adding duplicates the sorting from largest to lowest

lcall · Oct 4, 2010

<TABLE style="WIDTH: 484pt; BORDER-COLLAPSE: collapse" cellSpacing=0 cellPadding=0 width=645 border=0><COLGROUP><COL style="WIDTH: 277pt; mso-width-source: userset; mso-width-alt: 13494" width=369><COL style="WIDTH: 143pt; mso-width-source: userset; mso-width-alt: 6985" width=191><COL style="WIDTH: 64pt; mso-width-source: userset; mso-width-alt: 3108" width=85><TBODY><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>10060 - DRAINAGE OF SKIN ABSCESS</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>3</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$450.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>10060 - DRAINAGE OF SKIN ABSCESS</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$150.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>10061 - DRAINAGE OF SKIN ABSCESS</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$265.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>10121 - REMOVE FOREIGN BODY</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$434.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>10140 - DRAINAGE OF HEMATOMA/FLUID</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>2</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$1,000.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>10180 - COMPLEX DRAINAGE, WOUND</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$305.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>11100 - BIOPSY, SKIN LESION</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>3</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$450.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>11200 - REMOVAL OF SKIN TAGS</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>3</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$345.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>11400 - EXC TR-EXT B9+MARG 0.5 < CM</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$190.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>11401 - EXC TR-EXT B9+MARG 0.6-1 CM</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$200.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>11402 - EXC TR-EXT B9+MARG 1.1-2 CM</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>2</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$500.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>11403 - EXC TR-EXT B9+MARG 2.1-3 CM</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$300.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>11420 - EXC H-F-NK-SP B9+MARG 0.5 <</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>2</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$320.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>11420 - EXC H-F-NK-SP B9+MARG 0.5 <</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$160.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>11646 - EXC FACE-MM MLG+MARG > 4 CM</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$650.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>11975 - INSERT CONTRACEPTIVE CAP</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>40</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$8,000.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>11975 - INSERT CONTRACEPTIVE CAP</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>24</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$4,800.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>11976 - REMOVAL OF CONTRACEPTIVE CAP</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$250.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>11976 - REMOVAL OF CONTRACEPTIVE CAP</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>6</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$1,500.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>11976 - REMOVAL OF CONTRACEPTIVE CAP</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>4</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$1,000.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>12020 - CLOSURE OF SPLIT WOUND</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>2</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$750.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>13160 - LATE CLOSURE OF WOUND</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$2,393.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>152 - KELO - COTE</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>95</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$0.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>152 - KELO - COTE</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>373</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$0.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>19000 - DRAINAGE OF BREAST LESION</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$175.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>19000 - DRAINAGE OF BREAST LESION</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$175.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>44970 - LAPAROSCOPY, APPENDECTOMY</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$1,250.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>47562 - LAPAROSCOPIC CHOLECYSTECTOMY</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$1,500.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>49000 - EXPLORATION OF ABDOMEN</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$1,200.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>49002 - REOPENING OF ABDOMEN</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$1,000.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>49002 - REOPENING OF ABDOMEN</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>2</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$2,000.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>49205 - EXC/DESTRUCTION OPEN ABDOMINAL TUMORS >10.0 CM</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$4,152.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>49320 - DIAG LAPARO SEPARATE PROC</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>3</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$4,500.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>49320 - DIAG LAPARO SEPARATE PROC</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>4</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$4,536.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>49320 - DIAG LAPARO SEPARATE PROC</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>3</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$2,304.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>49402 - REMOVE FOREIGN BODY, ADBOMEN</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$1,800.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>49652 - LAP VENT/ABD HERNIA REPAIR</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$1,722.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>51701 - INSERT BLADDER CATHETER</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$160.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>52000 - CYSTOSCOPY</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$375.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>54150 - CIRCUMCISION W/REGIONL BLOCK</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>34</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$12,750.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>54150 - CIRCUMCISION W/REGIONL BLOCK</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>27</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$10,125.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>56405 - I & D OF VULVA/PERINEUM</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>2</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$450.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>56405 - I & D OF VULVA/PERINEUM</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>3</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$675.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>56420 - DRAINAGE OF GLAND ABSCESS</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>3</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$675.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>56420 - DRAINAGE OF GLAND ABSCESS</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>6</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$1,350.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>56440 - SURGERY FOR VULVA LESION</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$950.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>56501 - DESTROY, VULVA LESIONS, SIM</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>3</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$675.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>56501 - DESTROY, VULVA LESIONS, SIM</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>6</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$1,350.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>56501 - DESTROY, VULVA LESIONS, SIM</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>2</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$450.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>56515 - DESTROY VULVA LESION/S COMPL</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>2</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$1,000.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>56515 - DESTROY VULVA LESION/S COMPL</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$500.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>56605 - BIOPSY OF VULVA/PERINEUM</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>2</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$350.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>56605 - BIOPSY OF VULVA/PERINEUM</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>25</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$4,375.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>56605 - BIOPSY OF VULVA/PERINEUM</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>2</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$350.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>56606 - BIOPSY OF VULVA/PERINEUM</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>11</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$990.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>56700 - PARTIAL REMOVAL OF HYMEN</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$500.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>56740 - REMOVE ****** GLAND LESION</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$500.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>56810 - REPAIR OF PERINEUM</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>2</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$1,000.