Medicare Fee Schudule

2 0 1 1
M E D I C A R E
F E E
S C H E D U L E
Attached is a report of the 2011 Medicare Fees for your locality. The fee schedule amounts
and the codes that have been added for 2011 are effective for services performed on or after
January 1 2011.
The Medicare Fees report is formatted in three columns and reads from left to right.
The 2011 Medicare Fees report includes the following information:
PROC/MOD
CPT or HCPCS code along with -TC (Technical componnt) -26 (Professional component)
or -53 (Discontinued procedure) modifiers when applicable.
NOTE:
"F" - Facility Fee. These amounts apply when the service is performed in a facility
setting: Inpatient Hospital (Place of Service (POS) 21) Outpatient Hospital
(POS 22) Emergency Room of Hospital(POS 23) Ambulatory Surgical Center (POS 24 Note: ASC is only treated as a facility setting when an ASC list procedure is
performed in an ASC) Military Treatment Facility (POS 26) Skilled Nursing
Facility (POS 31) Hospice (POS 34) Ambulance via Land (POS 41) Ambulance via Air
or Water (POS 42) Inpatient Psychiatric Facility (POS 51) Psychiatric Facility
Partial Hospitalization (POS 52) Community Mental Health Center (POS 53)
Psychiatric Residential Treatment Facility (POS 56) and Comprehensive Inpatient
Rehabilitation Facility (POS 61).
"N" - Non-Facility Fee. These amounts apply when the service is performed in a place
of service setting other than listed in the "F" - Facility Fee description above.
"C" - The payment for the Technical Component is capped at the OPPS amount.
2011 NOTE:
Medicare is applying a new Multiple Procedure Payment Reduction (MPPR)

to the practice expense (PE) payment of select therapy services paid under
the physician fee schedule. The reduction will be similar to that currently
applied to multiple surgical procedures and to diagnostic imaging procedures.
The MPPR services are:
92506, 92507, 92508, 92526, 92597,
97003, 97004, 97012, 97016, 97018,
97033, 97034, 97035, 97036, 97110,
97150, 97530, 97533, 97535, 97537,
97762, G0281, G0283 and G0329.
92607,
97022,
97112,
97542,
92609,
97024,
97113,
97750,
96125,
97026,
97116,
97755,
97001,
97028,
97124,
97760,
97002,
97032,
97140,
97761,
To find these fee rates, go to our website:

< www.trailblazerhealth.com/tools/fee schedule/medicarefeeschedule.aspx >
PAR FEE: Allowed amount for participating physicians.
NPAR FEE: Allowed amount for non-participating physicians.
LC FEE:
The maximum limiting charge amount that can be charged for that service on a nonassigned claim.
Anesthesia Note: A new line with "ANSCF" has been added to the fee report. The dollar values
represent the 2011 anesthesia conversion factor for the locality. Please note
the ANSCF is not a valid procedure code. Providers are required to bill with the
CPT-4 code range 00100 to 01999 for anesthesia services.
Drug Fees Note:
The Drug and Biological Fees are not included in the Medicare Fee Schedule
locality reports. Please visit our Web page: www.TrailBlazerHealth.com to obtain
the 2011 fees as they become available.
Payable Note:
A fee schedule amount has been given for each procedure code listed in the
Medicare Fee Schedule Data Base. However based on Medicare policy the specific
procedure may not be payable by the Medicare program.
Visit us on the Web at www.TrailBlazerHealth.com.
MFI00A11
FSY-2011
PROC MOD NOTE PAR FEE

----- -- ---- --------
"STATE OK"
NPAR FEE
--------
M E D I C A R E
LC FEE
--------
F E E

----- -- ---- --------
ANSCF
11
20.23
19.22
22.10
A9500
A9503
N 11
19.31
18.34
21.09
A9505
A9510
N 11
39.90
37.91
43.60
A9512
A9517
N 11
21.00
19.95
22.94
A9521
A9526
N 11
143.00
135.85
156.23
A9528
A9530
N 11
9.66
9.18
10.56
A9531
A9537
N 11
40.00
38.00
43.70
A9538
A9540
N 11
20.00
19.00
21.85
A9541
A9544
N 11 1279.00
1215.05
1397.31
A9545
A9548
N 11
320.39
304.37
350.03
A9551
A9553
N 11
257.18
244.32
280.97
A9554
A9557
N 11
424.18
402.97
463.42
A9558
A9561
N 11
34.00
32.30
37.15
A9562
A9564
N 11
158.88
150.94
173.58
A9568
G0101
F 11
26.05
24.75
28.46
G0102
G0104
N 11
128.72
122.28
140.62
G0104
G0105
F 11
208.75
198.31
228.06
G0105 53
G0106
11
199.27
189.31
217.71
G0106 TC
G0108
11
52.51
49.88
57.36
G0109
G0118
11
31.83
30.24
34.78
G0120
G0120 26
11
47.23
44.87
51.60
G0121
G0121 53 N 11
128.72
122.28
140.62
G0121 53
G0127
N 11
20.18
19.17
22.05
G0127
G0130
11
31.24
29.68
34.13
G0130 TC
G0141
11
27.55
26.17
30.10
G0166
G0168
F 11
24.79
23.55
27.08
G0179
G0181
11
100.11
95.10
109.37
G0182
G0202 TC
11
97.55
92.67
106.57
G0202 26
G0204 TC
11
115.50
109.73
126.19
G0204 26
G0206 TC
11
90.62
86.09
99.00
G0206 26
G0238
11
9.99
9.49
10.91
G0239
G0245
F 11
44.90
42.66
49.06
G0246
G0247
N 11
54.44
51.72
59.48
G0247
G0249
11
114.56
108.83
125.15
G0250
G0268
F 11
31.17
29.61
34.05
G0270
G0271
11
13.45
12.78
14.70
G0275
G0281
11
12.01
11.41
13.12
G0283
G0289
11
83.67
79.49
91.41
G0329
G0340
11 1408.89
1338.45
1539.22
G0341
G0342
11
649.03
616.58
709.07
G0343
G0364
F 11
8.50
8.08
09.29
G0365
G0365 26
11
12.01
11.41
13.12
G0372
G0389
11
105.03
99.78
114.75
G0389 TC
G0396
N 11
31.82
30.23
34.76
G0396
G0397
F 11
63.63
60.45
69.52
G0398
G0398 26
11
103.32
98.15
112.87
G0399
G0399 26
11
87.83
83.44
95.96
G0400
G0400 26
11
72.33
68.71
79.02
G0402
G0403
N 11
18.52
17.59
20.23
G0403
G0405
N 11
8.52
8.09
09.30
G0405
G0407
11
67.00
63.65
73.20
G0408
G0412
11
676.52
642.69
739.09
G0413
G0415
11 1290.26
1225.75
1409.61
G0416
G0416 26
11
164.82
156.58
180.07
G0417
G0417 26
11
316.38
300.56
345.64
G0418
G0418 26
11
550.17
522.66
601.06
G0419
G0419 26
11
633.39
601.72
691.98
G0420
G0422
11
66.04
62.74
72.15
G0423
G0424
F 11
13.98
13.28
15.27
G0425
G0427
11
193.51
183.83
211.40
G0429
G0436
N 11
13.42
12.75
14.66
G0436
G0437
F 11
25.23
23.97
27.57
G0438
G0440
N 11
166.94
158.59
182.38
G0440
G0441
F 11
24.88
23.64
27.19
G9041
G9043
11
16.60
15.77
18.14
G9044
M0064
F 11
15.63
14.85
17.08
P3001
Q0035 TC
11
9.36
8.89
10.22
Q0035 26
Q0091
F 11
17.98
17.08
19.64
Q0092
R0075
11
239.64
227.66
261.81
0073T
0075T TC
11 1030.49
978.97
1125.82
0075T 26
0172T
11
265.46
252.19
290.02
10021
10022
N 11
128.55
122.12
140.44
10022
10040
F 11
83.64
79.46
91.38
10060
10061
N 11
171.66
163.08
187.54
10061
10080
F 11
92.00
87.40
100.51
10081
10120
N 11
126.12
119.81
137.78
10120
*** All Current Procedural Terminology (CPT) codes
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
F
N
S C H E D U L E
NPAR FEE
--------
"ALL OF OKLAHOMA"
LC FEE
--------
11
188.00
178.60
205.39
11
34.20
32.49
37.36
11
3.93
3.73
04.29
11
567.61
539.23
620.11
11
46.79
44.45
51.12
11
9.59
9.11
10.48
11
40.81
38.77
44.59
11
48.74
46.30
53.25
11 22896.90 21752.06 25014.87
11
124.50
118.28
136.02
11
640.40
608.38
699.64
11
42.16
40.05
46.06
11
279.00
265.05
304.81
11 1235.00
1173.25
1349.24
11
18.29
17.38
19.99
11
59.75
56.76
65.27
11
128.72
122.28
140.62
11
152.04
144.44
166.11
11
17.86
16.97
19.52
C11
126.52
120.19
138.22
N 11
370.95
352.40
405.26
F 11
59.75
56.76
65.27
F 11
7.89
7.50
08.63
11
20.70
19.67
22.62
11
141.96
134.86
155.09
11
38.34
36.42
41.88
11
101.37
96.30
110.75
11
33.83
32.14
36.96
11
41.72
39.63
45.57
11
33.83
32.14
36.96
11
10.94
10.39
11.95
N 11
38.02
36.12
41.54
F 11
23.57
22.39
25.75
11
8.86
8.42
09.68
N 11
26.68
25.35
29.15
11
12.82
12.18
14.01
11
12.01
11.41
13.12
11
8.57
8.14
09.36
N 11 1176.83
1117.99
1285.69
11 1087.14
1032.78
1187.70
C11
153.97
146.27
168.21
N 11
9.78
9.29
10.68
11
76.76
72.92
83.86
F 11
30.24
28.73
33.04
11
154.99
147.24
169.33
11
129.16
122.70
141.11
11
103.32
98.15
112.87
N 11
141.99
134.89
155.12
F 11
17.89
17.00
19.55
F 11
7.89
7.50
08.63
11
96.20
91.39
105.10
11
989.09
939.64
1080.59
11
547.41
520.04
598.05
11 1063.39
1010.22
1161.75
11 1825.99
1734.69
1994.89
11 2164.33
2056.11
2364.53
11
106.66
101.33
116.53
11
66.04
62.74
72.15
11
96.43
91.61
105.35
N 11
83.38
79.21
91.09
F 11
11.53
10.95
12.59
11
154.27
146.56
168.54
F 11
113.39
107.72
123.88
11
33.17
31.51
36.24
11
14.37
13.65
15.70
11
27.55
26.17
30.10
11
7.89
7.50
08.63
11
18.81
17.87
20.55
11
481.80
457.71
526.37
11
67.73
64.34
73.99
N 11
133.21
126.55
145.53
F 11
62.72
59.58
68.52
N 11
102.77
97.63
112.27
F 11
150.87
143.33
164.83
N 11
240.40
228.38
262.64
F 11
85.49
81.22
93.40
and descriptors are copyrighted 2010
09/12/2011

----- -- ---- --------
NPAR FEE
--------
PAGE 001
LC FEE
--------
A9502
N 11
200.00
190.00
218.50
A9508
N 11
402.79
382.65
440.05
A9516
N 11
28.32
26.90
30.94
A9524
N 11
61.75
58.66
67.46
A9529
N 11
109.00
103.55
119.08
A9532
N 11
282.00
267.90
308.09
A9539
N 11
13.68
13.00
14.95
A9542
N 11 2769.63
2631.15
3025.82
A9546
N 11
235.83
224.04
257.65
A9552
N 11
195.00
185.25
213.04
A9555
N 11
260.00
247.00
284.05
A9559
N 11
88.59
84.16
96.78
A9563
N 11
46.57
44.24
50.88
G0101
N 11
34.87
33.13
38.10
G0102
F 11
8.52
8.09
09.30
G0105
N 11
370.95
352.40
405.26
G0105 53 F 11
59.75
56.76
65.27
G0106 26
11
47.23
44.87
51.60
G0117
11
46.52
44.19
50.82
G0120 TC C11
79.28
75.32
86.62
G0121
F 11
208.75
198.31
228.06
G0124
11
27.55
26.17
30.10
G0128
11
8.93
8.48
09.75
G0130 26
11
10.54
10.01
11.51
G0168
N 11
80.86
76.82
88.34
G0180
11
50.45
47.93
55.12
G0202
11
131.38
124.81
143.53
G0204
11
157.23
149.37
171.78
G0206
11
124.45
118.23
135.96
G0237
11
9.36
8.89
10.22
G0245
N 11
65.37
62.10
71.42
G0246
F 11
22.90
21.76
25.02
G0248
11
129.68
123.20
141.68
G0268
N 11
48.50
46.08
52.99
G0270
F 11
24.79
23.55
27.08
G0278
11
12.82
12.18
14.01
G0288
11
80.54
76.51
87.99
G0339
11 1917.41
1821.54
2094.77
G0341
F 11
368.96
350.51
403.09
G0364
N 11
11.65
11.07
12.73
G0365 TC C11
141.96
134.86
155.09
G0372
F 11
8.21
7.80
08.97
G0389 26
11
28.26
26.85
30.88
G0397
N 11
65.21
61.95
71.24
G0398 TC
11
51.66
49.08
56.44
G0399 TC
11
36.17
34.36
39.51
G0400 TC
11
31.00
29.45
33.87
G0402
F 11
121.52
115.44
132.76
G0404
11
9.99
9.49
10.91
G0406
11
37.04
35.19
40.47
G0409
11
9.36
8.89
10.22
G0414
11
940.91
893.86
1027.94
G0416 TC
11
382.59
363.46
417.98
G0417 TC
11
747.00
709.65
816.10
G0418 TC
11 1275.82
1212.03
1393.83
G0419 TC
11 1530.94
1454.39
1672.55
G0421
11
25.23
23.97
27.57
G0424
N 11
28.78
27.34
31.44
G0426
11
131.49
124.92
143.66
G0429
F 11
63.54
60.36
69.41
G0437
N 11
27.12
25.76
29.62
G0439
11
102.99
97.84
112.52
G0441
N 11
44.41
42.19
48.52
G9042
11
16.60
15.77
18.14
M0064
N 11
43.98
41.78
48.05
Q0035
11
17.26
16.40
18.86
Q0091
N 11
40.97
38.92
44.76
R0070
11
239.64
227.66
261.81
0075T
11 1104.12
1048.91
1206.25
0171T
11
635.91
604.11
694.73
10021
F 11
66.43
63.11
72.58
10040
N 11
95.29
90.53
104.11
10060
F 11
87.34
82.97
95.42
10080
N 11
155.62
147.84
170.02
10081
F 11
157.25
149.39
171.80
10121
N 11
244.81
232.57
267.46
by the American Medical Association. **
MFI00A11
FSY-2011

----- -- ---- -------10121
10160
10180
11001
11005
11010
11011
11042
11043
11045
11046
11055
11056
11100
11101
11201
11300
11302
11303
11306
11307
11310
11311
11313
11400
11402
11403
11406
11420
11422
11423
11426
11440
11442
11443
11446
11450
11462
11463
11471
11600
11602
11603
11606
11620
11622
11623
11626
11640
11642
11643
11646
11719
11721
11730
11740
11750
11755
11760
11765
11770
11772
11900
11920
11921
11950
11951
11954
11970
11976
11980
11982
11983
12002
12004
12006
***
F
N
F
N
"STATE OK"
NPAR FEE
--------
M E D I C A R E
LC FEE
--------
F E E

----- -- ---- --------
11
172.05
163.45
187.97
10140
11
117.30
111.44
128.16
10160
11
164.05
155.85
179.23
11000
11
20.01
19.01
21.86
11001
11
736.42
699.60
804.54
11006
N 11
440.32
418.30
481.05
11010
F 11
281.84
267.75
307.91
11012
N 11
81.43
77.36
88.96
11042
F 11
115.48
109.71
126.17
11044
N 11
28.87
27.43
31.54
11045
F 11
35.97
34.17
39.30
11047
N 11
45.22
42.96
49.40
11055
F 11
27.94
26.54
30.52
11057
N 11
95.86
91.07
104.73
11100
F 11
23.89
22.70
26.11
11200
N 11
17.69
16.81
19.33
11201
F 11
28.37
26.95
30.99
11301
N 11
103.12
97.96
112.65
11302
F 11
70.80
67.26
77.35
11305
N 11
88.43
84.01
96.61
11306
F 11
62.40
59.28
68.17
11308
N 11
78.42
74.50
85.68
11310
F 11
60.28
57.27
65.86
11312
N 11
143.03
135.88
156.26
11313
F 11
72.05
68.45
78.72
11401
N 11
149.23
141.77
163.04
11402
F 11
133.52
126.84
145.87
11404
N 11
278.18
264.27
303.91
11406
F 11
75.53
71.75
82.51
11421
N 11
158.44
150.52
173.10
11422
F 11
144.92
137.67
158.32
11424
N 11
302.24
287.13
330.20
11426
F 11
93.18
88.52
101.80
11441
N 11
171.32
162.75
187.16
11442
F 11
165.33
157.06
180.62
11444
N 11
354.55
336.82
387.34
11446
F 11
225.01
213.76
245.82
11451
N 11
326.95
310.60
357.19
11462
F 11
296.25
281.44
323.66
11470
N 11
451.46
428.89
493.22
11471
F 11
109.18
103.72
119.28
11601
N 11
227.24
215.88
248.26
11602
F 11
182.24
173.13
199.10
11604
N 11
405.43
385.16
442.93
11606
F 11
111.10
105.55
121.38
11621
N 11
235.83
224.04
257.65
11622
F 11
199.04
189.09
217.45
11624
N 11
374.24
355.53
408.86
11626
F 11
115.90
110.11
126.63
11641
N 11
250.67
238.14
273.86
11642
F 11
217.96
207.06
238.12
11644
N 11
476.95
453.10
521.07
11646
F 11
7.89
7.50
08.63
11720
N 11
39.73
37.74
43.40
11721
F 11
50.54
48.01
55.21
11732
N 11
42.86
40.72
46.83
11740
F 11
162.40
154.28
177.42
11752
N 11
122.29
116.18
133.61
11755
F 11
122.41
116.29
133.73
11762
N 11
125.18
118.92
136.76
11765
F 11
167.11
158.75
182.56
11771
N 11
606.08
575.78
662.15
11772
F 11
29.97
28.47
32.74
11901
N 11
162.56
154.43
177.59
11920
F 11
127.87
121.48
139.70
11922
N 11
66.10
62.80
72.22
11950
F 11
67.64
64.26
73.90
11952
N 11
149.26
141.80
163.07
11954
11
569.99
541.49
622.71
11971
N 11
135.35
128.58
147.87
11976
F 11
76.95
73.10
84.07
11981
N 11
140.28
133.27
153.26
11982
F 11
168.92
160.47
184.54
12001
N 11
105.11
99.85
114.83
12002
F 11
81.17
77.11
88.68
12005
N 11
194.49
184.77
212.49
12006
All Current Procedural Terminology (CPT) codes
N
F
N
F
S C H E D U L E
NPAR FEE
--------
"ALL OF OKLAHOMA"
LC FEE
--------
11
144.86
137.62
158.26
11
88.95
84.50
97.18
11
49.24
46.78
53.80
11
14.34
13.62
15.66
11
673.87
640.18
736.21
F 11
262.68
249.55
286.98
N 11
648.48
616.06
708.47
F 11
44.89
42.65
49.05
N 11
273.06
259.41
298.32
F 11
16.90
16.06
18.47
N 11
82.95
78.80
90.62
F 11
19.70
18.72
21.53
N 11
64.52
61.29
70.48
F 11
47.04
44.69
51.39
N 11
78.56
74.63
85.82
F 11
15.80
15.01
17.26
N 11
86.19
81.88
94.16
F 11
60.28
57.27
65.86
N 11
63.90
60.71
69.82
F 11
52.21
49.60
57.04
N 11
116.30
110.49
127.06
F 11
41.26
39.20
45.08
N 11
115.11
109.35
125.75
F 11
93.27
88.61
101.90
N 11
134.03
127.33
146.43
F 11
104.82
99.58
114.52
N 11
195.09
185.34
213.14
F 11
222.75
211.61
243.35
N 11
142.21
135.10
155.37
F 11
124.43
118.21
135.94
N 11
211.09
200.54
230.62
F 11
252.79
240.15
276.17
N 11
151.94
144.34
165.99
F 11
134.47
127.75
146.91
N 11
257.25
244.39
281.05
F 11
301.01
285.96
328.85
N 11
425.84
404.55
465.23
F 11
216.08
205.28
236.07
N 11
364.68
346.45
398.42
F 11
315.08
299.33
344.23
N 11
207.79
197.40
227.01
F 11
153.22
145.56
167.39
N 11
286.17
271.86
312.64
F 11
295.82
281.03
323.18
N 11
209.39
198.92
228.76
F 11
161.81
153.72
176.78
N 11
309.90
294.41
338.57
F 11
277.55
263.67
303.22
N 11
218.58
207.65
238.80
F 11
174.45
165.73
190.59
N 11
363.96
345.76
397.62
F 11
376.47
357.65
411.30
N 11
28.88
27.44
31.56
F 11
24.93
23.68
27.23
N 11
40.75
38.71
44.52
F 11
29.63
28.15
32.37
N 11
289.08
274.63
315.82
F 11
76.31
72.49
83.36
N 11
249.95
237.45
273.07
F 11
64.08
60.88
70.01
N 11
505.42
480.15
552.17
F 11
511.27
485.71
558.57
N 11
65.91
62.61
72.00
F 11
108.38
102.96
118.40
N 11
56.27
53.46
61.48
F 11
46.25
43.94
50.53
N 11
120.84
114.80
132.02
F 11
109.58
104.10
119.72
N 11
427.77
406.38
467.34
F 11
90.94
86.39
99.35
N 11
125.36
119.09
136.95
F 11
94.30
89.59
103.03
N 11
89.37
84.90
97.64
F 11
66.69
63.36
72.86
N 11
161.07
153.02
175.97
F 11
130.55
124.02
142.62
09/12/2011

----- -- ---- -------10140
F 11
10180
N 11
11000
F 11
11004
11
11008
11
11011
N 11
11012
F 11
11043
N 11
11044
F 11
11046
N 11
11047
F 11
11056
N 11
11057
F 11
11101
N 11
11200
F 11
11300
N 11
11301
F 11
11303
N 11
11305
F 11
11307
N 11
11308
F 11
11311
N 11
11312
F 11
11400
N 11
11401
F 11
11403
N 11
11404
F 11
11420
N 11
11421
F 11
11423
N 11
11424
F 11
11440
N 11
11441
F 11
11443
N 11
11444
F 11
11450
N 11
11451
F 11
11463
N 11
11470
F 11
11600
N 11
11601
F 11
11603
N 11
11604
F 11
11620
N 11
11621
F 11
11623
N 11
11624
F 11
11640
N 11
11641
F 11
11643
N 11
11644
F 11
11719
N 11
11720
F 11
11730
N 11
11732
F 11
11750
N 11
11752
F 11
11760
N 11
11762
F 11
11770
N 11
11771
F 11
11900
N 11
11901
F 11
11921
N 11
11922
F 11
11951
N 11
11952
F 11
11960
11
11971
F 11
11980
N 11
11981
F 11
11983
N 11
12001
F 11
12004
N 11
12005
F 11
12007
N 11
by the American
NPAR FEE
--------
PAGE 002
LC FEE
--------
109.58
104.10
119.72
218.54
207.61
238.75
28.45
27.03
31.08
552.71
525.07
603.83
258.70
245.77
282.64
482.78
458.64
527.44
403.13
382.97
440.42
178.78
169.84
195.32
200.30
190.29
218.83
50.46
47.94
55.13
62.48
59.36
68.26
54.39
51.67
59.42
36.17
34.36
39.51
30.82
29.28
33.67
66.27
62.96
72.40
63.33
60.16
69.18
48.40
45.98
52.88
121.51
115.43
132.74
32.41
30.79
35.41
104.60
99.37
114.28
72.52
68.89
79.22
99.02
94.07
108.18
69.76
66.27
76.21
109.54
104.06
119.67
94.98
90.23
103.76
171.63
163.05
187.51
147.84
140.45
161.52
109.54
104.06
119.67
102.84
97.70
112.36
183.66
174.48
200.65
165.73
157.44
181.06
120.58
114.55
131.73
120.76
114.72
131.93
204.39
194.17
223.30
210.95
200.40
230.46
333.04
316.39
363.85
291.35
276.78
318.30
434.83
413.09
475.05
254.44
241.72
277.98
170.60
162.07
186.38
139.13
132.17
152.00
258.46
245.54
282.37
200.19
190.18
218.71
173.78
165.09
189.85
140.42
133.40
153.41
275.89
262.10
301.42
225.18
213.92
246.01
180.46
171.44
197.16
148.02
140.62
161.71
295.44
280.67
322.77
270.10
256.60
295.09
19.86
18.87
21.70
14.71
13.97
16.07
88.96
84.51
97.19
26.26
24.95
28.69
200.82
190.78
219.40
244.67
232.44
267.31
196.74
186.90
214.94
177.51
168.63
193.92
243.65
231.47
266.19
392.04
372.44
428.31
52.02
49.42
56.83
46.70
44.37
51.03
187.40
178.03
204.73
28.24
26.83
30.85
93.15
88.49
101.76
90.61
86.08
98.99
842.42
800.30
920.35
290.45
275.93
317.32
97.42
92.55
106.43
79.06
75.11
86.38
210.18
199.67
229.62
51.89
49.30
56.70
124.95
118.70
136.51
106.90
101.56
116.79
226.78
215.44
247.76
Medical Association. **
MFI00A11
FSY-2011

----- -- ---- -------12007
12013
12014
12016
12018
12021
12031
12034
12035
12037
12041
12044
12045
12047
12051
12053
12054
12056
12057
13101
13102
13121
13122
13132
13133
13151
13152
13160
14001
14020
14040
14041
14061
14301
15002
15003
15005
15040
15100
15101
15111
15115
15120
15121
15131
15135
15150
15151
15155
15156
15170
15171
15176
15200
15220
15221
15241
15260
15300
15301
15321
15330
15335
15336
15341
15360
15365
15366
15401
15420
15430
15570
15574
15576
15610
15620
***
F
N
F
N
"STATE OK"
NPAR FEE
--------
M E D I C A R E
LC FEE
--------
F E E

----- -- ---- --------
11
156.86
149.02
171.37
12011
11
115.30
109.54
125.97
12013
11
87.30
82.94
95.38
12015
11
209.89
199.40
229.31
12016
11
192.99
183.34
210.84
12020
N 11
148.13
140.72
161.83
12021
F 11
151.70
144.12
165.74
12032
N 11
282.39
268.27
308.51
12034
F 11
220.99
209.94
241.43
12036
N 11
418.97
398.02
457.72
12037
F 11
161.21
153.15
176.12
12042
N 11
318.35
302.43
347.79
12044
F 11
226.96
215.61
247.95
12046
N 11
438.68
416.75
479.26
12047
F 11
171.36
162.79
187.21
12052
N 11
313.12
297.46
342.08
12053
F 11
213.94
203.24
233.73
12055
N 11
477.82
453.93
522.02
12056
F 11
359.45
341.48
392.70
13100
N 11
369.24
350.78
403.40
13101
F 11
71.31
67.74
77.90
13120
N 11
411.75
391.16
449.83
13121
F 11
81.63
77.55
89.18
13131
N 11
541.97
514.87
592.10
13132
F 11
126.57
120.24
138.28
13150
N 11
378.85
359.91
413.90
13151
F 11
404.39
384.17
441.80
13153
11
756.29
718.48
826.25
14000
N 11
746.34
709.02
815.37
14001
F 11
540.61
513.58
590.62
14021
N 11
717.25
681.39
783.60
14040
F 11
751.98
714.38
821.54
14060
N 11
954.70
906.97
1043.02
14061
F 11
864.42
821.20
944.38
14302
N 11
311.43
295.86
340.24
15002
F 11
42.80
40.66
46.76
15004
N 11
112.45
106.83
122.85
15005
F 11
119.54
113.56
130.59
15050
N 11
797.83
757.94
871.63
15100
F 11
104.62
99.39
114.30
15110
N 11
110.26
104.75
120.46
15111
F 11
712.99
677.34
778.94
15116
N 11
883.97
839.77
965.74
15120
F 11
161.33
153.26
176.25
15130
N 11
94.57
89.84
103.32
15131
F 11
719.35
683.38
785.89
15136
N 11
641.89
609.80
701.27
15150
F 11
114.38
108.66
124.96
15152
N 11
610.67
580.14
667.16
15155
F 11
149.09
141.64
162.89
15157
N 11
403.49
383.32
440.82
15170
F 11
83.35
79.18
91.06
15175
N 11
138.43
131.51
151.24
15176
F 11
625.98
594.68
683.88
15201
N 11
714.75
679.01
780.86
15220
F 11
68.67
65.24
75.03
15240
N 11
171.51
162.93
187.37
15241
F 11
818.52
777.59
894.23
15261
N 11
323.11
306.95
352.99
15300
F 11
53.65
50.97
58.62
15320
N 11
88.04
83.64
96.19
15321
F 11
249.27
236.81
272.33
15331
N 11
298.15
283.24
325.73
15335
F 11
76.06
72.26
83.10
15340
N 11
43.47
41.30
47.50
15341
F 11
282.86
268.72
309.03
15361
N 11
319.23
303.27
348.76
15365
F 11
69.92
66.42
76.38
15400
N 11
84.03
79.83
91.80
15401
F 11
361.17
343.11
394.58
15421
N 11
501.05
476.00
547.40
15430
F 11
676.30
642.49
738.86
15572
N 11
845.36
803.09
923.55
15574
F 11
635.99
604.19
694.82
15600
N 11
314.15
298.44
343.21
15610
F 11
301.63
286.55
329.53
15630
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
N
F
N
F
N
F
S C H E D U L E
NPAR FEE
--------
"ALL OF OKLAHOMA"
LC FEE
--------
11
107.14
101.78
117.05
11
70.26
66.75
76.76
11
167.71
159.32
183.22
11
142.17
135.06
155.32
11
248.64
236.21
271.64
11
127.98
121.58
139.82
11
282.95
268.80
309.12
11
191.36
181.79
209.06
11
373.75
355.06
408.32
11
292.99
278.34
320.09
11
269.18
255.72
294.08
11
199.30
189.34
217.74
11
403.96
383.76
441.32
11
289.39
274.92
316.16
11
283.78
269.59
310.03
11
203.51
193.33
222.33
11
399.07
379.12
435.99
11
324.43
308.21
354.44
11
290.44
275.92
317.31
11
269.40
255.93
294.32
11
302.37
287.25
330.34
11
309.07
293.62
337.66
11
334.13
317.42
365.03
11
445.59
423.31
486.81
11
332.12
315.51
362.84
11
301.06
286.01
328.91
11
172.68
164.05
188.66
11
577.31
548.44
630.71
11
623.82
592.63
681.52
11
816.93
776.08
892.49
11
609.54
579.06
665.92
11
729.60
693.12
797.09
11
802.58
762.45
876.82
11
221.09
210.04
241.55
F 11
213.16
202.50
232.88
N 11
367.74
349.35
401.75
F 11
85.37
81.10
93.27
N 11
517.48
491.61
565.35
F 11
671.22
637.66
733.31
N 11
788.04
748.64
860.94
F 11
99.24
94.28
108.42
N 11
158.47
150.55
173.13
F 11
741.92
704.82
810.54
N 11
624.07
592.87
681.80
F 11
86.38
82.06
94.37
N 11
84.11
79.90
91.89
F 11
589.29
559.83
643.80
N 11
145.25
137.99
158.69
F 11
567.20
538.84
619.67
N 11
157.34
149.47
171.89
F 11
348.05
330.65
380.25
N 11
485.02
460.77
529.89
F 11
129.30
122.84
141.27
N 11
137.08
130.23
149.76
F 11
583.41
554.24
637.38
N 11
865.52
822.24
945.58
F 11
107.88
102.49
117.86
N 11
200.42
190.40
218.96
F 11
273.66
259.98
298.98
N 11
348.99
331.54
381.27
F 11
81.43
77.36
88.96
N 11
59.64
56.66
65.16
F 11
249.33
236.86
272.39
N 11
291.25
276.69
318.19
F 11
24.88
23.64
27.19
N 11
61.59
58.51
67.29
F 11
275.13
261.37
300.58
N 11
375.16
356.40
409.86
F 11
53.80
51.11
58.78
N 11
107.57
102.19
117.52
F 11
480.89
456.85
525.38
N 11
807.38
767.01
882.06
F 11
722.21
686.10
789.02
N 11
298.69
283.76
326.32
F 11
223.44
212.27
244.11
N 11
428.40
406.98
468.03
09/12/2011

----- -- ---- --------
NPAR FEE
--------
PAGE 003
LC FEE
--------
12011
F 11
62.10
59.00
67.85
12014
N 11
136.75
129.91
149.40
12015
F 11
107.24
101.88
117.16
12017
11
163.02
154.87
178.10
12020
F 11
173.68
165.00
189.75
12031
N 11
224.77
213.53
245.56
12032
F 11
183.42
174.25
200.39
12035
N 11
341.94
324.84
373.57
12036
F 11
252.81
240.17
276.20
12041
N 11
234.91
223.16
256.63
12042
F 11
187.61
178.23
204.96
12045
N 11
341.29
324.23
372.86
12046
F 11
268.53
255.10
293.37
12051
N 11
248.53
236.10
271.52
12052
F 11
204.73
194.49
223.66
12054
N 11
332.05
315.45
362.77
12055
F 11
256.39
243.57
280.11
12057
N 11
544.97
517.72
595.38
13100
F 11
220.84
209.80
241.27
13102
N 11
100.29
95.28
109.57
13120
F 11
231.50
219.93
252.92
13122
N 11
110.92
105.37
121.18
13131
F 11
261.06
248.01
285.21
13133
N 11
157.44
149.57
172.01
13150
F 11
259.05
246.10
283.02
13152
N 11
524.07
497.87
572.55
13153
F 11
136.14
129.33
148.73
14000
F 11
474.63
450.90
518.54
14020
N 11
648.96
616.51
708.99
14021
F 11
691.26
656.70
755.21
14041
N 11
889.62
845.14
971.91
14060
F 11
645.19
612.93
704.87
14301
N 11 1028.83
977.39
1124.00
14350
11
681.01
646.96
744.00
15003
N 11
67.68
64.30
73.95
15004
F 11
259.08
246.13
283.05
15040
N 11
233.55
221.87
255.15
15050
F 11
418.90
397.96
457.65
15101
N 11
172.02
163.42
187.93
15110
F 11
688.82
654.38
752.54
15115
N 11
803.70
763.52
878.05
15116
F 11
144.62
137.39
158.00
15121
N 11
246.37
234.05
269.16
15130
F 11
526.75
500.41
575.47
15135
N 11
808.49
768.07
883.28
15136
F 11
78.44
74.52
85.70
15151
N 11
123.20
117.04
134.60
15152
F 11
135.80
129.01
148.36
15156
N 11
157.91
150.01
172.51
15157
F 11
146.00
138.70
159.51
15171
N 11
88.08
83.68
96.23
15175
F 11
433.05
411.40
473.11
15200
N 11
759.21
721.25
829.44
15201
F 11
75.97
72.17
83.00
15221
N 11
126.94
120.59
138.68
15240
F 11
755.60
717.82
825.49
15260
N 11
940.09
893.09
1027.05
15261
F 11
136.49
129.67
149.12
15301
N 11
58.69
55.76
64.12
15320
F 11
295.45
280.68
322.78
15330
N 11
299.98
284.98
327.73
15331
F 11
55.23
52.47
60.34
15336
N 11
84.25
80.04
92.05
15340
F 11
249.05
236.60
272.09
15360
N 11
331.37
314.80
362.02
15361
F 11
56.23
53.42
61.43
15366
N 11
76.85
73.01
83.96
15400
F 11
332.02
315.42
362.73
15420
N 11
408.41
387.99
446.19
15421
F 11
81.11
77.05
88.61
15570
N 11
826.22
784.91
902.65
15572
F 11
690.53
656.00
754.40
15576
N 11
751.26
713.70
820.76
15600
F 11
190.66
181.13
208.30
15620
N 11
404.94
384.69
442.39
15630
F 11
326.99
310.64
357.24
MFI00A11
FSY-2011

----- -- ---- -------15650
15731
15734
15736
15740
15756
15760
15775
15776
15781
15782
15786
15787
15789
15792
15819
15821
15822
15830
15834
15837
15839
15841
15851
15860
15931
15935
15940
15945
15951
15956
16000
16025
16030
17000
17003
17106
17107
17110
17111
17260
17261
17263
17264
17270
17271
17273
17274
17280
17281
17283
17284
17311
17312
17314
17315
17360
19000
19020
19030
19101
19102
19105
19110
19120
19125
19271
19290
19295
19297
19300
19302
19305
19316
19325
19340
***
N
F
N
F
N
"STATE OK"
NPAR FEE
--------
M E D I C A R E
LC FEE
--------
F E E
S C H E D U L E

----- -- ---- --------
11
473.71
450.02
517.52
15650
11
966.52
918.19
1055.92
15732
11 1422.75
1351.61
1554.35
15734
11 1090.52
1035.99
1191.39
15738
11
958.13
910.22
1046.75
15740
11 2235.36
2123.59
2442.13
15757
N 11
794.34
754.62
867.81
15760
N 11
271.84
258.25
296.99
15775
F 11
295.77
280.98
323.13
15780
N 11
504.42
479.20
551.08
15781
F 11
372.46
353.84
406.92
15783
N 11
223.71
212.52
244.40
15786
F 11
16.85
16.01
18.41
15788
N 11
520.91
494.86
569.09
15789
F 11
244.52
232.29
267.13
15793
11
665.79
632.50
727.38
15820
N 11
553.74
526.05
604.96
15821
F 11
357.40
339.53
390.46
15823
11 1092.01
1037.41
1193.02
15832
11
816.87
776.03
892.43
15835
N 11
767.47
729.10
838.47
15837
N 11
801.07
761.02
875.17
15839
11 1600.28
1520.27
1748.31
15842
N 11
87.70
83.32
95.82
15851
11
102.95
97.80
112.47
15920
11
625.24
593.98
683.08
15933
11 1019.36
968.39
1113.65
15936
11
644.46
612.24
704.08
15941
11
922.40
876.28
1007.72
15946
11
797.96
758.06
871.77
15952
11 1077.73
1023.84
1177.42
15958
F 11
43.68
41.50
47.73
16020
N 11
137.01
130.16
149.68
16025
F 11
123.20
117.04
134.60
16035
N 11
74.62
70.89
81.52
17000
F 11
4.18
3.97
04.57
17004
N 11
318.87
302.93
348.37
17106
F 11
336.24
319.43
367.34
17108
N 11
101.51
96.43
110.89
17110
F 11
80.10
76.10
87.52
17250
N 11
88.27
83.86
96.44
17260
F 11
87.13
82.77
95.19
17262
N 11
177.74
168.85
194.18
17263
F 11
131.23
124.67
143.37
17266
N 11
138.67
131.74
151.50
17270
F 11
106.07
100.77
115.89
17272
N 11
193.78
184.09
211.70
17273
F 11
168.68
160.25
184.29
17276
N 11
129.96
123.46
141.98
17280
F 11
119.29
113.33
130.33
17282
N 11
230.14
218.63
251.42
17283
F 11
204.17
193.96
223.05
17286
N 11
627.02
595.67
685.02
17311
F 11
194.82
185.08
212.84
17313
N 11
346.61
329.28
378.67
17314
F 11
51.28
48.72
56.03
17340
N 11
123.28
117.12
134.69
17360
F 11
42.07
39.97
45.97
19001
N 11
413.11
392.45
451.32
19020
F 11
75.02
71.27
81.96
19100
N 11
302.34
287.22
330.30
19101
F 11
98.80
93.86
107.94
19103
N 11 1892.38
1797.76
2067.42
19105
F 11
306.86
291.52
335.25
19112
N 11
438.14
416.23
478.66
19120
F 11
414.32
393.60
452.64
19126
11 1519.15
1443.19
1659.67
19272
F 11
62.58
59.45
68.37
19291
11
83.69
79.51
91.44
19296
11
88.15
83.74
96.30
19298
N 11
464.13
440.92
507.06
19300
11
812.88
772.24
888.08
19303
11 1030.71
979.17
1126.05
19306
11
724.68
688.45
791.72
19318
11
606.42
576.10
662.52
19328
11
819.60
778.62
895.41
19342
F
N
F
N
F
11
364.42
11 1404.08
11 1265.89
11 1333.14
11
823.01
11 2217.66
F 11
672.45
F 11
202.87
N 11
765.86
F 11
405.21
N 11
452.39
F 11
130.79
N 11
412.22
F 11
399.97
N 11
450.31
N 11
518.78
F 11
501.78
N 11
567.42
11
863.69
11
864.44
F 11
650.93
F 11
680.44
11 2403.83
F 11
43.61
11
558.13
11
774.22
11
831.15
11
835.35
11 1534.44
11
778.68
11 1099.62
N 11
76.30
F 11
108.35
11
192.46
F 11
52.26
N 11
161.61
F 11
260.92
N 11
589.86
F 11
64.35
N 11
69.92
F 11
64.33
N 11
161.41
F 11
122.93
N 11
216.20
F 11
94.57
N 11
173.91
F 11
138.03
N 11
264.99
F 11
86.18
N 11
191.24
F 11
172.19
N 11
338.20
F 11
366.55
N 11
571.73
F 11
180.63
N 11
46.71
F 11
95.88
N 11
25.17
F 11
272.95
N 11
132.54
F 11
201.55
N 11
511.75
F 11
184.66
N 11
402.49
F 11
372.63
11
150.45
11 1680.51
N 11
63.80
N 11 3663.13
N 11 1131.42
F 11
365.86
11
912.59
11 1085.64
11 1051.96
11
462.26
11
868.69
and descriptors
NPAR FEE
--------
"ALL OF OKLAHOMA"
LC FEE
--------
346.20
398.13
1333.88
1533.96
1202.60
1382.99
1266.48
1456.45
781.86
899.14
2106.78
2422.80
638.83
734.65
192.73
221.64
727.57
836.71
384.95
442.69
429.77
494.24
124.25
142.89
391.61
450.35
379.97
436.97
427.79
491.96
492.84
566.77
476.69
548.19
539.05
619.91
820.51
943.59
821.22
944.40
618.38
711.14
646.42
743.38
2283.64
2626.19
41.43
47.64
530.22
609.75
735.51
845.84
789.59
908.03
793.58
912.62
1457.72
1676.38
739.75
850.71
1044.64
1201.34
72.49
83.36
102.93
118.37
182.84
210.27
49.65
57.10
153.53
176.56
247.87
285.05
560.37
644.43
61.13
70.30
66.42
76.38
61.11
70.28
153.34
176.34
116.78
134.30
205.39
236.20
89.84
103.32
165.21
189.99
131.13
150.80
251.74
289.50
81.87
94.15
181.68
208.93
163.58
188.12
321.29
369.48
348.22
400.45
543.14
624.61
171.60
197.34
44.37
51.03
91.09
104.75
23.91
27.50
259.30
298.20
125.91
144.80
191.47
220.19
486.16
559.08
175.43
201.74
382.37
439.73
354.00
407.10
142.93
164.37
1596.48
1835.95
60.61
69.70
3479.97
4001.97
1074.85
1236.08
347.57
399.71
866.96
997.00
1031.36
1186.06
999.36
1149.26
439.15
505.02
825.26
949.05
are copyrighted 2010
09/12/2011

----- -- ---- --------
NPAR FEE
--------
PAGE 004
LC FEE
--------
15731
N 11 1066.99
1013.64
1165.69
15732
F 11 1257.94
1195.04
1374.30
15736
N 11 1252.10
1189.50
1367.93
15738
F 11 1182.59
1123.46
1291.98
15750
11
861.36
818.29
941.03
15758
11 2207.59
2097.21
2411.79
15770
11
626.63
595.30
684.60
15776
N 11
397.81
377.92
434.61
15780
F 11
595.15
565.39
650.20
15782
N 11
512.94
487.29
560.38
15783
F 11
352.55
334.92
385.16
15787
N 11
44.25
42.04
48.35
15788
F 11
229.23
217.77
250.44
15792
N 11
395.71
375.92
432.31
15793
F 11
341.64
324.56
373.24
15820
F 11
472.17
448.56
515.84
15822
N 11
402.75
382.61
440.00
15823
F 11
516.40
490.58
564.17
15833
11
811.46
770.89
886.52
15836
11
675.31
641.54
737.77
15838
11
544.47
517.25
594.84
15840
11
964.02
915.82
1053.19
15845
11
924.71
878.47
1010.24
15852
11
44.38
42.16
48.48
15922
11
719.59
683.61
786.15
15934
11
861.09
818.04
940.75
15937
11
972.51
923.88
1062.46
15944
11
830.84
789.30
907.70
15950
11
529.87
503.38
578.89
15953
11
856.42
813.60
935.64
16000
N 11
63.53
60.35
69.40
16020
F 11
53.31
50.64
58.24
16030
N 11
164.46
156.24
179.68
16036
11
77.59
73.71
84.77
17003
N 11
6.70
6.37
07.33
17004
F 11
126.65
120.32
138.37
17107
N 11
413.41
392.74
451.65
17108
F 11
493.80
469.11
539.48
17111
N 11
121.05
115.00
132.25
17250
F 11
33.70
32.02
36.82
17261
N 11
132.80
126.16
145.08
17262
F 11
111.02
105.47
121.29
17264
N 11
190.45
180.93
208.07
17266
F 11
152.89
145.25
167.04
17271
N 11
152.37
144.75
166.46
17272
F 11
122.25
116.14
133.56
17274
N 11
228.84
217.40
250.01
17276
F 11
202.00
191.90
220.69
17281
N 11
164.96
156.71
180.22
17282
F 11
138.01
131.11
150.78
17284
N 11
267.16
253.80
291.87
17286
F 11
273.32
259.65
298.60
17312
N 11
373.72
355.03
408.28
17313
F 11
328.90
312.46
359.33
17315
N 11
75.53
71.75
82.51
17340
F 11
44.82
42.58
48.97
19000
N 11
101.91
96.81
111.33
19001
F 11
20.76
19.72
22.68
19030
N 11
152.18
144.57
166.26
19100
F 11
64.83
61.59
70.83
19102
N 11
200.21
190.20
218.73
19103
F 11
183.88
174.69
200.89
19110
N 11
429.07
407.62
468.76
19112
F 11
277.77
263.88
303.46
19125
N 11
486.45
462.13
531.45
19260
11 1121.47
1065.40
1225.21
19290
N 11
149.82
142.33
163.68
19291
F 11
30.73
29.19
33.57
19296
F 11
195.10
185.35
213.15
19298
F 11
309.69
294.21
338.34
19301
11
589.42
559.95
643.94
19304
11
518.58
492.65
566.55
19307
11 1086.20
1031.89
1186.67
19324
11
448.26
425.85
489.73
19330
11
591.00
561.45
645.67
19350
N 11
776.88
738.04
848.75
MFI00A11
FSY-2011

----- -- ---- -------19350
19357
19366
19369
19380
20005
20101
20102
20150
20205
20206
20225
20245
20500
20501
20525
20526
20551
20552
20555
20605
20610
20615
20650
20662
20665
20670
20690
20694
20697
20808
20824
20900
20910
20922
20926
20938
20955
20962
20972
20974
20979
20985
21011
21013
21016
21026
21029
21031
21032
21040
21045
21048
21060
21073
21077
21079
21081
21082
21084
21085
21087
21100
21116
21120
21122
21125
21137
21141
21145
21150
21155
21172
21180
21183
21193
***
"STATE OK"
NPAR FEE
--------
M E D I C A R E
LC FEE
--------
F E E
S C H E D U L E

----- -- ---- --------
F 11
634.20
602.49
692.86
19355
11 1387.00
1317.65
1515.30
19361
11 1295.69
1230.91
1415.55
19367
11 1946.06
1848.76
2126.07
19370
11
725.33
689.06
792.42
19396
N 11
277.76
263.87
303.45
20005
N 11
368.31
349.89
402.37
20101
F 11
234.41
222.69
256.09
20103
11
922.28
876.17
1007.60
20200
N 11
249.46
236.99
272.54
20205
F 11
57.65
54.77
62.99
20220
N 11
567.05
538.70
619.51
20225
11
588.64
559.21
643.09
20250
N 11
102.60
97.47
112.09
20500
F 11
37.50
35.63
40.97
20520
N 11
432.82
411.18
472.86
20525
F 11
53.71
51.02
58.67
20550
N 11
54.08
51.38
59.09
20551
F 11
35.04
33.29
38.28
20553
11
312.60
296.97
341.52
20600
N 11
54.53
51.80
59.57
20605
F 11
46.90
44.56
51.24
20612
N 11
201.68
191.60
220.34
20615
F 11
143.29
136.13
156.55
20660
11
406.74
386.40
444.36
20663
N 11
103.20
98.04
112.75
20665
F 11
137.89
131.00
150.65
20680
11
536.51
509.68
586.13
20692
N 11
390.46
370.94
426.58
20694
11 1552.04
1474.44
1695.61
20802
11 3908.21
3712.80
4269.72
20816
11 2032.73
1931.09
2220.75
20827
N 11
381.15
362.09
416.40
20900
11
397.15
377.29
433.88
20912
N 11
555.66
527.88
607.06
20922
11
406.07
385.77
443.64
20931
11
174.13
165.42
190.23
20950
11 2416.33
2295.51
2639.84
20956
11 2463.09
2339.94
2690.93
20969
11 2209.39
2098.92
2413.76
20973
F 11
44.90
42.66
49.06
20975
F 11
32.02
30.42
34.98
20982
11
139.89
132.90
152.84
21010
F 11
235.63
223.85
257.43
21012
F 11
380.17
361.16
415.33
21014
11
994.59
944.86
1086.59
21025
N 11
561.88
533.79
613.86
21026
F 11
602.36
572.24
658.08
21030
N 11
354.86
337.12
387.69
21031
F 11
266.99
253.64
291.69
21034
N 11
474.32
450.60
518.19
21040
11 1164.75
1106.51
1272.49
21046
11 1050.28
997.77
1147.44
21049
11
764.90
726.66
835.66
21070
F 11
235.71
223.92
257.51
21076
N 11 2271.75
2158.16
2481.88
21077
F 11 1311.00
1245.45
1432.27
21080
N 11 1597.32
1517.45
1745.07
21081
F 11 1248.63
1186.20
1364.13
21083
N 11 1639.67
1557.69
1791.34
21084
F 11
582.14
553.03
635.98
21086
N 11 1665.37
1582.10
1819.42
21087
F 11
346.95
329.60
379.04
21110
N 11
136.06
129.26
148.65
21116
F 11
477.57
453.69
521.74
21121
11
660.08
627.08
721.14
21123
F 11
739.51
702.53
807.91
21127
11
672.89
639.25
735.14
21138
11 1288.44
1224.02
1407.62
21142
11 1427.36
1355.99
1559.39
21146
11 1566.50
1488.18
1711.41
21151
11 2072.54
1968.91
2264.25
21159
11 1694.21
1609.50
1850.93
21175
11 1575.93
1497.13
1721.70
21181
11 2122.61
2016.48
2318.95
21184
11 1228.75
1167.31
1342.41
21194
N 11
649.08
11 1588.96
11 1704.73
11
643.62
N 11
223.20
F 11
217.29
F 11
187.52
N 11
524.32
N 11
181.22
F 11
141.43
N 11
152.74
F 11
107.83
11
351.55
F 11
84.02
N 11
179.43
F 11
231.25
N 11
53.13
F 11
40.22
N 11
56.05
N 11
50.16
F 11
38.79
N 11
54.27
F 11
148.45
11
226.81
11
423.53
F 11
87.77
N 11
561.47
11 1009.70
F 11
312.67
11 2211.78
11 2030.37
11 1843.70
F 11
216.43
11
458.63
F 11
461.49
11
105.45
N 11
226.01
11 2485.60
11 2673.25
11 2576.98
11
165.10
N 11 3323.52
11
683.38
11
325.72
11
502.71
N 11
825.90
F 11
461.41
N 11
470.77
F 11
269.50
N 11 1251.49
F 11
384.55
11 1026.98
11 1181.80
11
589.45
N 11
911.68
F 11 1979.16
N 11 1740.84
F 11 1339.05
N 11 1399.66
F 11 1348.02
N 11 1668.52
F 11 1443.33
N 11
716.28
F 11
39.68
N 11
720.19
11
825.89
N 11 3434.98
11
837.51
11 1299.29
11 1606.78
11 1857.40
11 2652.92
11 2204.43
11
673.63
11 2336.29
11 1325.20
and descriptors
NPAR FEE
--------
"ALL OF OKLAHOMA"
LC FEE
--------
616.63
709.12
1509.51
1735.94
1619.49
1862.41
611.44
703.16
212.04
243.85
206.43
237.39
178.14
204.86
498.10
572.82
172.16
197.98
134.36
154.51
145.10
166.87
102.44
117.81
333.97
384.07
79.82
91.79
170.46
196.03
219.69
252.64
50.47
58.04
38.21
43.94
53.25
61.24
47.65
54.80
36.85
42.38
51.56
59.29
141.03
162.18
215.47
247.79
402.35
462.70
83.38
95.89
533.40
613.41
959.22
1103.10
297.04
341.60
2101.19
2416.37
1928.85
2218.18
1751.52
2014.25
205.61
236.45
435.70
501.06
438.42
504.18
100.18
115.21
214.71
246.92
2361.32
2715.52
2539.59
2920.53
2448.13
2815.35
156.85
180.38
3157.34
3630.94
649.21
746.59
309.43
355.84
477.57
549.21
784.61
902.30
438.34
504.09
447.23
514.31
256.03
294.43
1188.92
1367.26
365.32
420.12
975.63
1121.97
1122.71
1291.12
559.98
643.98
866.10
996.02
1880.20
2162.23
1653.80
1901.87
1272.10
1462.92
1329.68
1529.13
1280.62
1472.71
1585.09
1822.85
1371.16
1576.83
680.47
782.54
37.70
43.36
684.18
786.81
784.60
902.29
3263.23
3752.71
795.63
914.97
1234.33
1419.48
1526.44
1755.41
1764.53
2029.21
2520.27
2898.31
2094.21
2408.34
639.95
735.94
2219.48
2552.40
1258.94
1447.78
09/12/2011

----- -- ---- --------
NPAR FEE
--------
PAGE 005
LC FEE
--------
19355
F 11
526.56
500.23
575.26
19364
11 2628.82
2497.38
2871.99
19368
11 2107.96
2002.56
2302.94
19371
11
737.79
700.90
806.04
19396
F 11
127.77
121.38
139.59
20100
11
558.93
530.98
610.63
20102
N 11
435.04
413.29
475.28
20103
F 11
327.15
310.79
357.41
20200
F 11
87.37
83.00
95.45
20206
N 11
230.56
219.03
251.88
20220
F 11
71.48
67.91
78.10
20240
11
210.23
199.72
229.68
20251
11
384.44
365.22
420.00
20501
N 11
115.29
109.53
125.96
20520
F 11
133.76
127.07
146.13
20526
N 11
69.46
65.99
75.89
20550
F 11
38.96
37.01
42.56
20552
N 11
49.53
47.05
54.11
20553
F 11
39.36
37.39
43.00
20600
F 11
36.93
35.08
40.34
20610
N 11
72.10
68.50
78.78
20612
F 11
39.47
37.50
43.13
20650
N 11
182.66
173.53
199.56
20661
11
447.20
424.84
488.57
20664
11
742.84
705.70
811.56
20670
N 11
354.90
337.16
387.73
20680
F 11
394.85
375.11
431.38
20693
11
423.91
402.71
463.12
20696
11 1023.23
972.07
1117.88
20805
11 2677.87
2543.98
2925.58
20822
11 1775.56
1686.78
1939.80
20838
11 2269.03
2155.58
2478.92
20902
11
306.16
290.85
334.48
20920
11
378.69
359.76
413.72
20924
11
470.07
446.57
513.56
20937
11
159.43
151.46
174.18
20950
F 11
84.59
80.36
92.41
20957
11 2421.52
2300.44
2645.51
20970
11 2655.05
2522.30
2900.65
20974
N 11
64.12
60.91
70.05
20979
N 11
48.72
46.28
53.22
20982
F 11
369.18
350.72
403.33
21011
N 11
308.07
292.67
336.57
21013
N 11
476.86
453.02
520.97
21015
11
616.54
585.71
673.57
21025
F 11
703.06
667.91
768.10
21029
N 11
714.18
678.47
780.24
21030
F 11
384.78
365.54
420.37
21032
N 11
360.85
342.81
394.23
21034
F 11 1110.39
1054.87
1213.10
21044
11
835.16
793.40
912.41
21047
11 1231.98
1170.38
1345.94
21050
11
822.08
780.98
898.13
21073
N 11
356.97
339.12
389.99
21076
F 11
780.97
741.92
853.21
21079
N 11 1541.87
1464.78
1684.50
21080
F 11 1467.13
1393.77
1602.84
21082
N 11 1497.76
1422.87
1636.30
21083
F 11 1132.57
1075.94
1237.33
21085
N 11
722.61
686.48
789.45
21086
F 11 1448.05
1375.65
1582.00
21100
N 11
604.59
574.36
660.51
21110
F 11
606.36
576.04
662.45
21120
N 11
590.95
561.40
645.61
21121
F 11
606.49
576.17
662.60
21125
N 11 2806.92
2666.57
3066.56
21127
F 11
831.51
789.93
908.42
21139
11
939.85
892.86
1026.79
21143
11 1373.79
1305.10
1500.87
21147
11 1564.89
1486.65
1709.65
21154
11 2012.81
1912.17
2199.00
21160
11 2576.64
2447.81
2814.98
21179
11 1433.14
1361.48
1565.70
21182
11 1886.97
1792.62
2061.51
21188
11 1525.99
1449.69
1667.14
21195
11 1271.88
1208.29
1389.53
MFI00A11
FSY-2011

----- -- ---- -------21196
21206
21209
21210
21230
21240
21244
21246
21248
21255
21261
21268
21275
21295
21310
21320
21330
21337
21339
21344
21346
21355
21356
21366
21387
21400
21401
21408
21422
21432
21436
21445
21450
21452
21453
21461
21465
21480
21490
21497
21502
21550
21555
21557
21610
21620
21632
21705
21740
21800
21820
21920
21925
21931
21935
22015
22102
22112
22206
22210
22216
22224
22305
22315
22319
22327
22520
22521
22524
22533
22551
22556
22590
22610
22630
22802
***
"STATE OK"
NPAR FEE
--------
M E D I C A R E
LC FEE
--------
F E E
S C H E D U L E

----- -- ---- --------
11 1391.59
1322.01
1520.31
21198
11 1139.35
1082.38
1244.74
21208
N 11
776.71
737.87
848.55
21209
F 11
793.81
754.12
867.24
21215
11
729.92
693.42
797.43
21235
11 1039.44
987.47
1135.59
21242
11
998.73
948.79
1091.11
21245
11
793.76
754.07
867.18
21247
F 11
834.12
792.41
911.27
21249
11 1304.09
1238.89
1424.72
21256
11 2073.30
1969.64
2265.09
21263
11 1723.06
1636.91
1882.45
21270
11
785.23
745.97
857.87
21280
11
164.64
156.41
179.87
21296
F 11
26.71
25.37
29.18
21315
N 11
236.65
224.82
258.54
21320
11
535.26
508.50
584.78
21335
N 11
372.07
353.47
406.49
21337
11
752.16
714.55
821.73
21340
11 1535.47
1458.70
1677.51
21345
11
878.20
834.29
959.43
21347
N 11
416.25
395.44
454.76
21355
F 11
353.84
336.15
386.57
21360
11 1190.28
1130.77
1300.39
21385
11
703.06
667.91
768.10
21390
N 11
170.51
161.98
186.28
21400
F 11
280.35
266.33
306.28
21406
11
847.58
805.20
925.98
21421
11
625.68
594.40
683.56
21423
11
657.40
624.53
718.21
21433
11 1928.43
1832.01
2106.81
21440
N 11
703.06
667.91
768.10
21445
F 11
441.66
419.58
482.52
21451
N 11
537.53
510.65
587.25
21452
F 11
712.85
677.21
778.79
21454
F 11
871.70
828.12
952.34
21462
11
890.96
846.41
973.37
21470
F 11
30.56
29.03
33.38
21485
11
873.79
830.10
954.62
21495
F 11
535.02
508.27
584.51
21501
11
477.48
453.61
521.65
21510
F 11
148.77
141.33
162.53
21552
N 11
379.73
360.74
414.85
21555
11
838.46
796.54
916.02
21558
11 1062.78
1009.64
1161.09
21615
11
490.58
466.05
535.96
21627
11 1179.70
1120.72
1288.83
21685
11
568.98
540.53
621.61
21720
11
983.48
934.31
1074.46
21750
F 11
96.69
91.86
105.64
21805
N 11
125.21
118.95
136.79
21820
N 11
238.81
226.87
260.90
21920
F 11
319.62
303.64
349.19
21930
11
445.03
422.78
486.20
21932
11
965.09
916.84
1054.37
21936
11
852.44
809.82
931.29
22100
11
760.48
722.46
830.83
22103
11
966.09
917.79
1055.46
22114
11 2204.93
2094.68
2408.88
22207
11 1635.11
1553.35
1786.35
22212
11
345.76
328.47
377.74
22220
11 1464.97
1391.72
1600.48
22226
F 11
158.25
150.34
172.89
22310
N 11
803.53
763.35
877.85
22315
11 1659.18
1576.22
1812.65
22325
11 1358.86
1290.92
1484.56
22328
N 11 2080.42
1976.40
2272.86
22520
F 11
471.57
447.99
515.19
22522
11
529.99
503.49
579.01
22525
11 1558.12
1480.21
1702.24
22534
11 1606.88
1526.54
1755.52
22552
11 1547.85
1470.46
1691.03
22558
11 1444.94
1372.69
1578.59
22595
11 1155.55
1097.77
1262.44
22612
11 1423.88
1352.69
1555.59
22632
11 1972.43
1873.81
2154.88
22804
11 1096.86
11 1673.64
11
616.71
11 3482.54
11
683.37
11
953.07
N 11 1061.17
11 1528.76
N 11 1391.98
11 1120.84
11 1805.81
N 11
887.88
11
526.14
11
376.94
N 11
250.52
F 11
129.24
11
691.45
F 11
274.75
11
736.89
N 11
737.97
11 1040.73
F 11
312.31
11
501.26
11
659.74
11
746.22
F 11
139.64
11
519.12
N 11
693.17
11
770.19
11 1588.26
N 11
511.37
F 11
578.33
N 11
699.41
F 11
315.48
11
524.18
N 11 1993.86
11 1137.34
N 11
628.26
11
659.13
N 11
413.11
11
437.96
11
426.38
F 11
286.82
11 1304.34
11
620.27
11
513.68
11
954.66
11
411.18
11
664.23
11
243.52
F 11
127.41
F 11
151.57
N 11
428.26
11
634.61
11 1357.02
11
796.94
11
135.36
11
922.84
11 2222.61
11 1360.65
11 1485.47
11
346.10
N 11
276.25
F 11
709.98
11 1314.44
11
266.35
F 11
499.00
11
220.14
11
247.23
11
343.70
11
376.07
11 1436.22
11 1374.52
11 1481.66
11
301.95
11 2275.83
and descriptors
N
F
N
N
NPAR FEE
--------
"ALL OF OKLAHOMA"
LC FEE
--------
1042.02
1198.32
1589.96
1828.45
585.87
673.75
3308.41
3804.67
649.20
746.58
905.42
1041.23
1008.11
1159.33
1452.32
1670.17
1322.38
1520.74
1064.80
1224.52
1715.52
1972.85
843.49
970.01
499.83
574.80
358.09
411.80
237.99
273.69
122.78
141.20
656.88
755.41
261.01
300.16
700.05
805.06
701.07
806.23
988.69
1136.99
296.69
341.19
476.20
547.63
626.75
720.76
708.91
815.25
132.66
152.56
493.16
567.13
658.51
757.29
731.68
841.43
1508.85
1735.18
485.80
558.67
549.41
631.82
664.44
764.11
299.71
344.67
497.97
572.67
1894.17
2178.30
1080.47
1242.54
596.85
686.38
626.17
720.10
392.45
451.32
416.06
478.47
405.06
465.82
272.48
313.35
1239.12
1424.99
589.26
677.65
488.00
561.20
906.93
1042.97
390.62
449.21
631.02
725.67
231.34
266.04
121.04
139.20
143.99
165.59
406.85
467.88
602.88
693.31
1289.17
1482.55
757.09
870.65
128.59
147.88
876.70
1008.21
2111.48
2428.20
1292.62
1486.51
1411.20
1622.88
328.80
378.12
262.44
301.81
674.48
775.65
1248.72
1436.03
253.03
290.98
474.05
545.16
209.13
240.50
234.87
270.10
326.52
375.50
357.27
410.86
1364.41
1569.07
1305.79
1501.66
1407.58
1618.72
286.85
329.88
2162.04
2486.35
09/12/2011

