Procedure Code	Procedure Description	Pricing Indicator	Rate Type	Mod1	Mod2	Mod3	Mod4	Max Fee	Max Fee Eff. Date	Max Fee End Date	PA
A4566	SHOULD SLING/VEST/ABRESTRAIN	PRXOVR	DEF					NA	NA	NA	Y
A4566	SHOULD SLING/VEST/ABRESTRAIN	MAXFEE	DEF					95	1/1/2011	12/31/2299	Y
A5500	DIAB SHOE FOR DENSITY INSERT	PRXOVR	DEF					NA	NA	NA	Y
A5500	DIAB SHOE FOR DENSITY INSERT	MAXFEE	DEF					46.07	1/1/2010	12/31/2299	Y
A5501	DIABETIC CUSTOM MOLDED SHOE	PRXOVR	DEF					NA	NA	NA	Y
A5501	DIABETIC CUSTOM MOLDED SHOE	MAXFEE	DEF					160.19	1/1/2010	12/31/2299	Y
A5503	DIABETIC SHOE W/ROLLER/ROCKR	PRXOVR	DEF					NA	NA	NA	Y
A5503	DIABETIC SHOE W/ROLLER/ROCKR	MAXFEE	DEF					30	1/1/2022	12/31/2299	Y
A5504	DIABETIC SHOE WITH WEDGE	PRXOVR	DEF					NA	NA	NA	Y
A5504	DIABETIC SHOE WITH WEDGE	MAXFEE	DEF					30	1/1/2022	12/31/2299	Y
A5505	DIAB SHOE W/METATARSAL BAR	PRXOVR	DEF					NA	NA	NA	Y
A5505	DIAB SHOE W/METATARSAL BAR	MAXFEE	DEF					30	1/1/2022	12/31/2299	Y
A5506	DIABETIC SHOE W/OFF SET HEEL	PRXOVR	DEF					NA	NA	NA	Y
A5506	DIABETIC SHOE W/OFF SET HEEL	MAXFEE	DEF					30	1/1/2022	12/31/2299	Y
A5512	MULTI DEN INSERT DIRECT FORM	PRXOVR	DEF					NA	NA	NA	Y
A5512	MULTI DEN INSERT DIRECT FORM	MAXFEE	DEF					18.80	1/1/2010	12/31/2299	Y
A5513	MULTI DEN INSERT CUSTOM MOLD	PRXOVR	DEF					NA	NA	NA	Y
A5513	MULTI DEN INSERT CUSTOM MOLD	MAXFEE	DEF					28.04	1/1/2010	12/31/2299	Y
A5514	MULT DEN INSERT DIR CARV/CAM	PRXOVR	DEF					NA	NA	NA	Y
A5514	MULT DEN INSERT DIR CARV/CAM	MAXFEE	DEF					35.65	1/1/2019	12/31/2299	Y
A8000	SOFT PROTECT HELMET PREFAB	PRXOVR	DEF					NA	NA	NA	S
A8000	SOFT PROTECT HELMET PREFAB	MAXFEE	DEF					103.41	1/1/2010	12/31/2299	S
A8001	HARD PROTECT HELMET PREFAB	PRXOVR	DEF					NA	NA	NA	S
A8001	HARD PROTECT HELMET PREFAB	MAXFEE	DEF					103.41	1/1/2010	12/31/2299	S
A8002	SOFT PROTECT HELMET CUSTOM	PRXOVR	DEF					NA	NA	NA	S
A8002	SOFT PROTECT HELMET CUSTOM	MAXFEE	DEF					441.26	1/1/2010	12/31/2299	S
A8003	HARD PROTECT HELMET CUSTOM	PRXOVR	DEF					NA	NA	NA	S
A8003	HARD PROTECT HELMET CUSTOM	MAXFEE	DEF					441.26	1/1/2010	12/31/2299	S
E2500	SGD DIGITIZED PRE-REC <=8MIN	PRXOVR	DEF					NA	NA	NA	N
E2500	SGD DIGITIZED PRE-REC <=8MIN	MAXFEE	DEF					266.75	1/1/2010	12/31/2299	N
E2502	SGD PREREC MSG >8MIN <=20MIN	PRXOVR	DEF					NA	NA	NA	N
E2502	SGD PREREC MSG >8MIN <=20MIN	MAXFEE	DEF					811.95	1/1/2010	12/31/2299	N
E2504	SGD PREREC MSG>20MIN <=40MIN	PRXOVR	DEF					NA	NA	NA	Y
E2504	SGD PREREC MSG>20MIN <=40MIN	MAXFEE	DEF					1071.06	1/1/2010	12/31/2299	Y
E2506	SGD PREREC MSG > 40 MIN	PRXOVR	DEF					NA	NA	NA	Y
E2506	SGD PREREC MSG > 40 MIN	MAXFEE	DEF					2129.15	1/1/2010	12/31/2299	Y
E2508	SGD SPELLING PHYS CONTACT	PRXOVR	DEF					NA	NA	NA	Y
E2508	SGD SPELLING PHYS CONTACT	MAXFEE	DEF					3452.16	1/1/2010	12/31/2299	Y
E2510	SGD W MULTI METHODS MSG/ACCS	PRXOVR	DEF					NA	NA	NA	Y
E2510	SGD W MULTI METHODS MSG/ACCS	MAXFEE	DEF					6565.20	1/1/2010	12/31/2299	Y
E2511	SGD SFTWRE PRGRM FOR PC/PDA	PRXOVR	DEF					NA	NA	NA	Y
E2511	SGD SFTWRE PRGRM FOR PC/PDA	MAXFEE	DEF					645	7/1/2021	12/31/2299	Y
E2512	SGD ACCESSORY; MOUNTING SYS	PRXOVR	DEF					NA	NA	NA	Y
E2512	SGD ACCESSORY; MOUNTING SYS	MAXFEE	DEF					652.16	12/7/2010	12/31/2299	Y
E2599	SGD ACCESSORY NOC	PRXOVR	DEF					NA	NA	NA	Y
E2599	SGD ACCESSORY NOC	PADOLR	DEF					NA	NA	NA	Y
K1015	FOOT; ADDUCTUS POSITION; ADJ	PRXOVR	DEF					NA	NA	NA	Y
K1015	FOOT; ADDUCTUS POSITION; ADJ	MANUAL	DEF					NA	NA	NA	Y
K1022	ENDOSKEL POSIT ROTAT UNIT	PRXOVR	DEF					NA	NA	NA	S
K1022	ENDOSKEL POSIT ROTAT UNIT	MAXFEE	DEF					415	10/1/2021	12/31/2023	S
K1024	NON PNEUM COMP CONTROL CAL	PRXOVR	DEF					NA	NA	NA	N
K1024	NON PNEUM COMP CONTROL CAL	MAXFEE	DEF					150	1/1/2023	12/31/2023	N
K1025	NON PNEUM COMPRESS FULL ARM	PRXOVR	DEF					NA	NA	NA	N
K1025	NON PNEUM COMPRESS FULL ARM	MAXFEE	DEF					150	10/1/2021	12/31/2023	N
K1027	ORAL DEV WITHOUT FIX MECH	PRXOVR	DEF					NA	NA	NA	Y
K1027	ORAL DEV WITHOUT FIX MECH	MAXFEE	DEF					600	10/1/2021	12/31/2299	Y
L0100	CRANIAL ORTHOSIS/HELMET MOLD	PRXOVR	DEF					NA	NA	NA	Y
L0100	CRANIAL ORTHOSIS/HELMET MOLD	MAXFEE	DEF					0	1/1/2007	12/31/2299	Y
L0110	CRANIAL ORTHOSIS/HELMET NONM	PRXOVR	DEF					NA	NA	NA	N
L0110	CRANIAL ORTHOSIS/HELMET NONM	MAXFEE	DEF					0	1/1/2007	12/31/2299	N
L0120	CERV FLEX N/ADJ FOAM PRE OTS	PRXOVR	DEF					NA	NA	NA	N
L0120	CERV FLEX N/ADJ FOAM PRE OTS	MAXFEE	DEF					16.89	1/1/2010	12/31/2299	N
L0140	CERVICAL SEMI-RIGID ADJUSTAB	PRXOVR	DEF					NA	NA	NA	N
L0140	CERVICAL SEMI-RIGID ADJUSTAB	MAXFEE	DEF					38.25	1/1/2010	12/31/2299	N
L0160	CERV SR WIRE OCC/MAN PRE OTS	PRXOVR	DEF					NA	NA	NA	S
L0160	CERV SR WIRE OCC/MAN PRE OTS	MAXFEE	DEF					120	1/1/2022	12/31/2299	S
L0170	CERVICAL COLLAR MOLDED TO PT	PRXOVR	DEF					NA	NA	NA	S
L0170	CERVICAL COLLAR MOLDED TO PT	MAXFEE	DEF					513.69	1/1/2010	12/31/2299	S
L0172	CERV COL SR FOAM 2PC PRE OTS	PRXOVR	DEF					NA	NA	NA	S
L0172	CERV COL SR FOAM 2PC PRE OTS	MAXFEE	DEF					90.48	1/1/2010	12/31/2299	S
L0174	CERV SR 2PC THOR EXT PRE OTS	PRXOVR	DEF					NA	NA	NA	S
L0174	CERV SR 2PC THOR EXT PRE OTS	MAXFEE	DEF					177.92	1/1/2010	12/31/2299	S
L0180	CER POST COL OCC/MAN SUP ADJ	PRXOVR	DEF					NA	NA	NA	S
L0180	CER POST COL OCC/MAN SUP ADJ	MAXFEE	DEF					288.26	1/1/2010	12/31/2299	S
L0190	CERV COLLAR SUPP ADJ CERV BA	PRXOVR	DEF					NA	NA	NA	S
L0190	CERV COLLAR SUPP ADJ CERV BA	MAXFEE	DEF					339.95	1/1/2010	12/31/2299	S
L0200	CERV COL SUPP ADJ BAR & THOR	PRXOVR	DEF					NA	NA	NA	S
L0200	CERV COL SUPP ADJ BAR & THOR	MAXFEE	DEF					394.31	1/1/2010	12/31/2299	S
L0210	THORACIC RIB BELT	PRXOVR	DEF					NA	NA	NA	N
L0210	THORACIC RIB BELT	MAXFEE	DEF					0	12/7/2010	12/31/2299	N
L0220	THOR RIB BELT CUSTOM FABRICA	PRXOVR	DEF					NA	NA	NA	Y
L0220	THOR RIB BELT CUSTOM FABRICA	MAXFEE	DEF					82.55	1/1/2010	12/31/2299	Y
L0300	TLSO FLEX SURGICAL SUPPORT	PRXOVR	DEF					NA	NA	NA	Y
L0300	TLSO FLEX SURGICAL SUPPORT	MAXFEE	DEF					0	4/1/2005	12/31/2299	Y
L0310	TLSO FLEXIBLE CUSTOM FABRICA	PRXOVR	DEF					NA	NA	NA	Y
L0310	TLSO FLEXIBLE CUSTOM FABRICA	MAXFEE	DEF					0	4/1/2005	12/31/2299	Y
L0315	TLSO FLEX ELAS RIGID POST PA	PRXOVR	DEF					NA	NA	NA	Y
L0315	TLSO FLEX ELAS RIGID POST PA	MAXFEE	DEF					0	4/1/2005	12/31/2299	Y
L0317	TLSO FLEX HYPEXT ELAS POST P	PRXOVR	DEF					NA	NA	NA	Y
L0317	TLSO FLEX HYPEXT ELAS POST P	MAXFEE	DEF					0	4/1/2005	12/31/2299	Y
L0320	TLSO A-P CONTRL W APRON FRNT	PRXOVR	DEF					NA	NA	NA	Y
L0320	TLSO A-P CONTRL W APRON FRNT	MAXFEE	DEF					0	4/1/2005	12/31/2299	Y
L0330	TLSO ANT-POS-LATERAL CONTROL	PRXOVR	DEF					NA	NA	NA	Y
L0330	TLSO ANT-POS-LATERAL CONTROL	MAXFEE	DEF					0	4/1/2005	12/31/2299	Y
L0340	TLSO A-P-L-ROTARY WITH APRON	PRXOVR	DEF					NA	NA	NA	Y
L0340	TLSO A-P-L-ROTARY WITH APRON	MAXFEE	DEF					0	4/1/2005	12/31/2299	Y
L0350	TLSO FLEX COMPRESS JACKET CU	PRXOVR	DEF					NA	NA	NA	Y
L0350	TLSO FLEX COMPRESS JACKET CU	MAXFEE	DEF					0	4/1/2005	12/31/2299	Y
L0360	TLSO FLEX COMPRESS JACKET MO	PRXOVR	DEF					NA	NA	NA	Y
L0360	TLSO FLEX COMPRESS JACKET MO	MAXFEE	DEF					0	4/1/2005	12/31/2299	Y
L0370	TLSO A-P-L-ROTARY HYPEREXTEN	PRXOVR	DEF					NA	NA	NA	Y
L0370	TLSO A-P-L-ROTARY HYPEREXTEN	MAXFEE	DEF					0	4/1/2005	12/31/2299	Y
L0380	TLSO A-P-L-ROT W/ POS EXTENS	PRXOVR	DEF					NA	NA	NA	Y
L0380	TLSO A-P-L-ROT W/ POS EXTENS	MAXFEE	DEF					0	4/1/2005	12/31/2299	Y
L0390	TLSO A-P-L CONTROL MOLDED	PRXOVR	DEF					NA	NA	NA	Y
L0390	TLSO A-P-L CONTROL MOLDED	MAXFEE	DEF					0	4/1/2005	12/31/2299	Y
L0400	TLSO A-P-L W INTERFACE MATER	PRXOVR	DEF					NA	NA	NA	Y
L0400	TLSO A-P-L W INTERFACE MATER	MAXFEE	DEF					0	4/1/2005	12/31/2299	Y
L0410	TLSO A-P-L TWO PIECE CONSTR	PRXOVR	DEF					NA	NA	NA	Y
L0410	TLSO A-P-L TWO PIECE CONSTR	MAXFEE	DEF					0	4/1/2005	12/31/2299	Y
L0420	TLSO A-P-L 2 PIECE W INTERFA	PRXOVR	DEF					NA	NA	NA	Y
L0420	TLSO A-P-L 2 PIECE W INTERFA	MAXFEE	DEF					0	4/1/2005	12/31/2299	Y
L0440	TLSO A-P-L OVERLAP FRNT CUST	PRXOVR	DEF					NA	NA	NA	Y
L0440	TLSO A-P-L OVERLAP FRNT CUST	MAXFEE	DEF					0	4/1/2005	12/31/2299	Y
L0450	TLSO FLEX TRUNK/THOR PRE OTS	PRXOVR	DEF					NA	NA	NA	S
L0450	TLSO FLEX TRUNK/THOR PRE OTS	MAXFEE	DEF					155	7/1/2018	12/31/2299	S
L0452	TLSO FLEX CUSTOM FAB THORACI	PRXOVR	DEF					NA	NA	NA	S
L0452	TLSO FLEX CUSTOM FAB THORACI	MAXFEE	DEF					202.07	1/1/2010	12/31/2299	S
L0454	TLSO TRNK SJ-T9 PRE CST	PRXOVR	DEF					NA	NA	NA	S
L0454	TLSO TRNK SJ-T9 PRE CST	MAXFEE	DEF					195.52	1/1/2010	12/31/2299	S
L0455	TLSO FLEX TRNK SJ-T9 PRE OTS	PRXOVR	DEF					NA	NA	NA	S
L0455	TLSO FLEX TRNK SJ-T9 PRE OTS	MAXFEE	DEF					180	1/1/2022	12/31/2299	S
L0457	TLSO FLEX TRNK SJ-SS PRE OTS	PRXOVR	DEF					NA	NA	NA	S
L0457	TLSO FLEX TRNK SJ-SS PRE OTS	MAXFEE	DEF					630	1/1/2022	12/31/2299	S
L0464	TLSO 4MOD SACRO-SCAP PRE	PRXOVR	DEF					NA	NA	NA	S
L0464	TLSO 4MOD SACRO-SCAP PRE	MAXFEE	DEF					1200	1/1/2022	12/31/2299	S
L0466	TLSO R FRAM SOFT ANT PRE CST	PRXOVR	DEF					NA	NA	NA	S
L0466	TLSO R FRAM SOFT ANT PRE CST	MAXFEE	DEF					242.40	1/1/2010	12/31/2299	S
L0467	TLSO R FRAM SOFT PRE OTS	PRXOVR	DEF					NA	NA	NA	S
L0467	TLSO R FRAM SOFT PRE OTS	MAXFEE	DEF					240	1/1/2022	12/31/2299	S
L0468	TLSO RIG FRAM PELVIC PRE CST	PRXOVR	DEF					NA	NA	NA	S
L0468	TLSO RIG FRAM PELVIC PRE CST	MAXFEE	DEF					303.78	1/1/2010	12/31/2299	S
L0469	TLSO RIG FRAM PELVIC PRE OTS	PRXOVR	DEF					NA	NA	NA	S
L0469	TLSO RIG FRAM PELVIC PRE OTS	MAXFEE	DEF					310	1/1/2022	12/31/2299	S
L0470	TLSO RIGID FRAME PRE SUBCLAV	PRXOVR	DEF					NA	NA	NA	S
L0470	TLSO RIGID FRAME PRE SUBCLAV	MAXFEE	DEF					413.62	1/1/2010	12/31/2299	S
L0472	TLSO RIGID FRAME HYPEREX PRE	PRXOVR	DEF					NA	NA	NA	S
L0472	TLSO RIGID FRAME HYPEREX PRE	MAXFEE	DEF					258.66	1/1/2010	12/31/2299	S
L0476	TLSO FLEXION COMPRES JAC PRE	PRXOVR	DEF					NA	NA	NA	Y
L0476	TLSO FLEXION COMPRES JAC PRE	MAXFEE	DEF					NA			Y
L0478	TLSO FLEXION COMPRES JAC CUS	PRXOVR	DEF					NA	NA	NA	Y
L0478	TLSO FLEXION COMPRES JAC CUS	MAXFEE	DEF					NA			Y
L0480	TLSO RIGID PLASTIC CUSTOM FA	PRXOVR	DEF					NA	NA	NA	S
L0480	TLSO RIGID PLASTIC CUSTOM FA	MAXFEE	DEF					965.02	1/1/2010	12/31/2299	S
L0482	TLSO RIGID LINED CUSTOM FAB	PRXOVR	DEF					NA	NA	NA	S
L0482	TLSO RIGID LINED CUSTOM FAB	MAXFEE	DEF					1077.94	1/1/2010	12/31/2299	S
L0484	TLSO RIGID PLASTIC CUST FAB	PRXOVR	DEF					NA	NA	NA	S
L0484	TLSO RIGID PLASTIC CUST FAB	MAXFEE	DEF					1164.14	1/1/2010	12/31/2299	S
L0486	TLSO RIGIDLINED CUST FAB TWO	PRXOVR	DEF					NA	NA	NA	S
L0486	TLSO RIGIDLINED CUST FAB TWO	MAXFEE	DEF					1307.38	1/1/2010	12/31/2299	S
L0488	TLSO RIGID LINED PRE ONE PIE	PRXOVR	DEF					NA	NA	NA	S
L0488	TLSO RIGID LINED PRE ONE PIE	MAXFEE	DEF					727.15	12/7/2010	12/31/2299	S
L0500	LSO FLEX SURGICAL SUPPORT	PRXOVR	DEF					NA	NA	NA	Y
L0500	LSO FLEX SURGICAL SUPPORT	MAXFEE	DEF					NA			Y
L0510	LSO FLEXIBLE CUSTOM FABRICAT	PRXOVR	DEF					NA	NA	NA	Y
L0510	LSO FLEXIBLE CUSTOM FABRICAT	MAXFEE	DEF					NA			Y
L0515	LSO FLEX ELAS W/ RIG POST PA	PRXOVR	DEF					NA	NA	NA	Y
L0515	LSO FLEX ELAS W/ RIG POST PA	MAXFEE	DEF					NA			Y
L0520	LSO A-P-L CONTROL WITH APRON	PRXOVR	DEF					NA	NA	NA	Y
L0520	LSO A-P-L CONTROL WITH APRON	MAXFEE	DEF					NA			Y
L0540	LSO LUMBAR FLEXION A-P-L	PRXOVR	DEF					NA	NA	NA	Y
L0540	LSO LUMBAR FLEXION A-P-L	MAXFEE	DEF					NA			Y
L0550	LSO A-P-L CONTROL MOLDED	PRXOVR	DEF					NA	NA	NA	Y
L0550	LSO A-P-L CONTROL MOLDED	MAXFEE	DEF					NA			Y
L0560	LSO A-P-L W INTERFACE	PRXOVR	DEF					NA	NA	NA	Y
L0560	LSO A-P-L W INTERFACE	MAXFEE	DEF					NA			Y
L0565	LSO A-P-L CONTROL CUSTOM	PRXOVR	DEF					NA	NA	NA	Y
L0565	LSO A-P-L CONTROL CUSTOM	MAXFEE	DEF					NA			Y
L0600	SACROILIAC FLEX SURG SUPPORT	PRXOVR	DEF					NA	NA	NA	Y
L0600	SACROILIAC FLEX SURG SUPPORT	MAXFEE	DEF					NA			Y
L0621	SIO FLEX PELVIC/SACR PRE OTS	PRXOVR	DEF					NA	NA	NA	S
L0621	SIO FLEX PELVIC/SACR PRE OTS	MAXFEE	DEF					55.09	1/1/2010	12/31/2299	S
L0625	LO FLEX L1-BELOW L5 PRE OTS	PRXOVR	DEF					NA	NA	NA	S
L0625	LO FLEX L1-BELOW L5 PRE OTS	MAXFEE	DEF					39.90	12/7/2010	12/31/2299	S
L0626	LO SAG RIG PNL STAYS PRE CST	PRXOVR	DEF					NA	NA	NA	S
L0626	LO SAG RIG PNL STAYS PRE CST	MAXFEE	DEF					56.46	12/7/2010	12/31/2299	S
L0627	LO SAG RI AN/POS PNL PRE CST	PRXOVR	DEF					NA	NA	NA	S
L0627	LO SAG RI AN/POS PNL PRE CST	MAXFEE	DEF					147.95	1/1/2006	12/31/2299	S
L0628	LSO FLEX NO RI STAYS PRE OTS	PRXOVR	DEF					NA	NA	NA	N
L0628	LSO FLEX NO RI STAYS PRE OTS	MAXFEE	DEF					60.76	12/7/2010	12/31/2299	N
L0629	LSO FLEX W/RIGID STAYS CUST	PRXOVR	DEF					NA	NA	NA	N
L0629	LSO FLEX W/RIGID STAYS CUST	MAXFEE	DEF					164.66	1/1/2010	12/31/2299	N
L0630	LSO R POST PNL SJ-T9 PRE CST	PRXOVR	DEF					NA	NA	NA	N
L0630	LSO R POST PNL SJ-T9 PRE CST	MAXFEE	DEF					135	7/1/2018	12/31/2299	N
L0631	LSO SAG R AN/POS PNL PRE CST	PRXOVR	DEF					NA	NA	NA	N
L0631	LSO SAG R AN/POS PNL PRE CST	MAXFEE	DEF					143.51	1/1/2010	12/31/2299	N
L0632	LSO SAG RIGID FRAME CUST	PRXOVR	DEF					NA	NA	NA	N
L0632	LSO SAG RIGID FRAME CUST	MAXFEE	DEF					143.51	1/1/2010	12/31/2299	N
L0633	LSO SC R POS/LAT PNL PRE CST	PRXOVR	DEF					NA	NA	NA	S
L0633	LSO SC R POS/LAT PNL PRE CST	MAXFEE	DEF					250	7/1/2018	12/31/2299	S
L0634	LSO FLEXION CONTROL CUSTOM	PRXOVR	DEF					NA	NA	NA	Y
L0634	LSO FLEXION CONTROL CUSTOM	MAXFEE	DEF					246.18	1/1/2010	12/31/2299	Y
L0635	LSO SAGIT RIGID PANEL PREFAB	PRXOVR	DEF					NA	NA	NA	S
L0635	LSO SAGIT RIGID PANEL PREFAB	MAXFEE	DEF					271.88	1/1/2010	12/31/2299	S
L0636	LSO SAGITTAL RIGID PANEL CUS	PRXOVR	DEF					NA	NA	NA	S
L0636	LSO SAGITTAL RIGID PANEL CUS	MAXFEE	DEF					271.88	1/1/2010	12/31/2299	S
L0637	LSO SC R ANT/POS PNL PRE CST	PRXOVR	DEF					NA	NA	NA	S
L0637	LSO SC R ANT/POS PNL PRE CST	MAXFEE	DEF					1040	1/1/2022	12/31/2299	S
L0639	LSO S/C SHELL/PANEL PREFAB	PRXOVR	DEF					NA	NA	NA	S
L0639	LSO S/C SHELL/PANEL PREFAB	MAXFEE	DEF					827.69	1/1/2010	12/31/2299	S
L0640	LSO S/C SHELL/PANEL CUSTOM	PRXOVR	DEF					NA	NA	NA	S
L0640	LSO S/C SHELL/PANEL CUSTOM	MAXFEE	DEF					757.98	12/7/2010	12/31/2299	S
L0641	LO RIG POS PNL L1-L5 PRE OTS	PRXOVR	DEF					NA	NA	NA	S
L0641	LO RIG POS PNL L1-L5 PRE OTS	MAXFEE	DEF					70	10/1/2021	12/31/2299	S
L0642	LO SAG RI AN/POS PNL PRE OTS	PRXOVR	DEF					NA	NA	NA	S
L0642	LO SAG RI AN/POS PNL PRE OTS	MAXFEE	DEF					360	10/1/2021	12/31/2299	S
L0643	LSO SAG CTR RIGI POS PRE OTS	PRXOVR	DEF					NA	NA	NA	S
L0643	LSO SAG CTR RIGI POS PRE OTS	MAXFEE	DEF					105	1/1/2022	12/31/2299	S
L0648	LSO SAG R AN/POS PNL PRE OTS	PRXOVR	DEF					NA	NA	NA	S
L0648	LSO SAG R AN/POS PNL PRE OTS	MAXFEE	DEF					880	10/1/2021	12/31/2299	S
L0649	LSO SC R POS/LAT PNL PRE OTS	PRXOVR	DEF					NA	NA	NA	S
L0649	LSO SC R POS/LAT PNL PRE OTS	MAXFEE	DEF					180	1/1/2022	12/31/2299	S