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>56821 - EXAM/BIOPSY OF VULVA W/SCOPE</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$540.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>57061 - DESTROY VAG LESIONS, SIMPLE</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$225.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>57061 - DESTROY VAG LESIONS, SIMPLE</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>9</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$2,025.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>57100 - BIOPSY OF ******</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$150.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>57100 - BIOPSY OF ******</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$150.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>57135 - REMOVE ****** LESION</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$290.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>57160 - INSERT PESSARY/OTHER DEVICE</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>5</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$675.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>57160 - INSERT PESSARY/OTHER DEVICE</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>4</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$540.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>57200 - REPAIR OF ******</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$405.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>57240 - REPAIR BLADDER & ******</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>3</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$2,100.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>57240 - REPAIR BLADDER & ******</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>16</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$11,200.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>57240 - REPAIR BLADDER & ******</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$700.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>57250 - REPAIR RECTUM & ******</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>3</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$2,100.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>57250 - REPAIR RECTUM & ******</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>16</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$11,200.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>57250 - REPAIR RECTUM & ******</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>4</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$2,800.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>57260 - REPAIR OF ******</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$1,350.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>57260 - REPAIR OF ******</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>13</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$17,550.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>57260 - REPAIR OF ******</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>5</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$6,750.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>57267 - INSERT MESH/PELVIC FLR ADDON</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$643.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>57267 - INSERT MESH/PELVIC FLR ADDON</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>24</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$15,432.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>57282 - COLPOPEXY, EXTRAPERITONEAL</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$1,350.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>57282 - COLPOPEXY, EXTRAPERITONEAL</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>29</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$39,150.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>57283 - COLPOPEXY, INTRAPERITONEAL</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$750.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>57287 - REVISE/REMOVE SLING REPAIR</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>2</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$3,354.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>57288 - REPAIR BLADDER DEFECT</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>7</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$9,450.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>57288 - REPAIR BLADDER DEFECT</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>58</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$78,300.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>57295 - REVISE VAG GRAFT VIA ******</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>2</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$2,940.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>57420 - EXAM OF ****** W/SCOPE</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$205.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>57420 - EXAM OF ****** W/SCOPE</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$205.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>57421 - EXAM/BIOPSY OF VAG W/SCOPE</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$275.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>57452 - EXAM OF CERVIX W/SCOPE</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>6</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$1,050.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>57452 - EXAM OF CERVIX W/SCOPE</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>34</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$5,950.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>57452 - EXAM OF CERVIX W/SCOPE</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>21</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$3,675.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>57454 - BX/CURETT OF CERVIX W/SCOPE</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>25</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$6,750.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>57454 - BX/CURETT OF CERVIX W/SCOPE</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>56</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$15,120.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>57454 - BX/CURETT OF CERVIX W/SCOPE</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>33</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$8,910.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>57455 - BIOPSY OF CERVIX W/SCOPE</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>11</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$2,585.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>57455 - BIOPSY OF CERVIX W/SCOPE</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>5</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$1,175.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>57456 - ENDOCERV CURETTAGE W/SCOPE</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>9</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$1,800.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>57456 - ENDOCERV CURETTAGE W/SCOPE</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>6</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$1,200.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>57456 - ENDOCERV CURETTAGE W/SCOPE</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>7</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$1,400.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>57460 - BX OF CERVIX W/SCOPE, LEEP</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>5</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$3,500.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>57460 - BX OF CERVIX W/SCOPE, LEEP</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>10</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$7,000.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>57460 - BX OF CERVIX W/SCOPE, LEEP</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$700.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>57461 - CONZ OF CERVIX W/SCOPE, LEEP</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$700.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>57500 - BIOPSY OF CERVIX</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$215.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>57500 - BIOPSY OF CERVIX</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>6</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$1,290.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>57500 - BIOPSY OF CERVIX</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>2</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$430.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>57511 - CRYOCAUTERY OF CERVIX</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>7</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$1,855.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>57520 - CONIZATION OF CERVIX</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>2</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$1,300.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>57522 - CONIZATION OF CERVIX</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$700.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>57522 - CONIZATION OF CERVIX</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$700.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>57800 - DILATION OF CERVICAL CANAL</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$105.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>58100 - BIOPSY OF UTERUS LINING</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>50</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$10,000.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>58100 - BIOPSY OF UTERUS LINING</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>51</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$10,200.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>58100 - BIOPSY OF UTERUS LINING</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>16</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$3,200.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>58110 - BX DONE W/COLPOSCOPY ADD-ON</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>3</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$1,620.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>58110 - BX DONE W/COLPOSCOPY ADD-ON</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$540.