.12 32.9294 $2,305.58 $464.85 $461.12 32.9294 $2,305.58 $464.85 $461.12 32.9294 $2,305.58 $464.85 $461.12 32.9294 $2,305.58 $464.85 $461.12 32.9294 $2,305.58 $464.85 $461.12 32.9294 $2,305.58 $464.85 $461.12 32.9294 $2,305.58 $464.85 $461.12 32.9294 $2,305.58 $464.85 $461.12 32.9294 $2,305.58 $464.85 $461.12 32.9294 $2,305.58 $464.85 $461.12 32.9294 $2,305.58 $464.85 $461.12 32.9294 $2,305.58 $464.85 $461.12 32.9294 $2,305.58 $464.85 $461.12 32.9294 $2,305.58 $464.85 $461.12 32.9294 $2,305.58 $464.85 $461.12 32.9294 $2,305.58 $464.85 $461.12 32.9294 $2,305.58 $464.85 $461.12 32.9294 $2,305.58 $464.85 $461.12 32.9294 $2,305.58 $464.85 $461.12 32.9294 $2,305.58 $464.85 $461.12 32.9294 $2,305.58 $464.85 $461.12 32.9294 $2,305.58 $464.85 $461.12

47.9394 $3,356.53 $1,001.89 $671.31 47.9394 $3,356.53 $1,001.89 $671.31 71.5658$5,010.75 $1,236.99 $1,002.15 71.5658$5,010.75 $1,236.99 $1,002.15 71.5658$5,010.75 $1,236.99 $1,002.15 71.5658$5,010.75 $1,236.99 $1,002.15 71.5658$5,010.75 $1,236.99 $1,002.15 71.5658$5,010.75 $1,236.99 $1,002.15 38.9223$2,725.18 $659.53 $545.04

27.2798$1,910.02

. $382.0126.2973$1,841.23

. $368.25

15.3535$1,074.99 $227.40 $215.00

45.7676 $3,204.46

. $640.90 45.7676 $3,204.46

. $640.90

9.6713 $677.15

. $135.43

26.2973$1,841.23

. $368.25 17.4715$1,223.28

. $244.66 26.2973$1,841.23

. $368.25 6.7736 $474.26

. $94.86 16.2412 $1,137.14

. $227.43 6.7736 $474.26

. $94.86 9.6713 $677.15

. $135.43 1.1095 $77.68 $16.21 $15.54 17.4715$1,223.28

. $244.66 26.2973$1,841.23

. $368.25

26.2973$1,841.23

. $368.25 1.9499 $136.52

. $27.31 16.2412 $1,137.14

. $227.4338.9223$2,725.18 $659.53 $545.04

111.6495$7,817.25 $2,055.58 $1,563.45 47.9394 $3,356.53 $1,001.89 $671.31 47.9394 $3,356.53 $1,001.89 $671.31

38.9223$2,725.18 $659.53 $545.04 6.7736 $474.26

. $94.86 26.2973$1,841.23

. $368.25 6.7736 $474.26

. $94.86 26.2973$1,841.23

. $368.25 26.2973$1,841.23

. $368.25 6.7736 $474.26

. $94.86 6.7736 $474.26

. $94.86 6.7736 $474.26

. $94.86 6.7736 $474.26

. $94.86 37.0730 $2,595.70

. $519.14 17.4715$1,223.28

. $244.66 17.4715$1,223.28

. $244.66 52.0882 $3,647.01 $997.74 $729.41 58.4890 $4,095.17

. $819.04 58.4890 $4,095.17

. $819.04

1.1095 $77.68 $16.21 $15.54 16.2412 $1,137.14

. $227.43

20.4158$1,429.43

. $285.8947.9394 $3,356.53 $1,001.89 $671.31

47.9394 $3,356.53 $1,001.89 $671.31 47.9394 $3,356.53 $1,001.89 $671.31 38.9223$2,725.18 $659.53 $545.04 6.7736 $474.26

. $94.86 6.7736 $474.26

. $94.86 26.2973$1,841.23

. $368.25 26.2973$1,841.23

. $368.25 26.2973$1,841.23

. $368.25 6.7736 $474.26

. $94.86 6.7736 $474.26

. $94.86 17.4715$1,223.28

. $244.66 17.4715$1,223.28

. $244.66 26.2973$1,841.23

. $368.25 26.2973$1,841.23

. $368.25 26.2973$1,841.23

. $368.25 26.2973$1,841.23

. $368.25 6.7736 $474.26

. $94.86 26.2973$1,841.23

. $368.25 37.0730 $2,595.70

. $519.14 26.2973$1,841.23

. $368.25 20.5510 $1,438.90

. $287.78 1.9499 $136.52

. $27.31 1.1095 $77.68 $16.21 $15.54 20.4158$1,429.43

. $285.89 32.9294 $2,305.58 $464.85 $461.12 26.2973$1,841.23

. $368.25

26.2973$1,841.23

. $368.251.9499 $136.52

. $27.31

0.6499 $45.50

. $9.10 0.6499 $45.50

. $9.10 1.1095 $77.68 $16.21 $15.54 1.9499 $136.52

. $27.31 6.2123 $434.96

. $87.00 32.3061 $2,261.94

. $452.39 3.1886 $223.25

. $44.65 3.1886 $223.25

. $44.65 3.1886 $223.25

. $44.65 3.1886 $223.25

. $44.65 3.1886 $223.25

. $44.65 3.1886 $223.25

. $44.65 0.6499 $45.50

. $9.10 1.1095 $77.68 $16.21 $15.54 1.1095 $77.68 $16.21 $15.54 1.9499 $136.52

. $27.31 1.1095 $77.68 $16.21 $15.54 1.9499 $136.52

. $27.31 0.6499 $45.50

. $9.10

45.9895$3,220.00 $981.50 $644.00 26.2973$1,841.23

. $368.25

26.2973$1,841.23

. $368.25

47.9394 $3,356.53 $1,001.89 $671.31 47.9394 $3,356.53 $1,001.89 $671.31 38.9223$2,725.18 $659.53 $545.04 6.7736 $474.26

. $94.86 17.4715$1,223.28

. $244.66 26.2973$1,841.23

. $368.25 26.2973$1,841.23

. $368.25 6.7736 $474.26

. $94.86 26.2973$1,841.23

. $368.25 26.2973$1,841.23

. $368.25 26.2973$1,841.23

. $368.25 26.2973$1,841.23

. $368.25 26.2973$1,841.23

. $368.25 26.2973$1,841.23

. $368.25 26.2973$1,841.23

. $368.25 17.4715$1,223.28

. $244.66 6.7736 $474.26

. $94.86 17.4715$1,223.28

. $244.66 26.2973$1,841.23

. $368.25 26.2973$1,841.23

. $368.25 26.2973$1,841.23

. $368.2517.4715$1,223.28

. $244.66

37.0730 $2,595.70

. $519.14 26.2973$1,841.23

. $368.25 17.4715$1,223.28

. $244.66 26.2973$1,841.23

. $368.25 26.2973$1,841.23

. $368.25 26.2973$1,841.23

. $368.25 26.2973$1,841.23

. $368.25 17.4715$1,223.28

. $244.66 26.2973$1,841.23

. $368.25 26.2973$1,841.23

. $368.25 26.2973$1,841.23

. $368.25 26.2973$1,841.23

. $368.25 26.2973$1,841.23

. $368.25 37.0730 $2,595.70

. $519.14 26.2973$1,841.23

. $368.25 26.2973$1,841.23

. $368.25 26.2973$1,841.23

. $368.25 26.2973$1,841.23

. $368.25 26.2973$1,841.23

. $368.25 26.2973$1,841.23

. $368.25 26.2973$1,841.23

. $368.25 26.2973$1,841.23

. $368.25 26.2973$1,841.23

. $368.25 26.2973$1,841.23

. $368.25 26.2973$1,841.23

. $368.25 37.0730 $2,595.70

. $519.14 26.2973$1,841.23

. $368.25 26.2973$1,841.23

. $368.25 26.2973$1,841.23

. $368.25 26.2973$1,841.23

. $368.25 26.2973$1,841.23

. $368.25 26.2973$1,841.23

. $368.25 37.0730 $2,595.70

. $519.14 37.0730 $2,595.70

. $519.14 26.2973$1,841.23

. $368.25 45.7676 $3,204.46

. $640.90 45.7676 $3,204.46

. $640.90 45.7676 $3,204.46

. $640.90 26.2973$1,841.23

. $368.25 21.0031 $1,470.55

. $294.11 21.0031 $1,470.55

. $294.11 21.0031 $1,470.55

. $294.11 21.0031 $1,470.55

. $294.11 21.0031 $1,470.55

. $294.11 21.0031 $1,470.55

. $294.11 21.0031 $1,470.55

. $294.11 21.0031 $1,470.55

. $294.11 21.0031 $1,470.55

. $294.11 32.3061 $2,261.94

. $452.39 21.0031 $1,470.55

. $294.11 32.3061 $2,261.94

. $452.39 32.3061 $2,261.94

. $452.39 21.0031 $1,470.55

. $294.11 32.3061 $2,261.94

. $452.3921.0031 $1,470.55

. $294.11

21.0031 $1,470.55

. $294.11 21.0031 $1,470.55

. $294.11 21.0031 $1,470.55

. $294.11 21.0031 $1,470.55

. $294.11 32.3061 $2,261.94

. $452.39 32.3061 $2,261.94

. $452.39 32.3061 $2,261.94

. $452.39

32.3061 $2,261.94

. $452.39 32.3061 $2,261.94

. $452.39 32.3061 $2,261.94

. $452.39 32.3061 $2,261.94

. $452.39 104.8530 $7,341.39

. $1,468.28 32.3061 $2,261.94

. $452.39 104.8530 $7,341.39

. $1,468.28 169.3017$11,853.83

. $2,370.77 32.3061 $2,261.94

. $452.39 169.3017$11,853.83

. $2,370.77

32.3061 $2,261.94

. $452.39 32.3061 $2,261.94

. $452.39 21.0031 $1,470.55

. $294.11 32.3061 $2,261.94

. $452.39 21.0031 $1,470.55

. $294.11 32.3061 $2,261.94

. $452.39 21.0031 $1,470.55

. $294.11 32.3061 $2,261.94

. $452.39 32.3061 $2,261.94

. $452.39 3.1886 $223.25

. $44.65 1.1095 $77.68 $16.21 $15.54 17.4715$1,223.28

. $244.66 20.4158$1,429.43

. $285.89 1.9499 $136.52

. $27.31 1.1095 $77.68 $16.21 $15.54 1.1095 $77.68 $16.21 $15.54 21.0031 $1,470.55

. $294.11 45.7676 $3,204.46

. $640.90 45.7676 $3,204.46

. $640.90 1.9499 $136.52

. $27.31 20.4158$1,429.43

. $285.89 1.1095 $77.68 $16.21 $15.54 21.0031 $1,470.55

. $294.11 21.0031 $1,470.55

. $294.11 20.5510 $1,438.90

. $287.78 1.4966 $104.79

. $20.96 21.6700 $1,517.25

. $303.45 0.8768 $61.39

. $12.28 21.6700 $1,517.25

. $303.45 21.6700 $1,517.25

. $303.45 21.6700 $1,517.25

. $303.45 16.9957$1,189.97

. $238.00 23.2636 $1,628.82 $350.74 $325.77 34.6069$2,423.04 $607.60 $484.61 34.6069$2,423.04 $607.60 $484.6134.6069$2,423.04 $607.60 $484.61

20.5510 $1,438.90

. $287.78 34.6069$2,423.04 $607.60 $484.61

23.5454 $1,648.55

. $329.71 23.5454 $1,648.55

. $329.71 23.5454 $1,648.55

. $329.71 23.5454 $1,648.55

. $329.71 23.5454 $1,648.55

. $329.71 23.5454 $1,648.55

. $329.71 1.9499 $136.52

. $27.31 34.6069$2,423.04 $607.60 $484.61 1.9499 $136.52

. $27.31

20.4158$1,429.43

. $285.89 1.9499 $136.52

. $27.31 1.1095 $77.68 $16.21 $15.54 1.9499 $136.52

. $27.31 34.6069$2,423.04 $607.60 $484.61 34.6069$2,423.04 $607.60 $484.61 34.6069$2,423.04 $607.60 $484.61 34.6069$2,423.04 $607.60 $484.61 34.6069$2,423.04 $607.60 $484.61 34.6069$2,423.04 $607.60 $484.61 34.6069$2,423.04 $607.60 $484.61 34.6069$2,423.04 $607.60 $484.61 34.6069$2,423.04 $607.60 $484.61 34.6069$2,423.04 $607.60 $484.61 34.6069$2,423.04 $607.60 $484.61 34.6069$2,423.04 $607.60 $484.61 34.6069$2,423.04 $607.60 $484.61 34.6069$2,423.04 $607.60 $484.61 34.6069$2,423.04 $607.60 $484.61 34.6069$2,423.04 $607.60 $484.61 34.6069$2,423.04 $607.60 $484.61 34.6069$2,423.04 $607.60 $484.61 34.6069$2,423.04 $607.60 $484.61

104.8530 $7,341.39

. $1,468.28 169.3017$11,853.83

. $2,370.77 169.3017$11,853.83

. $2,370.77 34.6069$2,423.04 $607.60 $484.61 34.6069$2,423.04 $607.60 $484.61 169.3017$11,853.83

. $2,370.77

34.6069$2,423.04 $607.60 $484.61 169.3017$11,853.83

. $2,370.77

34.6069$2,423.04 $607.60 $484.61

34.6069$2,423.04 $607.60 $484.61 34.6069$2,423.04 $607.60 $484.61 3.1886 $223.25

. $44.6515.3535$1,074.99 $227.40 $215.00

23.5454 $1,648.55

. $329.71 23.5454 $1,648.55

. $329.71 23.5454 $1,648.55

. $329.71 23.5454 $1,648.55

. $329.71 32.9294 $2,305.58 $464.85 $461.12 34.6069$2,423.04 $607.60 $484.61 32.9294 $2,305.58 $464.85 $461.12 23.5454 $1,648.55

. $329.71 23.5454 $1,648.55

. $329.71 23.5454 $1,648.55

. $329.71 32.9294 $2,305.58 $464.85 $461.12 32.9294 $2,305.58 $464.85 $461.12 23.5454 $1,648.55

. $329.71 23.5454 $1,648.55

. $329.71 23.5454 $1,648.55

. $329.71 47.9394 $3,356.53 $1,001.89 $671.31 71.5658$5,010.75 $1,236.99 $1,002.15 38.9223$2,725.18 $659.53 $545.04 23.5454 $1,648.55

. $329.71 4.5721 $320.12

. $64.03 23.5454 $1,648.55

. $329.71 23.5454 $1,648.55

. $329.71 23.5454 $1,648.55

. $329.71 23.5454 $1,648.55

. $329.71 23.5454 $1,648.55

. $329.71 23.5454 $1,648.55

. $329.71 23.5454 $1,648.55

. $329.71 4.5721 $320.12

. $64.03 32.9294 $2,305.58 $464.85 $461.12 32.9294 $2,305.58 $464.85 $461.12 23.5454 $1,648.55

. $329.71 12.8082 $896.78

. $179.36 23.5454 $1,648.55

. $329.71 23.5454 $1,648.55

. $329.71 23.5454 $1,648.55

. $329.71 23.5454 $1,648.55

. $329.71 23.5454 $1,648.55

. $329.71 23.5454 $1,648.55

. $329.71 23.5454 $1,648.55

. $329.71

23.5454 $1,648.55

. $329.71 23.5454 $1,648.55

. $329.71 23.5454 $1,648.55

. $329.71 23.5454 $1,648.55

. $329.71 23.5454 $1,648.55

. $329.71 32.9294 $2,305.58 $464.85 $461.12 32.9294 $2,305.58 $464.85 $461.12 47.9394 $3,356.53 $1,001.89 $671.31 38.9223$2,725.18 $659.53 $545.04 23.5454 $1,648.55

