1 November 2012 to 31 October 2013 - Department of Veterans' Affairs

Department ofVeterans’ AffairsFee Schedulesfor Medical Services1 November 2012 – 31 October 2013

© Commonwealth of Australia 2012This work is copyright. Apart from any use as permitted under theCopyright Act 1968, no part may be reproduced by any processwithout prior written permission from the Commonwealth. Requestsand inquiries concerning reproduction and rights should be addressedto the publications section, Department of Veterans’ Affairs or emailedto publications@dva.gov.au.Published by the Department of Veterans’ Affairs, Canberra, 2012.DVA P01693 November 2012

REPATRIATION MEDICAL FEE SCHEDULEDepartment of Veterans’ affairs meDical fee scheDules1 november 2012upDateD: 1 november 2012contentslocal meDical officer fee scHeDUle 2DeriVeD fees – reaDY recKoNer for local meDical officers 6rePatriatioN meDical fee scHeDUle 11relatiVe ValUe gUiDe fee scHeDUle 59DiagNostic imagiNg fee scHeDUle 64PatHologY fee scHeDUle 72Notes for claimiNg DVa fees• The fee schedules list the fees that will be implemented on the MedicareAustralia payment system from 1 November 2012.• The fee schedules in this booklet are also available on the DVA website atwww.dva.gov.au/service_providers/Fee_schedules/GPs_LMOs_and_Specialists/Pages/RMFS.aspx• All item assessments are based on Medicare assessment rules.• A “D” in a fee column indicates a derived fee.1 November 2012 – 31 october 2013 1

LocaL MedicaL officer fee ScheduLelocal meDical officer fee scheDule1 november 2012The Local Medical Officer Fee Schedule lists fees for medical attendances and consultationsprovided by general practitioners participating in DVA’s Local Medical Officer (LMO) Scheme.LMOs will be paid at 115% of the listed MBS fee plus the relevant Veterans Access Payment (VAP)or where applicable the Rural Enhancement Initiative (REI) loading.The VAP can be claimed using the Medicare Bulk Billing Incentive item numbers as follows:• • Items 10990, 64990 and 74990 are to be used when claiming the $ 7.05VAP; and• • Items 10991, 10992, 64991 and 74991 when claiming the $10.65 VAP.Please note that VAP is not payable on items provided to inpatients of a hospital or day surgery,Coordinated Veterans’ Care Program UP items and Telehealth consultation items. Items 10990,10991 and 10992 are VAP incentives and are paid at 100% of the MBS fee.Derived fees are indicated by a “D” in the column of the Schedule. Please refer to the derived feessection of the booklet for benefit calculation.The REI loading is available to LMOs who provide services to veterans in designated rural publichospitals by State or Territory governments. The REI only applies to those In Hospital items indicatedin the Local Medical Officer Fee Schedule. The REI loading is an additional 10% of the LMO fee.DVA Practice Nurse Incentive Payments may be payable see www.dva.gov.au/service_providers/doctors/Pages/index.aspx for more information.For items not listed in the LMO schedule please refer to the appropriate schedule in this booklet.• For derived fees for Local Medical Officers, please use the Derived Fees for Local MedicalOfficers Fee Schedule.• For all specialist attendances and consultations, investigative and general medicalprocedures claim from the Repatriation Medical Fee Schedule.• For In Hospital anaesthetic services please use Relative Value Guide Fee Schedule.• For diagnostic imaging services claim from the Diagnostic Imaging Fee Schedule.• For pathology services claim from the Pathology Fee Schedule.2 1 November 2012 – 31 october 2013

Local Medical officer Fee ScheduleItem LMO Fee REIVAP10990,64990,74990VAP10991,10992,64991,749913 19.10 Y Y4 D Y Y Y20 D Y Y23 41.75 Y Y24 D Y Y Y35 D Y Y36 80.85 Y Y37 D Y Y Y43 D Y Y44 119.05 Y Y47 D Y Y Y51 D Y Y52 12.65 Y Y53 24.15 Y Y54 43.70 Y Y57 70.15 Y Y58 D Y Y59 D Y Y60 D Y Y65 D Y Y92 D Y Y93 D Y Y95 D Y Y96 D Y Y597 146.35 Y Y599 172.50 Y Y701 66.95 Y Y703 155.50 Y Y705 214.55 Y Y707 303.10 Y Y715 239.35 Y Y721 162.65 Y Y723 128.90 Y Y729 79.35 Y Y731 79.35 Y Y732 81.25 Y YItem LMO Fee REIVAP10990,64990,74990VAP10991,10992,64991,74991735 79.65 Y Y739 136.40 Y Y743 227.40 Y Y747 58.55 Y Y750 100.35 Y Y758 167.10 Y Y900 174.55 Y Y903 119.50 Y Y2100 25.852122 D2125 D2126 56.302137 D2138 D2143 109.202147 D2179 D2195 160.702199 D2220 D2497 19.10 Y Y2501 41.75 Y Y2503 D Y Y2504 80.85 Y Y2506 D Y Y2507 119.05 Y Y2509 D Y Y2517 41.75 Y Y2518 D Y Y2521 80.85 Y Y2522 D Y Y2525 119.05 Y Y2526 D Y Y2546 41.75 Y Y2547 D Y Y2552 80.85 Y Y1 November 2012 – 31 october 2013 3

Item LMO Fee REIVAP10990,64990,74990VAP10991,10992,64991,749912553 D Y Y2558 119.05 Y Y2559 D Y Y2598 12.65 Y Y2600 24.15 Y Y2603 43.70 Y Y2606 70.15 Y Y2610 D Y Y2613 D Y Y2616 D Y Y2620 24.15 Y Y2622 43.70 Y Y2624 70.15 Y Y2631 D Y Y2633 D Y Y2635 D Y Y2664 24.15 Y Y2666 43.70 Y Y2668 70.15 Y Y2673 D Y Y2675 D Y Y2677 D Y Y2700 80.85 Y Y2701 119.05 Y Y2712 80.85 Y Y2713 80.85 Y Y2715 102.65 Y Y2717 151.20 Y Y2721 104.60 Y Y2723 D Y Y2725 149.70 Y Y2727 D Y Y4001 86.40 Y Y5000 32.75 Y Y5003 D Y Y5010 D Y YItem LMO Fee REIVAP10990,64990,74990VAP10991,10992,64991,749915020 55.30 Y Y5023 D Y Y5028 D Y Y5040 94.65 Y Y5043 D Y Y5049 D Y Y5060 132.80 Y Y5063 D Y Y5067 D Y Y5200 24.15 Y Y5203 35.65 Y Y5207 55.20 Y Y5208 81.65 Y Y5220 D Y Y5223 D Y Y5227 D Y Y5228 D Y Y5260 D Y Y5263 D Y Y5265 D Y Y5267 D Y Y10983 37.30 Y Y10984 37.30 Y Y10986 66.95 Y Y10987 27.60 Y Y10988 13.80 Y Y10989 13.80 Y Y10990 7.0510991 10.6510992 10.6510997 13.80 Y Y64990 7.0564991 10.6574990 7.0574991 10.6582100 53.404 1 November 2012 – 31 october 2013

Local Medical officer Fee ScheduleItem LMO Fee REI82105 32.3082110 53.4082115 319.0082120 753.3082125 753.3082130 53.4082135 78.5082140 53.4082150 28.3082151 53.7082152 78.9582200 9.6082205 20.9582210 39.7582215 58.5582220 28.3082221 53.7082222 78.9582223 28.3082224 53.7082225 78.95UP01 415.80UP02 259.85UP03 433.95VAP10990,64990,74990VAP10991,10992,64991,74991UP04 194.90 Y1 November 2012 – 31 october 2013 5

DERIVED FEES - REaDy REckonER FoR LocaL MEDIcaL oFFIcERSDeriVeD fees – reaDY recKoner forlocal meDical officers1 november 2012Derived fees are indicated by a “D” in the column of the Schedule. Derived Fees Ready Reckoner forLocal Medical Officers is a quick reference table for all derived fees. The derived fees are calculatedat 115% of the listed MBS fee.LMOs will be paid the relevant Veterans Access Payment (VAP) and where applicable the RuralEnhancement Initiative (REI) loading.The VAP can be claimed using the Medicare Bulk Billing Incentive item numbers as follows:• • Items 10990, 64990 and 74990 are to be used when claiming the $7.05 VAP; and• • Items 10991, 10992, 64991 and 74991 when claiming the $10.65 VAP.Please note that VAP is not payable on items provided to inpatients of a hospital or day surgery,Coordinated Veterans’ Care Program UP items and Telehealth consultation items. Items 10990,10991 and 10992 are VAP incentives and are paid at 100% of the MBS fee.The REI loading is available to LMOs who provide services to veterans in designated rural publichospitals by State or Territory governments. The REI only applies to those In Hospital items indicatedin the Local Medical Officer Fee Schedule. The REI loading of 10% is added to 100% of the MBS feeprior to the LMO fee calculation.For items not listed in the Derived Fees schedule please refer to the appropriate schedule in thisbooklet.• For medical attendances and consultations provided by general practitioners participatingin DVA’s Local Medical Officer Scheme, please use the Local Medical Fee Schedule for therelevant fees.• For all specialist attendances and consultations, investigative and general medicalprocedures claim from the Repatriation Medical Fee Schedule.• For In Hospital anaesthetic services please use Relative Value Guide Fee Schedule.• For diagnostic imaging services claim from the Diagnostic Imaging Fee Schedule.• For pathology services claim from the Pathology Fee Schedule.6 1 November 2012 – 31 october 2013

DERIVED FEES - Ready Reckoner for Local Medical OfficersItem Nos. Patients LMO Fee4 1 $47.502 $33.153 $28.354 $25.955 $24.506 $23.557+ $20.95Item Nos. Patients LMO Fee43 1 $131.052 $105.203 $96.604 $92.305 $89.706 $88.007+ $83.05Item Nos. Patients LMO Fee60 1 $58.652 $49.753 $46.754 $45.305 $44.406 $43.857 $41.6520 1 $70.452 $44.603 $36.004 $31.705 $29.106 $27.407+ $22.4547 1 $145.552 $131.203 $126.404 $124.005 $122.556 $121.607+ $119.0065 1 $83.952 $75.053 $72.054 $70.605 $69.706 $69.157 $66.9524 1 $69.702 $55.353 $50.554 $48.155 $46.706 $45.757+ $43.1551 1 $168.502 $142.603 $134.054 $129.755 $127.156 $125.457+ $120.5092 1 $41.952 $25.853 $20.504 $17.855 $16.256 $15.157+ $11.2535 1 $92.652 $66.803 $58.204 $53.905 $51.306 $49.607+ $44.6558 1 $27.602 $18.703 $15.704 $14.255 $13.356 $12.807+ $10.6093 1 $54.702 $36.553 $30.504 $27.505 $25.656 $24.457 $19.8537 1 $108.102 $93.753 $89.004 $86.555 $85.106 $84.157+ $81.5559 1 $38.552 $28.503 $25.154 $23.455 $22.456 $21.757+ $19.2595 1 $73.002 $56.903 $51.554 $48.905 $47.306 $46.207 $42.301 November 2012 – 31 october 2013 7

Item Nos. Patients LMO Fee96 1 $98.302 $82.203 $76.854 $74.205 $72.606 $71.507+ $67.60Item Nos. Patients LMO Fee2147 1 $135.952 $121.603 $116.804 $114.405 $112.956 $112.007+ $109.40Item Nos. Patients LMO Fee2506,2522,25531 $108.102 $93.753 $89.004 $86.555 $85.106 $84.157+ $81.552122 1 $54.152 $39.753 $35.002179 1 $158.902 $133.003 $124.452509,2526,25591 $145.552 $131.203 $126.404 $32.554 $120.154 $124.005 $31.155 $117.555 $122.556 $30.156 $115.856 $121.607+ $27.557+ $110.907+ $119.002125 1 $77.052 $51.203 $42.654 $38.305 $35.756 $34.007+ $29.052199 1 $186.452 $172.053 $167.304 $164.905 $163.456 $162.457+ $159.852610 1 $38.552 $28.503 $25.154 $23.455 $22.456 $21.757+ $19.252137 1 $54.152 $39.753 $35.004 $32.555 $31.156 $30.157+ $27.552220 1 $209.402 $183.503 $174.954 $170.655 $168.056 $166.307+ $161.352613 1 $58.652 $49.753 $46.754 $45.305 $44.406 $43.857+ $41.652138 1 $106.952 $81.103 $72.552503,2518,25471 $69.702 $55.353 $50.552616 1 83.952 75.053 72.054 $68.204 $48.154 70.605 $65.655 $46.705 69.706 $63.906 $45.756 69.157+ $58.957+ $43.157+ 66.958 1 November 2012 – 31 october 2013

DERIVED FEES - Ready Reckoner for Local Medical OfficersItem Nos. Patients LMO Fee2631 1 $38.552 $28.503 $25.154 $23.455 $22.456 $21.757+ $19.25Item Nos. Patients LMO Fee2677 1 $83.952 $75.053 $72.054 $70.605 $69.706 $69.157+ $66.95Item Nos. Patients LMO Fee5023 1 $83.002 $68.603 $63.854 $61.455 $60.006 $59.007+ $56.452633 1 $58.652 $49.753 $46.754 $45.305 $44.406 $43.857+ $41.652723 1 $131.402 $117.053 $112.254 $109.855 $108.406 $107.457+ $104.855028 1 $105.952 $80.053 $71.504 $67.205 $64.606 $62.857+ $57.952635 1 $83.952 $75.053 $72.054 $70.605 $69.706 $69.157+ $66.952727 1 $152.702 $140.203 $136.054 $133.955 $132.706 $131.857+ $129.605043 1 $121.652 $107.253 $102.504 $100.055 $98.656 $97.657+ $95.052673 1 $38.552 $28.503 $25.154 $23.455 $22.456 $21.757+ $19.255003 1 $60.852 $46.503 $41.704 $39.305 $37.856 $36.907+ $34.305049 1 $144.602 $118.703 $110.154 $105.805 $103.256 $101.507+ $96.552675 1 $58.652 $49.753 $46.754 $45.305 $44.406 $43.857+ $41.655010 1 $83.802 $57.953 $49.354 $45.055 $42.456 $40.757+ $35.805063 1 $159.052 $144.703 $139.904 $137.505 $136.056 $135.107+ $132.501 November 2012 – 31 october 2013 9

Item Nos. Patients LMO Fee5067 1 $182.002 $156.153 $147.554 $143.255 $140.656 $138.957+ $134.00Item Nos. Patients LMO Fee5260 1 $53.452 $37.353 $32.004 $29.355 $27.756 $26.657+ $22.755220 1 $39.102 $30.203 $27.204 $25.755 $24.856 $24.307+ $22.105263 1 $66.202 $48.053 $42.004 $39.005 $37.156 $35.957+ $31.355223 1 $50.052 $40.003 $36.654 $34.955 $33.956 $33.257+ $30.755265 1 $84.502 $68.403 $63.054 $60.405 $58.806 $57.707+ $53.805227 1 $70.152 $61.253 $58.254 $56.805 $55.906 $55.357+ $53.155267 1 $109.802 $93.703 $88.354 $85.705 $84.106 $83.007+ $79.105228 1 $95.452 $86.553 $83.554 $82.105 $81.206 $80.657+ $78.4510 1 November 2012 – 31 october 2013

epatriation meDical fee scheDule1 november 2012The fees listed in the Repatriation Medical Fee Schedule (RMFS) are for specialist consultations andprocedures.In Hospital items have been calculated with consideration given to private health industry rates.Out of Hospital items have been calculated based on the Medicare Benefits Schedule (MBS) at a rateof 135% of the MBS for consultations and 140% of the MBS for procedures.All medical practitioners, including LMOs and general practitioners, who have the appropriatequalifications updated with Medicare Australia, are eligible to claim for services listed in theRMFS. Items listed on the RMFS do not attract the Veterans Access Payment (VAP) or the RuralEnhancement Initiative (REI) loading.When claiming an RMFS item using the DVA treatment service voucher, electronic funds transfer oryour own stationery, please ensure that you have correctly indicated whether you have performedthe service In Hospital or Out of Hospital and claimed at the appropriate rate. Whether a service isconsidered In Hospital or Out of Hospital is assessed as per Medicare assessment rules.For items not listed in the RMFS please refer to the appropriate schedule in this booklet.• For medical attendances and consultations provided by general practitioners participatingin DVA’s Local Medical Officer Scheme, please use the Local Medical Fee Schedule for therelevant fees.• For derived fees for Local Medical Officers, please use the Derived Fees for Local MedicalOfficers Fee Schedule.• For In Hospital anaesthetic services please use Relative Value Guide Fee Schedule.• For diagnostic imaging services please use the Diagnostic Imaging Fee Schedule.• For pathology services please use the Pathology Fee Schedule.1 November 2012 – 31 october 2013 11