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>58120 - DILATION AND CURETTAGE</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>2</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$1,100.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>58120 - DILATION AND CURETTAGE</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$550.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>58120 - DILATION AND CURETTAGE</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>2</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$1,100.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>58150 - TOTAL HYSTERECTOMY</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>9</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$21,600.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>58150 - TOTAL HYSTERECTOMY</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>17</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$40,800.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>58150 - TOTAL HYSTERECTOMY</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>15</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$36,000.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>58180 - PARTIAL HYSTERECTOMY</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$2,800.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>58180 - PARTIAL HYSTERECTOMY</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>4</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$11,200.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>58200 - EXTENSIVE HYSTERECTOMY</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>2</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$5,000.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>58260 - VAGINAL HYSTERECTOMY</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>7</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$12,600.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>58260 - VAGINAL HYSTERECTOMY</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>25</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$45,000.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>58260 - VAGINAL HYSTERECTOMY</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$1,800.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>58262 - VAG HYST INCLUDING T/O</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$2,400.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>58262 - VAG HYST INCLUDING T/O</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>36</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$86,400.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>58263 - VAG HYST W/T/O & VAG REPAIR</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>3</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$7,800.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>58270 - VAG HYST W/ENTEROCELE REPAIR</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$2,600.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>58300 - INSERT INTRAUTERINE DEVICE</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>19</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$3,040.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>58300 - INSERT INTRAUTERINE DEVICE</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>107</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$17,120.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>58300 - INSERT INTRAUTERINE DEVICE</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>74</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$11,840.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>58301 - REMOVE INTRAUTERINE DEVICE</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>4</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$680.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>58301 - REMOVE INTRAUTERINE DEVICE</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>23</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$3,780.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>58301 - REMOVE INTRAUTERINE DEVICE</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>12</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$2,040.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>58340 - CATHETER FOR HYSTEROGRAPHY</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>4</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$2,600.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>58350 - REOPEN FALLOPIAN TUBE</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$155.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>58542 - LSH W/T/O UT 250 G OR LESS</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$2,700.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>58545 - LAPAROSCOPIC MYOMECTOMY</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$2,167.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>58550 - LAPARO-ASST VAG HYSTERECTOMY</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$3,400.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>58550 - LAPARO-ASST VAG HYSTERECTOMY</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>8</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$27,200.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>58550 - LAPARO-ASST VAG HYSTERECTOMY</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>4</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$13,600.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>58552 - LAPARO-VAG HYST INCL T/O</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$2,700.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>58552 - LAPARO-VAG HYST INCL T/O</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>24</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$64,800.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>58552 - LAPARO-VAG HYST INCL T/O</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>11</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$29,700.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>58553 - LAPARO-VAG HYST, COMPLEX</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>2</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$5,400.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>58558 - HYSTEROSCOPY, BIOPSY</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>12</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$12,000.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>58558 - HYSTEROSCOPY, BIOPSY</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>15</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$15,000.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>58558 - HYSTEROSCOPY, BIOPSY</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>15</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$15,000.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>58562 - HYSTEROSCOPY, REMOVE FB</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$855.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>58562 - HYSTEROSCOPY, REMOVE FB</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$855.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>58563 - HYSTEROSCOPY, ABLATION</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>21</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$45,220.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>58563 - HYSTEROSCOPY, ABLATION</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>29</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$62,028.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>58563 - HYSTEROSCOPY, ABLATION</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>19</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$36,622.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>58565 - HYSTEROSCOPY, STERILIZATION</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>6</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$19,200.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>58570 - TLH, UTERUS 250 G OR LESS</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>3</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$6,525.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>58570 - TLH, UTERUS 250 G OR LESS</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$2,175.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>58571 - TLH W/T/O 250 G OR LESS</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$2,450.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>58600 - DIVISION OF FALLOPIAN TUBE</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$1,000.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>58611 - LIGATE OVIDUCT(S) ADD-ON</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>3</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$4,800.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>58611 - LIGATE OVIDUCT(S) ADD-ON</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>4</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$6,400.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>58615 - OCCLUDE FALLOPIAN TUBE(S)</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>4</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$3,560.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>58615 - OCCLUDE FALLOPIAN TUBE(S)</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>2</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$2,130.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>58660 - LAPAROSCOPY, LYSIS</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$1,400.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>58660 - LAPAROSCOPY, LYSIS</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>2</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$2,800.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>58660 - LAPAROSCOPY, LYSIS</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>3</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$4,200.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>58661 - LAPAROSCOPY, REMOVE ADNEXA</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>6</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$6,990.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>58661 - LAPAROSCOPY, REMOVE ADNEXA</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>7</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$8,155.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>58661 - LAPAROSCOPY, REMOVE ADNEXA</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>5</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$5,825.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>58662 - LAPAROSCOPY, EXCISE LESIONS</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>2</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$3,200.