[Federal Register: August 24, 2001 (Volume 66, Number 165)]
[Proposed Rules]
[Page 44871-44912]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr24au01-42]

[[pp. 44871-44912]] Medicare Program; Changes to the Hospital Outpatient Prospective
Payment System and Calendar Year 2002 Payment Rates

[[Continued from page 44870]]

[[Page 44870]]

   L3204  E                Hightop w/ supp/      ...........  ...........  ...........  ...........  ...........
                            pronator inf.
   L3206  E                Hightop w/ supp/      ...........  ...........  ...........  ...........  ...........
                            pronator chi.
   L3207  E                Hightop w/ supp/      ...........  ...........  ...........  ...........  ...........
                            pronator jun.
   L3208  E                Surgical boot each    ...........  ...........  ...........  ...........  ...........
                            infant.
   L3209  E                Surgical boot each    ...........  ...........  ...........  ...........  ...........
                            child.
   L3211  E                Surgical boot each    ...........  ...........  ...........  ...........  ...........
                            junior.
   L3212  E                Benesch boot pair     ...........  ...........  ...........  ...........  ...........
                            infant.
   L3213  E                Benesch boot pair     ...........  ...........  ...........  ...........  ...........
                            child.
   L3214  E                Benesch boot pair     ...........  ...........  ...........  ...........  ...........
                            junior.
   L3215  E                Orthopedic ftwear     ...........  ...........  ...........  ...........  ...........
                            ladies oxf.
   L3216  E                Orthoped ladies       ...........  ...........  ...........  ...........  ...........
                            shoes dpth i.
   L3217  E                Ladies shoes hightop  ...........  ...........  ...........  ...........  ...........
                            depth i.
   L3218  E                Ladies surgical boot  ...........  ...........  ...........  ...........  ...........
                            each.
   L3219  E                Orthopedic mens       ...........  ...........  ...........  ...........  ...........
                            shoes oxford.
   L3221  E                Orthopedic mens       ...........  ...........  ...........  ...........  ...........
                            shoes dpth i.
   L3222  E                Mens shoes hightop    ...........  ...........  ...........  ...........  ...........
                            depth inl.
   L3223  E                Mens surgical boot    ...........  ...........  ...........  ...........  ...........
                            each.
   L3224  A                Woman's shoe oxford   ...........  ...........  ...........  ...........  ...........
                            brace.
   L3225  A                Man's shoe oxford     ...........  ...........  ...........  ...........  ...........
                            brace.
   L3230  E                Custom shoes depth    ...........  ...........  ...........  ...........  ...........
                            inlay.
   L3250  E                Custom mold shoe      ...........  ...........  ...........  ...........  ...........
                            remov prost.
   L3251  E                Shoe molded to pt     ...........  ...........  ...........  ...........  ...........
                            silicone s.
   L3252  E                Shoe molded           ...........  ...........  ...........  ...........  ...........
                            plastazote cust.
   L3253  E                Shoe molded           ...........  ...........  ...........  ...........  ...........
                            plastazote cust.
   L3254  E                Orth foot non-        ...........  ...........  ...........  ...........  ...........
                            stndard size/w.
   L3255  E                Orth foot non-        ...........  ...........  ...........  ...........  ...........
                            standard size/.
   L3257  E                Orth foot add charge  ...........  ...........  ...........  ...........  ...........
                            split s.
   L3260  E                Ambulatory surgical   ...........  ...........  ...........  ...........  ...........
                            boot eac.
   L3265  E                Plastazote sandal     ...........  ...........  ...........  ...........  ...........
                            each.
   L3300  E                Sho lift taper to     ...........  ...........  ...........  ...........  ...........
                            metatarsal.
   L3310  E                Shoe lift elev heel/  ...........  ...........  ...........  ...........  ...........
                            sole neo.
   L3320  E                Shoe lift elev heel/  ...........  ...........  ...........  ...........  ...........
                            sole cor.
   L3330  E                Lifts elevation       ...........  ...........  ...........  ...........  ...........
                            metal extens.
   L3332  E                Shoe lifts tapered    ...........  ...........  ...........  ...........  ...........
                            to one-ha.
   L3334  E                Shoe lifts elevation  ...........  ...........  ...........  ...........  ...........
                            heel /i.
   L3340  E                Shoe wedge sach.....  ...........  ...........  ...........  ...........  ...........
   L3350  E                Shoe heel wedge.....  ...........  ...........  ...........  ...........  ...........
   L3360  E                Shoe sole wedge       ...........  ...........  ...........  ...........  ...........
                            outside sole.
   L3370  E                Shoe sole wedge       ...........  ...........  ...........  ...........  ...........
                            between sole.
   L3380  E                Shoe clubfoot wedge.  ...........  ...........  ...........  ...........  ...........
   L3390  E                Shoe outflare wedge.  ...........  ...........  ...........  ...........  ...........
   L3400  E                Shoe metatarsal bar   ...........  ...........  ...........  ...........  ...........
                            wedge ro.
   L3410  E                Shoe metatarsal bar   ...........  ...........  ...........  ...........  ...........
                            between.
   L3420  E                Full sole/heel wedge  ...........  ...........  ...........  ...........  ...........
                            btween.
   L3430  E                Sho heel count plast  ...........  ...........  ...........  ...........  ...........
                            reinfor.
   L3440  E                Heel leather          ...........  ...........  ...........  ...........  ...........
                            reinforced.
   L3450  E                Shoe heel sach        ...........  ...........  ...........  ...........  ...........
                            cushion type.
   L3455  E                Shoe heel new         ...........  ...........  ...........  ...........  ...........
                            leather standa.
   L3460  E                Shoe heel new rubber  ...........  ...........  ...........  ...........  ...........
                            standar.
   L3465  E                Shoe heel thomas      ...........  ...........  ...........  ...........  ...........
                            with wedge.
   L3470  E                Shoe heel thomas      ...........  ...........  ...........  ...........  ...........
                            extend to b.
   L3480  E                Shoe heel pad &       ...........  ...........  ...........  ...........  ...........
                            depress for.
   L3485  E                Shoe heel pad         ...........  ...........  ...........  ...........  ...........
                            removable for.
   L3500  E                Ortho shoe add        ...........  ...........  ...........  ...........  ...........
                            leather insol.
   L3510  E                Orthopedic shoe add   ...........  ...........  ...........  ...........  ...........
                            rub insl.
   L3520  E                O shoe add felt w     ...........  ...........  ...........  ...........  ...........
                            leath insl.
   L3530  E                Ortho shoe add half   ...........  ...........  ...........  ...........  ...........
                            sole.
   L3540  E                Ortho shoe add full   ...........  ...........  ...........  ...........  ...........
                            sole.
   L3550  E                O shoe add standard   ...........  ...........  ...........  ...........  ...........
                            toe tap.
   L3560  E                O shoe add horseshoe  ...........  ...........  ...........  ...........  ...........
                            toe tap.
   L3570  E                O shoe add instep     ...........  ...........  ...........  ...........  ...........
                            extension.
   L3580  E                O shoe add instep     ...........  ...........  ...........  ...........  ...........
                            velcro clo.
   L3590  E                O shoe convert to     ...........  ...........  ...........  ...........  ...........
                            sof counte.
   L3595  E                Ortho shoe add march  ...........  ...........  ...........  ...........  ...........
                            bar.
   L3600  E                Trans shoe calip      ...........  ...........  ...........  ...........  ...........
                            plate exist.
   L3610  E                Trans shoe caliper    ...........  ...........  ...........  ...........  ...........
                            plate new.
   L3620  E                Trans shoe solid      ...........  ...........  ...........  ...........  ...........
                            stirrup exi.
   L3630  E                Trans shoe solid      ...........  ...........  ...........  ...........  ...........
                            stirrup new.
   L3640  E                Shoe dennis browne    ...........  ...........  ...........  ...........  ...........
                            splint bo.
   L3649  E                Orthopedic shoe       ...........  ...........  ...........  ...........  ...........
                            modifica NOS.
   L3650  A                Shlder fig 8 abduct   ...........  ...........  ...........  ...........  ...........
                            restrain.
   L3660  A                Abduct restrainer     ...........  ...........  ...........  ...........  ...........
                            canvas&web.
   L3670  A                Acromio/clavicular    ...........  ...........  ...........  ...........  ...........
                            canvas&we.
   L3675  A                Canvas vest SO......  ...........  ...........  ...........  ...........  ...........
   L3700  A                Elbow orthoses elas   ...........  ...........  ...........  ...........  ...........
                            w stays.

[[Page 44871]]