L0650	LSO SC R ANT/POS PNL PRE OTS	PRXOVR	DEF					NA	NA	NA	S
L0650	LSO SC R ANT/POS PNL PRE OTS	MAXFEE	DEF					990	10/1/2021	12/31/2299	S
L0651	LSO SAG-CO SHELL PNL PRE OTS	PRXOVR	DEF					NA	NA	NA	S
L0651	LSO SAG-CO SHELL PNL PRE OTS	MAXFEE	DEF					990	1/1/2022	12/31/2299	S
L0700	CTLSO A-P-L CONTROL MOLDED	PRXOVR	DEF					NA	NA	NA	S
L0700	CTLSO A-P-L CONTROL MOLDED	MAXFEE	DEF					1271.88	1/1/2010	12/31/2299	S
L0710	CTLSO A-P-L CONTROL W/ INTER	PRXOVR	DEF					NA	NA	NA	S
L0710	CTLSO A-P-L CONTROL W/ INTER	MAXFEE	DEF					1398.16	1/1/2010	12/31/2299	S
L0810	HALO CERVICAL INTO JCKT VEST	PRXOVR	DEF					NA	NA	NA	S
L0810	HALO CERVICAL INTO JCKT VEST	MAXFEE	DEF					1707.70	1/1/2010	12/31/2299	S
L0859	MRI COMPATIBLE SYSTEM	PRXOVR	DEF					NA	NA	NA	S
L0859	MRI COMPATIBLE SYSTEM	MAXFEE	DEF					750.27	1/1/2006	12/31/2299	S
L0860	MAGNETIC RESONANC IMAGE COMP	PRXOVR	DEF					NA	NA	NA	Y
L0860	MAGNETIC RESONANC IMAGE COMP	MAXFEE	DEF					NA			Y
L0970	TLSO CORSET FRONT	PRXOVR	DEF					NA	NA	NA	Y
L0970	TLSO CORSET FRONT	MAXFEE	DEF					68.28	1/1/2010	12/31/2299	Y
L0972	LSO CORSET FRONT	PRXOVR	DEF					NA	NA	NA	S
L0972	LSO CORSET FRONT	MAXFEE	DEF					62.14	1/1/2010	12/31/2299	S
L0974	TLSO FULL CORSET	PRXOVR	DEF					NA	NA	NA	Y
L0974	TLSO FULL CORSET	MAXFEE	DEF					111.65	1/1/2010	12/31/2299	Y
L0976	LSO FULL CORSET	PRXOVR	DEF					NA	NA	NA	S
L0976	LSO FULL CORSET	MAXFEE	DEF					95.52	1/1/2010	12/31/2299	S
L0978	AXILLARY CRUTCH EXTENSION	PRXOVR	DEF					NA	NA	NA	Y
L0978	AXILLARY CRUTCH EXTENSION	MAXFEE	DEF					120.22	1/1/2010	12/31/2299	Y
L0980	PERONEAL STRAPS PAIR PRE OTS	PRXOVR	DEF					NA	NA	NA	N
L0980	PERONEAL STRAPS PAIR PRE OTS	MAXFEE	DEF					10.93	1/1/2010	12/31/2299	N
L0982	STOCKING SUP GRIPS 4 PRE OTS	PRXOVR	DEF					NA	NA	NA	N
L0982	STOCKING SUP GRIPS 4 PRE OTS	MAXFEE	DEF					12.60	1/1/2022	12/31/2299	N
L0984	PROTECT BODY SOCK EA PRE OTS	PRXOVR	DEF					NA	NA	NA	S
L0984	PROTECT BODY SOCK EA PRE OTS	MAXFEE	DEF					43.25	1/1/2010	12/31/2299	S
L1000	CTLSO MILWAUKE INITIAL MODEL	PRXOVR	DEF					NA	NA	NA	S
L1000	CTLSO MILWAUKE INITIAL MODEL	MAXFEE	DEF					1295.56	1/1/2010	12/31/2299	S
L1010	CTLSO AXILLA SLING	PRXOVR	DEF					NA	NA	NA	S
L1010	CTLSO AXILLA SLING	MAXFEE	DEF					53.46	1/1/2010	12/31/2299	S
L1020	KYPHOSIS PAD	PRXOVR	DEF					NA	NA	NA	S
L1020	KYPHOSIS PAD	MAXFEE	DEF					68.85	1/1/2010	12/31/2299	S
L1025	KYPHOSIS PAD FLOATING	PRXOVR	DEF					NA	NA	NA	Y
L1025	KYPHOSIS PAD FLOATING	MAXFEE	DEF					99.32	1/1/2010	12/31/2299	Y
L1030	LUMBAR BOLSTER PAD	PRXOVR	DEF					NA	NA	NA	S
L1030	LUMBAR BOLSTER PAD	MAXFEE	DEF					50.01	1/1/2010	12/31/2299	S
L1040	LUMBAR OR LUMBAR RIB PAD	PRXOVR	DEF					NA	NA	NA	S
L1040	LUMBAR OR LUMBAR RIB PAD	MAXFEE	DEF					56.65	1/1/2010	12/31/2299	S
L1050	STERNAL PAD	PRXOVR	DEF					NA	NA	NA	S
L1050	STERNAL PAD	MAXFEE	DEF					64.10	1/1/2010	12/31/2299	S
L1060	THORACIC PAD	PRXOVR	DEF					NA	NA	NA	S
L1060	THORACIC PAD	MAXFEE	DEF					69.19	1/1/2010	12/31/2299	S
L1070	TRAPEZIUS SLING	PRXOVR	DEF					NA	NA	NA	Y
L1070	TRAPEZIUS SLING	MAXFEE	DEF					71.67	1/1/2010	12/31/2299	Y
L1080	OUTRIGGER	PRXOVR	DEF					NA	NA	NA	S
L1080	OUTRIGGER	MAXFEE	DEF					33.43	1/1/2010	12/31/2299	S
L1085	OUTRIGGER BIL W/ VERT EXTENS	PRXOVR	DEF					NA	NA	NA	Y
L1085	OUTRIGGER BIL W/ VERT EXTENS	MAXFEE	DEF					111.91	1/1/2010	12/31/2299	Y
L1090	LUMBAR SLING	PRXOVR	DEF					NA	NA	NA	Y
L1090	LUMBAR SLING	MAXFEE	DEF					64.30	1/1/2010	12/31/2299	Y
L1100	RING FLANGE PLASTIC/LEATHER	PRXOVR	DEF					NA	NA	NA	S
L1100	RING FLANGE PLASTIC/LEATHER	MAXFEE	DEF					125.08	1/1/2000	12/31/2299	S
L1110	RING FLANGE PLAS/LEATHER MOL	PRXOVR	DEF					NA	NA	NA	Y
L1110	RING FLANGE PLAS/LEATHER MOL	MAXFEE	DEF					203.43	1/1/2010	12/31/2299	Y
L1120	COVERS FOR UPRIGHT EACH	PRXOVR	DEF					NA	NA	NA	N
L1120	COVERS FOR UPRIGHT EACH	MAXFEE	DEF					24.29	1/1/2010	12/31/2299	N
L1200	FURNSH INITIAL ORTHOSIS ONLY	PRXOVR	DEF					NA	NA	NA	S
L1200	FURNSH INITIAL ORTHOSIS ONLY	MAXFEE	DEF					1143.33	1/1/2010	12/31/2299	S
L1210	LATERAL THORACIC EXTENSION	PRXOVR	DEF					NA	NA	NA	S
L1210	LATERAL THORACIC EXTENSION	MAXFEE	DEF					156.32	1/1/2010	12/31/2299	S
L1220	ANTERIOR THORACIC EXTENSION	PRXOVR	DEF					NA	NA	NA	S
L1220	ANTERIOR THORACIC EXTENSION	MAXFEE	DEF					152.14	1/1/2010	12/31/2299	S
L1230	MILWAUKEE TYPE SUPERSTRUCTUR	PRXOVR	DEF					NA	NA	NA	Y
L1230	MILWAUKEE TYPE SUPERSTRUCTUR	MAXFEE	DEF					426.24	1/1/2010	12/31/2299	Y
L1240	LUMBAR DEROTATION PAD	PRXOVR	DEF					NA	NA	NA	S
L1240	LUMBAR DEROTATION PAD	MAXFEE	DEF					58.10	1/1/2010	12/31/2299	S
L1250	ANTERIOR ASIS PAD	PRXOVR	DEF					NA	NA	NA	S
L1250	ANTERIOR ASIS PAD	MAXFEE	DEF					50.51	1/1/2010	12/31/2299	S
L1260	ANTERIOR THORACIC DEROTATION	PRXOVR	DEF					NA	NA	NA	S
L1260	ANTERIOR THORACIC DEROTATION	MAXFEE	DEF					60.27	1/1/2010	12/31/2299	S
L1270	ABDOMINAL PAD	PRXOVR	DEF					NA	NA	NA	S
L1270	ABDOMINAL PAD	MAXFEE	DEF					52.97	1/1/2010	12/31/2299	S
L1280	RIB GUSSET (ELASTIC) EACH	PRXOVR	DEF					NA	NA	NA	S
L1280	RIB GUSSET (ELASTIC) EACH	MAXFEE	DEF					55.80	1/1/2010	12/31/2299	S
L1290	LATERAL TROCHANTERIC PAD	PRXOVR	DEF					NA	NA	NA	S
L1290	LATERAL TROCHANTERIC PAD	MAXFEE	DEF					49.64	1/1/2010	12/31/2299	S
L1300	BODY JACKET MOLD TO PATIENT	PRXOVR	DEF					NA	NA	NA	S
L1300	BODY JACKET MOLD TO PATIENT	MAXFEE	DEF					1101.13	1/1/2010	12/31/2299	S
L1310	POST-OPERATIVE BODY JACKET	PRXOVR	DEF					NA	NA	NA	S
L1310	POST-OPERATIVE BODY JACKET	MAXFEE	DEF					1146.93	1/1/2010	12/31/2299	S
L1499	SPINAL ORTHOSIS NOS	PRXOVR	DEF					NA	NA	NA	Y
L1499	SPINAL ORTHOSIS NOS	PADOLR	DEF					NA	NA	NA	Y
L1500	THKAO MOBILITY FRAME	PRXOVR	DEF					NA	NA	NA	Y
L1500	THKAO MOBILITY FRAME	MAXFEE	DEF					NA			Y
L1510	THKAO STANDING FRAME	PRXOVR	DEF					NA	NA	NA	Y
L1510	THKAO STANDING FRAME	MAXFEE	DEF					NA			Y
L1520	THKAO SWIVEL WALKER	PRXOVR	DEF					NA	NA	NA	Y
L1520	THKAO SWIVEL WALKER	MAXFEE	DEF					NA			Y
L1600	HO FLEX FREJKA W/COV PRE CST	PRXOVR	DEF					NA	NA	NA	N
L1600	HO FLEX FREJKA W/COV PRE CST	MAXFEE	DEF					82.33	1/1/2010	12/31/2299	N
L1620	HO FLEX PAVLIK HARNS PRE CST	PRXOVR	DEF					NA	NA	NA	N
L1620	HO FLEX PAVLIK HARNS PRE CST	MAXFEE	DEF					100.40	1/1/2010	12/31/2299	N
L1630	ABDUCT CONTROL HIP SEMI-FLEX	PRXOVR	DEF					NA	NA	NA	Y
L1630	ABDUCT CONTROL HIP SEMI-FLEX	MAXFEE	DEF					134.98	1/1/2010	12/31/2299	Y
L1640	PELV BAND/SPREAD BAR THIGH C	PRXOVR	DEF					NA	NA	NA	N
L1640	PELV BAND/SPREAD BAR THIGH C	MAXFEE	DEF					302.44	1/1/2010	12/31/2299	N
L1650	HO ABDUCTION HIP ADJUSTABLE	PRXOVR	DEF					NA	NA	NA	N
L1650	HO ABDUCTION HIP ADJUSTABLE	MAXFEE	DEF					157.56	1/1/2010	12/31/2299	N
L1660	HO ABDUCTION STATIC PLASTIC	PRXOVR	DEF					NA	NA	NA	N
L1660	HO ABDUCTION STATIC PLASTIC	MAXFEE	DEF					115.46	1/1/2010	12/31/2299	N
L1680	PELVIC & HIP CONTROL THIGH C	PRXOVR	DEF					NA	NA	NA	S
L1680	PELVIC & HIP CONTROL THIGH C	MAXFEE	DEF					727.88	1/1/2010	12/31/2299	S
L1681	HO BILATERAL HIP ABDUCTION	PRXOVR	DEF					NA	NA	NA	S
L1681	HO BILATERAL HIP ABDUCTION	MAXFEE	DEF					1800	10/1/2023	12/31/2299	S
L1685	POST-OP HIP ABDUCT CUSTOM FA	PRXOVR	DEF					NA	NA	NA	S
L1685	POST-OP HIP ABDUCT CUSTOM FA	MAXFEE	DEF					710.59	1/1/2010	12/31/2299	S
L1686	HO POST-OP HIP ABDUCTION	PRXOVR	DEF					NA	NA	NA	S
L1686	HO POST-OP HIP ABDUCTION	MAXFEE	DEF					598.67	1/1/2010	12/31/2299	S
L1690	COMBINATION BILATERAL HO	PRXOVR	DEF					NA	NA	NA	S
L1690	COMBINATION BILATERAL HO	MAXFEE	DEF					1438.91	1/1/2010	12/31/2299	S
L1720	LEGG PERTHES ORTHOSIS TRILAT	PRXOVR	DEF					NA	NA	NA	Y
L1720	LEGG PERTHES ORTHOSIS TRILAT	MAXFEE	DEF					942.49	1/1/2010	12/31/2299	Y
L1730	LEGG PERTHES ORTH SCOTTISH R	PRXOVR	DEF					NA	NA	NA	S
L1730	LEGG PERTHES ORTH SCOTTISH R	MAXFEE	DEF					795.67	1/1/2010	12/31/2299	S
L1750	LEGG PERTHES SLING	PRXOVR	DEF					NA	NA	NA	Y
L1750	LEGG PERTHES SLING	MAXFEE	DEF					NA			Y
L1755	LEGG PERTHES PATTEN BOTTOM T	PRXOVR	DEF					NA	NA	NA	Y
L1755	LEGG PERTHES PATTEN BOTTOM T	MAXFEE	DEF					1143.95	1/1/2010	12/31/2299	Y
L1800	KNEE ORTHOSES ELAS W STAYS	PRXOVR	DEF					NA	NA	NA	S
L1800	KNEE ORTHOSES ELAS W STAYS	MAXFEE	DEF					0	12/7/2010	12/31/2299	S
L1810	KO ELASTIC WITH JOINTS	PRXOVR	DEF					NA	NA	NA	N
L1810	KO ELASTIC WITH JOINTS	MAXFEE	DEF					65.77	1/1/2010	12/31/2299	N
L1812	KO ELASTIC W/JOINTS PRE OTS	PRXOVR	DEF					NA	NA	NA	N
L1812	KO ELASTIC W/JOINTS PRE OTS	MAXFEE	DEF					55	10/1/2021	12/31/2299	N
L1815	ELASTIC WITH CONDYLAR PADS	PRXOVR	DEF					NA	NA	NA	S
L1815	ELASTIC WITH CONDYLAR PADS	MAXFEE	DEF					0	12/7/2010	12/31/2299	S
L1820	KO ELAS W/ CONDYLE PADS & JO	PRXOVR	DEF					NA	NA	NA	N
L1820	KO ELAS W/ CONDYLE PADS & JO	MAXFEE	DEF					90.80	1/1/2010	12/31/2299	N
L1825	KO ELASTIC KNEE CAP	PRXOVR	DEF					NA	NA	NA	N
L1825	KO ELASTIC KNEE CAP	MAXFEE	DEF					0	12/7/2010	12/31/2299	N
L1830	KO IMMOB CANVAS LONG PRE OTS	PRXOVR	DEF					NA	NA	NA	N
L1830	KO IMMOB CANVAS LONG PRE OTS	MAXFEE	DEF					53.13	1/1/2010	12/31/2299	N
L1832	KO ADJ JNT POS R SUP PRE CST	PRXOVR	DEF					NA	NA	NA	S
L1832	KO ADJ JNT POS R SUP PRE CST	MAXFEE	DEF					473.52	1/1/2010	12/31/2299	S
L1833	KO ADJ JNT POS R SUP PRE OTS	PRXOVR	DEF					NA	NA	NA	S
L1833	KO ADJ JNT POS R SUP PRE OTS	MAXFEE	DEF					445	10/1/2021	12/31/2299	S
L1834	KO W/0 JOINT RIGID MOLDED TO	PRXOVR	DEF					NA	NA	NA	S
L1834	KO W/0 JOINT RIGID MOLDED TO	MAXFEE	DEF					463.73	1/1/2010	12/31/2299	S
L1836	KO RIGID W/O JOINTS PRE OTS	PRXOVR	DEF					NA	NA	NA	N
L1836	KO RIGID W/O JOINTS PRE OTS	MAXFEE	DEF					90	1/1/2022	12/31/2299	N
L1840	KO DEROT ANT CRUCIATE CUSTOM	PRXOVR	DEF					NA	NA	NA	Y
L1840	KO DEROT ANT CRUCIATE CUSTOM	MAXFEE	DEF					600.83	1/1/2010	12/31/2299	Y
L1843	KO SINGLE UPRIGHT PRE CST	PRXOVR	DEF					NA	NA	NA	S
L1843	KO SINGLE UPRIGHT PRE CST	MAXFEE	DEF					345	1/1/2010	12/31/2299	S
L1844	KO W/ADJ JT ROT CNTRL MOLDED	PRXOVR	DEF					NA	NA	NA	S
L1844	KO W/ADJ JT ROT CNTRL MOLDED	MAXFEE	DEF					972.95	1/1/2010	12/31/2299	S
L1845	KO DOUBLE UPRIGHT PRE CST	PRXOVR	DEF					NA	NA	NA	S
L1845	KO DOUBLE UPRIGHT PRE CST	MAXFEE	DEF					535.18	1/1/2010	12/31/2299	S
L1846	KO W ADJ FLEX/EXT ROTAT MOLD	PRXOVR	DEF					NA	NA	NA	S
L1846	KO W ADJ FLEX/EXT ROTAT MOLD	MAXFEE	DEF					716.46	1/1/2010	12/31/2299	S
L1847	KO DBL UPRIGHT W/AIR PRE CST	PRXOVR	DEF					NA	NA	NA	S
L1847	KO DBL UPRIGHT W/AIR PRE CST	MAXFEE	DEF					427.98	1/1/2010	12/31/2299	S
L1848	KO DBL UPRIGHT W/AIR PRE OTS	PRXOVR	DEF					NA	NA	NA	N
L1848	KO DBL UPRIGHT W/AIR PRE OTS	MAXFEE	DEF					415	1/1/2022	12/31/2299	N
L1850	KO SWEDISH TYPE PRE OTS	PRXOVR	DEF					NA	NA	NA	S
L1850	KO SWEDISH TYPE PRE OTS	MAXFEE	DEF					182.02	1/1/2010	12/31/2299	S
L1851	KO SINGLE UPRIGHT PREFAB OTS	PRXOVR	DEF					NA	NA	NA	S
L1851	KO SINGLE UPRIGHT PREFAB OTS	MAXFEE	DEF					689.10	1/1/2017	12/31/2299	S
L1852	KO DOUBLE UPRIGHT PREFAB OTS	PRXOVR	DEF					NA	NA	NA	S
L1852	KO DOUBLE UPRIGHT PREFAB OTS	MAXFEE	DEF					643.33	1/1/2017	12/31/2299	S
L1855	KO PLAS DOUB UPRIGHT JNT MOL	PRXOVR	DEF					NA	NA	NA	Y
L1855	KO PLAS DOUB UPRIGHT JNT MOL	MAXFEE	DEF					0	1/1/2008	12/31/2299	Y
L1858	KO POLYCENTRIC PNEUMATIC PAD	PRXOVR	DEF					NA	NA	NA	Y
L1858	KO POLYCENTRIC PNEUMATIC PAD	MAXFEE	DEF					0	1/1/2008	12/31/2299	Y
L1860	KO SUPRACONDYLAR SOCKET MOLD	PRXOVR	DEF					NA	NA	NA	Y
L1860	KO SUPRACONDYLAR SOCKET MOLD	MAXFEE	DEF					796.69	1/1/2010	12/31/2299	Y
L1870	KO DOUB UPRIGHT LACERS MOLDE	PRXOVR	DEF					NA	NA	NA	Y
L1870	KO DOUB UPRIGHT LACERS MOLDE	MAXFEE	DEF					0	1/1/2008	12/31/2299	Y
L1880	KO DOUB UPRIGHT CUFFS/LACERS	PRXOVR	DEF					NA	NA	NA	Y
L1880	KO DOUB UPRIGHT CUFFS/LACERS	MAXFEE	DEF					0	1/1/2008	12/31/2299	Y
L1885	KNEE UPRIGHT W/RESISTANCE	PRXOVR	DEF					NA	NA	NA	Y
L1885	KNEE UPRIGHT W/RESISTANCE	MAXFEE	DEF					0	4/1/2005	12/31/2299	Y
L1900	AFO SPRNG WIR DRSFLX CALF BD	PRXOVR	DEF					NA	NA	NA	S
L1900	AFO SPRNG WIR DRSFLX CALF BD	MAXFEE	DEF					182.28	1/1/2010	12/31/2299	S
L1901	PREFAB ANKLE ORTHOSIS	PRXOVR	DEF					NA	NA	NA	S
L1901	PREFAB ANKLE ORTHOSIS	MAXFEE	DEF					0	12/7/2010	12/31/2299	S
L1902	AFO ANKLE GAUNTLET PRE OTS	PRXOVR	DEF					NA	NA	NA	N
L1902	AFO ANKLE GAUNTLET PRE OTS	MAXFEE	DEF					47.69	1/1/2010	12/31/2299	N
L1906	AFO MULTILIG ANK SUP PRE OTS	PRXOVR	DEF					NA	NA	NA	N
L1906	AFO MULTILIG ANK SUP PRE OTS	MAXFEE	DEF					71.85	1/1/2010	12/31/2299	N
L1907	AFO SUPRAMALLEOLAR CUSTOM	PRXOVR	DEF					NA	NA	NA	S
L1907	AFO SUPRAMALLEOLAR CUSTOM	MAXFEE	DEF					364.11	4/1/2009	12/31/2299	S
L1920	AFO SING UPRIGHT W/ ADJUST S	PRXOVR	DEF					NA	NA	NA	S
L1920	AFO SING UPRIGHT W/ ADJUST S	MAXFEE	DEF					262.46	1/1/2010	12/31/2299	S
L1930	AFO PLASTIC	PRXOVR	DEF					NA	NA	NA	S
L1930	AFO PLASTIC	MAXFEE	DEF					197.76	1/1/2010	12/31/2299	S
L1932	AFO RIG ANT TIB PREFAB TCF/=	PRXOVR	DEF					NA	NA	NA	N
L1932	AFO RIG ANT TIB PREFAB TCF/=	MAXFEE	DEF					570	7/1/2018	12/31/2299	N
L1940	AFO MOLDED TO PATIENT PLASTI	PRXOVR	DEF					NA	NA	NA	S
L1940	AFO MOLDED TO PATIENT PLASTI	MAXFEE	DEF					311.11	1/1/2010	12/31/2299	S
L1945	AFO MOLDED PLAS RIG ANT TIB	PRXOVR	DEF					NA	NA	NA	S
L1945	AFO MOLDED PLAS RIG ANT TIB	MAXFEE	DEF					717.14	1/1/2010	12/31/2299	S
L1951	AFO SPIRAL PREFABRICATED	PRXOVR	DEF					NA	NA	NA	N
L1951	AFO SPIRAL PREFABRICATED	MAXFEE	DEF					430	7/1/2018	12/31/2299	N
L1960	AFO POS SOLID ANK PLASTIC MO	PRXOVR	DEF					NA	NA	NA	S
L1960	AFO POS SOLID ANK PLASTIC MO	MAXFEE	DEF					396.02	1/1/2010	12/31/2299	S
L1970	AFO PLASTIC MOLDED W/ANKLE J	PRXOVR	DEF					NA	NA	NA	S
L1970	AFO PLASTIC MOLDED W/ANKLE J	MAXFEE	DEF					442.20	1/1/2010	12/31/2299	S
L1971	AFO W/ANKLE JOINT; PREFAB	PRXOVR	DEF					NA	NA	NA	N
L1971	AFO W/ANKLE JOINT; PREFAB	MAXFEE	DEF					360	7/1/2018	12/31/2299	N
L1980	AFO SING SOLID STIRRUP CALF	PRXOVR	DEF					NA	NA	NA	S
L1980	AFO SING SOLID STIRRUP CALF	MAXFEE	DEF					257.98	1/1/2010	12/31/2299	S
L1990	AFO DOUB SOLID STIRRUP CALF	PRXOVR	DEF					NA	NA	NA	S
L1990	AFO DOUB SOLID STIRRUP CALF	MAXFEE	DEF					298.57	1/1/2010	12/31/2299	S
L2000	KAFO SING FRE STIRR THI/CALF	PRXOVR	DEF					NA	NA	NA	S
L2000	KAFO SING FRE STIRR THI/CALF	MAXFEE	DEF					714.72	1/1/2010	12/31/2299	S
L2010	KAFO SNG SOLID STIRRUP W/O J	PRXOVR	DEF					NA	NA	NA	S
L2010	KAFO SNG SOLID STIRRUP W/O J	MAXFEE	DEF					557.47	1/1/2010	12/31/2299	S
L2020	KAFO DBL SOLID STIRRUP BAND/	PRXOVR	DEF					NA	NA	NA	S
L2020	KAFO DBL SOLID STIRRUP BAND/	MAXFEE	DEF					704.06	1/1/2010	12/31/2299	S
L2030	KAFO DBL SOLID STIRRUP W/O J	PRXOVR	DEF					NA	NA	NA	S
L2030	KAFO DBL SOLID STIRRUP W/O J	MAXFEE	DEF					692.05	1/1/2010	12/31/2299	S
L2034	KAFO PLA SIN UP W/WO K/A CUS	PRXOVR	DEF					NA	NA	NA	S
L2034	KAFO PLA SIN UP W/WO K/A CUS	MAXFEE	DEF					1419.88	1/1/2010	12/31/2299	S
L2035	KAFO PLASTIC PEDIATRIC SIZE	PRXOVR	DEF					NA	NA	NA	S
