1  C M S ,
   C M S     PRICER OPERATING  P R O S P E C T I V E   P A Y M E N T   T E S T   D A T A   R E P O R T  OPER147
0 HI CLAIM   PROVIDER WAGE  DRG GMN DRG DIS-DATE TOT OPERATING  FEDERAL     HOSPITAL     OUTLIER  DISPROP   IMETCH     OUTL REV  PPS
     NO         NO    INDEX  NO LOS CUT CCYYMMDD & CAPITAL PAY  PORTION     PORTION      PORTION   SHARE    ADJUST LOS DAYS  CD  RTC
  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -
 199800009J   370173 1.4448 208  2.4  0 19980201     3,343.27   3,054.62        .00          .00      .00      .00   1    0  07   00
 199800004L   100001 0.8969 208  2.4  0 19980305     4,107.44   2,185.17        .00          .00   978.52   678.76   1    0  00   00
 199800004L   100001 0.8969 208  2.4  0 19980305     4,107.44   2,185.17        .00          .00   978.52   678.76   1    0  00   00
 199900004A   100001 0.8919 208  2.3  0 19981001     4,145.34   2,229.42        .00          .00   988.52   644.19   1    0  09   00
 199900005M   140012 1.0469 236  4.1  0 19981001     4,916.67   2,930.04        .00          .00      .00      .00  30    0  09   14
 199900008J   370173 1.4448 208  2.3  0 19981001     3,428.54   3,128.48        .00          .00      .00      .00   1    0  07   00
 199900003A   100001 0.8919 209  4.9  0 19981002    14,650.83   7,879.41        .00          .00 3,493.73 2,276.77   2    0  00   00
 199900003B   100001 0.8919 209  4.9  0 19981002    11,810.35   6,351.75        .00          .00 2,816.37 1,835.35   2    0  09   10
 199900003C   100001 0.8919 209  4.9  0 19981002    26,473.52   6,351.75        .00    13,360.22 2,816.37 1,835.35   2    0  09   10
 199900013C   100001 0.8919 209  4.9  0 19981002    11,810.35   6,351.75        .00          .00 2,816.37 1,835.35   2    0  11   10
 199900009P   360015 0.8537 503  3.2  0 19981002    37,608.08   4,313.28        .00    30,702.80      .00      .00   1    0  00   02
 199900009Q   360016 0.8537 503  3.2  0 19981002    37,608.08   4,313.28        .00    30,702.80      .00      .00   1    0  00   02
 199900009A   390012 0.9809 503  3.2  0 19981002     6,834.67   4,762.83        .00          .00      .00      .00   1    0  00   00
 199900009B   390013 0.9809 503  3.2  0 19981002     9,684.02   4,762.83   2,699.35          .00      .00      .00   1    0  00   00
 199900009C   390014 1.0082 503  3.2  0 19981002     5,232.95   4,765.45        .00          .00      .00      .00   1    0  00   00
 199900009D   390015 0.9809 503  3.2  0 19981002     6,820.49   4,748.65        .00          .00      .00      .00   1    0  00   00
 199900009E   390016 0.9809 503  3.2  0 19981002     8,184.34   4,762.83   1,349.67          .00      .00      .00   1    0  00   00
 199900009F   390017 0.9809 503  3.2  0 19981002     8,177.64   4,748.65   1,357.15          .00      .00      .00   1    0  00   00
 199900009G   390018 0.9809 503  3.2  0 19981002     7,520.35   4,762.83        .00          .00   233.38   452.30   1    0  00   00
 199900009I   390018 0.9809 503  3.2  0 19981002   520,653.35   4,762.83        .00   502,822.36   233.38   452.30   1    0  00   02
 199900009H   390021 0.9809 503  3.2  0 19981002     7,504.13   4,748.65        .00          .00   232.68   450.96   1    0  00   00
 199900009J   390021 0.9809 503  3.2  0 19981002   520,650.10   4,748.65        .00   502,835.33   232.68   450.96   1    0  00   02
 199900009K   400012 0.4878 503  3.2  0 19981002     4,675.40   2,704.10        .00          .00      .00      .00   1    0  00   00
 199900009L   400012 0.4878 503  3.2  0 19981002    37,755.60   2,704.10        .00    32,458.60      .00      .00   1    0  00   02
 199901999A   400012 0.4878 234  2.8  0 19981002    37,729.59   2,579.64        .00    32,558.17      .00      .00   1    0  00   02
 199900009M   400015 0.0000 503  0.0  0 19981002          .00        .00        .00          .00      .00      .00   1    0  00   52
 199900009N   400017 0.0000 503  0.0  0 19981002          .00        .00        .00          .00      .00      .00   1    0  00   51
 199900009O   400017 0.0000 503  0.0  0 19981002          .00        .00        .00          .00      .00      .00   1    0  00   51
 199900008A   400018 0.0000 503  0.0  0 19981002          .00        .00        .00          .00      .00      .00   1    0  00   52
 199900009R   510015 0.8034 503  3.2  0 19981002    37,882.22   4,141.11        .00    31,144.15      .00      .00   1    0  00   02
 199900001A   100001 0.8919 424  9.0  0 19981004    15,779.75   8,486.55        .00          .00 3,762.94 2,452.20   4    0  00   00
 199900001B   100001 0.8919 424  9.0  0 19981004     8,766.62   4,714.79        .00          .00 2,090.54 1,362.35   4    0  03   03
 199900001C   100001 0.8919 424  9.0  0 19981004    15,779.75   8,486.55        .00          .00 3,762.94 2,452.20   4    0  09   00
 199900002A   100001 0.8919 113  9.8  0 19981004    18,404.44   9,898.14        .00          .00 4,388.84 2,860.08   4    0  00   00
 199900002B   100001 0.8919 113  9.8  0 19981004     9,389.93   5,050.03        .00          .00 2,239.18 1,459.21   4    0  09   12
 199900002C   100001 0.8919 113  9.8  0 19981004    28,313.66   5,050.03        .00    17,336.33 2,239.18 1,459.21   4    0  09   12
 199900012C   100001 0.8919 113  9.8  0 19981004     9,389.93   5,050.03        .00          .00 2,239.18 1,459.21   4    0  11   12
 199900004A   450377 0.7441 209  4.9  0 19981004     7,499.46   6,871.93        .00          .00      .00      .00   5    0  09   14
 199900004B   450377 0.7441 209  4.9  0 19981004    64,784.37   6,871.93        .00    53,863.15      .00      .00   5    0  09   16
 199900004C   450377 0.7441 209  4.9  0 19981004     7,499.46   6,871.93        .00          .00      .00      .00   5    0  09   14
 199900004D   450377 0.7441 210  6.1  0 19981004     5,673.17   5,198.46        .00          .00      .00      .00   4    0  09   10
 199900004E   450377 0.7441 210  6.1  0 19981004    64,519.57   5,713.63        .00    54,789.79      .00      .00   6    0  09   16
 199900004F   450377 0.7441 210  6.1  0 19981004     6,235.39   5,713.63        .00          .00      .00      .00   6    0  09   14
 199900004G   450377 0.7441 211  4.7  0 19981004     4,301.27   3,941.36        .00          .00      .00      .00   4    0  09   14
 199900004H   450377 0.7441 211  4.7  0 19981004     4,301.27   3,941.36        .00          .00      .00      .00   5    0  09   14
 199900004I   450377 0.7441 014  4.9  0 19981004    64,074.78   3,768.01        .00    56,346.29      .00      .00   4    0  09   16
 199900004J   450377 0.7441 014  4.9  0 19981004     4,112.10   3,768.01        .00          .00      .00      .00   4    0  09   14
 199900004K   450377 0.7441 014  4.9  0 19981004     4,112.10   3,768.01        .00          .00      .00      .00   5    0  09   14
 199900004L   450377 0.7441 113  9.8  0 19981004    67,724.58   4,404.32        .00    59,128.35      .00      .00   4    0  09   12
 199900004M   450377 0.7441 113  9.8  0 19981004     4,806.51   4,404.32        .00          .00      .00      .00   4    0  09   12
1  C M S ,
   C M S     PRICER OPERATING  P R O S P E C T I V E   P A Y M E N T   T E S T   D A T A   R E P O R T  OPER147
0 HI CLAIM   PROVIDER WAGE  DRG GMN DRG DIS-DATE TOT OPERATING  FEDERAL     HOSPITAL     OUTLIER  DISPROP   IMETCH     OUTL REV  PPS
     NO         NO    INDEX  NO LOS CUT CCYYMMDD & CAPITAL PAY  PORTION     PORTION      PORTION   SHARE    ADJUST LOS DAYS  CD  RTC
  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -
 199900004N   450377 0.7441 113  9.8  0 19981004     9,420.85   8,632.54        .00          .00      .00      .00   9    0  09   14
 199900004O   450377 0.7441 236  4.1  0 19981004    63,735.25   2,282.87        .00    57,534.40      .00      .00   4    0  09   16
 199900009A   450377 0.7441 002  7.5  0 19981004    10,701.77   9,806.28        .00          .00      .00      .00   4    0  09   00
 199900009B   450377 0.7441 209  4.9  0 19981004     7,499.46   6,871.93        .00          .00      .00      .00   4    0  09   14
 199900199A   450377 0.7441 002  7.5  0 19981004     7,134.55   6,537.55        .00          .00      .00      .00   4    0  03   03
 199900704A   450377 0.7441 236  4.1  0 19981004     2,491.34   2,282.87        .00          .00      .00      .00   4    0  09   14
 199900704B   450377 0.7441 263  8.8  0 19981004    67,124.31   3,593.07        .00    59,387.77      .00      .00   4    0  09   12
 199900704C   450377 0.7441 263  8.8  0 19981004     3,921.19   3,593.07        .00          .00      .00      .00   4    0  09   12
 199900704D   450377 0.7441 263  8.8  0 19981004     6,901.31   6,323.83        .00          .00      .00      .00   9    0  09   14
 199900704E   450377 0.7441 264  5.4  0 19981004    64,483.20   3,236.47        .00    57,269.22      .00      .00   4    0  09   12
 199900704F   450377 0.7441 264  5.4  0 19981004     3,532.02   3,236.47        .00          .00      .00      .00   4    0  09   12
 199900704G   450377 0.7441 264  5.4  0 19981004     3,814.57   3,495.38        .00          .00      .00      .00   5    0  09   14
 199900704H   450377 0.7441 429  5.2  0 19981004    64,091.99   2,639.66        .00    57,507.40      .00      .00   4    0  09   12
 199900704I   450377 0.7441 429  5.2  0 19981004     2,880.71   2,639.66        .00          .00      .00      .00   4    0  09   12
 199900704J   450377 0.7441 429  5.2  0 19981004     2,995.92   2,745.24        .00          .00      .00      .00   5    0  09   14
 199900704K   450377 0.7441 483 34.0  0 19981004    71,047.25   7,573.49        .00    59,033.07      .00      .00   4    0  09   12
 199900704L   450377 0.7441 483 34.0  0 19981004     8,265.08   7,573.49        .00          .00      .00      .00   4    0  09   12
 199900704M   450377 0.7441 234  2.8  0 19981004     4,035.05   3,697.41        .00          .00      .00      .00   4    0  09   14
 199900704N   450377 0.7441 483 34.0  0 19981004    56,202.09  51,499.29        .00          .00      .00      .00  33    0  09   14
 199900704O   450377 0.7441 483 34.0  0 19981004    56,202.09  51,499.29        .00          .00      .00      .00  34    0  09   14
 199900704P   450377 0.7441 504 23.7  0 19981004    48,551.63  44,488.99        .00          .00      .00      .00  34    0  00   14
 199900704Q   450377 0.7441 505  2.3  0 19981004     6,148.37   5,633.89        .00          .00      .00      .00  34    0  00   14
 199900704R   450377 0.7441 506 12.2  0 19981004    14,610.92  13,388.33        .00          .00      .00      .00  34    0  00   14
 199900704S   450377 0.7441 507  6.6  0 19981004     5,874.22   5,382.69        .00          .00      .00      .00  34    0  00   14
 199900704T   450377 0.7441 508  5.3  0 19981004     4,876.73   4,468.66        .00          .00      .00      .00  34    0  00   14
 199900704U   450377 0.7441 509  3.4  0 19981004     2,691.18   2,465.99        .00          .00      .00      .00  34    0  00   14
 199900704V   450377 0.7441 510  4.9  0 19981004     4,000.31   3,665.58        .00          .00      .00      .00  34    0  00   14
 199900704W   450377 0.7441 511  3.5  0 19981004     2,078.23   1,904.33        .00          .00      .00      .00  34    0  00   14
 199901999C   450377 0.7441 002  7.5  0 19981004    83,598.86   6,537.55        .00    71,870.64      .00      .00   4    0  03   05
 199900123A   450370 0.7441 503  3.2  0 19981006          .00        .00        .00          .00      .00      .00   5    0  00   67
 199900009S   510016 0.0000 503  0.0  0 19981006          .00        .00        .00          .00      .00      .00   5    0  00   52
 199900009T   510016 0.0000 503  0.0  0 19981006          .00        .00        .00          .00      .00      .00   1    0  00   52
 199900009U   510016 0.0000 503  0.0  0 19981006          .00        .00        .00          .00      .00      .00   1    0  00   52
 199900009V   510016 0.0000 503  0.0  0 19981006          .00        .00        .00          .00      .00      .00   1    0  00   52
 199900009W   510016 0.0000 503  0.0  0 19981006          .00        .00        .00          .00      .00      .00   1    0  00   52
 199900009X   510016 0.0000 503  0.0  0 19981006          .00        .00        .00          .00      .00      .00   5    0  00   52
 199900009Y   510016 0.0000 503  0.0  0 19981006          .00        .00        .00          .00      .00      .00   5    0  03   52
 199900009Z   510016 0.0000 503  0.0  0 19981006          .00        .00        .00          .00      .00      .00   5    0  00   52
 199900023A   510016 0.0000 503  0.0  0 19981006          .00        .00        .00          .00      .00      .00   1    0  00   52
 199900023B   510016 0.0000 503  0.0  0 19981006          .00        .00        .00          .00      .00      .00   5    0  00   52
 199900023C   510016 0.0000 503  0.0  0 19981006          .00        .00        .00          .00      .00      .00   5    0  00   52
 199900099A   510016 0.0000 503  0.0  0 19981006          .00        .00        .00          .00      .00      .00   5    0  03   52
 199900099B   510016 0.0000 503  0.0  0 19981006          .00        .00        .00          .00      .00      .00   5    0  00   52
 199900099C   510016 0.0000 503  0.0  0 19981006          .00        .00        .00          .00      .00      .00   5    0  00   52
 199900001D   100001 0.8919 424  9.0  0 19981014    15,779.75   8,486.55        .00          .00 3,762.94 2,452.20  14    0  00   14
 199900001E   100001 0.8919 424  9.0  0 19981014    25,775.20   8,486.55        .00     8,978.55 3,762.94 2,452.20  14    0  00   16
 199900123C   450370 0.7441 503  3.2  0 19990228     4,216.83   3,875.80        .00          .00      .00      .00   5    0  00   14
 199900123D   450370 0.7565 503  3.2  0 19990301     4,261.56   3,917.46        .00          .00      .00      .00   5    0  00   14
 199901111A   450371 0.0000 503  0.0  0 19990301          .00        .00        .00          .00      .00      .00   5    0  00   52
 199900123B   450370 0.7565 503  3.2  0 19990305          .00        .00        .00          .00      .00      .00   5    0  00   67
1  C M S ,
   C M S     PRICER OPERATING  P R O S P E C T I V E   P A Y M E N T   T E S T   D A T A   R E P O R T  OPER147
0 HI CLAIM   PROVIDER WAGE  DRG GMN DRG DIS-DATE TOT OPERATING  FEDERAL     HOSPITAL     OUTLIER  DISPROP   IMETCH     OUTL REV  PPS
     NO         NO    INDEX  NO LOS CUT CCYYMMDD & CAPITAL PAY  PORTION     PORTION      PORTION   SHARE    ADJUST LOS DAYS  CD  RTC
  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -
 199900004I   100001 0.8900 208  2.3  0 19990909     4,139.30   2,226.09        .00          .00   987.05   643.23   1    0  09   00
 200000004A   100001 0.8986 208  2.3  0 19991001     4,339.27   2,366.52        .00          .00 1,038.43   628.25   1    0  09   00
 199900005A   100001 0.8986 122  3.4  0 19991001     7,436.89   4,055.89        .00          .00 1,779.72 1,076.73   1    0  00   00