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>58662 - LAPAROSCOPY, EXCISE LESIONS</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>2</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$3,200.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>58670 - LAPAROSCOPY, TUBAL CAUTERY</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>2</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$2,000.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>58670 - LAPAROSCOPY, TUBAL CAUTERY</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>3</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$3,000.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>58671 - LAPAROSCOPY, TUBAL BLOCK</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>2</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$2,000.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>58671 - LAPAROSCOPY, TUBAL BLOCK</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>3</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$3,000.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>58673 - LAPAROSCOPY, SALPINGOSTOMY</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$1,225.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>58700 - REMOVAL OF FALLOPIAN TUBE</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$1,100.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>58720 - REMOVAL OF OVARY/TUBE(S)</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$1,220.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>58720 - REMOVAL OF OVARY/TUBE(S)</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>3</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$3,660.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>58823 - DRAIN PELVIC ABSCESS, PERCUT</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$2,052.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>58925 - REMOVAL OF OVARIAN CYST(S)</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>2</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$2,400.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>58925 - REMOVAL OF OVARIAN CYST(S)</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>2</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$2,400.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>58940 - REMOVAL OF OVARY(S)</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$1,500.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>59000 - AMNIOCENTESIS, DIAGNOSTIC</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>2</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$700.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>59000 - AMNIOCENTESIS, DIAGNOSTIC</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>3</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$1,050.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>59025 - FETAL NON-STRESS TEST</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>149</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$14,900.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>59025 - FETAL NON-STRESS TEST</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>314</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$31,400.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>59025 - FETAL NON-STRESS TEST</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>624</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$62,400.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>59150 - TREAT ECTOPIC PREGNANCY</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$1,500.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>59151 - TREAT ECTOPIC PREGNANCY</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>2</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$4,000.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>59151 - TREAT ECTOPIC PREGNANCY</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>3</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$6,000.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>59151 - TREAT ECTOPIC PREGNANCY</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>2</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$4,000.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>59160 - D & C AFTER DELIVERY</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$550.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>59160 - D & C AFTER DELIVERY</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$550.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>59160 - D & C AFTER DELIVERY</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$550.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>59300 - EPISIOTOMY OR VAGINAL REPAIR</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>2</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$720.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>59300 - EPISIOTOMY OR VAGINAL REPAIR</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$360.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>59320 - REVISION OF CERVIX</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>4</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$2,000.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>59400 - OBSTETRICAL CARE</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>105</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$294,000.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>59400 - OBSTETRICAL CARE</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>236</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$660,800.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>59400 - OBSTETRICAL CARE</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>248</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$694,400.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>59409 - OBSTETRICAL CARE</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>5</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$9,000.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>59409 - OBSTETRICAL CARE</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>14</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$25,200.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>59409 - OBSTETRICAL CARE</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>9</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$16,200.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>59410 - OBSTETRICAL CARE</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>7</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$11,305.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>59410 - OBSTETRICAL CARE</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>14</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$22,610.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>59410 - OBSTETRICAL CARE</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>5</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$8,075.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>59414 - DELIVER PLACENTA</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>5</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$1,500.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>59414 - DELIVER PLACENTA</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$300.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>59425 - ANTEPARTUM CARE ONLY</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>30</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$19,800.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>59425 - ANTEPARTUM CARE ONLY</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>36</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$23,760.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>59425 - ANTEPARTUM CARE ONLY</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>18</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$11,880.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>59426 - ANTEPARTUM CARE ONLY</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>21</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$27,300.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>59426 - ANTEPARTUM CARE ONLY</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>23</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$29,900.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>59426 - ANTEPARTUM CARE ONLY</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>11</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$14,300.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>59430 - CARE AFTER DELIVERY</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>21</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$840.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>59430 - CARE AFTER DELIVERY</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>100</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$3,860.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>59430 - CARE AFTER DELIVERY</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>55</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$1,690.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>59510 - CESAREAN DELIVERY</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>25</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$75,250.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>59510 - CESAREAN DELIVERY</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>64</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$192,640.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>59510 - CESAREAN DELIVERY</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>86</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$258,860.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>59514 - CESAREAN DELIVERY ONLY</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>3</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$4,500.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>59514 - CESAREAN DELIVERY ONLY</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>64</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$96,000.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>59514 - CESAREAN DELIVERY ONLY</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>25</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$37,500.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>59515 - CESAREAN DELIVERY</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>2</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$3,400.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>59515 - CESAREAN DELIVERY</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>7</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$11,900.