OUTPA|Outpatient Hospital|78267|Y||I~01/000;58/000||MAXFEE|C30||9.88|0.0||20080701|22991231||
OUTPA|Outpatient Hospital|78268|Y||I~01/000;58/000||MAXFEE|C30||84.70|0.0||20080701|22991231||
OUTPA|Outpatient Hospital|80047|Y||I~01/000;58/000||MAXFEE|LAC||11.89|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|80048|Y||I~01/000;58/000||MAXFEE|LAC||8.74|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|80051|Y||I~01/000;58/000||MAXFEE|LAC||7.24|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|80053|Y||I~01/000;58/000||MAXFEE|LAC||10.91|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|80055|Y||I~01/000;58/000||MAXFEE|LAC||18.84|0.0||20080701|22991231||
OUTPA|Outpatient Hospital|80061|Y||I~01/000;58/000||MAXFEE|LAC||13.84|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|80061|Y||I~01/000;58/000||MAXFEE|LAC|QW|13.84|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|80069|Y||I~01/000;58/000||MAXFEE|LAC||8.97|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|80074|Y||I~01/000;58/000||MAXFEE|LAC||49.22|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|80076|Y||I~01/000;58/000||MAXFEE|LAC||8.44|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|80081|Y||I~01/000;58/000||MAXFEE|LAC||77.35|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|80143|Y||I~01/000;58/000||MAXFEE|LAC||14.91|0.0||20210101|22991231||
OUTPA|Outpatient Hospital|80145|Y||I~01/000;58/000||MAXFEE|LAC||30.85|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|80150|Y||I~01/000;58/000||MAXFEE|LAC||15.58|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|80151|Y||I~01/000;58/000||MAXFEE|LAC||14.91|0.0||20210101|22991231||
OUTPA|Outpatient Hospital|80155|Y||I~01/000;58/000||MAXFEE|LAC||15.44|0.0||20140101|22991231||
OUTPA|Outpatient Hospital|80156|Y||I~01/000;58/000||MAXFEE|LAC||15.06|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|80157|Y||I~01/000;58/000||MAXFEE|LAC||13.69|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|80158|Y||I~01/000;58/000||MAXFEE|LAC||18.65|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|80159|Y||I~01/000;58/000||MAXFEE|LAC||20.18|0.0||20140101|22991231||
OUTPA|Outpatient Hospital|80161|Y||I~01/000;58/000||MAXFEE|LAC||14.91|0.0||20210101|22991231||
OUTPA|Outpatient Hospital|80162|Y||I~01/000;58/000||MAXFEE|LAC||13.72|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|80163|Y||I~01/000;58/000||MAXFEE|LAC||13.72|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|80164|Y||I~01/000;58/000||MAXFEE|LAC||13.99|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|80165|Y||I~01/000;58/000||MAXFEE|LAC||13.99|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|80167|Y||I~01/000;58/000||MAXFEE|LAC||14.91|0.0||20210101|22991231||
OUTPA|Outpatient Hospital|80168|Y||I~01/000;58/000||MAXFEE|LAC||16.88|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|80169|Y||I~01/000;58/000||MAXFEE|LAC||14.19|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|80170|Y||I~01/000;58/000||MAXFEE|LAC||16.93|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|80171|Y||I~01/000;58/000||MAXFEE|LAC||14.48|0.0||20140101|22991231||
OUTPA|Outpatient Hospital|80173|Y||I~01/000;58/000||MAXFEE|LAC||16.31|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|80175|Y||I~01/000;58/000||MAXFEE|LAC||13.69|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|80176|Y||I~01/000;58/000||MAXFEE|LAC||15.18|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|80177|Y||I~01/000;58/000||MAXFEE|LAC||13.69|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|80178|Y||I~01/000;58/000||MAXFEE|LAC||6.83|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|80179|Y||I~01/000;58/000||MAXFEE|LAC||14.91|0.0||20210101|22991231||
OUTPA|Outpatient Hospital|80180|Y||I~01/000;58/000||MAXFEE|LAC||18.65|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|80181|Y||I~01/000;58/000||MAXFEE|LAC||14.91|0.0||20210101|22991231||
OUTPA|Outpatient Hospital|80183|Y||I~01/000;58/000||MAXFEE|LAC||13.69|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|80184|Y||I~01/000;58/000||MAXFEE|LAC||15.81|0.0||20180101|22991231||
OUTPA|Outpatient Hospital|80185|Y||I~01/000;58/000||MAXFEE|LAC||13.69|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|80186|Y||I~01/000;58/000||MAXFEE|LAC||14.22|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|80187|Y||I~01/000;58/000||MAXFEE|LAC||21.69|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|80188|Y||I~01/000;58/000||MAXFEE|LAC||17.14|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|80189|Y||I~01/000;58/000||MAXFEE|LAC||27.11|0.0||20210101|22991231||
OUTPA|Outpatient Hospital|80190|Y||I~01/000;58/000||MAXFEE|LAC||23.56|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|80192|Y||I~01/000;58/000||MAXFEE|LAC||17.31|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|80193|Y||I~01/000;58/000||MAXFEE|LAC||38.57|0.0||20210101|22991231||
OUTPA|Outpatient Hospital|80194|Y||I~01/000;58/000||MAXFEE|LAC||15.09|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|80195|Y||I~01/000;58/000||MAXFEE|LAC||14.19|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|80197|Y||I~01/000;58/000||MAXFEE|LAC||14.19|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|80198|Y||I~01/000;58/000||MAXFEE|LAC||14.61|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|80199|Y||I~01/000;58/000||MAXFEE|LAC||19.70|0.0||20140101|22991231||
OUTPA|Outpatient Hospital|80200|Y||I~01/000;58/000||MAXFEE|LAC||16.67|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|80201|Y||I~01/000;58/000||MAXFEE|LAC||12.32|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|80202|Y||I~01/000;58/000||MAXFEE|LAC||13.99|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|80203|Y||I~01/000;58/000||MAXFEE|LAC||13.69|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|80204|Y||I~01/000;58/000||MAXFEE|LAC||38.57|0.0||20210101|22991231||
OUTPA|Outpatient Hospital|80210|Y||I~01/000;58/000||MAXFEE|LAC||21.69|0.0||20210101|22991231||
OUTPA|Outpatient Hospital|80220|Y||I~01/000;58/000||MAXFEE|LAC||14.91|0.0||20220101|22991231||
OUTPA|Outpatient Hospital|80230|Y||I~01/000;58/000||MAXFEE|LAC||30.85|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|80235|Y||I~01/000;58/000||MAXFEE|LAC||21.69|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|80280|Y||I~01/000;58/000||MAXFEE|LAC||30.85|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|80285|Y||I~01/000;58/000||MAXFEE|LAC||21.69|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|80299|Y||I~01/000;58/000||MAXFEE|LAC||19.26|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|80305|Y||I~01/000;58/000||MAXFEE|LAC||13.02|0.0||20190101|22991231||
OUTPA|Outpatient Hospital|80306|Y||I~01/000;58/000||MAXFEE|LAC||17.71|0.0||20190101|22991231||
OUTPA|Outpatient Hospital|80307|Y||I~01/000;58/000||MAXFEE|LAC||63.40|0.0||20170101|22991231||
OUTPA|Outpatient Hospital|80400|Y||I~01/000;58/000||MAXFEE|LAC||33.71|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|80402|Y||I~01/000;58/000||MAXFEE|LAC||89.86|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|80406|Y||I~01/000;58/000||MAXFEE|LAC||80.87|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|80408|Y||I~01/000;58/000||MAXFEE|LAC||129.68|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|80410|Y||I~01/000;58/000||MAXFEE|LAC||34.18|0.0||20180101|22991231||
OUTPA|Outpatient Hospital|80412|Y||I~01/000;58/000||MAXFEE|LAC||463.51|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|80414|Y||I~01/000;58/000||MAXFEE|LAC||53.36|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|80415|Y||I~01/000;58/000||MAXFEE|LAC||57.75|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|80416|Y||I~01/000;58/000||MAXFEE|LAC||185.56|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|80417|Y||I~01/000;58/000||MAXFEE|LAC||45.45|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|80418|Y||I~01/000;58/000||MAXFEE|LAC||598.78|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|80420|Y||I~01/000;58/000||MAXFEE|LAC||101.30|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|80422|Y||I~01/000;58/000||MAXFEE|LAC||47.60|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|80424|Y||I~01/000;58/000||MAXFEE|LAC||52.18|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|80426|Y||I~01/000;58/000||MAXFEE|LAC||153.35|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|80428|Y||I~01/000;58/000||MAXFEE|LAC||68.92|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|80430|Y||I~01/000;58/000||MAXFEE|LAC||110.36|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|80432|Y||I~01/000;58/000||MAXFEE|LAC||80.36|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|80434|Y||I~01/000;58/000||MAXFEE|LAC||142.26|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|80435|Y||I~01/000;58/000||MAXFEE|LAC||106.43|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|80436|Y||I~01/000;58/000||MAXFEE|LAC||94.20|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|80438|Y||I~01/000;58/000||MAXFEE|LAC||52.09|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|80439|Y||I~01/000;58/000||MAXFEE|LAC||69.45|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|81000|Y||I~01/000;58/000||MAXFEE|LAC||4.15|0.0||20180101|22991231||
OUTPA|Outpatient Hospital|81001|Y||I~01/000;58/000||MAXFEE|LAC||3.28|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|81002|Y||I~01/000;58/000||MAXFEE|LAC||3.60|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|81003|Y||I~01/000;58/000||MAXFEE|LAC||2.32|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|81005|Y||I~01/000;58/000||MAXFEE|LAC||2.24|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|81007|Y||I~01/000;58/000||MAXFEE|LAC||3.61|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|81015|Y||I~01/000;58/000||MAXFEE|LAC||3.15|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|81020|Y||I~01/000;58/000||MAXFEE|LAC||4.86|0.0||20180101|22991231||
OUTPA|Outpatient Hospital|81025|Y||I~01/000;58/000||MAXFEE|LAC||8.90|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|81050|Y||I~01/000;58/000||MAXFEE|LAC||3.76|0.0||20190101|22991231||
OUTPA|Outpatient Hospital|81105|Y||I~01/000;58/000||MAXFEE|LAC||120.71|0.0||20180101|22991231||
OUTPA|Outpatient Hospital|81106|Y||I~01/000;58/000||MAXFEE|LAC||120.71|0.0||20180101|22991231||
OUTPA|Outpatient Hospital|81107|Y||I~01/000;58/000||MAXFEE|LAC||120.71|0.0||20180101|22991231||
OUTPA|Outpatient Hospital|81108|Y||I~01/000;58/000||MAXFEE|LAC||120.71|0.0||20180101|22991231||
OUTPA|Outpatient Hospital|81109|Y||I~01/000;58/000||MAXFEE|LAC||120.71|0.0||20180101|22991231||
OUTPA|Outpatient Hospital|81110|Y||I~01/000;58/000||MAXFEE|LAC||120.71|0.0||20180101|22991231||
OUTPA|Outpatient Hospital|81111|Y||I~01/000;58/000||MAXFEE|LAC||120.71|0.0||20180101|22991231||
OUTPA|Outpatient Hospital|81112|Y||I~01/000;58/000||MAXFEE|LAC||120.71|0.0||20180101|22991231||
OUTPA|Outpatient Hospital|81120|Y||I~01/000;58/000||MAXFEE|LAC||154.60|0.0||20180101|22991231||
OUTPA|Outpatient Hospital|81121|Y||I~01/000;58/000||MAXFEE|LAC||236.63|0.0||20180101|22991231||
OUTPA|Outpatient Hospital|81161|Y||I~01/000;58/000||MAXFEE|LAC||140.01|0.0||20180101|22991231||
OUTPA|Outpatient Hospital|81162|Y||I~01/000;58/000||MAXFEE|LAC||1471.63|0.0||20160101|22991231||
OUTPA|Outpatient Hospital|81163|Y||I~01/000;58/000||MAXFEE|LAC||374.40|0.0||20190101|22991231||
OUTPA|Outpatient Hospital|81164|Y||I~01/000;58/000||MAXFEE|LAC||467.38|0.0||20190101|22991231||
OUTPA|Outpatient Hospital|81165|Y||I~01/000;58/000||MAXFEE|LAC||226.30|0.0||20190101|22991231||
OUTPA|Outpatient Hospital|81166|Y||I~01/000;58/000||MAXFEE|LAC||241.08|0.0||20190101|22991231||
OUTPA|Outpatient Hospital|81167|Y||I~01/000;58/000||MAXFEE|LAC||226.30|0.0||20190101|22991231||
OUTPA|Outpatient Hospital|81168|Y||I~01/000;58/000||MAXFEE|LAC||165.85|0.0||20210101|22991231||
OUTPA|Outpatient Hospital|81170|Y||I~01/000;58/000||MAXFEE|LAC||195.07|0.0||20160101|22991231||
OUTPA|Outpatient Hospital|81173|Y||I~01/000;58/000||MAXFEE|LAC||241.08|0.0||20190101|22991231||
OUTPA|Outpatient Hospital|81174|Y||I~01/000;58/000||MAXFEE|LAC||148.16|0.0||20190101|22991231||
OUTPA|Outpatient Hospital|81175|Y||I~01/000;58/000||MAXFEE|LAC||565.61|0.0||20180101|22991231||
OUTPA|Outpatient Hospital|81176|Y||I~01/000;58/000||MAXFEE|LAC||238.91|0.0||20180101|22991231||
OUTPA|Outpatient Hospital|81177|Y||I~01/000;58/000||MAXFEE|LAC||109.60|0.0||20190101|22991231||
OUTPA|Outpatient Hospital|81178|Y||I~01/000;58/000||MAXFEE|LAC||109.60|0.0||20190101|22991231||
OUTPA|Outpatient Hospital|81179|Y||I~01/000;58/000||MAXFEE|LAC||109.60|0.0||20190101|22991231||
OUTPA|Outpatient Hospital|81180|Y||I~01/000;58/000||MAXFEE|LAC||109.60|0.0||20190101|22991231||
OUTPA|Outpatient Hospital|81181|Y||I~01/000;58/000||MAXFEE|LAC||109.60|0.0||20190101|22991231||
OUTPA|Outpatient Hospital|81182|Y||I~01/000;58/000||MAXFEE|LAC||109.60|0.0||20190101|22991231||
OUTPA|Outpatient Hospital|81183|Y||I~01/000;58/000||MAXFEE|LAC||109.60|0.0||20190101|22991231||
OUTPA|Outpatient Hospital|81184|Y||I~01/000;58/000||MAXFEE|LAC||109.60|0.0||20190101|22991231||
OUTPA|Outpatient Hospital|81185|Y||I~01/000;58/000||MAXFEE|LAC||677.01|0.0||20190101|22991231||
OUTPA|Outpatient Hospital|81186|Y||I~01/000;58/000||MAXFEE|LAC||148.16|0.0||20190101|22991231||
OUTPA|Outpatient Hospital|81187|Y||I~01/000;58/000||MAXFEE|LAC||109.60|0.0||20190101|22991231||
OUTPA|Outpatient Hospital|81188|Y||I~01/000;58/000||MAXFEE|LAC||109.60|0.0||20190101|22991231||
OUTPA|Outpatient Hospital|81189|Y||I~01/000;58/000||MAXFEE|LAC||219.86|0.0||20190101|22991231||
OUTPA|Outpatient Hospital|81190|Y||I~01/000;58/000||MAXFEE|LAC||148.16|0.0||20190101|22991231||
OUTPA|Outpatient Hospital|81191|Y||I~01/000;58/000||MAXFEE|LAC||165.85|0.0||20210101|22991231||
OUTPA|Outpatient Hospital|81192|Y||I~01/000;58/000||MAXFEE|LAC||165.85|0.0||20210101|22991231||
OUTPA|Outpatient Hospital|81193|Y||I~01/000;58/000||MAXFEE|LAC||165.85|0.0||20210101|22991231||
OUTPA|Outpatient Hospital|81194|Y||I~01/000;58/000||MAXFEE|LAC||414.62|0.0||20210101|22991231||
OUTPA|Outpatient Hospital|81195|Y||I~01/000;58/000||MAXFEE|LAC||1010.82|0.0||20250101|22991231||
OUTPA|Outpatient Hospital|81200|Y||I~01/000;58/000||MAXFEE|LAC||48.82|0.0||20180101|22991231||
OUTPA|Outpatient Hospital|81201|Y||I~01/000;58/000||MAXFEE|LAC||599.94|0.0||20130101|22991231||
OUTPA|Outpatient Hospital|81202|Y||I~01/000;58/000||MAXFEE|LAC||75.15|0.0||20130101|22991231||
OUTPA|Outpatient Hospital|81203|Y||I~01/000;58/000||MAXFEE|LAC||206.66|0.0||20180101|22991231||
OUTPA|Outpatient Hospital|81204|Y||I~01/000;58/000||MAXFEE|LAC||109.60|0.0||20190101|22991231||
OUTPA|Outpatient Hospital|81205|Y||I~01/000;58/000||MAXFEE|LAC||98.15|0.0||20180101|22991231||
OUTPA|Outpatient Hospital|81206|Y||I~01/000;58/000||MAXFEE|LAC||169.42|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|81207|Y||I~01/000;58/000||MAXFEE|LAC||149.66|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|81208|Y||I~01/000;58/000||MAXFEE|LAC||175.54|0.0||20120101|22991231||
OUTPA|Outpatient Hospital|81209|Y||I~01/000;58/000||MAXFEE|LAC||40.62|0.0||20180101|22991231||
OUTPA|Outpatient Hospital|81210|Y||I~01/000;58/000||MAXFEE|LAC||143.40|0.0||20120101|22991231||
OUTPA|Outpatient Hospital|81212|Y||I~01/000;58/000||MAXFEE|LAC||141.36|0.0||20120101|22991231||
OUTPA|Outpatient Hospital|81215|Y||I~01/000;58/000||MAXFEE|LAC||74.59|0.0||20120101|22991231||
OUTPA|Outpatient Hospital|81216|Y||I~01/000;58/000||MAXFEE|LAC||191.28|0.0||20180101|22991231||
OUTPA|Outpatient Hospital|81217|Y||I~01/000;58/000||MAXFEE|LAC||74.59|0.0||20120101|22991231||
OUTPA|Outpatient Hospital|81218|Y||I~01/000;58/000||MAXFEE|LAC||195.07|0.0||20160101|22991231||
OUTPA|Outpatient Hospital|81219|Y||I~01/000;58/000||MAXFEE|LAC||98.08|0.0||20160101|22991231||
OUTPA|Outpatient Hospital|81220|Y||I~01/000;58/000||MAXFEE|LAC||210.00|0.0||20120101|22991231||
OUTPA|Outpatient Hospital|81221|Y||I~01/000;58/000||MAXFEE|LAC||75.15|0.0||20120101|22991231||
OUTPA|Outpatient Hospital|81222|Y||I~01/000;58/000||MAXFEE|LAC||103.64|0.0||20120101|22991231||
OUTPA|Outpatient Hospital|81223|Y||I~01/000;58/000||MAXFEE|LAC||515.62|0.0||20180101|22991231||
OUTPA|Outpatient Hospital|81224|Y||I~01/000;58/000||MAXFEE|LAC||66.06|0.0||20120101|22991231||
OUTPA|Outpatient Hospital|81228|Y||I~01/000;58/000||MAXFEE|LAC||516.91|0.0||20120101|22991231||
OUTPA|Outpatient Hospital|81229|Y||I~01/000;58/000||MAXFEE|LAC||608.00|0.0||20120101|22991231||
OUTPA|Outpatient Hospital|81233|Y||I~01/000;58/000||MAXFEE|LAC||140.32|0.0||20190101|22991231||
OUTPA|Outpatient Hospital|81234|Y||I~01/000;58/000||MAXFEE|LAC||109.60|0.0||20190101|22991231||
OUTPA|Outpatient Hospital|81235|Y||I~01/000;58/000||MAXFEE|LAC||264.01|0.0||20130101|22991231||
OUTPA|Outpatient Hospital|81238|Y||I~01/000;58/000||MAXFEE|LAC||480.00|0.0||20180101|22991231||
OUTPA|Outpatient Hospital|81239|Y||I~01/000;58/000||MAXFEE|LAC||219.86|0.0||20190101|22991231||
OUTPA|Outpatient Hospital|81240|Y||I~01/000;58/000||MAXFEE|LAC||53.70|0.0||20120101|22991231||
OUTPA|Outpatient Hospital|81241|Y||I~01/000;58/000||MAXFEE|LAC||66.70|0.0||20120101|22991231||
OUTPA|Outpatient Hospital|81242|Y||I~01/000;58/000||MAXFEE|LAC||37.84|0.0||20180101|22991231||
OUTPA|Outpatient Hospital|81243|Y||I~01/000;58/000||MAXFEE|LAC||54.46|0.0||20120101|22991231||
OUTPA|Outpatient Hospital|81244|Y||I~01/000;58/000||MAXFEE|LAC||46.38|0.0||20180101|22991231||
OUTPA|Outpatient Hospital|81245|Y||I~01/000;58/000||MAXFEE|LAC||132.74|0.0||20120101|22991231||
OUTPA|Outpatient Hospital|81246|Y||I~01/000;58/000||MAXFEE|LAC||85.76|0.0||20180101|22991231||
OUTPA|Outpatient Hospital|81247|Y||I~01/000;58/000||MAXFEE|LAC||139.84|0.0||20180101|22991231||
OUTPA|Outpatient Hospital|81248|Y||I~01/000;58/000||MAXFEE|LAC||300.02|0.0||20180101|22991231||
OUTPA|Outpatient Hospital|81249|Y||I~01/000;58/000||MAXFEE|LAC||480.00|0.0||20180101|22991231||
