| 1 | ECXAPRO3 ;ALB/JAP - PRO Extract Audit Report (cont) ; APR 25,2006
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| 2 |  ;;3.0;DSS EXTRACTS;**21,31,76,94**;Dec 22, 1997
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| 3 |  ;
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| 4 | TEXT ;description of line numbers as in des^rmprn62 plus summary headers
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| 5 |  ;;100;WHEELCHAIRS AND ACCESSORIES
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| 6 |  ;;100 A;MOTORIZED
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| 7 |  ;;100 A1;SCOOTERS
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| 8 |  ;;100 B;MANUAL CUSTOM
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| 9 |  ;;100 C;MANUAL A/O
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| 10 |  ;;100 D;ACCESSORIES
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| 11 |  ;;100 E;CUSHION FOAM
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| 12 |  ;;100 F;CUSHION SPEC
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| 13 |  ;;100 G;CARRIERS
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| 14 |  ;;100 H;NSC VAN MODS
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| 15 |  ;;100 I;SCOOTER ACCESSORIES
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| 16 |  ;;200;ARTIFICIAL LEGS
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| 17 |  ;;200 A;LEG IPOP
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| 18 |  ;;200 B;LEG TEM
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| 19 |  ;;200 C;LEG PART FOOT
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| 20 |  ;;200 E;LEG SYMES
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| 21 |  ;;200 F;LEG B/K
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| 22 |  ;;200 G;LEG A/O
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| 23 |  ;;200 H;LEG A/K
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| 24 |  ;;200 I;LEG COMPONENT
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| 25 |  ;;300;ARTIFICIAL ARMS AND TERMINAL DEVICES
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| 26 |  ;;300 A;ARM B/E
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| 27 |  ;;300 B;ARM, A/E
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| 28 |  ;;300 C;COSMETIC GLOVES
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| 29 |  ;;300 D;ARM, A/O
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| 30 |  ;;300 E;TERMINAL DEVICES
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| 31 |  ;;300 F;EXT. POWERED,ARM
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| 32 |  ;;400;BRACES AND ORTHOTICS
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| 33 |  ;;400 A;BRACE ANKLE
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| 34 |  ;;400 B;BRACE LEG AK
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| 35 |  ;;400 C;BRACE, SPINAL
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| 36 |  ;;400 D;BRACE AL/OTH
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| 37 |  ;;400 E;ELAS HOSE, EA
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| 38 |  ;;400 F;BRACES, KNEE
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| 39 |  ;;400 G;CORSET/BELT
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| 40 |  ;;400 H;ORTHOSIS WHO
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| 41 |  ;;400 X;ORTHOTICS UNKNOWN
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| 42 |  ;;500;SHOES/ORTHOTICS
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| 43 |  ;;500 A;ARCH SUPT, EA
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| 44 |  ;;500 B;SHOE INLAY, EA
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| 45 |  ;;500 C;SHOE MOLDED, EA
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| 46 |  ;;500 D;SHOE ORTH OTH
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| 47 |  ;;500 E;INSERTS, SHOE
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| 48 |  ;;500 F;SHOES A/O, EA
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| 49 |  ;;600;NEUROSENSORY AIDS
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| 50 |  ;;600 1;EYEGLASSES PR
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| 51 |  ;;600 A;SP OVER 2,500
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| 52 |  ;;600 B;HEARING AIDS
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| 53 |  ;;600 C;AID FOR BLIND
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| 54 |  ;;600 D;CONT LENS, EA.
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| 55 |  ;;600 E;EAR INSERT
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| 56 |  ;;600 F;ASST LISTENING DEVICES
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| 57 |  ;;600 G;SPEECH DEVICES
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| 58 |  ;;700;RESTORATIONS
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| 59 |  ;;700 A;EYE
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| 60 |  ;;700 B;FACIAL
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| 61 |  ;;700 C;BODY, OTHER
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| 62 |  ;;800;OXYGEN AND RESPIRATORY
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| 63 |  ;;800 A;OXYGEN EQP
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| 64 |  ;;800 B;OXYGEN CONCEN
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| 65 |  ;;800 C;OXYGEN GAS
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| 66 |  ;;800 D;OXYGEN, SUPPLIES
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| 67 |  ;;800 E;OXYGEN LIQUID
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| 68 |  ;;800 F;VENTILATOR, A/O
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| 69 |  ;;800 G;RESPIRATORY EQUIPMENT
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| 70 |  ;;800 H;RESPIRATORY SUPPLIES
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| 71 |  ;;900;MEDICAL EQUIPMENT
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| 72 |  ;;900 A;WALKING AIDS
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| 73 |  ;;900 B;INVALID LIFT
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| 74 |  ;;900 C;BED HOSP STD
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| 75 |  ;;900 D;BED HOSP SPEC
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| 76 |  ;;900 E;MATTRESS STAN
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| 77 |  ;;900 F;MATTRESS SPEC
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| 78 |  ;;900 G;BED, ACCESSORIES
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| 79 |  ;;900 H;ENVIRON CONTR
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| 80 |  ;;900 I;SPEC HOME EQP (SAFETY)
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| 81 |  ;;900 J;TENS UNIT
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| 82 |  ;;900 K;MED EQP AL/OTH
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| 83 |  ;;900 L;EQP RENTAL
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| 84 |  ;;900 M;COMPUTER EQUIPMENT
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| 85 |  ;;900 N;TELEHEALTH
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| 86 |  ;;910;ALL OTHER SUPPLIES AND EQUIPMENT
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| 87 |  ;;910 A;MED SUP AL/OTH
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| 88 |  ;;920;HOME DIALYSIS PROGRAM
