· Web viewDERIVED FEES - REaDy REckonER FoR LocaL MEDIcaL oFFIcERS DERIVED FEES - REaDy REckonER FoR LocaL MEDIcaL oFFIcERS DIAGNOSTIC IMAGING SERVICES DIAGNOSTIC IMAGING SERVICES

Department ofVeterans’ Affairs

Fee SchedulesFor Medical Services

1 November 2012 – 31 October 2013

© Commonwealth of Australia 2012

This work is copyright. Apart from any use as permitted under the Copyright Act 1968, no part may be reproduced by any process without prior written permission from the Commonwealth. Requests and inquiries concerning reproduction and rights should be addressed to the publications section, Department of Veterans’ Affairs or emailed to [email protected].

Published by the Department of Veterans’ Affairs, Canberra, 2012.

DVA P01693 November 2012

REPATRIATION MEDICAL FEE SCHEDULE

1 November 2012 – 31 october 2013

1

Department of Veterans’ affairs medical fee schedules

1 november 2012

Updated: 1 november 2012

ContentsLocal medical officer fee schedule 2

Derived fees – ready reckoner for local medical officers 6

repatriation medical fee schedule 11

relative value guide fee schedule 59

Diagnostic imaging fee schedule 64

Pathology fee schedule 72

Notes for claiming dva fees• The fee schedules list the fees that will be implemented on the Medicare

Australia payment system from 1 November 2012.

• The fee schedules in this booklet are also available on the DVA website at www.dva.gov.au/service_providers/Fee_schedules/gps_lmos_and_ Specialists/Pages/RMFS.aspx

• All item assessments are based on Medicare assessment rules.

• A “D” in a fee column indicates a derived fee.

LocaL MedicaL officer fee ScheduLe

2 1 November 2012 – 31 october 2013

Local medical officer fee schedule1 november 2012

The Local Medical Officer Fee Schedule lists fees for medical attendances and consultations provided by general practitioners participating in DVA’s Local Medical Officer (LMO) Scheme.

Lmos will be paid at 115% of the listed MBS fee plus the relevant Veterans Access Payment (VAP)Or where applicable the Rural Enhancement Initiative (REI) loading.

The VAP can be claimed using the Medicare Bulk Billing Incentive item numbers as follows:

• • Items 10990, 64990 and 74990 are to be used when claiming the $ 7.05VAP; and

• • Items 10991, 10992, 64991 and 74991 when claiming the $10.65 VAP.

Please note that VAP is not payable on items provided to inpatients of a hospital or day surgery, Coordinated Veterans’ Care Program UP items and Telehealth consultation items. Items 10990,10991 and 10992 are VAP incentives and are paid at 100% of the MBS fee.

Derived fees are indicated by a “D” in the column of the Schedule. Please refer to the derived fees section of the booklet for benefit calculation.

The REI loading is available to lmos who provide services to veterans in designated rural public hospitals by State or Territory governments. The REI only applies to those In Hospital items indicated in the Local Medical Officer Fee Schedule. The REI loading is an additional 10% of the LMO fee.

DVA Practice Nurse Incentive Payments may be payable see www.dva.gov.au/service_providers/Doctors/Pages/index.aspx for more information.

For items not listed in the LMO schedule please refer to the appropriate schedule in this booklet.

• For derived fees for Local Medical Officers, please use the Derived Fees for Local MedicalOfficers Fee Schedule.

• For all specialist attendances and consultations, investigative and general medical procedures claim from the Repatriation Medical Fee Schedule.

• For In Hospital anaesthetic services please use Relative Value Guide Fee Schedule.

• For diagnostic imaging services claim from the Diagnostic Imaging Fee Schedule.

• For pathology services claim from the Pathology Fee Schedule.


item lmo fee

vAPVaP 10991

10990 1099264990 64991

rei 74990 74991

735 79.65 Y Y

739 136.40 Y Y

743 227.40 Y Y

747 58.55 Y Y

750 100.35 Y Y

758 167.10 Y Y

900 174.55 Y Y

903 119.50 Y Y

2100 25.85

2122 D

2125 D

2126 56.30

2137 D

2138 D

2143 109.20

2147 D

2179 D

2195 160.70

2199 D

2220 D

2497 19.10 Y Y

2501 41.75 Y Y

2503 D Y Y

2504 80.85 Y Y

2506 D Y Y

2507 119.05 Y Y

2509 D Y Y

2517 41.75 Y Y

2518 D Y Y

2521 80.85 Y Y

2522 D Y Y

2525 119.05 Y Y

2526 D Y Y

2546 41.75 Y Y

2547 D Y Y

2552 80.85 Y Y


3

Item

VapVap 10991

10990 1099264990 64991

Lmo fee rei 74990 74991

3 19.10 Y Y

4 D Y Y Y

20 D Y Y

23 41.75 Y Y

24 D Y Y Y

35 D Y Y

36 80.85 Y Y

37 D Y Y Y

43 D Y Y

44 119.05 Y Y

47 D Y Y Y

51 D Y Y

52 12.65 Y Y

53 24.15 Y Y

54 43.70 Y Y

57 70.15 Y Y

58 D Y Y

59 D Y Y

60 D Y Y

65 D Y Y

92 D Y Y

93 D Y Y

95 D Y Y

96 D Y Y

597 146.35 Y Y

599 172.50 Y Y

701 66.95 Y Y

703 155.50 Y Y

705 214.55 Y Y

707 303.10 Y Y

715 239.35 Y Y

721 162.65 Y Y

723 128.90 Y Y

729 79.35 Y Y

731 79.35 Y Y

732 81.25 Y Y


item lmo fee

vAPVaP 10991

10990 1099264990 64991

rei 74990 74991

5020 55.30 Y Y

5023 D Y Y

5028 D Y Y

5040 94.65 Y Y

5043 D Y Y

5049 D Y Y

5060 132.80 Y Y

5063 D Y Y

5067 D Y Y

5200 24.15 Y Y

5203 35.65 Y Y

5207 55.20 Y Y

5208 81.65 Y Y

5220 D Y Y

5223 D Y Y

5227 D Y Y

5228 D Y Y

5260 D Y Y

5263 D Y Y

5265 D Y Y

5267 D Y Y

10983 37.30 Y Y

10984 37.30 Y Y

10986 66.95 Y Y

10987 27.60 Y Y

10988 13.80 Y Y

10989 13.80 Y Y

10990 7.05

10991 10.65

10992 10.65

10997 13.80 Y Y

64990 7.05

64991 10.65

74990 7.05

74991 10.65

82100 53.40


Item lmo fee rei

VapVap 10991

10990 1099264990 6499174990 74991

2553 D Y Y

2558 119.05 Y Y

2559 D Y Y

2598 12.65 Y Y

2600 24.15 Y Y

2603 43.70 Y Y

2606 70.15 Y Y

2610 D Y Y

2613 D Y Y

2616 D Y Y

2620 24.15 Y Y

2622 43.70 Y Y

2624 70.15 Y Y

2631 D Y Y

2633 D Y Y

2635 D Y Y

2664 24.15 Y Y

2666 43.70 Y Y

2668 70.15 Y Y

2673 D Y Y

2675 D Y Y

2677 D Y Y

2700 80.85 Y Y

2701 119.05 Y Y

2712 80.85 Y Y

2713 80.85 Y Y

2715 102.65 Y Y

2717 151.20 Y Y

2721 104.60 Y Y

2723 D Y Y

2725 149.70 Y Y

2727 D Y Y

4001 86.40 Y Y

5000 32.75 Y Y

5003 D Y Y

5010 D Y Y



5

Item

VapVap 10991

10990 1099264990 64991

Lmo fee rei 74990 74991

82105 32.30

82110 53.40

82115 319.00

82120 753.30

82125 753.30

82130 53.40

82135 78.50

82140 53.40

82150 28.30

82151 53.70

82152 78.95

82200 9.60

82205 20.95

82210 39.75

82215 58.55

82220 28.30

82221 53.70

82222 78.95

82223 28.30

82224 53.70

82225 78.95

UP01 415.80

UP02 259.85

UP03 433.95

UP04 194.90

DERIVED FEES - REaDy REckonER FoR LocaL MEDIcaL oFFIcERS


Derived fees – ready reckoner for local medical officers1 november 2012

Derived fees are indicated by a “D” in the column of the Schedule. Derived Fees Ready Reckoner for Local Medical Officers is a quick reference table for all derived fees. The derived fees are calculated at 115% of the listed MBS fee.

Lmos will be paid the relevant Veterans Access Payment (VAP) and where applicable the RuralEnhancement Initiative (REI) loading.

The VAP can be claimed using the Medicare Bulk Billing Incentive item numbers as follows:

• • Items 10990, 64990 and 74990 are to be used when claiming the $7.05 VAP; and

• • Items 10991, 10992, 64991 and 74991 when claiming the $10.65 VAP.

Please note that VAP is not payable on items provided to inpatients of a hospital or day surgery, Coordinated Veterans’ Care Program UP items and Telehealth consultation items. Items 10990,10991 and 10992 are VAP incentives and are paid at 100% of the MBS fee.

The REI loading is available to lmos who provide services to veterans in designated rural public hospitals by State or Territory governments. The REI only applies to those In Hospital items indicated in the Local Medical Officer Fee Schedule. The REI loading of 10% is added to 100% of the MBS fee prior to the LMO fee calculation.

For items not listed in the Derived Fees schedule please refer to the appropriate schedule in this booklet.

• For medical attendances and consultations provided by general practitioners participating in DVA’s Local Medical Officer Scheme, please use the Local Medical Fee Schedule for the relevant fees.





item Nos. Patients lmo fee

43 1 $133.55

2 $107.20

3 $98.40

4 $94.05

5 $91.40

6 $89.65

7+ $84.60

47 1 $148.30

2 $133.65

3 $128.80

4 $126.35

5 $124.90

6 $123.95

7+ $121.30

51 1 $171.70

2 $145.40

3 $136.60

4 $132.20

5 $129.55

6 $127.85

7+ $122.80

58 1 $27.60

2 $18.70

3 $15.70

4 $14.25

5 $13.35

6 $12.80

7+ $10.60

59 1 $38.55

2 $28.50

3 $25.15

4 $23.45

5 $22.45

6 $21.75

7+ $19.25


60 1 $58.65

2 $49.75

3 $46.75

4 $45.30

5 $44.40

6 $43.85

7 $41.65

65 1 $83.95

2 $75.05

3 $72.05

4 $70.60

5 $69.70

6 $69.15

7 $66.95

92 1 $41.95

2 $25.85

3 $20.50

4 $17.85

5 $16.25

6 $15.15

7+ $11.25

93 1 $54.70

2 $36.55

3 $30.50

4 $27.50

5 $25.65

6 $24.45

7 $19.85

95 1 $73.00

2 $56.90

3 $51.55

4 $48.90

5 $47.30

6 $46.20

7 $42.30



7

Item Nos. Patients Lmo fee

4 1 $48.40

2 $33.70

3 $28.90

4 $26.40

5 $25.00

6 $24.00

7+ $21.35

20 1 $71.80

2 $45.45

3 $36.65

4 $32.30

5 $29.65

6 $27.90

7+ $22.85

24 1 $71.05

2 $56.35

3 $51.55

4 $49.05

5 $47.65

6 $46.65

7+ $44.00

35 1 $94.45

2 $68.10

3 $59.30

4 $54.95

5 $52.30

6 $50.55

7+ $45.50

37 1 $110.15

2 $95.45

3 $90.65

4 $88.15

5 $86.75

6 $85.75

7+ $83.10



2147 1 $138.50

2 $123.80

3 $119.00

4 $116.50

5 $115.10

6 $114.10

7+ $111.45

2179 1 $161.90

2 $135.55

3 $126.75

4 $122.40

5 $119.75

6 $118.00

7+ $112.95

2199 1 $189.95

2 $175.30

3 $170.45

4 $168.00

5 $166.55

6 $165.55

7+ $162.90

2220 1 $213.35

2 $187.00

3 $178.20

4 $173.85

5 $171.20

6 $169.50

7+ $164.40

2503,2518,2547

1 $71.05

2 $56.35

3 $51.55

4 $49.05

5 $47.65

6 $46.65

7+ $44.00


2506,2522,2553

1 $110.15

2 $95.45

3 $90.65

4 $88.15

5 $86.75

6 $85.75

7+ $83.10

2509,2526,2559

1 $148.30

2 $133.65

3 $128.80

4 $126.35

5 $124.90

6 $123.95

7+ $121.30

2610 1 $38.55

2 $28.50

3 $25.15

4 $23.45

5 $22.45

6 $21.75

7+ $19.25

2613 1 $58.65

2 $49.75

3 $46.75

4 $45.30

5 $44.40

6 $43.85

7+ $41.65

2616 1 $83.95

2 $75.05

3 $72.05

4 $70.60

5 $69.70

6 $69.15

7+ $66.95



96 1 $98.30

2 $82.20

3 $76.85

4 $74.20

5 $72.60

6 $71.50

7+ $67.60

2122 1 $55.10

2 $40.45

3 $35.60

4 $33.15

5 $31.70

6 $30.75

7+ $28.10

2125 1 $78.50

2 $52.20

3 $43.40

4 $39.00

5 $36.35

6 $34.65

7+ $29.60

2137 1 $85.60

2 $70.90

3 $66.10

4 $63.60

5 $62.20

6 $61.20

7+ $58.55

2138 1 $109.00

2 $82.65

3 $73.85

4 $69.50

5 $66.85

6 $65.10

7+ $60.05


2677 1 $83.95

2 $75.05

3 $72.05

4 $70.60

5 $69.70

6 $69.15

7+ $66.95

2723 1 $133.90

2 $119.20

3 $114.40

4 $111.90

5 $110.50

6 $109.50

7+ $106.85

2727 1 $175.65

2 $161.25

3 $156.50

4 $154.05

5 $152.65

6 $151.65

7+ $149.05

5003 1 $62.00

2 $47.35

3 $42.50

4 $40.05

5 $38.60

6 $37.65

7+ $35.00

5010 1 $85.40

2 $59.10

3 $50.30

4 $45.90

5 $43.25

6 $41.55

7+ $36.50


5023 1 $84.55

2 $69.90

3 $65.05

4 $62.60

5 $61.15

6 $60.15

7+ $57.50

5028 1 $107.95

2 $81.60

3 $72.80

4 $68.45

5 $65.80

6 $64.10

7+ $59.00

5043 1 $123.95

2 $109.25

3 $104.45

4 $101.95

5 $100.55

6 $99.55

7+ $96.90

5049 1 $147.35

2 $121.00

3 $112.20

4 $107.85

5 $105.20

6 $103.45

7+ $98.40

5063 1 $162.05

2 $147.40

3 $142.55

4 $140.10

5 $138.65

6 $137.70

7+ $135.00



9


2631 1 $38.55

2 $28.50

3 $25.15

4 $23.45

5 $22.45

6 $21.75

7+ $19.25

2633 1 $58.65

2 $49.75

3 $46.75

4 $45.30

5 $44.40

6 $43.85

7+ $41.65

2635 1 $83.95

2 $75.05

3 $72.05

4 $70.60

5 $69.70

6 $69.15

7+ $66.95

2673 1 $38.55

2 $28.50

3 $25.15

4 $23.45

5 $22.45

6 $21.75

7+ $19.25

2675 1 $58.65

2 $49.75

3 $46.75

4 $45.30

5 $44.40

6 $43.85

7+ $41.65



5260 1 $53.45

2 $37.35

3 $32.00

4 $29.35

5 $27.75

6 $26.65

7+ $22.75

5263 1 $66.20

2 $48.05

3 $42.00

4 $39.00

5 $37.15

6 $35.95

7+ $31.35

5265 1 $84.50

2 $68.40

3 $63.05

4 $60.40

5 $58.80

6 $57.70

7+ $53.80

5267 1 $109.80

2 $93.70

3 $88.35

4 $85.70

5 $84.10

6 $83.00

7+ $79.10



5067 1 $185.45

2 $159.15

3 $150.35

4 $145.95

5 $143.30

6 $141.60

7+ $136.55

5220 1 $39.10

2 $30.20

3 $27.20

4 $25.75

5 $24.85

6 $24.30

7+ $22.10

5223 1 $50.05

2 $40.00

3 $36.65

4 $34.95

5 $33.95

6 $33.25

7+ $30.75

5227 1 $70.15

2 $61.25

3 $58.25

4 $56.80

5 $55.90

6 $55.35

7+ $53.15

5228 1 $95.45

2 $86.55

3 $83.55

4 $82.10

5 $81.20

6 $80.65

7+ $78.45



11

Repatriation medical fee schedule1 November 2012

The fees listed in the Repatriation Medical Fee Schedule (RMFS) are for specialist consultations and procedures.

In Hospital items have been calculated with consideration given to private health industry rates.

Out of Hospital items have been calculated based on the Medicare Benefits Schedule (MBS) at a rate of 135% of the MBS for consultations and 140% of the MBS for procedures.

All medical practitioners, including lmos and general practitioners, who have the appropriate qualifications updated with Medicare Australia, are eligible to claim for services listed in the RMFS. Items listed on the RMFS do not attract the Veterans Access Payment (VAP) or the Rural Enhancement Initiative (REI) loading.

When claiming an RMFS item using the DVA treatment service voucher, electronic funds transfer or your own stationery, please ensure that you have correctly indicated whether you have performed the service In Hospital or Out of Hospital and claimed at the appropriate rate. Whether a service is considered In Hospital or Out of Hospital is assessed as per Medicare assessment rules.

For items not listed in the RMFS please refer to the appropriate schedule in this booklet.


• For derived fees for Local Medical Officers, please use the Derived Fees for Local MedicalOfficers Fee Schedule.


• For diagnostic imaging services please use the Diagnostic Imaging Fee Schedule.