L2035	KAFO PLASTIC PEDIATRIC SIZE	MAXFEE	DEF					110.68	1/1/2010	12/31/2299	S
L2036	KAFO PLAS DOUB FREE KNEE MOL	PRXOVR	DEF					NA	NA	NA	S
L2036	KAFO PLAS DOUB FREE KNEE MOL	MAXFEE	DEF					1184.49	1/1/2010	12/31/2299	S
L2037	KAFO PLAS SING FREE KNEE MOL	PRXOVR	DEF					NA	NA	NA	S
L2037	KAFO PLAS SING FREE KNEE MOL	MAXFEE	DEF					1059.50	1/1/2010	12/31/2299	S
L2038	KAFO W/O JOINT MULTI-AXIS AN	PRXOVR	DEF					NA	NA	NA	S
L2038	KAFO W/O JOINT MULTI-AXIS AN	MAXFEE	DEF					854.11	1/1/2010	12/31/2299	S
L2039	KAFO;PLSTIC;MEDLAT ROTAT CON	PRXOVR	DEF					NA	NA	NA	Y
L2039	KAFO;PLSTIC;MEDLAT ROTAT CON	MAXFEE	DEF					NA			Y
L2040	HKAFO TORSION BIL ROT STRAPS	PRXOVR	DEF					NA	NA	NA	S
L2040	HKAFO TORSION BIL ROT STRAPS	MAXFEE	DEF					129.25	1/1/2010	12/31/2299	S
L2050	HKAFO TORSION CABLE HIP PELV	PRXOVR	DEF					NA	NA	NA	S
L2050	HKAFO TORSION CABLE HIP PELV	MAXFEE	DEF					311.34	1/1/2010	12/31/2299	S
L2060	HKAFO TORSION BALL BEARING J	PRXOVR	DEF					NA	NA	NA	S
L2060	HKAFO TORSION BALL BEARING J	MAXFEE	DEF					389.41	1/1/2010	12/31/2299	S
L2106	AFO TIB FX CAST PLASTER MOLD	PRXOVR	DEF					NA	NA	NA	S
L2106	AFO TIB FX CAST PLASTER MOLD	MAXFEE	DEF					503.59	1/1/2010	12/31/2299	S
L2108	AFO TIB FX CAST MOLDED TO PT	PRXOVR	DEF					NA	NA	NA	S
L2108	AFO TIB FX CAST MOLDED TO PT	MAXFEE	DEF					734.51	1/1/2010	12/31/2299	S
L2112	AFO TIBIAL FRACTURE SOFT	PRXOVR	DEF					NA	NA	NA	S
L2112	AFO TIBIAL FRACTURE SOFT	MAXFEE	DEF					322.32	1/1/2010	12/31/2299	S
L2114	AFO TIB FX SEMI-RIGID	PRXOVR	DEF					NA	NA	NA	S
L2114	AFO TIB FX SEMI-RIGID	MAXFEE	DEF					403.71	1/1/2010	12/31/2299	S
L2116	AFO TIBIAL FRACTURE RIGID	PRXOVR	DEF					NA	NA	NA	S
L2116	AFO TIBIAL FRACTURE RIGID	MAXFEE	DEF					492.44	1/1/2010	12/31/2299	S
L2122	KAFO FEM FX CAST PLASTER MOL	PRXOVR	DEF					NA	NA	NA	Y
L2122	KAFO FEM FX CAST PLASTER MOL	MAXFEE	DEF					0	4/1/2005	12/31/2299	Y
L2124	KAFO FEM FX CAST SYNTHET MOL	PRXOVR	DEF					NA	NA	NA	Y
L2124	KAFO FEM FX CAST SYNTHET MOL	MAXFEE	DEF					0	4/1/2005	12/31/2299	Y
L2126	KAFO FEM FX CAST THERMOPLAS	PRXOVR	DEF					NA	NA	NA	Y
L2126	KAFO FEM FX CAST THERMOPLAS	MAXFEE	DEF					815.82	1/1/2010	12/31/2299	Y
L2128	KAFO FEM FX CAST MOLDED TO P	PRXOVR	DEF					NA	NA	NA	S
L2128	KAFO FEM FX CAST MOLDED TO P	MAXFEE	DEF					1024.38	1/1/2010	12/31/2299	S
L2132	KAFO FEMORAL FX CAST SOFT	PRXOVR	DEF					NA	NA	NA	Y
L2132	KAFO FEMORAL FX CAST SOFT	MAXFEE	DEF					621.78	1/1/2010	12/31/2299	Y
L2134	KAFO FEM FX CAST SEMI-RIGID	PRXOVR	DEF					NA	NA	NA	Y
L2134	KAFO FEM FX CAST SEMI-RIGID	MAXFEE	DEF					736.26	1/1/2010	12/31/2299	Y
L2136	KAFO FEMORAL FX CAST RIGID	PRXOVR	DEF					NA	NA	NA	Y
L2136	KAFO FEMORAL FX CAST RIGID	MAXFEE	DEF					805.72	1/1/2010	12/31/2299	Y
L2180	PLAS SHOE INSERT W ANK JOINT	PRXOVR	DEF					NA	NA	NA	N
L2180	PLAS SHOE INSERT W ANK JOINT	MAXFEE	DEF					84.69	1/1/2010	12/31/2299	N
L2182	DROP LOCK KNEE	PRXOVR	DEF					NA	NA	NA	N
L2182	DROP LOCK KNEE	MAXFEE	DEF					73	1/1/2010	12/31/2299	N
L2184	LIMITED MOTION KNEE JOINT	PRXOVR	DEF					NA	NA	NA	Y
L2184	LIMITED MOTION KNEE JOINT	MAXFEE	DEF					74	1/1/2010	12/31/2299	Y
L2186	ADJ MOTION KNEE JNT LERMAN T	PRXOVR	DEF					NA	NA	NA	N
L2186	ADJ MOTION KNEE JNT LERMAN T	MAXFEE	DEF					98.43	1/1/2010	12/31/2299	N
L2188	QUADRILATERAL BRIM	PRXOVR	DEF					NA	NA	NA	Y
L2188	QUADRILATERAL BRIM	MAXFEE	DEF					178.92	1/1/2010	12/31/2299	Y
L2190	WAIST BELT	PRXOVR	DEF					NA	NA	NA	S
L2190	WAIST BELT	MAXFEE	DEF					54.50	1/1/2010	12/31/2299	S
L2192	PELVIC BAND & BELT THIGH FLA	PRXOVR	DEF					NA	NA	NA	S
L2192	PELVIC BAND & BELT THIGH FLA	MAXFEE	DEF					213.01	1/1/2010	12/31/2299	S
L2200	LIMITED ANKLE MOTION EA JNT	PRXOVR	DEF					NA	NA	NA	N
L2200	LIMITED ANKLE MOTION EA JNT	MAXFEE	DEF					32.22	1/1/2010	12/31/2299	N
L2210	DORSIFLEXION ASSIST EACH JOI	PRXOVR	DEF					NA	NA	NA	N
L2210	DORSIFLEXION ASSIST EACH JOI	MAXFEE	DEF					40.16	1/1/2010	12/31/2299	N
L2220	DORSI & PLANTAR FLEX ASS/RES	PRXOVR	DEF					NA	NA	NA	N
L2220	DORSI & PLANTAR FLEX ASS/RES	MAXFEE	DEF					51.69	1/1/2010	12/31/2299	N
L2230	SPLIT FLAT CALIPER STIRR & P	PRXOVR	DEF					NA	NA	NA	N
L2230	SPLIT FLAT CALIPER STIRR & P	MAXFEE	DEF					61.12	1/1/2010	12/31/2299	N
L2240	ROUND CALIPER AND PLATE ATTA	PRXOVR	DEF					NA	NA	NA	N
L2240	ROUND CALIPER AND PLATE ATTA	MAXFEE	DEF					60.81	1/1/2010	12/31/2299	N
L2250	FOOT PLATE MOLDED STIRRUP AT	PRXOVR	DEF					NA	NA	NA	S
L2250	FOOT PLATE MOLDED STIRRUP AT	MAXFEE	DEF					213.41	1/1/2010	12/31/2299	S
L2260	REINFORCED SOLID STIRRUP	PRXOVR	DEF					NA	NA	NA	S
L2260	REINFORCED SOLID STIRRUP	MAXFEE	DEF					119.75	1/1/2010	12/31/2299	S
L2265	LONG TONGUE STIRRUP	PRXOVR	DEF					NA	NA	NA	N
L2265	LONG TONGUE STIRRUP	MAXFEE	DEF					85.86	1/1/2010	12/31/2299	N
L2270	VARUS/VALGUS STRAP PADDED/LI	PRXOVR	DEF					NA	NA	NA	N
L2270	VARUS/VALGUS STRAP PADDED/LI	MAXFEE	DEF					39.38	1/1/2010	12/31/2299	N
L2275	PLASTIC MOD LOW EXT PAD/LINE	PRXOVR	DEF					NA	NA	NA	N
L2275	PLASTIC MOD LOW EXT PAD/LINE	MAXFEE	DEF					83.28	1/1/2010	12/31/2299	N
L2280	MOLDED INNER BOOT	PRXOVR	DEF					NA	NA	NA	S
L2280	MOLDED INNER BOOT	MAXFEE	DEF					360.68	1/1/2010	12/31/2299	S
L2300	ABDUCTION BAR JOINTED ADJUST	PRXOVR	DEF					NA	NA	NA	S
L2300	ABDUCTION BAR JOINTED ADJUST	MAXFEE	DEF					160.85	1/1/2010	12/31/2299	S
L2310	ABDUCTION BAR-STRAIGHT	PRXOVR	DEF					NA	NA	NA	N
L2310	ABDUCTION BAR-STRAIGHT	MAXFEE	DEF					73.50	1/1/2010	12/31/2299	N
L2320	NON-MOLDED LACER	PRXOVR	DEF					NA	NA	NA	S
L2320	NON-MOLDED LACER	MAXFEE	DEF					123.23	1/1/2010	12/31/2299	S
L2330	LACER MOLDED TO PATIENT MODE	PRXOVR	DEF					NA	NA	NA	S
L2330	LACER MOLDED TO PATIENT MODE	MAXFEE	DEF					234.57	1/1/2010	12/31/2299	S
L2335	ANTERIOR SWING BAND	PRXOVR	DEF					NA	NA	NA	Y
L2335	ANTERIOR SWING BAND	MAXFEE	DEF					179.60	1/1/2010	12/31/2299	Y
L2340	PRE-TIBIAL SHELL MOLDED TO P	PRXOVR	DEF					NA	NA	NA	S
L2340	PRE-TIBIAL SHELL MOLDED TO P	MAXFEE	DEF					267	1/1/2010	12/31/2299	S
L2350	PROSTHETIC TYPE SOCKET MOLDE	PRXOVR	DEF					NA	NA	NA	S
L2350	PROSTHETIC TYPE SOCKET MOLDE	MAXFEE	DEF					532.31	1/1/2010	12/31/2299	S
L2360	EXTENDED STEEL SHANK	PRXOVR	DEF					NA	NA	NA	N
L2360	EXTENDED STEEL SHANK	MAXFEE	DEF					32.96	1/1/2010	12/31/2299	N
L2370	PATTEN BOTTOM	PRXOVR	DEF					NA	NA	NA	S
L2370	PATTEN BOTTOM	MAXFEE	DEF					204.48	1/1/2010	12/31/2299	S
L2375	TORSION ANK & HALF SOLID STI	PRXOVR	DEF					NA	NA	NA	Y
L2375	TORSION ANK & HALF SOLID STI	MAXFEE	DEF					78.60	1/1/2010	12/31/2299	Y
L2380	TORSION STRAIGHT KNEE JOINT	PRXOVR	DEF					NA	NA	NA	N
L2380	TORSION STRAIGHT KNEE JOINT	MAXFEE	DEF					82.45	1/1/2010	12/31/2299	N
L2385	STRAIGHT KNEE JOINT HEAVY DU	PRXOVR	DEF					NA	NA	NA	N
L2385	STRAIGHT KNEE JOINT HEAVY DU	MAXFEE	DEF					93.88	1/1/2010	12/31/2299	N
L2390	OFFSET KNEE JOINT EACH	PRXOVR	DEF					NA	NA	NA	N
L2390	OFFSET KNEE JOINT EACH	MAXFEE	DEF					65.39	1/1/2010	12/31/2299	N
L2395	OFFSET KNEE JOINT HEAVY DUTY	PRXOVR	DEF					NA	NA	NA	N
L2395	OFFSET KNEE JOINT HEAVY DUTY	MAXFEE	DEF					93.47	1/1/2010	12/31/2299	N
L2397	SUSPENSION SLEEVE LOWER EXT	PRXOVR	DEF					NA	NA	NA	N
L2397	SUSPENSION SLEEVE LOWER EXT	MAXFEE	DEF					77.99	1/1/2010	12/31/2299	N
L2405	KNEE JOINT DROP LOCK EA JNT	PRXOVR	DEF					NA	NA	NA	N
L2405	KNEE JOINT DROP LOCK EA JNT	MAXFEE	DEF					40.54	1/1/2010	12/31/2299	N
L2415	KNEE JOINT CAM LOCK EACH JOI	PRXOVR	DEF					NA	NA	NA	N
L2415	KNEE JOINT CAM LOCK EACH JOI	MAXFEE	DEF					93.85	1/1/2010	12/31/2299	N
L2425	KNEE DISC/DIAL LOCK/ADJ FLEX	PRXOVR	DEF					NA	NA	NA	S
L2425	KNEE DISC/DIAL LOCK/ADJ FLEX	MAXFEE	DEF					110.73	1/1/2010	12/31/2299	S
L2430	KNEE JNT RATCHET LOCK EA JNT	PRXOVR	DEF					NA	NA	NA	N
L2430	KNEE JNT RATCHET LOCK EA JNT	MAXFEE	DEF					62.82	1/1/2010	12/31/2299	N
L2435	KNEE JOINT POLYCENTRIC JOINT	PRXOVR	DEF					NA	NA	NA	Y
L2435	KNEE JOINT POLYCENTRIC JOINT	MAXFEE	DEF					NA			Y
L2492	KNEE LIFT LOOP DROP LOCK RIN	PRXOVR	DEF					NA	NA	NA	N
L2492	KNEE LIFT LOOP DROP LOCK RIN	MAXFEE	DEF					74.93	1/1/2010	12/31/2299	N
L2500	THI/GLUT/ISCHIA WGT BEARING	PRXOVR	DEF					NA	NA	NA	N
L2500	THI/GLUT/ISCHIA WGT BEARING	MAXFEE	DEF					199.94	1/1/2010	12/31/2299	N
L2510	TH/WGHT BEAR QUAD-LAT BRIM M	PRXOVR	DEF					NA	NA	NA	N
L2510	TH/WGHT BEAR QUAD-LAT BRIM M	MAXFEE	DEF					515.28	1/1/2010	12/31/2299	N
L2520	TH/WGHT BEAR QUAD-LAT BRIM C	PRXOVR	DEF					NA	NA	NA	N
L2520	TH/WGHT BEAR QUAD-LAT BRIM C	MAXFEE	DEF					343.40	1/1/2010	12/31/2299	N
L2525	TH/WGHT BEAR NAR M-L BRIM MO	PRXOVR	DEF					NA	NA	NA	N
L2525	TH/WGHT BEAR NAR M-L BRIM MO	MAXFEE	DEF					728.22	1/1/2010	12/31/2299	N
L2526	TH/WGHT BEAR NAR M-L BRIM CU	PRXOVR	DEF					NA	NA	NA	N
L2526	TH/WGHT BEAR NAR M-L BRIM CU	MAXFEE	DEF					409.18	1/1/2010	12/31/2299	N
L2530	THIGH/WGHT BEAR LACER NON-MO	PRXOVR	DEF					NA	NA	NA	N
L2530	THIGH/WGHT BEAR LACER NON-MO	MAXFEE	DEF					153.22	1/1/2010	12/31/2299	N
L2540	THIGH/WGHT BEAR LACER MOLDED	PRXOVR	DEF					NA	NA	NA	N
L2540	THIGH/WGHT BEAR LACER MOLDED	MAXFEE	DEF					289.92	1/1/2010	12/31/2299	N
L2550	THIGH/WGHT BEAR HIGH ROLL CU	PRXOVR	DEF					NA	NA	NA	N
L2550	THIGH/WGHT BEAR HIGH ROLL CU	MAXFEE	DEF					217.39	1/1/2010	12/31/2299	N
L2570	HIP CLEVIS TYPE 2 POSIT JNT	PRXOVR	DEF					NA	NA	NA	N
L2570	HIP CLEVIS TYPE 2 POSIT JNT	MAXFEE	DEF					284.54	1/1/2010	12/31/2299	N
L2580	PELVIC CONTROL PELVIC SLING	PRXOVR	DEF					NA	NA	NA	N
L2580	PELVIC CONTROL PELVIC SLING	MAXFEE	DEF					277.26	1/1/2010	12/31/2299	N
L2600	HIP CLEVIS/THRUST BEARING FR	PRXOVR	DEF					NA	NA	NA	N
L2600	HIP CLEVIS/THRUST BEARING FR	MAXFEE	DEF					136.26	1/1/2010	12/31/2299	N
L2610	HIP CLEVIS/THRUST BEARING LO	PRXOVR	DEF					NA	NA	NA	N
L2610	HIP CLEVIS/THRUST BEARING LO	MAXFEE	DEF					150.57	1/1/2010	12/31/2299	N
L2620	PELVIC CONTROL HIP HEAVY DUT	PRXOVR	DEF					NA	NA	NA	N
L2620	PELVIC CONTROL HIP HEAVY DUT	MAXFEE	DEF					159.73	1/1/2010	12/31/2299	N
L2622	HIP JOINT ADJUSTABLE FLEXION	PRXOVR	DEF					NA	NA	NA	N
L2622	HIP JOINT ADJUSTABLE FLEXION	MAXFEE	DEF					203.30	1/1/2010	12/31/2299	N
L2624	HIP ADJ FLEX EXT ABDUCT CONT	PRXOVR	DEF					NA	NA	NA	N
L2624	HIP ADJ FLEX EXT ABDUCT CONT	MAXFEE	DEF					249.28	1/1/2010	12/31/2299	N
L2627	PLASTIC MOLD RECIPRO HIP & C	PRXOVR	DEF					NA	NA	NA	S
L2627	PLASTIC MOLD RECIPRO HIP & C	MAXFEE	DEF					1365.48	1/1/2010	12/31/2299	S
L2628	METAL FRAME RECIPRO HIP & CA	PRXOVR	DEF					NA	NA	NA	S
L2628	METAL FRAME RECIPRO HIP & CA	MAXFEE	DEF					1000.88	1/1/2010	12/31/2299	S
L2630	PELVIC CONTROL BAND & BELT U	PRXOVR	DEF					NA	NA	NA	N
L2630	PELVIC CONTROL BAND & BELT U	MAXFEE	DEF					147.93	1/1/2010	12/31/2299	N
L2640	PELVIC CONTROL BAND & BELT B	PRXOVR	DEF					NA	NA	NA	N
L2640	PELVIC CONTROL BAND & BELT B	MAXFEE	DEF					200.76	1/1/2010	12/31/2299	N
L2650	PELV & THOR CONTROL GLUTEAL	PRXOVR	DEF					NA	NA	NA	N
L2650	PELV & THOR CONTROL GLUTEAL	MAXFEE	DEF					88.42	1/1/2010	12/31/2299	N
L2660	THORACIC CONTROL THORACIC BA	PRXOVR	DEF					NA	NA	NA	N
L2660	THORACIC CONTROL THORACIC BA	MAXFEE	DEF					114.48	1/1/2010	12/31/2299	N
L2680	THORAC CONT LAT SUPPORT UPRI	PRXOVR	DEF					NA	NA	NA	N
L2680	THORAC CONT LAT SUPPORT UPRI	MAXFEE	DEF					93.48	1/1/2010	12/31/2299	N
L2755	CARBON GRAPHITE LAMINATION	PRXOVR	DEF					NA	NA	NA	N
L2755	CARBON GRAPHITE LAMINATION	MAXFEE	DEF					83.49	1/1/2010	12/31/2299	N
L2760	EXTENSION PER EXTENSION PER	PRXOVR	DEF					NA	NA	NA	N
L2760	EXTENSION PER EXTENSION PER	MAXFEE	DEF					36.30	1/1/2010	12/31/2299	N
L2768	ORTHO SIDEBAR DISCONNECT	PRXOVR	DEF					NA	NA	NA	N
L2768	ORTHO SIDEBAR DISCONNECT	MAXFEE	DEF					100.06	7/1/2018	12/31/2299	N
L2770	LOW EXT ORTHOSIS PER BAR/JNT	PRXOVR	DEF					NA	NA	NA	S
L2770	LOW EXT ORTHOSIS PER BAR/JNT	MAXFEE	DEF					0	12/7/2010	12/31/2299	S
L2785	DROP LOCK RETAINER EACH	PRXOVR	DEF					NA	NA	NA	N
L2785	DROP LOCK RETAINER EACH	MAXFEE	DEF					18.93	1/1/2010	12/31/2299	N
L2795	KNEE CONTROL FULL KNEECAP	PRXOVR	DEF					NA	NA	NA	N
L2795	KNEE CONTROL FULL KNEECAP	MAXFEE	DEF					52.37	1/1/2010	12/31/2299	N
L2800	KNEE CAP MEDIAL OR LATERAL P	PRXOVR	DEF					NA	NA	NA	N
L2800	KNEE CAP MEDIAL OR LATERAL P	MAXFEE	DEF					64.35	1/1/2010	12/31/2299	N
L2810	KNEE CONTROL CONDYLAR PAD	PRXOVR	DEF					NA	NA	NA	N
L2810	KNEE CONTROL CONDYLAR PAD	MAXFEE	DEF					52.18	1/1/2010	12/31/2299	N
L2820	SOFT INTERFACE BELOW KNEE SE	PRXOVR	DEF					NA	NA	NA	N
L2820	SOFT INTERFACE BELOW KNEE SE	MAXFEE	DEF					51.88	1/1/2010	12/31/2299	N
L2830	SOFT INTERFACE ABOVE KNEE SE	PRXOVR	DEF					NA	NA	NA	N
L2830	SOFT INTERFACE ABOVE KNEE SE	MAXFEE	DEF					56.12	1/1/2010	12/31/2299	N
L2840	TIBIAL LENGTH SOCK FX OR EQU	PRXOVR	DEF					NA	NA	NA	N
L2840	TIBIAL LENGTH SOCK FX OR EQU	MAXFEE	DEF					27.56	1/1/2010	12/31/2299	N
L2850	FEMORAL LGTH SOCK FX OR EQUA	PRXOVR	DEF					NA	NA	NA	N
L2850	FEMORAL LGTH SOCK FX OR EQUA	MAXFEE	DEF					38.64	1/1/2010	12/31/2299	N
L2860	TORSION MECHANISM KNEE/ANKLE	PRXOVR	DEF					NA	NA	NA	Y
L2860	TORSION MECHANISM KNEE/ANKLE	MAXFEE	DEF					0	1/1/2009	12/31/2299	Y
L2999	LOWER EXTREMITY ORTHOSIS NOS	PRXOVR	DEF					NA	NA	NA	Y
L2999	LOWER EXTREMITY ORTHOSIS NOS	PADOLR	DEF					NA	NA	NA	Y
L3000	FT INSERT UCB BERKELEY SHELL	PRXOVR	DEF					NA	NA	NA	S
L3000	FT INSERT UCB BERKELEY SHELL	MAXFEE	DEF					134.48	1/1/2010	12/31/2299	S
L3001	FOOT INSERT REMOV MOLDED SPE	PRXOVR	DEF					NA	NA	NA	N
L3001	FOOT INSERT REMOV MOLDED SPE	MAXFEE	DEF					12.19	1/1/2010	12/31/2299	N
L3002	FOOT INSERT PLASTAZOTE OR EQ	PRXOVR	DEF					NA	NA	NA	N
L3002	FOOT INSERT PLASTAZOTE OR EQ	MAXFEE	DEF					64.08	1/1/2010	12/31/2299	N
L3010	FOOT LONGITUDINAL ARCH SUPPO	PRXOVR	DEF					NA	NA	NA	S
L3010	FOOT LONGITUDINAL ARCH SUPPO	MAXFEE	DEF					96.11	1/1/2010	12/31/2299	S
L3020	FOOT LONGITUD/METATARSAL SUP	PRXOVR	DEF					NA	NA	NA	S
L3020	FOOT LONGITUD/METATARSAL SUP	MAXFEE	DEF					102.52	1/1/2010	12/31/2299	S
L3030	FOOT ARCH SUPPORT REMOV PREM	PRXOVR	DEF					NA	NA	NA	N
L3030	FOOT ARCH SUPPORT REMOV PREM	MAXFEE	DEF					66.97	1/1/2010	12/31/2299	N
L3040	FT ARCH SUPRT PREMOLD LONGIT	PRXOVR	DEF					NA	NA	NA	N
L3040	FT ARCH SUPRT PREMOLD LONGIT	MAXFEE	DEF					12.81	1/1/2010	12/31/2299	N
L3050	FOOT ARCH SUPP PREMOLD METAT	PRXOVR	DEF					NA	NA	NA	N
L3050	FOOT ARCH SUPP PREMOLD METAT	MAXFEE	DEF					12.81	1/1/2010	12/31/2299	N
L3060	FOOT ARCH SUPP LONGITUD/META	PRXOVR	DEF					NA	NA	NA	N
L3060	FOOT ARCH SUPP LONGITUD/META	MAXFEE	DEF					34.30	1/1/2010	12/31/2299	N
L3100	HALLUS-VALGUS NT DYN PRE OTS	PRXOVR	DEF					NA	NA	NA	N
L3100	HALLUS-VALGUS NT DYN PRE OTS	MAXFEE	DEF					25.63	1/1/2010	12/31/2299	N
L3140	ABDUCTION ROTATION BAR SHOE	PRXOVR	DEF					NA	NA	NA	S
L3140	ABDUCTION ROTATION BAR SHOE	MAXFEE	DEF					38.44	1/1/2010	12/31/2299	S