REPATRIATION MEDICAL FEE SCHEDULEItemRMFS InHospital %99 D104 118.10 115.50105 59.40 58.05106 98.00 95.85107 169.45108 107.30109 265.95 260.30110 208.15 203.75112 D116 104.25 101.95119 59.40 58.05122 247.20128 149.55131 107.70132 363.00 356.30133 181.75 178.35135 363.00 356.30137 363.00 356.30139 175.40141 622.55 611.10143 389.20 382.00145 740.95147 463.20149 D160 299.45 293.20161 498.95 488.60162 698.25 683.80163 898.00 879.55164 997.95 977.30170 138.15 155.60171 145.55 163.90172 177.15 199.50173 29.95 29.25193 49.05195 D 00023.83197 94.95199 139.75288 DRMFSOut ofHospital %ItemRMFS InHospital %289 356.35 356.30291 611.10293 382.00296 351.45RMFSOut ofHospital %297 358.85299 420.30300 58.55302 116.75304 179.70306 247.95308 287.80310 29.20312 58.55314 90.00316 124.15318 143.95319 247.95320 59.90322 119.25324 183.55326 253.35328 293.80330 107.40332 168.30334 245.25336 296.70338 336.90342 68.15 66.60344 90.40 88.40346 133.60 130.70348 174.90 171.15350 241.45 236.25352 174.90 171.15353 68.80 77.25355 137.20 154.55356 201.20 226.55357 277.55 312.50358 338.15 380.7012 1 November 2012 – 31 october 2013

ItemRMFS InHospital %359 447.55 439.25361 411.70 404.10364 59.90 58.55366 119.25 116.75367 174.90 179.70369 241.45 248.15370 293.80 287.80385 118.10 115.50386 59.40 58.05387 173.05 169.45388 109.60 107.30389 D410 26.40411 57.75412 111.60413 164.30414 D 37.97 D415 D 37.75 D416 D 37.89 D417 D 37.85 D501 46.20503 78.05507 131.05511 185.40515 287.05519 197.40520 379.15530 621.45532 863.70534 1,106.15536 1,227.30598 144.45 141.45600 171.25 167.75820 187.80822 281.75823 375.55825 134.90826 215.10RMFSOut ofHospital %ItemRMFS InHospital %828 295.35830 191.85 187.80832 287.80 281.75834 383.40 375.55835 137.85 134.90837 219.75 215.10838 301.65 295.35855 191.85 187.80857 287.80 281.75858 383.40 375.55861 191.85 187.80864 287.80 281.75866 383.40 375.55871 110.80 108.45872 51.60 50.50880 67.102100 25.852122 D2125 D2126 56.302137 D2138 D2143 109.202147 D2179 D2195 160.702199 D2220 D2801 208.15 203.752806 104.25 101.952814 59.40 58.052820 D2824 247.202832 149.552840 107.702946 191.85 187.802949 287.80 281.752954 383.40 375.55RMFSOut ofHospital %1 November 2012 – 31 october 2013 13

REPATRIATION MEDICAL FEE SCHEDULEItemRMFS InHospital %2958 137.90 134.902972 219.75 215.102974 301.70 295.352978 191.852984 287.802988 383.402992 134.902996 215.103000 295.353005 208.15 203.753010 104.25 101.953014 59.40 58.053015 D3018 247.203023 149.553028 107.703032 191.85 187.803040 287.80 281.753044 383.40 375.553051 137.90 134.903055 219.75 215.103062 301.70 295.353069 191.853074 287.803078 383.403083 134.903088 215.103093 295.356007 178.75 175.006009 59.40 58.056011 118.10 115.506013 163.45 160.006015 208.15 203.756016 D10801 167.85 164.2510802 167.85 164.2510803 167.85 164.2510804 167.85 164.25RMFSOut ofHospital %ItemRMFS InHospital %10805 167.85 164.2510806 167.85 164.2510807 167.85 164.2510808 167.85 164.2510809 167.85 164.2510816 167.85 164.2511000 154.50 172.3511003 393.60 456.0011004 392.60 456.0011005 392.60 456.0011006 201.30 233.8011009 274.55 318.8511012 135.25 156.8011015 180.70 209.9011018 269.95 313.5511021 218.30 209.9011024 137.35 159.4011027 203.55 236.5011200 53.55 57.1511204 142.35 151.5511205 142.35 151.5511210 156.20 151.5511211 142.35 151.5511215 183.80 172.2011218 283.05 212.7511221 103.50 94.8511222 89.20 94.8511224 53.60 57.2011225 53.60 57.2011235 161.40 171.8511237 107.20 114.0511240 106.05 114.0511241 136.40 145.1511242 105.40 112.1511243 105.40 112.1511300 253.30 269.4511303 253.30 269.4511304 416.75 443.75RMFSOut ofHospital %14 1 November 2012 – 31 october 2013

ItemRMFS InHospital %11306 28.90 30.7011309 36.80 36.8511312 52.30 52.0511315 72.95 68.9011318 90.75 85.0511321 151.75 161.5011324 44.45 46.0011327 29.20 27.6511330 10.40 11.1011332 76.90 82.0011333 58.65 62.4511336 58.65 62.4511339 58.65 62.4511500 288.75 233.8011503 173.70 194.1511506 25.30 28.8011509 43.10 49.9511512 74.45 86.4511600 96.90 97.0511602 74.50 80.8511604 90.90 106.0011605 90.90 106.0011610 76.65 89.2511611 77.90 89.2511612 134.90 157.4011614 95.95 106.0011615 102.45 106.3011627 300.65 320.1511700 38.35 43.7511701 19.05 21.8011702 20.05 21.8011708 154.30 179.1011709 201.95 234.4511710 62.60 72.7011711 34.20 39.6511712 183.40 213.0511713 89.30 97.6511715 145.30 169.05RMFSOut ofHospital %ItemRMFS InHospital %11718 42.00 48.6511721 84.15 97.6511722 42.00 48.6511724 203.55 236.5011727 124.45 132.6511800 209.50 244.2511810 209.50 244.2511820 2,447.05 2,854.9011823 2,447.05 2,854.9011830 224.15 261.5511833 299.90 349.6511900 34.40 38.6011903 134.05 155.5511906 134.05 155.5511909 199.05 231.2511912 216.65 231.2511915 199.05 231.2511917 521.35 599.7011919 515.00 599.7011921 98.55 105.1012000 56.30 54.5512003 113.55 82.4012012 25.05 29.1512015 75.00 87.4512018 96.60 112.5012021 141.50 165.0012200 44.75 52.1012201 2,871.65 3,350.1012203 705.75 823.2012207 705.75 823.2012210 842.30 982.6012213 758.95 885.2512215 842.30 982.6012217 758.95 885.2512250 402.50 469.4512306 122.95 143.4012309 122.95 143.4012312 122.95 143.40RMFSOut ofHospital %1 November 2012 – 31 october 2013 15

REPATRIATION MEDICAL FEE SCHEDULEItemRMFS InHospital %12315 129.25 143.4012318 122.95 143.4012321 129.70 143.4012323 129.80 143.4012500 260.05 303.3512503 509.90 594.6512506 364.10 424.6512509 260.05 303.3512512 126.20 147.1012515 275.95 321.8012518 126.20 147.1012521 152.05 177.3512524 190.05 221.7012527 102.10 118.9512530 152.05 177.3512533 101.65 118.5513015 305.85 356.6513020 310.60 362.4013025 138.95 162.0013030 196.25 228.8513100 195.45 191.3513103 85.50 99.7013104 207.1513106 145.80 169.9013109 273.30 318.8513110 274.35 319.9013112 183.80 191.3513200 4,258.65 4,355.0513201 3,983.45 4,073.6513202 637.40 651.8013203 674.25 681.4513206 1,172.30 651.8013209 122.25 118.6013210 D13212 467.05 496.2513215 161.50 155.5513218 1,130.65 1,111.0013221 71.55 71.15RMFSOut ofHospital %ItemRMFS InHospital %13251 580.00 585.1513290 275.70 285.9513292 551.25 572.2013300 68.50 79.7513303 101.30 118.2013306 401.00 467.7513309 341.90 398.8013312 45.65 39.8513318 273.00 318.4513319 273.00 318.4513400 116.30 135.5513500 216.45 252.4513503 432.90 505.0013506 221.45 258.3013700 401.70 466.5513703 144.05 167.3013706 100.65 116.7013709 64.05 67.8513750 164.85 191.3513755 180.45 191.3513757 87.95 102.1513760 918.95 1,067.6513815 102.75 119.3513818 137.10 159.2013830 90.85 105.5013839 29.10 32.3013842 83.60 97.0513847 188.00 218.5513848 162.60 183.5013851 594.50 691.1513854 189.00 160.8013857 176.50 205.0013870 434.70 506.9513873 322.45 376.0513876 98.10 107.7013881 175.75 205.0013882 138.45 161.3513885 184.50 215.15RMFSOut ofHospital %16 1 November 2012 – 31 october 2013

ItemRMFS InHospital %13888 92.40 107.7013915 78.20 91.1013918 117.55 137.1513921 133.15 155.1513924 78.45 91.3513927 101.30 118.2013930 141.45 164.9513933 156.95 183.0013936 102.35 119.2513939 117.55 137.1513942 78.45 91.3513945 63.20 73.5013948 78.45 91.3514050 63.65 73.8514053 63.65 73.8514100 216.75 213.5014106 222.45 213.5014109 274.65 262.3014112 296.60 310.4514115 309.35 359.1014118 433.90 456.0514124 183.90 213.5014200 82.55 83.7514201 312.00 331.6014202 157.90 167.9014203 67.25 71.6514206 46.95 49.8514209 116.65 124.2014212 244.65 259.4514215 128.80 137.1514218 128.80 137.1514221 63.25 73.5014224 89.20 98.5014227 122.00 137.1514230 371.3514233 450.9514236 822.2014239 198.75RMFSOut ofHospital %Item14242 590.10RMFS InHospital %14245 122.00 137.1515000 56.00 59.60RMFSOut ofHospital %15003 D 00031.25 D 4015006 142.70 132.1015009 D 00031.46 D 4015012 85.75 74.8515100 63.00 66.8015103 D D15106 74.15 78.8515109 D D15112 157.75 168.3515115 D 00031.15 D 4015211 66.90 76.6015214 D 00022.13 D 4015215 74.70 83.5515218 74.70 83.5515221 102.40 83.5515224 73.25 83.5515227 90.30 83.5515230 D 00025.02 D 4015233 D 00025.02 D 4015236 D 00071.28 D 4015239 D 00022.56 D 4015242 D 00051.09 D 4015245 89.60 83.5515248 74.70 83.5515251 84.40 83.5515254 88.65 83.5515257 89.80 83.5515260 D 00049.86 D 4015263 D 00025.02 D 4015266 D 00041.23 D 4015269 D 00048.25 D 4015272 D 00050.14 D 4015303 430.30 499.8015304 430.30 499.8015307 815.70 947.551 November 2012 – 31 october 2013 17

REPATRIATION MEDICAL FEE SCHEDULEItemRMFS InHospital %15308 815.70 947.5515311 401.65 466.5015312 398.80 463.1515315 788.55 915.9515316 1,114.85 915.9515319 489.35 568.5015320 489.35 568.5015323 870.00 1,010.8015324 870.00 1,010.8015327 1,323.40 1,099.6515328 946.65 1,099.6515331 902.35 1,044.1515332 1,121.65 1,044.1515335 815.70 947.5515336 815.70 947.5515338 1,268.75 1,309.8515339 91.95 106.7015342 229.45 266.4515345 637.40 710.9515348 70.55 81.8015351 140.65 163.2515354 170.70 198.1015357 48.20 56.1015500 305.80 339.7515503 388.65 436.2015506 562.25 651.4515509 262.35 294.4515512 338.15 379.5515513 528.25 429.2015515 493.55 549.5015518 99.50 107.8015521 428.90 475.9015524 768.20 892.3015527 103.00 110.5515530 482.65 493.0515533 848.55 934.8015536 362.85 373.7015539 790.25 878.25RMFSOut ofHospital %ItemRMFS InHospital %15550 794.30 922.0515553 856.90 994.8015556 801.20 930.2015559 1,045.00 1,213.2015562 1,351.50 1,569.0515600 2,042.95 2,383.2515700 59.70 64.3515705 99.40 107.2515710 99.40 107.2515800 125.00 134.8515850 356.00 279.3016003 812.40 910.7016006 600.00 699.8016009 409.45 477.6516012 354.40 413.2516015 4,902.95 5,720.0016018 2,930.95 3,419.4516399 D16400 38.1516401 118.10 119.8016404 59.40 60.2016406 193.45 187.5516500 68.15 66.0516501 191.65 196.8016502 60.9016504 56.65 66.0516505 61.9516508 58.0516509 58.60 66.0516511 361.80 307.9516512 105.30 88.9016514 49.15 51.3516515 937.95 630.9516518 729.65 630.9516519 1,824.30 971.5516520 2,132.0016522 2,305.30 2,281.1016525 1,010.50 538.10RMFSOut ofHospital %18 1 November 2012 – 31 october 2013

ItemRMFS InHospital %16527 921.35 630.9516528 2,094.20 1,135.5016564 299.30 305.2016567 430.45 446.3516570 547.00 582.5016571 418.90 446.3516573 362.65 363.7516590 453.7516591 199.7516600 116.45 88.9016603 160.25 170.6016606 366.35 340.5516609 652.00 694.4016612 512.70 546.3516615 273.20 291.0016618 273.20 291.0016621 273.20 291.0016624 393.35 418.7516627 800.50 852.5516633 D D16636 D D17609 D17610 69.45 60.2017615 138.40 119.8017620 191.70 165.9017625 244.10 211.3017640 69.45 60.2017645 138.40 119.8017650 191.70 165.9017655 244.10 211.3017680 138.40 119.8017690 55.4018213 131.65 124.1518216 302.45 265.90RMFSOut ofHospital %18219 D 00059.25 D 4018222 61.05 52.7518225 83.60 70.1018226 466.50 398.75ItemRMFS InHospital %RMFSOut ofHospital %18227 D 00063.77 D 4018228 95.15 87.5018230 320.90 333.8518232 271.40 265.9018233 267.45 265.9018234 167.45 174.8018236 87.70 87.5018238 68.90 52.7518240 130.30 131.0518242 57.75 52.7518244 160.65 141.1518246 154.70 141.1518248 129.35 124.1518250 95.95 87.5018252 143.80 141.1518254 147.40 141.1518256 83.20 87.5018258 104.50 87.5018260 128.05 124.1518262 90.65 87.5018264 145.10 141.1518266 98.65 87.5018268 155.40 124.1518270 151.55 124.1518272 105.15 87.5018274 135.05 124.1518276 169.40 174.8018278 128.25 124.1518280 199.05 174.8018282 154.70 141.1518284 215.70 206.7518286 199.85 206.7518288 205.40 206.7518290 383.20 349.6518292 237.85 174.8018294 232.20 246.4018296 246.80 210.8018298 332.95 246.401 November 2012 – 31 october 2013 19

REPATRIATION MEDICAL FEE SCHEDULEItemRMFS InHospital %18350 178.05 174.8018351 178.05 174.8018352 383.20 349.6518354 211.15 174.8018356 217.65 174.8018358 191.65 174.8018360 227.65 174.8018361 227.65 174.8018362 378.50 345.4018364 191.65 174.8018366 195.85 219.0018368 409.65 373.9018370 69.20 63.1018371 61.40 63.1018372 191.65 174.8018373 191.65 174.80RMFSOut ofHospital %30001 D D 4030003 46.45 50.8530006 62.25 65.1030009 98.6530010 98.6530013 207.4530014 207.4530017 438.75 456.5030020 795.0530023 435.00 456.5030024 435.00 456.5030026 69.65 73.1030029 120.10 126.0030032 110.25 115.5030035 152.95 164.6030038 149.85 126.0030041 250.25 201.6030042 250.25 259.8530045 157.00 164.6030048 196.55 209.6530049 243.65 259.8530052 338.90 355.60ItemRMFS InHospital %30055 99.45 103.5030058 187.25 202.1030061 32.95 32.9030062 81.10 85.0530064 133.75 153.9030067 383.05 313.0530068 383.05 387.5530071 69.65 73.1030074 205.40 164.6030075 205.40 209.6530078 61.75 67.8530081 137.85 153.9030084 72.40 82.3530087 39.40 41.2530090 159.45 180.0030093 228.95 240.2030094 252.75 265.2030096 279.65 257.5030097 132.05 136.0530099 120.10 126.0030102 229.20 209.6530103 229.20 257.5030104 197.20 177.7030106 296.10 217.6030107 296.10 307.9530110 495.70 398.1030111 495.70 520.1030114 447.8030165 817.95 636.8030168 606.85 636.8030171 1,292.35 968.4530174 922.70 968.4530177 1,315.0530180 182.10 191.1030183 328.75 345.1030185 252.25 255.5030186 62.75 66.4530187 360.30 359.75RMFSOut ofHospital %20 1 November 2012 – 31 october 2013