• For pathology services please use the Pathology Fee Schedule.


rmfs in item Hospital

rmfs out of

% Hospital %

289 356.35 356.30

291 611.10

293 382.00

296 351.45

297 358.85

299 420.30

300 58.55

302 116.75

304 179.70

306 247.95

308 287.80

310 29.20

312 58.55

314 90.00

316 124.15

318 143.95

319 247.95

320 59.90

322 119.25

324 183.55

326 253.35

328 293.80

330 107.40

332 168.30

334 245.25

336 296.70

338 336.90

342 68.15 66.60

344 90.40 88.40

346 133.60 130.70

348 174.90 171.15

350 241.45 236.25

352 174.90 171.15

353 68.80 77.25

355 137.20 154.55

356 201.20 226.55

357 277.55 312.50

358 338.15 380.70


Rmfs in item Hospital

Rmfs out of

% Hospital %

99 D

104 118.10 115.50

105 59.40 58.05

106 98.00 95.85

107 169.45

108 107.30

109 265.95 260.30

110 208.15 203.75

112 D

116 104.25 101.95

119 59.40 58.05

122 247.20

128 149.55

131 107.70

132 363.00 356.30

133 181.75 178.35

135 363.00 356.30

137 363.00 356.30

139 175.40

141 622.55 611.10

143 389.20 382.00

145 740.95

147 463.20

149 D

160 299.45 293.20

161 498.95 488.60

162 698.25 683.80

163 898.00 879.55

164 997.95 977.30

170 138.15 155.60

171 145.55 163.90

172 177.15 199.50

173 29.95 29.25

193 49.05

195 D 23.83

197 94.95

199 139.75

288 D


rmfs out of

% Hospital %

828 295.35

830 191.85 187.80

832 287.80 281.75

834 383.40 375.55

835 137.85 134.90

837 219.75 215.10

838 301.65 295.35

855 191.85 187.80

857 287.80 281.75

858 383.40 375.55

861 191.85 187.80

864 287.80 281.75

866 383.40 375.55

871 110.80 108.45

872 51.60 50.50

880 67.10

2100 25.85

2122 D

2125 D

2126 56.30

2137 D

2138 D

2143 109.20

2147 D

2179 D

2195 160.70

2199 D

2220 D

2801 208.15 203.75

2806 104.25 101.95

2814 59.40 58.05

2820 D

2824 247.20

2832 149.55

2840 107.70

2946 191.85 187.80

2949 287.80 281.75

2954 383.40 375.55



13

Item

Rmfs rmfs in out ofHospital % Hospital %

359 447.55 439.25

361 411.70 404.10

364 59.90 58.55

366 119.25 116.75

367 174.90 179.70

369 241.45 248.15

370 293.80 287.80

385 118.10 115.50

386 59.40 58.05

387 173.05 169.45

388 109.60 107.30

389 D

410 26.40

411 57.75

412 111.60

413 164.30

414 D 37.97 D

415 D 37.75 D

416 D 37.89 D

417 D 37.85 D

501 46.20

503 78.05

507 131.05

511 185.40

515 287.05

519 197.40

520 379.15

530 621.45

532 863.70

534 1,106.15

536 1,227.30

598 144.45 141.45

600 171.25 167.75

820 187.80

822 281.75

823 375.55

825 134.90

826 215.10



rmfs out of

% Hospital %

10805 167.85 164.25

10806 167.85 164.25

10807 167.85 164.25

10808 167.85 164.25

10809 167.85 164.25

10816 167.85 164.25

10950 62.25

10952 62.25

10956 62.25

11000 154.50 172.35

11003 393.60 456.00

11004 392.60 456.00

11005 392.60 456.00

11006 201.30 233.80

11009 274.55 318.85

11012 135.25 156.80

11015 180.70 209.90

11018 269.95 313.55

11021 218.30 209.90

11024 137.35 159.40

11027 203.55 236.50

11200 53.55 57.15

11204 142.35 151.55

11205 142.35 151.55

11210 156.20 151.55

11211 142.35 151.55

11215 183.80 172.20

11218 283.05 212.75

11221 103.50 94.85

11222 89.20 94.85

11224 53.60 57.20

11225 53.60 57.20

11235 161.40 171.85

11237 107.20 114.05

11240 106.05 114.05

11241 136.40 145.15

11242 105.40 112.15

11243 105.40 112.15



Rmfs out of

% Hospital %

2958 137.90 134.90

2972 219.75 215.10

2974 301.70 295.35

2978 191.85

2984 287.80

2988 383.40

2992 134.90

2996 215.10

3000 295.35

3005 208.15 203.75

3010 104.25 101.95

3014 59.40 58.05

3015 D

3018 247.20

3023 149.55

3028 107.70

3032 191.85 187.80

3040 287.80 281.75

3044 383.40 375.55

3051 137.90 134.90

3055 219.75 215.10

3062 301.70 295.35

3069 191.85

3074 287.80

3078 383.40

3083 134.90

3088 215.10

3093 295.35

6007 178.75 175.00

6009 59.40 58.05

6011 118.10 115.50

6013 163.45 160.00

6015 208.15 203.75

6016 D

10801 167.85 164.25

10802 167.85 164.25

10803 167.85 164.25

10804 167.85 164.25


rmfs out of

% Hospital %

11712 183.40 213.05

11713 89.30 97.65

11715 145.30 169.05

11718 42.00 48.65

11721 84.15 97.65

11722 42.00 48.65

11724 203.55 236.50

11727 124.45 132.65

11800 209.50 244.25

11810 209.50 244.25

11820 2,447.05 2,854.90

11823 2,447.05 2,854.90

11830 224.15 261.55

11833 299.90 349.65

11900 34.40 38.60

11903 134.05 155.55

11906 134.05 155.55

11909 199.05 231.25

11912 216.65 231.25

11915 199.05 231.25

11917 521.35 599.70

11919 515.00 599.70

11921 98.55 105.10

12000 56.30 54.55

12003 113.55 82.40

12012 25.05 29.15

12015 75.00 87.45

12018 96.60 112.50

12021 141.50 165.00

12200 44.75 52.10

12201 2,871.65 3,350.10

12203 705.75 823.20

12207 705.75 823.20

12210 842.30 982.60

12213 758.95 885.25

12215 842.30 982.60

12217 758.95 885.25

12250 402.50 469.45



15

Item


11300 253.30 269.45

11303 253.30 269.45

11304 416.75 443.75

11306 28.90 30.70

11309 36.80 36.85

11312 52.30 52.05

11315 72.95 68.90

11318 90.75 85.05

11321 151.75 161.50

11324 44.45 46.00

11327 29.20 27.65

11330 10.40 11.10

11332 76.90 82.00

11333 58.65 62.45

11336 58.65 62.45

11339 58.65 62.45

11500 288.75 233.80

11503 173.70 194.15

11506 25.30 28.80

11509 43.10 49.95

11512 74.45 86.45

11600 96.90 97.05

11602 74.50 80.85

11604 90.90 106.00

11605 90.90 106.00

11610 76.65 89.25

11611 77.90 89.25

11612 134.90 157.40

11614 95.95 106.00

11615 102.45 106.30

11627 300.65 320.15

11700 38.35 43.75

11701 19.05 21.80

11702 20.05 21.80

11708 154.30 179.10

11709 201.95 234.45

11710 62.60 72.70

11711 34.20 39.65



rmfs out of

% Hospital %

13215 161.50 155.55

13218 1,130.65 1,111.00

13221 71.55 71.15

13251 580.00 585.15

13290 275.70 285.95

13292 551.25 572.20

13300 68.50 79.75

13303 101.30 118.20

13306 401.00 467.75

13309 341.90 398.80

13312 45.65 39.85

13318 273.00 318.45

13319 273.00 318.45

13400 116.30 135.55

13500 216.45 252.45

13503 432.90 505.00

13506 221.45 258.30

13700 401.70 466.55

13703 144.05 167.30

13706 100.65 116.70

13709 64.05 67.85

13750 164.85 191.35

13755 180.45 191.35

13757 87.95 102.15

13760 918.95 1,067.65

13815 102.75 119.35

13818 137.10 159.20

13830 90.85 105.50

13839 29.10 32.30

13842 83.60 97.05

13847 188.00 218.55

13848 162.60 183.50

13851 594.50 691.15

13854 189.00 160.80

13857 176.50 205.00

13870 434.70 506.95

13873 322.45 376.05

13876 98.10 107.70



Rmfs out of

% Hospital %

12306 122.95 143.40

12309 122.95 143.40

12312 122.95 143.40

12315 129.25 143.40

12318 122.95 143.40

12321 129.70 143.40

12323 129.80 143.40

12500 260.05 303.35

12503 509.90 594.65

12506 364.10 424.65

12509 260.05 303.35

12512 126.20 147.10

12515 275.95 321.80

12518 126.20 147.10

12521 152.05 177.35

12524 190.05 221.70

12527 102.10 118.95

12530 152.05 177.35

12533 101.65 118.55

13015 305.85 356.65

13020 310.60 362.40

13025 138.95 162.00

13030 196.25 228.85

13100 195.45 191.35

13103 85.50 99.70

13104 207.15

13106 145.80 169.90

13109 273.30 318.85

13110 274.35 319.90

13112 183.80 191.35

13200 4,258.65 4,355.05

13201 3,983.45 4,073.65

13202 637.40 651.80

13203 674.25 681.45

13206 1,172.30 651.80

13209 122.25 118.60

13210 D

13212 467.05 496.25


rmfs out of

% Hospital %

14233 450.95

14236 822.20

14239 198.75

14242 590.10

14245 122.00 137.15

15000 56.00 59.60

15003 D 31.25 D $40.00

15006 142.70 132.10

15009 D 31.46 D $40.00

15012 85.75 74.85

15100 63.00 66.80

15103 D D

15106 74.15 78.85

15109 D D

15112 157.75 168.35

15115 D 31.15 D $40.00

15211 66.90 76.60

15214 D 22.13 D $40.00

15215 74.70 83.55

15218 74.70 83.55

15221 102.40 83.55

15224 73.25 83.55

15227 90.30 83.55

15230 D 25.02 D $40.00

15233 D 25.02 D $40.00

15236 D 71.28 D $40.00

15239 D 22.56 D $40.00

15242 D 51.09 D $40.00

15245 89.60 83.55

15248 74.70 83.55

15251 84.40 83.55

15254 88.65 83.55

15257 89.80 83.55

15260 D 49.86 D $40.00

15263 D 25.02 D $40.00

15266 D 41.23 D $40.00

15269 D 48.25 D $40.00

15272 D 50.14 D $40.00



17

Item


13881 175.75 205.00

13882 138.45 161.35

13885 184.50 215.15

13888 92.40 107.70

13915 78.20 91.10

13918 117.55 137.15

13921 133.15 155.15

13924 78.45 91.35

13927 101.30 118.20

13930 141.45 164.95

13933 156.95 183.00

13936 102.35 119.25

13939 117.55 137.15

13942 78.45 91.35

13945 63.20 73.50

13948 78.45 91.35

14050 63.65 73.85

14053 63.65 73.85

14100 216.75 213.50

14106 222.45 213.50

14109 274.65 262.30

14112 296.60 310.45

14115 309.35 359.10

14118 433.90 456.05

14124 183.90 213.50

14200 82.55 83.75

14201 312.00 331.60

14202 157.90 167.90

14203 67.25 71.65

14206 46.95 49.85

14209 116.65 124.20

14212 244.65 259.45

14215 128.80 137.15

14218 128.80 137.15

14221 63.25 73.50

14224 89.20 98.50

14227 122.00 137.15

14230 371.35



rmfs out of

% Hospital %

15533 848.55 934.80

15536 362.85 373.70

15539 790.25 878.25

15550 794.30 922.05

15553 856.90 994.80

15556 801.20 930.20

15559 1,045.00 1,213.20

15562 1,351.50 1,569.05

15600 2,042.95 2,383.25

15700 59.70 64.35

15705 99.40 107.25

15710 99.40 107.25

15800 125.00 134.85

15850 356.00 279.30

16003 812.40 910.70

16006 600.00 699.80

16009 409.45 477.65

16012 354.40 413.25

16015 4,902.95 5,720.00

16018 2,930.95 3,419.45

16399 D

16400 38.15

16401 118.10 119.80

16404 59.40 60.20

16406 193.45 187.55

16500 68.15 66.05

16501 191.65 196.80

16502 60.90

16504 56.65 66.05

16505 61.95

16508 58.05

16509 58.60 66.05

16511 361.80 307.95

16512 105.30 88.90

16514 49.15 51.35

16515 937.95 630.95

16518 729.65 630.95

16519 1,824.30 971.55



Rmfs out of

% Hospital %

15303 430.30 499.80

15304 430.30 499.80

15307 815.70 947.55

15308 815.70 947.55

15311 401.65 466.50

15312 398.80 463.15

15315 788.55 915.95

15316 1,114.85 915.95

15319 489.35 568.50

15320 489.35 568.50

15323 870.00 1,010.80

15324 870.00 1,010.80

15327 1,323.40 1,099.65

15328 946.65 1,099.65

15331 902.35 1,044.15

15332 1,121.65 1,044.15

15335 815.70 947.55

15336 815.70 947.55

15338 1,268.75 1,309.85

15339 91.95 106.70

15342 229.45 266.45

15345 637.40 710.95

15348 70.55 81.80

15351 140.65 163.25

15354 170.70 198.10

15357 48.20 56.10

15500 305.80 339.75

15503 388.65 436.20

15506 562.25 651.45

15509 262.35 294.45

15512 338.15 379.55

15513 528.25 429.20

15515 493.55 549.50

15518 99.50 107.80

15521 428.90 475.90

15524 768.20 892.30

15527 103.00 110.55

15530 482.65 493.05


rmfs out of

% Hospital %

18222 61.05 52.75

18225 83.60 70.10

18226 466.50 398.75

18227 D 63.77 D $40.00

18228 95.15 87.50

18230 320.90 333.85

18232 271.40 265.90

18233 267.45 265.90

18234 167.45 174.80

18236 87.70 87.50

18238 68.90 52.75

18240 130.30 131.05

18242 57.75 52.75

18244 160.65 141.15

18246 154.70 141.15

18248 129.35 124.15

18250 95.95 87.50

18252 143.80 141.15

18254 147.40 141.15

18256 83.20 87.50

18258 104.50 87.50

18260 128.05 124.15

18262 90.65 87.50

18264 145.10 141.15

18266 98.65 87.50

18268 155.40 124.15

18270 151.55 124.15

18272 105.15 87.50

18274 135.05 124.15

18276 169.40 174.80

18278 128.25 124.15

18280 199.05 174.80

18282 154.70 141.15

18284 215.70 206.75

18286 199.85 206.75

18288 205.40 206.75

18290 383.20 349.65

18292 237.85 174.80



19

Item


16520 2,132.00

16522 2,305.30 2,281.10

16525 1,010.50 538.10

16527 921.35 630.95

16528 2,094.20 1,135.50

16564 299.30 305.20

16567 430.45 446.35

16570 547.00 582.50

16571 418.90 446.35

16573 362.65 363.75

16590 453.75

16591 199.75

16600 116.45 88.90

16603 160.25 170.60

16606 366.35 340.55

16609 652.00 694.40

16612 512.70 546.35

16615 273.20 291.00

16618 273.20 291.00

16621 273.20 291.00

16624 393.35 418.75

16627 800.50 852.55

16633 D D

16636 D D

17609 D

17610 69.45 60.20

17615 138.40 119.80

17620 191.70 165.90

17625 244.10 211.30

17640 69.45 60.20

17645 138.40 119.80

17650 191.70 165.90

17655 244.10 211.30

17680 138.40 119.80

17690 55.40

18213 131.65 124.15

18216 302.45 265.90

18219 D 59.25 D $40.00



rmfs out of

% Hospital %

30048 196.55 209.65

30049 243.65 259.85

30052 338.90 355.60

30055 99.45 103.50

30058 187.25 202.10

30061 32.95 32.90

30062 81.10 85.05

30064 133.75 153.90

30067 383.05 313.05

30068 383.05 387.55

30071 69.65 73.10

30074 205.40 164.60

30075 205.40 209.65

30078 61.75 67.85

30081 137.85 153.90

30084 72.40 82.35

30087 39.40 41.25

30090 159.45 180.00

30093 228.95 240.20

30094 252.75 265.20

30096 279.65 257.50

30097 132.05 136.05

30099 120.10 126.00

30102 229.20 209.65

30103 229.20 257.50

30104 197.20 177.70

30106 296.10 217.60

30107 296.10 307.95

30110 495.70 398.10

30111 495.70 520.10

30114 447.80

30165 817.95 636.80

30168 606.85 636.80

30171 1,292.35 968.45

30174 922.70 968.45

30177 1,315.05

30180 182.10 191.10

30183 328.75 345.10



Rmfs out of

% Hospital %

18294 232.20 246.40

18296 246.80 210.80

18298 332.95 246.40

18350 178.05 174.80

18351 178.05 174.80

18352 383.20 349.65

18354 211.15 174.80

18356 217.65 174.80

18358 191.65 174.80

18360 227.65 174.80

18361 227.65 174.80

18362 378.50 345.40

18364 191.65 174.80

18366 195.85 219.00

18368 409.65 373.90

18370 69.20 63.10

18371 61.40 63.10

18372 191.65 174.80

18373 191.65 174.80

30001 D D $40.00

30003 46.45 50.85

30006 62.25 65.10

30009 98.65

30010 98.65

30013 207.45

30014 207.45

30017 438.75 456.50

30020 795.05

30023 435.00 456.50

30024 435.00 456.50

30026 69.65 73.10

30029 120.10 126.00

30032 110.25 115.50

30035 152.95 164.60

30038 149.85 126.00

30041 250.25 201.60

30042 250.25 259.85

30045 157.00 164.60


rmfs out of