   L3710  A                Elbow elastic with    ...........  ...........  ...........  ...........  ...........
                            metal joi.
   L3720  A                Forearm/arm cuffs     ...........  ...........  ...........  ...........  ...........
                            free motio.
   L3730  A                Forearm/arm cuffs     ...........  ...........  ...........  ...........  ...........
                            ext/flex a.
   L3740  A                Cuffs adj lock w/     ...........  ...........  ...........  ...........  ...........
                            active con.
   L3760  E                EO withjoint,         ...........  ...........  ...........  ...........  ...........
                            Prefabricated.
   L3800  A                Whfo short opponen    ...........  ...........  ...........  ...........  ...........
                            no attach.
   L3805  A                Whfo long opponens    ...........  ...........  ...........  ...........  ...........
                            no attach.
   L3807  A                WHFO,no joint,        ...........  ...........  ...........  ...........  ...........
                            prefabricated.
   L3810  A                Whfo thumb abduction  ...........  ...........  ...........  ...........  ...........
                            bar.
   L3815  A                Whfo second m.p.      ...........  ...........  ...........  ...........  ...........
                            abduction a.
   L3820  A                Whfo ip ext asst w/   ...........  ...........  ...........  ...........  ...........
                            mp ext s.
   L3825  A                Whfo m.p. extension   ...........  ...........  ...........  ...........  ...........
                            stop.
   L3830  A                Whfo m.p. extension   ...........  ...........  ...........  ...........  ...........
                            assist.
   L3835  A                Whfo m.p. spring      ...........  ...........  ...........  ...........  ...........
                            extension a.
   L3840  A                Whfo spring swivel    ...........  ...........  ...........  ...........  ...........
                            thumb.
   L3845  A                Whfo thumb ip ext     ...........  ...........  ...........  ...........  ...........
                            ass w/ mp.
   L3850  A                Action wrist w/       ...........  ...........  ...........  ...........  ...........
                            dorsiflex as.
   L3855  A                Whfo adj m.p.         ...........  ...........  ...........  ...........  ...........
                            flexion contro.
   L3860  A                Whfo adj m.p. flex    ...........  ...........  ...........  ...........  ...........
                            ctrl & i..
   L3890  E                Torsion mechanism     ...........  ...........  ...........  ...........  ...........
                            wrist/elbo.
   L3900  A                Hinge extension/flex  ...........  ...........  ...........  ...........  ...........
                            wrist/f.
   L3901  A                Hinge ext/flex wrist  ...........  ...........  ...........  ...........  ...........
                            finger.
   L3902  A                Whfo ext power        ...........  ...........  ...........  ...........  ...........
                            compress gas.
   L3904  A                Whfo electric custom  ...........  ...........  ...........  ...........  ...........
                            fitted.
   L3906  A                Wrist gauntlet        ...........  ...........  ...........  ...........  ...........
                            molded to pt.
   L3907  A                Whfo wrst gauntlt     ...........  ...........  ...........  ...........  ...........
                            thmb spica.
   L3908  A                Wrist cock-up non-    ...........  ...........  ...........  ...........  ...........
                            molded.
   L3910  A                Whfo swanson design.  ...........  ...........  ...........  ...........  ...........
   L3912  A                Flex glove w/elastic  ...........  ...........  ...........  ...........  ...........
                            finger.
   L3914  A                WHO wrist extension   ...........  ...........  ...........  ...........  ...........
                            cock-up.
   L3916  A                Whfo wrist extens w/  ...........  ...........  ...........  ...........  ...........
                            outrigg.
   L3918  A                HFO knuckle bender..  ...........  ...........  ...........  ...........  ...........
   L3920  A                Knuckle bender with   ...........  ...........  ...........  ...........  ...........
                            outrigge.
   L3922  A                Knuckle bend 2 seg    ...........  ...........  ...........  ...........  ...........
                            to flex j.
   L3923  A                HFO, no joint,        ...........  ...........  ...........  ...........  ...........
                            prefabricated.
   L3924  A                Oppenheimer.........  ...........  ...........  ...........  ...........  ...........
   L3926  A                Thomas suspension...  ...........  ...........  ...........  ...........  ...........
   L3928  A                Finger extension w/   ...........  ...........  ...........  ...........  ...........
                            clock sp.
   L3930  A                Finger extension      ...........  ...........  ...........  ...........  ...........
                            with wrist.
   L3932  A                Safety pin spring     ...........  ...........  ...........  ...........  ...........
                            wire.
   L3934  A                Safety pin modified.  ...........  ...........  ...........  ...........  ...........
   L3936  A                Palmer..............  ...........  ...........  ...........  ...........  ...........
   L3938  A                Dorsal wrist........  ...........  ...........  ...........  ...........  ...........
   L3940  A                Dorsal wrist w/       ...........  ...........  ...........  ...........  ...........
                            outrigger at.
   L3942  A                Reverse knuckle       ...........  ...........  ...........  ...........  ...........
                            bender.
   L3944  A                Reverse knuckle bend  ...........  ...........  ...........  ...........  ...........
                            w/ outr.
   L3946  A                HFO composite         ...........  ...........  ...........  ...........  ...........
                            elastic.
   L3948  A                Finger knuckle        ...........  ...........  ...........  ...........  ...........
                            bender.
   L3950  A                Oppenheimer w/        ...........  ...........  ...........  ...........  ...........
                            knuckle bend.
   L3952  A                Oppenheimer w/ rev    ...........  ...........  ...........  ...........  ...........
                            knuckle 2.
   L3954  A                Spreading hand......  ...........  ...........  ...........  ...........  ...........
   L3956  A                Add joint upper ext   ...........  ...........  ...........  ...........  ...........
                            orthosis.
   L3960  A                Sewho airplan desig   ...........  ...........  ...........  ...........  ...........
                            abdu pos.
   L3962  A                Sewho erbs palsey     ...........  ...........  ...........  ...........  ...........
                            design abd.
   L3963  A                Molded w/             ...........  ...........  ...........  ...........  ...........
                            articulating elbow.
   L3964  A                Seo mobile arm sup    ...........  ...........  ...........  ...........  ...........
                            att to wc.
   L3965  A                Arm supp att to wc    ...........  ...........  ...........  ...........  ...........
                            rancho ty.
   L3966  A                Mobile arm supports   ...........  ...........  ...........  ...........  ...........
                            reclinin.
   L3968  A                Friction dampening    ...........  ...........  ...........  ...........  ...........
                            arm supp.
   L3969  A                Monosuspension arm/   ...........  ...........  ...........  ...........  ...........
                            hand supp.
   L3970  A                Elevat proximal arm   ...........  ...........  ...........  ...........  ...........
                            support.
   L3972  A                Offset/lat rocker     ...........  ...........  ...........  ...........  ...........
                            arm w/ ela.
   L3974  A                Mobile arm support    ...........  ...........  ...........  ...........  ...........
                            supinator.
   L3980  A                Upp ext fx orthosis   ...........  ...........  ...........  ...........  ...........
                            humeral.
   L3982  A                Upper ext fx          ...........  ...........  ...........  ...........  ...........
                            orthosis rad/ul.
   L3984  A                Upper ext fx          ...........  ...........  ...........  ...........  ...........
                            orthosis wrist.
   L3985  A                Forearm hand fx orth  ...........  ...........  ...........  ...........  ...........
                            w/ wr h.
   L3986  A                Humeral rad/ulna      ...........  ...........  ...........  ...........  ...........
                            wrist fx or.
   L3995  A                Sock fracture or      ...........  ...........  ...........  ...........  ...........
                            equal each.
   L3999  A                Upper limb orthosis   ...........  ...........  ...........  ...........  ...........
                            NOS.
   L4000  A                Repl girdle           ...........  ...........  ...........  ...........  ...........
                            milwaukee orth.
   L4010  A                Replace trilateral    ...........  ...........  ...........  ...........  ...........
                            socket br.
   L4020  A                Replace quadlat       ...........  ...........  ...........  ...........  ...........
                            socket brim.
   L4030  A                Replace socket brim   ...........  ...........  ...........  ...........  ...........
                            cust fit.
   L4040  A                Replace molded thigh  ...........  ...........  ...........  ...........  ...........
                            lacer.

[[Page 44872]]

   L4045  A                Replace non-molded    ...........  ...........  ...........  ...........  ...........
                            thigh lac.
   L4050  A                Replace molded calf   ...........  ...........  ...........  ...........  ...........
                            lacer.
   L4055  A                Replace non-molded    ...........  ...........  ...........  ...........  ...........
                            calf lace.
   L4060  A                Replace high roll     ...........  ...........  ...........  ...........  ...........
                            cuff.
   L4070  A                Replace prox & dist   ...........  ...........  ...........  ...........  ...........
                            upright.
   L4080  A                Repl met band kafo-   ...........  ...........  ...........  ...........  ...........
                            afo prox.
   L4090  A                Repl met band kafo-   ...........  ...........  ...........  ...........  ...........
                            afo calf/.
   L4100  A                Repl leath cuff kafo  ...........  ...........  ...........  ...........  ...........
                            prox th.
   L4110  A                Repl leath cuff kafo- ...........  ...........  ...........  ...........  ...........
                            afo cal.
   L4130  A                Replace pretibial     ...........  ...........  ...........  ...........  ...........
                            shell.
   L4205  A                Ortho dvc repair per  ...........  ...........  ...........  ...........  ...........
                            15 min.
   L4210  A                Orth dev repair/repl  ...........  ...........  ...........  ...........  ...........
                            minor p.
   L4350  A                Pneumatic ankle       ...........  ...........  ...........  ...........  ...........
                            cntrl splint.
   L4360  A                Pneumatic walking     ...........  ...........  ...........  ...........  ...........
                            splint.
   L4370  A                Pneumatic full leg    ...........  ...........  ...........  ...........  ...........
                            splint.
   L4380  A                Pneumatic knee        ...........  ...........  ...........  ...........  ...........
                            splint.
   L4392  A                Replace AFO soft      ...........  ...........  ...........  ...........  ...........
                            interface.
   L4394  A                Replace foot drop     ...........  ...........  ...........  ...........  ...........
                            spint.
   L4396  A                Static AFO..........  ...........  ...........  ...........  ...........  ...........
   L4398  A                Foot drop splint      ...........  ...........  ...........  ...........  ...........
                            recumbent.
   L5000  A                Sho insert w arch     ...........  ...........  ...........  ...........  ...........
                            toe filler.
   L5010  A                Mold socket ank hgt   ...........  ...........  ...........  ...........  ...........
                            w/ toe f.
   L5020  A                Tibial tubercle hgt   ...........  ...........  ...........  ...........  ...........
                            w/ toe f.
   L5050  A                Ank symes mold sckt   ...........  ...........  ...........  ...........  ...........
                            sach ft.
   L5060  A                Symes met fr leath    ...........  ...........  ...........  ...........  ...........
                            socket ar.
   L5100  A                Molded socket shin    ...........  ...........  ...........  ...........  ...........
                            sach foot.
   L5105  A                Plast socket jts/     ...........  ...........  ...........  ...........  ...........
                            thgh lacer.
   L5150  A                Mold sckt ext knee    ...........  ...........  ...........  ...........  ...........
                            shin sach.
   L5160  A                Mold socket bent      ...........  ...........  ...........  ...........  ...........
                            knee shin s.
   L5200  A                Kne sing axis fric    ...........  ...........  ...........  ...........  ...........
                            shin sach.
   L5210  A                No knee/ankle joints  ...........  ...........  ...........  ...........  ...........
                            w/ ft b.
   L5220  A                No knee joint with    ...........  ...........  ...........  ...........  ...........
                            artic ali.
   L5230  A                Fem focal defic       ...........  ...........  ...........  ...........  ...........
                            constant fri.
   L5250  A                Hip canad sing axi    ...........  ...........  ...........  ...........  ...........
                            cons fric.
   L5270  A                Tilt table locking    ...........  ...........  ...........  ...........  ...........
                            hip sing.
   L5280  A                Hemipelvect canad     ...........  ...........  ...........  ...........  ...........
                            sing axis.
   L5300  A                Bk sach soft cover &  ...........  ...........  ...........  ...........  ...........
                            finish.
   L5310  A                Knee disart sach      ...........  ...........  ...........  ...........  ...........
                            soft cv/fin.
   L5320  A                Ak open end sach      ...........  ...........  ...........  ...........  ...........
                            soft cv/fin.
   L5330  A                Hip canadian sach     ...........  ...........  ...........  ...........  ...........
                            sft cv/fin.
   L5340  A                Hemipelvectomy canad  ...........  ...........  ...........  ...........  ...........
                            cv/fin.
   L5400  A                Postop dress & 1      ...........  ...........  ...........  ...........  ...........
                            cast chg bk.
   L5410  A                Postop dsg bk ea add  ...........  ...........  ...........  ...........  ...........
                            cast ch.
   L5420  A                Postop dsg & 1 cast   ...........  ...........  ...........  ...........  ...........
                            chg ak/d.
   L5430  A                Postop dsg ak ea add  ...........  ...........  ...........  ...........  ...........
                            cast ch.
   L5450  A                Postop app non-wgt    ...........  ...........  ...........  ...........  ...........
                            bear dsg.
   L5460  A                Postop app non-wgt    ...........  ...........  ...........  ...........  ...........
                            bear dsg.
   L5500  A                Init bk ptb plaster   ...........  ...........  ...........  ...........  ...........
                            direct.
   L5505  A                Init ak ischal plstr  ...........  ...........  ...........  ...........  ...........
                            direct.
   L5510  A                Prep BK ptb plaster   ...........  ...........  ...........  ...........  ...........
                            molded.
   L5520  A                Perp BK ptb           ...........  ...........  ...........  ...........  ...........
                            thermopls direct.
   L5530  A                Prep BK ptb           ...........  ...........  ...........  ...........  ...........
                            thermopls molded.
   L5535  A                Prep BK ptb open end  ...........  ...........  ...........  ...........  ...........
                            socket.
   L5540  A                Prep BK ptb           ...........  ...........  ...........  ...........  ...........
                            laminated socket.
   L5560  A                Prep AK ischial       ...........  ...........  ...........  ...........  ...........
                            plast molded.
   L5570  A                Prep AK ischial       ...........  ...........  ...........  ...........  ...........
                            direct form.
   L5580  A                Prep AK ischial       ...........  ...........  ...........  ...........  ...........
                            thermo mold.
   L5585  A                Prep AK ischial open  ...........  ...........  ...........  ...........  ...........
                            end.
   L5590  A                Prep AK ischial       ...........  ...........  ...........  ...........  ...........
                            laminated.
   L5595  A                Hip disartic sach     ...........  ...........  ...........  ...........  ...........
                            thermopls.
   L5600  A                Hip disart sach       ...........  ...........  ...........  ...........  ...........
                            laminat mold.
   L5610  A                Above knee            ...........  ...........  ...........  ...........  ...........
                            hydracadence.
   L5611  A                Ak 4 bar link w/fric  ...........  ...........  ...........  ...........  ...........
                            swing.
   L5613  A                Ak 4 bar ling w/      ...........  ...........  ...........  ...........  ...........
                            hydraul swig.
   L5614  A                4-bar link above      ...........  ...........  ...........  ...........  ...........
                            knee w/swng.
   L5616  A                Ak univ multiplex     ...........  ...........  ...........  ...........  ...........
                            sys frict.
   L5617  A                AK/BK self-aligning   ...........  ...........  ...........  ...........  ...........
                            unit ea.
   L5618  A                Test socket symes...  ...........  ...........  ...........  ...........  ...........
   L5620  A                Test socket below     ...........  ...........  ...........  ...........  ...........
                            knee.
   L5622  A                Test socket knee      ...........  ...........  ...........  ...........  ...........
                            disarticula.
   L5624  A                Test socket above     ...........  ...........  ...........  ...........  ...........
                            knee.
   L5626  A                Test socket hip       ...........  ...........  ...........  ...........  ...........
                            disarticulat.
   L5628  A                Test socket           ...........  ...........  ...........  ...........  ...........
                            hemipelvectomy.
   L5629  A                Below knee acrylic    ...........  ...........  ...........  ...........  ...........
                            socket.
   L5630  A                Syme typ expandabl    ...........  ...........  ...........  ...........  ...........
                            wall sckt.