. $329.71

23.5454 $1,648.55

. $329.71 13.7727 $964.31

. $192.8713.7727 $964.31

. $192.87

13.7727 $964.31

. $192.87 26.2973$1,841.23

. $368.25 26.2973$1,841.23

. $368.25

20.4158$1,429.43

. $285.89

3.4818 $243.78

. $48.76 113.8112 $7,968.60

. $1,593.72 37.0730 $2,595.70

. $519.14 13.6332 $954.54 $325.27 $190.91 1.1095 $77.68 $16.21 $15.54 27.2798$1,910.02

. $382.01

1.5841 $110.91

. $22.19 1.5841 $110.91

. $22.19 20.6493$1,445.78

. $289.16 20.6493$1,445.78

. $289.16 20.6493$1,445.78

. $289.16 21.6700 $1,517.25

. $303.45 21.6700 $1,517.25

. $303.45 3.4818 $243.78

. $48.76 1.5841 $110.91

. $22.19 20.6493$1,445.78

. $289.16 20.6493$1,445.78

. $289.16

20.6493$1,445.78

. $289.16 20.6493$1,445.78

. $289.16 20.6493$1,445.78

. $289.16 20.6493$1,445.78

. $289.16 20.6493$1,445.78

. $289.16 1.5841 $110.91

. $22.19 1.5841 $110.91

. $22.19 20.6493$1,445.78

. $289.16 20.6493$1,445.78

. $289.16 6.6979 $468.96

. $93.80 12.8082 $896.78

. $179.36 20.5510 $1,438.90

. $287.7820.6493$1,445.78

. $289.16

20.6493$1,445.78

. $289.16 6.6979 $468.96

. $93.80 20.6493$1,445.78

. $289.16 20.6493$1,445.78

. $289.16 35.9087$2,514.18

. $502.84 35.9087$2,514.18

. $502.84

35.9087$2,514.18

. $502.84 20.6493$1,445.78

. $289.16 20.6493$1,445.78

. $289.16 1.5841 $110.91

. $22.19 6.6979 $468.96

. $93.80 3.4818 $243.78

. $48.76 1.5841 $110.91

. $22.19 0.1337 $9.36 $1.95 $1.88 1.5841 $110.91

. $22.19 20.6493$1,445.78

. $289.16 20.6493$1,445.78

. $289.16 45.9895$3,220.00 $981.50 $644.00 35.9087$2,514.18

. $502.84 35.9087$2,514.18

. $502.84 35.9087$2,514.18

. $502.84 35.9087$2,514.18

. $502.84 45.9895$3,220.00 $981.50 $644.00 35.9087$2,514.18

. $502.84 35.9087$2,514.18

. $502.84

45.9895$3,220.00 $981.50 $644.00 45.9895$3,220.00 $981.50 $644.00 45.9895$3,220.00 $981.50 $644.00 45.9895$3,220.00 $981.50 $644.00 35.9087$2,514.18

. $502.84 45.9895$3,220.00 $981.50 $644.00 35.9087$2,514.18

. $502.84 35.9087$2,514.18

. $502.84 35.9087$2,514.18

. $502.84 20.6493$1,445.78

. $289.16

35.9087$2,514.18

. $502.84

45.9895$3,220.00 $981.50 $644.00

35.9087$2,514.18

. $502.84 35.9087$2,514.18

. $502.84 35.9087$2,514.18

. $502.84 20.6493$1,445.78

. $289.16 20.6493$1,445.78

. $289.16 20.6493$1,445.78

. $289.16 3.4818 $243.78

. $48.763.4818 $243.78

. $48.76

45.9895$3,220.00 $981.50 $644.00 47.9394 $3,356.53 $1,001.89 $671.31 20.6493$1,445.78

. $289.16 1.5841 $110.91

. $22.19 3.4818 $243.78

. $48.76 3.4818 $243.78

. $48.76 3.4818 $243.78

. $48.76 20.6493$1,445.78

. $289.16 20.6493$1,445.78

. $289.16 6.6979 $468.96

. $93.80 6.6979 $468.96

. $93.80 20.6493$1,445.78

. $289.16 1.5841 $110.91

. $22.19 20.6493$1,445.78

. $289.16 20.6493$1,445.78

. $289.16 20.6493$1,445.78

. $289.16 35.9087$2,514.18

. $502.84

35.9087$2,514.18

. $502.84 35.9087$2,514.18

. $502.84 45.9895$3,220.00 $981.50 $644.00 20.6493$1,445.78

. $289.16 20.6493$1,445.78

. $289.16 20.6493$1,445.78

. $289.16 20.6493$1,445.78

. $289.16 1.5841 $110.91

. $22.19

20.6493$1,445.78

. $289.16

35.9087$2,514.18

. $502.84

35.9087$2,514.18

. $502.84 35.9087$2,514.18

. $502.84 35.9087$2,514.18

. $502.84

35.9087$2,514.18

. $502.84

45.9895$3,220.00 $981.50 $644.00 45.9895$3,220.00 $981.50 $644.00 45.9895$3,220.00 $981.50 $644.00

45.9895$3,220.00 $981.50 $644.00

1.5841 $110.91

. $22.193.4818 $243.78

. $48.76

3.4818 $243.78

. $48.76 3.4818 $243.78

. $48.76

20.6493$1,445.78

. $289.16 20.6493$1,445.78

. $289.16 35.9087$2,514.18

. $502.84 35.9087$2,514.18

. $502.84 45.9895$3,220.00 $981.50 $644.00

71.5658$5,010.75 $1,236.99 $1,002.15 71.5658$5,010.75 $1,236.99 $1,002.15 71.5658$5,010.75 $1,236.99 $1,002.15 71.5658$5,010.75 $1,236.99 $1,002.15 38.9223$2,725.18 $659.53 $545.04 47.9394 $3,356.53 $1,001.89 $671.31

71.5658$5,010.75 $1,236.99 $1,002.15 47.9394 $3,356.53 $1,001.89 $671.31 47.9394 $3,356.53 $1,001.89 $671.31 47.9394 $3,356.53 $1,001.89 $671.31 23.0098$1,611.05 $424.28 $322.21 23.0098$1,611.05 $424.28 $322.21 23.0098$1,611.05 $424.28 $322.21 38.3457$2,684.81 $655.55 $536.97 38.3457$2,684.81 $655.55 $536.97 23.0098$1,611.05 $424.28 $322.21 38.3457$2,684.81 $655.55 $536.97 45.9895$3,220.00 $981.50 $644.00 47.9394 $3,356.53 $1,001.89 $671.31 47.9394 $3,356.53 $1,001.89 $671.31 47.9394 $3,356.53 $1,001.89 $671.31 47.9394 $3,356.53 $1,001.89 $671.31 38.9223$2,725.18 $659.53 $545.04 23.0098$1,611.05 $424.28 $322.21 35.9087$2,514.18

. $502.84

20.6493$1,445.78

. $289.16 47.9394 $3,356.53 $1,001.89 $671.31 47.9394 $3,356.53 $1,001.89 $671.31 47.9394 $3,356.53 $1,001.89 $671.31 47.9394 $3,356.53 $1,001.89 $671.31 47.9394 $3,356.53 $1,001.89 $671.31 47.9394 $3,356.53 $1,001.89 $671.31 47.9394 $3,356.53 $1,001.89 $671.31 38.9223$2,725.18 $659.53 $545.0435.9087$2,514.18

. $502.84

20.6493$1,445.78

. $289.16 35.9087$2,514.18

. $502.84 35.9087$2,514.18

. $502.84

20.6493$1,445.78

. $289.16

20.6493$1,445.78

. $289.16 35.9087$2,514.18

. $502.84 35.9087$2,514.18

. $502.84

3.4818 $243.78

. $48.76 3.4818 $243.78

. $48.76 3.4818 $243.78

. $48.76 0.1337 $9.36 $1.95 $1.88 3.4818 $243.78

. $48.76 6.6979 $468.96

. $93.80 3.4818 $243.78

. $48.76 3.4818 $243.78

. $48.76 1.5841 $110.91

. $22.19 1.5841 $110.91

. $22.19 3.4818 $243.78

. $48.76

1.5841 $110.91

. $22.19 3.4818 $243.78

. $48.76 3.4818 $243.78

. $48.76 3.4818 $243.78

. $48.76 35.9087$2,514.18

. $502.84

47.9394 $3,356.53 $1,001.89 $671.31 47.9394 $3,356.53 $1,001.89 $671.31 20.6493$1,445.78

. $289.16 1.5841 $110.91

. $22.19 20.6493$1,445.78

. $289.16 20.6493$1,445.78

. $289.1620.6493$1,445.78

. $289.16

20.6493$1,445.78

. $289.16 20.6493$1,445.78

. $289.16

20.6493$1,445.78

. $289.16

20.6493$1,445.78

. $289.16 20.6493$1,445.78

. $289.16 20.6493$1,445.78

. $289.16

20.6493$1,445.78

. $289.16 20.6493$1,445.78

. $289.16

3.4818 $243.78

. $48.76 20.6493$1,445.78

. $289.16 20.6493$1,445.78

. $289.16 0.1337 $9.36 $1.95 $1.88 38.9223$2,725.18 $659.53 $545.04 0.1337 $9.36 $1.95 $1.88 7.4614 $522.42 $104.55 $104.49 4.5721 $320.12

. $64.03 51.2792 $3,590.36

. $718.08 51.2792 $3,590.36

. $718.08 51.2792 $3,590.36

. $718.08 51.2792 $3,590.36

. $718.08 51.2792 $3,590.36

. $718.08 51.2792 $3,590.36

. $718.08 45.0377$3,153.36

. $630.68

45.0377$3,153.36

. $630.68

45.0377$3,153.36

. $630.68 51.2792 $3,590.36

. $718.08 51.2792 $3,590.36

. $718.08 4.5721 $320.12

. $64.03 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68

23.2636 $1,628.82 $350.74 $325.7745.0377$3,153.36

. $630.68

38.9223$2,725.18 $659.53 $545.04 51.2792 $3,590.36

. $718.08 7.4537 $521.88

. $104.38 7.4537 $521.88

. $104.38 7.4537 $521.88

. $104.38 7.4537 $521.88

. $104.38 7.4537 $521.88

. $104.38 7.4537 $521.88

. $104.38 6.2123 $434.96

. $87.00

41.5547$2,909.49

. $581.90

45.0377$3,153.36

. $630.68

45.0377$3,153.36

. $630.68105.0651 $7,356.24

. $1,471.25

105.0651 $7,356.24

. $1,471.25

36.1290 $2,529.61

. $505.93

36.1290 $2,529.61

. $505.93

18.8921 $1,322.75

. $264.55 12.7996 $896.18

. $179.2420.7198$1,450.72 $385.30 $290.15

216.9330$15,188.78

. $3,037.76 285.5893$19,995.82

. $3,999.17 31.1002 $2,177.51 $768.94 $435.51 24.8895$1,742.66

. $348.54

7.4537 $521.88

. $104.38

16.2412 $1,137.14

. $227.43 41.5547$2,909.49

. $581.90 2.3930 $167.55

. $33.51

12.7996 $896.18

. $179.24 12.7996 $896.18

. $179.24 4.5721 $320.12

. $64.03 7.4537 $521.88

. $104.389.6713 $677.15

. $135.43

3.8754 $271.34

. $54.27 3.8754 $271.34

. $54.27 7.4537 $521.88

. $104.38 7.4537 $521.88

. $104.38 12.7996 $896.18

. $179.24 12.7996 $896.18

. $179.24

36.1290 $2,529.61

. $505.93

7.4537 $521.88

. $104.38 7.4537 $521.88

. $104.38 7.4537 $521.88

. $104.38 7.4537 $521.88

. $104.38 7.4537 $521.88

. $104.38 12.7996 $896.18

. $179.24 41.5547$2,909.49

. $581.90 50.7343$3,552.21

. $710.45 12.7996 $896.18

. $179.24 41.5547$2,909.49

. $581.90 192.7379$13,494.74

. $2,698.95 192.7379$13,494.74

. $2,698.95 36.1290 $2,529.61

. $505.93 2.3930 $167.55

. $33.51 2.3930 $167.55

. $33.51 2.3930 $167.55

. $33.51 2.3930 $167.55

. $33.51 50.7343$3,552.21

. $710.45 50.7343$3,552.21

. $710.45 50.7343$3,552.21

. $710.45 50.7343$3,552.21

. $710.45 50.7343$3,552.21

. $710.45 50.7343$3,552.21

. $710.45 50.7343$3,552.21

. $710.45 50.7343$3,552.21

. $710.45 50.7343$3,552.21

. $710.45 50.7343$3,552.21

. $710.45 50.7343$3,552.21

. $710.45 50.7343$3,552.21

. $710.45 50.7343$3,552.21

. $710.45

50.7343$3,552.21

. $710.45 50.7343$3,552.21

. $710.45 50.7343$3,552.21

. $710.45 50.7343$3,552.21

. $710.45

50.7343$3,552.21

. $710.45 50.7343$3,552.21

. $710.45 50.7343$3,552.21

. $710.45 50.7343$3,552.21

. $710.45 50.7343$3,552.21

. $710.45 50.7343$3,552.21

. $710.4550.7343$3,552.21

. $710.4518.8921 $1,322.75

. $264.55

18.8921 $1,322.75

. $264.55 18.8921 $1,322.75

. $264.55

63.3729$4,437.12

. $887.43 88.6050 $6,203.77

. $1,240.76 20.7198$1,450.72 $385.30 $290.15 20.7198$1,450.72 $385.30 $290.15 63.3729$4,437.12

. $887.43 63.3729$4,437.12

. $887.43 216.9330$15,188.78

. $3,037.76 31.1002 $2,177.51 $768.94 $435.51

41.5547$2,909.49

. $581.90 41.5547$2,909.49

. $581.90 12.7996 $896.18

. $179.24 2.6055 $182.43

. $36.49 2.6055 $182.43

. $36.49 3.8754 $271.34

. $54.27 2.6055 $182.43

. $36.49 2.6055 $182.43

. $36.49 3.8754 $271.34

. $54.27 3.8754 $271.34

. $54.27 3.8754 $271.34

. $54.27 7.4537 $521.88

. $104.38 3.8754 $271.34

. $54.27 3.8754 $271.34

. $54.27 3.8754 $271.34

. $54.27 7.4537 $521.88

. $104.38 3.8754 $271.34

. $54.27 7.4537 $521.88

. $104.38 3.8754 $271.34

. $54.27 7.4537 $521.88

. $104.38 7.4537 $521.88

. $104.38 3.8754 $271.34

. $54.27 7.4537 $521.88

. $104.38 7.4537 $521.88

. $104.38 3.8754 $271.34

. $54.27 2.6055 $182.43

. $36.49 7.4537 $521.88

. $104.383.8754 $271.34

. $54.27

7.4537 $521.88

. $104.38 3.8754 $271.34

. $54.27 7.4537 $521.88

. $104.38 2.6055 $182.43

. $36.49 2.6055 $182.43

. $36.49 7.4537 $521.88

. $104.38 2.6055 $182.43

. $36.49 2.6055 $182.43

. $36.49 2.6055 $182.43

. $36.49 2.6055 $182.43

. $36.49 7.4537 $521.88

. $104.38 7.4537 $521.88

. $104.38 7.4537 $521.88

. $104.38 7.4537 $521.88

. $104.38

63.3729$4,437.12

. $887.43 63.3729$4,437.12

. $887.43

63.3729$4,437.12

. $887.43 63.3729$4,437.12

. $887.43 2.6055 $182.43

. $36.49 346.4693$24,258.39 $9,121.76 $4,851.68 20.7198$1,450.72 $385.30 $290.15 36.1290 $2,529.61