% Hospital %

30266 217.70 209.65

30269 199.85 209.65

30272 398.30 414.00

30275 2,548.40

30278 59.70 65.10

30281 148.85 167.30

30282 302.60 217.60

30283 302.60 286.60

30286 598.90 557.00

30289 623.30

30293 594.25 623.60

30294 3,202.45

30296 1,513.60

30297 1,520.00

30299 850.50

30300 1,020.55

30302 680.30

30303 816.35

30306 1,218.20

30308 1,235.05

30309 1,623.65

30310 593.15

30313 498.70 382.15

30314 694.60

30315 1,770.00

30317 2,051.80

30318 1,210.85

30320 1,780.65

30321 1,210.85

30323 2,086.85

30324 2,095.55

30329 329.45 345.75

30330 982.50

30332 461.50

30335 1,273.05

30336 1,489.40

30373 606.25

30375 695.40



21

Item


30185 252.25 255.50

30186 62.75 66.45

30187 360.30 359.75

30189 179.55 206.25

30190 596.40 556.85

30192 52.95 55.40

30195 84.70 88.90

30196 168.50 176.85

30197 734.15 616.10

30202 64.60 67.70

30203 227.20 238.35

30205 168.50 176.85

30207 59.65 62.45

30210 267.30

30213 146.55 153.75

30214 146.55 153.75

30216 36.60 38.30

30219 38.30

30223 201.05

30224 317.15 332.65

30225 345.20 374.75

30226 199.85 209.65

30229 364.25 382.15

30232 298.40 313.05

30235 394.50 414.00

30238 199.85 209.65

30241 495.90 498.90

30244 475.50

30246 1,014.25

30247 986.20

30250 1,695.50

30251 2,588.55 2,690.45

30253 1,180.30

30255 1,714.70

30256 681.30

30259 266.85 277.90

30262 78.65 82.35

30265 217.70 164.60



rmfs out of

% Hospital %

30433 968.75

30434 784.70

30436 871.95

30437 1,084.85

30438 1,488.10 1,611.20

30439 247.85

30440 702.20 737.00

30441 181.75

30442 247.85

30443 986.20

30445 1,082.45

30446 1,071.40

30448 1,400.80

30449 1,558.75

30450 699.45 734.20

30451 357.25 374.75

30452 503.75

30454 1,143.65

30455 1,267.45

30457 1,800.25 1,931.30

30458 1,401.65

30460 1,282.50

30461 1,972.50

30463 3,057.70

30464 4,086.30

30466 1,675.60

30467 2,072.65

30469 2,694.30 2,409.30

30472 1,239.80 1,301.10

30473 236.45 247.95

30475 427.35 448.35

30476 327.65 343.80

30478 327.65 343.80

30479 576.80 666.55

30481 476.35 499.80

30482 338.75 355.40

30483 236.40 247.90

30484 486.90 510.90



Rmfs out of

% Hospital %

30376 673.75

30378 698.65

30379 1,238.25

30382 1,784.40

30384 1,464.60

30385 790.65

30387 866.80

30388 1,964.30

30390 293.50

30391 379.50

30392 899.90

30393 698.65

30394 657.45

30396 1,223.60

30397 310.15

30399 426.45

30400 843.80

30402 619.90

30403 695.40

30405 1,195.20

30406 71.70 73.10

30408 588.55

30409 232.95 244.25

30411 118.60

30412 69.85 73.30

30414 920.25

30415 2,047.60

30416 999.25

30417 1,529.30

30418 2,119.50

30419 1,090.25 1,143.95

30421 3,131.25

30422 900.90

30425 1,651.20

30427 2,071.30

30428 2,796.30 2,338.00

30430 3,099.40 3,252.65

30431 695.40 729.75

rmfs in item

rmfs

3053

1,107.65

3054

2,458.45

3054

1,375.45

3054

965.30

3054

2,450.70

3054

1,616.55

1,768.70

3054

1,816.45

1,321.35

3055

2,750.75

3055

1,898.45

3055

1,325.45

1,473.75

3055

3,060.80

3055

2,111.55

3055

1,559.45

3055

1,136.75

1,189.40

3056

1,374.30

3056

790.95

3056

794.00

833.00

3056

1,030.25

3056

1,162.30

3056

1,291.20

3056

875.60

3056

494.10

3057

605.15

3057

634.60

3057

164.60

3057

669.70

3057

1,464.05

3057

1,444.75

3058

1,305.80

3058

1,067.75

3058

1,593.30

3058

2,503.35

3058

935.60

3058

968.75

3058

1,669.05

3059

1,947.60

3059

2,570.75

2,642.85

3059

3,085.75



23

Item


30485 729.55 788.65

30487 241.55 253.30

30488 120.10 126.00

30490 635.10 737.00

30491 740.95 777.50

30492 1,049.75

30493 444.70 466.50

30494 561.00

30495 1,049.75

30496 784.70 823.45

30497 935.60

30499 1,113.00

30500 1,191.40 1,250.35

30502 1,315.05

30503 1,472.40 1,545.35

30505 719.70

30506 1,288.45

30508 1,356.20

30509 1,356.20 1,423.20

30511 1,133.40

30512 1,394.80

30514 2,079.30

30515 939.50

30517 1,230.20

30518 1,317.35

30520 900.90

30521 2,071.95

30523 2,013.15

30524 2,301.15

30526 2,976.50

30527 1,233.75

30529 1,743.55

30530 1,046.20

30532 1,201.40

30533 1,559.55

30535 2,859.65

30536 2,653.40

30538 1,765.70



rmfs out of

% Hospital %

30687 576.80 666.55

30688 485.50 510.90

30690 749.35 788.65

30692 485.50 510.90

30694 749.35 788.65

30696 749.35 788.65

30710 749.35 788.65

31000 746.10 813.30

31001 1,114.45 1,016.50

31002 1,175.55 1,219.85

31200 45.45 47.60

31205 127.20 133.65

31210 164.45 172.35

31215 200.65 201.00

31220 295.45 300.40

31225 493.75 533.85

31230 224.20 235.30

31235 191.60 201.00

31240 224.20 235.30

31245 561.80 516.60

31250 627.45 516.60

31255 295.35 309.90

31256 295.30 309.90

31257 295.30 309.90

31258 295.30 309.90

31260 421.25 441.95

31261 420.95 441.95

31262 420.95 441.95

31263 420.95 441.95

31265 246.20 258.30

31266 226.60 258.30

31267 246.05 258.30

31268 246.05 258.30

31270 344.75 361.55

31271 344.50 361.55

31272 344.50 361.55

31273 344.50 361.55

31275 399.25 418.95



Rmfs out of

% Hospital %

30596 1,197.10

30597 960.90

30599 1,865.50

30600 1,036.95

30601 1,277.05

30602 2,072.65

30603 2,189.20 2,297.30

30605 2,753.55

30606 1,481.95

30609 683.55

30612 601.15

30614 601.15

30615 693.95

30616 452.75

30617 452.75

30620 490.35

30621 490.35

30628 47.65 49.85

30631 310.45 331.35

30634 472.45

30635 472.45

30638 541.00

30641 541.00

30644 792.75

30653 62.25 65.10

30656 144.25 151.45

30659 299.05 209.65

30660 299.05 259.85

30663 226.80 202.10

30666 84.30 66.45

30672 622.55

30675 512.35 419.25

30676 512.35 530.70

30679 117.90 134.85

30680 1,408.95 1,638.00

30682 1,408.95 1,638.00

30684 1,733.70 2,015.80

30686 1,733.70 2,015.80


rmfs out of

% Hospital %

31432 2,279.65

31435 1,304.10

31438 2,117.15

31441 307.35 352.40

31450 593.25

31452 1,068.00

31454 784.10

31456 296.60

31458 393.25

31460 494.15

31462 695.40

31464 1,321.55

31466 1,735.55

31468 2,141.95

31470 988.75

31472 1,409.05

31500 361.05 364.10

31503 459.35 485.45

31506 526.00

31509 451.80 485.45

31512 865.20

31515 562.00

31518 979.85

31521 618.80 606.90

31524 1,384.25

31527 924.30 728.30

31530 792.70 833.95

31533 177.20 193.10

31536 252.75 265.20

31539 507.35

31542 262.05 275.75

31545 774.20 833.95

31548 171.75 193.10

31551 282.80

31554 584.90

31557 475.20 485.45

31560 467.15 485.45

31563 375.30 363.65



25

Item


31276 399.05 418.95

31277 399.05 418.95

31278 399.05 418.95

31280 207.90 218.20

31281 208.70 219.00

31282 208.70 219.00

31283 208.70 219.00

31285 284.35 298.15

31286 323.10 298.15

31287 284.05 298.15

31288 284.05 298.15

31290 328.25 344.30

31291 314.10 344.30

31292 328.00 344.30

31293 328.00 344.30

31295 417.15 410.00

31300 426.80 447.90

31305 525.00 550.90

31310 371.85 390.15

31315 470.45 493.50

31320 525.00 550.90

31325 361.00 378.80

31330 426.80 447.90

31335 492.30 516.60

31340 D D

31345 292.70 295.35

31346 281.35 295.35

31350 615.50 606.70

31355 939.95 1,000.25

31400 348.35 365.50

31403 401.95

31406 738.55 703.05

31409 2,631.10

31412 2,974.15

31420 237.30 257.50

31423 490.25 562.45

31426 1,072.00

31429 1,882.65



rmfs out of

% Hospital %

32093 593.35 656.90

32094 711.65

32095 164.95 178.95

32096 453.50

32099 444.60

32102 889.50

32103 939.40

32104 1,308.85

32105 692.45 677.55

32106 1,820.45 1,910.45

32108 1,333.60

32111 871.35

32112 1,055.70

32114 232.95 244.25

32115 169.55

32117 1,333.60

32120 342.85

32123 444.60 466.50

32126 645.80

32129 846.60

32131 712.00

32132 60.35 63.15

32135 90.15 94.50

32138 502.50 514.85

32139 560.10

32142 90.15 94.50

32145 180.45 189.10

32147 60.35 63.15

32150 319.05 359.75

32153 97.60

32156 175.80 184.45

32159 433.20

32162 636.75

32165 846.60 888.60

32166 279.25 288.70

32168 173.05

32171 113.25

32174 118.60 124.35



Rmfs out of

% Hospital %

31566 234.70 181.95

32000 1,284.65

32003 1,453.35

32004 1,486.30

32005 1,802.35

32006 1,534.65

32009 1,922.35

32012 2,073.55

32015 2,531.75

32018 1,936.25

32021 843.15

32024 1,981.60

32025 2,558.05

32026 2,718.90

32028 3,093.75

32029 562.05

32030 1,390.00

32033 2,038.25

32036 2,767.00

32039 2,176.35

32042 1,715.85

32045 617.05

32046 1,012.45

32047 1,162.30

32051 3,201.75

32054 2,554.85

32057 751.40

32060 3,490.30

32063 2,836.40

32066 751.40

32069 2,260.15

32072 62.00 67.00

32075 91.65 105.10

32078 207.30 236.00

32081 302.75 324.05

32084 143.70 155.90

32087 264.25 286.60

32090 430.65 468.10

rmfs in item

rmfs

3272

3,051.55

3273

2,312.90

3273

2,640.90

3273

588.85

3273

1,713.95

3274

2,088.55

3274

2,403.50

3274

2,642.25

3275

1,707.35

3275

2,202.30

3275

588.85

3276

578.65

3276

1,574.35

3276

1,123.50

3276

389.70

3305

2,286.25

3305

1,714.35

3307

1,199.10

1,178.80

3307

1,525.45

3308

1,629.15

3310

2,114.95

2,010.85

3310

2,869.15

3310

3,884.15

3,411.10

3311

3,275.15

3311

2,144.20

3311

2,210.45

1,958.60

3311

2,358.70

3311

2,285.10

2,176.40

3312

2,738.15

3312

1,525.65

3312

2,259.05

2,221.45

3313

1,970.15

3313

1,478.65

3313

3,378.10

3313

2,182.90

3314

2,078.20

2,074.10

3314

3,629.30

3314

4,507.60



27

Item


32175 209.85

32177 212.60

32180 342.30

32183 749.30

32186 749.30

32200 394.50 414.00

32203 847.00

32206 731.45

32209 1,229.90

32210 340.85 357.65

32212 181.75

32213 881.45

32214 445.40

32215 167.25 175.60

32216 791.60

32217 208.55

32218 208.55

32220 1,205.85

32221 1,205.85

32500 166.25 153.75

32501 156.65 153.75

32504 381.25 374.75

32507 767.60 747.05

32508 796.00

32511 1,255.05

32514 1,354.55

32517 1,843.85

32520 759.80 747.05

32522 1,129.45 1,110.65

32700 2,174.30

32703 1,763.50

32708 1,971.70

32710 1,948.60

32711 2,866.55

32712 1,551.05

32715 1,633.30

32718 1,691.85

32721 3,154.50



rmfs out of

% Hospital %

33824 1,552.35

33827 1,737.30

33830 2,087.90

33833 1,895.20

33836 2,216.60

33839 3,405.05

33842 1,328.30

33845 805.50

33848 859.35

34100 969.10

34103 588.85

34106 415.50 408.40

34109 453.50 473.70

34112 1,399.20

34115 1,292.30

34118 2,113.50 1,937.15

34121 1,573.90

34124 1,723.75

34127 2,259.05

34130 706.95 694.85

34133 986.80

34136 1,483.15

34139 1,178.75

34142 1,513.15

34145 1,365.60

34148 2,241.70

34151 2,706.60

34154 2,918.85 3,274.25

34157 1,691.85

34160 3,169.10

34163 4,069.00

34166 3,828.50

34169 2,451.60

34172 2,334.55

34175 1,520.95

34500 439.15 431.80

34503 588.85

34506 299.90



Rmfs out of

% Hospital %

33151 5,403.00

33154 3,171.30

33157 3,473.85

33160 3,850.05

33163 3,857.05

33166 2,998.25 2,948.00

33169 2,246.25

33172 1,696.20

33175 1,567.00

33178 2,133.05

33181 3,277.70

33500 1,631.60

33506 1,809.65

33509 2,024.00

33512 2,404.60

33515 2,473.70

33518 1,810.95 1,779.30

33521 1,812.45

33524 2,312.90

33527 2,687.55

33530 2,276.80

33533 2,687.55

33536 1,916.75

33539 1,381.20

33542 2,159.70

33545 389.70

33548 792.65

33551 389.70

33554 388.00

33800 1,585.65 1,652.85

33803 1,606.10

33806 1,156.50 1,137.05

33810 843.75 829.45

33811 3,295.15

33812 1,212.90 1,305.45

33815 1,220.90

33818 1,265.05

33821 1,638.60


rmfs out of

% Hospital %

35312 1,230.50

35315 1,230.50

35317 507.00 498.15

35319 787.25 892.95

35320 1,219.70 1,199.40

35321 1,157.95 1,138.65

35324 434.25

35327 581.80

35330 734.05 721.50

35331 843.75

35360 1,179.00

35361 890.10

35362 843.50

35363 675.75

35404 395.50

35406 1,128.10

35408 846.25

35410 1,128.10 1,138.65

35412 3,963.45 4,000.60

35500 112.80 113.85

35502 98.55 112.25

35503 66.55 75.00

35506 76.70 75.20

35507 218.20

35508 386.70

35509 116.65 125.25

35512 354.95 251.20

35513 354.95 310.40

35516 211.65 162.90

35517 211.65 204.40

35518 297.00 291.00

35520 92.60 81.65

35523 106.05 81.65

35526 207.70 162.90

35527 207.70 204.40

35530 338.85

35533 459.65 489.80

35536 525.25 487.85



29

Item


34509 1,295.50

34512 1,366.40

34515 1,092.10

34518 1,779.15

34521 1,124.85

34524 704.90

34527 716.65 772.25

34528 330.35 381.40

34530 253.05

34533 1,766.65 1,736.95

34538 350.10 381.40

34539 246.55

34800 1,156.50 1,137.05

34803 2,377.50

34806 1,381.20

34809 1,381.20

34812 1,670.10

34815 1,785.30

34818 1,709.25

34821 2,066.70 2,032.05

34824 607.35

34827 856.60

34830 1,190.25 989.80

34833 1,371.60

35000 941.00 989.80

35003 1,396.25

35006 1,638.25

35009 1,722.95

35012 1,007.00

35100 452.60

35103 334.05

35200 244.40

35202 1,163.55

35300 734.05 721.50

35303 809.30 925.15

35306 754.25 853.90

35307 1,596.70

35309 935.35 1,067.30



rmfs out of

% Hospital %

35623 1,158.40

35626 116.50 115.95

35627 152.75

35630 242.90

35633 348.75 305.20

35634 851.80 960.00

35635 449.30

35636 653.75

35637 614.50

35638 1,158.95

35639 260.75

35640 260.75

35641 2,210.85

35643 325.45 305.20

35644 297.40 285.15

35645 449.50 446.20

35646 306.95

35647 314.80 285.15

35648 511.50 446.20

35649 782.10

35653 1,030.35

35657 957.20

35658 592.45

35661 1,380.25

35664 2,366.00

35667 1,852.90

35670 1,518.05

35673 1,085.15

35674 309.35 291.00

35676 798.75

35677 798.75

35678 1,009.10

35680 882.20 814.90

35683 684.55

35684 684.55

35687 536.00

35688 536.00

35691 226.85



Rmfs out of

% Hospital %

35539 408.50 382.15

35542 507.70 447.45

35545 241.65 257.05

35548 1,402.35

35551 973.85

35554 60.25 60.90

35557 269.15 300.30

35560 859.25

35561 1,749.45

35562 1,612.75

35564 744.55

35565 877.75

35566 623.50

35568 889.30

35569 196.80 225.20

35570 788.70

35571 788.70

35572 149.15