 199900005B   100001 0.8986 209  4.6  0 19991001    14,234.52   7,763.13        .00          .00 3,406.46 2,060.91   1    0  00   00
 199900005C   100001 0.8986 236  3.9  0 19991001     4,811.16   2,623.88        .00          .00 1,151.36   696.57   1    0  00   00
 199900005D   100001 0.8986 122  3.4  0 19991001     4,374.70   2,385.84        .00          .00 1,046.91   633.38   1    0  03   03
 199900005E   100001 0.8986 209  4.6  0 19991001     6,188.89   3,375.26        .00          .00 1,481.06   896.04   1    0  03   03
 199900005F   100001 0.8986 236  3.9  0 19991001     2,467.26   1,345.58        .00          .00   590.44   357.22   1    0  03   03
 199900005G   100001 0.8986 122  3.4  0 19991001     7,436.89   4,055.89        .00          .00 1,779.72 1,076.73   1    0  09   00
 199900005H   100001 0.8986 209  4.6  0 19991001    10,211.70   5,569.19        .00          .00 2,443.76 1,478.48   1    0  09   10
 199900005I   100001 0.8986 236  3.9  0 19991001     2,467.26   1,345.58        .00          .00   590.44   357.22   1    0  09   12
 199900005J   100001 0.8986 122  3.4  0 19991001     7,436.89   4,055.89        .00          .00 1,779.72 1,076.73  30    0  09   14
 199900005K   100001 0.8986 209  4.6  0 19991001    14,234.52   7,763.13        .00          .00 3,406.46 2,060.91  30    0  09   14
 199900005L   100001 0.8986 236  3.9  0 19991001     4,811.16   2,623.88        .00          .00 1,151.36   696.57  30    0  09   14
 199900005M   140012 1.0750 236  3.9  0 19991001     4,965.64   2,978.54        .00          .00      .00      .00  30    0  09   14
 1999000BBM   140012 1.0750 236  3.9  0 19991001     4,965.64   2,978.54        .00          .00      .00      .00  30    0  09   14
 199900005N   250078 0.7634 236  3.9  0 19991001     4,270.10   2,314.81        .00          .00      .00      .00  30    0  09   14
 199900005O   330126 1.4342 236  3.9  0 19991001     5,717.74   3,700.72        .00          .00      .00      .00  30    0  09   14
 199900005P   340039 0.9434 236  3.9  0 19991001     4,689.34   2,713.96        .00          .00      .00      .00  30    0  09   14
 199900005Q   360076 0.8989 236  3.9  0 19991001     4,550.68   2,582.92        .00          .00      .00      .00  30    0  09   14
 199900007J   370173 1.4448 208  2.3  0 19991001     3,616.93   3,303.80        .00          .00      .00      .00   1    0  07   00
 199900005R   390019 1.0228 236  3.9  0 19991001     5,190.65   2,828.09        .00          .00   137.16   246.75  30    0  09   14
 199900005S   450065 0.0000 236  0.0  0 19991001          .00        .00        .00          .00      .00      .00  30    0  09   52
 199900005T   470003 1.1359 236  3.9  0 19991001     5,514.32   3,100.98        .00          .00   150.40   270.56  30    0  09   14
 200000003A   100001 0.8986 209  4.6  0 19991002    14,234.52   7,763.13        .00          .00 3,406.46 2,060.91   2    0  00   00
 200000003B   100001 0.8986 209  4.6  0 19991002    11,758.94   6,413.01        .00          .00 2,814.03 1,702.49   2    0  09   10
 200000003C   100001 0.8986 209  4.6  0 19991002    24,697.74   6,413.01        .00    11,621.74 2,814.03 1,702.49   2    0  09   10
 200000013C   100001 0.8986 209  4.6  0 19991002    11,758.94   6,413.01        .00          .00 2,814.03 1,702.49   2    0  11   10
 200000009P   360015 0.8649 503  3.1  0 19991002    35,451.88   4,296.17        .00    28,609.34      .00      .00   1    0  00   02
 200000009Q   360016 0.8649 503  3.1  0 19991002    35,451.88   4,296.17        .00    28,609.34      .00      .00   1    0  00   02
 200000009A   390012 0.9634 503  3.1  0 19991002     6,692.79   4,629.02        .00          .00      .00      .00   1    0  00   00
 200000009B   390013 0.9634 503  3.1  0 19991002     9,581.67   4,629.02   2,738.88          .00      .00      .00   1    0  00   00
 200000009C   390014 0.9917 503  3.1  0 19991002     5,100.77   4,649.83        .00          .00      .00      .00   1    0  00   00
 200000009D   390015 0.9634 503  3.1  0 19991002     6,692.79   4,629.02        .00          .00      .00      .00   1    0  00   00
 200000009E   390016 0.9634 503  3.1  0 19991002     8,062.23   4,629.02   1,369.44          .00      .00      .00   1    0  00   00
 200000009F   390017 0.9634 503  3.1  0 19991002     8,062.23   4,629.02   1,369.44          .00      .00      .00   1    0  00   00
 200000009G   390018 0.9634 503  3.1  0 19991002     7,321.18   4,629.02        .00          .00   224.51   403.88   1    0  00   00
 200000009I   390018 0.9634 503  3.1  0 19991002   518,476.93   4,629.02        .00   500,883.33   224.51   403.88   1    0  00   02
 200000009H   390021 0.9634 503  3.1  0 19991002     7,321.18   4,629.02        .00          .00   224.51   403.88   1    0  00   00
 200000009J   390021 0.9634 503  3.1  0 19991002   518,476.93   4,629.02        .00   500,883.33   224.51   403.88   1    0  00   02
 200000009K   400012 0.4815 503  3.1  0 19991002     4,588.63   2,623.61        .00          .00      .00      .00   1    0  00   00
 200000009L   400012 0.4815 503  3.1  0 19991002    35,947.52   2,623.61        .00    30,767.99      .00      .00   1    0  00   02
 200001999A   400012 0.4815 234  2.7  0 19991002    35,966.68   2,715.43        .00    30,694.53      .00      .00   1    0  00   02
 200000009M   400015 0.0000 503  0.0  0 19991002          .00        .00        .00          .00      .00      .00   1    0  00   52
 200000009N   400017 0.0000 503  0.0  0 19991002          .00        .00        .00          .00      .00      .00   1    0  00   51
 200000009O   400017 0.0000 503  0.0  0 19991002          .00        .00        .00          .00      .00      .00   1    0  00   51
 200000009R   510015 0.8414 503  3.1  0 19991002    35,618.69   4,216.76        .00    28,852.42      .00      .00   1    0  00   02
 200000012C   100001 0.8986 113  9.5  0 19991004     9,652.98   5,264.48        .00          .00 2,310.05 1,397.58   4    0  11   12
 200000002C   100001 0.8986 113  9.5  0 19991004    27,327.90   5,264.48        .00    15,987.11 2,310.05 1,397.58   4    0  09   12
 200000002B   100001 0.8986 113  9.5  0 19991004     9,652.98   5,264.48        .00          .00 2,310.05 1,397.58   4    0  09   12
1  C M S ,
   C M S     PRICER OPERATING  P R O S P E C T I V E   P A Y M E N T   T E S T   D A T A   R E P O R T  OPER147
0 HI CLAIM   PROVIDER WAGE  DRG GMN DRG DIS-DATE TOT OPERATING  FEDERAL     HOSPITAL     OUTLIER  DISPROP   IMETCH     OUTL REV  PPS
     NO         NO    INDEX  NO LOS CUT CCYYMMDD & CAPITAL PAY  PORTION     PORTION      PORTION   SHARE    ADJUST LOS DAYS  CD  RTC
  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -
 200000002A   100001 0.8986 113  9.5  0 19991004    18,340.54  10,002.44        .00          .00 4,389.07 2,655.39   4    0  00   00
 200000001C   100001 0.8986 424  8.7  0 19991004    15,935.94   8,691.04        .00          .00 3,813.63 2,307.25   4    0  09   00
 200000001B   100001 0.8986 424  8.7  0 19991004     9,158.55   4,994.83        .00          .00 2,191.73 1,326.00   4    0  03   03
 200000001A   100001 0.8986 424  8.7  0 19991004    15,935.94   8,691.04        .00          .00 3,813.63 2,307.25   4    0  00   00
 200000704U   450377 0.7471 509  3.9  0 19991004     2,974.22   2,728.10        .00          .00      .00      .00  34    0  00   14
 200000704T   450377 0.7471 508  5.8  0 19991004     5,553.10   5,093.58        .00          .00      .00      .00  34    0  00   14
 200000704S   450377 0.7471 507  6.8  0 19991004     6,586.12   6,041.11        .00          .00      .00      .00  34    0  00   14
 200000704R   450377 0.7471 506 12.5  0 19991004    14,605.80  13,397.16        .00          .00      .00      .00  34    0  00   14
 200000704Q   450377 0.7471 505  2.6  0 19991004     7,855.56   7,205.51        .00          .00      .00      .00  34    0  00   14
 200000704P   450377 0.7471 504 24.0  0 19991004    46,219.63  42,394.93        .00          .00      .00      .00  34    0  00   14
 200000704O   450377 0.7471 483 33.0  0 19991004    56,052.91  51,414.50        .00          .00      .00      .00  34    0  09   14
 200000704N   450377 0.7471 483 33.0  0 19991004    56,052.91  51,414.50        .00          .00      .00      .00  33    0  09   14
 200000704M   450377 0.7471 234  2.7  0 19991004     4,328.85   3,970.64        .00          .00      .00      .00   4    0  09   14
 200000704L   450377 0.7471 483 33.0  0 19991004     8,493.13   7,790.32        .00          .00      .00      .00   4    0  09   12
 200000704K   450377 0.7471 483 33.0  0 19991004    70,770.37   7,790.32        .00    58,555.69      .00      .00   4    0  09   12
 200000704J   450377 0.7471 429  4.9  0 19991004     2,937.36   2,694.29        .00          .00      .00      .00   5    0  09   14
 200000704I   450377 0.7471 429  4.9  0 19991004     2,937.36   2,694.29        .00          .00      .00      .00   4    0  09   14
 200000704H   450377 0.7471 429  4.9  0 19991004    61,903.20   2,694.29        .00    55,397.33      .00      .00   4    0  09   16
 200000704G   450377 0.7471 264  5.3  0 19991004     3,899.79   3,577.08        .00          .00      .00      .00   5    0  09   14
 200000704F   450377 0.7471 264  5.3  0 19991004     3,679.07   3,374.62        .00          .00      .00      .00   4    0  09   12
 200000704E   450377 0.7471 264  5.3  0 19991004    62,572.40   3,374.62        .00    55,335.71      .00      .00   4    0  09   12
 200000704D   450377 0.7471 263  8.7  0 19991004     7,165.73   6,572.76        .00          .00      .00      .00   9    0  09   14
 200000704C   450377 0.7471 263  8.7  0 19991004     4,118.21   3,777.43        .00          .00      .00      .00   4    0  09   12
 200000704B   450377 0.7471 263  8.7  0 19991004    66,011.96   3,777.43        .00    58,157.37      .00      .00   4    0  09   12
 200000704A   450377 0.7471 236  3.9  0 19991004     2,488.48   2,282.56        .00          .00      .00      .00   4    0  09   14
 200000199A   450377 0.7471 002  7.4  0 19991004     7,293.97   6,690.39        .00          .00      .00      .00   4    0  03   03
 200000009B   450377 0.7471 209  4.6  0 19991004     7,362.52   6,753.27        .00          .00      .00      .00   4    0  09   14
 200000009A   450377 0.7471 002  7.4  0 19991004    10,795.01   9,901.72        .00          .00      .00      .00   4    0  09   00
 200000004O   450377 0.7471 236  3.9  0 19991004    61,809.22   2,282.56        .00    55,726.72      .00      .00   4    0  09   16
 200000004N   450377 0.7471 113  9.5  0 19991004     9,486.28   8,701.28        .00          .00      .00      .00   9    0  09   14
 200000004M   450377 0.7471 113  9.5  0 19991004     4,992.82   4,579.66        .00          .00      .00      .00   4    0  09   12
 200000004L   450377 0.7471 113  9.5  0 19991004    66,634.45   4,579.66        .00    57,928.22      .00      .00   4    0  09   12
 200000004K   450377 0.7471 014  4.7  0 19991004     4,142.48   3,799.69        .00          .00      .00      .00   5    0  09   14
 200000004J   450377 0.7471 014  4.7  0 19991004     4,142.48   3,799.69        .00          .00      .00      .00   4    0  09   14
 200000004I   450377 0.7471 014  4.7  0 19991004    62,155.50   3,799.69        .00    54,513.01      .00      .00   4    0  09   16
 200000004H   450377 0.7471 211  4.5  0 19991004     4,384.14   4,021.35        .00          .00      .00      .00   5    0  09   14
 200000004G   450377 0.7471 211  4.5  0 19991004     4,384.14   4,021.35        .00          .00      .00      .00   4    0  09   14
 200000004F   450377 0.7471 210  5.9  0 19991004     6,268.32   5,749.61        .00          .00      .00      .00   6    0  09   14
 200000004E   450377 0.7471 210  5.9  0 19991004    62,600.57   5,749.61        .00    52,953.07      .00      .00   6    0  09   16
 200000004D   450377 0.7471 210  5.9  0 19991004     5,790.23   5,311.09        .00          .00      .00      .00   4    0  09   10
 200000004C   450377 0.7471 209  4.6  0 19991004     7,362.52   6,753.27        .00          .00      .00      .00   5    0  09   14
 200000004B   450377 0.7471 209  4.6  0 19991004    62,829.65   6,753.27        .00    52,150.14      .00      .00   5    0  09   16
 200000004A   450377 0.7471 209  4.6  0 19991004     7,362.52   6,753.27        .00          .00      .00      .00   5    0  09   14
 200001999C   450377 0.7471 002  7.4  0 19991004    82,266.12   6,690.39        .00    70,466.24      .00      .00   4    0  03   05
 200000704W   450377 0.7471 511  3.6  0 19991004     2,890.07   2,650.92        .00          .00      .00      .00  34    0  00   14
 200000704V   450377 0.7471 510  5.1  0 19991004     4,636.57   4,252.89        .00          .00      .00      .00  34    0  00   14
 200000123A   450370 0.7471 503  3.1  0 19991006          .00        .00        .00          .00      .00      .00   5    0  00   67
 200000099A   510016 0.0000 503  0.0  0 19991006          .00        .00        .00          .00      .00      .00   5    0  03   52
 200000023C   510016 0.0000 503  0.0  0 19991006          .00        .00        .00          .00      .00      .00   5    0  00   52
 200000023B   510016 0.0000 503  0.0  0 19991006          .00        .00        .00          .00      .00      .00   5    0  00   52
1  C M S ,
   C M S     PRICER OPERATING  P R O S P E C T I V E   P A Y M E N T   T E S T   D A T A   R E P O R T  OPER147
0 HI CLAIM   PROVIDER WAGE  DRG GMN DRG DIS-DATE TOT OPERATING  FEDERAL     HOSPITAL     OUTLIER  DISPROP   IMETCH     OUTL REV  PPS
     NO         NO    INDEX  NO LOS CUT CCYYMMDD & CAPITAL PAY  PORTION     PORTION      PORTION   SHARE    ADJUST LOS DAYS  CD  RTC
  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -
 200000023A   510016 0.0000 503  0.0  0 19991006          .00        .00        .00          .00      .00      .00   1    0  00   52
 200000009Z   510016 0.0000 503  0.0  0 19991006          .00        .00        .00          .00      .00      .00   5    0  00   52
 200000009Y   510016 0.0000 503  0.0  0 19991006          .00        .00        .00          .00      .00      .00   5    0  03   52
 200000009X   510016 0.0000 503  0.0  0 19991006          .00        .00        .00          .00      .00      .00   5    0  00   52
 200000009W   510016 0.0000 503  0.0  0 19991006          .00        .00        .00          .00      .00      .00   1    0  00   52
 200000009V   510016 0.0000 503  0.0  0 19991006          .00        .00        .00          .00      .00      .00   1    0  00   52
 200000009U   510016 0.0000 503  0.0  0 19991006          .00        .00        .00          .00      .00      .00   1    0  00   52
 200000009T   510016 0.0000 503  0.0  0 19991006          .00        .00        .00          .00      .00      .00   1    0  00   52
 200000009S   510016 0.0000 503  0.0  0 19991006          .00        .00        .00          .00      .00      .00   5    0  00   52