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>59515 - CESAREAN DELIVERY</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>2</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$3,400.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>59525 - REMOVE UTERUS AFTER CESAREAN</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>2</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$3,600.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>59610 - VBAC DELIVERY</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>4</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$23,220.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>59610 - VBAC DELIVERY</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>3</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$17,415.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>59612 - VBAC DELIVERY ONLY</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$2,518.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>59614 - VBAC CARE AFTER DELIVERY</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$2,837.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>59812 - TREATMENT OF MISCARRIAGE</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>9</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$4,950.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>59812 - TREATMENT OF MISCARRIAGE</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>5</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$2,750.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>59812 - TREATMENT OF MISCARRIAGE</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>4</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$2,200.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>59820 - CARE OF MISCARRIAGE</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>2</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$980.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>59820 - CARE OF MISCARRIAGE</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>12</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$5,880.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>59820 - CARE OF MISCARRIAGE</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>9</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$4,410.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>59821 - TREATMENT OF MISCARRIAGE</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$1,450.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>59821 - TREATMENT OF MISCARRIAGE</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$1,450.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>59840 - ABORTION</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>2</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$1,190.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>59870 - EVACUATE MOLE OF UTERUS</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$1,132.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>76376 - 3D RENDER W/O POSTPROCESS</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$125.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>76700 - US EXAM, ABDOM, COMPLETE</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$395.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>76801 - OB US < 14 WKS, SINGLE FETUS</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>5</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$1,600.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>76801 - OB US < 14 WKS, SINGLE FETUS</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>150</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$48,000.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>76802 - OB US < 14 WKS, ADD'L FETUS</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$225.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>76805 - OB US >/= 14 WKS, SNGL FETUS</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>38</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$14,191.25</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>76805 - OB US >/= 14 WKS, SNGL FETUS</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>293</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$117,200.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>76810 - OB US >/= 14 WKS, ADDL FETUS</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>2</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$580.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>76815 - OB US, LIMITED, FETUS(S)</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>3</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$627.50</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>76815 - OB US, LIMITED, FETUS(S)</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>31</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$7,750.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>76816 - OB US, FOLLOW-UP, PER FETUS</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>19</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$5,700.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>76816 - OB US, FOLLOW-UP, PER FETUS</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>150</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$45,000.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>76817 - TRANSVAGINAL US, OBSTETRIC</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>28</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$8,260.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>76817 - TRANSVAGINAL US, OBSTETRIC</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>90</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$26,550.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>76818 - FETAL BIOPHYS PROFILE W/NST</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$348.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>76818 - FETAL BIOPHYS PROFILE W/NST</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$348.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>76818 - FETAL BIOPHYS PROFILE W/NST</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>3</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$1,044.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>76819 - FETAL BIOPHYS PROFIL W/O NST</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>10</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$3,480.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>76819 - FETAL BIOPHYS PROFIL W/O NST</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>2</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$696.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>76830 - TRANSVAGINAL US, NON-OB</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>39</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$12,870.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>76830 - TRANSVAGINAL US, NON-OB</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>162</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$53,460.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>76831 - ECHO EXAM, UTERUS</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$250.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>76856 - US EXAM, PELVIC, COMPLETE</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>4</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$1,120.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>76856 - US EXAM, PELVIC, COMPLETE</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>154</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$43,120.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>76857 - US EXAM, PELVIC, LIMITED</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$280.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>76946 - ECHO GUIDE FOR AMNIOCENTESIS</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>2</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$266.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>81000 - URINALYSIS, NONAUTO W/SCOPE</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$15.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>81002 - URINALYSIS NONAUTO W/O SCOPE</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>139</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$2,085.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>81002 - URINALYSIS NONAUTO W/O SCOPE</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>7</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$105.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>81002 - URINALYSIS NONAUTO W/O SCOPE</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>55</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$825.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>81003 - URINALYSIS, AUTO, W/O SCOPE</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$15.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>81003 - URINALYSIS, AUTO, W/O SCOPE</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>88</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$1,320.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>81003 - URINALYSIS, AUTO, W/O SCOPE</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$15.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>81025 - URINE PREGNANCY TEST</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>239</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$8,345.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>81025 - URINE PREGNANCY TEST</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>141</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$4,935.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>81025 - URINE PREGNANCY TEST</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>291</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$10,185.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>82270 - OCCULT BLOOD, FECES</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>2</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$30.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>82270 - OCCULT BLOOD, FECES</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>13</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$195.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>82272 - OCCULT BLOOD, FECES, SINGLE</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$12.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>82272 - OCCULT BLOOD, FECES, SINGLE</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$12.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>82274 - ASSAY TEST FOR BLOOD, FECAL</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>36</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$1,620.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>82274 - ASSAY TEST FOR BLOOD, FECAL</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>27</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$1,215.