35573 1,209.25

35577 1,158.35

35578 984.40

35595 1,946.95

35596 973.85

35597 2,214.85

35599 948.60

35602 1,116.10

35605 521.10 512.35

35608 91.10 89.60

35611 91.10 89.60

35612 720.50 708.40

35613 576.65

35614 90.95 89.50

35615 76.70 75.20

35616 660.00

35617 330.00 243.20

35618 330.00 305.20

35620 76.05 74.70

35622 859.05


rmfs out of

% Hospital %

36543 1,842.30 1,807.55

36546 1,001.35 968.00

36549 1,231.90

36552 1,179.55

36558 960.90 909.75

36561 208.25 241.50

36564 1,366.50

36567 1,761.45

36570 2,018.40

36573 1,310.30

36576 1,655.40

36579 1,096.45

36585 1,096.45

36588 1,275.80

36591 1,708.15

36594 1,367.25

36597 1,367.25

36600 1,878.65 1,551.15

36603 1,859.40

36604 395.95 374.75

36605 1,017.85

36606 3,424.20

36607 1,289.55

36608 394.50

36609 932.35

36612 794.70

36615 1,096.45

36618 960.90

36621 703.20

36624 825.25 781.35

36627 932.25

36630 547.80

36633 906.20 1,038.10

36636 591.45

36639 1,262.30

36642 615.95

36645 1,734.05

36648 1,417.30



31

Item


35694 793.40

35697 1,347.40

35700 1,310.50

35703 96.10 94.50

35706 96.10 94.50

35709 62.15 60.90

35710 659.90

35712 569.75

35713 569.75

35716 672.50

35717 672.50

35720 960.60

35723 687.80

35726 687.80

35729 310.20

35750 1,340.45

35753 1,483.45

35754 1,890.45

35756 1,271.35

35759 798.35

36500 1,367.25

36502 894.95

36503 1,805.95

36506 1,367.25

36509 978.30

36516 1,307.20

36519 1,864.90

36522 1,760.55

36525 2,313.90

36526 2,295.00 1,807.55

36527 2,316.05 2,230.80

36528 2,040.30

36529 2,457.25

36531 1,625.90

36532 2,457.70

36533 3,026.15

36537 976.00

36540 1,522.25 1,551.15



rmfs out of

% Hospital %

37000 1,096.45

37004 960.90

37008 615.95 583.05

37011 138.05 130.70

37014 1,576.55

37020 1,096.45

37023 615.95

37026 615.95

37029 1,647.85

37038 1,023.10

37041 69.05 65.25

37042 1,346.95

37043 935.65

37044 987.55

37045 2,112.55

37047 2,037.80

37050 1,096.45

37053 1,266.80

37200 1,643.40

37201 1,568.55

37202 615.25 582.50

37203 1,560.55

37206 825.25

37207 1,281.30

37208 615.25

37209 1,909.10

37210 3,067.55

37211 3,530.90

Ur372 5,296.30

37212 374.65

37215 500.70 583.05

37217 204.60 193.65

37218 204.60 193.65

37219 436.75 393.20

37220 1,544.10

37221 689.65

37223 305.05

37224 425.85 452.50



Rmfs out of

% Hospital %

36649 395.95 374.75

36650 220.70

36652 842.25

36654 1,130.60

36656 1,582.70

36658 750.15 737.00

36660 364.15 357.65

36662 869.70 854.45

36663 942.05 925.35

36664 845.95 831.00

36665 178.70 175.60

36666 475.95 467.60

36667 222.85 218.85

36668 222.85 218.85

36800 35.50 38.65

36803 634.65 652.90

36806 898.45

36809 1,269.35

36811 437.95 452.80

36812 205.75 233.40

36815 308.75 333.10

36818 409.00 387.25

36821 478.05 452.50

36824 315.30 298.45

36825 719.20

36827 340.00 321.80

36830 300.65

36833 409.00 387.25

36836 297.40 321.80

36840 462.65 452.50

36842 401.40

36845 938.65 968.00

36848 340.00

36851 329.70

36854 689.65

36857 559.70

36860 439.90 233.40

36863 759.70


rmfs out of

% Hospital %

37417 883.45

37418 1,101.45 1,038.10

37420 542.05

37423 1,266.05

37426 1,441.10

37429 478.05

37432 1,635.95

37435 127.30 130.70

37438 376.05 387.25

37444 1,478.15 1,399.55

37601 379.40 387.25

37604 405.20 387.25

37605 547.15 522.85

37606 812.35 776.40

37607 1,367.25

37610 2,530.70

37613 398.65 387.25

37616 1,223.80

37619 409.00 387.25

37622 345.00 270.50

37623 345.00 321.80

37800 713.90

37803 699.15

37806 808.75 843.15

37809 780.80

37812 684.25

37815 137.20

37818 726.70 688.05

37821 1,092.60

37824 1,770.05

37827 951.65

37830 965.00 968.00

37833 488.10

37836 1,027.75

37839 1,139.40

37842 2,261.05

37845 1,027.75

37848 1,849.65



33

Item


37227 818.70 792.20

37230 1,507.70 1,459.05

37233 807.50 781.35

37300 69.05 65.25

37303 109.70 103.70

37306 1,206.30

37309 1,452.70

37315 204.60 193.65

37318 409.00 387.25

37321 138.05 130.70

37324 287.60

37327 398.25

37330 960.90

37333 823.70

37336 1,096.45

37339 306.15 335.80

37340 532.80

37341 1,236.20

37342 1,338.10

37343 2,669.25

37345 1,039.90

37348 1,036.95

37351 409.00

37354 478.05

37369 325.90

37372 678.05

37375 1,712.05

37381 1,017.60

37384 1,712.05

37387 478.05

37390 1,347.50

37393 294.20 321.80

37396 1,080.45

37402 689.65

37405 1,574.15

37408 689.65

37411 1,213.30 1,294.60

37415 69.05 65.25



rmfs out of

% Hospital %

38353 336.00

38356 1,100.85

38358 4,146.25

38359 193.20 187.00

38362 506.10 538.95

38365 319.20

38368 1,529.60

38371 359.70 403.00

38384 1,314.95 1,473.75

38387 359.70 403.00

38390 1,383.85 1,473.75

38393 378.50 403.00

38415 577.40 559.10

38418 1,162.55

38421 2,036.95

38424 1,385.75

38427 1,710.95

38430 881.90

38436 361.10

38438 2,008.75

38440 1,658.65

38441 2,426.45

38446 1,710.95

38447 1,944.25

38448 524.90

38449 2,892.55

38450 1,238.65

38452 829.45

38453 2,214.65

38455 3,365.15

38456 1,908.25

38457 1,908.80

38458 1,014.65

38460 398.40

38462 433.25

38464 479.00

38466 1,320.25

38468 2,053.90



Rmfs out of

% Hospital %

37851 1,370.50

37854 453.55

38200 585.75 623.60

38203 980.40 744.20

38206 844.85 899.75

38209 1,084.70 1,155.25

38212 1,804.20 1,921.45

38213 537.30 572.20

38215 583.25 496.90

38218 826.90 745.15

38220 291.70 248.40

38222 583.25 496.90

38225 874.85 745.30

38228 1,114.20 993.90

38231 1,458.05 1,242.15

38234 1,066.50 993.65

38237 1,458.00 1,242.10

38240 1,599.70 1,490.45

38241 586.65 657.60

38243 583.25 621.05

38246 1,375.55 1,242.10

38256 351.45 374.15

38270 1,199.40 1,277.25

38272 1,199.40 1,277.25

38275 392.15 417.50

38285 253.80

38286 228.40

38287 2,592.60 2,937.85

38290 3,512.45

38293 3,498.20 4,015.30

38300 677.60 721.50

38303 868.80 925.15

38306 1,002.35 1,067.30

38309 1,164.15 1,239.65

38312 1,488.70 1,585.30

38315 1,598.40 1,702.20

38318 2,085.45 2,220.90

38350 839.75


rmfs out of

% Hospital %

38572 2,872.75

38577 801.65

38588 601.60

38600 1,863.85

38603 1,385.75

38609 692.80

38612 955.10 751.95

38613 974.70

38615 2,030.25

38618 2,760.70

38621 1,102.40

38624 1,148.70

38627 923.65

38637 801.65

38640 1,385.75

38643 1,543.15

38647 3,085.90

38650 2,494.40

38653 2,760.70

38654 1,617.65

38656 1,257.20

38670 2,760.20

38673 3,164.10

38677 2,906.30

38680 3,447.35 3,338.40

38700 1,414.10

38703 2,781.65

38706 2,453.90

38709 3,085.90

38712 3,705.50

38715 2,466.90

38718 3,085.90

38721 2,162.45

38724 2,567.00

38727 2,114.60

38730 3,085.90

38733 2,102.90

38736 3,085.90



35

Item


38469 2,083.75

38470 1,385.75

38473 829.45

38475 1,202.70

38477 2,896.35

38478 1,403.05

38480 2,717.50

38481 3,358.60

38483 2,487.90

38485 1,181.35

38487 2,496.40

38488 2,760.70

38489 3,283.25

38490 801.65

38493 2,830.20

38496 902.15

38497 2,618.35

38498 2,933.60

38500 3,190.35

38501 3,169.90

38503 3,471.00

38504 3,541.05

38505 401.00

38506 2,351.10

38507 2,760.20

38508 3,259.55

38509 3,160.70

38512 2,556.90

38515 4,144.75

38518 4,146.30

38550 3,102.85

38553 4,248.00

38556 4,289.70

38559 3,596.95

38562 4,426.45

38565 5,126.10

38568 2,269.15

38571 2,966.30



rmfs out of

% Hospital %

39134 485.65

39135 225.00

39136 227.40

39137 803.40

39138 909.75

39139 1,565.55

39140 422.85 410.00

39300 503.90

39303 765.15

39306 1,000.35

39309 1,018.35

39312 529.90

39315 1,595.45

39318 1,121.45

39321 618.30

39323 356.55 387.55

39324 394.50 387.55

39327 675.70

39330 367.20

39331 446.85 387.55

39333 568.15 558.00

39500 1,811.85

39503 1,663.00

39600 696.40

39603 1,582.80

39606 1,015.70

39609 1,197.45

39612 1,597.40

39615 1,752.45

39640 5,538.15

39642 4,523.70

39646 5,208.40

39650 4,766.90

39653 6,704.45

39654 4,876.00

39656 4,641.35

39658 5,313.30

39660 4,321.80



Rmfs out of

% Hospital %

38739 2,781.65

38742 2,781.65

38745 2,603.05

38748 3,085.90

38751 3,085.90

38754 4,192.00

38757 3,085.90

38760 3,085.90

38763 3,085.90

38766 3,085.90

38800 55.80 53.90

38803 111.20 107.70

38806 193.20 187.00

38809 238.05 230.40

38812 302.55 292.85

39000 103.05 105.45

39003 122.15 119.95

39006 306.85 223.20

39009 84.70

39012 338.80

39013 152.30 152.85

39015 536.05

39018 536.05

39100 328.65 332.65

39106 1,617.75

39109 727.05 621.20

39112 2,642.05

39115 92.15 105.45

39118 442.80 417.00

39121 900.60 884.45

39124 2,304.85

39125 448.80

39126 516.05

39127 636.50

39128 930.70

39130 917.30

39131 200.40 178.95

39133 227.40


rmfs out of

% Hospital %

40312 2,685.90

40315 2,782.95

40316 3,257.45

40318 3,487.60

40321 1,554.35

40324 911.30

40327 911.30

40330 1,361.50

40331 1,361.50

40332 2,658.95

40333 1,136.35

40334 1,615.10

40335 3,064.55

40336 450.60

40339 2,261.95

40342 2,499.10

40345 1,885.80

40348 2,470.65

40351 2,470.65

40600 1,361.50

40700 2,714.30

40703 2,011.15

40706 3,211.05 3,000.35

40709 739.80

40712 1,490.00

40800 799.40 894.15

40801 3,263.35

40803 1,704.50 1,674.00

40850 3,898.40

40851 6,692.60

40852 629.45

40854 977.05

40856 366.00

40858 789.30

40860 3,655.90

40862 266.05 265.60

40903 790.50

40905 838.95 842.40



37

Item


39662 4,321.80

39700 793.60

39703 739.80

39706 1,586.45

39709 2,504.85

39712 4,530.65

39715 3,444.05

39718 1,243.65

39721 1,039.40

39800 4,190.30

39803 4,175.90

39806 1,793.95

39812 900.60

39815 2,604.90 2,558.15

39818 2,853.30

39821 2,999.10

39900 739.80

39903 2,530.85

39906 1,075.75

40000 1,307.90

40003 1,279.95

40006 954.10

40009 699.85

40012 1,609.90

40015 910.60

40018 195.75 223.20

40100 986.30

40103 1,232.55

40106 1,861.35

40109 1,689.95

40112 1,937.05

40115 1,029.25

40118 1,648.10

40300 1,486.70

40301 1,714.95

40303 1,989.00

40306 2,333.45

40309 1,666.50



rmfs out of

% Hospital %

41604 245.00 261.10

41608 2,055.80

41611 1,091.60

41614 1,802.45 1,525.90

41615 1,426.90 1,525.90

41617 2,884.25

41620 1,218.55

41623 1,779.90

41626 224.20 201.60

41629 634.00

41632 353.15 334.35

41635 1,543.90 1,602.05

41638 2,364.15

41641 74.05 66.45

41644 242.35 199.95

41647 171.15 153.90

41650 144.95 153.90

41653 112.25 100.75

41656 196.40 172.00

41659 99.80 108.60

41662 128.55 115.50

41665 342.25

41668 342.25

41671 802.95

41672 1,031.00

41674 156.55 140.70

41677 140.15 126.00

41680 253.90 228.15

41683 182.45 164.10

41686 112.25 100.75

41689 212.55

41692 277.25

41695 155.50 140.00

41698 50.60 45.60

41701 143.40

41704 56.75 50.85

41707 698.15

41710 888.85



Rmfs out of

% Hospital %

41500 128.55 115.50

41503 371.90 334.35

41506 193.50 201.60

41509 273.30 228.15

41512 911.95

41515 598.60

41518 1,329.75

41521 1,455.30

41524 444.65

41527 868.50

41530 1,388.25

41533 1,877.75

41536 1,814.00

41539 1,545.15

41542 1,966.55

41545 811.25

41548 1,076.80

41551 2,498.40

41554 3,317.85

41557 1,696.30

41560 1,867.30

41563 2,300.95

41564 3,261.85

41566 1,455.85

41569 1,675.90

41572 1,607.80

41575 3,790.90

41576 6,176.75

41578 3,790.90

41579 3,038.90

41581 5,101.60

41584 2,883.55

41587 3,504.60

41590 1,721.75

41593 2,422.70

41596 2,707.35

41599 2,485.90

41603 661.70 705.40


rmfs out of

% Hospital %

41810 55.55 49.85

41813 477.40

41816 289.10 259.85

41819 473.10 488.55

41820 608.15 586.25

41822 371.90

41825 570.60

41828 81.40 73.10

41831 486.85 499.80

41832 355.45 319.90

41834 2,362.35

41837 1,835.00

41840 2,568.90

41843 2,080.00

41846 289.10 259.85

41849 417.50

41852 447.05

41855 447.05

41858 747.85

41861 905.00

41864 651.90

41867 896.70

41868 588.45

41870 639.35

41873 914.80 822.65

41876 739.05 822.65

41879 1,584.75

41880 306.30

41881 625.30

41884 128.80

41885 349.05

41886 277.25 249.30

41889 277.25 249.30

41892 365.90 329.10

41895 493.00 514.85

41898 340.00 359.75

41901 794.50

41904 323.95 345.10



39

Item


41713 1,130.70

41716 460.30

41719 164.80 164.60

41722 914.80 822.65

41725 698.15

41728 1,418.90

41729 861.70

41731 1,445.65

41734 1,656.55

41737 752.10

41740 91.60

41743 525.30

41746 1,209.60 1,087.95

41749 944.10

41752 460.30

41755 72.50 65.10

41758 183.10 164.60

41761 191.10 172.00

41764 191.10 172.00

41767 1,196.95 1,031.80

41770 1,048.75

41773 872.90

41776 822.70

41779 1,099.60

41782 1,362.75

41785 1,838.45 1,653.65

41786 1,116.10

41787 823.40

41788 564.60 307.95

41789 564.60

41792 623.75

41793 623.75

41796 194.15

41797 194.15

41800 253.90

41801 253.90

41804 140.15

41807 96.90 98.15



rmfs out of

% Hospital %

42605 663.65 652.55

42608 491.50 421.05

42610 142.75 134.75

42611 199.30 202.10

42614 69.10 67.65

42615 109.25 101.15

42617 195.05 191.75

42620 65.10 73.75

42621 75.20 73.75

42622 117.90 115.85

42623 1,243.95

42626 1,633.30 1,579.30

42629 1,152.00

42632 153.95 164.30

42635 401.70 421.05

42638 551.20 526.40

42641 716.70 684.25

42644 102.80 101.05

42647 260.50 286.45

42650 102.80 101.05

42651 250.20 225.15

42653 2,068.30

42656 2,457.95

42659 1,580.40 1,263.25

42662 1,183.50

42665 833.50 842.35

42667 183.80 198.75

42668 97.70 105.45

42672 1,302.65 1,263.25

42673 642.40 631.55

42676 168.40 162.00

42677 86.85 85.35

42680 428.40 421.05

42683 179.20

42686 389.70 383.15

42689 167.30 164.30

42692 344.70 387.55

42695 629.45 631.55



Rmfs out of

% Hospital %

41905 647.40

41907 191.10 172.00

41910 607.50

42503 163.70

42506 777.85 673.75

42509 972.95

42510 983.75

42512 685.80 673.75

42515 901.15

42518 478.05

42521 1,731.55

42524 291.35 286.45

42527 578.15