ItemRMFS InHospital %30189 179.55 206.2530190 596.40 556.8530192 52.95 55.4030195 84.70 88.9030196 168.50 176.8530197 734.15 616.1030202 64.60 67.7030203 227.20 238.3530205 168.50 176.8530207 59.65 62.4530210 267.3030213 146.55 153.7530214 146.55 153.7530216 36.60 38.3030219 38.3030223 201.0530224 317.15 332.6530225 345.20 374.7530226 199.85 209.6530229 364.25 382.1530232 298.40 313.0530235 394.50 414.0030238 199.85 209.6530241 495.90 498.9030244 475.5030246 1,014.2530247 986.2030250 1,695.5030251 2,588.55 2,690.4530253 1,180.3030255 1,714.7030256 681.3030259 266.85 277.9030262 78.65 82.3530265 217.70 164.6030266 217.70 209.6530269 199.85 209.6530272 398.30 414.00RMFSOut ofHospital %Item30275 2,548.40RMFS InHospital %30278 59.70 65.1030281 148.85 167.3030282 302.60 217.6030283 302.60 286.6030286 598.90 557.0030289 623.3030293 594.25 623.6030294 3,202.4530296 1,513.6030297 1,520.0030299 850.5030300 1,020.5530302 680.3030303 816.3530306 1,218.2030308 1,235.0530309 1,623.6530310 593.1530313 498.70 382.1530314 694.6030315 1,770.0030317 2,051.8030318 1,210.8530320 1,780.6530321 1,210.8530323 2,086.8530324 2,095.5530329 329.45 345.7530330 982.5030332 461.5030335 1,273.0530336 1,489.4030373 606.2530375 695.4030376 673.7530378 698.6530379 1,238.25RMFSOut ofHospital %1 November 2012 – 31 october 2013 21

REPATRIATION MEDICAL FEE SCHEDULEItem30382 1,784.4030384 1,464.6030385 790.6530387 866.8030388 1,964.3030390 293.5030391 379.5030392 899.9030393 698.6530394 657.4530396 1,223.6030397 310.1530399 426.4530400 843.8030402 619.9030403 695.4030405 1,195.20RMFS InHospital %30406 71.70 73.1030408 588.5530409 232.95 244.2530411 118.6030412 69.85 73.3030414 920.2530415 2,047.6030416 999.2530417 1,529.3030418 2,119.5030419 1,090.25 1,143.9530421 3,131.2530422 900.9030425 1,651.2030427 2,071.3030428 2,796.30 2,338.0030430 3,099.40 3,252.6530431 695.40 729.7530433 968.7530434 784.7030436 871.95RMFSOut ofHospital %Item30437 1,084.85RMFS InHospital %30438 1,488.10 1,611.2030439 247.8530440 702.20 737.0030441 181.7530442 247.8530443 986.2030445 1,082.4530446 1,071.4030448 1,400.8030449 1,558.7530450 699.45 734.2030451 357.25 374.7530452 503.7530454 1,143.6530455 1,267.4530457 1,800.25 1,931.3030458 1,401.6530460 1,282.5030461 1,972.5030463 3,057.7030464 4,086.3030466 1,675.6030467 2,072.6530469 2,694.30 2,409.3030472 1,239.80 1,301.1030473 236.45 247.9530475 427.35 448.3530476 327.65 343.8030478 327.65 343.8030479 576.80 666.5530481 476.35 499.8030482 338.75 355.4030483 236.40 247.9030484 486.90 510.9030485 729.55 788.6530487 241.55 253.3030488 120.10 126.00RMFSOut ofHospital %22 1 November 2012 – 31 october 2013

ItemRMFS InHospital %30490 635.10 737.0030491 740.95 777.5030492 1,049.7530493 444.70 466.5030494 561.0030495 1,049.7530496 784.70 823.4530497 935.6030499 1,113.0030500 1,191.40 1,250.3530502 1,315.0530503 1,472.40 1,545.3530505 719.7030506 1,288.4530508 1,356.2030509 1,356.20 1,423.2030511 1,133.4030512 1,394.8030514 2,079.3030515 939.5030517 1,230.2030518 1,317.3530520 900.9030521 2,071.9530523 2,013.1530524 2,301.1530526 2,976.5030527 1,233.7530529 1,743.5530530 1,046.2030532 1,201.4030533 1,559.5530535 2,859.6530536 2,653.4030538 1,765.7030539 1,107.6530541 2,458.4530542 1,375.45RMFSOut ofHospital %Item30544 965.3030545 2,450.70RMFS InHospital %30547 1,616.55 1,768.7030548 1,816.45 1,321.3530550 2,750.7530551 1,898.4530553 1,325.45 1,473.7530554 3,060.8030556 2,111.5530557 1,559.4530559 1,136.75 1,189.4030560 1,374.3030562 790.9530563 794.00 833.0030564 1,030.2530565 1,162.3030566 1,291.2030568 875.6030569 494.1030571 605.1530572 634.6030574 164.6030575 669.7030577 1,464.0530578 1,444.7530580 1,305.8030581 1,067.7530583 1,593.3030584 2,503.3530586 935.6030587 968.7530589 1,669.0530590 1,947.6030593 2,570.75 2,642.8530594 3,085.7530596 1,197.1030597 960.9030599 1,865.50RMFSOut ofHospital %1 November 2012 – 31 october 2013 23

REPATRIATION MEDICAL FEE SCHEDULEItem30600 1,036.9530601 1,277.0530602 2,072.65RMFS InHospital %30603 2,189.20 2,297.3030605 2,753.5530606 1,481.9530609 683.5530612 601.1530614 601.1530615 693.9530616 452.7530617 452.7530620 490.3530621 490.3530628 47.65 49.8530631 310.45 331.3530634 472.4530635 472.4530638 541.0030641 541.0030644 792.7530653 62.25 65.1030656 144.25 151.4530659 299.05 209.6530660 299.05 259.8530663 226.80 202.1030666 84.30 66.4530672 622.5530675 512.35 419.2530676 512.35 530.7030679 117.90 134.8530680 1,408.95 1,638.0030682 1,408.95 1,638.0030684 1,733.70 2,015.8030686 1,733.70 2,015.8030687 576.80 666.5530688 485.50 510.9030690 749.35 788.65RMFSOut ofHospital %ItemRMFS InHospital %30692 485.50 510.9030694 749.35 788.6530696 749.35 788.6530710 749.35 788.6531000 746.10 813.3031001 1,114.45 1,016.5031002 1,175.55 1,219.8531200 45.45 47.6031205 127.20 133.6531210 164.45 172.3531215 200.65 201.0031220 295.45 300.4031225 493.75 533.8531230 224.20 235.3031235 191.60 201.0031240 224.20 235.3031245 561.80 516.6031250 627.45 516.6031255 295.35 309.9031256 295.30 309.9031257 295.30 309.9031258 295.30 309.9031260 421.25 441.9531261 420.95 441.9531262 420.95 441.9531263 420.95 441.9531265 246.20 258.3031266 226.60 258.3031267 246.05 258.3031268 246.05 258.3031270 344.75 361.5531271 344.50 361.5531272 344.50 361.5531273 344.50 361.5531275 399.25 418.9531276 399.05 418.9531277 399.05 418.9531278 399.05 418.95RMFSOut ofHospital %24 1 November 2012 – 31 october 2013

ItemRMFS InHospital %31280 207.90 218.2031281 208.70 219.0031282 208.70 219.0031283 208.70 219.0031285 284.35 298.1531286 323.10 298.1531287 284.05 298.1531288 284.05 298.1531290 328.25 344.3031291 314.10 344.3031292 328.00 344.3031293 328.00 344.3031295 417.15 410.0031300 426.80 447.9031305 525.00 550.9031310 371.85 390.1531315 470.45 493.5031320 525.00 550.9031325 361.00 378.8031330 426.80 447.9031335 492.30 516.6031340 D D31345 292.70 295.3531346 281.35 295.3531350 615.50 606.7031355 939.95 1,000.2531400 348.35 365.5031403 401.9531406 738.55 703.0531409 2,631.1031412 2,974.1531420 237.30 257.5031423 490.25 562.4531426 1,072.0031429 1,882.6531432 2,279.6531435 1,304.1031438 2,117.15RMFSOut ofHospital %ItemRMFS InHospital %31441 307.35 352.4031450 593.2531452 1,068.0031454 784.1031456 296.6031458 393.2531460 494.1531462 695.4031464 1,321.5531466 1,735.5531468 2,141.9531470 988.7531472 1,409.0531500 361.05 364.1031503 459.35 485.4531506 526.0031509 451.80 485.4531512 865.2031515 562.0031518 979.8531521 618.80 606.9031524 1,384.2531527 924.30 728.3031530 792.70 833.9531533 177.20 193.1031536 252.75 265.2031539 507.3531542 262.05 275.7531545 774.20 833.9531548 171.75 193.1031551 282.8031554 584.9031557 475.20 485.4531560 467.15 485.4531563 375.30 363.6531566 234.70 181.9532000 1,284.6532003 1,453.35RMFSOut ofHospital %1 November 2012 – 31 october 2013 25

REPATRIATION MEDICAL FEE SCHEDULEItem32004 1,486.3032005 1,802.3532006 1,534.6532009 1,922.3532012 2,073.5532015 2,531.7532018 1,936.2532021 843.1532024 1,981.6032025 2,558.0532026 2,718.9032028 3,093.7532029 562.0532030 1,390.0032033 2,038.2532036 2,767.0032039 2,176.3532042 1,715.8532045 617.0532046 1,012.4532047 1,162.3032051 3,201.7532054 2,554.8532057 751.4032060 3,490.3032063 2,836.4032066 751.4032069 2,260.15RMFS InHospital %32072 62.00 67.0032075 91.65 105.1032078 207.30 236.0032081 302.75 324.0532084 143.70 155.9032087 264.25 286.6032090 430.65 468.1032093 593.35 656.9032094 711.6532095 164.95 178.95RMFSOut ofHospital %Item32096 453.5032099 444.6032102 889.5032103 939.4032104 1,308.85RMFS InHospital %32105 692.45 677.5532106 1,820.45 1,910.4532108 1,333.6032111 871.3532112 1,055.7032114 232.95 244.2532115 169.5532117 1,333.6032120 342.8532123 444.60 466.5032126 645.8032129 846.6032131 712.0032132 60.35 63.1532135 90.15 94.5032138 502.50 514.8532139 560.1032142 90.15 94.5032145 180.45 189.1032147 60.35 63.1532150 319.05 359.7532153 97.6032156 175.80 184.4532159 433.2032162 636.7532165 846.60 888.6032166 279.25 288.7032168 173.0532171 113.2532174 118.60 124.3532175 209.8532177 212.6032180 342.30RMFSOut ofHospital %26 1 November 2012 – 31 october 2013

Item32183 749.3032186 749.30RMFS InHospital %32200 394.50 414.0032203 847.0032206 731.4532209 1,229.9032210 340.85 357.6532212 181.7532213 881.4532214 445.4032215 167.25 175.6032216 791.6032217 208.5532218 208.5532220 1,205.8532221 1,205.8532500 166.25 153.7532501 156.65 153.7532504 381.25 374.7532507 767.60 747.0532508 796.0032511 1,255.0532514 1,354.5532517 1,843.8532520 759.80 747.0532522 1,129.45 1,110.6532700 2,174.3032703 1,763.5032708 1,971.7032710 1,948.6032711 2,866.5532712 1,551.0532715 1,633.3032718 1,691.8532721 3,154.5032724 3,051.5532730 2,312.9032733 2,640.90RMFSOut ofHospital %Item32736 588.8532739 1,713.9532742 2,088.5532745 2,403.5032748 2,642.2532751 1,707.3532754 2,202.3032757 588.8532760 578.6532763 1,574.3532766 1,123.5032769 389.7033050 2,286.2533055 1,714.35RMFS InHospital %33070 1,199.10 1,178.8033075 1,525.4533080 1,629.1533100 2,114.95 2,010.8533103 2,869.1533109 3,884.15 3,411.1033112 3,275.1533115 2,144.2033116 2,210.45 1,958.6033118 2,358.7033119 2,285.10 2,176.4033121 2,738.1533124 1,525.6533127 2,259.05 2,221.4533130 1,970.1533133 1,478.6533136 3,378.1033139 2,182.9033142 2,078.20 2,074.1033145 3,629.3033148 4,507.6033151 5,403.0033154 3,171.3033157 3,473.85RMFSOut ofHospital %1 November 2012 – 31 october 2013 27

REPATRIATION MEDICAL FEE SCHEDULEItem33160 3,850.0533163 3,857.05RMFS InHospital %33166 2,998.25 2,948.0033169 2,246.2533172 1,696.2033175 1,567.0033178 2,133.0533181 3,277.7033500 1,631.6033506 1,809.6533509 2,024.0033512 2,404.6033515 2,473.7033518 1,810.95 1,779.3033521 1,812.4533524 2,312.9033527 2,687.5533530 2,276.8033533 2,687.5533536 1,916.7533539 1,381.2033542 2,159.7033545 389.7033548 792.6533551 389.7033554 388.0033800 1,585.65 1,652.8533803 1,606.1033806 1,156.50 1,137.0533810 843.75 829.4533811 3,295.1533812 1,212.90 1,305.4533815 1,220.9033818 1,265.0533821 1,638.6033824 1,552.3533827 1,737.3033830 2,087.90RMFSOut ofHospital %Item33833 1,895.2033836 2,216.6033839 3,405.0533842 1,328.3033845 805.5033848 859.3534100 969.1034103 588.85RMFS InHospital %34106 415.50 408.4034109 453.50 473.7034112 1,399.2034115 1,292.3034118 2,113.50 1,937.1534121 1,573.9034124 1,723.7534127 2,259.0534130 706.95 694.8534133 986.8034136 1,483.1534139 1,178.7534142 1,513.1534145 1,365.6034148 2,241.7034151 2,706.6034154 2,918.85 3,274.2534157 1,691.8534160 3,169.1034163 4,069.0034166 3,828.5034169 2,451.6034172 2,334.5534175 1,520.9534500 439.15 431.8034503 588.8534506 299.9034509 1,295.5034512 1,366.4034515 1,092.10RMFSOut ofHospital %28 1 November 2012 – 31 october 2013

Item34518 1,779.1534521 1,124.8534524 704.90RMFS InHospital %34527 716.65 772.2534528 330.35 381.4034530 253.0534533 1,766.65 1,736.9534538 350.10 381.4034539 246.5534800 1,156.50 1,137.0534803 2,377.5034806 1,381.2034809 1,381.2034812 1,670.1034815 1,785.3034818 1,709.2534821 2,066.70 2,032.0534824 607.3534827 856.6034830 1,190.25 989.8034833 1,371.6035000 941.00 989.8035003 1,396.2535006 1,638.2535009 1,722.9535012 1,007.0035100 452.6035103 334.0535200 244.4035202 1,163.5535300 734.05 721.5035303 809.30 925.1535306 754.25 853.9035307 1,596.7035309 935.35 1,067.3035312 1,230.5035315 1,230.5035317 507.00 498.15RMFSOut ofHospital %ItemRMFS InHospital %35319 787.25 892.9535320 1,219.70 1,199.4035321 1,157.95 1,138.6535324 434.2535327 581.8035330 734.05 721.5035331 843.7535360 1,179.0035361 890.1035362 843.5035363 675.7535404 395.5035406 1,128.1035408 846.2535410 1,128.10 1,138.6535412 3,963.45 4,000.6035500 112.80 113.8535502 98.55 112.2535503 66.55 75.0035506 76.70 75.2035507 218.2035508 386.7035509 116.65 125.2535512 354.95 251.2035513 354.95 310.4035516 211.65 162.9035517 211.65 204.4035518 297.00 291.0035520 92.60 81.6535523 106.05 81.6535526 207.70 162.9035527 207.70 204.4035530 338.8535533 459.65 489.8035536 525.25 487.8535539 408.50 382.1535542 507.70 447.4535545 241.65 257.05RMFSOut ofHospital %1 November 2012 – 31 october 2013 29

REPATRIATION MEDICAL FEE SCHEDULEItem35548 1,402.3535551 973.85RMFS InHospital %35554 60.25 60.9035557 269.15 300.3035560 859.2535561 1,749.4535562 1,612.7535564 744.5535565 877.7535566 623.5035568 889.3035569 196.80 225.2035570 788.7035571 788.7035572 149.1535573 1,209.2535577 1,158.3535578 984.4035595 1,946.9535596 973.8535597 2,214.8535599 948.6035602 1,116.1035605 521.10 512.3535608 91.10 89.6035611 91.10 89.6035612 720.50 708.4035613 576.6535614 90.95 89.5035615 76.70 75.2035616 660.0035617 330.00 243.2035618 330.00 305.2035620 76.05 74.7035622 859.0535623 1,158.4035626 116.50 115.9535627 152.75RMFSOut ofHospital %Item35630 242.90RMFS InHospital %35633 348.75 305.2035634 851.80 960.0035635 449.3035636 653.7535637 614.5035638 1,158.9535639 260.7535640 260.7535641 2,210.8535643 325.45 305.2035644 297.40 285.1535645 449.50 446.2035646 306.9535647 314.80 285.1535648 511.50 446.2035649 782.1035653 1,030.3535657 957.2035658 592.4535661 1,380.2535664 2,366.0035667 1,852.9035670 1,518.0535673 1,085.1535674 309.35 291.0035676 798.7535677 798.7535678 1,009.1035680 882.20 814.9035683 684.5535684 684.5535687 536.0035688 536.0035691 226.8535694 793.4035697 1,347.4035700 1,310.50RMFSOut ofHospital %30 1 November 2012 – 31 october 2013