L3150	ABDUCT ROTATION BAR W/O SHOE	PRXOVR	DEF					NA	NA	NA	N
L3150	ABDUCT ROTATION BAR W/O SHOE	MAXFEE	DEF					43.81	1/1/2010	12/31/2299	N
L3160	SHOE STYLED POSITIONING DEV	PRXOVR	DEF					NA	NA	NA	Y
L3160	SHOE STYLED POSITIONING DEV	MAXFEE	DEF					96.11	1/1/2010	12/31/2299	Y
L3170	FOOT PLAS HEEL STABI PRE OTS	PRXOVR	DEF					NA	NA	NA	N
L3170	FOOT PLAS HEEL STABI PRE OTS	MAXFEE	DEF					10.25	1/1/2010	12/31/2299	N
L3201	OXFORD W SUPINAT/PRONAT INF	PRXOVR	DEF					NA	NA	NA	S
L3201	OXFORD W SUPINAT/PRONAT INF	MAXFEE	DEF					55.38	1/1/2010	12/31/2299	S
L3202	OXFORD W/ SUPINAT/PRONATOR C	PRXOVR	DEF					NA	NA	NA	S
L3202	OXFORD W/ SUPINAT/PRONATOR C	MAXFEE	DEF					55.38	1/1/2010	12/31/2299	S
L3203	OXFORD W/ SUPINATOR/PRONATOR	PRXOVR	DEF					NA	NA	NA	S
L3203	OXFORD W/ SUPINATOR/PRONATOR	MAXFEE	DEF					57.67	1/1/2010	12/31/2299	S
L3204	HIGHTOP W/ SUPP/PRONATOR INF	PRXOVR	DEF					NA	NA	NA	S
L3204	HIGHTOP W/ SUPP/PRONATOR INF	MAXFEE	DEF					57.67	1/1/2010	12/31/2299	S
L3206	HIGHTOP W/ SUPP/PRONATOR CHI	PRXOVR	DEF					NA	NA	NA	S
L3206	HIGHTOP W/ SUPP/PRONATOR CHI	MAXFEE	DEF					54.24	1/1/2010	12/31/2299	S
L3207	HIGHTOP W/ SUPP/PRONATOR JUN	PRXOVR	DEF					NA	NA	NA	S
L3207	HIGHTOP W/ SUPP/PRONATOR JUN	MAXFEE	DEF					53.12	1/1/2010	12/31/2299	S
L3208	SURGICAL BOOT EACH INFANT	PRXOVR	DEF					NA	NA	NA	N
L3208	SURGICAL BOOT EACH INFANT	MAXFEE	DEF					26.91	1/1/2010	12/31/2299	N
L3209	SURGICAL BOOT EACH CHILD	PRXOVR	DEF					NA	NA	NA	N
L3209	SURGICAL BOOT EACH CHILD	MAXFEE	DEF					26.91	1/1/2010	12/31/2299	N
L3211	SURGICAL BOOT EACH JUNIOR	PRXOVR	DEF					NA	NA	NA	N
L3211	SURGICAL BOOT EACH JUNIOR	MAXFEE	DEF					26.91	1/1/2010	12/31/2299	N
L3215	ORTHOPEDIC FTWEAR LADIES OXF	PRXOVR	DEF					NA	NA	NA	S
L3215	ORTHOPEDIC FTWEAR LADIES OXF	MAXFEE	DEF					90.40	1/1/2010	12/31/2299	S
L3216	ORTHOPED LADIES SHOES DPTH I	PRXOVR	DEF					NA	NA	NA	Y
L3216	ORTHOPED LADIES SHOES DPTH I	MAXFEE	DEF					102.52	1/1/2010	12/31/2299	Y
L3217	LADIES SHOES HIGHTOP DEPTH I	PRXOVR	DEF					NA	NA	NA	S
L3217	LADIES SHOES HIGHTOP DEPTH I	MAXFEE	DEF					114.05	1/1/2010	12/31/2299	S
L3218	LADIES SURGICAL BOOT EACH	PRXOVR	DEF					NA	NA	NA	S
L3218	LADIES SURGICAL BOOT EACH	MAXFEE	DEF					0	4/1/2005	12/31/2299	S
L3219	ORTHOPEDIC MENS SHOES OXFORD	PRXOVR	DEF					NA	NA	NA	S
L3219	ORTHOPEDIC MENS SHOES OXFORD	MAXFEE	DEF					90.40	1/1/2010	12/31/2299	S
L3221	ORTHOPEDIC MENS SHOES DPTH I	PRXOVR	DEF					NA	NA	NA	Y
L3221	ORTHOPEDIC MENS SHOES DPTH I	MAXFEE	DEF					112.77	1/1/2010	12/31/2299	Y
L3222	MENS SHOES HIGHTOP DEPTH INL	PRXOVR	DEF					NA	NA	NA	S
L3222	MENS SHOES HIGHTOP DEPTH INL	MAXFEE	DEF					117.89	1/1/2010	12/31/2299	S
L3223	MENS SURGICAL BOOT EACH	PRXOVR	DEF					NA	NA	NA	S
L3223	MENS SURGICAL BOOT EACH	MAXFEE	DEF					0	4/1/2005	12/31/2299	S
L3224	WOMAN'S SHOE OXFORD BRACE	PRXOVR	DEF					NA	NA	NA	S
L3224	WOMAN'S SHOE OXFORD BRACE	MAXFEE	DEF					43.17	1/1/2010	12/31/2299	S
L3225	MAN'S SHOE OXFORD BRACE	PRXOVR	DEF					NA	NA	NA	S
L3225	MAN'S SHOE OXFORD BRACE	MAXFEE	DEF					47.15	1/1/2010	12/31/2299	S
L3230	CUSTOM SHOES DEPTH INLAY	PRXOVR	DEF					NA	NA	NA	Y
L3230	CUSTOM SHOES DEPTH INLAY	MAXFEE	DEF					160.19	9/1/2011	12/31/2299	Y
L3251	SHOE MOLDED TO PT SILICONE S	PRXOVR	DEF					NA	NA	NA	S
L3251	SHOE MOLDED TO PT SILICONE S	MAXFEE	DEF					160.19	1/1/2010	12/31/2299	S
L3252	SHOE MOLDED PLASTAZOTE CUST	PRXOVR	DEF					NA	NA	NA	S
L3252	SHOE MOLDED PLASTAZOTE CUST	MAXFEE	DEF					84.76	1/1/2010	12/31/2299	S
L3253	SHOE MOLDED PLASTAZOTE CUST	PRXOVR	DEF					NA	NA	NA	S
L3253	SHOE MOLDED PLASTAZOTE CUST	MAXFEE	DEF					64.08	1/1/2010	12/31/2299	S
L3257	ORTH FOOT ADD CHARGE SPLIT S	PRXOVR	DEF					NA	NA	NA	S
L3257	ORTH FOOT ADD CHARGE SPLIT S	MAXFEE	DEF					138.57	1/1/2010	12/31/2299	S
L3300	SHO LIFT TAPER TO METATARSAL	PRXOVR	DEF					NA	NA	NA	N
L3300	SHO LIFT TAPER TO METATARSAL	MAXFEE	DEF					43.57	1/1/2010	12/31/2299	N
L3310	SHOE LIFT ELEV HEEL/SOLE NEO	PRXOVR	DEF					NA	NA	NA	N
L3310	SHOE LIFT ELEV HEEL/SOLE NEO	MAXFEE	DEF					51.25	1/1/2010	12/31/2299	N
L3320	SHOE LIFT ELEV HEEL/SOLE COR	PRXOVR	DEF					NA	NA	NA	N
L3320	SHOE LIFT ELEV HEEL/SOLE COR	MAXFEE	DEF					64.08	1/1/2010	12/31/2299	N
L3332	SHOE LIFTS TAPERED TO ONE-HA	PRXOVR	DEF					NA	NA	NA	N
L3332	SHOE LIFTS TAPERED TO ONE-HA	MAXFEE	DEF					25.79	1/1/2010	12/31/2299	N
L3334	SHOE LIFTS ELEVATION HEEL /I	PRXOVR	DEF					NA	NA	NA	N
L3334	SHOE LIFTS ELEVATION HEEL /I	MAXFEE	DEF					30.12	1/1/2010	12/31/2299	N
L3340	SHOE WEDGE SACH	PRXOVR	DEF					NA	NA	NA	N
L3340	SHOE WEDGE SACH	MAXFEE	DEF					19.22	1/1/2010	12/31/2299	N
L3350	SHOE HEEL WEDGE	PRXOVR	DEF					NA	NA	NA	N
L3350	SHOE HEEL WEDGE	MAXFEE	DEF					10.25	1/1/2010	12/31/2299	N
L3360	SHOE SOLE WEDGE OUTSIDE SOLE	PRXOVR	DEF					NA	NA	NA	N
L3360	SHOE SOLE WEDGE OUTSIDE SOLE	MAXFEE	DEF					17.95	1/1/2010	12/31/2299	N
L3370	SHOE SOLE WEDGE BETWEEN SOLE	PRXOVR	DEF					NA	NA	NA	N
L3370	SHOE SOLE WEDGE BETWEEN SOLE	MAXFEE	DEF					26.91	1/1/2010	12/31/2299	N
L3380	SHOE CLUBFOOT WEDGE	PRXOVR	DEF					NA	NA	NA	N
L3380	SHOE CLUBFOOT WEDGE	MAXFEE	DEF					15.82	1/1/2010	12/31/2299	N
L3390	SHOE OUTFLARE WEDGE	PRXOVR	DEF					NA	NA	NA	N
L3390	SHOE OUTFLARE WEDGE	MAXFEE	DEF					26.91	1/1/2010	12/31/2299	N
L3400	SHOE METATARSAL BAR WEDGE RO	PRXOVR	DEF					NA	NA	NA	N
L3400	SHOE METATARSAL BAR WEDGE RO	MAXFEE	DEF					32.04	1/1/2010	12/31/2299	N
L3410	SHOE METATARSAL BAR BETWEEN	PRXOVR	DEF					NA	NA	NA	N
L3410	SHOE METATARSAL BAR BETWEEN	MAXFEE	DEF					37.17	1/1/2010	12/31/2299	N
L3420	FULL SOLE/HEEL WEDGE BTWEEN	PRXOVR	DEF					NA	NA	NA	N
L3420	FULL SOLE/HEEL WEDGE BTWEEN	MAXFEE	DEF					43.57	1/1/2010	12/31/2299	N
L3430	SHO HEEL COUNT PLAST REINFOR	PRXOVR	DEF					NA	NA	NA	N
L3430	SHO HEEL COUNT PLAST REINFOR	MAXFEE	DEF					38.44	1/1/2010	12/31/2299	N
L3440	HEEL LEATHER REINFORCED	PRXOVR	DEF					NA	NA	NA	N
L3440	HEEL LEATHER REINFORCED	MAXFEE	DEF					33.19	1/1/2010	12/31/2299	N
L3450	SHOE HEEL SACH CUSHION TYPE	PRXOVR	DEF					NA	NA	NA	N
L3450	SHOE HEEL SACH CUSHION TYPE	MAXFEE	DEF					84.60	7/1/2021	12/31/2299	N
L3455	SHOE HEEL NEW LEATHER STANDA	PRXOVR	DEF					NA	NA	NA	S
L3455	SHOE HEEL NEW LEATHER STANDA	MAXFEE	DEF					15.38	1/1/2010	12/31/2299	S
L3460	SHOE HEEL NEW RUBBER STANDAR	PRXOVR	DEF					NA	NA	NA	S
L3460	SHOE HEEL NEW RUBBER STANDAR	MAXFEE	DEF					14.09	1/1/2010	12/31/2299	S
L3465	SHOE HEEL THOMAS WITH WEDGE	PRXOVR	DEF					NA	NA	NA	N
L3465	SHOE HEEL THOMAS WITH WEDGE	MAXFEE	DEF					17.64	1/1/2010	12/31/2299	N
L3470	SHOE HEEL THOMAS EXTEND TO B	PRXOVR	DEF					NA	NA	NA	N
L3470	SHOE HEEL THOMAS EXTEND TO B	MAXFEE	DEF					37.30	1/1/2010	12/31/2299	N
L3480	SHOE HEEL PAD & DEPRESS FOR	PRXOVR	DEF					NA	NA	NA	N
L3480	SHOE HEEL PAD & DEPRESS FOR	MAXFEE	DEF					19.22	1/1/2010	12/31/2299	N
L3500	ORTHO SHOE ADD LEATHER INSOL	PRXOVR	DEF					NA	NA	NA	N
L3500	ORTHO SHOE ADD LEATHER INSOL	MAXFEE	DEF					16.65	1/1/2010	12/31/2299	N
L3510	ORTHOPEDIC SHOE ADD RUB INSL	PRXOVR	DEF					NA	NA	NA	N
L3510	ORTHOPEDIC SHOE ADD RUB INSL	MAXFEE	DEF					11.59	1/1/2010	12/31/2299	N
L3520	O SHOE ADD FELT W LEATH INSL	PRXOVR	DEF					NA	NA	NA	N
L3520	O SHOE ADD FELT W LEATH INSL	MAXFEE	DEF					22.39	1/1/2010	12/31/2299	N
L3530	ORTHO SHOE ADD HALF SOLE	PRXOVR	DEF					NA	NA	NA	S
L3530	ORTHO SHOE ADD HALF SOLE	MAXFEE	DEF					19.33	1/1/2010	12/31/2299	S
L3540	ORTHO SHOE ADD FULL SOLE	PRXOVR	DEF					NA	NA	NA	N
L3540	ORTHO SHOE ADD FULL SOLE	MAXFEE	DEF					23.85	1/1/2010	12/31/2299	N
L3550	O SHOE ADD STANDARD TOE TAP	PRXOVR	DEF					NA	NA	NA	N
L3550	O SHOE ADD STANDARD TOE TAP	MAXFEE	DEF					5.13	1/1/2010	12/31/2299	N
L3570	O SHOE ADD INSTEP EXTENSION	PRXOVR	DEF					NA	NA	NA	N
L3570	O SHOE ADD INSTEP EXTENSION	MAXFEE	DEF					69.16	1/1/2010	12/31/2299	N
L3580	O SHOE ADD INSTEP VELCRO CLO	PRXOVR	DEF					NA	NA	NA	N
L3580	O SHOE ADD INSTEP VELCRO CLO	MAXFEE	DEF					25.63	1/1/2010	12/31/2299	N
L3595	ORTHO SHOE ADD MARCH BAR	PRXOVR	DEF					NA	NA	NA	N
L3595	ORTHO SHOE ADD MARCH BAR	MAXFEE	DEF					32.04	1/1/2010	12/31/2299	N
L3600	TRANS SHOE CALIP PLATE EXIST	PRXOVR	DEF					NA	NA	NA	N
L3600	TRANS SHOE CALIP PLATE EXIST	MAXFEE	DEF					37.44	1/1/2010	12/31/2299	N
L3610	TRANS SHOE CALIPER PLATE NEW	PRXOVR	DEF					NA	NA	NA	N
L3610	TRANS SHOE CALIPER PLATE NEW	MAXFEE	DEF					57.67	1/1/2010	12/31/2299	N
L3620	TRANS SHOE SOLID STIRRUP EXI	PRXOVR	DEF					NA	NA	NA	N
L3620	TRANS SHOE SOLID STIRRUP EXI	MAXFEE	DEF					48.56	1/1/2010	12/31/2299	N
L3630	TRANS SHOE SOLID STIRRUP NEW	PRXOVR	DEF					NA	NA	NA	N
L3630	TRANS SHOE SOLID STIRRUP NEW	MAXFEE	DEF					63.26	1/1/2010	12/31/2299	N
L3649	ORTHOPEDIC SHOE MODIFICA NOS	PRXOVR	DEF					NA	NA	NA	Y
L3649	ORTHOPEDIC SHOE MODIFICA NOS	PADOLR	DEF					NA	NA	NA	Y
L3650	SO 8 ABD RESTRAINT PRE OTS	PRXOVR	DEF					NA	NA	NA	N
L3650	SO 8 ABD RESTRAINT PRE OTS	MAXFEE	DEF					41.90	1/1/2010	12/31/2299	N
L3660	SO 8 AB RSTR CAN/WEB PRE OTS	PRXOVR	DEF					NA	NA	NA	S
L3660	SO 8 AB RSTR CAN/WEB PRE OTS	MAXFEE	DEF					76	1/1/2022	12/31/2299	S
L3670	SO ACRO/CLAV CAN WEB PRE OTS	PRXOVR	DEF					NA	NA	NA	N
L3670	SO ACRO/CLAV CAN WEB PRE OTS	MAXFEE	DEF					66.10	1/1/2010	12/31/2299	N
L3674	SO AIRPLANE W/WO JOINT CF	PRXOVR	DEF					NA	NA	NA	N
L3674	SO AIRPLANE W/WO JOINT CF	MAXFEE	DEF					778.74	1/1/2011	12/31/2299	N
L3675	SO VEST CANVAS/WEB PRE OTS	PRXOVR	DEF					NA	NA	NA	N
L3675	SO VEST CANVAS/WEB PRE OTS	MAXFEE	DEF					118.84	1/1/2010	12/31/2299	N
L3700	ELBOW ORTHOSES ELAS W STAYS	PRXOVR	DEF					NA	NA	NA	N
L3700	ELBOW ORTHOSES ELAS W STAYS	MAXFEE	DEF					0	12/7/2010	12/31/2299	N
L3701	PREFAB ELBOW ORTHOSIS	PRXOVR	DEF					NA	NA	NA	N
L3701	PREFAB ELBOW ORTHOSIS	MAXFEE	DEF					0	12/7/2010	12/31/2299	N
L3710	EO ELAS W/METAL JNTS PRE OTS	PRXOVR	DEF					NA	NA	NA	N
L3710	EO ELAS W/METAL JNTS PRE OTS	MAXFEE	DEF					83.03	1/1/2010	12/31/2299	N
L3720	FOREARM/ARM CUFFS FREE MOTIO	PRXOVR	DEF					NA	NA	NA	S
L3720	FOREARM/ARM CUFFS FREE MOTIO	MAXFEE	DEF					397.27	1/1/2010	12/31/2299	S
L3730	FOREARM/ARM CUFFS EXT/FLEX A	PRXOVR	DEF					NA	NA	NA	S
L3730	FOREARM/ARM CUFFS EXT/FLEX A	MAXFEE	DEF					526.97	1/1/2010	12/31/2299	S
L3740	CUFFS ADJ LOCK W/ ACTIVE CON	PRXOVR	DEF					NA	NA	NA	S
L3740	CUFFS ADJ LOCK W/ ACTIVE CON	MAXFEE	DEF					624.77	1/1/2010	12/31/2299	S
L3760	EO ADJ JT PREFAB CUSTOM FIT	PRXOVR	DEF					NA	NA	NA	S
L3760	EO ADJ JT PREFAB CUSTOM FIT	MAXFEE	DEF					285.67	1/1/2010	12/31/2299	S
L3761	EO; ADJ LOCK JOINT PREFAB OT	PRXOVR	DEF					NA	NA	NA	S
L3761	EO; ADJ LOCK JOINT PREFAB OT	MAXFEE	DEF					365	1/1/2022	12/31/2299	S
L3762	EO RIGID W/O JOINTS PRE OTS	PRXOVR	DEF					NA	NA	NA	S
L3762	EO RIGID W/O JOINTS PRE OTS	MAXFEE	DEF					79	1/1/2022	12/31/2299	S
L3763	EWHO RIGID W/O JNTS CF	PRXOVR	DEF					NA	NA	NA	S
L3763	EWHO RIGID W/O JNTS CF	MAXFEE	DEF					493.34	12/7/2010	12/31/2299	S
L3764	EWHO W/JOINT(S) CF	PRXOVR	DEF					NA	NA	NA	S
L3764	EWHO W/JOINT(S) CF	MAXFEE	DEF					516.30	12/7/2010	12/31/2299	S
L3800	WHFO SHORT OPPONEN NO ATTACH	PRXOVR	DEF					NA	NA	NA	Y
L3800	WHFO SHORT OPPONEN NO ATTACH	MAXFEE	DEF					0	1/1/2008	12/31/2299	Y
L3805	WHFO LONG OPPONENS NO ATTACH	PRXOVR	DEF					NA	NA	NA	Y
L3805	WHFO LONG OPPONENS NO ATTACH	MAXFEE	DEF					0	1/1/2008	12/31/2299	Y
L3807	WHFO W/O JOINTS PRE CST	PRXOVR	DEF					NA	NA	NA	S
L3807	WHFO W/O JOINTS PRE CST	MAXFEE	DEF					147.26	4/1/2009	12/31/2299	S
L3808	WHFO; RIGID W/O JOINTS	PRXOVR	DEF					NA	NA	NA	N
L3808	WHFO; RIGID W/O JOINTS	MAXFEE	DEF					168.26	1/1/2010	12/31/2299	N
L3809	WHFO W/O JOINTS PRE OTS	PRXOVR	DEF					NA	NA	NA	N
L3809	WHFO W/O JOINTS PRE OTS	MAXFEE	DEF					155	7/1/2021	12/31/2299	N
L3810	WHFO THUMB ABDUCTION BAR	PRXOVR	DEF					NA	NA	NA	Y
L3810	WHFO THUMB ABDUCTION BAR	MAXFEE	DEF					0	1/1/2008	12/31/2299	Y
L3815	WHFO SECOND M.P. ABDUCTION A	PRXOVR	DEF					NA	NA	NA	Y
L3815	WHFO SECOND M.P. ABDUCTION A	MAXFEE	DEF					0	1/1/2008	12/31/2299	Y
L3820	WHFO IP EXT ASST W/ MP EXT S	PRXOVR	DEF					NA	NA	NA	Y
L3820	WHFO IP EXT ASST W/ MP EXT S	MAXFEE	DEF					0	1/1/2008	12/31/2299	Y
L3825	WHFO M.P. EXTENSION STOP	PRXOVR	DEF					NA	NA	NA	Y
L3825	WHFO M.P. EXTENSION STOP	MAXFEE	DEF					0	1/1/2008	12/31/2299	Y
L3830	WHFO M.P. EXTENSION ASSIST	PRXOVR	DEF					NA	NA	NA	Y
L3830	WHFO M.P. EXTENSION ASSIST	MAXFEE	DEF					0	1/1/2008	12/31/2299	Y
L3835	WHFO M.P. SPRING EXTENSION A	PRXOVR	DEF					NA	NA	NA	Y
L3835	WHFO M.P. SPRING EXTENSION A	MAXFEE	DEF					0	1/1/2008	12/31/2299	Y
L3840	WHFO SPRING SWIVEL THUMB	PRXOVR	DEF					NA	NA	NA	Y
L3840	WHFO SPRING SWIVEL THUMB	MAXFEE	DEF					0	1/1/2008	12/31/2299	Y
L3845	WHFO THUMB IP EXT ASS W/ MP	PRXOVR	DEF					NA	NA	NA	Y
L3845	WHFO THUMB IP EXT ASS W/ MP	MAXFEE	DEF					0	1/1/2008	12/31/2299	Y
L3850	ACTION WRIST W/ DORSIFLEX AS	PRXOVR	DEF					NA	NA	NA	Y
L3850	ACTION WRIST W/ DORSIFLEX AS	MAXFEE	DEF					0	1/1/2008	12/31/2299	Y
L3855	WHFO ADJ M.P. FLEXION CONTRO	PRXOVR	DEF					NA	NA	NA	Y
L3855	WHFO ADJ M.P. FLEXION CONTRO	MAXFEE	DEF					0	1/1/2008	12/31/2299	Y
L3860	WHFO ADJ M.P. FLEX CTRL & I.	PRXOVR	DEF					NA	NA	NA	Y
L3860	WHFO ADJ M.P. FLEX CTRL & I.	MAXFEE	DEF					0	1/1/2008	12/31/2299	Y
L3890	TORSION MECHANISM WRIST/ELBO	PRXOVR	DEF					NA	NA	NA	Y
L3890	TORSION MECHANISM WRIST/ELBO	MAXFEE	DEF					0	1/1/2009	12/31/2299	Y
L3900	HINGE EXTENSION/FLEX WRIST/F	PRXOVR	DEF					NA	NA	NA	S
L3900	HINGE EXTENSION/FLEX WRIST/F	MAXFEE	DEF					941.93	1/1/2010	12/31/2299	S
L3901	HINGE EXT/FLEX WRIST FINGER	PRXOVR	DEF					NA	NA	NA	S
L3901	HINGE EXT/FLEX WRIST FINGER	MAXFEE	DEF					1234.46	1/1/2010	12/31/2299	S
L3906	WHO W/O JOINTS CF	PRXOVR	DEF					NA	NA	NA	N
L3906	WHO W/O JOINTS CF	MAXFEE	DEF					294.66	1/1/2010	12/31/2299	N
L3907	WHFO WRST GAUNTLT THMB SPICA	PRXOVR	DEF					NA	NA	NA	Y
L3907	WHFO WRST GAUNTLT THMB SPICA	MAXFEE	DEF					0	1/1/2008	12/31/2299	Y
L3908	WHO COCK-UP NONMOLDE PRE OTS	PRXOVR	DEF					NA	NA	NA	N
L3908	WHO COCK-UP NONMOLDE PRE OTS	MAXFEE	DEF					43.66	1/1/2010	12/31/2299	N
L3909	PREFAB WRIST ORTHOSIS	PRXOVR	DEF					NA	NA	NA	N
L3909	PREFAB WRIST ORTHOSIS	MAXFEE	DEF					0	12/7/2010	12/31/2299	N
L3910	WHFO SWANSON DESIGN	PRXOVR	DEF					NA	NA	NA	Y
L3910	WHFO SWANSON DESIGN	MAXFEE	DEF					0	1/1/2008	12/31/2299	Y
L3912	HFO FLEXION GLOVE PRE OTS	PRXOVR	DEF					NA	NA	NA	N
L3912	HFO FLEXION GLOVE PRE OTS	MAXFEE	DEF					61.27	1/1/2010	12/31/2299	N
L3914	WHO WRIST EXTENSION COCK-UP	PRXOVR	DEF					NA	NA	NA	S
L3914	WHO WRIST EXTENSION COCK-UP	MAXFEE	DEF					0	1/1/2007	12/31/2299	S
L3916	WHO NONTORSION JNTS PRE OTS	PRXOVR	DEF					NA	NA	NA	Y
L3916	WHO NONTORSION JNTS PRE OTS	MAXFEE	DEF					100	10/1/2021	12/31/2299	Y
L3918	METACARP FX ORTHOSIS PRE OTS	PRXOVR	DEF					NA	NA	NA	N