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>86580 - TB INTRADERMAL TEST</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>3</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$45.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>87210 - SMEAR, WET MOUNT, SALINE/INK</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>27</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$405.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>87210 - SMEAR, WET MOUNT, SALINE/INK</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>154</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$2,310.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>87210 - SMEAR, WET MOUNT, SALINE/INK</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>178</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$2,670.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>87220 - TISSUE EXAM FOR FUNGI</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>2</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$20.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>87220 - TISSUE EXAM FOR FUNGI</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>64</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$640.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>87808 - TRICHOMONAS ASSAY W/OPTIC</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$0.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>87880 - STREP A ASSAY W/OPTIC</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$22.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>88174 - CYTOPATH, C/V AUTO, IN FLUID</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>2</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$0.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>90470 - IMMUNE ADMIN H1N1 IM/NASAL</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>18</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$90.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>90471 - IMMUNIZATION ADMIN</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>14</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$714.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>90471 - IMMUNIZATION ADMIN</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>54</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$2,754.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>90471 - IMMUNIZATION ADMIN</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>56</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$2,856.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>90649 - H PAPILLOMA VACC 3 DOSE IM</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>12</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$2,400.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>90649 - H PAPILLOMA VACC 3 DOSE IM</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>24</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$4,800.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>90649 - H PAPILLOMA VACC 3 DOSE IM</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>28</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$5,600.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>90656 - FLU VACCINE NO PRESERV 3 & ></TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>26</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$260.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>90656 - FLU VACCINE NO PRESERV 3 & ></TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>27</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$270.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>90658 - FLU VACCINE, 3 YRS & >, IM</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>5</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$125.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>90701 - DTP VACCINE, IM</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$0.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>90715 - TDAP VACCINE >7 IM</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$60.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>95819 - EEG, AWAKE AND ASLEEP</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$400.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>96372 - THER/PROPH/DIAG INJ, SC/IM</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>58</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$2,030.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>96372 - THER/PROPH/DIAG INJ, SC/IM</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>67</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$2,345.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>96372 - THER/PROPH/DIAG INJ, SC/IM</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>97</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$3,395.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>98925 - OSTEOPATHIC MANIPULATION</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>3</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$187.20</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>98925 - OSTEOPATHIC MANIPULATION</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>21</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$1,310.40</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>98926 - OSTEOPATHIC MANIPULATION</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>6</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$633.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>98926 - OSTEOPATHIC MANIPULATION</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>10</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$1,055.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>98928 - OSTEOPATHIC MANIPULATION</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$157.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>99000 - SPECIMEN HANDLING</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>405</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$6,075.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>99000 - SPECIMEN HANDLING</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>4</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$60.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>99000 - SPECIMEN HANDLING</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>52</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$780.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>99024 - POSTOP FOLLOW-UP VISIT</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>118</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$0.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>99024 - POSTOP FOLLOW-UP VISIT</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>296</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$0.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>99024 - POSTOP FOLLOW-UP VISIT</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>217</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$0.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>99080 - SPECIAL REPORTS OR FORMS</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>18</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$547.65</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>99080 - SPECIAL REPORTS OR FORMS</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>20</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$475.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>99080 - SPECIAL REPORTS OR FORMS</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>58</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$1,450.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>99201 - OFFICE/OUTPATIENT VISIT, NEW</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>10</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$650.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>99201 - OFFICE/OUTPATIENT VISIT, NEW</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>7</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$455.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>99201 - OFFICE/OUTPATIENT VISIT, NEW</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>9</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$585.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>99202 - OFFICE/OUTPATIENT VISIT, NEW</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>79</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$9,085.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>99202 - OFFICE/OUTPATIENT VISIT, NEW</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>91</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$10,390.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>99202 - OFFICE/OUTPATIENT VISIT, NEW</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>15</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$1,675.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>99203 - OFFICE/OUTPATIENT VISIT, NEW</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>19</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$3,325.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>99203 - OFFICE/OUTPATIENT VISIT, NEW</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>279</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$48,825.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>99203 - OFFICE/OUTPATIENT VISIT, NEW</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>11</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$1,925.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>99204 - OFFICE/OUTPATIENT VISIT, NEW</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>56</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$13,440.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>99204 - OFFICE/OUTPATIENT VISIT, NEW</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>145</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$34,800.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>99204 - OFFICE/OUTPATIENT VISIT, NEW</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>74</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$17,760.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>99205 - OFFICE/OUTPATIENT VISIT, NEW</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$300.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>99205 - OFFICE/OUTPATIENT VISIT, NEW</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$300.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>99211 - OFFICE/OUTPATIENT VISIT, EST</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>13</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$80.