| 4810 |
EPS START OF CARE, CLIN A, FUNC E, AGE GRP 1 |
$2,036.63 |
$2,057.00 |
| 4811 |
EPS START OF CARE, CLIN A, FUNC E, AGE GRP 2 |
$2,266.91 |
$2,289.58 |
| 4812 |
EPS START OF CARE, CLIN A, FUNC E, AGE GRP 3 |
$2,266.91 |
$2,289.58 |
| 4813 |
EPS START OF CARE, CLIN A, FUNC E, AGE GRP 4 |
$2,635.34 |
$2,661.69 |
| 4814 |
EPS START OF CARE, CLIN A, FUNC E, AGE GRP 5 |
$2,635.34 |
$2,661.69 |
| 4815 |
EPS START OF CARE, CLIN A, FUNC E, AGE GRP 6 |
$2,777.76 |
$2,805.54 |
| 4816 |
EPS START OF CARE, CLIN A, FUNC F, AGE GRP 1 |
$3,161.71 |
$3,193.33 |
| 4817 |
EPS START OF CARE, CLIN A, FUNC F, AGE GRP 2 |
$3,687.78 |
$3,724.66 |
| 4818 |
EPS START OF CARE, CLIN A, FUNC F, AGE GRP 3 |
$3,687.78 |
$3,724.66 |
| 4819 |
EPS START OF CARE, CLIN A, FUNC F, AGE GRP 4 |
$4,079.96 |
$4,120.76 |
| 4820 |
EPS START OF CARE, CLIN A, FUNC F, AGE GRP 5 |
$4,079.96 |
$4,120.76 |
| 4821 |
EPS START OF CARE, CLIN A, FUNC F, AGE GRP 6 |
$4,533.28 |
$4,578.61 |
| 4822 |
EPS START OF CARE, CLIN A, FUNC G, AGE GRP 1 |
$3,820.52 |
$3,858.73 |
| 4823 |
EPS START OF CARE, CLIN A, FUNC G, AGE GRP 2 |
$4,103.92 |
$4,144.96 |
| 4824 |
EPS START OF CARE, CLIN A, FUNC G, AGE GRP 3 |
$4,103.92 |
$4,144.96 |
| 4825 |
EPS START OF CARE, CLIN A, FUNC G, AGE GRP 4 |
$4,960.44 |
$5,010.04 |
| 4826 |
EPS START OF CARE, CLIN A, FUNC G, AGE GRP 5 |
$4,960.44 |
$5,010.04 |
| 4827 |
EPS START OF CARE, CLIN A, FUNC G, AGE GRP 6 |
$6,360.35 |
$6,423.95 |
| 4828 |
EPS START OF CARE, CLIN B, FUNC E, AGE GRP 1 |
$2,291.03 |
$2,313.94 |
| 4829 |
EPS START OF CARE, CLIN B, FUNC E, AGE GRP 2 |
$2,487.44 |
$2,512.31 |
| 4830 |
EPS START OF CARE, CLIN B, FUNC E, AGE GRP 3 |
$2,487.44 |
$2,512.31 |
| 4831 |
EPS START OF CARE, CLIN B, FUNC E, AGE GRP 4 |
$2,573.06 |
$2,598.79 |
| 4832 |
EPS START OF CARE, CLIN B, FUNC E, AGE GRP 5 |
$2,573.06 |
$2,598.79 |
| 4833 |
EPS START OF CARE, CLIN B, FUNC E, AGE GRP 6 |
$2,800.71 |
$2,828.72 |
| 4834 |
EPS START OF CARE, CLIN B, FUNC F, AGE GRP 1 |
$3,512.24 |
$3,547.36 |
| 4835 |
EPS START OF CARE, CLIN B, FUNC F, AGE GRP 2 |
$3,778.23 |
$3,816.01 |
| 4836 |
EPS START OF CARE, CLIN B, FUNC F, AGE GRP 3 |
$3,778.23 |
$3,816.01 |
| 4837 |
EPS START OF CARE, CLIN B, FUNC F, AGE GRP 4 |