ItemRMFS InHospital %35703 96.10 94.5035706 96.10 94.5035709 62.15 60.9035710 659.9035712 569.7535713 569.7535716 672.5035717 672.5035720 960.6035723 687.8035726 687.8035729 310.2035750 1,340.4535753 1,483.4535754 1,890.4535756 1,271.3535759 798.3536500 1,367.2536502 894.9536503 1,805.9536506 1,367.2536509 978.3036516 1,307.2036519 1,864.9036522 1,760.5536525 2,313.9036526 2,295.00 1,807.5536527 2,316.05 2,230.8036528 2,040.3036529 2,457.2536531 1,625.9036532 2,457.7036533 3,026.1536537 976.0036540 1,522.25 1,551.1536543 1,842.30 1,807.5536546 1,001.35 968.0036549 1,231.90RMFSOut ofHospital %Item36552 1,179.55RMFS InHospital %36558 960.90 909.7536561 208.25 241.5036564 1,366.5036567 1,761.4536570 2,018.4036573 1,310.3036576 1,655.4036579 1,096.4536585 1,096.4536588 1,275.8036591 1,708.1536594 1,367.2536597 1,367.2536600 1,878.65 1,551.1536603 1,859.4036604 395.95 374.7536605 1,017.8536606 3,424.2036607 1,289.5536608 394.5036609 932.3536612 794.7036615 1,096.4536618 960.9036621 703.2036624 825.25 781.3536627 932.2536630 547.8036633 906.20 1,038.1036636 591.4536639 1,262.3036642 615.9536645 1,734.0536648 1,417.3036649 395.95 374.7536650 220.7036652 842.25RMFSOut ofHospital %1 November 2012 – 31 october 2013 31

REPATRIATION MEDICAL FEE SCHEDULEItem36654 1,130.6036656 1,582.70RMFS InHospital %36658 750.15 737.0036660 364.15 357.6536662 869.70 854.4536663 942.05 925.3536664 845.95 831.0036665 178.70 175.6036666 475.95 467.6036667 222.85 218.8536668 222.85 218.8536800 35.50 38.6536803 634.65 652.9036806 898.4536809 1,269.3536811 437.95 452.8036812 205.75 233.4036815 308.75 333.1036818 409.00 387.2536821 478.05 452.5036824 315.30 298.4536825 719.2036827 340.00 321.8036830 300.6536833 409.00 387.2536836 297.40 321.8036840 462.65 452.5036842 401.4036845 938.65 968.0036848 340.0036851 329.7036854 689.6536857 559.7036860 439.90 233.4036863 759.7037000 1,096.4537004 960.9037008 615.95 583.05RMFSOut ofHospital %ItemRMFS InHospital %37011 138.05 130.7037014 1,576.5537020 1,096.4537023 615.9537026 615.9537029 1,647.8537038 1,023.1037041 69.05 65.2537042 1,346.9537043 935.6537044 987.5537045 2,112.5537047 2,037.8037050 1,096.4537053 1,266.8037200 1,643.4037201 1,568.5537202 615.25 582.5037203 1,560.5537206 825.2537207 1,281.3037208 615.2537209 1,909.1037210 3,067.5537211 3,530.90UR372 5,296.3037212 374.6537215 500.70 583.0537217 204.60 193.6537218 204.60 193.6537219 436.75 393.2037220 1,544.1037221 689.6537223 305.0537224 425.85 452.5037227 818.70 792.2037230 1,507.70 1,459.0537233 807.50 781.35RMFSOut ofHospital %32 1 November 2012 – 31 october 2013

ItemRMFS InHospital %37300 69.05 65.2537303 109.70 103.7037306 1,206.3037309 1,452.7037315 204.60 193.6537318 409.00 387.2537321 138.05 130.7037324 287.6037327 398.2537330 960.9037333 823.7037336 1,096.4537339 306.15 335.8037340 532.8037341 1,236.2037342 1,338.1037343 2,669.2537345 1,039.9037348 1,036.9537351 409.0037354 478.0537369 325.9037372 678.0537375 1,712.0537381 1,017.6037384 1,712.0537387 478.0537390 1,347.5037393 294.20 321.8037396 1,080.4537402 689.6537405 1,574.1537408 689.6537411 1,213.30 1,294.6037415 69.05 65.2537417 883.4537418 1,101.45 1,038.1037420 542.05RMFSOut ofHospital %Item37423 1,266.0537426 1,441.1037429 478.0537432 1,635.95RMFS InHospital %37435 127.30 130.7037438 376.05 387.2537444 1,478.15 1,399.5537601 379.40 387.2537604 405.20 387.2537605 547.15 522.8537606 812.35 776.4037607 1,367.2537610 2,530.7037613 398.65 387.2537616 1,223.8037619 409.00 387.2537622 345.00 270.5037623 345.00 321.8037800 713.9037803 699.1537806 808.75 843.1537809 780.8037812 684.2537815 137.2037818 726.70 688.0537821 1,092.6037824 1,770.0537827 951.6537830 965.00 968.0037833 488.1037836 1,027.7537839 1,139.4037842 2,261.0537845 1,027.7537848 1,849.6537851 1,370.5037854 453.5538200 585.75 623.60RMFSOut ofHospital %1 November 2012 – 31 october 2013 33

REPATRIATION MEDICAL FEE SCHEDULEItemRMFS InHospital %38203 980.40 744.2038206 844.85 899.7538209 1,084.70 1,155.2538212 1,804.20 1,921.4538213 537.30 572.2038215 583.25 496.9038218 826.90 745.1538220 291.70 248.4038222 583.25 496.9038225 874.85 745.3038228 1,114.20 993.9038231 1,458.05 1,242.1538234 1,066.50 993.6538237 1,458.00 1,242.1038240 1,599.70 1,490.4538241 586.65 657.6038243 583.25 621.0538246 1,375.55 1,242.1038256 351.45 374.1538270 1,199.40 1,277.2538272 1,199.40 1,277.2538275 392.15 417.5038285 253.8038286 228.4038287 2,592.60 2,937.8538290 3,512.4538293 3,498.20 4,015.3038300 677.60 721.5038303 868.80 925.1538306 1,002.35 1,067.3038309 1,164.15 1,239.6538312 1,488.70 1,585.3038315 1,598.40 1,702.2038318 2,085.45 2,220.9038350 839.7538353 336.0038356 1,100.8538358 4,146.25RMFSOut ofHospital %ItemRMFS InHospital %38359 193.20 187.0038362 506.10 538.9538365 319.2038368 1,529.6038371 359.70 403.0038384 1,314.95 1,473.7538387 359.70 403.0038390 1,383.85 1,473.7538393 378.50 403.0038415 577.40 559.1038418 1,162.5538421 2,036.9538424 1,385.7538427 1,710.9538430 881.9038436 361.1038438 2,008.7538440 1,658.6538441 2,426.4538446 1,710.9538447 1,944.2538448 524.9038449 2,892.5538450 1,238.6538452 829.4538453 2,214.6538455 3,365.1538456 1,908.2538457 1,908.8038458 1,014.6538460 398.4038462 433.2538464 479.0038466 1,320.2538468 2,053.9038469 2,083.7538470 1,385.7538473 829.45RMFSOut ofHospital %34 1 November 2012 – 31 october 2013

Item38475 1,202.7038477 2,896.3538478 1,403.0538480 2,717.5038481 3,358.6038483 2,487.9038485 1,181.3538487 2,496.4038488 2,760.7038489 3,283.2538490 801.6538493 2,830.2038496 902.1538497 2,618.3538498 2,933.6038500 3,190.3538501 3,169.9038503 3,471.0038504 3,541.0538505 401.0038506 2,351.1038507 2,760.2038508 3,259.5538509 3,160.7038512 2,556.9038515 4,144.7538518 4,146.3038550 3,102.8538553 4,248.0038556 4,289.7038559 3,596.9538562 4,426.4538565 5,126.1038568 2,269.1538571 2,966.3038572 2,872.7538577 801.6538588 601.60RMFS InHospital %RMFSOut ofHospital %Item38600 1,863.8538603 1,385.7538609 692.80RMFS InHospital %38612 955.10 751.9538613 974.7038615 2,030.2538618 2,760.7038621 1,102.4038624 1,148.7038627 923.6538637 801.6538640 1,385.7538643 1,543.1538647 3,085.9038650 2,494.4038653 2,760.7038654 1,617.6538656 1,257.2038670 2,760.2038673 3,164.1038677 2,906.3038680 3,447.35 3,338.4038700 1,414.1038703 2,781.6538706 2,453.9038709 3,085.9038712 3,705.5038715 2,466.9038718 3,085.9038721 2,162.4538724 2,567.0038727 2,114.6038730 3,085.9038733 2,102.9038736 3,085.9038739 2,781.6538742 2,781.6538745 2,603.05RMFSOut ofHospital %1 November 2012 – 31 october 2013 35

REPATRIATION MEDICAL FEE SCHEDULEItem38748 3,085.9038751 3,085.9038754 4,192.0038757 3,085.9038760 3,085.9038763 3,085.9038766 3,085.90RMFS InHospital %38800 55.80 53.9038803 111.20 107.7038806 193.20 187.0038809 238.05 230.4038812 302.55 292.8539000 103.05 105.4539003 122.15 119.9539006 306.85 223.2039009 84.7039012 338.8039013 152.30 152.8539015 536.0539018 536.0539100 328.65 332.6539106 1,617.7539109 727.05 621.2039112 2,642.0539115 92.15 105.4539118 442.80 417.0039121 900.60 884.4539124 2,304.8539125 448.8039126 516.0539127 636.5039128 930.7039130 917.3039131 200.40 178.9539133 227.4039134 485.6539135 225.0039136 227.40RMFSOut ofHospital %Item39137 803.4039138 909.7539139 1,565.55RMFS InHospital %39140 422.85 410.0039300 503.9039303 765.1539306 1,000.3539309 1,018.3539312 529.9039315 1,595.4539318 1,121.4539321 618.3039323 356.55 387.5539324 394.50 387.5539327 675.7039330 367.2039331 446.85 387.5539333 568.15 558.0039500 1,811.8539503 1,663.0039600 696.4039603 1,582.8039606 1,015.7039609 1,197.4539612 1,597.4039615 1,752.4539640 5,538.1539642 4,523.7039646 5,208.4039650 4,766.9039653 6,704.4539654 4,876.0039656 4,641.3539658 5,313.3039660 4,321.8039662 4,321.8039700 793.6039703 739.80RMFSOut ofHospital %36 1 November 2012 – 31 october 2013

Item39706 1,586.4539709 2,504.8539712 4,530.6539715 3,444.0539718 1,243.6539721 1,039.4039800 4,190.3039803 4,175.9039806 1,793.9539812 900.60RMFS InHospital %39815 2,604.90 2,558.1539818 2,853.3039821 2,999.1039900 739.8039903 2,530.8539906 1,075.7540000 1,307.9040003 1,279.9540006 954.1040009 699.8540012 1,609.9040015 910.6040018 195.75 223.2040100 986.3040103 1,232.5540106 1,861.3540109 1,689.9540112 1,937.0540115 1,029.2540118 1,648.1040300 1,486.7040301 1,714.9540303 1,989.0040306 2,333.4540309 1,666.5040312 2,685.9040315 2,782.9540316 3,257.45RMFSOut ofHospital %Item40318 3,487.6040321 1,554.3540324 911.3040327 911.3040330 1,361.5040331 1,361.5040332 2,658.9540333 1,136.3540334 1,615.1040335 3,064.5540336 450.6040339 2,261.9540342 2,499.1040345 1,885.8040348 2,470.6540351 2,470.6540600 1,361.5040700 2,714.3040703 2,011.15RMFS InHospital %40706 3,211.05 3,000.3540709 739.8040712 1,490.0040800 799.40 894.1540801 3,263.3540803 1,704.50 1,674.0040850 3,898.4040851 6,692.6040852 629.4540854 977.0540856 366.0040858 789.3040860 3,655.9040862 266.05 265.6040903 790.5040905 838.95 842.4041500 128.55 115.5041503 371.90 334.3541506 193.50 201.60RMFSOut ofHospital %1 November 2012 – 31 october 2013 37

REPATRIATION MEDICAL FEE SCHEDULEItemRMFS InHospital %41509 273.30 228.1541512 911.9541515 598.6041518 1,329.7541521 1,455.3041524 444.6541527 868.5041530 1,388.2541533 1,877.7541536 1,814.0041539 1,545.1541542 1,966.5541545 811.2541548 1,076.8041551 2,498.4041554 3,317.8541557 1,696.3041560 1,867.3041563 2,300.9541564 3,261.8541566 1,455.8541569 1,675.9041572 1,607.8041575 3,790.9041576 6,176.7541578 3,790.9041579 3,038.9041581 5,101.6041584 2,883.5541587 3,504.6041590 1,721.7541593 2,422.7041596 2,707.3541599 2,485.9041603 661.70 705.4041604 245.00 261.1041608 2,055.8041611 1,091.60RMFSOut ofHospital %ItemRMFS InHospital %41614 1,802.45 1,525.9041615 1,426.90 1,525.9041617 2,884.2541620 1,218.5541623 1,779.9041626 224.20 201.6041629 634.0041632 353.15 334.3541635 1,543.90 1,602.0541638 2,364.1541641 74.05 66.4541644 242.35 199.9541647 171.15 153.9041650 144.95 153.9041653 112.25 100.7541656 196.40 172.0041659 99.80 108.6041662 128.55 115.5041665 342.2541668 342.2541671 802.9541672 1,031.0041674 156.55 140.7041677 140.15 126.0041680 253.90 228.1541683 182.45 164.1041686 112.25 100.7541689 212.5541692 277.2541695 155.50 140.0041698 50.60 45.6041701 143.4041704 56.75 50.8541707 698.1541710 888.8541713 1,130.7041716 460.3041719 164.80 164.60RMFSOut ofHospital %38 1 November 2012 – 31 october 2013

ItemRMFS InHospital %41722 914.80 822.6541725 698.1541728 1,418.9041729 861.7041731 1,445.6541734 1,656.5541737 752.1041740 91.6041743 525.3041746 1,209.60 1,087.9541749 944.1041752 460.3041755 72.50 65.1041758 183.10 164.6041761 191.10 172.0041764 191.10 172.0041767 1,196.95 1,031.8041770 1,048.7541773 872.9041776 822.7041779 1,099.6041782 1,362.7541785 1,838.45 1,653.6541786 1,116.1041787 823.4041788 564.60 307.9541789 564.6041792 623.7541793 623.7541796 194.1541797 194.1541800 253.9041801 253.9041804 140.1541807 96.90 98.1541810 55.55 49.8541813 477.4041816 289.10 259.85RMFSOut ofHospital %ItemRMFS InHospital %41819 473.10 488.5541820 608.15 586.2541822 371.9041825 570.6041828 81.40 73.1041831 486.85 499.8041832 355.45 319.9041834 2,362.3541837 1,835.0041840 2,568.9041843 2,080.0041846 289.10 259.8541849 417.5041852 447.0541855 447.0541858 747.8541861 905.0041864 651.9041867 896.7041868 588.4541870 639.3541873 914.80 822.6541876 739.05 822.6541879 1,584.7541880 306.3041881 625.3041884 128.8041885 349.0541886 277.25 249.3041889 277.25 249.3041892 365.90 329.1041895 493.00 514.8541898 340.00 359.7541901 794.5041904 323.95 345.1041905 647.4041907 191.10 172.0041910 607.50RMFSOut ofHospital %1 November 2012 – 31 october 2013 39