42530 842.00

42533 597.50

42536 1,183.75

42539 2,015.65

42542 705.20

42543 1,272.15

42545 2,013.20

42548 1,081.45

42551 844.85 884.45

42554 1,027.35

42557 1,368.40

42563 738.95 726.60

42569 1,466.90

42572 185.45 164.30

42573 343.00 318.45

42574 729.70 676.55

42575 121.65 115.85

42581 167.30 164.30

42584 394.10 387.55

42587 74.25 72.75

42590 432.55 473.70

42593 344.85

42596 717.80 705.40

42599 835.55 884.45

42602 899.90 884.45


rmfs out of

% Hospital %

42789 503.35 494.70

42791 459.30 494.70

42792 503.35 494.70

42794 96.40 94.75

42797 96.40 94.75

42801 1,375.25

42802 687.35

42805 835.05 821.10

42806 503.35 494.70

42807 506.70 498.15

42808 575.50 498.15

42809 642.40 631.55

42810 808.55 794.80

42811 642.40 631.55

42812 219.10 231.65

42815 899.90

42818 716.60 821.10

42821 128.60 126.50

42824 99.75 97.90

42833 939.20

42836 1,120.05

42839 1,041.30

42842 1,132.10

42845 255.75 265.20

42848 1,176.30

42851 1,239.65

42854 578.15 568.50

42857 529.50 568.50

42860 1,335.35 1,263.25

42863 1,129.65 1,084.40

42866 1,044.20 1,052.60

42869 781.45 768.60

42872 446.40 337.00

43021 546.15 637.10

43022 655.55 764.65

43023 104.05 123.90

43500 175.75

43503 247.20



41

Item


42698 1,002.40 832.65

42701 573.00 464.40

42702 1,366.90 1,064.95

42703 815.45 800.90

42704 719.75 652.55

42707 980.90 1,115.95

42710 1,284.95 1,263.25

42713 525.85 526.40

42716 1,505.25 1,674.00

42718 1,439.20 1,334.30

42719 650.95 726.60

42725 2,075.15

42731 2,144.65

42734 428.40 421.05

42737 428.40 421.05

42738 428.40 421.05

42739 428.40 421.05

42740 428.40 421.05

42741 428.40 421.05

42743 830.75 884.45

42744 427.95 420.80

42746 1,495.35

42749 1,717.25

42752 1,771.20

42755 235.95 231.65

42758 1,011.75

42761 722.55 726.60

42764 636.05 726.60

42767 1,880.95

42770 391.25 412.75

42773 1,284.95 1,263.25

42776 1,905.95

42779 2,353.45

42782 713.00 631.55

42783 642.40 631.55

42785 488.70 494.70

42786 503.35 494.70

42788 439.35 494.70



rmfs out of

% Hospital %

43909 2,220.20

43912 2,195.95

43915 1,578.90 1,621.65

43930 572.05

43933 699.15

43936 1,248.55

43939 956.85

43942 317.30 324.40

43945 1,284.40

43948 216.05 194.75

43951 1,195.90

43954 1,362.40

43957 1,586.05

43960 511.05

43963 2,146.95

43966 2,270.55

43969 3,488.95

43972 2,287.65

43975 2,988.10

43978 2,537.35

43981 697.90

43984 1,776.40

43987 1,967.15

43990 2,163.95

43993 2,601.00 2,659.55

43996 2,602.20 2,983.90

43999 326.40

44102 352.30

44105 62.10 63.15

44108 623.55

44111 740.25 805.95

44114 817.10

44130 581.70 648.65

44133 568.30

44136 218.85 237.30

44325 421.40 414.00

44328 480.00

44331 816.65



Rmfs out of

% Hospital %

43506 462.65

43509 507.60

43512 496.65

43515 518.85 498.90

43518 738.25

43521 661.25

43524 815.35 822.65

43801 1,235.55

43804 1,395.35

43807 1,341.10

43810 1,677.75

43813 2,024.45

43816 2,041.10

43819 1,333.15

43822 1,331.45

43825 1,737.20

43828 1,537.75

43831 1,231.45

43834 1,456.65

43837 1,672.75

43840 1,613.05

43843 2,640.60

43846 2,727.35

43849 642.00

43852 2,122.65 2,270.20

43855 2,244.00

43858 824.80 843.15

43861 2,151.55

43864 1,603.25

43867 951.60

43870 1,333.15

43873 1,588.20

43876 1,507.25

43879 1,776.40

43882 2,283.80 2,335.30

43900 1,522.35

43903 2,537.35

43906 2,220.20


rmfs out of

% Hospital %

45200 342.85 398.10

45203 588.35 568.50

45206 514.80 537.00

45207 502.60 537.00

45209 658.40 663.25

45212 331.80 329.10

45215 1,443.95

45218 604.40

45221 372.50 366.20

45224 206.15 164.60

45227 635.00 623.60

45230 270.00 311.85

45233 634.35 663.25

45236 527.50

45239 372.50 366.20

45240 342.65 366.20

45400 291.60 286.60

45403 614.45 570.50

45406 603.80 631.55

45409 750.75

45412 1,329.30

45415 1,284.95

45418 1,214.85

45439 404.90 398.10

45442 756.55 821.10

45445 748.35 779.25

45448 481.85 526.40

45451 672.80 663.25

45460 1,783.50

45461 1,271.20

45462 959.35

45464 2,650.75

45465 1,939.55 1,908.20

45466 1,462.55 1,439.15

45468 2,607.90

45469 1,967.40 1,935.80

45471 3,277.80 3,225.15

45472 2,472.70 2,432.65



43

Item


44334 1,703.25 1,671.95

44338 192.95 201.60

44342 266.05

44346 382.40

44350 400.70 403.50

44354 458.40

44358 241.80

44359 346.85

44361 580.75

44364 428.95

44367 688.45

44370 1,000.95

44373 2,054.45 2,069.80

44376 D D

45000 745.55 757.90

45003 906.70 842.35

45006 1,465.45

45009 539.85

45012 869.65

45015 428.40

45018 674.50 663.15

45019 561.55

45020 564.95

45021 252.75 248.30

45024 567.50 558.00

45025 271.95 248.30

45026 612.35 558.00

45027 171.50

45030 163.95 180.95

45033 361.15 337.00

45035 1,057.60

45036 1,615.50

45039 297.15 337.00

45042 547.75 431.80

45045 439.15 431.80

45048 1,055.90

45051 625.45

45054 350.35



rmfs out of

% Hospital %

45530 1,565.50

45533 1,772.60

45536 651.85

45539 1,844.40

45542 961.25

45545 843.50 871.60

45546 281.80 277.00

45548 438.90 387.55

45551 631.80

45552 1,172.30 894.15

45553 843.00 894.15

45554 995.95 979.25

45555 909.60

45556 1,090.45 1,072.50

45557 1,090.45

45558 1,635.85

45559 1,500.25 1,591.55

45560 674.50 663.15

45561 2,526.90

45562 1,565.50 1,539.20

45563 1,663.45 1,539.20

45564 4,080.05

45565 2,673.60

45566 1,530.20

45568 640.30

45569 894.25

45570 1,207.40 1,280.95

45572 415.30 408.40

45575 1,025.55 1,008.30

45578 1,187.75

45581 394.10 387.55

45584 899.65 884.45

45585 899.65 884.45

45586 899.65

45587 1,268.55 1,247.20

45588 1,836.25

45590 766.35

45593 790.95



Rmfs out of

% Hospital %

45474 3,946.20 3,882.65

45475 2,977.55 2,929.45

45477 4,614.55 4,540.20

45478 3,480.80 3,424.50

45480 5,282.90 5,197.65

45481 3,985.70 3,921.55

45483 6,018.85 5,921.95

45484 4,541.35 4,468.10

45485 1,005.35

45486 642.40

45487 531.60 568.50

45488 642.40

45489 1,119.70 947.55

45490 1,285.05

45491 1,606.10

45492 1,726.30

45493 488.50

45494 2,333.15 2,294.20

45496 592.00

45497 462.65

45498 372.50

45499 277.65

45500 1,781.50

45501 2,695.15

45502 2,528.50

45503 2,891.10

45504 3,265.00

45505 2,528.50

45506 271.65 307.95

45512 413.05 414.00

45515 266.05 261.10

45518 310.25 316.00

45519 610.85

45520 1,282.15

45522 1,164.35 884.45

45524 1,056.15

45527 1,325.95

45528 1,583.70


rmfs out of

% Hospital %

45676 819.40

45677 771.00

45680 1,051.80

45683 1,023.80

45686 1,146.15

45689 372.65

45692 374.85 421.05

45695 713.20

45698 653.75

45701 1,353.90

45704 428.40 421.05

45707 1,465.35

45710 695.95

45713 792.65

45714 1,161.05

45716 1,386.95

45720 1,376.55 1,353.55

45723 2,056.25

45726 1,915.80

45729 2,432.70

45731 1,972.00

45732 2,627.60

45735 2,411.10

45738 2,593.60

45741 2,412.70

45744 2,861.60

45747 2,753.00 2,707.00

45752 3,485.55

45753 3,034.35 3,050.05

45754 3,718.50

45755 523.70 514.85

45758 937.15

45761 1,044.10

45767 3,576.25 3,516.35

45770 2,739.50

45773 2,496.70 2,454.80

45776 2,496.70

45779 2,419.20



45

Item


45596 1,627.10

45597 1,716.30

45599 1,333.65 1,311.20

45602 995.95

45605 836.90

45608 1,366.20

45611 674.70

45614 808.85 822.65

45617 334.85 329.10

45620 574.80 456.50

45623 1,083.50 1,012.30

45624 1,413.00 1,312.40

45625 323.65

45626 464.40 456.50

45629 906.80 663.25

45632 895.80 716.75

45635 836.90 822.65

45638 1,443.95 1,419.70

45639 1,822.50 1,419.70

45641 1,552.90 1,516.10

45644 2,258.40 1,791.25

45645 318.60

45646 1,221.85 1,260.65

45647 1,657.05

45650 210.75 206.95

45652 507.35 498.90

45653 658.15 498.90

45656 764.70 703.15

45659 742.25 729.75

45660 4,791.40

45661 2,054.50

45662 998.65

45665 453.95 456.50

45668 396.30 456.50

45669 500.65 456.50

45671 1,575.20 1,167.70

45674 359.80 339.60

45675 688.20



rmfs out of

% Hospital %

45863 1,378.95 1,353.80

45865 414.30 406.70

45867 445.65 437.25

45869 1,694.40 1,663.50

45871 1,908.75 1,873.85

45873 2,144.80 2,105.70

45875 670.10 659.00

45877 670.10 659.00

45879 445.65 437.25

45882 61.30 60.20

45885 632.40 621.20

45888 589.35 579.00

45891 858.60 843.45

45894 291.80 286.60

45897 1,523.65 1,496.75

45900 343.75 337.65

45939 637.20 625.95

45945 169.40 166.20

45975 184.15 180.90

45978 224.95 221.00

45981 122.10 119.95

45984 878.85 863.35

45987 878.85 863.35

45990 1,200.25 1,179.15

45993 1,200.25 1,179.15

45996 340.40 334.35

46300 444.65

46303 574.60

46306 898.25

46307 883.45

46309 944.80

46312 1,186.85

46315 1,400.85

46318 1,932.30

46321 2,388.85 1,895.50

46324 1,277.55

46325 1,425.80

46327 289.40 284.45



Rmfs out of

% Hospital %

45782 1,229.30 1,380.00

45785 2,756.10

45788 2,347.95

45791 1,268.55

45794 957.60

45797 266.05

45799 42.15 41.25

45801 171.05 177.70

45803 465.00 456.50

45805 246.05 241.50

45807 351.60 345.10

45809 558.40 520.10

45811 716.40 703.15

45813 838.15 822.65

45815 523.60 498.90

45817 662.50 650.30

45819 821.70 822.60

45821 543.05 533.15

45823 155.30

45825 467.20 473.70

45827 461.20 452.80

45829 351.45 345.40

45831 399.85 452.80

45833 578.95 568.50

45835 718.60 705.40

45837 1,089.70 821.10

45839 836.35 821.10

45841 676.55 663.15

45843 414.30 406.70

45845 718.60 705.40

45847 266.05 261.10

45849 828.25 813.30

45851 203.90

45853 1,270.45 1,247.20

45855 582.75 572.20

45857 931.40 915.35

45859 469.65 461.45

45861 1,244.05 1,221.25


rmfs out of

% Hospital %

46442 438.20

46444 880.85

46447 997.70

46450 321.40

46453 451.55

46456 139.25 136.95

46459 259.85 263.30

46462 393.20 421.15

46464 331.75 316.00

46465 283.25 316.00

46468 562.35

46471 803.30 789.70

46474 1,044.25

46477 1,285.05

46480 581.45 526.55

46483 500.50 421.15

46486 321.40

46489 383.65

46492 514.45

46494 312.25 307.95

46495 289.40 284.45

46498 312.50 307.95

46500 397.90 368.65

46501 484.95 460.90

46502 495.85 424.15

46503 512.25 529.80

46504 1,739.55 1,547.80

46507 1,763.80

46510 518.95

46513 80.90 79.10

46516 167.90

46519 226.80 197.75

46522 635.80

46525 74.40

46528 236.60 237.30

46531 121.25 119.25

46534 291.00 329.70

47000 104.70 98.95



47

Item


46330 496.60

46333 912.40

46336 373.60 368.65

46339 689.85 652.70

46342 663.95

46345 754.25

46348 382.55 342.25

46351 631.15

46354 851.70

46357 1,022.80

46360 1,035.20

46363 297.75 294.85

46366 182.40 179.10

46369 299.95 294.85

46372 736.65 599.15

46375 903.50 710.80

46378 1,147.30

46381 428.40

46384 428.40

46387 982.85 868.85

46390 1,282.25

46393 1,715.20

46396 426.10 461.45

46399 824.25

46402 742.95

46405 899.85

46408 1,075.00

46411 578.40

46414 749.50 737.00

46417 661.65

46420 291.35 286.45

46423 466.50 458.05

46426 481.75

46429 624.05 579.15

46432 647.35

46435 849.95

46438 226.45 189.65

46441 465.90 458.05



rmfs out of

% Hospital %

47342 375.40 316.40

47345 453.30

47348 139.20 131.60

47351 425.50 329.70

47354 250.60 237.30

47357 626.80 527.20

47360 195.05 184.60

47363 263.00 276.65

47366 403.75 369.05

47369 224.75 237.30

47372 450.10 395.30

47375 556.60

47378 284.35 237.30

47381 391.15

47384 506.55

47385 488.80

47386 666.90

47387 475.40 382.15

47390 624.50

47393 794.90

47396 279.05 263.50

47399 584.25

47402 417.50 395.30

47405 279.05 263.50

47408 544.75

47411 153.10 158.00

47414 334.25 316.40

47417 388.65 369.05

47420 765.90

47423 319.35 303.10

47426 488.90

47429 640.45

47432 682.45

47435 608.90 579.95

47438 974.75

47441 1,420.55

47444 353.20 316.40

47447 524.10



Rmfs out of

% Hospital %

47003 102.90 118.75

47006 251.90 238.35

47009 257.75 237.30

47012 501.40

47015 102.85 118.75

47018 279.10 276.65

47021 389.90

47024 331.40 276.65

47027 398.15

47030 316.25 276.65

47033 389.90 369.05

47036 107.75 118.75

47039 167.90 158.00

47042 163.00 158.00

47045 222.90 211.05

47048 441.05 454.75

47051 610.40

47054 427.90 454.75

47057 165.85 177.80

47060 250.60 237.30

47063 375.95 355.90

47066 501.40

47069 104.70 98.95

47072 125.45 131.60

47300 125.70 118.75

47303 128.40 138.50

47306 167.90 158.00

47309 216.35 197.75

47312 231.70 177.80

47315 213.20 204.35

47318 250.60 237.30

47321 310.60

47324 277.05 237.30

47327 292.40 276.65

47330 405.85 316.40

47333 418.65

47336 311.00 237.30

47339 310.40 276.65


rmfs out of

% Hospital %

47555 945.05

47558 1,275.00

47561 469.80 382.15

47564 650.90 573.40

47565 1,091.20

47566 1,398.40

47567 723.65 665.50

47570 923.60 764.40

47573 1,171.95

47576 136.75 158.00

47579 223.95 224.10

47582 418.95

47585 665.55

47588 2,160.25

47591 2,787.45

47594 293.90 303.10

47597 506.95 454.75

47600 660.30

47603 873.80

47606 309.05 329.70

47609 522.10 494.30

47612 524.80 573.40

47615 691.40 659.00

47618 833.50

47621 770.55 573.40

47624 1,012.85

47627 236.90 224.10

47630 444.50 474.40

47633 164.60 158.00

47636 274.40 237.30

47639 315.60 316.40

47642 222.90 211.05

47645 336.15 316.40

47648 427.80

47651 348.15 329.70

47654 522.10 494.30

47657 856.95

47663 208.80 197.75



49

Item


47450 583.75

47451 791.30

47453 370.25 369.05

47456 630.55

47459 789.05

47462 156.45 158.00

47465 333.50 316.40

47466 167.90 158.00

47467 322.45

47468 640.45 606.15

47471 63.60 60.20

47474 259.95 263.50

47477 324.10 329.70

47480 871.35

47483 807.80

47486 1,298.45

47489 2,088.25

47492 341.00 329.70

47495 759.80 659.00

47498 1,122.55

47501 1,432.90

47504 2,481.30 1,977.10

47507 2,408.60

47510 2,582.55

47513 556.85

47516 589.15 606.15

47519 1,415.95

47522 1,104.80

47525 1,324.65

47528 1,096.75

47531 1,448.25

47534 1,612.60