OUTPA|Outpatient Hospital|81250|Y||I~01/000;58/000||MAXFEE|LAC||60.44|0.0||20180101|22991231||
OUTPA|Outpatient Hospital|81251|Y||I~01/000;58/000||MAXFEE|LAC||48.82|0.0||20180101|22991231||
OUTPA|Outpatient Hospital|81252|Y||I~01/000;58/000||MAXFEE|LAC||104.49|0.0||20180101|22991231||
OUTPA|Outpatient Hospital|81253|Y||I~01/000;58/000||MAXFEE|LAC||63.57|0.0||20180101|22991231||
OUTPA|Outpatient Hospital|81254|Y||I~01/000;58/000||MAXFEE|LAC||36.17|0.0||20180101|22991231||
OUTPA|Outpatient Hospital|81255|Y||I~01/000;58/000||MAXFEE|LAC||53.16|0.0||20180101|22991231||
OUTPA|Outpatient Hospital|81256|Y||I~01/000;58/000||MAXFEE|LAC||67.54|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|81257|Y||I~01/000;58/000||MAXFEE|LAC||105.67|0.0||20180101|22991231||
OUTPA|Outpatient Hospital|81258|Y||I~01/000;58/000||MAXFEE|LAC||300.02|0.0||20180101|22991231||
OUTPA|Outpatient Hospital|81259|Y||I~01/000;58/000||MAXFEE|LAC||480.00|0.0||20180101|22991231||
OUTPA|Outpatient Hospital|81260|Y||I~01/000;58/000||MAXFEE|LAC||40.62|0.0||20180101|22991231||
OUTPA|Outpatient Hospital|81261|Y||I~01/000;58/000||MAXFEE|LAC||204.58|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|81262|Y||I~01/000;58/000||MAXFEE|LAC||47.64|0.0||20120101|22991231||
OUTPA|Outpatient Hospital|81263|Y||I~01/000;58/000||MAXFEE|LAC||304.33|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|81264|Y||I~01/000;58/000||MAXFEE|LAC||162.98|0.0||20120101|22991231||
OUTPA|Outpatient Hospital|81265|Y||I~01/000;58/000||MAXFEE|LAC||234.70|0.0||20120101|22991231||
OUTPA|Outpatient Hospital|81266|Y||I~01/000;58/000||MAXFEE|T18||304.81|0.0|OPXOVER80|20180101|22991231||
OUTPA|Outpatient Hospital|81267|Y||I~01/000;58/000||MAXFEE|LAC||214.37|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|81268|Y||I~01/000;58/000||MAXFEE|LAC||269.47|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|81269|Y||I~01/000;58/000||MAXFEE|LAC||161.92|0.0||20180101|22991231||
OUTPA|Outpatient Hospital|81270|Y||I~01/000;58/000||MAXFEE|LAC||94.71|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|81271|Y||I~01/000;58/000||MAXFEE|LAC||109.60|0.0||20190101|22991231||
OUTPA|Outpatient Hospital|81272|Y||I~01/000;58/000||MAXFEE|LAC||195.07|0.0||20160101|22991231||
OUTPA|Outpatient Hospital|81273|Y||I~01/000;58/000||MAXFEE|LAC||73.92|0.0||20160101|22991231||
OUTPA|Outpatient Hospital|81274|Y||I~01/000;58/000||MAXFEE|LAC||219.86|0.0||20190101|22991231||
OUTPA|Outpatient Hospital|81275|Y||I~01/000;58/000||MAXFEE|LAC||157.98|0.0||20120101|22991231||
OUTPA|Outpatient Hospital|81276|Y||I~01/000;58/000||MAXFEE|LAC||116.74|0.0||20160101|22991231||
OUTPA|Outpatient Hospital|81277|Y||I~01/000;58/000||MAXFEE|LAC||928.00|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|81278|Y||I~01/000;58/000||MAXFEE|LAC||165.85|0.0||20210101|22991231||
OUTPA|Outpatient Hospital|81279|Y||I~01/000;58/000||MAXFEE|LAC||148.16|0.0||20210101|22991231||
OUTPA|Outpatient Hospital|81284|Y||I~01/000;58/000||MAXFEE|LAC||109.60|0.0||20190101|22991231||
OUTPA|Outpatient Hospital|81285|Y||I~01/000;58/000||MAXFEE|LAC||219.86|0.0||20190101|22991231||
OUTPA|Outpatient Hospital|81286|Y||I~01/000;58/000||MAXFEE|LAC||219.86|0.0||20190101|22991231||
OUTPA|Outpatient Hospital|81287|Y||I~01/000;58/000||MAXFEE|LAC||83.09|0.0||20180101|22991231||
OUTPA|Outpatient Hospital|81288|Y||I~01/000;58/000||MAXFEE|LAC||164.96|0.0||20160101|22991231||
OUTPA|Outpatient Hospital|81289|Y||I~01/000;58/000||MAXFEE|LAC||148.16|0.0||20190101|22991231||
OUTPA|Outpatient Hospital|81290|Y||I~01/000;58/000||MAXFEE|LAC||40.62|0.0||20180101|22991231||
OUTPA|Outpatient Hospital|81292|Y||I~01/000;58/000||MAXFEE|LAC||270.25|0.0||20120101|22991231||
OUTPA|Outpatient Hospital|81293|Y||I~01/000;58/000||MAXFEE|LAC||152.54|0.0||20120101|22991231||
OUTPA|Outpatient Hospital|81294|Y||I~01/000;58/000||MAXFEE|LAC||121.37|0.0||20120101|22991231||
OUTPA|Outpatient Hospital|81295|Y||I~01/000;58/000||MAXFEE|LAC||103.62|0.0||20120101|22991231||
OUTPA|Outpatient Hospital|81296|Y||I~01/000;58/000||MAXFEE|LAC||121.37|0.0||20120101|22991231||
OUTPA|Outpatient Hospital|81297|Y||I~01/000;58/000||MAXFEE|LAC||156.37|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|81298|Y||I~01/000;58/000||MAXFEE|LAC||230.26|0.0||20120101|22991231||
OUTPA|Outpatient Hospital|81299|Y||I~01/000;58/000||MAXFEE|LAC||129.00|0.0||20120101|22991231||
OUTPA|Outpatient Hospital|81300|Y||I~01/000;58/000||MAXFEE|LAC||129.34|0.0||20120101|22991231||
OUTPA|Outpatient Hospital|81301|Y||I~01/000;58/000||MAXFEE|LAC||316.03|0.0||20120101|22991231||
OUTPA|Outpatient Hospital|81302|Y||I~01/000;58/000||MAXFEE|LAC||281.65|0.0||20120101|22991231||
OUTPA|Outpatient Hospital|81303|Y||I~01/000;58/000||MAXFEE|LAC||105.91|0.0||20120101|22991231||
OUTPA|Outpatient Hospital|81304|Y||I~01/000;58/000||MAXFEE|LAC||76.88|0.0||20120101|22991231||
OUTPA|Outpatient Hospital|81305|Y||I~01/000;58/000||MAXFEE|LAC||140.32|0.0||20190101|22991231||
OUTPA|Outpatient Hospital|81307|Y||I~01/000;58/000||MAXFEE|LAC||226.30|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|81308|Y||I~01/000;58/000||MAXFEE|LAC||241.08|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|81309|Y||I~01/000;58/000||MAXFEE|LAC||219.86|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|81310|Y||I~01/000;58/000||MAXFEE|LAC||197.71|0.0||20120101|22991231||
OUTPA|Outpatient Hospital|81311|Y||I~01/000;58/000||MAXFEE|LAC||175.10|0.0||20160101|22991231||
OUTPA|Outpatient Hospital|81312|Y||I~01/000;58/000||MAXFEE|LAC||109.60|0.0||20190101|22991231||
OUTPA|Outpatient Hospital|81314|Y||I~01/000;58/000||MAXFEE|LAC||329.51|0.0||20160101|22991231||
OUTPA|Outpatient Hospital|81315|Y||I~01/000;58/000||MAXFEE|LAC||214.21|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|81316|Y||I~01/000;58/000||MAXFEE|LAC||214.21|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|81317|Y||I~01/000;58/000||MAXFEE|LAC||625.03|0.0||20120101|22991231||
OUTPA|Outpatient Hospital|81318|Y||I~01/000;58/000||MAXFEE|LAC||147.69|0.0||20120101|22991231||
OUTPA|Outpatient Hospital|81319|Y||I~01/000;58/000||MAXFEE|LAC||177.33|0.0||20120101|22991231||
OUTPA|Outpatient Hospital|81321|Y||I~01/000;58/000||MAXFEE|LAC||480.56|0.0||20130101|22991231||
OUTPA|Outpatient Hospital|81322|Y||I~01/000;58/000||MAXFEE|LAC||46.72|0.0||20130101|22991231||
OUTPA|Outpatient Hospital|81323|Y||I~01/000;58/000||MAXFEE|LAC||70.08|0.0||20130101|22991231||
OUTPA|Outpatient Hospital|81324|Y||I~01/000;58/000||MAXFEE|LAC||437.54|0.0||20130101|22991231||
OUTPA|Outpatient Hospital|81325|Y||I~01/000;58/000||MAXFEE|LAC||267.52|0.0||20130101|22991231||
OUTPA|Outpatient Hospital|81326|Y||I~01/000;58/000||MAXFEE|LAC||48.15|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|81329|Y||I~01/000;58/000||MAXFEE|LAC||109.60|0.0||20190101|22991231||
OUTPA|Outpatient Hospital|81330|Y||I~01/000;58/000||MAXFEE|LAC||48.57|0.0||20180101|22991231||
OUTPA|Outpatient Hospital|81331|Y||I~01/000;58/000||MAXFEE|LAC||52.77|0.0||20180101|22991231||
OUTPA|Outpatient Hospital|81334|Y||I~01/000;58/000||MAXFEE|LAC||263.61|0.0||20180101|22991231||
OUTPA|Outpatient Hospital|81335|Y||I~01/000;58/000||MAXFEE|LAC||139.84|0.0||20180101|22991231||
OUTPA|Outpatient Hospital|81336|Y||I~01/000;58/000||MAXFEE|LAC||241.08|0.0||20190101|22991231||
OUTPA|Outpatient Hospital|81337|Y||I~01/000;58/000||MAXFEE|LAC||148.16|0.0||20190101|22991231||
OUTPA|Outpatient Hospital|81338|Y||I~01/000;58/000||MAXFEE|LAC||120.26|0.0||20210101|22991231||
OUTPA|Outpatient Hospital|81339|Y||I~01/000;58/000||MAXFEE|LAC||148.16|0.0||20210101|22991231||
OUTPA|Outpatient Hospital|81340|Y||I~01/000;58/000||MAXFEE|LAC||215.88|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|81341|Y||I~01/000;58/000||MAXFEE|LAC||51.24|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|81342|Y||I~01/000;58/000||MAXFEE|LAC||208.21|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|81347|Y||I~01/000;58/000||MAXFEE|LAC||193.25|0.0||20210101|22991231||
OUTPA|Outpatient Hospital|81348|Y||I~01/000;58/000||MAXFEE|LAC||175.40|0.0||20210101|22991231||
OUTPA|Outpatient Hospital|81349|Y||I~01/000;58/000||MAXFEE|LAC||175.40|0.0||20220101|22991231||
OUTPA|Outpatient Hospital|81351|Y||I~01/000;58/000||MAXFEE|LAC||513.48|0.0||20210101|22991231||
OUTPA|Outpatient Hospital|81352|Y||I~01/000;58/000||MAXFEE|LAC||329.51|0.0||20210101|22991231||
OUTPA|Outpatient Hospital|81353|Y||I~01/000;58/000||MAXFEE|LAC||246.40|0.0||20210101|22991231||
OUTPA|Outpatient Hospital|81357|Y||I~01/000;58/000||MAXFEE|LAC||193.25|0.0||20210101|22991231||
OUTPA|Outpatient Hospital|81360|Y||I~01/000;58/000||MAXFEE|LAC||193.25|0.0||20210101|22991231||
OUTPA|Outpatient Hospital|81361|Y||I~01/000;58/000||MAXFEE|LAC||139.84|0.0||20180101|22991231||
OUTPA|Outpatient Hospital|81362|Y||I~01/000;58/000||MAXFEE|LAC||300.02|0.0||20180101|22991231||
OUTPA|Outpatient Hospital|81363|Y||I~01/000;58/000||MAXFEE|LAC||161.92|0.0||20180101|22991231||
OUTPA|Outpatient Hospital|81364|Y||I~01/000;58/000||MAXFEE|LAC||259.66|0.0||20180101|22991231||
OUTPA|Outpatient Hospital|81370|Y||I~01/000;58/000||MAXFEE|LAC||415.51|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|81371|Y||I~01/000;58/000||MAXFEE|LAC||262.69|0.0||20120101|22991231||
OUTPA|Outpatient Hospital|81372|Y||I~01/000;58/000||MAXFEE|LAC||241.09|0.0||20120101|22991231||
OUTPA|Outpatient Hospital|81373|Y||I~01/000;58/000||MAXFEE|LAC||121.54|0.0||20120101|22991231||
OUTPA|Outpatient Hospital|81374|Y||I~01/000;58/000||MAXFEE|LAC||76.81|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|81375|Y||I~01/000;58/000||MAXFEE|LAC||228.09|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|81376|Y||I~01/000;58/000||MAXFEE|LAC||126.29|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|81377|Y||I~01/000;58/000||MAXFEE|LAC||97.89|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|81378|Y||I~01/000;58/000||MAXFEE|LAC||357.08|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|81379|Y||I~01/000;58/000||MAXFEE|LAC||346.55|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|81380|Y||I~01/000;58/000||MAXFEE|LAC||183.15|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|81381|Y||I~01/000;58/000||MAXFEE|LAC||103.22|0.0||20120101|22991231||
OUTPA|Outpatient Hospital|81382|Y||I~01/000;58/000||MAXFEE|LAC||127.80|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|81383|Y||I~01/000;58/000||MAXFEE|LAC||112.76|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|81400|Y||I~01/000;58/000||MAXFEE|T18||63.96|0.0|OPXOVER80|20180101|22991231||
OUTPA|Outpatient Hospital|81401|Y||I~01/000;58/000||MAXFEE|T18||137.00|0.0|OPXOVER80|20180101|22991231||
OUTPA|Outpatient Hospital|81402|Y||I~01/000;58/000||MAXFEE|T18||150.33|0.0|OPXOVER80|20180101|22991231||
OUTPA|Outpatient Hospital|81403|Y||I~01/000;58/000||MAXFEE|T18||185.20|0.0|OPXOVER80|20180101|22991231||
OUTPA|Outpatient Hospital|81404|Y||I~01/000;58/000||MAXFEE|T18||274.83|0.0|OPXOVER80|20180101|22991231||
OUTPA|Outpatient Hospital|81405|Y||I~01/000;58/000||MAXFEE|T18||301.35|0.0|OPXOVER80|20180101|22991231||
OUTPA|Outpatient Hospital|81406|Y||I~01/000;58/000||MAXFEE|T18||282.88|0.0|OPXOVER80|20180101|22991231||
OUTPA|Outpatient Hospital|81407|Y||I~01/000;58/000||MAXFEE|T18||846.27|0.0|OPXOVER80|20180101|22991231||
OUTPA|Outpatient Hospital|81408|Y||I~01/000;58/000||MAXFEE|T18||2000.00|0.0|OPXOVER80|20180101|22991231||
OUTPA|Outpatient Hospital|81410|Y||I~01/000;58/000||MAXFEE|T18||504.00|0.0|OPXOVER80|20180101|22991231||
OUTPA|Outpatient Hospital|81411|Y||I~01/000;58/000||MAXFEE|T18||1350.19|0.0|OPXOVER80|20180101|22991231||
OUTPA|Outpatient Hospital|81413|Y||I~01/000;58/000||MAXFEE|T18||584.90|0.0|OPXOVER80|20200101|22991231||
OUTPA|Outpatient Hospital|81414|Y||I~01/000;58/000||MAXFEE|T18||584.90|0.0|OPXOVER80|20200101|22991231||
OUTPA|Outpatient Hospital|81415|Y||I~01/000;58/000||MAXFEE|C52||3824.00|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|81416|Y||I~01/000;58/000||MAXFEE|C52||9600.00|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|81417|Y||I~01/000;58/000||MAXFEE|C52||256.00|0.0||20201001|22991231||
OUTPA|Outpatient Hospital|81418|Y||I~01/000;58/000||MAXFEE|LAC||917.08|0.0||20230101|22991231||
OUTPA|Outpatient Hospital|81419|Y||I~01/000;58/000||MAXFEE|LAC||2448.56|0.0||20210101|22991231||
OUTPA|Outpatient Hospital|81420|Y||I~01/000;58/000||MAXFEE|LAC||607.24|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|81430|Y||I~01/000;58/000||MAXFEE|T18||1625.00|0.0|OPXOVER80|20180101|22991231||
OUTPA|Outpatient Hospital|81431|Y||I~01/000;58/000||MAXFEE|T18||679.57|0.0|OPXOVER80|20180101|22991231||
OUTPA|Outpatient Hospital|81435|Y||I~01/000;58/000||MAXFEE|T18||1303.95|0.0|OPXOVER80|20250101|22991231||
OUTPA|Outpatient Hospital|81437|Y||I~01/000;58/000||MAXFEE|LAC||438.93|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|81439|Y||I~01/000;58/000||MAXFEE|LAC||597.91|0.0||20170101|22991231||
OUTPA|Outpatient Hospital|81440|Y||I~01/000;58/000||MAXFEE|T18||3324.00|0.0|OPXOVER80|20180101|22991231||
OUTPA|Outpatient Hospital|81441|Y||I~01/000;58/000||MAXFEE|LAC||2448.56|0.0||20230101|22991231||
OUTPA|Outpatient Hospital|81445|Y||I~01/000;58/000||MAXFEE|T18||597.91|0.0|OPXOVER80|20180101|22991231||
OUTPA|Outpatient Hospital|81450|Y||I~01/000;58/000||MAXFEE|T18||759.53|0.0|OPXOVER80|20180101|22991231||
OUTPA|Outpatient Hospital|81455|Y||I~01/000;58/000||MAXFEE|T18||2919.60|0.0|OPXOVER80|20180101|22991231||
OUTPA|Outpatient Hospital|81460|Y||I~01/000;58/000||MAXFEE|T18||1287.00|0.0|OPXOVER80|20180101|22991231||
OUTPA|Outpatient Hospital|81465|Y||I~01/000;58/000||MAXFEE|T18||936.00|0.0|OPXOVER80|20180101|22991231||
OUTPA|Outpatient Hospital|81500|Y||I~01/000;58/000||MAXFEE|T18||260.50|0.0|OPXOVER80|20180101|22991231||
OUTPA|Outpatient Hospital|81503|Y||I~01/000;58/000||MAXFEE|T18||897.00|0.0|OPXOVER80|20180101|22991231||
OUTPA|Outpatient Hospital|81504|Y||I~01/000;58/000||MAXFEE|T18||520.00|0.0|OPXOVER80|20180101|22991231||
OUTPA|Outpatient Hospital|81506|Y||I~01/000;58/000||MAXFEE|T18||68.92|0.0|OPXOVER80|20200101|22991231||
OUTPA|Outpatient Hospital|81507|Y||I~01/000;58/000||MAXFEE|LAC||636.00|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|81508|Y||I~01/000;58/000||MAXFEE|T18||54.30|0.0|OPXOVER80|20180101|22991231||
OUTPA|Outpatient Hospital|81509|Y||I~01/000;58/000||MAXFEE|T18||1487.37|0.0|OPXOVER80|20180101|22991231||
OUTPA|Outpatient Hospital|81510|Y||I~01/000;58/000||MAXFEE|T18||55.54|0.0|OPXOVER80|20180101|22991231||
OUTPA|Outpatient Hospital|81511|Y||I~01/000;58/000||MAXFEE|T18||153.50|0.0|OPXOVER80|20180101|22991231||
OUTPA|Outpatient Hospital|81512|Y||I~01/000;58/000||MAXFEE|T18||69.52|0.0|OPXOVER80|20180101|22991231||
OUTPA|Outpatient Hospital|81513|Y||I~01/000;58/000||MAXFEE|LAC||114.10|0.0||20210101|22991231||
OUTPA|Outpatient Hospital|81514|Y||I~01/000;58/000||MAXFEE|LAC||210.39|0.0||20210101|22991231||
OUTPA|Outpatient Hospital|81515|Y||I~01/000;58/000||MAXFEE|LAC||210.39|0.0||20250101|22991231||
OUTPA|Outpatient Hospital|81518|Y||I~01/000;58/000||MAXFEE|LAC||3098.40|0.0||20190101|22991231||
OUTPA|Outpatient Hospital|81519|Y||I~01/000;58/000||MAXFEE|LAC||2062.40|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|81522|Y||I~01/000;58/000||MAXFEE|LAC||3098.40|0.0||20220101|22991231||
OUTPA|Outpatient Hospital|81523|Y||I~01/000;58/000||MAXFEE|LAC||3098.40|0.0||20220101|22991231||
OUTPA|Outpatient Hospital|81528|Y||I~01/000;58/000||MAXFEE|LAC||407.09|0.0||20160101|22991231||
OUTPA|Outpatient Hospital|81529|Y||I~01/000;58/000||MAXFEE|LAC||5754.40|0.0||20210101|22991231||
OUTPA|Outpatient Hospital|81541|Y||I~01/000;58/000||MAXFEE|LAC||3098.40|0.0||20180101|22991231||
OUTPA|Outpatient Hospital|81542|Y||I~01/000;58/000||MAXFEE|T18||3873.00|0.0|OPXOVER80|20210101|22991231||
OUTPA|Outpatient Hospital|81546|Y||I~01/000;58/000||MAXFEE|LAC||2880.00|0.0||20210101|22991231||
OUTPA|Outpatient Hospital|81552|Y||I~01/000;58/000||MAXFEE|T18||7776.00|0.0|OPXOVER80|20210101|22991231||
OUTPA|Outpatient Hospital|81554|Y||I~01/000;58/000||MAXFEE|LAC||4400.00|0.0||20210101|22991231||
OUTPA|Outpatient Hospital|81558|Y||I~01/000;58/000||MAXFEE|LAC||2592.00|0.0||20250101|22991231||
OUTPA|Outpatient Hospital|81560|Y||I~01/000;58/000||MAXFEE|LAC||12.05|0.0||20220101|22991231||
OUTPA|Outpatient Hospital|81595|Y||I~01/000;58/000||MAXFEE|LAC||2592.00|0.0||20190101|22991231||
OUTPA|Outpatient Hospital|82009|Y||I~01/000;58/000||MAXFEE|LAC||4.67|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82010|Y||I~01/000;58/000||MAXFEE|LAC||8.44|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82013|Y||I~01/000;58/000||MAXFEE|LAC||12.70|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82016|Y||I~01/000;58/000||MAXFEE|LAC||17.04|0.0||20190101|22991231||
OUTPA|Outpatient Hospital|82017|Y||I~01/000;58/000||MAXFEE|LAC||17.43|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82024|Y||I~01/000;58/000||MAXFEE|LAC||39.91|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82030|Y||I~01/000;58/000||MAXFEE|LAC||26.66|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82040|Y||I~01/000;58/000||MAXFEE|LAC||5.11|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82042|Y||I~01/000;58/000||MAXFEE|LAC||7.27|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|82043|Y||I~01/000;58/000||MAXFEE|LAC||5.97|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82044|Y||I~01/000;58/000||MAXFEE|LAC||4.27|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|82044|Y||I~01/000;58/000||MAXFEE|LAC|QW|4.27|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|82045|Y||I~01/000;58/000||MAXFEE|LAC||35.07|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82075|Y||I~01/000;58/000||MAXFEE|LAC||16.95|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|82077|Y||I~01/000;58/000||MAXFEE|LAC||13.82|0.0||20210101|22991231||