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| 89 |  ;;920 A;HOME DIAL EQP
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| 90 |  ;;920 B;HOME DIAL SUP
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| 91 |  ;;930;ADAPTIVE EQUIPMENT
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| 92 |  ;;930 A;MOD VANS
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| 93 |  ;;930 B;ADAPT EQP AL/OTH
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| 94 |  ;;940;HISA
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| 95 |  ;;940 A;HISA SC
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| 96 |  ;;940 B;HISA NSC
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| 97 |  ;;960;SURGICAL IMPLANTS
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| 98 |  ;;960 A;HEAD & NECK
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| 99 |  ;;960 A1;H&N INTRAOCULAR LENS
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| 100 |  ;;960 A2;H&N HEAD
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| 101 |  ;;960 A3;H&N NECK
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| 102 |  ;;960 A4;H&N EYES A/O
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| 103 |  ;;960 B;ABDOMEN
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| 104 |  ;;960 B1;ABDOMEN STENT
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| 105 |  ;;960 B2;ABDOMEN MESH
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| 106 |  ;;960 B3;ABDOMEN CATHETER
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| 107 |  ;;960 C;UPPER EXTREMITY
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| 108 |  ;;960 C1;UE ARM
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| 109 |  ;;960 C2;UE SHOULDER
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| 110 |  ;;960 C3;UE HAND
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| 111 |  ;;960 D;LOWER EXTREMITY
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| 112 |  ;;960 D1;LE HIP
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| 113 |  ;;960 D2;LE KNEE
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| 114 |  ;;960 D3;LE FOOT
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| 115 |  ;;960 E;THORACIC
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| 116 |  ;;960 E1;THOR PACEMAKER/LEADS
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| 117 |  ;;960 E2;THOR ICD/LEADS
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| 118 |  ;;960 E3;THOR STENTS
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| 119 |  ;;960 E4;THOR VALVE
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| 120 |  ;;960 F;DENTAL IMPLANT
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| 121 |  ;;960 G;ALL SCRWS,PLTS, ANCRS, ETC.
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| 122 |  ;;960 X;SI UNKNOWNS (ALL)
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| 123 |  ;;999;MISC
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| 124 |  ;;999 A;AL/OTH ITEMS
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| 125 |  ;;999 X;HCPCS NOT GRP
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| 126 |  ;;999 Z;NO HCPCS
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| 127 |  ;;R07;HEARING AID, LOCAL REPAIRS
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| 128 |  ;;R10;WHEELCHAIRS AND ACCESSORIES
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| 129 |  ;;R10 A;WHEELCHAIR
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| 130 |  ;;R10 B;CARRIERS
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| 131 |  ;;R10 C;NSC VAN MODS
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| 132 |  ;;R10 ;WHEELCHAIR
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| 133 |  ;;R20;ARTIFICIAL LEGS
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| 134 |  ;;R20 A;LEG A/K
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| 135 |  ;;R20 B;LEG B/K, PTB
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| 136 |  ;;R20 C;LEG B/K, STD
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| 137 |  ;;R20 D;LEG ALL OTHER
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| 138 |  ;;R30;ARTIFICIAL ARMS AND TERMINAL DEVICES
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| 139 |  ;;R30 ;ART ARM,TOTAL
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| 140 |  ;;R40;BRACES AND ORTHOTICS
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| 141 |  ;;R40 ;BRACE TOTAL
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| 142 |  ;;R50;SHOES/ORTHOTICS
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| 143 |  ;;R50 A;ORTH SHOE ALL
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| 144 |  ;;R50 B;SHOE MOD
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| 145 |  ;;R50 C;A/O ITEM SERV
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| 146 |  ;;R60;NEUROSENSORY AIDS
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| 147 |  ;;R60 A;AID FOR BLIND
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| 148 |  ;;R60 B;EYEGLASS RPR
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| 149 |  ;;R60 C;HEARING AID
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| 150 |  ;;R60 D;ASST LISTENING DEVICE
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| 151 |  ;;R60 E;SPEECH DEVICES
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| 152 |  ;;R70;HOME DIALYSIS EQUIPMENT
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| 153 |  ;;R70 ;HOME DIAL EQU
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| 154 |  ;;R80;MEDICAL EQUIPMENT
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| 155 |  ;;R80 A;INVALID LIFTS
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| 156 |  ;;R80 B;REPAIR TO ECU
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| 157 |  ;;R80 C;MED EQUIP A/O
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| 158 |  ;;R80 D;HME DELIVERY/PICKUP
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| 159 |  ;;R80 E;TELEHEALTH
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| 160 |  ;;R90;ALL OTHER
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| 161 |  ;;R90 ;ALL OTHER
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| 162 |  ;;R90 A;SHIPPING
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| 163 |  ;;R90 B;TRAINING
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| 164 |  ;;R91;O2 & RESPIRATORY
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| 165 |  ;;R91 A;CONCENTRATOR
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| 166 |  ;;R91 B;VENTILATOR
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| 167 |  ;;R91 C;EQUIPMENT A/O
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| 168 |  ;;R91 D;SERVICE VISIT
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| 169 |  ;;R91 E;COMPRESSED O2
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| 170 |  ;;R91 F;LIQUID O2
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| 171 |  ;;R91 G;LIQUID DEL SYS
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| 172 |  ;;R91 H;RESPIRATORY EQUIP
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| 173 |  ;;R99 A;SHIPPING
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| 174 |  ;;R99 X;HCPCS NOT GRP
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| 175 |  ;;R99 Z;NO HCPCS
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| 176 |  ;;QUIT
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