 200000099C   510016 0.0000 503  0.0  0 19991006          .00        .00        .00          .00      .00      .00   5    0  00   52
 200000099B   510016 0.0000 503  0.0  0 19991006          .00        .00        .00          .00      .00      .00   5    0  00   52
 200000001E   100001 0.8986 424  8.7  0 19991014    23,788.03   8,691.04        .00     6,891.67 3,813.63 2,307.25  14    0  00   16
 200000001D   100001 0.8986 424  8.7  0 19991014    15,935.94   8,691.04        .00          .00 3,813.63 2,307.25  14    0  00   14
 200000004F   100001 0.8986 208  2.3  0 19991231     4,339.27   2,366.52        .00          .00 1,038.43   628.25   1    0  09   00
 200000004F   100001 0.8986 208  2.3  0 19991231     4,339.27   2,366.52        .00          .00 1,038.43   628.25   1    0  09   00
 200000004G   100001 0.8986 208  2.3  0 20000101     4,339.27   2,366.52        .00          .00 1,038.43   628.25   1    0  09   00
 200000004G   100001 0.8986 208  2.3  0 20000101     4,339.27   2,366.52        .00          .00 1,038.43   628.25   1    0  09   00
 200001112A   510017 0.0000 503  0.0  0 20000114          .00        .00        .00          .00      .00      .00   5    0  00   52
 200001113A   510017 0.0000 503  0.0  0 20000116          .00        .00        .00          .00      .00      .00   5    0  00   52
 200000004B   100001 0.8986 208  2.3  0 20000229     4,339.27   2,366.52        .00          .00 1,038.43   628.25   1    0  09   00
 200000004B   100001 0.8986 208  2.3  0 20000229     4,339.27   2,366.52        .00          .00 1,038.43   628.25   1    0  09   00
 200000123C   450370 0.7471 503  3.1  0 20000229     4,182.47   3,836.37        .00          .00      .00      .00   5    0  00   14
 200000000A   510016 0.0000 503  0.0  0 20000229          .00        .00        .00          .00      .00      .00   5    0  00   52
 200000000A   510016 0.0000 503  0.0  0 20000229          .00        .00        .00          .00      .00      .00   5    0  00   52
 200000004D   100001 0.8986 208  2.3  0 20000301     4,339.27   2,366.52        .00          .00 1,038.43   628.25   1    0  09   00
 200000004D   100001 0.8986 208  2.3  0 20000301     4,339.27   2,366.52        .00          .00 1,038.43   628.25   1    0  09   00
 200000123D   450370 0.7471 503  3.1  0 20000301     4,182.47   3,836.37        .00          .00      .00      .00   5    0  00   14
 200001111A   450371 0.0000 503  0.0  0 20000301          .00        .00        .00          .00      .00      .00   5    0  00   52
 200000123B   450370 0.7471 503  3.1  0 20000305          .00        .00        .00          .00      .00      .00   5    0  00   67
 200000004I   100001 0.8986 208  2.3  0 20000909     4,339.27   2,366.52        .00          .00 1,038.43   628.25   1    0  09   00
 200600018J   050192 0.9208 500  2.2  0 20001001     6,893.44   3,727.43        .00          .00 1,635.60 1,036.66   1    0  09   00
 199900005M   140012 1.1015 236  4.0  0 20001001     5,109.99   3,117.54        .00          .00      .00      .00  30    0  09   14
 200000006J   370173 1.4448 208  2.3  0 20001001     3,733.19   3,411.83        .00          .00      .00      .00   1    0  07   00
 200000009B   390014 0.9386 503  3.1  0 20001001    88,140.75   4,609.01        .00    67,849.13      .00      .00   1    0  00   02
 200000009K   400012 0.4525 503  3.1  0 20001002     4,573.34   2,608.42        .00          .00      .00      .00   1    0  00   00
 200001999A   400012 0.4525 234  2.7  0 20001002    34,174.00   2,716.78        .00    28,935.64      .00      .00   1    0  00   02
 200000009L   400012 0.4525 503  3.1  0 20001002    34,151.37   2,608.42        .00    29,022.33      .00      .00   1    0  00   02
 200000009M   400015 0.0000 503  0.0  0 20001002          .00        .00        .00          .00      .00      .00   1    0  00   52
 200000009O   400017 0.0000 503  0.0  0 20001002          .00        .00        .00          .00      .00      .00   1    0  00   51
 200000009N   400017 0.0000 503  0.0  0 20001002          .00        .00        .00          .00      .00      .00   1    0  00   51
 200200002A   510016 0.8231 503  3.1  0 20001006     6,327.54   4,281.01        .00          .00      .00      .00   5    0  00   14
 200200002A   510016 0.8231 503  3.1  0 20001006     6,327.54   4,281.01        .00          .00      .00      .00   5    0  00   14
 200100004E   100001 0.9208 208  2.3  0 20001231     4,596.56   2,485.46        .00          .00 1,090.62   691.25   1    0  09   00
 200100004E   100001 0.9208 208  2.3  0 20001231     4,596.56   2,485.46        .00          .00 1,090.62   691.25   1    0  09   00
 200100004C   100001 0.9208 208  2.3  0 20010229     4,596.56   2,485.46        .00          .00 1,090.62   691.25   1    0  09   00
 200100004C   100001 0.9208 208  2.3  0 20010229     4,596.56   2,485.46        .00          .00 1,090.62   691.25   1    0  09   00
 200000009C   390014 0.9386 503  3.1  0 20010402    89,078.60   4,708.19        .00    68,523.54      .00      .00   1    0  00   02
 200000009K   400012 0.4525 503  3.1  0 20010402     4,627.92   2,663.31        .00          .00      .00      .00   1    0  00   00
 200000009L   400012 0.4525 503  3.1  0 20010402    34,905.37   2,663.31        .00    29,706.69      .00      .00   1    0  00   02
 200001999A   400012 0.4525 234  2.7  0 20010402    34,928.44   2,773.95        .00    29,618.17      .00      .00   1    0  00   02
1  C M S ,
   C M S     PRICER OPERATING  P R O S P E C T I V E   P A Y M E N T   T E S T   D A T A   R E P O R T  OPER147
0 HI CLAIM   PROVIDER WAGE  DRG GMN DRG DIS-DATE TOT OPERATING  FEDERAL     HOSPITAL     OUTLIER  DISPROP   IMETCH     OUTL REV  PPS
     NO         NO    INDEX  NO LOS CUT CCYYMMDD & CAPITAL PAY  PORTION     PORTION      PORTION   SHARE    ADJUST LOS DAYS  CD  RTC
  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -
 200000009A   400015 0.0000 503  0.0  0 20010402          .00        .00        .00          .00      .00      .00   1    0  00   52
 200000009N   400017 0.0000 503  0.0  0 20010402          .00        .00        .00          .00      .00      .00   1    0  00   51
 200000009A   400017 0.0000 503  0.0  0 20010402          .00        .00        .00          .00      .00      .00   1    0  00   51
 200600018J   050192 0.9659 500  2.2  0 20011001     5,465.75   3,746.24        .00          .00   190.68 1,082.48   1    0  09   00
 200600017J   100001 0.0000 524  0.0  0 20011001          .00        .00        .00          .00      .00      .00   1    0  09   54
 200600016J   100001 0.9223 523  3.5  0 20011001     2,924.12   1,569.66        .00          .00   688.77   453.56   1    0  09   00
 200600015J   100001 0.9223 522  8.6  0 20011001     4,571.64   2,454.05        .00          .00 1,076.84   709.10   1    0  09   00
 200600014J   100001 0.9223 521  5.0  0 20011001     5,380.77   2,888.38        .00          .00 1,267.42   834.60   1    0  09   00
 200600013J   100001 0.9223 520  1.7  0 20011001    10,384.78   5,574.52        .00          .00 2,446.10 1,610.77   1    0  09   14
 200600012J   100001 0.9223 519  3.8  0 20011001    17,008.51   9,130.12        .00          .00 4,006.30 2,638.16   1    0  09   00
 200600011J   100001 0.9223 518  2.5  0 20011001    12,428.80   6,671.75        .00          .00 2,927.56 1,927.81   1    0  09   00
 200600010J   100001 0.9223 517  1.9  0 20011001    15,640.46   8,395.75        .00          .00 3,684.06 2,425.97   1    0  09   14
 200600009J   100001 0.9223 516  4.1  0 20011001    20,100.16  10,789.71        .00          .00 4,734.52 3,117.70   1    0  09   00
 200600008J   100001 0.9223 515  4.2  0 20011001    36,509.49  19,598.20        .00          .00 8,599.69 5,662.93   1    0  09   00
 200600007J   100001 0.9223 514  6.7  0 20011001    46,574.59  25,001.11        .00          .0010,970.49 7,224.11   1    0  09   00
 200600006J   100001 0.9223 513  9.7  0 20011001    42,724.28  22,934.28        .00          .0010,063.56 6,626.90   1    0  09   00
 200600005J   100001 0.9223 512 12.7  0 20011001    42,294.86  22,703.76        .00          .00 9,962.41 6,560.29   1    0  09   00
 200200004G   100001 0.9223 208  2.4  0 20011001     4,667.48   2,505.49        .00          .00 1,099.41   723.97   1    0  09   00
 200200004G   100001 0.9223 208  2.4  0 20011001     4,667.48   2,505.49        .00          .00 1,099.41   723.97   1    0  09   00
 220200005M   140012 1.0917 236  3.9  0 20011001     5,038.50   3,050.28        .00          .00      .00      .00  30    0  09   14
 200200006J   370173 1.4448 208  2.4  0 20011001     3,756.17   3,435.43        .00          .00      .00      .00   1    0  07   00
 200200009B   390014 0.9425 503  3.3  0 20011001    85,480.85   4,822.59        .00    65,457.23      .00      .00   1    0  00   02
 200201112A   510017 0.0000 503  0.0  0 20011001          .00        .00        .00          .00      .00      .00   5    0  00   52
 200201113A   510017 0.0000 503  0.0  0 20011001          .00        .00        .00          .00      .00      .00   5    0  00   52
 200200009K   400012 0.4832 503  3.3  0 20011002     4,781.25   2,808.49        .00          .00      .00      .00   1    0  00   00
 200201999A   400012 0.4832 234  2.7  0 20011002    31,642.66   2,764.16        .00    26,408.06      .00      .00   1    0  00   02
 200200009L   400012 0.4832 503  3.3  0 20011002    31,651.92   2,808.49        .00    26,372.60      .00      .00   1    0  00   02
 200200009M   400015 0.0000 503  0.0  0 20011002          .00        .00        .00          .00      .00      .00   1    0  00   52
 200200009O   400017 0.0000 503  0.0  0 20011002          .00        .00        .00          .00      .00      .00   1    0  00   51
 200200009N   400017 0.0000 503  0.0  0 20011002          .00        .00        .00          .00      .00      .00   1    0  00   51
 200200002A   510016 0.0000 503  0.0  0 20011006          .00        .00        .00          .00      .00      .00   5    0  00   52
 200200002A   510016 0.0000 503  0.0  0 20011006          .00        .00        .00          .00      .00      .00   5    0  00   52
 200200022B   510016 0.0000 503  0.0  0 20011006          .00        .00        .00          .00      .00      .00   5    0  00   52
 200200022B   510016 0.0000 503  0.0  0 20011006          .00        .00        .00          .00      .00      .00   5    0  00   52
 200200022B   510016 0.0000 503  0.0  0 20011006          .00        .00        .00          .00      .00      .00   5    0  00   52
 200200022B   510016 0.0000 503  0.0  0 20011006          .00        .00        .00          .00      .00      .00   5    0  00   52
 200200003A   510016 0.0000 503  0.0  0 20011006          .00        .00        .00          .00      .00      .00   5    0  00   52
 2003000032   510016 0.0000 503  0.0  0 20011006          .00        .00        .00          .00      .00      .00   5    0  00   52
 2003000034   510016 0.0000 503  0.0  0 20011006          .00        .00        .00          .00      .00      .00   5    0  00   52
 2003000036   510016 0.0000 503  0.0  0 20011006          .00        .00        .00          .00      .00      .00   5    0  00   52
 200200004E   100001 0.9223 208  2.4  0 20011231     4,667.48   2,505.49        .00          .00 1,099.41   723.97   1    0  09   00
 200200004E   100001 0.9223 208  2.4  0 20011231     4,667.48   2,505.49        .00          .00 1,099.41   723.97   1    0  09   00
 200301113A   510017 0.0000 503  0.0  0 20020116          .00        .00        .00          .00      .00      .00   5    0  00   52
 200200004C   100001 0.9223 208  2.4  0 20020229     4,667.48   2,505.49        .00          .00 1,099.41   723.97   1    0  09   00
 200200004C   100001 0.9223 208  2.4  0 20020229     4,667.48   2,505.49        .00          .00 1,099.41   723.97   1    0  09   00
 200200004B   100001 0.9223 208  2.4  0 20020229     4,667.48   2,505.49        .00          .00 1,099.41   723.97   1    0  09   00
 200200004B   100001 0.9223 208  2.4  0 20020229     4,667.48   2,505.49        .00          .00 1,099.41   723.97   1    0  09   00
 200200123C   450370 0.7714 503  3.3  0 20020229     4,827.31   4,210.90        .00          .00   214.33      .00   5    0  00   14
 200200000A   510016 0.0000 503  0.0  0 20020229          .00        .00        .00          .00      .00      .00   5    0  00   52
 200200000A   510016 0.0000 503  0.0  0 20020229          .00        .00        .00          .00      .00      .00   5    0  00   52
1  C M S ,
   C M S     PRICER OPERATING  P R O S P E C T I V E   P A Y M E N T   T E S T   D A T A   R E P O R T  OPER147
0 HI CLAIM   PROVIDER WAGE  DRG GMN DRG DIS-DATE TOT OPERATING  FEDERAL     HOSPITAL     OUTLIER  DISPROP   IMETCH     OUTL REV  PPS
     NO         NO    INDEX  NO LOS CUT CCYYMMDD & CAPITAL PAY  PORTION     PORTION      PORTION   SHARE    ADJUST LOS DAYS  CD  RTC
  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -
 200200004D   100001 0.9223 208  2.4  0 20020301     4,667.48   2,505.49        .00          .00 1,099.41   723.97   1    0  09   00
 200200004D   100001 0.9223 208  2.4  0 20020301     4,667.48   2,505.49        .00          .00 1,099.41   723.97   1    0  09   00
 200200123D   450370 0.7714 503  3.3  0 20020301     4,827.31   4,210.90        .00          .00   214.33      .00   5    0  00   14
 200201111A   450371 0.7714 503  3.3  0 20020301     4,827.31   4,210.90        .00          .00   214.33      .00   5    0  00   14
 200200123B   450370 0.7714 503  3.3  0 20020305          .00        .00        .00          .00      .00      .00   5    0  00   67
 200200009C   390014 0.9425 503  3.3  0 20020402    85,480.85   4,822.59        .00    65,457.23      .00      .00   1    0  00   02
 200200009K   400012 0.4832 503  3.3  0 20020402     4,781.25   2,808.49        .00          .00      .00      .00   1    0  00   00
 200200009L   400012 0.4832 503  3.3  0 20020402    31,651.92   2,808.49        .00    26,372.60      .00      .00   1    0  00   02
 200201999A   400012 0.4832 234  2.7  0 20020402    31,642.66   2,764.16        .00    26,408.06      .00      .00   1    0  00   02
 200200009A   400015 0.0000 503  0.0  0 20020402          .00        .00        .00          .00      .00      .00   1    0  00   52
 200200009N   400017 0.0000 503  0.0  0 20020402          .00        .00        .00          .00      .00      .00   1    0  00   51
 200200009A   400017 0.0000 503  0.0  0 20020402          .00        .00        .00          .00      .00      .00   1    0  00   51
 200200004I   100001 0.9223 208  2.4  0 20020909     4,667.48   2,505.49        .00          .00 1,099.41   723.97   1    0  09   00
 2006000045   100001 0.9381 516  3.7  0 20021001    20,326.20  11,084.02        .00          .00 5,014.41 2,702.32   1    0  09   00
 2006000046   100001 0.9381 517  1.9  0 20021001    16,239.05   8,855.27        .00          .00 4,006.12 2,158.94   1    0  09   14