OUTPA|Outpatient Hospital|82085|Y||I~01/000;58/000||MAXFEE|LAC||10.03|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82088|Y||I~01/000;58/000||MAXFEE|LAC||42.11|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82103|Y||I~01/000;58/000||MAXFEE|LAC||13.89|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82104|Y||I~01/000;58/000||MAXFEE|LAC||14.94|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82105|Y||I~01/000;58/000||MAXFEE|LAC||17.33|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82106|Y||I~01/000;58/000||MAXFEE|LAC||17.57|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82107|Y||I~01/000;58/000||MAXFEE|LAC||66.55|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82108|Y||I~01/000;58/000||MAXFEE|LAC||26.33|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82120|Y||I~01/000;58/000||MAXFEE|LAC||5.29|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|82127|Y||I~01/000;58/000||MAXFEE|LAC||14.65|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82128|Y||I~01/000;58/000||MAXFEE|LAC||14.33|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82131|Y||I~01/000;58/000||MAXFEE|LAC||21.01|0.0||20080701|22991231||
OUTPA|Outpatient Hospital|82135|Y||I~01/000;58/000||MAXFEE|LAC||17.00|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82136|Y||I~01/000;58/000||MAXFEE|LAC||20.26|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|82139|Y||I~01/000;58/000||MAXFEE|LAC||17.43|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82140|Y||I~01/000;58/000||MAXFEE|LAC||15.06|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82143|Y||I~01/000;58/000||MAXFEE|LAC||9.66|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|82150|Y||I~01/000;58/000||MAXFEE|LAC||6.70|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82154|Y||I~01/000;58/000||MAXFEE|LAC||29.79|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82157|Y||I~01/000;58/000||MAXFEE|LAC||30.26|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82160|Y||I~01/000;58/000||MAXFEE|LAC||26.40|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82163|Y||I~01/000;58/000||MAXFEE|LAC||21.20|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82164|Y||I~01/000;58/000||MAXFEE|LAC||15.09|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82172|Y||I~01/000;58/000||MAXFEE|LAC||21.79|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|82175|Y||I~01/000;58/000||MAXFEE|LAC||19.60|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82180|Y||I~01/000;58/000||MAXFEE|LAC||10.22|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82190|Y||I~01/000;58/000||MAXFEE|LAC||16.43|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82232|Y||I~01/000;58/000||MAXFEE|LAC||16.72|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82239|Y||I~01/000;58/000||MAXFEE|LAC||17.69|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82240|Y||I~01/000;58/000||MAXFEE|LAC||27.47|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82247|Y||I~01/000;58/000||MAXFEE|LAC||4.24|0.0||20080701|22991231||
OUTPA|Outpatient Hospital|82248|Y||I~01/000;58/000||MAXFEE|LAC||4.70|0.0||20080701|22991231||
OUTPA|Outpatient Hospital|82252|Y||I~01/000;58/000||MAXFEE|LAC||4.71|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82261|Y||I~01/000;58/000||MAXFEE|LAC||17.43|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82270|Y||I~01/000;58/000||MAXFEE|LAC||3.66|0.0||20080701|22991231||
OUTPA|Outpatient Hospital|82271|Y||I~01/000;58/000||MAXFEE|LAC||4.26|0.0||20080701|22991231||
OUTPA|Outpatient Hospital|82272|Y||I~01/000;58/000||MAXFEE|LAC||4.26|0.0||20080701|22991231||
OUTPA|Outpatient Hospital|82274|Y||I~01/000;58/000||MAXFEE|LAC||16.45|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82286|Y||I~01/000;58/000||MAXFEE|LAC||5.33|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82300|Y||I~01/000;58/000||MAXFEE|LAC||24.43|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82306|Y||I~01/000;58/000||MAXFEE|LAC||30.59|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82308|Y||I~01/000;58/000||MAXFEE|LAC||27.68|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82310|Y||I~01/000;58/000||MAXFEE|LAC||5.33|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82330|Y||I~01/000;58/000||MAXFEE|LAC||14.14|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82331|Y||I~01/000;58/000||MAXFEE|LAC||7.27|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|82340|Y||I~01/000;58/000||MAXFEE|LAC||6.23|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82355|Y||I~01/000;58/000||MAXFEE|LAC||11.97|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82360|Y||I~01/000;58/000||MAXFEE|LAC||13.30|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82365|Y||I~01/000;58/000||MAXFEE|LAC||13.33|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82370|Y||I~01/000;58/000||MAXFEE|LAC||12.94|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82373|Y||I~01/000;58/000||MAXFEE|LAC||10.38|0.0||20080701|22991231||
OUTPA|Outpatient Hospital|82374|Y||I~01/000;58/000||MAXFEE|LAC||5.04|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82375|Y||I~01/000;58/000||MAXFEE|LAC||12.73|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82376|Y||I~01/000;58/000||MAXFEE|LAC||8.42|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|82378|Y||I~01/000;58/000||MAXFEE|LAC||19.59|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82379|Y||I~01/000;58/000||MAXFEE|LAC||17.43|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82380|Y||I~01/000;58/000||MAXFEE|LAC||9.53|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82382|Y||I~01/000;58/000||MAXFEE|LAC||24.18|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|82383|Y||I~01/000;58/000||MAXFEE|LAC||30.05|0.0||20190101|22991231||
OUTPA|Outpatient Hospital|82384|Y||I~01/000;58/000||MAXFEE|LAC||26.09|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82387|Y||I~01/000;58/000||MAXFEE|LAC||18.66|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82390|Y||I~01/000;58/000||MAXFEE|LAC||11.10|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82397|Y||I~01/000;58/000||MAXFEE|LAC||14.59|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82415|Y||I~01/000;58/000||MAXFEE|LAC||13.09|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82435|Y||I~01/000;58/000||MAXFEE|LAC||4.75|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82436|Y||I~01/000;58/000||MAXFEE|LAC||5.94|0.0||20190101|22991231||
OUTPA|Outpatient Hospital|82438|Y||I~01/000;58/000||MAXFEE|LAC||5.17|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82441|Y||I~01/000;58/000||MAXFEE|LAC||6.21|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82465|Y||I~01/000;58/000||MAXFEE|LAC||4.49|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82465|Y||I~01/000;58/000||MAXFEE|LAC|QW|4.49|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82480|Y||I~01/000;58/000||MAXFEE|LAC||8.13|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82482|Y||I~01/000;58/000||MAXFEE|LAC||10.14|0.0||20180101|22991231||
OUTPA|Outpatient Hospital|82485|Y||I~01/000;58/000||MAXFEE|LAC||21.34|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82495|Y||I~01/000;58/000||MAXFEE|LAC||10.23|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|82507|Y||I~01/000;58/000||MAXFEE|LAC||28.73|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82523|Y||I~01/000;58/000||MAXFEE|LAC||14.65|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|82525|Y||I~01/000;58/000||MAXFEE|LAC||12.82|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82528|Y||I~01/000;58/000||MAXFEE|LAC||23.27|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82530|Y||I~01/000;58/000||MAXFEE|LAC||17.27|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82533|Y||I~01/000;58/000||MAXFEE|LAC||16.84|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82540|Y||I~01/000;58/000||MAXFEE|LAC||4.79|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82542|Y||I~01/000;58/000||MAXFEE|LAC||24.89|0.0||20180101|22991231||
OUTPA|Outpatient Hospital|82550|Y||I~01/000;58/000||MAXFEE|LAC||6.73|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82552|Y||I~01/000;58/000||MAXFEE|LAC||13.84|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82553|Y||I~01/000;58/000||MAXFEE|LAC||8.66|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|82554|Y||I~01/000;58/000||MAXFEE|LAC||8.66|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|82565|Y||I~01/000;58/000||MAXFEE|LAC||5.29|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82570|Y||I~01/000;58/000||MAXFEE|LAC||5.35|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82575|Y||I~01/000;58/000||MAXFEE|LAC||9.78|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82585|Y||I~01/000;58/000||MAXFEE|LAC||9.02|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|82595|Y||I~01/000;58/000||MAXFEE|LAC||6.69|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82600|Y||I~01/000;58/000||MAXFEE|LAC||20.05|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82607|Y||I~01/000;58/000||MAXFEE|LAC||15.58|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82608|Y||I~01/000;58/000||MAXFEE|LAC||14.80|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82610|Y||I~01/000;58/000||MAXFEE|LAC||19.00|0.0||20080101|22991231||
OUTPA|Outpatient Hospital|82615|Y||I~01/000;58/000||MAXFEE|LAC||9.87|0.0||20190101|22991231||
OUTPA|Outpatient Hospital|82626|Y||I~01/000;58/000||MAXFEE|LAC||26.11|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82627|Y||I~01/000;58/000||MAXFEE|LAC||22.97|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82633|Y||I~01/000;58/000||MAXFEE|LAC||32.01|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82634|Y||I~01/000;58/000||MAXFEE|LAC||30.26|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82638|Y||I~01/000;58/000||MAXFEE|LAC||12.66|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82642|Y||I~01/000;58/000||MAXFEE|LAC||30.26|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82652|Y||I~01/000;58/000||MAXFEE|LAC||39.78|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82653|Y||I~01/000;58/000||MAXFEE|LAC||23.73|0.0||20220101|22991231||
OUTPA|Outpatient Hospital|82656|Y||I~01/000;58/000||MAXFEE|LAC||11.91|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82657|Y||I~01/000;58/000||MAXFEE|LAC||22.91|0.0||20190101|22991231||
OUTPA|Outpatient Hospital|82658|Y||I~01/000;58/000||MAXFEE|LAC||25.40|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|82664|Y||I~01/000;58/000||MAXFEE|LAC||48.31|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|82668|Y||I~01/000;58/000||MAXFEE|LAC||19.42|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82670|Y||I~01/000;58/000||MAXFEE|LAC||28.87|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82671|Y||I~01/000;58/000||MAXFEE|LAC||33.38|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82672|Y||I~01/000;58/000||MAXFEE|LAC||22.42|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82677|Y||I~01/000;58/000||MAXFEE|LAC||24.99|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82679|Y||I~01/000;58/000||MAXFEE|LAC||25.78|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82681|Y||I~01/000;58/000||MAXFEE|LAC||22.35|0.0||20210101|22991231||
OUTPA|Outpatient Hospital|82693|Y||I~01/000;58/000||MAXFEE|LAC||7.95|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|82696|Y||I~01/000;58/000||MAXFEE|LAC||27.11|0.0||20190101|22991231||
OUTPA|Outpatient Hospital|82705|Y||I~01/000;58/000||MAXFEE|LAC||5.27|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82710|Y||I~01/000;58/000||MAXFEE|LAC||17.36|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82715|Y||I~01/000;58/000||MAXFEE|LAC||9.02|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|82725|Y||I~01/000;58/000||MAXFEE|LAC||18.72|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|82726|Y||I~01/000;58/000||MAXFEE|LAC||20.41|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82728|Y||I~01/000;58/000||MAXFEE|LAC||14.08|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82731|Y||I~01/000;58/000||MAXFEE|LAC||66.55|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82735|Y||I~01/000;58/000||MAXFEE|LAC||19.16|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82746|Y||I~01/000;58/000||MAXFEE|LAC||15.19|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82747|Y||I~01/000;58/000||MAXFEE|LAC||16.37|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|82757|Y||I~01/000;58/000||MAXFEE|LAC||8.76|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|82759|Y||I~01/000;58/000||MAXFEE|LAC||22.20|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82760|Y||I~01/000;58/000||MAXFEE|LAC||11.57|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82775|Y||I~01/000;58/000||MAXFEE|LAC||21.77|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82776|Y||I~01/000;58/000||MAXFEE|LAC||11.79|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|82777|Y||I~01/000;58/000||MAXFEE|LAC||24.14|0.0||20170501|22991231||
OUTPA|Outpatient Hospital|82784|Y||I~01/000;58/000||MAXFEE|LAC||9.61|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82785|Y||I~01/000;58/000||MAXFEE|LAC||17.01|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82787|Y||I~01/000;58/000||MAXFEE|LAC||5.90|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|82800|Y||I~01/000;58/000||MAXFEE|LAC||11.37|0.0||20180101|22991231||
OUTPA|Outpatient Hospital|82803|Y||I~01/000;58/000||MAXFEE|LAC||26.94|0.0||20180101|22991231||
OUTPA|Outpatient Hospital|82805|Y||I~01/000;58/000||MAXFEE|LAC||39.91|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|82810|Y||I~01/000;58/000||MAXFEE|LAC||10.10|0.0||20190101|22991231||
OUTPA|Outpatient Hospital|82820|Y||I~01/000;58/000||MAXFEE|LAC||13.78|0.0||20180101|22991231||
OUTPA|Outpatient Hospital|82930|Y||I~01/000;58/000||MAXFEE|LAC||6.93|0.0||20190101|22991231||
OUTPA|Outpatient Hospital|82938|Y||I~01/000;58/000||MAXFEE|LAC||18.28|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82941|Y||I~01/000;58/000||MAXFEE|LAC||18.22|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82943|Y||I~01/000;58/000||MAXFEE|LAC||13.88|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|82945|Y||I~01/000;58/000||MAXFEE|LAC||4.06|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82946|Y||I~01/000;58/000||MAXFEE|LAC||10.45|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|82947|Y||I~01/000;58/000||MAXFEE|LAC||4.06|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82947|Y||I~01/000;58/000||MAXFEE|LAC|QW|4.06|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82948|Y||I~01/000;58/000||MAXFEE|LAC||4.45|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|82950|Y||I~01/000;58/000||MAXFEE|LAC||4.91|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82950|Y||I~01/000;58/000||MAXFEE|LAC|QW|4.91|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82951|Y||I~01/000;58/000||MAXFEE|LAC||13.30|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82951|Y||I~01/000;58/000||MAXFEE|LAC|QW|13.30|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82952|Y||I~01/000;58/000||MAXFEE|LAC||4.05|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82952|Y||I~01/000;58/000||MAXFEE|LAC|QW|4.05|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82955|Y||I~01/000;58/000||MAXFEE|LAC||10.02|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82960|Y||I~01/000;58/000||MAXFEE|LAC||6.25|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82962|Y||I~01/000;58/000||MAXFEE|LAC||3.30|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|82963|Y||I~01/000;58/000||MAXFEE|LAC||22.20|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82965|Y||I~01/000;58/000||MAXFEE|LAC||10.87|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|82977|Y||I~01/000;58/000||MAXFEE|LAC||7.44|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82978|Y||I~01/000;58/000||MAXFEE|LAC||15.96|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|82979|Y||I~01/000;58/000||MAXFEE|LAC||9.69|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|82985|Y||I~01/000;58/000||MAXFEE|LAC||16.62|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|82985|Y||I~01/000;58/000||MAXFEE|LAC|QW|16.62|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|83001|Y||I~01/000;58/000||MAXFEE|LAC||19.20|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|83002|Y||I~01/000;58/000||MAXFEE|LAC||19.14|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|83003|Y||I~01/000;58/000||MAXFEE|LAC||17.23|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|83006|Y||I~01/000;58/000||MAXFEE|LAC||24.00|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|83009|Y||I~01/000;58/000||MAXFEE|LAC||69.60|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|83010|Y||I~01/000;58/000||MAXFEE|LAC||13.00|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|83012|Y||I~01/000;58/000||MAXFEE|LAC||24.18|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|83013|Y||I~01/000;58/000||MAXFEE|LAC||69.60|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|83014|Y||I~01/000;58/000||MAXFEE|LAC||8.12|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|83015|Y||I~01/000;58/000||MAXFEE|LAC||21.64|0.0||20190101|22991231||
OUTPA|Outpatient Hospital|83018|Y||I~01/000;58/000||MAXFEE|LAC||22.69|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|83020|Y||I~01/000;58/000||MAXFEE|LAC||6.41|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|83021|Y||I~01/000;58/000||MAXFEE|LAC||18.66|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|83026|Y||I~01/000;58/000||MAXFEE|LAC||3.33|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|83030|Y||I~01/000;58/000||MAXFEE|LAC||11.10|0.0||20180101|22991231||
OUTPA|Outpatient Hospital|83033|Y||I~01/000;58/000||MAXFEE|LAC||8.27|0.0||20180101|22991231||
OUTPA|Outpatient Hospital|83036|Y||I~01/000;58/000||MAXFEE|LAC||10.03|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|83037|Y||I~01/000;58/000||MAXFEE|LAC||10.03|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|83045|Y||I~01/000;58/000||MAXFEE|LAC||6.71|0.0||20180101|22991231||
