( a ) excludes discontinued operations .
( b ) earnings before interest expense and taxes as a percent of average total assets .
( c ) total debt as a percent of the sum of total debt , shareholders 2019 equity and non-current deferred income tax liabilities .
the results above include the impact of the specified items detailed below .
additional discussion regarding the specified items in fiscal years 2017 , 2016 and 2015 are provided in item 7 .
management 2019s discussion and analysis of financial condition and results of operations. .

Years Ended September 30
Millions of dollars, except per share amounts
2017
2016
2015
2014
2013
Total specified items
$1,466
$1,261
$1,186
$153
$442
After-tax impact of specified items
$971
$892
$786
$101
$279
Impact of specified items on diluted earnings per share
$(4.34)
$(4.10)
$(3.79)
$(0.51)
$(1.40)
Impact of dilution from share issuances
$(0.54)
$—
$(0.02)
$—
$—

item 7 .
management 2019s discussion and analysis of financial condition and results of operations the following commentary should be read in conjunction with the consolidated financial statements and accompanying notes .
within the tables presented throughout this discussion , certain columns may not add due to the use of rounded numbers for disclosure purposes .
percentages and earnings per share amounts presented are calculated from the underlying amounts .
references to years throughout this discussion relate to our fiscal years , which end on september 30 .
company overview description of the company and business segments becton , dickinson and company ( 201cbd 201d ) is a global medical technology company engaged in the development , manufacture and sale of a broad range of medical supplies , devices , laboratory equipment and diagnostic products used by healthcare institutions , life science researchers , clinical laboratories , the pharmaceutical industry and the general public .
the company's organizational structure is based upon two principal business segments , bd medical ( 201cmedical 201d ) and bd life sciences ( 201clife sciences 201d ) .
bd 2019s products are manufactured and sold worldwide .
our products are marketed in the united states and internationally through independent distribution channels and directly to end-users by bd and independent sales representatives .
we organize our operations outside the united states as follows : europe ; ema ( which includes the commonwealth of independent states , the middle east and africa ) ; greater asia ( which includes japan and asia pacific ) ; latin america ( which includes mexico , central america , the caribbean , and south america ) ; and canada .
we continue to pursue growth opportunities in emerging markets , which include the following geographic regions : eastern europe , the middle east , africa , latin america and certain countries within asia pacific .
we are primarily focused on certain countries whose healthcare systems are expanding , in particular , china and india .
strategic objectives bd remains focused on delivering sustainable growth and shareholder value , while making appropriate investments for the future .
bd management operates the business consistent with the following core strategies : 2022 to increase revenue growth by focusing on our core products , services and solutions that deliver greater benefits to patients , healthcare workers and researchers; .

Question: Analyse this data from a financial earnings document. based on the management 2019s discussion and analysis of financial condition and results of operations what wa steh approximate tax expense of the total specified items in 2018 in millions
Choices:
2437
0
5
495.0
496.4
Correct choice index: 3