47537 598.70 606.15

47540 320.10 303.10

47543 335.45 316.40

47546 501.40 474.40

47549 609.30

47552 555.20 527.20



rmfs out of

% Hospital %

47903 319.55 329.70

47904 83.90 79.10

47906 135.95

47912 83.90 79.10

47915 237.15 237.30

47916 118.25 119.25

47918 321.90 329.70

47920 563.20

47921 167.90 158.00

47924 55.95 52.75

47927 193.65

47930 325.45

47933 306.40 289.80

47936 375.95

47948 245.25

47951 279.05 263.50

47954 550.10 527.20

47957 417.50

47960 195.05 184.60

47963 320.10 303.10

47966 640.45

47969 389.90

47972 311.45

47975 545.85

47978 371.20

47981 222.45 210.80

47982 500.20

48200 1,113.90

48203 1,404.85

48206 836.20

48209 1,072.10

48212 836.20

48215 1,030.90

48218 982.10

48221 1,410.35

48224 556.85

48227 733.35

48230 702.05



Rmfs out of

% Hospital %

47666 299.55 329.70

47672 165.30 158.00

47678 250.60 237.30

47681 63.60 60.20

47684 1,112.70 1,054.55

47687 1,949.00

47690 1,407.90

47693 1,610.75

47696 519.65

47699 2,531.30

47702 3,051.35

47703 63.60 60.20

47705 417.50

47708 320.10 303.10

47711 452.85

47714 355.05

47717 626.80

47720 626.80 593.25

47723 626.80 593.25

47726 208.80

47729 348.15

47732 556.85

47735 66.00 60.30

47738 390.50 329.70

47741 732.05

47753 601.50

47756 590.80

47762 453.70 334.35

47765 643.25

47768 649.20

47771 993.55

47774 644.25

47777 644.25

47780 710.10

47783 837.45 792.90

47786 1,190.95

47789 1,063.25

47900 238.50 237.30


rmfs out of

% Hospital %

48654 1,601.10

48657 2,635.65

48660 1,900.70

48663 1,197.20

48666 778.05

48669 2,158.00

48672 1,320.55

48675 868.10

48678 836.20

48681 1,392.25

48684 1,392.25

48687 1,949.00

48690 2,227.60

48691 2,399.25 2,511.15

48692 1,617.20 1,692.55

48693 782.25 818.60

48694 1,900.70

48900 406.05 395.30

48903 749.10

48906 691.95

48909 1,322.30

48912 487.45 461.45

48915 1,254.70

48918 2,736.15

48921 2,700.25

48924 2,917.50

48927 542.90

48930 1,283.30

48933 1,815.50

48936 1,191.70

48939 1,623.00

48942 2,167.80

48945 403.80

48948 860.70

48951 1,548.45

48954 1,734.85

48957 1,878.40

48960 1,608.20



51

Item


48233 1,130.05

48236 1,180.65

48239 654.30

48242 1,123.65

48400 413.20

48403 738.80

48406 487.45

48409 742.40

48412 806.90

48415 1,179.45

48418 769.75

48421 1,431.65

48424 952.15

48427 1,267.20

48500 476.35

48503 467.55

48506 654.10

48509 302.20

48512 1,664.60

48600 139.20

48603 208.80

48606 2,304.70

48612 4,214.20

48613 5,473.30

48615 589.00

48618 3,594.90

48621 2,367.00

48624 2,923.95

48627 4,373.55

48630 4,594.60

48632 2,161.35

48636 1,069.10 1,133.40

48639 1,815.55

48640 5,532.35

48642 1,183.50

48645 1,601.10

48648 1,601.10

48651 2,315.80



rmfs out of

% Hospital %

49345 4,608.05

49346 1,261.50

49360 481.10

49363 556.75 579.90

49366 974.95

49500 556.85

49503 688.55

49506 1,116.80

49509 1,113.90

49512 1,558.90

49515 1,443.85

49517 2,092.05

49518 2,219.40

49519 3,948.65

49521 2,634.75

49524 3,049.55

49527 2,568.40

49530 2,943.75

49533 3,354.50

49534 730.10

49536 1,537.30

49539 1,710.35

49542 2,341.20

49545 1,113.90

49548 1,380.10

49551 2,295.85

49554 2,482.75

49557 401.25

49558 459.50

49559 679.60

49560 939.35

49561 1,143.75

49562 1,297.10

49563 1,303.60

49564 1,554.10

49566 1,215.90

49569 978.25

49700 403.80



Rmfs out of

% Hospital %

49100 487.45

49103 1,252.35

49106 1,449.00 1,318.05

49109 1,231.80

49112 1,031.20

49115 1,849.90

49116 2,128.60

49117 2,554.10

49118 403.80

49121 965.30

49200 1,322.55

49203 979.00

49206 835.35

49209 1,278.00

49210 1,419.30

49211 1,703.15

49212 348.15

49215 1,118.15

49218 439.05

49221 1,102.50

49224 1,162.00

49227 1,287.60

49300 821.50

49303 747.35

49306 1,733.30

49309 1,047.40

49312 1,715.15

49315 1,301.60

49318 2,206.50

49319 4,305.25

49321 2,576.65

49324 2,738.65

49327 3,421.45

49330 3,354.80

49333 3,987.20

49336 529.00

49339 4,509.85

49342 4,641.55


rmfs out of

% Hospital %

50100 344.20 382.15

50102 1,010.00

50103 487.45

50104 462.00 437.25

50106 599.95

50109 696.10

50112 444.30

50115 197.25

50118 640.45

50121 1,253.15

50127 1,107.95

50130 462.00

50200 278.50 263.50

50201 486.85

50203 653.05 579.95

50206 1,019.55

50209 1,050.35

50212 2,370.60

50215 2,534.30

50218 4,134.10

50221 3,536.85

50224 4,742.50 3,954.10

50227 5,043.30

50230 2,675.25

50233 3,354.95

50236 2,329.50

50239 1,661.95

50300 1,412.65

50303 2,337.35

50306 3,649.40 3,455.10

50309 379.95

50312 1,066.35

50315 995.20

50318 1,179.45

50321 1,406.25

50324 2,050.05

50327 2,693.50

50330 298.25



53

Item


49703 1,029.65

49706 487.45

49709 1,044.20

49712 1,362.75

49715 1,950.70

49716 1,993.00

49717 2,391.55

49718 618.45

49721 348.15 329.70

49724 1,109.65

49727 417.50

49728 754.75

49800 195.05 184.60

49803 224.45 237.30

49806 195.05 184.60

49809 320.10

49812 640.45

49815 1,341.40

49818 387.70

49821 656.45

49824 1,262.10

49827 696.10

49830 1,218.30

49833 801.25

49836 1,488.35

49837 957.25

49838 2,008.85

49839 765.90

49842 1,713.65

49845 728.90

49848 236.90 224.10

49851 306.40

49854 578.40

49857 538.20

49860 417.50

49863 626.80

49866 452.50

49878 83.90 79.10



rmfs out of

% Hospital %

50455 1,898.55

50456 1,898.55

50460 2,834.55

50461 2,834.55

50465 3,992.40

50466 3,992.40

50470 5,063.35

50471 5,063.35

50475 5,842.60

50476 5,842.60

50500 378.05 387.35

50504 504.40 516.70

50508 540.20 553.35

50512 720.70

50516 486.40 498.20

50520 648.35

50524 558.25

50528 900.50

50532 783.60

50536 1,044.55

50540 720.70

50544 360.30 369.05

50548 720.70

50552 621.50

50556 828.30

50560 648.35

50564 864.65

50568 756.70

50572 1,008.70

50576 828.30 848.70

50580 864.65

50584 828.30

50588 1,080.60

50600 594.10 608.60

50604 2,521.25

50608 4,682.80

50612 6,660.65

50616 846.40



Rmfs out of

% Hospital %

50333 939.55

50336 1,376.25

50339 830.50

50342 1,067.45

50345 451.95

50348 298.60

50349 473.45 448.25

50351 2,361.00

50352 92.55 79.10

50353 549.35

50354 1,937.50 1,834.25

50357 830.50

50360 1,001.00

50363 738.25

50366 1,309.00

50369 963.65

50372 1,645.50

50375 738.25

50378 1,291.80

50381 963.65

50384 1,809.30

50387 963.65

50390 338.35

50393 1,250.70

50394 4,698.00

50396 760.05

50399 1,363.55

50402 672.35

50405 1,021.35

50408 1,619.95

50411 1,937.50 1,834.25

50414 2,613.95 2,474.65

50417 1,937.50 1,834.25

50420 1,599.30

50423 1,476.35 1,397.55

50426 752.70

50450 1,676.60

50451 1,676.60


rmfs out of

% Hospital %

52027 274.70 209.65

52030 123.20 126.00

52033 258.35 257.50

52034 61.25 60.20

52035 679.00 666.55

52036 170.90 177.70

52039 411.35 456.50

52042 246.05 241.50

52045 307.60 345.10

52048 547.55 520.10

52051 642.20 703.15

52054 1,023.45 822.65

52055 38.30

52056 43.45 38.30

52057 209.85

52058 338.90 332.65

52059 381.75 374.75

52060 246.60 265.20

52061 318.95 313.05

52062 421.85 414.00

52063 512.00 498.90

52064 312.10 237.30

52066 635.30 623.60

52069 377.90 277.90

52072 83.95 82.35

52073 213.65 209.65

52075 210.35 209.65

52078 520.60 414.00

52081 66.45 65.10

52084 162.35 167.30

52087 333.95 286.60

52090 463.35 498.90

52092 662.50 650.30

52094 804.90 822.60

52095 543.05 533.15

52096 161.15 158.00

52097 280.90 224.10

52098 268.55 263.50



55

Item


50620 4,682.80

50624 4,682.80

50628 5,784.45

50632 4,862.70

50636 5,403.00

50640 2,986.80

50644 2,881.70

50650 566.85 580.65

50654 678.85

50658 270.25 276.85

50950 1,208.55 1,143.95

50952 1,208.55 1,143.95

51300 124.75 120.85

51303 D D

51306 203.60 174.55

51309 D D

51312 D D

51315 385.40 381.40

51318 241.65 251.65

51700 113.85 119.80

51703 63.50 60.20

51800 123.05 120.85

51803 D D

51900 413.95 456.50

51902 115.70 103.50

51904 621.80 636.80

51906 986.70 968.45

52000 117.75 115.50

52003 167.70 164.60

52006 167.70 164.60

52009 255.90 259.85

52010 309.80 355.60

52012 33.55 32.90

52015 156.90 153.90

52018 354.70 387.55

52021 42.15 41.25

52024 74.55 73.10

52025 262.35 257.50



rmfs out of

% Hospital %

52327 335.40 329.10

52330 1,315.25 1,094.75

52333 1,115.20 1,094.75

52336 670.30 684.25

52337 1,335.30 1,496.75

52339 793.95 779.25

52342 1,513.20 1,353.55

52345 1,554.75 1,526.50

52348 2,096.45 1,724.90

52351 1,973.15 1,937.15

52354 2,116.80 1,963.80

52357 3,018.85 2,210.90

52360 2,297.40 2,255.50

52363 2,584.45 2,537.40

52366 2,527.35 2,481.25

52369 2,841.60 2,789.80

52372 2,757.30 2,707.00

52375 3,088.40 3,032.05

52378 1,258.30 1,048.15

52379 1,747.90 1,791.25

52380 3,106.85 3,050.05

52382 3,724.15 3,656.25

52420 344.05 337.65

52424 675.50 663.15

52430 1,554.75 1,526.50

52440 772.05 757.90

52442 965.30 947.55

52444 1,072.30 1,052.60

52446 1,265.55 1,242.50

52450 429.00 421.05

52452 697.00 684.25

52456 1,179.65 1,158.25

52458 429.00 421.05

52460 1,115.20 1,094.75

52480 716.40 703.15

52482 689.15 676.55

52484 820.40 805.45

52600 489.45 473.70



Rmfs out of

% Hospital %

52099 178.50 197.75

52102 201.55

52105 376.05 369.05

52106 208.00

52108 442.45 456.50

52111 481.15 456.50

52114 933.65 822.65

52117 1,154.45 979.25

52120 1,175.85 1,158.25

52122 1,347.75 1,158.25

52123 1,335.65 1,311.20

52126 1,284.10 1,260.65

52129 1,718.85 1,687.60

52130 661.95 619.45

52131 947.60 856.70

52132 340.75 348.55

52133 129.85 127.50

52135 195.50

52138 635.30 628.00

52141 648.30 621.20

52144 589.75 579.00

52147 556.60 546.35

52148 983.70 965.75

52158 1,583.80 1,554.95

52180 327.95 263.50

52182 647.20 579.95

52184 951.05 856.70

52186 1,074.20 1,054.55

52300 352.45 398.10

52303 578.95 568.50

52306 859.25 843.45

52309 292.00 286.60

52312 405.60 398.10

52315 628.55 663.25

52318 201.55 197.75

52319 335.40 329.70

52321 678.05 663.25

52324 675.75 663.25


rmfs out of

% Hospital %

53056 102.70 100.75

53058 175.20 172.00

53060 143.40 140.70

53062 128.40 126.00

53064 232.50 228.15

53068 192.45 191.10

53070 253.95 249.30

53200 100.90 98.95

53203 169.60 166.20

53206 189.05

53209 2,351.60 2,308.75

53212 1,270.45 1,247.20

53215 582.75 572.20

53218 931.40 915.35

53220 469.65 461.45

53221 1,289.20 1,221.25

53224 1,196.05 1,353.80

53225 458.90 406.70

53226 445.65 437.25

53227 1,655.15 1,663.50

53230 1,770.40 1,873.85

53233 2,144.80 2,105.70

53236 670.10 659.00

53239 670.10 659.00

53242 445.65 437.25

53400 184.30 180.90

53403 225.20 221.00

53406 557.35 569.35

53409 489.10 569.35

53410 157.75 119.95

53411 393.75 334.35

53412 621.70 548.95

53413 683.30 672.50

53414 786.90 772.60

53415 633.95 609.95

53416 621.50 609.95

53418 944.20 792.90

53419 807.75 792.90



57

Item


52603 391.85 452.80

52606 351.45 345.40

52609 461.20 452.80

52612 578.95 568.50

52615 718.60 705.40

52618 772.00 821.10

52621 836.35 821.10

52624 845.50 663.15

52626 414.30 406.70

52627 707.25 705.40

52630 266.05 261.10

52633 718.60 705.40

52636 288.95 261.10

52800 394.60 387.55

52803 649.30 558.00

52806 394.60 387.55

52809 675.75 663.25

52812 1,007.35 947.55

52815 1,301.70 1,000.10

52818 801.85 663.25

52821 1,469.10 1,442.30

52824 568.85 621.20

52826 338.90 332.65

52828 504.05 494.70

52830 664.70 652.55

52832 911.55 894.90

53000 46.45 45.60

53003 131.30

53004 47.95 49.85

53006 668.50 729.75

53009 421.85 414.00

53012 167.70 164.60

53015 743.00 822.65

53016 689.15 676.55

53017 863.80 844.00

53019 828.25 813.30

53052 175.25 172.00

53054 175.20 172.00



rmfs out of

% Hospital %

75803 476.75 461.65

75806 559.15 541.45

75809 665.65 641.15

75812 735.65 712.40

75815 897.55 869.30

75818 1,059.30 1,025.80

75821 853.25 826.25

75824 985.70 954.55

75827 1,132.85 1,097.25

75830 1,250.65 1,211.15

75833 1,530.00 1,481.70

75836 1,584.10 1,695.50

75839 35.90 38.30

75842 53.40 57.05

75845 266.55 285.15

75848 319.55 341.95

75851 159.85 171.05

75854 159.85 171.05

81300 62.25

81325 62.25

82300 153.95

82306 17.50

82309 21.05

82312 29.70

82315 39.35

82318 48.60

82324 26.30

82327 15.80

82332 46.85



Rmfs out of

% Hospital %

53422 1,102.55 1,006.25

53423 1,200.90 1,006.25

53424 965.60 863.35

53425 957.20 863.35

53427 1,201.10 1,179.15

53429 1,313.15 1,179.15

53439 340.75 334.35

53453 689.15 676.55

53455 809.55 794.75

53458 61.30 60.30

53459 312.30 329.70

53460 685.00 672.50

53600 59.95 54.55

53700 216.70 174.80

53702 95.90 87.50

53704 57.80 52.75

53706 191.70 174.80

75150 123.80 119.80

75153 62.20 60.20

75156 110.30 106.75

75200 79.50 76.90

75203 119.20 115.45

75206 39.55 38.30

75400 238.35 230.65

75403 273.65 264.95

75406 311.95 301.95

75409 353.15 341.95

75412 197.30 191.00

75415 238.35 230.65

75600 335.60 324.90

75603 394.35 381.85

75606 394.35 381.85

75609 588.70 570.05

75612 728.45 705.40

75615 269.70 261.10

75618 334.95 324.25

75621 334.95 324.25

75800 119.20 115.45

RELATIVE VALUE GUIDE


59

Relative Value guide fee schedule1 November 2012

The Relative Value Guide (RVG) lists fees for In Hospital anaesthetic services.

The RVG basic unit cost has been reviewed to $32.70.

In addition all medical practitioners will be paid RVG fees where they have qualifications updated with Medicare Australia.

For items not listed in the RVG Fee Schedule please refer to the appropriate schedule in this booklet.

• For medical attendances and consultations provided by general practitioners participating in DVA’s Local Medical Officer Scheme, please use the Local Medical Officer Fee Schedule for the relevant fees.