OUTPA|Outpatient Hospital|83050|Y||I~01/000;58/000||MAXFEE|LAC||4.12|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|83051|Y||I~01/000;58/000||MAXFEE|LAC||4.90|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|83060|Y||I~01/000;58/000||MAXFEE|LAC||9.09|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|83065|Y||I~01/000;58/000||MAXFEE|LAC||9.30|0.0||20180101|22991231||
OUTPA|Outpatient Hospital|83068|Y||I~01/000;58/000||MAXFEE|LAC||9.79|0.0||20190101|22991231||
OUTPA|Outpatient Hospital|83069|Y||I~01/000;58/000||MAXFEE|LAC||4.08|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|83070|Y||I~01/000;58/000||MAXFEE|LAC||4.91|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|83080|Y||I~01/000;58/000||MAXFEE|LAC||17.43|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|83088|Y||I~01/000;58/000||MAXFEE|LAC||30.51|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|83090|Y||I~01/000;58/000||MAXFEE|LAC||18.52|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|83150|Y||I~01/000;58/000||MAXFEE|LAC||19.62|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|83491|Y||I~01/000;58/000||MAXFEE|LAC||18.50|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|83497|Y||I~01/000;58/000||MAXFEE|LAC||13.33|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|83498|Y||I~01/000;58/000||MAXFEE|LAC||28.07|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|83500|Y||I~01/000;58/000||MAXFEE|LAC||23.40|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|83505|Y||I~01/000;58/000||MAXFEE|LAC||25.11|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|83516|Y||I~01/000;58/000||MAXFEE|LAC||11.91|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|83518|Y||I~01/000;58/000||MAXFEE|LAC||9.96|0.0||20190101|22991231||
OUTPA|Outpatient Hospital|83519|Y||I~01/000;58/000||MAXFEE|LAC||19.00|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|83520|Y||I~01/000;58/000||MAXFEE|LAC||17.85|0.0||20180101|22991231||
OUTPA|Outpatient Hospital|83521|Y||I~01/000;58/000||MAXFEE|LAC||17.27|0.0||20220101|22991231||
OUTPA|Outpatient Hospital|83525|Y||I~01/000;58/000||MAXFEE|LAC||11.81|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|83527|Y||I~01/000;58/000||MAXFEE|LAC||13.38|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|83528|Y||I~01/000;58/000||MAXFEE|LAC||20.48|0.0||20180101|22991231||
OUTPA|Outpatient Hospital|83529|Y||I~01/000;58/000||MAXFEE|LAC||17.85|0.0||20220101|22991231||
OUTPA|Outpatient Hospital|83540|Y||I~01/000;58/000||MAXFEE|LAC||6.69|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|83550|Y||I~01/000;58/000||MAXFEE|LAC||9.03|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|83570|Y||I~01/000;58/000||MAXFEE|LAC||9.14|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|83582|Y||I~01/000;58/000||MAXFEE|LAC||15.99|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|83586|Y||I~01/000;58/000||MAXFEE|LAC||13.23|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|83593|Y||I~01/000;58/000||MAXFEE|LAC||29.45|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|83605|Y||I~01/000;58/000||MAXFEE|LAC||11.96|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|83615|Y||I~01/000;58/000||MAXFEE|LAC||6.24|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|83625|Y||I~01/000;58/000||MAXFEE|LAC||13.22|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|83630|Y||I~01/000;58/000||MAXFEE|LAC||16.82|0.0||20080701|22991231||
OUTPA|Outpatient Hospital|83631|Y||I~01/000;58/000||MAXFEE|LAC||20.28|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|83632|Y||I~01/000;58/000||MAXFEE|LAC||20.89|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|83633|Y||I~01/000;58/000||MAXFEE|LAC||7.73|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|83655|Y||I~01/000;58/000||MAXFEE|LAC||12.51|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|83661|Y||I~01/000;58/000||MAXFEE|LAC||22.72|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|83662|Y||I~01/000;58/000||MAXFEE|LAC||19.54|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|83663|Y||I~01/000;58/000||MAXFEE|LAC||13.65|0.0||20080701|22991231||
OUTPA|Outpatient Hospital|83664|Y||I~01/000;58/000||MAXFEE|LAC||6.82|0.0||20080701|22991231||
OUTPA|Outpatient Hospital|83670|Y||I~01/000;58/000||MAXFEE|LAC||10.14|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|83690|Y||I~01/000;58/000||MAXFEE|LAC||7.12|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|83695|Y||I~01/000;58/000||MAXFEE|LAC||14.80|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|83698|Y||I~01/000;58/000||MAXFEE|LAC||47.73|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|83700|Y||I~01/000;58/000||MAXFEE|LAC||11.63|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|83701|Y||I~01/000;58/000||MAXFEE|LAC||32.56|0.0||20080701|22991231||
OUTPA|Outpatient Hospital|83704|Y||I~01/000;58/000||MAXFEE|LAC||35.33|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|83718|Y||I~01/000;58/000||MAXFEE|LAC||8.46|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|83718|Y||I~01/000;58/000||MAXFEE|LAC|QW|8.46|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|83719|Y||I~01/000;58/000||MAXFEE|LAC||13.17|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|83721|Y||I~01/000;58/000||MAXFEE|LAC||10.85|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|83727|Y||I~01/000;58/000||MAXFEE|LAC||17.76|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|83735|Y||I~01/000;58/000||MAXFEE|LAC||6.92|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|83775|Y||I~01/000;58/000||MAXFEE|LAC||7.62|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|83785|Y||I~01/000;58/000||MAXFEE|LAC||27.54|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|83789|Y||I~01/000;58/000||MAXFEE|LAC||24.91|0.0||20180101|22991231||
OUTPA|Outpatient Hospital|83825|Y||I~01/000;58/000||MAXFEE|LAC||16.80|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|83835|Y||I~01/000;58/000||MAXFEE|LAC||17.50|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|83857|Y||I~01/000;58/000||MAXFEE|LAC||11.10|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|83861|Y||I~01/000;58/000||MAXFEE|LAC||23.23|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|83864|Y||I~01/000;58/000||MAXFEE|LAC||28.00|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|83872|Y||I~01/000;58/000||MAXFEE|LAC||6.06|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|83873|Y||I~01/000;58/000||MAXFEE|LAC||17.77|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|83874|Y||I~01/000;58/000||MAXFEE|LAC||13.35|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|83876|Y||I~01/000;58/000||MAXFEE|LAC||19.54|0.0||20090101|22991231||
OUTPA|Outpatient Hospital|83880|Y||I~01/000;58/000||MAXFEE|LAC||40.57|0.0||20190101|22991231||
OUTPA|Outpatient Hospital|83883|Y||I~01/000;58/000||MAXFEE|LAC||14.05|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|83885|Y||I~01/000;58/000||MAXFEE|LAC||25.33|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|83915|Y||I~01/000;58/000||MAXFEE|LAC||11.52|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|83916|Y||I~01/000;58/000||MAXFEE|LAC||28.28|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|83918|Y||I~01/000;58/000||MAXFEE|LAC||23.14|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|83919|Y||I~01/000;58/000||MAXFEE|LAC||17.00|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|83921|Y||I~01/000;58/000||MAXFEE|LAC||21.92|0.0||20180101|22991231||
OUTPA|Outpatient Hospital|83930|Y||I~01/000;58/000||MAXFEE|LAC||6.83|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|83935|Y||I~01/000;58/000||MAXFEE|LAC||7.05|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|83937|Y||I~01/000;58/000||MAXFEE|LAC||30.84|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|83945|Y||I~01/000;58/000||MAXFEE|LAC||14.93|0.0||20190101|22991231||
OUTPA|Outpatient Hospital|83950|Y||I~01/000;58/000||MAXFEE|LAC||66.55|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|83951|Y||I~01/000;58/000||MAXFEE|LAC||66.55|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|83970|Y||I~01/000;58/000||MAXFEE|LAC||42.65|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|83986|Y||I~01/000;58/000||MAXFEE|LAC||3.70|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|83986|Y||I~01/000;58/000||MAXFEE|LAC|QW|3.70|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|83987|Y||I~01/000;58/000||MAXFEE|LAC||3.70|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|83992|Y||I~01/000;58/000||MAXFEE|LAC||20.67|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|83993|Y||I~01/000;58/000||MAXFEE|LAC||20.28|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|84030|Y||I~01/000;58/000||MAXFEE|LAC||5.68|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|84035|Y||I~01/000;58/000||MAXFEE|LAC||4.11|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|84060|Y||I~01/000;58/000||MAXFEE|LAC||7.89|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|84066|Y||I~01/000;58/000||MAXFEE|LAC||9.98|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|84075|Y||I~01/000;58/000||MAXFEE|LAC||5.35|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|84078|Y||I~01/000;58/000||MAXFEE|LAC||8.54|0.0||20190101|22991231||
OUTPA|Outpatient Hospital|84080|Y||I~01/000;58/000||MAXFEE|LAC||15.27|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|84081|Y||I~01/000;58/000||MAXFEE|LAC||17.07|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|84085|Y||I~01/000;58/000||MAXFEE|LAC||9.49|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|84087|Y||I~01/000;58/000||MAXFEE|LAC||11.09|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|84100|Y||I~01/000;58/000||MAXFEE|LAC||4.90|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|84105|Y||I~01/000;58/000||MAXFEE|LAC||5.97|0.0||20190101|22991231||
OUTPA|Outpatient Hospital|84106|Y||I~01/000;58/000||MAXFEE|LAC||6.01|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|84110|Y||I~01/000;58/000||MAXFEE|LAC||8.72|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|84112|Y||I~01/000;58/000||MAXFEE|LAC||90.57|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|84119|Y||I~01/000;58/000||MAXFEE|LAC||12.11|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|84120|Y||I~01/000;58/000||MAXFEE|LAC||15.20|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|84126|Y||I~01/000;58/000||MAXFEE|LAC||35.81|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|84132|Y||I~01/000;58/000||MAXFEE|LAC||4.92|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|84133|Y||I~01/000;58/000||MAXFEE|LAC||4.89|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|84134|Y||I~01/000;58/000||MAXFEE|LAC||7.85|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|84135|Y||I~01/000;58/000||MAXFEE|LAC||21.98|0.0||20190101|22991231||
OUTPA|Outpatient Hospital|84138|Y||I~01/000;58/000||MAXFEE|LAC||21.75|0.0||20190101|22991231||
OUTPA|Outpatient Hospital|84140|Y||I~01/000;58/000||MAXFEE|LAC||21.36|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|84143|Y||I~01/000;58/000||MAXFEE|LAC||23.57|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|84144|Y||I~01/000;58/000||MAXFEE|LAC||21.55|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|84145|Y||I~01/000;58/000||MAXFEE|LAC||28.13|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|84146|Y||I~01/000;58/000||MAXFEE|LAC||20.03|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|84150|Y||I~01/000;58/000||MAXFEE|LAC||35.09|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|84152|Y||I~01/000;58/000||MAXFEE|LAC||19.00|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|84153|Y||I~01/000;58/000||MAXFEE|LAC||19.00|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|84154|Y||I~01/000;58/000||MAXFEE|LAC||19.00|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|84155|Y||I~01/000;58/000||MAXFEE|LAC||3.79|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|84156|Y||I~01/000;58/000||MAXFEE|LAC||3.79|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|84157|Y||I~01/000;58/000||MAXFEE|LAC||4.13|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|84160|Y||I~01/000;58/000||MAXFEE|LAC||5.63|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|84163|Y||I~01/000;58/000||MAXFEE|LAC||15.55|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|84165|Y||I~01/000;58/000||MAXFEE|LAC||11.10|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|84166|Y||I~01/000;58/000||MAXFEE|LAC||18.42|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|84181|Y||I~01/000;58/000||MAXFEE|LAC||17.60|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|84182|Y||I~01/000;58/000||MAXFEE|LAC||25.31|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|84202|Y||I~01/000;58/000||MAXFEE|LAC||14.83|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|84203|Y||I~01/000;58/000||MAXFEE|LAC||10.06|0.0||20190101|22991231||
OUTPA|Outpatient Hospital|84206|Y||I~01/000;58/000||MAXFEE|LAC||25.05|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|84207|Y||I~01/000;58/000||MAXFEE|LAC||29.04|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|84210|Y||I~01/000;58/000||MAXFEE|LAC||14.96|0.0||20180101|22991231||
OUTPA|Outpatient Hospital|84220|Y||I~01/000;58/000||MAXFEE|LAC||9.75|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|84228|Y||I~01/000;58/000||MAXFEE|LAC||12.02|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|84233|Y||I~01/000;58/000||MAXFEE|LAC||90.57|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|84234|Y||I~01/000;58/000||MAXFEE|LAC||67.04|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|84235|Y||I~01/000;58/000||MAXFEE|LAC||73.25|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|84238|Y||I~01/000;58/000||MAXFEE|LAC||37.79|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|84244|Y||I~01/000;58/000||MAXFEE|LAC||22.72|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|84252|Y||I~01/000;58/000||MAXFEE|LAC||20.91|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|84255|Y||I~01/000;58/000||MAXFEE|LAC||26.38|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|84260|Y||I~01/000;58/000||MAXFEE|LAC||32.01|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|84270|Y||I~01/000;58/000||MAXFEE|LAC||22.45|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|84275|Y||I~01/000;58/000||MAXFEE|LAC||13.89|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|84285|Y||I~01/000;58/000||MAXFEE|LAC||26.05|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|84295|Y||I~01/000;58/000||MAXFEE|LAC||4.97|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|84300|Y||I~01/000;58/000||MAXFEE|LAC||5.23|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|84302|Y||I~01/000;58/000||MAXFEE|LAC||5.02|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|84305|Y||I~01/000;58/000||MAXFEE|LAC||21.97|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|84307|Y||I~01/000;58/000||MAXFEE|LAC||12.48|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|84311|Y||I~01/000;58/000||MAXFEE|LAC||8.37|0.0||20190101|22991231||
OUTPA|Outpatient Hospital|84315|Y||I~01/000;58/000||MAXFEE|LAC||3.39|0.0||20180101|22991231||
OUTPA|Outpatient Hospital|84375|Y||I~01/000;58/000||MAXFEE|LAC||8.17|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|84376|Y||I~01/000;58/000||MAXFEE|LAC||5.68|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|84377|Y||I~01/000;58/000||MAXFEE|LAC||5.68|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|84378|Y||I~01/000;58/000||MAXFEE|LAC||11.91|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|84379|Y||I~01/000;58/000||MAXFEE|LAC||11.91|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|84392|Y||I~01/000;58/000||MAXFEE|LAC||5.67|0.0||20190101|22991231||
OUTPA|Outpatient Hospital|84402|Y||I~01/000;58/000||MAXFEE|LAC||26.32|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|84403|Y||I~01/000;58/000||MAXFEE|LAC||26.67|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|84410|Y||I~01/000;58/000||MAXFEE|LAC||52.99|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|84425|Y||I~01/000;58/000||MAXFEE|LAC||21.94|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|84430|Y||I~01/000;58/000||MAXFEE|LAC||12.02|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|84431|Y||I~01/000;58/000||MAXFEE|LAC||19.16|0.0||20100101|22991231||
OUTPA|Outpatient Hospital|84432|Y||I~01/000;58/000||MAXFEE|LAC||16.59|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|84433|Y||I~01/000;58/000||MAXFEE|LAC||22.17|0.0||20230101|22991231||
OUTPA|Outpatient Hospital|84436|Y||I~01/000;58/000||MAXFEE|LAC||7.10|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|84437|Y||I~01/000;58/000||MAXFEE|LAC||6.69|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|84439|Y||I~01/000;58/000||MAXFEE|LAC||9.32|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|84442|Y||I~01/000;58/000||MAXFEE|LAC||15.27|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|84443|Y||I~01/000;58/000||MAXFEE|LAC||17.36|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|84445|Y||I~01/000;58/000||MAXFEE|LAC||32.70|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|84446|Y||I~01/000;58/000||MAXFEE|LAC||14.65|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|84449|Y||I~01/000;58/000||MAXFEE|LAC||18.60|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|84450|Y||I~01/000;58/000||MAXFEE|LAC||5.35|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|84460|Y||I~01/000;58/000||MAXFEE|LAC||5.48|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|84466|Y||I~01/000;58/000||MAXFEE|LAC||13.18|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|84478|Y||I~01/000;58/000||MAXFEE|LAC||5.93|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|84478|Y||I~01/000;58/000||MAXFEE|LAC|QW|5.93|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|84479|Y||I~01/000;58/000||MAXFEE|LAC||6.69|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|84480|Y||I~01/000;58/000||MAXFEE|LAC||14.65|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|84481|Y||I~01/000;58/000||MAXFEE|LAC||16.62|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|84482|Y||I~01/000;58/000||MAXFEE|LAC||10.82|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|84484|Y||I~01/000;58/000||MAXFEE|LAC||12.89|0.0||20180101|22991231||