----- -- ---- --------
NPAR FEE
--------
PAGE 006
LC FEE
--------
21199
11
971.77
923.18
1061.66
21208
F 11
787.34
747.97
860.17
21210
N 11 2007.05
1906.70
2192.71
21215
F 11
840.01
798.01
917.71
21235
F 11
540.06
513.06
590.02
21243
11 1569.42
1490.95
1714.59
21245
F 11
857.70
814.82
937.04
21248
N 11 1010.49
959.97
1103.97
21249
F 11 1184.11
1124.90
1293.64
21260
11 1262.64
1199.51
1379.44
21267
11 1503.08
1427.93
1642.12
21270
F 11
687.25
652.89
750.82
21282
11
346.48
329.16
378.53
21310
N 11
103.56
98.38
113.14
21315
F 11
141.86
134.77
154.99
21325
11
441.39
419.32
482.22
21336
11
609.51
579.03
665.88
21338
11
697.18
662.32
761.67
21343
11 1079.25
1025.29
1179.08
21345
F 11
603.16
573.00
658.95
21348
11 1100.11
1045.10
1201.87
21356
N 11
461.55
438.47
504.24
21365
11 1053.78
1001.09
1151.25
21386
11
625.02
593.77
682.84
21395
11
922.79
876.65
1008.15
21401
N 11
439.72
417.73
480.39
21407
11
609.49
579.02
665.87
21421
F 11
591.44
561.87
646.15
21431
11
693.04
658.39
757.15
21435
11 1236.77
1174.93
1351.17
21440
F 11
422.23
401.12
461.29
21450
N 11
536.78
509.94
586.43
21451
F 11
587.28
557.92
641.61
21453
N 11
815.21
774.45
890.62
21461
N 11 1876.43
1782.61
2050.00
21462
F 11
959.21
911.25
1047.94
21480
N 11
85.05
80.80
92.92
21485
F 11
531.25
504.69
580.39
21497
N 11
626.99
595.64
684.99
21501
F 11
298.78
283.84
326.42
21550
N 11
238.84
226.90
260.94
21554
11
701.17
666.11
766.03
21556
11
482.70
458.57
527.36
21600
11
524.04
497.84
572.52
21616
11
757.48
719.61
827.55
21630
11 1191.96
1132.36
1302.21
21700
11
401.66
381.58
438.82
21725
11
496.82
471.98
542.78
21800
N 11
94.48
89.76
103.22
21810
11
484.52
460.29
529.33
21825
11
527.83
501.44
576.66
21925
N 11
397.10
377.25
433.84
21930
F 11
337.87
320.98
369.13
21933
11
699.45
664.48
764.15
22010
11
864.43
821.21
944.39
22101
11
780.04
741.04
852.20
22110
11
979.86
930.87
1070.50
22116
11
132.50
125.88
144.76
22208
11
552.61
524.98
603.73
22214
11 1368.23
1299.82
1494.79
22222
11 1395.02
1325.27
1524.06
22305
N 11
172.43
163.81
188.38
22310
F 11
257.04
244.19
280.82
22318
11 1493.81
1419.12
1631.99
22326
11 1362.56
1294.43
1488.59
22505
11
111.09
105.54
121.37
22521
N 11 2040.39
1938.37
2229.13
22523
11
551.39
523.82
602.39
22532
11 1646.18
1563.87
1798.45
22548
11 1779.11
1690.15
1943.67
22554
11 1173.62
1114.94
1282.18
22585
11
317.66
301.78
347.05
22600
11 1175.78
1116.99
1284.54
22614
11
370.95
352.40
405.26
22800
11 1256.14
1193.33
1372.33
22808
11 1707.36
1621.99
1865.29
MFI00A11
FSY-2011

----- -- ---- -------22810
22819
22842
22845
22848
22851
22856
22862
22900
22902
22905
23020
23031
23040
23065
23071
23075
23078
23105
23120
23140
23150
23170
23180
23190
23210
23330
23350
23397
23406
23415
23440
23460
23466
23480
23491
23505
23520
23525
23540
23545
23570
23575
23600
23615
23620
23630
23655
23665
23675
23800
23920
23930
23935
24065
24066
24075
24077
24101
24110
24120
24130
24138
24147
24152
24164
24201
24220
24305
24330
24340
24343
24346
24359
24362
24366
***
"STATE OK"
NPAR FEE
--------
M E D I C A R E
LC FEE
--------
F E E
S C H E D U L E

----- -- ---- --------
11 1902.70
1807.57
2078.71
22812
11 2503.74
2378.55
2735.33
22830
11
724.07
687.87
791.05
22843
11
693.84
659.15
758.02
22846
11
342.29
325.18
373.96
22849
11
386.32
367.00
422.05
22852
11 1531.14
1454.58
1672.77
22857
11 1795.80
1706.01
1961.91
22864
11
493.64
468.96
539.30
22901
F 11
321.64
305.56
351.39
22903
11 1267.06
1203.71
1384.27
23000
11
637.17
605.31
696.11
23030
N 11
366.41
348.09
400.30
23031
11
666.15
632.84
727.77
23044
F 11
157.05
149.20
171.58
23066
11
396.58
376.75
433.26
23073
F 11
268.16
254.75
292.96
23076
11 1318.26
1252.35
1440.20
23100
11
588.96
559.51
643.44
23106
11
535.71
508.92
585.26
23125
11
480.58
456.55
525.03
23145
11
608.17
577.76
664.42
23155
11
504.43
479.21
551.09
23172
11
628.29
596.88
686.41
23182
11
522.51
496.38
570.84
23195
11 1545.91
1468.61
1688.90
23220
F 11
138.36
131.44
151.16
23331
N 11
138.93
131.98
151.78
23350
11 1067.58
1014.20
1166.33
23400
11
725.06
688.81
792.13
23410
11
643.69
611.51
703.24
23420
11
703.19
668.03
768.23
23450
11 1019.89
968.90
1114.24
23462
11 1041.34
989.27
1137.66
23470
11
762.67
724.54
833.22
23485
11
945.28
898.02
1032.72
23500
N 11
315.36
299.59
344.53
23505
N 11
203.74
193.55
222.58
23520
F 11
306.99
291.64
335.39
23530
N 11
198.11
188.20
216.43
23540
F 11
265.97
252.67
290.57
23550
N 11
206.44
196.12
225.54
23570
F 11
335.87
319.08
366.94
23585
F 11
269.58
256.10
294.52
23605
11
820.03
779.03
895.88
23616
F 11
226.95
215.60
247.94
23625
11
716.24
680.43
782.49
23650
11
357.22
339.36
390.26
23660
F 11
358.55
340.62
391.71
23670
F 11
458.03
435.13
500.40
23680
11
956.56
908.73
1045.04
23802
11 1029.75
978.26
1125.00
23921
F 11
200.54
190.51
219.09
23931
11
463.62
440.44
506.51
24000
N 11
234.77
223.03
256.48
24065
F 11
374.27
355.56
408.89
24071
N 11
445.42
423.15
486.62
24075
11
936.37
889.55
1022.98
24079
11
460.22
437.21
502.79
24102
11
539.93
512.93
589.87
24115
11
484.75
460.51
529.59
24125
11
466.59
443.26
509.75
24134
11
617.98
587.08
675.14
24140
11
578.28
549.37
631.78
24149
11 1168.79
1110.35
1276.90
24155
11
458.76
435.82
501.19
24200
N 11
505.30
480.04
552.05
24201
F 11
65.83
62.54
71.92
24300
11
535.89
509.10
585.47
24310
11
664.59
631.36
726.06
24331
11
566.93
538.58
619.37
24341
11
651.03
618.48
711.25
24344
11 1019.42
968.45
1113.72
24357
11
608.06
577.66
664.31
24360
11
989.20
939.74
1080.70
24363
11
633.33
601.66
691.91
24400
11 2073.17
11
747.80
11
770.45
11
720.17
11 1209.14
11
634.72
11 1572.29
11 1760.79
11
623.19
11
419.18
N 11
506.31
N 11
393.87
F 11
198.53
11
527.98
N 11
478.32
11
657.46
11
500.99
11
456.11
11
449.09
11
653.46
11
642.19
11
733.99
11
515.67
11
614.22
11
698.43
11 1706.87
11
544.78
F 11
49.48
11
906.00
11
765.79
11
903.76
11
883.80
11 1002.41
11 1132.58
11
896.20
N 11
194.04
F 11
298.67
F 11
205.95
11
514.34
F 11
198.42
11
528.25
F 11
210.85
11
906.41
N 11
421.03
11 1171.91
N 11
342.60
N 11
270.54
11
537.61
11
803.60
11
857.51
11 1183.34
11
405.82
N 11
255.47
11
438.61
F 11
156.97
11
386.73
F 11
300.85
11 1215.86
11
568.27
11
680.23
11
567.94
11
695.20
11
658.60
11 1086.44
11
791.33
N 11
184.16
F 11
337.11
11
369.11
11
439.25
11
746.64
11
683.67
11 1017.85
11
409.89
11
836.94
11 1401.92
11
761.50
and descriptors
NPAR FEE
--------
"ALL OF OKLAHOMA"
LC FEE
--------
1969.51
2264.94
710.41
816.97
731.93
841.72
684.16
786.78
1148.68
1320.98
602.98
693.43
1493.68
1717.73
1672.75
1923.66
592.03
680.83
398.22
457.95
480.99
553.14
374.18
430.31
188.60
216.89
501.58
576.82
454.40
522.56
624.59
718.28
475.94
547.33
433.30
498.30
426.64
490.64
620.79
713.91
610.08
701.59
697.29
801.88
489.89
563.37
583.51
671.04
663.51
763.04
1621.53
1864.76
517.54
595.17
47.01
54.06
860.70
989.81
727.50
836.63
858.57
987.36
839.61
965.55
952.29
1095.13
1075.95
1237.34
851.39
979.10
184.34
211.99
283.74
326.30
195.65
225.00
488.62
561.91
188.50
216.78
501.84
577.12
200.31
230.36
861.09
990.25
399.98
459.98
1113.31
1280.31
325.47
374.29
257.01
295.56
510.73
587.34
763.42
877.93
814.63
936.82
1124.17
1292.80
385.53
443.36
242.70
279.11
416.68
479.18
149.12
171.49
367.39
422.50
285.81
328.68
1155.07
1328.33
539.86
620.84
646.22
743.15
539.54
620.47
660.44
759.51
625.67
719.52
1032.12
1186.94
751.76
864.52
174.95
201.19
320.25
368.29
350.65
403.25
417.29
479.88
709.31
815.71
649.49
746.91
966.96
1112.00
389.40
447.81
795.09
914.35
1331.82
1531.59
723.43
831.94
09/12/2011

----- -- ---- --------
NPAR FEE
--------
PAGE 007
LC FEE
--------
22818
11 2050.29
1947.78
2239.95
22840
11
722.36
686.24
789.18
22844
11
935.25
888.49
1021.76
22847
11
816.64
775.81
892.18
22850
11
663.39
630.22
724.75
22855
11 1031.09
979.54
1126.47
22861
11 1875.86
1782.07
2049.38
22865
11 1903.76
1808.57
2079.86
22902
N 11
409.51
389.03
447.38
22904
11
974.30
925.59
1064.43
23000
F 11
336.55
319.72
367.68
23030
F 11
237.34
225.47
259.29
23035
11
631.95
600.35
690.40
23065
N 11
199.57
189.59
218.03
23066
F 11
318.01
302.11
347.43
23075
N 11
367.69
349.31
401.71
23077
11 1080.61
1026.58
1180.57
23101
11
414.44
393.72
452.78
23107
11
610.91
580.36
667.41
23130
11
560.38
532.36
612.21
23146
11
564.64
536.41
616.87
23156
11
625.52
594.24
683.38
23174
11
699.76
664.77
764.49
23184
11
684.79
650.55
748.13
23200
11 1320.67
1254.64
1442.84
23330
N 11
209.86
199.37
229.28
23332
11
820.20
779.19
896.07
23395
11 1198.07
1138.17
1308.90
23405
11
581.86
552.77
635.69
23412
11
796.90
757.06
870.62
23430
11
688.72
654.28
752.42
23455
11
939.39
892.42
1026.28
23465
11 1043.06
990.91
1139.55
23472
11 1403.88
1333.69
1533.74
23490
11
812.12
771.51
887.24
23500
F 11
194.99
185.24
213.03
23515
11
667.12
633.76
728.82
23525
N 11
333.76
317.07
364.63
23532
11
575.15
546.39
628.35
23545
N 11
290.22
275.71
317.07
23552
11
608.98
578.53
665.31
23575
N 11
356.97
339.12
389.99
23600
N 11
289.42
274.95
316.19
23605
F 11
388.28
368.87
424.20
23620
N 11
239.23
227.27
261.36
23625
F 11
320.87
304.83
350.55
23650
F 11
248.80
236.36
271.81
23665
N 11
382.17
363.06
417.52
23675
N 11
497.71
472.82
543.74
23700
11
179.44
170.47
196.04
23900
11 1268.65
1205.22
1386.00
23930
N 11
323.06
306.91
352.95
23931
F 11
145.86
138.57
159.36
24006
11
659.67
626.69
720.69
24066
N 11
548.44
521.02
599.17
24073
11
659.93
626.93
720.97
24076
11
489.29
464.83
534.55
24100
11
378.28
359.37
413.28
24105
11
315.24
299.48
344.40
24116
11
801.50
761.43
875.64
24126
11
598.18
568.27
653.51
24136
11
567.43
539.06
619.92
24145
11
553.06
525.41
604.22
24150
11 1374.14
1305.43
1501.24
24160
11
560.18
532.17
612.00
24200
F 11
127.78
121.39
139.60
24220
N 11
151.50
143.93
165.52
24301
11
697.22
662.36
761.71
24320
11
722.34
686.22
789.15
24332
11
562.99
534.84
615.07
24342
11
724.21
688.00
791.20
24345
11
647.25
614.89
707.12
24358
11
482.81
458.67
527.47
24361
11
939.86
892.87
1026.80
24365
11
592.19
562.58
646.97
24410
11
979.03
930.08
1069.59
MFI00A11
FSY-2011

----- -- ---- -------24420
24470
24500
24505
24530
24535
24546
24565
24575
24577
24582
24600
24615
24640
24650
24665
24670
24685
24900
24930
25000
25023
25028
25040
25066
25075
25077
25100
25107
25111
25116
25120
25130
25145
25170
25230
25246
25251
25263
25272
25280
25300
25312
25320
25337
25360
25375
25392
25400
25420
25430
25441
25444
25447
25455
25492
25505
25520
25526
25535
25560
25565
25600
25605
25608
25622
25628
25635
25650
25652
25671
25676
25690
25805
25825
25905
***
"STATE OK"
NPAR FEE
--------
M E D I C A R E
LC FEE
--------
11
920.41
874.39
1005.55
24430
11
602.35
572.23
658.06
24495
11
315.96
300.16
345.18
24500
11
412.43
391.81
450.58
24515
11
338.58
321.65
369.90
24530
11
521.63
495.55
569.88
24538
11
973.33
924.66
1063.36
24560
N 11
474.03
450.33
517.88
24565
11
678.28
644.37
741.03
24576
N 11
490.63
466.10
536.02
24577
11
737.29
700.43
805.49
24586
N 11
325.80
309.51
355.94
24600
11
661.61
628.53
722.81
24620
N 11
114.80
109.06
125.42
24640
F 11
210.90
200.36
230.41
24655
11
600.61
570.58
656.17
24666
F 11
232.87
221.23
254.41
24675
11
601.63
571.55
657.28
24800
11
674.22
640.51
736.59
24920
11
710.93
675.38
776.69
24931
11
315.68
299.90
344.89
25001
11 1021.81
970.72
1116.33
25024
11
475.59
451.81
519.58
25031
11
524.57
498.34
573.09
25065
11
339.38
322.41
370.77
25071
N 11
440.38
418.36
481.11
25075
11
820.08
779.08
895.94
25078
11
318.46
302.54
347.92
25101
11
571.99
543.39
624.90
25109
11
292.38
277.76
319.42
25112
11
581.67
552.59
635.48
25118
11
487.90
463.51
533.04
25125
11
416.20
395.39
454.70
25135
11
503.36
478.19
549.92
25150
11 1321.33
1255.26
1443.55
25210
11
401.08
381.03
438.18
25240
F 11
71.99
68.39
78.65
25248
11
666.47
633.15
728.12
25259
11
606.51
576.18
662.61
25265
11
541.84
514.75
591.96
25274
11
550.19
522.68
601.08
25290
11
635.87
604.08
694.69
25301
11
696.12
661.31
760.51
25315
11
912.44
866.82
996.84
25332
11
827.68
786.30
904.25
25350
11
635.99
604.19
694.82
25365
11
878.89
834.95
960.19
25390
11
974.72
925.98
1064.88
25393
11
779.42
740.45
851.52
25405
11 1123.42
1067.25
1227.34
25425
11
655.45
622.68
716.08
25431
11
869.95
826.45
950.42
25442
11
748.93
711.48
818.20
25445
11
764.28
726.07
834.98
25449
11
588.56
559.13
643.00
25490
11
867.15
823.79
947.36
25500
N 11
452.75
430.11
494.63
25505
N 11
507.35
481.98
554.28
25520
11
901.34
856.27
984.71
25530
N 11
440.64
418.61
481.40
25535
N 11
241.62
229.54
263.97
25560
F 11
432.34
410.72
472.33
25574
N 11
260.01
247.01
284.06
25600
F 11
534.40
507.68
583.83
25606
11
756.54
718.71
826.52
25609
F 11
244.29
232.08
266.89
25624
11
666.17
632.86
727.79
25630
N 11
402.98
382.83
440.25
25635
N 11
285.94
271.64
312.39
25650
11
573.51
544.83
626.55
25660
11
484.98
460.73
529.84
25675
11
583.55
554.37
637.53
25680
11
433.56
411.88
473.66
25695
11
790.82
751.28
863.97
25810
11
700.36
665.34
765.14
25830
11
670.03
636.53
732.01
25907
N
F
N
F
F E E

----- -- ---- --------
S C H E D U L E
NPAR FEE
--------
"ALL OF OKLAHOMA"
LC FEE
--------
11
984.14
934.93
1075.17
11
608.35
577.93
664.62
F 11
287.93
273.53
314.56
11
813.80
773.11
889.08
F 11
307.72
292.33
336.18
11
688.16
653.75
751.81
N 11
283.78
269.59
310.03
F 11
437.49
415.62
477.96
N 11
300.73
285.69
328.54
F 11
451.89
429.30
493.70
11 1015.76
964.97
1109.72
F 11
298.72
283.78
326.35
11
509.07
483.62
556.16
F 11
81.41
77.34
88.94
N 11
391.70
372.12
427.94
11
678.51
644.58
741.27
N 11
412.59
391.96
450.75
11
756.13
718.32
826.07
11
670.81
637.27
732.86
11
734.68
697.95
802.64
11
311.29
295.73
340.09
11
721.08
685.03
787.78
11
334.06
317.36
364.96
N 11
233.69
222.01
255.31
11
406.69
386.36
444.31
F 11
301.48
286.41
329.37
11 1062.97
1009.82
1161.29
11
373.92
355.22
408.50
11
492.41
467.79
537.96
11
355.20
337.44
388.06
11
353.52
335.84
386.22
11
575.65
546.87
628.90
11
517.91
492.01
565.81
11
529.94
503.44
578.96
11
454.61
431.88
496.66
11
401.79
381.70
438.96
11
395.53
375.75
432.11
11
371.32
352.75
405.66
11
721.62
685.54
788.37
11
648.04
615.64
707.99
11
447.46
425.09
488.85
11
600.09
570.09
655.60
11
746.18
708.87
815.20
11
785.59
746.31
858.26
11
654.84
622.10
715.42
11
877.24
833.38
958.39
11
745.62
708.34
814.59
11 1109.55
1054.07
1212.18
11
998.28
948.37
1090.63
11
949.67
902.19
1037.52
11
728.31
691.89
795.67
11
738.96
702.01
807.31
11
669.32
635.85
731.23
11
972.97
924.32
1062.97
11
658.62
625.69
719.54
N 11
238.13
226.22
260.15
F 11
417.79
396.90
456.44
F 11
482.78
458.64
527.44
N 11
230.34
218.82
251.64
F 11
411.35
390.78
449.40
F 11
218.00
207.10
238.17
11
618.06
587.16
675.23
F 11
236.70
224.87
258.60
11
613.54
582.86
670.29
11
965.03
916.78
1054.30
N 11
415.83
395.04
454.30
N 11
272.57
258.94
297.78
F 11
364.87
346.63
398.62
F 11
266.10
252.80
290.72
11
368.30
349.89
402.37
N 11
390.70
371.17
426.85
11
424.01
402.81
463.23
11
585.57
556.29
639.73
11
808.37
767.95
883.14
11
878.52
834.59
959.78
11
586.08
556.78
640.30
09/12/2011

----- -- ---- --------
NPAR FEE
--------
PAGE 008
LC FEE
--------
24435
11 1000.36
950.34
1092.89
24498
11
807.92
767.52
882.65
24505
N 11
451.80
429.21
493.59
24516
11
801.66
761.58
875.82
24535
N 11
561.31
533.24
613.23
24545
11
860.11
817.10
939.67
24560
F 11
253.86
241.17
277.35
24566
11
657.84
624.95
718.69
24576
F 11
271.12
257.56
296.19
24579
11
773.96
735.26
845.55
24587
11 1014.94
964.19
1108.82
24605
11
425.30
404.04
464.65
24635
11
651.40
618.83
711.65
24650
N 11
230.74
219.20
252.08
24655
F 11
359.25
341.29
392.48
24670
N 11
258.07
245.17
281.95
24675
F 11
379.52
360.54
414.62
24802
11
931.53
884.95
1017.69
24925
11
519.28
493.32
567.32
24935
11
901.44
856.37
984.83
25020
11
531.17
504.61
580.30
25025
11 1130.24
1073.73
1234.79
25035
11
569.57
541.09
622.25
25065
F 11
154.95
147.20
169.28
25073
11
508.53
483.10
555.57
25076
11
478.97
455.02
523.27
25085
11
423.00
401.85
462.13
25105
11
450.72
428.18
492.41
25110
11
323.18
307.02
353.07
25115
11
730.00
693.50
797.53
25119
11
464.63
441.40
507.61
25126
11
577.95
549.05
631.41
25136
11
456.04
433.24
498.23
25151
11
568.75
540.31
621.36
25215
11
579.67
550.69
633.29
25246
N 11
154.19
146.48
168.45
25250
11
486.89
462.55
531.93
25260
11
609.59
579.11
665.98
25270
11
482.06
457.96
526.65
25275
11
624.78
593.54
682.57
25295
11
511.92
486.32
559.27
25310
11
599.76
569.77
655.24
25316
11
854.53
811.80
933.57
25335
11
791.56
751.98
864.78
25355
11
740.71
703.67
809.22
25370
11
961.34
913.27
1050.26
25391
11
956.95
909.10
1045.47
25394
11
726.09
689.79
793.26
25415
11
944.11
896.90
1031.44
25426
11 1046.32
994.00
1143.10
25440
11
717.45
681.58
783.82
25443
11
725.34
689.07
792.43
25446
11 1097.25
1042.39
1198.75
25450
11
524.04
497.84
572.52
25491
11
716.21
680.40
782.46
25500
F 11
218.28
207.37
238.48
25515
11
616.75
585.91
673.80
25525
11
732.15
695.54
799.87
25530
F 11
208.29
197.88
227.56
25545
11
574.75
546.01
627.91
25565
N 11
472.97
449.32
516.72
25575
11
832.18
790.57
909.16
25605
N 11
564.63
536.40
616.86
25607
11
672.76
639.12
734.99
25622
N 11
268.85
255.41
293.72
25624
F 11
379.93
360.93
415.07
25630
F 11
248.94
236.49
271.96
25645
11
524.04
497.84
572.52
25651
11
442.35
420.23
483.26
25670
11
560.09
532.09
611.90
25675
F 11
359.52
341.54
392.77
25685
11
679.39
645.42
742.23
25800
11
684.82
650.58
748.17
25820
11
566.72
538.38
619.14
25900
11
680.45
646.43
743.39
25909
11
655.91
623.11
716.58
MFI00A11
FSY-2011

----- -- ---- -------25915
25924
25931
26011
26025
26035
26045
26060
26080
26110
26115
26117
26123
26135
26160
26180
26205
26230
26250
26320
26352
26358
26373
26410
26416
26426
26433
26440
26449
26460
26476
26479
26485
26492
26497
26500
26510
26518
26530
26536
26542
26548
26553
26556
26562
26568
26590
26596
26605
26608
26641
26650
26670
26676
26700
26705
26720
26725
26740
26742
26750
26756
26770
26776
26841
26844
26860
26863
26952
26991
27001
27006
27030
27036
27041
27047
***
"STATE OK"
NPAR FEE
--------
M E D I C A R E
LC FEE
--------
F E E
S C H E D U L E

----- -- ---- --------
11 1061.22
1008.16
1159.38
25920
11
593.44
563.77
648.34
25927
11
640.43
608.41
699.67
26010
N 11
350.51
332.98
382.93
26011
11
385.16
365.90
420.79
26030
11
781.09
742.04
853.35
26037
11
428.67
407.24
468.33
26055
11
243.47
231.30
266.00
26070
11
354.54
336.81
387.33
26100
11
292.62
277.99
319.69
26111
N 11
509.16
483.70
556.26
26115
11
677.70
643.82
740.39
26118
11
767.45
729.08
838.44
26125
11
509.00
483.55
556.08
26140
N 11
517.22
491.36
565.06
26160
11
405.13
384.87
442.60
26185
11
556.57
528.74
608.05
26210
11
461.34
438.27
504.01
26235
11
919.89
873.90
1004.99
26260
11
318.01
302.11
347.43
26340
11
742.10
705.00
810.75
26356
11
846.81
804.47
925.14
26370
11
774.70
735.97
846.37
26390
11
515.76
489.97
563.47
26412
11
767.36
728.99
838.34
26418
11
496.47
471.65
542.40
26428
11
484.49
460.27
529.31
26434
11
567.49
539.12
619.99
26442
11
677.46
643.59
740.13
26450
11
356.79
338.95
389.79
26471
11
534.13
507.42
583.53
26477
11
567.32
538.95
619.79
26480
11
740.62
703.59
809.13
26489
11
804.79
764.55
879.23
26494
11
791.13
751.57
864.31
26498
11
572.85
544.21
625.84
26502
11
543.95
516.75
594.26
26516
11
767.79
729.40
838.81
26520
11
494.33
469.61
540.05
26531
11
631.95
600.35
690.40
26540
11
623.37
592.20
681.03
26545
11
699.94
664.94
764.68
26550
11 2821.30
2680.24
3082.28
26554
11 2705.33
2570.06
2955.57
26560
11 1180.09
1121.09
1289.25
26565
11
819.76
778.77
895.59
26580
11 1170.35
1111.83
1278.60
26591
11
685.67
651.39
749.10
26600
N 11
286.74
272.40
313.26
26605
11
436.93
415.08
477.34
26615
F 11
298.47
283.55
326.08
26645
11
437.15
415.29
477.58
26665
F 11
269.81
256.32
294.77
26675
11
457.62
434.74
499.95
26685
N 11
283.85
269.66
310.11
26700
F 11
341.68
324.60
373.29
26706
N 11
173.78
165.09
189.85
26720
F 11
274.56
260.83
299.95
26727
N 11
202.41
192.29
221.13
26740
F 11
301.59
286.51
329.49
26746
F 11
160.02
152.02
174.82
26755
11
380.83
361.79
416.06
26765
F 11
223.59
212.41
244.27
26775
11
404.15
383.94
441.53
26785
11
666.30
632.99
727.94
26842
11
748.52
711.09
817.75
26850
11
512.20
486.59
559.58
26861
11
220.13
209.12
240.49
26910
11
592.32
562.70
647.11
26990
F 11
483.85
459.66
528.61
26992
11
499.08
474.13
545.25
27003
11
683.62
649.44
746.86
27025
11
873.94
830.24
954.78
27033
11
937.07
890.22
1023.75
27040
11
632.18
600.57
690.66
27043
N 11
448.11
425.70
489.56
27047
11
640.30
11
735.71
N 11
231.52
F 11
169.72
11
453.60
11
527.83
N 11
509.62
11
280.02
11
300.69
11
397.59
F 11
316.40
11 1018.09
11
262.23
11
465.02
F 11
301.47
11
498.58
11
405.56
11
456.21
11
720.44
11
297.54
11
992.95
11
700.09
11
763.12
11
626.14
11
523.01
11
687.77
11
585.84
11
878.66
11
367.90
11
560.64
11
530.31
11
687.54
11
830.98
11
728.99
11 1052.15
11
652.05
11
640.64
11
595.51
11
575.95
11
602.33
11
636.83
11 1452.63
11 3102.63
11
531.46
11
620.11
11 1257.99
11
397.72
N 11
256.45
F 11
261.86
11
521.59
N 11
379.45
11
573.21
N 11
403.72
11
526.08
F 11
266.52
11
401.13
F 11
160.55
11
430.34
F 11
190.12
11
673.08
N 11
280.05
11
449.46
N 11
342.25
11
490.57
11
722.53
11
634.01
11
98.63
11
655.41
11
573.54
11
893.05
11
546.45
11
843.63
11
909.40
N 11
311.41
11
445.03
F 11
354.88
and descriptors
NPAR FEE
--------
"ALL OF OKLAHOMA"
LC FEE
--------
608.29
699.53
698.92
803.76
219.94
252.93
161.23
185.41
430.92
495.56
501.44
576.66
484.14
556.76
266.02
305.92
285.66
328.51
377.71
434.37
300.58
345.67
967.19
1112.27
249.12
286.49
441.77
508.04
286.40
329.36
473.65
544.70
385.28
443.07
433.40
498.41
684.42
787.08
282.66
325.06
943.30
1084.80
665.09
764.85
724.96
833.70
594.83
684.05
496.86
571.39
653.38
751.39
556.55
640.03
834.73
959.94
349.51
401.94
532.61
612.50
503.79
579.36
653.16
751.13
789.43
907.84
692.54
796.42
999.54
1149.47
619.45
712.37
608.61
699.90
565.73
650.59
547.15
629.22
572.21
658.04
604.99
695.74
1380.00
1587.00
2947.50
3389.63
504.89
580.62
589.10
677.47
1195.09
1374.35
377.83
434.50
243.63
280.17
248.77
286.09
495.51
569.84
360.48
414.55
544.55
626.23
383.53
441.06
499.78
574.75
253.19
291.17
381.07
438.23
152.52
175.40
408.82
470.14
180.61
207.70
639.43
735.34
266.05
305.96
426.99
491.04
325.14
373.91
466.04
535.95
686.40
789.36
602.31
692.66
93.70
107.76
622.64
716.04
544.86
626.59
848.40
975.66
519.13
597.00
801.45
921.67
863.93
993.52
295.84
340.22
422.78
486.20
337.14
387.71
09/12/2011

----- -- ---- --------
NPAR FEE
--------
PAGE 009
LC FEE
--------
25922
11
486.49
462.17
531.50
25929
11
546.16
518.85
596.68
26010
F 11
124.12
117.91
135.60
26020
11
396.64
376.81
433.33
26034
11
492.76
468.12
538.34
26040
11
283.40
269.23
309.61
26055
F 11
278.12
264.21
303.84
26075
11
293.95
279.25
321.14
26105
11
305.02
289.77
333.24
26113
11
521.46
495.39
569.70
26116
11
485.02
460.77
529.89
26121
11
551.88
524.29
602.93
26130
11
421.65
400.57
460.66
26145
11
471.98
448.38
515.64
26170
11
372.89
354.25
407.39
26200
11
414.82
394.08
453.19
26215
11
516.69
490.86
564.49
26236
11
405.65
385.37
443.18
26262
11
553.56
525.88
604.76
26350
11
649.98
617.48
710.10
26357
11
793.02
753.37
866.38
26372
11
810.96
770.41
885.97
26392
11
889.61
845.13
971.90
26415
11
643.69
611.51
703.24
26420
11
648.76
616.32
708.77
26432
11
452.79
430.15
494.67
26437
11
567.47
539.10
619.97
26445
11
527.40
501.03
576.18
26455
11
366.47
348.15
400.37
26474
11
545.64
518.36
596.11
26478
11
569.74
541.25
622.44
26483
11
773.05
734.40
844.56
26490
11
726.32
690.00
793.50
26496
11
786.28
746.97
859.02
26499
11
756.92
719.07
826.93
26508
11
575.84
547.05
629.11
26517
11
754.58
716.85
824.38
26525
11
596.25
566.44
651.41
26535
11
376.91
358.06
411.77
26541
11
732.41
695.79
800.16
26546
11
903.37
858.20
986.93
26551
11 2833.40
2691.73
3095.49
26555
11 1263.05
1199.90
1379.89
26561
11
867.25
823.89
947.47
26567
11
621.99
590.89
679.52
26587
11
956.09
908.29
1044.53
26593
11
545.40
518.13
595.85
26600
F 11
239.75
227.76
261.92
26607
11
410.36
389.84
448.32
26641
N 11
324.61
308.38
354.64
26645
F 11
349.85
332.36
382.21
26670
N 11
296.59
281.76
324.02
26675
F 11
372.85
354.21
407.34
26686
11
573.82
545.13
626.90
26705
N 11
372.24
353.63
406.67
26715
11
519.11
493.15
567.12
26725
N 11
304.17
288.96
332.30
26735
11
541.61
514.53
591.71
26742
N 11
331.19
314.63
361.82
26750
N 11
161.91
153.81
176.88
26755
F 11
245.40
233.13
268.10
26770
N 11
241.54
229.46
263.88
26775
F 11
309.50
294.03
338.13
26820
11
718.96
683.01
785.46
26843
11
672.36
638.74
734.55
26852
11
728.50
692.08
795.89
26862
11
663.42
630.25
724.79
26951
11
584.28
555.07
638.33
26991
N 11
643.53
611.35
703.05
27000
11
406.42
386.10
444.02
27005
11
674.61
640.88
737.01
27027
11
789.78
750.29
862.83
27035
11 1067.74
1014.35
1166.50
27040
F 11
186.69
177.36
203.96
27045
11
706.53
671.20
771.88
27048
11
551.72
524.13
602.75
MFI00A11
FSY-2011

----- -- ---- -------27049
27054
27060
27066
27071
27077
27086
27090
27093
27096
27098
27110
27122
27132
27138
27147
27158
27170
27177
27181
27193
27200
27220
27226
27230
27235
27240
27246
27250
27254
27257
27265
27268
27280
27286
27301
27305
27310
27324
27327
27329
27332
27335
27340
27350
27357
27364
27370
27380
27386
27392
27395
27400
27407
27415
27420
27425
27429
27437
27441
27445
27448
27455
27466
27472
27479
27487
27496
27499
27501
27503
27508
27510
27514
27517
27520
***
"STATE OK"
NPAR FEE
--------
M E D I C A R E
LC FEE
--------
F E E
S C H E D U L E

----- -- ---- --------
11 1228.39
1166.97
1342.02
27050
11
632.61
600.98
691.13
27057
11
415.41
394.64
453.84
27062
11
752.58
714.95
822.19
27067
11
845.41
803.14
923.61
27075
11 2640.31
2508.29
2884.53
27078
N 11
224.74
213.50
245.53
27086
11
772.23
733.62
843.66
27091
F 11
67.20
63.84
73.42
27095
N 11
173.45
164.78
189.50
27096
11
617.19
586.33
674.28
27100
11
896.80
851.96
979.75
27111
11 1030.06
978.56
1125.34
27125
11 1578.45
1499.53
1724.46
27134
11 1446.20
1373.89
1579.97
27140
11 1376.36
1307.54
1503.67
27151
11 1303.65
1238.47
1424.24
27161
11 1103.58
1048.40
1205.66
27175
11 1038.48
986.56
1134.54
27178
11 1042.85
990.71
1139.32
27185
N 11
432.07
410.47
472.04
27193
N 11
160.46
152.44
175.31
27200
N 11
486.32
462.00
531.30
27220
11
979.70
930.72
1070.33
27227
N 11
433.16
411.50
473.23
27230
11
849.03
806.58
927.57
27236
11
889.91
845.41
972.22
27244
N 11
352.55
334.92
385.16
27246
11
193.25
183.59
211.13
27252
11 1185.87
1126.58
1295.57
27256
11
311.91
296.31
340.76
27258
11
361.13
343.07
394.53
27266
11
486.43
462.11
531.43
27269
11
957.90
910.01
1046.51
27282
11 1555.58
1477.80
1699.47
27290
N 11
609.00
578.55
665.33
27301
11
437.16
415.30
477.60
27306
11
676.42
642.60
738.99
27323
11
358.96
341.01
392.16
27325
N 11
402.23
382.12
439.44
27327
11
970.70
922.17
1060.50
27330
11
591.51
561.93
646.22
27333
11
708.95
673.50
774.53
27337
11
338.21
321.30
369.50
27345
11
602.37
572.25
658.09
27355
11
754.69
716.96
824.50
27358
11 1488.07
1413.67
1625.72
27365
F 11
50.16
47.65
54.80
27372
11
546.48
519.16
597.03
27381
11
770.13
731.62
841.36
27390
11
655.01
622.26
715.60
27393
11
816.33
775.51
891.84
27396
11
640.84
608.80
700.12
27403
11
725.15
688.89
792.22
27409
11 1279.05
1215.10
1397.37
27416
11
692.46
657.84
756.52
27422
11
409.50
389.03
447.38
27427
11 1156.32
1098.50
1263.28
27430
11
612.11
581.50
668.73
27438
11
751.64
714.06
821.17
27442
11 1174.73
1115.99
1283.39
27446
11
761.93
723.83
832.40
27450
11
877.35
833.48
958.50
27457
11 1101.93
1046.83
1203.85
27468
11 1186.22
1126.91
1295.95
27475
11
820.77
779.73
896.69
27485
11 1658.91
1575.96
1812.35
27488
11
484.93
460.68
529.78
27497
11
630.20
598.69
688.49
27500
N 11
463.53
440.35
506.40
27501
11
746.46
709.14
815.51
27506
N 11
478.01
454.11
522.23
27508
11
643.86
611.67
703.42
27511
11
927.79
881.40
1013.61
27516
11
632.79
601.15
691.32
27519
F 11
262.25
249.14
286.51
27524
11
348.23
11
888.87
11
418.61
11
963.64
11 1967.17
11 1800.18
F 11
136.55
11 1497.70
N 11
216.96
F 11
67.94
11
764.66
11
816.16
11 1057.15
11 1816.02
11
834.66
11 1461.26
11 1137.31
11
618.83
11
848.84
11
570.41
F 11
436.79
F 11
165.18
F 11
482.54
11 1564.33
F 11
429.06
11 1116.80
11 1149.16
F 11
353.50
11
703.23
N 11
270.23
11 1035.61
11
537.10
11 1146.33
11
773.39
11 1501.23
F 11
461.59
11
346.03
N 11
247.88
11
502.20
F 11
292.94
11
374.18
11
538.59
11
397.84
11
442.78
11
557.28
11
267.12
11 1828.98
N 11
548.85
11
740.53
11
409.28
11
466.86
11
569.05
11
593.00
11
898.31
11
906.92
11
689.59
11
665.22
11
686.32
11
781.51
11
808.37
11 1037.42
11
947.39
11
900.87
11 1252.83
11
569.90
11
622.02
11 1123.08
11
523.09
N 11
472.73
F 11
458.50
11 1250.67
F 11
451.24
11
945.73
N 11
456.58
11
848.90
11
699.40
and descriptors
NPAR FEE
--------
"ALL OF OKLAHOMA"
LC FEE
--------
330.82
380.44
844.43
971.09
397.68
457.33
915.46
1052.78
1868.81
2149.13
1710.17
1966.70
129.72
149.18
1422.82
1636.24
206.11
237.03
64.54
74.22
726.43
835.39
775.35
891.65
1004.29
1154.93
1725.22
1984.00
792.93
911.87
1388.20
1596.43
1080.44
1242.51
587.89
676.07
806.40
927.36
541.89
623.17
414.95
477.19
156.92
180.46
458.41
527.17
1486.11
1709.03
407.61
468.75
1060.96
1220.10
1091.70
1255.46
335.83
386.20
668.07
768.28
256.72
295.23
983.83
1131.40
510.25
586.79
1089.01
1252.36
734.72
844.93
1426.17
1640.10
438.51
504.29
328.73
378.04
235.49
270.81
477.09
548.65
278.29
320.03
355.47
408.79
511.66
588.41
377.95
434.64
420.64
483.74
529.42
608.83
253.76
291.82
1737.53
1998.16
521.41
599.62
703.50
809.03
388.82
447.14
443.52
510.05
540.60
621.69
563.35
647.85
853.39
981.40
861.57
990.81
655.11
753.38
631.96
726.75
652.00
749.80
742.43
853.79
767.95
883.14
985.55
1133.38
900.02
1035.02
855.83
984.20
1190.19
1368.72
541.41
622.62
590.92
679.56
1066.93
1226.97
496.94
571.48
449.09
516.45
435.58
500.92
1188.14
1366.36
428.68
492.98
898.44
1033.21
433.75
498.81
806.46
927.43
664.43
764.09
09/12/2011

----- -- ---- --------
NPAR FEE
--------
PAGE 010
LC FEE
--------
27052
11
525.30
499.04
573.90
27059
11 1732.76
1646.12
1893.04
27065
11
465.59
442.31
508.66
27070
11
789.40
749.93
862.42
27076
11 2253.75
2141.06
2462.22
27080
11
466.79
443.45
509.97
27087
11
584.44
555.22
638.50
27093
N 11
177.44
168.57
193.86
27095
F 11
78.06
74.16
85.28
27097
11
624.49
593.27
682.26
27105
11
804.07
763.87
878.45
27120
11 1210.29
1149.78
1322.25
27130
11 1351.85
1284.26
1476.90
27137
11 1389.80
1320.31
1518.36
27146
11 1193.30
1133.64
1303.69
27156
11 1606.64
1526.31
1755.26
27165
11 1283.97
1219.77
1402.74
27176
11
851.67
809.09
930.45
27179
11
908.37
862.95
992.39
27187
11
925.59
879.31
1011.21
27194
11
647.08
614.73
706.94
27202
11
557.24
529.38
608.79
27222
11
910.20
864.69
994.39
27228
11 1786.26
1696.95
1951.49
27232
11
715.96
680.16
782.18
27238
11
419.55
398.57
458.36
27245
11 1161.44
1103.37
1268.88
27248
11
697.12
662.26
761.60
27253
11
879.44
835.47
960.79
27256
F 11
220.79
209.75
241.21
27259
11 1452.90
1380.26
1587.30
27267
11
392.51
372.88
428.81
27275
11
164.57
156.34
179.79
27284
11 1487.14
1412.78
1624.70
27295
11 1189.00
1129.55
1298.98
27303
11
591.59
562.01
646.31
27307
11
436.09
414.29
476.43
27323
F 11
166.94
158.59
182.38
27326
11
462.01
438.91
504.75
27328
11
546.05
518.75
596.56
27331
11
437.11
415.25
477.54
27334
11
631.30
599.74
689.70
27339
11
715.98
680.18
782.21
27347
11
483.01
458.86
527.69
27356
11
682.54
648.41
745.67
27360
11
788.61
749.18
861.56
27370
N 11
156.30
148.49
170.76
27372
F 11
374.04
355.34
408.64
27385
11
584.24
555.03
638.28
27391
11
530.43
503.91
579.50
27394
11
601.35
571.28
656.97
27397
11
847.31
804.94
925.68
27405
11
626.71
595.37
684.68
27412
11 1543.87
1466.68
1686.68
27418
11
773.52
734.84
845.07
27424
11
690.52
655.99
754.39
27428
11 1033.50
981.83
1129.10
27435
11
744.98
707.73
813.89
27440
11
727.92
691.52
795.25
27443
11
758.65
720.72
828.83
27447
11 1445.01
1372.76
1578.67
27454
11 1208.06
1147.66
1319.81
27465
11 1163.02
1104.87
1270.60
27470
11 1102.16
1047.05
1204.11
27477
11
679.97
645.97
742.87
27486
11 1321.17
1255.11
1443.38
27495
11 1056.22
1003.41
1153.92
27498
11
579.69
550.71
633.32
27500
F 11
439.66
417.68
480.33
27502
11
727.87
691.48
795.20
27507
11
914.35
868.63
998.92
27509
11
595.97
566.17
651.10
27513
11 1182.25
1123.14
1291.61
27516
F 11
430.44
408.92
470.26
27520
N 11
287.76
273.37
314.38
27530
N 11
358.32
340.40
391.46
MFI00A11
FSY-2011

----- -- ---- -------27530
27535
27538
27550
27557
27560
27570
27591
27596
27601
27603
27605
27607
27613
27614
27618
27620
27630
27634
27638
27645
27648
27652
27656
27664
27676
27685
27687
27692
27698
27703
27707
27715
27724
27727
27734
27745
27752
27758
27760
27766
27768
27780
27784
27788
27808
27810
27816
27822
27824
27826
27829
27831
27842
27860
27880
27884
27889
27894
28002
28003
28008
28011
28020
28024
28035
28041
28045
28047
28052
28054
28060
28070
28072
28086
28088
***
"STATE OK"
NPAR FEE
--------
M E D I C A R E
LC FEE
--------
F E E
S C H E D U L E

----- -- ---- --------
F 11
334.38
317.66
365.31
27532
11
848.50
806.08
926.99
27536
F 11
401.18
381.12
438.29
27540
F 11
421.01
399.96
459.95
27552
11
999.53
949.55
1091.98
27558
F 11
313.52
297.84
342.52
27562
11
137.23
130.37
149.93
27580
11
852.10
809.50
930.93
27592
11
691.54
656.96
755.50
27598
11
415.93
395.13
454.40
27602
F 11
364.82
346.58
398.57
27604
N 11
320.51
304.48
350.15
27605
11
572.05
543.45
624.97
27610
N 11
232.10
220.50
253.58
27613
F 11
381.81
362.72
417.13
27615
N 11
404.42
384.20
441.83
27618
11
427.54
406.16
467.08
27625
N 11
501.85
476.76
548.27
27630
11
641.28
609.22
700.60
27635
11
723.75
687.56
790.69
27640
11 1572.37
1493.75
1717.81
27646
N 11
150.00
142.50
163.88
27648
11
668.41
634.99
730.24
27654
F 11
347.39
330.02
379.52
27658
11
340.01
323.01
371.46
27665
11
581.04
551.99
634.79
27680
N 11
594.82
565.08
649.84
27685
11
428.71
407.27
468.36
27690
11
103.10
97.95
112.64
27695
11
607.55
577.17
663.75
27700
11 1066.64
1013.31
1165.31
27704
11
371.90
353.31
406.31
27709
11
991.81
942.22
1083.55
27720
11 1195.95
1136.15
1306.57
27725
11
938.48
891.56
1025.29
27730
11
558.78
530.84
610.47
27740
11
701.82
666.73
766.74
27750
N 11
491.33
466.76
536.77
27752
11
829.32
787.85
906.03
27759
F 11
272.75
259.11
297.98
27762
11
565.49
537.22
617.80
27767
11
390.02
370.52
426.10
27769
F 11
246.19
233.88
268.96
27781
11
659.60
626.62
720.61
27786
N 11
384.05
364.85
419.58
27788
N 11
297.45
282.58
324.97
27808
F 11
394.02
374.32
430.47
27814
F 11
254.89
242.15
278.47
27818
11
787.92
748.52
860.80
27823
F 11
272.51
258.88
297.71
27825
11
774.90
736.16
846.58
27827
11
628.55
597.12
686.69
27830
11
358.46
340.54
391.62
27832
11
454.32
431.60
496.34
27846
11
163.17
155.01
178.26
27870
11
882.32
838.20
963.93
27881
11
553.27
525.61
604.45
27886
11
645.03
612.78
704.70
27892
11
805.37
765.10
879.87
28001
N 11
470.30
446.79
513.81
28002
F 11
514.04
488.34
561.59
28005
F 11
280.57
266.54
306.52
28010
N 11
306.83
291.49
335.21
28011
F 11
337.66
320.78
368.90
28022
N 11
410.71
390.17
448.70
28024
F 11
337.08
320.23
368.26
28039
11
424.88
403.64
464.19
28043
N 11
463.14
439.98
505.98
28045
11
891.56
846.98
974.03
28050
N 11
387.54
368.16
423.38
28052
F 11
231.70
220.12
253.14
28055
F 11
337.52
320.64
368.74
28062
N 11
473.95
450.25
517.79
28070
F 11
321.73
305.64
351.49
28080
N 11
491.30
466.74
536.75
28086
F 11
285.18
270.92
311.56
28090
N 11
564.59
11 1113.14
11
760.85
11
576.99
11 1134.44
11
435.75
11 1348.21
11
662.00
11
701.42
11
482.69
N 11
429.17
F 11
178.14
11
609.41
F 11
154.94
11
951.52
F 11
295.13
11
542.61
F 11
342.79
11
552.07
11
796.11
11 1356.72
F 11
49.84
11
668.73
11
353.32
11
385.06
11
403.86
F 11
438.91
11
596.15
11
453.52
11
565.65
11
533.64
11 1088.92
11
818.29
11 1133.58
11
540.05
11
592.59
N 11
309.25
F 11
456.68
11
934.60
N 11
438.80
N 11
247.55
11
667.05
N 11
383.98
N 11
282.79
F 11
353.49
F 11
267.84
11
720.41
N 11
440.57
11
896.45
N 11
501.84
11 1013.04
N 11
335.50
11
686.03
11
685.39
11
977.96
11
835.51
11
630.49
11
516.07
N 11
248.67
F 11
358.49
11
565.41
N 11
216.36
F 11
280.05
N 11
434.44
F 11
288.19
N 11
459.14
N 11
347.85
F 11
333.37
N 11
400.25
F 11
264.08
11
363.12
N 11
539.56
F 11
334.11
N 11
463.63
F 11
338.22
N 11
422.86
and descriptors
NPAR FEE
--------
"ALL OF OKLAHOMA"
LC FEE
--------
536.36
616.81
1057.48
1216.10
722.81
831.23
548.14
630.36
1077.72
1239.38
413.96
476.05
1280.80
1472.92
628.90
723.24
666.35
766.30
458.56
527.34
407.71
468.87
169.23
194.61
578.94
665.78
147.19
169.27
903.94
1039.53
280.37
322.43
515.48
592.80
325.65
374.50
524.47
603.14
756.30
869.75
1288.88
1482.21
47.35
54.45
635.29
730.58
335.65
386.00
365.81
420.68
383.67
441.22
416.96
479.50
566.34
651.29
430.84
495.47
537.37
617.98
506.96
583.00
1034.47
1189.64
777.38
893.99
1076.90
1238.44
513.05
590.01
562.96
647.40
293.79
337.86
433.85
498.93
887.87
1021.05
416.86
479.39
235.17
270.45
633.70
728.76
364.78
419.50
268.65
308.95
335.82
386.19
254.45
292.62
684.39
787.05
418.54
481.32
851.63
979.37
476.75
548.26
962.39
1106.75
318.73
366.54
651.73
749.49
651.12
748.79
929.06
1068.42
793.73
912.79
598.97
688.82
490.27
563.81
236.24
271.68
340.57
391.66
537.14
617.71
205.54
236.37
266.05
305.96
412.72
474.63
273.78
314.85
436.18
501.61
330.46
380.03
316.70
364.21
380.24
437.28
250.88
288.51
344.96
396.70
512.58
589.47
317.40
365.01
440.45
506.52
321.31
369.51
401.72
461.98
09/12/2011

----- -- ---- --------
NPAR FEE
--------
PAGE 011
LC FEE
--------
27532
F 11
533.10
506.45
582.42
27538
N 11
427.32
405.95
466.84
27550
N 11
451.88
429.29
493.68
27556
11
834.77
793.03
911.98
27560
N 11
340.29
323.28
371.77
27566
11
830.57
789.04
907.40
27590
11
779.41
740.44
851.51
27594
11
479.25
455.29
523.58
27600
11
393.52
373.84
429.92
27603
N 11
489.54
465.06
534.82
27604
F 11
315.15
299.39
344.30
27606
11
271.19
257.63
296.27
27612
11
526.03
499.73
574.69
27614
N 11
523.54
497.36
571.96
27616
11 1215.94
1155.14
1328.41
27619
11
467.00
443.65
510.20
27626
11
590.14
560.63
644.72
27632
11
394.44
374.72
430.93
27637
11
705.41
670.14
770.66
27641
11
635.08
603.33
693.83
27647
11 1033.54
981.86
1129.14
27650
11
624.51
593.28
682.27
27656
N 11
536.05
509.25
585.64
27659
11
460.02
437.02
502.57
27675
11
464.48
441.26
507.45
27681
11
495.16
470.40
540.96
27686
11
520.44
494.42
568.58
27691
11
702.16
667.05
767.11
27696
11
534.66
507.93
584.12
27702
11
921.06
875.01
1006.26
27705
11
713.08
677.43
779.04
27712
11 1029.69
978.21
1124.94
27722
11
823.83
782.64
900.04
27726
11
893.28
848.62
975.91
27732
11
394.39
374.67
430.87
27742
11
662.76
629.62
724.06
27750
F 11
284.37
270.15
310.67
27756
11
529.87
503.38
578.89
27760
N 11
298.89
283.95
326.54
27762
F 11
404.15
383.94
441.53
27767
F 11
248.81
236.37
271.83
27780
N 11
270.44
256.92
295.46
27781
F 11
357.83
339.94
390.93
27786
F 11
256.02
243.22
279.70
27792
11
660.36
627.34
721.44
27810
N 11
429.29
407.83
469.00
27816
N 11
282.92
268.77
309.09
27818
F 11
400.57
380.54
437.62
27824
N 11
281.64
267.56
307.69
27825
F 11
459.63
436.65
502.15
27828
11 1213.86
1153.17
1326.15
27830
F 11
313.76
298.07
342.78
27840
11
328.39
311.97
358.77
27848
11
770.66
732.13
841.95
27871
11
645.68
613.40
705.41
27882
11
590.46
560.94
645.08
27888
11
651.77
619.18
712.06
27893
11
545.23
517.97
595.67
28001
F 11
163.01
154.86
178.09
28003
N 11
627.74
596.35
685.80
28008
N 11
393.33
373.66
429.71
28010
F 11
198.72
188.78
217.10
28020
N 11
478.44
454.52
522.70
28022
F 11
306.25
290.94
334.58
28035
N 11
474.72
450.98
518.63
28039
F 11
323.71
307.52
353.65
28043
F 11
253.04
240.39
276.45
28046
11
707.61
672.23
773.06
28050
F 11
278.05
264.15
303.77
28054
N 11
349.50
332.03
381.83
28060
N 11
466.97
443.62
510.16
28062
F 11
390.90
371.36
427.06
28072
N 11
463.46
440.29
506.33
28080
F 11
337.96
321.06
369.22
28088
N 11
431.00
409.45
470.87
28090
F 11
291.84
277.25
318.84
MFI00A11
FSY-2011

----- -- ---- -------28092
28100
28104
28107
28108
28111
28112
28114
28116
28119
28120
28124
28126
28140
28153
28160
28175
28192
28193
28202
28208
28220
28222
28226
28230
28234
28238
28250
28260
28262
28264
28272
28280
28286
28288
28290
28292
28294
28296
28298
28299
28304
28306
28307
28309
28312
28313
28320
28340
28341
28345
28400
28405
28420
28435
28445
28450
28456
28470
28476
28490
28496
28505
28515
28525
28531
28540
28546
28555
28575
28585
28600
28606
28630
28636
28645
***
N
F
N
N
F
N
F
N
F
N
F
N
F
F
N
F
"STATE OK"
NPAR FEE
--------
M E D I C A R E
LC FEE
--------
F E E

----- -- ---- --------
11
383.94
364.74
419.45
28092
11
382.02
362.92
417.36
28102
11
463.78
440.59
506.68
28104
11
489.93
465.43
535.24
28107
11
272.24
258.63
297.42
28110
11
465.19
441.93
508.22
28111
11
299.24
284.28
326.92
28113
11
976.04
927.24
1066.33
28114
11
540.39
513.37
590.38
28118
11
474.38
450.66
518.26
28119
11
495.01
470.26
540.80
28122
11
433.32
411.65
473.40
28124
11
236.62
224.79
258.51
28130
11
427.83
406.44
467.41
28150
11
371.25
352.69
405.59
28153
11
257.66
244.78
281.50
28171
11
457.38
434.51
499.69
28190
N 11
429.33
407.86
469.04
28192
F 11
354.96
337.21
387.79
28200
N 11
548.98
521.53
599.76
28202
F 11
291.33
276.76
318.27
28210
N 11
407.39
387.02
445.07
28220
F 11
340.02
323.02
371.47
28225
N 11
428.38
406.96
468.00
28226
F 11
271.67
258.09
296.80
28232
N 11
369.20
350.74
403.35
28234
F 11
468.01
444.61
511.30
28240
N 11
518.34
492.42
566.28
28250
F 11
491.36
466.79
536.81
28261
N 11 1271.31
1207.74
1388.90
28262
F 11
667.79
634.40
729.56
28270
N 11
356.63
338.80
389.62
28272
F 11
338.40
321.48
369.70
28285
N 11
413.62
392.94
451.88
28286
F 11
407.53
387.15
445.22
28289
N 11
529.09
502.64
578.04
28290
F 11
567.32
538.95
619.79
28293
N 11
671.25
637.69
733.34
28294
F 11
499.14
474.18
545.31
28297
N 11
656.06
623.26
716.75
28298
F 11
648.70
616.27
708.71
28300
N 11
732.82
696.18
800.61
28304
N 11
556.32
528.50
607.78
28306
F 11
436.49
414.67
476.87
28308
11
842.68
800.55
920.63
28310
N 11
452.95
430.30
494.85
28312
F 11
345.36
328.09
377.30
28315
11
581.23
552.17
635.00
28322
N 11
544.06
516.86
594.39
28340
F 11
479.42
455.45
523.77
28344
N 11
497.18
472.32
543.17
28345
N 11
223.61
212.43
244.29
28400
F 11
331.46
314.89
362.12
28406
11 1149.74
1092.25
1256.09
28430
N 11
310.50
294.98
339.23
28435
11
996.33
946.51
1088.49
28446
F 11
173.45
164.78
189.50
28455
11
277.50
263.63
303.17
28465
F 11
172.87
164.23
188.86
28475
11
317.08
301.23
346.41
28485
F 11
110.80
105.26
121.05
28495
N 11
389.25
369.79
425.26
28496
F 11
465.48
442.21
508.54
28510
N 11
143.72
136.53
157.01
28515
F 11
371.23
352.67
405.57
28530
N 11
329.27
312.81
359.73
28531
F 11
169.19
160.73
184.84
28545
N 11
475.36
451.59
519.33
28546
F 11
622.22
591.11
679.78
28570
N 11
318.02
302.12
347.44
28575
N 11
846.01
803.71
924.27
28585
F 11
172.88
164.24
188.88
28605
11
362.80
344.66
396.36
28615
F 11
102.50
97.38
111.99
28635
N 11
250.09
237.59
273.23
28636
F 11
448.35
425.93
489.82
28660
S C H E D U L E
NPAR FEE
--------
"ALL OF OKLAHOMA"
LC FEE
--------
F 11
257.01
244.16
280.78
11
528.04
501.64
576.89
F 11
328.35
311.93
358.72
F 11
344.73
327.49
376.61
N 11
414.46
393.74
452.80
F 11
318.74
302.80
348.22
N 11
539.44
512.47
589.34
F 11
783.29
744.13
855.75
N 11
534.35
507.63
583.77
F 11
341.78
324.69
373.39
N 11
602.57
572.44
658.31
F 11
314.58
298.85
343.68
11
645.81
613.52
705.55
N 11
393.61
373.93
430.02
F 11
249.99
237.49
273.11
11
808.10
767.70
882.86
N 11
227.81
216.42
248.88
F 11
300.82
285.78
328.65
N 11
430.84
409.30
470.70
F 11
407.56
387.18
445.26
N 11
524.62
498.39
573.15
F 11
288.33
273.91
315.00
N 11
358.77
340.83
391.95
F 11
297.99
283.09
325.55
N 11
352.21
334.60
384.79
F 11
251.09
238.54
274.32
N 11
400.99
380.94
438.08
F 11
380.39
361.37
415.58
N 11
890.99
846.44
973.41
F 11 1060.29
1007.28
1158.37
N 11
443.16
421.00
484.15
F 11
242.93
230.78
265.40
N 11
426.48
405.16
465.93
F 11
288.27
273.86
314.94
N 11
672.61
638.98
734.83
F 11
375.70
356.92
410.46
N 11
953.44
905.77
1041.64
F 11
500.86
475.82
547.19
N 11
753.28
715.62
822.96
F 11
481.89
457.80
526.47
11
623.04
591.89
680.67
F 11
562.74
534.60
614.79
F 11
384.04
364.84
419.57
N 11
504.67
479.44
551.36
N 11
490.06
465.56
535.39
F 11
301.14
286.08
328.99
N 11
431.76
410.17
471.70
N 11
713.70
678.02
779.72
F 11
403.90
383.71
441.27
N 11
411.74
391.15
449.82
F 11
363.32
345.15
396.92
F 11
205.35
195.08
224.34
11
487.04
462.69
532.09
N 11
210.65
200.12
230.14
F 11
282.78
268.64
308.94
11 1130.65
1074.12
1235.24
N 11
267.52
254.14
292.26
11
572.04
543.44
624.96
N 11
236.60
224.77
258.49
11
497.44
472.57
543.46
N 11
159.28
151.32
174.02
F 11
212.87
202.23
232.56
N 11
109.40
103.93
119.52
F 11
129.86
123.37
141.88
N 11
104.16
98.95
113.79
F 11
179.98
170.98
196.63
N 11
247.77
235.38
270.69
F 11
296.15
281.34
323.54
N 11
151.98
144.38
166.04
F 11
292.51
277.88
319.56
F 11
683.81
649.62
747.06
N 11
256.16
243.35
279.85
11
734.61
697.88
802.56
N 11
162.63
154.50
177.68
F 11
174.82
166.08
190.99
N 11
101.59
96.51
110.99
09/12/2011