• For derived fees for Local Medical Officers, please use the Derived Fees for LocalMedical Officers Fee Schedule.





relativeValue

item guide

20355 392.40

20400 98.10

20401 130.80

20402 163.50

20403 163.50

20404 196.20

20405 261.60

20406 425.10

20410 163.50

20420 163.50

20440 130.80

20450 163.50

20452 196.20

20470 196.20

20472 327.00

20474 425.10

20475 327.00

20500 490.50

20520 196.20

20522 130.80

20524 130.80

20526 327.00

20528 261.60

20540 425.10

20542 490.50

20546 490.50

20548 490.50

20560 654.00

20600 327.00

20604 425.10

20620 327.00

20622 425.10

20630 261.60

20632 228.90

20634 327.00

20670 425.10

20680 98.10

relativeValue

item guide

20690 163.50

20700 98.10

20702 130.80

20703 130.80

20704 327.00

20705 196.20

20706 228.90

20730 163.50

20740 163.50

20745 196.20

20750 130.80

20752 196.20

20754 228.90

20756 294.30

20770 490.50

20790 261.60

20791 327.00

20792 425.10

20793 490.50

20794 392.40

20798 327.00

20799 196.20

20800 98.10

20802 163.50

20803 130.80

20804 327.00

20805 196.20

20806 228.90

20810 130.80

20815 196.20

20820 163.50

20830 130.80

20832 196.20

20840 196.20

20841 261.60

20842 130.80

20844 327.00

relativeValue

item guide

20845 327.00

20846 327.00

20847 327.00

20848 327.00

20850 392.40

20855 490.50

20860 196.20

20862 228.90

20863 327.00

20864 327.00

20866 327.00

20867 327.00

20868 327.00

20880 490.50

20882 327.00

20884 163.50

20886 196.20

20900 98.10

20902 130.80

20904 228.90

20905 327.00

20906 130.80

20910 130.80

20911 163.50

20912 163.50

20914 228.90

20916 228.90

20920 130.80

20924 130.80

20926 130.80

20928 196.20

20930 130.80

20932 130.80

20934 196.20

20936 261.60

20938 130.80

20940 130.80


RelativeValue

item guide

20100 163.50

20102 196.20

20104 130.80

20120 163.50

20124 130.80

20140 163.50

20142 196.20

20143 196.20

20144 261.60

20145 261.60

20146 163.50

20147 196.20

20148 130.80

20160 196.20

20162 228.90

20164 130.80

20170 196.20

20172 228.90

20174 294.30

20176 327.00

20190 163.50

20192 327.00

20210 490.50

20212 163.50

20214 294.30

20216 654.00

20220 327.00

20222 196.20

20225 392.40

20230 392.40

20300 163.50

20305 490.50

20320 196.20

20321 327.00

20330 261.60

20350 327.00

20352 163.50

relativeValue

item guide

21270 261.60

21272 130.80

21274 196.20

21275 327.00

21280 490.50

21300 98.10

21321 130.80

21340 130.80

21360 163.50

21380 98.10

21382 130.80

21390 98.10

21392 130.80

21400 130.80

21402 228.90

21403 327.00

21404 163.50

21420 98.10

21430 130.80

21432 163.50

21440 261.60

21445 327.00

21460 98.10

21461 130.80

21462 98.10

21464 130.80

21472 163.50

21474 163.50

21480 130.80

21482 163.50

21484 163.50

21486 228.90

21490 98.10

21500 261.60

21502 196.20

21520 130.80

21522 163.50

relativeValue

item guide

21530 490.50

21532 261.60

21535 327.00

21600 98.10

21610 163.50

21620 130.80

21622 163.50

21630 163.50

21632 196.20

21634 294.30

21636 490.50

21638 327.00

21650 261.60

21652 327.00

21654 261.60

21656 327.00

21670 130.80

21680 98.10

21682 130.80

21685 327.00

21700 98.10

21710 130.80

21712 163.50

21714 163.50

21716 163.50

21730 98.10

21732 130.80

21740 163.50

21756 196.20

21760 228.90

21770 261.60

21772 196.20

21780 130.80

21785 327.00

21790 490.50

21800 98.10

21810 130.80

relativeValue

item guide

21820 98.10

21830 130.80

21832 228.90

21834 130.80

21840 261.60

21842 196.20

21850 130.80

21860 98.10

21865 327.00

21870 490.50

21872 261.60

21878 98.10

21879 163.50

21880 228.90

21881 294.30

21882 359.70

21883 425.10

21884 490.50

21885 555.90

21886 621.30

21887 686.70

21900 98.10

21906 163.50

21908 196.20

21910 294.30

21912 163.50

21914 196.20

21915 163.50

21916 163.50

21918 163.50

21922 228.90

21925 130.80

21926 163.50

21927 163.50

21930 196.20

21935 163.50

21936 196.20



61

RelativeValue

item guide

20942 163.50

20943 130.80

20944 196.20

20946 261.60

20948 130.80

20950 163.50

20952 130.80

20953 163.50

20954 327.00

20956 130.80

20958 163.50

20960 228.90

21100 98.10

21110 163.50

21112 130.80

21114 163.50

21116 196.20

21120 196.20

21130 98.10

21140 490.50

21150 327.00

21155 327.00

21160 130.80

21170 261.60

21195 98.10

21199 130.80

21200 130.80

21202 130.80

21210 196.20

21212 327.00

21214 327.00

21216 457.80

21220 130.80

21230 196.20

21232 163.50

21234 261.60

21260 130.80


relativeValue

item guide

22060 654.00

22065 163.50

22070 327.00

22075 490.50

22900 196.20

22905 196.20

23010 32.70

23021 65.40

23022 65.40

23023 65.40

23031 98.10

23032 98.10

23033 98.10

23041 130.80

23042 130.80

23043 130.80

23051 163.50

23052 163.50

23053 163.50

23061 196.20

23062 196.20

23063 196.20

23071 228.90

23072 228.90

23073 228.90

23081 261.60

23082 261.60

23083 261.60

23091 294.30

23101 327.00

23111 359.70

23112 392.40

23113 425.10

23114 457.80

23115 490.50

23116 523.20

23117 555.90

relativeValue

item guide

23118 588.60

23119 621.30

23121 654.00

23170 686.70

23180 719.40

23190 752.10

23200 784.80

23210 817.50

23220 850.20

23230 882.90

23240 915.60

23250 948.30

23260 981.00

23270 1,013.70

23280 1,046.40

23290 1,079.10

23300 1,111.80

23310 1,144.50

23320 1,177.20

23330 1,209.90

23340 1,242.60

23350 1,275.30

23360 1,308.00

23370 1,340.70

23380 1,373.40

23390 1,406.10

23400 1,438.80

23410 1,471.50

23420 1,504.20

23430 1,536.90

23440 1,569.60

23450 1,602.30

23460 1,635.00

23470 1,667.70

23480 1,700.40

23490 1,733.10

23500 1,765.80

relativeValue

item guide

23510 1,798.50

23520 1,831.20

23530 1,863.90

23540 1,896.60

23550 1,929.30

23560 1,962.00

23570 1,994.70

23580 2,027.40

23590 2,060.10

23600 2,092.80

23610 2,125.50

23620 2,158.20

23630 2,190.90

23640 2,223.60

23650 2,256.30

23660 2,289.00

23670 2,321.70

23680 2,354.40

23690 2,387.10

23700 2,419.80

23710 2,452.50

23720 2,485.20

23730 2,517.90

23740 2,550.60

23750 2,583.30

23760 2,616.00

23770 2,648.70

23780 2,681.40

23790 2,714.10

23800 2,746.80

23810 2,779.50

23820 2,812.20

23830 2,844.90

23840 2,877.60

23850 2,910.30

23860 2,943.00

23870 2,975.70


RelativeValue

item guide

21939 98.10

21941 228.90

21942 327.00

21943 163.50

21945 163.50

21949 163.50

21952 327.00

21955 163.50

21959 163.50

21962 163.50

21965 163.50

21969 261.60

21970 490.50

21973 163.50

21976 163.50

21980 163.50

21981 130.80

21990 98.10

21992 130.80

21997 130.80

22001 98.10

22002 130.80

22007 130.80

22008 130.80

22012 98.10

22014 98.10

22015 196.20

22018 228.90

22020 130.80

22025 130.80

22031 163.50

22036 98.10

22040 65.40

22045 98.10

22050 65.40

22051 294.30

22055 392.40

relativeValue

item guide

24103 3,498.90

24104 3,531.60

24105 3,564.30

24106 3,597.00

24107 3,629.70

24108 3,662.40

24109 3,695.10

24110 3,727.80

24111 3,760.50

24112 3,793.20

24113 3,825.90

24114 3,858.60

24115 3,891.30

24116 3,924.00

24117 3,956.70

relativeValue

item guide

24118 3,989.40

24119 4,022.10

24120 4,054.80

24121 4,087.50

24122 4,120.20

24123 4,152.90

24124 4,185.60

24125 4,218.30

24126 4,251.00

24127 4,283.70

24128 4,316.40

24129 4,349.10

24130 4,381.80

24131 4,414.50

24132 4,447.20

relativeValue

item guide

24133 4,479.90

24134 4,512.60

24135 4,545.30

24136 4,578.00

25000 32.70

25005 65.40

25010 98.10

25015 32.70

25020 65.40

25025 D

25030 D

25050 D

25200 D

25205 D



63

RelativeValue

item guide

23880 3,008.40

23890 3,041.10

23900 3,073.80

23910 3,106.50

23920 3,139.20

23930 3,171.90

23940 3,204.60

23950 3,237.30

23960 3,270.00

23970 3,302.70

23980 3,335.40

23990 3,368.10

24100 3,400.80

24101 3,433.50

24102 3,466.20

DIAGNOSTIC IMAGING SERVICES


Diagnostic imaging fee schedule1 november 2012

All medical practitioners will be paid 100% of the MBS for diagnostic imaging services, where they have the appropriate qualifications updated with Medicare Australia.

Local Medical Officers claiming from the Diagnostic Imaging Fee Schedule can also claim the relevant Veterans Access Payment (VAP) on these items.

For items not listed in the Diagnostic Imaging Fee schedule please refer to the appropriate schedule in this booklet.





• For pathology services please use the Pathology Fee Schedule.