 2003000007   100001 0.9381 424  8.1  0 20021001    17,177.36   9,366.94        .00          .00 4,237.60 2,283.69  14    0  00   14
 2003000045   100001 0.9381 516  3.7  0 20021001    20,326.20  11,084.02        .00          .00 5,014.41 2,702.32   1    0  09   00
 2003000046   100001 0.9381 517  1.9  0 20021001    16,239.05   8,855.27        .00          .00 4,006.12 2,158.94   1    0  09   14
 2003000002   390014 0.9223 503  2.9  0 20021001    76,240.93   4,793.91        .00    57,900.32      .00      .00   1    0  00   02
 2003000005   400012 0.4356 234  2.3  0 20021001    24,869.37   2,751.58        .00    19,780.35      .00      .00   1    0  00   02
 2003000003   400012 0.4356 503  2.9  0 20021001     4,654.03   2,685.16        .00          .00      .00      .00   1    0  00   00
 2003000004   400012 0.4356 503  2.9  0 20021001    24,855.49   2,685.16        .00    19,833.48      .00      .00   1    0  00   02
 2003000006   400015 0.0000 503  0.0  0 20021001          .00        .00        .00          .00      .00      .00   1    0  00   52
 2003000001   450370 0.7827 503  2.9  0 20021001     4,932.86   4,290.26        .00          .00   225.24      .00   5    0  00   14
 200300003B   100001 0.9381 209  4.5  0 20021002    12,907.15   7,038.36        .00          .00 3,184.15 1,715.97   2    0  09   10
 200300003C   100001 0.9381 209  4.5  0 20021002    12,907.15   7,038.36        .00          .00 3,184.15 1,715.97   2    0  09   10
 200300013C   100001 0.9381 209  4.5  0 20021002    12,907.15   7,038.36        .00          .00 3,184.15 1,715.97   2    0  11   10
 2003000113   100001 0.9381 209  4.5  0 20021002    12,907.15   7,038.36        .00          .00 3,184.15 1,715.97   2    0  11   10
 2003000114   100001 0.9381 209  4.5  0 20021002    16,307.15   7,038.36        .00          .00 3,184.15 1,715.97   2    0  11   10
 2003000115   100001 0.9381 209  4.5  0 20021002    12,907.15   7,038.36        .00          .00 3,184.15 1,715.97   2    0  11   10
 2003000116   100001 0.9381 209  4.5  0 20021002    12,907.15   7,038.36        .00          .00 3,184.15 1,715.97   2    0  11   10
 2003000117   100001 0.9381 209  4.5  0 20021002    12,907.15   7,038.36        .00          .00 3,184.15 1,715.97   2    0  11   10
 2003000118   100001 0.9381 209  4.5  0 20021002    12,907.15   7,038.36        .00          .00 3,184.15 1,715.97   2    0  11   10
 2003000119   100001 0.9381 209  4.5  0 20021002    16,307.15   7,038.36        .00          .00 3,184.15 1,715.97   2    0  11   10
 2003000120   100001 0.9381 209  4.5  0 20021002    12,907.15   7,038.36        .00          .00 3,184.15 1,715.97   2    0  11   10
 2003000121   100001 0.9381 209  4.5  0 20021002    16,307.15   7,038.36        .00          .00 3,184.15 1,715.97   2    0  11   10
 2003000126   100001 0.9381 209  4.5  0 20021002    12,907.15   7,038.36        .00          .00 3,184.15 1,715.97   2    0  11   10
 2003000127   100001 0.9381 209  4.5  0 20021002    16,307.15   7,038.36        .00          .00 3,184.15 1,715.97   2    0  11   10
 2003000128   100001 0.9381 209  4.5  0 20021002    16,307.15   7,038.36        .00          .00 3,184.15 1,715.97   2    0  11   10
 2003000129   100001 0.9381 209  4.5  0 20021002    16,307.15   7,038.36        .00          .00 3,184.15 1,715.97   2    0  11   10
 2003000130   100001 0.9381 209  4.5  0 20021002    16,307.15   7,038.36        .00          .00 3,184.15 1,715.97   2    0  11   10
 2003000131   100001 0.9381 209  4.5  0 20021002    16,307.15   7,038.36        .00          .00 3,184.15 1,715.97   2    0  11   10
 2003000132   100001 0.9381 209  4.5  0 20021002    12,907.15   7,038.36        .00          .00 3,184.15 1,715.97   2    0  11   10
 2003000133   100001 0.9381 209  4.5  0 20021002    12,907.15   7,038.36        .00          .00 3,184.15 1,715.97   2    0  11   10
 2003000134   100001 0.9381 209  4.5  0 20021002    12,907.15   7,038.36        .00          .00 3,184.15 1,715.97   2    0  11   10
 2003000135   100001 0.9381 209  4.5  0 20021002    12,907.15   7,038.36        .00          .00 3,184.15 1,715.97   2    0  11   10
 2003000144   100001 0.9381 209  4.5  0 20021002    12,907.15   7,038.36        .00          .00 3,184.15 1,715.97   2    0  11   10
 200300001B   100001 0.9381 424  8.1  0 20021004    10,603.24   5,782.02        .00          .00 2,615.79 1,409.67   4    0  03   03
 200300001C   100001 0.9381 424  8.1  0 20021004    10,603.24   5,782.02        .00          .00 2,615.79 1,409.67   4    0  06   06
 200300704H   450377 0.7827 429  4.7  0 20021004    49,414.69   2,988.47        .00    42,617.07    94.14      .00   4    0  09   16
1  C M S ,
   C M S     PRICER OPERATING  P R O S P E C T I V E   P A Y M E N T   T E S T   D A T A   R E P O R T  OPER147
0 HI CLAIM   PROVIDER WAGE  DRG GMN DRG DIS-DATE TOT OPERATING  FEDERAL     HOSPITAL     OUTLIER  DISPROP   IMETCH     OUTL REV  PPS
     NO         NO    INDEX  NO LOS CUT CCYYMMDD & CAPITAL PAY  PORTION     PORTION      PORTION   SHARE    ADJUST LOS DAYS  CD  RTC
  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -
 200300704C   450377 0.7827 263  9.3  0 20021004     4,906.26   4,346.51        .00          .00   136.92      .00   4    0  09   12
 200300704B   450377 0.7827 263  9.3  0 20021004    60,217.07   4,346.51        .00    51,204.73   136.92      .00   4    0  09   02
 200300004M   450377 0.7827 113 10.4  0 20021004     5,809.32   5,146.54        .00          .00   162.12      .00   4    0  09   12
 200300004L   450377 0.7827 113 10.4  0 20021004    61,688.40   5,146.54        .00    51,738.42   162.12      .00   4    0  09   02
 200301999C   450377 0.7827 002  4.0  0 20021004    67,073.20   6,979.46        .00    54,823.95   219.85      .00   4    0  03   05
 200300023C   510016 0.0000 503  0.0  0 20021006          .00        .00        .00          .00      .00      .00   5    0  00   52
 2003000037   510016 0.0000 503  0.0  0 20021006          .00        .00        .00          .00      .00      .00   5    0  00   52
 2003000035   510016 0.0000 503  0.0  0 20021006          .00        .00        .00          .00      .00      .00   5    0  00   52
 2003000033   510016 0.0000 503  0.0  0 20021006          .00        .00        .00          .00      .00      .00   5    0  00   52
 2003000031   510016 0.0000 503  0.0  0 20021006          .00        .00        .00          .00      .00      .00   5    0  00   52
 2003000004   510016 0.0000 503  0.0  0 20021006          .00        .00        .00          .00      .00      .00   5    0  00   52
 2003000002   510016 0.0000 503  0.0  0 20021006          .00        .00        .00          .00      .00      .00   5    0  00   52
 2003000006   510016 0.0000 503  0.0  0 20021006          .00        .00        .00          .00      .00      .00   5    0  00   52
 200301113A   510017 0.0000 503  0.0  0 20030116          .00        .00        .00          .00      .00      .00   5    0  00   52
 2003000077   100001 0.9381 424  8.1  0 20030201    17,177.36   9,366.94        .00          .00 4,237.60 2,283.69  14    0  00   14
 2003000136   390014 0.9223 503  2.9  0 20030201    76,240.93   4,793.91        .00    57,900.32      .00      .00   1    0  00   02
 2003000138   390014 0.9223 503  2.9  0 20030201    76,920.93   4,793.91        .00    55,180.32      .00      .00   1    0  00   02
 2003000140   390014 0.9223 503  2.9  0 20030201     5,260.92   4,793.91        .00          .00      .00      .00   1    0  00   00
 2003000122   390014 0.9223 503  2.9  0 20030201    76,240.93   4,793.91        .00    57,900.32      .00      .00   1    0  00   02
 2003000123   390014 0.9223 503  2.9  0 20030201    76,920.93   4,793.91        .00    55,180.32      .00      .00   1    0  00   02
 2003000124   390014 0.9223 503  2.9  0 20030201     5,260.92   4,793.91        .00          .00      .00      .00   1    0  00   00
 2003000125   390014 0.9223 503  2.9  0 20030201     5,260.92   4,793.91        .00          .00      .00      .00   1    0  00   00
 2003000022   390014 0.9223 503  2.9  0 20030201    76,240.93   4,793.91        .00    57,900.32      .00      .00   1    0  00   02
 2003000142   390014 0.9223 503  2.9  0 20030201     5,260.92   4,793.91        .00          .00      .00      .00   1    0  00   00
 2003000055   400012 0.4356 234  2.3  0 20030201    24,869.37   2,751.58        .00    19,780.35      .00      .00   1    0  00   02
 2003000044   400012 0.4356 503  2.9  0 20030201    24,855.49   2,685.16        .00    19,833.48      .00      .00   1    0  00   02
 2003000033   400012 0.4356 503  2.9  0 20030201     4,654.03   2,685.16        .00          .00      .00      .00   1    0  00   00
 2003000066   400015 0.0000 503  0.0  0 20030201          .00        .00        .00          .00      .00      .00   1    0  00   52
 2003000111   400015 0.0000 503  0.0  0 20030201          .00        .00        .00          .00      .00      .00   1    0  00   52
 2003000112   400015 0.0000 503  0.0  0 20030201          .00        .00        .00          .00      .00      .00   1    0  00   52
 2003000011   450370 0.7827 503  2.9  0 20030201     4,932.86   4,290.26        .00          .00   225.24      .00   5    0  00   14
 2003000047   100001 0.9381 526  3.7  0 20030401    23,232.63  12,669.02        .00          .00 5,731.46 3,088.74   1    0  09   00
 2003000048   100001 0.9381 527  1.9  0 20030401    18,885.08  10,298.25        .00          .00 4,658.93 2,510.74   1    0  09   14
 2003000145   100001 0.9381 209  4.5  0 20030401    12,905.80   7,037.68        .00          .00 3,183.85 1,715.81   2    0  11   10
 2003000143   390014 0.9223 503  2.9  0 20030401     5,337.48   4,870.55        .00          .00      .00      .00   1    0  00   00
 2003000141   390014 0.9223 503  2.9  0 20030401     5,337.48   4,870.55        .00          .00      .00      .00   1    0  00   00
 2003000139   390014 0.9223 503  2.9  0 20030401    76,936.24   4,870.55        .00    55,119.00      .00      .00   1    0  00   02
 2003000137   390014 0.9223 503  2.9  0 20030401    76,256.24   4,870.55        .00    57,839.00      .00      .00   1    0  00   02
 2004000007   100001 0.9563 424  8.0  0 20031001    18,841.77  10,289.66        .00          .00 4,655.04 2,508.65  14    0  00   14
 2004000002   390014 0.9164 503  3.0  0 20031001    78,322.19   4,995.16        .00    59,413.25      .00      .00   1    0  00   02
 2004000114   390014 0.9164 014  4.7  0 20031001    91,114.24   2,203.61        .00    72,647.95      .00      .00   1    0  09   12
 2004000116   390014 0.9164 014  4.7  0 20031001     2,414.16   2,203.61        .00          .00      .00      .00   1    0  09   12
 2004000115   390014 0.9164 014  4.7  0 20031001    78,362.37   5,178.50        .00    59,266.58      .00      .00   1    0  00   02
 2004000118   390014 0.9164 014  4.7  0 20031001     2,414.16   2,203.61        .00          .00      .00      .00   1    0  11   12
 2004000117   390014 0.9164 014  4.7  0 20031001    78,362.37   5,178.50        .00    59,266.58      .00      .00   1    0  00   02
 2004000119   390014 0.9164 014  4.7  0 20031001     2,414.16   2,203.61        .00          .00      .00      .00   1    0  11   12
 200400120A   390022 0.0000 014  0.0  0 20031001          .00        .00        .00          .00      .00      .00   1    0  11   52
 2004000111   400012 0.4155 234  2.2  0 20031001    26,863.91   2,676.11        .00    21,810.47      .00      .00   1    0  00   02
 2004000003   400012 0.4155 503  3.0  0 20031001     4,702.12   2,733.31        .00          .00      .00      .00   1    0  00   00
 2004000005   400012 0.4155 234  2.2  0 20031001    26,863.91   2,676.11        .00    21,810.47      .00      .00   1    0  00   02
1  C M S ,
   C M S     PRICER OPERATING  P R O S P E C T I V E   P A Y M E N T   T E S T   D A T A   R E P O R T  OPER147
0 HI CLAIM   PROVIDER WAGE  DRG GMN DRG DIS-DATE TOT OPERATING  FEDERAL     HOSPITAL     OUTLIER  DISPROP   IMETCH     OUTL REV  PPS
     NO         NO    INDEX  NO LOS CUT CCYYMMDD & CAPITAL PAY  PORTION     PORTION      PORTION   SHARE    ADJUST LOS DAYS  CD  RTC
  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -
 2004000004   400012 0.4155 503  3.0  0 20031001    26,875.84   2,733.31        .00    21,764.71      .00      .00   1    0  00   02
 2004000006   400015 0.0000 503  0.0  0 20031001          .00        .00        .00          .00      .00      .00   1    0  00   52
 2004000113   400015 0.0000 503  0.0  0 20031001          .00        .00        .00          .00      .00      .00   1    0  00   52
 2004000001   450370 0.7780 503  3.0  0 20031001     5,134.03   4,472.56        .00          .00   234.81      .00   5    0  00   14
 2004000113   100001 0.9563 209  4.4  0 20031002    13,378.16   7,305.93        .00          .00 3,305.20 1,781.21   2    0  11   10
 2004000114   100001 0.9563 209  4.4  0 20031002    16,778.16   7,305.93        .00          .00 3,305.20 1,781.21   2    0  11   10
 2004000115   100001 0.9563 209  4.4  0 20031002    13,378.16   7,305.93        .00          .00 3,305.20 1,781.21   2    0  11   10
 2004000116   100001 0.9563 209  4.4  0 20031002    13,378.16   7,305.93        .00          .00 3,305.20 1,781.21   2    0  11   10
 2004000117   100001 0.9563 209  4.4  0 20031002    13,378.16   7,305.93        .00          .00 3,305.20 1,781.21   2    0  11   10
 2004000118   100001 0.9563 209  4.4  0 20031002    13,378.16   7,305.93        .00          .00 3,305.20 1,781.21   2    0  11   10
 2004000119   100001 0.9563 209  4.4  0 20031002    16,778.16   7,305.93        .00          .00 3,305.20 1,781.21   2    0  11   10
 2004000120   100001 0.9563 209  4.4  0 20031002    13,378.16   7,305.93        .00          .00 3,305.20 1,781.21   2    0  11   10
 2004000121   100001 0.9563 209  4.4  0 20031002    16,778.16   7,305.93        .00          .00 3,305.20 1,781.21   2    0  11   10
 200400003B   100001 0.9563 209  4.4  0 20031002    13,378.16   7,305.93        .00          .00 3,305.20 1,781.21   2    0  09   10
 200400003C   100001 0.9563 209  4.4  0 20031002    13,763.45   7,305.93        .00        72.97 3,305.20 1,781.21   2    0  09   10
 200400013C   100001 0.9563 209  4.4  0 20031002    13,378.16   7,305.93        .00          .00 3,305.20 1,781.21   2    0  11   10
 2004000126   100001 0.9563 209  4.4  0 20031002    13,378.16   7,305.93        .00          .00 3,305.20 1,781.21   2    0  11   10
 2004000127   100001 0.9563 209  4.4  0 20031002    16,778.16   7,305.93        .00          .00 3,305.20 1,781.21   2    0  11   10
 2004000128   100001 0.9563 209  4.4  0 20031002    16,778.16   7,305.93        .00          .00 3,305.20 1,781.21   2    0  11   10
 2004000129   100001 0.9563 209  4.4  0 20031002    16,778.16   7,305.93        .00          .00 3,305.20 1,781.21   2    0  11   10
 2004000130   100001 0.9563 209  4.4  0 20031002    16,778.16   7,305.93        .00          .00 3,305.20 1,781.21   2    0  11   10