----- -- ---- --------
NPAR FEE
--------
PAGE 012
LC FEE
--------
28100
N 11
540.45
513.43
590.44
28103
11
392.35
372.73
428.64
28106
11
421.55
400.47
460.54
28108
N 11
393.50
373.83
429.90
28110
F 11
273.04
259.39
298.30
28112
N 11
445.39
423.12
486.59
28113
F 11
402.43
382.31
439.66
28116
N 11
688.42
654.00
752.10
28118
F 11
389.47
370.00
425.50
28120
N 11
646.82
614.48
706.65
28122
F 11
471.86
448.27
515.51
28126
N 11
354.73
336.99
387.54
28140
N 11
564.21
536.00
616.40
28150
F 11
271.09
257.54
296.17
28160
N 11
379.55
360.57
414.66
28173
11
726.35
690.03
793.53
28190
F 11
126.71
120.37
138.43
28193
N 11
488.19
463.78
533.35
28200
F 11
299.18
284.22
326.85
28208
N 11
420.15
399.14
459.01
28210
F 11
389.19
369.73
425.19
28222
N 11
467.26
443.90
510.49
28225
F 11
241.29
229.23
263.61
28230
N 11
391.36
371.79
427.56
28232
F 11
235.04
223.29
256.78
28238
N 11
618.88
587.94
676.13
28240
F 11
279.41
265.44
305.26
28260
N 11
632.14
600.53
690.61
28261
F 11
733.51
696.83
801.35
28264
N 11
840.07
798.07
917.78
28270
F 11
317.17
301.31
346.51
28280
N 11
475.09
451.34
519.04
28285
F 11
304.27
289.06
332.42
28288
N 11
547.37
520.00
598.00
28289
F 11
520.80
494.76
568.97
28292
N 11
720.71
684.67
787.37
28293
F 11
675.64
641.86
738.14
28296
N 11
659.14
626.18
720.11
28297
F 11
563.99
535.79
616.16
28299
N 11
828.23
786.82
904.84
28302
11
648.09
615.69
708.04
28305
11
626.83
595.49
684.81
28307
N 11
640.90
608.86
700.19
28308
F 11
352.54
334.91
385.15
28310
F 11
337.31
320.44
368.51
28313
N 11
477.32
453.45
521.47
28315
F 11
307.04
291.69
335.44
28322
F 11
544.25
517.04
594.60
28341
N 11
629.03
597.58
687.22
28344
F 11
281.34
267.27
307.36
28360
11
973.44
924.77
1063.49
28405
N 11
359.17
341.21
392.39
28415
11 1054.91
1002.16
1152.48
28430
F 11
187.66
178.28
205.02
28436
11
404.26
384.05
441.66
28450
N 11
193.92
184.22
211.85
28455
F 11
245.47
233.20
268.18
28470
N 11
191.46
181.89
209.17
28475
F 11
214.55
203.82
234.39
28490
N 11
127.18
120.82
138.94
28495
F 11
137.86
130.97
150.62
28505
N 11
612.57
581.94
669.23
28510
F 11
106.88
101.54
116.77
28525
N 11
518.63
492.70
566.61
28530
F 11
94.39
89.67
103.12
28540
N 11
184.31
175.09
201.35
28545
F 11
224.15
212.94
244.88
28555
N 11
800.48
760.46
874.53
28570
F 11
133.72
127.03
146.08
28576
11
347.83
330.44
380.01
28600
N 11
196.50
186.68
214.68
28605
F 11
236.00
224.20
257.83
28630
N 11
138.40
131.48
151.20
28635
F 11
127.04
120.69
138.79
28645
N 11
584.72
555.48
638.80
28660
F 11
80.81
76.77
88.29
MFI00A11
FSY-2011

----- -- ---- -------28665
28675
28715
28735
28740
28755
28760
28810
28825
28890
29010
29015
29025
29035
29044
29046
29055
29058
29075
29085
29105
29125
29130
29131
29240
29260
29305
29325
29355
29358
29405
29425
29440
29445
29505
29515
29530
29540
29580
29581
29700
29705
29715
29720
29740
29750
29805
29819
29822
29825
29828
29835
29838
29844
29847
29851
29860
29863
29868
29871
29875
29879
29882
29885
29888
29892
29894
29898
29901
29905
29914
30000
30020
30110
30117
30120
***
"STATE OK"
NPAR FEE
--------
M E D I C A R E
LC FEE
--------
F E E

----- -- ---- --------
N 11
142.96
135.81
156.18
28665
N 11
529.62
503.14
578.61
28675
11
914.17
868.46
998.73
28725
11
749.34
711.87
818.65
28737
F 11
593.26
563.60
648.14
28750
N 11
457.98
435.08
500.34
28755
F 11
551.49
523.92
602.51
28800
11
417.54
396.66
456.16
28820
N 11
533.90
507.21
583.29
28825
F 11
214.65
203.92
234.51
29000
N 11
256.52
243.69
280.24
29010
F 11
149.18
141.72
162.98
29020
N 11
227.92
216.52
249.00
29025
F 11
131.83
125.24
144.03
29040
N 11
247.36
234.99
270.24
29044
F 11
163.38
155.21
178.49
29049
N 11
193.81
184.12
211.74
29055
F 11
74.95
71.20
81.88
29065
N 11
79.75
75.76
87.12
29075
F 11
61.41
58.34
67.09
29086
N 11
77.79
73.90
84.99
29105
F 11
39.96
37.96
43.65
29126
N 11
36.85
35.01
40.26
29130
F 11
31.22
29.66
34.11
29200
N 11
52.66
50.03
57.53
29240
F 11
34.63
32.90
37.84
29280
N 11
216.76
205.92
236.81
29305
F 11
164.99
156.74
180.25
29345
N 11
127.26
120.90
139.04
29355
F 11
96.46
91.64
105.39
29365
N 11
80.14
76.13
87.55
29405
F 11
63.82
60.63
69.72
29435
N 11
44.18
41.97
48.27
29440
F 11
102.17
97.06
111.62
29450
N 11
69.73
66.24
76.18
29505
F 11
45.98
43.68
50.23
29520
N 11
47.59
45.21
51.99
29530
F 11
22.27
21.16
24.33
29550
N 11
48.00
45.60
52.44
29580
F 11
30.49
28.97
33.32
29590
N 11
59.13
56.17
64.60
29700
F 11
44.31
42.09
48.40
29710
N 11
78.14
74.23
85.36
29715
F 11
40.96
38.91
44.75
29730
N 11
82.79
78.65
90.45
29740
F 11
72.04
68.44
78.71
29800
11
435.56
413.78
475.85
29806
11
544.37
517.15
594.72
29820
11
533.05
506.40
582.36
29823
11
543.11
515.95
593.34
29826
11
855.47
812.70
934.61
29830
11
469.14
445.68
512.53
29836
11
549.49
522.02
600.32
29840
11
461.32
438.25
503.99
29845
11
503.83
478.64
550.44
29848
11
869.72
826.23
950.16
29855
11
613.77
583.08
670.54
29861
11
755.97
718.17
825.90
29866
11 1567.86
1489.47
1712.89
29870
11
475.12
451.36
519.06
29873
11
459.13
436.17
501.60
29876
11
615.41
584.64
672.34
29880
11
648.32
615.90
708.29
29883
11
696.75
661.91
761.20
29886
11
924.50
878.28
1010.02
29889
11
620.90
589.86
678.34
29893
11
482.27
458.16
526.88
29895
11
538.34
511.42
588.13
29899
11
479.14
455.18
523.46
29902
11
633.17
601.51
691.74
29906
11
966.04
917.74
1055.40
29915
N 11
214.04
203.34
233.84
30000
F 11
112.48
106.86
122.89
30100
N 11
212.25
201.64
231.89
30110
N 11
789.40
749.93
862.42
30117
N 11
484.80
460.56
529.64
30120
S C H E D U L E
NPAR FEE
--------
"ALL OF OKLAHOMA"
LC FEE
--------
F 11
125.63
119.35
137.25
F 11
380.64
361.61
415.85
11
746.77
709.43
815.84
11
647.72
615.33
707.63
N 11
761.67
723.59
832.13
F 11
312.15
296.54
341.02
11
532.30
505.69
581.54
N 11
483.22
459.06
527.92
F 11
383.66
364.48
419.15
N 11
267.64
254.26
292.40
F 11
151.32
143.75
165.31
N 11
196.66
186.83
214.85
F 11
157.05
149.20
171.58
N 11
215.08
204.33
234.98
F 11
153.50
145.83
167.70
N 11
84.11
79.90
91.89
F 11
126.73
120.39
138.45
N 11
85.49
81.22
93.40
F 11
57.07
54.22
62.35
N 11
67.30
63.94
73.53
F 11
54.80
52.06
59.87
N 11
70.87
67.33
77.43
F 11
26.77
25.43
29.24
N 11
48.74
46.30
53.25
F 11
40.70
38.67
44.47
N 11
45.64
43.36
49.86
F 11
146.52
139.19
160.07
N 11
122.38
116.26
133.70
F 11
99.86
94.87
109.10
N 11
110.22
104.71
120.42
F 11
59.04
56.09
64.50
N 11
107.07
101.72
116.98
F 11
30.01
28.51
32.79
N 11
134.90
128.16
147.38
F 11
44.53
42.30
48.65
N 11
45.40
43.13
49.60
F 11
34.99
33.24
38.23
N 11
24.85
23.61
27.15
F 11
33.83
32.14
36.96
N 11
49.32
46.85
53.88
F 11
32.36
30.74
35.35
N 11
110.27
104.76
120.47
F 11
51.37
48.80
56.12
N 11
58.86
55.92
64.31
F 11
60.74
57.70
66.36
11
486.03
461.73
530.99
11
990.53
941.00
1082.15
11
501.14
476.08
547.49
11
581.99
552.89
635.82
11
620.61
589.58
678.02
11
420.47
399.45
459.37
11
541.05
514.00
591.10
11
416.54
395.71
455.07
11
533.14
506.48
582.45
11
469.30
445.84
512.72
11
731.40
694.83
799.05
11
675.95
642.15
738.47
11
976.43
927.61
1066.75
N 11
539.43
512.46
589.33
11
480.46
456.44
524.91
11
608.76
578.32
665.07
11
641.68
609.60
701.04
11
783.05
743.90
855.49
11
588.04
558.64
642.44
11 1137.53
1080.65
1242.75
N 11
553.37
525.70
604.56
11
461.71
438.62
504.41
11
980.19
931.18
1070.86
11
498.40
473.48
544.50
11
666.39
633.07
728.03
11
984.46
935.24
1075.53
F 11
111.99
106.39
122.35
N 11
130.82
124.28
142.92
F 11
123.74
117.55
135.18
F 11
315.07
299.32
344.22
F 11
418.03
397.13
456.70
09/12/2011

----- -- ---- --------
NPAR FEE
--------
PAGE 013
LC FEE
--------
28666
11
189.48
180.01
207.01
28705
11 1223.17
1162.01
1336.31
28730
11
791.74
752.15
864.97
28740
N 11
784.44
745.22
857.00
28750
F 11
566.08
537.78
618.45
28760
N 11
725.98
689.68
793.13
28805
11
717.79
681.90
784.19
28820
F 11
327.63
311.25
357.94
28890
N 11
315.43
299.66
344.61
29000
F 11
158.03
150.13
172.65
29015
N 11
216.90
206.06
236.97
29020
F 11
123.28
117.12
134.69
29035
N 11
224.11
212.90
244.84
29040
F 11
144.53
137.30
157.90
29046
N 11
244.32
232.10
266.92
29049
F 11
61.11
58.05
66.76
29058
N 11
93.22
88.56
101.84
29065
F 11
62.81
59.67
68.62
29085
N 11
84.72
80.48
92.55
29086
F 11
46.20
43.89
50.47
29125
N 11
62.01
58.91
67.75
29126
F 11
48.83
46.39
53.35
29131
N 11
46.65
44.32
50.97
29200
F 11
37.40
35.53
40.86
29260
N 11
46.91
44.56
51.24
29280
F 11
33.04
31.39
36.10
29325
N 11
240.90
228.86
263.19
29345
F 11
94.04
89.34
102.74
29358
N 11
141.18
134.12
154.24
29365
F 11
81.87
77.78
89.45
29425
N 11
85.87
81.58
93.82
29435
F 11
79.35
75.38
86.69
29445
N 11
129.57
123.09
141.55
29450
F 11
110.33
104.81
120.53
29515
N 11
65.19
61.93
71.22
29520
F 11
33.75
32.06
36.87
29540
N 11
31.08
29.53
33.96
29550
F 11
15.09
14.34
16.49
29581
N 11
85.92
81.62
93.86
29590
F 11
37.04
35.19
40.47
29705
N 11
60.68
57.65
66.30
29710
F 11
78.46
74.54
85.72
29720
N 11
73.40
69.73
80.19
29730
F 11
42.48
40.36
46.41
29750
N 11
92.83
88.19
101.42
29804
11
607.81
577.42
664.03
29807
11
966.70
918.37
1056.13
29821
11
548.45
521.03
599.18
29824
11
625.78
594.49
683.66
29827
11 1008.73
958.29
1102.03
29834
11
456.34
433.52
498.55
29837
11
490.91
466.36
536.31
29843
11
446.30
423.99
487.59
29846
11
484.27
460.06
529.07
29850
11
555.71
527.92
607.11
29856
11
932.38
885.76
1018.62
29862
11
758.26
720.35
828.40
29867
11 1189.25
1129.79
1299.26
29870
F 11
380.06
361.06
415.22
29874
11
499.83
474.84
546.07
29877
11
576.58
547.75
629.91
29881
11
599.57
569.59
655.03
29884
11
574.95
546.20
628.13
29887
11
692.30
657.69
756.34
29891
11
645.85
613.56
705.59
29893
F 11
402.19
382.08
439.39
29897
11
482.96
458.81
527.63
29900
11
424.25
403.04
463.50
29904
11
585.97
556.67
640.17
29907
11
808.39
767.97
883.17
29916
11
984.46
935.24
1075.53
30020
N 11
212.01
201.41
231.62
30100
F 11
65.63
62.35
71.70
30115
11
403.62
383.44
440.96
30118
11
725.34
689.07
792.43
30124
11
256.97
244.12
280.74
MFI00A11
FSY-2011

----- -- ---- -------30125
30150
30200
30220
30300
30400
30430
30460
30520
30560
30580
30620
30801
30901
30903
30906
30920
31000
31020
31032
31051
31080
31085
31090
31205
31231
31233
31237
31238
31254
31267
31288
31292
31295
31296
31300
31365
31370
31382
31400
31502
31510
31511
31513
31520
31526
31529
31535
31541
31560
31570
31575
31577
31578
31580
31587
31595
31603
31611
31613
31615
31622
31623
31625
31626
31628
31629
31632
31633
31635
31637
31641
31645
31656
31717
31725
***
"STATE OK"
NPAR FEE
--------
M E D I C A R E
LC FEE
--------
F E E
S C H E D U L E

----- -- ---- --------
11
576.32
547.50
629.63
30130
11
734.17
697.46
802.08
30160
F 11
56.81
53.97
62.07
30210
N 11
276.05
262.25
301.59
30220
F 11
115.82
110.03
126.53
30310
11
962.56
914.43
1051.59
30410
11
846.35
804.03
924.63
30435
11
718.98
683.03
785.48
30462
11
580.27
551.26
633.95
30540
N 11
249.87
237.38
272.99
30560
F 11
470.92
447.37
514.48
30600
11
581.17
552.11
634.93
30630
F 11
126.02
119.72
137.68
30802
N 11
90.16
85.65
98.50
30901
F 11
77.41
73.54
84.57
30905
N 11
258.64
245.71
282.57
30906
11
787.53
748.15
860.37
30930
F 11
98.77
93.83
107.90
31002
F 11
331.15
314.59
361.78
31030
11
536.90
510.06
586.57
31040
11
605.97
575.67
662.02
31070
11
962.30
914.19
1051.32
31081
11 1229.60
1168.12
1343.34
31086
11
954.76
907.02
1043.07
31200
11
824.38
783.16
900.63
31225
N 11
177.75
168.86
194.19
31231
F 11
132.33
125.71
144.57
31235
N 11
305.82
290.53
334.11
31237
F 11
190.35
180.83
207.95
31239
11
265.50
252.23
290.06
31255
11
308.62
293.19
337.17
31276
11
261.86
248.77
286.09
31290
11
960.91
912.86
1049.79
31293
N 11 1888.07
1793.67
2062.72
31295
F 11
198.52
188.59
216.88
31297
11 1196.61
1136.78
1307.30
31320
11 2427.51
2306.13
2652.05
31367
11 1956.33
1858.51
2137.29
31375
11 2005.07
1904.82
2190.54
31390
11
947.06
899.71
1034.67
31420
11
33.76
32.07
36.88
31505
N 11
198.72
188.78
217.10
31510
F 11
123.29
117.13
134.70
31512
11
127.90
121.51
139.74
31515
11
150.88
143.34
164.84
31525
11
153.43
145.76
167.62
31527
11
157.39
149.52
171.95
31530
11
184.74
175.50
201.83
31536
11
258.68
245.75
282.61
31545
11
306.73
291.39
335.10
31561
F 11
222.60
211.47
243.19
31571
F 11
73.18
69.52
79.95
31576
N 11
229.08
217.63
250.27
31577
F 11
165.89
157.60
181.24
31579
11 1150.72
1093.18
1257.16
31582
11
953.20
905.54
1041.37
31588
11
724.77
688.53
791.81
31600
11
214.98
204.23
234.86
31605
11
508.43
483.01
555.46
31612
11
422.43
401.31
461.51
31614
F 11
123.24
117.08
134.64
31620
N 11
294.96
280.21
322.24
31622
F 11
141.57
134.49
154.66
31624
N 11
319.02
303.07
348.53
31625
F 11
202.58
192.45
221.32
31627
N 11
373.75
355.06
408.32
31628
F 11
197.42
187.55
215.68
31630
N 11
68.09
64.69
74.39
31632
F 11
60.99
57.94
66.63
31634
N 11
327.29
310.93
357.57
31635
11
74.77
71.03
81.68
31638
11
249.52
237.04
272.60
31643
F 11
154.92
147.17
169.25
31646
N 11
288.72
274.28
315.42
31656
N 11
268.43
255.01
293.26
31717
11
91.63
87.05
100.11
31730
11
353.76
11
738.69
N 11
138.59
F 11
119.20
11
192.33
11 1133.72
11 1133.62
11 1465.59
11
640.38
F 11
130.19
N 11
538.57
11
588.68
N 11
269.58
F 11
54.57
N 11
227.79
F 11
128.88
11
115.38
11
188.11
N 11
643.03
11
706.00
11
410.51
11 1269.04
11 1058.90
11
510.97
11 1761.33
F 11
73.50
N 11
282.42
F 11
175.11
11
639.13
11
389.43
11
491.38
11 1114.54
11 1047.24
F 11
166.17
N 11 3498.72
11
613.30
11 2083.81
11 1854.65
11 2694.96
11
794.78
N 11
77.75
F 11
116.52
N 11
196.80
N 11
195.76
N 11
236.95
11
189.11
11
192.59
11
206.15
11
354.18
11
335.49
11
243.98
N 11
211.93
F 11
144.04
N 11
203.63
11 1805.76
11 1084.33
11
380.60
11
175.34
N 11
76.58
11
707.52
N 11
260.07
F 11
140.63
N 11
296.54
F 11
164.38
N 11 1182.33
F 11
183.19
11
195.74
F 11
47.62
N 11 1679.18
F 11
182.40
11
247.08
11
169.28
N 11
260.55
F 11
106.35
F 11
106.23
N 11
946.78
and descriptors
NPAR FEE
--------
"ALL OF OKLAHOMA"
LC FEE
--------
336.07
386.48
701.76
807.02
131.66
151.41
113.24
130.23
182.71
210.12
1077.03
1238.58
1076.94
1238.48
1392.31
1601.16
608.36
699.61
123.68
142.23
511.64
588.39
559.25
643.14
256.10
294.52
51.84
59.62
216.40
248.86
122.44
140.81
109.61
126.05
178.70
205.51
610.88
702.51
670.70
771.31
389.98
448.48
1205.59
1386.43
1005.96
1156.85
485.42
558.23
1673.26
1924.25
69.83
80.30
268.30
308.55
166.35
191.30
607.17
698.25
369.96
425.45
466.81
536.83
1058.81
1217.63
994.88
1144.11
157.86
181.54
3323.78
3822.35
582.64
670.04
1979.62
2276.56
1761.92
2026.21
2560.21
2944.24
755.04
868.30
73.86
84.94
110.69
127.29
186.96
215.00
185.97
213.87
225.10
258.87
179.65
206.60
182.96
210.40
195.84
225.22
336.47
386.94
318.72
366.53
231.78
266.55
201.33
231.53
136.84
157.37
193.45
222.47
1715.47
1972.79
1030.11
1184.63
361.57
415.81
166.57
191.56
72.75
83.66
672.14
772.96
247.07
284.13
133.60
153.64
281.71
323.97
156.16
179.58
1123.21
1291.69
174.03
200.13
185.95
213.84
45.24
52.03
1595.22
1834.50
173.28
199.27
234.73
269.94
160.82
184.94
247.52
284.65
101.03
116.18
100.92
116.06
899.44
1034.36
09/12/2011

----- -- ---- --------
NPAR FEE
--------
PAGE 014
LC FEE
--------
30140
11
407.15
386.79
444.81
30200
N 11
105.00
99.75
114.71
30210
F 11
93.87
89.18
102.56
30300
N 11
210.62
200.09
230.10
30320
11
424.24
403.03
463.48
30420
11 1296.63
1231.80
1416.57
30450
11 1449.84
1377.35
1583.95
30465
11
926.70
880.37
1012.43
30545
11
825.15
783.89
901.47
30580
N 11
590.29
560.78
644.90
30600
F 11
411.01
390.46
449.03
30801
N 11
209.48
199.01
228.86
30802
F 11
178.24
169.33
194.73
30903
N 11
183.55
174.37
200.53
30905
F 11
98.34
93.42
107.43
30915
11
545.28
518.02
595.72
31000
N 11
167.11
158.75
182.56
31020
N 11
447.06
424.71
488.42
31030
F 11
489.33
464.86
534.59
31050
11
459.06
436.11
501.53
31075
11
738.65
701.72
806.98
31084
11 1103.22
1048.06
1205.27
31087
11 1030.67
979.14
1126.01
31201
11
690.16
655.65
754.00
31230
11 1967.99
1869.59
2150.03
31233
N 11
248.87
236.43
271.89
31235
F 11
156.12
148.31
170.56
31238
N 11
315.07
299.32
344.22
31240
11
155.64
147.86
170.04
31256
11
192.00
182.40
209.76
31287
11
225.51
214.23
246.36
31291
11 1178.37
1119.45
1287.37
31294
11 1200.27
1140.26
1311.30
31296
N 11 3532.70
3356.07
3859.48
31297
F 11
162.65
154.52
177.70
31360
11 1953.16
1855.50
2133.83
31368
11 2315.05
2199.30
2529.20
31380
11 1826.62
1735.29
1995.58
31395
11 2847.07
2704.72
3110.43
31500
11
105.13
99.87
114.85
31505
F 11
46.57
44.24
50.88
31511
N 11
198.57
188.64
216.94
31512
F 11
125.94
119.64
137.59
31515
F 11
105.68
100.40
115.46
31525
F 11
154.43
146.71
168.72
31528
11
140.50
133.48
153.50
31531
11
207.17
196.81
226.33
31540
11
236.79
224.95
258.69
31546
11
536.73
509.89
586.37
31570
N 11
325.28
309.02
355.37
31575
N 11
108.46
103.04
118.50
31576
F 11
119.65
113.67
130.72
31578
N 11
266.05
252.75
290.66
31579
F 11
136.54
129.71
149.17
31584
11 1437.03
1365.18
1569.96
31590
11
839.89
797.90
917.59
31601
11
252.44
239.82
275.79
31610
11
674.46
640.74
736.85
31612
F 11
46.02
43.72
50.28
31615
N 11
172.69
164.06
188.67
31620
F 11
65.74
62.45
71.82
31623
N 11
317.01
301.16
346.33
31624
F 11
141.89
134.80
155.02
31626
N 11
418.02
397.12
456.69
31627
F 11
98.86
93.92
108.01
31629
N 11
577.58
548.70
631.01
31631
11
222.92
211.77
243.54
31633
N 11
83.35
79.18
91.06
31634
F 11
198.55
188.62
216.91
31636
11
216.19
205.38
236.19
31640
11
249.50
237.03
272.58
31645
N 11
286.26
271.95
312.74
31646
F 11
134.56
127.83
147.00
31715
11
51.82
49.23
56.61
31720
11
49.81
47.32
54.42
31730
F 11
142.37
135.25
155.54
MFI00A11
FSY-2011

----- -- ---- -------31750
31766
31780
31786
31820
31825
32035
32100
32124
32150
32200
32215
32310
32400
32405
32421
32440
32480
32486
32500
32504
32550
32552
32560
32561
32601
32604
32650
32653
32656
32659
32662
32665
32815
32852
32856
32906
32960
32998
33015
33030
33120
33141
33206
33210
33213
33216
33220
33224
33233
33236
33240
33244
33251
33256
33259
33266
33300
33315
33322
33335
33403
33406
33412
33415
33420
33426
33460
33465
33471
33475
33496
33502
33505
33508
33512
***
"STATE OK"
NPAR FEE
--------
M E D I C A R E
LC FEE
--------
F E E
S C H E D U L E

----- -- ---- --------
11 1285.83
1221.54
1404.77
31755
11 1715.61
1629.83
1874.30
31770
11 1147.42
1090.05
1253.56
31781
11 1408.38
1337.96
1538.65
31800
N 11
408.83
388.39
446.65
31820
F 11
461.21
438.15
503.87
31830
11
687.22
652.86
750.79
32036
11
920.73
874.69
1005.89
32110
11
891.12
846.56
973.54
32140
11
960.61
912.58
1049.47
32151
11 1086.18
1031.87
1186.65
32201
11
768.67
730.24
839.78
32220
11
881.06
837.01
962.56
32320
F 11
85.63
81.35
93.55
32402
F 11
94.88
90.14
103.66
32420
F 11
74.41
70.69
81.29
32422
11 1519.43
1443.46
1659.98
32442
11 1437.16
1365.30
1570.10
32482
11 2272.96
2159.31
2483.21
32488
11 1393.03
1323.38
1521.89
32501
11 1992.27
1892.66
2176.56
32540
F 11
218.20
207.29
238.38
32551
F 11
154.76
147.02
169.07
32553
N 11
243.05
230.90
265.54
32560
F 11
68.76
65.32
75.12
32562
11
298.85
283.91
326.50
32602
11
468.89
445.45
512.27
32605
11
643.09
610.94
702.58
32651
11 1008.92
958.47
1102.24
32654
11
770.17
731.66
841.41
32657
11
708.25
672.84
773.77
32660
11
865.95
822.65
946.05
32663
11 1173.39
1114.72
1281.93
32800
11 2674.76
2541.02
2922.17
32820
11 2760.56
2622.53
3015.91
32853
11
184.60
175.37
201.68
32900
11 1597.49
1517.62
1745.26
32940
F 11
99.18
94.22
108.35
32997
F 11
286.67
272.34
313.19
33010
11
504.56
479.33
551.23
33020
11 1249.26
1186.80
1364.82
33031
11 1511.73
1436.14
1651.56
33130
11
134.54
127.81
146.98
33202
11
451.80
429.21
493.59
33207
11
178.70
169.77
195.24
33211
11
381.89
362.80
417.22
33214
11
373.19
354.53
407.71
33217
11
392.35
372.73
428.64
33222
11
504.01
478.81
550.63
33225
11
236.39
224.57
258.26
33234
11
761.71
723.62
832.16
33237
11
459.63
436.65
502.15
33241
11
847.42
805.05
925.81
33249
11 1591.86
1512.27
1739.11
33254
11 1921.95
1825.85
2099.73
33257
11
826.03
784.73
902.44
33261
11 1803.09
1712.94
1969.88
33282
11 2356.39
2238.57
2574.36
33305
11 1446.42
1374.10
1580.22
33320
11 1359.44
1291.47
1485.19
33330
11 1841.31
1749.24
2011.63
33400
11 1461.08
1388.03
1596.23
33404
11 2816.76
2675.92
3077.31
33410
11 2413.94
2293.24
2637.23
33413
11 1976.13
1877.32
2158.92
33416
11 1386.56
1317.23
1514.81
33422
11 2344.05
2226.85
2560.88
33427
11 2357.34
2239.47
2575.39
33463
11 2681.90
2547.81
2929.98
33468
11 1218.61
1157.68
1331.33
33472
11 2284.47
2170.25
2495.79
33476
11 1633.46
1551.79
1784.56
33500
11 1241.04
1178.99
1355.84
33503
11 2016.47
1915.65
2203.00
33506
11
15.91
15.11
17.38
33510
11 2379.41
2260.44
2599.51
33513
11 1625.51
11 1284.25
11 1358.50
11
662.18
F 11
313.40
N 11
412.53
11
741.66
11 1400.81
11
950.48
11
971.58
N 11
863.29
11 1532.25
11 1539.15
11
542.86
11
106.94
N 11
185.88
11 2730.50
11 1536.32
11 2305.94
11
239.29
11 1654.78
11
165.84
N 11
576.58
F 11
79.90
N 11
81.08
11
323.87
11
372.52
11 1046.57
11 1126.67
11
759.02
11 1009.78
11 1353.55
11
901.67
11 1290.54
11 2967.23
11 1333.91
11 1188.57
11
343.13
11
118.81
11
847.50
11 1390.59
11 1343.79
11
753.60
11
481.42
11
181.41
11
476.79
11
370.91
11
341.95
11
454.60
11
482.28
11
817.80
11
222.77
11
901.03
11 1332.67
11
568.83
11 1583.65
11
320.57
11 3962.80
11 1035.99
11 1388.46
11 2237.70
11 1720.74
11 2493.72
11 3172.07
11 1984.76
11 1650.15
11 2413.34
11 3003.05
11 1823.17
11 1193.57
11 1473.66
11 1540.87
11 1302.09
11 2118.46
11 1914.72
11 2438.22
and descriptors
NPAR FEE
--------
"ALL OF OKLAHOMA"
LC FEE
--------
1544.23
1775.86
1220.04
1403.05
1290.58
1484.17
629.07
723.43
297.73
342.39
391.90
450.69
704.58
810.27
1330.77
1530.39
902.96
1038.40
923.00
1061.45
820.13
943.15
1455.64
1673.99
1462.19
1681.52
515.72
593.08
101.59
116.83
176.59
203.08
2593.98
2983.08
1459.50
1678.43
2190.64
2519.24
227.33
261.43
1572.04
1807.85
157.55
181.18
547.75
629.91
75.91
87.30
77.03
88.58
307.68
353.83
353.89
406.97
994.24
1143.38
1070.34
1230.89
721.07
829.23
959.29
1103.18
1285.87
1478.75
856.59
985.08
1226.01
1409.91
2818.87
3241.70
1267.21
1457.29
1129.14
1298.51
325.97
374.87
112.87
129.80
805.13
925.90
1321.06
1519.22
1276.60
1468.09
715.92
823.31
457.35
525.95
172.34
198.19
452.95
520.89
352.36
405.21
324.85
373.58
431.87
496.65
458.17
526.90
776.91
893.45
211.63
243.37
855.98
984.38
1266.04
1455.95
540.39
621.45
1504.47
1730.14
304.54
350.22
3764.66
4329.36
984.19
1131.82
1319.04
1516.90
2125.82
2444.69
1634.70
1879.91
2369.03
2724.38
3013.47
3465.49
1885.52
2168.35
1567.64
1802.79
2292.67
2636.57
2852.90
3280.84
1732.01
1991.81
1133.89
1303.97
1399.98
1609.98
1463.83
1683.40
1236.99
1422.54
2012.54
2314.42
1818.98
2091.83
2316.31
2663.76
09/12/2011

----- -- ---- --------
NPAR FEE
--------
PAGE 015
LC FEE
--------
31760
11 1323.96
1257.76
1446.42
31775
11 1315.14
1249.38
1436.79
31785
11 1039.82
987.83
1136.00
31805
11
784.70
745.47
857.29
31825
N 11
569.87
541.38
622.59
31830
F 11
325.28
309.02
355.37
32095
11
604.80
574.56
660.74
32120
11
839.51
797.53
917.16
32141
11 1469.39
1395.92
1605.31
32160
11
745.07
707.82
813.99
32201
F 11
196.51
186.68
214.68
32225
11
958.00
910.10
1046.62
32400
N 11
142.01
134.91
155.15
32405
N 11
95.19
90.43
103.99
32421
N 11
146.54
139.21
160.09
32422
F 11
119.11
113.15
130.12
32445
11 3368.56
3200.13
3680.15
32484
11 1393.59
1323.91
1522.50
32491
11 1432.25
1360.64
1564.74
32503
11 1751.13
1663.57
1913.11
32550
N 11
742.61
705.48
811.30
32552
N 11
175.86
167.07
192.13
32553
F 11
197.36
187.49
215.61
32561
N 11
90.81
86.27
99.21
32562
F 11
61.86
58.77
67.59
32603
11
421.28
400.22
460.25
32606
11
449.38
426.91
490.95
32652
11 1589.24
1509.78
1736.25
32655
11
916.92
871.07
1001.73
32658
11
691.11
656.55
755.03
32661
11
772.45
733.83
843.90
32664
11
817.53
776.65
893.15
32810
11
866.71
823.37
946.88
32851
11 2494.82
2370.08
2725.59
32854
11 3246.25
3083.94
3546.53
32905
11 1289.82
1225.33
1409.13
32960
N 11
132.25
125.64
144.49
32998
N 11 2685.72
2551.43
2934.14
33011
11
118.46
112.54
129.42
33025
11
775.48
736.71
847.22
33050
11
969.45
920.98
1059.13
33140
11 1546.04
1468.74
1689.05
33203
11
791.32
751.75
864.51
33208
11
520.01
494.01
568.11
33212
11
334.82
318.08
365.79
33215
11
302.34
287.22
330.30
33218
11
389.09
369.64
425.09
33223
11
410.79
390.25
448.79
33226
11
485.23
460.97
530.12
33235
11
629.23
597.77
687.44
33238
11
908.78
863.34
992.84
33243
11 1337.57
1270.69
1461.29
33250
11 1433.88
1362.19
1566.52
33255
11 1617.16
1536.30
1766.75
33258
11
640.00
608.00
699.20
33265
11 1319.27
1253.31
1441.31
33284
11
230.54
219.01
251.86
33310
11 1131.40
1074.83
1236.05
33321
11 1157.60
1099.72
1264.68
33332
11 1362.33
1294.21
1488.34
33401
11 1404.85
1334.61
1534.80
33405
11 2248.96
2136.51
2456.99
33411
11 3282.99
3118.84
3586.67
33414
11 2122.62
2016.49
2318.96
33417
11 1633.56
1551.88
1784.66
33425
11 2652.07
2519.47
2897.39
33430
11 2745.04
2607.79
2998.96
33464
11 2386.39
2267.07
2607.13
33470
11 1228.40
1166.98
1342.03
33474
11 2075.08
1971.33
2267.03
33478
11 1534.37
1457.65
1676.30
33501
11 1092.79
1038.15
1193.87
33504
11 1422.32
1351.20
1553.88
33507
11 1683.56
1599.38
1839.29
33511
11 2097.75
1992.86
2291.79
33514
11 2581.72
2452.63
2820.52
MFI00A11
FSY-2011

----- -- ---- -------33516
33519
33523
33534
33542
33572
33606
33611
33617
33621
33645
33665
33676
33684
33692
33702
33722
33730
33736
33755
33766
33770
33775
33778
33781
33786
33802
33814
33824
33851
33860
33870
33880
33884
33891
33916
33922
33926
33960
33968
33973
33976
33979
34051
34151
34401
34471
34502
34530
34803
34806
34813
34826
34832
34900
35005
35021
35081
35092
35111
35122
35141
35152
35184
35190
35207
35221
35236
35251
35266
35281
35302
35305
35321
35351
35363
***
"STATE OK"
NPAR FEE
--------
M E D I C A R E
LC FEE
--------
F E E
S C H E D U L E

----- -- ---- --------
11 2686.49
2552.17
2935.00
33517
11
184.15
11
535.12
508.36
584.61
33521
11
644.38
11
823.86
782.67
900.07
33530
11
514.31
11 2173.70
2065.02
2374.77
33535
11 2421.27
11 2559.44
2431.47
2796.19
33545
11 3009.00
11
228.71
217.27
249.86
33600
11 1662.42
11 1742.91
1655.76
1904.12
33608
11 1756.55
11 1916.64
1820.81
2093.93
33612
11 1934.05
11 2095.39
1990.62
2289.21
33619
11 2661.30
11
868.22
824.81
948.53
33622
11 3404.20
11 1547.22
1469.86
1690.34
33647
11 1653.78
11 1879.40
1785.43
2053.24
33670
11 1940.23
11 1886.10
1791.80
2060.57
33677
11 1865.87
11 1854.23
1761.52
2025.75
33688
11 1837.61
11 1623.24
1542.08
1773.39
33694
11 1921.05
11 1506.60
1431.27
1645.96
33710
11 1731.92
11 1616.29
1535.48
1765.80
33724
11 1510.70
11 1935.96
1839.16
2115.03
33732
11 1611.38
11 1369.73
1301.24
1496.43
33737
11 1258.08
11 1257.18
1194.32
1373.47
33762
11 1188.51
11 1313.05
1247.40
1434.51
33767
11 1383.44
11 2064.79
1961.55
2255.78
33771
11 2026.42
11 1723.61
1637.43
1883.04
33776
11 1820.16
11 2187.85
2078.46
2390.23
33779
11 2171.69
11 2153.37
2045.70
2352.56
33782
11 3118.92
11 2065.96
1962.66
2257.06
33788
11 1393.27
11 1075.79
1022.00
1175.30
33803
11 1113.91
11 1486.26
1411.95
1623.74
33820
11
950.87
11 1159.50
1101.53
1266.76
33840
11 1227.90
11 1347.64
1280.26
1472.30
33852
11 1359.30
11 3134.40
2977.68
3424.33
33863
11 3090.84
11 2473.06
2349.41
2701.82
33875
11 1948.55
11 1801.93
1711.83
1968.60
33881
11 1550.14
11
409.69
389.21
447.59
33886
11
972.82
11
988.13
938.72
1079.53
33910
11 1638.13
11 1597.71
1517.82
1745.49
33917
11 1438.66
11 1352.25
1284.64
1477.34
33924
11
278.39
11 2464.50
2341.28
2692.47
33935
11 3381.19
11
966.85
918.51
1056.29
33961
11
538.61
11
33.76
32.07
36.88
33970
11
354.24
11
514.13
488.42
561.68
33974
11
878.19
11 1193.50
1133.83
1303.90
33977
11 1174.68
11 2356.51
2238.68
2574.48
33980
11 3536.71
11
962.66
914.53
1051.71
34101
11
606.66
11 1401.88
1331.79
1531.56
34201
11 1027.30
11 1467.89
1394.50
1603.68
34421
11
738.04
11 1147.71
1090.32
1253.87
34490
11
613.26
11 1511.62
1436.04
1651.45
34510
11 1107.40
11
957.70
909.82
1046.29
34800
11 1135.88
11 1296.69
1231.86
1416.64
34804
11 1255.88
11
103.56
98.38
113.14
34808
11
205.86
11
238.53
226.60
260.59
34820
11
487.40
11
206.66
196.33
225.78
34830
11 1811.20
11 1947.40
1850.03
2127.53
34833
11
611.75
11
903.88
858.69
987.49
35001
11 1131.90
11 1098.18
1043.27
1199.76
35011
11
998.99
11 1184.56
1125.33
1294.13
35022
11 1388.08
11 1761.73
1673.64
1924.69
35082
11 2198.01
11 2618.52
2487.59
2860.73
35102
11 1903.09
11 1430.56
1359.03
1562.88
35112
11 1756.17
11 1928.27
1831.86
2106.64
35131
11 1402.35
11 1115.05
1059.30
1218.20
35142
11 1335.91
11 1440.44
1368.42
1573.68
35180
11
912.14
11 1016.53
965.70
1110.56
35188
11
818.87
11
747.77
710.38
816.94
35201
11
933.70
11
705.15
669.89
770.37
35211
11 1356.02
11 1406.50
1336.18
1536.61
35226
11
838.20
11
974.72
925.98
1064.88
35241
11 1426.29
11 1666.14
1582.83
1820.25
35256
11 1020.38
11
861.95
818.85
941.68
35271
11 1360.63
11 1594.71
1514.97
1742.22
35286
11
941.11
11 1125.98
1069.68
1230.13
35303
11 1242.17
11 1239.34
1177.37
1353.98
35306
11
474.45
11
896.55
851.72
979.48
35331
11 1475.10
11 1294.10
1229.40
1413.81
35355
11 1049.60
11 1730.62
1644.09
1890.70
35371
11
828.46
All Current Procedural Terminology (CPT) codes and descriptors
NPAR FEE
--------
"ALL OF OKLAHOMA"
LC FEE
--------
174.94
201.18
612.16
703.98
488.59
561.88
2300.21
2645.24
2858.55
3287.33
1579.30
1816.20
1668.72
1919.03
1837.35
2112.95
2528.24
2907.48
3233.99
3719.09
1571.09
1806.75
1843.22
2119.70
1772.58
2038.47
1745.73
2007.59
1825.00
2098.75
1645.32
1892.12
1435.17
1650.45
1530.81
1760.43
1195.18
1374.46
1129.08
1298.44
1314.27
1511.41
1925.10
2213.87
1729.15
1988.52
2063.11
2372.58
2962.97
3407.42
1323.61
1522.15
1058.21
1216.94
903.33
1038.83
1166.51
1341.49
1291.34
1485.04
2936.30
3376.75
1851.12
2128.79
1472.63
1693.52
924.18
1062.81
1556.22
1789.65
1366.73
1571.74
264.47
304.14
3212.13
3693.95
511.68
588.43
336.53
387.01
834.28
959.42
1115.95
1283.34
3359.87
3863.85
576.33
662.78
975.94
1122.33
701.14
806.31
582.60
669.99
1052.03
1209.83
1079.09
1240.95
1193.09
1372.05
195.57
224.91
463.03
532.48
1720.64
1978.74
581.16
668.33
1075.31
1236.61
949.04
1091.40
1318.68
1516.48
2088.11
2401.33
1807.94
2079.13
1668.36
1918.61
1332.23
1532.06
1269.11
1459.48
866.53
996.51
777.93
894.62
887.02
1020.07
1288.22
1481.45
796.29
915.73
1354.98
1558.23
969.36
1114.76
1292.60
1486.49
894.05
1028.16
1180.06
1357.07
450.73
518.34
1401.35
1611.55
997.12
1146.69
787.04
905.10
09/12/2011

----- -- ---- --------
NPAR FEE
--------
PAGE 016
LC FEE
--------
33518
11
403.69
383.51
441.04
33522
11
725.55
689.27
792.66
33533
11 1852.37
1759.75
2023.71
33536
11 2603.87
2473.68
2844.73
33548
11 2918.21
2772.30
3188.15
33602
11 1590.07
1510.57
1737.16
33610
11 1721.36
1635.29
1880.58
33615
11 1954.77
1857.03
2135.58
33620
11 1612.33
1531.71
1761.47
33641
11 1598.84
1518.90
1746.74
33660
11 1816.01
1725.21
1983.99
33675
11 1930.12
1833.61
2108.65
33681
11 1795.05
1705.30
1961.10
33690
11 1187.37
1128.00
1297.20
33697
11 2046.83
1944.49
2236.16
33720
11 1503.46
1428.29
1642.53
33726
11 2056.71
1953.87
2246.95
33735
11 1256.70
1193.87
1372.95
33750
11 1317.67
1251.79
1439.56
33764
11 1266.64
1203.31
1383.81
33768
11
391.66
372.08
427.89
33774
11 1759.33
1671.36
1922.06
33777
11 1682.29
1598.18
1837.91
33780
11 2226.55
2115.22
2432.50
33783
11 3370.91
3202.36
3682.71
33800
11
955.92
908.12
1044.34
33813
11 1250.03
1187.53
1365.66
33822
11
947.70
900.32
1035.37
33845
11 1319.79
1253.80
1441.87
33853
11 1816.45
1725.63
1984.47
33864
11 3164.62
3006.39
3457.35
33877
11 3542.71
3365.57
3870.41
33883
11 1123.56
1067.38
1227.49
33889
11
800.00
760.00
874.00
33915
11 1330.79
1264.25
1453.89
33920
11 1776.04
1687.24
1940.33
33925
11 1690.19
1605.68
1846.53
33945
11 4693.39
4458.72
5127.53
33967
11
262.77
249.63
287.07
33971
11
697.98
663.08
762.54
33975
11 1077.90
1024.01
1177.61
33978
11 1303.24
1238.08
1423.79
34001
11
971.15
922.59
1060.98
34111
11
606.52
576.19
662.62
34203
11
968.55
920.12
1058.14
34451
11 1481.69
1407.61
1618.75
34501
11
923.22
877.06
1008.62
34520
11 1018.39
967.47
1112.59
34802
11 1255.05
1192.30
1371.15
34805
11 1192.86
1133.22
1303.20
34812
11
337.72
320.83
368.95
34825
11
703.58
668.40
768.66
34831
11 1932.60
1835.97
2111.37
34834
11
276.48
262.66
302.06
35002
11 1163.43
1105.26
1271.05
35013
11 1250.12
1187.61
1365.75
35045
11
980.27
931.26
1070.95
35091
11 1816.76
1725.92
1984.81
35103
11 2255.32
2142.55
2463.93
35121
11 1657.01
1574.16
1810.28
35132
11 1672.14
1588.53
1826.81
35151
11 1258.82
1195.88
1375.26
35182
11 1702.69
1617.56
1860.19
35189
11 1652.28
1569.67
1805.12
35206
11
766.77
728.43
837.69
35216
11 1973.77
1875.08
2156.34
35231
11 1164.96
1106.71
1272.72
35246
11 1490.17
1415.66
1628.01
35261
11 1046.04
993.74
1142.80
35276
11 1416.89
1346.05
1547.96
35301
11 1055.28
1002.52
1152.90
35304
11 1286.52
1222.19
1405.52
35311
11 1516.60
1440.77
1656.89
35341
11 1379.55
1310.57
1507.16
35361
11 1565.85
1487.56
1710.69
35372
11
990.45
940.93
1082.07
MFI00A11
FSY-2011

----- -- ---- -------35390
35452
35471
35472
35476
35501
35509
35512
35518
35523
35531
35536
35539
35549
35558
35565
35571
35585
35601
35616
35626
35633
35637
35645
35650
35656
35665
35681
35685
35693
35697
35721
35800
35860
35876
35883
35903
36000
36002
36010
36011
36013
36014
36100
36120
36147
36148
36200
36215
36217
36218
36246
36247
36260
36400
36405
36410
36425
36450
36470
36471
36476
36478
36481
36510
36512
36514
36516
36522
36556
36557
36560
36561
36565
36566
36569
***
"STATE OK"
NPAR FEE
--------
M E D I C A R E
LC FEE
--------
F E E
S C H E D U L E

----- -- ---- --------
11
160.30
152.29
175.13
35400
11
358.65
340.72
391.83
35458
N 11 2746.52
2609.19
3000.57
35471
F 11
364.59
346.36
398.31
35475
N 11 1634.20
1552.49
1785.36
35476
11 1578.60
1499.67
1724.62
35506
11 1497.64
1422.76
1636.17
35510
11 1241.35
1179.28
1356.17
35515
11 1184.82
1125.58
1294.42
35521
11 1295.65
1230.87
1415.50
35525
11 2038.09
1936.19
2226.62
35533
11 1732.02
1645.42
1892.23
35537
11 2240.30
2128.29
2447.53
35540
11 1382.57
1313.44
1510.46
35551
11 1243.36
1181.19
1358.37
35560
11 1333.04
1266.39
1456.35
35566
11 1349.39
1281.92
1474.21
35572
11 1695.88
1611.09
1852.75
35587
11 1467.48
1394.11
1603.23
35606
11 1183.44
1124.27
1292.91
35621
11 1564.95
1486.70
1709.71
35631
11 1895.82
1801.03
2071.18
35634
11 1729.77
1643.28
1889.77
35638
11 1036.17
984.36
1132.01
35646
11 1078.34
1024.42
1178.08
35651
11 1093.59
1038.91
1194.75
35661
11 1188.23
1128.82
1298.14
35666
11
80.44
76.42
87.88
35682
11
201.62
191.54
220.27
35686
11
863.81
820.62
943.71
35694
11
150.10
142.60
163.99
35700
11
453.78
431.09
495.75
35741
11
482.40
458.28
527.02
35820
11
405.90
385.61
443.45
35870
11
953.28
905.62
1041.46
35879
11 1214.12
1153.41
1326.42
35884
11
567.46
539.09
619.95
35905
N 11
23.49
22.32
25.67
36000
F 11
106.19
100.88
116.01
36005
N 11
529.28
502.82
578.24
36010
F 11
156.09
148.29
170.53
36012
N 11
764.23
726.02
834.92
36013
F 11
150.13
142.62
164.01
36015
N 11
500.25
475.24
546.53
36100
F 11
99.44
94.47
108.64
36140
N 11
771.18
732.62
842.51
36147
F 11
48.37
45.95
52.84
36160
N 11
613.93
583.23
670.71
36200
F 11
241.93
229.83
264.30
36216
N 11 1958.20
1860.29
2139.33
36217
F 11
51.82
49.23
56.61
36245
N 11 1162.34
1104.22
1269.85
36246
F 11
322.82
306.68
352.68
36248
11
590.39
560.87
645.00
36261
N 11
27.59
26.21
30.14
36400
F 11
15.45
14.68
16.88
36406
N 11
17.19
16.33
18.78
36410
11
38.09
36.19
41.62
36430
11
110.72
105.18
120.96
36455
N 11
134.99
128.24
147.48
36470
F 11
97.29
92.43
106.29
36475
N 11
376.92
358.07
411.78
36476
F 11
345.34
328.07
377.28
36479
N 11 1185.72
1126.43
1295.39
36481
N 11
99.51
94.53
108.71
36510
11
89.22
84.76
97.47
36513
F 11
89.53
85.05
97.81
36515
N 11 1989.59
1890.11
2173.63
36516
F 11
97.87
92.98
106.93
36555
N 11
222.09
210.99
242.64
36556
F 11
305.32
290.05
333.56
36558
N 11 1190.94
1131.39
1301.10
36560
F 11
341.16
324.10
372.72
36563
N 11
942.66
895.53
1029.86
36565
F 11
363.92
345.72
397.58
36568
N 11
243.89
231.70
266.46
36569
11
150.50
11
489.94
F 11
537.38
N 11 2162.74
F 11
308.84
11 1344.32
11 1269.75
11 1346.62
11 1333.16
11 1151.63
11 1638.28
11 2254.59
11 2562.53
11 1526.25
11 1756.80
11 1689.02
11
347.63
11 1395.78
11 1188.31
11 1113.11
11 1866.21
11 1715.34
11 1767.68
11 1733.90
11 1352.53
11 1098.10
11 1284.44
11
358.04
11
167.43
11 1029.49
11
154.53
11
503.35
11 1941.63
11 1351.02
11
936.49
11 1262.31
11 1727.61
F 11
9.32
N 11
324.92
F 11
120.46
N 11
841.03
F 11
127.69
N 11
873.52
F 11
158.51
N 11
453.56
F 11
182.83
N 11
492.39
F 11
153.45
N 11 1200.26
F 11
325.75
N 11 1150.16
F 11
271.00
N 11
152.92
11
366.18
F 11
16.89
N 11
16.25
F 11
9.00
11
32.35
11
116.94
F 11
68.53
N 11 1719.60
F 11
169.68
N 11
388.56
F 11
351.71
F 11
58.25
11
95.53
N 11 1802.23
F 11
66.12
N 11
255.76
F 11
117.21
N 11
760.07
F 11
347.48
N 11 1179.20
F 11
338.88
N 11
281.31
F 11
90.82
and descriptors
NPAR FEE
--------
"ALL OF OKLAHOMA"
LC FEE
--------
142.98
164.43
465.44
535.26
510.51
587.09
2054.60
2362.79
293.40
337.41
1277.10
1468.67
1206.26
1387.20
1279.29
1471.18
1266.50
1456.48
1094.05
1258.16
1556.37
1789.83
2141.86
2463.14
2434.40
2799.56
1449.94
1667.43
1668.96
1919.30
1604.57
1845.26
330.25
379.79
1325.99
1524.89
1128.89
1298.22
1057.45
1216.07
1772.90
2038.84
1629.57
1874.01
1679.30
1931.20
1647.21
1894.29
1284.90
1477.64
1043.20
1199.68
1220.22
1403.25
340.14
391.16
159.06
182.92
978.02
1124.72
146.80
168.82
478.18
549.91
1844.55
2121.23
1283.47
1475.99
889.67
1023.12
1199.19
1379.07
1641.23
1887.41
8.85
10.18
308.67
354.97
114.44
131.61
798.98
918.83
121.31
139.51
829.84
954.32
150.58
173.17
430.88
495.51
173.69
199.74
467.77
537.94
145.78
167.65
1140.25
1311.29
309.46
355.88
1092.65
1256.55
257.45
296.07
145.27
167.06
347.87
400.05
16.05
18.46
15.44
17.76
8.55
09.83
30.73
35.34
111.09
127.75
65.10
74.87
1633.62
1878.66
161.20
185.38
369.13
424.50
334.12
384.24
55.34
63.64
90.75
104.36
1712.12
1968.94
62.81
72.23
242.97
279.42
111.35
128.05
722.07
830.38
330.11
379.63
1120.24
1288.28
321.94
370.23
267.24
307.33
86.28
99.22
09/12/2011

----- -- ---- --------
NPAR FEE
--------
PAGE 017
LC FEE
--------
35450
11
515.91
490.11
563.63
35460
11
312.77
297.13
341.70
35472
N 11 1987.90
1888.51
2171.79
35475
F 11
485.25
460.99
530.14
35500
11
322.61
306.48
352.45
35508
11 1416.51
1345.68
1547.53
35511
11 1240.64
1178.61
1355.40
35516
11 1237.84
1175.95
1352.34
35522
11 1232.75
1171.11
1346.78
35526
11 1653.72
1571.03
1806.68
35535
11 1827.86
1736.47
1996.94
35538
11 2527.30
2400.94
2761.08
35548
11 1191.74
1132.15
1301.97
35556
11 1409.79
1339.30
1540.20
35563
11 1356.46
1288.64
1481.94
35570
11 1417.13
1346.27
1548.21
35583
11 1458.24
1385.33
1593.13
35600
11
255.67
242.89
279.32
35612
11
908.03
862.63
992.02
35623
11 1426.32
1355.00
1558.25
35632
11 1735.61
1648.83
1896.15
35636
11 1730.02
1643.52
1890.05
35642
11 1088.55
1034.12
1189.24
35647
11 1574.04
1495.34
1719.64
35654
11 1388.14
1318.73
1516.54
35663
11 1266.58
1203.25
1383.74
35671
11 1131.52
1074.94
1236.18
35683
11
419.10
398.15
457.87
35691
11
975.21
926.45
1065.42
35695
11 1054.34
1001.62
1151.86
35701
11
546.98
519.63
597.57
35761
11
377.35
358.48
412.25
35840
11
629.42
597.95
687.64
35875
11
598.75
568.81
654.13
35881
11 1036.66
984.83
1132.55
35901
11
504.65
479.42
551.33
35907
11 1936.78
1839.94
2115.93
36002
N 11
158.47
150.55
173.13
36005
F 11
48.07
45.67
52.52
36011
N 11
866.95
823.60
947.14
36012
F 11
176.47
167.65
192.80
36014
N 11
803.36
763.19
877.67
36015
F 11
173.68
165.00
189.75
36120
N 11
425.42
404.15
464.77
36140
F 11
102.70
97.57
112.21
36148
N 11
243.01
230.86
265.49
36160
F 11
127.67
121.29
139.48
36215
N 11 1090.75
1036.21
1191.64
36216
F 11
273.64
259.96
298.95
36218
N 11
181.90
172.81
198.73
36245
F 11
245.91
233.61
268.65
36247
N 11 1825.50
1734.23
1994.36
36248
F 11
51.19
48.63
55.92
36262
11
276.96
263.11
302.58
36405
N 11
22.70
21.57
24.81
36406
F 11
9.00
8.55
09.83
36420
11
45.56
43.28
49.77
36440
11
53.70
51.02
58.67
36460
11
340.84
323.80
372.37
36471
N 11
166.26
157.95
181.64
36475
F 11
346.68
329.35
378.75
36478
N 11 1361.09
1293.04
1487.00
36479
F 11
169.34
160.87
185.00
36500
11
177.95
169.05
194.41
36511
11
91.10
86.55
99.53
36514
N 11
485.12
460.86
529.99
36515
F 11
89.16
84.70
97.41
36522
N 11 1268.58
1205.15
1385.92
36555
F 11
119.38
113.41
130.42
36557
N 11
879.49
835.52
960.85
36558
F 11
273.46
259.79
298.76
36561
N 11 1110.61
1055.08
1213.34
36563
F 11
356.52
338.69
389.49
36566
N 11 4180.62
3971.59
4567.33
36568
F 11
93.28
88.62
101.91
36570
N 11 1061.32
1008.25
1159.49
MFI00A11
FSY-2011

----- -- ---- -------36570
36575
36576
36580
36581
36583
36584
36589
36590
36593
36596
36597
36600
36625
36680
36815
36820
36823
36831
36835
36860
36870
37160
37182
37184
37185
37187
37188
37202
37204
37206
37208
37210
37220
37222
37223
37225
37226
37228
37229
37231
37232
37234
37235
37500
37605
37609
37616
37620
37700
37735
37765
37766
37785
38100
38115
38205
38220
38230
38242
38305
38381
38500
38510
38525
38550
38564
38572
38724
38746
38765
38790
38900
39200
39501
39541
***
F
N
F
N
F
N
F
N
F
"STATE OK"
NPAR FEE
--------
M E D I C A R E
LC FEE
--------
F E E

----- -- ---- --------
11
294.07
279.37
321.28
36571
11
152.29
144.68
166.38
36575
11
187.73
178.34
205.09
36578
11
210.68
200.15
230.17
36580
11
195.04
185.29
213.08
36582
11 1150.92
1093.37
1257.38
36583
11
65.64
62.36
71.71
36585
11
159.92
151.92
174.71
36589
11
195.59
185.81
213.68
36591
11
26.68
25.35
29.15
36595
N 11
127.92
121.52
139.75
36596
F 11
60.63
57.60
66.24
36598
N 11
29.19
27.73
31.89
36600
11
103.31
98.14
112.86
36640
11
57.44
54.57
62.76
36800
11
146.51
139.18
160.06
36818
11
793.54
753.86
866.94
36821
11 1270.12
1206.61
1387.60
36825
11
450.90
428.36
492.61
36832
11
469.29
445.83
512.70
36838
F 11
103.83
98.64
113.44
36861
F 11
297.69
282.81
325.23
37140
11 1280.56
1216.53
1399.01
37180
11
843.75
801.56
921.79
37183
N 11 2249.92
2137.42
2458.03
37184
F 11
166.92
158.57
182.36
37186
N 11 2143.64
2036.46
2341.93
37187
F 11
294.46
279.74
321.70
37200
11
329.47
313.00
359.95
37203
11
896.48
851.66
979.41
37205
N 11 2427.66
2306.28
2652.22
37206
11
205.91
195.61
224.95
37209
F 11
530.18
503.67
579.22
37215
F 11
410.10
389.60
448.04
37221
N 11
850.52
807.99
929.19
37222
F 11
211.74
201.15
231.32
37224
N 11 9979.83
9480.84 10902.97
37225
F 11
508.97
483.52
556.05
37227
N 11 5035.67
4783.89
5501.47
37228
F 11
711.61
676.03
777.43
37230
N 11 12476.15 11852.34 13630.19
37231
F 11
199.64
189.66
218.11
37233
N 11 3600.07
3420.07
3933.08
37234
F 11
388.54
369.11
424.48
37250
11
681.66
647.58
744.72
37565
11
794.28
754.57
867.76
37606
N 11
288.61
274.18
315.31
37609
11 1060.24
1007.23
1158.31
37617
11
637.22
605.36
696.16
37650
11
246.89
234.55
269.73
37718
11
617.81
586.92
674.96
37760
N 11
632.87
601.23
691.41
37765
F 11
546.95
519.60
597.54
37780
F 11
255.18
242.42
278.78
37788
11 1060.56
1007.53
1158.66
38101
11 1173.49
1114.82
1282.04
38120
11
77.04
73.19
84.17
38206
F 11
58.73
55.79
64.16
38221
11
320.57
304.54
350.22
38240
11
91.88
87.29
100.38
38300
11
429.57
408.09
469.30
38308
11
770.92
732.37
842.23
38382
F 11
233.48
221.81
255.08
38505
N 11
482.10
458.00
526.70
38510
11
397.19
377.33
433.93
38530
11
458.27
435.36
500.66
38555
11
655.90
623.11
716.58
38570
11
895.47
850.70
978.31
38700
11 1380.82
1311.78
1508.55
38740
11
250.38
237.86
273.54
38747
11 1205.90
1145.61
1317.45
38770
11
79.22
75.26
86.55
38792
11
128.84
122.40
140.76
39000
11
849.79
807.30
928.40
39220
11
794.21
754.50
867.68
39503
11
881.93
837.83
963.50
39545
N
F
N
F
N
F
N
F
S C H E D U L E
NPAR FEE
--------
"ALL OF OKLAHOMA"
LC FEE
--------
11 1193.04
1133.39
1303.40
11
34.49
32.77
37.69
11
482.91
458.76
527.57
11
65.48
62.21
71.54
11 1034.95
983.20
1130.68
11
313.76
298.07
342.78
11 1040.82
988.78
1137.10
11
135.35
128.58
147.87
11
21.33
20.26
23.30
N 11
556.69
528.86
608.19
F 11
44.14
41.93
48.22
N 11
107.05
101.70
116.96
F 11
15.02
14.27
16.41
11
121.56
115.48
132.80
11
155.13
147.37
169.48
11
661.56
628.48
722.75
11
675.76
641.97
738.27
11
802.46
762.34
876.69
11
573.32
544.65
626.35
11 1149.41
1091.94
1255.73
11
147.59
140.21
161.24
11 1385.55
1316.27
1513.71
11 1431.09
1359.54
1563.47
N 11 5062.93
4809.78
5531.25
F 11
451.50
428.93
493.27
N 11 1462.53
1389.40
1597.81
F 11
411.03
390.48
449.05
11
223.70
212.52
244.40
N 11 1268.27
1204.86
1385.59
N 11 4038.67
3836.74
4412.25
F 11
212.22
201.61
231.85
11
112.68
107.05
123.11
11 1093.94
1039.24
1195.13
N 11 4352.62
4134.99
4755.24
F 11
186.26
176.95
203.49
N 11 3538.87
3361.93
3866.22
F 11
607.85
577.46
664.08
N 11 13490.72 12816.18 14738.61
F 11
551.88
524.29
602.93
N 11 7779.41
7390.44
8499.01
F 11
749.20
711.74
818.50
N 11 1384.68
1315.45
1512.77
F 11
273.77
260.08
299.09
11
108.07
102.67
118.07
11
693.52
658.84
757.67
11
495.26
470.50
541.08
F 11
196.64
186.81
214.83
11 1270.78
1207.24
1388.33
11
479.98
455.98
524.38
11
427.02
405.67
466.52
11
629.81
598.32
688.07
F 11
446.73
424.39
488.05
11
254.55
241.82
278.09
11 1337.07
1270.22
1460.75
11 1068.06
1014.66
1166.86
11
970.31
921.79
1060.06
11
77.72
73.83
84.90
N 11
154.20
146.49
168.46
11
120.38
114.36
131.51
N 11
254.57
241.84
278.12
11
416.16
395.35
454.65
11
631.64
600.06
690.07
N 11
118.32
112.40
129.26
F 11
395.17
375.41
431.72
11
506.90
481.56
553.79
11
933.94
887.24
1020.33
11
510.78
485.24
558.03
11
763.46
725.29
834.08
11
632.71
601.07
691.23
11
250.07
237.57
273.21
11
771.92
733.32
843.32
11
38.07
36.17
41.60
11
473.86
450.17
517.70
11 1098.06
1043.16
1199.63
11 5672.81
5389.17
6197.55
11
854.20
811.49
933.21
09/12/2011