REPATRIATION MEDICAL FEE SCHEDULEItem42503 163.70RMFS InHospital %42506 777.85 673.7542509 972.9542510 983.7542512 685.80 673.7542515 901.1542518 478.0542521 1,731.5542524 291.35 286.4542527 578.1542530 842.0042533 597.5042536 1,183.7542539 2,015.6542542 705.2042543 1,272.1542545 2,013.2042548 1,081.4542551 844.85 884.4542554 1,027.3542557 1,368.4042563 738.95 726.6042569 1,466.9042572 185.45 164.3042573 343.00 318.4542574 729.70 676.5542575 121.65 115.8542581 167.30 164.3042584 394.10 387.5542587 74.25 72.7542590 432.55 473.7042593 344.8542596 717.80 705.4042599 835.55 884.4542602 899.90 884.4542605 663.65 652.5542608 491.50 421.0542610 142.75 134.75RMFSOut ofHospital %ItemRMFS InHospital %42611 199.30 202.1042614 69.10 67.6542615 109.25 101.1542617 195.05 191.7542620 65.10 73.7542621 75.20 73.7542622 117.90 115.8542623 1,243.9542626 1,633.30 1,579.3042629 1,152.0042632 153.95 164.3042635 401.70 421.0542638 551.20 526.4042641 716.70 684.2542644 102.80 101.0542647 260.50 286.4542650 102.80 101.0542651 250.20 225.1542653 2,068.3042656 2,457.9542659 1,580.40 1,263.2542662 1,183.5042665 833.50 842.3542667 183.80 198.7542668 97.70 105.4542672 1,302.65 1,263.2542673 642.40 631.5542676 168.40 162.0042677 86.85 85.3542680 428.40 421.0542683 179.2042686 389.70 383.1542689 167.30 164.3042692 344.70 387.5542695 629.45 631.5542698 1,002.40 832.6542701 573.00 464.4042702 1,366.90 1,064.95RMFSOut ofHospital %40 1 November 2012 – 31 october 2013

ItemRMFS InHospital %42703 815.45 800.9042704 719.75 652.5542707 980.90 1,115.9542710 1,284.95 1,263.2542713 525.85 526.4042716 1,505.25 1,674.0042718 1,439.20 1,334.3042719 650.95 726.6042725 2,075.1542731 2,144.6542734 428.40 421.0542737 428.40 421.0542738 428.40 421.0542739 428.40 421.0542740 428.40 421.0542741 428.40 421.0542743 830.75 884.4542744 427.95 420.8042746 1,495.3542749 1,717.2542752 1,771.2042755 235.95 231.6542758 1,011.7542761 722.55 726.6042764 636.05 726.6042767 1,880.9542770 391.25 412.7542773 1,284.95 1,263.2542776 1,905.9542779 2,353.4542782 713.00 631.5542783 642.40 631.5542785 488.70 494.7042786 503.35 494.7042788 439.35 494.7042789 503.35 494.7042791 459.30 494.7042792 503.35 494.70RMFSOut ofHospital %ItemRMFS InHospital %42794 96.40 94.7542797 96.40 94.7542801 1,375.2542802 687.3542805 835.05 821.1042806 503.35 494.7042807 506.70 498.1542808 575.50 498.1542809 642.40 631.5542810 808.55 794.8042811 642.40 631.5542812 219.10 231.6542815 899.9042818 716.60 821.1042821 128.60 126.5042824 99.75 97.9042833 939.2042836 1,120.0542839 1,041.3042842 1,132.1042845 255.75 265.2042848 1,176.3042851 1,239.6542854 578.15 568.5042857 529.50 568.5042860 1,335.35 1,263.2542863 1,129.65 1,084.4042866 1,044.20 1,052.6042869 781.45 768.6042872 446.40 337.0043021 546.15 637.1043022 655.55 764.6543023 104.05 123.9043500 175.7543503 247.2043506 462.6543509 507.6043512 496.65RMFSOut ofHospital %1 November 2012 – 31 october 2013 41

REPATRIATION MEDICAL FEE SCHEDULEItemRMFS InHospital %43515 518.85 498.9043518 738.2543521 661.2543524 815.35 822.6543801 1,235.5543804 1,395.3543807 1,341.1043810 1,677.7543813 2,024.4543816 2,041.1043819 1,333.1543822 1,331.4543825 1,737.2043828 1,537.7543831 1,231.4543834 1,456.6543837 1,672.7543840 1,613.0543843 2,640.6043846 2,727.3543849 642.0043852 2,122.65 2,270.2043855 2,244.0043858 824.80 843.1543861 2,151.5543864 1,603.2543867 951.6043870 1,333.1543873 1,588.2043876 1,507.2543879 1,776.4043882 2,283.80 2,335.3043900 1,522.3543903 2,537.3543906 2,220.2043909 2,220.2043912 2,195.95RMFSOut ofHospital %43915 1,578.90 1,621.65Item43930 572.0543933 699.1543936 1,248.5543939 956.85RMFS InHospital %43942 317.30 324.4043945 1,284.4043948 216.05 194.7543951 1,195.9043954 1,362.4043957 1,586.0543960 511.0543963 2,146.9543966 2,270.5543969 3,488.9543972 2,287.6543975 2,988.1043978 2,537.3543981 697.9043984 1,776.4043987 1,967.1543990 2,163.9543993 2,601.00 2,659.5543996 2,602.20 2,983.9043999 326.4044102 352.3044105 62.10 63.1544108 623.5544111 740.25 805.9544114 817.1044130 581.70 648.6544133 568.3044136 218.85 237.3044325 421.40 414.0044328 480.0044331 816.6544334 1,703.25 1,671.9544338 192.95 201.6044342 266.05RMFSOut ofHospital %42 1 November 2012 – 31 october 2013

Item44346 382.40RMFS InHospital %44350 400.70 403.5044354 458.4044358 241.8044359 346.8544361 580.7544364 428.9544367 688.4544370 1,000.9544373 2,054.45 2,069.8044376 D D45000 745.55 757.9045003 906.70 842.3545006 1,465.4545009 539.8545012 869.6545015 428.4045018 674.50 663.1545019 561.5545020 564.9545021 252.75 248.3045024 567.50 558.0045025 271.95 248.3045026 612.35 558.0045027 171.5045030 163.95 180.9545033 361.15 337.0045035 1,057.6045036 1,615.5045039 297.15 337.0045042 547.75 431.8045045 439.15 431.8045048 1,055.9045051 625.4545054 350.3545200 342.85 398.1045203 588.35 568.5045206 514.80 537.00RMFSOut ofHospital %ItemRMFS InHospital %45207 502.60 537.0045209 658.40 663.2545212 331.80 329.1045215 1,443.9545218 604.4045221 372.50 366.2045224 206.15 164.6045227 635.00 623.6045230 270.00 311.8545233 634.35 663.2545236 527.5045239 372.50 366.2045240 342.65 366.2045400 291.60 286.6045403 614.45 570.5045406 603.80 631.5545409 750.7545412 1,329.3045415 1,284.9545418 1,214.8545439 404.90 398.1045442 756.55 821.1045445 748.35 779.2545448 481.85 526.4045451 672.80 663.2545460 1,783.5045461 1,271.2045462 959.3545464 2,650.7545465 1,939.55 1,908.2045466 1,462.55 1,439.1545468 2,607.9045469 1,967.40 1,935.8045471 3,277.80 3,225.1545472 2,472.70 2,432.6545474 3,946.20 3,882.6545475 2,977.55 2,929.4545477 4,614.55 4,540.20RMFSOut ofHospital %1 November 2012 – 31 october 2013 43

REPATRIATION MEDICAL FEE SCHEDULEItemRMFS InHospital %45478 3,480.80 3,424.5045480 5,282.90 5,197.6545481 3,985.70 3,921.5545483 6,018.85 5,921.9545484 4,541.35 4,468.1045485 1,005.3545486 642.4045487 531.60 568.5045488 642.4045489 1,119.70 947.5545490 1,285.0545491 1,606.1045492 1,726.3045493 488.5045494 2,333.15 2,294.2045496 592.0045497 462.6545498 372.5045499 277.6545500 1,781.5045501 2,695.1545502 2,528.5045503 2,891.1045504 3,265.0045505 2,528.5045506 271.65 307.9545512 413.05 414.0045515 266.05 261.1045518 310.25 316.0045519 610.8545520 1,282.1545522 1,164.35 884.4545524 1,056.1545527 1,325.9545528 1,583.7045530 1,565.5045533 1,772.6045536 651.85RMFSOut ofHospital %Item45539 1,844.4045542 961.25RMFS InHospital %45545 843.50 871.6045546 281.80 277.0045548 438.90 387.5545551 631.8045552 1,172.30 894.1545553 843.00 894.1545554 995.95 979.2545555 909.6045556 1,090.45 1,072.5045557 1,090.4545558 1,635.8545559 1,500.25 1,591.5545560 674.50 663.1545561 2,526.9045562 1,565.50 1,539.2045563 1,663.45 1,539.2045564 4,080.0545565 2,673.6045566 1,530.2045568 640.3045569 894.2545570 1,207.40 1,280.9545572 415.30 408.4045575 1,025.55 1,008.3045578 1,187.7545581 394.10 387.5545584 899.65 884.4545585 899.65 884.4545586 899.6545587 1,268.55 1,247.2045588 1,836.2545590 766.3545593 790.9545596 1,627.1045597 1,716.3045599 1,333.65 1,311.20RMFSOut ofHospital %44 1 November 2012 – 31 october 2013

Item45602 995.9545605 836.9045608 1,366.2045611 674.70RMFS InHospital %45614 808.85 822.6545617 334.85 329.1045620 574.80 456.5045623 1,083.50 1,012.3045624 1,413.00 1,312.4045625 323.6545626 464.40 456.5045629 906.80 663.2545632 895.80 716.7545635 836.90 822.6545638 1,443.95 1,419.7045639 1,822.50 1,419.7045641 1,552.90 1,516.1045644 2,258.40 1,791.2545645 318.6045646 1,221.85 1,260.6545647 1,657.0545650 210.75 206.9545652 507.35 498.9045653 658.15 498.9045656 764.70 703.1545659 742.25 729.7545660 4,791.4045661 2,054.5045662 998.6545665 453.95 456.5045668 396.30 456.5045669 500.65 456.5045671 1,575.20 1,167.7045674 359.80 339.6045675 688.2045676 819.4045677 771.0045680 1,051.80RMFSOut ofHospital %Item45683 1,023.8045686 1,146.1545689 372.65RMFS InHospital %45692 374.85 421.0545695 713.2045698 653.7545701 1,353.9045704 428.40 421.0545707 1,465.3545710 695.9545713 792.6545714 1,161.0545716 1,386.9545720 1,376.55 1,353.5545723 2,056.2545726 1,915.8045729 2,432.7045731 1,972.0045732 2,627.6045735 2,411.1045738 2,593.6045741 2,412.7045744 2,861.6045747 2,753.00 2,707.0045752 3,485.5545753 3,034.35 3,050.0545754 3,718.5045755 523.70 514.8545758 937.1545761 1,044.1045767 3,576.25 3,516.3545770 2,739.5045773 2,496.70 2,454.8045776 2,496.7045779 2,419.2045782 1,229.30 1,380.0045785 2,756.1045788 2,347.95RMFSOut ofHospital %1 November 2012 – 31 october 2013 45

REPATRIATION MEDICAL FEE SCHEDULEItem45791 1,268.5545794 957.6045797 266.05RMFS InHospital %45799 42.15 41.2545801 171.05 177.7045803 465.00 456.5045805 246.05 241.5045807 351.60 345.1045809 558.40 520.1045811 716.40 703.1545813 838.15 822.6545815 523.60 498.9045817 662.50 650.3045819 821.70 822.6045821 543.05 533.1545823 155.3045825 467.20 473.7045827 461.20 452.8045829 351.45 345.4045831 399.85 452.8045833 578.95 568.5045835 718.60 705.4045837 1,089.70 821.1045839 836.35 821.1045841 676.55 663.1545843 414.30 406.7045845 718.60 705.4045847 266.05 261.1045849 828.25 813.3045851 203.9045853 1,270.45 1,247.2045855 582.75 572.2045857 931.40 915.3545859 469.65 461.4545861 1,244.05 1,221.2545863 1,378.95 1,353.8045865 414.30 406.7045867 445.65 437.25RMFSOut ofHospital %ItemRMFS InHospital %45869 1,694.40 1,663.5045871 1,908.75 1,873.8545873 2,144.80 2,105.7045875 670.10 659.0045877 670.10 659.0045879 445.65 437.2545882 61.30 60.2045885 632.40 621.2045888 589.35 579.0045891 858.60 843.4545894 291.80 286.6045897 1,523.65 1,496.7545900 343.75 337.6545939 637.20 625.9545945 169.40 166.2045975 184.15 180.9045978 224.95 221.0045981 122.10 119.9545984 878.85 863.3545987 878.85 863.3545990 1,200.25 1,179.1545993 1,200.25 1,179.1545996 340.40 334.3546300 444.6546303 574.6046306 898.2546307 883.4546309 944.8046312 1,186.8546315 1,400.8546318 1,932.3046321 2,388.85 1,895.5046324 1,277.5546325 1,425.8046327 289.40 284.4546330 496.6046333 912.4046336 373.60 368.65RMFSOut ofHospital %46 1 November 2012 – 31 october 2013

ItemRMFS InHospital %46339 689.85 652.7046342 663.9546345 754.2546348 382.55 342.2546351 631.1546354 851.7046357 1,022.8046360 1,035.2046363 297.75 294.8546366 182.40 179.1046369 299.95 294.8546372 736.65 599.1546375 903.50 710.8046378 1,147.3046381 428.4046384 428.4046387 982.85 868.8546390 1,282.2546393 1,715.2046396 426.10 461.4546399 824.2546402 742.9546405 899.8546408 1,075.0046411 578.4046414 749.50 737.0046417 661.6546420 291.35 286.4546423 466.50 458.0546426 481.7546429 624.05 579.1546432 647.3546435 849.9546438 226.45 189.6546441 465.90 458.0546442 438.2046444 880.8546447 997.70RMFSOut ofHospital %Item46450 321.4046453 451.55RMFS InHospital %46456 139.25 136.9546459 259.85 263.3046462 393.20 421.1546464 331.75 316.0046465 283.25 316.0046468 562.3546471 803.30 789.7046474 1,044.2546477 1,285.0546480 581.45 526.5546483 500.50 421.1546486 321.4046489 383.6546492 514.4546494 312.25 307.9546495 289.40 284.4546498 312.50 307.9546500 397.90 368.6546501 484.95 460.9046502 495.85 424.1546503 512.25 529.8046504 1,739.55 1,547.8046507 1,763.8046510 518.9546513 80.90 79.1046516 167.9046519 226.80 197.7546522 635.8046525 74.4046528 236.60 237.3046531 121.25 119.2546534 291.00 329.7047000 104.70 98.9547003 102.90 118.7547006 251.90 238.3547009 257.75 237.30RMFSOut ofHospital %1 November 2012 – 31 october 2013 47

REPATRIATION MEDICAL FEE SCHEDULEItem47012 501.40RMFS InHospital %47015 102.85 118.7547018 279.10 276.6547021 389.9047024 331.40 276.6547027 398.1547030 316.25 276.6547033 389.90 369.0547036 107.75 118.7547039 167.90 158.0047042 163.00 158.0047045 222.90 211.0547048 441.05 454.7547051 610.4047054 427.90 454.7547057 165.85 177.8047060 250.60 237.3047063 375.95 355.9047066 501.4047069 104.70 98.9547072 125.45 131.6047300 125.70 118.7547303 128.40 138.5047306 167.90 158.0047309 216.35 197.7547312 231.70 177.8047315 213.20 204.3547318 250.60 237.3047321 310.6047324 277.05 237.3047327 292.40 276.6547330 405.85 316.4047333 418.6547336 311.00 237.3047339 310.40 276.6547342 375.40 316.4047345 453.3047348 139.20 131.60RMFSOut ofHospital %ItemRMFS InHospital %47351 425.50 329.7047354 250.60 237.3047357 626.80 527.2047360 195.05 184.6047363 263.00 276.6547366 403.75 369.0547369 224.75 237.3047372 450.10 395.3047375 556.6047378 284.35 237.3047381 391.1547384 506.5547385 488.8047386 666.9047387 475.40 382.1547390 624.5047393 794.9047396 279.05 263.5047399 584.2547402 417.50 395.3047405 279.05 263.5047408 544.7547411 153.10 158.0047414 334.25 316.4047417 388.65 369.0547420 765.9047423 319.35 303.1047426 488.9047429 640.4547432 682.4547435 608.90 579.9547438 974.7547441 1,420.5547444 353.20 316.4047447 524.1047450 583.7547451 791.3047453 370.25 369.05RMFSOut ofHospital %48 1 November 2012 – 31 october 2013