[[Page 44873]]

   L5631  A                Ak/knee disartic      ...........  ...........  ...........  ...........  ...........
                            acrylic soc.
   L5632  A                Symes type ptb brim   ...........  ...........  ...........  ...........  ...........
                            design s.
   L5634  A                Symes type poster     ...........  ...........  ...........  ...........  ...........
                            opening so.
   L5636  A                Symes type medial     ...........  ...........  ...........  ...........  ...........
                            opening so.
   L5637  A                Below knee total      ...........  ...........  ...........  ...........  ...........
                            contact.
   L5638  A                Below knee leather    ...........  ...........  ...........  ...........  ...........
                            socket.
   L5639  A                Below knee wood       ...........  ...........  ...........  ...........  ...........
                            socket.
   L5640  A                Knee disarticulat     ...........  ...........  ...........  ...........  ...........
                            leather so.
   L5642  A                Above knee leather    ...........  ...........  ...........  ...........  ...........
                            socket.
   L5643  A                Hip flex inner        ...........  ...........  ...........  ...........  ...........
                            socket ext fr.
   L5644  A                Above knee wood       ...........  ...........  ...........  ...........  ...........
                            socket.
   L5645  A                Bk flex inner socket  ...........  ...........  ...........  ...........  ...........
                            ext fra.
   L5646  A                Below knee air        ...........  ...........  ...........  ...........  ...........
                            cushion socke.
   L5647  A                Below knee suction    ...........  ...........  ...........  ...........  ...........
                            socket.
   L5648  A                Above knee air        ...........  ...........  ...........  ...........  ...........
                            cushion socke.
   L5649  A                Isch containmt/       ...........  ...........  ...........  ...........  ...........
                            narrow m-l so.
   L5650  A                Tot contact ak/knee   ...........  ...........  ...........  ...........  ...........
                            disart s.
   L5651  A                Ak flex inner socket  ...........  ...........  ...........  ...........  ...........
                            ext fra.
   L5652  A                Suction susp ak/knee  ...........  ...........  ...........  ...........  ...........
                            disart.
   L5653  A                Knee disart expand    ...........  ...........  ...........  ...........  ...........
                            wall sock.
   L5654  A                Socket insert symes.  ...........  ...........  ...........  ...........  ...........
   L5655  A                Socket insert below   ...........  ...........  ...........  ...........  ...........
                            knee.
   L5656  A                Socket insert knee    ...........  ...........  ...........  ...........  ...........
                            articulat.
   L5658  A                Socket insert above   ...........  ...........  ...........  ...........  ...........
                            knee.
   L5660  A                Sock insrt syme       ...........  ...........  ...........  ...........  ...........
                            silicone gel.
   L5661  A                Multi-durometer       ...........  ...........  ...........  ...........  ...........
                            symes.
   L5662  A                Socket insert bk      ...........  ...........  ...........  ...........  ...........
                            silicone ge.
   L5663  A                Sock knee disartic    ...........  ...........  ...........  ...........  ...........
                            silicone.
   L5664  A                Socket insert ak      ...........  ...........  ...........  ...........  ...........
                            silicone ge.
   L5665  A                Multi-durometer       ...........  ...........  ...........  ...........  ...........
                            below knee.
   L5666  A                Below knee cuff       ...........  ...........  ...........  ...........  ...........
                            suspension.
   L5667  A                Socket insert w lock  ...........  ...........  ...........  ...........  ...........
                            lower.
   L5668  A                Socket insert w/o     ...........  ...........  ...........  ...........  ...........
                            lock lower.
   L5669  A                Below knee socket w/  ...........  ...........  ...........  ...........  ...........
                            o lock.
   L5670  A                Bk molded             ...........  ...........  ...........  ...........  ...........
                            supracondylar susp.
   L5672  A                Bk removable medial   ...........  ...........  ...........  ...........  ...........
                            brim sus.
   L5674  A                Bk suspension sleeve  ...........  ...........  ...........  ...........  ...........
   L5675  A                Bk heavy duty susp    ...........  ...........  ...........  ...........  ...........
                            sleeve.
   L5676  A                Bk knee joints        ...........  ...........  ...........  ...........  ...........
                            single axis p.
   L5677  A                Bk knee joints        ...........  ...........  ...........  ...........  ...........
                            polycentric p.
   L5678  A                Bk joint covers pair  ...........  ...........  ...........  ...........  ...........
   L5680  A                Bk thigh lacer non-   ...........  ...........  ...........  ...........  ...........
                            molded.
   L5682  A                Bk thigh lacer glut/  ...........  ...........  ...........  ...........  ...........
                            ischia m.
   L5684  A                Bk fork strap.......  ...........  ...........  ...........  ...........  ...........
   L5686  A                Bk back check.......  ...........  ...........  ...........  ...........  ...........
   L5688  A                Bk waist belt         ...........  ...........  ...........  ...........  ...........
                            webbing.
   L5690  A                Bk waist belt padded  ...........  ...........  ...........  ...........  ...........
                            and lin.
   L5692  A                Ak pelvic control     ...........  ...........  ...........  ...........  ...........
                            belt light.
   L5694  A                Ak pelvic control     ...........  ...........  ...........  ...........  ...........
                            belt pad/l.
   L5695  A                Ak sleeve susp        ...........  ...........  ...........  ...........  ...........
                            neoprene/equa.
   L5696  A                Ak/knee disartic      ...........  ...........  ...........  ...........  ...........
                            pelvic join.
   L5697  A                Ak/knee disartic      ...........  ...........  ...........  ...........  ...........
                            pelvic band.
   L5698  A                Ak/knee disartic      ...........  ...........  ...........  ...........  ...........
                            silesian ba.
   L5699  A                Shoulder harness....  ...........  ...........  ...........  ...........  ...........
   L5700  A                Replace socket below  ...........  ...........  ...........  ...........  ...........
                            knee.
   L5701  A                Replace socket above  ...........  ...........  ...........  ...........  ...........
                            knee.
   L5702  A                Replace socket hip..  ...........  ...........  ...........  ...........  ...........
   L5704  A                Custom shape covr     ...........  ...........  ...........  ...........  ...........
                            below knee.
   L5705  A                Custm shape cover     ...........  ...........  ...........  ...........  ...........
                            above knee.
   L5706  A                Custm shape cvr knee  ...........  ...........  ...........  ...........  ...........
                            disart.
   L5707  A                Custm shape cover     ...........  ...........  ...........  ...........  ...........
                            hip disart.
   L5710  A                Kne-shin exo sng axi  ...........  ...........  ...........  ...........  ...........
                            mnl loc.
   L5711  A                Knee-shin exo mnl     ...........  ...........  ...........  ...........  ...........
                            lock ultra.
   L5712  A                Knee-shin exo frict   ...........  ...........  ...........  ...........  ...........
                            swg & st.
   L5714  A                Knee-shin exo         ...........  ...........  ...........  ...........  ...........
                            variable frict.
   L5716  A                Knee-shin exo mech    ...........  ...........  ...........  ...........  ...........
                            stance ph.
   L5718  A                Knee-shin exo frct    ...........  ...........  ...........  ...........  ...........
                            swg & sta.
   L5722  A                Knee-shin pneum swg   ...........  ...........  ...........  ...........  ...........
                            frct exo.
   L5724  A                Knee-shin exo fluid   ...........  ...........  ...........  ...........  ...........
                            swing ph.
   L5726  A                Knee-shin ext jnts    ...........  ...........  ...........  ...........  ...........
                            fld swg e.
   L5728  A                Knee-shin fluid swg   ...........  ...........  ...........  ...........  ...........
                            & stance.
   L5780  A                Knee-shin pneum/      ...........  ...........  ...........  ...........  ...........
                            hydra pneum.
   L5785  A                Exoskeletal bk        ...........  ...........  ...........  ...........  ...........
                            ultralt mater.
   L5790  A                Exoskeletal ak ultra- ...........  ...........  ...........  ...........  ...........
                            light m.
   L5795  A                Exoskel hip ultra-    ...........  ...........  ...........  ...........  ...........
                            light mate.

[[Page 44874]]