100%of item mBs

55724 57.50

55725 40.00

55726 19.00

55727 20.00

55729 27.25

55730 13.65

55731 98.00

55732 49.00

55733 35.00

55734 17.50

55735 63.50

55736 127.00

55737 28.50

55739 57.00

55759 150.00

55760 75.00

55762 60.00

55763 30.00

55764 160.00

55765 80.00

55766 65.00

55767 32.50

55768 150.00

55769 75.00

55770 60.00

55771 30.00

55772 160.00

55773 80.00

55774 65.00

55775 32.50

55800 109.10

55801 54.55

55802 37.85

55803 18.95

55804 109.10

55805 54.55

55806 37.85

55807 18.95

100%of item mBs

55252 169.50

55274 169.50

55276 169.50

55278 169.50

55280 169.50

55282 169.50

55284 169.50

55292 169.50

55294 169.50

55296 111.05

55600 109.10

55601 54.55

55603 109.10

55604 54.55

55700 60.00

55701 30.00

55702 17.50

55703 35.00

55704 70.00

55705 35.00

55706 100.00

55707 70.00

55708 35.00

55709 38.00

55710 35.00

55711 17.50

55712 115.00

55713 50.00

55714 35.00

55715 40.00

55716 17.50

55717 19.00

55718 100.00

55719 57.50

55720 20.00

55721 115.00

55722 50.00

55723 38.00

100%of item mBs

55076 109.10

55079 37.85

55084 98.25

55085 34.05

55113 230.65

55114 230.65

55115 230.65

55116 261.65

55117 261.65

55118 275.50

55119 115.35

55120 115.35

55121 115.35

55122 130.85

55123 130.85

55125 137.75

55130 170.00

55131 85.00

55135 353.60

55136 176.80

55220 84.75

55221 84.75

55222 84.75

55223 84.75

55224 84.75

55226 84.75

55227 84.75

55228 84.75

55229 84.75

55230 84.75

55232 84.75

55233 84.75

55235 84.75

55236 55.55

55238 169.50

55244 169.50

55246 169.50

55248 169.50



65

100%of item mbs

55005 54.55

55007 18.95

55008 54.55

55010 18.95

55011 54.55

55013 18.95

55014 55.65

55016 18.95

55017 54.55

55019 18.95

55020 55.65

55022 18.95

55023 54.75

55025 18.95

55026 54.55

55028 109.10

55029 37.85

55030 109.10

55031 37.85

55032 109.10

55033 37.85

55036 111.30

55037 37.85

55038 109.10

55039 37.85

55044 111.30

55045 37.85

55048 109.50

55049 37.85

55054 109.10

55059 49.15

55060 17.05

55061 54.55

55062 18.95

55063 49.15

55064 17.05

55070 98.25

55073 34.05


100%of item mBs

56659 112.10

56665 167.40

56801 466.55

56807 560.00

56841 233.35

56847 283.85

57001 466.65

57007 567.75

57041 233.40

57047 283.90

57201 155.20

57247 77.55

57341 470.00

57345 241.60

57350 510.00

57351 510.00

57355 264.15

57356 264.15

57360 700.00

57361 350.00

57506 29.75

57509 39.75

57512 40.50

57515 54.00

57518 32.50

57521 43.40

57524 49.40

57527 65.75

57529 14.90

57530 19.90

57532 20.25

57533 27.00

57535 16.25

57536 21.70

57538 24.70

57539 32.90

57700 40.50

57702 20.25

100%of item mBs

56224 351.40

56225 351.40

56226 351.40

56227 122.50

56228 122.50

56229 122.50

56230 177.45

56231 177.45

56232 177.45

56233 240.00

56234 351.40

56235 122.45

56236 177.45

56237 240.00

56238 351.40

56239 122.45

56240 177.45

56259 164.80

56301 295.00

56307 400.00

56341 149.45

56347 202.00

56401 250.00

56407 360.00

56409 250.00

56412 360.00

56441 126.80

56447 181.50

56449 126.80

56452 181.50

56501 385.00

56507 480.05

56541 193.15

56547 243.75

56552 600.00

56554 600.00

56619 220.00

56625 334.65

100%of item mBs

55846 37.85

55847 18.95

55848 109.10

55849 54.55

55850 152.85

55851 76.45

55852 109.10

55853 54.55

55854 37.85

55855 18.95

56001 195.05

56007 250.00

56010 252.10

56013 250.00

56016 290.00

56022 225.00

56025 113.15

56026 56.60

56028 336.80

56030 225.00

56036 336.80

56041 98.75

56047 126.10

56050 128.20

56053 128.20

56056 155.45

56062 113.15

56068 168.40

56070 113.15

56076 168.40

56101 230.00

56107 340.00

56141 116.45

56147 171.60

56219 326.20

56220 240.00

56221 240.00

56223 240.00


100%of item mbs

55808 109.10

55809 54.55

55810 37.85

55811 18.95

55812 109.10

55813 54.55

55814 37.85

55815 18.95

55816 109.10

55817 54.55

55818 37.85

55819 18.95

55820 109.10

55821 54.55

55822 37.85

55823 18.95

55824 109.10

55825 54.55

55826 37.85

55827 18.95

55828 109.10

55829 54.55

55830 37.85

55831 18.95

55832 109.10

55833 54.55

55834 37.85

55835 18.95

55836 109.10

55837 54.55

55838 37.85

55839 18.95

55840 109.10

55841 54.55

55842 37.85

55843 18.95

55844 87.35

55845 43.70

100%of item mBs

58927 76.45

58929 38.25

58933 205.60

58935 102.80

58936 195.95

58938 98.00

58939 139.30

58941 69.65

59103 21.30

59104 10.65

59300 89.50

59301 44.75

59303 53.95

59304 27.00

59306 100.30

59307 50.15

59309 200.60

59310 100.30

59312 87.00

59313 43.50

59314 52.50

59315 26.25

59318 47.05

59319 23.55

59503 89.40

59504 44.70

59700 96.55

59701 48.30

59703 75.90

59704 37.95

59712 113.70

59713 56.85

59715 143.55

59716 71.80

59718 134.65

59719 67.35

59724 226.45

59725 113.25

100%of item mBs

58503 47.15

58505 23.60

58506 60.75

58508 30.40

58509 39.75

58511 19.90

58521 43.40

58523 21.70

58524 56.50

58526 28.25

58527 69.40

58529 34.70

58700 46.05

58702 23.05

58706 157.90

58708 78.95

58715 151.55

58717 75.80

58718 126.10

58720 63.05

58721 138.25

58723 69.15

58900 35.70

58902 17.85

58903 47.60

58905 23.80

58909 89.95

58911 45.00

58912 110.25

58914 55.15

58915 78.95

58916 138.50

58917 39.50

58920 69.25

58921 135.25

58923 67.65

58924 84.05

58926 42.05

100%of item mBs

57944 16.45

57945 43.40

57947 39.15

57950 32.25

57953 24.85

57956 21.70

57959 23.70

57960 47.40

57962 23.70

57963 47.40

57965 23.70

57966 47.40

57968 23.70

57969 47.40

58100 67.15

58102 33.60

58103 55.10

58105 27.55

58106 77.00

58108 110.00

58109 47.00

58111 38.50

58112 97.25

58114 55.00

58115 110.00

58117 23.50

58120 110.00

58121 110.00

58123 48.65

58124 55.00

58126 55.00

58127 55.00

58300 40.10

58302 20.05

58306 89.40

58308 44.70

58500 35.35

58502 17.70



67

100%of item mbs

57703 54.00

57705 27.00

57706 32.50

57708 16.25

57709 43.40

57711 21.70

57712 47.15

57714 23.60

57715 60.90

57717 30.45

57721 99.25

57723 49.65

57901 64.50

57902 64.50

57903 47.30

57906 64.50

57909 64.50

57911 32.25

57912 47.15

57914 32.25

57915 47.15

57917 23.65

57918 47.15

57920 32.25

57921 47.15

57923 32.25

57924 47.15

57926 23.60

57927 49.65

57929 23.60

57930 32.90

57932 23.60

57933 78.25

57935 23.60

57938 23.60

57939 64.50

57941 24.85

57942 49.65

DIAGNoStIc ImAGING ServIceSDIAGNOSTIC IMAGING SERVICES


100%of item mBs

61446 333.55

61449 456.20

61450 397.55

61453 514.70

61454 348.10

61457 470.45

61458 396.95

61461 527.85

61462 129.00

61465 265.50

61469 348.10

61473 175.40

61480 386.85

61484 880.85

61485 999.20

61495 223.10

61499 253.00

61505 100.00

61523 953.00

61529 953.00

61538 901.00

61541 953.00

61553 999.00

61559 918.00

61565 953.00

61571 953.00

61575 953.00

61577 953.00

61598 953.00

61604 953.00

61610 953.00

61616 953.00

61620 953.00

61622 953.00

61628 953.00

61632 953.00

61640 999.00

61646 999.00

100%of item mBs

61352 259.35

61353 386.60

61356 392.80

61360 403.35

61361 461.40

61364 496.95

61368 223.10

61369 2,015.75

61372 223.10

61373 489.70

61376 143.35

61381 574.35

61383 624.95

61384 687.70

61386 332.50

61387 430.75

61389 370.55

61390 409.95

61393 605.50

61397 246.85

61401 162.30

61402 605.05

61405 346.00

61409 873.50

61413 225.95

61417 118.85

61421 479.80

61425 600.70

61426 554.80

61429 543.00

61430 659.45

61433 496.95

61434 615.40

61437 542.75

61438 672.95

61441 489.70

61442 752.35

61445 286.80

100%of item mBs

60048 564.00

60051 827.10

60054 1,176.10

60057 1,376.30

60060 564.00

60063 827.10

60066 1,176.10

60069 1,376.30

60072 48.10

60075 96.10

60078 144.25

60100 60.75

60101 30.40

60500 43.40

60501 21.70

60503 29.75

60504 14.90

60506 63.75

60507 31.90

60509 98.90

60510 49.45

60918 47.15

60927 38.05

61109 258.90

61110 129.45

61302 448.85

61303 565.30

61306 709.70

61307 834.90

61310 367.30

61313 303.35

61314 420.00

61316 381.15

61317 492.40

61320 228.90

61328 227.65

61340 253.00

61348 443.35

100%of item mbs

59733 107.70

59734 53.85

59736 62.00

59737 31.00

59739 73.75

59740 36.90

59751 139.15

59752 69.60

59754 219.35

59755 109.70

59760 115.15

59761 57.60

59763 133.90

59764 66.95

59903 114.55

59912 305.20

59925 362.45

59970 168.30

59971 57.30

59972 152.60

59973 181.25

59974 84.20

60000 564.00

60003 827.10

60006 1,176.10

60009 1,376.30

60012 564.00

60015 827.10

60018 1,176.10

60021 1,376.30

60024 564.00

60027 827.10

60030 1,176.10

60033 1,376.30

60036 564.00

60039 827.10

60042 1,176.10

60045 1,376.30

100%of item mBs

63081 201.60

63082 201.60

63083 201.60

63084 201.60

63085 201.60

63101 492.80

63102 492.80

63104 246.40

63111 492.80

63113 492.80

63114 492.80

63116 492.80

63117 246.40

63119 246.40

63125 492.80

63126 492.80

63128 492.80

63129 492.80

63131 492.80

63132 492.80

63134 246.40

63135 246.40

63136 246.40

63151 358.40

63152 358.40

63154 358.40

63155 358.40

63157 179.20

63158 179.20

63161 358.40

63163 358.40

63164 358.40

63165 358.40

63167 358.40

63168 358.40

63169 358.40

63170 358.40

63171 358.40

100%of item mBs

63008 403.20

63010 336.00

63011 336.00

63013 201.60

63014 201.60

63016 201.60

63017 168.00

63040 336.00

63041 336.00

63042 358.40

63043 358.40

63044 403.20

63045 403.20

63046 403.20

63047 403.20

63048 403.20

63049 403.20

63051 403.20

63052 403.20

63054 403.20

63055 403.20

63057 403.20

63058 403.20

63060 403.20

63061 403.20

63063 403.20

63064 403.20

63065 403.20

63067 403.20

63070 403.20

63073 403.20

63074 168.00

63075 179.20

63076 201.60

63077 201.60

63078 201.60

63079 201.60

63080 201.60

100%of item mBs

61688 113.00

61689 59.45

61690 239.90

61691 300.35

61692 277.40

61693 271.50

61694 329.75

61695 248.50

61696 307.70

61697 271.40

61698 336.50

61699 244.85

61700 376.20

61701 143.40

61702 166.80

61703 228.10

61704 198.80

61705 257.35

61706 174.05

61707 235.25

61708 198.50

61709 263.95

61710 64.50

61711 132.75

61712 174.05

61713 87.70

61714 193.45

61715 440.45

61716 499.60

61717 111.55

61718 126.50

61719 50.00

61729 439.35

63001 403.20

63002 403.20

63004 403.20

63005 403.20

63007 403.20



69

100%of item mbs

61650 878.70

61651 224.45

61652 282.65

61653 354.85

61654 417.45

61655 183.65

61656 151.70

61657 210.00

61658 190.60

61659 246.20

61660 114.45

61661 113.85

61662 126.50

61663 221.70

61664 129.70

61665 193.30

61666 196.40

61667 201.70

61668 230.70

61669 248.50

61670 111.55

61671 1,007.90

61672 111.55

61673 244.85

61674 71.70

61675 287.20

61676 312.50

61677 343.85

61678 166.25

61679 215.40

61680 185.30

61681 205.00

61682 302.75

61683 123.45

61684 81.15

61685 302.55

61686 173.00

61687 436.75



100%of item mBs

63425 403.20

63426 403.20

63428 403.20

63429 403.20

63432 201.60

63433 201.60

63440 403.20

63441 403.20

63442 403.20

63443 403.20

63444 403.20

63446 403.20

63447 201.60

63448 201.60

63449 201.60

63455 179.20

63457 345.00

63458 345.00

63461 358.40

63463 358.40

63464 690.00

63466 690.00

63467 690.00

63469 690.00

63470 403.20

63472 403.20

63473 627.20

63475 627.20

63476 403.20

63478 403.20

63479 201.60

63481 313.60

63482 403.20

63483 403.20

63484 201.60

63486 201.60

63491 44.80

63492 44.80

100%of item mBs

63326 403.20

63327 403.20

63328 403.20

63329 336.00

63330 448.00

63331 403.20

63332 403.20

63334 336.00

63337 448.00

63340 403.20

63341 201.60

63342 201.60

63343 201.60

63345 201.60

63346 168.00

63347 224.00

63348 201.60

63361 403.20

63363 403.20

63364 201.60

63385 448.00

63386 448.00

63387 448.00

63388 448.00

63389 403.20

63391 403.20

63392 224.00

63393 224.00

63394 201.60

63401 403.20

63402 403.20

63404 403.20

63405 403.20

63407 201.60

63408 201.60

63416 403.20

63417 403.20

63419 201.60

100%of item mBs

63237 448.00

63240 448.00

63243 448.00

63244 448.00

63257 224.00

63258 224.00

63259 224.00

63260 224.00

63261 224.00

63262 224.00

63263 224.00

63264 224.00

63265 224.00

63271 492.80

63272 492.80

63274 492.80

63275 492.80

63277 492.80

63278 492.80

63280 492.80

63281 492.80

63282 246.40

63283 246.40

63284 246.40

63285 246.40

63301 380.80

63302 380.80

63304 380.80

63305 380.80

63307 380.80

63308 380.80

63310 190.40

63311 190.40

63313 190.40

63322 403.20

63323 403.20

63324 403.20

63325 403.20

100%of item mbs

63172 358.40

63173 358.40

63174 358.40

63175 358.40

63176 358.40

63177 358.40

63179 358.40

63182 358.40

63185 358.40

63186 179.20

63187 179.20

63188 179.20

63189 179.20

63190 179.20

63191 179.20

63192 179.20

63193 179.20

63194 179.20

63201 448.00

63202 448.00

63204 448.00

63205 448.00

63207 224.00

63208 224.00

63219 448.00

63220 448.00

63222 448.00

63223 448.00

63224 448.00

63225 448.00

63226 448.00

63227 448.00

63228 448.00

63229 448.00

63230 448.00

63231 448.00

63232 448.00

63234 448.00



71

100%of item mbs

63493 44.80

63494 44.80

63495 156.80

63497 156.80

63498 44.80

63499 156.80

63501 500.00

63502 500.00

63504 500.00

63505 500.00

63507 403.20

63508 201.60

63510 448.00

63511 224.00

63513 403.20

63514 201.60

63516 403.20

63517 201.60

63519 403.20

63520 201.60

63522 448.00

63523 224.00

63525 403.20

63526 448.00

63527 403.20

63528 403.20

65529 403.20

63530 448.00

64990 7.05

64991 10.65

pathology SERVICES


Pathology fee schedule1 November 2012

All medical practitioners will be paid 100% of the MBS for pathology services, where they have the appropriate qualifications updated with Medicare Australia.

Local Medical Officers claiming the Pathology Fee Schedule can also claim the relevant VeteransAccess Payment on these items if they do not receive the bulk billing incentive.

In addition, DVA does not apply the coning or super coning rule to “Out of Hospital” pathology services.

For items not listed in the Pathology Fee schedule please refer to the appropriate schedule in this booklet.





• For diagnostic imaging services please use the Diagnostic Imaging FeeSchedule.

item 100% mBs

65165 34.70

65166 34.70

65171 25.50

65175 25.50

65176 49.00

65177 72.45

65178 95.85

65179 119.30

65180 25.50

65181 23.45

66500 9.75

66503 11.75

66506 13.75

66509 15.75

66512 17.80

66517 19.80

66518 20.20

66519 40.40

66536 11.10

66539 30.80

66542 19.10

66545 15.90

66548 20.05

66551 16.90

66554 16.90

66557 9.75

66560 20.25

66563 24.85

66566 33.95

66569 42.90

66572 51.90

66575 60.85

66578 69.80

66581 78.80

66584 9.75

66587 47.85

66590 30.80

66593 18.10

item 100% mBs

66596 32.75

66599 23.75

66602 43.25

66605 30.80

66606 30.80

66607 76.25

66608 42.55

66609 42.55

66610 76.25

66623 41.80

66626 24.25

66629 20.25

66632 20.25

66635 20.25

66638 49.40

66639 29.40

66641 29.40

66642 29.40

66644 20.30

66647 45.40

66650 24.50

66651 24.50

66652 20.45

66653 44.90

66655 20.30

66656 20.30

66659 37.55

66660 37.55

66662 80.50

66663 80.50

66665 30.80

66666 30.80

66667 30.80

66671 37.15

66674 40.20

66677 11.25

66680 74.95

66683 74.95

item 100% mBs

66686 51.00

66695 30.70

66696 30.70

66697 13.30

66698 44.00

66701 57.30

66704 70.60

66707 83.90

66711 30.35

66712 43.35

66714 30.35

66715 12.95

66716 25.20

66719 35.05

66722 38.15

66723 38.15

66724 13.25

66725 51.40

66728 64.65

66731 77.90

66734 91.15

66743 20.25

66749 33.15

66750 40.00

66751 55.60

66752 24.85

66755 39.10

66756 98.95

66757 98.95

66758 24.85

66761 13.25

66764 8.95

66767 17.95

66770 26.90

66773 24.80

66776 24.80

66779 40.20

66780 40.20

pathology SERVICES


73

Item 100% mbs

65060 7.90

65066 10.45

65070 17.05

65072 10.25

65075 52.30

65078 90.80

65079 90.80

65081 97.25

65082 97.25

65084 166.95

65087 83.65

65090 11.20

65093 22.15

65096 41.30

65099 109.65

65102 165.70

65105 109.65

65108 165.70

65109 13.00

65110 13.00

65111 23.35

65114 9.15

65117 20.40

65120 13.80

65123 20.50

65126 28.05

65129 35.75

65137 25.50

65142 25.50

65144 56.95

65147 38.15

65150 71.40

65153 142.80

65156 214.20

65157 71.40

65158 71.40

65159 71.40

65162 10.50


item 100% mBs

69321 48.45

69324 43.30

69325 43.30

69327 85.55

69328 85.55

69330 128.85

69331 128.85

69333 20.70

69336 33.65

69339 19.25

69345 53.25

69354 30.95

69357 61.85

69360 92.80

69363 28.85

69378 181.45

69379 181.45

69380 775.50

69381 181.45

69382 181.45

69383 181.45

69384 15.75

69387 29.20

69390 42.65

69393 56.10

69396 69.55

69400 15.75

69401 13.45

69405 15.75

69408 29.20

69411 42.65

69413 56.10

69415 69.55

69418 64.00

69419 64.00

69445 92.80

69451 92.80

69471 35.15

item 100% mBs

69472 15.75

69474 28.85

69475 15.75

69478 29.45

69481 40.80

69482 153.10

69483 153.10

69484 17.20

69488 181.45

69489 181.45

69491 206.20

69492 206.20

69494 28.85

69495 36.10

69496 43.35

69497 28.85

69498 7.25

69499 92.80

69500 92.80

71057 33.10

71058 50.85

71059 35.90

71060 44.35

71062 44.35

71064 20.90

71066 14.65

71068 14.65

71069 22.90

71071 31.15

71072 14.65

71073 106.85

71074 14.65

71075 23.15

71076 106.85

71077 27.25

71079 27.00

71081 40.80

71083 20.30

item 100% mBs

71085 29.15

71087 37.95

71089 29.35

71090 29.35

71091 53.20

71092 23.85

71093 76.95

71095 40.80

71096 40.80

71097 24.60

71099 26.70

71101 17.50

71103 52.40

71106 11.40

71119 17.45

71121 20.95

71123 24.40

71125 27.85

71127 177.55

71129 219.30

71131 261.10

71133 10.45

71134 104.75

71135 209.35

71137 30.45

71139 104.75

71141 198.70

71143 261.75

71145 427.35

71146 104.75

71147 40.80

71148 40.80

71149 109.00

71151 119.65

71153 34.80

71154 34.80

71155 47.75

71156 12.95

pathology SERVICES

Item 100% mbs

66782 13.25

66783 13.25

66785 40.20

66788 66.30

66789 40.20

66790 26.05

66791 74.95

66792 74.95

66800 18.25

66803 30.70

66804 18.25

66805 12.45

66806 42.15

66812 35.05

66815 59.95

66816 35.05

66817 24.90

66819 30.80

66820 30.80

66821 21.95

66822 52.80

66825 30.80

66826 30.80

66827 21.95

66828 52.80

66830 58.90

66831 31.15

66832 31.15

66900 78.15

69300 12.60

69303 22.15

69306 34.00

69309 48.45

69312 34.00

69316 28.85

69317 36.10

69318 34.00

69319 43.25

item 100% mBs

73321 40.80

73323 40.80

73324 41.25

73325 75.00

73326 232.50

73327 52.30

73521 9.75

73523 42.05

73525 28.55

73527 10.05

73529 28.85

73801 6.95

73802 4.60

73803 6.40

73804 8.20

73805 4.60

73806 10.20

73807 6.95

73808 8.70

73809 2.35

73810 6.95

73811 11.30

73818 13.75

73824 20.50

73827 14.05

73828 6.95

73829 4.60

73830 6.40

73831 8.20

73832 4.60

73833 10.20

73834 6.95

73835 8.70

73836 2.35

73837 6.95

73840 17.10

73844 20.50

73920 2.40

73922 8.25

item 100% mBs

72852 247.45

72855 185.60

72856 247.45

72857 288.70

73043 23.00

73045 48.95

73047 95.35

73049 68.60

73051 171.50

73053 19.60

73055 19.60

73057 19.60

73059 43.30

73060 57.75

73061 51.55

73062 89.60

73063 100.00

73064 72.20

73065 86.60

73066 222.95

73067 130.00

73287 397.20

73289 361.35

73290 397.20

73291 232.50

73292 593.85

73293 232.50

73294 232.50

73300 102.00

73305 204.00

73308 36.70

73309 36.70

73311 36.70

73312 36.70

73314 232.50

73315 232.50

73317 36.70

73318 36.70

73320 40.80

item 100% mBs

73923 2.40

73924 14.75

73925 2.40

73926 8.25

73927 2.40

73928 6.00

73929 2.40

73930 6.00

73931 2.40

73932 10.30

73933 2.40

73934 17.70

73935 2.40

73936 6.00

73937 2.40

73938 8.00

73939 2.40

73940 10.30

74990 6.90

74991 10.45

74992 1.60

74993 3.75

74994 3.25

74995 4.00

74996 3.70

74997 3.30

74998 2.00

74999 1.60

pathology SERVICES


75

Item 100% mbs

71157 60.70

71159 73.65

71163 24.90

71164 40.15

71165 34.80

71166 47.75

71167 60.70

71168 73.65

71169 34.80

71170 12.95

71180 34.80

71183 47.75

71186 60.70

71189 15.60

71192 28.55

71195 40.30

71198 40.80

71200 60.00

71203 40.80

72813 72.00

72816 86.95

72817 97.45

72818 107.75

72823 97.80

72824 142.30

72825 181.45

72826 195.90

72827 210.35

72828 224.80

72830 276.00

72836 420.00

72838 470.00

72844 30.95

72846 60.00

72847 90.00

72848 75.00

72849 105.00

72850 120.00

72851 185.60

Documents

· Web viewDERIVED FEES - REaDy REckonER FoR LocaL MEDIcaL oFFIcERS DERIVED FEES - REaDy REckonER FoR LocaL MEDIcaL oFFIcERS DIAGNOSTIC IMAGING SERVICES DIAGNOSTIC IMAGING SERVICES