----- -- ---- --------
NPAR FEE
--------
PAGE 018
LC FEE
--------
36571
F 11
307.05
291.70
335.46
36576
N 11
353.40
335.73
386.09
36578
F 11
210.15
199.64
229.59
36581
N 11
721.03
684.98
787.73
36582
F 11
297.94
283.04
325.50
36584
N 11
202.33
192.21
221.04
36585
F 11
274.21
260.50
299.58
36590
N 11
270.55
257.02
295.57
36592
11
23.85
22.66
26.06
36595
F 11
183.78
174.59
200.78
36597
N 11
119.52
113.54
130.57
36598
F 11
47.84
45.45
52.27
36620
11
49.23
46.77
53.79
36660
11
72.01
68.41
78.67
36810
11
205.99
195.69
225.04
36819
11
787.78
748.39
860.65
36822
11
369.52
351.04
403.70
36830
11
649.42
616.95
709.49
36833
11
647.89
615.50
707.83
36860
N 11
191.07
181.52
208.75
36870
N 11 1759.43
1671.46
1922.18
37145
11 1452.50
1379.88
1586.86
37181
11 1545.08
1467.83
1688.00
37183
F 11
398.98
379.03
435.88
37185
N 11
742.99
705.84
811.72
37186
F 11
254.33
241.61
277.85
37188
N 11 1807.53
1717.15
1974.72
37201
11
273.48
259.81
298.78
37203
F 11
260.40
247.38
284.49
37205
F 11
431.11
409.55
470.98
37207
11
426.07
404.77
465.49
37210
N 11 3370.18
3201.67
3681.92
37220
N 11 2945.85
2798.56
3218.34
37221
F 11
500.33
475.31
546.61
37223
N 11 2395.68
2275.90
2617.29
37224
F 11
451.93
429.33
493.73
37226
N 11 8361.59
7943.51
9135.04
37227
F 11
734.16
697.45
802.07
37229
N 11 9895.88
9401.09 10811.25
37230
F 11
689.32
654.85
753.08
37232
N 11 1132.24
1075.63
1236.97
37233
F 11
327.67
311.29
357.98
37235
N 11 3847.76
3655.37
4203.68
37251
11
80.61
76.58
88.07
37600
11
696.82
661.98
761.28
37607
11
369.89
351.40
404.11
37615
11
493.50
468.83
539.15
37618
11
373.24
354.58
407.77
37660
11 1214.89
1154.15
1327.27
37722
11
475.36
451.59
519.33
37761
11
549.53
522.05
600.36
37766
N 11
753.88
716.19
823.62
37785
N 11
342.43
325.31
374.11
37790
11
470.79
447.25
514.34
38102
11
245.47
233.20
268.18
38200
11
140.91
133.86
153.94
38220
N 11
141.88
134.79
155.01
38221
F 11
72.94
69.29
79.68
38241
11
120.24
114.23
131.36
38300
F 11
171.74
163.15
187.62
38380
11
541.27
514.21
591.34
38500
N 11
299.62
284.64
327.34
38505
F 11
69.50
66.03
75.93
38520
11
433.75
412.06
473.87
38542
11
489.41
464.94
534.68
38562
11
654.79
622.05
715.36
38571
11
779.96
740.96
852.10
38720
11 1272.83
1209.19
1390.57
38745
11
803.70
763.52
878.05
38760
11
782.43
743.31
854.81
38780
11
984.47
935.25
1075.54
38794
11
285.60
271.32
312.02
39010
11
767.07
728.72
838.03
39400
11
486.13
461.82
531.09
39540
11
814.04
773.34
889.34
39560
11
744.50
707.28
813.37
MFI00A11
FSY-2011

----- -- ---- -------39561
40500
40510
40525
40530
40652
40654
40702
40800
40801
40805
40806
40810
40812
40816
40818
40820
40830
40840
40842
40844
40845
41005
41006
41008
41009
41015
41016
41018
41100
41105
41110
41112
41114
41116
41130
41145
41155
41251
41252
41512
41530
41800
41806
41822
41825
41826
41828
41830
41874
42000
42104
42106
42120
42145
42180
42182
42210
42225
42235
42280
42281
42305
42320
42330
42340
42400
42408
42409
42420
42440
42500
42505
42509
42550
42650
***
"STATE OK"
NPAR FEE
--------
M E D I C A R E
LC FEE
--------
F E E
S C H E D U L E

----- -- ---- --------
11 1168.97
1110.52
1277.10
40490
N 11
471.09
447.54
514.67
40500
F 11
338.06
321.16
369.33
40520
11
527.47
501.10
576.27
40527
F 11
386.42
367.10
422.17
40650
N 11
451.94
429.34
493.74
40652
F 11
402.98
382.83
440.25
40700
11
796.29
756.48
869.95
40720
N 11
190.46
180.94
208.08
40800
F 11
208.34
197.92
227.61
40804
N 11
299.94
284.94
327.68
40805
F 11
29.40
27.93
32.12
40808
N 11
189.52
180.04
207.05
40810
F 11
185.23
175.97
202.37
40814
N 11
374.28
355.57
408.91
40816
F 11
255.45
242.68
279.08
40819
N 11
244.91
232.66
267.56
40820
F 11
150.48
142.96
164.40
40831
N 11
780.94
741.89
853.17
40840
F 11
598.26
568.35
653.60
40843
N 11 1306.02
1240.72
1426.83
40844
F 11 1179.52
1120.54
1288.62
41000
N 11
206.90
196.56
226.04
41005
F 11
247.78
235.39
270.70
41007
N 11
346.49
329.17
378.55
41008
F 11
275.26
261.50
300.73
41010
N 11
404.65
384.42
442.08
41015
F 11
328.62
312.19
359.02
41017
N 11
462.24
439.13
505.00
41018
N 11
157.37
149.50
171.93
41100
F 11
106.47
101.15
116.32
41108
N 11
197.55
187.67
215.82
41110
F 11
238.45
226.53
260.51
41113
11
606.66
576.33
662.78
41115
N 11
305.66
290.38
333.94
41116
11 1237.96
1176.06
1352.47
41135
11 2635.66
2503.88
2879.46
41150
11 2836.66
2694.83
3099.05
41250
N 11
234.64
222.91
256.35
41251
F 11
201.74
191.65
220.40
41500
11
591.97
562.37
646.73
41520
N 11 2995.90
2846.11
3273.03
41530
F 11
128.80
122.36
140.71
41805
N 11
330.41
313.89
360.97
41806
F 11
169.27
160.81
184.93
41823
N 11
193.25
183.59
211.13
41825
F 11
195.72
185.93
213.82
41827
N 11
281.56
267.48
307.60
41828
F 11
264.57
251.34
289.04
41872
N 11
340.90
323.86
372.44
41874
F 11
98.48
93.56
107.59
42100
N 11
198.41
188.49
216.76
42104
F 11
169.42
160.95
185.09
42107
11
941.75
894.66
1028.86
42140
11
675.75
641.96
738.25
42160
N 11
220.15
209.14
240.51
42180
F 11
250.06
237.56
273.19
42200
11
996.64
946.81
1088.83
42215
11
867.85
824.46
948.13
42226
11
704.14
668.93
769.27
42260
N 11
151.85
144.26
165.90
42280
F 11
145.33
138.06
158.77
42300
11
412.90
392.26
451.10
42310
N 11
236.01
224.21
257.84
42320
F 11
158.27
150.36
172.91
42335
N 11
437.58
415.70
478.06
42340
F 11
54.15
51.44
59.16
42405
N 11
429.65
408.17
469.40
42408
F 11
214.08
203.38
233.89
42410
11 1227.79
1166.40
1341.36
42425
11
449.11
426.65
490.65
42450
N 11
408.58
388.15
446.37
42500
F 11
435.80
414.01
476.11
42507
11
780.82
741.78
853.05
42510
F 11
61.36
58.29
67.03
42600
N 11
78.52
74.59
85.78
42650
N 11
121.15
F 11
345.42
N 11
460.79
11
607.01
N 11
387.66
F 11
332.57
11
916.95
11
930.26
F 11
121.49
N 11
195.53
F 11
213.32
N 11
170.60
F 11
120.23
N 11
355.74
F 11
299.95
N 11
282.73
F 11
162.07
N 11
303.82
F 11
612.12
N 11
994.06
F 11 1098.46
N 11
150.13
F 11
120.60
N 11
334.45
F 11
253.26
N 11
190.51
F 11
321.19
N 11
408.30
F 11
380.35
F 11
103.83
N 11
136.94
F 11
125.74
N 11
338.05
N 11
226.69
F 11
208.65
11 2053.48
11 2085.29
N 11
223.09
F 11
157.48
11
425.01
N 11
323.03
F 11
387.39
N 11
222.55
F 11
246.63
N 11
396.04
F 11
117.98
N 11
402.72
F 11
202.19
N 11
341.46
F 11
238.85
N 11
140.08
F 11
131.64
N 11
429.17
N 11
237.18
N 11
221.08
F 11
169.44
11
829.99
11
678.94
11
870.57
N 11
777.42
F 11
104.61
N 11
196.89
N 11
152.95
F 11
169.56
N 11
350.95
F 11
323.88
N 11
282.74
F 11
315.32
11
596.72
11
809.41
N 11
427.92
F 11
327.63
11
492.95
11
605.33
N 11
457.08
F 11
56.47
and descriptors
NPAR FEE
--------
"ALL OF OKLAHOMA"
LC FEE
--------
115.09
132.35
328.15
377.37
437.75
503.41
576.66
663.16
368.28
423.52
315.94
363.33
871.10
1001.77
883.75
1016.31
115.42
132.73
185.75
213.61
202.65
233.05
162.07
186.38
114.22
131.35
337.95
388.64
284.95
327.69
268.59
308.88
153.97
177.07
288.63
331.92
581.51
668.74
944.36
1086.01
1043.54
1200.07
142.62
164.01
114.57
131.76
317.73
365.39
240.60
276.69
180.98
208.13
305.13
350.90
387.89
446.07
361.33
415.53
98.64
113.44
130.09
149.60
119.45
137.37
321.15
369.32
215.36
247.66
198.22
227.95
1950.81
2243.43
1981.03
2278.18
211.94
243.73
149.61
172.05
403.76
464.32
306.88
352.91
368.02
423.22
211.42
243.13
234.30
269.45
376.24
432.68
112.08
128.89
382.58
439.97
192.08
220.89
324.39
373.05
226.91
260.95
133.08
153.04
125.06
143.82
407.71
468.87
225.32
259.12
210.03
241.53
160.97
185.12
788.49
906.76
644.99
741.74
827.04
951.10
738.55
849.33
99.38
114.29
187.05
215.11
145.30
167.10
161.08
185.24
333.40
383.41
307.69
353.84
268.60
308.89
299.55
344.48
566.88
651.91
768.94
884.28
406.52
467.50
311.25
357.94
468.30
538.55
575.06
661.32
434.23
499.36
53.65
61.70
09/12/2011

----- -- ---- --------
NPAR FEE
--------
PAGE 019
LC FEE
--------
40490
F 11
71.38
67.81
77.98
40510
N 11
451.45
428.88
493.21
40520
F 11
341.42
324.35
373.00
40530
N 11
508.94
483.49
556.01
40650
F 11
273.01
259.36
298.26
40654
N 11
532.43
505.81
581.68
40701
11 1061.71
1008.62
1159.91
40761
11 1033.80
982.11
1129.43
40801
N 11
288.66
274.23
315.36
40804
F 11
122.78
116.64
134.14
40806
N 11
97.43
92.56
106.44
40808
F 11
101.30
96.24
110.68
40812
N 11
263.97
250.77
288.39
40814
F 11
286.76
272.42
313.28
40818
N 11
328.21
311.80
358.57
40819
F 11
220.05
209.05
240.41
40830
N 11
228.27
216.86
249.39
40831
F 11
210.60
200.07
230.08
40842
N 11
749.13
711.67
818.42
40843
F 11
777.99
739.09
849.95
40845
N 11 1385.19
1315.93
1513.32
41000
F 11
105.72
100.43
115.49
41006
N 11
335.34
318.57
366.36
41007
F 11
236.50
224.68
258.38
41009
N 11
368.81
350.37
402.93
41010
F 11
104.21
99.00
113.85
41016
N 11
404.84
384.60
442.29
41017
F 11
329.88
313.39
360.40
41019
11
451.25
428.69
492.99
41105
N 11
159.07
151.12
173.79
41108
F 11
85.92
81.62
93.86
41112
N 11
309.63
294.15
338.27
41113
F 11
263.72
250.53
288.11
41115
F 11
141.97
134.87
155.10
41120
11
998.38
948.46
1090.73
41140
11 2091.88
1987.29
2285.38
41153
11 2267.95
2154.55
2477.73
41250
F 11
138.05
131.15
150.82
41252
N 11
290.56
276.03
317.43
41510
11
359.21
341.25
392.44
41520
F 11
240.83
228.79
263.11
41800
N 11
226.43
215.11
247.38
41805
F 11
157.35
149.48
171.90
41822
N 11
266.59
253.26
291.25
41823
F 11
303.13
287.97
331.17
41826
N 11
277.93
264.03
303.63
41827
F 11
289.02
274.57
315.76
41830
N 11
359.69
341.71
392.97
41872
F 11
251.38
238.81
274.63
42000
N 11
146.35
139.03
159.88
42100
F 11
103.85
98.66
113.46
42106
N 11
249.42
236.95
272.49
42107
F 11
328.38
311.96
358.75
42140
F 11
148.67
141.24
162.43
42160
F 11
142.97
135.82
156.19
42182
N 11
306.75
291.41
335.12
42205
11
908.88
863.44
992.96
42220
11
504.43
479.21
551.09
42227
11
831.46
789.89
908.37
42260
F 11
639.78
607.79
698.96
42281
N 11
192.57
182.94
210.38
42300
F 11
146.18
138.87
159.70
42310
F 11
119.56
113.58
130.62
42330
N 11
219.06
208.11
239.33
42335
F 11
247.32
234.95
270.19
42400
N 11
101.08
96.03
110.43
42405
F 11
216.91
206.06
236.97
42409
N 11
313.29
297.63
342.27
42415
11 1071.77
1018.18
1170.91
42426
11 1310.01
1244.51
1431.19
42450
F 11
344.14
326.93
375.97
42505
N 11
526.51
500.18
575.21
42508
11
676.64
642.81
739.23
42550
N 11
131.28
124.72
143.43
42600
F 11
338.03
321.13
369.30
42660
N 11
100.48
95.46
109.78
MFI00A11
FSY-2011

----- -- ---- -------42660
42700
42720
42800
42804
42806
42809
42810
42821
42830
42836
42845
42890
42900
42955
42962
42972
43045
43107
43113
43118
43123
43135
43201
43202
43215
43217
43220
43228
43234
43235
43237
43239
43242
43245
43248
43251
43257
43260
43263
43267
43271
43279
43282
43305
43313
43325
43330
43333
43336
43340
43351
43361
43405
43420
43450
43456
43458
43501
43520
43611
43622
43633
43640
43645
43652
43753
43755
43756
43760
43761
43772
43800
43825
43832
43845
***
F
N
F
F
N
F
N
F
"STATE OK"
NPAR FEE
--------
M E D I C A R E
LC FEE
--------
F E E
S C H E D U L E

----- -- ---- --------
11
74.66
70.93
81.57
42665
11
178.20
169.29
194.68
42700
11
379.77
360.78
414.90
42725
11
107.97
102.57
117.96
42802
11
187.95
178.55
205.33
42804
11
128.43
122.01
140.31
42808
11
161.01
152.96
175.90
42809
11
275.60
261.82
301.09
42815
11
291.61
277.03
318.58
42825
11
199.21
189.25
217.64
42831
11
232.55
220.92
254.06
42842
11 2131.96
2025.36
2329.16
42860
11 1344.90
1277.66
1469.31
42892
11
328.78
312.34
359.19
42950
11
714.22
678.51
780.29
42960
11
499.54
474.56
545.74
42970
11
493.77
469.08
539.44
43020
11 1249.42
1186.95
1364.99
43100
11 2421.84
2300.75
2645.86
43108
11 4257.58
4044.70
4651.41
43116
11 3525.13
3348.87
3851.20
43121
11 4354.18
4136.47
4756.94
43124
11 1423.06
1351.91
1554.70
43200
N 11
277.54
263.66
303.21
43201
F 11
110.83
105.29
121.08
43204
11
148.71
141.27
162.46
43216
N 11
355.37
337.60
388.24
43217
11
122.51
116.38
133.84
43226
11
215.22
204.46
235.13
43231
N 11
262.82
249.68
287.13
43234
F 11
140.03
133.03
152.98
43236
11
227.65
216.27
248.71
43238
F 11
165.36
157.09
180.65
43240
11
409.66
389.18
447.56
43243
11
181.49
172.42
198.28
43246
11
182.17
173.06
199.02
43249
11
210.58
200.05
230.06
43255
11
307.79
292.40
336.26
43258
11
335.38
318.61
366.40
43261
11
408.35
387.93
446.12
43264
11
412.60
391.97
450.77
43268
11
413.86
393.17
452.15
43272
11 1203.46
1143.29
1314.78
43280
11 1659.80
1576.81
1813.33
43283
11 1058.82
1005.88
1156.76
43310
11 2647.59
2515.21
2892.49
43314
11 1241.76
1179.67
1356.62
43327
11 1222.91
1161.76
1336.02
43331
11 1204.52
1144.29
1315.93
43334
11 1434.24
1362.53
1566.91
43337
11 1276.14
1212.33
1394.18
43341
11 1250.44
1187.92
1366.11
43352
11 2430.16
2308.65
2654.95
43400
11 1417.93
1347.03
1549.08
43410
11
971.90
923.31
1061.81
43425
F 11
85.92
81.62
93.86
43453
N 11
559.61
531.63
611.37
43456
F 11
175.33
166.56
191.54
43460
11 1240.62
1178.59
1355.38
43502
11
645.94
613.64
705.69
43605
11 1126.53
1070.20
1230.73
43620
11 2125.71
2019.42
2322.33
43631
11 1767.77
1679.38
1931.29
43634
11 1085.75
1031.46
1186.18
43641
11 1713.44
1627.77
1871.94
43647
11
701.10
666.05
765.96
43653
11
20.07
19.07
21.93
43754
N 11
113.13
107.47
123.59
43755
F 11
49.66
47.18
54.26
43757
N 11
375.50
356.73
410.24
43760
F 11
101.17
96.11
110.53
43770
11
883.10
838.95
964.79
43773
11
857.99
815.09
937.35
43810
11 1203.22
1143.06
1314.52
43830
11
974.08
925.38
1064.19
43840
11 1807.33
1716.96
1974.50
43846
N 11
294.59
F 11
130.33
11
780.73
N 11
223.13
F 11
109.84
N 11
215.82
F 11
125.10
11
533.44
11
252.44
11
214.63
11
944.47
11
180.73
11 1775.92
11
756.74
11
162.89
11
378.47
11
511.67
11
601.52
11 4315.79
11 4923.96
11 2727.18
11 3729.22
N 11
203.20
F 11
124.46
11
214.27
N 11
195.98
F 11
164.51
11
136.44
11
183.89
F 11
116.04
N 11
345.95
11
284.04
11
383.46
11
258.62
11
242.82
11
167.95
11
273.16
11
257.94
11
352.49
11
497.27
11
419.53
11
414.18
11 1002.59
11
154.22
11 1434.72
11 2752.46
11
774.08
11 1295.90
11 1217.68
11 1565.23
11 1397.15
11 1023.43
11 1447.40
11
979.27
11 1426.28
N 11
276.71
F 11
149.53
11
213.84
11 1404.49
11
773.48
11 1824.84
11 1340.60
11 1954.92
11 1100.93
11
415.36
11
520.25
N 11
73.84
F 11
55.18
N 11
262.59
F 11
47.31
11 1028.83
11 1172.32
11
934.11
11
641.22
11 1245.25
11 1506.36
and descriptors
NPAR FEE
--------
"ALL OF OKLAHOMA"
LC FEE
--------
279.86
321.84
123.81
142.38
741.69
852.94
211.97
243.77
104.35
120.00
205.03
235.78
118.85
136.68
506.77
582.79
239.82
275.79
203.90
234.49
897.25
1031.84
171.69
197.44
1687.12
1940.19
718.90
826.74
154.75
177.96
359.55
413.48
486.09
559.00
571.44
657.16
4100.00
4715.00
4677.76
5379.42
2590.82
2979.44
3542.76
4074.17
193.04
222.00
118.24
135.98
203.56
234.09
186.18
214.11
156.28
179.72
129.62
149.06
174.70
200.91
110.24
126.78
328.65
377.95
269.84
310.32
364.29
418.93
245.69
282.54
230.68
265.28
159.55
183.48
259.50
298.43
245.04
281.80
334.87
385.10
472.41
543.27
398.55
458.33
393.47
452.49
952.46
1095.33
146.51
168.49
1362.98
1567.43
2614.84
3007.07
735.38
845.69
1231.11
1415.78
1156.80
1330.32
1486.97
1710.02
1327.29
1526.38
972.26
1118.10
1375.03
1581.28
930.31
1069.86
1354.97
1558.22
262.87
302.30
142.05
163.36
203.15
233.62
1334.27
1534.41
734.81
845.03
1733.60
1993.64
1273.57
1464.61
1857.17
2135.75
1045.88
1202.76
394.59
453.78
494.24
568.38
70.15
80.67
52.42
60.28
249.46
286.88
44.94
51.68
977.39
1124.00
1113.70
1280.76
887.40
1020.51
609.16
700.53
1182.99
1360.44
1431.04
1645.70
09/12/2011

----- -- ---- --------
NPAR FEE
--------
PAGE 020
LC FEE
--------
42665
F 11
199.16
189.20
217.58
42720
N 11
434.89
413.15
475.12
42800
N 11
149.86
142.37
163.73
42802
F 11
129.59
123.11
141.58
42806
N 11
211.26
200.70
230.81
42808
F 11
157.24
149.38
171.79
42810
N 11
366.62
348.29
400.53
42820
11
280.19
266.18
306.11
42826
11
242.53
230.40
264.96
42835
11
171.48
162.91
187.35
42844
11 1308.77
1243.33
1429.83
42870
11
550.82
523.28
601.77
42894
11 2253.25
2140.59
2461.68
42953
11
918.82
872.88
1003.81
42961
11
404.81
384.57
442.26
42971
11
440.88
418.84
481.67
43030
11
500.98
475.93
547.32
43101
11
966.29
917.98
1055.68
43112
11 2568.03
2439.63
2805.57
43117
11 2355.33
2237.56
2573.19
43122
11 2399.59
2279.61
2621.55
43130
11
756.13
718.32
826.07
43200
F 11
100.53
95.50
109.83
43202
N 11
265.47
252.20
290.03
43205
11
216.47
205.65
236.50
43216
F 11
138.34
131.42
151.13
43219
11
164.97
156.72
180.23
43227
11
202.95
192.80
221.72
43232
11
253.27
240.61
276.70
43235
N 11
278.93
264.98
304.73
43236
F 11
169.57
161.09
185.25
43239
N 11
323.47
307.30
353.40
43241
11
150.12
142.61
164.00
43244
11
285.84
271.55
312.28
43247
11
193.47
183.80
211.37
43250
11
182.00
172.90
198.84
43256
11
246.11
233.80
268.87
43259
11
293.91
279.21
321.09
43262
11
414.18
393.47
452.49
43265
11
557.76
529.87
609.35
43269
11
458.95
436.00
501.40
43273
11
123.95
117.75
135.41
43281
11 1476.91
1403.06
1613.52
43300
11
591.60
562.02
646.32
43312
11 1565.01
1486.76
1709.77
43320
11 1299.86
1234.87
1420.10
43328
11 1130.79
1074.25
1235.39
43332
11 1109.00
1053.55
1211.58
43335
11 1312.28
1246.67
1433.67
43338
11
127.43
121.06
139.22
43350
11 1146.73
1089.39
1252.80
43360
11 2173.95
2065.25
2375.04
43401
11 1417.19
1346.33
1548.28
43415
11 1625.64
1544.36
1776.01
43450
N 11
147.65
140.27
161.31
43453
F 11
92.77
88.13
101.35
43458
N 11
364.31
346.09
398.00
43500
11
723.74
687.55
790.68
43510
11
889.11
844.65
971.35
43610
11
904.61
859.38
988.29
43621
11 2096.40
1991.58
2290.32
43632
11 1865.77
1772.48
2038.35
43635
11
104.76
99.52
114.45
43644
11 1603.39
1523.22
1751.70
43651
11
599.09
569.14
654.51
43752
11
39.74
37.75
43.41
43754
F 11
30.06
28.56
32.84
43756
N 11
203.68
193.50
222.53
43757
F 11
72.04
68.44
78.71
43761
N 11
114.71
108.97
125.32
43771
11 1172.32
1113.70
1280.76
43774
11
885.77
841.48
967.70
43820
11 1228.65
1167.22
1342.30
43831
11
541.06
514.01
591.11
43843
11 1174.55
1115.82
1283.19
43847
11 1653.65
1570.97
1806.62
MFI00A11
FSY-2011

----- -- ---- -------43848
43860
43880
43888
44015
44025
44100
44120
44126
44130
44141
44145
44150
44156
44160
44187
44203
44206
44210
44213
44310
44316
44340
44360
44364
44369
44373
44378
44382
44385
44388
44389
44391
44392
44394
44500
44604
44620
44640
44661
44701
44800
44900
44950
44970
45005
45108
45112
45116
45121
45130
45150
45172
45300
45305
45307
45309
45315
45320
45327
45331
45332
45334
45337
45339
45340
45345
45378
45379
45380
45382
45383
45385
45386
45392
45400
***
"STATE OK"
NPAR FEE
--------
M E D I C A R E
LC FEE
--------
F E E
S C H E D U L E

----- -- ---- --------
11 1783.39
1694.22
1948.35
43850
11 1511.26
1435.70
1651.06
43865
11 1475.48
1401.71
1611.97
43886
11
417.29
396.43
455.89
44005
11
134.23
127.52
146.65
44020
11
911.59
866.01
995.91
44050
11
109.69
104.21
119.84
44110
11 1128.94
1072.49
1233.36
44121
11 2270.24
2156.73
2480.24
44127
11 1204.15
1143.94
1315.53
44139
11 1673.98
1590.28
1828.82
44143
11 1540.40
1463.38
1682.89
44146
11 1720.52
1634.49
1879.66
44151
11 2120.01
2014.01
2316.11
44157
11 1147.05
1089.70
1253.16
44180
11 1018.46
967.54
1112.67
44188
11
226.55
215.22
247.50
44204
11 1628.11
1546.70
1778.71
44207
11 1663.15
1579.99
1816.99
44211
11
177.34
168.47
193.74
44227
11
966.29
917.98
1055.68
44312
11 1299.71
1234.72
1419.93
44320
11
567.93
539.53
620.46
44345
11
152.10
144.50
166.18
44361
11
213.69
203.01
233.46
44365
11
256.87
244.03
280.63
44370
11
198.38
188.46
216.73
44376
11
399.08
379.13
436.00
44379
11
79.52
75.54
86.87
44383
F 11
101.78
96.69
111.19
44386
N 11
326.55
310.22
356.75
44388
F 11
177.99
169.09
194.45
44390
N 11
476.85
453.01
520.96
44391
F 11
210.58
200.05
230.06
44393
N 11
473.62
449.94
517.43
44394
11
23.86
22.67
26.07
44602
11
978.67
929.74
1069.20
44605
11
800.47
760.45
874.52
44625
11 1301.59
1236.51
1421.99
44650
11 1454.66
1381.93
1589.22
44680
11
156.89
149.05
171.41
44720
11
702.21
667.10
767.17
44820
11
710.58
675.05
776.31
44901
11
592.41
562.79
647.21
44955
11
549.61
522.13
600.45
45000
F 11
143.12
135.96
156.35
45020
11
332.04
315.44
362.76
45110
11 1755.40
1667.63
1917.77
45113
11 1464.23
1391.02
1599.67
45119
11 1596.87
1517.03
1744.58
45123
11 1007.32
956.95
1100.49
45135
11
366.35
348.03
400.23
45160
11
770.38
731.86
841.64
45190
F 11
48.81
46.37
53.33
45303
N 11
169.92
161.42
185.63
45305
F 11
94.57
89.84
103.32
45308
N 11
191.29
181.73
208.99
45309
F 11
102.38
97.26
111.85
45317
N 11
198.88
188.94
217.28
45320
11
118.79
112.85
129.78
45330
N 11
160.34
152.32
175.17
45331
F 11
105.85
100.56
115.64
45333
11
158.02
150.12
172.64
45335
11
136.41
129.59
149.03
45338
N 11
313.85
298.16
342.88
45339
F 11
111.05
105.50
121.33
45341
11
168.14
159.73
183.69
45355
F 11
208.75
198.31
228.06
45378 53
N 11
473.38
449.71
517.17
45379
F 11
250.51
237.98
273.68
45381
N 11
580.96
551.91
634.70
45382
F 11
323.16
307.00
353.05
45384
N 11
500.36
475.34
546.64
45385
F 11
256.10
243.30
279.80
45387
11
366.72
348.38
400.64
45395
11 1068.19
1014.78
1167.00
45402
11 1497.58
11 1576.01
11
325.42
11 1010.50
11
896.96
11
861.65
11
782.83
11
226.49
11 2629.92
11
113.52
11 1538.06
11 1953.16
11 1970.25
11 2004.63
11
850.93
11 1128.61
11 1428.86
11 1700.38
11 2067.81
11 1549.01
11
549.62
11 1108.79
11
971.22
11
167.33
11
190.72
11
277.38
11
293.45
11
422.88
11
163.48
N 11
325.54
F 11
159.30
N 11
435.16
F 11
242.52
N 11
475.92
F 11
246.85
11 1297.90
11 1210.06
11
944.03
11 1347.74
11
989.10
11
244.63
11
775.11
N 11
879.65
11
78.58
11
387.56
11
516.43
11 1713.15
11 1825.86
11 1809.94
11 1031.81
11 1255.63
11
927.72
11
629.82
N 11
815.32
F 11
73.23
N 11
179.48
F 11
87.67
N 11
204.93
F 11
101.56
N 11
128.72
F 11
72.47
N 11
270.26
N 11
235.95
N 11
296.93
F 11
179.68
11
151.49
11
195.07
N 11
128.72
F 11
261.41
N 11
431.69
F 11
319.85
N 11
439.30
F 11
297.21
11
332.96
11 1845.18
11 1422.26
and descriptors
NPAR FEE
--------
"ALL OF OKLAHOMA"
LC FEE
--------
1422.70
1636.11
1497.21
1721.79
309.15
355.52
959.98
1103.98
852.11
979.93
818.57
941.36
743.69
855.24
215.17
247.45
2498.42
2873.18
107.84
124.02
1461.16
1680.33
1855.50
2133.83
1871.74
2152.50
1904.40
2190.06
808.38
929.64
1072.18
1233.01
1357.42
1561.03
1615.36
1857.66
1964.42
2259.08
1471.56
1692.29
522.14
600.46
1053.35
1211.35
922.66
1061.06
158.96
182.80
181.18
208.36
263.51
303.04
278.78
320.60
401.74
462.00
155.31
178.61
309.26
355.65
151.34
174.04
413.40
475.41
230.39
264.95
452.12
519.94
234.51
269.69
1233.01
1417.96
1149.56
1321.99
896.83
1031.35
1280.35
1472.40
939.65
1080.60
232.40
267.26
736.35
846.80
835.67
961.02
74.65
85.85
368.18
423.41
490.61
564.20
1627.49
1871.61
1734.57
1994.76
1719.44
1977.36
980.22
1127.25
1192.85
1371.78
881.33
1013.53
598.33
688.08
774.55
890.73
69.57
80.01
170.51
196.09
83.29
95.78
194.68
223.88
96.48
110.95
122.28
140.62
68.85
79.18
256.75
295.26
224.15
257.77
282.08
324.39
170.70
196.31
143.92
165.51
185.32
213.12
122.28
140.62
248.34
285.59
410.11
471.63
303.86
349.44
417.34
479.94
282.35
324.70
316.31
363.76
1752.92
2015.86
1351.15
1553.82
09/12/2011

----- -- ---- --------
NPAR FEE
--------
PAGE 021
LC FEE
--------
43855
11 1558.49
1480.57
1702.66
43870
11
653.92
621.22
714.40
43887
11
295.40
280.63
322.72
44010
11
798.48
758.56
872.34
44021
11
906.28
860.97
990.12
44055
11 1381.47
1312.40
1509.26
44111
11
909.32
863.85
993.43
44125
11 1091.76
1037.17
1192.75
44128
11
227.49
216.12
248.54
44140
11 1239.93
1177.93
1354.62
44144
11 1630.83
1549.29
1781.68
44147
11 1785.85
1696.56
1951.04
44155
11 1919.26
1823.30
2096.80
44158
11 2052.22
1949.61
2242.05
44186
11
602.66
572.53
658.41
44202
11 1282.92
1218.77
1401.59
44205
11 1244.24
1182.03
1359.33
44208
11 1848.48
1756.06
2019.47
44212
11 1909.74
1814.25
2086.39
44300
11
777.30
738.44
849.21
44314
11
935.30
888.54
1021.82
44322
11
902.51
857.38
985.99
44346
11 1091.48
1036.91
1192.45
44363
11
199.41
189.44
217.86
44366
11
251.33
238.76
274.57
44372
11
246.49
234.17
269.30
44377
11
310.81
295.27
339.56
44380
11
65.64
62.36
71.71
44385
N 11
236.90
225.06
258.82
44386
F 11
120.81
114.77
131.99
44389
N 11
373.90
355.21
408.49
44390
F 11
215.31
204.54
235.22
44392
N 11
410.27
389.76
448.22
44393
F 11
268.05
254.65
292.85
44397
11
265.90
252.61
290.50
44603
11 1489.35
1414.88
1627.11
44615
11
996.54
946.71
1088.72
44626
11 1490.18
1415.67
1628.02
44660
11 1274.32
1210.60
1392.19
44700
11
945.42
898.15
1032.87
44721
11
360.54
342.51
393.89
44850
11
688.43
654.01
752.11
44901
F 11
165.94
157.64
181.29
44960
11
804.77
764.53
879.21
45005
N 11
236.67
224.84
258.57
45100
11
270.53
257.00
295.55
45111
11 1007.18
956.82
1100.34
45114
11 1669.30
1585.84
1823.72
45120
11 1461.55
1388.47
1596.74
45126
11 2689.93
2555.43
2938.74
45136
11 1686.28
1601.97
1842.27
45171
11
563.57
535.39
615.70
45300
N 11
106.14
100.83
115.95
45303
F 11
83.98
79.78
91.75
45307
N 11
190.95
181.40
208.61
45308
F 11
80.27
76.26
87.70
45315
N 11
211.99
201.39
231.60
45317
F 11
109.18
103.72
119.28
45321
11
100.68
95.65
110.00
45330
F 11
59.75
56.76
65.27
45332
N 11
267.43
254.06
292.17
45333
F 11
105.54
100.26
115.30
45335
F 11
88.24
83.83
96.40
45338
F 11
135.99
129.19
148.57
45340
N 11
423.50
402.33
462.68
45342
11
231.28
219.72
252.68
45378
N 11
370.95
352.40
405.26
45378 53 F 11
59.75
56.76
65.27
45380
N 11
443.59
421.41
484.62
45381
F 11
237.67
225.79
259.66
45383
N 11
533.23
506.57
582.56
45384
F 11
261.03
247.98
285.18
45386
N 11
617.99
587.09
675.15
45391
11
285.96
271.66
312.41
45397
11 1996.28
1896.47
2180.94
45500
11
476.68
452.85
520.78
MFI00A11
FSY-2011

----- -- ---- -------45505
45540
45560
45800
45825
45910
45990
46030
46040
46050
46080
46083
46220
46221
46250
46255
46260
46270
46275
46285
46320
46505
46600
46606
46608
46611
46612
46615
46705
46710
46716
46740
46746
46751
46754
46762
46910
46916
46922
46924
46940
46942
46946
47000
47010
47100
47125
47136
47142
47147
47360
47370
47381
47400
47460
47500
47511
47530
47552
47555
47561
47564
47605
47620
47701
47715
47740
47765
47800
47900
48020
48102
48140
48148
48153
48400
***
"STATE OK"
NPAR FEE
--------
M E D I C A R E
LC FEE
--------
F E E
S C H E D U L E

----- -- ---- --------
11
532.01
505.41
581.22
45520
11
980.64
931.61
1071.35
45541
11
656.96
624.11
717.73
45562
11 1129.24
1072.78
1233.70
45805
11 1353.64
1285.96
1478.85
45900
11
181.16
172.10
197.92
45915
11
100.35
95.33
109.63
46020
N 11
121.75
115.66
133.01
46030
F 11
371.75
353.16
406.13
46045
F 11
87.60
83.22
95.70
46060
N 11
218.68
207.75
238.91
46080
F 11
98.20
93.29
107.28
46200
N 11
179.65
170.67
196.27
46220
F 11
171.42
162.85
187.28
46230
N 11
404.67
384.44
442.11
46250
F 11
319.63
303.65
349.20
46257
11
427.38
406.01
466.91
46261
N 11
443.05
420.90
484.04
46270
F 11
369.64
351.16
403.83
46280
F 11
367.10
348.75
401.06
46288
F 11
100.99
95.94
110.33
46500
N 11
255.98
243.18
279.66
46505
F 11
36.57
34.74
39.95
46604
N 11
197.83
187.94
216.13
46606
F 11
74.84
71.10
81.77
46610
N 11
157.13
149.27
171.66
46611
F 11
88.27
83.86
96.44
46614
N 11
131.91
125.31
144.11
46615
11
452.96
430.31
494.86
46706
11 1005.24
954.98
1098.23
46712
11 1079.33
1025.36
1179.16
46730
11 1952.85
1855.21
2133.49
46742
11 3385.58
3216.30
3698.75
46748
11
568.78
540.34
621.39
46753
F 11
206.65
196.32
225.77
46760
11
848.56
806.13
927.05
46900
N 11
220.05
209.05
240.41
46910
F 11
135.30
128.54
147.82
46917
N 11
232.24
220.63
253.72
46922
F 11
170.30
161.79
186.06
46930
N 11
200.72
190.68
219.28
46940
F 11
121.00
114.95
132.19
46945
N 11
275.77
261.98
301.28
46946
N 11
322.66
306.53
352.51
47000
11 1105.64
1050.36
1207.91
47011
11
772.09
733.49
843.51
47120
11 2844.54
2702.31
3107.66
47130
11 3841.06
3649.01
4196.36
47140
11 4335.45
4118.68
4736.48
47143
11
358.82
340.88
392.01
47300
11 1727.05
1640.70
1886.81
47361
11 1144.97
1087.72
1250.88
47371
11 1329.54
1263.06
1452.52
47382
11 1986.96
1887.61
2170.75
47420
11 1176.35
1117.53
1285.16
47480
11
96.67
91.84
105.62
47505
11
573.75
545.06
626.82
47525
N 11 1352.06
1284.46
1477.13
47530
11
311.21
295.65
340.00
47553
11
371.29
352.73
405.64
47556
11
274.12
260.41
299.47
47562
11
796.91
757.06
870.62
47570
11
903.29
858.13
986.85
47610
11 1269.69
1206.21
1387.14
47630
11 1623.79
1542.60
1773.99
47711
11 1217.85
1156.96
1330.50
47720
11 1200.75
1140.71
1311.82
47741
11 2775.32
2636.55
3032.03
47780
11 1455.35
1382.58
1589.97
47801
11 1255.55
1192.77
1371.69
48000
11 1081.47
1027.40
1181.51
48100
F 11
240.27
228.26
262.50
48105
11 1441.32
1369.25
1574.64
48145
11 1143.85
1086.66
1249.66
48150
11 2863.67
2720.49
3128.56
48154
11
99.95
94.95
109.19
48500
N 11
128.00
11
853.05
11 1030.32
11 1335.16
11
184.28
N 11
291.26
N 11
242.43
F 11
82.07
11
387.69
11
425.38
F 11
146.56
N 11
378.54
F 11
107.84
N 11
241.06
F 11
283.41
11
378.44
11
478.65
F 11
348.25
11
419.88
11
493.47
N 11
201.67
F 11
216.93
N 11
507.31
F 11
70.58
N 11
200.77
F 11
76.18
N 11
115.28
F 11
88.13
11
153.58
11 1924.57
11 1671.24
11 2279.91
11 3601.31
11
534.27
11
999.66
N 11
211.89
F 11
122.73
N 11
413.84
F 11
123.27
N 11
190.39
F 11
135.21
N 11
264.22
F 11
203.96
F 11
94.63
11
181.86
11 2148.38
11 3054.14
11 3283.12
11
203.55
11 1039.94
11 2797.08
11 1165.41
N 11 4318.11
11 1235.76
11
796.03
11
37.18
N 11
479.45
F 11
347.97
11
312.29
11
420.86
11
685.71
11
712.81
11 1156.18
11
534.67
11 1437.05
11 1050.80
11 1354.70
11 2267.18
11
979.91
11 1718.41
11
816.79
11 2636.37
11 1501.64
11 2867.72
11 2671.15
11 1051.07
and descriptors
NPAR FEE
--------
"ALL OF OKLAHOMA"
LC FEE
--------
121.60
139.84
810.40
931.96
978.80
1125.62
1268.40
1458.66
175.07
201.33
276.70
318.21
230.31
264.86
77.97
89.67
368.31
423.56
404.11
464.73
139.23
160.11
359.61
413.55
102.45
117.82
229.01
263.36
269.24
309.63
359.52
413.45
454.72
522.93
330.84
380.47
398.89
458.72
468.80
539.12
191.59
220.33
206.08
236.99
481.94
554.23
67.05
77.11
190.73
219.34
72.37
83.23
109.52
125.95
83.72
96.28
145.90
167.79
1828.34
2102.59
1587.68
1825.83
2165.91
2490.80
3421.24
3934.43
507.56
583.69
949.68
1092.13
201.30
231.50
116.59
134.08
393.15
452.12
117.11
134.68
180.87
208.00
128.45
147.72
251.01
288.66
193.76
222.82
89.90
103.39
172.77
198.69
2040.96
2347.10
2901.43
3336.64
3118.96
3586.80
193.37
222.38
987.94
1136.13
2657.23
3055.81
1107.14
1273.21
4102.20
4717.53
1173.97
1350.07
756.23
869.66
35.32
40.62
455.48
523.80
330.57
380.16
296.68
341.18
399.82
459.79
651.42
749.13
677.17
778.75
1098.37
1263.13
507.94
584.13
1365.20
1569.98
998.26
1148.00
1286.97
1480.02
2153.82
2476.89
930.91
1070.55
1632.49
1877.36
775.95
892.34
2504.55
2880.23
1426.56
1640.54
2724.33
3132.98
2537.59
2918.23
998.52
1148.30
09/12/2011

----- -- ---- --------
NPAR FEE
--------
PAGE 022
LC FEE
--------
45520
F 11
36.66
34.83
40.05
45550
11 1355.14
1287.38
1480.49
45563
11 1504.65
1429.42
1643.83
45820
11 1105.29
1050.03
1207.53
45905
11
154.70
146.97
169.02
45915
F 11
205.91
195.61
224.95
46020
F 11
209.67
199.19
229.07
46040
N 11
468.44
445.02
511.77
46050
N 11
171.70
163.12
187.59
46070
11
208.96
198.51
228.29
46083
N 11
158.99
151.04
173.70
46200
F 11
286.57
272.24
313.08
46221
N 11
234.41
222.69
256.09
46230
F 11
158.23
150.32
172.87
46255
N 11
445.61
423.33
486.83
46258
11
420.05
399.05
458.91
46262
11
499.38
474.41
545.57
46275
N 11
467.91
444.51
511.19
46285
N 11
460.33
437.31
502.91
46320
N 11
160.20
152.19
175.02
46500
F 11
116.95
111.10
127.77
46600
N 11
76.89
73.05
84.01
46604
F 11
61.32
58.25
66.99
46608
N 11
204.29
194.08
223.19
46610
F 11
75.10
71.35
82.05
46612
N 11
236.62
224.79
258.51
46614
F 11
61.11
58.05
66.76
46700
11
592.52
562.89
647.32
46707
11
442.35
420.23
483.26
46715
11
454.92
432.17
497.00
46735
11 1938.78
1841.84
2118.12
46744
11 3153.90
2996.21
3445.64
46750
11
704.66
669.43
769.84
46754
N 11
264.92
251.67
289.42
46761
11
860.97
817.92
940.61
46900
F 11
127.17
120.81
138.93
46916
N 11
213.10
202.45
232.82
46917
F 11
123.13
116.97
134.52
46924
N 11
473.61
449.93
517.42
46930
F 11
138.74
131.80
151.57
46942
N 11
187.46
178.09
204.80
46945
F 11
199.97
189.97
218.47
46947
11
346.70
329.37
378.78
47001
11
96.84
92.00
105.80
47015
11 1062.73
1009.59
1161.03
47122
11 3176.49
3017.67
3470.32
47135
11 4524.91
4298.66
4943.46
47141
11 3663.55
3480.37
4002.43
47146
11
307.69
292.31
336.16
47350
11 1263.41
1200.24
1380.28
47362
11 1324.40
1258.18
1446.91
47380
11 1334.71
1267.97
1458.17
47382
F 11
775.74
736.95
847.49
47425
11 1253.94
1191.24
1369.93
47490
11
346.56
329.23
378.61
47510
11
462.41
439.29
505.18
47525
F 11
93.94
89.24
102.63
47550
11
155.08
147.33
169.43
47554
11
472.31
448.69
515.99
47560
11
251.16
238.60
274.39
47563
11
694.93
660.18
759.21
47600
11
991.33
941.76
1083.02
47612
11 1168.74
1110.30
1276.85
47700
11
965.27
917.01
1054.56
47712
11 1841.80
1749.71
2012.17
47721
11 1241.06
1179.01
1355.86
47760
11 2067.97
1964.57
2259.26
47785
11 2972.72
2824.08
3247.69
47802
11 1401.07
1331.02
1530.67
48001
11 2133.98
2027.28
2331.37
48102
N 11
508.93
483.48
556.00
48120
11 1019.84
968.85
1114.18
48146
11 1721.55
1635.47
1880.79
48152
11 2662.20
2529.09
2908.45
48155
11 1667.02
1583.67
1821.22
48510
11
995.98
946.18
1088.11
MFI00A11
FSY-2011

----- -- ---- -------48511
48540
48548
48556
49010
49021
49041
49061
49080
49180
49204
49220
49320
49323
49326
49400
49411
49418
49422
49424
49426
49429
49440
49441
49446
49450
49452
49460
49491
49496
49505
49521
49550
49557
49565
49570
49582
49590
49606
49650
49653
49656
49904
50020
50040
50065
50080
50120
50135
50205
50230
50240
50290
50325
50329
50365
50382
50384
50386
50387
50390
50392
50394
50398
50405
50525
50541
50544
50547
50551
50555
50557
50562
50574
50580
50592
***
"STATE OK"
NPAR FEE
--------
M E D I C A R E
LC FEE
--------
F E E
S C H E D U L E

----- -- ---- --------
N 11
879.98
835.98
961.38
48511
11 1195.53
1135.75
1306.11
48545
11 1536.17
1459.36
1678.26
48552
11 1158.97
1101.02
1266.17
49000
11
881.29
837.23
962.81
49020
F 11
165.66
157.38
180.99
49040
F 11
196.51
186.68
214.68
49060
F 11
181.63
172.55
198.43
49062
F 11
66.87
63.53
73.06
49081
N 11
155.03
147.28
169.37
49180
11 1414.96
1344.21
1545.84
49205
11
895.03
850.28
977.82
49250
11
303.32
288.15
331.37
49321
11
596.68
566.85
651.88
49324
11
177.13
168.27
193.51
49327
F 11
93.60
88.92
102.26
49402
F 11
189.74
180.25
207.29
49412
F 11
222.60
211.47
243.19
49419
11
356.82
338.98
389.83
49423
N 11
142.38
135.26
155.55
49424
11
594.27
564.56
649.24
49427
11
424.78
403.54
464.07
49435
N 11 1016.59
965.76
1110.62
49440
F 11
251.23
238.67
274.47
49442
N 11
939.69
892.71
1026.62
49446
F 11
65.95
62.65
72.05
49451
N 11
843.80
801.61
921.85
49452
F 11
47.50
45.13
51.90
49465
11
723.76
687.57
790.71
49492
11
563.60
535.42
615.73
49500
11
475.54
451.76
519.52
49507
11
703.90
668.71
769.02
49525
11
527.75
501.36
576.56
49553
11
665.15
631.89
726.67
49560
11
706.02
670.72
771.33
49566
11
378.05
359.15
413.02
49572
11
437.85
415.96
478.35
49585
11
523.83
497.64
572.29
49600
11 1045.51
993.23
1142.21
49610
11
390.03
370.53
426.11
49651
11
865.71
822.42
945.78
49654
11
797.14
757.28
870.87
49657
11 1364.67
1296.44
1490.91
49905
11 1008.45
958.03
1101.73
50021
11
912.97
867.32
997.42
50045
11 1187.44
1128.07
1297.28
50070
11
860.83
817.79
940.46
50081
11
934.39
887.67
1020.82
50125
11 1107.46
1052.09
1209.90
50200
11
699.06
664.11
763.73
50220
11 1265.78
1202.49
1382.86
50234
11 1307.98
1242.58
1428.97
50250
11
894.75
850.01
977.51
50320
11
129.80
123.31
141.81
50327
11
169.15
160.69
184.79
50340
11 2654.97
2522.22
2900.55
50370
N 11 1196.84
1137.00
1307.55
50382
F 11
248.23
235.82
271.19
50385
N 11
761.71
723.62
832.16
50386
F 11
98.97
94.02
108.12
50389
11
96.21
91.40
105.11
50391
11
177.00
168.15
193.37
50393
F 11
48.84
46.40
53.36
50395
N 11
500.85
475.81
547.18
50398
11 1378.78
1309.84
1506.32
50500
11 1384.40
1315.18
1512.46
50526
11
909.55
864.07
993.68
50542
11 1235.98
1174.18
1350.31
50545
11 1503.95
1428.75
1643.06
50548
F 11
292.95
278.30
320.05
50553
N 11
408.17
387.76
445.92
50555
F 11
344.06
326.86
375.89
50561
11
578.45
549.53
631.96
50570
11
563.72
535.53
615.86
50575
11
603.84
573.65
659.70
50590
N 11 3208.16
3047.75
3504.91
50592
F 11
196.83
11 1232.41
11
221.11
11
712.37
11 1470.66
11
924.56
11 1025.52
11
693.32
N 11
153.23
F 11
85.10
11 1622.60
11
536.42
11
320.83
11
365.05
11
124.25
11
789.88
11
77.65
11
412.93
N 11
531.40
F 11
38.44
11
44.49
11
112.22
F 11
221.00
N 11
946.23
F 11
163.31
N 11
677.79
F 11
141.44
N 11
161.42
11
877.06
11
352.36
11
584.76
11
524.71
11
578.31
11
678.23
11
865.65
11
469.42
11
404.74
11
673.48
11
632.48
11
507.67
11
794.36
11 1147.33
11
332.05
N 11
883.77
11
916.45
11 1174.97
11 1264.34
11
992.79
N 11
540.52
11 1021.41
11 1285.36
11 1207.49
11 1333.38
11
204.08
11
862.50
11 1102.94
F 11
273.37
N 11 1167.68
F 11
175.88
N 11
308.00
N 11
123.12
11
215.49
11
178.72
F 11
72.81
11 1189.70
11 1368.14
11 1155.03
11 1329.43
11 1336.59
N 11
378.94
F 11
339.20
N 11
472.12
11
489.42
11
711.93
N 11
836.13
F 11
357.44
and descriptors
NPAR FEE
--------
"ALL OF OKLAHOMA"
LC FEE
--------
186.99
215.04
1170.79
1346.41
210.05
241.56
676.75
778.26
1397.13
1606.70
878.33
1010.08
974.24
1120.38
658.65
757.45
145.57
167.41
80.85
92.98
1541.47
1772.69
509.60
586.04
304.79
350.51
346.80
398.82
118.04
135.75
750.39
862.95
73.77
84.84
392.28
451.12
504.83
580.55
36.52
42.00
42.27
48.61
106.61
122.60
209.95
241.44
898.92
1033.76
155.14
178.41
643.90
740.49
134.37
154.53
153.35
176.35
833.21
958.19
334.74
384.95
555.52
638.85
498.47
573.24
549.39
631.80
644.32
740.97
822.37
945.73
445.95
512.84
384.50
442.18
639.81
735.78
600.86
690.99
482.29
554.63
754.64
867.84
1089.96
1253.45
315.45
362.77
839.58
965.52
870.63
1001.22
1116.22
1283.65
1201.12
1381.29
943.15
1084.62
513.49
590.51
970.34
1115.89
1221.09
1404.25
1147.12
1319.19
1266.71
1456.72
193.88
222.96
819.38
942.29
1047.79
1204.96
259.70
298.66
1109.30
1275.70
167.09
192.15
292.60
336.49
116.96
134.50
204.72
235.43
169.78
195.25
69.17
79.55
1130.22
1299.75
1299.73
1494.69
1097.28
1261.87
1262.96
1452.40
1269.76
1460.22
359.99
413.99
322.24
370.58
448.51
515.79
464.95
534.69
676.33
777.78
794.32
913.47
339.57
390.51
09/12/2011

----- -- ---- --------
NPAR FEE
--------
PAGE 023
LC FEE
--------
48520
11 1007.52
957.14
1100.71
48547
11 1649.09
1566.64
1801.64
48554
11 2331.59
2215.01
2547.26
49002
11
959.93
911.93
1048.72
49021
N 11
836.84
795.00
914.25
49041
N 11
863.29
820.13
943.15
49061
N 11
844.62
802.39
922.75
49080
N 11
153.80
146.11
168.03
49081
F 11
64.73
61.49
70.71
49203
11 1110.55
1055.02
1213.27
49215
11 2045.21
1942.95
2234.39
49255
11
727.71
691.32
795.02
49322
11
345.60
328.32
377.57
49325
11
390.59
371.06
426.72
49400
N 11
148.72
141.28
162.47
49411
N 11
490.21
465.70
535.56
49418
N 11 1413.15
1342.49
1543.86
49421
11
252.99
240.34
276.39
49423
F 11
72.81
69.17
79.55
49425
11
702.20
667.09
767.15
49428
11
403.62
383.44
440.96
49436
11
171.69
163.11
187.58
49441
N 11 1126.82
1070.48
1231.05
49442
F 11
208.59
198.16
227.88
49450
N 11
668.47
635.05
730.31
49451
F 11
91.64
87.06
100.12
49460
N 11
736.63
699.80
804.77
49465
F 11
30.39
28.87
33.20
49495
11
370.20
351.69
404.44
49501
11
552.05
524.45
603.12
49520
11
579.43
550.46
633.03
49540
11
620.84
589.80
678.27
49555
11
548.20
520.79
598.91
49561
11
856.58
813.75
935.81
49568
11
250.07
237.57
273.21
49580
11
298.89
283.95
326.54
49587
11
478.63
454.70
522.91
49605
11 4611.57
4380.99
5038.14
49611
11
524.91
498.66
573.46
49652
11
690.89
656.35
754.80
49655
11
955.99
908.19
1044.42
49900
11
749.70
712.22
819.05
50010
11
707.40
672.03
772.83
50021
F 11
165.35
157.08
180.64
50060
11 1126.76
1070.42
1230.98
50075
11 1444.00
1371.80
1577.57
50100
11
939.97
892.97
1026.92
50130
11 1022.03
970.93
1116.57
50200
F 11
141.15
134.09
154.20
50225
11 1175.62
1116.84
1284.37
50236
11 1450.47
1377.95
1584.64
50280
11
938.97
892.02
1025.82
50323
11
126.05
119.75
137.71
50328
11
178.60
169.67
195.12
50360
11 2360.59
2242.56
2578.94
50380
11 1859.88
1766.89
2031.92
50384
N 11 1000.35
950.33
1092.88
50385
F 11
232.87
221.23
254.41
50387
N 11
553.77
526.08
604.99
50389
F 11
54.14
51.43
59.14
50391
F 11
98.87
93.93
108.02
50394
N 11
98.60
93.67
107.72
50396
11
114.94
109.19
125.57
50400
11 1142.21
1085.10
1247.87
50520
11 1019.17
968.21
1113.44
50540
11 1123.50
1067.33
1227.43
50543
11 1473.31
1399.64
1609.59
50546
11 1184.79
1125.55
1294.38
50551
N 11
357.20
339.34
390.24
50553
F 11
312.17
296.56
341.04
50557
N 11
415.55
394.77
453.99
50561
F 11
393.07
373.42
429.43
50572
11
530.22
503.71
579.27
50576
11
561.93
533.83
613.90
50590
F 11
557.39
529.52
608.95
50593
N 11 4413.28
4192.62
4821.51
MFI00A11
FSY-2011

----- -- ---- -------50593
50610
50650
50684
50688
50700
50725
50740
50770
50783
50810
50825
50845
50920
50945
50951
50953
50957
50961
50974
51020
51045
51065
51100
51102
51520
51535
51565
51580
51595
51600
51610
51700
51702
51703
51710
51715
51725
51726
51727
51728
51729
51736
51741
51784
51785
51792
51797
51798
51840
51860
51900
51940
51990
52000
52005
52007
52204
52214
52234
52250
52265
52275
52277
52282
52285
52300
52310
52315
52318
52327
52332
52341
52344
52351
52354
***
"STATE OK"
NPAR FEE
--------
M E D I C A R E
LC FEE
--------
F E E
S C H E D U L E