OUTPA|Outpatient Hospital|84485|Y||I~01/000;58/000||MAXFEE|LAC||7.44|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|84488|Y||I~01/000;58/000||MAXFEE|LAC||7.54|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|84490|Y||I~01/000;58/000||MAXFEE|LAC||10.26|0.0||20180101|22991231||
OUTPA|Outpatient Hospital|84510|Y||I~01/000;58/000||MAXFEE|LAC||10.98|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|84512|Y||I~01/000;58/000||MAXFEE|LAC||10.43|0.0||20180101|22991231||
OUTPA|Outpatient Hospital|84520|Y||I~01/000;58/000||MAXFEE|LAC||4.08|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|84525|Y||I~01/000;58/000||MAXFEE|LAC||5.29|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|84540|Y||I~01/000;58/000||MAXFEE|LAC||5.75|0.0||20190101|22991231||
OUTPA|Outpatient Hospital|84545|Y||I~01/000;58/000||MAXFEE|LAC||7.44|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|84550|Y||I~01/000;58/000||MAXFEE|LAC||4.67|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|84560|Y||I~01/000;58/000||MAXFEE|LAC||5.25|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|84577|Y||I~01/000;58/000||MAXFEE|LAC||17.36|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|84578|Y||I~01/000;58/000||MAXFEE|LAC||4.58|0.0||20140101|22991231||
OUTPA|Outpatient Hospital|84580|Y||I~01/000;58/000||MAXFEE|LAC||9.87|0.0||20190101|22991231||
OUTPA|Outpatient Hospital|84583|Y||I~01/000;58/000||MAXFEE|LAC||6.25|0.0||20190101|22991231||
OUTPA|Outpatient Hospital|84585|Y||I~01/000;58/000||MAXFEE|LAC||16.02|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|84586|Y||I~01/000;58/000||MAXFEE|LAC||17.93|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|84588|Y||I~01/000;58/000||MAXFEE|LAC||35.07|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|84590|Y||I~01/000;58/000||MAXFEE|LAC||12.00|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|84591|Y||I~01/000;58/000||MAXFEE|LAC||16.32|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|84597|Y||I~01/000;58/000||MAXFEE|LAC||14.18|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|84600|Y||I~01/000;58/000||MAXFEE|LAC||17.68|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|84620|Y||I~01/000;58/000||MAXFEE|LAC||13.34|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|84630|Y||I~01/000;58/000||MAXFEE|LAC||11.77|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|84681|Y||I~01/000;58/000||MAXFEE|LAC||7.34|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|84702|Y||I~01/000;58/000||MAXFEE|LAC||15.55|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|84703|Y||I~01/000;58/000||MAXFEE|LAC||7.77|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|84704|Y||I~01/000;58/000||MAXFEE|LAC||15.80|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|84830|Y||I~01/000;58/000||MAXFEE|LAC||13.12|0.0||20180101|22991231||
OUTPA|Outpatient Hospital|85002|Y||I~01/000;58/000||MAXFEE|LAC||4.77|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|85004|Y||I~01/000;58/000||MAXFEE|LAC||6.69|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|85007|Y||I~01/000;58/000||MAXFEE|LAC||3.93|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|85008|Y||I~01/000;58/000||MAXFEE|LAC||3.54|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|85009|Y||I~01/000;58/000||MAXFEE|LAC||5.23|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|85013|Y||I~01/000;58/000||MAXFEE|LAC||3.34|0.0||20140101|22991231||
OUTPA|Outpatient Hospital|85014|Y||I~01/000;58/000||MAXFEE|LAC||2.45|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|85014|Y||I~01/000;58/000||MAXFEE|LAC|QW|2.45|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|85018|Y||I~01/000;58/000||MAXFEE|LAC||2.45|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|85018|Y||I~01/000;58/000||MAXFEE|LAC|QW|2.45|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|85025|Y||I~01/000;58/000||MAXFEE|LAC||8.03|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|85027|Y||I~01/000;58/000||MAXFEE|LAC||6.69|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|85032|Y||I~01/000;58/000||MAXFEE|LAC||4.45|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|85041|Y||I~01/000;58/000||MAXFEE|LAC||3.12|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|85044|Y||I~01/000;58/000||MAXFEE|LAC||4.45|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|85045|Y||I~01/000;58/000||MAXFEE|LAC||4.12|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|85046|Y||I~01/000;58/000||MAXFEE|LAC||5.76|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|85048|Y||I~01/000;58/000||MAXFEE|LAC||2.62|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|85049|Y||I~01/000;58/000||MAXFEE|LAC||4.63|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|85055|Y||I~01/000;58/000||MAXFEE|LAC||18.97|0.0||20080701|22991231||
OUTPA|Outpatient Hospital|85130|Y||I~01/000;58/000||MAXFEE|LAC||12.29|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|85170|Y||I~01/000;58/000||MAXFEE|LAC||5.08|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|85175|Y||I~01/000;58/000||MAXFEE|LAC||6.40|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|85210|Y||I~01/000;58/000||MAXFEE|LAC||8.17|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|85220|Y||I~01/000;58/000||MAXFEE|LAC||18.24|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|85230|Y||I~01/000;58/000||MAXFEE|LAC||18.50|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|85240|Y||I~01/000;58/000||MAXFEE|LAC||9.84|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|85244|Y||I~01/000;58/000||MAXFEE|LAC||21.10|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|85245|Y||I~01/000;58/000||MAXFEE|LAC||23.70|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|85246|Y||I~01/000;58/000||MAXFEE|LAC||23.70|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|85247|Y||I~01/000;58/000||MAXFEE|LAC||23.70|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|85250|Y||I~01/000;58/000||MAXFEE|LAC||19.67|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|85260|Y||I~01/000;58/000||MAXFEE|LAC||18.50|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|85270|Y||I~01/000;58/000||MAXFEE|LAC||18.50|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|85280|Y||I~01/000;58/000||MAXFEE|LAC||19.99|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|85290|Y||I~01/000;58/000||MAXFEE|LAC||16.88|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|85291|Y||I~01/000;58/000||MAXFEE|LAC||9.41|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|85292|Y||I~01/000;58/000||MAXFEE|LAC||19.56|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|85293|Y||I~01/000;58/000||MAXFEE|LAC||19.56|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|85300|Y||I~01/000;58/000||MAXFEE|LAC||12.24|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|85301|Y||I~01/000;58/000||MAXFEE|LAC||11.17|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|85302|Y||I~01/000;58/000||MAXFEE|LAC||12.41|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|85303|Y||I~01/000;58/000||MAXFEE|LAC||14.30|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|85305|Y||I~01/000;58/000||MAXFEE|LAC||12.00|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|85306|Y||I~01/000;58/000||MAXFEE|LAC||15.83|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|85307|Y||I~01/000;58/000||MAXFEE|LAC||15.83|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|85335|Y||I~01/000;58/000||MAXFEE|LAC||13.30|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|85337|Y||I~01/000;58/000||MAXFEE|LAC||14.66|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|85345|Y||I~01/000;58/000||MAXFEE|LAC||4.85|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|85347|Y||I~01/000;58/000||MAXFEE|LAC||4.42|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|85348|Y||I~01/000;58/000||MAXFEE|LAC||2.75|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|85360|Y||I~01/000;58/000||MAXFEE|LAC||8.69|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|85362|Y||I~01/000;58/000||MAXFEE|LAC||7.12|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|85366|Y||I~01/000;58/000||MAXFEE|LAC||12.11|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|85370|Y||I~01/000;58/000||MAXFEE|LAC||11.40|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|85378|Y||I~01/000;58/000||MAXFEE|LAC||10.03|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|85379|Y||I~01/000;58/000||MAXFEE|LAC||10.52|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|85380|Y||I~01/000;58/000||MAXFEE|LAC||10.52|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|85384|Y||I~01/000;58/000||MAXFEE|LAC||10.04|0.0||20190101|22991231||
OUTPA|Outpatient Hospital|85385|Y||I~01/000;58/000||MAXFEE|LAC||11.94|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|85390|Y||I~01/000;58/000||MAXFEE|LAC||7.27|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|85397|Y||I~01/000;58/000||MAXFEE|LAC||31.89|0.0||20180101|22991231||
OUTPA|Outpatient Hospital|85400|Y||I~01/000;58/000||MAXFEE|LAC||7.97|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|85410|Y||I~01/000;58/000||MAXFEE|LAC||7.97|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|85415|Y||I~01/000;58/000||MAXFEE|LAC||17.76|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|85420|Y||I~01/000;58/000||MAXFEE|LAC||6.75|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|85421|Y||I~01/000;58/000||MAXFEE|LAC||10.52|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|85441|Y||I~01/000;58/000||MAXFEE|LAC||4.34|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|85445|Y||I~01/000;58/000||MAXFEE|LAC||7.05|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|85460|Y||I~01/000;58/000||MAXFEE|LAC||7.99|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|85461|Y||I~01/000;58/000||MAXFEE|LAC||9.33|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|85475|Y||I~01/000;58/000||MAXFEE|LAC||9.17|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|85520|Y||I~01/000;58/000||MAXFEE|LAC||13.53|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|85525|Y||I~01/000;58/000||MAXFEE|LAC||12.23|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|85530|Y||I~01/000;58/000||MAXFEE|LAC||13.53|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|85536|Y||I~01/000;58/000||MAXFEE|LAC||7.11|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|85540|Y||I~01/000;58/000||MAXFEE|LAC||8.89|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|85547|Y||I~01/000;58/000||MAXFEE|LAC||8.89|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|85549|Y||I~01/000;58/000||MAXFEE|LAC||19.37|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|85555|Y||I~01/000;58/000||MAXFEE|LAC||7.72|0.0||20190101|22991231||
OUTPA|Outpatient Hospital|85557|Y||I~01/000;58/000||MAXFEE|LAC||13.80|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|85576|Y||I~01/000;58/000||MAXFEE|LAC||25.74|0.0||20190101|22991231||
OUTPA|Outpatient Hospital|85597|Y||I~01/000;58/000||MAXFEE|LAC||18.58|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|85598|Y||I~01/000;58/000||MAXFEE|LAC||18.58|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|85610|Y||I~01/000;58/000||MAXFEE|LAC||4.43|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|85610|Y||I~01/000;58/000||MAXFEE|LAC|QW|4.43|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|85611|Y||I~01/000;58/000||MAXFEE|LAC||4.07|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|85612|Y||I~01/000;58/000||MAXFEE|LAC||13.46|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|85613|Y||I~01/000;58/000||MAXFEE|LAC||9.90|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|85635|Y||I~01/000;58/000||MAXFEE|LAC||10.18|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|85651|Y||I~01/000;58/000||MAXFEE|LAC||4.01|0.0||20080701|22991231||
OUTPA|Outpatient Hospital|85652|Y||I~01/000;58/000||MAXFEE|LAC||2.79|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|85660|Y||I~01/000;58/000||MAXFEE|LAC||5.69|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|85705|Y||I~01/000;58/000||MAXFEE|LAC||8.17|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|85730|Y||I~01/000;58/000||MAXFEE|LAC||6.21|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|85732|Y||I~01/000;58/000||MAXFEE|LAC||6.69|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|85810|Y||I~01/000;58/000||MAXFEE|LAC||12.06|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86000|Y||I~01/000;58/000||MAXFEE|LAC||7.21|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86001|Y||I~01/000;58/000||MAXFEE|LAC||4.57|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|86003|Y||I~01/000;58/000||MAXFEE|LAC||4.57|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|86005|Y||I~01/000;58/000||MAXFEE|LAC||8.24|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86008|Y||I~01/000;58/000||MAXFEE|LAC||17.71|0.0||20180101|22991231||
OUTPA|Outpatient Hospital|86015|Y||I~01/000;58/000||MAXFEE|LAC||11.53|0.0||20220101|22991231||
OUTPA|Outpatient Hospital|86021|Y||I~01/000;58/000||MAXFEE|LAC||15.55|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86022|Y||I~01/000;58/000||MAXFEE|LAC||18.98|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86023|Y||I~01/000;58/000||MAXFEE|LAC||12.87|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86036|Y||I~01/000;58/000||MAXFEE|LAC||12.05|0.0||20220101|22991231||
OUTPA|Outpatient Hospital|86037|Y||I~01/000;58/000||MAXFEE|LAC||12.05|0.0||20220101|22991231||
OUTPA|Outpatient Hospital|86038|Y||I~01/000;58/000||MAXFEE|LAC||12.49|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86039|Y||I~01/000;58/000||MAXFEE|LAC||11.16|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86041|Y||I~01/000;58/000||MAXFEE|LAC||14.72|0.0||20240101|22991231||
OUTPA|Outpatient Hospital|86042|Y||I~01/000;58/000||MAXFEE|LAC||14.72|0.0||20240101|22991231||
OUTPA|Outpatient Hospital|86043|Y||I~01/000;58/000||MAXFEE|LAC||9.64|0.0||20240101|22991231||
OUTPA|Outpatient Hospital|86051|Y||I~01/000;58/000||MAXFEE|LAC||11.53|0.0||20220101|22991231||
OUTPA|Outpatient Hospital|86052|Y||I~01/000;58/000||MAXFEE|LAC||12.05|0.0||20220101|22991231||
OUTPA|Outpatient Hospital|86053|Y||I~01/000;58/000||MAXFEE|LAC||12.05|0.0||20220101|22991231||
OUTPA|Outpatient Hospital|86060|Y||I~01/000;58/000||MAXFEE|LAC||7.54|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86063|Y||I~01/000;58/000||MAXFEE|LAC||5.96|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86140|Y||I~01/000;58/000||MAXFEE|LAC||5.35|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86141|Y||I~01/000;58/000||MAXFEE|LAC||13.38|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86146|Y||I~01/000;58/000||MAXFEE|LAC||8.17|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|86147|Y||I~01/000;58/000||MAXFEE|LAC||8.17|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|86148|Y||I~01/000;58/000||MAXFEE|LAC||8.17|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|86152|Y||I~01/000;58/000||MAXFEE|LAC||259.13|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86155|Y||I~01/000;58/000||MAXFEE|LAC||16.52|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86156|Y||I~01/000;58/000||MAXFEE|LAC||8.17|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|86157|Y||I~01/000;58/000||MAXFEE|LAC||8.17|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|86160|Y||I~01/000;58/000||MAXFEE|LAC||12.40|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86161|Y||I~01/000;58/000||MAXFEE|LAC||12.40|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86162|Y||I~01/000;58/000||MAXFEE|LAC||21.00|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86171|Y||I~01/000;58/000||MAXFEE|LAC||10.34|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86200|Y||I~01/000;58/000||MAXFEE|LAC||13.38|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86215|Y||I~01/000;58/000||MAXFEE|LAC||13.69|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86225|Y||I~01/000;58/000||MAXFEE|LAC||14.20|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86226|Y||I~01/000;58/000||MAXFEE|LAC||12.51|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86231|Y||I~01/000;58/000||MAXFEE|LAC||12.05|0.0||20220101|22991231||
OUTPA|Outpatient Hospital|86235|Y||I~01/000;58/000||MAXFEE|LAC||18.53|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86255|Y||I~01/000;58/000||MAXFEE|LAC||12.45|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86256|Y||I~01/000;58/000||MAXFEE|LAC||12.45|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86258|Y||I~01/000;58/000||MAXFEE|LAC||11.53|0.0||20220101|22991231||
OUTPA|Outpatient Hospital|86277|Y||I~01/000;58/000||MAXFEE|LAC||16.26|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86280|Y||I~01/000;58/000||MAXFEE|LAC||8.46|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86294|Y||I~01/000;58/000||MAXFEE|LAC||22.39|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|86300|Y||I~01/000;58/000||MAXFEE|LAC||21.50|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86301|Y||I~01/000;58/000||MAXFEE|LAC||21.50|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86304|Y||I~01/000;58/000||MAXFEE|LAC||21.50|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86305|Y||I~01/000;58/000||MAXFEE|LAC||21.50|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86308|Y||I~01/000;58/000||MAXFEE|LAC||5.35|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86309|Y||I~01/000;58/000||MAXFEE|LAC||6.69|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86310|Y||I~01/000;58/000||MAXFEE|LAC||7.62|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86316|Y||I~01/000;58/000||MAXFEE|LAC||21.50|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86317|Y||I~01/000;58/000||MAXFEE|LAC||15.49|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86318|Y||I~01/000;58/000||MAXFEE|LAC||18.21|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|86318|Y||I~01/000;58/000||MAXFEE|LAC|QW|18.21|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|86320|Y||I~01/000;58/000||MAXFEE|LAC||30.92|0.0||20180101|22991231||