$4,216.11 |
$4,258.27 |
| 4838 |
EPS START OF CARE, CLIN B, FUNC F, AGE GRP 5 |
$4,216.11 |
$4,258.27 |
| 4839 |
EPS START OF CARE, CLIN B, FUNC F, AGE GRP 6 |
$4,627.07 |
$4,673.34 |
| 4840 |
EPS START OF CARE, CLIN B, FUNC G, AGE GRP 1 |
$4,915.44 |
$4,964.59 |
| 4841 |
EPS START OF CARE, CLIN B, FUNC G, AGE GRP 2 |
$5,543.06 |
$5,598.49 |
| 4842 |
EPS START OF CARE, CLIN B, FUNC G, AGE GRP 3 |
$5,543.06 |
$5,598.49 |
| 4843 |
EPS START OF CARE, CLIN B, FUNC G, AGE GRP 4 |
$6,582.34 |
$6,648.16 |
| 4844 |
EPS START OF CARE, CLIN B, FUNC G, AGE GRP 5 |
$6,582.34 |
$6,648.16 |
| 4845 |
EPS START OF CARE, CLIN B, FUNC G, AGE GRP 6 |
$7,187.88 |
$7,259.76 |
| 4846 |
EPS START OF CARE, CLIN C, FUNC E, AGE GRP 1 |
$2,511.16 |
$2,536.27 |
| 4847 |
EPS START OF CARE, CLIN C, FUNC E, AGE GRP 2 |
$2,849.21 |
$2,877.70 |
| 4848 |
EPS START OF CARE, CLIN C, FUNC E, AGE GRP 3 |
$2,849.21 |
$2,877.70 |
| 4849 |
EPS START OF CARE, CLIN C, FUNC E, AGE GRP 4 |
$3,086.25 |
$3,117.11 |
| 4850 |
EPS START OF CARE, CLIN C, FUNC E, AGE GRP 5 |
$3,086.25 |
$3,117.11 |
| 4851 |
EPS START OF CARE, CLIN C, FUNC E, AGE GRP 6 |
$3,782.27 |
$3,820.09 |
| 4852 |
EPS START OF CARE, CLIN C, FUNC F, AGE GRP 1 |
$4,511.25 |
$4,556.36 |
| 4853 |
EPS START OF CARE, CLIN C, FUNC F, AGE GRP 2 |
$5,210.64 |
$5,262.75 |
| 4854 |
EPS START OF CARE, CLIN C, FUNC F, AGE GRP 3 |
$5,210.64 |
$5,262.75 |
| 4855 |
EPS START OF CARE, CLIN C, FUNC F, AGE GRP 4 |
$5,793.68 |
$5,851.62 |
| 4856 |
EPS START OF CARE, CLIN C, FUNC F, AGE GRP 5 |
$5,793.68 |
$5,851.62 |
| 4857 |
EPS START OF CARE, CLIN C, FUNC F, AGE GRP 6 |
$6,089.15 |
$6,150.04 |
| 4858 |
EPS START OF CARE, CLIN C, FUNC G, AGE GRP 1 |
$5,647.17 |
$5,703.64 |
| 4859 |
EPS START OF CARE, CLIN C, FUNC G, AGE GRP 2 |
$7,942.98 |
$8,022.41 |
| 4860 |
EPS START OF CARE, CLIN C, FUNC G, AGE GRP 3 |
$7,942.98 |
$8,022.41 |
| 4861 |
EPS START OF CARE, CLIN C, FUNC G, AGE GRP 4 |
$7,969.83 |
$8,049.53 |
| 4862 |
EPS START OF CARE, CLIN C, FUNC G, AGE GRP 5 |
$7,969.83 |
$8,049.53 |
| 4863 |
EPS START OF CARE, CLIN C, FUNC G, AGE GRP 6 |
$9,236.38 |
$9,328.74 |
| 4864 |
EPS RECERTIFICATION, CLIN A, FUNC E, AGE GRP 1 |
$1,496.68 |
$1,511.65 |
| 4865 |