   L5810  A                Endoskel knee-shin    ...........  ...........  ...........  ...........  ...........
                            mnl lock.
   L5811  A                Endo knee-shin mnl    ...........  ...........  ...........  ...........  ...........
                            lck ultra.
   L5812  A                Endo knee-shin frct   ...........  ...........  ...........  ...........  ...........
                            swg & st.
   L5814  A                Endo knee-shin        ...........  ...........  ...........  ...........  ...........
                            hydral swg ph.
   L5816  A                Endo knee-shin polyc  ...........  ...........  ...........  ...........  ...........
                            mch sta.
   L5818  A                Endo knee-shin frct   ...........  ...........  ...........  ...........  ...........
                            swg & st.
   L5822  A                Endo knee-shin pneum  ...........  ...........  ...........  ...........  ...........
                            swg frc.
   L5824  A                Endo knee-shin fluid  ...........  ...........  ...........  ...........  ...........
                            swing p.
   L5826  A                Miniature knee joint  ...........  ...........  ...........  ...........  ...........
   L5828  A                Endo knee-shin fluid  ...........  ...........  ...........  ...........  ...........
                            swg/sta.
   L5830  A                Endo knee-shin pneum/ ...........  ...........  ...........  ...........  ...........
                            swg pha.
   L5840  A                Multi-axial knee/     ...........  ...........  ...........  ...........  ...........
                            shin system.
   L5845  A                Knee-shin sys stance  ...........  ...........  ...........  ...........  ...........
                            flexion.
   L5846  A                Knee-shin sys         ...........  ...........  ...........  ...........  ...........
                            microprocessor.
   L5850  A                Endo ak/hip knee      ...........  ...........  ...........  ...........  ...........
                            extens assi.
   L5855  A                Mech hip extension    ...........  ...........  ...........  ...........  ...........
                            assist.
   L5910  A                Endo below knee       ...........  ...........  ...........  ...........  ...........
                            alignable sy.
   L5920  A                Endo ak/hip           ...........  ...........  ...........  ...........  ...........
                            alignable system.
   L5925  A                Above knee manual     ...........  ...........  ...........  ...........  ...........
                            lock.
   L5930  A                High activity knee    ...........  ...........  ...........  ...........  ...........
                            frame.
   L5940  A                Endo bk ultra-light   ...........  ...........  ...........  ...........  ...........
                            material.
   L5950  A                Endo ak ultra-light   ...........  ...........  ...........  ...........  ...........
                            material.
   L5960  A                Endo hip ultra-light  ...........  ...........  ...........  ...........  ...........
                            materia.
   L5962  A                Below knee flex       ...........  ...........  ...........  ...........  ...........
                            cover system.
   L5964  A                Above knee flex       ...........  ...........  ...........  ...........  ...........
                            cover system.
   L5966  A                Hip flexible cover    ...........  ...........  ...........  ...........  ...........
                            system.
   L5968  A                Multiaxial ankle w    ...........  ...........  ...........  ...........  ...........
                            dorsiflex.
   L5970  A                Foot external keel    ...........  ...........  ...........  ...........  ...........
                            sach foot.
   L5972  A                Flexible keel foot..  ...........  ...........  ...........  ...........  ...........
   L5974  A                Foot single axis      ...........  ...........  ...........  ...........  ...........
                            ankle/foot.
   L5975  A                Combo ankle/foot      ...........  ...........  ...........  ...........  ...........
                            prosthesis.
   L5976  A                Energy storing foot.  ...........  ...........  ...........  ...........  ...........
   L5978  A                Ft prosth multiaxial  ...........  ...........  ...........  ...........  ...........
                            ankl/ft.
   L5979  A                Multi-axial ankle/ft  ...........  ...........  ...........  ...........  ...........
                            prosth.
   L5980  A                Flex foot system....  ...........  ...........  ...........  ...........  ...........
   L5981  A                Flex-walk sys low     ...........  ...........  ...........  ...........  ...........
                            ext prosth.
   L5982  A                Exoskeletal axial     ...........  ...........  ...........  ...........  ...........
                            rotation u.
   L5984  A                Endoskeletal axial    ...........  ...........  ...........  ...........  ...........
                            rotation.
   L5985  A                Lwr ext dynamic       ...........  ...........  ...........  ...........  ...........
                            prosth pylon.
   L5986  A                Multi-axial rotation  ...........  ...........  ...........  ...........  ...........
                            unit.
   L5987  A                Shank ft w vert load  ...........  ...........  ...........  ...........  ...........
                            pylon.
   L5988  A                Vertical shock        ...........  ...........  ...........  ...........  ...........
                            reducing pylo.
   L5999  A                Lowr extremity        ...........  ...........  ...........  ...........  ...........
                            prosthes NOS.
   L6000  A                Par hand robin-aids   ...........  ...........  ...........  ...........  ...........
                            thum rem.
   L6010  A                Hand robin-aids       ...........  ...........  ...........  ...........  ...........
                            little/ring.
   L6020  A                Part hand robin-aids  ...........  ...........  ...........  ...........  ...........
                            no fing.
   L6050  A                Wrst MLd sck flx hng  ...........  ...........  ...........  ...........  ...........
                            tri pad.
   L6055  A                Wrst mold sock w/exp  ...........  ...........  ...........  ...........  ...........
                            interfa.
   L6100  A                Elb mold sock flex    ...........  ...........  ...........  ...........  ...........
                            hinge pad.
   L6110  A                Elbow mold sock       ...........  ...........  ...........  ...........  ...........
                            suspension t.
   L6120  A                Elbow mold doub splt  ...........  ...........  ...........  ...........  ...........
                            soc ste.
   L6130  A                Elbow stump           ...........  ...........  ...........  ...........  ...........
                            activated lock h.
   L6200  A                Elbow mold outsid     ...........  ...........  ...........  ...........  ...........
                            lock hinge.
   L6205  A                Elbow molded w/       ...........  ...........  ...........  ...........  ...........
                            expand inter.
   L6250  A                Elbow inter loc       ...........  ...........  ...........  ...........  ...........
                            elbow forarm.
   L6300  A                Shlder disart int     ...........  ...........  ...........  ...........  ...........
                            lock elbow.
   L6310  A                Shoulder passive      ...........  ...........  ...........  ...........  ...........
                            restor comp.
   L6320  A                Shoulder passive      ...........  ...........  ...........  ...........  ...........
                            restor cap.
   L6350  A                Thoracic intern lock  ...........  ...........  ...........  ...........  ...........
                            elbow.
   L6360  A                Thoracic passive      ...........  ...........  ...........  ...........  ...........
                            restor comp.
   L6370  A                Thoracic passive      ...........  ...........  ...........  ...........  ...........
                            restor cap.
   L6380  A                Postop dsg cast chg   ...........  ...........  ...........  ...........  ...........
                            wrst/elb.
   L6382  A                Postop dsg cast chg   ...........  ...........  ...........  ...........  ...........
                            elb dis/.
   L6384  A                Postop dsg cast chg   ...........  ...........  ...........  ...........  ...........
                            shlder/t.
   L6386  A                Postop ea cast chg &  ...........  ...........  ...........  ...........  ...........
                            realign.
   L6388  A                Postop applicat       ...........  ...........  ...........  ...........  ...........
                            rigid dsg on.
   L6400  A                Below elbow prosth    ...........  ...........  ...........  ...........  ...........
                            tiss shap.
   L6450  A                Elb disart prosth     ...........  ...........  ...........  ...........  ...........
                            tiss shap.
   L6500  A                Above elbow prosth    ...........  ...........  ...........  ...........  ...........
                            tiss shap.
   L6550  A                Shldr disar prosth    ...........  ...........  ...........  ...........  ...........
                            tiss shap.
   L6570  A                Scap thorac prosth    ...........  ...........  ...........  ...........  ...........
                            tiss shap.
   L6580  A                Wrist/elbow bowden    ...........  ...........  ...........  ...........  ...........
                            cable mol.
   L6582  A                Wrist/elbow bowden    ...........  ...........  ...........  ...........  ...........
                            cbl dir f.
   L6584  A                Elbow fair lead       ...........  ...........  ...........  ...........  ...........
                            cable molded.
   L6586  A                Elbow fair lead       ...........  ...........  ...........  ...........  ...........
                            cable dir fo.

[[Page 44875]]

   L6588  A                Shdr fair lead cable  ...........  ...........  ...........  ...........  ...........
                            molded.
   L6590  A                Shdr fair lead cable  ...........  ...........  ...........  ...........  ...........
                            direct.
   L6600  A                Polycentric hinge     ...........  ...........  ...........  ...........  ...........
                            pair.
   L6605  A                Single pivot hinge    ...........  ...........  ...........  ...........  ...........
                            pair.
   L6610  A                Flexible metal hinge  ...........  ...........  ...........  ...........  ...........
                            pair.
   L6615  A                Disconnect locking    ...........  ...........  ...........  ...........  ...........
                            wrist uni.
   L6616  A                Disconnect insert     ...........  ...........  ...........  ...........  ...........
                            locking wr.
   L6620  A                Flexion-friction      ...........  ...........  ...........  ...........  ...........
                            wrist unit.
   L6623  A                Spring-ass rot wrst   ...........  ...........  ...........  ...........  ...........
                            w/ latch.
   L6625  A                Rotation wrst w/      ...........  ...........  ...........  ...........  ...........
                            cable lock.
   L6628  A                Quick disconn hook    ...........  ...........  ...........  ...........  ...........
                            adapter o.
   L6629  A                Lamination collar w/  ...........  ...........  ...........  ...........  ...........
                            couplin.
   L6630  A                Stainless steel any   ...........  ...........  ...........  ...........  ...........
                            wrist.
   L6632  A                Latex suspension      ...........  ...........  ...........  ...........  ...........
                            sleeve each.
   L6635  A                Lift assist for       ...........  ...........  ...........  ...........  ...........
                            elbow.
   L6637  A                Nudge control elbow   ...........  ...........  ...........  ...........  ...........
                            lock.
   L6640  A                Shoulder abduction    ...........  ...........  ...........  ...........  ...........
                            joint pai.
   L6641  A                Excursion amplifier   ...........  ...........  ...........  ...........  ...........
                            pulley t.
   L6642  A                Excursion amplifier   ...........  ...........  ...........  ...........  ...........
                            lever ty.
   L6645  A                Shoulder flexion-     ...........  ...........  ...........  ...........  ...........
                            abduction j.
   L6650  A                Shoulder universal    ...........  ...........  ...........  ...........  ...........
                            joint.
   L6655  A                Standard control      ...........  ...........  ...........  ...........  ...........
                            cable extra.
   L6660  A                Heavy duty control    ...........  ...........  ...........  ...........  ...........
                            cable.
   L6665  A                Teflon or equal       ...........  ...........  ...........  ...........  ...........
                            cable lining.
   L6670  A                Hook to hand cable    ...........  ...........  ...........  ...........  ...........
                            adapter.
   L6672  A                Harness chest/shlder  ...........  ...........  ...........  ...........  ...........
                            saddle.
   L6675  A                Harness figure of 8   ...........  ...........  ...........  ...........  ...........
                            sing con.
   L6676  A                Harness figure of 8   ...........  ...........  ...........  ...........  ...........
                            dual con.
   L6680  A                Test sock wrist       ...........  ...........  ...........  ...........  ...........
                            disart/bel e.
   L6682  A                Test sock elbw        ...........  ...........  ...........  ...........  ...........
                            disart/above.
   L6684  A                Test socket shldr     ...........  ...........  ...........  ...........  ...........
                            disart/tho.
   L6686  A                Suction socket......  ...........  ...........  ...........  ...........  ...........
   L6687  A                Frame typ socket bel  ...........  ...........  ...........  ...........  ...........
                            elbow/w.
   L6688  A                Frame typ sock above  ...........  ...........  ...........  ...........  ...........
                            elb/dis.
   L6689  A                Frame typ socket      ...........  ...........  ...........  ...........  ...........
                            shoulder di.
   L6690  A                Frame typ sock        ...........  ...........  ...........  ...........  ...........
                            interscap-tho.
   L6691  A                Removable insert      ...........  ...........  ...........  ...........  ...........
                            each.
   L6692  A                Silicone gel insert   ...........  ...........  ...........  ...........  ...........
                            or equal.
   L6693  A                Lockingelbow forearm  ...........  ...........  ...........  ...........  ...........
                            cntrbal.
   L6700  A                Terminal device       ...........  ...........  ...........  ...........  ...........
                            model 3.
   L6705  A                Terminal device       ...........  ...........  ...........  ...........  ...........
                            model 5.
   L6710  A                Terminal device       ...........  ...........  ...........  ...........  ...........
                            model 5x.
   L6715  A                Terminal device       ...........  ...........  ...........  ...........  ...........
                            model 5xa.
   L6720  A                Terminal device       ...........  ...........  ...........  ...........  ...........
                            model 6.
   L6725  A                Terminal device       ...........  ...........  ...........  ...........  ...........
                            model 7.
   L6730  A                Terminal device       ...........  ...........  ...........  ...........  ...........
                            model 7lo.
   L6735  A                Terminal device       ...........  ...........  ...........  ...........  ...........
                            model 8.
   L6740  A                Terminal device       ...........  ...........  ...........  ...........  ...........
                            model 8x.
   L6745  A                Terminal device       ...........  ...........  ...........  ...........  ...........
                            model 88x.
   L6750  A                Terminal device       ...........  ...........  ...........  ...........  ...........
                            model 10p.
   L6755  A                Terminal device       ...........  ...........  ...........  ...........  ...........
                            model 10x.
   L6765  A                Terminal device       ...........  ...........  ...........  ...........  ...........
                            model 12p.
   L6770  A                Terminal device       ...........  ...........  ...........  ...........  ...........
                            model 99x.
   L6775  A                Terminal device       ...........  ...........  ...........  ...........  ...........
                            model555.
   L6780  A                Terminal device       ...........  ...........  ...........  ...........  ...........
                            model ss555.
   L6790  A                Hooks-accu hook or    ...........  ...........  ...........  ...........  ...........
                            equal.
   L6795  A                Hooks-2 load or       ...........  ...........  ...........  ...........  ...........
                            equal.
   L6800  A                Hooks-aprl vc or      ...........  ...........  ...........  ...........  ...........
                            equal.
   L6805  A                Modifier wrist        ...........  ...........  ...........  ...........  ...........
                            flexion unit.
   L6806  A                Trs grip vc or equal  ...........  ...........  ...........  ...........  ...........
   L6807  A                Term device grip1/2   ...........  ...........  ...........  ...........  ...........
                            or equal.
   L6808  A                Term device infant    ...........  ...........  ...........  ...........  ...........
                            or child.
   L6809  A                Trs super sport       ...........  ...........  ...........  ...........  ...........
                            passive.
   L6810  A                Pincher tool otto     ...........  ...........  ...........  ...........  ...........
                            bock or eq.
   L6825  A                Hands dorrance vo...  ...........  ...........  ...........  ...........  ...........
   L6830  A                Hand aprl vc........  ...........  ...........  ...........  ...........  ...........
   L6835  A                Hand sierra vo......  ...........  ...........  ...........  ...........  ...........
   L6840  A                Hand becker imperial  ...........  ...........  ...........  ...........  ...........
   L6845  A                Hand becker lock      ...........  ...........  ...........  ...........  ...........
                            grip.
   L6850  A                Term dvc-hand becker  ...........  ...........  ...........  ...........  ...........
                            plylite.
   L6855  A                Hand robin-aids vo..  ...........  ...........  ...........  ...........  ...........
   L6860  A                Hand robin-aids vo    ...........  ...........  ...........  ...........  ...........
                            soft.
   L6865  A                Hand passive hand...  ...........  ...........  ...........  ...........  ...........
   L6867  A                Hand detroit infant   ...........  ...........  ...........  ...........  ...........
                            hand.
   L6868  A                Passive inf hand      ...........  ...........  ...........  ...........  ...........
                            steeper/hos.