----- -- ---- --------
F 11
465.24
441.98
508.28
50600
11
934.17
887.46
1020.58
50620
11 1022.05
970.95
1116.59
50660
F 11
48.84
46.40
53.36
50686
11
78.24
74.33
85.48
50690
11
911.40
865.83
995.70
50715
11 1107.47
1052.10
1209.92
50727
11 1132.78
1076.14
1237.56
50750
11 1121.82
1065.73
1225.59
50780
11 1124.66
1068.43
1228.69
50785
11 1259.11
1196.15
1375.57
50815
11 1634.67
1552.94
1785.88
50830
11 1232.02
1170.42
1345.98
50860
11
869.60
826.12
950.04
50930
11
962.04
913.94
1051.03
50947
N 11
373.37
354.70
407.91
50951
F 11
337.08
320.23
368.26
50955
N 11
425.02
403.77
464.34
50957
F 11
315.99
300.19
345.22
50970
11
471.13
447.57
514.71
50976
11
461.11
438.05
503.76
51030
11
473.77
450.08
517.59
51050
11
569.86
541.37
622.58
51080
F 11
38.72
36.78
42.30
51101
N 11
224.65
213.42
245.43
51102
11
580.49
551.47
634.19
51525
11
763.07
724.92
833.66
51550
11 1272.96
1209.31
1390.71
51570
11 1877.65
1783.77
2051.34
51585
11 2168.16
2059.75
2368.71
51596
N 11
183.22
174.06
200.17
51600
N 11
105.99
100.69
115.79
51610
F 11
44.01
41.81
48.08
51701
N 11
72.30
68.69
78.99
51702
F 11
80.54
76.51
87.99
51705
N 11
149.01
141.56
162.79
51710
F 11
196.73
186.89
214.92
51720
11
198.21
188.30
216.55
51725 TC
11
288.43
274.01
315.11
51726 TC
11
287.33
272.96
313.90
51727 TC
11
284.84
270.60
311.19
51728 TC
11
312.08
296.48
340.95
51729 TC
11
33.00
31.35
36.05
51736 TC
11
40.25
38.24
43.98
51741 TC
11
193.53
183.85
211.43
51784 TC
11
212.43
201.81
232.08
51785 TC
11
217.83
206.94
237.98
51792 TC
11
126.82
120.48
138.55
51797 TC
11
18.18
17.27
19.86
51800
11
641.27
609.21
700.59
51841
11
720.36
684.34
786.99
51865
11
807.87
767.48
882.60
51920
11 1597.21
1517.35
1744.95
51960
11
734.91
698.16
802.88
51992
F 11
124.16
117.95
135.64
52001
N 11
274.97
261.22
300.40
52005
F 11
164.25
156.04
179.45
52010
N 11
397.55
377.67
434.32
52204
F 11
206.45
196.13
225.55
52224
11
244.48
232.26
267.10
52235
11
240.92
228.87
263.20
52260
F 11
160.15
152.14
174.96
52270
N 11
508.51
483.08
555.54
52275
11
323.13
306.97
353.02
52281
11
334.29
317.58
365.22
52283
N 11
275.95
262.15
301.47
52285
11
281.03
266.98
307.03
52301
N 11
239.72
227.73
261.89
52310
F 11
272.49
258.87
297.70
52317
11
471.18
447.62
514.76
52320
11
260.92
247.87
285.05
52330
N 11
468.76
445.32
512.12
52332
11
287.80
273.41
314.42
52342
11
377.87
358.98
412.83
52345
11
311.69
296.11
340.53
52352
11
389.33
369.86
425.34
52355
11
924.84
11
893.38
11 1127.39
N 11
138.84
N 11
95.24
11 1124.86
11
496.07
11 1142.92
11 1083.56
11 1194.31
11 1205.87
11 1771.05
11
930.69
11 1120.71
11 1363.14
F 11
305.34
N 11
429.96
F 11
352.27
11
368.94
11
463.96
11
457.57
11
465.58
11
400.60
N 11
122.43
F 11
145.28
11
848.53
11
945.38
11 1456.67
11 2091.29
11 2329.98
F 11
43.69
F 11
62.52
N 11
56.24
F 11
29.47
N 11
106.93
F 11
93.58
N 11
109.59
11
123.38
11
203.20
11
182.28
11
181.65
11
187.94
11
21.33
11
24.48
11
117.71
11
136.29
11
162.75
11
86.21
11 1030.84
11
763.12
11
876.03
11
742.67
11 1372.24
11
820.32
N 11
369.83
F 11
131.67
N 11
380.31
F 11
139.91
N 11
707.14
11
286.68
11
208.20
N 11
373.65
F 11
247.09
N 11
276.23
N 11
274.07
F 11
193.74
11
290.92
F 11
150.59
N 11
863.90
11
244.88
N 11
632.78
F 11
144.97
11
312.95
11
403.02
11
366.17
11
463.82
and descriptors
NPAR FEE
--------
"ALL OF OKLAHOMA"
LC FEE
--------
878.60
1010.39
848.71
976.02
1071.02
1231.67
131.90
151.69
90.48
104.05
1068.62
1228.91
471.27
541.96
1085.77
1248.64
1029.38
1183.79
1134.59
1304.78
1145.58
1317.42
1682.50
1934.88
884.16
1016.78
1064.67
1224.37
1294.98
1489.23
290.07
333.58
408.46
469.73
334.66
384.86
350.49
403.06
440.76
506.87
434.69
499.89
442.30
508.65
380.57
437.66
116.31
133.76
138.02
158.72
806.10
927.02
898.11
1032.83
1383.84
1591.42
1986.73
2284.74
2213.48
2545.50
41.51
47.74
59.39
68.30
53.43
61.44
28.00
32.20
101.58
116.82
88.90
102.24
104.11
119.73
117.21
134.79
193.04
222.00
173.17
199.15
172.57
198.46
178.54
205.32
20.26
23.30
23.26
26.75
111.82
128.59
129.48
148.90
154.61
177.80
81.90
94.19
979.30
1126.20
724.96
833.70
832.23
957.06
705.54
811.37
1303.63
1499.17
779.30
896.20
351.34
404.04
125.09
143.85
361.29
415.48
132.91
152.85
671.78
772.55
272.35
313.20
197.79
227.46
354.97
408.22
234.74
269.95
262.42
301.78
260.37
299.43
184.05
211.66
276.37
317.83
143.06
164.52
820.71
943.82
232.64
267.54
601.14
691.31
137.72
158.38
297.30
341.90
382.87
440.30
347.86
400.04
440.63
506.72
09/12/2011

----- -- ---- --------
NPAR FEE
--------
PAGE 024
LC FEE
--------
50605
11
929.46
882.99
1015.44
50630
11
875.68
831.90
956.69
50684
N 11
141.12
134.06
154.17
50686
F 11
91.28
86.72
99.73
50690
F 11
68.46
65.04
74.80
50722
11
995.00
945.25
1087.04
50728
11
681.99
647.89
745.07
50760
11 1095.22
1040.46
1196.53
50782
11 1104.60
1049.37
1206.78
50800
11
910.61
865.08
994.84
50820
11 1293.35
1228.68
1412.98
50840
11 1214.21
1153.50
1326.53
50900
11
828.93
787.48
905.60
50940
11
872.01
828.41
952.67
50948
11 1264.90
1201.66
1381.91
50953
N 11
395.03
375.28
431.57
50955
F 11
363.19
345.03
396.78
50961
N 11
383.71
364.52
419.20
50972
11
356.12
338.31
389.06
50980
11
354.62
336.89
387.42
51040
11
285.42
271.15
311.82
51060
11
573.32
544.65
626.35
51100
N 11
60.45
57.43
66.04
51101
F 11
51.56
48.98
56.33
51500
11
638.17
606.26
697.20
51530
11
769.58
731.10
840.77
51555
11 1247.16
1184.80
1362.52
51575
11 1802.73
1712.59
1969.48
51590
11 1911.10
1815.55
2087.88
51597
11 2262.18
2149.07
2471.43
51605
11
37.69
35.81
41.18
51700
N 11
82.75
78.61
90.40
51701
F 11
26.95
25.60
29.44
51703
N 11
131.88
125.29
144.08
51705
F 11
66.30
62.99
72.44
51715
N 11
284.28
270.07
310.58
51720
F 11
80.30
76.29
87.73
51725 26
11
74.83
71.09
81.75
51726 26
11
85.23
80.97
93.12
51727 26
11
105.05
99.80
114.77
51728 26
11
103.20
98.04
112.75
51729 26
11
124.14
117.93
135.62
51736 26
11
11.67
11.09
12.75
51741 26
11
15.77
14.98
17.23
51784 26
11
75.82
72.03
82.83
51785 26
11
76.14
72.33
83.18
51792 26
11
55.09
52.34
60.19
51797 26
11
40.60
38.57
44.36
51820
11 1051.68
999.10
1148.97
51845
11
577.89
549.00
631.35
51880
11
458.15
435.24
500.53
51925
11 1019.22
968.26
1113.50
51980
11
701.51
666.43
766.39
52000
N 11
201.64
191.56
220.29
52001
F 11
285.10
270.85
311.48
52007
N 11
491.50
466.93
536.97
52010
F 11
161.42
153.35
176.35
52214
N 11
593.54
563.86
648.44
52224
F 11
167.93
159.53
183.46
52240
11
501.18
476.12
547.54
52265
N 11
388.19
368.78
424.10
52270
F 11
180.58
171.55
197.28
52276
11
263.86
250.67
288.27
52281
F 11
144.89
137.65
158.30
52283
F 11
199.73
189.74
218.20
52290
11
242.81
230.67
265.27
52305
11
276.97
263.12
302.59
52315
N 11
420.52
399.49
459.41
52317
F 11
345.79
328.50
377.78
52325
11
318.70
302.77
348.19
52330
F 11
262.07
248.97
286.32
52334
11
255.02
242.27
278.61
52343
11
348.32
330.90
380.54
52346
11
455.01
432.26
497.10
52353
11
420.69
399.66
459.61
52400
11
475.35
451.58
519.32
MFI00A11
FSY-2011

----- -- ---- --------
"STATE OK"
NPAR FEE
--------
M E D I C A R E
LC FEE
--------
F E E
S C H E D U L E

----- -- ---- --------
52402
11
265.73
252.44
290.31
52450
52601
11
826.06
784.76
902.47
52630
52647
N 11 1941.93
1844.83
2121.55
52647
52648
F 11
680.80
646.76
743.77
52649
53000
11
146.37
139.05
159.91
53010
53025
11
65.50
62.23
71.56
53040
53060
F 11
159.36
151.39
174.10
53080
53200
N 11
152.42
144.80
166.52
53200
53215
11
918.64
872.71
1003.62
53220
53235
11
626.54
595.21
684.49
53240
53260
N 11
196.91
187.06
215.12
53260
53265
F 11
182.54
173.41
199.42
53270
53275
11
260.02
247.02
284.07
53400
53410
11
968.51
920.08
1058.09
53415
53425
11
929.09
882.64
1015.04
53430
53440
11
870.68
827.15
951.22
53442
53445
11
868.50
825.08
948.84
53446
53448
11 1266.83
1203.49
1384.01
53449
53460
11
451.30
428.74
493.05
53500
53505
11
479.67
455.69
524.04
53510
53520
11
548.51
521.08
599.24
53600
53601
N 11
80.48
76.46
87.93
53601
53620
N 11
117.59
111.71
128.47
53620
53621
F 11
71.28
67.72
77.88
53660
53661
N 11
69.52
66.04
75.95
53661
53850
N 11 2195.29
2085.53
2398.36
53850
53852
F 11
613.23
582.57
669.96
53855
53860
N 11 1357.32
1289.45
1482.87
53860
54000
F 11
105.40
100.13
115.15
54001
54015
11
304.17
288.96
332.30
54050
54055
N 11
113.38
107.71
123.87
54055
54056
F 11
104.94
99.69
114.64
54057
54060
N 11
178.12
169.21
194.59
54060
54065
F 11
163.75
155.56
178.89
54100
54105
N 11
265.26
252.00
289.80
54105
54111
11
792.41
752.79
865.71
54112
54115
F 11
416.77
395.93
455.32
54120
54130
11 1181.24
1122.18
1290.51
54135
54150
F 11
96.89
92.05
105.86
54160
54161
11
194.25
184.54
212.22
54162
54163
11
215.13
204.37
235.03
54164
54200
F 11
82.83
78.69
90.49
54205
54220
F 11
133.19
126.53
145.51
54230
54231
N 11
137.81
130.92
150.56
54231
54235
F 11
72.23
68.62
78.91
54240
54240 26
11
64.29
61.08
70.24
54250
54250 26
11
109.49
104.02
119.62
54300
54308
11
722.74
686.60
789.59
54312
54318
11
709.88
674.39
775.55
54322
54326
11
922.04
875.94
1007.33
54328
54336
11 1169.53
1111.05
1277.71
54340
54348
11 1112.33
1056.71
1215.22
54352
54380
11
793.96
754.26
867.40
54385
54400
11
524.38
498.16
572.88
54401
54406
11
721.89
685.80
788.67
54408
54411
11 1013.65
962.97
1107.42
54415
54417
11
888.01
843.61
970.15
54420
54435
11
411.55
390.97
449.62
54450
54500
11
73.70
70.02
80.52
54505
54520
11
320.60
304.57
350.26
54522
54535
11
728.35
691.93
795.72
54550
54600
11
446.30
423.99
487.59
54620
54650
11
697.69
662.81
762.23
54660
54680
11
771.97
733.37
843.38
54690
54700
11
208.99
198.54
228.32
54800
54840
11
317.21
301.35
346.55
54860
54865
11
352.12
334.51
384.69
54900
55000
N 11
116.66
110.83
127.45
55000
55041
11
501.54
476.46
547.93
55060
55100
F 11
161.58
153.50
176.53
55110
55150
11
482.32
458.20
526.93
55175
55200
N 11
453.76
431.07
495.73
55200
55250
F 11
224.07
212.87
244.80
55300
55450
N 11
362.93
344.78
396.50
55450
55520
11
414.14
393.43
452.44
55530
55540
11
497.89
473.00
543.95
55550
11
462.54
11
437.85
F 11
637.99
11
955.29
11
289.27
11
386.11
11
421.10
F 11
139.19
11
446.28
11
420.15
F 11
175.49
N 11
206.33
11
790.89
11 1116.75
11
947.04
11
768.84
11
635.49
11
604.78
11
735.73
11
623.32
N 11
82.99
F 11
52.76
F 11
86.72
N 11
70.13
F 11
39.92
F 11
560.96
N 11
665.98
F 11
220.63
N 11
184.97
N 11
123.70
F 11
88.50
N 11
133.18
F 11
127.09
N 11
188.77
F 11
211.09
11
929.04
11
623.81
11 1498.95
N 11
221.20
N 11
259.54
11
189.67
11
527.52
N 11
94.88
F 11
115.45
11
96.95
11
120.42
11
637.51
11
827.91
11
776.55
11
927.87
11
559.30
11 1567.99
11
964.59
11
646.54
11
780.70
11
520.69
11
698.63
N 11
70.25
11
208.24
11
574.75
11
483.33
11
297.08
11
350.33
11
662.88
11
143.70
11
412.58
11
757.37
F 11
82.96
11
373.52
11
381.12
11
358.00
F 11
272.34
11
180.84
F 11
252.06
11
348.00
11
417.53
and descriptors
NPAR FEE
--------
"ALL OF OKLAHOMA"
LC FEE
--------
439.41
505.32
415.96
478.35
606.09
697.00
907.53
1043.66
274.81
316.03
366.80
421.82
400.05
460.06
132.23
152.06
423.97
487.57
399.14
459.01
166.72
191.73
196.01
225.41
751.35
864.05
1060.91
1220.05
899.69
1034.64
730.40
839.96
603.72
694.28
574.54
660.72
698.94
803.78
592.15
680.97
78.84
90.67
50.12
57.64
82.38
94.74
66.62
76.61
37.92
43.61
532.91
612.85
632.68
727.58
209.60
241.04
175.72
202.08
117.52
135.15
84.08
96.69
126.52
145.50
120.74
138.85
179.33
206.23
200.54
230.62
882.59
1014.98
592.62
681.51
1424.00
1637.60
210.14
241.66
246.56
283.54
180.19
207.22
501.14
576.31
90.14
103.66
109.68
126.13
92.10
105.92
114.40
131.56
605.63
696.47
786.51
904.49
737.72
848.38
881.48
1013.70
531.34
611.04
1489.59
1713.03
916.36
1053.81
614.21
706.34
741.67
852.92
494.66
568.86
663.70
763.26
66.74
76.75
197.83
227.50
546.01
627.91
459.16
528.03
282.23
324.56
332.81
382.73
629.74
724.20
136.52
157.00
391.95
450.74
719.50
827.43
78.81
90.63
354.84
408.07
362.06
416.37
340.10
391.12
258.72
297.53
171.80
197.57
239.46
275.38
330.60
380.19
396.65
456.15
09/12/2011

----- -- ---- --------
NPAR FEE
--------
PAGE 025
LC FEE
--------
52500
11
481.12
457.06
525.62
52640
11
292.69
278.06
319.77
52648
N 11 1990.10
1890.60
2174.19
52700
11
430.90
409.36
470.76
53020
11
96.05
91.25
104.94
53060
N 11
177.94
169.04
194.40
53085
11
627.63
596.25
685.69
53210
11
761.76
723.67
832.22
53230
11
597.77
567.88
653.06
53250
11
415.79
395.00
454.25
53265
N 11
215.30
204.54
235.22
53270
F 11
186.17
176.86
203.39
53405
11
864.99
821.74
945.00
53420
11
810.90
770.36
885.91
53431
11 1140.30
1083.29
1245.78
53444
11
784.86
745.62
857.46
53447
11
801.20
761.14
875.31
53450
11
402.63
382.50
439.88
53502
11
477.47
453.60
521.64
53515
11
784.30
745.09
856.85
53600
F 11
63.15
59.99
68.99
53605
11
63.86
60.67
69.77
53621
N 11
110.65
105.12
120.89
53660
F 11
40.84
38.80
44.62
53665
11
38.04
36.14
41.56
53852
N 11 2118.43
2012.51
2314.39
53855
F 11
79.53
75.55
86.88
54000
N 11
148.87
141.43
162.64
54001
F 11
136.47
129.65
149.10
54050
F 11
99.13
94.17
108.30
54056
N 11
132.34
125.72
144.58
54057
F 11
91.29
86.73
99.74
54065
N 11
208.47
198.05
227.76
54100
F 11
121.05
115.00
132.25
54110
11
615.66
584.88
672.61
54115
N 11
444.17
421.96
485.25
54125
11
803.08
762.93
877.37
54150
N 11
158.93
150.98
173.63
54160
F 11
142.14
135.03
155.28
54162
F 11
195.29
185.53
213.36
54200
N 11
106.45
101.13
116.30
54220
N 11
202.80
192.66
221.56
54230
F 11
78.50
74.58
85.77
54235
N 11
88.29
83.88
96.46
54240 TC
11
32.67
31.04
35.70
54250 TC
11
10.94
10.39
11.95
54304
11
745.59
708.31
814.56
54316
11 1008.85
958.41
1102.17
54324
11
964.26
916.05
1053.46
54332
11 1006.78
956.44
1099.91
54344
11
958.67
910.74
1047.35
54360
11
716.35
680.53
782.61
54390
11 1214.67
1153.94
1327.03
54405
11
800.67
760.64
874.74
54410
11
851.24
808.68
929.98
54416
11
700.33
665.31
765.11
54430
11
634.10
602.40
692.76
54450
F 11
57.34
54.47
62.64
54512
11
529.38
502.91
578.35
54530
11
498.77
473.83
544.90
54560
11
665.10
631.85
726.63
54640
11
467.04
443.69
510.24
54670
11
398.33
378.41
435.17
54692
11
751.73
714.14
821.26
54830
11
365.96
347.66
399.81
54861
11
557.39
529.52
608.95
54901
11 1052.24
999.63
1149.57
55040
11
332.62
315.99
363.39
55100
N 11
211.66
201.08
231.24
55120
11
349.67
332.19
382.02
55180
11
679.73
645.74
742.60
55250
N 11
403.60
383.42
440.93
55400
11
493.82
469.13
539.50
55500
11
381.95
362.85
417.28
55535
11
421.91
400.81
460.93
55600
11
415.88
395.09
454.35
MFI00A11
FSY-2011

----- -- ---- -------55605
55700
55706
55801
55815
55840
55860
55866
55873
55876
56405
56420
56441
56501
56605
56606
56630
56633
56640
56800
56820
56821
57020
57023
57065
57100
57106
57110
57120
57135
57150
57156
57160
57180
57210
57240
57265
57270
57283
57287
57291
57296
57307
57311
57335
57415
57421
57425
57452
57455
57456
57461
57500
57510
57511
57520
57522
57540
57555
57558
57800
58100
58120
58145
58152
58210
58262
58270
58285
58292
58301
58321
58323
58340
58350
58353
***
"STATE OK"
NPAR FEE
--------
M E D I C A R E
LC FEE
--------
F E E
S C H E D U L E

----- -- ---- --------
11
512.37
486.75
559.76
55650
N 11
220.52
209.49
240.91
55700
11
370.49
351.97
404.77
55720
11 1076.51
1022.68
1176.08
55810
11 1746.49
1659.17
1908.05
55821
11 1324.54
1258.31
1447.06
55842
11
865.12
821.86
945.14
55862
11 1715.17
1629.41
1873.82
55870
N 11 5892.78
5598.14
6437.86
55873
N 11
133.61
126.93
145.97
55876
N 11
103.48
98.31
113.06
56405
F 11
87.47
83.10
95.57
56440
F 11
132.88
126.24
145.18
56442
F 11
108.34
102.92
118.36
56515
N 11
78.33
74.41
85.57
56605
F 11
28.07
26.67
30.67
56620
11
838.06
796.16
915.58
56631
11 1090.34
1035.82
1191.19
56634
11 1338.49
1271.57
1462.31
56700
11
230.32
218.80
251.62
56805
N 11
104.45
99.23
114.11
56820
F 11
109.21
103.75
119.31
57000
N 11
89.33
84.86
97.59
57020
11
296.62
281.79
324.06
57061
N 11
181.35
172.28
198.12
57065
F 11
62.65
59.52
68.45
57105
11
456.27
433.46
498.48
57107
11
856.81
813.97
936.07
57111
11
487.13
462.77
532.19
57130
N 11
182.08
172.98
198.93
57135
F 11
28.07
26.67
30.67
57155
N 11
142.14
135.03
155.28
57156
F 11
45.40
43.13
49.60
57170
N 11
133.35
126.68
145.68
57180
11
348.30
330.89
380.52
57220
11
637.65
605.77
696.64
57250
11
868.84
825.40
949.21
57267
11
761.11
723.05
831.51
57280
11
659.47
626.50
720.48
57284
11
658.65
625.72
719.58
57288
11
563.61
535.43
615.74
57292
11
907.83
862.44
991.81
57300
11
978.86
929.92
1069.41
57308
11
511.63
486.05
558.96
57320
11 1112.45
1056.83
1215.35
57400
11
152.25
144.64
166.34
57420
N 11
147.44
140.07
161.08
57421
11
928.31
881.89
1014.17
57426
F 11
86.99
82.64
95.04
57454
N 11
135.29
128.53
147.81
57455
F 11
98.90
93.96
108.05
57460
N 11
308.57
293.14
337.11
57461
F 11
71.79
68.20
78.43
57505
N 11
124.85
118.61
136.40
57510
F 11
125.43
119.16
137.03
57513
N 11
289.63
275.15
316.42
57520
F 11
231.02
219.47
252.39
57530
11
742.39
705.27
811.06
57545
11
571.79
543.20
624.68
57556
F 11
107.89
102.50
117.88
57700
N 11
56.61
53.78
61.85
57800
F 11
83.74
79.55
91.48
58110
N 11
240.45
228.43
262.69
58120
11
517.40
491.53
565.26
58146
11 1188.93
1129.48
1298.90
58180
11 1668.63
1585.20
1822.98
58240
11
879.76
835.77
961.14
58263
11
841.42
799.35
919.25
58275
11 1253.41
1190.74
1369.35
58290
11 1257.43
1194.56
1373.74
58293
N 11
90.69
86.16
99.08
58301
F 11
45.00
42.75
49.16
58322
N 11
16.60
15.77
18.14
58323
F 11
55.31
52.54
60.42
58345
N 11
91.46
86.89
99.92
58350
F 11
209.61
199.13
229.00
58356
11
704.54
F 11
137.05
11
444.95
11 1301.35
11
864.66
11 1418.21
11 1087.09
N 11
172.33
F 11
824.74
F 11
99.91
F 11
102.22
11
174.24
11
45.77
N 11
212.11
F 11
57.86
11
474.72
11 1062.96
11 1152.46
11
177.99
11 1092.35
F 11
81.14
11
181.09
F 11
77.99
N 11
107.45
F 11
162.46
N 11
127.78
11 1336.63
11 1537.04
N 11
169.46
F 11
164.13
N 11
310.00
F 11
98.36
N 11
61.51
F 11
100.91
11
304.60
11
637.86
11
249.31
11
915.55
11
787.46
11
684.29
11
785.42
11
519.88
11
615.34
11
517.77
11
127.99
N 11
109.42
F 11
116.88
11
802.85
N 11
145.78
F 11
106.00
N 11
274.03
F 11
180.38
N 11
96.02
F 11
110.05
N 11
136.14
F 11
258.45
11
327.08
11
783.67
11
541.23
11
294.92
F 11
45.91
N 11
45.91
F 11
207.06
11 1103.68
11
910.68
11 2648.64
11
946.56
11
938.28
11 1099.81
11 1306.80
F 11
65.17
N 11
81.79
F 11
11.88
11
266.92
F 11
74.76
N 11 1862.26
and descriptors
NPAR FEE
--------
"ALL OF OKLAHOMA"
LC FEE
--------
669.31
769.71
130.20
149.73
422.70
486.11
1236.28
1421.72
821.43
944.64
1347.30
1549.40
1032.74
1187.65
163.71
188.27
783.50
901.03
94.91
109.15
97.11
111.68
165.53
190.36
43.48
50.00
201.50
231.73
54.97
63.22
450.98
518.63
1009.81
1161.28
1094.84
1259.07
169.09
194.45
1037.73
1193.39
77.08
88.64
172.04
197.85
74.09
85.20
102.08
117.39
154.34
177.49
121.39
139.60
1269.80
1460.27
1460.19
1679.22
160.99
185.14
155.92
179.31
294.50
338.68
93.44
107.46
58.43
67.19
95.86
110.24
289.37
332.78
605.97
696.87
236.84
272.37
869.77
1000.24
748.09
860.30
650.08
747.59
746.15
858.07
493.89
567.97
584.57
672.26
491.88
565.66
121.59
139.83
103.95
119.54
111.04
127.70
762.71
877.12
138.49
159.26
100.70
115.81
260.33
299.38
171.36
197.06
91.22
104.90
104.55
120.23
129.33
148.73
245.53
282.36
310.73
357.34
744.49
856.16
514.17
591.30
280.17
322.20
43.61
50.15
43.61
50.15
196.71
226.22
1048.50
1205.78
865.15
994.92
2516.21
2893.64
899.23
1034.11
891.37
1025.08
1044.82
1201.54
1241.46
1427.68
61.91
71.20
77.70
89.36
11.29
12.98
253.57
291.61
71.02
81.67
1769.15
2034.52
09/12/2011

----- -- ---- --------
NPAR FEE
--------
PAGE 026
LC FEE
--------
55680
11
335.67
318.89
366.72
55705
11
264.21
251.00
288.65
55725
11
582.07
552.97
635.92
55812
11 1592.13
1512.52
1739.40
55831
11
935.60
888.82
1022.14
55845
11 1620.97
1539.92
1770.91
55865
11 1322.45
1256.33
1444.78
55870
F 11
141.78
134.69
154.89
55875
11
752.87
715.23
822.51
55920
11
430.03
408.53
469.81
56420
N 11
116.76
110.92
127.56
56441
N 11
139.18
132.22
152.05
56501
N 11
123.46
117.29
134.88
56515
F 11
188.80
179.36
206.26
56606
N 11
35.63
33.85
38.93
56625
11
570.55
542.02
623.32
56632
11 1234.95
1173.20
1349.18
56637
11 1357.00
1289.15
1482.52
56740
11
283.00
268.85
309.18
56810
11
247.79
235.40
270.71
56821
N 11
139.14
132.18
152.01
57010
11
412.55
391.92
450.71
57022
11
159.71
151.72
174.48
57061
F 11
92.65
88.02
101.22
57100
N 11
83.13
78.97
90.82
57105
F 11
118.33
112.41
129.27
57109
11 1527.91
1451.51
1669.24
57112
11 1468.82
1395.38
1604.69
57130
F 11
152.14
144.53
166.21
57150
N 11
45.08
42.83
49.25
57155
F 11
173.62
164.94
189.68
57160
N 11
72.49
68.87
79.20
57170
F 11
46.08
43.78
50.35
57200
11
282.90
268.76
309.07
57230
11
380.89
361.85
416.13
57260
11
788.38
748.96
861.30
57268
11
458.56
435.63
500.97
57282
11
479.22
455.26
523.55
57285
11
647.76
615.37
707.68
57289
11
705.37
670.10
770.62
57295
11
460.93
437.88
503.56
57305
11
864.84
821.60
944.84
57310
11
449.16
426.70
490.71
57330
11
721.16
685.10
787.87
57410
11
101.98
96.88
111.41
57420
F 11
85.80
81.51
93.74
57423
11
880.16
836.15
961.57
57452
N 11
102.74
97.60
112.24
57454
F 11
129.72
123.23
141.71
57456
N 11
127.88
121.49
139.71
57460
F 11
155.92
148.12
170.34
57500
N 11
122.50
116.38
133.84
57505
F 11
86.57
82.24
94.58
57511
N 11
137.71
130.82
150.44
57513
F 11
125.75
119.46
137.38
57522
N 11
249.92
237.42
273.03
57531
11 1631.22
1549.66
1782.11
57550
11
388.38
368.96
424.30
57558
N 11
118.59
112.66
129.56
57720
11
292.07
277.47
319.09
58100
N 11
103.90
98.71
113.52
58110
F 11
39.29
37.33
42.93
58140
11
873.08
829.43
953.84
58150
11
947.13
899.77
1034.74
58200
11 1248.97
1186.52
1364.50
58260
11
788.57
749.14
861.51
58267
11 1006.75
956.41
1099.87
58280
11 1003.87
953.68
1096.73
58291
11 1192.98
1133.33
1303.33
58294
11 1163.98
1105.78
1271.65
58321
N 11
71.14
67.58
77.72
58322
F 11
56.28
53.47
61.49
58340
N 11
115.15
109.39
125.80
58346
11
420.20
399.19
459.07
58353
N 11 1005.20
954.94
1098.18
58356
F 11
332.17
315.56
362.89
MFI00A11
FSY-2011

----- -- ---- --------
"STATE OK"
NPAR FEE
--------
M E D I C A R E
LC FEE
--------
F E E
S C H E D U L E

----- -- ---- --------
58400
11
421.23
400.17
460.20
58410
58540
11
865.68
822.40
945.76
58541
58543
11
931.30
884.74
1017.45
58544
58546
11 1076.98
1023.13
1176.60
58548
58552
11
933.83
887.14
1020.21
58553
58555
N 11
255.04
242.29
278.63
58555
58558
F 11
255.19
242.43
278.79
58559
58561
11
524.58
498.35
573.10
58562
58563
N 11 1645.52
1563.24
1797.73
58563
58565
F 11
413.52
392.84
451.77
58570
58572
11 1095.53
1040.75
1196.86
58573
58605
11
313.47
297.80
342.47
58611
58660
11
639.67
607.69
698.84
58661
58670
11
347.92
330.52
380.10
58671
58673
11
764.62
726.39
835.35
58700
58740
11
832.58
790.95
909.59
58750
58760
11
774.51
735.78
846.15
58770
58800
F 11
284.85
270.61
311.20
58805
58822
11
683.59
649.41
746.82
58823
58825
11
667.20
633.84
728.92
58900
58925
11
701.51
666.43
766.39
58940
58950
11 1023.28
972.12
1117.94
58951
58953
11 1838.55
1746.62
2008.61
58954
58957
11 1430.21
1358.70
1562.51
58958
58970
N 11
204.58
194.35
223.50
58970
58976
F 11
201.14
191.08
219.74
59000
59001
11
172.87
164.23
188.86
59012
59015
F 11
125.33
119.06
136.92
59020
59020 26
11
34.89
33.15
38.12
59025
59025 26
11
27.99
26.59
30.58
59030
59051
11
39.92
37.92
43.61
59070
59072
11
496.78
471.94
542.73
59074
59076
11
491.42
466.85
536.88
59100
59121
11
750.54
713.01
819.96
59130
59136
11
828.66
787.23
905.31
59140
59151
11
707.17
671.81
772.58
59160
59200
N 11
68.62
65.19
74.97
59200
59300
F 11
139.28
132.32
152.17
59320
59350
11
264.78
251.54
289.27
59400
59410
11
879.58
835.60
960.94
59412
59425
N 11
392.92
373.27
429.26
59425
59426
F 11
534.54
507.81
583.98
59430
59510
11 1964.17
1865.96
2145.85
59514
59525
11
460.41
437.39
503.00
59610
59614
11
961.30
913.24
1050.23
59618
59622
11 1102.54
1047.41
1204.52
59812
59820
N 11
356.45
338.63
389.42
59820
59821
F 11
335.59
318.81
366.63
59830
59840
F 11
195.15
185.39
213.20
59841
59850
11
333.59
316.91
364.45
59851
59855
11
391.67
372.09
427.90
59856
59866
11
207.37
197.00
226.55
59870
60000
N 11
152.95
145.30
167.10
60000
60100
F 11
77.12
73.26
84.25
60200
60212
11
951.14
903.58
1039.12
60220
60240
11
914.10
868.40
998.66
60252
60260
11 1033.50
981.83
1129.10
60270
60280
11
419.63
398.65
458.45
60281
60300
F 11
47.75
45.36
52.16
60500
60505
11 1309.30
1243.84
1430.42
60512
60521
11 1089.43
1034.96
1190.20
60522
60545
11 1151.16
1093.60
1257.64
60600
60650
11 1126.29
1069.98
1230.48
61000
61020
11
125.07
118.82
136.64
61026
61055
11
128.67
122.24
140.58
61070
61107
11
293.90
279.21
321.09
61108
61140
11 1149.28
1091.82
1255.59
61150
61154
11 1153.69
1096.01
1260.41
61156
61215
11
453.51
430.83
495.45
61250
61304
11 1504.97
1429.72
1644.18
61305
61313
11 1814.56
1723.83
1982.40
61314
61316
11
81.39
77.32
88.92
61320
61322
11 2165.60
2057.32
2365.92
61323
61332
11 1800.60
1710.57
1967.16
61333
61340
11 1318.02
1252.12
1439.94
61343
61440
11 1835.85
1744.06
2005.67
61450
11
766.26
11
819.79
11 1006.77
11 1702.73
11 1083.49
F 11
181.34
11
328.35
N 11
354.31
F 11
328.35
11
881.19
11 1250.89
11
74.26
11
613.25
11
347.61
11
733.68
11
861.18
11
806.56
11
383.45
N 11
851.35
11
411.73
11
486.68
11 1316.41
11 1993.31
11 1576.28
F 11
183.16
N 11
119.38
11
192.68
11
64.41
11
43.96
11
96.18
N 11
395.14
N 11
387.58
11
784.33
11
800.61
11
345.34
N 11
196.91
F 11
42.79
11
144.09
11 1765.45
11
89.42
F 11
302.84
N 11
146.38
11
786.66
11 1857.87
11 1999.93
N 11
297.78
F 11
334.09
11
411.56
N 11
358.98
11
375.73
11
460.71
11
445.53
F 11
138.47
11
619.83
11
724.42
11 1241.32
11 1301.02
11
560.62
11
953.60
11
229.31
11 1320.35
11 1365.34
11
102.86
11
118.68
11
77.63
11
820.89
11 1237.04
11 1140.96
11
783.85
11 1842.10
11 1671.80
11 1747.51
11 2189.70
11 1877.88
11 2017.47
11 1761.12
and descriptors
NPAR FEE
--------
"ALL OF OKLAHOMA"
LC FEE
--------
727.95
837.14
778.80
895.62
956.43
1099.89
1617.59
1860.23
1029.32
1183.72
172.27
198.11
311.93
358.72
336.59
387.08
311.93
358.72
837.13
962.70
1188.35
1366.60
70.55
81.13
582.59
669.98
330.23
379.76
697.00
801.55
818.12
940.84
766.23
881.16
364.28
418.92
808.78
930.10
391.14
449.81
462.35
531.70
1250.59
1438.18
1893.64
2177.69
1497.47
1722.09
174.00
200.10
113.41
130.42
183.05
210.51
61.19
70.37
41.76
48.02
91.37
105.08
375.38
431.69
368.20
423.43
745.11
856.88
760.58
874.67
328.07
377.28
187.06
215.12
40.65
46.75
136.89
157.42
1677.18
1928.76
84.95
97.69
287.70
330.86
139.06
159.92
747.33
859.43
1764.98
2029.73
1899.93
2184.92
282.89
325.32
317.39
365.00
390.98
449.63
341.03
392.18
356.94
410.48
437.67
503.32
423.25
486.74
131.55
151.28
588.84
677.17
688.20
791.43
1179.25
1356.14
1235.97
1421.37
532.59
612.48
905.92
1041.81
217.84
250.52
1254.33
1442.48
1297.07
1491.63
97.72
112.38
112.75
129.66
73.75
84.81
779.85
896.83
1175.19
1351.47
1083.91
1246.50
744.66
856.36
1750.00
2012.50
1588.21
1826.44
1660.13
1909.15
2080.22
2392.25
1783.99
2051.59
1916.60
2204.09
1673.06
1924.02
09/12/2011

----- -- ---- --------
NPAR FEE
--------
PAGE 027
LC FEE
--------
58520
11
762.86
724.72
833.43
58542
11
915.62
869.84
1000.32
58545
11
852.83
810.19
931.72
58550
11
841.64
799.56
919.49
58554
11 1253.06
1190.41
1368.97
58558
N 11
338.66
321.73
369.99
58560
11
370.85
352.31
405.16
58562
F 11
277.77
263.88
303.46
58565
N 11 1791.79
1702.20
1957.53
58571
11
976.12
927.31
1066.41
58600
11
346.66
329.33
378.73
58615
11
234.50
222.78
256.20
58662
11
671.66
638.08
733.79
58672
11
702.82
667.68
767.83
58720
11
685.16
650.90
748.54
58752
11
826.39
785.07
902.83
58800
N 11
304.06
288.86
332.19
58820
11
309.44
293.97
338.07
58823
F 11
166.94
158.59
182.38
58920
11
666.10
632.80
727.72
58943
11 1070.71
1017.17
1169.75
58952
11 1485.36
1411.09
1622.75
58956
11 1255.55
1192.77
1371.69
58960
11
880.36
836.34
961.79
58976
N 11
231.38
219.81
252.78
59000
F 11
76.54
72.71
83.62
59015
N 11
146.75
139.41
160.32
59020 TC
11
29.52
28.04
32.25
59025 TC
11
15.98
15.18
17.46
59050
11
48.14
45.73
52.59
59070
F 11
295.61
280.83
322.95
59074
F 11
299.08
284.13
326.75
59120
11
749.51
712.03
818.83
59135
11
800.07
760.07
874.08
59150
11
725.05
688.80
792.12
59160
F 11
166.99
158.64
182.44
59300
N 11
180.54
171.51
197.24
59325
11
210.07
199.57
229.51
59409
11
693.83
659.14
758.01
59414
11
78.75
74.81
86.03
59426
N 11
702.72
667.58
767.72
59430
F 11
119.61
113.63
130.67
59515
11 1064.52
1011.29
1162.98
59612
11
780.86
741.82
853.09
59620
11
818.93
777.98
894.68
59812
F 11
277.62
263.74
303.30
59821
N 11
359.84
341.85
393.13
59840
N 11
202.40
192.28
221.12
59841
F 11
339.45
322.48
370.85
59852
11
482.37
458.25
526.99
59857
11
500.95
475.90
547.29
59871
11
126.59
120.26
138.30
60100
N 11
106.41
101.09
116.25
60210
11
662.45
629.33
723.73
60225
11
870.73
827.19
951.27
60254
11 1596.76
1516.92
1744.46
60271
11
998.00
948.10
1090.32
60300
N 11
104.13
98.92
113.76
60502
11 1197.47
1137.60
1308.24
60520
11
972.07
923.47
1061.99
60540
11 1003.14
952.98
1095.93
60605
11 1707.78
1622.39
1865.75
61001
11
105.54
100.26
115.30
61050
11
98.76
93.82
107.89
61105
11
414.14
393.43
452.44
61120
11
675.92
642.12
738.44
61151
11
902.77
857.63
986.27
61210
11
343.14
325.98
374.88
61253
11
798.43
758.51
872.29
61312
11 1906.97
1811.62
2083.36
61315
11 1897.99
1803.09
2073.55
61321
11 1943.46
1846.29
2123.23
61330
11 1617.39
1536.52
1767.00
61334
11 1229.45
1167.98
1343.18
61345
11 1872.28
1778.67
2045.47
61458
11 1843.80
1751.61
2014.35
MFI00A11
FSY-2011

----- -- ---- -------61460
61490
61510
61516
61519
61522
61530
61534
61537
61540
61543
61546
61552
61558
61564
61570
61576
61582
61585
61591
61596
61600
61606
61609
61612
61616
61623
61630
61682
61690
61698
61703
61710
61735
61760
61782
61791
61798
61850
61864
61870
61885
62000
62100
62117
62140
62143
62147
62161
62164
62190
62200
62223
62252
62256
62263
62267
62268
62270
62272
62280
62281
62284
62290
62291
62310
62311
62319
62351
62361
62367
62368
63005
63015
63020
63040
***
"STATE OK"
NPAR FEE
--------
M E D I C A R E
LC FEE
--------
F E E
S C H E D U L E

----- -- ---- --------
11 1919.22
1823.26
2096.75
61470
11 1740.16
1653.15
1901.12
61500
11 1999.60
1899.62
2184.56
61512
11 1700.29
1615.28
1857.57
61517
11 2714.41
2578.69
2965.49
61520
11 2009.69
1909.21
2195.59
61524
11 2819.13
2678.17
3079.90
61531
11 1505.54
1430.26
1644.80
61535
11 2252.84
2140.20
2461.23
61538
11 2006.62
1906.29
2192.23
61541
11 1983.13
1883.97
2166.57
61544
11 2116.92
2011.07
2312.73
61548
11 1128.29
1071.88
1232.66
61556
11 1626.48
1545.16
1776.93
61559
11 2212.53
2101.90
2417.19
61566
11 1703.98
1618.78
1861.60
61571
11 3366.77
3198.43
3678.19
61580
11 2728.89
2592.45
2981.32
61583
11 2898.36
2753.44
3166.46
61586
11 2935.49
2788.72
3207.03
61592
11 2384.18
2264.97
2604.72
61597
11 2002.38
1902.26
2187.60
61601
11 2764.21
2626.00
3019.90
61607
11
556.15
528.34
607.59
61610
11 1393.42
1323.75
1522.31
61613
11 3056.42
2903.60
3339.14
61618
11
527.64
501.26
576.45
61624
11 1210.20
1149.69
1322.14
61635
11 3869.87
3676.38
4227.84
61684
11 2003.42
1903.25
2188.74
61692
11 4243.54
4031.36
4636.06
61700
11 1243.98
1181.78
1359.05
61705
11 1750.66
1663.13
1912.60
61711
11 1386.31
1316.99
1514.54
61750
11 1432.62
1360.99
1565.14
61770
11
184.57
175.34
201.64
61783
11 1016.30
965.49
1110.31
61796
11 1188.99
1129.54
1298.97
61799
11
850.55
808.02
929.22
61860
11
265.16
251.90
289.69
61867
11 1085.85
1031.56
1186.29
61875
11
498.10
473.20
544.18
61886
11
904.36
859.14
988.01
62005
11 1480.29
1406.28
1617.22
62115
11 1658.33
1575.41
1811.72
62120
11
956.35
908.53
1044.81
62141
11
946.80
899.46
1034.38
62145
11 1336.51
1269.68
1460.13
62148
11 1388.59
1319.16
1517.03
62162
11 1900.12
1805.11
2075.88
62165
11
839.11
797.15
916.72
62192
11 1260.01
1197.01
1376.56
62201
11
960.85
912.81
1049.73
62225
11
84.70
80.47
92.54
62252 TC
11
541.26
514.20
591.33
62258
F 11
382.09
362.99
417.44
62264
N 11
233.49
221.82
255.09
62267
F 11
248.13
235.72
271.08
62269
N 11
145.33
138.06
158.77
62270
F 11
79.22
75.26
86.55
62273
N 11
302.02
286.92
329.96
62280
F 11
143.15
135.99
156.39
62282
N 11
200.36
190.34
218.89
62284
N 11
312.55
296.92
341.46
62290
F 11
157.31
149.44
171.86
62292
N 11
216.89
206.05
236.96
62310
F 11
81.52
77.44
89.06
62318
N 11
178.36
169.44
194.86
62319
11
790.30
750.79
863.41
62355
11
364.13
345.92
397.81
62362
N 11
37.92
36.02
41.42
62367
F 11
36.53
34.70
39.91
63001
11 1084.13
1029.92
1184.41
63011
11 1360.19
1292.18
1486.01
63016
11 1072.71
1019.07
1171.93
63030
11 1295.05
1230.30
1414.85
63042
11 1759.95
11 1235.41
11 2344.49
11
81.05
11 3482.31
11 1906.39
11 1113.88
11
908.73
11 2436.25
11 1970.35
11 1694.17
11 1447.20
11 1508.52
11 1976.81
11 2070.27
11 1826.27
11 2308.70
11 2651.61
11 2140.11
11 2905.37
11 2662.56
11 2180.28
11 2665.72
11 1743.15
11 2990.26
11 1200.98
11 1056.17
11 1312.70
11 2606.09
11 3371.54
11 3158.71
11 2377.72
11 2395.96
11 1287.94
11 1465.97
11
223.00
11
890.66
11
277.47
11 1436.11
11 2099.03
11
979.31
11
758.74
11 1155.29
11 1179.74
11 1623.34
11 1050.05
11 1297.04
11
117.21
11 1736.59
11 1450.40
11
890.16
11 1094.20
11
466.77
11
41.80
11 1027.47
N 11
390.28
F 11
152.55
N 11
359.05
F 11
74.47
N 11
158.87
F 11
152.41
N 11
275.07
F 11
83.20
F 11
162.94
11
520.96
F 11
99.09
N 11
223.20
F 11
90.49
11
277.20
11
381.53
F 11
23.43
11 1134.66
11 1006.16
11 1396.62
11
890.37
11 1203.51
and descriptors
NPAR FEE
--------
"ALL OF OKLAHOMA"
LC FEE
--------
1671.95
1922.74
1173.64
1349.69
2227.27
2561.36
77.00
88.55
3308.19
3804.42
1811.07
2082.73
1058.19
1216.92
863.29
992.78
2314.44
2661.61
1871.83
2152.60
1609.46
1850.88
1374.84
1581.07
1433.09
1648.05
1877.97
2159.67
1966.76
2261.77
1734.96
1995.20
2193.27
2522.26
2519.03
2896.88
2033.10
2338.07
2760.10
3174.12
2529.43
2908.84
2071.27
2381.96
2532.43
2912.29
1655.99
1904.39
2840.75
3266.86
1140.93
1312.07
1003.36
1153.86
1247.07
1434.13
2475.79
2847.16
3202.96
3683.40
3000.77
3450.89
2258.83
2597.65
2276.16
2617.58
1223.54
1407.07
1392.67
1601.57
211.85
243.63
846.13
973.05
263.60
303.14
1364.30
1568.95
1994.08
2293.19
930.34
1069.89
720.80
828.92
1097.53
1262.16
1120.75
1288.86
1542.17
1773.50
997.55
1147.18
1232.19
1417.02
111.35
128.05
1649.76
1897.22
1377.88
1584.56
845.65
972.50
1039.49
1195.41
443.43
509.94
39.71
45.67
976.10
1122.52
370.77
426.39
144.92
166.66
341.10
392.27
70.75
81.36
150.93
173.57
144.79
166.51
261.32
300.52
79.04
90.90
154.79
178.01
494.91
569.15
94.14
108.26
212.04
243.85
85.97
98.87
263.34
302.84
362.45
416.82
22.26
25.60
1077.93
1239.62
955.85
1099.23
1326.79
1525.81
845.85
972.73
1143.33
1314.83
09/12/2011

----- -- ---- --------
NPAR FEE
--------
PAGE 028
LC FEE
--------
61480
11 1461.26
1388.20
1596.43
61501
11 1064.50
1011.28
1162.97
61514
11 1744.26
1657.05
1905.61
61518
11 2531.41
2404.84
2765.57
61521
11 2927.39
2781.02
3198.17
61526
11 3335.08
3168.33
3643.58
61533
11 1394.85
1325.11
1523.88
61536
11 2376.11
2257.30
2595.90
61539
11 2163.55
2055.37
2363.68
61542
11 2055.59
1952.81
2245.73
61545
11 2922.38
2776.26
3192.70
61550
11
887.68
843.30
969.80
61557
11 1542.50
1465.38
1685.19
61563
11 1818.59
1727.66
1986.81
61567
11 2362.86
2244.72
2581.43
61575
11 2281.45
2167.38
2492.49
61581
11 2560.31
2432.29
2797.13
61584
11 2607.30
2476.94
2848.48
61590
11 2909.64
2764.16
3178.78
61595
11 2217.40
2106.53
2422.51
61598
11 2510.75
2385.21
2742.99
61605
11 2084.66
1980.43
2277.49
61608
11 2977.61
2828.73
3253.04
61611
11
375.43
356.66
410.16
61615
11 2211.86
2101.27
2416.46
61619
11 1383.70
1314.52
1511.70
61626
11
835.47
793.70
912.76
61680
11 2077.73
1973.84
2269.92
61686
11 4158.48
3950.56
4543.14
61697
11 3883.27
3689.11
4242.48
61702
11 3689.44
3504.97
4030.72
61708
11 1982.65
1883.52
2166.05
61720
11 1137.62
1080.74
1242.85
61751
11 1256.68
1193.85
1372.93
61781
11
223.00
211.85
243.63
61790
11
789.91
750.41
862.97
61797
11
201.06
191.01
219.66
61800
11
139.39
132.42
152.28
61863
11 1373.78
1305.09
1500.85
61868
11
467.04
443.69
510.24
61880
11
510.17
484.66
557.36
61888
11
359.04
341.09
392.25
62010
11 1396.35
1326.53
1525.51
62116
11 1625.53
1544.25
1775.89
62121
11 1560.31
1482.29
1704.63
62142
11
809.29
768.83
884.15
62146
11 1133.10
1076.45
1237.92
62160
11
177.26
168.40
193.66
62163
11 1119.90
1063.91
1223.50
62180
11 1467.36
1393.99
1603.09
62194
11
372.31
353.69
406.74
62220
11
929.03
882.58
1014.97
62230
11
767.68
729.30
838.70
62252 26
11
42.90
40.76
46.87
62263
N 11
668.71
635.27
730.56
62264
F 11
223.35
212.18
244.01
62268
N 11
334.43
317.71
365.37
62269
F 11
254.17
241.46
277.68
62272
N 11
179.06
170.11
195.63
62273
F 11
106.90
101.56
116.79
62281
N 11
244.56
232.33
267.18
62282
F 11
132.71
126.07
144.98
62287
11
524.56
498.33
573.08
62291
N 11
295.26
280.50
322.58
62294
11
659.27
626.31
720.26
62311
N 11
186.08
176.78
203.30
62318
F 11
95.64
90.86
104.49
62350
11
367.13
348.77
401.09
62360
11
281.91
267.81
307.98
62365
11
304.35
289.13
332.50
62368
N 11
54.79
52.05
59.86
63003
11 1140.54
1083.51
1246.04
63012
11 1095.07
1040.32
1196.37
63017
11 1145.72
1088.43
1251.69
63035
11
181.58
172.50
198.38
63045
11 1168.86
1110.42
1276.98
MFI00A11
FSY-2011

----- -- ---- -------63046
63050
63056
63066
63077
63082
63087
63091
63103
63173
63185
63194
63197
63200
63252
63267
63271
63275
63278
63282
63286
63295
63302
63305
63308
63610
63621
63661
63663
63685
63702
63707
63740
63746
64402
64405
64410
64412
64415
64417
64418
64421
64425
64435
64445
64447
64450
64455
64480
64483
64490
64491
64493
64494
64505
64508
64517
64520
64550
64553
64560
64561
64566
64569
64577
64585
64590
64600
64605
64611
64612
64614
64620
64623
64626
64630
***
"STATE OK"
NPAR FEE
--------
M E D I C A R E
LC FEE
--------
F E E
S C H E D U L E

----- -- ---- --------
11 1116.19
1060.38
1219.44
63047
11 1438.39
1366.47
1571.44
63051
11 1370.77
1302.23
1497.56
63057
11
193.19
183.53
211.06
63075
11 1397.19
1327.33
1526.43
63078
11
252.96
240.31
276.36
63085
11 2232.08
2120.48
2438.55
63088
11
169.47
161.00
185.15
63101
11
276.96
263.11
302.58
63170
11 1581.67
1502.59
1727.98
63180
11 1086.10
1031.80
1186.57
63190
11 1299.09
1234.14
1419.26
63195
11 1565.51
1487.23
1710.31
63198
11 1393.55
1323.87
1522.45
63250
11 2789.22
2649.76
3047.22
63265
11 1264.66
1201.43
1381.64
63268
11 1901.33
1806.26
2077.20
63272
11 1649.16
1566.70
1801.71
63276
11 1444.30
1372.09
1577.90
63280
11 1812.25
1721.64
1979.89
63283
11 2364.96
2246.71
2583.72
63287
11
307.22
291.86
335.64
63300
11 1970.66
1872.13
2152.95
63303
11 2256.10
2143.30
2464.80
63306
11
302.33
287.21
330.29
63600
F 11
384.85
365.61
420.45
63615
11
230.88
219.34
252.24
63650
N 11
560.44
532.42
612.28
63661
N 11
801.24
761.18
875.36
63663
11
373.00
354.35
407.50
63688
11 1296.81
1231.97
1416.77
63704
11
836.52
794.69
913.89
63709
11
860.10
817.10
939.67
63741
11
534.83
508.09
584.30
64400
N 11
105.79
100.50
115.58
64402
F 11
74.71
70.97
81.62
64408
N 11
138.00
131.10
150.77
64410
F 11
69.85
66.36
76.31
64413
N 11
116.10
110.30
126.85
64415
N 11
121.67
115.59
132.93
64417
F 11
70.26
66.75
76.76
64420
N 11
183.53
174.35
200.50
64421
F 11
89.85
85.36
98.16
64430
N 11
132.22
125.61
144.45
64435
F 11
72.20
68.59
78.88
64446
F 11
63.87
60.68
69.78
64448
N 11
97.00
92.15
105.97
64450
F 11
35.50
33.73
38.79
64479
N 11
118.58
112.65
129.55
64480
F 11
98.15
93.24
107.23
64484
N 11
184.82
175.58
201.92
64490
F 11
60.19
57.18
65.76
64492
N 11
164.76
156.52
180.00
64493
F 11
51.23
48.67
55.97
64495
N 11
93.21
88.55
101.83
64505
F 11
69.98
66.48
76.45
64510
N 11
164.52
156.29
179.73
64517
F 11
74.83
71.09
81.75
64530
N 11
14.85
14.11
16.23
64550
F 11
150.58
143.05
164.51
64555
N 11
216.87
206.03
236.93
64560
F 11
391.42
371.85
427.63
64565
N 11
120.74
114.70
131.91
64566
11
587.20
557.84
641.52
64570
11
308.29
292.88
336.81
64580
N 11
273.12
259.46
298.38
64585
F 11
159.46
151.49
174.21
64595
N 11
384.20
364.99
419.74
64600
F 11
325.46
309.19
355.57
64610
N 11
92.95
88.30
101.55
64611
F 11
143.90
136.71
157.22
64613
N 11
164.01
155.81
179.18
64614
F 11
161.81
153.72
176.78
64622
N 11
117.67
111.79
128.56
64623
F 11
236.37
224.55
258.23
64627
N 11
213.43
202.76
233.17
64630
11 1014.88
11 1588.65
11
303.20
11 1268.86
11
184.60
11 1766.96
11
245.59
11 2145.19
11 1446.15
11 1335.57
11 1182.45
11 1399.64
11 1529.74
11 2725.18
11 1532.43
11 1319.72
11 1749.31
11 1640.25
11 1941.88
11 1735.00
11 2519.99
11 1688.93
11 2093.54
11 2104.35
11
807.38
11 1114.30
11
396.86
F 11
312.57
F 11
454.15
11
336.64
11 1477.04
11 1013.85
11
569.87
N 11
105.75
F 11
68.94
N 11
115.81
F 11
78.16
N 11
111.65
F 11
65.08
F 11
67.18
N 11
127.87
F 11
87.47
N 11
134.69
F 11
78.99
11
79.81
11
71.03
F 11
65.82
N 11
249.32
F 11
63.46
N 11
100.37
F 11
106.08
N 11
92.94
F 11
89.48
N 11
84.30
F 11
78.41
N 11
127.20
F 11
114.76
N 11
181.91
F 11
8.55
N 11
189.95
F 11
154.51
N 11
165.55
F 11
28.77
11
511.29
11
282.42
F 11
143.67
N 11
265.49
F 11
207.83
N 11
673.80
F 11
84.13
N 11
151.98
F 11
142.59
N 11
315.86
F 11
48.06
N 11
160.43
F 11
178.78
and descriptors
NPAR FEE
--------
"ALL OF OKLAHOMA"
LC FEE
--------
964.14
1108.76
1509.22
1735.60
288.04
331.25
1205.42
1386.23
175.37
201.68
1678.61
1930.40
233.31
268.31
2037.93
2343.62
1373.84
1579.92
1268.79
1459.11
1123.33
1291.83
1329.66
1529.11
1453.25
1671.24
2588.92
2977.26
1455.81
1674.18
1253.73
1441.79
1661.84
1911.12
1558.24
1791.98
1844.79
2121.51
1648.25
1895.49
2393.99
2753.09
1604.48
1845.15
1988.86
2287.19
1999.13
2299.00
767.01
882.06
1058.59
1217.38
377.02
433.57
296.94
341.48
431.44
496.16
319.81
367.78
1403.19
1613.67
963.16
1107.63
541.38
622.59
100.46
115.53
65.49
75.31
110.02
126.52
74.25
85.39
106.07
121.98
61.83
71.10
63.82
73.39
121.48
139.70
83.10
95.57
127.96
147.15
75.04
86.30
75.82
87.19
67.48
77.60
62.53
71.91
236.85
272.38
60.29
69.33
95.35
109.65
100.78
115.90
88.29
101.53
85.01
97.76
80.09
92.10
74.49
85.66
120.84
138.97
109.02
125.37
172.81
198.73
8.12
09.34
180.45
207.52
146.78
168.80
157.27
180.86
27.33
31.43
485.73
558.59
268.30
308.55
136.49
156.96
252.22
290.05
197.44
227.06
640.11
736.13
79.92
91.91
144.38
166.04
135.46
155.78
300.07
345.08
45.66
52.51
152.41
175.27
169.84
195.32
09/12/2011

----- -- ---- --------
NPAR FEE
--------
PAGE 029
LC FEE
--------
63048
11
200.45
190.43
218.99
63055
11 1499.82
1424.83
1638.55
63064
11 1634.31
1552.59
1785.48
63076
11
235.05
223.30
256.80
63081
11 1639.26
1557.30
1790.90
63086
11
180.82
171.78
197.55
63090
11 1841.18
1749.12
2011.49
63102
11 2088.83
1984.39
2282.05
63172
11 1287.59
1223.21
1406.69
63182
11 1437.33
1365.46
1570.28
63191
11 1111.72
1056.13
1214.55
63196
11 1379.31
1310.34
1506.89
63199
11 1683.23
1599.07
1838.93
63251
11 2791.45
2651.88
3049.66
63266
11 1578.39
1499.47
1724.39
63270
11 1901.39
1806.32
2077.27
63273
11 1689.48
1605.01
1845.76
63277
11 1429.93
1358.43
1562.19
63281
11 1923.31
1827.14
2101.21
63285
11 2391.31
2271.74
2612.50
63290
11 2556.73
2428.89
2793.22
63301
11 1991.95
1892.35
2176.20
63304
11 2150.65
2043.12
2349.59
63307
11 2197.63
2087.75
2400.91
63610
N 11
811.94
771.34
887.04
63620
11
972.45
923.83
1062.40
63655
11
790.26
750.75
863.36
63662
11
678.05
644.15
740.77
63664
11
705.28
670.02
770.52
63700
11 1170.93
1112.38
1279.24
63706
11 1668.28
1584.87
1822.60
63710
11 1014.51
963.78
1108.35
63744
11
605.32
575.05
661.31
64400
F 11
62.92
59.77
68.74
64405
N 11
105.26
100.00
115.00
64408
F 11
86.20
81.89
94.17
64412
N 11
139.46
132.49
152.36
64413
F 11
74.80
71.06
81.72
64416
11
78.55
74.62
85.81
64418
N 11
129.16
122.70
141.11
64420
F 11
63.62
60.44
69.51
64425
N 11
123.55
117.37
134.98
64430
F 11
79.25
75.29
86.58
64445
N 11
126.06
119.76
137.72
64447
N 11
113.00
107.35
123.45
64449
11
81.07
77.02
88.57
64455
N 11
46.52
44.19
50.82
64479
F 11
124.91
118.66
136.46
64483
N 11
225.71
214.42
246.58
64484
F 11
50.92
48.37
55.63
64491
N 11
92.00
87.40
100.51
64492
F 11
61.13
58.07
66.78
64494
N 11
83.04
78.89
90.72
64495
F 11
51.86
49.27
56.66
64508
N 11
97.38
92.51
106.39
64510
F 11
66.72
63.38
72.89
64520
N 11
179.40
170.43
195.99
64530
F 11
86.48
82.16
94.48
64553
N 11
193.41
183.74
211.30
64555
F 11
141.13
134.07
154.18
64561
N 11
915.52
869.74
1000.20
64565
F 11
117.68
111.80
128.57
64568
11
606.41
576.09
662.50
64575
11
272.65
259.02
297.87
64581
11
671.64
638.06
733.77
64590
N 11
268.75
255.31
293.61
64595
F 11
125.65
119.37
137.28
64605
N 11
609.87
579.38
666.29
64610
F 11
450.50
427.98
492.18
64612
N 11
158.07
150.17
172.70
64613
F 11
134.66
127.93
147.12
64620
N 11
226.06
214.76
246.97
64622
F 11
174.75
166.01
190.91
64626
N 11
376.21
357.40
411.01
64627
F 11
56.50
53.68
61.73
64632
N 11
80.92
76.87
88.40
MFI00A11
FSY-2011

----- -- ---- -------64632
64650
64653
64681
64704
64713
64718
64721
64727
64736
64742
64752
64761
64771
64776
64783
64787
64792
64804
64820
64823
64834
64837
64857
64861
64865
64870
64876
64890
64893
64897
64902
64910
65093
65105
65114
65130
65150
65205
65210
65222
65260
65270
65273
65280
65286
65400
65420
65426
65435
65436
65600
65730
65756
65772
65778
65780
65800
65805
65815
65855
65860
65875
65920
66020
66130
66155
66170
66175
66220
66250
66600
66630
66682
66710
66720
***
F
N
F
N
"STATE OK"
NPAR FEE
--------
M E D I C A R E
LC FEE
--------
F E E
S C H E D U L E