OUTPA|Outpatient Hospital|86325|Y||I~01/000;58/000||MAXFEE|LAC||23.90|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86328|Y||I~01/000;58/000||MAXFEE|LAC||45.23|0.0||20200410|22991231||
OUTPA|Outpatient Hospital|86329|Y||I~01/000;58/000||MAXFEE|LAC||14.52|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86331|Y||I~01/000;58/000||MAXFEE|LAC||12.38|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86332|Y||I~01/000;58/000||MAXFEE|LAC||25.18|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86334|Y||I~01/000;58/000||MAXFEE|LAC||23.08|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86335|Y||I~01/000;58/000||MAXFEE|LAC||30.33|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86336|Y||I~01/000;58/000||MAXFEE|LAC||16.11|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86337|Y||I~01/000;58/000||MAXFEE|LAC||22.12|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86340|Y||I~01/000;58/000||MAXFEE|LAC||14.28|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|86341|Y||I~01/000;58/000||MAXFEE|LAC||19.88|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|86343|Y||I~01/000;58/000||MAXFEE|LAC||12.87|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86344|Y||I~01/000;58/000||MAXFEE|LAC||10.74|0.0||20180101|22991231||
OUTPA|Outpatient Hospital|86352|Y||I~01/000;58/000||MAXFEE|LAC||100.54|0.0||20100101|22991231||
OUTPA|Outpatient Hospital|86353|Y||I~01/000;58/000||MAXFEE|LAC||50.66|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86355|Y||I~01/000;58/000||MAXFEE|LAC||38.99|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86356|Y||I~01/000;58/000||MAXFEE|LAC||27.67|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86357|Y||I~01/000;58/000||MAXFEE|LAC||38.99|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86359|Y||I~01/000;58/000||MAXFEE|LAC||38.99|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86360|Y||I~01/000;58/000||MAXFEE|LAC||48.54|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86361|Y||I~01/000;58/000||MAXFEE|LAC||27.67|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86362|Y||I~01/000;58/000||MAXFEE|LAC||12.05|0.0||20220101|22991231||
OUTPA|Outpatient Hospital|86363|Y||I~01/000;58/000||MAXFEE|LAC||12.05|0.0||20220101|22991231||
OUTPA|Outpatient Hospital|86364|Y||I~01/000;58/000||MAXFEE|LAC||11.53|0.0||20220101|22991231||
OUTPA|Outpatient Hospital|86366|Y||I~01/000;58/000||MAXFEE|LAC||14.72|0.0||20240101|22991231||
OUTPA|Outpatient Hospital|86367|Y||I~01/000;58/000||MAXFEE|LAC||49.49|0.0||20080701|22991231||
OUTPA|Outpatient Hospital|86376|Y||I~01/000;58/000||MAXFEE|LAC||15.03|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86381|Y||I~01/000;58/000||MAXFEE|LAC||16.91|0.0||20220101|22991231||
OUTPA|Outpatient Hospital|86382|Y||I~01/000;58/000||MAXFEE|LAC||17.47|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86384|Y||I~01/000;58/000||MAXFEE|LAC||14.06|0.0||20190101|22991231||
OUTPA|Outpatient Hospital|86386|Y||I~01/000;58/000||MAXFEE|LAC||18.09|0.0||20130401|22991231||
OUTPA|Outpatient Hospital|86403|Y||I~01/000;58/000||MAXFEE|LAC||11.92|0.0||20190101|22991231||
OUTPA|Outpatient Hospital|86406|Y||I~01/000;58/000||MAXFEE|LAC||9.85|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|86430|Y||I~01/000;58/000||MAXFEE|LAC||6.34|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86431|Y||I~01/000;58/000||MAXFEE|LAC||5.86|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86480|Y||I~01/000;58/000||MAXFEE|LAC||64.04|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86481|Y||I~01/000;58/000||MAXFEE|LAC||90.12|0.0||20110101|22991231||
OUTPA|Outpatient Hospital|86590|Y||I~01/000;58/000||MAXFEE|LAC||13.08|0.0||20190101|22991231||
OUTPA|Outpatient Hospital|86592|Y||I~01/000;58/000||MAXFEE|LAC||4.41|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86593|Y||I~01/000;58/000||MAXFEE|LAC||4.55|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86596|Y||I~01/000;58/000||MAXFEE|LAC||12.05|0.0||20220101|22991231||
OUTPA|Outpatient Hospital|86602|Y||I~01/000;58/000||MAXFEE|LAC||8.17|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|86603|Y||I~01/000;58/000||MAXFEE|LAC||8.17|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|86606|Y||I~01/000;58/000||MAXFEE|LAC||8.17|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|86609|Y||I~01/000;58/000||MAXFEE|LAC||8.17|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|86611|Y||I~01/000;58/000||MAXFEE|LAC||8.17|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|86612|Y||I~01/000;58/000||MAXFEE|LAC||8.17|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|86615|Y||I~01/000;58/000||MAXFEE|LAC||8.17|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|86617|Y||I~01/000;58/000||MAXFEE|LAC||16.01|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86618|Y||I~01/000;58/000||MAXFEE|LAC||17.60|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86619|Y||I~01/000;58/000||MAXFEE|LAC||13.83|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86622|Y||I~01/000;58/000||MAXFEE|LAC||8.17|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|86625|Y||I~01/000;58/000||MAXFEE|LAC||8.17|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|86628|Y||I~01/000;58/000||MAXFEE|LAC||8.17|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|86631|Y||I~01/000;58/000||MAXFEE|LAC||8.17|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|86632|Y||I~01/000;58/000||MAXFEE|LAC||8.17|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|86635|Y||I~01/000;58/000||MAXFEE|LAC||8.17|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|86638|Y||I~01/000;58/000||MAXFEE|LAC||8.17|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|86641|Y||I~01/000;58/000||MAXFEE|LAC||8.17|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|86644|Y||I~01/000;58/000||MAXFEE|LAC||14.87|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86645|Y||I~01/000;58/000||MAXFEE|LAC||8.17|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|86648|Y||I~01/000;58/000||MAXFEE|LAC||8.17|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|86651|Y||I~01/000;58/000||MAXFEE|LAC||8.17|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|86652|Y||I~01/000;58/000||MAXFEE|LAC||8.17|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|86653|Y||I~01/000;58/000||MAXFEE|LAC||8.17|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|86654|Y||I~01/000;58/000||MAXFEE|LAC||8.17|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|86658|Y||I~01/000;58/000||MAXFEE|LAC||8.17|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|86663|Y||I~01/000;58/000||MAXFEE|LAC||13.56|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86664|Y||I~01/000;58/000||MAXFEE|LAC||15.80|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86665|Y||I~01/000;58/000||MAXFEE|LAC||18.74|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86666|Y||I~01/000;58/000||MAXFEE|LAC||8.17|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|86668|Y||I~01/000;58/000||MAXFEE|LAC||14.63|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|86671|Y||I~01/000;58/000||MAXFEE|LAC||7.15|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|86674|Y||I~01/000;58/000||MAXFEE|LAC||15.21|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86677|Y||I~01/000;58/000||MAXFEE|LAC||8.17|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|86682|Y||I~01/000;58/000||MAXFEE|LAC||8.17|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|86684|Y||I~01/000;58/000||MAXFEE|LAC||16.37|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86687|Y||I~01/000;58/000||MAXFEE|LAC||9.39|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86688|Y||I~01/000;58/000||MAXFEE|LAC||14.47|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86689|Y||I~01/000;58/000||MAXFEE|LAC||19.99|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86692|Y||I~01/000;58/000||MAXFEE|LAC||17.73|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86694|Y||I~01/000;58/000||MAXFEE|LAC||14.87|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86695|Y||I~01/000;58/000||MAXFEE|LAC||13.63|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86696|Y||I~01/000;58/000||MAXFEE|LAC||19.99|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86698|Y||I~01/000;58/000||MAXFEE|LAC||14.25|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86701|Y||I~01/000;58/000||MAXFEE|LAC||9.19|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86702|Y||I~01/000;58/000||MAXFEE|LAC||13.97|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86703|Y||I~01/000;58/000||MAXFEE|LAC||14.17|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86704|Y||I~01/000;58/000||MAXFEE|LAC||12.45|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86705|Y||I~01/000;58/000||MAXFEE|LAC||12.16|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86706|Y||I~01/000;58/000||MAXFEE|LAC||11.10|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86707|Y||I~01/000;58/000||MAXFEE|LAC||11.96|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86708|Y||I~01/000;58/000||MAXFEE|LAC||12.80|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86709|Y||I~01/000;58/000||MAXFEE|LAC||11.63|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86710|Y||I~01/000;58/000||MAXFEE|LAC||14.00|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86711|Y||I~01/000;58/000||MAXFEE|LAC||15.79|0.0||20170501|22991231||
OUTPA|Outpatient Hospital|86713|Y||I~01/000;58/000||MAXFEE|LAC||15.81|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86717|Y||I~01/000;58/000||MAXFEE|LAC||8.17|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|86720|Y||I~01/000;58/000||MAXFEE|LAC||8.17|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|86723|Y||I~01/000;58/000||MAXFEE|LAC||8.17|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|86727|Y||I~01/000;58/000||MAXFEE|LAC||8.17|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|86732|Y||I~01/000;58/000||MAXFEE|LAC||15.50|0.0||20190101|22991231||
OUTPA|Outpatient Hospital|86735|Y||I~01/000;58/000||MAXFEE|LAC||13.48|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86738|Y||I~01/000;58/000||MAXFEE|LAC||13.68|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86741|Y||I~01/000;58/000||MAXFEE|LAC||8.17|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|86744|Y||I~01/000;58/000||MAXFEE|LAC||8.17|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|86747|Y||I~01/000;58/000||MAXFEE|LAC||15.53|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86750|Y||I~01/000;58/000||MAXFEE|LAC||13.63|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86753|Y||I~01/000;58/000||MAXFEE|LAC||8.17|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|86756|Y||I~01/000;58/000||MAXFEE|LAC||8.17|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|86757|Y||I~01/000;58/000||MAXFEE|LAC||19.99|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86759|Y||I~01/000;58/000||MAXFEE|LAC||18.55|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|86762|Y||I~01/000;58/000||MAXFEE|LAC||14.87|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86765|Y||I~01/000;58/000||MAXFEE|LAC||13.31|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86768|Y||I~01/000;58/000||MAXFEE|LAC||11.50|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|86769|Y||I~01/000;58/000||MAXFEE|LAC||42.13|0.0||20200410|22991231||
OUTPA|Outpatient Hospital|86771|Y||I~01/000;58/000||MAXFEE|LAC||15.78|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|86774|Y||I~01/000;58/000||MAXFEE|LAC||15.29|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86777|Y||I~01/000;58/000||MAXFEE|LAC||14.87|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86778|Y||I~01/000;58/000||MAXFEE|LAC||14.89|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86780|Y||I~01/000;58/000||MAXFEE|LAC||11.13|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|86784|Y||I~01/000;58/000||MAXFEE|LAC||8.17|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|86787|Y||I~01/000;58/000||MAXFEE|LAC||8.17|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|86788|Y||I~01/000;58/000||MAXFEE|LAC||8.17|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|86789|Y||I~01/000;58/000||MAXFEE|LAC||14.87|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86793|Y||I~01/000;58/000||MAXFEE|LAC||8.17|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|86794|Y||I~01/000;58/000||MAXFEE|LAC||16.64|0.0||20180101|22991231||
OUTPA|Outpatient Hospital|86800|Y||I~01/000;58/000||MAXFEE|LAC||16.44|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86803|Y||I~01/000;58/000||MAXFEE|LAC||14.75|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86804|Y||I~01/000;58/000||MAXFEE|LAC||16.01|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86805|Y||I~01/000;58/000||MAXFEE|LAC||73.53|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|86806|Y||I~01/000;58/000||MAXFEE|LAC||49.17|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86807|Y||I~01/000;58/000||MAXFEE|LAC||55.65|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|86808|Y||I~01/000;58/000||MAXFEE|LAC||30.67|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86812|Y||I~01/000;58/000||MAXFEE|LAC||26.67|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86813|Y||I~01/000;58/000||MAXFEE|LAC||59.93|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86816|Y||I~01/000;58/000||MAXFEE|LAC||31.17|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86817|Y||I~01/000;58/000||MAXFEE|LAC||90.54|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|86821|Y||I~01/000;58/000||MAXFEE|LAC||37.78|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86825|Y||I~01/000;58/000||MAXFEE|LAC||112.94|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|86826|Y||I~01/000;58/000||MAXFEE|LAC||37.65|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|86828|Y||I~01/000;58/000||MAXFEE|LAC||43.43|0.0||20170501|22991231||
OUTPA|Outpatient Hospital|86829|Y||I~01/000;58/000||MAXFEE|LAC||32.57|0.0||20170501|22991231||
OUTPA|Outpatient Hospital|86830|Y||I~01/000;58/000||MAXFEE|LAC||88.60|0.0||20170501|22991231||
OUTPA|Outpatient Hospital|86831|Y||I~01/000;58/000||MAXFEE|LAC||75.94|0.0||20170501|22991231||
OUTPA|Outpatient Hospital|86832|Y||I~01/000;58/000||MAXFEE|LAC||139.23|0.0||20170501|22991231||
OUTPA|Outpatient Hospital|86833|Y||I~01/000;58/000||MAXFEE|LAC||126.58|0.0||20170501|22991231||
OUTPA|Outpatient Hospital|86834|Y||I~01/000;58/000||MAXFEE|LAC||362.38|0.0||20170501|22991231||
OUTPA|Outpatient Hospital|86835|Y||I~01/000;58/000||MAXFEE|LAC||333.71|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86850|Y||I~01/000;58/000||MAXFEE|LAC||5.38|0.0||20160101|22991231||
OUTPA|Outpatient Hospital|86880|Y||I~01/000;58/000||MAXFEE|LAC||5.57|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86885|Y||I~01/000;58/000||MAXFEE|LAC||5.91|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86886|Y||I~01/000;58/000||MAXFEE|LAC||5.35|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86900|Y||I~01/000;58/000||MAXFEE|LAC||3.09|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86901|Y||I~01/000;58/000||MAXFEE|LAC||3.09|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86902|Y||I~01/000;58/000||MAXFEE|LAC||5.37|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|86904|Y||I~01/000;58/000||MAXFEE|LAC||13.37|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|86905|Y||I~01/000;58/000||MAXFEE|LAC||3.96|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86906|Y||I~01/000;58/000||MAXFEE|LAC||8.01|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86940|Y||I~01/000;58/000||MAXFEE|LAC||9.06|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|86941|Y||I~01/000;58/000||MAXFEE|LAC||12.51|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87003|Y||I~01/000;58/000||MAXFEE|LAC||17.40|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87015|Y||I~01/000;58/000||MAXFEE|LAC||5.25|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|87040|Y||I~01/000;58/000||MAXFEE|LAC||10.66|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87045|Y||I~01/000;58/000||MAXFEE|LAC||9.75|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87046|Y||I~01/000;58/000||MAXFEE|LAC||3.40|0.0||20080701|22991231||
OUTPA|Outpatient Hospital|87070|Y||I~01/000;58/000||MAXFEE|LAC||8.91|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87071|Y||I~01/000;58/000||MAXFEE|LAC||6.81|0.0||20080701|22991231||
OUTPA|Outpatient Hospital|87073|Y||I~01/000;58/000||MAXFEE|LAC||6.81|0.0||20080701|22991231||
OUTPA|Outpatient Hospital|87075|Y||I~01/000;58/000||MAXFEE|LAC||9.79|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87076|Y||I~01/000;58/000||MAXFEE|LAC||8.35|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87077|Y||I~01/000;58/000||MAXFEE|LAC||8.35|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87081|Y||I~01/000;58/000||MAXFEE|LAC||6.85|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87084|Y||I~01/000;58/000||MAXFEE|LAC||10.59|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|87086|Y||I~01/000;58/000||MAXFEE|LAC||8.34|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87088|Y||I~01/000;58/000||MAXFEE|LAC||8.36|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87101|Y||I~01/000;58/000||MAXFEE|LAC||7.97|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87102|Y||I~01/000;58/000||MAXFEE|LAC||8.69|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87103|Y||I~01/000;58/000||MAXFEE|LAC||12.68|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|87106|Y||I~01/000;58/000||MAXFEE|LAC||10.66|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87107|Y||I~01/000;58/000||MAXFEE|LAC||10.66|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87109|Y||I~01/000;58/000||MAXFEE|LAC||14.01|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|87110|Y||I~01/000;58/000||MAXFEE|LAC||20.25|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87116|Y||I~01/000;58/000||MAXFEE|LAC||11.16|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87118|Y||I~01/000;58/000||MAXFEE|LAC||15.10|0.0||20180101|22991231||