 2004000131   100001 0.9563 209  4.4  0 20031002    16,778.16   7,305.93        .00          .00 3,305.20 1,781.21   2    0  11   10
 2004000132   100001 0.9563 209  4.4  0 20031002    13,378.16   7,305.93        .00          .00 3,305.20 1,781.21   2    0  11   10
 2004000133   100001 0.9563 209  4.4  0 20031002    13,378.16   7,305.93        .00          .00 3,305.20 1,781.21   2    0  11   10
 2004000134   100001 0.9563 209  4.4  0 20031002    13,378.16   7,305.93        .00          .00 3,305.20 1,781.21   2    0  11   10
 2004000135   100001 0.9563 209  4.4  0 20031002    13,378.16   7,305.93        .00          .00 3,305.20 1,781.21   2    0  11   10
 2004000144   100001 0.9563 209  4.4  0 20031002    13,378.16   7,305.93        .00          .00 3,305.20 1,781.21   2    0  11   10
 200400001B   100001 0.9563 424  8.0  0 20031004    11,776.12   6,431.04        .00          .00 2,909.40 1,567.91   4    0  03   03
 200400001C   100001 0.9563 424  8.0  0 20031004    11,776.12   6,431.04        .00          .00 2,909.40 1,567.91   4    0  06   06
 200400704H   450377 0.7780 429  4.5  0 20031004    51,237.78   3,031.31        .00    44,260.04    95.49      .00   4    0  09   16
 200400704C   450377 0.7780 263  8.3  0 20031004     8,469.26   7,515.57        .00          .00   236.74      .00   4    0  09   00
 200400704B   450377 0.7780 263  8.3  0 20031004    52,248.44   7,515.57        .00    40,559.63   236.74      .00   4    0  09   02
 200400004M   450377 0.7780 113 10.4  0 20031004     5,963.46   5,291.93        .00          .00   166.70      .00   4    0  09   12
 200400004L   450377 0.7780 113 10.4  0 20031004    62,591.62   5,291.93        .00    52,425.34   166.70      .00   4    0  09   12
 200401999C   450377 0.7780 002  4.1  0 20031004    69,030.20   7,623.06        .00    55,971.17   240.13      .00   4    0  03   05
 2004007156   450377 0.7780 012  4.5  0 20031004    51,317.55   3,385.23        .00    43,967.99   106.63      .00   4    0  09   16
 2004007157   450377 0.7780 088  4.1  0 20031004     3,720.86   3,301.87        .00          .00   104.01      .00   4    0  09   14
 200400704C   450377 0.7780 263  8.3  0 20031004     8,469.26   7,515.57        .00          .00   236.74      .00   4    0  09   00
 2004007158   450377 0.7780 263  8.3  0 20031004    52,248.44   7,515.57        .00    40,559.63   236.74      .00   4    0  09   02
 2004000159   450377 0.7780 297  2.7  0 20031004     2,095.06   1,859.15        .00          .00    58.56      .00   4    0  09   14
 2004000160   450377 0.7780 320  4.3  0 20031004    51,284.09   3,236.79        .00    44,090.48   101.96      .00   4    0  09   16
 200400023C   510016 0.0000 503  0.0  0 20031006          .00        .00        .00          .00      .00      .00   5    0  00   52
 2004000003   510016 0.0000 503  0.0  0 20031006          .00        .00        .00          .00      .00      .00   5    0  00   52
 2004000001   510016 0.0000 503  0.0  0 20031006          .00        .00        .00          .00      .00      .00   5    0  00   52
 2004000005   510016 0.0000 503  0.0  0 20031006          .00        .00        .00          .00      .00      .00   5    0  00   52
 2004000007   510016 0.0000 503  0.0  0 20031006          .00        .00        .00          .00      .00      .00   5    0  00   52
 2004000115   390014 0.9164 014  4.7  0 20031101    78,382.36   5,278.47        .00    59,186.60      .00      .00   1    0  00   02
 2004000114   390014 0.9164 014  4.7  0 20031101    91,122.75   2,246.15        .00    72,613.92      .00      .00   1    0  09   12
 2004000119   390014 0.9164 014  4.7  0 20031101     2,456.70   2,246.15        .00          .00      .00      .00   1    0  11   12
 2004000117   390014 0.9164 014  4.7  0 20031101    78,382.36   5,278.47        .00    59,186.60      .00      .00   1    0  00   02
1  C M S ,
   C M S     PRICER OPERATING  P R O S P E C T I V E   P A Y M E N T   T E S T   D A T A   R E P O R T  OPER147
0 HI CLAIM   PROVIDER WAGE  DRG GMN DRG DIS-DATE TOT OPERATING  FEDERAL     HOSPITAL     OUTLIER  DISPROP   IMETCH     OUTL REV  PPS
     NO         NO    INDEX  NO LOS CUT CCYYMMDD & CAPITAL PAY  PORTION     PORTION      PORTION   SHARE    ADJUST LOS DAYS  CD  RTC
  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -
 2004000116   390014 0.9164 014  4.7  0 20031101     2,456.70   2,246.15        .00          .00      .00      .00   1    0  09   12
 2004000118   390014 0.9164 014  4.7  0 20031101     2,456.70   2,246.15        .00          .00      .00      .00   1    0  11   12
 2004000111   400012 0.4155 234  2.2  0 20031101    26,867.03   2,691.68        .00    21,798.02      .00      .00   1    0  00   02
 2004000077   100001 0.9563 424  8.0  0 20040201    18,841.77  10,289.66        .00          .00 4,655.04 2,508.65  14    0  00   14
 2004000122   390014 0.9164 503  3.0  0 20040201    78,341.48   5,091.59        .00    59,336.11      .00      .00   1    0  00   02
 2004000123   390014 0.9164 503  3.0  0 20040201    79,021.48   5,091.59        .00    56,616.11      .00      .00   1    0  00   02
 2004000124   390014 0.9164 503  3.0  0 20040201     5,568.87   5,091.59        .00          .00      .00      .00   1    0  00   00
 2004000125   390014 0.9164 503  3.0  0 20040201     5,568.87   5,091.59        .00          .00      .00      .00   1    0  00   00
 2004000142   390014 0.9164 503  3.0  0 20040201     5,568.87   5,091.59        .00          .00      .00      .00   1    0  00   00
 2004000136   390014 0.9164 503  3.0  0 20040201    78,341.48   5,091.59        .00    59,336.11      .00      .00   1    0  00   02
 2004000138   390014 0.9164 503  3.0  0 20040201    79,021.48   5,091.59        .00    56,616.11      .00      .00   1    0  00   02
 2004000140   390014 0.9164 503  3.0  0 20040201     5,568.87   5,091.59        .00          .00      .00      .00   1    0  00   00
 2004000022   390014 0.9164 503  3.0  0 20040201    78,341.48   5,091.59        .00    59,336.11      .00      .00   1    0  00   02
 2004000142   390014 0.9164 497  5.2  0 20040201    81,008.40  14,174.71        .00    49,349.61      .00      .00   1    0  00   02
 2004000142   390014 0.9164 497  5.2  0 20040201    81,898.40  14,174.71        .00    45,789.61      .00      .00   1    0  00   02
 2004000142   390014 0.9164 497  5.2  0 20040201    81,218.40  14,174.71        .00    48,509.61      .00      .00   1    0  00   02
 2004000142   390014 0.9164 497  5.2  0 20040201    81,008.40  14,174.71        .00    49,349.61      .00      .00   1    0  00   02
 2004000142   390014 0.9164 540  2.9  0 20040201    79,081.40   5,365.46        .00    56,397.01      .00      .00   1    0  00   02
 2004000142   390014 0.9164 498  3.6  0 20040201    80,422.93  10,538.22        .00    51,418.81      .00      .00   1    0  00   02
 2004000142   390014 0.9164 104 12.2  0 20040201    84,455.82  33,043.11        .00    36,974.89      .00      .00   1    0  00   02
 2004000142   390014 0.9164 105  8.2  0 20040201    82,431.58  23,789.34        .00    44,377.91      .00      .00   1    0  00   02
 2004000142   390014 0.9164 525 10.2  0 20040201    90,146.88  59,059.64        .00    16,161.67      .00      .00   1    0  00   02
 2004000055   400012 0.4155 234  2.2  0 20040201    26,867.03   2,691.68        .00    21,798.02      .00      .00   1    0  00   02
 2004000044   400012 0.4155 503  3.0  0 20040201    26,879.02   2,749.21        .00    21,751.99      .00      .00   1    0  00   02
 2004000033   400012 0.4155 503  3.0  0 20040201     4,718.02   2,749.21        .00          .00      .00      .00   1    0  00   00
 2004000066   400015 0.0000 503  0.0  0 20040201          .00        .00        .00          .00      .00      .00   1    0  00   52
 2004000111   400015 0.0000 503  0.0  0 20040201          .00        .00        .00          .00      .00      .00   1    0  00   52
 2004000112   400015 0.0000 503  0.0  0 20040201          .00        .00        .00          .00      .00      .00   1    0  00   52
 2004000011   450370 0.7780 503  3.0  0 20040201     5,224.91   4,558.91        .00          .00   239.34      .00   5    0  00   14
 2004000047   100001 0.9563 526  3.6  0 20040401    23,662.19  12,772.30        .00          .00 5,778.19 3,390.72   1    0  09   00
 2004000048   100001 0.9563 527  1.8  0 20040401    19,381.15  10,461.49        .00          .00 4,732.78 2,777.26   1    0  09   14
 2004000145   100001 0.9563 209  4.4  0 20040401    13,531.22   7,303.84        .00          .00 3,304.26 1,938.98   2    0  11   10
 2004000146   100001 0.9563 540  2.9  0 20040401    10,204.72   5,508.27        .00          .00 2,491.94 1,462.30   2    0  11   14
 2004000147   100001 0.9563 516  3.8  0 20040401    21,303.18  11,498.96        .00          .00 5,202.13 3,052.68   2    0  11   00
 2004000148   100001 0.9563 517  1.8  0 20040401    17,097.32   9,228.74        .00          .00 4,175.08 2,449.99   2    0  11   14
 2004000149   100001 0.9563 539  7.4  0 20040401    26,793.05  14,462.26        .00          .00 6,542.73 3,839.36   2    0  11   00
 2004000150   100001 0.9563 538  2.1  0 20040401     7,852.04   4,238.35        .00          .00 1,917.43 1,125.17   2    0  11   14
 2004000151   100001 0.9563 537  4.7  0 20040401    14,395.55   7,770.38        .00          .00 3,515.32 2,062.84   2    0  11   00
 2004000152   100001 0.9563 536  3.9  0 20040401    49,693.69  26,823.50        .00          .0012,134.95 7,120.95   2    0  11   00
 2004000153   100001 0.9563 535  8.1  0 20040401    64,564.19  34,850.25        .00          .0015,766.25 9,251.85   2    0  11   00
 2004000143   390014 0.9164 503  3.0  0 20040401     5,550.55   5,074.07        .00          .00      .00      .00   1    0  00   00
 2004000141   390014 0.9164 503  3.0  0 20040401     5,550.55   5,074.07        .00          .00      .00      .00   1    0  00   00
 2004000139   390014 0.9164 503  3.0  0 20040401    79,657.58   5,074.07        .00    57,155.22      .00      .00   1    0  00   02
 2004000137   390014 0.9164 503  3.0  0 20040401    78,977.58   5,074.07        .00    59,875.22      .00      .00   1    0  00   02
 2004000114   390014 0.9164 014  4.7  0 20040401    91,393.38   2,238.42        .00    72,843.55      .00      .00   1    0  09   12
 2004000115   390014 0.9164 014  4.7  0 20040401    79,018.32   5,260.31        .00    59,726.23      .00      .00   1    0  00   02
 2004000118   390014 0.9164 014  4.7  0 20040401     2,448.62   2,238.42        .00          .00      .00      .00   1    0  11   12
 2004000117   390014 0.9164 014  4.7  0 20040401    79,018.32   5,260.31        .00    59,726.23      .00      .00   1    0  00   02
 2004000116   390014 0.9164 014  4.7  0 20040401     2,448.62   2,238.42        .00          .00      .00      .00   1    0  09   12
 2004000119   390014 0.9164 014  4.7  0 20040401     2,448.62   2,238.42        .00          .00      .00      .00   1    0  11   12
1  C M S ,
   C M S     PRICER OPERATING  P R O S P E C T I V E   P A Y M E N T   T E S T   D A T A   R E P O R T  OPER147
0 HI CLAIM   PROVIDER WAGE  DRG GMN DRG DIS-DATE TOT OPERATING  FEDERAL     HOSPITAL     OUTLIER  DISPROP   IMETCH     OUTL REV  PPS
     NO         NO    INDEX  NO LOS CUT CCYYMMDD & CAPITAL PAY  PORTION     PORTION      PORTION   SHARE    ADJUST LOS DAYS  CD  RTC
  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -
 200400120B   390022 1.3540 014  4.7  0 20040401     5,665.69   2,978.88   1,132.37          .00      .00      .00   1    0  11   12
 2004000111   400012 0.4155 234  2.2  0 20040401    28,374.33   2,819.24        .00    23,145.21      .00      .00   1    0  00   02
 2004000113   400015 0.0000 503  0.0  0 20040401          .00        .00        .00          .00      .00      .00   1    0  00   52
 2004000006   100001 0.9563 525 10.2  0 20040601   112,327.15  60,631.58        .00          .0027,429.7316,096.13   1    0  09   00
 2005000001   100001 1.7777 525  8.2  0 20041001   119,062.24  80,137.36        .00          .00 9,616.4820,550.79   1    0  09   00
 2005000002   100001 1.7777 208  2.3  0 20041001     7,240.09   4,873.10        .00          .00   584.77 1,249.68   1    0  09   00
 2005000003   100001 1.7777 208  2.3  0 20041001     7,240.09   4,873.10        .00          .00   584.77 1,249.68   1    0  09   00
 2005000004   100001 1.7777 209  4.3  0 20041001    18,064.67  12,158.80        .00          .00 1,459.06 3,118.06   2    0  11   10
 2005000005   100001 1.7777 209  4.3  0 20041001    18,064.67  12,158.80        .00          .00 1,459.06 3,118.06   2    0  11   10
 2005000006   100001 1.7777 424  7.6  0 20041001    25,463.34  17,138.63        .00          .00 2,056.64 4,395.11  14    0  00   14
 2005000007   100001 1.7777 430  5.6  0 20041001     6,916.67   4,655.41        .00          .00   558.65 1,193.85  14    0  00   44
 2005000008   100001 1.7777 430  5.6  0 20041001     6,916.67   4,655.41        .00          .00   558.65 1,193.85  14    0  09   44
 2005000009   100001 1.7777 541 38.7  0 20041001   209,775.39 141,193.76        .00          .0016,943.2536,208.37  14    0  00   00
 2005000010   100001 1.7777 541 38.7  0 20041001    81,308.93  54,726.70        .00          .00 6,567.2014,034.36  14    0  09   12
 2005000011   100001 1.7777 542 27.5  0 20041001   125,904.61  84,742.75        .00          .0010,169.1321,731.82  14    0  00   00
 2005000012   100001 1.7777 542 27.5  0 20041001    68,674.65  46,222.93        .00          .00 5,546.7511,853.62  14    0  09   12
 2005000013   100001 0.0000 483  0.0  0 20041001          .00        .00        .00          .00      .00      .00  14    0  09   54
 2005000014   100001 1.7777 208  2.3  0 20041001     7,240.09   4,873.10        .00          .00   584.77 1,249.68   1    0  09   00
 2005000015   100001 1.7777 208  2.3  0 20041001     7,240.09   4,873.10        .00          .00   584.77 1,249.68   1    0  09   00
 2005000016   100001 1.7777 525  8.2  0 20041001   119,062.24  80,137.36        .00          .00 9,616.4820,550.79   1    0  09   00
 2005000017   100001 1.7777 208  2.3  0 20041001     7,240.09   4,873.10        .00          .00   584.77 1,249.68   1    0  09   00
 2005000018   100001 1.7777 208  2.3  0 20041001     7,240.09   4,873.10        .00          .00   584.77 1,249.68   1    0  09   00
 2006000055   100001 1.7777 497  5.2  0 20041001    38,852.58  24,834.70        .00          .00 2,980.16 6,368.72   1    0  09   00
 2005000020   390014 0.0000 497  0.0  0 20041001          .00        .00        .00          .00      .00      .00   1    0  00   52
 2005000021   390014 0.0000 001  0.0  0 20041001          .00        .00        .00          .00      .00      .00   1    0  00   52
 2005000022   390014 0.0000 001  0.0  0 20041001          .00        .00        .00          .00      .00      .00   1    0  00   52
 2005000023   390014 0.0000 497  0.0  0 20041001          .00        .00        .00          .00      .00      .00   1    0  00   52
 2005000024   390014 0.0000 014  0.0  0 20041001          .00        .00        .00          .00      .00      .00   1    0  00   52