L3918	METACARP FX ORTHOSIS PRE OTS	MAXFEE	DEF					100	10/1/2021	12/31/2299	N
L3920	KNUCKLE BENDER WITH OUTRIGGE	PRXOVR	DEF					NA	NA	NA	S
L3920	KNUCKLE BENDER WITH OUTRIGGE	MAXFEE	DEF					0	1/1/2008	12/31/2299	S
L3922	KNUCKLE BEND 2 SEG TO FLEX J	PRXOVR	DEF					NA	NA	NA	S
L3922	KNUCKLE BEND 2 SEG TO FLEX J	MAXFEE	DEF					0	1/1/2008	12/31/2299	S
L3923	HFO WITHOUT JOINTS PRE CST	PRXOVR	DEF					NA	NA	NA	N
L3923	HFO WITHOUT JOINTS PRE CST	MAXFEE	DEF					27.65	1/1/2010	12/31/2299	N
L3924	HFO WITHOUT JOINTS PRE OTS	PRXOVR	DEF					NA	NA	NA	S
L3924	HFO WITHOUT JOINTS PRE OTS	MAXFEE	DEF					69.82	1/1/2014	12/31/2299	S
L3925	FO PIP DIP JNT/SPRNG PRE OTS	PRXOVR	DEF					NA	NA	NA	N
L3925	FO PIP DIP JNT/SPRNG PRE OTS	MAXFEE	DEF					39.04	1/1/2010	12/31/2299	N
L3926	THOMAS SUSPENSION	PRXOVR	DEF					NA	NA	NA	S
L3926	THOMAS SUSPENSION	MAXFEE	DEF					0	1/1/2008	12/31/2299	S
L3928	FINGER EXTENSION W/ CLOCK SP	PRXOVR	DEF					NA	NA	NA	S
L3928	FINGER EXTENSION W/ CLOCK SP	MAXFEE	DEF					0	1/1/2008	12/31/2299	S
L3929	HFO NONTORSION JNTS PRE CST	PRXOVR	DEF					NA	NA	NA	N
L3929	HFO NONTORSION JNTS PRE CST	MAXFEE	DEF					66.19	1/1/2010	12/31/2299	N
L3930	HFO NONTORSION JNTS PRE OTS	PRXOVR	DEF					NA	NA	NA	S
L3930	HFO NONTORSION JNTS PRE OTS	MAXFEE	DEF					67	1/1/2022	12/31/2299	S
L3931	WHFO NONTORSION JOINT PREFAB	PRXOVR	DEF					NA	NA	NA	N
L3931	WHFO NONTORSION JOINT PREFAB	MAXFEE	DEF					142.53	1/1/2010	12/31/2299	N
L3932	SAFETY PIN SPRING WIRE	PRXOVR	DEF					NA	NA	NA	S
L3932	SAFETY PIN SPRING WIRE	MAXFEE	DEF					0	1/1/2008	12/31/2299	S
L3933	FO W/O JOINTS CF	PRXOVR	DEF					NA	NA	NA	S
L3933	FO W/O JOINTS CF	MAXFEE	DEF					156	1/1/2022	12/31/2299	S
L3934	SAFETY PIN MODIFIED	PRXOVR	DEF					NA	NA	NA	S
L3934	SAFETY PIN MODIFIED	MAXFEE	DEF					0	1/1/2008	12/31/2299	S
L3936	PALMER	PRXOVR	DEF					NA	NA	NA	S
L3936	PALMER	MAXFEE	DEF					0	1/1/2008	12/31/2299	S
L3938	DORSAL WRIST	PRXOVR	DEF					NA	NA	NA	S
L3938	DORSAL WRIST	MAXFEE	DEF					0	1/1/2008	12/31/2299	S
L3940	DORSAL WRIST W/ OUTRIGGER AT	PRXOVR	DEF					NA	NA	NA	S
L3940	DORSAL WRIST W/ OUTRIGGER AT	MAXFEE	DEF					0	1/1/2008	12/31/2299	S
L3942	REVERSE KNUCKLE BENDER	PRXOVR	DEF					NA	NA	NA	S
L3942	REVERSE KNUCKLE BENDER	MAXFEE	DEF					0	1/1/2008	12/31/2299	S
L3944	REVERSE KNUCKLE BEND W/ OUTR	PRXOVR	DEF					NA	NA	NA	S
L3944	REVERSE KNUCKLE BEND W/ OUTR	MAXFEE	DEF					0	1/1/2008	12/31/2299	S
L3946	HFO COMPOSITE ELASTIC	PRXOVR	DEF					NA	NA	NA	S
L3946	HFO COMPOSITE ELASTIC	MAXFEE	DEF					0	1/1/2008	12/31/2299	S
L3948	FINGER KNUCKLE BENDER	PRXOVR	DEF					NA	NA	NA	S
L3948	FINGER KNUCKLE BENDER	MAXFEE	DEF					0	1/1/2008	12/31/2299	S
L3950	OPPENHEIMER W/ KNUCKLE BEND	PRXOVR	DEF					NA	NA	NA	Y
L3950	OPPENHEIMER W/ KNUCKLE BEND	MAXFEE	DEF					0	1/1/2008	12/31/2299	Y
L3952	OPPENHEIMER W/ REV KNUCKLE 2	PRXOVR	DEF					NA	NA	NA	Y
L3952	OPPENHEIMER W/ REV KNUCKLE 2	MAXFEE	DEF					0	1/1/2008	12/31/2299	Y
L3954	SPREADING HAND	PRXOVR	DEF					NA	NA	NA	Y
L3954	SPREADING HAND	MAXFEE	DEF					0	1/1/2008	12/31/2299	Y
L3956	ADD JOINT UPPER EXT ORTHOSIS	PRXOVR	DEF					NA	NA	NA	S
L3956	ADD JOINT UPPER EXT ORTHOSIS	MAXFEE	DEF					187.75	1/1/2010	12/31/2299	S
L3960	SEWHO AIRPLAN DESIG ABDU POS	PRXOVR	DEF					NA	NA	NA	N
L3960	SEWHO AIRPLAN DESIG ABDU POS	MAXFEE	DEF					463.75	1/1/2010	12/31/2299	N
L3963	MOLDED W/ ARTICULATING ELBOW	PRXOVR	DEF					NA	NA	NA	Y
L3963	MOLDED W/ ARTICULATING ELBOW	MAXFEE	DEF					NA			Y
L3971	SEWHO CAP DESIGN W/JNT(S) CF	PRXOVR	DEF					NA	NA	NA	S
L3971	SEWHO CAP DESIGN W/JNT(S) CF	MAXFEE	DEF					975.27	1/1/2010	12/31/2299	S
L3980	UP EXT FX ORTHOS HUMERAL NOS	PRXOVR	DEF					NA	NA	NA	N
L3980	UP EXT FX ORTHOS HUMERAL NOS	MAXFEE	DEF					224.94	1/1/2010	12/31/2299	N
L3982	UPPER EXT FX ORTHOSIS RAD/UL	PRXOVR	DEF					NA	NA	NA	N
L3982	UPPER EXT FX ORTHOSIS RAD/UL	MAXFEE	DEF					228.40	1/1/2010	12/31/2299	N
L3984	UPPER EXT FX ORTHOSIS WRIST	PRXOVR	DEF					NA	NA	NA	N
L3984	UPPER EXT FX ORTHOSIS WRIST	MAXFEE	DEF					201.21	1/1/2010	12/31/2299	N
L3985	FOREARM HAND FX ORTH W/ WR H	PRXOVR	DEF					NA	NA	NA	Y
L3985	FOREARM HAND FX ORTH W/ WR H	MAXFEE	DEF					0	1/1/2008	12/31/2299	Y
L3995	SOCK FRACTURE OR EQUAL EACH	PRXOVR	DEF					NA	NA	NA	S
L3995	SOCK FRACTURE OR EQUAL EACH	MAXFEE	DEF					23.88	1/1/2010	12/31/2299	S
L3999	UPPER LIMB ORTHOSIS NOS	PRXOVR	DEF					NA	NA	NA	Y
L3999	UPPER LIMB ORTHOSIS NOS	PADOLR	DEF					NA	NA	NA	Y
L4000	REPL GIRDLE MILWAUKEE ORTH	PRXOVR	DEF					NA	NA	NA	Y
L4000	REPL GIRDLE MILWAUKEE ORTH	MAXFEE	DEF					844.25	1/1/2010	12/31/2299	Y
L4010	REPLACE TRILATERAL SOCKET BR	PRXOVR	DEF					NA	NA	NA	Y
L4010	REPLACE TRILATERAL SOCKET BR	MAXFEE	DEF					513.16	1/1/2010	12/31/2299	Y
L4020	REPLACE QUADLAT SOCKET BRIM	PRXOVR	DEF					NA	NA	NA	Y
L4020	REPLACE QUADLAT SOCKET BRIM	MAXFEE	DEF					616.43	1/1/2010	12/31/2299	Y
L4030	REPLACE SOCKET BRIM CUST FIT	PRXOVR	DEF					NA	NA	NA	Y
L4030	REPLACE SOCKET BRIM CUST FIT	MAXFEE	DEF					391.73	1/1/2010	12/31/2299	Y
L4040	REPLACE MOLDED THIGH LACER	PRXOVR	DEF					NA	NA	NA	S
L4040	REPLACE MOLDED THIGH LACER	MAXFEE	DEF					265.30	1/1/2010	12/31/2299	S
L4045	REPLACE NON-MOLDED THIGH LAC	PRXOVR	DEF					NA	NA	NA	S
L4045	REPLACE NON-MOLDED THIGH LAC	MAXFEE	DEF					195.96	1/1/2010	12/31/2299	S
L4050	REPLACE MOLDED CALF LACER	PRXOVR	DEF					NA	NA	NA	Y
L4050	REPLACE MOLDED CALF LACER	MAXFEE	DEF					262.73	1/1/2010	12/31/2299	Y
L4055	REPLACE NON-MOLDED CALF LACE	PRXOVR	DEF					NA	NA	NA	S
L4055	REPLACE NON-MOLDED CALF LACE	MAXFEE	DEF					159.70	1/1/2010	12/31/2299	S
L4060	REPLACE HIGH ROLL CUFF	PRXOVR	DEF					NA	NA	NA	S
L4060	REPLACE HIGH ROLL CUFF	MAXFEE	DEF					211.11	1/1/2010	12/31/2299	S
L4070	REPLACE PROX & DIST UPRIGHT	PRXOVR	DEF					NA	NA	NA	S
L4070	REPLACE PROX & DIST UPRIGHT	MAXFEE	DEF					183.88	1/1/2010	12/31/2299	S
L4080	REPL MET BAND KAFO-AFO PROX	PRXOVR	DEF					NA	NA	NA	N
L4080	REPL MET BAND KAFO-AFO PROX	MAXFEE	DEF					64.32	1/1/2010	12/31/2299	N
L4090	REPL MET BAND KAFO-AFO CALF/	PRXOVR	DEF					NA	NA	NA	N
L4090	REPL MET BAND KAFO-AFO CALF/	MAXFEE	DEF					53.98	1/1/2010	12/31/2299	N
L4100	REPL LEATH CUFF KAFO PROX TH	PRXOVR	DEF					NA	NA	NA	N
L4100	REPL LEATH CUFF KAFO PROX TH	MAXFEE	DEF					64.88	1/1/2010	12/31/2299	N
L4110	REPL LEATH CUFF KAFO-AFO CAL	PRXOVR	DEF					NA	NA	NA	N
L4110	REPL LEATH CUFF KAFO-AFO CAL	MAXFEE	DEF					50.66	1/1/2010	12/31/2299	N
L4130	REPLACE PRETIBIAL SHELL	PRXOVR	DEF					NA	NA	NA	S
L4130	REPLACE PRETIBIAL SHELL	MAXFEE	DEF					306.22	1/1/2010	12/31/2299	S
L4205	ORTHO DVC REPAIR PER 15 MIN	PRXOVR	DEF					NA	NA	NA	S
L4205	ORTHO DVC REPAIR PER 15 MIN	REPAIR	DEF					NA	NA	NA	S
L4210	ORTH DEV REPAIR/REPL MINOR P	PRXOVR	DEF					NA	NA	NA	S
L4210	ORTH DEV REPAIR/REPL MINOR P	REPAIR	DEF					NA	NA	NA	S
L4350	ANKLE CONTROL ORTHO PRE OTS	PRXOVR	DEF					NA	NA	NA	N
L4350	ANKLE CONTROL ORTHO PRE OTS	MAXFEE	DEF					61.83	1/1/2010	12/31/2299	N
L4360	PNEUMAT WALKING BOOT PRE CST	PRXOVR	DEF					NA	NA	NA	S
L4360	PNEUMAT WALKING BOOT PRE CST	MAXFEE	DEF					165.41	1/1/2010	12/31/2299	S
L4361	PNEUMA/VAC WALK BOOT PRE OTS	PRXOVR	DEF					NA	NA	NA	Y
L4361	PNEUMA/VAC WALK BOOT PRE OTS	MAXFEE	DEF					150	10/1/2021	12/31/2299	Y
L4370	PNEUM FULL LEG SPLNT PRE OTS	PRXOVR	DEF					NA	NA	NA	S
L4370	PNEUM FULL LEG SPLNT PRE OTS	MAXFEE	DEF					150.37	1/1/2010	12/31/2299	S
L4380	PNEUMATIC KNEE SPLINT	PRXOVR	DEF					NA	NA	NA	Y
L4380	PNEUMATIC KNEE SPLINT	MAXFEE	DEF					NA			Y
L4386	NON-PNEUM WALK BOOT PRE CST	PRXOVR	DEF					NA	NA	NA	N
L4386	NON-PNEUM WALK BOOT PRE CST	MAXFEE	DEF					99.06	1/1/2010	12/31/2299	N
L4387	NON-PNEUM WALK BOOT PRE OTS	PRXOVR	DEF					NA	NA	NA	N
L4387	NON-PNEUM WALK BOOT PRE OTS	MAXFEE	DEF					85	10/1/2021	12/31/2299	N
L4392	REPLACE AFO SOFT INTERFACE	PRXOVR	DEF					NA	NA	NA	N
L4392	REPLACE AFO SOFT INTERFACE	MAXFEE	DEF					15.04	1/1/2010	12/31/2299	N
L4396	STATIC OR DYNAMI AFO PRE CST	PRXOVR	DEF					NA	NA	NA	S
L4396	STATIC OR DYNAMI AFO PRE CST	MAXFEE	DEF					107.22	1/1/2010	12/31/2299	S
L4397	STATIC OR DYNAMI AFO PRE OTS	PRXOVR	DEF					NA	NA	NA	S
L4397	STATIC OR DYNAMI AFO PRE OTS	MAXFEE	DEF					95	10/1/2021	12/31/2299	S
L4398	FOOT DROP SPLINT PRE OTS	PRXOVR	DEF					NA	NA	NA	S
L4398	FOOT DROP SPLINT PRE OTS	MAXFEE	DEF					63	1/1/2022	12/31/2299	S
L4631	AFO; WALK BOOT TYPE; CUS FAB	PRXOVR	DEF					NA	NA	NA	Y
L4631	AFO; WALK BOOT TYPE; CUS FAB	MAXFEE	DEF					1066.77	1/1/2011	12/31/2299	Y
L5000	SHO INSERT W ARCH TOE FILLER	PRXOVR	DEF					NA	NA	NA	S
L5000	SHO INSERT W ARCH TOE FILLER	MAXFEE	DEF					366.87	1/1/2010	12/31/2299	S
L5010	MOLD SOCKET ANK HGT W/ TOE F	PRXOVR	DEF					NA	NA	NA	S
L5010	MOLD SOCKET ANK HGT W/ TOE F	MAXFEE	DEF					1025.10	1/1/2010	12/31/2299	S
L5020	TIBIAL TUBERCLE HGT W/ TOE F	PRXOVR	DEF					NA	NA	NA	S
L5020	TIBIAL TUBERCLE HGT W/ TOE F	MAXFEE	DEF					1605.99	1/1/2010	12/31/2299	S
L5050	ANK SYMES MOLD SCKT SACH FT	PRXOVR	DEF					NA	NA	NA	S
L5050	ANK SYMES MOLD SCKT SACH FT	MAXFEE	DEF					1754.04	1/1/2010	12/31/2299	S
L5060	SYMES MET FR LEATH SOCKET AR	PRXOVR	DEF					NA	NA	NA	Y
L5060	SYMES MET FR LEATH SOCKET AR	MAXFEE	DEF					2162.23	1/1/2010	12/31/2299	Y
L5100	MOLDED SOCKET SHIN SACH FOOT	PRXOVR	DEF					NA	NA	NA	S
L5100	MOLDED SOCKET SHIN SACH FOOT	MAXFEE	DEF					1746.54	1/1/2010	12/31/2299	S
L5105	PLAST SOCKET JTS/THGH LACER	PRXOVR	DEF					NA	NA	NA	Y
L5105	PLAST SOCKET JTS/THGH LACER	MAXFEE	DEF					2464.74	1/1/2010	12/31/2299	Y
L5150	MOLD SCKT EXT KNEE SHIN SACH	PRXOVR	DEF					NA	NA	NA	Y
L5150	MOLD SCKT EXT KNEE SHIN SACH	MAXFEE	DEF					2740.21	1/1/2010	12/31/2299	Y
L5160	MOLD SOCKET BENT KNEE SHIN S	PRXOVR	DEF					NA	NA	NA	Y
L5160	MOLD SOCKET BENT KNEE SHIN S	MAXFEE	DEF					3008.61	1/1/2010	12/31/2299	Y
L5200	KNE SING AXIS FRIC SHIN SACH	PRXOVR	DEF					NA	NA	NA	S
L5200	KNE SING AXIS FRIC SHIN SACH	MAXFEE	DEF					2326.94	1/1/2010	12/31/2299	S
L5210	NO KNEE/ANKLE JOINTS W/ FT B	PRXOVR	DEF					NA	NA	NA	S
L5210	NO KNEE/ANKLE JOINTS W/ FT B	MAXFEE	DEF					1847.59	1/1/2010	12/31/2299	S
L5220	NO KNEE JOINT WITH ARTIC ALI	PRXOVR	DEF					NA	NA	NA	S
L5220	NO KNEE JOINT WITH ARTIC ALI	MAXFEE	DEF					2035.24	1/1/2010	12/31/2299	S
L5230	FEM FOCAL DEFIC CONSTANT FRI	PRXOVR	DEF					NA	NA	NA	S
L5230	FEM FOCAL DEFIC CONSTANT FRI	MAXFEE	DEF					3052.57	1/1/2010	12/31/2299	S
L5250	HIP CANAD SING AXI CONS FRIC	PRXOVR	DEF					NA	NA	NA	S
L5250	HIP CANAD SING AXI CONS FRIC	MAXFEE	DEF					3579.21	1/1/2010	12/31/2299	S
L5280	HEMIPELVECT CANAD SING AXIS	PRXOVR	DEF					NA	NA	NA	Y
L5280	HEMIPELVECT CANAD SING AXIS	MAXFEE	DEF					3876.41	1/1/2010	12/31/2299	Y
L5301	BK MOLD SOCKET SACH FT ENDO	PRXOVR	DEF					NA	NA	NA	S
L5301	BK MOLD SOCKET SACH FT ENDO	MAXFEE	DEF					2073.45	1/1/2010	12/31/2299	S
L5311	KNEE DISART; SACH FT; ENDO	PRXOVR	DEF					NA	NA	NA	Y
L5311	KNEE DISART; SACH FT; ENDO	MAXFEE	DEF					NA			Y
L5321	AK OPEN END SACH	PRXOVR	DEF					NA	NA	NA	S
L5321	AK OPEN END SACH	MAXFEE	DEF					2764.88	1/1/2010	12/31/2299	S
L5331	HIP DISART CANADIAN SACH FT	PRXOVR	DEF					NA	NA	NA	S
L5331	HIP DISART CANADIAN SACH FT	MAXFEE	DEF					4049.55	1/1/2010	12/31/2299	S
L5341	HEMIPELVECTOMY CANADIAN SACH	PRXOVR	DEF					NA	NA	NA	S
L5341	HEMIPELVECTOMY CANADIAN SACH	MAXFEE	DEF					4304.60	1/1/2010	12/31/2299	S
L5400	POSTOP DRESS & 1 CAST CHG BK	PRXOVR	DEF					NA	NA	NA	Y
L5400	POSTOP DRESS & 1 CAST CHG BK	MAXFEE	DEF					1021.32	1/1/2010	12/31/2299	Y
L5410	POSTOP DSG BK EA ADD CAST CH	PRXOVR	DEF					NA	NA	NA	Y
L5410	POSTOP DSG BK EA ADD CAST CH	MAXFEE	DEF					282.16	1/1/2010	12/31/2299	Y
L5420	POSTOP DSG & 1 CAST CHG AK/D	PRXOVR	DEF					NA	NA	NA	Y
L5420	POSTOP DSG & 1 CAST CHG AK/D	MAXFEE	DEF					1289.89	1/1/2010	12/31/2299	Y
L5430	POSTOP DSG AK EA ADD CAST CH	PRXOVR	DEF					NA	NA	NA	Y
L5430	POSTOP DSG AK EA ADD CAST CH	MAXFEE	DEF					350.13	1/1/2010	12/31/2299	Y
L5510	PREP BK PTB PLASTER MOLDED	PRXOVR	DEF					NA	NA	NA	Y
L5510	PREP BK PTB PLASTER MOLDED	MAXFEE	DEF					1377.79	1/1/2010	12/31/2299	Y
L5535	PREP BK PTB OPEN END SOCKET	PRXOVR	DEF					NA	NA	NA	S
L5535	PREP BK PTB OPEN END SOCKET	MAXFEE	DEF					1513.49	1/1/2010	12/31/2299	S
L5540	PREP BK PTB LAMINATED SOCKET	PRXOVR	DEF					NA	NA	NA	S
L5540	PREP BK PTB LAMINATED SOCKET	MAXFEE	DEF					1603.02	1/1/2010	12/31/2299	S
L5560	PREP AK ISCHIAL PLAST MOLDED	PRXOVR	DEF					NA	NA	NA	Y
L5560	PREP AK ISCHIAL PLAST MOLDED	MAXFEE	DEF					1826.51	1/1/2010	12/31/2299	Y
L5580	PREP AK ISCHIAL THERMO MOLD	PRXOVR	DEF					NA	NA	NA	S
L5580	PREP AK ISCHIAL THERMO MOLD	MAXFEE	DEF					2200.15	1/1/2010	12/31/2299	S
L5585	PREP AK ISCHIAL OPEN END	PRXOVR	DEF					NA	NA	NA	Y
L5585	PREP AK ISCHIAL OPEN END	MAXFEE	DEF					2576.61	1/1/2010	12/31/2299	Y
L5590	PREP AK ISCHIAL LAMINATED	PRXOVR	DEF					NA	NA	NA	S
L5590	PREP AK ISCHIAL LAMINATED	MAXFEE	DEF					2293.95	1/1/2010	12/31/2299	S
L5595	HIP DISARTIC SACH THERMOPLS	PRXOVR	DEF					NA	NA	NA	Y
L5595	HIP DISARTIC SACH THERMOPLS	MAXFEE	DEF					2933.02	1/1/2010	12/31/2299	Y
L5600	HIP DISART SACH LAMINAT MOLD	PRXOVR	DEF					NA	NA	NA	Y
L5600	HIP DISART SACH LAMINAT MOLD	MAXFEE	DEF					3338.21	1/1/2010	12/31/2299	Y
L5610	ABOVE KNEE HYDRACADENCE	PRXOVR	DEF					NA	NA	NA	Y
L5610	ABOVE KNEE HYDRACADENCE	MAXFEE	DEF					1610	1/1/2010	12/31/2299	Y
L5611	AK 4 BAR LINK W/FRIC SWING	PRXOVR	DEF					NA	NA	NA	S
L5611	AK 4 BAR LINK W/FRIC SWING	MAXFEE	DEF					1025.44	1/1/2010	12/31/2299	S
L5613	AK 4 BAR LING W/HYDRAUL SWIG	PRXOVR	DEF					NA	NA	NA	S
L5613	AK 4 BAR LING W/HYDRAUL SWIG	MAXFEE	DEF					1559.75	1/1/2010	12/31/2299	S
L5614	4-BAR LINK ABOVE KNEE W/SWNG	PRXOVR	DEF					NA	NA	NA	S
L5614	4-BAR LINK ABOVE KNEE W/SWNG	MAXFEE	DEF					1080.22	1/1/2010	12/31/2299	S
L5616	AK UNIV MULTIPLEX SYS FRICT	PRXOVR	DEF					NA	NA	NA	S
L5616	AK UNIV MULTIPLEX SYS FRICT	MAXFEE	DEF					940.49	1/1/2010	12/31/2299	S
L5617	AK/BK SELF-ALIGNING UNIT EA	PRXOVR	DEF					NA	NA	NA	S
L5617	AK/BK SELF-ALIGNING UNIT EA	MAXFEE	DEF					358.18	1/1/2010	12/31/2299	S
L5618	TEST SOCKET SYMES	PRXOVR	DEF					NA	NA	NA	S
L5618	TEST SOCKET SYMES	MAXFEE	DEF					213.89	1/1/2010	12/31/2299	S
L5620	TEST SOCKET BELOW KNEE	PRXOVR	DEF					NA	NA	NA	S
L5620	TEST SOCKET BELOW KNEE	MAXFEE	DEF					189.77	1/1/2010	12/31/2299	S
L5622	TEST SOCKET KNEE DISARTICULA	PRXOVR	DEF					NA	NA	NA	S
L5622	TEST SOCKET KNEE DISARTICULA	MAXFEE	DEF					255.66	1/1/2010	12/31/2299	S
L5624	TEST SOCKET ABOVE KNEE	PRXOVR	DEF					NA	NA	NA	S
L5624	TEST SOCKET ABOVE KNEE	MAXFEE	DEF					255.59	1/1/2010	12/31/2299	S
L5626	TEST SOCKET HIP DISARTICULAT	PRXOVR	DEF					NA	NA	NA	S
L5626	TEST SOCKET HIP DISARTICULAT	MAXFEE	DEF					404.60	1/1/2010	12/31/2299	S
L5628	TEST SOCKET HEMIPELVECTOMY	PRXOVR	DEF					NA	NA	NA	S
L5628	TEST SOCKET HEMIPELVECTOMY	MAXFEE	DEF					409.72	1/1/2010	12/31/2299	S