[[Page 44876]]

   L6870  A                Hand child mitt.....  ...........  ...........  ...........  ...........  ...........
   L6872  A                Hand nyu child hand.  ...........  ...........  ...........  ...........  ...........
   L6873  A                Hand mech inf         ...........  ...........  ...........  ...........  ...........
                            steeper or equ.
   L6875  A                Hand bock vc........  ...........  ...........  ...........  ...........  ...........
   L6880  A                Hand bock vo........  ...........  ...........  ...........  ...........  ...........
   L6890  A                Production glove....  ...........  ...........  ...........  ...........  ...........
   L6895  A                Custom glove........  ...........  ...........  ...........  ...........  ...........
   L6900  A                Hand restorat thumb/  ...........  ...........  ...........  ...........  ...........
                            1 finger.
   L6905  A                Hand restoration      ...........  ...........  ...........  ...........  ...........
                            multiple fi.
   L6910  A                Hand restoration no   ...........  ...........  ...........  ...........  ...........
                            fingers.
   L6915  A                Hand restoration      ...........  ...........  ...........  ...........  ...........
                            replacmnt g.
   L6920  A                Wrist disarticul      ...........  ...........  ...........  ...........  ...........
                            switch ctrl.
   L6925  A                Wrist disart          ...........  ...........  ...........  ...........  ...........
                            myoelectronic c.
   L6930  A                Below elbow switch    ...........  ...........  ...........  ...........  ...........
                            control.
   L6935  A                Below elbow           ...........  ...........  ...........  ...........  ...........
                            myoelectronic ct.
   L6940  A                Elbow                 ...........  ...........  ...........  ...........  ...........
                            disarticulation
                            switch.
   L6945  A                Elbow disart          ...........  ...........  ...........  ...........  ...........
                            myoelectronic c.
   L6950  A                Above elbow switch    ...........  ...........  ...........  ...........  ...........
                            control.
   L6955  A                Above elbow           ...........  ...........  ...........  ...........  ...........
                            myoelectronic ct.
   L6960  A                Shldr disartic        ...........  ...........  ...........  ...........  ...........
                            switch contro.
   L6965  A                Shldr disartic        ...........  ...........  ...........  ...........  ...........
                            myoelectronic.
   L6970  A                Interscapular-thor    ...........  ...........  ...........  ...........  ...........
                            switch ct.
   L6975  A                Interscap-thor        ...........  ...........  ...........  ...........  ...........
                            myoelectronic.
   L7010  A                Hand otto back        ...........  ...........  ...........  ...........  ...........
                            steeper/eq sw.
   L7015  A                Hand sys teknik       ...........  ...........  ...........  ...........  ...........
                            village swit.
   L7020  A                Electronic greifer    ...........  ...........  ...........  ...........  ...........
                            switch ct.
   L7025  A                Electron hand         ...........  ...........  ...........  ...........  ...........
                            myoelectronic.
   L7030  A                Hand sys teknik vill  ...........  ...........  ...........  ...........  ...........
                            myoelec.
   L7035  A                Electron greifer      ...........  ...........  ...........  ...........  ...........
                            myoelectro.
   L7040  A                Prehensile actuator   ...........  ...........  ...........  ...........  ...........
                            hosmer s.
   L7045  A                Electron hook child   ...........  ...........  ...........  ...........  ...........
                            michigan.
   L7170  A                Electronic elbow      ...........  ...........  ...........  ...........  ...........
                            hosmer swit.
   L7180  A                Electronic elbow      ...........  ...........  ...........  ...........  ...........
                            utah myoele.
   L7185  A                Electron elbow        ...........  ...........  ...........  ...........  ...........
                            adolescent sw.
   L7186  A                Electron elbow child  ...........  ...........  ...........  ...........  ...........
                            switch.
   L7190  A                Elbow adolescent      ...........  ...........  ...........  ...........  ...........

                            myoelectron.
   L7191  A                Elbow child           ...........  ...........  ...........  ...........  ...........
                            myoelectronic ct.
   L7260  A                Electron wrist        ...........  ...........  ...........  ...........  ...........
                            rotator otto.
   L7261  A                Electron wrist        ...........  ...........  ...........  ...........  ...........
                            rotator utah.
   L7266  A                Servo control         ...........  ...........  ...........  ...........  ...........
                            steeper or equ.
   L7272  A                Analogue control unb  ...........  ...........  ...........  ...........  ...........
                            or equa.
   L7274  A                Proportional ctl 12   ...........  ...........  ...........  ...........  ...........
                            volt uta.
   L7360  A                Six volt bat otto     ...........  ...........  ...........  ...........  ...........
                            bock/eq ea.
   L7362  A                Battery chrgr six     ...........  ...........  ...........  ...........  ...........
                            volt otto.
   L7364  A                Twelve volt battery   ...........  ...........  ...........  ...........  ...........
                            utah/equ.
   L7366  A                Battery chrgr 12      ...........  ...........  ...........  ...........  ...........
                            volt utah/e.
   L7499  A                Upper extremity       ...........  ...........  ...........  ...........  ...........
                            prosthes NOS.
   L7500  A                Prosthetic dvc        ...........  ...........  ...........  ...........  ...........
                            repair hourly.
   L7510  A                Prosthetic device     ...........  ...........  ...........  ...........  ...........
                            repair rep.
   L7520  A                Repair prosthesis     ...........  ...........  ...........  ...........  ...........
                            per 15 min.
   L7900  A                Vacuum erection       ...........  ...........  ...........  ...........  ...........
                            system.
   L8000  A                Mastectomy bra......  ...........  ...........  ...........  ...........  ...........
   L8010  A                Mastectomy sleeve...  ...........  ...........  ...........  ...........  ...........
   L8015  A                Ext breastprosthesis  ...........  ...........  ...........  ...........  ...........
                            garment.
   L8020  A                Mastectomy form.....  ...........  ...........  ...........  ...........  ...........
   L8030  A                Breast prosthesis     ...........  ...........  ...........  ...........  ...........
                            silicone/e.
   L8035  A                Custom breast         ...........  ...........  ...........  ...........  ...........
                            prosthesis.
   L8039  A                Breast prosthesis     ...........  ...........  ...........  ...........  ...........
                            NOS.
   L8040  A                Nasal prosthesis....  ...........  ...........  ...........  ...........  ...........
   L8041  A                Midfacial prosthesis  ...........  ...........  ...........  ...........  ...........
   L8042  A                Orbital prosthesis..  ...........  ...........  ...........  ...........  ...........
   L8043  A                Upper facial          ...........  ...........  ...........  ...........  ...........
                            prosthesis.
   L8044  A                Hemi-facial           ...........  ...........  ...........  ...........  ...........
                            prosthesis.
   L8045  A                Auricular prosthesis  ...........  ...........  ...........  ...........  ...........
   L8046  A                Partial facial        ...........  ...........  ...........  ...........  ...........
                            prosthesis.
   L8047  A                Nasal septal          ...........  ...........  ...........  ...........  ...........
                            prosthesis.
   L8048  A                Unspec maxillofacial  ...........  ...........  ...........  ...........  ...........
                            prosth.
   L8049  A                Repair maxillofacial  ...........  ...........  ...........  ...........  ...........
                            prosth.
   L8100  E                Compression stocking  ...........  ...........  ...........  ...........  ...........
                            BK18-30.
   L8110  E                Compression stocking  ...........  ...........  ...........  ...........  ...........
                            BK30-40.
   L8120  E                Compression stocking  ...........  ...........  ...........  ...........  ...........
                            BK40-50.
   L8130  E                Gc stocking           ...........  ...........  ...........  ...........  ...........
                            thighlngth 18-30.
   L8140  E                Gc stocking           ...........  ...........  ...........  ...........  ...........
                            thighlngth 30-40.
   L8150  E                Gc stocking           ...........  ...........  ...........  ...........  ...........
                            thighlngth 40-50.
   L8160  E                Gc stocking full      ...........  ...........  ...........  ...........  ...........
                            lngth 18-30.