 2005000025   390014 0.0000 014  0.0  0 20041001          .00        .00        .00          .00      .00      .00   1    0  11   52
 2005000026   390022 0.0000 542  0.0  0 20041001          .00        .00        .00          .00      .00      .00  14    0  09   52
 2005000027   390022 0.0000 014  0.0  0 20041001          .00        .00        .00          .00      .00      .00   1    0  11   52
 2005000028   400012 0.4274 234  2.5  0 20041001    38,287.56   3,944.68        .00    31,254.38      .00      .00   1    0  00   02
 2005000029   400015 0.0000 503  0.0  0 20041001          .00        .00        .00          .00      .00      .00   1    0  00   55
 2005000030   450370 0.0000 503  0.0  0 20041001          .00        .00        .00          .00      .00      .00   5    0  00   52
 2005000031   100001 1.7777 424  7.6  0 20041004    16,752.07  11,275.33        .00          .00 1,353.04 2,891.50   4    0  03   03
 2005000032   100001 0.8558 525  8.2  0 20041101    57,937.41  46,989.92        .00          .00 5,638.79      .00   1    0  09   00
 2005000033   100001 0.8558 208  2.3  0 20041101     3,523.14   2,857.43        .00          .00   342.89      .00   1    0  09   00
 2005000034   390014 0.0000 497  0.0  0 20041101          .00        .00        .00          .00      .00      .00   1    0  00   52
 2005000035   390014 0.0000 498  0.0  0 20041101          .00        .00        .00          .00      .00      .00   1    0  00   52
 2005000036   390014 0.0000 014  0.0  0 20041101          .00        .00        .00          .00      .00      .00   1    0  00   52
 2005000037   390014 0.0000 014  0.0  0 20041101          .00        .00        .00          .00      .00      .00   1    0  00   52
 2005000038   390014 0.0000 498  0.0  0 20041101          .00        .00        .00          .00      .00      .00   1    0  00   52
 2005000039   390014 0.0000 498  0.0  0 20041101          .00        .00        .00          .00      .00      .00   1    0  00   52
 2005000040   390014 0.0000 498  0.0  0 20041101          .00        .00        .00          .00      .00      .00   1    0  00   52
 2005000041   390014 0.0000 535  0.0  0 20041101          .00        .00        .00          .00      .00      .00   1    0  00   52
 2005000042   390014 0.0000 535  0.0  0 20041101          .00        .00        .00          .00      .00      .00   1    0  00   52
 2005000043   390014 0.0000 535  0.0  0 20041101          .00        .00        .00          .00      .00      .00   1    0  00   52
 2005000056   390014 0.0000 498  0.0  0 20041101          .00        .00        .00          .00      .00      .00   1    0  00   52
 2005000044   400012 0.4274 234  2.5  0 20041101    38,287.56   3,944.68        .00    31,254.38      .00      .00   1    0  00   02
 2005000045   100001 0.8558 208  2.3  0 20041201     3,523.14   2,857.43        .00          .00   342.89      .00   1    0  09   00
1  C M S ,
   C M S     PRICER OPERATING  P R O S P E C T I V E   P A Y M E N T   T E S T   D A T A   R E P O R T  OPER147
0 HI CLAIM   PROVIDER WAGE  DRG GMN DRG DIS-DATE TOT OPERATING  FEDERAL     HOSPITAL     OUTLIER  DISPROP   IMETCH     OUTL REV  PPS
     NO         NO    INDEX  NO LOS CUT CCYYMMDD & CAPITAL PAY  PORTION     PORTION      PORTION   SHARE    ADJUST LOS DAYS  CD  RTC
  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -
 2007000053   100001 0.0000 107  0.0  0 20061001          .00        .00        .00          .00      .00      .00   1    0  09   54
 2007000054   100001 0.8733 014  4.3  0 20061001     3,053.99   2,482.63        .00          .00   297.92      .00   1    0  09   12
 2007000055   100001 0.8733 210  5.9  0 20061001     7,773.82   6,319.46        .00          .00   758.34      .00   2    0  11   10
 2007000057   390014 0.0000 010  0.0  0 20061001          .00        .00        .00          .00      .00      .00   1    0  11   52
 2007000058   390014 0.0000 110  0.0  0 20061001          .00        .00        .00          .00      .00      .00   1    0  11   52
 2007000059   390014 0.0000 113  0.0  0 20061001          .00        .00        .00          .00      .00      .00   1    0  11   52
 2007000060   390014 0.0000 007  0.0  0 20061001          .00        .00        .00          .00      .00      .00   1    0  11   52
 2007000061   390014 0.0000 007  0.0  0 20061001          .00        .00        .00          .00      .00      .00   1    0  09   52
 2007000062   390014 0.0000 559  0.0  0 20061001          .00        .00        .00          .00      .00      .00   1    0  00   52
 2007000063   100001 0.8733 559  5.4  0 20061001    40,860.18   9,921.16        .00    25,493.17 1,190.54      .00   2    0  00   02
 2007000064   300001 0.0000 559  0.0  0 20061001          .00        .00        .00          .00      .00      .00   2    0  00   55
 2007000065   510001 0.8568 558  1.5  0 20061001    53,510.17   9,244.98        .00    35,214.16 1,959.94 3,133.70   2    0  00   16
 2007000066   390014 0.0000 478  0.0  0 20061001          .00        .00        .00          .00      .00      .00   1    0  09   52
 2007000067   390014 0.0000 107  0.0  0 20061001          .00        .00        .00          .00      .00      .00   1    0  09   52
 2007000068   390014 0.0000 544  0.0  0 20061001          .00        .00        .00          .00      .00      .00   1    0  09   52
 2007000069   390014 0.0000 544  0.0  0 20061001          .00        .00        .00          .00      .00      .00   1    0  00   52
 2007000070   390014 0.0000 233  0.0  0 20061001          .00        .00        .00          .00      .00      .00   1    0  11   52
 2007000071   390014 0.0000 579  0.0  0 20061001          .00        .00        .00          .00      .00      .00   1    0  00   52
 2007000072   100001 0.8733 579  8.4  0 20061001    41,497.83  12,512.89        .00    23,170.98 1,501.55      .00   2    0  00   02
 2007000073   300001 0.0000 579  0.0  0 20061001          .00        .00        .00          .00      .00      .00   2    0  00   55
 2007000074   510001 0.8568 578 12.7  0 20061001    57,637.65  21,608.94        .00    19,873.33 4,581.10 7,324.62   2    0  00   02
 2007000075   390014 0.0000 577  0.0  0 20061001          .00        .00        .00          .00      .00      .00   1    0  09   52
 2007000076   390014 0.0000 580  0.0  0 20061001          .00        .00        .00          .00      .00      .00   1    0  09   52
 2007000077   390014 0.0000 579  0.0  0 20061001          .00        .00        .00          .00      .00      .00   1    0  09   52
 2007000078   390014 0.0000 579  0.0  0 20061001          .00        .00        .00          .00      .00      .00   1    0  09   52
 2007000080   390014 0.0000 579  0.0  0 20061001          .00        .00        .00          .00      .00      .00   1    0  09   52
 2007000081   390014 0.0000 579  0.0  0 20061001          .00        .00        .00          .00      .00      .00   1    0  09   52
 2007000082   390014 0.0000 579  0.0  0 20061001          .00        .00        .00          .00      .00      .00   1    0  09   52
 2007000083   390014 0.0000 579  0.0  0 20061001          .00        .00        .00          .00      .00      .00   1    0  09   52
 2007000083   390014 0.0000 579  0.0  0 20061001          .00        .00        .00          .00      .00      .00   1    0  09   52
 2007000083   390014 0.0000 579  0.0  0 20061001          .00        .00        .00          .00      .00      .00   1    0  09   52
 2008000053   100001 0.0000 107  0.0  0 20071001          .00        .00        .00          .00      .00      .00   1    0  09   54
 2008000054   100001 0.0000 014  0.0  0 20071001          .00        .00        .00          .00      .00      .00   1    0  09   54
 2008000055   100001 0.0000 210  0.0  0 20071001          .00        .00        .00          .00      .00      .00   2    0  11   54
 2008000057   390014 0.0000 010  0.0  0 20071001          .00        .00        .00          .00      .00      .00   1    0  11   52
 2008000058   390014 0.0000 110  0.0  0 20071001          .00        .00        .00          .00      .00      .00   1    0  11   52
 2008000059   390014 0.0000 113  0.0  0 20071001          .00        .00        .00          .00      .00      .00   1    0  11   52
 2008000060   390014 0.0000 007  0.0  0 20071001          .00        .00        .00          .00      .00      .00   1    0  11   52
 2008000061   390014 0.0000 007  0.0  0 20071001          .00        .00        .00          .00      .00      .00   1    0  09   52
 2008000062   390014 0.0000 559  0.0  0 20071001          .00        .00        .00          .00      .00      .00   1    0  00   52
 2008000063   100001 0.8733 559  5.1  0 20071001    41,452.69   5,458.33        .00    31,009.99   655.00      .00   2    0  00   02
 2008000064   300001 0.0000 559  0.0  0 20071001          .00        .00        .00          .00      .00      .00   2    0  00   55
 2008000065   510001 0.8391 558  3.5  0 20071001    53,571.37   3,809.85        .00    43,667.65   807.69 1,320.75   2    0  00   02
 2008000066   390014 0.0000 478  0.0  0 20071001          .00        .00        .00          .00      .00      .00   1    0  09   52
 2008000067   390014 0.0000 107  0.0  0 20071001          .00        .00        .00          .00      .00      .00   1    0  09   52
 2008000068   390014 0.0000 544  0.0  0 20071001          .00        .00        .00          .00      .00      .00   1    0  09   52
 2008000069   390014 0.0000 544  0.0  0 20071001          .00        .00        .00          .00      .00      .00   1    0  00   52
 2008000070   390014 0.0000 233  0.0  0 20071001          .00        .00        .00          .00      .00      .00   1    0  11   52
 2008000071   390014 0.0000 579  0.0  0 20071001          .00        .00        .00          .00      .00      .00   1    0  00   52
 2008000072   100001 0.8733 579  8.1  0 20071001    42,669.13  10,413.86        .00    26,569.84 1,249.66      .00   2    0  00   02
1  C M S ,
   C M S     PRICER OPERATING  P R O S P E C T I V E   P A Y M E N T   T E S T   D A T A   R E P O R T  OPER147
0 HI CLAIM   PROVIDER WAGE  DRG GMN DRG DIS-DATE TOT OPERATING  FEDERAL     HOSPITAL     OUTLIER  DISPROP   IMETCH     OUTL REV  PPS
     NO         NO    INDEX  NO LOS CUT CCYYMMDD & CAPITAL PAY  PORTION     PORTION      PORTION   SHARE    ADJUST LOS DAYS  CD  RTC
  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -
 2008000073   300001 0.0000 579  0.0  0 20071001          .00        .00        .00          .00      .00      .00   2    0  00   55
 2008000074   510001 0.8391 578  2.5  0 20071001    53,911.54   4,826.11        .00    42,400.44 1,023.14 1,673.05   2    0  00   16
 2008000075   330005 0.9589 577  4.1  0 20071001    19,193.20   7,908.91        .00     7,151.34 1,154.70 1,346.52   1    0  09   02
 2008000076   330005 0.9589 580  3.6  0 20071001    25,726.78   3,851.87        .00    18,445.82   562.37   655.80   1    0  09   42
 2008000077   330005 0.9589 579  8.1  0 20071001    30,757.61   2,773.08        .00    24,458.63   404.87   472.13   1    0  09   42
 2008000078   330005 0.9589 579  8.1  0 20071001    30,757.61   2,773.08        .00    24,458.63   404.87   472.13   1    0  09   42
 2008000080   330005 0.9589 579  8.1  0 20071001    22,783.13   2,773.08        .00          .00   404.87   472.13   1    0  09   12
 2008000081   330005 0.9589 579  8.1  0 20071001    41,631.13   2,773.08        .00          .00   404.87   472.13   1    0  09   12
 2008000082   330005 0.9589 579  8.1  0 20071001    41,631.13   2,773.08        .00          .00   404.87   472.13   1    0  09   12
 2008000083   330005 0.9589 579  8.1  0 20071001    41,631.13   2,773.08        .00          .00   404.87   472.13   1    0  09   12
 2008000083   330005 0.9589 579  8.1  0 20071001    41,631.13   2,773.08        .00          .00   404.87   472.13   1    0  09   12
 2008000083   330005 0.9589 579  8.1  0 20071001    22,783.13   2,773.08        .00          .00   404.87   472.13   1    0  09   12
 2008008401   330005 0.9589 029  5.3  0 20071114    13,477.26   9,497.41        .00          .00 1,386.62 1,616.97   1    0  09   10
 2008008401   330005 0.9589 029  5.3  0 20071114    13,477.26   9,497.41        .00          .00 1,386.62 1,616.97   1    0  09   10
 2008008401   330245 0.8753 029  5.3  0 20071114    10,647.38   8,992.27        .00          .00   270.67   568.79   1    0  09   10
 2008008402   330245 0.8753 029  5.3  0 20071114    10,647.38   8,992.27        .00          .00   270.67   568.79   1    0  09   10
 2008008403   150100 0.8569 314  5.1  0 20071017     8,306.08   6,958.16        .00          .00   590.75   131.79   4    0  09   12
 2008008404   150100 0.8569 314  5.1  0 20071018     8,306.08   6,958.16        .00          .00   590.75   131.79   4    0  09   12
 2008008404   440144 0.9364 314  5.1  0 20071018     8,780.02   7,334.51        .00          .00   822.20      .00   4    0  09   12
 2009000080   330005 0.9556 579  7.8  0 20081001    23,907.59   3,573.67        .00          .00   521.76   608.43   1    0  09   12
 2009000081   330005 0.9556 579  7.8  0 20081001    42,755.59   3,573.67        .00          .00   521.76   608.43   1    0  09   12
 2009000082   330005 0.9556 579  7.8  0 20081001    42,755.59   3,573.67        .00          .00   521.76   608.43   1    0  09   12
 2009000083   330005 0.9556 579  7.8  0 20081001    42,755.59   3,573.67        .00          .00   521.76   608.43   1    0  09   12
 2009000084   330005 0.9556 579  7.8  0 20081001    42,755.59   3,573.67        .00          .00   521.76   608.43   1    0  09   12
 2009000085   330005 0.9556 579  7.8  0 20081001    23,907.59   3,573.67        .00          .00   521.76   608.43   1    0  09   12
 2009008406   330005 0.9556 029  5.1  0 20081114    13,733.87   9,700.45        .00          .00 1,416.27 1,651.54   1    0  09   10
 2009008407   330005 0.9556 029  5.1  0 20081114    13,733.87   9,700.45        .00          .00 1,416.27 1,651.54   1    0  09   10
 2009008408   330245 0.8753 029  5.1  0 20081114    10,871.70   9,203.84        .00          .00   277.04   582.17   1    0  09   10
 2009008409   330245 0.8753 029  5.1  0 20081114    10,871.70   9,203.84        .00          .00   277.04   582.17   1    0  09   10
 2009008410   150100 0.8498 314  5.0  0 20081017     9,720.86   8,163.14        .00          .00   693.05   154.61   4    0  09   14
 2009008411   150100 0.8498 314  5.0  0 20081018     9,720.86   8,163.14        .00          .00   693.05   154.61   4    0  09   14
 2009008412   440144 0.9236 314  5.0  0 20081018    10,241.32   8,575.01        .00          .00   961.26      .00   4    0  09   14
 2009008413   150021 0.8975 028 10.7  0 20081001    29,677.75  24,934.10        .00          .00 2,331.34   246.78   4    0  00   00
 2009HMOPAS   380007 1.1170 028 10.7  0 20081015    39,359.55  28,797.53        .00          .00 5,926.53 1,944.91  14    0  00   14