EPS RECERTIFICATION, CLIN A, FUNC E, AGE GRP 2 |
$1,635.88 |
$1,652.24 |
| 4866 |
EPS RECERTIFICATION, CLIN A, FUNC E, AGE GRP 3 |
$1,635.88 |
$1,652.24 |
| 4867 |
EPS RECERTIFICATION, CLIN A, FUNC E, AGE GRP 4 |
$2,387.46 |
$2,411.33 |
| 4868 |
EPS RECERTIFICATION, CLIN A, FUNC E, AGE GRP 5 |
$2,387.46 |
$2,411.33 |
| 4869 |
EPS RECERTIFICATION, CLIN A, FUNC E, AGE GRP 6 |
$2,531.39 |
$2,556.70 |
| 4870 |
EPS RECERTIFICATION, CLIN A, FUNC F, AGE GRP 1 |
$3,560.28 |
$3,595.88 |
| 4871 |
EPS RECERTIFICATION, CLIN A, FUNC F, AGE GRP 2 |
$3,737.70 |
$3,775.08 |
| 4872 |
EPS RECERTIFICATION, CLIN A, FUNC F, AGE GRP 3 |
$3,737.70 |
$3,775.08 |
| 4873 |
EPS RECERTIFICATION, CLIN A, FUNC F, AGE GRP 4 |
$4,819.60 |
$4,867.80 |
| 4874 |
EPS RECERTIFICATION, CLIN A, FUNC F, AGE GRP 5 |
$4,819.60 |
$4,867.80 |
| 4875 |
EPS RECERTIFICATION, CLIN A, FUNC F, AGE GRP 6 |
$5,304.94 |
$5,357.99 |
| 4876 |
EPS RECERTIFICATION, CLIN A, FUNC G, AGE GRP 1 |
$4,412.54 |
$4,456.67 |
| 4877 |
EPS RECERTIFICATION, CLIN A, FUNC G, AGE GRP 2 |
$4,204.08 |
$4,246.12 |
| 4878 |
EPS RECERTIFICATION, CLIN A, FUNC G, AGE GRP 3 |
$4,204.08 |
$4,246.12 |
| 4879 |
EPS RECERTIFICATION, CLIN A, FUNC G, AGE GRP 4 |
$6,084.43 |
$6,145.27 |
| 4880 |
EPS RECERTIFICATION, CLIN A, FUNC G, AGE GRP 5 |
$6,084.43 |
$6,145.27 |
| 4881 |
EPS RECERTIFICATION, CLIN A, FUNC G, AGE GRP 6 |
$7,595.12 |
$7,671.07 |
| 4882 |
EPS RECERTIFICATION, CLIN B, FUNC E, AGE GRP 1 |
$1,748.99 |
$1,766.48 |
| 4883 |
EPS RECERTIFICATION, CLIN B, FUNC E, AGE GRP 2 |
$1,910.82 |
$1,929.93 |
| 4884 |
EPS RECERTIFICATION, CLIN B, FUNC E, AGE GRP 3 |
$1,910.82 |
$1,929.93 |
| 4885 |
EPS RECERTIFICATION, CLIN B, FUNC E, AGE GRP 4 |
$2,445.08 |
$2,469.53 |
| 4886 |
EPS RECERTIFICATION, CLIN B, FUNC E, AGE GRP 5 |
$2,445.08 |
$2,469.53 |
| 4887 |
EPS RECERTIFICATION, CLIN B, FUNC E, AGE GRP 6 |
$2,720.27 |
$2,747.47 |
| 4888 |
EPS RECERTIFICATION, CLIN B, FUNC F, AGE GRP 1 |
$3,692.48 |
$3,729.40 |
| 4889 |
EPS RECERTIFICATION, CLIN B, FUNC F, AGE GRP 2 |
$4,288.41 |
$4,331.29 |
| 4890 |
EPS RECERTIFICATION, CLIN B, FUNC F, AGE GRP 3 |
$4,288.41 |
$4,331.29 |
| 4891 |
EPS RECERTIFICATION, CLIN B, FUNC F, AGE GRP 4 |
$5,308.99 |
$5,362.08 |
| 4892 |
