Chgs/U/O 056 - DEGENERATIVE NERV " 2,753.20 " 064 - INTRACRANIAL HEMO " 7,228.49 " 065 - INTRACRANIAL HEMO " 18,476.10 " 068 - NONSPECIFIC CVA & " 15,912.52 " 069 - TRANSIENT ISCHEMI " 14,877.65 " 070 - NONSPECIFIC CEREB " 25,611.27 " 071 - NONSPECIFIC CEREB " 13,281.46 " 074 - CRANIAL & PERIPHE " 13,330.30 " 078 - HYPERTENSIVE ENCE " 15,715.40 " 091 - OTHER DISORDERS O " 18,588.94 " 092 - OTHER DISORDERS O " 15,712.04 " 093 - OTHER DISORDERS O " 13,777.78 " 101 - SEIZURES W/O MCC " 10,579.81 " 103 - HEADACHES W/O MCC " 11,128.23 " "134 - ""OTHER EAR, NOSE," " 14,667.49 " 153 - OTITIS MEDIA & UR " 9,625.11 " "155 - ""OTHER EAR, NOSE," " 8,133.66 " 157 - DENTAL & ORAL DIS " 27,860.46 " 158 - DENTAL & ORAL DIS " 8,323.77 " 166 - OTHER RESP SYSTEM " 47,576.75 " 175 - PULMONARY EMBOLIS " 32,629.15 " 176 - PULMONARY EMBOLIS " 11,502.75 " 177 - RESPIRATORY INFEC " 47,122.65 " 178 - RESPIRATORY INFEC " 15,650.94 " 179 - RESPIRATORY INFEC " 15,940.20 " 180 - RESPIRATORY NEOPL " 26,778.69 " 189 - PULMONARY EDEMA & " 18,882.99 " 190 - CHRONIC OBSTRUCTI " 21,132.71 " 191 - CHRONIC OBSTRUCTI " 16,168.33 " 192 - CHRONIC OBSTRUCTI " 14,468.93 " 193 - SIMPLE PNEUMONIA " 20,470.66 " 194 - SIMPLE PNEUMONIA " 17,229.49 " 195 - SIMPLE PNEUMONIA " 11,875.82 " 199 - PNEUMOTHORAX W MC " 21,015.12 " 202 - BRONCHITIS & ASTH " 16,648.87 " 203 - BRONCHITIS & ASTH " 9,077.02 " 204 - RESPIRATORY SIGNS " 10,324.59 " 205 - OTHER RESPIRATORY " 37,172.89 " 206 - OTHER RESPIRATORY " 13,205.94 " 240 - AMPUTATION FOR CI " 28,680.69 " 256 - UPPER LIMB & TOE " 25,508.37 " "280 - ""ACUTE MYOCARDIAL" " 18,860.04 " "281 - ""ACUTE MYOCARDIAL" " 10,317.44 " "282 - ""ACUTE MYOCARDIAL" " 29,670.23 " 291 - HEART FAILURE & S " 21,288.34 " 292 - HEART FAILURE & S " 19,388.06 " 293 - HEART FAILURE & S " 13,342.34 " 299 - PERIPHERAL VASCUL " 45,345.67 " 300 - PERIPHERAL VASCUL " 5,612.41 " 304 - HYPERTENSION W MC " 13,849.50 " 305 - HYPERTENSION W/O " 12,838.79 " 308 - CARDIAC ARRHYTHMI " 18,199.39 " 309 - CARDIAC ARRHYTHMI " 17,091.71 " 310 - CARDIAC ARRHYTHMI " 9,205.17 " 311 - ANGINA PECTORIS " 10,085.70 " 312 - SYNCOPE & COLLAPS " 13,909.03 " 313 - CHEST PAIN " 14,626.40 " 314 - OTHER CIRCULATORY " 6,188.75 " "326 - ""STOMACH, ESOPHAG" " 84,182.99 " "328 - ""STOMACH, ESOPHAG" " 27,206.77 " 329 - MAJOR SMALL & LAR " 53,647.25 " 330 - MAJOR SMALL & LAR " 69,363.74 " 331 - MAJOR SMALL & LAR " 45,206.34 " 336 - PERITONEAL ADHESI " 40,718.14 " 337 - PERITONEAL ADHESI " 30,150.13 " 338 - APPENDECTOMY W CO " 38,167.09 " 340 - APPENDECTOMY W CO " 40,781.12 " 342 - APPENDECTOMY W/O " 31,146.91 " 343 - APPENDECTOMY W/O " 27,339.10 " 348 - ANAL & STOMAL PRO " 24,774.04 " 350 - INGUINAL & FEMORA " 29,071.97 " 352 - INGUINAL & FEMORA " 29,970.72 " 355 - HERNIA PROCEDURES " 34,853.25 " 358 - OTHER DIGESTIVE S " 49,214.37 " Golden Valley Memorial 1600 N Second St "Clinton, MO 64735" Primary Sort DRG 371 - MAJOR