. $505.93 88.6050 $6,203.77

. $1,240.76

88.6050 $6,203.77

. $1,240.76 88.6050 $6,203.77

. $1,240.76 20.7198$1,450.72 $385.30 $290.15 216.9330$15,188.78

. $3,037.76 31.1002 $2,177.51 $768.94 $435.51 12.7996 $896.18

. $179.24 18.8921 $1,322.75

. $264.55 18.8921 $1,322.75

. $264.55 2.6055 $182.43

. $36.49 2.6055 $182.43

. $36.49 3.8754 $271.34

. $54.27 3.8754 $271.34

. $54.27 12.7996 $896.18

. $179.24

7.4537 $521.88

. $104.38 2.6055 $182.43

. $36.49 7.4537 $521.88

. $104.38 2.6055 $182.43

. $36.49 12.7996 $896.18

. $179.24 7.4537 $521.88

. $104.38 7.4537 $521.88

. $104.38 2.6055 $182.43

. $36.49 2.6055 $182.43

. $36.49 12.7996 $896.18

. $179.24 12.7996 $896.18

. $179.2418.8921 $1,322.75

. $264.55

18.8921 $1,322.75

. $264.55 18.8921 $1,322.75

. $264.55 18.8921 $1,322.75

. $264.55 18.8921 $1,322.75

. $264.55 18.8921 $1,322.75

. $264.55 18.8921 $1,322.75

. $264.55 18.8921 $1,322.75

. $264.55 18.8921 $1,322.75

. $264.55 18.8921 $1,322.75

. $264.55 18.8921 $1,322.75

. $264.55 18.8921 $1,322.75

. $264.55 18.8921 $1,322.75

. $264.55 18.8921 $1,322.75

. $264.55 18.8921 $1,322.75

. $264.55 18.8921 $1,322.75

. $264.55 18.8921 $1,322.75

. $264.55 18.8921 $1,322.75

. $264.55 18.8921 $1,322.75

. $264.55 18.8921 $1,322.75

. $264.55 18.8921 $1,322.75

. $264.55

18.8921 $1,322.75

. $264.55 18.8921 $1,322.75

. $264.55 36.1290 $2,529.61

. $505.93 18.8921 $1,322.75

. $264.55 18.8921 $1,322.75

. $264.55 18.8921 $1,322.75

. $264.55 18.8921 $1,322.75

. $264.55 18.8921 $1,322.75

. $264.55 18.8921 $1,322.75

. $264.55 18.8921 $1,322.75

. $264.55 18.8921 $1,322.75

. $264.55 36.1290 $2,529.61

. $505.93 18.8921 $1,322.75

. $264.55 18.8921 $1,322.75

. $264.55 18.8921 $1,322.75

. $264.55 36.1290 $2,529.61

. $505.93 18.8921 $1,322.75

. $264.55 18.8921 $1,322.75

. $264.55 18.8921 $1,322.75

. $264.55

18.8921 $1,322.75

. $264.55 28.8625$2,020.84

. $404.17 28.8625$2,020.84

. $404.17 28.8625$2,020.84

. $404.17 36.1290 $2,529.61

. $505.93 36.1290 $2,529.61

. $505.93 36.1290 $2,529.61

. $505.93 36.1290 $2,529.61

. $505.93 36.1290 $2,529.61

. $505.93 36.1290 $2,529.61

. $505.9336.1290 $2,529.61

. $505.93

36.1290 $2,529.61

. $505.93 36.1290 $2,529.61

. $505.93 36.1290 $2,529.61

. $505.93 36.1290 $2,529.61

. $505.93 36.1290 $2,529.61

. $505.93 36.1290 $2,529.61

. $505.93 36.1290 $2,529.61

. $505.93 36.1290 $2,529.61

. $505.93

36.1290 $2,529.61

. $505.93 36.1290 $2,529.61

. $505.93 36.1290 $2,529.61

. $505.93 36.1290 $2,529.61

. $505.93 36.1290 $2,529.61

. $505.93 36.1290 $2,529.61

. $505.93 36.1290 $2,529.61

. $505.93 36.1290 $2,529.61

. $505.93 36.1290 $2,529.61

. $505.93 36.1290 $2,529.61

. $505.93 36.1290 $2,529.61

. $505.93 36.1290 $2,529.61

. $505.93 36.1290 $2,529.61

. $505.93 36.1290 $2,529.61

. $505.93 36.1290 $2,529.61

. $505.93 36.1290 $2,529.61

. $505.93 36.1290 $2,529.61

. $505.93 36.1290 $2,529.61

. $505.93 36.1290 $2,529.61

. $505.93 36.1290 $2,529.61

. $505.93 2.6055 $182.43

. $36.49 40.4039$2,828.92 $597.36 $565.79 40.4039$2,828.92 $597.36 $565.79 40.4039$2,828.92 $597.36 $565.79 40.4039$2,828.92 $597.36 $565.79 40.4039$2,828.92 $597.36 $565.79 40.4039$2,828.92 $597.36 $565.79 40.4039$2,828.92 $597.36 $565.79 40.4039$2,828.92 $597.36 $565.79 27.3416 $1,914.35 $383.45 $382.87 27.3416 $1,914.35 $383.45 $382.87 27.3416 $1,914.35 $383.45 $382.87 40.4039$2,828.92 $597.36 $565.79 27.3416 $1,914.35 $383.45 $382.87 40.4039$2,828.92 $597.36 $565.79 19.7786 $1,384.82 $296.20 $276.97 1.0589 $74.14

. $14.83 1.0589 $74.14

. $14.83 1.0589 $74.14

. $14.83 1.0589 $74.14

. $14.83 16.6214 $1,163.76

. $232.76 4.8135 $337.02

. $67.41 21.5368$1,507.92

. $301.59 19.7786 $1,384.82 $296.20 $276.9723.2851 $1,630.33 $347.90 $326.07

23.2851 $1,630.33 $347.90 $326.07 21.5368$1,507.92

. $301.59 41.0159$2,871.77

. $574.36 7.2190 $505.45 $101.81 $101.09 24.8671 $1,741.09 $411.91 $348.22 16.6214 $1,163.76

. $232.76 16.6214 $1,163.76

. $232.76 16.6214 $1,163.76

. $232.76 23.2851 $1,630.33 $347.90 $326.07 1.0589 $74.14

. $14.83 7.6566 $536.08

. $107.22 16.6214 $1,163.76

. $232.76 2.0294 $142.09

. $28.42 19.7786 $1,384.82 $296.20 $276.97 37.8979$2,653.46 $794.94 $530.70 37.8979$2,653.46 $794.94 $530.70 37.8979$2,653.46 $794.94 $530.70 37.8979$2,653.46 $794.94 $530.70 37.8979$2,653.46 $794.94 $530.70

117.1298$8,200.96

. $1,640.20

16.6214 $1,163.76

. $232.76 16.6214 $1,163.76

. $232.76 16.6214 $1,163.76

. $232.76 16.6214 $1,163.76

. $232.76 37.8979$2,653.46 $794.94 $530.70 37.8979$2,653.46 $794.94 $530.70 37.8979$2,653.46 $794.94 $530.70 7.2190 $505.45 $101.81 $101.09 23.2851 $1,630.33 $347.90 $326.07 23.2851 $1,630.33 $347.90 $326.07 23.2851 $1,630.33 $347.90 $326.07 23.2851 $1,630.33 $347.90 $326.07 23.2851 $1,630.33 $347.90 $326.07 5.4120 $378.93 $102.28 $75.79 5.4120 $378.93 $102.28 $75.79 16.6214 $1,163.76

. $232.76 23.2851 $1,630.33 $347.90 $326.07 23.2851 $1,630.33 $347.90 $326.07 16.6214 $1,163.76

. $232.76 2.8247 $197.77 $42.27 $39.56 23.2851 $1,630.33 $347.90 $326.07 23.2851 $1,630.33 $347.90 $326.07 16.6214 $1,163.76

. $232.76 16.6214 $1,163.76

. $232.76 23.2851 $1,630.33 $347.90 $326.07 23.2851 $1,630.33 $347.90 $326.07 23.2851 $1,630.33 $347.90 $326.07 23.2851 $1,630.33 $347.90 $326.0723.2851 $1,630.33 $347.90 $326.07

23.2851 $1,630.33 $347.90 $326.07 23.2851 $1,630.33 $347.90 $326.07 41.5778$2,911.11 $634.95 $582.23 41.5778$2,911.11 $634.95 $582.23 41.5778$2,911.11 $634.95 $582.23 23.2851 $1,630.33 $347.90 $326.07 41.0159$2,871.77

. $574.36 41.5778$2,911.11 $634.95 $582.23 16.6214 $1,163.76

. $232.76 2.8247 $197.77 $42.27 $39.56 7.2190 $505.45 $101.81 $101.09 23.2851 $1,630.33 $347.90 $326.07 23.2851 $1,630.33 $347.90 $326.07 7.2190 $505.45 $101.81 $101.09 23.2851 $1,630.33 $347.90 $326.07 23.2851 $1,630.33 $347.90 $326.07 23.2851 $1,630.33 $347.90 $326.07 23.2851 $1,630.33 $347.90 $326.07 16.6214 $1,163.76

. $232.76 16.6214 $1,163.76

. $232.76 23.2851 $1,630.33 $347.90 $326.07 16.6214 $1,163.76

. $232.76 23.2851 $1,630.33 $347.90 $326.07 5.4120 $378.93 $102.28 $75.79 5.4120 $378.93 $102.28 $75.79 5.4120 $378.93 $102.28 $75.79 7.2190 $505.45 $101.81 $101.09 5.4120 $378.93 $102.28 $75.79 23.2851 $1,630.33 $347.90 $326.07 7.2190 $505.45 $101.81 $101.09 16.6214 $1,163.76

. $232.76 30.9855$2,169.48 $516.99 $433.90 30.9855$2,169.48 $516.99 $433.90 30.9855$2,169.48 $516.99 $433.90 30.9855$2,169.48 $516.99 $433.90 7.2190 $505.45 $101.81 $101.09 23.8810 $1,672.05 $490.37 $334.41 23.8810 $1,672.05 $490.37 $334.41 23.8810 $1,672.05 $490.37 $334.41 23.8810 $1,672.05 $490.37 $334.41 23.8810 $1,672.05 $490.37 $334.41

2.8247 $197.77 $42.27 $39.56 21.5368$1,507.92

. $301.59 41.0159$2,871.77

. $574.36 41.0159$2,871.77

. $574.36 41.0159$2,871.77

. $574.36 41.0159$2,871.77

. $574.36 3.1036 $217.30

. $43.46 21.5368$1,507.92

. $301.59 5.4120 $378.93 $102.28 $75.79 41.0159$2,871.77

. $574.36 41.0159$2,871.77

. $574.36 41.0159$2,871.77

. $574.3641.0159$2,871.77

. $574.36

41.0159$2,871.77

. $574.36 41.0159$2,871.77

. $574.36 21.5368$1,507.92

. $301.59 5.4120 $378.93 $102.28 $75.79 41.0159$2,871.77

. $574.36 41.0159$2,871.77

. $574.36 21.5368$1,507.92

. $301.59 41.0159$2,871.77

. $574.36 41.0159$2,871.77

. $574.36 21.5368$1,507.92

. $301.59 21.5368$1,507.92

. $301.59 41.0159$2,871.77

. $574.36 4.8135 $337.02

. $67.41 5.4120 $378.93 $102.28 $75.79 4.8135 $337.02

. $67.41 5.4120 $378.93 $102.28 $75.79 21.5368$1,507.92

. $301.59 4.8135 $337.02

. $67.41 4.8135 $337.02

. $67.41 4.8135 $337.02

. $67.41 21.5368$1,507.92

. $301.59 5.4120 $378.93 $102.28 $75.79 5.4120 $378.93 $102.28 $75.79 19.7786 $1,384.82 $296.20 $276.97 21.5368$1,507.92

. $301.59 4.8135 $337.02

. $67.41 24.8671 $1,741.09 $411.91 $348.22 24.8671 $1,741.09 $411.91 $348.22 24.8671 $1,741.09 $411.91 $348.22 24.8671 $1,741.09 $411.91 $348.22 24.8671 $1,741.09 $411.91 $348.22 24.8671 $1,741.09 $411.91 $348.22 24.8671 $1,741.09 $411.91 $348.22 24.8671 $1,741.09 $411.91 $348.22 24.8671 $1,741.09 $411.91 $348.22 24.8671 $1,741.09 $411.91 $348.22 24.8671 $1,741.09 $411.91 $348.22 24.8671 $1,741.09 $411.91 $348.22 3.1036 $217.30

. $43.46 15.4248$1,079.98

. $216.00 24.8671 $1,741.09 $411.91 $348.22 19.7786 $1,384.82 $296.20 $276.97 27.3416 $1,914.35 $383.45 $382.87 19.7786 $1,384.82 $296.20 $276.97 27.3416 $1,914.35 $383.45 $382.87 40.4039$2,828.92 $597.36 $565.79 19.7786 $1,384.82 $296.20 $276.97 40.4039$2,828.92 $597.36 $565.79 40.4039$2,828.92 $597.36 $565.79 40.4039$2,828.92 $597.36 $565.79 40.4039$2,828.92 $597.36 $565.79 40.4039$2,828.92 $597.36 $565.79 2.0294 $142.09

. $28.42 3.1036 $217.30

. $43.463.1036 $217.30

. $43.46

40.4039$2,828.92 $597.36 $565.79 27.3416 $1,914.35 $383.45 $382.87 40.4039$2,828.92 $597.36 $565.79 3.1036 $217.30

. $43.46 3.1036 $217.30

. $43.46 7.6566 $536.08

. $107.22 19.7786 $1,384.82 $296.20 $276.97 3.1036 $217.30

. $43.46 7.6566 $536.08

. $107.22 3.1036 $217.30

. $43.46 19.7786 $1,384.82 $296.20 $276.97 3.1036 $217.30

. $43.46 1.0589 $74.14

. $14.83 3.1036 $217.30

. $43.46 7.6566 $536.08

. $107.22 19.7786 $1,384.82 $296.20 $276.97 7.6566 $536.08

. $107.22 7.6566 $536.08

. $107.22 7.6566 $536.08

. $107.22 16.6214 $1,163.76

. $232.76 19.7786 $1,384.82 $296.20 $276.97 27.3416 $1,914.35 $383.45 $382.87 19.7786 $1,384.82 $296.20 $276.97 27.3416 $1,914.35 $383.45 $382.87 19.7786 $1,384.82 $296.20 $276.97 19.7786 $1,384.82 $296.20 $276.97 19.7786 $1,384.82 $296.20 $276.97 19.7786 $1,384.82 $296.20 $276.97 19.7786 $1,384.82 $296.20 $276.97 19.7786 $1,384.82 $296.20 $276.97 19.7786 $1,384.82 $296.20 $276.97 19.7786 $1,384.82 $296.20 $276.97 19.7786 $1,384.82 $296.20 $276.97 19.7786 $1,384.82 $296.20 $276.97 19.7786 $1,384.82 $296.20 $276.97 19.7786 $1,384.82 $296.20 $276.97 19.7786 $1,384.82 $296.20 $276.97 19.7786 $1,384.82 $296.20 $276.97 19.7786 $1,384.82 $296.20 $276.97 19.7786 $1,384.82 $296.20 $276.97 19.7786 $1,384.82 $296.20 $276.97 2.0294 $142.09

. $28.42 19.7786 $1,384.82 $296.20 $276.97 19.7786 $1,384.82 $296.20 $276.97 19.7786 $1,384.82 $296.20 $276.97 19.7786 $1,384.82 $296.20 $276.97 27.3416 $1,914.35 $383.45 $382.87 19.7786 $1,384.82 $296.20 $276.97 19.7786 $1,384.82 $296.20 $276.97 3.1036 $217.30

. $43.46 3.1036 $217.30

. $43.46 1.0589 $74.14

. $14.83 7.6566 $536.08

. $107.22 15.4248$1,079.98

. $216.0019.7786 $1,384.82 $296.20 $276.97

16.6214 $1,163.76

. $232.76 7.6566 $536.08

. $107.22 0.6424 $44.98

. $9.00 27.3416 $1,914.35 $383.45 $382.87 27.3416 $1,914.35 $383.45 $382.87 19.7786 $1,384.82 $296.20 $276.97 27.3416 $1,914.35 $383.45 $382.87 23.2851 $1,630.33 $347.90 $326.07 27.3416 $1,914.35 $383.45 $382.87 19.7786 $1,384.82 $296.20 $276.97 23.2851 $1,630.33 $347.90 $326.07 23.2851 $1,630.33 $347.90 $326.07 23.2851 $1,630.33 $347.90 $326.07 3.1036 $217.30