OUTPA|Outpatient Hospital|87140|Y||I~01/000;58/000||MAXFEE|LAC||5.76|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87143|Y||I~01/000;58/000||MAXFEE|LAC||12.94|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87147|Y||I~01/000;58/000||MAXFEE|LAC||5.35|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87149|Y||I~01/000;58/000||MAXFEE|LAC||20.72|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87150|Y||I~01/000;58/000||MAXFEE|LAC||36.26|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87152|Y||I~01/000;58/000||MAXFEE|LAC||7.36|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|87153|Y||I~01/000;58/000||MAXFEE|LAC||119.20|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87154|Y||I~01/000;58/000||MAXFEE|LAC||12.05|0.0||20220101|22991231||
OUTPA|Outpatient Hospital|87158|Y||I~01/000;58/000||MAXFEE|LAC||7.36|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|87164|Y||I~01/000;58/000||MAXFEE|LAC||11.10|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87166|Y||I~01/000;58/000||MAXFEE|LAC||11.68|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87168|Y||I~01/000;58/000||MAXFEE|LAC||4.41|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87169|Y||I~01/000;58/000||MAXFEE|LAC||4.45|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87172|Y||I~01/000;58/000||MAXFEE|LAC||4.41|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87176|Y||I~01/000;58/000||MAXFEE|LAC||6.08|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87177|Y||I~01/000;58/000||MAXFEE|LAC||9.20|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87181|Y||I~01/000;58/000||MAXFEE|LAC||4.91|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87184|Y||I~01/000;58/000||MAXFEE|LAC||7.73|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87185|Y||I~01/000;58/000||MAXFEE|LAC||4.91|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87186|Y||I~01/000;58/000||MAXFEE|LAC||8.94|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87187|Y||I~01/000;58/000||MAXFEE|LAC||14.57|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|87188|Y||I~01/000;58/000||MAXFEE|LAC||6.86|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87190|Y||I~01/000;58/000||MAXFEE|LAC||4.05|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|87197|Y||I~01/000;58/000||MAXFEE|LAC||15.52|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87205|Y||I~01/000;58/000||MAXFEE|LAC||4.41|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87206|Y||I~01/000;58/000||MAXFEE|LAC||5.57|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87207|Y||I~01/000;58/000||MAXFEE|LAC||6.19|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87209|Y||I~01/000;58/000||MAXFEE|LAC||18.58|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87210|Y||I~01/000;58/000||MAXFEE|LAC||6.00|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|87220|Y||I~01/000;58/000||MAXFEE|LAC||4.41|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87230|Y||I~01/000;58/000||MAXFEE|LAC||20.40|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87250|Y||I~01/000;58/000||MAXFEE|LAC||20.21|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87252|Y||I~01/000;58/000||MAXFEE|LAC||26.94|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87253|Y||I~01/000;58/000||MAXFEE|LAC||19.61|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|87254|Y||I~01/000;58/000||MAXFEE|LAC||7.06|0.0||20080701|22991231||
OUTPA|Outpatient Hospital|87255|Y||I~01/000;58/000||MAXFEE|LAC||34.99|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87260|Y||I~01/000;58/000||MAXFEE|LAC||14.91|0.0||20190101|22991231||
OUTPA|Outpatient Hospital|87265|Y||I~01/000;58/000||MAXFEE|LAC||12.38|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87267|Y||I~01/000;58/000||MAXFEE|LAC||13.87|0.0||20190101|22991231||
OUTPA|Outpatient Hospital|87269|Y||I~01/000;58/000||MAXFEE|LAC||14.06|0.0||20190101|22991231||
OUTPA|Outpatient Hospital|87270|Y||I~01/000;58/000||MAXFEE|LAC||12.38|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87271|Y||I~01/000;58/000||MAXFEE|LAC||13.87|0.0||20190101|22991231||
OUTPA|Outpatient Hospital|87272|Y||I~01/000;58/000||MAXFEE|LAC||12.38|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87273|Y||I~01/000;58/000||MAXFEE|LAC||12.38|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87274|Y||I~01/000;58/000||MAXFEE|LAC||12.38|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87275|Y||I~01/000;58/000||MAXFEE|LAC||12.66|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87276|Y||I~01/000;58/000||MAXFEE|LAC||16.61|0.0||20180101|22991231||
OUTPA|Outpatient Hospital|87278|Y||I~01/000;58/000||MAXFEE|LAC||16.12|0.0||20180101|22991231||
OUTPA|Outpatient Hospital|87279|Y||I~01/000;58/000||MAXFEE|LAC||16.86|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|87280|Y||I~01/000;58/000||MAXFEE|LAC||13.87|0.0||20190101|22991231||
OUTPA|Outpatient Hospital|87281|Y||I~01/000;58/000||MAXFEE|LAC||12.38|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87283|Y||I~01/000;58/000||MAXFEE|LAC||16.86|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|87285|Y||I~01/000;58/000||MAXFEE|LAC||12.59|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87290|Y||I~01/000;58/000||MAXFEE|LAC||13.87|0.0||20190101|22991231||
OUTPA|Outpatient Hospital|87299|Y||I~01/000;58/000||MAXFEE|LAC||16.64|0.0||20180101|22991231||
OUTPA|Outpatient Hospital|87300|Y||I~01/000;58/000||MAXFEE|LAC||8.66|0.0||20080701|22991231||
OUTPA|Outpatient Hospital|87301|Y||I~01/000;58/000||MAXFEE|LAC||12.38|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87305|Y||I~01/000;58/000||MAXFEE|LAC||12.38|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87320|Y||I~01/000;58/000||MAXFEE|LAC||15.50|0.0||20180101|22991231||
OUTPA|Outpatient Hospital|87324|Y||I~01/000;58/000||MAXFEE|LAC||12.38|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87327|Y||I~01/000;58/000||MAXFEE|LAC||13.87|0.0||20190101|22991231||
OUTPA|Outpatient Hospital|87328|Y||I~01/000;58/000||MAXFEE|LAC||14.28|0.0||20190101|22991231||
OUTPA|Outpatient Hospital|87329|Y||I~01/000;58/000||MAXFEE|LAC||12.38|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87332|Y||I~01/000;58/000||MAXFEE|LAC||12.38|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87335|Y||I~01/000;58/000||MAXFEE|LAC||13.08|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87336|Y||I~01/000;58/000||MAXFEE|LAC||16.53|0.0||20180101|22991231||
OUTPA|Outpatient Hospital|87337|Y||I~01/000;58/000||MAXFEE|LAC||12.38|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87338|Y||I~01/000;58/000||MAXFEE|LAC||14.86|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87339|Y||I~01/000;58/000||MAXFEE|LAC||16.53|0.0||20180101|22991231||
OUTPA|Outpatient Hospital|87340|Y||I~01/000;58/000||MAXFEE|LAC||10.67|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87341|Y||I~01/000;58/000||MAXFEE|LAC||10.67|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87350|Y||I~01/000;58/000||MAXFEE|LAC||11.91|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87380|Y||I~01/000;58/000||MAXFEE|LAC||18.97|0.0||20190101|22991231||
OUTPA|Outpatient Hospital|87385|Y||I~01/000;58/000||MAXFEE|LAC||13.69|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87389|Y||I~01/000;58/000||MAXFEE|LAC||24.88|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87390|Y||I~01/000;58/000||MAXFEE|LAC||24.81|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|87391|Y||I~01/000;58/000||MAXFEE|LAC||22.63|0.0||20180101|22991231||
OUTPA|Outpatient Hospital|87400|Y||I~01/000;58/000||MAXFEE|LAC||8.66|0.0||20080701|22991231||
OUTPA|Outpatient Hospital|87420|Y||I~01/000;58/000||MAXFEE|LAC||14.37|0.0||20190101|22991231||
OUTPA|Outpatient Hospital|87425|Y||I~01/000;58/000||MAXFEE|LAC||12.38|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87426|Y||I~01/000;58/000||MAXFEE|LAC||35.33|0.0||20200625|22991231||
OUTPA|Outpatient Hospital|87427|Y||I~01/000;58/000||MAXFEE|LAC||12.38|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87428|Y||I~01/000;58/000||MAXFEE|LAC||30.94|0.0||20220101|22991231||
OUTPA|Outpatient Hospital|87430|Y||I~01/000;58/000||MAXFEE|LAC||16.86|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|87449|Y||I~01/000;58/000||MAXFEE|LAC||12.38|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87451|Y||I~01/000;58/000||MAXFEE|LAC||10.86|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87467|Y||I~01/000;58/000||MAXFEE|LAC||15.05|0.0||20230101|22991231||
OUTPA|Outpatient Hospital|87468|Y||I~01/000;58/000||MAXFEE|LAC||35.09|0.0||20230101|22991231||
OUTPA|Outpatient Hospital|87469|Y||I~01/000;58/000||MAXFEE|LAC||35.09|0.0||20230101|22991231||
OUTPA|Outpatient Hospital|87471|Y||I~01/000;58/000||MAXFEE|LAC||36.26|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87472|Y||I~01/000;58/000||MAXFEE|LAC||44.27|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87475|Y||I~01/000;58/000||MAXFEE|LAC||20.72|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87476|Y||I~01/000;58/000||MAXFEE|LAC||36.26|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87478|Y||I~01/000;58/000||MAXFEE|LAC||35.09|0.0||20230101|22991231||
OUTPA|Outpatient Hospital|87480|Y||I~01/000;58/000||MAXFEE|LAC||20.72|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87481|Y||I~01/000;58/000||MAXFEE|LAC||36.26|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87482|Y||I~01/000;58/000||MAXFEE|LAC||57.60|0.0||20180101|22991231||
OUTPA|Outpatient Hospital|87483|Y||I~01/000;58/000||MAXFEE|T18||416.78|0.0|OPXOVER80|20200101|22991231||
OUTPA|Outpatient Hospital|87484|Y||I~01/000;58/000||MAXFEE|LAC||35.09|0.0||20230101|22991231||
OUTPA|Outpatient Hospital|87485|Y||I~01/000;58/000||MAXFEE|LAC||20.72|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87486|Y||I~01/000;58/000||MAXFEE|LAC||36.26|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87487|Y||I~01/000;58/000||MAXFEE|LAC||44.27|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87490|Y||I~01/000;58/000||MAXFEE|LAC||23.51|0.0||20190101|22991231||
OUTPA|Outpatient Hospital|87491|Y||I~01/000;58/000||MAXFEE|LAC||36.26|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87492|Y||I~01/000;58/000||MAXFEE|LAC||49.15|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|87493|Y||I~01/000;58/000||MAXFEE|LAC||38.51|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87495|Y||I~01/000;58/000||MAXFEE|LAC||28.20|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|87496|Y||I~01/000;58/000||MAXFEE|LAC||36.26|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87497|Y||I~01/000;58/000||MAXFEE|LAC||44.27|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87498|Y||I~01/000;58/000||MAXFEE|LAC||36.26|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87500|Y||I~01/000;58/000||MAXFEE|LAC||36.26|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87501|Y||I~01/000;58/000||MAXFEE|LAC||53.02|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87502|Y||I~01/000;58/000||MAXFEE|LAC||98.99|0.0||20190101|22991231||
OUTPA|Outpatient Hospital|87503|Y||I~01/000;58/000||MAXFEE|LAC||29.20|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|87505|Y||I~01/000;58/000||MAXFEE|LAC||132.56|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87506|Y||I~01/000;58/000||MAXFEE|LAC||232.94|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|87507|Y||I~01/000;58/000||MAXFEE|LAC||430.66|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87510|Y||I~01/000;58/000||MAXFEE|LAC||20.72|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87511|Y||I~01/000;58/000||MAXFEE|LAC||36.26|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87512|Y||I~01/000;58/000||MAXFEE|LAC||43.15|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87513|Y||I~01/000;58/000||MAXFEE|LAC||28.07|0.0||20250101|22991231||
OUTPA|Outpatient Hospital|87516|Y||I~01/000;58/000||MAXFEE|LAC||36.26|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87517|Y||I~01/000;58/000||MAXFEE|LAC||44.27|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87520|Y||I~01/000;58/000||MAXFEE|LAC||28.20|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|87521|Y||I~01/000;58/000||MAXFEE|LAC||36.26|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87522|Y||I~01/000;58/000||MAXFEE|LAC||44.27|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87523|Y||I~01/000;58/000||MAXFEE|LAC||34.27|0.0||20240101|22991231||
OUTPA|Outpatient Hospital|87525|Y||I~01/000;58/000||MAXFEE|LAC||28.20|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|87526|Y||I~01/000;58/000||MAXFEE|LAC||40.57|0.0||20190101|22991231||
OUTPA|Outpatient Hospital|87527|Y||I~01/000;58/000||MAXFEE|LAC||43.15|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87528|Y||I~01/000;58/000||MAXFEE|LAC||20.72|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87529|Y||I~01/000;58/000||MAXFEE|LAC||36.26|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87530|Y||I~01/000;58/000||MAXFEE|LAC||44.27|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87531|Y||I~01/000;58/000||MAXFEE|LAC||28.20|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|87532|Y||I~01/000;58/000||MAXFEE|LAC||36.26|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87533|Y||I~01/000;58/000||MAXFEE|LAC||43.15|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87534|Y||I~01/000;58/000||MAXFEE|LAC||22.65|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87535|Y||I~01/000;58/000||MAXFEE|LAC||36.26|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87536|Y||I~01/000;58/000||MAXFEE|LAC||87.93|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87537|Y||I~01/000;58/000||MAXFEE|LAC||22.65|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87538|Y||I~01/000;58/000||MAXFEE|LAC||36.26|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87539|Y||I~01/000;58/000||MAXFEE|LAC||60.23|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|87540|Y||I~01/000;58/000||MAXFEE|LAC||20.72|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87541|Y||I~01/000;58/000||MAXFEE|LAC||36.26|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87542|Y||I~01/000;58/000||MAXFEE|LAC||43.15|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87550|Y||I~01/000;58/000||MAXFEE|LAC||20.72|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87551|Y||I~01/000;58/000||MAXFEE|LAC||49.35|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|87552|Y||I~01/000;58/000||MAXFEE|LAC||44.27|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87555|Y||I~01/000;58/000||MAXFEE|LAC||27.78|0.0||20180101|22991231||
OUTPA|Outpatient Hospital|87556|Y||I~01/000;58/000||MAXFEE|LAC||43.07|0.0||20190101|22991231||
OUTPA|Outpatient Hospital|87557|Y||I~01/000;58/000||MAXFEE|LAC||44.27|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87560|Y||I~01/000;58/000||MAXFEE|LAC||28.20|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|87561|Y||I~01/000;58/000||MAXFEE|LAC||36.26|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87562|Y||I~01/000;58/000||MAXFEE|LAC||44.27|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87563|Y||I~01/000;58/000||MAXFEE|LAC||28.07|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87564|Y||I~01/000;58/000||MAXFEE|LAC||61.42|0.0||20250101|22991231||
OUTPA|Outpatient Hospital|87580|Y||I~01/000;58/000||MAXFEE|LAC||20.72|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87581|Y||I~01/000;58/000||MAXFEE|LAC||36.26|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87582|Y||I~01/000;58/000||MAXFEE|LAC||58.71|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|87590|Y||I~01/000;58/000||MAXFEE|LAC||27.78|0.0||20180101|22991231||
OUTPA|Outpatient Hospital|87591|Y||I~01/000;58/000||MAXFEE|LAC||36.26|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87592|Y||I~01/000;58/000||MAXFEE|LAC||44.27|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87594|Y||I~01/000;58/000||MAXFEE|LAC||28.07|0.0||20250101|22991231||
OUTPA|Outpatient Hospital|87623|Y||I~01/000;58/000||MAXFEE|LAC||36.26|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87624|Y||I~01/000;58/000||MAXFEE|LAC||36.26|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87625|Y||I~01/000;58/000||MAXFEE|LAC||38.30|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|87626|Y||I~01/000;58/000||MAXFEE|LAC||56.16|0.0||20250101|22991231||
OUTPA|Outpatient Hospital|87631|Y||I~01/000;58/000||MAXFEE|LAC||140.78|0.0||20170501|22991231||
OUTPA|Outpatient Hospital|87632|Y||I~01/000;58/000||MAXFEE|LAC||225.32|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87633|Y||I~01/000;58/000||MAXFEE|LAC||430.66|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87634|Y||I~01/000;58/000||MAXFEE|LAC||69.33|0.0||20180101|22991231||
OUTPA|Outpatient Hospital|87635|Y||I~01/000;58/000||MAXFEE|LAC||51.31|0.0||20200313|22991231||
OUTPA|Outpatient Hospital|87636|Y||I~01/000;58/000||MAXFEE|LAC||142.63|0.0||20210801|22991231||
OUTPA|Outpatient Hospital|87637|Y||I~01/000;58/000||MAXFEE|LAC||142.63|0.0||20210801|22991231||