Item47456 630.5547459 789.05RMFS InHospital %47462 156.45 158.0047465 333.50 316.4047466 167.90 158.0047467 322.4547468 640.45 606.1547471 63.60 60.2047474 259.95 263.5047477 324.10 329.7047480 871.3547483 807.8047486 1,298.4547489 2,088.2547492 341.00 329.7047495 759.80 659.0047498 1,122.5547501 1,432.9047504 2,481.30 1,977.1047507 2,408.6047510 2,582.5547513 556.8547516 589.15 606.1547519 1,415.9547522 1,104.8047525 1,324.6547528 1,096.7547531 1,448.2547534 1,612.6047537 598.70 606.1547540 320.10 303.1047543 335.45 316.4047546 501.40 474.4047549 609.3047552 555.20 527.2047555 945.0547558 1,275.0047561 469.80 382.15RMFSOut ofHospital %ItemRMFS InHospital %47564 650.90 573.4047565 1,091.2047566 1,398.4047567 723.65 665.5047570 923.60 764.4047573 1,171.9547576 136.75 158.0047579 223.95 224.1047582 418.9547585 665.5547588 2,160.2547591 2,787.4547594 293.90 303.1047597 506.95 454.7547600 660.3047603 873.8047606 309.05 329.7047609 522.10 494.3047612 524.80 573.4047615 691.40 659.0047618 833.5047621 770.55 573.4047624 1,012.8547627 236.90 224.1047630 444.50 474.4047633 164.60 158.0047636 274.40 237.3047639 315.60 316.4047642 222.90 211.0547645 336.15 316.4047648 427.8047651 348.15 329.7047654 522.10 494.3047657 856.9547663 208.80 197.7547666 299.55 329.7047672 165.30 158.0047678 250.60 237.30RMFSOut ofHospital %1 November 2012 – 31 october 2013 49

REPATRIATION MEDICAL FEE SCHEDULEItemRMFS InHospital %47681 63.60 60.2047684 1,112.70 1,054.5547687 1,949.0047690 1,407.9047693 1,610.7547696 519.6547699 2,531.3047702 3,051.3547703 63.60 60.2047705 417.5047708 320.10 303.1047711 452.8547714 355.0547717 626.8047720 626.80 593.2547723 626.80 593.2547726 208.8047729 348.1547732 556.8547735 66.00 60.3047738 390.50 329.7047741 732.0547753 601.5047756 590.8047762 453.70 334.3547765 643.2547768 649.2047771 993.5547774 644.2547777 644.2547780 710.1047783 837.45 792.9047786 1,190.9547789 1,063.2547900 238.50 237.3047903 319.55 329.7047904 83.90 79.1047906 135.95RMFSOut ofHospital %ItemRMFS InHospital %47912 83.90 79.1047915 237.15 237.3047916 118.25 119.2547918 321.90 329.7047920 563.2047921 167.90 158.0047924 55.95 52.7547927 193.6547930 325.4547933 306.40 289.8047936 375.9547948 245.2547951 279.05 263.5047954 550.10 527.2047957 417.5047960 195.05 184.6047963 320.10 303.1047966 640.4547969 389.9047972 311.4547975 545.8547978 371.2047981 222.45 210.8047982 500.2048200 1,113.9048203 1,404.8548206 836.2048209 1,072.1048212 836.2048215 1,030.9048218 982.1048221 1,410.3548224 556.8548227 733.3548230 702.0548233 1,130.0548236 1,180.6548239 654.30RMFSOut ofHospital %50 1 November 2012 – 31 october 2013

Item48242 1,123.6548400 413.2048403 738.8048406 487.4548409 742.4048412 806.9048415 1,179.4548418 769.7548421 1,431.6548424 952.1548427 1,267.2048500 476.3548503 467.5548506 654.1048509 302.2048512 1,664.6048600 139.2048603 208.8048606 2,304.7048612 4,214.2048613 5,473.3048615 589.0048618 3,594.9048621 2,367.0048624 2,923.9548627 4,373.5548630 4,594.6048632 2,161.35RMFS InHospital %48636 1,069.10 1,133.4048639 1,815.5548640 5,532.3548642 1,183.5048645 1,601.1048648 1,601.1048651 2,315.8048654 1,601.1048657 2,635.6548660 1,900.70RMFSOut ofHospital %Item48663 1,197.2048666 778.0548669 2,158.0048672 1,320.5548675 868.1048678 836.2048681 1,392.2548684 1,392.2548687 1,949.0048690 2,227.60RMFS InHospital %48691 2,399.25 2,511.1548692 1,617.20 1,692.5548693 782.25 818.6048694 1,900.7048900 406.05 395.3048903 749.1048906 691.9548909 1,322.3048912 487.45 461.4548915 1,254.7048918 2,736.1548921 2,700.2548924 2,917.5048927 542.9048930 1,283.3048933 1,815.5048936 1,191.7048939 1,623.0048942 2,167.8048945 403.8048948 860.7048951 1,548.4548954 1,734.8548957 1,878.4048960 1,608.2049100 487.4549103 1,252.3549106 1,449.00 1,318.05RMFSOut ofHospital %1 November 2012 – 31 october 2013 51

REPATRIATION MEDICAL FEE SCHEDULEItem49109 1,231.8049112 1,031.2049115 1,849.9049116 2,128.6049117 2,554.1049118 403.8049121 965.3049200 1,322.5549203 979.0049206 835.3549209 1,278.0049210 1,419.3049211 1,703.1549212 348.1549215 1,118.1549218 439.0549221 1,102.5049224 1,162.0049227 1,287.6049300 821.5049303 747.3549306 1,733.3049309 1,047.4049312 1,715.1549315 1,301.6049318 2,206.5049319 4,305.2549321 2,576.6549324 2,738.6549327 3,421.4549330 3,354.8049333 3,987.2049336 529.0049339 4,509.8549342 4,641.5549345 4,608.0549346 1,261.5049360 481.10RMFS InHospital %RMFSOut ofHospital %ItemRMFS InHospital %49363 556.75 579.9049366 974.9549500 556.8549503 688.5549506 1,116.8049509 1,113.9049512 1,558.9049515 1,443.8549517 2,092.0549518 2,219.4049519 3,948.6549521 2,634.7549524 3,049.5549527 2,568.4049530 2,943.7549533 3,354.5049534 730.1049536 1,537.3049539 1,710.3549542 2,341.2049545 1,113.9049548 1,380.1049551 2,295.8549554 2,482.7549557 401.2549558 459.5049559 679.6049560 939.3549561 1,143.7549562 1,297.1049563 1,303.6049564 1,554.1049566 1,215.9049569 978.2549700 403.8049703 1,029.6549706 487.4549709 1,044.20RMFSOut ofHospital %52 1 November 2012 – 31 october 2013

Item49712 1,362.7549715 1,950.7049716 1,993.0049717 2,391.5549718 618.45RMFS InHospital %49721 348.15 329.7049724 1,109.6549727 417.5049728 754.7549800 195.05 184.6049803 224.45 237.3049806 195.05 184.6049809 320.1049812 640.4549815 1,341.4049818 387.7049821 656.4549824 1,262.1049827 696.1049830 1,218.3049833 801.2549836 1,488.3549837 957.2549838 2,008.8549839 765.9049842 1,713.6549845 728.9049848 236.90 224.1049851 306.4049854 578.4049857 538.2049860 417.5049863 626.8049866 452.5049878 83.90 79.1050100 344.20 382.1550102 1,010.0050103 487.45RMFSOut ofHospital %ItemRMFS InHospital %50104 462.00 437.2550106 599.9550109 696.1050112 444.3050115 197.2550118 640.4550121 1,253.1550127 1,107.9550130 462.0050200 278.50 263.5050201 486.8550203 653.05 579.9550206 1,019.5550209 1,050.3550212 2,370.6050215 2,534.3050218 4,134.1050221 3,536.8550224 4,742.50 3,954.1050227 5,043.3050230 2,675.2550233 3,354.9550236 2,329.5050239 1,661.9550300 1,412.6550303 2,337.3550306 3,649.40 3,455.1050309 379.9550312 1,066.3550315 995.2050318 1,179.4550321 1,406.2550324 2,050.0550327 2,693.5050330 298.2550333 939.5550336 1,376.2550339 830.50RMFSOut ofHospital %1 November 2012 – 31 october 2013 53

REPATRIATION MEDICAL FEE SCHEDULEItem50342 1,067.4550345 451.9550348 298.60RMFS InHospital %50349 473.45 448.2550351 2,361.0050352 92.55 79.1050353 549.3550354 1,937.50 1,834.2550357 830.5050360 1,001.0050363 738.2550366 1,309.0050369 963.6550372 1,645.5050375 738.2550378 1,291.8050381 963.6550384 1,809.3050387 963.6550390 338.3550393 1,250.7050394 4,698.0050396 760.0550399 1,363.5550402 672.3550405 1,021.3550408 1,619.9550411 1,937.50 1,834.2550414 2,613.95 2,474.6550417 1,937.50 1,834.2550420 1,599.3050423 1,476.35 1,397.5550426 752.7050450 1,676.6050451 1,676.6050455 1,898.5550456 1,898.5550460 2,834.55RMFSOut ofHospital %Item50461 2,834.5550465 3,992.4050466 3,992.4050470 5,063.3550471 5,063.3550475 5,842.6050476 5,842.60RMFS InHospital %50500 378.05 387.3550504 504.40 516.7050508 540.20 553.3550512 720.7050516 486.40 498.2050520 648.3550524 558.2550528 900.5050532 783.6050536 1,044.5550540 720.7050544 360.30 369.0550548 720.7050552 621.5050556 828.3050560 648.3550564 864.6550568 756.7050572 1,008.7050576 828.30 848.7050580 864.6550584 828.3050588 1,080.6050600 594.10 608.6050604 2,521.2550608 4,682.8050612 6,660.6550616 846.4050620 4,682.8050624 4,682.8050628 5,784.45RMFSOut ofHospital %54 1 November 2012 – 31 october 2013

Item50632 4,862.7050636 5,403.0050640 2,986.8050644 2,881.70RMFS InHospital %50650 566.85 580.6550654 678.8550658 270.25 276.8550950 1,208.55 1,143.9550952 1,208.55 1,143.9551300 124.75 120.8551303 D D51306 203.60 174.5551309 D D51312 D D51315 385.40 381.4051318 241.65 251.6551700 113.85 119.8051703 63.50 60.2051800 123.05 120.8551803 D D51900 413.95 456.5051902 115.70 103.5051904 621.80 636.8051906 986.70 968.4552000 117.75 115.5052003 167.70 164.6052006 167.70 164.6052009 255.90 259.8552010 309.80 355.6052012 33.55 32.9052015 156.90 153.9052018 354.70 387.5552021 42.15 41.2552024 74.55 73.1052025 262.35 257.5052027 274.70 209.6552030 123.20 126.0052033 258.35 257.50RMFSOut ofHospital %ItemRMFS InHospital %52034 61.25 60.2052035 679.00 666.5552036 170.90 177.7052039 411.35 456.5052042 246.05 241.5052045 307.60 345.1052048 547.55 520.1052051 642.20 703.1552054 1,023.45 822.6552055 38.3052056 43.45 38.3052057 209.8552058 338.90 332.6552059 381.75 374.7552060 246.60 265.2052061 318.95 313.0552062 421.85 414.0052063 512.00 498.9052064 312.10 237.3052066 635.30 623.6052069 377.90 277.9052072 83.95 82.3552073 213.65 209.6552075 210.35 209.6552078 520.60 414.0052081 66.45 65.1052084 162.35 167.3052087 333.95 286.6052090 463.35 498.9052092 662.50 650.3052094 804.90 822.6052095 543.05 533.1552096 161.15 158.0052097 280.90 224.1052098 268.55 263.5052099 178.50 197.7552102 201.5552105 376.05 369.05RMFSOut ofHospital %1 November 2012 – 31 october 2013 55

REPATRIATION MEDICAL FEE SCHEDULEItem52106 208.00RMFS InHospital %52108 442.45 456.5052111 481.15 456.5052114 933.65 822.6552117 1,154.45 979.2552120 1,175.85 1,158.2552122 1,347.75 1,158.2552123 1,335.65 1,311.2052126 1,284.10 1,260.6552129 1,718.85 1,687.6052130 661.95 619.4552131 947.60 856.7052132 340.75 348.5552133 129.85 127.5052135 195.5052138 635.30 628.0052141 648.30 621.2052144 589.75 579.0052147 556.60 546.3552148 983.70 965.7552158 1,583.80 1,554.9552180 327.95 263.5052182 647.20 579.9552184 951.05 856.7052186 1,074.20 1,054.5552300 352.45 398.1052303 578.95 568.5052306 859.25 843.4552309 292.00 286.6052312 405.60 398.1052315 628.55 663.2552318 201.55 197.7552319 335.40 329.7052321 678.05 663.2552324 675.75 663.2552327 335.40 329.1052330 1,315.25 1,094.75RMFSOut ofHospital %52333 1,115.20 1,094.75ItemRMFS InHospital %52336 670.30 684.2552337 1,335.30 1,496.7552339 793.95 779.2552342 1,513.20 1,353.5552345 1,554.75 1,526.5052348 2,096.45 1,724.9052351 1,973.15 1,937.1552354 2,116.80 1,963.8052357 3,018.85 2,210.9052360 2,297.40 2,255.5052363 2,584.45 2,537.4052366 2,527.35 2,481.2552369 2,841.60 2,789.8052372 2,757.30 2,707.0052375 3,088.40 3,032.0552378 1,258.30 1,048.1552379 1,747.90 1,791.2552380 3,106.85 3,050.0552382 3,724.15 3,656.2552420 344.05 337.6552424 675.50 663.1552430 1,554.75 1,526.5052440 772.05 757.9052442 965.30 947.5552444 1,072.30 1,052.6052446 1,265.55 1,242.5052450 429.00 421.0552452 697.00 684.2552456 1,179.65 1,158.2552458 429.00 421.0552460 1,115.20 1,094.7552480 716.40 703.1552482 689.15 676.5552484 820.40 805.4552600 489.45 473.7052603 391.85 452.8052606 351.45 345.4052609 461.20 452.80RMFSOut ofHospital %56 1 November 2012 – 31 october 2013

ItemRMFS InHospital %52612 578.95 568.5052615 718.60 705.4052618 772.00 821.1052621 836.35 821.1052624 845.50 663.1552626 414.30 406.7052627 707.25 705.4052630 266.05 261.1052633 718.60 705.4052636 288.95 261.1052800 394.60 387.5552803 649.30 558.0052806 394.60 387.5552809 675.75 663.2552812 1,007.35 947.5552815 1,301.70 1,000.1052818 801.85 663.2552821 1,469.10 1,442.3052824 568.85 621.2052826 338.90 332.6552828 504.05 494.7052830 664.70 652.5552832 911.55 894.9053000 46.45 45.6053003 131.3053004 47.95 49.8553006 668.50 729.7553009 421.85 414.0053012 167.70 164.6053015 743.00 822.6553016 689.15 676.5553017 863.80 844.0053019 828.25 813.3053052 175.25 172.0053054 175.20 172.0053056 102.70 100.7553058 175.20 172.0053060 143.40 140.70RMFSOut ofHospital %ItemRMFS InHospital %53062 128.40 126.0053064 232.50 228.1553068 192.45 191.1053070 253.95 249.3053200 100.90 98.9553203 169.60 166.2053206 189.0553209 2,351.60 2,308.7553212 1,270.45 1,247.2053215 582.75 572.2053218 931.40 915.3553220 469.65 461.4553221 1,289.20 1,221.2553224 1,196.05 1,353.8053225 458.90 406.7053226 445.65 437.2553227 1,655.15 1,663.5053230 1,770.40 1,873.8553233 2,144.80 2,105.7053236 670.10 659.0053239 670.10 659.0053242 445.65 437.2553400 184.30 180.9053403 225.20 221.0053406 557.35 569.3553409 489.10 569.3553410 157.75 119.9553411 393.75 334.3553412 621.70 548.9553413 683.30 672.5053414 786.90 772.6053415 633.95 609.9553416 621.50 609.9553418 944.20 792.9053419 807.75 792.9053422 1,102.55 1,006.2553423 1,200.90 1,006.2553424 965.60 863.35RMFSOut ofHospital %1 November 2012 – 31 october 2013 57

REPATRIATION MEDICAL FEE SCHEDULEItemRMFS InHospital %53425 957.20 863.3553427 1,201.10 1,179.1553429 1,313.15 1,179.1553439 340.75 334.3553453 689.15 676.5553455 809.55 794.7553458 61.30 60.3053459 312.30 329.7053460 685.00 672.5053600 59.95 54.5553700 216.70 174.8053702 95.90 87.5053704 57.80 52.7553706 191.70 174.8075150 123.80 119.8075153 62.20 60.2075156 110.30 106.7575200 79.50 76.9075203 119.20 115.4575206 39.55 38.3075400 238.35 230.6575403 273.65 264.9575406 311.95 301.9575409 353.15 341.9575412 197.30 191.0075415 238.35 230.6575600 335.60 324.9075603 394.35 381.8575606 394.35 381.8575609 588.70 570.0575612 728.45 705.4075615 269.70 261.1075618 334.95 324.2575621 334.95 324.2575800 119.20 115.4575803 476.75 461.6575806 559.15 541.4575809 665.65 641.15RMFSOut ofHospital %ItemRMFS InHospital %75812 735.65 712.4075815 897.55 869.3075818 1,059.30 1,025.8075821 853.25 826.2575824 985.70 954.5575827 1,132.85 1,097.2575830 1,250.65 1,211.1575833 1,530.00 1,481.7075836 1,584.10 1,695.5075839 35.90 38.3075842 53.40 57.0575845 266.55 285.1575848 319.55 341.9575851 159.85 171.0575854 159.85 171.0575833 1,501.45 1,454.0575836 1,554.55 1,663.8575839 35.20 37.6075842 52.40 56.0075845 261.55 279.8075848 313.55 335.6075851 156.85 167.8075854 156.85 167.80RMFSOut ofHospital %58 1 November 2012 – 31 october 2013