L5629	BELOW KNEE ACRYLIC SOCKET	PRXOVR	DEF					NA	NA	NA	S
L5629	BELOW KNEE ACRYLIC SOCKET	MAXFEE	DEF					202.26	1/1/2010	12/31/2299	S
L5630	SYME TYP EXPANDABL WALL SCKT	PRXOVR	DEF					NA	NA	NA	S
L5630	SYME TYP EXPANDABL WALL SCKT	MAXFEE	DEF					351.43	1/1/2010	12/31/2299	S
L5631	AK/KNEE DISARTIC ACRYLIC SOC	PRXOVR	DEF					NA	NA	NA	S
L5631	AK/KNEE DISARTIC ACRYLIC SOC	MAXFEE	DEF					279.65	1/1/2010	12/31/2299	S
L5632	SYMES TYPE PTB BRIM DESIGN S	PRXOVR	DEF					NA	NA	NA	S
L5632	SYMES TYPE PTB BRIM DESIGN S	MAXFEE	DEF					172.35	1/1/2010	12/31/2299	S
L5634	SYMES TYPE POSTER OPENING SO	PRXOVR	DEF					NA	NA	NA	S
L5634	SYMES TYPE POSTER OPENING SO	MAXFEE	DEF					215.55	1/1/2010	12/31/2299	S
L5636	SYMES TYPE MEDIAL OPENING SO	PRXOVR	DEF					NA	NA	NA	S
L5636	SYMES TYPE MEDIAL OPENING SO	MAXFEE	DEF					164.75	1/1/2010	12/31/2299	S
L5637	BELOW KNEE TOTAL CONTACT	PRXOVR	DEF					NA	NA	NA	S
L5637	BELOW KNEE TOTAL CONTACT	MAXFEE	DEF					245.16	1/1/2010	12/31/2299	S
L5638	BELOW KNEE LEATHER SOCKET	PRXOVR	DEF					NA	NA	NA	Y
L5638	BELOW KNEE LEATHER SOCKET	MAXFEE	DEF					412.99	1/1/2010	12/31/2299	Y
L5639	BELOW KNEE WOOD SOCKET	PRXOVR	DEF					NA	NA	NA	Y
L5639	BELOW KNEE WOOD SOCKET	MAXFEE	DEF					713.58	1/1/2010	12/31/2299	Y
L5640	KNEE DISARTICULAT LEATHER SO	PRXOVR	DEF					NA	NA	NA	S
L5640	KNEE DISARTICULAT LEATHER SO	MAXFEE	DEF					469.04	1/1/2010	12/31/2299	S
L5642	ABOVE KNEE LEATHER SOCKET	PRXOVR	DEF					NA	NA	NA	S
L5642	ABOVE KNEE LEATHER SOCKET	MAXFEE	DEF					434.79	1/1/2010	12/31/2299	S
L5643	HIP FLEX INNER SOCKET EXT FR	PRXOVR	DEF					NA	NA	NA	S
L5643	HIP FLEX INNER SOCKET EXT FR	MAXFEE	DEF					1282.40	1/1/2010	12/31/2299	S
L5645	BK FLEX INNER SOCKET EXT FRA	PRXOVR	DEF					NA	NA	NA	S
L5645	BK FLEX INNER SOCKET EXT FRA	MAXFEE	DEF					623.61	1/1/2010	12/31/2299	S
L5646	BELOW KNEE CUSHION SOCKET	PRXOVR	DEF					NA	NA	NA	Y
L5646	BELOW KNEE CUSHION SOCKET	MAXFEE	DEF					398.77	1/1/2010	12/31/2299	Y
L5647	BELOW KNEE SUCTION SOCKET	PRXOVR	DEF					NA	NA	NA	S
L5647	BELOW KNEE SUCTION SOCKET	MAXFEE	DEF					506.27	1/1/2010	12/31/2299	S
L5648	ABOVE KNEE CUSHION SOCKET	PRXOVR	DEF					NA	NA	NA	Y
L5648	ABOVE KNEE CUSHION SOCKET	MAXFEE	DEF					475.45	1/1/2010	12/31/2299	Y
L5649	ISCH CONTAINMT/NARROW M-L SO	PRXOVR	DEF					NA	NA	NA	S
L5649	ISCH CONTAINMT/NARROW M-L SO	MAXFEE	DEF					1569.04	1/1/2010	12/31/2299	S
L5650	TOT CONTACT AK/KNEE DISART S	PRXOVR	DEF					NA	NA	NA	S
L5650	TOT CONTACT AK/KNEE DISART S	MAXFEE	DEF					310.70	1/1/2010	12/31/2299	S
L5651	AK FLEX INNER SOCKET EXT FRA	PRXOVR	DEF					NA	NA	NA	S
L5651	AK FLEX INNER SOCKET EXT FRA	MAXFEE	DEF					910.35	1/1/2010	12/31/2299	S
L5652	SUCTION SUSP AK/KNEE DISART	PRXOVR	DEF					NA	NA	NA	S
L5652	SUCTION SUSP AK/KNEE DISART	MAXFEE	DEF					277.48	1/1/2010	12/31/2299	S
L5653	KNEE DISART EXPAND WALL SOCK	PRXOVR	DEF					NA	NA	NA	S
L5653	KNEE DISART EXPAND WALL SOCK	MAXFEE	DEF					432.93	1/1/2010	12/31/2299	S
L5654	SOCKET INSERT SYMES	PRXOVR	DEF					NA	NA	NA	S
L5654	SOCKET INSERT SYMES	MAXFEE	DEF					250.96	1/1/2010	12/31/2299	S
L5655	SOCKET INSERT BELOW KNEE	PRXOVR	DEF					NA	NA	NA	S
L5655	SOCKET INSERT BELOW KNEE	MAXFEE	DEF					181.21	1/1/2010	12/31/2299	S
L5656	SOCKET INSERT KNEE ARTICULAT	PRXOVR	DEF					NA	NA	NA	S
L5656	SOCKET INSERT KNEE ARTICULAT	MAXFEE	DEF					275.31	1/1/2010	12/31/2299	S
L5658	SOCKET INSERT ABOVE KNEE	PRXOVR	DEF					NA	NA	NA	S
L5658	SOCKET INSERT ABOVE KNEE	MAXFEE	DEF					290.59	1/1/2010	12/31/2299	S
L5660	SOCK INSRT SYME SILICONE GEL	PRXOVR	DEF					NA	NA	NA	Y
L5660	SOCK INSRT SYME SILICONE GEL	MAXFEE	DEF					0	4/1/2005	12/31/2299	Y
L5661	MULTI-DUROMETER SYMES	PRXOVR	DEF					NA	NA	NA	Y
L5661	MULTI-DUROMETER SYMES	MAXFEE	DEF					416.91	1/1/2010	12/31/2299	Y
L5662	SOCKET INSERT BK SILICONE GE	PRXOVR	DEF					NA	NA	NA	Y
L5662	SOCKET INSERT BK SILICONE GE	MAXFEE	DEF					0	4/1/2005	12/31/2299	Y
L5663	SOCK KNEE DISARTIC SILICONE	PRXOVR	DEF					NA	NA	NA	Y
L5663	SOCK KNEE DISARTIC SILICONE	MAXFEE	DEF					0	4/1/2005	12/31/2299	Y
L5664	SOCKET INSERT AK SILICONE GE	PRXOVR	DEF					NA	NA	NA	Y
L5664	SOCKET INSERT AK SILICONE GE	MAXFEE	DEF					0	4/1/2005	12/31/2299	Y
L5665	MULTI-DUROMETER BELOW KNEE	PRXOVR	DEF					NA	NA	NA	S
L5665	MULTI-DUROMETER BELOW KNEE	MAXFEE	DEF					370.67	1/1/2010	12/31/2299	S
L5666	BELOW KNEE CUFF SUSPENSION	PRXOVR	DEF					NA	NA	NA	S
L5666	BELOW KNEE CUFF SUSPENSION	MAXFEE	DEF					49.07	1/1/2010	12/31/2299	S
L5668	BK MOLDED DISTAL CUSHION	PRXOVR	DEF					NA	NA	NA	S
L5668	BK MOLDED DISTAL CUSHION	MAXFEE	DEF					73.12	1/1/2010	12/31/2299	S
L5670	BK MOLDED SUPRACONDYLAR SUSP	PRXOVR	DEF					NA	NA	NA	S
L5670	BK MOLDED SUPRACONDYLAR SUSP	MAXFEE	DEF					172.71	1/1/2010	12/31/2299	S
L5671	BK/AK LOCKING MECHANISM	PRXOVR	DEF					NA	NA	NA	S
L5671	BK/AK LOCKING MECHANISM	MAXFEE	DEF					358.93	4/1/2009	12/31/2299	S
L5672	BK REMOVABLE MEDIAL BRIM SUS	PRXOVR	DEF					NA	NA	NA	S
L5672	BK REMOVABLE MEDIAL BRIM SUS	MAXFEE	DEF					228.53	1/1/2010	12/31/2299	S
L5673	SOCKET INSERT W LOCK MECH	PRXOVR	DEF					NA	NA	NA	Y
L5673	SOCKET INSERT W LOCK MECH	MAXFEE	DEF					745	7/1/2018	12/31/2299	Y
L5674	BK SUSPENSION SLEEVE	PRXOVR	DEF					NA	NA	NA	N
L5674	BK SUSPENSION SLEEVE	MAXFEE	DEF					NA			N
L5675	BK HEAVY DUTY SUSP SLEEVE	PRXOVR	DEF					NA	NA	NA	N
L5675	BK HEAVY DUTY SUSP SLEEVE	MAXFEE	DEF					NA			N
L5676	BK KNEE JOINTS SINGLE AXIS P	PRXOVR	DEF					NA	NA	NA	S
L5676	BK KNEE JOINTS SINGLE AXIS P	MAXFEE	DEF					230.63	1/1/2010	12/31/2299	S
L5677	BK KNEE JOINTS POLYCENTRIC P	PRXOVR	DEF					NA	NA	NA	S
L5677	BK KNEE JOINTS POLYCENTRIC P	MAXFEE	DEF					353.23	1/1/2010	12/31/2299	S
L5678	BK JOINT COVERS PAIR	PRXOVR	DEF					NA	NA	NA	S
L5678	BK JOINT COVERS PAIR	MAXFEE	DEF					25.27	1/1/2010	12/31/2299	S
L5679	SOCKET INSERT W/O LOCK MECH	PRXOVR	DEF					NA	NA	NA	Y
L5679	SOCKET INSERT W/O LOCK MECH	MAXFEE	DEF					625	7/1/2018	12/31/2299	Y
L5680	BK THIGH LACER NON-MOLDED	PRXOVR	DEF					NA	NA	NA	S
L5680	BK THIGH LACER NON-MOLDED	MAXFEE	DEF					193.72	1/1/2010	12/31/2299	S
L5681	INTL CUSTM CONG/LATYP INSERT	PRXOVR	DEF					NA	NA	NA	S
L5681	INTL CUSTM CONG/LATYP INSERT	MAXFEE	DEF					1029.21	1/1/2010	12/31/2299	S
L5682	BK THIGH LACER GLUT/ISCHIA M	PRXOVR	DEF					NA	NA	NA	S
L5682	BK THIGH LACER GLUT/ISCHIA M	MAXFEE	DEF					398.03	1/1/2010	12/31/2299	S
L5683	INITIAL CUSTOM SOCKET INSERT	PRXOVR	DEF					NA	NA	NA	S
L5683	INITIAL CUSTOM SOCKET INSERT	MAXFEE	DEF					1029.21	1/1/2010	12/31/2299	S
L5684	BK FORK STRAP	PRXOVR	DEF					NA	NA	NA	S
L5684	BK FORK STRAP	MAXFEE	DEF					30.63	1/1/2010	12/31/2299	S
L5685	BELOW KNEE SUS/SEAL SLEEVE	PRXOVR	DEF					NA	NA	NA	N
L5685	BELOW KNEE SUS/SEAL SLEEVE	MAXFEE	DEF					55.13	1/1/2010	12/31/2299	N
L5686	BK BACK CHECK	PRXOVR	DEF					NA	NA	NA	N
L5686	BK BACK CHECK	MAXFEE	DEF					36.84	1/1/2010	12/31/2299	N
L5688	BK WAIST BELT WEBBING	PRXOVR	DEF					NA	NA	NA	N
L5688	BK WAIST BELT WEBBING	MAXFEE	DEF					39.13	1/1/2010	12/31/2299	N
L5690	BK WAIST BELT PADDED AND LIN	PRXOVR	DEF					NA	NA	NA	N
L5690	BK WAIST BELT PADDED AND LIN	MAXFEE	DEF					79.87	1/1/2010	12/31/2299	N
L5692	AK PELVIC CONTROL BELT LIGHT	PRXOVR	DEF					NA	NA	NA	N
L5692	AK PELVIC CONTROL BELT LIGHT	MAXFEE	DEF					84.57	1/1/2010	12/31/2299	N
L5694	AK PELVIC CONTROL BELT PAD/L	PRXOVR	DEF					NA	NA	NA	N
L5694	AK PELVIC CONTROL BELT PAD/L	MAXFEE	DEF					115.47	1/1/2010	12/31/2299	N
L5695	AK SLEEVE SUSP NEOPRENE/EQUA	PRXOVR	DEF					NA	NA	NA	S
L5695	AK SLEEVE SUSP NEOPRENE/EQUA	MAXFEE	DEF					103.79	1/1/2010	12/31/2299	S
L5696	AK/KNEE DISARTIC PELVIC JOIN	PRXOVR	DEF					NA	NA	NA	S
L5696	AK/KNEE DISARTIC PELVIC JOIN	MAXFEE	DEF					125.38	1/1/2010	12/31/2299	S
L5697	AK/KNEE DISARTIC PELVIC BAND	PRXOVR	DEF					NA	NA	NA	S
L5697	AK/KNEE DISARTIC PELVIC BAND	MAXFEE	DEF					59.55	1/1/2010	12/31/2299	S
L5698	AK/KNEE DISARTIC SILESIAN BA	PRXOVR	DEF					NA	NA	NA	S
L5698	AK/KNEE DISARTIC SILESIAN BA	MAXFEE	DEF					76.38	1/1/2010	12/31/2299	S
L5699	SHOULDER HARNESS	PRXOVR	DEF					NA	NA	NA	S
L5699	SHOULDER HARNESS	MAXFEE	DEF					130.54	1/1/2010	12/31/2299	S
L5700	REPLACE SOCKET BELOW KNEE	PRXOVR	DEF					NA	NA	NA	Y
L5700	REPLACE SOCKET BELOW KNEE	MAXFEE	DEF					1963.56	1/1/2010	12/31/2299	Y
L5701	REPLACE SOCKET ABOVE KNEE	PRXOVR	DEF					NA	NA	NA	Y
L5701	REPLACE SOCKET ABOVE KNEE	MAXFEE	DEF					2435.96	1/1/2010	12/31/2299	Y
L5702	REPLACE SOCKET HIP	PRXOVR	DEF					NA	NA	NA	S
L5702	REPLACE SOCKET HIP	MAXFEE	DEF					3070.16	1/1/2010	12/31/2299	S
L5704	CUSTOM SHAPE COVER BK	PRXOVR	DEF					NA	NA	NA	S
L5704	CUSTOM SHAPE COVER BK	MAXFEE	DEF					400.36	1/1/2010	12/31/2299	S
L5705	CUSTOM SHAPE COVER AK	PRXOVR	DEF					NA	NA	NA	S
L5705	CUSTOM SHAPE COVER AK	MAXFEE	DEF					733.99	1/1/2010	12/31/2299	S
L5706	CUSTOM SHAPE CVR KNEE DISART	PRXOVR	DEF					NA	NA	NA	S
L5706	CUSTOM SHAPE CVR KNEE DISART	MAXFEE	DEF					715.93	1/1/2010	12/31/2299	S
L5707	CUSTOM SHAPE CVR HIP DISART	PRXOVR	DEF					NA	NA	NA	S
L5707	CUSTOM SHAPE CVR HIP DISART	MAXFEE	DEF					961.85	1/1/2010	12/31/2299	S
L5710	KNE-SHIN EXO SNG AXI MNL LOC	PRXOVR	DEF					NA	NA	NA	Y
L5710	KNE-SHIN EXO SNG AXI MNL LOC	MAXFEE	DEF					228.91	1/1/2010	12/31/2299	Y
L5711	KNEE-SHIN EXO MNL LOCK ULTRA	PRXOVR	DEF					NA	NA	NA	Y
L5711	KNEE-SHIN EXO MNL LOCK ULTRA	MAXFEE	DEF					384.17	1/1/2010	12/31/2299	Y
L5712	KNEE-SHIN EXO FRICT SWG & ST	PRXOVR	DEF					NA	NA	NA	S
L5712	KNEE-SHIN EXO FRICT SWG & ST	MAXFEE	DEF					274.25	1/1/2010	12/31/2299	S
L5714	KNEE-SHIN EXO VARIABLE FRICT	PRXOVR	DEF					NA	NA	NA	Y
L5714	KNEE-SHIN EXO VARIABLE FRICT	MAXFEE	DEF					279.04	1/1/2010	12/31/2299	Y
L5716	KNEE-SHIN EXO MECH STANCE PH	PRXOVR	DEF					NA	NA	NA	S
L5716	KNEE-SHIN EXO MECH STANCE PH	MAXFEE	DEF					551.77	1/1/2010	12/31/2299	S
L5718	KNEE-SHIN EXO FRCT SWG & STA	PRXOVR	DEF					NA	NA	NA	Y
L5718	KNEE-SHIN EXO FRCT SWG & STA	MAXFEE	DEF					590.02	1/1/2010	12/31/2299	Y
L5722	KNEE-SHIN PNEUM SWG FRCT EXO	PRXOVR	DEF					NA	NA	NA	Y
L5722	KNEE-SHIN PNEUM SWG FRCT EXO	MAXFEE	DEF					717.50	1/1/2010	12/31/2299	Y
L5724	KNEE-SHIN EXO FLUID SWING PH	PRXOVR	DEF					NA	NA	NA	Y
L5724	KNEE-SHIN EXO FLUID SWING PH	MAXFEE	DEF					1105.92	1/1/2010	12/31/2299	Y
L5728	KNEE-SHIN FLUID SWG & STANCE	PRXOVR	DEF					NA	NA	NA	S
L5728	KNEE-SHIN FLUID SWG & STANCE	MAXFEE	DEF					1542.94	1/1/2010	12/31/2299	S
L5785	EXOSKELETAL BK ULTRALT MATER	PRXOVR	DEF					NA	NA	NA	S
L5785	EXOSKELETAL BK ULTRALT MATER	MAXFEE	DEF					330.67	1/1/2010	12/31/2299	S
L5790	EXOSKELETAL AK ULTRA-LIGHT M	PRXOVR	DEF					NA	NA	NA	S
L5790	EXOSKELETAL AK ULTRA-LIGHT M	MAXFEE	DEF					477.25	1/1/2010	12/31/2299	S
L5795	EXOSKEL HIP ULTRA-LIGHT MATE	PRXOVR	DEF					NA	NA	NA	S
L5795	EXOSKEL HIP ULTRA-LIGHT MATE	MAXFEE	DEF					683.36	1/1/2010	12/31/2299	S
L5810	ENDOSKEL KNEE-SHIN MNL LOCK	PRXOVR	DEF					NA	NA	NA	S
L5810	ENDOSKEL KNEE-SHIN MNL LOCK	MAXFEE	DEF					364.10	1/1/2010	12/31/2299	S
L5811	ENDO KNEE-SHIN MNL LCK ULTRA	PRXOVR	DEF					NA	NA	NA	S
L5811	ENDO KNEE-SHIN MNL LCK ULTRA	MAXFEE	DEF					502.44	1/1/2010	12/31/2299	S
L5812	ENDO KNEE-SHIN FRCT SWG & ST	PRXOVR	DEF					NA	NA	NA	S
L5812	ENDO KNEE-SHIN FRCT SWG & ST	MAXFEE	DEF					378.10	1/1/2010	12/31/2299	S
L5814	ENDO KNEE-SHIN HYDRAL SWG PH	PRXOVR	DEF					NA	NA	NA	S
L5814	ENDO KNEE-SHIN HYDRAL SWG PH	MAXFEE	DEF					2377.43	1/1/2010	12/31/2299	S
L5816	ENDO KNEE-SHIN POLYC MCH STA	PRXOVR	DEF					NA	NA	NA	S
L5816	ENDO KNEE-SHIN POLYC MCH STA	MAXFEE	DEF					541.27	1/1/2010	12/31/2299	S
L5818	ENDO KNEE-SHIN FRCT SWG & ST	PRXOVR	DEF					NA	NA	NA	S
L5818	ENDO KNEE-SHIN FRCT SWG & ST	MAXFEE	DEF					611.21	1/1/2010	12/31/2299	S
L5822	ENDO KNEE-SHIN PNEUM SWG FRC	PRXOVR	DEF					NA	NA	NA	S
L5822	ENDO KNEE-SHIN PNEUM SWG FRC	MAXFEE	DEF					1121.22	1/1/2010	12/31/2299	S
L5824	ENDO KNEE-SHIN FLUID SWING P	PRXOVR	DEF					NA	NA	NA	Y
L5824	ENDO KNEE-SHIN FLUID SWING P	MAXFEE	DEF					1059.89	1/1/2010	12/31/2299	Y
L5826	MINIATURE KNEE JOINT	PRXOVR	DEF					NA	NA	NA	S
L5826	MINIATURE KNEE JOINT	MAXFEE	DEF					1999.12	1/1/2010	12/31/2299	S
L5828	ENDO KNEE-SHIN FLUID SWG/STA	PRXOVR	DEF					NA	NA	NA	S
L5828	ENDO KNEE-SHIN FLUID SWG/STA	MAXFEE	DEF					1886.34	1/1/2010	12/31/2299	S
L5830	ENDO KNEE-SHIN PNEUM/SWG PHA	PRXOVR	DEF					NA	NA	NA	S
L5830	ENDO KNEE-SHIN PNEUM/SWG PHA	MAXFEE	DEF					1271.88	1/1/2010	12/31/2299	S
L5840	MULTI-AXIAL KNEE/SHIN SYSTEM	PRXOVR	DEF					NA	NA	NA	S
L5840	MULTI-AXIAL KNEE/SHIN SYSTEM	MAXFEE	DEF					2496.40	1/1/2010	12/31/2299	S
L5845	KNEE-SHIN SYS STANCE FLEXION	PRXOVR	DEF					NA	NA	NA	S
L5845	KNEE-SHIN SYS STANCE FLEXION	MAXFEE	DEF					1147.38	1/1/2010	12/31/2299	S
L5846	KNEE-SHIN SYS MICROPROCESSOR	PRXOVR	DEF					NA	NA	NA	Y
L5846	KNEE-SHIN SYS MICROPROCESSOR	MAXFEE	DEF					NA			Y
L5850	ENDO AK/HIP KNEE EXTENS ASSI	PRXOVR	DEF					NA	NA	NA	S
L5850	ENDO AK/HIP KNEE EXTENS ASSI	MAXFEE	DEF					81.42	1/1/2010	12/31/2299	S
L5855	MECH HIP EXTENSION ASSIST	PRXOVR	DEF					NA	NA	NA	S
L5855	MECH HIP EXTENSION ASSIST	MAXFEE	DEF					196.55	1/1/2010	12/31/2299	S
L5857	ELEC KNEE-SHIN SWING ONLY	PRXOVR	DEF					NA	NA	NA	Y
L5857	ELEC KNEE-SHIN SWING ONLY	MAXFEE	DEF					3470.01	1/1/2010	12/31/2299	Y
L5910	ENDO BELOW KNEE ALIGNABLE SY	PRXOVR	DEF					NA	NA	NA	Y
L5910	ENDO BELOW KNEE ALIGNABLE SY	MAXFEE	DEF					230.50	1/1/2010	12/31/2299	Y
L5920	ENDO AK/HIP ALIGNABLE SYSTEM	PRXOVR	DEF					NA	NA	NA	S
L5920	ENDO AK/HIP ALIGNABLE SYSTEM	MAXFEE	DEF					337.70	1/1/2010	12/31/2299	S
L5925	ABOVE KNEE MANUAL LOCK	PRXOVR	DEF					NA	NA	NA	S
L5925	ABOVE KNEE MANUAL LOCK	MAXFEE	DEF					213.86	1/1/2010	12/31/2299	S
L5930	HIGH ACTIVITY KNEE FRAME	PRXOVR	DEF					NA	NA	NA	Y
L5930	HIGH ACTIVITY KNEE FRAME	MAXFEE	DEF					2154.68	1/1/2010	12/31/2299	Y
L5940	ENDO BK ULTRA-LIGHT MATERIAL	PRXOVR	DEF					NA	NA	NA	S
L5940	ENDO BK ULTRA-LIGHT MATERIAL	MAXFEE	DEF					319.25	1/1/2010	12/31/2299	S
L5950	ENDO AK ULTRA-LIGHT MATERIAL	PRXOVR	DEF					NA	NA	NA	S
L5950	ENDO AK ULTRA-LIGHT MATERIAL	MAXFEE	DEF					495.17	1/1/2010	12/31/2299	S
L5960	ENDO HIP ULTRA-LIGHT MATERIA	PRXOVR	DEF					NA	NA	NA	S
L5960	ENDO HIP ULTRA-LIGHT MATERIA	MAXFEE	DEF					740.39	1/1/2010	12/31/2299	S
L5961	ENDO POLY HIP; PNEU/HYD/ROT	PRXOVR	DEF					NA	NA	NA	Y
L5961	ENDO POLY HIP; PNEU/HYD/ROT	MAXFEE	DEF					3835	7/1/2021	12/31/2299	Y
L5962	BELOW KNEE FLEX COVER SYSTEM	PRXOVR	DEF					NA	NA	NA	S
L5962	BELOW KNEE FLEX COVER SYSTEM	MAXFEE	DEF					374.10	1/1/2010	12/31/2299	S
L5964	ABOVE KNEE FLEX COVER SYSTEM	PRXOVR	DEF					NA	NA	NA	S
L5964	ABOVE KNEE FLEX COVER SYSTEM	MAXFEE	DEF					717.60	1/1/2010	12/31/2299	S
L5966	HIP FLEXIBLE COVER SYSTEM	PRXOVR	DEF					NA	NA	NA	S