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>99211 - OFFICE/OUTPATIENT VISIT, EST</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>57</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$800.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>99211 - OFFICE/OUTPATIENT VISIT, EST</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>78</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$960.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>99212 - OFFICE/OUTPATIENT VISIT, EST</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>157</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$10,205.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>99212 - OFFICE/OUTPATIENT VISIT, EST</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>141</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$9,165.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>99212 - OFFICE/OUTPATIENT VISIT, EST</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>94</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$6,110.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>99213 - OFFICE/OUTPATIENT VISIT, EST</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>196</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$17,550.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>99213 - OFFICE/OUTPATIENT VISIT, EST</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>646</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$58,122.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>99213 - OFFICE/OUTPATIENT VISIT, EST</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>374</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$33,660.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>99214 - OFFICE/OUTPATIENT VISIT, EST</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>19</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$2,660.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>99214 - OFFICE/OUTPATIENT VISIT, EST</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>86</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$12,040.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>99214 - OFFICE/OUTPATIENT VISIT, EST</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>72</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$10,080.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>99215 - OFFICE/OUTPATIENT VISIT, EST</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>10</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$2,050.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>99215 - OFFICE/OUTPATIENT VISIT, EST</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>2</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$410.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>99218 - OBSERVATION CARE</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>3</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$600.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>99219 - OBSERVATION CARE</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>2</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$450.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>99221 - INITIAL HOSPITAL CARE</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>4</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$500.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>99222 - INITIAL HOSPITAL CARE</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>4</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$800.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>99222 - INITIAL HOSPITAL CARE</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>11</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$2,200.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>99222 - INITIAL HOSPITAL CARE</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>6</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$1,200.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>99223 - INITIAL HOSPITAL CARE</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$275.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>99223 - INITIAL HOSPITAL CARE</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>5</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$1,375.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>99223 - INITIAL HOSPITAL CARE</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>2</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$550.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>99231 - SUBSEQUENT HOSPITAL CARE</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>6</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$450.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>99231 - SUBSEQUENT HOSPITAL CARE</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>3</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$225.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>99232 - SUBSEQUENT HOSPITAL CARE</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>2</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$210.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>99232 - SUBSEQUENT HOSPITAL CARE</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>5</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$525.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>99233 - SUBSEQUENT HOSPITAL CARE</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>5</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$750.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>99234 - OBSERV/HOSP SAME DATE</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$305.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>99238 - HOSPITAL DISCHARGE DAY</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>5</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$675.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>99238 - HOSPITAL DISCHARGE DAY</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>2</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$270.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>99241 - OFFICE CONSULTATION</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>2</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$300.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>99242 - OFFICE CONSULTATION</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>3</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$525.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>99244 - OFFICE CONSULTATION</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>14</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$4,130.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>99245 - OFFICE CONSULTATION</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>3</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$1,140.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>99252 - INPATIENT CONSULTATION</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$175.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>99253 - INPATIENT CONSULTATION</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>5</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$925.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>99253 - INPATIENT CONSULTATION</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>3</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$555.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>99254 - INPATIENT CONSULTATION</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>2</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$490.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>99384 - PREV VISIT, NEW, AGE 12-17</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>15</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$3,075.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>99384 - PREV VISIT, NEW, AGE 12-17</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>16</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$3,280.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>99384 - PREV VISIT, NEW, AGE 12-17</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>12</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$2,460.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>99385 - PREV VISIT, NEW, AGE 18-39</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>163</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$34,230.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>99385 - PREV VISIT, NEW, AGE 18-39</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>272</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$57,120.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>99385 - PREV VISIT, NEW, AGE 18-39</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>119</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$24,990.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>99386 - PREV VISIT, NEW, AGE 40-64</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>89</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$21,360.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>99386 - PREV VISIT, NEW, AGE 40-64</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>170</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$40,800.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>99386 - PREV VISIT, NEW, AGE 40-64</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>78</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$18,720.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>99387 - INIT PM E/M, NEW PAT 65+ YRS</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$260.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>99387 - INIT PM E/M, NEW PAT 65+ YRS</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>15</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$3,900.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>99387 - INIT PM E/M, NEW PAT 65+ YRS</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>3</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$780.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>99394 - PREV VISIT, EST, AGE 12-17</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>6</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$1,020.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>99394 - PREV VISIT, EST, AGE 12-17</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>14</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$2,380.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>99394 - PREV VISIT, EST, AGE 12-17</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>6</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$1,020.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>99395 - PREV VISIT, EST, AGE 18-39</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>177</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$30,975.