 2009008414   150021 0.8975 028 10.7  0 20081001    29,677.75  24,934.10        .00          .00 2,331.34   246.78   4    0  00   00
 2009008415   150021 0.8975 028 10.7  0 20081001    34,071.64  24,934.10        .00          .00 2,331.34   246.78   4    0  00   30
 2009300001   400015 0.0000 871  0.0  0 20071001          .00        .00        .00          .00      .00      .00   8    0  00   55
 2009300002   310115 0.0000 606  0.0  0 20081201          .00        .00        .00          .00      .00      .00   8    0  00   55
 2009300003   310115 0.0000 001  0.0  0 20081201          .00        .00        .00          .00      .00      .00   8    0  00   55
 2009300004   030099 0.8824 036  1.3  0 20081201    60,140.68   7,451.71   4,708.70    44,216.10   894.21      .00   8    0  00   16
 2009300005   180038 0.7899 247  1.7  0 20081201    44,534.18   8,531.36   2,442.38    29,787.96   869.35      .00   8    0  00   16
 2009300006   450224 0.8870 281  3.9  0 20081201    46,000.19   5,824.52   2,341.11    34,325.03      .00      .00   8    0  00   16
 2007400001   100022 1.0002 956  7.6  0 20090101    13,851.39   7,170.78        .00          .00 4,024.24 1,832.89   2    0  09   12
 2007400002   100022 1.0002 956  7.6  0 20090101    18,468.54   9,561.04        .00          .00 5,365.66 2,443.86   3    0  09   12
 2010PR0001   400015 0.0000 871  0.0  0 20091201          .00        .00        .00          .00      .00      .00   8    0  00   55
 2010NOTEC2   310115 0.0000 606  0.0  0 20091201          .00        .00        .00          .00      .00      .00   8    0  00   55
 2010NEWTC3   310115 0.0000 001  0.0  0 20091201          .00        .00        .00          .00      .00      .00   8    0  00   55
 2010NEWT4A   310115 0.0000 163  0.0  0 20091201          .00        .00        .00          .00      .00      .00   8    0  00   55
 2010NEWT4B   310115 0.0000 164  0.0  0 20091201          .00        .00        .00          .00      .00      .00   8    0  00   55
 2010NEWT4C   310115 0.0000 165  0.0  0 20091201          .00        .00        .00          .00      .00      .00   8    0  00   55
1  C M S ,
   C M S     PRICER OPERATING  P R O S P E C T I V E   P A Y M E N T   T E S T   D A T A   R E P O R T  OPER147
0 HI CLAIM   PROVIDER WAGE  DRG GMN DRG DIS-DATE TOT OPERATING  FEDERAL     HOSPITAL     OUTLIER  DISPROP   IMETCH     OUTL REV  PPS
     NO         NO    INDEX  NO LOS CUT CCYYMMDD & CAPITAL PAY  PORTION     PORTION      PORTION   SHARE    ADJUST LOS DAYS  CD  RTC
  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -
 2010NEWT4D   310115 0.0000 166  0.0  0 20091201          .00        .00        .00          .00      .00      .00   8    0  00   55
 2010SCH005   010012 0.8665 247  1.7  0 20091201    28,793.32   9,160.53        .00    16,724.87 1,099.26      .00   8    0  00   16
 2010SCH006   040014 0.8455 036  1.3  0 20091201    19,051.98   7,435.60   7,373.28     2,403.39   959.94      .00   8    0  00   16
 2010MDH007   180149 0.7961 164  6.3  0 20091201    28,076.07  11,481.93   7,871.22     1,158.87 3,160.98      .00  20    0  00   16
 2010MDH008   050454 1.5454 495  7.4  0 20091201    49,240.05  15,903.17        .00    20,873.81 4,273.18 5,311.87   3    0  09   40
 2010MDH008   050454 1.5439 495  7.4  0 20100501    49,246.16  15,863.48        .00    20,942.57 4,262.52 5,298.61   3    0  09   40
 2010PR0001   400015 0.0000 871  0.0  0 20100501          .00        .00        .00          .00      .00      .00   8    0  00   55
 2010NOTEC2   310115 0.0000 606  0.0  0 20100501          .00        .00        .00          .00      .00      .00   8    0  00   55
 2010NEWTC3   310115 0.0000 001  0.0  0 20100501          .00        .00        .00          .00      .00      .00   8    0  00   55
 2010NEWT4A   310115 0.0000 163  0.0  0 20100501          .00        .00        .00          .00      .00      .00   8    0  00   55
 2010NEWT4B   310115 0.0000 164  0.0  0 20100501          .00        .00        .00          .00      .00      .00   8    0  00   55
 2010NEWT4C   310115 0.0000 165  0.0  0 20100501          .00        .00        .00          .00      .00      .00   8    0  00   55
 2010NEWT4D   310115 0.0000 166  0.0  0 20100501          .00        .00        .00          .00      .00      .00   8    0  00   55
 2010SCH005   010012 0.8665 247  1.7  0 20100501    28,793.49   9,144.53        .00    16,742.64 1,097.34      .00   8    0  00   16
 2010SCH006   040014 0.8455 036  1.3  0 20100501    19,028.42   7,422.62   7,348.97     2,418.46   958.26      .00   8    0  00   16
 2010MDH007   180149 0.7961 164  6.3  0 20100501    28,047.14  11,461.89   7,843.78     1,182.65 3,155.46      .00  20    0  00   16
 2010MDH008   050454 1.5439 495  7.4  0 20100501    49,246.16  15,863.48        .00    20,942.57 4,262.52 5,298.61   3    0  09   40
 2010HCR01    400015 0.0000 871  0.0  0 20100425          .00        .00        .00          .00      .00      .00   8    0  00   55
 2010HCR02    310115 0.0000 606  0.0  0 20100425          .00        .00        .00          .00      .00      .00   8    0  00   55
 2010HCR3A    310115 0.0000 001  0.0  0 20100425          .00        .00        .00          .00      .00      .00   8    0  00   55
 2010HCR4A    310115 0.0000 163  0.0  0 20100425          .00        .00        .00          .00      .00      .00   8    0  00   55
 2010HCR4B    310115 0.0000 164  0.0  0 20100425          .00        .00        .00          .00      .00      .00   8    0  00   55
 2010HCR4C    310115 0.0000 165  0.0  0 20100425          .00        .00        .00          .00      .00      .00   8    0  00   55
 2010C5SCH    010112 0.7389 247  1.7  0 20100425    50,016.75   8,355.81   9,789.38    27,927.87 1,002.70      .00   8    0  00   16
 2010C6MDH    040014 0.8455 036  1.3  0 20100425    19,028.42   7,422.62   7,348.97     2,418.46   958.26      .00   8    0  00   16
 2010C7MDH    180149 0.7961 164  6.3  0 20100425    27,359.64  11,461.89   7,843.78     3,932.65 3,155.46      .00  20    0  00   16
 2010C9PAC    050454 1.5439 495  7.4  0 20100425    45,036.77  20,594.70        .00     9,365.42 5,533.80 6,878.90   3    0  00   02
 2010C8PAC    050454 1.5439 495  7.4  0 20100425    45,036.77  20,594.70        .00     9,365.42 5,533.80 6,878.90   3    0  00   02
 2010C9PAC    050454 1.5439 495  7.4  0 20100425    49,246.16  15,863.48        .00    20,942.57 4,262.52 5,298.61   3    0  09   40
 2010C8PAC    050454 1.5439 498  5.4  0 20100425    48,050.82  10,205.24        .00    28,905.78 2,742.15 3,408.68   3    0  03   05
 2010C9PAC    330268 0.0000 495  0.0  0 20100425          .00        .00        .00          .00      .00      .00   3    0  09   55
 2010C8PAC    300023 1.0525 498  5.4  0 20100425   102,181.35   7,694.54        .00    85,317.40      .00      .00   3    0  03   05
 2010C8PAC    330263 0.8474 498  5.4  0 20100425   116,934.56   6,723.69     776.46   102,085.07   734.23      .00   3    0  03   05
 2010C5SCH    010112 0.7436 247  1.8  0 20101025    40,258.29   8,552.16        .00    27,739.36 1,026.26      .00   8    0  00   16
 2011PRPRV    400015 0.0000 871  0.0  0 20101025          .00        .00        .00          .00      .00      .00   8    0  00   55
 20110002A    310115 1.1246 606  4.3  0 20101025     7,939.13   7,334.82        .00          .00      .00      .00   8    0  00   44
 20110002B    310115 1.1246 606  4.3  0 20101025    15,959.22   7,334.82        .00          .00      .00      .00   8    0  00   44
 2011C5SCH    010112 0.7436 247  1.8  0 20101025    20,737.50   8,552.16  10,483.88          .00 1,026.26      .00   8    0  00   14
 2011C6MDH    340132 0.0000 036  0.0  0 20101025          .00        .00        .00          .00      .00      .00   8    0  00   55
 2011SCHLW    010069 0.7436 164  6.2  0 20101025   268,206.69  11,394.77 254,801.30          .00 1,110.99      .00  20    0  00   44
 2011CMDHL    040072 0.7479 164  6.2  0 20101025    34,948.96  11,430.89        .00    15,505.54 2,070.13      .00  20    0  00   16
 2011IPSRL    040145 0.7794 606  4.3  0 20101025    68,757.25   5,831.70        .00    37,156.18      .00      .00  20    0  00   16
 201119SLW    260021 0.9014 606  4.3  0 20101025    85,163.52   6,342.70        .00    65,300.68 1,104.90   184.68  20    0  00   16
 2011C8PAC    330268 0.0000 495  0.0  0 20101025          .00        .00        .00          .00      .00      .00   3    0  09   55
 2011C8PAC    330263 0.8282 498  5.4  0 20101025   116,372.40   6,805.55        .00   102,196.34   743.17      .00   3    0  03   05
 201104A-1    310115 1.1246 026  5.8  0 20110425    20,023.89  16,722.29        .00          .00      .00      .00   8    0  00   14
 201104A-2    310115 1.1246 027  3.0  0 20110425    17,242.47  11,946.41        .00          .00      .00      .00   8    0  00   44
 20110004B    310115 1.1246 164  6.2  0 20110425    18,851.96  14,710.01        .00          .00      .00      .00   8    0  00   44
 20110004F    310115 1.1246 165  3.7  0 20110425    14,214.37   9,956.56        .00          .00      .00      .00   8    0  00   44
 201104H-1    310115 1.1246 200  3.7  0 20110425     9,659.17   5,748.09        .00          .00      .00      .00   8    0  00   44
1  C M S ,
   C M S     PRICER OPERATING  P R O S P E C T I V E   P A Y M E N T   T E S T   D A T A   R E P O R T  OPER147
0 HI CLAIM   PROVIDER WAGE  DRG GMN DRG DIS-DATE TOT OPERATING  FEDERAL     HOSPITAL     OUTLIER  DISPROP   IMETCH     OUTL REV  PPS
     NO         NO    INDEX  NO LOS CUT CCYYMMDD & CAPITAL PAY  PORTION     PORTION      PORTION   SHARE    ADJUST LOS DAYS  CD  RTC
  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -
 201104H-2    310115 1.1246 200  3.7  0 20110425     9,659.17   5,748.09        .00          .00      .00      .00   8    0  00   44
 20110003A    310115 1.1246 001 31.6  0 20110425   264,935.42 147,706.17        .00    45,280.89      .00      .00   8    0  00   02
 2011IPSRL    050397 1.1870 015 16.7  0 20101025   103,550.59  34,681.93        .00    59,227.45      .00      .00  20    0  00   16
 2011IPSRL    050397 1.1870 014 21.1  0 20101025   140,401.70  67,579.76  29,738.34    32,909.19      .00      .00  20    0  00   02
 201104A-1    310115 1.1246 026  5.8  0 20110425    20,023.89  16,722.29        .00          .00      .00      .00   8    0  00   14
 201104A-2    310115 1.1246 027  3.0  0 20110425    17,242.47  11,946.41        .00          .00      .00      .00   8    0  00   44
 20110004B    310115 1.1246 164  6.2  0 20110425    18,851.96  14,710.01        .00          .00      .00      .00   8    0  00   44
 20110004F    310115 1.1246 165  3.7  0 20110425    14,214.37   9,956.56        .00          .00      .00      .00   8    0  00   44
 201104H-1    310115 1.1246 200  3.7  0 20110425     9,659.17   5,748.09        .00          .00      .00      .00   8    0  00   44
 201104H-2    310115 1.1246 200  3.7  0 20110425     9,659.17   5,748.09        .00          .00      .00      .00   8    0  00   44
 20110003A    310115 1.1246 001 31.6  0 20110425   264,935.42 147,706.17        .00    45,280.89      .00      .00   8    0  00   02
 2011IPSRL    050397 1.1870 015 16.7  0 20101025   103,550.59  34,681.93        .00    59,227.45      .00      .00  20    0  00   16
 2011IPSRL    050397 1.1870 014 21.1  0 20101025   140,401.70  67,579.76  29,738.34    32,909.19      .00      .00  20    0  00   02
 2012B4A-1    310115 1.1264 026  5.5  0 20111025    18,239.50  16,858.14        .00          .00      .00      .00   8    0  00   44
 2012B4A-2    310115 1.1264 027  2.9  0 20111025    13,060.51  12,071.38        .00          .00      .00      .00   8    0  00   44
 2012B004B    310115 1.1264 164  5.9  0 20111025    15,947.47  14,739.69        .00          .00      .00      .00   8    0  00   44
 2012B004F    310115 1.1264 165  3.6  0 20111025    10,938.80  10,110.36        .00          .00      .00      .00   8    0  00   44
 2012B4H-1    310115 1.1264 200  3.5  0 20111025     6,060.64   5,601.64        .00          .00      .00      .00   8    0  00   44
 2012B4H-2    310115 1.1264 200  3.5  0 20111025     6,060.64   5,601.64        .00          .00      .00      .00   8    0  00   44
 2012B003A    310115 1.1264 001 28.6  0 20111025   252,688.46 137,489.28        .00    96,388.69      .00      .00   8    0  00   02
 201204A-1    400015 0.0000 871  0.0  0 20111201          .00        .00        .00          .00      .00      .00   8    0  00   55
 201204A-2    050625 0.0000 606  0.0  0 20111201          .00        .00        .00          .00      .00      .00   8    0  00   55
 2011000-3    050625 0.0000 606  0.0  0 20110930          .00        .00        .00          .00      .00      .00   8    0  00   55
 2012000-4    010012 0.7454 247  1.9  0 20111201    24,512.45   8,699.28   9,320.99     4,466.83 1,043.91      .00   8    0  00   16
 201204H-5    340132 0.0000 036  0.0  0 20111201          .00        .00        .00          .00      .00      .00   8    0  00   55
 201204H-6    010120 0.7277 164  5.9  0 20111201    36,588.92  11,271.08  14,238.25     4,028.24 1,352.53      .00  20    0  00   16
 2012000-7    010022 0.7277 164  5.9  0 20111201    42,718.09  11,271.08        .00    21,489.55 1,007.63      .00  20    0  00   16
 2012IPS-8    050349 0.0000 606  0.0  0 20111201          .00        .00        .00          .00      .00      .00   8    0  00   55
 2012IPS-9    260021 0.9035 606  4.3  0 20111201    28,551.36   6,661.34        .00    14,223.24 1,160.41   193.95   8    0  00   16
 2012B4-10    120001 0.0000 023  0.0  0 20111201          .00        .00        .00          .00      .00      .00   3    0  09   55
 2012B4-11    330268 0.0000 216  0.0  0 20111201          .00        .00        .00          .00      .00      .00   7    0  09   55
 2012B0-12    020017 0.0000 216  0.0  0 20111201          .00        .00        .00          .00      .00      .00  17    0  09   55
 2012B0-13    010015 0.7332 216 14.1  0 20111201   153,190.81  41,314.27        .00    87,289.80 4,957.71      .00  17    0  00   16
 2011SC-14    010069 0.0000 164  0.0  0 20091005          .00        .00        .00          .00      .00      .00  20    0  00   55
 2011SC-15    010069 0.0000 164  0.0  0 20100425          .00        .00        .00          .00      .00      .00  20    0  00   55
 20131R001    400015 0.4288 025  8.1  0 20121201   193,668.74  14,818.28        .00   156,084.68 4,402.51 1,649.62  10    0  00   16
 20131UT02    050625 1.2282 070  5.1  0 20121201    67,405.50  10,555.15        .00    11,191.56 1,885.15 1,534.60   8    0  00   16
 20131UT03    170049 0.0000 135  0.0  0 20110930          .00        .00        .00          .00      .00      .00   8    0  00   55
 20131UT04    670024 0.9920 230  4.8  0 20121201    50,167.60  20,283.55        .00    23,511.64      .00      .00   8    0  00   16
 20131UT05    390028 0.8496 284  1.9  0 20121201          .00        .00        .00          .00      .00      .00   8    0  00   65