[[Page 44877]]

   L8170  E                Gc stocking full      ...........  ...........  ...........  ...........  ...........
                            lngth 30-40.
   L8180  E                Gc stocking full      ...........  ...........  ...........  ...........  ...........
                            lngth 40-50.
   L8190  E                Gc stocking           ...........  ...........  ...........  ...........  ...........
                            waistlngth 18-30.
   L8195  E                Gc stocking           ...........  ...........  ...........  ...........  ...........
                            waistlngth 30-40.
   L8200  E                Gc stocking           ...........  ...........  ...........  ...........  ...........
                            waistlngth 40-50.
   L8210  E                Gc stocking custom    ...........  ...........  ...........  ...........  ...........
                            made.
   L8220  E                Gc stocking           ...........  ...........  ...........  ...........  ...........
                            lymphedema.
   L8230  E                Gc stocking garter    ...........  ...........  ...........  ...........  ...........
                            belt.
   L8239  E                G compression         ...........  ...........  ...........  ...........  ...........
                            stocking NOS.
   L8300  A                Truss single w/       ...........  ...........  ...........  ...........  ...........
                            standard pad.
   L8310  A                Truss double w/       ...........  ...........  ...........  ...........  ...........
                            standard pad.
   L8320  A                Truss addition to     ...........  ...........  ...........  ...........  ...........
                            std pad wa.
   L8330  A                Truss add to std pad  ...........  ...........  ...........  ...........  ...........
                            scrotal.
   L8400  A                Sheath below knee...  ...........  ...........  ...........  ...........  ...........
   L8410  A                Sheath above knee...  ...........  ...........  ...........  ...........  ...........
   L8415  A                Sheath upper limb...  ...........  ...........  ...........  ...........  ...........
   L8417  A                Pros sheath/sock w    ...........  ...........  ...........  ...........  ...........
                            gel cushn.
   L8420  A                Prosthetic sock       ...........  ...........  ...........  ...........  ...........
                            multi ply BK.
   L8430  A                Prosthetic sock       ...........  ...........  ...........  ...........  ...........
                            multi ply AK.
   L8435  A                Pros sock multi ply   ...........  ...........  ...........  ...........  ...........
                            upper lm.
   L8440  A                Shrinker below knee.  ...........  ...........  ...........  ...........  ...........
   L8460  A                Shrinker above knee.  ...........  ...........  ...........  ...........  ...........
   L8465  A                Shrinker upper limb.  ...........  ...........  ...........  ...........  ...........
   L8470  A                Pros sock single ply  ...........  ...........  ...........  ...........  ...........
                            BK.
   L8480  A                Pros sock single ply  ...........  ...........  ...........  ...........  ...........
                            AK.
   L8485  A                Pros sock single ply  ...........  ...........  ...........  ...........  ...........
                            upper l.
   L8490  A                Air seal suction      ...........  ...........  ...........  ...........  ...........
                            reten systm.
   L8499  A                Unlisted misc         ...........  ...........  ...........  ...........  ...........
                            prosthetic ser.
   L8500  A                Artificial larynx...  ...........  ...........  ...........  ...........  ...........
   L8501  A                Tracheostomy          ...........  ...........  ...........  ...........  ...........
                            speaking valve.
   L8600  N                Implant breast        ...........  ...........  ...........  ...........  ...........
                            silicone/eq.
   L8603  N                Collagen imp urinary  ...........  ...........  ...........  ...........  ...........
                            2.5 ml.
   L8606  A                Synthetic implnt      ...........  ...........  ...........  ...........  ...........
                            urinary 1ml.
   L8610  N                Ocular implant......  ...........  ...........  ...........  ...........  ...........
   L8612  N                Aqueous shunt         ...........  ...........  ...........  ...........  ...........
                            prosthesis.
   L8613  N                Ossicular implant...  ...........  ...........  ...........  ...........  ...........
   L8614  H                Cochlear device/             1002  ...........  ...........  ...........  ...........
                            system.
   L8619  A                Replace cochlear      ...........  ...........  ...........  ...........  ...........
                            processor.
   L8630  N                Metacarpophalangeal   ...........  ...........  ...........  ...........  ...........
                            implant.
   L8641  N                Metatarsal joint      ...........  ...........  ...........  ...........  ...........
                            implant.
   L8642  N                Hallux implant......  ...........  ...........  ...........  ...........  ...........
   L8658  N                Interphalangeal       ...........  ...........  ...........  ...........  ...........
                            joint implnt.
   L8670  N                Vascular graft,       ...........  ...........  ...........  ...........  ...........
                            synthetic.
   L8699  N                Prosthetic implant    ...........  ...........  ...........  ...........  ...........
                            NOS.
   L9900  A                O&P supply/accessory/ ...........  ...........  ...........  ...........  ...........
                            service.
   M0064  X                Visit for drug               0374         0.96       $48.81       $10.74        $9.76
                            monitoring.
   M0075  E                Cellular therapy....  ...........  ...........  ...........  ...........  ...........
   M0076  E                Prolotherapy........  ...........  ...........  ...........  ...........  ...........
   M0100  E                Intragastric          ...........  ...........  ...........  ...........  ...........
                            hypothermia.
   M0300  E                IV chelationtherapy.  ...........  ...........  ...........  ...........  ...........
   M0301  E                Fabric wrapping of    ...........  ...........  ...........  ...........  ...........
                            aneurysm.
   M0302  T                Assessment of                0970         0.47       $23.90  ...........        $4.78
                            cardiac output.
   P2028  X                Cephalin floculation         0349         0.34       $17.29        $3.46        $3.46
                            test.
   P2029  X                Congo red blood test         0349         0.34       $17.29        $3.46        $3.46
   P2031  E                Hair analysis.......  ...........  ...........  ...........  ...........  ...........
   P2033  X                Blood thymol                 0349         0.34       $17.29        $3.46        $3.46
                            turbidity.
   P2038  A                Blood mucoprotein...  ...........  ...........  ...........  ...........  ...........
   P3000  A                Screen pap by tech w  ...........  ...........  ...........  ...........  ...........
                            md supv.
   P3001  E                Screening pap smear   ...........  ...........  ...........  ...........  ...........
                            by phys.
   P7001  E                Culture bacterial     ...........  ...........  ...........  ...........  ...........
                            urine.
   P9010  K                Whole blood for              0950         2.13      $108.29  ...........       $21.66
                            transfusion.
   P9011  E                Blood split unit....  ...........  ...........  ...........  ...........  ...........
   P9012  K                Cryoprecipitate each         0952         0.72       $36.61  ...........        $7.32
                            unit.
   P9016  K                RBC leukocytes               0954         2.89      $146.93  ...........       $29.39
                            reduced.
   P9017  K                One donor fresh              0955         2.31      $117.45  ...........       $23.49
                            frozn plasma.
   P9019  K                Platelets, each unit         0957         1.00       $50.84  ...........       $10.17
   P9020  K                Plaelet rich plasma          0958         1.19       $60.50  ...........       $12.10
                            unit.
   P9021  K                Red blood cells unit         0959         2.09      $106.26  ...........       $21.25
   P9022  K                Washed red blood             0960         3.89      $197.78  ...........       $39.56
                            cells unit.
   P9023  K                Frozen plasma,               0949         3.00      $152.53  ...........       $30.51
                            pooled, sd.
   P9031  K                Platelets leukocytes         0954         2.89      $146.93  ...........       $29.39
                            reduced.
   P9032  K                Platelets,                   9500         1.81       $92.02  ...........       $18.40
                            irradiated.
   P9033  K                Platelets                    0954         2.89      $146.93  ...........       $29.39
                            leukoreduced irrad.
   P9034  K                Platelets, pheresis.         9501         9.91      $503.84  ...........      $100.77
   P9035  K                Platelet pheres              9501         9.91      $503.84  ...........      $100.77
                            leukoreduced.

[[Page 44878]]

   P9036  K                Platelet pheresis            9502        10.75      $546.55  ...........      $109.31
                            irradiated.
   P9037  K                Plate pheres                 9501         9.91      $503.84  ...........      $100.77
                            leukoredu irrad.
   P9038  K                RBC irradiated......         9505         2.64      $134.22  ...........       $26.84
   P9039  K                RBC deglycerolized..         9504         4.45      $226.25  ...........       $45.25
   P9040  K                RBC leukoreduced             9504         4.45      $226.25  ...........       $45.25
                            irradiated.
   P9041  K                Albumin(human), 5%..         0961         2.24      $113.89  ...........       $22.78
   P9042  K                Albumin (human), 25%         0962         1.12       $56.94  ...........       $11.39
   P9043  K                Plasma protein               0956         1.29       $65.59  ...........       $13.12
                            fraction.
   P9044  K                Cryoprecipitatereduc         1009         0.88       $44.74  ...........        $8.95
                            edplasma.
   P9603  A                One-way allow         ...........  ...........  ...........  ...........  ...........
                            prorated miles.
   P9604  A                One-way allow         ...........  ...........  ...........  ...........  ...........
                            prorated trip.
   P9612  N                Catheterize for       ...........  ...........  ...........  ...........  ...........
                            urine spec.
   P9615  N                Urine specimen        ...........  ...........  ...........  ...........  ...........
                            collect mult.
   Q0035  X                Cardiokymography....         0100         1.63       $82.87       $45.58       $16.57
   Q0081  T                Infusion ther other          0120         2.35      $119.48       $42.67       $23.90
                            than che.
   Q0083  S                Chemo by other than          0116         0.98       $49.83        $9.97        $9.97
                            infusion.
   Q0084  S                Chemotherapy by              0117         3.48      $176.93       $52.69       $35.39
                            infusion.
   Q0085  S                Chemo by both                0118         3.52      $178.96       $72.03       $35.79
                            infusion and o.
   Q0086  A                Physical therapy      ...........  ...........  ...........  ...........  ...........
                            evaluation/.
   Q0091  T                Obtaining screen pap         0191         0.27       $13.73        $3.98        $2.75
                            smear.
   Q0092  N                Set up port xray      ...........  ...........  ...........  ...........  ...........
                            equipment.
   Q0111  A                Wet mounts/ w         ...........  ...........  ...........  ...........  ...........
                            preparations.
   Q0112  A                Potassium hydroxide   ...........  ...........  ...........  ...........  ...........
                            preps.
   Q0113  A                Pinworm examinations  ...........  ...........  ...........  ...........  ...........
   Q0114  A                Fern test...........  ...........  ...........  ...........  ...........  ...........
   Q0115  A                Post-coital mucous    ...........  ...........  ...........  ...........  ...........
                            exam.
   Q0136  G                Non esrd epoetin             0733  ...........       $11.85  ...........        $1.52
                            alpha inj.
   Q0144  E                Azithromycin          ...........  ...........  ...........  ...........  ...........
                            dihydrate, oral.
   Q0160  G                Factor IX non-               0931  ...........         $.76  ...........         $.10
                            recombinant.
   Q0161  G                Factor IX                    0932  ...........        $1.12  ...........         $.16
                            recombinant.
   Q0163  G                Diphenhydramine HCl          1400  ...........         $.12  ...........         $.01
                            50mg.
   Q0164  G                Prochlorperazine             1401  ...........         $.57  ...........         $.05
                            maleate 5mg.
   Q0165  E                Prochlorperazine      ...........  ...........  ...........  ...........  ...........
                            maleate10mg.
   Q0166  G                Granisetron HCl 1 mg         0765  ...........       $44.70  ...........        $5.74
                            oral.
   Q0167  G                Dronabinol 2.5mg             0762  ...........        $3.28  ...........         $.42
                            oral.
   Q0168  E                Dronabinol 5mg oral.  ...........  ...........  ...........  ...........  ...........
   Q0169  G                Promethazine HCl             1402  ...........         $.03  ...........         $.00
                            12.5mg oral.
   Q0170  E                Promethazine HCl 25   ...........  ...........  ...........  ...........  ...........
                            mg oral.
   Q0171  G                Chlorpromazine HCl           1403  ...........         $.07  ...........         $.01
                            10mg oral.
   Q0172  E                Chlorpromazine HCl    ...........  ...........  ...........  ...........  ...........
                            25mg oral.
   Q0173  G                Trimethobenzamide            1404  ...........         $.36  ...........         $.03
                            HCl 250mg.
   Q0174  G                Thiethylperazine             1405  ...........         $.56  ...........         $.08
                            maleate10mg.
   Q0175  G                Perphenazine 4mg             1406  ...........         $.62  ...........         $.06
                            oral.
   Q0176  E                Perphenazine 8mg      ...........  ...........  ...........  ...........  ...........
                            oral.
   Q0177  G                Hydroxyzine pamoate          1407  ...........         $.20  ...........         $.02
                            25mg.
   Q0178  E                Hydroxyzine pamoate   ...........  ...........  ...........  ...........  ...........
                            50mg.
   Q0179  G                Ondansetron HCl 8mg          0769  ...........       $25.15  ...........        $3.23
                            oral.
   Q0180  G                Dolasetron mesylate          0763  ...........       $69.64  ...........        $8.94
                            oral.
   Q0181  E                Unspecified oral      ...........  ...........  ...........  ...........  ...........
                            anti-emetic.
   Q0183  N                Nonmetabolic active   ...........  ...........  ...........  ...........  ...........
                            tissue.
   Q0184  N                Metabolically active  ...........  ...........  ...........  ...........  ...........
                            tissue.
   Q0185  N                Metabolic active D/E  ...........  ...........  ...........  ...........  ...........
                            tissue.
   Q0187  G                Factor viia                  1409  ...........    $1,596.00  ...........      $228.48
                            recombinant.
   Q1001  E                Ntiol category 1....  ...........  ...........  ...........  ...........  ...........
   Q1002  E                Ntiol category 2....  ...........  ...........  ...........  ...........  ...........
   Q1003  E                Ntiol category 3....  ...........  ...........  ...........  ...........  ...........
   Q1004  E                Ntiol category 4....  ...........  ...........  ...........  ...........  ...........
   Q1005  E                Ntiol category 5....  ...........  ...........  ...........  ...........  ...........
   Q2001  N                Oral cabergoline 0.5  ...........  ...........  ...........  ...........  ...........
                            mg.
   Q2002  G                Elliotts b solution          7022  ...........       $14.25  ...........        $2.04
                            per ml.
   Q2003  G                Aprotinin, 10,000            7019  ...........        $2.06  ...........         $.30
                            kiu.
   Q2004  G                Bladder calculi              7023  ...........       $24.70  ...........        $3.54
                            irrig sol.
   Q2005  G                Corticorelin ovine           7024  ...........      $368.03  ...........       $52.69
                            triflutat.
   Q2006  G                Digoxin immune fab           7025  ...........      $551.66  ...........       $78.97
                            (ovine).
   Q2007  G                Ethanolamine oleate          7026  ...........       $39.73  ...........        $5.69
                            100 mg.
   Q2008  G                Fomepizole, 15 mg...         7027  ...........        $1.09  ...........         $.16
   Q2009  G                Fosphenytoin, 50 mg.         7028  ...........        $9.55  ...........        $1.37
   Q2010  G                Glatiramer acetate,          7029  ...........       $30.07  ...........        $4.30
                            per dose.
   Q2011  G                Hemin, per 1 mg.....         7030  ...........         $.99  ...........         $.14
   Q2012  G                Pegademase bovine,           7039  ...........      $139.33  ...........       $19.95
                            25 iu.
   Q2013  G                Pentastarch 10%              7040  ...........       $15.11  ...........        $2.16
                            solution.
   Q2014  G                Sermorelin acetate,          7032  ...........       $15.78  ...........        $2.26
                            0.5 mg.
   Q2015  G                Somatrem, 5 mg......         7033  ...........      $209.48  ...........       $29.99
   Q2016  G                Somatropin, 1 mg....         7034  ...........       $39.90  ...........        $5.12
   Q2017  G                Teniposide, 50 mg...         7035  ...........      $216.32  ...........       $30.97