GASTROINTES " 11,625.27 " 372 - MAJOR GASTROINTES " 27,181.77 " 373 - MAJOR GASTROINTES " 18,258.53 " 374 - DIGESTIVE MALIGNA " 47,279.51 " 375 - DIGESTIVE MALIGNA " 18,458.86 " 377 - G.I. HEMORRHAGE W " 37,927.78 " 378 - G.I. HEMORRHAGE W " 18,329.33 " 379 - G.I. HEMORRHAGE W " 18,828.23 " 388 - G.I. OBSTRUCTION " 25,297.64 " 389 - G.I. OBSTRUCTION " 16,219.60 " 390 - G.I. OBSTRUCTION " 18,314.62 " "391 - ""ESOPHAGITIS, GAS" " 26,176.13 " "392 - ""ESOPHAGITIS, GAS" " 13,850.49 " 394 - OTHER DIGESTIVE S " 10,848.37 " 395 - OTHER DIGESTIVE S " 9,301.09 " 416 - CHOLECYSTECTOMY E " 39,297.26 " 418 - LAPAROSCOPIC CHOL " 38,524.92 " 419 - LAPAROSCOPIC CHOL " 35,538.17 " 433 - CIRRHOSIS & ALCOH " 20,082.93 " 436 - MALIGNANCY OF HEP " 42,065.44 " 438 - DISORDERS OF PANC " 18,133.43 " 439 - DISORDERS OF PANC " 15,255.53 " 440 - DISORDERS OF PANC " 12,234.13 " 445 - DISORDERS OF THE " 22,811.86 " 446 - DISORDERS OF THE " 9,770.56 " 462 - BILATERAL OR MULT " 75,184.77 " "464 - ""WND DEBRID & SKN" " 41,242.86 " 467 - REVISION OF HIP O " 76,781.56 " 468 - REVISION OF HIP O " 78,207.21 " 469 - MAJOR HIP AND KNE " 87,982.12 " 470 - MAJOR HIP AND KNE " 48,056.54 " 475 - AMPUTATION FOR MU " 37,250.29 " 480 - HIP & FEMUR PROCE " 43,826.58 " 481 - HIP & FEMUR PROCE " 60,252.90 " 483 - MAJOR JOINT/LIMB " 54,319.16 " "493 - ""LOWER EXTREM & H" " 52,088.37 " "494 - ""LOWER EXTREM & H" " 63,689.86 " Golden Valley Memorial 1600 N Second St "Clinton, MO 64735" Primary Sort DRG 501 - SOFT TISSUE PROCE " 32,813.43 " 504 - FOOT PROCEDURES W " 25,362.56 " 505 - FOOT PROCEDURES W " 39,568.77 " "510 - ""SHOULDER,ELBOW O" " 51,484.52 " "512 - ""SHOULDER,ELBOW O" " 28,280.71 " "513 - ""HAND OR WRIST PR" " 35,593.50 " 515 - OTHER MUSCULOSKEL " 69,432.78 " 535 - FRACTURES OF HIP " 20,307.68 " 536 - FRACTURES OF HIP " 25,754.14 " 542 - PATHOLOGICAL FRAC " 23,028.65 " 543 - PATHOLOGICAL FRAC " 10,734.83 " 552 - MEDICAL BACK PROB " 18,366.71 " "558 - ""TENDONITIS, MYOS" " 12,512.66 " "560 - ""AFTERCARE, MUSCU" " 18,653.37 " "563 - ""FX, SPRN, STRN &" " 11,464.73 " 572 - SKIN DEBRIDEMENT " 24,040.24 " "580 - ""OTHER SKIN, SUBC" " 33,925.19 " "581 - ""OTHER SKIN, SUBC" " 18,996.95 " 602 - CELLULITIS W MCC " 37,170.24 " 603 - CELLULITIS W/O MC " 13,688.69 " "605 - ""TRAUMA TO THE SK" " 8,043.19 " 606 - MINOR SKIN DISORD " 10,857.94 " 607 - MINOR SKIN DISORD " 5,635.74 " "617 - ""AMPUTAT OF LOWER" " 39,343.03 " "623 - ""SKIN GRAFTS & WO" " 26,445.14 " "627 - ""THYROID, PARATHY" " 23,544.46 " "630 - ""OTHER ENDOCRINE," " 50,037.01 " 637 - DIABETES W MCC " 18,738.02 " 638 - DIABETES W CC " 18,949.19 " 639 - DIABETES W/O CC/M " 8,298.66 " "640 - ""MISC DISORDERS O" " 14,506.49 " "641 - ""MISC DISORDERS O" " 11,829.65 " 645 - ENDOCRINE DISORDE " 2,789.39 " 653 - MAJOR BLADDER PRO " 43,868.83 " 655 - MAJOR BLADDER PRO " 30,624.70 " 660 - KIDNEY & URETER P " 24,537.31 " 661 - KIDNEY & URETER P " 21,901.04 " Golden Valley Memorial 1600 N Second St "Clinton, MO 64735" Primary Sort DRG 682 - RENAL FAILURE W M " 24,033.36 " 683 - RENAL FAILURE W C " 18,152.85 " 684 - RENAL FAILURE W/O " 8,455.98 " 687 - KIDNEY & URINARY " 8,865.56 " 689 - KIDNEY & URINARY " 27,613.23 " 690 - KIDNEY & URINARY " 15,950.88 " 693 - URINARY STONES W/ " 30,920.44 " 694 - URINARY STONES W/ " 11,283.86 " 696 - KIDNEY & URINARY " 18,317.65 " 698 - OTHER KIDNEY & UR " 12,042.75 " 699 - OTHER KIDNEY & UR " 30,824.84 " 728 - INFLAMMATION OF T " 16,059.64 " "740 - ""UTERINE,ADNEXA P" " 34,970.26 " "741 - ""UTERINE,ADNEXA P" " 33,776.32 " 742 - UTERINE & ADNEXA " 36,159.55 " 743 - UTERINE & ADNEXA " 33,560.14 " "759 - ""INFECTIONS, FEMA" " 19,742.75 " 768 - VAGINAL DELIVERY " 12,865.97 " 776 - POSTPARTUM & POST " 7,530.33 " 783 - CESAREAN SECTION " 22,623.64 " 785 - CESAREAN SECTION " 20,946.00 " 786 - CESAREAN SECTION " 20,753.10 " 787 - CESAREAN SECTION " 23,626.36 " 788 - CESAREAN SECTION " 21,844.80 " "789 - ""NEONATES, DIED O" " 8,605.98 " "790 - ""EXTREME IMMATURI" " 7,422.50 " 791 - PREMATURITY W MAJ " 19,781.66 " 792 - PREMATURITY W/O M " 6,930.31 " 793 - FULL TERM NEONATE " 9,186.38 " 794 - NEONATE W OTHER S " 5,517.10 " 795 - NORMAL NEWBORN " 4,251.29 " 797 - VAGINAL DELIVERY " 23,210.40 " 798 - VAGINAL DELIVERY " 24,243.52 " 805 - VAGINAL DELIVERY " 13,318.39 " 806 - VAGINAL DELIVERY " 12,588.38 " 807 - VAGINAL DELIVERY " 11,342.13 " 808 - MAJOR HEMATOL/IMM " 43,199.91 " Golden Valley Memorial 1600 N Second St "Clinton, MO 64735" Primary Sort DRG 811 - RED BLOOD CELL DI " 48,153.72 " 812 - RED BLOOD CELL DI " 25,224.78 " 819 - OTHER ANTEPARTUM " 16,511.38 " 831 - OTHER ANTEPARTUM " 18,736.76 " 832 - OTHER ANTEPARTUM " 8,267.12 " 833 - OTHER ANTEPARTUM " 7,504.74 " 853 - INFECTIOUS & PARA " 55,927.96 " 854 - INFECTIOUS & PARA " 52,776.78 " 863 - POSTOPERATIVE & P " 10,601.55 " 864 - FEVER AND INFLAMM " 16,435.65 " 866 - VIRAL ILLNESS W/O " 7,000.66 " 871 - SEPTICEMIA OR SEV " 25,123.12 " 872 - SEPTICEMIA OR SEV " 15,940.93 " 880 - ACUTE ADJUSTMENT " 3,587.92 " 884 - ORGANIC DISTURBAN " 30,106.68 " 885 - PSYCHOSES " 14,334.82 " "894 - ""ALCOHOL/DRUG ABU" " 6,016.73 " 897 - ALCOHOL/DRUG ABUS " 10,459.84 " 909 - OTHER O.R. PROCED " 14,547.97 " 916 - ALLERGIC REACTION " 8,980.41 " 917 - POISONING & TOXIC " 16,834.83 " 918 - POISONING & TOXIC " 13,455.54 " 919 - COMPLICATIONS OF " 18,612.38 " 920 - COMPLICATIONS OF " 24,501.83 " "923 - ""OTHER INJURY, PO" " 3,045.33 " 940 - O.R. PROC W DIAGN " 33,565.68 " 947 - SIGNS & SYMPTOMS " 31,773.00 " 948 - SIGNS & SYMPTOMS " 15,108.49 " "956 - ""LIMB REATTACHMEN" " 110,193.96 " 963 - OTHER MULTIPLE SI " 15,783.75 " 977 - HIV W OR W/O OTHE " 6,662.92 " 982 - EXTENSIVE O.R. PR " 26,054.21 " 983 - EXTENSIVE O.R. PR " 18,204.89 " 987 - NON-EXTENSIVE O.R " 74,868.91 " 988 - NON-EXTENSIVE O.R " 24,950.75 " GRAND TOTALS " 163,666.38 "