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>99395 - PREV VISIT, EST, AGE 18-39</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>335</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$58,450.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>99395 - PREV VISIT, EST, AGE 18-39</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>274</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$47,950.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>99396 - PREV VISIT, EST, AGE 40-64</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>114</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$21,660.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>99396 - PREV VISIT, EST, AGE 40-64</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>260</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$49,400.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>99396 - PREV VISIT, EST, AGE 40-64</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>286</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$54,340.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>99397 - PER PM REEVAL EST PAT 65+ YR</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>3</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$630.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>99397 - PER PM REEVAL EST PAT 65+ YR</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>19</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$3,990.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>99397 - PER PM REEVAL EST PAT 65+ YR</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>7</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$1,470.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>A4561 - PESSARY RUBBER ANY TYPE</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>5</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$325.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>A4561 - PESSARY RUBBER ANY TYPE</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$65.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>A4562 - PESSARY NON RUBBER ANY TYPE</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>3</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$510.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>G0101 - CERV/VAG CANCR SCR;PELV&CLN BRST EX</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>34</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$2,380.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>G0101 - CERV/VAG CANCR SCR;PELV&CLN BRST EX</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>35</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$2,450.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>G0101 - CERV/VAG CANCR SCR;PELV&CLN BRST EX</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>63</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$4,410.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>G9141 - INFLUENZA A (H1N1) IMMUNIZATION ADMINIST</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>14</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$70.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>J0696 - INJ CEFTRIAXONE SODIUM PER 250 MG</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>2</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$64.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>J0696 - INJ CEFTRIAXONE SODIUM PER 250 MG</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>2</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$64.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>J0696 - INJ CEFTRIAXONE SODIUM PER 250 MG</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>2</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$64.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>J1051 - INJ MDRXYPRGESTRON ACTAT 50 MG</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$25.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>J1055 - INJ MDRXYPRGESTRON CNTRACPT 150 MG</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>9</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$765.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>J1055 - INJ MDRXYPRGESTRON CNTRACPT 150 MG</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>6</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$510.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>J1055 - INJ MDRXYPRGESTRON CNTRACPT 150 MG</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>35</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$2,975.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>J1950 - INJ LEUPROLIDE ACETATE PER 3.75 MG</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$720.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>J2675 - INJECTION PROGESTERONE PER 50 MG</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>4</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$34.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>J2790 - INJ RHO D IG HUMN FULL DOSE 300 MCG</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>12</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$3,405.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>J2790 - INJ RHO D IG HUMN FULL DOSE 300 MCG</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>25</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$7,135.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>J2790 - INJ RHO D IG HUMN FULL DOSE 300 MCG</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>12</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$3,460.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>J7300 - INTRAUTERINE COPPER CONTRACEPTIVE</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$695.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>J7300 - INTRAUTERINE COPPER CONTRACEPTIVE</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>1</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$695.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>J7302 - LEVONORGESTREL INTRAUTERN CNTRACPT</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>13</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$10,470.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>J7302 - LEVONORGESTREL INTRAUTERN CNTRACPT</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>70</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$51,315.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>J7302 - LEVONORGESTREL INTRAUTERN CNTRACPT</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>65</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$47,225.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>J7306 - LEVONORGESTREL CONTRACPTV IMPL SYS</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>2</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$250.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>J7306 - LEVONORGESTREL CONTRACPTV IMPL SYS</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>2</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$500.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>J7307 - ETONOGESTREL IMPL SYS W/IMPL SUPPL</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>22</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$19,030.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>J7307 - ETONOGESTREL IMPL SYS W/IMPL SUPPL</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>17</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$14,705.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>PRE-OP - PRE-OP</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>2</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$0.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>PRE-OP - PRE-OP</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>79</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$0.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>PRE-OP - PRE-OP</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>4</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$0.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>Q0091 - SCR PAP SMER; OBTAIN PREP&CONVY-LAB</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>24</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$1,080.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>Q0091 - SCR PAP SMER; OBTAIN PREP&CONVY-LAB</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>31</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$1,395.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>Q0091 - SCR PAP SMER; OBTAIN PREP&CONVY-LAB</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>54</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$2,430.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl67 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>Q0111 - WET MOUNTS W/PREP VAG CERV/SKN SPEC</TD><TD class=xl68 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>2</TD><TD class=xl69 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$30.00</TD></TR><TR style="HEIGHT: 15pt" height=20><TD class=xl64 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 277pt; BORDER-BOTTOM: #ece9d8; HEIGHT: 15pt; BACKGROUND-COLOR: transparent" width=369 height=20>Z7000 - 3-4D ULTRASOUNDS (OB/GYN)</TD><TD class=xl65 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 143pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=191>39</TD><TD class=xl66 style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; WIDTH: 64pt; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent" width=85>$4,415.00</TD></TR></TBODY></TABLE>

can someone help me with adding the duplicates then sorting from largest to smallest? thanks,

lori

sous2817 · Oct 4, 2010

Use a pivot table?

lcall · Oct 4, 2010

can you help me with that?

scottylad2 · Oct 4, 2010

Either do a Unique data extraction using either a Formula or Advanced filter, then with the resultant table of unique i'd do a sumif on your current table. The numbers in the middle column, do they have any relevance? should the total for that column be multiplied by that number? If so thats slightly different, but could also be acheived using the same extracted list as criteria in a sumproduct

adding duplicates the sorting from largest to lowest

lcall

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sous2817

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lcall

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adding duplicates the sorting from largest to lowest

lcall

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Excel Facts

sous2817

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lcall

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scottylad2

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