EPS RECERTIFICATION, CLIN B, FUNC F, AGE GRP 5 |
$5,308.99 |
$5,362.08 |
| 4893 |
EPS RECERTIFICATION, CLIN B, FUNC F, AGE GRP 6 |
$5,780.92 |
$5,838.73 |
| 4894 |
EPS RECERTIFICATION, CLIN B, FUNC G, AGE GRP 1 |
$5,019.77 |
$5,069.97 |
| 4895 |
EPS RECERTIFICATION, CLIN B, FUNC G, AGE GRP 2 |
$6,088.04 |
$6,148.92 |
| 4896 |
EPS RECERTIFICATION, CLIN B, FUNC G, AGE GRP 3 |
$6,088.04 |
$6,148.92 |
| 4897 |
EPS RECERTIFICATION, CLIN B, FUNC G, AGE GRP 4 |
$8,435.56 |
$8,519.92 |
| 4898 |
EPS RECERTIFICATION, CLIN B, FUNC G, AGE GRP 5 |
$8,435.56 |
$8,519.92 |
| 4899 |
EPS RECERTIFICATION, CLIN B, FUNC G, AGE GRP 6 |
$9,258.78 |
$9,351.37 |
| 4900 |
EPS RECERTIFICATION, CLIN C, FUNC E, AGE GRP 1 |
$1,783.87 |
$1,801.71 |
| 4901 |
EPS RECERTIFICATION, CLIN C, FUNC E, AGE GRP 2 |
$2,463.52 |
$2,488.16 |
| 4902 |
EPS RECERTIFICATION, CLIN C, FUNC E, AGE GRP 3 |
$2,463.52 |
$2,488.16 |
| 4903 |
EPS RECERTIFICATION, CLIN C, FUNC E, AGE GRP 4 |
$3,678.18 |
$3,714.96 |
| 4904 |
EPS RECERTIFICATION, CLIN C, FUNC E, AGE GRP 5 |
$3,678.18 |
$3,714.96 |
| 4905 |
EPS RECERTIFICATION, CLIN C, FUNC E, AGE GRP 6 |
$2,997.65 |
$3,027.63 |
| 4906 |
EPS RECERTIFICATION, CLIN C, FUNC F, AGE GRP 1 |
$4,803.16 |
$4,851.19 |
| 4907 |
EPS RECERTIFICATION, CLIN C, FUNC F, AGE GRP 2 |
$6,228.07 |
$6,290.35 |
| 4908 |
EPS RECERTIFICATION, CLIN C, FUNC F, AGE GRP 3 |
$6,228.07 |
$6,290.35 |
| 4909 |
EPS RECERTIFICATION, CLIN C, FUNC F, AGE GRP 4 |
$6,891.58 |
$6,960.50 |
| 4910 |
EPS RECERTIFICATION, CLIN C, FUNC F, AGE GRP 5 |
$6,891.58 |
$6,960.50 |
| 4911 |
EPS RECERTIFICATION, CLIN C, FUNC F, AGE GRP 6 |
$7,928.35 |
$8,007.63 |
| 4912 |
EPS RECERTIFICATION, CLIN C, FUNC G, AGE GRP 1 |
$7,412.10 |
$7,486.22 |
| 4913 |
EPS RECERTIFICATION, CLIN C, FUNC G, AGE GRP 2 |
$11,621.63 |
$11,737.85 |
| 4914 |
EPS RECERTIFICATION, CLIN C, FUNC G, AGE GRP 3 |
$11,621.63 |
$11,737.85 |
| 4915 |
EPS RECERTIFICATION, CLIN C, FUNC G, AGE GRP 4 |
$10,131.57 |
$10,232.88 |
| 4916 |
EPS RECERTIFICATION, CLIN C, FUNC G, AGE GRP 5 |
$10,131.57 |
$10,232.88 |
| 4917 |
EPS RECERTIFICATION, CLIN C, FUNC G, AGE GRP 6 |
$14,053.64 |
$14,194.17 |
| 4920 |
EPS MATERNITY, NO OASIS, 18 AND OLDER |
$1,496.68 |
$1,511.65 |