L5966	HIP FLEXIBLE COVER SYSTEM	MAXFEE	DEF					924.38	1/1/2010	12/31/2299	S
L5968	MULTIAXIAL ANKLE W DORSIFLEX	PRXOVR	DEF					NA	NA	NA	Y
L5968	MULTIAXIAL ANKLE W DORSIFLEX	MAXFEE	DEF					2920	7/1/2021	12/31/2299	Y
L5970	FOOT EXTERNAL KEEL SACH FOOT	PRXOVR	DEF					NA	NA	NA	S
L5970	FOOT EXTERNAL KEEL SACH FOOT	MAXFEE	DEF					139.06	1/1/2010	12/31/2299	S
L5972	FLEXIBLE KEEL FOOT	PRXOVR	DEF					NA	NA	NA	S
L5972	FLEXIBLE KEEL FOOT	MAXFEE	DEF					253.31	1/1/2010	12/31/2299	S
L5974	FOOT SINGLE AXIS ANKLE/FOOT	PRXOVR	DEF					NA	NA	NA	S
L5974	FOOT SINGLE AXIS ANKLE/FOOT	MAXFEE	DEF					148.31	1/1/2010	12/31/2299	S
L5975	COMBO ANKLE/FOOT PROSTHESIS	PRXOVR	DEF					NA	NA	NA	S
L5975	COMBO ANKLE/FOOT PROSTHESIS	MAXFEE	DEF					345.64	1/1/2010	12/31/2299	S
L5976	ENERGY STORING FOOT	PRXOVR	DEF					NA	NA	NA	S
L5976	ENERGY STORING FOOT	MAXFEE	DEF					376.20	1/1/2010	12/31/2299	S
L5978	FT PROSTH MULTIAXIAL ANKL/FT	PRXOVR	DEF					NA	NA	NA	S
L5978	FT PROSTH MULTIAXIAL ANKL/FT	MAXFEE	DEF					199.35	1/1/2010	12/31/2299	S
L5979	MULTI-AXIAL ANKLE/FT PROSTH	PRXOVR	DEF					NA	NA	NA	S
L5979	MULTI-AXIAL ANKLE/FT PROSTH	MAXFEE	DEF					1596.06	1/1/2010	12/31/2299	S
L5980	FLEX FOOT SYSTEM	PRXOVR	DEF					NA	NA	NA	S
L5980	FLEX FOOT SYSTEM	MAXFEE	DEF					2431.74	1/1/2010	12/31/2299	S
L5981	FLEX-WALK SYS LOW EXT PROSTH	PRXOVR	DEF					NA	NA	NA	S
L5981	FLEX-WALK SYS LOW EXT PROSTH	MAXFEE	DEF					2184.31	1/1/2010	12/31/2299	S
L5982	EXOSKELETAL AXIAL ROTATION U	PRXOVR	DEF					NA	NA	NA	S
L5982	EXOSKELETAL AXIAL ROTATION U	MAXFEE	DEF					410.34	1/1/2010	12/31/2299	S
L5984	ENDOSKELETAL AXIAL ROTATION	PRXOVR	DEF					NA	NA	NA	S
L5984	ENDOSKELETAL AXIAL ROTATION	MAXFEE	DEF					411.61	1/1/2010	12/31/2299	S
L5985	LWR EXT DYNAMIC PROSTH PYLON	PRXOVR	DEF					NA	NA	NA	S
L5985	LWR EXT DYNAMIC PROSTH PYLON	MAXFEE	DEF					180.77	1/1/2010	12/31/2299	S
L5986	MULTI-AXIAL ROTATION UNIT	PRXOVR	DEF					NA	NA	NA	S
L5986	MULTI-AXIAL ROTATION UNIT	MAXFEE	DEF					496.50	1/1/2010	12/31/2299	S
L5987	SHANK FT W VERT LOAD PYLON	PRXOVR	DEF					NA	NA	NA	Y
L5987	SHANK FT W VERT LOAD PYLON	MAXFEE	DEF					4605.07	1/1/2010	12/31/2299	Y
L5988	VERTICAL SHOCK REDUCING PYLO	PRXOVR	DEF					NA	NA	NA	S
L5988	VERTICAL SHOCK REDUCING PYLO	MAXFEE	DEF					1489.41	1/1/2010	12/31/2299	S
L5991	LOW PROS EXT OSSEO CONNECTOR	PRXOVR	DEF					NA	NA	NA	S
L5991	LOW PROS EXT OSSEO CONNECTOR	MAXFEE	DEF					8775.50	10/1/2023	12/31/2299	S
L5999	LOWR EXTREMITY PROSTHES NOS	PRXOVR	DEF					NA	NA	NA	Y
L5999	LOWR EXTREMITY PROSTHES NOS	PADOLR	DEF					NA	NA	NA	Y
L6000	PART HAND THUMB REM	PRXOVR	DEF					NA	NA	NA	Y
L6000	PART HAND THUMB REM	MAXFEE	DEF					1127.52	1/1/2010	12/31/2299	Y
L6010	PART HAND LITTLE/RING	PRXOVR	DEF					NA	NA	NA	Y
L6010	PART HAND LITTLE/RING	MAXFEE	DEF					1254.75	1/1/2010	12/31/2299	Y
L6020	PART HAND NO FINGERS	PRXOVR	DEF					NA	NA	NA	S
L6020	PART HAND NO FINGERS	MAXFEE	DEF					1169.86	1/1/2010	12/31/2299	S
L6050	WRST MLD SCK FLX HNG TRI PAD	PRXOVR	DEF					NA	NA	NA	S
L6050	WRST MLD SCK FLX HNG TRI PAD	MAXFEE	DEF					1591.24	1/1/2010	12/31/2299	S
L6055	WRST MOLD SOCK W/EXP INTERFA	PRXOVR	DEF					NA	NA	NA	Y
L6055	WRST MOLD SOCK W/EXP INTERFA	MAXFEE	DEF					2029.71	1/1/2010	12/31/2299	Y
L6100	ELB MOLD SOCK FLEX HINGE PAD	PRXOVR	DEF					NA	NA	NA	S
L6100	ELB MOLD SOCK FLEX HINGE PAD	MAXFEE	DEF					1610.29	1/1/2010	12/31/2299	S
L6110	ELBOW MOLD SOCK SUSPENSION T	PRXOVR	DEF					NA	NA	NA	S
L6110	ELBOW MOLD SOCK SUSPENSION T	MAXFEE	DEF					1703.56	1/1/2010	12/31/2299	S
L6120	ELBOW MOLD DOUB SPLT SOC STE	PRXOVR	DEF					NA	NA	NA	S
L6120	ELBOW MOLD DOUB SPLT SOC STE	MAXFEE	DEF					1926.74	1/1/2010	12/31/2299	S
L6130	ELBOW STUMP ACTIVATED LOCK H	PRXOVR	DEF					NA	NA	NA	Y
L6130	ELBOW STUMP ACTIVATED LOCK H	MAXFEE	DEF					2032.76	1/1/2010	12/31/2299	Y
L6200	ELBOW MOLD OUTSID LOCK HINGE	PRXOVR	DEF					NA	NA	NA	Y
L6200	ELBOW MOLD OUTSID LOCK HINGE	MAXFEE	DEF					2093.98	1/1/2010	12/31/2299	Y
L6205	ELBOW MOLDED W/ EXPAND INTER	PRXOVR	DEF					NA	NA	NA	Y
L6205	ELBOW MOLDED W/ EXPAND INTER	MAXFEE	DEF					2888.62	1/1/2010	12/31/2299	Y
L6250	ELBOW INTER LOC ELBOW FORARM	PRXOVR	DEF					NA	NA	NA	S
L6250	ELBOW INTER LOC ELBOW FORARM	MAXFEE	DEF					2060.12	1/1/2010	12/31/2299	S
L6300	SHLDER DISART INT LOCK ELBOW	PRXOVR	DEF					NA	NA	NA	Y
L6300	SHLDER DISART INT LOCK ELBOW	MAXFEE	DEF					2841.46	1/1/2010	12/31/2299	Y
L6310	SHOULDER PASSIVE RESTOR COMP	PRXOVR	DEF					NA	NA	NA	Y
L6310	SHOULDER PASSIVE RESTOR COMP	MAXFEE	DEF					2575.16	1/1/2010	12/31/2299	Y
L6320	SHOULDER PASSIVE RESTOR CAP	PRXOVR	DEF					NA	NA	NA	Y
L6320	SHOULDER PASSIVE RESTOR CAP	MAXFEE	DEF					1342.11	1/1/2010	12/31/2299	Y
L6350	THORACIC INTERN LOCK ELBOW	PRXOVR	DEF					NA	NA	NA	S
L6350	THORACIC INTERN LOCK ELBOW	MAXFEE	DEF					3113.36	1/1/2010	12/31/2299	S
L6360	THORACIC PASSIVE RESTOR COMP	PRXOVR	DEF					NA	NA	NA	Y
L6360	THORACIC PASSIVE RESTOR COMP	MAXFEE	DEF					2702.94	1/1/2010	12/31/2299	Y
L6370	THORACIC PASSIVE RESTOR CAP	PRXOVR	DEF					NA	NA	NA	Y
L6370	THORACIC PASSIVE RESTOR CAP	MAXFEE	DEF					1567.52	1/1/2010	12/31/2299	Y
L6400	BELOW ELBOW PROSTH TISS SHAP	PRXOVR	DEF					NA	NA	NA	S
L6400	BELOW ELBOW PROSTH TISS SHAP	MAXFEE	DEF					1741.93	1/1/2010	12/31/2299	S
L6450	ELB DISART PROSTH TISS SHAP	PRXOVR	DEF					NA	NA	NA	Y
L6450	ELB DISART PROSTH TISS SHAP	MAXFEE	DEF					2276.62	1/1/2010	12/31/2299	Y
L6500	ABOVE ELBOW PROSTH TISS SHAP	PRXOVR	DEF					NA	NA	NA	S
L6500	ABOVE ELBOW PROSTH TISS SHAP	MAXFEE	DEF					2235.58	1/1/2010	12/31/2299	S
L6550	SHLDR DISAR PROSTH TISS SHAP	PRXOVR	DEF					NA	NA	NA	Y
L6550	SHLDR DISAR PROSTH TISS SHAP	MAXFEE	DEF					2895.52	1/1/2010	12/31/2299	Y
L6570	SCAP THORAC PROSTH TISS SHAP	PRXOVR	DEF					NA	NA	NA	Y
L6570	SCAP THORAC PROSTH TISS SHAP	MAXFEE	DEF					3232.48	1/1/2010	12/31/2299	Y
L6600	POLYCENTRIC HINGE PAIR	PRXOVR	DEF					NA	NA	NA	S
L6600	POLYCENTRIC HINGE PAIR	MAXFEE	DEF					145.21	1/1/2010	12/31/2299	S
L6605	SINGLE PIVOT HINGE PAIR	PRXOVR	DEF					NA	NA	NA	S
L6605	SINGLE PIVOT HINGE PAIR	MAXFEE	DEF					149.46	1/1/2010	12/31/2299	S
L6610	FLEXIBLE METAL HINGE PAIR	PRXOVR	DEF					NA	NA	NA	Y
L6610	FLEXIBLE METAL HINGE PAIR	MAXFEE	DEF					141.28	1/1/2010	12/31/2299	Y
L6615	DISCONNECT LOCKING WRIST UNI	PRXOVR	DEF					NA	NA	NA	S
L6615	DISCONNECT LOCKING WRIST UNI	MAXFEE	DEF					137.13	1/1/2010	12/31/2299	S
L6616	DISCONNECT INSERT LOCKING WR	PRXOVR	DEF					NA	NA	NA	S
L6616	DISCONNECT INSERT LOCKING WR	MAXFEE	DEF					41.28	1/1/2010	12/31/2299	S
L6620	FLEXION/EXTENSION WRIST UNIT	PRXOVR	DEF					NA	NA	NA	S
L6620	FLEXION/EXTENSION WRIST UNIT	MAXFEE	DEF					239.75	1/1/2010	12/31/2299	S
L6623	SPRING-ASS ROT WRST W/ LATCH	PRXOVR	DEF					NA	NA	NA	S
L6623	SPRING-ASS ROT WRST W/ LATCH	MAXFEE	DEF					456.72	1/1/2010	12/31/2299	S
L6625	ROTATION WRST W/ CABLE LOCK	PRXOVR	DEF					NA	NA	NA	Y
L6625	ROTATION WRST W/ CABLE LOCK	MAXFEE	DEF					338.50	1/1/2010	12/31/2299	Y
L6628	QUICK DISCONN HOOK ADAPTER O	PRXOVR	DEF					NA	NA	NA	S
L6628	QUICK DISCONN HOOK ADAPTER O	MAXFEE	DEF					364.35	1/1/2010	12/31/2299	S
L6629	LAMINATION COLLAR W/ COUPLIN	PRXOVR	DEF					NA	NA	NA	S
L6629	LAMINATION COLLAR W/ COUPLIN	MAXFEE	DEF					124.16	1/1/2010	12/31/2299	S
L6630	STAINLESS STEEL ANY WRIST	PRXOVR	DEF					NA	NA	NA	S
L6630	STAINLESS STEEL ANY WRIST	MAXFEE	DEF					182.89	1/1/2010	12/31/2299	S
L6632	LATEX SUSPENSION SLEEVE EACH	PRXOVR	DEF					NA	NA	NA	S
L6632	LATEX SUSPENSION SLEEVE EACH	MAXFEE	DEF					41.35	1/1/2010	12/31/2299	S
L6635	LIFT ASSIST FOR ELBOW	PRXOVR	DEF					NA	NA	NA	S
L6635	LIFT ASSIST FOR ELBOW	MAXFEE	DEF					132.19	1/1/2010	12/31/2299	S
L6637	NUDGE CONTROL ELBOW LOCK	PRXOVR	DEF					NA	NA	NA	S
L6637	NUDGE CONTROL ELBOW LOCK	MAXFEE	DEF					258.81	1/1/2010	12/31/2299	S
L6640	SHOULDER ABDUCTION JOINT PAI	PRXOVR	DEF					NA	NA	NA	Y
L6640	SHOULDER ABDUCTION JOINT PAI	MAXFEE	DEF					215.53	1/1/2010	12/31/2299	Y
L6641	EXCURSION AMPLIFIER PULLEY T	PRXOVR	DEF					NA	NA	NA	Y
L6641	EXCURSION AMPLIFIER PULLEY T	MAXFEE	DEF					125.51	1/1/2010	12/31/2299	Y
L6642	EXCURSION AMPLIFIER LEVER TY	PRXOVR	DEF					NA	NA	NA	S
L6642	EXCURSION AMPLIFIER LEVER TY	MAXFEE	DEF					184.52	1/1/2010	12/31/2299	S
L6645	SHOULDER FLEXION-ABDUCTION J	PRXOVR	DEF					NA	NA	NA	S
L6645	SHOULDER FLEXION-ABDUCTION J	MAXFEE	DEF					233.08	1/1/2010	12/31/2299	S
L6650	SHOULDER UNIVERSAL JOINT	PRXOVR	DEF					NA	NA	NA	S
L6650	SHOULDER UNIVERSAL JOINT	MAXFEE	DEF					252.80	1/1/2010	12/31/2299	S
L6655	STANDARD CONTROL CABLE EXTRA	PRXOVR	DEF					NA	NA	NA	S
L6655	STANDARD CONTROL CABLE EXTRA	MAXFEE	DEF					49.02	1/1/2010	12/31/2299	S
L6660	HEAVY DUTY CONTROL CABLE	PRXOVR	DEF					NA	NA	NA	S
L6660	HEAVY DUTY CONTROL CABLE	MAXFEE	DEF					65.62	1/1/2010	12/31/2299	S
L6665	TEFLON OR EQUAL CABLE LINING	PRXOVR	DEF					NA	NA	NA	S
L6665	TEFLON OR EQUAL CABLE LINING	MAXFEE	DEF					29.31	1/1/2010	12/31/2299	S
L6670	HOOK TO HAND CABLE ADAPTER	PRXOVR	DEF					NA	NA	NA	S
L6670	HOOK TO HAND CABLE ADAPTER	MAXFEE	DEF					30.53	1/1/2010	12/31/2299	S
L6672	HARNESS CHEST/SHLDER SADDLE	PRXOVR	DEF					NA	NA	NA	S
L6672	HARNESS CHEST/SHLDER SADDLE	MAXFEE	DEF					140.08	1/1/2010	12/31/2299	S
L6675	HARNESS FIGURE OF 8 SING CON	PRXOVR	DEF					NA	NA	NA	S
L6675	HARNESS FIGURE OF 8 SING CON	MAXFEE	DEF					76.43	1/1/2010	12/31/2299	S
L6676	HARNESS FIGURE OF 8 DUAL CON	PRXOVR	DEF					NA	NA	NA	S
L6676	HARNESS FIGURE OF 8 DUAL CON	MAXFEE	DEF					79.96	1/1/2010	12/31/2299	S
L6680	TEST SOCK WRIST DISART/BEL E	PRXOVR	DEF					NA	NA	NA	S
L6680	TEST SOCK WRIST DISART/BEL E	MAXFEE	DEF					196.88	1/1/2010	12/31/2299	S
L6682	TEST SOCK ELBW DISART/ABOVE	PRXOVR	DEF					NA	NA	NA	S
L6682	TEST SOCK ELBW DISART/ABOVE	MAXFEE	DEF					217.68	1/1/2010	12/31/2299	S
L6684	TEST SOCKET SHLDR DISART/THO	PRXOVR	DEF					NA	NA	NA	S
L6684	TEST SOCKET SHLDR DISART/THO	MAXFEE	DEF					295.80	1/1/2010	12/31/2299	S
L6686	SUCTION SOCKET	PRXOVR	DEF					NA	NA	NA	S
L6686	SUCTION SOCKET	MAXFEE	DEF					438.93	1/1/2010	12/31/2299	S
L6687	FRAME TYP SOCKET BEL ELBOW/W	PRXOVR	DEF					NA	NA	NA	S
L6687	FRAME TYP SOCKET BEL ELBOW/W	MAXFEE	DEF					367.11	1/1/2010	12/31/2299	S
L6688	FRAME TYP SOCK ABOVE ELB/DIS	PRXOVR	DEF					NA	NA	NA	S
L6688	FRAME TYP SOCK ABOVE ELB/DIS	MAXFEE	DEF					406.28	1/1/2010	12/31/2299	S
L6689	FRAME TYP SOCKET SHOULDER DI	PRXOVR	DEF					NA	NA	NA	Y
L6689	FRAME TYP SOCKET SHOULDER DI	MAXFEE	DEF					484.22	1/1/2010	12/31/2299	Y
L6690	FRAME TYP SOCK INTERSCAP-THO	PRXOVR	DEF					NA	NA	NA	S
L6690	FRAME TYP SOCK INTERSCAP-THO	MAXFEE	DEF					570.12	1/1/2010	12/31/2299	S
L6691	REMOVABLE INSERT EACH	PRXOVR	DEF					NA	NA	NA	S
L6691	REMOVABLE INSERT EACH	MAXFEE	DEF					225.03	1/1/2010	12/31/2299	S
L6692	SILICONE GEL INSERT OR EQUAL	PRXOVR	DEF					NA	NA	NA	S
L6692	SILICONE GEL INSERT OR EQUAL	MAXFEE	DEF					409.41	1/1/2010	12/31/2299	S
L6693	LOCKINGELBOW FOREARM CNTRBAL	PRXOVR	DEF					NA	NA	NA	S
L6693	LOCKINGELBOW FOREARM CNTRBAL	MAXFEE	DEF					2370	7/1/2018	12/31/2299	S
L6700	TERMINAL DEVICE MODEL #3	PRXOVR	DEF					NA	NA	NA	Y
L6700	TERMINAL DEVICE MODEL #3	MAXFEE	DEF					0	1/1/2007	12/31/2299	Y
L6704	TERM DEV; SPORT/REC/WORK ATT	PRXOVR	DEF					NA	NA	NA	S
L6704	TERM DEV; SPORT/REC/WORK ATT	MAXFEE	DEF					352.81	1/1/2010	12/31/2299	S
L6705	TERMINAL DEVICE MODEL #5	PRXOVR	DEF					NA	NA	NA	Y
L6705	TERMINAL DEVICE MODEL #5	MAXFEE	DEF					0	1/1/2007	12/31/2299	Y
L6706	TERM DEV MECH HOOK VOL OPEN	PRXOVR	DEF					NA	NA	NA	S
L6706	TERM DEV MECH HOOK VOL OPEN	MAXFEE	DEF					261.92	1/1/2010	12/31/2299	S
L6707	TERM DEV MECH HOOK VOL CLOSE	PRXOVR	DEF					NA	NA	NA	S
L6707	TERM DEV MECH HOOK VOL CLOSE	MAXFEE	DEF					740.62	1/1/2010	12/31/2299	S
L6708	TERM DEV MECH HAND VOL OPEN	PRXOVR	DEF					NA	NA	NA	S
L6708	TERM DEV MECH HAND VOL OPEN	MAXFEE	DEF					589.16	1/1/2010	12/31/2299	S
L6709	TERM DEV MECH HAND VOL CLOSE	PRXOVR	DEF					NA	NA	NA	S
L6709	TERM DEV MECH HAND VOL CLOSE	MAXFEE	DEF					795.89	1/1/2010	12/31/2299	S
L6710	TERMINAL DEVICE MODEL #5X	PRXOVR	DEF					NA	NA	NA	Y
L6710	TERMINAL DEVICE MODEL #5X	MAXFEE	DEF					0	1/1/2007	12/31/2299	Y
L6720	TERMINAL DEVICE MODEL #6	PRXOVR	DEF					NA	NA	NA	Y
L6720	TERMINAL DEVICE MODEL #6	MAXFEE	DEF					0	1/1/2007	12/31/2299	Y
L6725	TERMINAL DEVICE MODEL #7	PRXOVR	DEF					NA	NA	NA	Y
L6725	TERMINAL DEVICE MODEL #7	MAXFEE	DEF					0	1/1/2007	12/31/2299	Y
L6730	TERMINAL DEVICE MODEL #7LO	PRXOVR	DEF					NA	NA	NA	Y
L6730	TERMINAL DEVICE MODEL #7LO	MAXFEE	DEF					0	1/1/2007	12/31/2299	Y
L6735	TERMINAL DEVICE MODEL #8	PRXOVR	DEF					NA	NA	NA	Y
L6735	TERMINAL DEVICE MODEL #8	MAXFEE	DEF					0	1/1/2007	12/31/2299	Y
L6740	TERMINAL DEVICE MODEL #8X	PRXOVR	DEF					NA	NA	NA	Y
L6740	TERMINAL DEVICE MODEL #8X	MAXFEE	DEF					0	1/1/2007	12/31/2299	Y
L6745	TERMINAL DEVICE MODEL #88X	PRXOVR	DEF					NA	NA	NA	Y
L6745	TERMINAL DEVICE MODEL #88X	MAXFEE	DEF					0	1/1/2007	12/31/2299	Y
L6750	TERMINAL DEVICE MODEL #10P	PRXOVR	DEF					NA	NA	NA	Y
L6750	TERMINAL DEVICE MODEL #10P	MAXFEE	DEF					0	1/1/2007	12/31/2299	Y
L6755	TERMINAL DEVICE MODEL #10X	PRXOVR	DEF					NA	NA	NA	Y
L6755	TERMINAL DEVICE MODEL #10X	MAXFEE	DEF					0	1/1/2007	12/31/2299	Y
L6765	TERMINAL DEVICE MODEL #12P	PRXOVR	DEF					NA	NA	NA	Y
L6765	TERMINAL DEVICE MODEL #12P	MAXFEE	DEF					0	1/1/2007	12/31/2299	Y
L6770	TERMINAL DEVICE MODEL #99X	PRXOVR	DEF					NA	NA	NA	Y
L6770	TERMINAL DEVICE MODEL #99X	MAXFEE	DEF					0	1/1/2007	12/31/2299	Y
L6775	TERMINAL DEVICE MODEL#555	PRXOVR	DEF					NA	NA	NA	Y
L6775	TERMINAL DEVICE MODEL#555	MAXFEE	DEF					0	1/1/2007	12/31/2299	Y
L6780	TERMINAL DEVICE MODEL #SS555	PRXOVR	DEF					NA	NA	NA	Y
L6780	TERMINAL DEVICE MODEL #SS555	MAXFEE	DEF					0	1/1/2007	12/31/2299	Y
L6790	HOOKS-ACCU HOOK OR EQUAL	PRXOVR	DEF					NA	NA	NA	Y
L6790	HOOKS-ACCU HOOK OR EQUAL	MAXFEE	DEF					0	1/1/2007	12/31/2299	Y
L6795	HOOKS-2 LOAD OR EQUAL	PRXOVR	DEF					NA	NA	NA	Y
L6795	HOOKS-2 LOAD OR EQUAL	MAXFEE	DEF					0	1/1/2007	12/31/2299	Y
L6800	HOOKS-APRL VC OR EQUAL	PRXOVR	DEF					NA	NA	NA	Y
L6800	HOOKS-APRL VC OR EQUAL	MAXFEE	DEF					0	1/1/2007	12/31/2299	Y
L6805	TERM DEV MODIFIER WRIST UNIT	PRXOVR	DEF					NA	NA	NA	S
L6805	TERM DEV MODIFIER WRIST UNIT	MAXFEE	DEF					245.52	1/1/2010	12/31/2299	S
L6810	TERM DEV PRECISION PINCH DEV	PRXOVR	DEF					NA	NA	NA	Y
L6810	TERM DEV PRECISION PINCH DEV	MAXFEE	DEF					130.51	1/1/2010	12/31/2299	Y
L6825	HANDS DORRANCE VO	PRXOVR	DEF					NA	NA	NA	Y
L6825	HANDS DORRANCE VO	MAXFEE	DEF					0	1/1/2007	12/31/2299	Y
L6830	HAND APRL VC	PRXOVR	DEF					NA	NA	NA	Y
L6830	HAND APRL VC	MAXFEE	DEF					0	1/1/2007	12/31/2299	Y
L6845	HAND BECKER LOCK GRIP	PRXOVR	DEF					NA	NA	NA	Y
L6845	HAND BECKER LOCK GRIP	MAXFEE	DEF					0	1/1/2007	12/31/2299	Y