OUTPA|Outpatient Hospital|87640|Y||I~01/000;58/000||MAXFEE|LAC||36.26|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87641|Y||I~01/000;58/000||MAXFEE|LAC||36.26|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87650|Y||I~01/000;58/000||MAXFEE|LAC||20.72|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87651|Y||I~01/000;58/000||MAXFEE|LAC||36.26|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87652|Y||I~01/000;58/000||MAXFEE|LAC||43.15|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87653|Y||I~01/000;58/000||MAXFEE|LAC||36.26|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87660|Y||I~01/000;58/000||MAXFEE|LAC||20.72|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87661|Y||I~01/000;58/000||MAXFEE|LAC||36.26|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87662|Y||I~01/000;58/000||MAXFEE|LAC||50.68|0.0||20180101|22991231||
OUTPA|Outpatient Hospital|87797|Y||I~01/000;58/000||MAXFEE|LAC||28.20|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|87798|Y||I~01/000;58/000||MAXFEE|LAC||36.26|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87799|Y||I~01/000;58/000||MAXFEE|LAC||44.27|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87800|Y||I~01/000;58/000||MAXFEE|LAC||28.92|0.0||20080701|22991231||
OUTPA|Outpatient Hospital|87801|Y||I~01/000;58/000||MAXFEE|LAC||50.62|0.0||20080701|22991231||
OUTPA|Outpatient Hospital|87802|Y||I~01/000;58/000||MAXFEE|LAC||13.15|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87803|Y||I~01/000;58/000||MAXFEE|LAC||16.53|0.0||20180101|22991231||
OUTPA|Outpatient Hospital|87804|Y||I~01/000;58/000||MAXFEE|LAC||16.86|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|87806|Y||I~01/000;58/000||MAXFEE|LAC||26.28|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|87807|Y||I~01/000;58/000||MAXFEE|LAC||13.54|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87808|Y||I~01/000;58/000||MAXFEE|LAC||15.80|0.0||20180101|22991231||
OUTPA|Outpatient Hospital|87809|Y||I~01/000;58/000||MAXFEE|LAC||13.15|0.0||20170501|22991231||
OUTPA|Outpatient Hospital|87810|Y||I~01/000;58/000||MAXFEE|LAC||16.86|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|87811|Y||I~01/000;58/000||MAXFEE|LAC||41.38|0.0||20201006|22991231||
OUTPA|Outpatient Hospital|87850|Y||I~01/000;58/000||MAXFEE|LAC||16.86|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|87880|Y||I~01/000;58/000||MAXFEE|LAC||16.86|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|87899|Y||I~01/000;58/000||MAXFEE|LAC||16.61|0.0||20180101|22991231||
OUTPA|Outpatient Hospital|87900|Y||I~01/000;58/000||MAXFEE|LAC||134.69|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87901|Y||I~01/000;58/000||MAXFEE|LAC||266.02|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87902|Y||I~01/000;58/000||MAXFEE|LAC||266.02|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87903|Y||I~01/000;58/000||MAXFEE|LAC||504.93|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87904|Y||I~01/000;58/000||MAXFEE|LAC||26.94|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87905|Y||I~01/000;58/000||MAXFEE|LAC||12.63|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87906|Y||I~01/000;58/000||MAXFEE|LAC||133.02|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87910|Y||I~01/000;58/000||MAXFEE|LAC||266.02|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|87912|Y||I~01/000;58/000||MAXFEE|LAC||266.02|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|88130|Y||I~01/000;58/000||MAXFEE|LAC||18.58|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|88140|Y||I~01/000;58/000||MAXFEE|LAC||8.26|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|88142|Y||I~01/000;58/000||MAXFEE|LAC||20.93|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|88143|Y||I~01/000;58/000||MAXFEE|LAC||23.81|0.0||20190101|22991231||
OUTPA|Outpatient Hospital|88147|Y||I~01/000;58/000||MAXFEE|LAC||14.86|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|88148|Y||I~01/000;58/000||MAXFEE|LAC||14.86|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|88150|Y||I~01/000;58/000||MAXFEE|LAC||14.86|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|88152|Y||I~01/000;58/000||MAXFEE|LAC||14.86|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|88153|Y||I~01/000;58/000||MAXFEE|LAC||14.86|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|88155|Y||I~01/000;58/000||MAXFEE|LAC||8.42|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|88164|Y||I~01/000;58/000||MAXFEE|LAC||14.86|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|88165|Y||I~01/000;58/000||MAXFEE|LAC||14.86|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|88166|Y||I~01/000;58/000||MAXFEE|LAC||14.86|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|88167|Y||I~01/000;58/000||MAXFEE|LAC||14.86|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|88174|Y||I~01/000;58/000||MAXFEE|LAC||26.21|0.0||20190101|22991231||
OUTPA|Outpatient Hospital|88175|Y||I~01/000;58/000||MAXFEE|LAC||27.50|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|88230|Y||I~01/000;58/000||MAXFEE|LAC||70.04|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|88233|Y||I~01/000;58/000||MAXFEE|LAC||70.04|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|88235|Y||I~01/000;58/000||MAXFEE|LAC||70.04|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|88237|Y||I~01/000;58/000||MAXFEE|LAC||70.04|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|88239|Y||I~01/000;58/000||MAXFEE|LAC||70.04|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|88240|Y||I~01/000;58/000||MAXFEE|LAC||9.83|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|88241|Y||I~01/000;58/000||MAXFEE|LAC||9.83|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|88245|Y||I~01/000;58/000||MAXFEE|LAC||178.94|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|88248|Y||I~01/000;58/000||MAXFEE|LAC||178.94|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|88249|Y||I~01/000;58/000||MAXFEE|LAC||178.94|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|88261|Y||I~01/000;58/000||MAXFEE|LAC||248.52|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|88262|Y||I~01/000;58/000||MAXFEE|LAC||129.67|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|88263|Y||I~01/000;58/000||MAXFEE|LAC||155.29|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|88264|Y||I~01/000;58/000||MAXFEE|LAC||149.43|0.0||20190101|22991231||
OUTPA|Outpatient Hospital|88267|Y||I~01/000;58/000||MAXFEE|LAC||194.85|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|88269|Y||I~01/000;58/000||MAXFEE|LAC||179.44|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|88271|Y||I~01/000;58/000||MAXFEE|LAC||20.36|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|88272|Y||I~01/000;58/000||MAXFEE|LAC||35.62|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|88273|Y||I~01/000;58/000||MAXFEE|LAC||35.97|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|88274|Y||I~01/000;58/000||MAXFEE|LAC||43.79|0.0||20190101|22991231||
OUTPA|Outpatient Hospital|88275|Y||I~01/000;58/000||MAXFEE|LAC||52.89|0.0||20180101|22991231||
OUTPA|Outpatient Hospital|88280|Y||I~01/000;58/000||MAXFEE|LAC||34.58|0.0||20180101|22991231||
OUTPA|Outpatient Hospital|88283|Y||I~01/000;58/000||MAXFEE|LAC||70.88|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|88285|Y||I~01/000;58/000||MAXFEE|LAC||26.72|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|88289|Y||I~01/000;58/000||MAXFEE|LAC||35.58|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|88371|Y||I~01/000;58/000||MAXFEE|LAC||22.97|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|88372|Y||I~01/000;58/000||MAXFEE|LAC||27.09|0.0||20190101|22991231||
OUTPA|Outpatient Hospital|88720|Y||I~01/000;58/000||MAXFEE|LAC||3.63|0.0||20090101|22991231||
OUTPA|Outpatient Hospital|88738|Y||I~01/000;58/000||MAXFEE|LAC||5.19|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|88740|Y||I~01/000;58/000||MAXFEE|LAC||5.50|0.0||20170501|22991231||
OUTPA|Outpatient Hospital|88741|Y||I~01/000;58/000||MAXFEE|LAC||5.50|0.0||20170501|22991231||
OUTPA|Outpatient Hospital|89050|Y||I~01/000;58/000||MAXFEE|LAC||4.88|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|89051|Y||I~01/000;58/000||MAXFEE|LAC||5.79|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|89055|Y||I~01/000;58/000||MAXFEE|LAC||4.41|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|89060|Y||I~01/000;58/000||MAXFEE|LAC||7.57|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|89125|Y||I~01/000;58/000||MAXFEE|LAC||6.08|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|89160|Y||I~01/000;58/000||MAXFEE|LAC||5.01|0.0||20180101|22991231||
OUTPA|Outpatient Hospital|89190|Y||I~01/000;58/000||MAXFEE|LAC||5.98|0.0||20190101|22991231||
OUTPA|Outpatient Hospital|89300|Y||I~01/000;58/000||MAXFEE|LAC||10.17|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|89310|Y||I~01/000;58/000||MAXFEE|LAC||8.90|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|89320|Y||I~01/000;58/000||MAXFEE|LAC||12.72|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|89321|Y||I~01/000;58/000||MAXFEE|LAC||12.45|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|89322|Y||I~01/000;58/000||MAXFEE|LAC||16.02|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|89331|Y||I~01/000;58/000||MAXFEE|LAC||20.02|0.0||20170501|22991231||
OUTPA|Outpatient Hospital|90380|Y||I~01/000;58/000|0 - 18|MAXFEE|PT1||556.13|0.0||20260201|22991231||
OUTPA|Outpatient Hospital|90380|Y||I~01/000;58/000|0 - 18|MAXFEE|PT1|SL|0.00|0.0||20260201|22991231||
OUTPA|Outpatient Hospital|90380|Y||I~01/000;58/000|19 - 999|MAXFEE|MED||0.00|0.0||20230717|20260131||
OUTPA|Outpatient Hospital|90380|Y||I~01/000;58/000|19 - 999|MAXFEE|MED||556.13|0.0||20260201|22991231||
OUTPA|Outpatient Hospital|90381|Y||I~01/000;58/000|0 - 18|MAXFEE|PT1||556.13|0.0||20260201|22991231||
OUTPA|Outpatient Hospital|90381|Y||I~01/000;58/000|0 - 18|MAXFEE|PT1|SL|0.00|0.0||20260201|22991231||
OUTPA|Outpatient Hospital|90381|Y||I~01/000;58/000|19 - 999|MAXFEE|MED||0.00|0.0||20230717|20260131||
OUTPA|Outpatient Hospital|90381|Y||I~01/000;58/000|19 - 999|MAXFEE|MED||556.13|0.0||20260201|22991231||
OUTPA|Outpatient Hospital|90480|Y||I~01/000;58/000||MAXFEE|MED||44.95|0.0||20251001|22991231||
OUTPA|Outpatient Hospital|91304|Y||I~01/000;58/000|0 - 18|MAXFEE|PEM||191.92|0.0||20251001|22991231||
OUTPA|Outpatient Hospital|91304|Y||I~01/000;58/000|0 - 18|MAXFEE|PEM|SL|0.00|0.0||20251001|22991231||
OUTPA|Outpatient Hospital|91304|Y||I~01/000;58/000|19 - 999|MAXFEE|MED||191.92|0.0||20251001|22991231||
OUTPA|Outpatient Hospital|91319|Y||I~01/000;58/000|0 - 18|MAXFEE|PEM||77.00|0.0||20251001|22991231||
OUTPA|Outpatient Hospital|91319|Y||I~01/000;58/000|0 - 18|MAXFEE|PEM|SL|0.00|0.0||20251001|22991231||
OUTPA|Outpatient Hospital|91319|Y||I~01/000;58/000|19 - 999|MAXFEE|MED||77.00|0.0||20251001|22991231||
OUTPA|Outpatient Hospital|91320|Y||I~01/000;58/000|0 - 18|MAXFEE|PEM||136.75|0.0||20251001|22991231||
OUTPA|Outpatient Hospital|91320|Y||I~01/000;58/000|0 - 18|MAXFEE|PEM|SL|0.00|0.0||20251001|22991231||
OUTPA|Outpatient Hospital|91320|Y||I~01/000;58/000|19 - 999|MAXFEE|MED||136.75|0.0||20251001|22991231||
OUTPA|Outpatient Hospital|91321|Y||I~01/000;58/000|0 - 18|MAXFEE|PEM||129.00|0.0||20251001|22991231||
OUTPA|Outpatient Hospital|91321|Y||I~01/000;58/000|0 - 18|MAXFEE|PEM|SL|0.00|0.0||20251001|22991231||
OUTPA|Outpatient Hospital|91321|Y||I~01/000;58/000|19 - 999|MAXFEE|MED||129.00|0.0||20251001|22991231||
OUTPA|Outpatient Hospital|91322|Y||I~01/000;58/000|0 - 18|MAXFEE|PEM||141.80|0.0||20251001|22991231||
OUTPA|Outpatient Hospital|91322|Y||I~01/000;58/000|0 - 18|MAXFEE|PEM|SL|0.00|0.0||20251001|22991231||
OUTPA|Outpatient Hospital|91322|Y||I~01/000;58/000|19 - 999|MAXFEE|MED||141.80|0.0||20251001|22991231||
OUTPA|Outpatient Hospital|99000|Y||I~01/000;58/000||MAXFEE|LAC||3.47|0.0||20080701|22991231||
OUTPA|Outpatient Hospital|99001|Y||I~01/000;58/000||MAXFEE|LAC||3.92|0.0||20130401|22991231||
OUTPA|Outpatient Hospital|C9507|Y||I~01/000;58/000||MAXFEE|T18||750.50|0.0||20211228|22991231||
OUTPA|Outpatient Hospital|G0103|Y||I~01/000;58/000||MAXFEE|LAC||19.95|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|G0123|Y||I~01/000;58/000||MAXFEE|LAC||20.93|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|G0143|Y||I~01/000;58/000||MAXFEE|LAC||27.95|0.0||20180101|22991231||
OUTPA|Outpatient Hospital|G0144|Y||I~01/000;58/000||MAXFEE|LAC||29.85|0.0||20080701|22991231||
OUTPA|Outpatient Hospital|G0145|Y||I~01/000;58/000||MAXFEE|LAC||27.37|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|G0147|Y||I~01/000;58/000||MAXFEE|LAC||14.76|0.0||20080701|22991231||
OUTPA|Outpatient Hospital|G0148|Y||I~01/000;58/000||MAXFEE|LAC||14.76|0.0||20080701|22991231||
OUTPA|Outpatient Hospital|G0306|Y||I~01/000;58/000||MAXFEE|LAC||8.03|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|G0307|Y||I~01/000;58/000||MAXFEE|LAC||6.69|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|G0480|Y||I~01/000;58/000||MAXFEE|LAC||63.95|0.0||20160101|22991231||
OUTPA|Outpatient Hospital|G0481|Y||I~01/000;58/000||MAXFEE|LAC||98.39|0.0||20160101|22991231||
OUTPA|Outpatient Hospital|G0482|Y||I~01/000;58/000||MAXFEE|LAC||132.80|0.0||20160101|22991231||
OUTPA|Outpatient Hospital|G0483|Y||I~01/000;58/000||MAXFEE|LAC||172.18|0.0||20160101|22991231||
OUTPA|Outpatient Hospital|G0659|Y||I~01/000;58/000||MAXFEE|LAC||63.40|0.0||20170101|22991231||
OUTPA|Outpatient Hospital|J0248|Y||I~01/000;58/000||MAXFEE|MED||6.90|0.0||20260101|22991231||
OUTPA|Outpatient Hospital|J9359|Y||I~01/000;58/000||MAXFEE|MED||221.22|0.0||20260101|20260331||
OUTPA|Outpatient Hospital|J9359|Y||I~01/000;58/000||MAXFEE|MED||221.49|0.0||20260401|22991231||
OUTPA|Outpatient Hospital|P2028|||I~01/000;58/000||MAXFEE|T18||4.95|0.0|OPXOVER80|20200101|22991231||
OUTPA|Outpatient Hospital|P2029|||I~01/000;58/000||MAXFEE|T18||4.95|0.0|OPXOVER80|20200101|22991231||
OUTPA|Outpatient Hospital|P2031|||I~01/000;58/000||MAXFEE|T18||4.95|0.0|OPXOVER80|20200101|22991231||
OUTPA|Outpatient Hospital|P2033|||I~01/000;58/000||MAXFEE|T18||4.95|0.0|OPXOVER80|20200101|22991231||
OUTPA|Outpatient Hospital|P2038|Y||I~01/000;58/000||MAXFEE|LAC||5.11|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|P3000|Y||I~01/000;58/000||MAXFEE|LAC||14.86|0.0||20150101|22991231||
OUTPA|Outpatient Hospital|P9016|Y||I~01/000;58/000||MAXFEE|LAC||449.49|0.0||20130401|22991231||
OUTPA|Outpatient Hospital|P9017|Y||I~01/000;58/000||MAXFEE|LAC||38.65|0.0||20130401|22991231||
OUTPA|Outpatient Hospital|P9019|Y||I~01/000;58/000||MAXFEE|LAC||64.42|0.0||20130401|22991231||
OUTPA|Outpatient Hospital|P9041|Y||I~01/000;58/000||MAXFEE|LAC||9.55|0.0||20130401|22991231||
OUTPA|Outpatient Hospital|P9043|Y||I~01/000;58/000||MAXFEE|LAC||8.33|0.0||20130401|22991231||
OUTPA|Outpatient Hospital|P9615|Y||I~01/000;58/000||MAXFEE|LAC||3.00|0.0||20130401|22991231||
OUTPA|Outpatient Hospital|Q0111|Y||I~01/000;58/000||MAXFEE|LAC||5.87|0.0||20130401|22991231||
OUTPA|Outpatient Hospital|Q0112|Y||I~01/000;58/000||MAXFEE|LAC||5.87|0.0||20130401|22991231||
OUTPA|Outpatient Hospital|Q0113|Y||I~01/000;58/000||MAXFEE|LAC||4.41|0.0||20200101|22991231||
OUTPA|Outpatient Hospital|Q0114|Y||I~01/000;58/000||MAXFEE|LAC||9.83|0.0||20130401|22991231||
OUTPA|Outpatient Hospital|Q0115|Y||I~01/000;58/000||MAXFEE|LAC||7.66|0.0||20130401|22991231||
OUTPA|Outpatient Hospital|Q0478|Y||I~01/000;58/000||MAXFEE|C11||138.90|0.0||20130401|22991231||
OUTPA|Outpatient Hospital|Q0479|Y||I~01/000;58/000||MAXFEE|C11||9129.31|0.0||20130401|22991231||
OUTPA|Outpatient Hospital|Q0480|Y||I~01/000;58/000||MAXFEE|C11||68078.22|0.0||20130401|22991231||
OUTPA|Outpatient Hospital|Q0481|Y||I~01/000;58/000||MAXFEE|C11||10983.65|0.0||20130401|22991231||
OUTPA|Outpatient Hospital|Q0482|Y||I~01/000;58/000||MAXFEE|C11||3440.27|0.0||20130401|22991231||
OUTPA|Outpatient Hospital|Q0483|Y||I~01/000;58/000||MAXFEE|C11||14172.40|0.0||20130401|22991231||
OUTPA|Outpatient Hospital|Q0484|Y||I~01/000;58/000||MAXFEE|C11||2752.23|0.0||20130401|22991231||
OUTPA|Outpatient Hospital|Q0485|Y||I~01/000;58/000||MAXFEE|C11||265.74|0.0||20130401|22991231||
OUTPA|Outpatient Hospital|Q0486|Y||I~01/000;58/000||MAXFEE|C11||221.15|0.0||20130401|22991231||
OUTPA|Outpatient Hospital|Q0487|Y||I~01/000;58/000||MAXFEE|C11||258.01|0.0||20130401|22991231||
OUTPA|Outpatient Hospital|Q0489|Y||I~01/000;58/000||MAXFEE|C11||12286.70|0.0||20130401|22991231||
OUTPA|Outpatient Hospital|Q0490|Y||I~01/000;58/000||MAXFEE|C11||531.45|0.0||20130401|22991231||
OUTPA|Outpatient Hospital|Q0491|Y||I~01/000;58/000||MAXFEE|C11||835.51|0.0||20130401|22991231||
OUTPA|Outpatient Hospital|Q0492|Y||I~01/000;58/000||MAXFEE|C11||67.32|0.0||20130401|22991231||
OUTPA|Outpatient Hospital|Q0493|Y||I~01/000;58/000||MAXFEE|C11||191.66|0.0||20130401|22991231||
OUTPA|Outpatient Hospital|Q0494|Y||I~01/000;58/000||MAXFEE|C11||162.18|0.0||20130401|22991231||
OUTPA|Outpatient Hospital|Q0495|Y||I~01/000;58/000||MAXFEE|C11||3157.36|0.0||20130401|22991231||
OUTPA|Outpatient Hospital|Q0496|Y||I~01/000;58/000||MAXFEE|C11||1133.25|0.0||20130401|22991231||
OUTPA|Outpatient Hospital|Q0497|Y||I~01/000;58/000||MAXFEE|C11||353.86|0.0||20130401|22991231||
OUTPA|Outpatient Hospital|Q0498|Y||I~01/000;58/000||MAXFEE|C11||388.26|0.0||20130401|22991231||
OUTPA|Outpatient Hospital|Q0499|Y||I~01/000;58/000||MAXFEE|C11||126.14|0.0||20130401|22991231||
OUTPA|Outpatient Hospital|Q0500|Y||I~01/000;58/000||MAXFEE|C11||23.08|0.0||20130401|22991231||
OUTPA|Outpatient Hospital|Q0503|Y||I~01/000;58/000||MAXFEE|C11||982.92|0.0||20130401|22991231||
OUTPA|Outpatient Hospital|Q0504|Y||I~01/000;58/000||MAXFEE|C11||518.67|0.0||20130401|22991231||
OUTPA|Outpatient Hospital|Q0506|Y||I~01/000;58/000||MAXFEE|C11||645.60|0.0||20130401|22991231||
OUTPA|Outpatient Hospital|Q0507|Y||I~01/000;58/000||BILLED|DEF||||OUTPA62||||
OUTPA|Outpatient Hospital|Q0508|Y||I~01/000;58/000||BILLED|DEF||||OUTPA62||||
OUTPA|Outpatient Hospital|U0001|Y||I~01/000;58/000||MAXFEE|LAC||35.91|0.0||20200204|22991231||
OUTPA|Outpatient Hospital|U0002|Y||I~01/000;58/000||MAXFEE|LAC||51.31|0.0||20200204|22991231||