[[Page 44879]]

   Q2018  G                Urofollitropin, 75           7037  ...........       $73.29  ...........        $9.41
                            iu.
   Q2019  G                Basiliximab.........         1615  ...........    $1,348.76  ...........      $193.09
   Q2020  G                Histrelin acetate...         1616  ...........       $14.16  ...........        $2.03
   Q2021  G                Lepirudin...........         1617  ...........      $131.96  ...........       $18.89
   Q2022  G                VonWillebrandFactrCm         1618  ...........         $.95  ...........         $.14
                            plxperIU.
   Q3001  E                Brachytherapy                0918  ...........  ...........  ...........  ...........
                            Radioelements.
   Q3002  G                Gallium ga 67.......         1619  ...........       $24.38  ...........        $3.13
   Q3003  G                Technetium tc99m             1620  ...........      $384.75  ...........       $55.08
                            bicisate.
   Q3004  G                Xenon xe 133........         1621  ...........       $29.93  ...........        $3.84
   Q3005  G                Technetium tc99m             1622  ...........      $176.53  ...........       $25.27
                            mertiatide.
   Q3006  G                Technetium tc99m             1623  ...........       $22.61  ...........        $3.24
                            glucepatate.
   Q3007  G                Sodium phosphate p32         1624  ...........       $81.10  ...........       $11.61
   Q3008  G                Indium 111-in                1625  ...........      $935.75  ...........      $133.96
                            pentetreotide.
   Q3009  G                Technetium tc99m             1626  ...........       $36.74  ...........        $5.26
                            oxidronate.
   Q3010  G                Technetium                   1627  ...........       $40.90  ...........        $5.85
                            tc99mlabeledrbcs.
   Q3011  G                Chromic phosphate            1628  ...........      $150.86  ...........       $21.60
                            p32.
   Q3012  G                Cyanocobalamin               1089  ...........       $97.85  ...........       $14.01
                            cobalt co57.
   Q3013  G                Verteporfin for              1203  ...........    $1,458.25  ...........      $208.76
                            injection.
   Q4001  A                Cast sup body cast    ...........  ...........  ...........  ...........  ...........
                            plaster.
   Q4002  A                Cast sup body cast    ...........  ...........  ...........  ...........  ...........
                            fiberglas.
   Q4003  A                Cast sup shoulder     ...........  ...........  ...........  ...........  ...........
                            cast plstr.
   Q4004  A                Cast sup shoulder     ...........  ...........  ...........  ...........  ...........
                            cast fbrgl.
   Q4005  A                Cast sup long arm     ...........  ...........  ...........  ...........  ...........
                            adult plst.
   Q4006  A                Cast sup long arm     ...........  ...........  ...........  ...........  ...........
                            adult fbrg.
   Q4007  A                Cast sup long arm     ...........  ...........  ...........  ...........  ...........
                            ped plster.
   Q4008  A                Cast sup long arm     ...........  ...........  ...........  ...........  ...........
                            ped fbrgls.
   Q4009  A                Cast sup sht arm      ...........  ...........  ...........  ...........  ...........
                            adult plstr.
   Q4010  A                Cast sup sht arm      ...........  ...........  ...........  ...........  ...........
                            adult fbrgl.
   Q4011  A                Cast sup sht arm ped  ...........  ...........  ...........  ...........  ...........
                            plaster.
   Q4012  A                Cast sup sht arm ped  ...........  ...........  ...........  ...........  ...........
                            fbrglas.
   Q4013  A                Cast sup gauntlet     ...........  ...........  ...........  ...........  ...........
                            plaster.
   Q4014  A                Cast sup gauntlet     ...........  ...........  ...........  ...........  ...........
                            fiberglass.
   Q4015  A                Cast sup gauntlet     ...........  ...........  ...........  ...........  ...........
                            ped plster.
   Q4016  A                Cast sup gauntlet     ...........  ...........  ...........  ...........  ...........
                            ped fbrgls.
   Q4017  A                Cast sup lng arm      ...........  ...........  ...........  ...........  ...........
                            splint plst.
   Q4018  A                Cast sup lng arm      ...........  ...........  ...........  ...........  ...........
                            splint fbrg.
   Q4019  A                Cast sup lng arm      ...........  ...........  ...........  ...........  ...........
                            splnt ped p.
   Q4020  A                Cast sup lng arm      ...........  ...........  ...........  ...........  ...........
                            splnt ped f.
   Q4021  A                Cast sup sht arm      ...........  ...........  ...........  ...........  ...........
                            splint plst.
   Q4022  A                Cast sup sht arm      ...........  ...........  ...........  ...........  ...........
                            splint fbrg.
   Q4023  A                Cast sup sht arm      ...........  ...........  ...........  ...........  ...........
                            splnt ped p.
   Q4024  A                Cast sup sht arm      ...........  ...........  ...........  ...........  ...........
                            splnt ped f.
   Q4025  A                Cast sup hip spica    ...........  ...........  ...........  ...........  ...........
                            plaster.
   Q4026  A                Cast sup hip spica    ...........  ...........  ...........  ...........  ...........
                            fiberglas.
   Q4027  A                Cast sup hip spica    ...........  ...........  ...........  ...........  ...........
                            ped plstr.
   Q4028  A                Cast sup hip spica    ...........  ...........  ...........  ...........  ...........
                            ped fbrgl.
   Q4029  A                Cast sup long leg     ...........  ...........  ...........  ...........  ...........
                            plaster.
   Q4030  A                Cast sup long leg     ...........  ...........  ...........  ...........  ...........
                            fiberglass.
   Q4031  A                Cast sup lng leg ped  ...........  ...........  ...........  ...........  ...........
                            plaster.
   Q4032  A                Cast sup lng leg ped  ...........  ...........  ...........  ...........  ...........
                            fbrgls.
   Q4033  A                Cast sup lng leg      ...........  ...........  ...........  ...........  ...........
                            cylinder pl.
   Q4034  A                Cast sup lng leg      ...........  ...........  ...........  ...........  ...........
                            cylinder fb.
   Q4035  A                Cast sup lngleg       ...........  ...........  ...........  ...........  ...........
                            cylndr ped p.
   Q4036  A                Cast sup lngleg       ...........  ...........  ...........  ...........  ...........
                            cylndr ped f.
   Q4037  A                Cast sup shrt leg     ...........  ...........  ...........  ...........  ...........
                            plaster.
   Q4038  A                Cast sup shrt leg     ...........  ...........  ...........  ...........  ...........
                            fiberglass.
   Q4039  A                Cast sup shrt leg     ...........  ...........  ...........  ...........  ...........
                            ped plster.
   Q4040  A                Cast sup shrt leg     ...........  ...........  ...........  ...........  ...........
                            ped fbrgls.
   Q4041  A                Cast sup lng leg      ...........  ...........  ...........  ...........  ...........
                            splnt plstr.
   Q4042  A                Cast sup lng leg      ...........  ...........  ...........  ...........  ...........
                            splnt fbrgl.
   Q4043  A                Cast sup lng leg      ...........  ...........  ...........  ...........  ...........
                            splnt ped p.
   Q4044  A                Cast sup lng leg      ...........  ...........  ...........  ...........  ...........
                            splnt ped f.
   Q4045  A                Cast sup sht leg      ...........  ...........  ...........  ...........  ...........
                            splnt plstr.
   Q4046  A                Cast sup sht leg      ...........  ...........  ...........  ...........  ...........
                            splnt fbrgl.
   Q4047  A                Cast sup sht leg      ...........  ...........  ...........  ...........  ...........
                            splnt ped p.
   Q4048  A                Cast sup sht leg      ...........  ...........  ...........  ...........  ...........
                            splnt ped f.
   Q4049  A                Finger splint,        ...........  ...........  ...........  ...........  ...........
                            static.
   Q4050  A                Cast supplies         ...........  ...........  ...........  ...........  ...........
                            unlisted.
   Q4051  A                Splint supplies misc  ...........  ...........  ...........  ...........  ...........
   Q9920  A                Epoetin with hct =    ...........  ...........  ...........  ...........  ...........
                            20.
   Q9921  A                Epoetin with hct =    ...........  ...........  ...........  ...........  ...........
                            21.
   Q9922  A                Epoetin with hct =    ...........  ...........  ...........  ...........  ...........
                            22.
   Q9923  A                Epoetin with hct =    ...........  ...........  ...........  ...........  ...........
                            23.
   Q9924  A                Epoetin with hct =    ...........  ...........  ...........  ...........  ...........
                            24.
   Q9925  A                Epoetin with hct =    ...........  ...........  ...........  ...........  ...........
                            25.