. $43.46 3.1036 $217.30

. $43.46 19.7786 $1,384.82 $296.20 $276.97 3.1036 $217.30

. $43.46 27.3416 $1,914.35 $383.45 $382.87 27.3416 $1,914.35 $383.45 $382.87 19.7786 $1,384.82 $296.20 $276.97 27.3416 $1,914.35 $383.45 $382.87 19.7786 $1,384.82 $296.20 $276.97 3.1036 $217.30

. $43.46 19.7786 $1,384.82 $296.20 $276.97 27.3416 $1,914.35 $383.45 $382.87 19.7786 $1,384.82 $296.20 $276.97 3.1036 $217.30

. $43.46 27.3416 $1,914.35 $383.45 $382.87 27.3416 $1,914.35 $383.45 $382.87 27.3416 $1,914.35 $383.45 $382.87 3.1036 $217.30

. $43.46 3.1036 $217.30

. $43.46 27.3416 $1,914.35 $383.45 $382.87 1.0589 $74.14

. $14.83 3.1036 $217.30

. $43.46 19.7786 $1,384.82 $296.20 $276.97 19.7786 $1,384.82 $296.20 $276.97 19.7786 $1,384.82 $296.20 $276.97 2.0294 $142.09

. $28.42

3.1036 $217.30

. $43.46 1.4209 $99.49

. $19.90 20.5510 $1,438.90

. $287.78 1.4209 $99.49

. $19.90

3.1150 $218.10

. $43.62 16.8699$1,181.16 $279.20 $236.24 16.9957$1,189.97

. $238.00 24.8895$1,742.66

. $348.54 24.8895$1,742.66

. $348.54 16.9957$1,189.97

. $238.00 7.4614 $522.42 $104.55 $104.49

0.6499 $45.50

. $9.1023.2636 $1,628.82 $350.74 $325.77

0.6499 $45.50

. $9.10 0.8768 $61.39

. $12.28 16.8699$1,181.16 $279.20 $236.24 24.8895$1,742.66

. $348.54 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 1.0709 $74.98 $24.12 $15.00 3.1150 $218.10

. $43.62 3.1150 $218.10

. $43.62 7.4614 $522.42 $104.55 $104.49 3.1150 $218.10

. $43.62 16.8699$1,181.16 $279.20 $236.24 16.8699$1,181.16 $279.20 $236.24 7.4614 $522.42 $104.55 $104.49 16.8699$1,181.16 $279.20 $236.24 24.8895$1,742.66

. $348.54 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 24.8895$1,742.66

. $348.54 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68

16.8699$1,181.16 $279.20 $236.24 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68

45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 24.8895$1,742.66

. $348.54 24.8895$1,742.66

. $348.54 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 24.8895$1,742.66

. $348.54 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.6845.0377$3,153.36

. $630.68

45.0377$3,153.36

. $630.68 132.5319$9,279.35

. $1,855.87 132.5319$9,279.35

. $1,855.87 132.5319$9,279.35

. $1,855.87 132.5319$9,279.35

. $1,855.87 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 1.0709 $74.98 $24.12 $15.00 16.8699$1,181.16 $279.20 $236.24

45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 412.7299$28,897.70 $7,948.75 $5,779.54 1.0709 $74.98 $24.12 $15.00

45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 45.0377$3,153.36

. $630.68 1.0709 $74.98 $24.12 $15.00

7.0678 $494.86

. $98.98 7.0678 $494.86

. $98.98 0.6409 $44.87

. $8.98 0.6409 $44.87

. $8.98 0.6409 $44.87

. $8.98 0.6409 $44.87

. $8.98 0.6409 $44.87

. $8.98 1.0790 $75.55

. $15.11 0.6409 $44.87

. $8.98 0.6409 $44.87

. $8.98 0.6409 $44.87

. $8.98 3.3643 $235.55

. $47.11 0.6409 $44.87

. $8.98 0.6409 $44.87

. $8.98 0.6409 $44.87

. $8.98 0.6409 $44.87

. $8.98 0.6409 $44.87

. $8.98 0.6409 $44.87

. $8.98 1.0790 $75.55

. $15.11 0.4640 $32.49

. $6.50 0.4640 $32.49

. $6.50 0.4640 $32.49

. $6.50 0.6409 $44.87

. $8.98 0.6409 $44.87

. $8.98 4.0104 $280.79 $68.90 $56.16 4.8381 $338.74 $133.48 $67.750.6409 $44.87

. $8.98

0.4640 $32.49

. $6.50 0.6409 $44.87

. $8.98 1.2171 $85.22 $30.47 $17.05 1.2171 $85.22 $30.47 $17.05 3.3643 $235.55

. $47.11 0.6409 $44.87

. $8.98 3.3643 $235.55

. $47.11 2.7436 $192.10 $74.27 $38.42 4.2929 $300.57 $96.62 $60.12 4.7767 $334.45 $116.13 $66.89 2.7436 $192.10 $74.27 $38.42 4.2929 $300.57 $96.62 $60.12 4.7767 $334.45 $116.13 $66.89 2.7436 $192.10 $74.27 $38.42 4.2929 $300.57 $96.62 $60.12 4.7767 $334.45 $116.13 $66.89 2.7436 $192.10 $74.27 $38.42 4.2929 $300.57 $96.62 $60.12 4.7767 $334.45 $116.13 $66.89 4.8375 $338.70 $114.37 $67.74 4.8375 $338.70 $114.37 $67.74 4.8381 $338.74 $133.48 $67.75 6.2343 $436.50 $146.69 $87.30 7.6347 $534.55 $197.64 $106.91 4.8381 $338.74 $133.48 $67.75 6.2343 $436.50 $146.69 $87.30 7.6347 $534.55 $197.64 $106.91 4.8381 $338.74 $133.48 $67.75 6.2343 $436.50 $146.69 $87.30 7.6347 $534.55 $197.64 $106.91 4.8381 $338.74 $133.48 $67.75 6.2343 $436.50 $146.69 $87.30 7.6347 $534.55 $197.64 $106.91 4.8381 $338.74 $133.48 $67.75 4.8381 $338.74 $133.48 $67.75 4.8381 $338.74 $133.48 $67.75 6.2343 $436.50 $146.69 $87.30 7.6347 $534.55 $197.64 $106.91 0.6409 $44.87

. $8.98 0.6409 $44.87

. $8.98 0.6409 $44.87

. $8.98 0.6409 $44.87

. $8.98 0.6409 $44.87

. $8.98 1.2171 $85.22 $30.47 $17.05 0.6409 $44.87

. $8.98 1.2171 $85.22 $30.47 $17.05 0.6409 $44.87

. $8.98 3.3643 $235.55

. $47.11 3.3643 $235.55

. $47.11

0.6409 $44.87

. $8.98 0.6409 $44.87

. $8.98 0.6409 $44.87

. $8.98 1.0790 $75.55

. $15.110.6409 $44.87

. $8.98

0.6409 $44.87

. $8.98 2.7436 $192.10 $74.27 $38.42 4.2929 $300.57 $96.62 $60.12 4.7767 $334.45 $116.13 $66.89 4.8375 $338.70 $114.37 $67.74 4.8381 $338.74 $133.48 $67.75 6.2343 $436.50 $146.69 $87.30 7.6347 $534.55 $197.64 $106.91

1.0790 $75.55

. $15.11 0.6409 $44.87

. $8.98 0.6409 $44.87

. $8.98 1.0790 $75.55

. $15.11 1.0790 $75.55

. $15.11 0.6409 $44.87

. $8.98 0.6409 $44.87

. $8.98 0.6409 $44.87

. $8.98 0.6409 $44.87

. $8.98 0.6409 $44.87

. $8.98 1.0790 $75.55

. $15.11 0.6409 $44.87

. $8.98 1.0790 $75.55

. $15.11 1.0790 $75.55

. $15.11 0.6409 $44.87

. $8.98 2.7436 $192.10 $74.27 $38.42 4.2929 $300.57 $96.62 $60.12 4.7767 $334.45 $116.13 $66.89 2.7436 $192.10 $74.27 $38.42 4.2929 $300.57 $96.62 $60.12 4.7767 $334.45 $116.13 $66.89 2.7436 $192.10 $74.27 $38.42 4.2929 $300.57 $96.62 $60.12 4.7767 $334.45 $116.13 $66.89 4.8381 $338.74 $133.48 $67.75 6.2343 $436.50 $146.69 $87.30 4.8381 $338.74 $133.48 $67.75 6.2343 $436.50 $146.69 $87.30 4.8381 $338.74 $133.48 $67.75 6.2343 $436.50 $146.69 $87.30 7.6347 $534.55 $197.64 $106.91 7.6347 $534.55 $197.64 $106.91 7.6347 $534.55 $197.64 $106.91

0.6409 $44.87

. $8.98 0.6409 $44.87

. $8.98 4.8375 $338.70 $114.37 $67.74 2.7436 $192.10 $74.27 $38.42 4.2929 $300.57 $96.62 $60.12 4.7767 $334.45 $116.13 $66.89 4.8381 $338.74 $133.48 $67.75 6.2343 $436.50 $146.69 $87.30 7.6347 $534.55 $197.64 $106.91

0.6409 $44.87

. $8.980.6409 $44.87

. $8.98

0.6409 $44.87

. $8.98 7.0678 $494.86

. $98.98 7.0678 $494.86

. $98.98 7.0678 $494.86

. $98.98 7.0678 $494.86

. $98.98

22.7689$1,594.19

. $318.84

22.7689$1,594.19

. $318.84 0.6409 $44.87

. $8.98 0.6409 $44.87

. $8.98 0.6409 $44.87

. $8.98 0.6409 $44.87

. $8.98 4.0104 $280.79 $68.90 $56.16 0.6409 $44.87

. $8.98 0.6409 $44.87

. $8.98 0.6409 $44.87

. $8.98 0.6409 $44.87

. $8.98 4.0104 $280.79 $68.90 $56.16 0.6409 $44.87

. $8.98 0.6409 $44.87

. $8.98 0.6409 $44.87

. $8.98 0.6409 $44.87

. $8.98 4.0104 $280.79 $68.90 $56.16 0.6409 $44.87

. $8.98 0.6409 $44.87

. $8.98 0.6409 $44.87

. $8.98 2.7436 $192.10 $74.27 $38.42 4.2929 $300.57 $96.62 $60.12 4.7767 $334.45 $116.13 $66.89 4.8375 $338.70 $114.37 $67.74 4.8381 $338.74 $133.48 $67.75 6.2343 $436.50 $146.69 $87.30 7.6347 $534.55 $197.64 $106.91 4.8381 $338.74 $133.48 $67.75 6.2343 $436.50 $146.69 $87.30 7.6347 $534.55 $197.64 $106.91

0.6409 $44.87

. $8.98 0.6409 $44.87

. $8.98 0.6409 $44.87

. $8.98 4.0104 $280.79 $68.90 $56.16

0.6409 $44.87

. $8.98

0.6409 $44.87

. $8.98 0.6409 $44.87

. $8.98 0.6409 $44.87

. $8.98 0.6409 $44.87

. $8.98 0.6409 $44.87

. $8.98 4.0104 $280.79 $68.90 $56.16 0.6409 $44.87

. $8.98 0.6409 $44.87

. $8.980.6409 $44.87

. $8.98

0.6409 $44.87

. $8.98 4.0104 $280.79 $68.90 $56.16 0.6409 $44.87

. $8.98 0.6409 $44.87

. $8.98 0.6409 $44.87

. $8.98 0.6409 $44.87

. $8.98 2.7436 $192.10 $74.27 $38.42 4.2929 $300.57 $96.62 $60.12 4.7767 $334.45 $116.13 $66.89 4.8375 $338.70 $114.37 $67.74 4.8381 $338.74 $133.48 $67.75 6.2343 $436.50 $146.69 $87.30 7.6347 $534.55 $197.64 $106.91 4.8381 $338.74 $133.48 $67.75 6.2343 $436.50 $146.69 $87.30 7.6347 $534.55 $197.64 $106.91

0.6409 $44.87

. $8.98 0.6409 $44.87

. $8.98 0.6409 $44.87

. $8.98 1.0790 $75.55

. $15.11 2.7436 $192.10 $74.27 $38.42 4.2929 $300.57 $96.62 $60.12 4.7767 $334.45 $116.13 $66.89 8.2987 $581.04 $187.25 $116.21 4.8375 $338.70 $114.37 $67.74 5.7930 $405.60 $156.82 $81.12 8.2987 $581.04 $187.25 $116.21 8.2987 $581.04 $187.25 $116.21 4.8381 $338.74 $133.48 $67.75 6.2343 $436.50 $146.69 $87.30 7.6347 $534.55 $197.64 $106.91

3.3643 $235.55

. $47.11 1.2186 $85.32 $33.87 $17.07 1.2186 $85.32 $33.87 $17.07 1.2186 $85.32 $33.87 $17.07

1.2186 $85.32 $33.87 $17.07 1.2186 $85.32 $33.87 $17.07 2.0340 $142.41 $53.90 $28.49 1.2186 $85.32 $33.87 $17.07 1.2186 $85.32 $33.87 $17.07 2.0340 $142.41 $53.90 $28.49 1.2186 $85.32 $33.87 $17.07 2.0340 $142.41 $53.90 $28.49 1.2186 $85.32 $33.87 $17.07 2.7436 $192.10 $74.27 $38.42 4.2929 $300.57 $96.62 $60.12

1.2186 $85.32 $33.87 $17.07 2.0340 $142.41 $53.90 $28.49 1.2186 $85.32 $33.87 $17.07 1.2186 $85.32 $33.87 $17.071.2186 $85.32 $33.87 $17.07

3.3643 $235.55

. $47.11 5.7208 $400.55

. $80.11

2.6196 $183.41 $58.44 $36.69 2.6196 $183.41 $58.44 $36.69 2.6196 $183.41 $58.44 $36.69 2.6196 $183.41 $58.44 $36.69 2.6196 $183.41 $58.44 $36.69 2.6196 $183.41 $58.44 $36.69 2.6196 $183.41 $58.44 $36.69 2.6196 $183.41 $58.44 $36.69 2.6196 $183.41 $58.44 $36.69 2.6196 $183.41 $58.44 $36.69 3.3643 $235.55

. $47.11 17.4715$1,223.28

. $244.66 17.4715$1,223.28

. $244.66 17.4715$1,223.28

. $244.66 1.0790 $75.55

. $15.11 3.3643 $235.55

. $47.11

2.6196 $183.41 $58.44 $36.69 4.8381 $338.74 $133.48 $67.75 4.8381 $338.74 $133.48 $67.75 7.6347 $534.55 $197.64 $106.91 7.6347 $534.55 $197.64 $106.91

0.6499 $45.50

. $9.10 3.7417 $261.98

. $52.40 3.7417 $261.98

. $52.40 3.7417 $261.98

. $52.40 29.7209$2,080.94

. $416.19 29.7209$2,080.94

. $416.19 29.7209$2,080.94

. $416.19 29.7209$2,080.94

. $416.19 4.8375 $338.70 $114.37 $67.74 49.6878$3,478.94

. $695.79 29.7209$2,080.94

. $416.19 49.6878$3,478.94

. $695.79 49.6878$3,478.94

. $695.79 29.7209$2,080.94

. $416.19 49.6878$3,478.94

. $695.79 29.7209$2,080.94

. $416.19 29.7209$2,080.94

. $416.19 29.7209$2,080.94

. $416.19 29.7209$2,080.94

. $416.1929.7209$2,080.94

. $416.19

29.7209$2,080.94

. $416.19

29.7209$2,080.94

. $416.19 29.7209$2,080.94

. $416.19 29.7209$2,080.94

. $416.19 29.7209$2,080.94

. $416.19 29.7209$2,080.94

. $416.19 29.7209$2,080.94

. $416.19 9.4045 $658.47

. $131.70 9.4045 $658.47

. $131.70

9.4045 $658.47

. $131.70 5.7208 $400.55

. $80.11 5.7208 $400.55

. $80.11 5.7208 $400.55

. $80.11 5.7208 $400.55

. $80.11 1.0790 $75.55

. $15.11 29.7209$2,080.94

. $416.19 9.4045 $658.47

. $131.70 9.4045 $658.47

. $131.70 29.7209$2,080.94

. $416.19 9.4045 $658.47

. $131.70 29.7209$2,080.94

. $416.19 29.7209$2,080.94

. $416.19 29.7209$2,080.94

. $416.19 29.7209$2,080.94

. $416.19 9.4045 $658.47

. $131.70 9.4045 $658.47

. $131.70 9.4045 $658.47

. $131.70 9.4045 $658.47

. $131.70 29.7209$2,080.94

. $416.19 9.4045 $658.47

. $131.70 29.7209$2,080.94

. $416.19 29.7209$2,080.94

. $416.19 29.7209$2,080.94

. $416.19

1.0790 $75.55

. $15.11

2.1681 $151.80 $59.37 $30.3665.8519$4,610.69

. $922.14

65.8519$4,610.69

. $922.14

31.1505$2,181.03

. $436.21

1.2171 $85.22 $30.47 $17.05

0.6409 $44.87

. $8.98 3.3643 $235.55

. $47.11 5.7208 $400.55

. $80.11 1.0790 $75.55

. $15.11 3.3643 $235.55

. $47.11 3.3643 $235.55

. $47.11 1.2171 $85.22 $30.47 $17.05

1.5251 $106.78 $35.57 $21.36

1.2171 $85.22 $30.47 $17.05 1.5251 $106.78 $35.57 $21.36 4.8381 $338.74 $133.48 $67.75 0.6409 $44.87

