| 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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