L6850	TERM DVC-HAND BECKER PLYLITE	PRXOVR	DEF					NA	NA	NA	Y
L6850	TERM DVC-HAND BECKER PLYLITE	MAXFEE	DEF					0	1/1/2007	12/31/2299	Y
L6855	HAND ROBIN-AIDS VO	PRXOVR	DEF					NA	NA	NA	Y
L6855	HAND ROBIN-AIDS VO	MAXFEE	DEF					0	1/1/2007	12/31/2299	Y
L6860	HAND ROBIN-AIDS VO SOFT	PRXOVR	DEF					NA	NA	NA	Y
L6860	HAND ROBIN-AIDS VO SOFT	MAXFEE	DEF					0	1/1/2007	12/31/2299	Y
L6865	HAND PASSIVE HAND	PRXOVR	DEF					NA	NA	NA	Y
L6865	HAND PASSIVE HAND	MAXFEE	DEF					0	1/1/2007	12/31/2299	Y
L6870	HAND CHILD MITT	PRXOVR	DEF					NA	NA	NA	Y
L6870	HAND CHILD MITT	MAXFEE	DEF					0	1/1/2007	12/31/2299	Y
L6875	HAND BOCK VC	PRXOVR	DEF					NA	NA	NA	Y
L6875	HAND BOCK VC	MAXFEE	DEF					0	1/1/2007	12/31/2299	Y
L6890	PREFAB GLOVE FOR TERM DEVICE	PRXOVR	DEF					NA	NA	NA	S
L6890	PREFAB GLOVE FOR TERM DEVICE	MAXFEE	DEF					127.85	1/1/2010	12/31/2299	S
L6900	HAND RESTORAT THUMB/1 FINGER	PRXOVR	DEF					NA	NA	NA	Y
L6900	HAND RESTORAT THUMB/1 FINGER	MAXFEE	DEF					1241.44	1/1/2010	12/31/2299	Y
L6905	HAND RESTORATION MULTIPLE FI	PRXOVR	DEF					NA	NA	NA	Y
L6905	HAND RESTORATION MULTIPLE FI	MAXFEE	DEF					1228.68	1/1/2010	12/31/2299	Y
L6910	HAND RESTORATION NO FINGERS	PRXOVR	DEF					NA	NA	NA	S
L6910	HAND RESTORATION NO FINGERS	MAXFEE	DEF					1207.87	1/1/2010	12/31/2299	S
L6915	HAND RESTORATION REPLACMNT G	PRXOVR	DEF					NA	NA	NA	Y
L6915	HAND RESTORATION REPLACMNT G	MAXFEE	DEF					518.99	1/1/2010	12/31/2299	Y
L7368	LITHIUM ION BATTERY CHARGER	PRXOVR	DEF					NA	NA	NA	N
L7368	LITHIUM ION BATTERY CHARGER	MAXFEE	DEF					366.30	9/1/2011	12/31/2299	N
L7499	UPPER EXTREMITY PROSTHES NOS	PRXOVR	DEF					NA	NA	NA	Y
L7499	UPPER EXTREMITY PROSTHES NOS	PADOLR	DEF					NA	NA	NA	Y
L7510	PROSTHETIC DEVICE REPAIR REP	PRXOVR	DEF					NA	NA	NA	S
L7510	PROSTHETIC DEVICE REPAIR REP	REPAIR	DEF					NA	NA	NA	S
L7520	REPAIR PROSTHESIS PER 15 MIN	PRXOVR	DEF					NA	NA	NA	S
L7520	REPAIR PROSTHESIS PER 15 MIN	REPAIR	DEF					NA	NA	NA	S
L8000	MASTECTOMY BRA	PRXOVR	DEF					NA	NA	NA	N
L8000	MASTECTOMY BRA	MAXFEE	DEF					29.10	1/1/2010	12/31/2299	N
L8010	MASTECTOMY SLEEVE	PRXOVR	DEF					NA	NA	NA	N
L8010	MASTECTOMY SLEEVE	MAXFEE	DEF					46.67	1/1/2010	12/31/2299	N
L8015	EXT BREASTPROSTHESIS GARMENT	PRXOVR	DEF					NA	NA	NA	N
L8015	EXT BREASTPROSTHESIS GARMENT	MAXFEE	DEF					42.21	1/1/2010	12/31/2299	N
L8020	MASTECTOMY FORM	PRXOVR	DEF					NA	NA	NA	S
L8020	MASTECTOMY FORM	MAXFEE	DEF					144.73	1/1/2010	12/31/2299	S
L8030	BREAST PROSTHES W/O ADHESIVE	PRXOVR	DEF					NA	NA	NA	S
L8030	BREAST PROSTHES W/O ADHESIVE	MAXFEE	DEF					232.80	1/1/2010	12/31/2299	S
L8035	CUSTOM BREAST PROSTHESIS	PRXOVR	DEF					NA	NA	NA	Y
L8035	CUSTOM BREAST PROSTHESIS	MAXFEE	DEF					2579.86	1/1/2010	12/31/2299	Y
L8100	COMPRESSION STOCKING BK18-30	PRXOVR	DEF					NA	NA	NA	Y
L8100	COMPRESSION STOCKING BK18-30	MAXFEE	DEF					NA			Y
L8110	COMPRESSION STOCKING BK30-40	PRXOVR	DEF					NA	NA	NA	Y
L8110	COMPRESSION STOCKING BK30-40	MAXFEE	DEF					NA			Y
L8120	COMPRESSION STOCKING BK40-50	PRXOVR	DEF					NA	NA	NA	Y
L8120	COMPRESSION STOCKING BK40-50	MAXFEE	DEF					NA			Y
L8130	GC STOCKING THIGHLNGTH 18-30	PRXOVR	DEF					NA	NA	NA	Y
L8130	GC STOCKING THIGHLNGTH 18-30	MAXFEE	DEF					NA			Y
L8140	GC STOCKING THIGHLNGTH 30-40	PRXOVR	DEF					NA	NA	NA	Y
L8140	GC STOCKING THIGHLNGTH 30-40	MAXFEE	DEF					NA			Y
L8150	GC STOCKING THIGHLNGTH 40-50	PRXOVR	DEF					NA	NA	NA	Y
L8150	GC STOCKING THIGHLNGTH 40-50	MAXFEE	DEF					NA			Y
L8160	GC STOCKING FULL LNGTH 18-30	PRXOVR	DEF					NA	NA	NA	Y
L8160	GC STOCKING FULL LNGTH 18-30	MAXFEE	DEF					NA			Y
L8170	GC STOCKING FULL LNGTH 30-40	PRXOVR	DEF					NA	NA	NA	Y
L8170	GC STOCKING FULL LNGTH 30-40	MAXFEE	DEF					NA			Y
L8180	GC STOCKING FULL LNGTH 40-50	PRXOVR	DEF					NA	NA	NA	Y
L8180	GC STOCKING FULL LNGTH 40-50	MAXFEE	DEF					NA			Y
L8190	GC STOCKING WAISTLNGTH 18-30	PRXOVR	DEF					NA	NA	NA	Y
L8190	GC STOCKING WAISTLNGTH 18-30	MAXFEE	DEF					NA			Y
L8195	GC STOCKING WAISTLNGTH 30-40	PRXOVR	DEF					NA	NA	NA	Y
L8195	GC STOCKING WAISTLNGTH 30-40	MAXFEE	DEF					NA			Y
L8200	GC STOCKING WAISTLNGTH 40-50	PRXOVR	DEF					NA	NA	NA	Y
L8200	GC STOCKING WAISTLNGTH 40-50	MAXFEE	DEF					NA			Y
L8210	GC STOCKING CUSTOM MADE	PRXOVR	DEF					NA	NA	NA	Y
L8210	GC STOCKING CUSTOM MADE	PADOLR	DEF					NA	NA	NA	Y
L8220	GC STOCKING LYMPHEDEMA	PRXOVR	DEF					NA	NA	NA	Y
L8220	GC STOCKING LYMPHEDEMA	MAXFEE	DEF					NA			Y
L8230	GC STOCKING GARTER BELT	PRXOVR	DEF					NA	NA	NA	Y
L8230	GC STOCKING GARTER BELT	MAXFEE	DEF					NA			Y
L8300	TRUSS SINGLE W/ STANDARD PAD	PRXOVR	DEF					NA	NA	NA	N
L8300	TRUSS SINGLE W/ STANDARD PAD	MAXFEE	DEF					59.12	1/1/2010	12/31/2299	N
L8310	TRUSS DOUBLE W/ STANDARD PAD	PRXOVR	DEF					NA	NA	NA	N
L8310	TRUSS DOUBLE W/ STANDARD PAD	MAXFEE	DEF					95.12	1/1/2010	12/31/2299	N
L8320	TRUSS ADDITION TO STD PAD WA	PRXOVR	DEF					NA	NA	NA	Y
L8320	TRUSS ADDITION TO STD PAD WA	MAXFEE	DEF					41.52	1/1/2010	12/31/2299	Y
L8330	TRUSS ADD TO STD PAD SCROTAL	PRXOVR	DEF					NA	NA	NA	N
L8330	TRUSS ADD TO STD PAD SCROTAL	MAXFEE	DEF					31.42	1/1/2010	12/31/2299	N
L8400	SHEATH BELOW KNEE	PRXOVR	DEF					NA	NA	NA	N
L8400	SHEATH BELOW KNEE	MAXFEE	DEF					10.02	1/1/2010	12/31/2299	N
L8410	SHEATH ABOVE KNEE	PRXOVR	DEF					NA	NA	NA	N
L8410	SHEATH ABOVE KNEE	MAXFEE	DEF					13.19	1/1/2010	12/31/2299	N
L8415	SHEATH UPPER LIMB	PRXOVR	DEF					NA	NA	NA	N
L8415	SHEATH UPPER LIMB	MAXFEE	DEF					13.65	1/1/2010	12/31/2299	N
L8417	PROS SHEATH/SOCK W GEL CUSHN	PRXOVR	DEF					NA	NA	NA	N
L8417	PROS SHEATH/SOCK W GEL CUSHN	MAXFEE	DEF					48.14	1/1/2010	12/31/2299	N
L8420	PROSTHETIC SOCK MULTI PLY BK	PRXOVR	DEF					NA	NA	NA	N
L8420	PROSTHETIC SOCK MULTI PLY BK	MAXFEE	DEF					13.36	1/1/2010	12/31/2299	N
L8430	PROSTHETIC SOCK MULTI PLY AK	PRXOVR	DEF					NA	NA	NA	N
L8430	PROSTHETIC SOCK MULTI PLY AK	MAXFEE	DEF					15.11	1/1/2010	12/31/2299	N
L8435	PROS SOCK MULTI PLY UPPER LM	PRXOVR	DEF					NA	NA	NA	S
L8435	PROS SOCK MULTI PLY UPPER LM	MAXFEE	DEF					14.37	1/1/2010	12/31/2299	S
L8440	SHRINKER BELOW KNEE	PRXOVR	DEF					NA	NA	NA	N
L8440	SHRINKER BELOW KNEE	MAXFEE	DEF					29.85	1/1/2010	12/31/2299	N
L8460	SHRINKER ABOVE KNEE	PRXOVR	DEF					NA	NA	NA	S
L8460	SHRINKER ABOVE KNEE	MAXFEE	DEF					42.42	1/1/2010	12/31/2299	S
L8465	SHRINKER UPPER LIMB	PRXOVR	DEF					NA	NA	NA	S
L8465	SHRINKER UPPER LIMB	MAXFEE	DEF					39.22	1/1/2010	12/31/2299	S
L8470	PROS SOCK SINGLE PLY BK	PRXOVR	DEF					NA	NA	NA	N
L8470	PROS SOCK SINGLE PLY BK	MAXFEE	DEF					4.25	1/1/2010	12/31/2299	N
L8480	PROS SOCK SINGLE PLY AK	PRXOVR	DEF					NA	NA	NA	S
L8480	PROS SOCK SINGLE PLY AK	MAXFEE	DEF					5.86	1/1/2010	12/31/2299	S
L8485	PROS SOCK SINGLE PLY UPPER L	PRXOVR	DEF					NA	NA	NA	S
L8485	PROS SOCK SINGLE PLY UPPER L	MAXFEE	DEF					7.89	1/1/2010	12/31/2299	S
L8499	UNLISTED MISC PROSTHETIC SER	PRXOVR	DEF					NA	NA	NA	Y
L8499	UNLISTED MISC PROSTHETIC SER	PADOLR	DEF					NA	NA	NA	Y
L8500	ARTIFICIAL LARYNX	PRXOVR	DEF					NA	NA	NA	S
L8500	ARTIFICIAL LARYNX	MAXFEE	DEF					421.25	1/1/2010	12/31/2299	S
L8501	TRACHEOSTOMY SPEAKING VALVE	PRXOVR	DEF					NA	NA	NA	N
L8501	TRACHEOSTOMY SPEAKING VALVE	MAXFEE	DEF					83.66	1/1/2010	12/31/2299	N
L8615	COCH IMPLANT HEADSET REPLACE	PRXOVR	DEF					NA	NA	NA	Y
L8615	COCH IMPLANT HEADSET REPLACE	MAXFEE	DEF					346.02	1/1/2016	12/31/2299	Y
L8616	COCH IMPLANT MICROPHONE REPL	PRXOVR	DEF					NA	NA	NA	Y
L8616	COCH IMPLANT MICROPHONE REPL	MAXFEE	DEF					80.58	1/1/2016	12/31/2299	Y
L8617	COCH IMPLANT TRANS COIL REPL	PRXOVR	DEF					NA	NA	NA	Y
L8617	COCH IMPLANT TRANS COIL REPL	MAXFEE	DEF					70.39	1/1/2016	12/31/2299	Y
L8618	COCH IMPLANT TRAN CABLE REPL	PRXOVR	DEF					NA	NA	NA	Y
L8618	COCH IMPLANT TRAN CABLE REPL	MAXFEE	DEF					20.12	1/1/2016	12/31/2299	Y
L8619	COCH IMP EXT PROC/CONTR RPLC	PRXOVR	DEF					NA	NA	NA	N
L8619	COCH IMP EXT PROC/CONTR RPLC	MAXFEE	DEF					6448.80	1/1/2016	12/31/2299	N
L8621	REPL ZINC AIR BATTERY	PRXOVR	DEF					NA	NA	NA	S
L8621	REPL ZINC AIR BATTERY	MAXFEE	DEF					0.45	9/1/2011	12/31/2299	S
L8622	REPL ALKALINE BATTERY	PRXOVR	DEF					NA	NA	NA	S
L8622	REPL ALKALINE BATTERY	MAXFEE	DEF					0.24	9/1/2011	12/31/2299	S
L8623	LITH ION BATT CID;NON-EARLVL	PRXOVR	DEF					NA	NA	NA	S
L8623	LITH ION BATT CID;NON-EARLVL	MAXFEE	DEF					46.94	9/1/2011	12/31/2299	S
L8624	LITH ION BATT CID; EAR LEVEL	PRXOVR	DEF					NA	NA	NA	S
L8624	LITH ION BATT CID; EAR LEVEL	MAXFEE	DEF					117.04	9/1/2011	12/31/2299	S
L8627	CID EXT SPEECH PROCESS REPL	PRXOVR	DEF					NA	NA	NA	Y
L8627	CID EXT SPEECH PROCESS REPL	MAXFEE	DEF					5473.60	1/1/2016	12/31/2299	Y
L8628	CID EXT CONTROLLER REPL	PRXOVR	DEF					NA	NA	NA	Y
L8628	CID EXT CONTROLLER REPL	MAXFEE	DEF					975.19	1/1/2016	12/31/2299	Y
L8629	CID TRANSMIT COIL AND CABLE	PRXOVR	DEF					NA	NA	NA	Y
L8629	CID TRANSMIT COIL AND CABLE	MAXFEE	DEF					137.06	1/1/2016	12/31/2299	Y
L8691	AOI SND PROC REPL EXCL ACTUA	PRXOVR	DEF					NA	NA	NA	Y
L8691	AOI SND PROC REPL EXCL ACTUA	MAXFEE	DEF					2045.83	1/1/2016	12/31/2299	Y
L8692	NON-OSSEOINTEGRATED SND PROC	PRXOVR	DEF					NA	NA	NA	Y
L8692	NON-OSSEOINTEGRATED SND PROC	MAXFEE	DEF					3500	7/1/2021	12/31/2299	Y
S1040	CRANIAL REMOLDING ORTHOSIS	PRXOVR	DEF					NA	NA	NA	N
S1040	CRANIAL REMOLDING ORTHOSIS	MAXFEE	DEF					2000	9/1/2011	12/31/2299	N
V5014	HEARING AID REPAIR/MODIFYING	PRXOVR	DEF					NA	NA	NA	S
V5014	HEARING AID REPAIR/MODIFYING	REPAIR	DEF					NA	NA	NA	S
V5030	BODY-WORN HEARING AID AIR	PRXOVR	DEF					NA	NA	NA	Y
V5030	BODY-WORN HEARING AID AIR	MAXFEE	DEF					339.50	1/1/2010	12/31/2299	Y
V5040	BODY-WORN HEARING AID BONE	PRXOVR	DEF					NA	NA	NA	Y
V5040	BODY-WORN HEARING AID BONE	MAXFEE	DEF					339.50	1/1/2010	12/31/2299	Y
V5050	HEARING AID MONAURAL IN EAR	PRXOVR	DEF					NA	NA	NA	Y
V5050	HEARING AID MONAURAL IN EAR	MAXFEE	DEF					242.50	1/1/2010	12/31/2299	Y
V5060	BEHIND EAR HEARING AID	PRXOVR	DEF					NA	NA	NA	Y
V5060	BEHIND EAR HEARING AID	MAXFEE	DEF					242.50	1/1/2010	12/31/2299	Y
V5070	GLASSES AIR CONDUCTION	PRXOVR	DEF					NA	NA	NA	Y
V5070	GLASSES AIR CONDUCTION	MAXFEE	DEF					242.50	1/1/2010	12/31/2299	Y
V5080	GLASSES BONE CONDUCTION	PRXOVR	DEF					NA	NA	NA	Y
V5080	GLASSES BONE CONDUCTION	MAXFEE	DEF					242.50	1/1/2010	12/31/2299	Y
V5130	IN EAR BINAURAL HEARING AID	PRXOVR	DEF					NA	NA	NA	Y
V5130	IN EAR BINAURAL HEARING AID	MAXFEE	DEF					485	1/1/2010	12/31/2299	Y
V5140	BEHIND EAR BINAUR HEARING AI	PRXOVR	DEF					NA	NA	NA	Y
V5140	BEHIND EAR BINAUR HEARING AI	MAXFEE	DEF					485	1/1/2010	12/31/2299	Y
V5150	GLASSES BINAURAL HEARING AID	PRXOVR	DEF					NA	NA	NA	Y
V5150	GLASSES BINAURAL HEARING AID	MAXFEE	DEF					485	1/1/2010	12/31/2299	Y
V5160	DISPENSING FEE BINAURAL	PRXOVR	DEF					NA	NA	NA	Y
V5160	DISPENSING FEE BINAURAL	MAXFEE	DEF					291	1/1/2010	12/31/2299	Y
V5170	WITHIN EAR CROS HEARING AID	PRXOVR	DEF					NA	NA	NA	Y
V5170	WITHIN EAR CROS HEARING AID	MAXFEE	DEF					NA			Y
V5171	HEARING AID MONAURAL ITE	PRXOVR	DEF					NA	NA	NA	Y
V5171	HEARING AID MONAURAL ITE	MAXFEE	DEF					800	7/1/2021	12/31/2299	Y
V5172	HEARING AID MONAURAL ITC	PRXOVR	DEF					NA	NA	NA	Y
V5172	HEARING AID MONAURAL ITC	MAXFEE	DEF					800	7/1/2021	12/31/2299	Y
V5180	BEHIND EAR CROS HEARING AID	PRXOVR	DEF					NA	NA	NA	Y
V5180	BEHIND EAR CROS HEARING AID	MAXFEE	DEF					NA			Y
V5181	HEARING AID MONAURAL BTE	PRXOVR	DEF					NA	NA	NA	Y
V5181	HEARING AID MONAURAL BTE	MAXFEE	DEF					800	7/1/2021	12/31/2299	Y
V5190	HEARING AID MONAURAL GLASSES	PRXOVR	DEF					NA	NA	NA	Y
V5190	HEARING AID MONAURAL GLASSES	MAXFEE	DEF					242.50	1/1/2010	12/31/2299	Y
V5200	DISP FEE CONTRALATERAL MONAU	PRXOVR	DEF					NA	NA	NA	Y
V5200	DISP FEE CONTRALATERAL MONAU	MAXFEE	DEF					194	1/1/2010	12/31/2299	Y
V5210	IN EAR BICROS HEARING AID	PRXOVR	DEF					NA	NA	NA	Y
V5210	IN EAR BICROS HEARING AID	MAXFEE	DEF					NA			Y
V5211	HEARING AID BINAURAL ITE/ITE	PRXOVR	DEF					NA	NA	NA	Y
V5211	HEARING AID BINAURAL ITE/ITE	MAXFEE	DEF					1600	7/1/2021	12/31/2299	Y
V5212	HEARING AID BINAURAL ITE/ITC	PRXOVR	DEF					NA	NA	NA	Y
V5212	HEARING AID BINAURAL ITE/ITC	MAXFEE	DEF					1600	7/1/2021	12/31/2299	Y
V5213	HEARING AID BINAURAL ITE/BTE	PRXOVR	DEF					NA	NA	NA	Y
V5213	HEARING AID BINAURAL ITE/BTE	MAXFEE	DEF					1600	7/1/2021	12/31/2299	Y
V5214	HEARING AID BINAURAL ITC/ITC	PRXOVR	DEF					NA	NA	NA	Y
V5214	HEARING AID BINAURAL ITC/ITC	MAXFEE	DEF					1600	7/1/2021	12/31/2299	Y
V5215	HEARING AID BINAURAL ITC/BTE	PRXOVR	DEF					NA	NA	NA	Y
V5215	HEARING AID BINAURAL ITC/BTE	MAXFEE	DEF					1600	7/1/2021	12/31/2299	Y
V5220	BEHIND EAR BICROS HEARING AI	PRXOVR	DEF					NA	NA	NA	Y
V5220	BEHIND EAR BICROS HEARING AI	MAXFEE	DEF					NA			Y
V5221	HEARING AID BINAURAL BTE/BTE	PRXOVR	DEF					NA	NA	NA	Y
V5221	HEARING AID BINAURAL BTE/BTE	MAXFEE	DEF					1600	7/1/2021	12/31/2299	Y
V5230	HEARING AID BINAURAL GLASSES	PRXOVR	DEF					NA	NA	NA	Y
V5230	HEARING AID BINAURAL GLASSES	MAXFEE	DEF					242.50	1/1/2010	12/31/2299	Y
V5240	DISP FEE CONTRALATERAL BINAU	PRXOVR	DEF					NA	NA	NA	Y
V5240	DISP FEE CONTRALATERAL BINAU	MAXFEE	DEF					194	1/1/2010	12/31/2299	Y
V5241	DISPENSING FEE; MONAURAL	PRXOVR	DEF					NA	NA	NA	Y
V5241	DISPENSING FEE; MONAURAL	MAXFEE	DEF					194	1/1/2010	12/31/2299	Y
V5246	HEARING AID; PROG; MON; ITE	PRXOVR	DEF					NA	NA	NA	Y
V5246	HEARING AID; PROG; MON; ITE	MAXFEE	DEF					339.50	1/1/2010	12/31/2299	Y
V5247	HEARING AID; PROG; MON; BTE	PRXOVR	DEF					NA	NA	NA	Y
V5247	HEARING AID; PROG; MON; BTE	MAXFEE	DEF					339.50	1/1/2010	12/31/2299	Y
V5252	HEARING AID; PROG; BIN; ITE	PRXOVR	DEF					NA	NA	NA	Y
V5252	HEARING AID; PROG; BIN; ITE	MAXFEE	DEF					679	1/1/2010	12/31/2299	Y
V5253	HEARING AID; PROG; BIN; BTE	PRXOVR	DEF					NA	NA	NA	Y
V5253	HEARING AID; PROG; BIN; BTE	MAXFEE	DEF					679	1/1/2010	12/31/2299	Y
V5256	HEARING AID; DIGIT; MON; ITE	PRXOVR	DEF					NA	NA	NA	Y
V5256	HEARING AID; DIGIT; MON; ITE	MAXFEE	DEF					727.50	1/1/2010	12/31/2299	Y
V5257	HEARING AID; DIGIT; MON; BTE	PRXOVR	DEF					NA	NA	NA	Y
V5257	HEARING AID; DIGIT; MON; BTE	MAXFEE	DEF					727.50	1/1/2010	12/31/2299	Y
V5260	HEARING AID; DIGIT; BIN; ITE	PRXOVR	DEF					NA	NA	NA	Y
V5260	HEARING AID; DIGIT; BIN; ITE	MAXFEE	DEF					1455	1/1/2010	12/31/2299	Y
V5261	HEARING AID; DIGIT; BIN; BTE	PRXOVR	DEF					NA	NA	NA	Y
V5261	HEARING AID; DIGIT; BIN; BTE	MAXFEE	DEF					1455	1/1/2010	12/31/2299	Y
V5264	EAR MOLD/INSERT	PRXOVR	DEF					NA	NA	NA	S
V5264	EAR MOLD/INSERT	MAXFEE	DEF					24.25	1/1/2010	12/31/2299	S
V5266	BATTERY FOR HEARING DEVICE	PRXOVR	DEF					NA	NA	NA	N
V5266	BATTERY FOR HEARING DEVICE	MAXFEE	DEF					0.97	1/1/2010	12/31/2299	N
V5267	HEARING AID SUP/ACCESS/DEV	PRXOVR	DEF					NA	NA	NA	Y
V5267	HEARING AID SUP/ACCESS/DEV	PADOLR	DEF					NA	NA	NA	Y