----- -- ---- --------
11
67.38
64.01
73.61
64640
11
85.82
81.53
93.76
64650
11
49.23
46.77
53.79
64680
11
352.91
335.26
385.55
64681
11
304.89
289.65
333.10
64708
11
709.03
673.58
774.62
64714
11
540.57
513.54
590.57
64719
F 11
389.95
370.45
426.02
64722
11
174.75
166.01
190.91
64732
11
395.68
375.90
432.29
64738
11
450.05
427.55
491.68
64744
11
480.50
456.48
524.95
64755
11
422.54
401.41
461.62
64763
11
531.40
504.83
580.55
64772
11
365.01
346.76
398.77
64778
11
207.81
197.42
227.03
64784
11
232.13
220.52
253.60
64788
11 1038.04
986.14
1134.06
64795
11
783.69
744.51
856.19
64809
11
711.44
675.87
777.25
64821
11
722.45
686.33
789.28
64831
11
695.13
660.37
759.43
64835
11
343.38
326.21
375.14
64840
11
989.99
940.49
1081.56
64858
11 1209.68
1149.20
1321.58
64862
11 1078.86
1024.92
1178.66
64866
11 1016.08
965.28
1110.07
64872
11
183.81
174.62
200.81
64885
11 1015.28
964.52
1109.20
64891
11 1054.28
1001.57
1151.81
64895
11 1197.52
1137.64
1308.29
64898
11
684.48
650.26
747.80
64905
11
767.65
729.27
838.66
64911
11
577.97
549.07
631.43
65101
11
779.64
740.66
851.76
65110
11 1353.12
1285.46
1478.28
65125
11
670.16
636.65
732.15
65135
11
512.82
487.18
560.26
65155
N 11
50.66
48.13
55.35
65205
F 11
49.54
47.06
54.12
65220
N 11
69.12
65.66
75.51
65222
11
850.85
808.31
929.56
65265
F 11
128.47
122.05
140.36
65272
11
339.66
322.68
371.08
65275
11
620.77
589.73
678.19
65285
F 11
449.56
427.08
491.14
65290
F 11
543.82
516.63
594.12
65410
N 11
458.86
435.92
501.31
65420
F 11
432.98
411.33
473.03
65430
N 11
73.02
69.37
79.78
65435
F 11
340.71
323.67
372.22
65450
N 11
353.23
335.57
385.91
65600
11 1116.91
1061.06
1220.22
65750
11 1056.21
1003.40
1153.91
65770
F 11
366.03
347.73
399.89
65775
F 11
70.99
67.44
77.56
65779
11
802.24
762.13
876.45
65781
N 11
135.93
129.13
148.50
65800
F 11
122.10
116.00
133.40
65810
F 11
436.53
414.70
476.91
65820
N 11
308.98
293.53
337.56
65855
F 11
251.91
239.31
275.21
65865
11
569.98
541.48
622.70
65880
11
711.51
675.93
777.32
65930
F 11
116.50
110.68
127.28
66030
N 11
644.04
611.84
703.62
66130
11
771.56
732.98
842.93
66160
11 1080.40
1026.38
1180.34
66172
11 1023.82
972.63
1118.52
66180
11
666.60
633.27
728.26
66225
F 11
513.15
487.49
560.61
66500
11
732.51
695.88
800.26
66605
11
520.20
494.19
568.32
66635
11
579.03
550.08
632.59
66700
N 11
404.51
384.28
441.92
66710
N 11
420.35
399.33
459.23
66720
N
F
N
F
11
206.77
11
37.94
11
294.72
11
191.33
11
450.41
11
631.14
11
367.07
11
321.18
11
383.82
11
473.51
11
421.96
11
844.37
11
491.36
11
532.84
11
180.36
11
681.07
11
367.70
11
183.64
11
811.51
11
641.15
11
634.68
11
755.86
11
833.26
11 1140.29
11 1344.89
11 1085.32
11
110.08
11 1059.67
11 1102.33
11 1271.44
11 1292.85
11
960.54
11
954.93
11
675.70
11 1105.01
N 11
408.53
11
681.14
11
779.89
F 11
40.58
N 11
52.14
F 11
54.32
11 1005.63
N 11
440.09
N 11
511.43
11
960.01
11
455.46
N 11
131.03
F 11
338.54
N 11
104.72
F 11
64.51
N 11
290.73
F 11
309.45
11 1123.92
11 1386.44
11
489.41
N 11 1057.14
11 1193.23
F 11
120.50
11
426.97
11
663.23
F 11
273.71
11
419.74
11
587.49
11
588.73
N 11
147.49
F 11
534.12
11
873.87
11 1361.25
11 1062.31
11
864.87
11
311.72
11
938.84
11
509.19
N 11
399.67
F 11
363.88
F 11
379.09
and descriptors
NPAR FEE
--------
"ALL OF OKLAHOMA"
LC FEE
--------
196.43
225.89
36.04
41.45
279.98
321.98
181.76
209.02
427.89
492.07
599.58
689.52
348.72
401.03
305.12
350.89
364.63
419.32
449.83
517.30
400.86
460.99
802.15
922.47
466.79
536.81
506.20
582.13
171.34
197.04
647.02
744.07
349.32
401.72
174.46
200.63
770.93
886.57
609.09
700.45
602.95
693.39
718.07
825.78
791.60
910.34
1083.28
1245.77
1277.65
1469.30
1031.05
1185.71
104.58
120.27
1006.69
1157.69
1047.21
1204.29
1207.87
1389.05
1228.21
1412.44
912.51
1049.39
907.18
1043.26
641.92
738.21
1049.76
1207.22
388.10
446.32
647.08
744.14
740.90
852.04
38.55
44.33
49.53
56.96
51.60
59.34
955.35
1098.65
418.09
480.80
485.86
558.74
912.01
1048.81
432.69
497.59
124.48
143.15
321.61
369.85
99.48
114.40
61.28
70.47
276.19
317.62
293.98
338.08
1067.72
1227.88
1317.12
1514.69
464.94
534.68
1004.28
1154.92
1133.57
1303.61
114.48
131.65
405.62
466.46
630.07
724.58
260.02
299.02
398.75
458.56
558.12
641.84
559.29
643.18
140.12
161.14
507.41
583.52
830.18
954.71
1293.19
1487.17
1009.19
1160.57
821.63
944.87
296.13
340.55
891.90
1025.69
483.73
556.29
379.69
436.64
345.69
397.54
360.14
414.16
09/12/2011

----- -- ---- --------
NPAR FEE
--------
PAGE 030
LC FEE
--------
64640
F 11
160.79
152.75
175.66
64653
N 11
101.83
96.74
111.25
64680
F 11
155.19
147.43
169.54
64702
11
450.09
427.59
491.73
64712
11
515.22
489.46
562.88
64716
11
498.22
473.31
544.31
64721
N 11
391.84
372.25
428.09
64726
11
262.63
249.50
286.93
64734
11
398.46
378.54
435.32
64740
11
433.04
411.39
473.10
64746
11
411.07
390.52
449.10
64760
11
462.15
439.04
504.90
64766
11
560.77
532.73
612.64
64774
11
386.36
367.04
422.10
64782
11
424.85
403.61
464.15
64786
11 1004.83
954.59
1097.78
64790
11
773.34
734.67
844.87
64802
11
587.09
557.74
641.40
64818
11
627.76
596.37
685.83
64822
11
636.43
604.61
695.30
64832
11
323.02
306.87
352.90
64836
11
756.49
718.67
826.47
64856
11
950.32
902.80
1038.22
64859
11
248.68
236.25
271.69
64864
11
819.11
778.15
894.87
64868
11
984.12
934.91
1075.15
64874
11
167.32
158.95
182.79
64886
11 1243.85
1181.66
1358.91
64892
11
984.82
935.58
1075.92
64896
11 1411.35
1340.78
1541.90
64901
11
593.10
563.45
647.97
64907
11 1102.84
1047.70
1204.86
65091
11
583.44
554.27
637.41
65103
11
706.32
671.00
771.65
65112
11 1290.98
1226.43
1410.39
65125
F 11
265.85
252.56
290.44
65140
11
728.13
691.72
795.48
65175
11
591.19
561.63
645.87
65210
N 11
62.77
59.63
68.57
65220
F 11
39.23
37.27
42.86
65235
11
641.17
609.11
700.48
65270
N 11
236.50
224.68
258.38
65272
F 11
311.27
295.71
340.07
65275
F 11
417.26
396.40
455.86
65286
N 11
629.72
598.23
687.96
65400
N 11
609.01
578.56
665.34
65410
F 11
97.96
93.06
107.02
65426
N 11
582.28
553.17
636.15
65430
F 11
95.28
90.52
104.10
65436
N 11
354.26
336.55
387.03
65450
F 11
287.58
273.20
314.18
65710
11 1005.79
955.50
1098.83
65755
11 1121.26
1065.20
1224.98
65772
N 11
404.45
384.23
441.86
65778
N 11 1164.54
1106.31
1272.26
65779
F 11
274.14
260.43
299.49
65782
11 1073.70
1020.02
1173.02
65805
N 11
150.13
142.62
164.01
65815
N 11
575.74
546.95
628.99
65850
11
776.93
738.08
848.79
65860
N 11
299.47
284.50
327.18
65870
11
541.60
514.52
591.70
65900
11
857.39
814.52
936.70
66020
N 11
163.74
155.55
178.88
66030
F 11
99.93
94.93
109.17
66150
11
772.21
733.60
843.64
66165
11
756.46
718.64
826.44
66174
11
922.68
876.55
1008.03
66185
11
686.09
651.79
749.56
66250
N 11
679.76
645.77
742.64
66505
11
341.72
324.63
373.32
66625
11
388.30
368.89
424.22
66680
11
476.78
452.94
520.88
66700
F 11
352.11
334.50
384.68
66711
11
567.24
538.88
619.71
66740
N 11
386.40
367.08
422.14
MFI00A11
FSY-2011

----- -- ---- -------66740
66762
66770
66821
66840
66920
66982
66985
67005
67025
67028
67031
67039
67042
67101
67107
67110
67115
67121
67145
67208
67218
67221
67225
67228
67250
67312
67318
67332
67340
67345
67405
67414
67430
67450
67505
67515
67570
67710
67715
67801
67805
67810
67825
67830
67840
67875
67880
67900
67901
67903
67906
67909
67912
67914
67916
67917
67922
67923
67930
67935
67950
67961
67971
67975
68040
68100
68115
68130
68200
68320
68328
68335
68360
68371
68420
***
F
N
F
F
"STATE OK"
NPAR FEE
--------
M E D I C A R E
LC FEE
--------
F E E
S C H E D U L E

----- -- ---- --------
11
349.55
332.07
381.88
66761
11
425.70
404.42
465.08
66762
11
426.98
405.63
466.47
66820
11
279.15
265.19
304.97
66825
11
644.19
611.98
703.78
66850
11
670.92
637.37
732.98
66930
11
973.21
924.55
1063.23
66983
11
695.42
660.65
759.75
66986
11
436.49
414.67
476.87
67010
N 11
660.50
627.48
721.60
67025
N 11
120.89
114.85
132.08
67028
N 11
348.95
331.50
381.23
67031
11 1140.73
1083.69
1246.24
67040
11 1387.06
1317.71
1515.37
67043
F 11
618.74
587.80
675.97
67105
11 1123.19
1067.03
1227.08
67108
F 11
700.96
665.91
765.80
67112
11
448.06
425.66
489.51
67120
11
837.11
795.25
914.54
67141
N 11
474.97
451.22
518.90
67145
F 11
512.95
487.30
560.40
67210
11 1241.90
1179.81
1356.78
67220
N 11
264.85
251.61
289.35
67221
F 11
25.47
24.20
27.83
67227
N 11 1066.09
1012.79
1164.71
67228
11
715.26
679.50
781.43
67255
11
661.21
628.15
722.37
67314
11
624.61
593.38
682.39
67320
11
312.79
297.15
341.72
67334
11
324.93
308.68
354.98
67343
F 11
202.08
191.98
220.78
67346
11
715.86
680.07
782.08
67412
11 1200.96
1140.91
1312.05
67415
11 1108.44
1053.02
1210.97
67440
11 1134.16
1077.45
1239.07
67500
N 11
83.09
78.94
90.78
67505
F 11
82.79
78.65
90.45
67550
11 1114.30
1058.59
1217.38
67700
N 11
199.17
189.21
217.59
67710
F 11
100.42
95.40
109.71
67800
N 11
148.92
141.47
162.69
67801
F 11
153.93
146.23
168.16
67808
F 11
86.17
81.86
94.14
67820
N 11
117.73
111.84
128.62
67825
F 11
127.68
121.30
139.50
67835
F 11
145.85
138.56
159.34
67850
N 11
154.65
146.92
168.96
67875
F 11
337.19
320.33
368.38
67882
N 11
584.89
555.65
639.00
67900
F 11
533.02
506.37
582.33
67902
F 11
453.92
431.22
495.90
67904
11
454.82
432.08
496.89
67908
N 11
490.55
466.02
535.92
67909
N 11
801.70
761.62
875.86
67912
F 11
266.38
253.06
291.02
67915
N 11
489.42
464.95
534.69
67916
F 11
440.22
418.21
480.94
67921
N 11
301.46
286.39
329.35
67922
F 11
431.32
409.75
471.21
67924
N 11
333.90
317.21
364.79
67930
F 11
417.19
396.33
455.78
67938
N 11
524.35
498.13
572.85
67950
F 11
421.98
400.88
461.01
67966
11
677.39
643.52
740.05
67973
11
640.26
608.25
699.49
68020
N 11
60.24
57.23
65.81
68040
F 11
90.11
85.60
98.44
68110
N 11
276.98
263.13
302.60
68115
F 11
365.83
347.54
399.67
68135
N 11
38.63
36.70
42.21
68200
F 11
495.01
470.26
540.80
68325
11
660.80
627.76
721.92
68330
11
598.67
568.74
654.05
68340
N 11
481.75
457.66
526.31
68360
11
366.75
348.41
400.67
68400
N 11
284.48
270.26
310.80
68420
N 11
295.50
F 11
383.81
11
356.56
11
684.93
11
720.56
11
762.77
11
664.64
11
828.41
11
492.14
F 11
579.56
F 11
101.36
F 11
321.55
11 1297.37
11 1477.42
N 11
649.72
11 1469.46
11 1212.19
N 11
600.08
N 11
476.64
F 11
449.46
N 11
631.42
N 11
980.44
F 11
199.97
N 11
540.37
F 11
964.05
11
775.16
11
616.17
11
291.98
11
273.10
11
603.42
11
189.21
11
785.12
11
98.03
11 1091.38
N 11
77.58
F 11
75.85
11
891.71
N 11
236.12
F 11
88.93
N 11
115.43
F 11
125.30
11
339.01
N 11
47.10
F 11
111.43
11
407.14
N 11
197.50
F 11
90.39
N 11
514.59
F 11
472.45
11
667.41
N 11
667.97
N 11
450.94
F 11
406.77
F 11
452.10
N 11
311.89
F 11
397.77
N 11
337.50
F 11
222.72
N 11
534.64
F 11
228.07
N 11
215.68
F 11
430.17
N 11
703.84
11
875.24
N 11
108.24
F 11
50.17
N 11
203.05
F 11
167.06
N 11
141.64
F 11
32.02
11
610.17
N 11
548.67
N 11
493.17
F 11
378.44
N 11
251.75
F 11
155.98
and descriptors
NPAR FEE
--------
"ALL OF OKLAHOMA"
LC FEE
--------
280.73
322.84
364.62
419.31
338.73
389.54
650.68
748.28
684.53
787.21
724.63
833.32
631.41
726.12
786.99
905.04
467.53
537.66
550.58
633.17
96.29
110.73
305.47
351.29
1232.50
1417.38
1403.55
1614.08
617.23
709.81
1395.99
1605.39
1151.58
1324.32
570.08
655.59
452.81
520.73
426.99
491.04
599.85
689.83
931.42
1071.13
189.97
218.47
513.35
590.35
915.85
1053.23
736.40
846.86
585.36
673.16
277.38
318.99
259.45
298.37
573.25
659.24
179.75
206.71
745.86
857.74
93.13
107.10
1036.81
1192.33
73.70
84.76
72.06
82.87
847.12
974.19
224.31
257.96
84.48
97.15
109.66
126.11
119.04
136.90
322.06
370.37
44.75
51.46
105.86
121.74
386.78
444.80
187.63
215.77
85.87
98.75
488.86
562.19
448.83
516.15
634.04
729.15
634.57
729.76
428.39
492.65
386.43
444.39
429.50
493.93
296.30
340.75
377.88
434.56
320.63
368.72
211.58
243.32
507.91
584.10
216.67
249.17
204.90
235.64
408.66
469.96
668.65
768.95
831.48
956.20
102.83
118.25
47.66
54.81
192.90
221.84
158.71
182.52
134.56
154.74
30.42
34.98
579.66
666.61
521.24
599.43
468.51
538.79
359.52
413.45
239.16
275.03
148.18
170.41
09/12/2011

----- -- ---- --------
NPAR FEE
--------
PAGE 031
LC FEE
--------
66761
F 11
252.03
239.43
275.34
66770
N 11
465.10
441.85
508.13
66821
N 11
295.53
280.75
322.86
66830
11
633.72
602.03
692.33
66852
11
779.09
740.14
851.16
66940
11
717.36
681.49
783.71
66984
11
699.93
664.93
764.67
66990
11
82.25
78.14
89.86
67015
11
525.00
498.75
573.56
67027
11
785.34
746.07
857.98
67030
11
466.62
443.29
509.78
67036
11
876.74
832.90
957.84
67041
11 1212.19
1151.58
1324.32
67101
N 11
710.71
675.17
776.45
67105
F 11
584.84
555.60
638.94
67110
N 11
781.90
742.81
854.23
67113
11 1596.39
1516.57
1744.06
67120
F 11
514.41
488.69
561.99
67141
F 11
445.77
423.48
487.00
67208
N 11
530.90
504.36
580.01
67210
F 11
611.58
581.00
668.15
67220
F 11
937.29
890.43
1023.99
67225
N 11
27.05
25.70
29.56
67227
F 11
506.67
481.34
553.54
67229
11 1018.92
967.97
1113.17
67311
11
548.35
520.93
599.07
67316
11
743.21
706.05
811.96
67331
11
287.76
273.37
314.38
67335
11
140.88
133.84
153.92
67345
N 11
221.61
210.53
242.11
67400
11
855.76
812.97
934.92
67413
11
790.37
750.85
863.48
67420
11 1511.88
1436.29
1651.73
67445
11 1306.92
1241.57
1427.81
67500
F 11
70.96
67.41
77.52
67515
N 11
89.09
84.64
97.34
67560
11
895.30
850.54
978.12
67700
F 11
105.41
100.14
115.16
67715
N 11
210.65
200.12
230.14
67800
F 11
95.90
91.11
104.78
67805
N 11
184.80
175.56
201.89
67810
N 11
198.92
188.97
217.32
67820
F 11
49.31
46.84
53.87
67830
N 11
238.55
226.62
260.61
67840
N 11
247.90
235.51
270.84
67850
F 11
127.27
120.91
139.05
67880
N 11
414.67
393.94
453.03
67882
F 11
435.85
414.06
476.17
67901
N 11
660.27
627.26
721.35
67903
N 11
551.56
523.98
602.58
67904
F 11
551.11
523.55
602.08
67908
F 11
395.82
376.03
432.43
67911
11
516.98
491.13
564.80
67914
N 11
352.99
335.34
385.64
67915
F 11
231.57
219.99
252.99
67917
N 11
535.66
508.88
585.21
67921
F 11
250.88
238.34
274.09
67923
N 11
518.56
492.63
566.52
67924
F 11
416.53
395.70
455.06
67935
N 11
545.38
518.11
595.83
67938
F 11
105.45
100.18
115.21
67961
N 11
525.28
499.02
573.87
67966
F 11
607.78
577.39
664.00
67974
11
872.64
829.01
953.36
68020
F 11
101.00
95.95
110.34
68100
N 11
152.16
144.55
166.23
68110
F 11
136.90
130.06
149.57
68130
N 11
475.43
451.66
519.41
68135
F 11
136.91
130.06
149.57
68320
N 11
655.01
622.26
715.60
68326
11
597.40
567.53
652.66
68330
F 11
424.58
403.35
463.85
68340
F 11
367.18
348.82
401.14
68362
11
607.29
576.93
663.47
68400
F 11
124.51
118.28
136.02
68440
N 11
95.52
90.74
104.35
MFI00A11
FSY-2011

----- -- ---- --------
"STATE OK"
NPAR FEE
--------
M E D I C A R E
LC FEE
--------
F E E
S C H E D U L E

----- -- ---- --------
68440
F 11
89.53
85.05
97.81
68500
68510
N 11
410.83
390.29
448.83
68510
68525
11
253.25
240.59
276.68
68530
68540
11
842.70
800.57
920.66
68550
68705
N 11
214.90
204.16
234.78
68705
68745
11
704.92
669.67
770.12
68750
68760
F 11
134.37
127.65
146.80
68761
68770
11
568.05
539.65
620.60
68801
68810
N 11
216.74
205.90
236.79
68810
68815
N 11
400.22
380.21
437.24
68815
68816
F 11
230.72
219.18
252.06
68840
68850
N 11
56.81
53.97
62.07
68850
69000
F 11
111.73
106.14
122.06
69005
69020
N 11
217.17
206.31
237.26
69020
69100
F 11
47.35
44.98
51.73
69105
69110
N 11
428.40
406.98
468.03
69110
69140
11
827.75
786.36
904.31
69145
69150
11
995.70
945.92
1087.81
69155
69200
F 11
53.95
51.25
58.94
69205
69210
F 11
31.14
29.58
34.02
69220
69222
N 11
206.76
196.42
225.88
69222
69300
F 11
453.84
431.15
495.82
69310
69400
N 11
135.68
128.90
148.24
69400
69401
F 11
46.94
44.59
51.28
69405
69420
N 11
179.81
170.82
196.44
69420
69424
N 11
120.61
114.58
131.77
69424
69433
F 11
124.19
117.98
135.68
69436
69450
11
514.31
488.59
561.88
69501
69505
11 1144.81
1087.57
1250.71
69511
69535
11 2562.29
2434.18
2799.31
69540
69550
11
989.94
940.44
1081.51
69552
69601
11
998.96
949.01
1091.36
69602
69604
11 1066.64
1013.31
1165.31
69605
69610
F 11
282.18
268.07
308.28
69620
69631
11
839.22
797.26
916.85
69632
69635
11 1162.00
1103.90
1269.49
69636
69641
11
992.25
942.64
1084.04
69642
69644
11 1410.51
1339.98
1540.98
69645
69650
11
761.15
723.09
831.55
69660
69662
11 1107.60
1052.22
1210.05
69666
69670
11
899.11
854.15
982.27
69676
69711
11
824.59
783.36
900.86
69714
69717
11 1089.17
1034.71
1189.92
69718
69725
11 1808.07
1717.67
1975.32
69740
69801
N 11
189.85
180.36
207.41
69801
69805
11 1010.28
959.77
1103.74
69806
69840
11
800.33
760.31
874.36
69905
69915
11 1479.78
1405.79
1616.66
69930
69955
11 1905.92
1810.62
2082.21
69960
69990
11
202.59
192.46
221.33
70010
70015 TC
11
81.80
77.71
89.37
70015 26
70030 TC
11
18.81
17.87
20.55
70030 26
70100 TC
11
22.28
21.17
24.35
70100 26
70110 TC
11
25.42
24.15
27.77
70110 26
70120 TC
11
24.17
22.96
26.40
70120 26
70130 TC
11
36.76
34.92
40.16
70130 26
70134 TC
11
27.63
26.25
30.19
70134 26
70140 TC
11
19.13
18.17
20.90
70140 26
70150 TC
11
27.94
26.54
30.52
70150 26
70160 TC
11
22.91
21.76
25.02
70160 26
70170 TC
11
32.83
31.19
35.87
70170 26
70190 TC
11
23.54
22.36
25.71
70190 26
70200 TC
11
28.26
26.85
30.88
70200 26
70210 TC
11
20.70
19.67
22.62
70210 26
70220 TC
11
24.79
23.55
27.08
70220 26
70240 TC
11
18.81
17.87
20.55
70240 26
70250 TC
11
23.22
22.06
25.37
70250 26
70260 TC
11
28.57
27.14
31.21
70260 26
70300 TC
11
8.10
7.70
08.86
70300 26
70310 TC
11
26.68
25.35
29.15
70310 26
70320 TC C11
28.26
26.85
30.88
70320 26
70328 TC
11
20.39
19.37
22.28
70328 26
70330 TC
11
33.61
31.93
36.72
70330 26
70332 TC
11
53.14
50.48
58.05
70332 26
70336 TC C11
317.71
301.82
347.09
70336 26
70350 TC
11
10.94
10.39
11.95
70350 26
11
913.70
F 11
276.97
N 11
390.00
11 1032.47
F 11
153.79
11
728.23
N 11
132.92
N 11
111.33
F 11
172.96
F 11
237.70
N 11
115.15
F 11
52.08
N 11
200.63
F 11
135.28
N 11
131.32
F 11
309.66
N 11
367.43
11 1603.08
11
96.41
N 11
128.75
F 11
130.53
11 1030.12
F 11
59.14
N 11
245.90
F 11
114.61
F 11
59.19
11
154.85
11
697.31
11 1174.81
N 11
196.04
11 1500.97
11 1038.89
11 1489.74
N 11
654.33
11 1026.84
11 1313.74
11 1277.76
11 1384.06
11
886.28
11
769.30
11
791.83
11 1029.74
11 1291.54
11 1120.85
F 11
283.71
11
904.71
11
876.96
11 1181.08
11 1854.90
11
120.41
11
57.78
11
8.21
11
8.86
11
11.87
11
8.86
11
16.19
11
16.19
11
9.52
11
12.53
11
8.21
11
14.66
11
10.20
11
13.52
11
8.52
11
11.87
11
9.20
11
11.85
11
16.19
11
5.52
11
8.50
11
11.17
11
8.86
11
11.85
11
27.54
11
71.01
11
9.15
and descriptors
NPAR FEE
--------
"ALL OF OKLAHOMA"
LC FEE
--------
868.02
998.22
263.12
302.59
370.50
426.08
980.85
1127.98
146.10
168.02
691.82
795.59
126.27
145.21
105.76
121.62
164.31
188.96
225.82
259.69
109.39
125.80
49.48
56.90
190.60
219.19
128.52
147.80
124.75
143.46
294.18
338.31
349.06
401.42
1522.93
1751.37
91.59
105.33
122.31
140.66
124.00
142.60
978.61
1125.40
56.18
64.61
233.61
268.65
108.88
125.21
56.23
64.66
147.11
169.18
662.44
761.81
1116.07
1283.48
186.24
214.18
1425.92
1639.81
986.95
1134.99
1415.25
1627.54
621.61
714.85
975.50
1121.83
1248.05
1435.26
1213.87
1395.95
1314.86
1512.09
841.97
968.27
730.84
840.47
752.24
865.08
978.25
1124.99
1226.96
1411.00
1064.81
1224.53
269.52
309.95
859.47
988.39
833.11
958.08
1122.03
1290.33
1762.16
2026.48
114.39
131.55
54.89
63.12
7.80
08.97
8.42
09.68
11.28
12.97
8.42
09.68
15.38
17.69
15.38
17.69
9.04
10.40
11.90
13.69
7.80
08.97
13.93
16.02
9.69
11.14
12.84
14.77
8.09
09.30
11.28
12.97
8.74
10.05
11.26
12.95
15.38
17.69
5.24
06.03
8.08
09.29
10.61
12.20
8.42
09.68
11.26
12.95
26.16
30.08
67.46
77.58
8.69
09.99
09/12/2011

----- -- ---- --------
NPAR FEE
--------
PAGE 032
LC FEE
--------
68505
11
902.82
857.68
986.33
68520
11
622.89
591.75
680.51
68530
F 11
242.60
230.47
265.04
68700
11
558.88
530.94
610.58
68720
11
696.25
661.44
760.66
68760
N 11
182.25
173.14
199.11
68761
F 11
108.36
102.94
118.38
68801
F 11
96.84
92.00
105.80
68811
11
189.93
180.43
207.49
68816
N 11
630.09
598.59
688.38
68840
F 11
104.76
99.52
114.45
69000
N 11
170.94
162.39
186.75
69005
F 11
149.61
142.13
163.45
69100
N 11
96.49
91.67
105.42
69105
F 11
60.77
57.73
66.39
69120
11
380.17
361.16
415.33
69145
F 11
236.09
224.29
257.93
69200
N 11
114.43
108.71
125.02
69210
N 11
47.20
44.84
51.57
69220
F 11
59.14
56.18
64.61
69300
N 11
630.22
598.71
688.52
69320
11 1459.07
1386.12
1594.04
69401
N 11
79.38
75.41
86.72
69405
F 11
184.48
175.26
201.55
69421
11
143.20
136.04
156.45
69433
N 11
187.49
178.12
204.84
69440
11
653.03
620.38
713.44
69502
11
927.01
880.66
1012.76
69530
11 1579.35
1500.38
1725.44
69540
F 11
121.08
115.03
132.28
69554
11 2398.73
2278.79
2620.61
69603
11 1204.27
1144.06
1315.67
69610
N 11
368.79
350.35
402.90
69620
F 11
465.35
442.08
508.39
69633
11
990.56
941.03
1082.18
69637
11 1309.42
1243.95
1430.54
69643
11 1167.73
1109.34
1275.74
69646
11 1469.53
1396.05
1605.46
69661
11 1156.27
1098.46
1263.23
69667
11
770.59
732.06
841.87
69700
11
657.04
624.19
717.82
69715
11 1277.32
1213.45
1395.47
69720
11 1120.84
1064.80
1224.52
69745
11 1194.28
1134.57
1304.76
69802
11
994.68
944.95
1086.69
69820
11
820.25
779.24
896.13
69910
11
976.96
928.11
1067.33
69950
11 1807.73
1717.34
1974.94
69970
11 2067.51
1964.13
2258.75
70015
11
139.58
132.60
152.49
70030
11
27.02
25.67
29.52
70100
11
31.14
29.58
34.02
70110
11
37.30
35.44
40.76
70120
11
33.03
31.38
36.09
70130
11
52.95
50.30
57.85
70134
11
43.82
41.63
47.87
70140
11
28.64
27.21
31.29
70150
11
40.47
38.45
44.22
70160
11
31.11
29.55
33.98
70170
11
48.15
45.74
52.60
70190
11
33.73
32.04
36.85
70200
11
41.78
39.69
45.64
70210
11
29.22
27.76
31.92
70220
11
36.67
34.84
40.07
70240
11
28.01
26.61
30.60
70250
11
35.07
33.32
38.32
70260
11
44.76
42.52
48.90
70300
11
13.62
12.94
14.88
70310
11
35.18
33.42
38.43
70320
C11
39.43
37.46
43.08
70328
11
29.25
27.79
31.96
70330
11
45.46
43.19
49.67
70332
11
80.68
76.65
88.15
70336
C11
388.72
369.28
424.67
70350
11
20.09
19.09
21.95
70355
11
20.48
19.46
22.38
MFI00A11
FSY-2011

----- -- ---- --------
"STATE OK"
NPAR FEE
--------
M E D I C A R E
LC FEE
--------
F E E

----- -- ---- --------
S C H E D U L E
NPAR FEE
--------
"ALL OF OKLAHOMA"
LC FEE
--------
70355 TC
11
10.31
9.79
11.26
70355 26
11
10.17
9.66
11.11
70360 TC
11
17.87
16.98
19.53
70360 26
11
8.21
7.80
08.97
70370 TC
11
61.02
57.97
66.67
70370 26
11
15.51
14.73
16.94
70371 TC
11
49.68
47.20
54.28
70371 26
11
39.93
37.93
43.62
70373 TC
11
56.92
54.07
62.18
70373 26
11
20.53
19.50
22.43
70380 TC
11
28.26
26.85
30.88
70380 26
11
8.84
8.40
09.66
70390 TC
11
76.76
72.92
83.86
70390 26
11
18.63
17.70
20.36
70450 TC
11
143.85
136.66
157.16
70450 26
11
40.82
38.78
44.60
70460 TC
11
186.37
177.05
203.61
70460 26
11
54.34
51.62
59.36
70470 TC
11
229.52
218.04
250.75
70470 26
11
61.44
58.37
67.13
70480 TC C11
179.76
170.77
196.39
70480 26
11
61.78
58.69
67.49
70481 TC
11
276.13
262.32
301.67
70481 26
11
66.66
63.33
72.83
70482 TC C11
309.83
294.34
338.49
70482 26
11
69.67
66.19
76.12
70486 TC C11
179.76
170.77
196.39
70486 26
11
54.99
52.24
60.08
70487 TC
11
233.93
222.23
255.56
70487 26
11
62.77
59.63
68.57
70488 TC
11
291.88
277.29
318.88
70488 26
11
68.34
64.92
74.66
70490 TC C11
179.76
170.77
196.39
70490 26
11
61.78
58.69
67.49
70491 TC
11
224.48
213.26
245.25
70491 26
11
66.44
63.12
72.59
70492 TC
11
281.17
267.11
307.18
70492 26
11
69.67
66.19
76.12
70496 TC C11
313.93
298.23
342.96
70496 26
11
84.73
80.49
92.56
70498 TC C11
313.93
298.23
342.96
70498 26
11
84.73
80.49
92.56
70540 TC C11
318.02
302.12
347.44
70540 26
11
65.01
61.76
71.02
70542 TC C11
404.95
384.70
442.41
70542 26
11
78.11
74.20
85.33
70543 TC C11
494.72
469.98
540.48
70543 26
11
103.19
98.03
112.73
70544 TC C11
318.02
302.12
347.44
70544 26
11
57.80
54.91
63.15
70545 TC C11
404.95
384.70
442.41
70545 26
11
57.80
54.91
63.15
70546 TC C11
494.72
469.98
540.48
70546 26
11
86.97
82.62
95.01
70547 TC C11
318.02
302.12
347.44
70547 26
11
57.80
54.91
63.15
70548 TC C11
404.95
384.70
442.41
70548 26
11
57.80
54.91
63.15
70549 TC C11
494.72
469.98
540.48
70549 26
11
86.74
82.40
94.76
70551 TC C11
318.02
302.12
347.44
70551 26
11
71.32
67.75
77.91
70552 TC C11
404.95
384.70
442.41
70552 26
11
86.29
81.98
94.28
70553 TC C11
494.72
469.98
540.48
70553 26
11
113.93
108.23
124.46
70554 TC
11
432.35
410.73
472.34
70554 26
11
102.46
97.34
111.94
70557 26
11
169.71
161.22
185.40
70558 26
11
157.45
149.58
172.02
71010
11
22.32
21.20
24.38
71010 TC
11
13.77
13.08
15.04
71015
11
28.38
26.96
31.00
71015 TC
11
18.50
17.58
20.22
71020
11
29.35
27.88
32.06
71020 TC
11
18.81
17.87
20.55
71021
11
36.09
34.29
39.43
71021 TC
11
23.22
22.06
25.37
71022
11
44.06
41.86
48.14
71022 TC
11
29.20
27.74
31.90
71023
11
65.34
62.07
71.38
71023 TC
11
46.84
44.50
51.18
71030
11
43.74
41.55
47.78
71030 TC
11
28.89
27.45
31.57
71034
11
83.80
79.61
91.55
71034 TC
11
61.02
57.97
66.67
71035
11
33.34
31.67
36.42
71035 TC
11
24.48
23.26
26.75
71040
11
91.34
86.77
99.79
71040 TC
11
64.17
60.96
70.10
71060
11
133.05
126.40
145.36
71060 TC
11
97.55
92.67
106.57
71090
11
86.73
82.39
94.75
71090 TC
11
58.11
55.20
63.48
71100
11
30.61
29.08
33.44
71100 TC
11
20.07
19.07
21.93
71101
11
37.35
35.48
40.80
71101 TC
11
24.48
23.26
26.75
71110
11
38.61
36.68
42.18
71110 TC
11
25.74
24.45
28.12
71111
11
49.75
47.26
54.35
71111 TC
11
34.56
32.83
37.75
71120
11
30.24
28.73
33.04
71120 TC
11
20.70
19.67
22.62
71130
11
35.33
33.56
38.59
71130 TC
11
24.79
23.55
27.08
71250
C11
229.05
217.60
250.24
71250 TC C11
179.76
170.77
196.39
71260
11
291.83
277.24
318.83
71260 TC
11
231.72
220.13
253.15
71270
11
358.00
340.10
391.12
71270 TC
11
291.57
276.99
318.54
71275
C11
406.55
386.22
444.15
71275 TC C11
313.61
297.93
342.62
71550
C11
388.04
368.64
423.94
71550 TC C11
318.02
302.12
347.44
71551
C11
488.06
463.66
533.21
71551 TC C11
404.95
384.70
442.41
71552
C11
603.85
573.66
659.71
71552 TC C11
494.72
469.98
540.48
71555
11
519.75
493.76
567.82
71555 TC
11
432.04
410.44
472.01
72010
11
70.06
66.56
76.54
72010 TC
11
48.10
45.70
52.56
72020
11
22.56
21.43
24.64
72020 TC
11
15.03
14.28
16.42
72040
11
36.73
34.89
40.12
72040 TC
11
25.42
24.15
27.77
72050
11
49.87
47.38
54.49
72050 TC
11
34.56
32.83
37.75
72052
11
63.22
60.06
69.07
72052 TC
11
45.58
43.30
49.80
72069
11
35.16
33.40
38.41
72069 TC
11
23.85
22.66
26.06
72070
11
32.18
30.57
35.16
72070 TC
11
21.33
20.26
23.30
72072
11
35.65
33.87
38.95
72072 TC
11
25.11
23.85
27.43
72074
11
41.95
39.85
45.83
72074 TC
11
31.41
29.84
34.32
72080
11
34.53
32.80
37.72
72080 TC
11
23.22
22.06
25.37
72090
11
46.56
44.23
50.86
72090 TC
11
32.04
30.44
35.01
72100
11
38.31
36.39
41.85
72100 TC
11
27.00
25.65
29.50
72110
11
52.39
49.77
57.24
72110 TC
11
37.08
35.23
40.51
72114
11
70.06
66.56
76.54
72114 TC
11
51.88
49.29
56.68
72120
11
48.39
45.97
52.87
72120 TC
11
37.08
35.23
40.51
*** All Current Procedural Terminology (CPT) codes and descriptors are copyrighted 2010
09/12/2011

----- -- ---- -------70360
11
70370
11
70371
11
70373
11
70380
11
70390
11
70450
11
70460
11
70470
11
70480
C11
70481
11
70482
C11
70486
C11
70487
11
70488
11
70490
C11
70491
11
70492
11
70496
C11
70498
C11
70540
C11
70542
C11
70543
C11
70544
C11
70545
C11
70546
C11
70547
C11
70548
C11
70549
C11
70551
C11
70552
C11
70553
C11
70554
11
70555 26
11
70559 26
11
71010 26
11
71015 26
11
71020 26
11
71021 26
11
71022 26
11
71023 26
11
71030 26
11
71034 26
11
71035 26
11
71040 26
11
71060 26
11
71090 26
11
71100 26
11
71101 26
11
71110 26
11
71111 26
11
71120 26
11
71130 26
11
71250 26
11
71260 26
11
71270 26
11
71275 26
11
71550 26
11
71551 26
11
71552 26
11
71555 26
11
72010 26
11
72020 26
11
72040 26
11
72050 26
11
72052 26
11
72069 26
11
72070 26
11
72072 26
11
72074 26
11
72080 26
11
72090 26
11
72100 26
11
72110 26
11
72114 26
11
72120 26
11
by the American
NPAR FEE
--------
PAGE 033
LC FEE
--------
26.07
24.77
28.49
76.53
72.70
83.61
89.61
85.13
97.90
77.45
73.58
84.62
37.10
35.25
40.54
95.40
90.63
104.22
184.67
175.44
201.76
240.71
228.67
262.97
290.96
276.41
317.87
241.53
229.45
263.87
342.80
325.66
374.51
379.51
360.53
414.61
234.75
223.01
256.46
296.70
281.87
324.15
360.22
342.21
393.54
241.53
229.45
263.87
290.92
276.37
317.83
350.85
333.31
383.31
398.66
378.73
435.54
398.66
378.73
435.54
383.04
363.89
418.47
483.06
458.91
527.75
597.90
568.01
653.21
375.82
357.03
410.58
462.75
439.61
505.55
581.69
552.61
635.50
375.82
357.03
410.58
462.75
439.61
505.55
581.46
552.39
635.25
389.35
369.88
425.36
491.25
466.69
536.69
608.64
578.21
664.94
534.81
508.07
584.28
125.16
118.90
136.74
159.03
151.08
173.74
8.55
8.12
09.34
9.88
9.39
10.80
10.54
10.01
11.51
12.87
12.23
14.06
14.86
14.12
16.24
18.49
17.57
20.21
14.86
14.12
16.24
22.79
21.65
24.90
8.86
8.42
09.68
27.18
25.82
29.69
35.50
33.73
38.79
27.45
26.08
29.99
10.54
10.01
11.51
12.87
12.23
14.06
12.87
12.23
14.06
15.19
14.43
16.59
9.54
9.06
10.42
10.54
10.01
11.51
49.29
46.83
53.85
60.10
57.10
65.67
66.44
63.12
72.59
92.94
88.29
101.53
70.01
66.51
76.49
83.11
78.95
90.79
109.13
103.67
119.22
87.71
83.32
95.82
21.96
20.86
23.99
7.53
7.15
08.22
11.31
10.74
12.35
15.31
14.54
16.72
17.64
16.76
19.27
11.31
10.74
12.35
10.85
10.31
11.86
10.54
10.01
11.51
10.54
10.01
11.51
11.31
10.74
12.35
14.52
13.79
15.86
11.31
10.74
12.35
15.31
14.54
16.72
18.18
17.27
19.86
11.31
10.74
12.35
MFI00A11
FSY-2011

----- -- ---- --------
"STATE OK"
NPAR FEE
--------
M E D I C A R E
LC FEE
--------
F E E

----- -- ---- --------
S C H E D U L E
NPAR FEE
--------
"ALL OF OKLAHOMA"
LC FEE
--------
72125
C11
229.05
217.60
250.24
72125 TC C11
179.76
170.77
196.39
72126
11
291.15
276.59
318.08
72126 TC
11
232.35
220.73
253.84
72127
11
352.38
334.76
384.97
72127 TC
11
291.25
276.69
318.19
72128
C11
229.05
217.60
250.24
72128 TC C11
179.76
170.77
196.39
72129
11
291.78
277.19
318.77
72129 TC
11
232.67
221.04
254.20
72130
11
352.69
335.06
385.32
72130 TC
11
291.57
276.99
318.54
72131
C11
229.05
217.60
250.24
72131 TC C11
179.76
170.77
196.39
72132
11
291.15
276.59
318.08
72132 TC
11
232.04
220.44
253.51
72133
11
352.38
334.76
384.97
72133 TC
11
291.25
276.69
318.19
72141
C11
395.14
375.38
431.69
72141 TC C11
317.71
301.82
347.09
72142
C11
497.58
472.70
543.61
72142 TC C11
404.95
384.70
442.41
72146
C11
395.14
375.38
431.69
72146 TC C11
317.71
301.82
347.09
72147
11
493.80
469.11
539.48
72147 TC
11
400.86
380.82
437.94
72148
C11
389.49
370.02
425.52
72148 TC C11
317.71
301.82
347.09
72149
C11
491.25
466.69
536.69
72149 TC C11
404.95
384.70
442.41
72156
C11
619.07
588.12
676.34
72156 TC C11
494.72
469.98
540.48
72157
C11
619.07
588.12
676.34
72157 TC C11
494.72
469.98
540.48
72158
C11
609.10
578.65
665.45
72158 TC C11
494.72
469.98
540.48
72159
11
574.16
545.45
627.27
72159 TC
11
486.84
462.50
531.88
72170
11
25.59
24.31
27.96
72170 TC
11
16.61
15.78
18.15
72190
11
39.54
37.56
43.19
72190 TC
11
28.57
27.14
31.21
72191
C11
401.47
381.40
438.61
72191 TC C11
313.61
297.93
342.62
72192
11
228.32
216.90
249.44
72192 TC
11
175.98
167.18
192.26
72193
11
276.20
262.39
301.75
72193 TC
11
220.07
209.07
240.43
72194
11
353.20
335.54
385.87
72194 TC
11
294.40
279.68
321.63
72195
C11
388.81
369.37
424.78
72195 TC C11
318.02
302.12
347.44
72196
C11
488.69
464.26
533.90
72196 TC C11
404.95
384.70
442.41
72197
C11
603.53
573.35
659.35
72197 TC C11
494.72
469.98
540.48
72198
11
517.52
491.64
565.39
72198 TC
11
430.78
409.24
470.63
72200
11
27.96
26.56
30.54
72200 TC
11
19.76
18.77
21.59
72202
11
32.74
31.10
35.77
72202 TC
11
23.54
22.36
25.71
72220
11
27.65
26.27
30.21
72220 TC
11
19.44
18.47
21.24
72240
11
136.54
129.71
149.17
72240 TC
11
92.51
87.88
101.06
72255
11
128.44
122.02
140.32
72255 TC
11
84.95
80.70
92.81
72265
11
130.13
123.62
142.16
72265 TC
11
89.99
85.49
98.31
72270
11
202.60
192.47
221.34
72270 TC
11
138.50
131.58
151.32
72275
11
105.39
100.12
115.14
72275 TC
11
68.57
65.14
74.91
72285
11
139.68
132.70
152.61
72285 TC
11
83.06
78.91
90.75
72291 26
11
68.74
65.30
75.10
72292
11
171.21
162.65
187.05
72295
11
122.57
116.44
133.91
72295 TC
11
81.80
77.71
89.37
73000
11
26.99
25.64
29.49
73000 TC
11
19.13
18.17
20.90
73010
11
28.74
27.30
31.40
73010 TC
11
19.76
18.77
21.59
73020
11
22.25
21.14
24.31
73020 TC
11
15.03
14.28
16.42
73030
11
29.07
27.62
31.76
73030 TC
11
19.44
18.47
21.24
73040
11
101.38
96.31
110.76
73040 TC
11
74.87
71.13
81.80
73050
11
36.05
34.25
39.39
73050 TC
11
25.42
24.15
27.77
73060
11
27.65
26.27
30.21
73060 TC
11
19.13
18.17
20.90
73070
11
26.65
25.32
29.12
73070 TC
11
19.13
18.17
20.90
73080
11
32.06
30.46
35.03
73080 TC
11
23.85
22.66
26.06
73085
11
92.02
87.42
100.53
73085 TC
11
65.42
62.15
71.47
73090
11
26.36
25.04
28.80
73090 TC
11
18.50
17.58
20.22
73092
11
28.88
27.44
31.56
73092 TC
11
21.02
19.97
22.97
73100
11
29.03
27.58
31.72
73100 TC
11
20.39
19.37
22.28
73110
11
34.26
32.55
37.43
73110 TC
11
25.74
24.45
28.12
73115
11
102.64
97.51
112.14
73115 TC
11
75.50
71.73
82.49
73120
11
26.05
24.75
28.46
73120 TC
11
18.18
17.27
19.86
73130
11
30.17
28.66
32.96
73130 TC
11
21.96
20.86
23.99
73140
11
29.44
27.97
32.17
73140 TC
11
22.91
21.76
25.02
73200
C11
228.87
217.43
250.04
73200 TC C11
179.76
170.77
196.39
73201
11
280.92
266.87
306.90
73201 TC
11
224.80
213.56
245.59
73202
11
358.87
340.93
392.07
73202 TC
11
300.07
285.07
327.83
73206
C11
400.87
380.83
437.95
73206 TC C11
313.61
297.93
342.62
73218
C11
383.13
363.97
418.57
73218 TC C11
318.02
302.12
347.44
73219
C11
483.38
459.21
528.09
73219 TC C11
404.95
384.70
442.41
73220
C11
598.53
568.60
653.89
73220 TC C11
494.72
469.98
540.48
73221
C11
384.12
364.91
419.65
73221 TC C11
318.02
302.12
347.44
73222
C11
483.38
459.21
528.09
73222 TC C11
404.95
384.70
442.41
73223
C11
598.22
568.31
653.56
73223 TC C11
494.72
469.98
540.48
73225
11
564.86
536.62
617.11
73225 TC
11
480.86
456.82
525.34
73500
11
25.27
24.01
27.61
73500 TC
11
16.29
15.48
17.80
73510
11
36.39
34.57
39.76
73510 TC
11
25.42
24.15
27.77
73520
11
38.41
36.49
41.96
73520 TC
11
25.42
24.15
27.77
73525
11
94.45
89.73
103.19
73525 TC
11
67.31
63.94
73.53
73530
11
32.70
31.07
35.73
73530 TC
11
17.78
16.89
19.42
73540
11
38.26
36.35
41.80
73540 TC
11
27.94
26.54
30.52
73542
11
77.97
74.07
85.18
73542 TC
11
49.36
46.89
53.92
09/12/2011

----- -- ---- -------72125 26
11
72126 26
11
72127 26
11
72128 26
11
72129 26
11
72130 26
11
72131 26
11
72132 26
11
72133 26
11
72141 26
11
72142 26
11
72146 26
11
72147 26
11
72148 26
11
72149 26
11
72156 26
11
72157 26
11
72158 26
11
72159 26
11
72170 26
11
72190 26
11
72191 26
11
72192 26
11
72193 26
11
72194 26
11
72195 26
11
72196 26
11
72197 26
11
72198 26
11
72200 26
11
72202 26
11
72220 26
11
72240 26
11
72255 26
11
72265 26
11
72270 26
11
72275 26
11
72285 26
11
72292 26
11
72295 26
11
73000 26
11
73010 26
11
73020 26
11
73030 26
11
73040 26
11
73050 26
11
73060 26
11
73070 26
11
73080 26
11
73085 26
11
73090 26
11
73092 26
11
73100 26
11
73110 26
11
73115 26
11
73120 26
11
73130 26
11
73140 26
11
73200 26
11
73201 26
11
73202 26
11
73206 26
11
73218 26
11
73219 26
11
73220 26
11
73221 26
11
73222 26
11
73223 26
11
73225 26
11
73500 26
11
73510 26
11
73520 26
11
73525 26
11
73530 26
11
73540 26
11
73542 26
11
by the American
NPAR FEE
--------
PAGE 034
LC FEE
--------
49.29
46.83
53.85
58.80
55.86
64.24
61.12
58.06
66.77
49.29
46.83
53.85
59.11
56.15
64.57
61.12
58.06
66.77
49.29
46.83
53.85
59.11
56.15
64.57
61.12
58.06
66.77
77.43
73.56
84.59
92.62
87.99
101.19
77.43
73.56
84.59
92.94
88.29
101.53
71.78
68.19
78.42
86.29
81.98
94.28
124.35
118.13
135.85
124.35
118.13
135.85
114.38
108.66
124.96
87.32
82.95
95.39
8.98
8.53
09.81
10.97
10.42
11.98
87.86
83.47
95.99
52.35
49.73
57.19
56.13
53.32
61.32
58.80
55.86
64.24
70.78
67.24
77.33
83.74
79.55
91.48
108.81
103.37
118.88
86.74
82.40
94.76
8.21
7.80
08.97
9.20
8.74
10.05
8.21
7.80
08.97
44.03
41.83
48.10
43.48
41.31
47.51
40.14
38.13
43.85
64.11
60.90
70.04
36.81
34.97
40.22
56.62
53.79
61.86
70.97
67.42
77.53
40.77
38.73
44.54
7.87
7.48
08.60
8.98
8.53
09.81
7.21
6.85
07.88
9.63
9.15
10.52
26.50
25.18
28.96
10.63
10.10
11.62
8.52
8.09
09.30
7.53
7.15
08.22
8.21
7.80
08.97
26.59
25.26
29.05
7.87
7.48
08.60
7.87
7.48
08.60
8.64
8.21
09.44
8.52
8.09
09.30
27.13
25.77
29.64
7.87
7.48
08.60
8.21
7.80
08.97
6.53
6.20
07.13
49.12
46.66
53.66
56.13
53.32
61.32
58.80
55.86
64.24
87.26
82.90
95.34
65.10
61.85
71.13
78.42
74.50
85.68
103.82
98.63
113.42
66.10
62.80
72.22
78.42
74.50
85.68
103.50
98.33
113.08
84.00
79.80
91.77
8.98
8.53
09.81
10.97
10.42
11.98
12.98
12.33
14.18
27.13
25.77
29.64
14.32
13.60
15.64
10.31
9.79
11.26
28.60
27.17
31.25
MFI00A11
FSY-2011

----- -- ---- --------
"STATE OK"
NPAR FEE
--------
M E D I C A R E
LC FEE
--------
F E E

----- -- ---- --------
S C H E D U L E
NPAR FEE
--------
"ALL OF OKLAHOMA"
LC FEE
--------
73550
11
26.85
25.51
29.34
73550 TC
11
18.18
17.27
19.86
73560
11
28.74
27.30
31.40
73560 TC
11
19.76
18.77
21.59
73562
11
34.43
32.71
37.62
73562 TC
11
24.79
23.55
27.08
73564
11
39.57
37.59
43.23
73564 TC
11
28.26
26.85
30.88
73565
11
31.88
30.29
34.83
73565 TC
11
22.59
21.46
24.68
73580
11
123.65
117.47
135.09
73580 TC
11
95.66
90.88
104.51
73590
11
26.07
24.77
28.49
73590 TC
11
17.87
16.98
19.53
73592
11
29.20
27.74
31.90
73592 TC
11
21.33
20.26
23.30
73600
11
26.68
25.35
29.15
73600 TC
11
18.81
17.87
20.55
73610
11
30.48
28.96
33.30
73610 TC
11
22.28
21.17
24.35
73615
11
97.91
93.01
106.96
73615 TC
11
70.78
67.24
77.33
73620
11
25.73
24.44
28.11
73620 TC
11
18.18
17.27
19.86
73630
11
29.85
28.36
32.61
73630 TC
11
21.65
20.57
23.66
73650
11
26.36
25.04
28.80
73650 TC
11
18.50
17.58
20.22
73660
11
27.55
26.17
30.10
73660 TC
11
21.33
20.26
23.30
73700
C11
228.87
217.43
250.04
73700 TC C11
179.76
170.77
196.39
73701
11
283.44
269.27
309.66
73701 TC
11
227.32
215.95
248.34
73702
11
360.76
342.72
394.13
73702 TC
11
301.65
286.57
329.56
73706
C11
405.87
385.58
443.42
73706 TC C11
313.61
297.93
342.62
73718
C11
383.04
363.89
418.47
73718 TC C11
318.02
302.12
347.44
73719
C11
483.06
458.91
527.75
73719 TC C11
404.95
384.70
442.41
73720
C11
598.22
568.31
653.56
73720 TC C11
494.72
469.98
540.48
73721
C11
383.81
364.62
419.31
73721 TC C11
318.02
302.12
347.44
73722
C11
483.92
459.72
528.68
73722 TC C11
404.95
384.70
442.41
73723
C11
598.22
568.31
653.56
73723 TC C11
494.72
469.98
540.48
73725
11
518.83
492.89
566.82
73725 TC
11
431.09
409.54
470.97
74000
11
23.58
22.40
25.76
74000 TC
11
15.03
14.28
16.42
74010
11
35.99
34.19
39.32
74010 TC
11
25.11
23.85
27.43
74020
11
37.98
36.08
41.49
74020 TC
11
25.11
23.85
27.43
74022
11
45.66
43.38
49.89
74022 TC
11
30.46
28.94
33.28
74150
11
232.18
220.57
253.66
74150 TC
11
174.72
165.98
190.88
74160
11
313.32
297.65
342.30
74160 TC
11
251.88
239.29
275.18
74170
C11
377.49
358.62
412.41
74170 TC C11
309.83
294.34
338.49
74175
C11
406.10
385.80
443.67
74175 TC C11
313.93
298.23
342.96
74176
11
203.99
193.79
222.86
74176 TC
11
122.12
116.01
133.41
74177
11
318.83
302.89
348.32
74177 TC
11
232.98
221.33
254.53
74178
11
402.91
382.76
440.17
74178 TC
11
307.95
292.55
336.43
74181
C11
388.04
368.64
423.94
74181 TC C11
317.71
301.82
347.09
74182
C11
488.37
463.95
533.54
74182 TC C11
404.95
384.70
442.41
74183
C11
603.22
573.06
659.02
74183 TC C11
494.72
469.98
540.48
74185
11
516.58
490.75
564.36
74185 TC
11
429.84
408.35
469.60
74190
11
69.65
66.17
76.10
74190 TC
11
45.08
42.83
49.25
74210
11
73.79
70.10
80.62
74210 TC
11
56.61
53.78
61.85
74220
11
84.89
80.65
92.75
74220 TC
11
62.59
59.46
68.38
74230
11
86.32
82.00
94.30
74230 TC
11
60.70
57.67
66.32
74235 26
11
62.55
59.42
68.33
74240
11
105.53
100.25
115.29
74240 26
11
33.49
31.82
36.59
74241
11
111.91
106.31
122.26
74241 26
11
32.95
31.30
36.00
74245
11
166.77
158.43
182.19
74245 26
11
44.03
41.83
48.10
74246
C11
113.72
108.03
124.23
74246 26
11
33.49
31.82
36.59
74247
C11
113.72
108.03
124.23
74247 26
11
33.49
31.82
36.59
74249
C11
175.59
166.81
191.83
74249 26
11
44.03
41.83
48.10
74250
11
100.03
95.03
109.28
74250 26
11
22.64
21.51
24.74
74251
C11
164.83
156.59
180.08
74251 26
11
33.49
31.82
36.59
74260
C11
104.29
99.08
113.94
74260 26
11
23.97
22.77
26.19
74261
C11
292.15
277.54
319.17
74261 26
11
112.63
107.00
123.05
74262
C11
395.76
375.97
432.37
74262 26
11
117.74
111.85
128.63
74270
C11
114.03
108.33
124.58
74270 26
11
33.49
31.82
36.59
74280
C11
179.26
170.30
195.85
74280 26
11
47.69
45.31
52.11
74283
C11
176.46
167.64
192.79
74283 26
11
96.23
91.42
105.13
74290
11
64.24
61.03
70.18
74290 26
11
15.19
14.43
16.59
74291
11
59.85
56.86
65.39
74291 26
11
9.54
9.06
10.42
74300
11
70.57
67.04
77.10
74300 26
11
17.64
16.76
19.27
74301
11
41.57
39.49
45.41
74301 26
11
10.65
10.12
11.64
74305
11
48.50
46.08
52.99
74305 26
11
20.54
19.51
22.44
74320
11
101.78
96.69
111.19
74320 26
11
26.28
24.97
28.72
74327
11
129.11
122.65
141.05
74327 26
11
35.65
33.87
38.95
74328
11
144.49
137.27
157.86
74328 26
11
34.69
32.96
37.90
74329 26
11
34.69
32.96
37.90
74330 TC
11
108.75
103.31
118.81
74330 26
11
44.46
42.24
48.58
74340 TC
11
90.50
85.98
98.88
74340 26
11
26.50
25.18
28.96
74355 TC
11
90.50
85.98
98.88
74355 26
11
37.81
35.92
41.31
74360 TC
11
108.75
103.31
118.81
74360 26
11
28.08
26.68
30.68
74400
11
105.12
99.86
114.84
74400 TC
11
81.49
77.42
89.03
74410
11
108.27
102.86
118.29
74410 TC
11
84.32
80.10
92.12
74415
11
127.80
121.41
139.62
74415 TC
11
104.17
98.96
113.80
74420
11
108.99
103.54
119.07
74420 TC
11
90.50
85.98
98.88
09/12/2011

----- -- ---- -------73550 26
11
73560 26
11
73562 26
11
73564 26
11
73565 26
11
73580 26
11
73590 26
11
73592 26
11
73600 26
11
73610 26
11
73615 26
11
73620 26
11
73630 26
11
73650 26
11
73660 26
11
73700 26
11
73701 26
11
73702 26
11
73706 26
11
73718 26
11
73719 26
11
73720 26
11
73721 26
11
73722 26
11
73723 26
11
73725 26
11
74000 26
11
74010 26
11
74020 26
11
74022 26
11
74150 26
11
74160 26
11
74170 26
11
74175 26
11
74176 26
11
74177 26
11
74178 26
11
74181 26
11
74182 26
11
74183 26
11
74185 26
11
74190 26
11
74210 26
11
74220 26
11
74230 26
11
74240 TC
11
74241 TC
11
74245 TC
11
74246 TC C11
74247 TC C11
74249 TC C11
74250 TC
11
74251 TC C11
74260 TC C11
74261 TC C11
74262 TC C11
74270 TC C11
74280 TC C11
74283 TC C11
74290 TC
11
74291 TC
11
74300 TC
11
74301 TC
11
74305 TC
11
74320 TC
11
74327 TC
11
74328 TC
11
74330
11
74340
11
74355
11
74360
11
74363 26
11
74400 26
11
74410 26
11
74415 26
11
74420 26
11
by the American
NPAR FEE
--------
PAGE 035
LC FEE
--------
8.66
8.23
09.46
8.98
8.53
09.81
9.63
9.15
10.52
11.31
10.74
12.35
9.29
8.83
10.15
27.99
26.59
30.58
8.21
7.80
08.97
7.87
7.48
08.60
7.87
7.48
08.60
8.21
7.80
08.97
27.13
25.77
29.64
7.55
7.17
08.25
8.21
7.80
08.97
7.87
7.48
08.60
6.22
5.91
06.80
49.12
46.66
53.66
56.13
53.32
61.32
59.11
56.15
64.57
92.26
87.65
100.80
65.01
61.76
71.02
78.11
74.20
85.33
103.50
98.33
113.08
65.79
62.50
71.88
78.97
75.02
86.27
103.50
98.33
113.08
87.74
83.35
95.85
8.55
8.12
09.34
10.88
10.34
11.89
12.87
12.23
14.06
15.19
14.43
16.59
57.46
54.59
62.78
61.44
58.37
67.13
67.66
64.28
73.92
92.17
87.56
100.69
81.87
77.78
89.45
85.85
81.56
93.79
94.97
90.22
103.75
70.33
66.81
76.83
83.42
79.25
91.14
108.50
103.08
118.54
86.74
82.40
94.76
23.52
22.34
25.69
17.18
16.32
18.77
22.30
21.19
24.37
25.62
24.34
27.99
72.04
68.44
78.71
78.97
75.02
86.27
122.75
116.61
134.10
80.23
76.22
87.65
80.23
76.22
87.65
131.57
124.99
143.74
77.39
73.52
84.55
131.34
124.77
143.49
80.32
76.30
87.75
179.53
170.55
196.13
278.02
264.12
303.74
80.54
76.51
87.99
131.57
124.99
143.74
80.23
76.22
87.65
49.05
46.60
53.59
50.31
47.79
54.96
42.33
40.21
46.24
24.95
23.70
27.26
26.97
25.62
29.46
75.50
71.73
82.49
93.46
88.79
102.11
108.75
103.31
118.81
154.53
146.80
168.82
118.10
112.20
129.03
129.25
122.79
141.21
136.70
129.87
149.35
43.38
41.21
47.39
23.63
22.45
25.82
23.95
22.75
26.16
23.63
22.45
25.82
17.64
16.76
19.27
MFI00A11
FSY-2011