. $8.98 0.8990 $62.94 $22.26 $12.59 2.8247 $197.77 $42.27 $39.56 1.3781 $96.49 $37.23 $19.30 1.3781 $96.49 $37.23 $19.30 1.3781 $96.49 $37.23 $19.30 0.2673 $18.72

. $3.75 0.8990 $62.94 $22.26 $12.59 1.3781 $96.49 $37.23 $19.30 0.8990 $62.94 $22.26 $12.59 1.3781 $96.49 $37.23 $19.30 0.8990 $62.94 $22.26 $12.59 0.8990 $62.94 $22.26 $12.59 1.3781 $96.49 $37.23 $19.30 1.3781 $96.49 $37.23 $19.30 1.3781 $96.49 $37.23 $19.30 1.3781 $96.49 $37.23 $19.30 1.3781 $96.49 $37.23 $19.30 1.3781 $96.49 $37.23 $19.30 1.3781 $96.49 $37.23 $19.30 0.8990 $62.94 $22.26 $12.59 1.3781 $96.49 $37.23 $19.30 1.3781 $96.49 $37.23 $19.30 2.1681 $151.80 $59.37 $30.36 0.8990 $62.94 $22.26 $12.59 0.8990 $62.94 $22.26 $12.59 0.8990 $62.94 $22.26 $12.590.8990 $62.94 $22.26 $12.59

0.8990 $62.94 $22.26 $12.59 0.8990 $62.94 $22.26 $12.59 1.3781 $96.49 $37.23 $19.30 1.3781 $96.49 $37.23 $19.30 0.8990 $62.94 $22.26 $12.59 0.8990 $62.94 $22.26 $12.59 3.1615 $221.36

. $44.28 3.1615 $221.36

. $44.28 0.8990 $62.94 $22.26 $12.59 0.8990 $62.94 $22.26 $12.59 1.3781 $96.49 $37.23 $19.30 2.1681 $151.80 $59.37 $30.36 1.3781 $96.49 $37.23 $19.30 0.8990 $62.94 $22.26 $12.59 1.3781 $96.49 $37.23 $19.30 1.3781 $96.49 $37.23 $19.30 1.3781 $96.49 $37.23 $19.30 1.3781 $96.49 $37.23 $19.30 0.8990 $62.94 $22.26 $12.59 0.8990 $62.94 $22.26 $12.59 0.8990 $62.94 $22.26 $12.59

1.5248 $106.76 $36.86 $21.36

0.8990 $62.94 $22.26 $12.59 2.1681 $151.80 $59.37 $30.36 0.6499 $45.50 $0.00 $0.00

0.8990 $62.94 $22.26 $12.59

3.3643 $235.55

. $47.11 3.3643 $235.55

. $47.110.6409 $44.87

. $8.98

0.6409 $44.87

. $8.98 0.6409 $44.87

. $8.98 1.0790 $75.55

. $15.11 1.0790 $75.55

. $15.11 1.0790 $75.55

. $15.11 0.6409 $44.87

. $8.98 1.0218 $71.54 $0.00 $0.00

1.0218 $71.54 $0.00 $0.00 0.4865 $34.06 $0.00 $0.00 0.6409 $44.87

. $8.98

4.8381 $338.74 $133.48 $67.75

1.5329 $107.33 $34.63 $21.47 3.7681 $263.83 $88.76 $52.77 3.7681 $263.83 $88.76 $52.77 13.6332 $954.54 $325.27 $190.91 1.5329 $107.33 $34.63 $21.47 1.5329 $107.33 $34.63 $21.47 13.6332 $954.54 $325.27 $190.91 1.5329 $107.33 $34.63 $21.47 1.5329 $107.33 $34.63 $21.47 3.7681 $263.83 $88.76 $52.77 3.7681 $263.83 $88.76 $52.77 1.5329 $107.33 $34.63 $21.47 3.7681 $263.83 $88.76 $52.77 3.7681 $263.83 $88.76 $52.77 1.5329 $107.33 $34.63 $21.47 2.8573 $200.06 $66.95 $40.02 2.8573 $200.06 $66.95 $40.02 2.8573 $200.06 $66.95 $40.02 1.5329 $107.33 $34.63 $21.47 3.7681 $263.83 $88.76 $52.77 1.5329 $107.33 $34.63 $21.47 106.5454 $7,459.88

. $1,491.98

1.5329 $107.33 $34.63 $21.47 1.4252 $99.79

. $19.96 1.4252 $99.79

. $19.96 1.4252 $99.79

. $19.96 1.4252 $99.79

. $19.96 1.4252 $99.79

. $19.96 1.4252 $99.79

. $19.96 2.4149 $169.08

. $33.82 2.4149 $169.08

. $33.82 2.4149 $169.08

. $33.822.4149 $169.08

. $33.82

2.4149 $169.08

. $33.82 2.4149 $169.08

. $33.82 2.4149 $169.08

. $33.82

6.5452 $458.27

. $91.66

2.4149 $169.08

. $33.82 2.4149 $169.08

. $33.82

5.6386 $394.79

. $78.96

16.9101 $1,183.98

. $236.80 16.9101 $1,183.98

. $236.80 22.1209$1,548.82

. $309.77 22.1209$1,548.82

. $309.77 5.6386 $394.79

. $78.96 5.6386 $394.79

. $78.96 5.6386 $394.79

. $78.96 5.6386 $394.79

. $78.96 5.6386 $394.79

. $78.96 2.4149 $169.08

. $33.82 5.4044 $378.39

. $75.68 5.4044 $378.39

. $75.68 5.4044 $378.39

. $75.68 5.4044 $378.39

. $75.68 5.4044 $378.39

. $75.68 11.9274 $835.11

. $167.03 9.9687 $697.97 $263.92 $139.60 9.9687 $697.97 $263.92 $139.60 9.9687 $697.97 $263.92 $139.60 1.4252 $99.79

. $19.96

5.4044 $378.39

. $75.68 1.5569 $109.01 $26.88 $21.81 1.5569 $109.01 $26.88 $21.81 1.5569 $109.01 $26.88 $21.81 3.1610 $221.32 $65.46 $44.27 3.1610 $221.32 $65.46 $44.27 1.8944 $132.64 $47.64 $26.53 1.8944 $132.64 $47.64 $26.53 4.0053 $280.44 $85.08 $56.09 4.0053 $280.44 $85.08 $56.09 4.0053 $280.44 $85.08 $56.09

3.1610 $221.32 $65.46 $44.27 13.6750 $957.47

. $191.50 1.8944 $132.64 $47.64 $26.53 3.6580 $256.12 $90.92 $51.233.6580 $256.12 $90.92 $51.23

3.6580 $256.12 $90.92 $51.23 6.9196 $484.48

. $96.90 6.9196 $484.48

. $96.90 6.9196 $484.48

. $96.90 6.9196 $484.48

. $96.90 6.9196 $484.48

. $96.90 6.9196 $484.48

. $96.90 6.9196 $484.48

. $96.90 6.9196 $484.48

. $96.90 3.6580 $256.12 $90.92 $51.23 2.2892 $160.28 $39.07 $32.06 2.2892 $160.28 $39.07 $32.06 3.6580 $256.12 $90.92 $51.23 3.6580 $256.12 $90.92 $51.23 4.1909 $293.43 $90.78 $58.69 4.1909 $293.43 $90.78 $58.69 4.1909 $293.43 $90.78 $58.69 4.1909 $293.43 $90.78 $58.69 4.1909 $293.43 $90.78 $58.69 4.1909 $293.43 $90.78 $58.69

4.1909 $293.43 $90.78 $58.69 4.1909 $293.43 $90.78 $58.69 3.4841 $243.94 $87.01 $48.79 3.4841 $243.94 $87.01 $48.79 3.4841 $243.94 $87.01 $48.79 3.4841 $243.94 $87.01 $48.79 3.4841 $243.94 $87.01 $48.79 3.4841 $243.94 $87.01 $48.79 3.4841 $243.94 $87.01 $48.79

2.2892 $160.28 $39.07 $32.06 2.2892 $160.28 $39.07 $32.06 2.2892 $160.28 $39.07 $32.06 3.4841 $243.94 $87.01 $48.79 3.4841 $243.94 $87.01 $48.79 3.4841 $243.94 $87.01 $48.79 3.4841 $243.94 $87.01 $48.79 3.4841 $243.94 $87.01 $48.79 3.5304 $247.18 $94.20 $49.44 3.5304 $247.18 $94.20 $49.44 3.5304 $247.18 $94.20 $49.44 3.5304 $247.18 $94.20 $49.44 3.5304 $247.18 $94.20 $49.44

3.5304 $247.18 $94.20 $49.44 4.2548 $297.90 $93.33 $59.58 4.2548 $297.90 $93.33 $59.58 2.0980 $146.89 $33.94 $29.38 9.6018 $672.28

. $134.46 9.6018 $672.28

. $134.469.6018 $672.28

. $134.46

9.6018 $672.28

. $134.46 2.0980 $146.89 $33.94 $29.38 2.0980 $146.89 $33.94 $29.38 2.0980 $146.89 $33.94 $29.38 14.8260 $1,038.06

. $207.62 4.2548 $297.90 $93.33 $59.58 4.2548 $297.90 $93.33 $59.58 4.2548 $297.90 $93.33 $59.58 4.2548 $297.90 $93.33 $59.58 4.2548 $297.90 $93.33 $59.58 4.2548 $297.90 $93.33 $59.58 4.2548 $297.90 $93.33 $59.58 14.8260 $1,038.06

. $207.62 14.8260 $1,038.06

. $207.62 4.2548 $297.90 $93.33 $59.58

4.2548 $297.90 $93.33 $59.58 2.8915 $202.45 $71.16 $40.49 2.8915 $202.45 $71.16 $40.49 4.5192 $316.42 $126.56 $63.29

2.8915 $202.45 $71.16 $40.49 4.5192 $316.42 $126.56 $63.29 2.8915 $202.45 $71.16 $40.49 3.4408 $240.91 $72.42 $48.19 8.6793 $607.69

. $121.54 3.4408 $240.91 $72.42 $48.19 8.6793 $607.69

. $121.54 8.6793 $607.69

. $121.54 14.8260 $1,038.06

. $207.62

3.4408 $240.91 $72.42 $48.19 8.6793 $607.69

. $121.54 8.6793 $607.69

. $121.54 3.4408 $240.91 $72.42 $48.19 8.6793 $607.69

. $121.54 8.6793 $607.69

. $121.54 3.4408 $240.91 $72.42 $48.19 3.4408 $240.91 $72.42 $48.19 4.5536 $318.82 $81.52 $63.77 4.5536 $318.82 $81.52 $63.77 4.5536 $318.82 $81.52 $63.77 4.5536 $318.82 $81.52 $63.77 4.5536 $318.82 $81.52 $63.77 4.5536 $318.82 $81.52 $63.77 2.2892 $160.28 $39.07 $32.061.5569 $109.01 $26.88 $21.81

4.5536 $318.82 $81.52 $63.77 4.5536 $318.82 $81.52 $63.77 4.5536 $318.82 $81.52 $63.77 4.0053 $280.44 $85.08 $56.09 7.0664 $494.76

. $98.96 7.0664 $494.76

. $98.96 7.0664 $494.76

. $98.96 13.6750 $957.47

. $191.50 7.0664 $494.76

. $98.96 7.0664 $494.76

. $98.96 7.0664 $494.76

. $98.96 2.2892 $160.28 $39.07 $32.06 14.8260 $1,038.06

. $207.62 14.8260 $1,038.06

. $207.62 14.8260 $1,038.06

. $207.62 14.8260 $1,038.06

. $207.62 14.8260 $1,038.06

. $207.62 14.8260 $1,038.06

. $207.62 1.5569 $109.01 $26.88 $21.81 3.2941 $230.64 $78.13 $46.13 3.2941 $230.64 $78.13 $46.13 4.0373 $282.68

. $56.54 3.2941 $230.64 $78.13 $46.13 4.0373 $282.68

. $56.54 4.0373 $282.68

. $56.54 3.2941 $230.64 $78.13 $46.13 3.2941 $230.64 $78.13 $46.130.1601 $11.21

. $2.25

0.1601 $11.21

. $2.250.5259 $36.82 $10.84 $7.370.1601 $11.21

. $2.25

0.5259 $36.82 $10.84 $7.37 0.1601 $11.21

. $2.250.0806 $5.64 $2.09 $1.13

0.0806 $5.64 $2.09 $1.13 0.0806 $5.64 $2.09 $1.13 0.0806 $5.64 $2.09 $1.13 0.0806 $5.64 $2.09 $1.130.2135 $14.95

. $2.99

0.3538 $24.77

. $4.96 0.3538 $24.77

. $4.96 0.1101 $7.71 $2.17 $1.55 0.1101 $7.71 $2.17 $1.55 0.1101 $7.71 $2.17 $1.55 0.6730 $47.12

. $9.43 0.2135 $14.95

. $2.99 0.1101 $7.71 $2.17 $1.55 0.1101 $7.71 $2.17 $1.55 0.2135 $14.95

. $2.99 0.2135 $14.95

. $2.99 0.2135 $14.95

. $2.99 0.2135 $14.95

. $2.99

0.2135 $14.95

. $2.99 0.2135 $14.95

. $2.99 0.3538 $24.77

. $4.96 0.2135 $14.95

. $2.99 0.2135 $14.95

. $2.99 0.6730 $47.12

. $9.43 0.6730 $47.12

. $9.43 0.6730 $47.12

. $9.43

0.2135 $14.95

. $2.990.2135 $14.95

. $2.99

0.2135 $14.95

. $2.99 0.3538 $24.77

. $4.96 0.2135 $14.95

. $2.99 0.2135 $14.95

. $2.99 0.2135 $14.95

. $2.99 0.3538 $24.77

. $4.96 0.2135 $14.95

. $2.99 0.6730 $47.12

. $9.43 0.3538 $24.77

. $4.96 0.2135 $14.95

. $2.99 0.2135 $14.95

. $2.990.2434 $17.04 $5.06 $3.41

0.2434 $17.04 $5.06 $3.41

0.2434 $17.04 $5.06 $3.41 0.5259 $36.82 $10.84 $7.37 0.8180 $57.27 $15.56 $11.46 0.8180 $57.27 $15.56 $11.46 0.2434 $17.04 $5.06 $3.41

0.2434 $17.04 $5.06 $3.41 0.2434 $17.04 $5.06 $3.41 0.5259 $36.82 $10.84 $7.37

0.2434 $17.04 $5.06 $3.41 0.5259 $36.82 $10.84 $7.37

0.1601 $11.21

. $2.25 0.5259 $36.82 $10.84 $7.37 0.2434 $17.04 $5.06 $3.41 0.2434 $17.04 $5.06 $3.41 0.1601 $11.21

. $2.25 0.5259 $36.82 $10.84 $7.37 0.5259 $36.82 $10.84 $7.370.1601 $11.21

. $2.25

0.1601 $11.21

. $2.25 0.1601 $11.21

. $2.25 0.2434 $17.04 $5.06 $3.41 0.5259 $36.82 $10.84 $7.37 0.5259 $36.82 $10.84 $7.37 0.8180 $57.27 $15.56 $11.46 0.8180 $57.27 $15.56 $11.46 0.1601 $11.21