RELATIVE VALUE GUIDErelatiVe Value GuiDe fee scheDule1 november 2012The Relative Value Guide (RVG) lists fees for In Hospital anaesthetic services.The RVG basic unit cost has been reviewed to $32.70.In addition all medical practitioners will be paid RVG fees where they have qualificationsupdated with Medicare Australia.For items not listed in the RVG Fee Schedule please refer to the appropriate schedule inthis booklet.• For medical attendances and consultations provided by general practitionersparticipating in DVA’s Local Medical Officer Scheme, please use the Local MedicalOfficer Fee Schedule for the relevant fees.• For derived fees for Local Medical Officers, please use the Derived Fees for LocalMedical Officers Fee Schedule.• For all specialist attendances and consultations, investigative and general medicalprocedures claim from the Repatriation Medical Fee Schedule.• For diagnostic imaging services claim from the Diagnostic Imaging Fee Schedule.• For pathology services claim from the Pathology Fee Schedule.1 November 2012 – 31 october 2013 59

RELATIVE VALUE GUIDEItemRelativeValueGuideItemRelativeValueGuideItemRelativeValueGuideItemRelativeValueGuide20100 160.2520355 384.6020690 160.2520845 320.5020102 192.3020400 96.1520700 96.1520846 320.5020104 128.2020401 128.2020702 128.2020847 320.5020120 160.2520402 160.2520703 128.2020848 320.5020124 128.2020403 160.2520704 320.5020850 384.6020140 160.2520404 192.3020705 192.3020855 480.7520142 192.3020405 256.4020706 224.3520860 192.3020143 192.3020406 416.6520730 160.2520862 224.3520144 256.4020410 160.2520740 160.2520863 320.5020145 256.4020420 160.2520745 192.3020864 320.5020146 160.2520440 128.2020750 128.2020866 320.5020147 192.3020450 160.2520752 192.3020867 320.5020148 128.2020452 192.3020754 224.3520868 320.5020160 192.3020470 192.3020756 288.4520880 480.7520162 224.3520472 320.5020770 480.7520882 320.5020164 128.2020474 416.6520790 256.4020884 160.2520170 192.3020475 320.5020791 320.5020886 192.3020172 224.3520500 480.7520792 416.6520900 96.1520174 288.4520520 192.3020793 480.7520902 128.2020176 320.5020522 128.2020794 384.6020904 224.3520190 160.2520524 128.2020798 320.5020905 320.5020192 320.5020526 320.5020799 192.3020906 128.2020210 480.7520528 256.4020800 96.1520910 128.2020212 160.2520540 416.6520802 160.2520911 160.2520214 288.4520542 480.7520803 128.2020912 160.2520216 641.0020546 480.7520804 320.5020914 224.3520220 320.5020548 480.7520805 192.3020916 224.3520222 192.3020560 641.0020806 224.3520920 128.2020225 384.6020600 320.5020810 128.2020924 128.2020230 384.6020604 416.6520815 192.3020926 128.2020300 160.2520620 320.5020820 160.2520928 192.3020305 480.7520622 416.6520830 128.2020930 128.2020320 192.3020630 256.4020832 192.3020932 128.2020321 320.5020632 224.3520840 192.3020934 192.3020330 256.4020634 320.5020841 256.4020936 256.4020350 320.5020670 416.6520842 128.2020938 128.2020352 160.2520680 96.1520844 320.5020940 128.2060 1 November 2012 – 31 october 2013

ItemRelativeValueGuideItemRelativeValueGuideItemRelativeValueGuideItemRelativeValueGuide20942 160.2521270 256.4021530 480.7521820 96.1520943 128.2021272 128.2021532 256.4021830 128.2020944 192.3021274 192.3021535 320.5021832 224.3520946 256.4021275 320.5021600 96.1521834 128.2020948 128.2021280 480.7521610 160.2521840 256.4020950 160.2521300 96.1521620 128.2021842 192.3020952 128.2021321 128.2021622 160.2521850 128.2020953 160.2521340 128.2021630 160.2521860 96.1520954 320.5021360 160.2521632 192.3021865 320.5020956 128.2021380 96.1521634 288.4521870 480.7520958 160.2521382 128.2021636 480.7521872 256.4020960 224.3521390 96.1521638 320.5021878 96.1521100 96.1521392 128.2021650 256.4021879 160.2521110 160.2521400 128.2021652 320.5021880 224.3521112 128.2021402 224.3521654 256.4021881 288.4521114 160.2521403 320.5021656 320.5021882 352.5521116 192.3021404 160.2521670 128.2021883 416.6521120 192.3021420 96.1521680 96.1521884 480.7521130 96.1521430 128.2021682 128.2021885 544.8521140 480.7521432 160.2521685 320.5021886 608.9521150 320.5021440 256.4021700 96.1521887 673.0521155 320.5021445 320.5021710 128.2021900 96.1521160 128.2021460 96.1521712 160.2521906 160.2521170 256.4021461 128.2021714 160.2521908 192.3021195 96.1521462 96.1521716 160.2521910 288.4521199 128.2021464 128.2021730 96.1521912 160.2521200 128.2021472 160.2521732 128.2021914 192.3021202 128.2021474 160.2521740 160.2521915 160.2521210 192.3021480 128.2021756 192.3021916 160.2521212 320.5021482 160.2521760 224.3521918 160.2521214 320.5021484 160.2521770 256.4021922 224.3521216 448.7021486 224.3521772 192.3021925 128.2021220 128.2021490 96.1521780 128.2021926 160.2521230 192.3021500 256.4021785 320.5021927 160.2521232 160.2521502 192.3021790 480.7521930 192.3021234 256.4021520 128.2021800 96.1521935 160.2521260 128.2021522 160.2521810 128.2021936 192.301 November 2012 – 31 october 2013 61

RELATIVE VALUE GUIDEItemRelativeValueGuideItemRelativeValueGuideItemRelativeValueGuideItemRelativeValueGuide21939 96.1522060 641.0023118 576.9023510 1,762.7521941 224.3522065 160.2523119 608.9523520 1,794.8021942 320.5022070 320.5023121 641.0023530 1,826.8521943 160.2522075 480.7523170 673.0523540 1,858.9021945 160.2522900 192.3023180 705.1023550 1,890.9521949 160.2522905 192.3023190 737.1523560 1,923.0021952 320.5023010 32.0523200 769.2023570 1,955.0521955 160.2523021 64.1023210 801.2523580 1,987.1021959 160.2523022 64.1023220 833.3023590 2,019.1521962 160.2523023 64.1023230 865.3523600 2,051.2021965 160.2523031 96.1523240 897.4023610 2,083.2521969 256.4023032 96.1523250 929.4523620 2,115.3021970 480.7523033 96.1523260 961.5023630 2,147.3521973 160.2523041 128.2023270 993.5523640 2,179.4021976 160.2523042 128.2023280 1,025.6023650 2,211.4521980 160.2523043 128.2023290 1,057.6523660 2,243.5021981 128.2023051 160.2523300 1,089.7023670 2,275.5521990 96.1523052 160.2523310 1,121.7523680 2,307.6021992 128.2023053 160.2523320 1,153.8023690 2,339.6521997 128.2023061 192.3023330 1,185.8523700 2,371.7022001 96.1523062 192.3023340 1,217.9023710 2,403.7522002 128.2023063 192.3023350 1,249.9523720 2,435.8022007 128.2023071 224.3523360 1,282.0023730 2,467.8522008 128.2023072 224.3523370 1,314.0523740 2,499.9022012 96.1523073 224.3523380 1,346.1023750 2,531.9522014 96.1523081 256.4023390 1,378.1523760 2,564.0022015 192.3023082 256.4023400 1,410.2023770 2,596.0522018 224.3523083 256.4023410 1,442.2523780 2,628.1022020 128.2023091 288.4523420 1,474.3023790 2,660.1522025 128.2023101 320.5023430 1,506.3523800 2,692.2022031 160.2523111 352.5523440 1,538.4023810 2,724.2522036 96.1523112 384.6023450 1,570.4523820 2,756.3022040 64.1023113 416.6523460 1,602.5023830 2,788.3522045 96.1523114 448.7023470 1,634.5523840 2,820.4022050 64.1023115 480.7523480 1,666.6023850 2,852.4522051 288.4523116 512.8023490 1,698.6523860 2,884.5022055 384.6023117 544.8523500 1,730.7023870 2,916.5562 1 November 2012 – 31 october 2013

ItemRelativeValueGuideItemRelativeValueGuideItemRelativeValueGuideItemRelativeValueGuide23880 2,948.6024103 3,429.3524118 3,910.1024133 4,390.8523890 2,980.6524104 3,461.4024119 3,942.1524134 4,422.9023900 3,012.7024105 3,493.4524120 3,974.2024135 4,454.9523910 3,044.7524106 3,525.5024121 4,006.2524136 4,487.0023920 3,076.8024107 3,557.5524122 4,038.3025000 32.0523930 3,108.8524108 3,589.6024123 4,070.3525005 64.1023940 3,140.9024109 3,621.6524124 4,102.4025010 96.1523950 3,172.9524110 3,653.7024125 4,134.4525015 32.0523960 3,205.0024111 3,685.7524126 4,166.5025020 64.1023970 3,237.0524112 3,717.8024127 4,198.5525025 D23980 3,269.1024113 3,749.8524128 4,230.6025030 D23990 3,301.1524114 3,781.9024129 4,262.6525050 D24100 3,333.2024115 3,813.9524130 4,294.7025200 D24101 3,365.2524116 3,846.0024131 4,326.7525205 D24102 3,397.3024117 3,878.0524132 4,358.801 November 2012 – 31 october 2013 63

DIAGNOSTIC IMAGING SERVICESDiaGnostic imaGinG fee scheDule1 november 2012All medical practitioners will be paid 100% of the MBS for diagnostic imaging services,where they have the appropriate qualifications updated with Medicare Australia.Local Medical Officers claiming from the Diagnostic Imaging Fee Schedule can also claimthe relevant Veterans Access Payment (VAP) on these items.For items not listed in the Diagnostic Imaging Fee schedule please refer to the appropriateschedule in this booklet.• For medical attendances and consultations provided by general practitionersparticipating in DVA’s Local Medical Officer Scheme, please use the Local MedicalFee Schedule for the relevant fees.• For derived fees for Local Medical Officers, please use the Derived Fees for LocalMedical Officers Fee Schedule.• For all specialist attendances and consultations, investigative and general medicalprocedures claim from the Repatriation Medical Fee Schedule.• For In Hospital anaesthetic services please use Relative Value Guide Fee Schedule.• For pathology services please use the Pathology Fee Schedule.64 1 November 2012 – 31 october 2013

DIAGNOSTIC IMAGING SERVICESItem100% MBSItem100% MBSItem100% MBSItem100% MBS55005 54.5555079 37.8555276 169.5055727 20.0055007 18.9555084 98.2555278 169.5055729 27.2555008 54.5555085 34.0555280 169.5055730 13.6555010 18.9555113 230.6555282 169.5055731 98.0055011 54.5555114 230.6555284 169.5055732 49.0055013 18.9555115 230.6555292 169.5055733 35.0055014 55.6555116 261.6555294 169.5055734 17.5055016 18.9555117 261.6555296 111.0555735 63.5055017 54.5555118 275.5055600 109.1055736 127.0055019 18.9555119 115.3555601 54.5555737 28.5055020 55.6555120 115.3555603 109.1055739 57.0055022 18.9555121 115.3555604 54.5555759 150.0055023 54.7555122 130.8555700 60.0055760 75.0055025 18.9555123 130.8555701 30.0055762 60.0055026 54.5555125 137.7555702 17.5055763 30.0055028 109.1055130 170.0055703 35.0055764 160.0055029 37.8555131 85.0055704 70.0055765 80.0055030 109.1055135 353.6055705 35.0055766 65.0055031 37.8555136 176.8055706 100.0055767 32.5055032 109.1055220 84.7555707 70.0055768 150.0055033 37.8555221 84.7555708 35.0055769 75.0055036 111.3055222 84.7555709 38.0055770 60.0055037 37.8555223 84.7555710 35.0055771 30.0055038 109.1055224 84.7555711 17.5055772 160.0055039 37.8555226 84.7555712 115.0055773 80.0055044 111.3055227 84.7555713 50.0055774 65.0055045 37.8555228 84.7555714 35.0055775 32.5055048 109.5055229 84.7555715 40.0055800 109.1055049 37.8555230 84.7555716 17.5055801 54.5555054 109.1055232 84.7555717 19.0055802 37.8555059 49.1555233 84.7555718 100.0055803 18.9555060 17.0555235 84.7555719 57.5055804 109.1055061 54.5555236 55.5555720 20.0055805 54.5555062 18.9555238 169.5055721 115.0055806 37.8555063 49.1555244 169.5055722 50.0055807 18.9555064 17.0555246 169.5055723 38.0055808 109.1055070 98.2555248 169.5055724 57.5055809 54.5555073 34.0555252 169.5055725 40.0055810 37.8555076 109.1055274 169.5055726 19.0055811 18.951 November 2012 – 31 october 2013 65

Item100% MBSItem100% MBSItem100% MBSItem100% MBS55812 109.1055851 76.4556230 177.4557007 567.7555813 54.5555852 109.1056231 177.4557041 233.4055814 37.8555853 54.5556232 177.4557047 283.9055815 18.9555854 37.8556233 240.0057201 155.2055816 109.1055855 18.9556234 351.4057247 77.5555817 54.5556001 195.0556235 122.4557341 470.0055818 37.8556007 250.0056236 177.4557345 241.6055819 18.9556010 252.1056237 240.0057350 510.0055820 109.1056013 250.0056238 351.4057351 510.0055821 54.5556016 290.0056239 122.4557355 264.1555822 37.8556022 225.0056240 177.4557356 264.1555823 18.9556025 113.1556259 164.8057360 700.0055824 109.1056026 56.6056301 295.0057361 350.0055825 54.5556028 336.8056307 400.0057506 29.7555826 37.8556030 225.0056341 149.4557509 39.7555827 18.9556036 336.8056347 202.0057512 40.5055828 109.1056041 98.7556401 250.0057515 54.0055829 54.5556047 126.1056407 360.0057518 32.5055830 37.8556050 128.2056409 250.0057521 43.4055831 18.9556053 128.2056412 360.0057524 49.4055832 109.1056056 155.4556441 126.8057527 65.7555833 54.5556062 113.1556447 181.5057529 14.9055834 37.8556068 168.4056449 126.8057530 19.9055835 18.9556070 113.1556452 181.5057532 20.2555836 109.1056076 168.4056501 385.0057533 27.0055837 54.5556101 230.0056507 480.0557535 16.2555838 37.8556107 340.0056541 193.1557536 21.7055839 18.9556141 116.4556547 243.7557538 24.7055840 109.1056147 171.6056552 600.0057539 32.9055841 54.5556219 326.2056554 600.0057700 40.5055842 37.8556220 240.0056619 220.0057702 20.2555843 18.9556221 240.0056625 334.6557703 54.0055844 87.3556223 240.0056659 112.1057705 27.0055845 43.7056224 351.4056665 167.4057706 32.5055846 37.8556225 351.4056801 466.5557708 16.2555847 18.9556226 351.4056807 560.0057709 43.4055848 109.1056227 122.5056841 233.3557711 21.7055849 54.5556228 122.5056847 283.8557712 47.1555850 152.8556229 122.5057001 466.6557714 23.6066 1 November 2012 – 31 october 2013