----- -- ---- --------
"STATE OK"
NPAR FEE
--------
M E D I C A R E
LC FEE
--------
F E E

----- -- ---- --------
S C H E D U L E
NPAR FEE
--------
"ALL OF OKLAHOMA"
LC FEE
--------
74425
11
63.59
60.41
69.47
74425 TC
11
45.08
42.83
49.25
74430
11
57.31
54.44
62.61
74430 TC
11
42.12
40.01
46.01
74440
11
81.22
77.16
88.73
74440 TC
11
62.59
59.46
68.38
74445
11
97.23
92.37
106.23
74445 TC
11
38.88
36.94
42.48
74450
11
67.26
63.90
73.49
74450 TC
11
50.27
47.76
54.92
74455
11
84.11
79.90
91.89
74455 TC
11
68.26
64.85
74.58
74470
11
70.66
67.13
77.20
74470 TC
11
43.07
40.92
47.06
74475
11
105.24
99.98
114.98
74475 TC
11
78.97
75.02
86.27
74480
11
105.56
100.28
115.32
74480 TC
11
79.28
75.32
86.62
74485
11
103.98
98.78
113.60
74485 TC
11
77.71
73.82
84.89
74710
11
37.52
35.64
40.99
74710 TC
11
21.33
20.26
23.30
74740
11
74.47
70.75
81.36
74740 TC
11
56.29
53.48
61.50
74742 26
11
29.74
28.25
32.49
74775
11
97.04
92.19
106.02
74775 26
11
30.39
28.87
33.20
75557
11
421.25
400.19
460.22
75557 26
11
115.20
109.44
125.86
75559
C11
464.45
441.23
507.41
75559 26
11
146.43
139.11
159.98
75561
11
569.19
540.73
621.84
75561 26
11
127.70
121.32
139.52
75563
C11
645.14
612.88
704.81
75563 26
11
150.42
142.90
164.34
75565
11
69.42
65.95
75.84
75565 26
11
12.19
11.58
13.32
75571
C11
69.93
66.43
76.39
75571 26
11
26.86
25.52
29.35
75572
11
275.63
261.85
301.13
75572 26
11
81.70
77.62
89.26
75573
C11
357.67
339.79
390.76
75573 26
11
119.64
113.66
130.71
75574
C11
350.37
332.85
382.78
75574 26
11
112.34
106.72
122.73
75600
11
252.21
239.60
275.54
75600 26
11
24.58
23.35
26.85
75605
11
202.13
192.02
220.82
75605 26
11
56.08
53.28
61.27
75625
11
202.19
192.08
220.89
75625 26
11
55.82
53.03
60.98
75630
11
236.87
225.03
258.78
75630 26
11
87.03
82.68
95.08
75635
C11
430.25
408.74
470.05
75635 26
11
116.72
110.88
127.51
75650
11
220.06
209.06
240.42
75650 26
11
72.75
69.11
79.48
75658
11
225.14
213.88
245.96
75658 26
11
62.40
59.28
68.17
75660
11
228.64
217.21
249.79
75660 26
11
63.37
60.20
69.23
75662
11
271.91
258.31
297.06
75662 26
11
81.93
77.83
89.50
75665
11
237.80
225.91
259.80
75665 26
11
64.97
61.72
70.98
75671
11
277.63
263.75
303.31
75671 26
11
81.36
77.29
88.88
75676
11
228.35
216.93
249.47
75676 26
11
64.65
61.42
70.63
75680
11
259.22
246.26
283.20
75680 26
11
81.36
77.29
88.88
75685
11
229.55
218.07
250.78
75685 26
11
64.29
61.08
70.24
75705
11
269.28
255.82
294.19
75705 26
11
105.27
100.01
115.01
75710
11
219.31
208.34
239.59
75710 26
11
54.68
51.95
59.74
75716
11
253.14
240.48
276.55
75716 26
11
63.80
60.61
69.70
75722
11
212.53
201.90
232.19
75722 26
11
56.08
53.28
61.27
75724
11
252.45
239.83
275.80
75724 26
11
74.44
70.72
81.33
75726
11
217.48
206.61
237.60
75726 26
11
55.36
52.59
60.48
75731
11
220.98
209.93
241.42
75731 26
11
56.34
53.52
61.55
75733
11
254.29
241.58
277.82
75733 26
11
65.58
62.30
71.65
75736
11
216.79
205.95
236.84
75736 26
11
54.99
52.24
60.08
75741
11
206.25
195.94
225.33
75741 26
11
63.66
60.48
69.55
75743
11
231.19
219.63
252.57
75743 26
11
80.73
76.69
88.19
75746
11
210.64
200.11
230.13
75746 26
11
55.45
52.68
60.58
75756
11
225.71
214.42
246.58
75756 26
11
60.76
57.72
66.38
75774
11
148.58
141.15
162.32
75774 26
11
17.64
16.76
19.27
75791
C11
229.74
218.25
250.99
75791 26
11
79.91
75.91
87.30
75801
11
229.00
217.55
250.18
75801 26
11
42.02
39.92
45.91
75803
11
246.41
234.09
269.20
75803 26
11
57.47
54.60
62.79
75805
11
252.35
239.73
275.69
75805 26
11
39.83
37.84
43.52
75807 26
11
57.78
54.89
63.12
75809 TC
11
68.89
65.45
75.27
75809 26
11
22.95
21.80
25.07
75810 TC
11
434.57
412.84
474.77
75810 26
11
56.45
53.63
61.67
75820 TC
11
84.01
79.81
91.78
75820 26
11
34.14
32.43
37.29
75822 TC
11
94.09
89.39
102.80
75822 26
11
51.15
48.59
55.88
75825 TC
11
139.13
132.17
152.00
75825 26
11
54.73
51.99
59.79
75827 TC
11
141.96
134.86
155.09
75827 26
11
54.19
51.48
59.20
75831 TC
11
142.28
135.17
155.45
75831 26
11
58.69
55.76
64.12
75833 TC
11
157.39
149.52
171.95
75833 26
11
70.40
66.88
76.91
75840 TC
11
139.44
132.47
152.34
75840 26
11
57.75
54.86
63.09
75842 TC
11
156.45
148.63
170.92
75842 26
11
71.98
68.38
78.64
75860 TC
11
143.85
136.66
157.16
75860 26
11
56.31
53.49
61.51
75870 TC
11
142.59
135.46
155.78
75870 26
11
55.13
52.37
60.23
75872 TC
11
207.16
196.80
226.32
75872 26
11
58.91
55.96
64.35
75880 TC
11
126.21
119.90
137.89
75880 26
11
34.77
33.03
37.98
75885 TC
11
142.28
135.17
155.45
75885 26
11
69.65
66.17
76.10
75887 TC
11
144.48
137.26
157.85
75887 26
11
69.28
65.82
75.69
75889 TC
11
142.28
135.17
155.45
75889 26
11
55.13
52.37
60.23
75891 TC
11
142.59
135.46
155.78
75891 26
11
55.13
52.37
60.23
75893 TC
11
141.33
134.26
154.40
75893 26
11
25.50
24.23
27.86
75896
11
791.41
751.84
864.62
75896 TC
11
723.98
687.78
790.95
75898
11
120.66
114.63
131.82
75898 TC
11
36.19
34.38
39.54
09/12/2011

----- -- ---- -------74425 26
11
74430 26
11
74440 26
11
74445 26
11
74450 26
11
74455 26
11
74470 26
11
74475 26
11
74480 26
11
74485 26
11
74710 26
11
74740 26
11
74775 TC
11
75557 TC
11
75559 TC C11
75561 TC
11
75563 TC C11
75565 TC
11
75571 TC C11
75572 TC
11
75573 TC C11
75574 TC C11
75600 TC
11
75605 TC
11
75625 TC
11
75630 TC
11
75635 TC C11
75650 TC
11
75658 TC
11
75660 TC
11
75662 TC
11
75665 TC
11
75671 TC
11
75676 TC
11
75680 TC
11
75685 TC
11
75705 TC
11
75710 TC
11
75716 TC
11
75722 TC
11
75724 TC
11
75726 TC
11
75731 TC
11
75733 TC
11
75736 TC
11
75741 TC
11
75743 TC
11
75746 TC
11
75756 TC
11
75774 TC
11
75791 TC C11
75801 TC
11
75803 TC
11
75805 TC
11
75809
11
75810
11
75820
11
75822
11
75825
11
75827
11
75831
11
75833
11
75840
11
75842
11
75860
11
75870
11
75872
11
75880
11
75885
11
75887
11
75889
11
75891
11
75893
11
75894 26
11
75896 26
11
75898 26
11
by the American
NPAR FEE
--------
PAGE 036
LC FEE
--------
17.64
16.76
19.27
15.19
14.43
16.59
18.63
17.70
20.36
56.76
53.92
62.01
16.31
15.49
17.81
15.85
15.06
17.32
26.50
25.18
28.96
26.28
24.97
28.72
26.28
24.97
28.72
26.28
24.97
28.72
16.19
15.38
17.69
18.18
17.27
19.86
62.34
59.22
68.10
306.06
290.76
334.37
318.02
302.12
347.44
441.49
419.42
482.33
494.72
469.98
540.48
57.24
54.38
62.54
43.06
40.91
47.05
193.93
184.23
211.86
238.02
226.12
260.04
238.02
226.12
260.04
227.63
216.25
248.69
146.06
138.76
159.57
146.37
139.05
159.91
149.83
142.34
163.69
313.53
297.85
342.53
147.31
139.94
160.93
162.75
154.61
177.80
165.27
157.01
180.56
189.98
180.48
207.55
172.83
164.19
188.82
196.27
186.46
214.43
163.69
155.51
178.84
177.87
168.98
194.33
165.27
157.01
180.56
164.01
155.81
179.18
164.64
156.41
179.87
189.35
179.88
206.86
156.45
148.63
170.92
178.01
169.11
194.48
162.12
154.01
177.11
164.64
156.41
179.87
188.72
179.28
206.17
161.80
153.71
176.77
142.59
135.46
155.78
150.46
142.94
164.38
155.19
147.43
169.54
164.95
156.70
180.21
130.94
124.39
143.05
149.83
142.34
163.69
186.85
177.51
204.14
186.85
177.51
204.14
210.63
200.10
230.12
91.84
87.25
100.34
492.61
467.98
538.18
118.15
112.24
129.08
145.24
137.98
158.68
193.86
184.17
211.80
196.15
186.34
214.29
200.97
190.92
219.56
227.80
216.41
248.87
197.19
187.33
215.43
228.43
217.01
249.56
200.16
190.15
218.67
197.72
187.83
216.00
266.07
252.77
290.69
160.99
152.94
175.88
211.92
201.32
231.52
213.76
203.07
233.53
197.41
187.54
215.67
197.72
187.83
216.00
166.83
158.49
182.26
65.16
61.90
71.19
65.79
62.50
71.88
82.98
78.83
90.65
MFI00A11
FSY-2011

----- -- ---- --------
"STATE OK"
NPAR FEE
--------
M E D I C A R E
LC FEE
--------
F E E

----- -- ---- --------
S C H E D U L E
NPAR FEE
--------
"ALL OF OKLAHOMA"
LC FEE
--------
75900 26
11
24.09
22.89
26.32
75901
11
156.46
148.64
170.94
75901 26
11
23.63
22.45
25.82
75902
11
72.34
68.72
79.03
75902 26
11
18.89
17.95
20.64
75940
11
462.48
439.36
505.26
75940 26
11
26.56
25.23
29.01
75945
C11
161.42
153.35
176.35
75945 26
11
19.77
18.78
21.60
75946 26
11
19.91
18.91
21.75
75953 26
11
68.11
64.70
74.41
75954 26
11
111.94
106.34
122.29
75957 26
11
300.11
285.10
327.87
75958 26
11
199.32
189.35
217.75
75960
11
181.67
172.59
198.48
75960 TC
11
141.96
134.86
155.09
75961
11
351.39
333.82
383.89
75961 TC
11
146.68
139.35
160.25
75962
11
198.47
188.55
216.83
75962 TC
11
172.51
163.88
188.46
75964
11
123.61
117.43
135.04
75964 TC
11
106.05
100.75
115.86
75966
11
240.03
228.03
262.23
75966 TC
11
175.66
166.88
191.91
75968
11
121.35
115.28
132.57
75968 TC
11
103.85
98.66
113.46
75970
11
440.53
418.50
481.28
75970 TC
11
397.86
377.97
434.67
75978
11
198.79
188.85
217.18
75978 TC
11
173.14
164.48
189.15
75980
11
260.21
247.20
284.28
75980 TC
11
186.85
177.51
204.14
75982 26
11
70.56
67.03
77.08
75984
11
108.44
103.02
118.47
75984 26
11
34.82
33.08
38.04
75989
11
128.73
122.29
140.63
75989 26
11
57.00
54.15
62.27
76000
11
72.37
68.75
79.06
76000 26
11
8.21
7.80
08.97
76001
11
125.00
118.75
136.56
76001 26
11
34.04
32.34
37.19
76010
11
26.10
24.80
28.52
76010 26
11
8.86
8.42
09.68
76080
11
59.26
56.30
64.75
76080 26
11
26.28
24.97
28.72
76098
11
18.18
17.27
19.86
76098 26
11
7.87
7.48
08.60
76100
C11
99.81
94.82
109.04
76100 26
11
29.67
28.19
32.42
76101
11
165.07
156.82
180.34
76101 26
11
31.92
30.32
34.87
76102
11
221.27
210.21
241.74
76102 26
11
32.38
30.76
35.37
76120
11
72.09
68.49
78.76
76120 26
11
18.32
17.40
20.01
76125
11
40.77
38.73
44.54
76125 26
11
13.95
13.25
15.24
76376
11
67.09
63.74
73.30
76376 26
11
9.86
9.37
10.78
76377
11
88.45
84.03
96.63
76377 26
11
38.15
36.24
41.68
76380
C11
152.23
144.62
166.31
76380 26
11
47.12
44.76
51.47
76506
C11
88.37
83.95
96.54
76506 26
11
30.51
28.98
33.33
76510
11
156.77
148.93
171.27
76510 26
11
87.88
83.49
96.01
76511
11
94.44
89.72
103.18
76511 26
11
49.49
47.02
54.07
76512
11
87.57
83.19
95.67
76512 26
11
50.17
47.66
54.81
76513
11
83.04
78.89
90.72
76513 26
11
33.05
31.40
36.11
76514
11
13.16
12.50
14.38
76514 26
11
9.15
8.69
09.99
76516
11
67.94
64.54
74.22
76516 26
11
28.34
26.92
30.96
76519
11
73.43
69.76
80.22
76519 26
11
29.11
27.65
31.80
76529
11
69.41
65.94
75.83
76529 26
11
30.76
29.22
33.60
76536
11
111.28
105.72
121.58
76536 26
11
26.95
25.60
29.44
76604
11
82.91
78.76
90.57
76604 26
11
26.30
24.99
28.74
76645
C11
83.74
79.55
91.48
76645 26
11
26.19
24.88
28.61
76700
C11
127.87
121.48
139.70
76700 26
11
38.83
36.89
42.42
76705
11
100.64
95.61
109.95
76705 26
11
28.29
26.88
30.91
76770
C11
124.55
118.32
136.07
76770 26
11
35.50
33.73
38.79
76775
11
105.03
99.78
114.75
76775 26
11
28.26
26.85
30.88
76776
11
142.55
135.42
155.73
76776 26
11
36.50
34.68
39.88
76800
11
126.46
120.14
138.16
76800 26
11
53.48
50.81
58.43
76801
11
123.37
117.20
134.78
76801 26
11
47.55
45.17
51.95
76802
11
66.91
63.56
73.09
76802 26
11
39.91
37.91
43.60
76805
C11
136.60
129.77
149.24
76805 26
11
47.55
45.17
51.95
76810
11
93.11
88.45
101.72
76810 26
11
46.89
44.55
51.23
76811
11
184.03
174.83
201.05
76811 26
11
91.21
86.65
99.65
76812
C11
143.11
135.95
156.34
76812 26
11
85.24
80.98
93.13
76813
11
120.60
114.57
131.76
76813 26
11
56.44
53.62
61.66
76814
11
77.38
73.51
84.54
76814 26
11
47.23
44.87
51.60
76815
11
86.48
82.16
94.48
76815 26
11
30.82
29.28
33.67
76816
C11
98.45
93.53
107.56
76816 26
11
40.90
38.86
44.69
76817
C11
93.48
88.81
102.13
76817 26
11
35.93
34.13
39.25
76818
11
116.27
110.46
127.03
76818 26
11
50.53
48.00
55.20
76819
11
87.23
82.87
95.30
76819 26
11
37.24
35.38
40.69
76820
11
44.53
42.30
48.65
76820 26
11
23.83
22.64
26.04
76821
C11
91.47
86.90
99.94
76821 26
11
33.92
32.22
37.05
76825
11
205.91
195.61
224.95
76825 26
11
79.70
75.72
87.08
76826
11
118.25
112.34
129.19
76826 26
11
39.59
37.61
43.25
76827
11
63.00
59.85
68.83
76827 26
11
27.49
26.12
30.04
76828
11
46.57
44.24
50.88
76828 26
11
26.81
25.47
29.29
76830
11
117.90
112.01
128.81
76830 26
11
33.26
31.60
36.34
76831
11
118.29
112.38
129.24
76831 26
11
34.60
32.87
37.80
76856
11
117.58
111.70
128.46
76856 26
11
33.26
31.60
36.34
76857
C11
76.50
72.68
83.58
76857 26
11
18.95
18.00
20.70
76870
11
116.74
110.90
127.54
76870 26
11
31.16
29.60
34.04
76872
C11
123.17
117.01
134.56
76872 26
11
34.12
32.41
37.27
76873
C11
164.64
156.41
179.87
76873 26
11
75.59
71.81
82.58
76881
11
107.80
102.41
117.77
09/12/2011

----- -- ---- -------75901 TC
11
75902 TC
11
75940 TC
11
75945 TC C11
75952 26
11
75956 26
11
75959 26
11
75960 26
11
75961 26
11
75962 26
11
75964 26
11
75966 26
11
75968 26
11
75970 26
11
75978 26
11
75980 26
11
75984 TC
11
75989 TC
11
76000 TC
11
76001 TC
11
76010 TC
11
76080 TC
11
76098 TC
11
76100 TC C11
76101 TC
11
76102 TC
11
76120 TC
11
76125 TC
11
76376 TC
11
76377 TC
11
76380 TC C11
76506 TC C11
76510 TC
11
76511 TC
11
76512 TC
11
76513 TC
11
76514 TC
11
76516 TC
11
76519 TC
11
76529 TC
11
76536 TC
11
76604 TC
11
76645 TC C11
76700 TC C11
76705 TC
11
76770 TC C11
76775 TC
11
76776 TC
11
76800 TC
11
76801 TC
11
76802 TC
11
76805 TC C11
76810 TC
11
76811 TC
11
76812 TC C11
76813 TC
11
76814 TC
11
76815 TC
11
76816 TC C11
76817 TC C11
76818 TC
11
76819 TC
11
76820 TC
11
76821 TC C11
76825 TC
11
76826 TC
11
76827 TC
11
76828 TC
11
76830 TC
11
76831 TC
11
76856 TC
11
76857 TC C11
76870 TC
11
76872 TC C11
76873 TC C11
76881 TC
11
by the American
NPAR FEE
--------
PAGE 037
LC FEE
--------
132.83
126.19
145.12
53.46
50.79
58.41
434.57
412.84
474.77
141.65
134.57
154.76
223.81
212.62
244.51
350.66
333.13
383.10
175.32
166.55
191.53
39.71
37.72
43.38
204.70
194.47
223.64
25.96
24.66
28.36
17.55
16.67
19.17
64.37
61.15
70.32
17.50
16.63
19.12
40.82
38.78
44.60
25.65
24.37
28.03
70.56
67.03
77.08
73.61
69.93
80.42
71.72
68.13
78.35
64.17
60.96
70.10
90.50
85.98
98.88
17.24
16.38
18.84
32.98
31.33
36.03
10.31
9.79
11.26
70.15
66.64
76.64
133.14
126.48
145.45
188.89
179.45
206.37
53.77
51.08
58.74
26.97
25.62
29.46
57.24
54.38
62.54
50.31
47.79
54.96
105.11
99.85
114.83
57.87
54.98
63.23
68.89
65.45
75.27
44.95
42.70
49.11
37.39
35.52
40.85
49.99
47.49
54.61
4.01
3.81
04.38
39.60
37.62
43.26
44.32
42.10
48.42
38.65
36.72
42.23
84.32
80.10
92.12
56.61
53.78
61.85
57.55
54.67
62.87
89.05
84.60
97.29
72.35
68.73
79.04
89.05
84.60
97.29
76.76
72.92
83.86
106.05
100.75
115.86
72.98
69.33
79.73
75.82
72.03
82.83
27.00
25.65
29.50
89.05
84.60
97.29
46.21
43.90
50.49
92.83
88.19
101.42
57.87
54.98
63.23
64.17
60.96
70.10
30.15
28.64
32.94
55.66
52.88
60.81
57.55
54.67
62.87
57.55
54.67
62.87
65.74
62.45
71.82
49.99
47.49
54.61
20.70
19.67
22.62
57.55
54.67
62.87
126.21
119.90
137.89
78.65
74.72
85.93
35.50
33.73
38.79
19.76
18.77
21.59
84.64
80.41
92.47
83.69
79.51
91.44
84.32
80.10
92.12
57.55
54.67
62.87
85.58
81.30
93.50
89.05
84.60
97.29
89.05
84.60
97.29
79.91
75.91
87.30
MFI00A11
FSY-2011

----- -- ---- --------
"STATE OK"
NPAR FEE
--------
M E D I C A R E
LC FEE
--------
F E E

----- -- ---- --------
S C H E D U L E
NPAR FEE
--------
"ALL OF OKLAHOMA"
LC FEE
--------
76881 26
11
27.89
26.50
30.48
76882
11
28.70
27.27
31.36
76882 26
11
19.34
18.37
21.13
76885
C11
93.68
89.00
102.35
76885 26
11
35.82
34.03
39.13
76886
C11
87.66
83.28
95.77
76886 26
11
30.11
28.60
32.89
76930
11
85.90
81.61
93.85
76930 26
11
33.07
31.42
36.13
76932
11
87.65
83.27
95.76
76932 26
11
34.07
32.37
37.23
76936
C11
196.86
187.02
215.07
76936 26
11
98.05
93.15
107.12
76937
11
32.84
31.20
35.88
76937 26
11
14.66
13.93
16.02
76940
11
160.65
152.62
175.51
76940 26
11
100.39
95.37
109.68
76941
11
122.20
116.09
133.50
76941 26
11
66.30
62.99
72.44
76942
11
184.85
175.61
201.95
76942 26
11
32.50
30.88
35.51
76945
11
86.83
82.49
94.86
76945 26
11
32.81
31.17
35.85
76946
11
36.04
34.24
39.38
76946 26
11
18.18
17.27
19.86
76948
11
36.50
34.68
39.88
76948 26
11
18.63
17.70
20.36
76950
11
65.34
62.07
71.38
76950 26
11
28.26
26.85
30.88
76965
11
112.46
106.84
122.87
76965 26
11
65.93
62.63
72.02
76970
C11
77.09
73.24
84.23
76970 26
11
19.54
18.56
21.34
76975
11
94.47
89.75
103.21
76975 26
11
41.63
39.55
45.48
76977
11
9.71
9.22
10.60
76977 26
11
2.56
2.43
02.79
76998
11
182.66
173.53
199.56
76998 26
11
61.50
58.43
67.19
77001
11
107.05
101.70
116.96
77001 26
11
18.63
17.70
20.36
77002
11
71.23
67.67
77.82
77002 26
11
26.59
25.26
29.05
77003
11
59.09
56.14
64.56
77003 26
11
28.63
27.20
31.28
77011
11
451.07
428.52
492.80
77011 26
11
59.03
56.08
64.49
77012
11
154.25
146.54
168.52
77012 26
11
55.44
52.67
60.57
77013
11
625.52
594.24
683.38
77013 26
11
195.97
186.17
214.10
77014
11
179.63
170.65
196.25
77014 26
11
41.13
39.07
44.93
77021
11
405.43
385.16
442.93
77021 26
11
73.23
69.57
80.01
77022
11
765.10
726.85
835.88
77022 26
11
207.21
196.85
226.38
77031
11
152.73
145.09
166.85
77031 26
11
77.23
73.37
84.38
77032
11
53.01
50.36
57.91
77032 26
11
26.95
25.60
29.44
77051
11
10.68
10.15
11.67
77051 26
11
2.90
2.76
03.17
77052
11
10.68
10.15
11.67
77052 26
11
2.90
2.76
03.17
77053
11
63.71
60.52
69.60
77053 26
11
17.18
16.32
18.77
77054
11
86.12
81.81
94.08
77054 26
11
21.96
20.86
23.99
77055
11
81.62
77.54
89.17
77055 26
11
33.83
32.14
36.96
77056
11
104.31
99.09
113.95
77056 26
11
42.04
39.94
45.93
77057
11
76.58
72.75
83.66
77057 26
11
33.83
32.14
36.96
77058
C11
573.48
544.81
626.53
77058 26
11
78.76
74.82
86.04
77059
C11
573.48
544.81
626.53
77059 26
11
78.76
74.82
86.04
77071
11
43.87
41.68
47.93
77072 TC
11
13.14
12.48
14.35
77072 26
11
9.20
8.74
10.05
77073 TC
11
22.59
21.46
24.68
77073 26
11
14.18
13.47
15.49
77074 TC
11
44.01
41.81
48.08
77074 26
11
21.96
20.86
23.99
77075 TC C11
70.15
66.64
76.64
77075 26
11
25.96
24.66
28.36
77076 TC
11
61.65
58.57
67.36
77076 26
11
33.20
31.54
36.27
77077 TC
11
23.85
22.66
26.06
77077 26
11
15.85
15.06
17.32
77078 TC C11
65.20
61.94
71.23
77078 26
11
11.87
11.28
12.97
77079 TC
11
37.08
35.23
40.51
77079 26
11
10.54
10.01
11.51
77080 TC
11
79.18
75.22
86.50
77080 26
11
10.56
10.03
11.53
77081 TC
11
17.55
16.67
19.17
77081 26
11
9.59
9.11
10.48
77082 TC
11
19.49
18.52
21.30
77082 26
11
6.22
5.91
06.80
77083 TC
11
14.09
13.39
15.40
77083 26
11
9.54
9.06
10.42
77084 TC C11
318.02
302.12
347.44
77084 26
11
77.74
73.85
84.93
77262
11
104.77
99.53
114.46
77263
11
155.45
147.68
169.83
77280 TC
11
142.59
135.46
155.78
77280 26
11
33.92
32.22
37.05
77285 TC
11
258.18
245.27
282.06
77285 26
11
50.99
48.44
55.71
77290 TC
11
418.81
397.87
457.55
77290 26
11
75.70
71.92
82.71
77295 TC
11
310.52
294.99
339.24
77295 26
11
221.82
210.73
242.34
77300 TC
11
35.82
34.03
39.13
77300 26
11
30.25
28.74
33.05
77301 TC
11 1561.55
1483.47
1705.99
77301 26
11
388.54
369.11
424.48
77305 TC
11
29.20
27.74
31.90
77305 26
11
33.92
32.22
37.05
77310 TC
11
38.34
36.42
41.88
77310 26
11
50.99
48.44
55.71
77315 TC
11
59.76
56.77
65.29
77315 26
11
75.70
71.92
82.71
77321 TC
11
55.35
52.58
60.47
77321 26
11
45.79
43.50
50.03
77326 TC
11
91.39
86.82
99.84
77326 26
11
44.79
42.55
48.93
77327 TC
11
125.72
119.43
137.34
77327 26
11
67.41
64.04
73.65
77328 TC
11
159.97
151.97
174.77
77328 26
11
101.32
96.25
110.69
77331 TC
11
17.87
16.98
19.53
77331 26
11
42.44
40.32
46.37
77332 TC
11
47.79
45.40
52.21
77332 26
11
26.28
24.97
28.72
77333 TC
11
16.29
15.48
17.80
77333 26
11
40.79
38.75
44.56
77334 TC
11
84.95
80.70
92.81
77334 26
11
59.96
56.96
65.50
77338
11
452.70
430.07
494.58
77338 TC
11
242.17
230.06
264.57
77370
11
107.68
102.30
117.65
77372
11
789.17
749.71
862.17
77401
11
23.54
22.36
25.71
77402
11
163.38
155.21
178.49
77404
11
135.03
128.28
147.52
77406
11
136.29
129.48
148.90
77408
11
165.27
157.01
180.56
77409
11
183.85
174.66
200.86
09/12/2011

----- -- ---- --------
NPAR FEE
--------
PAGE 038
LC FEE
--------
76882 TC
11
9.36
8.89
10.22
76885 TC C11
57.87
54.98
63.23
76886 TC C11
57.55
54.67
62.87
76930 TC
11
52.83
50.19
57.72
76932 TC
11
52.58
49.95
57.44
76936 TC C11
98.81
93.87
107.95
76937 TC
11
18.18
17.27
19.86
76940 TC
11
55.44
52.67
60.57
76941 TC
11
52.62
49.99
57.49
76942 TC
11
152.35
144.73
166.44
76945 TC
11
52.62
49.99
57.49
76946 TC
11
17.87
16.98
19.53
76948 TC
11
17.87
16.98
19.53
76950 TC
11
37.08
35.23
40.51
76965 TC
11
46.53
44.20
50.83
76970 TC C11
57.55
54.67
62.87
76975 TC
11
52.58
49.95
57.44
76977 TC
11
7.16
6.80
07.82
76998 TC
11
112.09
106.49
122.46
77001 TC
11
88.42
84.00
96.60
77002 TC
11
44.64
42.41
48.77
77003 TC
11
30.46
28.94
33.28
77011 TC
11
392.04
372.44
428.31
77012 TC
11
98.81
93.87
107.95
77013 TC
11
404.93
384.68
442.38
77014 TC
11
138.50
131.58
151.32
77021 TC
11
332.20
315.59
362.93
77022 TC
11
528.25
501.84
577.12
77031 TC
11
75.50
71.73
82.49
77032 TC
11
26.05
24.75
28.46
77051 TC
11
7.79
7.40
08.51
77052 TC
11
7.79
7.40
08.51
77053 TC
11
46.53
44.20
50.83
77054 TC
11
64.17
60.96
70.10
77055 TC
11
47.79
45.40
52.21
77056 TC
11
62.28
59.17
68.05
77057 TC
11
42.75
40.61
46.70
77058 TC C11
494.72
469.98
540.48
77059 TC C11
494.72
469.98
540.48
77072
11
22.34
21.22
24.40
77073
11
36.77
34.93
40.17
77074
11
65.97
62.67
72.07
77075
C11
96.11
91.30
105.00
77076
11
94.84
90.10
103.62
77077
11
39.70
37.72
43.38
77078
C11
77.07
73.22
84.20
77079
11
47.62
45.24
52.03
77080
11
89.75
85.26
98.05
77081
11
27.14
25.78
29.65
77082
11
25.71
24.42
28.08
77083
11
23.63
22.45
25.82
77084
C11
395.77
375.98
432.38
77261
11
69.66
66.18
76.11
77280
11
176.51
167.68
192.83
77285
11
309.17
293.71
337.77
77290
11
494.51
469.78
540.25
77295
11
532.34
505.72
581.58
77300
11
66.07
62.77
72.19
77301
11 1950.09
1852.59
2130.48
77305
11
63.12
59.96
68.95
77310
11
89.33
84.86
97.59
77315
11
135.46
128.69
147.99
77321
11
101.13
96.07
110.48
77326
11
136.19
129.38
148.79
77327
11
193.13
183.47
210.99
77328
11
261.29
248.23
285.46
77331
11
60.31
57.29
65.88
77332
11
74.06
70.36
80.91
77333
11
57.08
54.23
62.36
77334
11
144.92
137.67
158.32
77336
11
48.42
46.00
52.90
77338 26
11
210.53
200.00
230.00
77373
11 1473.72
1400.03
1610.03
77403
11
121.49
115.42
132.73
77407
11
236.76
224.92
258.66
77411
11
182.91
173.76
199.82
MFI00A11
FSY-2011

----- -- ---- --------
"STATE OK"
NPAR FEE
--------
M E D I C A R E
LC FEE
--------
F E E

----- -- ---- --------
S C H E D U L E
NPAR FEE
--------
"ALL OF OKLAHOMA"
LC FEE
--------
77412
11
215.66
204.88
235.61
77413
11
217.24
206.38
237.34
77416
11
244.32
232.10
266.92
77417
11
13.77
13.08
15.04
77421
11
102.84
97.70
112.36
77421 TC
11
84.01
79.81
91.78
77422
11
184.48
175.26
201.55
77423
11
234.56
222.83
256.25
77431
11
94.93
90.18
103.71
77432
11
392.89
373.25
429.24
77435
F 11
651.20
618.64
711.44
77470
11
191.63
182.05
209.36
77470 26
11
101.64
96.56
111.04
77520
11
809.81
769.32
884.72
77523
11
870.91
827.36
951.46
77525
11
972.33
923.71
1062.27
77600 TC
11
305.25
289.99
333.49
77600 26
11
75.70
71.92
82.71
77605 TC
11
759.74
721.75
830.01
77605 26
11
105.50
100.23
115.26
77610 TC
11
715.02
679.27
781.16
77610 26
11
74.44
70.72
81.33
77615 TC
11
804.12
763.91
878.50
77615 26
11
101.32
96.25
110.69
77620 TC
11
375.72
356.93
410.47
77620 26
11
73.44
69.77
80.24
77750 TC
11
93.91
89.21
102.59
77750 26
11
242.90
230.76
265.37
77761 TC
11
162.80
154.66
177.86
77761 26
11
186.08
176.78
203.30
77762 TC
11
190.43
180.91
208.05
77762 26
11
279.71
265.72
305.58
77763 TC
11
246.32
234.00
269.10
77763 26
11
420.17
399.16
459.03
77776 TC
11
169.96
161.46
185.68
77776 26
11
229.75
218.26
251.00
77777 TC
11
185.71
176.42
202.88
77777 26
11
370.30
351.79
404.56
77778 TC
11
252.85
240.21
276.24
77778 26
11
549.79
522.30
600.65
77785 TC
11
137.38
130.51
150.09
77785 26
11
69.05
65.60
75.44
77786 TC
11
379.09
360.14
414.16
77786 26
11
156.59
148.76
171.07
77787 TC
11
614.42
583.70
671.26
77787 26
11
239.16
227.20
261.28
77789 TC
11
49.68
47.20
54.28
77789 26
11
55.62
52.84
60.77
77790 TC
11
35.82
34.03
39.13
77790 26
11
50.76
48.22
55.45
78000 TC
11
57.87
54.98
63.23
78000 26
11
9.20
8.74
10.05
78001 TC
11
73.44
69.77
80.24
78001 26
11
12.53
11.90
13.69
78003 TC
11
59.13
56.17
64.60
78003 26
11
15.85
15.06
17.32
78006 TC
11
195.64
185.86
213.74
78006 26
11
23.63
22.45
25.82
78007 TC
11
157.85
149.96
172.45
78007 26
11
23.97
22.77
26.19
78010 TC C11
122.89
116.75
134.26
78010 26
11
18.20
17.29
19.88
78011 TC C11
122.89
116.75
134.26
78011 26
11
21.96
20.86
23.99
78015 TC
11
168.87
160.43
184.49
78015 26
11
31.87
30.28
34.82
78016 TC
11
247.30
234.94
270.18
78016 26
11
36.73
34.89
40.12
78018 TC
11
256.43
243.61
280.15
78018 26
11
40.53
38.50
44.28
78020 TC
11
53.14
50.48
58.05
78020 26
11
28.00
26.60
30.59
78070 TC
11
115.96
110.16
126.68
78070 26
11
39.17
37.21
42.79
78075 TC
11
361.23
343.17
394.65
78075 26
11
34.87
33.13
38.10
78102 TC
11
129.19
122.73
141.14
78102 26
11
25.99
24.69
28.39
78103 TC
11
169.50
161.03
185.18
78103 26
11
35.21
33.45
38.47
78104 TC
11
194.70
184.97
212.72
78104 26
11
37.86
35.97
41.37
78110 TC
11
67.77
64.38
74.04
78110 26
11
9.20
8.74
10.05
78111 TC
11
71.24
67.68
77.83
78111 26
11
10.22
9.71
11.17
78120 TC
11
70.61
67.08
77.14
78120 26
11
11.19
10.63
12.22
78121 TC
11
78.79
74.85
86.08
78121 26
11
15.19
14.43
16.59
78122 TC
11
84.15
79.94
91.93
78122 26
11
20.87
19.83
22.80
78130 TC
11
114.93
109.18
125.56
78130 26
11
29.83
28.34
32.59
78135 TC
11
288.24
273.83
314.90
78135 26
11
31.16
29.60
34.04
78140 TC
11
100.53
95.50
109.83
78140 26
11
29.51
28.03
32.23
78185 TC
11
167.93
159.53
183.46
78185 26
11
19.17
18.21
20.94
78190 TC C11
161.09
153.04
176.00
78190 26
11
51.80
49.21
56.59
78191 TC
11
135.72
128.93
148.27
78191 26
11
29.51
28.03
32.23
78195 TC C11
238.16
226.25
260.19
78195 26
11
57.49
54.62
62.81
78201 TC
11
151.87
144.28
165.92
78201 26
11
20.90
19.86
22.84
78202 TC
11
165.41
157.14
180.71
78202 26
11
23.23
22.07
25.38
78205 TC
11
178.32
169.40
194.81
78205 26
11
33.85
32.16
36.98
78206 TC C11
245.72
233.43
268.44
78206 26
11
45.50
43.23
49.71
78215 TC
11
155.33
147.56
169.69
78215 26
11
23.63
22.45
25.82
78216 TC
11
95.17
90.41
103.97
78216 26
11
26.98
25.63
29.47
78220 TC
11
104.62
99.39
114.30
78220 26
11
22.86
21.72
24.98
78223 TC C11
245.72
233.43
268.44
78223 26
11
40.16
38.15
43.87
78230 TC
11
132.97
126.32
145.27
78230 26
11
21.64
20.56
23.64
78231 TC
11
95.80
91.01
104.66
78231 26
11
24.51
23.28
26.77
78232 TC
11
88.24
83.83
96.40
78232 26
11
21.38
20.31
23.36
78258 TC
11
177.38
168.51
193.79
78258 26
11
35.59
33.81
38.88
78261 TC
11
199.42
189.45
217.87
78261 26
11
33.49
31.82
36.59
78262 TC
11
196.59
186.76
214.77
78262 26
11
31.84
30.25
34.79
78264 TC C11
221.47
210.40
241.96
78264 26
11
37.18
35.32
40.62
78270 TC
11
66.05
62.75
72.16
78270 26
11
9.54
9.06
10.42
78271 TC
11
70.15
66.64
76.64
78271 26
11
9.54
9.06
10.42
78272 TC
11
72.18
68.57
78.86
78272 26
11
12.55
11.92
13.71
78278 TC C11
221.56
210.48
242.05
78278 26
11
47.37
45.00
51.75
78282 TC
11
44.28
42.07
48.38
78282 26
11
18.63
17.70
20.36
78290 TC C11
221.79
210.70
242.31
78290 26
11
32.83
31.19
35.87
78291 TC
11
193.76
184.07
211.68
78291 26
11
42.06
39.96
45.95
78300 TC
11
134.54
127.81
146.98
78300 26
11
29.94
28.44
32.71
09/12/2011

----- -- ---- -------77414
11
77418
11
77421 26
11
77427
11
77435
N 11
77470 TC
11
77522
11
77600
11
77605
11
77610
11
77615
11
77620
11
77750
11
77761
11
77762
11
77763
11
77776
11
77777
11
77778
11
77785
11
77786
11
77787
11
77789
11
77790
11
78000
11
78001
11
78003
11
78006
11
78007
11
78010
C11
78011
C11
78015
11
78016
11
78018
11
78020
11
78070
11
78075
11
78102
11
78103
11
78104
11
78110
11
78111
11
78120
11
78121
11
78122
11
78130
11
78135
11
78140
11
78185
11
78190
C11
78191
11
78195
C11
78201
11
78202
11
78205
11
78206
C11
78215
11
78216
11
78220
11
78223
C11
78230
11
78231
11
78232
11
78258
11
78261
11
78262
11
78264
C11
78270
11
78271
11
78272
11
78278
C11
78282
11
78290
C11
78291
11
78300
11
78305
11
by the American
NPAR FEE
--------
PAGE 039
LC FEE
--------
243.06
230.91
265.55
481.80
457.71
526.37
18.83
17.89
20.57
173.25
164.59
189.28
650.57
618.04
710.75
89.99
85.49
98.31
838.15
796.24
915.68
380.95
361.90
416.19
865.24
821.98
945.28
789.46
749.99
862.49
905.44
860.17
989.20
449.16
426.70
490.71
336.81
319.97
367.97
348.88
331.44
381.16
470.14
446.63
513.62
666.49
633.17
728.15
399.71
379.72
436.68
556.00
528.20
607.43
802.64
762.51
876.89
206.43
196.11
225.53
535.68
508.90
585.24
853.58
810.90
932.54
105.30
100.04
115.05
86.58
82.25
94.59
67.07
63.72
73.28
85.97
81.67
93.92
74.98
71.23
81.91
219.28
208.32
239.57
181.82
172.73
198.64
141.09
134.04
154.15
144.85
137.61
158.25
200.74
190.70
219.31
284.03
269.83
310.30
296.96
282.11
324.43
81.14
77.08
88.64
155.13
147.37
169.48
396.10
376.30
432.75
155.17
147.41
169.52
204.72
194.48
223.65
232.56
220.93
254.07
76.97
73.12
84.09
81.46
77.39
89.00
81.80
77.71
89.37
93.99
89.29
102.68
105.02
99.77
114.74
144.75
137.51
158.14
319.40
303.43
348.94
130.04
123.54
142.07
187.10
177.75
204.41
212.89
202.25
232.59
165.23
156.97
180.52
295.65
280.87
323.00
172.77
164.13
188.75
188.63
179.20
206.08
212.18
201.57
231.81
291.22
276.66
318.16
178.96
170.01
195.51
122.15
116.04
133.45
127.48
121.11
139.28
285.88
271.59
312.33
154.61
146.88
168.91
120.31
114.29
131.43
109.62
104.14
119.76
212.97
202.32
232.67
232.91
221.26
254.45
228.43
217.01
249.56
258.65
245.72
282.58
75.60
71.82
82.59
79.69
75.71
87.07
84.73
80.49
92.56
268.93
255.48
293.80
73.82
70.13
80.65
254.62
241.89
278.17
235.82
224.03
257.63
164.48
156.26
179.70
217.20
206.34
237.29
MFI00A11
FSY-2011

----- -- ---- --------
"STATE OK"
NPAR FEE
--------
M E D I C A R E
LC FEE
--------
F E E
S C H E D U L E

----- -- ---- --------
78305 TC
11
177.69
168.81
194.13
78305 26
11
39.51
78306 TC
11
195.33
185.56
213.39
78306 26
11
41.16
78315 TC C11
226.60
215.27
247.56
78315 26
11
48.71
78320 TC
11
178.95
170.00
195.50
78320 26
11
49.39
78428
11
181.26
172.20
198.03
78428 TC
11
143.05
78445
11
159.61
151.63
174.37
78445 TC
11
136.75
78451
11
318.95
303.00
348.45
78451 TC
11
254.86
78452
11
446.07
423.77
487.34
78452 TC
11
370.36
78453
11
273.60
259.92
298.91
78453 TC
11
226.83
78454
11
394.98
375.23
431.51
78454 TC
11
332.57
78456
C11
235.12
223.36
256.86
78456 TC C11
185.65
78457
11
182.40
173.28
199.27
78457 TC
11
145.57
78458
11
183.58
174.40
200.56
78458 TC
11
142.10
78459
C11 1099.14
1044.18
1200.81
78459 TC C11 1026.37
78466
11
168.75
160.31
184.36
78466 TC
11
134.86
78468
11
204.61
194.38
223.54
78468 TC
11
164.78
78469
11
240.82
228.78
263.10
78469 TC
11
194.70
78472
11
235.52
223.74
257.30
78472 TC
11
187.77
78473
11
311.61
296.03
340.43
78473 TC
11
239.42
78481
11
197.04
187.19
215.27
78481 TC
11
147.94
78483
11
273.50
259.83
298.80
78483 TC
11
199.42
78491
C11 1100.09
1045.09
1201.85
78491 TC C11 1026.37
78492
C11 1119.73
1063.74
1223.30
78492 TC C11 1026.37
78494
11
251.16
238.60
274.39
78494 TC
11
192.50
78496
11
76.03
72.23
83.06
78496 TC
11
51.57
78580
11
198.48
188.56
216.84
78580 TC
11
163.20
78584
11
143.49
136.32
156.77
78584 TC
11
95.80
78585
11
329.57
313.09
360.05
78585 TC
11
277.53
78586
11
154.98
147.23
169.31
78586 TC
11
136.12
78587
11
194.08
184.38
212.04
78587 TC
11
170.76
78588
11
319.49
303.52
349.05
78588 TC
11
267.46
78591
11
156.86
149.02
171.37
78591 TC
11
137.69
78593
11
182.43
173.31
199.31
78593 TC
11
158.79
78594
11
201.74
191.65
220.40
78594 TC
11
176.75
78596
11
348.05
330.65
380.25
78596 TC
11
288.87
78600
11
167.36
158.99
182.84
78600 TC
11
146.20
78601
11
198.54
188.61
216.90
78601 TC
11
174.23
78605
11
183.79
174.60
200.79
78605 TC
11
157.85
78606
11
301.40
286.33
329.28
78606 TC
11
271.24
78607
11
338.73
321.79
370.06
78607 TC
11
281.00
78608
C11 1037.64
985.76
1133.62
78608 TC C11
965.90
78610
11
164.81
156.57
180.06
78610 TC
11
150.29
78630
11
312.98
297.33
341.93
78630 TC
11
280.37
78635
11
298.49
283.57
326.11
78635 TC
11
269.35
78645
C11
250.03
237.53
273.16
78645 TC C11
222.73
78647
11
323.74
307.55
353.68
78647 TC
11
281.31
78650
11
306.42
291.10
334.77
78650 TC
11
277.22
78660
11
164.89
156.65
180.15
78660 TC
11
138.95
78700
11
164.06
155.86
179.24
78700 TC
11
142.10
78701
11
198.17
188.26
216.50
78701 TC
11
174.54
78707
11
222.25
211.14
242.81
78707 TC
11
176.75
78708
11
169.86
161.37
185.58
78708 TC
11
112.18
78709
11
342.47
325.35
374.15
78709 TC
11
275.33
78710
11
207.59
197.21
226.79
78710 TC
11
177.06
78725
11
95.71
90.92
104.56
78725 TC
11
77.85
78730
11
69.49
66.02
75.92
78730 TC
11
61.65
78740
11
206.25
195.94
225.33
78740 TC
11
178.32
78761
11
198.32
188.40
216.66
78761 TC
11
163.83
78800
11
174.57
165.84
190.72
78800 TC
11
143.05
78801
11
235.68
223.90
257.49
78801 TC
11
197.85
78802
11
304.52
289.29
332.68
78802 TC
11
263.68
78803
11
327.68
311.30
358.00
78803 TC
11
276.28
78804
11
540.05
513.05
590.01
78804 TC
11
489.33
78805
11
172.23
163.62
188.16
78805 TC
11
137.38
78806
11
315.23
299.47
344.39
78806 TC
11
274.39
78807
11
327.13
310.77
357.39
78807 TC
11
276.28
78808
11
40.19
38.18
43.91
78811
C11 1042.17
78811 26
11
76.27
72.46
83.33
78812
C11 1059.69
78812 26
11
93.79
89.10
102.47
78813
C11 1063.78
78813 26
11
97.88
92.99
106.94
78814
C11 1072.61
78814 26
11
106.71
101.37
116.58
78815
C11 1084.68
78815 26
11
118.78
112.84
129.77
78816
C11 1086.72
78816 26
11
120.82
114.78
132.00
79005
11
136.05
79005 26
11
85.43
81.16
93.33
79101
11
153.77
79101 26
11
98.74
93.80
107.87
79200
11
159.17
79200 26
11
96.58
91.75
105.51
79300 26
11
78.34
*** All Current Procedural Terminology (CPT) codes and descriptors
NPAR FEE
--------
"ALL OF OKLAHOMA"
LC FEE
--------
37.53
43.16
39.10
44.97
46.27
53.21
46.92
53.96
135.90
156.29
129.91
149.40
242.12
278.44
351.84
404.62
215.49
247.81
315.94
363.33
176.37
202.83
138.29
159.03
135.00
155.25
975.05
1121.31
128.12
147.34
156.54
180.02
184.97
212.72
178.38
205.14
227.45
261.57
140.54
161.62
189.45
217.87
975.05
1121.31
975.05
1121.31
182.88
210.31
48.99
56.34
155.04
178.30
91.01
104.66
263.65
303.20
129.31
148.71
162.22
186.55
254.09
292.20
130.81
150.43
150.85
173.48
167.91
193.10
274.43
315.59
138.89
159.72
165.52
190.35
149.96
172.45
257.68
296.33
266.95
306.99
917.61
1055.25
142.78
164.20
266.35
306.30
255.88
294.26
211.59
243.33
267.24
307.33
263.36
302.86
132.00
151.80
135.00
155.25
165.81
190.68
167.91
193.10
106.57
122.56
261.56
300.79
168.21
193.44
73.96
85.05
58.57
67.36
169.40
194.81
155.64
178.99
135.90
156.29
187.96
216.15
250.50
288.08
262.47
301.84
464.86
534.59
130.51
150.09
260.67
299.77
262.47
301.84
990.06
1138.57
1006.71
1157.72
1010.59
1162.18
1018.98
1171.83
1030.45
1185.02
1032.38
1187.24
129.25
148.64
146.08
167.99
151.21
173.89
74.42
85.58
09/12/2011

----- -- ---- -------78306
11
78315
C11
78320
11
78414 26
11
78428 26
11
78445 26
11
78451 26
11
78452 26
11
78453 26
11
78454 26
11
78456 26
11
78457 26
11
78458 26
11
78459 26
11
78466 26
11
78468 26
11
78469 26
11
78472 26
11
78473 26
11
78481 26
11
78483 26
11
78491 26
11
78492 26
11
78494 26
11
78496 26
11
78580 26
11
78584 26
11
78585 26
11
78586 26
11
78587 26
11
78588 26
11
78591 26
11
78593 26
11
78594 26
11
78596 26
11
78600 26
11
78601 26
11
78605 26
11
78606 26
11
78607 26
11
78608 26
11
78610 26
11
78630 26
11
78635 26
11
78645 26
11
78647 26
11
78650 26
11
78660 26
11
78700 26
11
78701 26
11
78707 26
11
78708 26
11
78709 26
11
78710 26
11
78725 26
11
78730 26
11
78740 26
11
78761 26
11
78800 26
11
78801 26
11
78802 26
11
78803 26
11
78804 26
11
78805 26
11
78806 26
11
78807 26
11
78811 TC C11
78812 TC C11
78813 TC C11
78814 TC C11
78815 TC C11
78816 TC C11
79005 TC
11
79101 TC
11
79200 TC
11
79403
11
by the American
NPAR FEE
--------
PAGE 040
LC FEE
--------
236.49
224.67
258.37
275.31
261.54
300.77
228.34
216.92
249.46
21.64
20.56
23.64
38.21
36.30
41.75
22.86
21.72
24.98
64.09
60.89
70.02
75.71
71.92
82.71
46.77
44.43
51.09
62.42
59.30
68.20
49.46
46.99
54.04
36.84
35.00
40.25
41.48
39.41
45.32
72.77
69.13
79.50
33.89
32.20
37.03
39.83
37.84
43.52
46.12
43.81
50.38
47.75
45.36
52.16
72.19
68.58
78.87
49.10
46.65
53.65
74.08
70.38
80.94
73.72
70.03
80.53
93.36
88.69
101.99
58.67
55.74
64.10
24.46
23.24
26.73
35.28
33.52
38.55
47.69
45.31
52.11
52.03
49.43
56.84
18.86
17.92
20.61
23.32
22.15
25.47
52.03
49.43
56.84
19.17
18.21
20.94
23.63
22.45
25.82
24.99
23.74
27.30
59.18
56.22
64.65
21.16
20.10
23.12
24.31
23.09
26.55
25.94
24.64
28.34
30.16
28.65
32.95
57.73
54.84
63.07
71.74
68.15
78.37
14.52
13.79
15.86
32.61
30.98
35.63
29.14
27.68
31.83
27.29
25.93
29.82
42.43
40.31
46.36
29.20
27.74
31.90
25.94
24.64
28.34
21.96
20.86
23.99
23.63
22.45
25.82
45.50
43.23
49.71
57.68
54.80
63.02
67.14
63.78
73.35
30.53
29.00
33.35
17.86
16.97
19.52
7.84
7.45
08.57
27.92
26.52
30.50
34.48
32.76
37.67
31.53
29.95
34.44
37.83
35.94
41.33
40.84
38.80
44.62
51.40
48.83
56.15
50.72
48.18
55.41
34.85
33.11
38.08
40.84
38.80
44.62
50.86
48.32
55.57
965.90
917.61
1055.25
965.90
917.61
1055.25
965.90
917.61
1055.25
965.90
917.61
1055.25
965.90
917.61
1055.25
965.90
917.61
1055.25
50.62
48.09
55.30
55.03
52.28
60.12
62.59
59.46
68.38
193.34
183.67
211.22
MFI00A11
FSY-2011

----- -- ---- --------
"STATE OK"
NPAR FEE
--------
M E D I C A R E
LC FEE
--------
F E E

----- -- ---- --------
79403 TC
11
85.09
80.84
92.97
79403 26
79440 TC
11
52.51
49.88
57.36
79440 26
80500
N 11
19.87
18.88
21.71
80500
80502
F 11
60.33
57.31
65.91
83020 26
84165 26
11
18.29
17.38
19.99
84166 26
84182 26
11
18.29
17.38
19.99
85060
85097
F 11
45.36
43.09
49.55
85390 26
85576 26
11
18.61
17.68
20.33
86077
86078
N 11
49.46
46.99
54.04
86078
86079
F 11
46.62
44.29
50.93
86255 26
86320 26
11
18.15
17.24
19.83
86325 26
86334 26
11
18.61
17.68
20.33
86335 26
86486
11
4.64
4.41
05.07
86490
86580
11
6.84
6.50
07.48
87164 26
88104
11
61.69
58.61
67.40
88104 TC
88106
11
75.23
71.47
82.19
88106 TC
88107
11
94.45
89.73
103.19
88107 TC
88108
11
71.14
67.58
77.72
88108 TC
88112
11
97.61
92.73
106.64
88112 TC
88120
11
425.45
404.18
464.81
88120 TC
88121
11
359.30
341.34
392.54
88121 TC
88125
11
20.94
19.89
22.87
88125 TC
88141
11
27.55
26.17
30.10
88160
88160 26
11
23.83
22.64
26.04
88161
88161 26
11
23.20
22.04
25.35
88162
88162 26
11
35.95
34.15
39.27
88172
88172 26
11
29.12
27.66
31.81
88173
88173 26
11
66.41
63.09
72.55
88177
88177 26
11
20.80
19.76
22.72
88182
88182 26
11
33.77
32.08
36.89
88184
88187
11
65.35
62.08
71.39
88188
88291
11
28.12
26.71
30.72
88300
88300 26
11
4.21
4.00
04.60
88302
88302 26
11
6.22
5.91
06.80
88304
88304 26
11
10.54
10.01
11.51
88305
88305 26
11
35.47
33.70
38.76
88307
88307 26
11
77.30
73.44
84.46
88309
88309 26
11
135.07
128.32
147.57
88311
88311 26
11
11.53
10.95
12.59
88312
88312 26
11
25.50
24.23
27.86
88313
88313 26
11
11.22
10.66
12.26
88314
88314 26
11
21.82
20.73
23.84
88318
88318 26
11
20.17
19.16
22.03
88319
88319 26
11
25.62
24.34
27.99
88321
88323
11
136.39
129.57
149.01
88323 TC
88325
N 11
190.04
180.54
207.62
88325
88329
F 11
33.12
31.46
36.18
88331
88331 26
11
57.98
55.08
63.34
88332
88332 26
11
28.46
27.04
31.10
88333
88333 26
11
58.38
55.46
63.78
88334
88334 26
11
35.57
33.79
38.86
88342
88342 26
11
39.96
37.96
43.65
88346
88346 26
11
40.16
38.15
43.87
88347
88347 26
11
37.32
35.45
40.77
88348
88348 26
11
71.11
67.55
77.68
88349
88349 26
11
37.53
35.65
41.00
88355
88355 26
11
81.63
77.55
89.18
88356
88356 26
11
127.85
121.46
139.68
88358
88358 26
11
41.15
39.09
44.95
88360
88360 26
11
50.97
48.42
55.68
88361
88361 26
11
54.23
51.52
59.25
88362
88362 26
11
103.73
98.54
113.32
88363
88365
11
156.01
148.21
170.44
88365 TC
88367
11
240.18
228.17
262.40
88367 TC
88368
11
206.82
196.48
225.95
88368 TC
88371 26
11
18.29
17.38
19.99
88372 26
88380 TC
11
95.03
90.28
103.82
88380 26
88381 TC
11
121.17
115.11
132.38
88381 26
88385 TC
11
471.24
447.68
514.83
88385 26
88386 TC
11
513.44
487.77
560.94
88386 26
88387 TC
11
8.10
7.70
08.86
88387 26
88388 TC
11
4.01
3.81
04.38
88388 26
89049
F 11
64.02
60.82
69.94
89060 26
89230
11
2.75
2.61
03.00
90460
90471
11
21.75
20.66
23.76
90472
90474
11
10.99
10.44
12.01
90801
S C H E D U L E
NPAR FEE
--------
"ALL OF OKLAHOMA"
LC FEE
--------
11
108.25
102.84
118.27
11
97.73
92.84
106.77
F 11
17.66
16.78
19.30
11
18.61
17.68
20.33
11
18.29
17.38
19.99
11
22.27
21.16
24.33
11
18.92
17.97
20.67
N 11
49.14
46.68
53.68
F 11
46.62
44.29
50.93
11
18.61
17.68
20.33
11
17.84
16.95
19.49
11
18.29
17.38
19.99
11
6.21
5.90
06.79
11
18.61
17.68
20.33
11
34.87
33.13
38.10
11
48.73
46.29
53.23
11
57.55
54.67
62.87
11
44.64
42.41
48.77
11
42.75
40.61
46.70
11
374.23
355.52
408.85
11
313.93
298.23
342.96
11
8.10
7.70
08.86
11
51.46
48.89
56.22
11
51.46
48.89
56.22
11
73.98
70.28
80.82
11
48.24
45.83
52.70
11
130.57
124.04
142.65
11
26.69
25.36
29.16
11
97.77
92.88
106.81
11
77.71
73.82
84.89
11
81.12
77.06
88.62
11
24.91
23.66
27.21
11
49.60
47.12
54.19
11
58.32
55.40
63.71
11
99.95
94.95
109.19
11
213.27
202.61
233.00
11
323.78
307.59
353.73
11
17.74
16.85
19.38
11
100.06
95.06
109.32
11
72.55
68.92
79.26
11
84.41
80.19
92.22
11
108.90
103.46
118.98
11
136.71
129.87
149.35
N 11
87.27
82.91
95.35
11
54.40
51.68
59.43
F 11
123.58
117.40
135.01
11
87.50
83.13
95.60
11
38.77
36.83
42.35
11
90.73
86.19
99.12
11
55.95
53.15
61.12
11
98.14
93.23
107.21
11
96.45
91.63
105.37
11
73.46
69.79
80.26
11
633.88
602.19
692.52
11
334.19
317.48
365.10
11
202.18
192.07
220.88
11
268.29
254.88
293.11
11
71.30
67.74
77.90
11
116.71
110.87
127.50
11
142.96
135.81
156.18
11
265.90
252.61
290.50
N 11
35.93
34.13
39.25
11
100.39
95.37
109.68
11
181.02
171.97
197.77
11
146.06
138.76
159.57
11
18.61
17.68
20.33
11
70.61
67.08
77.14
11
52.11
49.50
56.93
11
64.16
60.95
70.09
11
84.23
80.02
92.02
11
30.74
29.20
33.58
11
18.67
17.74
20.40
11
18.61
17.68
20.33
11
21.75
20.66
23.76
11
10.99
10.44
12.01
N 11
148.67
141.24
162.43
09/12/2011

----- -- ---- -------79440
11
79445 26
11
80502
N 11
83912 26
11
84181 26
11
85097
N 11
85396
11
86077
F 11
86079
N 11
86256 26
11
86327 26
11
86485
11
86510
11
87207 26
11
88104 26
11
88106 26
11
88107 26
11
88108 26
11
88112 26
11
88120 26
11
88121 26
11
88125 26
11
88160 TC
11
88161 TC
11
88162 TC
11
88172 TC
11
88173 TC
11
88177 TC
11
88182 TC
11
88185
11
88189
11
88300 TC
11
88302 TC
11
88304 TC
11
88305 TC
11
88307 TC
11
88309 TC
11
88311 TC
11
88312 TC
11
88313 TC
11
88314 TC
11
88318 TC
11
88319 TC
11
88321
F 11
88323 26
11
88329
N 11
88331 TC
11
88332 TC
11
88333 TC
11
88334 TC
11
88342 TC
11
88346 TC
11
88347 TC
11
88348 TC
11
88349 TC
11
88355 TC
11
88356 TC
11
88358 TC
11
88360 TC
11
88361 TC
11
88362 TC
11
88363
F 11
88365 26
11
88367 26
11
88368 26
11
88380
11
88381
11
88385
11
88386
11
88387
11
88388
11
89049
N 11
89220
11
90461
11
90473
11
90801
F 11
by the American
NPAR FEE
--------
PAGE 041
LC FEE
--------
150.24
142.73
164.14
115.71
109.92
126.41
61.90
58.81
67.63
17.66
16.78
19.30
18.61
17.68
20.33
81.27
77.21
88.79
18.29
17.38
19.99
46.31
43.99
50.59
49.46
46.99
54.04
18.15
17.24
19.83
21.25
20.19
23.22
16.23
15.42
17.73
5.90
5.61
06.45
18.61
17.68
20.33
26.81
25.47
29.29
26.50
25.18
28.96
36.90
35.06
40.32
26.50
25.18
28.96
54.86
52.12
59.94
51.22
48.66
55.96
45.37
43.10
49.57
12.84
12.20
14.03
27.63
26.25
30.19
28.26
26.85
30.88
38.02
36.12
41.54
19.13
18.17
20.90
64.17
60.96
70.10
5.90
5.61
06.45
63.99
60.79
69.91
46.53
44.20
50.83
100.24
95.23
109.51
20.70
19.67
22.62
43.38
41.21
47.39
47.79
45.40
52.21
64.48
61.26
70.45
135.98
129.18
148.56
188.72
179.28
206.17
6.21
5.90
06.79
74.56
70.83
81.45
61.33
58.26
67.00
62.59
59.46
68.38
88.73
84.29
96.93
111.09
105.54
121.37
78.45
74.53
85.71
81.99
77.89
89.57
49.50
47.03
54.08
29.52
28.04
32.25
10.31
9.79
11.26
32.35
30.73
35.34
20.39
19.37
22.28
58.18
55.27
63.56
56.29
53.48
61.50
36.13
34.32
39.47
562.77
534.63
614.82
296.66
281.83
324.10
120.54
114.51
131.69
140.44
133.42
153.43
30.15
28.64
32.94
65.74
62.45
71.82
88.73
84.29
96.93
162.17
154.06
177.17
16.40
15.58
17.92
55.63
52.85
60.78
59.17
56.21
64.64
60.76
57.72
66.38
165.64
157.36
180.96
173.29
164.63
189.32
535.40
508.63
584.92
597.67
567.79
652.96
38.84
36.90
42.44
22.67
21.54
24.77
238.82
226.88
260.91
14.72
13.98
16.08
10.99
10.44
12.01
21.75
20.66
23.76
120.32
114.30
131.45
MFI00A11
FSY-2011