 20131UT06    280020 0.9500 326 12.0  0 20121201   138,040.81  29,085.67        .00    41,965.03 2,815.49   226.45  15    0  00   16
 20131OV07    050349 1.2282 372  4.9  0 20121201          .00        .00        .00          .00      .00      .00   8    0  00   65
 20131CH08    010012 0.7454 421  4.6  0 20121201    67,956.15   7,829.18   1,174.98     8,478.54   939.50      .00   8    0  00   16
 20131CH09    040019 0.7454 468  3.1  0 20121201    72,290.80  11,743.10   9,907.23     4,572.23 1,409.17      .00   8    0  00   16
 20131CH10    010069 0.7071 506  3.0  0 20121201   161,028.64   5,691.98 108,651.12     4,127.82   554.97      .00   8    0  00   16
 20131CH11    040015 0.7501 557  5.2  0 20121201   159,471.03   5,428.34 134,387.19     8,467.49   651.40      .00   3    0  03   05
 20131LV12    050434 1.2282 604  3.9  0 20121201   151,785.38   8,228.88 105,176.89       917.68   987.47      .00  20    0  00   16
 20131DH13    340132 0.8261 659  7.9  0 20121201   105,822.41  16,793.86  72,378.16     1,157.29 4,227.01      .00  10    0  00   16
 20131DH14    360121 0.8458 708  1.5  0 20121201    64,721.74   6,257.66  25,235.29     3,720.97      .00      .00   8    0  00   16
 20131AC15    120001 1.2016 855  3.5  0 20121201   145,373.24   8,551.43        .00    72,443.01 1,809.48   723.35   2    0  03   05
1  C M S ,
   C M S     PRICER OPERATING  P R O S P E C T I V E   P A Y M E N T   T E S T   D A T A   R E P O R T  OPER147
0 HI CLAIM   PROVIDER WAGE  DRG GMN DRG DIS-DATE TOT OPERATING  FEDERAL     HOSPITAL     OUTLIER  DISPROP   IMETCH     OUTL REV  PPS
     NO         NO    INDEX  NO LOS CUT CCYYMMDD & CAPITAL PAY  PORTION     PORTION      PORTION   SHARE    ADJUST LOS DAYS  CD  RTC
  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -
 20131AC16    330268 0.8249 502  2.4  0 20121201   464,827.72   4,663.76        .00   392,732.22   559.65   482.50   1    0  09   40
 20131AC17    020017 1.2727 516  4.6  0 20121201    92,564.03  10,986.94        .00    20,833.79   989.92      .00   2    0  09   40
 20131RT18    010015 0.7332 987  8.6  0 20121201    74,636.56  14,605.40        .00    15,131.00 1,752.65      .00  17    0  00   16
 20131UR19    330267 0.7332 927 22.5  0 20121201   120,060.41  73,221.04        .00    28,011.52 2,613.99      .00  25    0  00   16
 20131AC20    170027 0.7935 175  5.5  0 20121201    60,198.92   5,383.26   3,578.06     7,859.49      .00      .00   3    0  03   05
 20131UT21    250141 0.8967 326 12.0  0 20121201          .00        .00        .00          .00      .00      .00  15    0  00   65
 20131UT22    400117 0.4288 326 12.0  0 20121201          .00        .00        .00          .00      .00      .00  15    0  00   65
 20131UT23    210005 0.0000 326  0.0  0 20121201          .00        .00        .00          .00      .00      .00  15    0  00   53
 20131UT24    330043 1.2845 326 12.0  0 20121201          .00        .00        .00          .00      .00      .00  15    0  00   65
 20131UT25    440153 0.7614 326 12.0  0 20121201          .00        .00        .00          .00      .00      .00  15    0  00   65
 20131UT26    440181 0.7614 326 12.0  0 20121201          .00        .00        .00          .00      .00      .00  15    0  00   65
 20131UT27    440156 0.8498 326 12.0  0 20121201          .00        .00        .00          .00      .00      .00  15    0  00   68
 20131UT28    440159 0.8967 326 12.0  0 20121201          .00        .00        .00          .00      .00      .00  15    0  00   68
 20131UT29    400048 0.3963 326 12.0  0 20121201          .00        .00        .00          .00      .00      .00  15    0  00   68
 20131UT30    210006 0.0000 326  0.0  0 20121201          .00        .00        .00          .00      .00      .00  15    0  00   53
 20131UT31    440161 0.8974 326 12.0  0 20121201          .00        .00        .00          .00      .00      .00  15    0  00   68
 20131UT32    440168 0.8967 326 12.0  0 20121201          .00        .00        .00          .00      .00      .00  15    0  00   68
 20131UT33    440173 0.7635 326 12.0  0 20121201          .00        .00        .00          .00      .00      .00  15    0  00   68
 00131UT34    440174 0.7614 326 12.0  0 20121201          .00        .00        .00          .00      .00      .00  15    0  00   65
 20131UT35    300001 1.1131 025  8.1  0 20121201   154,832.49  26,494.61        .00    59,804.00      .00 2,117.61  10    0  00   16
 20131UT36    300001 1.1131 026  5.3  0 20121201   145,376.07  17,038.35        .00    97,436.45      .00 1,361.81  10    0  00   16
 20131UT37    300001 1.1131 027  2.8  0 20121201   142,708.78  12,470.19        .00   107,920.27      .00   996.69  10    0  00   16
 20131UT38    300001 1.1131 165  3.5  0 20121201   151,675.97  10,331.97        .00    71,470.37      .00   825.79  10    0  00   16
 20131UT39    300001 1.1131 025  8.1  0 20121201   153,785.16  26,494.61        .00    64,044.00      .00 2,117.61  10    0  00   16
 20131UT40    300001 1.1131 025  8.1  0 20121201   153,785.16  26,494.61        .00    64,044.00      .00 2,117.61  10    0  00   16
 20131UT41    310115 1.0994 025  8.1  0 20121201    74,407.83  26,262.92        .00     9,629.16      .00      .00  10    0  00   16
 20131UT42    050758 1.2282 025  8.1  0 20121201          .00        .00        .00          .00      .00      .00  10    0  00   65
 20131UT43    050760 1.6090 025  8.1  0 20121201          .00        .00        .00          .00      .00      .00  10    0  00   65
 20131UT44    050761 1.2282 025  8.1  0 20121201          .00        .00        .00          .00      .00      .00  10    0  00   65
 20131UT45    490097 0.8011 492  6.7  0 20121201    75,094.70  14,554.69        .00    14,011.70 1,539.89      .00  10    0  00   16
 20131UT46    490114 0.8011 492  6.7  0 20121201   121,274.19  12,707.70        .00    50,114.88 1,524.92 1,222.10   4    0  09   40
 20131UT47    360038 0.9319 492  6.7  0 20121201   477,046.91  15,901.05        .00   277,715.25      .00      .00  10    0  00   16
 20131R048    250018 0.7541 407  4.1  0 20121201    51,074.45   8,084.67   8,210.48     2,652.99      .00      .00   3    0  03   05
 20131R049    260186 0.8503 407  4.1  0 20121201    43,145.50   8,653.61   7,160.99     2,952.03   531.33      .00   3    0  03   05
 2014PR001    400015 0.4318 025  7.8  0 20131201   203,978.73  14,428.35        .00   114,946.95 1,071.67 1,606.21  10    0  00   16
 2014OUT02    050625 1.2477 070  4.9  0 20131201    67,131.49  10,447.14        .00    11,315.12   466.46 1,518.90   8    0  00   16
 2014OUT03    170049 0.9442 135  4.3  0 20120930   116,489.57  10,040.40        .00    99,330.20      .00      .00   8    0  00   16
 2014OUT04    670024 0.9884 230  4.4  0 20131201    50,281.47  19,550.65        .00    23,487.62      .00      .00   8    0  00   16
 2014OUT05    390028 0.8566 284  1.8  0 20140402    80,148.72   3,725.39        .00    61,595.45   133.00   764.47   8    0  00   16
 2014OUT06    280020 0.9251 326 11.6  0 20140402   139,917.77  28,683.67        .00    35,636.79   694.14   223.32  15    0  00   16
 2014LOV07    050349 1.2477 372  4.8  0 20131201   228,569.78   7,387.23        .00   161,374.12   221.62      .00   8    0  00   16
 2014SCH08    010035 0.7094 421  4.6  0 20131201   107,955.01   7,798.96        .00    85,935.94   204.72      .00   8    0  00   16
 2014SCH09    180093 0.7790 468  3.0  0 20131201   258,601.90  12,802.19  99,481.06    61,687.12   384.07   402.56   8    0  00   16
 2014SCH10    010069 0.7094 506  2.9  0 20131201   126,926.27   5,301.30  22,696.96    83,133.01   129.22      .00   8    0  00   16
 2014SCH11    040015 0.7441 557  5.1  0 20131201   200,358.57   5,229.02  67,608.14    68,866.18   156.87      .00   3    0  03   05
 2014SLV12    050434 1.2477 604  3.9  0 20131201   149,506.45   8,325.35  18,795.49    87,807.46   249.76      .00  20    0  00   16
 2014MDH13    340132 0.8078 659  7.6  0 20131201    96,842.76  16,107.27  65,438.67    10,908.56 1,013.55      .00  10    0  00   16
 2014MDH14    360121 0.8411 708  1.4  0 20131201    54,578.54   6,258.72  17,478.20    14,599.07      .00      .00   8    0  00   16
 2014PAC15    120001 1.2164 016 18.1  0 20131201   157,824.41   8,778.97        .00    89,443.88   464.41   742.59   3    0  03   05
 2014PAC16    330268 0.8255 040  8.3  0 20131201   480,355.59   6,551.41        .00   372,149.84   196.54   677.79   2    0  03   05
1  C M S ,
   C M S     PRICER OPERATING  P R O S P E C T I V E   P A Y M E N T   T E S T   D A T A   R E P O R T  OPER147
0 HI CLAIM   PROVIDER WAGE  DRG GMN DRG DIS-DATE TOT OPERATING  FEDERAL     HOSPITAL     OUTLIER  DISPROP   IMETCH     OUTL REV  PPS
     NO         NO    INDEX  NO LOS CUT CCYYMMDD & CAPITAL PAY  PORTION     PORTION      PORTION   SHARE    ADJUST LOS DAYS  CD  RTC
  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -  -
 2014PAC17    020017 1.3556 981 10.1  0 20131201    92,177.74  17,271.89        .00    57,932.06   389.05      .00   4    0  03   05
 2014RRT18    010015 0.7332 987  8.4  0 20131201    74,864.17  14,684.99        .00    14,396.32   440.55      .00  17    0  00   16
 2014BUR19    330267 0.7332 927 22.3  0 20131201   120,155.41  73,743.33        .00    27,571.68   658.16      .00  25    0  00   16
 2014PAC20    170027 0.7859 175  5.3  0 20131201   210,303.01   5,394.05        .00    65,882.32      .00      .00   3    0  03   05
 2014OUT21    250141 0.8981 326 11.6  0 20131201          .00        .00        .00          .00      .00      .00  15    0  00   65
 2014OUT22    400117 0.4318 326 11.6  0 20131201          .00        .00        .00          .00      .00      .00  15    0  00   65
 2014OUT23    210005 0.0000 326  0.0  0 20131201          .00        .00        .00          .00      .00      .00  15    0  00   53
 2014OUT24    330043 1.2884 326 11.6  0 20131201          .00        .00        .00          .00      .00      .00  15    0  00   65
 2014OUT25    440153 0.7456 326 11.6  0 20131201          .00        .00        .00          .00      .00      .00  15    0  00   65
 2014OUT26    440181 0.7456 326 11.6  0 20131201          .00        .00        .00          .00      .00      .00  15    0  00   65
 2014OUT27    440156 0.8702 326 11.6  0 20131201          .00        .00        .00          .00      .00      .00  15    0  00   68
 2014OUT28    440159 0.8981 326 11.6  0 20131201          .00        .00        .00          .00      .00      .00  15    0  00   68
 2014OUT29    400048 0.3972 326 11.6  0 20131201          .00        .00        .00          .00      .00      .00  15    0  00   68
 2014OUT30    210006 0.0000 326  0.0  0 20131201          .00        .00        .00          .00      .00      .00  15    0  00   53
 2014OUT31    440161 0.9039 326 11.6  0 20131201          .00        .00        .00          .00      .00      .00  15    0  00   68
 2014OUT32    440168 0.8981 326 11.6  0 20131201          .00        .00        .00          .00      .00      .00  15    0  00   68
 2014OUT33    440173 0.7456 326 11.6  0 20131201          .00        .00        .00          .00      .00      .00  15    0  00   68
 0014OUT34    440174 0.7456 326 11.6  0 20131201          .00        .00        .00          .00      .00      .00  15    0  00   65
 2014OUT35    300001 1.1048 025  7.8  0 20131201   144,836.49  25,595.92        .00   100,951.25      .00 2,045.78  10    0  00   16
 2014OUT36    300001 1.1048 026  5.0  0 20131201   151,792.69  17,194.94        .00    72,209.21      .00 1,374.33  10    0  00   16
 2014OUT37    300001 1.1048 165  3.3  0 20131201   155,553.61  10,338.74        .00    56,509.55      .00   826.34  10    0  00   16
 2014OUT38    300001 1.1048 165  3.3  0 20131201   142,934.82  10,338.74        .00   107,595.35      .00   826.34  10    0  00   16
 2014OUT39    300001 1.1048 025  7.8  0 20131201   145,173.46  25,595.92        .00    99,587.05      .00 2,045.78  10    0  00   16
 2014OUT40    300001 1.1048 025  7.8  0 20131201   145,008.01  25,595.92        .00   100,256.85      .00 2,045.78  10    0  00   16
 2014OUT41    310115 1.1133 025  7.8  0 20131201    67,849.15  25,737.05        .00    35,563.82      .00      .00  10    0  00   16
 2014OUT42    050758 1.2477 025  7.8  0 20131201          .00        .00        .00          .00      .00      .00  10    0  00   65
 2014OUT43    050760 1.6439 025  7.8  0 20131201          .00        .00        .00          .00      .00      .00  10    0  00   65
 2014OUT44    050761 1.2477 025  7.8  0 20131201          .00        .00        .00          .00      .00      .00  10    0  00   65
 2014OUT45    490097 0.7819 492  6.4  0 20131201    77,980.63  14,782.64        .00    14,446.54   391.00      .00  10    0  00   16
 2014OUT46    490114 0.7819 492  6.4  0 20131201   124,902.29  13,165.42        .00    50,146.37   394.96 1,266.12   4    0  09   40
 2014OUT47    360038 0.9264 492  6.4  0 20131201   381,716.99  16,314.10        .00   277,486.59      .00      .00  10    0  00   16
 2014OUT48    400126 0.4631 492  6.4  0 20131201   222,257.01   8,291.77        .00   156,025.23    67.16      .00   4    0  03   05
 2014OUT49    300001 1.1048 025  7.8  0 20131201   144,836.49  25,595.92        .00   100,951.25      .00 2,045.78  10    0  00   16
 2014OUT50    300001 1.1048 025  7.8  0 20131201   144,836.49  25,595.92        .00   100,951.25      .00 2,045.78  10    0  00   16
 2014OUT51    490114 0.7819 492  6.4  0 20131201   126,272.50  11,549.67        .00    53,167.71   346.49 1,110.73   4    0  03   05
 2014OUT52    320057 1.4448 025  7.8  0 20131201   171,265.53  31,241.16        .00    49,221.59   937.23      .00  10    0  00   16
 2014MDH53    340132 0.8078 659  7.6  0 20140402    96,842.76  16,107.27  65,438.67    10,908.56 1,013.55      .00  10    0  00   16
 2014MDH54    360121 0.8411 708  1.4  0 20140402    47,623.00   6,258.72  12,575.30    21,136.27      .00      .00   8    0  00   16
 2014OUT55    490097 0.7819 492  6.4  0 20140402    77,980.63  14,782.64        .00    14,446.54   391.00      .00  10    0  00   16
 2014OUT56    040074 0.8575 070  4.9  0 20131201   192,562.45   8,123.63        .00   134,212.55    66.61      .00   8    0  00   16
 2014OUT57    370015 0.7917 070  4.9  0 20140402   202,296.79   7,760.10        .00   104,316.78   214.18      .00   8    0  00   16
 2014BUN58    310092 1.1133 151  2.2  0 20131124     5,324.44   3,798.97        .00          .00    94.40   371.72   2    0  00   14
 2014BUN59    310092 1.1133 151  2.2  0 20131124     5,343.43   3,798.97        .00          .00    94.40   371.72   2    0  00   14
 2014OUT60    300003 1.1048 025  7.8  0 20131201          .00        .00        .00          .00      .00      .00  10    0  00   68
 2014OUT61    300001 1.1048 025  7.8  0 20131201          .00        .00        .00          .00      .00      .00  12    0  00   67
 2014BUN62    310092 1.1133 151  2.2  0 20131124     5,324.44   3,798.97        .00          .00    94.40   371.72  15    0  00   44