DIAGNOSTIC IMAGING SERVICESItem100% MBSItem100% MBSItem100% MBSItem100% MBS57715 60.9057963 47.4058527 69.4059301 44.7557717 30.4557965 23.7058529 34.7059303 53.9557721 99.2557966 47.4058700 46.0559304 27.0057723 49.6557968 23.7058702 23.0559306 100.3057901 64.5057969 47.4058706 157.9059307 50.1557902 64.5058100 67.1558708 78.9559309 200.6057903 47.3058102 33.6058715 151.5559310 100.3057906 64.5058103 55.1058717 75.8059312 87.0057909 64.5058105 27.5558718 126.1059313 43.5057911 32.2558106 77.0058720 63.0559314 52.5057912 47.1558108 110.0058721 138.2559315 26.2557914 32.2558109 47.0058723 69.1559318 47.0557915 47.1558111 38.5058900 35.7059319 23.5557917 23.6558112 97.2558902 17.8559503 89.4057918 47.1558114 55.0058903 47.6059504 44.7057920 32.2558115 110.0058905 23.8059700 96.5557921 47.1558117 23.5058909 89.9559701 48.3057923 32.2558120 110.0058911 45.0059703 75.9057924 47.1558121 110.0058912 110.2559704 37.9557926 23.6058123 48.6558914 55.1559712 113.7057927 49.6558124 55.0058915 78.9559713 56.8557929 23.6058126 55.0058916 138.5059715 143.5557930 32.9058127 55.0058917 39.5059716 71.8057932 23.6058300 40.1058920 69.2559718 134.6557933 78.2558302 20.0558921 135.2559719 67.3557935 23.6058306 89.4058923 67.6559724 226.4557938 23.6058308 44.7058924 84.0559725 113.2557939 64.5058500 35.3558926 42.0559733 107.7057941 24.8558502 17.7058927 76.4559734 53.8557942 49.6558503 47.1558929 38.2559736 62.0057944 16.4558505 23.6058933 205.6059737 31.0057945 43.4058506 60.7558935 102.8059739 73.7557947 39.1558508 30.4058936 195.9559740 36.9057950 32.2558509 39.7558938 98.0059751 139.1557953 24.8558511 19.9058939 139.3059752 69.6057956 21.7058521 43.4058941 69.6559754 219.3557959 23.7058523 21.7059103 21.3059755 109.7057960 47.4058524 56.5059104 10.6559760 115.1557962 23.7058526 28.2559300 89.5059761 57.601 November 2012 – 31 october 2013 67

DIAGNOSTIC IMAGING SERVICESItem100% MBSItem100% MBSItem100% MBSItem100% MBS59763 133.9060500 43.4061386 332.5061495 223.1059764 66.9560501 21.7061387 430.7561499 253.0059903 114.5560503 29.7561389 370.5561505 100.0059912 305.2060504 14.9061390 409.9561506 0.0559925 362.4560506 63.7561393 605.5061523 953.0059970 168.3060507 31.9061397 246.8561529 953.0059971 57.3060509 98.9061401 162.3061538 901.0059972 152.6060510 49.4561402 605.0561541 953.0059973 181.2560918 47.1561405 346.0061553 999.0059974 84.2060927 38.0561409 873.5061559 918.0060000 564.0061109 258.9061413 225.9561565 953.0060003 827.1061110 129.4561417 118.8561571 953.0060006 1,176.1061302 448.8561421 479.8061575 953.0060009 1,376.3061303 565.3061425 600.7061577 953.0060012 564.0061306 709.7061426 554.8061598 953.0060015 827.1061307 834.9061429 543.0061604 953.0060018 1,176.1061310 367.3061430 659.4561610 953.0060021 1,376.3061313 303.3561433 496.9561616 953.0060024 564.0061314 420.0061434 615.4061620 953.0060027 827.1061316 381.1561437 542.7561622 953.0060030 1,176.1061317 492.4061438 672.9561628 953.0060033 1,376.3061320 228.9061441 489.7061632 953.0060036 564.0061328 227.6561442 752.3561640 999.0060039 827.1061340 253.0061445 286.8061646 999.0060042 1,176.1061348 443.3561446 333.5561650 878.7060045 1,376.3061352 259.3561449 456.2061651 224.4560048 564.0061353 386.6061450 397.5561652 282.6560051 827.1061356 392.8061453 514.7061653 354.8560054 1,176.1061360 403.3561454 348.1061654 417.4560057 1,376.3061361 461.4061457 470.4561655 183.6560060 564.0061364 496.9561458 396.9561656 151.7060063 827.1061368 223.1061461 527.8561657 210.0060066 1,176.1061369 2,015.7561462 129.0061658 190.6060069 1,376.3061372 223.1061465 265.5061659 246.2060072 48.1061373 489.7061469 348.1061660 114.4560075 96.1061376 143.3561473 175.4061661 113.8560078 144.2561381 574.3561480 386.8561662 126.5060100 60.7561383 624.9561484 880.8561663 221.7060101 30.4061384 687.7061485 999.2061664 129.7068 1 November 2012 – 31 october 2013

DIAGNOSTIC IMAGING SERVICESItem100% MBSItem100% MBSItem100% MBSItem100% MBS61665 193.3061704 198.8063051 403.2063131 492.8061666 196.4061705 257.3563052 403.2063132 492.8061667 201.7061706 174.0563054 403.2063134 246.4061668 230.7061707 235.2563055 403.2063135 246.4061669 248.5061708 198.5063057 403.2063136 246.4061670 111.5561709 263.9563058 403.2063151 358.4061671 1,007.9061710 64.5063060 403.2063152 358.4061672 111.5561711 132.7563061 403.2063154 358.4061673 244.8561712 174.0563063 403.2063155 358.4061674 71.7061713 87.7063064 403.2063157 179.2061675 287.2061714 193.4563065 403.2063158 179.2061676 312.5061715 440.4563067 403.2063161 358.4061677 343.8561716 499.6063070 403.2063163 358.4061678 166.2561717 111.5563073 403.2063164 358.4061679 215.4061718 126.5063074 168.0063165 358.4061680 185.3061719 50.0063075 179.2063167 358.4061681 205.0061729 439.3563076 201.6063168 358.4061682 302.7563001 403.2063077 201.6063169 358.4061683 123.4563002 403.2063078 201.6063170 358.4061684 81.1563004 403.2063079 201.6063171 358.4061685 302.5563005 403.2063080 201.6063172 358.4061686 173.0063007 403.2063081 201.6063173 358.4061687 436.7563008 403.2063082 201.6063174 358.4061688 113.0063010 336.0063083 201.6063175 358.4061689 59.4563011 336.0063084 201.6063176 358.4061690 239.9063013 201.6063085 201.6063177 358.4061691 300.3563014 201.6063101 492.8063179 358.4061692 277.4063016 201.6063102 492.8063182 358.4061693 271.5063017 168.0063104 246.4063185 358.4061694 329.7563040 336.0063111 492.8063186 179.2061695 248.5063041 336.0063113 492.8063187 179.2061696 307.7063042 358.4063114 492.8063188 179.2061697 271.4063043 358.4063116 492.8063189 179.2061698 336.5063044 403.2063117 246.4063190 179.2061699 244.8563045 403.2063119 246.4063191 179.2061700 376.2063046 403.2063125 492.8063192 179.2061701 143.4063047 403.2063126 492.8063193 179.2061702 166.8063048 403.2063128 492.8063194 179.2061703 228.1063049 403.2063129 492.8063201 448.001 November 2012 – 31 october 2013 69

Item100% MBSItem100% MBSItem100% MBSItem100% MBS63202 448.0063281 492.8063386 448.0063467 690.0063204 448.0063282 246.4063387 448.0063469 690.0063205 448.0063283 246.4063388 448.0063470 403.2063207 224.0063284 246.4063389 403.2063472 403.2063208 224.0063285 246.4063391 403.2063473 627.2063219 448.0063301 380.8063392 224.0063475 627.2063220 448.0063302 380.8063393 224.0063476 403.2063222 448.0063304 380.8063394 201.6063478 403.2063223 448.0063305 380.8063401 403.2063479 201.6063224 448.0063307 380.8063402 403.2063481 313.6063225 448.0063308 380.8063404 403.2063482 403.2063226 448.0063310 190.4063405 403.2063483 403.2063227 448.0063311 190.4063407 201.6063484 201.6063228 448.0063313 190.4063408 201.6063486 201.6063229 448.0063322 403.2063416 403.2063491 44.8063230 448.0063323 403.2063417 403.2063492 44.8063231 448.0063324 403.2063419 201.6063493 44.8063232 448.0063325 403.2063425 403.2063494 44.8063234 448.0063326 403.2063426 403.2063495 156.8063237 448.0063327 403.2063428 403.2063497 156.8063240 448.0063328 403.2063429 403.2063498 44.8063243 448.0063329 336.0063432 201.6063499 156.8063244 448.0063330 448.0063433 201.6063501 500.0063257 224.0063331 403.2063440 403.2063502 500.0063258 224.0063332 403.2063441 403.2063504 500.0063259 224.0063334 336.0063442 403.2063505 500.0063260 224.0063337 448.0063443 403.2063507 403.2063261 224.0063340 403.2063444 403.2063508 201.6063262 224.0063341 201.6063446 403.2063510 448.0063263 224.0063342 201.6063447 201.6063511 224.0063264 224.0063343 201.6063448 201.6063513 403.2063265 224.0063345 201.6063449 201.6063514 201.6063271 492.8063346 168.0063455 179.2063516 403.2063272 492.8063347 224.0063457 345.0063517 201.6063274 492.8063348 201.6063458 345.0063519 403.2063275 492.8063361 403.2063461 358.4063520 201.6063277 492.8063363 403.2063463 358.4063522 448.0063278 492.8063364 201.6063464 690.0063523 224.0063280 492.8063385 448.0063466 690.0063525 403.2070 1 November 2012 – 31 october 2013

DIAGNOSTIC IMAGING SERVICESItem 100% MBS63526 448.0063527 403.2063528 403.2063529 403.2063530 448.0064990 6.9064991 10.451 November 2012 – 31 october 2013 71

pathology SERVICESpatholoGY fee scheDule1 november 2012All medical practitioners will be paid 100% of the MBS for pathology services, where they havethe appropriate qualifications updated with Medicare Australia.Local Medical Officers claiming the Pathology Fee Schedule can also claim the relevant VeteransAccess Payment on these items if they do not receive the bulk billing incentive.In addition, DVA does not apply the coning or super coning rule to “Out of Hospital” pathologyservices.For items not listed in the Pathology Fee schedule please refer to the appropriate schedule inthis booklet.• For medical attendances and consultations provided by general practitionersparticipating in DVA’s Local Medical Officer Scheme, please use the Local Medical FeeSchedule for the relevant fees.• For derived fees for Local Medical Officers, please use the Derived Fees for LocalMedical Officers Fee Schedule.• For all specialist attendances and consultations, investigative and general medicalprocedures claim from the Repatriation Medical Fee Schedule.• For In Hospital anaesthetic services please use Relative Value Guide Fee Schedule.• For diagnostic imaging services please use the Diagnostic Imaging FeeSchedule.72 1 November 2012 – 31 october 2013

pathology SERVICESItem100% MBSItem100% MBSItem100% MBSItem100% MBS65060 7.9065165 34.7066596 32.7566686 51.0065066 10.4565166 34.7066599 23.7566695 30.7065070 17.0565171 25.5066602 43.2566696 30.7065072 10.2565175 25.5066605 30.8066697 13.3065075 52.3065176 49.0066606 30.8066698 44.0065078 90.8065177 72.4566607 76.2566701 57.3065079 90.8065178 95.8566608 42.5566704 70.6065081 97.2565179 119.3066609 42.5566707 83.9065082 97.2565180 25.5066610 76.2566711 30.3565084 166.9565181 23.4566623 41.8066712 43.3565087 83.6566500 9.7566626 24.2566714 30.3565090 11.2066503 11.7566629 20.2566715 12.9565093 22.1566506 13.7566632 20.2566716 25.2065096 41.3066509 15.7566635 20.2566719 35.0565099 109.6566512 17.8066638 49.4066722 38.1565102 165.7066517 19.8066639 29.4066723 38.1565105 109.6566518 20.2066641 29.4066724 13.2565108 165.7066519 40.4066642 29.4066725 51.4065109 13.0066536 11.1066644 20.3066728 64.6565110 13.0066539 30.8066647 45.4066731 77.9065111 23.3566542 19.1066650 24.5066734 91.1565114 9.1566545 15.9066651 24.5066743 20.2565117 20.4066548 20.0566652 20.4566749 33.1565120 13.8066551 16.9066653 44.9066750 40.0065123 20.5066554 16.9066655 20.3066751 55.6065126 28.0566557 9.7566656 20.3066752 24.8565129 35.7566560 20.2566659 37.5566755 39.1065137 25.5066563 24.8566660 37.5566756 98.9565142 25.5066566 33.9566662 80.5066757 98.9565144 56.9566569 42.9066663 80.5066758 24.8565147 38.1566572 51.9066665 30.8066761 13.2565150 71.4066575 60.8566666 30.8066764 8.9565153 142.8066578 69.8066667 30.8066767 17.9565156 214.2066581 78.8066671 37.1566770 26.9065157 71.4066584 9.7566674 40.2066773 24.8065158 71.4066587 47.8566677 11.2566776 24.8065159 71.4066590 30.8066680 74.9566779 40.2065162 10.5066593 18.1066683 74.9566780 40.201 November 2012 – 31 october 2013 73

Item100% MBSItem100% MBSItem100% MBSItem100% MBS66782 13.2569321 48.4569472 15.7571085 29.1566783 13.2569324 43.3069474 28.8571087 37.9566785 40.2069325 43.3069475 15.7571089 29.3566788 66.3069327 85.5569478 29.4571090 29.3566789 40.2069328 85.5569481 40.8071091 53.2066790 26.0569330 128.8569482 153.1071092 23.8566791 74.9569331 128.8569483 153.1071093 76.9566792 74.9569333 20.7069484 17.2071095 40.8066800 18.2569336 33.6569488 181.4571096 40.8066803 30.7069339 19.2569489 181.4571097 24.6066804 18.2569345 53.2569491 206.2071099 26.7066805 12.4569354 30.9569492 206.2071101 17.5066806 42.1569357 61.8569494 28.8571103 52.4066812 35.0569360 92.8069495 36.1071106 11.4066815 59.9569363 28.8569496 43.3571119 17.4566816 35.0569378 181.4569497 28.8571121 20.9566817 24.9069379 181.4569498 7.2571123 24.4066819 30.8069380 775.5069499 92.8071125 27.8566820 30.8069381 181.4569500 92.8071127 177.5566821 21.9569382 181.4571057 33.1071129 219.3066822 52.8069383 181.4571058 50.8571131 261.1066825 30.8069384 15.7571059 35.9071133 10.4566826 30.8069387 29.2071060 44.3571134 104.7566827 21.9569390 42.6571062 44.3571135 209.3566828 52.8069393 56.1071064 20.9071137 30.4566830 58.9069396 69.5571066 14.6571139 104.7566831 31.1569400 15.7571068 14.6571141 198.7066832 31.1569401 13.4571069 22.9071143 261.7566900 78.1569405 15.7571071 31.1571145 427.3569300 12.6069408 29.2071072 14.6571146 104.7569303 22.1569411 42.6571073 106.8571147 40.8069306 34.0069413 56.1071074 14.6571148 40.8069309 48.4569415 69.5571075 23.1571149 109.0069312 34.0069418 64.0071076 106.8571151 119.6569316 28.8569419 64.0071077 27.2571153 34.8069317 36.1069445 92.8071079 27.0071154 34.8069318 34.0069451 92.8071081 40.8071155 47.7569319 43.2569471 35.1571083 20.3071156 12.9574 1 November 2012 – 31 october 2013

pathology SERVICESItem100% MBSItem100% MBSItem100% MBSItem100% MBS71157 60.7072852 247.4573321 40.8073923 2.4071159 73.6572855 185.6073323 40.8073924 14.7571163 24.9072856 247.4573324 41.2573925 2.4071164 40.1572857 288.7073325 75.0073926 8.2571165 34.8073043 23.0073326 232.5073927 2.4071166 47.7573045 48.9573327 52.3073928 6.0071167 60.7073047 95.3573521 9.7573929 2.4071168 73.6573049 68.6073523 42.0573930 6.0071169 34.8073051 171.5073525 28.5573931 2.4071170 12.9573053 19.6073527 10.0573932 10.3071180 34.8073055 19.6073529 28.8573933 2.4071183 47.7573057 19.6073801 6.9573934 17.7071186 60.7073059 43.3073802 4.6073935 2.4071189 15.6073060 57.7573803 6.4073936 6.0071192 28.5573061 51.5573804 8.2073937 2.4071195 40.3073062 89.6073805 4.6073938 8.0071198 40.8073063 100.0073806 10.2073939 2.4071200 60.0073064 72.2073807 6.9573940 10.3071203 40.8073065 86.6073808 8.7074990 6.9072813 72.0073066 222.9573809 2.3574991 10.4572816 86.9573067 130.0073810 6.9574992 1.6072817 97.4573287 397.2073811 11.3074993 3.7572818 107.7573289 361.3573818 13.7574994 3.2572823 97.8073290 397.2073824 20.5074995 4.0072824 142.3073291 232.5073827 14.0574996 3.7072825 181.4573292 593.8573828 6.9574997 3.3072826 195.9073293 232.5073829 4.6074998 2.0072827 210.3573294 232.5073830 6.4074999 1.6072828 224.8073300 102.0073831 8.2074994 3.2572830 276.0073305 204.0073832 4.6074995 4.0072836 420.0073308 36.7073833 10.2074996 3.7072838 470.0073309 36.7073834 6.9574997 3.3072844 30.9573311 36.7073835 8.7074998 2.0072846 60.0073312 36.7073836 2.3574999 1.6072847 90.0073314 232.5073837 6.9572848 75.0073315 232.5073840 17.1072849 105.0073317 36.7073844 20.5072850 120.0073318 36.7073920 2.4072851 185.6073320 40.8073922 8.251 November 2012 – 31 october 2013 75