----- -- ---- --------
"STATE OK"
NPAR FEE
--------
M E D I C A R E
LC FEE
--------
F E E

----- -- ---- --------
90802
N 11
161.38
153.31
176.31
90802
90804
F 11
52.40
49.78
57.25
90805
90806
N 11
86.88
82.54
94.92
90806
90807
F 11
89.52
85.04
97.80
90808
90809
N 11
143.17
136.01
156.41
90809
90810
F 11
57.21
54.35
62.50
90811
90812
N 11
95.11
90.35
103.90
90812
90813
F 11
94.44
89.72
103.18
90814
90815
N 11
155.18
147.42
169.53
90815
90816
F 11
57.13
54.27
62.41
90817
90818
N 11
80.35
76.33
87.78
90818
90819
F 11
94.56
89.83
103.30
90821
90822
N 11
134.01
127.31
146.41
90822
90823
F 11
61.71
58.62
67.41
90824
90826
N 11
85.95
81.65
93.90
90826
90827
F 11
99.15
94.19
108.32
90828
90829
N 11
138.26
131.35
151.05
90829
90845
F 11
75.33
71.56
82.29
90846
90847
N 11
102.11
97.00
111.55
90847
90849
F 11
28.60
27.17
31.25
90853
90857
N 11
35.32
33.55
38.58
90857
90862
F 11
43.58
41.40
47.61
90865
90870
N 11
159.89
151.90
174.69
90870
90880
F 11
91.04
86.49
99.46
90901
90911
N 11
82.54
78.41
90.17
90911
90937
11
103.17
98.01
112.71
90945
90951
11
922.58
876.45
1007.92
90954
90956
11
299.99
284.99
327.74
90957
90959
11
278.98
265.03
304.78
90960
90962
11
168.59
160.16
184.18
90963
90965
11
427.06
405.71
466.57
90966
90968
11
14.83
14.09
16.20
90969
90997
11
86.21
81.90
94.19
91010
91010 26
11
66.50
63.18
72.66
91013
91013 26
11
9.49
9.02
10.37
91020
91020 26
11
74.46
70.74
81.35
91022
91022 26
11
75.58
71.80
82.57
91030
91030 26
11
47.89
45.50
52.33
91034
91034 26
11
49.93
47.43
54.54
91035
91035 26
11
82.39
78.27
90.01
91037
91037 26
11
51.25
48.69
55.99
91038
91038 26
11
57.41
54.54
62.72
91040
91040 26
11
48.44
46.02
52.92
91065
91065 26
11
10.17
9.66
11.11
91110
91110 26
11
190.31
180.79
207.91
91111
91111 26
11
52.53
49.90
57.39
91117
91120
11
358.47
340.55
391.63
91120 TC
91122
11
215.40
204.63
235.32
91122 TC
91132
11
131.97
125.37
144.18
91132 TC
91133
11
161.20
153.14
176.11
91133 TC
92002
N 11
71.50
67.93
78.12
92002
92004
F 11
93.23
88.57
101.86
92012
92014
N 11
110.05
104.55
120.23
92014
92019
11
64.69
61.46
70.68
92020
92025
11
33.14
31.48
36.20
92025 TC
92060
11
57.43
54.56
62.74
92060 TC
92065
11
45.78
43.49
50.01
92065 TC
92070
N 11
63.44
60.27
69.31
92070
92081 TC
11
29.52
28.04
32.25
92081 26
92082 TC
11
42.12
40.01
46.01
92082 26
92083 TC
11
52.51
49.88
57.36
92083 26
92100
F 11
47.20
44.84
51.57
92120
92130
N 11
77.88
73.99
85.09
92130
92132 TC
11
14.09
13.39
15.40
92132 26
92133 TC
11
14.09
13.39
15.40
92133 26
92134 TC
11
14.09
13.39
15.40
92134 26
92136 TC
11
49.36
46.89
53.92
92136 26
92140
F 11
25.23
23.97
27.57
92225
92226
N 11
21.83
20.74
23.85
92226
92228
11
28.29
26.88
30.91
92228 TC
92230
N 11
54.37
51.65
59.40
92230
92235 TC
11
78.97
75.02
86.27
92235 26
92240 TC C11
147.31
139.94
160.93
92240 26
92250 TC
11
46.53
44.20
50.83
92250 26
92260
F 11
10.49
9.97
11.47
92265
92265 26
11
41.61
39.53
45.46
92270
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
N
F
S C H E D U L E
NPAR FEE
--------
"ALL OF OKLAHOMA"
LC FEE
--------
11
131.46
124.89
143.62
11
73.22
69.56
79.99
11
80.27
76.26
87.70
11
128.06
121.66
139.91
11
131.60
125.02
143.77
11
82.26
78.15
89.87
11
84.85
80.61
92.70
11
137.18
130.32
149.87
11
139.30
132.34
152.19
11
65.06
61.81
71.08
11
84.98
80.73
92.84
11
119.23
113.27
130.26
11
136.33
129.51
148.94
11
70.12
66.61
76.60
11
90.25
85.74
98.60
11
124.14
117.93
135.62
11
140.91
133.86
153.94
11
82.04
77.94
89.63
11
94.55
89.82
103.29
11
30.81
29.27
33.66
11
30.91
29.36
33.76
11
152.23
144.62
166.31
11
105.09
99.84
114.82
11
34.95
33.20
38.18
11
43.80
41.61
47.85
11
79.71
75.72
87.08
11
774.80
736.06
846.47
11
619.12
588.16
676.38
11
274.40
260.68
299.78
11
527.12
500.76
575.87
11
224.37
213.15
245.12
11
14.49
13.77
15.84
11
176.34
167.52
192.65
11
21.69
20.61
23.70
11
222.72
211.58
243.32
11
172.81
164.17
188.80
11
132.53
125.90
144.79
11
185.28
176.02
202.42
11
454.27
431.56
496.29
11
153.52
145.84
167.72
11
279.37
265.40
305.21
11
319.85
303.86
349.44
11
74.02
70.32
80.87
11
860.46
817.44
940.06
11
684.88
650.64
748.24
N 11
134.74
128.00
147.20
11
310.46
294.94
339.18
11
128.73
122.29
140.63
11
104.80
99.56
114.49
11
126.21
119.90
137.89
F 11
45.04
42.79
49.21
N 11
75.69
71.91
82.70
F 11
74.15
70.44
81.01
N 11
24.91
23.66
27.21
11
14.72
13.98
16.08
11
21.33
20.26
23.30
11
28.57
27.14
31.21
F 11
36.35
34.53
39.71
11
15.92
15.12
17.39
11
21.12
20.06
23.07
11
26.49
25.17
28.95
N 11
70.24
66.73
76.74
F 11
42.61
40.48
46.55
11
20.13
19.12
21.99
11
28.07
26.67
30.67
11
28.07
26.67
30.67
11
28.65
27.22
31.30
N 11
24.30
23.09
26.55
F 11
17.42
16.55
19.03
11
11.57
10.99
12.64
F 11
31.06
29.51
33.94
11
43.64
41.46
47.68
11
58.85
55.91
64.30
11
22.42
21.30
24.50
11
74.28
70.57
81.16
11
82.61
78.48
90.25
09/12/2011

----- -- ---- -------90804
N 11
90805
F 11
90807
N 11
90808
F 11
90810
N 11
90811
F 11
90813
N 11
90814
F 11
90816
N 11
90817
F 11
90819
N 11
90821
F 11
90823
N 11
90824
F 11
90827
N 11
90828
F 11
90845
N 11
90846
F 11
90849
N 11
90853
F 11
90862
N 11
90865
F 11
90880
N 11
90901
F 11
90935
11
90947
11
90955
11
90958
11
90961
11
90964
11
90967
11
90970
11
91010 TC
11
91013 TC
11
91020 TC
11
91022 TC
11
91030 TC
11
91034 TC
11
91035 TC
11
91037 TC
11
91038 TC
11
91040 TC
11
91065 TC
11
91110 TC
11
91111 TC
11
91117
F 11
91120 26
11
91122 26
11
91132 26
11
91133 26
11
92004
N 11
92012
F 11
92018
11
92020
F 11
92025 26
11
92060 26
11
92065 26
11
92081
11
92082
11
92083
11
92100
N 11
92120
F 11
92132
11
92133
11
92134
11
92136
11
92140
N 11
92225
F 11
92227
11
92228 26
11
92235
11
92240
C11
92250
11
92260
N 11
92265 TC
11
92270 TC
11
by the American
NPAR FEE
--------
PAGE 042
LC FEE
--------
64.30
61.09
70.25
60.66
57.63
66.27
101.76
96.67
111.17
121.44
115.37
132.68
66.48
63.16
72.63
66.38
63.06
72.52
110.31
104.79
120.51
126.60
120.27
138.31
54.15
51.44
59.16
66.05
62.75
72.16
93.24
88.58
101.87
125.52
119.24
137.13
59.06
56.11
64.53
71.44
67.87
78.05
97.49
92.62
106.51
130.76
124.22
142.85
77.53
73.65
84.70
79.52
75.54
86.87
32.70
31.07
35.73
28.60
27.17
31.25
55.55
52.77
60.69
123.88
117.69
135.34
97.96
93.06
107.02
19.51
18.53
21.31
72.27
68.66
78.96
120.85
114.81
132.03
437.38
415.51
477.84
419.03
398.08
457.79
225.63
214.35
246.50
448.07
425.67
489.52
18.10
17.20
19.78
7.50
7.13
08.20
109.83
104.34
119.99
12.20
11.59
13.33
148.26
140.85
161.98
97.24
92.38
106.24
84.64
80.41
92.47
135.35
128.58
147.87
371.88
353.29
406.28
102.28
97.17
111.75
221.96
210.86
242.49
271.41
257.84
296.52
63.85
60.66
69.76
670.15
636.64
732.14
632.36
600.74
690.85
143.24
136.08
156.49
48.01
45.61
52.45
86.67
82.34
94.69
27.17
25.81
29.68
34.99
33.24
38.23
133.23
126.57
145.56
48.60
46.17
53.10
133.31
126.64
145.64
19.87
18.88
21.71
18.42
17.50
20.13
36.10
34.30
39.45
17.21
16.35
18.80
45.44
43.17
49.65
63.23
60.07
69.08
79.00
75.05
86.31
85.94
81.64
93.89
41.57
39.49
45.41
34.22
32.51
37.39
42.15
40.04
46.05
42.15
40.04
46.05
78.02
74.12
85.24
55.47
52.70
60.61
20.21
19.20
22.08
10.62
10.09
11.60
16.72
15.88
18.26
122.61
116.48
133.95
206.16
195.85
225.23
68.95
65.50
75.33
16.79
15.95
18.34
32.67
31.04
35.70
43.06
40.91
47.05
MFI00A11
FSY-2011

----- -- ---- --------
"STATE OK"
NPAR FEE
--------
M E D I C A R E
LC FEE
--------
F E E

----- -- ---- --------
92270 26
11
39.54
37.56
43.19
92275
92275 26
11
53.81
51.12
58.79
92283
92283 26
11
8.52
8.09
09.30
92284
92284 26
11
11.53
10.95
12.59
92285
92285 26
11
3.82
3.63
04.17
92286
92286 26
11
33.99
32.29
37.13
92287
92311
N 11
91.12
86.56
99.54
92311
92312
F 11
61.90
58.81
67.63
92313
92315
N 11
65.65
62.37
71.73
92315
92316
F 11
36.30
34.49
39.66
92317
92325
11
31.09
29.54
33.97
92326
92504
N 11
28.39
26.97
31.02
92504
92507
11
78.84
74.90
86.14
92508
92511
F 11
57.80
54.91
63.15
92512
92516
N 11
63.80
60.61
69.70
92516
92520
F 11
39.62
37.64
43.29
92526
92540 TC
11
17.24
16.38
18.84
92540 26
92541 TC
11
23.22
22.06
25.37
92541 26
92542 TC
11
26.05
24.75
28.46
92542 26
92543 TC
11
15.66
14.88
17.11
92543 26
92544 TC
11
21.96
20.86
23.99
92544 26
92545 TC
11
21.02
19.97
22.97
92545 26
92546 TC
11
73.61
69.93
80.42
92546 26
92548
11
95.87
91.08
104.74
92548 TC
92550
11
19.99
18.99
21.84
92552
92555
11
17.24
16.38
18.84
92556
92557
F 11
34.93
33.18
38.16
92561
92563
11
22.91
21.76
25.02
92564
92567
N 11
14.58
13.85
15.93
92567
92568
F 11
15.75
14.96
17.20
92570
92571
11
18.50
17.58
20.22
92572
92576
11
24.48
23.26
26.75
92577
92579
F 11
38.01
36.11
41.53
92582
92584
11
61.65
58.57
67.36
92585
92585 26
11
24.78
23.54
27.07
92586
92587 TC
11
27.63
26.25
30.19
92587 26
92588 TC
11
44.01
41.81
48.08
92588 26
92597
11
93.23
88.57
101.86
92601
92602
N 11
86.08
81.78
94.05
92602
92603
F 11
119.90
113.91
131.00
92604
92607
11
167.18
158.82
182.64
92608
92610
N 11
99.94
94.94
109.18
92610
92612
N 11
157.19
149.33
171.73
92612
92613
F 11
36.69
34.86
40.09
92614
92615
11
32.80
31.16
35.83
92616
92617
11
40.67
38.64
44.44
92620
92621
N 11
18.42
17.50
20.13
92621
92625
F 11
57.54
54.66
62.86
92626
92627
N 11
19.63
18.65
21.45
92627
92640
F 11
87.76
83.37
95.88
92950
92953
11
10.88
10.34
11.89
92960
92961
11
243.78
231.59
266.33
92970
92973
11
179.28
170.32
195.87
92974
92977
11
85.41
81.14
93.31
92978
92978 26
11
92.24
87.63
100.77
92979
92979 26
11
73.88
70.19
80.72
92980
92982
11
606.17
575.86
662.24
92984
92987
11 1392.49
1322.87
1521.30
92990
92996
11
178.60
169.67
195.12
92997
93000
11
18.52
17.59
20.23
93005
93015
11
87.27
82.91
95.35
93016
93018
11
14.83
14.09
16.20
93024
93024 26
11
58.30
55.39
63.70
93025
93025 26
11
37.82
35.93
41.32
93040
93042
11
7.21
6.85
07.88
93224
93226
11
42.75
40.61
46.70
93227
93229
11
631.41
599.84
689.82
93268
93271
11
194.24
184.53
212.21
93272
93278 TC
11
20.70
19.67
22.62
93278 26
93279 TC
11
16.92
16.07
18.48
93279 26
93280 TC
11
19.76
18.77
21.59
93280 26
93281 TC
11
22.91
21.76
25.02
93281 26
93282 TC
11
20.39
19.37
22.28
93282 26
93283 TC
11
23.54
22.36
25.71
93283 26
93284 TC
11
26.68
25.35
29.15
93284 26
93285 TC
11
15.66
14.88
17.11
93285 26
S C H E D U L E
NPAR FEE
--------
"ALL OF OKLAHOMA"
LC FEE
--------
11
133.41
126.74
145.75
11
45.29
43.03
49.48
11
55.22
52.46
60.33
11
25.78
24.49
28.16
11
111.38
105.81
121.68
N 11
109.38
103.91
119.50
F 11
53.95
51.25
58.94
N 11
89.41
84.94
97.68
F 11
22.19
21.08
24.24
N 11
65.60
62.32
71.67
11
32.98
31.33
36.03
F 11
9.49
9.02
10.37
11
25.61
24.33
27.98
N 11
58.11
55.20
63.48
F 11
22.54
21.41
24.62
11
89.96
85.46
98.28
11
76.13
72.32
83.17
11
19.80
18.81
21.63
11
16.48
15.66
18.01
11
5.20
4.94
05.68
11
12.84
12.20
14.03
11
11.51
10.93
12.57
11
14.18
13.47
15.49
11
71.09
67.54
77.67
11
23.54
22.36
25.71
11
26.68
25.35
29.15
11
30.15
28.64
32.94
11
20.70
19.67
22.62
F 11
12.06
11.46
13.18
N 11
30.71
29.17
33.55
11
29.20
27.74
31.90
11
15.03
14.28
16.42
11
47.47
45.10
51.87
11
105.95
100.65
115.75
11
65.11
61.85
71.13
11
6.85
6.51
07.49
11
18.13
17.22
19.80
N 11
139.87
132.88
152.81
F 11
72.85
69.21
79.59
N 11
80.78
76.74
88.25
11
49.89
47.40
54.51
F 11
66.87
63.53
73.06
F 11
65.53
62.25
71.59
N 11
140.18
133.17
153.15
N 11
190.25
180.74
207.85
N 11
79.65
75.67
87.02
F 11
16.84
16.00
18.40
N 11
80.66
76.63
88.12
F 11
17.74
16.85
19.38
N 11
267.26
253.90
291.99
N 11
227.67
216.29
248.73
11
172.60
163.97
188.57
11
164.31
156.09
179.50
11
252.79
240.15
276.17
11
155.65
147.87
170.05
11
818.03
777.13
893.70
11
162.11
154.00
177.10
11 1083.37
1029.20
1183.58
11
643.23
611.07
702.73
11
9.99
9.49
10.91
11
22.45
21.33
24.53
11
110.81
105.27
121.06
11
180.41
171.39
197.10
11
12.48
11.86
13.64
11
98.04
93.14
107.11
11
26.40
25.08
28.84
11
233.47
221.80
255.07
11
25.14
23.88
27.46
11
12.19
11.58
13.32
11
33.16
31.50
36.23
11
39.44
37.47
43.09
11
46.07
43.77
50.34
11
43.11
40.95
47.09
11
57.94
55.04
63.30
11
63.85
60.66
69.76
11
26.40
25.08
28.84
09/12/2011

----- -- ---- --------
NPAR FEE
--------
PAGE 043
LC FEE
--------
92275 TC
11
79.60
75.62
86.96
92283 TC
11
36.76
34.92
40.16
92284 TC
11
43.69
41.51
47.74
92285 TC
11
21.96
20.86
23.99
92286 TC
11
77.39
73.52
84.55
92287
F 11
43.24
41.08
47.24
92312
N 11
103.79
98.60
113.39
92313
F 11
47.83
45.44
52.26
92316
N 11
88.27
83.86
96.44
92317
F 11
20.87
19.83
22.80
92502
11
92.90
88.26
101.50
92506
11
156.66
148.83
171.15
92511
N 11
150.08
142.58
163.97
92512
F 11
27.87
26.48
30.45
92520
N 11
64.19
60.98
70.13
92540
11
93.36
88.69
101.99
92541
11
43.02
40.87
47.00
92542
11
42.53
40.40
46.46
92543
11
20.86
19.82
22.79
92544
11
34.80
33.06
38.02
92545
11
32.52
30.89
35.52
92546
11
87.79
83.40
95.91
92547
11
4.64
4.41
05.07
92548 26
11
24.78
23.54
27.07
92553
11
29.83
28.34
32.59
92557
N 11
38.71
36.77
42.29
92562
11
29.20
27.74
31.90
92565
11
11.88
11.29
12.98
92568
N 11
16.07
15.27
17.56
92570
F 11
28.82
27.38
31.49
92575
11
45.58
43.30
49.80
92579
N 11
41.79
39.70
45.66
92583
11
32.98
31.33
36.03
92585 TC
11
81.17
77.11
88.68
92587
11
34.48
32.76
37.67
92588
11
62.14
59.03
67.88
92596
11
36.76
34.92
40.16
92601
F 11
124.75
118.51
136.29
92603
N 11
136.59
129.76
149.22
92604
F 11
67.23
63.87
73.45
92609
11
110.51
104.98
120.73
92611
11
107.82
102.43
117.79
92613
N 11
37.00
35.15
40.42
92614
F 11
65.85
62.56
71.94
92616
F 11
96.71
91.87
105.65
92620
F 11
74.92
71.17
81.85
92625
N 11
61.00
57.95
66.64
92626
F 11
74.67
70.94
81.58
92640
N 11
92.80
88.16
101.38
92950
F 11
168.68
160.25
184.29
92960
F 11
123.73
117.54
135.17
92971
11
95.40
90.63
104.22
92975
11
396.03
376.23
432.66
92978 TC
11
157.19
149.33
171.73
92979 TC
11
79.25
75.29
86.58
92981
11
227.37
216.00
248.40
92986
11 1349.11
1281.65
1473.90
92995
11
667.54
634.16
729.28
92998
11
323.46
307.29
353.38
93010
11
8.52
8.09
09.30
93017
11
49.99
47.49
54.61
93024 TC
11
52.51
49.88
57.36
93025 TC
11
142.59
135.46
155.78
93041
11
5.27
5.01
05.76
93225
11
28.89
27.45
31.57
93228
11
24.97
23.72
27.28
93270
11
14.09
13.39
15.40
93278
11
32.89
31.25
35.94
93279
11
50.08
47.58
54.72
93280
11
59.20
56.24
64.68
93281
11
68.97
65.52
75.35
93282
11
63.49
60.32
69.37
93283
11
81.47
77.40
89.01
93284
11
90.54
86.01
98.91
93285
11
42.06
39.96
45.95
93286
11
25.14
23.88
27.46
MFI00A11
FSY-2011

----- -- ---- --------
"STATE OK"
NPAR FEE
--------
M E D I C A R E
LC FEE
--------
F E E

----- -- ---- --------
93286 TC
11
10.94
10.39
11.95
93286 26
93287 TC
11
11.88
11.29
12.98
93287 26
93288 TC
11
15.98
15.18
17.46
93288 26
93289 TC
11
19.76
18.77
21.59
93289 26
93290 TC
11
9.05
8.60
09.89
93290 26
93291 TC
11
14.40
13.68
15.73
93291 26
93292 TC
11
10.94
10.39
11.95
93292 26
93293 TC
11
37.08
35.23
40.51
93293 26
93295
11
65.81
62.52
71.90
93296
93298
11
26.86
25.52
29.35
93303
93303 26
11
64.29
61.08
70.24
93304
93304 26
11
36.87
35.03
40.28
93306
93306 26
11
65.55
62.27
71.61
93307
93307 26
11
46.12
43.81
50.38
93308
93308 26
11
26.42
25.10
28.87
93312
93312 26
11
106.90
101.56
116.79
93313
93314 TC
11
206.04
195.74
225.10
93314 26
93316
11
43.32
41.15
47.32
93317
93318 26
11
109.22
103.76
119.32
93320
93320 26
11
18.81
17.87
20.55
93321
93321 26
11
7.53
7.15
08.22
93325
93325 26
11
3.55
3.37
03.88
93350
93350 26
11
73.74
70.05
80.56
93351
93351 26
11
88.95
84.50
97.18
93352
93451 TC
11
569.82
541.33
622.53
93451 26
93452 TC
11
544.31
517.09
594.65
93452 26
93453 TC
11
711.78
676.19
777.62
93453 26
93454 TC
11
566.98
538.63
619.42
93454 26
93455 TC
11
664.54
631.31
726.01
93455 26
93456 TC
11
702.65
667.52
767.65
93456 26
93457 TC
11
799.97
759.97
873.97
93457 26
93458 TC
11
680.91
646.86
743.89
93458 26
93459 TC
11
745.80
708.51
814.79
93459 26
93460 TC
11
783.59
744.41
856.07
93460 26
93461 TC
11
913.58
867.90
998.09
93461 26
93463
11
101.73
96.64
111.14
93464
93464 26
11
89.61
85.13
97.90
93503
93505 TC
11
511.55
485.97
558.87
93505 26
93530 TC
11
585.43
556.16
639.58
93530 26
93531 TC
11 1673.31
1589.64
1828.09
93531 26
93533 26
11
359.08
341.13
392.30
93561
93561 26
11
23.88
22.69
26.09
93562
93562 26
11
7.24
6.88
07.91
93563
93565
11
41.44
39.37
45.28
93566
93567
N 11
131.16
124.60
143.29
93567
93568
F 11
42.43
40.31
46.36
93571
93571 26
11
91.70
87.12
100.19
93572 26
93581
11 1313.12
1247.46
1434.58
93600
93600 26
11
115.05
109.30
125.70
93602
93602 26
11
114.73
108.99
125.34
93603
93603 26
11
114.73
108.99
125.34
93609
93609 26
11
272.19
258.58
297.37
93610
93610 26
11
163.10
154.95
178.19
93612
93612 26
11
162.47
154.35
177.50
93613
93615 TC
11
11.06
10.51
12.09
93615 26
93618
11
364.92
346.67
398.67
93618 TC
93619
11
669.05
635.60
730.94
93619 TC
93620
11
919.22
873.26
1004.25
93620 TC
93621 26
11
114.37
108.65
124.95
93622 26
93624
11
336.62
319.79
367.76
93624 TC
93631 26
11
395.84
376.05
432.46
93640
93640 26
11
191.39
181.82
209.09
93641
93641 26
11
323.15
306.99
353.04
93642
93642 26
11
248.02
235.62
270.96
93650
93652
11
963.99
915.79
1053.16
93660
93660 26
11
95.42
90.65
104.25
93662 26
93720
11
45.60
43.32
49.82
93721
93724
11
288.88
274.44
315.61
93724 TC
93745
11
56.74
53.90
61.99
93745 TC
93750
N 11
49.41
46.94
53.98
93750
93786
11
28.89
27.45
31.57
93788
93797
N 11
17.05
16.20
18.63
93797
93798
F 11
14.15
13.44
15.46
93875
93875 26
11
10.54
10.01
11.51
93880
93880 26
11
29.17
27.71
31.87
93882
93882 26
11
19.45
18.48
21.25
93886
S C H E D U L E
NPAR FEE
--------
"ALL OF OKLAHOMA"
LC FEE
--------
11
14.20
13.49
15.51
11
21.19
20.13
23.15
11
21.77
20.68
23.78
11
45.49
43.22
49.70
11
20.19
19.18
22.06
11
21.77
20.68
23.78
11
21.77
20.68
23.78
11
15.51
14.73
16.94
11
30.15
28.64
32.94
11
197.75
187.86
216.04
11
125.92
119.62
137.56
11
218.54
207.61
238.75
11
139.26
132.30
152.15
11
98.78
93.84
107.92
11
304.74
289.50
332.93
11
40.17
38.16
43.88
11
61.02
57.97
66.67
11
317.73
301.84
347.12
11
58.72
55.78
64.15
11
27.28
25.92
29.81
11
33.07
31.42
36.13
11
198.06
188.16
216.38
11
233.25
221.59
254.83
11
34.09
32.39
37.25
11
139.25
132.29
152.13
11
243.82
231.63
266.37
11
319.78
303.79
349.36
11
245.81
233.52
268.55
11
283.85
269.66
310.11
11
314.87
299.13
344.00
11
353.02
335.37
385.68
11
299.98
284.98
327.73
11
337.79
320.90
369.04
11
376.37
357.55
411.18
11
415.09
394.34
453.49
11
235.03
223.28
256.77
11
128.02
121.62
139.86
11
235.43
223.66
257.21
11
228.69
217.26
249.85
11
449.58
427.10
491.17
11
43.73
41.54
47.77
11
19.48
18.51
21.29
11
53.85
51.16
58.83
N 11
158.29
150.38
172.94
F 11
46.75
44.41
51.07
11
251.78
239.19
275.07
11
73.17
69.51
79.94
11
181.55
172.47
198.34
11
151.90
144.31
165.96
11
171.48
162.91
187.35
11
361.81
343.72
395.28
11
208.31
197.89
227.57
11
217.35
206.48
237.45
11
381.75
362.66
417.06
11
49.89
47.40
54.51
11
137.03
130.18
149.71
11
266.52
253.19
291.17
11
301.06
286.01
328.91
11
168.16
159.75
183.71
11
68.83
65.39
75.20
11
435.40
413.63
475.67
11
565.06
536.81
617.33
11
406.81
386.47
444.44
11
581.71
552.62
635.51
11
156.43
148.61
170.90
11
143.16
136.00
156.40
11
37.71
35.82
41.19
11
42.75
40.61
46.70
11
39.73
37.74
43.40
F 11
43.11
40.95
47.09
11
10.94
10.39
11.95
F 11
9.18
8.72
10.03
11
98.32
93.40
107.41
C11
171.13
162.57
186.96
C11
161.10
153.05
176.01
C11
187.41
178.04
204.75
09/12/2011

----- -- ---- --------
NPAR FEE
--------
PAGE 044
LC FEE
--------
93287
11
33.07
31.42
36.13
93288
11
37.74
35.85
41.23
93289
11
65.24
61.98
71.28
93290
11
29.24
27.78
31.95
93291
11
36.17
34.36
39.51
93292
11
32.70
31.07
35.73
93293
11
52.59
49.96
57.45
93294
11
33.39
31.72
36.48
93297
11
24.97
23.72
27.28
93303 TC
11
133.46
126.79
145.81
93304 TC
11
89.05
84.60
97.29
93306 TC
11
152.98
145.33
167.13
93307 TC
11
93.14
88.48
101.75
93308 TC
11
72.35
68.73
79.04
93312 TC
11
197.85
187.96
216.15
93314
11
267.06
253.71
291.77
93315 26
11
140.01
133.01
152.96
93317 26
11
90.41
85.89
98.77
93320 TC
11
39.91
37.91
43.60
93321 TC
11
19.76
18.77
21.59
93325 TC
11
29.52
28.04
32.25
93350 TC
11
124.32
118.10
135.82
93351 TC
11
144.31
137.09
157.65
93451
11
709.07
673.62
774.66
93452
11
788.13
748.72
861.03
93453
11 1031.56
979.98
1126.98
93454
11
812.79
772.15
887.97
93455
11
948.38
900.96
1036.10
93456
11 1017.51
966.63
1111.62
93457
11 1152.99
1095.34
1259.64
93458
11
980.90
931.86
1071.64
93459
11 1083.59
1029.41
1183.82
93460
11 1159.96
1101.96
1267.25
93461
11 1328.67
1262.24
1451.58
93462
11
191.27
181.71
208.97
93464 TC
11
145.43
138.16
158.88
93505
11
746.98
709.63
816.07
93530
11
821.05
780.00
897.00
93531
11 2130.89
2024.35
2328.00
93532 26
11
534.64
507.91
584.10
93561 TC
11
18.39
17.47
20.09
93562 TC
11
11.35
10.78
12.40
93564
11
54.76
52.02
59.82
93566
F 11
41.44
39.37
45.28
93568
N 11
143.22
136.06
156.47
93571 TC
11
157.19
149.33
171.73
93580
11
989.37
939.90
1080.89
93600 TC
11
67.83
64.44
74.11
93602 TC
11
38.36
36.44
41.91
93603 TC
11
58.11
55.20
63.48
93609 TC
11
94.30
89.59
103.03
93610 TC
11
46.88
44.54
51.22
93612 TC
11
55.76
52.97
60.92
93615
11
59.54
56.56
65.04
93616 26
11
65.42
62.15
71.47
93618 26
11
232.23
220.62
253.71
93619 26
11
401.15
381.09
438.25
93620 26
11
632.92
601.27
691.46
93623 26
11
155.61
147.83
170.00
93624 26
11
263.56
250.38
287.94
93640 TC
11
247.95
235.55
270.88
93641 TC
11
247.95
235.55
270.88
93642 TC
11
158.79
150.85
173.48
93651
11
885.69
841.41
967.62
93660 TC
11
61.02
57.97
66.67
93701
11
24.79
23.55
27.08
93722
11
7.89
7.50
08.63
93724 26
11
246.13
233.82
268.89
93745 26
11
17.02
16.17
18.60
93784
11
58.32
55.40
63.71
93790
11
18.49
17.57
20.21
93798
N 11
24.23
23.02
26.47
93875 TC
11
87.79
83.40
95.91
93880 TC C11
141.96
134.86
155.09
93882 TC C11
141.65
134.57
154.76
93886 TC C11
141.96
134.86
155.09
MFI00A11
FSY-2011

----- -- ---- --------
"STATE OK"
NPAR FEE
--------
M E D I C A R E
LC FEE
--------
F E E

----- -- ---- --------
93886 26
11
45.45
43.18
49.66
93888
93888 26
11
30.17
28.66
32.96
93890
93890 26
11
47.80
45.41
52.22
93892
93892 26
11
55.33
52.56
60.44
93893
93893 26
11
55.65
52.87
60.80
93922
93922 26
11
11.87
11.28
12.97
93923
93923 26
11
21.87
20.78
23.90
93924
93924 26
11
24.20
22.99
26.44
93925
93925 26
11
27.86
26.47
30.44
93926
93926 26
11
19.12
18.16
20.88
93930
93930 26
11
22.21
21.10
24.27
93931
93931 26
11
15.00
14.25
16.39
93965
93965 26
11
16.99
16.14
18.56
93970
93970 26
11
33.20
31.54
36.27
93971
93971 26
11
21.87
20.78
23.90
93975
93975 26
11
87.34
82.97
95.42
93976
93976 26
11
58.68
55.75
64.11
93978
93978 26
11
31.87
30.28
34.82
93979
93979 26
11
21.22
20.16
23.18
93980
93980 26
11
61.07
58.02
66.72
93981
93981 26
11
21.30
20.24
23.28
93982
93990 TC C11
89.13
84.67
97.37
93990 26
94003
11
63.00
59.85
68.83
94004
94010 TC
11
24.79
23.55
27.08
94010 26
94012
11
147.11
139.75
160.71
94013
94015
11
22.59
21.46
24.68
94016
94060 TC
11
42.75
40.61
46.70
94060 26
94070 TC
11
28.89
27.45
31.57
94070 26
94200 TC
11
17.24
16.38
18.84
94200 26
94240 TC
11
25.74
24.45
28.12
94240 26
94250 TC
11
18.50
17.58
20.22
94250 26
94260 TC
11
24.48
23.26
26.75
94260 26
94350 TC
11
20.70
19.67
22.62
94350 26
94360 TC
11
29.83
28.34
32.59
94360 26
94370 TC
11
20.39
19.37
22.28
94370 26
94375 TC
11
21.96
20.86
23.99
94375 26
94400 TC
11
32.35
30.73
35.34
94400 26
94450 TC
11
37.08
35.23
40.51
94450 26
94452 TC
11
39.91
37.91
43.60
94452 26
94453 TC
11
54.72
51.98
59.78
94453 26
94620
11
60.14
57.13
65.70
94620 TC
94621
11
153.87
146.18
168.11
94621 TC
94640
11
14.72
13.98
16.08
94644
94660
N 11
56.57
53.74
61.80
94660
94664
11
14.72
13.98
16.08
94667
94680
11
54.96
52.21
60.04
94680 TC
94681
11
53.24
50.58
58.17
94681 TC
94690
11
47.87
45.48
52.30
94690 TC
94720
11
48.97
46.52
53.50
94720 TC
94725
11
55.90
53.11
61.08
94725 TC
94750
11
72.52
68.89
79.22
94750 TC
94760
11
2.43
2.31
02.66
94761
94770
11
21.53
20.45
23.52
95004
95012
11
19.13
18.17
20.90
95015
95024
11
6.87
6.53
07.51
95027
95044
11
5.58
5.30
06.10
95052
95060
11
26.37
25.05
28.81
95065
95071
11
47.16
44.80
51.52
95075
95115
11
9.36
8.89
10.22
95117
95144
F 11
3.21
3.05
03.51
95145
95146
N 11
30.93
29.38
33.79
95146
95147
F 11
3.21
3.05
03.51
95148
95149
N 11
55.81
53.02
60.97
95149
95165
F 11
3.21
3.05
03.51
95170
95180
N 11
135.09
128.34
147.59
95180
95251
11
40.50
38.48
44.25
95800
95800 26
11
56.11
53.30
61.30
95801
95801 26
11
49.69
47.21
54.29
95803
95803 26
11
45.35
43.08
49.54
95805
95805 26
11
59.95
56.95
65.49
95806
95806 26
11
60.93
57.88
66.56
95807
95807 26
11
61.32
58.25
66.99
95808
95808 26
11
87.17
82.81
95.23
95810
95810 26
11
121.55
115.47
132.79
95811
95811 26
11
127.07
120.72
138.83
95812
95812 26
11
52.41
49.79
57.26
95813
S C H E D U L E
NPAR FEE
--------
"ALL OF OKLAHOMA"
LC FEE
--------
C11
87.80
83.41
95.92
C11
136.94
130.09
149.60
C11
144.46
137.24
157.83
C11
144.78
137.54
158.17
11
102.81
97.67
112.32
11
159.11
151.15
173.82
11
198.60
188.67
216.97
C11
169.74
161.25
185.44
C11
108.48
103.06
118.52
C11
164.17
155.96
179.35
C11
104.36
99.14
114.01
11
118.00
112.10
128.92
C11
175.16
166.40
191.36
C11
111.23
105.67
121.52
C11
229.21
217.75
250.41
C11
200.33
190.31
218.86
C11
173.83
165.14
189.91
C11
110.58
105.05
120.81
11
165.87
157.58
181.22
11
112.55
106.92
122.96
11
40.31
38.29
44.03
11
12.24
11.63
13.37
11
45.97
43.67
50.22
11
8.21
7.80
08.97
11
30.27
28.76
33.07
11
23.88
22.69
26.09
11
14.23
13.52
15.55
11
27.68
26.30
30.25
11
5.23
4.97
05.72
11
11.90
11.31
13.01
11
5.23
4.97
05.72
11
5.90
5.61
06.45
11
11.90
11.31
13.01
11
11.90
11.31
13.01
11
11.90
11.31
13.01
11
14.23
13.52
15.55
11
18.23
17.32
19.92
11
18.54
17.61
20.25
11
13.91
13.21
15.19
11
18.23
17.32
19.92
11
30.46
28.94
33.28
11
87.16
82.80
95.22
11
37.08
35.23
40.51
F 11
35.47
33.70
38.76
11
20.70
19.67
22.62
11
42.75
40.61
46.70
11
44.01
41.81
48.08
11
44.32
42.10
48.42
11
37.08
35.23
40.51
11
43.69
41.51
47.74
11
61.96
58.86
67.69
11
4.01
3.81
04.38
11
5.92
5.62
06.46
N 11
13.51
12.83
14.75
11
4.35
4.13
04.75
11
6.53
6.20
07.13
11
22.59
21.46
24.68
N 11
61.54
58.46
67.23
11
11.57
10.99
12.64
N 11
17.70
16.82
19.34
F 11
3.21
3.05
03.51
N 11
41.95
39.85
45.83
F 11
3.21
3.05
03.51
N 11
9.20
8.74
10.05
F 11
102.01
96.91
111.45
11
192.72
183.08
210.54
11
91.81
87.22
100.30
11
152.35
144.73
166.44
11
382.75
363.61
418.15
11
171.22
162.66
187.06
11
437.46
415.59
477.93
11
605.04
574.79
661.01
11
647.84
615.45
707.77
11
698.94
663.99
763.59
11
294.04
279.34
321.24
11
332.47
315.85
363.23
09/12/2011

----- -- ---- -------93888 TC C11
93890 TC C11
93892 TC C11
93893 TC C11
93922 TC
11
93923 TC
11
93924 TC
11
93925 TC C11
93926 TC C11
93930 TC C11
93931 TC C11
93965 TC
11
93970 TC C11
93971 TC C11
93975 TC C11
93976 TC C11
93978 TC C11
93979 TC C11
93980 TC
11
93981 TC
11
93990
C11
94002
11
94010
11
94011
11
94014
11
94060
11
94070
11
94200
11
94240
11
94250
11
94260
11
94350
11
94360
11
94370
11
94375
11
94400
11
94450
11
94452
11
94453
11
94610
11
94620 26
11
94621 26
11
94645
11
94662
11
94668
11
94680 26
11
94681 26
11
94690 26
11
94720 26
11
94725 26
11
94750 26
11
94762
11
95010
11
95015
F 11
95028
11
95056
11
95070
11
95075
F 11
95144
N 11
95145
F 11
95147
N 11
95148
F 11
95165
N 11
95170
F 11
95250
11
95800 TC
11
95801 TC
11
95803 TC
11
95805 TC
11
95806 TC
11
95807 TC
11
95808 TC
11
95810 TC
11
95811 TC
11
95812 TC
11
95813 TC
11
by the American
NPAR FEE
--------
PAGE 045
LC FEE
--------
57.64
54.76
62.97
89.13
84.67
97.37
89.13
84.67
97.37
89.13
84.67
97.37
90.94
86.39
99.35
137.24
130.38
149.94
174.40
165.68
190.53
141.87
134.78
155.00
89.36
84.89
97.62
141.96
134.86
155.09
89.36
84.89
97.62
101.02
95.97
110.37
141.96
134.86
155.09
89.36
84.89
97.62
141.87
134.78
155.00
141.65
134.57
154.76
141.96
134.86
155.09
89.36
84.89
97.62
104.80
99.56
114.49
91.25
86.69
99.69
101.37
96.30
110.75
87.64
83.26
95.75
33.00
31.35
36.05
95.40
90.63
104.22
46.47
44.15
50.77
56.97
54.12
62.24
56.57
53.74
61.80
22.46
21.34
24.54
37.64
35.76
41.12
23.72
22.53
25.91
30.38
28.86
33.19
32.60
30.97
35.62
41.73
39.64
45.59
32.28
30.67
35.27
36.19
34.38
39.54
50.58
48.05
55.26
55.62
52.84
60.77
53.82
51.13
58.80
72.94
69.29
79.68
57.07
54.22
62.35
29.67
28.19
32.42
66.71
63.37
72.88
13.46
12.79
14.71
34.84
33.10
38.07
20.07
19.07
21.93
12.21
11.60
13.34
9.23
8.77
10.09
3.55
3.37
03.88
11.90
11.31
13.01
12.21
11.60
13.34
10.56
10.03
11.53
18.50
17.58
20.22
17.29
16.43
18.89
7.53
7.15
08.22
11.57
10.99
12.64
37.71
35.82
41.19
35.19
33.43
38.44
46.42
44.10
50.72
11.72
11.13
12.80
3.21
3.05
03.51
29.04
27.59
31.73
3.21
3.05
03.51
11.72
11.13
12.80
3.21
3.05
03.51
137.24
130.38
149.94
136.61
129.78
149.25
42.12
40.01
46.01
107.00
101.65
116.90
322.80
306.66
352.66
110.29
104.78
120.50
376.14
357.33
410.93
517.87
491.98
565.78
526.29
499.98
574.98
571.87
543.28
624.77
241.63
229.55
263.98
248.79
236.35
271.80
MFI00A11
FSY-2011

----- -- ---- --------
"STATE OK"
NPAR FEE
--------
M E D I C A R E
LC FEE
--------
F E E

----- -- ---- --------
95813 26
11
83.68
79.50
91.43
95816
95816 26
11
52.95
50.30
57.85
95819
95819 26
11
52.72
50.08
57.59
95822
95822 26
11
52.72
50.08
57.59
95824 26
95827 TC
11
467.34
443.97
510.57
95827 26
95829 TC
11 1097.52
1042.64
1199.04
95829 26
95830
F 11
83.00
78.85
90.68
95831
95832
N 11
26.29
24.98
28.73
95832
95833
F 11
21.87
20.78
23.90
95834
95851
N 11
16.37
15.55
17.88
95851
95852
F 11
5.54
5.26
06.05
95857
95860
11
85.81
81.52
93.75
95860 TC
95861
11
124.87
118.63
136.42
95861 TC
95863
11
150.71
143.17
164.65
95863 TC
95864
11
165.50
157.23
180.81
95864 TC
95865
11
114.33
108.61
124.90
95865 TC
95866
11
98.64
93.71
107.77
95866 TC
95867
11
75.94
72.14
82.96
95867 TC
95868
11
103.28
98.12
112.84
95868 TC
95869
11
54.92
52.17
60.00
95869 TC
95870
11
53.66
50.98
58.63
95870 TC
95872
11
170.82
162.28
186.62
95872 TC
95873
11
54.60
51.87
59.65
95873 TC
95874
11
52.08
49.48
56.90
95874 TC
95875
11
99.53
94.55
108.73
95875 TC
95900
11
56.62
53.79
61.86
95900 TC
95903
11
65.71
62.42
71.78
95903 TC
95904
11
49.80
47.31
54.41
95904 TC
95905
11
78.06
74.16
85.28
95905 TC
95920
11
151.22
143.66
165.21
95920 TC
95921
11
75.90
72.11
82.93
95921 TC
95922
11
93.37
88.70
102.01
95922 TC
95923
11
135.97
129.17
148.55
95923 TC
95925
11
146.36
139.04
159.90
95925 TC
95926
11
141.78
134.69
154.89
95926 TC
95927
11
133.13
126.47
145.44
95927 TC
95928
11
219.54
208.56
239.84
95928 TC
95929
11
232.46
220.84
253.97
95929 TC
95930
11
124.16
117.95
135.64
95930 TC
95933
11
69.78
66.29
76.23
95933 TC
95934
11
53.06
50.41
57.97
95934 TC
95936
11
44.02
41.82
48.09
95936 TC
95937
11
61.02
57.97
66.67
95937 TC
95950
11
253.58
240.90
277.04
95950 TC
95951
11
959.88
911.89
1048.67
95951 TC
95953
11
388.75
369.31
424.71
95953 TC
95954
11
292.33
277.71
319.37
95954 TC
95955
11
157.66
149.78
172.25
95955 TC
95956
11
941.92
894.82
1029.04
95956 TC
95957
11
317.97
302.07
347.38
95957 TC
95958
11
428.73
407.29
468.38
95958 TC
95961
11
238.82
226.88
260.91
95961 TC
95962
11
216.11
205.30
236.10
95962 TC
95965 26
11
402.28
382.17
439.50
95966
95966 26
11
200.90
190.86
219.49
95967
95967 26
11
174.32
165.60
190.44
95970
95971
N 11
54.87
52.13
59.95
95971
95972
F 11
74.31
70.59
81.18
95973
95974
N 11
176.52
167.69
192.84
95974
95975
F 11
84.12
79.91
91.90
95978
95979
N 11
93.56
88.88
102.21
95979
95981
N 11
28.83
27.39
31.50
95981
95982
F 11
32.67
31.04
35.70
95990
95991
F 11
36.44
34.62
39.81
95992
96000
11
87.92
83.52
96.05
96001
96003
11
17.98
17.08
19.64
96004
96101
N 11
80.85
76.81
88.33
96101
96102
F 11
22.71
21.57
24.81
96103
96105
11
102.89
97.75
112.41
96110
96111
F 11
116.87
111.03
127.68
96116
96118
N 11
94.08
89.38
102.79
96118
96119
F 11
22.69
21.56
24.79
96120
96125
11
90.54
86.01
98.91
96150
96151
N 11
20.00
19.00
21.85
96151
96152
F 11
18.69
17.76
20.42
96153
96154
N 11
18.67
17.74
20.40
96154
S C H E D U L E
NPAR FEE
--------
"ALL OF OKLAHOMA"
LC FEE
--------
11
272.53
258.90
297.74
11
303.80
288.61
331.90
11
284.28
270.07
310.58
11
36.36
34.54
39.72
11
52.64
50.01
57.51
11
300.60
285.57
328.41
N 11
27.21
25.85
29.73
F 11
14.95
14.20
16.33
N 11
44.06
41.86
48.14
F 11
7.55
7.17
08.25
N 11
44.43
42.21
48.54
11
37.71
35.82
41.19
11
48.10
45.70
52.56
11
58.50
55.58
63.92
11
67.00
63.65
73.20
11
35.50
33.73
38.79
11
36.76
34.92
40.16
11
36.45
34.63
39.82
11
44.95
42.70
49.11
11
36.45
34.63
39.82
11
35.50
33.73
38.79
11
32.35
30.73
35.34
11
35.50
33.73
38.79
11
33.61
31.93
36.72
11
45.58
43.30
49.80
11
35.82
34.03
39.13
11
36.13
34.32
39.47
11
32.98
31.33
36.03
11
75.19
71.43
82.14
11
47.79
45.40
52.21
11
32.67
31.04
35.70
11
47.16
44.80
51.52
11
91.88
87.29
100.38
11
120.23
114.22
131.35
11
115.19
109.43
125.84
11
106.68
101.35
116.55
11
146.20
138.89
159.72
11
158.79
150.85
173.48
11
107.00
101.65
116.90
11
40.54
38.51
44.29
11
27.94
26.54
30.52
11
17.24
16.38
18.84
11
28.89
27.45
31.57
11
179.90
170.91
196.55
11
632.50
600.88
691.01
11
236.90
225.06
258.82
11
181.70
172.62
198.51
11
108.89
103.45
118.97
11
769.95
731.45
841.17
11
221.02
209.97
241.47
11
221.70
210.62
242.21
11
91.88
87.29
100.38
11
58.81
55.87
64.25
11
540.23
513.22
590.20
11
446.41
424.09
487.70
N 11
55.26
52.50
60.38
F 11
38.49
36.57
42.06
N 11
57.02
54.17
62.30
F 11
148.17
140.76
161.87
N 11
212.94
202.29
232.63
F 11
81.91
77.81
89.48
F 11
16.23
15.42
17.73
11
69.66
66.18
76.11
N 11
40.80
38.76
44.57
11
97.20
92.34
106.19
11
107.40
102.03
117.33
F 11
77.39
73.52
84.55
N 11
52.97
50.32
57.87
11
7.47
7.10
08.17
N 11
88.15
83.74
96.30
F 11
76.76
72.92
83.86
N 11
77.22
73.36
84.36
N 11
20.68
19.65
22.60
F 11
19.69
18.71
21.52
N 11
4.57
4.34
04.99
F 11
18.35
17.43
20.04
09/12/2011

----- -- ---- --------
NPAR FEE
--------
PAGE 046
LC FEE
--------
95816 TC
11
219.58
208.60
239.89
95819 TC
11
251.08
238.53
274.31
95822 TC
11
231.55
219.97
252.97
95827
11
519.97
493.97
568.07
95829
11 1398.12
1328.21
1527.44
95830
N 11
179.69
170.71
196.32
95831
F 11
14.29
13.58
15.62
95833
N 11
35.09
33.34
38.34
95834
F 11
28.63
27.20
31.28
95852
N 11
13.73
13.04
15.00
95857
F 11
27.42
26.05
29.96
95860 26
11
48.10
45.70
52.56
95861 26
11
76.77
72.93
83.87
95863 26
11
92.22
87.61
100.75
95864 26
11
98.50
93.58
107.62
95865 26
11
78.82
74.88
86.11
95866 26
11
61.88
58.79
67.61
95867 26
11
39.49
37.52
43.15
95868 26
11
58.33
55.41
63.72
95869 26
11
18.47
17.55
20.18
95870 26
11
18.15
17.24
19.83
95872 26
11
138.47
131.55
151.28
95873 26
11
19.10
18.15
20.87
95874 26
11
18.47
17.55
20.18
95875 26
11
53.95
51.25
58.94
95900 26
11
20.80
19.76
22.72
95903 26
11
29.57
28.09
32.30
95904 26
11
16.82
15.98
18.38
95905 26
11
2.87
2.73
03.14
95920 26
11
103.44
98.27
113.01
95921 26
11
43.23
41.07
47.23
95922 26
11
46.21
43.90
50.49
95923 26
11
44.09
41.89
48.17
95925 26
11
26.13
24.82
28.54
95926 26
11
26.59
25.26
29.05
95927 26
11
26.45
25.13
28.90
95928 26
11
73.35
69.68
80.13
95929 26
11
73.66
69.98
80.48
95930 26
11
17.16
16.30
18.75
95933 26
11
29.23
27.77
31.94
95934 26
11
25.12
23.86
27.44
95936 26
11
26.79
25.45
29.27
95937 26
11
32.13
30.52
35.10
95950 26
11
73.69
70.01
80.51
95951 26
11
297.93
283.03
325.48
95953 26
11
151.85
144.26
165.90
95954 26
11
110.63
105.10
120.87
95955 26
11
48.77
46.33
53.28
95956 26
11
171.97
163.37
187.88
95957 26
11
96.95
92.10
105.92
95958 26
11
207.03
196.68
226.18
95961 26
11
146.94
139.59
160.53
95962 26
11
157.30
149.44
171.86
95966 TC
11
324.14
307.93
354.12
95967 TC
11
267.85
254.46
292.63
95970
F 11
22.19
21.08
24.24
95972
N 11
101.09
96.04
110.45
95973
F 11
45.37
43.10
49.57
95975
N 11
95.77
90.98
104.63
95978
F 11
176.71
167.87
193.05
95980
11
42.48
40.36
46.41
95982
N 11
45.27
43.01
49.46
95991
N 11
99.11
94.15
108.27
95992
F 11
36.70
34.87
40.10
96002
11
20.28
19.27
22.16
96020 26
11
169.28
160.82
184.94
96102
N 11
62.71
59.57
68.51
96103
F 11
23.68
22.50
25.88
96111
N 11
121.28
115.22
132.50
96116
F 11
83.11
78.95
90.79
96119
N 11
66.47
63.15
72.62
96120
F 11
23.37
22.20
25.53
96150
F 11
20.37
19.35
22.25
96152
N 11
19.01
18.06
20.77
96153
F 11
4.26
4.05
04.66
96360
11
53.07
50.42
57.98
MFI00A11
FSY-2011

----- -- ---- -------96361
96367
96370
96373
96401
96405
96409
96415
96420
96425
96446
96450
96523
96567
96900
96912
96920
96922
97002
97012
97022
97028
97034
97110
97116
97150
97533
97542
97598
97605
97750
97761
97802
97804
98926
98927
98929
98940
98942
99143
99145
99149
99170
99183
99201
99203
99204
99211
99212
99214
99215
99219
99222
99225
99232
99235
99239
99283
99291
99292
99306
99309
99316
99325
99328
99336
99342
99345
99349
99354
99356
99406
99460
99462
99465
99468
***
"STATE OK"
NPAR FEE
--------
M E D I C A R E
LC FEE
--------
F E E

----- -- ---- --------
11
14.31
13.59
15.63
96365
11
30.94
29.39
33.80
96368
11
14.53
13.80
15.87
96371
11
17.97
17.07
19.63
96374
11
67.57
64.19
73.82
96402
F 11
29.06
27.61
31.75
96406
11
104.73
99.49
114.41
96411
11
29.36
27.89
32.07
96416
11
100.83
95.79
110.16
96422
11
166.17
157.86
181.54
96440
N 11
164.40
156.18
179.61
96446
F 11
82.21
78.10
89.82
96521
11
23.63
22.45
25.82
96542
11
121.17
115.11
132.38
96570
11
19.13
18.17
20.90
96904
11
82.43
78.31
90.06
96913
F 11
64.87
61.63
70.87
96921
N 11
236.01
224.21
257.84
96922
11
38.39
36.47
41.94
97003
11
14.71
13.97
16.07
97016
11
19.23
18.27
21.01
97024
11
6.41
6.09
07.00
97032
11
15.55
14.77
16.99
97035
11
28.43
27.01
31.06
97112
11
25.16
23.90
27.49
97124
11
18.22
17.31
19.91
97530
11
26.52
25.19
28.97
97535
11
27.49
26.12
30.04
97597
N 11
22.70
21.57
24.81
97598
F 11
25.87
24.58
28.27
97606
11
29.83
28.34
32.59
97755
11
29.52
28.04
32.25
97762
F 11
28.77
27.33
31.43
97803
11
13.45
12.78
14.70
98925
N 11
38.83
36.89
42.42
98926
F 11
40.87
38.83
44.65
98928
N 11
68.17
64.76
74.47
98929
F 11
19.84
18.85
21.68
98941
N 11
43.22
41.06
47.22
98942
N 11
60.07
57.07
65.63
99143
11
9.20
8.74
10.05
99148
11
40.88
38.84
44.67
99150
F 11
90.86
86.32
99.27
99175
F 11
113.46
107.79
123.96
99195
F 11
24.78
23.54
27.07
99202
N 11
97.74
92.85
106.78
99203
F 11
121.19
115.13
132.40
99205
N 11
18.63
17.70
20.36
99211
F 11
24.15
22.94
26.38
99213
N 11
97.65
92.77
106.69
99214
F 11
103.23
98.07
112.78
99217
11
103.62
98.44
113.21
99220
11
127.08
120.73
138.84
99223
11
47.62
45.24
52.03
99226
11
67.00
63.65
73.20
99233
11
166.14
157.83
181.50
99236
11
97.61
92.73
106.64
99281
11
59.15
56.19
64.62
99284
N 11
253.24
240.58
276.67
99291
F 11
105.12
99.86
114.84
99304
11
151.42
143.85
165.43
99307
11
82.20
78.09
89.80
99310
11
77.04
73.19
84.17
99318
11
76.60
72.77
83.69
99326
11
200.18
190.17
218.70
99334
11
122.99
116.84
134.37
99337
11
76.51
72.68
83.58
99343
11
201.90
191.81
220.58
99347
11
117.32
111.45
128.17
99350
F 11
86.27
81.96
94.25
99355
11
84.23
80.02
92.02
99357
F 11
11.53
10.95
12.59
99407
11
56.01
53.21
61.19
99461
11
30.17
28.66
32.96
99463
11
133.86
127.17
146.25
99466
11
865.64
822.36
945.71
99469
S C H E D U L E
NPAR FEE
--------
"ALL OF OKLAHOMA"
LC FEE
--------
11
66.09
62.79
72.21
11
18.29
17.38
19.99
11
74.24
70.53
81.11
11
51.84
49.25
56.64
11
32.83
31.19
35.87
N 11
111.24
105.68
121.53
11
58.82
55.88
64.26
11
149.52
142.04
163.35
11
162.25
154.14
177.26
N 11
676.77
642.93
739.37
F 11
20.15
19.14
22.01
11
123.55
117.37
134.98
N 11
119.31
113.34
130.34
11
56.28
53.47
61.49
11
62.91
59.76
68.72
11
114.56
108.83
125.15
N 11
163.50
155.33
178.63
F 11
116.64
110.81
127.43
11
76.56
72.73
83.64
11
16.42
15.60
17.94
11
5.73
5.44
06.26
11
16.91
16.06
18.47
11
11.46
10.89
12.52
11
29.69
28.21
32.44
11
23.14
21.98
25.28
11
30.93
29.38
33.79
11
30.95
29.40
33.81
N 11
67.60
64.22
73.85
F 11
11.04
10.49
12.06
N 11
39.67
37.69
43.34
11
33.09
31.44
36.16
11
38.01
36.11
41.53
N 11
26.68
25.35
29.15
N 11
28.89
27.45
31.57
F 11
30.96
29.41
33.82
N 11
59.13
56.17
64.60
F 11
56.20
53.39
61.40
N 11
33.43
31.76
36.52
F 11
38.90
36.96
42.50
F 11
38.23
36.32
41.77
N 11
60.07
57.07
65.63
11
13.29
12.63
14.52
11
22.59
21.46
24.68
11
79.57
75.59
86.93
N 11
67.52
64.14
73.76
F 11
71.60
68.02
78.22
N 11
188.19
178.78
205.60
F 11
8.86
8.42
09.68
N 11
65.73
62.44
71.81
F 11
73.09
69.44
79.86
11
66.73
63.39
72.90
11
144.89
137.65
158.30
11
186.89
177.55
204.18
11
71.22
67.66
77.81
11
96.20
91.39
105.10
11
206.47
196.15
225.57
11
20.07
19.07
21.93
11
111.52
105.94
121.83
F 11
209.46
198.99
228.84
11
84.42
80.20
92.23
11
40.59
38.56
44.34
11
121.78
115.69
133.04
11
86.84
82.50
94.88
11
130.17
123.66
142.21
11
56.22
53.41
61.42
11
176.96
168.11
193.33
11
125.02
118.77
136.59
11
52.27
49.66
57.11
11
163.39
155.22
178.50
N 11
90.99
86.44
99.41
11
84.54
80.31
92.36
N 11
25.55
24.27
27.91
N 11
86.84
82.50
94.88
11
76.41
72.59
83.48
11
248.36
235.94
271.33
11
379.00
360.05
414.06
09/12/2011

----- -- ---- -------96366
11
96369
11
96372
11
96375
11
96405
N 11
96406
F 11
96413
11
96417
11
96423
11
96440
F 11
96450
N 11
96522
11
96542
F 11
96571
11
96910
11
96920
N 11
96921
F 11
97001
11
97004
11
97018
11
97026
11
97033
11
97036
11
97113
11
97140
11
97532
11
97537
11
97597
F 11
97605
N 11
97606
F 11
97760
11
97802
N 11
97803
F 11
98925
F 11
98927
N 11
98928
F 11
98940
N 11
98941
F 11
99082
11
99144
11
99148
F 11
99170
N 11
99183
N 11
99201
N 11
99202
F 11
99204
N 11
99205
F 11
99212
N 11
99213
F 11
99215
N 11
99218
11
99221
11
99224
11
99231
11
99234
11
99238
11
99282
11
99285
11
99292
N 11
99305
11
99308
11
99315
11
99324
11
99327
11
99335
11
99341
11
99344
11
99348
11
99354
N 11
99355
F 11
99406
N 11
99407
F 11
99461
F 11
99464
11
99467
11
99471
11
by the American
NPAR FEE
--------
PAGE 047
LC FEE
--------
20.52
19.49
22.41
158.69
150.76
173.37
21.75
20.66
23.76
21.26
20.20
23.23
80.71
76.67
88.17
42.27
40.16
46.18
136.01
129.21
148.59
67.35
63.98
73.58
74.09
70.39
80.95
138.50
131.58
151.32
187.09
177.74
204.40
103.08
97.93
112.62
42.14
40.03
46.03
26.21
24.90
28.64
64.17
60.96
70.10
163.13
154.97
178.22
64.60
61.37
70.58
69.63
66.15
76.07
46.27
43.96
50.55
8.88
8.44
09.71
5.10
4.85
05.58
26.70
25.37
29.18
27.69
26.31
30.26
36.91
35.06
40.32
26.81
25.47
29.29
24.31
23.09
26.55
27.17
25.81
29.68
23.19
22.03
25.33
37.20
35.34
40.64
28.33
26.91
30.95
33.30
31.64
36.39
30.66
29.13
33.50
24.79
23.55
27.08
21.64
20.56
23.64
50.63
48.10
55.32
48.10
45.70
52.56
24.16
22.95
26.39
29.41
27.94
32.13
.88
.84
00.97
33.73
32.04
36.85
38.23
36.32
41.77
137.16
130.30
149.85
196.30
186.49
214.46
38.95
37.00
42.55
47.05
44.70
51.41
150.80
143.26
164.75
156.07
148.27
170.51
39.27
37.31
42.91
47.47
45.10
51.87
131.57
124.99
143.74
62.01
58.91
67.75
93.28
88.62
101.91
26.82
25.48
29.30
37.04
35.19
40.47
126.33
120.01
138.01
66.50
63.18
72.66
39.05
37.10
42.67
163.67
155.49
178.81
114.25
108.54
124.82
118.73
112.79
129.71
62.43
59.31
68.21
59.20
56.24
64.68
52.92
50.27
57.81
171.08
162.53
186.91
87.18
82.82
95.24
52.60
49.97
57.47
168.04
159.64
183.59
79.22
75.26
86.55
91.94
87.34
100.44
85.32
81.05
93.21
13.11
12.45
14.32
23.97
22.77
26.19
61.33
58.26
67.00
69.57
66.09
76.00
114.66
108.93
125.27
749.86
712.37
819.23
MFI00A11
FSY-2011

----- -- ---- -------99472
99477
99480
***
"STATE OK"
NPAR FEE
--------
M E D I C A R E
LC FEE
--------
F E E

----- -- ---- --------
S C H E D U L E
NPAR FEE
--------
"ALL OF OKLAHOMA"
LC FEE
--------
09/12/2011

----- -- ---- --------
NPAR FEE
--------
PAGE 048
LC FEE
--------
11
376.90
358.06
411.77
99475
11
527.83
501.44
576.66
99476
11
319.62
303.64
349.19
11
334.37
317.65
365.30
99478
11
132.50
125.88
144.76
99479
11
121.66
115.58
132.92
11
113.54
107.86
124.04
All Current Procedural Terminology (CPT) codes and descriptors are copyrighted 2010 by the American Medical Association. **

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