. $2.25 0.2434 $17.04 $5.06 $3.41 0.2434 $17.04 $5.06 $3.41 0.2434 $17.04 $5.06 $3.41

0.2434 $17.04 $5.06 $3.41 0.2434 $17.04 $5.06 $3.41 0.5259 $36.82 $10.84 $7.37 0.8180 $57.27 $15.56 $11.46 0.2434 $17.04 $5.06 $3.41 0.5259 $36.82 $10.84 $7.37 0.1601 $11.21

. $2.25 0.2434 $17.04 $5.06 $3.41 0.2434 $17.04 $5.06 $3.41 0.5259 $36.82 $10.84 $7.37 0.5259 $36.82 $10.84 $7.37 0.5259 $36.82 $10.84 $7.37 2.3496 $164.51

. $32.91 2.3496 $164.51

. $32.91 0.5259 $36.82 $10.84 $7.37 0.8180 $57.27 $15.56 $11.460.5259 $36.82 $10.84 $7.37

0.5259 $36.82 $10.84 $7.37 0.8180 $57.27 $15.56 $11.46 0.8180 $57.27 $15.56 $11.46 0.1601 $11.21

. $2.25 0.8180 $57.27 $15.56 $11.46 0.5259 $36.82 $10.84 $7.37 0.8180 $57.27 $15.56 $11.46

0.2434 $17.04 $5.06 $3.41 0.5259 $36.82 $10.84 $7.37 0.8180 $57.27 $15.56 $11.46

0.1601 $11.21

. $2.25

0.1601 $11.21

. $2.25

0.2434 $17.04 $5.06 $3.41 0.5259 $36.82 $10.84 $7.37 0.1601 $11.21

. $2.25 0.8180 $57.27 $15.56 $11.46 0.8180 $57.27 $15.56 $11.46 0.8180 $57.27 $15.56 $11.46 0.8180 $57.27 $15.56 $11.46 0.8180 $57.27 $15.56 $11.46 0.5259 $36.82 $10.84 $7.37 0.8180 $57.27 $15.56 $11.46 0.2434 $17.04 $5.06 $3.41 0.5259 $36.82 $10.84 $7.37 0.5259 $36.82 $10.84 $7.37 0.8180 $57.27 $15.56 $11.46 0.8180 $57.27 $15.56 $11.46 0.8180 $57.27 $15.56 $11.46 0.8180 $57.27 $15.56 $11.46 0.8180 $57.27 $15.56 $11.46 0.8180 $57.27 $15.56 $11.46 0.8180 $57.27 $15.56 $11.460.8180 $57.27 $15.56 $11.46

0.8180 $57.27 $15.56 $11.46 0.8180 $57.27 $15.56 $11.46 0.8180 $57.27 $15.56 $11.46 0.8180 $57.27 $15.56 $11.46 0.8180 $57.27 $15.56 $11.46 0.8180 $57.27 $15.56 $11.46 0.8180 $57.27 $15.56 $11.46 0.8180 $57.27 $15.56 $11.46 0.1601 $11.21

. $2.25

$113.50

. $22.70 $185.74

. $37.15 $177.81

. $35.57 $1,158.85

. $231.77

$94.28

. $18.86

0.4972 $34.81

. $6.97 0.3545 $24.82

. $4.97 0.3545 $24.82

. $4.97 0.3545 $24.82

. $4.97

$112.23

. $22.45$205.48

. $41.10 $139.69

. $27.94

$106.60

. $21.32

$110.75

. $22.15 $92.92

. $18.59 $100.15

. $20.031.5910 $111.40

. $22.28

1.5910 $111.40

. $22.28 1.1395 $79.78

. $15.96 1.1395 $79.78

. $15.96 1.5910 $111.40

. $22.28 1.5910 $111.40

. $22.28 1.5910 $111.40

. $22.28 1.5910 $111.40

. $22.28 1.1395 $79.78

. $15.96 1.1395 $79.78

. $15.96 1.5910 $111.40

. $22.28 1.5910 $111.40

. $22.28 1.5910 $111.40

. $22.28 1.5910 $111.40

. $22.28

1.5910 $111.40

. $22.28 1.8190 $127.36

. $25.48 1.8190 $127.36

. $25.48 0.8088 $56.63 $11.70 $11.33 0.8088 $56.63 $11.70 $11.33 0.8088 $56.63 $11.70 $11.33 1.0311 $72.19

. $14.44 1.5910 $111.40

. $22.28 1.2025 $84.19

. $16.84 1.2025 $84.19

. $16.84 1.2025 $84.19

. $16.84 5.9715 $418.10

. $83.62

1.5910 $111.40

. $22.28

1.1395 $79.78

. $15.96

1.1095 $77.68 $16.21 $15.54 6.2419 $437.03

. $87.412.5237 $176.70

. $35.34

4.0827 $285.85 $83.23 $57.17 4.0827 $285.85 $83.23 $57.17 4.0827 $285.85 $83.23 $57.17 4.0827 $285.85 $83.23 $57.17 4.0827 $285.85 $83.23 $57.17 4.0827 $285.85 $83.23 $57.17 4.0827 $285.85 $83.23 $57.17 1.7152 $120.09 $33.87 $24.02 4.0827 $285.85 $83.23 $57.17 1.7152 $120.09 $33.87 $24.02 1.7152 $120.09 $33.87 $24.02 10.4394 $730.93 $152.78 $146.19 12.6671 $886.90 $207.88 $177.38 3.1886 $223.25

. $44.65 1.1095 $77.68 $16.21 $15.54 3.1886 $223.25

. $44.65 1.7152 $120.09 $33.87 $24.02 1.7152 $120.09 $33.87 $24.02 1.7152 $120.09 $33.87 $24.02 1.3588 $95.14

. $19.03 1.3588 $95.14

. $19.03 1.0311 $72.19

. $14.44 1.0311 $72.19

. $14.44

15.4248$1,079.98

. $216.00 15.4248$1,079.98

. $216.00 0.6424 $44.98

. $9.000.6424 $44.98

. $9.00

0.6424 $44.98

. $9.00 0.6424 $44.98

. $9.00

0.6424 $44.98

. $9.00 0.6424 $44.98

. $9.00 1.0589 $74.14

. $14.83

0.6424 $44.98

. $9.00 0.6424 $44.98

. $9.00 0.6424 $44.98

. $9.00 1.0589 $74.14

. $14.83 0.6424 $44.98

. $9.00 0.6424 $44.98

. $9.00 0.6424 $44.98

. $9.00 0.2673 $18.72

. $3.75 0.2673 $18.72

. $3.75 1.0589 $74.14

. $14.83 2.0294 $142.09

. $28.42 2.0294 $142.09

. $28.42 0.6424 $44.98

. $9.00 0.6424 $44.98

. $9.00 0.6424 $44.98

. $9.00 0.6424 $44.98

. $9.00 2.0294 $142.09

. $28.42 0.6424 $44.98

. $9.00 0.6424 $44.98

. $9.00 0.6424 $44.98

. $9.00 1.0589 $74.14

. $14.83 1.0589 $74.14

. $14.83

1.0589 $74.14

. $14.83 0.6424 $44.98

. $9.00 1.0589 $74.14

. $14.83

1.0589 $74.14

. $14.83 1.0589 $74.14

. $14.83 0.6424 $44.98

. $9.00 1.0589 $74.14

. $14.83 0.6424 $44.98

. $9.00

1.0589 $74.14

. $14.83 1.0589 $74.14

. $14.83 0.6424 $44.98

. $9.00 0.6424 $44.98

. $9.00 0.6424 $44.98

. $9.00

1.0589 $74.14

. $14.83 0.6424 $44.98

. $9.003.1150 $218.10

. $43.62

1.0729 $75.12

. $15.03 0.9638 $67.48 $17.10 $13.50 0.9638 $67.48 $17.10 $13.50 1.8189 $127.35 $27.10 $25.47

1.8189 $127.35 $27.10 $25.47 0.9638 $67.48 $17.10 $13.50 0.9638 $67.48 $17.10 $13.50 1.8189 $127.35 $27.10 $25.47 0.9638 $67.48 $17.10 $13.50 0.9638 $67.48 $17.10 $13.50 1.8189 $127.35 $27.10 $25.47

1.8189 $127.35 $27.10 $25.47 0.4911 $34.38 $7.06 $6.88

0.4911 $34.38 $7.06 $6.88 1.2175 $85.24 $18.05 $17.05 0.4911 $34.38 $7.06 $6.88 0.4911 $34.38 $7.06 $6.88 1.2175 $85.24 $18.05 $17.05

1.2175 $85.24 $18.05 $17.05 0.4911 $34.38 $7.06 $6.88 0.4911 $34.38 $7.06 $6.88 0.4911 $34.38 $7.06 $6.88 0.4911 $34.38 $7.06 $6.88 0.4911 $34.38 $7.06 $6.88 0.4911 $34.38 $7.06 $6.88 1.2175 $85.24 $18.05 $17.05 0.4911 $34.38 $7.06 $6.88 1.6864 $118.07 $23.65 $23.62 0.4911 $34.38 $7.06 $6.88 0.4911 $34.38 $7.06 $6.88 1.6864 $118.07 $23.65 $23.62 1.2175 $85.24 $18.05 $17.05 1.2175 $85.24 $18.05 $17.05 0.4911 $34.38 $7.06 $6.88 2.6488 $185.46

. $37.10 2.6488 $185.46

. $37.10 1.2025 $84.19

. $16.84 0.9638 $67.48 $17.10 $13.50 0.9638 $67.48 $17.10 $13.500.4911 $34.38 $7.06 $6.88

1.6864 $118.07 $23.65 $23.62 1.6864 $118.07 $23.65 $23.62 1.6864 $118.07 $23.65 $23.62 1.6864 $118.07 $23.65 $23.62

1.2175 $85.24 $18.05 $17.05

1.2175 $85.24 $18.05 $17.05 1.6864 $118.07 $23.65 $23.62

1.2175 $85.24 $18.05 $17.05 0.4911 $34.38 $7.06 $6.88 2.2326 $156.32 $43.83 $31.27 2.2326 $156.32 $43.83 $31.27 5.3254 $372.86 $95.30 $74.58 5.3254 $372.86 $95.30 $74.58

41.0387$2,873.37 $655.18 $574.68 16.3852 $1,147.23

. $229.45

2.3021 $161.18

. $32.24

81.1503$5,681.82

. $1,136.37 81.1503$5,681.82

. $1,136.37 65.8519$4,610.69

. $922.14 65.8519$4,610.69

. $922.14 65.8519$4,610.69

. $922.14 65.8519$4,610.69

. $922.14 65.8519$4,610.69

. $922.14105.0651 $7,356.24

. $1,471.25

105.0651 $7,356.24

. $1,471.25 65.8519$4,610.69

. $922.14 65.8519$4,610.69

. $922.14

0.3817 $26.73

. $5.35

2.5439 $178.11 $41.37 $35.63

2.5439 $178.11 $41.37 $35.63 2.5439 $178.11 $41.37 $35.63

0.2673 $18.72

. $3.75

0.9350 $65.46

. $13.10 0.9350 $65.46

. $13.10

11.3569 $795.16 $268.73 $159.04

0.9350 $65.46

. $13.10 1.5944 $111.63

. $22.33

0.2673 $18.72

. $3.75 0.4928 $34.50

. $6.90 0.4928 $34.50

. $6.90 0.4928 $34.50

. $6.90 0.4928 $34.50

. $6.90 0.4928 $34.50

. $6.90 0.4928 $34.50

. $6.90 0.4928 $34.50

. $6.90

0.4928 $34.50

. $6.90 0.4928 $34.50

. $6.90 0.2673 $18.72

. $3.75 0.4928 $34.50

. $6.90 0.4928 $34.50

. $6.90 0.4928 $34.50

. $6.90

0.4928 $34.50

. $6.90

0.4928 $34.50

. $6.90 8.2952 $580.80 $133.61 $116.16 5.6156 $393.18

. $78.64 5.6156 $393.18

. $78.64 5.6156 $393.18

. $78.64 3.1615 $221.36

. $44.28 8.2952 $580.80 $133.61 $116.16 5.6156 $393.18

. $78.645.6156 $393.18

. $78.64

8.2952 $580.80 $133.61 $116.16

8.2952 $580.80 $133.61 $116.16

5.6156 $393.18

. $78.64 8.2952 $580.80 $133.61 $116.16

38.8523$2,720.28 $836.90 $544.06 38.8523$2,720.28 $836.90 $544.06 38.8523$2,720.28 $836.90 $544.06 38.8523$2,720.28 $836.90 $544.06 38.8523$2,720.28 $836.90 $544.06 38.8523$2,720.28 $836.90 $544.06 38.8523$2,720.28 $836.90 $544.06 38.8523$2,720.28 $836.90 $544.06 38.8523$2,720.28 $836.90 $544.06 38.8523$2,720.28 $836.90 $544.06 38.8523$2,720.28 $836.90 $544.06 38.8523$2,720.28 $836.90 $544.06

16.3852 $1,147.23

. $229.45 16.3852 $1,147.23

. $229.45 38.8523$2,720.28 $836.90 $544.06 38.8523$2,720.28 $836.90 $544.06 38.8523$2,720.28 $836.90 $544.06 38.8523$2,720.28 $836.90 $544.06

171.3141$11,994.73

. $2,398.95 171.3141$11,994.73

. $2,398.95 9.9330 $695.47

. $139.10 9.9330 $695.47

. $139.10 9.9330 $695.47

. $139.10

9.9330 $695.47

. $139.10 9.9330 $695.47

. $139.10

9.9330 $695.47

. $139.10 9.9330 $695.47

. $139.10 9.9330 $695.47

. $139.10 53.2719$3,729.89

. $745.98 53.2719$3,729.89

. $745.9853.2719$3,729.89

. $745.98

9.9330 $695.47

. $139.10 53.2719$3,729.89

. $745.98 121.8174 $8,529.17

. $1,705.84 121.8174 $8,529.17

. $1,705.84 4.2669 $298.75 $100.24 $59.75

0.3817 $26.73

. $5.35

0.4928 $34.50

. $6.90 0.7420 $51.95 $13.76 $10.39 0.4928 $34.50

. $6.90 1.5944 $111.63

. $22.33

0.9350 $65.46

. $13.10 0.9350 $65.46

. $13.10

0.9930 $69.53

. $13.91 0.9930 $69.53

. $13.91 0.9350 $65.46

. $13.10

2.1681 $151.80 $59.37 $30.36 2.1681 $151.80 $59.37 $30.36 2.1681 $151.80 $59.37 $30.36 0.8990 $62.94 $22.26 $12.59 1.3781 $96.49 $37.23 $19.30 1.3781 $96.49 $37.23 $19.30 1.3781 $96.49 $37.23 $19.30 0.9350 $65.46

. $13.10 1.5248 $106.76 $36.86 $21.36 1.5248 $106.76 $36.86 $21.36 2.1681 $151.80 $59.37 $30.36 1.3781 $96.49 $37.23 $19.30 2.1681 $151.80 $59.37 $30.36 1.3781 $96.49 $37.23 $19.30 1.5248 $106.76 $36.86 $21.36 2.1681 $151.80 $59.37 $30.36 1.3781 $96.49 $37.23 $19.30 2.1681 $151.80 $59.37 $30.36 2.1681 $151.80 $59.37 $30.36 2.1681 $151.80 $59.37 $30.36 1.3781 $96.49 $37.23 $19.30 2.1681 $151.80 $59.37 $30.36 2.1681 $151.80 $59.37 $30.36 0.9350 $65.46

. $13.101.3781 $96.49 $37.23 $19.30

0.2673 $18.72

. $3.75 3.1979 $223.90

. $44.78 3.1979 $223.90

. $44.78

0.7420 $51.95 $13.76 $10.39 0.7420 $51.95 $13.76 $10.39 0.7420 $51.95 $13.76 $10.39 2.6868 $188.12 $38.23 $37.63 0.7420 $51.95 $13.76 $10.39 0.7420 $51.95 $13.76 $10.39