[[Page 44880]]

   Q9926  A                Epoetin with hct =    ...........  ...........  ...........  ...........  ...........
                            26.
   Q9927  A                Epoetin with hct =    ...........  ...........  ...........  ...........  ...........
                            27.
   Q9928  A                Epoetin with hct =    ...........  ...........  ...........  ...........  ...........
                            28.
   Q9929  A                Epoetin with hct =    ...........  ...........  ...........  ...........  ...........
                            29.
   Q9930  A                Epoetin with hct =    ...........  ...........  ...........  ...........  ...........
                            30.
   Q9931  A                Epoetin with hct =    ...........  ...........  ...........  ...........  ...........
                            31.
   Q9932  A                Epoetin with hct =    ...........  ...........  ...........  ...........  ...........
                            32.
   Q9933  A                Epoetin with hct =    ...........  ...........  ...........  ...........  ...........
                            33.
   Q9934  A                Epoetin with hct =    ...........  ...........  ...........  ...........  ...........
                            34.
   Q9935  A                Epoetin with hct =    ...........  ...........  ...........  ...........  ...........
                            35.
   Q9936  A                Epoetin with hct =    ...........  ...........  ...........  ...........  ...........
                            36.
   Q9937  A                Epoetin with hct =    ...........  ...........  ...........  ...........  ...........
                            37.
   Q9938  A                Epoetin with hct =    ...........  ...........  ...........  ...........  ...........
                            38.
   Q9939  A                Epoetin with hct =    ...........  ...........  ...........  ...........  ...........
                            39.
   Q9940  A                Epoetin with hct >=   ...........  ...........  ...........  ...........  ...........
                            40.
   R0070  N                Transport portable x- ...........  ...........  ...........  ...........  ...........
                            ray.
   R0075  N                Transport port x-ray  ...........  ...........  ...........  ...........  ...........
                            multipl.
   R0076  N                Transport portable    ...........  ...........  ...........  ...........  ...........
                            EKG.
   V2020  A                Vision svcs frames    ...........  ...........  ...........  ...........  ...........
                            purchases.
   V2025  E                Eyeglasses delux      ...........  ...........  ...........  ...........  ...........
                            frames.
   V2100  A                Lens spher single     ...........  ...........  ...........  ...........  ...........
                            plano 4.00.
   V2101  A                Single visn sphere    ...........  ...........  ...........  ...........  ...........
                            4.12-7.00.
   V2102  A                Singl visn sphere     ...........  ...........  ...........  ...........  ...........
                            7.12-20.00.
   V2103  A                Spherocylindr 4.00d/  ...........  ...........  ...........  ...........  ...........
                            12-2.00d.
   V2104  A                Spherocylindr 4.00d/  ...........  ...........  ...........  ...........  ...........
                            2.12-4d.
   V2105  A                Spherocylinder 4.00d/ ...........  ...........  ...........  ...........  ...........
                            4.25-6d.
   V2106  A                Spherocylinder 4.00d/ ...........  ...........  ...........  ...........  ...........
                            >6.00d.
   V2107  A                Spherocylinder 4.25d/ ...........  ...........  ...........  ...........  ...........
                            12-2d.
   V2108  A                Spherocylinder 4.25d/ ...........  ...........  ...........  ...........  ...........
                            2.12-4d.
   V2109  A                Spherocylinder 4.25d/ ...........  ...........  ...........  ...........  ...........
                            4.25-6d.
   V2110  A                Spherocylinder 4.25d/ ...........  ...........  ...........  ...........  ...........
                            over 6d.
   V2111  A                Spherocylindr 7.25d/  ...........  ...........  ...........  ...........  ...........
                            .25-2.25.
   V2112  A                Spherocylindr 7.25d/  ...........  ...........  ...........  ...........  ...........
                            2.25-4d.
   V2113  A                Spherocylindr 7.25d/  ...........  ...........  ...........  ...........  ...........
                            4.25-6d.
   V2114  A                Spherocylinder over   ...........  ...........  ...........  ...........  ...........
                            12.00d.
   V2115  A                Lens lenticular       ...........  ...........  ...........  ...........  ...........
                            bifocal.
   V2116  A                Nonaspheric lens      ...........  ...........  ...........  ...........  ...........
                            bifocal.
   V2117  A                Aspheric lens         ...........  ...........  ...........  ...........  ...........
                            bifocal.
   V2118  A                Lens aniseikonic      ...........  ...........  ...........  ...........  ...........
                            single.
   V2199  A                Lens single vision    ...........  ...........  ...........  ...........  ...........
                            not oth c.
   V2200  A                Lens spher bifoc      ...........  ...........  ...........  ...........  ...........
                            plano 4.00d.
   V2201  A                Lens sphere bifocal   ...........  ...........  ...........  ...........  ...........
                            4.12-7.0.
   V2202  A                Lens sphere bifocal   ...........  ...........  ...........  ...........  ...........
                            7.12-20..
   V2203  A                Lens sphcyl bifocal   ...........  ...........  ...........  ...........  ...........
                            4.00d/.1.
   V2204  A                Lens sphcy bifocal    ...........  ...........  ...........  ...........  ...........
                            4.00d/2.1.
   V2205  A                Lens sphcy bifocal    ...........  ...........  ...........  ...........  ...........
                            4.00d/4.2.
   V2206  A                Lens sphcy bifocal    ...........  ...........  ...........  ...........  ...........
                            4.00d/ove.
   V2207  A                Lens sphcy bifocal    ...........  ...........  ...........  ...........  ...........
                            4.25-7d/..
   V2208  A                Lens sphcy bifocal    ...........  ...........  ...........  ...........  ...........
                            4.25-7/2..
   V2209  A                Lens sphcy bifocal    ...........  ...........  ...........  ...........  ...........
                            4.25-7/4..
   V2210  A                Lens sphcy bifocal    ...........  ...........  ...........  ...........  ...........
                            4.25-7/ov.
   V2211  A                Lens sphcy bifo 7.25- ...........  ...........  ...........  ...........  ...........
                            12/.25-.
   V2212  A                Lens sphcyl bifo      ...........  ...........  ...........  ...........  ...........
                            7.25-12/2.2.
   V2213  A                Lens sphcyl bifo      ...........  ...........  ...........  ...........  ...........
                            7.25-12/4.2.
   V2214  A                Lens sphcyl bifocal   ...........  ...........  ...........  ...........  ...........
                            over 12..
   V2215  A                Lens lenticular       ...........  ...........  ...........  ...........  ...........
                            bifocal.
   V2216  A                Lens lenticular       ...........  ...........  ...........  ...........  ...........
                            nonaspheric.
   V2217  A                Lens lenticular       ...........  ...........  ...........  ...........  ...........
                            aspheric bif.
   V2218  A                Lens aniseikonic      ...........  ...........  ...........  ...........  ...........
                            bifocal.
   V2219  A                Lens bifocal seg      ...........  ...........  ...........  ...........  ...........
                            width over.
   V2220  A                Lens bifocal add      ...........  ...........  ...........  ...........  ...........
                            over 3.25d.
   V2299  A                Lens bifocal          ...........  ...........  ...........  ...........  ...........
                            speciality.
   V2300  A                Lens sphere trifocal  ...........  ...........  ...........  ...........  ...........
                            4.00d.
   V2301  A                Lens sphere trifocal  ...........  ...........  ...........  ...........  ...........
                            4.12-7..
   V2302  A                Lens sphere trifocal  ...........  ...........  ...........  ...........  ...........
                            7.12-20.
   V2303  A                Lens sphcy trifocal   ...........  ...........  ...........  ...........  ...........
                            4.0/.12-.
   V2304  A                Lens sphcy trifocal   ...........  ...........  ...........  ...........  ...........
                            4.0/2.25.
   V2305  A                Lens sphcy trifocal   ...........  ...........  ...........  ...........  ...........
                            4.0/4.25.
   V2306  A                Lens sphcyl trifocal  ...........  ...........  ...........  ...........  ...........
                            4.00/>6.
   V2307  A                Lens sphcy trifocal   ...........  ...........  ...........  ...........  ...........
                            4.25-7/..
   V2308  A                Lens sphc trifocal    ...........  ...........  ...........  ...........  ...........
                            4.25-7/2..
   V2309  A                Lens sphc trifocal    ...........  ...........  ...........  ...........  ...........
                            4.25-7/4..
   V2310  A                Lens sphc trifocal    ...........  ...........  ...........  ...........  ...........
                            4.25-7/>6.
   V2311  A                Lens sphc trifo 7.25- ...........  ...........  ...........  ...........  ...........
                            12/.25-.
   V2312  A                Lens sphc trifo 7.25- ...........  ...........  ...........  ...........  ...........
                            12/2.25.

[[Page 44881]]

   V2313  A                Lens sphc trifo 7.25- ...........  ...........  ...........  ...........  ...........
                            12/4.25.
   V2314  A                Lens sphcyl trifocal  ...........  ...........  ...........  ...........  ...........
                            over 12.
   V2315  A                Lens lenticular       ...........  ...........  ...........  ...........  ...........
                            trifocal.
   V2316  A                Lens lenticular       ...........  ...........  ...........  ...........  ...........
                            nonaspheric.
   V2317  A                Lens lenticular       ...........  ...........  ...........  ...........  ...........
                            aspheric tri.
   V2318  A                Lens aniseikonic      ...........  ...........  ...........  ...........  ...........
                            trifocal.
   V2319  A                Lens trifocal seg     ...........  ...........  ...........  ...........  ...........
                            width > 28.
   V2320  A                Lens trifocal add     ...........  ...........  ...........  ...........  ...........
                            over 3.25d.
   V2399  A                Lens trifocal         ...........  ...........  ...........  ...........  ...........
                            speciality.
   V2410  A                Lens variab           ...........  ...........  ...........  ...........  ...........
                            asphericity sing.
   V2430  A                Lens variable         ...........  ...........  ...........  ...........  ...........
                            asphericity bi.
   V2499  A                Variable asphericity  ...........  ...........  ...........  ...........  ...........
                            lens.
   V2500  A                Contact lens pmma     ...........  ...........  ...........  ...........  ...........
                            spherical.
   V2501  A                Cntct lens pmma-      ...........  ...........  ...........  ...........  ...........
                            toric/prism.
   V2502  A                Contact lens pmma     ...........  ...........  ...........  ...........  ...........
                            bifocal.
   V2503  A                Cntct lens pmma       ...........  ...........  ...........  ...........  ...........
                            color vision.
   V2510  A                Cntct gas permeable   ...........  ...........  ...........  ...........  ...........
                            sphericl.
   V2511  A                Cntct toric prism     ...........  ...........  ...........  ...........  ...........
                            ballast.
   V2512  A                Cntct lens gas        ...........  ...........  ...........  ...........  ...........
                            permbl bifocl.
   V2513  A                Contact lens          ...........  ...........  ...........  ...........  ...........
                            extended wear.
   V2520  A                Contact lens          ...........  ...........  ...........  ...........  ...........
                            hydrophilic.
   V2521  A                Cntct lens            ...........  ...........  ...........  ...........  ...........
                            hydrophilic toric.
   V2522  A                Cntct lens hydrophil  ...........  ...........  ...........  ...........  ...........
                            bifocl.
   V2523  A                Cntct lens hydrophil  ...........  ...........  ...........  ...........  ...........
                            extend.
   V2530  A                Contact lens gas      ...........  ...........  ...........  ...........  ...........
                            impermeable.
   V2531  A                Contact lens gas      ...........  ...........  ...........  ...........  ...........
                            permeable.
   V2599  A                Contact lens/es       ...........  ...........  ...........  ...........  ...........
                            other type.
   V2600  A                Hand held low vision  ...........  ...........  ...........  ...........  ...........
                            aids.
   V2610  A                Single lens           ...........  ...........  ...........  ...........  ...........
                            spectacle mount.
   V2615  A