1.4089 $98.65

. $19.73 2.6868 $188.12 $38.23 $37.63 0.7420 $51.95 $13.76 $10.39 0.7420 $51.95 $13.76 $10.39

0.7420 $51.95 $13.76 $10.39

0.7420 $51.95 $13.76 $10.39 0.7420 $51.95 $13.76 $10.39 0.8906 $62.36 $20.93 $12.48 0.8906 $62.36 $20.93 $12.48 0.7420 $51.95 $13.76 $10.39 0.4237 $29.67 $7.74 $5.94 0.8906 $62.36 $20.93 $12.48 2.6868 $188.12 $38.23 $37.63 0.4237 $29.67 $7.74 $5.94 1.4089 $98.65

. $19.73 0.6499 $45.50

. $9.10 0.6499 $45.50

. $9.10 1.4089 $98.65

. $19.73 3.1979 $223.90

. $44.78 0.4237 $29.67 $7.74 $5.94 0.4237 $29.67 $7.74 $5.94 0.4237 $29.67 $7.74 $5.94 0.8906 $62.36 $20.93 $12.48 2.6868 $188.12 $38.23 $37.63 0.7420 $51.95 $13.76 $10.39

0.7420 $51.95 $13.76 $10.39 0.7420 $51.95 $13.76 $10.39 0.7420 $51.95 $13.76 $10.39 0.8906 $62.36 $20.93 $12.48 0.7420 $51.95 $13.76 $10.39

0.9350 $65.46

. $13.10 0.8906 $62.36 $20.93 $12.48 2.6868 $188.12 $38.23 $37.630.9350 $65.46

. $13.10

0.9350 $65.46

. $13.10

0.6499 $45.50

. $9.10 0.6499 $45.50

. $9.10 0.7420 $51.95 $13.76 $10.39 0.4426 $30.99

. $6.20 0.4426 $30.99

. $6.20 0.7420 $51.95 $13.76 $10.39 0.4426 $30.99

. $6.20 0.4426 $30.99

. $6.20 0.4426 $30.99

. $6.20 0.4426 $30.99

. $6.20 0.4426 $30.99

. $6.20 0.4426 $30.99

. $6.20 1.1369 $79.60

. $15.92 1.1369 $79.60

. $15.92 0.4426 $30.99

. $6.20 2.6868 $188.12 $38.23 $37.63 0.8906 $62.36 $20.93 $12.48 4.0827 $285.85 $83.23 $57.17 0.3545 $24.82

. $4.97 0.3545 $24.82

. $4.97

0.4972 $34.81

. $6.97 0.4972 $34.81

. $6.97 1.0388 $72.73

. $14.55 1.0388 $72.73

. $14.55 0.4972 $34.81

. $6.97 0.4972 $34.81

. $6.97 0.3545 $24.82

. $4.97 0.4972 $34.81

. $6.97 1.1369 $79.60

. $15.92 0.4426 $30.99

. $6.20 1.8647 $130.56

. $26.12

2.4298 $170.12 $53.58 $34.03 2.4298 $170.12 $53.58 $34.03 1.2025 $84.19

. $16.84 11.3569 $795.16 $268.73 $159.04 2.4298 $170.12 $53.58 $34.03 11.3569 $795.16 $268.73 $159.04 11.3569 $795.16 $268.73 $159.04 11.3569 $795.16 $268.73 $159.04 11.3569 $795.16 $268.73 $159.04 2.4298 $170.12 $53.58 $34.03 2.4298 $170.12 $53.58 $34.03 2.4298 $170.12 $53.58 $34.032.4298 $170.12 $53.58 $34.03

2.4298 $170.12 $53.58 $34.03 2.6488 $185.46

. $37.10 2.4298 $170.12 $53.58 $34.03

1.2025 $84.19

. $16.84 1.2025 $84.19

. $16.84 1.2025 $84.19

. $16.84 1.2025 $84.19

. $16.84 1.2025 $84.19

. $16.84 1.2025 $84.19

. $16.84 1.2025 $84.19

. $16.84 1.2025 $84.19

. $16.84 1.2025 $84.19

. $16.84 0.6335 $44.36

. $8.88 0.6335 $44.36

. $8.88 1.2025 $84.19

. $16.84

1.2025 $84.19

. $16.84 1.2025 $84.19

. $16.84 1.2025 $84.19

. $16.84 0.6335 $44.36

. $8.88 0.6335 $44.36

. $8.88 0.6335 $44.36

. $8.88 0.6335 $44.36

. $8.88 0.6335 $44.36

. $8.88

1.2025 $84.19

. $16.84 1.2025 $84.19

. $16.84 1.2025 $84.19

. $16.84 2.6488 $185.46

. $37.10 2.6488 $185.46

. $37.10 2.6488 $185.46

. $37.10 1.2025 $84.19

. $16.84 1.2025 $84.19

. $16.84 2.6488 $185.46

. $37.10 0.6335 $44.36

. $8.88 0.6335 $44.36

. $8.88 0.6335 $44.36

. $8.88 1.2025 $84.19

. $16.84 2.6488 $185.46

. $37.10 1.2025 $84.19

. $16.84 11.3569 $795.16 $268.73 $159.04 11.3569 $795.16 $268.73 $159.04 11.3569 $795.16 $268.73 $159.04 1.2025 $84.19

. $16.8411.3569 $795.16 $268.73 $159.04

2.4298 $170.12 $53.58 $34.03 2.6488 $185.46

. $37.10 2.6488 $185.46

. $37.10 35.9961 $2,520.30

. $504.06 12.8903 $902.53

. $180.51 12.8903 $902.53

. $180.51 1.2025 $84.19

. $16.84 1.5944 $111.63

. $22.33 1.5944 $111.63

. $22.33 1.2025 $84.19

. $16.84 1.5944 $111.63

. $22.33 1.2025 $84.19

. $16.84 1.5944 $111.63

. $22.33 1.5944 $111.63

. $22.33

1.2025 $84.19

. $16.84 1.5944 $111.63

. $22.33 1.8098 $126.71

. $25.35 1.8098 $126.71

. $25.35

0.6335 $44.36

. $8.88 2.6488 $185.46

. $37.10 2.6488 $185.46

. $37.10 1.2025 $84.19

. $16.84 1.2025 $84.19

. $16.84

2.5717 $180.06

. $36.02 1.3842 $96.92

. $19.39 1.3842 $96.92

. $19.39

1.3842 $96.92

. $19.39 2.5717 $180.06

. $36.02 2.5717 $180.06

. $36.02 2.5717 $180.06

. $36.02 2.5717 $180.06

. $36.02

0.5154 $36.09

. $7.22 0.5154 $36.09

. $7.22 0.5154 $36.09

. $7.22 0.5154 $36.09

. $7.22 0.5154 $36.09

. $7.22

1.0388 $72.73

. $14.55 0.3545 $24.82

. $4.97 1.8098 $126.71

. $25.35 0.4972 $34.81

. $6.97 0.4972 $34.81

. $6.97

1.8098 $126.71

. $25.35 0.4972 $34.81

. $6.970.4972 $34.81

. $6.97

0.4972 $34.81

. $6.97 0.4972 $34.81

. $6.97 0.4972 $34.81

. $6.97 0.4972 $34.81

. $6.97

0.3545 $24.82

. $4.97 0.4972 $34.81

. $6.97 0.4972 $34.81

. $6.97 0.4972 $34.81

. $6.97 1.8098 $126.71

. $25.35 1.8098 $126.71

. $25.35 1.0388 $72.73

. $14.55 2.9679 $207.80

. $41.56 0.4972 $34.81

. $6.97 2.9679 $207.80

. $41.56 1.0388 $72.73

. $14.55 1.0388 $72.73

. $14.55 2.9679 $207.80

. $41.56 1.0388 $72.73

. $14.55 2.9679 $207.80

. $41.56 1.8098 $126.71

. $25.35 1.8098 $126.71

. $25.35 2.9679 $207.80

. $41.56 1.8098 $126.71

. $25.35 1.8098 $126.71

. $25.35 0.6068 $42.49 $12.33 $8.50 1.0388 $72.73

. $14.55 0.3545 $24.82

. $4.97 1.4966 $104.79

. $20.96 1.4966 $104.79

. $20.96 1.4966 $104.79

. $20.96 0.5043 $35.31

. $7.07

0.5043 $35.31

. $7.07 0.5043 $35.31

. $7.07 3.0368 $212.62

. $42.53 1.4966 $104.79

. $20.96 1.4966 $104.79

. $20.96 1.4966 $104.79

. $20.96 0.3878 $27.15

. $5.431.4966 $104.79

. $20.96

1.4966 $104.79

. $20.96 0.8768 $61.39

. $12.28 0.8768 $61.39

. $12.28 1.4966 $104.79

. $20.96

0.3428 $24.00

. $4.80 0.3428 $24.00

. $4.80 0.3428 $24.00

. $4.80 0.3428 $24.00

. $4.80 0.3428 $24.00

. $4.80 0.3428 $24.00

. $4.80 0.3428 $24.00

. $4.80 0.3428 $24.00

. $4.800.1337 $9.36 $1.95 $1.88

0.6068 $42.49 $12.33 $8.50

0.7689 $53.84

. $10.77 1.0311 $72.19

. $14.44 1.3588 $95.14

. $19.03 1.8647 $130.56

. $26.12 2.5237 $176.70

. $35.34 0.7689 $53.84

. $10.77 1.0311 $72.19

. $14.44 1.0311 $72.19

. $14.44 1.3588 $95.14

. $19.03 1.8647 $130.56

. $26.120.7181 $50.28 $12.04 $10.06

1.2356 $86.51 $20.79 $17.31 1.9447 $136.16 $33.59 $27.24 3.1277 $218.99 $47.70 $43.80 4.6152 $323.14 $71.44 $64.63

6.6453 $465.28 $104.95 $93.060.2988 $20.92

. $4.19

0.2988 $20.92

. $4.191.0311 $72.19

. $14.44

1.0311 $72.19

. $14.44

2.2326 $156.32 $43.83 $31.270.8180 $57.27 $15.56 $11.46

0.8180 $57.27 $15.56 $11.46 48.1833$3,373.60

. $674.72 48.1833$3,373.60

. $674.72 6.5452 $458.27

. $91.66

23.2851 $1,630.33 $347.90 $326.07 41.0159$2,871.77

. $574.36 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35

0.0806 $5.64 $2.09 $1.13 0.0806 $5.64 $2.09 $1.13 0.0806 $5.64 $2.09 $1.13 0.0806 $5.64 $2.09 $1.13 0.0806 $5.64 $2.09 $1.13

23.2851 $1,630.33 $347.90 $326.07 2.8247 $197.77 $42.27 $39.56 0.6499 $45.50

. $9.10

88.8483$6,220.80

. $1,244.16 88.8483$6,220.80

. $1,244.16

2.5439 $178.11 $41.37 $35.630.6424 $44.98

. $9.00

9.9687 $697.97 $263.92 $139.60 1.4966 $104.79

. $20.96 24.4382 $1,711.07

. $342.22

21.5368$1,507.92

. $301.59

21.5368$1,507.92

. $301.59 41.5778$2,911.11 $634.95 $582.23 41.5778$2,911.11 $634.95 $582.23

1.0589 $74.14

. $14.83 0.6335 $44.36

. $8.88 32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35

0.6499 $45.50

. $9.10 0.6424 $44.98

. $9.00 0.2673 $18.72

. $3.75 0.2673 $18.72

. $3.75 0.2673 $18.72

. $3.75 0.2673 $18.72

. $3.75 1.2175 $85.24 $18.05 $17.05 7.4537 $521.88

. $104.38 2.6055 $182.43

. $36.49 2.6055 $182.43

. $36.49 7.4537 $521.88

. $104.38 2.6055 $182.43

. $36.49 2.6055 $182.43

. $36.49

32.4461 $2,271.75

. $454.35 32.4461 $2,271.75

. $454.35 0.3817 $26.73

. $5.35 0.4928 $34.50

. $6.90 0.4928 $34.50

. $6.90 0.6499 $45.50

. $9.10 6.2205 $435.53

. $87.11 7.4537 $521.88

. $104.38 3.8754 $271.34

. $54.27 7.4537 $521.88

. $104.38 3.8754 $271.34

. $54.27 0.6499 $45.50

. $9.10

105.0651 $7,356.24

. $1,471.25

105.0651 $7,356.24

. $1,471.25 105.0651 $7,356.24

. $1,471.25 105.0651 $7,356.24

. $1,471.25 0.9350 $65.46

. $13.10 4.0827 $285.85 $83.23 $57.174.0827 $285.85 $83.23 $57.17

4.0827 $285.85 $83.23 $57.17 1.4089 $98.65

. $19.73 2.6868 $188.12 $38.23 $37.63 26.1202 $1,828.83 $372.85 $365.77 26.1202 $1,828.83 $372.85 $365.77 26.1202 $1,828.83 $372.85 $365.77 26.1202 $1,828.83 $372.85 $365.77 15.4175$1,079.47

. $215.90 28.9051 $2,023.82 $459.92 $404.77 10.4689 $732.99 $189.82 $146.60 10.4689 $732.99 $189.82 $146.60 41.5778$2,911.11 $634.95 $582.23

35.6252 $2,494.33

. $498.87 35.6252 $2,494.33

. $498.87 35.6252 $2,494.33

. $498.87

20.7198$1,450.72 $385.30 $290.15 216.9330$15,188.78

. $3,037.76 36.1290 $2,529.61

. $505.93 20.7198$1,450.72 $385.30 $290.15 31.1002 $2,177.51 $768.94 $435.51 1.2025 $84.19

. $16.84 1.2025 $84.19

. $16.84 50.7343$3,552.21

. $710.45 50.7343$3,552.21

. $710.45 28.9051 $2,023.82 $459.92 $404.77 28.9051 $2,023.82 $459.92 $404.77 0.6335 $44.36

. $8.88 0.1601 $11.21

. $2.25 0.1601 $11.21

. $2.25

63.3729$4,437.12

. $887.43 346.4693$24,258.39 $9,121.76 $4,851.68 20.7198$1,450.72 $385.30 $290.15 1.2025 $84.19

. $16.84

5.5158 $386.19

. $77.240.9350 $65.46

. $13.10

0.9350 $65.46

. $13.10

0.6499 $45.50

. $9.10 0.6499 $45.50

. $9.10 12.8903 $902.53

. $180.51$17.26

. $3.46

0.2404 $16.83

. $3.37

$10.49

. $2.10

$36,100.41

. $7,220.09

$29,618.96

. $5,923.80

$126.14

. $25.23 $579.98

. $116.00

$1,908.00 $0.00 $0.00$954.77

. $190.96 $7,592.00

. $1,518.401.4941 $104.61

. $20.93

0.5004 $35.04

. $7.01 3.3224 $232.62

. $46.53 0.4544 $31.82

. $6.37224.7054$15,732.97

. $3,146.600.8944 $62.62

. $12.53

0.3855 $26.99

. $5.40 0.5294 $37.07

. $7.42

0.6498 $45.50

. $9.10 0.5078 $35.55

. $7.11 1.1433 $80.05

. $16.01 0.9180 $64.27

. $12.86 1.7379 $121.68

. $24.34 1.1044 $77.33

. $15.47 0.6498 $45.50

. $9.10 0.3855 $26.99

. $5.40 6.2343 $436.50 $146.69 $87.30 4.8381 $338.74 $133.48 $67.75 7.6347 $534.55 $197.64 $106.91 6.2343 $436.50 $146.69 $87.30 4.8381 $338.74 $133.48 $67.75 7.6347 $534.55 $197.64 $106.91 6.2343 $436.50 $146.69 $87.30 4.8381 $338.74 $133.48 $67.75 7.6347 $534.55 $197.64 $106.91 6.2343 $436.50 $146.69 $87.30 4.8381 $338.74 $133.48 $67.75 7.6347 $534.55 $197.64 $106.91 6.2343 $436.50 $146.69 $87.30 4.8381 $338.74 $133.48 $67.75 7.6347 $534.55 $197.64 $106.91 6.2343 $436.50 $146.69 $87.30 4.8381 $338.74 $133.48 $67.75 7.6347 $534.55 $197.64 $106.91 7.9593 $557.28 $166.16 $111.46 7.9593 $557.28 $166.16 $111.46 7.9593 $557.28 $166.16 $111.46 7.9593 $557.28 $166.16 $111.46 7.9593 $557.28 $166.16 $111.46 7.9593 $557.28 $166.16 $111.46 7.9593 $557.28 $166.16 $111.46 7.9593 $557.28 $166.16 $111.46 7.9593 $557.28 $166.16 $111.46 7.9593 $557.28 $166.16 $111.46 6.2343 $436.50 $146.69 $87.30 4.8381 $338.74 $133.48 $67.75 7.6347 $534.55 $197.64 $106.91 6.2343 $436.50 $146.69 $87.30 4.8381 $338.74 $133.48 $67.75 7.6347 $534.55 $197.64 $106.91 2.9679 $207.80

. $41.56

$20.16

. $4.04 $2.66

. $0.54 $129.72

. $25.95 $0.15

. $0.03 $1.50

. $0.30$623.28 $0.00 $0.00

$1.62

. $0.32

$13.57

. $2.67 $3.91

. $0.77 $95.40

. $18.72

$10.91

. $2.19

$11.23

. $2.25

$20.60

. $4.12

$177.77

. $34.89 $4.35

. $0.86

32.9805$2,309.16

. $461.84 25.9792 $1,818.96

. $363.80 5.5158 $386.19

. $77.24 25.5066 $1,785.87

. $357.18 7.4614 $522.42 $104.55 $104.49 13.6332 $954.54 $325.27 $190.91

23.2851 $1,630.33 $347.90 $326.07 4.9271 $344.98

. $69.00

8.2687 $578.94

. $115.79

8.2687 $578.94

. $115.79 8.2687 $578.94

. $115.798.2687 $578.94

. $115.79

8.2687 $578.94

. $115.79 8.2687 $578.94

. $115.79

8.2687 $578.94

. $115.79 8.2687 $578.94

. $115.79

8.2687 $578.94

. $115.79

8.2687 $578.94

. $115.79 8.2687 $578.94

. $115.798.2687 $578.94

. $115.79

8.2687 $578.94

. $115.79 8.2687 $578.94

. $115.798.2687 $578.94

. $115.79

8.2687 $578.94

. $115.798.2687 $578.94

. $115.79

8.2687 $578.94

. $115.79

8.2687 $578.94

. $115.79 8.2687 $578.94

. $115.79

8.2687 $578.94

. $115.79 8.2687 $578.94

. $115.79 8.2687 $578.94

. $115.79 8.2687 $578.94

. $115.79

8.2687 $578.94

. $115.79 8.2687 $578.94

. $115.798.2687 $578.94

. $115.79

8.2687 $578.94

. $115.798.2687 $578.94

. $115.79

8.2687 $578.94

. $115.79 8.2687 $578.94

. $115.79

8.2687 $578.94

. $115.798.2687 $578.94

. $115.798.2687 $578.94

. $115.79

8.2687 $578.94

. $115.79 8.2687 $578.94

. $115.79 8.2687 $578.94

. $115.79 8.2687 $578.94

. $115.79 8.2687 $578.94

. $115.79 8.2687 $578.94

. $115.79 8.2687 $578.94

. $115.79

8.2687 $578.94

. $115.79 8.2687 $578.94

. $115.79

8.2687 $578.94

. $115.798.2687 $578.94

. $115.798.2687 $578.94

. $115.79

8.2687 $578.94

. $115.79 8.2687 $578.94

. $115.79

8.2687 $578.94

. $115.79 8.2687 $578.94

. $115.79 8.2687 $578.94

. $115.790.3545 $24.82 $0.00 $0.00

0.3545 $24.82 $0.00 $0.00 0.4972 $34.81 $0.00 $0.00

0.7689 $53.84 $0.00 $0.00

5.3772 $376.49 $0.00 $0.00 8.3164 $582.28 $0.00 $0.00 2.7510 $192.61

. $38.53

1.0589 $74.14

. $14.83 0.6424 $44.98

. $9.00 2.7510 $192.61

. $38.53 8.3164 $582.28 $0.00 $0.00

0.3878 $27.15

. $5.43

0.6409 $44.87 $0.00 $0.001.3360 $93.54

. $18.71

48.1833$3,373.60

. $674.72 1.8647 $130.56

. $26.12

4.8135 $337.02

. $67.41

0.4237 $29.67 $7.74 $5.94 0.4237 $29.67 $7.74 $5.94 0.4237 $29.67 $7.74 $5.94 0.7689 $53.84

. $10.77 1.0311 $72.19

. $14.44 0.8768 $61.39

. $12.28 1.8647 $130.56

. $26.12 1.8647 $130.56

. $26.12

12.8903 $902.53

. $180.51

6.2419 $437.03

. $87.41

7.4537 $521.88

. $104.38

105.6644 $7,398.20

. $1,479.64 105.6644 $7,398.20

. $1,479.64 0.6499 $45.50

. $9.100.6499 $45.50

. $9.10

11.3569 $795.16 $268.73 $159.04 11.3569 $795.16 $268.73 $159.04 2.4298 $170.12 $53.58 $34.03 2.4298 $170.12 $53.58 $34.03

48.1833$3,373.60

. $674.72 35.9961 $2,520.30

. $504.06

0.6499 $45.50

. $9.10 2.1681 $151.80 $59.37 $30.36

0.7689 $53.84

. $10.77 0.5627 $39.40

. $7.88 0.7972 $55.82

. $11.17 1.3178 $92.27

. $18.46 1.9503 $136.55

. $27.31 3.7639 $263.53

. $52.71 1.3781 $96.49 $0.00 $0.00 11.2658 $788.79

. $157.76 0.5154 $36.09

. $7.22 1.1395 $79.78

. $15.96 2.4298 $170.12 $53.58 $34.03 2.4298 $170.12 $53.58 $34.03 2.4298 $170.12 $53.58 $34.03 1.3588 $95.14 $0.00 $0.00

0.3817 $26.73

. $5.35

32.4461 $2,271.75

. $454.35

2.3496 $164.51

. $32.91

$350.00

. $70.00 $450.00

. $90.00 $650.00

. $130.00

0.9930 $69.53

. $13.910.9930 $69.53

. $13.91

0.5346 $37.43

. $7.49

0.2988 $20.92 $0.00 $0.00 0.2988 $20.92 $0.00 $0.00

0.5154 $36.09

. $7.22

21.9850 $1,539.30

. $307.860.3545 $24.82 $0.00 $0.00

$20.72

. $4.15$548.95

. $109.79 $0.11

. $0.03 $2.74

. $0.55

$410.95

. $82.19

$94.42

. $18.89

$138.53

. $27.71

$41.24

. $8.25 $315.94

. $63.19 $39.16

. $7.84 $38.72

. $7.75 $155.84

. $31.17 $148.30

. $29.10 $3.83

. $0.77 $3.81

. $0.77

$8.42

. $1.69 $14.56

. $2.92 $14.25

. $2.85

$113.08

. $22.62

$1.20

. $0.24

$5.12

. $1.03

$187.46

. $37.50 $76.39

. $15.28 $2,190.58

. $438.12 $38.61

. $7.58

$2.71

. $0.55 $5.38

. $1.08$7.29

. $1.46 $10.78

. $2.16 $5.53

. $1.08

$18.72

. $3.75

$30.23

. $5.94 $43.37

. $8.68 $189.47

. $37.90

$13.32

. $2.67 $88.97

. $17.46

$1.58

. $0.32

$0.74

. $0.14

$4.12

. $0.83

$742.66

. $148.54

$37.51

. $7.36

$5.58

. $1.12 $2,516.22

. $503.25 $99.76

. $19.96

$2,111.36

. $414.31 $947.86

. $189.58 $0.48

. $0.10 $3.14

. $0.63

$9.70

. $1.94

$31.94

. $6.39$14.47

. $2.84

$626.71

. $125.35

$207.92

. $41.59

$269.86

. $53.98 $94.38

. $18.88

$289.07

. $56.73 $186.37

. $37.28

$0.51

. $0.11

$22.02

. $4.41

$103.54

. $20.71 $294.28

. $58.86

$204.31

. $40.87 $246.80

. $49.36 $390.07

. $78.02

$6.91

. $1.39

$1.69

. $0.34$14.37

. $2.88

$341.40

. $68.28 $34.42

. $6.89 $20.62

. $4.13 $37.29

. $7.32 $7.15

. $1.43 $206.16

. $41.24 $36.78

. $7.36 $12.48

. $2.50 $30.46

. $6.10 $55.80

. $11.16 $37.08

. $7.42 $66.58

. $13.32 $52.11

. $10.43 $35.15

. $6.90 $52.11

. $10.43

$109.30

. $21.86

$101.30

. $20.26 $167.25

. $33.45

$10.41

. $2.09 $0.18

. $0.04 $0.27

. $0.06

$245.02

. $49.01

$71.57

. $14.32

$2.52

. $0.51

$148.02

. $29.61 $133.80

. $26.76 $446.44

. $89.29 $62.01

. $12.41 $11.53

. $2.31 $0.32

. $0.07 $41.20

. $8.24$211.59

. $42.32 $372.55

. $74.51

$30.98

. $6.20 $26.33

. $5.27

$346.19

. $69.24 $590.71

. $118.15

$34.48

. $6.90

$25.65

. $5.13

$0.98

. $0.20

$6.48

. $1.30

$2.78

. $0.56

$10.32

. $2.07 $46.36

. $9.28 $117.11

. $23.43

$239.90

. $47.98 $21.34

. $4.27 $2.70

. $0.54

$11.45

. $2.29 $6.56

. $1.32$18.83

. $3.77

$1,001.34

. $200.27 $248.56

. $49.72 $2,676.49

. $535.30 $301.75

. $59.22

$13.23

. $2.65

$275.80

. $55.16

$2.51

. $0.51

$12.90

. $2.58 $27.03

. $5.41 $88.51

. $17.71 $53.76

. $10.76

$171.48

. $34.30 $395.53

. $79.11

$188.98

. $37.80 $51.22

. $10.25 $21.52

. $4.31 $82.14

. $16.43 $5.09

. $1.02 $17.21

. $3.45 $23.64

. $4.73 $5.07

. $1.02

$45.87

. $9.18

$24.22

. $4.85 $26.98

. $5.40$61.81

. $12.37

$1,623.59

. $324.72 $19.78

. $3.96 $42.24

. $8.45

$76.71

. $15.35

$2.10

. $0.42 $57.15

. $11.43

$1,032.25

. $206.45 $1.30

. $0.26 $8.92

. $1.79

$3.47

. $0.68

$60.08

. $12.02 $3.41

. $0.69

$19.54

. $3.91 $176.18

. $35.24

$72.00

. $14.40 $65.66

. $13.14 $117.56

. $23.07

$449.09

. $89.82

$349.51

. $68.59 $9.76

. $1.96

$6.07

. $1.22$220.30

. $44.06 $218.44

. $43.69

$8.44

. $1.66 $0.87

. $0.17

$1.07

. $0.22 $0.90

. $0.18 $0.88

. $0.18 $1.52

. $0.31 $0.85

. $0.17 $9.12

. $1.83 $1.09

. $0.22 $0.89

. $0.18 $0.91

. $0.19 $1.14

. $0.23 $101.40

. $20.28 $2.71

. $0.55 $1.60

. $0.32

$147.80

. $29.56 $74.52

. $14.91 $16,640.00

. $3,328.00 $18,980.00

. $3,796.00 $192.26

. $38.46 $88.00

. $17.60 $146.10

. $29.22 $166.14

. $33.23 $11.93

. $2.39$1,014.00

. $202.80

$25.55

. $5.02

$122.53

. $24.51

$556.51

. $111.31 $1,111.59

. $222.32

$432.20

. $86.44 $516.41

. $103.29

$136.86

. $27.38$6.06

. $1.22 $3.77

. $0.76

$7.32

. $1.47 $24.63

. $4.93

$37.54

. $7.51 $5.68

. $1.14 $77.93

. $15.30

$9.48

. $1.90 $77.92

. $15.59

$525.35

. $105.07 $575.18

. $115.04 $969.60

. $193.92 $40.10

. $8.02 $62.08

. $12.42 $5.15

. $1.03 $119.68

. $23.94 $117.34

. $23.47 $18.47

. $3.70 $59.98

. $12.00$40.67

. $8.14 $135.57

. $26.61

$172.53

. $34.51 $49.53

. $9.91

$23.94

. $4.79 $13.43

. $2.69 $503.48

. $100.70

$567.28

. $113.46

$15.60

. $3.12 $56.58

. $11.32 $2.71

. $0.55 $1,603.01

. $320.61

$15.75

. $3.15

$1.87

. $0.38 $90.06

. $17.68

$101.84

. $20.37

$60.82

. $12.17 $89.64

. $17.93 $186.43

. $37.29 $6.42

. $1.29 $63.47

. $12.70 $32.03

. $6.41

$58.32

. $11.67

$16.82

. $3.37 $31.20

. $6.24 $582.59

. $116.52 $216.90

. $43.38 $4.42

. $0.89 $4,728.88

. $945.78 $3,816.98

. $763.40 $15,418.48

. $3,083.70 $127.20

. $24.96 $154.88

. $30.98 $1,512.71

. $302.55

$113.99

. $22.80 $9.96

. $2.00 $9.33

. $1.87

$2,675.40

. $535.08 $1,084.10

. $216.82$19.55

. $3.91 $37.36

. $7.48 $2,690.84

. $538.17 $45.41

. $8.91 $85.59

. $17.12 $52.76

. $10.56 $165.63

. $32.50 $615.22

. $123.05 $224.79

. $44.11 $265.69

. $53.14 $4.75

. $0.95 $50.57

. $10.12 $131.18

. $26.24 $9.85

. $1.97 $71.08

. $14.22 $959.07

. $191.82

$17.45

. $3.49 $83.63

. $16.73 $19,348.11

. $3,869.631.8647 $130.56

. $26.122.7245 $190.76

. $38.16

1.6761 $117.35

. $23.47 1.1823 $82.78

. $16.56 2.8408 $198.90

. $39.78 1.1408 $79.87

. $15.98 1.2822 $89.77

. $17.96 2.0257 $141.83

. $28.37 2.1303 $149.16

. $29.84 4.1045 $287.38

. $57.48 0.9547 $66.84

. $13.37 1.8720 $131.07

. $26.22 1.8342 $128.42

. $25.69 1.9996 $140.00

. $28.00 6.3148 $442.14

. $88.43 7.6960 $538.84

. $107.77 7.9257 $554.93

. $110.99 9.8804 $691.79

. $138.36 2.8419 $198.98

. $39.80 3.4084 $238.64

. $47.73 3.7309 $261.22

. $52.25

$21.32

. $4.27 0.2574 $18.02

. $3.61 1.0622 $74.37

. $14.88

$61.94

. $12.39 $26.84

. $5.37 $68.03

. $13.61 1.0362 $72.55

. $14.51 19.1478$1,340.65

. $268.13 2.6930 $188.55

. $37.71 11.4695 $803.05

. $160.61 8.7936 $615.69

. $123.14 1.4989 $104.95

. $20.99 5.4802 $383.70

. $76.74 2.0966 $146.80

. $29.36 6.4103 $448.82

. $89.77 4.3700 $305.97

. $61.20 1.0400 $72.82

. $14.57 1.1562 $80.95

. $16.19

2.5439 $178.11 $41.37 $35.63

0.1337 $9.36 $0.00 $0.00$0.65

. $0.13$1.77

. $0.36

$316.31

. $63.27

$32,860.00

. $6,448.00

$238.30

. $47.66$35.88

. $7.18 $5.74

. $1.15 $5.74

. $1.15 $16.26

. $3.26 $9.62

. $1.93 $40.51

. $8.11 $94.95

. $18.99 $21.73

. $4.35 $31.42

. $6.29 $6.78

. $1.36 $332.25

. $66.45 $332.25

. $66.45 $1,019.89

. $203.98 $8.26

. $1.66 $31.72

. $6.35

$2.94

. $0.59 $4.52

. $0.91

$32.84

. $6.57 $31.52

. $6.31

$10.39

. $2.04